bluuebunny/crossref_metadata_2025 huggingface dataset:
Challenging the current model of early‐onset myasthenia gravis pathogenesis in the light of the MGTX trial and histological heterogeneity of thymectomy specimens
Authors: Weis Cleo‐Aron , Schalke Berthold , Ströbel Philipp , Marx Alexander
Published: January 2018

The MGTX trial provided evidence that, in general, thymectomy is beneficial in adult patients up to 60 years of age with anti‐acetylcholine receptor–positive, nonthymomatous myasthenia gravis (MG). This finding supports the long‐held view that the pathogenesis of this type of MG (early‐onset MG (EOMG)) starts inside the thymus, results in the long‐term intrathymic recruitment of autoantibody‐producing B cells and plasma cells, and eventually spreads to the peripheral immune system. However, observed clinical responses to treatment in the MGTX trial were diverse. This might be due to heterogeneous epidemiological and genetic features of EOMG patients and variable durations of corticosteroid treatment before surgery, including a paucity of patients that were corticosteroid naive. Furthermore, the observed histological heterogeneity suggests that a single pathogenetic model may not fully reflect the spectrum of events that modify the course of EOMG. Here, we describe the morphology of the normal and MG‐associated thymus, how to evaluate morphological changes, and the current pathogenetic model of EOMG and discuss how it could be refined by integrating MGTX‐derived histological findings in thymectomy specimens and associated clinical observations.
Cost‐effectiveness of intravenous acetaminophen and ketorolac in adolescents undergoing idiopathic scoliosis surgery
Authors: Chidambaran Vidya , Subramanyam Rajeev , Ding Lili , Sadhasivam Senthilkumar , Geisler Kristie , Stubbeman Bobbie , Sturm Peter , Jain Viral , Eckman Mark H.
Published: January 2018

Background

Enhanced recovery after surgery protocols increasingly use multimodal analgesia after major surgeries with intravenous acetaminophen and ketorolac, despite no documented cost‐effectiveness of these strategies.

Aims

The goal of this prospective cohort study was to model cost‐effectiveness of adding acetaminophen or acetaminophen + ketorolac to opioids for postoperative outcomes in children having scoliosis surgery.

Methods

Of 106 postsurgical children, 36 received only opioids, 26 received intravenous acetaminophen, and 44 received acetaminophen + ketorolac as analgesia adjuncts. Costs were calculated in 2015 US $. Decision analytic model was constructed with Decision Maker® software. Base‐case and sensitivity analyses were performed with effectiveness defined as avoidance of opioid adverse effects.

Results

The groups were comparable demographically. Compared with opioids‐only strategy, subjects in the intravenous acetaminophen + ketorolac strategy consumed less opioids (P = .002; difference in mean morphine consumption on postoperative days 1 and 2 was −0.44 mg/kg (95% CI −0.72 to −0.16); tolerated meals earlier (P < .001; RR 0.250 (0.112‐0.556)) and had less constipation (P < .001; RR 0.226 (0.094‐0.546)). Base‐case analysis showed that of the 3 strategies, use of opioids alone is both most costly and least effective, opioids + intravenous acetaminophen is intermediate in both cost and effectiveness; and opioids + intravenous acetaminophen and ketorolac is the least expensive and most effective strategy. The addition of intravenous acetaminophen with or without ketorolac to an opioid‐only strategy saves $510‐$947 per patient undergoing spine surgery and decreases opioid side effects.

Conclusion

Intravenous acetaminophen with or without ketorolac reduced opioid consumption, opioid‐related adverse effects, length of stay, and thereby cost of care following idiopathic scoliosis in adolescents compared with opioids‐alone postoperative analgesia strategy.
Grapevine VpPR10.1 functions in resistance to Plasmopara viticola through triggering a cell death‐like defence response by interacting with VpVDAC3
Authors: Ma Hui , Xiang Gaoqing , Li Zhiqian , Wang Yuting , Dou Mengru , Su Li , Yin Xiao , Liu Ruiqi , Wang Yuejin , Xu Yan
Published: January 2018

As one of the most serious diseases in grape, downy mildew caused by Plasmopara viticola is a worldwide grape disease. Much effort has been focused on improving susceptible grapevine resistance, and wild resistant grapevine species are important for germplasm improvement of commercial cultivars. Using yeast two‐hybrid screen followed by a series of immunoprecipitation experiments, we identified voltage‐dependent anion channel 3 (VDAC3) protein from Vitis piasezkii ‘Liuba‐8’ as an interacting partner of VpPR10.1 cloned from Vitis pseudoreticulata ‘Baihe‐35‐1’, which is an important germplasm for its resistance to a range of pathogens. Co‐expression of VpPR10.1/VpVDAC3 induced cell death in Nicotiana benthamiana, which accompanied by ROS accumulation. VpPR10.1 transgenic grapevine line showed resistance to P. viticola. We conclude that the VpPR10.1/VpVDAC3 complex is responsible for cell death‐mediated defence response to P. viticola in grapevine.
A prospective randomized, controlled trial of eculizumab to prevent ischemia‐reperfusion injury in pediatric kidney transplantation
Authors: Kaabak Michael , Babenko Nadeen , Shapiro Ron , Zokoyev Allan , Dymova Olga , Kim Edward
Published: January 2018

Ischemia‐reperfusion injury has multiple effects on a transplanted allograft, including delayed or impaired graft function, compromised long‐term survival, and an association with an increased incidence of rejection. Eculizumab, a monoclonal antibody blocking terminal complement activation, has been postulated to be an effective agent in the prevention or amelioration of IRI. We performed a single‐center prospective, randomized controlled trial involving 57 pediatric kidney transplant recipients between 2012 and 2016. The immunosuppressive protocol included two doses of alemtuzumab; half of the patients were randomized to receive a single dose of eculizumab prior to transplantation. Maintenance immunosuppression was based on a combination of low‐dose tacrolimus and mycophenolate, without steroids. Eculizumab‐treated patients had a significantly better early graft function, less arteriolar hyalinosis and chronic glomerulopathy on a protocol biopsies taken on day 30, 1 year, and 3 years after transplantation. In the eculizumab group, four non‐vaccinated children lost their grafts during the course of a flu‐like infection. Eculizumab is associated with better early graft function and improved graft morphology; however, there was an unacceptably high number of early graft losses among the eculizumab‐treated children. While a promising strategy, the best approach to complement inhibition remains to be established.
Policy‐Seeking and Office‐Seeking: Categorizing Parties Based on Coalition Payoff Allocation
Authors: Evans Matt
Published: January 2018

Characterizations of political parties as policy‐seeking or office‐seeking have been vague, anecdotal, or theoretical. This research builds on coalition allocation research to develop an empirical determination of parties’ behavior. Through analysis of eight coalition governments in Israel from 1992 to 2015, this work classifies parties based on the degree to which the payoffs they obtain in coalition negotiations are conducive to their policy goals. The results indicate that nonformateur parties tend to be more policy‐seeking and formateur parties more office‐seeking. The research also reveals disparities in proportions of policy‐seeking and office‐seeking payoffs obtained by different types of parties. This work makes several research contributions, including development of an empirical method for identifying parties as policy‐seeking or office‐seeking, broadening allocation analysis to include deputy ministers and committee chairs, and providing a qualitative evaluation of coalition allocation based on the policy value of each payoff for the party obtaining it.

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Vercesi, Michelangelo. 2016. “.” Politics & Policy 44 (): 168‐219. http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1747-1346

Posey, Kevin H. 1994. “.” Southeastern Political Review 22 (): 549‐557. http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1747-1346

Mizrahi, Shlomo,
Fany Yuval, and
Nissim Cohen. 2014. “.” Politics & Policy 42 (): 850‐880. http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1747-1346
The Behavioral‐Economics Basis of Mutual Accountability to Achieve Food Security
Authors: Oehmke James F. , Young Sera L. , Bahiigwa Godfrey , Keizire Boaz Blackie , Post Lori Ann
Published: January 2018

Mutual accountability is a social construct designed to overcome informational, transactional, and enforcement barriers to alignment and coordination among development stakeholders. In Africa, it has been implemented at the country and regional levels and will be presented at the African Union Summit in January 2018. However, the literature contains little on either the conceptual underpinnings of mutual accountability or its implementation in the African agricultural development context. Therefore, we reviewed the literature on mutual accountability to articulate its behavioral economics foundations. We also tested predictions using an adapted Prisoner's Dilemma model. We found several implications of mutual accountability for African development strategy within and beyond agricultural policy, including the importance of changing initial conditions to include cooperative action, the potential impermanence of cooperative action, and the importance of a critical mass of cooperating agents for maximum synergy. Finally, evidence suggests that mutual accountability processes increase the likelihood of achieving cooperative outcomes.

Related Articles

Raile,Eric D.,Amber N. W.Raile,Charles T.Salmon, andLoriAnn Post.2014. “.”Politics & Policy42():103‐130.http://onlinelibrary.wiley.com/doi/10.1111/polp.12063/abstract

Post,Lori Ann,Amber N. W.Raile, andEric D.Raile.2010. “.”Politics & Policy38():653‐676.http://onlinelibrary.wiley.com/doi/10.1111/j.1747-1346.2010.00253.x/abstract

Elliot‐Teague,Ginger.2011. “.”Politics & Policy39():835‐861.http://onlinelibrary.wiley.com/doi/10.1111/j.1747-1346.2011.00318.x/abstract

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.2014. “Mutual Accountability Explained.”http://www.un.org/en/ecosoc/newfunct/pdf14/ma_guidance_note.pdf

This Place.2014. “The Prisoner's Dilemma.”https://www.youtube.com/watch?v=t9Lo2fgxWHw

Post,Lori Ann.2017. “.”The World Bank.https://blogs.worldbank.org/publicsphere/generating-political-will-and-public-will-positive-social-change
“Pot”reneurial Politics: The Budgetary Highs and Lows of Recreational Marijuana Policy Innovation
Authors: Fisk Jonathan M. , Vonasek Joseph A. , Davis Elvis
Published: January 2018

Public‐ and elite‐level interest concerning recreational marijuana is increasing, thanks in large part to the successful legalization campaigns in four states. Scholars, however, have yet to systemically assess how states allocate and manage marijuana‐related dollars. Some states likely prefer “tight” budgetary control, suggesting that remitted marijuana dollars are largely earmarked to specific purposes. Other states might opt for “looser” budgetary mechanisms, giving law makers more freedom in how they spend marijuana revenues. States may also vary in the tax rates applied to marijuana purchases with some states preferring to charge higher rates. Using information drawn from primary sources, we assess which factors are most helpful in accounting for the budgetary innovations related to recreational marijuana revenues.

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Lamothe, Scott. 2004. “.” Politics & Policy 32 (): 684‐707. http://onlinelibrary.wiley.com/doi/10.1111/j.1747-1346.2004.tb00201.x/full

Bernick, Ethan M., and
Nathan Myers. 2012. “.” Politics & Policy 40 (): 131‐159. http://onlinelibrary.wiley.com/doi/10.1111/j.1747-1346.2011.00340.x/full

Adams, Brian E. 2016. “.” Politics & Policy 44 (): 820‐849. http://onlinelibrary.wiley.com/doi/10.1111/polp.12172/full

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Brookings. 2014. “The Nation Continues to Embrace Marijuana Legalization.” November 5. https://www.brookings.edu/blog/fixgov/2014/11/05/the-nation-continues-to-embrace-marijuana-legalization/

C‐Span. 2014. “Ballot Measures on Marijuana.” November 8. https://www.c-span.org/video/?322625-5/washington-journal-john-hudak-ballot-measures-marijuana

Governing States and Localities. 2017. “State Marijuana Laws in 2017 Map.” http://www.governing.com/gov-data/state-marijuana-laws-map-medical-recreational.html
Effect of preceding home‐visit nursing on time to discharge in hospitalization for the treatment of behavioural and psychological symptoms of dementia among patients with limited familial care
Authors: Kitamura Tatsuru , Shiota Shigehito , Jinkawa Shigetoshi , Kitamura Maki , Hino Shoryoku
Published: January 2018

Background

During hospitalization for behavioural and psychological symptoms of dementia (BPSD), it is imperative to build a support system for each patient in the community for after they obtain symptom remission. To this end, patients lacking adequate family support are less likely to be discharged to their own homes and need stronger support systems to be established. This study therefore investigated the effects of home‐visit nursing before admission on time to home discharge among patients with limited familial care who were hospitalized for treatment of BPSD.

Methods

A single‐centre chart review study was conducted on consecutive patients admitted from home between April 2013 and September 2015 for treatment of BPSD and who had lived alone or with a working family member. Time to home discharge was compared between patients who had home‐visit nursing before their admission and those who did not.

Results

In total, 58 patients were enrolled in the study, of whom 12 had preceding home‐visit nursing (PHN group) and 46 did not (non‐PHN group). Patients in the PHN group were younger (77.7 ± 4.9 vs. 84.1 ± 6.1 years, P = 0.0011) and had higher Mini‐Mental State Examination scores (16.8 ± 7.2 vs 11.8 ± 7.3, P = 0.0287). A multivariate Cox proportional hazard regression analysis adjusted for age and Mini‐Mental State Examination scores showed a higher likelihood of discharge to home in the PHN group (hazard ratio: 3.85; 95% confidence interval: 1.27–11.6;, P = 0.017) than in the non‐PHN group.

Conclusion

Home‐visit nursing before admission of BPSD patients for treatment could improve the rate of discharge to home among patients with limited familial care after subsequent hospitalization. Home‐visit nursing could also enhance collaborative relationships between social and hospital‐based care systems, and early implementation could improve the likelihood of vulnerable patient types remaining in their own homes for as long as possible.
Lognormal Approximations of Fault Tree Uncertainty Distributions
Authors: El‐Shanawany Ashraf Ben , Ardron Keith H. , Walker Simon P.
Published: January 2018

Fault trees are used in reliability modeling to create logical models of fault combinations that can lead to undesirable events. The output of a fault tree analysis (the top event probability) is expressed in terms of the failure probabilities of basic events that are input to the model. Typically, the basic event probabilities are not known exactly, but are modeled as probability distributions: therefore, the top event probability is also represented as an uncertainty distribution. Monte Carlo methods are generally used for evaluating the uncertainty distribution, but such calculations are computationally intensive and do not readily reveal the dominant contributors to the uncertainty. In this article, a closed‐form approximation for the fault tree top event uncertainty distribution is developed, which is applicable when the uncertainties in the basic events of the model are lognormally distributed. The results of the approximate method are compared with results from two sampling‐based methods: namely, the Monte Carlo method and the Wilks method based on order statistics. It is shown that the closed‐form expression can provide a reasonable approximation to results obtained by Monte Carlo sampling, without incurring the computational expense. The Wilks method is found to be a useful means of providing an upper bound for the percentiles of the uncertainty distribution while being computationally inexpensive compared with full Monte Carlo sampling. The lognormal approximation method and Wilks’s method appear attractive, practical alternatives for the evaluation of uncertainty in the output of fault trees and similar multilinear models.
Estimated Wold Representation and Spectral-Density-Driven Bootstrap for Time Series
Authors: Krampe Jonas , Kreiss Jens-Peter , Paparoditis Efstathios
Published: January 2018

The second-order dependence structure of purely non-deterministic stationary processes is described by the coefficients of the famous Wold representation. These coefficients can be obtained by factorizing the spectral density of the process. This relationship together with some spectral density estimator is used to obtain consistent estimators of these coefficients. A spectral-density-driven bootstrap for time series is then developed which uses the entire sequence of estimated moving average coefficients together with appropriately generated pseudoinnovations to obtain a bootstrap pseudo-time-series. It is shown that if the underlying process is linear and if the pseudoinnovations are generated by means of an independent and identically distributed wild bootstrap which mimics, to the extent necessary, the moment structure of the true innovations, this bootstrap proposal asymptotically works for a wide range of statistics. The relationships of the proposed bootstrap procedure to some other bootstrap procedures, including the auto-regressive sieve bootstrap, are discussed. It is shown that the latter is a special case of the spectral-density-driven bootstrap, if a parametric auto-regressive spectral density estimator is used. Simulations investigate the performance of the new bootstrap procedure in finite sample situations. Furthermore, a real life data example is presented.
Business of dialysis and the role of the medical director
Authors: Scheel Paul J.
Published: January 2018

Since the inception of the Medicare End Stage Renal Disease Program in 1972, the medical director has been an important leader in the dialysis unit. The initial duties of the medical director were focused on quality and safety but were gradually expanded over the decades to include the development and oversight of protocols to manage metabolic bone disease and anemia. As the total cost of ESRD care has escalated, there have been progressive attempts to control costs through additional bundling and the creation of alternative payment schemes. While we await the financial and clinical outcomes of these initiatives, the medical director's role continues to expand in scope and now includes an enhanced role for not only clinical outcomes but financial outcomes as well.
Task experience influences coordinative structures and performance variables in learning a slalom ski‐simulator task
Authors: Dutt‐Mazumder A. , Newell K. M.
Published: January 2018

The experiment investigated the progressions of the qualitative and quantitative changes in the movement dynamics of learning the ski‐simulator as a function of prior‐related task experience. The focus was the differential timescales of change in the candidate collective variable, neuromuscular synergies, joint motions, and task outcome as a function of learning over 7 days of practice. Half of the novice participants revealed in day 1 a transition of in‐phase to anti‐phase coupling of center of mass (CoM)‐platform motion whereas the remaining novices and experienced group all produced on the first trial an anti‐phase CoM‐platform coupling. The experienced group also had initially greater amplitude and velocity of platform motion—a performance advantage over the novice group that was reduced but not eliminated with 7 days of practice. The novice participants who had an in‐phase CoM‐platform coupling on the initial trials of day 1 also showed the most restricted platform motion in those trials. Prior‐related practice experience differentially influenced the learning of the task as evidenced by both the qualitative organization and the quantitative motion properties of the individual degrees of freedom (dof) to meet the task demands. The findings provide further evidence to the proposition that CoM‐platform coupling is a candidate collective variable in the ski‐simulator task that provides organization and boundary conditions to the motions of the individual jointdofand their couplings.
Regulation of bone blood flow in humans: The role of nitric oxide, prostaglandins, and adenosine
Authors: Heinonen I. , Boushel R. , Hellsten Y. , Kalliokoski K.
Published: January 2018

The mechanisms that regulate bone blood flow (BBF) in humans are largely unknown. Animal studies suggest that nitric oxide (NO) could be involved, and in this study, we investigated the effects of inhibition of nitric oxide synthase (NOS) alone and in combination with inhibition of cyclooxygenase (COX) enzyme, thus prostaglandin (PG) synthesis on femoral bone marrow blood flow by positron emission tomography in healthy young men at rest and during one‐leg dynamic exercise. In an additional group of healthy men, the role of adenosine (ADO) in the regulation of BBF during exercise was investigated by use of an adenosine receptor blocker (aminophylline). Inhibitors were directly infused into the femoral artery. Resting BBF was 1.1 ± 0.4 mL 100 g−1min−1 and increased to almost sixfold in response to exercise (6.3 ± 1.5 mL 100 g−1 min−1). Inhibition of NOS reduced BBF at rest to 0.7 ± 0.3 mL 100 g−1 min−1 (P = .036), but did not affect BBF significantly during exercise (5.5 ± 1.4 mL 100 g−1 min−1, P = .25). On the other hand, while combined NOS and COX inhibition did not cause any further reduction of blood flow at rest (0.6 ± 0.2 mL 100 g−1min−1), the combined blockade reduced BBF during exercise by ~21%, to 5.0 ± 1.8 mL 100 g−1 min−1 (P = .014). Finally, the ADO inhibition during exercise reduced BBF from 5.5 ± 1.9 mL 100 g−1 min−1 to 4.6 ± 1.2 mL 100 g−1 min−1 (P = .045). In conclusion, our results support the view that NO is involved in controlling bone marrow blood flow at rest, and NO, PG, and ADO play important roles in controlling human BBF during exercise.
Handheld 3‐dimensional wound measuring system
Authors: Pavlovčič U. , Jezeršek M.
Published: January 2018

Background

Measuring wound dimensions is important for monitoring and predicting the healing process. In our paper we propose and validate a handheld measuring system with dedicated software for measuring wound dimensions.

Methods

The measuring system comprises a commercial DSLR camera and a light pattern projection system. It is based on triangulation and structured illumination principles which enable handheld measuring. An edge of the wound is detected from the colour information of the measurement. Across the area of the wound, virtual healthy skin is approximated which enables the calculation of the wound volume and area, in addition to the wound circumference, which is calculated from the detected edge.

Results

In vitro verification using virtual standards showed that the accuracy of the analysis software is over 95% and 93% for measuring the area and volume respectively. A significant part of the error can be attributed to the inability of approximation to replicate entirely missing features. The accuracy of measuring the volume reduced to about 89% when a 3D measuring step was included in the analysis. When measuring in vivo wounds, the unrepeatability of the system was under 8% for measuring the area, which is a bit lower than comparable systems, and 5% for measuring the volume, which is about 4 times lower.

Conclusion

Based on these results and the ease of use, we conclude that the system is suitable to be used in daily clinical practice for measuring wound dimensions.
Comparison of two kinds of skin imaging analysis software: VISIA® from Canfield and IPP® from Media Cybernetics
Authors: Wang X. , Shu X. , Li Z. , Huo W. , Zou L. , Tang Y. , Li L.
Published: January 2018

Background

Skin imaging analysis, acting as a supplement to noninvasive bioengineering devices, has been widely used in medical cosmetology and cosmetic product evaluation. The main aim of this study is to assess the differences and correlations in measuring skin spots, wrinkles, vascular features, porphyrin, and pore between two commercially available image analysis software.

Materials and Methods

Seventy healthy women were included in the study. Before taking pictures, the dermatologist evaluated subjects’ skin conditions. Test sites included the forehead, cheek, and periorbital skin. A 2 × 2 cm cardboard was used to make a mark on the skin surface. Pictures were taken using VISIA® under three kinds light conditions and analyzed using VISIA® and IPP® respectively.

Results

(1) Skin pore, red area, ultraviolet spot, brown spot, porphyrin, and wrinkle measured with VISIA® were correlated with those measured with IPP® (P < .01). (2) Spot, wrinkle, fine line, brown spot, and red area analyzed with VISIA® were correlated with age on the forehead and periorbital skin (P < .05). L‐value, Crow's feet, ultraviolet spot, brown spot, and red area analyzed with IPP® were correlated with age on the periorbital skin (P < .05). (3) L‐value, spot, wrinkle, fine line, porphyrin, red area, and pore analyzed with VISIA® and IPP® showed correlations with the subjective evaluation scores (P < .05).

Conclusions

VISIA® and IPP® showed acceptable correlation in measuring various skin conditions. VISIA® showed a high sensibility when measured on the forehead skin. IPP® is available as an alternative software program to evaluate skin features.
Changes in dermal structure and skin oxidative stress in overweight and obese Japanese males after weight loss: a longitudinal observation study
Authors: Matsumoto M. , Ogai K. , Aoki M. , Urai T. , Yokogawa M. , Tawara M. , Kobayashi M. , Minematsu T. , Sanada H. , Sugama J.
Published: January 2018

Background/Purpose

Previous studies have reported decreased dermal echogenicity and increased skin oxidative stress in overweight males. However, it is unknown whether these skin parameters of overweight and obese people are similar to those of individuals exhibiting a normal body weight following weight loss. The purpose of this study was to (1) compare the changes in the dermal structure parameters and levels of skin oxidative stress before and after weight loss in overweight and obese people in Japan and (2) to clarify how these aspects changed when body weight would be reduced to normal body weight.

Methods

Male volunteers with a body mass index of ≥25 kg/m2 were recruited. The dermal structure was visualized and dermal echogenicity and thickness were measured using ultrasound scanners. The mRNA expression level of heme oxygenase‐1 in the hair follicles was quantitatively analyzed as a marker of skin oxidative stress.

Results

When overweight individuals in their 20s to 30s reduced their weight to normal, decreased dermal thickness in the abdominal region was observed in 50% of the subjects; however, no increase in dermal echogenicity was observed. A decrease in dermal thickness and an increase in dermal echogenicity in the thighs was observed in 83.3% of the subjects. No decrease in the level of dermal oxidative stress was observed.

Conclusion

The dermal structure in the thighs of overweight young individuals can be improved to the level of the structure in those of normal body weight individuals following weight loss.
Phosphorus bioavailability in ash from straw and sewage sludge processed by low‐temperature biomass gasification
Authors: Müller‐Stöver D. S. , Jakobsen I. , Grønlund M. , Rolsted M. M. M. , Magid J. , Hauggaard‐Nielsen H.
Published: January 2018

Reuse of phosphorus (P) from waste streams used for bioenergy conversion is desirable to reduce dependence on nonrenewable P resources. Two different ash materials from low‐temperature biomass gasification of wheat straw and sewage sludge, respectively, were investigated with regard to their P bioavailability. A set of pot experiments with spring barley was carried out to compare the ash P fertiliser value with mineral P fertiliser and the sewage sludge feedstock. An indirect radioactive labelling approach with 33P was used to determine the amount of P taken up from the fertiliser materials. Depending on the application rate, straw gasification ash produced a fertiliser response comparable to mineral P. However, P uptake from the ash was generally less than uptake from equivalent amounts of mineral P, and the calculated relative effectiveness was 44% after 6 weeks of plant growth. In contrast, the P fertiliser value of Fe‐rich sewage sludge after low‐temperature gasification was practically zero. These results suggest that ash from low‐temperature gasification could be developed into alternative P fertilisers; however, as the P bioavailability depends greatly on the feedstock used, a greater emphasis on feedstock composition is required.
Infection transmission among lung transplant couples
Authors: Rademacher Jessica , Fuge Jan , Welte Tobias , Gottlieb Jens , Suhling Hendrik
Published: January 2018

The risk of transmission of infections in partnerships between 2 transplant recipients is unknown. The aim of this study was to evaluate transmission in such couples. In this single‐center study, lung transplant (LTx) couples were identified among outpatients between 1988 and 2016. Infection rates per year and survival were compared to matched LTx‐recipients not living in a transplant partnership. Twelve transplant couples were analyzed with cumulative 65 years of relationship. Overall infections were similar between LTx‐couples and matched LTx‐patients. No significant differences were noted in bacterial infections (.12 vs .27 per year), community‐acquired viral (CARV) infections (.26 vs .22 per year), rejection treatments (.22 vs .12 per year), or hospitalizations (.26 vs .46 per year) in transplant couples and matched controls, respectively. There was no transmission of any microbial colonization from 1 partner to the other. Five cases of simultaneously detected CARV infections occurred (metapneumovirus [3], H1N1 [1], and respiratory syncytial virus [RSV; 1]). Three couples exhibited cytomegalovirus (CMV) reactivation in both partners at the same time with confirmed seronegativity before transplantation. In this case series of 12 lung transplant couples, the partnerships between 2 transplant recipients have no greater risk of bacterial infection and colonization transmission in comparison with recipients not living in a transplant relationship. However, transplant couples should be informed about the risk for transmission of viral infections, which could impact the development of chronic lung allograft dysfunction (CLAD).
Obstetric intra‐operative cell salvage and maternal fetal red cell contamination
Authors: Sullivan I.J. , Ralph C.J.
Published: January 2018

Background

The significance of fetal red blood cell (RBC) contamination in obstetric intra‐operative cell salvage is not fully known. It is unclear if we re‐infuse a larger volume of fetal RBCs into the maternal circulation than the amount that occurs secondary to transplacental haemorrhages is unclear. We also do not know if there is a critical volume required to cause alloimmunisation or if larger volumes increase the risk.

Objectives

The aim of this study is to provide data on the level of fetal RBC contamination in the maternal circulation prior to delivery and immediately post‐partum and to compare these levels to those found in processed cell‐salvaged blood.

Methods

In the first part of this study, we quantified the levels of fetal RBCs circulating in women immediately prior to delivery. This was then repeated with a separate group measuring the levels of fetal RBCs pre‐ and post‐delivery.

Results

We found that 37% of women had fetal cells detected in their circulation, median 0·00 mL (IQR 0–0·24; average 0·3 mL, maximum 4·56 mL). Fetal RBCs were present pre‐delivery (maximum 0·66 mL) in 16% of women, increasing to 53% post‐delivery (median 0·66 mL; IQR 0·22–2·20, maximum 21·20 mL).

Conclusions

We have shown that fetal RBCs are present in the maternal circulation throughout pregnancy and that the volumes are comparable to that obtained from intra‐operative salvage, with contamination amounts of up to 19 mL. At the Royal Cornwall Hospital, our experience and evidence supports offering intra‐operative salvage to all women, and we have not noted an increase in antibody formation, compared to allogeneic transfusion.
RBC alloantibody prevalence and specificity in a Western Norwegian tertiary hospital
Authors: Erikstein B. S. , Hagen K. G. , Hervig T.
Published: January 2018

Background and Objective

Although several studies focus on red blood cell (RBC) alloantibody distribution in selected patient populations, few address the specificity and frequency in all relevant groups. This study reports alloantibody frequency, distribution and the relationship to age and gender in blood donors, pregnant women and potential recipients of blood products.

Methods

This historical cohort study included 55 462 consecutive antibody screening tests from a tertiary Western Norwegian Hospital. Descriptive statistics were performed, and the results were compared with the literature.

Results

The detection and immunisation frequency for the whole cohort were 0·39 and 0·51%, respectively, whereas the RBC alloantibody prevalence was 0·73%. The most frequent RBC alloantibodies were anti‐E (20·1%), anti‐M (18·7%), anti‐K (9·8%), anti‐D (8·9%) and anti‐Fy(a) (7·0%). In pregnant women, the most frequent RBC alloantibodies were anti‐M, anti‐D and anti‐Le(a) (20·8, 18·9 and 18·9%, respectively), whereas there was no anti‐K detected. Anti‐E and anti‐M were the dominating RBC alloantibodies in the pre‐transfusion testing of in‐hospital patients (24·1 and 17·1%, respectively). Eighteen (9·2%) persons in the total cohort had two RBC alloantibodies, six persons had three alloantibodies, and two persons had four alloantibodies.

Rh and K typing to prevent future immunisations was only performed in 21·0% of the individuals who presented with a new alloantibody; despite that, 50·5% of the detected alloantibodies had such specificities.

Conclusions

The immunisation frequency and the level of anti‐K are low compared to national and international studies. Rh and K phenotype‐matched blood transfusions might be a feasible future strategy to further decrease RBC alloantibodies.
Biased Decision-Making and Liquidity Buffer in Commercial Banking
Authors: Sun Mingyuan
Published: January 2018

Few derived versions based on the classic bank run model have taken into account the framing effect of general lenders. The purpose of this study is to revisit the issue and discuss a model of bank run equilibrium combined with biased risk preference, which is applied to analyze how portfolio allocation and liquidity buffer in commercial banks are affected by liquidation cost and the reference point. The results suggest the condition on which the liquidity buffer of a particular bank should provide. Liquidation cost is positively correlated with the lower bound of liquidity buffer. The effect of the reference point on liquidity buffer partially depends on the slope of yield curve term structure. Higher reference point could typically cause a lower portion of long-term investment.
Creation of Zero CO2 Emission Plants Due to Energy Use: A Case Study in Crete, Greece
Authors: Vourdoubas John
Published: January 2018

Creation of zero CO2 emission enterprises due to energy use in Crete, Greece has been examined with reference to an orange juice producing plant (Viochym). Energy intensity at Viochym has been estimated at 1.66 KWh per € of annual sales. Oil used for heat generation has been replaced with solid biomass produced locally in Crete and resulting in zero CO2 emissions due to the use of heat. Offsetting CO2 emissions due to grid electricity use has been proposed with two options. The first includes the installation of a solar photovoltaic system with nominal power of 417 KWp, according to net metering regulations, generating annually 625 MWh equal to annual grid electricity consumption in the plant. Its capital cost has been estimated at 0.5 mil € which corresponds to 1.07 € per kg of CO2 saved annually.The second option includes the creation of a tree plantation in an area of 107 hectare resulting in carbon sequestration equal to carbon emissions in the plant due to electricity use. Both options for offsetting CO2 emissions in Viochym have various advantages and drawbacks and they are considered realistic and feasible, resulting in the elimination of its carbon emissions due to energy use. Improvement of the energy intensity of various processes in Viochym could result in lower CO2 emissions and smaller sizing of the required renewable energy systems for eliminating them.
Mechanisms linking T‐wave alternans to spontaneous initiation of ventricular arrhythmias in rabbit models of long QT syndrome
Authors: Liu Weiqing , Kim Tae Yun , Huang Xiaodong , Liu Michael B. , Koren Gideon , Choi Bum‐Rak , Qu Zhilin
Published: January 2018

Key points

T‐wave alternans (TWA) and T‐wave lability (TWL) are precursors of ventricular arrhythmias in long QT syndrome; however, the mechanistic link remains to be clarified.

Computer simulations show that action potential duration (APD) prolongation and slowed heart rates promote APD alternans and chaos, manifesting as TWA and TWL, respectively.

Regional APD alternans and chaos can exacerbate pre‐existing or induce de novo APD dispersion, which combines with enhanced ICa,L to result in premature ventricular complexes (PVCs) originating from the APD gradient region.

These PVCs can directly degenerate into re‐entrant arrhythmias without the need for an additional tissue substrate or further exacerbate the APD dispersion to cause spontaneous initiation of ventricular arrhythmias.

Experiments conducted in transgenic long QT rabbits show that PVC alternans occurs at slow heart rates, preceding spontaneous intuition of ventricular arrhythmias.

T‐wave alternans (TWA) and irregular beat‐to‐beat T‐wave variability or T‐wave lability (TWL), the ECG manifestations of action potential duration (APD) alternans and variability, are precursors of ventricular arrhythmias in long QT syndromes. TWA and TWL in patients tend to occur at normal heart rates and are usually potentiated by bradycardia. Whether or how TWA and TWL at normal or slow heart rates are causally linked to arrhythmogenesis remains unknown. In the present study, we used computer simulations and experiments of a transgenic rabbit model of long QT syndrome to investigate the underlying mechanisms. Computer simulations showed that APD prolongation and slowed heart rates caused early afterdepolarization‐mediated APD alternans and chaos, manifesting as TWA and TWL, respectively. Regional APD alternans and chaos exacerbated pre‐existing APD dispersion and, in addition, APD chaos could also induce APD dispersion de novo via chaos desynchronization. Increased APD dispersion, combined with substantially enhanced ICa,L, resulted in a tissue‐scale dynamical instability that gave rise to the spontaneous occurrence of unidirectionally propagating premature ventricular complexes (PVCs) originating from the APD gradient region. These PVCs could directly degenerate into re‐entrant arrhythmias without the need for an additional tissue substrate or could block the following sinus beat to result in a longer RR interval, which further exacerbated the APD dispersion giving rise to the spontaneous occurrence of ventricular arrhythmias. Slow heart rate‐induced PVC alternans was observed in experiments of transgenic LQT2 rabbits under isoproterenol, which was associated with increased APD dispersion and spontaneous occurrence of ventricular arrhythmias, in agreement with the theoretical predictions.
Water Treatment in Citrus Processing Plants
Authors: Lohkamp A. T.
Published: January 2018

The primary aim of this paper is to point out the need for proper water treatment for boiler and refrigeration equipment in the citrus industry. Generally speaking, the treatment that applies in this industry will apply in any other industry as well. However, since many packing and processing plants in Florida have grown up practically overnight, the production end of the operation has been stressed but some of the basic needs have been by-passed because there has, at times, been a lack of capital. At other times speed was an essential and some of the fundamentals of good operation were forgotten.

Paper published with permission.
Design Considerations for Cold Storage Warehousing
Authors: Fiske James M.
Published: January 2018

A general expansion of existing Cold Storage Warehousing or a program for construction of entirely new facilities calls for the proper analysis of design considerations and, most important, it requires that management properly establish the design consideration or search-out through study and professional advice, all fundamental considerations for analysis. The high cost per unit of warehouse space plus the fact that, once in use, the building and mechanical equipment cannot be readily and inexpensively repaired, changed, or added to makes careful selection and analysis of all considerations most important.

Paper published with permission.
Progress in Waste Treatment in the Citrus Industry
Authors: Wakefield John W.
Published: January 2018

Pollution has been defined as “too much of anything” and that is about as satisfactory as any other definition. Thus, the discharge of sewage into a bathing lake to such an extent as to render the waters unsatisfactory for bathing purposes is definitely pollution. By the same token, so is the discharge of acid wastes in sufficient quantity so that the biological balance of a stream is upset also pollution. In like manner, the discharge of heated water into an underground stratum from which cooling water is taken may constitute pollution and, in some cases, decaying vegetation or fertilizer washed from the soil by surface runoff has been considered pollution.

Paper published with permission.
Booster Compressors for the Citrus Industry: Reciprocating, Rotary and Centrifugal
Authors: St. Onge L. R.
Published: January 2018

To a citrus engineering group, refrigeration is a common-place item. However, except to those directly concerned with the subject, immediate reference to specific terms might be somewhat confusing. Since our subject is “Booster Compressors For The Citrus Industry”, it might be well to define a booster compressor.

Paper published with permission.
Continuous Vacuum Dehydration of Citrus Juices
Authors: Bonnell J. M.
Published: January 2018

The dry, nonvolatile solids of citrus juices, produced by high vacuum dehydration, represent the ultimate in edible juice concentrates. Upon the addition of certain volatile constituents, and reconstitution with water, a juice can be obtained which closely resembles the fresh original material. The major difference is that the reconstituted powder lacks the bouquet characteristic of fresh juice. So far as this author knows, the only method of returning this “fresh bouquet” to vacuum concentrated citrus juices is by the addition of “cut back” fresh juice to the product. With a dry powder this is, of course, impossible.

Paper published with permission.
Automation for the Citrus Industry
Authors: Barker Jack
Published: January 2018

With the ever-increasing necessity of economy of processing and uniformity of product, automation becomes more and more vital to the citrus industry. Our present purpose is to define the subject, briefly describe its functions, and discuss, as time will allow, its pertinent applications.

Paper published with permission.
Steam Economics of Molasses Plant Evaporators: Molasses Plant Place in Citrus Industry
Authors: Cahill John M.
Published: January 2018

Processors of citrus fruit are faced with disposal of the pulp left over after juice is extracted from the fruit. Generally, the pulp is dried in steam or oil fired dryers and then sold as cattle feed. If disposal of the pulp is the prime factor of interest to the operator; shredding and hot air drying is sufficient. For more efficient removal of water from the pulp and the obtainment of other by-products, mainly citrus molasses and stripper oil, consideration should be given to the installation of presses and a molasses evaporator. Most authorities will agree that water can be evaporated more efficiently in a multiple effect evaporator than in a hot air dryer. Presses and an evaporator represent considerable investment, therefore the decision to install a Molasses Plant must be weighed carefully, balancing potential savings against the installed cost.

Paper published with permission.
Process Treatment of Citrus Fruits for the Fresh Fruit Markets
Authors: Gerwe R. D.
Published: January 2018

The growth of the Citrus Canning and Processing Industry of Florida during the past twenty years has been phenomenal. In 1940, approximately 70% of the crop was merchandised as fresh fruit and 30% was processed in canning plants. Today, these figures are exactly reversed with 70% being processed and 30% sold as fresh fruit. As a result of this trend, there has been some tendency to relegate the fresh fruit segment of the industry to the position of step-child. It is becoming increasingly apparent, however, that the continued success of the industry is dependent upon maintaining and developing all possible sales outlets for the ever increasing crop. This is especially recognized this season, when with high inventories of processed citrus at the beginning of the season, the fresh fruit packing houses had to take up the slack. Thus far, fresh fruit shipments are about 25% greater than they were last season when total fresh shipments were 28,000,000 boxes. Without this increased movement, prices of all citrus products undoubtedly would have been depressed. The continuing importance of the fresh fruit segment of the industry is therefore becoming more fully recognized.

Paper published with permission.
Nitrogen Treatment as a Means of Extending Shelf-Life of Chilled and Canned Single Strength Orange Juice
Authors: Webster Robert C.
Published: January 2018

The use of Nitrogen and other inert atmospheres to reduce or replace oxygen is an old, yet not well practiced art in the manufacture, storage, handling and packaging of orange juice. The art of Nitrogen treatment of orange products was first developed with canned and bottled single strength juice. The primary or designed purpose being to increase product end container shelf-life by eliminating oxygen.

Paper published with permission.
Treatment of Citrus Juice by Ion Exchange Membrane
Authors: Kilburn R. W.
Published: January 2018

Citrus juice sometimes taste more tart than is desirable for ready consumer acceptance. This is particularly true with grapefruit juice, a characteristically tart juice. More than half of the grapefruit juice packed in Florida contains sugar, added to make the juice acceptable to the modern palate. Sugar added to citrus juice not only represents additional processing cost, but also offers only a limited solution to the problem of improving the taste of citrus juice.

Paper published with permission.
The APV Plate Evaporator in the Citrus Industry
Authors: Dinnage Derek F.
Published: January 2018

One of the most interesting recent developments in equipment for food products processing is the new APV Plate Evaporator.

The purpose of this paper will be to briefly describe the development, design, operation and application of this Plate Evaporator, particularly with reference to the citrus processing industry.

Paper published with permission.
The Use of Fluid Mixers in the Citrus Industry
Authors: Oldshue J. Y.
Published: January 2018

Mixing is involved in all aspects of citrus processing. This discussion is concerned primarily with the use of a rotating mixing impeller which imparts a velocity to the fluid in the mixing vessel.

Paper published with permission.