bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advances in testing technology to ensure transfusion safety – NAT and beyond
Authors: Stramer S. L. , Dodd R. Y. , Chiu C. Y. 
Published: April 2015

AimsTo provide an update on state‐of‐the‐art testing technologies for infectious disease (ID) blood donation screening, including emerging molecular methods such as multiplexed nucleic acid testing (NAT) platforms, mass spectrometry, nucleic acid and protein microarrays, and next‐generation sequencing.BackgroundTesting donated blood for ID markers plays a major role in establishing and maintaining blood safety. The norm for ID testing has been serology, but increasingly, NAT is used where resources allow, including testing for emerging infectious disease (EID) agents. The appropriate mix of ID tests and associated algorithms depends on local epidemiology, infrastructure and economic considerations. Although NAT will detect acute infections, not all pathogens have adequate concentrations of nucleic acid for detection in the early acute or later chronic phases of infection. Thus, both NAT and serological approaches may be required to detect recent, current or past infection. The advent of new technologies to augment or potentially replace current NAT and/or serologic testing has spurred debate as to their optimal future role in blood‐borne pathogen screening.Methods and ResultsInfectious disease testing has progressed from manual technologies using single markers to highly multiplexed automated assays. Emerging technologies allow the simultaneous detection and differentiation of hundreds of pathogens and will likely play an important role in future testing, but there are many hurdles prior to routine adoption.ConclusionsBlood systems worldwide must be ready to adapt to EID agents, availability of new diagnostic technologies, and shifts in economic conditions and public expectations to accommodate the changing landscape of ID testing.
Cost‐effectiveness of patient blood management methods in elective orthopaedic surgery
Authors: So – Osman C. 
Published: April 2015

BackgroundA randomized study was conducted on the integrated use of patient blood management methods as erythropoietin (Epo), cell saver and/or postoperative drain reinfusion to evaluate the effect on red blood cell (RBC) transfusion reduction and costs in 2442 adult elective hip and knee surgery patients while applying a restrictive transfusion threshold.MethodsFirstly, patients were stratified by the preoperative haemoglobin (Hb) level: low Hb (10–13 g/dl) patients were randomized for Epo or no Epo and normal Hb patients (above 13 g/dl) were ineligible for Epo. Secondly, patients from both strata were randomized for autologous reinfusion by cell saver device or postoperative drain reinfusion device or for no blood salvage device. Outcome measures: RBC use and cost‐effectiveness.ResultsEpo resulted in a significant 50% reduction of transfused patients (OR 0·5, 95% CI: 0·35–0·75) and a non‐significant 29% mean reduction in RBC use (ratio 0·71, 0·42–1·13). Epo, however, increased costs by €785 per patient (262–1309), that is €7300 per avoided transfusion (1900–24000). In both strata, autologous blood reinfusion did not result in a RBC reduction and increased costs by €378 per patient (161–595).ConclusionsIn elective knee and hip surgery, while using a restrictive transfusion trigger, autologous reinfusion by cell saver and postoperative drain reinfusion were no longer found to be effective in reducing RBC use and are consequently not cost‐effective, while Epo, although it is effective in reducing RBC use, is not cost‐effective due to its high costs. Therefore, these interventions are no longer considered as appropriate transfusion alternatives.
Blood donation screening for Babesia microti: feasibility and results
Authors: Moritz Erin D. , Stramer Susan L. 
Published: April 2015

Background and ObjectivesBabesia microti, an intraerythrocytic parasite, causes babesiosis; transfusion‐transmitted babesiosis (TTB) is reported primarily in the United States where no licensed screening tests are available.Materials and MethodsBabesia microti donor screening results using investigational antibody and DNA tests in six US states are reviewed from both repository testing and prospective screening. Testing results performed in endemic counties from June 2012 to April 2014 were combined to update prevalence and marker duration in infected donors and estimate testing efficacy (i.e. the reduction of reported TTB cases).ResultsA total of 84 209 donations were tested and 331 were reactive by either antibody and/or DNA for a total prevalence of 0·39%. Of those that were DNA positive, the retrieved red cell units from nearly one‐third caused infection in hamsters. In addition, eight units were identified that were PCR positive but antibody negative (window‐period donors).ConclusionsScreening is feasible, removing likely infectious donations. Followed donors retained PCR positivity over several months but antibody reactivity for over 3 years.
USE OF CONTRAST‐ENHANCED COMPUTED TOMOGRAPHY TO STUDY THE CRANIAL MIGRATION OF A LUMBOSACRAL INJECTATE IN CADAVER DOGS
Authors: Kawalilak Lukas T. , Tucker Russell L. , Greene Stephen A. 
Published: April 2015

Volumes used in lumbosacral epidural injections for anesthesia have remained unchanged since the 1960s. The goals of this cross‐sectional observational study were to characterize the three‐dimensional spread of a lumbosacral epidural injection, as well as confirm that the commonly used volume of 0.2 ml/kg injected into the lumbosacral epidural space reaches the thoracolumbar (TL) junction in the majority (≥80%) of dogs. Ten clinically normal, adult, nonpregnant, mixed‐breed dogs were obtained within five minutes of euthanasia and 0.2 ml/kg of radiopaque contrast medium was injected into the lumbosacral epidural space. A computed tomography scan of the TL spine was performed immediately following the injection. Migration of contrast reached the TL junction in 8 of 10 (80%) dogs. Contrast was well visualized in all epidural planes with contrast travelling predominantly in the dorsal epidural space in 7 of 10 (70%) dogs. There was no significant difference in the weight of dogs where the epidural injectate reached the TL junction and those where it did not (P= 0.16), or in the weight of dogs where the cranial‐most point of the contrast column was in the dorsal versus the ventral epidural space (P= 0.32). This preliminary study supports the use of computed tomography to characterize injectate distribution in the canine thoracolumbar epidural space and provides evidence that a 0.2‐ml/kg volume is likely to reache the TL junction in most dogs. Further studies are needed in live dogs to determine if variables affecting human epidural injectate doses have similar effects in the dog.
Preoperative β‐cell function in patients with type 2 diabetes is important for the outcome of Roux‐en‐Y gastric bypass surgery
Authors: Lund Michael Taulo , Hansen Merethe , Skaaby Stinna , Dalby Sina , Støckel Mikael , Floyd Andrea Karen , Bech Karsten , Helge Jørn Wulff , Holst Jens Juul , Dela Flemming 
Published: April 2015

Key points
Roux‐en‐Y gastric bypass surgery leads to remission of type 2 diabetes in the majority of patients suffering from the disease.
The gut hormone glucagon‐like peptide‐1 is believed to be of major importance for the remission process.
The present project demonstrates a marked difference in the chance of remission of type 2 diabetes in patients with low or high preoperative β‐cell function in spite of a similar post‐surgery increase in postprandial glucagon‐like peptide‐1 release.
Furthermore, post‐surgery intravenous glucose administration, which does not stimulate release of glucagon‐like peptide‐1, leads to increased insulin secretion in the patients with the best preoperative β‐cell function.
Together the present findings indicate that patients with type 2 diabetes with high preoperative β‐cell function experience a glucagon‐like peptide‐1‐independent increase in β‐cell function after gastric bypass surgery.
AbstractThe majority of the patients with type 2 diabetes (T2DM) show remission after Roux‐en‐Y gastric bypass (RYGB). This is the result of increased postoperative insulin sensitivity and β‐cell secretion. The aim of the present study was to elucidate the importance of the preoperative β‐cell function in T2DM for the chance of remission after RYGB. Fifteen patients with and 18 without T2DM had 25 g oral (OGTT) and intravenous (IVGTT) glucose tolerance tests performed at inclusion, after a diet‐induced weight loss, and 4 and 18 months after RYGB. Postoperative first phase insulin secretion rate (ISR) during the IVGTT and β‐cell glucose sensitivity during the OGTT increased in T2DM. Postoperative insulin sensitivity and the disposition index (DI) markedly increased in both groups. By stratifying the T2DM into two groups according to highest (T2DMhigh) and lowest (T2DMlow) baseline DI, a restoration of first phase ISR and β‐cell glucose sensitivity were seen only in T2DMhigh. Remission of type 2 diabetes was 71 and 38% in T2DMhigh and T2DMlow, respectively. Postoperative postprandial GLP‐1 concentrations increased markedly, but did not differ between the groups. Our findings emphasize the importance of the preoperative of β‐cell function for remission of diabetes after RYGB.
The effects of resistance exercise training on macro‐ and micro‐circulatory responses to feeding and skeletal muscle protein anabolism in older men
Authors: Phillips Bethan E. , Atherton Philip J. , Varadhan Krishna , Limb Marie C. , Wilkinson Daniel J. , Sjøberg Kim A. , Smith Kenneth , Williams John P. 
Published: April 2015

Key points
Increases in limb blood flow in response to nutrition are reduced in older age.
Muscle microvascular blood flow (MBF) in response to nutrition is also reduced with advancing age and this may contribute to age‐related ‘anabolic resistance’.
Resistance exercise training (RET) can rejuvenate limb blood flow responses to nutrition in older individuals.
We report here that 20 weeks of RET also restores muscle MBF in older individuals.
Restoration of MBF does not, however, enhance muscle anabolic responses to nutrition.
AbstractThe anabolic effects of dietary protein on skeletal muscle depend on adequate skeletal muscle perfusion, which is impaired in older people. This study explores fed state muscle microvascular blood flow, protein metabolism and exercise training status in older men. We measured leg blood flow (LBF), muscle microvascular blood volume (MBV) and muscle protein turnover under post‐absorptive and fed state (i.v. Glamin to double amino acids, dextrose to sustain glucose ∼7–7.5 mmol l−1) conditions in two groups: 10 untrained men (72.3 ± 1.4 years; body mass index (BMI) 26.5 ± 1.15 kg m2) and 10 men who had undertaken 20 weeks of fully supervised, whole‐body resistance exercise training (RET) (72.8 ± 1.4 years; BMI 26.3 ± 1.2 kg m2). We measured LBF by Doppler ultrasound and muscle MBV by contrast‐enhanced ultrasound. Muscle protein synthesis (MPS) was measured using [1, 2‐13C2] leucine with breakdown (MPB) and net protein balance (NPB) by ring‐[D5] phenylalanine tracers. Plasma insulin was measured via ELISA and indices of anabolic signalling (e.g. Akt/mTORC1) by immunoblotting from muscle biopsies. Whereas older untrained men did not exhibit fed‐state increases in LBF or MBV, the RET group exhibited increases in both LBF and MBV. Despite our hypothesis that enhanced fed‐state circulatory responses would improve anabolic responses to nutrition, fed‐state increases in MPS (∼50–75%; P < 0.001) were identical in both groups. Finally, whereas only the RET group exhibited fed‐state suppression of MPB (∼–38%; P < 0.05), positive NPB achieved was similar in both groups. We conclude that RET enhances fed‐state LBF and MBV and restores nutrient‐dependent attenuation of MPB without robustly enhancing MPS or NPB.
Effectiveness of digital infrared thermal imaging in detecting lower extremity deep venous thrombosis
Authors: Deng Fangge , Tang Qing , Zeng Guangqiao , Wu Hua , Zhang Nuofu , Zhong Nanshan 
Published: April 2015

Purpose:The authors aimed to determine the effectiveness of infrared thermal imaging (IRTI) as a novel, noninvasive technique in adjunctive diagnostic screening for lower limb deep venous thrombosis (DVT).Methods:The authors used an infrared thermal imaging sensor to examine the lower limbs of 64 DVT patients and 64 healthy volunteers. The DVT patients had been definitively diagnosed with either Doppler vascular compression ultrasonography or angiography. The mean area temperature (T_area) and mean linear temperature (T_line) in the region of interest were determined with infrared thermal imaging. Images were evaluated with qualitative pseudocolor analysis to verify specific color‐temperature responses and with quantitative temperature analysis. Differences in T_area and T_line between the DVT limb and the nonaffected limb in each DVT patient and temperature differences (TDs) in T_area (TDarea) and T_line (TDline) between DVT patients and non‐DVT volunteers were compared.Results:Qualitative pseudocolor analysis revealed visible asymmetry between the DVT side and non‐DVT side in the presentation and distribution characteristics (PDCs) of infrared thermal images. The DVT limbs had areas of abnormally high temperature, indicating the presence of DVT. Of the 64 confirmed DVT patients, 62 (96.88%) were positive by IRTI detection. Among these 62 IRTI‐positive cases, 53 (82.81%) showed PDCs that agreed with the DVT regions detected by Doppler vascular compression ultrasonography or angiography. In nine patients (14.06%), IRTI PDCs did not definitively agree with the DVT regions established with other testing methods, but still correctly indicated the DVT‐affected limb. There was a highly significant difference between DVT and non‐DVT sides in DVT patients (P < 0.01). The TDarea and TDline in non‐DVT volunteers ranged from 0.19 ± 0.15 °C to 0.21 °C ± 0.17 °C; those in DVT patients ranged from 0.86 °C ± 0.71 °C to 1.03 °C ± 0.79 °C (P < 0.01).Conclusions:Infrared thermal imaging can be effectively used in DVT detection and adjunctive diagnostic screening because of its specific infrared PDCs and TDs values.
The emergence of nonuniform spatiotemporal fractionation schemes within the standard BED model
Authors: Unkelbach Jan , Papp Dávid 
Published: April 2015

Purpose:Nonuniform spatiotemporal radiotherapy fractionation schemes, i.e., delivering distinct dose distributions in different fractions can potentially improve the therapeutic ratio. This is possible if the dose distributions are designed such that similar doses are delivered to normal tissues (exploit the fractionation effect) while hypofractionating subregions of the tumor. In this paper, the authors develop methodology for treatment planning with nonuniform fractions and demonstrate this concept in the context of intensity‐modulated proton therapy (IMPT).Methods:Treatment planning is performed by simultaneously optimizing (possibly distinct) IMPT dose distributions for multiple fractions. This is achieved using objective and constraint functions evaluated for the cumulative biologically equivalent dose (BED) delivered at the end of treatment. BED based treatment planning formulations lead to nonconvex optimization problems, such that local gradient based algorithms require adequate starting positions to find good local optima. To that end, the authors develop a combinatorial algorithm to initialize the pencil beam intensities.Results:The concept of nonuniform spatiotemporal fractionation schemes is demonstrated for a spinal metastasis patient treated in two fractions using stereotactic body radiation therapy. The patient is treated with posterior oblique beams with the kidneys being located in the entrance region of the beam. It is shown that a nonuniform fractionation scheme that hypofractionates the central part of the tumor allows for a skin and kidney BED reduction of approximately 10%–20%.Conclusions:Nonuniform spatiotemporal fractionation schemes represent a novel approach to exploit fractionation effects that deserves further exploration for selected disease sites.
Vigorous-Intensity Physical Activity is Associated with Metabolic Syndrome Among the Chinese Middle-Aged Population: A Cross-Sectional Study
Authors: Hu Bo , Liu Xiaoyu , Wang Chenggang , Yin Sufeng , Yu Liqun , Zhang Tianzhe , Wu Jianhui , Chen Yinping , Zheng Yao , Feng Fumin 
Published: April 2015

Objective:To examine the association and relative contribution of different levels of physical activity (PA) with metabolic syndrome (MS).Methods:The cluster sampling method was used to recruit 8,750 communitybased individuals between 40 and 60 years of age. MS was defined according to the International Diabetes Federation, 2005. PA was estimated with the International Physical Activity Questionnaire, and three levels of PA (low, moderate, vigorous) were used to classify the individuals. The risk factors of MS were comprehensively collected, and logistic regression methods were used to measure the association between PA and MS. Population-attributable risks and their 95% confidence intervals (CI) were calculated based on the regression model.Results:Approximately 30.4% (2,661) of the participants were MS patients. The percentage of individuals with vigorous levels of PA was 46.2% and 43.5% and with low levels of PA was 11.3% and 11.3% in non-MS and MS group, respectively. Individuals with vigorous PA had an odds ratio (OR) of 0.78 (95% CI: 0.66, 0.91) for MS compared with those with low PA, and the OR for individuals with moderate PA was 0.85 (95% CI: 0.73, 1.01). Moderate and vigorous PA levels decreased risk of MS by 18.3%, with approximately 11% of that decrease due to vigorous PA.Conclusions:Vigorous PA levels were consistently associated with a reduced risk of MS; however, a protective role of moderate PA was not found. The population-attributable risk for vigorous PA was about 11% for all MS risk factors.
Understanding the Slowing Growth Rate of the People's Republic of China
Authors: Perkins Dwight H. 
Published: April 2015

It is increasingly accepted that the gross domestic product (GDP) growth rate of the People's Republic of China (PRC) is slowing down, but the reasons for the slowdown are not yet well understood. Part of the reason is that growth in all countries that reach high-income status slows down when they reach a global research income level that is still far below the level of the highest income countries. In the PRC, on the supply side, this is happening because total factor productivity (TFP) is slowing down whereas, because of slowing labor force growth, it would have to increase in order to maintain near double-digit GDP growth. On the demand side, a low share of household income in GDP has required the PRC to maintain an unusually high rate of investment in transport infrastructure and housing, but the rapid growth in both of these areas is coming to an end. Environmental investment could take up the slack and keep aggregate demand at a level that would fully employ resources. Finally, the PRC has reached the point where the manufacturing share of GDP has peaked and will begin to decline as the economy becomes increasingly service based, but services seldom grow at the double-digit rates that manufacturing is sometimes capable of.
Multidecadal Variability of the Summer Length in Europe*
Authors: Peña-Ortiz Cristina , Barriopedro David , García-Herrera Ricardo 
Published: April 2015

Abstract
This study analyzes the multidecadal variability of the European summer timing and length. The dates of the summer onset and end are computed through an objective algorithm based on locally defined temperature thresholds applied to the European daily high-resolution gridded dataset (E-OBS) during the period 1950–2012. The results reveal a European mean summer lengthening of 2.4 days decade−1 for the period 1950–2012. However, this trend is confined to the post-1979 period, when lengthening rates range between 5 and 12 days decade−1 over western Europe and the Mediterranean region. In contrast, a widespread summer shortening occurred for the 1950–78 period. The reported changes in the summer length are in agreement with temperature trends during June and September, which affect the summer onset and end dates.
It is shown that the shortening and lengthening with a turning point around 1979 is a leading mode of the summer length multidecadal variability. The trends in the summer length can be explained by the superposition of an Atlantic multidecadal oscillation signal and a long-term trend toward more persistent summers in Europe associated with global warming.
Granulicatella adiacens, an unusual causative agent in chronic dacryocystitis
Authors: Ku Cristy A , Forcina Blake , LaSala Paul Rocco , Nguyen John 
Published: April 2015

Abstract

Background

Granulicatella adiacens, a recent taxonomic addition, is a commensal organism of the oral, gastrointestinal, and urogenital tracts and is rarely encountered in the orbit and eye.

Findings
We present a 46-year-old Caucasian woman with chronic dacryocystitis who underwent an external dacryocystorhinostomy and was found to have G. adiacens.

Conclusions
This is an unusual causative organism isolated in the nasolacrimal system and, to our knowledge, the first reported case of chronic dacryocystitis associated with G. adiacens.
Worldwide productivity in the field of foot and ankle research from 2009–2013: a bibliometric analysis of highly cited journals
Authors: Luo Xuyao , Liang Zhimin , Gong Feng , Bao Hongwei , Huang Li , Jia Zhiwei 
Published: April 2015

AbstractBackgroundSignificant growth has been observed in the field of foot and ankle research in recent years. However, bibliometric studies concerning the quantity and quality of articles published in foot and ankle journals are scarce. This study aimed to reveal the characteristics of national productivity in the field of foot and ankle research and to provide a general picture of foot and ankle research for surgeons and researchers.MethodsWeb of Science was searched for foot and ankle articles in 4 highly cited journals from 2009 to 2013. The number of total articles and citations were collected to evaluate the contribution of different countries. Publication activity was adjusted for the countries by population size and gross domestic product (GDP).ResultsA total number of 2083 articles were published worldwide. North America, West Europe, Australia and East Asia were the most productive world regions. High income countries published 90.35% of articles, middle‐income 9.60%, and low‐income just 0.05%. The United States published the largest number of articles (1025/2083, 49.2%), followed by the United Kingdom (221/2083, 10.6%), Australia (92/2083, 4.4%), and had the highest total citations (3631). However, Canada had the highest average citations per article (5.0), followed by Australia (4.6) and Switzerland (4.2). There were positive correlations between the total number of publications and population/GDP (p < 0.01). When normalized to population size, Switzerland ranked the highest, followed by Australia, and the United Kingdom. When adjusted for GDP, Switzerland ranked the highest, followed by United Kingdom, and South Korea.ConclusionsThe United States is the most productive country in the field of foot and ankle research. However, Australia, some smaller European and Asian countries may be more productive relative to their size.