bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute Disseminated Encephal Omyelitis (ADEM) After Pneumococcal Meningitis In A Child
Authors: FOIADELLI THOMAS , TRABATTI CHIARA , BASSANESE FRANCESCO , LANDI ENRICO , LICARI AMELIA , ORSINI ALESSANDRO , LUZZI SABINO , MARSEGLIA GIAN LUIGI , SAVASTA SALVATORE 
Published: June 2020

Abstract
Background: Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disorder of the central nervous system (CNS), whose pathogenesis is still debated. It occurs more frequently in children, and the first neurological symptoms usually appear between 2 and 4 weeks after a trigger event, such as an infection or vaccination. Several viral agents have been related to the development of ADEM, while bacteria and parasites are less frequently involved. Severe Streptococcus pneumoniae infection has been rarely described as a trigger for CNS demyelination in particularly predisposed subjects.Case presentation: A 10 year old girl was evaluated for headache, fever and vomit. CSF analysis revealed pleocytosis and presence of S. pneumoniae antigen, and proper antibiotic therapy for bacterial meningitis was started, with rapid improvement. A breach in the right frontal bone, due to a car accident occurring the previous year, was considered the gateway for pneumococcal infection. Three days after admission, the girl developed drowsiness, altered speech and left hemiparesis. Brain MRI showed multiple T2-hyperintense bilateral lesions in the supratentorial white matter, and ADEM was diagnosed. Considering the underlying bacterial meningitis, intravenous immunoglobulins were preferred to steroid therapy, and the patient progressively recovered. However, due to recurrence of encephalopathic symptoms after 11 days, high-dose intravenous steroid therapy was performed. The neurological outcome was favourable, with complete regression of the white matter lesions after 4 months and absence of relapses over a follow-up period of 2 years.Conclusions: Occurrence of ADEM following pneumococcal meningitis is rare, and very few cases have been described in children. It should be suspected in case of persistence, recurrence or onset of new symptoms despite adequate antimicrobial treatment, relying on brain MRI for a thorough differential diagnosis. High level of surveillance is mandatory in patients with predisposing factors to invasive pneumococcal disease. In some cases, acute demyelination can occur few days after the onset of meningitis; pathogenetic mechanisms are not yet fully clarified and the choice of the correct therapeutic approach can be challenging.
Comparison of Glycated Albumin, Hemoglobin Alc and Admission Blood Glucoseforpredictionof in-hospital Major Adverse Cardiac Events: a Retrospective Study
Authors: Sun Lin , Yuan Haitao 
Published: June 2020

Abstract
Background: Hyperglycemia is an independent predictor of major adverse cardiovascular events (MACEs) in patients with acute coronary syndrome (ACS) in 30 days.The purpose of this study is to evaluate the prognostic roles of different glycemic markers for in-hospital MACEs in acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI), including hemoglobin A1c (HbA1c) and glycated albumin (GA) and admission blood glucose (ABG).Methods: We conducted a retrospective study with 200 MI patientswho undergone PCI during the hospitalization period. We collected the clinical data and divided all patients into groups based on MACEs.T test and Chi-Square (Fisher) test were conducted to examine the difference between the two groups. Univariate and Multivariate Logistic Analysis and receptor operating curve(ROC) were performed to investigate the prognostic role of each glycemic markers in AMI patients with PCI.Patients were regrouped based on ROC curve and cutoff levels. The Cox regression analysis, Kaplan Meier method and Log rank test was performed for MACEs cumulative events.Results: Among the 200 patients, 18 patients developed MACE. Patients in MACE group had a higherdiastolic blood pressure (DBP) (p=0.019), high-sensitivity troponin T (HS-TnT) peak (p=0.011), CKMB peak (p=0.026),myoglobin (MYO) peak (p=0.006), estimated glomerular filtration rate (eGFR) (p=0.005), low-density lipoprotein cholesterol (LDL-c) (p=0.027),GA(p=0.001) and HbA1c (p=0.010). There were more smokers (p=0.017), diabetic patients (p<0.001) and patients with hypertension(p=0.009) in MACE group. Univariate and Multivariate logistic analysis showed GA (p=0.029) and HbA1c (p=0.048) were independent risk factors of MACEs. ROC curve showed GA had a larger area under the curve (AUC) as prognostic marker of in-hospital MACEs (0.743; 95%confidenceinterval[CI], 0.578-0.907; p=0.001) than HbA1c (0.689; 95%CI, 0.530-0.849; p=0.008) and ABG (0.593; 95%CI, 0.441-0.745; p=0.192).Kaplan Meier curves showed that patients with higher levels of GA (p=0.001), HbA1c (p<0.001) and ABG (p=0.008)had worse clinical events (p=0.001).Univariate and multivariate cox regression analysis presented GA has significant predictive role for MACEs.Conclusion: Among ABG, GA and HbA1c, elevated GA were significant to predict the risk of in-hospital MACEs in AMI patients who undergone PCI during the hospitalization period.
Overexpression of Nitric Oxide and Inducible Nitric Oxide Synthase in Mucous Membrane of the Maxillary Sinus Fungus Ball
Authors: Li Hang-jin , Guo Yan , Yu Bo , Zhang Ling-yan , Zhang Wei , Wang Jizhe , Qu Hui 
Published: June 2020

Abstract
Objective: We aimed to explore the expression and interplay of NO and iNOS to elucidate their roles in human maxillary sinus mucosa with maxillary sinus fungus ball (MSFB) and chronic rhinosinusitis (CRS).Methods: Fifty-one patients with MSFB, CRS and simple maxillary sinus cyst were included in this study. The NO content of the mucosa of each group was detected by Nitric acid reductase method. The expression of iNOS was tested by immunohistochemistry and Western blott. Spearman correlation analysis was used to analyze the correlation between the expression of iNOS and the occurrence of MSFB and CRS.Results: The results showed that NO and iNOS were highly expressed in the maxillary sinus mucosa of MSFB group, which were significantly different from CRS and control group (P<0.01). The expressions of NO and iNOS in the samples of CRS group were higher than that of the control group (P<0.05). Moreover, iNOS was widely presented in the cytoplasm of sinus mucosa epithelium and inflammatory cells in the maxillary sinus mucosa of MSFB patients. Furthermore, Spearman correlation coefficient indicated that the expression of iNOS was positively correlated with the incidence of MSFB (r=0.6395, P<0.05).Conclusion: NO and iNOS are overexpressed in the maxillary sinus mucosa of MSFB and CRS patients, and the increase in the MSFB patients was better than the CRS. The expressions of NO, iNOS were also correlated with the incidence of MSFB. We thus provide a new indicator to assist the diagnosis of MSFB and its distinction from CRS.
Environmental factors associated with diarrhoea among under-five children attending at Muhimbili National Hospital, Tanzania: a descriptive cross sectional study
Authors: Mathias Victor Aidan , Mkalagale Asumin Abdul , Mtshengu Margareth Thulisile 
Published: June 2020

Abstract
Background: Generally, diarrhea is still a second major reason of death and illness in children below the age of five years. It holds breathes of around half a million under five children’s every year and causes million more to be admitted. Every year diarrhea kills around 525000 children of under five years.Although few study have been done in Tanzania to determine factors associated with diarrhea among under five children, but environment factors have not yet well addressed. Therefore, this study seeks to address environmental factors associated with diarrhoea among under-five children attending at Muhimbili National Hospital, in Tanzania. Methods: A quantitative descriptive cross sectional study design of 100 simple randomly participants were selected. Questionnaires were used to collect data form key informants who were mothers/ carers with a child of under-five suffering from diarrhoea admitted at Muhimbili National Hospital, Tanzania. Data were analysed using SPSS. Statistical tests used were mean, median, proportions and chi square. Environmental risk factors associated with diarrhoea were determined with a p value of less than 0.05. Ethical approval and permission to collect data were obtained from relevant authorities.Results: Unsuitable infrastructure for grey water disposal, improper hand washing before feeding the baby and hand washing without using clean water and soap had strongly association with the occurrence of diarrhoea in under-five children attending at Muhimbili National Hospital (MNH) with P-value of 0.00, 0.00, and 0.01 respectively.Conclusion: Childhood diarrhoea is contributed by various environmental risk factors including unimproved sanitation, lack of hand washing facilities and poor knowledge among caregivers. This calls for the importance of providing health education to the caregivers on the cause, prevention and treatment of diarrhoea among under-five children.
Hsa-circ-0001860 promotes Smad7 to enhance MPA resistance in endometrial cancer via miR-520h
Authors: Yuan Shuang , Zheng Panchan , Zeng Judan , Sun Xiao , Wang Lihua 
Published: June 2020

Abstract
Background Medroxyprogesterone acetate (MPA) is one of the most commonly prescribed progestin for the treatment of endometrial cancer (EC). Despite initial benefits, many patients ultimately develop progesterone resistance. Circular RNA (circRNA) is a kind of noncoding RNA, contributing greatly to the development of human tumor. However, the role of circular RNA in MPA resistance is unknown. Methods We explored the expression profile of circRNAs in Ishikawa cells treated with (ISK/MPA) or without MPA (ISK) by RNA sequencing, and identified a key circRNA hsa_circ_0001860. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to verify its expression in MPA-resistant cell lines and tissues. CCK8, Transwell and flow cytometry were used to evaluate the functional roles of hsa_circ_0001860 in MPA resistance. The interaction between hsa_circ_0001860 and miR-520h was confirmed by bioinformatics analysis and luciferase reporter assay. Results The expression of hsa_circ_0001860 was significantly downregulated in MPA-resistant cell lines and tissues, and negatively correlated with lymph node metastasis and histological grade of EC. Functional analysis showed that hsa_circ_0001860 knockdown by shRNA promoted the proliferation, migration and invasion and inhibited the apoptosis of Ishikawa cells treated with MPA. Mechanistically, hsa_circ_0001860 promoted Smad7 expression by sponging miR-520h. Conclusion Hsa_circ_0001860 plays an important role in the development of MPA resistance in EC through miR-520h / Smad7 axis, and it could be targeted to reverse the MPA resistance in endometrial cancer.
Urban–rural disparities in healthcare financing: An analysis under China’s unified residents’ health insurance scheme
Authors: Zhou Guoliang , Xiao Jian , Chen Mingsheng , Si Lei 
Published: June 2020

Abstract
Background: Few empirical studies have explored disparities in healthcare financing between urban and rural areas after China’s integration of health insurance schemes for residents. This study characterizes and compares disparities in healthcare financing distribution between urban and rural areas in China. Methods: Data were collected from 3918 individuals in 1800 urban households and 2609 individuals in 1200 rural households in 2018. We conducted tests of dominance on concentration curves of healthcare payments between urban and rural areas to compare urban–rural disparities in healthcare financing. Results: Disparities were found in healthcare financing equity of direct taxes, the Urban–Rural Residents’ Basic Medical Insurance (URRBMI), and out-of-pocket payments between urban and rural areas. Conclusions: Government subsidies on URRBMI need to be increasingly allocated to residents, especially in rural areas, providing sustainable pooled funding and continuation of URRBMI.
The Accuracy of Individualized Three Dimensional-printing Template Assisted I125 Radioactive Seed Implantation for Recurrent head and Neck Cancer
Authors: Qiu Bin , Jiang Yuliang , Ji Zhe , Sun Haitao , Fan Jinghong , Li Weiyan , Shao Yuxia , Jiang Ping , Wang Junjie 
Published: June 2020

Abstract
Background:Individualized threedimensional-printing template(3D-PT) is developed to facilitate I125radioactive seed implantation (RSI) for recurrent head and neck cancer, while most of the previous studies were focused on the efficacy and safety profiles, study on the accuracy of I125 RSI is lacking. Therefore, the aim of this study is to evaluate the accuracy involvingneedle puncture and dosimetry of individualized 3D-printing template (3D-PT) assisted I125 radioactive seed implantation (RSI) for head and neck cancer.Materials and Methods: From February 2017 to January 2020, clinical data of 41 patients (mean age, 58.5 ± 16.1 years; 28 males) with recurrent primary (48.8%)/secondary (51.2%) head and neck cancer underwent individualized 3D-PT assisted I125 RSI under CT guidance in our institute were retrospectively reviewed.Results:A total of 430 [mean, 10.5 (range 3–17) per patient] needles were inserted. Technical success rate was 100% without major complication. The mean entrance deviation was 0.090 cm (95% Confidence Interval, 0.081–0.098), whichwas significantly larger in patients with primary cancer than patients with secondary cancer (0.107 ± 0.012 vs. 0.072 ± 0.012 cm, p ＜ 0.001).The mean intraoperative depth and angular of the needle were consistent with planned depth and angular (6.23 ± 0.24 vs. 6.21 ± 0.24 cm, p = 0.903; 83.14 ± 3.64 vs. 83.09 ± 3.66 degrees, p = 0.985, respectively). The mean deviation between planned and intraoperative depth and angular of the needle were 0.168 ± 0.024 cm and 1.56 ± 0.14 degrees, respectively, without significant difference involving cancer type and implantation site (p = 0.065 and 0.092, respectively). The post-plan dosimetry parameters, including D90, D100, V100, V150, V200, conformity index, external index, and homogeneity index, were all well coordinate with planned dosimetry without significant deference (all p ＞ 0.05).Conclusions:Individualized 3D-PT assisted I125 RSI may be accurate with consistent planed and post-plan dosimetry for patients with recurrent head and neck cancer, further prospective study is warranted.
Hub Genes of Stroke Identified by Weighted Gene Co-expression Network Analysis
Authors: Li Junhong , Zhai Yang , Wu Peng , Hu Yueqiang , Chen Wei , Zheng Jinghui , Tang Nong 
Published: June 2020

Abstract
BACKGROUD: Microarray-based gene expression profiling is widely used in biomedical research. Weighted gene co-expression network analysis (WGCNA) links microarray data directly to clinical traits and identifies rules for predicting pathological stage and prognosis of disease.WGCNA is useful in understandingmany biological processes. Stroke is a common disease worldwide, however, molecular mechanisms of its pathogenesis are largely unknown. The aim of this study was to construct gene co-expression networks for identification of key modules and hub genes associated with stroke pathogenesis.METHODS: Gene microarray expression profiles of stroke samples were retrieved from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were screened by the limma package in R software. WGCNA was used to construct free-scale gene co-expression networks to explore the associations between gene sets and clinical features, and to identify key modules and hub genes. Subsequently, functional enrichment analyses were performed. Further, receiver operating characteristic (ROC) curve analysis was carried out to validate expression of hub genes and literature validation was performed as well.RESULTS: A total of 11,747 most variant genes were used for co-expression network construction. Pink and yellow modules were significantly correlated to stroke pathogenesis. Functional enrichment analysis showed that the pink module was mainly involved in regulation of neuron regeneration, and repair of DNA damage.On the other hand, yellow module was mainly enriched in ion transport system dysfunction which was correlated with neuron death. A total of eight hub genes (PRR11, NEDD9, Notch2, RUNX1-IT1, ANP32A-IT1, ASTN2, SAMHD1 and STIM1) were identified and validated at transcriptional levels and through existing literature.CONCLUSION: The eight hub genes (PRR11, NEDD9, Notch2, RUNX1-IT1, ANP32A-IT1, ASTN2, SAMHD1 and STIM1) identified in the study are potentialbiomarkers and therapeutic targets for effective diagnosis and treatment of stroke.
Pleural effusion as the initial manifestation of metastatic melanoma: a case report and literature review
Authors: Yu LiHua , Quan Duoduo , Qiu Zhangwei , Xu Hui , He Jianbo , Dai Yuanrong 
Published: June 2020

Abstract
Background: Malignant melanoma (MM) is a highly invasive form of skin cancer with poor prognosis. Pleural metastatic melanoma is rare, with only a few reported cases.Case presentation: A 47-year-old woman with a medical history of right heel melanoma was diagnosed with left-sided pleural effusion, with pleural thickening and calcified mediastinal lymph nodes, using chest computed tomography (CT). A video-assisted thoracoscopic biopsy was performed which revealed numerous pink lumps arising from the parietal pleura and viscera along the diaphragmatic surface. The pathological diagnosis was pleural metastatic melanoma and the tumor cells were immunocytochemically positive for S100, SOX10, and Melan-A.Conclusions: The clinical manifestations of metastatic pleural melanoma are nonspecific. Pleural effusion cytology combined with thoracoscopy is an effective diagnostic method. The presence of melanocytes has improved the diagnosis of this condition.
A Study of the Spatial Network Structure of the Health Economy in China: Regional Health Inequality and Patient Mobility
Authors: Fu Liping , Kaibo Xu , Feng Lu , Lu Liang , Zhengmin Wang 
Published: June 2020

Abstract
Background: The distribution of medical resources in China is seriously imbalanced due to imbalanced economic development in the country. To meet the challenges presented by increasing demand and unevenness in medical resources, the primary goal of health system reform is to eliminate spatial disproportion. Against this background, this study aims to assess the distribution characteristics of regional medical resources and the effects of regional imbalances.Methods: Data for this study were drawn from the China Health Statistical Yearbooks and China Statistical Books . The gravitational value of China’s health spatial network was calculated to establish a network of gravitational relationships. The social network analysis method is used for centrality analysis and spillover effect analysis. Based on the gravitational value, we used indicators for visits, health expenditure, GDP and geographical distance, as well as an illustrative index for the population, bed utilization, and burden of consultations per day. Results: A gravity correlation matrix was constructed among provinces by calculating the gravitational value, indicating the spatial relationships of different provinces in the health economic network. Economically developed provinces, such as Shanghai and Jiangsu, are at the centre of the health economic network (centrality degree=93.333). These provinces also play a strong intermediary role in the network and have connections with other provinces. In the CONCOR analysis, 31 provinces are divided into four blocks. In the traditional meaning analysis, the gap between eastern and western China is still obvious. In comparing the northern and southern regions, this study finds that the concentration of medical resources in northern provinces seems to be higher. The spillover effect of the blocks indicates provinces with medical resource centres have beneficial effects, while provinces with insufficient resources have obvious spillover effects.Conclusion: There is a significant gap in the geographical distribution of medical resources, and the health economic spatial network structure needs to be improved. Most medical resources are concentrated in economically developed provinces, and these provinces’ positions in the health economic spatial network are becoming more centralized. By contrast, economically underdeveloped regions are at the edge of the network, causing patients to move to provinces with medical resource centres. There are health risks of the increasing pressure to seek medical treatment in developed provinces with abundant medical resources.
Thermoelectric Study of La2Ti2-xNbxO7 (0 ≤ x ≤ 0.25) Ceramics
Authors: Iyasara Adindu Cyril , Idu Felix U 
Published: June 2020

Abstract
La2Ti2 − xNbxO7 (x = 0.00, 0.05, 0.10, 0.15, 0.20, 0.25) powders were synthesised via solid state reaction method, followed by sintering at 1673 K in a reducing atmosphere of 5% H2/N2 gas. The crystal structure, microstructure and thermoelectric (TE) properties of the pure and Nb-doped La2Ti2O7 ceramics were investigated. All compositions were single phase with porous microstructures consistent with their low experimental densities. Thermoelectric results of Nb-doped compositions showed improved properties in comparison to pure La2Ti2O7, suggesting that cation doping has the potential to improve the thermoelectric properties. Generally, the TE results obtained are not suitable for thermoelectric applications. However, the high Seebeck coefficient (

\ge
190 µV/K) and glass-like thermal conductivity (

\le 2.26 \text{W}/\text{m}.\text{K})
values achieved have opened a new window for exploring the thermoelectric potentials of La2Ti2O7 and other related oxides.
Is it necessary for suspected children&nbsp;with coronavirus disease-2019(COVID-19) to perform CT scan?
Authors: Qiyi Chen , Ruming Xie , Hui Chen , Yajie Wang , Budong Chen 
Published: June 2020

Abstract
Objectives: the aim is to evaluate justification for suspected children withcoronavirus disease-2019 (COVID-19) to perform CT scanning. Methods: Eighteen suspected children (7 male and 11 female) accepted both CT scanning (except one) and then pharyngeal swab assays from 26th January to 9th March 2020 in the retrospective study. They were confirmed COVID-19 by twice positive test and divided into two groups: asymptomatic subgroup and symptomatic subgroup. Fisher`s exact test was used in statistical analysis. Results: The CT positive ratio was not significant in the two subgroups (0 (0%) vs 3 (23.1%), p=0.541), the same as that in different sex and ages (female vs male: 2 (20.0%) vs 1 (14.3%), p=1.000; <=3 years vs >3 years: 2 (28.6%) vs 1 (10.0%), p=0.537). The demonstrations of the two positive CT were multiple patchy infiltration or ill-fined ground-glass opacity in subpleural regions. Conclusions: It was unnecessary for suspected children with COVID-19 to perform CT scanning as a “routine” ahead of viral nucleic acid assays.