bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expression and Diagnostic Value of Serum Protein Z, Protein Z-dependent Protease Inhibitor and Coagulation-related Indicators in Foetal Growth Restriction.
Authors: Luo Xiaohua , Huang Yulian , Gu Cunhua , Guo Xiaopei , Guo Jing , Tao Lingling , Sun Peiyan 
Published: August 2020

Abstract
Objective: This study aimed to explore the expression and associations between levels of serum protein Z (PZ), protein Z-dependent protease inhibitor (ZPI), and coagulation-related indicators and foetal growth restriction (FGR).Methods: A total of 50 pregnant women with FGR, 50 healthy pregnant women (Healthy control, HC), and 30 childbearing-age women without pregnancy group (Blank control, BC) were collected in this study. The serum PZ, ZPI, protein C (PC), protein C (PS), and antithrombin III (ATIII) levels of women in each group were determined and compared. Moreover, correlations between these indices and FGR were assessed using Spearman analysis and diagnostic values of these indices for FGR were evaluated using the receiver operating characteristics (ROC) curves.Results: Serum levels of PZ, ZPI, PC, PS, and ATIII were significantly downregulated in the HC and FGR groups compared with the BC group (P <0.001), while PZ, ZPI, PS, and ATIII levels in the FGR groups were significantly lower than that in the HC group (P <0.01). PZ serum concentration was positively correlated with ZPI concentration in the HC and FGR groups, and PZ and ZPI levels were negatively correlated with FGR (r = -0.198, r = -0.247, P <0.05). Combined of PZ, ZPI, PS, and ATIII performed a better value than each of them with AUC of 0.935 (95% CI=0.890-0.981), a sensitivity of 0.920, and a specificity of 0.800.Conclusion: Serum PZ, ZPI, PS, and ATIII were significantly decreased in pregnant women with FGR and could be used for FGR screening in pregnant women.
Dynamic Public Health Interventions Consistent With the Development of COVID-19 Epidemic: The Targeted Prevention and Control Guidelines in Mainland, China
Authors: Miao Xinlei , Wu Zhiyuan , Qiao Chen , Liu Mengmeng , Li Zhiwei , Wang Yijie , Xu Zongkai , Guo Xiuhua , Meng Qun 
Published: August 2020

Abstract
Background: This study aims to describe the dynamic characteristics of COVID-19 transmission and the public health interventions in three phases in mainland, China.Methods: The number of daily reported new confirmed cases, severe cases and asymptomatic infected cases from Jan 10 to Jul 10 was analyzed. We calculated the effective reproduction number (Rt) to reflect the dynamic characteristics of epidemic transmission and intervention effect. According to the overall guidelines for prevention and control, we divided the past six months into three phases and summarized the features of main public health interventions in each phase.Results: The daily confirmed cases and severe cases of COVID-19 mainly concentrated in the first phase and the maximum Rt reached 10.75 (95%CI: 10.26-11.24). With the society-wide efforts and joint prevention and control strategy, Rt began to decline below 1.0 from Feb 19. In the second phase, the occurrence of imported infected cases caused small fluctuations. The preventive strategy, preventing both imported cases and local spread of epidemic, was mainly taken. In the third phase, the government adopted policies to prevent imported cases and domestic re-infections, responding to the regular epidemic prevention demands. Conclusion: Social isolation, wearing masks, digital management based on community and area hierarchical control were effective public health interventions in consistent with the development of COVID-19 epidemic. The targeted dynamic interventions in different phases could provide reference for other countries and regions to deal with COVID-19.
Effect of critical care pharmacist on antibiotic medication optimizations, reduce drug costs but not increase mortality: A retrospective cohort study in the real world research
Authors: Gu Hongyan , Sun Lulu , Sheng Bo , Gu Xuyun , Wang Suozhu , Chen Wei 
Published: August 2020

Abstract
Background

We aims to investigate the roles of clinical pharmacist on optimizing the antibiotic pharmacotherapy regimens and achieved better clinical and economic outcomes in the critical care unit (ICU).
Methods

A retrospective cohort study in real world was undertaken from the year of 2016 to 2017 as the pharmacist pre-intervention period and 2018 to 2019 as the pharmacist intervention period in ICU. All interventions and consensus with clinicians were recorded. The outcomes of the patients’ mortality, microorganism detections, antibiotic utilities, length of ICU stay (LOS), costs of the antibiotics and the total drugs used were reviewed.
Results

Of 1436 patients were evaluated and 1252 recommendations were identified. The main points of the pharmacist interventions were medication regimen adjustments (52.32%) and drug withdrawal (22.60%). Before and after the pharmaceutical interventions, the AUD of all antimicrobials consumed decreased from 211.83 to174.02 (p = 0.000), the rate of antimicrobial utility decreased from 89.88–86.82% (p = 0.001), mortality reduced from 18.73–15.21% (p = 0.002), antibiotic charges were from ࿥8,644 ± 12,556 to ࿥5,587 ± 7,606 (p = 0.000) with 39% reduction.
Conclusions

The services provided by the clinical pharmacist with highly professional training could optimize the antibiotic therapy regimes, saved the drug costs and did not increase mortalities.
Gender Differences in Health Insurance Coverage in China
Authors: Zhou Mei , Zhao Shaoyang , Zhao Zhi 
Published: August 2020

Abstract
Background: The Chinese government has been trying to build a universal public social health insurance (SHI) system since the early 2000s and has essentially achieved universal SHI coverage. By 2018, more than 97% of the entire Chinese population had SHI. However, there are still some obvious inequities in the SHI system. Methods: based on three datasets, we first use statistical methods to identify gender differences in health insurance. Next, we construct a simple multiple regression model to capture the differences in insurance coverage across age groups using the parameter of interaction terms for gender and age groups.Results: Based on data from a demographic survey that covers a large sample, we find that in the below 50 (in 2005) or 60 (in 2015) years age group, the coverage gap of urban employees' basic medical insurance (UEBMI) between men and women was relatively smaller, while a larger disparity existed in the above 50 (in 2005) or 60 (in 2015) group. Moreover, gender differences in health insurance were more pronounced in the low-education group, while no gender differences were found in the high-education group.Conclusions: This paper explains the gender gap in health insurance and the reason for the wider gap among older people. Our study indicates that because the UEBMI in China mainly covers people with formal jobs, a lower labor participation rate (even much lower in formal jobs) of women has led to their greater difficulty in obtaining health insurance. Since the older women’s greater difficulty in obtaining jobs or susceptibility to lay-offs during the period of the UEBMI’s implementation, the possibility of being covered was even much lower. In fact, it was because of the combined effects of the UEBMI system and the labor market condition at that time that older women had a lower proportion of being covered under the UEBMI.
Myocardial infarction detection using artificial intelligence and nonlinear features based on synthesis of the standard 12-lead and Frank XYZ leads
Authors: Zeng Wei , Lin Zixiang , Yuan Chengzhi 
Published: August 2020

Abstract
Nowadays cardiovascular diseases ( CVD ) is one of the prime causes of human mortality, which has received tremendous and elaborative research interests regarding the prevention of CVD . Myocardial ischemia is a kind of CVD which will lead to myocardial infarction (MI). The diagnostic criterion of MI is supplemented with clinical judgment and several electrocardiographic (ECG) or vectorcardiographic ( VCG ) programs. However the visual inspection of ECG or VCG signals by cardiologists is tedious, laborious and subjective. To overcome such disadvantages, numerous MI detection techniques including signal processing and artificial intelligence tools have been developed. In this study we propose a novel technique for automatic detection of MI based on disparity of cardiac system dynamics and synthesis of the standard 12-lead and Frank XYZ leads. First, 12-lead ECG signals are reduced to 3-dimensional VCG signals, which are synthesized with Frank XYZ leads to build a hybrid 4-dimensional cardiac vector. This vector is decomposed into a series of proper rotation components ( PRCs ) by using the intrinsic time-scale decomposition ( ITD ) method. Second, four levels discrete wavelet transform ( DWT ) is employed to decompose the predominant PRCs into different frequency bands, in which third-order Daubechies ( db3 ) wavelet function is selected as reference variable for analysis. Third, phase space of the reference variable is reconstructed based on db3 , in which the properties associated with the nonlinear cardiac system dynamics are preserved. Three-dimensional ( 3D ) phase space reconstruction ( PSR ) together with Euclidean distance (ED) has been utilized to derive features. Fourth, neural networks are then used to model, identify and classify cardiac system dynamics between normal (healthy) and MI cardiac vector signals. Finally, experiments are carried out on the PhysioNet PTB database to assess the effectiveness of the proposed method, in which conventional 12-lead and Frank XYZ leads ECG signal fragments from 148 patients with MI and 52 healthy controls were extracted. By using the 10-fold cross-validation style, the achieved average classification accuracy is reported to be 98.20 % . The result verifies the effectiveness of the proposed method which can serve as a potential candidate for the automatic detection of MI in the clinical application.
Evaluation of the Solar Quiet Reference Field (SQRF) Model for Space Weather Applications in the South America Magnetic Anomaly
Authors: Chen Sony Su , Denardini Clezio Marcos , Resende Láysa C. A. , Chagas Ronan A. J. , Moro Juliano , Silva Régia P. , Carmo Carolina S. , Picanço Giorgio A. S. 
Published: August 2020

Abstract
In the present work, we evaluate the accuracy of the Solar Quiet Reference Field (SQRF) model for forecasting and predicting the geomagnetic solar quiet (Sq) daily field variation in the South America Magnetic Anomaly (SAMA) region. The model simulates the monthly average horizontal field of the geomagnetic quiet (Sq-H) daily variation solving a set of functional fitting equations for the specified geographic coordinates. We carried out two comparisons between the simulated and observational data of the Sq-H field. The first part attempts to evaluate the accuracy for predicting the Sq-H field over Medianeira (25.30°S, 54.11°W, dip angle: -33.45°) by using linear interpolation on the SQRF coefficients. The second part of the analysis attempts to evaluate the accuracy for forecasting the quiet daily field variation over Cachoeira Paulista (22.70°S, 45.01°W, dip angle: -38.48°). The results of the simulation for both locations show that this empirical model presents a good agreement with the Sq-H field obtained from the magnetic field data. The accuracy of the SQRF model (high correlation, r>0.9) provides a high potential for estimating and forecasting geomagnetic quiet daily field variation for space weather applications. Therefore, this model could be useful in the Sq-H field regions near of SAMA.
Addressing the quality of paediatric primary care: Health worker and caregiver perspectives of PACK Child, a health systems intervention in South Africa
Authors: Curran Robyn Leigh , Murdoch Jamie , Bachmann Max , Bateman Eric , Cornick Ruth , Picken Sandy , Simelane Makhosazana Lungile , Fairall Lara 
Published: August 2020

Abstract
Background: The WHO’s Integrated Management of Childhood Illness (IMCI) has resulted in progress in addressing infant and child mortality. However, unmet needs of children continue to present a burden upon primary healthcare services. The capacity of services and quality of care offered require greater support to address these needs by extending and integrating curative and preventive care for the child with a long-term health condition and the child older than 5, not prioritised in IMCI. In response to these needs, the PACK Child intervention was developed, to expand the scope of integrated management and training programmes for paediatric primary care. We report health worker and caregiver perspectives of the existing paediatric primary care context as well as the extent to which PACK Child functions to address perceived problems within the current local healthcare system. Methods: This process evaluation involved 52 individual interviews with caregivers, 10 focus group discussions with health workers, 3 individual interviews with trainers, and 31 training observations. Interviews and focus groups explored participants’ experiences of paediatric primary care, perspectives of the PACK Child intervention, and tensions with implementation in each context. Inductive thematic analysis was used to analyse verbatim interview and discussion transcripts.Results: Perspectives of caregivers and health workers suggest an institutionalised focus of paediatric primary care to treating children’s symptoms as acute episodic conditions. Health workers’ reports imply that this focus is perpetuated by interactions between contextual features such as, IMCI policy, documentation-driven consultations, overcrowded clinics and verticalised care. Whilst these contextual conditions constrained health workers’ ability to translate skills developed within PACK Child training into practice, the intervention initiated expanded care of children 0-13 years and those with long-term health conditions, enhanced professional competence, improved teamwork and referrals, streamlined triaging, and facilitated probing for psychosocial risk.ConclusionPACK Child appears to be catalysing paediatric primary care to address the broader needs of children, including long-term health conditions and the identification of psychosocial problems. However, to maximise this requires primary care to re-orientate from risk minimisation on the day of attendance towards a view of the child beyond the day of presentation at clinics.
Ovarian Fibrosarcoma: 5 Case Reports and Review of Literature
Authors: Sun Tingting , Cheng Ning-Hai , Cao Dong-Yan , Peng Peng 
Published: August 2020

Abstract
Ovarian fibrosarcoma is an extremely rare and malignant sex-cord stromal tumor. Due to its low incidence and poor prognosis, till now very few cases have been reported and most of them are sporadic. The treatments and prognostic factors of ovarian fibrosarcoma are still under discussion. Here we report 5 cases of ovarian fibrosarcoma in Peking Union Medical College Hospital during the past 20 years. The 5 patients were 41, 51, 54, 76, 76 years old with initial symptoms of pelvic mass or pain. Manifestations on ultrasound are usually as unilateral pelvic masses, within which are uneven echo enhancement and some blood flow signals. There was no significant increase in preoperative tumor markers such as serum CA125 and sex hormones. Final diagnosis depends on postoperative histopathological results since these tumors were easily misdiagnosed by intraoperative frozen sections. Pathological examinations showed the tumor cells were spindle shaped with moderate to severe atypia and high mitotic counts. Immunohistochemistry is not specific but the positive rate of Ki-67 was consistent with the degree of malignancy and prognosis of the tumor. In addition, Vimentin, α-inhibin, SMA, estrogen receptor and progesterone receptor could also be positive. There were significant differences in surgical methods and there is also no unified chemotherapy. The overall survival was >15, >7, >6, <1, <1 year for each patient. After reviewing the literature, there is a lack of evidence-based large-scale case study. As for treatments, complete cytoreductive surgery plus regimens of malignant cord stromal tumors in NCCN guidelines are recommended. Due to its low incidence, multi-center clinical studies and molecular studies are required to give gynecologists a better understanding and guidance for future managements of ovarian fibrosarcoma.
Coronary Aneurysm and IVIG Resistance Prediction in Kawasaki Disease
Authors: Varlı Yusuf Ziya , Oztarhan Kazim 
Published: August 2020

Abstract
Background: Kawasaki disease (KD) is the most common cause of coronary artery aneurysm (CAA) in children. This study aimed to determine the clinical characteristics, demographic features, frequency of coronary involvement, and resistance to intravenous immunoglobulin (IVIG) treatment in Turkey based on our data.Methods: Patients with KD were evaluated with demographic data, clinical, laboratory, and echocardiographic findings. Results: Between 2010–2019, a total of 259 patients (male/female: 1.67) were treated in our hospital, with 48 (%19) cases < 1 year of age. According to diagnostic criteria, 31% were diagnosed with typical KD and 69% with atypical (incomplete) KD. The frequency of clinical findings were as follows: changes in the lips and oral mucosa (79%); polymorphic rash (69%); conjunctivitis (65%); changes in the extremities (54%); and cervical lymphadenopathy (48%). There was no significant difference between typical and atypical KD in the frequency order. CAA development and IVIG resistance occurred in 11.6% and 12.3% of cases, respectively. IVIG resistance was more common in infants and hospitalization times were longer in this group. Coronary artery lesions existed in 45 patients; right coronary artery (RCA) alone (20%), left coronary artery (LCA) alone (44.5%), and RCA and LCA together were involved (35.5%). The left main coronary artery affected 20 patients, the left anterior descending artery (LAD) affected nine patients (45%), the left circumflex artery (LCx) affected two patients (10%), and the LAD and LCx together affected two patients (10%). None of the patients had myocardial infarctions or died during follow-up. Conclusion: KD is a systemic vasculitis common in pediatric infants in which coronary artery involvement affects prognosis. Due to IVIG resistance and increased coronary involvement accompanying this vasculitis, it is an important problem in countries where the disease is common. It is important to know the factors that increase the risk of coronary involvement and IVIG resistance development.
The Beneficial Effects of Square Dance on Musculoskeletal System in Early Postmenopausal Chinese Women: A Cross-sectional Study.
Authors: Sun Jie , Yao Chen , Wang Ziping , Wu Jiancheng , Zhang Bo , Zhou Zhenyu , Liu Fan , Zhang Yafeng 
Published: August 2020

Abstract
Background: This study was set to investigate the beneficial effects of square dance on musculoskeletal system of early postmenopausal Chinese women.Methods: Chinese postmenopausal women, who had been without menstruation for 1 to 10 years from the onset of menopause were recruited from community centers for this study. A standardized structured face-to-face interview was performed to collect demographic information, life styles, personal medical history, diet and menstrual status. Subjects who had been practicing regular square dance without participated in other sports activities for more than 2 years and over 4 hours per week (usually more than 45 minutes per time and more than 5 times per week) were assigned to square dance group. Those postmenopausal women who had not participated in regular exercises (no more than 0.5 hour per week) were recruited as the sedentary control group. Bone mineral density (BMD) of spine, total hip and femoral neck was measured by using dual-energy X-ray absorptiometry (DXA). Low limb muscle strength was measured for the non-dominant leg, body flexibility was measured by a simple trunk bend-and-reach test, and body balance was evaluated using a single-stance test for the non-dominant leg. Independent two-tailed Student’s t-test was used for data analysis.Results: 152 subjects from community centers were selected for this study and divided into square dance group (n=74) and control group (n=78). The square dance subjects had higher lumbar spine BMD (P=0.01) and total hip BMD (P=0.02) than control subjects, but there was no significant difference of femoral neck BMD (P=0.48) between these two groups. Functional testing indicated that square dance subjects had higher low limb muscle strength (P<0.01) and longer single-stance time (P=0.02) than the control subject, but there was no significant difference in trunk bend-and-reach (P=0.12) between these two groups.Conclusion: Our results show that postmenopausal Chinese women can get beneficial effects, like higher BMD, stronger low limb muscle and improved body balance ability on musculoskeletal system by participating in square dance regularly.
The explanation on the essence of Qi &amp; Blood at meridians theory
Authors: cha yongchol , choe hyok , oh songjin , cha zinhwa 
Published: August 2020

Abstract
Background; By the classical meridian theory, acupuncture meridian is the channel through which Qi & Blood flows. And "When Qi moves, Blood follows". "When Qi stagnates, Blood congeals." Therefor Qi and Blood are inseparable, and the disease is treated by transmission and regulating of Qi & Blood. So then, what’s the essence of Qi & Blood?Objectives; The purpose of this study is to explain clinical-physiologically the essence of Qi & Blood. Methods; The nephrotic syndrome cure result by mineral and non-mineral pulse light stimuli on acupoints, were researched and analyzed contrast. And the classical meridian theory on Qi & Blood was analyzed. Results and discussion; Nephrotic syndrome was only treated by mineral pulse light stimuli on SP6, KI3 acupoints without any drug use, but was never treated by non-mineral pulse light stimuli. And Qi & Blood is inseparable. Conclusions; Qi & Blood transmitted into kidney along KI meridian course from SP6, KI3 acupoints at legs, is DNA-biophoton spectrum code inputted by mineral filter spectrum, and pulse ion current flowing into the primo vascular system. In a word, Qi & Blood is DNA-biophoton spectrum code (Qi) and pulse ion current (Blood) flowing into primo vascular system, the meridian’s substance.