bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reduction of biological response modifiers in the supernatant of washed paediatric red blood cells
Authors: Loh Y. S. , Tan S. , Kwok M. , Stark M. J. , Marks D. C. 
Published: October 2016

BackgroundWashing of red blood cells (RBC) can reduce unwanted biological response modifiers (BRMs) that can mediate transfusion complications in infants. The aim of this study was to examine the in vitro quality and the changes in BRMs following washing in paediatric RBC units.Materials and MethodsA pool and split design was used to prepare RBC (either 1 or 4 days old; n = 26 pairs). One unit was washed with 0·9% saline by centrifugation and then resuspended in SAG‐M, while the other remained unwashed. Each RBC unit was divided to produce four units of paediatric‐sized components. Samples were taken after 3 h and subsequently on days 1, 2, 7 and 14 post‐wash.ResultsWashing of RBC resulted in some red cell loss, with a minor increase in haemolysis. Washing effectively reduced supernatant potassium and IgA, as well as cytokines and complement proteins. RBC microparticles were significantly reduced in RBC washed at 1, but not 4 days post‐collection. Incubation with supernatant from unwashed but not washed RBC led to endothelial cell activation, with increased cell surface expression of CD62E (E‐selectin) and CD106 (VCAM).ConclusionAlthough washing affected some aspects of the in vitro quality of RBC, it effectively reduced the concentration and activity of BRMs in the supernatant of RBC. Such a reduction may be clinically beneficial in selected patient groups.
An effective diagnostic strategy for accurate detection of RhD variants including Asian DEL type in apparently RhD‐negative blood donors in Korea
Authors: Seo M. H. , Won E. J. , Hong Y. J. , Chun S. , Kwon J. R. , Choi Y. S. , Kim J. N. , Lee S. A. , Lim A. H. , Kim S. H. , Park K. U. , Cho D. 
Published: October 2016

Background and ObjectivesThe purpose of this study was to provide an effective RHD genotyping strategy for the East Asian blood donors.Material and MethodsRhD phenotyping, weak D testing and RhCE phenotyping were performed on 110 samples from members of the RhD‐negative club, private organization composed of RhD‐negative blood donors, in the GwangJu‐Chonnam region of Korea. The RHD promoter, intron 4, and exons 7 and 10 were analysed by real‐time PCR. Two nucleotide changes (c.1227 G>A, and c.1222 T>C) in exon 9 were analysed by sequencing.ResultsOf 110 RhD‐negative club members, 79 (71·8%) showed complete deletion of the RHD gene, 10 (9·1%) showed results consistent with RHD‐CE‐D hybrid, and 21 (19·1%) showed amplification of RHD promoter, intron 4, and exons 7 and 10. Of the latter group, 16 (14·5%) were in the DEL blood group including c.1227 G>A (N = 14) and c.1222 T>C (N = 2), 2 (1·8%) were weak D, 1(0·9%) was partial D, and 2 (1·8%) were undetermined. The RhD‐negative phenotype samples consisted of 58 C‐E‐c+e+, 19 C‐E+c+e+, 3 C‐E+c+e‐, 21 C+E‐c+e‐, 6 C+E‐c+e+ and 3 C+E‐c‐e + . Notably, all 58 samples with the C‐E‐c+e+ phenotype were revealed to have complete deletion of the RHD gene. The C‐E‐c+e+ phenotype showed 100% positive predictive value for detecting D‐negative cases.ConclusionsRHD genotyping is not required in half of D‐negative cases. We suggest here an effective RHD genotyping strategy for accurate detection of RhD variants in apparently RhD‐negative blood donors in East Asia.
Non‐polar lipids accumulate during storage of transfusion products and do not contribute to the onset of transfusion‐related acute lung injury
Authors: Peters A. L. , Vervaart M. A. T. , van Bruggen R. , de Korte D. , Nieuwland R. , Kulik W. , Vlaar A. P. J. 
Published: October 2016

Background and ObjectivesThe accumulation of non‐polar lipids arachidonic acid, 5‐hydroxyeicosatetraenoic acid (HETE), 12‐HETE and 15‐HETE during storage of transfusion products may play a role in the onset of transfusion‐related acute lung injury (TRALI), a syndrome of respiratory distress after transfusion.Materials and MethodsWe investigated non‐polar lipid accumulation in red blood cells (RBCs) stored for 42 days, plasma stored for 7 days at either 4 or 20°C and platelet (PLT) transfusion products stored for 7 days. Furthermore, we investigated whether transfusion of RBCs with increased levels of non‐polar lipids induces TRALI in a ‘two‐hit’ human volunteer model. All products were produced following Dutch Blood Bank protocols and are according to European standards. Non‐polar lipids were measured with high‐performance liquid chromotography followed by mass spectrometry.ResultsAll non‐polar lipids increased in RBCs after 21 days of storage compared to baseline. The non‐polar lipid concentration in plasma increased significantly, and the increase was even more pronounced in products stored at 20°C. In platelets, baseline levels of 5‐HETE and 15‐HETE were higher than in RBCs or plasma. However, the non‐polar lipids did not change significantly during storage of PLT products. Infusion of RBCs with increased levels of non‐polar lipids did not induce TRALI in LPS‐primed human volunteers.ConclusionWe conclude that non‐polar lipids accumulate in RBC and plasma transfusion products and that accumulation is temperature dependent. Accumulation of non‐polar lipids does not appear to explain the onset of TRALI (Dutch Trial Register – NTR4455).
β-alanine supplementation to improve exercise capacity and performance: a systematic review and meta-analysis
Authors: Saunders Bryan , Elliott-Sale Kirsty , Artioli Guilherme G , Swinton Paul A , Dolan Eimear , Roschel Hamilton , Sale Craig , Gualano Bruno 
Published: October 2016

ObjectiveTo conduct a systematic review and meta-analysis of the evidence on the effects of β-alanine supplementation on exercise capacity and performance.DesignThis study was designed in accordance with PRISMA guidelines. A 3-level mixed effects model was employed to model effect sizes and account for dependencies within data.Data sources3 databases (PubMed, Google Scholar, Web of Science) were searched using a number of terms (‘β-alanine’ and ‘Beta-alanine’ combined with ‘supplementation’, ‘exercise’, ‘training’, ‘athlete’, ‘performance’ and ‘carnosine’).Eligibility criteria for selecting studiesInclusion/exclusion criteria limited articles to double-blinded, placebo-controlled studies investigating the effects of β-alanine supplementation on an exercise measure. All healthy participant populations were considered, while supplementation protocols were restricted to chronic ingestion. Cross-over designs were excluded due to the long washout period for skeletal muscle carnosine following supplementation. A single outcome measure was extracted for each exercise protocol and converted to effect sizes for meta-analyses.Results40 individual studies employing 65 different exercise protocols and totalling 70 exercise measures in 1461 participants were included in the analyses. A significant overall effect size of 0.18 (95% CI 0.08 to 0.28) was shown. Meta-regression demonstrated that exercise duration significantly (p=0.004) moderated effect sizes. Subgroup analyses also identified the type of exercise as a significant (p=0.013) moderator of effect sizes within an exercise time frame of 0.5–10 min with greater effect sizes for exercise capacity (0.4998 (95% CI 0.246 to 0.753)) versus performance (0.1078 (95% CI −0.201 to 0.416)). There was no moderating effect of training status (p=0.559), intermittent or continuous exercise (p=0.436) or total amount of β-alanine ingested (p=0.438). Co-supplementation with sodium bicarbonate resulted in the largest effect size when compared with placebo (0.43 (95% CI 0.22 to 0.64)).Summary/conclusionsβ-alanine had a significant overall effect while subgroup analyses revealed a number of modifying factors. These data allow individuals to make informed decisions as to the likelihood of an ergogenic effect with β-alanine supplementation based on their chosen exercise modality.
Seasonality of gestational diabetes mellitus: a South Australian population study
Authors: Verburg Petra E , Tucker Graeme , Scheil Wendy , Erwich Jan Jaap H M , Dekker Gus A , Roberts Claire T 
Published: October 2016

ObjectiveTo investigate whether there is a seasonal variation in the incidence of gestational diabetes mellitus (GDM).Research design and methodsThis retrospective cohort study of 60 306 eligible South Australian live-born singletons during 2007–2011 recorded in the South Australian Perinatal Statistics Collection (SAPSC) examined the incidence of GDM in relation to estimated date of conception (eDoC). Fourier series analysis was used to model seasonal trends.ResultsDuring the study period, 3632 (6.0%) women were diagnosed with GDM. Seasonal modeling showed a strong relation between GDM and eDoC (p<0.001). Unadjusted and adjusted models (adjusted for maternal age, body mass index (BMI), parity, ethnicity, socioeconomic status, and chronic hypertension) demonstrated the presence of a peak incidence occurring among pregnancies with eDoC in winter (June/July/August), with a trough for eDoc in summer (December/January/February). As this was a retrospective study, we could only use variables that had been collected as part of the routine registration system, the SAPSC.ConclusionsThis study is the first population-based study to demonstrate a seasonal variation for GDM. Several maternal lifestyle and psychosocial factors associated with seasonality and GDM may be influential in the pathophysiologic mechanisms of GDM. Ambient temperature, physical activity, nutrient intake, and vitamin D levels may affect maternal physiology, and fetal and placental development at the cellular level and contribute to the development of GDM. The mechanisms underlying these possible associations are not fully understood and warrant further investigation.
Cholera in the time of war: implications of weak surveillance in Syria for the WHO's preparedness—a comparison of two monitoring systems
Authors: Sparrow Annie , Almilaji Khaled , Tajaldin Bachir , Teodoro Nicholas , Langton Paul 
Published: October 2016

BackgroundPublic health breakdown from the Syrian government's targeting of healthcare systems in politically unsympathetic areas has yielded a resurgence of infectious diseases. Suspected cholera recently reappeared but conflict-related constraints impede laboratory confirmation. Given the government's previous under-reporting of infectious outbreaks and the reliance of the WHO on government reporting, we sought to assess the reliability of current surveillance systems.MethodsWe compared weekly surveillance reports of waterborne diseases from the Syrian government's (WHO-associated) Early Warning and Response System (EWARS), based in Damascus, and the independent, non-governmental Early Warning and Response Network (EWARN) headquartered in Gaziantep, Turkey. We compared raw case rates by EWARS and EWARN and assessed the quality of reporting against the WHO benchmarks.ResultsWe identified significant under-reporting and delays in the government's surveillance. On average, EWARS reports were published 24 days (range 12–61) after the reference week compared with 11 days (5–21) for EWARN. Average completeness for EWARS was 75% (55–84%), compared with 92% for EWARN (85–99%). Average timeliness for EWARS was 79% (51–100%), compared with 88% for EWARN (70–97%). EWARS made limited use of rapid diagnostic tests, and rates of collection of stool samples for laboratory cholera testing were well below reference levels.ConclusionsIn the context of the current Syrian war, the government's surveillance is inadequate due to lack of access to non-government held territory, an incentive to under-report the consequence of government attacks on health infrastructure, and an impractical insistence on laboratory confirmation. These findings should guide the WHO reform for surveillance in conflict zones.
Leptin status in adolescence is associated with academic performance in high school: a cross-sectional study in a Chilean birth cohort
Authors: Correa-Burrows Paulina , Blanco Estela , Reyes Marcela , Castillo Marcela , Peirano Patricio , Algarín Cecilia , Lozoff Betsy , Gahagan Sheila , Burrows Raquel 
Published: October 2016

ObjectiveLeptin is a pleiotropic hormone associated with learning and memory via brain receptors. However, elevated plasma leptin levels may impair cognitive and memory functions. Since individual differences in memory performance affect students’ ability to learn, we aimed to study the relation between leptin status in adolescence and school performance.Design and settingWe studied 568 adolescents aged 16–17 years from Santiago. A cross-sectional analysis was carried out on a birth cohort conducted in Santiago (Chile).Primary and secondary outcome measuresWe measured serum leptin concentration using an enzyme-linked immunosorbent assay. Cut-offs from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Study for 16-year-olds were used to define abnormally high leptin levels (hyperleptinaemia). Academic performance was measured using high-school grades and grade point average (GPA). Data were collected in 2009–2012; data analysis was performed in 2014.Results15% of participants had hyperleptinaemia. They had significantly lower school grades and GPA compared with participants with normal leptin levels (eg, GPA mean difference=33.8 points). Leptin levels were negative and significantly correlated with school grades in 9th, 10th and 12th. Similarly, it was negatively correlated with high-school GPA. After controlling for health, sociodemographic and education confounders, the chances of having a performance ≥75th centile in students having hyperleptinaemia were 32% (95% CI 0.19% to 0.89%) that of students having normal serum leptin concentration.ConclusionsIn high school students, abnormally high levels of leptin were associated with poorer academic performance. These findings support the idea of a relationship between leptin and cognition. Further research is needed on the cognitive effects of leptin in younger populations.
Effect of characteristics of women on attendance in blind and non-blind randomised trials: analysis of recruitment data from the EPHT Trial
Authors: Veerus Piret , Fischer Krista , Hemminki Elina , Hovi Sirpa-Liisa , Hakama Matti 
Published: October 2016

ObjectivesTo analyse the effect of women's characteristics on their willingness to join a blind or a non-blind subtrial or to be excluded by physicians.DesignPrimary prevention trial of postmenopausal hormone therapy (HT). A 2×2, randomised design with a non-blind HT arm or control arm and a blind HT arm or placebo arm.Setting3 clinical centres in Estonia.MethodsInterest in joining the trial was asked in a questionnaire together with demographic and health status data. Interested and eligible women were invited to a health examination that also informed whether they belonged to a blind or to a non-blind subtrial; the arm was not revealed. Trial physicians made further exclusions when checking the women's eligibility. Thereafter, informed consent was asked as detailed in the flow chart. Comparisons were made between non-blind and blind subtrials. Analyses were carried out for each of the background variables.Outcome measuresThe proportion of willingness, eligibility and attendance.ResultsWomen randomised to the non-blind subtrial were more willing to join (relative risk (RR) 1.17) and more likely to be found eligible by physicians (RR 1.10) than women in the blind subtrial, resulting in larger attendance (RR 1.29). Women with higher education were differentially more willing to join the non-blind trial (RR 1.29) than those with basic education (RR 1.08); the differential willingness of never-smokers (RR 1.20) was larger than that of current smokers (RR 1.07). The differential exclusion by physicians by education and smoking were small. Some subjective symptoms (eg, diarrhoea/constipation, stomach pain) had reverse differential effects on attendance in the non-blind subtrial in comparison to the blind subtrial. Menopausal symptoms did not affect the differential interest, eligibility or attendance.ConclusionsBlinding in RCT reduces attendance, due to decisions of the women and the trial physicians. Differential attendance by blinding may affect the generalisability of the results from trials.Trial registration numberISRCTN35338757.
Cross-sectional and longitudinal study protocols of the ‘ADIposity and BOne metabolism: effects of eXercise-induced weight loss in obese adolescents’ (ADIBOX) project
Authors: Chaplais Elodie , Dutheil Frédéric , Naughton Geraldine , Greene David , Pereira Bruno , Thivel David , Courteix Daniel 
Published: October 2016

IntroductionA need exists for sustainable and clinically effective weight management interventions, suitable for preventing well-linked chronic disease such as diabetes and cardiovascular disease and some less investigated secondary conditions such as bone alteration. The ADIposity and BOne metabolism: effects of eXercise-induced weight loss in obese adolescents (ADIBOX) protocol was designed to provide a better understanding of the interaction between adipokines and bone hormones in adolescents with obesity and how a 10-month physical activity programme may affect these interactions.Methods and analysisThe ADIBOX protocol combines 2 studies. The first study involves a total of 68 adolescents aged 12–16 years. This cross-sectional study will include both males and females (1:1 ratio), either living with obesity/overweight (n=34; body mass index (BMI) ≤97th centile and ≥85th centile) or normal weight (n=34; BMI<85th centile). The second study is a longitudinal study that will include 50 obese adolescent girls and track them over a period of 42 weeks. Weight loss programme will consist of a combination of physical activity and a normocaloric diet. Bone and adiposity-related measurements will be performed every 14 weeks. Both studies will assess participants' anthropometric profile, nutrition and physical activity, body composition, bone densitometry and blood markers of bone, growth and adiposity.Ethics and disseminationThe ADIBOX protocol complies with the ethics guidelines for clinical research and has been approved by their respective ethics committee (Australian Catholic University Committee Ethic, Australia and Hospital Sud Est 1 committee, France). Findings from this protocol are expected to clarify the possible interactions between adiposity and bone in childhood obesity and will be disseminated at several research conferences and published articles in peer-reviewed journals.Trial registration numberNCT02626273; Pre-results.
Evaluation of the acceptability of a vaccine against herpes zoster in the over 50 years old: an Italian observational study
Authors: Valente Nicoletta , Lupi Silvia , Stefanati Armando , Cova Marisa , Sulcaj Najada , Piccinni Lucia ,   GPs Study Group, Gabutti Giovanni 
Published: October 2016

ObjectiveThe aim of the study was to evaluate awareness of the varicella zoster virus and the acceptability of the newly available herpes zoster (HZ) vaccine in the over 50 years old general population.DesignThe research was observational.SettingThe study was carried out in Ferrara by administering a questionnaire to patients of the Local Health Authority (LHA), general practitioners (GPs) and Public Health Department outpatient clinics.ParticipantsThe questionnaire was completed by 1001 residents of Ferrara Province.ResultsOf the respondents, 98% and 95% (57% female) were aware of varicella and HZ, respectively, but 91% were unaware of the HZ vaccine. Nevertheless, 58% declared that they were in favour of vaccination in this regard, and the acceptability of the vaccine was positively affected by: age (p=0.005); knowing someone who had suffered from HZ (p=0.05); being in favour of vaccination in general (p<0.0001); receiving advice to do so from their GP (p<0.0001) and willingness to get vaccinated even on a fee-paying basis (p<0.0001). Indeed, most (73%) respondents were willing to pay to get vaccinated, indicating an ideal cost of €50. Higher education (p=0.04), being in favour of vaccinations in general (p<0.0001) and GP advice (p<0.0001) positively affected this choice. Furthermore, 61% of the participants initially unfavourable (p<0.0001) to this immunisation would change their decision not to vaccinate thanks to their GP's advice.ConclusionsThis study assessed the level of awareness and the attitudes of the population aged over 50 years, highlighting aspects to be focused on in the promotion of the HZ vaccine.
Changes to physician processing times in response to clinic congestion and patient punctuality: a retrospective study
Authors: Chambers Chester G , Dada Maqbool , Elnahal Shereef , Terezakis Stephanie , DeWeese Theodore , Herman Joseph , Williams Kayode A 
Published: October 2016

ObjectivesWe examine interactions among 3 factors that affect patient waits and use of overtime in outpatient clinics: clinic congestion, patient punctuality and physician processing rates. We hypothesise that the first 2 factors affect physician processing rates, and this adaptive physician behaviour serves to reduce waiting times and the use of overtime.Setting2 urban academic clinics and an affiliated suburban clinic in metropolitan Baltimore, Maryland, USA.ParticipantsAppointment times, patient arrival times, start of service and physician processing times were collected for 105 visits at a low-volume suburban clinic 1, 264 visits at a medium-volume academic clinic 2 and 22 266 visits at a high-volume academic clinic 3 over 3 distinct spans of time.InterventionData from the first clinic were previously used to document an intervention to influence patient punctuality. This included a policy that tardy patients were rescheduled.Primary and secondary outcome measuresClinicians' processing times were gathered, conditioned on whether the patient or clinician was tardy to test the first hypothesis. Probability distributions of patient unpunctuality were developed preintervention and postintervention for the clinic in which the intervention took place and these data were used to seed a discrete-event simulation.ResultsAverage physician processing times differ conditioned on tardiness at clinic 1 with p=0.03, at clinic 2 with p=10−5and at clinic 3 with p=10−7. Within the simulation, the adaptive physician behaviour degrades system performance by increasing waiting times, probability of overtime and the average amount of overtime used. Each of these changes is significant at the p<0.01 level.ConclusionsProcessing times differed for patients in different states in all 3 settings studied. When present, this can be verified using data commonly collected. Ignoring these behaviours leads to faulty conclusions about the efficacy of efforts to improve clinic flow.