bluuebunny/crossref_metadata_2025_split huggingface dataset:
Part 1: Pressure ulcer assessment – the development of Critical Care Pressure Ulcer Assessment Tool made Easy (CALCULATE)
Authors: Richardson Annette , Barrow Isabel 
Published: March 2015

ABSTRACTIntroductionCritically ill patients are at high risk of developing pressure ulcers resulting in serious untoward patient and health care system outcomes. Pressure ulcer prevention is therefore an important patient safety priority and establishing a structured approach to pressure ulcer risk assessment to identify patients at risk is a critical first step.MethodsThe literature was searched using three electronic databases from 2000 to 2011 to identify papers reporting on pressure ulcer risk factors and assessment in adult critical care. The review and appraisal of papers were conducted by two critical care nurses. Papers underwent detailed review if they met inclusion criteria where they identified pressure ulcer assessment scores, scales or risk factors and related to adult critical care patientsFindingsSeven papers were reviewed. No single assessment tool was sufficiently validated for critically ill patients and seven key critical care risk factors were identified. These risk factors were: mechanical ventilation, impaired circulation, dialysis, long surgery, low protein and too unstable to turn.Tool developmentThe tool Critical Care Pressure Ulcer Assessment Tool made Easy (CALCULATE) was developed utilizing the risk factors from the literature and expert critical care nursing consensus decision‐making.DiscussionIn the absence of current consensus, valid assessment scales and limited evidence for the most appropriate pressure ulcer assessment for critically ill patients, this assessment tool offers an easy, appropriate alternative for critically ill patients than existing tools primarily validated for acute care wards.Conclusions‘CALCULATE’ offers an important contribution towards the advancement and development of critical care pressure ulcer risk assessment. Future research is needed to further enhance and inform pressure ulcer risk assessment of the critically ill patients.Implications for practiceThe identification of critical care risk factors may be an indicative method of assessing pressure ulcer risk in the critically ill patients.
Long‐Term Results of Cardiac Resynchronization Therapy: A Comparison between CRT‐Pacemakers versus Primary Prophylactic CRT‐Defibrillators
Authors: REITAN CHRISTIAN , CHAUDHRY UZMA , BAKOS ZOLTAN , BRANDT JOHAN , WANG LINGWEI , PLATONOV PYOTR G. , BORGQUIST RASMUS 
Published: March 2015

BackgroundCardiac resynchronization therapy (CRT) with or without a defibrillator has a positive effect on mortality and morbidity for patients with heart failure. However, comparisons between CRT‐defibrillators (CRT‐D) and CRT‐pacemakers (CRT‐P) are relatively scarce outside the clinical trial setting. This study aimed to assess baseline characteristics in relation to long‐term prognosis in patients treated with CRT, and to investigate the potential benefit of CRT‐D versus CRT‐P.MethodsData were retrospectively collected from the medical records of all consecutive patients treated with CRT‐P or primary prophylactic CRT‐D at a large tertiary care center between 1999 and 2012. Predictors of mortality were investigated, and time‐dependent analysis was performed with all‐cause mortality as the primary end point.ResultsA total of 705 patients were included (69.6 ± 10 years, 78% New York Heart Association classes III–IV, left ventricular ejection fraction median 25%, 16% female, 36% CRT‐D). The patients were followed for a median of 59 months. Annual mortality differed between CRT‐D primary prophylactic and CRT‐P groups (5.3% and 11.8%, respectively), but when adjusted for covariates, CRT‐D treatment (compared to CRT‐P) was not associated with better long‐term survival. Independent predictors of survival were: age, use of loop diuretics, hemoglobin levels, and use of renin angiotensin aldosterone system blockers.ConclusionsIn CRT treatment outside of the clinical trial setting, CRT‐D treatment was not an independent predictor of long‐term survival. Future research should focus on correct selection of the patients who receive enough benefit of an added defibrillator to justify CRT‐D implantation instead of CRT‐P treatment only.
Catheter Ablation of Atrial Fibrillation Using Zero‐Fluoroscopy Technique: A Randomized Trial
Authors: BULAVA ALAN , HANIS JIRI , EISENBERGER MARTIN 
Published: March 2015

BackgroundRecent advances in 3D mapping systems, such as simultaneous visualization of multiple catheters and contact force measurement, have allowed a significant reduction in fluoroscopic times during radiofrequency (RF) ablation (RFA) procedures. The objective was to investigate whether RFA of paroxysmal atrial fibrillation (PAF) using the CARTO 3 system (Biosense Webster, Diamond Bar, CA, USA) and intracardiac echocardiography (ICE) can be performed safely without fluoroscopy.Methods and ResultsEighty patients with PAF were randomized in a 1:1 ratio to undergo either fluoroscopically guided pulmonary vein isolation (PVI) (X+) or PVI without fluoroscopy (X−). In the X− fluoroscopy group, catheter placement, transseptal puncture, left atrial geometry reconstruction, and PVI were accomplished solely using ICE imaging and CARTO mapping. The total procedure duration and RF application time in both the X− and X+ groups were comparable (92.5 ± 22.9 minutes vs 99.9 ± 15.9 minutes, P = 0.11 and 1785 ± 548 seconds vs 1755 ± 450 seconds, P = 0.79, respectively). Zero fluoroscopic time was achieved in all patients in the X− group with the exception of one patient, where 8 seconds of fluoroscopy was needed to assess proper position of the guide‐wire in the femoral vein. No serious procedure‐related complications were recorded and no differences in arrhythmia‐free survival at 12 months were found between the groups.ConclusionRFA using ICE imaging and the CARTO 3 mapping system with contact force measurement is capable of eliminating fluoroscopy in patients undergoing PVI. Exclusion of fluoroscopic imaging does not seem to compromise patient safety and does not affect overall procedure duration, RF application time, or mid‐term efficacy.
Lumbar Lipomeningomyelocele Associated with Multiple Café au Lait Spots: A Case Report
Authors: Balasubramanian Pradeep , Srinivas C. R. , Arunachalam Pavai , Thirumurthy K. S. , Rajkumar P. R. , Manuvidhya H. 
Published: March 2015

AbstractWe report on a child with several café au lait spots in association with a lumbar lipomeningomyelocele as an apparently new association. Cutaneous markers, the identification of which plays a crucial role in the early diagnosis and management of spinal malformations, can accompany occult spinal dysraphism. Herein we report a case of lumbar lipomeningomyelocele associated with an overlying café au lait spot that served as a marker of occult spinal dysraphism. The patient also had segmental café au lait spots on the face, making the association unique.
Bacterial Colonization of Thrombosed Dialysis Arteriovenous Grafts
Authors: Beathard Gerald A. 
Published: March 2015

AbstractIn the absence of obvious infection, an abandoned arteriovenous graft (AVG) is generally left in place. This has been thought to be the best solution in view of the surgical procedure that would be required for its removal. However, there are reports of occult infection in these retained AVGs that can lead to significant infectious complications. In addition, there is evidence that abandoned, retained AVGs may contribute to the inflammatory state that exist in association with dialysis patients. This observational report of 100 cases of thrombosed AVG in which the thrombus was cultured at the time of thrombectomy demonstrated a significant degree of bacterial colonization in these cases without evidence of bacteremia. It is proposed that this could be the mechanism by which occult infection in an abandoned, retained AVGs occurs.
Scripted secure base knowledge and its relation to perceived social acceptance and competence in early middle childhood
Authors: Psouni Elia , Di Folco Simona , Zavattini Giulio Cesare 
Published: March 2015

Attachment theory regards experiences with caregivers as the affective ground for the development of early images of self, possibly embedded in scripted secure‐base knowledge as a rudimentary representation of early caregiver‐child attachment relationships. However, the possible link between implicit representations of secure base availability – and the image of self in these representations – and explicit evaluations of self, is still unclear. The present study assessed whether implicit knowledge of secure‐base interactions with caregivers is related to self‐reported self‐esteem in early middle childhood (N = 97 second‐grade children). Results revealed that children with rich knowledge of secure base interactions perceived themselves not only as more accepted and appreciated by their peers and mothers but also as more cognitively competent, beyond actual differences in cognitive competence. Yet, given the limited strength of this link, the role of contextual factors beyond attachment ought to be considered in the assessment of self‐perception in early middle childhood.
Inter‐individual differences in HLA expression can impact the CDC crossmatch
Authors: Hönger G. , Krähenbühl N. , Dimeloe S. , Stern M. , Schaub S. , Hess C. 
Published: March 2015

AbstractHow human leucocyte antigen (HLA) expression levels on human lymphocytes relate to clinically relevant in vitro cytotoxicity testing has not been defined. Here, cross‐sectional (n = 14) and longitudinal (n = 6) semi‐quantitative assessment of HLA expression on lymphocytes was performed. Complement‐dependent cytotoxicity (CDC) and cellular allo‐reactivity were assessed vis‐à‐vis target cells with defined levels of HLA expression. On CD4+ and CD8+ T‐cells, and on B‐cells, intra‐individual HLA levels varied ≤1.5‐fold, whereas inter‐individual HLA expression varied 2.34‐fold and 2.07‐fold on CD4+ and CD8+ T‐cells, respectively, and 2.90‐fold on B‐cells. Importantly, CDC crossmatch reactions induced by anti‐HLA‐A2 monoclonal antibody as well as patient sera solely containing HLA‐A2 antibodies were significantly impacted by HLA‐A2 expression levels on donor cells. Likewise, cytotoxicity of HLA‐A2 reactive effector cells was induced proportionate to availability of HLA‐A2. These data demonstrate that human HLA expression on lymphocytes from healthy blood donors is fairly stable intra‐individually, yet varies significantly from person to person. Variability in HLA expression levels can impact functional cytotoxic reactions in vitro, including the widely used CDC crossmatch assay. Prospective studies are required to test the clinical relevance of this finding.
A molecular mechanism that confines the activity pattern of miR165 in Arabidopsis leaf primordia
Authors: Tatematsu Kiyoshi , Toyokura Koichi , Miyashima Shunsuke , Nakajima Keiji , Okada Kiyotaka 
Published: March 2015

SummaryIn Arabidopsis leaf primordia, the expression of HD‐Zip III, which promotes tissue differentiation on the adaxial side of the leaf primordia, is repressed by miRNA165/166 (miR165/166). Small RNAs, including miRNAs, can move from cell to cell. In this study, HD‐Zip III expression was strikingly repressed by miR165/166 in the epidermis and parenchyma cells on the abaxial side of the leaf primordia compared with those on the adaxial side. We also found that the MIR165A locus, which was expressed in the abaxial epidermis, was sufficient to establish the rigid repression pattern of HD‐Zip III expression in the leaf primordia. Ectopic expression analyses of MIR165A showed that the abaxial‐biased miR165 activity in the leaf primordia was formed neither by a polarized distribution of factors affecting miR165 activity nor by a physical boundary inhibiting the cell‐to‐cell movement of miRNA between the adaxial and abaxial sides. We revealed that cis‐acting factors, including the promoter, backbone, and mature miRNA sequence of MIR165A, are necessary for the abaxial‐biased activity of miR165 in the leaf primordia. We also found that the abaxial‐determining genes YABBYs are trans‐acting factors that are necessary for the miR165 activity pattern, resulting in the rigid determination of the adaxial–abaxial boundary in leaf primordia. Thus, we proposed a molecular mechanism in which the abaxial‐biased patterning of miR165 activity is confined.
Using Rose's metal alloy as a pinhole collimator material in preclinical small‐animal imaging: A Monte Carlo evaluation
Authors: Peterson Mikael , Strand Sven‐Erik , Ljungberg Michael 
Published: March 2015

Purpose:Pinhole collimation is the most common method of high‐resolution preclinical single photon emission computed tomography imaging. The collimators are usually constructed from dense materials with high atomic numbers, such as gold and platinum, which are expensive and not always flexible in the fabrication step. In this work, the authors have investigated the properties of a fusible alloy called Rose's metal and its potential in pinhole preclinical imaging. When compared to current standard pinhole materials such as gold and platinum, Rose's metal has a lower density and a relatively low effective atomic number. However, it is inexpensive, has a low melting point, and does not contract when solidifying. Once cast, the piece can be machined with high precision. The aim of this study was to evaluate the imaging properties for Rose's metal and compare them with those of standard materials.Methods:After validating their Monte Carlo code by comparing its results with published data and the results from analytical calculations, they investigated different pinhole geometries by varying the collimator material, acceptance angle, aperture diameter, and photon incident angle. The penetration‐to‐scatter and penetration‐to‐total component ratios, sensitivity, and the spatial resolution were determined for gold, tungsten, and Rose's metal for two radionuclides, 99Tcm and 125I.Results:The Rose's metal pinhole‐imaging simulations show higher penetration/total and scatter/total ratios. For example, the penetration/total is 50% for gold and 75% for Rose's metal when simulating 99Tcm with a 0.3 mm aperture diameter and a 60° acceptance angle. However, the degradation in spatial resolution remained below 10% relative to the spatial resolution for gold for acceptance angles below 40° and aperture diameters larger than 0.5 mm.Conclusions:Extra penetration and scatter associated with Rose's metal contribute to degradation in the spatial resolution, but this degradation is not always substantial. The most important factor besides the collimator material was the acceptance angle. This should be kept to a minimum to prevent unnecessary scatter and penetration. For 125I, the difference in spatial resolution between gold and Rose's metal is very small, 2.2% in the worst‐case scenario. Based on these results, the authors conclude that Rose's metal is an alternative to standard materials not only for low‐energy photon imaging but also for medium‐energy applications that require low‐cost, flexible pinhole configurations and designs, and that can tolerate a degraded spatial resolution.
Systematic calibration of an integrated x‐ray and optical tomography system for preclinical radiation research
Authors: Yang Yidong , Wang Ken Kang‐Hsin , Eslami Sohrab , Iordachita Iulian I. , Patterson Michael S. , Wong John W. 
Published: March 2015

Purpose:The cone beam computed tomography (CBCT) guided small animal radiation research platform (SARRP) has been developed for focal tumor irradiation, allowing laboratory researchers to test basic biological hypotheses that can modify radiotherapy outcomes in ways that were not feasible previously. CBCT provides excellent bone to soft tissue contrast, but is incapable of differentiating tumors from surrounding soft tissue. Bioluminescence tomography (BLT), in contrast, allows direct visualization of even subpalpable tumors and quantitative evaluation of tumor response. Integration of BLT with CBCT offers complementary image information, with CBCT delineating anatomic structures and BLT differentiating luminescent tumors. This study is to develop a systematic method to calibrate an integrated CBCT and BLT imaging system which can be adopted onboard the SARRP to guide focal tumor irradiation.Methods:The integrated imaging system consists of CBCT, diffuse optical tomography (DOT), and BLT. The anatomy acquired from CBCT and optical properties acquired from DOT serve as a priori information for the subsequent BLT reconstruction. Phantoms were designed and procedures were developed to calibrate the CBCT, DOT/BLT, and the entire integrated system. Geometrical calibration was performed to calibrate the CBCT system. Flat field correction was performed to correct the nonuniform response of the optical imaging system. Absolute emittance calibration was performed to convert the camera readout to the emittance at the phantom or animal surface, which enabled the direct reconstruction of the bioluminescence source strength. Phantom and mouse imaging were performed to validate the calibration.Results:All calibration procedures were successfully performed. Both CBCT of a thin wire and a euthanized mouse revealed no spatial artifact, validating the accuracy of the CBCT calibration. The absolute emittance calibration was validated with a 650 nm laser source, resulting in a 3.0% difference between simulated and measured signal. The calibration of the entire system was confirmed through the CBCT and BLT reconstruction of a bioluminescence source placed inside a tissue‐simulating optical phantom. Using a spatial region constraint, the source position was reconstructed with less than 1 mm error and the source strength reconstructed with less than 24% error.Conclusions:A practical and systematic method has been developed to calibrate an integrated x‐ray and optical tomography imaging system, including the respective CBCT and optical tomography system calibration and the geometrical calibration of the entire system. The method can be modified and adopted to calibrate CBCT and optical tomography systems that are operated independently or hybrid x‐ray and optical tomography imaging systems.
Characterization and implementation of OSL dosimeters for use in evaluating the efficacy of organ‐based tube current modulation for CT scans of the face and orbits
Authors: Marsh R. M. , Silosky M. 
Published: March 2015

Purpose:The purpose of this work was to characterize commercially available optically stimulated luminescent (OSL) dosimeters for general clinical applications and apply the results to the development of a method to evaluate the efficacy of a vendor‐specific organ‐based tube current modulation application for both phantom and clinical computed tomography (CT) scans of the face and orbits.Methods:This study consisted of three components: (1) thorough characterization of the dosimeters for CT scans in phantom, including evaluations of depletion, fading, angular dependence, and conversion from counts to absorbed dose; (2) evaluation of the efficacy of using plastic glasses to position the dosimeters over the eyes in both phantom and clinical studies; and (3) preliminary dosimetry measurements made using organ‐based tube current modulation in computed tomography dose index (CTDI) and anthropomorphic phantom studies.Results:(1) Depletion effects were found to have a linear relationship with the output of the OSL dosimeters (R2 = 0.96). Fading was found to affect dosimeter readings during the first two hours following exposure but had no effect during the remaining 60‐h period observed. No significant angular dependence was observed for the exposure conditions used in this study (with p‐values ranging from 0.9 to 0.26 for all t‐tests). Dosimeter counts varied linearly with absorbed dose when measured in the center and 12 o'clock positions of the CTDI phantoms. These linear models of counts versus absorbed dose had overlapping 95% confidence intervals for the intercepts but not for the slopes. (2) When dosimeters were positioned using safety glasses, there was no adverse effect on image quality, and there was no statistically significant difference between this placement and placement of the dosimeters directly on the eyes of the phantom (p = 0.24). (3) When using organ‐based tube current modulation, the dose to the lens of the eye was reduced between 19% and 43%, depending on the scan protocol used and the positioning of the phantom. Furthermore, the amount of dose reduction was significantly affected by the vertical position of the phantom, with the largest reduction in dose seen when the phantom was centered in the gantry.Conclusions:(1) An appropriate correction factor, specific to CT scanning, was developed to account for depletion and fading characteristics of the dosimeters. Additionally, an equation to convert dosimeter counts to absorbed dose was established. (2) The use of plastic safety glasses was validated as an appropriate positioning device when measuring dose to the lens of the eye. (3) The use of organ‐based tube current modulation can reduce dose to the lens of the eye during CT scanning. The amount of dose reduction, however, is largely influenced by the positioning of the anatomy in the gantry.
Identification of Pertussis-Specific Effector Memory T Cells in Preschool Children
Authors: de Rond Lia , Schure Rose-Minke , Öztürk Kemal , Berbers Guy , Sanders Elisabeth , van Twillert Inonge , Carollo Maria , Mascart Françoise , Ausiello Clara M. , van Els Cecile A. C. M. , Smits Kaat , Buisman Anne-Marie 
Published: March 2015

ABSTRACTWhooping cough remains a problem despite vaccination, and worldwide resurgence of pertussis is evident. Since cellular immunity plays a role in long-term protection against pertussis, we studied pertussis-specific T-cell responses. Around the time of the preschool acellular pertussis (aP) booster dose at 4 years of age, T-cell memory responses were compared in children who were primed during infancy with either a whole-cell pertussis (wP) or an aP vaccine. Peripheral blood mononuclear cells (PBMCs) were isolated and stimulated with pertussis vaccine antigens for 5 days. T cells were characterized by flow-based analysis of carboxyfluorescein succinimidyl ester (CFSE) dilution and CD4, CD3, CD45RA, CCR7, gamma interferon (IFN-γ), and tumor necrosis factor alpha (TNF-α) expression. Before the aP preschool booster vaccination, both the proliferated pertussis toxin (PT)-specific CD4+and CD8+T-cell fractions (CFSEdim) were higher in aP- than in wP-primed children. Post-booster vaccination, more pertussis-specific CD4+effector memory cells (CD45RA−CCR7−) were induced in aP-primed children than in those primed with wP. The booster vaccination did not appear to significantly affect the T-cell memory subsets and functionality in aP-primed or wP-primed children. Although the percentages of Th1 cytokine-producing cells were alike in aP- and wP-primed children pre-booster vaccination, aP-primed children produced more Th1 cytokines due to higher numbers of proliferated pertussis-specific effector memory cells. At present, infant vaccinations with four aP vaccines in the first year of life result in pertussis-specific CD4+and CD8+effector memory T-cell responses that persist in children until 4 years of age and are higher than those in wP-primed children. The booster at 4 years of age is therefore questionable; this may be postponed to 6 years of age.
Refinement of Whole-Genome Multilocus Sequence Typing Analysis by Addressing Gene Paralogy
Authors: Zhang Ji , Halkilahti Jani , Hänninen Marja-Liisa , Rossi Mirko 
Published: March 2015

ABSTRACT
We developed a user-friendly program, Genome Profiler (GeP), to refine whole-genome multilocus sequence typing analysis by addressing gene paralogy with conserved gene neighborhoods. In comparison to similar programs, GeP produced overall the best results in terms of accuracy and is thus a useful alternative to resolve relationships of bacterial isolates.