bluuebunny/crossref_metadata_2025_split huggingface dataset:
Applying systematic review search methods to the grey literature: a review of education and training courses on breastfeeding support for health professionals
Authors: Navarro Ivette , Soriano Jose M. , Laredo Salomé 
Published: April 2021

Abstract
Background
Currently, lactation training courses aimed at health professionals are important for informing and supporting mothers who are breastfeeding. In this review, we seek to analyze similarities and/or variations in course content, modes of delivery, costs, teaching style and learning strategies among courses. To our knowledge, a review of lactation training courses available worldwide is lacking. Thus, the aim of this review is to describe course models aimed at training health professionals in lactation support for mothers.

Methods
Through searching grey literature, training courses were obtained from several directories, including the Alaska Breastfeeding Coalition, International Board of Lactation Consultant Examiners (IBLCE), International Lactation Consultant Association (ILCA), Lactation Education Accreditation Association and Approval Review Committee (LEAARC), World Alliance for Breastfeeding Action (WABA), World Health Organization (WHO), and United Nations Children’s Fund (UNICEF).

Results
Descriptions of ten training programs were included in the final review. Our group found variations in costs, modes of delivery and duration among courses.

Conclusions
Certified training for health professionals in lactation is a promising approach for increasing and protecting breastfeeding. Breastfeeding mothers might also benefit from specifically trained health professionals, yet, well-conducted research on such training courses is still required. The variability in the mode of teaching, tuition costs and course content in breastfeeding education programs around the globe must be kept in mind when considering providing training on the optimal competency for health professionals.
Assessing the impact of Indiana legislation on opioid-based doctor shopping among Medicaid-enrolled pregnant women: a regression analysis
Authors: Joshi Sukhada S. , Adams Nicole , Yih Yuehwern , Griffin Paul M. 
Published: April 2021

Abstract
Background
States have passed various legislative acts in an attempt to reduce opioid prescribing and corresponding doctor shopping, including prescription drug monitoring programs. This study seeks to determine the association between two state-based interventions enacted in Indiana and the level of doctor shopping among Medicaid-enrolled pregnant women.

Methods
Indiana Medicaid claims data over the period of January 2014 to March 2019 were used in a regression model to determine the longitudinal change in percentage of pregnant women engaged in doctor shopping based on passage of Indiana Administrative Code Title 884 in 2014 and Public Law 194 in 2018. The primary reasons for prescribing were also identified.

Results
There were 37,451 women that had both pregnancy and prescription opioid claims over the time horizon. Of these, 2130 women met the criteria for doctor shopping. Doctor shopping continued to increase over the time between the passage of the two interventions but decreased after passage of Public Law 194.

Conclusion
The decrease in doctor shopping among Medicaid-enrolled pregnant women after passage of Public Law 194 points to the importance of addressing this issue across a broad set of healthcare professionals including nurse practitioners and physician assistants. It is also possible that the potential punitive component in the Law for non-compliance played a role.
The socioeconomic burden of antibiotic resistance in conflict-affected settings and refugee hosting countries: a systematic scoping review
Authors: Kobeissi Elsa , Menassa Marilyne , Moussally Krystel , Repetto Ernestina , Soboh Ismail , Hajjar Marwan , Saleh Shadi , Abu-Sittah Ghassan 
Published: April 2021

Abstract
Background
Antibiotic resistance (ABR) is a major global threat. Armed and protracted conflicts act as multipliers of infection and ABR, thus leading to increased healthcare and societal costs. We aimed to understand and describe the socioeconomic burden of ABR in conflict-affected settings and refugee hosting countries by conducting a systematic scoping review.

Methods
A systematic search of PubMed, Medline (Ovid), Embase, Web of Science, SCOPUS and Open Grey databases was conducted to identify all relevant human studies published between January 1990 and August 2019. An updated search was also conducted in April 2020 using Medline/Ovid. Independent screenings of titles/abstracts followed by full texts were performed using pre-defined criteria. The Newcastle-Ottawa Scale was used to assess study quality. Data extraction and analysis were based on the PICOS framework and following the PRISMA-ScR guideline.

Results
The search yielded 8 studies (7 publications), most of which were single-country, mono-center and retrospective studies. The studies were conducted in Lebanon (n = 3), Iraq (n = 2), Jordan (n = 1), Palestine (n = 1) and Yemen (n = 1). Most of the studies did not have a primary aim to assess the socioeconomic impact of ABR and were small studies with limited statistical power that could not demonstrate significant associations. The included studies lacked sufficient information for the accurate evaluation of the cost incurred by antibiotic resistant infections in conflict-affected countries.

Conclusion
This review highlights the scarcity of research on the socioeconomic burden of ABR on general populations in conflict-affected settings and on refugees and migrants in host countries, and lists recommendations for consideration in future studies. Further studies are needed to understand the cost of ABR in these settings to develop and implement adaptable policies.
Prone position in intubated, mechanically ventilated patients with COVID-19: a multi-centric study of more than 1000 patients
Authors:   PRONA-COVID Group, Langer Thomas , Brioni Matteo , Guzzardella Amedeo , Carlesso Eleonora , Cabrini Luca , Castelli Gianpaolo , Dalla Corte Francesca , De Robertis Edoardo , Favarato Martina , Forastieri Andrea , Forlini Clarissa , Girardis Massimo , Grieco Domenico Luca , Mirabella Lucia , Noseda Valentina , Previtali Paola , Protti Alessandro , Rona Roberto , Tardini Francesca , Tonetti Tommaso , Zannoni Fabio , Antonelli Massimo , Foti Giuseppe , Ranieri Marco , Pesenti Antonio , Fumagalli Roberto , Grasselli Giacomo 
Published: April 2021

Abstract
Background
Limited data are available on the use of prone position in intubated, invasively ventilated patients with Coronavirus disease-19 (COVID-19). Aim of this study is to investigate the use and effect of prone position in this population during the first 2020 pandemic wave.

Methods
Retrospective, multicentre, national cohort study conducted between February 24 and June 14, 2020, in 24 Italian Intensive Care Units (ICU) on adult patients needing invasive mechanical ventilation for respiratory failure caused by COVID-19. Clinical data were collected on the day of ICU admission. Information regarding the use of prone position was collected daily. Follow-up for patient outcomes was performed on July 15, 2020. The respiratory effects of the first prone position were studied in a subset of 78 patients. Patients were classified as Oxygen Responders if the PaO2/FiO2 ratio increased ≥ 20 mmHg during prone position and as Carbon Dioxide Responders if the ventilatory ratio was reduced during prone position.

Results
Of 1057 included patients, mild, moderate and severe ARDS was present in 15, 50 and 35% of patients, respectively, and had a resulting mortality of 25, 33 and 41%. Prone position was applied in 61% of the patients. Patients placed prone had a more severe disease and died significantly more (45% vs. 33%, p < 0.001). Overall, prone position induced a significant increase in PaO2/FiO2 ratio, while no change in respiratory system compliance or ventilatory ratio was observed. Seventy-eight % of the subset of 78 patients were Oxygen Responders. Non-Responders had a more severe respiratory failure and died more often in the ICU (65% vs. 38%, p = 0.047). Forty-seven % of patients were defined as Carbon Dioxide Responders. These patients were older and had more comorbidities;
however, no difference in terms of ICU mortality was observed (51% vs. 37%, p = 0.189 for Carbon Dioxide Responders and Non-Responders, respectively).

Conclusions
During the COVID-19 pandemic, prone position has been widely adopted to treat mechanically ventilated patients with respiratory failure. The majority of patients improved their oxygenation during prone position, most likely due to a better ventilation perfusion matching.
Trial registration: clinicaltrials.gov number: NCT04388670
PCIP-seq: simultaneous sequencing of integrated viral genomes and their insertion sites with long reads
Authors: Artesi Maria , Hahaut Vincent , Cole Basiel , Lambrechts Laurens , Ashrafi Fereshteh , Marçais Ambroise , Hermine Olivier , Griebel Philip , Arsic Natasa , van der Meer Frank , Burny Arsène , Bron Dominique , Bianchi Elettra , Delvenne Philippe , Bours Vincent , Charlier Carole , Georges Michel , Vandekerckhove Linos , Van den Broeke Anne , Durkin Keith 
Published: April 2021

AbstractThe integration of a viral genome into the host genome has a major impact on the trajectory of the infected cell. Integration location and variation within the associated viral genome can influence both clonal expansion and persistence of infected cells. Methods based on short-read sequencing can identify viral insertion sites, but the sequence of the viral genomes within remains unobserved. We develop PCIP-seq, a method that leverages long reads to identify insertion sites and sequence their associated viral genome. We apply the technique to exogenous retroviruses HTLV-1, BLV, and HIV-1, endogenous retroviruses, and human papillomavirus.
Ultrasound-guided erector spinae plane block versus thoracic paravertebral block on postoperative analgesia after laparoscopic nephroureterectomy: study protocol of a randomized, double-blinded, non-inferiority design trial
Authors: Xu Zhen-Zhen , Li Xue , Zhang Zhen , Liu Zheng-Ye , Song Lin-Lin , Li Xue-Ying , Zhang Hong 
Published: April 2021

Abstract
Introduction
Erector spinae plane block (ESPB) is a novel inter-fascial plane block, which is applied more and more in postoperative pain control, especially in chest surgery. Regional block is advocated in order to decrease opioid consumption and improve analgesia in urological surgery. Therefore, we aimed to explore whether ESPB would have similar analgesia compared with thoracic paravertebral block (TPVB) in laparoscopic nephroureterectomy.

Methods and analysis
This prospective, randomized, double-blinded, non-inferiority trial will enroll 166 patients undergoing laparoscopic nephroureterectomy. Participants will be randomly assigned 1:1 into receiving ESPB or TPVB before surgery. Both ultrasound-guided ESPB and TPVB will be performed with an injection of 0.375% ropivacaine 0.4 ml/kg before anesthesia induction. Standardized patients controlled intravenous analgesia (PCIA) will be applied for each patient. The primary endpoint is the joint of cumulative 24 h opioid (sufentanil) consumption and average pain score via numeric rating scale (NRS) at 24 h after surgery. Secondary endpoints include rescued analgesic demand, cumulative opioid consumption, and pain NRS scores at different preset timepoints within 48 h after surgery. Other predefined outcomes include clinical features of blockage, quality of recovery, subjective sleep quality, time to ambulation and diet, and adverse events, as well as length of stay in hospital and anesthesia cost.

Discussion
Previous studies investigating the analgesic efficacy of ESPB only concentrated on a single endpoint for postoperative pain evaluation, while studies focusing on the direct comparison between ESPB and TPVB in urological surgery are still lacking. Our study is the first trial in non-inferiority design of comparing ESPB and TPVB in patient undergoing laparoscopic nephroureterectomy, and the primary outcome is the joint endpoint of opioid consumption and pain NRS score.

Trial registration
Chinese Clinical Trial Registry ChiCTR 2000031916. Registered on 14 April 2020.
How ‘place’ matters for addressing the HIV epidemic: evidence from the HPTN 071 (PopART) cluster-randomised controlled trial in Zambia and South Africa
Authors:   on behalf of the HPTN071 (PopART) study team, Bond Virginia , Hoddinott Graeme , Viljoen Lario , Ngwenya Fredrick , Simuyaba Melvin , Chiti Bwalya , Ndubani Rhoda , Makola Nozizwe , Donnell Deborah , Schaap Ab , Floyd Sian , Hargreaves James , Shanaube Kwame , Fidler Sarah , Bock Peter , Ayles Helen , Hayes Richard , Simwinga Musonda , Seeley Janet 
Published: April 2021

Abstract
Background
In a cluster-randomised trial (CRT) of combination HIV prevention (HPTN 071 (PopART)) in 12 Zambian communities and nine South African communities, carried out from 2012 to 2018, the intervention arm A that offered HIV treatment irrespective of CD4 count did not have a significant impact on population level HIV incidence. Intervention arm B, where HIV incidence was reduced by 30%, followed national guidelines that mid trial (2016) changed from starting HIV treatment according to a CD4 threshold of 500 to universal treatment. Using social science data on the 21 communities, we consider how place (community context) might have influenced the primary outcome result.

Methods
A social science component documented longitudinally the context of trial communities. Data were collected through rapid qualitative assessment, interviews, group discussions and observations. There were a total of 1547 participants and 1127 observations. Using these data, literature and a series of qualitative analysis steps, we identified key community characteristics of relevance to HIV and triangulated these with HIV community level incidence.

Results
Two interdependent social factors were relevant to communities’ capability to manage HIV: stability/instability and responsiveness/resistance. Key components of stability were social cohesion; limited social change; a vibrant local economy; better health, education and recreational services; strong institutional presence; established middle-class residents; predictable mobility; and less poverty and crime. Key components of responsiveness were community leadership being open to change, stronger history of HIV initiatives, willingness to take up HIV services, less HIV-related stigma and a supported and enterprising youth population. There was a clear pattern of social factors across arms. Intervention arm A communities were notably more resistant and unstable. Intervention arm B communities were overall more responsive and stable.

Conclusions
In the specific case of the dissonant primary outcome results from the HPTN 071 (PopART) trial, the chance allocation of less stable, less responsive communities to arm A compared to arm B may explain some of the apparently smaller impact of the intervention in arm A. Stability and responsiveness appear to be two key social factors that may be relevant to secular trends in HIV incidence. We advocate for a systematic approach, using these factors as a framework, to community context in CRTs and monitoring HIV prevention efforts.

Trial registration
ClinicalTrials.gov NCT01900977. Registered on July 17, 2013.
Esophageal cancer responsive to the combination of immune cell therapy and low-dose nivolumab: two case reports
Authors: Takimoto Rishu , Kamigaki Takashi , Gotoda Takuji , Takahashi Toshimi , Okada Sachiko , Ibe Hiroshi , Oguma Eri , Goto Shigenori 
Published: April 2021

Abstract
Background
Blocking the programmed death 1 pathway by immune checkpoint inhibitors induces dramatic antitumor activity in patients with malignant tumors. However, the clinical response to immune checkpoint inhibitors remains limited owing to the patients’ immunological status, such as the number of lymphocytes, programmed death ligand 1 expression, and tumor mutation burden. In this study, we successfully treated two patients with advanced esophageal cancer who responded to the combination of adoptive immune cell therapy and a low-dose immune checkpoint inhibitor, nivolumab.

Case presentation
Two Asian (Japanese) patients with advanced esophageal cancer who were resistant to conventional chemoradiation therapy were referred to our hospital for immune therapy. Case 1 was a 66-year-old woman who was diagnosed as having esophageal cancer. She received concurrent chemoradiation therapy and then underwent subtotal esophagectomy, after which she became cancer free. However, she relapsed, and cancer cells were found in the lung and lymph nodes 6 months later. She enrolled in a clinical trial at our institution (clinical trial number UMIN000028756). She received adoptive immune cell therapy twice at a 2-week interval followed by low-dose nivolumab with adoptive immune cell therapy four times at 2-week intervals. A follow-up computed tomography scan showed partial response, with mass reduction of the metastatic lung and mediastinal lesions. Case 2 was a 77-year-old man. He received concurrent chemoradiation therapy with fluoropyrimidine/platinum, and gastroscopy revealed complete remission of esophageal cancer. He was disease free for 5 months, but routine computed tomography revealed multiple metastases in his lungs and lymph nodes. He visited our clinic to receive adoptive immune cell therapy and immune checkpoint inhibitor combination therapy. Radiographic evidence showed continuous improvement of lesions. There was no evidence of severe adverse events during the combination therapy.

Conclusion
The combination of adoptive immune cell therapy and an immune checkpoint inhibitor might be a possible treatment strategy for advanced esophageal cancer.
Trial registration UMIN000028756. Registered 14 September 2017
Shelter cats host infections with multiple Trypanosoma cruzi discrete typing units in southern Louisiana
Authors: Dumonteil Eric , Desale Hans , Tu Weihong , Duhon Brandy , Wolfson Wendy , Balsamo Gary , Herrera Claudia 
Published: April 2021

AbstractTrypanosoma cruzi is a zoonotic parasite endemic in the southern US and the Americas, which may frequently infect dogs, but limited information is available about infections in cats. We surveyed a convenience sample of 284 shelter cats from Southern Louisiana to evaluate T. cruzi infection using serological and PCR tests. Parasites from PCR positive cats were also genotyped by PCR and deep sequencing to assess their genetic diversity. We detected a seropositivity rate for T. cruzi of at least 7.3% (17/234), and 24.6% of cats (70/284) were PCR positive for the parasite. Seropositivity increased with cat age (R2 = 0.91, P = 0.011), corresponding to an incidence of 7.2% ± 1.3 per year, while PCR positivity decreased with age (R2 = 0.93, P = 0.007). Cats were predominantly infected with parasites from TcI and TcVI DTUs, and to a lesser extent from TcIV and TcV DTUs, in agreement with the circulation of these parasite DTUs in local transmission cycles. These results indicate that veterinarians should have a greater awareness of T. cruzi infection in pets and that it would be important to better evaluate the risk for spillover infections in humans.
Acoustic DOA estimation using space alternating sparse Bayesian learning
Authors: Bai Zonglong , Shi Liming , Jensen Jesper Rindom , Sun Jinwei , Christensen Mads Græsbøll 
Published: April 2021

AbstractEstimating the direction-of-arrival (DOA) of multiple acoustic sources is one of the key technologies for humanoid robots and drones. However, it is a most challenging problem due to a number of factors, including the platform size which puts a constraint on the array aperture. To overcome this problem, a high-resolution DOA estimation algorithm based on sparse Bayesian learning is proposed in this paper. A group sparse prior based hierarchical Bayesian model is introduced to encourage spatial sparsity of acoustic sources. To obtain approximate posteriors of the hidden variables, a variational Bayesian approach is proposed. Moreover, to reduce the computational complexity, the space alternating approach is applied to push the variational Bayesian inference to the scalar level. Furthermore, an acoustic DOA estimator is proposed to jointly utilize the estimated source signals from all frequency bins. Compared to state-of-the-art approaches, the high-resolution performance of the proposed approach is demonstrated in experiments with both synthetic and real data. The experiments show that the proposed approach achieves lower root mean square error (RMSE), false alert (FA), and miss-detection (MD) than other methods. Therefore, the proposed approach can be applied to some applications such as humanoid robots and drones to improve the resolution performance for acoustic DOA estimation especially when the size of the array aperture is constrained by the platform, preventing the use of traditional methods to resolve multiple sources.
Evaluation of von Willebrand factor as a marker for early diagnosis of Acute Respiratory Distress Syndrome in comparison to Interleukin-6
Authors: ELfawy Dalia M. , Elkalek Mohmmed Abd , Hamed Ehab , Ibrahem Samer , ELzoghby Doaa M. A. , Abdalla Waleed 
Published: April 2021

Abstract
Background
Acute respiratory distress syndrome (ARDS) constitutes a clinical phenotype of severe lung injury associated with many causes. Endothelial activation and injury is a component of ARDS. The release of von Willebrand factor (vWF) indicates direct endothelial cell damage has occurred, and this can be used as a marker of endothelium injury. The aim of the study was to investigate the diagnostic value of vWF antigen as a determinant of early detection of ARDS in comparison to interleukin-6 (IL-6) as a control biomarker. vWF antigen and IL-6 were measured in 60 patients who were at risk of developing ARDS on T0 (at the start of the study), T48 (after 48 h), and T72 (after 72 h).

Results
Higher vWF Ag levels were seen in patients at risk of developing ARDS with direct cause of lung injury than those with indirect causes. Include groups I and II. There was a highly significant increase between the “at risk of developing ARDS” patients, VWF Ag, and IL-6 levels. The results were recorded at T0 (i.e., at start of the study baseline reading), T48 (after 48 h), and T72 (after 72 h), p 0.001 and p 0.05, respectively. A value of vWF Ag of 447% on the 3rd day of ARDS showed a sensitivity of 94.9% and specificity 56.7% compared to IL-6 at 246 pg/ml with 79.5% sensitivity and 52.4% specificity. As a comparison between VWF and IL6 levels among ARDS patients, they both show statistical correlation together.

Conclusion
The results of our study point out to VWF as a sensitive and good diagnostic marker for ARDS diagnosis.