bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reliability of Echocardiographic Measurements in Infants Exposed to Zika Virus.
Authors: Orofino Dulce Helena Gonçalves , Passos Sonia Regina Lambert , Leite Maria de Fatima Moreira Pereira , Farias Carla Verona Barreto , Ramos Thiago Moreira , Silva Leticia Machado Lima e , Oliva Raffaela Andrade , Oliveira Raquel de Vasconcellos Carvalhaes 
Published: September 2020

Abstract
Background: Ecocardiography is currently the gold standard imaging method for the diagnosis of most congenital and acquired cardiopathies and for the evaluation of myocardial function and cardiac chamber size and overload. Ecocardiographic measures of left ventricular and right ventricular structure and function are used to define ventricular function and guide medical decisions.The objective of this study is to assess the reproducibility of echocardiographic cardiac chamber measurements in infants in utero exposed to Zika virus. Methods: Masked cross-sectional diagnostic study with two independent measurements of cardiac chamber dimensions using echocardiography. We studied 50 infants with in utero exposure to Zika virus ranging from 30 to 270 days old of the outpatient clinic of a national reference center for maternal and child health, Rio de Janeiro, Brazil.The analysis included the measurements of the aortic root, left atrium, end diastolic left ventricle, systolic left ventricule, left ventricular ejection fraction, ventricular end diastolic septal thickness, end diastolic thickness of the left ventricular posterior wall and right ventricule. Bland-Altman plots were used to explore differences. Agreement according to intraclass correlation coefficients (ICC) was interpreted as follows: excellent≥0.75, fair to good 0.4≤ICC<0.75, and poor with ICC<0.4. Results: All parameters had mean difference of diameters near to zero, excluding left ventricule ejection fraction. Ventricular end-diastolic septal thickness and end-diastolic-thickness of the left ventricular posterior wall showed few unique mean values. Reproducibility was excellent for the aortic root and end diastolic left ventricule (ICC=0.86 and 0.91, respectively), fair/good to poor for other parameters and the left ventricule ejection fraction, ventricular end diastolic septal thickness and the end diastolic thickness of the left ventricular posterior wall showed the lowest reproducibility (ICC=0.46,0.37,0.53, respectively). Conclusions: The minor divergences did not affect the echocardiography results in our sample. However, caution is required to interpret results of measures with low reproducibility.
Factors Influencing the Result of Superior Oblique Weakening Procedures in Patients with Superior Oblique Overaction in Horizontal Strabismus
Authors: Chun Junwoo , Kim Seong-Joon 
Published: September 2020

Abstract
Background: Few studies have evaluated the surgical outcome of superior oblique weakening procedures in patients with superior oblique overaction associated with exotropia or esotropia. This study aimed to evaluate the outcome of superior oblique muscle weakening and the influencing factors in patients with superior oblique overaction.Methods: The medical charts of 37 patients (55 eyes) with superior oblique overaction associated with esotropia or exotropia who were treated with a superior oblique weakening procedure at the Seoul National University Hospital from January 2010 to June 2017 were retrospectively reviewed. Superior oblique overaction was graded using, a 6-point scale ranging from +0.5 to +3, and pre- and postoperative grades were recorded for all patients. Results: The mean age of the patients was 91.81 ± 59.37 months. Superior oblique muscle suture spacer and superior oblique posterior tenectomy were performed for 17 (23 eyes) and 20 (32 eyes) patients, respectively. Surgical success was achieved in 15 (65.2%) eyes in the suture spacer group and 23 (71.9%) eyes in the posterior tenectomy group. Surgical success was achieved for 69.1% (38/55 eyes) of patients. Dissociated vertical deviation exhibited a significant negative association with the surgical success rate (p<0.001).Conclusions: There was no significant difference in surgical success rate between the superior oblique posterior tenectomy and superior oblique suture spacer groups in superior oblique overaction associated with horizontal strabismus. Associated dissociated vertical deviation can affect the surgical success of the superior oblique weakening procedure.
Two-year outcomes after full-thickness astigmatic keratotomy combined with small-incision lenticule extraction for high astigmatism
Authors: Kim Bu Ki , Chung Young Taek 
Published: September 2020

Abstract
Background: To evaluate clinical outcomes after full-thickness astigmatic keratotomy (FTAK) combined with small-incision lenticule extraction (SMILE) in eyes with high astigmatism.Methods: This study comprised 75 eyes of 43 patients with over 4.0 diopters (D) of astigmatism who were treated with SMILE after FTAK. Visual acuities and refractive measurements were evaluated at 1 month after FTAK, and 1, 6, 12, and 24 months after SMILE. Vector analysis of the astigmatic changes was performed using the Alpins method.Results: Twenty-four months after the combined procedure, the average spherical equivalent was reduced from -6.56 ± 2.38 D to -0.36 ± 0.42 D (p < 0.001). The uncorrected and corrected distance visual acuities improved from 1.54 ± 5.53 to -0.02 ± 0.09 and from -0.03 ± 0.07 D to -0.07 ± 0.08 D (both p < 0.001), respectively. The preoperative mean astigmatism was -5.48 ± 1.17 D, which was reduced to -2.27 ± 0.97 D and -0.34 ± 0.26 D at 1 month after FTAK and 24 months after SMILE, respectively (p <0.001). The surgically-induced astigmatism after FTAK, SMILE, and FTAK and SMILE combined was 3.38 ± 1.18 D, 2.22 ± 0.84 D, and 5.39 ± 1.20 D, respectively. Furthermore, the correction index of FTAK, SMILE, and FTAK and SMILE combined was 0.63 ± 0.17, 0.90 ± 0.40, and 0.98 ± 0.06, respectively. There were no intraoperative or postoperative complications. Conclusion: Our surgical procedure combining FTAK and SMILE showed good and stable clinical outcomes during two-year follow-up for the treatment of high astigmatism.
Prospective study on a fast-track training in psychiatry for medical students: The Psychiatric Hat Game
Authors: Clément Anthony , Delage Raphaël , Chollier Marie , Josse Laure , Gaudry Stéphane , Zahar Jean-Ralph , Baubet Thierry , Degos Bertrand 
Published: September 2020

Abstract
Background: While medical students are losing interest in lectures in favor of other educational materials, many studies suggest the benefit of active learning, combined with gamified educational tools. The authors developed a psychiatric adaptation of the « Hat Game ». It was hypothesised that this game would increase both knowledge and motivation in medical students toward psychiatric semiology. The aim of the study was to assess the benefit of a Psychiatric Hat Game session for learning psychiatric symptoms in third-year medical students. Student performance was also evaluated at 3 months.Methods: This gamified fast-track training consisted of two teams and each team must guess as many psychiatric semiology terms as possible using different techniques (i.e. speech, mime). The study involved a pre- and post-evaluation of knowledge (Multiple Choice Questions) and a satisfaction survey. Baseline, post-immediate, and three-months scores were compared by using Friedman analysis for paired samples. Comparisons of mean scores at two different times were performed by using Wilcoxon test for paired samples.Results: Knowledge mean scores were significantly higher after the game than before (+ 28.6%, p < 0.001). Improvement was maintained three months after the game (+ 18.9%, p < 0.001). Satisfaction survey items highlighted that students enjoyed and would recommend this type of gamified training.Conclusions: The Psychiatric Hat Game improved knowledge of psychiatric semiology in medical students. Results suggest that it is a promising and efficient tool to playfully teach medical semiology, with transferable features, utility and acceptability from one medical field to another. This study contributes to the growing body of knowledge advocating for serious games and gamified training in medical education.
Autopsy and Informatics Analysis Evidence Coagulopathy Progress in COVID-19 Patients
Authors: Jiang Tiebin , Lv Bo , Liu Hongxia , He Shiwen , Zhang Guogang , Li Chanyi , Li Wanqiong , Li Weilin , He Yaqi , Zhang Tong , Wang Yunyun , Mo Wu , Yi Ning , Peng Luying , Li Ying , Ruan Chunhong , Li Chengyuan , Liu Yaqi , Luo Peipei , Jiang Huan , Xue Zhigang , Liu Liang , Wang Wenjun 
Published: September 2020

Abstract
Background
The outbreak of COVID-19 around the world resulted in more than 480 thousand deaths.
Objective
To clarify the thrombotic phenomena with coagulation progress in COVID-19 patients based on epidemiological statistics combining the autopsy and informatics analysis.
Methods
Using 9 autopsy results with COVID-19 pneumonia and the medical records of 407 patients including 39 deceased ones whose discharge status was certain, time-sequential changes of 11 coagulation relevant indices within mild, severe and critical infection throughout hospitalization according to NHC guidelines were evaluated. Informatics tools were applied to calculate the importance and correlation between them and the progression of thrombosis.
Results
At the beginning of the hospitalization, PLT had a significant decrease in critically ill patients. GLU, PT, APTT, and D-dimer in critical patients were higher than those in mild and severe during the whole admission period. The ISTH DIC score also showed the continuous overt DIC in critical patients. At the late stage of non-survivors, the dynamic profiles of PLT, PT, and D-dimer were significantly different from survivors. A random forest model indicated that the most important feature was PT, followed by D-dimer, indicating their crucial roles for the progression of disease.
Conclusions
COVID-19 is constantly spreading wildly around the world, combining autopsy data, time-sequential profiles and informatics methods to explore the dynamic changes of coagulation relevant indices throughout the course of the disease deterioration, which helps guide the therapy and detect the prognosis in different level of COVID-19 infection.
Identification of co-existence of Alport syndrome and C3 glomerulonephritis in a proband with family history
Authors: Ding Yin , Tang Xuanli , Du Yuanyuan , Chen hongyu , Yu Dongrong , Zhu Bin , Yuan Bohan 
Published: September 2020

Abstract
Background

Alport syndrome and C3 glomerulonephritis (C3GN) are rare kidney diseases, frequently responsible for familial haematuria, proteinuria, and renal impairment. With the rapid development of molecular genetic testing, Alport syndrome causes have been restricted mostly to variants in the COL4A5 or COL4A3/COL4A4 genes. Moreover, a broad range of genetic contributors in the complement and complement-regulating proteins are definitely implicated in the pathogenesis of C3GN.

Methods

We sought a family with persistent microscopic haematuria associated with renal failure. Clinicopathologic and follow-up data were obtained, and molecular genetic testing was used to screen for pathogenic variants.

Results

We describe a three-generation family with Alport syndrome showing a dominant maternal inheritance. Notably, renal biopsy showed the concurrent histological evidence of C3GN in the proband harbouring a rare heterozygous variation in CFHR5 , c.508G>A. The alteration leads to replacement of a highly conserved residue at position 170 of the β-strand subunit of CFHR5 (p.Val170Met). In silico analysis showed that the variation was predicted to deregulate complement activation by altering the structural properties and enhancing C3b binding capacity to compete with Complement Factor H (CFH), which was in line with experimental data previously published.

Conclusions

The comorbidity findings between Alport syndrome and C3GN indicate an underlying overlap and require further study.
Exogenous melatonin enhances salt secretion from salt glands by upregulating the expression of ion transporter and vesicle transport genes in Limonium bicolor
Authors: Li Junpeng , Yuan Fang , Liu Yanlu , Zhang Mingjing , Liu Yun , Zhao Yang , Wang Baoshan , Chen Min 
Published: September 2020

Abstract
Background: Salt, a common environmental stress factor, inhibits plant growth and reduces yields. Melatonin is a pleiotropic molecule that regulates plant growth and can alleviate environmental stress in plants. All previous research on this topic has focused on the use of melatonin to improve the relatively low salt tolerance of glycophytes by promoting growth and enhancing antioxidant ability. It is unclear whether exogenous melatonin can increase the salt tolerance of halophytes, particularly recretohalophytes, by enhancing salt secretion from the salt glands. Results: To examine the mechanisms of melatonin-mediated salt tolerance, we explored the effects of exogenous applications of melatonin on the secretion of salt from the salt glands of Limonium bicolor (a kind of recretohalophyte) seedlings and on the expression of associated genes. A pretreatment with 5 μM melatonin significantly improved the growth of L. bicolor seedlings under 300 mM NaCl. Furthermore, exogenous melatonin significantly increased the dry weight and endogenous melatonin content of L. bicolor. In addition, this treatment reduced the content of Na+ and Cl– in leaves, but increased the K+ content. Both the salt secretion rate of the salt glands and the expression level of genes encoding ion transporters (LbHTK1, LbSOS1, LbPMA, and LbNHX1) and vesicular transport proteins (LbVAMP721, LbVAP27, and LbVAMP12) were significantly increased by exogenous melatonin treatment. These results indicate that melatonin improves the salt tolerance of the recretohalophyte L. bicolor via the upregulation of salt secretion by the salt glands.Conclusions: Our results showed that melatonin can upregulate the expression of genes encoding ion transporters and vesicle transport proteins to enhance salt secretion from the salt glands. Combining the results of the current study with previous research, we formulated a novel mechanism by which melatonin increases salt secretion in L. bicolor. Ions in mesophyll cells are transported to the salt glands through ion transporters located at the plasma membrane. After the ions enter the salt glands, they are transported to the collecting chamber adjacent to the secretory pore through vesicle transport and ions transporter and then are secreted from the secretory pore of salt glands, which maintain ionic homeostasis in the cells and alleviate NaCl-induced growth inhibition.
RNA-seq reveals tight junction-relevant erythropoietic fate induced by OCT4 in human hair follicle mesenchymal stem cells
Authors: Yu Xiaozhen , Sun Pengpeng , Huang Xingang , Chen Hua , Huang Weiqing , Ruan Yingchun , Jiang Weina , Tan Xiaohua , Liu Zhijing 
Published: September 2020

Abstract
Background: Human hair follicle mesenchymal stem cells (hHFMSCs) isolated from hair follicles possess multilineage differentiation potential. OCT4 is a gene critically associated with pluripotency properties. The cell morphology and adhesion of hHFMSCs significantly changed after transduction of OCT4 and two subpopulations emerged, including adherent cells and floating cell. Floating cells cultured in hematopoietic induction medium and stimulated with erythropoetic growth factors could transdifferentiate into mature erythrocytes, whereas adherent cells formed negligible hematopoietic colonies. The aim of this study was to reveal the role of cell morphology and adhesion on erythropoiesis induced by OCT4 in hHFMSCs and to characterize the molecular mechanisms involved.Methods: Floating cell were separated from adherent cell by centrifugation of the upper medium during cell culture. Cell size was observed through flow cytometry and cell adhesion was tested by disassociation and adhesion assays. RNA sequencing was performed to detect genome-wide transcriptomes and identify differentially expressed genes. GO enrichment analysis and KEGG pathway analysis were performed to analysis the functions and pathways enriched by differentially expressed genes. The expression of tight junction core members was verified by qPCR and Western blot. A regulatory network was constructed to figure out the relationship between cell adhesin, cytoskeleton, pluripotency and hematopoiesis.Results: The overexpression of OCT4 influenced the morphology and adhesion of hHFMSCs. Transcripts in floating cells and adherent cells are quite different. Data analysis showed that upregulated genes in floating cells were mainly related to pluripotency, germ layer development (including hematopoiesis lineage development), and downregulated genes were mainly related to cell adhesion, cell junctions and the cytoskeleton. Most molecules of the tight junction (TJ) pathway were downregulated and molecular homeostasis of the TJ was disturbed, as CLDNs were disrupted, and JAMs and TJPs were upregulated. The dynamic expression of cell adhesion-related gene E-cadherin and cytoskeleton-related gene ACTN2 might cause different morphology and adhesion. Finally, a regulatory network centered to OCT4 was constructed, which elucidated that he TJ pathway critically bridges pluripotency and hematopoiesis in a TJP1-dependent way.Conclusions: Regulations of cell morphology and adhesion via the TJ pathway conducted by OCT4 might modulate hematopoiesis in hHFMSCs, thus developing potential mechanism of erythropoiesis in vitro.
Association between Economic Development Level and Tuberculosis Registered Incidence in Shandong,China
Authors: Zhang Qianyun , Yang Dongmei , Cao Linqing , Liu Jinyue , Tao Ningning , Li Yifan , Liu Yao , Song Wanmei , Xu Tingting , Li Shijin , An Qiqi , Liu Siqi , Gao Lei , Song Wanyan , Li Huaichen 
Published: September 2020

Abstract
Background : Tuberculosis (TB) is one of the major infectious diseases that seriously endanger people's health.In Shandong province, the relationship between the level of economic development and TB incidence has not been studied.This study aims to provide more research basis for the government to prevent and control TB by exploring the impact of different economic factors on TB incidence. Methods : By constructing threshold regression model (TRM),we described the extent to which different economic factors contribute to TB registered incidence and differences in TB registered incidence among seventeen cities with different levels of economic development in Shandong province, China, during 2006-2017. Data were retrieved from the China Information System for Disease Control and Prevention. Results: Per capita medical expenditure（regression coefficient，-0.0314462；SD，0.0079305；P>|t|，0.000）and per capita savings（regression coefficient，0.0001924；SD，0.0000566；P>|t|，0.001） passed the significance test at the level of 1%.They are the two economic indicators that have the greatest impact on TB registered incidence.Through the threshold test, we selected the per capita savings as the threshold variable.In the three stages of per capita savings(＜9772.8086 China Yuan(CNY)；9772.8086 - 33835.5391 CNY；＞33835.5391 CNY), rural per capita income always has a significant negative impact on the TB registered incidence (The regression coefficients are -0.0015682, -0.0028132 and -0.0022253 respectively.P is 0.007,0.000 and 0.000 respectively.).In cities with good economies,TB registered incidence was 38.30% in 2006 and dropped to 25.10% by 2017. In cities with moderate economies, TB registered incidence peaked in 2008 at 43.10% and dropped to 27.1% by 2017.In poorer cities, TB registered incidence peaked in 2008 at 56.30% and dropped to 28.9% in 2017. Conclusion: We found that per capita savings and per capita medical expenditure are most closely related to the TB incidence. Therefore, relevant departments should formulate a more complete medical system and medical insurance policy to effectively solve the problem of "difficult and expensive medical treatment". In order to further reduce the TB incidence, in addition to timely and accurate diagnosis and treatment, it is more important for governments to increase investment in medicine and health care.
Response inhibition alterations in migraine: Evidence from event-related potentials and evoked&nbsp;oscillations
Authors: Chen Guoliang , Li Yansong , Dong Zhao , Wang Rongfei , Zhao Dengfa , Obeso Ignacio , Yu Shengyuan 
Published: September 2020

Abstract
Background: Migraine is characterized by a hypersensitivity to environmental stimulation which climaxes during headache attacks but persists during attack-free period. Despite ongoing debates about the nature of the mechanisms giving rise to this abnormality, the presence of deficient inhibitory cortical processes has been proposed to be one possible mechanism underlying its pathogenesis. Empirical evidence supporting this claim is mainly based on previous accounts showing functional cortical disexcitability in the sensory domain. Considering that a general inhibitory control process can play an important role across early to later stage of information processing, this may indicate the important role other dimensions of inhibitory control can play in migraine disability. The present study examined the pathophysiological features of inhibitory control that takes place during suppression of prepotent responses in migraineurs. Methods: Twenty-two patients with migraine without aura (mean age = 30.86 ± 5.69 years; 19 females) during the interictal period and 25 healthy controls (mean age = 30.24 ± 3.52 years; 18 females) were recruited. We used a stop signal task in combination with event-related potentials (ERPs) to examine participants’ neural activity supporting response inhibition. Results: Behaviorally, migraineurs exhibited prolonged stop signal reaction times relative to healthy controls. At the neural level, the amplitude of the stop-N2 over fronto-central, central and centro-parietal scalp regions, a component of the ERPs related to conflict monitoring during early, non-motoric stages of inhibition, was significantly increased in migraineurs. Meanwhile, the amplitude of the stop-P3 over central and centro-parietal scalp regions, a component of the ERPs reflecting late-stage inhibition of the motor system and cognitive evaluation of motor inhibition, was also significantly increased in migraineurs. Ultimately, our time-frequency analysis further revealed increased delta activity in migraineurs. Conclusions: Consistent with the theory that alterations in cognitive cortical processes are a key signature of migraine, our findings revealed an abnormal state of suppressing prepotent responses in migraineurs, which can be attributed to cortical disexcitability of the pre-frontal executive network and centro-parietal sensorimotor network. These novel findings extend to show the existence of dysfunctional inhibition control that occurs during suppression of prepotent responses in migraneurs.nctional inhibition control that occurs during suppression of prepotent responses in migraneurs.