bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validity of administrative data in recording sepsis: a systematic review
Authors: Jolley Rachel J , Sawka Keri Jo , Yergens Dean W , Quan Hude , Jetté Nathalie , Doig Christopher J 
Published: March 2015

Abstract
Introduction
Administrative health data have been used to study sepsis in large population-based studies. The validity of these study findings depends largely on the quality of the administrative data source and the validity of the case definition used. We systematically reviewed the literature to assess the validity of case definitions of sepsis used with administrative data.

Methods
Embase and MEDLINE were searched for published articles with International Classification of Diseases (ICD) coded data used to define sepsis. Abstracts and full-text articles were reviewed in duplicate. Data were abstracted from all eligible full-text articles, including ICD-9- and/or ICD-10-based case definitions, sensitivity (Sn), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV).

Results
Of 2,317 individual studies identified, 12 full-text articles met all eligibility criteria. A total of 38 sepsis case definitions were tested, which included over 130 different ICD codes. The most common ICD-9 codes were 038.x, 790.7 and 995.92, and the most common ICD-10 codes were A40.x and A41.x. The PPV was reported in ten studies and ranged from 5.6% to 100%, with a median of 50%. Other tests of diagnostic accuracy were reported only in some studies. Sn ranged from 5.9% to 82.3%; Sp ranged from 78.3% to 100%; and NPV ranged from 62.1% to 99.7%.

Conclusions
The validity of administrative data in recording sepsis varied substantially across individual studies and ICD definitions. Our work may serve as a reference point for consensus towards an improved and harmonized ICD-coded definition of sepsis.
Significant modification of traditional rapid sequence induction improves safety and effectiveness of pre-hospital trauma anaesthesia
Authors: Lyon Richard M , Perkins Zane B , Chatterjee Debamoy , Lockey David J , Russell Malcolm Q ,   on behalf of Kent, Surrey & Sussex Air Ambulance Trust
Published: March 2015

Abstract
Introduction
Rapid Sequence Induction of anaesthesia (RSI) is the recommended method to facilitate emergency tracheal intubation in trauma patients. In emergency situations, a simple and standardised RSI protocol may improve the safety and effectiveness of the procedure. A crucial component of developing a standardised protocol is the selection of induction agents. The aim of this study is to compare the safety and effectiveness of a traditional RSI protocol using etomidate and suxamethonium with a modified RSI protocol using fentanyl, ketamine and rocuronium.

Methods
We performed a comparative cohort study of major trauma patients undergoing pre-hospital RSI by a physician-led Helicopter Emergency Medical Service. Group 1 underwent RSI using etomidate and suxamethonium and Group 2 underwent RSI using fentanyl, ketamine and rocuronium. Apart from the induction agents, the RSI protocol was identical in both groups. Outcomes measured included laryngoscopy view, intubation success, haemodynamic response to laryngoscopy and tracheal intubation, and mortality.

Results
Compared to Group 1 (n = 116), Group 2 RSI (n = 145) produced significantly better laryngoscopy views (p = 0.013) and resulted in significantly higher first-pass intubation success (95% versus 100%; p = 0.007). A hypertensive response to laryngoscopy and tracheal intubation was less frequent following Group 2 RSI (79% versus 37%; p < 0.0001). A hypotensive response was uncommon in both groups (1% versus 6%; p = 0.05). Only one patient in each group developed true hypotension (SBP < 90 mmHg) on induction.

Conclusions
In a comparative, cohort study, pre-hospital RSI using fentanyl, ketamine and rocuronium produced superior intubating conditions and a more favourable haemodynamic response to laryngoscopy and tracheal intubation. An RSI protocol using fixed ratios of these agents delivers effective pre-hospital trauma anaesthesia.
Inhaled nitric oxide therapy and risk of renal dysfunction: a systematic review and meta-analysis of randomized trials
Authors: Ruan Sheng-Yuan , Huang Tao-Min , Wu Hon-Yen , Wu Huey-Dong , Yu Chong-Jen , Lai Mei-Shu 
Published: March 2015

Abstract
Introduction
Inhaled nitric oxide (iNO) is an important therapy for acute respiratory distress syndrome (ARDS), pulmonary hypertension and pediatric hypoxemic respiratory failure. Safety concerns regarding iNO and renal dysfunction have been reported; however, there are currently no systematic reviews on this issue. Our objective was to evaluate published randomized controlled trials (RCTs) to ascertain the risk of renal dysfunction associated with iNO therapy in patients with and without ARDS.

Methods
A systematic review of databases was performed to identify RCTs which compared iNO with controls up to September 2014. Effect estimates for risk ratio (RR) of acute kidney injury (AKI) were pooled using a random-effects model.

Results
Ten RCTs involving 1363 participants were included. Inhaled nitric oxide significantly increased the risk of AKI compared with controls (RR, 1.4, 95%CI, 1.06 to 1.83, p = 0.02). In the stratified analysis, a high cumulative-dose of iNO significantly increased the risk of AKI (RR, 1.52, 95%CI, 1.14 to 2.02, p = 0.004), whereas medium and low cumulative-doses did not (RR, 0.64, 95%CI, 0.23 to 1.81 and RR, 0.56, 95%CI, 0.11 to 2.86 respectively). In subgroup analysis by study population, an increased risk of AKI was observed in patients with ARDS (RR, 1.55, 95%CI, 1.15 to 2.09, p = 0.005) but not in those without (RR, 0.90, 95%CI, 0.49 to 1.67, p = 0.75).

Conclusions
The available data show that iNO therapy may increase the risk of renal dysfunction, especially with prolonged use and in patients with ARDS. The risk in pediatric population is unknown owing to limited data. We suggest monitoring renal function during iNO therapy, and that future trials of iNO should evaluate renal safety.
Mesenchymal stem cells mediate the clinical phenotype of inflammatory breast cancer in a preclinical model
Authors: Lacerda Lara , Debeb Bisrat G , Smith Daniel , Larson Richard , Solley Travis , Xu Wei , Krishnamurthy Savitri , Gong Yun , Levy Lawrence B , Buchholz Thomas , Ueno Naoto T , Klopp Ann , Woodward Wendy A 
Published: March 2015

Abstract
Introduction
Inflammatory breast cancer (IBC) is an aggressive type of breast cancer, characterized by very rapid progression, enlargement of the breast, skin edema causing an orange peel appearance (peau d’orange), erythema, thickening, and dermal lymphatic invasion. It is characterized by E-cadherin overexpression in the primary and metastatic disease, but to date no robust molecular features that specifically identify IBC have been reported. Further, models that recapitulate all of these clinical findings are limited and as a result no studies have demonstrated modulation of these clinical features as opposed to simply tumor cell growth.

Methods
Hypothesizing the clinical presentation of IBC may be mediated in part by the microenvironment, we examined the effect of co-injection of IBC xenografts with mesenchymal stem/stromal cells (MSCs).

Results
MSCs co-injection significantly increased the clinical features of skin invasion and metastasis in the SUM149 xenograft model. Primary tumors co-injected with MSCs expressed higher phospho-epidermal growth factor receptor (p-EGFR) and promoted metastasis development after tumor resection, effects that were abrogated by treatment with the epidermal growth factor receptor (EGFR) inhibitor, erlotinib. E-cadherin expression was maintained in primary tumor xenografts with MSCs co-injection compared to control and erlotinib treatment dramatically decreased this expression in control and MSCs co-injected tumors. Tumor samples from patients demonstrate correlation between stromal and tumor p-EGFR staining only in IBC tumors.

Conclusions
Our findings demonstrate that the IBC clinical phenotype is promoted by signaling from the microenvironment perhaps in addition to tumor cell drivers.
Gene-expression molecular subtyping of triple-negative breast cancer tumours: importance of immune response
Authors: Jézéquel Pascal , Loussouarn Delphine , Guérin-Charbonnel Catherine , Campion Loïc , Vanier Antoine , Gouraud Wilfried , Lasla Hamza , Guette Catherine , Valo Isabelle , Verrièle Véronique , Campone Mario 
Published: March 2015

Abstract
Introduction
Triple-negative breast cancers need to be refined in order to identify therapeutic subgroups of patients.

Methods
We conducted an unsupervised analysis of microarray gene-expression profiles of 107 triple-negative breast cancer patients and undertook robust functional annotation of the molecular entities found by means of numerous approaches including immunohistochemistry and gene-expression signatures. A triple-negative external cohort (n = 87) was used for validation.

Results
Fuzzy clustering separated triple-negative tumours into three clusters: C1 (22.4%), C2 (44.9%) and C3 (32.7%). C1 patients were older (mean = 64.6 years) than C2 (mean = 56.8 years; P = 0.03) and C3 patients (mean = 51.9 years; P = 0.0004). Histological grade and Nottingham prognostic index were higher in C2 and C3 than in C1 (P < 0.0001 for both comparisons). Significant event-free survival (P = 0.03) was found according to cluster membership: patients belonging to C3 had a better outcome than patients in C1 (P = 0.01) and C2 (P = 0.02). Event-free survival analysis results were confirmed when our cohort was pooled with the external cohort (n = 194; P = 0.01). Functional annotation showed that 22% of triple-negative patients were not basal-like (C1). C1 was enriched in luminal subtypes and positive androgen receptor (luminal androgen receptor). C2 could be considered as an almost pure basal-like cluster. C3, enriched in basal-like subtypes but to a lesser extent, included 26% of claudin-low subtypes. Dissection of immune response showed that high immune response and low M2-like macrophages were a hallmark of C3, and that these patients had a better event-free survival than C2 patients, characterized by low immune response and high M2-like macrophages: P = 0.02 for our cohort, and P = 0.03 for pooled cohorts.

Conclusions
We identified three subtypes of triple-negative patients: luminal androgen receptor (22%), basal-like with low immune response and high M2-like macrophages (45%), and basal-enriched with high immune response and low M2-like macrophages (33%). We noted out that macrophages and other immune effectors offer a variety of therapeutic targets in breast cancer, and particularly in triple-negative basal-like tumours. Furthermore, we showed that CK5 antibody was better suited than CK5/6 antibody to subtype triple-negative patients.
PCAC: Power- and Connectivity-Aware Clustering for Wireless Sensor Networks
Authors: Butun Ismail , Ra In-ho , Sankar Ravi 
Published: March 2015

Abstract
In this article, we investigate clustering algorithms that are proposed for wireless sensor networks (WSNs). Then, we propose a clustering algorithm for WSNs called PCAC, that is both power and connectivity aware. Our proposed Power- and Connectivity-Aware Clustering (PCAC) algorithm provides higher energy efficiency and increases the total life time (TLT) of the network. We evaluate our proposed PCAC algorithm in a simulation environment and compare its performance to previously proposed algorithms. According to the simulation results, our proposed PCAC algorithm is energy efficient and also provides longer TLT (in worst-case, up to 85% improvement for a 15-node network with one-hop connectivity) to the network, compared to the previously proposed algorithms.
Application of Reverse Transcriptase –PCR (RT-PCR) for rapid detection of viable Escherichia coli in drinking water samples
Authors: Molaee Neda , Abtahi Hamid , Ghannadzadeh Mohammad Javad , Karimi Masoude , Ghaznavi-Rad Ehsanollah 
Published: March 2015

Abstract

Background
Polymerase chain reaction (PCR) is preferred to other methods for detecting Escherichia coli (E. coli) in water in terms of speed, accuracy and efficiency. False positive result is considered as the major disadvantages of PCR. For this reason, reverse transcriptase-polymerase chain reaction (RT-PCR) can be used to solve this problem. The aim of present study was to determine the efficiency of RT-PCR for rapid detection of viable Escherichia coli in drinking water samples and enhance its sensitivity through application of different filter membranes.

Materials and methods
Specific primers were designed for 16S rRNA and elongation Factor II genes. Different concentrations of bacteria were passed through FHLP and HAWP filters. Then, RT-PCR was performed using 16srRNA and EF –Tu primers. Contamination of 10 wells was determined by RT-PCR in Arak city. To evaluate RT-PCR efficiency, the results were compared with most probable number (MPN) method.

Results
RT-PCR is able to detect bacteria in different concentrations. Application of EF II primers reduced false positive results compared to 16S rRNA primers. The FHLP hydrophobic filters have higher ability to absorb bacteria compared with HAWB hydrophilic filters. So the use of hydrophobic filters will increase the sensitivity of RT-PCR.

Conclusion
RT-PCR shows a higher sensitivity compared to conventional water contamination detection method. Unlike PCR, RT-PCR does not lead to false positive results. The use of EF-Tu primers can reduce the incidence of false positive results. Furthermore, hydrophobic filters have a higher ability to absorb bacteria compared to hydrophilic filters.
A Modified Delphi Process to Identify Process of Care Indicators for the Identification, Prevention and Management of Acute Kidney Injury after Major Surgery
Authors: James Matthew T , Pannu Neesh , Barry Rebecca , Karsanji Divya , Tonelli Marcello , Hemmelgarn Brenda R , Manns Braden J , Bagshaw Sean M , Stelfox H Tom , Dixon Elijah 
Published: March 2015

Background: The outcomes of acute kidney injury (AKI) are well appreciated. However, valid indicators of high quality processes of care for AKI after major surgery are lacking. Objectives: To identify indicators of high quality processes of care related to AKI prevention, identification, and management after major surgery. Design: A three stage modified Delphi process. Setting: The study was conducted in Alberta, Canada using an online format. Participants: A panel of care providers from surgery, critical care, and nephrology. Measurements: The degree of validity of candidate indicators were rated by panelists on a 7-point Likert scale that ranged from “strongly disagree” to “strongly agree”. Methods: A focused literature review was performed to identify candidate indicators. A modified Delphi process, with three rounds, was used to obtain expert consensus on the validity of potential process of care quality indicators. Results: Thirty-three physicians participated (6 from surgery, 10 from critical care, and 17 from nephrology). A list of 58 potential process of care quality indicators for AKI after surgery was generated including 28 indicators from the initial literature review and 30 indicators suggested by panelists. Following the third round of questioning, 40 process of care indicators were identified with a high level of agreement for face validity; 16 of these reached high consensus among all panelists. Limitations: The consensus of panelists from Alberta, Canada may not be generalizable to other settings. The modified Delphi process did not focus on the feasibility of measuring these process indicators. Conclusions: These indicators can be used to measure and improve the quality of care for AKI after major surgery.
Weak and contradictory effects of self-medication with nectar nicotine by parasitized bumblebees
Authors: Baracchi David , Brown Mark J. F. , Chittka Lars 
Published: March 2015

The presence of antimicrobial secondary metabolites in nectar suggests that pollinators, which are threatened globally by emergent disease, may benefit from the consumption of nectars rich in these metabolites. We tested whether nicotine, a nectar secondary metabolite common inSolenaceaeandTiliaspecies, is used by parasitized bumblebees as a source of self-medication,using a series of toxicological, microbiological and behavioural experiments. Caged bees infected withCrithidia bombi[TI1] had a slight preference for sucrose solution laced with the alkaloid and behavioural tests showed that the parasite infection induced an increased consumption of nicotine during foraging activity. When ingested, nicotine delayed the progression of a gut infection in bumblebees by a few days, but dietary nicotine did not clear the infection, and after 10 days the parasite load approached that of control bees. Moreover, when pathogens were exposed to the alkaloid prior to host ingestion the protozoan’s viability was not directly affected, suggesting that anti-parasite effects were relatively weak. Nicotine consumption in a single dose did not impose any cost even in food-stressed bees (starved) but the alkaloid had detrimental effects on healthy bees if consistently consumed for weeks. These toxic effects disappeared in infected bees suggesting that detoxification costs might have been counterbalanced by the advantages in slowing the progression of the infection. Nonetheless we did not find a benefit of nicotine consumption in terms of life expectancy of infected bees, making these findings difficult to interpret. Our results indicate that caution is warranted in interpreting impacts of plant metabolites on insect parasites and suggest that the conditions under which nicotine consumption provides benefits to either bees or plants remain to be identified. The contention that secondary metabolites in nectar may be under selection from pollinators, or used by plants to enhance their own reproductive success, remains to be confirmed.
Yakutia’s Mining Science Contribution to the Republic’s Ecological Security Problems Solution
Authors: Киселев  , Kiselev V. , Каймонов  , Kaimonov Mikhail , Хохолов  , Khokholov Yu. 
Published: March 2015

Created by unutilized waste a potential radiation hazard for a biota has been noted in this paper. The radiation and
ecological situation in Yakutia’s certain regions have been considered. Developed by institute a concept and solid highly
toxic waste disposal processes have been submitted.
Ice-Jam Floods in the Irkutsk Region and Possibility of Their Elimination by Combined Methods
Authors: Тимофеева  , Timofeeva Svetlana , Морозова  , Morozova O. 
Published: March 2015

A retrospective analysis of floods in the Irkutsk region territory caused by ice-jam phenomena has been performed. The
region’s most dangerous sites and areas have been revealed. Prediction estimates for a possible number of the floods
caused by ice-jam formation in the Irkutsk region territory have been carried out based on statistical information analysis
for the last 20 years. Methods of fight against ice-jams have been considered, and a combined technology of ice weakening
has been offered. Field trial results have been presented. It has been recommended to apply an entering of brine from
Znamensky industrial water field into ice kerfs or ice’s blackened surface irrigation.
Staff Training on Work Safety Within a Framework of “Technosphere Safety” Direction
Authors: Девисилов  , Devisilov Vladimir 
Published: March 2015

The problem related to staff training on work safety – what and how specialists for labor protection services should learn —
is considered. An offered structure of educational program for “Work Safety” profile within a framework of &#34;Technosphere
safety&#34; higher education direction has been presented. Tasks related to improvement of education system in the specified
area have been defined.
No Unlabeled Containers Anywhere, Ever! Where Did this Come From?
Authors: Cohen Michael R. , Smetzer Judy L. 
Published: March 2015

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site ( www.ismp.org ), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications.
Retrospective Review of Critically Ill Patients Experiencing Alcohol withdrawal: Dexmedetomidine versus Propofol and/or Lorazepam Continuous Infusions
Authors: Ludtke Kimberly A. , Stanley Kevin S. , Yount Natalie L. , Gerkin Richard D. 
Published: March 2015

Background Alcohol withdrawal symptoms can be difficult to manage and may lead to an intensive care unit (ICU) admission. Patients experiencing severe alcohol withdrawal often require high doses of sedatives, which can lead to respiratory depression and the need for endotracheal intubation. Dexmedetomidine, an alpha-2 adrenoreceptor agonist, provides adequate sedation with little effect on respiratory function when compared to other sedatives. Objective To evaluate sedation with a continuous infusion of dexmedetomidine versus propofol and/or lorazepam in critically ill patients experiencing alcohol withdrawal. Methods A retrospective chart review was conducted on ICU admissions between March 2002 and April 2009 for alcohol withdrawal patients who necessitated treatment with a continuous infusion of dexmedetomidine, propofol, and/or lorazepam. Primary outcomes included the incidence of mechanical ventilation, length of mechanical ventilation (if applicable), and ICU and hospital length of stay. Results Fifteen patients were treated with a continuous infusion of dexmedetomidine, and 17 were treated with an infusion of propofol and/or lorazepam. Two patients (13.3%) required intubation and mechanical ventilation in the dexmedetomidine group versus 10 (58.8%) in the propofol and/or lorazepam group ( P = .006). Length of stay in the ICU was 53 hours for patients treated with dexmedetomidine versus 114.9 hours in the propofol and/or lorazepam group ( P = .016). Hospital length of stay was less for the dexmedetomidine group, 135.8 hours versus 241.1 hours in the propofol and/or lorazepam group ( P = .008). Conclusions Dexmedetomidine use was associated with a decrease in the incidence of endotracheal intubation when used to sedate patients experiencing alcohol withdrawal. Patients transferred to a lower level of care faster and were discharged from the hospital sooner when treated with dexmedetomidine.
Extremo climático e riscos na cidade de Campo Grande-MS/Brasil
Authors: Sant’Anna Neto João Lima , Anunciação Andrade Vicentina Socorro da 
Published: March 2015

Os excepcionalismos climáticos, sobretudo as enchentes, têm se constituído num dos mais ressaltados impactos sobre a população citadina na atualidade, pois com o avanço do processo de urbanização, a impermeabilização do solo vem adquirindo níveis elevados, colaborando com a origem e intensificação da problemática ambiental nos espaços urbanos. Este artigo apresenta uma análise de eventos climáticos que convergiram em “acidentes” materializados na cidade de Campo Grande-MS, a partir das notícias veiculadas pela imprensa local especificamente representada pelo “Jornal Correio do Estado”.