bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Practice Guideline for Postreduction Management of Intussusception of Children in the Emergency Department
Authors: Kwon Hyuksool , Lee Jin Hee , Jeong Jin Hee , Yang Hye Ran , Kwak Young Ho , Kim Do Kyun , Kim Kyuseok 
Published: February 2017

Objectives
The aim of this study was to evaluate the effects of a practice guideline of postreduction management of intussusception in children on the length of stay (LOS) from reduction in the pediatric emergency department (PED) and on the incidence of recurrence.

Methods
We developed a practice guideline of postreduction management of intussusception in the PED. The practice guideline involved feeding 2 hours after reduction and discharge 2 hours after successful feeding. The guideline was implemented on October 1, 2012. Retrospective quasi-experimental study was conducted for evaluation of the difference in LOS in the PED after reduction of intussusceptions, and the recurrence rate of intussusceptions between the preimplementation and postimplementation periods. Piecewise regression was performed to determine the differences between groups.

Results
In total, 45 and 52 patients were included in the preimplementation and postimplementation periods, respectively. The median LOS in the postimplementation period was significantly shorter than that in the preimplementation period (289 vs 532 minutes, respectively; P = 0.001). The slope of the LOS changed from 0.68 to −0.29. The slope decreased by 0.97 after practice guideline implementation. This difference was not statistically significant (P = 0.123), but it changed from a positive to negative gradient. The recurrence rate was not significantly different between the 2 periods (P = 0.605).

Conclusions
Implementation of a practice guideline involving early feeding and discharge after reduction of intussusception resulted in a reduced LOS from reduction of intussusception in the PED and was not associated with recurrence of intussusception.
Effect of an Asthma Guideline in 2 Pediatric Emergency Departments and an Urgent Care Center
Authors: Dilts Jennifer J. , Humiston Sharon G. , Lee Brian R. , Allen Nancy H. , Michael Jeffrey G. 
Published: February 2017

Objectives
The objective of this study was to evaluate ordering of albuterol via metered-dose inhaler with spacer (MDI-spacer), length of stay (LOS), and 72-hour return rates before and after publication of an internally developed pediatric asthma clinical practice guideline (CPG).

Methods
The internally developed CPG reflected national recommendations. It was explained at faculty meetings by a respected clinician and published on the intranet on February 6, 2012. We performed a retrospective study of visits from January 1, 2009, to October 31, 2014, by children aged 2 to 17 years with a primary diagnosis of asthma and discharged from a target site (2 pediatric emergency departments and 1 urgent care center). We excluded critical/emergent visits and those by patients who transferred to the emergency department/urgent care center from another facility or were admitted. We extracted data for 37 months before and 33 months after CPG implementation (post-CPG) using a single electronic health record system.

Results
Albuterol delivery via MDI-spacer increased by 33.95% (P < 0.0001) during 1-month post-CPG implementation with no significant subsequent decrease. An unexpected decline was noted for median LOS before CPG implementation (−1.24 minutes; P < 0.0001). For MDI-spacer–treated patients post-CPG, decreased median LOS was maintained and there was decreased variability of the median LOS (P < 0.001). For nebulizer-treated patients post-CPG, median LOS increased (.95 minutes; P = 0.033). No change was observed for 72-hour return rates.

Conclusions
Implementation of an asthma CPG increased ordering of albuterol via MDI-spacer. The increase was sustained over time in all study sites. Decreased variability in median LOS for MDI-spacer patients was observed post-CPG. Median LOS for those treated with MDI-spacer exclusively remained unchanged in the post-CPG period, whereas post-CPG LOS increased in those who received nebulized albuterol.
Acute Focal Dystonia After a Single Dose of Oral Cetirizine in a 9-Year-Old Boy
Authors: Sharawat Indar Kumar , Dawman Lesa 
Published: February 2017

Abstract
Common cold is an acute illness affecting pediatric population in particular. The use of antihistamines is a common practice, with cetirizine being a frequently used drug with a good safety profile. However, adverse events due to the use of antihistamines have been rarely reported, such as drug-induced dystonia with the use of cetirizine. In our present case, dystonia due to the intake of cetirizine was observed, which the patient responded well to the use of benzodiazapines, namely, clonazepam. We report this case to highlight the occurrence of this adverse event with the use of cetirizine.
First-Attempt Success, Longevity, and Complication Rates of Ultrasound-Guided Peripheral Intravenous Catheters in Children
Authors: Vinograd Alexandra M. , Zorc Joseph J. , Dean Anthony J. , Abbadessa Mary Kate F. , Chen Aaron E. 
Published: February 2017

Objective
The aim of this study was to examine the success rates, longevity, and complications of ultrasound-guided peripheral intravenous lines (USgPIVs) placed in a pediatric emergency department.

Methods
The study analyzed 300 USgPIV attempts in an urban tertiary-care pediatric emergency department. Data regarding USgPIV placement were collected from a 1-page form completed by the clinician placing the USgPIV. The time and reason for USgPIV removal were extracted from the medical record for patients with USgPIVs admitted to the hospital. A Kaplan-Meier survival analysis was performed.

Results
This study demonstrated a success rate of 68% and 87% for the first and second attempts with USgPIV. Fifty-five percent of patients had 1 or more prior traditional intravenous access attempt. Most USgPIVs placed on patients admitted to the hospital were removed because they were no longer needed (101/160). We calculated a Kaplan-Meier median survival of 143 hours (6 days; interquartile range, 68–246 hours). The failure rate at 48 hours was 25%.

Conclusion
Ultrasound-guided intravenous access is a feasible alternative to traditional peripheral intravenous access in the pediatric emergency setting. We observed a high first-stick success rate even in patients who had failed traditional peripheral intravenous access attempts, few complications, and a long intravenous survival time.
The Elusive Diagnosis of Adolescent Systemic Lupus Erythematosus
Authors: Mancini Michelino 
Published: February 2017

Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disease affecting multiple systems, and its various symptoms are often mistaken for other diseases. This case report describes a 15-year-old girl who presented to the emergency department with complaints of diffuse abdominal pain, facial swelling, joint pain, low-grade fever, and rash. An initial autoimmune process was suspected, and, with prompt referral, a diagnosis of SLE was confirmed. This case report and discussion review the difficulty of diagnosing SLE and the importance of maintaining autoimmune diseases, such as SLE, on an emergency physician's differential.
Risk Factors for Recurrent Intussusception After Fluoroscopy-Guided Air Enema
Authors: Kim Jung Heon , Lee Jong Seung , Ryu Jeong Min , Lim Kyoung Soo , Kim Won Young 
Published: February 2017

Objectives
The aim of this study was to identify risk factors for recurrent intussusception after a successful reduction by fluoroscopy-guided air enema, the time required for recurrence, and the association between delayed reduction and the recurrence.

Methods
Medical records of 479 consecutive children with intussusception who underwent fluoroscopy-guided air enema between January 2004 and September 2014 were reviewed. Recurrent intussusception was defined as a recurrence within 48 hours of a reduction. Symptom-to-door time was defined as the time from symptom onset to emergency department arrival. Door-to-reduction time was defined as the time from emergency department arrival to reduction. Time-to-recurrence was defined as the time required for recurrence from the first ultrasound diagnosis.

Results
Of the 360 eligible children, 32 had recurrent intussusceptions (8.9%). Multivariable logistic regression showed that age 2 years or older is an independent predictor of recurrent intussusception (odds ratio, 2.39; 95% confidence interval, 1.13–5.02; P = 0.02). Median time to recurrence was 25 hours (18.0–36.0 hours). Although symptom-to-door and door-to-reduction times tended to be longer in the recurrence group, these differences were not significant (12.5 vs 7.0 hours, P = 0.18; 154.0 vs 143.0 minutes, P = 0.67, respectively).

Conclusions
Our data suggest that provision for early recurrence and extended observation may be beneficial for children 2 years or older. Delayed reduction was not associated with recurrent intussusception, but further studies with larger sample sizes are needed to explain this issue.
Systematic Review and Meta-analysis of Interventions for Depression and Anxiety in Persons With Rheumatoid Arthritis
Authors: Fiest Kirsten M. , Hitchon Carol A. , Bernstein Charles N. , Peschken Christine A. , Walker John R. , Graff Lesley A. , Zarychanski Ryan , Abou-Setta Ahmed , Patten Scott B. , Sareen Jitender , Bolton James , Marrie Ruth Ann 
Published: February 2017

Background
Psychiatric comorbidities, such as depression and anxiety, are very common in persons with rheumatoid arthritis (RA) and can lead to adverse outcomes. By appropriately treating these comorbidities, disease-specific outcomes and quality of life may be improved.

Objective
The aim of this study was to systematically review the literature from controlled trials of treatments for depression and anxiety in persons with RA.

Methods
We searched multiple online databases from inception until March 25, 2015, without restrictions on language, date, or location of publication. We included controlled trials conducted in persons with RA and depression or anxiety. Two independent reviewers extracted information including trial and participant characteristics. The standardized mean differences (SMDs) of depression or anxiety scores at postassessment were pooled between treatment and comparison groups, stratified by active versus inactive comparators.

Results
From 1291 unique abstracts, we included 8 RA trials of depression interventions (6 pharmacological, 1 psychological, 1 both). Pharmacological interventions for depression with inactive comparators (n = 3 trials, 143 participants) did not reduce depressive symptoms (SMD, −0.21; 95% confidence interval [CI], −1.27 to 0.85), although interventions with active comparators (n = 3 trials, 190 participants) did improve depressive symptoms (SMD, −0.79; 95% CI, −1.34 to −0.25). The single psychological trial of depression treatment in RA did not improve depressive symptoms (SMD, −0.44; 95% CI, −0.96 to 0.08). Seven of the trials had an unclear risk of bias.

Conclusions
Few trials examining interventions for depression or anxiety in adults with RA exist, and the level of evidence is low to moderate because of the risk of bias and small number of trials.
Hyperpolarized Helium-3 Diffusion-weighted Magnetic Resonance Imaging Detects Abnormalities of Lung Structure in Children With Bronchopulmonary Dysplasia
Authors: Flors Lucia , Mugler John P. , Paget-Brown Alix , Froh Deborah K. , de Lange Eduard E. , Patrie James T. , Altes Talissa A. 
Published: February 2017

Purpose:
The aim of the study was to determine whether hyperpolarized 3He diffusion-weighted magnetic resonance imaging detects abnormalities in the lungs in children with bronchopulmonary dysplasia (BPD) as compared with age-matched normal children.

Materials and Methods:
All experiments were compliant with Health Insurance Portability and Accountability Act (HIPAA) and performed with Food and Drug Administration approval under an IND application. The protocol was approved by our Institutional Review Board, and written informed consent was obtained. Hyperpolarized 3He diffusion-weighted magnetic resonance imaging was performed in 16 subjects with a history of preterm birth complicated by BPD (age range, 6.8 to 13.5 y; mean, 9.0 y) and in 29 healthy term-birth subjects (age range, 4.5-14.7 y; mean, 9.2 y) using a gradient-echo sequence with bipolar diffusion gradients and with measurements at 2 b values (0 and 1.6 s/cm2). Age-related comparison of the whole-lung mean apparent diffusion coefficient (ADC), 90th percentile ADC, and percentage of whole-lung volume with ADC>0.2 cm2/s between the 2 groups was examined using ordinary least-squares multiple regression.

Results:
The mean ADC was significantly greater in subjects with BPD (0.187 vs. 0.152 cm2/s, P<0.001). The 90th percentile ADC and mean percentage lung volume with ADC>0.2 cm2/s were also higher in the BPD group (0.258 vs. 0.215 cm2/s, 30.3% vs. 11.9%, P<0.001 for both). The body surface area–adjusted ventilated lung volume was similar in the 2 groups (1.93 vs. 1.91 L, P=0.90).

Conclusions:
Children with BPD had higher ADCs and the same lung volumes when compared with age-matched healthy subjects, suggesting that children with BPD have enlarged alveoli that are reduced in number.
Additional Magnetic Resonance Imaging–Detected Suspicious Lesions in Known Patients With Breast Cancer
Authors: Koh Jieun , Kim Eun-Kyung , Kim Min Jung , Yoon Jung Hyun , Moon Hee Jung 
Published: February 2017

Purpose
The aim of the study was to compare the performances of second-look digital breast tomosynthesis (DBT) and ultrasonography (US) for additional magnetic resonance imaging (MRI)–detected suspicious lesions in patients referred for breast cancer.

Methods
Fifty-five patients (52.5 [9.3] years) with breast cancers newly diagnosed at a referring hospital underwent MRI and afterward DBT and US in our institution. The frequency for detecting additional MRI-detected suspicious lesions on DBT and US and performances of DBT and US were compared.

Results
Of 37 additional MRI-detected suspicious lesions, 27 were detected on DBT and/or US; 2 were detected on both DBT and US, 1 was detected only on DBT, and 24 were detected only on US. Ultrasonography detected more additional suspicious lesions than DBT (P < 0.0001). Twelve (44.4%) of the 27 lesions were malignant. The sensitivity and negative predictive value of US (100.0% and 100.0%) were significantly higher than those of DBT (16.7% and 83.6%, P < 0.001 and P = 0.001). The specificity of DBT was significantly higher (98.1%) than that of US (78.9%, P = 0.002). Positive predictive values of DBT and US were not significantly different (66.7% vs 52.2%, P = 0.598). The area under the receiver operating characteristic curve of US was significantly higher (0.894) than that of DBT (0.574, P < 0.001).

Conclusions
Second-look US showed higher performances than DBT for detecting and characterizing suspicious lesions additionally detected on MRI in patients referred for breast cancer.
The Effect of the Amniotic Fluid Index on the Accuracy of Ultrasonographic-Estimated Fetal Weight
Authors: Karahanoglu Ertugrul , Altinboga Orhan , Akpinar Funda , Gultekin Ismail Burak , Ozdemirci Safak , Akyol Aysegul , Yalvac Serdar 
Published: February 2017

Background
Fetal weight estimation is one of the most important aspects of antenatal care. The effects of amniotic fluid volume on the accuracy of estimated fetal weight (EFW) depend on the amount of fluid, in particular whether it is polyhydramnios or oligohydramnios. Previous studies have reported conflicting results of the effects of amniotic fluid volume on EFW accuracy.

Aim
The aim of the study was to evaluate the effects of isolated oligohydramnios cases and polyhydramnios on the accuracy of EFW.

Materials and Methods
A retrospective study was conducted at a tertiary center. The study groups consisted of 1069 term isolated oligohydramnios cases, 182 term isolated polyhydramnios cases, and 392 term-matched cases with a normal volume of amniotic fluid. Estimated fetal weight error was determined and expressed in terms of systematic error, calculated from mean percentage error and random error.

Results
The systematic error did not differ significantly between polyhydramnios and oligohydramnios cases (−3.60 [8.94%] vs −2.73 [9.7%]). The random error was 8.94% in polyhydramnios cases and 9.7% in oligohydramnios cases. The overestimation rate was 63.6% in polyhydramnios cases and 66.3% in oligohydramnios cases.

Conclusions
There were no significant differences in the accuracy of EFW between oligohydramnios and polyhydramnios. However, there was a tendency for overestimation in both types of cases.
Mass spectrometrists should search for all peptides, but assess only the ones they care about
Authors: Sticker Adriaan , Martens Lennart , Clement Lieven 
Published: February 2017

AbstractIn shotgun proteomics identified mass spectra that are deemed irrelevant to the scientific hypothesis are often discarded. Noble (2015)1therefore urged researchers to remove irrelevant peptides from the database prior to searching to improve statistical power. We here however, argue that both the classical as well as Noble’s revised method produce suboptimal peptide identifications and have problems in controlling the false discovery rate (FDR). Instead, we show that searching for all expected peptides, and removing irrelevant peptides prior to FDR calculation results in more reliable identifications at controlled FDR level than the classical strategy that discards irrelevant peptides post FDR calculation, or than Noble’s strategy that discards irrelevant peptides prior to searching.
Learning place cells, grid cells and invariances: A unifying model
Authors: Weber Simon N. , Sprekeler Henning 
Published: February 2017

AbstractNeurons in the hippocampus and adjacent brain areas show a large diversity in their tuning to location and head direction. The underlying circuit mechanisms are not fully resolved. In particular, it is unclear why certain cell types are selective to one spatial variable, but invariant to another. For example, a place cell is highly selective to location, but typically invariant to head direction. Here, we propose that all observed spatial tuning patterns – in both their selectivity and their invariance – are a consequence of the same mechanism: Excitatory and inhibitory synaptic plasticity that is driven by the spatial tuning statistics of synaptic inputs. Using simulations and a mathematical analysis, we show that combined excitatory and inhibitory plasticity can lead to localized, grid-like or invariant activity. Combinations of different input statistics along different spatial dimensions reproduce all major spatial tuning patterns observed in rodents. The model is robust to changes in parameters, develops patterns on behavioral time scales and makes distinctive experimental predictions. Our results suggest that the interaction of excitatory and inhibitory plasticity is a general principle for the formation of neural representations.
Parsing propagule pressure: Number, not size, of introductions drives colonization success in a novel environment
Authors: Koontz Michael J , Oldfather Meagan F , Melbourne Brett A , Hufbauer Ruth A 
Published: February 2017

ABSTRACTPredicting whether individuals will colonize a novel habitat is of fundamental ecological interest and is crucial to both conservation efforts and invasive species management. A consistently supported predictor of colonization success is the number of individuals introduced, also called propagule pressure. Propagule pressure increases with the number of introductions and the number of individuals per introduction (the size of the introduction), but it is unresolved which process is a stronger driver of colonization success. Furthermore their relative importance may depend upon the environment, with multiple introductions potentially enhancing colonization of fluctuating environments. To evaluate the relative importance of the number and size of introductions and its dependence upon environmental variability, we paired demographic simulations with a microcosm experiment. UsingTriboliumflour beetles as a model system, we introduced a fixed number of individuals into replicated novel habitats of stable or fluctuating quality, varying the number of introductions through time and size of each introduction. We evaluated establishment probability and the size of extant populations after 7 generations. In the simulations and microcosms, we found that establishment probability increased with more, smaller introductions, but was not affected by biologically realistic fluctuations in environmental quality. Population size was not significantly affected by environmental variability in the simulations, but populations in the microcosms grew larger in a stable environment, especially with more introduction events. In general, the microcosm experiment yielded higher establishment probability and larger populations than the demographic simulations. We suggest that genetic mechanisms likely underlie these differences and thus deserve more attention in efforts to parse propagule pressure. Our results highlight the importance of preventing further introductions of undesirable species to invaded sites, and suggest conservation efforts should focus on increasing the number of introductions or re-introductions of desirable species rather than increasing the size of those introduction events.
Individual differences in responsivity to social rewards: Insights from two eye-tracking tasks
Authors: Chakrabarti Bhismadev , Haffey Anthony , Canzano Loredana , P. Taylor Christopher , McSorley Eugene 
Published: February 2017

AbstractHumans generally prefer social over nonsocial stimuli from an early age. Reduced preference for social rewards has been observed in individuals with autism spectrum conditions (ASC). This preference has typically been noted in separate tasks that measure orienting toward and engaging with social stimuli. In this experiment, we used two eye-tracking tasks to index both of these aspects of social preference in in 77 typical adults. We used two measures, global effect and preferential looking time. The global effect task measures saccadic deviation toward a social stimulus (related to ‘orienting’), while the preferential looking task records gaze duration bias toward social stimuli (relating to ‘engaging’). Social rewards were found to elicit greater saccadic deviation and greater gaze duration bias, suggesting that they have both greater salience and higher value compared to nonsocial rewards. Trait empathy was positively correlated with the measure of relative value of social rewards, but not with their salience. This study thus elucidates the relationship of empathy with social reward processing.