bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute pancreatitis concomitant with diabetic ketoacidosis: a cohort from South China
Authors: Yuan Shiwen , Liao Jinli , Cai Ruibin , Xiong Yan , Zhan Hong , Zheng Ziyu 
Published: March 2020

Objective To evaluate the clinical characteristics of acute pancreatitis (AP) concomitant with diabetic ketoacidosis (DKA) in a cohort from South China and identify factors associated with early detection of DKA in AP patients. Methods Inpatient medical records of AP concomitant with DKA were retrospectively reviewed. Results Forty-eight patients with AP concomitant with DKA were enrolled in this study. The results indicated that comorbidity history of diabetes mellitus and mental status of not alert on admission were factors associated with DKA in AP patients. Compared with patients without DKA, patients with DKA showed significantly higher rates of hypertriglyceridemia and lower rates of gallstones than those without DKA. AP patients with concurrent DKA had higher levels of serum triglycerides, longer lengths of hospital stays, and higher complication rates of systemic inflammatory response syndrome and acute kidney injury. Conclusion AP patients might have higher risks of concomitant DKA if presenting as not alert upon admission or if they have past medical histories of diabetes mellitus. Serum triglyceride levels were significantly higher in AP patients with DKA. DKA raised the severity of AP, but did not increase in-hospital mortality.
Survival, Outcomes, and Use of Acuity Scoring Systems Following Tracheotomy in Veteran Patients
Authors: Bier-Laning Carol M. , Hotaling Jeffrey , Canar W. Jeffrey , Ansari Aziz A. 
Published: March 2020

Objectives: To determine whether established prognosis tools used in the general population of critically ill patients will accurately predict tracheotomy-related outcomes and survival outcomes in critically ill patients undergoing tracheotomy. Methods: Retrospective chart review of 94 consecutive critically ill patients undergoing isolated tracheotomy. Results: Logistic Organ Dysfunction System (LODS) and sepsis-related organ failure assessment (SOFA) scores, 2 validated measures of acuity in critically ill patients, were calculated for all patients. The only tracheotomy-related outcome of significance was the finding that patients with an LODS score ≤6 were more likely to become ventilator independent ( P < .015). Higher LODS or SOFA scores were associated with in-house death (LODS, P = .001, SOFA, P = .008) and death within 90 days (LODS, P = .009, SOFA, P = .031), while death within 180 days was associated only with a higher LODS score (LODS, P = .018). When controlling for age, there was an association between both LODS ( P = .015) and SOFA ( P = .019) scores and death within 90 days of tracheotomy. Conclusions: The survival outcome for critically ill patients undergoing tracheotomy seems accurately predicted based on scoring systems designed for use in the general population of critically ill patients. Logistic Organ Dysfunction System may also be useful to predict the likelihood of the tracheotomy-related outcome of ventilator independence. This suggests that LODS scores may be helpful to palliative care clinicians as part of a shared decision-making aid in critically ill, ventilated patients for whom tracheotomy is being considered.
Prediction of ovarian aging using ovarian expression of BMP15, GDF9, and C-KIT
Authors: Park Min Jung , Ahn Jun-Woo , Kim Ki Hyung , Bang Junghee , Kim Seung Chul , Jeong Jae Yi , Choi Ye Eun , Kim Chang-Woon , Joo Bo Sun 
Published: March 2020

This study investigated ovarian expressions of bone morphogenetic protein 15 (BMP15), growth differentiation factor 9 (GDF9), and C-KIT according to age in female mice to determine whether these factors can be served as new potential biomarkers of ovarian aging. Ovaries were collected from mice aged 10, 20, 30, and 40 weeks, and ovarian expressions of BMP15, GDF9, and C-KIT were examined by real-time PCR, Western blot, and immunohistochemistry. Follicle counts were measured on histological hematoxylin and eosin staining. In the second experiment to evaluate ovarian function, after superovulation with PMSG and hCG, the numbers of zygotes retrieved and embryo development rate were examined. Ovarian expressions of BMP15, GDF9, and C-KIT decreased with age. Follicle counts, numbers of retrieved zygotes, and embryo development rate were also significantly reduced in old mice over 30 weeks compared with young mice. These results indicate that these factors could be served as new potential biomarkers of ovarian aging. Impact statement Ovarian aging is becoming a more important issue in terms of fertility preservation and infertility treatment. Serum anti-Mullerian hormone (AMH) level and antral follicle count (AFC) are being practically used as markers of ovarian aging as well as ovarian reserve in human. However, these factors have some drawbacks in assessing ovarian aging and reserve. Therefore, the identification of ovarian expressions of BMP15, GDF9, and C-KIT according to female could be applied as a potent predictor of ovarian aging. This work provides new information on the development of diagnosis and treatment strategy of age-related fertility decline and premature ovarian insufficiency.
The significance of urgent ultrasound scan for shoulder dislocation in patients above the age of 40: A prospective British Elbow and Shoulder Society pathway implementation study
Authors: Zhou R , Prasad G , Robinson S , Shahane S , Sinha A 
Published: March 2020

Background The highlight of the British Elbow and Shoulder Society pathway for the management of traumatic anterior shoulder instability is early imaging in patients aged over 40 years to assess rotator cuff integrity and early repair, if indicated to optimise function. The senior author set up a protocol in our institute to streamline the diagnostic process for this cohort of patients. This was a retrospective analysis from a prospectively collected database to highlight the importance of early specialist imaging. Methods Our protocol is to perform urgent ultrasound scans for all suitable patients above 40 years after first-time traumatic shoulder dislocation. Demographics, associated injuries, ultrasound scan results, operations and functional outcomes were collated. Results One year following the introduction of our protocol, 40 patients with a mean age of 67 (range, 42–89; SD = 13.1) had ultrasound. The incidence of full-thickness rotator cuff tears was 57.5% (n = 23). Eleven patients with confirmed full-thickness rotator cuff tears underwent surgery. The mean age of surgical patients was significantly younger than the non-surgical group (p = 0.004). Discussion The use of early diagnostic imaging demonstrated a high incidence of full-thickness rotator cuff tears in this cohort of patients. This allowed early surgical repair to optimise function.
The likelihood of requiring a diagnostic test: Classifying emergency department patients with logistic regression
Authors: Sarıyer Görkem , Ataman Mustafa Gökalp 
Published: March 2020

Background: Emergency departments (EDs) play an important role in health systems since they are the front line for patients with emergency medical conditions who frequently require diagnostic tests and timely treatment. Objective: To improve decision-making and accelerate processes in EDs, this study proposes predictive models for classifying patients according to whether or not they are likely to require a diagnostic test based on referral diagnosis, age, gender, triage category and type of arrival. Method: Retrospective data were categorised into four output patient groups: not requiring any diagnostic test (group A); requiring a radiology test (group B); requiring a laboratory test (group C); requiring both tests (group D). Multivariable logistic regression models were used, with the outcome classifications represented as a series of binary variables: test (1) or no test (0); in the case of group A, no test (1) or test (0). Results: For all models, age, triage category, type of arrival and referral diagnosis were significant predictors whereas gender was not. The main referral diagnosis with high model coefficients varied by designed output groups (groups A, B, C and D). The overall accuracies of the logistic regression models for groups A, B, C and D were, respectively, 74.11%, 73.07%, 82.47% and 85.79%. Specificity metrics were higher than the sensitivities for groups B, C and D, meaning that these models were better able to predict negative outcomes. Implications: These results provide guidance for ED triage staff, researchers and practitioners in making rapid decisions regarding patients’ diagnostic test requirements based on specified variables in the predictive models. This is critical in ED operations planning as it potentially decreases waiting times, while increasing patient satisfaction and operational performance.
Lesser Metatarsophalangeal Instability: Diagnosis and Conservative Management of a Common Cause of Metatarsalgia
Authors: Kinter Christopher W. , Hodgkins Christopher W. 
Published: March 2020

Context: Lesser metatarsophalangeal (MTP) instability is a common condition that can become debilitating and require surgery. Evidence Acquisition: An extensive literature review was performed through MEDLINE and Google Scholar for publications relating to the etiology, diagnosis, and treatment of lesser MTP instability using the keywords metatarsophalangeal instability, athlete, forefoot pain, and metatarsalgia from database inception to 2019. Study Design: Clinical review. Level of Evidence: Level 4. Results: Lesser MTP instability is a common condition, especially in the active and aging populations. It is frequently misdiagnosed, causing delays in treatment that allow for progressive pain and deformity, which prevents an active lifestyle. Fortunately, MTP instability can be diagnosed easily with the drawer test. Magnetic resonance imaging is helpful when still in doubt. Conservative treatment entails joint immobilization and gradual return to play with taping and offloading metatarsal pads. Conclusion: Lesser MTP instability is a common diagnosis. Its early detection and conservative treatment can help the patient regain their previous level of activity and avoid surgery.
Acute type A aortic dissection: Aortic Dissection Detection Risk Score in emergency care – surgical delay because of initial misdiagnosis
Authors: Zaschke Lisa , Habazettl Helmut , Thurau Jana , Matschilles Christian , Göhlich Amélie , Montagner Matteo , Falk Volkmar , Kurz Stephan D 
Published: March 2020

Background:Acute type A aortic dissection requires immediate surgical treatment, but the correct diagnosis is often delayed. This study aimed to analyse how initial misdiagnosis affected the time intervals before surgical treatment, symptoms associated with correct or incorrect initial diagnosis and the potential of the Aortic Dissection Detection Risk Score to improve the sensitivity of initial diagnosis.Methods:We conducted a retrospective analysis of 350 patients with acute type A aortic dissection. Patients were divided into two groups: initial misdiagnosis (group 0) and correct initial diagnosis of acute type A aortic dissection (group 1). Symptoms were analysed as predictors for the correct or incorrect initial diagnosis by multivariate analysis. Based on these findings, the Aortic Dissection Detection Risk Score was calculated retrospectively; a result ⩾2 was defined as a positive score.Results:The early suspicion of aortic dissection significantly shortened the median time from pain to surgical correction from 8.6 h in patients with an initial misdiagnosis to 5.5 h in patients with the correct initial diagnosis (p&lt;0.001). Of all acute type A aortic dissection patients, 49% had a positive Aortic Dissection Detection Risk Score. Of all initial misdiagnosed patients, 41% had a positive score (⩾2). The presence of lumbar pain (p&lt;0.001), any paresis (p=0.037) and sweating (p=0.042) was more likely to lead to the correct initial diagnosis.Conclusion:An early consideration of acute aortic dissection may reduce the delay of surgical care. The suggested Aortic Dissection Detection Risk Score may be a useful tool to improve the preclinical assessment.
Radiostereometric Analysis Of Biceps Tenodesis: A Comparison Of Techniques
Authors: Okoroha Kelechi , Manderle Brandon J. , Beletsky Alexander , Yanke Adam Blair , Cole Brian J. , Forsythe Brian , Verma Nikhil N. 
Published: March 2020

Objectives: Arthroscopic biceps tenodesis (BT) is a common surgical procedure for treatment of anterior shoulder pain due to long head of the biceps pathology. BT can be accomplished via several different techniques. There continues to be a paucity of literature comparing the different techniques and fixation devices. The purpose of this study was to compare 4 different techniques for accomplishing a BT utilizing radiostereometric analysis. Methods: This study was a prospectively enrolled non-randomized trial of patients undergoing BT. All patients were treated at a single institution by 1 of 4 surgeons. Four different techniques were analyzed, 1) open BT with screw fixation, 2) open BT with single anchor fixation, 3) arthroscopic BT with screw fixation, and 4) arthroscopic BT with two suture anchor fixation. After the BT was completed a tantalum bead was sewn to the long head of the biceps tendon. This bead acted as a marker of the position of the biceps tendon. X-rays were taken during surgery while the patient remained sedated to establish time zero bead position. Follow up x-rays were completed at the patients 1st post-operative visit and 12 week post-operative visit. Position of the bead was measured at each time point in mm from the proximal most point of the humerus to its position distally. Results: A total of 60 patients were included in the analysis, with 15 patients in each of the 4 groups. Final bead position differed significantly for the open and arthroscopic techniques (107.35±20.39mm, 65.64±23.69mm, p<0.001), but did not differ significantly between the two open techniques and the two arthroscopic technique (p>0.05). The open technique resulted in 7.69±5.98mm of distal migration while the arthroscopic technique resulted in a similar amount of distal migration, 8.93±2.71mm. Conclusion: Short-term radiographic outcomes following open and arthroscopic biceps tenodesis revealed that each technique results in stable fixation of the tendon with minimal migration. Although a statistically significant migration occurred, this is likely clinically insignificant. This initial migration observed could be due to increased tensioning of the tendon when the patient is awake versus sedated.
Bouncing of Hydroxylated Silica Nanoparticles: an Atomistic Study Based on REAX Potentials
Authors: Nietiadi Maureen L. , Rosandi Yudi , Urbassek Herbert M. 
Published: March 2020

AbstractClean silica surfaces have a high surface energy. In consequence, colliding silica nanoparticles will stick rather than bounce over a wide range of collision velocities. Often, however, silica surfaces are passivated by adsorbates, in particular water, which considerably reduce the surface energy. We study the effect of surface hydroxylation on silica nanoparticle collisions by atomistic simulation, using the REAX potential that allows for bond breaking and formation. We find that the bouncing velocity is reduced by more than an order of magnitude compared to clean nanoparticle collisions.
Ultrasensitive Wearable Pressure Sensors Based on Silver Nanowire-Coated Fabrics
Authors: Lian Yunlu , Yu He , Wang Mingyuan , Yang Xiaonan , Zhang Hefei 
Published: March 2020

AbstractFlexible pressure sensors have attracted increasing attention due to their potential applications in wearable human health monitoring and care systems. Herein, we present a facile approach for fabricating all-textile-based piezoresistive pressure sensor with integrated Ag nanowire-coated fabrics. It fully takes advantage of the synergistic effect of the fiber/yarn/fabric multi-level contacts, leading to the ultrahigh sensitivity of 3.24 × 105 kPa−1 at 0–10 kPa and 2.16 × 104 kPa−1 at 10–100 kPa, respectively. Furthermore, the device achieved a fast response/relaxation time (32/24 ms) and a high stability (> 1000 loading/unloading cycles). Thus, such all-textile pressure sensor with high performance is expected to be applicable in the fields of smart cloths, activity monitoring, and healthcare device.
Identification and evolutionary analysis of the nucleolar proteome of Giardia lamblia
Authors: Feng Jin-Mei , Yang Chun-Lin , Tian Hai-Feng , Wang Jiang-Xin , Wen Jian-Fan 
Published: March 2020

Abstract
Background
The nucleoli, including their proteomes, of higher eukaryotes have been extensively studied, while few studies about the nucleoli of the lower eukaryotes – protists were reported. Giardia lamblia, a protist with the controversy of whether it is an extreme primitive eukaryote or just a highly evolved parasite, might be an interesting object for carrying out the nucleolar proteome study of protists and for further examining the controversy.

Results
Using bioinformatics methods, we reconstructed G. lamblia nucleolar proteome (GiNuP) and the common nucleolar proteome of the three representative higher eukaryotes (human, Arabidopsis, yeast) (HEBNuP). Comparisons of the two proteomes revealed that: 1) GiNuP is much smaller than HEBNuP, but 78.4% of its proteins have orthologs in the latter; 2) More than 68% of the GiNuP proteins are involved in the “Ribosome related” function, and the others participate in the other functions, and these two groups of proteins are much larger and much smaller than those in HEBNuP, respectively; 3) Both GiNuP and HEBNuP have their own specific proteins, but HEBNuP has a much higher proportion of such proteins to participate in more categories of nucleolar functions.

Conclusion
For the first time the nucleolar proteome of a protist - Giardia was reconstructed. The results of comparison of it with the common proteome of three representative higher eukaryotes -- HEBNuP indicated that the simplicity of GiNuP is most probably a reflection of primitiveness but not just parasitic reduction of Giardia, and simultaneously revealed some interesting evolutionary phenomena about the nucleolus and even the eukaryotic cell, compositionally and functionally.
Transcriptomic analysis of marine endophytic fungi extract identifies highly enriched anti-fungal fractions targeting cancer pathways in HepG2 cell lines
Authors: Blessie Ethel Juliet , Wruck Wasco , Abbey Benaiah Annertey , Ncube Audrey , Graffmann Nina , Amarh Vincent , Arthur Patrick Kobina , Adjaye James 
Published: March 2020

Abstract
Background
Marine endophytic fungi (MEF) are good sources of structurally unique and biologically active secondary metabolites. Due to the increase in antimicrobial resistance, the secondary metabolites from MEF ought to be fully explored to identify candidates which could serve as lead compounds for novel drug development. These secondary metabolites might also be useful for development of new cancer drugs. In this study, ethyl acetate extracts from marine endophytic fungal cultures were tested for their antifungal activity and anticancer properties against C. albicans and the human liver cancer cell line HepG2, respectively. The highly enriched fractions were also analyzed by high performance liquid chromatography coupled with high resolution mass spectrometry (HPLC-HRMS) and their effect on the HepG2 cells was assessed via transcriptomics and with a proliferation assay.

Results
We demonstrated that the fractions could reduce proliferation in HepG2 cells. The detailed transcriptome analysis revealed regulation of several cancer- and metabolism-related pathways and gene ontologies. The down-regulated pathways included, cell cycle, p53 signaling, DNA replication, sphingolipid metabolism and drug metabolism by cytochrome P450. The upregulated pathways included HIF-1 signaling, focal adhesion, necroptosis and transcriptional mis-regulation of cancer. Furthermore, a protein interaction network was constructed based on the 26 proteins distinguishing the three treatment conditions from the untreated cells. This network was composed of central functional components associated with metabolism and cancer such as TNF, MAPK, TRIM21 and one component contained APP.

Conclusions
The purified fractions from MEF investigated in this study showed antifungal activity against C. albicans and S. cerevisiae alone or both and reduced proliferation of the human liver cancer cell line HepG2 implicating regulation of several cancer- and metabolism-related pathways. The data from this study could be instrumental in identifying new pathways associated with liver cancer anti-proliferative processes which can be used for the development of novel antifungal and anti-cancer drugs.
Awareness of, attitude toward, and willingness to participate in pay for performance programs among family physicians: a cross-sectional study
Authors: Jan Chyi-Feng , Lee Meng-Chih , Chiu Ching-Ming , Huang Cheng-Kuo , Hwang Shinn-Jang , Chang Che-Jui , Chiu Tai-Yuan 
Published: March 2020

Abstract
Background
The National Health Insurance Administration of Taiwan has introduced several pay-for-performance programs to improve the quality of healthcare. This study aimed to provide government with evidence-based research findings to help primary care physicians to actively engage in pay-for-performance programs.

Methods
We conducted a questionnaire survey among family physicians with age-stratified sampling from September 2016 to December 2017. The structured questionnaire consisted of items including the basic demographics of the surveyee and their awareness of and attitudes toward the strengths and/or weaknesses of the pay-for-performance programs, as well as their subjective norms, and the willingness to participate in the pay-for-performance programs. Univariate analysis and multivariate logistic regression analysis were performed to compare the differences between family physicians who participate in the pay-for-performance programs versus those who did not.

Results
A total of 543 family physicians completed the questionnaire. Among family physicians who participated in the pay-for-performance programs, more had joined the Family Practice Integrated Care Project [Odds ratio (OR): 2.70; 95% Confidence interval (CI): 1.78 ~ 4.09], had a greater awareness of pay-for-performance programs (OR: 2.37; 95% CI: 1.50 ~ 3.83), and a less negative attitude to pay-for-performance programs (OR: 0.50; 95% CI: 0.31 ~ 0.80) after adjusting for age and gender. The major reasons for family physicians who decided to join the pay-for-performance programs included believing the programs help enhance the quality of healthcare (80.8%) and recognizing the benefit of saving health expenditure (63.4%). The causes of unwillingness to join in a pay-for-performance program among non-participants were increased load of administrative works (79.6%) and inadequate understanding of the contents of the pay-for-performance programs (62.9%).

Conclusions
To better motivate family physicians into P4P participation, hosting effective training programs, developing a more transparent formula for assessing financial risk, providing sufficient budget for healthcare quality improvement, and designing a reasonable profit-sharing plan to promote collaboration between different levels of medical institutions are all imperative.