bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of various aspects of women’s lives between infertile and women with and without tubal ligation: a comparative cross-sectional study
Authors: Ashrafi Mahnaz , Sadatmahalleh Shahideh Jahanian , Mirzaei Negin , Jahangiri  , Youseflu Samaneh , Nasiri Malihe 
Published: January 2021

Abstract
Background: The aim of this study is to compare anxiety, depression, body image, self-esteem, sexual function (SF), and quality of life (QoL) between infertile women and women with or without tubal ligation (TL).Methods: This cross-sectional study was conducted on 600 women, distributed equally as infertile women, women with or without TL, who met the inclusion criteria. They were selected from the Royan Institute in Tehran (Iran) and a number of health care centers in Tehran (Iran) from May 2017 to February 2019. The subjects were asked to fill out the Short Form Health Survey (SF-12), Female Sexual Function Index (FSFI), Hospital Anxiety and Depression Scale (HADS), Body Image Concern Inventory (BICI), and Rosenberg’ Self-Esteem Scale (RSES). One-way ANOVA was used to find the statistical differences between the three groups.Results: Mean scores of all FSFI domains were found to be lower in the TL women and the differences between the three groups were statistically significant in all domains. Women with TL had more female sexual dysfunction (FSD) (22.43±5.30 vs 24.79±4.74 vs 28.03±3.29, P˂0.001). There was a significant difference between the three groups in SF-12 scores (76.59±13.14 vs 68.49±14.47 vs 78.87±12.62, P˂0.001). Also, there was a significant difference between the three groups in anxiety, depression, and total scores HADS (P˂0.001). Infertile women had lower body image (P˂0.05) and self-esteem was lower in the TL group (P˂0.05).Conclusions: Our findings reveal the adverse effects of TL on the anxiety and depression, sexual life, body image, and QoL of women. It is recommended that the awareness and knowledge of health-care professionals regarding the side-effects of TL in the above-mentioned aspects of women’s lives should be increased and discussed with patients.
Risk factors related to acute respiratory distress syndrome and death in patients with COVID-19: a retrospective cohort study in Wuhan, China
Authors: Wang Jing , Wang Lu , Jin Meng , Lu Zequn , Li Yao , Zhang Xu , Yao Zhi , Dong Tianyi , Wang Yanan , Niu Siyuan , Li Qinglin , Liu Cai , Qi Jirong , Tian Jianbo , Wang Ying , Wang Zhihua 
Published: January 2021

Abstract
Background:The COVID-19 pandemic has been considered a great threat to global public health. We aimed to clarify the risk factors associated with the development of acute respiratory distress syndrome (ARDS) and progression from ARDS to death and construct a risk prediction model.Methods:In this single-centered, retrospective, and observational study, 796 COVID-19 patients developed ARDS and 735 COVID-19 patients without ARDS were matched by propensity score at an approximate ratio of 1:1 based on age, sex and comorbidities. Demographic data, symptoms, radiological findings, laboratory examinations, and clinical outcomes were compared between those with or without ARDS. Univariable and multivariable logistic regression models were applied to explore the risk factors for development of ARDS and progression from ARDS to death and establish a comprehensive risk model. Results:Higher SOFA, qSOFA, APACHE II and SIRS scores, elevated inflammatory cytokines, dysregulated multi-organ damage biomarkers, decreased immune cell subsets were associated with higher proportion of death (34.17% vs 1.22%; P<0.001) and increased risk odds of death (OR=57.216, 95%CI=28.373-115.378; P<0.001) in COVID-19 patients with ARDS. In addition to previous reported risk factors related to ARDS development and death, such as neutrophils, IL-6, D-Dimer, leukocytes and platelet, we identified elevated TNF-α (OR=1.146, 95%CI=1.100-1.194; P<0.001), CK-MB (OR=1.350, 95%CI=1.180-1.545; P<0.001), declined ALB (OR=0.834, 95%CI=0.799-0.872; P<0.001), CD8+ T cells (OR=0.983, 95%CI=0.976-0.990; P<0.001) and CD3-CD19+ B cells (OR=0.992, 95%CI=0.988-0.997; P=0.003) as novel risk factors. Most importantly, the predictive accuracy of the combined model integrating four score systems and these risk factors demonstrated highest among all models for the development of ARDS (AUC= 0.904) and the progression from ARDS to death (AUC= 0.959).Conclusion:COVID-19 patients with ARDS were more likely to develop into death. The potential risk factors and the comprehensive prediction model could be helpful to identify patients that are at risk of developing ARDS with poor prognosis at an early stage, which might help physicians to formulate a timely therapeutic strategy.
Burden and consequence of birth defects in Nepal-evidence from prospective cohort study
Authors: Paudel Prajwal , Sunny Avinash K , Gurung Rejina , Gurung Abhishek , Malla Honey , Rana Netra B , KC Nawaraj , Chaudhary Ram Narayan , KC Ashish 
Published: January 2021

Abstract
Background-Every year an estimated 7.9 million babies are born with birth defect. Of these babies, more than 3 million die and 3.2 million have disability. Improving nationwide information on prevalence of birth defect, risk factor and consequence is required for better resource allocation for prevention, management and rehabilitation. In this study, we assess the prevalence of birth defect, associated risk factors and consequences in Nepal.Method-This is a prospective cohort study conducted in 12 hospitals of Nepal for 18 months. All the women who delivered in the hospitals during the study period was enrolled. Independent researchers collected data on the social and demographic information using semi-structured questionnaire at the time of discharge and clinical events and birth outcome information from the clinical case note. Data were analyzed on the prevalence and type of birth defect. Logistic regression was done to assess the risk factor and consequences for birth defect. Results-Among the total 87,242 livebirths, the prevalence of birth defects was found to be 5.8 per 1000 live births. The commonly occurring birth defects were anencephaly (3.95%), cleft lip (2.77%), cleft lip and palate (6.13%), clubfeet (3.95%), eye abnormalities (3.95%) and meningomyelocele (3.36%). The odds of birth defect was higher among mothers with age <20 years (adjusted Odds ratio (aOR) 1.64; 95% CI, 1.18-2.28) and disadvantaged ethnicity (aOR 1.78; 95% CI, 1.46-2.18). The odds of birth asphyxia was twice fold higher among babies with birth defect (aOR 1.88; 95% CI, 1.41-2.51) in reference with babies without birth defect. The odds of neonatal infection was twice fold higher among babies with birth defect (aOR 1.82; 95% CI, 1.12-2.96) in reference with babies without birth defect. Babies with birth defect had three-fold risk of pre-discharge mortality (aOR 3.00; 95% CI, 1.93-4.69). Conclusion- Babies with birth defect have high risk for birth asphyxia, neonatal infection and pre-discharge mortality at birth. Further evaluation on the care provided to babies who have birth defect is warranted.
A nomogram based on combining systemic and hepatic inflammation markers for predicting microscopic bile duct tumour thrombus in hepatocellular carcinoma
Authors: Wu Jun-Yi , Sun Ju-Xian , Wu Jia-Yi , Huang Xiao-Xiao , Bai Yan-Nan , Zeng Yong-Yi , Zhang Zhi-bo , Cheng Shu-Qun , Yan Mao-Lin 
Published: January 2021

Abstract
Background: Bile duct invasion is a relatively rare event and is not well characterised in hepatocellular carcinoma (HCC). It remains very difficult to diagnose HCC with bile duct tumour thrombus (BDTT) before surgery. Increasing evidence has revealed that inflammation plays a critical role in tumorigenesis. This study aimed to develop nomograms based on systemic and hepatic inflammation markers to predict microscopic BDTT (micro-BDTT) before surgery in HCC. Methods: A total of 723 HCC patients who underwent hepatectomy as initial therapy between January 2012 and June 2020 were included in the study. Logistic regression analysis was used to identify independent risk factors for micro-BDTT. The nomograms were constructed using significant predictors, including α-fetoprotein (AFP), alkaline phosphatase (ALP), direct bilirubin (DB), prognostic nutritional index (PNI), and γ-glutamyl transferase (γ-GT)/alanine aminotransferase (ALT). The prediction accuracies of the nomograms were evaluated using the area under the receiver operating characteristic (ROC) curve. Results: AFP, ALP, DB, PNI, and γ-GT/ALT were independent risk factors for predicting micro-BDTT (P=0.036, P=0.004, P=0.013, P=0.012, and P=0.006, respectively), which were assembled into the nomograms. The area under the ROC curve of the nomograms combining PNI and γ-GT/ALT for predicting micro-BDTT was 0.804 (95% confidence interval [CI]: 0.730–0.878). The sensitivity and specificity values when used in predicting micro-BDTT before surgery were 0.739 (95% CI: 0.612–0.866) and 0.781 (95% CI: 0.750–0.813), respectively. Conclusions: The nomogram based on combining systemic and hepatic inflammation markers is suitable for predicting micro-BDTT before surgery in HCC patients, leading to a rational therapeutic choice for HCC.
Current status and related factors of turnover intention of primary medical staff in Anhui Province, China: a cross-sectional study
Authors: Chen Guimei , Sang Lingzhi , Rong Jian , Yan Huosheng , Liu Hongzhang , Cheng Jing , Wang Li , Ding Hong , Chen Ren 
Published: January 2021

Abstract
Background The shortage of primary medical staff is an important issue in the management of health human resources, and it is also a problem that all countries in the world need to face together. Since 2009, China has implemented a new series of medical system reforms and the shortage and loss of primary medical staff have been alleviated accordingly. However, China has a large population and it is difficult to distribute health human resources evenly across regions. This study aimed to explore the current status of turnover intention and its relationship with psychological capital, social support, and job burnout, as well as how these factors influence turnover intention of primary medical staff in Anhui province, China.Methods Using structured questionnaires to collect data, including demographic characteristics, turnover intention, psychological capital, social support, and Chinese Maslach Burnout Inventory scale. A total of 1,152 primary medical workers of Anhui were investigated. Data were analyzed by t-test, analysis of variance (ANOVA), Pearson correlation analysis, and multiple linear regression model.Results Total scores of turnover intention, psychological capital, social support, and job burnout of subjects were 14.15 ± 4.35, 100.09 ± 15.98, 64.93 ± 13.23 and 41.07 ± 9.437, respectively. Multiple linear regression showed the related factors of turnover intention were age, job position, work unit, and scores of job burnout. Pearson correlation showed psychological capital and social support were negatively correlated with turnover intention, while the score of job burnout was positively correlated with turnover intention.Conclusion The improvement of psychological capital and social support and the reduction of job burnout may play an important role in reducing turnover intention of primary medical staff. Primary medical managers should strengthen the humanistic care for primary medical staff, optimize the incentive mechanism, and improve internal management of medical institutions for stability.
Automatic Segmentation of Coronary Lumen and External Elastic Membrane in Intravascular Ultrasound Images Using 8-layer U-Net
Authors: Dong Liang , Lu Wei , Jiang Jun , Zhao Ya , Song Xiangfen , Leng Xiaochang , Zhao Hang , Wang Jian’an , Li Changling , Xiang Jianping 
Published: January 2021

Abstract
Background: Intravascular ultrasound (IVUS) is the golden standard in accessing the coronary lesions, stenosis, and atherosclerosis plaques. In this paper, a fully-automatic approach by an 8-layer U-Net is developed to segment the coronary artery lumen and the area bounded by external elastic membrane (EEM), i.e. cross section area (EEM-CSA). The database comprises of single-vendor and single-frequency IVUS data. Particularly, the proposed data augmentation of MeshGrid combined with flip and rotation operations is implemented, improving the model performance without pre- or post-processing of the raw IVUS images.Results: The mean intersection of union (mIoU) of 0.937 and 0.804 for the lumen and EEM-CSA respectively were achieved, which exceeded the manual labeling accuracy of the clinician. Conclusion: The accuracy shown by the proposed method is sufficient for subsequent reconstruction of 3D IVUS images, which is essential for doctors’ diagnosis in the tissue characterization of coronary artery walls and plaque compositions, qualitatively and quantitatively.
Bilateral Cervical Plexus Block for Anterior Cervical Spine Surgery: Study Protocol for a Randomised Placebo-Controlled Trial
Authors: Mulcahy Michael , Elalingam Thananchayan , Jang Kevin , D'Souza Mario , Tait Matthew 
Published: January 2021

Abstract
Background There has been increasing focus to improve the quality of recovery following anterior cervical spine surgery (ACSS). Postoperative pain and nausea are the most common reasons for prolonged hospital stay and readmission after ACSS. Superficial cervical plexus block (SCPB) provides site-specific analgesia with minimal side-effects, thereby improving quality of recovery. The aim of our study was to investigate the effect bilateral cervical plexus block has on post-operative recovery in patients undergoing ACSS. Methods The study is a pragmatic, multi-centre, blinded, parallel-group, randomised placebo-controlled trial. 136 eligible patients (68 in each group) undergoing ACSS will be included. Patients randomised to the intervention group will have a SCPB administered under ultrasound guidance with a local anaesthetic solution (0.2% ropivacaine, 15mL); patients randomised to the placebo group will be injected in an identical manner with a saline solution. The primary outcome is the 40-item quality of recovery questionnaire score at 24 hours after surgery. In addition, comparisons between groups will be made for 24-hour opioid usage and length of hospital stay. Neck pain intensity will be quantified using the numeric rating scale at 1, 3, 6 and at 24 hours post-operatively. Incidence of nausea, vomiting, dysphagia or hoarseness in the first 24 hours after surgery will also be measured. Discussion By conducting a blinded placebo trial, we aim to control for the bias inherently associated with a tangible medical intervention and show the true treatment effect of SCPB in ACSS. A statistically significant result will indicate an overall improved quality of recovery for patients; alternatively, if no benefit is shown, this trial will provide evidence that this intervention is unnecessary. Trial registration Prospectively registered with the Australia New Zealand Clinical Trials Registry: ACTRN12619000028101. Registration date: 11/01/19.
Patterns of coronal and sagittal deformities in adolescent idiopathic scoliosis
Authors: Mak Trixie , Cheung Prudence Wing Hang , Zhang Teng , Cheung Jason Pui Yin 
Published: January 2021

Abstract
Background: Thoracic scoliosis has been shown to be associated with hypokyphosis in adolescent idiopathic scoliosis (AIS). However, the relationship of sagittal spino-pelvic parameters with different coronal curve patterns and their influence on patient-perceived quality of life is unknown. This study aims to determine the association between coronal and sagittal malalignment in patients with AIS and to determine their effects on SRS-22r scores. Methods: A cross-sectional study was conducted on 1054 consecutive patients with AIS. The coronal Cobb angle, thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), PI-LL mismatch (PI-LL), pelvic tilt (PT), and sacral slope (SS) were measured on standing radiographs. The coronal Cobb angle (mild: 10-20°; moderate: >20-40°; severe: >40°) and PI (low: <35°; average: 35-50°; high: >50°) were divided into 3 sub-groups for comparison. Relationship between coronal curve magnitudes and sagittal parameters was studied as was their association with SRS-22r scores. Results: Low PI had smaller SS (30.1±8.3° vs 44.8±7.7°; p<0.001), PT (-0.3±8.1° vs 14.4±7.5°; p<0.001), and LL (42.0±13.2° vs 55.1±10.6°; p<0.001), negative PI-LL mismatch (-12.1±13.1° vs 4.1±10.5°; p<0.001) as compared to large PI. There were no significant relationships with PI and TK (p=0.905) or curve magnitude (p=0.431). No differences in sagittal parameters were observed for mild, moderate or severe coronal Cobb angles. SRS-22r scores only correlated with coronal Cobb angle and larger Cobb angles were negatively correlated with the function, appearance and pain domains. Conclusions: The sagittal profile for AIS is associated with the pelvic parameters especially PI but not with the coronal curve pattern. All patients have a similar TK regardless of coronal curve type. However, it appears that the coronal deformity is a greater influence on quality of life outcomes especially those >40°.
LncRNA MT1JP plays a protective role in intrahepatic cholangiocarcinoma by regulating miR-18a-5p/FBP1 axis
Authors: Zhao Wei , Zhao Jing , Guo Xiao , Feng Yujie , Zhang Bingyuan , Tian Lantian 
Published: January 2021

Abstract
Background: Cholangiocarcinoma is a common malignant tumor of digestive system. LncRNA metallothionein 1J, pseudogene (MT1JP) has been reported to play tumor-suppressing roles in multiple cancers. However, its effect on cholangiocarcinoma has not been evaluated. Methods: The expression of MT1JP in intrahepatic cholangiocarcinoma specimens and paired para-carcinoma tissues were detected by real-time PCR. The overexpression plasmid and siRNA of MT1JP were transfected into intrahepatic cholangiocarcinoma cells to change the expression levels of MT1JP. CCK-8, flow cytometry and transwell assays were performed to measure proliferation, cell cycle transition, apoptosis, migration and invasion. Dual-luciferase reporter assay, real-time PCR and western blot were carried out to screen the miRNA bound by MT1JP. In addition, xneograft experiment was used to determine the tumorigenesis of cholangiocarcinoma cells in nude mice. Results: MT1JP was downregulated in intrahepatic cholangiocarcinoma specimens, and its expression was related with TNM stage and lymph node metastasis. Overexpression of MT1JP inhibited proliferation, cell cycle transition, migration and invasion, and induced apoptosis in intrahepatic cholangiocarcinoma cells. The knockdown of MT1JP led to opposite results. MT1JP bound to miR-18a-5p to facilitate the expression of fructose-1,6-bisphosphatase 1 (FBP1). MiR-18a-5p was increased in intrahepatic cholangiocarcinoma samples, and its expression was negatively correlated with that of MT1JP. In addition, MT1JP also suppressed tumorigenesis in nude mice. Conclusions: MT1JP alleviated proliferation, migration and invasion, and induced apoptosis in cholangiocarcinoma cells by regulating miR-18a-5p/FBP1 axis. These findings may provide novel insights for clinical diagnosis and treatment of cholangiocarcinoma.
Depressive, anxiety, and burnout symptoms on health care personnel at a month after COVID-19 outbreak in Indonesia: a documentary research using Rasch model analysis
Authors: Sunjaya Deni Kurniadi , Herawati Dewi Marhaeni Diah , Siregar Adiatma YM 
Published: January 2021

Abstract
Background: Health personnel who demonstrated close contact with patients with COVID-19, might experience a higher risk of infection and psychological problems. This study aims to explore depressive, anxiety, and burnout symptoms among health care personnel with a higher risk for psychological trauma.Methods: This study was a cross-sectional study using secondary data from an online assessment, which was conducted one month after the COVID-19 outbreak. A total of 544 respondents from 21 provinces in Indonesia were included. Data on depressive, anxiety, and burnout symptoms were transformed first using the Rasch model and then categorized. Data from health professionals in the higher risk group and the lower risk group were analyzed.Results: A higher percentage of health professionals experiencing depressive symptoms (22.8%), anxiety (28.1%), and burnout (26.8%) are found in the higher risk group. The chance for the higher risk group’s personnel to present with moderate and severe depressive symptoms, anxiety, and burnout are 5.28 (CI: 2.01–13.89; p < 0.05), 1.36 (CI: 0.09–1.96; p > 0.05), and 3.92 (CI: 2.08–7.40; p < 0.05) times higher, respectively. The probability for patient-induced burnout is 2.13 (CI: 1.51–3.007; p < 0.05) times higher and highest among the other burn out dimensions. The depressive symptoms complained were similar between groups: loneliness, sleep disturbances, difficulty concentrating, and inability to initiate activities. Loneliness demonstrates the highest logit value among the symptoms.Conclusions: Health professionals with direct contact and responsibility to treat COVID-19 patients exhibit a higher risk to experience depressive symptoms and burnout. Communication with peers and staying in contact with family needs to be encouraged. Physiological well-being should be considered for high-risk health personnel. Incentive or insurance guaranteed by the government or institution is essential as a reward and compensation during this period.
Two-step Seismic Noise Reduction caused by COVID-19 Induced Reduction in Social Activity in metropolitan Tokyo, Japan
Authors: Yabe Suguru , Imanishi Kazutoshi , Nishida Kiwamu 
Published: January 2021

Abstract
The COVID-19 pandemic that started at the end of 2019 forced populations around the world to reduce social and economic activities; it is believed that this can prevent the spread of the disease. In this paper, we report an analysis of the seismic noise during such an induced social activity reduction in the Tokyo metropolitan area, Japan. Using seismic data obtained from 18 stations in the Metropolitan Seismic Observation Network (MeSO-net), a two-step seismic noise reduction was observed during the timeline of COVID-19 in Tokyo. The first noise reduction occurred at the beginning of March 2020 in the frequency band of 20–40 Hz. This corresponded with the request by the Prime Minister of Japan for a nationwide shutdown of schools. Although social activity was not reduced significantly at this juncture, local reduction of seismic wave excitation in the high frequency band, 20–40 Hz, was recorded at some MeSO-net stations located in school properties. The second reduction of seismic noise occurred at the end of March to the beginning of April 2020 in a wider frequency band including lower frequency bands of 1–20 Hz. This timing corresponds to when the Governors of the Tokyo metropolitan area requested citizens to stay home and when the state of emergency was declared for the Tokyo metropolitan area by the government, respectively. Since then, the estimated population at train stations abruptly dropped, which suggests that social activity was severely reduced. Such large-scale changes in social activity affect the seismic noise level in low frequency bands. The seismic noise level started to increase from the middle of May correlating with increase in population at the train stations. This suggests that social activity restarted even before the state of emergency was lifted at the end of May. The two-step seismic noise reduction observed in this study has not been reported in other cities around the world. Unexpected reduction of social activity due to COVID-19 provided a rare opportunity to investigate the characteristics of seismic noise caused by human activities.