bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical Treatment of Sacral Neurogenic Tumor: A 10‐year Experience with 64 Cases
Authors: Sun Wei , Ma Xiao‐jun , Zhang Fan , Miao Wei‐liang , Wang Chong‐ren , Cai Zheng‐dong
Published: July 2016

Objective

To explore the outcomes of surgical treatment of sacral neurogenic tumors

Methods

Between 1 January 2003 and 31 December 2012, data on 64 patients with sacral neurogenic tumors treated with surgery were retrospectively analyzed. The mean age of the 64 cases (35 males and 29 females) was 37.2 years (range, 21–69 years); 38 had neurilemmomas and 26 neurofibromas. Thirty‐four of the tumors involved S
1 and S
2, 11 S
3 or lower, and 19 were single presacral soft tissue masses. Tumors were removed via anterior, posterior or combined anteroposterior approaches. Patients with unstable sacroiliac joints underwent iliolumbar fixation.

Results

Depending on the extent of tumor involvement, one of three surgical approaches was used: a single anterior approach (19 patients), single posterior approach (25 patients), or a combined anteroposterior approach (20 patients). The mean operation time was 3 h (range, 2–6 h) and the mean blood loss 878 mL (range, 400–3120 mL). The mean duration of follow‐up was 58.2 months (range, 24–93 months). These surgeries had the following complications. Three patients had massive intraoperative hemorrhage and posterior back pain and discomfort postoperatively. One patient had intraoperative ureteral injuries requiring intraoperative ureteral catheterization. In two patients, the tumor involved the S
1 nerve roots bilaterally, necessitating their removal, which resulted in obvious lower limb motion and sphincteric dysfunction. In 13 patients with unilateral tumor involvement of the nerve roots of S
1 and lower spinal levels, only the contralateral nerve roots of the S1 and lower levels were preserved; eight of these patients had impaired bladder and bowel function. Posterior incisions failed to heal in 10 patients, secondary wound healing occurred in nine of them and one required a gluteus maximus myocutaneous flap. Three patients developed postoperative cerebrospinal fluid leaks that were and alleviated by waist belt compression bandaging and placing them in the Trendelenburg position. Eight patients developed tumor recurrences postoperatively; pathological examination of the tissue excised in the second surgeries revealed malignant changes in the three patients with neurilemmomas. There were no intraoperative deaths. Rod fractures occurred in three of the 18 patients requiring iliolumbar reconstruction.

Conclusions

The clinical characteristics of sacral neurogenic tumors make them easy to diagnose. The approach to resection should be determined by the location and size of the tumor. Patients with huge tumors may lose considerable blood intraoperatively and a have higher risk rate of postoperative complications.
Closed Suction Drainage Is Not Associated with Faster Recovery after Total Knee Arthroplasty
Authors: Wang Duan , Xu Jin , Zeng Wei‐nan , Zhou Kai , Xie Tian‐hang , Chen Zhi , Yu Hao‐da , Li Jin‐long , Zhou Zong‐ke , Pei Fu‐xing
Published: July 2016

Objective

To evaluate whether closed suction drainage (CSD) is associated with early recovery of knee function in patients undergoing total knee arthroplasty (TKA).

Methods

Between January 2015 and September 2015, 80 consecutive patients were prospectively randomized into two groups: a CSD group (40 cases; average age, 66.9 ± 8.6 years; male, 8; female, 32) and a non‐CSD group (40 cases; average age, 66.8 ± 10.1 years; male, 9; female, 31). Local inflammation outcomes (assessed by a visual analog scale [VAS], swelling and skin temperature), calculated total blood loss (CBL), hidden blood loss (HBL), blood transfusion requirements and hemoglobin concentrations were recorded. Hospital for Special Surgery (HSS) knee scores, range of motion (ROM), limb swelling, tension vesicles, ecchymosis, time to regaining straight leg raising and duration of hospital stay were documented. All surgeries were performed by the same surgeon and followed up for 3 months.

Results

The peri‐wound skin temperature and knee VAS pain scores were lower in the non‐CSD group. Patients in the non‐CSD group had significantly better knee ROM (P = 0.028). The time to regaining active straight leg raising was significantly shorter in the non‐CSD groupN than in the CSD group (P = 0.014). In addition, patients in the non‐CSD group had a shorter length of hospital stay (P = 0.004) than those in the CSD group, indicating earlier recovery of knee function. HBL was significantly less in the CSD group than the non‐CSD group (P = 0.006) on postoperative day (POD) 5. However, CBL did not differ significantly between the two groups on POD5. There were no significant differences between two groups in all other assessed variables.

Conclusion

In this randomized study, primary TKA without CSD was associated with faster recovery related to less local inflammation and better early knee function. Furthermore, use of a drain had no significant advantage with respect to other outcome measures and may have increased costs. Based on these data, CSD after primary TKA is not routinely indicated.
Expression of Matrix Metalloproteinase‐9 and CD34 in Giant Cell Tumor of Bone
Authors: Zhou Xing , Liu Xiao‐zhou , Fan Gen‐tao , Wu Su‐jia , Zhao Jian‐ning , Shi Xin
Published: July 2016

Objective

Giant cell tumor of bone (GCTB) invades extensively and metastasizes, however, the pathological grade and imaging findings are not accurate predictors of its prognosis. Thus, the aim of this study was to explore the relationships between expression of cluster of differentiation (CD)34 and matrix metalloproteinase‐9 (MMP‐9) and the biological behavior of GCTB with the hope of identifying predictors of prognosis.

Methods

Sixty‐eight patients with GCTBs attending our institution from September 2008 to August 2013 were enrolled in this prospective study and grouped according to tumor location. Relevant patient characteristics were assessed. Additionally, the expression of CD34 and MMP‐9 in these patients was assayed by an immunohistochemistry staining procedure and the relationships between CD34/MMP‐9 and microvessel density (MVD) analyzed by Spearman correlation analysis.

Results

It was found that CD34 factor localizes in the cytoplasm of the endothelial cells of small blood vessels in the tumor stroma and is strongly expressed in GCTBs. In addition, radiological grading showed that there was significantly more CD34 antibody‐labeled MVD in invasive than in non‐invasive tumors (P < 0.05) and significantly more CD34 antibody‐labeled MVD in patients who developed recurrences than in those who did not (P < 0.05). Expression of MMP‐9 was localized in the cytoplasm of tumor cells and the rate of MMP‐9 positivity in GCTBs was significantly higher in active and invasive tumors than in non‐invasive tumors (P < 0.01). Moreover, there were significantly more MVDs in MMP‐9‐positive than in MMP‐9 negative tumors (P < 0.01). CD34 and MMP‐9 are positively correlated with MVD values in GCTBs and closely correlated with their grade of malignancy.

Conclusion

Expression of CD34 and MMP‐9 accurately predicts clinical behavior detection and prognosis of GCTBs.
Epistemic Warrants and Higher‐Order Theories of Conscious Perception
Authors: Edwards James , Platchias Dimitris
Published: July 2016

We present a new account of perceptual consciousness, one which gives due weight to the epistemic commitment of normal perception in familiar circumstances. The account is given in terms of a higher‐order attitude for which the subject has an immediate perceptual epistemic warrant in the form of an appropriate first‐order perception. We develop our account in contrast to Rosenthal's higher‐order account, rejecting his view of consciousness in virtue of so‐called ‘targetless’ higher‐order states. We explain the key notion of an immediate perceptual warrant and show both that it requires the content of the higher‐order attitude to match that of the first‐order perception, and also that it gives a new perspective on the intimate relationship, rightly emphasised by Rosenthal, between consciousness and a subject's testimony as to ‘how it is with her’.
Sensitivity and Higher‐Order Knowledge
Authors: Wallbridge Kevin
Published: July 2016

Vogel, Sosa, and Huemer have all argued that sensitivity is incompatible with knowing that you do not believe falsely, therefore the sensitivity condition must be false. I show that this objection misses its mark because it fails to take account of the basis of belief. Moreover, if the objection is modified to account for the basis of belief then it collapses into the more familiar objection that sensitivity is incompatible with closure. (But that is an objection which sensitivity theorists are already prepared to meet, one way or another.)
The Eagle Ford Shale Development and Local Government Fiscal Behavior
Authors: Rahm Dianne , Farmer Jayce L. , Fields Billy
Published: July 2016

Drawing on data gathered through a survey of local officials, this study examines the impacts of the Eagle Ford Shale development on the fiscal behavior of local governments in its region. This study focused on how gas and oil production influences local governments’ revenue generation, tax structures, abilities to handle fiscal stress, and revenue stabilization strategies. The findings provide insight that suggests strong tax revenue gains for these jurisdictions. In some instances, these revenue gains have allowed these governments to buffer themselves against fiscal stress and maintain some revenue that allows them to offset specific costs associated with local oil production. However, the long‐term outlook of several of the localities in question makes them vulnerable to possible fiscal troubles. The short‐term planning of spending coupled with the long‐term expectation of oil and natural gas production may lead to many of these governments experiencing financial hardship when oil production declines.
A Day Late and A Dollar Short? A Study of Budget Passage in New York State
Authors: Yi Lu Elaine , Chen Gang
Published: July 2016

Passing a budget is an attribute of sovereignty. This research highlights the fusion of multiple forces in the broader context—economic factors, political factors, budget rules, and leadership stability—in which budget negotiation takes place. Through an in‐depth case study of New York State from 1970 to 2012 and extensive interviews with prior and current key participants in the budgeting process, this research found that a divided government contributes to a late budget only when budget rules are not controlled. In addition, legal clarity of authorities among the key budget negotiators, their willingness to compromise, as well as effective executive leadership in bringing people to budget negotiation, hold the potential to reduce the extent of budget delays in an increasingly contentious and turbulent budgeting environment.
Virtual Versus Physical Government Decentralization: Effects on Corruption and the Shadow Economy
Authors: Goel Rajeev K. , Saunoris James W.
Published: July 2016

This paper examines the relative effectiveness of cross‐national virtual decentralization and physical decentralization of government functions on corruption and the shadow economy. Results show that while virtual decentralization reduces both corruption and the shadow economy, physical decentralization reduces only the shadow economy. The e‐government results are robust to alternate measures and specifications, while those of government tiers are not.
The Responsiveness of Casino Revenue to the Casino Tax Rate
Authors: Combs Kathryn L. , Kim Jaebeom , Landers Jim , Spry John A.
Published: July 2016

This paper examines the tax base elasticity of the regulated casino industry in Illinois to help estimate state‐level revenue impacts of casino tax rate changes. Illinois’ shift to a graduated rate schedule increased the highest marginal tax rate on casino adjusted gross receipts (AGR) from 20 percent to 70 percent before reverting to a 50 percent rate. We construct a state‐level casino tax rate variable, which is a statewide average for each month of the marginal casino tax rate facing each casino. We find that a 1 percent increase in this state‐level casino tax rate decreases overall Illinois casino AGR by around 1.1 percent.
A Payback Approach to Generational Inequity
Authors: Couch Robert B.
Published: July 2016

The payback approach to capital budgeting is proposed as a clear and intuitive way to think about fiscal policy and the normative problem of generational equity. Payback has been an enduring tool of corporate capital budgeting decisions and the home mortgage industry. As a clear and resonant conceptual tool, payback measures thus have the potential to mobilize political will for overcoming difficult fiscal policy problems, when they arise. Numerical examples calibrated to U.S. federal budget history illustrate how payback measures can be used in practice.
Is a Good Normative Model of Public Spending Run Backward a Good Positive Model?
Authors: Thompson Fred , Pierson Kawika , Hand Michael L. , Dothan Michael U.
Published: July 2016

We test a positive model of government spending and savings, where jurisdictions seek to stabilize spending growth and where revenue growth and savings are assumed to be continuous‐time stochastic processes, the Dothan–Thompson optimal budget model. Our empirical tests address two reduced‐form specifications derived from this model, each applied to two different subsets of municipalities. For each of the two specifications, we first estimated models using data for all available municipalities (more than 20,000) covered by the U.S. Census government finance data, and then tested them again on a much smaller balanced subset of the full panel. We find that municipalities do not, on average, optimally stabilize spending in the face of revenue volatility, nor do they consistently use savings to do so. There is, however, at least modest statistical evidence that savings reflect revenue volatility at typical levels of volatility. For all model specifications tested, the single greatest determinant of savings at the municipal level is the state in which the municipality is located. The next challenge is to identify and measure the impact of the underlying factors that explain the dramatic state‐to‐state differences observed in municipal savings patterns.
Special Districts and Local Government Debt: An Analysis of “Old Northwest Territory” States
Authors: Faulk Dagney , Killian Larita
Published: July 2016

Special districts potentially offer a way for local governments to issue more debt than allowed by debt limits. This research examines the relationship between the number of special districts in a county and local government debt levels. Using data from states formed from the Northwest Territory and controlling for other local governments, demographic, and fiscal factors, we find that the number of special districts in a county is positively related to local government debt in four of the five states examined (Indiana, Michigan, Ohio, and Wisconsin). The results for Illinois were insignificant.
Living donor liver transplantation for biliary atresia – An Indian experience
Authors: Safwan Mohamed , Ramachandran Priya , Reddy Mettu Srinivas , Shanmugam Naresh , Rela Mohamed
Published: July 2016

LT has played a significant role in improving the outcome of children with BA. We review our five‐yr experience of LDLT for children with BA. Records of all children who underwent LDLT in our institution over a five‐yr period (August 2010–June 2015) were reviewed and those with a primary diagnosis of BA were selected for our study. Data were extracted from a prospectively maintained database. Additional data were collected by review of case notes and imaging studies. Analysis was carried out using standard statistical means. One hundred and thirty‐two children underwent LDLT at our center over the study period, of which 58 children (31 females) had a primary diagnosis of BA. Thirty‐three (56.9%) children had undergone a prior KPE and 25 (43.1%) had a primary LT. Thirty‐four children had at least one post‐op complication, of which 13 had minor complications (Clavien grades I and II) and 21 had major complications (Clavien grade >II). Thirty‐day survival was 96.6% and one‐yr survival was 91.4%. Univariate analysis of variables comparing children who did and did not have a KPE prior to LT showed that age at LT, weight at LT, PELD, and GRWR were significantly different. LDLT provides excellent outcomes in children with BA. Primary LDLT and LT after KPE provide equivalent results, although the former is technically more challenging as the child is younger.
On the sustainability of a reintroduced Crested Ibis population in Qinling Mountains, Shaanxi, Central China
Authors: Wang Min , Ye Xin‐ping , Li Yan‐fang , Huo Zhi‐ping , Li Xia , Yu Xiao‐ping
Published: July 2016

Reintroduction projects aim to reestablish a self‐sustaining population of an endangered species within its historical range. Adequate post‐release monitoring by gathering demographic data is important to evaluate the success of a reintroduction. Survival and reproduction rates of a reintroduced population can be compared with a self‐sustaining wild population to evaluate the success of a reintroduction. In early 2007, Nipponia nippon (Crested Ibis) was reintroduced into the Qinling Mountains (Shaanxi, Central China). In this study, we attempt to evaluate the demographic status of the reintroduced population. Age‐specific survival rates of 56 released adults and 77 wild‐born fledglings were estimated using mark‐recapture data obtained from 2007 to 2014. Survival rates for the yearlings (0.599, with 95% confidence interval [CI]: 0.467–0.719) were lower than the estimates from a wild population in Yangxian County, but the survival rates of the adults (0.678, with 95% CI: 0.603–0.745) were similar. The number of breeding pairs gradually increased since 2008, although breeding success (52.5%) was somewhat less than that of the wild population (67.6%). The stochastic estimation of population growth rate (1.084 with 95% CI: 1.069–1.098) and population size (5‐fold increase) estimated from an age‐classified Leslie matrix indicate that the reintroduced population of the Crested Ibis is more likely in regulation phase over the next 25 years. We conclude that the reintroduction of the Crested Ibis in Qinling Mountains has great promise, and progress toward a self‐sustaining population has been made under some interventions. Governments, local communities, and scientists need to facilitate habitat restoration for the long‐term survival of this endangered species.
Exercise simultaneously increases nasal patency and bronchial obstruction in asthmatic children
Authors: Lukkarinen Minna , Haavisto Lotta E. , Lukkarinen Heikki , Sipilä Jukka I. , Papadopoulos Nikolaos G. , Jartti Tuomas
Published: July 2016

We found that simultaneous post‐exercise increase in nasal patency and bronchial obstruction occurs only in children with atopic asthma, but not in sensitized children without asthma. In healthy children, the increase in nasal patency is accompanied by bronchial dilatation.
The Networked Partial Correlation and Its Application to the Analysis of Genetic Interactions
Authors: Roverato Alberto , Castelo Robert
Published: July 2016

Genetic interactions confer robustness on cells in response to genetic perturbations. This often occurs through molecular buffering mechanisms that can be predicted by using, among other features, the degree of coexpression between genes, which is commonly estimated through marginal measures of association such as Pearson or Spearman correlation coefficients. However, marginal correlations are sensitive to indirect effects and often partial correlations are used instead. Yet, partial correlations convey no information about the (linear) influence of the coexpressed genes on the entire multivariate system, which may be crucial to discriminate functional associations from genetic interactions. To address these two shortcomings, here we propose to use the edge weight derived from the covariance decomposition over the paths of the associated gene network. We call this new quantity the networked partial correlation and use it to analyse genetic interactions in yeast.
An Evolutionary Spectrum Approach to Incorporate Large-Scale Geographical Descriptors on Global Processes
Authors: Castruccio Stefano , Guinness Joseph
Published: July 2016

We introduce a non-stationary spatiotemporal model for gridded data on the sphere. The model specifies a computationally convenient covariance structure that depends on heterogeneous geography. Widely used statistical models on a spherical domain are non-stationary for different latitudes, but stationary at the same latitude (axial symmetry). This assumption has been acknowledged to be too restrictive for quantities such as surface temperature, whose statistical behaviour is influenced by large-scale geographical descriptors such as land and ocean. We propose an evolutionary spectrum approach that can account for different regimes across the Earth's geography and results in a more general and flexible class of models that vastly outperforms axially symmetric models and captures longitudinal patterns that would otherwise be assumed constant. The model can be estimated with a multistep conditional likelihood approximation that preserves the non-stationary features while allowing for easily distributed computations: we show how the model can be fitted to more than 20 million data points in less than 1 day on a state of the art workstation. The resulting estimates from the statistical model can be regarded as a synthetic description (i.e. a compression) of the space–time characteristics of an entire initial condition ensemble.
Mesenchymal Stromal Cells Protect Endothelial Cells from Cytotoxic T Lymphocyte‐Induced Lysis
Authors: Cahill E. F. , Sax T. , Hartmann I. , Haffner S. , Holler E. , Holler B. , Huss R. , Günther C. , Parolini O. , Kolch W. , Eissner G.
Published: July 2016

The integrity of the vasculature plays an important role in the success of allogeneic organ and haematopoietic stem cell transplantation. Endothelial cells (EC) have previously been shown to be the target of activated cytotoxic T lymphocytes (CTL) resulting in extensive cell lysis. Mesenchymal stromal cells (MSC) are multipotent cells which can be isolated from multiple sites, each demonstrating immunomodulatory capabilities. They are explored herein for their potential to protect EC from CTL‐targeted lysis. CD8+ T cells isolated from human PBMC were stimulated with mitotically inactive cells of a human microvascular endothelial cell line (CDC/EU.HMEC‐1, further referred to as HMEC) for 7 days. Target HMEC were cultured in the presence or absence of MSC for 24 h before exposure to activated allogeneic CTL for 4 h. EC were then analysed for cytotoxic lysis by flow cytometry. Culture of HMEC with MSC in the efferent immune phase (24 h before the assay) led to a decrease in HMEC lysis. This lysis was determined to be MHC Class I restricted linked and further analysis suggested that MSC contact is important in abrogation of lysis, as protection is reduced where MSC are separated in transwell experiments. The efficacy of multiple sources of MSC was also confirmed, and the collaborative effect of MSC and the endothelium protective drug defibrotide were determined, with defibrotide enhancing the protection provided by MSC. These results support the use of MSC as an adjuvant cellular therapeutic in transplant medicine, alone or in conjunction with EC protective agents such as defibrotide.
Serum Proteomics Analysis in Rats of Immunosuppression Induced by Chronic Stress
Authors: Hou D. D. , Zhu R. Z. , Sun Z. , Ma X. D. , Wang D. C. , Timothy H. , Chen W. N. , Yan F. , Lei P. , Han X. W. , Chen D. X. , Cai L. P. , Guan H. Q.
Published: July 2016

The immune system can be damaged by chronic stress. However, for this process, the involved molecular alterations and their regulatory roles played in immunosuppression still remain unclear. This study was aimed to identify the differences in serum protein expressions that are closely associated with the effect of chronic stress on immune function. Serum protein levels of rats in control group and chronic stress group were measured by iTRAQ analysis. Subsequently, among the 121 differentially expressed proteins screened between the two groups, 46 proteins were upregulated (>1.5‐fold, P < 0.05), while 75 proteins were downregulated (<0.67‐fold, P < 0.05). Bioinformatics analysis revealed that most of the differentially expressed proteins were in relation with the metabolic, cellular, response stimulus and immune system processes. The significantly differential expression of ceruloplasmin, haptoglobin, catalase and peroxiredoxin‐1 were picked out for reconfirmation by ELISA analysis. The results were consistent with those obtained by iTRAQ. What is more, the roles of above‐mentioned four proteins, apolipoprotein B‐100 and heat‐shock protein 90 in immunosuppression induced by chronic stress were discussed. Taken together, these findings may provide a new insight into better understanding the molecular mechanisms of immunosuppression induced by chronic stress.
Moving Beyond Self‐Report: Implicit Associations about Death/Life Prospectively Predict Suicidal Behavior among Veterans
Authors: Barnes Sean M. , Bahraini Nazanin H. , Forster Jeri E. , Stearns‐Yoder Kelly A. , Hostetter Trisha A. , Smith Geoffrey , Nagamoto Herbert T. , Nock Matthew K.
Published: July 2016

Reliance on self‐report limits clinicians' ability to accurately predict suicidal behavior. In this study the predictive validity of an objective measure, the death/suicide Implicit Association Test (d/sIAT), was tested among psychiatrically hospitalized veterans. Following acute stabilization, 176 participants completed the d/sIAT and traditional suicide risk assessments. Participants had similar d/sIAT scores regardless of whether they had recently attempted suicide. However, d/sIAT scores significantly predicted suicide attempts during the 6‐month follow‐up above and beyond other known risk factors for suicidal behavior (OR = 1.89; 95% CI: 1.15–3.12; based on 1SD increase). The d/sIAT may augment the accuracy of suicide risk assessment.
Incidence and differential characteristics of culture‐negative fever following pancreas transplantation with anti‐thymocyte globulin induction
Authors: Shin S. , Kim Y.H. , Kim S.‐H. , Lee S.‐O. , Kwon H.W. , Choi J.Y. , Han D.J.
Published: July 2016

Background

Limited data are available on the incidence and characteristics of culture‐negative fever following pancreas transplantation (PTx) with anti‐thymocyte globulin (ATG) induction. Our study aims to better define the features of culture‐negative fever, so it can be delineated from infectious fever, hopefully helping clinicians to guide antibiotic therapy in this high‐risk patient population.

Methods

We performed a retrospective cohort study of postoperative fever among 198 consecutive patients undergoing PTx at our center between August 1, 2004 and December 31, 2014. Fever was classified as culture‐negative if there was neither a positive culture nor a documented clinical diagnosis of infection.

Results

Fever was identified in 113 patients; 66 were deemed to be infectious, 39 were culture‐negative, and 8 were indeterminate. High body mass index of recipient (odds ratio 1.87, 95% confidence interval: 1.15–3.03, P = 0.011) was a significant factor associated with culture‐negative fever in multivariate analysis. No patients with culture‐negative fever were diagnosed with infiltrates or effusion on chest radiography. In addition, an increase in white blood cell count, C‐reactive protein, and serum amylase was less prominent in culture‐negative fever. Culture‐negative fever developed most frequently at postoperative 7 or 14 days, showing a biphasic curve.

Conclusion

Culture‐negative fever develops in a substantial proportion of patients early after PTx. The awareness of the possibility and clinical features of post‐transplant culture‐negative fever might help clinicians to guide antibiotic therapy in this high‐risk patient population, especially following ATG induction and early steroid withdrawal.
Low transfusion transmission of hepatitis E among 25,637 single‐donation, nucleic acid‐tested blood donors
Authors: Harritshøj Lene H. , Holm Dorte K. , Sækmose Susanne G. , Jensen Bitten A. , Hogema Boris M. , Fischer Thea K. , Midgley Sofie E. , Krog Jesper S. , Erikstrup Christian , Ullum Henrik
Published: July 2016

BACKGROUND

Hepatitis E virus genotype‐3 (HEV‐gt‐3) causes autochthonous infections in western countries, with a primary reservoir in animals, especially pigs. HEV transfusion transmission has been reported, and HEV‐gt‐3 prevalence is high in some European countries. The prevalence of HEV RNA was investigated among Danish blood donors, and the prevalence of HEV transfusion‐transmitted infection (TTI) was investigated among recipients.

STUDY DESIGN AND METHODS

Samples from 25,637 consenting donors collected during 1 month in 2015 were screened retrospectively using an individual‐donation HEV RNA nucleic acid test with a 95% detection probability of 7.9 IU/mL. HEV‐positive samples were quantified by real‐time polymerase chain reaction and genotyped. Transmission was evaluated among recipients of HEV RNA‐positive blood components. Phylogenetic analyses compared HEV sequences from blood donors, symptomatic patients, and swine.

RESULTS

Eleven donations (0.04%) were confirmed as positive for HEV RNA (median HEV RNA level, 13 IU/mL). Two donations were successfully genotyped as HEV‐gt‐3. Only one donor had a travel history outside Europe. Nine of 11 donors were male, but the gender ratio was nonsignificant compared with the total donor population. Seven available recipients tested negative for HEV RNA and anti‐HEV immunoglobulin M in follow‐up samples. One recipient was HEV RNA‐negative but anti‐HEV immunoglobulin G‐positive. HEV TTI was considered unlikely, but a transfusion‐induced secondary immune response could not be excluded. Phylogenetic analysis showed relatively large sequence differences between HEV from donors, symptomatic patients, and swine.

CONCLUSIONS

Despite an HEV RNA prevalence of 0.04% in Danish blood donations, all HEV‐positive donations carried low viral loads, and no evidence of TTI was found.
Inactivation of viruses during a new manufacturing process of α2‐macroglobulin from Cohn Fraction IV by dry‐heat treatment
Authors: Huangfu Chaoji , Zhao Xiong , Lv Maomin , Jia Junting , Zhu Fengxuan , Wang Rui , Ma Yuyuan , Zhang Jingang
Published: July 2016

BACKGROUND

α2‐Macroglobulin (α2‐M) has a curative effect on radiation injury. Virus transmission through plasma derivatives is still not risk‐free. Effect of dry heat on α2‐M activity and virus inactivation by dry heat in a new manufacturing process of α2‐M were studied.

STUDY DESIGN AND METHODS

Effects of 100°C for 30 minutes, 80°C for 72 hours, and lyophilization on α2‐M activity were detected, and stabilizing agents were optimized. Effect of a treatment at 100°C for 30 minutes has been tested on a range of viruses and characteristics change of α2‐M was investigated.

RESULTS

More than 90 and 80% α2‐M activity recovery were reserved after treatment at 100°C for 30 minutes and 80°C for 72 hours, respectively. A concentration of 0.05 mol/L histidine presented a better protecting effect for α‐M activity. No substantial changes were observed in the characteristics of α2‐M compared with the untreated. By lyophilization and dry‐heat treatment at 100°C for 30 minutes, murine encephalomyocarditis virus and pseudorabies virus (PRV) were inactivated below detectable level within 5 minutes (virus titers reduction ≥ 5.75 log) and 30 minutes (virus titers reduction ≥ 6.00 log), respectively. Bovine viral diarrhea virus and porcine parvovirus were inactivated by 4.29 and 2.46 log reduction, respectively.

CONCLUSION

Treatment at 100°C for 30 minutes could improve the virus safety of α2‐M with a slight activity loss.
Relative impact of a patient blood management program on utilization of all three major blood components
Authors: Thakkar Rajiv N. , Lee K.H. Ken , Ness Paul M. , Wintermeyer Tyler L. , Johnson Daniel J. , Liu Emily , Rajprasad Anjuli , Knight Amy M. , Wachter Pat A. , Demski Renee , Frank Steven M.
Published: July 2016

BACKGROUND

Although patient blood management (PBM) programs clearly reduce transfusion overuse, the relative impact on red blood cell (RBC), plasma, and platelet (PLT) utilization is unclear.

STUDY DESIGN AND METHODS

A retrospective analysis of electronic records was conducted at a medium‐sized academic hospital to assess blood utilization for all inpatients admitted during 1‐year periods before (n = 20,531) and after (n = 19,477) PBM efforts began in September 2014. Transfusion guideline compliance and overall utilization were assessed for RBCs, plasma, and PLTs. The primary PBM efforts included education on evidence‐based transfusion guidelines, decision support in the computerized provider order entry system, and distribution of provider‐specific reports showing comparison to peers for guideline compliance. Cost avoidance was determined by two methods (acquisition cost and activity‐based cost), and clinical outcomes were compared during the two periods.

RESULTS

For RBCs, orders outside hospital guidelines decreased (from 23.9% to 17.1%, p < 0.001), and utilization decreased by 12% (p < 0.035). For plasma and PLTs, both orders outside guidelines and utilization changed minimally. Overall cost avoidance was $181,887/year by acquisition cost (and from $582,039 to $873,058/year by activity‐based cost), 93% of which was attributed to reduction in RBC utilization. Length of stay, morbidity, and mortality were unchanged.

CONCLUSIONS

Our findings demonstrate a greater opportunity for reducing RBC compared to plasma and PLT utilization. A properly implemented PBM program has potential to reduce unnecessary transfusions and their associated risk and costs, without compromising clinical outcomes.
Robotic weeding's false dawn? Ten requirements for fully autonomous mechanical weed management
Authors: Merfield C N
Published: July 2016

While machines called weeding robots are now commercially available and many more designs are being actively researched, I contend that current machines are not truly robotic weeders, rather they are essentially self‐guiding vehicles carrying weeding tools. I consider true robotic weeders to be a far more difficult objective. While advances in robotics have been outstanding, the weeding component often appears to be an afterthought. I contend that the weeding is as complex as the robotics. A genuine weeding robot should be able to: (i) monitor the crop, weeds, weather and soil, (ii) decide when the crop should be weeded, (iii) choose the optimal weeder, (iv) take the weeder to the field, (v) adjust the weeder for optimal performance, (vi) continuously monitor the entire weeder for blockages and mechanical breakages and fix them in the field, (vii) continuously monitor and adjust the weeder's performance, (viii) return the weeder to the farmyard and (ix) clean, maintain and store the weeder, that is replace all human intervention. This ten‐point list both defines and is a guide to what is required for completely autonomous robotic weeding. Currently, this list is far beyond current technology and it may be decades before it is realisable. The aim of this study therefore was not to disparage the achievements of agricultural roboticists, rather it is to highlight the complexity and demands of mechanical weeding and therefore describe what is really required to create a true robotic weeder. I therefore hope it will guide and expedite research and lead to more rapid success for robotic weeding.
Using Do-It-Yourself Practitioners as Lead Users: A Case Study on the Hair Care Industry
Authors: Hahn Jaesik , Marconnet Amy , Reid Tahira
Published: July 2016

Lead users play an integral part in helping engineers to identify latent needs of customers, and this approach has been used in a variety of ways within the design community. However, despite their close resemblance to lead users, do-it-yourself (DIY) practitioners have not been directly examined by the design community. A seven-step framework is presented where the first four steps resemble a typical design process and the remaining steps are relevant for the approach of identifying DIY practitioners as lead users. A case study from the hair care industry is presented to illustrate this framework. This paper establishes a connection between these two groups of customers and demonstrates how the insights of DIY practitioners, which manifest as latent needs for knowledge, can inspire research for the development of new technologies.
Validating Dynamic Engineering Models Under Uncertainty
Authors: Wang Zequn , Fu Yan , Yang Ren-Jye , Barbat Saeed , Chen Wei
Published: July 2016

Validating dynamic engineering models is critically important in practical applications by assessing the agreement between simulation results and experimental observations. Though significant progresses have been made, the existing metrics lack the capability of managing uncertainty in both simulations and experiments. In addition, it is challenging to validate a dynamic model aggregately over both the time domain and a model input space with data at multiple validation sites. To overcome these difficulties, this paper presents an area-based metric to systemically handle uncertainty and validate computational models for dynamic systems over an input space by simultaneously integrating the information from multiple validation sites. To manage the complexity associated with a high-dimensional data space, eigenanalysis is performed for the time series data from simulations at each validation site to extract the important features. A truncated Karhunen–Loève (KL) expansion is then constructed to represent the responses of dynamic systems, resulting in a set of uncorrelated random coefficients with unit variance. With the development of a hierarchical data-fusion strategy, probability integral transform (PIT) is then employed to pool all the resulting random coefficients from multiple validation sites across the input space into a single aggregated metric. The dynamic model is thus validated by calculating the cumulative area difference of the cumulative density functions. The proposed model validation metric for dynamic systems is illustrated with a mathematical example, a supported beam problem with stochastic loads, and real data from the vehicle occupant-restraint system.
Discovery of Mental Metadata Used for Analogy Formation in Function-Based Design
Authors: Arlitt Ryan M. , Nix Anthony A. , Sen Chiradeep , Stone Robert B.
Published: July 2016

Applying previous solutions to solve new problems is a core aspect of design, and designers routinely use informal analogies to solve a wide variety of design problems. However, when the goal is to consider a large quantity and variety of creative solutions, relying on informal analogy recall may limit the analogy and solution breadth. This paper reports on work to identify the analogy connections that designers make during concept generation such that computational support can be employed to intentionally retrieve analogical solutions from existing systems. A study of the types of similarity that are commonly used to draw design analogies, and whether some types of similarity are used more frequently in compound analogy versus single analogy, was designed and implemented. The experiment consists of a design task and a follow up interview. Ten mechanical engineering graduate students specializing in design participated. Eight different types of analogical similarity are observed, and each type is equally likely to be used to form either single or compound analogies. Notably, the flow behavior was a commonly observed type of abstract similarity that helped designers notice connections across domains, suggesting the value of capturing and retrieving (computationally) flow behavior abstractions for the purpose of relating systems analogically.
Enhanced nearfield acoustic holography for larger distances of reconstructions using fixed parameter Tikhonov regularization
Authors: Chelliah Kanthasamy , Raman Ganesh G. , Muehleisen Ralph T.
Published: July 2016

This paper evaluates the performance of various regularization parameter choice methods applied to different approaches of nearfield acoustic holography when a very nearfield measurement is not possible. For a fixed grid resolution, the larger the hologram distance, the larger the error in the naive nearfield acoustic holography reconstructions. These errors can be smoothed out by using an appropriate order of regularization. This study shows that by using a fixed/manual choice of regularization parameter, instead of automated parameter choice methods, reasonably accurate reconstructions can be obtained even when the hologram distance is 16 times larger than the grid resolution.
Classification and automatic transcription of primate calls
Authors: Versteegh Maarten , Kuhn Jeremy , Synnaeve Gabriel , Ravaux Lucie , Chemla Emmanuel , Cäsar Cristiane , Fuller James , Murphy Derek , Schel Anne , Dunbar Ewan
Published: July 2016

This paper reports on an automated and openly available tool for automatic acoustic analysis and transcription of primate calls, which takes raw field recordings and outputs call labels time-aligned with the audio. The system's output predicts a majority of the start times of calls accurately within 200 milliseconds. The tools do not require any manual acoustic analysis or selection of spectral features by the researcher.
The Effects of Acute Exercise on Memory and Brain-Derived Neurotrophic Factor (BDNF)
Authors: Etnier Jennifer L. , Wideman Laurie , Labban Jeffrey D. , Piepmeier Aaron T. , Pendleton Daniel M. , Dvorak Kelly K. , Becofsky Katie
Published: July 2016

Acute exercise benefits cognition, and some evidence suggests that brain-derived neurotrophic factor (BDNF) plays a role in this effect. The purpose of this study was to explore the dose–response relationship between exercise intensity, memory, and BDNF. Young adults completed 3 exercise sessions at different intensities relative to ventilator threshold (Vt) (VO2max, Vt – 20%, Vt + 20%). For each session, participants exercised for approximately 30 min. Following exercise, they performed the Rey Auditory Verbal Learning Test (RAVLT) to assess short-term memory, learning, and long-term memory recall. Twenty-four hours later, they completed the RAVLT recognition trial, which provided another measure of long-term memory. Blood was drawn before exercise, immediately postexercise, and after the 30-min recall test. Results indicated that long-term memory as assessed after the 24-hr delay differed as a function of exercise intensity with the largest benefits observed following maximal intensity exercise. BDNF data showed a significant increase in response to exercise; however, there were no differences relative to exercise intensity and there were no significant associations between BDNF and memory. Future research is warranted so that we can better understand how to use exercise to benefit cognitive performance.
Comment on “Long-term climate forcing by atmospheric oxygen concentrations”
Authors: Goldblatt Colin
Published: July 2016

Poulsen
et al
. (Reports, 12 June 2015, p. 1238) argued that lower atmospheric oxygen levels during the Phanerozoic would have given a warmer climate. However, radiative and atmospheric structure changes under lower pressure both cause cooling, making their result unusual in that a hierarchy of models gives opposing results. Scrutiny of how radiative and cloud processes were represented, and a mechanistic explanation of the results, are required.
Higher-order organization of complex networks
Authors: Benson Austin R. , Gleich David F. , Leskovec Jure
Published: July 2016

Resolving a network of hubs

Graphs are a pervasive tool for modeling and analyzing network data throughout the sciences. Benson
et al.
developed an algorithmic framework for studying how complex networks are organized by higher-order connectivity patterns (see the Perspective by Pržulj and Malod-Dognin). Motifs in transportation networks reveal hubs and geographical elements not readily achievable by other methods. A motif previously suggested as important for neuronal networks is part of a “rich club” of subnetworks.

Science
, this issue p.
163
; see also p.
123
Learning to move on land
Authors: Nyakatura John A.
Published: July 2016

Interdisciplinary research suggests that early four-limbed vertebrates relied on their tails
Performance of a Cartridge-Based Assay for Detection of Clinically Significant Human Papillomavirus (HPV) Infection: Lessons from VALGENT (Validation of HPV Genotyping Tests)
Authors: Cuschieri Kate , Geraets Daan , Cuzick Jack , Cadman Louise , Moore Catherine , Vanden Broeck Davy , Padalko Elisaveta , Quint Wim , Arbyn Marc
Published: July 2016

The Validation of Human Papillomavirus (HPV) Genotyping Tests (VALGENT) studies offer an opportunity to clinically validate HPV assays for use in primary screening for cervical cancer and also provide a framework for the comparison of analytical and type-specific performance. Through VALGENT, we assessed the performance of the cartridge-based Xpert HPV assay (Xpert HPV), which detects 14 high-risk (HR) types and resolves HPV16 and HPV18/45. Samples from women attending the United Kingdom cervical screening program enriched with cytologically abnormal samples were collated. All had been previously tested by a clinically validated standard comparator test (SCT), the GP5+/6+ enzyme immunoassay (EIA). The clinical sensitivity and specificity of the Xpert HPV for the detection of cervical intraepithelial neoplasia grade 2 or higher (CIN2+) and CIN3+ relative to those of the SCT were assessed as were the inter- and intralaboratory reproducibilities according to international criteria for test validation. Type concordance for HPV16 and HPV18/45 between the Xpert HPV and the SCT was also analyzed. The Xpert HPV detected 94% of CIN2+ and 98% of CIN3+ lesions among all screened women and 90% of CIN2+ and 96% of CIN3+ lesions in women 30 years and older. The specificity for CIN1 or less (≤CIN1) was 83% (95% confidence interval [CI], 80 to 85%) in all women and 88% (95% CI, 86 to 91%) in women 30 years and older. Inter- and intralaboratory agreements for the Xpert HPV were 98% and 97%, respectively. The kappa agreements for HPV16 and HPV18/45 between the clinically validated reference test (GP5+/6+ LMNX) and the Xpert HPV were 0.92 and 0.91, respectively. The clinical performance and reproducibility of the Xpert HPV are comparable to those of well-established HPV assays and fulfill the criteria for use in primary cervical cancer screening.
Efficacy of extracorporeal albumin dialysis for acute kidney injury due to cholestatic jaundice nephrotoxicity
Authors: Sens Florence , Bacchetta Justine , Rabeyrin Maud , Juillard Laurent
Published: July 2016

We report a case of a 37-year-old man with Maturity Onset Diabetes of the Youth (MODY) type 5, admitted for an episode of cholestasis and a simultaneous acute kidney injury (AKI). Chronic liver disease was due to a mutation in thetranscription factor 2(TCF2) gene, thus highlighting the need for a close liver follow-up in these patients. AKI was attributed to a cholemic nephropathy based on the following rationale: (1) alternative diagnoses were actively ruled out; (2) the onset of AKI coincided with the onset of severe hyperbilirubinaemia; (3) renal pathology showed large bile tubular casts and a marked tubular necrosis and (4) creatinine serum dramatically decreased when bilirubin levels improved after the first sessions of extracorporeal albumin dialysis (ECAD), thus suggesting its role in renal recovery. Even though cholestasis can precipitate renal injury, the diagnosis of cholemic nephropathy could require a renal biopsy at times. Future studies should confirm the benefits of ECAD in cholemic nephropathy.