bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cocktail Treatment by GnRH-Antagonist, Letrozole, and Mifepristone for the Prevention of Ovarian Hyperstimulation Syndrome: A Prospective Randomized Trial
Authors: Qi Qianrong , Xia Yi , Luo Jin , Wang Yaqin , Xie Qingzhen 
Published: August 2021

Abstract
Ovarian hyperstimulation syndrome (OHSS) is a major complication of controlled ovarian hyperstimulation. This study is aimed to determine the efficacy of a cocktail style treatment by combining GnRH-antagonist, letrozole, and mifepristone on the prevention of ovarian hyperstimulation syndrome (OHSS) in high-risk women. This prospective, randomized controlled clinical trial included 170 women who identified as high risk of OHSS during the ovarian hyperstimulation and underwent cryopreservation of whole embryos. On the day of oocyte retrieval, the combination group (89 cases) received 0.25 mg Cetrorelix for three days, 5 mg letrozole for five days, and 50 mg mifepristone for three days, the mifepristone group (80 cases) received 50 mg mifepristone for three days. 156 cases were included in final analysis. The combination group showed significantly decreased incidence of moderate and severe OHSS than mifepristone group (20.5% vs. 42.3%), with remarkably reduced serum estradiol level on hCG+3 and +5 day, decreased ovarian diameter, and shortened luteal phase. Oocyte retrieval number, levels of estradiol on hCG+0 and VEGF, and ovarian diameter on hCG+5 were associated with the severity of the symptoms. In Conclusion, the combination treatment effectively reduce the incidence of moderate/severe OHSS in high-risk women. Clinical trial registration information:Date of registration: 12-27-2017Date of initial participant enrollment: 01-01-2018Clinical trial identification number: ChiCTR-INR-17014174 URL of the registration site: www.chictr.org.cn
Inappropriate Use of Antibiotics and Their Predictors in Pediatric Patients Admitted at the Hospital Central De Nampula, Mozambique
Authors: Xavier Sancho Pedro , Victor Audêncio , Cumaquela Graciano , Vasco Melsequisete Daniel , Rodrigues Osiyallê , Cobre Alexandre de Fátima 
Published: August 2021

Abstract
Background

Antibiotics are synthetic or natural substances used to treat diseases of infectious origin. When used incorrectly, they can be a factor in the development of antimicrobial resistance, increased treatment time, costs, and mortality. The present study aimed to assess the pattern inappropriate use of antibiotics and their predictors in pediatric patients admitted to the Hospital Central de Nampula, Mozambique
Methods

A cross-sectional, retrospective study with a quantitative approach was conducted between January and July 2019. The population consisted of children aged 0 to 10 years hospitalized in the pediatric ward I. Binary logistic regression was used to determine risk factors for inappropriate use of antibiotics with 95% CI.
Results

The prevalence of antibiotic use among pediatric patients was 97.5%. Of the 464 antibiotics prescribed, 39.9% were for patients suffering from gastroenteritis, 21.8% and 9.1% Affected with pneumonia and malaria. Most antibiotics were for systemic use (95.9%, 445/464). Most (36.5%) of prescriptions had errors. Duration of treatment (74.6%) and dosage (25.4%) were the most frequent errors. Binary logistic regression analysis revealed that patients were prescribed with ≥ 3 antibiotics (OR = 2.920, 95% CI = 1.283–6.646, p–value = 0.011) and with a short hospitalization time (OR = 1.726, 95% CI = 1.040–2.864, p–value = 0.035) were more likely to experience some inappropriate use of antibiotics.
Conclusion

The study showed a higher prevalence of antibiotic use, however, a greater number of prescriptions contained errors. Errors related to dose and duration of treatment were the most common among pediatric patients. These results reveal a concern, since inappropriate and excessive use of antibiotics is a major factor for the development of antibiotic resistant microorganisms. Therefore, strategies concerning the use of antibiotics in order to reduce their inappropriate and excessive use are necessary.
Paraneoplastic Cerebellar Degeneration Associated with Anti-CV2/CRMP5 Antibodies in Ovarian Cancer: Case Report and Review of Literature.
Authors: Whaley Juan Jose Juarez-Vignon , Carrera-Muiños Aurelio , Hernandez-Gutierrez Karol Gema , Rodriguez-Cid Jerónimo Rafael , Otero-Cerdeira Maria Elisa , Garcia-Montes Vanessa 
Published: August 2021

Abstract
BackgroundParaneoplastic neurological syndromes are rare presentations of an underlying oncological disease and even more unusual they can present during an oncological disease. These syndromes more likely present in small cell lung carcinomas and thymomas, but in less than 1% of the cases gynecological neoplasms have shown this paraneoplastic presentation, such as the case presented. Even though not completely understood yet, acknowledging the pathophysiology is essential for management, relate other types of neoplasms and explain its clinical presentation. We present a patient with an underlying gynecological cancer, that during her disease developed a paraneoplastic neurological syndrome with an unusual autoantibody (anti-CV2/CRMP5) mediating the disease.Case PresentationA 62-yo female diagnosed with ovarian cancer who in the course of her disease develops neurological symptoms associated with cerebellar degeneration. After ruling out differential diagnoses such as metastases, a neurological paraneoplastic syndrome was suspected and studied, in which anti-CV2/CRMP5 were positive. Putting together her clinical presentation, radiological features, auto-antibody positivity on CSF related with paraneoplastic neurological syndromes and an underlying oncological disease, cerebellar degeneration as a paraneoplastic syndrome was diagnosed.ConclusionThe pathophysiology of neurological paraneoplastic syndromes is not fully understood; therefore, its diagnosis and management are complex. Diagnosis is based on clinical presentation and specific antibodies associated. Unfortunately, patients have a bad prognosis and diminished quality of life, therefore its management needs a multidisciplinary approach. It is important to mention that the presentation of paraneoplastic neurological syndromes do not mandatory appear before the diagnosis of cancer, multiple cases have been reported in which patients with an underlying oncological disease develop these syndromes. As medical oncologists and neurologists we must consider and study these syndromes as a possible etiology in cases with an underlying cancer who develop neurological symptoms in the course of their disease after ruling out differential diagnoses such as brain metastases.
Factors influencing sternal healing and comparison of different sternal closure methods: a retrospective analysis
Authors: Long Xuanren , Mei Kun , Qian Yongxiang , Zhang Xiaoyin , Wang Min , Wang Bin , Di Dongmei 
Published: August 2021

Abstract
Background

We determined the factors affecting sternum healing after a median sternotomy based on a retrospective analysis; additionally, we compared the stability of different sternal closure techniques.
Methods

We collected information involving patients who underwent a median sternotomy in Changzhou First People's Hospital from 2014–2019 and who had chest CT examinations at 1–24 months post-operation. The main outcome included the average sternal healing score at the five specific anatomic levels and adverse events of transverse displacement of the sternum.
Results

In the short-term healing group, the sternal score was only correlated with postoperative time (HR = 0.18, 95% CI: 0.135–0.225, p < 0.001). In the long-term healing group, older people had a higher risk of poor sternal healing than young people (age, HR=-0.028, 95% CI: -0.05–0.006, p = 0.013). Patients with left internal mammary artery dissociation (LIMA-d) had a high risk of poor sternal healing (HR=-0.444, 95% CI: -0.869-0.019, p = 0.045). The binary logistic regression showed that steel wire fixation was a favorable factor for preventing transverse displacement of the sternum (HR = 0.122, 95% CI: 0.007–0.651, p = 0.047).
Conclusion

In summary, advanced age and internal mammary artery interception are risk factors that affect sternal healing, based on the imaging findings. This new method of sternal closure provides an effective way of ensuring sternal stability of both sternal plates and reduces the risk for complications after cardiac surgery in high-risk patients.
Determining The Age Priority in Universal Vaccination Using Economic Evidence: Case From US Based On Dynamic Transmission Model
Authors: Zhou Dachuang , Shao Taihang , Liu Zeyao , Pan Xingming , Zhang Xueke , Zhou Chengchao , Tang Wenxi 
Published: August 2021

Abstract
Background: Currently, increasing regions have realized that universal vaccination are necessary to prevent COVID-19. However many of them are facing problems associated with insufficient supply or chaotic allocation of vaccines. This study selected the United States population as an example and explored prioritization strategies of COVID-19 vaccination for different age groups to achieve the highest economic efficiency.Methods: We built a dynamic transmission model to predict the incidence of SARS-CoV-2 infections under the prioritization strategies of vaccination for different ages within a 180-day simulation period. Quality-adjusted life year (QALY) was selected as the outcome. Medical costs included direct medical cost and vaccine cost based on a healthcare system perspective. Data on SARS-CoV-2 epidemiology, vaccine efficacy, and medical costs were derived from publicly available databases and previously published literature. Different COVID-19 vaccines were included in scenario analysis. The robustness of the study results was evaluated by one-way sensitivity analysis and probabilistic sensitivity analysis.Results: COVID-19 vaccination is economical compared with no vaccination. Priority vaccination for adults aged 25–59 years saves $31,664.2 million and that for adults over 60 years old saves $30,082.9 million in medical costs compared with no vaccine intervention. Additionally, priority vaccination for adults aged 25–59 years vs. over 60 years old saves $1,581.3 million. In contrast, priority vaccination for adults aged over 60 years vs. 25–59 years old gains 0.001 QALYs and costs $4.7 per capita, with an incremental cost-effectiveness ratio of $4,829.3/QALY, and it is economical when taking gross domestic product per capita of the United States in 2020 as the willingness-to-pay threshold. The results of sensitivity analysis indicate that the base-case results are robust.Conclusions: From a healthcare system perspective, it is most economical to prioritize adults aged over 60 years for COVID-19 vaccination in the United States, thereby achieving effective resource allocation and saving the government costs.
A Dual-Emitting Two-Dimensional Nickel-Based Metal-Organic Framework Nanosheets: Eu3+/Ag+ Functionalization Synthesis and Ratiometric Sensing in Aqueous Solution
Authors: Shu Yun , Dai Tao , Ye Qiuyu , Jin Dangqin , Xu Qin , Hu Xiaoya 
Published: August 2021

Abstract
Using two-dimensional (2D) nickel-based metal organic framework (Ni-MOF) nanosheets as a matrix, Eu3+ and Ag+ were incorporated to synthesize Ag/Eu@Ni-MOF with double luminescence centers of Eu3+ ion (615 nm) and organic ligand (524 nm). And a ratiometric luminescence sensor is constructed based on Ag/Eu@Ni-MOF for sensitive detection of biothiols in aqueous solutions. The dual-emissive fluorescence properties can be tuned by changing the amounts of Ag+ ions doping. The results of temperature and pH effects on the fluorescence of Ag/Eu@Ni-MOF indicates that the Ag/Eu@Ni-MOF is a temperature-sensitive material and the fluorescence of Ag/Eu@Ni-MOF can keep stable over a wide pH range. Due to the binding of -SH in Cys and GSH with Ag+, the ligand luminescence was significantly inhibited by weakening the Ag+ influence on the energy transfer process in the MOFs. Therefore, ratiometric fluorescent sensing of biomolecular thiols was realized based on the dual-emission Ag/Eu@Ni-MOF. More importantly, the fluorescence color change can be observed with naked eyes to realize visual detection. The ratiometric fluorescent sensor exhibits high performance for Cys and GSH detection with a wide linear range of 5-250 μM and a relatively low detection limit of 0.20 μM and 0.17 μM, respectively. Furthermore, the biothiols content in human serum was determined with satisfactory results. It proves the Ni-MOF nanosheets can be used as a stable matrix for construction luminescent MOFs for the first time, and validate the great potential of Ag/Eu@Ni-MOF as a ratiometric fluorescent probe for point-of-care testing (POCT) in disease diagnosis.
Short-term Effect of Monosodium glutamate on serum hormonal level and histological changes of uterus during estrus phase in rat
Authors: Abdulghani Mahfoudh Almuslai Mohammed 
Published: August 2021

Abstract
Background

Monosodium glutamate (MSG) is commonly used in the Middle East and worldwide as a flavour enhancer in food. MSG is called Chinese salt and is commonly used by the food processing industry, restaurants, and institutional services. The current study was conducted to investigate the effects of monosodium glutamate on the uterine tissue of adult female Sprague Dawley rats with a regular estrus cycle.
Results

The mean relative values of progesterone and estrogen to the control in the MSG-treated animal group significantly affect (P < 0.05) compared with the control group. The means of the relative lumen area (um2) showed smaller than the control group.
Conclusions

MSG may cause disturbance in serum progesterone and estrogen levels in young female rats. So, a precautionary utilised for this compound, especially for females under risk factor of hormonal abnormality, is recommended. Further study should be conducted to evaluate the effect of MSG on corpus lutea function.
Sargassum Horneri (Turner) C. Agardh Regulates Neuroinflammation via Inhibition of LPS-stimulated Microglia Activation in Vitro and in Vivo
Authors: Lee Jun Sik , Cho Jun Hwi , Kim Mi Eun 
Published: August 2021

Abstract
Previously we reported that Sargassum horneri (Turner) C. Agardh (S. horneri) is a brown algae species that exerts anti-inflammatory activity toward murine macrophages. However, the anti-neuroinflammatory effects and the mechanism of S. horneri on microglia cells are still unknown. We investigated the anti-neuroinflammatory effects of S. horneri extract on microglia in vitro and in vivo. In present study, we found that S. horneri was not cytotoxic to BV-2 microglia cells, and it significantly decreased lipopolysaccharide (LPS)-induced NO production. Moreover, S. horneri also diminished the protein expression of iNOS, COX-2, and cytokines production including IL-1b, TNF-a, and IL-6 on LPS-stimulated microglia activation. S. horneri elicited anti-neuroinflammatory effects by inhibiting phosphorylation of p38 MAPK and NF-kB. In addition, S. horneri inhibited astrocytes and microglia activation in LPS-challenged mice brain. Therefore, these results suggested that S. horneri exerted anti-neuroinflammatory effects on LPS-stimulated microglia cells activation by inhibiting MAPK phosphorylation and NF-kB signaling.
Applying Low-Cost Air-Pollution Sensors’ Information to Explore PM2.5 Concentration With an Emphasis on Spatial and Temporal Analysis: A Case in Chiayi City
Authors: Tseng Chao-Heng , Chen Ling Ling , Tseng Guan-Hua 
Published: August 2021

Abstract
Low-cost air-pollution sensors are attracting increasing attention. They offer air-pollution monitoring at a cost lower than that of conventional methods, theoretically facilitating air-pollution monitoring in several locations and immediate application of acquired information. We establish a particulate matter (PM2.5) map based on low-cost air-pollution sensor information developed using internet of things at Taiwan’s Environmental Protection Agency. We synergize data from one monitoring station with 287 low-cost air-pollution-pollution sensors (data entries = ∼50 million) to estimate PM2.5 concentrations from September 1, 2018 to August 31, 2019. We investigate Chiayi City because it has the second-highest PM2.5 concentration in Taiwan. By analyzing Geographic Information System data, we map Chiayi City’s spatial and temporal distributions, identify PM2.5, and recognize the characteristics of Chiayi City’s hotspots. Our main discoveries are as follows: Chiayi City’s spatial distribution reveals PM2.5 concentrated in its industrial area, which increasingly reduces from the industrial area to the city center. Hot spots are identified by two types of space units: northwest industrial and central and western agricultural zone. Concentrated PM2.5 occurs mainly in winter, with the highest rate in January, occurring most frequently and less frequently from 7 to 10 a.m. and 3 to 5 p.m., respectively. Although this study focuses on Chiayi City, the proposed approach has general applicability to wide-ranging environment-monitoring studies and air-pollution interventions and will substantially assist in validating PM2.5 transport models and enhance exposure estimation accuracy in further research.
New Insights Into the Regulation of TGF-β/Smad and MPK Signaling Pathway Gene Expression by Nasal Allergen and Methacholine Challenge Test in Asthma.
Authors: Panek Michał , Karbownik Michał Seweryn , Górski Karol Maksymilian , Koćwin Marcelina , Kardas Grzegorz , Marynowski Mateusz , Kuna Piotr 
Published: August 2021

Abstract
BackgroundAsthma is a heterogeneous chronic inflammatory disease of the bronchi, the course of which is significantly influenced by specific and non-specific extrinsic factors. The aim of this study was to evaluate the effect of these factors on changes in the mRNA expression of genes encoding the TGF-β (TGF-β1 and TGF-β3) - Smad (MPK1/3, Smad1/3/6/7) signaling pathway in asthmatic patients. Methods and ResultsSeventy-five subjects were included in the study, of whom 27 (nine men and 18 women) received an intranasal allergen provocation (specific factors) and 48 (17 men and 31 women) were administered a methacholine provocation (non-specific factors). ConclusionBoth examined types of challenges were found to contribute to changes in the relative expression of genes of the TGF-β (TGF-β1 and TGF-β3) - Smad (MPK1/3, Smad1/3/6/7) signaling pathway in asthmatic patients. A decrease was noted for the MAPK1, MAPK3, Smad3, Smad6 and Smad7 genes, while an increase of up to 2.5 times was observed for the TGF-β1 gene. Our findings suggest that intranasal allergen or bronchial methacholine challenge influences the mRNA expression of the TGF-β1- MPK1/3 and Smad3/6/7 genes.
The Effectiveness of Felt in Reducing Peak Plantar Pressures at the 1st Metatarsophalangeal Joint: In a Healthy Population
Authors: Connell Lauren , MacGilchrist Claire 
Published: August 2021

Abstract
Semi-compressed felt is frequently used in clinical podiatric practice to offload areas of high pressure, particularly in patients with chronic ulceration. The study aimed to assess the effectiveness of semi-compressed felt, on plantar pressures, in offloading the 1st metatarsophalangeal joint, whilst assessing pressure encountered at the peripheries. Elevated plantar pressures are a strong predictor of ulceration in patients with diabetic foot disease, where undetected mechanical trauma can rapidly become ulcerative. In this study, plantar pressure was assessed using the Foot Work Pro plate (AM CUBE, Inc., France, www.amcube.net), in three conditions: barefoot; 5mm thickness and 10mm thickness conditions. This study was of a cross sectional design, where participants were conveniently sampled within the Podiatric Medicine student population within the National University of Ireland, Galway. 33 participants (28 females; 5 males) with a mean age of 23 years (Interquartile Range, 18-44). Plantar pressures at the 1st metatarsophalangeal joint decreased (P<0.01; P<0.01), when semi-compressed felt was applied to offload the 1st metatarsophalangeal joint. Whereas, plantar pressures were found to be increased at both the 3rd metatarsophalangeal joint (P= 0.04; P= 0.01) and the 5th metatarsophalangeal joint (P=0.82; P=0.40), as a result of applying felt to the 1st metatarsophalangeal joint. Evidently, offloading one joint subjected other joints to greater mechanical load allowing insight into the mechanical redistribution associated with the use of felt in offloading, which must be accounted for in the high risk diabetic foot.
An Updated Checklist of The Alien Flora In a Mediterranean Region of Europe: The Case of Calabria (Southern Italy)
Authors: Spampinato Giovanni , Laface Valentina Lucia Astrid , Posillipo Giandomenico , Ortiz Ana Cano , Canas Ricardo Quinto , Musarella Carmelo Maria 
Published: August 2021

Abstract
An updated checklist of the Calabrian alien vascular flora is presented. The alien flora of the Calabria region (Southern Italy) representing almost 12% of the regional flora and comprises 381 alien taxa, among which there are 370 angiosperms, 9 gymnosperms and 2 ferns. In relation to the state of spread, 35 invasive alien species (IAS) have been identified (4 of these are included in the list of Union Concern, sensu Regulation (EU) no. 1143/2014) which represent 9% of the Calabrian alien flora.In the last years the alien flora in Calabria has increased: in particular, alien species have increased over a decade from 190 to the current 381 taxa. If on the one hand this is due to new introductions, resulting from the globalization that relentlessly affects the whole planet, on the other hand it is to be linked to awareness of the problem of alien species and the increasing intensity of research in recent decades. This study would provide a baseline for further advanced studies on the management of invasive species and on the invasion ecology.
Hurdles for Adopting Mobile Learning Devices at the Outset of Clinical Courses
Authors: Folger Daniel , Merenmies Jussi , Sjöberg Lena , Pyörälä Eeva 
Published: August 2021

Abstract
Background: Mobile devices provide medical students with easy access to medical information and educational resources. Since 2013, we have followed the study use of iPads among medical students. In 2016, we observed a notable drop in the mobile device usage in the first cohort of medical students entering their clinical courses. Methods: The aim of the study was to identify the hurdles for adopting mobile devices at the beginning of the clinical courses. We examined how students evaluated their own and the clinical teachers’ ability to use the iPad, how the study assignments fit into digital learning, and how students used the mobile device with patients. The data were collected with online surveys among three consecutive student cohorts and the distributions of closed-ended questions analyzed. Results: Response rates ranged from 67.5% to 90.8%. Students evaluated their own ability to use the iPad as good or excellent and teachers' skills as relatively poor and wanted more digitally tailored assignments. They reported negative attitudes towards mobile device use in the clinical setting and were hesitant to use them in patient contact. Teachers seldom communicated suitable quality medical applications to students. Conclusions: Clinical teachers need support and training to implement a learning environment and assignments appropriate for mobile devices. Both students and teachers were concerned about using these devices with patients. To achieve the full potential of digitalisation in clinical courses, their use should be developed collectively with students.