bluuebunny/crossref_metadata_2025_split huggingface dataset:
The prevalence and associated factors of metabolic syndrome in Chinese aging population
Authors: Ge Huisheng , Yang Zihui , Li Xiaoyu , Liu Dandan , Li Yan , Pan Yue , Luo Dan , Wu Xixi 
Published: November 2020

AbstractMetabolic syndrome (MetS) is hitting high notes in the aging society in China. However, the prevalence and associated factors in Chinese aging population lack clarity to some extent. In the present study, we projected to inquire into the prevalence of MetS and its associated factors by analyzing datasets downloaded from the China Health and Retirement Longitudinal Study (CHARLS). Data comprising age, gender, socioeconomic status, lifestyle and health behaviors as well as blood biomarkers were subjected to descriptive statistics followed by univariate logistic regression and multivariate logistic regression. The overall prevalence of MetS was 33.38% (95% CI 32.42–34.34%). With age augments, prevalence increased during 40–70 years, while declined in participants aged 70 years above. Females had 2.94 times of risks (95% CI 2.55–3.39, P < 0.001). Marital status and alcohol consumption contributed nothing to the suffering of MetS. Participants with GDP per capita > 10,000 RMB and a non-agricultural hukou sustained higher risks than other participants (P < 0.05). Participants under education of middle school suffered 1.16 times of risks than other level of education (95% CI 1.01–1.34, P < 0.05). Smokers, participants with high low-density lipoprotein (LDL) or hyperuricemia or high glycosylated hemoglobin HbA1c sustained increased risks (P < 0.05). In Chinese aging population, with the augment of age, the prevalence ascended in men, while descended in women and was interfered by socioeconomic status, lifestyle and health behaviors as well as blood biomarkers, but not marital status and alcohol consumption.
Arctic riparian shrub expansion indicates a shift from streams gaining water to those that lose flow
Authors: Liljedahl Anna K. , Timling Ina , Frost Gerald V. , Daanen Ronald P. 
Published: November 2020

AbstractShrub expansion has been observed across the Arctic in recent decades along with warming air temperatures, but tundra shrub expansion has been most pronounced in protected landscape positions such as floodplains, streambanks, water tracks, and gullies. Here we show through field measurements and laboratory analyses how stream hydrology, permafrost, and soil microbial communities differed between streams in late summer with and without tall shrubs. Our goal was to assess the causes and consequences of tall shrub expansion in Arctic riparian ecosystems. Our results from Toolik Alaska, show greater canopy height and density, and distinctive plant and soil microbial communities along stream sections that lose water into unfrozen ground (talik) compared to gaining sections underlain by shallow permafrost. Leaf Area Index is linearly related to the change in streamflow per unit stream length, with the densest canopies coinciding with increasingly losing stream sections. Considering climate change and the circumpolar scale of riparian shrub expansion, we suggest that permafrost thaw and the resulting talik formation and shift in streamflow regime are occurring across the Low Arctic.
Lanthanum chloride causes blood–brain barrier disruption through intracellular calcium-mediated RhoA/Rho kinase signaling and myosin light chain kinase
Authors: Wu Jie , Yang Jinghua , Yu Miao , Sun Wenchang , Han Yarao , Lu Xiaobo , Jin Cuihong , Wu Shengwen , Cai Yuan 
Published: November 2020

Abstract
Rare earth elements (REEs) have caused bioaccumulation and adverse health effects attributed to extensive application. The penetrability of REEs across the blood–brain barrier (BBB) contributes to their neurotoxicity process, but potential mechanisms affecting BBB integrity are still obscure. The present study was designed to investigate the effects of lanthanum on BBB adheren junctions and the actin cytoskeleton in vitro using bEnd.3 cells. After lanthanum chloride (LaCl3, 0.125, 0.25 and 0.5 mM) treatment, cytotoxicity against bEnd.3 cells was observed accompanied by increased intracellular Ca2+. Higher paracellular permeability presented as decreased TEER (transendothelial electrical resistance) and increased HRP (horse radish peroxidase) permeation, and simultaneously reduced VE-cadherin expression and F-actin stress fiber formation caused by LaCl3 were reversed by inhibition of ROCK (Rho-kinase) and MLCK (myosin light chain kinase) using inhibitor Y27632 (10 μM) and ML-7 (10 μM). Moreover, chelating overloaded intracellular Ca2+ by BAPTA-AM (25 μM) remarkably abrogated RhoA/ROCK and MLCK activation and downstream phosphorylation of MYPT1 (myosin phosphatase target subunit 1) and MLC2 (myosin light chain 2), therefore alleviating LaCl3-induced BBB disruption and dysfunction. In conclusion, this study indicated that lanthanum caused endothelial barrier hyperpermeability accompanied by loss of VE-cadherin and rearrangement of the actin cytoskeleton though intracellular Ca2+-mediated RhoA/ROCK and MLCK pathways.
Behandlungsmöglichkeiten nach fehlgeschlagenen Osteosynthesen am Femurschaft mit Pseudarthrosen und Torsionsdifferenzen
Authors: Rüther Johannes , Geßlein Markus , Bail Hermann Josef 
Published: November 2020

ZusammenfassungFemurschaftfrakturen sind komplikationsträchtige Verletzungen. Die exakte Reposition der Fragmente, weichteilschonendes Operieren und stabile Osteosyntheseverfahren stellen hohe Anforderungen dar. Kommt es zur Pseudarthrosenbildung, ist in jedem Fall ein individueller Behandlungsplan zu erstellen. Frakturen mit erhaltender Biologie und geringem Knochenverlust lassen sich durch vergleichsweise einfache Techniken zur Durchbauung bringen. Die infizierte Defektpseudarthrose stellt die aufwendigste Komplikation dar. Hierbei muss einerseits die Osteitis saniert werden, andererseits müssen Knochen und Weichteile rekonstruiert werden. Vielfach ist hier ein interdisziplinäres Vorgehen zwischen Unfallchirurg, Gefäßchirurg und plastischem Chirurgen erforderlich. Besonderes Augenmerk muss auf die Führung des Patienten gelegt werden. Behandlungsverläufe von vielen Monaten sind keine Seltenheit. Durch eine korrekte Erstbehandlung lassen sich viele Komplikationen vermeiden, daher sind an die erste Operation genauso hohe Anforderungen zu stellen wie an die weitere Behandlung der Pseudarthrose. Die postoperative Torsionsfehlstellung nach antegrader Marknagelosteosynthese ist eine häufig unterschätze Komplikation mit erheblichen Folgen. Eine intra- und postoperative Kontrolle der Torsion sollte obligat durchgeführt und dokumentiert werden.
Molar Pregnancy in Cesarean Section Scar: A Case Report and Literature Review
Authors: Daggez Mine , Dolanbay Mehmet 
Published: November 2020

AbstractMolar pregnancy in cesarean scar is an extremely rare condition. It has a high risk of uterine rupture and bleeding. There is a small number of case reports in the literature, so the optimal diagnostic algorithms and management are not clear. We reported a 25-year-old woman who presented to our clinic with amenorrhea for 40 days and vaginal bleeding for 3 days. Transvaginal ultrasonography and serum human chorionic gonadotropin (hCG) level raised suspicion of a molar cesarean scar pregnancy (CSP). Magnetic resonance imaging (MRI) was conducted for further knowledge of the characteristics of the mass. Careful suction curettage under ultrasound guidance was performed. The histologic examination of the tissue confirmed a partial hydatidiform mole. The differential diagnosis between CSP and molar CSP is extremely challenging. Serum hCG, sonogram, and MRI are our tools, but none of them suffice for a definitive diagnosis. Histological examination of the postoperative sample is still the gold standard for the diagnosis of molar CSP; however, MRI can assist in planning the necessary interventions.
Tapering body stiffness shortens upper gastrointestinal examination via transoral insertion with ultrathin endoscope
Authors: Ono Satoshi , Ito Shun , Maejima Kyohei , Hosaka Shosuke , Umeki Kiyotaka , Sato Shin-ichiro 
Published: November 2020

Abstract
Background and study aims Ultrathin endoscopes are commonly used for surveillance esophagogastroduodenoscopy (EGD) to reduce discomfort associated with scope insertion. However, the flexibility of an ultrathin endoscope is a trade-off between reducing discomfort and lengthening examination time.
Patients and methods The EG17-J10 (EG17) is a novel ultrathin endoscope characterized by its tapering body stiffness; however, the flexibility of its tip is comparable to that of the traditional ultrathin endoscope EG16-K10 (EG16). We compared EGD examination time between EG17 and EG16. A total of 319 examinees who underwent EGD from November 2019 to January 2020 at the Chiba-Nishi General Hospital were enrolled. Six examinees were excluded due to past history of surgical resection of the upper gastrointestinal tract or too much food residues; 313 examinees (EG17, 209; EG16,104) were retrospectively analyzed. The examination time was divided into three periods: esophageal insertion time (ET), gastroduodenal insertion time (GDT), and surveillance time of the stomach (ST). The total amount of ET, GDT, and ST was defined as total examination time (TT).
Results TT of EGD using EG17 was significantly shorter compared to EGD using EG16 (222.7 ± 68.9 vs. 245.7 ± 78.5 seconds) (P = 0.004). Among the three periods of examination time, ET (66.7 ± 24.1 vs. 76.0 ± 24.1 seconds) (P = 0.001) and GDT (47.9 ± 17.4 vs. 55.2 ± 35.2 seconds) (P = 0.007) of EGD using EG17 were significantly shorter compared to EGD using EG16, except for ST (108.1 ± 51.5.1 vs. 114.5 ± 50.1 seconds) (P = 0.148).
Conclusion An ultrathin endoscope with tapering body stiffness can shorten EGD examination time, mainly due to the shortening of insertion time.
The Swinging Flashlight Test – Flawed Execution and Interpretation in Ophthalmological Routine
Authors: Beisse Flemming , Ring Alina , Wilhelm Helmut , Beisse Christina 
Published: November 2020

Abstract
Background The swinging flashlight test is a standard diagnostic procedure to detect relative afferent pupillary defects. The advantages of the test lie within its objectivity and minimal effort. However, its value depends on its correct execution and interpretation. This questionnaire-based survey investigates whether this is given among German speaking ophthalmologists.
Methods A multiple-choice questionnaire with 14 questions on the use of the swinging flashlight test was designed. It was presented to German speaking ophthalmology specialists (primary data) and orthoptists (secondary data) on specialist conferences or by telephone interviews.
Results 249 ophthalmologists and 76 orthoptists participated in the survey. Only 2% of ophthalmologists answered all 14 questions correctly. On average 66% (range 29 – 100%) of the questions were answered correctly by the ophthalmologists. The question with the lowest result had a rate of 19%, the question with the highest result was correctly answered by 95%. The orthoptists achieved similar results.
Conclusion The rate of correct answers appears disturbingly low. The swinging flashlight test being a basic tool and an obligatory test in a number of guidelines should rather be performed nearly error-free. In light of the high error rates, misdiagnoses and treatment errors must be feared. Better training seems necessary.
Ophthalmological Management of Patients with Pituitary Adenomas
Authors: Küchlin Sebastian , Lagrèze Wolf Alexander 
Published: November 2020

AbstractPituitary tumours are a common cause of functional impairment and degeneration of the anterior visual pathway. Depending on localization and size, they clinically manifest as initially reversible visual field defects. As part of interdisciplinary tumour management, ophthalmologic examinations are of particular importance concerning diagnostics, indication for tumour resection and documentation of functional surgical results. Based on the relationship between clinical dysfunction and manifest atrophy, together with the patientʼs age and the duration of symptoms, the ophthalmologist can provide insights into the postoperative visual prognosis. Under good conditions, surgical tumour resection often results in significant improvements to visual fields and acuity. Long-term ophthalmological controls are required in cases of persistent visual loss, radiotherapy or tumour remnants abutting the visual pathway.
A Molecular Stereostructure Descriptor Based On Spherical Projection
Authors: Zhang Shuo-Qing , Hong Xin , Xu Li-Cheng , Li Xin , Tang Miao-Jiong , Yuan Luo-Tian , Zheng Jia-Yu 
Published: November 2020

AbstractDescription of molecular stereostructure is critical for the machine learning prediction of asymmetric catalysis. Herein we report a spherical projection descriptor of molecular stereostructure (SPMS), which allows precise representation of the molecular van der Waals (vdW) surface. The key features of SPMS descriptor are presented using the examples of chiral phosphoric acid, and the machine learning application is demonstrated in Denmark’s dataset of asymmetric thiol addition to N-acylimines. In addition, SPMS descriptor also offers a color-coded diagram that provides straightforward chemical interpretation of the steric environment.
Impaired Platelet Function in Sept8-Deficient Mice In Vitro
Authors: Jurk Kerstin , Neubauer Katharina , Petermann Victoria , Kumm Elena , Zieger Barbara 
Published: November 2020

AbstractSeptins (Septs) are a widely expressed protein family of 13 mammalian members, recognized as a unique component of the cytoskeleton. In human platelets, we previously described that SEPT4 and SEPT8 are localized surrounding α-granules and move to the platelet surface after activation, indicating a possible role in platelet physiology. In this study, we investigated the impact of Sept8 on platelet function in vitro using Sept8-deficient mouse platelets. Deletion of Sept8 in mouse platelets caused a pronounced defect in activation of the fibrinogen receptor integrin αIIbβ3, α-granule exocytosis, and aggregation, especially in response to the glycoprotein VI agonist convulxin. In contrast, δ-granule and lysosome exocytosis of Sept8-deficient platelets was comparable to wild-type platelets. Sept8-deficient platelet binding to immobilized fibrinogen under static conditions was diminished and spreading delayed. The procoagulant activity of Sept8-deficient platelets was reduced in response to convulxin as determined by lactadherin binding. Also thrombin generation was decreased relative to controls. Thus, Sept8 is required for efficient integrin αIIbβ3 activation, α-granule release, platelet aggregation, and contributes to platelet-dependent thrombin generation. These results revealed Sept8 as a modulator of distinct platelet functions involved in primary and secondary hemostatic processes.
Augmenting the Clinical Data Sources for Enigmatic Diseases: A Cross-Sectional Study of Self-Tracking Data and Clinical Documentation in Endometriosis
Authors: Ensari Ipek , Pichon Adrienne , Lipsky-Gorman Sharon , Bakken Suzanne , Elhadad Noémie 
Published: November 2020

AbstractBackground Self-tracking through mobile health technology can augment the electronic health record (EHR) as an additional data source by providing direct patient input. This can be particularly useful in the context of enigmatic diseases and further promote patient engagement.Objectives This study aimed to investigate the additional information that can be gained through direct patient input on poorly understood diseases, beyond what is already documented in the EHR.Methods This was an observational study including two samples with a clinically confirmed endometriosis diagnosis. We analyzed data from 6,925 women with endometriosis using a research app for tracking endometriosis to assess prevalence of self-reported pain problems, between- and within-person variability in pain over time, endometriosis-affected tasks of daily function, and self-management strategies. We analyzed data from 4,389 patients identified through a large metropolitan hospital EHR to compare pain problems with the self-tracking app and to identify unique data elements that can be contributed via patient self-tracking.Results Pelvic pain was the most prevalent problem in the self-tracking sample (57.3%), followed by gastrointestinal-related (55.9%) and lower back (49.2%) pain. Unique problems that were captured by self-tracking included pain in ovaries (43.7%) and uterus (37.2%). Pain experience was highly variable both across and within participants over time. Within-person variation accounted for 58% of the total variance in pain scores, and was large in magnitude, based on the ratio of within- to between-person variability (0.92) and the intraclass correlation (0.42). Work was the most affected daily function task (49%), and there was significant within- and between-person variability in self-management effectiveness. Prevalence rates in the EHR were significantly lower, with abdominal pain being the most prevalent (36.5%).Conclusion For enigmatic diseases, patient self-tracking as an additional data source complementary to EHR can enable learning from the patient to more accurately and comprehensively evaluate patient health history and status.
The Benefits of the Supercharged Ileocolic Flap in Patients Who Underwent Total Esophagectomy and Gastrectomy
Authors: Marchi Filippo , Kang Shih Ching , Cheong David Chon Fok , Hung Shao Yu , Wang Szu Han , Chiu Ting Han , Chen Yu Ting , Tsao Chung Kan 
Published: November 2020

Abstract
Background Patients who undergo total esophagectomy and gastrectomy present a challenging scenario for reconstructive surgeons. Several techniques have been described. However, the best choice is still a matter of debate. We aim to report our experience with the supercharged ileocolic flap, then to compare the long-term functional outcomes in cancer and caustic injury patients. We investigate the safest route of transposition and demonstrate the importance of supercharging the flap. Last, we perform a literature review to compare our results with the ones reported in the literature.
Methods A total of 36 patients underwent the supercharged ileocolic flap procedure. The details reviewed included the type of defect, flap characteristic, route of transposition, complications, patient survival, and swallowing evaluation. Survival and long-term function preservation were considered as the main outcomes. A secondary end-point was the identification of the safest route of transposition. We extracted the pertinent literature on supercharged bowel flaps from 1995 to July 2020
Results All flaps survived; only two flaps were partially lost. Thirty-three percent of the cohort experienced postoperative complications; the most common was leakage of the cervical anastomosis (17%), followed by neck wound infection (8%). The 5-year dysphagia-free survival rate was 87% in corrosive injury patients and 78% in cancer patients. The mean time to be free from dysphagia after surgery was 25.12 ± 4.55 months for corrosive patients and 39.56 ± 9.45 months for cancer patients (p = 0.118). The safest route of transposition was retrosternal extra-mediastinal. From the literature review, the data from 11 studies were extracted.
Conclusion The supercharged ileocolic flap is a robust option for total esophageal replacement when the stomach is not available and the retrosternal route is the safest for transposition. The functional outcomes are excellent, with acceptable morbidity and a good life expectancy, either in cancer and noncancer patients. Supercharging the flap is recommended.
Rooming-in for Infants at Risk for Neonatal Abstinence Syndrome: Outcomes 5 Years following Its Introduction as the Standard of Care at One Hospital
Authors: Newman Adam Isaiah , Mauer-Vakil Dane , Coo Helen , Newton Lynn , Wilkerson Emily , McKnight Sarah , Brogly Susan B. 
Published: November 2020

Objective The practice of rooming-in for opioid-dependent infants was introduced as the standard of care at our hospital following a pilot study which demonstrated that such infants had shorter lengths of stay and were less likely to require pharmacological treatment. We sought to determine whether these benefits have continued, and whether outcomes support continuing to use rooming-in as standard care.
Study Design Opioid-dependent infants delivered at 36 weeks gestation or later between January 1, 2015, and December 31, 2019, were eligible for rooming-in. Charts were reviewed and data were extracted regarding maternal and infant conditions, whether neonatal pharmacological treatment was required, and total length of hospital stay. Outcomes were compared with two historical groups reported in a previous pilot study: 24 healthy near-term opioid-dependent newborns who were admitted directly to the neonatal intensive care unit (NICU) prior to the introduction of rooming-in (May 1, 2012–May 31, 2013), and 20 similar opioid-dependent infants who were the first to room-in at our hospital (September 1, 2013–September 30, 2014).
Results Only 3.5% of 57 infants who roomed-in during the 5-year study period required pharmacological treatment, compared with 15% who roomed-in during the first year of the program's introduction and 83.3% who had been admitted directly to the NICU. The median length of stay remained 5 days for infants rooming-in, compared with 24 days for opioid-dependent infants in the cohort admitted to the NICU.
Conclusion Early observations of the benefits of rooming-in on neonatal outcomes were sustained. Infants allowed to room-in were significantly less likely to require initiation of pharmacotherapy and a prolonged hospital stay than similar infants prior to the implementation of rooming-in as standard care. A large proportion of the infants who might have benefited from rooming-in required admission to the NICU for reasons other than neonatal abstinence syndrome (NAS).
Key Points
Legal issues in automated vehicles: critically considering the potential role of consent and interactive digital interfaces
Authors: Pattinson Jo-Ann , Chen Haibo , Basu Subhajit 
Published: November 2020

AbstractSome of the first ‘automated’ vehicles to be deployed on our roads will require a system of shared driving with a human driver. While this creates technical and operational challenges, the law must also facilitate such a transfer. One method may be to obtain the driver’s consent to share operational responsibility and to delineate legal responsibility between vehicle and driver in the event of an accident. Consent is a voluntary agreement where an individual is aware of the potential consequences of their consent, including the risks. The driver of a partially automated vehicle must be informed of potential risks before giving consent to share operational responsibility. This paper will refer to the inherent dangers associated with shared operational responsibility, in particular where there has been a request for the driver to take back control from the automated vehicle during the journey. Drivers are likely to experience delay in regaining situational awareness, making such operational transfers hazardous. It is argued that where an interactive digital interface is used to convey information, such as driver responsibility, risk and legal terms, drivers may fail to sufficiently process such communications due to fundamental weaknesses in human–machine interaction. The use of an interactive digital interface alone may be inadequate to effectively communicate information to drivers. If the problems identified are not addressed, it is argued that driver consent may be inconsequential, and fail to facilitate a predicable demarcation of legal responsibility between automated vehicles and drivers. Ongoing research into automated vehicle driver training is considered as part of the preparation required to design driver education to a level whereby drivers may be able to sufficiently understand the responsibilities involved in operating a partially automated vehicle, which has implications for future driver training, licensing and certification.