bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost‐effectiveness of implementing molecular immunohematology
Authors: Denomme G. A. 
Published: December 2016

BackgroundMolecular immunohematology is practised in clinical laboratories and blood centres. It is based on red cell genotyping, which is a technology whereby DNA‐based techniques are used to evaluate genes for the particular single and multiple nucleotide substitutions, deletions, insertions and gene conversions that determine the expression of red cell antigens. Fetal red cell genotyping, and in particular RHD genotyping, using the discarded cell pellet of amniotic fluid was developed some 20 years ago. It replaced the need for fetal blood sampling and also can determine paternal zygosity with better certainty. Cell‐free fetal DNA in maternal plasma is now the non‐invasive (fetal) alternative to amniotic fluid as the biological material of choice. It is being used in Europe to reduce the exposure of Rh immune globulin for the routine Rh‐negative pregnancy. RHD genotyping is used to determine zygosity and resolve weak D antigen discrepancies as a cost equivalent alternative to the administration of Rh immune globulin. Since then, a plethora of data has accumulated on the value of screening donors for rare blood types. For common antigens, red cell genotyping as an historical test‐of‐record will create efficiencies in the labelling of antigen‐negative blood if care is taken in testing appropriate repeat donors. Certainly, it has been shown that exposing antigen‐negative types through the entire supply chain replaces shipping from a central facility.ConclusionMolecular immunohematology is not the implementation of cost reductions but the recognition of ‘effective’ processes and algorithms that incorporate molecular testing to provide tangible benefits to pregnant women and transfusion recipients.
β1‐Adrenoceptor autoantibodies increase the susceptibility to ventricular arrhythmias involving abnormal repolarization in guinea‐pigs
Authors: Zhao Yu‐Hui , Huang Hai‐Xia , Liu Ping , Du Yun‐Hui , Wang Peng , Wang Wen , Wu Ye , Wang Li , Ma Chang‐Sheng , Liu Hui‐Rong 
Published: December 2016

New Findings
What is the central question of this study?
High titres of autoantibodies against the second extracellular loop of the β1‐adrenergic receptor (β1‐AAs) can be detected in the sera of patients with ventricular arrhythmias, but a causal relationship between β1‐AAs and ventricular arrhythmias has not been established.

What is the main finding and its importance?
Monoclonal β1‐AAs (β1‐AR mAbs) were used in the experiments. We showed that β1‐AR mAbs increased susceptibility to ventricular arrhythmias and induced repolarization abnormalities. Antibody adsorption of β1‐AAs will be a potential new therapeutic strategy for ventricular arrhythmias in patients with high titres of β1‐AAs.

High titres of autoantibodies against the second extracellular loop of the β1‐adrenergic receptor (β1‐AAs) can be detected in sera from patients with ventricular arrhythmias, but a causal relationship between β1‐AAs and ventricular arrhythmias has not been established. In this work, ECGs of guinea‐pigs and isolated guinea‐pig hearts were recorded. Ventricular tachycardia (VT) and ventricular fibrillation (VF) were evoked by programmed electrical stimulation of the left ventricular epicardium of isolated guinea‐pig hearts. The monophasic action potential and effective refractory period of the left ventricle were recorded in paced isolated guinea‐pig hearts. Furthermore, to increase the specificity, monoclonal autoantibodies against the second extracellular loop of the β1‐adrenergic receptor (β1‐AR mAbs) were used in all experiments. The results showed that β1‐AR mAbs induced premature ventricular contractions in guinea‐pigs and isolated guinea‐pig hearts. In addition, β1‐AR mAbs decreased the threshold of VT/VF and prolonged the duration of VT/VF. Furthermore, β1‐AR mAbs shortened the corrected QT interval and effective refractory period, and prolonged late‐phase repolarization of the monophasic action potential (MAPD90−30). These changes in electrophysiological parameters might be attributed, at least in part, to the arrhythmogenicity of β1‐AR mAbs.
Should all anticoagulated patients with head injury receive a CT scan? Decision-analysis modelling of an observational cohort
Authors: Kuczawski Maxine , Stevenson Matt , Goodacre Steve , Teare M Dawn , Ramlakhan Shammi , Morris Francis , Mason Suzanne 
Published: December 2016

ObjectivesIt is not currently clear whether all anticoagulated patients with a head injury should receive CT scanning or only those with evidence of traumatic brain injury (eg, loss of consciousness or amnesia). We aimed to determine the cost-effectiveness of CT for all compared with selective CT use for anticoagulated patients with a head injury.DesignDecision-analysis modelling of data from a multicentre observational study.Setting33 emergency departments in England and Scotland.Participants3566 adults (aged ≥16 years) who had suffered blunt head injury, were taking warfarin and underwent selective CT scanning.Main outcome measuresEstimated expected benefits in terms of quality-adjusted life years (QALYs) were the entire cohort to receive a CT scan; estimated increased costs of CT and also the potential cost implications associated with patient survival and improved health. These values were used to estimate the cost per QALY of implementing a strategy of CT for all patients compared with observed practice based on guidelines recommending selective CT use.ResultsOf the 1420 of 3534 patients (40%) who did not receive a CT scan, 7 (0.5%) suffered a potentially avoidable head injury-related adverse outcome. If CT scanning had been performed in all patients, appropriate treatment could have gained 3.41 additional QALYs but would have incurred £193 149 additional treatment costs and £130 683 additional CT costs. The incremental cost-effectiveness ratio of £94 895/QALY gained for unselective compared with selective CT use is markedly above the threshold of £20–30 000/QALY used by the UK National Institute for Care Excellence to determine cost-effectiveness.ConclusionsCT scanning for all anticoagulated patients with head injury is not cost-effective compared with selective use of CT scanning based on guidelines recommending scanning only for those with evidence of traumatic brain injury.Trial registration numberNCT 02461498.
Patients' perceptions and experiences of the prevention of hospital-acquired thrombosis: a qualitative study
Authors: Apenteng Patricia N , Fitzmaurice David , Litchfield Ian , Harrison Sian , Heneghan Carl , Ward Alison , Greenfield Sheila 
Published: December 2016

ObjectiveTo examine patients' understanding of hospital-associated thrombosis, and their experiences of thromboprophylaxis.DesignQualitative study using semi-structured interviews with 31 patients requiring venous thromboembolism (VTE) prophylaxis following a recent hospital admission. Interviews were audio-recorded, transcribed verbatim and analysed thematically using framework analysis.Setting4 hospitals in Birmingham and Oxford.ResultsAll the participants received thromboprophylaxis following surgical procedures. Participants were aware of a risk of blood clots; however, they lacked a good understanding of VTE and its components. Experiences of VTE prophylaxis were characterised with good adherence to heparin injections and poor adherence to elastic compression stockings, largely due to perceived lack of clarity in guidance from health professionals. Participants had limited knowledge of the signs and symptoms of VTE and would value improved education on VTE.ConclusionsFindings suggest that patient education is often inadequate and impacts negatively on patients' involvement in VTE prevention. An enhanced patient education programme incorporating a consistent message on the appropriate use of elastic compression stockings and description of VTE symptoms is likely to optimise the effectiveness of the prevention of hospital-associated thrombosis. Physicians may use the results of this study to improve individual patient education.
Non-communicable diseases in decontamination workers in areas affected by the Fukushima nuclear disaster: a retrospective observational study
Authors: Sawano Toyoaki , Tsubokura Masaharu , Ozaki Akihiko , Leppold Claire , Nomura Shuhei , Shimada Yuki , Ochi Sae , Tsukada Manabu , Nemoto Tsuyoshi , Kato Shigeaki , Kanazawa Yukio , Ohira Hiromichi 
Published: December 2016

ObjectivesTo assess the prevalence of non-communicable diseases (NCDs), and whether NCDs were treated or not, among hospitalised decontamination workers who moved to radio-contaminated areas after Japan's 2011 Fukushima Daiichi Nuclear Power Plant disaster.MethodsWe retrospectively extracted records of decontamination workers admitted to Minamisoma Municipal General Hospital between 1 June 2012 and 31 August 2015, from hospital records. We investigated the incidence of underlying NCDs such as hypertension, dyslipidaemia and diabetes among the decontamination workers, and their treatment status, in addition to the reasons for their hospital admission.ResultsA total of 113 decontamination workers were admitted to the hospital (112 male patients, median age of 54 years (age range: 18–69 years)). In terms of the demographics of underlying NCDs in this population, 57 of 72 hypertensive patients (79.2%), 37 of 45 dyslipidaemic patients (82.2%) and 18 of 27 hyperglycaemic patients (66.7%) had not been treated for their NCDs before admission to the hospital.ConclusionsA high burden of underlying NCDs was found in hospitalised decontamination workers in Fukushima. Managing underlying diseases such as hypertension, hyperlipidaemia and diabetes mellitus is essential among this population.
Incidence and risk factors for type 2 diabetes mellitus in transitional Thailand: results from the Thai cohort study
Authors: Papier Keren , Jordan Susan , D‘Este Catherine , Bain Chris , Peungson Janya , Banwell Cathy , Yiengprugsawan Vasoontara , Seubsman Sam-ang , Sleigh Adrian 
Published: December 2016

BackgroundType 2 diabetes mellitus (T2DM) is increasingly prevalent in countries undergoing rapid development, including Thailand. We assessed T2DM incidence over an 8-year period in a nationwide cohort of Thai adults.MethodsThai Cohort Study participants were surveyed in 2005, 2009 and 2013. The analysed cohort members were aged (15–88), did not have diabetes in 2005 and were followed up by questionnaire in 2013 (n=39 507). T2DM was ascertained using self-report, which has been validated using physician interviews. We calculated the 8-year cumulative incidence of T2DM. Multivariable logistic regression assessed associations between potential risk factors and T2DM incidence.Results8-year cumulative incidence of T2DM (2005 to 2013) was 177 per 10 000 (95% CI 164 to 190). Crude and age-standardised cumulative incidences of T2DM by sex were 249 per 10 000 (95% CI 226 to 272) and 222 per 10 000 (95% CI 219 to 225) for men; and 119 per 10 000 (95% CI 105 to 133) and 96 per 10 000 (95% CI 94 to 98) for women, respectively. T2DM increased significantly for both sexes with increasing age and body mass index (BMI) (p trend <0.001 for both). Residence in an urban area as a child associated with T2DM among men and women (OR=1.4, 95% CI 1.1 to 1.7 and OR=1.4, 95% CI 1.01 to 1.79); this was no longer statistically significant after adjusting for BMI. Among men, smoking (OR=1.7, 95% CI 1.3 to 2.2) and alcohol intake (OR=1.8, 95% CI 1.1 to 3.0) were associated with T2DM.ConclusionsThis study found that the sociodemographic and lifestyle changes that have accompanied Thailand's economic development are associated with T2DM risk in a large cohort of Thai adults. Our findings highlight the need to address these transitions to prevent a further increase in the national incidence of T2DM, particularly among Thai men.
A comparative effectiveness trial of two faecal immunochemical tests for haemoglobin (FIT). Assessment of test performance and adherence in a single round of a population-based screening programme for colorectal cancer
Authors: Passamonti Basilio , Malaspina Morena , Fraser Callum G , Tintori Beatrice , Carlani Angela , D'Angelo Valentina , Galeazzi Paola , Di Dato Eugenio , Mariotti Loretta , Bulletti Simonetta , D'Amico Maria Rosaria , Gustinucci Daniela , Martinelli Nadia , Spita Nicoletta , Cesarini Elena , Rubeca Tiziana , Giaimo Mariadonata , Segnan Nereo , Senore Carlo 
Published: December 2016

AimTo compare acceptability and diagnostic accuracy of a recently available faecal immunochemical test (FIT) system (HM-JACKarc) with the FIT routinely used in an established screening programme (OC-Sensor).DesignRandomised controlled trial (ISRCTN20086618) within a population-based colorectal cancer (CRC) screening programme. Subjects eligible for invitation in the Umbria Region (Italy) programme were randomised (ratio 1:1) to be screened using one of the FIT systems.ResultsScreening uptake among the 48 888 invitees was the same for both systems among subjects invited in the first round and higher with OC-Sensor than with HM-JACKarc (relative risk (RR): 1.03; 95% CI 1.02 to 1.04) among those invited in subsequent rounds. Positivity rate (PR) was similar with OC-Sensor (6.5%) as with HM-JACKarc (6.2%) among subjects performing their first FIT screening and higher with OC-Sensor (5.6%, RR: 1.25, 95% CI 1.12 to 1.40) than with HM-JACKarc (4.4%) among those screened in previous rounds. Positive predictive value (PPV) (OC-Sensor: 25.9%, HM-JACKarc: 25.6%) and detection rate (DR) (OC-Sensor: 1.40%; HM-JACKarc: 1.42%) for advanced neoplasia (AN: CRC + advanced adenoma) were similar among subjects performing their first FIT screening. The differences in the AN PPV (OC-Sensor: 20.3%, HM-JACKarc: 22.6%) and DR (OC-Sensor: 0.96%, HM-JACKarc: 0.83%) among those screened in previous rounds were not statistically significant. The number needed to scope to detect one AN was 3.9 (95% CI 5.8 to 2.9) and 3.9 (95% CI 5.5 to 2.9) at first and 4.9 (95% CI 5.8 to 4.2) and 4.4 (95% CI 5.3 to 3.7) at subsequent screening, with OC-Sensor and HM-JACKarc, respectively.ConclusionsOur results suggest that acceptability and diagnostic performance of HM-JACKarc and of OC-Sensor systems are similar in a screening setting.Trial registration numberISRCTN20086618; Results.
Catch Plus thrombectomy device in acute stroke: initial evaluation
Authors: Peker Ahmet , Arsava Ethem Murat , Topçuoğlu Mehmet Akif , Arat Anıl 
Published: December 2016

ObjectiveTo report our initial experience with the Catch Plus thrombectomy device (CPD) in patients with acute ischemic stroke (AIS).Materials and methodsWe retrospectively evaluated the procedural variables as well as the clinical and angiographic outcomes of patients with acute occlusion of a major intracranial artery in the anterior circulation who were treated with CPD at our center. Baseline characteristics (gender, age, comorbidities, cardiovascular risk factors, National Institutes of Health Stroke Scale (NIHSS) score, and vessel occlusion sites) of these patients were recorded. Thrombolysis in Cerebral Infarction (TICI) score, incidence of symptomatic and asymptomatic bleeding, and 90 day modified Rankin Scale (mRS) scores were evaluated as indicators of outcome.Results38 patients with a mean age of 67.5 years were treated with CPD. Mean time from symptom onset to procedure initiation was 226.7 min. Recanalization (TICI 2b–3) was achieved in 27 patients (71.1%). The median NIHSS score on admission was 20. Rates of symptomatic and asymptomatic intracerebral hemorrhage were 7.9% and 13.2%, respectively. The 90 day clinical follow-up data were available for 37 patients. The 90 day mortality rate was 18.9%, and the 90 day clinically acceptable functional outcome (mRS score ≤2) rate was 43.2% (mRS score 0–3, 54.1%). Very distal thrombectomy involving the cortical arteries was performed on four patients without complications.ConclusionsOur initial experience suggests that mechanical thrombectomy with the CPD improves 90 day outcomes of patients with AIS by facilitating effective recanalization.
Impact of MRI on changing management of the cervical spine in blunt trauma patients with a ‘negative’ CT scan
Authors: Mohamed Mohamed A , Majeske Karl D , Sachwani-Daswani Gul , Coffey Daniel , Elghawy Karim M , Pham Amanda , Scholten Donald , Wilson Kenneth L , Mercer Leo , McCann Michael L 
Published: December 2016

BackgroundOwing to the potential risks associated with missed injury, many blunt trauma patients with suspected cervical spine injury undergo some form of imaging technique which has progressed from primarily using plain radiography to relying on CT. Recently, studies have shown that in certain situations, adding MRI may improve the diagnostic accuracy over solely relying on CT.MethodsRetrospective study of 3468 adult blunt trauma patients at a level I trauma center of which 94 with an initial negative CT scan underwent subsequent MRI. These 94 patients were classified as reliable or unreliable for examination; coded as either having a positive or negative MRI result; and assessed for a change in management.ResultsOf the 94 patients in the study population, 69 (73.4%) were deemed reliable and 25 (26.6%) deemed unreliable for examination. Overall, 65 (69.1%) patients had a positive MRI result—49 (71.0%) reliable and 16 (64.0%) unreliable—with some patients testing positive for more than one finding. There was no significant difference in positive MRI rates between reliable and unreliable patients. None of the 29 patients who had negative MRI had a change in management, while 31 of the 65 (47.7%) patients with positive MRI did have a change in management of either continued cervical collar immobilization or neck surgery.ConclusionsThe use of CT scans should be continued as the primary imaging technique for patients with suspected cervical spine injuries. In cases where obtundation or clinical suspicion exists for a false-negative CT scan, MRI should be considered as a supplement and should not be rejected solely based on the negative result of the CT.Level of evidenceLevel IV.
Seismic volcanostratigraphy of the NE Greenland continental margin
Authors: Geissler Wolfram H. , Gaina Carmen , Hopper John R. , Funck Thomas , Blischke Anett , Arting Uni , Horni Jim á , Péron-Pinvidic Gwenn , Abdelmalak Mansour M. 
Published: December 2016

Abstract
The Early Eocene continental break-up between the NE Greenland and the mid-Norwegian–SW Barents Sea margins was associated with voluminous magmatism and led to the emplacement of massive volcanic complexes including wedges of seawards-dipping reflections (SDR). We study the distribution of these break-up-related volcanic rocks along the NE Greenland margin by revisiting existing seismic reflection data and comparing our observations to better-studied segments of the conjugate margin. Seismic facies types match between the conjugate margins and show strong lateral variations. Seaward-dipping wedges are mapped offshore East Greenland, the conjugate to the Vøring continental margin. The geophysical signature of the SDRs becomes less visible towards the north, as it does along the conjugate Lofoten–Vesterålen margin. We suggest that the Traill Ø volcanic ridge is a result of plume–ridge interactions formed between approximately 54 and 47 Ma. North of the East Greenland Ridge, strong basement reflections conjugate to the Vestbakken Volcanic Province are interpreted as lava flows or ‘spurious’ SDRs. We discuss our findings in conjunction with results from seismic wide-angle experiments, gravity and magnetic data. We focus on the spatial and temporal relationships of the break-up volcanic rocks, and their structural setting in a late rift and initial oceanic drift stage.

Supplementary material:
The figures show the original seismic data used as the base for the interpretations shown in this paper. The seismic profiles are marked on Figure 1 (in the paper) as numbers 1 to 10 and are available at
https://doi.org/10.6084/m9.figshare.c.3593780
Earth system transition during the Tonian–Cambrian interval of biological innovation: nutrients, climate, oxygen and the marine organic carbon capacitor
Authors: Shields Graham A. 
Published: December 2016

Abstract

The Tonian–Cambrian interval (
c.
0.9–0.5 Ga) witnessed major tectonic, climatic and chemical changes to the Earth system and culminated in the Ediacaran–Cambrian radiation of animals. Negative carbon isotope (δ
13
C) excursions of extraordinary magnitude form the backdrop to all these events and are consistent with the presence of a vast marine organic carbon reservoir that changed its size due to periodic imbalances between organic production (as an oxidant source) and terrestrial oxidant sinks. Prior to both Cryogenian glaciations, this pool of long-lived organic carbon may have become substantially depleted, leading to a weakening of the regulation of climate and oxygen. The late Ediacaran Shuram anomaly probably represents a third depletion event, which was followed by oxygenation and the Ediacaran–Cambrian radiation. The evolutionary diversification of animals shortened the ocean residence time of organic carbon and introduced new carbon cycle feedbacks that together helped to mould the modern Earth system.
Effects of different stresses on cardiac autonomic control and cardiovascular coupling
Authors: Xie Lin , Liu Binbin , Wang Xiaoni , Mei Mengqi , Li Mengjun , Yu Xiaolin , Zhang Jianbao 
Published: December 2016

The objective of this study was to investigate the impacts of different stresses on time-varying autonomic reactivity and cardiovascular coupling. In total, 25 male subjects were recruited. RR intervals (RRI), systolic and diastolic blood pressure (SBP, DBP), stroke volume (SV), cardiac output (CO), and systemic vascular resistance (SVR) values were collected during rest, mental arithmetic task (MAT), and cold pressor test (CPT). Baroreflex sensitivity (BRS) was derived using the transfer function method. Continuous wavelet transformation of RRI was used to describe the time-variant patterns of autonomic neural activities. Wavelet cross correlation and phase synchronization were used to estimate the amplitude and phase coupling between RRI and SBP. MAT was characterized by increased heart rate (HR), SBP, DBP, and CO with decreased BRS attributable to prolonged parasympathetic withdrawal. Moreover, cardiovascular coupling was disrupted in MAT. These results indicated that baroreflex was depressed, and the top-down system started to take action under mental stress. In CPT, SBP, DBP, and SVR increased significantly, whereas HR and BRS remained unchanged. The increase of sympathetic activity was transient, and cardiovascular coupling did not change in CPT. Intriguingly, the frequency of the maximum cross-correlation coefficient in the low-frequency band (0.04–0.15 Hz) was significantly decreased in CPT, which may be due to the change of resonance frequency of the baroreflex loop. NEW & NOTEWORTHY The study is the first to compare the time-variant pattern of autonomic nervous activities and cardiovascular coupling between the mental arithmetic task (MAT) and the cold pressor test (CPT). Our results demonstrated that MAT and CPT elicited different time-varying patterns of autonomic neural activities and cardiovascular synchronization. Both the amplitude and phase consistency of blood pressure and heart rate decreased in MAT. CPT may affect the harmonic frequency of the baroreflex loop.