bluuebunny/crossref_metadata_2025 huggingface dataset:
Body Mass Index and Prognosis of Metastatic Breast Cancer Patients Receiving First-Line Chemotherapy
Authors: Gennari Alessandra , Nanni Oriana , Puntoni Matteo , DeCensi Andrea , Scarpi Emanuela , Conte PierFranco , Antonucci Giancarlo , Amadori Dino , Bruzzi Paolo
Published: August 2013

Background: The effect of body mass index (BMI) on the prognosis of metastatic breast cancer (MBC) has not been explored so far.

Methods: The relationship between BMI (kg/m2) and progression-free survival (PFS) or overall survival (OS) was assessed in 489 patients with MBC enrolled in three clinical trials of first-line chemotherapy. World Health Organization BMI categories were used: normal, 18.5–24.9 kg/m2; overweight, 25–29.9 kg/m2; and obese, 30+ kg/m2. Univariate PFS and OS curves were estimated; multivariate Cox analysis was conducted adjusting for age, menopausal status, performance status (PS), hormonal status and site, and number of metastases.

Results: Overall, 39.9% of the patients were normal or underweight, 37.8% were overweight, and 22.3% were obese. Median age was 57 years (range 25–73); median PS was 0. Median PFS was 10.9 months [interquartile range (IQR) 5.5 to 19.9] in normal weight women, 13.0 months (IQR 7.8 to 23.7) in overweight, and 12.2 (IQR 7.1 to 23.0) in obese women, P = 0.17. Median OS was 32.0 months [95% confidence interval (CI), 14.5–88.3] versus 33.2 months (95% CI, 19.4–81.1) and 30.7 (95% CI, 17.6–50.8), respectively. In multivariate analyses, no statistically significant association between BMI category and PFS or OS was observed.

Conclusions: In this study, BMI was not associated with the outcome of patients with MBC treated with first-line chemotherapy.

Impact: In the absence of any evidence in support of a prognostic role of obesity in patients with MBC treated with chemotherapy, dietary restrictions, medical interventions aimed at reducing BMI/insulin resistance, or specific anticancer treatment strategies do not seem to be appropriate. Cancer Epidemiol Biomarkers Prev; 22(10); 1862–7. ©2013 AACR.
MicroRNA-31 Predicts the Presence of Lymph Node Metastases and Survival in Patients with Lung Adenocarcinoma
Authors: Meng Wei , Ye Zhenqing , Cui Ri , Perry James , Dedousi-Huebner Vaia , Huebner Alexander , Wang Yao , Li Bin , Volinia Stefano , Nakanishi Hiroshi , Kim Taewan , Suh Sung-Suk , Ayers Leona W. , Ross Patrick , Croce Carlo M. , Chakravarti Arnab , Jin Victor X. , Lautenschlaeger Tim
Published: August 2013

Purpose: We conducted genome-wide miRNA-sequencing (miRNA-seq) in primary cancer tissue from patients of lung adenocarcinoma to identify markers for the presence of lymph node metastasis.

Experimental Design: Markers for lymph node metastasis identified by sequencing were validated in a separate cohort using quantitative PCR. After additional validation in the The Cancer Genome Atlas (TCGA) dataset, functional characterization studies were conducted in vitro.

Results: MiR-31 was upregulated in lung adenocarcinoma tissues from patients with lymph node metastases compared with those without lymph node metastases. We confirmed miR-31 to be upregulated in lymph node-positive patients in a separate patient cohort (P = 0.009, t test), and to be expressed at higher levels in adenocarcinoma tissue than in matched normal adjacent lung tissues (P < 0.0001, paired t test). MiR-31 was then validated as a marker for lymph node metastasis in an external validation cohort of 233 lung adenocarcinoma cases of the TCGA (P = 0.031, t test). In vitro functional assays showed that miR-31 increases cell migration, invasion, and proliferation in an ERK1/2 signaling-dependent manner. Notably, miR-31 was a significant predictor of survival in a multivariate cox regression model even when controlling for cancer staging. Exploratory in silico analysis showed that low expression of miR-31 is associated with excellent survival for T2N0 patients.

Conclusions: We applied miRNA-seq to study microRNomes in lung adenocarcinoma tissue samples for the first time and potentially identified a miRNA predicting the presence of lymph node metastasis and survival outcomes in patients of lung adenocarcinoma. Clin Cancer Res; 19(19); 5423–33. ©2013 AACR.
Human Milk and the Premature Infant
Authors: Bhatia Jatinder
Published: August 2013

Human milk is the preferred feeding for both term and preterm infants. While being considered optimal for term infants, human milk, even from mothers delivering preterm infants, is lacking in protein, energy, sodium, calcium, and phosphorus, resulting in poorer growth and nutrient deficiencies when compared to formulas designed for these high-risk infants. Further, the lack of growth is associated with long-term adverse consequences. Since human milk has unique properties in promoting gastrointestinal maturation and immunological benefits, it is prudent to implement strategies to fortify it appropriately to realize its benefits which include reduced rates of necrotizing enterocolitis, fewer episodes of sepsis and urinary tract infections, and improved visual and neurocognitive development. Donor human milk is being widely used when mothers' own milk is not available or is in short supply. While it retains some of the biological properties and clinical benefits of mothers' own milk, it requires additional care in fortification, especially if the donor milk is from a pool of term human milk. As nutritional strategies improve, the ultimate goal is to minimize extrauterine growth restriction and promote appropriate growth after regaining birth weight.
Validation of the Addenbrooke's Cognitive Examination III in Frontotemporal Dementia and Alzheimer's Disease
Authors: Hsieh Sharpley , Schubert Samantha , Hoon Christopher , Mioshi Eneida , Hodges John R.
Published: August 2013

Background/Aims: The aims of this study were to validate the newly developed version of the Addenbrooke's Cognitive Examination (ACE-III) against standardised neuropsychological tests and its predecessor (ACE-R) in early dementia. Methods: A total of 61 patients with dementia (frontotemporal dementia, FTD, n = 33, and Alzheimer's disease, AD, n = 28) and 25 controls were included in the study. Results: ACE-III cognitive domains correlated significantly with standardised neuropsychological tests used in the assessment of attention, language, verbal memory and visuospatial function. The ACE-III also compared very favourably with its predecessor, the ACE-R, with similar levels of sensitivity and specificity. Conclusion: The results of this study provide objective validation of the ACE-III as a screening tool for cognitive deficits in FTD and AD.
Preventing and Managing Indoor Falls with Home-Based Technologies in Mild and Moderate Alzheimer's Disease Patients: Pilot Study in a Community Dwelling
Authors: Tchalla Achille E. , Lachal Florent , Cardinaud Noëlle , Saulnier Isabelle , Rialle Vincent , Preux Pierre-Marie , Dantoine Thierry
Published: August 2013

Background: Alzheimer's disease (AD) is known to increase the risk of falls. We aim to determine the effectiveness of home-based technologies coupled with teleassistance service (HBTec-TS) in older people with AD. Methods: A study of falls and the HBTec-TS system (with a light path combined with a teleassistance service) was conducted in the community. The 96 subjects, drawn from a random population of frail elderly people registered as receiving an allocation for lost autonomy from the county, were aged 65 or more and had mild-to-moderate AD with 1 year of follow-up; 49 were in the intervention group and 47 in the control group. Results: A total of 16 (32.7%) elderly people fell in the group with HBTec-TS versus 30 (63.8%) in the group without HBTec-TS. The use of HBTec-TS was significantly associated with a reduction in the number of indoor falls among elderly people with mild-to-moderate AD (OR = 0.37, 95% CI = 0.15-0.88, p = 0.0245). Conclusion: The use of the HBTec-TS significantly reduced the incidence of primary indoor falling needing GP intervention or attendance at an emergency room among elderly people with AD and mild-to-moderate dementia.
Predictive Factors for Development of Chronic Pouchitis after Ileal Pouch-Anal Anastomosis in Ulcerative Colitis
Authors: Okita Yoshiki , Araki Toshimitsu , Tanaka Koji , Hashimoto Kiyoshi , Kondo Satoru , Kawamura Mikio , Koike Yuki , Otake Kohei , Fujikawa Hiroyuki , Inoue Mikihiro , Ohi Masaki , Inoue Yasuhiro , Uchida Keiichi , Mohri Yasuhiko , Kusunoki Masato
Published: August 2013

Background: No previous studies have examined predictive factors for chronic pouchitis after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC) with consideration of changes in pouchitis subtypes during follow-up. This study evaluated the independent predictive factors for chronic pouchitis. Methods: A total of 244 consecutive patients who underwent IPAA were enrolled. We assessed the possible associations between pouchitis and clinical factors using Cox proportional hazard regression. Results: 231 patients met the inclusion criteria. 66 (28.5%) patients developed pouchitis. In 9 of 44 (20.4%) patients, antibiotic-responsive pouchitis at the first episode changed into chronic pouchitis after the occurrence of a subsequent episode. The median duration from occurrence of antibiotic-responsive pouchitis to alteration into chronic pouchitis was 502 (range 147-1,697) days. Overall pouchitis was finally classified into 35 acute pouchitis and 31 chronic pouchitis cases. Multivariate analysis revealed that a ≥7.5-g cumulative steroid dose before colectomy and a ≥500-mg monthly steroid dose just before colectomy were significant predictive factors for chronic pouchitis (p = 0.0001 and 0.0095, respectively). Conclusion: Patients with UC and a higher cumulative steroid dose before colectomy or higher monthly steroid dose just before colectomy may have a predictive factor for developing chronic pouchitis.
Effects of Parenteral Nutrition Formulas on Plasma Lipid Profile in Children with Bone Marrow Transplantation
Authors: Baena-Gómez M.A. , de la Torre Aguilar M.J. , Mesa M.D. , Llorente-Cantarero F.J. , Pérez Navero J.L. , Gil-Campos M.
Published: August 2013

Background/Aims: Children undergoing bone marrow transplantation (BMT) often require parenteral nutrition (PN). This is a comparative study of plasma lipid profiles in BMT children after fish oil or soybean PN. Methods: A total of 14 children with BMT requiring PN for at least 10 days were recruited during 24 months. They were randomized to receive a lipid emulsion enriched with ω3 polyunsaturated fatty acid, or soybean oil. Clinical monitoring was performed. Blood samples were collected before and after administration of PN to analyze the lipid profile. Results: There were no complications associated with PN. The increase in TG levels was more pronounced after administration of an enriched ω3 emulsion and the decrease in cHDL and apo A was greater after administration of soybean. The ω3 group showed an increase in eicosapentaenoic and a decrease in arachidonic acids compared to the soybean group. Both groups showed similar levels of linolenic acid. Conclusion: PN with soybean or ω3 emulsions for 10 days is safe in children. However, research in children are necessary in order to examine the impact of the duration of PN and the type of lipid formula used, and determine their health benefits in relation to the fatty acid profile.
Inflammatory Pseudotumor of the Lateral Ventricle in a Pediatric Patient
Authors: Choi Bryan D. , Hodges Tiffany R. , Grant Gerald A. , Fuchs Herbert E. , Cummings Thomas J. , Muh Carrie R.
Published: August 2013

Inflammatory pseudotumor (IP) is a benign process that most commonly occurs in the lung and orbit. Extension into the central nervous system is extremely rare, and primary intraventricular lesions of the lateral ventricles are even more infrequent with only 2 cases reported in pediatric patients to date. Here, the authors present an unusual case of IP occurring in a 16-year-old female presenting with a 2-week history of progressive headaches and vomiting, without focal neurological deficits or radiographic evidence of hydrocephalus. The patient underwent left parietal craniotomy and complete resection of the tumor, with no signs of recurrence at 3-month follow-up. Although the rarity of intraventricular IP in pediatric patients can make its initial identification difficult, IP should be considered as a potential diagnosis in this population wherein good outcomes may be achieved following surgical resection.
Genome Duplication in Early Vertebrates: Insights from Agnathan Cytogenetics
Authors: Caputo Barucchi V. , Giovannotti M. , Nisi Cerioni P. , Splendiani A.
Published: August 2013

Agnathans represent a remnant of a primitive offshoot of the vertebrates, and the long evolutionary separation between their 2 living groups, namely hagfishes and lampreys, could explain profound biological differences, also in karyotypes and genome sizes. Here, cytogenetic studies available on these vertebrates were summarized and data discussed with reference to the recently demonstrated monophyly of this group and to the 2 events of whole genome duplication (1R and 2R) characterizing the evolution of vertebrates. The comparison of cytogenetic data and phylogenetic relationships among agnathans and gnathostomes seems to support the hypothesis that 1R and 2R occurred before the evolutionary divergence between jawless and jawed vertebrates.
World Health Organization Approaches for Surveys of Health Behaviour among Schoolchildren and for Health-Promoting Schools
Authors: Honkala Sisko
Published: August 2013

Adolescents make up about one-sixth of the world's population. Most of the healthy and detrimental habits are adopted during childhood and adolescence. In the mid 1980s, a cross-national Health Behaviour in School-Aged Children (HBSC) survey was created to increase information about the well-being, health behaviours and social context of young people by using standard school-based questionnaires adopted by the World Health Organization (WHO) European office. The European Network of Health-Promoting Schools (HPS) was commenced in 1992, followed by the establishment of the WHO Global School Health Initiative in 1995. The initiative aims to improve the health of students, school personnel, families and other members of the community through schools by mobilizing and strengthening health promotion and educational activities at local, national, regional and global levels. The HBSC and HPS programmes have been accepted as activity areas for the WHO Collaborating Centre for Primary Oral Health Care in Kuwait. This article describes the HBSC and the HPS programmes and discusses the importance of establishing these programmes in Kuwait.
Nutrition as a link between obesity and cardiovascular disease: how can we stop the obesity epidemic?
Authors: van Baak Marleen A.
Published: August 2013

summary

Overweight and obesity are associated with excess cardiovascular risk. To reduce cardiovascular risk at the population level, the prevention of overweight and obesity is key. This requires adoption of a healthy lifestyle, including less inactivity and more moderate-to-vigorous physical activity, and a healthy diet. Diet composition may facilitate weight gain prevention and weight loss. Effects of dietary fats, carbohydrates and proteins will be discussed in this context. Current evidence indicates that moderation of the intake of (saturated) fat, a moderate increase in protein content of the diet, a replacement of refined grain/high glucose index (GI) by whole-grain/low GI carbohydrates and limitation of the consumption of calorically-sweetened beverages are likely to facilitate weight control.
Differentiating haemostasis from thrombosis for therapeutic benefit
Authors: McFadyen James D. , Jackson Shaun P.
Published: August 2013

The central role of platelets in the formation of the primary haemostatic plug as well as in the development of arterial thrombosis is well defined. In general, the molecular events underpinning these processes are broadly similar. Whilst it has long been known that disturbances in blood flow, changes in platelet reactivity and enhanced coagulation reactions facilitate pathological thrombus formation, the precise details underlying these events remain incompletely understood. Intravital microscopy studies have highlighted the dynamic and heterogeneous nature of thrombus development and demonstrated that there are considerable spatiotemporal differences in the activation states of platelets within a forming thrombus. In this review we will consider the factors regulating the activation state of platelets in a developing thrombus and discuss how specific prothrombotic factors may influence this process, leading to excessive thrombus propagation. We will also discuss some potentially novel therapeutic approaches that may reduce excess thrombus development whilst minimising bleeding risk.
IDEOLOGIES AND AGENDAS IN LATE ANTIQUE STUDIES
Authors: Cameron Averil
Published: August 2013

This paper sets a framework by discussing the trends and approaches observable in the study of Late Antiquity over the last few decades. It takes up the points made in a recent article by A. Giardina and considers the models of continuity and change adopted in several recent collective publications. It questions whether the current enthusiasm for the ‘long Late Antiquity’, and the privileging of cultural over social and economic history are likely to continue in their present form. It draws attention to differences of emphasis between historians and archaeologists, and between analyses of the Eastern and Western parts of the empire, and stresses the complementarity of historical and archaeological approaches.
THE CONSTRUCTION OF IDENTITIES IN POST-ROMAN ALBANIA
Authors: Bowden William
Published: August 2013

Late antique social structures in the provinces of Epirus Vetus and Epirus Nova, as represented by urban centres, ecclesiastical authority and Roman material culture, largely disappeared during the first half of the 7th c. Around this time the practice of furnished burial was adopted by sections of the population. This transition has traditionally been interpreted as reflecting an expression of ethnic identity on the part of an indigenous population. This paper argues, however, that these post-Roman cemeteries are a reflection of the more localised and fluid social structures that emerged in post-Roman Epirus rather than an attempt to construct or maintain ethnic identities.
LATE ANTIQUE TRADE: RESEARCH METHODOLOGIES & FIELD PRACTICES
Authors: Kingsley Sean A.
Published: August 2013

Trade patterns offer multifarious insights into ideology, politics and social orders between the 4th and 7th centuries A.D. Whilst various models of trade have been formulated for the West Mediterranean, the East is in comparison very poorly understood. This paper examines trade in the East, with special reference to Byzantine Palestine, by considering three key topics: rural production, urban economies, and overseas trade as represented by shipwrecks and pottery. It is argued that more focused research strategies are required to maximise available sources.
CHRISTIAN TOPOGRAPHY IN THE LATE ANTIQUE TOWN: RECENT RESULTS AND OPEN QUESTIONS
Authors: Wataghin Gisella Cantino
Published: August 2013

The study of Christian topography has become increasingly subtle in its appreciation of both textual and archaeological evidence. Despite this, the model established in the 1980s, of an intra-mural episcopal church and extra-mural cemetery churches, seems still to be valid. However, this picture remains provisional; it must not be assumed where evidence is poor. There remain many questions open to investigation. Excavations conducted to a high standard may go some way to resolving these. Nevertheless, urban data remains fragmentary, so historical discussions must remain at the level of models.
SETTLEMENT EXPANSION ON THE KONYA PLAIN, ANATOLIA: 5th–7th CENTURIES A.D.
Authors: Baird Douglas
Published: August 2013

The evidence from the Konya Plain Survey Project suggests significant population increase in the Konya Plain during the Early Byzantine period. This and evidence relating to drainage, manuring and the settlement of locally less productive zones indicates a high intensity of land use and a degree of pressure on the landscape. The vulnerability of this system to disruption is highlighted and possible factors underlying expansion and intensive landscape use are raised. Survey evidence also reveals the substantial growth of some rural sites possibly in connection with church building. This appears not to correlate with simple economic processes but may be the outcome of social and political decisions.
CIVIL WAR AND PUBLIC DISSENT: THE STATE MONUMENTS OF THE DECENTRALISED ROMAN EMPIRE
Authors: Mayer Emanuel
Published: August 2013

From the tetrarchy onwards, the arches and columns erected in praise of emperors show a distinct change in the ways in which victory in civil war was commemorated or justified. The attitudes towards civil war demonstrated on these monuments also changed according to their location and the attitudes and social mores of those who erected them. From the time of Augustus onwards, in both panegyrical texts and public monuments, victory in civil war had been presented in terms of the defeat of non-Roman combatants. However, by the 4th c., despite protest from the conservative aristocracy, it was possible to commemorate defeat of fellow Romans. This paper suggests that this development reflects both a change in imperial image and in the sociopolitical context of these monuments, whereby the need to establish the legitimacy of imperial rule overrode the traditional concerns of conservative sections of the public.
SOME ASPECTS OF SOCIAL AND CULTURAL TIME IN LATE ANTIQUITY
Authors: Gutteridge Adam
Published: August 2013

This study examines some aspects of social time in Late Antiquity, arguing that conceptions of time can be found in places other than the calendar, and that numerous different levels of time exist simultaneously, some of which can be investigated through texts and material culture. Late antique conceptions of renovatio, especially those expressed through numismatic legends, are examined, alongside evidence relating to the destruction and conversion of pagan temples during the period. This evidence is used to suggest that during this period time was conceptualised in a way that stressed its discontinuous, non-sequential, character. This is interpreted in the context of other recent studies of late antique culture which have argued that the period witnessed a characteristic fragmentation of larger structures into smaller discontinuous elements, subsequently made available for non-linear reassembly.
DOMUS IN QUA MANEBAT EPISCOPUS: EPISCOPAL RESIDENCES IN NORTHERN ITALY DURING LATE ANTIQUITY (4TH TO 6TH CENTURIES A.D.)
Authors: Marano Yuri A.
Published: August 2013

This article addresses the development of three episcopal complexes in Northern Italy: at Aquileia, Milan and Parenzo-Poreč, leaving aside the very special case of Ravenna. Episcopal complexes (meaning the monumental headquarters of the bishop) initially centred on the cathedral and evidence for residence is slight in contrast, reflecting perhaps that the influence of bishops derived primarily from liturgy and their ecclesiastical status. Nevertheless, during the 5th and 6th c. A.D. monumental episcopal residences develop, that seem to reflect the rising social and political status of bishops in wider society.
THE INFRASTRUCTURE OF A GREAT CITY: EARTH, WALLS AND WATER IN LATE ANTIQUE CONSTANTINOPLE
Authors: Crow James
Published: August 2013

By the later 5th c. A.D., Constantinople was the greatest urban centre in the Mediterranean world. This paper considers three associated elements of the infrastructure of the city, each of which applied aspects of ancient technology: a first theme will consider the urban terraces which have only been studied in detail for the area of the Great Palace, but which represent a massive investment in the transformation of the built topography of the city; a second theme will examine the new Theodosian fortifications and suggest that these reflect a new level of innovation more often associated with the religious and civic architecture of the city; the third theme will briefly review recent research on the water supply and will identify major areas of continuity and innovation into the Middle Byzantine period.
ARCHITECTURE AND INFRASTRUCTURE IN THE EARLY MEDIEVAL VILLAGE: THE CASE OF TUSCANY
Authors: Valenti Marco
Published: August 2013

This article discusses the design and architectural structures of Early Medieval rural settlements in Tuscany, covering the period between the 7th and 10th c. It considers hut types, granaries and store-buildings, along with enclosures, roads, courtyards and artisanal structures. The construction of palisades, ditches and stone fortifications is also discussed. Technological characteristics are discussed in detail. A social interpretation of village development is presented. The origin of village settlement seems to be in the reaction of rural populations to the failure of centralised leadership in Late Antiquity, through the formation of communities, of an egalitarian nature, to cope with changed circumstances. The increasing structural complexity of the settlement is connected to the emergence of a resident elite.
SOLDIERS AND SPACES: DAILY LIFE IN LATE ROMAN FORTS
Authors: Gardner Andrew
Published: August 2013

Roman forts in the north-western part of the empire were vibrant, dynamic environments through which different groups of people moved, and in which they interacted. They are thus essential contexts for the understanding of broader changes in the Roman world. In Late Antiquity, the forts of Britain and northern Gaul show clear signs of the kinds of changes that overtook these provinces in the 5th c. A.D., at the same time as indicating long-term continuities in daily practices. In this paper, the evidence of both settlement and burial deposits from such sites will be explored to try and capture something of this balance between tradition and transformation. The emphasis will be on the vital importance for archaeologists of understanding the different temporal scales at which various past processes occurred.
INTERPRETING FINDS IN CONTEXT: NICOPOLIS AND DICHIN REVISITED
Authors: Poulter Andrew
Published: August 2013

It is no easy task to reconstruct human activity from layers or objects excavated on archaeological sites. The reconstruction of a stratigraphic sequence (integrating finds in the process) can change the interpretation of a deposit. Particular attention should be paid to the interplay between sites and finds. Too often the latter become the property of the specialist and acquire their importance as objects in themselves, not as essential tools for reconstructing a sites history, a problem exacerbated by the usual relegation of finds to an attached report, divorced from any meaningful description of the archaeological context. However, the value of involving finds in the interpretation of archaeological sequences is illustrated by examples from two sites excavated by the author, Nicopolis and Dichin, both in Bulgaria.
GRAPPLING WITH THE GRANARY: CONTEXT ISSUES AT DICHIN
Authors: Grinter Pam
Published: August 2013

This paper summarises the evidence of plant remains discovered in buildings at the Late Roman site at Dichin, Bulgaria, with a focus on the context and location in which they were discovered.
WHERE IS THE ARCHAEOLOGY AND ICONOGRAPHY OF GERMANIC ARIANISM?
Authors: Ward-Perkins Bryan
Published: August 2013

This article examines the evidence for Germanic ‘Arianism’ in the exceptionally well preserved buildings and mosaics of Ravenna. Despite theological differences, Arian iconography appears to be almost identical to that of the ‘Catholics’ (e.g. in depictions of Christ in S. Apollinare Nuovo and the Arian Baptistery). Different attitudes to God the Son are only really apparent when supported by texts. However, there are clear material traces of Catholic triumphalism after the defeat of the Arian Goths; and we should not assume that there were no strongly held differences of view, just because the iconography of the two sects is so similar.
THE ARCHAEOLOGY OF PILGRIMAGE: ABU MINA AND BEYOND
Authors: Bangert Susanne
Published: August 2013

Christian pilgrimage offers a unique insight into popular piety in Late Antiquity. However, our sources for pilgrimage, both literary and archaeological, vary widely in quality and volume, and modern scholarship has often depended heavily on the evidence from particular wellknown sites, most notably the sanctuary of St Menas at Abu Mina in Egypt. This site has revealed a remarkable density of archaeological remains, not only buildings but also the production and circulation of a wide variety of pilgrim souvenirs. Yet it is essential that we move beyond the sanctuary of St Menas and compare the evidence from Abu Mina with that from other major pilgrimage sites in the eastern Mediterranean. As we shall see in this paper, there is no simple pattern in organisation or souvenir production that can be identified in the archaeology of late antique pilgrimage.
LATE ANTIQUE PAGANISM: ADAPTATION UNDER DURESS
Authors: Caseau Béatrice
Published: August 2013

This paper examines the ways in which worshippers of the old gods adapted to the new world order of the 4th c. Roman empire, where emperors, through various pronouncements, consistently attacked elements of their religious infrastructure and rituals. This included forbidding divination sacrifices, temple funding, and eventually led to the temples’ definitive closure. This led to a privatisation of pagan worship and then to secrecy, a process difficult to detect in the archaeological record.
WELLS AND BELIEF SYSTEMS AT THE END OF ROMAN BRITAIN: A CASE STUDY FROM ROMAN LONDON
Authors: Gerrard James
Published: August 2013

The recent discovery of a large hoard of copper-alloy, pewter and iron vessels in a late 4th to early 5th c. well at Drapers’ Gardens in the City of London highlights the role that wells and shafts played in late antique ritual life. Examination of the well’s contents reveals that these ‘pots and pans’ were not hidden in a time of crisis but were carefully placed alongside ritually killed objects and a dismembered juvenile red deer in a complex ritual act. This paper undertakes a speculative exploration of this act’s significance and its possible meaning.
Two new species of Oxalis (Oxalidaceae) from the Greater Cape Floristic Region
Authors: SUDA JAN , KREJČÍKOVÁ JANA , SUDOVÁ RADKA , OBERLANDER KENNETH C. , DREYER LÉANNE L.
Published: August 2013

Two new multifoliolate species of Oxalis L. (Oxalidaceae) from the Hantam Karoo region of South Africa are described and illustrated: Oxalis carolina and O. filifoliolata. Both species occur in single populations in the extremely geophyte-rich area on the Bokkeveld Plateau in the Northern Cape Province. Morphological characteristics, phylogenetic position, habitat description and conservation status of the new species are provided, in addition to a diagnostic comparison with other phenotypically similar Cape species. Fifteen multifoliolate Oxalis species are currently recognized in South Africa, disregarding multifoliolate varieties of otherwise trifoliolate species. A key for multifoliolate Oxalis species known from the Bokkeveld Plateau is presented.
A further study on Inonotus linteus complex (Hymenochaetales, Basidiomycota) in tropical America
Authors: VLASÁK JOSEF , LI HAI-JIAO , ZHOU LI-WEI , DAI YU-CHENG
Published: August 2013

Based on morphological and phylogenetic data, two new species in the Inonotus linteus complex (Hymenochaetales, Basidiomycota), Inonotus pseudolinteus and I. sideroxylicola, are described from tropical America. In addition, a new combination, Inonotus dependens, is proposed. Previously, the species was treated as Phellinus dependens (Murrill) Ryvarden. However, it is phylogenetically related to the Inonotus linteus complex. Its description is given based on our recent collections. An identification key to tropical species of Inonotus linteus complex is provided.
Dynamics of Tropical Cyclone Intensification: Deep Convective Cyclonic “Left Movers”
Authors: Hogsett Wallace A. , Stewart Stacy R.
Published: August 2013

Deep convective processes play an important role in tropical cyclone (TC) formation and intensification. In this study, the authors investigate the interaction between discrete buoyant updrafts and the vertically sheared azimuthal flow of an idealized TC vortex by adapting the updraft–shear dynamical framework to the TC. The authors argue theoretically that deep updrafts initiating near the TC radius of maximum wind (RMW) may propagate with a component left of the mean tangential flow, or radially inward toward the TC center. Results suggest that these unique TC updrafts, or “left movers” with respect to the mean azimuthal flow, may play an active role in TC intensification.

The notion that updraft-scale convection may propagate with a component transverse to the mean flow is not at all new. Cyclonic midlatitude supercell thunderstorms often deviate from their mean environmental flow, always to the right of the environmental vertical shear vector. The deviant motion arises owing to nonlinear interactions between the incipient updraft and the environmental vertical shear. Although significant differences exist between the idealized TC considered here and real TCs, observational and high-resolution operational modeling evidence suggests that some intense TC updrafts may propagate with a radially inward and right-of-shear component and exhibit structural characteristics consistent with theory.

The authors propose that left movers constitute a unique class of intense TC updrafts that may be favored near the TC RMW where local vertical shear of the TC azimuthal winds may be maximized. To simulate these left movers in a realistic way, mesoscale TC forecasting models must resolve nonlinear interactions between updrafts and vertical shear.
Perceptions of Academic Performance
Authors: Heath Nancy , Roberts Elizabeth , Toste Jessica R.
Published: August 2013

Children with academic and behavioral difficulties have been found to report overly positive self-perceptions of performance in their areas of specific deficit. Researchers typically investigate self-perceptions in reference to both actual performance and ratings by teachers, peers, and parents. However, few studies have investigated whether or not adolescents with difficulty report overly positive self-perceptions. The present study sought to investigate self-perceptions of performance in the domains of spelling and math among a sample of adolescents with and without learning disabilities (LD). A total of 58 adolescents with and without LD participated. Adolescents with LD significantly overestimated their performance in math relative to their actual performance, but not in spelling, reflecting the predominant difficulty of the sample in the area of math rather than spelling. In addition, the magnitude of the gap between math predictions and actual performance was significantly greater for the group with LD than the group without LD. Findings support the existence of positive illusions in specific areas of deficit.
Missed opportunities for HIV diagnosis: a three-year audit in the West of Scotland
Authors: Brawley D , MacConnachie A , Nandwani R , Bell DJ , Fargie F , Fox R , Peters E , Seaton RA , Winter A
Published: August 2013

Background

National specialty guidelines for HIV testing aim to increase diagnosis and reduce late presentation. An audit of new HIV diagnoses in Glasgow was performed to assess local performance against these guidelines and estimate the proportion of patients presenting who had previous missed opportunities for diagnosis.

Methods

A retrospective case note review of 339 patients diagnosed from September 2008 to September 2011 was performed. Documented past medical history was assessed for HIV clinical indicator conditions prior to HIV diagnosis and prior review by medical services.

Results

Ninety (26%) individuals had at least one documented clinical indicator condition prior to HIV diagnosis, of whom 80 had prior contact with at least one speciality. This group also had a lower mean nadir CD4 count (258 cells/cmm versus 393 cells/cmm, p = <0.005) and were more likely to be severely immunocompromised at diagnosis, with a CD4 count below 50 cells/cmm (31% versus 9%, p = <0.005). AIDS-defining illnesses were also more common (31% versus 8%, p ≤ 0.005) as was HIV-related mortality ( p ≤ 0.005).

Conclusion

Additional support and training are required to increase adherence to HIV-testing guidelines within primary and secondary care in order to prevent ongoing late presentation with both individual clinical and public health implications.
A collaborative approach to developing probation practice
Authors: Rex Sue , Hosking Nigel
Published: August 2013

This article reports our experience of developing a skills-based practice framework for effective engagement with offenders. The project began with extensive engagement with probation staff at every level. This was followed by collaborative pilots in 22 probation trusts on effective engagement by practitioners and reflective supervision by managers, using the best available international research and insights from research on desistance. The learning and feedback from these pilots was used to bring together the two complementary elements into a single evidence-based model. Feedback from managers and practitioners gathered in external evaluation of the pilots was very positive, with the vast majority seeing the approaches as having a positive impact on their practice and seeing it as important that the model continued to be used. Observation of practice and constructive feedback was particularly valued as was positive leadership and support by senior managers. The external evaluation of the pilots continues, and we are conducting an internal evaluation of the integrated model, which will look at practitioners’ and offenders’ experiences in three probation trusts over this year and next.
Neurological and chest symptoms following sclerotherapy: A single centre experience
Authors: Hill Douglas A
Published: August 2013

Objectives

Documentation and analysis of adverse neurological and chest symptoms in a large single centre series of sclerotherapy treatments.

Method

In this retrospective study, patient-reported adverse events occurring during liquid or foam sclerotherapy were recorded over a 30 month period and subsequently analyzed. The relevant patient records were reviewed to determine patient characteristics, treatment details and results of subsequent investigations.

Results

A total of 1744 ultrasound guided sclerotherapy treatments were performed during the study period. Almost all treatments were done with air-based sodium tetradecyl sulphate foam. During the same time period, 6504 direct vision surface vein sclerotherapy treatments were completed. Approximately 1/4 of these utilized air-based foam in varying concentrations. There were 14 adverse events in 14 patients involving neurological or chest symptoms for an incidence of 0.17%. Five patients injected with foam complained of isolated chest discomfort, tightness or shortness of breath. Nine patients reported various brief neurological symptoms. These events occurred with both liquid and foam, although the majority involved foam. More neurological events were associated with direct vision sclerotherapy of smaller superficial veins than with ultrasound guided injection of intrafascial truncular veins. Seven patients who experienced neurological symptoms had a history of migraine. Five of the patients who had neurological events were investigated for right to left shunts and found to be positive.

Conclusions

These events were uncommon and brief. The incidence of neurological and chest symptoms was higher with foam sclerotherapy than with liquid. A history of migraine with aura was associated with an increased risk of post-treatment neurological symptoms. Events occurred with both large vein and small vein treatment. Some events were associated with liquid sclerotherapy rather than foam and with carbon dioxide based foam as well as air foam. There were no long-term adverse consequences.
The feasibility and validity of the comprehensive ICF core set for stroke in Chinese clinical settings
Authors: Wang Pu , Li Huagang , Guo Yi , Xie Yuxiao , Ge Ruidong , Qiu Zhuoying
Published: August 2013

Objective:

To inspect the feasibility and content validity of the comprehensive International Classification of Functioning, Disability and Health (ICF) core set for stroke by describing relevant aspects of functioning, disability and environmental factors affected in Chinese patients post stroke.

Design:

Multicentre, cross-sectional study.

Setting:

Department of rehabilitation medicine.

Subjects:

The content validity was evaluated using frequency and percentage of 208 patients with a mean age of 60 years post stroke in China.

Outcome measures:

Aspects of body function and structure, activity and participation, and environmental factors in the comprehensive ICF core set for stroke.

Results:

Six ICF categories of body function were identified as a problem in over 90% ( n = 187) of the patients (functions of the cardiovascular system and neuromusculoskeletal and movement-related functions). Impairments of brain, upper and lower extremity were identified as a problem in over 50% ( n = 104) of the patients. Four ICF categories of activities and participation were documented as a problem in 100% ( n = 208) of the patients (domestic and civic life). In environmental factors, nine ICF categories were documented as barriers by more than 10% ( n = 20) and fewer than 50% ( n = 104) of the patients (products and technology, physical geography, societal attitudes, services, systems and polices). Six ICF categories were identified as facilitators in over 90% ( n = 187) of the patients (support and relationships and attitudes).

Conclusion:

The findings suggest that it is feasible to apply the comprehensive ICF core set for stroke in the Chinese clinical setting, after the appropriate reduction of some categories according to Chinese patients’ characteristics and culture.
Botulinum toxin injection into the forearm muscles for wrist and fingers spastic overactivity in adults with chronic stroke: a randomized controlled trial comparing three injection techniques
Authors: Picelli Alessandro , Lobba Davide , Midiri Alessandro , Prandi Paolo , Melotti Camilla , Baldessarelli Silvia , Smania Nicola
Published: August 2013

Objective:

To compare the outcome of manual needle placement, electrical stimulation and ultrasonography-guided techniques for botulinum toxin injection into the forearm muscles of adults with arm spasticity.

Design:

Randomized controlled trial.

Setting:

University hospital.

Subjects:

Sixty chronic stroke patients with wrist and fingers spasticity.

Intervention:

After randomization into three groups, each patient received botulinum toxin type A in at least two of these muscles: flexor carpi radialis and ulnaris, flexor digitorum superficialis and profundus (no fascicles selection). The manual needle placement group underwent injections using palpation; the electrical stimulation group received injections with electrical stimulation guidance; the ultrasonography group was injected under sonographic guidance. A sole injector was used.

Main measures:

All patients were evaluated at baseline and four weeks after injection. Outcomes: Modified Ashworth Scale; Tardieu Scale; wrist and fingers passive range of motion.

Results:

One month after injection, Modified Ashworth Scale scores improved more in the electrical stimulation group than the manual needle placement group (wrist: P = 0.014; fingers: P = 0.011), as well as the Tardieu angle (wrist: P = 0.008; fingers: P = 0.015) and passive range of motion (wrist: P = 0.004). Furthermore, Modified Ashworth Scale scores improved more in the ultrasonography group than in the manual needle placement group (wrist: P = 0.001; fingers: P = 0.003), as well as the Tardieu angle (wrist: P = 0.010; fingers: P = 0.001) and passive range of motion (wrist: P < 0.001; proximal interphalangeal joints: P = 0.009). No difference was found between the ultrasonography and electrical stimulation groups.

Conclusions:

Instrumental guidance may improve the outcome of botulinum toxin injections into the spastic forearm muscles of stroke patients.
Prediction of nuclear grade of clear cell renal cell carcinoma with MRI: intratumoral susceptibility signal intensity versus necrosis
Authors: Chen Jie , Sun Jun , Xing Wei , Ding Jiule , Chen Tongbing , Dai Yongming , Sun Jingyi , Hu Jiani
Published: August 2013

Background

End-stage renal disease and dialysis patients have a higher incidence of renal cell carcinoma (RCC) than the general population. Preoperatively evaluating the biological behavior of RCC plays an important role in treatment decision-making. Susceptibility-weighted imaging (SWI) can visualize the distribution of microvenous structures and hemorrhage without contrast materials.

Purpose

To evaluate the feasibility of SWI in grading clear cell RCCs (CRCC) and compare the ability of SWI and necrosis for grading CRCCs.

Material and Methods

Retrospective reviews of 35 patients with pathologically-proven CRCCs were performed. All patients underwent both conventional magnetic resonance imaging (MRI) and SWI examinations. The morphology of the intratumoral susceptibility signal intensities (ITSS) was classified into hemorrhage and microvessels. The differences of ITSSs on SWI and necrosis between low- and high-grade CRCCs were assessed. The diagnostic values of ITSSs and necrosis in differentiating low- from high-grade CRCCs were compared by receiver-operating characteristics.

Results

ITSSs were seen in 31 of 35 patients. No ITSSs were seen in four patients with low-grade CRCCs. Mean scores of ITSSs on SWI were significantly lower for low-grade CRCCs (1.24 ± 0.72) than that for the high-grade CRCCs (2.70 ± 0.48). No significant necrosis was seen in 10 patients with low-grade CRCCs. There was a significant difference of the presence of intratumoral necrosis between low- and high-grade CRCCs. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) were for ITSSs: 70%, 100%, 100%, and 89.3%, respectively; for necrosis: 100%, 40%, 40%, and 100%.

Conclusion

SWI can evaluate ITSSs without contrast materials and can be an alternative to grading CRCCs preoperatively for some special patients.
Why do Highly Qualified Women (Still) Earn Less? Gender Differences in Long-Term Predictors of Career Success
Authors: Evers Andrea , Sieverding Monika
Published: August 2013

Our study investigated gender differences in the long-term effects of education, work experience, agentic personality traits, and number of children on career success (i.e., salary) in medicine. German male and female students ( N = 99) were surveyed at a German medical school (T1) and 15 years later (T2). Women interrupted their careers for longer than men ( d = .92). Men had a substantially higher income at T2 ( d = 1.07). Career interruptions, agentic personality traits, and high school grades were significant predictors of salary for both sexes. High final grades at medical school were significantly and positively related to salary but only for men. Low final grades at medical school and number of children predicted the length of career interruptions. For women, number of children was significantly and positively related to career interruptions. For men, number of children was significantly but negatively related to career interruptions. The findings corroborate research from other occupational fields, showing that a discontinuous work history has a negative influence on career success and that human capital variables are better rewarded for men than for women.