bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decolonising archaeology in South Africa: two decades after the National Heritage Resources Act of 1999
Authors: P Reddy Kerry-Leigh , Russell Thembi 
Published: February 2024

Twenty-four years ago, the National Heritage Resources Act, No. 25 of 1999 (NHRA) was enacted in South Africa. This was a moment of change, when the heritage of those marginalised during the colonial and Apartheid eras would finally be given its rightful place on the national heritage list. There was a sense of optimism amongst politicians that the African past was finally to be recognised in an inclusive and representative future. This was echoed in archaeology, given its central role in uncovering and telling the story of precolonial South Africa. The discipline slowly opened its doors to academics of all ethnic groups and new perspectives were identified. But an examination of the practical consequences and impact of this progressive legislation for transforming officially declared heritage in the past 24 years shows surprisingly little change in the overall body of recognized, listed heritage. Recent studies of transformation in South African archaeology have focussed on institutional transformation; possible transformation of the types and frequency of sites declared as national and provincial heritage sites has not yet been examined. It is this issue which our paper addresses. The paper presents analysis that relies on the South African Heritage Resources Information System (SAHRIS) database covering the period 1936 to mid-2022. Whilst sites associated with European colonialism still predominate, there has been a change in the frequency of types of heritage declared since 1999, with an increase in sites associated with the Black liberation struggle. Yet the list remains very unbalanced, with only a single heritage site connected to the precolonial past of Black South Africans having been declared as a national heritage site since 1999. We discuss and classify the types of heritage declared since 1999 and suggest reasons for the distortion.
Causes of infant and under-five (under-5) morbidity and mortality among hospitalized patients in Southern Nigeria: A hospital based study
Authors: Okoroiwu Henshaw Uchechi , Edet Uwem Okon , Uchendu Ikenna Kingsley , Echieh Chidiebere Peter , Nneoyi-Egbe Ada Francesca , Anyanwu Stanley Obialor , Umoh Ekementeabasi Aniebo , Nwaiwu Ndidi Patience , Mbabuike Ikenna Uchechukwu 
Published: February 2024

Background: Rate and pattern of under-five mortality is a reflection of a society’s healthcare system and quality of life. This study is aimed at reviewing the causes of infants and under-five morbidity and mortality in Calabar, Southern Nigeria. Methods: This study used retrospective descriptive cross-sectional design. We did a retrospective collation of data on under-five morbidity and mortality from 2012 to 2017 of under-five patients admitted or died while in admission in University of Calabar Teaching Hospital. The causes of morbidity and mortality were reported based on International Classification of Diseases 10 (ICD-10). The morbidity, mortality and fatality rates were computed. Results: A total of 11,416 under-five admissions and 391 deaths were recorded within the study period giving a fatality rate of 3.4%. Age 1–4 years category represented 50.5% of the admissions while infants (<1 year) constitute majority of the deaths (64.7%). There were 5652 infant admissions and 253 infant deaths giving fatality rate of 4.5% within the study period. Males constituted majority (55.8%) of under-five morbidity whereas females constituted majority (51.2%) of the deaths. Conditions originating from perinatal period; and infectious and parasitic diseases were the leading broad cause of under-five mortality. Specific disease analysis showed sepsis/septicemia; congenital infectious and parasitic diseases; slow fetal growth, malnutrition and short gestation as the chief causes of both infant and under-five mortality. Conclusion: The leading causes of under-five deaths in the studied population are amenable. Improved healthcare and antenatal will be of immense benefit.
Using transfer learning-based plant disease classification and detection for sustainable agriculture
Authors: Shafik Wasswa , Tufail Ali , De Silva Liyanage Chandratilak , Apong Rosyzie Anna Awg Haji Mohd 
Published: February 2024

AbstractSubsistence farmers and global food security depend on sufficient food production, which aligns with the UN's “Zero Hunger,” “Climate Action,” and “Responsible Consumption and Production” sustainable development goals. In addition to already available methods for early disease detection and classification facing overfitting and fine feature extraction complexities during the training process, how early signs of green attacks can be identified or classified remains uncertain. Most pests and disease symptoms are seen in plant leaves and fruits, yet their diagnosis by experts in the laboratory is expensive, tedious, labor-intensive, and time-consuming. Notably, how plant pests and diseases can be appropriately detected and timely prevented is a hotspot paradigm in smart, sustainable agriculture remains unknown. In recent years, deep transfer learning has demonstrated tremendous advances in the recognition accuracy of object detection and image classification systems since these frameworks utilize previously acquired knowledge to solve similar problems more effectively and quickly. Therefore, in this research, we introduce two plant disease detection (PDDNet) models of early fusion (AE) and the lead voting ensemble (LVE) integrated with nine pre-trained convolutional neural networks (CNNs) and fine-tuned by deep feature extraction for efficient plant disease identification and classification. The experiments were carried out on 15 classes of the popular PlantVillage dataset, which has 54,305 image samples of different plant disease species in 38 categories. Hyperparameter fine-tuning was done with popular pre-trained models, including DenseNet201, ResNet101, ResNet50, GoogleNet, AlexNet, ResNet18, EfficientNetB7, NASNetMobile, and ConvNeXtSmall. We test these CNNs on the stated plant disease detection and classification problem, both independently and as part of an ensemble. In the final phase, a logistic regression (LR) classifier is utilized to determine the performance of various CNN model combinations. A comparative analysis was also performed on classifiers, deep learning, the proposed model, and similar state-of-the-art studies. The experiments demonstrated that PDDNet-AE and PDDNet-LVE achieved 96.74% and 97.79%, respectively, compared to current CNNs when tested on several plant diseases, depicting its exceptional robustness and generalization capabilities and mitigating current concerns in plant disease detection and classification.
The safety of preoperative carbohydrate drinks in extremely elderly patients assessed by gastric ultrasonography: a randomized controlled trial
Authors: Chen Lingyang , Wang Nana , Xie Guohao , Wang Mingcang , Yu Yulong , Wang Huiqin , Fang Xiangming 
Published: February 2024

AbstractBackgroundModern perioperative guidelines encourage drinking oral carbohydrates 2 h before management. Nevertheless, research on the safety of preoperative carbohydrate drinks, particularly in extremely elderly patients is lacking. We aimed to evaluate the safety of carbohydrate drinks 2 h before surgery in extremely elderly patients (≥ 80 years) using gastric ultrasonography.MethodsWe conducted a randomized prospective comparative study of 70 patients aged over 80 years who were scheduled for total knee arthroplasty, hip fracture or humerus fracture surgery. These patients were randomly assigned to the carbohydrate group (n = 35), which fasted from midnight, except for drinking 355 mL of a carbohydrate-containing fluid 2 h before surgery, or the fasting group (n = 35), which fasted from midnight and drank no fluid before surgery. The primary outcome of the study was the cross-sectional area (CSA) of the gastric antrum in the right lateral decubitus position (RLDP) before surgery. The secondary outcomes included CSA in the supine position, intraoperative blood glucose levels and their variability coefficients, Perlas grade, and the visual analog scale of subjective feelings.ResultsThe CSA in the RLDP and supine positions revealed no differences between the carbohydrate and fasting groups at 0 h preoperatively (P > 0.05). In the qualitative assessment, preoperative 0-h Perlas grading did not differ significantly between the groups (P > 0.05). From 2 h before surgery to transfer out of the post-anesthesia care unit, the average blood glucose level of patients in the carbohydrate group was significantly higher than that in the fasting group (P < 0.001) but remained within the normal range. Moreover, the blood glucose variability coefficient was significantly lower in the carbohydrate group than in the fasting group (P = 0.009). Oral intake of 355 mL carbohydrates before surgery significantly relieved patients’ feelings (P < 0.001).ConclusionPreoperative consumption of carbohydrate drinks 2 h before surgery is safe in “healthy” extremely elderly patients. In addition, preoperative drinking has potential value in maintaining ideal blood glucose levels and stable blood glucose fluctuations perioperatively and improving subjective perceptions of preoperative preparation. This finding warrants further investigation in clinical practice.Trial registrationChinese Clinical Trial Registry (Registration Number ChiCTR1900024812), first registered on 29/07/2019.
The effects of low-dose IL-2 on Th17/Treg cell imbalance in primary biliary cholangitis mouse models
Authors: Wang Zilong , Liu Zhicheng , Zheng Jiarui , Huang Linxiang , Jin Rui , Wang Xiaoxiao , Chen Dongbo , Xie Yandi , Feng Bo 
Published: February 2024

Abstract
Background/aims
Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease. The imbalance of Th17/Treg cells has been reported in PBC patients. Low-dose IL-2 can alleviate disease severity through modulating CD4 + T cell subsets in patients with autoimmune diseases. Hence, the present study aimed to examine the effects and mechanism of low-dose IL-2 in PBC mouse models.

Methods
PBC models were induced in female C57BL/6 mice by two immunizations with 2OA-BSA at two-week intervals, and poly I: C every three days. PBC mouse models were divided into the IL-2 treated and untreated groups and low-dose IL-2 was injected at three different time points. Th17 and Tregs were analyzed by flow cytometry, and the related cytokines were analyzed by ELISA. Liver histopathology was examined by H&E and immunohistochemical staining.

Results
Twelve weeks after modeling, the serum AMA was positive and the ALP was significantly increased in PBC mouse models (P<0.05). The pathology showed lymphocyte infiltration in the portal area, damage, and reactive proliferation of the small bile duct (P<0.05). The flow cytometric showed the imbalance of Th17/Treg cells in the liver of PBC mouse models, with decreased Treg cells, increased Th17 cells, and Th17/Treg ratio (P < 0.05). After the low-dose IL-2 intervention, biochemical index and liver pathologies showed improvement at 12 weeks. Besides, the imbalance of Th17 and Treg cells recovered. Public database mining showed that Th17 cell differentiation may contribute to poor response in PBC patients.

Conclusion
Low-dose IL-2 can significantly improve liver biochemistry and pathology by reversing the imbalance of Th17 and Treg cells, suggesting that it may be a potential therapeutic target for PBC.
The molecular epidemiology and clinical implication of methicillin-resistant Staphylococcus aureus (MRSA) sequence types in pediatric bacteremia: a restrospective observational study, 2016–2021
Authors: Kim Gahee , Lee Sanghoon , Lee Yonghee , Kim Jung Hwa , Lee Jina 
Published: February 2024

Abstract
Background
While there is a high burden of methicillin-resistant Staphylococcus aureus (MRSA) infections among pediatric patients, studies on the molecular epidemiology of MRSA infections in Korean children since the 2010s are lacking. This study aimed to investigate the molecular genotypes and clinical characteristics of MRSA isolates from children with MRSA bacteremia at Asan Medical Center Children’s Hospital from 2016 to 2021.

Methods
Clinical data were retrospectively reviewed, and the molecular types of MRSA were determined using multilocus sequence typing (MLST) and Staphylococcal cassette chromosome mec (SCCmec) typing.

Results
The overall methicillin resistance rate of S. aureus bacteremia was 44.8% (77/172); 49.5% in the period 2016–2018 (period 1) and 37.3% in the period 2019–2021 (period 2) (P = 0.116). Community-acquired infections accounted for only 3.9% of cases. The predominant ST group was ST72 group (67.6%), followed by ST5 group (18.9%) and ST1 group (5.4%). The proportion of ST5 was significantly lower in period 2 compared to period 1 (P = 0.02). Compared to the ST5 and ST1 groups, the ST72 group exhibited lower overall antibiotic resistance and multidrug-resistant (MDR) rates (12.0% [6/50] in ST72 group vs. 100.0% [14/14] in ST5 group vs. 50.0% [2/4] in ST1 group; P < 0.001). In the multivariate analysis, the ST1 group was an independent risk factor for 30-day all-cause mortality (aOR, 44.12; 95% CI, 3.46–562.19).

Conclusion
The ST72-MRSA strain remained the most frequently isolated genotype in Korean children, while the ST1 group emerged as an independent risk factor for 30-day all-cause mortality in pediatric MRSA bacteremia. Ongoing efforts to uncover the evolving epidemiology of MRSA are essential for developing effective strategies for prevention and treatment.
Intimate partner violence and postpartum healthcare access in Kenya: a cross-sectional study
Authors: Woofter Rebecca , Mboya John , Golub Ginger , Sudhinaraset May 
Published: February 2024

Abstract
Background
Intimate partner violence (IPV) impacts physical health, mental health, and healthcare use. IPV during pregnancy, in particular, is associated with lower rates of antenatal care, but no studies have assessed the association between IPV and postpartum healthcare. This study aims to examine the link between IPV (emotional, physical, and sexual) and two outcomes: postpartum healthcare use and access to family planning.

Methods
This study uses data from a cross-sectional survey of 859 women in Nairobi and Kiambu counties in Kenya who gave birth during the COVID-19 pandemic in 2020.

Results
In this sample, 36% of women reported ever experiencing IPV. Of those, 33% indicated the frequency of IPV stayed the same or increased during COVID-19. Nearly 17% of women avoided postpartum healthcare and 10% experienced issues accessing family planning. Those who experienced any form of IPV during pregnancy had approximately twice the odds of avoiding postpartum healthcare compared to those who did not experience any form of IPV. Compared to those who did not experience IPV during pregnancy, experiencing sexual IPV was associated with 2.25 times higher odds of reporting issues accessing family planning. Additionally, reporting fair or poor self-rated health was associated with both avoiding postpartum healthcare and reporting issues accessing family planning. Experiencing food insecurity was also associated with avoiding postpartum healthcare.

Conclusions
To our knowledge, this is the first study to establish the link between IPV during pregnancy and postpartum healthcare access. During COVID-19 in Kenya, postpartum women who had experienced IPV were at increased risk of disengagement with healthcare services. Women should be screened for IPV during pregnancy and postpartum in order to better support their healthcare needs. In times of crisis, such as pandemics, policymakers and healthcare providers must address barriers to healthcare for postpartum women.
Association of maternal phthalates exposure and metabolic gene polymorphisms with congenital heart diseases: a multicenter case-control study
Authors: Li Nana , Kang Hong , Liu Zhen , Li Lu , Deng Ying , Wang Meixian , Li Yuting , Xu Wenli , Li Xiaohong , Wang Yanping , Zhu Jun , Tao Jing , Yu Ping 
Published: February 2024

Abstract
Background
The majority of congenital heart diseases (CHDs) are thought to result from the interactions of genetics and the environment factors. This study aimed to assess the association of maternal non-occupational phthalates exposure, metabolic gene polymorphisms and their interactions with risk of CHDs in offspring.

Methods
A multicenter case-control study of 245 mothers with CHDs infants and 268 control mothers of health infant was conducted from six hospitals. Maternal urinary concentrations of eight phthalate metabolites were measured by ultra-high performance liquid chromatography coupled with tandem mass spectrometry (UHPLC-MS/MS). Twenty single nucleotide polymorphisms (SNPs) in cytochrome P450 family 2 subfamily C member 9 (CYP2C9) and 19 (CYP2C19), uridine diphosphate (UDP) glucuronosyl transferase family 1 member A7 (UGT1A7), family 2 member B7 (UGT2B7) and B15(UGT2B15) genes were genotyped. The multivariate logistic regressions were used to estimate the association between maternal phthalates exposure or gene polymorphisms and risk of CHDs. Generalized multifactor dimensionality reduction (GMDR) was used to analyze the gene–gene and gene–phthalates exposure interactions.

Results
There was no significant difference in phthalate metabolites concentrations between the cases and controls. No significant positive associations were observed between maternal exposure to phthalates and CHDs. The SNPs of UGT1A7 gene at rs4124874 (under three models, log-additive: aOR = 1.74, 95% CI:1.28–2.37; dominant: aOR = 1.86, 95% CI:1.25–2.78; recessive: aOR = 2.50, 95% CI: 1.26–4.94) and rs887829 (under the recessive model: aOR = 13.66, 95% CI: 1.54–121) were significantly associated with an increased risk of CHDs. Furthermore, the associations between rs4124874 (under log-additive and dominant models) of UGT1A7 were statistically significant after the false discovery rate correction. No significant gene-gene or gene-phthalate metabolites interactions were observed.

Conclusions
The polymorphisms of maternal UGT1A7 gene at rs4124874 and rs887829 were significantly associated with an increased risk of CHDs. More large-scale studies or prospective study designs are needed to confirm or refute our findings in the future.
Critical congenital heart disease: contemporary prenatal screening performance and outcomes in a multi-centre perinatology service
Authors: Cody Fiona , Franklin Orla , Mc Cay Nicola , Molphy Zara , Dicker Patrick , Breathnach Fionnuala M. 
Published: February 2024

Abstract
Background
Prenatal detection of critical congenital heart disease (CCHD) optimises perinatal decision-making and neonatal outcomes. The objective of this study was to determine the prenatal screening performance, care pathways and perinatal outcomes for prenatally and postnatally diagnosed cases of CCHD over a four-year period.

Study design
This retrospective cohort study in a tertiary centre and its two affiliated secondary sites examined all cases of CCHD, including cases of pregnancy termination and in-utero fetal death, neonatal death and liveborn babies that underwent cardiac catheterization or surgery in the first six weeks of life. Prenatal and postnatal data were ascertained from the first trimester assessment for all patients diagnosed prenatally. Cases requiring intervention that were first identified in the postnatal period were included to determine prenatal detection rates. Follow-up for all cases of CCHD continued to one year of age.

Results
In a consecutive cohort of 49,950 pregnancies in a 4-year period 01/2019 to 12/2022, a prenatal diagnosis of CCHD was made in 96 cases, yielding a prevalence of 1.9 per 1000 births. The prenatal detection for right duct-dependant heart pathology and congenital heart block was 100%, 85% for left duct-dependant pathology and 93% for transposition of the great arteries (TGA). In the prenatally diagnosed group, 37% of cases were complicated by extracardiac structural abnormalities, a genetic diagnosis or both. All cases of prenatal detection were identified in the context of routine anatomy screening rather than specialist Fetal Cardiac screening services. Almost half of all pregnancies complicated by CCHD did not undergo neonatal cardiac intervention, by virtue of parental choice determined either prenatally or after birth. An additional eight babies were diagnosed with CCHD in the neonatal period, such that the prenatal detection rate for CCHD was 92% (96/104, 95% CI = 84%-96%). Survival at 1-year for infants deemed suitable for CCHD surgery was 85%.

Conclusion
In a large unselected population, optimal rates of prenatal detection of critical congenital heart disease can be achieved by a protocolised approach to mid-trimester fetal anatomy ultrasound, underpinned by a programme of sonographer education and training. The cardiac abnormalities most likely to evade prenatal detection are left-sided obstructive lesions.
Pancreatic adenocarcinoma third line systemic treatments: a retrospective cohort study
Authors: Gueiderikh A. , Tarabay A. , Abdelouahab M. , Smolenschi C. , Tanguy M. L. , Valery M. , Malka D. , Pudlarz T. , Fuerea A. , Boige V. , Hollebecque A. , Ducreux M. , Boilève A. 
Published: February 2024

Abstract
Background
Chemotherapy for metastatic pancreatic adenocarcinoma (PDAC) primarily relies on FOLFIRINOX (LV5FU- irinotecan – Oxaliplatine) and Gemcitabine – Nab-Paclitaxel in the first-line setting. However, second-lines remain less well-defined and there is limited data regarding third-line treatments. The objective of our study was to determine the proportion of patients advancing to third line chemotherapy, to outline the various third-line chemotherapy regimens used in routine practice and to evaluate their respective efficacy.

Methods
A retrospective single-center cohort from 2010-2022 compiled baseline characteristics, treatment outcomes and survival of PDAC patients who received at least one chemotherapy line in a French tertiary-center. Overall survivals (OS) were analyzed using a Cox multivariable model.

Results
In total, 676 patients were included, with a median follow-up time of 69.4 months, (Interquartile Range (IQR) = 72.1). Of these, 251 patients (37%) that proceeded to 3rd-line chemotherapy. The median PFS in 3rd line was 2.03 months, [CI95%: 1.83, 2.36]. The median 3rd line overall survival was 5.5 months, [CI95%: 4.8, 6.3]. In multivariable analysis erlotinib-based chemotherapy was found to be deleterious (HR=2.38, [CI95%: 1.30, 4.34], p=0.005) compared to fluoropyrimidine-based chemotherapy in terms of 3rd line overall survival while gemcitabine monotherapy showed a tendency towards negative outcomes. First and 2nd line chemotherapies sequence didn’t influence 3rd line outcome.

Conclusion
In our cohort, one-third of treated patients proceeded to 3rd line chemotherapy resulting in a 5.5 months median 3rd line OS, consistent with treatments at advanced stage. Our results argue against the use of erlotinib and gemcitabine monotherapy.