bluuebunny/crossref_metadata_2025_split huggingface dataset:
Electronic spectroscopy of 1-cyanonaphthalene cation for astrochemical consideration
Authors: Daly Francis C. , Palotás Julianna , Jacovella Ugo , Campbell Ewen K. 
Published: August 2023

Context. Polycyclic aromatic hydrocarbons (PAHs) are believed to be the carriers of the aromatic infrared bands and have been proposed as candidates to explain other astronomical phenomena such as diffuse interstellar bands (DIBs). The first aromatic structures possessing more than one ring, 1- and 2-cyanonaphthalene (CNN), were recently detected by rotational spectroscopy in the dense molecular cloud TMC-1. Laboratory investigations have indicated that due to fast and efficient relaxation through recurrent fluorescence (RF), CNN+ may be photostable in the harsh conditions of the lower density, more diffuse regions of the interstellar medium (ISM) exposed to ultraviolet (UV) radiation. As a result, it has been suggested that the widely held belief that small PAHs present in these regions are dissociated may need to be revisited. If 1-CNN+ is able to survive in the diffuse ISM it may contribute to the population of 1-CNN observed in TMC-1. To investigate the abundance of 1-CNN+ in diffuse clouds, laboratory spectroscopy is required. The present work concerns the electronic spectroscopy of 1-CNN+ in absorption and the search for its spectroscopic fingerprints in diffuse clouds.
Aims. The aim is to obtain laboratory data on the electronic transitions of gas-phase 1-CNN+ under conditions appropriate for comparison with DIBs and assess abundance in diffuse clouds.
Methods. Spectroscopic experiments are carried out using a cryogenic ion trapping apparatus in which gas-phase 1-CNN+ is cooled to temperatures below 10 K through buffer gas cooling. Calculations are carried out using time-dependent density-functional theory.
Results. Experimental and theoretical data on the D2 ← D0 and D3 ← D0 electronic transitions of 1-CNN+ are reported. The former transition has a calculated oscillator strength of f = 0.075 and possesses a pattern dominated by its origin band. The origin band is located at 7343 Å and has a full width at half maximum of 28 Å. In observational data, this falls in a region polluted by telluric water lines, hindering assessment of its abundance.
Conclusions. Space-based observations are required to search for the spectroscopic signatures of 1-CNN+ and evaluate the hypothesis that this small aromatic system, stabilised by RF, may be able to survive in regions of the ISM exposed to UV photons.
A Modified Collection and Rapid Infusion System for Shed Whole Blood Autotransfusion During Aortic Aneurysm Surgery
Authors: Dekkers René J. , Rizzo Robert J. , Fitzgerald Daniel J. , Cohn Lawrence H. 
Published: August 2023

We describe our experience in 10 patients (5 males) undergoing resection of a descending thoracic aortic aneurysm or a thoracoabdominal aortic aneurysm in which a modified shed whole blood collection and autotransfusion system was used. This modification allows several options for the processing and autotransfusion of shed blood: use of the cell saving device or the ultrafiltration of collected blood, and the autotransfusion of unprocessed shed whole blood. Either low dose heparin or sodium citrate was used for anticoagulation.
All 10 patients underwent autotransfusion and volume resuscitation with the modified rapid infusion device. Total autotransfusion ranged from 1400 ml to 7843 ml. Ultrafiltration volumes ranged from 600 ml to 1100 ml. There were no intraoperative deaths and no patient reoperations for bleeding. Arterial blood gases, potassium, and platelet counts were all within the normal laboratory ranges. This modification enables the clinician to process poor quality shed blood and reinfuse whole blood, in an attempt to decrease the need for homologous blood products.
Pumpless Arterial-Venous Extracorporeal CO2 Removal During Acute Lung Injury
Authors: Cappellett Dominic D. , Olshove Vincent , Tallman Richard D. 
Published: August 2023

Acute Respiratory Distress Syndrome (ARDS) is associated with high morbidity and mortality. It has been shown that extracorporeal CO2 removal (ECCO2R) can be used to supplement mechanical ventilatory support for ARDS patients. This makes it possible to reduce the amount of positive pressure ventilation, thus reducing cardiovascular compromise and barotrauma, promoting lung rest and healing.
We have been evaluating a pumpless arterial-venous ECCO2R circuit with a priming volume of approximately 150 ml. A 0.8 m2 hollow fiber membrane oxygenator was studied in 5 dogs (average weight= 27.8 kg) anesthetized with sodium pentobarbital. A femoral artery and vein were cannulated with 17 Fr cannulae. The blood flow through this circuit averaged 1.11 1/min or approximately 23% of the animal's cardiac output. Acute lung injury was induced with oleic acid, (100 mg/kg). Following lung injury, the pulmonary shunt increased by 69% over baseline, while the pulmonary artery pressure increased from 12.7 to 18.7 mmHg. Despite this lung injury, pump less arterial-venous ECCO2R was able to support all of the animal's CO2 exchange without ventilating the native lungs, which were held inflated with oxygen at 5 cmH2O.
The results of this study indicate that a small, highly efficient, low resistance gas exchanger can completely supplant the need for artificial ventilation during pumpless arterial-venous bypass, even with severe respiratory distress. This simple method of ventilatory support should prove to be an important adjunct to positive pressure ventilation.
Ultrafiltration of the Waste Plasma Effluent from Cardiopulmonary Bypass Circuit Contents Processed with a Cell-Washing Device
Authors: Stammers Alfred H. , Morrow John F. , Brady Chad P. , Deptula Joseph J. , Huffman Suzanne M. , Bonness Andrew S. , Galbraith Timothy A. , Alonso Anselmo 
Published: August 2023

Blood conservation methods are commonly practiced throughout most hospitals that conduct cardiothoracic surgery. In an effort to reduce patients' exposure to homologous blood products and due to cost effectiveness of blood conservation techniques, this present study combines autotransfusion of the remaining blood in the extracorporeal circuit and ultrafiltration of the plasma effluent, and describes the resulting product.
Seven patients, greater than 19 years of age, requiring cardiopulmonary bypass (CPB) were incorporated into this study. Exclusion criteria included age limitation. At termination of CPB, the remaining blood in the circuit was transferred to an autotransfusion machine and processed. Plasma (1054 ± 206 ml) effluent was collected directly from the centrifugal bowl and processed through a ultrafiltrator, with a constant flow rate and negative pressure, until the plasma effluent concentrated down to an end processed volume of approximately 150 ml. The following variables were either measured or calculated: plasma-concentrate volumes per three minute interval, inlet/outlet pressures of an ultrafiltrator, transmembrane pressure (TMP), plasma free hemoglobin, fibrinogen, total protein, and colloid osmotic pressure.
The average ultrafiltrate volume taken off from the plasma effluent was 828 ± 237 ml, with an average ultrafiltrate volume of 115 ml in every three minute interval. The TMP did not change over the first 15 minutes of processing but became significantly elevated at the 18th minute interval and continued to increase and reach a maximum TMP of 286.5 ± 2.1 mmHg at the end of concentration. Fibrinogen levels increased from pre-concentration values of 118.2 ± 64 to 317 ± 177 mg/dl (p=.03) along with increases in plasma free hemoglobin from 97.7 ± 46 to 402.1 ± 180 mg/dl (p=.0002). The total protein concentration increased by over 330% from baseline values.
Ultrafiltrating plasma effluent from autotransfused cell salvaged CPB circuit contents could prove beneficial, but further study is required to discover ways to separate unfavorable products, such as activated platelet-leukocyte products and reduced plasma free hemoglobin, and to lower heparin concentrations of the plasma-concentrate.
Evaluation of a Variable Ratio Cardioplegia System
Authors: Deptula Joseph J. , Zavadil Douglas P. , Christensen Kevin A. , Sydzyik R. Troy , Stammers Alfred H. 
Published: August 2023

Gish Biomedical has designed a blood cardioplegia delivery system (MyoManagerTM) which is purported to provide rapid control of blood and crystalloid solution ratios for myocardial preservation. The present study was designed to evaluate the ability of this device to provide cardioplegia solutions of specific hematocrit and potassium ion concentrations ([K+]).
An in vitro circuit was designed whereby a blood perfusate with a [K+] of 5 mEq/L was mixed with a base crystalloid solution containing 210 mEq/L of K+. Data was collected at several blood to crystalloid ratios (1: 1,4: 1,8: 1, 16: 1, 25: 1), and at four delivery rates (100, 150, 200, 250 ml/min). Predicted and observed values of total cardioplegia volume. hematocrit, crystalloid volume, and [K+] were statistically (ANOV A) analyzed. and statistical significance accepted at p 0.05.
There were no statistically significant differences observed at any flows or ratios in hematocrit. However, at 100 ml/min flow rates, the crystalloid delivery volume difference of 2.4±2.0 ml was significantly higher than that observed at 250 ml/min, 1.5± 1.5 ml (p<0.02) and at 200 ml/min flow rates, 1.5± 1.6 ml (p<0.02). There was no statistical significance in [K+] difference between flows across all ratios. However. within ratios, a significant difference in [K+] at 100 ml/min, 1:1 blood to crystalloid ratio, was observed (p<0.0001) versus all other ratios and flows. The only statistically significant difference that was shown in total cardioplegia delivery volume was observed between 100 and 200 ml/min (p<0.04) when analyzed across all ratios.
The data suggests that the MyoManagerTM effectively provides precise control of [K+] and hematocrit at cardioplegia flows greater than 100 ml/min.
Single Hospital Experience with Emergency Cardiopulmonary Bypass Using the Portable CPS® (Bard) System
Authors: Wittenmyer Barbara L. , Pomerants B.J. , Duff Steven B. , Watson William D. , Blackford James M. 
Published: August 2023

One hundred four patients were placed emergently on the Bard CPS® portable femoro-femoral bypass system over a 4 year period. Thirty-two patients (31%) were discharged from the hospital. Seventy-six of these patients (73%) required emergency bypass following cardiac arrest, and twenty-eight patients (26%) were in cardiogenic shock or respiratory failure. In the arrest group, no one survived an unwitnessed arrest and those with cardiopulmonary resuscitation times less than 30 minutes had a better survival rate. The highest survival rate was in those patients who did not arrest prior to bypass. Fifty-two percent of these patients were released.
The 74 patients receiving interventional therapy on bypass had a higher survival rate than those unable to be treated. Of the thirty patients receiving no intervention, only three (10%) were eventually discharged. For the 19 patients receiving treatment only in the cardiovascular laboratory, the discharge rate was 26%. Of the 55 patients taken to the operating room for surgical correction, 24 (44%) were discharged from the hospital.
No patients placed on bypass at an outlying hospital or treated using CPS® within 72 hours of a previous open heart procedure survived.
The Antiinflammatory Effects of Aprotinin in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass
Authors: Stammers Alfred H. , Huffman Suzanne , Alonso Anselmo , Fristoe Lance W. , Hill Gary , Casebeer Dana , Diego Robert P. , Song Zuorui 
Published: August 2023

Aprotinin has been shown to effectively attenuate cardiopulmonary bypass (CPB) induced coagulopathies. Because aprotinin is a serine protease inhibitor, it may exert additional properties that reduce the risks associated with extracorporeal flow. The purpose of this study was to prospectively evaluate the antiinflammatory effects of aprotinin with specific emphasis on pulmonary function.
After Institutional Review Board approval, 20 patients undergoing first time coronary artery bypass grafting were randomly assigned to receive either a full dose regimen of aprotinin (APR, n=8), or volumetric equal control (CTR, n= 12). Biological markers of inflammation and coagulation were measured at 3 time periods: immediately prior to drug administration, at chest closure, and at 24 hours post cardiotomy, and included total complement, polymorphonuclear neutrophil (PMN) elastase, Factor XII, protein C, protein S, fibrin split products (FSP), D-dimers. Pulmonary function was assessed throughout intensive care unit (ICU) stay.
There were no differences observed between groups in either preoperative, surgical, anesthesia or perfusion parameters. Twenty-four hour chest tube drainage in the APR group was significantly less than that observed in CTR patients (435.1±169.6 vs. 944.0±585.1, p<.02). Patients receiving aprotinin received significantly lower transfusions of red blood cells, platelets, and fresh frozen plasma. Upon entry into the ICU the CTR group had significantly higher mean airway pressures (8.3±1.5 vs. 10.8±2.9 em H2O, p<.03), higher PaCO2 levels (37.1±4.8 vs. 43.3±7.1 mmHg, p<.04), and higher FIO2 settings (0.63±0.18 vs. 0.75±0.20, p=.l6). Postoperative FSP and D-dimers were significantly lower in the APR treated patients.
In conclusion, the use of aprotinin resulted in significant improvements to postoperative patient outcomes as assessed by transfusion requirements, blood loss, coagulation markers and pulmonary function.
Platelet-Rich Plasmapheresis: A Meta-Analysis of Clinical Outcomes and Costs
Authors: Mahoney Chris Brown 
Published: August 2023

Platelet-rich plasmapheresis (PRP) just prior to cardiopulmonary bypass (CPB) surgery is used to improve post CPB hemostasis and to minimize the risks associated with exposure to allogeneic blood and its components.
Meta-analysis examines evidence of PRP's impact on clinical outcomes by integrating the results across published research studies. Data on clinical outcomes was collected from 20 published studies. These outcomes, DRG payment rates, and current national average costs were used to examine the impact of PRP on costs.
This study provides evidence that the use of PRP results in improved clinical outcomes when compared to the identical control groups not receiving PRP. These improved clinical outcomes result in subsequent lower costs per patient in the PRP groups. All clinical outcomes analyzed were improved: blood product usage, length of stay, intensive care stay, time to extubation, incidence of cardiovascular accident, and incidence of reoperation. The most striking differences occur in use of all blood products, particularly packed red blood cells.
This study provides an example of how initial expenditure on technology used during CPB results in overall cost savings. Estimated cost savings range from $2,505.00 to $4,209.00. More importantly, patients benefit from improved clinical outcomes.
Fiber Manufacturing, Membrane Classification, and Winding Technologies Associated with Membrane Oxygenators
Authors: Schaadt Jennifer 
Published: August 2023

Fiber bundling refers to the process of winding hollow polypropylene fibers onto the central core of a membrane oxygenator. Identifying the various bundling techniques serves to facilitate the clinician's understanding of unique device characteristics and the subsequent manufacturing process. This technical information has been voluntarily provided by the product managers and engineers of current membrane manufacturers. Currently the industry employs four primary bundling techiques: single strand, mat configuration, tape and helical.
Single strand wraps one fiber at a time, up and down a central core to create the fiber bundle. A modification of the single strand technique is the single strand multi toe, where multiple fibers are wound at a time. Mat technology wraps a large, woven sheet consisting of uniformly placed fibers and spacing filaments, around the oxygenator core. A modification is the double mat, where two sheets of fibers oriented at a specific bias to each other, are wrapped to yield a fiber bundle. Tape technology involves evenly spaced fibers, 5 to 10 fibers wide, wrapped up and down the length of the core. Helical utilizes a spacing filament that is spiraled around each individual fiber and then around the core of the device.
Do Different Heparin Brands Influence Activated Clotting Times?
Authors: Dyck Louise , Friesen Robert M. 
Published: August 2023

A change in brand suppliers of heparin at our institution resulted in a number of anecdotal reports of possible differences in potency. Both products are marketed as heparin sodium extracted from porcine intestinal mucosa. Heparin Leo® is 1000 international units (British Pharmacopeia) per ml. while Hepalean® is 10000 United States Pharmacopeia (U.S.P) units per ml.
Perfusion records were retrospectively reviewed for one month periods when Heparin Leo® (n=52) or Hepalean® (n=61) were used to provide anticoagulation therapy for cardiopulmonary bypass.
Heparin Leo® was found to be less clinically potent than Hepalean®. While increasing the initial loading dose of Heparin Leo® by 5% (378 vs 395 units/kg−1), the initial post load activated clotting time (ACT) was 17% lower (556 vs 666 seconds). Heparin units required per kilogram per minute of cardiopulmonary bypass were 23% higher for Heparin Leo®. Additionally 8 of 52 Heparin Leo® patients did not achieve an initial post load ACT of greater than 400 sees while this occurred in 2 of 61 patients treated with Hepalean®. These results were statistically significant.
British Pharmacopeia and United States Pharmacopeia heparin reference standards differences are insufficient to explain the discrepancies observed in this study.
Hematological Abnormalities in Neonatal Patients Treated with Extracorporeal Membrane Oxygenation (ECMO)
Authors: Zavadil Douglas P. , Stammers Alfred H. , Willett Lynne D. , Deptula Joseph J. , Christensen Kevin A. , Sydzyik R. Troy 
Published: August 2023

The physical process of extracorporeal membrane oxygenation (ECMO) results in derangement of the hemostatic mechanism, which may lead to increased morbidity, secondary to the disease process. The purpose of this study was to evaluate the hematological status of neonates undergoing ECMO therapy, and to evaluate coagulation tests in predicting hemorrhagic risk.
Following Institutional Review Board approval, 30 patients undergoing ECMO treatment were retrospectively entered into this study. Medical records were reviewed and indicators of hemostasis, transfusion, morbidity, and outcomes recorded. Assessment of coagulation was determined through serial analysis of platelet count, fibrinogen concentration, prothrombin time (PT), activated partial thromboplastin time (aPTT), antithrombin III, fibrin split products, D-dimers, plasma free hemoglobin, activated clotting time, ionized calcium, and thrombelastography (TEG).
Median total transfusion requirements for all patients were 1.79 ml/kg/ECMO hr. Fifty-seven percent of the 30 patients were diagnosed as coagulopathic according to Extracorporeal Life Support Organization standards. Patients were separated into either a hemorrhagic group (HEM, >2.0 ml/kg/ECMO hr, n=13) or a nonhemorrhagic group (N-HEM, n=17), with HEM patients requiring twice the transfusion volume of N-HEM (p<0.0001). Hemorrhagic complications were reported in 53.8% of the HEM patients vs. 35.3% in the N-HEM group. HEM patients were transfused with significantly greater quantities of platelets on days 1,3,5, and 8 and packed red blood cells on day 7 when compared to N-HEM (p<0.05). TEG determination showed significant differences between groups on days 3 and 6 (p<0.005), and 8 (p<0.05).
Derangements in hemostasis resulting from ECMO are profound, with methods of assessing coagulation complicated by both the variability in patient condition and lack of specificity of laboratory tests. Interpretation of TEG data has shown to be a valuable supplement for managing this challenging patient population.
Patientenzufriedenheit nach minimalinvasiver Trichterbrustkorrektur (MIRPE)
Authors: Staubach Raphael , Glosse Helen , Skandul Martina , Alazki Ammar , Loff Steffan 
Published: August 2023

ZUSAMMENFASSUNGDie Nuss-OP ist eine sichere Variante zur Korrektur einer Trichterbrust mit einer sehr guten Patientenakzeptanz und einer sehr hohen Patientenzufriedenheit. Allerdings setzt die operative Korrektur viel Erfahrung des Operateurs voraus und sollte deshalb nur in entsprechenden chirurgischen Abteilungen mit hoher Expertise durchgeführt werden 10.
Klimawandel – eine Gefahr für die Gesundheit und Zukunft unserer Kinder
Authors: Knüpfer Matthias 
Published: August 2023

ZUSAMMENFASSUNGDer Klimawandel ist mit dem Gesundheitswesen in Deutschland auf zwei Ebenen eng verwoben, zum einen ist das Gesundheitswesen mit ca. 5–9 % vom Gesamtvolumen ein erheblicher Emittent von CO2-Äquivalenten, zum anderen wird die Gesundheit auch hierzulande schon durch den Klimawandel belastet. Zahlreichen Publikationen weisen auf die Bedeutung des Klimawandels für die Gesundheit pädiatrischer Patienten hin: Verlängerte Hitzeperioden sind assoziiert mit mehr angeborenen Fehlbildungen, einer erhöhten Frühgeburtenrate und mit mehr Adipositas. Eine klimawandelbedingte erhöhte Luftverschmutzung führt zu mehr Frühgeburten und einer erhöhten Allergierate bei Kindern. Bei höheren Temperaturen steigt die Rate von Vektor-assoziierten Infektionskrankheiten und Kinder sind dabei besonders gefährdet. Kindergesundheit spielt für die Zukunft dieser Welt naturgemäß eine existenzielle Rolle. Der Einsatz für mehr Nachhaltigkeit schützt die Gesundheit ALLER Kinder dieser Welt. Diese Aufgabe ist wichtig für uns alle, besonders aber für Kinderärzt:innen. Wir haben eine Verantwortung für die Gesundheit der Kinder, und zwar heute und auch morgen.