bluuebunny/crossref_metadata_2025_split huggingface dataset:
Where does the Albumin go? Human Albumin Solution usage following the implementation of a demand management programme
Authors: Yazdani M. S. , Retter A. , Maggs T. , Li P. , Robson M. G. , Reid C. , Holmes P. , Garood T. , Robinson S. E. 
Published: April 2017

SUMMARYObjectiveTo outline the Guy's and St Thomas' NHS Foundation Trust (GSTFT) and Evelina London Children's Hospital (ELCH) demand management plan for human albumin solution (HAS) and usage.BackgroundThere is no UK‐wide guidance governing the use of HAS. A severe shortage in 2015 prompted a Trust demand management programme. Indications were categorised according to locally agreed colour code and ASFA categories.MethodsFollowing the implementation of the demand management programme, a 6‐month audit of HAS usage was completed.ResultsA total of 1303.1 L of HAS was used in 1139 infusions; 737 infusions were 20% HAS, accounting for 175.7 L (13.5%) in 181 patients. Indications for 20% HAS were red in 53.9% (94.7 L), blue in 26.5% (46.5 L) and grey in 19.6% (34.5 L). The remaining 1127.4 L (86.5%) infused were of 4.5 and 5 % HAS. A total of 1102.3 L (97.8%) was used for plasma exchange, 941.4 L (85.4%) ASFA category I, 93.7 L (8.5%) category II, 25.5 L (2.3%) category IV and 41.7 L (3.8%) for indications not specified according to ASFA; 25.1 L (2.2%) were used for a grey indication (volume resuscitation for hypovolaemia).ConclusionsThe demand management programme provides surveillance of indications and retrospective verification of appropriate use. The majority of HAS indications were appropriate. Plasma exchange accounted for 84.6% of HAS usage and will be the focus of further demand management strategies. The demand management programme whilst aiming to promote best transfusion practice also ensures a tool to manage future shortages according to indication and available supply.
Disease spectrum and management of children admitted with acute respiratory infection in Viet Nam
Authors: Nguyen T. K. P. , Nguyen D. V. , Truong T. N. H. , Tran M. D. , Graham S. M. , Marais B. J. 
Published: April 2017

AbstractObjectiveTo assess the acute respiratory infection (ARI) disease spectrum, duration of hospitalisation and outcome in children hospitalised with an ARI in Viet Nam.MethodsWe conducted a retrospective descriptive study of ARI admissions to primary (Hoa Vang District Hospital), secondary (Da Nang Hospital for Women and Children) and tertiary (National Hospital of Paediatrics in Ha Noi) level hospitals in Viet Nam over 12 months (01/09/2015 to 31/08/2016).ResultsAcute respiratory infections accounted for 27.9% (37 436/134 061) of all paediatric admissions; nearly half (47.6%) of all children admitted to Hoa Vang District Hospital. Most (64.6%) of children hospitalised with an ARI were <2 years of age. Influenza/pneumonia accounted for 69.4% of admissions; tuberculosis for only 0.3%. Overall 284 (0.8%) children died; most deaths (269/284; 94.7%) occurred at the tertiary referral hospital. The average duration of hospitalisation was 7.6 days (median 7 days). The average direct hospitalisation cost per ARI admission was 157.5 USD in Da Nang Provincial Hospital. In total, 62.6% of admissions were covered by health insurance.ConclusionAcute respiratory infection is a major cause of paediatric hospitalisation in Viet Nam, characterised by prolonged hospitalisation for relatively mild disease. There is huge potential to reduce unnecessary hospital admission and cost.
Causes and consequences of higher Leishmania infantum burden in patients with kala‐azar: a study of 625 patients
Authors: Zacarias Danielle A. , Rolão Nuno , de Pinho Flaviane A. , Sene Ingridi , Silva Jailthon C. , Pereira Teresinha C. , Costa Dorcas L. , Costa Carlos H. N. 
Published: April 2017

AbstractBackgroundAn infected host's Leishmania infantum load in blood is considered to be an estimate of his or her total parasite burden. Therefore, the measurement of blood parasite burden is important in the identification of factors involved in parasite control.MethodsQuantitative polymerase chain reaction was performed on blood samples from 625 patients with kala‐azar consecutively admitted to a reference hospital in Teresina, Brazil. Primers were used to amplify a segment of kDNA using the TaqMan system. Non‐parametric statistical tests were applied.ResultsThe median blood parasite burden was 499.2 amastigote equivalents (AE)/ml. Children <1 year old (yo) had a high parasite burden, which dropped sharply after the first year of life (192.8, AE/ml at 1 < 2 yo) and remained lower until adolescence. Following adolescence, the parasite burden increased with age, peaking among elderly individuals. Men had a higher parasite burden than women. HIV‐infected patients had a much higher parasite burden than non‐infected patients. The parasite burden of children under 5 years with acute moderate to severe malnourishment (weight‐for‐age and body mass index z‐scores <−2) was almost three times greater than that of better‐nourished children. The parasite burden identified in deceased patients was more than twice that of surviving patients; those with a higher risk of death, sepsis, pneumonia and jaundice also had increased parasite burdens. All of these differences were statistically significant at P‐values <0.05.ConclusionsThese data indicate that the parasite burden in patients with kala‐azar was associated with age‐ and gender‐associated factors and with HIV infection status. Acute malnutrition could be either a cause or a consequence of a higher parasite burden. An individual's parasite burden influences his or her clinical profile, disease severity and mortality risk. The best explanation for the presence of a higher parasite burden in individuals with these immunoregulatory conditions and severe disease is the occurrence of acquired immunosuppression followed by heightened innate immunity.
Microscopic observation drug‐susceptibility assay vs. Xpert®MTB/RIF for the diagnosis of tuberculosis in a rural African setting: a cost–utility analysis
Authors: Wikman‐Jorgensen Philip E. , Llenas‐García Jara , Pérez‐Porcuna Tomàs M. , Hobbins Michael , Ehmer Jochen , Mussa Manuel A. , Ascaso Carlos 
Published: April 2017

AbstractObjectiveTo compare the cost–utility of microscopic observation drug‐susceptibility assay (MODS) and Xpert® MTB/RIF implementation for tuberculosis (TB) diagnosis in rural northern Mozambique.MethodsStochastic transmission compartmental TB model from the healthcare provider perspective with parameter input from direct measurements, systematic literature reviews and expert opinion. MODS and Xpert® MTB/RIF were evaluated as replacement test of smear microscopy (SM) or as an add‐on test after a negative SM. Costs were calculated in 2013 USD, effects in disability‐adjusted life years (DALY). Willingness to pay threshold (WPT) was established at once the per capita Gross National Income of Mozambique.ResultsMODS as an add‐on test to negative SM produced an incremental cost‐effectiveness ratio (ICER) of 5647.89USD/DALY averted. MODS as a substitute for SM yielded an ICER of 5374.58USD/DALY averted. Xpert® MTB/RIF as an add‐on test to negative SM yielded ICER of 345.71USD/DALY averted. Xpert® MTB/RIF as a substitute for SM obtained an ICER of 122.13USD/DALY averted. TB prevalence and risk of infection were the main factors impacting MODS and Xpert® MTB/RIF ICER in the one‐way sensitivity analysis. In the probabilistic sensitivity analysis, Xpert® MTB/RIF was most likely to have an ICER below the WPT, whereas MODS was not.ConclusionOur cost–utility analysis favours the implementation of Xpert® MTB/RIF as a replacement of SM for all TB suspects in this rural high TB/HIV prevalence African setting.
Alcohol acyl transferase 1 links two distinct volatile pathways that produce esters and phenylpropenes in apple fruit
Authors: Yauk Yar‐Khing , Souleyre Edwige J.F. , Matich Adam J. , Chen Xiuyin , Wang Mindy Y. , Plunkett Blue , Dare Andrew P. , Espley Richard V. , Tomes Sumathi , Chagné David , Atkinson Ross G. 
Published: April 2017

SummaryFruit accumulate a diverse set of volatiles including esters and phenylpropenes. Volatile esters are synthesised via fatty acid degradation or from amino acid precursors, with the final step being catalysed by alcohol acyl transferases (AATs). Phenylpropenes are produced as a side branch of the general phenylpropanoid pathway. Major quantitative trait loci (QTLs) on apple (Malus × domestica) linkage group (LG)2 for production of the phenylpropene estragole and volatile esters (including 2‐methylbutyl acetate and hexyl acetate) both co‐located with the MdAAT1 gene. MdAAT1 has previously been shown to be required for volatile ester production in apple (Plant J., 2014, https://doi.org/10.1111/tpj.12518), and here we show it is also required to produce p‐hydroxycinnamyl acetates that serve as substrates for a bifunctional chavicol/eugenol synthase (MdoPhR5) in ripe apple fruit. Fruit from transgenic ‘Royal Gala’ MdAAT1 knockdown lines produced significantly reduced phenylpropene levels, whilst manipulation of the phenylpropanoid pathway using MdCHS (chalcone synthase) knockout and MdMYB10 over‐expression lines increased phenylpropene production. Transient expression of MdAAT1, MdoPhR5 and MdoOMT1 (O‐methyltransferase) genes reconstituted the apple pathway to estragole production in tobacco. AATs from ripe strawberry (SAAT1) and tomato (SlAAT1) fruit can also utilise p‐coumaryl and coniferyl alcohols, indicating that ripening‐related AATs are likely to link volatile ester and phenylpropene production in many different fruit.
Phylogenetic evidence for underreporting of male‐to‐male sex among human immunodeficiency virus–infected donors in the Netherlands and Flanders
Authors: van de Laar Thijs J. , Bezemer Daniela , van Laethem Kristel , Vandewalle Giovani , de Smet Annie , van Wijngaerden Eric , Claas Eric C. , van Sighem Ard I. , Vandamme Anne‐Mieke , Compernolle Veerle , Zaaijer Hans L. 
Published: April 2017

BACKGROUNDSeparate transmission networks for human immunodeficiency virus (HIV) coexist. Molecular typing of viral genomes can provide insight in HIV transmission routes in donors for whom risk behavior–based donor selection failed.STUDY DESIGN AND METHODSThis study includes all HIV‐infected Dutch and Flemish donors in the period 2005 to 2014 (n = 55). Part of the HIV polymerase (pol) gene was amplified, sequenced, and compared with more than 10,000 HIV strains obtained from HIV‐infected Dutch and Flemish patients. The most likely transmission route was determined based on HIV phylogeny and the donor's self‐reported risk behavior during the exit interview.RESULTSHIV‐infected donors were predominantly male (69%), were repeat donors (73%), were born in the Netherlands or Belgium (95%), and harbored HIV Subtype B (68%). Seventy‐five percent of HIV‐infected male donors were part of robust phylogenetic clusters linked to male‐to‐male sex, while only 24% of HIV‐infected male donors reported male‐to‐male sex during posttest counseling. Sex between men and women accounted for 13% of HIV infections in male donors and 93% of HIV infections in female donors based on phylogenetic analysis. Only 40% of HIV‐infected female donors had HIV Subtype B; 65% of female donors reported a foreign partner and indeed HIV sequences interspersed with sequences from HIV‐endemic areas abroad, in particular sub‐Saharan Africa.CONCLUSIONHIV typing helps to understand HIV transmission routes in donor populations. We found substantial underreporting of male‐to‐male sex among HIV‐infected male donors. Donor education on HIV risk factors and the danger of window‐period donations and a donor environment that encourages frank disclosure of sexual behavior will contribute to a decrease of HIV‐infected donors.
Lack of consensus on consensual response
Authors: Stonex Tara M. , Bartoe Joshua T. , Aguirre Gustavo D. 
Published: April 2017

AbstractThe pupillary light reflex (PLR) is a routinely utilized clinical test to quickly assess integrity of subcortical light perception pathways in patients. While interpretation is simple for ophthalmologists, interestingly discrepancy occurs in annotation of the test results, especially for the consensual response. An email survey sent to diplomates of either the American or European Colleges of Veterinary Ophthalmologists (ACVO and ECVO, respectively), requesting use of a ‘direct/consensual’ annotation convention, showed 58% of respondents preferred one convention while 39% preferred a different convention. The majority preferred convention was different between ACVO and ECVO respondents. Standardization of PLR annotation convention across specialists is recommended for clarity in medical record keeping and communication among colleagues.
Identification and content validation of wound therapy clinical endpoints relevant to clinical practice and patient values for FDA approval. Part 1. Survey of the wound care community
Authors: Driver Vickie R. , Gould Lisa J. , Dotson Peggy , Gibbons Gary W. , Li William W. , Ennis William J. , Kirsner Robert S. , Eaglstein William H. , Bolton Laura L. , Carter Marissa J. 
Published: April 2017

AbstractWounds that exhibit delayed healing add extraordinary clinical, economic, and personal burdens to patients, as well as to increasing financial costs to health systems. New interventions designed to ease such burdens for patients with cancer, renal, or ophthalmologic conditions are often cleared for approval by the U.S. Food and Drug Administration (FDA) using multiple endpoints but the requirement of complete healing as a primary endpoint for wound products impedes FDA clearance of interventions that can provide other clinical or patient‐centered benefits for persons with wounds. A multidisciplinary group of wound experts undertook an initiative, in collaboration with the FDA, to identify and content validate supporting FDA criteria for qualifying wound endpoints relevant to clinical practice (CP) and patient‐centered outcomes (PCO) as primary outcomes in clinical trials. As part of the initiative, a research study was conducted involving 628 multidisciplinary expert wound clinicians and researchers from 4 different groups: the interdisciplinary core advisory team; attendees of the Spring 2015 Symposium on Advanced Wound Care (SAWC); clinicians employed by a national network of specialty clinics focused on comprehensive wound care; and Association for the Advancement of Wound Care (AAWC) and Wound Healing Society (WHS) members who had not previously completed the survey. The online survey assessed 28 literature‐based wound care endpoints for their relevance and importance to clinical practice and clinical research. Fifteen of the endpoints were evaluated for their relevance to improving quality of life. Twenty‐two endpoints had content validity indexes (CVI) ≥ 0.75, and 15 were selected as meriting potential inclusion as additional endpoints for FDA approval of future wound care interventions. This study represents an important first step in identifying and validating new measurable wound care endpoints for clinical research and practice and for regulatory evaluation.
An increased extrasynaptic NMDA tone inhibits A‐type K+ current and increases excitability of hypothalamic neurosecretory neurons in hypertensive rats
Authors: Zhang Meng , Biancardi Vinicia C. , Stern Javier E. 
Published: April 2017

Key points
A functional coupling between extrasynaptic NMDA receptors (eNMDARs) and the A‐type K+ current (IA) influences homeostatic firing responses of magnocellular neurosecretory cells (MNCs) to a physiological challenge. However, whether an altered eNMDAR–IA coupling also contributes to exacerbated MNC activity and neurohumoral activation during disease states is unknown.
We show that activation of eNMDARs by exogenously applied NMDA inhibited IA in MNCs obtained from sham, but not in MNCs from renovascular hypertensive (RVH) rats.
Neither the magnitude of the exogenously evoked NMDA current nor the expression of NMDAR subunits were altered in RVH rats.
Conversely, we found that a larger endogenous glutamate tone, which was not due to blunted glutamate transport activity, led to the sustained activation of eNMDARs that tonically inhibited IA, contributing in turn to higher firing activity in RVH rats.
Our studies show that exacerbated activation of eNMDARs by endogenous glutamate contributes to tonic inhibition of IA and enhanced MNC excitability in RVH rats.
AbstractWe recently showed that a functional coupling between extrasynaptic NMDA receptors (eNMDARs) and the A‐type K+ current (IA) influences the firing activity of hypothalamic magnocellular neurosecretory neurons (MNCs), as well as homeostatic adaptive responses to a physiological challenge. Here, we aimed to determine whether changes in the eNMDAR–IA coupling also contributed to exacerbated MNC activity during disease states. We used a combination of patch‐clamp electrophysiology and real‐time PCR in MNCs in sham and renovascular hypertensive (RVH) rats. Activation of eNMDARs by exogenously applied NMDA inhibited IA in sham rats, but this effect was largely blunted in RVH rats. The blunted response was not due to changes in eNMDAR expression and/or function, since neither NMDA current magnitude or reversal potential, nor the levels of NR1‐NR2A–D subunit expression were altered in RVH rats. Conversely, we found a larger endogenous glutamate tone, resulting in the sustained activation of eNMDARs that tonically inhibited IA and contributed also to higher ongoing firing activity in RVH rats. The enhanced endogenous glutamate tone in RVH rats was not due to blunted glutamate transporter activity. Rather, a higher transporter activity was observed, which possibly acted as a compensatory mechanism in the face of the elevated endogenous tone. In summary, our studies indicate that an elevated endogenous glutamate tone results in an exacerbated activation of eNMDARs, which in turn contributes to diminished IA magnitude and increased firing activity of MNCs from hypertensive rats.
Small-Scale Smart Electrical Grid Design, Construction, and Analysis
Authors: Craig Andrew , Li Xiaokuan , Sesker Patrick , Mcinerny Alex , DeAgostino Thomas , Depcik Christopher 
Published: April 2017

As society moves into the digital age, the expectation of instantaneous electricity at the flip of a switch is more prominent than ever. The traditional electric grid has become outdated and Smart Grids are being developed to deliver reliable and efficient energy to consumers. However, the costs involved with implementing their infrastructure often limits research to theoretical models.
As a result, an undergraduate capstone design team constructed a small-scale 12 VDC version to be used in conjunction with classroom and research activities. In this model Smart Grid, two houses act as residential consumers, an industrial building serves as a high-load demand device, and a lead-acid battery connected to a 120 VAC wall outlet simulates fossil fuel power plants. A smaller lead-acid battery provides a microgrid source while a photovoltaic solar panel adds renewable energy into the mix and can charge either lead-acid battery. All components are connected to a National Instruments CompactRIO system while being controlled and monitored via a LabVIEW software program. The resulting Smart Grid can run independently based on constraints related to energy demand, cost, efficiency, and environmental impact. Results are shown demonstrating choices based on these constraints, including a corresponding weighting according to controller objectives.
The Transcriptome ofLeishmania majorDevelopmental Stages in Their Natural Sand Fly Vector
Authors: Inbar Ehud , Hughitt V. Keith , Dillon Laura A. L. , Ghosh Kashinath , El-Sayed Najib M. , Sacks David L. 
Published: April 2017

ABSTRACTThe life cycle of theLeishmaniaparasite in the sand fly vector involves differentiation into several distinctive forms, each thought to represent an adaptation to specific microenvironments in the midgut of the fly. Based on transcriptome sequencing (RNA-Seq) results, we describe the first high-resolution analysis of the transcriptome dynamics of four distinct stages ofLeishmania majoras they develop in a natural vector,Phlebotomus duboscqi. The early transformation from tissue amastigotes to procyclic promastigotes in the blood-fed midgut was accompanied by the greatest number of differentially expressed genes, including the downregulation of amastins, and upregulation of multiple cell surface proteins, sugar and amino acid transporters, and genes related to glucose metabolism and cell cycle progression. The global changes accompanying post-blood meal differentiation of procyclic promastigotes to the nectomonad and metacyclic stages were less extensive, though each displayed a unique signature. The transcriptome of nectomonads, which has not been studied previously, revealed changes consistent with cell cycle arrest and the upregulation of genes associated with starvation and stress, including autophagic pathways of protein recycling. Maturation to the infective, metacyclic stage was accompanied by changes suggesting preadaptation to the intracellular environment of the mammalian host, demonstrated by the amastigote-like profiles of surface proteins and metabolism-related genes. Finally, a direct comparison between sand fly-derived and culture-derived metacyclics revealed a reassuring similarity between the two forms, with thein vivoforms distinguished mainly by a stronger upregulation of transcripts associated with nutrient stress.IMPORTANCEThe life cycle ofLeishmaniaparasites in the sand fly vector includes their growth and development as morphologically distinct forms of extracellular promastigotes found within the different microenvironments of the gut. Based on RNA-Seq, we provide here the first high-resolution, transcriptomic analysis ofLeishmaniainsect stages during their cyclical developmentin vivo, from tissue amastigotes ingested with the blood meal to infective, metacyclic promastigotes that initiate infection in the mammalian host. The most extensive genetic reprogramming occurred during the early transformation of amastigotes to rapidly dividing procyclic promastigotes in the blood-fed midgut, with major changes in the abundance of mRNAs for surface proteins and metabolism. The post-blood meal-adapted nectomonad stage was characterized by the downregulation of cell cycle-related genes and the upregulation of stress- and starvation-related genes. Finally, the transcriptome of metacyclic promastigotes shifted to a more amastigote-like profile, suggesting their preadaptation to the intracellular host environment.