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 Ziyang , Gu Wei 
Published: September 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.
Vitamin D supplementation in obese Sri Lankan children: a randomized controlled trial
Authors: Samaranayake D. B. D. L. , Adikaram S. G. S. , Atapattu N. , Kendaragama K. M. D. L. D. , Senevirathne J. T. N. , Jayasekera H. D. , Wickramasinghe V. P. 
Published: September 2020

AbstractBackgroundMicronutrient deficiencies are identified among obese individuals. Vitamin D deficiency (VDD) is prevalent in obese children, and is hypothesized to cause insulin resistance and metabolic abnormalities. This study aimed to determine the effect of vitamin D supplementation on obesity and related metabolic abnormalities among obese Sri Lankan children with VDD.MethodsA triple-blind randomized controlled trial was conducted among vitamin D deficient (< 20 ng/ml), obese children (n = 96), randomly allocated to three intervention arms - treatment arm receiving weekly vitamin D250,000 IU; supplementation arm receiving 2500 IU weekly and control arm, receiving placebo. Anthropometry, percentage fat mass (%FM) and blood pressure were assessed and fasting blood glucose, fasting insulin, lipid profile, aspartate transaminase (ALT), alanine transaminase (AST), vitamin D, parathyroid hormone (PTH) and hs-CRP and OGTT with 2-h random blood glucose and insulin was performed at baseline and after 24 weeks of treatment. Ethics Review Committee of Faculty of Medicine, University of Colombo approved the protocol.ResultsWaist circumference Z-score, %FM and serum calcium significantly improved across all three arms, ALT significantly improved in treatment and supplementation arms while, BMI Z-score, PTH and vitamin D significantly improved in the treatment arm. Biceps (p = 0.035) and subscapular (0.048) skin fold thickness, vitamin D (p = 0.004) and ALT (p = 0.012) significantly improved in the treatment arm.ConclusionsA strict dietary and physical activity regimen could improve some of the anthropometric, body composition and metabolic profiles, but high dose vitamin D, enhances those improvements. Therefore high dose vitamin D seems to potentiate management outcomes of obese children with vitamin D deficiency.Trial registrationThe study was registered at the Sri Lanka Clinical Trials Registry (SLCTR/2015/017) on 12th September 2015 athttps://slctr.lk/trials/slctr-2015-017.
The mental health of neurological doctors and nurses in Hunan Province, China during the initial stages of the COVID-19 outbreak
Authors: Ning Xianjun , Yu Fang , Huang Qin , Li Xi , Luo Yunfang , Huang Qing , Chen Changqing 
Published: September 2020

Abstract
Background
Neurological symptoms are increasingly being noted among COVID-19 patients. Currently, there is little data on the mental health of neurological healthcare workers. The aim of this study was to identify the prevalence and influencing factors on anxiety and depression in neurological healthcare workers in Hunan Province, China during the early stage of the Coronavirus Disease 2019 (COVID-19) outbreak.

Methods
An online cross-sectional study was conducted among neurological doctors and nurses in early February 2020 in Hunan Province. Symptoms of anxiety and depression were assessed by the Chinese version of the Self-Rating Anxiety Scale (SAS) (defined as a total score ≥ 50) and Self-Rating Depression Scale (SDS) (defined as a total score ≥ 53). The prevalences of probable anxiety and depression were compared between different groups, and multivariate logistic regression analysis was used to understand the independent influencing factors on anxiety and depression.

Results
The prevalence of probable anxiety and depression in neurological nurses (20.3 and 30.2%, respectively) was higher than that in doctors (12.6 and 20.2%, respectively). Female healthcare workers (18.4%) had a higher proportion of anxiety than males (10.8%). Probable anxiety and depression were more prevalent among nurses, younger workers (≤ 40 years), and medical staff with junior titles. Logistic regression analysis showed that a shortage of protective equipment was independently associated with probable anxiety (OR = 1.980, 95% CI: 1.241–3.160, P = 0.004), while young age was a risk factor for probable depression (OR = 2.293, 95% CI: 1.137–4.623, P = 0.020) among neurological healthcare workers.

Conclusions
Probable anxiety and depression were more prevalent among neurological nurses than doctors in Hunan Province. The shortage of protective equipment led to probable anxiety, and young age led to probable depression in healthcare workers in neurology departments, which merits attention during the battle against COVID-19.
Spatial distribution of incomplete immunization among under-five children in Ethiopia: evidence from 2005, 2011, and 2016 Ethiopian Demographic and health survey data
Authors: Melaku Mequannent Sharew , Nigatu Araya Mesfin , Mewosha Wondewossen Zemene 
Published: September 2020

Abstract
Background
An estimate of 2–3 million children under 5 die in the world annually due to vaccine-preventable disease. In Ethiopia, incomplete immunization accounts for nearly 16% of under-five mortality, and there is spatial variation for vaccination of children in Ethiopia. Spatial variation of vaccination can create hotspot of under vaccination and delay control and elimination of vaccine preventable disease. Thus, this study aims to assess the spatial distribution of incomplete immunization among children in Ethiopia from the three consecutive Ethiopia demographic and health survey data.

Method
A cross-sectional study was employed from Ethiopia demographic and health survey (2005, 2011and 2016) data. In total, 7901mothers who have children aged (12–35) months were included in this study. ArcGIS 10.5 Software was used for global and local statistics analysis and mapping. In addition, a Bernoulli model was used to analyze the purely spatial cluster detection of incomplete immunization. GWR version 4 Software was used to model spatial relationships.

Result
The proportion of incomplete immunization was 74.6% in 2005, 71.4% in 2011, and 55.1% in 2016. The spatial distribution of incomplete immunization was clustered in all the study periods (2005, 2011, and 2016) with global Moran’s I of 0.3629, 1.0700, and 0.8796 respectively. Getis-Ord analysis pointed out high-risk regions for incomplete immunization: In 2005, hot spot (high risk) regions were detected in Kefa, Gamogofa, KembataTemibaro, and Hadya zones of SNNPR region, Jimma zone of Oromiya region. Similarly, Kefa, Gamogofa, Kembatatemibaro, Dawuro, and Hadya zones of SNNPR region; Jimma and West Arsi zones of Oromiya region were hot spot regions. In 2016, Afder, Gode, Korahe, Warder Zones of Somali region were hot spot regions. Geographically weighted regression identified different significant variables; being not educated and poor wealth index were the two common for incomplete immunization in different parts of the country in all the three surveys.

Conclusion
Incomplete immunization was reduced overtime across the study periods. The spatial distribution of incomplete immunization was clustered and High-risk areas were identified in all the study periods. Predictors of incomplete immunization were identified in the three consecutive surveys.
Mathematical modeling study of school-based chlamydia screening: potential impact on chlamydia prevalence in intervention schools and surrounding communities
Authors: Rönn Minttu M. , Dunville Richard , Wang Li Yan , Bellerose Meghan , Malyuta Yelena , Menzies Nicolas A. , Aslam Maria , Lewis Felicia , Walker-Baban Cherie , Asbel Lenore , Parchem Sarah , Masinter Lisa , Perez Ernestina , Gift Tom L. , Hsu Katherine , Barrios Lisa C. , Salomon Joshua A. 
Published: September 2020

Abstract
Background
Chlamydia screening in high schools offers a way to reach adolescents outside of a traditional clinic setting. Using transmission dynamic modeling, we examined the potential impact of high-school-based chlamydia screening programs on the burden of infection within intervention schools and surrounding communities, under varying epidemiological and programmatic conditions.

Methods
A chlamydia transmission model was calibrated to epidemiological data from three different settings. Philadelphia and Chicago are two high-burden cities with existing school-based screening programs. Rural Iowa does not have an existing program but represents a low-burden setting. We modeled the effects of the two existing programs to analyze the potential influence of program coverage and student participation. All three settings were used to examine a broader set of hypothetical programs with varying coverage levels and time trends in participation.

Results
In the modeled Philadelphia program, prevalence among the intervention schools’ sexually active 15–18 years old population was 4.34% (95% credible interval 3.75–4.71%)after 12 program years compared to 5.03% (4.39–5.43%) in absence of the program. In the modeled Chicago program, prevalence was estimated as 5.97% (2.60–7.88%) after 4 program years compared to 7.00% (3.08–9.29%) without the program. In the broader hypothetical scenarios including both high-burden and low-burden settings, impact of school-based screening programs was greater in absolute terms in the higher-prevalence settings, and benefits in the community were approximately proportional to population coverage of intervention schools. Most benefits were garnered if the student participation did not decline over time.

Conclusions
Sustained high student participation in school-based screening programs and broad coverage of schools within a target community are likely needed to maximize program benefits in terms of reduced burden of chlamydia in the adolescent population.
Cardiometabolic risk factors among patients with tuberculosis attending tuberculosis treatment centers in Nepal
Authors: Poudyal Indra Prasad , Khanal Pratik , Mishra Shiva Raj , Malla Milan , Poudel Prakash , Jha Raj Kumar , Phuyal Anil , Barakoti Abiral , Adhikari Bipin 
Published: September 2020

Abstract
Background
The co-morbidity of cardiometabolic diseases in patients with Tuberculosis adds a significant burden in current health systems in developing countries including Nepal. The main objective of this study was to explore cardiometabolic risk factors among patients with Tuberculosis.

Methods
This was a cross-sectional study conducted among patients with tuberculosis in 12 tuberculosis treatment centers from eight districts of Nepal between May and July 2017. Interviews with participants were conducted using a structured questionnaire and were supplemented by anthropometric measurements and on-site blood glucose tests. Data were analyzed using descriptive and inferential statistics.

Results
Among 221 study participants, 138 (62.4%) had new smear-positive pulmonary tuberculosis, 24 (10.9%) had new smear-negative pulmonary tuberculosis and 34 (15.4%) had new extra- pulmonary tuberculosis. Overall, 43.1% of the patients with tuberculosis had at least one cardiometabolic risk factor. The prevalence of at least one cardiometabolic risk factor was more in male than female (47.8% versus 33.8%). Prevalence of tobacco (18.9% versus 4.8%), and alcohol (12.6% versus 6.5%) use was proportionately higher in male compared to female. The prevalence of hypertension (17% vs. 21%) and obesity (11.9% vs. 12.9%) was lower in male compared to females. Female (AOR = 0.47; CI: 0.23–0.94), those from Gandaki Province (AOR = 0.32; CI: 0.13–0.79) and literate (AOR = 0.49; CI: 0.25–0.96) had reduced risk of cardiometabolic disease risk factors.

Conclusions
This study highlights the role of gender and socio-demographic characteristics associated with the risk of cardiometabolic diseases in patients with Tuberculosis. The findings from this study can guide medical practitioners and policy makers to consider clinical suspicion, diagnosis and treatment. National treatment guideline can benefit by integrating the management of non-communicable diseases in Tuberculosis treatment centers.
Validation of the Pneumocystis pneumonia score in haematology patients with acute respiratory failure
Authors: Ko Ryoung-Eun , Lee Jongmin , Na Soo Jin , Jeong Na Ri , Kim Seon Woo , Jeon Kyeongman 
Published: September 2020

Abstract
Background
Pneumocystis pneumonia (PCP) is an important cause of acute respiratory failure (ARF) in immunocompromised patients, yet no actual clinical tool suitably identifies patients at risk. Recently, a multivariable prediction model has been proposed for haematology patients with ARF requiring intensive care unit (ICU) admission to assess the risk of PCP (PCP score). However, it has not yet been validated externally.

Methods
To validate the PCP score, a retrospective cohort study was conducted in two large designated haematology centres in Korea. One-hundred and forty haematology patients with ARF were admitted to ICU. They underwent aetiologic evaluations between July 2016 and June 2019. The predictive ability of the score was assessed with the receiver operating characteristic (ROC) curve analysis for both the discrimination and calibration of the score.

Results
Among the 141 patients, 13 (9.2%) were finally diagnosed of PCP. Although the median of PCP score in PCP group was higher than in non-PCP group (3.0 [interquartile range 0.0–4.0] vs. 2.0 [0.5–4.0]), the difference was not statistically significant (P = 0.679). The area under the ROC curve of the PCP score in our cohort was 0.535 (95% CI, 0.449–0.620), indicating no discriminatory ability. When using a cut-off of 3.0 the score, the result was 38.5% (95% CI, 13.9–68.4) sensitive and 7.03% (95% CI, 61.6–78.1) specific. The negative predictive value was 58.8% and positive predictive value was 59.8% for a 10% prevalence of PCP.

Conclusions
In this study, the PCP score was not useful to predict the risk of PCP in haematology patients with ARF. Further prospective validation studies are needed to validate the score’s use in routine clinical practice for the early diagnosis of PCP in haematology patients.
The association between pelvic asymmetry and non-specific chronic low back pain as assessed by the global postural system
Authors: Yu Qiuhua , Huang Huanjie , Zhang Zhou , Hu Xiaoqian , Li Wenfeng , Li Le , Chen Min , Liang Zhenwen , Lo Wai Leung Ambrose , Wang Chuhuai 
Published: September 2020

Abstract
Background
Empirical evidence that demonstrates the relationship between pelvic asymmetry and non-specific chronic low back pain (NCLBP) is currently lacking.

Objective
To establish the reliability of the Global Postural System (GPS) in assessing pelvic asymmetry and identify the association between pelvic asymmetry parameters and the occurrence of NCLBP in young adults.

Design
A cross-sectional, regression study.

Methods
People who were aged between 18 and 30 and were diagnosed with NCLBP were recruited. Healthy individuals who were matched for age, sex, and education level were recruited as controls. Global Postural System (GPS) was employed to assess pelvic asymmetry. Prior to exploring the association, the reliability of GPS was assessed by the ICC (2, k) for interrater reliability, ICC (3, k) for intra-rater reliability, standard error and minimal detectable difference. Bivariate correlation analysis and logistic regression analysis were used to determine the relationship between pelvic asymmetry and the occurrence of NCLBP.

Results
Twenty-eight healthy participants and 28 people with NCLBP were recruited. Moderate to excellent ICCs were observed for the inter-rater and intra-rater reliability of most postural parameters. The bivariate correlation analysis indicated that age, body mass index and pelvic asymmetry parameters were related to the occurrence of NCLBP. Pelvic angle asymmetry (odds ratio = 1.17), and asymmetry of the distance between the posterior superior iliac spine and the floor (odds ratio = 1.21) were associated with NCLBP.

Limitations
This study did not explore the causal relationship between pelvic asymmetry in the sagittal plane/pelvic asymmetry in the transverse plane and the occurrence of NCLBP. The interpretation of the results may not be generalized beyond the sample population.

Conclusions
The GPS is a reliable method to assess pelvic asymmetry in a clinical setting. Two pelvic parameters were associated with the presence of NLBP. Measurement of pelvic asymmetry may assist in the early identification of potential occurrence of NCLBP but further work is required.
Central sensitization inventory scores correlate with pain at rest in patients with hip osteoarthritis: a retrospective study
Authors: Ohashi Yoshihisa , Fukushima Kensuke , Inoue Gen , Uchida Kentaro , Koyama Tomohisa , Tsuchiya Maho , Uchiyama Katsufumi , Takahira Naonobu , Takaso Masashi 
Published: September 2020

Abstract
Background
Patients with persistent pain due to osteoarthritis (OA) complain of multiple symptoms that cannot be explained solely by structural changes. A poor correlation exists between structural and inflammatory changes in OA and pain levels. Central sensitization (CS) has been identified as a factor that induces chronic pain in patients with OA. Although it is important to identify osteoarthritis patients with CS components, the prevalence and characteristics of CS, especially those in patients with hip OA, are not well understood. Thus, we aimed to determine the prevalence and characteristics of CS in patients with hip OA, in this study.

Methods
The CS Inventory (CSI), used as a non-invasive routine clinical tool to evaluate the presence of CS 1 month before surgery in 100 patients with hip OA, was measured at our outpatient clinic, and the data were retrospectively reviewed. We determined the number of patients with a CSI score of 40 points or higher and assessed the relationships between the CSI score and clinical factors (including age, duration of hip pain, degree pain at rest and on activity, by using the visual analogue scale [VAS] and the Harris Hip Score) using the Spearman’s correlation coefficient.

Results
The mean age of participants was 63.9 ± 11.6 years, and there were 15 men and 85 women. All patients had hip OA, categorised as advanced and terminal stage (Tönnis grade 2–3) on preoperative plain radiography. The mean duration of hip pain was 4.2 ± 4.4 years. The mean CSI score was 19.5 ± 11.3 and 5 (5.0%) of the patients had a score of 40 or more points. CSI scores correlated significantly only with VAS pain at rest (r = 0.348, P < 0.001).

Conclusion
In this study, 1 out of every 20 hip OA patients had CS components. CSI scores were significantly correlated with pain at rest in hip OApatients. CS approaches to hip OA may be one of the treatment options for pain at rest.
Clinical outcome of surgical management for symptomatic metastatic spinal cord compression from prostate cancer
Authors: Miyoshi Yasuhide , Kawahara Takashi , Yao Masahiro , Uemura Hiroji 
Published: September 2020

Abstract
Background
Metastatic spinal cord compression (MSCC) from prostate cancer (PC) influences not only patients’ prognosis but also their quality of life. However, little is known about the clinical outcome of surgery for MSCC from PC. We evaluated both the oncological and functional outcomes of decompression and reconstruction surgery for patients with symptomatic MSCC from PC.

Methods
We assessed 19 patients who underwent decompression and reconstruction surgery for symptomatic MSCC from PC. Of these 19 patients, 8 had metastatic hormone-naïve PC (mHNPC) and 11 had metastatic castration-resistant PC (mCRPC).

Results
The median age of the patients with mHNPC and mCRPC was 72 and 65 years, respectively. The median prostate-specific antigen level at the time of diagnosis of MSCC in patients with mHNPC and mCRPC was 910 and 67 ng/mL, respectively. Although two of eight patients (25.0%) with mHNPC were ambulatory preoperatively, six patients (75.0%) were ambulatory postoperatively. Among 11 patients with mCRPC, only 3 (27.3%) were ambulatory preoperatively, while 6 (54.5%) were ambulatory postoperatively. The median postoperative overall survival among patients with mHNPC and mCRPC were not reached and 8 months, respectively.

Conclusions
Decompression and reconstruction surgery for symptomatic MSCC from PC might contribute to a favorable functional outcome among men with mHNPC and mCRPC. However, its role in improving the oncological outcome remains unclear. The treatment strategy should be chosen by shared decision-making among patients, urologists, radiation oncologists, and orthopedic surgeons.