bluuebunny/crossref_metadata_2025_split huggingface dataset:
Large Scale Expansion of Human Umbilical Cord Cells in a Rotating Bed System Bioreactor for Cardiovascular Tissue Engineering Applications
Authors: Reichardt Anne , Polchow Bianca , Shakibaei Mehdi , Henrich Wolfgang , Hetzer Roland , Lueders Cora 
Published: June 2013

Widespread use of human umbilical cord cells for cardiovascular tissue engineering requires production of large numbers of well-characterized cells under controlled conditions. In current research projects, the expansion of cells to be used to create a tissue construct is usually performed in static cell culture systems which are, however, often not satisfactory due to limitations in nutrient and oxygen supply. To overcome these limitations dynamic cell expansion in bioreactor systems under controllable conditions could be an important tool providing continuous perfusion for the generation of large numbers of viable pre-conditioned cells in a short time period. For this purpose cells derived from human umbilical cord arteries were expanded in a rotating bed system bioreactor for up to 9 days. For a comparative study, cells were cultivated under static conditions in standard culture devices.Our results demonstrated that the microenvironment in the perfusion bioreactor was more favorable than that of the standard cell culture flasks. Data suggested that cells in the bioreactor expanded 39 fold (38.7 ± 6.1 fold) in comparison to statically cultured cells (31.8 ± 3.0 fold). Large-scale production of cells in the bioreactor resulted in more than 3 x 108cells from a single umbilical cord fragment within 9 days. Furthermore cell doubling time was lower in the bioreactor system and production of extracellular matrix components was higher. With this study, we present an appropriate method to expand human umbilical cord artery derived cells with high cellular proliferation rates in a well-defined bioreactor system under GMP conditions.
Race/Ethnicity Disparities in Dysglycemia Among U.S. Women of Childbearing Age Found Mainly in the Nonoverweight/Nonobese
Authors: Marcinkevage Jessica A. , Alverson C.J. , Narayan K.M. Venkat , Kahn Henry S. , Ruben Julia , Correa Adolfo 
Published: June 2013

OBJECTIVE
To describe the burden of dysglycemia—abnormal glucose metabolism indicative of diabetes or high risk for diabetes—among U.S. women of childbearing age, focusing on differences by race/ethnicity.

RESEARCH DESIGN AND METHODS
Using U.S. National Health and Nutrition Examination Survey data (1999–2008), we calculated the burden of dysglycemia (i.e., prediabetes or diabetes from measures of fasting glucose, A1C, and self-report) in nonpregnant women of childbearing age (15–49 years) by race/ethnicity status. We estimated prevalence risk ratios (PRRs) for dysglycemia in subpopulations stratified by BMI (measured as kilograms divided by the square of height in meters), using predicted marginal estimates and adjusting for age, waist circumference, C-reactive protein, and socioeconomic factors.

RESULTS
Based on data from 7,162 nonpregnant women, representing &gt;59,000,000 women nationwide, 19% (95% CI 17.2–20.9) had some level of dysglycemia, with higher crude prevalence among non-Hispanic blacks and Mexican Americans vs. non-Hispanic whites (26.3% [95% CI 22.3–30.8] and 23.8% [19.5–28.7] vs. 16.8% [14.4–19.6], respectively). In women with BMI &lt;25 kg/m2, dysglycemia prevalence was roughly twice as high in both non-Hispanic blacks and Mexican Americans vs. non-Hispanic whites. This relative increase persisted in adjusted models (PRRadj 1.86 [1.16–2.98] and 2.23 [1.38–3.60] for non-Hispanic blacks and Mexican Americans, respectively). For women with BMI 25–29.99 kg/m2, only non-Hispanic blacks showed increased prevalence vs. non-Hispanic whites (PRRadj 1.55 [1.03–2.34] and 1.28 [0.73–2.26] for non-Hispanic blacks and Mexican Americans, respectively). In women with BMI &gt;30 kg/m2, there was no significant increase in prevalence of dysglycemia by race/ethnicity category.

CONCLUSIONS
Our findings show that dysglycemia affects a significant portion of U.S. women of childbearing age and that disparities by race/ethnicity are most prominent in the nonoverweight/nonobese.
Acute Hypoglycemia Impairs Executive Cognitive Function in Adults With and Without Type 1 Diabetes
Authors: Graveling Alex J. , Deary Ian J. , Frier Brian M. 
Published: June 2013

OBJECTIVE
Acute hypoglycemia impairs cognitive function in several domains. Executive cognitive function governs organization of thoughts, prioritization of tasks, and time management. This study examined the effect of acute hypoglycemia on executive function in adults with and without diabetes.

RESEARCH DESIGN AND METHODS
Thirty-two adults with and without type 1 diabetes with no vascular complications or impaired awareness of hypoglycemia were studied. Two hyperinsulinemic glucose clamps were performed at least 2 weeks apart in a single-blind, counterbalanced order, maintaining blood glucose at 4.5 mmol/L (euglycemia) or 2.5 mmol/L (hypoglycemia). Executive functions were assessed with a validated test suite (Delis-Kaplan Executive Function). A general linear model (repeated-measures ANOVA) was used. Glycemic condition (euglycemia or hypoglycemia) was the within-participant factor. Between-participant factors were order of session (euglycemia-hypoglycemia or hypoglycemia-euglycemia), test battery used, and diabetes status (with or without diabetes).

RESULTS
Compared with euglycemia, executive functions (with one exception) were significantly impaired during hypoglycemia; lower test scores were recorded with more time required for completion. Large Cohen d values (&gt;0.8) suggest that hypoglycemia induces decrements in aspects of executive function with large effect sizes. In some tests, the performance of participants with diabetes was more impaired than those without diabetes.

CONCLUSIONS
Executive cognitive function, which is necessary to carry out many everyday activities, is impaired during hypoglycemia in adults with and without type 1 diabetes. This important aspect of cognition has not received previous systematic study with respect to hypoglycemia. The effect size is large in terms of both accuracy and speed.
Early dynamic 18F-FDG PET/CT to diagnose chronic osteomyelitis following lower extremity fractures
Authors: Stecker F. F. , Schierz J.-H. , Opfermann T. , Driesch D. , Hofmann G. O. , Winkens T. , Freesmeyer M. 
Published: June 2013

SummaryAim: The study investigates whether early dynamic PET/CT (edPET/CT) using 18F-fluoro- deoxyglucose (FDG) discriminates between affected versus non-affected sites in patients with complicated, protracted fracture healing and suspected COM in the lower extremities. Patients, methods: In nine consecutive patients (1 woman, 8 men; age 54 ± 13 years), before standard late FDG-PET/CT, altogether 10 edFDG-PET/CT examinations were performed in list mode over 5 min starting with radiopharmaceutical injection. Eight consecutive time intervals (frames), four 15-s, then four 60-s, were reconstructed. For every patient, several volumes-of-interest were selected. To measure early FDG influx and accumulation, maximum and mean ed standardized uptake values (respectively, ed SUVmax, edSUVmean) were calculated in each volume-of-interest during each frame. Results were compared between affected and non-affected (contralateral) bone. Results: Starting in the 31-45s frame, the affected bone area showed significantly higher ed- SUVmax and edSUVmean than did the healthy contralateral region. In conventional PET/CT, affected bone areas also significantly differed from non-affected contralateral regions. Conclusion: This pilot study suggests that edFDG- PET may offer a less time consuming add on to standard FDG-PET/CT while being equally accurate. The results should be validated pros- pectively in larger trials.
Prise de conscience écologique
Authors: Cesarman Fernando C. , Mendèz Roberto 
Published: June 2013

L’auteur ne se contente pas de percevoir l’importance et l’influence considérables d’un sujet qui, à l’époque, n’agitait qu’un petit nombre. Il émet également plusieurs idées pour expliquer comment et pourquoi l’humanité en arrive à poursuivre des activités et des méthodes dont elle connaît parfaitement les effets destructeurs sur elle-même. Il écrit ainsi : « Le concept de conscience écologique est en rapport étroit avec la structuration du principe de réalité et avec les fonctions liées à l’épreuve de réalité. » Et encore : « dans le processus d’épreuve de réalité deux facteurs sont importants : premièrement la confrontation de pulsions avec des situations de réalité, deuxièmement le développement de fonctions du Moi relatives à ce processus. » Puis : « le Moi est inadéquatement développé et ne parvient pas à tenir compte de l’écosystème, ses réalisations sont le résultat de buts conflictuels du Moi. » Et « nous continuons à nous préoccuper à peu près exclusivement de notre univers de réalité immédiate... »
La théorie de la vision chez Calcidius (IV e siècle) entre géométrie, médecine et philosophie
Authors: Bakhouche Béatrice 
Published: June 2013

Calcidius est le seul des exégètes du Timée de Platon dont nous ayons conservé le commentaire aux pages du dialogue grec consacrées à la vue. Ce document est d’autant plus précieux que le texte latin est également le témoin unique de théories optiques ou ophtalmologiques – deux domaines dans lesquels, vu la terminologie utilisée, le commentateur est tributaire du grec ; il est également digne d’intérêt car c’est encore le seul passage du commentaire où l’exégète adopte un ton polémique en s’attaquant aux iuniores . Nous nous proposons d’étudier ici l’image que Calcidius donne des théories géométriques liées à l’optique et des pratiques médicales en relation avec l’anatomie et la pathologie oculaires, et de cerner le groupe attaqué par l’exégète.
Théorie mathématique des catégories en biologie et notion d'équivalence naturelle chez Robert Rosen
Authors: Varenne Franck 
Published: June 2013

L’objectif de cet article est de rendre compte de la justification épistémologique de la proposition faite, dès 1958, par le biomathématicien Robert Rosen d’introduire le concept mathématique de « catégorie » et celui – corrélatif – d’« équivalence naturelle » dans la modélisation mathématique appliquée au vivant. Nos questions sont les suivantes : en quoi la notion mathématique de catégorie permet-elle, selon Rosen, de donner accès à des formalismes plus « naturels » pour la modélisation du vivant ? La naturalité de certaines équivalences (que la notion mathématique de catégorie sert justement à généraliser et à mettre en évidence) est-elle analogue à la naturalité des systèmes vivants ? Rosen semble faire fond sur cette dernière hypothèse, féconde, mais pourtant discutable. Cet article propose ensuite de mesurer l’évolution des arguments de Rosen à ce sujet, en particulier dans ses conséquences apparemment décisives pour la critique des modèles computationnels du vivant, modèles aujourd’hui en pleine expansion.
Electroborus brighti: the first Hylesinini bark beetle described from Dominican amber (Coleoptera: Curculionidae: Scolytinae)
Authors: Cognato Anthony I. 
Published: June 2013

AbstractElectroborus brighti, new genus, new species (Coleoptera: Curculionidae: Scolytinae) is described based on two specimens from Dominican amber, which represents the first Hylesinini found in Dominican amber. A phylogenetic analysis of 24 Hylesinini species and a Strombophorus Hagedorn species based on morphological characters suggests E. brighti is not related to the Neotropical genus Phloeoborus Erichson, but shares a close affinity to African Hylesinini genera. The discovery of this new genus adds to the evidence that tropical South America and Africa shared similar faunas throughout evolutionary history. Although many Old World taxa have become extinct in the New World, the existence of E. brighti among Recent faunas is a possibility, given that the South American and African scolytine faunas are relatively poorly studied.
Usability characteristics of self-administered computer-assisted interviewing in the emergency department
Authors: Herrick D. B. , Nakhasi A. , Nelson B. , Rice S. , Abbott P. A. , Tehrani A. S. Saber , Rothman R. E. , Lehmann H. P. , Newman-Toker D. E. 
Published: June 2013

SummaryObjective: Self-administered computer-assisted interviewing (SACAI) gathers accurate information from patients and could facilitate Emergency Department (ED) diagnosis. As part of an ongoing research effort whose long-range goal is to develop automated medical interviewing for diagnostic decision support, we explored usability attributes of SACAI in the ED.Methods: Cross-sectional study at two urban, academic EDs. Convenience sample recruited daily over six weeks. Adult, non-level I trauma patients were eligible. We collected data on ease of use (self-reported difficulty, researcher documented need for help), efficiency (mean time-per-click on a standardized interview segment), and error (self-report age mismatched with age derived from electronic health records) when using SACAI on three different instruments: Elo TouchSystems ESY15A2 (finger touch), Toshiba M200 (with digitizer pen), and Motion C5 (with digitizer pen). We calculated descriptive statistics and used regression analysis to evaluate the impact of patient and computer factors on time-per-click.Results: 841 participants completed all SACAI questions. Few (<1%) thought using the touch computer to ascertain medical information was difficult. Most (86%) required no assistance. Participants needing help were older (54 ± 19 vs. 40 ± 15 years, p<0.001) and more often lacked internet at home (13.4% vs. 7.3%, p = 0.004). On multivariate analysis, female sex (p<0.001), White (p<0.001) and other (p = 0.05) race (vs. Black race), younger age (p<0.001), internet access at home (p<0.001), high school graduation (p = 0.04), and touch screen entry (vs. digitizer pen) (p = 0.01) were independent predictors of decreased time-per-click. Participant misclick errors were infrequent, but, in our sample, occurred only during interviews using a digitizer pen rather than a finger touch-screen interface (1.9% vs. 0%, p = 0.09).Discussion: Our results support the facility of interactions between ED patients and SACAI. Demographic factors associated with need for assistance or slower interviews could serve as important triggers to offering human support for SACAI interviews during implementation.Conclusion: Understanding human-computer interactions in real-world clinical settings is essential to implementing automated interviewing as means to a larger long-term goal of enhancing clinical care, diagnostic accuracy, and patient safety.Citation: Herrick DB, Nakhasi A, Nelson B, Rice S, Abbott PA, Tehrani ASS, Rothman RE, Lehmann HP, NewmanToker DE. Usability characteristics of self-administered computer-assisted interviewing in the emergency department. Factors affecting ease of use, efficiency, and entry error.
¿Son los Signos Duros de Lesión en Cuello Mandatorios de Exploración Quirúgica?
Authors: Quiodettis Martha , V Otilda M Valderrama , Ávila Aldo A , Valle Ayusel , Rodríguez Loyda 
Published: June 2013

RESUMEN

Introducción
Las lesiones en cuello siguen siendo un reto diagnóstico para los médicos de trauma. En la literatura se encuentran diversos algoritmos de manejo. En los últimos años, el abordaje de estos pacientes ha evolucionado con la utilización de diversas técnicas diagnósticas e incluso el manejo conservador de algunas lesiones venosas.

Objetivo
Determinar la relación entre los hallazgos clínicos y paraclínicos con las lesiones comprobadas mediante cirugía o estudios diagnósticos.

Métodos
Estudio Descriptivo Retrospectivo, se revisaron los expedientes de todos los pacientes admitidos con trauma en cuello entre el 2010 y 2011.

Resultados
Se analizaron 84 pacientes, 94.1% de sexo masculino, edad promedio de 30.4 años, e ISS de 8.8. El 98.8% con lesiones penetrantes, principalmente en Zona II (62.7%). El 25.7% fueron llevados a exploración quirúrgica inmediata y el resto se les realizó estudios diagnósticos en el cuarto de urgencias. La incidencia de lesiones fue del 21.4%, siendo la mayoría lesiones venosa... Al evaluar los pacientes que presentaron lesión vs que no presentaban, no se encontraron diferencias estadísticamente significativas (p > 0.05) en cuanto a mecanismo de lesión, inestabilidad hemodinámica, sangrado a través de la herida, trayecto vascular, enfisema subcutáneo y hematoma (expansivo o no). Se encontró diferencias significativas (p < 0.05) en cuanto a dificultad respiratoria OR 8.24 IC95% (1.08-20.7) y necesidad de intubación en el cuarto de urgencias OR 4.0 IC95% (1.32-12.1). La mortalidad fue de 2.38%.

Conclusión
No todos los síntomas y signos en los pacientes con lesiones de cuello son predictivas de lesiones significativas que requieran cirugía.
Trauma en Mayores de 65 años. Experiencia en 2 Hospitales Universitarios en Cali
Authors: Badiel Marisol , Loaiza Jhon Harry , Pino Luis Fernando , Aboutanos Michael , Cepeda Magda Cristina 
Published: June 2013

RESUMEN

Introducción
Colombia es uno de los países con más morbimortalidad secundaria a lesiones por violencia. Se esperaría que este fenómeno se refleje en todos los grupos de edad. Sin embargo no se ha descrito que sucede en la población del adulto mayor. El objetivo fue describir la tendencia del trauma en la población que consulta a dos hospitales de referencia en Cali.

Materiales y métodos
Entre enero y abril de 2012 se implementó el piloto del Registro Internacional de Trauma de la Sociedad Panamericana de Trauma. Incluye la información sociodemográfica, causas, severidad del trauma, escala de Glasgow (GCS) y estatus al egreso en sujetos de 65 años y más.

Resultados
En este periodo incluimos, 5432 pacientes, de ellos el 7.8% (n = 423) fueron mayores de 65+ años y el 43.1% hombres. La edad fue 77 ± 8.5 años. El mecanismo de trauma más frecuente fue caídas 298 (70.4%), el 77% de estas ocurridas en el domicilio y 12.5% en la calle. El promedio de GCS fue 14.4 ± 2.1 y de ISS fue 5.3 ± 5.7. Las lesiones más frecuentes fueron: contusiones (44.6%), fracturas (15.6%) y trauma craneoencefálico (14.2%). Fueron hospitalizados 109 (25.8%), promedio de estancia en UCI fue 4.8 ± 4 (días) y total 5.4 ± 6.5 (días). Mortalidad global de 4.73% (20/423); se presentó más en pacientes con lesiones en cabeza (50%) y cadera (15%).

Conclusión
El riesgo de trauma en sujetos de 65+ años es alto. La principal causa son las caídas. Las causas de las lesiones son modificables. En particular para este grupo de edad, las acciones de educación y prevención tendrían gran impacto social y económico dado el costo que tiene la atención de estos pacientes y sus pobres resultados dadas las complicaciones en la atención y las secuelas posteriores.
Canadian Traumatologists and the Recognition of Occult Shock: Results of a National Survey
Authors: Zakrison Tanya L , Leung Eman , McCredie Victoria , Nathens Avery B , Diez Christian , Namias Nicholas 
Published: June 2013

ABSTRACT

Introduction and objective
Occult shock (OS) is important to recognize early in trauma patients, before perturbations in vital signs occur. Early trauma resuscitation is multidisciplinary in Canada. It is unclear how well Canadian traumatologists of all types recognize OS. Our objective was to explore the knowledge of OS in Canadian traumatologists.

Materials and methods
An on-line national survey was created for all multidisciplinary members of the Trauma Association of Canada (TAC). Survey questions explored the awareness, screening, prevalence, outcomes and treatment of occult and early shock.

Results
Response rate for TAC membership overall was 45%. Overall, 78% of respondents were aware of OS and 96% felt that trauma centers should be screening for this. Traumatologists were largely uncertain as to how many patients presented to their institutions in OS, or were screened for such an entity. One out of every five Canadian traumatologists did not know how to screen for OS with over half still relying on changes in vital signs for early detection. Fifty-eight percent of Canadian traumatologists only draw blood gases on patients that are already hemodynamically abnormal. The most effective way to reverse OS remained elusive.

Conclusion
Most Canadian traumatologists recognize OS as an important clinical entity with significant morbidity and mortality. Trauma patients, however, are largely being screened late, once vital signs have changed. This may have an impact on patient care across Canada. It is unclear if this practice pattern persists throughout the Americas with inherent ramifications in quality of care and patient safety. Clinical equipoise exists in the resuscitation of OS.

How to cite this article
Zakrison TL, Leung E, McCredie V, Nathens AB, Diez C, Rizoli S, Namias N. Canadian Traumatologists and the Recognition of Occult Shock: Results of a National Survey. Panam J Trauma Critical Care Emerg Surg 2013;2(1):33-36.
Impact of Crystalloid to PRBC Ratio in Patients with Exsanguinating Penetrating Abdominal Injuries: The Conundrum of Resuscitation
Authors: Unruh Marie , Duke Marquinn , Meade Peter , McSwain Norman E , Duchesne Juan C 
Published: June 2013

ABSTRACTBackgroundWhen intraoperative hemostatic resuscitation (IHR) implements high transfusion ratios of FFP:PRBC (>1:2), there is an associated increased survival in patients with exsanguinating penetrating abdominal injuries (EPAI). The impact of crystalloids: PRBC during IHR has not been analyzed. We hypothesize that minimizing the amount of intraoperative crystalloids:PRBC in combination with high ratio FFP: PRBC will correlate with a survival benefit in patients with EPAI.MethodsThis was a 9-year retrospective analysis of patients with EPAI at a Level 1 Trauma Center. EPAI was defined as any patient who received >20 units of PRBC during IHR. Intraoperative ratio for FFP:PRBC was recorded, and patients were placed in three separate categories accordingly: high (>1:2), mid (1:4 - 1:2), and low ratio (<1:4) groups. Quantity of crystalloids used during each category was recorded and a ratio of crystalloids:PRBC calculated. Logistic regression model was applied to analyze impact of crystalloid:PRBC on mortality, comparing the high FFP:PRBC ratio group to the low FFP: PRBC ratio group.ResultsIntraoperative high ratio FFP:PRBC conveyed a 32% overall survival benefit when compared with low ratio groups. Patients that received a high ratio FFP:PRBC when compared to low ratio group, received less intraoperative crystalloids (calculated crystalloids:PRBC ratios 1:3.4vs1:1.1; p = 0.001). Our logistic regression demonstrated a survival benefit with a high FFP:PRBC [OR 95%;0.19 , CI (0.05-0.33), p = 0.003] and the calculated low crystalloid:PRBC [OR 95%; 0.11 CI (0.01- 0.59), p = 0.001].ConclusionWe were able to demonstrate a survival advantage in patients with EPAI that received IHR of a high ratio of FFP:PRBC and a low ratio of crystalloids:PRBC. These findings suggest that in patients with EAPI requiring massive volumes of PRBC, the ratio of intraoperative FFP:PRBC should be high and crystalloids:PRBC should be low.How to cite this articleGuidry C, Unruh M, Duke M, Meade P, McSwain NE Jr, Duchesne JC. Impact of Crystalloid to PRBC Ratio in Patients with Exsanguinating Penetrating Abdominal Injuries: The Conundrum of Resuscitation. Panam J Trauma Critical Care Emerg Surg 2013;2(1):52-57.