bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is current serologic RhD typing of blood donors sufficient for avoiding immunization of recipients? (CME)
Authors: Krog Grethe Risum , Clausen Frederik Banch , Berkowicz Adela , Jørgensen Lone , Rieneck Klaus , Nielsen Leif Kofoed , Dziegiel Morten Hanefeld 
Published: May 2011

BACKGROUND: Avoiding immunization with clinically important antibodies is a primary objective in transfusion medicine. Therefore, it is central to identify the extent of D antigens that escape routine RhD typing of blood donors and to improve methodology if necessary.STUDY DESIGN AND METHODS: We screened 5058 D− donors for the presence of the RHD gene, targeting Exons 5, 7, and 10 with real‐time polymerase chain reaction. Samples that were positive in the screen test were investigated further by adsorption‐elution, antibody consumption, flow cytometry, and sequencing of all RHD exons with intron‐specific primers. Lookback was performed on all recipients of RBCs from RHD+ donors.RESULTS: We found 13 RHD+ samples (0.26%). No variants or chimeras were found. Characterization of DNA revealed a novel DEL type (IVS2‐2 A>G). In the lookback of the 136 transfusions with subsequent antibody follow‐up, of which 13 were from DEL donors, one recipient developed anti‐D. However, in this case, a competing and more likely cause of immunization was the concurrent transfusion of D+ platelets. Eleven recipients were immunized with 13 antibodies different from anti‐D, of which five were anti‐K.CONCLUSION: In our laboratory, serologic RhD typing was safe. We detected all D variants and only missed DEL types. In assessing the immunization risk we included a DEL donor, found previous to this study, that did immunize a recipient with anti‐D. We conclude that inadvertent immunization with D antigens in our setting was rare and in the order of 1.4 in 100,000 D− transfusions.
Knops blood group polymorphism and susceptibility to Mycobacterium tuberculosis infection
Authors: Noumsi Ghislain T. , Tounkara Anatole , Diallo Hama , Billingsley Katrina , Moulds John J. , Moulds Joann M. 
Published: May 2011

BACKGROUND: Complement receptor 1 (CR1) protein carries the Knops blood group antigens and is the receptor for the major ligand involved in Mycobacterium tuberculosis (Mtb) adhesion to macrophages. Erythrocyte CR1 binds immune complexes (ICs) formed during Mtb invasion, facilitating their clearance by the host immune system. The occurrence of specific Knops blood group genotypes among African populations was investigated to evaluate their impact on resistance or susceptibility to Mtb infection.STUDY DESIGN AND METHODS: The distribution of the Knops blood group genotypes (McC and Sl) was compared between tuberculosis (TB) patients with confirmed diagnosis of Mtb in isolates and negative controls. Conditional logistic regression was used to access the association between genotypes distribution and susceptibility to Mtb infection.RESULTS: At the McC locus, individuals heterozygous (McCa/McCb) were more resistant to Mtb infection (odds ratio [OR], 0.42; 95% confidence interval [CI], 0.22‐0.81; p = 0.007). Although less significant, a similar effect was conferred by Sl1/Sl2 genotype (OR, 0.05; 95% CI, 0.28‐0.9; p = 0.02). This protective effect was maintained among individuals presenting the McCb/Sl2 haplotype (OR, 0.25; 95% CI, 0.08‐0.74; p = 0.008).CONCLUSION: Acquisition of McCb and Sl2 alleles among African population is correlated with resistance to Mtb infection, adding this bacterium to the list of mechanisms underlying the selection of the Knops blood group polymorphism among these populations.
Stored red blood cell viability is maintained after treatment with a second‐generation S‐303 pathogen inactivation process
Authors: Cancelas Jose A. , Dumont Larry J. , Rugg Neeta , Szczepiorkowski Zbigniew M. , Herschel Louis , Siegel Alan , Pratt P. Gayle , Worsham D. Nicole , Erickson Anne , Propst Meisa , North Anne , Sherman Claire D. , Mufti Nina A. , Reed William F. , Corash Laurence 
Published: May 2011

BACKGROUND: Transfusion‐transmitted infections and immunologic effects of viable residual lymphocytes remain a concern in red blood cell (RBC) transfusion. Pathogen reduction technologies for RBC components are under development to further improve transfusion safety. S‐303 is a frangible anchor‐linker‐effector with labile alkylating activity and a robust pathogen reduction profile. This study characterized the viability of RBCs prepared with a second‐generation S‐303 process and stored for 35 days.STUDY DESIGN AND METHODS: This was a two‐center, single‐blind randomized, controlled, crossover study in 27 healthy subjects. S‐303 (test) or control RBCs were prepared in random sequence and stored for 35 days, at which time an aliquot of radiolabeled RBCs was transfused. The 24‐hour recovery, RBC life span, and in vitro metabolic and viability variables were analyzed.RESULTS: The mean 24‐hour RBC recovery and hemolysis of test RBCs were similar to control RBCs and were consistent with the Food and Drug Administration (FDA) guidance for RBC viability. The mean differences in life span and median life span (T50) of circulating test RBCs were 13.7 and 6.8 days, while the mean difference in the area under the curve of surviving RBCs was 1.38%, in favor of control RBCs. There were no clinically relevant abnormal laboratory values after the infusion of test RBCs. All crossmatch assays of autologous S‐303 RBCs were nonreactive.CONCLUSIONS: RBCs prepared using the S‐303 pathogen inactivation process were physiologically and metabolically suitable for transfusion after 35 days of storage, met the FDA guidance criteria for 24‐hour recovery, and did not induce antibody formation.
Exploring the dynamics of the theory of planned behavior in the context of blood donation: does donation experience make a difference?
Authors: Veldhuizen Ingrid , Ferguson Eamonn , de Kort Wim , Donders Rogier , Atsma Femke 
Published: May 2011

BACKGROUND: This study investigates the influence of different variables from the theory of planned behavior (TPB) on intention within multiple donation categories, covering the entire range of lifetime number of donations (LND). Does the same set of variables predict intention equally strong throughout the donor career?STUDY DESIGN AND METHODS: Measures of intention, self‐efficacy, cognitive and affective attitude, and subjective and moral norms were assessed within a sample of 11,480 whole blood donors. Donors were categorized into 65 donation classes using their LND; for example, all donors with one donation (n = 483) in the first donation class, all donors with two donations (n = 447) in the second donation class, and so on. For each donation class, separately for men and women, linear multiple regression models for intention were fitted using self‐efficacy, cognitive attitude, affective attitude, subjective norm, and moral norm as predictor variables.RESULTS: During all stages of the donor career, self‐efficacy is the main predictor of intention, with a relatively constant beta (β = 0.64, p < 0.001). Cognitive attitude (β = 0.11, p < 0.001) and moral norm (β = 0.10, p < 0.001) contributed marginally to the prediction. Several sex effects were observed; self‐efficacy is a stronger predictor of intention in women, whereas subjective norm predicts intention in men only.CONCLUSION: Regardless of the number of lifetime donations, the same set of TPB variables, both in composition and in relative strength, predicts intention. A feeling of self‐efficacy remains equally important for all donors. It is worthwhile to study whether directed intervention strategies are necessary to target self‐efficacy within donor groups with different levels of donation experience.
Earnings Smoothing, Executive Compensation, and Corporate Governance: Evidence From the Property–Liability Insurance Industry
Authors: Eckles David L. , Halek Martin , He Enya , Sommer David W. , Zhang Rongrong 
Published: May 2011

AbstractUnlike studies that estimate managerial bias, we utilize a direct measure of managerial bias in the U.S. insurance industry to investigate the effects of executive compensation and corporate governance on firms’ earnings management behaviors. We find managers receiving larger bonuses and stock awards tend to make reserving decisions that serve to decrease firm earnings. Moreover, we examine the monitoring effect of corporate board structures in mitigating managers’ reserve manipulation practices. We find managers are more likely to manipulate reserves in the presence of particular board structures. Similar results are not found when we employ traditional estimated measures of managerial bias.
Measures of Crowding in the Emergency Department: A Systematic Review
Authors: Hwang Ula , McCarthy Melissa L. , Aronsky Dominik , Asplin Brent , Crane Peter W. , Craven Catherine K. , Epstein Stephen K. , Fee Christopher , Handel Daniel A. , Pines Jesse M. , Rathlev Niels K. , Schafermeyer Robert W. , Zwemer, Jr. Frank L. , Bernstein Steven L. 
Published: May 2011

ACADEMIC EMERGENCY MEDICINE 2011; 18:527–538 © 2011 by the Society for Academic Emergency MedicineAbstractObjectives:  Despite consensus regarding the conceptual foundation of crowding, and increasing research on factors and outcomes associated with crowding, there is no criterion standard measure of crowding. The objective was to conduct a systematic review of crowding measures and compare them in conceptual foundation and validity.Methods:  This was a systematic, comprehensive review of four medical and health care citation databases to identify studies related to crowding in the emergency department (ED). Publications that “describe the theory, development, implementation, evaluation, or any other aspect of a ‘crowding measurement/definition’ instrument (qualitative or quantitative)” were included. A ”measurement/definition” instrument is anything that assigns a value to the phenomenon of crowding in the ED. Data collected from papers meeting inclusion criteria were: study design, objective, crowding measure, and evidence of validity. All measures were categorized into five measure types (clinician opinion, input factors, throughput factors, output factors, and multidimensional scales). All measures were then indexed to six validation criteria (clinician opinion, ambulance diversion, left without being seen (LWBS), times to care, forecasting or predictions of future crowding, and other).Results:  There were 2,660 papers identified by databases; 46 of these papers met inclusion criteria, were original research studies, and were abstracted by reviewers. A total of 71 unique crowding measures were identified. The least commonly used type of crowding measure was clinician opinion, and the most commonly used were numerical counts (number or percentage) of patients and process times associated with patient care. Many measures had moderate to good correlation with validation criteria.Conclusions:  Time intervals and patient counts are emerging as the most promising tools for measuring flow and nonflow (i.e., crowding), respectively. Standardized definitions of time intervals (flow) and numerical counts (nonflow) will assist with validation of these metrics across multiple sites and clarify which options emerge as the metrics of choice in this “crowded” field of measures.
Effect of an Educational Intervention on Faculty and Resident Satisfaction with Real‐time Feedback in the Emergency Department
Authors: Yarris Lalena M. , Fu Rongwei , LaMantia Joseph , Linden Judith A. , Gene Hern H. , Lefebvre Cedric , Nestler David M. , Tupesis Janis , Kman Nicholas ,   on behalf of the Emergency Medicine Education Research Group (EMERGe)
Published: May 2011

Academic Emergency Medicine 2011; 18:504–512 © 2011 by the Society for Academic Emergency MedicineAbstractObjectives:  Effective real‐time feedback is critical to medical education. This study tested the hypothesis that an educational intervention related to feedback would improve emergency medicine (EM) faculty and resident physician satisfaction with feedback.Methods:  This was a cluster‐randomized, controlled study of 15 EM residency programs in 2007–2008. An educational intervention was created that combined a feedback curriculum with a card system designed to promote timely, effective feedback. Sites were randomized either to receive the intervention or to continue their current feedback method. All participants completed a Web‐based survey before and after the intervention period. The primary outcome was overall feedback satisfaction on a 10‐point scale. Additional items addressed specific aspects of feedback. Responses were compared using a generalized estimating equations model, adjusting for confounders and baseline differences between groups. The study was designed to achieve at least 80% power to detect a one‐point difference in overall satisfaction (α = 0.05).Results:  Response rates for pre‐ and postintervention surveys were 65.9 and 47.3% (faculty) and 64.7 and 56.9% (residents). Residents in the intervention group reported a mean overall increase in feedback satisfaction scores compared to those in the control group (mean increase 0.96 points, standard error [SE] ± 0.44, p = 0.03) and significantly higher satisfaction with the quality, amount, and timeliness of feedback. There were no significant differences in mean scores for overall and specific aspects of satisfaction between the faculty physician intervention and control groups.Conclusions:  An intervention designed to improve real‐time feedback in the ED resulted in higher resident satisfaction with feedback received, but did not affect faculty satisfaction with the feedback given.
Mathematical Modeling for Prediction of Survival From Resuscitation Based on Computerized Continuous Capnography: Proof of Concept
Authors: Einav Sharon , Bromiker Ruben , Weiniger Carolyn F. , Matot Idit 
Published: May 2011

ACADEMIC EMERGENCY MEDICINE 2011; 18:468–475 © 2011 by the Society for Academic Emergency MedicineAbstractObjectives:  The objective was to describe a new method of studying correlations between real‐time end tidal carbon dioxide (ETCO2) data and resuscitation outcomes.Methods:  This was a prospective cohort study of 30 patients who underwent cardiopulmonary resuscitation (CPR) in a university hospital. Sidestream capnograph data were collected during CPR and analyzed by a mathematician blinded to patient outcome. The primary outcome measure was to determine whether a meaningful relationship could be drawn between detailed computerized ETCO2 characteristics and the return of spontaneous circulation (ROSC). Significance testing was performed for proof‐of‐concept purposes only.Results:  Median patient age was 74 years (interquartile range [IQR] = 60–80 years; range = 16–92 years). Events were mostly witnessed (63%), with a median call‐to‐arrival time of 150 seconds (IQR = 105–255 seconds; range = 60–300 seconds). The incidence of ROSC was 57% (17 of 30), and of hospital discharge 20% (six of 30). Ten minutes after intubation, patients with ROSC had higher peak ETCO2 values (p = 0.035), larger areas under the ETCO2 curve (p = 0.016), and rising ETCO2 slopes versus flat or falling slopes (p = 0.016) when compared to patients without ROSC. Cumulative maxETCO2 > 20 mm Hg at all time points measured between 5 and 10 minutes postintubation best predicted ROSC (sensitivity = 0.88; specificity = 0.77; p < 0.001). Mathematical modeling targeted toward avoiding misdiagnosis of patients with recovery potential (fixed condition, false‐negative rate = 0) demonstrated that cumulative maxETCO2 (at 5–10 minutes) > 25 mm Hg or a slope greater than 0 measured between 0 and 8 minutes correctly predicted patient outcome in 70% of cases within less than 10 minutes of intubation.Conclusions:  This preliminary study suggests that computerized ETCO2 carries potential as a tool for early, real‐time decision‐making during some resuscitations.
Test Characteristics of Focused Assessment of Sonography for Trauma for Clinically Significant Abdominal Free Fluid in Pediatric Blunt Abdominal Trauma
Authors: Fox J. Christian , Boysen Megan , Gharahbaghian Laleh , Cusick Seric , Ahmed Suleman S. , Anderson Craig L. , Lekawa Michael , Langdorf Mark I. 
Published: May 2011

ACADEMIC EMERGENCY MEDICINE 2011; 18:477–482 © 2011 by the Society for Academic Emergency MedicineAbstractObjectives:  Focused assessment of sonography in trauma (FAST) has been shown useful to detect clinically significant hemoperitoneum in adults, but not in children. The objectives were to determine test characteristics for clinically important intraperitoneal free fluid (FF) in pediatric blunt abdominal trauma (BAT) using computed tomography (CT) or surgery as criterion reference and, second, to determine the test characteristics of FAST to detect any amount of intraperitoneal FF as detected by CT.Methods:  This was a prospective observational study of consecutive children (0–17 years) who required trauma team activation for BAT and received either CT or laparotomy between 2004 and 2007. Experienced physicians performed and interpreted FAST. Clinically important FF was defined as moderate or greater amount of intraperitoneal FF per the radiologist CT report or surgery.Results:  The study enrolled 431 patients, excluded 74, and analyzed data on 357. For the first objective, 23 patients had significant hemoperitoneum (22 on CT and one at surgery). Twelve of the 23 had true‐positive FAST (sensitivity = 52%; 95% confidence interval [CI] = 31% to 73%). FAST was true negative in 321 of 334 (specificity = 96%; 95% CI = 93% to 98%). Twelve of 25 patients with positive FAST had significant FF on CT (positive predictive value [PPV] = 48%; 95% CI = 28% to 69%). Of 332 patients with negative FAST, 321 had no significant fluid on CT (negative predictive value [NPV] = 97%; 95% CI = 94% to 98%). Positive likelihood ratio (LR) for FF was 13.4 (95% CI = 6.9 to 26.0) while the negative LR was 0.50 (95% CI = 0.32 to 0.76). Accuracy was 93% (333 of 357, 95% CI = 90% to 96%). For the second objective, test characteristics were as follows: sensitivity = 20% (95% CI = 13% to 30%), specificity = 98% (95% CI = 95% to 99%), PPV = 76% (95% CI = 54% to 90%), NPV = 78% (95% CI = 73% to 82%), positive LR = 9.0 (95% CI = 3.7 to 21.8), negative LR = 0.81 (95% CI = 0.7 to 0.9), and accuracy = 78% (277 of 357, 95% CI = 73% to 82%).Conclusion:  In this population of children with BAT, FAST has a low sensitivity for clinically important FF but has high specificity. A positive FAST suggests hemoperitoneum and abdominal injury, while a negative FAST aids little in decision‐making.
A longitudinal study of plasma levels of soluble fms‐like tyrosine kinase 1 (sFlt1), placental growth factor (PlGF), sFlt1: PlGF ratio and vascular endothelial growth factor (VEGF‐A) in normal pregnancy
Authors: PALM MARIA , BASU SAMAR , LARSSON ANDERS , WERNROTH LISA , ÅKERUD HELENA , AXELSSON OVE 
Published: May 2011

AbstractObjective. To describe plasma levels of angiogenic (PlGF, VEGF‐A) and anti‐angiogenic (sFlt1) factors as well as the sFlt1:PlGF ratio throughout normal pregnancy and postpartum. Design. Longitudinal prospective study. Setting. One outpatient antenatal clinic in Uppsala, Sweden. Population. Thirty‐seven healthy women with normal pregnancies and normal neonatal outcome were included. Methods. Blood samples were collected from each woman at least six times. Plasma levels of sFlt1, PlGF and VEGF‐A were measured using commercially available ELISA kits. Main outcome measures. Median plasma levels, the 25th to the 75th percentile and the average change per gestational week of sFlt1, PlGF and the sFlt1:PlGF ratio. Results. sFlt1 levels were relatively constant until weeks 29–30, when they increased, reaching a peak at week 40. An increase of 643pg/ml per week was observed from weeks 30 to 40. Postpartum levels were low. PlGF increased by 16pg/ml per week from early pregnancy until weeks 29–30 and thereafter decreased by 14pg/ml per week until week 40. The sFlt1:PlGF ratio decreased from weeks 9–12, was constantly low from weeks 19–20 to 37–38 and then increased to weeks 39–40. VEGF‐A was detectable in only 8% of the samples during pregnancy and in 64% postpartum. Conclusion. This longitudinal study demonstrates how sFlt1, PlGF and the sFlt1:PlGF ratio fluctuate throughout normal pregnancy and postpartum and may serve as a reference against which these factors can be studied in complicated pregnancies. VEGF‐A levels were more often detectable postpartum.
The A domain of fibronectin‐binding protein B of Staphylococcus aureus contains a novel fibronectin binding site
Authors: Burke Fiona M. , Di Poto Antonella , Speziale Pietro , Foster Timothy J. 
Published: May 2011

The fibronectin‐binding proteins FnBPA and FnBPB are multifunctional adhesins than can also bind to fibrinogen and elastin. In this study, the N2N3 subdomains of region A of FnBPB were shown to bind fibrinogen with a similar affinity to those of FnBPA (2 μm). The binding site for FnBPB in fibrinogen was localized to the C‐terminus of the γ‐chain. Like clumping factor A, region A of FnBPB bound to the γ‐chain of fibrinogen in a Ca2+‐inhibitable manner. The deletion of 17 residues from the C‐terminus of domain N3 and the substitution of two residues in equivalent positions for crucial residues for fibrinogen binding in clumping factor A and FnBPA eliminated fibrinogen binding by FnBPB. This indicates that FnBPB binds fibrinogen by the dock–lock–latch mechanism. In contrast, the A domain of FnBPB bound fibronectin with KD = 2.5 μm despite lacking any of the known fibronectin‐binding tandem repeats. A truncate lacking the C‐terminal 17 residues (latching peptide) bound fibronectin with the same affinity, suggesting that the FnBPB A domain binds fibronectin by a novel mechanism. The substitution of the two residues required for fibrinogen binding also resulted in a loss of fibronectin binding. This, combined with the observation that purified subdomain N3 bound fibronectin with a measurable, but reduced, KD of 20 μm, indicates that the type I modules of fibronectin bind to both the N2 and N3 subdomains. The fibronectin‐binding ability of the FnBPB A domain was also functional when the protein was expressed on and anchored to the surface of staphylococcal cells, showing that it is not an artifact of recombinant protein expression.Structured digital abstract
Fibronectin binds to fnbB by filter binding (View interaction)
Fibronectin binds to fnbB by surface plasmon resonance (View Interaction 1, 2)