bluuebunny/crossref_metadata_2025 huggingface dataset:
Osteoporotic alterations in a group of different ethnicity Brazilian postmenopausal women: An observational study
Authors: Munhoz Luciana , Aoki Eduardo M. , Cortes Arthur R. G. , de Freitas Cláudio F. , Arita Emiko S.
Published: January 2018

Objectives

To compare peripheral bone mineral density alterations among Brazilian postmenopausal women from three ethnic groups considering age and body mass index influence; to correlate their bone mineral density with the mandibular cortical index (MCI); and to evaluate the influence of age, body mass index and ethnicity in the MCI using risk factor analysis.

Background

Osteoporosis risk is known to have ethical influences. However, little is known about the differences in ethnicity in radiomorphometric indices.

Materials and methods

A total of 150 postmenopausal women with different ethnicities (Caucasian, Asian and Afro‐descendant) who underwent peripheral dual X‐ray absorptiometry and panoramic examination were included. Bone mineral density and MCI were assessed. Adjusted odds ratio analyses were performed on bone density and MCI considering the effect of age, ethnicity and body mass index. The correlations between the MCI and the dual X‐ray absorptiometry results were made.

Results

Old age, low body mass index and non‐Afro‐descendant were associated with low bone density. Compared with Afro‐descendants, Asians and Caucasians have higher chances of having decreased bone mass. For the MCI, statistical analysis showed that age is the only variable associated with osteoporotic alterations in the mandible. Furthermore, an inverse correlation was found between the MCI and the T‐scores.

Conclusion

Bone density is higher in Brazilian Afro‐descendant women than in Caucasians and Asians. Patient's age is associated with bone density and the MCI. The mandibular cortical index is inversely correlated with the peripheral densitometry results within the study ethnic population.
Acute hemodialysis in a young man with severe symptomatic hyponatremia and kidney injury
Authors: Courteau Catherine , Al Khoury Alex , Michel Rene P. , Weber Catherine L.
Published: January 2018

A 35‐year‐old man presented with severe hypo‐osmolar hyponatremia (serum sodium 99 mmol/L), profound nonoliguric renal failure (serum creatinine 1240 μmol/L), and nephrotic range proteinuria. Computed tomography of the abdomen revealed nephromegaly and no obstruction. The patient was admitted to the intensive care unit (ICU) and conventional hemodialysis was initiated. To avoid rapid sodium correction, we prescribed concurrent dialysate flow, a low dialysate sodium concentration, a small surface area dialyzer, and a low blood flow rate. We infused dextrose 5% water into the venous return line and adjusted the infusion rate according to hourly sodium concentration. The rate of sodium correction was 7.7 mmol/day over the first 3 days of admission. A subsequent renal biopsy revealed focal segmental glomerulosclerosis and interstitial infiltration with extranodal NK/T‐cell lymphoma nasal type. The patient died of massive lower gastrointestinal bleeding secondary to lymphomatous involvement day 19 in the ICU. In the setting of acute kidney injury requiring renal replacement therapy and concomitant severe hyponatremia, it is challenging to avoid overcorrection of serum sodium. We describe several key prescription modifications to conventional hemodialysis, factors that affect sodium diffusion at the level of the dialyzer membrane, and the importance of frequent laboratory monitoring.
Removal of vancomycin administered during dialysis by a high‐flux dialyzer
Authors: Nyman Heather A. , Agarwal Adhish , Senekjian Harry O. , Leypoldt John K. , Cheung Alfred K.
Published: January 2018

Introduction: Hemodialysis patients frequently receive vancomycin for treatment of gram‐positive bacterial infections. This drug is most conveniently administered in outpatient dialysis units during the hemodialysis treatment. However, there is a paucity of data on the removal of vancomycin by high‐flux polyamide dialyzers.

Methods: This is a prospective crossover study in which seven uninfected chronic hemodialysis patients at three dialysis units received vancomycin 1 gram intravenously over one hour immediately after the dialysis treatment (Phase 1), and vancomycin 1.5 grams during the last hour of dialysis treatment using a polyarylethersulfone, polyvinylpyrrolidone, polyamide high‐flux (Polyflux 24R) dialyzer (Phase 2). There was a three‐week washout period between phases. Serial serum vancomycin concentrations were used to determine the removal of vancomycin when administered during dialysis.

Findings: Dialysis removed 35 ± 15% (range 18‐56%) of the vancomycin dose when administered during the last hour of dialysis. The calculated area under the curve (AUC) of vancomycin levels for 0‐44.5 hours from the start of infusion were similar between the two phases (AUCPhase 1 884 ± 124 mg‐hr/L, mean ± SD; AUCPhase 2 856 ± 208 mg‐hr/L; P=0.72). Serum vancomycin concentrations immediately prior to the next dialysis treatment following vancomycin administration were also similar between the two phases (13.1 ± 2.7 mg/L in Phase 1 and 12.3 ± 3.3 mg/L in Phase 2; P=0.55).

Discussion: When using a polyarylethersulfone, polyvinylpyrrolidone, and polyamide high‐flux HD membrane with a 24R Polyflux dialyzer, vancomycin can be administered during the last hour of dialysis if the dose that is prescribed for intra‐dialysis dosing is empirically increased to account for intra‐dialytic drug removal.
New practical methods to obtain crucial data in performing diagnostic meta‐analysis of the published literature
Authors: Ma Xuelei , Zeng Hao , Zhang Jing , Chen Linyan , Jia Hongyuan
Published: January 2018

Aim

Found some new methods that can be used to obtain values such as true positives (TP), false negatives (FN), false positives (FP), and true negatives (TN) which did not provide in diagnostic meta‐analysis indirectly.

Methods

Using mathematical deduction and programming calculus.

Results

We have succeeded in increasing the number of articles that can be used from two(228 patients) to five(469 patients) by using our new method.

Conclusion

Using these methods, it can greatly increase the number of the inclusion articles, as well as the number of inclusion patients, which will contribute to improve the persuasiveness and comprehensiveness of diagnostic meta‐analysis.
Effects of lactoperoxidase system‐alginate coating on chemical, microbial, and sensory properties of chicken breast fillets during cold storage
Authors: Yousefi Mohammad , Farshidi Maryam , Ehsani Ali
Published: January 2018

The main aim of this study was to investigate the effect of alginate coating samples without lactoperoxidase system (A‐L 0) and alginate coating samples containing lactoperoxidase system (LPOS) at levels of 2% (A‐L 2), 4% (A‐L 4), and 6% (A‐L 6) on the shelf‐life of chicken breast fillets. Chemical tests, including total volatile basic nitrogen (TVB‐N), peroxide value (PV), pH, thiobarbituric acid reactive substances (TBARS), and free fatty acids (FFA), bacteriological tests of aerobic mesophilic bacteria (AMB), lactic acid bacteria (LAB), Pseudomonas aeruginosa, and Enterobacteriaceae and sensory analyses, including odor, transparency, color, and overall acceptability were performed. These coatings (especially A‐L 6), despite the effect on decreasing the formation of TVB‐N compounds (27.82 for control samples, and 21.72 mg N/100 g for A‐L 6 samples) had no significant impact (p > .05) on FFA, PV, and TBARS. The LPOS‐alginate coating was effective against Enterobacteriaceae, Pseudomonas aeruginosa, and aerobic mesophilic bacteria (AMB). Also, A‐L 6 samples got acceptable sensory results. Overall acceptability of A‐L 0 and A‐L 6 samples were 3.21 ± 0.36 and 6.23 ± 0.38, respectively on the last day. These scores are significantly different (p < .05). Generally, results demonstrated a positive effect of alginate‐LPOS coatings on shelf‐life extension of chicken breast fillets during cold storage.

Practical applications

Concerning the effect of alginate coating incorporated with lactoperoxidase system on controlling the bacterial growth and improving the shelf‐life of chicken breast fillets, such coating could has practical applications in increasing the food safety in meats and meat products.
Risk for the development of non‐alcoholic fatty liver disease: A prospective study
Authors: Wang Jinghua , Ma Liang , Chen Shenghui , Xu Lei , Miao Min , Yu Chaohui , Li Youming , Xu Chengfu
Published: January 2018

Background and Aim

Non‐invasive assessment was widely used to identify the risk of non‐alcoholic fatty liver disease (NAFLD) among individuals with increased metabolic risks. This study aimed to investigate the prospective relationship between ZJU index and the development of NAFLD in a Chinese population.

Methods

A cohort of 6310 initially NAFLD‐free participants was enrolled in this prospective study. Abdominal ultrasound was used to diagnosis NAFLD. NAFLD incidence was calculated among participants with different baseline ZJU index quintiles. Cox proportional hazards regression analyses were conducted to calculate the risks for incident NAFLD.

Results

During 37 705 person‐year follow‐ups, 1071 incident NAFLD cases were identified. The baseline ZJU index was linear and positively correlated with NAFLD incidence. The incidence was 5.53, 11.75, 23.77, 43.28, and 85.60 cases per 1000 person‐year follow‐up for participants with baseline ZJU index in quintiles 1–5, respectively. Compared with participants with baseline ZJU index in quintile 1, the hazard ratios (95% confidence interval) for incident NAFLD were 2.092 (1.458–3.002), 4.094 (2.942–5.698), 7.095 (5.167–9.742), and 13.191 (9.684–17.968) for participants with baseline ZJU index in quintiles 2–5, respectively. Further analysis found that the changes of ZJU index during follow‐up was also independently associated with risk for incident NAFLD.

Conclusions

Baseline ZJU index and absolute ZJU index changes independently predicts the risk for incident NAFLD in Chinese population.
Cellulose synthase ‘class specific regions’ are intrinsically disordered and functionally undifferentiated
Authors: Scavuzzo‐Duggan Tess R. , Chaves Arielle M. , Singh Abhishek , Sethaphong Latsavongsakda , Slabaugh Erin , Yingling Yaroslava G. , Haigler Candace H. , Roberts Alison W.
Published: January 2018

Cellulose synthases (CESAs) are glycosyltransferases that catalyze formation of cellulose microfibrils in plant cell walls. Seed plant CESA isoforms cluster in six phylogenetic clades, whose non‐interchangeable members play distinct roles within cellulose synthesis complexes (CSCs). A ‘class specific region’ (CSR), with higher sequence similarity within versus between functional CESA classes, has been suggested to contribute to specific activities or interactions of different isoforms. We investigated CESA isoform specificity in the moss, Physcomitrella patens (Hedw.) B. S. G. to gain evolutionary insights into CESA structure/function relationships. Like seed plants, P. patens has oligomeric rosette‐type CSCs, but the PpCESAs diverged independently and form a separate CESA clade. We showed that P. patens has two functionally distinct CESAs classes, based on the ability to complement the gametophore‐negative phenotype of a ppcesa5 knockout line. Thus, non‐interchangeable CESA classes evolved separately in mosses and seed plants. However, testing of chimeric moss CESA genes for complementation demonstrated that functional class‐specificity is not determined by the CSR. Sequence analysis and computational modeling showed that the CSR is intrinsically disordered and contains predicted molecular recognition features, consistent with a possible role in CESA oligomerization and explaining the evolution of class‐specific sequences without selection for class‐specific function.
Management of comedonal acne vulgaris with fixed‐combination topical therapy
Authors: Gold Michael H , Baldwin Hilary , Lin Tina
Published: January 2018

Background

Acne vulgaris (acne) is the most common skin disease we see in dermatology practice. Clinically, it is characterized by a combination of open and closed comedones (formally referred to as noninflammatory lesions) and inflammatory papules and pustules. Comedonal acne is more typical in young adolescents, but can occur in combination with inflammatory papules and pustules at any time. Topical retinoids have long been advocated for the treatment of comedonal acne.

Aims

Given the increasing recognition of the inflammatory nature of acne and the synergistic benefits seen with fixed combinations we review the latest clinical data to provide guidance on optimal management of comedonal acne.

Methods

An English language literature search of Medline, EMBASE, and the Web of Science using key terms (acne, comedonal, noninflammatory, clinical trials) was conducted, and relevant articles reviewed.

Results

Comparative data is sparse, but we show the importance of fixed combinations with and without retinoids, where treatment benefits are comparable. Adapalene 0.1%‐benzoyl peroxide 2.5% gel has been shown to be comparable to clindamycin 1%‐benzoyl peroxide 5% gel, and adapalene 0.3%‐benzoyl peroxide 2.5% gel. A meta‐analysis suggested that clindamycin 1.2%‐benzoyl peroxide 2.5% gel was more effective than clindamycin‐benzoyl peroxide 5% gel in noninflammatory lesions, and two equivalent clinical programs suggest additional benefits of higher doses of benzoyl peroxide (3.75% vs 2.5%) in this fixed combination.

Conclusions

Clindamycin 1.2%‐benzoyl peroxide 3.75% gel may afford similar benefits to adapalene 0.3%‐benzoyl peroxide 2.5% gel in this sometimes difficult to treat patient population.
Metabolomic response to coffee consumption: application to a three‐stage clinical trial
Authors: Cornelis M. C. , Erlund I. , Michelotti G. A. , Herder C. , Westerhuis J. A. , Tuomilehto J.
Published: January 2018

Background

Coffee is widely consumed and contains many bioactive compounds, any of which may impact pathways related to disease development.

Objective

To identify individual metabolite changes in response to coffee.

Methods

We profiled the metabolome of fasting serum samples collected from a previously reported single‐blinded, three‐stage clinical trial. Forty‐seven habitual coffee consumers refrained from drinking coffee for 1 month, consumed four cups of coffee/day in the second month and eight cups/day in the third month. Samples collected after each coffee stage were subject to nontargeted metabolomic profiling using UPLC‐ESI‐MS/MS. A total of 733 metabolites were included for univariate and multivariate analyses.

Results

A total of 115 metabolites were significantly associated with coffee intake (P < 0.05 and Q < 0.05). Eighty‐two were of known identity and mapped to one of 33 predefined biological pathways. We observed a significant enrichment of metabolite members of five pathways (P < 0.05): (i) xanthine metabolism: includes caffeine metabolites, (ii) benzoate metabolism: reflects polyphenol metabolite products of gut microbiota metabolism, (iii) steroid: novel but may reflect phytosterol content of coffee, (iv) fatty acid metabolism (acylcholine): novel link to coffee and (v) endocannabinoid: novel link to coffee.

Conclusions

The novel metabolites and candidate pathways we have identified may provide new insight into the mechanisms by which coffee may be exerting its health effects.
Novel application of internal obturator and semitendinosus muscle flaps for rectal wall repair or reinforcement
Authors: Riggs J. , Ladlow J. F. , Owen L. J. , Hall J. L.
Published: January 2018

Internal obturator and/or semitendinosus muscle flaps were used to reinforce primary appositional rectal wall repair in three dogs and one cat in this case series. All three dogs incurred rectal wall compromise during surgical excision of anal sac tumours. The cat sustained bite wounds to the perianal region resulting in abscessation and a rectal tear. Our results indicate that application of an internal obturator and/or semitendinosus muscle flap can reduce the risk of rectal wall dehiscence after primary repair, and consequently the risk of pararectal abscess or rectocutaneous fistula formation.
Role of clarity of other's feelings for dyadic coping
Authors: LEUCHTMANN LORENA , ZEMP MARTINA , MILEK ANNE , NUSSBECK FRIDTJOF W. , BRANDSTÄTTER VERONIKA , BODENMANN GUY
Published: January 2018

Dyadic coping has repeatedly been associated with positive outcomes in intimate relationships. However, less is known about the prospective predictors of dyadic coping. This study investigates clarity of other's feelings (CoF) as a potential predictor of supportive dyadic coping in a longitudinal study. In a sample of 368 couples, self‐reported CoF and supportive dyadic coping perceived by the partner were assessed annually over 3 years. Results revealed that interpersonal differences in men and women's CoF are positively associated with interpersonal differences in supportive dyadic coping. Moreover, interpersonal differences in men's CoF predicted long‐term intrapersonal changes in supportive dyadic coping of both partners. Couple intervention programs might strengthen couple's dyadic coping skills by targeting men's understanding of their partner's feelings.
Extracorporeal photopheresis as second‐line treatment therapy in life‐threatening primary graft dysfunction following lung transplantation
Authors: Robinson Cécile A , Inci Ilhan , Naegeli Mirjam , Murer Christian , Schuurmans Macé M , Urosevic‐Maiwald Mirjana , Schüpbach Reto , Weder Walter , Benden Christian
Published: January 2018

ECP is an established “second‐line” treatment for CLAD/BOS. Recently, ECP was used for the first time in an adolescent CF patient as a “second‐line” treatment therapy in life‐threatening primary graft dysfunction following lung transplantation who deteriorated despite extensive treatment including ECMO and ATG. Within 10 days after initiation of ECP twice weekly, allograft function and clinical status improved significantly and the patient was weaned from mechanical ventilation support. ECP has been continued every 2 weeks since. Two hundred days after lung transplantation, the patient has an acceptable allograft function (FEV1 67%) and no signs of allograft rejection. We advocate that use of ECP and its immunomodulatory effects should be evaluated in the early period following lung transplantation.
Leishmania amazonensis induces modulation of costimulatory and surface marker molecules in human macrophages
Authors: Costa S. S. , Fornazim M. C. , Nowill A. E. , Giorgio S.
Published: January 2018

Manipulation of costimulatory and surface molecules that shape the extent of immune responses by Leishmania is suggested as one of the mechanisms of evading the host's defences. The experiments reported here were designed to evaluate the expressions of CD11b, CD11c, CD14, CD18, CD54, CD80, CD86, CD206, MHC class II and TLR‐2 (Toll‐like receptor 2) in human macrophages infected with L. amazonensis. Phenotypic evaluation revealed a negative modulation in CD11b, CD11c, CD14, CD18, CD54 and MHC class II molecules, depending on the level of infection. The results showed that as early as 1 hour after infection no reduction in marker expression occurs, whereas after 24 hours, downregulation of these molecules was observed in macrophages. No significant changes were observed in the expressions of CD80, CD86, CD206 and TLR2. Evidence of the differential modulation of markers expression and that after parasite uptake no reduction in surface marker expression occurs indicates that parasite internalization is not involved in the phenomena of down‐modulation.
Evaluating the importance of the tan spot ToxA–Tsn1 interaction in Australian wheat varieties
Authors: See P. T. , Marathamuthu K. A. , Iagallo E. M. , Oliver R. P. , Moffat C. S.
Published: January 2018

The necrotrophic fungal pathogen Pyrenophora tritici‐repentis (Ptr) causes the major wheat disease tan spot, and produces multiple necrotrophic effectors that contribute to virulence. The proteinaceous effector ToxA induces necrosis in wheat genotypes possessing the Tsn1 gene, although the importance of the ToxA–Tsn1 interaction itself in varietal disease development has not been well studied. Here, 40 Australian spring wheat varieties were assessed for ToxA sensitivity and disease response to a race 1 wildtype Ptr isolate and ToxA‐deleted strain at both seedling and tillering growth stages. ToxA sensitivity was generally associated with disease susceptibility, but did not always predict spreading necrotic symptoms. Whilst the majority of Tsn1 varieties exhibited lower disease scores following toxa mutant infection, several exhibited no distinct differences between wildtype and toxa symptoms. This implies that ToxA is not the major determinant in tan spot disease development in some host backgrounds and indicates the presence of additional effectors. Unexpectedly, several tsn1 varieties exhibited a reduction in disease severity following toxa mutant inoculation, which may suggest an indirect role for ToxA in pathogen fitness. Additionally, increased chlorosis was observed following toxa mutant infection in three varieties, and further work is required to determine whether this is likely to be due to ToxA epistasis of ToxC symptoms. Taken together, these observations demonstrate that Ptr interacts with the host in a complex and intricate manner, leading to a variety of disease reactions that are dependent or independent of the ToxA–Tsn1 interaction.
Pregnancy Weight Gain by Gestational Age in Women with Uncomplicated Dichorionic Twin Pregnancies
Authors: Hutcheon Jennifer A. , Platt Robert W. , Abrams Barbara , Braxter Betty J. , Eckhardt Cara L. , Himes Katherine P. , Bodnar Lisa M.
Published: January 2018

Background

Twin pregnancies are at increased risk for adverse outcomes and are associated with greater gestational weight gain compared to singleton pregnancies. Studies that disentangle the relationship between gestational duration, weight gain and adverse outcomes are needed to inform weight gain guidelines. We created charts of the mean, standard deviation and select percentiles of maternal weight gain‐for‐gestational age in twin pregnancies and compared them to singleton curves.

Methods

We abstracted serial prenatal weight measurements of women delivering uncomplicated twin pregnancies at Magee‐Womens Hospital (Pittsburgh, PA, 1998–2013) and merged them with the hospital's perinatal database. Hierarchical linear regression was used to express pregnancy weight gain as a smoothed function of gestational age according to pre‐pregnancy BMI category. Charts of week‐ and day‐specific values for the mean, standard deviation, and percentiles of maternal weight gain were created.

Results

Prenatal weight measurements (median: 11 [interquartile range: 9, 13] per woman) were available for 1109 women (573 normal weight, 287 overweight, and 249 obese). The slope of weight gain was most pronounced in normal weight women and flattened with increasing pre‐pregnancy BMI (e.g. 50th percentiles of 6.8, 5.7, and 3.6 kg at 20 weeks and 19.8, 18.1, and 14.4 at 37 weeks in normal weight, overweight, and obese women, respectively). Weight gain patterns in twins diverged from singletons after 17–19 weeks.

Conclusions

Our charts provide a tool for the classification of maternal weight gain in twin pregnancies. Future work is needed to identify the range of weight gain associated with optimal pregnancy health outcomes.
T‐cell cross‐reactivity may explain the large variation in how cancer patients respond to checkpoint inhibitors
Authors: Sioud Mouldy
Published: January 2018

The therapeutic use of the immune system to specifically attack tumours has been a long‐standing vision among tumour immunologists. Recently, the use of checkpoint inhibitors to turn‐off immunosuppressive signals has proven to be effective in enhancing T‐cell reactivity against patient‐specific neoantigens, resulting from somatic mutations. Several of the identified T‐cell epitopes share similarity with common bacterial and viral antigens, suggesting the involvement of pre‐existing microbial cross‐reactive T cells in rapid and durable tumour regression seen in some patients. This notion of T‐cell cross‐reactivity is further supported by the findings that intestinal bacteria can influence checkpoint‐blockade therapy. Moreover, early data indicate the presence of such T cells in long‐term survival breast cancer patients. This review highlights the main challenges for cancer immunotherapy and discusses the potential contribution of T‐cell cross‐reactivity in cancer immunotherapy and whether it can be used as a biomarker to predict the responsiveness to checkpoint inhibitors.
Identification of a novel HLA‐C allele, HLA‐C*15:151, in a Taiwanese individual
Authors: Yang K. L. , Lin P. Y.
Published: January 2018

One nucleotide substitution in codon 240 of HLA‐C*15:02:01:01 results in a novel allele, HLA‐C*15:151.
Platelet sequestration with a new‐generation autotransfusion device
Authors: Seyfried Timo F. , Streithoff Fabian , Gruber Michael , Unterbuchner Christoph , Zech Nina , Kieninger Martin , Hansen Ernil
Published: January 2018

BACKGROUND

Autologous platelet‐rich plasma (PRP) can be used either to prevent platelets (PLTs) from lesions during extracorporeal circulation or for wound therapy, when processed into PLT gel. The aim of this study was to evaluate the PLT sequestration abilities of a new‐generation autotransfusion device.

STUDY DESIGN AND METHODS

In this experimental study the discontinuous, new‐generation autotransfusion device XTRA was evaluated using fresh donor blood. The blood was processed in four different size bowls (X55, X125, X175, X225 [bowls' size in mL]) using the device's built‐in “PLT sequestration program.” PLT functionality was tested using aggregometry; for PLT activation, β‐thromboglobulin (β‐TG) and soluble P‐selectin levels were determined. Cell damage was assessed by a morphology score and hypotonic shock response. Additionally, PLTs were tested after 6 hours to identify storage lesions.

RESULTS

Platelet recovery in the PRP ranged from 39% to 64% and averaged 6.2‐fold PLT enrichment as defined by the increase in PLT concentration. The preparation caused minimal cell damage and a decrease in cell function by only 10%, but a slight activation was observed amounting to 9% of the maximal β‐TG release. The efficiency of the preparation, represented by the PLT recovery rate, increased in a linear fashion with the increasing bowl sizes being tested. After 6 hours of storage the prepared PLTs showed an additional 9% loss in function, but only 4% decrease in viability.

CONCLUSION

The autotransfusion device XTRA was capable of high‐quality perioperative PRP preparation, and the bowl size was found to have an influence on the efficiency of the preparation.
Accurate costs of blood transfusion: a microcosting of administering blood products in the United Kingdom National Health Service
Authors: Stokes Elizabeth A. , Wordsworth Sarah , Staves Julie , Mundy Nicola , Skelly Jane , Radford Kelly , Stanworth Simon J.
Published: January 2018

BACKGROUND

In an environment of limited health care resources, it is crucial for health care systems which provide blood transfusion to have accurate and comprehensive information on the costs of transfusion, incorporating not only the costs of blood products, but also their administration. Unfortunately, in many countries accurate costs for administering blood are not available. Our study aimed to generate comprehensive estimates of the costs of administering transfusions for the UK National Health Service.

STUDY DESIGN AND METHODS

A detailed microcosting study was used to cost two key inputs into transfusion: transfusion laboratory and nursing inputs. For each input, data collection forms were developed to capture staff time, equipment, and consumables associated with each step in the transfusion process. Costing results were combined with costs of blood product wastage to calculate the cost per unit transfused, separately for different blood products. Data were collected in 2014/15 British pounds and converted to US dollars.

RESULTS

A total of 438 data collection forms were completed by 74 staff. The cost of administering blood was $71 (£49) per unit for red blood cells, $84 (£58) for platelets, $55 (£38) for fresh‐frozen plasma, and $72 (£49) for cryoprecipitate.

CONCLUSIONS

Blood administration costs add substantially to the costs of the blood products themselves. These are frequently incurred costs; applying estimates to the blood components supplied to UK hospitals in 2015, the annual cost of blood administration, excluding blood products, exceeds $175 (£120) million. These results provide more accurate estimates of the total costs of transfusion than those previously available.
Neural crest‐derived cells migrate from nerve to participate in Achilles tendon remodeling
Authors: Xu Kang , Pan Xin , Qiu Xuefeng , Wang Dong , Dong Nianguo , Yang Li , Li Song
Published: January 2018

During tendon injury, nerve ingrowth is one of the earliest events of tendon repair and remodeling. Since peripheral neurons and associated cells are mostly derived from neural crest (NC) cells, we sought to investigate the role of NC‐derived cells in tendon regeneration. Thus, we used Sox10‐Cre/ROSA26‐Flox‐Red Fluorescent Protein (RFP) transgenic mice to trace these cells during tendon regeneration. After 4 weeks of Achilles tendon rupture, the injured tendon tissues were harvested for immunohistological analyses, cell isolation, and phenotype identification. In addition, the tenocytes were co‐cultured with RFP labeled cells to examine cellular functions. Following the injury, a significant number of RFP‐labeled cells penetrated into the wound site and reached a peak (∼30% of cells) after 2 weeks, and then stabilized at a level of approximately 20%. Interestingly, 36.9% RFP labeled cells in the injured area expressed Tuj1, suggesting that most of the cells are peripheral neurons. Some RFP+/Tuj1+ cells were also found adjacent to newly formed blood vessels in the tendon. Importantly, the existing neuropeptide Y (NPY) and neuropeptide Y receptor (NPYr) in the invading nerve and blood vessels were directly correlated. In addition, there were also RFP+ cells (∼30%) negative for neuronal markers but positive for fibroblast markers, that is, FAP (34.7%) and Vimentin (Vmt) (27.2%), and approximately 10% positive for Sox10. Indeed, many RFP+ cells isolated from the ruptured Achilles tendon showed long spindle shapes and expressed fibroblast phenotypic markers FSP1 and FAP. Part of the Sox10+RFP‐labeled cells exhibited osteogenic and adipogenic differentiation ability. It is concluded that after Achilles tendon injury, nerves sprout into the wound site. The NC‐derived Vmt+/FAP+ mesenchymal cells and peripheral nerves participate in tendon regeneration.
Effect of Local Coil Density on Blood Flow Stagnation in Densely Coiled Cerebral Aneurysms: A Computational Study Using a Cartesian Grid Method
Authors: Otani Tomohiro , Shindo Takuya , Ii Satoshi , Hirata Masayuki , Wada Shigeo
Published: January 2018

Aneurysm recurrence is the most critical concern following coil embolization of a cerebral aneurysm. Adequate packing density (PD) and coil uniformity are believed necessary to achieve sufficient flow stagnation, which decreases the risk of aneurysm recurrence. The effect of coil distribution on the extent of flow stagnation, however, especially in cases of dense packing (high PD), has received less attention. Thus, the cause of aneurysm recurrence despite dense packing is still an open question. The primary aim of this study is to evaluate the effect of local coil density on the extent of blood flow stagnation in densely coiled aneurysms. For this purpose, we developed a robust computational framework to determine blood flow using a Cartesian grid method, by which the complex fluid pathways in coiled aneurysms could be flexibly treated using an implicit function. This tool allowed us to conduct blood flow analyses in two patient-specific geometries with 50 coil distribution patterns in each aneurysm at clinically adequate PD. The results demonstrated that dense packing in the aneurysm may not necessarily block completely the inflow into the aneurysm and local flow that formed in the neck region, whose strength was inversely related to this local PD. This finding suggests that local coil density in the neck region still plays an important role in disturbing the remaining local flow, which possibly prevents thrombus formation in a whole aneurysm sac, increasing the risk of aneurysm regrowth and subsequent recurrence.
Slipping Dynamics of Slender-Beam Payloads During Lay-Down Operations
Authors: Wang Shenghai , Ferri Aldo , Singhose William
Published: January 2018

When laying down a long slender beam from a near-vertical orientation, to a horizontal position on a flat surface, the payload may slip and move suddenly in unintended and unpredictable ways. This occurs during crane operations when the movements of the overhead trolley and lowering of the hoist cable are not properly coordinated. The payload's unintended sliding can potentially cause damage and injure people. This paper presents static and dynamic analyses of slender-beam payload lay-down operations that establish a structured method to predict the safe conditions for lay-down operations. Also, a new method to measure the friction coefficient of surface-to-line contact is proposed. Lay-down experiments are carried out to verify the theoretical predictions.
Investigation of Flow Dynamics Over Transitional-Type Microcavity
Authors: Vilkinis Paulius , Pedišius Nerijus , Valantinavičius Mantas
Published: January 2018

Flow over a transitional-type cavity in microchannels is studied using a microparticle image velocimetry system (μPIV) and commercially available computational fluid dynamics (CFD) software in laminar, transitional, and turbulent flow regimes. According to experimental results, in the transitional-type cavity (L/h1 = 10) and under laminar flow in the channel, the recirculation zone behind the backward-facing step stretches linearly with ReDh until the reattachment point reaches the middle of the cavity at xr/L = (0.5 to 0.6). With further increase in ReDh, the forward-facing step lifts the reattaching flow from the bottom of the cavity and stagnant recirculation flow fills the entire space of the cavity. Flow reattachment to the bottom of the cavity is again observed only after transition to the turbulent flow regime in the channel. Reynolds-averaged Navier–Stokes (RANS) equations and large eddy simulation (LES) results revealed changes in vortex topology, with the flow regime changing from laminar to turbulent. During the turbulent flow regime in the recirculation zone, periodically recurring vortex systems are formed. Experimental and computational results have a good qualitative agreement regarding the changes in the flow topology. However, the results of numerical simulations based on RANS equations and the Reynolds-stress-baseline turbulence model (RSM-BSL), show that computed reattachment length values overestimate the experimentally obtained values. The RSM-BSL model underestimates the turbulent kinetic energy intensity, generated by flow separation phenomena, on the stage of transitional flow regime.
Springing Responses Analysis and Segmented Model Test on a 550,000 Dead Weight Tonnage Ore Carrier
Authors: Li Hui , Wang Di , Zhou Chen-Ming , Zhang Kai-Hong , Ren Hui-Long
Published: January 2018

In hydroelastic model tests, segmented ship models are usually used to make sure that the model scale and the full size ship satisfy the similarity law of structural natural frequency and distribution of ship bending stiffness. However, springing barely occurs in those tests because the natural frequency of segmented ship models is too high for the regular waves required to be generated in a tank. In order to investigate the springing effect, three sets of backbone of variable cross section are adopted in the test. One set of backbones satisfies the similarity law of natural frequency, and two extra sets of low stiffness backbones are used so that the springing effect can appear and be measured. Experimental results show that the springing occurs when the wave encounter frequency coincides with the first elastic natural frequency of the ship, or with half or one-third of it. A good agreement has also been obtained between the experimental and the numerical results by a three-dimensional (3D) hydroelasticity method. Based on these results, the contribution of the springing responses to the fatigue damage of the ship is estimated and analyzed.
Influence of Donut-Shaped Bump on the Hydrodynamic Lubrication of Textured Parallel Sliders
Authors: Fu Hao , Ji Jinghu , Fu Yonghong , Hua Xijun
Published: January 2018

The influence of donut-shaped bump texture on the hydrodynamic lubrication performance for parallel surfaces is presented in this paper. A mathematical equation has been applied to express the shape of three-dimensional donut-shaped bump texture. Numerical simulation of the pressure distribution of lubricant between a textured slider and a smooth, moving slider has been performed to analyze the geometrical parameters' influence on the hydrodynamic performance for textured surfaces. The numerical results show that the convex of the donut-shaped bump provides a microstep slider, which can form a convergent wedge and build up hydrodynamic pressure. Optimum values of horizontal spacing and bump height are obtained to maximize the hydrodynamic pressure. It is also noted that the average pressure increases monotonically with the increase of bump radius, but decreases with the increase of vertical spacing and dimple depth, respectively.
Evaluation of Contact Fatigue Life of a Wind Turbine Gear Pair Considering Residual Stress
Authors: Liu Heli , Liu Huaiju , Zhu Caichao , He Haifeng , Wei Peitang
Published: January 2018

Contact fatigue is a main fatigue mode of gears such as those used in wind turbines, due to heavy duties occurring in engineering practice. The understanding of the gear contact fatigue should be based on the interaction between the local material strength and the stress state. Under the rolling–sliding motion, the multi-axial stress state makes the gear contact fatigue problem more complicated. A numerical contact model is proposed to evaluate the contact fatigue life of an intermediate parallel gear stage of a megawatt level wind turbine gearbox. The gear meshing theory is applied to calculate the geometry kinematics parameters of the gear pair. The gear contact is assumed as a plane strain contact problem without the consideration of the influence of the helical angle. The quasi-static tooth surface load distribution is assumed along the line of action. The elastic mechanics theory is used to calculate the elastic stress field generated by surface tractions. The discrete convolute, fast Fourier transformation method is applied to estimate the subsurface stresses distributions. In order to describe the time-varying multi-axial stress states during contact, the Matake, Findley, and Dang Van multi-axial fatigue criteria are used to calculate the critical planes and equivalent stresses. Both the statistic and the deterministic fatigue life models are applied by choosing the Lundberg–Palmgren (LP), Zaretsky models, respectively. The effect of the residual stress distribution on the contact fatigue initiation lives is discussed. In addition, the crack propagation lives are estimated by using the Paris theory.
Validation of a Custom Instrumented Retainer Form Factor for Measuring Linear and Angular Head Impact Kinematics
Authors: Miller Logan E. , Kuo Calvin , Wu Lyndia C. , Urban Jillian E. , Camarillo David B. , Stitzel Joel D.
Published: January 2018

Head impact exposure in popular contact sports is not well understood, especially in the youth population, despite recent advances in impact-sensing technology which has allowed widespread collection of real-time head impact data. Previous studies indicate that a custom-instrumented mouthpiece is a superior method for collecting accurate head acceleration data. The objective of this study was to evaluate the efficacy of mounting a sensor device inside an acrylic retainer form factor to measure six-degrees-of-freedom (6DOF) head kinematic response. This study compares 6DOF mouthpiece kinematics at the head center of gravity (CG) to kinematics measured by an anthropomorphic test device (ATD). This study found that when instrumentation is mounted in the rigid retainer form factor, there is good coupling with the upper dentition and highly accurate kinematic results compared to the ATD. Peak head kinematics were correlated with r2 > 0.98 for both rotational velocity and linear acceleration and r2 = 0.93 for rotational acceleration. These results indicate that a rigid retainer-based form factor is an accurate and promising method of collecting head impact data. This device can be used to study head impacts in helmeted contact sports such as football, hockey, and lacrosse as well as nonhelmeted sports such as soccer and basketball. Understanding the magnitude and frequency of impacts sustained in various sports using an accurate head impact sensor, such as the one presented in this study, will improve our understanding of head impact exposure and sports-related concussion.
The Evolution and Learner-Centered Status of a Coach Education Program
Authors: Paquette Kyle , Trudel Pierre
Published: January 2018

The history of coach education in Western countries, much like higher education, has been shaped by societal influences and external drivers. The resulting trajectory includes a notable movement and shift in focus related to educational paradigms. Being learner-centered (LC) has become a central theme and mission by many coach education programs. The purpose of this case study was twofold: to explore the evolution of the historically rich coach education program of golf in Canada, and to assess the LC status of the most recently developed context of the program using Blumberg’s (2009) framework for developing and assessing learner-centered teaching (LCT). A series of program documents and interviews with seven coach development administrators involved in the program were analyzed. Findings revealed the turbulent epistemic evolution of the program and its pedagogical approaches, as well as the combination of internal and external drivers that triggered the shift from one extreme (instructor-centered teaching) to another (LCT) until finding a functional equilibrium. Moreover, the assessment of the program confirmed its claims of being LC. Discussions are presented on leading a LC change, facilitating learning, and using the framework to assess LC coach education.
The Surfing Coaching: Sources of Knowledge Acquisition
Authors: Correia Marco Catarino Espada Estêvão , Bertram Rachael
Published: January 2018

A career as a surfing coach is a relatively recent profession, and has not yet been the subject of extensive research. The aim of the present study was to investigate the specific sources of knowledge acquisition of surfing coaches. Individual semi-structured open-ended interviews were conducted with 11 expert surfing coaches. Results revealed that their knowledge acquisition was similar in many ways. Their formal higher education provided them with training in sport sciences and physical education pedagogy, as well as their athletes’ surfing experiences. Their knowledge base was further developed by acquiring additional information through surfing coaching courses, books, and the use of the Internet.
KIF22 coordinates CAR and EGFR dynamics to promote cancer cell proliferation
Authors: Pike Rosemary , Ortiz-Zapater Elena , Lumicisi Brooke , Santis George , Parsons Maddy
Published: January 2018

The cell junction–associated receptor CAR coordinates the dynamics between EGFR signaling and the cytoskeleton during cell proliferation.
Characterization of a Unique Outer Membrane Protein Required for Oxidative Stress Resistance and Virulence of Francisella tularensis
Authors: Alqahtani Maha , Ma Zhuo , Ketkar Harshada , Suresh Ragavan Varadharajan , Malik Meenakshi , Bakshi Chandra Shekhar
Published: January 2018

Francisella tularensis
, the causative agent of tularemia, lacks typical bacterial virulence factors and toxins but still exhibits extreme virulence. The bacterial multidrug efflux systems consist of an inner membrane, a transmembrane membrane fusion protein, and an outer membrane (OM) component that form a contiguous channel for the secretion of a multitude of bacterial products.
Francisella
contains three orthologs of the OM proteins; two of these, termed TolC and FtlC, are important for tularemia pathogenesis. The third OM protein, SilC, is homologous to the silver cation efflux protein of other bacterial pathogens. The
silC
gene (
FTL_0686
) is located on an operon encoding an Emr-type multidrug efflux pump of
F. tularensis
. The role of SilC in tularemia pathogenesis is not known. In this study, we investigated the role of SilC in secretion and virulence of
F. tularensis
by generating a
silC
gene deletion (Δ
silC
) mutant and its transcomplemented strain. Our results demonstrate that the Δ
silC
mutant exhibits increased sensitivity to antibiotics, oxidants, silver, diminished intramacrophage growth, and attenuated virulence in mice compared to wild-type
F. tularensis
. However, the secretion of antioxidant enzymes of
F. tularensis
is not impaired in the Δ
silC
mutant. The virulence of the Δ
silC
mutant is restored in NADPH oxidase-deficient mice, indicating that SilC resists oxidative stress
in vivo
. Collectively, this study demonstrates that the OM component SilC serves a specialized role in virulence of
F. tularensis
by conferring resistance against oxidative stress and silver.

IMPORTANCE
Francisella tularensis
, the causative agent of a fatal human disease known as tularemia, is a category A select agent and a potential bioterror agent. The virulence mechanisms of
Francisella
are not completely understood. This study investigated the role of a unique outer membrane protein, SilC, of a multidrug efflux pump in the virulence of
F. tularensis
. This is the first report demonstrating that the OM component SilC plays an important role in efflux of silver and contributes to the virulence of
F. tularensis
primarily by providing resistance against oxidative stress. Characterization of these unique virulence mechanisms will provide an understanding of the pathogenesis of tularemia and identification of potential targets for the development of effective therapeutics and prophylactics for protection from this lethal disease.