bluuebunny/crossref_metadata_2025 huggingface dataset:
Relation Between Socioeconomic Status, Race–Ethnicity, and Left Ventricular Mass
Authors: Rodriguez Carlos J. , Sciacca Robert R. , Diez-Roux Ana V. , Boden-Albala Bernadette , Sacco Ralph L. , Homma Shunichi , DiTullio Marco R.
Published: February 2004

Increased left ventricular mass (LVM) and lower socioeconomic status (SES) are predictors of cardiovascular morbidity and mortality. Blacks and Hispanics are more likely to have higher LVM and lower SES. The relation between SES, race–ethnicity, and LVM has not been fully explored. Data were used from the NOMAS population-based sample of 1916 subjects living in Northern Manhattan. SES was characterized on the basis of educational attainment and divided into 4 categories. Echocardiography-defined LVM was indexed according to height at the allometric power of 2.7 and analyzed as a continuous variable. LVM varied by race in our cohort (blacks 48.9 g/m
2.7
, Hispanics 48.4 g/m
2.7
, whites 45.6 g/m
2.7
;
P
=0.004). Using ANCOVA, there was a significant inverse and graded association between mean LVM and SES for the total cohort. Mean LVM was 48.4 g/m
2.7
, 48.6 g/m
2.7
, 47.1 g/m
2.7
, and 45.3 g/m
2.7
for the lowest to the highest educational level category (
P
trend=0.0004). This relationship remained among normotensives (
P
trend=0.0005) and was present for blacks (
P
trend=0.009), but not for whites (
P
trend=0.86) or Hispanics (
P
trend=0.47). The difference in mean LVM between the highest and lowest categories of education was 5.3 g/m
2.7
for blacks, 0.0 g/m
2.7
for whites, and 1.0 g/m
2.7
for Hispanics. Lower SES is an independent predictor of increased LVM among hypertensive and normotensive blacks.
Depletion of Tissue Angiotensin-Converting Enzyme Differentially Influences the Intrarenal and Urinary Expression of Angiotensin Peptides
Authors: Modrall J. Gregory , Sadjadi Javid , Brosnihan K. Bridget , Gallagher Patricia E. , Yu Chun-hua , Kramer Gerald L. , Bernstein Kenneth E. , Chappell Mark C.
Published: February 2004

The relative contribution of circulating versus tissue renin-angiotensin systems to the tissue expression of angiotensin peptides in the kidney remains unresolved. To address this issue, intrarenal and urinary levels of the peptide products of the renin-angiotensin system were assessed in a tissue angiotensin-converting enzyme knockout (
tis
ACE
−/−
) mouse model. Systolic blood pressure was significantly lower (64.6±3.6 versus 81.4±4.5 mm Hg;
P
<0.02) and urinary volume was increased (7.25±0.86 versus 2.86±0.48 mL/d;
P
<0.001) in
tis
ACE
−/−
mice compared with wild-type mice. Intrarenal angiotensin II was 80% lower in
tis
ACE
−/−
mice compared with wild-type mice (5.17±0.60 versus 25.5±2.4 fmol/mg protein;
P
<0.001). Intrarenal angiotensin I levels also declined by a comparable extent (73%) in the
tis
ACE
−/−
mice (
P
<0.01). Intrarenal angiotensin-(1–7) concentrations were similar between the strains, but the ratio of intrarenal angiotensin-(1–7) to angiotensin II and angiotensin I in
tis
ACE
−/−
mice increased 470% and 355%, respectively, compared with wild-type mice. Urinary excretion of angiotensin II and angiotensin-(1–7) were not different, but the excretion of angiotensin I increased 270% in
tis
ACE
−/−
mice (
P
<0.01). These studies suggest 2 potential mechanisms for the reduction of intrarenal angiotensin II in
tis
ACE
−/−
mice: (1) an attenuated capacity to form angiotensin II by renal angiotensin-converting enzyme and (2) significant depletion of its direct precursor angiotensin I in renal tissue. Sustained intrarenal levels of angiotensin-(1–7) may contribute to chronic hypotension and polyuria in
tis
ACE
−/−
mice, particularly in the context of depleted angiotensin II in the kidney.
Association of Mean Platelet Volume With Risk of Stroke Among 3134 Individuals With History of Cerebrovascular Disease
Authors: Bath Philip , Algert Charles , Chapman Neil , Neal Bruce
Published: February 2004

Background and Purpose—

Mean platelet volume (MPV) is positively associated with measures of platelet activity and may be a useful indicator of the risk of vascular events in a variety of patient groups.

Methods—

The association of MPV with the risk of stroke was assessed in the Perindopril Protection Against Recurrent Stroke Study (PROGRESS). All participants had a history of cerebrovascular disease at baseline, and analyses were adjusted for the effects of potential confounders.

Results—

The study followed 3134 individuals for an average of 3.9 years (mean age, 65 years; 71% male; average MPV, 10.0 fL). Three hundred eighty-three individuals had 402 stroke events, and 160 had major coronary events. MPV was positively associated with the risk of stroke, with an 11% increased relative risk (95% CI, 3% to 19%) of stroke per femtoliter greater MPV. There was no clear association of MPV with the risk of major coronary events (9% decreased relative risk; 95% CI, −23% to 7%). Perindopril did not alter MPV.

Conclusions—

MPV is an independent predictor of the risk of stroke among individuals with a history of stroke or transient ischemic attack. The measurement of MPV may add useful prognostic information for clinicians managing patients with a history of cerebrovascular disease.
Prognosis of Cerebral Vein and Dural Sinus Thrombosis
Authors: Ferro José M. , Canhão Patrícia , Stam Jan , Bousser Marie-Germaine , Barinagarrementeria Fernando
Published: February 2004

Background and Purpose—

The natural history and long-term prognosis of cerebral vein and dural sinus thrombosis (CVT) have not been examined previously by adequately powered prospective studies.

Methods—

We performed a multinational (21 countries), multicenter (89 centers), prospective observational study. Patients were followed up at 6 months and yearly thereafter. Primary outcome was death or dependence as assessed by modified Rankin Scale (mRS) score >2 at the end of follow-up.

Results—

From May 1998 to May 2001, 624 adult patients with CVT were registered. At the end of follow-up (median 16 months), 356 patients (57.1%) had no symptom or signs (mRS=0), 137 (22%) had minor residual symptoms (mRS=1), and 47 (7.5%) had mild impairments (mRS=2). Eighteen (2.9%) were moderately impaired (mRS=3), 14 (2.2%) were severely handicapped (mRS=4 or 5), and 52 (8.3%) had died. Multivariate predictors of death or dependence were age >37 years (hazard ratio [HR]=2.0), male sex (HR=1.6), coma (HR=2.7), mental status disorder (HR=2.0), hemorrhage on admission CT scan (HR=1.9), thrombosis of the deep cerebral venous system (HR=2.9), central nervous system infection (HR=3.3), and cancer (HR=2.9). Fourteen patients (2.2%) had a recurrent sinus thrombosis, 27 (4.3%) had other thrombotic events, and 66 (10.6%) had seizures.

Conclusions—

The prognosis of CVT is better than reported previously. A subgroup (13%) of clinically identifiable CVT patients is at increased risk of bad outcome. These high-risk patients may benefit from more aggressive therapeutic interventions, to be studied in randomized clinical trials.
REMEDIUM AMORIS, A CURSE FROM CUMAE
Authors: Jordan David
Published: February 2004

A new edition of DTAud 198, from autopsy.
Der Mensch im Tod nach der Apokalypse des Mose Eine frühjüdische Anthropologie in der Zeit des Paulus
Authors: Schreiber Stefan
Published: February 2004

In the Apocalypse of Moses the themes of the protoplasts' death and of God's mercy with Adam are dominant. The anthropological views, however, are ambivalent: man as a unity, or a dichotomy of body and soul. In the literary setting of the document as a whole, traditio-historical solutions are not satisfying. On the background of the use of the key terms σ μα, πνε μα and ψυχ in the Septuagint, the author of the Apocalypse does not provide a clear anthropological system, but articulates the "self," the "life" of man as owed to God. Avoiding the dualistic picture of man common in Greek philosophy, he is guided by the biblical view of man as a unity in order to strengthen the reader's hope in a life after death in the face of negative earthly conditions. This has consequences, for example, for the theological diversity in Early Judaism, or for the dilemma of the empty tomb of Jesus.
Platelet-associated autoantibodies as detected by a solid-phase modified antigen capture ELISA test (MACE) are a useful prognostic factor in idiopathic thrombocytopenic purpura
Authors: Fabris Fabrizio , Scandellari Raffaella , Ruzzon Elisabetta , Randi Maria Luigia , Luzzatto Guido , Girolami Antonio
Published: February 2004

There were 50 consecutive idiopathic thrombocytopenic purpura (ITP) adult patients (platelet count < 100 × 109/L) grouped according to positivity or negativity of a solid-phase modified antigen capture enzyme-linked immunosorbent assay (ELISA) test (MACE) against glycoprotein IIb/IIIa (GPIIb/IIIa), Ib/IX, and IIa/IIIa. Observation started on the day of MACE assay and lasted at least 6 months. Clinical worsening was defined as the need for starting or modifying therapy because of thrombocytopenia lower than 20 × 109/L or patient admission due to bleeding symptoms. MACE-positive patients had a higher probability of clinical worsening than MACE-negatives (P < .004). The proportion of patients worsening was 18 (72%) of 25 among MACE-positives and 8 (32%) of 25 among MACE-negatives. The median time to clinical worsening was 2.1 months for MACE-positive patients and 27.7 months for MACE-negatives. The assay of specific platelet autoantibodies may be a useful prognostic tool for the clinical course of ITP. (Blood. 2004;103:4562-4564)
Classification of fresh edible oils using a coated piezoelectric sensor array-based electronic nose with soft computing approach for pattern recognition
Authors: James D. , Scott S. M. , O’Hare W. T. , Ali Z. , Rowell F. J.
Published: February 2004

An electronic nose based on an array of six bulk acoustic wave polymer-coated piezoelectric quartz (PZQ) sensors with soft computing-based pattern recognition was used for the classi-fication of edible oils. The electronic nose was presented with 346 samples of fresh edible oil headspace volatiles, generated at 45°C. Extra virgin olive (EVO), nonvirgin olive oil (NVO) and sunflower oil (SFO) were used over a period of 30 days. The sensor responses were visualized by plotting the results from principal component analysis (PCA). Classification of edible oils was carried out using fuzzy c-means as well as radial basis function (RBF) neural networks both from a raw data and data after having been preprocessed by fuzzy c-means. The fuzzy c-means results were poor (74%) due to the different cluster sizes. The result of RBF with fuzzy c-means preprocessing was 95% and 99% for raw data input. RBF networks with fuzzy c-means preprocessing provide the advantage of a simple architecture that is quicker to train.
p53, p21, pRB, and p16 Expression Predict Clinical Outcome in Cystectomy With Bladder Cancer
Authors: Shariat Shahrokh F. , Tokunaga Hideo , Zhou JainHua , Kim JaHong , Ayala Gustavo E. , Benedict William F. , Lerner Seth P.
Published: February 2004

Purpose

To determine whether p53, p21, pRB, and/or p16 expression is associated with bladder cancer stage, progression, and prognosis.

Patients and Methods

Immunohistochemical staining for p53, p21, pRB, and p16 was carried out on serial sections from archival specimens of 80 patients who underwent bilateral pelvic lymphadenectomy and radical cystectomy for bladder cancer (median follow-up, 101 months).

Results

p53, p21, and pRB or p16 expression was altered in 45 (56%), 39 (49%), and 43 (54%) tumors, respectively. Sixty-six patients (83%) had at least one marker altered, and 21 patients (26%) had all three altered. Abnormal expressions of p53, p21, and pRB/p16 expression were associated with muscle-invasive disease (P = .007, P = .003, and P = .003, respectively). The alteration of each marker was independently associated with disease progression (P ≤ .038) and disease-specific survival (P ≤ .039). In multivariable models that included standard pathologic features and p53 with p21 or p53 with pRB/p16, only p53 and lymph node metastases were associated with bladder cancer progression (P ≤ .026) and death (P ≤ .028). In models that included p21 and pRB/p16, only p21 and lymph node metastases were associated with bladder cancer progression (P ≤ .022) and death (P ≤ .028). In a model that included the combined variables p53/p21 and pRB/p16, only p53/p21 and lymph node status were associated with bladder cancer progression (P ≤ .047) and death (P ≤ .036). The incremental number of altered markers was independently associated with an increased risk of bladder cancer progression (P = .005) and mortality (P = .007).

Conclusion

Although altered expression of each of the four cell cycle regulators is associated with bladder cancer outcome in patients undergoing radical cystectomy, p53 is the strongest predictor, followed by p21, suggesting a more pivotal role of the p53/p21 pathway in bladder cancer progression.
Critical in Vivo Roles for Classical Estrogen Receptors in Rapid Estrogen Actions on Intracellular Signaling in Mouse Brain
Authors: Ábrahám István M. , Todman Martin G. , Korach Kenneth S. , Herbison Allan E.
Published: February 2004

Estrogen exerts classical genomic as well as rapid nongenomic actions on neurons. The mechanisms involved in rapid estrogen signaling are poorly defined, and the roles of the classical estrogen receptors (ERs α and β) are unclear. We examined here the in vivo role of classical ERs in rapid estrogen actions by evaluating the estrogen-induced effects on two major signaling pathways within the brains of αER-, βER-, and double αβER-knockout (ERKO) ovariectomized female mice. Estrogen significantly (P < 0.05) increased the numbers of phospho-cAMP response element binding protein (phospho-CREB)-immunoreactive cells in specific brain regions of wild-type mice in a time-dependent manner beginning within 15 min. In brain areas that express predominantly ERβ, this response was absent in βERKO mice, whereas brain regions that express mostly ERα displayed no change in αERKO mice. In the medial preoptic nucleus (MPN), an area that expresses both ERs, the estrogen-induced phosphorylation of CREB was normal in both αERKO and βERKO mice. However, estrogen had no effect on CREB phosphorylation in the MPN, or any other brain region, in double αβERKO animals. Estrogen was also found to increase MAPK phosphorylation levels in a rapid (<15 min) manner within the MPN. In contrast to CREB signaling, this effect was lost in either αERKO or βERKO mice. These data show that ERα and ERβ play region- and pathway-specific roles in rapid estrogen actions throughout the brain. They further indicate an indispensable role for classical ERs in rapid estrogen actions in vivo and highlight the importance of ERs in coordinating both classical and rapid actions of estrogen.
Transient requirement for ganglion cells during assembly of retinal synaptic layers
Authors: Kay Jeremy N. , Roeser Tobias , Mumm Jeff S. , Godinho Leanne , Mrejeru Ana , Wong Rachel O. L. , Baier Herwig
Published: February 2004

The inner plexiform layer (IPL) of the vertebrate retina comprises functionally specialized sublaminae, representing connections between bipolar,amacrine and ganglion cells with distinct visual functions. Developmental mechanisms that target neurites to the correct synaptic sublaminae are largely unknown. Using transgenic zebrafish expressing GFP in subsets of amacrine cells, we imaged IPL formation and sublamination in vivo and asked whether the major postsynaptic cells in this circuit, the ganglion cells, organize the presynaptic inputs. We found that in the lak/ath5 mutant retina,where ganglion cells are never born, formation of the IPL is delayed, with initial neurite outgrowth ectopically located and grossly disorganized. Over time, the majority of early neurite projection errors are corrected, and major ON and OFF sublaminae do form. However, focal regions of disarray persist where sublaminae do not form properly. Bipolar axons, which arrive later, are targeted correctly, except at places where amacrine stratification is disrupted. The lak mutant phenotype reveals that ganglion cells have a transient role organizing the earliest amacrine projections to the IPL. However, it also suggests that amacrine cells interact with each other during IPL formation; these interactions alone appear sufficient to form the IPL. Furthermore, our results suggest that amacrines may guide IPL sublamination by providing stratification cues for other cell types.
On-road determination of aerodynamic drag improvements
Authors: Bischof G , Bratschitsch E , Haas A , Kaltenhauser A , Ullrich F
Published: February 2004

The objective of this work is an attempt to understand the potential for aerodynamic improvements by the application of different underfloor panels that might be masked by traditional fixed-ground wind tunnel testing. The coastdown method is chosen to determine drag coeffents on the road which could then be compared with wind tunnel data. Of prime importance were the simplicity and practicability of the developed analysis method, with particular emphasis on industrial applicability. As a result of the investigations, the resolution of the new method and an astonishing conformity of the identification of small changes in the underfloor configuration of the test vehicle with wind tunnel tests are demonstrated.
The application of artificial neural networks to the characterization of interior noise booming in passenger cars
Authors: Lee S-K , Chae H-C
Published: February 2004

The booming index has been developed recently to evaluate the sound characteristics of passenger cars. Previous work maintained that booming sound quality is related to loudness and sharpness -the sound metrics used in psychoacoustics-and that the booming index is developed by using the loudness and sharpness for a signal within whole frequencies between 20 Hz and 20 kHz. In the present paper, the booming sound quality was found to be effectively related to the loudness at frequencies below 200 Hz; thus the booming index is updated by using the loudness of the signal filtered by the low pass filter at frequencies under 200 Hz. The relationship between the booming index and the sound metric is identified by an artificial neural network (ANN). Interior sounds of 10 passenger cars were measured, and 21 persons subjectively evaluated the booming sound qualities for these interior sounds. Throughout this research, it was found that there is a high correlation between the results of these evaluations and the output of a neural network. The updated booming index has been successfully applied to the objective evaluation of the booming sound quality of massproduced passenger cars.
Evaluation of thermal comfort in a vehicle cabin
Authors: Martinho N A G , Silva M C G , Ramos J A E
Published: February 2004

The objective of the work presented in this article was to study the airflow in a vehicle cabin with the typical dimensions and geometry of a multi-purpose vehicle (MPV) with a view to evaluating the thermal comfort through the equivalent temperature index. Tests were carried out on a life-size laboratory model of a car cabin, constructed with a simplified geometry, for different conditions: with and without the presence of a thermal mannequin, with different values of air velocity and temperature and with different regulation of the air inlets.

The values of equivalent temperature were determined for each one of the various parts of the body, by two distinct forms: from the measurements performed by the thermal mannequin and from the physical parameters of the airflow, i.e. air velocity and temperature. The mapping of these flow parameters inside the cabin was done through a scanning process carried out with a traversing mechanism with eight low-velocity thermal anemometer probes, controlled from the exterior of the car cabin. Thus, using the values measured in plans in the neighbourhood of the different parts of the thermal mannequin, the equivalent temperature profiles were computed during tests carried out without the presence of the thermal mannequin.
Flow distribution effects in the loading and catalytic regeneration of wall-flow diesel particulate filters
Authors: Stratakis G A , Stamatelos A M
Published: February 2004

The study of catalytic regeneration characteristics of porous ceramic diesel particulate filters (DPFs) is of growing interest to industry as diesel soot emissions are limited by legislation to levels below 0.01 g/km (for passenger cars). More specifically, pressure drop computations and correlations are important factors employed in the design and control of diesel filter systems. However, in numerous cases, computations and models fail to match the experimentally observed evolution of soot combustion in the filter. In this paper, the role of flow maldistribution in this issue is investigated, by means of full-scale tests of the loading and regeneration behaviour of a particulate filter installed on a modern diesel engine run on catalyst-doped fuel. Loading tests were performed at three characteristic engine operation points with markedly different levels of engine exhaust gas mass flowrate. In these tests, it becomes apparent that complex flow maldistribution phenomena exist during the loading phase, which are not directly reflected by the behaviour of the pressure drop versus time curve. However, these phenomena are shown to affect the distribution of collected soot mass in the different channels of the filter and, consequently, the regeneration behaviour. The evolution of flow maldistribution was also studied in a number of regeneration experiments. It was confirmed that the variation of the volatile organic fraction in the filter and the associated partial catalytic regenerations at low temperatures interact with flow and soot maldistribution in a complex way. The conclusions from this study set the scene for future, more detailed investigations that are expected to improve understanding and modelling of diesel filter pressure drop and regeneration characteristics.
An algorithm to determine the mass transfer rate from a pure liquid surface using the volume of fluid multiphase model
Authors: Banerjee R , Isaac K. M.
Published: February 2004

An algorithm to determine the mass transfer rate from the surface of a pure liquid in conjunction with the volume of fluid (VOF) was developed. The algorithm determines the liquid/gas interface by using information of the volume fractions of individual phases in the flow field obtained from the VOF method. It then solves the species equation in the gas phase. It is assumed that the carrier gas at the liquid/gas interface is saturated with vapour. Four test cases were designed to evaluate the algorithm. Concentration profiles obtained from these test cases were compared with results from available analytical solutions. The algorithm was then implemented to determine vapour emission from a two-phase stratified flow inside an axisymmetric funnel representative of an automotive fuel filler pipe.
Development of a multizone model for direct injection diesel combustion
Authors: Liu Y , Midkiff K. C. , Bell S. R.
Published: February 2004

Diesel engines have attracted considerable attention in recent years because of the increasingly restrictive ‘engine-out’ emission standards being adopted by regulatory agencies. The cutting-edge technologies of emissions reduction in engines fall into three categories: preprocessing, improved combustion processing and post-processing. An engine cycle simulation was developed to investigate and, thus, find possible avenues of reducing emissions through modifying the combustion process. This simulation includes models for fresh air charging, fuel and air mixing, wall heat transfer, diesel droplet evaporation, ignition delay and mixture combustion with species equilibrium reactions. These models, together with a thermo-dynamic analysis of the cylinder gas, yield instantaneous cylinder conditions, overall indicated engine performance and a prediction of the engine-out NOx and soot emissions.

The engine parameters and operating conditions used in the work presented here were chosen to be representative of a Caterpillar 3401 single-cylinder diesel engine. Experimental investigations were also conducted with the engine, and the combustion model has been verified by comparing the experiment results to the simulation results.
Combustion chamber resonances in direct injection automotive diesel engines: A numerical approach
Authors: Torregrosa A. J. , Broatch A , Margot X , Marant V , Beauge Y
Published: February 2004

The resonant oscillation of burned gases in the combustion chamber of direct injection (DI) diesel engines appears to be the main excitation source of the engine block during combustion. This has led to the application of different techniques in order to study its generation mechanisms and to determine its relationship with combustion parameters such as bowl geometry, type of injector, injection parameters, etc. In this paper, a numerical methodology for the analysis of combustion chamber resonances is proposed. The numerical approach is validated by comparison with results from modal theory in a simple case. Then, this technique has been applied to the analysis of three different bowls, indicating their potential for the control of combustion chamber resonances.
Improving emissions and performance characteristics of lean burn natural gas engines through partial stratification
Authors: Reynolds C. C. O. B. , Evans R. L.
Published: February 2004

A partially stratified charge (PSC) engine concept has been developed to improve the combustion process in a spark ignition engine fuelled by natural gas, operating at lean air-fuel ratios. In general, this technique is effective at increasing fuel conversion efficiency and brake mean effective pressure at relative air-fuel ratios greater than λ = 1.5. Preliminary testing at 2500r/min showed that PSC reduced combustion duration by almost 10 per cent at a given air-fuel ratio. It was also effective in extending the lean limit of engine operation, which meant that the engine could be run at lower loads without throttling. PSC technology provides an alternative method of load control to throttling, and hence reduces associated pumping losses. Further investigation was conducted at 1500 r/min and a lean air-fuel ratio of λ = 1.65. PSC was found to significantly improve engine performance when compared with homogeneous charge operation at the same air-fuel ratio. The optimized data were compared to simple throttled and lean baseline data and a dramatic reduction in NOx emissions was observed, with little efficiency penalty. These initial results demonstrate that the lean-burn, partially stratified charge strategy is a viable means of engine control, and has significant performance and emissions benefits.
The Guide to Expression of Uncertainty in Measurement Approach for Estimating Uncertainty
Authors: Kristiansen Jesper
Published: February 2004

Background: The aim of the Guide to Expression of Uncertainty in Measurement (GUM) is to harmonize the different practices for estimating and reporting uncertainty of measurement. Although there are clear advantages in having a common approach for evaluating uncertainty, application of the GUM approach to chemistry measurements is not straightforward. In the above commentary, Krouwer suggests that the GUM approach should not be applied to diagnostic assays, because (a) the quality of diagnostic assays is to low, and (b) the GUM uncertainty intervals are too narrow to predict the outliers that occasionally trouble these methods.

Methods: Some of the examples presented by Krouwer are reviewed. Sodium measurements are modeled mathematically to illustrate the GUM approach to uncertainty. A standardized uncertainty evaluation process is presented.

Results: Modeling of sodium measurements demonstrates how the GUM uncertainty interval reflects the treatment of a bias: The width of the uncertainty interval varied depending on whether a correction for a calibrator lot bias was applied, but in both cases it was consistent with the distribution of measurement results. Expanding the uncertainty interval to include outliers runs counter to the definition of uncertainty. Used appropriately, the GUM uncertainty can be helpful in detecting outliers. In standardizing the uncertainty evaluation, the importance of the analytical imprecision and traceability was emphasized. It is problematic that manufacturers of commercial assays rarely inform about the uncertainty of the values assigned to the calibrators. As demonstrated by an example, external quality-assurance data may be used to estimate this uncertainty.

Conclusions: The GUM uncertainty should be applied to measurements in laboratory medicine because it may actually support the forces that drive the work on improving the quality of measurement procedures. However, it is important that the GUM approach is made more manageable by standardizing the uncertainty evaluation procedure as much as possible. It is essential to focus on the traceability and uncertainty of calibrators and reagents supplied by manufacturers of assays. Information about uncertainty is necessary in the evaluation of the uncertainty associated with manufacturers’ measurement procedures, and in general it may force manufacturers to increase their efforts in improving the metrologic and analytical quality of their products.
Turbidimetric D-Dimer Test in the Diagnosis of Pulmonary Embolism: A Metaanalysis
Authors: Brown Michael D , Lau Joseph , Nelson R Darrell , Kline Jeffery A
Published: February 2004

Background: Clinicians in outpatient clinics and emergency departments desire an accurate quantitative D-dimer assay. The study objective was to evaluate the diagnostic performance characteristics of the latex turbidimetric D-dimer test in the diagnosis of pulmonary embolism (PE) in the emergency department population.

Methods: We conducted a search of MEDLINE, EMBASE, and bibliographies of previous systematic reviews with no language restriction. Experts in the field of PE research were contacted to identify unpublished studies. Prospective investigations involving predominately outpatient populations with suspected PE that used a turbidimetric D-dimer test were included. Two authors extracted data independently and assessed study quality based on the composition of the patient spectrum and the reference standard used. Consensus was reached by conference. The analysis was based on a summary ROC curve and combining sensitivity and specificity independently across studies using a random-effects model.

Results: The search yielded 264 publications and 2 unpublished studies. Nine studies met the inclusion criteria and provided a sample of 1901 individuals. Eight of the nine studies were homogeneous in terms of both sensitivity and specificity. One study had similar sensitivity but higher specificity. Combining the studies yielded an overall sensitivity of 0.93 (95% confidence interval, 0.89–0.96) and an overall specificity of 0.51 (95% confidence interval, 0.42–0.59).

Conclusions: The turbidimetric D-dimer test is sensitive but nonspecific for the detection of PE in the emergency department setting. D-Dimer tests using latex turbidimetric methods appear to have test characteristics comparable to those for ELISA methods.
How to approach ethical issues ‐ a brief guide
Authors: Stirrat Gordon M
Published: February 2004

The practice of clinical medicine cannot be isolated from ethical judgements. These judgements must take full account of all the circumstances of the case and be based on sound principles. Decisions must be consistent, free from contradiction and clinically relevant. Some of the principles are outlined here and a guide is provided to facilitate the translation of ethical analysis into moral action. The purpose of this brief outline is to assist in the development of consistent, critical and reflective attitudes to ethical decision making. My aim is to make you think and the ‘further reading’ is designed to assist in this.
The management of ovarian cysts in premenopausal women
Authors: Prakash Alka , Li Tin‐Chiu , Ledger William L.
Published: February 2004

As high‐resolution transvaginal ultrasound becomes more widely available, asymptomatic cysts are diagnosed with increasing frequency. Womens' anxieties centre on the risk of cancer and possible loss of fertility due to the cyst and treatment complications. Investigations include measurement of serum tumour markers, basic assessment of ovarian function, transvaginal ultrasonography and possibly cyst fluid cytology. While a proportion of simple cysts will resolve spontaneously, others require surgical management. Laparoscopic surgery is the treatment of choice in young women at low risk of malignancy.
Self-Rated Health and Semen Quality in Men Undergoing Assisted Reproductive Technology
Authors: Liu Xiao-Ying , Deng Yan-Ling , Chen Pan-Pan , Liu Chong , Miao Yu , Zhang Min , Cui Fei-Peng , Zeng Jia-Yue , Wu Yang , Li Cheng-Ru , Liu Chang-Jiang , Zeng Qiang
Published: January 2024

Importance

Numerous studies have documented the association of self-rated health (SRH) with chronic diseases. However, few studies have investigated its association with semen quality.

Objective

To examine the association of SRH with semen quality among men undergoing assisted reproductive technology (ART) in China.

Design, Setting, and Participants

This cross-sectional study recruited male partners in couples undergoing ART treatment at the Center for Reproductive Medicine, Tongji Hospital, Wuhan, China. A total of 1262 men underwent 2 semen examinations and completed a questionnaire on SRH between December 2018 and January 2020. Data analysis was performed from November 20, 2022, to March 24, 2023.

Exposure

SRH, including overall physical and mental health, as well as reproductive-related physical and mental health specifically, were reported at baseline recruitment.

Main Outcomes and Measures

Sperm concentration, sperm progressive motility, sperm motility, and sperm count as semen quality parameters.

Results

The study included 1262 men with a mean (SD) age of 32.79 (5.25) years and body mass index of 24.37 (3.68). Men with poorer SRH had lower semen quality (eg, sperm concentration among poor vs very good overall physical health: percentage variation, −14.67%; 95% CI, −23.62% to −4.66%). Among 4 components of SRH, a greater reduction in semen quality was estimated for reproductive-related SRH compared with overall SRH, whereas the greatest reduction was observed for reproductive-related physical SRH. In comparison with men with very good reproductive-related physical SRH, men with poor reproductive-related physical SRH had differences of −24.78% (95% CI, −32.71% to −15.93%) and −25.61% (95% CI, −33.95% to −16.22%) in sperm count and concentration, respectively, and regression coefficients of −9.38 (95% CI, −12.01 to −6.76) and −9.24 (95% CI, −11.82 to −6.66) for sperm motility and sperm progressive motility, respectively.

Conclusions and Relevance

In this cross-sectional study of Chinese men, poorer SRH was associated with lower semen quality, and reproductive-related physical SRH was the most pronounced indicator. Our findings suggest that SRH, especially reproductive-related physical SRH, was a good indicator of semen quality, which should inform public and clinical regulatory decisions.
Inherent Tumor Microenvironment‐Reversing Hydrogels: Potentiating Molecular Therapy Efficacy Against Drug‐Resistant Tumors
Authors: Liang Xiaoyu , Li Yachao , Guo Beiling , Zeng Zenan , Deng Kefurong , Zou Dongzhe , Xie Yuxin , Xu Yini , Shen Cheng , Xu Xianghui
Published: January 2024

The tumor microenvironment is a pivotal driver of tumor progression, highlighting the potential of microenvironment reversal as a promising breakthrough in cancer therapy. However, the current tumor microenvironment reversing capacity through targeted drug delivery remains limited, posing a significant challenge in the biomedical field. In this study, a materials science strategy to achieve an inherently efficient reversal of the solid tumor microenvironment while potentiating molecular therapy efficacy against drug‐resistant tumors is proposed. To construct bioactive hydrogel materials, biocompatible and acid‐reversible nanoclays are utilized as building blocks, and peptide polydendrons are designed as supramolecular cross‐linkers. To drive hydrogel network formation, bioactive hydrogels are capable of reversing tumor acidotic microenvironment, integrating superior mechanical properties, injectability, self‐healing capability, and drug‐loading capacity. Through a drug‐resistant cell line in vitro and a tumor‐bearing mouse model in vivo, the hydrogel materials successfully modulate acidic accumulation resulting from tumor metabolic abnormalities and reverse the acidic microenvironment within the tumor tissue. Remarkably, the tumor microenvironment‐reversing hydrogels effectively suppress tumor cell proliferation, migration, and invasion, while significantly amplifying the antitumor drug efficacy. The bioactive hydrogel materials offer an innovative avenue for reversing the tumor microenvironment, displaying promising prospects for clinical translation and applications.
High Entropy‐Driven Role of Oxygen Vacancies for Water Oxidation
Authors: Liu Yifan , Ye Caichao , Chen Long , Fan Jinbo , Liu Chao , Xue Liang , Sun Jingwen , Zhang Wenqing , Wang Xin , Xiong Pan , Zhu Junwu
Published: January 2024

Oxygen vacancy engineering is a promising strategy to enhance the electrocatalytic activities in conventional metal oxide electrocatalysts. However, the utilization of oxygen vacancies in high‐entropy oxides remains unknown, primarily due to the challenges associated with facile introduction of the oxygen vacancies and explanation of their roles in complex high‐entropy systems. Herein, the facile introduction of oxygen vacancies into high‐entropy oxides is realized and the unique high entropy‐driven role of oxygen vacancies for oxygen evolution reaction (OER) process is revealed. A low‐temperature surface carbonization–decarbonization approach is developed to introduce and regulate the oxygen vacancies in high‐entropy spinel oxides (HEOs). The oxygen vacancies in HEOs can both facilitate pre‐oxidation process for faster OH− adsorption and induce the unique bridge site pathway for easier deprotonation, distinctive in conventional oxides where oxygen vacancies favor *OH adsorption yet hinder the deprotonation. Consequently, the as‐prepared high‐entropy spinel oxides with oxygen vacancies (HEOs‐Ov) exhibit superior OER activities, outperforming the HEOs and most reported oxide‐based electrocatalysts. Besides, this universal method can be extended to other spinel oxides with different configuration entropies and can be scaled up. The work paves the way for the exploration of oxygen vacancies in high‐entropy oxides toward electrocatalysis fields.
Waste‐to‐Energy: Development of a Highly Efficient Keratin Enhanced Chitosan Bio‐Waste‐Derived Triboelectric Nanogenerator for Energy Harvesting and Real Applications
Authors: Motora Kebena Gebeyehu , Wu Chang‐Mou , Jose Cathlene Roi Mongaya , Rani Gokana Mohana
Published: January 2024

In this study, a novel and sustainable triboelectric material is successfully designed and developed by extracting keratin from recycled fur and combining it with chitosan to create a keratin/chitosan triboelectric nanogenerator (CK‐TENG) device. The device is designed for the simultaneous treatment of waste and the generation of green and clean energy, crucial for addressing global challenges. CK is prepared through a freeze‐drying method to overcome the weak mechanical properties of keratin and achieve a high surface contact area, which is important for triboelectric properties. The results showed that the output voltage is improved by 375% compared to the TENG without keratin, with values reaching 322 V under a 6 N. It produced a high power density of 14.4 W m−2 and excellent cyclic stability for more than 8000 cycles, which are crucial for practical applications. Further, the potential applications are also studied, and the results showed that it can turn on over 250 light‐emitting diodes (LEDs), display liquid crystal display (LCD), and charge capacitors under 6 N. Moreover, it is successful in harvesting energy from waste vibrations, acoustic energy, and as a shoe, and the electrical output is utilized to power electronic devices. Furthermore, the power density harvested by the device is higher than that of TENG devices made with keratin‐rich materials. Therefore, this study paves the way for the use of keratin‐based bio‐waste materials for clean and green energy production, which can play significant roles in applications such as the charging of electronic devices, biomedicine, sensors, and smart textiles.
Dynamic Antimicrobial Poly(disulfide) Coatings Exfoliate Biofilms On Demand Via Triggered Depolymerization
Authors: Lou Yang , Palermo Edmund F.
Published: January 2024

Bacterial biofilms are notoriously problematic in applications ranging from biomedical implants to ship hulls. Cationic, amphiphilic antibacterial surface coatings delay the onset of biofilm formation by killing microbes on contact, but they lose effectiveness over time due to non‐specific binding of biomass and biofilm formation. Harsh treatment methods are required to forcibly expel the biomass and regenerate a clean surface. Here, a simple, dynamically reversible method of polymer surface coating that enables both chemical killing on contact, and on‐demand mechanical delamination of surface‐bound biofilms, by triggered depolymerization of the underlying antimicrobial coating layer, is developed. Antimicrobial polymer derivatives based on α‐lipoic acid (LA) undergo dynamic and reversible polymerization into polydisulfides functionalized with biocidal quaternary ammonium salt groups. These coatings kill >99.9% of Staphylococcus aureus cells, repeatedly for 15 cycles without loss of activity, for moderate microbial challenges (≈105 colony‐forming units (CFU) mL−1, 1 h), but they ultimately foul under intense challenges (≈107 CFU mL−1, 5 days). The attached biofilms are then exfoliated from the polymer surface by UV‐triggered degradation in an aqueous solution at neutral pH. This work provides a simple strategy for antimicrobial coatings that can kill bacteria on contact for extended timescales, followed by triggered biofilm removal under mild conditions.
Anti‐Inflammatory Peptide‐Conjugated Silk Fibroin/Cryogel Hybrid Dual Fiber Scaffold with Hierarchical Structure Promotes Healing of Chronic Wounds
Authors: Fan Ruyi , Zhao Jiebing , Yi Lei , Yuan Jiayi , McCarthy Alec , Li Bo , Yang Ganghua , John Johnson V. , Wan Wenbing , Zhang Yi , Chen Shixuan
Published: January 2024

Chronic wounds resulting from diabetes, pressure, radiation therapy, and other factors continue to pose significant challenges in wound healing. To address this, this study introduces a novel hybrid fibroin fibrous scaffold (FFS) comprising randomly arranged fibroin fibers and vertically aligned cryogel fibers (CFs). The fibroin scaffold is efficiently degummed at room temperature and simultaneously formed a porous structure. The aligned CFs are produced via directional freeze‐drying, achieved by controlling solution concentration and freezing polymerization temperature. The incorporation of aligned CFs into the expanded fibroin fiber scaffold leads to enhanced cell infiltration both in vitro and in vivo, further elevating the hybrid scaffold's tissue compatibility. The anti‐inflammatory peptide 1 (AP‐1) is also conjugated to the hybrid fibrous scaffold, effectively transforming the inflammatory status of chronic wounds from pro‐inflammatory to pro‐reparative. Consequently, the FFS‐AP1+CF group demonstrates superior granulation tissue formation, angiogenesis, collagen deposition, and re‐epithelialization during the proliferative phase compared to the commercial product PELNAC. Moreover, the FFS‐AP1+CF group displays epidermis thickness, number of regenerated hair follicles, and collagen density closer to normal skin tissue. These findings highlight the potential of random fibroin fibers/aligned CFs hybrid fibrous scaffold as a promising approach for skin tissue filling and tissue regeneration.
Tunable Adhesion for All‐Dry Transfer of 2D Materials Enabled by the Freezing of Transfer Medium
Authors: Chen Sensheng , Chen Ge , Zhao Yixuan , Bu Saiyu , Hu Zhaoning , Mao Boyang , Wu Haotian , Liao Junhao , Li Fangfang , Zhou Chaofan , Guo Bingbing , Liu Wenlin , Zhu Yaqi , Lu Qi , Hu Jingyi , Shang Mingpeng , Shi Zhuofeng , Yu Beiming , Zhang Xiaodong , Zhao Zhenxin , Jia Kaicheng , Zhang Yanfeng , Sun Pengzhan , Liu Zhongfan , Lin Li , Wang Xiaomin
Published: January 2024

The real applications of chemical vapor deposition (CVD)‐grown graphene films require the reliable techniques for transferring graphene from growth substrates onto application‐specific substrates. The transfer approaches that avoid the use of organic solvents, etchants, and strong bases are compatible with industrial batch processing, in which graphene transfer should be conducted by dry exfoliation and lamination. However, all‐dry transfer of graphene remains unachievable owing to the difficulty in precisely controlling interfacial adhesion to enable the crack‐ and contamination‐free transfer. Herein, through controllable crosslinking of transfer medium polymer, the adhesion is successfully tuned between the polymer and graphene for all‐dry transfer of graphene wafers. Stronger adhesion enables crack‐free peeling of the graphene from growth substrates, while reduced adhesion facilitates the exfoliation of polymer from graphene surface leaving an ultraclean surface. This work provides an industrially compatible approach for transferring 2D materials, key for their future applications, and offers a route for tuning the interfacial adhesion that would allow for the transfer‐enabled fabrication of van der Waals heterostructures.
Molecular Engineering Enables Hydrogel Electrolyte with Ionic Hopping Migration and Self‐Healability toward Dendrite‐Free Zinc‐Metal Anodes
Authors: Zhu Kaiping , Luo Jie , Zhang Dehe , Wang Nanyang , Pan Shibo , Zhou Shujin , Zhang Zhenjie , Guo Gengde , Yang Peng , Fan Yuan , Hou Shisheng , Shao Zhipeng , Liu Shizhuo , Lin Lin , Xue Pan , Hong Guo , Yang Yurong , Yao Yagang
Published: January 2024

Hydrogel electrolytes (HEs), characterized by intrinsic safety, mechanical stability, and biocompatibility, can promote the development of flexible aqueous zinc‐ion batteries (FAZIBs). However, current FAZIB technology is severely restricted by the uncontrollable dendrite growth arising from undesirable reactions between the HEs with sluggish ionic conductivity and Zn metal. To overcome this challenge, this work proposes a molecular engineering strategy, which involves the introduction of oxygen‐rich poly(urea‐urethane) (OR‐PUU) into polyacrylamide (PAM)‐based HEs. The OR‐PUU/PAM HEs facilitate rapid ion transfer through their ionic hopping migration mechanism, resulting in uniform and orderly Zn2+ deposition. The abundant polar groups on the OR‐PUU molecules in OR‐PUU/PAM HEs break the inherent H‐bond network, tune the solvation structure of hydrated Zn2+, and inhibit the occurrence of side reactions. Moreover, the interaction of hierarchical H‐bonds in the OR‐PUU/PAM HEs endows them with self‐healability, enabling in situ repair of cracks induced by plating/stripping. Consequently, Zn symmetric cells incorporating the novel OR‐PUU/PAM HEs exhibit a long cycling life of 2000 h. The resulting Zn–MnO2 battery displays a low capacity decay rate of 0.009% over 2000 cycles at 2000 mA g−1. Overall, this work provides valuable insights to facilitate the realization of dendrite‐free Zn‐metal anodes through the molecular engineering of HEs.