bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transient Central Precocious Puberty: a new entity among the spectrum of Precocious Puberty?
Authors: Assirelli Valentina , Baronio Federico , Ortolano Rita , Maltoni Giulio , Zucchini Stefano , Natale Valeria Di , Cassio Alessandra 
Published: March 2021

Abstract
Objective

The aim of this study is to evaluate clinical, hormonal and ultrasound features in girls with precocious puberty (PP).
Methods

96 girls referred to our center for PP between 1st January 2007 and 31th December 2017 fulfilled inclusion criteria and were recruited for the study. 3 groups of patients were considered. Group 1: 56 subjects with Central PP (CPP) requiring treatment with GnRH analogue; Group 2: 22 subjects characterized by some criteria of CPP without indication to treatment, “Transient CPP”(T-CPP); Group 3: 18 subjects with Isolated Thelarche (IT). A questionnaire about anamnestic and environmental data was provided to patients which were followed through normal clinical care.
Results

an increase in Groups 2 and 3 diagnosis was observed over the years. LH peak (UI/ml) at diagnosis was higher in Group 1 vs Group 2 (11.7 ± 7.8 vs 4.58 ± 1.60)(p < 0.001) and 3 (11.7 ± 7.9 vs 2.18 ± 1.15)(p < 0.001) and also in Group 2 vs Group 3 (4.58 ± 1.6 vs 2.18 ± 1.1)(p < 0.05). At 6–12 months, LH peak of Group 2 was lower (2.35 ± 1.3) compared with diagnosis data (4.58 ± 1.60)(p < 0.05). Uterine Longitudinal Diameter (ULD) (mm) was longer in Group 1 (42.53 ± 6.26) vs Group 2 (36.54 ± 4.86)(p < 0.001) and 3 (30.70 ± 4.74)(p < 0.001), and this difference is also found between Group 2 and 3 (p < 0.005). Potential exposure to herbicides and pesticides was reported in 17.5% in Group 2 vs 12.5% in Group 1 (p < 0.001).
Conclusions

This study seemed to indicate an increase in diagnosis of T-CPP and IT cases. To our knowledge, this is the first report of a form defined as T-CPP, characterized by a partial activation in the HPG axis normalizing over time. As for environmental factors, we indirectly evaluated the role of some endocrine disruptors (EDCs) affecting pubertal axis activation, without leading to a complete maturation.
WITHDRAWN: Liver resection promotes (regulates) pro-inflammatory cytokines in patients with hepatocellular carcinoma
Authors: Fathi Farshid , Sanei Behnam , Hakemi Mazdak Ganjalikhani , Saidi Reza F. , Rezaei Abbass 
Published: March 2021

Abstract
Objective: Several animal studies have shown the roles of cytokines in regulating liver regeneration following liver resection (LR), which is a type of surgery is designed to remove cancerous tumors from liver. This study investigated how the expressions and serum levels of some pro- and anti-inflammatory cytokines in patients with hepatocellular carcinoma (HCC) were changed during LR.Liver tissues from 15 patients with HCC were collected and the levels of interleukin-6 (IL-6), tumornecrosis factor-alpha (TNF-α), IL-1α, IL-1 β, IL-10, and transforming growth factor- beta1 (TGF-β1) were assessed using real-time PCR assay at different times before and after LR. The serum values of TNF-α and IL-6 were also measured by ELISA.Results: After 60 and 90 minutes of LR, IL-6 gene expression was significantly increased (P < 0.001-0.05). The same trend was also observed in TNF-α expression after 90 minutes of LR (P <0.01). No significant changes were observed in the expressions of IL-1α, IL-1β, IL-10, and TGF-β1 before and after LR. In addition, LR had significant effects on TNF-α and IL-6 serum levels (P<0.05-0.0001). Our data provided further evidence to reveal that IL-6 and TNF-α cytokines are critical to improve liver regeneration.
Herbal Medicine for Cervicogenic Dizziness: A Systematic Review and Meta-Analysis
Authors: Oh Hyunjoo , Shin Seungwon , Lee Euiju , Chung Won-Seok 
Published: March 2021

Abstract
Background: Herbal medicines (HMs) have been widely used in the treatment of cervicogenic dizziness (CGD) based on their empirical effectiveness and safety. Herein, we reviewed and evaluated the clinical evidence on the efficacy and safety of HM for CGD. Methods: Among the relevant studies published up to December 2019 in 11 electronic databases, only randomised controlled trials (RCTs) were included. The studies’ methodological quality was assessed using the revised Cochrane risk-of-bias tool for randomised trials, and the strength of evidence for the main findings was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: All 17 included RCTs with 1,797 participants were conducted with six types of modified HM prescriptions and three types of active controls. More than half of the included studies were of low quality because of the high risk of bias due to deviations from the intended intervention. HMs plus active controls were more effective in CGD treatment than active controls alone. HMs plus antivertigo drugs, HMs plus manual therapy, and HMs plus acupuncture therapy were all effective in CGD treatment, with HMs plus antivertigo drugs showing the most reliable effect. All HM prescriptions were effective for specific patterns of CGD when administered with active controls, with Banxia Baizhu Tianma tang and Dingxuan tang demonstrating the most reliable effect. No serious adverse events were reported in all included studies. Conclusions: The current evidence suggests that HMs may enhance the treatment effect on CGD when combined with other treatments without serious adverse events. Further high-quality evidence is needed to draw a definite conclusion.Systematic review registration: PROSPERO (registration number: CRD42020199222), and the Research Registry (Review Registry Unique Identifying Number: reviewregistry1036)
Initial Presenting Symptoms, Comorbidities and Severity of COVID-19&nbsp;Patients Attending Hmawbi and Indine Treatment Centers During the Second Wave of Epidemic in Myanmar: a Cross-sectional Study
Authors: Htun Ye Minn , Win Tun Tun , Aung Aung , Latt Thant Zin , Phyo Yan Naung , Tun Thet Min , Htun Nyan Sint , Tun Kyaw Myo , Htun Khin Aung 
Published: March 2021

Abstract
Background: Coronavirus disease (COVID-19) caused by a highly contagious virus called severe acute respiratory syndrome coronavirus 2 emerged in China at the end of 2019 and became a major threat to health around the world. The health experts are still learning more about the detailed knowledge of the natural course and the severity of COVID-19. The study aimed to assess the prevalence and association of severity with demographic characteristics, initial presenting symptoms, and comorbidities among COVID-19 patients in Treatment Centers, Myanmar. Methods: A cross-sectional study was conducted at Hmawbi and Indine Treatment Centers from November to December 2020 and a total of 176 adult COVID-19 patients participated in this study. Data were collected by telephone surveys using structured questionnaires. The odds ratio with a 95% confidence interval was used as a measure of association and the independent associated factors for severity (pneumonia) were investigated using logistic regression analysis. Results: In total, 76.7% were symptomatic patients and the most common presenting symptoms were fever 43.2%, loss of smell 42.0%, and cough 25.6%. The prevalence of comorbidity in COVID-19 patients was 35.8% and the most common comorbidities were hypertension 19.9%, heart diseases 9.7%, and diabetes mellitus 9.1%, respectively. As a severity, 23.3% of patients had signs of pneumonia. The associated factors of pneumonia were aged 60 years and older [Adjusted Odds Ratio (AOR) = 8.82, 95 % CI: 2.68-29.08], overweight or obese (AOR: 3.33, 95% CI: 1.30-8.54), current smoking (AOR: 15.29, 95% CI: 2.91-80.37), and alcohol drinking (AOR: 7.04, 95% CI: 1.40-35.31). Thirty percent of symptomatic patients present with pneumonia. Conclusions: Nearly one-fourth of the patients developed pneumonia. The COVID-19 patients who are aged 60 years and older, overweight or obese, current smokers, and alcohol drinkers should be monitored carefully during the course of treatment to reduce the disease severity.
Clinical Efficacy of Combination Therapy for the Treatment of Severe Infections Caused by Carbapenem Resistant Gram-Negatives. A Systematic Review of Clinical Studies
Authors: Savoldi Alessia , CARRARA Elena , Piddock Laura JV , FRANCESCHI Francois , ELLIS Sally , CHIAMENTI Margherita , BRAGANTINI Damiano , RIGHI Elda , TACCONELLI Evelina 
Published: March 2021

Abstract
Background: The combination of antibiotics has become the clinicians’ preferred strategy for the treatment of sepsis due to carbapenem-resistant Gram-negative bacteria (CR-GNB) although the evidence supporting its use is weak. This systematic review aimed at critically evaluating all available antibiotic options for CR-GNB sepsis with particular focus on combination. Methods: Comparative and non-comparative observational studies, randomized control trials (RCTs) and case series were considered eligible with no language restriction. Studies were included if reporting microbiologically-confirmed sepsis caused by Acinetobacter baumannii, Enterobacterales/Klebsiella spp., or Pseudomonas aeruginosa, reporting at least one of the study outcome and targeted antibiotic treatment. Carbapenem-resistance was defined as phenotypically-detected in vitro resistance to at least one of the following carbapenems: doripenem, ertapenem, imipenem, meropenem. Primary outcomes were 30-day and attributable mortality. Bayesian network meta-analysis (NMA) approach was selected to explore feasibility of pooling data on antibiotic regimens. Results: A total of 6306 records were retrieved and 134 studies (11546 patients) were included [54 studies on Acinetobacter, 52 on Enterobacterales/Klebsiella, 21 on mixed Gram-negative, and 7 on Pseudomonas]. Nine (7%) were RCTs; 19 prospective cohorts (14%), 89 (66%) retrospective and 17 (13%) case series. Forty-one studies (31%) were multicentric. Ninety-two distinct regimens were identified with 47 (51%, 5863 patients) not reporting any details on combination. 30-day mortality was assessed in 65 (48%) studies while attributable mortality was reported only in 19 (14%).The NMAs were not applicable for any of selected outcomes given the presence of too many disconnected components. Conclusion: The existing evidence is too weak for allowing formulating any evidence-based therapeutic recommendation for combination of antibiotics to treat CR-GNB sepsis. Future studies must clearly define number, type, dosages, and in vitro activity of each antibiotic included in the regimen to drive recommendations for using combination of antibiotics that might be reliably applied into clinical practice.
The Changing Landscape of Molecular Epidemiology of Staphylococcus Aureus Infections in Children.
Authors: Tsirigotaki Maria , Giormezis Nikolaos , Maraki Sofia , Spiliopoulou Iris , Galanakis Emmanouil 
Published: March 2021

Abstract
Background: Staphylococcus aureus infections cause significant morbidity and mortality in children and adolescents. Aim of this study was to investigate the molecular epidemiology and antibiotic resistance of Staphylococcus aureus clinical isolates from children and adolescents.Methods: All S. aureus isolates recovered from patients aged < 18 years, admitted to a referral hospital, with culture-proven invasive or non-invasive, community-associated or community-onset healthcare-associated or hospital-associated infections during the 4-year period from January 2015 to December 2018 were analyzed for antimicrobial resistance, virulence genes, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST).Results: Among 139 S. aureus clinical isolates, 16 (11.5%) were methicillin-resistant (MRSA) and 123 (88.5%) methicillin-susceptible (MSSA). MSSA infections increased significantly over time (2017-2018 vs. 2015-2016, 0R 3.32; 95%CI 1.18-8.96; p 0.03) along with increasing resistance to fusidic acid (OR 2.38; 95%CI 1.14-5.12; p 0.02) and in staphylococcal scalded skin syndrome prevalence (OR 3.24; 95% CI 1.10-8.36; p 0.03). A total of five sequence types (ST) were identified among 58 isolates that were analyzed by MLST. By PFGE typing, 22 pulsotypes were identified, whereas, PFGE type 1 classified as ST121 clone was the predominant (40/58,68.9%). MRSA were distributed into four pulsotypes and PFGE type C- ST80 was the most frequent. ST121 strains carried fnbA (40/40), eta/etb genes (29/40) and lukF/S-PVL genes in 3/40 cases. All ST121 exhibited high resistance percentage to fusidic acid and were increasingly resistant to mupirocin. Conclusion: In our population, a CA-MSSA clone emerged, resistant to fusidic acid and increasingly resistant to mupirocin which belonged to the PFGE type 1, ST121 clone, harbored exfoliative toxins genes and was associated with rising trends of SSSS.
A Critical Analysis of Risk Factors for Selected Tropical Diseases
Authors: Uzoka Faith-Michael , Akwaowo Christie , Okoli Chinyere Nwafor , Ekpin Victory , Nwokoro Chukwudi , Hussein Mohamed El , Osuji Joseph , Aladi Flora , Akinnuwesi Boluwaji , Akpelishi Temitope Funmilola 
Published: March 2021

Abstract
Aim: The aim of this study was to examine the impacts of different (non-clinical) risk factors on the populations’ predisposition to tropical diseases specifically Malaria, yellow fever, typhoid fever, chicken pox, measles, hepatitis B and UTI.Subject and Methods: Data for this study was obtained through patient diagnosis forms, distributed to physicians in Nigeria. A total of 2199 patient consultation forms were returned by 102 (out of 125) physicians, and considered useful for analysis. Demographic data of patients, physicians, and diagnosis outcomes were analysed descriptively through frequency distributions, aggregate analysis, and graphs, while the influence of risk factors on the disease manifestations (diagnosis outcomes) were determined using regression analysis.Results: Findings from our study demonstrated that the difficulty in diagnosing tropical disease was associated with significant increase in morbidity and mortality especially in patients with malaria, UTI and typhoid fever. Factors such as contact with an infected person and poor personal hygiene posed significant risk, while urbanization and homelessness, posed very low risks across all the diseases. Conclusion: The risk factors identified in our study exert differential and discriminating influences in the causation, predisposition, and transmission of these conditions, understanding the individual risk factors for each condition have significant socio-economic implications for people living in tropical and endemic regions, especially with respect to management and prevention of these conditions.
Effects of Pyruvate Supplementation on High-intensity Interval Exercise Induced Metabolic Acidosis and Repeated Sprint Exercise Performance of College Soccer Athletes
Authors: yang yanping , Qiu Junqiang , Wang Mengyue , Feng Lin , Luo Dan , Gao Ruirui 
Published: March 2021

Abstract
Background: The effects of pyruvate on metabolic acidosis and oxidative metabolism had been studied. The ability to attenuate acidosis and improve oxidative system contribution are critical to the performance of team sport athletes during perform multiple high-intensity exercise over a limited period of time. This study aimed to investigate the impact of pyruvate supplementation on energy metabolism and metabolic acidosis during high-intensity interval exercise (HIIE), as well as to evaluate its role on repeated sprint exercise (RSE) performance.Methods: 14 well-trained male college soccer athletes (age: 20 ± 2 years, body fat: 13.11 ± 3.50 %) were studied in a randomized, double-blind, cross-over study. The participants ingested either 0.1g/kg/d of pyruvate or a placebo for 1-week. Metabolic acidosis was induced by HIIE after the supplement period, and RSE ability in the acidosis state was assessed. Venous blood pH, bicarbonate (HCO3-) and base excess (BE) were measured at baseline, pre-HIIE, post-HIIE, pre-RSE and post-RSE. Finger-stick blood lactate were collected at baseline, immediately after each bout of HIIE and 3, 5, 7, 10 min after HIIE. The energy systems contribution during HIIE were estimated. Results: Blood pH, HCO3- and BE were significantly lower than baseline after HIIE (p < 0.01) in both pyruvate group (PYR) and placebo group (PLA). Compared to PLA, the blood pH, HCO3- and BE were significantly improved in PYR at pre-HIIE (p < 0.01), post-HIIE (p < 0.01) and pre-RSE (p < 0.01). Furthermore, blood BE remained higher in PYR than PLA till end of RSE (p < 0.05). The contribution of oxidative system in the fourth bout of HIIE was higher in PYR than PLA (p < 0.05). In PLA, the ratio of total anaerobic energy contribution during HIIE was higher than that of aerobic (oxidative) (p < 0.01), but not in PYR (p > 0.05). Relative peak power (RPP) of first, fifth sprint, relative average power (RAP) of fifth sprint, the average of RPP and RAP during RSE were significantly improved in PYR compared with PLA (p < 0.05). While no significant changes in the PD% of each bout (p > 0.05) or average PD% (p > 0.05) were observed between the two groups. Conclusion: Pyruvate supplementation for 1-week enhances oxidative system energy contribution and buffers metabolic acidosis during HIIE, and improves RSE performance in acidosis.
The Prevalence and Types of Advance Care Planning Use in Patients with Advanced Cancer: A Retrospective Single-Centre Perspective, Australia
Authors: Veltre Arron S. , Broadbent Andrew , Sanmugarajah Jasotha , Marshall Amy , Hamiduzzaman Mohammad 
Published: March 2021

Abstract
Background: Advance Care Planning (ACP) has been reported to be of value in maintaining patients’ autonomy and dignity; reducing patient and family anxiety; improving end-of-life care and reducing futile interventions. But in Australia participation rate in advance care directives is 14%, and research is limited on ACP invitations and uptake among the patients with advanced cancer (PwAC). This study identifies the prevalence and types of documented ACP discussions in PwAC who died within two or four weeks of receiving chemotherapy.
Methods: A retrospective audit was conducted in Gold Coast University Hospital, Australia, and the records of 339 patients were examined and 320 patients were found eligible. Descriptive statistics were calculated in SPSS. The difference in ACP invitation and utilisation between three groups [control, <2-weeks, and –4 weeks] was measured by the Kruskal-Wallis test and Chi-square (or Fisher-Exact) test. Post-hoc follow-up pair-wise comparisons were performed. Adjusted prevalence ratios were estimated using two logistic regression models, and the significance of the coefficients was assessed using Wald test.
Results: Of the 320 PwAC [male: 55%; median age: 65 years], 227 (71%) received ACP invitation, and among the invited patients, 89% used Acute Resuscitation Plan; 54% used Enduring Power-of-Attorney; and 20% completed Advance Health Directive. From 7.5% [n=24] of the patients who received chemotherapy in their last 2-weeks of life, 42% had not received an ACP invitation, 29% didn’t have Acute Resuscitation Plan and only 4% completed Advance Health Directive. There were significant differences among the Control, <2-weeks, and 2–4 weeks groups in completing Acute Resuscitation Plan (p=0.003) and Advance Health Directives (p=0.045). A significant difference was also observed between control and <2-weeks groups in number of days since Acute Resuscitation Plan used. Completing an Acute Resuscitation Plan was associated with a lower risk of dying within two-weeks of chemotherapy (OR=0.246; p=0.008).
Conclusions: The low rates of ACP invitation and use in PwAC, especially who received chemotherapy in 2-weeks of dying confirm a need of embedding and regular revisiting the ACP framework in cancer care and educating staff, patients, and their family caregivers to increase the uptake.
Common Microcirculatory Framework for Monitoring Integrated Microcirculation
Authors: Li Yuan , Wang Bing , Li Bingwei , Zhang Xiaoyan , Liu Xueting , Wang Qin , Liu Mingming , Zhang Jian , Zhang Honggang , Xiu Ruijuan 
Published: March 2021

Abstract
Wide variation in magnitudes, units, and ranges of the microcirculatory variables brings hindrance in describing and evaluating the integrated microcirculatory function of tissues. We designed to establish common microcirculatory framework that contains microhemodynamic and microcirculatory oxygen parameters. To integrate microcirculatory information, demo microcirculatory permutations were generated by a computer algorithm based on microcirculatory characteristics. Four dimensionless methods (Z-score, Min-max, L2, and median scaling) were applied to transform microcirculatory data set into the dimensionless form. Three-dimensional (3-D) common microcirculatory framework was constructed and visualized by using Python and Apache ECharts. The performance of the four dimensionless methods in the pre-processing of multiple microcirculatory variables and the establishment of the common microcirculatory framework were compared. Microhemodynamic and microcirculatory oxygen parameters were embedded in the common microcirculatory framework. After processing by Min-max normalization, the transformed multiple microcirculatory values remained positive with fixed range mapping within [0, 1] and maintained the identity property of microcirculation both of microhemodynamic and microcirculatory oxygen variables in the common microcirculatory framework. Conclusively, Min-max normalization displays preferable integration efficiency, compatibility, and adaptability in the establishment of the 3-D visualized multiparametric common microcirculatory framework.
Coffee residue-based activated carbons for phenol removal
Authors: Palanisami Hemavathy , Azmi Mohamad Rafiuddin Mohd , Zaini Muhammad Abbas Ahmad , Zakaria Zainul Akmar , Alam Muhd Nazrul Hisham Zainal , Yunus Mohd Azizi Che 
Published: March 2021

Abstract
This work was aimed to evaluate the adsorptive properties of activated carbons from coffee residue for phenol removal. The coffee residue was activated using H3PO4 and KOH, and the resultant activated carbons were characterized for surface area and functional groups. The values of surface area were recorded as 1,030 m2/g and 399 m2/g for H3PO4- and KOH-activated carbons, respectively. The maximum capacity for phenol removal is comparable for both activated carbons at 43 mg/g. The pores might be inaccessible due to electrostatic repulsion by surface functional groups and hydroxyl anions. The second stage in a two-stage adsorber design is necessary to accomplish the process with high performance and minimum dosage of activated carbon. Coffee residue is a promising activated carbon precursor for phenol removal.