bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incorporating a Peer-Mediated Approach Into Speech-Generating Device Intervention: Effects on Communication of Preschoolers With Autism Spectrum Disorder
Authors: Thiemann-Bourque Kathy , Feldmiller Sarah , Hoffman Lesa , Johner Stacy 
Published: July 2018

Purpose
This study examined the effects of incorporating a peer-mediated approach into a speech-generating device (SGD) intervention on communication of 45 nonverbal and minimally verbal preschoolers with autism spectrum disorder (ASD) and 95 peers without disabilities. The SGD was an iPad 2 (Apple) with voice output app.

Method
Effects were evaluated using a multivariate randomized control trial design with repeated measures for 4 cohorts across baseline, intervention, generalization, and maintenance phases. Children were randomly assigned to an experimental treatment that trained peers on use of the SGD or a business-as-usual comparison condition with untrained peers. Communication outcomes were measured for both children with ASD and peers.

Results
Children receiving the treatment demonstrated significant increases in rates of communication and more balanced responses and initiations (a measure of reciprocity) than children in the comparison group. They were able to generalize improvements and maintain communication gains. Treatment fidelity was high for school staff and peer implementation.

Conclusions
Results support positive effects on communication of teaching young children with ASD and peers without disabilities to use the same SGD system in typical preschool activities. SGD interventions that utilize peer-mediated approaches may improve core deficits in communication and reciprocity and allow for greater classroom social participation and interactions with peers.
Contrat de travail : le danger du Contrat à Durée Déterminée
Authors: Bigey N. 
Published: July 2018

Embaucher un salarié n’est pas sans risque, notamment dans le choix du contrat qui va lier l’employeur au salarié.
Il est fondamental de faire le choix d’un contrat adapté. Très souvent, le choix se porte sur le Contrat à Durée Déterminée. Si le motif du recours est contesté, les conséquences financières peuvent être exorbitantes.
Pourquoi est-il important de concevoir une identité visuelle pour son cabinet d’orthodontie ?
Authors: Castellani S. 
Published: July 2018

Le cerveau humain ne met que quelques secondes pour se faire un premier avis sur ce qu’il voit. Cet avis dont l’impact est considérable chez l’individu va profondément influencer sa perception des choses…
L’identité visuelle (logo, couleurs, visuel) d’un cabinet d’orthodontie que l’on perçoit sur la carte de rendez-vous, le site Internet ou d’autres supports de communication, est la première image que le cabinet renvoie à ses patients actuels ou futurs. Il est donc primordial de se doter d’une image efficace, valorisante et en parfaite adéquation avec les valeurs que l’on défend et le service que l’on propose.
Au cœur de l’offre de santé, il est aujourd’hui important de communiquer des messages forts, différenciants et de qualité.
Primäre und sekundäre Sturzprävention in der Rehabilitation: Hinweise zur Sturzprophylaxe
Authors: Bujan Bartosz , Döring Christian , Sturzenegger Christian , Bürk Katrin 
Published: July 2018

ZusammenfassungEine aktive Sturzprävention bedarf einer genauen Analyse der Sturzursachen und der Einleitung gezielter Gegenmaßnahmen. Sie ist für die Qualitätssicherung der stationären Rehabilitation unentbehrlich. Von der primären Prävention mit allgemeinen Maßnahmen zur Sturzvermeidung ist die Sekundärprävention mit ihren spezifischen und individuell angepassten Maßnahmen zu differenzieren. Sie wird nach dem ersten Sturzereignis eingeleitet und berücksichtigt die mechanistische Sturzanalyse. Dieser Beitrag stellt einen praxisorientierten Leitfaden zur Sturzprävention in der Rehabilitation vor, die bei Erstellung von Rehabilitationskonzepten als ein wichtiger Bestandteil anzusehen ist.
Diabetes Mellitus in der medizinischen Rehabilitation – Inanspruchnahme rehabilitativer Maßnahmen im Zeitraum 2006–2013
Authors: Schmidt Christian , Baumert Jens , Gabrys Lars , Ziese Thomas 
Published: July 2018

Zusammenfassung
Hintergrund und Ziele Seit Jahren steigt die Prävalenz des Diabetes mellitus (DM) an. Aufgrund des Krankheitsbildes wird mit steigender Bedeutung rehabilitativer Leistungen gerechnet. In diesem Beitrag wird die Inanspruchnahme medizinischer Rehabilitation von 2006 bis 2013 untersucht.
Methodik Die Sekundärdatenanalyse basiert auf einem scientific use file. DM wird gemäß ICD-10 (E10-E14) definiert. Die Verläufe werden roh, altersstandardisiert und stratifiziert nach Alter und Geschlecht dargestellt. Die Inanspruchnahmen und Prävalenzen pro Bundesland werden korreliert.
Ergebnisse Die standardisierte Inanspruchnahme stieg von 2006 bis 2013 bei Männern von 170 auf 204,4 und Frauen von 99 auf 123,6 je 100 000. Während sie bei unter 60-Jährigen rückläufig ist, stieg sie in der Altersgruppe der 60–64-Jährigen um zirka 80%. Die Inanspruchnahme korreliert positiv (r=0,64) mit der bevölkerungsbezogenen Prävalenz.
Schlussfolgerung Aufgrund des zunehmend späteren Renteneintritts wächst die Bedeutung rehabilitativer Leistungen bei Personen mit DM.
Kosten von multiresistenten Erregern in der stationären Palliativversorgung
Authors: Adelhardt Thomas , Hessemer Stefanie , Heckel Maria , Herbst Franziska A. , Stiel Stephanie , Ostgathe Christoph , Schöffski Oliver 
Published: July 2018

ZusammenfassungDie Studie beschäftigt sich mit den finanziellen Auswirkungen des Auftretens von multiresistenten Erregern auf einer palliativmedizinischen Station eines
deutschen Universitätskrankenhauses. Ziele der Studie sind eine Analyse der Kostentreiber sowie ein Kostenvergleich zwischen MRE-positiven und -negativen
Patienten. Zur Analyse der Kostendaten der auf der betreffenden Palliativstation behandelten Patienten wurde ein retrospektives Studiendesign mit einer
Fall-Kontroll-Analyse gewählt. Die analysierten Daten umfassen dabei neben Kostendaten wie beispielsweise den Gesamtkosten bzw. den Kosten für den Pflegedienst
auch die Verweildauer und demografische Daten der Patienten wie das Alter. Der Vergleich der Kostenunterschiede zwischen MRE-negativen und MRE-positiven
Patienten wurde mittels t-Test durchgeführt. Eine multivariate Regressionsanalyse wurde zur Identifikation der Kostentreiber verwendet.
Effects of Metformin and Metoprolol CR on Hormones and Fibrinolytic Variables during a Hyperinsulinemic, Euglycemic Clamp in Man
Authors: Landin Kerstin , Tengborn Lilian , Smith Ulf 
Published: July 2018

SummaryThe aim of this study was to characterize the acute effect of euglycemic (glucose 5.2 ± 0.6 mrnol/1) hyperinsulinemia (mean 118 ± 32 mU/1) on fibrinolytic variables, free fatty acids (FFA) and counter-regulatory hormones. In addition, the effect of chronic treatment with metformin, an oral antidiabetic agent which enhances insulin action, and metoprolol CR, a relatively betaj-selective adrenergic antagonist, was also evaluated. A randomized, double-blind, placebo-controlled, cross-over study including 18 non-obese men, aged 53 ± 6 years, was performed. The investigations were performed after each treatment period of 6 weeks in both the postabsorptive state and during a euglycemic, hyperinsulinemic clamp.Compared to the postabsorptive state, plasminogen activator inhibitor (PAI-1) activity and antigen, tissue plasminogen activator (t-PA) antigen and FFA decreased (p <0.001) after 120 min of euglycemic hyperinsulinemia. In addition, t-PA activity increased (p <0.01) while blood levels of lipoprotein (a), catecholamines and cortisol remained unchanged. Growth hormone increased during the clamps and this was most pronounced after treatment with metoprolol CR.When the effect of treatment was compared, postabsorptive levels of C-peptide, FFA and t-PA antigen were lower after metformin than after the placebo period (p <0.05). t-PA antigen also remained lower during the clamp after metformin treatment. No significant effects of metformin or metoprolol CR were seen on insulin-stimulated glucose uptake during the clamps or on postabsorptive levels of counterregulatory hormones, PAI-1 or Lp(a).Thus, the rapidly increased fibrinolytic activity after 2 h hyperinsulinemia with maintained euglycemia can not be explained by the concomitant changes in counterregulatory hormones. It is more likely that the decreased FFA and/or triglyceride levels play a role.
Lupus Anticoagulant IgG's (LA) Are Not Directed to Phospholipids only, but to a Complex of Lipid-Bound Human Prothrombin
Authors: Bevers E M , Galli M , Barbui T , Comfurius P , Zwaal R F A 
Published: July 2018

SummaryPlasmas from 16 patients that were found to be positive both for anticardiolipin antibodies (ACA) and lupus anticoagulants (LA) were incubated with liposomes that contained anionic phospholipids. In 11 of these plasmas, ACA could be cosedimented with the liposomes in a dose-dependent manner, whereas LA activity of the remaining supernatant was unaffected. LA activity of purified total IgG from 6 patients was measured in three different coagulation tests, using normal plasmas from different species. Prolongation of the aPTT, KCT and dRW clotting times was observed only with normal plasma from human origin, not with bovine, rat or sheep plasma.Highly purified coagulation factors Xa, Va and prothrombin, both of human and bovine origin, were used to establish for two patient IgG's the effect of LA on the rate of thrombin formation in the presence and absence of lipid vesicles composed of 20 mole% phosphatidylserine and 80 mole% phosphatidylcholine. A strong and dose dependent inhibition by LA was observed only when human prothrombin was used as substrate in the prothrombinase complex in the presence of lipids. No inhibition was found when bovine prothrombin was used as substrate. The inhibitory effect observed in the presence of human prothrombin was independent of the source of factors Xa and Va, and was not found in the absence of lipid. Preliminary binding studies suggest that LA only associate with a lipid surface, provided that human prothrombin and calcium ions are present. These data indicate that LA are not directed to phospholipids alone, but presumably recognize an epitope which becomes exposed upon Ca2+-mediated binding of human prothrombin to phospholipids.
Enhancement of Clot Lysis In Vitro and In Vivo with a Bispecific Monoclonal Antibody Directed against Human Fibrin and against Urokinase-Type Plasminogen Activator
Authors: Kurokawa Tomofumi , Iwasa Susumu , Kakinuma Atsushi , Stassen Jean-Marie , Lijnen H Roger , Collen Desire 
Published: July 2018

SummaryA hybrid hybridoma (FU1-74), secreting a bispecific monoclonal antibody (bs mAb), was obtained by fusion of a murine hybridoma secreting a monoclonal antibody (mAb) specific for human fibrin with a murine hybridoma secreting a mAb against urokinase-type plasminogen activator (u-PA). The bs mAb (MA-FU1-74), purified to homogeneity from mouse ascitic fluid, migrated as a single band with apparent M
r 150,000 on non-reduced SDS-PAGE and had an affinity for both human fibrin (K
a = 2 × 107 M–1) and for u-PA (K
a = 108 M–1) comparable to that of the mAbs obtained from the respective parental hybridomas. MA-FU1-74 did not influence the enzymatic activity of two-chain u-PA (tcu-PA) towards plasminogen or towards a chromogenic substrate. The complex of MA-FU1-74 with recombinant single chain u-PA (rscu-PA) or with tcu-PA (urokinase) enhanced the fibrinolytic potency of the plasminogen activator towards clotted human plasma 20-fold and 5-fold, respectively.In a hamster pulmonary embolism model, the rscu-PA/MA-FU1-74 complex had a 13- to 17-fold increased thrombolytic potency (percent lysis per mg/kg u-PA administered) relative to that of rscu-PA. The specific thrombolytic activity (percent lysis per εg/ml steady state plasma level of u-PA antigen) of the complex was, however, not significantly different from that of rscu-PA. The complex of rscu-PA with the parental anti-u-PA mAb (MA-UK1-3) had only a 2-fold enhanced thrombolytic potency relative to that of rscu-PA and had a 5-fold decreased specific thrombolytic activity. The plasma clearance rates of the complexes of rscu-PA with both MA-FU1-74 and MA-UK1-3 were about 10-fold lower than that of rscu-PA. In a rabbit jugular vein thrombosis model, the rscu-PA/MA-FU1-74 complex had a 4-fold enhanced thrombolytic potency, an unchanged specific thrombolytic activity and 20-fold reduced plasma clearance. In both animal models, the rscu-PA/MA-FUl-74 complex did not cause more extensive systemic activation of the fibrinolytic system than rscu-PA.It is concluded that the bispecific anti-fibrin/anti-u-PA mAb MA-FU1-74 targets u-PA to the fibrin clot, resulting in a significantly enhanced thrombolytic potency of the plasminogen activator.
The Effect of Interleukin-1 on Venous Endothelium – An Ultrastructural Study
Authors: Merton R E , Hockley D , Gray E , Poole S , Thomas D P 
Published: July 2018

SummaryThe effect of systemic interleukin-1 (IL-1) on venous endothelium in the presence and absence of stasis has been studied by scanning electron microscopy (SEM). Recombinant human IL-1β at a concentration of 1 εg/kg or saline was injected intravenously into rabbits and allowed to circulate for 0.5 or 4.0 h after which complete stasis was induced for 1 h in an isolated segment of each jugular vein. One vein segment was then excised and the contents examined macroscopically for thrombi, while the other segment was fixed for SEM examination. When examined by SEM the endothelium from rabbits injected with IL-1β was perturbed with increased surface microvilli, blebs and gaps at cell junctions when compared with saline controls. Fibrin deposition was also observed after IL-1β, as was the adherence of essentially non-activated platelets to intact endothelium. However, macroscopic thrombi were not formed in isolated vein segments. We conclude that although fibrin strands and platelets were deposited on the endothelium, IL-1 is not a sufficiently powerful procoagulant stimulus to lead to an occlusive thrombus in acute experiments.
The Measurement of Human Plasma Antiplasmin Activity by Radial Diffusion Assay
Authors: Andes W A 
Published: July 2018

SummaryAn assay of human antiplasmins has been developed utilizing radial diffusion of plasma from wells cut in plasmin-enriched, fibrinogen-agarose plates. After diffusion the fibrinogen is clotted. Zones of fibrin protected from background fibrinolysis develop as the result of plasma antiplasmin activity. A pooled plasma standard was taken to contain 100 % antiplasmin activity. Antiplasmin activity of 52 normal subjects varied from 64 to 132 %. Washed platelets contained 1-5 % antiplasmin activity. Using antisera to precipitate individual inhibitors, physical methods of separation, and electrophoresis of plasma in agarose, several different proteins were found to have antiplasmin activity in this assay. Thus, α2-macroglobulin contributed 56%, α1-antitrypsin 20%, antithrombin III 2%, and other proteins 22% of the total antiplasmin activity. 1 ml of whole plasma neutralized 7.0 CTA units of plasmin.
The Hemostatic Mechanism after Open-Heart Surgery
Authors: Cole E R , Bachmann F , Curry C A , Roby D 
Published: July 2018

SummaryA prospective study in 13 patients undergoing open-heart surgery with extracorporeal circulation revealed a marked decrease of the mean one-stage prothrombin time activity from 88% to 54% (p <0.005) but lesser decreases of factors I, II, V, VII and X. This apparent discrepancy was due to the appearance of an inhibitor of the extrinsic coagulation system, termed PEC (Protein after Extracorporeal Circulation). The mean plasma PEC level rose from 0.05 U/ml pre-surgery to 0.65 U/ml post-surgery (p <0.0005), and was accompanied by the appearance of additional proteins as evidenced by disc polyacrylamide gel electrophoresis of plasma fractions (p <0.0005). The observed increases of PEC, appearance of abnormal protein bands and concomitant increases of LDH and SGOT suggest that the release of an inhibitor of the coagulation system (similar or identical to PIVKA) may be due to hypoxic liver damage during extracorporeal circulation.
The Influence of Residual Factor VII on the Sensitivity of Brain Thromboplastin
Authors: Spurling Neville W , Savory Janet 
Published: July 2018

SummaryOne-stage prothrombin times of normal and of factor VII-deficient beagle plasma were determined with two types of beagle brain thromboplastin, one prepared from normal beagles and the other from factor VII-deficient beagles. There was little difference between the reagents in the prothrombin times obtained for normal plasma. However, when factor VII-deficient plasma was tested, reagent prepared from factor VII-deficient beagles gave considerably longer prothrombin times than were obtained with the normal reagent and the difference increased with increasing reagent concentration to a maximum at 140 mg/ml.Prothrombin times of a series of mixtures of normal and factor VII-deficient plasma indicated that the presence of only 1/90 part of normal plasma was necessary to compensate for the difference between the two reagents. Determination of the iron content of the reagent suggested that the microcirculation of an average brain contained some 1.8 g of whole blood.The finding that brain thromboplastin prepared from factor VII-deficient beagles is more sensitive to a deficiency of factor VII in plasma, presumably a result of the smaller quantity of factor VII present in the reagent, is compatible with the known kinetics of extrinsic coagulation.
Human Pharmacokinetics and Pharmacodynamics of MF 701 Dermatan Sulfate Administered by Continuous Intravenous Infusion
Authors: Agnelli Giancarlo , Cosmi Benilde , Renga Cinzia , Federici Fiorella , Necil Giuseppe G , Houin Georges , Gianese Francesco 
Published: July 2018

SummaryThe pharmacokinetics and haemostatic effects of MF 701 dermatan sulfate (DS) administered by i. v. infusion were studied in 11 healthy volunteers. Each subject received 0.6 mg kg-1 h-1 MF 701 for 10 h. DS plasma concentrations were measured by a chromogenic assay based on the catalysis of thrombin inhibition by HCII. DS plasma levels followed a single compartment pharmacokinetic model, with a half-life of 1.28 ± 0.46 h, a plasma clearance of 2.75 ± 0.46 1/h and a volume of distribution of 4.92 ± 1.36 1 (means ± SD). Steady-state was reached 3 to 6 h after infusion started. The maximal DS plasma concentration was 16.4 ± 5.7 μg/ml. Maximal APTT prolongation over pre-infusion values was 42 ± 7%; TCT performed with bovine and human thrombin was prolonged by 16 ± 7% and 83 ± 35% respectively. No anti-IIa or anti-Xa activities were detected by chromogenic tests. The treatment was well tolerated. The pharmacokinetics of MF 701 infusion are consistent with those previously described after i. v. bolus administration. The infusion of MF 701 allows fast achievement and steady maintenance of elevated DS plasma concentrations.
HIV-Antibody Seroconversions in Dutch Haemophiliacs Using Heat-Treated and Non Heat-Treated Coagulation Factor Concentrates
Authors: Wolfs Tom F W , Breederveld Cees , Krone Willy J A , Hoek Lia v d , Bakker Margreet , Smit Lia , Goudsmit Jaap ,   The Dutch haemophilia group
Published: July 2018

SummaryA national multicentre study was performed to investigate the effects of donorselection and the use of heat-treated plasma products on seroconversion to HIV in 157 Dutch haemophiliacs. All patients included in the study were seronegative for HIV antibodies in 1983.Thirteen percent (20/157) seroconverted between 1983 and 1986. Nineteen of 20 seroconversions could be related to the use of non heat-treated products in the year preceding HIV antibody seroconversion. One seroconversion occurred in a person using heat-treated non donor screened product.Seroconversion rate decreased as a result of the policy to discourage high risk blood donors and no seroconversions were observed following the introduction of donor screening in 1985.
Adenosine Nucleotides and Serotonin Stimulate von Wille-brand Factor Release from Cultured Human Endothelial Cells
Authors: Palmer D S , Aye M T , Ganz P R , Halpenny M , Hashemi S 
Published: July 2018

SummaryEndothelial cells (ECs) synthesize and release von Willebrand factor (vWf) either constitutively or from Weibel-Palade bodies by a regulated pathway. Although stimulated release of vWf from ECs occurs following exposure to thrombin, histamine, interleukin, tissue necrosis factor and fibrin in vitro, these agents are unlikely to be present in physiologically relevant concentrations during the initial stages of primary hemostasis. Alternatively, agents known to be released from the dense granules of activated platelets at the sites of vascular injury may provide the initial physiological stimuli for vWf release from ECs in vivo. We have examined the effects of the platelet secretagogues ADP, AMP, ATP and serotonin on the release of vWf from ECs and demonstrated enhanced release in all cases. The extent and time at which optimum vWf release was observed depended on the agonist and its concentration. At 3 nM, optimum release occurred after 4 hours with ADP (330 %/ml) or 1 h with AMP (153%/ml) or ATP (450%/ml). At 30 nM, optimum release was seen after 1 hour with ADP (315 %/ml) or AMP (595%/ml) and after 15 min with ATP (938%/ml). With serotonin, optimal release was seen by 30 min at 0.3 μM (1034%/ml) and after 1 h at 1 pM (745%/ml) although the response after 15 min was nearly equivalent (667%/ml). The doses giving 50% of maximal response (ED50) after 1 h were 6.5 nM (ADP), 15.2 nM (AMP) and 2.4 nM (ATP) and 20 nM for ATP or 75 nM for serotonin after 15 or 30 min respectively. ADP also enhanced PGI2 release from ECs in a dose- and time-dependent manner. These observations support a mechanism whereby activated platelets, which interact with and bind to ECs or subendothelium and release adenine nucleotides or serotonin from platelet dense granules, could stimulate the release of vWf from adjacent ECs thereby enhancing EC-platelet interactions and facilitating primary hemostasis.
Construction and Characterization of Thrombin-resistant Variants of Recombinant Human Protein S
Authors: Chang Glenn T G , Aaldering Leonie , Hackeng Tilman M , Reitsma Pieter H , Bertina Rogier M , Bouma Bonno N 
Published: July 2018

SummaryProtein S is a vitamin K-dependent plasma protein that functions as a cofactor of activated protein C (APC) in the inactivation of coagulation factors Va and Villa.Protein S, migrates as a doublet on reduced SDS polyacrylamide gel electrophoresis. This heterogeneity in molecular weight has been explained by limited proteolysis of protein S. Human protein S contains at Arg-49, Arg-60 and Arg-70 three potential cleavage sites. Whether cleavage occurs at all three sites is not known. To study the role of these arginine residues in human protein S, we have replaced them by leucine or isoleucine. All seven possible variants were constructed: three variants with single mutations (R49L, R60L, R70I), three variants with double mutations (R49L/R60L, R60L/R70I, R49L/R70I) and one variant with a triple mutation (R49L/R60L/R70I). On reduced SDS polyacrylamide gels the single and double variants migrate as a doublet just like the wild type protein S. The triple variant migrates as a single band at a molecular weight corresponding to the upper band of the doublet. The upper band of the single and double variants but not of the triple variant could be converted into the lower band by thrombin treatment.All variants showed cofactor activity to APC in a clotting assay. After thrombin treatment, this cofactor activity was abolished for the single (R49L, R60L, R70I) and double variants (R49L/R60L, R60L/R70I, R49L/R70I), while the triple variant (R49L/R60L/R70I) tested at several concentrations, retained its cofactor activity completely, suggesting resistance to thrombin. This shows that thrombin can cleave at all three arginine sites and that cleavage at each of these sites results in the loss of APC cofactor activity. Finally, all variants bind to C4b-binding protein with an affinity similar as the wild type recombinant molecule.