bluuebunny/crossref_metadata_2025_split huggingface dataset:
Point-of-Care Ultrasound May Be Useful for Detecting Pediatric Intussusception at an Early Stage
Authors: Lee Jeong-Yong , Kim Jung Heon , Choi Seung Jun , Lee Jong Seung , Ryu Jeong-Min 
Published: February 2020

Abstract
Background: This study aimed to verify the usefulness of point-of-care ultrasound (POCUS) performed by pediatric emergency physicians for detecting intussusception at an early stage.

Methods: This retrospective study included 1-month- to 6-year-old children with clinically suspected intussusception, who underwent POCUS in the pediatric emergency department between December 2016 and February 2018. The criteria for performing POCUS were set to broader standards: presenting any one of intermittent abdominal pain/irritability or bloody stool, or ≥2 symptoms among nonspecific abdominal pain/irritability, abdominal mass/distension, vomiting, or lethargy. POCUS results were interpreted and categorized as “negative” or “suspicious,” and a radiologist performed confirmatory ultrasound in “suspicious” cases.

Results: We analyzed 575 POCUS scans from 549 patients (mean age, 25.5 months). Among the 92 “suspicious” cases (16.0%), 70 (12.2%) were confirmed to have intussusception. POCUS showed 100% sensitivity, 95.6% specificity, and 97.8% accuracy. Patients with confirmed intussusception were mainly diagnosed in the early stages, with a mean symptom duration of 11.7 hours, and most patients (97.1%) were treated successfully via air enema reduction. Compared to the non-intussusception group, the intussusception group had more intermittent abdominal pain ( P < 0.001), but less vomiting ( P = 0.001); the other clinical features showed no intergroup differences.

Conclusion: POCUS performed using the criteria set to broader standards by pediatric emergency physicians may be useful for detecting intussusception at an early stage, which may present with obscure clinical symptoms.
On Sackin's original proposal: The variance of the leaves' depths as a phylogenetic balance index
Authors: Coronado Tomás Martínez , Mir Arnau , Rossello Francesc , Rotger Lucía 
Published: February 2020

Abstract
Background. The Sackin index S of a rooted phylogenetic tree, defined as the sum of its leaves' depths, is one of the most popular balance indices in phylogenetics, and Sackin's 1972 paper is usually cited as the source for this index. However, what Sackin actually proposed in his paper as a measure of the imbalance of a rooted tree was not the sum of its leaves' depths, but their ``variation''. This proposal was later implemented as the variance of the leaves' depths by Kirkpatrick and Slatkin in 1993, where they also posed the problem of finding a closed formula for its expected value under the Yule model. Nowadays, Sackin's original proposal seems to have passed into oblivion in the phylogenetics literature, replaced by the index bearing his name, which, in fact, was introduced a decade later by Sokal.
Results. In this paper we study the properties of the variance of the leaves' depths, V, as a balance index. Firstly, we prove that the rooted trees with $n$ leaves and maximum V value are exactly the combs with n leaves. But although V achieves its minimum value on every space of bifurcating rooted phylogenetic trees with at most 183 leaves at the so-called ``maximally balanced trees'' with n leaves, this property fails for almost every n larger than 184 We provide then an algorithm that finds the bifurcating rooted trees with n leaves and minimum V value in quasilinear time. Secondly, we obtain closed formulas for the expected V value of a bifurcating rooted tree with any number n of leaves under the Yule and the uniform models and, as a by-product of the computations leading to these formulas, we also obtain closed formulas for the variance under the uniform model of the Sackin index and the total cophenetic index of a bifurcating rooted tree, as well as of their covariance, thus filling this gap in the literature.
Circulating betatrophin/ANGPTL8 levels correlate with body fat distribution in individuals with normal glucose tolerance but not those with glucose disorders
Authors: zheng jing , Liu Juan , Hong Beverly S , Li Yanbing 
Published: February 2020

Abstract
Background: The relationship between betatrophin/ANGPTL8 and obesity has been investigated using body mass index (BMI); however, since BMI reflects overall adiposity rather than body fat distribution, it remains unclear whether fat deposition in different areas of the body affects betatrophin expression. Here, we investigated the correlation between circulating betatrophin levels and body fat distribution in patients with different glucose tolerance.Methods: ﻿We performed a cross-sectional study in 128 participants with impaired glucose tolerance (IGT; n = 64) or normal glucose tolerance (NGT; n = 64). Circulating betatrophin levels were detected by enzyme-linked immunosorbent assay. Body fat distribution (subcutaneous, visceral, and limb fat) was measured by magnetic resonance imaging (MRI) and a body fat meter.Results: After controlling for age, sex, and BMI, betatrophin was correlated positively with visceral adipose tissue-to-subcutaneous adipose tissue ratio ( VAT/SAT ratio; r = 0.339, p = 0.009) and negatively with body fat ratio (BFR; r = -0.275, p = 0.035), left lower limb fat ratio (LLR; r = -0.330, p = 0.011), and right lower limb fat ratio (RLR; r = -0.288, p = 0.027) in the NGT group, with these correlations remaining after controlling for triglycerides. VAT/SAT ratio (standardized β = 0.419, p = 0.001) was independently associated with serum betatrophin levels; however, betatrophin was not associated with body fat distribution variables in the IGT group.Conclusions: Circulating betatrophin levels correlated positively with VAT/SAT ratio and negatively with lower limb fat, but not subcutaneous or upper limb fat, in individuals with normal glucose tolerance. Thus, betatrophin may be a poten­tial biomarker for body fat distribution in individuals without glucose disorders.
Lactic acid level as an outcome predictor in pediatric patients with intussusception in the emergency department
Authors: Lee Jeong-Yong , Byun Young-Hoon , Park Jun-Sung , Lee Jong Seung , Ryu Jeong-Min , Choi Seung Jun 
Published: February 2020

Abstract
Background: Intussusception decreases blood flow to the bowel, and tissue hypoperfusion results in increased lactic acid levels. We aimed to determine whether lactic acid levels are associated with pediatric intussusception outcomes.

Methods: The electronic medical records of our emergency department pediatric patients diagnosed with intussusception, between January 2015 and October 2018, were reviewed. An outcome was considered poor when intussusception recurred within 48 hours of reduction or when surgical reduction was required due to air enema failure.

Results: A total of 249 patients were included in the study, including 39 who experienced intussusception recurrence and 11 who required surgical reductions; hence, 50 patients were included in the poor outcome group. The poor and good outcome groups showed significant differences in their respective blood gas analyses for pH (7.39 vs. 7.41, P = .001), lactic acid (1.70 vs. 1.30 mmol/L, P < .001), and bicarbonate (20.70 vs. 21.80 mmol/L, P = .036). Multivariable logistic regression analyses showed that pH and lactic acid levels were the two factors significantly associated with poor outcomes. When the lactic acid level cutoff values were ≥1.5, ≥2.0, ≥2.5, and ≥3.0 mmol/L, the positive predictive values for poor outcomes were 30.0%, 34.6%, 50.0%, and 88.9%, respectively.

Conclusion: Lactic acid levels affect outcomes in pediatric patients with intussusception; higher lactic acid levels are associated with higher positive predictive values for poor outcomes.
What hinders and facilitates the implementation of nurse-led interventions in dementia care? A scoping review
Authors: Karrer Melanie , Hirt Julian , Zeller Adelheid , Saxer Susi 
Published: February 2020

Abstract

Background The implementation of evidence-based interventions for people with dementia is complex and challenging. However, successful implementation might be a key element to ensure evidence-based practice and high quality of care. There is a need to improve implementation processes in dementia care by better understanding the arising challenges. Thus, the aim of this study was to identify recent knowledge concerning barriers and facilitators to implementing nurse-led interventions in dementia care. Methods We performed a scoping review using the methodological framework of Arksey and O’Malley. Studies explicitly reporting on the implementation process and factors influencing the implementation of a nurse-led intervention in dementia care in all settings were included. We searched eight databases from January 2015 until January 2019. Two authors independently selected the studies. For data analysis, we used an inductive approach to build domains and categories. Results We included 26 studies in the review and identified barriers as well as facilitators in five domains: policy (e.g. financing issues, health insurance), organisation (e.g. organisational culture and vision, resources, management support), intervention/implementation (e.g. complexity of the intervention, perceived value of the intervention), staff (e.g. knowledge, experience and skills, attitude towards the intervention), and person with dementia/family (e.g. nature and stage of dementia, response of persons with dementia and their families). Conclusions Besides general influencing factors for implementing nursing interventions, we identified dementia-specific factors reaching beyond already known barriers and facilitators. A pre-existing person-centred culture of care as well as consistent team cultures and attitudes have a facilitating effect on implementation processes. Furthermore, there is a need for interventions that are highly flexible and sensitive to patients’ condition, needs and behaviour.
Time evolution of β-lactoglobulin corona formation on gold nanoparticles and impact on allergy
Authors: Zhang Xiaoning , Li Meifeng , Lv Yuanping , Sun Xiaoling , Han Yao , Zhao Xiangzhong , Huang Xiaowen 
Published: February 2020

Abstract
Gold nanoparticles (AuNPs) are modified immediately by the adsorption of β-lactoglobulin (βlg) when designed as colorimetric probe in raw milk, leading to the formation of a protein corona. This adsorption results mainly from a fast electrostatic force and a slow formation of Au-S covalent bonds, which is a precondition for the use of AuNPs in biodetection. The proteins corona influences the structure and bioactivity of adsorbed protein, such as the allergy. In this study, the mechanism of βlg adsorbed on AuNPs was investigated in terms of stoichiometry, binding affinity (Ka), time evolution of Au-S bond, and general secondary structure changes to address the desensitization of AuNPs. The results show that about 3,600 βlg are adsorbed on a single AuNPs, and the Ka is 2.9 ± 0.7 × 10 6 M -1 . The formation of Au-S bonds takes about 9 h, which is the time needed for complete changes in secondary structure and the IgE combining capacity. The structure of allergenic epitopes assigned to β-sheet was destroyed by the formation of Au-S bond, then induced to the decrease allergy. Furthermore, Fourier transform infrared spectroscopy confirmed a decrease in β-sheet contents after conjugated with AuNPs.
Childhood Socioeconomic Status and Type 2 Diabetes Mellitus among Mid-late Chinese: A Structural Equation Modeling Analysis
Authors: zhang xiaoning , jiang xue , zhou qiong 
Published: February 2020

Abstract
Objectives This present study was aimed to examine the associations between childhood socioeconomic status (CSES) and type 2 diabetes mellitus (T2DM) among mid-late Chinese and disentangle the pathways using structural equation modelling (SEM). Methods Using cross-sectional data from China Health and Retirement Longitudinal Study (CHARLS), this study included 19767 participants aged 45 and over. SEM models were constructed to decompose the intricate relationships between CSES, childhood health history (CHH), adulthood socioeconomic status (ASES), health-related behaviors (HRB) and T2DM. Results The results showed that T2DM was significantly associated with CSES (sβ = -0.239; P = 0.001), CHH (sβ = -0.016; P = 0.005) and ASES (sβ = -0.180; P = 0.002) directly, While the indirect effect of CSES on T2DM was sβ = -0.111; P = 0.001with an acceptable goodness-of-fit. The model presented an acceptable goodness of fit: RMSA0.082, CFI 0.803, GFI 0.938, AGFI 0.904, and SRMR 0.060. Conclusions CSES had direct and indirect effects on later incidence of T2DM, which was mediated by ASES and CHH, supporting the life course theory, indicating that optimal interventions should be conducted in the early stages of life to narrow the socioeconomic and obtain maximal health benefits.
Clinical outcomes after small incision lenticule extraction versus femtosecond laser-assisted LASIK for high myopia: a Meta-analysis.
Authors: Fu Yanyan , Yin Yewei , Zhao Yang , Xiang Aiqun , Lu Ying , Hu Tu , Li Yuanjun , Du Kaixuan , Wu Xiaoying , Wen Dan 
Published: February 2020

Abstract
Background To compare postoperative clinical outcomes of high myopia after being treated by Small incision lenticule extraction (SMILE) and femtosecond laser in situ keratomileusis (FS-LASIK).Methods Comprehensive studies were conducted on the PubMed, MEDLINE, EMBASE, the Cochrane Library, and Chinese databases.Trials meeting the selection criteria were quality appraised, and the data were extracted by 2 independent authors, and the RevMan 5.3 version software were used in analyzing.Result Ten studies involving 637 patients (1093 eyes;575 eyes in the SMILE group and 518 eyes in the FS-LASIK group) were included in this meta-analysis. Pooled result revealed no significant differences in the following outcomes: the logMAR values of postoperative UDVA(WMD = -0.01, 95% CI: -0.02,0.00, I²=0%, P = 0.10 at postoperative 1mo; WMD =-0.01, 95% CI: -0.00 to 0.01, I²=0%,P = 0.35 at postoperative 3mo; WMD = -0.01, 95% CI:-0.02 to 0.01, I²=17%,P = 0.26 at long term), the logMAR values of postoperative CDVA(WMD = -0.02, 95% CI, -0.04 to 0.00, I²=0%, P = 0.11),and the postoperative mean refractive SE (WMD =0.02, 95% CI:0.04 to 0.08, I²=29%, P=0.60) . In the long-term observation, postoperative tHOA (WMD =-0.10, 95% CI:-0.13 to -0.07, I²=15%, P<0.00001)and postoperative spherical aberration (WMD =-0.13, 95% CI:--0.17 to -0.09, I²=38%, P<0.00001) were found to be less in the SMILE group compared with the FS-LASIK group, but no significant difference was found in postoperative coma (WMD =-0.02, 95% CI:-0.04 to 0.00, I²=98%, P=0.40).We also found greater PCE change post FS-LASIK than SMILE at long term follow-ups(WMD =-0.69, 95% CI:-1.36 to -0.01, I²=0%, P<0.05, however, there was no significant difference between the two groups at 3- or 6- months.(WMD =-0.19, 95% CI:-0.41 to 0.03, I²=31%, P=0.09;WMD =-0.20, 95% CI:-0.50 to 0.10, I²=17%, P=0.20)Conclusion For patients with high myopia, both SMILE and FS-LASIK are safe and efficacious. However, SMILE induced less tHOA and spherical aberration compared with FS-LASIK. Besides, FS-LASIK showed a greater increase in PCE than SMILE only at long term follow-ups. It remains to be seen whether the patients can get a better visual quality after SMILE and more comparative studies focused on high myopia is necessary.
Association of ABO Polymorphisms and Pancreatic Cancer/Cardiocerebrovascular Disease: a Meta-analysis
Authors: Li Yanxia , Liu Luyang , Huang Yubei , Zheng Hong , Li Lian 
Published: February 2020

Abstract
Background: ABO gene polymorphisms have been reported to be associated with the risk of multiple cancers and cardiocerebrovascular disease s. However, the results remained controversial. In this study, we conducted a systematic review and meta-analysis to clarify the association between two SNPs (rs505922 and rs657152) in ABO gene and cancers/ cardiocerebrovascular disease s.
Method: All eligible case-control studies come from PubMed, Embase and Web of Science up to Jan. 1, 2019. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the corresponding associations. Sensitivity analysis, publication bias assessment, and heterogeneity test were performed using STATA 12.0.
Results : A total of nineteen articles involving twenty-two case-control populations were included according to inclusion and exclusion criteria. Twelve populations (20,820 cases and 27,837 controls) were used to evaluate the relationship between rs505922 and overall cancers and nine populations (22,275 cases and 71,549 controls) were included to assess the association between rs505922 and cardiocerebrovascular diseases. The results showed a significant association between the rs505922 polymorphism and cancers (CvsT: OR=1.13, 95%CI=1.05-1.22, P =0.001), and cardiocerebrovascular diseases (OR=1.36, 95%CI=1.19-1.57, P <0.001). Five populations (8,660 cases and 10,618 controls) were included to evaluate association between rs657152 and cancers and five populations (8,105 cases and 6,712 controls) were included to estimate the relationship between rs657152 and cardiocerebrovascular diseases. The result of meta-analysis reveals that rs657152 was significantly associated with cancers (OR=1.18, 95%CI=1.13-1.23, P <0.001) and cardiocerebrovascular diseases (OR=1.54, 95%CI=1.24-1.92, P <0.001).
Conclusion: Our study suggested that ABO polymorphisms might serve as a risk factor of pancreatic cancers and cardiocerebrovascular diseases.
Segmental versus main renal artery clamping in nephron sparing surgery: an updated Meta-analysis
Authors: Xu Jinhong , Xu YuanGao , Xu Shuxiong , Sun Fa , Shi Hua 
Published: February 2020

Abstract
ObjectsIschemia-reperfusion injury is very harmful in partial nephrectomy (PN) in renal cell carcinoma (RCC). It is important to choose an appropriate surgical method to reduce ischemia-reperfusion injury. To compare the impact of segmental artery clamping (SAC) and main artery clamping (MAC) on some clinical data of the patients underwent PN. MethodsStudies from January 2008 to November 2019 were identified by electronical search of the English databases including PubMed, EMBASE, the Cochrane Library and Chinese database including Wanfang, VIP and CNKI without language restriction. Two reviewers were involved in the trial. The impact on operation time(OT), Warm ischemia time (WIT), length of stay in hospital (LOS), blood transfusion rate, postoperative complication rate, Clavien classification ≥3 and positive surgery margin (PSM) were evaluated using Stata software, and standardized mean difference (SMD)%(for the continuous data) and the pooled odds ratios (ORs) (used for counting data) with 95% confidence interval (CI) were used as effect indicators. ResultsThirty-two studies were eligible. SAC showed characteristics through decreasing 1 week post-operative percentage changes of renal function [SMD:-0.973, 95% CI (-1.414, -0.532), P=0.000], 1 month post-operative percentage change in eGFR [SMD:-0.411, 95CI (-0.769, -0.053), P=0.025] and percentage change of eGFR of the affected kidney 3 months postoperatively between SAC and MAC group [SMD:-0.914, 95%CI (-1.662, -0.617), P=0.000]. During sub-group analysis, SAC had longer OT [SMD:0.562, 95CI (0.252, 0.871), P=0.000] compared to MAC group. However, no difference was observed between the two groups in OT, WIT LOS, blood transfusion rate, postoperative complication rate, Clavien classification ≥3 and PSM%. ConclusionsSAC has more superiority with advantages in short term post-operative renal function recovery compared to MAC. Whether to use SAC or MAC depends on tumor size, location, surgical modality, and surgeon’s judgements.
Comparison of ED95 of Butorphanol with Sufentanil for Gastrointestinal Endoscopy Sedation: a randomized controlled trial
Authors: Zhu Xiaona , Chen Limei , Zheng Shuang , Pan Linmin 
Published: February 2020

Abstract
Background: Butorphanol, a synthetic opioid partial agonist analgesic, has been widely used for the control of perioperative pain. However, the ideal dose and availability of butorphanol for gastrointestinal (GI) endoscopy are not well known. The aim of this study was to evaluated the 95% effective dose (ED95) of butorphanol and sufentanil in GI endoscopy and compared their clinical efficacy, especially the recovery time. Methods: The study was divided into two parts. For the first part, voluntary patients who needed GI endoscopy anesthesia were recruited to measure the ED95 of butorphanol and sufentanil when they reached successful sedation during GI endoscopy using the sequential method (the Dixon up-and-down method). In the second part, this was a double-blind, randomized study. Two hundred cases of painless GI endoscopy patients were randomly divided into two groups (n=100), including group B (butorphanol at the ED95 dose) and group S (sufentanil at the ED95 dose). Propofol was infused intravenously to both groups as the sedative. The recovery time, VAS (visual analogue scale) score, hand grip strength, fatigue severity scores, incidence of nausea and vomiting, and incidence of dizziness were recorded. Results: The ED95 of butorphanol in painless GI endoscopy was 9.07μg/kg (95% confidence interval: 7.81-19.66μg/kg). The ED95 of sufentanil was 0.1μg/kg (95% CI, 0.079-0.422μg/kg). Both butorphanol and sufentanil provided a good analgesic effect in GI endoscopy. However, the recovery time for butorphanol was significantly shorter than sufentanil (P<0.05, group B versus group S:21.26±7.70 vs. 24.03±7.80, min). Conclusions: Butorphanol at 9.07μg/kg showed a better effect compared with sufentanil in GI endoscopy sedation, notably reduced the recovery time.