bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breastfeeding Experiences of Women- The Essence of Womanhood: A Qualitative Study
Authors: Muktamath Vinutha Umesh , Itagi Sunanda Kotrabsappa , Khadi Pushpa Basavaraj 
Published: December 2020

Abstract
Qualitative Research for the Social Sciences uses a conversational writing style that draws readers into the excitement of the research process. It provides insights into behaviours, moods and interactions which would have been difficult to measure using traditional survey techniques. “Narrative Analysis” is a qualitative approach which emphasises on power of spoken word. This approach was used because of its tremendous initiative appeal and is the best approach to “restory” the breastfeeding experience of the woman –the essence of womanhood. The study participants included four mothers who breast fed their children exclusively for six months, four mothers who complementarily breast fed for first six months and four mothers who never breast fed the babies from Dharwad district of Northern Karnataka. A total of 12 mothers in the year 2017-18 were selected by purposive sampling method. The participants consent was taken for their participation in lengthy, in depth interview and to audio record their interview by assuring confidentiality. Analytical procedures like data reduction, coding and thematic development were done based on repeated readings of transcript. Based on this, five themes like Barriers vs Promoters, idealism vs realism, Knowledge vs Ignorance, Sense of Satisfaction vs Guilt and Normal Development vs Developmental delay were framed. Peer debriefing, member checking and triangulation were used as strategies of rigor. The results of qualitative analysis revealed that the support of husband, family and health personnel were the promoters and cultural beliefs, responsibilities of mothers,illness in infants and mothers were barriers of breast feeding. Conflicting advice by health personnel and elders in the family, and promotion of formula and other prelacteal feeds by popular brands were also the negative determinants of breastfeeding practices in mothers.The feeling that breastfeeding is the essence of motherhood was universal among mothers. Exclusively breastfed mothers perceived that their children had normal development while complementarily and never breastfed mothers perceived the delay in development of their children.
Photosynthetic Characteristics of Cotton Are Enhanced by Altering the Timing of Mulch Film Removal&nbsp;
Authors: ZHANG Zhanqin , ZHANG Li , TIAN Haiyan , NIU Yuan , Yang Xiang kun 
Published: December 2020

Abstract
Background: The photosynthetic parameters of cotton plants may be modified by the timing of film-removal during their growing period. This study was undertaken during 2015–2017 in Xinjiang, China, to determine to what extent the film mulching removal time—1 and 10 days before the first irrigation and 1 day before the second irrigation after seedling emergence—influenced cotton’s photosynthetic characteristics. The control group consisted of film mulching present throughout the growing period. Results: The results suggested the following: (1) Removing mulching-film within 50 days of seedling emergence had adverse effects on soil temperature and moisture. (2) Film-removal before the first or second irrigation after emergence improved the net photosynthetic rate in cotton’s later flowering stage and its transpiration rate in mid and later flowering stages, while enhancing the actual electron transport rate (ETR) and maximum electron transfer rate (ETRmax) between cotton photosystems I and II. (3) Film-removal treatment post-emergence also increased cotton plants’ tolerance to high irradiation, a trend more pronounced in the early flowering stage in wetter years. (4) Leaf area index (LAI) of cotton was reduced in the film-removal treatment, for which the greatest maximum accumulation of dry matter occurred in a drought year (i.e., 2015). (5) Film-removal increased lint cotton yield, except in dry year (2015). Conclusions: Film-removal can improve cotton’s fiber quality to a certain extent. Collectively, our study’s experimental results indicate that applying mulch film removal at an appropriate, targeted time can improve photosynthesis and yield of cotton crops.
Real-Time Ethiopian Currency Recognition for Visually Disabled Peoples Using Convolutional Neural Network
Authors: Meharu Mekonnen Legess , Worku Hussien Seid 
Published: December 2020

Abstract
A survey report made by the Ethiopian Ministry of Health along with several non-governmental organizations in 2006 G.C, there were about 5.3% of the Ethiopian population lives with blindness and low vision problems. This research work aims to develop a Convolutional Neural Network-based model by using pre-trained models to enable vision-impaired peoples to recognize Ethiopian currency banknotes in real-time scenarios. The models attempt to accurately recognize Ethiopian currency banknotes even if the input images come up with partially or highly distorted and folded Birr notes. 8500 (1700 for each class) banknotes data are collected within real-life situations by using 9 blind persons. The models were evaluated with 500 real-time videos of different conditions. The whole training, classification, and detection tasks have been demonstrated by adopting Tensorflow Object Detection API and the pre-trained Faster R-CNN Inception, and SSD MobileNet models. All the codes are implemented using Python. The model tested using numerous Ethiopian currencies at different banknotes status and light conditions. In the case of Faster R-CNN Inception model an average accuracy, precision, recall, and F1-score of 91.8%, 91.8%, 92.8%, and 91.8% are obtained respectively and in the case of SSD MobileNet model an average accuracy, precision, recall, and F1-score of 79.4%, 79.4%, 93.6%, and 84.4% are obtained respectively within a real-time video. Therefore as the first research work, the model has shown good performance in both models but Faster R-CNN provides a promising result with an average accuracy of 91.8%.
Prevalence and Influencing Factors of Anxiety and Depression Symptoms Amongst Surgical Nurses During COVID-19 Pandemic: A Large-Scale Cross-Sectional Study
Authors: Ren Chun-Xia , Zhou De-Cun , Fan Yin-Guang , Li Bao-Zhu , Zhang Wan-Fei , Shen Yun , Yu Shi-Hui , Jiang Li , Yu Feng-Qiong , Duan Yong-Li , Peng De-Qing , Cheng Xue-Hong , Wu Le , Wu Chang-Hao , Ye Dong-Qing 
Published: December 2020

Abstract
BackgroundThe outbreak of novel 2019 coronavirus disease (COVID-19) has imposed an enormous physical and psychological pressure on people across the world. This study focused on evaluating the prevalence and influencing factors of anxiety and depression symptoms in surgical nurses during the epidemic in China. MethodA cross-sectional, multicenter quantitative study was conducted in Anhui province (China) from March 3, 2020 to March 19, 2020, with a questionnaire package which consisted of general information questionnaire，Zung's self-rating anxiety scale (SAS), Zung's self-rating Depression Scale (SDS) and social support rating scale (SSRS). A total of 3600 surgical nurses participated in the survey by Wechat and QQ. Data were analysed using multiple linear regression models. ResultsA total of 3492 surgical nurses from 12tertiary hospitals and 12 secondary hospitals in one province of mainland China completed the survey. The prevalence rates of anxiety symptoms and depressive symptoms were 24.83% and 22.39%, respectively. The average level of anxiety and depression of surgical nurses were higher than that of the Chinese norm (P< 0.05).Levels of social support for surgical nurses were significantly negatively associated with the degree of anxiety (r = -0.630, P < 0.001) and depression (r = -0.578, P < 0.001). Fertility status (β = 1.469, P = 0.003), hospital (β = -0.611, P < 0.001), participation in care for COVID-19 patients (β = 2.229, P < 0.001), likelihood of being infected with COVID-19 (β = 1.146, P < 0.001), social support (β = -0.623, P < 0.001) were significantly influencing surgical nurses’ anxiety degree. Similarly, these characteristics were significantly associated with the odds of experiencing depression symptoms in surgical nurses. Divorce and widowed surgical nurses (β = -2.654, P < 0.001) were significantly more likely to experience depressive symptoms than single nurses. ConclusionIn this survey, we found that the surgical nurses had high anxiety and depression symptoms during the COVID-19 outbreak in China. The findings suggest that targeted psychological interventions to promote the mental health of surgical nurses with psychological problems need to be immediately implemented.
Detection of Serum KL-6 and SARS-CoV-2 Antibody in Patients with Coronavirus Disease 2019 and the Diagnostic Value in Severe Disease
Authors: Wang Huiyan , Chen Lichang , Zhang Yang , Liu Long , Xu Meimei , Sun Baoqing , Gao Yong , Jin Tengchuan , Li Ming 
Published: December 2020

Abstract
Background: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a significant threat to human health, but its clinical manifestations vary greatly among individuals. Early detection and treatment are important for severely ill patients to improve their prognosis and reduce the risk of death. Methods: In the present study, serum markers were detected and analyzed in moderately ill and severely ill patients. Results: The results found that there were statistically significant differences in age, serum Krebs von den Lungen-6 (KL-6) and Immunoglobulin A (IgA) levels between severely ill patients and moderately ill patients (P < 0.05). The cut-off of using KL-6 alone for the diagnosis of severely ill patients was 298.91 U/mL, with an AUC of 0.737, a sensitivity of 100%, and a specificity of 43%. When the diagnosis was performed using KL-6 in combination with Interleukin-6 (IL-6), an indicator of infection, the AUC was 0.776, with a sensitivity and specificity of 82% and 69%, respectively. When the three above were used in combination for diagnosis, the AUC was 0.785, and the sensitivity and specificity were 100% and 59%, respectively. After rehabilitation, the serum levels of KL-6, C-reactive protein (CRP), as well as antibodies, IgA, IgM and IgG, were significantly lower than those in the early stage of hospitalization. Conclusion: In the present study, KL-6 and IgA were found to have some diagnostic efficacy for severely ill patients with COVID-19, but larger cohort studies are still needed for further confirmation, which in turn improves the diagnostic and therapeutic efficiency of severely ill patients.
Adherence to Low Carbohydrate Diet in Relation to Chronic Obstructive Pulmonary Disease (COPD)
Authors: Malmir Hanieh , Onvani Shokouh , Ardestani Mohammad Emami , Feizi Awat , Azadbakht Leila , Esmaillzadeh Ahmad 
Published: December 2020

Abstract
Purpose: Data on the link between adherence to low-carbohydrate diet (LCD) and odds of chronic obstructive pulmonary disease (COPD) are scarce. The current study aimed to investigate the relation between adherence to LCD and COPD in Iranian adults.Methods: In this hospital-based case-control study, we enrolled 84 newly-diagnosed COPD patients and 252 age and sex matched healthy controls in Alzahra University Hospital, Isfahan, Iran. COPD was defined based on findings of spirometry test (forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) < 70% or FEV1 < 80%). Dietary intakes of study participants were assessed using the validated Block-format 168-item FFQ. Data on potential confounders were also collected through the use of a pre-tested questionnaire. Results: Mean age of cases and controls were 57.7 and 55.07 years, respectively. Adherence to LCD was inversely associated with odds of COPD (0.35; 95% CI: 0.16-0.75). This inverse association did not alter after controlling for age, sex, and energy intake (0.42; 95% CI: 0.19-0.93). Adjustments for other potential confounders, including dietary intakes, smoking and educational status, did not affect these findings; such that those in the top quintile of LCD score were 64% less likely to have COPD than those in the bottom quintile (OR: 0.36; 95% CI: 0.13-0.99). Conclusion: We found an inverse association between adherence to LCD and odds of COPD. The association remained statistically significant even after taking other potential confounders, including socioeconomic characteristic and dietary intakes into account.
Downregulation of GLYAT facilities tumor growth and metastasis and poor clinical outcomes through the PI3K/AKT/Snail pathway in human breast cancer
Authors: Tian Xin , Wu Lina , Jiang Min , Zhang Zhenyong , Wu Rong , Miao Jianing , Liu Caigang , Gao Song 
Published: December 2020

Abstract
Background

The Glycine N-acyltransferase (GLYAT) gene encodes a protein that catalyzes the transfer of acyl groups from acyl CoA to glycine, resulting in acyl glycine and coenzyme A. Aberrant GLYAT expression is associated with several malignant tumors, but its clinical importance in malignant tumors, especially human breast cancer (BC), has yet to be fully addressed. This study aims to evaluate the clinical function of GLYAT in BC patients.
Methods

GLYAT expression was determined by immune blot and immunohistochemistry in three BC cell lines and primary cancer tissues. The MDA-MB 231 cell line was used for GLYAT gene knockdown experiments while the MCF7 cell line for overexpression experiments. Colony formation experiments, soft agar experiments, and transwell assays were utilized for further inspection of cell migration and proliferation capabilities. Immunofluorescence and western blot were used to detect markers of the epithelial-mesenchymal transition (EMT) and changes in the PI3K/AKT/Snail pathway. The role of GLYAT in tumor growth and metastasis was also assessed in nude mice in vivo. Also, a correlation analysis was performed between clinicopathological features and GLYAT expression in BC patients.
Results

GLYAT was decreased in human BC tissues and cell lines. Functional analysis showed that knockdown of GLYAT augmented BC cell proliferation in vitro and in vivo. However, this phenomenon was reversed when GLYAT was overexpressed in the transfected cells. Moreover, GLYAT inhibited the migratory properties of BC cells, likely through the activation of PI3K/ATK/Snail signaling, which subsequently induced the EMT. IHC analysis indicated that GLYAT was decreased in human BC tissues and lower GLYAT expression was correlated with histological grade, tumor TNM stage, Ki-67 status, and poorer survival in BC patients. Furthermore, lower GLYAT expression seemed as an independent risk factor related to poor prognosis in BC patients based on Cox regression analyses.
Conclusions

Our findings demonstrate that downregulation of GLYAT expression in human breast cancer is correlated with EMT via the PI3K/ATK/Snail pathway and is also associated with histological grade, tumor TNM stage, Ki-67 status, and poor survival in breast cancer patients.
Factors Associated With Influenza Vaccine Coverage Among Patients With Diabetes: Korea National Health and Nutrition Examination Survey 2016–2018
Authors: Han A Lum 
Published: December 2020

Abstract
Background: Although the influenza vaccine has been proven to be effective, this common disease has high morbidity and mortality rates. Moreover, adults with diabetes are at a high risk of influenza-mediated morbidity and mortality. With the increasing prevalence of diabetes and the efficacy of vaccination in preventing influenza, the aim of this study was to investigate the factors associated with influenza vaccination coverage in patients with diabetes.Methods: Cross-sectional data were obtained from the Korea National Health and Nutrition Examination Survey (2016–2018). We analyzed whether sociodemographic, health-related, and medical factors are associated with influenza vaccination coverage in patients with diabetes. A complex sample logistic regression analysis was performed and odds ratios (ORs) were estimated by adjusting for statistically significant factors.Results: The number of survey subjects was 18553. The vaccination coverage rate among patients with diabetes was 60.6%. In the univariate analysis, gender, educational level, smoking, exercise, drinking, marital status, private health insurance, activity limit, economic activity, age, and EuroQol-5 Dimension scores were associated with vaccination coverage. In the multivariate analysis, only age and economic activity were associated with vaccination coverage. The vaccination coverage rate was higher for people who did not undertake economic activities and who were older (OR 1.512 (1.087–2.105), OR 2.212 (1.822–2.686), respectively, p < 0.001).Conclusions: National interventions involving public health centers are necessary to encourage influenza immunization for patients with diabetes, especially younger patients and those who are working or undertaking economic activities.
The Temporal Pattern of Fibrinogen and Albumin Synthesis Rates Perioperatively in Major Abdominal Surgery
Authors: Dumitrescu Gabriel , Januszkiewicz Anna , Ågren Anna , Magnusson Maria , Sparrelid Ernesto , Rooyackers Olav , Wernerman Jan 
Published: December 2020

Abstract
Background: Plasma fibrinogen and albumin concentrations decrease initially after abdominal surgery. On postoperative days 3-5 fibrinogen concentration returns to preoperative level or even higher, while albumin stays low. Fibrinogen and albumin synthesis may be affected differently following major abdominal surgery related to injury and/or loss of liver tissue.The objective of the study was to determine fibrinogen and albumin quantitative synthesis rates in patients undergoing hepatectomies or pancreatectomies with intact liver size.Methods: Patients undergoing liver or pancreatic resection (n=9+6) were studied preoperatively, on postoperative days 1 and 3-5. De novo syntheses of fibrinogen and albumin were determined using the flooding dose technique with 2H5-phenylalanine as a tracer. In addition, several biomarkers indicative of fibrinogen utilization were monitored.Results: After hemi-hepatectomy, fibrinogen synthesis was 2-3-fold higher on postoperative day 1 than preoperatively. On postoperative days 3-5 the synthesis level was still higher than preoperatively. Following major liver resections albumin synthesis was not altered postoperatively compared to preoperative values. After pancreatic resection, on postoperative day 1 fibrinogen synthesis was 5-6-fold higher than preoperatively and albumin synthesis 1.5-fold higher. On postoperative days 3-5 the synthesis levels decreased towards the preoperative levels.Conclusions: De novo synthesis of fibrinogen was markedly stimulated on postoperative day 1 after both hepatectomies and pancreatectomies, while albumin synthesis remained grossly unchanged. The less pronounced changes seen following hepatectomies were possibly related to the loss of liver tissue.
Head-to-Head Comparison of Clinical Scores for Predicting Stroke Associated Pneumonia after Intracerebral Hemorrhage
Authors: JI RUIJUN , LIU YANFANG , LIU XINYU , WANG LINLIN , WANG DANDAN , WANG WENJUAN , ZHANG RUNHUA , JIANG RUIXUAN , JIA JIAOKUN , FENG HAO , DING ZEYU , LIU GAIFEN , LU JINGJING , JU YI , ZHAO XINGQUAN 
Published: December 2020

Abstract
Background: Despite advances in medical knowledge, treatment for ICH remains strictly supportive with not many evidence-based interventions currently available. Stroke associated pneumonia (SAP) is a common medical complication after stroke and has significant impact on stroke outcomes. In the study, we aimed to systematically compare discrimination and calibration of clinical scores with regard to in-hospital SAP after ICH. Methods: The validation cohort was derived from the Beijing Registration of Intracerebral Hemorrhage. The SAP was diagnosed according to the criteria for hospital-acquired pneumonia of Center for Disease Control and Prevention. Five clinical scores were included in the study: the ICH-APS-A, ICH-ASP-B, ISAN, ACCD4 and PASS score. Discrimination was assessed by calculating the area under the receiver operating characteristic curve (AUROC). Pairwise AUROC was compared by using Delong’s method. Calibration was assessed by performing the Hosmer-Lemeshow goodness-of-fit test and plot of observed versus predicted risk according to 10 deciles of the predicted risk. The Cox and Snell R-square and Nagelkerke R-square of the Hosmer-Lemeshow goodness-of-fit test were calculated. Results: A total number of 1964 patients were enrolled. The mean age was 56.8±14.4 and 67.6% were male. The median admission NIHSS was 11 (IQR: 3-21). The median length of stay (LOS) was 16 days (IQR: 8-22). A total number of 575 (29.2%) patients was diagnosed with in-hospital SAP after ICH. The AUROC of five clinical scores ranged from 0.732 to 0.800. In pairwise comparison, the ICH-APS-B (0.800, 95% CI=0.780-0.820, P<0.001) showed statistically better discrimination than other risk models (all P<0.001). All clinical scores performed better among patients with LOS longer than 72 hours. The ICH-APS-B (0.827, 95% CI=0.806-0.848, P<0.001) still showed statistically better discrimination than other risk models in patients with LOS longer than 72 hours (all P<0.001). The ICH-SAP-B had the largest Cox and Snell R-square of the Hosmer-Lemeshow test for in-hospital SAP after ICH.Conclusion: Several models are externally validated to be effective for risk stratification and outcome prediction for in-hospital SAP after ICH, which would be useful tools for personalized care and clinical trials in prevention of SAP after ICH.
Association between early mobilization or rehabilitation and intensive care unit acquired weakness: A systematic review and meta-analysis of randomized controlled trials.
Authors: Li Minghang , Ding Mingyue , Shao Huanzhang , Qin Bingyu , Wang Xingwei , Zhao Xiafei , Ren Shengyong , Zhang Wenxiao , Ye Ling 
Published: December 2020

Abstract
Background

The prognosis of intensive care unit acquired weakness (ICUAW) is poor and the treatment effect is not ideal. At present, some effective and safe early prevention means are urgently needed to reduce its incidence.This study evaluated the effectiveness and safety of early activities or rehabilitation in the prevention of ICUAW.
Methods

We searched for articles in five electronic databases, including PubMed, EMBASE, the Cochrane Library, the China National Knowledge Infrastructure (CNKI) and Wanfang Med Online. All publications until June, 2020 were searched. We have selected trials investigating early mobilization or rehabilitation as compared to standard of care in critically ill adults.The extracted data included adverse events, the number of patients with ICUAW, the length of stay in the ICU (ICU-LOS) the length of mechanical ventilation (MV) etc.
Results

The final results showed that compared with the usual care group, early mobilization or rehabilitation reduced the prevalence of ICUAW (RR, 0.73; [0.61, 0.87]; I2 = 44%; P = 0.0006), ICU-LOS (MD, − 1.47;[2.83, 0.10]; I2 = 56%; P = 0.04), length of MV (MD, − 1.96; [2.41, 1.51]; I2 = 0%; P = 0.00001), but the mortality (RR, 0.90; [0.62, 1.32]; I2 = 3%; P = 0.60) at ICU discharge was not associated. The subgroup analysis of ICUAW prevalence and ICU-LOS based on the intervention methods showed that early combined rehabilitation could reduce the prevalence of ICUAW (RR, 0.56; [0.43, 0.74]; I2 = 34%; P = 0.0001) and shorten the ICU-LOS (MD, − 2.21; [3.28, 0.97]; I2 = 23%; P = 0.0003). EGDM was not associated with a decrease in ICUAW prevalence (RR, 0.85; [0.65, 1.09]; I2 = 26%; P = 0.20), but it reduced the ICU-LOS (MD, − 2.27; [3.86, 0.68]; I2 = 0%; P = 0.005).Early in-bed cycling was not associated with reduced ICUAW prevalence(RR, 1.25; [0.73, 2.13]; I2 = 0%; P = 0.41) and ICU-LOS(MD, 2.27; [0.27, 4.80]; I2 = 0%; P = 0.08) .
Conclusions

Early mobilization or rehabilitation was associated with a shorter length of MV and ICU-LOS, but not mortality. Of course, not all early activities or forms of rehabilitation are effective. The early combined rehabilitation model is effective for the prevention of ICUAW. However, EGDM and early in-bed cycling were not effective in preventing ICUAW.