bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conversion of Human Fibroblasts to Functional Endothelial Cells by Defined Factors
Authors: Li Jun , Huang Ngan F. , Zou Jun , Laurent Timothy J. , Lee Jerry C. , Okogbaa Janet , Cooke John P. , Ding Sheng 
Published: March 2013

Objective—
Transdifferentiation of fibroblasts to endothelial cells (ECs) may provide a novel therapeutic avenue for diseases, including ischemia and fibrosis. Here, we demonstrate that human fibroblasts can be transdifferentiated into functional ECs by using only 2 factors, Oct4 and Klf4, under inductive signaling conditions.

Approach and Results—
To determine whether human fibroblasts could be converted into ECs by transient expression of pluripotency factors, human neonatal fibroblasts were transduced with lentiviruses encoding Oct4 and Klf4 in the presence of soluble factors that promote the induction of an endothelial program. After 28 days, clusters of induced endothelial (iEnd) cells seemed and were isolated for further propagation and subsequent characterization. The iEnd cells resembled primary human ECs in their transcriptional signature by expressing endothelial phenotypic markers, such as CD31, vascular endothelial-cadherin, and von Willebrand Factor. Furthermore, the iEnd cells could incorporate acetylated low–density lipoprotein and form vascular structures in vitro and in vivo. When injected into the ischemic limb of mice, the iEnd cells engrafted, increased capillary density, and enhanced tissue perfusion. During the transdifferentiation process, the endogenous pluripotency network was not activated, suggesting that this process bypassed a pluripotent intermediate step.

Conclusions—
Pluripotent factor–induced transdifferentiation can be successfully applied for generating functional autologous ECs for therapeutic applications.
Angiotensin II–Induced Vascular Dysfunction Depends on Interferon-γ–Driven Immune Cell Recruitment and Mutual Activation of Monocytes and NK-Cells
Authors: Kossmann Sabine , Schwenk Melanie , Hausding Michael , Karbach Susanne H. , Schmidgen Maria I. , Brandt Moritz , Knorr Maike , Hu Hanhan , Kröller-Schön Swenja , Schönfelder Tanja , Grabbe Stephan , Oelze Matthias , Daiber Andreas , Münzel Thomas , Becker Christian , Wenzel Philip 
Published: March 2013

Objective—
Immune cells contribute to angiotensin II (ATII)–induced vascular dysfunction and inflammation. Interferon-γ (IFN-γ), an inflammatory cytokine exclusively produced by immune cells, seems to be involved in ATII-driven cardiovascular injury, but the actions and cellular source of IFN-γ remain incompletely understood.

Approach and Results—

IFN-γ
−/−
and Tbx21
−/−
mice were partially protected from ATII-induced (1 mg/kg per day of ATII, infused subcutaneously by miniosmotic pumps) vascular endothelial and smooth muscle dysfunction, whereas mice overexpressing IFN-γ showed constitutive vascular dysfunction. Absence of T-box expressed in T cells (T-bet), the IFN-γ transcription factor encoded by Tbx21, reduced vascular superoxide and peroxynitrite formation and attenuated expression of nicotinamide adenosine dinucleotide phosphate oxidase subunits as well as inducible NO synthase, monocyte chemoattractant protein 1, and interleukin-12 in aortas of ATII-infused mice. Compared with controls, IFN-γ
−/−
and Tbx21
−/−
mice were characterized by reduced ATII-mediated vascular recruitment of both natural killer (NK)1.1
+
NK-cells as the major producers of IFN-γ and CD11b
+
Gr-1
low
interleukin-12 secreting monocytes. Selective depletion and adoptive transfer experiments identified NK-cells as essential contributors to vascular dysfunction and showed that T-bet
+
lysozyme M
+
myelomonocytic cells were required for NK-cell recruitment into vascular tissue and local IFN-γ production.

Conclusions—
We provide first evidence that NK-cells play an essential role in ATII-induced vascular dysfunction. In addition, we disclose the T-bet-IFN-γ pathway and mutual monocyte–NK-cell activation as potential therapeutic targets in cardiovascular disease.
The United Nations Convention on the Rights of Persons with Disabilities: A New Approach to Decision-Making in Mental Health Law
Authors: Morrissey Fiona 
Published: March 2013

Abstract
The UN Convention on the Rights of Persons with Disabilities (CRPD) requires us to engage in new approaches to decision-making in mental health law. The reclassification of mental health rights to the realm of disability rights is an important step towards equal treatment for persons with psychosocial disabilities. Law reformers worldwide are beginning to consider the implications of the provisions. Legislators will be required to understand the underlying philosophy of the CRPD to realise the rights set out in it. The CRPD possesses a number of innovative provisions which can transform decision-making in the mental health context. Article 12 provides a new conceptualisation of persons with disabilities and their capacity to participate by requiring support to exercise legal capacity. While good practice exists, the provision has yet to be fully implemented by many State Parties. This article discusses the impact of the CRPD on mental health law, legal capacity law and describes examples of supported decision-making models for mental health care.
The Legal Position of Vulnerable People in the Future: Improving or Going Backwards?
Authors: Dörenberg Vivianne , Frederiks Brenda 
Published: March 2013

Abstract
Two vulnerable groups in our society are children with psychiatric problems and people with intellectual disabilities. The demand for care is growing every year in both groups. The current (Dutch) legal status of people with intellectual disabilities and children with psychiatric problems is one in which too much attention is devoted to the right to self-determination. An important question is whether this central feature is enough to support clients in both groups in such a way that they can develop their abilities. The Dutch government is currently preparing new legislation to replace the Psychiatric Hospitals Act. We recommend that this legislation should also take account of the right to development and the right to good care in order to deal with the dilemmas that will arise in the near future.
On the Identification of the Large-Scale Properties of Tropical Convection Using Cloud Regimes
Authors: Tan Jackson , Jakob Christian , Lane Todd P. 
Published: March 2013

Abstract
The use of cloud regimes in identifying tropical convection and the associated large-scale atmospheric properties is investigated. The regimes are derived by applying cluster analysis to satellite retrievals of daytime-averaged frequency distributions of cloud-top pressure and optical thickness within grids of 280 km by 280 km resolution from the International Satellite Cloud Climatology Project between 1983 and 2008. An investigation of atmospheric state variables as a function of cloud regime reveals that the regimes are useful indicators of the archetypal states of the tropical atmosphere ranging from a strongly convecting regime with large stratiform cloudiness to strongly suppressed conditions showing a large coverage with stratocumulus clouds. The convectively active regimes are shown to be moist and unstable with large-scale ascending motion, while convectively suppressed regimes are dry and stable with large-scale descending winds. Importantly, the cloud regimes also represent several transitional states. In particular, the cloud regime approach allows for the identification of the “building blocks” of tropical convection, namely, the regimes dominated by stratiform, deep, and congestus convection. The availability of the daily distribution of these building blocks for more than 20 years opens new avenues for the diagnosis of convective behavior as well as the evaluation of the representation of convection in global and regional models.
Equally Unprepared: Assessing the Hurricane Vulnerability of Undergraduate Students
Authors: Simms Jason L. , Kusenbach Margarethe , Tobin Graham A. 
Published: March 2013

AbstractStudents have been described as being both particularly vulnerable to natural disasters and highly resilient in recovery. In addition, they often have been treated as a distinct, homogeneous group sharing similar characteristics. This research tests these ideas through an examination of hurricane-related perceptions and preparations of students in a hurricane-prone area. A survey of over 500 undergraduate students (15% on-campus residents, 85% off campus) was conducted at the University of South Florida, a large, metropolitan-based university located in Tampa Bay, Florida, near the Gulf Coast. Following Mann–Whitney and Kruskal–Wallis tests, results showed that students were ill prepared for hurricanes and lacked specific knowledge of the risk. There were small but statistically significant differences in mean responses with respect to gender, age, and ethnicity on specific questions, while ethnicity most strongly warrants future research. Whether the magnitude of statistical differences results in behavioral differences is unclear. Using discriminant function analysis, attempts to identify heterogeneous subgroups based on gender, ethnicity, and age likewise found weak to moderate significant differences, supporting the contention that students are largely homogeneous with regard to certain aspects of hurricane perceptions and preparedness, though again ethnicity demands closer attention in subsequent studies.
Evaluating the Autonomic Nervous System in Patients with Laryngopharyngeal Reflux
Authors: Huang Wan‐Ju , Shu Chih‐Hung , Chou Kun‐Ta , Wang Yi‐Fen , Hsu Yen‐Bin , Ho Ching‐Yin , Lan Ming‐Ying 
Published: March 2013

ObjectivesThe pathogenesis of laryngopharyngeal reﬂux (LPR) remains unclear. It is linked to but distinct from gastroesophageal reflux disease (GERD), which has been shown to be related to disturbed autonomic regulation. The aim of this study is to investigate whether autonomic dysfunction also plays a role in the pathogenesis of LPR.Study DesignCase‐control study.SettingTertiary care center.Subjects and MethodsSeventeen patients with LPR and 19 healthy controls, aged between 19 and 50 years, were enrolled in the study. The patients were diagnosed with LPR if they had a reflux symptom index (RSI) ≥13 and a reflux finding score (RFS) ≥7. Spectral analysis of heart rate variability (HRV) analysis was used to assess autonomic function. Anxiety and depression levels measured by the Beck Anxiety Inventory (BAI) and Beck Depression Inventory II (BDI‐II) were also conducted.ResultsIn HRV analysis, high frequency (HF) represents the parasympathetic activity of the autonomic nervous system, whereas low frequency (LF) represents the total autonomic activity. There were no significant differences in the LF power and HF power between the 2 groups. However, significantly lower HF% (P =. 003) and a higher LF/HF ratio (P =. 012) were found in patients with LPR, who demonstrated poor autonomic modulation and higher sympathetic activity. Anxiety was also frequently observed in the patient group.ConclusionThe study suggests that autonomic dysfunction seems to be involved in the pathogenesis of LPR. The potential beneficial effect of autonomic nervous system modulation as a therapeutic modality for LPR merits further investigation.
Children with Deep Space Neck Infections: Our Experience with 178 Children
Authors: Cheng Jeffrey , Elden Lisa 
Published: March 2013

ObjectiveTo identify clinical features associated with unsuccessful medical therapy in children with deep space neck infections (DSNIs).Study DesignConsecutive case series with chart review.SettingTertiary‐care, academic children's hospital.Subjects and MethodsOne hundred seventy‐eight pediatric patients treated for retropharyngeal or parapharyngeal infections between July 1, 2007, and May 23, 2012.ResultsMedian age was 34.5 months (2.9 years; range, 2‐142 months); two‐thirds were male. Increased surgical drainage was found in children age ≤15 months (P =. 002) and for abscesses >2.2 cm (P =. 0001). Risk factors associated with increased likelihood of medical therapy failure included age ≤51 months, intensive care unit admission, and computed tomography findings consistent with abscess size >2.2 cm. Methicillin‐resistant Staphylococcus aureus infections were found more often in younger children, with the highest incidence in those ≤15 months of age (P =. 001). All children had resolution of infection.ConclusionDeep space neck infections in children can often be successfully managed with medical therapy alone, but life‐threatening complications may occur. We recommend that young patients be managed cautiously.
The proper delivery pressure for cardioplegic solution in neonatal cardiac surgery – an investigation of biomechanical and structural properties of neonatal and adult coronary arteries
Authors: Sikora N , Lacis A , Kasyanov V , Groma V , Ligere E , Ozolins V , Smits L 
Published: March 2013

When cardioplegic solution is injected into coronary arteries with a pump in order to ensure myocardial protection, it is necessary to determine the correct delivery pressure to avoid damage of the heart. Biomechanical and structural properties of the neonatal coronary artery wall should be taken into account when determining the delivery pressure. We investigated twelve coronary artery specimens without cardiac pathology retrieved from autopsies of neonates 9.3 ± 9.7 days old and compared them to adult specimens with no detected atherosclerosis. There was a rapid increase in the strain until the inner pressure reached 80 – 100 mmHg, whilst the increase of stress in the wall of the neonatal coronary arteries was less rapid. When the pressure exceeded 100 mmHg, the increase in the strain slowed down, whilst the wall stress and modulus of elasticity began to increase rapidly. Morphologic examination of tensile properties revealed prominent affection of the vascular wall of the neonates, with accentuated redistribution (loosening) of medial myocytes and the adventitial vasa vasorum. Collectively, a raised inner pressure applied to cardioplegic solution injected into the coronary artery of a neonate may increase the risk of structural damage to the vascular wall.
Does off-pump coronary revascularization reduce mortality in re-operative coronary artery surgery? A meta-analysis of observational studies
Authors: Sepehripour AH , Saso S , Harling L , Punjabi P , Ashrafian H , Athanasiou T 
Published: March 2013

Background: Re-operative coronary artery bypass grafting (CABG) is a challenging operation that is often performed in a high-risk patient group. Avoiding cardiopulmonary bypass (CPB) in these patients is hypothesised to be advantageous due to the reduced invasiveness and physiological stress of off-pump coronary artery bypass grafting (OPCAB). The aims of this study were to assess whether OPCAB may improve outcomes in patients undergoing re-operative CABG. Methods: Twelve studies, incorporating 3471 patients, were identified by systematic literature review. These were meta-analysed using random-effects modelling. Primary endpoints were 30-day and mid-term mortality. Secondary endpoints were completeness of revascularization, mean number of grafts per patient and the effect of intra-operative conversion on mortality. Results: A significantly lower rate of 30-day mortality was observed with OPCAB (OR 0.51, 95% CI [0.35, 0.74]), however, no difference was demonstrated in mid-term mortality. Significantly less complete revascularization and mean number of grafts per patient were observed in the OPCAB group. Meta-regression revealed no change in 30-day mortality when the effect of conversion from one technique to the other was assessed. Conclusions: Off-pump techniques may reduce early mortality in selected patients undergoing re-operative CABG; however, this does not persist into mid-term follow-up. OPCAB may also lead to intra-operative conversion and, although this did not affect outcomes in this study, these results are constrained by the limited data available. Furthermore, OPCAB may increase target vessel revascularization and, consequently, incomplete revascularization which, whilst not reflected in the short-term outcomes, requires longer-term follow-up in order to be fully assessed.
State vocational rehabilitation services and employment in multiple sclerosis
Authors: Chiu Chung-Yi , Chan Fong , Bishop Malachy , da Silva Cardoso Elizabeth , O’Neill John 
Published: March 2013

Background: Obtaining and maintaining suitable employment can be a significant challenge for people with multiple sclerosis (MS). Objective: The objective of this article is to identify what vocational rehabilitation (VR) services helped MS clients obtain and maintain employment, after controlling for the effect of demographic covariates and disability-related government benefits. Methods: We retrieved data from the Rehabilitation Services Administration (RSA) 911 database in the fiscal year (FY) 2009, and used VR services as predictors to predict employment outcomes of people with MS by hierarchical logistic regression. Results: A total of 924 out of 1920 MS clients (48.1%) were successfully employed after receiving VR services. Logistic regression analysis results indicated that cash benefits (OR =0.51, p < 0.001) and public medical benefits (OR =0.76, p < 0.01) were negatively associated with employment outcomes, whereas counseling and guidance (OR = 1.68, p < 0.001), job placement assistance (OR = 2.43, p < 0.001), on-the-job supports (OR = 1.62, p < 0.01), maintenance services (OR = 1.59, p < 0.01), and assistive technology services (OR =2.09, p < 0.001) were significant predictors of positive employment outcomes. Conclusion: VR services were found to be associated with employment status. MS patients experiencing problems obtaining or maintaining employment should be encouraged to pursue services from state VR agencies.
Association of vitamin D and multiple sclerosis in India
Authors: Pandit Lekha , Ramagopalan Sreeram V , Malli Chaithra , D’Cunha Anitha , Kunder Ramya , Shetty Rajesh 
Published: March 2013

Background: Vitamin D deficiency is widely prevalent in India. The association between vitamin D status and multiple sclerosis (MS) has not been previously studied in Indians. Objective: The objective of this paper is to determine whether vitamin D status is associated with MS in India. Methods: In this study 110 MS patients and 108 matched controls were included. Serum 25-hydroxyvitamin D (25(OH)D) was measured in 63 patients in relapse, 77 patients in remission and all controls. Quantity of sun exposure in childhood and body mass index (BMI) were calculated. Patients and controls were genotyped for HLA-DRB1*1501. Results: Patients had significantly lower 25(OH)D levels than matched controls ( p = 0.003), and patients in relapse had a significantly lower vitamin D level as compared to those in remission ( p = 0.001). Vitamin D deficiency (< 50 nmol/l) was seen in a higher proportion of cases (71.8%) than controls (53.7%) ( p = 0.01). Higher quartiles of vitamin D (> 58 nmol/l) showed an inverse relationship with MS (OR = 0.28, CI = 0.11–0.68, p= 0.005). This effect persisted after adjusting for sun exposure. Conclusion: The results of our study indicated that serum 25(OH)D shows an inverse relationship with MS in the Indian population. Reverse causality cannot be excluded.
Between the cultural and the professional in management: The experiences of Arab public welfare agency managers in Israel
Authors: Buchbinder Eli , Siman Lama 
Published: March 2013

Summary This article examines the dilemmas and coping of Arab public welfare agency managers in Israel, who operate within a culture whose collectivist values may clash with professional social work values. The article is based on qualitative interviews with 12 welfare agency managers in Arab villages in Israel. Findings Analysis of the interviews revealed three focal areas of conflict. The first stems from the managers’ need to balance between their role as service providers and the politics of municipal administration. The second stems from the perception of gender in a patriarchal society. The third stems from the clients’ perception of the managers’ geographical and religious origins. Applications The discussion analyzes the dilemmas through social construction and culture lenses.
There are no shortcuts: Trusting the social work training process
Authors: Hantman Shira , Ben-Oz Miriam 
Published: March 2013

Summary The article explors the effects of a disrupting situation on the professional socialization process of social work students. It relates to the various phases of developing the role of consistency of the process and its effect on the student's development as a social worker. Students worked with refugees in a makeshift camp in wartime, professional identity and self-efficacy as they appear in the literature. In the absence of supervisors and other social workers, surrounded by an extremely distressed population, students confronted a series of acute, challenging problems without having had adequate academic or pratice preparation. In spite of this, students entered this activity with an enthusiastic approach wanting to provide help and support to the population of the camp. Findings Two months after their work at the refugee camp, students reported a sense of powerlessness and insignificance in their field placements – feelings that we think were related to the disruption of their structured training program. This incongruence created a dissonance for the students who found it difficult to bridge a connection between their academic field experiences and their wartime role. After sharing their ambivalence with faculty members through focus groups they worked through their feelings Applications Student social workers can be a valuable source of manpower in man-made or natural disasters; but teachers and supervisors must bear in mind their responsibility to carefully reintegrate them into the normal academic training process following such an experience.
The career journeys of health trainers in two health trainer services in England
Authors: Rahman Em , Wills Jane 
Published: March 2013

Aims: This study follows the career journeys of health trainers and explores their reasons for becoming a health trainer, their experiences of being a health trainer and where and what they go on to. Methods: The study used biographical research methods to explore the experiences of seven individuals in two health trainer services. Individual maps were drawn up to preserve the uniqueness and individuality of each biographical story within its social context. Semi-structured interviews explored their journey using a narrative approach, focusing on the stages of becoming, being and moving forward as a health trainer. Thematic analysis of these interviews identified common themes and differences in the experience. Results: The start of each health trainer’s journey is different but there is a remarkable similarity in the experience of being a health trainer. Being a health trainer affirmed the participants’ values about ‘giving back’ to their community. It resulted in improved confidence as well as improved status in the community. All expressed a similar desire to progress within a health field but expressed frustration at being unable to develop a career. Conclusions: This study explored the motivations for lay people to become health trainers using the concept of career anchors. It shows how the role strengthens desires to continue working within a health-related field thus creating a potential future public health workforce. However, the lack of progression routes for individuals creates an obstacle for them to progress. This study raises implications for how policy makers, commissioners and workforce planners can appropriately support this public health workforce.