Miracle-dz/UniFAR-FTUs huggingface dataset:
Tailoring haemostatic treatment to patient requirements – an update on monitoring haemostatic response using thrombelastography

Summary. Currently, there is no single haemostasis laboratory test that has the capacity to accurately illustrate the clinical effects of procoagulant or anticoagulant interventions. Although the time course of thrombin generation in plasma and the endogenous thrombin potential (ETP) may be useful coagulation parameters, clotting involves components other than thrombin (e.g. platelets, fibrinogen). The continuous coagulation profiles of thrombelastography may provide a more accurate reflection of in vivo biology, covering initiation, development and final clot strength during whole blood clot formation. This method has helped to clarify the mechanism of action of whole blood clot formation, demonstrating the differences from clotting in plasma, and the importance of platelets and tissue factor titrations. It has also been used to investigate hypocoagulation (in haemophilia A, rare coagulation disorders, anticoagulant therapy and dilutional coagulopathy), hypercoagulation and the ex vivo testing of haemostatic interventions. Thrombelastography has been shown to reflect the clinical efficacy of activated prothrombin complex concentrate (aPCC) and recombinant activated factor VII (rFVIIa) in patients with haemophilia A with inhibitors and in patients with acquired haemophilia. Overall, tailoring laboratory assays to illustrate and correlate with clinical phenotypes is essential for effective coagulation monitoring. Applying an algorithm of preoperative, perioperative and postoperative tests, including thrombelastography, may enable physicians to achieve this.
In situ immunophenotyping study of endothelial cells of the human hepatic sinusoid: Results and functional implications

Hepatic sinusoids are highly specialized capillary vessels characterized by the presence of resident macrophages adhering to the endothelial lining. Although it is likely that sinusoidal endothelial cells have specific adaptations, little is known about the roles that they actually play in vivo. We therefore designed an in situ immunophenotyping study of sinusoidal endothelial cells in normal human liver to compare this population with those of the other vascular compartments of the liver and to determine whether it expresses molecules involved in the following physiological processes: scavenging and nonspecific immune functions, antigen presentation and endothelialleukocyte adhesion. Our study showed that sinusoidal endothelial cells displayed a highly distinctive immunophenotype characterized by the expression of several molecules not found in the other vascular compartments of the liver. A first group of molecules restricted to sinusoidal endothelial cells were: the receptors II and III for the Fc fragment of IgG; the CD14 molecule, serving as a receptor for the lipopolysaccharide‐binding protein; and aminopeptidase N. The presence of those molecules suggests that sinusoidal endothelial cells contribute to the scavenger and nonspecific immune functions of hepatic sinusoids. No direct evidence for an antigenpresenting function of this cell population was obtained. Another group of proteins restricted to sinusoidal endothelial cells comprised the leukocyte adhesion molecules CD4 and intercellular adhesion molecule–1, which may be involved in the adhesion of Kupffer cells to the sinusoidal wall. Therefore our immunophenotyping study makes it possible to provide an in situ demonstration of the phenotypical and functional diversity of endothelial cells in normal human liver. The distinctive phenotype of sinusoidal endothelial cells is likely to correlate with specific functional adaptations to their particular microenvironments. (HEPATOLOGY 1991;14:789–797).
The Iterated Kalman Smoother as a Gauss-Newton Method

The Kalman smoother is known to be the maximum likelihood estimator when the measurement and transition functions are affine; i.e., a linear function plus a constant. A new proof of this result is presented that shows that the Kalman smoother decomposes a large least squares problem into a sequence of much smaller problems. The iterated Kalman smoother is then presented and shown to be a Gauss–Newton method for maximizing the likelihood function in the nonaffine case. This method takes advantage of the decomposition obtained with the Kalman smoother.
Silicone Tracheal T-Tube

The silicone T-tube tracheal stent, which has been in usage for the past nine years, is described and illustrated. This stent has served to support the repaired and reconstructed cervical trachea and also an end-to-end anastomosis of the trachea. While the T-tube is in place with its external limb plugged, the patient usually enjoys a normal airway and phonatory function. Of utmost importance is the care of the tracheal T-tube following its insertion into the cervical trachea. Detailed instructions are included for suctioning, cleaning, and changing of the T-tube. The patient should be familiar with these techniques prior to his discharge from the hospital. With proper care the T-tube has remained in place and uncomplicated for periods ranging from one month to one and one-half years.
Perceptions and Practices Regarding Sleep in the Intensive Care Unit. A Survey of 1,223 Critical Care Providers.

RATIONALE Poor sleep affects a majority of critically ill patients and is believed to be associated with adverse intensive care unit (ICU) outcomes such as delirium. While recent guidelines recommend sleep promotion efforts to improve delirium and other ICU outcomes, little is known about critical care providers' beliefs regarding sleep in the ICU. OBJECTIVES To evaluate providers' perceptions and practices regarding sleep in the ICU. METHODS From April to July 2014, the Sleep in the ICU Survey was disseminated to ICU providers via institutional e-mail lists and four international critical care society distribution lists. MEASUREMENTS AND MAIN RESULTS A total of 1,223 surveys were completed by providers from 24 countries. Respondents were primarily nurses (59%) or physicians (39%). Most respondents indicated that ICU patients experienced "poor" or "very poor" sleep (75%) and that poor sleep could affect the ICU recovery process (88%). Respondents also felt that poor sleep was associated with negative ICU outcomes such as the development of delirium (97%), longer length of stay (88%), poor participation in physical therapy (87%), and delayed liberation from mechanical ventilation (83%). The minority (32%) of providers had sleep-promoting protocols; these providers tended to believe their patients slept longer and experienced better sleep quality. CONCLUSIONS Though most clinicians believe that sleep in the ICU is poor and adversely affects patient outcomes, a minority of the ICUs represented by our respondents have sleep promotion protocols. These findings highlight discordant provider perceptions and practices surrounding sleep in the ICU, as well as a possible lack of available evidence-based guidelines for promoting sleep in the ICU.
Effector Cell Protease Receptor-1, a Platelet Activation-dependent Membrane Protein, Regulates Prothrombinase-catalyzed Thrombin Generation*

At sites of vascular injury thrombin is generated via prothrombinase, a stoichiometric (1:1), Ca2+-dependent, and membrane-bound complex consisting of the nonenzymatic cofactor factor Va and the serine protease factor Xa. While the importance of anionic platelet membrane phospholipids in regulating thrombin generation is well recognized, the identification of regulatory protein receptors has eluded investigators. This study reports the first description of a human platelet membrane protein that regulates prothrombinase complex assembly and function. Direct platelet-protein binding studies indicated that, although required, platelet-bound factor Va alone is insufficient to mediate factor Xa binding, and that factor Va and factor Xa bind to discrete sites on activated platelets for which expression is independently regulated as a function of the agonist concentration. When specific monoclonal antibodies against effector cell protease receptor-1 (EPR-1, a 65-kDa membrane receptor for factor Xa) were used in Western blotting, immunohistochemical staining, and/or flow cytometric analyses, activated platelets and their precursors, megakaryocytes, were shown to express EPR-1. These results were confirmed by reverse transcription-polymerase chain reaction of mRNA extracted from megakaryocyte-like cell lines. Additional flow cytometric studies demonstrated that a platelet-bound factor Va/factor Xa complex precluded binding of the anti-EPR-1 antibody, B6, to activated platelets by ∼50%. Likewise, the anti-EPR-1 antibody was shown to inhibit prothrombinase-catalyzed thrombin generation on activated platelets in a dose- and platelet donor-dependent manner, indicating that platelet-expressed EPR-1 mediates factor Xa assembly into the prothrombinase complex. These collective data indicate that both EPR-1 and membrane-bound factor Va are required to mediate factor Xa binding to the activated platelet to form a functional prothrombinase complex.
War zone traumas and posttraumatic stress disorder symptomatology.

The diagnosis and clinical understanding of posttraumatic stress disorder (PTSD) rests upon the explicit identification of traumatic experiences that give rise to a well-defined constellation of symptoms. Most efforts to investigate the characteristics of these experiences have attempted to specify war zone stressors as objectively as possible. In this study, we add specification of the psychological meaning of war zone stressors to their objective specification. Eleven traumas are organized in terms of four roles that veterans played in the initiation of death and injury; namely, target, observer, agent, and failure. These roles can be ordered in terms of the degree of personal responsibility involved in the initiation of death and injury. The relationships of these roles to current symptomatology were examined in combination with a set of objective measures of war zone stressors. The sample consisted of the first 1709 Vietnam theater veterans who were assessed in a national evaluation of the PTSD Clinical Teams initiative of the Department of Veterans Affairs. Results show that having been a target of others' attempts to kill or injure is related more uniquely than any other role to symptoms that are diagnostic criteria for PTSD. On the other hand, having been an agent of killing and having been a failure at preventing death and injury are related more strongly than other roles to general psychiatric distress and suicide attempts. (ABSTRACT TRUNCATED AT 250 WORDS)
Cortical Tonic Inhibition Regulates the Expression of Spike-and-Wave Discharges Associated with Absence Epilepsy

Synchronous and bilateral spike-and-wave discharges accompany nonconvulsive behavioral and cognitive arrest during seizures associated with absence epilepsy. Previous investigation of multiple absence animal models suggests that the underlying cause of absence seizures is an increase in thalamic inhibitory tonic currents. In contrast, in this study we provide evidence that the level of cortical tonic inhibition also regulates absence seizure expression. Using continuous video-EEG recordings to monitor absence seizures and spike-and-wave discharge expression we show that pharmacological blockade of cortical tonic inhibition provokes absence seizures in wild-type mice. Furthermore, we show that pharmacological rescue of cortical tonic inhibition in an absence mouse (γ2R43Q) model, which lacks tonic inhibition, suppresses absence seizure and spike-and-wave discharge expression. Collectively, these results suggest an optimum level of tonic inhibition in the thalamocortical circuit is required for normal functioning and that a deviation from this optimum results in aberrant thalamocortical function, SWDs and absence seizures.
Regulation of eIF2α Phosphorylation by Different Functions That Act during Discrete Phases in the Herpes Simplex Virus Type 1 Life Cycle

ABSTRACT Multiple herpes simplex virus type 1 functions control translation by regulating phosphorylation of the initiation factor eIF2 on its alpha subunit. Both of the two known regulators, the γ134. 5 and Us11 gene products, are produced late in the viral life cycle, although the γ134. 5 gene is expressed prior to the γ2 Us11 gene, as γ2 genes require viral DNA replication for their expression while γ1 genes do not. The γ134. 5 protein, through a GADD34-related domain, binds a cellular phosphatase (PP1α), maintaining pools of active, unphosphorylated eIF2. Infection of a variety of cultured cells with a γ134. 5 mutant virus results in the accumulation of phosphorylated eIF2α and the inhibition of translation prior to the completion of the viral lytic program. Ectopic, immediate-early Us11 expression prevents eIF2α phosphorylation and the inhibition of translation observed in cells infected with a γ134. 5 mutant by inhibiting activation of the cellular kinase PKR and the subsequent phosphorylation of eIF2α; however, a requirement for the Us11 protein, produced in its natural context as a γ2 polypeptide, remains to be demonstrated. To determine if Us11 regulates late translation, we generated two Us11 null viruses. In cells infected with a Us11 mutant, elevated levels of activated PKR and phosphorylated eIF2α were detected, viral translation rates were reduced 6- to 7-fold, and viral replication was reduced 13-fold compared to replication in cells infected with either wild-type virus or a virus in which the Us11 mutation was repaired. This establishes that the Us11 protein is critical for proper late translation rates. Moreover, it demonstrates that the shutoff of protein synthesis observed in cells infected with a γ134. 5 mutant virus, previously ascribed solely to the γ134. 5 mutation, actually results from the combined loss of γ134. 5 and Us11 functions, as the γ2 Us11 mRNA is not translated in cells infected with a γ134. 5 mutant.
[Effects of video information in patients undergoing coronary angiography].

BACKGROUND informed consent is a fundamental and legal obligation for each interventional cardiologist. The effect of consent form describing risks of invasive procedure on anxiety is controversial. This trial was aimed to assess the added value of video information to the standard informed consent process. METHODS 200 consecutive patients undergoing coronary angiography were enrolled. The first one hundred were assigned to conventional education conducted by the physician (no video group) and the second one hundred had consent obtained in the conventional manner assisted by video information (video group). The outcome variables for this comparison consisted of a standard anxiety score (Spielberger Statement Anxiety Inventory questionnary) plus hemodynamics measurements of heart rate, systolic and diastolic blood pressure obtained at baseline and immediately after written informed consent In addition, before discharge, patients graded the tolerability and satisfaction on a 4-point scale. RESULTS The groups were similar with regard to their baseline characteristics and anxity score (37+23 vs 37+23). Patients who had not had prior experience of catheterization had higher baseline anxiety than those who had prior angiography (45 + 22 vs 31 + 20; p = 0.027). Patients who watched the video were significantly less anxious after informed consent (28 + 21 vs 34 + 22; p = 0.048) and had a significantly lower heart rate (65 + 10 vs 71 + 12; p = 0.03). The benefits of video information were especially prominent in those with higher anxiety scores at baseline (score after 45 + 24 vs 57 + 26; p = 0.046). Tolerability were higher in the video group compared with no video group (98% vs 86%; p = 0.003). Finally, satisfaction of information for informed consent process was higher in video group than in no video group (99% vs 76%; p = 0.001). CONCLUSION a video information decreased anxiety level after written informed consent and improved tolerability and satisfaction scales in patients undergoing coronary angiography. The most likely to benefit from video information are patients with higher anxiety level at baseline. Beneficial effect on informed refusal should be investigated in larger population.
The CaMV 35S enhancer contains at least two domains which can confer different developmental and tissue‐specific expression patterns

We have analyzed expression conferred by two domains from the cauliflower mosaic virus (CaMV) 35S promoter and found different patterns in seeds, seedlings and seven week old plants. Expression from domain A (‐90 to +8) is strongest in the radicle of the embryo, the radicle pole of the endosperm and in root tissue of seedlings and mature plants. Expression from domain B (‐343 to ‐90) is strongest in the cells adjacent the cotyledon of the endosperm, in the cotyledons of the embryo and seedings and in the leaves and stem of mature plants. When both domain A and domain B are present expression is detectable in most tissues at all stages of development. Thus analysis of a constitutive promoter in transgenic plants can be used to identify cis elements that confer tissue specific and developmentally regulated expression.
Analysis of lead in 55 brands of dietary calcium supplements by graphite furnace atomic absorption spectrometry after microwave digestion

The lead (Pb) contents of calcium (Ca) supplements available in Korea were determined by graphite furnace atomic absorption spectrometry using Zeeman background correction and peak area mode. All samples were microwave-digested in concentrated HNO3. Ammonium dihydrogen phosphate and magnesium nitrate were used as matrix modifiers. Fifty-five brands of Ca supplements were classified into seven categories based on the major composite: bone, milk, oyster/clam shell, egg shell, algae, shark cartilage and chelated. The mean Pb contents of Ca supplements were 1.1 μ g g−1 (coefficient of variation 5.7%), ranging from n.d. (not detected) to 6.7 μ g g−1. Ca supplements made of bone have the highest Pb contents (2.3 μ g g−1) with a wide range (0.1-6.7 μ g g−1). The results were similar to those reported in other countries. The mean daily intakes of Pb from the supplement could be about 5 μ g (mean Pb concentration 1.1 μ g g−1 × mean daily intake 4.5 g) taking 2% of provisional tolerable daily intake that the FAO/WHO Joint Food Additive and Contaminants Committee has set to evaluate its safety. However, measures to prevent potentials of Pb toxicity from overtaking some Ca supplements should be considered.
The Price of Immediacy

This paper models transaction costs as the rents that a monopolistic market maker extracts from impatient investors who trade via limit orders. We show that limit orders are American options. The limit prices inducing immediate execution of the order are functionally equivalent to bid and ask prices and can be solved for various transaction sizes to characterize the market maker's entire supply curve. We find considerable empirical support for the model's predictions in the cross‐section of NYSE firms. The model produces unbiased, out‐of‐sample forecasts of abnormal returns for firms added to the S&P 500 index.
Directional delay spread characteristics based on indoor channel measurements at 28GHz

Millimeter-wave propagation characteristics and channel models are being recently studied for applicability of the fifth generation (5G) mobile communication systems. To overcome the larger path loss on the higher frequency band above 6 GHz, highly directive antennas or beamforming techniques using large array antennas can be used to establish a reliable communication link between a transmitter and a receiver. In this paper, a recently conducted channel measurement campaign is introduced which makes use of a direction-scanning-sounding technique to study channel characteristics of 28 GHz millimeter-wave propagation in indoor environments. The measurement campaign has been conducted in passenger terminals at Seoul Railway Station and Incheon International Airport, which are representative indoor hotspot regions in Korea. Based on our experimental data, we investigate the relationship between the beamwidth of antenna and r.m.s. delay spread characteristics.
Gender Differences and Transformational Leadership Behavior : Do Both German Men and Women Lead in the Same Way ?

This article examines the differences between men and women leaders with respect to their transformational leadership behaviors. Subordinates of the leaders rated the frequency of use of transformational leadership behaviors from five different categories. The five behavior categories and the instrument used (The Leader Behavior Inventory or LBI) to rate those behaviors were developed in several previous studies. Generally, it was found that men and women leaders behave as leaders in the same way. It was also found that men and women do not differ in their general perceptions of others as leaders. Possible explanations for these findings are discussed.
Effects of intrinsic prostaglandins on the spontaneous contractile and electrical activity of the proximal renal pelvis of the guinea‐pig

1 The effects of blocking prostaglandin biosynthesis with indomethacin on the spontaneous electrical and contractile activity recorded in smooth muscle strips of the guinea‐pig renal pelvis were examined using standard tension and membrane potential recording techniques. 2 Circumferentially cut strips of proximal renal pelvis contracted more frequently (4.5 ± 0.2 mm−1) than strips cut from the mid region (1.3 ± 0.2; P<0.05, n = 5) of the renal pelvis. 3 Indomethacin (1 nm‐10 μm) reduced the amplitude and frequency of the contractions of the renal pelvis in a concentration‐ and time‐dependent manner. Contractions were completely abolished in the presence of 30 μm indomethacin. 4 After indomethacin blockade, activation of prostaglandin F2α (PGF2α) receptors with dinoprost (1 − 100 nm) restored the amplitude and frequency of the spontaneous contractions of renal pelvis. Higher concentrations of dinoprost (> 100 nm − 3 μm) increased the contraction amplitude of the proximal and mid renal pelvis 1.9 and 1.6 times respectively. The contraction frequency of the mid renal pelvis, but not the proximal pelvis, was also raised above its pre‐indomethacin frequency. 5 The spontaneous electrical activity recorded in proximal strips of the renal pelvis was designated to come from three cell types: (i), pacemaker cells (10% of cells recorded), with simple action potentials comprising relatively slow rising and repolarizing phases triggered on top of a slowly‐developing pre‐potential; (ii), driven cells (75% of cells), with complex action potentials comprising a rapid initial spike, followed by a period of membrane oscillation and a plateau of 0.2–2 s duration; and (iii), intermediate cells (15%) which fired action potentials with an initial rapid and a long plateau phase. 6 Indomethacin (10–30 μm) decreased the amplitude and frequency of the action potentials recorded in driven and intermediate cells. The membrane potential of these cells also depolarized 5 mV to − 51.2 ± 2.6 mV (n = 5). 7 Dinoprost (300 nm − 1.5 μm) increased the rate of action potential discharge, without affecting the membrane potential of driven cells previously exposed to indomethacin (30 μm). 8 These data suggest that the endogenous release of prostaglandins is necessary for the in vitro spontaneous contractile activity recorded in the guinea‐pig renal pelvis. Blockade of the synthesis of these prostaglandins appears either to modify the ability of the driven regions of the renal pelvis to fire action potentials or to reduce the coupling of these driven regions to their pacemaker cells.