bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endobronchial ultrasound‐guided transbronchial needle aspiration for diagnosis of sarcoidosis in clinically unselected study populations
Authors: Trisolini Rocco , Lazzari Agli Luigi , Tinelli Carmine , De Silvestri Annalisa , Scotti Valeria , Patelli Marco 
Published: December 2014

AbstractLiterature suggests that ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) has excellent performance characteristics for diagnosis of sarcoidosis. However, many authors challenge the external validity of EBUS‐TBNA results, as most studies were performed in referral centres by highly experienced investigators, and included populations with very high sarcoidosis prevalence.We performed a systematic review and meta‐analysis to estimate the role of EBUS‐TBNA for diagnosis of sarcoidosis in studies enrolling consecutive patients with lymphadenopathy detected at imaging studies, regardless of the suspected underlying clinical aetiology. The Pubmed, Embase, Cinahl, Web of Science and Cochrane Library databases were screened to identify the pertinent literature. Quality of eligible studies was assessed by Quality Assessment, Data Abstraction and Synthesis‐2 criteria. Pooled diagnostic yield, sensitivity and specificity were calculated, and a summary receiver operating characteristic curve was constructed. Subgroup analysis was planned to identify possible sources of study heterogeneity. Fourteen studies, collectively involving 2097 patients, fulfilled eligibility criteria. The median prevalence of sarcoidosis was 15%. EBUS‐TBNA had a pooled diagnostic yield of 0.79 (standard deviation, 0.24), a pooled sensitivity of 0.84 (95% confidence interval (CI), 0.79–0.88) and a pooled specificity of 1.00 (95% CI, 0.99–1.00). Only subgroup analysis exploring the influence of study design seemed to influence the observed inter‐study heterogeneity for sensitivity, retrospective studies showing worst sensitivity than prospective ones. The results of EBUS‐TBNA for diagnosis of sarcoidosis in clinically unselected populations are excellent and compare favourably with published results from studies conducted in selected populations. High‐quality trials would be needed to evaluate factors possibly explaining the observed heterogeneity in sensitivity.
Endobronchial ultrasound learning curve in interventional pulmonary fellows
Authors: Stather David R. , Chee Alex , MacEachern Paul , Dumoulin Elaine , Hergott Christopher A. , Gelberg Jacob , Folch Eric , Majid Adnan , Gonzalez Anne V. , Tremblay Alain 
Published: December 2014

AbstractBackground and objectiveLittle published data exist regarding the learning curve for endobronchial ultrasound‐transbronchial needle aspiration (EBUS‐TBNA). We sought to assess the improvement in skill as trainees learned EBUS‐TBNA in a clinical setting.MethodsThis is a multicentre cohort study of EBUS‐TBNA technical skill of interventional pulmonology (IP) fellows as assessed with EBUS‐TBNA computer simulator testing every 25 clinical cases throughout IP fellowship training.ResultsNine fellows from three academic centres in the United States and Canada were enrolled in the study. Ongoing improvements were seen for EBUS‐TBNA efficiency score and percentage of lymph nodes correctly identified on ultrasound exam, even after 200 clinical cases. Expert‐level technical skill was obtained for EBUS efficiency score and for percentage of lymph nodes correctly identified on ultrasound exam at a median of 212 and 164 procedures, respectively; however, 33% of fellows did not achieve expert‐level technical skill for either metric during their fellowship training. Significant variation in learning curves of the fellows was observed.ConclusionsSignificant variation is seen in the EBUS‐TBNA learning curves of individual IP fellows and for individual procedure components, with ongoing improvement in EBUS‐TBNA skill even after 200 clinical cases. These results highlight the need for validated, objective measures of individual competence, and can assist training programmes in ensuring adequate procedure volumes required for a majority of trainees to successfully complete these assessments.
Analysis of Forensic DNA Mixtures with Artefacts
Authors: Cowell R. G. , Graversen T. , Lauritzen S. L. , Mortera J. 
Published: December 2014

SummaryDNA is now routinely used in criminal investigations and court cases, although DNA samples taken at crime scenes are of varying quality and therefore present challenging problems for their interpretation. We present a statistical model for the quantitative peak information obtained from an electropherogram of a forensic DNA sample and illustrate its potential use for the analysis of criminal cases. In contrast with most previously used methods, we directly model the peak height information and incorporate important artefacts that are associated with the production of the electropherogram. Our model has a number of unknown parameters, and we show that these can be estimated by the method of maximum likelihood in the presence of multiple unknown individuals contributing to the sample, and their approximate standard errors calculated; the computations exploit a Bayesian network representation of the model. A case example from a UK trial, as reported in the literature, is used to illustrate the efficacy and use of the model, both in finding likelihood ratios to quantify the strength of evidence, and in the deconvolution of mixtures for finding likely profiles of the individuals contributing to the sample. Our model is readily extended to simultaneous analysis of more than one mixture as illustrated in a case example. We show that the combination of evidence from several samples may give an evidential strength which is close to that of a single-source trace and thus modelling of peak height information provides a potentially very efficient mixture analysis.
A Hybrid Model for Combining Case–Control and Cohort Studies in Systematic Reviews of Diagnostic Tests
Authors: Chen Yong , Liu Yulun , Ning Jing , Cormier Janice , Chu Haitao 
Published: December 2014

SummarySystematic reviews of diagnostic tests often involve a mixture of case–control and cohort studies. The standard methods for evaluating diagnostic accuracy focus only on sensitivity and specificity and ignore the information on disease prevalence that is contained in cohort studies. Consequently, such methods cannot provide estimates of measures related to disease prevalence, such as population-averaged or overall positive and negative predictive values, which reflect the clinical utility of a diagnostic test. We propose a hybrid approach that jointly models the disease prevalence along with diagnostic test sensitivity and specificity in cohort studies, and sensitivity and specificity in case–control studies. To overcome the potential computational difficulties in the standard full likelihood inference of the hybrid model proposed, we propose an alternative inference procedure based on composite likelihood. Such composite-likelihood-based inference does not suffer computational problems and maintains high relative efficiency. In addition, it is more robust to model misspecifications compared with standard full likelihood inference. We apply our approach to a review of the performance of contemporary diagnostic imaging modalities for detecting metastases in patients with melanoma.
Optimal Marker-Adaptive Designs for Targeted Therapy Based on Imperfectly Measured Biomarkers
Authors: Zang Yong , Liu Suyu , Yuan Ying 
Published: December 2014

SummaryTargeted therapy revolutionizes the way that physicians treat cancer and other diseases, enabling them to select individualized treatment adaptively according to the patient's biomarker profile. The implementation of targeted therapy requires that the biomarkers are accurately measured, which may not always be feasible in practice. We propose two optimal marker-adaptive trial designs in which the biomarkers are subject to measurement errors. The first design focuses on a patient's individual benefit and minimizes the treatment assignment error so that each patient has the highest probability of being assigned to the treatment that matches his or her true biomarker status. The second design focuses on the group benefit, which maximizes the overall response rate for all the patients enrolled in the trial. We develop a Wald test to evaluate the treatment effects for marker subgroups at the end of the trial and derive the corresponding asymptotic power function. Simulation studies and an application to a lymphoma cancer trial show that the optimal designs proposed achieve our design goal and obtain desirable operating characteristics.
Future Directions for Vascular Access for Hemodialysis
Authors: Roy‐Chaudhury Prabir , Kruska Lindsay 
Published: December 2014

AbstractHemodialysis vascular access is at the same time both the “Lifeline” and the “Achilles Heel” of hemodialysis. This review will initially summarize the vascular biology of dialysis vascular access dysfunction and then use this information to describe some novel and innovative ways (including advances in the process of care for vascular access) to prevent this problem.
Low Dialysate Potassium Concentration: An Overrated Risk Factor for Cardiac Arrhythmia?
Authors: Abuelo J. Gary 
Published: December 2014

AbstractSerum potassium concentrations rise with dietary potassium intake between dialysis sessions and are often at hyperkalemic levels by the next session. Conversely, potassium concentrations fall during each hemodialysis, and sometimes reach hypokalemic levels by the end. Low potassium dialysate, which rapidly decreases serum potassium and often brings it to hypokalemic levels, is almost universally considered a risk factor for life‐threatening arrhythmias. While there is little doubt about the threat of lethal arrhythmias due to hyperkalemia, convincing evidence for the danger of low potassium dialysate and rapid or excess potassium removal has not been forthcoming. The original report of more frequent ventricular ectopy in early dialysis that was improved by reducing potassium removal has received very little confirmation from subsequent studies. Furthermore, the occurrence of ventricular ectopy during dialysis does not appear to predict mortality. Studies relating sudden deaths to low potassium dialysate are countered by studies with more thorough adjustment for markers of poor health. Dialysate potassium concentrations affect the excursions of serum potassium levels above or below the normal range, and have the potential to influence dialysis safety. Controlled studies of different dialysate potassium concentration and their effect on mortality and cardiac arrests have not been done. Until these results become available, I propose interim guidelines for the setting of dialysate potassium levels that may better balance risks and benefits.
Helping Children Help: The Relation between Maternal Scaffolding and Children's Early Help
Authors: Hammond Stuart I. , Carpendale Jeremy I. M. 
Published: December 2014

AbstractTheory and empirical research suggest that parental scaffolding of children's participation in chores may contribute to the development of early helping. Sixty mother–child dyads with toddlers between 18 and 24 months of age were assessed on two measures of scaffolding (during a cleanup chore; reading an emotionally laden book together). Children's helping was assessed in five tasks with an experimenter, and children were also assessed for social approach to an unfamiliar adult as a measure of sociability, and for internal state language as a measure of social understanding. Both mothers' scaffolding of everyday helping and children's sociability uniquely predicted individual differences in children's helping. Thus, individual differences in children's helping appear early, and are associated with both temperament and with parents' efforts to support and encourage young children's helpfulness.
LOOSE FLOWER, a WUSCHEL‐like Homeobox gene, is required for lateral fusion of floral organs in Medicago truncatula
Authors: Niu Lifang , Lin Hao , Zhang Fei , Watira Tezera W. , Li Guifen , Tang Yuhong , Wen Jiangqi , Ratet Pascal , Mysore Kirankumar S. , Tadege Million 
Published: December 2014

SummaryThe Medicago truncatula WOX gene, STENOFOLIA (STF), and its orthologs in Petunia, pea, and Nicotiana sylvestris are required for leaf blade outgrowth and floral organ development as demonstrated by severe phenotypes in single mutants. But the Arabidopsis wox1 mutant displays a narrow leaf phenotype only when combined with the prs/wox3 mutant. In maize and rice, WOX3 homologs are major regulators of leaf blade development. Here we investigated the role of WOX3 in M. truncatula development by isolating the lfl/wox3 loss‐of‐function mutant and performing genetic crosses with the stf mutant. Lack of WOX3 function in M. truncatula leads to a loose‐flower (lfl) phenotype, where defects are observed in sepal and petal development, but leaf blades are apparently normal. The stf lfl double mutant analysis revealed that STF and LFL act mainly independently with minor redundant functions in flower development, but LFL has no obvious role in leaf blade outgrowth in M. truncatula on its own or in combination with STF. Interestingly, LFL acts as a transcriptional repressor by recruiting TOPLESS in the same manner as STF does, and can substitute for STF function in leaf blade and flower development if expressed under the STF promoter. STF also complements the lfl mutant phenotype in the flower if expressed under the LFL promoter. Our data suggest that the STF/WOX1 and LFL/WOX3 genes of M. truncatula employ a similar mechanism of action in organizing cell proliferation for lateral outgrowth but may have evolved different cis elements to acquire distinct functions.
Increased hospital costs associated with red blood cell transfusion
Authors: Trentino Kevin M. , Farmer Shannon L. , Swain Stuart G. , Burrows Sally A. , Hofmann Axel , Ienco Rinaldo , Pavey Warren , Daly Frank F.S. , Van Niekerk Anton , Webb Steven A.R. , Towler Simon , Leahy Michael F. 
Published: December 2014

BackgroundRed blood cell (RBC) transfusion is independently associated in a dose‐dependent manner with increased intensive care unit stay, total hospital length of stay, and hospital‐acquired complications. Since little is known of the cost of these transfusion‐associated adverse outcomes our aim was to determine the total hospital cost associated with RBC transfusion and to assess any dose‐dependent relationship.Study Design and MethodsA retrospective cohort study of all multiday acute care inpatients discharged from a five hospital health service in Western Australia between July 2011 and June 2012 was conducted. Main outcome measures were incidence of RBC transfusion and mean inpatient hospital costs.ResultsOf 89,996 multiday, acute care inpatient discharges, 4805 (5.3%) were transfused at least 1 unit of RBCs. After potential confounders were adjusted for, the mean inpatient cost was 1.83 times higher in the transfused group compared with the nontransfused group (95% confidence interval, 1.78‐1.89; p < 0.001). The estimated total hospital‐associated cost of RBC transfusion in this study was AUD $77 million (US $72 million), representing 7.8% of total hospital expenditure on acute care inpatients. There was a significant dose‐dependent association between the number of RBC units transfused and increased costs after adjusting for confounders.ConclusionRBC transfusions were independently associated with significantly higher hospital costs. The financial implication to hospital budgets will assist in prioritizing areas to reduce the rate of RBC transfusions and in implementing patient blood management programs.
Expression microarray as a tool to identify differentially expressed genes in horses suffering from inflammatory airway disease
Authors: Ramery Eve , Fraipont Audrey , Richard Eric A. , Art Tatiana , Pirottin Dimitri , van Delm Wouter , Bureau Fabrice , Lekeux Pierre 
Published: December 2014

BackgroundInflammatory airway disease (IAD) affects performance and well‐being of horses. Diagnosis is primarily reached by bronchoalveolar lavage (BAL) cytology which is invasive and requires sedation.ObjectivesThe purpose of this study was to identify differential gene expression in peripheral blood of horses withIADusing species‐specific expression microarrays.MethodsEquine gene expression microarrays were used to investigate globalmRNAexpression in circulating leukocytes from healthy, IAD‐affected, and low‐performing Standardbred and endurance horses.ResultsNine genes in Standardbred and 61 genes in endurance horses were significantly differentially regulated (P < .001). These genes were related to inflammation (eg,ALOX15B,PLA2G12B,and PENK), oxidant/antioxidant balance (eg,DUOXA2andGSTO1‐1), and stress (eg,V1aR, GRLF1,Homer‐2, andMAOB). All these genes were up‐regulated, except down‐regulatedHomer‐2andMAOB. DUOXA2,ALOX15B,PLA2G12B, MAOB, andGRLF1expression was further validated by RT‐qPCR. An increase in glutathione peroxidase (GPx) activity in heparinized whole blood of IAD‐affected Standardbred (P = .0025) and endurance horses (P = .0028) also suggests a deregulation of the oxidant/antioxidant balance. There was good correlation (r = .7354) between BAL neutrophil percentage and whole blood GPx activity in all horses.ConclusionsThis study showed that circulating blood cell gene expression reflects inflammatory responses in tissues. Whether any of the genes have potential for diagnostic applications in the future remains to be investigated. Although not specific forIAD, whole bloodGPx activity appears to be correlated withBALneutrophil percentage. This finding should be further assessed by testing a larger number of horses.
Biochemical variables from Holstein‐Friesian calves older than one week are comparable to those obtained from adult animals of stable metabolic status on the same farm
Authors: Pérez‐Santos María , Castillo Cristina , Hernández Joaquín , Abuelo Ángel 
Published: December 2014

BackgroundAge‐related changes in blood variables have previously been reported for cattle. A few studies have investigated differences in biochemistry analytes over time using repeat measures.ObjectivesThe purpose of the study was to investigate the variation in select variables during the first 3 months of life of Holstein‐Friesian calves using repeat sampling.MethodsTwenty healthy calves were sampled on the day of birth (0) and at 6, 13, 21, 30, 60, and 90 days of life. Analyzed variables included concentration of glucose, total protein, albumin, urea and creatinine, and activity of AST, GGT, and CK. Reference intervals (RI) were obtained from 40 adult cows using specific computer software. The variation in each analyte throughout the study period and differences relative to the RI in adult cattle were assessed.ResultsWith the exception of glucose, the studied variables were affected by the calf's age. However, for most of the analytes studied, the values obtained from calves from one week of age onwards remained within the RI determined in adult cattle. During the calves' first week of life, some variables outside the RI of adult cattle were due to the changes associated with birth and colostrum intake.ConclusionsWith the exception of AST and GGT activity, RI for standard biochemistry variables determined for adult cattle are likely to be valid for calves older than one week. However, special consideration is necessary for calves within their first week of life.
Particulate Emissions From Karanja Biodiesel Fuelled Turbocharged CRDI SUV Engine
Authors: Gupta Jai Gopal , Agarwal Avinash Kumar , Aggarwal Suresh K. 
Published: December 2014

The use of biodiesel substantially reduces particulate matter (PM), hydrocarbon (HC) and carbon monoxide (CO) emissions, slightly reduces power output; increases fuel consumption and marginally increases oxides of nitrogen (NOx) emission in an unmodified common rail direct injection (CRDI) diesel engine. Lower blends of biodiesel demonstrated lower emissions, while easing pressure on scarce petroleum resources, without significantly sacrificing engine power output and fuel economy.
However due to adverse health effects of smaller size particulate matter (PM) emitted by internal combustion (IC) engines, most recent emission legislations restrict the PM mass emissions in addition to total particle numbers emitted. It is an overwhelming argument that usage of biodiesel leads to reduction in PM mass emissions. In this paper, experimental results of PM emissions using Karanja biodiesel blends (KB20 and KB40) in a modern CRDI transportation engine (maximum fuel injection pressure of 1600 bar) have been reported. This study also explores comparative effect of varying engine speed and load on PM emissions for biodiesel blends vis-à-vis baseline mineral diesel. Particulate size-number distribution, particle size-surface area distribution and total particulate number concentrations were experimentally determined under varying engine operating conditions and compared with baseline mineral diesel. KB20 showed highest particulate number concentration upto 80% rated engine loads, however at rated load, KB40 emitted highest number of particulates.
Multi-Dimensional Engine Modeling Study of EGR, Fuel Pressure, Post-Injection and Compression Ratio for a Light Duty Diesel Engine
Authors: Almeida Fabio L. , Zoldak Philip , Wang Yan , Sobiesiak Andrzej , Lacava Pedro T. 
Published: December 2014

For copious levels of exhaust gas recirculation (EGR) (>30 %), oxides of nitrogen (NOx) emissions can be reduced from Euro V to Euro VI regulated levels at the expense of fuel economy and soot emissions. The Lifted-Flame Concept (LFC) has been demonstrated by several researchers to be successful in reducing NOx, while minimizing soot emissions and impact to fuel economy. By simultaneously applying increased EGR and fuel pressure the LFC extends the lift-off length of a diffusion flame and enhances fuel-air entrainment leading to improved fuel and oxygen utilization. When combined with advanced turbocharging and EGR systems the LFC applied to a modern light duty (LD) diesel engine can result in improved fuel economy and lower soot emissions and shows good potential for meeting low soot engine-out targets.
In the proposed paper a computational study was conducted using a multi-dimensional engine model. A modified 3D CFD KIVA code with detailed chemistry solver was used to model the diesel fuel spray, droplet breakup, vaporization, mixing, auto-ignition and subsequent heat release and emissions. The model uses inputs from 1D Amesim electro-hydraulic solver to generate the rate of injection (ROI) profile to raise pressure of 1800 bar to 2500 bar as well as to include a simulated post-injection. A 1D model using GT-Power was developed and utilized to provide air system boundary conditions for the 3D CFD model. Post-processing optimization was conducted using Matlab to identify minimum fuel economy and soot emissions for the study of several parameters.
The objective of the study was to demonstrate Euro VI emissions levels on a 3.2 L LD diesel engine without NOx aftertreatment and minimal impact to fuel economy using the lifted flame concept. The engine-out NOx emission level was targeted at 0.4 g/kWh and the soot levels were targeted at 0.2 g/kWh assuming diesel particulate filter would be used for after-treatment. The results of the computational study successfully demonstrate the potential of the lifted flame concept to meet Euro VI without the use of NOx aftertreatment technology.