bluuebunny/crossref_metadata_2025_split huggingface dataset:
Partial trisomy 4q and monosomy 5p inherited from a maternal translocationt(4;5)(q33;p15) in three adverse pregnancies
Authors: Zhang Jingbo , Zhang Bei , Liu Tong , Xie Huihui , Zhai Jingfang 
Published: June 2020

Abstract
Background：Carriers of balanced reciprocal chromosomal translocations are at known reproductive risk for offspring with unbalanced genotypes and resultantly abnormal phenotypes. Once fertilization of a balanced translocation gamete with a normal gamete, the partial monosomy or partial trisomy embryo will undergo abortion, fetal arrest or fetal malformations. We reported a woman with chromosomal balanced translocation who had two adverse pregnancies. Prenatal diagnosis was made for her third pregnancy to provide genetic counseling and guide her fertility. Case presentation：We presented a woman with chromosomal balanced translocation who had three adverse pregnancies. Routine G banding and CNV-seq were used to analyze the chromosome karyotypes and copy number variants of amniotic fluid cells and peripheral blood. The karyotype of the woman was 46,XX,t(4;5)(q33;p15). During her first pregnancy, odinopoeia was performed due to fetal edema and abdominal fluid. The umbilical cord tissue of the fetus was examined by CNV-seq. The results showed a genomic gain of 24.18 Mb at 4q32.3-q35.2 and a genomic deletion of 10.84 Mb at 5p15.2-p15.33 and 2.36 Mb at 15q11.1-q11.2. During her second pregnancy, she did not receive a prenatal diagnosis because a routine prenatal ultrasound examination found no abnormalities. In 2016, she gave birth to a boy.. The karyotype the of the boy was 46,XY,der(5)t(4;5)(q33;p15)mat. The results of CNV-seq showed a deletion of short arm of chromosome 5 capturing regions 5p15.2-p15.33, a copy gain of the distal region of chromosome 4 at segment 4q32.3q35.2, a duplication of chromosome 1 at segment 1q41q42.11 and a duplication of chromosome 17 at segment 17p12. During her third pregnancy, she underwent amniocentesis at 17 weeks of gestation. Chromosome karyotype hinted 46,XY,der(5)t(4;5)(q33;p15)mat. Results of CNV-seq showed a deletion of short arm (p) of chromosome 5 at the segment 5p15.2p15.33 and a duplication of the distal region of chromosome 4 at segment 4q32.3q35.2.Conclusions：Chromosomal abnormalities in three pregnancies were inherited from the mother. Preimplantation genetic diagnosis is recommended to prevent the birth of children with chromosomal abnormalities.
Comparison of whole-body vibration training, strength training and health education on physical function and neuromuscular function of individuals with knee osteoarthritis: a randomized clinical trial
Authors: Lai Zhangqi , Lee Seullee , Chen Yiyang , Wang Lin 
Published: June 2020

Abstract
Background Knee osteoarthritis (KOA) is one of the leading causes of global disability which causes knee pain, stiﬀness, and swelling. Impaired neuromuscular function contributes to the development and/or progression of KOA. As a new modality to treat KOA, whole-body vibration (WBV) training is considered to improve pain and physical function effectively. However, limited numbers of studies were designed to investigate the effect of WBV on neuromuscular function in KOA.Methods 81 eligible participants with KOA were randomly allocated to WBV, strength training (ST) and health education (HE) groups. Each group of participants was encouraged to perform the WBV training, similar strength training and health education program, respectively. These supervised interventions were performed three times per week for 8 consecutive weeks. Neuromuscular function was measured with isokinetic muscle strength and proprioception. Physical function was assessed with Timed Up and Go (TUG) and 6-min Walk Distance tests. Results Physical function and neuromuscular function did not show significant difference between three groups (p > 0.05). However, post-hoc test showed that isokinetic knee muscle strength of WBV group (peak torque of extensor at 180°/s, peak torque of flexors at 180°/s, peak work of extensor at 180°/s, and peak work of flexor at 90°/s, all p < 0.05) increased significantly compared with HE group. Similarly, compared with ST group, muscle strength of WBV group (peak torque of extensor at 180°/s and peak work of extensor at 180°/s, p < 0.05) improved significantly. Conclusion The current study showed that the advantage of WBV training on muscle strength gain in patients with KOA compared with similar strength training without vibration and health education.Trial registration It was registered at Chinese Clinical Trial Registry a priori as a clinical trial (ID: ChiCTR-IOR-16009234). Registered 21 September 2016.
Importance of lipid ratios for predicting intracranial atherosclerotic stenosis
Authors: Yang Wen-Song , Li Rui , Shen Yi-Qing , Wang Xing-Chen , Liu Qing-Jun , Wang Hai-Yang , Li Qi , Yao Guo-En , Xie Peng 
Published: June 2020

Abstract
Background: This study aims to investigate the association of lipid ratios with intracranial atherosclerotic stenosis (ICAS) in a Chinese population.Methods: This cross-sectional study included 658 consecutive patients with ischemic stroke. Intracranial and extracranial arteries were evaluated for atherosclerotic stenosis using digital subtraction angiography or computed tomography angiography. Lipid ratios [total cholesterol (TC)/high-density lipoprotein-cholesterol (HDL-C), triglycerides (TG)/HDL-C, low-density lipoprotein-cholesterol (LDL-C)/HDL-C, non-high-density lipoprotein-cholesterol (non-HDL-C)/HDL-C, remnant cholesterol (RC)/HDL-C, apolipoprotein B (apo B)/apolipoprotein A-I (apo A-I), and apo B/HDL-C] were calculated.Results: The TC/HDL-C, LDL-C/HDL-C, RC/HDL-C, non-HDL-C/HDL-C, apo B/HDL-C and apo B/apo A-I ratios were significantly associated with ICAS but not with extracranial atherosclerotic stenosis after adjustment for confounding factors. Receiver operating characteristic (ROC) curves analyses revealed that the apo B/apo A-I ratio had the largest area under the ROC curve (AUC) among lipid levels alone and for lipid ratios (AUC = 0.588). Lipid ratios had higher AUC values than those for lipid levels alone for identification of ICAS.Conclusion: The TC/HDL-C, LDL-C/HDL-C, RC/HDL-C, non-HDL-C/HDL-C apo B/HDL-C, and apo B/apo A-I ratios were significantly related to ICAS risk. Compared with the other variables tested, the apo B/apo A-I ratio appeared to be a better discriminator for identifying ICAS risk in stroke patients. Take home message: Variables that were significantly related to ICAS risk included the TC/HDL-C, LDL-C/HDL-C, RC/HDL-C, non-HDL-C/HDL-C, apo B/HDL-C, and apo B/apo A-I ratios. Among the variables tested, the apo B/apo A-I ratio showed the best performance in identifying ICAS risk in stroke patients. Besides, several gender differences were observed with regard to other lipid ratios.
Estimation of the Ideal Correction of Lumbar Lordosis to Prevent Reoperation for Symptomatic Adjacent Segment Disease After Lumbar Fusion in Older People
Authors: Wang Shan-Jin , Zhang Shu-Bao , Yi Yu-Yang , Xu Hao-Wei , Wu De-Sheng 
Published: June 2020

Abstract
Background Symptomatic adjacent segment disease (ASDis) is a major complication following spinal fusion. Sagittal spinopelvic imbalance may contribute to the development of ASDis. However, the exact ideal correction of LL is unknown for different ages of people to prevent ASDis. The purpose of this study was to estimate the ideal correction of lumbar lordosis (LL) required to prevent symptomatic ASDis requiring revision surgery in patients of various ages, and to determine the radiographic risk factors for ASDis.Methods 468 patients who underwent lumbar fusion between January 2014 and December 2016, were enrolled in the present study. The patients were classified into the ASDis and N-ASD group. These two matched groups were compared regarding surgery-related factors and radiographic features. Multivariate logistic regression analysis was used to evaluate the risk factors for ASDis.Results Sixty-two patients (13.25%) underwent reoperation for ASDis during a mean follow-up duration of 38.07 months. Receiver operating characteristic curve analysis showed that the postoperative LL - preoperative LL (△LL) cutoff value was 11.7°for the development of ASDis. Logistic regression analysis revealed that the risk factors for symptomatic ASDis were a smaller LL angle, △LL > 12°, and PI-LL > 10° (p < 0.05). For patients > 60 years, the incidence of ASDis was higher in patients with a LL correction of ≥ 10° and a lumbar-pelvic mismatch (PI-LL) of > 20°.Conclusions The significant predictors of the occurrence of ASD were a smaller LL angle, △LL > 12°, and PI-LL > 10°. However, in patients older than 60 years, the incidence of ASD after lumbar fusion was higher in those with a LL correction of ≥ 10° and PI-LL of > 20°. More attention should be paid to patient age and the angle of correction of LL before lumbar fusion.
Prospective evaluation of contrast-enhanced ultrasound of breast BI-RADS 3-5 lesions
Authors: Eva Janu , Lucie Krikavova , Jirina Little , Karel Dvorak , Dagmar Brancikova , Eva Jandakova , Tomas Pavlik , Petra Kovalcikova , Kazda Tomas , Vlastimil Valek 
Published: June 2020

Abstract
Background

To determine the benefit of contrast-enhanced ultrasound (CEUS) in the assessment of breast lesions.

Methods

A standardized contrast-enhanced ultrasound was performed in 230 breast lesions classified as BI-RADS category 3 to 5. All lesions were subjected to qualitative and quantitative analysis. MVI (MicroVascular Imaging) technique was used to derive qualitative analysis parameters; blood perfusion of the lesions was assessed (perfusion homogeneity, type of vascularization, enhancement degree). Quantitative analysis was conducted to estimate perfusion changes in the lesions within drawn regions of interest (ROI); parameters TTP (time to peak), PI (peak intensity), WIS (wash in slope), AUC (area under curve) were obtained from time intensity (TI) curves. Acquired data were statistically analyzed to assess the ability of each parameter to differentiate between malignant and benign lesions. The combination of parameters was also evaluated for the possibility of increasing the overall diagnostic accuracy. Biological nature of the lesions was verified by a pathologist. Benign lesions without histopathological verification (BI-RADS 3) were followed up for at least 24 months.

Results

Out of 230 lesions, 146 (64%) were benign, 67 (29%) were malignant, 17 (7%) lesions were eliminated. Malignant tumors showed statistically significantly lower TTP parameters (sensitivity 77.6%, specificity 52.7%) and higher WIS values (sensitivity 74.6%, specificity 66.4%) than benign tumors. Enhancement degree also proved to be statistically well discriminating as 55.2% of malignant lesions had a rich vascularity (sensitivity 89.6% and specificity 48.6%). The combination of quantitative analysis parameters (TTP, WIS) with enhancement degree did not result in higher accuracy in distinguishing between malignant and benign breast lesions.

Conclusions

We have demonstrated that contrast-enhanced breast ultrasound has the potential to distinguish between malignant and benign lesions. In particular, this method could help to differentiate lesions BI-RADS category 3 and 4 and thus reduce the number of core-cut biopsies performed in benign lesions. Qualitative analysis, despite its subjective element, appeared to be more beneficial. A combination of quantitative and qualitative analysis did not increase the predictive capability of CEUS.
Transmission characteristics of the COVID-19 outbreak in China: a study driven by data
Authors: Li Meili , Chen Pian , Yuan Qianqian , Song Baojun , Ma Junling 
Published: June 2020

Abstract
Background

The COVID-19 outbreak has been a serious public health threat worldwide. Individually documented case descriptions of COVID-19 are published by Chinese provinces (excluding Hubei). We use these descriptions to study the transmission characteristics in China, and how they are influenced by public awareness and control measures.
Methods

Dates for infection, symptom onset, quarantine, hospitalization and diagnosis, and sources of infection are tabulated from published cases descriptions. We use MCMC to estimate the exponential growth rate of cases infected in Hubei, and parametrize the distributions for the incubation period, and periods from symptom onset to hospitalization and diagnosis. Graph of infection is constructed and used to estimate the reproduction number in each generation.
Results

The median incubation period is 6.2 days overall, and 7.3% patients have an incubation period longer than the recommended 14-day quarantine period. The median period from symptom onset to hospitalization is 4.4 days before the lockdown of Wuhan city, and 2.1 days after the lockdown. The median period from symptom onset to diagnosis is 8.8 days before the lockdown, and 4.8 days after the lockdown. The number of cases in Hubei doubled every 3 days before the lockdown. In other provinces, reproduction number decreased from 1.51 in the first-generation patients to less than 0.21 in later generation patients.
Conclusions

We parametrized incubation period, and the periods from symptom onset to hospitalization and diagnosis. Some (possibly a majority of) patients were infected before the symptom onset of their sources of infection, causing a low success rate of official (not self) quarantines. Social distancing and self-quarantine greatly reduced the reproduction number, and shorted the periods from symptom onset to hospitalization and diagnosis.
Implementation of the POGIL-based flipped classroom learning: an approach to promote learning in emergency medicine
Authors: tang yishu , liu huaizheng , Zhou Kefu , zhang tianyi , Sun Chuanzheng 
Published: June 2020

Abstract
Background: As the Emergency medicine is a multidisciplinary discipline, the emergency medicine education is focuses on teaching students to think actively. The flipped classroom was widely used in various medicine teaching that can improve the efficacy of classroom learning. While the process-oriented guided-inquiry learning (POGIL), which be proved can promoting active learning and critical thinking.We assume that both two teaching methods may complement each other in emergency medicine education. Object: To evaluate the student’ learning effectiveness and acceptability of the process-oriented guided-inquiry learning (POGIL)-based flipped classroom model for teaching emergency medicine education. Methods: A total of 90 students majoring in clinical medicine at Xiangya School of Medicine, Central South University, were enrolled in this study. They were randomly divided into an experimental group and control group, with 45 students in each group. The experimental group adopted the POGIL-based flipped classroom model, and the control group adopted the traditional teaching model; teaching effectiveness was evaluated through tests, an operation exam and questionnaire surveys. Results: After the completion of the course, the scores of the two groups were compared. The theoretical and operational scores of the experimental group were higher than those of the control group, and the differences were statistically significant (P < 0.05). The learning interest, clinical thinking ability, and acceptance of the teaching model for the students in the experimental group were significantly higher than those for students in the control group, and the differences were statistically significant (P < 0.05). Conclusion: The POGIL-based flipped classroom model can significantly improve students' scores, students' acceptance of the teaching model, and teaching quality.
The constraints between amino acids influence the unequal distribution of codons and protein sequence evolution
Authors: Qian Yi , Zhang Rui , Jiang Xinglu , Wu Guoqiu 
Published: June 2020

Abstract
4 nucleotides(A, U, C, G) constitute 64 codons at free combination but 64 codons are unequally assigned to 21 items (20 amino acids plus one stop). About 500 amino acids are known but only 20 ones are selected to make up the proteins. However, the relationships between amino acid and codon and between 20 amino acids have been unclear. In this paper, we studied on the relationships between 20 amino acids in 33 species and found there were three constraints between 20 amino acids, such as the relatively stable mean carbon and hydrogen(C:H) ratios(0.50), similarity interactions between the constituent ratios of amino acids, and the frequency of amino acids according with Poisson distribution under a certain conditions. We demonstrated that the unequal distribution of 64 codons and the choice of amino acids in molecular evolution would be constrained to remain stable C:H ratios. The constituent ratios and frequency of 20 amino acids in a species or a protein are two determinants of protein sequence evolution, so this findings showed the constraints between 20 amino acids played an important role in protein sequence evolution.
Barriers and Facilitators to Colorectal Cancer Diagnosis in New Zealand: A Qualitative Study
Authors: Blackmore Tania , Norman Kimberley , Kidd Jacquie , Cassim Shemana , Chepulis Lynne , Keenan Rawiri , Firth Melissa , Jackson Christopher , Elwood Mark , Stokes Tim , Weller David , Emery Jon , Lawrenson Ross 
Published: June 2020

Abstract
Background
New Zealand (NZ) has high rates of colorectal cancer but low rates of early diagnosis. Due to a lack of understanding of the pre-diagnostic experience from the patient’s perspective, it is necessary to investigate potential patient and health system factors that contribute to longer diagnostic intervals. Previous qualitative studies have discussed delays using The Model of Pathways to Treatment, but this has not been explored in the NZ context. This study aimed to understand the patient experience and perception of their general practitioner (GP) through the diagnostic process in the Waikato region of NZ. In particular, we sought to investigate potential barriers and facilitators that contribute to longer diagnostic intervals.
Methods
Ethical approval for this study was granted by the New Zealand Health and Disability Ethics Committee. Twenty-eight participants, diagnosed with colorectal cancer, were interviewed about their experience. Semi-structured interviews were audio recorded, transcribed verbatim and analysed thematically using The Model of Pathways to Treatment framework (intervals: appraisal, help-seeking, diagnostic).
Results
Participant appraisal of symptoms was a barrier to prompt diagnosis, particularly if symptoms were normalised, intermittent, or isolated in occurrence. Successful self-management techniques also resulted in delayed help-seeking. However if symptoms worsened, disruption to work and daily routines were important facilitators to seeking a GP consultation. Participants positively appraised GPs if they showed good technical competence and were proactive in investigating symptoms. Negative GP appraisals were associated with a lack of physical examinations and misdiagnosis, and left participants feeling dehumanised during the diagnostic process. However high levels of GP interpersonal competence could override poor technical competence, resulting in an overall positive experience, even if the cancer was diagnosed at an advanced stage. Māori participants often appraised symptoms inclusive of their sociocultural environment and considered the impact of their symptoms in relation to family.
Conclusions
The findings of this study highlight the importance of tailored colorectal cancer symptom communication in health campaigns, and indicate the significance of the interpersonal competence aspect of GP-patient interactions. These findings suggest that interpersonal competence be overtly displayed in all GP interactions to ensure a higher likelihood of a positive experience for the patient.
Why do male students in higher education buy sex? A Phenomenological Exploration
Authors: Estifanos Nathan , Serbessa Mirgissa Kaba 
Published: June 2020

Abstract
Background

Epidemiological and behavioral studies have concentrated on female sex workers. There's a crucial ought to focus equivalent attention on the activities of male clients as has been directed towards female sex workers. In Ethiopia, where higher education students considered as the most at-risk population for human immune deficiency virus, the transmission of infection may occur within networks composed of female sexworkers, their clients and the other sexual partners of the latter. However, there is a huge gap in qualitative studieson the exploration of why higher education male students buy sex.
Objective

The purpose of this study was to explore why higher education male students buy sex.
Methods

A qualitative phenomenological approach was used. Semi-structured interviews wereconducted with 12 higher education male students who had a history of visiting female sex workers during their stay on campus.Inductive codingwas used to determine invariant constituents reduce constituents to sub-themes, and clustersub-themes into themes. Dependability and credibility were achieved through an audio recording, bracketing, and member checking.
Results

Through the use of thematic analysis two common themes and five sub-themes were identified from motives of male higher education students to buy sex.These themes are motives associated with desires including emotional and experiential; and motives associated with context including academic, time and money context, socio-environmental context and family, romantic partner and campus girl context.
Conclusions

In this study, Sexual need, sexual fantasies,experiential desire, Peer pressure, substance use, low academic result, availability of time and money, break up with a romantic partner and demanding nature of campus girls were the reasons reported by participants when they were asked about why they visited female sex worker. Therefore, addressing higher education male students’ motives related to their desire and context is vital.
Prototyping and Performance Evaluation of Household Cow Dung Gasifier Stove: Cooking and Environmental Performance in the Case of Ethiopia
Authors: Tadesse Adamu Sh. , Gabisa Elias , Mekonnen Basazzin A. 
Published: June 2020

Abstract
Biomass energy is the most important primary energy sources in Ethiopia, above 90% of primary energy comes from biomass.Cow dung is one of the widely consumed biomass as a source of energy in rural areas of Ethiopia in traditional and inefficient cook stoves. To this end, this piece of research work is aimed at designing, manufacturing and experimentally testing its environmental and energy performance compared to the traditional three-stone stove. In this study water boiling test and control cooking test was used to investigate the performance of stoves. The proposed gasifier stove shows a better performance than three stones stove when water-boiling test conducted in terms of cooking duration, specific fuel consumption, and pollutant gases emission. The experimental results revealed that gasifier stove has shown an increase of thermal efficiency by 26.6% and reduced PM2.5 and CO emission by 58.9% and 88.6% respectively as compared to the traditional three-stone cook stove.Furthermore, the gasifier stove has shown 64% fuel saving efficiency as compared to the three stones stove and 54% cooking time saving to cook the same amount and kind of meal. In every aspect of the measuring parameters whether the energy efficiency performance or environmental performance the designed gasifier stove performs better than the traditional three-stone cook stoves. Therefore, with a small and simple modification, the gasifier stove could be disseminated to the rural community of the region in collaboration with the regional bureau.