bluuebunny/crossref_metadata_2025_split huggingface dataset:
Women empowerment and minimum daily meal frequency among infants and young children in Ghana: analysis of Ghana demographic and health survey
Authors: Dadzie Louis Kobina , Amo-Adjei Joshua , Esia-Donkoh Kobina 
Published: September 2021

Abstract
Background
The nutritional quality of food has an important impact on the health and well-being of families, especially children whose bodies need to grow, develop and reach their full physical and mental potential. Traditionally, women in Ghana provide care and nourishment for their children and families if they have the means to do so or if they are financially, legally and socially empowered. Women’s empowerment is not only important for women’s human rights, but also improves nutrition and health outcomes of both mothers and their children. Women’s empowerment is concerned with increasing ability to make strategic life choices in situations where the ability was hitherto denied. This study sought to investigate the association between women’s empowerment and minimum daily meal frequency (minimum number of meals to be consumed in a day) in Ghana.

Methods
The study used data from the 2014 Ghana Demographic and Health Survey (GDHS). A sample of 1640 mother-child dyad was used. Mothers ages ranged from 15 to 49 while children’s ages ranged from 6 to 23 months. Univariate and multiple linear regression techniques were applied to identify women empowerment (economic, socio-familial and legal) and sociodemographic factors associated with minimum daily meal frequency scores. Data was analyzed by the STATA statistical package software version 13.0. Statistical significance level was set at P < 0.10.

Results
Data from decisions on large household purchases (β = 0.351, p < 0.01) family visits (β = 0.743, p < 0.01), home ownership (β = − 0.245, p < 0.10), age of child (β = 1.387, p < 0.01), mother’s educational attainment (β = 0.496, p < 0.10) and place of residence (β = − 0.298, p < 0.10) showed significant positive association with minimum daily meal frequency in Ghana.

Conclusion
Minimum daily meal frequency was largely influenced by economic and socio-familial factors that contribute to empowerment of women. as decisions on large household purchases and family visits showed significant positive association with minimum daily meal frequency. Interventional programs should target households and mothers with lower socio-demographic characteristics such as lower educational levels and low economic status to improve minimal daily meal frequency in their children thereby ensuring better child health and well-being.
Development and validation of a set of patient reported outcome measures to assess effectiveness of asthma prophylaxis
Authors: Guruparan Yalini , Navaratinaraja Thiyahiny S. , Selvaratnam Gowry , Gunawardena Nalika , Sri Ranganathan Shalini 
Published: September 2021

Abstract
Background
In the local setting, asthma control is assessed by symptoms and signs elicited by clinicians because of the limited availability of spirometry. Hence, we intended to develop a patient reported outcome measure (PROM) with more holistic interpretation that could also serve as a tool to measure the asthma control in resource limited settings. Therefore, this study was carried out in Northern Sri Lanka to develop and validate the Asthma Control PROM (AC-PROM) Tamil to measure the effectiveness of asthma prophylaxis based on symptoms, exacerbation and limitation of activity which could also serve as an easy measure of asthma control to the provider.

Methods
The AC-PROM Tamil was developed in 3 steps: item generation, item reduction and psychometric evaluation. Items were generated through thematic analysis from focus group discussions among patients with asthma. Items were converted to an interviewer administered questionnaire in Tamil in the format of 5-point Likert scale. Item reduction was done by two rounds of online Delphi surveys among 10 experts and an exploratory factor analysis among 200 patients with asthma. The face and content validity were assessed by a panel of experts during Delphi survey and patients during the pre-test of the tool. Criterion validity of the tool was assessed against the forced expiratory volume in one second of 187 patients with asthma. The cut-off value to assess the asthma control was determined by receiver operating characteristic curve. Reliability was verified by Cronbach’s alpha coefficient.

Results
From thematic analysis of focus group discussions 10 items were generated. One item was removed during Delphi survey. Exploratory factor analysis indicated removal of another item with 8 items categorised into two factors. Cronbach’s alpha coefficient of factors 1 and 2 were 0.821 and 0.903 respectively, indicating good reliability. Observations made by experts and responses made by patients were incorporated to improve the clarity and relevance of the items. Criterion validity was demonstrated by significant correlation between the AC-PROM Tamil and forced expiratory volume in one second (r = 0.66, p = 0.001). The cut-off value of the AC-PROM Tamil to detect asthma control was 28.5 with 79% (95% CI 71.3–86.9) sensitivity and 71% (95% CI 61.9–79.6) specificity. The AC-PROM Tamil showed moderate accuracy (the area under the receiver operating characteristic curve = 0.796; 95% CI 0.73–0.86). Response rate of the AC-PROM Tamil was 100% and time taken to complete was 3–4 min.

Conclusion
The AC-PROM Tamil is a simple, feasible and reasonably accurate tool to assesses the effectiveness of asthma prophylaxis, particularly in resource limited settings.
Sulfamethoxazole-induced sulfamethoxazole urolithiasis: a case report
Authors: Roedel Megan M. , Nakada Stephen Y. , Penniston Kristina L. 
Published: September 2021

Abstract
Background
Drug-induced urolithiasis falls into two categories: drug-induced and metabolically-induced. Certain antimicrobials are associated with each; sulfonamides are associated with drug- or metabolite-containing calculi when taken in large doses over a long period of time. Trimethoprim-sulfamethoxazole, a member of the sulfonamide family, is a rare cause of drug-induced calculi. Cases of sulfonamide urolithiasis occurring in patients with known stone disease have rarely been reported.

Case presentation
We report a case of a patient with a brief history of recurrent calcium oxalate nephrolithiasis requiring 2 ureteroscopic procedures whose existing 6 mm lower pole renal stone more than quadrupled in size to form a 4 cm renal staghorn after 4 months of high-dose treatment for Nocardia pneumonia with trimethoprim-sulfamethoxazole. After ureteroscopy with laser lithotripsy and basketing of fragments, the stone was found to be predominantly composed of N4-acetyl-sulfamethoxazole, a metabolite of sulfamethoxazole.

Conclusion
Stones composed of sulfamethoxazole or its metabolites are rare but have known associated risk factors that should be considered when prescribing this antibiotic. This case report illustrates additional risk factors for consideration, including pre-existing urinary calculi that may serve as a nidus for sulfamethoxazole deposition, and reviews treatment and prevention methods.
Real-time co-site optical microscopy study on the morphological changes of the dentine’s surface after citric acid and sodium hypochlorite: a single-tooth model
Authors: Wilkoński Wojciech , Jamróz-Wilkońska Lidia , Zapotoczny Szczepan , Opiła Janusz , Giardino Luciano 
Published: September 2021

Abstract
Background
To this day, the effects of sodium hypochlorite and chelating agents on the smear layer and on the dentine’s surface, remain not fully examined. The study is aimed to analyze the dentine's surface treated with 40% citric acid and 5.25% sodium hypochlorite according to two irrigation protocols.

Materials and methods
The study employed a computer-controlled Nikon Eclipse LV100 optical microscope. Ten roots split longitudinally with canals prepared mechanically using the MTwo system to a size of 40/04 were observed. The root halves were divided into two study groups, one half in each of the groups. According to two irrigation protocols, the dentine's surface was irrigated with 40% citric acid and 5.25% sodium hypochlorite, separated with water. Dentine surface was observed in a fixed place and photographed in 500 × magnification after each irrigation stage. The obtained images were then analyzed using computer software (NIS-Elements AR, GIMP-2.6, ImageJ 1.45s).

Results
Various speed of removal of the smear layer and varied morphological changes of the dentine's surface were observed in both examined groups. Double irrigation of the dentine with citric acid for 30 s resulted in complete removal of the smear layer, and double irrigation for 60 s resulted in increased mean diameter of the dentine tubules (degradation of the dentine's surface).

Conclusions
Double alternating irrigation with citric acid and sodium hypochlorite for 30 s yielded satisfactory results, while double irrigation for 60 s resulted in increased mean diameter of the dentine tubules. A real time assessment of the dentine’s surface changes after both tested solutions can improve understanding of the phenomena that occur during the irrigation and as a result it might help to improve clinical outcomes in root canal treatment.
Patterns of hospital utilization in the Unified Health System in six Brazilian capitals: comparison between the year before and the first six first months of the COVID-19 pandemic
Authors: Portela Margareth Crisóstomo , de Aguiar Pereira Claudia Cristina , Lima Sheyla Maria Lemos , de Andrade Carla Lourenço Tavares , Martins Mônica 
Published: September 2021

Abstract
Objective
To analyze the temporal evolution of the pattern of hospital use in the context of the COVID-19 pandemic in Brazil.

Methods
This retrospective observational study compared hospital use and mortality in the Brazilian Unified Health System (SUS) in the first six months of the COVID-19 pandemic with the year before the onset of the pandemic in six Brazilian capitals (São Paulo, Rio de Janeiro, Manaus, Fortaleza, Recife, and Brasilia). It was based on secondary administrative data from the SUS Hospital Information System (SIH), focusing on the number of hospitalizations per fortnight, age, and gender of patients, hospital length of stay, and the proportions of surgical, elective, with the use of ICU, and resulting in death hospitalizations. It also compared the number of hospitalizations and mortality related to frequent diagnostic groups.

Results
A significant drop was identified in the number of hospitalizations as of March 2020, with the first peak of COVID-19 hospitalizations in five capitals recorded in May 2020. In the six capitals, we observed significant reductions in the mean number of hospitalizations per fortnight from the beginning of the pandemic. We also identified an increase in the mean age of the patients and the proportion of male patients. The proportion of surgical and elective hospitalizations dropped significantly in all capitals, while the proportion of hospitalizations with ICU use increased significantly. Significant increases in-hospital mortality were also recorded in the six capitals with the pandemic, including or excluding COVID-19 hospitalizations from the comparison.

Conclusion
The pandemic caused changes in the pattern of use and hospital indicators in the first six months in the cities considered, evidencing the need for attention to diseases with a hospital production altered by the COVID-19 course and health system performance problems in the face of challenges.
Clinical and laboratory findings and PCR results in severe and non-severe COVID19 patients based on CURB-65 and WHO severity indices
Authors: Karimi Farnaz , Saleh Mahshid , Vaezi Amir Abbas , Qorbani Mostafa , Avanaki Foroogh Alborzi 
Published: September 2021

Abstract
Background
The importance of clinicolaboratory characteristics of COVID-19 made us report our findings in the Alborz province according to the latest National Guideline for the diagnosis and treatment of COVID-19 in outpatients and inpatients (trial five versions, 25 March 2020) of Iran by emphasizing rRT-PCR results, clinical features, comorbidities, and other laboratory findings in patients according to the severity of the disease.

Methods
In this study, 202 patients were included, primarily of whom 164 had fulfilled the inclusion criteria. This cross-sectional, two-center study that involved 164 symptomatic adults hospitalized with the diagnosis of COVID-19 between March 5 and April 5, 2020, was performed to analyze the frequency of rRT-PCR results, distribution of comorbidities, and initial clinicolaboratory data in severe and non-severe cases, comparing the compatibility of two methods for categorizing the severity of the disease.

Results
According to our findings, 111 patients were rRT-PCR positive (67.6%), and 53 were rRT-PCR negative (32.4%), indicating no significant difference between severity groups that were not related to the date of symptoms' onset before admission.
Based on the National Guideline, among vital signs and symptoms, mean oxygen saturation and frequency of nausea showed a significant difference between the two groups (P < 0.05); however, no significant difference was observed in comorbidities. In CURB-65 groups, among vital signs and comorbidities, mean oxygen saturation, diabetes, hypertension (HTN), hyperlipidemia, chronic heart disease (CHD), and asthma showed a significant difference between the two groups (P < 0.05), but no significant difference was seen in symptoms.

Conclusion
In this study, rRT-PCR results of hospitalized patients with COVID-19 were not related to severity categories. From initial clinical characteristics, decreased oxygen saturation appears to be a more common abnormality in severe and non-severe categories. National Guideline indices seem to be more comprehensive to categorize patients in severity groups than CURB-65, and there was compatibility just in non-severe groups of National Guideline and CURB-65 categories.
Lung ultrasound in a tertiary intensive care unit population: a diagnostic accuracy study
Authors: Smit Jasper M. , Haaksma Mark E. , Winkler Michiel H. , Heldeweg Micah L. A. , Arts Luca , Lust Erik J. , Elbers Paul W. G. , Meijboom Lilian J. , Girbes Armand R. J. , Heunks Leo M. A. , Tuinman Pieter R. 
Published: September 2021

AbstractBackgroundEvidence from previous studies comparing lung ultrasound to thoracic computed tomography (CT) in intensive care unit (ICU) patients is limited due to multiple methodologic weaknesses. While addressing methodologic weaknesses of previous studies, the primary aim of this study is to investigate the diagnostic accuracy of lung ultrasound in a tertiary ICU population.MethodsThis is a single-center, prospective diagnostic accuracy study conducted at a tertiary ICU in the Netherlands. Critically ill patients undergoing thoracic CT for any clinical indication were included. Patients were excluded if time between the index and reference test was over eight hours. Index test and reference test consisted of 6-zone lung ultrasound and thoracic CT, respectively. Hemithoraces were classified by the index and reference test as follows: consolidation, interstitial syndrome, pneumothorax and pleural effusion. Sensitivity, specificity, positive and negative likelihood ratio were estimated.ResultsIn total, 87 patients were included of which eight exceeded the time limit and were subsequently excluded. In total, there were 147 respiratory conditions in 79 patients. The estimated sensitivity and specificity to detect consolidation were 0.76 (95%CI: 0.68 to 0.82) and 0.92 (0.87 to 0.96), respectively. For interstitial syndrome they were 0.60 (95%CI: 0.48 to 0.71) and 0.69 (95%CI: 0.58 to 0.79). For pneumothorax they were 0.59 (95%CI: 0.33 to 0.82) and 0.97 (95%CI: 0.93 to 0.99). For pleural effusion they were 0.85 (95%CI: 0.77 to 0.91) and 0.77 (95%CI: 0.62 to 0.88).ConclusionsIn conclusion, lung ultrasound is an adequate diagnostic modality in a tertiary ICU population to detect consolidations, interstitial syndrome, pneumothorax and pleural effusion. Moreover, one should be careful not to interpret lung ultrasound results in deterministic fashion as multiple respiratory conditions can be present in one patient.Trial registrationThis study was retrospectively registered at Netherlands Trial Register on March 17, 2021, with registration number NL9344.
Use of CytoSorb therapy to treat critically ill coronavirus disease 2019 patients: a case series
Authors: Mehta Yatin , Mehta Chitra , Nanda Saurabh , Kochar Gaurav , George Joby V. , Singh Manish Kumar 
Published: September 2021

Abstract
Background
Acute respiratory distress syndrome is an important clinical presentation of respiratory complications caused by severe acute respiratory syndrome coronavirus 2, a novel coronavirus responsible for the ongoing pandemic. The disease is poorly understood, and immunopathogenesis is constantly evolving. Cytokine release syndrome remains central to pathology of coronavirus disease 2019. Antivirals, anticytokine treatment, and other pharmacological approaches have failed to treat it. CytoSorb, an extracorporeal cytokine adsorber that reduces the cytokine storm and other inflammatory mediators in the blood, seems promising in treating severely ill patients with coronavirus disease 2019.

Case presentation
This article presents three cases of Asian ethnicity of severely ill adult patients with coronavirus disease 2019 admitted to intensive care unit who were treated with CytoSorb therapy. All patients used single CytoSorb device. During their clinical course, all patients were prescribed tocilizumab (an interleukin-6 receptor blocker), antivirals, hydroxychloroquine, azithromycin, and other antibiotics and general antipyretic drugs. No vasopressor treatment was required. The patients’ average duration of stay in intensive care unit was 30 days; the average duration of stay in hospital was 31 days. All three patients showed significant improvement in biochemical parameters and clinical outcomes post CytoSorb therapy. C-reactive protein levels decreased by 91.5%, 97.4%, and 55.75 %, and mean arterial pressure improved by 18%, 23%, and 17 % in patient 1, 2, and 3, respectively, on day 7 post-therapy.

Conclusions
All three patients improved clinically and survived.
Personnel emotion recognition model for Internet of vehicles security monitoring in community public space
Authors: Fu Erkang , Li Xi , Yao Zhi , Ren Yuxin , Wu Yuanhao , Fan Qiqi 
Published: September 2021

AbstractIn recent years, the Internet of vehicles (IOV) with intelligent networked automobiles as terminal node has gradually become the development trend of automotive industry and research hot spot in related fields. This is due to its characteristics of intelligence, networking, low-carbon and energy saving. Real time emotion recognition for drivers and pedestrians in the community can be utilized to prevent fatigue driving and malicious collision, keep safety verification and pedestrian safety detection. This paper mainly studies the face emotion recognition model that can be utilized for IOV. Considering the fluctuation of image acquisition perspective and image quality in the application scene of IOV, the natural scene video similar to vehicle environment and its galvanic skin response (GSR) are utilized to make the testing set of emotion recognition. Then an expression recognition model combining codec and Support Vector Machine classifier is proposed. Finally, emotion recognition testing is completed on the basis of Algorithm 1. The matching accuracy between the emotion recognition model and GSR is 82.01%. In the process of model testing, 189 effective videos are involved and 155 are correctly identified.
Performance enhancement method for multiple license plate recognition in challenging environments
Authors: Khan Khurram , Imran Abid , Rehman Hafiz Zia Ur , Fazil Adnan , Zakwan Muhammad , Mahmood Zahid 
Published: September 2021

AbstractMultiple-license plate recognition is gaining popularity in the Intelligent Transport System (ITS) applications for security monitoring and surveillance. Advancements in acquisition devices have increased the availability of high definition (HD) images, which can capture images of multiple vehicles. Since license plate (LP) occupies a relatively small portion of an image, therefore, detection of LP in an image is considered a challenging task. Moreover, the overall performance deteriorates when the aforementioned factor combines with varying illumination conditions, such as night, dusk, and rainy. As it is difficult to locate a small object in an entire image, this paper proposes a two-step approach for plate localization in challenging conditions. In the first step, the Faster-Region-based Convolutional Neural Network algorithm (Faster R-CNN) is used to detect all the vehicles in an image, which results in scaled information to locate plates. In the second step, morphological operations are employed to reduce non-plate regions. Meanwhile, geometric properties are used to localize plates in the HSI color space. This approach increases accuracy and reduces processing time. For character recognition, the look-up table (LUT) classifier using adaptive boosting with modified census transform (MCT) as a feature extractor is used. Both proposed plate detection and character recognition methods have significantly outperformed conventional approaches in terms of precision and recall for multiple plate recognition.
Emergent heritage: the digital conservation of archaeological sites in reservoirs and the case of the Dolmen de Guadalperal (Spain)
Authors: Cerrillo-Cuenca Enrique , de Sanjosé Blasco José Juan , Bueno-Ramírez Primitiva , Pérez-Álvarez Juan Antonio , de Balbín Behrmann Rodrigo , Sánchez-Fernández Manuel 
Published: September 2021

Abstract
The dolmen of Guadalperal (Spain) became well known in 2019 when the waters of the reservoir in which it had long been submerged became so depleted as to leave it above water and highly visible. This gave rise to great media and social polemic. In this study, we deal with the ‘recovery’ of the dolmen using digital techniques, including a strategy of geometrical documentation of long, medium and short-range through the use of terrestrial laser scanning (TLS) and photogrammetry. The result is a set of products that trace the changes that have taken place in the monument since its excavation in 1925, the identification of conditions affecting it and the acquisition of new information on the decorated supports that formed part of the megalithic architecture. To do so, the time during which it was accessible (i.e., not underwater) was used to acquire the only heritage information currently available on the monument. This new information offers a complete assessment of a megalithic monument using a protocol that is exportable to other sites submerged in lakes or reservoirs.