bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Cross-Sectional Study of Obstetrical and Gynecological Parameters in Twins – A Potential Increase in Premature Rupture of Membranes and Pre-eclampsia in Twin Women
Authors: Keller Nathan , Kiley Kevin C. 
Published: September 2020

Abstract
Background

This cross-sectional study of 192 twins across a wide geographical area compared obstetrical and gynecological parameters between twins and the general population.
Methods

The study is a cross-sectional study. Gynecological variables included age of menarche, abnormal pap smears, birth control usage, endometriosis, fibroids, infertility, gynecological cancer, and osteoporosis. Obstetrical variables studied included pregnancy, ectopic pregnancies, hypertension, pre-eclampsia, gestational diabetes, and premature rupture of membranes (PROM). Chi Square and Fisher’s Exact tests were utilized to compare these binary variables between identical and fraternal twins. Finally, odds ratios were used to compare the rates of PROM, pre-eclampsia, hypertension, ectopic pregnancy, and gestational diabetes among twins compared to the general population using reputable literature sources.
Results

Identical twins reported the same age of menarche more frequently than their fraternal counterparts (p = 0.0021) with an odds ratio of 4.56 (95% CI = 1.62,12.83). There was also an increase in the odds of PROM 1.37 to 5.42 (95% CI = 0.95,1.96 and 4.21,6.98) and pre-eclampsia 1.17 to 3.16 (95% CI = 0.66,2.09 and 2.16,4.62) in our twin sample verse the general population. Finally, only 9.9% (18/184) reported knowledge of amnionicity and chorionicity.
Conclusions

Our findings suggest that further large scale research concerning PROM and pre-eclampsia in twin women may be warranted.
Analysis of Prenatal Diagnosis Results and Pregnancy Outcome of Non-invasive Prenatal Screening High-risk Fetuses
Authors: Luo Yan , Sun Yanmei , Tian Haishen , Lu Hezhen , Ma Lishuang , Li Yali , Zhang Yanshang , Yu Xiaoping , Gao Jian 
Published: September 2020

Abstract
BackgroundWith the development of whole-genome sequencing, small chromosomal deletions and duplications could be found by NIPT. This study is to evaluate the clinical significance of fetal chromosomal karyotype analysis and chromosomal microarray analysis (CMA) to clarify the clinical significance of 528 cases of high-throughput sequencing noninvasive prenatal screening suggesting high-risk cases. MethodsNon-invasive prenatal screening showed that the fetus 21, 18, 13, sex chromosomes, and other chromosomes are at high risk of aneuploidy and fetal chromosome copy number variations (CNVs) are at high risk, requiring prenatal diagnosis Pregnant women are the research objects. After obtaining informed consent, fetal cells were obtained by amniocentesis or umbilical vein puncture for chromosomal karyotype and CMA analysis. All cases of childbirth were followed up by telephone over a period of 1 year.Results Among 528 fetuses, 447 were at high risk of aneuploidy. The positive predictive value (PPV) for trisomy 21(T21), trisomy 18 (T18), trisomy 13 (T13), sex chromosome aneuploidies (SCAs), and other chromosome aneuploidy was 85.24%, 51.52%, 12.5%, 50.82%, and 5.88% respectively. Another 81 cases of non-invasive prenatal screening suggest CNVs High risk. The PPV for CNVs was 34.57% .Among them, CNVs has a clear pathogenic significance can reach 24.69% . Follow-up of childbirth cases: Of the 62 pregnant women diagnosed with fetal SCA, 13 chose to continue their pregnancy, and the overall continued pregnancy rate was 20.97% (13/62); CNVs has no clear significance/no disease reported in 8 cases, 1 case After being lost to follow-up, all 7 cases chose to continue their pregnancy. One of the children was not informed about the specific situation; one girl had six fingers on both hands, and the rest had no abnormal growth; the remaining five children developed normally. ConclusionThis study has obtained relatively reliable PPV data for NIPT screening for chromosomal aneuploidy, which provides a reliable basis for clinical genetic counseling and treatment; it is recommended to perform prenatal diagnosis and perform chromosomal nucleus when non-invasive and high-risk prompts suspicious chromosomal abnormalities (over/under/microdeletion/microduplication). Type and CMA inspection, so that the inspection is more comprehensive and not easy to miss the diagnosis.
Audiological Rehabilitation After Cochlear Implantation: A New Model Developed Based on the International Classification of Functioning, Disability and Health (ICF)
Authors: Lorens Artur , Mertens Griet , Kurz Anja 
Published: September 2020

Abstract
Background: There is a need for a more holistic approach to treating hearing impairment, as it affects many aspects of a person’s life, not just their hearing. This article describes how The International Classification of Functioning, Disability and Health (ICF), particularly the ICF core sets for hearing loss, can be used to plan and evaluate the audiological (re)habilitation of cochlear implant (CI) recipients. Using the ICF core sets should help clinicians better address not only hearing impairment but also its consequences.Methods: The opinions of experts were gathered on their clinical experience about the most relevant ICF categories and codes to describe audiological rehabilitation after cochlear implantation. For the relevant ICF categories, the most commonly used audiological assessment tools and methods were identified.Results: The most relevant codes for Body Functions and Structures, Activity, and Participation were identified. These include: structure of the inner ear (s260), auditory nerve (s260), brainstem (s1105), midbrain (s1101), diencephalon (s1102), and cortical lobe (s110); sound detection (b2300); sound discrimination (b2301); localization of sound source (b2302); lateralization of sound (b2303); speech discrimination (b2304); listening (d115); communicating with – receiving – spoken messages (d310); handling stress and other psychological demands (d240); using communication devices and techniques (d360); conversation (d350); family relationships (d760); school education (d820); remunerative employment (d850); and community life (d910). The appropriate questionnaires as an assessment tools were proposed.Conclusions: Using the ICF can help target the holistic (re)habilitation of CI recipients and reduce hearing loss-induced deficits in function, activity, and participation.
Evaluation of the Probiotic Potential of Weissella Confusa Isolated From Traditional Fermented Rice
Authors: Nath Soumitra , Roy Monisha , Sikidar Jibalok , Deb Bibhas 
Published: September 2020

Abstract
Background: Probiotic are microorganism that is good for health, especially for the digestive system and can be consumed through fermented foods or supplements. The study aims to identify potential probiotic bacteria from fermented rice sample that are commonly found in Cachar district of Assam, India.Methods: White rice sample of “Ranjit” variety was collected from the local market, cooked in the laboratory and soaked overnight in sterile water for microbial fermentation. Probiotic properties of isolates were tested, and was identified by biochemical tests and 16S rRNA sequencing. In-vitro tests were also performed to demonstrate their colonisation properties, haemolytic activity and antagonistic activity against other pathogens.Results: The predominant fermentative-bacteria was identified as Weissella confusa strain GCC_19R1 (GenBank: MN394112). The isolate showed significant growth in the presence of artificial gastric-juice, bile and pancreatin. A moderate percentage of hydrophobicity (35.8% for n-hexadecane and 32.56% for toluene) and autoaggregation (38.7%) was also recorded. The strain survived well at acidic pH, 12.5% NaCl, and able to ferment glucose. The strain fulfilled the safety criteria concerning haemolytic activity, inhibits the growth of other bacteria, and found to be resistant towards antibiotics that are commonly used for GI-tract infections.Conclusion: The present study reports the prevalence of W. confusa in fermented rice samples. The finding of also supports the indegenious knowledge of fermented products, and its nutritional health benefits.
Identification of Potential Indicators for Survival in Patients With Thyroid Cancer Based on Mrna Expression Levels of Family With Sequence Similarity 3 Members
Authors: Ma Yuting , Shi Junfeng , Liu Yongping , Pan Ruiyan , Qiu Hongyan , Han Fang , Hou Ningning , Sun Xiaodong 
Published: September 2020

Abstract
Background: Thyroid cancer (THCA) is a common head and neck malignancy. The family with sequence similarity 3 (FAM3) is a cytokine-like gene family with four members, which is presumed to participate in the development of many cancer types. However, the expression patterns of FAM3s in THCA and their prognostic values, have not yet been established. Methods: We investigated differential expressions of FAM3 mRNA and protein in THCA, then validated the findings for FAM3B by immunohistochemistry. We also investigated survival data with respect to FAM3 expression patterns in patients with THCA. FAM3s information regarding their relationships with clinical pathological parameters were obtained and FAM3 mutations were assessed. KEGG and GO pathway regarding FAM3C were obtained using online databases. To investigate potential correlations between FAM3s and immune cell infiltration, we investigated the roles of FAM3s in immune cells of patients with THCA. Results: The mRNA expression of FAM3C were significantly elevated in THCA tissues; high expression levels of FAM3C protein were also observed in THCA tissues. A significant association between the pathological stage and the expression of FAM3C was found in patients with THCA. Patients with THCA who had high mRNA expression levels of FAM3C exhibited significantly more favourable prognosis, compared with patients who had low mRNA expression levels of FAM3C. Conclusions: Overall, FAM3C may play vital roles in the pathogenesis and development of THCA, and these findings constitute novel insights for biomarkers of immunotherapeutic targeted agents and may aid in the identification of prognostic biomarkers for THCA.
A cross-national comparison of medicinal plants used by the Miao, Yi and Lisu ethnic groups in Yanbian, China
Authors: Wang Ke-ru , Nan Cuo , Ding Rong , Lin Jing , Hu Ding-jian , Zhong Shi-hong , Gu Rui 
Published: September 2020

Abstract
Background

The Miao, Yi and Lisu ethnic groups all have traditional medicinal knowledge, and the unique climate and topography of Yanbian County make it rich in medicinal plants. So the exchange, collision and integration of medical cultures of ethnic minorities in Yanbian County have research significance. The study compared and analyzed the similarities and differences in the traditional medicinal usage of the Miao, Yi and Lisu ethnic groups in Yanbian, to provide the basis for the traditional medicinal culture and characteristics of the three medical systems in southwest China.
Methods

36 sample plots were selected in this study and 5 sample quadrats were randomly set up in each plot to collect specimens. Identified the collected medicinal plant specimens, and sort out the catalog of medicinal plants of Miao medicine (MM), Yi medicine (YM) and Lisu medicine (LM) in Yanbian County. The catalog includes scientific name, family names, latin names, medicinal parts, and diseases treated, etc. The existing traditional doctors were interviewed to supplement the efficacy and usage of the medicinal plants in the catalog. Finally, the similarities and differences of the three medical systems were analyzed and sorted out the special medication in each ethnic group.
Results

Among the medicinal plants collected in the sample plot survey, 345 species of 299 genera and 109 families are used in the 3 medical systems. 102 species are shared-use in MM, YM and LM, among which Compositae (14 species, 14%), Labiatae (6 species, 6%), Polygonaceae (4 species, 4%) and Rosaceae (4 species, 4%) were the dominant families. The statistical data shows that the Jaccard similarity index (JI) of the MM and YM is the highest (47.6%), and the whole similarity percentage of the drug system is the highest (45.9%). A total of 18 special usages were used in MM, YM and LM in Yanbian.
Conclusions

The results show that a large number of shared-use medicinal plants in MM, YM and LM in Yanbian County. The reason may be the intersecting medicine collecting location, frequent market communications and exchanges, and the influence of Han medicine. The more similar geographic environment, vegetation types, lifestyles, and closer spatial distance have resulted in MM and YM in Yanbian County being more parallel than those of LM.
T cell anergy in COVID-19 reflects virus persistence and poor outcomes
Authors: Renner Kerstin , Müller Christine , Tiefenböck Charlotte , Salewski Jan-Niklas , Winter Frederike , Buchtler Simone , Malfertheiner Maximilian , Lubnow Matthias , Lunz Dirk , Graf Bernhard , Hitzenbichler Florian , Hanses Frank , Poeck Hendrik , Kreutz Marina , Orso Evelyn , Burkhardt Ralph , Niedermair Tanja , Brochhausen Christoph , Gessner Andre , Salzberger Bernd , Mack Matthias 
Published: September 2020

Abstract
Coronavirus disease 2019 (COVID-19) can lead to severe pneumonia and hyperinflammation. So far, insufficient or excessive T cell responses were described in patients. We applied novel approaches to analyze T cell reactivity and showed that T anergy is already present in non-ventilated COVID-19 patients, very pronounced in ventilated patients, strongly associated with virus persistence and reversible with clinical recovery. T cell activation was measured by downstream effects on responder cells like basophils, plasmacytoid dendritic cells, monocytes and neutrophils in whole blood and proved to be much more meaningful than classical readouts with PBMCs. Monocytes responded stronger in males than females and IL-2 partially reversed T cell anergy. Downstream markers of T cell anergy were also found in fresh blood samples of critically ill patients with severe T cell anergy. Based on our data we were able to develop a score to predict fatal outcomes and to identify patients that may benefit from strategies to overcome T cell anergy.
Altitude conditions seem to determine the evolution of COVID-19 in Brazil: a significance relationship with cases and deaths
Authors: Fernandes José Sebastião Cunha , Silva Ricardo Siqueira , Silva Alexandre Christófaro , Villela Daniel Campos , Mendonça Vanessa Amaral , Lacerda Ana Cristina Rodrigues 
Published: September 2020

Abstract
Background

COVID-19 is spreading rapidly in Brazil, a country of continental dimensions, but the incidence of the disease is showing to be very heterogeneous, affecting cities and regions differently. Thus, there is a gap regarding what factors would contribute to accentuate the differences in the incidence of COVID-19 among Brazilian cities. This work aimed to evaluate the effect of altitude on incidence of COVID-19 in Brazilian cities.
Methods

We analysed the relative incidence, relative death rate of COVID-19, and air relative humidity in all 154 cities in Brazil with a population above 200 thousand inhabitants, located between 5 and 1,135 m in altitude. Pearson's correlation analysis was performed to compare a relationship between altitude with relative incidence (RI) and relative death rate (RDR) and between air relative humidity (RH). Altitudes were classified into three classes (low class, up to 97 m; middle class, 97 m to 795 m; and upper class, 795 m to 1,135 m) for the RI, RDR and RH variables. To compare the three classes of altitude, analysis of variance (ANOVA) and Tukey test were used to compare media (p < 0.05).
Results

Our epidemiological analysis found that the IR, RDR and RH were higher in cities located in low (0 to 97 m a.s.l) compared to medium (98 to 790 m a.s.l) and high (791 to 1135 m a.s.l) cities altitudes. Furthermore, it has been shown that there is a negative correlation between the incidence of COVID-19 with altitude and a positive correlation with air relative humidity in the cities analysed.
Conclusion

Brazilian cities at lower altitudes and greater air relative humidity have higher relative incidence and relative deaths from COVID-19. Thus, higher altitude cities may be favourable to shelter people at risk. This study may be useful for understanding the behaviour of SARS-CoV2, and start point for future studies to establish causality of environmental conditions with SARS-CoV2 contributing to the implementation of measures to prevent and control the spread of COVID-19.
Towards a framework approach to integrating pathways for infection prevention and antibiotic stewardship in surgery: a qualitative study from India and South Africa
Authors: Singh Sanjeev , Mendelson Marc , Surendran Surya , Bonaconsa Candice , Mbamalu Oluchi , Nampoothiri Vrinda , Boutall Adam , Hampton Mark , Dhar Puneet , Pennel Tim , Tarrant Carolyn , Leather Andy , Holmes Alison , Charani Esmita 
Published: September 2020

Abstract
Background

The surgical pathway remains a hard to reach, critical target for antimicrobial stewardship (AMS) and infection prevention and control (IPC). We investigated the drivers for surgical AMS and IPC, across cardiovascular and thoracic surgery (CVTS) and gastrointestinal surgery teams in two academic hospitals in South Africa (SA) and India.
Materials and methods

An ethnographic observational study of IPC and AMS was conducted (July 2018–August 2019), with data gathered from 190 hours of non-participant observations (138 India, 60 SA); face-to-face interviews with patients (6 India, 7 South Africa), and healthcare professionals (HCPs) (44 India, 61 SA); and, in-depth patient case studies (4 India, 2 SA). A grounded theory approach aided by Nvivo 11 software, analyzed the emerging themes. An iterative and recursive process of moving between the coded data and the higher-level themes, ensured saturation of the themes. The multiple modes of enquiry enabled cross-validation and triangulation of findings.
Results

Across surgical pathways, multiple barriers exist impeding effective IPC and AMS practices. The existing, implicit roles of HCPs (including nurses, and senior surgeons) are overlooked as interventions target junior doctors, bypassing the opportunity for integrating care across the surgical team members. Critically, the ownership of decisions remains with the operating surgeons and entrenched hierarchies restrict the integration of other HCPs in IPC and AMS.
Conclusions

IPC and AMS are not integrated in surgery. Identifying the implicit existing HCPs roles in IPC and AMS is critical and will facilitate the development of effective and transparent processes across the surgical team for IPC and AMS. Developing a framework approach that includes nurse leadership, empowering pharmacists and engaging surgical leads is essential for integrated care.
Is metoclopramide beneficial for the post-pyloric placement of nasoenteric tubes? A systematic review and meta-analysis of randomized controlled trials
Authors: Ouyang Xin , Qu Rong , Hu Bei , Wang Yifan , Yao Fen , He Zhimei , Lv Bo , Sun Cheng , Deng Yiyu , Chen Chunbo 
Published: September 2020

Abstract
BackgroundMetoclopramide is frequently prescribed as an adjuvant for the post-pyloric placement of nasoenteric tubes (NETs). However, the efficacy and safety of metoclopramide remain controversial. The latest meta-analysis showed that metoclopramide was not beneficial in adults. Thus, this study aimed to reevaluate the effect of metoclopramide on the post-pyloric placement of NETs.MethodsA systematic search of PubMed, Embase, the Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure (CNKI), and Wanfang data was conducted up to August 2020 for randomized controlled trials (RCTs) comparing metoclopramide with placebo or no intervention. The effect sizes of eligible studies were pooled using the relative risk (RR) and 95% confidence interval (CI) in a random-effects model. Trial sequential analysis (TSA) was used for the primary outcomes (the success rate of the post-pyloric placement of NETs).ResultsSeven eligible RCTs that included 520 participants were identified. The results of the pooled effect sizes showed that metoclopramide significantly facilitated the post-pyloric placement of NETs (RR, 1.48; 95% CI, 1.11–1.97; P = 0.007; I2 = 37%). However, the risk of bias assessment and the TSA results indicated that the qualities of the RCTs and the sample sizes were insufficient to confirm the efficacy of metoclopramide. Further subgroup analysis revealed that successful post-pyloric placement was more pronounced in studies in which spiral NETs were employed (RR, 1.85; 95% CI, 1.41–2.43; P < 0.001; I2 = 0%). Additionally, a significant increase in the success rate was also observed for post-D1 (reaching the second portion of the duodenum or beyond), post-D2 (reaching the third portion of the duodenum or beyond), and post-D3 (reaching the fourth portion of the duodenum or beyond) placement of spiral NETs. Overall adverse events were minimal.ConclusionsThe evidence accumulated so far was not strong enough to demonstrate metoclopramide’s beneficial effects on the post-pyloric placement of NETs; however, it might be effective for spiral NETs. Further high-quality, large-sample RCTs are required to elucidate the effects of metoclopramide.Trial registrationPROSPERO CRD42019123424 (10 July 2019)
Management of Acute Clonidine Poisoning in Adults: The Role of Resin Hemoperfusion
Authors: Fang Shanshan , Han Bo , Liu Xiaoling , Mao Dan , Sun Chengwen , Chen Zhi , Wang Ruimiao , Xiong Xishan 
Published: September 2020

Abstract
Clonidine poisoning in adults is rare. An observational retrospective study including 102 adults with clonidine poisoning was conducted. 57 patients with relatively mild conditions were placed in the local emergency departments (EDs) for clinical observation, while the remaining 45 were transferred to the tertiary hospital for intensive treatment, of whom 9 were given supportive care only and 36 were given hemoperfusion (HP), as well as similar supportive treatment. The main symptoms of these cases were: sleepiness, dizziness, fatigue, headache, inarticulacy, tinnitus and dry mouth. Physical examination showed hypotension, bradycardia and shallow and slow breathing. Serum and urine clonidine concentrations were significantly elevated（24.4 ng/ml, 313.2 ng/ml, respectively）. All cases slowly returned to their baseline state over 48 to 96 hours, which is co-related with the drawn of serum clonidine level. HP showed more efficient in reducing the serum/urine clonidine level. Clonidine poisoning is a potentially serious condition, which involves multiple system injury, including persistent central nervous system depression, cardiovascular and inhalation inhibition, often requiring intensive treatment. Patients with mild presentations only needed to be monitored and treated with symptomatic support. Of critically ill patients, HP significantly reduced clonidine concentrations, which was effective and had few side effects.