bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Accuracy of Pulse Spectroscopy for Detecting Hypoxemia and Coexisting Methemoglobin or Carboxyhemoglobin
Authors: Kulcke Axel , Feiner John , Menn Ingolf , Holmer Amadeus , Hayoz Josef , Bickler Philip 
Published: April 2016

BACKGROUND:
Pulse spectroscopy is a new noninvasive technology involving hundreds of wavelengths of visible and infrared light, enabling the simultaneous quantitation of multiple types of normal and dysfunctional hemoglobin. We evaluated the accuracy of a first-generation pulse spectroscopy system (V-Spec™ Monitoring System, Senspec, Germany) in measuring oxygen saturation (Spo
2) and detecting carboxyhemoglobin (COHb) or methemoglobin (MetHb), alone or simultaneously, with hypoxemia.

METHODS:
Nineteen volunteers were fitted with V-Spec probes on the forehead and fingers. A radial arterial catheter was placed for blood sampling during (1) hypoxemia with arterial oxygen saturations (Sao
2) of 100% to 58.5%; (2) normoxia with MetHb and COHb increased to approximately 10%; (3) 10% COHb or MetHb combined with hypoxemia with Sao
2 of 100% to 80%. Standard measures of pulse-oximetry performance were calculated: bias (pulse spectroscopy measured value − arterial measured value) mean ± SD and root-mean-square error (Arms).

RESULTS:
The Spo
2 bias for Sao
2 approximately 60% to 100% was 0.06% ± 1.30% and Arms of 1.30%. COHb bias was 0.45 ± 1.63, with an Arms of 1.69% overall, and did not degrade substantially during moderate hypoxemia. MetHb bias was 0.36 ± 0.80 overall and stayed small with hypoxemia. Arms was 0.88 and was <3% at all levels of Sao
2 and MetHb. Hypoxemia was also accurately detected by pulse spectroscopy at elevated levels of COHb. At elevated MetHb levels, a substantial negative bias developed, −10.3 at MetHb >10%.

CONCLUSIONS:
Pulse spectroscopy accurately detects hypoxemia, MetHb, and COHb. The technology also accurately detects these dysfunctional hemoglobins during hypoxemia. Future releases of this device may have an improved Spo
2 algorithm that is more robust with methemoglobinemia.
Costs Associated with Anesthesia-Related Adverse Events During Labor and Delivery in New York State, 2010
Authors: Hunt Tristan D. , Guglielminotti Jean , Li Guohua 
Published: April 2016

BACKGROUND:
The safety of anesthetic care provided during childbirth has improved during the past 2 decades in the United States, with a marked decrease in the rate of anesthesia-related adverse events (ARAEs). To date, there is little research on the costs of ARAEs in obstetrics. This study aims to assess the excess cost and cost per admission associated with ARAEs during labor and delivery.

METHODS:
Data came from the New York State Inpatient Database 2010. Discharge records indicating labor and delivery and ARAEs were identified with International Classification of Diseases, Ninth Revision, Clinical Modification codes. ARAEs were defined as minor if not associated with maternal death, cardiac arrest, or severe morbidity. Costs were calculated as the product of hospital charges and the group average all-payer inpatient charge-to-cost conversion ratio. Excess cost was calculated as the difference between the mean cost of discharges with and without ARAEs. The cost per admission was calculated as the product of the excess cost and ARAE incidence. Excess costs and cost per admission were also calculated for 2 pregnancy-related complications: postpartum hemorrhage and preeclampsia/eclampsia.

RESULTS:
There were 228,104 delivery-related discharges in the study; of these, 1053 recorded at least 1 ARAE (4.6 per 1000), with 1034 (98.2%) of the ARAEs being minor. The adjusted excess cost associated with ARAEs was $1189 (95% confidence interval [CI], 1033–1350) and the cost per admission $5.49 (95% CI, 4.77–6.23). The incidence of postpartum hemorrhage and preeclamspia/eclampsia was 25.1 and 43.8 per 1000, respectively. The adjusted excess cost was $679 (95% CI, 608–748) and $1328 (95% CI, 1272–1378), respectively; the cost per admission was $17.07 (95% CI, 15.27–18.81) and $58.16 (95% CI, 55.72–60.34), respectively.

CONCLUSIONS:
ARAEs during labor and delivery are associated with significant excess cost. However, the excess cost per admission for ARAEs is significantly less compared with the excess cost per admission for preeclampsia/eclampsia and postpartum hemorrhage.
Comparison of Changes in Tensile Strength in Three Different Flexible Epidural Catheters Under Various Conditions
Authors: Gonzalez Fiol Antonio , Horvath Robert , Schoenberg Catherine , Ahmed Nubyra , Dhar Sunil Kumar , Le Vanny 
Published: April 2016

BACKGROUND:
Rarely, epidural catheters may fracture upon removal or insertion. Understanding some of the mechanical properties of epidural catheters, such as their tensile strength and how external factors (including temperature) can influence their strength, will aid physicians in making decisions if faced with an entrapped catheter. In the present study, we evaluated the impact in tensile strength when catheters are exposed to 37 ± 1°C, after the removal of the inner metal coil and after the injection of sterile saline through the catheter.

METHODS:
We analyzed the tensile strength of a total of 120 catheters (19-gauge) from 3 different brands and materials. The reinforced epidural catheters were affixed to opposing, specially designed tensile test fixtures and then installed in an Applied Test System tensile test apparatus. We evaluated the strength of 10 catheters from different brands and materials for each of the following variables: at room temperature (control group), after the removal of the inner wire present in all the flexible catheters tested, injection of normal saline, and at 37 ± 1°C.

RESULTS:
When compared with their control groups, the Arrow catheter (2.85 kg) was shown to be superior to B-Braun (2.17 kg; P < 0.0001) and Smith catheters (2.33 kg; P < 0.0005). No statistical difference was noted between the Smith and B-Braun catheters (P = 0.39). When comparing catheters after wire removal against their respective control group, no statistical difference was noted. A decrease in tensile strength was noted in the B-Braun catheters (1.53 kg) when tested at 37°C (P ≤ 0.0001). In contrast, the Smith and the Arrow catheters did not show a statistically significant change when tested at 37°C (P = 1.0 and P = 0.063, respectively). After the injection of normal saline, the Arrow (2.33 kg) and the B-Braun (1.58 kg) catheters showed a decrease in tensile strength (P = 0.0010 and P = 0.0001, respectively).

CONCLUSIONS:
The current recommendation of injecting saline through an entrapped catheter resulted in a decrease in tensile strength of the Arrow and B-Braun catheters. A decrease in tensile strength also was noted in the B-Braun catheters when tested at 37°C. There is no benefit, at least in terms of tensile strength, in removing the wire or inner coil from any of the tested brands. The Smith catheter was the most resilient, showing no decrease in tensile strength at 37°C and after the injection of normal saline when compared with control.
One-Year Mortality, Causes of Death, and Cardiac Interventions in Patients with Postoperative Myocardial Injury
Authors: van Waes Judith A. R. , Grobben Remco B. , Nathoe Hendrik M. , Kemperman Hans , de Borst Gert Jan , Peelen Linda M. , van Klei Wilton A. ,   the Cardiac Health After Surgery (CHASE) Investigators
Published: April 2016

BACKGROUND:To evaluate the role of routine troponin surveillance in patients undergoing major noncardiac surgery, unblinded screening with cardiac consultation per protocol was implemented at a tertiary care center. In this study, we evaluated 1-year mortality, causes of death, and consequences of cardiac consultation of this protocol.METHODS:This observational cohort included 3224 patients ≥60 years old undergoing major noncardiac surgery. Troponin I was measured routinely on the first 3 postoperative days. Myocardial injury was defined as troponin I >0.06 μg/L. Regression analysis was used to determine the association between myocardial injury and 1-year mortality. The causes of death, the diagnoses of the cardiologists, and interventions were determined for different levels of troponin elevation.RESULTS:Postoperative myocardial injury was detected in 715 patients (22%) and was associated with 1-year all-cause mortality (relative risk [RR] 1.4,P= 0.004; RR 1.6,P< 0.001; and RR 2.2,P< 0.001 for minor, moderate, and major troponin elevation, respectively). Cardiac death within 1 year occurred in 3%, 5%, and 11% of patients, respectively, in comparison with 3% of the patients without myocardial injury (P= 0.059). A cardiac consultation was obtained in 290 of the 715 patients (41%). In 119 (41%) of these patients, the myocardial injury was considered to be attributable to a predisposing cardiac condition, and in 111 patients (38%), an intervention was initiated.CONCLUSIONS:Postoperative myocardial injury was associated with an increased risk of 1-year all-cause but not cardiac mortality. A cardiac consultation with intervention was performed in less than half of these patients. The small number of interventions may be explained by a low suspicion of a cardiac etiology in most patients and lack of consensus for standardized treatment in these patients.
Time-resolved functional analysis of acute impairment of frataxin expression in an inducible cell model of Friedreich ataxia
Authors: Poburski Dörte , Boerner Josefine Barbara , Koenig Michel , Ristow Michael , Thierbach René 
Published: April 2016

ABSTRACT
Friedreich ataxia is a neurodegenerative disease caused by a GAA triplet repeat expansion in the first intron of the frataxin gene, which results in reduced expression levels of the corresponding protein. Despite numerous animal and cellular models, therapeutic options that mechanistically address impaired frataxin expression are lacking. Here, we have developed a new mammalian cell model employing the Cre/loxP recombination system to induce a homozygous or heterozygous frataxin knockout in mouse embryonic fibroblasts. Induction of Cre-mediated disruption by tamoxifen was successfully tested on RNA and protein levels. After loss of frataxin protein, cell division, aconitase activity and oxygen consumption rates were found to be decreased, while ROS production was increased in the homozygous state. By contrast, in the heterozygous state no such changes were observed. A time-resolved analysis revealed the loss of aconitase activity as an initial event after induction of complete frataxin deficiency, followed by secondarily elevated ROS production and a late increase in iron content. Initial impairments of oxygen consumption and ATP production were found to be compensated in the late state and seemed to play a minor role in Friedreich ataxia pathophysiology. In conclusion and as predicted from its proposed role in iron sulfur cluster (ISC) biosynthesis, disruption of frataxin primarily causes impaired function of ISC-containing enzymes, whereas other consequences, including elevated ROS production and iron accumulation, appear secondary. These parameters and the robustness of the newly established system may additionally be used for a time-resolved study of pharmacological candidates in a HTS manner.
PRDM14 promotes RAG-dependent Notch1 driver mutations in mouse T-ALL
Authors: Carofino Brandi L. , Ayanga Bernard , Tracey Lauren J. , Brooke-Bisschop Travis , Justice Monica J. 
Published: April 2016

ABSTRACT
PRDM14 is an epigenetic regulator known for maintaining embryonic stem cell identity and resetting potency in primordial germ cells. However, hematopoietic expression of Prdm14 at supraphysiological levels results in fully penetrant and rapid-onset T-cell acute lymphoblastic leukemia (T-ALL) in the mouse. Here, we show that PRDM14-induced T-ALLs are driven by NOTCH1, a frequently mutated driver of human T-ALL. Notch1 is activated in this murine model via RAG-dependent promoter deletions and subsequent production of truncated, ligand-independent protein from downstream regions of the Notch1 locus. These T-ALLs also have focal changes in H3K4me3 deposition at the Notch1 locus and global increases in both H3K4me1 and H3K4me3. Using a PRDM14-FLAG mouse model, we show that PRDM14 binds within an intron of Notch1 prior to leukemia development. Our data support the idea that PRDM14 binding promotes a chromatin state that allows access of the RAG recombinase complex to cryptic RAG signal sequences embedded at the Notch1 locus. Indeed, breeding into a RAG recombination-deficient background abrogates T-ALL development and prevents Notch1 deletions, while allowing for transient hematopoietic stem cell (HSC)-like pre-leukemia cell expansion. Together, our data suggest that PRDM14 expands a progenitor cell population while promoting a permissive epigenetic state for the creation of driver mutations (here, in Notch1), enabling cancer development through the misappropriation of endogenous cellular DNA recombination machinery.
An international survey to identify the intrinsic and extrinsic factors of research studies most likely to change orthopaedic practice
Authors: Thornley P. , de SA D. , Evaniew N. , Farrokhyar F. , Bhandari M. , Ghert M. 
Published: April 2016

Objectives Evidence -based medicine (EBM) is designed to inform clinical decision-making within all medical specialties, including orthopaedic surgery. We recently published a pilot survey of the Canadian Orthopaedic Association (COA) membership and demonstrated that the adoption of EBM principles is variable among Canadian orthopaedic surgeons. The objective of this study was to conduct a broader international survey of orthopaedic surgeons to identify characteristics of research studies perceived as being most influential in informing clinical decision-making. Materials and Methods A 29-question electronic survey was distributed to the readership of an established orthopaedic journal with international readership. The survey aimed to analyse the influence of both extrinsic (journal quality, investigator profiles, etc.) and intrinsic characteristics (study design, sample size, etc.) of research studies in relation to their influence on practice patterns. Results A total of 353 surgeons completed the survey. Surgeons achieved consensus on the ‘importance’ of three key designs on their practices: randomised controlled trials (94%), meta-analyses (75%) and systematic reviews (66%). The vast majority of respondents support the use of current evidence over historical clinical training; however subjective factors such as journal reputation (72%) and investigator profile (68%) continue to influence clinical decision-making strongly. Conclusion Although intrinsic factors such as study design and sample size have some influence on clinical decision-making, surgeon respondents are equally influenced by extrinsic factors such as investigator reputation and perceived journal quality. Cite this article: Dr M. Ghert. An international survey to identify the intrinsic and extrinsic factors of research studies most likely to change orthopaedic practice. Bone Joint Res 2016;5:130–136. DOI: 10.1302/2046-3758.54.2000578.
The effects of perceptions about Turkish baths on future intentions in context of thermal tourism<p>Termal turizm kapsamında hamamlarla ilgili algıların gelecek niyeti üzerine etkileri
Authors: Temizkan Saadet Pınar , Ekici Aykut , Demirci Barış 
Published: April 2016

This study aims to explore the service quality perceptions of visitors who experience the Turkish baths in Eskisehir and determine the effects of these perceptions’ on future intentions. The future intention includes behaviors that formed within customers' experience after the acquired service. Within this context, the future intention topics discussed in the study were revisit intention and recommendation factor. Research population constituted visitors benefiting from Turkish baths in Eskisehir Center hot water region. There are 14 baths businesses located in the area. Data is gathered through survey method. The survey consisted two parts. In the first part, there were six expressions to determine the demographic characteristics of participants. The second part consisted 16 expressions to determine the perception and future intentions of the participants regarding Turkish baths. 369 surveys which are collected by convenience sampling method are analyzed with a statistic software and interpreted in accordance with the aims of study. Results indicate that service quality perceptions about Turkish baths have influence on future intentions (r=,458) and 20,9% of future intentions could be explained with perceptions about Turkish baths. ÖzetBu araştırma Eskişehir’de termal hamam deneyimlerinde bulunan ziyaretçilerin hamamlardaki hizmet kalitesi algılarına ilişkin değerlendirmelerini ortaya koymak ve bu algıların gelecek niyeti üzerindeki etkisini belirlemek maksadıyla yapılmıştır. Çalışmada gelecek niyeti kapsamında ele alınan konu; hamamlardan yararlanan müşterilerinin aldıkları hizmet sonrası sahip olduğu düşüncelerdir. Bu çerçevede tekrar ziyaret niyeti ve tavsiye faktörü gelecek niyeti olarak adlandırılmıştır. Araştırma evrenini Eskişehir Merkez Sıcak Sular bölgesinde yer alan hamamlardan yararlanan ziyaretçiler oluşturmaktadır. Söz konusu bölgede 14 hamam işletmesi yer almaktadır. Araştırmada veri toplama yöntemi olarak anket tekniği kullanılmıştır. Anket iki bölümden oluşmaktadır. Birinci bölümde katılımcıların demografik özelliklerini belirlemeye yönelik 6 ifade bulunmaktadır. İkinci bölümde ise katılımcıların hamamlarla ilgili algılarını ve gelecek niyetlerini belirlemeye yönelik 16 ifade yer almaktadır. Kolayda örnekleme yöntemine göre 396 kişiden elde edilen veriler, güncel istatistik programında analiz edilerek, araştırmanın amacı doğrultusunda yorumlanmıştır. Araştırmada hamamlar ile ilgili hizmet kalitesi algılarının gelecek niyeti üzerinde etkisi olduğu (r=,458); gelecek niyetinin % 20,9’unun hamamlar ile ilgili algılarla açıklanabileceği tespit edilmiştir.
Microscopy Techniques for Viewing the Inner Structure of Shear Bands in Sensitive Clays
Authors: Samstad Gylland A. , Rueslåtten H. , Paniagua P. , Nordal S. 
Published: April 2016

Abstract
Sample preparation and imaging techniques were evaluated for the investigation of fabric and the structures of shear bands in sensitive clays. This included the preparation of polished thin sections, which were studied in a polarized light microscope and in an electron probe micro-analyzer (EPMA). In addition, a set of samples was investigated by X-ray micro-Computerized Tomography, micro-CT. The shear band was seen as a non-continuous displacement field with complex inner patterns of shear fractures, like Riedel shears. Light microscopy of the thin sections was found to be useful for studying the outline and distribution of Riedel shears in the millimeter-sized shear band, whereas EPMA allows for studying microstructures at the micrometer level. The micro-CT makes it possible to extend the 2D representation of the studied macro-features from EPMA and light microscopy into 3D space. The main challenge with sensitive clays is sample preparation; the material can take little or no handling in its wet state, and when dried, substantial shrinkage occurs. The micro-CT holds several strong advantages which overcome these issues and also adds 3D visualization. Despite challenges related to image processing and image resolution versus sample size, the CT-tool is preferred for future studies of shear features in sensitive clays.
Consolidation Coefficient by Combined Probabilistic and Least Residuals Methods
Authors: Sebai S. , Belkacemi S. 
Published: April 2016

Abstract
Accurate prediction of the rate of consolidation settlement is dependent upon a reliable method of determining the coefficient of consolidation (cv) and the time to end of primary consolidation of the natural soil. For this purpose, and to circumvent errors associated with graphical procedures in evaluating cv, a FORTRAN program was developed to determine the best fit of laboratory consolidation test data using a combination of a probabilistic method and a minimization of the sum of squared residual (SSR) method. The proposed computer procedure does not use any particular point on the time-settlement curve. The program uses ranges of probable values of d0, d100, and cv. For each set of values d0, d100, and cv selected in a random manner, the SSR is computed. The set of values with the smallest SSR is considered as the best fit. This procedure leads to suitable reference values of the coefficient of consolidation and the end of primary consolidation, and permits an assessment of the accuracy of classical graphical log(t) and t1/2 procedures.
Effects of Chronic Sleep Restriction during Early Adolescence on the Adult Pattern of Connectivity of Mouse Secondary Motor Cortex
Authors: Billeh Yazan N. , Rodriguez Alexander V. , Bellesi Michele , Bernard Amy , de Vivo Luisa , Funk Chadd M. , Harris Julie , Honjoh Sakiko , Mihalas Stefan , Ng Lydia , Koch Christof , Cirelli Chiara , Tononi Giulio 
Published: April 2016

AbstractCortical circuits mature in stages, from early synaptogenesis and synaptic pruning to late synaptic refinement, resulting in the adult anatomical connection matrix. Because the mature matrix is largely fixed, genetic or environmental factors interfering with its establishment can have irreversible effects. Sleep disruption is rarely considered among those factors, and previous studies have focused on very young animals and the acute effects of sleep deprivation on neuronal morphology and cortical plasticity. Adolescence is a sensitive time for brain remodeling, yet whether chronic sleep restriction (CSR) during adolescence has long-term effects on brain connectivity remains unclear. We used viral-mediated axonal labeling and serial two-photon tomography to measure brain-wide projections from secondary motor cortex (MOs), a high-order area with diffuse projections. For each MOs target, we calculated the projection fraction, a combined measure of passing fibers and axonal terminals normalized for the size of each target. We found no homogeneous differences in MOs projection fraction between mice subjected to 5 days of CSR during early adolescence (P25–P30, ≥50% decrease in daily sleep,n=14) and siblings that slept undisturbed (n=14). Machine learning algorithms, however, classified animals at significantly above chance levels, indicating that differences between the two groups exist, but are subtle and heterogeneous. Thus, sleep disruption in early adolescence may affect adult brain connectivity. However, because our method relies on a global measure of projection density and was not previously used to measure connectivity changes due to behavioral manipulations, definitive conclusions on the long-term structural effects of early CSR require additional experiments.