bluuebunny/crossref_metadata_2025_split huggingface dataset:
CAPS Registry
Authors: Cervera R 
Published: May 2012

Patients with catastrophic antiphospholipid syndrome (APS) have in common: a) clinical evidence of multiple organ involvement developing over a very short period of time; b) histopathological evidence of multiple small vessel occlusions, and c) laboratory confirmation of the presence of antiphospholipid antibodies (aPL), usually in high titre. Although patients with catastrophic APS represent less than 1% of all patients with APS, they are usually in a life-threatening situation. The rarity of this syndrome makes it extraordinarily difficult to study in any systematic way. In order to correlate all the published case reports as well as newly diagnosed cases from all over the world, an international registry of patients with catastrophic APS (CAPS Registry) was created in 2000 by the European Forum on aPL. Currently, it documents the clinical, laboratory and therapeutic data of more than 400 patients and can be consulted through Internet at www.med.ub.es/MIMMUN/FORUM/CAPS.HTM . The analysis of this registry has allowed the characterization of the clinical and laboratory features of the catastrophic APS as well as the establishment of preliminary criteria for its classification and guidelines for its management.
Obstetric and vascular APS: Same autoantibodies but different diseases?
Authors: Meroni PL , Raschi E , Grossi C , Pregnolato F , Trespidi L , Acaia B , Borghi MO 
Published: May 2012

Beta2 glycoprotein I (β2GPI)-dependent antiphospholipid antibodies (aPLs) are the main pathogenic autoantibody population and at the same time the laboratory diagnostic tool for the antiphospholipid syndrome (APS). These antibodies are responsible for both the vascular and the obstetric manifestations of the syndrome but the pathogenic mechanisms behind these manifestations are not the same. For example, thrombotic events do not appear to play a major role in APS miscarriages and a direct reactivity of β2GPI-dependent aPLs on decidual and trophoblast cells was reported. A local expression of β2GPI on these tissues was reported both in physiological conditions and in APS women, thus explaining the local tropism of the autoantibodies. The two hit hypothesis was suggested to explain why the vascular manifestations of APS may occur only occasionally in spite of the persistent presence of aPLs. This is not apparently the case for the obstetric variant of the syndrome, making the difference even more striking. A different pathogenesis may also provide the rationale for the well-known fact that the vascular and the obstetric manifestations may occur independently although in a minority of cases.
Repeated miscarriages in patients with antiphospholipid syndrome and subjected to in vitro fertilization: the importance of preimplantation genetic diagnosis
Authors: Ulcova-Gallova Z 
Published: May 2012

The aim of this study was to investigate two patients with antiphospholipid syndrome (APS) who suffered from multiple repeated pregnancy losses of probably genetically impaired embryos. Sera from these patients contained high levels of IgG antibodies against cardiolipin, IgG and IgM phosphatidyl inositol, IgG phosphatidyl L-serine, and IgG against anti-annexin V. The conventional treatment of APS was ineffective. Preimplantation genetic diagnosis (PGD) showed chromosomally impaired embryos. The course of pregnancies and deliveries were monitored due to the close collaboration of in vitro fertilization and PGD in early embryos. After the selection of normal embryos using PGD, and the treatment of APS, both patients became pregnant and delivered healthy babies. Without such selection, both women would probably have miscarried their embryos again.
Vitamin D and antiphospholipid syndrome
Authors: Andreoli L , Piantoni S , Dall’Ara F , Allegri F , Meroni PL , Tincani A 
Published: May 2012

Vitamin D (vitD) has been shown to have multiple immunomodulatory properties. Hypovitaminosis D has been described in many systemic autoimmune diseases. Antiphospholipid syndrome (APS), an autoimmune disease characterized by immune-mediated thrombosis and pregnancy loss, is a peculiar model for studying vitD, since these patients do not usually have a full-blown autoimmune disease, nor do they have particular restrictions regarding sun exposure. We assessed 25-OH vitD levels in 115 APS and 128 normal healthy donors (NHD) with the LIAISON® chemiluminescent immunoassay by DiaSorin (Italy). Median values were lower in APS patients than in NHD, with the greatest difference occurring during summertime ( p < 0.01), suggesting that APS patients may be somehow prevented from vitD generation upon sun exposure. In our cohort, APS patients may have been instructed to use sunscreens in the presence of positive antinuclear antibodies (ANA). Comparing patients with positive and negative ANA, we found comparable vitD levels during the summer. By subdividing APS patients according to clinical features, thrombotic APS patients showed significantly lower levels than did pure obstetric APS patients ( p < 0.01). In conclusion, our study confirms previous reports of hypovitaminosis D in APS patients, making them more similar to patients with other systemic autoimmune diseases than NHD. Hypovitaminosis D may be part of the mosaic of factors that determine autoimmunity, rather than a consequence of chronic disease and its treatment. The observation that patients with thrombotic APS, an aggressive phenotype, may be more deficient than those with exclusive obstetric manifestations fits well with the beneficial effects of vitD on thrombosis described both in vitro and in vivo. Therefore, there may be a rationale to assess the efficacy of vitD supplementation in APS patients.
Why do Palliative Care Patients Present to the Emergency Department? Avoidable or Unavoidable?
Authors: Wallace Elaine M. , Cooney Mary C. , Walsh Jackie , Conroy Marian , Twomey Feargal 
Published: May 2012

Introduction: Presentations by patients with advanced illness to the Emergency Department (ED) towards the end-of-life can be distressing for both patients and caregivers. With an understanding of why patients present, interventions to avoid these presentations close to the end-of-life may be possible. Aims: To identify patients under the specialist palliative care service (SPCS) who attended the ED over 6 months and to determine if these presentations were potentially avoidable. Presentations were deemed avoidable if the problem could have been dealt with in another manner, i.e. by the home care team or by the family physician, or in another setting, such as by admission to the hospice. Results: Thirty-five ED presentations by 30 patients were included. Eighteen (60%) male, mean age 68.7 (47-89). Twenty-two (63%) ED presentations were outside working hours. The main reasons for attending were: dyspnea (9, 26%), nausea/vomiting/constipation (6, 17%) and uncontrolled pain (5, 14.5%). Thirty-three (94%) of the 35 presentations resulted in hospitalization. The average length of time spent in the ED was 9.2 hours (3-24). Referral to the hospital SPCS was made in 20 (60%) cases. Fifteen (50%) patients died within one month of presentation. Eighteen (51.5%) ED presentations were deemed potentially avoidable. Conclusion: Many ED presentations by palliative care patients may be avoidable. Appropriate sharing of information to on-call doctors, creating confidence in carers and providing extra practical supports is necessary. A comprehensive, coordinated specialist palliative care approach across community and acute services may help ensure patients are not sent to the ED inappropriately.
Effect of application area distributions of mass, force, and support on free and forced vibration behavior of viscoelastically supported plates
Authors: Ergut Abdulkerim , Altintas Gokhan 
Published: May 2012

In real world systems, implementation areas of mass, force and supports have considerable quantity, unlike homogenized areas in numerical solutions. In this study, the effect of area distributions of non-structural additional mass, external force and supports on linear vibrating plate systems are analyzed. There are two key questions addressed in this study. First, the majority of the previous works cover the range of a fundamental mode, and do not answer the question of how results of the fundamental analyses can be generalized for the higher modes based on investigated parameters, particularly for the case of forced vibration. Second, how structural safety is threatened by focused idealizations has not been adequately studied before. Numerical results of this study are obtained by using the variational difference method (VDM), which is based on a variational procedure in conjunction with traditional finite difference method. VDM is applied for determining free vibration characteristics and steady-state responses to a sinusoidally varying force applied to a viscoelastically supported plate. Because the results of the investigated systems showed that the vibration characteristics had a high sensitivity to analyzed parameters (the amount of area distributions of non-structural additional mass, external force and supports), the idealization process of areas must be attentively employed. The study provides insight not only for a fundamental mode but also for higher modes. Obviously the results of this deterministic study have showed that theoretical importance shall be considered in practical applications.
Enhancing HIV Medication Adherence in India
Authors: Jones Deborah , Sharma Aman , Kumar Mahendra , Waldrop-Valverde Drenna , Nehra Ritu , Vamos Szonja , Cook Ryan , Weiss Stephen M. 
Published: May 2012

Background: This pilot study evaluated an intervention designed to enhance adherence among those new to antiretroviral therapy. Methods: Participants (n = 80) were recruited from a hospital clinic in Chandigarh, India, and randomized to a 3-month group intervention or individual enhanced standard of care followed by crossover of condition and assessed over 6 months. Adherence was measured by prescription refill, pill count, and self-report. Results: At baseline, 56% of group condition (immediate intervention) and 54% of individual condition (delayed intervention) participants were nonadherent by pill count and 23% of group and 26% of individual condition participants self-reported skipping medication at least once over the last 3 months. From the postintervention to long-term follow-up, adherence in the group condition (immediate intervention) improved in comparison with adherence in the individual condition (delayed intervention; χ2 = 5.67, P = .02). Conclusions: Results support the use of interventions early in treatment to provide information and social support to establish long-term healthy adherence behaviors.
Classically or alternatively activated bovine monocyte-derived macrophages in vitro do not resemble CD163/Calprotectin biased macrophage populations in the teat
Authors: Düvel Anna , Frank Constanze , Schnapper Anke , Schuberth Hans-Joachim , Sipka Anja 
Published: May 2012

The functional phenotype of resident macrophages significantly determines the character of an inflammatory response. In this study we identified two phenotypes of tissue macrophages in bovine teat tissue based on expression of Calprotectin and CD163. To investigate a possible link between the dichotomy in phenotype and functional properties of cells in association with different host mediators we set up an in vitro model with bovine monocyte-derived macrophages (MdM). In vitro differentiated MdM invariably and uniformly expressed both antigens. Classically activated MdM (IFN-γ priming and LPS stimulation) showed a decreased CD163 expression while alternative activation (IL-4/IL-13 priming) did not change expression of CD163 and Calprotectin. Differently activated MdM showed a clearly distinct expression of genes related to classical (IL-12, inducible NO synthase) or alternative activation (IL-10, arginase I). The presence of the inflammatory host mediator prostaglandin E2 (PGE2) neither influenced expression of Calprotectin and CD163 nor gene expression profiles in MdM generated in the presence of PGE2 (PGE2-MdM). Supernatants of PGE2-MdM, however, significantly dampened the migration of neutrophilic granulocytes. The results of this study highlight the discrepancy between in vivo and in vitro obtained macrophages and point to the necessity to analyze the functional capacities of bovine tissue macrophages in situ.
Predictive mathematical model of time saved on descents in road cycling achieved through reduction in aerodynamic drag area
Authors: Drory Ami , Yanagisawa Masahiro 
Published: May 2012

This paper presents empirically-based simulation results of descent time to completion in road cycling. A mathematical model is formulated to predict time saved on road cycling descents where a cyclist’s position is static through manipulation of aerodynamic drag area, system parameters and initial conditions. Road cyclists often adopt drastic static riding positions on long descents in order to minimize aerodynamic drag and optimize performance, measured as race time to completion. In those riding positions bicycle control is compromised and the risk of fall and injury increases. The aims of this study were to empirically determine whether there is a difference in aerodynamic drag area associated with the ‘Top-Tube’ descending riding position compared to ‘Normal’ descending riding position, and to investigate the effect of the difference on time to completion of road descents. Two elite male Australian time-trial cyclists were tested in an open jet wind tunnel. Drag force was measured using a force platform and a custom air bearing drag measurement system at 50 Hz at wind velocity of 15.6 m/s. Athletes were tested in their ‘Normal’ descending position and in the ‘Top-Tube’ position. Based on Newtonian–Lagrangian equations of motion of the cyclist–bicycle system, an analogue mathematical model as a non-linear Riccati ordinary differential equation was developed to enable prediction of velocity and time to completion of a road cycling course descent of known length and gradient as measures of performance for an athlete of known mass and empirically determined drag area in a descending position. Previously, proposed models of cycling performance have been based on physiological, anthropometric, and mechanical power output. No general closed-form time-to-completion mathematical model for cycling was found in the literature. Analytical solutions allow for a concise investigation of a dynamical system model behaviour that is not as readily available with a numerical solution. Wind tunnel testing showed up to 25% reduction in drag area for changes to cyclists riding position from their ‘Normal’ to the ‘Top-Tube’ dropped descending position. The analytical solution to the nonlinear Riccati differential equation showed that large time savings as a result of reduction of drag area can be made on road cycling race descents. In the example scenario simulated here, 29.2 s may be saved on a 5 km descent of 10% gradient with 25% reduction in aerodynamic drag area (CdA). The ‘Top-Tube’ riding position is associated with a large reduction in aerodynamic drag area in road descents compared to conventional descending riding position. Our model enables the prediction of time to completion on descents. This may assist cyclists to assess the trade-off between undertaking increased risk associated with drastic rider descending position and the potential for improved performance in the context of race tactics and strategy.
Reducing the distance: providing challenging and engaging online postgraduate education in pain management
Authors: Devonshire Elizabeth , Henderson Sarah E 
Published: May 2012

Summary points 1. Health professionals need access to flexible, high-quality, advanced education in pain management. 2. There are multiple pedagogical distances to be negotiated in the delivery of effective postgraduate education. 3. A critical consideration in the design and delivery of effective online learning for postgraduate education in pain management is how to: actively engage students in the learning process; and encourage students to become lifelong learners. 4. Conceptual frameworks for encouraging student interaction online provide a useful tool in the design of postgraduate online learning activities.
Evaluating the impact of pain education: how do we know we have made a difference?
Authors: Briggs Emma 
Published: May 2012

Summary points 1. Education is a core activity for most healthcare professionals working in pain management and an effective evaluation strategy should assess its impact. 2. Evaluation may have one or more purposes: accountability, development or knowledge generation. Other key principles include making evaluation integral to the education process, reflecting with learners on progress, self-evaluation by the pain educator and involving all the key stakeholders. 3. A wide variety of methods are available, but the choice will be influenced by the nature and amount of the pain education, number of learners, purpose of the evaluation and time and resources available. 4. Patient education can be evaluated through knowledge and attitude questionnaires, concordance with the treatment plan, satisfaction and pain- and disability-related measures. 5. Further research is needed to explore the specific strategies or combination of techniques that are effective for different groups, and build on the theoretical base underpinning effective pain education and evaluation for patients and professionals. 6. The importance of education for the public has also been recently recognised, but this wider educational initiative should also be fully evaluated to assess whether this initiative is making a difference.
Geriatric Fracture Center
Authors: Folbert E. C. Ellis , Smit Ruth S. , van der Velde Detlef , Regtuijt E. M. Marlies , Klaren M. Hester , Hegeman J. H. Han 
Published: May 2012

Objective: Since April 1, 2008, patients aged ≥65 years presenting with a hip fracture at Ziekenhuisgroep Twente, Almelo (ZGT-A), The Netherlands, have been admitted to the geriatric fracture center (GFC) and treated according to the multidisciplinary treatment approach. The objective of this study was to evaluate how implementation of the treatment approach has influenced the quality of care given to older patients with hip fracture. Design: Prospective cohort study with historical control group. Method: Two groups of patients with hip fracture were compared, 1 group was treated according to the new multidisciplinary treatment approach in 2009-2010, and the other group received the usual treatment in 2007-2008. The number of readmissions within 30 days after discharge was compared, and an analysis was carried out regarding the number of complications, the number of consultations with various specialists and with the geriatrician, and the duration of hospital stay. Results: In all, 140 patients from 2009 to 2010 group and 90 patients from 2007 to 2008 group were included. In 2009-2010 group, the number of readmissions within 30 days dropped by 11 percentage points ( P = .001). The incidence of the number of complications decreased with a median of 1 compared with 2007-2008 ( P = .017) group. Delirium was diagnosed to be 6 percentage points more frequent. The median number of consultations with various specialists per patient decreased by 1 percentage point as a result of geriatrician cotreatment ( P = .002). The median duration of hospital stay was 1 day shorter than that in 2007-2008 group. Conclusion: The use of the multidisciplinary treatment approach led to a significant reduction in the number of readmissions within 30 days after discharge. It appears to be associated with improved short-term treatment outcomes for older patients with a hip fracture.
Eltrombopag inhibits the proliferation of leukemia cells via reduction of intracellular iron and induction of differentiation
Authors: Roth Michael , Will Britta , Simkin Guillermo , Narayanagari Swathi , Barreyro Laura , Bartholdy Boris , Tamari Roni , Mitsiades Constantine S. , Verma Amit , Steidl Ulrich 
Published: May 2012

Abstract
Eltrombopag (EP) is a small-molecule, nonpeptide thrombopoietin receptor (TPO-R) agonist that has been approved recently for the treatment of thrombocytopenia in patients with chronic immune thrombocytopenic purpura. Prior studies have shown that EP stimulates megakaryopoiesis in BM cells from patients with acute myeloid leukemia and myelodysplastic syndrome, and the results also suggested that it may inhibit leukemia cell growth. In the present study, we studied the effects of EP on leukemia cell proliferation and the mechanism of its antiproliferative effects. We found that EP leads to a decreased cell division rate, a block in G1 phase of cell cycle, and increased differentiation in human and murine leukemia cells. Because EP is species specific in that it can only bind TPO-R in human and primate cells, these findings further suggested that the antileukemic effect is independent of TPO-R. We found that treatment with EP leads to a reduction in free intracellular iron in leukemic cells in a dose-dependent manner. Experimental increase of intracellular iron abrogated the antiproliferative and differentiation-inducing effects of EP, demonstrating that its antileukemic effects are mediated through modulation of intracellular iron content. Finally, determination of EP's antileukemic activity in vivo demonstrated its ability to prolong survival in 2 mouse models of leukemia.
Relationship between progression of brain white matter changes and late-life depression: 3-year results from the LADIS study
Authors: Firbank Michael J. , Teodorczuk Andrew , Van Der Flier Wiesje M. , Gouw Alida A. , Wallin Anders , Erkinjuntti Timo , Inzitari Domenico , Wahlund Lars-Olof , Pantoni Leonardo , Poggesi Anna , Pracucci Giovanni , Langhorne Peter , O'Brien John T. 
Published: May 2012

BackgroundBrain white matter changes (WMC) and depressive symptoms are linked, but the directionality of this association remains unclear.AimsTo investigate the relationship between baseline and incident depression and progression of white matter changes.MethodIn a longitudinal multicentre pan-European study (Leukoaraiosis and Disability in the elderly, LADIS), participants aged over 64 underwent baseline magnetic resonance imaging (MRI) and clinical assessments. Repeat scans were obtained at 3 years. Depressive outcomes were assessed in terms of depressive episodes and the Geriatric Depression Scale (GDS). Progression of WMC was measured using the modified Rotterdam Progression scale.ResultsProgression of WMC was significantly associated with incident depression during year 3 of the study (P = 0.002) and remained significant after controlling for transition to disability, baseline WMC and baseline history of depression. There was no significant association between progression of WMC and GDS score, and no significant relationship between progression of WMC and history of depression at baseline.ConclusionsOur results support the vascular depression hypothesis and implicate WMC as causal in the pathogenesis of late-life depression.
Zur Funktion von (i)binnaim Neu- und Spätbabylonischen
Authors: Hackl Johannes 
Published: May 2012

Abstract
Der Imperativ (i)binna „gib!“ begegnet vor allem in neu- und spätbabylonischen Urkunden und Briefen. Nach einer Darstellung früherer etymologischer Deutungsversuche befasst sich vorliegende Studie mit den Funktionen, die diese Form auf syntaktischer Ebene übernimmt. Insbesondere soll dabei die Frage nach dem Verhältnis zur suffigierten Kurzform inna „gib!“ geklärt werden.