bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of the oral, direct thrombin inhibitor dabigatran on five common coagulation assays
Authors: Baghaei Fariba , Blixter Inger Fagerberg , Gustafsson Kerstin , Stigendal Lennart , Sten-Linder Margareta , Strandberg Karin , Hillarp Andreas , Lindahl Tomas ,   and from the expert group on coagulation of the External Quality Assurance in Laboratory Medicine in Sweden
Published: November 2010

SummaryDabigatran is an oral, reversible thrombin inhibitor that has shown promising results in large clinical trials. Laboratory monitoring is not needed but the effects on common coagulation assays are incompletely known. Dabigatran was added to plasma from healthy subjects in the concentration range 0–1,000 μg/l and analysed using several reagents for activated thromboplastin time (APTT), prothrombin time (PT), fibrinogen, antithrombin, and activated protein C resistance. Typical trough concentrations are about 50 μg/l, peak concentrations 100–300 μg/l. At 100 μg/l all APTT-results were prolonged. The concentration required to double APTT ranged between 227 and 286 μg/l, the responses for all five reagents were similar. PT-reagents were much less affected with almost no samples above INR 1.2 at 100 μg/l. The effect was sample dilution dependent with PT Quick type more sensitive than PT Owren type methods. If a patient on dabigatran has prolonged APTT, >90 seconds, and Quick PT INR>2 or Owren PT INR>1.5 over-dosing or accumulation of dabigatran should be considered. Two of four fibrinogen reagents underestimated the fibrinogen concentration considerably at expected peak concentration. Methods based on inhibition of thrombin over-estimated the antithrombin concentration, but not Xa-based. The APC-resistance methods over-estimated the APC-ratio, which may lead to miss-classification of factor V Leiden patients as being normal. Different coagulation assays, and even different reagents within an assay group, display variable effects at therapeutic concentrations of dabigatran. Some of these assay variations are of clinical importance, thus knowledge is needed for a correct interpretation of results.
Inflammation, oxidative stress and platelet activation in aspirin-treated critical limb ischaemia: Beneficial effects of iloprost
Authors: Cuccurullo Chiara , Di Michele Dario , Laurora Giuseppe , Sgrò Giuseppe , Di Ruscio Paolo , Simeone Emilio , Di Iorio Pierangelo , Lattanzio Stefano , Liani Rossella , Ferrante Elisabetta , Lessiani Gianfranco , Vazzana Natale , Davì Giovanni 
Published: November 2010

SummaryPlatelets critically contribute to atherothrombosis and worsening ischaemia in patients with peripheral arterial disease (PAD), eventually leading to critical limb ischaemia (CLI). Furthermore, persistent platelet activation despite antiplatelet therapy has been reported in this setting. The prostacyclin analogue iloprost is currently recommended in CLI patients for its effects in relieving symptoms by promoting local perfusion. In this study, we investigated the effects of iloprost infusion on urinary 11-dehydro-TXB2 and 8-iso-PGF2α excretion rate, as in vivoindexes of thromboxane-dependent platelet activation and lipid peroxidation, respectively, and on platelet-derived proinflammatory sCD40L and nitric oxide bioavailability in 44 patients with CLI while on chronic treatment with low-dose aspirin. Daily iloprost infusion for one-week significantly decreased urinary 11-dehydro-TXB2 [499 (277 – 807) vs. 380 (189 – 560) pg/mg creatinine, p < 0.0001] and 8-iso-PGF2α [533 (316 – 842) vs. 334 (196 – 540) pg/mg creatinine, p < 0.0001] as well as plasma sCD40L [1540 (1005 – 3015) vs. 948 (845 – 2030) pg/ml, p < 0.0001]. Furthermore, a significant increase in plasma nitrate plus nitrite levels has been observed [26.8 (18.8 – 35.9) vs. 43.7 (33.0 – 75.5) μM, p < 0.0001]. A significant direct correlation was also found between urinary 8-iso-PGF2α and 11-dehydro-TXB2 before and after iloprost treatment (Rho = 0.695, p < 0.0001). In conclusion, we report that a short-term course of iloprost is able to significantly reduce residual thromboxane biosynthesis, oxidative stress, endothelial dysfunction and platelet-derived inflammation in low-dose aspirin treated patients with CLI.
Drug-Eluting or Bare Metal Stents for the Treatment of Saphenous Vein Graft Disease
Authors: Paradis Jean-Michel , Bélisle Patrick , Joseph Lawrence , Bertrand Olivier F. , DeLarochellière Robert , Déry Jean-Pierre , Larose Éric , Rodés-Cabau Josep , Rinfret Stéphane 
Published: November 2010

Background—
Observational studies and randomized, controlled trials have yielded uncertain results regarding the benefits of drug-eluting stents (DES) for the treatment of saphenous vein graft (SVG) disease. The objective of this meta-analysis was to assess the cumulative evidence regarding the efficacy and effectiveness of DES to treat SVG compared with bare metal stent (BMS).

Methods and Results—
We conducted a bayesian hierarchical meta-analysis of all randomized, controlled trials and observational studies that compared clinical outcomes after DES or BMS placement in SVG disease. Our search resulted in 25 studies, cumulating 5755 patients. DES implantation was not associated with an increased risk of death (odds ratio [OR], 0.85; 95% credible intervals (CrI) [CrI], 0.62 to 1.21) or myocardial infarction (OR, 0.83; 95% CrI, 0.56 to 1.32), but wide CrIs preclude definitive conclusions. Target vessel revascularization (OR, 0.55; 95% CrI, 0.39 to 0.76) and target lesion revascularization (OR, 0.58; 95% CrI, 0.37 to 0.87) were both reduced by approximately 45% with DES. When combining these outcomes, the OR for major adverse cardiac events was reduced in patients treated with DES (OR, 0.62; 95% CrI, 0.46 to 0.81). Finally, the relative risk of stent thrombosis appeared lower with DES, although again the CrIs were very wide (OR, 0.54; 95% CrI, 0.13 to 1.39).

Conclusions—
In this study-level meta-analysis, the largest ever reported and the first using bayesian methods, the use of DES for the treatment of SVG disease reduces target vessel revascularization and target lesion revascularization procedures compared with BMS. Although there is no evidence to date to suggest increased rates of mortality, myocardial infarction, or stent thrombosis, further data are needed to address this safety issue.
Predictors of Neurological Events Associated With Carotid Artery Stenting in High-Surgical-Risk Patients
Authors: Aronow Herbert D. , Gray William A. , Ramee Stephen R. , Mishkel Gregory J. , Schreiber Theodore J. , Wang Hong 
Published: November 2010

Background—
Comorbid and anatomic characteristics that portend higher procedural risk are well defined for carotid endarterectomy but less so for carotid artery stenting.

Methods and Results—
We pooled carotid stent data from 4 Cordis-sponsored trials (n=2104) with similar patient cohorts and end point determination to identify predictors of neurological death or stroke within 30 days of the procedure. Median age was 74 years (24% >80 years), 36% were women, and 24.2% were symptomatic in the previous 6 months. There were 88 (4.2%) neurological deaths or strokes at 30 days. Among symptomatic patients, the risk of adverse neurological outcome declined with increasing time between the incident neurological event and carotid stent procedure. In a logistic regression model that included preprocedural and procedural variables, significant multivariable predictors of 30-day neurological death or stroke were older age (continuous), black race, angiographically visible thrombus in symptomatic patients, procedural use of glycoprotein IIb/IIIa inhibitors, procedural transient ischemic attack, final residual stenosis >30%, and periprocedural use of protamine or vasopressors.

Conclusions—
In this pooled analysis, a number of preprocedural and procedural factors predicted higher risk of stroke and neurological death within 30 days of a carotid stent procedure. Identification of such predictors may help to guide patient selection and further refine procedural technique.
Use of Antithrombotic Medications Among Elderly Ischemic Stroke Patients
Authors: Lichtman Judith H. , Naert Lisa , Allen Norrina B. , Watanabe Emi , Jones Sara B. , Barry Lisa C. , Bravata Dawn M. , Goldstein Larry B. 
Published: November 2010

Background—
The use of antithrombotic medications after ischemic stroke is recommended for deep vein thrombosis prophylaxis and secondary stroke prevention. We assessed the rate of receipt of these therapies among eligible ischemic stroke patients age ≥65 years and determined the effects of age and other patient characteristics on treatment.

Methods and Results—
The analysis included Medicare fee-for-service beneficiaries discharged with ischemic stroke (ICD 433.x1, 434.x1, 436) randomly selected for inclusion in the Medicare Health Care Quality Improvement Program's National Stroke Project 1998 to 1999, 2000 to 2001. Patients discharged from nonacute facilities, transferred, or terminally ill were excluded. Receipt of in-hospital pharmacological deep vein thrombosis prophylaxis, antiplatelet medication, anticoagulants for atrial fibrillation, and antithrombotic medications at discharge were assessed in eligible patients, stratified by age (65 to 74, 75 to 84, and 85+ years). Descriptive models identified characteristics associated with treatment. Among 31 554 patients, 14.9% of those eligible received pharmacological deep vein thrombosis prophylaxis, 83.9% antiplatelet drugs, 82.8% anticoagulants for atrial fibrillation, and 74.2% were discharged on an antithrombotic medication. Rates of treatment decreased with age and were lowest for patients ages 85 years or older. Admission from a skilled nursing facility and functional dependence were associated with lower treatment rates.

Conclusions—
There was substantial underutilization of antithrombotic therapies among elderly ischemic stroke patients, particularly among the very elderly, those admitted from skilled nursing facilities, and patients with functional dependence. The reasons for low use of antithrombotic therapies, including the apparent underutilization of deep vein thrombosis prophylaxis in otherwise eligible patients, require further investigation.
Risk-Adjusted Percent Time in Therapeutic Range as a Quality Indicator for Outpatient Oral Anticoagulation
Authors: Rose Adam J. , Hylek Elaine M. , Ozonoff Al , Ash Arlene S. , Reisman Joel I. , Berlowitz Dan R. 
Published: November 2010

Background—
Oral anticoagulation is safer and more effective when patients receive high-quality care. However, there have been no prior efforts to measure quality of oral anticoagulation care or to risk adjust it to ensure credible comparisons. Our objective was to profile site performance in the Veterans Health Administration (VA) using risk-adjusted percent time in therapeutic range (TTR).

Methods and Results—
We included 124 551 patients who received outpatient oral anticoagulation from 100 VA sites of care for indications other than valvular heart disease from October 1, 2006, to September 30, 2008. We calculated TTR for each patient and mean TTR for each site of care. Expected TTR was calculated for each patient and each site based on the variables in the risk adjustment model, which included demographics, comorbid conditions, medications, and hospitalizations. Mean TTR for the entire sample was 58%. Site-observed TTR varied from 38% to 69% or from poor to excellent. Site-expected TTR varied from 54% to 62%. Site risk-adjusted performance ranged from 18% below expected to 12% above expected. Risk adjustment did not alter performance rankings for many sites, but for other sites, it made an important difference. For example, the site ranked 27th of 100 before risk adjustment was one of the best (risk-adjusted rank, 7). Risk-adjusted site rankings were consistent from year to year (correlation between years, 0.89).

Conclusions—
Risk-adjusted TTR can be used to profile the quality of outpatient oral anticoagulation in a large, integrated health system. This measure can serve as the basis for quality measurement and quality improvement efforts.
Beyond Chapter VIII: Limits and Opportunities for Regional Representation at the UN security Council
Authors: Drieskens Edith 
Published: November 2010

AbstractZooming in on the serving European Union (EU) Member States and exploring the legal parameters defining regional actorness both directly and indirectly, this article analyzes the EU's representation at the United Nations (UN) Security Council. Looking at the theory and practice behind Articles 52, 23 and 103 of the UN Charter, we shed fresh light on the only provision in the European Treaties that explicitly referred to the UN Security Council, i.e. the former Article 19 of the EU Treaty. We define that provision as a regional interpretation of Article 103 of the UN Charter and discuss its implementation in day-to-day decision-making, especially as for economic and financial sanctions measures. Hereby, we focus on the negotiations leading to UN Security Council Resolution 1822(2008).
Aid or Assistance and Direction and Control between states and International Organizations in the Commission of Internationally Wrongful Acts
Authors: Reinisch August 
Published: November 2010

AbstractQuestions concerning the international responsibility of international organizations and/or their member States for internationally wrongful acts primarily raise important issues of attribution. In addition, a concurrent responsibility may arise from situations where international organizations aid or assist or direct and control the acts of States or other international organizations. This contribution intends to highlight some problems that stem from the fact that the current formulations of Articles 13 and 14 of the ILC Draft Articles on responsibility of international organizations are largely based on the corresponding provisions of the 2001 ILC Articles on State responsibility.
Daytime Heat Transfer Processes Related to Slope Flows and Turbulent Convection in an Idealized Mountain Valley
Authors: Serafin Stefano , Zardi Dino 
Published: November 2010

AbstractThe mechanisms governing the daytime development of thermally driven circulations along the transverse axis of idealized two-dimensional valleys are investigated by means of large-eddy simulations. In particular, the impact of slope winds and turbulent convection on the heat transfer from the vicinity of the ground surface to the core of the valley atmosphere is examined. The interaction between top-down heating produced by compensating subsidence in the valley core and bottom-up heating due to turbulent convection is described. Finally, an evaluation of the depth of the atmospheric layer affected by the slope wind system is provided.
The Resonant Interaction of a Tropical Cyclone and a Tropopause Front in a Barotropic Model. Part I: Zonally Oriented Front
Authors: Scheck Leonhard , Jones Sarah C. , Juckes Martin 
Published: November 2010

AbstractThe interaction of a tropical cyclone and a zonally aligned tropopause front is investigated in an idealized framework. A nondivergent barotropic model is used in which the front is represented by a vorticity step, giving a jetlike velocity profile. The excitation of frontal waves by a cyclone located south of the front and the impact of the wave flow on the cyclone motion is studied for different representations of the cyclone and the jet. The evolution from the initial wave excitation until after the cyclone has crossed the front is discussed. The interaction becomes stronger with increasing jet speed. For cyclone representations containing negative relative vorticity, anticyclones develop and can influence the excitation of frontal waves significantly. Resonant frontal waves propagating with a phase speed matching the zonal translation speed of the cyclone are decisive for the interaction. The frontal wave spectrum excited by a cyclone on the front is dominated by waves that are in resonance in the initial phase. These waves have the largest impact on the cyclone motion.
A Prospective Randomized Study Comparing Arthroscopic Single-Bundle and Double-Bundle Posterior Cruciate Ligament Reconstructions Preserving Remnant Fibers
Authors: Yoon Kyoung Ho , Bae Dae Kyung , Song Sang Jun , Cho Hyung Jun , Lee Jung Hwan 
Published: November 2010

Background: Several controversies exist regarding the superiority of double-bundle (DB) posterior cruciate ligament (PCL) reconstruction versus single-bundle (SB) reconstruction, although DB reconstruction has been shown to restore the intact knee kinematics more closely than SB reconstruction. Hypothesis: Double-bundle PCL reconstruction will present better results than SB reconstruction in postoperative outcomes. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: The authors prospectively analyzed 25 cases of SB reconstruction and 28 cases of DB reconstruction using Achilles tendon allograft with a minimum 2-year follow-up. They compared preoperative and postoperative range of motion, posterior stability by posterior stress radiography, Tegner activity score, Lysholm score, and International Knee Documentation Committee (IKDC) subjective knee evaluation form and knee examination form between the 2 groups. Results: There was no difference in range of motion, Tegner activity score, Lysholm score, and IKDC subjective knee evaluation form between the 2 groups at last follow-up. The side-to-side difference in posterior translation significantly improved in both groups. There was no preoperative difference in posterior instability between the groups but a significant difference at last follow-up. On the IKDC knee examination form, the DB reconstruction group presented better results in grade distribution. Conclusion: The DB reconstruction for PCL ruptures using the Achilles allograft showed better results in posterior stability and IKDC knee examination form than the SB reconstruction did. Although the difference of 1.4 mm in posterior stability was statistically significant, it is unclear that DB reconstruction is definitely superior to SB reconstruction clinically and functionally because there was no difference in the subjective scores.
Risk of Serious Injury for Young Baseball Pitchers
Authors: Fleisig Glenn S. , Andrews James R. , Cutter Gary R. , Weber Adam , Loftice Jeremy , McMichael Chris , Hassell Nina , Lyman Stephen 
Published: November 2010

Background: The risk of elbow or shoulder injury for young baseball pitchers is unknown. Purpose/Hypothesis: The purpose of this study was to quantify the cumulative incidence of throwing injuries in young baseball pitchers who were followed for 10 years. Three hypotheses were tested: Increased amount of pitching, throwing curveballs at a young age, and concomitantly playing catcher increase a young pitcher’s risk of injury. Study Design: Cohort study; Level of evidence, 3. Methods: In sum, 481 youth pitchers (aged 9 to 14 years) were enrolled in a 10-year follow-up study. Participants were interviewed annually. Injury was defined as elbow surgery, shoulder surgery, or retirement due to throwing injury. Fisher exact test compared the risk of injury between participants who pitched at least 4 years during the study and those who pitched less. Fisher exact tests were used to investigate risks of injury for pitching more than 100 innings in at least 1 calendar year, starting curveballs before age 13 years, and playing catcher for at least 3 years. Results: The cumulative incidence of injury was 5.0%. Participants who pitched more than 100 innings in a year were 3.5 times more likely to be injured (95% confidence interval = 1.16 to 10.44). Pitchers who concomitantly played catcher seemed to be injured more frequently, but this trend was not significant with the study sample size. Conclusion: Pitching more than 100 innings in a year significantly increases risk of injury. Playing catcher appears to increase a pitcher’s risk of injury, although this trend is not significant. The study was unable to demonstrate that curveballs before age 13 years increase risk of injury. Clinical Relevance: The risk of a youth pitcher sustaining a serious throwing injury within 10 years is 5%. Limiting the number of innings pitched per year may reduce the risk of injury. Young baseball pitchers are encouraged to play other positions as well but might avoid playing catcher.
iGTP: A software package for large-scale gene tree parsimony analysis
Authors: Chaudhary Ruchi , Bansal Mukul S , Wehe André , Fernández-Baca David , Eulenstein Oliver 
Published: November 2010

Abstract

Background
The ever-increasing wealth of genomic sequence information provides an unprecedented opportunity for large-scale phylogenetic analysis. However, species phylogeny inference is obfuscated by incongruence among gene trees due to evolutionary events such as gene duplication and loss, incomplete lineage sorting (deep coalescence), and horizontal gene transfer. Gene tree parsimony (GTP) addresses this issue by seeking a species tree that requires the minimum number of evolutionary events to reconcile a given set of incongruent gene trees. Despite its promise, the use of gene tree parsimony has been limited by the fact that existing software is either not fast enough to tackle large data sets or is restricted in the range of evolutionary events it can handle.

Results
We introduce iGTP, a platform-independent software program that implements state-of-the-art algorithms that greatly speed up species tree inference under the duplication, duplication-loss, and deep coalescence reconciliation costs. iGTP significantly extends and improves the functionality and performance of existing gene tree parsimony software and offers advanced features such as building effective initial trees using stepwise leaf addition and the ability to have unrooted gene trees in the input. Moreover, iGTP provides a user-friendly graphical interface with integrated tree visualization software to facilitate analysis of the results.

Conclusions
iGTP enables, for the first time, gene tree parsimony analyses of thousands of genes from hundreds of taxa using the duplication, duplication-loss, and deep coalescence reconciliation costs, all from within a convenient graphical user interface.