bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the quality of care in a new nation: South Sudan's first national health facility assessment
Authors: Berendes Sima , Lako Richard L. , Whitson Donald , Gould Simon , Valadez Joseph J. 
Published: August 2014

AbstractObjectivesWe adapted a rapid quality of care monitoring method to a fragile state with two aims: to assess the delivery of child health services in South Sudan at the time of independence and to strengthen local capacity to perform regular rapid health facility assessments.MethodsUsing a two‐stage lot quality assurance sampling (LQAS) design, we conducted a national cross‐sectional survey among 156 randomly selected health facilities in 10 states. In each of these facilities, we obtained information on a range of access, input, process and performance indicators during structured interviews and observations.ResultsQuality of care was poor with all states failing to achieve the 80% target for 14 of 19 indicators. For example, only 12% of facilities were classified as acceptable for their adequate utilisation by the population for sick‐child consultations, 16% for staffing, 3% for having infection control supplies available and 0% for having all child care guidelines. Health worker performance was categorised as acceptable in only 6% of cases related to sick‐child assessments, 38% related to medical treatment for the given diagnosis and 33% related to patient counselling on how to administer the prescribed drugs. Best performance was recorded for availability of in‐service training and supervision, for seven and ten states, respectively.ConclusionsDespite ongoing instability, the Ministry of Health developed capacity to use LQAS for measuring quality of care nationally and state‐by‐state, which will support efficient and equitable resource allocation. Overall, our data revealed a desperate need for improving the quality of care in all states.
Oral susceptibility of Aedes aegypti (Diptera: Culicidae) from Senegal for dengue serotypes 1 and 3 viruses
Authors: Gaye Alioune , Faye Oumar , Diagne Cheikh T. , Faye Ousmane , Diallo Diawo , Weaver Scott C. , Sall Amadou A. , Diallo Mawlouth 
Published: August 2014

AbstractObjectiveTo investigate the potential for domestic and wild populations of Aedes aegypti from Dakar and Kedougou to develop a disseminated infection after exposure to DENV‐3 and DENV‐1.MethodsWe have exposed sylvatic and urban population of Ae. aegypti from Senegal to bloomeals containing dengue serotype 1 and 3. At different incubation period, individual mosquito legs/wings and bodies were tested for virus presence using real time RT–PCR to estimate the infection and dissemination rates.ResultsThe data indicated low susceptibility to DENV‐3 (infection: 2.4–15.2%, and dissemination rates: 0–8.3%) and higher susceptibility to DENV‐1 (infection and dissemination rates up to 50%).ConclusionAedes aegypti from Senegal seem able to develop a disseminated infection of DENV‐1 and DENV‐3. Further studies are needed to test their ability to transmit the two serotypes.
Unexpected roles for ancient proteins: flavone 8‐hydroxylase in sweet basil trichomes is a Rieske‐type, PAO‐family oxygenase
Authors: Berim Anna , Park Jeong‐Jin , Gang David R. 
Published: August 2014

SummaryMost elucidated hydroxylations in plant secondary metabolism are catalyzed by oxoglutarate‐ or cytochrome P450‐dependent oxygenases. Numerous hydroxylations still evade clarification, suggesting that they might be performed by alternative enzyme types. Here, we report the identification of the flavone 8‐hydroxylase (F8H) in sweet basil (Ocimum basilicum L.) trichomes as a Rieske‐type oxygenase. Several features of the F8H activity in trichome protein extracts helped to differentiate it from a cytochrome P450‐catalyzed reaction and identify candidate genes in the basil trichome EST database. The encoded ObF8H proteins share approximately 50% identity with Rieske‐type protochlorophyllide a oxygenases (PTC52) from higher plants. Homology cloning and DNA blotting revealed the presence of several PTC52‐like genes in the basil genome. The transcripts of the candidate gene designated ObF8H‐1 are strongly enriched in trichomes compared to whole young leaves, indicating trichome‐specific expression. The full‐length ObF8H‐1 protein possesses a predicted N‐terminal transit peptide, which directs green fluorescent protein at least in part to chloroplasts. The F8H activity in crude trichome protein extracts correlates well with the abundance of ObF8H peptides. The purified recombinant ObF8H‐1 displays high affinity for salvigenin and is inactive with other tested flavones except cirsimaritin, which is 8‐hydroxylated with less than 0.2% relative activity. The efficiency of in vivo 8‐hydroxylation by engineered yeast was improved by manipulation of protein subcellular targeting. blast searches showed that occurrence of several PTC52‐like genes is rather common in sequenced plant genomes. The discovery of ObF8H suggests that Rieske‐type oxygenases may represent overlooked candidate catalysts for oxygenations in specialized plant metabolism.
Low‐risk transfusion‐related acute lung injury donor strategies and the impact on the onset of transfusion‐related acute lung injury: a meta‐analysis
Authors: Müller Marcella C.A. , van Stein Danielle , Binnekade Jan M. , van Rhenen Dick J. , Vlaar Alexander P.J. 
Published: August 2014

BackgroundTransfusion‐related acute lung injury (TRALI) is the leading cause of transfusion‐related mortality. In the past decade blood banks have implemented low‐risk TRALI donor strategies, including a male‐only donor policy for plasma‐containing blood products to prevent onset of TRALI. We performed a meta‐analysis to determine whether use of low‐risk TRALI donor strategies for plasma indeed reduces onset of TRALI.Study Design and MethodsWe searched MEDLINE and Cochrane Central Register of Controlled Trials from January 1995 up to January 2013. Two reviewers independently extracted data on study characteristics, methods, and outcomes. Primary endpoint was onset of TRALI. Subgroup analyses were performed for patient populations prone to develop TRALI and general patient populations.ResultsTen articles were included. Meta‐analysis using a random‐effects model taking into account all transfused products showed a significant reduction for the risk of TRALI after implementation of low‐risk TRALI donor strategies (odds ratio [OR], 0.61; 95% confidence interval [CI], 0.42‐0.88). Data from patient populations prone to develop TRALI showed a significant reduction of TRALI risk (OR, 0.51; 95% CI, 0.29‐0.90), while data from general patient populations showed a similar nonsignificant trend (OR, 0.66; 95% CI, 0.40‐1.09). Results were similar when taking only plasma products into account (OR, 0.62; 95% CI, 0.42‐0.92).ConclusionThe introduction of low‐risk TRALI donor strategies for plasma‐containing products results in a reduction of TRALI.
Trends in red blood cell transfusion and 30‐day mortality among hospitalized patients
Authors: Roubinian Nareg H. , Escobar Gabriel J. , Liu Vincent , Swain Bix E. , Gardner Marla N. , Kipnis Patricia , Triulzi Darrell J. , Gottschall Jerome L. , Wu Yan , Carson Jeffrey L. , Kleinman Steven H. , Murphy Edward L. ,   NHLBI Recipient Epidemiology and Donor Evaluation Study (REDS‐III)
Published: August 2014

BackgroundBlood conservation strategies have been shown to be effective in decreasing red blood cell (RBC) utilization in specific patient groups. However, few data exist describing the extent of RBC transfusion reduction or their impact on transfusion practice and mortality in a diverse inpatient population.Study Design and MethodsWe conducted a retrospective cohort study using comprehensive electronic medical record data from 21 medical facilities in Kaiser Permanente Northern California. We examined unadjusted and risk‐adjusted RBC transfusion and 30‐day mortality coincident with implementation of RBC conservation strategies.ResultsThe inpatient study cohort included 391,958 patients who experienced 685,753 hospitalizations. From 2009 to 2013, the incidence of RBC transfusion decreased from 14.0% to 10.8% of hospitalizations; this change coincided with a decline in pretransfusion hemoglobin (Hb) levels from 8.1 to 7.6 g/dL. Decreased RBC utilization affected broad groups of admission diagnoses and was most pronounced in patients with a nadir Hb level between 8 and 9 g/dL (n = 73,057; 50.8% to 19.3%). During the study period, the standard deviation of risk‐adjusted RBC transfusion incidence across hospitals decreased by 44% (p < 0.001). Thirty‐day mortality did not change significantly with declines in RBC utilization in patient groups previously studied in clinical trials nor in other subgroups.ConclusionsAfter the implementation of blood conservation strategies, RBC transfusion incidence and pretransfusion Hb levels decreased broadly across medical and surgical patients. Variation in RBC transfusion incidence across hospitals decreased from 2010 to 2013. Consistent with clinical trial data, more restrictive transfusion practice did not appear to impact 30‐day mortality.
Pathogen reduction by ultraviolet C light effectively inactivates human white blood cells in platelet products
Authors: Pohler Petra , Müller Meike , Winkler Carla , Schaudien Dirk , Sewald Katherina , Müller Thomas H. , Seltsam Axel 
Published: August 2014

BackgroundResidual white blood cells (WBCs) in cellular blood components induce a variety of adverse immune events, including nonhemolytic febrile transfusion reactions, alloimmunization to HLA antigens, and transfusion‐associated graft‐versus‐host disease (TA‐GVHD). Pathogen reduction (PR) methods such as the ultraviolet C (UVC) light‐based THERAFLEX UV‐Platelets system were developed to reduce the risk of transfusion‐transmitted infection. As UVC light targets nucleic acids, it interferes with the replication of both pathogens and WBCs. This preclinical study aimed to evaluate the ability of UVC light to inactivate contaminating WBCs in platelet concentrates (PCs).Study Design and MethodsThe in vitro and in vivo function of WBCs from UVC‐treated PCs was compared to that of WBCs from gamma‐irradiated and untreated PCs by measuring cell viability, proliferation, cytokine secretion, antigen presentation in vitro, and xenogeneic GVHD responses in a humanized mouse model.ResultsUVC light was at least as effective as gamma irradiation in preventing GVHD in the mouse model. It was more effective in suppressing T‐cell proliferation (>5‐log reduction in the limiting dilution assay), cytokine secretion, and antigen presentation than gamma irradiation.ConclusionsThe THERAFLEX UV‐Platelets (MacoPharma) PR system can substitute gamma irradiation for TA‐GVHD prophylaxis in platelet (PLT) transfusion. Moreover, UVC treatment achieves suppression of antigen presentation and inhibition of cytokine accumulation during storage of PCs, which has potential benefits for transfusion recipients.
In vitro evaluation of the inhibitory effect of canine serum, canine fresh frozen plasma, freeze–thaw‐cycled plasma, and Solcoseryl™ on matrix metalloproteinases 2 and 9
Authors: Chow Derek W. Y. , Chau Ying , Yeung Wai Kit , Westermeyer Hans D. 
Published: August 2014

AbstractObjectiveCompare the efficacy of canine serum, fresh frozen plasma (FFP), freeze–thaw‐cycled plasma (FTCP), and Solcoseryl™ at inhibiting matrix metalloproteinases (MMP) 2 and 9 in vitro.ProcedureMatrix metalloproteinases 2 and 9 activity in the presence of serum, FFP, FTCP, or Solcoseryl™ was assayed using a commercially available fluorogenic gelatinase activity kit.ResultsMatrix metalloproteinases 2 activity in the presence of serum, FFP, FTCP, and Solcoseryl™ was 20.84%, 5.76%, 8.10%, and 83.03%, respectively of uninhibited MMP 2 activity. MMP 9 activity in the presence of serum, FFP, FTCP, and Solcoseryl™ was 57.36%, 58.35%, 49.35%, and −8.69%, respectively of uninhibited MMP 9 activity.ConclusionSerum, FFP, and FTCP exhibit similar levels of MMP 2 and 9 inhibitions. Solcoseryl™ causes minimal MMP 2 inhibition, but profound MMP 9 inhibition.
Analysis of leucocyte antibodies, cytokines, lysophospholipids and cell microparticles in blood components implicated in post‐transfusion reactions with dyspnoea
Authors: Maślanka K. , Uhrynowska M. , Łopacz P. , Wróbel A. , Smoleńska‐Sym G. , Guz K. , Lachert E. , Ostas A. , Brojer E. 
Published: August 2014

Background and ObjectivesPost‐transfusion reactions with dyspnoea (PTR) are major causes of morbidity and death after blood transfusion. Transfusion‐related acute lung injury (TRALI) and transfusion‐associated circulatory overload (TACO) are most dangerous, while transfusion‐associated dyspnoea (TAD) is a milder respiratory distress. We investigated blood components for immune and non‐immune factors implicated in PTR.Material and MethodsWe analysed 464 blood components (RBCs, PLTs, L‐PLTs, FFP) transfused to 271 patients with PTR. Blood components were evaluated for 1/antileucocyte antibodies, 2/cytokines: IL‐1β, IL‐6, IL‐8, TNF‐α, sCD40L, 3/lysophosphatidylcholines (LysoPCs), 4/microparticles (MPs) shed from plateletes (PMPs), erythrocytes (EMPs) and leucocytes (LMPs).ResultsAnti‐HLA class I/II antibodies or granulocyte‐reactive anti‐HLA antibodies were detected in 18·2% of blood components (RBC and FFP) transfused to TRALI and in 0·5% of FFP transfused to TAD cases. Cytokines and LysoPCs concentrations in blood components transfused to PTR patients did not exceed those in blood components transfused to patients with no PTR. Only EMPs percentage in RBCs transfused to patients with TRALI was significantly higher (P < 0·05) than in RBCs transfused to patients with no PTR.ConclusionImmune character of PTR was confirmed mainly in 1/5 TRALI cases. Among non‐immune factors, only MPs released from stored RBCs are suggested as potential mediators of TRALI. Our results require further observations in a more numerous and better defined group of patients.
Mitochondrial function/dysfunction in white adipose tissue
Authors: Boudina Sihem , Graham Timothy E. 
Published: August 2014

New Findings
What is the topic of this review?The review covers basic knowledge about the role of mitochondria in the homeostatic function of adipose tissue. It also provide a comprehensive analysis of how mitochondrial function is affected during obesity and lipoatrophies and discuss the results of recent studies that targeted mitochondrial function specifically in adipose tissue or in fat cells and how these interventions affected whole body adiposity and peripheral insulin sensitivity.
What advances does it highlight?The review provides specific highlights of the major roles of mitochondria in key metabolic processes that occur in adipose tissue including its role in adipogenesis, adipokine secretion, lipogenesis, fatty acid esterification, branched‐chain amino acid catabolism and lipolysis. Furthermore, we provide the reader with an update on the specific defects that affect mitochondrial function in adipose tissue during obesity and lipoatrophies. Finally, we discuss the latest mouse studies that specifically targeted mitochondrial function in adipose tissue to assess its contribution to the pathogenesis of obesity and insulin resistance.
The role of mitochondria in white adipocytes has long been neglected due in part to their lower abundance in these cells. However, accumulating evidence suggests that mitochondria are vital for maintaining metabolic homeostasis in white adipocytes because of their involvement in adipogenesis, fatty acid synthesis and esterification, branched‐chain amino acid catabolism and lipolysis. It is therefore not surprising that white adipose tissue function can be perturbed by altering mitochondrial components or oxidative capacity. Moreover, studies in humans and animals with significantly altered fat mass, such as in obesity or lipoatrophy, indicate that impaired mitochondrial function in adipocytes may be linked directly to the development of metabolic diseases such as diabetes and insulin resistance. However, recent studies that specifically targeted mitochondrial function in adipocytes indicated dissociation between impaired mitochondrial oxidative capacity and systemic insulin sensitivity.
Disregarding RBE variation in treatment plan comparison may lead to bias in favor of proton plans
Authors: Wedenberg Minna , Toma‐Dasu Iuliana 
Published: August 2014

Purpose:Currently in proton radiation therapy, a constant relative biological effectiveness (RBE) equal to 1.1 is assumed. The purpose of this study is to evaluate the impact of disregarding variations in RBE on the comparison of proton and photon treatment plans.Methods:Intensity modulated treatment plans using photons and protons were created for three brain tumor cases with the target situated close to organs at risk. The proton plans were optimized assuming a standard RBE equal to 1.1, and the resulting linear energy transfer (LET) distribution for the plans was calculated. In the plan evaluation, the effect of a variable RBE was studied. The RBE model used considers the RBE variation with dose, LET, and the tissue specific parameter α/β of photons. The plan comparison was based on dose distributions, DVHs and normal tissue complication probabilities (NTCPs).Results:Under the assumption of RBE = 1.1, higher doses to the tumor and lower doses to the normal tissues were obtained for the proton plans compared to the photon plans. In contrast, when accounting for RBE variations, the comparison showed lower doses to the tumor and hot spots in organs at risk in the proton plans. These hot spots resulted in higher estimated NTCPs in the proton plans compared to the photon plans.Conclusions:Disregarding RBE variations might lead to suboptimal proton plans giving lower effect in the tumor and higher effect in normal tissues than expected. For cases where the target is situated close to structures sensitive to hot spot doses, this trend may lead to bias in favor of proton plans in treatment plan comparisons.
Impact of extraneous mispositioned events on motion‐corrected brain SPECT images of freely moving animals
Authors: Angelis Georgios I. , Ryder William J. , Bashar Rezaul , Fulton Roger R. , Meikle Steven R. 
Published: August 2014

Purpose:Single photon emission computed tomography (SPECT) brain imaging of freely moving small animals would allow a wide range of important neurological processes and behaviors to be studied, which are normally inhibited by anesthetic drugs or precluded due to the animal being restrained. While rigid body motion of the head can be tracked and accounted for in the reconstruction, activity in the torso may confound brain measurements, especially since motion of the torso is more complex (i.e., nonrigid) and not well correlated with that of the head. The authors investigated the impact of mispositioned events and attenuation due to the torso on the accuracy of motion corrected brain images of freely moving mice.Methods:Monte Carlo simulations of a realistic voxelized mouse phantom and a dual compartment phantom were performed. Each phantom comprised a target and an extraneous compartment which were able to move independently of each other. Motion correction was performed based on the known motion of the target compartment only. Two SPECT camera geometries were investigated: a rotating single head detector and a stationary full ring detector. The effects of motion, detector geometry, and energy of the emitted photons (hence, attenuation) on bias and noise in reconstructed brain regions were evaluated.Results:The authors observed two main sources of bias: (a) motion‐related inconsistencies in the projection data and (b) the mismatch between attenuation and emission. Both effects are caused by the assumption that the orientation of the torso is difficult to track and model, and therefore cannot be conveniently corrected for. The motion induced bias in some regions was up to 12% when no attenuation effects were considered, while it reached 40% when also combined with attenuation related inconsistencies. The detector geometry (i.e., rotating vs full ring) has a big impact on the accuracy of the reconstructed images, with the full ring detector being more advantageous.Conclusions:Motion‐induced inconsistencies in the projection data and attenuation/emission mismatch are the two main causes of bias in reconstructed brain images when there is complex motion. It appears that these two factors have a synergistic effect on the qualitative and quantitative accuracy of the reconstructed images.
Changes in Pneumococcal Serotypes and Antimicrobial Resistance after Introduction of the 13-Valent Conjugate Vaccine in the United States
Authors: Richter Sandra S. , Diekema Daniel J. , Heilmann Kristopher P. , Dohrn Cassie L. , Riahi Fathollah , Doern Gary V. 
Published: August 2014

ABSTRACT

Ongoing surveillance for
Streptococcus pneumoniae
is needed to assess the impact of the pneumococcal conjugate vaccine introduced in 2010 (PCV13). Forty-two U.S. centers submitted
S. pneumoniae
isolates between 1 October 2012 and 31 March 2013. Susceptibility testing was performed by use of a broth dilution method as recommended by the Clinical and Laboratory Standards Institute. Serotyping was performed by multiplex PCR and the Quellung reaction. Multidrug resistance (MDR) was defined as nonsusceptibility to penicillin (PNSP; MIC ≥ 0.12 μg/ml) combined with resistance to ≥2 non-β-lactam antimicrobials. Penicillin-resistant
S. pneumoniae
(PRSP) was defined as a penicillin MIC of ≥2 μg/ml. For the 1,498 isolates collected during 2012-13, the PRSP and MDR rates were 14.2 and 21.0%, respectively. These percentages were lower than rates obtained in a surveillance study conducted 4 years earlier in 2008-09 (17.0 and 26.6%, respectively). The most common serotypes identified in 2012-13 were 3, 35B, and 19A, each representing 9 to 10% of all isolates. The largest percentage of PNSP in 2012-13 were found in serotypes 35B (24.8%), 19A (23.5%), and 15A (10.3%). Predominant PRSP serotypes were 19A (54.5%), 35B (28.2%), and 19F (7.0%). Major MDR serotypes were 19A (38.5%), 15A (16.9%), 6C (8.3%), and 35B (6.4%). The change in prevalence of PCV13 serotypes (43.4 to 27.1%) was primarily due to a decrease in serotype 19A strains, i.e., 22% of all strains in 2008-09 to 10% of all strains in 2012-13. Among the PNSP subset, serotypes showing a proportional increase were 35B, 15B, and 23B. Among MDR strains, the largest proportional increases were observed in serotypes 35B, 15B, and 23A.
Antimicrobial Resistance in Salmonella enterica Serovar Typhi Isolates from Bangladesh, Indonesia, Taiwan, and Vietnam
Authors: Chiou Chien-Shun , Lauderdale Tsai-Ling , Phung Dac Cam , Watanabe Haruo , Kuo Jung-Che , Wang Pei-Jen , Liu Yen-Yi , Liang Shiu-Yun , Chen Pei-Chen 
Published: August 2014

ABSTRACT

We characterized
Salmonella enterica
serovar Typhi isolates from Bangladesh, Indonesia, Taiwan, and Vietnam to investigate their genetic relatedness and antimicrobial resistance. The isolates from Bangladesh and Vietnam were genetically closely related but were distant from those from Indonesia and Taiwan. All but a few isolates from Indonesia and Taiwan were susceptible to all antimicrobials tested. The majority of isolates from Bangladesh and Vietnam were multidrug resistant (MDR) and belonged to the widespread haplotype H58 clone. IncHI1 plasmids were detected in all MDR
S
. Typhi isolates from Vietnam but in only 15% of MDR isolates from Bangladesh. Resistance genes in the majority of MDR
S
. Typhi isolates from Bangladesh should reside in the chromosome. Among the isolates from Bangladesh, 82% and 40% were resistant to various concentrations of nalidixic acid and ciprofloxacin, respectively. Several resistance mechanisms, including alterations in gyrase A, the presence of QnrS, and enhanced efflux pumps, were involved in the reduced susceptibility and resistance to fluoroquinolones. Intensive surveillance is necessary to monitor the spread of chromosome-mediated MDR and fluoroquinolone-resistant
S
. Typhi emerging in Bangladesh.