bluuebunny/crossref_metadata_2025_split huggingface dataset:
Misidentification of anti-Vel due to inappropriate use of prewarming and adsorption techniques
Authors: Storry J.R. , Mallory D. 
Published: May 2021

Abstract
Two units of red blood cells (RBCs) were ordered for a 44-year-old Caucasian woman with renal failure and cancer. Pretransfusion testing performed at the regional reference laboratory had revealed the presence of an antibody reactive with all cells at the indirect antiglobulin test (LAT) but apparently nonreactive by a prewarmed IAT. The patient’s RBCs were direct antiglobulin test negative. Adsorption of the serum with rabbit erythrocyte stroma or with allogeneic RBCs at 4°C reduced the reactivity at the IAT. The patient was transfused with two units of washed RBCs and died 6 to 8 hours later. Retrospective testing in our laboratory detected anti-Vel in both pretransfusion and posttransfusion samples. The pretransfnsio serum was hemolytic when tested in LISS or with papain-treated RBCs. Weak reactivity (1+) was observed at the IAT. EDTA-treated serum (to prevent C’-mediated hemolysis) was strongly reactive (3+s) with Vel+ RBCs but compatible with 10 examples of Vel-RBCs. Adsorptions with rabbit RBCs did not affect reactivity. Pretransfusion RBCs were nonreactive with three examples of anti-Vel at the IAT. The posttransfusion serum was grossly hemolyzed and anti-Vel was demonstrable, although weaker than in the pretransfusion sample. The antibody was subclassed as IgG1 and IgG3. In this case, the use of a prewarming technique precluded detection of hemolysis caused by the antibody prior to the IAT. This case stresses the importance of antibody identification and the correct use of such techniques as prewarming and adsorptions.
Immunohematology
1994;10:83-86.
Successful transfusion in the presence of anti-K4 (anti-Kpb)
Authors: Watt J. , Moffatt P. , Chatfield S. , Grimm W. , Bryant J. 
Published: May 2021

Abstract
A 71-year-old group A, D+ female, with anti-K4(-Kpb),-E, and -S was admitted for her second coronary artery surgery. Four units of autologous red blood cells (RBCs) were transfused perioperatively, and four units of homologous K:-4, E-, S-RBCs were transfused over the next 24 hours. Ten units of fresh frozen plasma and 28 units of platelets were also transfused. Continued bleeding necessitated calling donors from other states in Australia and from the International Panel of Donors of Rare Type, Bristol, UK, maintained by the World Health Organization. Four units of group O, K:4, E-, S-RBCs were transfused in the next 24 hours while the K: 4 blood was in transit. No immediate signs of a transfusion reaction were noted. Blood pressure, temperature, bilirubin, and urinary output were normal, and an increase in hemoglobin was observed. A positive direct antiglobulin test was evident 3 days posttransfusion of the incompatible units and was still present 8 days later. Anti-A and anti-K4 were eluted from the patient’s RBCs. The titer of anti-K4 increased from 8 preoperatively to 2,048 19 days posttransfusion of K:4 RBCs. Subsequent transfusions were not required, and the patient was discharged 3 weeks after the operation without further incident.
Immunohematology
1994;10:87-89.
A comparison of the monocyte monolayer assay with 51chromium red cell recovery for determining the clinical significance of red cell alloantibodies
Authors: Davey R.J. , Esty S.S , Chin J.F. , Mallory D. 
Published: May 2021

Abstract
The 51chromium (51Cr) red cell recovery study is a reliable measure of transfusion compatibility. However, the monocyte monolayer assay (MMA) does not require the use of radioactive isotopes or the injection of incompatible RBCs. In this study, 51Cr recoveries were performed on 12 patients with well-defined antibodies, and the results compared to the MMA procedure. The MMA method was interpreted by counting the percentage of monocytes with associated RBCs (>3% = positive). The MMA correlated with the 51Cr recovery in 11 of 12 subjects. One anti-K1 that caused moderately accelerated red cell destruction (60% recovery at 24 hours) had a negative MMA. Four control subjects with no atypical antibodies had normal autologous RBC 51Cr recoveries and were negative by the MMA technique. The MMA test can be a reliable predictor of in vivo antibody behavior and an acceptable alternative to 51Cr recovery studies.
Immunohematology
1994;10:90–94.
Loss and reappearance of Rho(D) antigen on the red blood cells of an individual with acute myelogenous leukemia
Authors: Mohandas K. , Najfield V. , Gilbert H. , Azar P. , Skerrett D. 
Published: May 2021

Abstract
Complete loss of Rho(D) antigen from red blood cells (RBCs) of individuals with hematologic disorders, though not frequent, has been reported. This case reports the loss of D antigen on the RBCs of a patient with acute myelogenous leukemia and its reappearance when he was in remission. Loss of D antigen expression coincided with worsening clinical and cytogenetic disease. At the time of D antigen loss, the patient also had cytogenetic abnormalities in the bone marrow cells. When he was in remission, the chromosomal abnormalities were no longer detectable, and his RBCs regained D antigen expression.
Immunohematology
1994;10:134–135.
The incidence of V (Rh10) and Jsa (K6) in the contemporary African American blood donor
Authors: Byrne P.C. , Howard J.H. 
Published: May 2021

Abstract
Following an apparent increase in the number of patients with anti- V and/or anti-Jsa who required V– and/or Js(a–) red cell units, red cells from African American blood donors negative for C, E, S, K, Fya, Fyb, and Jkb were typed for V and Jsa over a 2-year period. Of the 438 donors typed for V and Jsa, 168 (38.36%) were V+ and 71 (16.44%) were Js(a+). The incidence of V (Rh10) was higher than that reported in previous studies, but no change was seen in the incidence of Jsa (K6).
Immunohematology
1994;10:136–138.
Study on anti-scaling of landfill leachate treated by evaporation method
Authors: Bai Zhongteng , Wang Yanqiu , Shan Mingjun , Lv Yanli , Meng Guangcai , Zhu Siwei , Pan Dawei 
Published: May 2021

Abstract
In the mechanical vapor recompression (MVR) treatment of landfill leachate, scaling in the evaporator and heat exchanger poses a serious problem. This study explored the reasons for such scaling and proposed acid or ion-exchange pre-treatments to reduce the alkalinity of the landfill leachate nanofiltration concentrate (LLNC) to prevent scaling. The feasibility of these two methods was evaluated and the technical and economic parameters for application were obtained via experiments. A large amount of HCO3- in the LLNC was the main cause of scaling. The acid addition experiment and field application demonstrated that this method could prevent fouling problems. The cost of acid addition was USD 0.18/t. LLNC pre-treatment by ion-exchange showed that a weakly acidic cation-exchange resin performed better than a strongly acidic cation-exchange resin did. The amount of solid residue under an alkalinity of 0 mg/L could be decreased by 92.9% compared with that of raw LLNC during evaporation. Both methods could alleviate scaling and enable the wide application of the MVR evaporation process in landfill leachate treatment.
Effects of Macroporous Resin Extract of Dendrobium officinale Leaves in
Rats with Hyperuricemia Induced by Fructose and Potassium Oxonate
Authors: Yu Qiao-Xian , Lv Gui-Yuan , Chen Su-Hong , Wang Yu-Zhi , Zhou Cong , Zhu Li-Jie , He Xing-Li-Shang , Li Lin-Zi , Zheng Xiang , Xu Wan-Feng , Dong Ying-Jie , Li Bo 
Published: May 2021

Aim and Objective:
Fructose, as a ubiquitous monosaccharide, can promote ATP
consumption and elevate circulating Uric acid (UA) levels. Our previous studies have confirmed that
the macroporous resin extract of Dendrobium officinale leaves (DoMRE) could reduce the UA level of
rats with hyperuricemia induced by a high-purine diet. This study aimed to investigate whether
DoMRE had a UA-lowering effect on rats with hyperuricemia caused by fructose combined with
potassium oxonate, so as to further clarify the UA-lowering effect of DoMRE, and to explore the UAlowering
effect of DoMRE on both UA production and excretion.

Materials and Methods:
Rats with hyperuricemia induced by fructose and potassium oxonate were
administered with DoMRE and vehicle control, respectively, to compare the effects of the drugs. At
the end of the experiment, the Serum Uric Acid (SUA) and Creatinine (Cr) levels were measured using
an automatic biochemical analyzer, the activities of xanthine oxidase (XOD) were measured using an
assay kit, and the protein expressions of Urate Transporter 1 (URAT1), glucose transporter 9
(GLUT9), and ATP-Binding Cassette Superfamily G member 2 (ABCG2) were assessed using
immune-histochemical and western blot analyses. Hematoxylin and eosin staining was used to assess
the histological changes in the kidney, liver, and intestine.

Results:
Fructose and potassium induced hyperuricemia in rats. Meanwhile, the activities of XOD
were markedly augmented, the expression of URAT1 and GLUT9 was promoted, and the expression
of ABCG2 was reduced, which were conducive to the elevation of UA. However, exposure to DoMRE
reversed these fructose- and potassium oxonate-induced negative alternations in rats. The activities of
XOD were recovered to the normal level, reducing UA formation; the expressions of URAT1,
ABCG2, and GLUT9 returned to the normal level, resulting in an increase in renal urate excretion.

Conclusion:
DoMRE reduces UA levels in rats with hyperuricemia induced by fructose combined with
potassium oxonate by inhibiting XOD activity and regulating the expression of ABCG2, URAT1, and
GLUT9. DoMRE is a potential therapeutic agent for treating hyperuricemia through inhibiting UA
formation and promoting UA excretion.
Celastrol Inhibits the Proliferation and Decreases Drug Resistance of Cisplatin-
Resistant Gastric Cancer SGC7901/DDP Cells
Authors: Zhan Dongmei , Ni Tengyang , Wang Haibo , Lv Mengying , Sunagawa Masataka , Liu Yanqing 
Published: May 2021

Background:
This study aimed to determine the effect and mechanism of Celastrol inhibiting the
proliferation and decreasing the drug resistance of cisplatin-resistant gastric cancer cells.

Objective:
The objective of this study was to explore the effect and mechanism of Celastrol on proliferation and
drug resistance of human gastric cancer cisplatin-resistant cells SGC7901/DDP.

Methods:
The thiazole blue (MTT) method was used to detect the sensitivity of human gastric cancer cisplatinresistant
cells SGC7901/DPP to cisplatin and Celastrol to determine the Drug Resistance Index (DRI). According
to the half Inhibitory Concentration (IC50) value, the action of the concentration of the following experimental
drugs was set to reduce the cytotoxicity. Annexin V-FITC/PI double staining method was used to detect the
apoptosis of SGC7901/DDP cells induced by Celastrol. Western Blot was used to examine the expression levels
of P-glycoprotein (P-gp), Multidrug Resistance Associated Protein 1 (MRP1), Breast Cancer Resistance Associated
Protein (Breast Cancer Resistance)-relative protein (BCRP), and mechanistic Target of Rapamycin
(mTOR) pathway-related proteins. Real-time fluorescence quantitative polymerase chain reaction (RT-qPCR)
was used to detect the mRNA expression levels of P-gp, MRP1, and BCRP.

Results:
(1) Compared with the control group (we set the untreated group as the control group), the proliferation
of the SGC7901/DPP cells was significantly inhibited after treating with 0.1-6.4μmol/L Celastrol in a time- and
concentration-dependent manner (P<0.05). The Drug Resistance Index (DRI) of the SGC7901/DPP cells to
DDP was 5.64. (2) Compared with the control group, Celastrol could significantly inhibit the proliferation and
induce the apoptosis of the SGC7901/DPP cells (P<0.05). (3) The mRNA and protein expression levels of P-gp,
MRP1, and BCRP in the SGC7901/DPP cells were significantly higher than those in the SGC7901 cells. However,
after treating with Celastrol, the expression levels of P-gp, MRP1, and BCRP in the SGC7901/DPP cells
were significantly reduced (P<0.05). (4) Compared with the control group, the Celastrol treatment also reduced
the expression of the mTOR signaling pathway-related proteins, suggesting that the mTOR signaling pathway
may be involved in the process of Celastrol inhibiting the proliferation of the SGC7901/DDP cells and reducing
their drug resistance. (5) Significantly, the combination of Celastrol and DDP reduced the expression of P-gp,
MRP1, and BCRP in the SGC7901/DPP cells.

Conclusion:
Celastrol can inhibit the proliferation of the SGC7901/DDP cells, induce their apoptosis, and reduce
the expression of drug resistance genes, probably by inhibiting the expression of the proteins related to the
mTOR signaling pathway.
Evaluation of the Privacy Risks of Personal Health Identifiers and Quasi-Identifiers in a Distributed Research Network: Development and Validation Study
Authors: Oh SeHee , Sung MinDong , Rhee Yumie , Hong Namki , Park Yu Rang 
Published: May 2021

Background
Privacy should be protected in medical data that include patient information. A distributed research network (DRN) is one of the challenges in privacy protection and in the encouragement of multi-institutional clinical research. A DRN standardizes multi-institutional data into a common structure and terminology called a common data model (CDM), and it only shares analysis results. It is necessary to measure how a DRN protects patient information privacy even without sharing data in practice.

Objective
This study aimed to quantify the privacy risk of a DRN by comparing different deidentification levels focusing on personal health identifiers (PHIs) and quasi-identifiers (QIs).

Methods
We detected PHIs and QIs in an Observational Medical Outcomes Partnership (OMOP) CDM as threatening privacy, based on 18 Health Insurance Portability and Accountability Act of 1996 (HIPPA) identifiers and previous studies. To compare the privacy risk according to the different privacy policies, we generated limited and safe harbor data sets based on 16 PHIs and 12 QIs as threatening privacy from the Synthetic Public Use File 5 Percent (SynPUF5PCT) data set, which is a public data set of the OMOP CDM. With minimum cell size and equivalence class methods, we measured the privacy risk reduction with a trust differential gap obtained by comparing the two data sets. We also measured the gap in randomly sampled records from the two data sets to adjust the number of PHI or QI records.

Results
The gaps averaged 31.448% and 73.798% for PHIs and QIs, respectively, with a minimum cell size of one, which represents a unique record in a data set. Among PHIs, the national provider identifier had the highest gap of 71.236% (71.244% and 0.007% in the limited and safe harbor data sets, respectively). The maximum size of the equivalence class, which has the largest size of an indistinguishable set of records, averaged 771. In 1000 random samples of PHIs, Device_exposure_start_date had the highest gap of 33.730% (87.705% and 53.975% in the data sets). Among QIs, Death had the highest gap of 99.212% (99.997% and 0.784% in the data sets). In 1000, 10,000, and 100,000 random samples of QIs, Device_treatment had the highest gaps of 12.980% (99.980% and 87.000% in the data sets), 60.118% (99.831% and 39.713%), and 93.597% (98.805% and 5.207%), respectively, and in 1 million random samples, Death had the highest gap of 99.063% (99.998% and 0.934% in the data sets).

Conclusions
In this study, we verified and quantified the privacy risk of PHIs and QIs in the DRN. Although this study used limited PHIs and QIs for verification, the privacy limitations found in this study could be used as a quality measurement index for deidentification of multi-institutional collaboration research, thereby increasing DRN safety.
User Experience With Dynamic Difficulty Adjustment Methods for an Affective Exergame: Comparative Laboratory-Based Study
Authors: Darzi Ali , McCrea Sean M , Novak Domen 
Published: May 2021

Background
In affective exergames, game difficulty is dynamically adjusted to match the user’s physical and psychological state. Such an adjustment is commonly made based on a combination of performance measures (eg, in-game scores) and physiological measurements, which provide insight into the player’s psychological state. However, although many prototypes of affective games have been presented and many studies have shown that physiological measurements allow more accurate classification of the player’s psychological state than performance measures, few studies have examined whether dynamic difficulty adjustment (DDA) based on physiological measurements (which requires additional sensors) results in a better user experience than performance-based DDA or manual difficulty adjustment.

Objective
This study aims to compare five DDA methods in an affective exergame: manual (player-controlled), random, performance-based, personality-performance–based, and physiology-personality-performance–based (all-data).

Methods
A total of 50 participants (N=50) were divided into five groups, corresponding to the five DDA methods. They played an exergame version of Pong for 18 minutes, starting at a medium difficulty; every 2 minutes, two game difficulty parameters (ball speed and paddle size) were adjusted using the participant’s assigned DDA method. The DDA rules for the performance-based, personality-performance–based, and all-data groups were developed based on data from a previous open-loop study. Seven physiological responses were recorded throughout the sessions, and participants self-reported their preferred changes to difficulty every 2 minutes. After playing the game, participants reported their in-game experience using two questionnaires: the Intrinsic Motivation Inventory and the Flow Experience Measure.

Results
Although the all-data method resulted in the most accurate changes to ball speed and paddle size (defined as the percentage match between DDA choice and participants’ preference), no significant differences between DDA methods were found on the Intrinsic Motivation Inventory and Flow Experience Measure. When the data from all four automated DDA methods were pooled together, the accuracy of changes in ball speed was significantly correlated with players’ enjoyment (r=0.38) and pressure (r=0.43).

Conclusions
Although our study is limited by the use of a between-subjects design and may not generalize to other exergame designs, the results do not currently support the inclusion of physiological measurements in affective exergames, as they did not result in an improved user experience. As the accuracy of difficulty changes is correlated with user experience, the results support the development of more effective DDA methods. However, they show that the inclusion of physiological measurements does not guarantee a better user experience even if it yields promising results in offline cross-validation.
Developing Adaptive Serious Games for Children With Specific Learning Difficulties: A Two-phase Usability and Technology Acceptance Study
Authors: Yildirim Oguzcan , Surer Elif 
Published: May 2021

Background
Specific learning difficulties (SpLD) include several disorders such as dyslexia, dyscalculia, and dysgraphia, and the children with these SpLD receive special education. However, the studies and the educational material so far focus mainly on one specific disorder.

Objective
This study’s primary goal is to develop comprehensive training material for different types of SpLD, with five serious games addressing different aspects of the SpLD. The second focus is measuring the impact of adaptive difficulty level adjustment in the children’s and their educators’ usability and technology acceptance perception. Receiving feedback from the children and their educators, and refining the games according to their suggestions have also been essential in this two-phase study.

Methods
A total of 10 SpLD educators and 23 children with different types of SpLD tested the prototypes of the five serious games (ie, Word game, Memory game, Category game, Space game, and Math game), gave detailed feedback, answered the System Usability Scale and Technology Acceptance Model (TAM) questionnaires, and applied think-aloud protocols during game play.

Results
The games’ standard and adaptive versions were analyzed in terms of average playtime and the number of false answers. Detailed analyses of the interviews, with word clouds and player performances, were also provided. The TAM questionnaires’ average and mean values and box plots of each data acquisition session for the children and the educators were also reported via System Usability Scale and TAM questionnaires. The TAM results of the educators had an average of 8.41 (SD 0.87) out of 10 in the first interview and an average of 8.71 (SD 0.64) out of 10 in the second interview. The children had an average of 9.07 (SD 0.56) out of 10 in the first interview.

Conclusions
Both the educators and the children with SpLD enjoyed playing the games, gave positive feedback, and suggested new ways for improvement. The results showed that these games provide thorough training material for different types of SpLD with personalized and tailored difficulty systems. The final version of the proposed games will become a part of the special education centers’ supplementary curriculum and training materials, making new enhancements and improvements possible in the future.