Evaluation of a coagulation assay determining the activity state of factor VII in plasma

A coagulation assay is described that allows the measurement of the degree of activation of factor VII in circulating blood. The test is based on the use of both bovine and human brain thromboplastin, together with an artificial factor VII-deficient plasma. The latter can be prepared on a relatively large scale which makes it possible to measure factor VII activation in large series of patients. The determination of factor VII activation during incubation at 4 °C of plasma of women using oral contraceptives shows that the test described adequately measures factor VII activation. Differences in the time course of factor VII activation during this incubation in glass and plastic containers are found and implicate that rigorous standardization of blood sampling and test conditions is necessary. A possible mechanism that causes this critical dependence upon the test conditions is discussed

The activity state of factor VII in plasma:Two pathways for the cold promoted activation of factor VII

The apparent amount of factor VII as determined in a one-stage test depends on the type of thromboplastin used: bovine thromboplastin only reacts with human factor VIIa whereas human thromboplastin interacts with unactivated human factor VII as well. Therefore the ratio factor VII activity as measured with bovine thromboplastin divided by the factor VII activity as assessed with human thromboplastin reflects the state of activation of factor VII in plasma. This approach was used to study the process of cold promoted factor VII activation and the involvement of different clotting factors therein. It could be shown that cold promoted activation does not occur in the absence of factors II and XII and is reduced for about 50% in factor IX deficient plasma. The other coagulation factors have a minor influence on the process. The results indicate that the cold promoted factor VII activation is the result of activation by both activated contact products and thrombin

Derivation of fluid dynamics from kinetic theory with the 14--moment approximation

We review the traditional derivation of the fluid-dynamical equations from kinetic theory according to Israel and Stewart. We show that their procedure to close the fluid-dynamical equations of motion is not unique. Their approach contains two approximations, the first being the so-called 14-moment approximation to truncate the single-particle distribution function. The second consists in the choice of equations of motion for the dissipative currents. Israel and Stewart used the second moment of the Boltzmann equation, but this is not the only possible choice. In fact, there are infinitely many moments of the Boltzmann equation which can serve as equations of motion for the dissipative currents. All resulting equations of motion have the same form, but the transport coefficients are different in each case.Comment: 15 pages, 3 figures, typos fixed and discussions added; EPJA: Topical issue on "Relativistic Hydro- and Thermodynamics

Effect of Sun and Planet-Bound Dark Matter on Planet and Satellite Dynamics in the Solar System

We apply our recent results on orbital dynamics around a mass-varying central body to the phenomenon of accretion of Dark Matter-assumed not self-annihilating-on the Sun and the major bodies of the solar system due to its motion throughout the Milky Way halo. We inspect its consequences on the orbits of the planets and their satellites over timescales of the order of the age of the solar system. It turns out that a solar Dark Matter accretion rate of \approx 10^-12 yr^-1, inferred from the upper limit \Delta M/M= 0.02-0.05 on the Sun's Dark Matter content, assumed somehow accumulated during last 4.5 Gyr, would have displaced the planets faraway by about 10^-2-10^1 au 4.5 Gyr ago. Another consequence is that the semimajor axis of the Earth's orbit, approximately equal to the Astronomical Unit, would undergo a secular increase of 0.02-0.05 m yr^-1, in agreement with the latest observational determinations of the Astronomical Unit secular increase of 0.07 +/- 0.02 m yr^-1 and 0.05 m yr^-1. By assuming that the Sun will continue to accrete Dark Matter in the next billions year at the same rate as in the past, the orbits of its planets will shrink by about 10^-1-10^1 au (\approx 0.2-0.5 au for the Earth), with consequences for their fate, especially of the inner planets. On the other hand, lunar and planetary ephemerides set upper bounds on the secular variation of the Sun's gravitational parameter GM which are one one order of magnitude smaller than 10^-12 yr^-1. Dark Matter accretion on planets has, instead, less relevant consequences for their satellites. Indeed, 4.5 Gyr ago their orbits would have been just 10^-2-10^1 km wider than now. (Abridged)Comment: LaTex2e, 17 pages, no figures, 7 tables, 61 references. Small problem with a reference fixed. To appear in Journal of Cosmology and Astroparticle Physics (JCAP

Attenuation of leukocyte sequestration by selective blockade of PECAM-1 or VCAM-1 in murine endotoxemia

Background: Molecular mechanisms regulating leukocyte sequestration into the tissue during endotoxemia and/or sepsis are still poorly understood. This in vivo study investigates the biological role of murine PECAM-1 and VCAM-1 for leukocyte sequestration into the lung, liver and striated skin muscle. Methods: Male BALB/c mice were injected intravenously with murine PECAM-1 IgG chimera or monoclonal antibody (mAb) to VCAM-1 ( 3 mg/kg body weight); controls received equivalent doses of IgG2a ( n = 6 per group). Fifteen minutes thereafter, 2 mg/kg body weight of Salmonella abortus equi endotoxin was injected intravenously. At 24 h after the endotoxin challenge, lungs, livers and striated muscle of skin were analyzed for their myeloperoxidase activity. To monitor intravital leukocyte-endothelial cell interactions, fluorescence videomicroscopy was performed in the skin fold chamber model of the BALB/c mouse at 3, 8 and 24 h after injection of endotoxin. Results: Myeloperoxidase activity at 24 h after the endotoxin challenge in lungs (12,171 +/- 2,357 mU/g tissue), livers ( 2,204 +/- 238 mU/g) and striated muscle of the skin ( 1,161 +/- 110 mU/g) was significantly reduced in both treatment groups as compared to controls, with strongest attenuation in the PECAM-1 IgG treatment group. Arteriolar leukocyte sticking at 3 h after endotoxin (230 +/- 46 cells x mm(-2)) was significantly reduced in both treatment groups. Leukocyte sticking in postcapillary venules at 8 h after endotoxin ( 343 +/- 69 cells/mm(2)) was found reduced only in the VCAM-1-mAb-treated animals ( 215 +/- 53 cells/mm(2)), while it was enhanced in animals treated with PECAM-1 IgG ( 572 +/- 126 cells/mm(2)). Conclusion: These data show that both PECAM-1 and VCAM-1 are involved in endotoxin-induced leukocyte sequestration in the lung, liver and muscle, presumably through interference with arteriolar and/or venular leukocyte sticking. Copyright (C) 2004 S. Karger AG, Basel

Electronic properties of metal induced gap states at insulator/metal interfaces -- dependence on the alkali halide and the possibility of excitonic mechanism of superconductivity

Motivated from the experimental observation of metal induced gap states (MIGS) at insulator/metal interfaces by Kiguchi {\it et al.} [Phys. Rev. Lett. {\bf 90}, 196803 (2003)], we have theoretically investigated the electronic properties of MIGS at interfaces between various alkali halides and a metal represented by a jellium with the first-principles density functional method. We have found that, on top of the usual evanescent state, MIGS generally have a long tail on halogen sites with a $p_z$-like character, whose penetration depth ($\lambda$) is as large as half the lattice constant of bulk alkali halides. This implies that $\lambda$, while little dependent on the carrier density in the jellium, is dominated by the lattice constant (hence by energy gap) of the alkali halide, where $\lambda_{\rm LiF} < \lambda_{\rm LiCl} < \lambda_{\rm LiI}$. We also propose a possibility of the MIGS working favorably for the exciton-mediated superconductivity.Comment: 7 pages, 9 figure

Increasing the etanercept dose in a treat-to-target approach in juvenile idiopathic arthritis:does it help to reach the target? A post-hoc analysis of the BeSt for Kids randomised clinical trial

Background: Etanercept has been studied in doses up to 0.8 mg/kg/week (max 50 mg/week) in juvenile idiopathic arthritis (JIA) patients. In clinical practice higher doses are used off-label, but evidence regarding the relation with outcomes is lacking. We describe the clinical course of JIA-patients receiving high-dose etanercept (1.6 mg/kg/week; max 50 mg/week) in the BeSt for Kids trial. Methods: 92 patients with oligoarticular JIA, RF-negative polyarticular JIA or juvenile psoriatic arthritis were randomised across three treat-to-target arms: (1) sequential DMARD-monotherapy (sulfasalazine or methotrexate (MTX)), (2) combination-therapy MTX + 6 weeks prednisolone and (3) combination therapy MTX + etanercept. In any treatment-arm, patients could eventually escalate to high-dose etanercept alongside MTX 10mg/m2/week. Results: 32 patients received high-dose etanercept (69% female, median age 6 years (IQR 4–10), median 10 months (7–16) from baseline). Median follow-up was 24.6 months. Most clinical parameters improved within 3 months after dose-increase: median JADAS10 from 7.2 to 2.8 (p = 0.008), VAS-physician from 12 to 4 (p = 0.022), VAS-patient/parent from 38.5 to 13 (p = 0.003), number of active joints from 2 to 0.5 (p = 0.12) and VAS-pain from 35.5 to 15 (p = 0.030). Functional impairments (CHAQ-score) improved more gradually and ESR remained stable. A comparable pattern was observed in 11 patients (73% girls, median age 8 (IQR 6–9)) who did not receive high-dose etanercept despite eligibility (comparison group). In both groups, 56% reached inactive disease at 6 months. No severe adverse events (SAEs) occurred after etanercept dose-increase. In the comparison group, 2 SAEs consisting of hospital admission occurred. Rates of non-severe AEs per subsequent patient year follow-up were 2.27 in the high-dose and 1.43 in the comparison group. Conclusions: Escalation to high-dose etanercept in JIA-patients who were treated to target was generally followed by meaningful clinical improvement. However, similar improvements were observed in a smaller comparison group who did not escalate to high-dose etanercept. No SAEs were seen after escalation to high-dose etanercept. The division into the high-dose and comparison groups was not randomised, which is a potential source of bias. We advocate larger, randomised studies of high versus regular dose etanercept to provide high level evidence on efficacy and safety. Trial registration: Dutch Trial Register; NTR1574; 3 December 2008; https://onderzoekmetmensen.nl/en/trial/26585.</p

Increasing the etanercept dose in a treat-to-target approach in juvenile idiopathic arthritis:does it help to reach the target? A post-hoc analysis of the BeSt for Kids randomised clinical trial

Background: Etanercept has been studied in doses up to 0.8 mg/kg/week (max 50 mg/week) in juvenile idiopathic arthritis (JIA) patients. In clinical practice higher doses are used off-label, but evidence regarding the relation with outcomes is lacking. We describe the clinical course of JIA-patients receiving high-dose etanercept (1.6 mg/kg/week; max 50 mg/week) in the BeSt for Kids trial. Methods: 92 patients with oligoarticular JIA, RF-negative polyarticular JIA or juvenile psoriatic arthritis were randomised across three treat-to-target arms: (1) sequential DMARD-monotherapy (sulfasalazine or methotrexate (MTX)), (2) combination-therapy MTX + 6 weeks prednisolone and (3) combination therapy MTX + etanercept. In any treatment-arm, patients could eventually escalate to high-dose etanercept alongside MTX 10mg/m2/week. Results: 32 patients received high-dose etanercept (69% female, median age 6 years (IQR 4–10), median 10 months (7–16) from baseline). Median follow-up was 24.6 months. Most clinical parameters improved within 3 months after dose-increase: median JADAS10 from 7.2 to 2.8 (p = 0.008), VAS-physician from 12 to 4 (p = 0.022), VAS-patient/parent from 38.5 to 13 (p = 0.003), number of active joints from 2 to 0.5 (p = 0.12) and VAS-pain from 35.5 to 15 (p = 0.030). Functional impairments (CHAQ-score) improved more gradually and ESR remained stable. A comparable pattern was observed in 11 patients (73% girls, median age 8 (IQR 6–9)) who did not receive high-dose etanercept despite eligibility (comparison group). In both groups, 56% reached inactive disease at 6 months. No severe adverse events (SAEs) occurred after etanercept dose-increase. In the comparison group, 2 SAEs consisting of hospital admission occurred. Rates of non-severe AEs per subsequent patient year follow-up were 2.27 in the high-dose and 1.43 in the comparison group. Conclusions: Escalation to high-dose etanercept in JIA-patients who were treated to target was generally followed by meaningful clinical improvement. However, similar improvements were observed in a smaller comparison group who did not escalate to high-dose etanercept. No SAEs were seen after escalation to high-dose etanercept. The division into the high-dose and comparison groups was not randomised, which is a potential source of bias. We advocate larger, randomised studies of high versus regular dose etanercept to provide high level evidence on efficacy and safety. Trial registration: Dutch Trial Register; NTR1574; 3 December 2008; https://onderzoekmetmensen.nl/en/trial/26585.</p

The Surprising Transparency of the sQGP at LHC

We present parameter-free predictions of the nuclear modification factor, R_{AA}^pi(p_T,s), of high p_T pions produced in Pb+Pb collisions at sqrt{s}_{NN}=2.76 and 5.5 ATeV based on the WHDG/DGLV (radiative+elastic+geometric fluctuation) jet energy loss model. The initial quark gluon plasma (QGP) density at LHC is constrained from a rigorous statistical analysis of PHENIX/RHIC pi^0 quenching data at sqrt{s}_{NN}=0.2 ATeV and the charged particle multiplicity at ALICE/LHC at 2.76 ATeV. Our perturbative QCD tomographic theory predicts significant differences between jet quenching at RHIC and LHC energies, which are qualitatively consistent with the p_T-dependence and normalization---within the large systematic uncertainty---of the first charged hadron nuclear modification factor, R^{ch}_{AA}, data measured by ALICE. However, our constrained prediction of the central to peripheral pion modification, R^pi_{cp}(p_T), for which large systematic uncertainties associated with unmeasured p+p reference data cancel, is found to be over-quenched relative to the charged hadron ALICE R^{ch}_{cp} data in the range 5<p_T<20 GeV/c. The discrepancy challenges the two most basic jet tomographic assumptions: (1) that the energy loss scales linearly with the initial local comoving QGP density, rho_0, and (2) that \rho_0 \propto dN^{ch}(s,C)/dy is proportional to the observed global charged particle multiplicity per unit rapidity as a function of sqrt{s} and centrality class, C. Future LHC identified (h=pi,K,p) hadron R^h_{AA} data (together with precise p+p, p+Pb, and Z boson and direct photon Pb+Pb control data) are needed to assess if the QGP produced at LHC is indeed less opaque to jets than predicted by constrained extrapolations from RHIC.Comment: 13 pages, 8 figure

Significant pain decrease in children with non-systemic Juvenile Idiopathic Arthritis treated to target:results over 24 months of follow up

Background: The aim of this study was to compare pain-scores in three targeted treatment-strategies in JIA-patients and to identify characteristics predicting persistent pain. Methods: In the BeSt-for-Kids-study 92 DMARD-naïve JIA-patients were randomized in 3 treatment-strategies: 1) initial sequential DMARD-monotherapy 2) initial methotrexate (MTX)/prednisolone-bridging or 3) initial MTX/etanercept. Potential differences in VAS pain scores (0-100 mm) over time between treatment-strategies were compared using linear mixed models with visits clustered within patients. A multivariable model was used to assess the ability of baseline characteristics to predict the chance of high pain-scores during follow-up. Results: Pain-scores over time reduced from mean 55.3 (SD 21.7) to 19.5 (SD 25.3) mm after 24 months. On average, pain-scores decreased significantly with β -1.37 mm (95% CI -1.726; -1.022) per month. No significant difference was found between treatment-strategies (interaction term treatment arm*time (months) β (95% CI) arm 1: 0.13 (-0.36; 0.62) and arm 2: 0.37 (-0.12; 0.86) compared to arm 3). Correction for sex and symptom duration yielded similar results. Several baseline characteristics were predictive for pain over time. Higher VAS pain [β 0.44 (95% CI 0.25; 0.65)] and higher active joint count [0.77 (0.19; 1.34)] were predictive of higher pain over time, whereas, low VAS physician [-0.34 (-0.55; -0.06)], CHQ Physical [-0.42 (-0.72; -0.11)] and Psychosocial summary Score [-0.42 (-0.77; -0.06)] were predictive of lower pain. Conclusions: Treatment-to-target seems effective in pain-reduction in non-systemic JIA-patients irrespective of initial treatment-strategy. Several baseline-predictors for pain over time were found, which could help to identify patients with a high risk for development of chronic pain. Trial registration: Dutch Trial Registry number 1574.</p