bluuebunny/crossref_metadata_2025_split huggingface dataset:
A value-based approach to optimize red blood cell transfusion in patients receiving extracorporeal membrane oxygenation
Authors: Shudo Yasuhiro , Cheng Nathalie , He Hao , Rosenberg Corinne , Hiesinger William , Hadhazy Eric , Shepard John , Krishna Purnima , Resnik Josh , Fong Robyn , Hill Charles , Hsu Joe L , Maggio Paul M , Chang Sang-Ick , Boyd Jack H , Woo Y Joseph 
Published: September 2022

Introduction The risk, cost, and adverse outcomes associated with packed red blood cell (RBC) transfusions in patients with cardiopulmonary failure requiring extracorporeal membrane oxygenation (ECMO) have raised concerns regarding the overutilization of RBC products. It is, therefore, necessary to establish optimal transfusion criteria and protocols for patients supported with ECMO. The goal of this study was to establish specific criteria for RBC transfusions in patients undergoing ECMO. Methods This was a retrospective cohort study conducted at Stanford University Hospital. Data on RBC utilization during the entire hospital stay were obtained, which included patients aged ≥18 years who received ECMO support between 1 January 2017, and 30 June 2020 ( n = 281). The primary outcome was in-hospital mortality. Results Hemoglobin (HGB) levels >10 g/dL before transfusion did not improve in-hospital survival. Therefore, we revised the HGB threshold to ≤10 g/dL to guide transfusion in patients undergoing ECMO. To validate this intervention, we prospectively compared the pre- and post-intervention cohorts for in-hospital mortality. Post-intervention analyses found 100% compliance for all eligible records and a decrease in the requirement for RBC transfusion by 1.2 units per patient without affecting the mortality. Conclusions As an institution-driven value-based approach to guide transfusion in patients undergoing ECMO, we lowered the threshold HGB level. Validation of this revised intervention demonstrated excellent compliance and reduced the need for RBC transfusion while maintaining the clinical outcome. Our findings can help reform value-based healthcare in this cohort while maintaining the outcome.
The effect of relative cerebral hyperperfusion during cardiac surgery with cardiopulmonary bypass to delayed neurocognitive recovery
Authors: Kasputytė Greta , Bukauskienė Rasa , Širvinskas Edmundas , Razlevičė Ilona , Bukauskas Tomas , Lenkutis Tadas 
Published: September 2022

Objective Delayed neurocognitive recovery (dNCR) remains a common complication after surgery and the incidence of it is determined 30–80% after cardiac surgery with cardiac bypass (CPB) in eldery patients. Many researchers have identified that neuropsychological complications emerge from insufficient cerebral perfusion. Relative cerebral hyperperfusion also disrupts cerebral autoregulation and might play a significant role in dNCR development. The aim of this study is to determine hyperperfusion in the middle cerebral artery during CPB influence to dNCR development and brain biomarker glial fibrillary acidic protein (GFAP) impact in diagnosing dNCR. Designs and methods This prospective - case control study included patients undergoing elective coronary artery bypass grafting or/and valve surgery with CPB. For cognitive evaluation 101 patients completed Addenbrooke’s cognitive examination - ACE-III. To determine mild cognitive dysfunction, cut - off 88 was chosen. Mean BFV was monitored with transcranial Doppler ultrasonography (TCD) and performed before surgery, after induction of anaesthesia, during CPB and after surgery. Preoperative BFV was converted to 100% and used as a baseline. The percentage change of cerebral blood flow velocity during CPB was calculated from baseline. Patients with decreased blood flow velocity were included for further investigation. To measure glial fibrillary acidic protein, blood samples were collected after anaesthesia induction, 24 and 48 h after the surgery. According to the ACE-III test results, patients with relative hyperperfusion were divided into two groups: with Delayed neurocognitive recovery and without dNCR (non‐dNCR group). Results 101 patients were examined, 67 (69.1%) men and 29 (29.9%) women, age 67.9 (SD 9.2) Increased percentage of BFV was determined for 40 (39.60%) patients. There were no differences in sex, haematocrit, paCO2, aortic cross-clamping or CPB time between the two groups. Percentage change of BFV was 105.60% in the non-dNCR group and 132.29% in the dNCR group, p = .033. Patients who developed dNCR in the early post-surgical period were significantly older, p < .001 and had a lower baseline of BFV, p = .004. GFAP concentration significantly increased in the dNCR group 48 hours after surgery, compared to the non-dNCR group, p = .01. Conclusions Relative hyperperfusion during CPB may cause dNCR. Elderly patients are sensitive to blood flow velocity acceleration during CPB. GFAP concentration increased 48 h after surgery in dNCR group but did not have any connection with risk factors.
The additional value of high-resolution vessel wall imaging in screening suitable chronic internal carotid artery occlusion candidates for endovascular recanalization: comparison with digital subtraction angiography
Authors: Hou Yanwei , Ren Lei , Cao Chen , Zhang Heliang , Zhao Wei , Zhu Jinxia , Guo Zaiyu , Xia Shuang 
Published: September 2022

Background High-resolution vessel wall imaging (HR-VWI) can provide information about exact occluded length, etiology, and the presence of intraluminal thrombus or residual cavity. Purpose To investigate the extra value of HR-VWI in screening patients with chronic internal carotid artery occlusion (CICAO) for recanalization suitability in comparison with digital subtraction angiography (DSA). Material and Methods We retrospectively reviewed patients who underwent endovascular recanalization with no internal carotid artery signal on magnetic resonance angiography (MRA) and whose both preoperative DSA and HR-VWI data were available. Patients were classified into type I (focal occlusion distal to ophthalmic artery), type II or III (occlusion proximal or at/distal to clinoid segment), and near-occlusion. Occlusion etiology and suitability for recanalization were analyzed both on preoperative DSA and HR-VWI. Accuracy of occlusion classification and differences in the modified Rankin scale scores between the baseline and follow-up were estimated. Results A total of 20 patients were included. With intraoperative DSA as the gold standard, we found HR-VWI could additionally show intraluminal thrombi. Preoperative DSA misclassified one near-occlusion, one type I occlusion, and one type II occlusion as type III occlusions, and one near-occlusion as a type II occlusion. Therefore, compared with the preoperative DSA, three additional cases were successfully recanalized based on HR-VWI. The accuracy of HR-VWI was higher than preoperative DSA (100% vs. 80%). Prognosis improvement of type I was significantly better than type II and near-occlusion ( P<0.05). Conclusion HR-VWI can identify occluded etiology, extent, and classification of CICAO. This information is potentially useful in screening candidates for endovascular recanalization and helpful to indicate prognosis.
Dementia Care in the Last Year of Life: Experiences in a Community Practice and in Skilled Nursing Facilities
Authors: Bartley Mairead M. , Manggaard Jennifer M. , Fischer Karen M. , Holland Diane E. , Takahashi Paul Y. 
Published: September 2022

Objective People living with dementia often have high care needs at the end-of-life. We compared care delivery in the last year of life for people living with dementia in the community (home or assisted living facilities [ALFs]) versus those in skilled nursing facilities (SNFs). Methods A retrospective study was performed of older adults with a dementia diagnosis who died in the community or SNFs from 2013 through 2018. Primary outcomes were numbers of hospitalizations and emergency department visits in the last year of life. Secondary outcomes were completed advance care plans, hospice enrollment, time in hospice, practitioner visits, and intensive care unit admissions. Results Of 1203 older adults with dementia, 622 (51.7%) lived at home/ALFs; 581 (48.3%) lived in SNFs. At least 1 hospitalization was recorded for 70.7% living at home/ALFs versus 50.8% in SNFs ( P < .001), similar to percentages of emergency department visits (80.2% vs 58.0% of the home/ALF and SNF groups, P < .001). SNF residents had more practitioner visits than home/ALF residents: median (IQR), 9.0 (6.0-12.0) versus 5.0 (3.0-9.0; P < .001). No advance care plan was documented for 12.2% (n = 76) of the home/ALF group versus 4.6% (n = 27) of the SNF group ( P < .001). Nearly 57% of SNF residents were enrolled in hospice versus 68.3% at home/ALFs ( P < .001). The median time in hospice was 26.5 days in SNFs versus 30.0 days at home/ALFs ( P = .67). Conclusions Older adults with dementia frequently receive acute care in their last year of life. Hospice care was more common for home/ALF residents. Time in hospice was short.
Evaluation of the Diagnostic Value of Cell Population Data in Sepsis in Comparison to Localized Infection, Chronic Inflammation, and Noninfectious Inflammation Cases
Authors: Çevlik Tülay , Kaya Özlem , Gül Fethi , Turkal Rana , İnanç Nevsun , Direskeneli Haner , İlki Arzu , Şirikçi Önder , Haklar Goncagül , Cinel İsmail 
Published: September 2022

Introduction Sepsis, defined as an increase of 2 points or more in the sequential organ failure assessment score, is a life-threatening organ dysfunction caused by the dysregulated host response to infection. Volume-conductivity-scatter (VCS) parameters of cell counters which are known as cell population data (CPD) have been suggested to be beneficial in diagnosing sepsis. We aimed to evaluate the diagnostic value of CPD parameters in sepsis in comparison to nonsystemic infection cases (NSI) and non-infectious acute and chronic inflammatory conditions. Materials and Methods We prospectively included four groups of patients” data: sepsis (n = 66), localized infection (pneumonia, n = 59), chronic inflammation (rheumatoid arthritis, n = 92) and noninfectious inflammation (coronary artery bypass graft operation, n = 56) groups, according to their clinical status and laboratory results. Samples for cell counting and serum markers were collected on the same day of culture collection. VCS parameters were measured by Unicel DxH800 Coulter Cellular Analyzer (Beckman Coulter, USA). Results Mean neutrophil volume (MN-V-NE), was highest in the sepsis group [155(149-168)] compared to the localized infection [148(140-158)], chronic inflammation [144.5(142-149)] and noninfectious inflammation [149(145.2-153.7)] (P = 0.001, P < 0.001, P < 0.001, respectively). Neutrophil volume SD (SD-V-NE) was higher in the sepsis [21(18.8-23.7)], significantly differentiating sepsis from other groups. The area under curves of procalcitonin and hs-C-reactive protein were 0.846 and 0.837, respectively, in the receiver-operating characteristic curves (ROC) . CPD combinations, (SD-V NE + SD-V LY + SD-V MO), (SD-V NE + SD-V MO), and (MN-V NE + SD-V NE + SD-C LY + SD-V MO) had greater AUC values than procalcitonin’s. Conclusion VCS parameters might be promising for differentiating sepsis and non-sepsis cases. Additionally, obtaining these data routinely makes their prospects promising without any additional cost and time.
Carbon nanotubes-filled polylactic acid/polycaprolactone biodegradable blends: Effect of the polycaprolactone viscosity and carbon nanotubes addition on the microstructure, electrical and mechanical properties
Authors: Al-Saleh Mohammed H , Al-Shboul Tamer S 
Published: September 2022

The effects of polycaprolactone (PCL) viscosity and carbon nanotubes (CNT) content on the microstructure, morphology development, tensile strength, and electrical percolation behavior of CNT/polylactic acid (PLA)/PCL blends were investigated. PLA/PCL blends with a volume ratio of 80/20 were prepared using a low viscosity PCL (PCL1) and a high viscosity PCL (PCL2). The microstructure analysis showed finer dispersion of PCL2 than PCL1 within the PLA matrix. The addition of CNT changed the PLA/PCL morphology from dispersed to co-continuous due to the localization of the nanotubes in the PCL domain (i.e. the minor domain). In addition, the introduction of CNT reduced the PCL domain size and improved the adhesion at the PLA/PCL interface. For the electrical percolation behavior, PLA/PCL2 blend exhibited a percolation threshold concentration (EPTC) of 0.5 wt.% CNT compared to 1.0 wt.% CNT for the PLA/PCL1 blend. This remarkably lower EPTC for the PCL2-based blend is in line with the microstructure analysis that indicated finer dispersion of PCL2 than PCL1 within the PLA matrix. The tensile strength analysis showed that adding up to 5 wt.% CNT does not influence the PLA/PCL blend’s tensile strength. However, remarkable adhesion and tensile strength enhancements were obtained at a CNT content of 10 wt.% and above.
Hormonal Therapy in Pretreated Patients With Recurrent Ovary Granulosa Cell Tumor
Authors: Dogan Izzet , Aydin Esra , Topuz Samet , Saip Pinar , Salihoglu Mehmet Y. , Aydiner Adnan 
Published: September 2022

Objective: To evaluate the effectiveness of hormonal therapy (HT) in patients with recurrent adult ovary granulosa cell tumors. Methods: The clinical and treatments features of the patients who received HT were studied retrospectively. The efficacy and safety of HT were evaluated. The Kaplan-Meier technique was used to conduct survival analysis. Results: The research involved a total of thirteen patients. The median age of the participants was 49 years (range: 34-61). Since diagnosis, the median number of surgeries has been three (range: 2-8). At least one chemotherapy regimen has been administered to 12 (92.3%) patients. Ten of the patients (76.9%) had at least two metastatic areas. Lung metastases were found in two (15.4%) of the patients. Inhibin B levels were elevated in 81.2% of patients before hormone treatment. The patients received different HTs (Leuprolide acetate + anastrozole-three patients, leuprolide acetate + tamoxifen-six patients, only anastrozole-three patients, only tamoxifen-one patients). The median progression-free survival was found 17.7 months (95 % CI: 14.7-20.6). In four (33.4%) patients, an overall response (complete or partial) was identified. A stable response was observed in eight (66.7%) patients. Conclusions: HT is effective in pretreated individuals with recurrent ovarian granulosa cell tumors, according to this research. Despite the limited number of patients and treatment variability, disease control was achieved in all patients. Also, we found that Inhibin B levels were associated with treatment response.
Efficacy and Safety of Venous Sac Embolization With or Without Feeding Artery Embolization Versus Feeding Artery Embolization Alone in the Management of Pulmonary Arteriovenous Malformations: A Systematic Review and Meta-analysis
Authors: Taxak Avichala , Verma Mansi , Pandey Niraj Nirmal , Singh Vishwajeet , Kumar Sanjeev , Jagia Priya 
Published: September 2022

Purpose: To evaluate by meta-analysis the safety and efficacy of venous sac embolization (VSE) with or without feeding artery embolization versus feeding artery embolization (FAE) alone in the management of pulmonary arteriovenous malformations (PAVMs). Methods: This systematic review and meta-analysis was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic literature search was performed in MEDLINE, Embase, and Scopus till August 31, 2021 to identify studies comparing the safety and efficacy of VSE with or without FAE versus FAE alone in PAVMs. The success of treatment was assessed by comparing the number of PAVMs with ≥70% decrease in the size of draining vein/sac between the 2 groups. The pooled odds ratio (OR) and 95% confidence interval (95% CI) were calculated using the random-effects inverse-variance model and were used to compare pooled therapeutic efficacy between the groups. Results: Three studies were found eligible for the meta-analysis. The included studies had a total of 169 patients (119 females and 50 males). The total number of PAVMs was 298, and hereditary hemorrhagic telangiectasia was present in 119 patients. The success of treatment was higher with VSE as compared to FAE (OR=3.54, 95% CI=1.66–7.56). The minor complications were similar in both groups, and one major complication occurred in the FAE group. More coils were used in the VSE group. Conclusions: The present systematic review and meta-analysis has consolidated the evidence that VSE with or without FAE is more efficacious than FAE alone in the management of PAVMs without any increase in the associated risk of sac rupture or coil migration. Clinical Impact Until high-quality data from a prospective, multicentric, randomized controlled trial becomes available, the evidence consolidated by the present systematic review and meta-analysis showing the efficacy of venous sac embolization (with or without feeding artery embolization) over feeding artery embolization alone, can be used for clinical decision-making in the management of pulmonary arterio-venous malformations.
Behavior of woven fabric composite under tensile loads in different directions using acoustic emission
Authors: Dehnad Milad , Dolatabadi Mehdi Kamali , Najafabadi Mehdi Ahmadi , Asgharian Jeddi Ali Asghar 
Published: September 2022

The woven fabric composites were used in different industries for their special specification. This study aimed to address failure mechanisms in single-layer woven fabrics. The acoustic emission (AE) technique and wavelet transform were used for composite structural health monitoring and failure rate evaluation. From a mechanical study viewpoint, the load-displacement behavior of plain-woven glass composite was examined under tension in the principal directions (0 and 90°) and off-axis (30, 45, and 60°). The results indicated that off-axis samples are deformed and curled due to the slippage and rotation of warp and weft yarns. The mechanical measurements were synchronized with the AE data in an acousto-mechanical study. The load-displacement behavior of samples was zoned out with two criteria: frequency and energy. Eventually, three failure modes were identified: matrix damage, interface damage, and fiber breakage. The results showed that events with a frequency above 400 kHz at different angles could be attributed to fiber breakage. Also, the applied force angle effectively affects the type of fiber failure (tensile and shear failure). It was found that in addition to tensile failure, shear failure also increases sharply by increasing the angle between the main directions. So that the maximum number of shear fiber failures occurred at the angle of 45° between the main directions. On the off-axis, the number of fibers exposed to the load also increased, increasing the number of breakages.
Preparation and characterization of a flexible lithium ion electrode based on carbonized cotton fabric
Authors: Li Renkun , Wang Xiwen , Yang Jin 
Published: September 2022

In order to prepare flexible electrode with excellent performance, cotton fabric was used as the substrate in this study. The surface of cotton fabric was modified by polydopamine(PDA). The cotton fabric was then carbonized. Finally, a three-dimensional porous flexible electrode for carbonized cotton fabric was prepared. The maximum stress of the flexible electrode is 0.5 MPa. With the increase of carbonization temperature, the specific capacity of flexible electrode increases gradually. The specific capacity of flexible electrode reaches 282 mAh.g−1 at 0.1c charge/discharge rate. The specific capacity of flexible electrode reaches 200 mAh.g−1 at 5C charge/discharge rate. The specific capacity retention rate of the flexible electrode is above 95% when the cycle is 100 weeks at 0.1 c and 600 weeks at 5C. CV test results show that with the decrease of scanning rate, the more stable the cyclic performance of flexible electrode is, the better the reversibility of Li+ stripping/embedding is. The conductivity of the flexible electrode increases with the increase of carbonization temperature. The surface resistance and AC impedance of the flexible electrode are reduced. When the carbonization temperature is 1000°C, the surface resistance of the flexible electrode is 2 Ω.−1, and the AC impedance is 5 Ω.
Experimental study on abrasive water jet machining of WCFC reinforced flax/wire mesh/hemp composite
Authors: Singh Quberk Jeeva , Rajamurugan G 
Published: September 2022

Conventional machining of composite material was challenging due to delamination, tool wear, fiber pull-out, spalling, fiber fraying, heat generation, and excessive stresses. The non-conventional machining process was preferred for high-strength materials to produce complicated shapes with a better surface finish. This research describes an experimental analysis of abrasive water jet machining (AWJM) on flax/wire mesh/hemp reinforced epoxy composite. In addition, recycling of waste carbon fiber composite (WCFC) was also practiced and reused as a filler particle along with the fabricated hybrid composite. The hybrid composite was fabricated using the hand layup technique with 20.3 wt% of fiber, 10.5 wt% of wire mesh, and 2 wt% of WCFC. Experiments were conducted to evaluate the influence of standoff distance, traverse speed, and abrasive mass flow rate on the output responses such as kerf angle (θ) and surface roughness (Ra). The design of experiments found that surface finish was improved with optimum process parameters. It was detected that spalling defects, wear track, and micro-cutting were noteworthy in the machined hybrid composite concerning high standoff distance and abrasive mass flow rate. Morphological study in the cut surface of the hybrid composite was analyzed through a scanning electron microscope (SEM), and the fiber characterization was done through Fourier-transform infrared spectroscopy (FTIR).
Reducing foot plantar pressure using superelastic nitinol monofilaments as spacer yarns in a novel weft knitted spacer fabric insole
Authors: Hamedi Mohsen , Salimi Parisa 
Published: September 2022

Insoles as devices for plantar pressure reduction have developed and undergone many clinical experiments to deliver better performance, helping patients with diabetic foot ulceration. Elastomer foams are used as the base material in commercial diabetic foot insoles. However, their energy absorption capacity degrades because of microclimate in footwear and their shape deform during usage. Therefore insoles with better-cushioning properties and durability are required. In this paper, a novel insole with 3D spacer fabric with superelastic nitinol monofilaments (NiTi) is introduced. The fabricated insole and commercial Plastazote insoles (PLT) are experimentally compared on five healthy persons with measuring plantar pressure right after wearing and 1 month after. The temperature increase is also measured after 15 min of walking. Statistical analysis is used to evaluate insoles performance. Although NiTi and PLT showed a reduction in peak plantar pressure (PPP) right after wearing, after one month, 48.5% and 43.8% reduction in mean PPP for NiTi and 28% and 23.9% for PLT were observed compared to without-insole condition on the right and left foot respectively. NiTi delivered 11.8% and 13.9% PPP increases on right and left foot compared to 61% and 61.8% respectively in PLT after 1 month. Lower temperature increase and homogenous plantar surface pressure distribution were also seen on NiTi. Eventually, the proposed NiTi insole delivered higher cushioning properties, enhanced breathability, more uniform pressure distribution, and superior endurance compared to PLT as a commercial insole. Therefore, it is a promising device for protecting the diabetic foot against pressure, impact and preventing ulceration.