bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anti‐D reagents should be chosen accordingly to the prevalence of D variants in the obstetric population
Authors: Lukacevic Krstic Jelena , Dajak Slavica , Bingulac‐Popovic Jasna , Dogic Vesna , Mratinovic‐Mikulandra Jela 
Published: June 2017

BackgroundResolving ambiguous results of D antigen typing is crucial for appropriate and rational administration of anti‐D immunoprophylaxis and transfusion practice in obstetric population. The aim of the study was to establish selection criteria of anti‐D reagents for our population.MethodsA total of 12 689 samples from primiparous women in Split‐Dalmatia County, Croatia, were typed for RhD antigen during the period of 5 years. Ambiguous results were submitted to additional serologic investigation and genotyping. RHD genotyping was performed by commercial genotyping kits (Ready Gene weak D ®and Ready gene CDE, Inno‐Train, Kronberg, Germany). Relative frequencies and accompanying 95% confidence intervals were used to estimate the prevalence of variants.ResultsThe prevalence of D variants was 0.42% (95% CI 0.31; 0.53). The most common partial D variant was D Va (RHD*05.05), with the prevalence of 0.08% (95% CI 0.03; 0.13). All weak D variants were weak D types 1, 2 and 3 (RHD*weak D type 1, RHD*weak D type 2, RHD*weak D type 3). Weak D samples were distinguishable from partial D in routine typing due to the difference in reactivity of partial D samples with clones D7B8 and RUM‐1. Cell line RUM‐1 gives weak or negative reactions with partial DVa category.ConclusionThe most common partial D variant in our population is DVa. It is recommended to use cell lines which do not strongly agglutinate DVa variant in routine RhD typing. The appropriate choice of reagents will enable the serology methods to recognize the cases in which RHD genotyping is required.
A retrospective analysis of the application of the Elecsys®HIV combi PT assay in southern China
Authors: Liang Shaocong , Deng Guihua , Zhou Shaosong , Zeng Jing , Tan Weiqing , Yuan Xiaopeng 
Published: June 2017

BackgroundFourth‐generation HIV assays have been implemented worldwide as a screening test for many years. Understanding the performance of fourth‐generation assay in low HIV prevalence region is pivotal to interpret the test result correctly. In this study, retrospective analysis was used to evaluate application of the Elecsys® HIV combi PT assay.MethodsA total of 85 043 specimens from a low prevalence setting were detected between June 2013 and October 2015. We evaluated the false‐positive rate (FPR), specificity, and positive predictive value (PPV).ResultsThe specificity between male and female were 99.85% and 99.82%, respectively. The PPV on male (50.75%) was higher than female (17.05%) significantly, while the FPR was 0.15% and 0.18%. The gap between false‐positive (median: 1.83, [IQR]: 1.30, 3.38) and confirmed‐positive (median: 407.5, [IQR]: 184.2, 871.7) is enormous. The highest s/co ratio for false‐positive cases was 85.45, while the lowest s/co ratio for confirmed‐positive cases was 59.68. Various reasons were attributed to false‐positive cases.ConclusionOptimal cutoff value is needed to be set to reduce the false‐positive cases and predict the final status of HIV infection reliably. Retrospective analysis will help us to understand more about diagnosis of HIV.
Surveillance for lung metastasis from giant cell tumor of bone
Authors: Rosario Mamer , Kim Han‐Soo , Yun Ji Yeon , Han Ilkyu 
Published: June 2017

Background and ObjectivesLiterature on surveillance for lung metastasis from giant cell tumor of bone (GCTB) is scarce. We aimed to develop one by determining: (1) the optimal surveillance schedule by analyzing time‐to‐event data, taking into account the predictive factors, and (2) the effective diagnostic modality.MethodsA total of 333 patients who underwent surgery for GCTB were followed for at least 2 years. All had chest radiography, and 169 had additional CT for surveillance. Time to lung metastasis and cumulative incidence were calculated, and diagnostic performance between chest radiography and CT was compared.ResultsTwenty‐five (7.5%) of 333 patients developed lung metastasis, and local recurrence (LR) was the only predictive factor (RR = 6.54). Median interval from LR to metastasis was 15 months, and 17 (85%) of the 20 metastases with LR occurred within 3 years of LR. Cumulative post‐LR incidences at 1, 3, and 5 years were 15.4%, 21.5%, and 21.5%, respectively. CT was more sensitive (100% vs 32%), and had higher positive predictive value (81% vs 57%) and accuracy (96% vs 93%).ConclusionsIntensified lung surveillance is warranted for GCTB patients with LR, especially for 3 years from diagnosis of LR. CT is effective for detecting lung metastasis from GCTB.
Perioperative BRAF inhibitors in locally advanced stage III melanoma
Authors: Zippel Douglas , Markel Gal , Shapira‐Frommer Roni , Ben‐Betzalel Guy , Goitein David , Ben‐Ami Eytan , Nissan Aviram , Schachter Jacob , Schneebaum Schlomo 
Published: June 2017

Background and ObjectivesStage III malignant melanoma is a heterogeneous disease where those cases deemed marginally resectable or irresecatble are frequently incurable by surgery alone. Targeted therapy takes advantage of the high incidence of BRAF mutations in melanomas, most notably the V600E mutation. These agents have rarely been used in a neoadjuvant setting prior to surgery.MethodsThirteen consecutive patients with confirmed BRAFV600E regionally advanced melanoma deemed marginally resectable or irrresectable, were treated with BRAF inhibiting agents, prior to undergoing surgery. The primary outcome measures were a successful resection and pathological response. Disease‐free survival was a secondary outcome measure.ResultsOverall, 12/13 patients showed a marked clinical responsiveness to medical treatment, enabling a macroscopically successful resection in all cases. Four patients had a complete pathological response with no viable tumor evident in the resected specimens and eight patients showed evidence of minimally residual tumor with extensive tumoral necrosis and fibrosis. One patient progressed and died before surgery. At a median follow up of 20 months, 10 patients remain free of disease.ConclusionsPerioperative treatment with BRAF inhibiting agents in BRAFV600E mutated Stage III melanoma patients facilitates surgical resection and affords satisfactory disease free survival.
Coupled simulation of high‐frequency dynamics of dissolved oxygen and chlorophyll widens the scope of lake metabolism studies
Authors: Istvánovics Vera , Honti Márk 
Published: June 2017

AbstractHigh frequency time series of dissolved oxygen (DO), delayed chlorophyll fluorescence (Chl) and relevant background variables were recorded on nearly 900 d during 7 yr in large, shallow, meso‐eutrophic Lake Balaton (Hungary). Novel models were developed for coupled simulation of diel dynamics of DO and Chl using sequential learning and uncertainty assessment in a Bayesian framework. Despite the generally good model fit for both variables, the uncertainty of the metabolic estimates was high, due primarily to the identification problem of individual metabolic processes. Deviations between observed and simulated DO concentrations suggested that neglect of transient stratification might be responsible for the bulk of the systematic model errors. Net ecosystem production (NEP) was uncertain. Unless air‐water oxygen exchange can be estimated from direct measurements, the free‐water DO method cannot reliably estimate NEP. Gross primary production (GPP) could satisfactorily be hindcasted assuming non‐linear multiplicative dependence on Chl, water temperature and light. Hindcast of community respiration (CR) was less successful, possibly due to the impact of local benthic respiration. Results suggested a major shift in lake metabolism at about 16°C. Below and above this temperature, 70% and 90% of net primary production could be utilized by heterotrophs within a day, respectively. Indirect evidence suggested that biomass‐specific net primary production was determined by phosphorus. The large difference between reproductive rates and net growth rates estimated from GPP and Chl and from daily change in Chl, respectively indicated that loss rates of phytoplankton were as important determinants of algal dynamics as reproductive rates.
Developing a framework for integrating health equity into the learning health system
Authors: Brooks Danielle , Douglas Megan , Aggarwal Neelum , Prabhakaran Shyam , Holden Kisha , Mack Dominic 
Published: June 2017

AbstractWhile there have been gains in the overall quality of health care, racial and ethnic disparities in health outcomes continue to persist in the United States. The Learning Health System (LHS) has the potential to significantly improve health care quality using patient‐centered design, data analytics, and continuous improvement. To ensure that health disparities are also being addressed, targeted approaches must be used. This document sets forth a practical framework to incorporate health equity into a developing LHS. Using a case study approach, the framework is applied to 2 projects focused on the reduction of health disparities to highlight its application.
Extreme Toughness Exhibited in Electrospun Polystyrene Fibers
Authors: Zhang Fengfeng , Barber Asa H. 
Published: June 2017

Polystyrene (PS) commonly exhibits brittle behavior and poor mechanical properties due to the presence of structural heterogeneities promoting localized failure. The removal of this localized failure is shown here by processing PS into fibers with a range of diameters using electrospinning. Mechanical properties of individual electrospun fibers were quantified with atomic force microscopy based nanomechanical tensile testing. The resultant stress–strain behavior of PS fibers highlights considerable enhancement of mechanical properties when fiber diameter decreases below 600 nm such that polystyrene toughness increases significantly by over two orders of magnitude compared to the bulk. Consideration of the network properties of polystyrene is used to demonstrate the increase of draw ratio toward a theoretical limit and is potentially applicable to a range of glassy polymeric materials.
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Automatic segmentation of the spine by means of a probabilistic atlas with a special focus on ribs suppression
Authors: Ruiz‐España Silvia , Domingo Juan , Díaz‐Parra Antonio , Dura Esther , D'Ocón‐Alcañiz Víctor , Arana Estanislao , Moratal David 
Published: June 2017

PurposeThe development of automatic and reliable algorithms for the detection and segmentation of the vertebrae are of great importance prior to any diagnostic task. However, an important problem found to accurately segment the vertebrae is the presence of the ribs in the thoracic region. To overcome this problem, a probabilistic atlas of the spine has been developed dealing with the proximity of other structures, with a special focus on ribs suppression.MethodsThe data sets used consist of Computed Tomography images corresponding to 21 patients suffering from spinal metastases. Two methods have been combined to obtain the final result: firstly, an initial segmentation is performed using a fully automatic level‐set method; secondly, to refine the initial segmentation, a 3D volume indicating the probability of each voxel of belonging to the spine has been developed. In this way, a probability map is generated and deformed to be adapted to each testing case.ResultsTo validate the improvement obtained after applying the atlas, the Dice coefficient (DSC), the Hausdorff distance (HD), and the mean surface‐to‐surface distance (MSD) were used. The results showed up an average of 10 mm of improvement accuracy in terms of HD, obtaining an overall final average of 15.51 ± 2.74 mm. Also, a global value of 91.01 ± 3.18% in terms of DSC and a MSD of 0.66 ± 0.25 mm were obtained. The major improvement using the atlas was achieved in the thoracic region, as ribs were almost perfectly suppressed.ConclusionThe study demonstrated that the atlas is able to detect and appropriately eliminate the ribs while improving the segmentation accuracy.
Intake of Energy and Protein is Associated with Overweight Risk at Age 5.5 Years: Results from the Prospective TEDDY Study
Authors: Beyerlein Andreas , Uusitalo Ulla M. , Virtanen Suvi M. , Vehik Kendra , Yang Jimin , Winkler Christiane , Kersting Mathilde , Koletzko Sibylle , Schatz Desmond , Aronsson Carin Andrén , Elding Larsson Helena , Krischer Jeffrey P. , Ziegler Anette‐G. , Norris Jill M. , Hummel Sandra ,   for the TEDDY Study Group
Published: June 2017

ObjectiveThe associations of energy, protein, carbohydrate, and fat intake with weight status up to the age of 5.5 years were prospectively assessed in The Environmental Determinants of Diabetes in the Young (TEDDY) study.MethodsFood record data (over 3 days) and BMI measurements between 0.25 and 5.5 years were available from 5,563 children with an increased genetic risk for type 1 diabetes followed from shortly after birth. Odds ratios (ORs) were calculated for overweight and obesity by previous intake of energy, protein, carbohydrate, and fat with adjustment for potential confounders.ResultsHaving overweight or obesity at the age of 5.5 years was positively associated with mean energy intake in previous age intervals (e.g., adjusted OR [95% CI] for overweight: 1.06 [1.04‐1.09] per 100 kcal intake at the age of 4.5‐5.0 years) and with protein intake after the age of 3.5 and 4.5 years, respectively (e.g., adjusted OR for overweight: 1.06 [1.03‐1.09] per 1% of energy intake at the age of 4.5‐5.0 years). The respective associations with carbohydrate and fat intake were less consistent.ConclusionsThese findings indicate that energy and protein intake are positively associated with increased risk for overweight in childhood but yield no evidence for potential programming effects of protein intake in infancy.
N‐alkoxypyridinium salts as coinitiators in radical polymerization: Synthesis and Photochemical Properties
Authors: Kabatc Janina , Kostrzewska Katarzyna , Dobosz Robert , Orzeł Łukasz , Jurek Katarzyna 
Published: June 2017

ABSTRACTA few N‐alkoxypyridinium salts are developed as photoinitiators for efficient polymerization reactions. They are characterized by absorption properties below 300 nm, and generate alkoxy radicals on UV‐Vis light exposure. The squarylium dye was used as a blue‐light photosensitizer. Polymerization results are correlated with the photochemistry of N‐alkoxypyridinium salts. The quenching of the excited singlet state of squarylium dye by pyridinium salt and the formation of the semioxidized species of squaraine suggests an electron transfer from an excited dye to a coinitiator, and that the resulting oxygen‐centered radical initiates the polymerization process. The chemical mechanism was investigated by steady state photolysis and nanosecond laser flash photolysis experiments. Photoinitiating activity of new photoinitiators for initiation of polymerization of trimethylolpropane triacrylate in the UV‐blue light region was compared with photoinitiating ability of selected commercially available initiators. © 2017 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2017, 55, 2840–2850
Tautomerization and Dissociation of Molecular Peptide Radical Cations
Authors: Mu Xiaoyan , Song Tao , Siu Chi‐Kit , Chu Ivan K. 
Published: June 2017

AbstractRadical‐mediated dissociations of peptide radical cations have intriguing unimolecular gas phase chemistry, with cleavages of almost every bond of the peptide backbone and amino acid side chains in a competitive and apparently “stochastic” manner. Challenges of unraveling mechanistic details are related to complex tautomerizations prior to dissociations. Recent conjunctions of experimental and theoretical investigations have revealed the existence of non‐interconvertible isobaric tautomers with a variety of radical‐site‐specific initial structures, generated from dissociative electron transfer of ternary metal‐ligand‐peptide complexes. Their reactivity is influenced by the tautomerization barriers, perturbing the nature, location, or number of radical and charge site(s), which also determine the energetics and dynamics of the subsequent radical‐mediated dissociatons. The competitive radical‐ and charge‐induced dissociations are extremely dependent on charge density. Charge sequesting can reduce the charge densities on the peptide backbone and hence enhance the flexibility of structural rearrangement. Analysing the structures of precursors, intermediates and products has led to the discovery of many novel radical migration prior to peptide backbone and/or side chain fragmentations. Upon these successes, scientists will be able to build peptide cationic analogues/tautomers having a variety of well‐defined radical sites.
Development of Proton‐Responsive Catalysts
Authors: Wang Lin , Kanega Ryoichi , Kawanami Hajime , Himeda Yuichiro 
Published: June 2017

AbstractA changeable ligand, which involves in activation of a catalyst or assists a reaction, draws an increasing attention, in contrast to a classical ligand as spectator. Proton‐responsive catalysts, which are capable of undergoing changes of properties on gaining/losing one or more protons, provides interesting features as follows: (i) catalyst activation by electronic effect, (ii) pH‐tuning of water‐solubility, and (iii) second‐coordination‐sphere interaction. On the basis of this catalyst design concept, we developed several highly efficient proton‐responsive catalysts for CO2 hydrogenation as H2 storage, formic acid (FA) dehydrogenation as H2 production, and transfer hydrogenation. The transformable ligands of proton‐responsive catalysts in promoting effective catalysis have aroused our interest. In this account, we summarize our efforts for the development and application of proton‐responsive catalysts. Specifically, the important role of pH‐dependent proton‐responsive complexes will be discussed.
Prognostic Significance of Preoperative Controlling Nutritional Status (CONUT) Score in Patients Undergoing Hepatic Resection for Hepatocellular Carcinoma
Authors: Harimoto Norifumi , Yoshizumi Tomoharu , Sakata Kazuhito , Nagatsu Akihisa , Motomura Takashi , Itoh Shinji , Harada Noboru , Ikegami Toru , Uchiyama Hideaki , Soejima Yuji , Maehara Yoshihiko 
Published: June 2017

AbstractBackgroundThe Controlling Nutritional Status (CONUT) score is an objective tool widely used to assess nutritional status in patients with inflammatory disease, chronic heart failure, and chronic liver disease. The relationship between CONUT score and prognosis in patients who have undergone hepatic resection, however, has not been evaluated.MethodsData were retrospectively collected for 357 consecutive patients with hepatocellular carcinoma (HCC) who had undergone hepatic resection with curative intent between January 2004 and December 2015. The patients were assigned to two groups, those with preoperative CONUT scores ≤3 (low CONUT score) and >3 (high CONUT score), and their clinicopathological characteristics, surgical outcomes, and long‐term survival were compared.ResultsOf the 357 patients, 69 (19.3%) had high (>3) and 288 (80.7%) had low (≤3) preoperative CONUT scores. High CONUT score was significantly associated with HCV infection, low serum albumin and cholesterol concentrations, low lymphocyte count, shorter prothrombin time, Child–Pugh B and liver damage B scores, and blood transfusion. Multivariate analysis identified six factors prognostic of poor overall survival (older age, liver damage B score, high CONUT score, poor tumor differentiation, the presence of intrahepatic metastases, and blood transfusion) and five factors prognostic of reduced recurrence‐free survival (older age, higher ICGR15, larger tumor size, presence of intrahepatic metastasis, and blood transfusion).ConclusionsIn patients with HCC, preoperative CONUT scores are predictive of poorer overall survival, even after adjustments for other known predictors.
Guideline Implementation: Minimally Invasive Surgery, Part 1
Authors: Wasielewski Annette 
Published: June 2017

AbstractSince its inception in the early 1990s, technological developments have made minimally invasive surgery the preferred approach for many operative procedures. However, perioperative personnel have had to develop new skills and techniques to manage this technology. The advent of robotic‐assisted procedures in the early 2000s added another level of complexity to the perioperative arena. The updated AORN “Guideline for minimally invasive surgery” provides guidance for creating a safe environment for patients undergoing a wide range of procedures in which complex, advanced equipment and techniques are used. This article focuses on key points of the guideline that address OR configuration for minimally invasive surgery, safe practices for robotic‐assisted procedures, and reducing risks associated with gas insufflation media. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.
Back to Basics: Radiation Safety
Authors: Spruce Lisa 
Published: June 2017

AbstractPerioperative team members and patients are frequently exposed to radiation during operative and other invasive procedures. The use of equipment that emits radiation (eg, a fluoroscopy unit) is beneficial for diagnosing and treating patients but carries the risk of harm if team members do not follow radiation safety guidelines. Perioperative team members should implement safety precautions for themselves and their patients when radiation is used. This Back to Basics article addresses the basics of radiation safety and the precautions that perioperative team members should implement in the perioperative setting.
Perioperative Nursing Management of Donor and Recipient Patients Undergoing Face Transplantation
Authors: Sweeney Nicole , Allen Kathryn , Miller Brooke , Nolan Theresa , Sheerin Kathleen 
Published: June 2017

AbstractIndividuals with debilitating facial injuries and deformities have achieved significant improvement of aesthetic form and function after undergoing a face transplantation. The involvement of surgical technologists and perioperative nurses in the care of the recipient and donor plays a critical role in the success of these procedures. There are unique challenges that staff members may be presented with when caring for a donor and recipient undergoing a face transplantation, including less comfort with and knowledge of the surgical procedure and instrumentation, an increased amount of equipment and personnel in the OR, donor and recipient admission and discharge care, and increased shift length. At New York University Langone Medical Center, New York, we have developed a comprehensive process to prepare staff members to care for patients undergoing face transplantation.
Clinical Issues—July 2017
Authors: Ogg Mary J. , Johnstone Esther M. 
Published: June 2017

This MonthOperation of fluoroscopy equipmentKey words: fluoroscopy, mini C‐arm, scope of practice, radiologic device.Patient education after radionuclide implantationKey words: radionuclides, brachytherapy, prostate cancer, radiation safety.Personal protective equipmentKey words: clean, decontamination, instruments, PPE, tray assembly.Safe staffing patternsKey words: on‐call staffing, schedules, safe staffing levels.Counting instruments when laparoscopy procedures convert to open proceduresKey words: counts, instrument, laparoscopy, retained surgical items.