bluuebunny/crossref_metadata_2025_split huggingface dataset:
The comparative safety of bacterial risk control strategies for platelet components: a simulation study
Authors: Walker Brandon S. , Schmidt Robert L. , Fisher Mark A. , White Sandra K. , Blaylock Robert C. , Metcalf Ryan A. 
Published: July 2020

BACKGROUNDBacterial contamination of platelets is a problem that can lead to harmful septic transfusion reactions. The US Food and Drug Administration published a guidance in September 2019 detailing several permissible risk control strategies. Our objective was to compare the safety of each bacterial testing strategy for apheresis platelets.STUDY DESIGN AND METHODSWe used simulation to compare safety of the nine risk control strategies involving apheresis platelet testing. The primary outcome was the risk of exposure. An exposure event occurred if a patient received platelets exceeding a specific contamination threshold (>0, 103, and 105 colony‐forming units (CFU/mL). We generated a range of bacterial contamination scenarios (inoculum size, doubling time, lag time) and compared risk of exposure for each policy in each contamination scenario. We then computed the average risk difference over all scenarios.RESULTSAt the 0 CFU/mL exposure threshold, two‐step policies that used secondary culture ranked best (all top three), while single‐step 24‐hour culture with 3‐day expiration ranked last (ninth). This latter policy performed well (median rank of 1) at both the 103 and 105 CFU/mL thresholds, but 48‐hour culture with 7‐day expiration performed relatively poorly. At these higher thresholds, median ranks of two‐step policies that used secondary culture were again top three. Two‐step policies that used rapid testing improved at the higher (105 CFU/mL) harm threshold, with median rankings between 1 and 5.CONCLUSIONTwo‐step policies that used secondary culture were generally safer than single‐step policies. Performance of two‐step policies that used rapid testing depended on the CFU per milliter threshold of exposure used.
Introduction of principles of blood management to healthy donor bone marrow harvesting
Authors: Kim‐Wanner Soo‐Zin , Luxembourg Beate , Schmidt Alexander H. , Schäfer Richard , Möller Nadine , Herbert Eva , Poppe Carolin , Hümmer Christiane , Bunos Milica , Seifried Erhard , Bonig Halvard 
Published: July 2020

Background and ObjectivesPatient blood (more accurately: haemoglobin, Hb) management (PBM) aims to optimize endogenous Hb production and to minimize iatrogenic Hb loss while maintaining patient safety and optimal effectiveness of medical interventions. PBM was adopted as policy for patients by the World Health Organization (WHO), and, all the more, should be applied to healthy donors.Materials and MethodsObservational data from 489 bone marrow (BM) donors were retrospectively analysed, and principles of patient blood management were applied to healthy volunteer BM donations.Results and ConclusionWe managed to render BM aspiration safe for donors, notably completely avoiding the collection of autologous blood units and blood transfusions through iron management, establishment and curation of high‐yield aspiration technique, limitation of collection volume to 1·5% of donor body weight and development of volume prediction algorithms for the requested cell dose.
Dietary education programs for adults with neurological diseases: a scoping review protocol
Authors: Russell Rebecca D. , Black Lucinda J. , Begley Andrea 
Published: July 2020

ABSTRACT

Objective:
The objective of this review is to identify and map the evidence on the types of dietary education programs that have been implemented and evaluated in any setting for adults with neurological diseases. This review will also examine program characteristics, including program duration, length, and number of sessions, and common behavior change techniques used.

Introduction:
Up to 1 billion people are affected by neurological diseases, most commonly Alzheimer's disease and dementias, epilepsy, Huntington's disease, motor neurone disease, multiple sclerosis, Parkinson's disease, and stroke. Dietary recommendations for most of these diseases follow national dietary guidelines. Dietary education programs are recommended by the World Health Organization to promote adherence to a healthy diet, but it is not clear which dietary education programs have been conducted for adults with neurological diseases or the characteristics of such programs.

Inclusion criteria:
This review will consider qualitative and intervention studies (randomized controlled trials, non-randomized controlled trials, and pre-post studies) evaluating dietary education programs for adults with neurological diseases. Programs can be any format in any setting, and may include a comparator group (waitlist control, treatment as usual, or another intervention) or have no comparator group.

Methods:
CINAHL, Cochrane Database of Systematic Reviews, Emcare, MEDLINE, ProQuest (ProQuest Central and ProQuest Dissertations & Theses), PsycINFO, Cochrane Central Register of Controlled Trials, and Google Scholar will be searched for publications in English. Neurological organizations will be contacted for unpublished literature. Titles and abstracts will be screened, and full texts accessed for final inclusion. Intervention details, study outcomes, behavior change techniques, and findings will be extracted. Results will be presented in a table with accompanying description.
Enhanced Spray Cooling Using Micropillar Arrays: A Systematic Study
Authors: Muthukrishnan Sankar , Srinivasan Vinod 
Published: July 2020

Abstract
The role of contact-line evaporation on spray impingement heat transfer is systematically studied by spraying de-ionized water on silicon substrates with micropillar arrays. The height, the pillar diameter, and the spacing of the micropillar array were varied from 5 to 50 μm while keeping the porosity constant at 0.75. An air-assisted nozzle was used to create a liquid spray with a Sauter mean diameter (SMD) of ∼22 to 42 μm depending on flow conditions. Most test runs were conducted at a water flow rate of 30 ml/min and an air-liquid mass flow rate ratio of ∼0.57. The results show a continuous increase in the critical heat flux (CHF) as the pillar diameter is decreased. The effects of pillar height are nonmonotonic, with CHF and peak heat transfer coefficient attaining a maximum as the height-to-diameter ratio approaches unity. Values of CHF as high as 830 W/cm2 were achieved, along with cooling efficiencies of 49%. The effect of liquid flow rates and air-flow rates were also investigated independently using textured surfaces.
Shape Memory Alloy Actuators in an Active Needle—Modeling, Precise Assembly, and Performance Evaluation
Authors: Padasdao Blayton , Konh Bardia 
Published: July 2020

AbstractToday, several medical diagnosis and therapeutic cancer interventions are performed using needles via percutaneous surgical procedures. The success of these procedures highly depends on accurate placement of the needle tip at target positions. Improving targeting accuracy necessitates improvements in medical imaging and needle steering techniques. The former provides an improved vision on the target (i.e., cancerous tissue) and the needle, while the latter enables an enhanced interventional tool. In spite of considerable advancements in the medical imaging field, structure of the needle itself has remained unchanged. In the past decade, research works have suggested passive or active navigation of the needle inside the tissue to improve targeting accuracy. In addition, to provide actuation and control for needle steering, an active needle has been introduced activated by shape memory alloy (SMA) actuators. However, actuation of SMAs is complex due to their nonlinear and hysteresis behavior that depends on stress, strain, and temperature during operation. This work studies rapid manufacturing (via 3D printing), precise assembly, and performance evaluation of multiple distributed SMA actuators in an active flexible needle. The interactive response of the SMA actuators was investigated using experimental tests, constitutive material model, and kinematics of the active needle. It was shown that with proper installation of SMA actuators on the active needle, an effective manipulation can be realized in three dimensions.
Numerical Investigation of Transitional Characteristics for Natural-Convection Flow in Open-Ended Inclined Channel Heated From Below
Authors: Talukdar D. , Li C. G. , Kurose R. , Tsubokura M. 
Published: July 2020

Abstract
This report presents an investigation of the characteristics for transitional natural-convection flow in an open-ended inclined channel heated from below in the air under uniform heat flux intensity and non-Boussinesq condition. The investigated range of modified Rayleigh number and inclination is from 5.93 × 106  to 1.45 × 109  and 30–90 deg to the horizontal, respectively. Fine-resolution implicit large Eddy simulation is performed to solve the compressible governing equations using the modified preconditioned all-speed Roe scheme, hybrid boundary condition, and dual-time-stepping technique. The Nusselt number based on the maximum wall-temperature differs significantly while based on averaged wall-temperature is closer to the previously proposed laminar correlations. Transition is found to be pronounced at a lower angle of inclination (30 deg) for the considered heat flux intensity. The absolute magnitude of the critical length for the start and end of the transition when converted to nondimensional parameters is found to be higher compared to similar data for natural convection flow over a flat plate in water but the ratio of the end to start of the transition is found to be comparable. Single-roll longitudinal vortices periodically placed in spanwise direction exists in the transition region whose wavelength is found to be higher than those reported for channel flow under the isothermal condition and flow over a flat plate in water. Correlations for Nusselt number, critical aspect ratio, and vortex wavelength to the modified Rayleigh number are presented.
Efficacy and safety of patient-led versus physician-led titration of basal insulin in patients with uncontrolled type 2 diabetes: a meta-analysis of randomized controlled trials
Authors: Castellana Marco , Procino Filippo , Sardone Rodolfo , Trimboli Pierpaolo , Giannelli Gianluigi 
Published: July 2020

IntroductionInsulin is the most effective antihyperglycemic treatment and basal insulin is the preferred initial formulation in patients with type 2 diabetes. However, its effects are dose-dependent, so adequate titration is necessary to reach targets. We performed a meta-analysis to compare the efficacy and safety of patient-led versus physician-led titration of basal insulin in patients with uncontrolled type 2 diabetes.Research design and methodsFour databases were searched from database inception through March 2020. Randomized controlled studies with at least 12 weeks of follow-up of patients with type 2 diabetes allocated to patient-led versus physician-led titration of basal insulin were selected. Data on glycemic endpoints (hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), hypoglycemia) and other outcomes (insulin dose, body weight, patient-reported outcomes, adverse events, rescue medication, discontinuation) were extracted. Data were pooled using a random-effects model.ResultsSix studies evaluating 12 409 patients were finally included. Compared with the physician-led performance, patient-led titration was associated with a statistically significant higher basal insulin dose (+6 IU/day), leading to benefits on HbA1c (−0.1%) and FPG (−5 mg/dL), despite a higher risk of any level hypoglycemia (relative risk=1.1) and a slight increase in body weight (+0.2 kg). No difference was found for the other outcomes.ConclusionsThe present study showed that patient-led titration of basal insulin was not inferior to physician-led titration in patients with uncontrolled type 2 diabetes. Therefore, diabetes self-management education and support programs on basal insulin should be widely adopted in clinical practice and patients provided with tools to self-adjust their dose when necessary.
Increased plasma neurofilament light chain levels in patients with type-1 diabetes with impaired awareness of hypoglycemia
Authors: Sampedro Frederic , Stantonyonge Nicole , Martínez-Horta Saül , Alcolea Daniel , Lleó Alberto , Muñoz Laia , Pérez-González Rocío , Marín-Lahoz Juan , Gómez-Ansón Beatriz , Chico Ana 
Published: July 2020

IntroductionImpaired awareness of hypoglycemia (IAH) is a common complication in patients with type-1 diabetes (T1D). IAH is a major risk factor for severe hypoglycemic events, leading to adverse clinical consequences and cerebral damage. Non-invasive, cost-effective, and logistically efficient biomarkers for this condition have not been validated. Here, we propose plasma neurofilament light chain (NfL) levels as a biomarker of neuroaxonal damage in patients with T1D-IAH.Research design and methods54 patients were included into the study (18 T1D-IAH, 18 T1D with normal awareness of hypoglycemia (NAH) and 18 healthy controls). We measured plasma NfL levels and studied cerebral gray matter alterations on MRI.ResultsWe found that NfL levels were increased in patients with T1D-IAH compared with patients with T1D-NAH and healthy controls. Importantly, increased NfL levels correlated with reduced cerebral gray matter volume and increased IAH severity in patients with T1D-IAH.ConclusionOverall, our findings identify plasma NfL levels as a potential biomarker of cerebral damage in this population, motivating further confirmatory studies with potential implications in clinical trials.
Estimating the yield of tuberculosis from key populations to inform targeted interventions in South Africa: a scoping review
Authors: Chimoyi Lucy Andere , Lienhardt Christian , Moodley Nishila , Shete Priya , Churchyard Gavin J , Charalambous Salome 
Published: July 2020

IntroductionTuberculosis (TB) case finding strategies are recommended to increase yield for TB in key populations. Several key populations are identified in the literature, but techniques for estimating yield and prioritising interventions are needed.MethodsWe conducted a scoping review of existing evidence on TB burden to assess contribution of key populations to the TB epidemic in South Africa. Reports, articles and conference abstracts from January 2000 to December 2016 were reviewed to determine TB incidence, prevalence and size of key populations in South Africa. Meta-analysis summarised prevalence and incidence rates of TB in selected key populations assessed for heterogeneity. TB risk was calculated for each key population. Number needed to screen (NNS) to diagnose one case of TB disease was computed. Population attributable fraction estimated the potential impact of interventions on TB cases per population.ResultsThe search yielded 140 citations, of which 49 were included in the review and a final 32 were included in the meta-analysis. A high prevalence of TB disease was observed in HIV-infected patients with an estimated effect size (ES=0.25, 95% CI 0.20 to 0.30). Heterogeneity was high in this population (I2=94.8%, p value=0.000). The highest incidence rate of TB disease was observed in the HIV-infected population (ES=6.07, 95% CI 4.90 to 7.51). The risk of TB disease in South Africa was high in informal settlements (RR=5.8), HIV-infected (RR=5.4) and inmates (RR=5.0). Most cases of TB would be found in inmates (NNS=26) and household contacts of patients with TB (NNS=25). A larger impact would be observed if interventions are directed towards inmates (31%), people living with HIV (PLHIV (37%) and informal settlements (43%).ConclusionsOur findings illustrate the of value using available epidemiological evidence to inform targeted TB interventions. This review suggests that targeting interventions towards inmates, PLHIV and informal settlements would have a bigger impact on TB burden in South Africa.
Risk factors of hyperprolactinemia induced by risperidone and olanzapine and their correlations with plasma glucose and lipids
Authors: He Sidi , Yu Wen Juan , Wang Xiaoliang , Zhang Lei , Zhao Nan , Li Guanjun , Shen Yi Feng , Li Huafang 
Published: July 2020

BackgroundHyperprolactinemia is a common adverse reaction in patients with schizophrenia who take antipsychotic drugs; it often leads to treatment non-compliance in patients and has an adverse effect on their prognosis.AimsThis study aimed to explore the risk factors of elevated prolactin (PRL) caused by risperidone (RIS) and olanzapine (OLZ) and the relationship between PRL and fasting plasma glucose and lipids.MethodsPatients with schizophrenia were divided into two groups: 264 patients who were taking RIS and 175 patients who were taking OLZ. These two groups were further divided according to serum PRL levels: an elevated PRL group (>30 ng/mL) and a normal PRL group (PRL ≤30 ng/mL). The demographics, medication dosage, fasting plasma glucose, total cholesterol and triglycerides were compared in the two groups. Logistic regression analysis was performed to explore the risk factors of elevated PRL levels.ResultsCompared with the OLZ group, the RIS group had a greater number of patients with elevated PRL (155/264 vs 58/175). Either the RIS or the OLZ group, the proportion of elevated PRL was greater in female patients (RIS: χ2=6.76, p=0.009; OLZ: χ2=12.98, p<0.001) and with higher doses of the related drugs (RIS: U=−3.73, p<0.001; OLZ: U=−2.31, p=0.021). In patients taking RIS, the elevated PRL subgroup took the drug for a longer period (U=−2.76, p=0.006) and had lower triglyceride levels (U=2.76, p=0.006). In patients taking OLZ, the elevated PRL subgroup had lower fasting plasma glucose levels (U=2.29, p=0.022). Logistic regression analysis showed that gender, dose and fasting glucose levels were significantly associated with elevated PRL levels (RIS: p=0.001, OLZ: p<0.001; RIS: p<0.001; OLZ: p=0.003; RIS: p=0.020, OLZ: p=0.001, respectively).ConclusionCompared with OLZ, RIS had a greater effect on PRL in patients with schizophrenia, and in patients with schizophrenia taking RIS or OLZ, gender and dose were significantly correlated with the PRL value. Moreover, the plasma glucose level of the group with elevated PRL was lower than that of the group with normal PRL. The results also showed that high serum PRL may be associated with a favourable glucose metabolic profile in patients with schizophrenia taking RIS or OLZ. Further studies are warranted to confirm this association.Trial registration numberNCT02640911
Predicting response to immunotherapy in advanced non-small-cell lung cancer using tumor mutational burden radiomic biomarker
Authors: He Bingxi , Dong Di , She Yunlang , Zhou Caicun , Fang Mengjie , Zhu Yongbei , Zhang Henghui , Huang Zhipei , Jiang Tao , Tian Jie , Chen Chang 
Published: July 2020

BackgroundTumor mutational burden (TMB) is a significant predictor of immune checkpoint inhibitors (ICIs) efficacy. This study investigated the correlation between deep learning radiomic biomarker and TMB, including its predictive value for ICIs treatment response in patients with advanced non-small-cell lung cancer (NSCLC).MethodsCT images from 327 patients with TMB data (TMB median=6.067 mutations per megabase (range: 0 to 42.151)) were retrospectively collected and randomly divided into a training (n=236), validation (n=26), and test cohort (n=65). We used 3D-densenet to estimate the target tumor area, which used 1020 deep learning features to distinguish High-TMB from Low-TMB patients and establish the TMB radiomic biomarker (TMBRB). The TMBRB was developed in the training cohort combined with validation cohort and evaluated in the test cohort. The predictive value of TMBRB was assessed in a cohort of 123 NSCLC patients who had received ICIs (survival median=462 days (range: 16 to 1128)).ResultsTMBRB discriminated between High-TMB and Low-TMB patients in the training cohort (area under the curve (AUC): 0.85, 95% CI: 0.84 to 0.87))and test cohort (AUC: 0.81, 95% CI: 0.77 to 0.85). In this study, the predictive value of TMBRB was better than that of a histological subtype (AUC of training cohort: 0.75, 95% CI: 0.72 to 0.77; AUC of test cohort: 0.71, 95% CI: 0.66 to 0.76) or Radiomic model (AUC of training cohort: 0.75, 95% CI: 0.72 to 0.77; AUC of test cohort: 0.74, 95% CI: 0.69 to 0.79). When predicting immunotherapy efficacy, TMBRB divided patients into a high- and low-risk group with distinctly different overall survival (OS; HR: 0.54, 95% CI: 0.31 to 0.95; p=0.030) and progression-free survival (PFS; HR: 1.78, 95% CI: 1.07 to 2.95; p=0.023). Moreover, TMBRB had a better predictive ability when combined with the Eastern Cooperative Oncology Group performance status (OS: p=0.007; PFS: p=0.003). Visual analysis revealed that tumor microenvironment was important for predicting TMB.ConclusionBy combining deep learning technology and CT images, we developed an individual non-invasive biomarker that could distinguish High-TMB from Low-TMB, which might inform decisions on the use of ICIs in patients with advanced NSCLC.
Environmental exposure to phthalates and dementia with Lewy bodies: contribution of metabolomics
Authors: Agin Arnaud , Blanc Frédéric , Bousiges Olivier , Villette Claire , Philippi Nathalie , Demuynck Catherine , Martin-Hunyadi Catherine , Cretin Benjamin , Lang Sabine , Zumsteg Julie , Namer Izzie Jacques , Heintz Dimitri 
Published: July 2020

BackgroundIn neurodegenerative diseases, alongside genetic factors, the possible intervention of environmental factors in the pathogenesis is increasingly being considered. In particular, recent evidence suggests the intervention of a pesticide-like xenobiotic in the initiation of disease with Lewy bodies (DLB).ObjectivesTo test for the presence of pesticides or other xenobiotics in the cerebrospinal fluid (CSF) of patients with DLB.MethodsA total of 45 patients were included in this study: 16 patients with DLB at the prodromal stage, 8 patients with DLB at the demented stage, 8 patients with Alzheimer’s disease (AD) at the prodromal stage and 13 patients with AD at the demented stage. CSF was obtained by lumbar puncture and analysed by liquid chromatography–mass spectrometry.ResultsAmong the compounds detected in greater abundance in the CSF of patients with DLB compared with patients with AD, only one had a xenobiotic profile potentially related to the pathophysiology of DLB. After normalisation and scaling, bis(2-ethylhexyl) phthalate was more abundant in the CSF of patients with DLB (whole cohort: 2.7-fold abundant in DLB, p=0.031; patients with dementia: 3.8-fold abundant in DLB, p=0.001).ConclusionsThis study is the first reported presence of a phthalate in the CSF of patients with DLB. This molecule, which is widely distributed in the environment and enters the body orally, nasally and transdermally, was first introduced in the 1920s as a plasticizer. Thereafter, the first cases of DLB were described in the 1960s and 1970s. These observations suggest that phthalates may be involved in the pathophysiology of DLB.