bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complexity of Continuous Glucose Monitoring Data in Critically Ill Patients: Continuous Glucose Monitoring Devices, Sensor Locations, and Detrended Fluctuation Analysis Methods
Authors: Signal Matthew , Thomas Felicity , Shaw Geoffrey M. , Chase J. Geoffrey 
Published: June 2016

Background: Critically ill patients often experience high levels of insulin resistance and stress-induced hyperglycemia, which may negatively impact outcomes. However, evidence surrounding the causes of negative outcomes remains inconclusive. Continuous glucose monitoring (CGM) devices allow researchers to investigate glucose complexity, using detrended fluctuation analysis (DFA), to determine whether it is associated with negative outcomes. The aim of this study was to investigate the effects of CGM device type/calibration and CGM sensor location on results from DFA. Methods: This study uses CGM data from critically ill patients who were each monitored concurrently using Medtronic iPro2s on the thigh and abdomen and a Medtronic Guardian REAL-Time on the abdomen. This allowed interdevice/calibration type and intersensor site variation to be assessed. Detrended fluctuation analysis is a technique that has previously been used to determine the complexity of CGM data in critically ill patients. Two variants of DFA, monofractal and multifractal, were used to assess the complexity of sensor glucose data as well as the precalibration raw sensor current. Monofractal DFA produces a scaling exponent ( H), where H is inversely related to complexity. The results of multifractal DFA are presented graphically by the multifractal spectrum. Results: From the 10 patients recruited, 26 CGM devices produced data suitable for analysis. The values of H from abdominal iPro2 data were 0.10 (0.03–0.20) higher than those from Guardian REAL-Time data, indicating consistently lower complexities in iPro2 data. However, repeating the analysis on the raw sensor current showed little or no difference in complexity. Sensor site had little effect on the scaling exponents in this data set. Finally, multifractal DFA revealed no significant associations between the multifractal spectrums and CGM device type/calibration or sensor location. Conclusions: Monofractal DFA results are dependent on the device/calibration used to obtain CGM data, but sensor location has little impact. Future studies of glucose complexity should consider the findings presented here when designing their investigations.
Blood Glucose Meters Employing Dynamic Electrochemistry are Stable against Hematocrit Interference in a Laboratory Setting
Authors: Pfützner Andreas , Musholt Petra B. , Schipper Christina , Demircik Filiz , Hengesbach Carina , Flacke Frank , Sieber Jochen , Forst Thomas 
Published: June 2016

Background: Hematocrit (HCT) is known to be a confounding factor that interferes with many blood glucose (BG) measurement technologies, resulting in wrong readings. Dynamic electrochemistry has been identified as one possible way to correct for these potential deviations. The purpose of this laboratory investigation was to assess the HCT stability of four BG meters known to employ dynamic electrochemistry (BGStar and iBGStar, Sanofi; Wavesense Jazz, AgaMatrix; Wellion Linus, MedTrust) in comparison with three other devices (GlucoDock, Medisana; OneTouch Verio Pro, LifeScan; FreeStyle Freedom InsuLinx, Abbott-Medisense). Methods: Venous heparinized blood was immediately aliquoted after draw and manipulated to contain three different BG concentrations (60–90, 130–160, and 280–320 mg/dl) and five different HCT levels (25%, 35%, 45%, 55%, and 60%). After careful oxygenation to normal blood oxygen pressure, each of the resulting 15 different samples was measured six times with three devices and three strip lots of each meter. The YSI Stat 2300 served as laboratory reference method. Stability to HCT influence was assumed when less than 10% difference occurred between the highest and lowest mean glucose deviations in relation to HCT concentrations [hematocrit interference factor (HIF)]. Results: Five of the investigated self-test meters showed a stable performance with the different HCT levels tested in this investigation: BGStar (HIF 4.6%), iBGStar (6.6%), Wavesense Jazz (4.1%), Wellion Linus (8.5%), and OneTouch Verio Pro (6.2%). The two other meters were influenced by HCT (FreeStyle InsuLinx 17.8%; GlucoDock 46.5%). Conclusions: In this study, meters employing dynamic electrochemistry, as used in the BGStar and iBGStar devices, were shown to correct for potential HCT influence on the meter results. Dynamic electrochemistry appears to be an effective way to handle this interfering condition.
Dependence on glutamine uptake and glutamine addiction characterize myeloma cells: a new attractive target
Authors: Bolzoni Marina , Chiu Martina , Accardi Fabrizio , Vescovini Rosanna , Airoldi Irma , Storti Paola , Todoerti Katia , Agnelli Luca , Missale Gabriele , Andreoli Roberta , Bianchi Massimiliano G. , Allegri Manfredi , Barilli Amelia , Nicolini Francesco , Cavalli Albertina , Costa Federica , Marchica Valentina , Toscani Denise , Mancini Cristina , Martella Eugenia , Dall’Asta Valeria , Donofrio Gaetano , Aversa Franco , Bussolati Ovidio , Giuliani Nicola 
Published: June 2016

Key Points
Myeloma cells produce ammonium in the presence of glutamine, showing high glutaminase and low glutamine synthetase expression. Myeloma cells show high expression of glutamine transporters and inhibition of ASCT2 transporter hinders myeloma growth.
Adult human megakaryocyte-erythroid progenitors are in the CD34+CD38mid fraction
Authors: Sanada Chad , Xavier-Ferrucio Juliana , Lu Yi-Chien , Min Elizabeth , Zhang Ping-Xia , Zou Siying , Kang Elaine , Zhang Meng , Zerafati Gazelle , Gallagher Patrick G. , Krause Diane S. 
Published: June 2016

Key Points
Purification strategies developed for human Mk-E progenitors, as well as committed Mk and E progenitors. MYB regulates the biphenotypic fate decision of human MEPs.
Dimethyl fumarate restores apoptosis sensitivity and inhibits tumor growth and metastasis in CTCL by targeting NF-κB
Authors: Nicolay Jan P. , Müller-Decker Karin , Schroeder Anne , Brechmann Markus , Möbs Markus , Géraud Cyrill , Assaf Chalid , Goerdt Sergij , Krammer Peter H. , Gülow Karsten 
Published: June 2016

Key Points
DMF induces specific cell death in CTCL cells and inhibits CTCL tumor growth and metastasis in vivo via inhibition of NF-κB. DMF therefore represents a promising, nontoxic novel therapeutic approach to treating CTCL.
Asperger syndrome in childhood – personality dimensions in adult life: temperament, character and outcome trajectories
Authors: Helles Adam , Gillberg I. Carina , Gillberg Christopher , Billstedt Eva , Wallinius Märta 
Published: June 2016

BackgroundTemperament and character have been shown to be important factors in understanding psychiatric and neurodevelopmental disorder. Adults with autism spectrum disorder (ASD) have repeatedly been shown to have a distinct temperament and character, but this has not been evaluated in relation to psychiatric comorbidity and ASD diagnostic stability.AimsTo examine temperament and character in males that were diagnosed with ASD in childhood and followed prospectively over almost two decades.MethodTemperament and character were assessed in 40 adult males with a childhood diagnosis of ASD. Results were analysed by the stability of ASD diagnosis over time and current psychiatric comorbidity.ResultsThree distinct temperament and character profiles emerged from the data. Those no longer meeting criteria for ASD had high reward dependence while those with a stable ASD diagnosis and psychiatric comorbidity showed elevated harm avoidance and low self-directedness and cooperativeness. Finally, those with a stable ASD and no comorbidity showed low novelty seeking and somewhat elevated harm avoidance.ConclusionsTemperament and character are important factors correlated with long-term diagnostic stability and psychiatric comorbidity in males diagnosed with ASD in childhood.
What do ambulance service personnel perceive to be the process of and issues with inter-hospital transfers?
Authors: Rouse James 
Published: June 2016

At present, the inter-hospital transfer process has been described as suboptimal and current literature fails to describe or analyse the complete transfer process. In particular, the challenges and barriers from UK NHS ambulance services are yet to be described. To examine this further, a study has been undertaken to explore a NHS ambulance service personnel's experiences, perceptions and issues relating to the inter-hospital transfer process. The findings have shown that ambulance personnel approach inter-hospital transfers from a business perspective, which affects the way they process and perceive transfers. There exists a consensus among staff that the inter-hospital transfer policy or procedure is not fully understood, due to a lack of clarity and mixed messages throughout the process. Staff members view the inter-hospital transfer process as a nuisance and have acknowledged it was inadequately executed. Additionally, undertaking certain inter-hospital transfers is seen as challenging paramedics' professional identities.
A comparative audit of gunshot wounds and stab wounds to the neck in a South African metropolitan trauma service
Authors: Madsen AS , Laing GL , Bruce JL , Clarke DL 
Published: June 2016

Introduction The aim of this comparative study of gunshot wounds (GSWs) and stab wounds (SWs) to the neck was to quantify the impact of the mechanism of injury on the outcome and management of penetrating neck injury (PNI). Methods A prospective trauma registry was interrogated retrospectively. Data were analysed pertaining to demographics and injury severity score (ISS), physiology on presentation, anatomical site of wounds and injuries sustained, investigations, management, outcome and complications. Results There were 452 SW and 58 GSW cases over the 46 months of the study. Patients with GSWs were more likely to have extracervical injuries than those with SWs (69% vs 63%). The incidence of a ‘significant cervical injury’ was almost twice as high in the GSW cohort (55% vs 31%). For patients with transcervical GSWs, this increased to 80%. The mean ISS was 17 for GSW and 11 for SW patients. Those in the GSW cohort presented with threatened airways and a requirement for an emergency airway three times as often as patients with SWs (24% vs 7% and 14% vs 5% respectively). The incidence among GSW and SW patients respectively was 5% and 6% for airway injuries, 12% and 8% for injuries to the digestive tract, 21% and 16% for vascular injuries, 59% and 10% for associated cervical injuries, 36% and 14% for maxillofacial injuries, 16% and 9% for injuries to the head, and 35% and 45% for injuries to the chest. In the GSW group, 91% underwent computed tomography angiography (CTA), with 23% of these being positive for a vascular injury. For SWs, 74% of patients underwent CTA, with 17% positive for a vascular injury. Slightly more patients with GSWs required operative intervention than those with SWs (29% vs 26%). Conclusions Patients with GSWs to the neck have a worse outcome than those with injuries secondary to SWs. However, the proportion of neck injuries actually requiring direct surgical intervention is not increased and most cases with PNI secondary to GSWs can be managed conservatively with a good outcome. Imaging should be performed for all GSWs to the neck.
Development of a Brief Intervention to Improve Knowledge of Autism and Behavioral Strategies Among Parents in Tanzania
Authors: Harrison Ashley Johnson , Long Kristin A. , Manji Karim P. , Blane Karyn K. 
Published: June 2016

Abstract
Despite the global presence of autism spectrum disorder (ASD), a paucity of treatment services exists in Tanzania and other low- and middle-income countries. The effect of delayed or low-quality treatments is enduring and contributes to lifelong variability in ASD-related functional impairments. Service disparities in Tanzania derive in part from a widespread lack of national ASD knowledge. Historically, in Western countries, parents have played a major role in increasing ASD awareness, advancing research, and encouraging empirically supported treatments. In the absence of established treatment services, parents of children with ASD have also learned to implement behavioral interventions to reduce the widening skills gaps. This article describes the development of an intervention designed to inform parents in Tanzania about ASD and empirically supported behavioral strategies. Preliminary data, collected from a clinical implementation with 29 Tanzanian families of children diagnosed with ASD or general developmental delays, support the initial feasibility and acceptability of this intervention. This brief intervention may help to ameliorate treatment disparities due to insufficient regional knowledge, language barriers, or limited service availability and may help improve functional outcomes among Tanzanian children with ASD.
Primary Cardiac Sarcoidosis with Syncope and Refractory Atrial Arrhythmia: A Case Report and Review of the Literature
Authors: Thangam Manoj , Nathan Sriram , Kar Biswajit , Petrovic Marija , Patel Manish , Loyalka Pranav , Buja L. Maximilian , Gregoric Igor D. 
Published: June 2016

We discuss the case of a 38-year-old black man who presented at our hospital with his first episode of syncope, recently developed atrial arrhythmias refractory to pharmacologic therapy, and a left atrial thrombus. He was diagnosed with primary cardiac sarcoidosis characterized by predominant involvement of the epicardium that caused atrial fibrillation and atrial flutter. Histologic analysis of his epicardial lesions yielded a diagnosis of sarcoidosis. This patient's atrial arrhythmia was successfully treated with a hybrid operation that involved resection of his atrial appendage, an Epicor maze procedure, and radiofrequency ablation during a catheter-based electrophysiologic study. The cardiac sarcoidosis was successfully managed with corticosteroid therapy.
Our case report shows that sarcoidosis can initially manifest itself as syncope with new-onset atrial arrhythmia. Sarcoidosis is important in the differential diagnosis because of its progressive nature and its potential for treatment with pharmacologic, surgical, and catheter-based interventions.
Endocarditis and Incomplete Endothelialization 12 Years after Amplatzer Septal Occluder Deployment
Authors: Nguyen Allan K. , Palafox Brian A. , Starr Joanne P. , Gates Richard N. , Berdjis Farbouch 
Published: June 2016

A 4-year-old boy had a 15-mm atrial septal defect repaired percutaneously with use of an Amplatzer Septal Occluder. At age 16 years, he presented with a week's history of fever, chills, dyspnea, fatigue, and malaise. Cultures grew methicillin-sensitive Staphylococcus aureus. A transesophageal echocardiogram showed a 1.25 × 1.5-cm pedunculated mass on the left aspect of the atrial septum just superior to the mitral valve, and a smaller vegetation on the right inferior medial aspect of the septum. At surgery, visual examination of both sides of the septum revealed granulation tissue, the pedunculated mass, the small vegetation, and exposed metal wires that suggested incomplete endothelialization of the occluder. We removed the occluder and patched the septal defect. The patient returned to full activity after 4 months and was asymptomatic 3 years postoperatively.
Our report reinforces the need for further investigation into prosthetic device endothelialization, endocarditis prophylaxis, and recommended levels of physical activity in patients whose devices might be incompletely endothelialized. In addition to reporting our patient's case, we review the medical literature on this topic.
Emergency Coronary Artery Bypass Grafting: Indications and Outcomes from 2003 through 2013
Authors: Schumer Erin M. , Chaney John H. , Trivedi Jaimin R. , Linsky Paul L. , Williams Matthew L. , Slaughter Mark S. 
Published: June 2016

Emergency coronary artery bypass grafting (CABG) is associated with increased in-hospital mortality rates and adverse events. This study retrospectively evaluated indications and outcomes in patients who underwent emergency CABG.
The Society of Thoracic Surgeons database for a single center (Jewish Hospital) was queried to identify patients undergoing isolated CABG. Univariate analysis was performed.
From January 2003 through December 2013, 5,940 patients underwent CABG; 212 presented with emergency status. A high proportion of female patients (28.2%) underwent emergency surgery. Emergency CABG patients experienced high rates of intra-aortic balloon pump support, bleeding, dialysis, in-hospital death, and prolonged length of stay. The proportion of emergency coronary artery bypass grafting declined during years 2008–2013 compared with 2003–2007 (2.2% vs. 4.5%, P < 0.001), but the incidence of angiographic accident (5.3% vs. 29.2%) increased as an indication.
Ongoing ischemia remains the most frequent indication for emergency CABG, yet the incidence of angiographic accident has greatly increased. In-hospital mortality rates and adverse events remain high. If we look specifically at emergency CABG cases arising from angiographic accident, we find that 14 (15%) of all 93 emergency CABG deaths occurred in that subset of patients. Efforts to improve outcomes should therefore be focused on this high-risk group.
Evaluation of the prognostic benefit of identifying the probable primary site in cancer of unknown primary
Authors: Das Joyutpal , Gilani Shahid 
Published: June 2016

Abstract
With the development of site-specific cancer therapy, identifying the primary origin allows the oncologist to personalise therapy for patients with the cancer of unknown primaries (CUPs). At present, immunohistochemistry (IHC) screening is the standard method used to postulate the primary site in CUP. In this retrospective study, we evaluated the prognostic benefit of identifying the primary site in CUP. All 84 patients who presented with suspected CUP to the Royal Stoke University Hospital between 2011 and 2012 were included in our study. Forty-eight percent (40/84) of these patients were unable to undergo necessary investigations to identify primary sites because of poor performance status. IHC screening was able to postulate the primary site in 59% (26/44) of the remaining patients with confirmed CUP. Therefore, the primary site was not identified in a significant proportion of patients with CUP. The median survival of confirmed CUP with probable primary site was 2.0 months (95% confidence interval (CI): 1.2 to 2.9 months), whereas the median survival of confirmed CUP with no probable primary site was 4.1 months (95% CI: 1.5 to 9.7 months). This difference in survival time was statistically significant. In addition, using the Cox regression model, we found that patients with confirmed CUP with primary sites had prognostically unfavourable diseases with a shorter median survival, regardless of the age of disease onset, gender, sites of metastases or number of metastases. One approach to improve the survival would be to start systemic therapy at the earliest possible opportunity rather than waiting for all investigation results, such as IHC.
Expectations of patients for the support and the support for hemodialysis patients given by nurses
Authors: Mianowana Violetta , Czekirda Marta , Bednarek Anna , Nalepa Dorota , Mianowana Kinga 
Published: June 2016

Abstract

Introduction. Undoubtedly, the renal replacement therapy is stressful situation for the patients with chronic renal failure. Chronic disease limits and prevents meeting the psychosocial needs. It often causes the frustration, to which patients react in different ways.

Aim of the Study. Purpose of the research was to investigate patients’ expectations for the support and to define the support given by nurses.

Material and Methodology. One hyndred chronic renal failure patients were examined on the basis of an author’s questionnaire survey. Results were subjected to statistical analysis. Homogeneity test was used for unrelated quality characteristics to detect the existence of differences between compared groups.

Results. Most of patients expected the support first from their families (39%), next from doctors and nurses. Almost everybody (95.0%) Experienced emotional support from nurses during every hemodialysis.

Conclusions. The research shows that patients during stress expect a conversation and almost all of them accept the attitude of empathy. Those who received information support felt less stressed.
The symbols and traditions of nursing in the opinion of nursing students
Authors: Gibas Beata , Dębska Grażyna 
Published: June 2016

Abstract

Aim. The aim of this study was to evaluate the students’ knowledge about the symbols and traditions in nursing. The merits of continuing the tradition and symbolism in contemporary nursing in the opinion of students were also evaluated.

Material and methods. The study involved 64 undergraduate nursing students of the Andrzej Frycz Modrzewski Kraków University. As a technique there was used author’s questionnaire to assess the validity of the symbolism there was used a Likert scale from 0-5. The median values and standard deviation were given.

Results. Almost every student mentioned a nursing cap and uniform as a symbol of professional nursing (95% vs. 83%). For students the most important is oath taking (x = 4.4, SD = 1.0) and symbolic caps awarding ceremony (x = 4.4, SD = 1.25). The least need is related to a return to the strap awarding tradition (x = 3.19, SD = 1.77). Approximately 45% of students would like to wear a nursing cap. In the opinion of 75% of students professional traditions should be cultivated during studies.

Conclusions. Traditions should be cultivated during studies in the current system of education. There is a need to remember about the history of the profession.
Review on ZnO hybrid photocatalyst: impact on photocatalytic activities of water pollutant degradation
Authors: Mohd Adnan Mohd Azam , Julkapli Nurhidayatullaili Muhd , Abd Hamid Sharifah Bee 
Published: June 2016

AbstractZinc oxide (ZnO) is one of the most widely used benchmark standard photocatalysts in the field of environmental applications. However, the large band gap of ZnO and the massive recombination of photogenerated charge carriers, especially in its nanosize, limit the overall photocatalytic efficiency. This can be further overcome by modifying the electronic band structure of ZnO by hybridization with a narrow band gap material, including metal, metal oxide, carbon based, and polymeric based. Indeed, ZnO hybridization with the respective materials contributed to its sensitizer by shifting the absorption wavelength to the visible region of the spectrum. This review encompasses several advancements made in the mentioned aspects, and also some of the new physical insights related to the charge transfer events, such as charge carrier generation, trapping, detrapping, and their transfer to surface, are discussed for each strategy of the hybrid ZnO. The synergistic effects in the mixed polymorphs of ZnO and also the theories proposed for their enhanced activity are reported. The review also highlights the potential application of ZnO hybrid for different kinds of pollutants from different wastewater sources.
Novel pyroelectric detectors for accurate THz power measurements
Authors: Steiger Andreas , Bohmeyer Werner , Lange Karsten , Müller Ralf 
Published: June 2016

Abstract
Novel pyroelectric THz detectors have been developed in close cooperation
between PTB, the National Metrology Institute of Germany, and the Sensor- und
Lasertechnik company. Covering the broad spectral range from below
50 GHz to beyond 5 THz, these detectors are suited to
measure the absolute THz power of time-domain spectroscopy (THz-TDS) systems
for the first time.