bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of Urine Test Results of Han and Tibetan 0-6 Years Old Children in Gansu Province, Western China: A Cross-Sectional Study
Authors: Li Yanfen , Pei Hongbo , Qiu Hao , Cui Jinqiao , Ma Liang , Fu Ping , Zhen Xiaoyan 
Published: September 2020

Abstract
Background Urine examination can reflect concealed kidney diseases in children. However, few surveys described the difference in urine routine indicators between children belonging to different ethnic groups. This study aimed to compare urine components between Han and Tibetan preschool children in western China and explore influencing factors for early kidney disease prevention.MethodsThe urine routine data were obtained by cluster sampling of children (N = 1645: NHan = 1019, NTibetan = 626, age range: 0–6 years) in 10 child care institutions of Lanzhou City and Gannan Tibetan Autonomous Prefecture through the medical examination center affiliated to a top three hospital in Gansu Province in western China. The correlation of the urine routine indicators with the factors, including living environment, diet, family income, and kidney disease in parents, were explored through multiple logistic regression analysis.ResultsThe lower age group (1–3 years old) was a protective factor for urinary vitamin C in Han children [odds ratio (OR) Han = 0.13, 95% confidence interval (CI) = 0.05–0.32], while it was a risk factor among Tibetan children (OR Tibetan = 3.01, 95% CI = 1.28–7.10), compared with the higher age group (4–6 years old). Among Han children, male sex was the risk factor for urinary ketone body (OR Han = 2.28, 95% CI = 1.20–4.33). Among Tibetan children, living in newly decorated houses was a risk factor for urinary ketone body and urinary occult blood (OR ketone body = 2.35, 95% CI = 1.12–4.93; ORoccult blood = 18.20, 95% CI = 4.30–76.92). Male sex is the protective factor for urinary leukocyte detection in both Han and Tibetan children (OR Han = 0.10, 95% CI = 0.04–0.20; ORTibetan = 0.25, 95% CI = 0.10–0.63). The intake of lead-containing foods is a risk factor for urinary leukocyte detection in Tibetan children (ORTibetan = 4.34, 95% CI=1.19–15.91). Parental kidney disease history is a risk factor for urinary occult blood in Han children (ORHan = 2.56, 95% CI=1.21–5.41).ConclusionThe differences in physiology, diet, and living environment in children belonging to different ethnic groups were influencing factors for different urine abnormalities.
The Association Between the Perceived Unjust Treatment in Healthcare Settings and the Unmet Need for General Practitioner Services Among People With Foreign Background in Finland
Authors: Somersalo Laura , Kankkunen Päivi , Lilja Eero , Koponen Päivikki , Kuusio Hannamaria 
Published: September 2020

Abstract
Background: Unjust experiences are relatively common among people with foreign background (PFB) in Finland. Despite universal access to public health care, previous studies have shown inequities in the unmet need for medical care between immigrants and the general population. This study examines the association between unjust treatment in healthcare settings and unmet need for general practitioner (GP) services among PFB. Method: The data for this study were drawn from Survey on work and well-being among people of foreign origin (UTH) (n = 4977, response rate 66%). The respondent characteristics were weighted and summarized, and multivariate logistic regression analyses were performed to assess the adjusted odds ratios (OR) of association between perceived unjust treatment and unmet need for GP services. The analyses were conducted in a four-step process where the first model tested the association between unjust treatment in health care settings and unmet need for GP services, second model adjusted this association by sociodemographic factors, third model was further adjusted by migration related factors, and the fourth model adjusted the previous models even further by health related factors.Results: The results of multivariate regression showed that PFB reporting unjust treatment were also significantly more likely to report an unmet need for GP services. The difference remained significant even after controlling for other tested factors (OR=8.68, 95% CI 6.09-12.36, p<.001). In addition to perceived unjust treatment, only younger age, lower self-rated health and existing long-term illness were significantly associated with unmet need for medical care in the final, fully adjusted model.Conclusions: Thus, perceived unjust treatment in health care settings is significantly associated with unmet need for general practitioner services. Ensuring cultural competence throughout the entire organizational structures creates an environment to promote equal treatment for all clients. The overall costs can be reduced effectively by giving the best possible treatment for all health care users.
Inequalities in socioeconomic status, behaviors, healthcare services and vulnerability to HIV/STIs between brothel-based and street-based female sex workers in Yunnan, China
Authors: Cai Guoxi , Liu Yufen , Lu Yixiao , Wu Jiwen , Zhuang Jinman , Hu Zhijian , Zhang Jianping , He Fei 
Published: September 2020

Abstract
BackgroundCommercial sex plays a critical role in the transmission of HIV/STI infections in mainland China because female sex workers (FSWs), who tend to be either street-based (SSWs) or brothel-based (BSWs), are extremely prevalent. These two groups had different behaviors and treatment. Few studies investigated due to SSWs group is difficult to reach. MethodsA cross-sectional survey was conducted in Yunnan Province of China with 129 street-based and 185 brothel-based participants. Peer educators conducted anonymous, face-to-face interviews to collect data on socio-demographic characteristics, HIV/STIs-related knowledge, sex work history, sex behaviours, experience of receiving healthcare service, and experience of abuse from clients. Blood samples were taken for HIV and syphilis testing. Urine samples were taken for gonorrhoea and chlamydia testing. ResultsSignificant differences on socio-economic characters and HIV/STIs prevalence are found between the two types of FSWs. SSWs are older than BSWs; have less education, more dependents, and more clients in one week; receive less healthcare services; and have a higher prevalence of HIV/STIs. Binary logistic regression model results showed that venue for sex trade and experience of HIV testing were significantly associated with the prevalence of HIV/STIs ConclusionsThe SSWs are at lower socio-economic status and have high HIV/STIs mobility, who are more marginalized, receive less healthcare and are, thus, more vulnerable. China’s next step in healthcare intervention should focus on the most hard-to-reach-marginalised groups. HIV/STIs testing and socio-psychological support programmes are urgent needed for these neglected people.
Whole Health System Change in Ireland: A Collaborative Inquiry Into the Enablers and Challenges of Implementation
Authors: Carroll Aine , Twomey Valerie 
Published: September 2020

Abstract
BackgroundAcross the world, health and care systems are struggling to contain costs and improve quality of services by improving prevention, developing wellness programmes, and providing person-centred coordinated health and care. The development of the National Clinical Programmes (NCPs) in Ireland in 2009 coincided with a profoundly challenging period for the Irish economy and consequently for publicly funded health services. These programmes are focused on implementing clinical and operational models of care that have access, quality and value at their core. By 2012, there was a clear recognition among senior health leaders that the desired outcome of nationalising best practice and achieving whole system change had not been achieved through the NCPs and a series of world café events were then planned to assess the challenges that had been experienced by the programmes in order to inform the next phase.MethodsA Multi-Stakeholder Engagement Process using the World Café method of collaborative participatory inquiry, was conducted to obtain a rich, in-depth understanding of the development and implementation of health service reform in Ireland. Three keys questions were explored through an inductive approach to analysis of themes that emerged from conversations with key stakeholders.ResultsThere were 59 participants. A total of 408 responses were received. Using an inductive approach to analysis of themes 5 key themes emerged; Integrated care; Patient Centred Care; Clinical Governance; Funding models and e-Health.ConclusionHaving a clear vision, a prescribed methodology and clinician buy and involvement in the design of new models of care is not sufficient to ensure implementation. A whole system approach to the design and implementation of new models of care must be supported by essential enablers such as policy, financial and human resource models and knowledge management systems. This research informed the planning and design for the second phase of the programmes and sought to overcome the barriers and work with operations and policy makers to improve outcomes for patients by implementing person centered evidence-based models of integrated care.
Simulation Analysis and Verification of Temperature and Stress of Wheel-Mounted Brake Disc of a High-Speed Train
Authors: Qu Junsheng , Wang Wenjing , Dong Ziyu 
Published: September 2020

Abstract
During the braking process, a large amount of heat energy is generated at the friction surfaces between the brake disc and pads and rapidly dissipates into the disc volume. In this paper, a three-dimensional thermo-mechanical coupling model of high-speed wheel-mounted brake discs containing bolted joints and contact relationships is established. The direct coupling method is used to analyse the temperature and stress of the brake discs during an emergency braking event with an initial speed of 300 km/h. A full-scale bench test is also conducted to monitor the temperatures of the friction ring and bolted joints. The simulation result shows that the surface temperature of the friction ring reaches its peak value of 413.7°C after 102 s of braking, which agrees well with the bench test result. The maximum alternating thermal stress occurs in the bolt hole where the maximum circumferential compressive stress is -658 MPa and the maximum circumferential tensile stress is 134 MPa. During the braking process, the out-of-plane deformation of the middle part of the friction ring is larger than that of the edge, which increases the axial tensile load of the connecting bolt. This work provides support for the design of brake discs and connecting bolts.
Identification of Missense Mutation Pro77Arg As A Founder Mutation in Morquio-A Syndrome in Indian Gujarati Patel Ethnicity
Authors: Sheth Jayesh J , Bhavsar Riddhi , Nair Aadhira , Patel Chandni , Naik Premal , Shah Maulin , Chaudhary Mayank , Sheth Frenny , Pandey Nishtha , Deshpande Prajakta , Dubey Shweta , Nair Sreeja , Tamraparni Vandana , Sriniva Sudha 
Published: September 2020

Abstract
Background: Morquio A syndrome (MPS IVA) is a mucopolysaccharide group storage disorder caused due to the deficient activity of the lysosomal enzyme N-acetylgalactoseamine-6-sulfatase encoded by GALNS. The present study represents the mutation spectrum of GALNS in 25 Gujarati Patel patients of India clinically and biochemically confirmed with Morquio-A disorder.Methods: Urinary GAG quantitation and leucocyte enzyme assay was carried out in all 25 patients. This was followed by molecular characterization by amplification and sequencing of the exons and adjacent intronic regions of GALNS gene. Haplotype analysis was performed in patients showing p.P77R variant, using microsatellite markers D16S3121, D16S3026 and D16S3023 and SNPs.Results: We identified 11 mutations that include eight missense mutations: (p.L36R, p.D39G, p.P77R, p.C79R, pP125L, p.P151L, p.G255A and p.L350P), one splice site mutation: (c.121-7C>G), one small insertion: (c.1241_1242insA, p.I416HfsTer2) and one small deletion: (c.839_41delACA). Of these, three missense mutations (p.D39G, p.G255A and p.L350P), one splice site and the two indels mentioned above are novel. In the present study, we found maximum number of mutant alleles in exon 2, and of note, the variant p.P77R was seen in fourteen patients. Conclusion: p.P77R variant was predominantly found in Gujarati Patel community and the results of haplotype analysis indicated it to be the founder mutation in this community. Further, a study of 200 unrelated healthy control participants from Gujarat has identified this mutation in the heterozygous status in two individuals. Overall, our study suggests that p.P77R is likely to be a founder mutation for Morquio-A syndrome in Gujarati Patel ethnicity.
Age is Associated With Increased Expression of Pattern Recognition Receptor Genes and ACE2, the Receptor for SARs-Cov-2:&nbsp;Implications for the Epidemiology of COVID-19 Disease
Authors: Bickler Stephen W. , Cauvi David M. , Fisch Kathleen M. , Prieto James M. , Gaidry Alicia D. , Thangarajah Hariharan , Lazar David , Ignacio Romeo , Gerstmann Dale R. , Ryan Allen F. , Bickler Philip E. , Maio Antonio De 
Published: September 2020

Abstract
Background: Older aged adults and those with pre-existing conditions are at highest risk for severe COVID-19 associated outcomes. Methods: Using a large dataset of genome-wide RNA-seq profiles derived from human dermal fibroblasts (GSE113957) we investigated whether age affects the expression of pattern recognition receptor (PRR) genes and ACE2, the receptor for SARS-CoV-2. Results: Older age was associated with increased expression of PRR genes, ACE2 and four genes that encode proteins that have been shown to interact with SAR2-CoV-2 proteins. Conclusions: Assessment of PRR expression might provide a strategy for stratifying the risk of severe COVID-19 disease at both the individual and population levels.
Effect of Bleomycin on Oral Leukoplakia Cell line- an in Vitro Study
Authors: Khair Al Moutassem B. , Luke Alexander , Shetty Shishir R. , Mathew Simy , Patnaik Rajashree 
Published: September 2020

Abstract
Background Leukoplakia generally refers to a firmly attached white patch on a mucous membrane which is associated with an increased risk of cancer. So it is important to diagnose leukoplakia in early stage. In this study we are trying to treat leukoplakia as a marker for prediagnosis of cancer. Since, bleomycin as a chemotherapeutic agent, is mainly used in the treatment of multiple tumors, and several cancers. Hence in this study effect of bleomycin was studied in D38, a leukoplakia cell line.Methods Percent lethality values of leukoplakia cells after treated with several concentations of bleomycin was studied by acridine orange/ethidium bromide staining (AO/EB), propidium iodide (PI) staining, 3-(4, 5-dimethythiazol-2-yl)-2, 5-diphenyl tetrazolium bromide (MTT) assay and comet assay. Minimum inhibitory concentration (MIC), lethal concentration25 (LC25), lethal concentration50 (LC50), lethal concentration75 (LC75) and highest permissive concentration (HPC) was calculated from probit computational method.Results From AO/EB staining, PI staining, MTT assay and comet assay the MIC value was 15 mg/L concentration of bleomycin, where as the HPC was found at 100 mg/L of bleomycin. The comet tail length gradually increased from 15 mg/L to 100 mg/L of bleomycin. Percent lethality values were also increased from 15 to 100 mg/L concentration of bleomycin in all the staining protocols as well as in comet assay technique.Conclusion It is important to diagnose leukoplakia in early stage. Since, bleomycin as a chemotherapeutic agent, it is mainly used in the treatment of multiple tumors, testicular carcinomas, lymphomas, and head, neck cancers. From the results, it was found that bleomycin can be used for treatment of oral leukoplakia to prevent its development to SCC.
Young Male With Recurrent Headache: A Case Report
Authors: Chien Yu-Ta , Feng Shang-Yu 
Published: September 2020

Abstract
Background Headache, one of the most common symptoms presenting to the emergency department, is usually benign but sometimes fatal. Identifying high-risk headache syndromes and providing appropriate headache therapy remain the first priority for emergency physicians. Common “Red flags” includes sudden onset, focal neurological deficit, fever, neck stiffness and so on. We categorize headache into primary (such as tension, cluster headache and migraine) and secondary (subarachnoid hemorrhage, acute meningitis, intracranial hemorrhage, etc) while ruling out secondary headache is the first step in management. Case presentation We report a case of nasopharyngeal carcinoma(NPC) with defect at left side of nasopharynx and sphenoid sinus causing diffuse pneumocephalus. The 35-year-old male presented to the emergency department for sudden-onset headache with unusual associated symptom: rhinorrhea. Computed tomographic (CT) examination revealed a diffuse pneumocephalus, which did not present in magnetic resonance imaging of brain one month ago. The treatment was mainly conservative and the recovery was smooth.Conclusions Unusual symptoms like rhinorrhea and otorrhea should not be ignored, they might be the only clues to the diagnosis of pneumocephalus. Most of the pneumocephalus related to NPC occurred after recent radiotherapy. However, this patient finished radiotherapy on 2012/5. Thus, metastatic skull bony erosion with associated pneumocephalus might be taken into consideration.
Quality Assessment of Fungal Synthesized Bio-Surfactants From Agro-Wastes(Cassava, Yam and Sweet Potato Peels)
Authors: Ezeonu Chukwuma Stephen , Otiwa Simon Ofana 
Published: September 2020

Abstract
Background: Biosurfactants are produced extracellularly by microorganism on cell surface or extracellularly on media environments. They are known for their role in surface and interfacial tension reduction between molecules at the surface and interface, respectively. Thus, this study was conducted to determine and compare the capability of biosurfactant production from immediate agrochemical wastes (yam, cassava and sweet potato peels) using fungal isolates. Materials and Method: The test fungi (Aspergillus niger and Fusarium oxysporum) were isolated from yam, potato and cassava peels showing advanced rottenness. Standardized production of biosurfactants using well researched protocol involving media and inclusion of agrochemical wastes in a fermentation broth containing the isolated fungi was carried out. Results and Discussion: The highest biosurfactant activity value obtained was with F. oxsporum on yam peels with emulsification index (EI) of 94.2±0.20% on kerosene after 72 hours (EI72). While the lowest activity of biosurfactant was observed in A. niger grown on cassava peels broth with EI72 activity of 36.36±0.53% on diesel. The trend showed that emulsification index on diesel after 24 hours (E24) with biosurfactant from A. niger grown in yam peel broth gave the highest EI concentration (48.42±0.14%) followed by biosurfactant from F. oxysporum cultured in yam peels (48.27±0.99%). In comparison with kerosene emulsion formed: biosurfactant from F. oxysporum grown in yam peels showed highest EI (94±0.10%) followed by A. niger cultured in yam peels (78.72±1.08). The EI results showed that yam peel served as a better substrate for biosurfactant production while F. oxysporum is the better biosurfactant producing fungi. The EI values were slightly maintained for 48hrs (EI48) and 72hrs (EI72). The result of the oil spreading assay using engine oil revealed that biosurfactants produced by F. oxysporum grown on sweet potato peels broth displaced more area of expired engine oil in water by forming miscelles with oil displacement area (ODA) of 9.08±0.02cm2 followed by biosurfactant from A. niger grown in sweet potato broth with ODA of 8.04±0.38 cm2. In terms of substrate specificity the sequence of increment in EI was: Yam>Cassava>Sweet potato. However, considering the critical micellar level or the oil displacement ability of the product, the sequential increment was: Sweet potato>Cassava>Yam peels. Conclusion: The biosurfactant produced shows more cleansing ability towards kerosene than it does for diesel. Conversely, it could be channelled toward clean-up of kerosene viz a-viz crude oil contaminated surfaces and environment.
Comparison of The Risk Factors For Falls Among Older&nbsp;Adults&nbsp;Between Urban and Rural Areas of Shantou City, China
Authors: Chen Xiaodong , Lin Zeting , Gao Ran , Yang Yijian , Li Liping 
Published: September 2020

Abstract
Background: To investigate the prevalence of falls and risk factors among older adults in urban and rural areas and to facilitate the design of fall prevention interventions.Methods: We used cluster random sampling to investigate the sociodemographic information, living habits, medical history, and falls among 649 older adult participants. Univariable and multivariable logistic regression was used to examine fall risk factors in urban and rural areas.Results: The fall rate and rate of injury from falls among older adults in urban areas were 27.3% and 18.6%, respectively, which were higher than those in rural areas (17.0% and 12.2%; P<0.05). Multivariable analysis showed that the risk factors for falls among urban older adults included a high school or below education level (OR=3.737, 95% CI: 1.503~9.291); diabetes medicine use (OR=4.518, 95% CI: 1.228~16.626); incontinence (OR=8.792, 95% CI: 1.894~40.824); lack of fall prevention education (OR = 11.907, 95% CI: 1.321～107.354); and reduced balance function (OR = 3.901, 95% CI: 1.894~7.815). The risk factors among rural older adults included a previous nonfarming occupation (OR=2.496, 95% CI: 1.416~4.398); incontinence (OR =11.396, 95% CI: 1.901~68.327); poor living environment (OR=3.457, 95% CI: 1.488~8.033); and reduced balance function (OR =4.260, 95% CI: 2.361~7.688).Discussion: The rate of falls among older adults in urban areas is higher than that in rural areas of Shantou City. Fall prevention in urban areas should target older adults with low education and modify the diabetes medication use. Interventions should focus on improving the home environment of older adults in rural areas.
C-type Lectin-like Molecule-1 as a Potential Biomarker for Diagnosis and Prognosis in Acute Myeloid Leukemia
Authors: Wang Jinghua , Wang Weida , Chen Hao , Li Wenmin , Huang Tian , Zhang Weiya , Ling Wei , Lai Peilong , Wang Yulian , Geng Suxia , Li Minming , Du Xin , weng jianyu 
Published: September 2020

Abstract
Background Cytogenetic and molecular genetic abnormalities are now considered to be important factors affecting the prognosis of acute myeloid leukemia (AML), while variable outcomes may appear in the same risk group. Immunophenotyping has been the core in AML diagnosis, which is simple and universal application. The aim of this study was to explore and identify new immunophenotypic markers that related to the diagnosis and prognosis of AML.Methods The expression of C type lectin like molecule 1 (CLL‐1) in AML blasts were examined in 52 patients with newly diagnosed or relapsed/refractory AML, and was compared with other classic markers in AML, in order to assess the value of CLL-1 as an independent biomarker or in combination with other markers for diagnosis in AML. Subsequently, we assessed the value of CLL-1 as a biomarker for prognosis in this malignant tumor.Results The results showed that CLL 1 was expressed on the cell surface of the majority of AML blasts (78.8%), and also expressed on leukemic stem cells in varying degree but absent on normal hematopoietic stem cells. Notably, CLL 1 was able to complement the classic markers CD33 or CD34. After dividing the cases into CLL‐1high and CLL‐1low groups according to cutoff 59.0%, we discovered that event free survival and overall survival (OS) of the CLL‐1low group were significantly lower than the CLL‐1high group, and low CLL 1 expression seems to be independently associated with shorter OS.Conclusions These data identified CLL 1 as a potential biomarker for diagnosis and prognosis of AML.