bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic Value of Pituitary Volume in Girls with Precocious Puberty
Authors: Wu Su , Yang Yan , Wang Yujiao , Liu Qianqi , Zhu Zi-yang , Gu Wei 
Published: August 2020

Abstract
Background: To date, the gonadotropin-releasing hormone (GnRH) stimulation test is still the gold standard for precocious puberty (PP) diagnosis. However, it has many disadvantages, including low sensitivity, high cost, and invasive operation. This study aims to evaluate whether magnetic resonance imaging (MRI)-derived variables, including pituitary volume (PV), could be used as diagnostic factors for PP in girls, providing a non-invasive diagnostic approach for PP.Methods: A total of 288 young female patients who presented to the Clinic of Pediatric Endocrinology for evaluation of PP from January 2015 to December 2017 were enrolled. The sample included 90 girls diagnosed with premature thelarche (PT), 133 girls determined as idiopathic central precocious puberty (ICPP), 35 early pubertal girls, and 30 normal girls. All patients received pituitary MRI examinations.Results: The largest PV and pituitary height were shown in the ICPP and pubertal groups, followed by the PT group. The receiver operating characteristic (ROC) curve analysis showed that PV is a predictive marker for ICPP, with a sensitivity of 54.10% and a specificity of 72.20% at the cutoff value of 196.01 mm3. By univariate analysis, PV was positively associated with peak luteinizing hormone (LH), LH/follicle-stimulating hormone (FSH), age, bone age, and body mass index (BMI) (all P < 0.05). However, bone age and peak LH were the only significant predictors of PV as demonstrated by the stepwise multivariate regression analysis (Model: PV = 9.431 * bone age + 1.230 * peak LH + 92.625 [P = 0.000, R2 = 0.159]).Conclusions: The PV in the ICPP group was significantly higher than in PT and control groups, but there was no reliable cutoff value to distinguish ICPP from PT. Pituitary MRI should be combined with clinical and laboratory tests to improve the diagnostic value of PV for PP.
Factors affecting postoperative mortality of patients with insufficient union following osteoporotic vertebral fractures and impact of preoperative serum albumin on mortality
Authors: Ohba Tetsuro , Yokomi Hiroshi MD , Koy Kensuke MD , Tanaka Nobuki , Oda Kotaro , H Hirotaka MD 
Published: August 2020

Abstract
Background: Numerous comparative studies of surgical procedures have focused on clinical and radiographical outcomes, as well as the effect of bone fragility on the outcome of spinal surgery; however, insights concerning a risk of mortality or morbidity have been limited. Additionally, the effect of surgical therapy on survival after vertebral compression fractures remains controversial. Our aim was to evaluate the preoperative factors that affected the long-term survival of patients who underwent spinal surgery for an insufficient union following osteoporotic vertebral fractures (OVF) and to determine postoperative mortality.Methods: We retrospectively reviewed the cases of 105 consecutive patients who underwent spinal surgery for OVF. Mortality was estimated using the Kaplan-Meier method and a log-rank test. The preoperative backgrounds of patients were analyzed to determine which risk factors led to death among the OVF cases. Kaplan-Meier curves were used to estimate survival based on preoperative albumin levels of £ 3.5 g/dL (hypoalbuminemia) versus > 3.5 mg/dL.Results: The mean follow-up time was 4.1 ±0.8 years. Two years after surgery, percentage of patients who had died was 15%. The VAS scores and modified Frankel classification were significantly improved one year after surgery. The ratio of male-to-female was significantly higher for patients with OVF who died than for those who were still alive. No significant difference in mortality was observed among surgical procedures for OVF. The univariate analysis showed that male gender, serum albumin <3.5g/dl, creatinine clearance<60mg/dl, and the American Society of Anesthesiologists classificat0ion ≥3 were significant risk factors for postoperative mortality. Multivariate analysis revealed that only serum albumin £3.5 g/dL was a significant risk factor for long-term postoperative mortality of patients with OVF.Conclusions: Preoperative hypoalbuminemia was associated with postoperative mortality following surgery for OVF.Level of Evidence: Level 3
District-level strategies to control the HIV epidemic in Zimbabwe: a practical example of precision public health
Authors: Makurumidze Richard , Decroo Tom , Lynen Lutgarde , Chinwadzimba Zororo Kudzaishe , Damme Wim Van , Hakim James , Rusakaniko Simbarashe 
Published: August 2020

Abstract
Objective We conducted a descriptive cross-sectional study using survey and programme data to assess district-level performance along the HIV care cascade (HIV testing target achievement, linkage to ART and ART coverage) in order to formulate district-specific recommendations, taking into consideration prevalence and yield of testing.Results Data from 60 districts were analysed. Forty-eight districts (80.0%) surpassed 90% of their 2018 HIV testing targets. Linkage to ART was less than 90% in 40 districts (83.3%). Thirty districts (50.0%) had ART coverage above 90%. Of the 30 districts with suboptimal (<90%) ART coverage, 18 districts had achieved high HIV testing target but with suboptimal linkage to ART, 6 had achieved high HIV testing targets and high linkage to ART, 4 had both suboptimal HIV testing target achievement and linkage to ART and 2 had suboptimal HIV testing target achievement and high linkage to ART. Priority should be given to districts with suboptimal ART coverage. Remediation strategies should be tailored to address the poorly performing stage of the cascade in each of the districts.
Study of hospitalization and mortality in Korean diabetic patients using the diabetes complications severity index
Authors: Yoo Hyunju , Choo Eunjung , Lee Sukhyang 
Published: August 2020

Abstract
Background The prevalence of type 2 diabetes mellitus (T2DM) is expected to increase from 7.7% in 2017 to 8.4% in 2045 worldwide. Diabetes complications contribute to morbidity and mortality. To evaluate whether the diabetes complications severity index (DCSI) was associated with increased risks of mortality and hospitalization. Methods A retrospective cohort study was conducted using the National Health Insurance Database (NHID) sample cohort of 1,102,047 patients (2002–2015) in Korea. Diabetes complications were evaluated at 2 years after the initial diagnosis and during the subsequent follow-up period (mean duration 6.56±2.81 years). The type and severity of complications were evaluated on the basis of the International Classification of Disease Ninth (ICD-9) codes used in DCSI with 7 categories and 55 subcategories of complications. The Cox proportional hazard and Poisson regression models were used to evaluate the mortality and hospitalization rates. The incidence and relative risk of diabetes complications as well as the risk of mortality and hospitalization were the main outcome measures. Results A total of 27,871 patients were finally included and grouped by the number of complications present at two years. Four hundred ninety patients (5.37%) died without complications, 659 (7.31%) died with one complication and 1,153 (11.85 %) died with two or more complications. As DCSI at index date increased, the risk of additional new diabetes complications increased by 26% [relative risk (RR) 1.26, 95% CI 1.25–1.27]. The risks of mortality and hospitalization were linearly related to DCSI [hazard ratio 1.13 (95% CI 1.11–1.16), relative risk 1.04 (95% CI 1.03–1.06)]. Conclusions Patients with higher incidence and severity of diabetes complications have increased risks of mortality and hospitalization.
Assessing intake and consumption level of spices among urban and rural households of Ludhiana district of Punjab, India
Authors: Bhathal Simranpreet Kaur , Kaur Harpreet , Bains Kiran , Mahal Amrit Kaur 
Published: August 2020

Abstract
Background: Spices are the esoteric food adjuncts that are used for enhancing the sensory quality of the food in Punjabi diets and add many health benefits. Estimating the intake of spices at the individual level is a challenging task as they are consumed in very small quantities as compared to other foods. The present study aimed to assess the intake and spices consumption level of spices among urban and rural households.Methods: A study was carried out among 100 households each from urban and rural areas from Ludhiana district of Punjab, India to collect the information regarding frequency of spice usage and portion sizes using a questionnaire. The information pertaining to sociodemographic characteristics of female respondents from urban and rural households was also collected. The commonly used 25 spices in Punjabi diets were selected to assess their dietary intake at the individual level among households. Results: Spice consumption frequency was more in urban households in comparison to rural households. The maximum mean consumption frequency score among urban and rural households was observed for red chilli powder (5.00) and turmeric powder (5.00). Maximum percentage (76 and 72%) of urban and rural households preferred to use the unroasted form of spices, respectively.The highest mean intake and range was observed for red chilli powder (3.19 g with range 0.35-5.23 g) among urban women and (2.41 g with range 0.25-3.75 g) for rural women. Spice intake from individual dishes showed the maximum number of portion sizes for red chilli powder that were from vegetable>dhal>curry preparations among urban and dhal>vegetable>curry preparation among rural households. Average amount of spices consumed by urban adult women was 10.04 g per day which was higher as compared to spices consumed by rural adult women per day (7.68 g).Conclusions: The study concluded that the urban households showed higher consumption of spices as compared to rural households thus assessing the quantifying intake of spices. Urban adult women consumed more spices per day as compared to rural women. Therefore, more encouragement for increased use of spices is required to reap various health benefits of spices in combating metabolic disorders.
Triglyceride Glucose Index for the Detection of Asymptomatic Coronary Artery Stenosis in Patients With Type 2 Diabetes
Authors: Thai Pham Viet , Tien Hoang Anh , Minh Huynh Van , Valensi Paul 
Published: August 2020

Abstract
Background: Triglyceride Glucose (TyG) index has been associated with an increased risk in cardiovascular events. Silent coronary disease is common in patients with type 2 diabetes. In Vietnam, a low-middle income country, the burden of cardiovascular disease is growing simultaneously with the epidemiologic transition. Our aim was to assess the prevalence of coronary stenoses (CS) in patients with type 2 diabetes and no history or symptom of cardiovascular disease and to investigate the association between TyG index and cardiovascular risk factors and both the presence and severity of CS. Futhermore, we assessed the value of TyG index in predicting subclinical CS. Methods: This was a cross-sectional observational study. We recruited 166 patients at Ninh Thuan General Hospital, Vietnam. TyG index and HOMA-IR were calculated, and a coronary computed tomography angiography (CCTA) was performed.Results: The population was classified according to tertiles of TyG index. The highest TyG values were associated with higher BMI, waist circumference, total cholesterol, LDL-cholesterol, triglycerides, plasma glucose, HbA1c levels and HOMA-IR, lower HDL-cholesterol, a higher incidence of metabolic syndrome and less frequent physical activity (p<0.05 to <0.0001). TyG index correlated with logHOMA-IR (p<0.0001). CS ≥50% were present in 60 participants and 32 had coronary artery stenosis ≥70%. TyG index and HOMA-IR were significantly higher in patients with CS ≥70%. The number of narrowed coronary arteries and the degree of stenosis were associated with higher TyG index levels (p=0.04 and <0.005 respectively). A TyG index ≥ 10 was significantly associated with an increased risk of multiple coronary artery disease and of more severe CS. After adjusting for confounding factors, including logHOMA-IR, these risks remained mostly significant. A TyG index threshold at 10 resulted in 57% sensitivity and 75% specificity for predicting the presence of CS ≥ 70%. In subgroup analysis TyG index ≥ 10 was associated with an increased risk in CS ≥ 70% in patients treated with statin or antiplatelet therapy.Conclusion: More than one third of asymptomatic patients with type 2 diabetes had significant CS on CCTA. TyG index may be considered as a marker for insulin resistance and increased TyG index could identify patients with high risk of coronary artery stenoses and is associated with the number and the severity of artery stenoses.
Ancestral origin, antigenic resemblance and epidemiological insights of novel coronavirus (SARS-CoV-2): Global burden and Bangladesh perspective
Authors: Uddin Md Bashir , Hasan Mahmudul , Harun-Al-Rashid Ahmed , Ahsan Md. Irtija , Imran Md. Abdus Shukur , Ahmed Syed Sayeem Uddin 
Published: August 2020

Abstract
Recently a new coronavirus strain, COVID-19 has emerged in Wuhan City, China which cause disease and in many cases deaths to humans. Considering its severity a number of works are working on it and full genomic sequences has already released in the last few weeks to understand the evolutionary origin and molecular characteristics of this virus. Based on currently available genomic information a phylogenetic tree was constructed from four types of representative viral proteins (Spike, Membrane, Envelope and Nucleoproetin) of COVID-19, HCoV-229E, HCoV-OC43, SARS-CoV, HCoV-NL63, HKU1, MERS-CoV, HKU4, HKU5 and BufCoV-HKU26 clearly demonstrated that the ancestral origin and distant evolutionary relation of newly epidemic novel coronavirus (COVID-19). It had been found that COVID-19 was evolutionary related to SARS-CoV. It was also found that COVID-19 proteins were almost more than ninety (90%) similar and identical with SARS-CoV proteins. The cross-checked conservancy analysis of COVID-19 antigenic epitopes showed significant conservancy with SARS-CoV proteins. VaxiJen server reveal almost 100% immunogenic potential of four viral proteins with COVID-19. In this article, we present an effort on molecular evolutionary analysis, temperature comparison and compile and analyze epidemiological outbreak information on the 2019 novel coronavirus based on the several open datasets on COVID-19 (SARS-COV-2) and possible threat to Bangladesh.Authors Md Bashir Uddin and Mahmudul Hasan contributed equally to this work
A geospatial analysis of two-hour surgical access to district hospitals in South Africa
Authors: Chu Kathryn , Dell Angela J , Moultrie Harry , Day Candy , Naidoo Megan , Straten Stephanie van , Rayne Sarah 
Published: August 2020

Abstract
Background: In a robust health care system, at least 80% of a country’s population should be able to access a district hospital that provides surgical care within two hours. The objective was to identify the proportion of the population living within two hours of a district hospital with surgical capacity in South Africa. Methods: All government hospitals in the country were identified. Surgical district hospitals were defined as district hospitals with a surgical provider, a functional operating theatre, and the provision of at least one caesarean section annually. The proportion of the population within two-hour access was estimated using service area methods. Results: Ninety-eight percent of the population had two-hour access to any government hospital in South Africa. One hundred and thirty-eight of 240 (58%) district hospitals had surgical capacity and 86% of the population had two-hour access to these facilities. Conclusion: Improving equitable surgical access is urgently needed in sub-Saharan Africa. This study demonstrated that in South Africa, just over half of district hospitals had surgical capacity but more than 80% of the population had two-hour access to these facilities. Strengthening district hospital surgical capacity is an international mandate and needed to improve access.
Influence of culture conditions on the production of extracellular polymeric substances (EPS) by Arthrospira platensis
Authors: Silva Mariana Barbalho , Azero Edwin G. , Teixeira Cláudia M. L. L. , Andrade Cristina T. 
Published: August 2020

Abstract
Arthrospira platensis is a cyanobacterium that is of great biotechnological interest, particularly for the food industry, as it possesses a high content of proteins, pigments, lipids and carbohydrates. Cyanobacteria produce extracellular polymeric substances (EPS), which are co-products of secondary metabolism that present thickening or gelling properties. A 3-level factorial design was used to study the combined effect of different nitrate concentrations and photon flux density (PFD) values to evaluate the biomass and EPS production of A. platensis. The best result in terms of biomass production was obtained under condition 6 (2 g.L-1 NaNO3 and 600 μE.m-2.s-1) yielding a concentration of 1.292 g.L-1. However, condition 1 (0.25 g.L-1 NaNO3 and 200 μE.m-2.s-1) produced the greatest EPS yield (111 mg.g-1), followed by condition 9 (2 g.L-1 NaNO3 and 1000 μE.m-2.s-1). FTIR analyses of EPS samples indicated the presence of carboxylate and sulfate functional groups, and rheological studies of the EPS at 5 and 10 g.L-1 revealed a dilute solution behavior.
A new diagnostic work-up for defining anemia etiologies: a cohort study in patients ≥ 50 years in general practices
Authors: Schop Annemarie , Stouten K. , Riedl J.A. , Houten R.J. van , Leening M.J.G. , Rosmalen J. van , Bindels P.J.E. , Levin M-D. 
Published: August 2020

Abstract
Background.
To study etiologies of anemia using an extensive laboratory analysis in general practices.
Method.
An extensive laboratory analysis was performed in blood of newly diagnosed anemia patients aged ≥ 50 years from the general population in the city of Dordrecht area, the Netherlands. Eight laboratory-orientated etiologies of anemia were defined. Patients were assigned one or more of these etiologies on the basis of their test results.

Results.
Blood of 4152 patients (median age 75 years; 49% male) was analyzed. The anemia etiology was unclear in 20%; a single etiology was established in 59%; and multiple etiologies in 22% of the patients. The most common etiologies were anemia of chronic disease (ACD) (54.5%), iron deficiency anemia (IDA) (19.1%) and renal anemia (13.8%). The most common single etiologies were IDA (82%) and ACD (68%), while the multiple etiologies most commonly included folic acid deficiency (94%) and suspected bone marrow disease (88%). Older age was associated with a lower incidence of IDA and a higher incidence of renal anemia. Mild anemia was more often associated with ACD and uncertain anemia, while severe anemia was mainly seen in patients with IDA.

Conclusion.
Extensive laboratory analysis in anemic patients from the general population helped clarify the etiology of anemia and revealed many various combinations of etiologies in a significant proportion of patients. Age, sex and the severity of anemia are predictive of the underlying etiology.
Early L-T4 intervention improves fetal heart development in pregnant rats with subclinical hypothyroidism rats by activating BMP4/Smad4 signaling pathway
Authors: Xue D , Sun JL , Yang J 
Published: August 2020

Abstract
Background: It is unclear whether the offspring of subclinical hypothyroidism (SCH) pregnant rats have abnormal cardiac development, and whether early intervention with L-T4 can improve the abnormality of these offspring. Therefore, the aim of this study was to investigate the effect of early L-T4 intervention on the heart development of offspring of SCH pregnant rats and its possible molecular mechanism. Methods: Eighty female Wistar rats were randomly divided into Sham group (placebo control), SCH group, LT4-E10 group (L-T4 treatment started on the 10th day of gestation), and LT4-E13 group (L-T4 treatment started on the 13th day of gestation). Each group was further divided into E16, E18, P5 (postnatal day 5 rats), and P10 (postnatal day 10 rats) subgroups. The levels of serum TT4 and TSH, the ratio of heart weight to body weight of offspring rats, the expression of metabolic enzymes, and the histopathology of cardiomyocytes were determined. To elucidate the effects of L-T4 on cardiac development of offspring of SCH pregnant rats, the expression levels of GATA4, Nkx2-5 and proteins involved in BMP4/Smad4 signaling pathway were detected by immunohistochemistry, real time quantitative polymerase chain reaction and Western blotting to elucidate the molecular mechanism of L-T4 regulating the heart development of the offspring of SCH pregnant rats. Results: Compared with Sham group, serum TSH was significantly increased in SCH pregnant rats. Moreover, early L-T4 intervention significantly reduced the levels of serum TSH. Compared with the offspring in the SCH group, early L-T4 intervention significantly increased the heart weight, heart weight to body weight ratio, the activities of succinate dehydrogenase (SDH), Na + /K + -ATPase and Ca 2+ -ATPase, but reduced myocardial cell shrinkage and nuclear staining, hyperemia/congestion and vacuolar degeneration. In addition, early L-T4 intervention not only significantly increased the mRNA and protein expression of Gata4 and Nkx2-5, but also increased the protein expression involved in BMP4/Smad4 signal pathway in myocardium of the offspring of SCH pregnant rats. Conclusions : Early L-T4 intervention can regulate the cardiac development of the offspring of SCH pregnant rats by activating BMP4/Smad4 signaling pathway and increasing the expression of Gata4 and Nkx2-5 proteins.