bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rates of Concussion Are Lower in National Football League Games Played at Higher Altitudes
Authors: Myer Gregory D. , Smith David , Barber Foss Kim D. , Dicesare Christopher A. , Kiefer Adam W. , Kushner Adam M. , Thomas Staci M. , Sucharew Heidi , Khoury Jane C. 
Published: January 2014

Study Design Retrospective epidemiologic investigation. Objective To investigate the relationship between altitude and concussion rate in the National Football League (NFL). Because of the physiologic responses that occur during acclimatization to altitude, it was hypothesized that games played on fields at a higher altitude would have reduced concussion rates compared to games played on fields at a lower altitude. Background Recent research indicates that the elevation above sea level at which football games are played may be associated with the likelihood of a concussion in high school football athletes. Methods Data on incident concussions and athlete exposures for the first 16 weeks of the NFL 2012 and 2013 regular seasons were obtained from publicly available web-based sources and used to calculate competition concussion rates for each NFL stadium. Concussion rates were analyzed in relation to game elevation. Results During the first 16 weeks of the 2012 and 2013 NFL regular seasons, 300 concussions, involving 284 players, were reported (64.3 primary cases per 10 000 game exposures). The odds of a concussion were 30% lower when playing at a higher elevation (equal to or greater than 644 ft [196.3 m] above sea level) compared to a lower elevation (odds ratio = 0.70; 95% confidence interval: 0.53, 0.94). A multivariable generalized linear model controlling for season, week, and clustering of team at home and away confirmed these results, showing that the odds of at least 1 concussion were reduced by 32% in games played at higher elevation. Conclusion The results of this epidemiological investigation indicate that increased altitude was associated with a reduction in the odds of a sport-related concussion in NFL athletes. The reported relationship of concussion incidence and field elevation should be further investigated, and, if verified, further work will be needed to understand why that relationship exists. Level of Evidence Prognosis, level 2c. J Orthop Sports Phys Ther 2014;44(3):164–172. Epub 28 January 2014. doi:10.2519/jospt.2014.5298
Hockey Concussion Education Project, Part 3. White matter microstructure in ice hockey players with a history of concussion: a diffusion tensor imaging study
Authors: Sasaki Takeshi , Pasternak Ofer , Mayinger Michael , Muehlmann Marc , Savadjiev Peter , Bouix Sylvain , Kubicki Marek , Fredman Eli , Dahlben Brian , Helmer Karl G. , Johnson Andrew M. , Holmes Jeffrey D. , Forwell Lorie A. , Skopelja Elaine N. , Shenton Martha E. , Echlin Paul S. , Koerte Inga K. 
Published: January 2014

Object
The aim of this study was to examine the brain's white matter microstructure by using MR diffusion tensor imaging (DTI) in ice hockey players with a history of clinically symptomatic concussion compared with players without a history of concussion.

Methods
Sixteen players with a history of concussion (concussed group; mean age 21.7 ± 1.5 years; 6 female) and 18 players without a history of concussion (nonconcussed group; mean age 21.3 ± 1.8 years, 10 female) underwent 3-T DTI at the end of the 2011–2012 Canadian Interuniversity Sports ice hockey season. Tract-based spatial statistics (TBSS) was used to test for group differences in fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and the measure “trace,” or mean diffusivity. Cognitive evaluation was performed using the Immediate Postconcussion Assessment and Cognitive Test (ImPACT) and the Sport Concussion Assessment Tool–2 (SCAT2).

Results
TBSS revealed a significant increase in FA and AD, and a significant decrease in RD and trace in several brain regions in the concussed group, compared with the nonconcussed group (p < 0.05). The regions with increased FA and decreased RD and trace included the right posterior limb of the internal capsule, the right corona radiata, and the right temporal lobe. Increased AD was observed in a small area in the left corona radiata. The DTI measures correlated with neither the ImPACT nor the SCAT2 scores.

Conclusions
The results of the current study indicate that a history of concussion may result in alterations of the brain's white matter microstructure in ice hockey players. Increased FA based on decreased RD may reflect neuroinflammatory or neuroplastic processes of the brain responding to brain trauma. Future studies are needed that include a longitudinal analysis of the brain's structure and function following a concussion to elucidate further the complex time course of DTI changes and their clinical meaning.
La garrigue, monde de l'écarlate
Authors: Cardon Dominique 
Published: January 2014

Scrubland, the world of scarlet -
The kermès (vermiculus in medieval Latin) parasitize the "kermès oak"; their dried bodies are used to make scarlet, the most prestigious red dye during the Middle Ages. The harvest of this dyestuff and international trade in it were so profitable that systems were set for managing scrublands in many mediterranean regions so as to favor the proliferation of this scale insect. This species and its natural environment waned and eventually disappeared as cochineal from America in the 16th century and chemical dyes more recently replaced this scarlet.
Gouvernance d'Internet, gouvernance de Wikipedia : l'apport des analyses d'E. Ostrom sur l'action collective auto-organisée
Authors: Fallery Bernard , Rodhain Florence 
Published: January 2014

Quel pourrait être l’apport des analyses d’E. Ostrom dans le champ de la gouvernance sur Internet ? Nous justifions d’abord notre appel au modèle du choix institutionnel, en montrant que le « système Internet » ne relève plus seulement d’une évidente logique de biens privés et d’une claire logique de biens publics, mais aussi aujourd’hui d’une nouvelle logique « d’appropriateurs » de ressources limitées, au sens de E. Ostrom (et notamment des ressources énergétiques et environnementales). Nous analysons ensuite la gouvernance de l’institution Internet comme un régime de légitimité faible (associant autorégulation libertaire, co-régulation normative et multi-régulation organisée), puis la gouvernance du collectif Wikipedia comme un régime de consensus approché (associant vigilance mutuelle, régulation des conflits et sanctions graduées). Les analyses d’E. Ostrom sur les systèmes auto-organisés permettent enfin de justifier pour Internet la légitimité du contrôle local (à chacun des trois niveaux de règles que distingue E. Ostrom : choix opérationnels, choix collectifs et choix constitutionnels) et la nécessaire réflexivité des choix (dans ce que E. Ostrom appelle les multiples arènes locales, où s’élaborent ces règles).
Geoelectrical monitoring of frozen ground and permafrost in alpine areas: field studies and considerations towards an improved measuring technology
Authors: Supper Robert , Ottowitz David , Jochum Birgit , Römer Alexander , Pfeiler Stefan , Kauer Stefanie , Keuschnig Markus , Ita Anna 
Published: January 2014

ABSTRACTProcesses that control permafrost warming in Alpine regions are still not completely understood. Recently, geoelectrical monitoring has emerged as a useful tool to investigate thawing and freezing processes. However, high resistive environments and harsh environmental conditions pose very unfavourable conditions for automated resistivity measurements. Based on the results of several test studies, an improved data acquisition system for geoelectrical monitoring of frozen soils was developed. Furthermore, the implementation of algorithms for statistical analysis of raw data time series led to a significant improvement in the reliability of inversion results. At two Alpine sites, namely Molltaler Glacier and Magnetkopfl/Kitzsteinhorn, the adapted system was tested at soil temperature conditions between 0°C and –12°C. Data was continuously collected at both locations over nearly a full seasonal cycle. The results showed an almost linear dependency of resistivity and temperature at values above –0.5°C. At lower temperatures, the relation was non‐linear, indicating that the reduction of porosity due to the shrinking of connected brine channels was the dominating process that determined the value of resistivity. Based on the derived results, further improvements were suggested, especially for measurements at soil temperatures below –4.5°C as low injection currents make it extremely challenging to gather these.
Frozen ground dynamics resolved by multi‐year and year‐round electrical resistivity monitoring at three alpine sites in the Swiss Alps
Authors: Kneisel C. , Rödder T. , Schwindt D. 
Published: January 2014

ABSTRACTFrozen ground characteristics resolved by annual, seasonal/monthly and daily electrical resistivity monitoring are presented based on case studies from three alpine sites in the Swiss Alps with different surface conditions and subsurface process dynamics.Data acquisition is achieved by different set‐ups ranging from low‐cost to automated and more expensive monitoring strategies. To ensure the reproducibility of measurement results a robust setup is required within the rough surface conditions of alpine environments, and this constitutes a fundamental precondition for time‐lapse measurements.The selected different monitoring approaches allow for a detection and analysis of processes related to frozen ground dynamics on varying timescales. The interpretation of the geophysical data is improved by temperature measurements from various data loggers and borehole data.All three approaches allowed detection of the interface between frozen and unfrozen ground. The variation of the frequency of measurements enabled exploration of the specific permafrost‐related problems. At one site, the multi‐annual resistivity distribution at the end of the thawing period revealed fairly stable permafrost conditions, while at the second site, year‐round measurements showed extremely divergent evolution of resistivity values in the subsurface throughout the measurement period, which could be ascribed to different site‐specific environmental parameters. Using measurements with daily resolution at the third field site, the rapid decrease in subsurface resistivity values due to the infiltration of meltwater in spring could be documented. The presented results show that the different monitoring set‐ups have their justification and are able to monitor timedependent subsurface dynamics within the scale of their temporal resolution.The operation of an automated monitoring system allows for very efficient observation especially of short‐time processes within the active layer and the frozen ground below, the major advantage in comparison to non‐automated monitoring approaches. However, the system is cost‐intensive, requires an extensive infrastructure, and is more prone to environmental forces. For monitoring the inter‐annual and long‐term permafrost evolution, application of a fixed monitoring set‐up that is accessible throughout the year and measured manually has proven to be a robust and cost‐efficient alternative. Focusing on the long‐term permafrost evolution, set‐ups using fixed electrodes and measurements conducted as needed with a brought‐along cable is a legitimate approach. Hence, for studies in alpine permafrost environments, choice of the monitoring set‐up remains a question of the scientific problem, infrastructure facilities, and cost‐efficiency.
Relevance of Nck–CD3ε Interaction for T Cell Activation In Vivo
Authors: Borroto Aldo , Arellano Irene , Blanco Raquel , Fuentes Manuel , Orfao Alberto , Dopfer Elaine P. , Prouza Marek , Suchànek Miloslav , Schamel Wolfgang W. , Alarcón Balbino 
Published: January 2014

Abstract
On TCR ligation, the adaptor Nck is recruited through its src homology 3.1 domain to a proline-rich sequence (PRS) in CD3ε. We have studied the relevance of this interaction for T cell activation in vitro and in vivo by targeting the interaction sites in both partners. The first approach consisted of studying a knockin (KI) mouse line (KI-PRS) bearing a conservative mutation in the PRS that makes the TCR incompetent to recruit Nck. This deficiency prevents T cell activation by Ag in vitro and inhibited very early TCR signaling events including the tyrosine phosphorylation of CD3ζ. Most important, KI-PRS mice are partly protected against the development of neurological symptoms in an experimental autoimmune encephalitis model, and show a deficient antitumoral response after vaccination. The second approach consisted of using a high-affinity peptide that specifically binds the src homology 3.1 domain and prevents the interaction of Nck with CD3ε. This peptide inhibits T cell proliferation in vitro and in vivo. These data suggest that Nck recruitment to the TCR is fundamental to mount an efficient T cell response in vivo, and that the Nck–CD3ε interaction may represent a target for pharmacological modulation of the immune response.
Phosphoinositide 3-Kinase δ Regulates Migration and Invasion of Synoviocytes in Rheumatoid Arthritis
Authors: Bartok Beatrix , Hammaker Deepa , Firestein Gary S. 
Published: January 2014

Abstract
Cartilage destruction mediated by invasive fibroblast-like synoviocytes (FLS) plays a central role in pathogenesis of rheumatoid arthritis (RA). Increased cell migration and degradation of extracellular matrix are fundamental to these processes. The class I PI3Ks control cell survival, proliferation, and migration, which might be involved in cartilage damage in RA. PI3Kδ isoform was recently identified as a key regulator of FLS growth and survival, suggesting that it could contribute to synoviocyte aggressive behavior. Therefore, we assessed the role of PI3Kδ in RA synoviocyte migration and invasion. We observed that PI3Kδ inhibition or small interfering RNA knockdown decreased platelet-derived growth factor (PDGF)–mediated migration and invasion of FLS. We then showed that PI3Kδ regulates the organization of actin cytoskeleton and lamellipodium formation during PDGF stimulation. To gain insight into molecular mechanisms, we examined the effect of PI3Kδ inhibition on Rac1/PAK, FAK, and JNK activation. Our studies suggest that Rac1/PAK is key target of PDGF-mediated PI3Kδ signaling, whereas FAK and JNK are not involved. Thus, PI3Kδ contributes to multiple aspects of the pathogenic FLS behavior in RA. These observations, together with previous findings that PI3Kδ regulates FLS growth and survival, suggest that PI3Kδ inhibition could be chondroprotective in RA by modulating synoviocyte growth, migration, and invasion.
Allelic Exclusion of IgH through Inhibition of E2A in a VDJ Recombination Complex
Authors: Hauser Jannek , Grundström Christine , Grundström Thomas 
Published: January 2014

Abstract
A key feature of the immune system is the paradigm that one lymphocyte has only one Ag specificity that can be selected for or against. This requires that only one of the alleles of genes for AgR chains is made functional. However, the molecular mechanism of this allelic exclusion has been an enigma. In this study, we show that B lymphocytes with E2A that cannot be inhibited by calmodulin are dramatically defective in allelic exclusion of the IgH locus. Furthermore, we provide data supporting that E2A, PAX5, and the RAGs are in a VDJ recombination complex bound to key sequences on the Igh gene. We show that pre-BCR activation releases the VDJ recombination complex through calmodulin binding to E2A. We also show that pre-BCR signaling downregulates several components of the recombination machinery, including RAG1, RAG2, and PAX5, through calmodulin inhibition of E2A.
G-CSF Drives a Posttraumatic Immune Program That Protects the Host from Infection
Authors: Gardner Jason C. , Noel John G. , Nikolaidis Nikolaos M. , Karns Rebekah , Aronow Bruce J. , Ogle Cora K. , McCormack Francis X. 
Published: January 2014

Abstract
Traumatic injury is generally considered to have a suppressive effect on the immune system, resulting in increased susceptibility to infection. Paradoxically, we found that thermal injury to the skin induced a robust time-dependent protection of mice from a lethal Klebsiella pneumoniae pulmonary challenge. The protective response was neutrophil dependent and temporally associated with a systemic increase in neutrophils resulting from a reprioritization of hematopoiesis toward myeloid lineages. A prominent and specific activation of STAT3 in the bone marrow preceded the myeloid shift in that compartment, in association with durable increases in STAT3 activating serum cytokines G-CSF and IL-6. Neutralization of the postburn increase in serum G-CSF largely blocked STAT3 activation in marrow cells, reversing the hematopoietic changes and systemic neutrophilia. Daily administration of rG-CSF was sufficient to recapitulate the changes induced by injury including hematopoietic reprioritization and protection from pulmonary challenge with K. pneumoniae. Analysis of posttraumatic gene expression patterns in humans reveals that they are also consistent with a role for G-CSF as a switch that activates innate immune responses and suppresses adaptive immune responses. Our findings suggest that the G-CSF STAT3 axis constitutes a key protective mechanism induced by injury to reduce the risk for posttraumatic infection.
Ethical practice of evidence-based medicine: A review for plastic surgeons
Authors: Ahuja Rajeev B. 
Published: January 2014

ABSTRACTLast decade has witnessed a spurt in articles focused on the topic of evidence-based medicine (EBM) and medical ethics. These articles are not only educative, but draw attention to the changing scenario of medical practice. Surgeons seem a bit less attentive to practice of EBM, more so in the developing world. The theme is now percolating in our realm for demonstrable incorporation of EBM in our practice, which is allegorical of a good physician and is also likely to become demanding legally. In practicing EBM, several conflicts may arise with the ethical vows of medicine. However, majority of these conflicting issues have germinated from a capitalistic approach to medical practice, where the fear of extraneous compulsions dictating prescriptions and procedures in the garb of ′evidence-based practice′ conflicts ethical behaviour. This review shall appraise the reader with important definitions of medical ethics, EBM and how to incorporate best evidence into ones practice. While, EBM brings objectivity to treatment to derive measurable outcomes it should not become regimented or metamorphose as a pseudonym for defensive medicine to escalate treatment costs. EBM also has several limitations one of which is to place the onus on the practicing physician to search for the best evidence and the other is the resource constraint of practice in the developing world. How a plastic surgery practice could be made to conform to evidence based (EB) procedures is proposed as insufficient surgical skills can pose a serious threat to not only the practice of EB procedures, but to ethical responsibilities as well. In conclusion, it is necessary to incorporate ethical temperance into EB procedures to withstand societal, peer and legal pressures of current times.
Sentinel lymph node biopsy for cutaneous melanoma: A 6 years study
Authors: Sánchez Jaime Lima , Medina M. Sánchez , Duque O. García , Pérez M. Fiúza , Hernández G. Carretero , Palácios J. Fernández 
Published: January 2014

ABSTRACT
Background: The aim of this study was to evaluate the results of sentinel lymph node biopsy (SLNB) in cutaneous melanoma at our institution. Materials and Methods: 128 patients with primary cutaneous melanoma who underwent SLNB between April, 2004, and August, 2010 were studied. Univariate and multivariate analysis was performed to explore the effect of variables on mortality and sentinel node status. Survival analysis was performed using the Kaplan-Meier approach. Results: Positive SLNB were detected in 35 (27.3%) of 128 cases. Mean Breslow depths were 3.7 mm for SLNB positive patients and 1.99 mm for SLNB negative patients. False negative rate was 1%. The recurrence rate was 40% for positive patients and 6.5% for negative patients (odds ratio 9.7 [confidence interval 95 % 3.3-28.1]). 33 patients (29%) had an ulcerated melanoma, 12 (10.5%) in the positive group and 21 (18.5%) in the negative group. The disease recurred in a 48.5% of patients with ulcerated melanoma, but only in a 2.5% of patients with non-ulcerated melanoma. Upon multivariate analysis, only Breslow thickness (P = 0.005) demonstrate statistically significance for SLNB status. Multivariate analysis for clinicopathologic predictors of death demonstrate statistically significance for Breslow thickness (P = 0.020), ulceration (P = 0.030) and sentinel node status (P = 0.020). Conclusions: This study confirms that the status of the sentinel node is a strong independent prognostic factor with a higher risk of death and lower survival. Patients with ulcerated melanoma are more likely to develop recurrence, and also higher risk of death than patients with non-ulcerated melanoma.
Julian of Norwich and Catherine of Siena:
Authors: Minore Anna 
Published: January 2014

ABSTRACT
This article explores the writings of Julian of Norwich and Catherine of Siena in relation to their treatment of pain. The first section gives a brief overview of their cultural contexts, and the second section situates their theology within the schema of judgment and compassion put forward by Rachel Fulton. In both of these sections, the lenses of the crucifix and of the will serve to highlight the different emphases in the women's theologies. The third section focuses on their analyses of the causes of pain, which yields three themes: the human condition, God, and sin. The article as a whole thus provides a deeper understanding of the different emphases within the two women's theologies, as well as providing two distinct models for analyzing and working with pain.
Optimal Initial Dose of Chloral Hydrate in Management of Pediatric Facial Laceration
Authors: Koo Su Han , Lee Dong Gwan , Shin Heakyeong 
Published: January 2014

BackgroundChloral hydrate (CH) is the primary agent most commonly used for pediatric sedation prior to diagnostic, therapeutic procedures. In the management of pediatric facial laceration, the initial dose of CH has to balance the need for adequate sedation against the need to minimize sedative complications.
MethodsA retrospective review of medical records of 834 children who visited our emergency room for facial lacerations from August 2010 to September 2012 was conducted. They were divided into six groups on the basis of the initial dose of CH administered. Further, each group was compared with the standard group (70 to ≤80 mg/kg) with respect to sedation success, augmentation dose, failed sedation, time to procedure, and time of stay.
ResultsWith respect to the complication rate, only group 1 (range, 40 to ≤50 mg/kg) showed a significantly lower complication rate. In the case of all the other variables considered, there were no significant differences among any of the groups.
ConclusionsAn initial CH dose of 48±2 mg/kg does not negatively affect the success rate of sedation or the need for additional sedative during the primary closure of facial lacerations in pediatric patients. Further, lower doses reduce the incidences of adverse effects and do not delay procedure readiness. Therefore, 48±2 mg/kg of CH can be considered the optimal initial dose for pediatric sedation.