bluuebunny/crossref_metadata_2025 huggingface dataset:
4-PBA inhibits endoplasmic reticulum stress to improve autophagic flux in the treatment of protamine/lipopolysaccharide-induced interstitial cystitis in rats
Authors: Jia Li , Jingzhen Zhu , Xinliang Yang , Bishao Sun , Xin Luo , Ji Zheng , Zhenqiang Fang
Published: August 2023

Interstitial cystitis (IC) has severe clinical symptoms with unclear mechanism. The continuous inflammatory response of the bladder is the basis of its pathogenesis. Endoplasmic reticulum stress (ERS) is involved in the regulation and development of various inflammatory diseases. And autophagy plays an important role in IC. In this study, we mainly focus on the therapeutic effect of endoplasmic reticulum stress and autophagy on protamine/lipopolysaccharide-induced interstitial cystitis. Female Sprague–Dawley rats were randomized into three experimental groups as follows: sham controls(N), IC alone, and IC+4-PBA.Rats in group IC received 10 mg/ml PS in the urinary bladder, followed by 2 mg/ml LPS instillation after 30 min, IC+4-PBA group SD rats received 4-PBA solution administered intragastrically once a day for 5 days. ERS biomarker (GRP78), autophagy-related proteins (LC3I/II, and Beclin1), autophagic flux biomarker (P62), inflammatory biomarkers (IL-6, TNF-a, NF-κB), apoptotic biomarkers (Caspase 3, Bax) were highest in the IC group compared to IC+4-PBA group and N group and the biomarkers expression in IC+4-PBA group were lower than in the IC group, anti-apoptotic biomarker (Bcl-2) was highest in the N group compared to the IC group and IC+4-PBA group and lower in the IC group than in the IC+4-PBA group, oxidative stress biomarkers (HO-1, NQO-1) were remarkably lower in the control group than in the IC and IC+4-PBA groups and notably lower in the IC group than in the IC+4-PBA group. The histological score and mast cell count demonstrated most severe in the IC group than those in the IC+4-PBA group. TUNEL assay examined the level of apoptosis in IC group was higher than in the IC+4-PBA group. The bladder micturition function was significantly improved with 4-PBA treatment. 4-PBA inhibits ERS to recover autophagic flux, and then to suppress the bladder oxidative stress, the inflammatory reaction and apoptosis, finally improve the bladder urinary function in Protamine/Lipopolysaccharide (PS/LPS) induced IC.
Changing environmental conditions have altered the feeding ecology of two keystone Arctic marine predators
Authors: Anderson Matthew A. , Fisk Aaron T. , Laing Rodd , Noël Marie , Angnatok Joey , Kirk Jane , Evans Marlene , Pijogge Liz , Brown Tanya M.
Published: August 2023

Environmental change in the Arctic has impacted the composition and structure of marine food webs. Tracking feeding ecology changes of culturally-valued Arctic char (Salvelinus alpinus) and ringed seals (Pusa hispida) can provide an indication of the ecological significance of climate change in a vulnerable region. We characterized how changes in sea ice conditions, sea surface temperature (SST), and primary productivity affected the feeding ecology of these two keystone species over a 13- and 18-year period, respectively, in northern Labrador, Canada. Arctic char fed consistently on pelagic resources (δ13C) but shifted over time to feeding at a higher trophic level (δ15N) and on more marine/offshore resources (δ34S), which correlated with decreases in chlorophyll a concentration. A reduction in Arctic char condition factor and lipid content was associated with higher trophic position. Ringed seals also shifted to feeding at a higher trophic level, but on more pelagic resources, which was associated with lower SST and higher chlorophyll a concentrations. Years with abnormally high SSTs and reduced sea ice concentrations resulted in large isotopic niche sizes for both species, suggesting abrupt change can result in more variable feeding. Changes in abundance and distribution of species long valued by the Inuit of Labrador could diminish food security.
Association between red blood cell distribution width and the prognosis of brain death in patients with a Glasgow Coma Scale < 6
Authors: Latifi Marzieh , Rahban Habib , Pourhosein Elahe , Shostak Daniel , Dehghani Sanaz
Published: August 2023

Red blood cell distribution width (RDW) has been reported as a meaningful prognostic factor in various diseases. Our study compared patients’ RDW levels and prognosis at admission and discharge time. A total of 128 patients 77 patients who suffered brain death (subject group), and 51 patients who were discharged from the hospital (control group) with GCS ≤ 6 were recruited from 60 hospitals for this study. Demographical data and RDW measurements in these patients at admission time and brain death/discharge time were extracted into two groups. 46 (35.9%) patients were females and 82 patients (64.1%) were males with a median age of 36 years old. A significant difference in baseline characteristics of GCS (P < 0.001), RDW at admission time (P < 0.001), and RDW at discharge or brain death time (P < 0.001) were noted between the two groups. In the overall population, RDW at admission time had a median value of 13.75% and was positively correlated with gender (P < 0.04, rs = 0.582) and age (P < 0.023, rs = − 0.201). Initially, there were no significant differences in RDW upon admission. However, upon discharge, although the RDW in the control group was not significant (P < 0. 1), the RDW level at the time of brain death was notably 0.45 fold higher (P = 0.001) compared to the time of admission. The standardized residuals at the two-time points showed an approximately normal distribution. The most effective RDW cut-off in Brain death was determined as 14.55. Based on the findings, using RDW as a prognostic factor has a sensitivity of 0.468 and a specificity of 0.137 in diagnosing brain death. RDW biomarker is a simple and inexpensive laboratory test that may be seen as a valuable perspective for initial patient evaluation. RDW is a powerful marker for the prognosis of brain death in patients with a GCS ≤ 6 at admission time, in order to identify a subset of patients who may require more aggressive management in the trauma center.
Economic potential of essential oil production from New Zealand-grown Eucalyptus bosistoana
Authors: Rajapaksha Chamira , Greaves Paul , Altaner Clemens M.
Published: August 2023

Farm foresters and other growers are establishing a ground-durable hardwood resource, including the emerging plantation species Eucalyptus bosistoana in New Zealand. The foliage of this species contains essential oils in quantity and quality suitable for commercial extraction. Essential oil production could improve the economic viability of E. bosistoana plantations, diversifying the grower’s income and providing an early revenue stream. This study assessed the economic potential for essential oil production from New Zealand grown E. bosistoana plantations. A sensitivity analysis indicated that uncertainty of leaf biomass availability, genetic as well as seasonal changes in oil content, and fluctuations in essential oil price are equally important on the viability of an essential oil operation. Small-scale essential oil production could be sustainably supplied with foliage from thinning and pruning operations sourced from the envisaged regional planting programmes and commence in 3–5 years. A large-scale operation could be supplied when trees will be harvested. Lastly, based on the operational costs of a domestic small-scale essential oil producer, oil value from E. bosistoana would exceed the cost of production.
Memory capacity and prioritization in female mice
Authors: Qiao Qinbo , Mairlot Caroline , Bendor Daniel
Published: August 2023

Our brain’s capacity for memory storage may be vast but is still finite. Given that we cannot remember the entirety of our experiences, how does our brain select what to remember and what to forget? Much like the triage of a hospital’s emergency room, where urgent cases are prioritized and less critical patients receive delayed or even no care, the brain is believed to go through a similar process of memory triage. Recent salient memories are prioritized for consolidation, which helps create stable, long-term representations in the brain; less salient memories receive a lower priority, and are eventually forgotten if not sufficiently consolidated (Stickgold and Walker in Nat Neurosci 16(2):139–145, 2013). While rodents are a primary model for studying memory consolidation, common behavioral tests typically rely on a limited number of items or contexts, well within the memory capacity of the subject. A memory test allowing us to exceed an animal’s memory capacity is key to investigating how memories are selectively strengthened or forgotten. Here we report a new serial novel object recognition task designed to measure memory capacity and prioritization, which we test and validate using female mice.
The Sendai river terraces monitored the co-seismic mega-thrusting
Authors: Osozawa Soichi , Ito Hisatoshi
Published: August 2023

We conducted a detailed geological survey of the Sendai region, covering an area of 100 × 50 km. Our survey focused on accurately mapping river terraces, identifying the source volcanoes responsible for intercalated tephras, and locating the Nagamachi-Rifu fault and associated faults. The river terraces were observed and categorized based on their elevation relative to the present river channels. These terraces are predominantly found on the hanging wall of major reverse faults. Each terrace comprises fluvial gravels at the lower levels and eolian loam intercalated with local and regional tephras at higher levels, with the contact age corresponding to the time of emergence. To determine the ages of the terrace gravels, we employed a combination of zircon U–Pb dating, sedimentation rate calculations, and extrapolation techniques. This allowed us to establish the abandonment or emergent dates of the terraces. The formation of these terraces coincided with periods of fault activity, including hanging wall uplift, footwall subsidence, and fault vertical displacement, effectively monitoring the co-seismicity of the Nagamachi-Rifu fault. While we cannot predict the exact timing of future events, it is crucial to remain vigilant regarding the potential occurrence of a significant earthquake triggered by these fault activities.
Infants’ representations of the infant body in the first year of life: a preferential looking time study
Authors: Rigato Silvia , Filippetti Maria Laura , de Klerk Carina
Published: August 2023

Representing others’ bodies is of fundamental importance for interacting with our environment, yet little is known about how body representations develop. Previous research suggests that infants have expectations about the typical structure of human bodies from relatively early in life, but that these expectations are dependent on how closely the stimuli resemble the bodies infants are exposed to in daily life. Yet, all previous studies used images of adult human bodies, and therefore it is unknown whether infants’ representations of infant bodies follow a similar developmental trajectory. In this study we investigated whether infants have expectations about the relative size of infant body parts in a preferential looking study using typical and disproportional infant bodies. We recorded the looking behaviour of three groups of infants between 5 and 14 months of age while they watched images of upright and inverted infant bodies, typical and proportionally distorted, and also collected data on participants’ locomotor abilities. Our results showed that infants of all ages looked equally at the typical and proportionally distorted infant body stimuli in both the upright and inverted conditions, and that their looking behaviour was unrelated to their locomotor skills. These findings suggest that infants may need additional visual experience with infant bodies to develop expectations about their typical proportions.
Tracking variations in daily questionable health behaviors and their psychological roots: a preregistered experience sampling study
Authors: Lazarević L. B. , Knežević G. , Purić D. , Teovanović P. , Petrović M. B. , Ninković M. , Živanović M. , Stanković S. , Branković M. , Lukić P. , Opačić G. , Žeželj I.
Published: August 2023

People resort to various questionable health practices to preserve or regain health - they intentionally do not adhere to medical recommendations (e.g. self-medicate or modify the prescribed therapies; iNAR), or use traditional/complementary/alternative (TCAM) medicine. As retrospective reports overestimate adherence and suffer from recall and desirability bias, we tracked the variations in daily questionable health behaviors and compared them to their retrospectively reported lifetime use. We also preregistered and explored their relations to a wide set of psychological predictors - distal (personality traits and basic thinking dispositions) and proximal (different unfounded beliefs and biases grouped under the term irrational mindset). A community sample (N = 224) tracked daily engagement in iNAR and TCAM use for 14 days, resulting in 3136 data points. We observed a high rate of questionable health practices over the 14 days; daily engagement rates roughly corresponded to lifetime ones. Both iNAR and TCAM were weakly, but robustly positively related. Independent of the assessment method, an irrational mindset was the most important predictor of TCAM use. For iNAR, however, psychological predictors emerged as relevant only when assessed retrospectively. Our study offers insight into questionable health behaviors from both a within and between-person perspective and highlights the importance of their psychological roots.
Estimation of the flow rate of pyrolysis gasoline, ethylene, and propylene in an industrial olefin plant using machine learning approaches
Authors: Abdi Jafar , Mazloom Golshan , Hadavimoghaddam Fahimeh , Hemmati-Sarapardeh Abdolhossein , Esmaeili-Faraj Seyyed Hamid , Bolhasani Akbar , Karamian Soroush , Hosseini Shahin
Published: August 2023

Light olefins, as the backbone of the chemical and petrochemical industries, are produced mainly via steam cracking route. Prediction the of effects of operating variables on the product yield distribution through the mechanistic approaches is complex and requires long time. While increasing in the industrial automation and the availability of the high throughput data, the machine learning approaches have gained much attention due to the simplicity and less required computational efforts. In this study, the potential capability of four powerful machine learning models, i.e., Multilayer perceptron (MLP) neural network, adaptive boosting-support vector regression (AdaBoost-SVR), recurrent neural network (RNN), and deep belief network (DBN) was investigated to predict the product distribution of an olefin plant in industrial scale. In this regard, an extensive data set including 1184 actual data points were gathered during four successive years under various practical conditions. 24 varying independent parameters, including flow rates of different feedstock, numbers of active furnaces, and coil outlet temperatures, were chosen as the input variables of the models and the outputs were the flow rates of the main products, i.e., pyrolysis gasoline, ethylene, and propylene. The accuracy of the models was assessed by different statistical techniques. Based on the obtained results, the RNN model accurately predicted the main product flow rates with average absolute percent relative error (AAPRE) and determination coefficient (R2) values of 1.94% and 0.97, 1.29% and 0.99, 0.70% and 0.99 for pyrolysis gasoline, propylene, and ethylene, respectively. The influence of the various parameters on the products flow rate (estimated by the RNN model) was studied by the relevancy factor calculation. Accordingly, the number of furnaces in service and the flow rates of some feedstock had more positive impacts on the outputs. In addition, the effects of different operating conditions on the propylene/ethylene (P/E) ratio as a cracking severity factor were also discussed. This research proved that intelligent approaches, despite being simple and straightforward, can predict complex unit performance. Thus, they can be efficiently utilized to control and optimize different industrial-scale units.
Investigation of factors influencing low physical activity levels in community-dwelling older adults with chronic pain: a cross-sectional study
Authors: Hida Mitsumasa , Imai Ryota , Nakamura Misa , Nakao Hidetoshi , Kitagawa Kodai , Wada Chikamune , Eto Shinji , Takeda Masatoshi , Imaoka Masakazu
Published: August 2023

Low levels of physical activity in individuals with chronic pain can lead to additional functional impairment and disability. This study aims to investigate the predictors of low physical activity levels in individuals with chronic pain, and to determine the accuracy of the artificial neural network used to analyze these predictors. Community-dwelling older adults with chronic pain (n = 103) were surveyed for their physical activity levels and classified into low, moderate, or high physical activity level groups. Chronic pain-related measurements, physical function assessment, and clinical history, which all influence physical activity, were also taken at the same time. Logistic regression analysis and analysis of multilayer perceptron, an artificial neural network algorithm, were performed. Both analyses revealed that history of falls was a predictor of low levels of physical activity in community-dwelling older adults. Multilayer perceptron analysis was shown to have excellent accuracy. Our results emphasize the importance of fall prevention in improving the physical activity levels of community-dwelling older adults with chronic pain. Future cross-sectional studies should compare multiple analysis methods to show results with improved accuracy.
Potential of circulating receptor-interacting protein kinase 3 levels as a marker of acute liver injury
Authors: Kondo Takayuki , Fujimoto Kentaro , Fujiwara Kisako , Yumita Sae , Ishino Takamasa , Ogawa Keita , Nakagawa Miyuki , Iwanaga Terunao , Koroki Keisuke , Kanzaki Hiroaki , Inoue Masanori , Kobayashi Kazufumi , Kiyono Soichiro , Nakamura Masato , Kanogawa Naoya , Ogasawara Sadahisa , Nakamoto Shingo , Chiba Tetsuhiro , Kato Jun , Fujiwara Keiichi , Kato Naoya
Published: August 2023

The pathogenesis of acute liver failure (ALF) involves cell death. Necroptosis is a newly suggested programmed cell death, and receptor-interacting protein kinase 3 (RIPK3) has been reported as a marker for necroptosis. However, there are few reports on necroptosis in ALF. Therefore, we evaluated the role of cell death markers such as cytokeratin (CK) 18, cleaved CK (cCK) 18, and RIPK3 in ALF, as well as cytokines and hepatocyte growth factor (HGF). Seventy-one hospitalized patients with acute liver injury (38 nonsevere hepatitis [non-SH]/22 severe hepatitis [SH]/11 ALF) were studied. No significant difference was found for cytokines, but a substantial increase in HGF levels was found following the severity of hepatitis. The non-SH group had lower levels of CK18 and cCK18 than the SH/ALF group. RIPK3 was significantly lower in the non-SH/SH group than in the ALF group. HGF, RIPK3, and albumin levels were found to be important predictive variables. The present study suggests that cCK18, CK18, and RIPK3 are associated with the severity of hepatitis. RIPK3 and other markers related cell death may be useful for understanding the pathogenesis of ALF and as a prognostic marker of acute liver injury.
Engineering receptor-mediated transmembrane signaling in artificial and living cells
Authors: Shi Ke , Song Chuwen , Wang Yayi , Chandrawati Rona , Lin Yiyang
Published: August 2023

Living cells possess a variety of transmembrane signaling systems that receive chemical and physical cues from the environment and transduce this information into an intracellular signal that triggers downstream cellular responses. This Review aims to present recent advances in the design of bioinspired systems that mimic transmembrane signaling in synthetic and living cells. We summarize the building of cell-like membranous structures and the construction of interfacial recognition between chemical or biological components. After introducing two main mechanisms of signal transduction in biology through receptor tyrosine kinase and G‐protein coupled receptors, we then highlight the possibility of mimicking transmembrane signaling with transducer integrated systems. We survey the potential for applying supramolecular materials (e.g., DNA origami, polypeptide structures and polymer scaffolds) to interact with surface receptors on the plasma membrane, providing an avenue for the application of therapeutics.
Velocity map imaging with no spherical aberrations
Authors: Ben-Shabo Yehuda , Kurbanov Adeliya , Schröter Claus Dieter , Moshammer Robert , Kreckel Holger , Toker Yoni
Published: August 2023

An analytical derivation for achieving velocity map imaging (VMI) with no spherical aberations is described. Simulations show how this method can be used for operating the CSR-ReMi in a VMI mode with an extremely large source volume.
Next generation decentralized water systems: a water-energy-infrastructure-human nexus (WEIHN) approach
Authors: Huang Yuankai , Zhang Jintao , Ren Zheng , Xiang Wenjun , Sifat Iram , Zhang Wei , Zhu Jin , Li Baikun
Published: August 2023

This review highlights the pressing need for sustainable water management strategies within the water-energy-infrastructure-human nexus, and accentuates the critical roles of infrastructure and human engagement for sustainable water management.
Light-manipulated binary droplet transport on a high-energy surface
Authors: Li Wei , Li Dongliang , Zhu Xun , Ye Dingding , Yang Yang , Wang Hong , Chen Rong , Liao Qiang
Published: August 2023

A light strategy for flexible and precise manipulation of binary droplet transport on high-energy surface by localized photothermal effect.
On the role of polymeric hydrogels in the thermal response of gold nanorods under NIR laser irradiation
Authors: Lacroce Elisa , Bianchi Leonardo , Polito Laura , Korganbayev Sanzhar , Molinelli Alessandro , Sacchetti Alessandro , Saccomandi Paola , Rossi Filippo
Published: August 2023

Hydrogels are 3D cross-linked networks of polymeric chains designed to be used in the human body.
Synthesis of novel thiazol-2(3H)-imine derivatives as ergosterol biosynthesis inhibitors, and elucidation of their structures using a 2D NMR technique
Authors: Osmaniye Derya , Levent Serkan , Sağlık Begum Nurpelin , Görgülü Şennur , Özkay Yusuf , Kaplancıklı Zafer Asım
Published: August 2023

In this study, new imidazole-2,3-dihydrothiazole derivatives were synthesized.
Multi-functionalized carbon nanotubes towards green fabrication of heterogeneous catalyst platforms with enhanced catalytic properties under NIR light irradiation
Authors: Pan Xuefeng , Liu Rongying , Yu Zhilong , Haas Benedikt , Kochovski Zdravko , Cao Sijia , Sarhan Radwan M. , Chen Guosong , Lu Yan
Published: August 2023

This work opens a new avenue for the synthesis of CNT composites as a sustainable and versatile catalyst platform.
A novel poly(acrylonitrile)/poly(ethylene glycol)-based polymer gel electrolyte for high efficiency dye sensitized solar cells
Authors: Varishetty Madhu Mohan , Kenji Murakami , Tarannum Nazia , Damaraju Srinivasa Rao , Jonnalagadda Madhavi
Published: August 2023

This research article reports on a systematic approach to the development of polymer gel electrolytes (PGEs) for the applications of dye-sensitized solar cells (DSSCs).
The Impact of Age and Psychosocial Factors on Cognitive and Auditory Outcomes During the COVID-19 Pandemic
Authors: Slade Kate , Davies Robert , Pennington Charlotte R. , Plack Christopher J. , Nuttall Helen E.
Published: August 2023

Purpose:

In March 2020, the U.K. government announced that people should isolate to reduce the spread of the virus that causes COVID-19. Outside a pandemic, psychosocial factors, such as socialization and mental health, may impact the relationship between hearing loss and increased dementia risk. We aim to report the impact of psychosocial factors, including social isolation, depression, and engagement in activities, on hearing and cognitive function in younger and older adults during the COVID-19 pandemic.

Method:

An online survey and experiment assessed self-reported psychosocial factors, self-reported hearing ability and speech-in-noise perception, and cognition. Data were collected between June 2020 and February 2021. Older (
n
= 112,

M
age

= 70.08) and younger (
n
= 121,

M
age

= 20.52) monolingual speakers of English, without any language or neurological disorders participated. Multiple linear regression models were employed to investigate hypothesized associations between psychosocial factors, and hearing and cognition, in older and younger adults.

Results:

Multiple regression analyses indicated that older adults displayed poorer speech-in-noise perception and poorer performance on one of four cognitive tasks, compared with younger adults; increased depression was associated with poorer subjective hearing. Other psychosocial factors did not significantly predict hearing or cognitive function.

Conclusions:

Data suggest that self-reported hearing and depression are related. This conclusion is important for understanding the associations between hearing loss and cognitive decline in the long term, as both hearing loss and depression are risk factors for dementia.

Supplemental Material:

https://doi.org/10.23641/asha.23810838
Lumped parameter thermal model for segmental translator linear switched reluctance motor
Authors: Golzarzadeh Milad , Oraee Hashem , Ganji Babak
Published: August 2023

The segmental translator linear switched reluctance motor (STLSRM) is a special type of linear switched reluctance motor (LSRM) that has more output power than its conventional type. Therefore, it can be a good choice for certain applications. Heat is one of the factors limiting the output in machines. Therefore, predicting the thermal distribution of machine is as important as the magnetic design. A comprehensive thermal model is presented based on the lumped parameter approach for STLSRM, which predicts temperature distribution in different parts of this motor, including slot winding, end‐winding, stator pole, stator yoke, and the moving part. Considering that the proposed thermal model depends on dimensions and materials used in machine, it can be used for other designs of the STLSRM. The presented thermal model is applied to a typical STLSRM and temperature is determined in its different parts. The simulation results are then compared with the results of 3‐D thermal modelling based on the finite element method (FEM) for validation.
An Air Embolism Detection Device for Use with a Non-Occlusive Arterial Pumphead
Authors: Vivian William A. , Stander Klint H. , Smith R. Glade
Published: August 2023

(J. Extra-Corpor. Technol. 19[4]: p. 406-407 Winter 1988). A clinical evaluation of an air-bubble detector system used in conjunction with a non-occlusive pumphead is described in this report. The detector system was originally designed for occlusive roller pumpheads. A non-occlusive pump system can now be integrated with an existing rollerhead pump setup to accomplish the same desired effect, that is, automatic shutoff of the non-occlusive arterial pumphead if air is detected. The system is designed to produce an audible alarm when a bolus of air enters the bypass circuit. This system can be operated in a manual or automatic mode for arterial pump shutoff. This system has been judged effective in our clinical setting.
Filtration of Recirculating Cardioplegia Systems
Authors: Dillon Virginia W. , Spielberg Richard , Reisinger Timothy J. , Baker Robert E. , Callard George M.
Published: August 2023

(J. Extra-Corpor. Technol. 20[1]: p. 30-34 Spring 1988) Two recirculating cardioplegia delivery systems were examined to measure their particulate contamination level and the rate of particulate removal using an 0.8 micron Capture Membrane with standard housing assembly. Capture Membranes were changed at 5, 10, 20, and 30 minute time periods with the cardioplegia recirculating at 400 ml/min. A logarithmic equation was derived from the particulate counts measured. The extrapolated points demonstrated that 98% of particulate contaminates were removed from these systems after 60 minutes of recirculating.
Technique for Improved Patient Care: Initial Experience with the GEM-6
Authors: Parault Beverly
Published: August 2023

(J. Extra-Corpor. Technol. 20[1]: p. 46–51 Spring 1988) In our institution, a “stat” lab is not available in close proximity to the OR. The problem of receiving lab results quickly (within 5-8 minutes) while on cardiopulmonary bypass was a persistent problem. Therefore, the decision was made to evaluate the GEM-6, a relatively new on-line blood gas, electrolyte, and hematocrit monitor for the heart-lung machine. for the first 30 days of use, simultaneous results were obtained from the GEM-6 and the hospital lab. Our lag time receiving results was greatly reduced and the lab values compared favorably with the hospital lab. The least reliable value with the original cartridge and software was the hematocrit levels. Hematocrits measured by the GEM-6 consistently were 2-5% higher than the hospital lab results. This problem appears to be proportionately related to the patient’s serum sodium level. Due to decreased work load on OR personnel, reliability, quickly obtainable results, and multiple parameters available with the GEM-6, we instituted use of the GEM-6 in January 1987. Through the use of Quality Assurance monitors and comparative Recovery Room first blood gases as QA monitors on open heart patients, documentation of improved patient care through the use of this on-line instrument is provided. Lab values readily available to the perfusionist can indeed result in the “fine tuning” of the pump run with improved patient care.
Techniques Involved in a Ventricular-Assist Program Using a Centrifugal Pump in a Community-Based Practice
Authors: Mills Dennis , Golden Thomas , Wolfe Roxanne , Johansen Keith , Pipp Connie
Published: August 2023

(J. Extra-Corpor. Technol. 20(2):72–77) Our community-based perfusion practice provides bypass and other cardiac-related services at six hospitals. While the incidence of ventricular dysfunction of sufficient severity to require ventricular assist (VA) is small (0.55%), it is necessary to provide this service for all of our surgeons at all six hospitals. We describe our VA program and present our experience with seven patients aided during a 22-month period. Four had left ventricular assist, two required bi-ventricular support, and one received right ventricular assist, all by means of Centrimed centrifugal pumps. Three of these patients have survived between 3 and 13.5 months. Three patients were not anticoagulated. Duration of support ranged from 6.5 to 96.5 hours; mean flows ranged from 3 to 6 L/min.
Pediatric Liver Resection Using the Pump-Oxygenator and Red Blood Cell Washers
Authors: Sistino Joseph J. , Rosa Miguel A.
Published: August 2023

This case report describes the use of the pumpoxygenator as a rapid infusion system during the resection of a liver tumor in a 12 month old child. All banked blood was washed in a cell washer before addition to the oxygenator to avoid the deleterious effects of hyperkalemia, acidosis and ionic hypocalcemia. The blood was warmed and recirculated in the perfusion circuit to provide volume replacement when necessary during the surgical procedure. The patient made an uneventful recovery after receiving transfusions exceeding 4½ times the patient’s estimated blood volume.
A Model for Estimating Post-Dilution Hematocrit with Minimal Blood Loss
Authors: Fletcher Robert W.
Published: August 2023

A hematocrit estimator model (HEM) for post dilutional hematocrit prior to cardiopulmonary bypass is presented. The estimator model was tested on 75 adult patients, whose ages range from 36–81 years with a median age of 62.4, undergoing cardiopulmonary bypass.

The estimator model allows an accurate and efficient determination of the hematocrit, after the patient receives large volumes of non-heamic fluid, based on a retrospective analysis of our patient database.
Clinical Evaluation of the Gas Transfer of the Bentley 10 Plus Bubble Oxygenator during Alpha-Stat Regulated Hypothermic Cardiopulmonary Bypass
Authors: Stinkens D. , Van den fonteyne F. , Alleman J. , Van Cauwelaert Ph. , Theunissen W. , Himpe D. , Alexander J.P. , Muylae Ph.
Published: August 2023

The gas transfer performance of the Bentley 10 Plusa bubble oxygenator was clinically investigated. 26 consenting adult patients undergoing either Coronary Artery Bypass Grafts (CABG) or valve replacement were perfused using this oxygenating system and moderate hypothermia. Mean body surface area (BSA) was 1.78 square meters ranging from 1.38 to 2.12. During bypass blood flow was maintained at 2.4 1/m2/min. We aimed for an arterial pO2 between 100 and 200 mmHg and an arterial pCO2 between 35 and 45 mmHg. Arterial pO2 was adjusted mainly by the pO2 control valve setting and pCO2 by total gas flow.

The blood gas result shows clearly the controllability of the PaO2 and the PaCO2. The mean PaO2 for all the procedures was 154 ± 38 mmHg and the mean PaCO2 was 39.7 ± mmHg.

The results of this study demonstrate that the correct use of the Bentley 10 Plusa bubble oxygenator during alpha-stat regulated hypothermic (26–30°C) CPB allows control of the PaO2 and PaCO2 levels within preset ranges.
Supported Angioplasty: A New Contribution for Extra-Corporeal Circulation Technology
Authors: Riley Jeffrey B , Litzie A Kenneth , Overlie Paul A , Justison George A , Soronen Scott W , Berryessa Richard G , Crowley Jeffrey C
Published: August 2023

To date there have been no fewer than seven palliative treatments for atherosclerotic coronary artery disease. The expanding role of interventional cardiology in the treatment of patients with severe coronary artery disease will result in a mandatory and significant allocation of perfusion services dedicated to the catheterization laboratory.

Historical, and now more recent data, indicate that femoro-femoral bypass can be utilized as a resuscitative tool and as an adjunct to interventional cardiology techniques. The role of the perfusion team in the catheterization lab will evolve and expand along with the growing application of interventional cardiology techniques.
A Technique to Improve the Estimation of Hemoglobin Percent Oxygen Saturation During Cardiopulmonary Bypass
Authors: Riley Jeffrey B. , Cassingham C. Vaughn , Justison George A. , Hilal N.S. , Crowley Jeffrey C.
Published: August 2023

Algorithms that estimate hemoglobin percent O2 saturation (%Hb·O2) from pH, pO2, and temperature assume a normal patient hemoglobin P50 equal to about 27 mmHg. Ischemic cardiac and peripheral vascular disease patients do not have P50s near normal.

A new continuous pH and blood gas monitor allows the user to evaluate and employ the patient's pre-CPB P50 to estimate the subsequent %Hb·O2. The P50 %Hb·O2 algorithm estimate was calculated retrospectively for a normal patient blood gas data set and the % error between the estimate and a cooximeter measurement correlated well with the patient P50 (r = .976).

The patient P50 %Hb·O2 algorithm estimate was compared to simultaneous in line %Hb·O2 readings (r = .42), a cooximeter measurement (r = .673), and a blood gas analyzer %Hb·O2 (assumes normal P50) estimate (r = .589). To employ a pre-CPB patient P50 value to estimate %Hb·O2 should improve the predicting power of a %Hb·O2 estimating algorithm during CPB.
Applications of a Laptop Microcomputer During Cardiopulmonary Bypass
Authors: Wilt Suzanne Lorenzo , Silvershein Jeffrey L.
Published: August 2023

A “user friendly” microcomputer-generated data management system designed for on-site documentation and immediate analysis of patient parameters during cardiopulmonary bypass is presented. The program is a macro-driven template for use with Lotus 1-2-3 (ver. 2.0) on IBM PC-XT or compatible such as the Zenith Z-183 Laptop computer used in this report. Automatic calculation of data requiring minimal input includes kilos, centimeters, body surface area, blood flow, fluid balance, heparin, protamine and mannitol dose and systemic vascular resistance. Also included is autocomputation of documented minimum, maximum and average pressure, blood flow, oxygen flow/percent, temperature, activated clotting time and SVR. Basic file functions are easily performed as saving, retrieving, deleting and report generation. Database management capabilities include sorting by contents of fields, searching for specific records and graphing of selected parameters. The use of a computer-generated perfusion record has become a valuable tool in the tracking and evaluation of important patient parameters during cardiopulmonary bypass.
Clinical Evaluation of Bentley 10 Plus Bubble Oxygenator
Authors: Basha J. W. , Sternlieb J.J. , Bjork V.O. , Gabrielson T. W. , Hodges V.
Published: August 2023

This is the first clinical report evaluating the accuracy, safety and operative simplicity of the new BENTLEY 10 PLUS (B10+) bubble oxygenator to control pO2 and pCO2 independently. Eleven patients undergoing cardiopulmonary bypass (CPB) were randomly selected. The Bentley Gas Stat (BGS) was used to obtain blood gas values during CPB at five-minute intervals, (N = 270). BGS calibration values were recorded. Confirming blood gas samples were sent to the hospital laboratory at approximately 15-minute intervals to ensure accuracy of the BGS. Adjustments to the gas flow controller (GFC) and total gas flow (TGF) were made to maintain the pO2 and pCO2 with predetermined ranges, 100–150 torr and 38–42 torr, respectively. The number of adjustments required to maintain values within ranges, GFC settings, TGF settings, Hemoglobin, and visual signs of hemolysis (hemoglobin-urea) were charted.

The B10+ unique gas flow control mechanism and central filming chamber enables the user to independently control pO2 and pCO2 during CPB: thus, A) maintain blood gases within physiologic ranges, B) reduces microgaseous emboli emission, C) reduces blood trauma and D) allows blood gas control similar to a membrane at significantly less cost. Use of a continuous on-line blood gas analyzer is recommended with this oxygenator.
Intra-Aortic Balloon Counterpulsation for the Treatment of Ischemic Stroke
Authors: Berryessa Richard G. , Tranmer Bruce I. , Tyndal Charles M. , Iacobacci Raymond L.
Published: August 2023

Colloid volume expansion has been shown to increase cerebral blood flow to ischemic brain in an animal stroke model and improve recovery in patients. It is, however, potentially hazardous to use in older patients because of frequently associated cardiovascular disease.

Intra-Aortic Balloon Counterpulsation might reduce the risks of using volume expansion therapy in the elderly patient.

This study was designed to see if Intra-Aortic Balloon Counterpulsation (without volume expansion), in an animal with a normal heart, would increase cerebral blood flow and EEG activity in the ischemic brain.

Unilateral cerebral ischemia was produced in baboons (n = 9) after right middle cerebral artery occlusion. A 12 ml intra-aortic balloon catheter was introduced into the descending aorta via the femoral artery prior to middle cerebral artery occlusion. The balloon was positioned distal to the origin of the left subclavian artery and following middle cerebral artery occlusion was inflated with each R wave on the ECG. Cardiac output, cerebral blood flow (by Hydrogen wash-out), computer-mapped EEG, and hemodynamic data were collected prior to middle cerebral artery occlusion and following occlusion both before and during counterpulsation.

Intra-Aortic Balloon Counterpulsation produced a significant increase in pulse pressure from 54.7 ± 21 to 70.6 ± 33 mmHg (p = .043). No significant change was seen in cardiac output, mean arterial pressure, or cerebral blood flow. Although the computer- mapped EEG improved and the right (ischemic) hemisphere cerebral blood flow did increase slightly from 16.9 ± 6.5 to 18.3 ± 8.3 ml/100 gm/min, the cerebral blood flow changes were not significant (p=.295).

It is possible that the desired increase in cerebral blood flow was not achieved partly because the animals were only 3-4 years old and were difficult to stroke.

We believe that there is merit to a follow-up study in older primates with colloid volume expansion where Intra-Aortic Balloon Counterpulsation is used to protect the heart from the deleterious effects of volume expansion and where the cardiac effects of volume expansion and counterpulsation are quantified.

Perhaps volume expansion with Intra-Aortic Balloon Counterpulsation will be safer and more effective than either treatment modality alone.

(All data reported as mean ± standard deviation)
Lactic Acid Generation During Pediatric Cardiopulmonary Bypass: A Comparison of Blood and Crystalloid Primes
Authors: McCormick James S. , Berryessa Richard G. , Clarke David R. , Campbell David N. , Tyndal Charles M.
Published: August 2023

With the increasing concern over patient exposure to donor blood, we undertook a study to determine whether the exclusion of red blood cells from the pump prime for pediatric cardiopulmonary bypass surgical procedures would contribute to the development of metabolic acidosis by either decreasing O2 carrying capacity or diluting plasma buffers with a crystalloid solution. We compared a cellular (blood) prime (fresh-frozen plasma and red blood cells) and a non-cellular prime (Isolyte E and serum albumin).

Lactic acid and venous saturation levels were used to evaluate the effects of the two types of priming solutions. Lactic acid samples were drawn two minutes after bypass was initiated, and two minutes after cross clamp removal (or two minutes after bypass was resumed on circulatory arrest cases) and two minutes before discontinuing bypass. Venous saturation samples were taken at random times during the procedures. For cases using the clear prime, we were more aggressive in our blood conservation techniques.

Two-way analysis of variance revealed that there was a significant increase in lactic acid levels in both groups as a result of circulatory arrest (p = .0000000887, n = 13). There was not a significant difference in lactic acid levels between groups at any period during cardiopulmonary bypass (p =. 7756). The only differences between groups 1 (n = 15) and 2 were the bypass hematocrits, number of donor blood exposures and patient cooling times. The two-way ANOVA "Interaction" p value (p = .6117) strongly suggests that this was a clean study. These findings are supported by the comparability of the exsanguination times and venous saturations.

Our study results indicate that an Isolyte E and serum albumin prime did not increase the pediatric patient's lactic acid levels compared to a blood prime, but it does reduce patient donor blood exposure.
More Than Turning Knobs: The Expanding Role of the Clinical Perfusionist
Authors: Birenbaum Irvin B. , Rivard Dennis C. , Thompson Steven J. , Baldwin Robert C. , Banchieri Candace L. , Harple Michael S.
Published: August 2023

The practice of clinical cardiovascular perfusion has experienced major changes in scope since its inception over thirty years ago. The tasks of today's clinical perfusionist may include not only the usual life support of patients undergoing cardiac surgery, but also such diverse duties as IABP therapy, VAD life support, artificial heart management, blood salvage for autotransfusion, rapid fluid administration, ECMO therapy, liver transplantation, circulatory support for cardiac arrest, and perfusion for distant heart-lung procurement for transplantation.

All of these duties are practiced by the perfusion team of the Johns Hopkins Medical Institutions. Except for the normal surgical tasks of a perfusion- 1st, these tasks have been assumed by the perfusion team over a recent three year period with no increase in staff. Certain managerial and team strategies were necessary to achieve this without sacrificing either patient safety or staff morale.
Perfusion Error Cause Removal: The Perfusion Case Conference
Authors: Tyndal Charles M. , Berryessa Richard G.
Published: August 2023

Prevention of accidents is one of the fundamental elements of perfusion quality. Unfortunately, errors and accidents frequently occur during cardiopulmonary bypass. A recent retrospective survey of perfusionists identified some common accidents. We have previously reported a method of developing protocols to prevent and treat the ten most common perfusion related problems.

Until we reach the day when perfusion accidents no longer occur, we need to be able to systematically evaluate failures and prevent their recurrence.

We have developed a non-judgmental forum to discuss, analyze, and prevent variances or unusual circumstances that occur during cardiopulmonary bypass. We hold a monthly case conference where we discuss all cases from which we can learn something–interesting cases and cases during which there was a departure from protocol.

The purpose of this paper is to discuss the development of a case conference and to outline the format and benefits of such an Error Cause Removal program.
Portable Bypass for the Procurement of Organs Used in Heart and Lung Transplants
Authors: Jones P.E.
Published: August 2023

In July 1985, a method of organ procurement was devised using a portable cardiopulmonary bypass machine. Up to July 1985 all donors were transferred to Harefield Hospital for organ removal. Only 7 were performed by this method. Upon the introduction of the portable device, 25 more organs were transplanted, a significant increase in organ availability. To date, 114 organ procurements have been performed not only in Great Britain and Northern Ireland, but also in Europe with the longest ischemic time being 4 hours and 45 minutes.

The following is a detailed description of what was used to develop the portable machine. We utilized a bubble oxygenator cardiotomy reservoir, and a cooling system, which allows the user to cool down the donor to a temperature of 6 degrees opesophageal and approximately 8 degrees nasopharyngeal. It is believed that this method could help with the procurement of other organs, such as liver and kidneys, because of the total body cooling. This device has also been used on two occasions for the treatment of pulmonary embolism, where the operation was carried out at a non-cardiac hospital, and the transfer of such a patient would have led to the patient's demise.