bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Inulin-Type Fructans on Appetite, Energy Intake, and Body Weight in Children and Adults: Systematic Review of Randomized Controlled Trials
Authors: Liber Anna , Szajewska Hania
Published: September 2013

Aim: To systematically evaluate the effects of inulin-type fructan (ITF) supplementation on appetite, energy intake, and body weight (BW) in children and adults. Methods: The MEDLINE, EMBASE, and Cochrane Library databases were searched up to December 2012 for randomized controlled trials (RCTs) that compared the effects of supplementation with well-defined ITF with placebo or no intervention. Results: For the pediatric population, 4 RCTs (n = 232) met the inclusion criteria. In infants, very limited evidence (1 RCT, n = 62) showed no effect of ITF supplementation on energy intake and BW. One RCT involving 97 nonobese adolescents aged 9 to 13 years found a reduced increase in BW in the oligofructose + inulin (8 g/day) group compared with the control group after 1 year. For the adult population, 15 RCTs (n = 545) met the inclusion criteria. Five RCTs found no effect of ITF supplementation on appetite sensations. Eleven RCTs found no effect of ITF supplementation on daily energy intake or energy intake during a meal tolerance test. Among 3 RCTs that assessed the effect of ITF supplementation on BW, 2 RCTs showed a (significant) reduction in BW. Of 3 RCTs that evaluated body mass index (BMI), 1 RCT showed a significant reduction in BMI in subjects supplemented with ITF. Conclusion: Limited data suggest that long-term administration of ITF may contribute to weight reduction.
Epidemiology of Traumatic Spinal Cord Injury in Developing Countries: A Systematic Review
Authors: Rahimi-Movaghar Vafa , Sayyah Mohammad Kazem , Akbari Hesam , Khorramirouz Reza , Rasouli Mohammad R. , Moradi-Lakeh Maziar , Shokraneh Farhad , Vaccaro Alexander R.
Published: September 2013

Background/Aims: To describe the epidemiology of spinal cord injury (SCI) in the developing world. Methods: Developing countries were selected based on the definition proposed by the International Monetary Fund. A literature search was performed in July 2012 in Medline and Embase. Further article procurement was obtained via the reference lists of the identified articles, websites, and direct contact with the authors of the identified studies. We designed search strategies using the key words: SCI, epidemiology, incidence, and prevalence. According to the inclusion criteria, 64 studies from 28 countries were included. Results: The incidence of SCI in developing countries is 25.5/million/year (95% CI: 21.7-29.4/million/year) and ranges from 2.1 to 130.7/million/year. Males comprised 82.8% (95% CI: 80.3-85.2) of all SCIs with a mean age of 32.4 years (95% CI: 29.7-35.2). The two leading causes of SCI were found to be motor vehicle crashes (41.4%; 95% CI: 35.4-47.4) and falls (34.9%; 95% CI: 26.7-43.1). Complete SCIs were found to be more common than incomplete injuries (complete SCI: 56.5%; 95% CI: 47.6-65.3; incomplete SCI: 43.0%; 95% CI: 34.1-52.0). Similarly, paraplegia was found to be more common than tetraplegia (paraplegia: 58.7%; 95% CI: 51.5-66.0; tetraplegia: 40.6%; 95% CI: 33.3-48.0). Conclusion: Through an understanding of the epidemiology of SCI in developing countries, appropriate preventative strategies and resource allocation may decrease the incidence and improve the care of these injuries.
Cerebral Aspects of Neonatal Extracorporeal Membrane Oxygenation: A Review
Authors: de Mol Amerik C. , Liem Kian D. , van Heijst Arno F.J.
Published: September 2013

Background: Neonatal extracorporeal membrane oxygenation (ECMO) is a lifesaving therapeutic approach in newborns suffering from severe, but potentially reversible, respiratory insufficiency, mostly complicated by neonatal persistent pulmonary hypertension. However, cerebral damage, intracerebral hemorrhage as well as ischemia belong to the most devastating complications of ECMO. Objectives: The objectives are to give insights into what is known from the literature concerning cerebral damage related to neonatal ECMO treatment for pulmonary reasons. Methods: A short introduction to ECMO indications and technical aspects of ECMO are provided for a better understanding of the process. The remainder of this review focuses on outcome and especially on (potential) risk factors for cerebral hemorrhage and ischemia during ECMO treatment. Results: Although neonatal ECMO treatment shows improved outcome compared to conservative treatment in cases of severe respiratory insufficiency, it is related to disturbances in various aspects of neurodevelopmental outcome. Risk factors for cerebral damage are either related to the patient's disease, EMCO treatment itself, or a combination of both. Conclusion: It is of ongoing importance to further understand pathophysiological mechanisms resulting in cerebral hemorrhage and ischemia due to ECMO and to develop neuroprotective strategies and approaches.
Besondere Qualitätsaspekte von Tibetischen Arzneimitteln - Erkenntnisse aus über 40 Jahren Erfahrung in der Herstellung in der Schweiz
Authors: Schwabl Alexandra , Gämperle Erich
Published: September 2013

Tibetische Rezepturen sind Komplexformeln aus pflanzlichen und mineralischen Inhaltsstoffen. Die Padma AG stellt seit über 40 Jahren ausgewählte Rezepturen der Tibetischen Medizin in der Schweiz her. Dabei werden moderne Qualitätsnormen und Good Manufacturing Practice (GMP)-Richtlinien befolgt, die die Qualität von den Ausgangsstoffen über die Herstellungsprozesse bis hin zum Fertigprodukt garantieren. Ziel ist es, diese wertvollen Formeln Menschen im Westen in gleichbleibend hoher Qualität «made in Switzerland» zur Verfügung zu stellen. Die Herstellung nach modernen Qualitätsrichtlinien ist anspruchsvoll, ressourcenintensiv und benötigt spezielles Know-how z.B. in der Rohstoffbeschaffung und der Qualitätsanalytik unter Einbezug von pharmakognostischem und botanischem Wissen.
Floppy Mitral Valve (FMV)/Mitral Valve Prolapse (MVP) and the FMV/MVP Syndrome: Pathophysiologic Mechanisms and Pathogenesis of Symptoms
Authors: Boudoulas Konstantinos Dean , Boudoulas Harisios
Published: September 2013

Mitral valve prolapse (MVP) results from the systolic movement of a portion or segments of the mitral valve leaflets into the left atrium during left ventricular systole. It is well appreciated today that floppy mitral valve (FMV) is the central issue in the MVP and mitral valve regurgitation (MVR) story. The term FMV refers to the expansion of the area of the mitral valve leaflets with elongated chordae tendineae, chordae rupture and mitral annular dilation. FMV/MVP occurs in a heterogeneous group of patients with a wide spectrum of mitral valve involvement from mild to severe. Two types of symptoms can be defined in FMV/MVP patients. In one group of patients, symptoms are directly related to progressive MVR. In the other group, symptoms cannot be explained by the degree of MVR alone; activation of the autonomic nervous system has been implicated for the explanation of symptoms in this group of patients which is referred to as the FMV/MVP syndrome. In this brief review, the natural history, pathophysiologic mechanisms and management of patients with FMV/MVP/MVR and FMV/MVP syndrome are discussed.
Spurious Electrolyte Disorders: A Diagnostic Challenge for Clinicians
Authors: Liamis George , Liberopoulos Evangelos , Barkas Fotis , Elisaf Moses
Published: September 2013

Spurious electrolyte disorders refer to an artifactually elevated or decreased serum electrolyte values that do not correspond to their actual systemic levels. When a clinician is confronted with a case of electrolyte disturbance, the first question should be whether it is an artifact. Spurious electrolyte disorders (pseudohyponatremia, pseudohypernatremia, pseudohypokalemia, pseudohyperkalemia, pseudohypomagnesemia, pseudohypophosphatemia, pseudohyperphosphatemia, pseudohypocalcemia and pseudohypercalcemia) are not infrequently observed in clinical practice. The recognition that an electrolyte disturbance may be an artifact may prevent inappropriate therapeutic interventions that could potentially have unfavorable outcomes. Clinicians must be alert to the possibility of spurious laboratory abnormalities when faced with conflicting laboratory values or measurements that are discordant with the clinical presentation. Moreover, in the presence of conditions that predispose to spurious electrolyte disorders, the normal measured electrolyte levels should raise the suspicion that true electrolyte disorders may be present.
The Clinical Use of Cetirizine in the Treatment of Allergic Rhinitis
Authors: Zhang Luo , Cheng Lei , Hong Jianguo
Published: September 2013

Background: Cetirizine is among the first second-generation H1 antihistamines (SGAHs) developed to provide selective H1 receptor inhibition without central nervous system depression. Objective: The aim of this review is to summarize the amount of data collected over 25 years of clinical use of cetirizine and compare this with data available for other SGAHs in the management of patients with allergic rhinitis (AR). Methods: A comprehensive literature search for publications relating to cetirizine was performed using the Pubmed database, and relevant papers published in English were selected for detailed review. Results: Compared with the majority of other SGAHs, cetirizine was generally shown to have a more favourable pharmacological profile, to be well tolerated, be at least equally or more efficacious in attenuating/inhibiting nasal and ocular symptoms and to improve the quality of life in AR patients. The majority of clinical trials investigating the effect of SGAHs in AR patients further indicated that cetirizine was often employed as the main comparator active drug. Conclusion: Based on the evidence that cetirizine is a commonly employed active comparator drug in AR, it is tempting to suggest that cetirizine may be a suitable benchmark in the development of novel pharmacotherapies for AR.
Longitudinal Changes in Clinical Outcomes in Older Patients with Asthma, COPD and Asthma-COPD Overlap Syndrome
Authors: Fu Juan-juan , Gibson Peter G. , Simpson Jodie L. , McDonald Vanessa M.
Published: September 2013

Background: The progression of obstructive airway diseases (OADs) including asthma, chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap syndrome in older adults is not well understood. Objective: To examine the prognosis of OADs and to identify potential determinants for longitudinal changes in clinical outcomes. Methods: We consecutively recruited 99 older adults (>55 years) with OADs who underwent a multidimensional assessment at baseline and 4 years which involved spirometry, 6-min walk distance (6MWD), assessments of health status (Saint George's Respiratory Questionnaire, SGRQ), comorbidity, and serum and sputum biomarkers. All-cause mortality and respiratory hospitalisation during the follow-up period were recorded. Clinical outcomes were compared between basal and final visits, and changes in clinical outcomes were compared among asthma, COPD and asthma-COPD overlap groups. Associations between clinical parameters, biomarkers and prognosis were examined. Results: After a median follow-up of 4.2 years, outcome data were available for 75 (75.8%) patients. There were 16 (16.2%) deaths. The BODE index predicted all-cause mortality in older people with OADs. While spirometry, 6MWD and SGRQ deteriorated significantly over the 4 years, there was significant heterogeneity in the longitudinal changes in these clinical outcomes. Participants with COPD had a significant decline in FEV1 (p = 0.003), SGRQ (p = 0.030) and 6MWD [decline of 75.5 (93.4) m, p = 0.024]. The change in 6MWD was lower in the asthma-COPD overlap group. Airflow reversibility was associated with a reduced decline in 6MWD. Conclusion: COPD patients had a poor prognosis compared with asthma and asthma-COPD overlap patients. The BODE index is a useful prognostic indicator in older adults with OADs. Both airway disease diagnosis and BODE index warrant specific attention in clinical practice.
Slow Sinus Heart Rate as a Potential Predictive Factor of Paroxysmal Atrial Fibrillation in Stroke Patients
Authors: Hoshino Takao , Ishizuka Kentaro , Nagao Takehiko , Shimizu Satoru , Uchiyama Shinichiro
Published: September 2013

Background: Paroxysmal atrial fibrillation (PAF) is a strong independent risk factor for ischemic stroke and is also associated with stroke severity and mortality. However, the detection rate of PAF in patients with ischemic stroke is limited because they are often asymptomatic or present with sinus rhythm on electrocardiograms (ECGs). In the present study, we aimed to identify predictors of PAF in stroke patients by continuous ECG monitoring of the heart rate in sinus rhythm. Methods: We enrolled 741 consecutive patients with acute symptomatic ischemic stroke who were admitted to our hospital. Exclusion criteria were the following: (1) patients with persistent AF, (2) cardiac pacemaker users and (3) incomplete clinical investigations. Each patient was subject to 24-hour Holter ECG, cardiac monitoring by inpatient telemetry and routine transthoracic echocardiography. The minimum and mean sinus heart rates (SHRs) on 24-hour Holter ECGs were recorded. The presence of PAF was judged on the basis of previous history and cardiac studies during hospitalization. Clinical characteristics of the patients with and without PAF were compared, and multiple logistic regression analysis was performed to identify the predictors of PAF. Results: Of all enrolled patients, 606 (mean age 68.2 years, 63.4% male) were eligible for analysis, and the presence of PAF was confirmed in 116 subjects (19.1%). In the univariate analysis, the patients with and without PAF showed significant differences in age (74.3 vs. 66.7 years, p < 0.001), dyslipidemia (32.8 vs. 50.4%, p = 0.001), chronic heart failure (16.4 vs. 4.7%, p < 0.001), admission National Institute of Health Stroke Scale score (8.5 vs. 6, p < 0.001) and absence of vascular etiology (80.2 vs. 54.1%, p < 0.001). Furthermore, the minimum and mean SHRs were slower in the patients with than in those without PAF (46.5 vs. 54.0 bpm, p < 0.001 and 70.7 vs. 73.8 bpm, p = 0.009, respectively). In 501 (82.7%) out of 606 patients, minimum SHRs were detected at night (from 9:00 p.m. to 7:00 a.m.). A minimum SHR was an independent predictive factor of PAF in the multivariate analysis (odds ratio 1.08, 95% confidence interval 1.05 - 1.12, p < 0.001). Conclusions: A slow SHR on monitoring ECG is a potential predictive factor of PAF in patients with ischemic stroke.
Predictors of Provider-Patient Visit Frequency during Hemodialysis
Authors: Slinin Yelena , Guo Haifeng , Li Suying , Liu Jiannong , Morgan Benjamin , Ensrud Kristine , Gilbertson David T. , Collins Allan J. , Ishani Areef
Published: September 2013

Background/Aims: In 2004, the Centers for Medicare and Medicaid Services tied reimbursement for outpatient hemodialysis services to the number of times per month providers see their dialysis patients, resulting in increased provider-patient visit frequency. Greater provider-patient visit frequency is associated with lower hospitalization risk for hemodialysis patients, and determinants of visit frequency are uncertain. We aimed to identify patient, provider, and dialysis facility characteristics associated with provider visit frequency. Methods: This retrospective cohort study used United States Renal Data System (USRDS) data for point-prevalent patients receiving in-center hemodialysis on January 1, 2006 (n = 144,860). Patient characteristics were defined from January 1 to June 30, 2006, and provider-patient visit frequency (<4 vs. ≥4 visits/month) from July 1 to December 31, 2006. Patient characteristics were obtained from the USRDS. Provider data were obtained from the American Medical Association Physician Master File. We determined longitudinal associations between patient, provider, and facility characteristics and provider-patient visit frequency using logistic regression. Results: Patient characteristics independently associated with greater provider-patient visit frequency included older age, African-American race, longer dialysis duration, higher comorbidity score, Medicaid eligibility, urban residence, better compliance with dialysis, and more hospital days during run-in. Provider characteristics associated with greater provider-patient visit frequency included more years in practice, graduation from a foreign medical school, shorter distance between provider office and dialysis unit, and caring for more dialysis patients; facility characteristics included free-standing, independent status. Conclusion: After the Medicare reimbursement policy change, several patient, provider, and facility characteristics were independently associated with greater dialysis provider-patient visit frequency.
Focal Cortical Subarachnoid Hemorrhage Revealed by Recurrent Paresthesias: A Clinico-Radiological Syndrome Strongly Associated with Cerebral Amyloid Angiopathy
Authors: Apoil Marion , Cogez Julien , Dubuc Lydie , Bataille Mathieu , de la Sayette Vincent , Touzé Emmanuel , Viader Fausto
Published: September 2013

Background: Focal subarachnoid hemorrhage (SAH) is often revealed by transient and recurrent focal neurological episodes. This cause is important to identify because it carries a high risk of intracerebral hemorrhage (ICH). We report the clinical, imaging and prognostic data of 17 patients with focal SAH revealed by short episodes of paresthesias mimicking transient ischemic attacks. Methods: The medical records and imaging data of patients with focal acute SAH at the cerebral convexity and at least one episode of focal paresthesia having attended the Neurology Department of Caen University Hospital in the last 10 years were retrospectively reviewed. Hemorrhagic lesions, ischemic lesions, cerebral microbleeds (CMBs), superficial siderosis, white matter changes (leukoaraiosis) and modified Boston criteria for cerebral amyloid angiopathy (CAA) were assessed. All patients or relatives were contacted after a median delay of 16 months in order to seek for new events (death, stroke, recurrent focal symptoms, ICH and dementia) that occurred since hospital discharge. Results: Seventeen patients (12 men) aged 69-96 years were identified. All but 1 had multiple, repeated, stereotyped and brief attacks of paresthesias, associated in some of them with motor and/or speech difficulties, but only 1 had a headache. SAHs were seen on CT scans in 15/17 patients and on T2* gradient-echo magnetic resonance imaging (MRI) in all patients. They were multiple SAHs in 14/17 patients, including at least 1 SAH in the central or pre- or postcentral sulcus contralateral to the symptoms in all patients. Five patients had punctate cortical hyperintensities on diffusion-weighted MRI. Eleven patients had CMBs, and 4 of them had more than 5 CMBs. Seven patients met the modified Boston criteria for probable and 10 for possible CAA. At follow-up, 5 patients had a subsequent ICH, 4 of whom had received antithrombotic treatments. Five patients died (1 from ICH). Six patients developed dementia. Conclusion: The combination of transient, repeated and stereotyped attacks of unilateral paresthesias with a contralateral sulcal SAH seems to preferentially occur in elderly people and is often indicative of CAA.
Defining Tiger Parenting in Chinese Americans
Authors: Kim Su Yeong
Published: September 2013

‘‘Tiger'' parenting, as described by Amy Chua [2011], has instigated scholarly discourse on this phenomenon and its possible effects on families. Our eight-year longitudinal study, published in the Asian American Journal of Psychology [Kim, Wang, Orozco-Lapray, Shen, & Murtuza, 2013b], demonstrates that tiger parenting is not a common parenting profile in a sample of 444 Chinese American families. Tiger parenting also does not relate to superior academic performance in children. In fact, the best developmental outcomes were found among children of supportive parents. We examine the complexities around defining tiger parenting by reviewing classical literature on parenting styles and scholarship on Asian American parenting, along with Amy Chua's own description of her parenting method, to develop, define, and categorize variability in parenting in a sample of Chinese American families. We also provide evidence that supportive parenting is important for the optimal development of Chinese American adolescents.
Increased Anxiety Induced by Listening to Unpleasant Music during Stress Exposure Is Associated with Reduced Blood Pressure and ACTH Responses in Healthy Men
Authors: Jezova Daniela , Hlavacova Natasa , Makatsori Aikaterini , Duncko Roman , Loder Ingrid , Hinghofer-Szalkay Helmut
Published: September 2013

The relationship between anxiety and the neuroendocrine response to stress stimuli is still not fully understood. The aim of this study was to evaluate the contribution of an acute increase in state anxiety to neuroendocrine activation under stress conditions. To do so, it was necessary to find a stress condition of the same character and intensity with and without a rise in state anxiety. We decided to examine the effects of listening to music on anxiety and to apply a new methodological approach. A group of 14 healthy volunteers participated in a counterbalanced crossover design study. The stress procedure consisted of mental (Stroop test, mental arithmetic) and physical (handgrip exercise) tasks combined with listening to music played forward (pleasant) or backwards (unpleasant). The results confirmed our hypothesis, namely the condition with listening to unpleasant music was anxiogenic, while the other was not. In case of increased state anxiety, the rise in ACTH concentrations in response to mental challenge and the increase in systolic blood pressure induced by handgrip exercise was reduced compared to the situation with unchanged anxiety. Concentrations of testosterone, oxytocin, vasopressin and aldosterone were slightly increased in response to the stress paradigm accompanied with increased anxiety. In conclusion, the present data demonstrate that an acute increase in state anxiety contributes to neuroendocrine activation under stress conditions. Moreover, the results show that listening to music may both positively and negatively influence the perception of stress and the level of anxiety, which might have functional consequences.
A Retrospective Study of Gemcitabine and Cisplatin Combination Therapy as Second-Line Treatment for Advanced Biliary Tract Cancer
Authors: Sasaki Takashi , Isayama Hiroyuki , Nakai Yousuke , Takahara Naminatsu , Akiyama Dai , Yagioka Hiroshi , Kogure Hirofumi , Matsubara Saburo , Ito Yukiko , Yamamoto Natsuyo , Sasahira Naoki , Hirano Kenji , Toda Nobuo , Tada Minoru , Koike Kazuhiko
Published: September 2013

Background: To evaluate the treatment outcome of gemcitabine and cisplatin combination therapy as second-line treatment for advanced biliary tract cancer. Patients and Methods: Patients with advanced biliary tract cancer who were refractory to gemcitabine-based first-line chemotherapy were treated with gemcitabine and cisplatin combination therapy. Gemcitabine (1,000 mg/m2) and cisplatin (25 mg/m2) were administered intravenously on days 1 and 8, repeated every 3 weeks. Results: Sixty patients were included. The tumor response and disease control rates were 1.7 and 58.3%, respectively. The median overall survival and time to progression were 6.7 months (95% CI 4.9-8.1) and 3.5 months (95% CI 2.5-5.0), respectively. Grade 3/4 toxicities included leucopenia (20%), neutropenia (25%), anemia (23%), thrombocytopenia (17%), nausea (2%), anorexia (2%), and liver dysfunction (2%). Conclusions: Gemcitabine and cisplatin combination therapy showed moderate efficacy and safety as second-line treatment for advanced biliary tract cancer that is refractory to gemcitabine-based first-line chemotherapy.
Improving the Safety of Aging Road Users: A Mini-Review
Authors: Boot Walter R. , Stothart Cary , Charness Neil
Published: September 2013

Older drivers are at greatest risk for injury or death as a result of a car crash. In this mini-review, we outline the normative age-related changes to perceptual, cognitive, and motor abilities that contribute to increased crash risk and decreased comfort with driving, and highlight specific driving scenarios and conditions that are particularly challenging for aging road users. Adopting a person-environment fit framework, we discuss how the roadway environment can be modified to better match the abilities of the aging driver. We also review evidence for the efficacy of training interventions that aim to change the abilities and strategies of the aging driver to better match the demands of the driving environment. Evidence suggests that specific changes to the roadway and driver training strategies can bring the abilities of the older driver back into alignment with the demands of the driving task. A focus on both approaches will help ensure the safety of all road users as the number of aging drivers greatly increases over the next few decades.
Endocrine Problems in Children and Adolescents Who Have Disabilities
Authors: Zacharin Margaret
Published: September 2013

The consequences of disability span almost all aspects of life, for families and for an affected individual. Endocrine aspects of disability cover disorders of hypothalamic pituitary dysfunction, bone health, puberty, fertility, sexual function and contraceptive needs. Adequate endocrine assessment for a child with a disability requires extensive and sensitive history to address social issues, general nutrition, vitamin D status, specific hypothalamic pituitary problems, together with parental concerns regarding puberty and contraception. Bone health assessment includes history of minimal trauma fracture, need for intervention or fitness for surgery. Strategic interventions to improve outcome include management of puberty, vitamin D status, biomechanical stimulation with vibration and standing and possible consideration for bisphosphonate in special circumstances. Both early and late puberty cause major family concerns. The paediatrician must be aware of a range of management options to improve outcomes for the child and family.
Solitary Fibrous Tumors of the Kidneys: Presentation, Evaluation, and Treatment
Authors: Khater Nazih , Khauli Raja , Shahait Mohammad , Degheili Jad , Khalifeh Ibrahim , Aoun Jessica
Published: September 2013

Introduction: Renal solitary fibrous tumors (SFTs) are spindle cell neoplasms of mesenchymal origin, and very rare with only 46 cases reported worldwide to date. It is crucial to differentiate this tumor from other tumors of the kidney, so as to avoid unnecessary treatment. Therefore, our objective was to review reports of renal SFTs, their clinical presentations, imaging methods, and surgical management, updated to 2013. Material and Methods: We retrospectively reviewed articles published in the USA, Europe, and Asia from 1996 to date using PubMed, Medscape, Medline, and several major journals. We report on areas of controversy and well-established guidelines. Results: We reviewed 58 articles which confirmed, with a high level of evidence-based medicine, that the male-to-female ratio is equal and their most common presentation is an incidental finding on a radiological study, in which it is difficult to differentiate them from renal cell carcinoma. Nephrectomy is the gold standard treatment, with almost no recurrence. Conclusions: In symptomatic patients, complete surgical resection of renal SFTs may provide a very good outcome, with almost no recurrence.
Dual Effects of Silymarin on Nasopharyngeal Carcinoma Cells (NPC-TW01)
Authors: Su Chin-Hui , Chen Li-Jen , Liao Jyh Fei , Cheng Juei-Tang
Published: September 2013

Background: Silymarin is an active component from the seeds of Silybum marianum and is widely used as a hepatic protection agent. Apoptosis induced by silymarin has been mentioned in cervical cancer cells. However, silymarin shows dual effects on tumor cells: cytostatic action at a low dose and cytotoxic action at higher dose. Thus, in the present study, we focused on low-dosing of silymarin in nasopharyngeal carcinoma cells, NPC-TW01 (TW01). Methods: Cell viability assay was used to screen the effect of silymarin in TW01 cells. Western blot analysis was used to identify the expressions of antioxidant enzymes and anti-/proapoptotic proteins. Fluorescent dyes are employed to detect the content of reactive oxygen species (ROS) and cell apoptosis. Results: Treatment of TW01 cells with silymarin at a low dose (80 µmol/l) resulted in a significant increase of antioxidant enzymes. Silymarin increased the expressions of superoxide dismutase 1, catalase, and glutathione peroxidase. Consequently, the cell apoptosis was reduced markedly. An increase of Bcl-2 expression and a decrease of activated caspase-3 or apoptosis-inducing factor (AIF) were observed in TW01 cells at a low dose (80 µmol/l) treatment. Conclusion: Silymarin at a low dose can induce cytostatic effect on TW01 cells mainly through an increase of antioxidant-like action. Thus, silymarin should be applied carefully to patients with nasopharyngeal carcinoma.
Evaluation of Plasma Trace Element and Mineral Status in Children and Adolescents with Phenylketonuria Using Data from Inductively-Coupled-Plasma Atomic Emission and Mass Spectrometric Analysis
Authors: Knerr I. , Blessing H. , Seyferth S. , Watling R.J. , Chaudhri M.A.
Published: September 2013

Background: Phenylketonuria (PKU) is caused by a severe phenylalanine hydroxylase deficiency; the mainstay of treatment is a low-phenylalanine diet. A diet which is so restrictive is associated with a risk of nutritional deficiencies. We investigated plasma concentrations for 46 elements, including minerals and trace elements. Methods: We enrolled 20 children and adolescents with PKU and 20 matched controls. Multi-elementary quantification was carried out by solution-based inductively coupled plasma atomic emission spectroscopy (ICP-AES) and ICP mass spectrometry (ICP-MS). Results: With the exception of manganese and aluminium, no significant differences were found for element levels between PKU patients and controls. As a trend, manganese levels were lower in PKU patients than in control subjects (p < 0.05) but were within the reference range. There was a positive linear relationship between manganese and tyrosine levels in subjects with PKU (r2 = 0.2295, p < 0.05). If detectable, potentially toxic elements were only identified in ultra-trace quantities in plasma samples of either group; aluminium levels were found to be slightly higher in PKU subjects than in controls (p < 0.01). Conclusion: The combination of ICP-AES and ICP-MS data is a useful diagnostic tool for element quantification at a high analytical rate and for monitoring bio-element status, e.g. in patients on a restrictive diet.
Effect of Copy Number Variants on Outcomes for Infants With Single Ventricle Heart Defects
Authors: Carey Abigail S. , Liang Li , Edwards Jonathan , Brandt Tracy , Mei Hui , Sharp Andrew J. , Hsu Daphne T. , Newburger Jane W. , Ohye Richard G. , Chung Wendy K. , Russell Mark W. , Rosenfeld Jill A. , Shaffer Lisa G. , Parides Michael K. , Edelmann Lisa , Gelb Bruce D.
Published: September 2013

Background—

Human genomes harbor copy number variants (CNVs), which are regions of DNA gains or losses. Although pathogenic CNVs are associated with congenital heart disease (CHD), their effect on clinical outcomes is unknown. This study sought to determine whether pathogenic CNVs among infants with single ventricle physiology were associated with inferior neurocognitive and somatic growth outcomes.

Methods and Results—

Genomic DNAs from 223 subjects of 2 National Heart, Lung, and Blood Institute–sponsored randomized clinical trials in infants with single ventricle CHD and 270 controls from The Cancer Genome Atlas project were analyzed for rare CNVs >300 kb using array comparative genomic hybridization. Neurocognitive and growth outcomes at 14 months from the CHD trials were compared among subjects with and without pathogenic CNVs. Putatively pathogenic CNVs, comprising 25 duplications and 6 deletions, had a prevalence of 13.9%, significantly greater than the 4.4% rate of such CNVs among controls. CNVs associated with genomic disorders were found in 13 cases but not in controls. Several CNVs likely to be causative of single ventricle CHD were observed, including aberrations altering the dosage of
GATA4
,
MYH11
, and
GJA5
. Subjects with pathogenic CNVs had worse linear growth, and those with CNVs associated with known genomic disorders had the poorest neurocognitive and growth outcomes. A minority of children with pathogenic CNVs were noted to be dysmorphic on clinical genetics examination.

Conclusions—

Pathogenic CNVs seem to contribute to the cause of single ventricle forms of CHD in ≥10% of cases and are clinically subtle but adversely affect outcomes in children harboring them.
Effectiveness and Safety of Digoxin Among Contemporary Adults With Incident Systolic Heart Failure
Authors: Freeman James V. , Yang Jingrong , Sung Sue Hee , Hlatky Mark A. , Go Alan S.
Published: September 2013

Background—

Clinical guidelines recommend digoxin for patients with symptomatic systolic heart failure (HF) receiving optimal medical therapy, but this recommendation is based on limited, older trial data. We evaluated the effectiveness and safety of digoxin in a contemporary cohort of patients with incident systolic HF.

Methods and Results—

We identified adults with incident systolic HF between 2006 and 2008 within Kaiser Permanente Northern California who had no prior digoxin use. We used multivariable extended Cox regression to examine the association between new digoxin use and risks of death and HF hospitalization, controlling for medical history, laboratory results, medications, HF disease severity, and the propensity for digoxin use. We also conducted analyses stratified by sex and concurrent β-blocker use. Among 2891 newly diagnosed patients with systolic HF, 529 (18%) received digoxin. During a median 2.5 years of follow-up, incident digoxin use was associated with higher rates of death (14.2 versus 11.3 per 100 person-years) and HF hospitalization (28.2 versus 24.4 per 100 person-years). In multivariable analysis, incident digoxin use was associated with higher mortality (hazard ratio, 1.72; 95% confidence interval, 1.25–2.36) but no significant difference in the risk of HF hospitalization (hazard ratio, 1.05; 95% confidence interval, 0.82–1.34). Results were similar in analyses stratified by sex and β-blocker use.

Conclusions—

Digoxin use in patients with incident systolic HF was independently associated with a higher risk of death but no difference in HF hospitalization.
Exercise Mediates the Association Between Positive Affect and 5-Year Mortality in Patients With Ischemic Heart Disease
Authors: Hoogwegt Madelein T. , Versteeg Henneke , Hansen Tina B. , Thygesen Lau C. , Pedersen Susanne S. , Zwisler Ann-Dorthe
Published: September 2013

Background—

Positive affect has been associated with better prognosis in patients with ischemic heart disease, but the underlying mechanisms remain unclear. We examined whether positive affect predicted time to first cardiac-related hospitalization and all-cause mortality, and whether exercise mediated this relationship in patients with established ischemic heart disease.

Methods and Results—

The sample comprised 607 patients with ischemic heart disease from Holbæk Hospital, Denmark. In 2005, patients completed the Global Mood Scale (GMS) to assess positive affect and a purpose-designed question on exercise. Data on mortality and hospitalization were collected from Danish national registers for the period 2006–2010. Adjusted Cox and logistic regression were used to analyze the mediation model. Because no significant association between positive affect and cardiac-related hospitalization was found, we constructed no mediation model for hospitalization. Importantly, patients with high positive affect had a significantly reduced risk of all-cause mortality (hazard ratio, 0.58; 95% confidence interval, 0.37–0.92; unadjusted analysis) and were more likely to exercise (odds ratio, 1.99; 95% confidence interval, 1.44–2.76; unadjusted analysis; odds ratio, 1.48; 95% confidence interval, 1.03–2.13; adjusted analysis). When controlling for positive affect and other relevant variables, patients engaged in exercise were less likely to die during follow-up (hazard ratio, 0.50; 95% confidence interval, 0.31–0.80;
P
=0.004). Importantly, exercise acted as a mediator in the relationship between positive affect and mortality.

Conclusions—

Patients with higher levels of positive affect were more likely to exercise and had a lower risk of dying during 5-year follow-up, with exercise mediating the relationship between positive affect and mortality. Interventions aimed at increasing both positive affect and exercise may have better results with respect to patients’ prognosis and psychological well-being than interventions focusing on 1 of these factors alone.
Labor Demonstrations: Aleksei Gan's Island of the Young Pioneers, Dziga Vertov's Kino-Eye, and the Rationalization of Artistic Labor
Authors: Romberg Kristin
Published: September 2013

Of Russian Constructivism's manifold demonstration pieces, the model workers' club that Aleksandr Rodchenko exhibited in Paris in 1925 is one of the best. It s economy of mater ials and transparent structural logic exemplify Constructivism's rationalist bid for a socialist aesthetics, while its function as a club models the ideal of enlightened recreation as the partner to unalienated labor. Visible in the well-known photograph of the club are posters for the two films that are the subject of this essay. Both were conceived as demonstration pieces in their own right. The poster in the center, also designed by Rodchenko, is for Dziga Vertov's first feature-length film, Kino-Eye. The one to the right, with the pared-down typographic layout, advertises Aleksei Gan's Island of the Young Pioneers. Both films were made in 1924 and featured the Young Pioneers, the Soviet youth organization for children ages ten to fifteen founded in 1922 on the model of the Boy Scouts. Both were produced as examples of a new approach to filmmaking called “the demonstration of everyday life.” But while Kino-Eye has gone on to be celebrated as the closest thing to Constructivism in cinema, Island has only been mentioned in passing, and even then as a complete disaster.
On the Eirobiblical
Authors: Cooper Harriss M.
Published: September 2013

The Bible (as it tends to do) supported both the justification of and resistance to American slavery as it was practiced in the antebellum era. Slaveholders and abolitionists alike “re-wrote” the Bible, attempting to bolster the legitimacy of their respective sides. Most scholarly treatments of these biblical interpretations discuss the myriad ways that agents (ranging from the nominally literate to the literary) deploy generally stable readings and reinscriptions of biblical passages as they apply to their contemporary circumstances. Enslaved Americans, however, tended to encounter the Bible orally/aurally as illiterate people, hearing it performed at second- or third-hand and assimilating its language and stories at considerable distance from the canonical “text.” Furthermore, most examples we possess of this language reside in contested documents narrated by the enslaved to problematic scribes. This essay explores how the enslaved wielded the inherent imprecision of their biblical language to articulate coherent, if ironic, biblical worldviews. Assessing the rhetorical and even semiotic distinctions between these two modes of biblical interpretation, I develop a category (“eirobiblical rhetoric”) that facilitates critical engagement with the instabilities that result from such rhetoric as it engages particularly with the political and social exigencies of a religiously ordered (and “justified”) system of chattel slavery. A series of close readings in the 1831 document The Confessions of Nat Turner, an exemplary text of eirobiblical rhetoric, allow for the critical application of this new rhetorical category in a way that offers an unprecedented and liberating interpretation of a troublesome and disputed text.
Two new species of Hyalella (Amphipoda, Dogielinotidae) from Brazil
Authors: Bueno Alessandra A. P. , Araujo Paula B. , Cardoso Giovanna M. , Gomes Kelly M. , Bond-Buckup Georgina
Published: September 2013

Two new freshwater species of amphipods from Brazil are described here. Hyalella xakriaba n. sp. occurs in the hydrographic basin of the São Francisco River, in a biome characterized by a semiarid climate, in the state of Minas Gerais. This new species constitutes the northernmost record of the genus in Brazil. Hyalella kaingang n. sp. occurs in the hydrographic basin of the Mampituba River, located in Rio Grande do Sul, the southernmost state in Brazil. Currently 14 species of Hyalella are known in Brazil, cave species among them. Some morphological characters and their respective states are analyzed, and constitute an important new tool for species identifications. In particular, we describe the cuticular structures, defined as denticles, on the distal inner margin of the carpus of gnathopods 1 and 2. These structures may have a polygonal pattern or appear as comb scales, and may be arranged in one or more rows.
Sediment quality assessment using Gmelinoides fasciatus and Monoporeia affinis (Amphipoda, Gammaridea) in the northeastern Baltic Sea
Authors: Berezina Nadezhda A. , Strode Evita , Lehtonen Kari K. , Balode Maija , Golubkov Sergey M.
Published: September 2013

Crustaceans in the order Amphipoda are sensitive organisms for the assessment of sediment quality. In this work we performed 10-day toxicity tests on muddy sediments collected from a total of 29 sites in the Gulf of Finland, the Gulf of Riga and the Gulf of Bothnia (northeastern Baltic Sea) using Baltic Sea species such as the native amphipod Monoporeia affinis (Bousfield, 1989) and the invasive amphipod Gmelinoides fasciatus (Stebbing, 1899), and also compared these results with those of bioassays carried out using the standard test species, laboratory-cultivated amphipod Hyalella azteca (Saussure, 1858). The sediment samples (three cm of the upper layer) were collected by a GEMAX Dual Corer during the R/V “Aranda” cruises in August and September of 2009 and 2010. Toxicity of sediments in bioassays with M. affinis and G. fasciatus gave varied results depending on the amphipod species used. The lowest quality of sediments determined using M. affinis was recorded at sites located in the offshore and deepwater areas (60-100 m depths) of the Gulf of Finland characterized by hypoxic/anoxic conditions. Toxicity testing applying G. fasciatus showed that sediments at >50% of the study sites in the Gulf of Finland and in the Gulf of Riga can be assessed as highly contaminated. Males of G. fasciatus were significantly more sensitive to potential contamination in sediments than females. The lower survival of males under contaminant stress may result in a skewed sex ratio in natural populations and in a decline of reproduction success. The survival rate of G. fasciatus in the toxicity tests correlated positively with the Shannon diversity index (calculated for macrozoobenthos at the study sites), weight losses on ignition (%) in sediments, and it also showed a negative relation with the bottom water oxygen content (mg/l). The results suggest that G. fasciatus is the more sensitive species of the three amphipods tested and can be used as a indicator of sediment quality in the Baltic Sea and other water bodies.
Geometric morphometry supports a taxonomic revision of the Mediterranean Bathyporeia guilliamsoniana (Spence Bate, 1857) (Amphipoda, Bathyporeiidae)
Authors: Curatolo Tiziana , Calvaruso Claudia , Galil Bella S. , Lo Brutto Sabrina
Published: September 2013

Bathyporeia guilliamsoniana (Spence Bate, 1857) specimens collected in the Levantine Basin of the Mediterranean Sea displayed polymorphism in some characters. More than 100 specimens were examined and their intra-specific variation in the shape of the third epimeral plate analysed and quantified. The morphometric geometry methodology is used to assess the ‘cryptic’ variation in shape which may obscure identification. The results support the assignment of sunnivae and megalops to morphotypes of B. guilliamsoniana sensu d’Udekem d’Acoz & Vader (2005).
The ‘Nuremberg Clause’ and Beyond: Legality Principle and Sources of International Criminal Law in the European Court’s Jurisprudence
Authors: Mariniello Triestino
Published: September 2013

Legislative acts or constitutional courts’ decisions allowing the prosecution of alleged perpetrators of international crimes committed in the past continue to attribute to the legality principle a central role within domestic criminal proceedings or complaints before the European Court of Human Rights. This article assesses the evolution of the recent jurisprudence of the Strasbourg Court, which in the 2008 Korbely and Kononov cases for the first time extended the standards of the legality principle over war crimes and crimes against humanity. It examines the rationale for this development, which constitutes an attempt by the Court to restore a proper balance between substantive justice and individual protection, by ascertaining whether domestic convictions were consistent with the qualitative elements of the legality principle, such as accessibility and foreseeability. Through a detailed analysis of the European jurisprudence, the article argues that, although the new approach of the Court entails in abstracto a strengthening of individual safeguards from the arbitrariness of state power, the meaningful protection of the legality principle may be in concreto significantly narrow. The reasons for such a result are two-pronged: first, the Court seems to provide an interpretation of past law which radically diverged from the interpretation of the law in place in the legal system at the material time of the events; second, the international sources accepted by the Court as a valid basis for the applicants’ convictions – pursuant to the standards of the legality principle – were intended to create obligations only upon states, rather than individuals.
Minorities’ Claim to Secession by Virtue of the Right to Self-Determination: Asian Perspectives with Special Reference to Kosovo and Sri Lanka
Authors: Welhengama Gnanapala , Pillay Nirmala
Published: September 2013

This study examines the attitudes of the South and South East Asian states to secession in the post-colonial context. The right to self-determination was a key argument in the overthrow of colonial rule, but states that won their independence from foreign rule are unwilling to recognise that ethnic minorities in these former colonial states have a right to make the same argument in their bid for self-government. These states insist on the inviolability of mainly colonial boundaries and reject any notion that the right to self-determination implies the right to secession. This article examines the reasons for this attitude. Also, in the last five years two significant events have occurred: Kosovo has seceded and the Tamil Tigers have been defeated. The article explores the implications of these two extremes.
“Muri puliti popoli muti”: Analisi tematica e dinamiche linguistiche del fenomeno del graffitismo a Roma
Authors: Guerra Nicola
Published: September 2013

Dall’osservazione dello spazio urbano della città di Roma, effettuato fra gennaio 2011 e giugno 2012, sono stati censiti e documentati 247 graffiti. Ciò che viene presentato in questo saggio è una prima analisi tematica del materiale raccolto. A questa centrale riflessione se ne accompagnano altre incentrate sul contributo che lo studio del graffitismo, osservato e documentato nello spazio urbano e linguistico della capitale italiana, può offrire relativamente a tematiche quali, per esempio, il rapporto diamesico fra lingua scritta e parlata, l’analisi delle varietà giovanili, le interferenze del dialetto e la creazione di neologismi.