bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adverse events after low titer group O whole blood versus component product transfusion in pediatric trauma patients: A propensity‐matched cohort study
Authors: Leeper Christine M. , Yazer Mark H. , Morgan Katrina M. , Triulzi Darrell J. , Gaines Barbara A. 
Published: May 2021

AbstractBackgroundLow titer group O whole blood (LTOWB) is used as the initial resuscitative fluid in an increasing number of pediatric trauma and massive bleeding transfusion protocols. There is little data on adverse events following its transfusion in pediatric trauma patients.Study Design and MethodsBlood bank records were queried for pediatric recipients of at least one unit of red blood cells (RBCs) (component group) or LTOWB (LTOWB group) within 24 h of admission between May 2013 and August 2020. Subjects with early death (<72 h) were excluded. Propensity‐score matching of LTOWB and component groups was performed. Adverse events were recorded, including transfusion reaction, thromboembolism, acute kidney injury, sepsis, and organ failure based on PELOD‐2 score, along with hospital and ICU length of stay (LOS) and ventilator days.ResultsThirty‐six LTOWB recipients were matched to 36 conventional component recipients. Subjects were 52% male, with blunt injury mechanism (82%), median (IQR) injury severity score = 27 (21–35), and 26% in‐hospital mortality. The groups were well matched in terms of demographics and injury characteristics. There were no clinically or statistically significant differences in adverse outcomes including reported transfusion reaction, organ failure, acute kidney injury, sepsis/bacteremia, and venous thromboembolism. Hospital LOS, ventilator days, mortality, and functional disability at discharge were also not significantly different. The LTOWB group had significantly shorter ICU LOS compared to the component group.ConclusionLTOWB transfusion did not increase the risk of adverse events in children. However, larger studies are required to confirm these results.
Multiorgan failure in a fatal case of autoimmune hemolytic anemia
Authors: Anandappa Annabelle J. , Stefely Jonathan A. , Hasserjian Robert P. , Dzik Walter H. , Waheed Anem 
Published: May 2021

AbstractBackgroundAutoimmune hemolytic anemia (AIHA) results in red blood cell destruction by auto‐antibodies directed against surface antigens and is rarely fatal. Here we describe a case of AIHA, refractory to both standard and experimental therapies, complicated by multiorgan failure, and rapidly leading to death.Case report and resultsA 65 year‐old man who presented with progressive dyspnea and jaundice was found to have hemolytic anemia. Diagnostic work‐up revealed a positive direct antiglobulin test and a strong pan‐reactive antibody in the plasma reacting to a titer of 1:1024 with strongest reactivity at 37 °C Coombs' phase with reagent anti‐IgG. The red cell eluate contained a pan‐agglutinin. The patient received multiple lines of treatment including glucocorticoids, intravenous immunoglobulin, rituximab, eculizumab, splenectomy and etoposide. Despite these interventions, he continued to experience brisk hemolysis and remained transfusion dependent. Repeat testing on day 16 demonstrated persistent high titer IgG auto‐antibodies, suggesting minimal suppressive effect of therapy. His course was complicated by acute renal and liver failure, venous thrombosis, and worsening coagulopathy, and he ultimately died from multiorgan failure on day 18.ConclusionSevere cases of AIHA can result in multiorgan failure and a fatal outcome. The rapid development of liver failure in this setting has been described in only few case reports to date, and represents an important complication for clinicians to be aware of when treating patients with AIHA.
Soleus responses to Achilles tendon stimuli are suppressed by heel and enhanced by metatarsal cutaneous stimuli during standing
Authors: Mildren Robyn L. , Peters Ryan M. , Carpenter Mark G. , Blouin Jean‐Sébastien , Inglis J. Timothy 
Published: May 2021

Key points
We examined the influence of cutaneous feedback from the heel and metatarsal regions of the foot sole on the soleus stretch reflex pathway during standing.
We found that heel electrical stimuli suppressed and metatarsal stimuli enhanced the soleus vibration response.
Follow‐up experiments indicated that the interaction between foot sole cutaneous feedback and the soleus vibration response was likely not mediated by presynaptic inhibition and was contingent upon a modulation at the ⍺‐motoneuron pool level.
The spatially organized interaction between cutaneous feedback from the foot sole and the soleus vibration response provides information about how somatosensory information is combined to appropriately respond to perturbations during standing.
AbstractCutaneous feedback from the foot sole provides balance‐relevant information and has the potential to interact with spinal reflex pathways. In this study, we examined how cutaneous feedback from the foot sole (heel and metatarsals) influenced the soleus response to proprioceptive stimuli during standing. We delivered noisy vibration (10–115 Hz) to the right Achilles tendon while we intermittently applied electrical pulse trains (five 1‐ms pulses at 200 Hz, every 0.8–1.0 s) to the skin under either the heel or the metatarsals of the ipsilateral foot sole. We analysed time‐dependent (referenced to cutaneous stimuli) coherence and cross‐correlations between the vibration acceleration and rectified soleus EMG. Vibration–EMG coherence was observed across a bandwidth of ∼10–80 Hz, and coherence was suppressed by heel but enhanced by metatarsal cutaneous stimuli. Cross‐correlations showed soleus EMG was correlated with the vibration (∼40 ms lag) and cross‐correlations were also suppressed by heel (from 104–155 ms) but enhanced by metatarsal (from 76–128 ms) stimuli. To examine the neural mechanisms mediating this reflex interaction, we conducted two further experiments to probe potential contributions from (1) presynaptic inhibition, and (2) modulations at the ⍺‐ and γ‐motoneuron pools. Results suggest the cutaneous interactions with the stretch reflex pathway required a modulation at the ⍺‐motoneuron pool and were likely not mediated by presynaptic inhibition. These findings demonstrate that foot sole cutaneous information functionally tunes the stretch reflex pathway during the control of upright posture and balance.
Systematic Design, Control, and Parametric Testing of an Automated Resuscitator Bag Mechanical Ventilator
Authors: du Pasquier Cosima , Hewing Lukas , Steffen Nicola , Lumpe Thomas S. , Tatchatos Nikolaos , Menner Marcel , Schmid Daners Marianne , Carron Andrea , Zeilinger Melanie N. , Shea Kristina 
Published: May 2021

AbstractThe COVID-19 crisis has revealed and exacerbated a shortage of mechanical ventilators in hospitals around the world, regardless of their government’s resources. Where some countries can respond to the situation by ordering more high-end ventilators, the price is often too high for low- and middle-income countries (LMICs) and securing them can be difficult. The goal of this work is to design, prototype, and test a low-cost ventilator, called ETH breathe, based on the automated compression of a resuscitator bag. A holistic and systematic design approach is taken to create a compact and adaptable device that can safely meet the current requirements. This is achieved by using 72% standard parts out of 33 (72%) and prioritizing compactness in the mechanical design. The control system is developed to provide both continuous mandatory ventilation (CMV) and spontaneous breathing support or assist control (AC), which significantly extends the potential use cases beyond patient sedation. The prototype is tested for accuracy, modularity, and oxygen response using a full physiological artificial lung. The results show for the first time in literature that the design operates within the defined requirements, based on emergency government regulations, and can be used with different sizes of resuscitator bags and different positions of the flow sensor. This provides a sound basis for further development of a low-cost, portable mechanical ventilator for potential use in LMICs.
Escherichia coli msbB
Gene as a Virulence Factor and a Therapeutic Target
Authors: Somerville John E. , Cassiano Linda , Darveau Richard P. 
Published: May 2021

ABSTRACT

A mutation in the
msbB
gene of
Escherichia coli
results in the synthesis of
E. coli
lipopolysaccharide (LPS) that lacks the myristic acid moiety of lipid A. Although such mutant
E. coli
cells and their purified LPS have a greatly reduced ability to stimulate human immune cells, a minor reduction in the mouse inflammatory response is observed. When the
msbB
mutation is transferred into a clinical isolate of
E. coli
, there is a significant loss in virulence, as assessed by lethality in BALB/c mice. When a cloned
msbB
gene is provided to functionally complement the
msbB
mutant, virulence returns, providing direct evidence that the
msbB
gene product is an important virulence factor in a murine model of
E. coli
pathogenicity. In the genetic background of the clinical
E. coli
isolate, the
msbB
mutation also results in filamentation of the cells at 37°C but not at 30°C, a reduction in the level of the K1 capsule, an increase in the level of complement C3 deposition, and an increase in both opsonic and nonopsonic phagocytosis of the
msbB
mutant, phenotypes that can help to explain the loss in virulence. The demonstration that the inhibition of
msbB
gene function reduces the virulence of
E. coli
in a mouse infection model warrants further investigation of the
msbB
gene product as a novel target for antibiotic therapy.
Sarcoid-like reaction: a unique response to immunotherapy in malignant melanoma
Authors: Khalid Taha , Patel Asma , Ahmed Alina , Yousif Ala 
Published: May 2021

In recent years, immunotherapy has revolutionised the treatment landscape for oncology patients with improved survival rates in cancers which previously had a dismissal prognosis. These agents target specific pathways of inhibition such as programmed cell death -1 (PD-1), PD ligand-1 and cytotoxic T-lymphocyte-associated antigen 4 resulting in stimulation of T cell activity. This results in enabling an individual’s own immune system to fight against cancer, a different modality of treatment when compared with traditional chemotherapy. While attacking the tumour cells, there is an increased chance of host tissue immune reactions.We report a case of a patient who received immunotherapy for metastatic malignant melanoma. During the course of the treatment, development of a sarcoid-like reaction was histologically confirmed in the mediastinal lymph nodes. The patient had no respiratory symptoms and continued on the immunotherapy treatment with good clinical and radiological response.
Spirituality and religion in residents and inter-relationships with clinical practice and residency training: a scoping review
Authors: Chow Hsin Han Elisha , Chew Qian Hui , Sim Kang 
Published: May 2021

ObjectivesWith the increased emphasis on personalised, patient-centred care, there is now greater acceptance and expectation for the physician to address issues related to spirituality and religion (SR) during clinical consultations with patients. In light of the clinical need to improve SR-related training in residency, this review sought to examine the extant literature on the attitudes of residents regarding SR during residency training, impact on clinical care and psychological well-being of residents and SR-related curriculum implemented within various residency programmes.DesignA scoping review was conducted on studies examining the topic of SR within residency training up until July 2020 on PubMed/Medline and Web of Science databases. Keywords for the literature search included: (Spirituality OR Religion) AND (Residen* OR “Postgraduate Medicine” OR “Post-graduate Medicine” OR “Graduate Medical Education”).ResultsOverall, 44 studies were included. The majority were conducted in North America (95.5%) predominantly within family medicine (29.5%), psychiatry (29.5%) and internal medicine (25%) residency programmes. While residents held positive attitudes about the role of SR and impact on patient care (such as better therapeutic relationship, treatment adherence and coping with illness), they often lacked the knowledge and skills to address these issues. Better spiritual well-being of residents was associated with greater sense of work accomplishment, overall self-rated health, decreased burnout and depressive symptoms. SR-related curricula varied from standalone workshops to continuous modules across the training years.ConclusionsThese findings suggest a need to better integrate appropriate SR-related education within residency training. Better engagement of the residents through different pedagogical strategies with supervision, feedback, reflective practice and ongoing faculty and peer support can enhance learning about SR in clinical care. Future studies should identify barriers to SR-related training and evaluate the outcomes of these SR-related curriculum including how they impact the well-being of patients and residents over time.
Non-fatal injuries in rural Burkina Faso amongst older adults, disease burden and health system responsiveness: a cross-sectional household survey
Authors: Whitaker John , Harling Guy , Sie Ali , Bountogo Mamadou , Hirschhorn Lisa R , Manne-Goehler Jennifer , Bärnighausen Till , Davies Justine 
Published: May 2021

ObjectivesThis study aimed to evaluate the epidemiology of injury as well as patient-reported health system responsiveness following injury and how this compares with non-injured patient experience, in older individuals in rural Burkina Faso.DesignCross-sectional household survey. Secondary analysis of the CRSN Heidelberg Ageing Study dataset.SettingRural Burkina Faso.Participants3028 adults, over 40, from multiple ethnic groups, were randomly sampled from the 2015 Nouna Health and Demographic Surveillance Site census.Primary and secondary outcome measuresPrimary outcome was incidence of injury. Secondary outcomes were incidence of injury related disability and patient-reported health system responsiveness following injury.Results7.7% (232/3028) of the population reported injury in the preceding 12 months. In multivariable analyses, younger age, male sex, highest wealth quintile, an abnormal Generalised Anxiety Disorder score and lower Quality of Life score were all associated with injury. The most common mechanism of injury was being struck or hit by an object, 32.8%. In multivariable analysis, only education was significantly negatively associated with odds of disability (OR 0.407, 95% CI 0.17 to 0.997). Across all survey participants, 3.9% (119/3028) reported their most recent care seeking episode was following injury, rather than for another condition. Positive experience and satisfaction with care were reported following injury, with shorter median wait times (10 vs 20 min, p=0.002) and longer consultation times (20 vs 15 min, p=0.002) than care for another reason. Injured patients were also asked to return to health facilities more often than those seeking care for another reason, 81.4% (95% CI 73.1% to 87.9%) vs 54.8% (95% CI 49.9% to 53.6%).ConclusionsInjury is an important disease burden in this older adult rural low-income and middle-income country population. Further research could inform preventative strategies, including safer rural farming methods, explore the association between adverse mental health and injury, and strengthen health system readiness to provide quality care.
Quantitative Checklist for Autism in Toddlers (Q-CHAT). A population screening study with follow-up: the case for multiple time-point screening for autism
Authors: Allison Carrie , Matthews Fiona E , Ruta Liliana , Pasco Greg , Soufer Renee , Brayne Carol , Charman Tony , Baron-Cohen Simon 
Published: May 2021

ObjectiveThis is a prospective population screening study for autism in toddlers aged 18–30 months old using the Quantitative Checklist for Autism in Toddlers (Q-CHAT), with follow-up at age 4.DesignObservational study.SettingLuton, Bedfordshire and Cambridgeshire in the UK.Participants13 070 toddlers registered on the Child Health Surveillance Database between March 2008 and April 2009, with follow-up at age 4; 3770 (29%) were screened for autism at 18–30 months using the Q-CHAT and the Childhood Autism Spectrum Test (CAST) at follow-up at age 4.InterventionsA stratified sample across the Q-CHAT score distribution was invited for diagnostic assessment (phase 1). The 4-year follow-up included the CAST and the Checklist for Referral (CFR). All with CAST ≥15, phase 1 diagnostic assessment or with developmental concerns on the CFR were invited for diagnostic assessment (phase 2). Standardised diagnostic assessment at both time-points was conducted to establish the test accuracy of the Q-CHAT.Main outcome measuresConsensus diagnostic outcome at phase 1 and phase 2.ResultsAt phase 1, 3770 Q-CHATs were returned (29% response) and 121 undertook diagnostic assessment, of whom 11 met the criteria for autism. All 11 screened positive on the Q-CHAT. The positive predictive value (PPV) at a cut-point of 39 was 17% (95% CI 8% to 31%). At phase 2, 2005 of 3472 CASTs and CFRs were returned (58% response). 159 underwent diagnostic assessment, including 82 assessed in phase 1. All children meeting the criteria for autism identified via the Q-CHAT at phase 1 also met the criteria at phase 2. The PPV was 28% (95% CI 15% to 46%) after phase 1 and phase 2.ConclusionsThe Q-CHAT can be used at 18–30 months to identify autism and enable accelerated referral for diagnostic assessment. The low PPV suggests that for every true positive there would, however, be ~4–5 false positives. At follow-up, new cases were identified, illustrating the need for continued surveillance and rescreening at multiple time-points using developmentally sensitive instruments. Not all children who later receive a diagnosis of autism are detectable during the toddler period.
Development of ion recoil energy distributions in the Coulomb explosion of argon clusters resolved by charge-state selective ion energy spectroscopy
Authors: Komar D. , Kazak L. , Meiwes-Broer K-H. , Tiggesbäumker J. 
Published: May 2021

AbstractThe laser intensity dependence of the recoil energies from the Coulomb explosion of small argon clusters has been investigated by resolving the contributions of the individual charge states to the ion recoil energy spectra. Between $$10^{14}$$

10
14

and $$10^{15}$$

10
15

W/cm$$^2$$

2

, the high-energy tail of the ion energy spectra changes its shape and develops into the well-known knee feature, which results from the cluster size distribution, laser focal averaging, and ionization saturation. Resolving the contributions of the different charge states to the recoil energies, the experimental data reveal that the basic assumption of an exploding homogeneously charged sphere cannot be maintained in general. In fact, the energy spectra of the high-q show distinct gaps in the yields at low kinetic energies, which hints at more complex radial ion charge distributions developing during the laser pulse impact.
Temperature coefficient of Young’s modulus of silver microwhiskers determined by a laser Doppler vibration measurement
Authors: Jiang Yijun , Lu Mingyuan , Wang Shiliang , Huang Han 
Published: May 2021

Temperature dependence of Young’s modulus of Ag microwhiskers was determined by a laser Doppler vibrometer. The Ag whiskers with diameters in sub-microns were synthesized by the use of physical vapor deposition (PVD). They have a five-fold twinned structure grown along the [1 1 0] direction. The temperature coefficient of Young’s modulus was measured to be [Formula: see text] ppm/K in the range of 300 K to 650 K. The measured values are very close to the reported values of [Formula: see text] ppm/K for bulk Ag single crystals. This finding can benefit the design of Ag-based micro/nano-electromechanical systems or micro/nano-interconnectors operated at elevated or lowered temperatures.
Structural, Electrical and Optical Properties of Zinc and Tungsten Modified Lead Titanate Ceramics for Photovoltaic Applications
Authors: Parida S. K. 
Published: May 2021

A novel lead zinc titanate tungsten oxide (PbZn[Formula: see text]Ti[Formula: see text]W[Formula: see text]O[Formula: see text] single perovskite was synthesized employing a cost-effective solid-state reaction technique. A phase transition occurs from tetragonal (P4mm) to monoclinic (C2/m) after substituting zinc (Zn) and tungsten (W) into the B-site of the pure lead titanate. The average crystallite size and micro-lattice strain are 66.2[Formula: see text]nm and 0.159%, respectively, calculated by the Williamson–Hall method. The grains are uniformly distributed through well-defined grain boundaries and the average grain size is about 17.8[Formula: see text][Formula: see text]m analyzed from the SEM micrograph. Raman spectrum suggests the presence of all constituent elements in the sample. The UV–Visible study suggests that the sample is suitable for photovoltaic applications because of high bandgap energy [Formula: see text][Formula: see text]eV. The dielectric study confirms the negative temperature coefficient resistance (NTCR) behavior of the sample. The activation energy increases from 13.9[Formula: see text]meV to 142[Formula: see text]meV with a rise of temperature suggesting that ac conductivity is thermally activated. The thermally activated relaxation process was managed by immobile charge carriers at low temperatures while defects and oxygen vacancies at higher temperatures. The presence of the asymmetrical curves in modulus plots confirms the non-Debye-type behavior. Both Nyquist and Cole–Cole semi-circular arcs confirm the semiconductor nature of the sample.
A Transcriptionally Distinct Subpopulation of Healthy Acinar Cells Exhibit Features of Pancreatic Progenitors and PDAC
Authors: Gopalan Vishaka , Singh Arashdeep , Rashidi Mehrabadi Farid , Wang Li , Ruppin Eytan , Arda H. Efsun , Hannenhalli Sridhar 
Published: May 2021

Abstract

Pancreatic ductal adenocarcinoma (PDAC) tumors can originate either from acinar or ductal cells in the adult pancreas. We re-analyze multiple pancreas and PDAC single-cell RNA-seq datasets and find a subset of nonmalignant acinar cells, which we refer to as acinar edge (AE) cells, whose transcriptomes highly diverge from a typical acinar cell in each dataset. Genes upregulated among AE cells are enriched for transcriptomic signatures of pancreatic progenitors, acinar dedifferentiation, and several oncogenic programs. AE-upregulated genes are upregulated in human PDAC tumors, and consistently, their promoters are hypomethylated. High expression of these genes is associated with poor patient survival. The fraction of AE-like cells increases with age in healthy pancreatic tissue, which is not explained by clonal mutations, thus pointing to a nongenetic source of variation. The fraction of AE-like cells is also significantly higher in human pancreatitis samples. Finally, we find edge-like states in lung, liver, prostate, and colon tissues, suggesting that subpopulations of healthy cells across tissues can exist in pre-neoplastic states.

Significance:
These findings show “edge” epithelial cell states with oncogenic transcriptional activity in human organs without oncogenic mutations. In the pancreas, the fraction of acinar cells increases with age.