bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health system performance assessment in small countries: The case study of Latvia
Authors: Noto Guido , Corazza Ilaria , Kļaviņa Kristīne , Lepiksone Jana , Nuti Sabina 
Published: May 2019

SummaryManaging the complexity that characterizes health systems requires sophisticated performance assessment information to support the decision‐making processes of healthcare stakeholders at various levels. Accordingly, in the past few decades, many countries have designed and implemented health system performance assessment (HSPA) programmes. Literature and practice agree on the key features that performance measurement in health should have, namely, multidimensionality, evidence‐based data collection, systematic benchmarking of results, shared design, transparent disclosure, and timeliness.Nevertheless, the specific characteristics of different countries may pose challenges in the implementation of such programmes. In the case of small countries, many of these challenges are common and related to their inherent characteristics, eg, small populations, small volumes of activity for certain treatments, and lack of benchmarks.Through the development of the case study of Latvia, this paper aims at discussing the challenges and opportunities for assessing health system performance in a small country.As a result, for each of the performance measurement features identified by the literature, the authors discuss the issues emerging when adopting them in Latvia and set out the potential solutions that have been designed during the development of the case study.
Low‐intensity pulsed ultrasound promotes the proliferation of human bone mesenchymal stem cells by activating PI3K/AKt signaling pathways
Authors: Xie Shucai , Jiang Xili , Wang Rui , Xie Shaowei , Hua Yongyong , Zhou Shuai , Yang Yijun , Zhang Jianquan 
Published: May 2019

AbstractLow‐intensity pulsed ultrasound (LIPUS) is a promising therapy that is widely used in clinical applications and fundamental research. Previous research has shown that LIPUS exposure has a positive effect on stem cell proliferation. However, the impact of LIPUS exposure on human bone marrow mesenchymal stem cells (hBMSCs) remains unknown. In our study, the effect and mechanism of LIPUS exposure on the proliferation of hBMSCs were investigated, and the optimal parameters of LIPUS were determined. hBMSCs were obtained and identified by flow cytometry, and the proliferation of hBMSCs was measured using the Cell Counting Kit‐8 assay to determine cell cycle and cell count. Expression levels of the phosphoinositide 3‐kinase (PI3K)/protein kinase B (AKt) pathway proteins and cyclin D1 were determined by western blot analysis. Next, hBMSCs were successfully cultured and identified as multipotent mesenchymal stem cells. We found that LIPUS could promote the proliferation of hBMSCs when the exposure time was 5 or 10 minutes per day. Furthermore, 50 or 60 mW/cm2 LIPUS had a more significant effect on cell proliferation, but if cells were irradiated by LIPUS for 20 minutes once a day, an intensity of at least 50 mW/cm2 could markedly inhibit cell growth. Cell cycle analysis demonstrated that LIPUS treatment drives cells to enter S and G2/M phases from the G0/G1 phase. LIPUS exposure increased phosphorylation of PI3K/AKt and significantly upregulated expression of cyclin D1. However, these effects were inhibited when cells were treated with PI3K inhibitor (LY294002), which in turn reduced LIPUS‐mediated proliferation of hBMSCs. These results suggest that LIPUS exposure may be involved in the proliferation of hBMSCs via activation of the PI3K/AKt signaling pathway and high expression of cyclin D1, and the intensity of 50 or 60 mW/cm2 and exposure time of 5 minutes were determined to be the optimal parameters for LIPUS exposure.
Screening candidate microRNA‐mRNA network for predicting the response to chemoresistance in osteosarcoma by bioinformatics analysis
Authors: Dai Penggao , He Yancheng , Luo Guosong , Deng Jiaqi , Jiang Nan , Fang Tingting , Li Yujuan , Cheng Ying 
Published: May 2019

AbstractThe search for biomarkers is important for providing more targeted treatments for osteosarcoma patients with chemoresistance. In this study, differentially expressed microRNAs (miRNAs) were identified from miRNA expression profiles. And the target messenger RNAs (mRNAs) of miRNA were obtained from two websites in public domains. Analysis of Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway by these miRNA targets suggests that they may have potential links to osteosarcoma chemoresistance. In the protein‐protein interaction (PPI) network, we screened three subnetworks and 10 hub RNAs, and analyzed through KEGG pathway and searched the PubMed database, indicating that they were significantly associated with drug resistance. Then we found 12 key mRNAs by analyzing the mRNA expression profile. Survival analyses showed that most of the 10 hub mRNAs and 12 key mRNAs had a significant influence on the prognosis of patients with chemoresistance osteosarcoma. A miRNA‐mRNA network is constructed by integrating mRNAs and miRNAs information. The network biomarkers in this study have an advantage over traditional single‐molecule biomarkers in terms of predictive power. And the mRNAs in this network biomarkers are supported by survival analysis or by existing theories. These results will contribute to the choice of chemotherapy before treatment and the prediction of patient prognosis.
Performance evaluation of thrombomodulin, thrombin‐antithrombin complex, plasmin‐α2‐antiplasmin complex, and t‐PA: PAI‐1 complex
Authors: Chen Qian , Shou Weiling , Wu Wei , Wang Geng , Cui Wei 
Published: May 2019

AbstractBackgroundTo conduct a comprehensive performance evaluation of a fully automated analyzer for measuring thrombomodulin (TM), thrombin‐antithrombin complex (TAT), plasmin‐α2‐antiplasmin complex (PAP), and t‐PA: PAI‐1 complex (tPAI‐C).MethodsAccording to the Clinical and Laboratory Standards Institute (CLSI) EP05‐A2, EP06‐A specifications, TM, TAT, PAP, and tPAI‐C were analyzed to evaluate intraassay variability and interassay variability, linear range, carryover rate, reference range, sample stability, and interferences.ResultsThe intraassay variability and interassay variability of the four factors were all below 5%. The carryover rates were below 1%. Linear verification analysis revealed correlation coefficients of 0.998‐0.999. The recommended reference ranges of TM, TAT, and PAP were appropriate for our laboratory, whereas the reference of tPAI‐C should be established by each laboratory. Stability assessment revealed that TM is stable for 2 days at room temperature but lacks stability at colder temperatures. In contrast, TAT is stable for 5 days at 4°C and −20°C but has poor stability at room temperature. PAP and tPAI‐C are stable for 3 days at all three temperatures. The measurement of TM, TAT, PAP, and tPAI‐C is not altered by the presence of 510 mg/dL hemoglobin, 1490 FTU triglycerides, or 21.1 mg/dL conjugated and free bilirubin.ConclusionThe determination of TM, TAT, PAP, and tPAI‐C using a high‐sensitivity chemiluminescence analyzer performs well in terms of precision, carryover rate, linear range, and interference. Thus, this method is suitable for the detection of these substances in clinical specimens.
Epidemiological and clinical suspicion of congenital Zika virus infection: Serological findings in mothers and children from Brazil
Authors: Venturi Giulietta , Fortuna Claudia , Alves Rita Maria , Passos do Prado Paschoal Ana Gabriela , da Silva Júnior Pedro José , Remoli Maria Elena , Benedetti Eleonora , Amendola Antonello , da Silva Batista Everton , Gama Deijamile Virginia Novais , Barros Davi Hasselmann , Fiorentini Cristiano , Rezza Giovanni , Leite Primo Chagas Janeusa Rita 
Published: May 2019

AbstractThe emergence of Zika virus in the Americas has caused an increase of babies born with microcephaly or other neurological malformations. The differential diagnosis of Zika infection, particularly serological diagnosis, is an important but complex issue. In this study, we describe clinical manifestations of 94 suspected cases of congenital Zika from Bahia state, Brazil, and the results of serological tests performed on children and/or their mothers at an average of 71 days after birth. Anti‐Zika immunoglobulin M (IgM) antibodies were detected in 44.4% and in 7.1% of samples from mothers and children, respectively. Nearly all the IgM, and 92% of immunoglobulin G positive results were confirmed by neutralization test. Zika specific neutralizing antibodies were detected in as much as 90.4% of the cases. Moreover, dengue specific neutralizing antibodies were detected in 79.0% of Zika seropositive mothers. In conclusion, Zika IgM negative results should be considered with caution, due to a possible rapid loss of sensitivity after birth, while the NS1‐based Zika IgM enzyme‐linked immunosorbent assay test we have used has demonstrated to be highly specific. In a high percentage of cases, Zika specific neutralizing antibodies were detected, which are indicative of a past Zika infection, probably occurred during pregnancy in this population.
Are Current Protein Recommendations for the Critically Ill Adequate for Patients on VV ECMO: Experience From a High‐Volume Center
Authors: Pelekhaty Stacy L. , Galvagno Samuel M. , Lantry James H. , Dolly Katelyn N. , Herr Daniel L. , Kon Zachary N. , Deatrick Kristopher B. , Cornachione Christopher R. , Scalea Thomas M. , Menaker Jay 
Published: May 2019

AbstractBackgroundThe nutrition needs of patients requiring extracorporeal membrane oxygenation (ECMO) have not been established in the literature. The purpose of this study is to investigate if current protein recommendations are adequate to achieve nitrogen equilibrium in patients on venovenous ECMO (VV ECMO).MethodsPatients aged ≥18 years on VV ECMO admitted November 2016 through January 2018 with a documented nitrogen balance (NB) study were included. Patients were stratified by body mass index (BMI) into obese (BMI ≥ 30 kg/m2) and nonobese (BMI < 30 kg/m2) categories for analysis.ResultsAfter exclusions, 55 NB studies in 29 patients were analyzed. Twelve nonobese patients received a median of 2.1 g protein/kg actual body weight (ABW) (interquartile range [IQR]: 1.7–2.5), and median NB was −2.2 g/d (IQR: −7.4 to 2.8). In 17 obese patients, median protein delivery of 2 g protein/kg ideal body weight (IBW) (IQR: 1.7–2.5) achieved a median NB of −7.3 g/d (IQR: −12.6 to −2.8). Obese patients exhibited greater urinary urea nitrogen excretion than nonobese patients did (24.6 vs 17.6 g/d, P < 0.0001).ConclusionsObese and nonobese patients undergoing VV ECMO may require more protein than is currently recommended for critical illness. Monitoring nutrition delivery and serial NB to assess prescription adequacy should be incorporated into routine patient care. Further research is needed to confirm these findings and create specific guidelines for patients on VV ECMO.
Universal detection of body fluid traces in situ with Raman hyperspectroscopy for forensic purposes: Evaluation of a new detection algorithm (HAMAND) using semen samples
Authors: McLaughlin Gregory , Fikiet Marisia A. , Ando Masahiro , Hamaguchi Hiro‐o , Lednev Igor K. 
Published: May 2019

AbstractTowards closing the technological gaps in forensic science, Raman spectroscopy has been a boon to the field. One area that this technique shows exceptional promise is in body fluid identification and characterization, but substrate interference remains a major impediment to its practical implementation. Here, we present an approach for the universal detection of body fluids regardless of the substrate. This approach, which is based on Raman hyperspectroscopy and multivariate curve resolution, was applied to datasets representing simulated semen evidence. In every instance, the signal of the fluid was extracted and matched to a reference of semen. This approach has immediate application for body fluid detection and allows for a universal, automatic, nondestructive, on‐field method for confirmatory identification of body fluid traces at a crime scene. This approach is applicable where an analyte is either a minor contributor or spatially distributed on a strongly interfering substrate.
Time‐gated Raman and laser‐induced breakdown spectroscopy in mapping of eudialyte and catapleiite
Authors: Romppanen Sari , Häkkänen Heikki , Kekkonen Jere , Nissinen Jan , Nissinen Ilkka , Kostamovaara Juha , Kaski Saara 
Published: May 2019

AbstractRaman analysis of rock samples containing rare earth elements (REEs) is challenging due to the strong fluorescence, which may mask the weaker Raman signal. In this research, time‐gated (TG) Raman has been applied to the construction of the mineral distribution map from REE‐bearing rock. With TG Raman, material is excited with a short subnanosecond laser pulse, and the Raman signal is collected within a picosecond‐scale time window prior to the formation of a strong fluorescent signal by means of single‐photon avalanche diode array. This allows signal readout with a significantly reduced fluorescence background. TG Raman maps are used to reveal the location of valuable minerals and are compared with the elemental distribution given by laser‐induced breakdown spectroscopy. The analysis was carried out from a REE‐bearing rock, nepheline syenite sample from the Norra Kärr deposit, where REEs are mainly hosted in eudialyte and catapleiite. The combination of these two complimentary laser spectroscopic methods offers valuable elemental and mineralogical information about rocks.
Pediatric airway tumors: A report from the International Network of Pediatric Airway Teams (INPAT)
Authors: Pio Luca , Varela Patricio , Eliott Martin J. , Couloigner Vincent , Guillén Burrieza Gabriela , Paraboschi Irene , Virgone Calogero , Maunsell Rebecca , Rachkov Victor , Rutter Michael J. , Boglione Mariano , Penchyna Grub Jaime , Bellía Munzón Gastón , Sarnacki Sabine , Irtan Sabine , Schweiger Claudia , Larroquet Michèle , Khen Dunlop Naziha , Ramaswamy Madhavan , Pistorio Angela , Cecchetto Giovanni , Ferrari Andrea , Bisogno Gianni , Torre Michele 
Published: May 2019

ObjectivePrimary tracheobronchial tumors (PTTs) are rare heterogeneous lesions arising from any part of the tracheobronchial tree. Nonspecific symptoms may lead to delayed diagnosis that requires more aggressive surgical treatment. An analysis of cases collected by the International Network of Pediatric Airway Team was undertaken to ensure proper insight into the behavior and management of PTTs.MethodsPatients <18 years of age with a histological confirmation of PTT diagnosed from 2000 to 2015 were included in this multicenter international retrospective study. Medical records, treatment modalities, and outcomes were analyzed. The patient presentation, tumor management, and clinical course were compared between malignant and benign histotypes. Clinical and surgical variables that might influence event‐free survival were considered.ResultsAmong the 78 children identified, PTTs were more likely to be malignant than benign; bronchial carcinoid tumor (n = 31; 40%) was the most common histological subtype, followed by inflammatory myofibroblastic tumor (n = 19; 25%) and mucoepidermoid carcinoma (n = 15; 19%). Regarding symptoms at presentation, wheezing (P = 0.001) and dyspnea (P = 0.03) were more often associated with benign growth, whereas hemoptysis was more frequently associated with malignancy (P = 0.042). Factors that significantly worsened event‐free survival were age at diagnosis earlier than 112 months (P = 0.0035) and duration of symptoms lasting more than 2 months (P = 0.0029).ConclusionThe results of this international study provide important information regarding the clinical presentation, diagnostic workup, and treatment of PTTs in children, casting new light on the biological behavior of PTTs to ensure appropriate treatments.Level of EvidenceNALaryngoscope, 130:E243–E251, 2020
Potential terrestrial influence on transparent exopolymer particle concentrations in boreal freshwaters
Authors: Attermeyer Katrin , Andersson Sara , Catalán Núria , Einarsdottir Karolina , Groeneveld Marloes , Székely Anna J. , Tranvik Lars J. 
Published: May 2019

AbstractTransparent exopolymer particles (TEP) are ubiquitous in aquatic ecosystems and contribute, for example, to sedimentation of organic matter in oceans and freshwaters. Earlier studies indicate that the formation of TEP is related to the in situ activity of phytoplankton or bacteria. However, terrestrial sources of TEP and TEP precursors are usually not considered. We investigated TEP concentration and its driving factors in boreal freshwaters, hypothesizing that TEP and TEP precursors can enter freshwaters via terrestrial inputs. In a field survey, we measured TEP concentrations and other environmental factors across 30 aquatic ecosystems in Sweden. In a mesocosm experiment, we further investigated TEP dynamics over time after manipulating terrestrial organic matter input and light conditions. The TEP concentrations in boreal freshwaters ranged from 83 to 4940 μg Gum Xanthan equivalent L−1, which is comparable to other studies in freshwaters. The carbon fraction in TEP in the sampled boreal freshwaters is much higher than the phytoplanktonic carbon, in contrast to previous studies in northern temperate and Mediterranean regions. Boreal TEP concentrations were mostly related to particulate organic carbon, dissolved organic carbon, and optical indices of terrestrial influence but less influenced by bacterial abundance, bacterial production, and chlorophyll a. Hence, our results do not support a major role of the phytoplankton community or aquatic bacteria on TEP concentrations and dynamics. This suggests a strong external control of TEP concentrations in boreal freshwaters, which can in turn affect particle dynamics and sedimentation in the recipient aquatic ecosystem.
Preparation of Hyaluronic‐Acid‐Based Microspherical Particles with Tunable Morphology Using a Spray Method on a Superhydrophobic Surface
Authors: Seong Yun‐Jeong , Kang In‐Gu , Song Eun‐Ho , Kim Hyoun‐Ee , Jeong Seol‐Ha 
Published: May 2019

AbstractHyaluronic acid (HA) gel microspheres have advantages in the application of hydrogel injections due to their uniform size and shape. The HA microspheres are typically prepared using oil‐emulsion methods, which often use toxic solvents, or spray methods involving dehydration, which can negatively affect the properties of the hydrogel. In this study, an alternative fabrication method that avoids the use of solvents or dehydration is introduced. A poly‐dimethylsiloxane template is micro‐patterned to mimic the papillae structure of the lotus leaf which has superhydrophobicity. Glycidyl‐methacrylate HA solution is sprayed on the superhydrophobic template followed by photocrosslinking the droplet to produce spherical shapes of HA hydrogel particles. Gel particles with diverse shapes are formed, with the shapes depending on the arrangement of the papillae and surface hydrophobicity. As a result, microspherical particles with aspect ratios greater than 0.8 are produced.
Transparent, Lightweight, and High Strength Polyethylene Films by a Scalable Continuous Extrusion and Solid‐State Drawing Process
Authors: Lin Yunyin , Tu Wei , Verpaalen Rob C. P. , Zhang Han , Bastiaansen Cees W. M. , Peijs Ton 
Published: May 2019

AbstractThe continuous production of transparent high strength ultra‐drawn high‐density polyethylene films or tapes is explored using a cast film extrusion and solid‐state drawing line. Two methodologies are explored to achieve such high strength transparent polyethylene films; i) the use of suitable additives like 2‐(2H‐benzotriazol‐2‐yl)‐4,6‐ditertpentylphenol (BZT) and ii) solid‐state drawing at an optimal temperature of 105 °C (without additives). Both methodologies result in highly oriented films of high transparency (≈91%) in the far field. Maximum attainable modulus (≈33 GPa) and tensile strength (≈900 MPa) of both types of solid‐state drawn films are similar and are an order of magnitude higher than traditional transparent plastics such as polycarbonate (PC) and poly(methyl methacrylate). Special emphasis is devoted to the effect of draw down and pre‐orientation in the as‐extruded films prior to solid‐state drawing. It is shown that pre‐orientation is beneficial in improving mechanical properties of the films at equal draw ratios. However, pre‐orientation lowers the maximum attainable draw ratio and as such the ultimate modulus and tensile strength of the films. Potential applications of these high strength transparent flexible films lie in composite laminates, automotive or aircraft glazing, high impact windows, safety glass, and displays.
Environmentally Benign Polyelectrolyte Complex That Renders Wood Flame Retardant and Mechanically Strengthened
Authors: Kolibaba Thomas J. , Grunlan Jaime C. 
Published: May 2019

AbstractHome structure fires are responsible for a majority of fire deaths and injuries. Wood is a key component of home construction due to its excellent mechanical properties and renewability, but it is inherently flammable. This study demonstrates the ability of a waterborne polyelectrolyte complex (PEC) to significantly increase wood's time to ignition, while decreasing peak heat release rate and total heat release. The PEC treatment, comprised of polyethylenimine and sodium hexametaphosphate, preserves the visual aesthetic of the wood and adds little additional weight (ca. 6%), while concurrently increasing flexural modulus and flexural strength. Scanning electron microscope images after torch testing provide evidence of a microintumescent flame retardant mechanism. This unique water‐based coating provides an environmentally benign means to render wood construction much safer.
“I wish someone had once asked me how I'm doing”: Disadvantages and support needs faced by parents of long‐term childhood cancer survivors
Authors: Christen Salome , Mader Luzius , Baenziger Julia , Roser Katharina , Schindera Christina , Tinner Eva Maria , Michel Gisela 
Published: May 2019

AbstractBackgroundChildhood cancer affects the whole family and can have a lasting impact on parents of childhood cancer survivors (CCS). We aimed to (1) describe parents’ perspective of currently experienced disadvantages and of their support needs during treatment, after treatment, and today; (2) identify characteristics associated with disadvantages and support needs; and (3) describe the use of existing support services.ProcedureIn this population‐based study, we identified parents of CCS (diagnosed ≤16 years of age, ≥5 years since diagnosis, aged ≥20 years at study) through the Swiss Childhood Cancer Registry (SCCR). Parents completed a questionnaire on perceived disadvantages (e.g., job‐related, financial, etc.), support needs (e.g., job‐related, financial, etc.), and socio‐demographics. Cancer‐related characteristics were available from the SCCR. We used multivariable multilevel logistic regression to identify characteristics associated with disadvantages and support needs.ResultsAn average of 24 years after diagnosis, one‐fifth of parents (n = 59/308; 19.2%) reported disadvantages, and 7.1% reported support needs. Many parents had desired more support during (66.9%) or after (34.4%) their child's cancer treatment. Parents whose child experienced late effects (OR = 26.6; 95% CI, 2.9–241.0) or was dependent on parents (OR = 10.6; 95% CI, 2.1–53.7) reported greater current need for more support. Almost half of parents (43.5%) reported having used existing support services.ConclusionsMany parents need more support during and after active treatment of their child's cancer, and some experience support needs and disadvantages long into survivorship. Better promotion of existing services for parental and familial support and setting up new services, where needed, may help parents in the long term.