Characteristics and outcomes of reversed patients admitted to an emergency department for VKA-related intramuscular hematoma.

BACKGROUND: According to the International Society on Thrombosis and Haemostasis (ISTH), intramuscular hematoma without other severity criteria is not considered a major bleeding. OBJECTIVES: In a large cohort of reversed vitamin K antagonist (VKA) patients admitted to the emergency unit for muscular hematoma, we assess frequency, severity, and anticoagulation management based on whether ISTH criteria were met or not. MATERIALS AND METHODS: We performed a retrospective single-center study involving patients admitted to an emergency unit for VKA-induced intramuscular hematoma whose bleeding was reversed with prothrombin complex concentrates. RESULTS: During the study period, 631 VKA-induced bleeding events occurred in our emergency unit, of which 73 (11.6%) were intramuscular hematomas and half met ISTH criteria. The mean age was 75.5years (95% CI=72.6-78.3). Admission blood tests showed that patients with ISTH criteria had higher international normalized ratio (7.0±4.6 vs. 4.1±3.0, p=0.002) and lower hemoglobin (8.1±1.8 vs. 11.9±2.2, p<0.001) than those without. Patients with ISTH criteria were more likely to have intramuscular hematoma in the iliopsoas, gluteal, and pectoral muscles than those without. Interestingly, two-thirds of rectus sheath hematomas involved patients without ISTH criteria. However, patients with or without ISTH criteria exhibited a similar hospitalization duration and rate of re-bleeding. CONCLUSION: We showed that half of the patients admitted with intramuscular hematoma could not be qualified as having ISTH-criteria major bleeding. Interestingly, these patients displayed a similar hospitalization duration and rate of re-bleeding to those with ISTH-criteria major bleeding.

Erratum: Resonance Effects in Photoemission Time Delays [Phys. Rev. Lett. 115, 133001 (2015)].

This corrects the article DOI: 10.1103/PhysRevLett.115.133001.

The fibronectin/α3ß1 integrin axis serves as molecular basis for keratinocyte invasion induced by ßHPV.

Organ-transplant-recipients exhibit cancerization of the skin from which multiple human papillomavirus (HPV)-positive squamous cell carcinomas (SCCs) arise. However, the molecular basis for HPV-induced invasion of skin keratinocytes is not known. We generated a transgenic mouse model expressing the E7 oncoprotein of HPV8 in the murine epidermis under the control of the keratin-14 promoter and showed that E7 is carcinogenic in mice. We further showed that both, the E7-expressing keratinocyte and mesenchymal components of the extracellular matrix as critical in eliciting the invasive behavior. E7 expression in basal keratinocytes, grown on fibronectin, led to epithelial-mesenchymal transition mediated by a cadherin switch. E7-positive keratinocytes displayed enhanced EDA-fibronectin expression and secretion and stimulated dermal fibroblasts to express EDA-fibronectin. Deposition of fibronectin was also detected in the peritumoral stroma of HPV8-positive skin SCC. When grown on fibronectin, E7-positive keratinocytes, in particular stem cell-like cells, exhibited increased cell surface levels of the α3-integrin chain. Functional blocking confirmed α3 as a critical molecule sufficient to induce E7-mediated invasion. This mechanistic link is further supported by expression of an E7-mutant, impaired in targeting α3 to the cell surface. These findings highlight the importance of epithelial-extracellular matrix interaction required for keratinocyte invasion and provide further mechanistic evidence for a role of HPV in skin carcinogenesis.

Resonance Effects in Photoemission Time Delays.

We present measurements of single-photon ionization time delays between the outermost valence electrons of argon and neon using a coincidence detection technique that allows for the simultaneous measurement of both species under identical conditions. The analysis of the measured traces reveals energy-dependent time delays of a few tens of attoseconds with high energy resolution. In contrast to photoelectrons ejected through tunneling, single-photon ionization can be well described in the framework of Wigner time delays. Accordingly, the overall trend of our data is reproduced by recent Wigner time delay calculations. However, besides the general trend we observe resonance features occurring at specific photon energies. These features have been qualitatively reproduced and identified by a calculation using the multiconfigurational Hartree-Fock method, including the influence of doubly excited states and ionization thresholds.

Revealing the time-dependent polarization of ultrashort pulses with sub-cycle resolution.

We report on the first experiments characterizing the complete time-dependent 2D vector potential of a few-cycle laser pulse. The instantaneous amplitude and orientation of the electric field is determined with sub-cycle resolution, directly giving access to the polarization state of the pulse at any instant in time. This is achieved by performing an attosecond streaking experiment using a reaction microscope, where the full pulse characterization is performed directly in the target region.

Combining attosecond XUV pulses with coincidence spectroscopy.

Here we present a successful combination of an attosecond beamline with a COLTRIMS apparatus, which we refer to as AttoCOLTRIMS. The setup provides either single attosecond pulses or attosecond pulse trains for extreme ultraviolet-infrared pump-probe experiments. We achieve full attosecond stability by using an active interferometer stabilization. The capability of the setup is demonstrated by means of two measurements, which lie at the heart of the COLTRIMS detector: firstly, we resolve the rotating electric field vector of an elliptically polarized few-cycle infrared laser field by attosecond streaking exploiting the access to the 3D momentum space of the charged particles. Secondly, we show streaking measurements on different atomic species obtained simultaneously in a single measurement making use of the advantage of measuring ions and electrons in coincidence. Both of these studies demonstrate the potential of the AttoCOLTRIMS for attosecond science.

Probing nonadiabatic effects in strong-field tunnel ionization.

We investigate experimentally the validity of proposed theories extending the tunneling approximation towards the multiphoton regime in strong-field ionization of helium. We employ elliptically polarized laser pulses and demonstrate how the influence of the ion potential on the released electron encoded in the measured observable provides the desired sensitivity to detect nonadiabatic effects in tunnel ionization. Our results show that for a large intensity range the proposed nonadiabatic theories contradict the experimental trends of the data, while adiabatic assumptions are confirmed.

A new approach reveals syncytia within the visceral musculature of Drosophila melanogaster.

In order to reveal syncytia within the visceral musculature of Drosophila melanogaster, we have combined the GAL4/UAS system with the single-cell transplantation technique. After transplantation of single cells from UAS-GFP donor embryos into ubiquitously GAL4-expressing recipients, the expression of the reporter gene was exclusively activated in syncytia containing both donor- and recipient-derived nuclei. In the first trial, we tested the system in the larval somatic musculature, which is already known to consist of syncytia. By this means we could show that most of the larval somatic muscles are generated by clonally non-related cells. Moreover, using this approach we were able to detect syncytia within the visceral musculature - a tissue that has previously been described as consisting of mononuclear cells. Both the longitudinal visceral musculature of the midgut and the circular musculature of the hindgut consist of syncytia and persist through metamorphosis. This novel application of the transplantation technique might be a powerful tool to trace syncytia in any organism using the GAL4/UAS system.