bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factor IX-Padua enhances the fibrinolytic resistance of plasma clots
Authors: Ammollo Concetta T. , Semeraro Fabrizio , Colucci Mario , Simioni Paolo 
Published: October 2013

SummaryHypercoagulable conditions may determine a hypofibrinolytic state by increasing the activation of thrombin-activatable fibrinolysis inhibitor (TAFI). Factor (F)IX-Padua is a mutated FIX with an eight-fold increased clotting activity and associates with a higher venous thrombotic risk. We evaluated the influence of FIX-Padua on TAFI-mediated regulation of fibrinolysis. A subject hemizygous for FIX-Padua, two family members (heterozygous and normal) and six healthy controls were studied. Clot lysis, TAFI activation and thrombin generation were evaluated in contact-inhibited plasma challenged with low concentrations of tissue factor. Fibrinolysis times were significantly longer in FIX-Padua carriers than controls. The difference disappeared when activated TAFI (TAFIa) was inhibited, when TAFI activation was avoided or when clotting was made independent of FIX. TAFIa generation was markedly enhanced in FIX-Padua carriers as compared to controls, and this could be explained by a greater thrombin generation in the former. Hyperactive FIX, but not wild-type FIX, enhanced fibrinolytic resistance also when the FXI-dependent positive feedback was blocked by a neutralising anti-FXI antibody. This thrombin-mediated, TAFI-dependent down-regulation of fibrinolysis provides new clues for explaining the heightened thrombotic risk in subjects carrying the FIXPadua mutation.
“The Redeemer to Arise from the House of Dan”: Samson, Apocalypticism, and Messianic Hopes in Late Antique Galilee
Authors: Grey Matthew J. 
Published: October 2013

Abstract
In the last five years, two mosaics depicting Samson’s biblical exploits have been discovered in Lower Eastern Galilee. Both mosaics were found in synagogues that date to the Late Roman/Byzantine period and are located in close proximity to Tiberias. Because of the rarity of Samson in ancient Jewish art and Samson’s lack of historical ties to the region, the significance of these mosaics requires explanation. This article explores this significance by considering the socio-religious context of the region in which the mosaics were discovered. Sources indicate that apocalyptic thought and messianic expectations flourished in Jewish Galilee throughout late antiquity, particularly in the vicinity of Tiberias. In addition, liturgical texts show that some Jews in this period viewed Samson as a biblical type of the future messiah—a redeemer of the past who foreshadowed Israel’s eschatological redemption. This confluence of evidence suggests that the Samson mosaics can be viewed as apocalyptic images reflecting messianic hopes that were popular in late antique Galilee.
Dual-Wavelength Polarimetric Radar Analyses of Tornadic Debris Signatures
Authors: Bodine David J. , Palmer Robert D. , Zhang Guifu 
Published: October 2013

AbstractStatistical properties of tornado debris signatures (TDSs) are investigated using S- and C-band polarimetric radar data with comparisons to damage surveys and satellite imagery. Close proximity of the radars to the 10 May 2010 Moore–Oklahoma City, Oklahoma, tornado that was rated as a 4 on the enhanced Fujita scale (EF4) provides a large number of resolution volumes, and good temporal and spatial matching for dual-wavelength comparisons. These comparisons reveal that S-band TDSs exhibit a higher radar reflectivity factor (ZHH) and copolar cross-correlation coefficient (ρhv) than do C-band TDSs. Higher S-bandρhvmay result from a smaller ratio of non-Rayleigh scatterers to total scatterers due to the smaller electrical sizes of debris and, consequently, reduced resonance effects. A negativeZDRsignature is observed at 350 m AGL at both the S and C bands as the tornado passes over a vegetated area near a large body of water. Another interesting signature is a positive (negative) shift in propagation differential phase (ΦDP) at S band (C band), which could result from increased phase folding at C band. With increasing height above 350 m AGL, the S- and C-bandZHHdecreases andρhvincreases, indicating a decrease in debris size. To investigate relationships between polarimetric variables and tornado wind fields, range profiles of radial and tangential wind speeds are obtained using two radars. Velocity profiles reveal radial divergence within vortex core flow through 700 m AGL collocated with the TDS. Formation of a weak-echo hole and higherρhvin the vortex center aloft suggests debris centrifuging, outward motion of scatterers due to radial divergence (i.e., two-cell vortex flow), or both.
Hypothesis Testing for Autocorrelated Short Climate Time Series
Authors: Guemas Virginie , Auger Ludovic , Doblas-Reyes Francisco J. 
Published: October 2013

AbstractCommonly used statistical tests of hypothesis, also termed inferential tests, that are available to meteorologists and climatologists all require independent data in the time series to which they are applied. However, most of the time series that are usually handled are actually serially dependent. A common approach to handle such a serial dependence is to replace in those statistical tests the actual number of data by an estimated effective number of independent data that is computed from a classical and widely used formula that relies on the autocorrelation function. Despite being perfectly demonstrable under some hypotheses, this formula provides unreliable results on practical cases, for two different reasons. First, the formula has to be applied using the estimated autocorrelation function, which bears a large uncertainty because of the usual shortness of the available time series. After the impact of this uncertainty is illustrated, some recommendations of preliminary treatment of the time series prior to any application of this formula are made. Second, the derivation of this formula is done under the hypothesis of identically distributed data, which is often not valid in real climate or meteorological problems. It is shown how this issue is due to real physical processes that induce temporal coherence, and an illustration is given of how not respecting the hypotheses affects the results provided by the formula.
Radial artery compression in incomplete palmar arch for radial artery harvesting
Authors: Mohite Prashant N , Thingnam Shyam K , Saxena Akshay K 
Published: October 2013

Background incomplete palmar arch causing inadequate collateral flow is considered a contraindication for harvesting radial artery as a conduit for coronary artery bypass grafting. The objective of this pilot study was to assess whether iatrogenic radial artery compression could improve collateral circulation in the nondominant hand in such patients. Methods 5 patients scheduled for coronary artery bypass, with incomplete palmar arch suspected by an abnormal modified Allen’s test and confirmed by dynamic color Doppler sonography, were included in the study. The flow in branches of the radial artery (superficial palmar branch and dorsal digital artery of the thumb) was measured by dynamic color Doppler sonography. Intermittent radial artery compression was applied to the nondominant hand, using a radial compression device for 15 days, and the tests were repeated to assess changes in radial artery branch flow. Results flow in the superficial palmar branch was increased in 3 patients, with a significant increase in 2 of them. The 3 patients in whom the dorsal digital artery of the thumb could be seen on precompression Doppler, all had substantially increased flow. The increase in flow assessed by the modified Allen’s test was statistically significant, but the flow change measured by Doppler sonography did not reach statistical significance. Conclusions collaterals developed during 15 days of intermittent radial artery compression. The collateral development led to increased flow in the radial artery branches. A larger sample is required to confirm the results.
Quality of chest radiograph reports
Authors: Hirvonen-Kari Mirja , Sormaala Markus J , Luoma Katariina , Kivisaari Leena , Lohman Martina 
Published: October 2013

Background Examination requests and imaging reports are the most important communication instruments between clinicians and radiologists. An accurate and clear report helps referring physicians make care decisions for their patients. Purpose To evaluate the contents of initial and re-reported chest reports, assess the inter-observer agreement, and evaluate the clarity of the report contents from the viewpoint of the referring physicians. Material and Methods The content and agreement of the reports were analyzed by comparing the initial reports with re-reports prepared by a chest radiologist. The referring physicians evaluated the contents of 50 reports regarding their medical facts, clarity, and intelligibility. The results were analyzed using cross-over tables, the Pearson Chi-Square, and kappa statistics. Results Radiologists mostly addressed the questions posed by the referring physicians. General radiologists included separate conclusions in their reports more frequently (22%) than the chest radiologist in her re-reports. Reports prepared by the chest radiologist contained nearly 50% more findings than the general radiologists’ reports. Inter-observer agreement between the initial and specialist re-reported reports was 66%, but the kappa value was 0.31. The reports were considered clear/intelligible by the referring physicians in 68% of the initial reports by the general radiologists and in 94% of the re-reported studies by the chest radiologist. Conclusion Radiology report quality was rather high despite their contents varying depending on the radiologist. Inter-observer agreement of the chest radiographs was low due to the non-structured reports containing different quantities of information, thus complicating the comparison. Referring physicians considered both short and long radiology reports to be clear.
Brain Injury as a Risk Factor for Fever Upon Admission to the Intensive Care Unit and Association With In-Hospital Case Fatality
Authors: Rincon Fred , Patel Utkal , Schorr Christa , Lee Elizabeth , Ross Steven , Dellinger R. Phillip , Zanotti-Cavazzoni Sergio 
Published: October 2013

Purpose: To test the hypothesis that fever was more frequent in critically ill patients with brain injury when compared to nonneurological patients and to study its effect on in-hospital case fatality. Methods: Retrospective matched cohort study utilizing a single-center prospectively compiled registry. Critically ill neurological patients ≥18 years and consecutively admitted to the intensive care unit (ICU) with acute ischemic stroke (AIS), intracerebral hemorrhage (ICH), and traumatic brain injury (TBI) were selected. Patients were matched by sex, age, and Acute Physiology and Chronic Health Evaluation II (APACHE-II) to a cohort of nonneurological patients. Fever was defined as any temperature ≥37.5°C within the first 24 hours upon admission to the ICU. The primary outcome measure was in-hospital case fatality. Results: Mean age among neurological patients was 65.6 ± 15 years, 46% were men, and median APACHE-II was 15 (interquartile range 11-20). There were 18% AIS, 27% ICH, and 6% TBI. More neurological patients experienced fever than nonneurological patients (59% vs 47%, P = .007). The mean hospital length of stay was higher for nonneurological patients (18 ± 20 vs 14 ± 15 days, P = .007), and more neurological patients were dead at hospital discharge (29% vs 20%, P < .0001). After risk factor adjustment, diagnosis (neurological vs nonneurological), and the probability of being exposed to fever (propensity score), the following variables were associated with higher in-hospital case fatality: APACHE-II, neurological diagnosis, mean arterial pressure, cardiovascular and respiratory dysfunction in ICU, and fever (odds ratio 1.9, 95% confidence interval 1.04-3.6, P = .04). Conclusion: These data suggest that fever is a frequent occurrence after brain injury, and that it is independently associated with in-hospital case fatality.
Non-scarring patchy alopecia in patients with systemic lupus erythematosus differs from that of alopecia areata
Authors: Ye Y , Zhao Y , Gong Y , Zhang X , Caulloo S , Zhang B , Cai Z , Yang J , McElwee KJ , Zhang X 
Published: October 2013

Background Non-scaring patchy alopecia associated with systematic lupus erythematosus (SLE) is sometimes mis-diagnosed as alopecia areata (AA). Objectives Our aim was to differentiate non-scarring patchy SLE alopecia features from patchy AA. Methods Clinical, dermatoscopic and histopathological data from 21 SLE patients with patchy alopecia were compared with data from 21 patients with patchy AA. Results Incomplete alopecia was common in SLE alopecia patches, while AA patches exhibited complete alopecia. Exclamation-mark hairs, black dots, broken hair and yellow dots were common to AA, while hair shaft thinning and hypopigmentation, angiotelectasis, peripilar sign, perifollicular red dots, white dots and honeycomb pigment patterns were more common in SLE. Interfollicular polymorphous vessels were the most common angiotelectasis presentation in the SLE alopecia patches, but interfollicular arborizing vessels were significantly more common in non-hair-loss-affected SLE regions and in AA hair-loss regions. During follow-up, increased vellus hair was the earliest feature that emerged after treatment both in SLE and AA, while the earliest feature that disappeared was hair shaft hypopigmentation in SLE and broken hair in AA. After treatment, no SLE patients had relapse of alopecia, while 41.7% of AA patients did. Conclusion Distinct clinical, dermatoscopic and histopathological features were found in SLE-associated alopecia regions, which were different from those of AA. Serological autoantibody tests are of value to confirm the differential diagnosis. Local angiotelectasis and vasculitis close to hair follicles may be involved in the pathogenesis of alopecia in SLE.
Percutaneous Tenotomy for the Treatment of Diabetic Toe Ulcers
Authors: Tamir Eran , Vigler Mordechai , Avisar Erez , Finestone Aharon S. 
Published: October 2013

Background: Foot ulcers have been implicated as a causative factor in diabetic foot amputations. The purpose of this study was to evaluate treating foot ulcers in patients with diabetes by percutaneous tenotomy. Methods: We retrospectively reviewed the computerized medical files of 83 patients treated for foot ulcers by percutaneous tenotomies. Results were analyzed on the basis of indication and per patient. Results: The 83 patients had 160 tenotomies for 4 indications: 103 tip-of-toe ulcers (treated by flexor digitorum longus tenotomy), 26 cock-up/dorsal ulcers (extensor digitorum longus tenotomy), 21 kissing ulcers (extensor digitorum longus and/or flexor digitorum longus tenotomies), and 10 plantar metatarsal ulcers (extensor digitorum longus with or without flexor digitorum longus tenotomy). Healing at 4 weeks was 98%, 96%, 81%, and 0%, respectively. The complication rate was very low, with the exception of “transfer lesions,” where an adjacent toe became involved and needed subsequent tenotomy in 8% of tip-of-toe ulcers. Conclusions: Percutaneous tenotomy was an effective and safe method for treating toe ulcers in neuropathic patients. It was not effective in treating plantar metatarsal ulcers. Level of Evidence: Level IV, case series.
Is the idea of a sovereign authority based on legal rules and human rights outdated?
Authors: Kunz Karl-Ludwig 
Published: October 2013

The desire to establish a sovereign authority governed by law, justice and the respect for individual dignity is fascinating. However, the history of the German version of the realization of this desire, the Rechtsstaat, proves that whether or not this works out depends on the conditions under which the concept is formed and implemented. Cultural, socio-economic and political conditions have always had a great influence on both the concrete interpretation of the idea and on the effectiveness of its realization. We are confronted with vast changes in the late modern era. Global society increasingly exercises risk control by means of international cooperation and transnational regulation. Human rights standards are neglected in order to prevent or avert danger. As the idea of a state based on legal rules and human rights continues to lose its grip, the question arises whether and how the basic values associated with this idea could be preserved in the globally intertwined risk society.
Pefluorocarbon inhibition of bubble induced Ca2+ transients in an in vitro model of vascular gas embolism
Authors: Klinger Alexandra L , Kandel Judith , Pichette Benjamin , Eckmann David M 
Published: October 2013

Endothelial injury resulting from deleterious interaction of gas microbubbles occurs in many surgical procedures and other medical interventions. The symptoms of vascular air embolism (VAE), while serious, are often difficult to detect, and there are essentially no pharmaceutical preventative or post-event treatments currently available. Perfluorocarbons (PFCs), however, have shown particular promise as a therapeutic option in reducing endothelial injury both in- and ex-vivo. Recently, we demonstrated the effectiveness of Oxycyte, a third-generation PFC formulated in a phosphotidylcholine emulsion, using an in vitro model of VAE developed in our laboratory. This apparatus allows live cell imaging concurrent with precise manipulation of physiologically sized microbubbles so that they may be brought into individual contact with human umbilical vein endothelial cells dye-loaded with the Ca2+ sensitive Fluo-4. Herein, we expand use of this fluorescence microscopy-based cell culture model. Specifically, we examined the concentration dependence of Oxycyte in reducing both the amplitude and frequency of large intracellular Ca2+ currents that are both a hallmark of bubble contact and a quantifiable indication that abnormal intracellular signaling has been triggered. We measured dose dependence curves and fit the resultant data using a modified Black and Leff operational model of agonism. The half maximal inhibitory concentrations of Oxycyte for (i) inhibition of occurrence and (ii) amplitude reduction were 229 ± 49 µM and 226 ± 167 µM, respectively. This investigation shows the preferential gas/liquid interface occupancy of the PFC component of Oxycyte over that of mechanosensing glycocalyx components and validates Oxycyte’s specific surfactant mechanism of action. Further, no lethality was observed for any concentration of this bioinert PFC, as it acts as a competitive allosteric inhibitor of syndecan activation to ameliorate cell response to bubble contact.
Implementation of the care programme approach across health and social services for dual diagnosis clients
Authors: Kelly Michael , Humphrey Charlotte 
Published: October 2013

Background: Care for clients with mental health problems and concurrent intellectual disability (dual diagnosis) is currently expected to be provided through the care programme approach (CPA), an approach to provide care to people with mental health problems in secondary mental health services. When CPA was originally introduced into UK mental health services in the 1990s, its implementation was slow and problematic, being hampered in part by problems occurring at a strategic level as health and social service organizations attempted to integrate complex systems. This article reports on a study of a more recent attempt to implement CPA for dual diagnosis clients in one mental health foundation trust, aiming to gauge progress and identify factors at the strategic level that were helping or hindering progress this time round. Methods: The study took place in a mental health National Health Service (NHS) Foundation Trust in a large English city, which was implementing a joint mental health and intellectual disability CPA policy across five of its constituent boroughs. Semi-structured interviews with key informants at Trust and borough levels focused on the Trust’s overall strategy for implementing CPA and on how it was being put into practice at the front line. Documentary analysis and the administration of the Partnership Assessment Tool were also undertaken. Data were analysed using a framework approach. Results: Progress in implementing CPA varied but overall was extremely limited in all the boroughs. The study identified six key contextual challenges that significantly hindered the implementation progress. These included organizational complexity; arrangements for governance and accountability; competing priorities; financial constraints; high staff turnover and complex information and IT systems. The only element of policy linked to CPA that had been widely taken up was the Greenlight Framework and Audit Toolkit (GLTK). The fact that the toolkit had targets and penalties associated with its implementation appeared to have given it priority. Conclusion: None of the contextual challenges identified in this study were specifically related to CPA as a policy or to the needs and circumstances of dual diagnosis clients. Nevertheless, they inhibited the types of organizational change and partnership working that implementing CPA for a client group of this kind required. Unless these more generic factors are acknowledged and addressed when introducing policies such as CPA, the chances of effective implementation will inevitably be compromised.