bluuebunny/crossref_metadata_2025_split huggingface dataset:
Socio-economic and geographical inequalities in adolescent fertility rate in Ghana, 1993–2014
Authors: Ahinkorah Bright Opoku , Budu Eugene , Duah Henry Ofori , Okyere Joshua , Seidu Abdul-Aziz 
Published: July 2021

Abstract
Background
Despite public health interventions to control adolescent fertility, it remains high in sub-Saharan Africa. Ghana is one of the countries in sub-Saharan Africa with the highest adolescent fertility rates. We examined the trends and socio-economic and geographical patterns of disparities in adolescent fertility in Ghana from 1993 to 2014.

Methods
Using the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software, data from the 1993–2014 Ghana Demographic and Health surveys were analyzed. First, we disaggregated adolescent fertility rates (AFR) by four equity stratifiers: wealth index, education, residence and region. Second, we measured the inequality through summary measures, namely Difference (D), Population Attributable Risk (PAR), Ratio (R) and Population Attributable Fraction (PAF). A 95 % confidence interval was constructed for point estimates to measure statistical significance.

Results
We observed substantial absolute and relative wealth-driven inequality in AFR (PAR=-47.18, 95 % CI; -49.24, -45.13) and (PAF= -64.39, 95 % CI; -67.19, -61.59) respectively in favour of the economically advantaged subpopulations. We found significant absolute (D = 69.56, 95 % CI; 33.85, 105.27) and relative (R = 3.67, 95 % CI; 0.95, 6.39) education-based inequality in AFR, with higher burden of AFR among disadvantaged subpopulations (no formal education). The Ratio measure (R = 2.00, 95 % CI; 1.53, 2.47) indicates huge relative pro-urban disparities in AFR with over time increasing pattern. Our results also show absolute (D, PAR) and relative (R, PAF) inequality in AFR across subnational region, between 2003 and 2014. For example, in the 2014 survey, the PAR measure (D=-28.22, 95 % CI; -30.58, -25.86) and the PAF measure (PAF=-38.51, 95 % CI; -41.73, -35.29) indicate substantial absolute and relative regional inequality.

Conclusions
This study has indicated the existence of inequality in adolescent fertility rate in Ghana, with higher ferlitiy rates among adolescent girls who are poor, uneducated, rural residents and those living in regions such as Northern, Brong Ahafo, and Central region, with increasing disparity over the time period of the study. There is the need for policy interventions that target adolescent girls residing in the rural areas and those in the low socioeconomic subgroups to enable the country to avert the high maternal/newborn morbidity and mortality usually associated with adolescent childbearing.
Dietary oregano essential oil supplementation improves intestinal functions and alters gut microbiota in late-phase laying hens
Authors: Feng Jia , Lu Mingyuan , Wang Jing , Zhang Haijun , Qiu Kai , Qi Guanghai , Wu Shugeng 
Published: July 2021

Abstract
Background
Dietary essential oil (EO) supplementation can exert favorable effects on gut health in broilers. However, it is unknown whether EO could improve intestinal functions, consequently beneficial for egg performance and quality in late-phase laying hens. This study was aimed to investigate the potential effects of EO on production performance, egg quality, intestinal health and ileal microbiota of hens in the late phase of production. A total of 288 60-week-old Hy-line Brown laying hens were randomly divided into 4 groups and fed a basal diet (control) or basal diets supplemented with oregano EO at 100, 200 and 400 mg/kg (EO100, EO200 and EO400).

Results
Dietary EO supplementation resulted in a quadratic decrease (P < 0.05) in feed conversion ratio with lower (P < 0.05) feed conversion ratio in EO200 group than the control during weeks 9–12 and 1–12 of the trial. Compared to the control, EO addition resulted in higher (P < 0.05) eggshell thickness at the end of week. 4, 8 and 12 and higher (P < 0.05) chymotrypsin activity. There was a quadratic elevation (P < 0.05) in ileal chymotrypsin and lipase activity, along with a linear increase in villus height to crypt depth ratio. Quadratic declines (P < 0.05) in mRNA expression of IL-1β, TNF-α, IFN-γ and TLR-4, concurrent with a linear and quadratic increase (P < 0.05) in ZO-1 expression were identified in the ileum with EO addition. These favorable effects were maximized at medium dosage (200 mg/kg) of EO addition and intestinal microbial composition in the control and EO200 groups were assessed. Dietary EO addition increased (P < 0.05) the abundances of Burkholderiales, Actinobacteria, Bifidobacteriales, Enterococcaceae and Bacillaceae, whereas decreased Shigella abundance in the ileum.

Conclusions
Dietary EO addition could enhance digestive enzyme activity, improve gut morphology, epithelial barrier functions and modulate mucosal immune status by altering microbial composition, thus favoring feed efficiency and eggshell quality of late-phase laying hens.
Recalling of multiple grasping methods from an object image with a convolutional neural network
Authors: Sanada Makoto , Matsuo Tadashi , Shimada Nobutaka , Shirai Yoshiaki 
Published: July 2021

AbstractIn this study, a method for a robot to recall multiple grasping methods for a given object is proposed. The aim of this study was for robots to learn grasping methods for new objects by observing the grasping activities of humans in daily life without special instructions. For this setting, only one grasping motion was observed for an object at a time, and it was never known whether other grasping methods were possible for the object, although supervised learning generally requires all possible answers for each training input. The proposed method gives a solution for that learning situations by employing a convolutional neural network with automatic clustering of the observed grasping method. In the proposed method, the grasping methods are clustered during the process of learning of the grasping position. The method first recalls grasping positions and the network estimates the multi-channel heatmap such that each channel heatmap indicates one grasping position, then checks the graspability for each estimated position. Finally, the method recalls the hand shapes based on the estimated grasping position and the object’s shape. This paper describes the results of recalling multiple grasping methods and demonstrates the effectiveness of the proposed method.
Deployment of workforce in global health: what should be the priorities for China?
Authors: Ma Xuejiao , Ding Wei , Qian Yingjun , Lu Shenning , Wang Bei , Xu Qiuli , Wang Duoquan , Guan Yayi , Xiao Ning , Zhou Xiaonong 
Published: July 2021

Abstract
Background
China has increasingly emerged as an important player in global health. However, compared to developed countries, China still lacks a sufficient health workforce for global health engagement with the necessary competencies required. The world has recognized that to solve global health issues, the role of China needs to be strengthened. The priorities for the deployment of the Chinese workforce in global health remain unclear. This study aims to identify the priorities of the deployment of Chinese global health workforce by exploring the core competencies for Chinese global health workforce, factors influencing the deployment and the approach of deployment.

Methods
Quantitative descriptive statistical analysis was applied to analyze the quantitative data. A total of 148 key respondents from 10 provinces in China conducting global health projects over the last 3 years were selected as the study subjects. A structured questionnaire was developed to collect the data on four aspects, including general information, core competencies, factors influencing deployment, and mode of deployment. The questionnaire was distributed to the respondents through an online survey. All original data were exported to Microsoft Excel 2010 to calculate the frequencies and percentages of each option. A descriptive analysis was carried out of the priorities of deployment of the Chinese global health workforce.

Results
More than half of the respondents (51.4%, 76/148) regarded “communication” as the most important competency of the Chinese global health workforce, while a large proportion of participants from Chinese embassies (50.0%, 6/12) and international organizations (75.0%, 12/16) believed that “professional skills” were paramount. In addition, 58.1% (86/148) of the participants agreed that incentive factors (salary, professional position, etc.) were the main factors that influenced deployment, whereas 75% (12/16) of participants from international organizations emphasized “security” as the most important determinant. In addition, 60.8% (90/148) of the participants thought that the deployment of staff should be based on the needs of the global health project implementation.

Conclusions
This study highlights the deployment priorities of the Chinese global health workforce, including strengthening communication and professional skills, focusing on personal security and incentives, and catering to the project implementation. This study also highlights the importance of Chinese agencies in developing global health mindsets through global health practices and proactive integration within the global community.
Patient-proxy agreement on change in acute stroke patient-reported outcome measures: a prospective study
Authors: Lapin Brittany R. , Thompson Nicolas R. , Schuster Andrew , Katzan Irene L. 
Published: July 2021

Abstract
Objectives
Research has indicated proxies overestimate symptoms on patients’ behalves, however it is unclear whether patients and proxies agree on meaningful change across domains over time. The objective of this study is to assess patient-proxy agreement over time, as well as agreement on identification of meaningful change, across 10 health domains in patients who underwent acute rehabilitation following stroke.

Methods
Stroke patients were recruited from an ambulatory clinic or inpatient rehabilitation unit, and were included in the study if they were undergoing rehabilitation. At baseline and again after 30 days, patients and their proxies completed PROMIS Global Health and eight domain-specific PROMIS short forms. Reliability of patient-proxy assessments at baseline, follow-up, and the change in T-score was evaluated for each domain using intra-class correlation coefficients (ICC(2,1)). Agreement on meaningful improvement or worsening, defined as 5+ T-score points, was compared using percent exact agreement.

Results
Forty-one patient-proxy dyads were included in the study. Proxies generally reported worse symptoms and functioning compared to patients at both baseline and follow-up, and reported less change than patients. ICCs for baseline and change were primarily poor to moderate (range: 0.06 (for depression change) to 0.67 (for physical function baseline)), and were better at follow-up (range: 0.42 (for anxiety) to 0.84 (for physical function)). Percent exact agreement between indicating meaningful improvement versus no improvement ranged from 58.5–75.6%. Only a small proportion indicated meaningful worsening.

Conclusions
Patient-proxy agreement across 10 domains of health was better following completion of rehabilitation compared to baseline or change. Overall change was minimal but the majority of patient-proxy dyads agreed on meaningful change. Our study provides important insight for clinicians and researchers when interpreting change scores over time for questionnaires completed by both patients and proxies.
Early CT features of COVID-19 pneumonia, association with patients’ age and duration of presenting complaint
Authors: EL Kady Reem M. , Hassan Hosam A. , Daqqaq Tareef S. , Makboul Rania , Ibrahim Hanan Mosleh 
Published: July 2021

Abstract
Background
Coronavirus disease (COVID-19) is a respiratory syndrome with a variable degree of severity. Imaging is a vital component of disease monitoring and follow-up in coronavirus pulmonary syndromes. The study of temporal changes of CT findings of COVID-19 pneumonia can help in better understanding of disease pathogenesis and prediction of disease prognosis. In this study, we aim to determine the typical and atypical CT imaging features of COVID-19 and discuss the association of typical CT imaging features with the duration of the presenting complaint and patients’ age.

Results
The lesions showed unilateral distribution in 20% of cases and bilateral distribution in 80% of cases. The lesions involved the lower lung lobes in 30% of cases and showed diffuse involvement in 58.2% of cases. The lesions showed peripheral distribution in 74.5% of cases. The most common pattern was multifocal ground glass opacity found in 72.7% of cases. Atypical features like cavitation and pleural effusion can occur early in the disease course. There was significant association between increased number of the lesions, bilaterality, diffuse pattern of lung involvement and older age group (≥ 50 years old) and increased duration of presenting complaint (≥ 4 days). There was significant association between crazy-paving pattern and increased duration of presenting complaint. No significant association could be detected between any CT pattern and increased patient age.

Conclusion
The most common CT feature of COVID-19 was multifocal ground glass opacity. Atypical features like cavitation and pleural effusion can occur early in the course of the disease. Our cases showed more extensive lesions with bilateral and diffuse patterns of distribution in the older age group and with increased duration of presenting complaint. There was a significant association between crazy-paving pattern and increased duration of presenting complaint. No significant association could be detected between any CT pattern and increased patient age.
Zoledronic Acid vs Placebo in Pediatric Glucocorticoid-Induced Osteoporosis: A Randomized, Double-Blind, Phase 3 Trial
Authors: Ward Leanne M , Choudhury Anup , Alos Nathalie , Cabral David A , Rodd Celia , Sbrocchi Anne Marie , Taback Shayne , Padidela Raja , Shaw Nick J , Hosszu Eva , Kostik Mikhail , Alexeeva Ekaterina , Thandrayen Kebashni , Shenouda Nazih , Jaremko Jacob L , Sunkara Gangadhar , Sayyed Sarfaraz , Aftring R Paul , Munns Craig F 
Published: July 2021

Abstract

Context
Glucocorticoids (GCs) prescribed for chronic pediatric illnesses are associated with osteoporotic fractures.

Objective
This study aims to determine the efficacy and safety of intravenous (IV) zoledronic acid (ZA) compared with placebo to treat pediatric GC-induced osteoporosis (GIO).

Methods
Children aged 5 to 17 years with GIO were enrolled in this multinational, randomized, double-blind, placebo-controlled phase 3 trial (ClinicalTrials.gov NCT 00799266). Eligible children were randomly assigned 1:1 to 6 monthly IV ZA 0.05 mg/kg or IV placebo. The primary end point was the change in lumbar spine bone mineral density z score (LSBMDZ) from baseline to month 12. Incident fractures and safety were assessed.

Results
Thirty-four children were enrolled (mean age 12.6 ± 3.4 years [18 on ZA, 16 on placebo]), all with low-trauma vertebral fractures (VFs). LSBMDZ increased from −2.13 ± 0.79 to −1.49 ± 1.05 on ZA, compared with −2.38 ± 0.90 to −2.27 ± 1.03 on placebo (least squares means difference 0.41 [95% CI, 0.02-0.81; P = .04]); when corrected for height z score, the least squares means difference in LBMDZ was 0.75 [95% CI, 0.27-1.22; P = .004]. Two children on placebo had new low-trauma VF vs none on ZA. Adverse events (AEs) were reported in 15 of 18 children (83%) on ZA, and in 12 of 16 (75%) on placebo, most frequently within 10 days after the first infusion. There were no deaths or treatment discontinuations due to treatment-emergent AEs.

Conclusion
LSBMDZ increased significantly on ZA compared with placebo over 1 year in children with GIO. Most AEs occurred after the first infusion.
A systematic review of the evidence of outdoor air pollution on asthma hospital visits in children and adolescents in South Asia – a call for data
Authors: Malamardi Sowmya , Lambert Katrina A. , Batra Mehak , Tham Rachel , Padukudru Anand Mahesh , Erbas Bircan 
Published: July 2021

Background: Outdoor air pollution and childhood asthma are increasing problems in South Asian countries. However, little is known about the associations between levels of air pollution and severe childhood asthma requiring hospital treatment in these regions. Methods: We undertook a systematic review to assess the evidence between outdoor air pollution exposure and childhood and adolescent asthma hospitalization in South Asia. MEDLINE, Web of Science, Google Scholar, CINAHL, Embase, Scopus, ProQuest Central databases were searched for peer-reviewed papers, and examination of reference lists was conducted for additional studies. We identified all the literature published in English up to January 2021 for the study population comprised of children aged less than 19 years. The search strategy was designed to identify all the studies and screen them as per the inclusion criteria. The method of qualitative synthesis using the standard tool determined the comprehensiveness of the assessment of bias. Results: Of the original 367 studies screened three studies were ultimately included from India, Pakistan and Sri Lanka and a narrative synthesis was conducted. Although studies reported adverse effects of outdoor pollution on asthma hospitalizations, limitations in exposure assessments, varying definitions of asthma hospitalizations and limited data analysis were identified. Conclusions: There is currently limited evidence that can provide meaningful risk estimates of the impact of outdoor air pollution on asthma hospitalizations during childhood and adolescence. Studies with comparable outcome definitions, appropriate exposure assessments and study designs are needed to inform future public and environmental health policy. PROSPERO registration: CRD42020156714 (28/04/2020)
Implementation of Environmental Approach to Professional Self-Determination of Russian Schoolchildren
Authors: Nechaev Mikhail , Frolova Svetlana 
Published: July 2021

The school should prepare a graduate who is able to successfully socialize and be in demand and competitive. That is why the problem of professional self-determination and choice of future profession by students is particularly acute.
Training of professional personnel of the XXI century should be carried out in educational institutions with pre-professional training, which is the basis for obtaining quality professional education in the near future. A specially organized environment is needed for the pre-professional training of schoolchildren. That is why the authors turned to the problem of formation of the environment of professional self-determination in Russian schools.
The study described the environment of professional self-determination on the basis of early career guidance and pre-professional training of students, which included the following blocks: resources, activities, results.
The results obtained in this study can be useful for creating an environment of professional self-determination, early career guidance and pre-professional training of students in educational institutions, which will ensure the emergence of a graduate of a «new type» – a young man with the ability to consciously choose a professional path in unity with professional mobility.
Millimeter-long metamaterial surface-emitting antenna in the silicon photonics platform
Authors: Ginel-Moreno Pablo , Sánchez-Postigo Alejandro , de-Oliva-Rubio José , Hadij-ElHouati Abdelfettah , Ye Winnie N. , Wangüemert-Pérez J. Gonzalo , Molina-Fernández Íñigo , Schmid Jens H. , Cheben Pavel , Ortega-Moñux Alejandro 
Published: July 2021

Integrated optical antennas are key components for on-chip light detection and ranging technology (LIDAR). In order to achieve a highly collimated far field with reduced beam divergence, antenna lengths on the order of several millimeters are required. In the high-index contrast silicon photonics platform, achieving such long antennas typically demands weakly modulated gratings with lithographic minimum feature sizes below 10 nm. Here, we experimentally demonstrate a new, to the best of our knowledge, strategy to make long antennas in silicon waveguides using a metamaterial subwavelength grating (SWG) waveguide core loaded with a lateral periodic array of radiative elements. The mode field confinement is controlled by the SWG duty cycle, and the delocalized propagating mode overlaps with the periodic perturbations. With this arrangement, weak antenna radiation strength can be achieved while maintaining a minimum feature size as large as 80 nm. Using this strategy, we experimentally demonstrate a 2-millimeter-long, single-etched subwavelength-engineered optical antenna on a conventional 220 nm SOI platform, presenting a measured far-field beam divergence of 0.1° and a wavelength scanning sensitivity of 0.13°/nm.
Ultraviolet disinfection of Schistosoma mansoni cercariae in water
Authors: Hazell Lucinda , Allan Fiona , Emery Aidan M. , Templeton Michael R. 
Published: July 2021

Background
Schistosomiasis is a parasitic disease that is transmitted by skin contact with waterborne schistosome cercariae. Mass drug administration with praziquantel is an effective control method, but it cannot prevent reinfection if contact with cercariae infested water continues. Providing safe water for contact activities such as laundry and bathing can help to reduce transmission. In this study we examine the direct effect of UV light on Schistosoma mansoni cercariae using ultraviolet light-emitting diodes (UV LEDs) and a low-pressure (LP) mercury arc discharge lamp.

Methodology
S. mansoni cercariae were exposed to UV light at four peak wavelengths: 255 nm, 265 nm, 285 nm (UV LEDs), and 253.7 nm (LP lamp) using bench scale collimated beam apparatus. The UV fluence ranged from 0–300 mJ/cm2 at each wavelength. Cercariae were studied under a stereo-microscope at 0, 60, and 180 minutes post-exposure and the viability of cercariae was determined by assessing their motility and morphology.

Conclusion
Very high UV fluences were required to kill S. mansoni cercariae, when compared to most other waterborne pathogens. At 265 nm a fluence of 247 mJ/cm2 (95% confidence interval (CI): 234–261 mJ/cm2) was required to achieve a 1-log10 reduction at 0 minutes post-exposure. Cercariae were visibly damaged at lower fluences, and the log reduction increased with time post-exposure at all wavelengths. Fluences of 127 mJ/cm2 (95% CI: 111–146 mJ/cm2) and 99 mJ/cm2 (95% CI: 85–113 mJ/cm2) were required to achieve a 1-log10 reduction at 60 and 180 minutes post-exposure at 265 nm. At 0 minutes post-exposure 285 nm was slightly less effective, but there was no statistical difference between 265 nm and 285 nm after 60 minutes. The least effective wavelengths were 255 nm and 253.7 nm. Due to the high fluences required, UV disinfection is unlikely to be an energy- or cost-efficient water treatment method against schistosome cercariae when compared to other methods such as chlorination, unless it can be demonstrated that UV-damaged cercariae are non-infective using alternative assay methods or there are improvements in UV LED technology.