bluuebunny/crossref_metadata_2025_split huggingface dataset:
Blood pack fault monitoring
Authors: Beckman N. , Nicholson G. , Ashford M. , Hambleton R. 
Published: December 2004

Background and Objectives  The National Blood Service (NBS) has recalled blood components as a result of manufacturing faults, or defective blood pack component parts leading to the possibility of an ‘open’ system. There has been an increase in the complexity of blood packs as a result of leucodepletion, sample diversion and sampling. The NBS implemented a mechanism to collate and analyse blood pack faults as a safety and quality initiative in conjunction with blood pack manufacturers.Materials and Methods  Standard reporting forms were produced and implemented at all Centres. The forms were collated and analysed using statistical analysis software. Control charts were used to identify trends for specific faults, which were resolved with the relevant manufacturer.Results  The overall defect rate per million for the three main blood pack manufacturers used by the NBS for the respective periods 2001, 2002 and 2003, were as follows: Manufacturer A, 1076, 1396 and 954; Manufacturer B, 1496, 1301 and 2169; and Manufacturer C, 1871, 1253 and 1392.Conclusions  Monitoring and analysis of blood pack faults has resulted in the identification and rectification of specific problems associated with blood pack manufacture and use. Close collaboration with manufacturers has enabled effective remedial action. Wider collation of data would provide an early warning of potential areas of concern.
Correlation between the extent of platelet activation in platelet concentrates and in vitro and in vivo parameters
Authors: Dijkstra‐Tiekstra M. J. , Pietersz R. N. I. , Huijgens P. C. 
Published: December 2004

Background and Objectives  Platelet activation, which is necessary to stop bleeding, also occurs in vitro during the storage of platelet concentrates (PCs). However, it is unknown whether in vitro‐activated platelets are able to reduce blood loss in the patient. We studied correlations between platelet activation in PCs and in vitro parameters (pH, platelet count, swirling effect, storage time). In addition, we studied the correlation between platelet activation and in vivo parameters [the volume of thorax drain fluid as a measure of blood loss, platelet count, international normalized ratio (INR), and activated partial thrombin time (APTT)] in a clinical pilot study.Materials and Methods  White blood cell‐reduced PCs prepared from five buffy coats and one plasma unit (n = 55; storage time: median, 5 days; range, 2–12 days) were sampled. Platelet activation (CD62p, CD63, CD42b), as measured by flow cytometry, pH, platelet count, swirling effect and storage time, was determined. For the in vivo pilot study, PCs (n = 21) stored for 2–7 days were also checked for the above parameters and transfused into patients (n = 21) immediately after coronary artery bypass graft surgery. The volume of thorax drain fluid was measured for up to 12 h after surgery, and the platelet count, INR and APTT were measured < 1 h and 16–24 h postsurgery.Results  A good correlation (r2 > 0·5) was observed between CD62p and CD63, between CD62p and CD42b, between CD62p or CD63 and pH and between CD62p or CD63 and swirling effect. Also, a significant increase in platelet activation was observed for PCs stored for ≥ 8 days (mean ± standard deviation: CD62p, 41·6 ± 30·7; CD63, 23·8 ± 18·6), compared to PCs stored for 2–7 days (mean ± standard deviation: CD62p, 12·3 ± 4·8; CD63, 10·4 ± 3·6). No correlation (r2 ≤ 0·1) was observed between platelet activation and the in vivo parameters.Conclusions  Although a correlation between platelet activation and in vitro parameters was observed, no correlation was found between platelet activation and in vivo parameters. Possible explanations for this are a too low variance in platelet activation in transfused PCs, and too small a number of patients.
Development of white blood cell fragments, during the preparation and storage of platelet concentrates, as measured by using real‐time polymerase chain reaction
Authors: Dijkstra‐Tiekstra M. J. , Van Der Schoot C. E. , Pietersz R. N. I. , Huijgens P. C. , Van Der Meer P. F. , Reesink H. W. 
Published: December 2004

Background and Objectives  White blood cell (WBC) fragments may cause human leucocyte antigen (HLA) immunization in recipients. We investigated the occurrence and production of WBC fragments in platelet concentrates (PCs) and plasma units, during storage and filtration, by using real‐time polymerase chain reaction (PCR) and flow cytometry.Materials and Methods  To study the occurrence of WBC fragments, ‘male’ WBCs were spiked into double‐filtered ‘female’ PCs in a concentration series of 0·03–100 WBCs/µl (n = 4 per level). To study the production of WBC fragments, ‘male’ WBCs were spiked into ‘female’ plasma units to 4 × 109 WBCs/l and stored at room temperature prior to filtration (n = 4 per storage time; t = 0, 24 or 48 h). DNA was measured by both albumin real‐time PCR and Y real‐time PCR. Intact WBCs were counted by using flow cytometry. The number of WBC fragments was calculated by subtracting cell‐free DNA (real‐time PCR on supernatant) and intact WBCs (flow cytometry) from the total DNA amount (real‐time PCR).Results  Spiking of ‘male’ WBCs into ‘female’ PCs showed that the Y real‐time PCR is linear and has a reproducible quantitative range down to 0·03 WBC/µl, but that the albumin‐PCR, in unspiked samples, revealed a total of 6–10 WBC equivalents/µl (eq/µl). After centrifugation, half of this was observed as cell‐free DNA in the supernatant, suggesting that the remaining DNA is derived from WBC fragments. The number of intact WBCs, amount of cell‐free DNA and number of WBC fragments after filtration increased significantly when filtration was delayed for up to 48 h, from 0·1 WBC/µl, 1·3 WBC eq/µl and 0·6 WBC eq/µl at t = 0 h to 25 WBC/µl, 38 WBC eq/µl and 57 WBC eq/µl at t = 48 h, respectively.Conclusions  WBC fragments occur in WBC‐reduced PCs and increase when products are stored, prior to filtration, up to levels that are equivalent to the amounts of intact WBCs that induce HLA immunization (i.e. > 5 × 106/unit).
Sociology and behaviour of West African blood donors: the impact of religion on human immunodeficiency virus infection
Authors: Allain J.‐P. , Anokwa M. , Casbard A. , Owusu‐Ofori S. , Dennis‐Antwi J. 
Published: December 2004

Background and Objectives  Ghana is one of the countries of sub‐Saharan Africa where the human immunodeficiency virus (HIV) prevalence in blood donors ranges between 1 and 4%. Considering the social importance of religion and the very high level of religious practice observed in Ghana, the hypothesis that these factors may play a role in containing HIV was tested.Materials and Methods  Consenting HIV‐infected candidate blood donors, and two age‐ and gender‐matched seronegative control donors, were asked to complete a questionnaire regarding their religious and sexual behaviour. Multivariable conditional logistic regression was used.Results  Irrespective of their HIV status or religion, 95% of the respondents believed that extra‐marital sex was a sin, and 79% of those tempted to have an extra‐marital affair considered that their religious beliefs helped them to abstain. In the multivariable models, having a formal role in church activities was associated with reduced odds of HIV [odds ratio (OR) = 0·41; 95% confidence interval (CI): 0·21–0·80]. Worshipping at the same location for more than 20 years was associated with a reduced risk (OR = 0·30; 95% CI: 0·08–1·10). In addition to other factors limiting HIV spread, such as male circumcision, relatively high level of education and an absence of armed conflicts in Ghana, the use of condoms conferred a reduced risk.Conclusions  An active role in religion, and reporting a lengthy duration of worship at the same place was beneficial. Collecting blood at places of worship with a strict behavioural code and from donors practicing in the community of their birth might improve blood safety.
Beyond floricentrism: The pollination function of inflorescences
Authors: HARDER LAWRENCE D. , JORDAN CRISPIN Y. , GROSS W. ERIC , ROUTLEY MATTHEW B. 
Published: December 2004

AbstractMating by outcrossing plants depends on the frequency and quality of the interaction between pollen vectors and individual flowers. However, the historical focus of pollination biology on individual flowers (floricentrism) cannot produce a complete understanding of the role of pollination in plant mating because mating is an aggregate process, which depends on the reproductive outcomes of all of a plant’s flowers. Simultaneous display of multiple flowers in an inflorescence increases a plant’s attractiveness to pollinators, which should, in general, enhance mating opportunities. However, whenever pollinators visit multiple flowers on an inflorescence, self‐pollination among flowers can reduce the pollen available for export to other plants (pollen discounting) and can increase the incidence of inbreeding depression for embryos and offspring. Therefore, the size of floral displays that maximize mating frequency and quality generally balance the benefits of attractiveness against the costs of self‐pollination. This balance can shift considerably if different flowers serve female and male functions at one time (sexual segregation) and flowers are arranged in inflorescences so that pollinators visit female flowers before male flowers. However, the effectiveness of sexual segregation depends on the extent to which a particular inflorescence architecture induces consistent movement patterns by pollinators. In general, the consistency of pollinator movement patterns varies with inflorescence architecture and differs between pollinator types. Such variation creates many options for the evolution of the diverse inflorescence characteristics observed within angiosperms, which can be appreciated only by moving beyond a floricentric perspective of the role of pollination in plant mating.
Using a cost–benefit approach to understand the evolution of self‐fertilization in plants: the perplexing case of Aquilegia canadensis (Ranunculaceae)
Authors: ECKERT CHRISTOPHER G. , HERLIHY CHRISTOPHER R. 
Published: December 2004

AbstractPlants exhibit tremendous variation in whether mating occurs via self‐fertilization versus outcrossing, and many species practice a mixture of both. In theory, the evolution of selfing is influenced by a few large costs and benefits, and the benefits of selfing should be balanced by its costs at equilibrium. We have attempted a cost–benefit analysis of selfing, using population genetic surveys, experimental manipulations and quantitative genetics to a spring‐flowering, short‐lived perennial, Aquilegia canadensis. This species invests heavily in large, nectar‐rich flowers but achieves full seed set in the absence of pollinators by automonous autogamy, and selfs 76% of its seed in natural populations. Floral emasculations reveal that 75% of selfing occurs via autogamy, which increases per‐flower seed production (reproductive assurance), but pre‐empts ovules and resources that could be used to make outcrossed seed (seed discounting). This is costly because outcrossed progeny appear to survive to maturity 10‐fold more often than selfed progeny. Almost all the apparent nonautogamous selfing involves cross‐pollination between relatives (biparental inbreeding). This could facilitate the evolution of mixed mating, but not when inbreeding is so strong. Though selfing seems strongly disadvantageous, A. canadensis exhibits striking heritable variation in the separation between anthers and stigmas within flowers (herkogamy), which correlates negatively with selfing. This suggests that the mating system is at equilibrium. There is no applicable theoretical explanation for high selfing in the face of strong inbreeding depression, which occurs in a variety of plants. Understanding the evolution of these enigmatic mating systems remains a major challenge.
EFFECT OF ARGON PLASMA COAGULATION IN PATIENTS WITH UPPER GASTROINTESTINAL ACTIVE HEMORRHAGE
Authors: Komatsu Hirokazu , Hara Yuriko , Naito Yoshitaka , Hosaka Yoshio , Yamanaka Shigeru , Masuda Hideaki , Imamura Kiyoko 
Published: December 2004

Background:  Acute upper gastrointestinal hemorrhage is a common and life‐threatening medical emergency. Despite a large number of endoscopic methods for hemostasis, active bleeding lacks an adequate therapeutic remedy. The aim of the present study was to evaluate the hemostatic effect of argon plasma coagulation on upper gastrointestinal active bleeding, especially in comparison with heater probe and pure ethanol injection therapy.Methods:  Sixty‐eight patients with 77 lesions presenting active bleeding were treated endoscopically and divided into three groups depending on the procedures, that is, argon plasma coagulation group (27 patients with 32 lesions), heater probe group (20 patients with 22 lesions) and pure ethanol injection group (21 patients with 23 lesions). The three groups were similar with respect to all background variables. Episodes of rebleeding were retreated with the same modality as used previously.Results:  The primary hemostatic rate in the argon plasma coagulation group was 81.3%, that in the heater probe group was 77.3%, and that in the pure ethanol injection group was 87.0%. The permanent hemostatic rate in the argon plasma coagulation group was 75.0%, that in the heater probe group was 63.6%, and that in the pure ethanol injection group was 78.3%. When examined in terms of Forrest's criteria, the argon plasma coagulation group in Forrest's type I b and the pure ethanol injection group in type I a showed the highest permanent hemostatic rate.Conclusions:  Argon plasma coagulation is most suitable in arresting oozing hemorrhage. If pure ethanol injection therapy is possible, it is more effective than other therapies in the case of spurters.
THREE‐DIMENSIONAL ENDOSCOPIC COLOR DOPPLER ULTRASONOGRAPHY OF ESOPHAGEAL VARICES
Authors: Sato Takahiro , Yamazaki Katsu , Akaike Jun , Toyota Jouji , Karino Yoshiyasu , Ohmura Takumi , Kuwata Yasuaki , Suga Toshihiro 
Published: December 2004

Background:  Endoscopic color Doppler ultrasonography (ECDUS) is a method for obtaining color flow images in blood vessels. In the present study, we evaluated the usefulness of three‐dimensional endoscopic color Doppler ultrasonography (3D‐ECDUS) using electronic radial ECDUS.Methods:  Five patients with esophageal varices were studied. The technique of ECDUS was performed using a Pentax EG3630‐UR (forward‐view) with a distal tip diameter of 12 mm. The instrument (electronic radial array) has a curved array scanning transducer with variable frequency (5.0, 7.5, 10.0 MHz) and B mode/color Doppler/power Doppler capability. A Hitachi EUB 8500 was used for the display, which provided a 270° image. We monitored the color flow images of esophageal varices, paraesophageal veins and perforating veins. Scanning was performed from the cardiac part of the stomach to the distal esophagus by moving the instrument. After completing the examination, 3D‐ECDUS images were reconstructed.Results:  Color flow images of esophageal varices and paraesophageal veins were obtained in five of the five patients. Color flow images of perforating veins were obtained in five of the five patients with 3D‐ECDUS. 3D‐ECDUS clearly delineated the continuity of vessels from the cardiac varices to the esophageal varices, and between the perforating veins and esophageal varices. Furthermore, 3D‐ECDUS clearly showed the continuity of vessels from the anterior branch of the left gastric vein to the esophageal varices and from the posterior branch of the left gastric vein to the paraesophageal veins.Conclusion:  3D‐ECDUS more clearly provides visualization of vessel continuity in esophageal varices, which allows for better understanding of the hemodynamics of esophageal variceal cases.
RELATIONSHIP BETWEEN PULSE WAVE VELOCITY AND CIRCULATORY HEMODYNAMICS DURING UPPER GASTROINTESTINAL ENDOSCOPY
Authors: Uemura Eiko , Nomura Masahiro , Uehara Kohzo , Sawa Yuko , Nakaya Yutaka , Ito Susumu 
Published: December 2004

Background:  Arterial stiffness has recently been proposed as a powerful independent predictor of cardiovascular disease. The aim of the present study was to establish the relationship between aortic stiffness and circulatory complications during gastrointestinal endoscopy using pulse wave velocity (PWV) as a parameter.Methods:  We serially monitored standard 12‐lead ECGs, blood pressure, and percutaneous arterial oxygen saturation during gastrointestinal endoscopy, and performed a spectral analysis of heart rate variability and an analysis of QT dispersion. We also performed a logistic multivariate analysis of the severity of atherosclerosis and changes in the circulatory kinetics using PWV.Results:  In the elderly group (older than 65 years), the rate of decrease in parasympathetic nervous activity and rate of change in blood pressure and QT dispersion were significantly larger than those in the non‐elderly group (younger than 65 years) (P < 0.05). However, a multivariate analysis showed that the relative risk for the grade of atherosclerosis was greater in an evaluation by PWV than by age.Conclusions:  We conclude that the grade of atherosclerosis, as evaluated from PWV, is a stronger predictive factor for changes in circulatory kinetics during gastrointestinal endoscopy than age. PWV screening may facilitate the prevention of cardiac accidents during gastrointestinal endoscopy to some degree.
USEFULNESS OF MULTI DETECTOR ROW COMPUTED TOMOGRAPHY FOR DETECTION OF FLAT AND DEPRESSED COLORECTAL CANCER
Authors: Izumiya Takashi , Hirata Ichiro , Hamamoto Norihiro , Matsuki Mitsuru , Narabayashi Isamu , Nishiguchi Kanji , Okuda Junji , Tanigawa Nobuhiko , Katsu Ken‐ichi 
Published: December 2004

Background:  Recently, the clinical usefulness of colorectal cancer screening by CT colonography has been reported in Europe and the USA. However, in Japan, the diagnosis of flat or depressed colorectal cancer lesions has been emphasized, and the question of whether CT colonography facilitates visualization of these lesions remains to be answered. In the present study, we compared the visualization of flat and depressed colorectal cancer lesions by CT colonography with that of protruding lesions.Methods:  We investigated 33 Dukes A colorectal cancer lesions that had been examined by 3D‐CT, colonoscopy, and barium enema prior to surgery. In all patients, CT colonography was performed immediately after colonoscopy. Volume rendering was used for 3‐D rearrangement, and imaging findings were examined with respect to morphology, tumor diameter, and tumor height.Results:  All (14/14) of the protruding‐type lesions were visualized by CT colonography, whereas 78.9% (15/19) of the flat and depressed‐type lesions were visualized. There was no significant difference in tumor diameter between protruding‐type lesions and flat and depressed‐type lesions. With respect to tumor height, 100% of the lesions measuring 2 mm or more in height were visualized, whereas only 42.9% of those measuring less than 2 mm in height were visualized; the difference was significant (P < 0.001).Conclusions:  These results suggest that the visualization capacity of CT colonography is associated with tumor height, but not with tumor diameter. Currently, lesions measuring 2 mm or more in height can be visualized reliably by CT colonography.
PATHOLOGICAL AND MOLECULAR‐BIOLOGICAL STUDIES ON SEQUENCE FROM REFLUX ESOPHAGITIS TO DEVELOPMENT OF BARRETT's ADENOCARCINOMA
Authors: Wada Ryo , Yamaguchi Toshikazu , Tanizaki Takayuki 
Published: December 2004

Background:  Barrett's adenocarcinoma is considered to develop via a dysplasia‐carcinoma sequence. However, this theory is thought to be incomplete, because the reports supporting it have been led by an investigation using relatively large‐sized neoplasias or biopsy materials. We think that the minute‐sized neoplasias and the propria mucosa adjacent to these lesions must be examined histologically to clarify the histogenesis of digestive tract carcinoma. In the present study, new findings on the histogenesis of Barrett's adenocarcinoma were revealed according to this point described above.Methods:  First, Barrett's epithelium (in particular, specialized colmunar epithelium: SCE) was investigated histologically and immunohistochemically. Second, 28 lesions of the super‐minute tubular neoplasia within 1 mm in maximum diameter in Barrett's esophagus (SMBa) were detected by pathological examinations, and loss of heterozygosity of microsatellite markers (TP53, D17S796 and D17S786) in chromosome 17‐related p53 (p53‐LOH) in these SMBa lesions were examined by DNA extraction using microdissection and high resolution fluorescence labeled PCR primers.Results:  Histological and immunohistochemical findings showed that the tubules of SCE had a three‐layer structure and typical SCE should be thought to be the large bowel‐type of the intestinal metaplasia (or goblet cell metaplasia) in the cardiac gland mucosa. According to the overexpression of p53 protein labeling index (p53‐LI), the SMBa lesions were divided into two groups. Three lesions with p53‐LI over 90%, which were thought to be intramucosal adenocarcinoma morphologically, showed high frequency of p53‐LOH (loss of heterozygosity) (100%), and 25 lesions with an average p53‐LI of 58%, which were thought to be benign neoplasia morphologically, also showed p53‐LOH (36%).Conclusions:  SCE is thought to be the large bowel type of the intestinal metaplasia in the cardiac gland mucosa. Pathological and molecular‐biological findings of SMBa in SCE supports the dysplasia‐carcinoma sequence in the histogenesis of Barrett's cancer and synchronously some SMBa suggests that there is a different route, the so‐called de novo carcinoma theory.
Employability in the Undergraduate Curriculum: some student perspectives
Authors: YORKE MANTZ 
Published: December 2004

AbstractGovernment policy around the world is heavily influenced by a ‘human capital’ perspective. Education systems are pressed towards developing young people for their roles in the labour market: in the UK this is signalled in the term ‘employability’. Curricula differ in the ways in which they respond. Data are provided from three recent UK surveys that bear on employability and are discussed with reference to the USEM account of employability.