bluuebunny/crossref_metadata_2025 huggingface dataset:
Low-Dose Intravaginal Estriol and Pelvic Floor Rehabilitation in Post-Menopausal Stress Urinary Incontinence
Authors: Castellani Daniele , Saldutto Pietro , Galica Vikiela , Pace Gianna , Biferi Daniela , Paradiso Galatioto Giuseppe , Vicentini Carlo
Published: May 2015

Introduction: Pelvic floor muscle training (PFMT) and electrical stimulation (ES) are conservative models of therapy for treating female stress urinary incontinence (SUI). The presence of estradiol receptors in the lower urinary tract advances the case for estradiol therapy in SUI. The aim of our study was to investigate the effects of the combination of pelvic floor rehabilitation and intravaginal estriol (IE) on SUI treatment in postmenopausal women. Material and Methods: Sixty-two women with SUI were randomized to PFMT, ES and biofeedback (Group 1) or the same treatment plus 1 mg IE (Group 2) for 6 months. Patients were evaluated with medical history, pelvic examination, urodynamics, 24-hour pad test. Urinary incontinence was evaluated using the International Consultation on Incontinence questionnaire on urinary incontinence short form and quality of life using the Incontinence Impact Questionnaire-Short Form. Results: Two patients were lost at follow-up and one discontinued the study. Mean urine leakage at the 24-hour pad test dropped from 42.3 ± 20.2 g/die to 31.5 ± 14.2 g/die in Group 1 and from 48.3 ± 19.8 g/die to 22.3 ± 10.1 g/die in Group 2. Symptoms scores and incontinence status were statistically significant better in Group 2 when compared to Group 1. Conclusion: IE added to PFMT, ES and BF is a safe and efficacious first-line therapy in postmenopausal women with SUI.
A Frameshift Mutation in PEN-2 Causes Familial Comedones Syndrome
Authors: Panmontha Wipa , Rerknimitr Pawinee , Yeetong Patra , Srichomthong Chalurmpon , Suphapeetiporn Kanya , Shotelersuk Vorasuk
Published: May 2015

Background: Familial comedones without dyskeratosis are a rare autosomal dominant skin disorder, characterized by the occurrence of comedones that are distributed all over the body with specific features. We have previously reported two Thai families with familial comedones with expanded phenotypic spectrum. However, its genetic defect and pathogenesis remain unknown. Objective: To explore the molecular defect causing familial comedones. Methods: Whole-genome linkage analysis and whole-exome sequencing in family I were performed. Results: We identified a heterozygous one-base pair insertion, c.84_85insT (p. L28FfsX93) in PEN-2, located within the linked region on chromosome 19. PCR-Sanger sequencing confirmed the identified mutation. The mutation segregated with the disease phenotype in family I and was fully penetrant. This similar mutation was also present in the unrelated affected individual from family II. Quantitative PCR revealed increased mRNA expression of PEN-2 in leukocytes of affected individuals. Conclusion: We for the first time identify PEN-2 as the causative gene of familial comedones.
Prevalence of Cancer in Patients with Thyroid Nodules in the Island of Cyprus: Predictive Value of Ultrasound Features and Thyroid Autoimmune Status
Authors: Hadjisavva Irini S. , Dina Roberto , Talias Michael A. , Economides Panayiotis A.
Published: May 2015

Background: The purpose of this study was to determine the prevalence of thyroid carcinoma in patients who underwent ultrasound-guided fine needle aspiration biopsy (USgFNA) of thyroid nodules in the island of Cyprus. Ultrasound features as well as the presence of autoimmune thyroid disease were evaluated as risk factors for malignancy. Methods: 322 consecutively examined patients (272 females/50 males, age 13-81) underwent USgFNA of thyroid nodules in a referral endocrine clinic between July 2007 and July 2009. The ultrasonographic characteristics examined were: echogenicity, margin irregularity, composition, calcifications, presence of increased vasculature and nodule size. The presence or absence of autoimmune thyroid disease was recorded. Results: From the 548 nodules examined, 74 (13.6%) were classified as THY3, 4 or 5. 75 patients (123 nodules) underwent surgical resection. 46 patients (64 nodules) proved to have thyroid carcinoma by histology. There was a significant correlation of suspicious/malignant cytology with solid composition, hypoechogenicity, irregular margins and the presence of calcifications. A significant association was also noted between the presence of positive antithyroglobulin antibodies (p < 0.05) and Graves' disease (p = 0.01) with suspicious/malignant cytology. Conclusion: The overall prevalence of thyroid cancer was 14.3%. Ultrasound characteristics were highly predictive of thyroid malignancy. Thyroid autoimmunity should be considered as a risk factor.
Application of the Bethesda System for Reporting Thyroid Cytopathology in the Eastern Province of Saudi Arabia: A Follow-Up Study
Authors: Alabdulqader Noof A. , Shareef Sameera Q. , Ali Jassim A. , Yousef Mohammad M. , Al-Abbadi Mousa A.
Published: May 2015

This is a follow-up study to our previous analysis of thyroid aspirates utilizing the Bethesda System for Reporting Thyroid Cytology (BSRTC). The same study design was utilized for 2 years comparing 2 periods. A total of 251 thyroid aspirates from 218 patients were reviewed and deemed comparable to the previous cohort. The variance and consequently the number of interpretations dropped from 26 to 11 with a statistically significant 58% reduction and more consistency. Our unsatisfactory rate dropped from 22 to 10% (reduction of 55%). The risk of malignancy in this follow-up study showed a similar trend: an increase in risk with each step up in the BSRTC categories starting from the ‘nondiagnostic' and up to ‘malignant'. Few of our benign cases ended up with resection. We noticed sensitivity to the word ‘follicular' in this benign category; therefore we propose a modification of the current BSRTC system by omitting the word ‘follicular' from the benign category. We strongly believe that this modification harbors no serious damage to the intentions of BSRTC. This follow-up study has shown that the previous awareness campaign about the implementation has worked and can be considered a valid performance improvement program.
Treatment of Incidental Prostate Cancer by Active Surveillance: Results of the HAROW Study
Authors: Herden Jan , Eminaga Okyaz , Wille Sebastian , Weissbach Lothar
Published: May 2015

Objective: To report on a cohort of patients with incidental prostate cancer (IPC) that was treated by an active surveillance (AS) protocol in the HAROW study. Materials and Methods: The HAROW study is an observational study on the management of localized prostate cancer in Germany. Treating urologists were reporting clinical parameters, information on therapy and clinical course of disease at 6-month intervals. Results: In total, 3,169 patients were enrolled. In 224 patients were found an IPC and 104 (46%) of them were put on an AS protocol. The mean follow-up was 26.5 months. Tumor progression was noted in 16 patients. In 11 patients, AS was replaced by a definite intervention. In univariate and multivariate analyses, only PSA density correlated with progression. Conclusion: This is the first prospective description of an IPC patient cohort on AS as part of an outcomes research study. AS was selected as a therapeutic strategy in nearly half of the patients (46%). Only a minor proportion (16%) displayed progression. Of the clinical parameters, only PSA density correlated with progression.
Our Experience with a Double-Layer Surgical Technique for Preventing Fistula Development in Children and Young Adults with Hypospadias
Authors: Demir Aslan , Karadağ Mert Ali , Çeçen Kürşat , Uslu Mehmet , Arslan Ömer Erkam
Published: May 2015

Introduction: In this study, we describe a new approach called the double-layer on and prepucial flap technique in order to prevent fistula or fissure development. Material and Method: Twenty-seven patients with subcoronal hypospadias were enrolled. The prepared prepucial flap was divided into two equal parts. A double-layer flap was formed and used for reinforcing of the neourethra. Uroflowmetric analysis was used for evaluating the urethral stricture at the end of the first year. A blinded urologist and the patients' themselves evaluated the aesthetic appearance. Results: The mean age was 12.17 ± 2.79. All cases were primary. All evaluated parameters were at the end of the first year. Only three (3/27, 11.1%) of the patients had minimal external mea stricture that managed with urethral dilatation. None of them had any fistula, fissure, or dehiscence as well as infection and hematoma. The mean Qmax value was 17 ml/s and the Qave value was 9 ml/s. The mean scores with standard deviations with regard to the appearance of the patients' penis before and after operations were 3.08 ± 0.77 and 8.25 ± 0.73, respectively and this difference was statistically significant (p < 0.001). Conclusion: The double-layer dartos flap technique is a candidate to be the least risky technique to prevent complications as well as to increase the aesthetic appearance up to satisfactory levels.
Editais de intercâmbio e difusão científica: uma aproximação entre arte, ciência e cotidiano
Authors: Moran Patricia
Published: May 2015

Analisaremos o programa de editais promovido pela Pró-Reitoria de Cultura e Extensão. Na primeira parte do artigo, discutimos as especificidades e pontos de aproximação entre as categorias dos editais, a partir de uma leitura panorâmica da estrutura e orientações conceituais do Programa. Seguimos apresentando projetos contemplados pelo edital de intercâmbio e difusão científica trazendo pontos de contatos entre os mesmos, já ensejados pelo próprio Programa. Finalmente propomos uma leitura do edital de intercâmbio e difusão científica a partir da generalização da presença da arte, ou de meios de criação e exposição artística, no cotidiano e na ciência. Da aproximação da arte e da ciência ao cotidiano, e entre procedimentos e representações produzidas pela arte e ciência levantam-se problemas tratados pela filosofia da estética como o fim da arte, entendido como o fim da especificidade manifesta entre produtos cotidianos e da arte. Andy Warhol, Jonh Cage, Marcel Duchamp, entre outros, são casos exemplares de mudanças no entendimento da arte pela filosofia da estética.
Internet como esfera pública global e o papel atual dos parlamentos no processo legislativo
Authors: Beçak Rubens , Longhi João Victor Rozatti
Published: May 2015

A popularização das Tecnologias da Informação e Comunicação trouxe diversas transformações nas várias searas do meio social. Do mercado às instituições públicas, as significativas alterações comportamentais recentes dividem opiniões e esperanças na superação das limitações até então impostos às interações sociais sem tais tecnologias. No campo da representação política e da expressão dos valores democráticos não é diferente. Muitas visões se cindem sobre o presente e o futuro no tocante à manifestação da vontade e exercício da soberania popular. Este trabalho, primeiramente, parte de breve análise sobre o conceito de esfera pública para averiguar as possibilidades de a Internet ser considerada um verdadeiro veículo para a consecução de uma esfera pública em âmbito global. Posteriormente, defronta-se com o problema da atual estrutura da Rede, com funcionamento cada vez mais baseado em interesses privados, o que impõe desafios teóricos e práticos à consecução de um ambiente efetivamente democrático. Finalmente, utiliza-se deste breve arcabouço teórico para discutir o problema de fundo acerca do papel dos parlamentos no funcionamento da democracia contemporânea no processo legislativo.
A atividade de extensão universitária, o Jardim São Remo e uma instituição educacional: desafios na criação de um campo comum de trabalho
Authors: Machado Adriana Marcondes , Azevedo Laura Albuquerque
Published: May 2015

Este trabalho tem por objetivo refletir sobre a função da extensão na universidade pública, por meio das atividades do Grupo de Articulação de Trabalhos de Extensão do Instituto de Psicologia da Universidade de São Paulo (USP). Trata-se de um grupo aberto, composto por alunos, professores e funcionários do Instituto preocupados em defender a função pública da universidade (em especial, a da USP) na sociedade brasileira. Duas alunas e uma professora participantes do Grupo de Articulação desenvolveram uma atividade no Espaço Girassol, instituição de atividade complementar à escola, localizada no Jardim São Remo, próximo ao campus USP da capital. Utilizando os registros das reuniões do Grupo de Articulação e os relatórios de estágio, apresentaremos o funcionamento desse grupo e focaremos a construção de um trabalho de estágio no Espaço Girassol. Nossa discussão afirma a relação entre o trabalho pontual de extensão universitária e a defesa do caráter público da extensão.
Torre de Marfim – Um panorama sobre a mercantilização do ensino superior nos Estados Unidos
Authors: Braghini Katya Zuquim
Published: May 2015

Torre de Marfim é um filme que mostra um processo de meio século de desmantelamento das linhas de subsídio público aos estudantes do ensino superior nos Estados Unidos e o paulatino aumento dos financiamentos privados que acabam por transformar os recém-formados em devedores antes mesmo de seres trabalhadores. Deixa evidente o estilo de mercantilização da educação superior no país como um processo histórico que ao mesmo tempo prega o consumo dos aparelhos estudantis; a busca incessante por prestígio social e a progressiva decomposição do modelo de graduação residencial, tão caro à tradição educacional estadunidense.
A violência escolar em matérias de jornal: um imaginário construído em Belém - PA
Authors: Silva Livia Sousa da , Mendonça Kátia Marly Leite
Published: May 2015

O presente trabalho tem como objetivo investigar de que forma se constitui o imaginário da violência escolar no texto midiático. Ao proceder à análise de textos midiáticos impressos buscamos a compreensão dos constituintes imaginários subjacentes à ideia de violência escolar conformada nesses discursos. Por acreditar numa construção midiática perpassada de intencionalidades, que ao construir um imaginário para a violência estará influenciando opiniões e decisões, quer seja no foro particular ou da esfera pública; participando mesmo da construção da Violência Escolar como objeto de estudo, de atenção e de intervenção. Para tanto, julgamos importante conjugar estudos do campo da Sociologia da Comunicação e do Imaginário e da Hermenêutica Compreensivo-Dialógica. Como uma primeira incursão de investigação nessa arena de significações, expomos um prelúdio da tessitura de tal pesquisa. 
Paulo Freire, comunicação e democracia
Authors: Fígaro Roseli
Published: May 2015

O objetivo da primeira parte deste artigo é retomar a discussão sobre a base conceitual e a referência teórica freireana que orientam a inter-relação comunicação/educação ou, o neologismo, educomunicação. Sobretudo, vamos nos pautar pelas contribuições do estudo de Venício A. Lima sobre as ideias de Paulo Freire. Na segunda parte, cumprimos o objetivo de apresentar os artigos e os autores da presente edição de Comunicação & Educação.
Role of Insulin in the Regulation of Proprotein Convertase Subtilisin/Kexin Type 9
Authors: Miao Ji , Manthena Praveen V. , Haas Mary E. , Ling Alisha V. , Shin Dong-Ju , Graham Mark J. , Crooke Rosanne M. , Liu Jingwen , Biddinger Sudha B.
Published: May 2015

Objective—

Proprotein convertase subtilisin/kexin type 9 (PCSK9), which binds the low-density lipoprotein receptor and targets it for degradation, has emerged as an important regulator of serum cholesterol levels and cardiovascular disease risk. Although much work is currently focused on developing therapies for inhibiting PCSK9, the endogenous regulation of PCSK9, particularly by insulin, remains unclear. The objective of these studies was to determine the effects of insulin on PCSK9 in vitro and in vivo.

Approach and Results—

Using rat hepatoma cells and primary rat hepatocytes, we found that insulin increased PCSK9 expression and increased low-density lipoprotein receptor degradation in a PCSK9-dependent manner. In parallel, hepatic
Pcsk9
mRNA and plasma PCSK9 protein levels were reduced by 55% to 75% in mice with liver-specific knockout of the insulin receptor; 75% to 88% in mice made insulin-deficient with streptozotocin; and 65% in
ob/ob
mice treated with antisense oligonucleotides against the insulin receptor. However, antisense oligonucleotide–mediated knockdown of insulin receptor in lean, wild-type mice had little effect. In addition, we found that fasting was able to reduce PCSK9 expression by 80% even in mice that lack hepatic insulin signaling.

Conclusions—

Taken together, these data indicate that although insulin induces PCSK9 expression, it is not the sole or even dominant regulator of PCSK9 under all conditions.
Electroanatomical Voltage and Morphology Characteristics in Postinfarction Patients Undergoing Ventricular Tachycardia Ablation
Authors: Tsiachris Dimitris , Silberbauer John , Maccabelli Giuseppe , Oloriz Teresa , Baratto Francesca , Mizuno Hiroya , Bisceglia Caterina , Vergara Pasquale , Marzi Alessandra , Sora Nicoleta , Guarracini Fabrizio , Radinovic Andrea , Cireddu Manuela , Sala Simone , Gulletta Simone , Paglino Gabriele , Mazzone Patrizio , Trevisi Nicola , Della Bella Paolo
Published: May 2015

Background—

Catheter ablation is an important therapeutic option in postmyocardial infarction patients with ventricular tachycardia (VT). We analyzed the endo–epicardial electroanatomical mapping (EAM) voltage and morphology characteristics, their association with clinical data and their prognostic value in a large cohort of postmyocardial infarction patients.

Methods and Results—

We performed total and segmental analysis of voltage (bipolar dense scar [DS] and low voltage areas, unipolar low voltage and penumbra areas) and morphology characteristics (presence of abnormal late potentials [LPs] and early potentials [EPs]) in 100 postmyocardial infarction patients undergoing electroanatomical mapping–based VT ablation (26 endo–epicardial procedures) from 2010–2012. All patients had unipolar low voltage areas, whereas 18% had no identifiable endocardial bipolar DS areas. Endocardial bipolar DS area >22.5 cm
2
best predicted scar transmurality. Endo–epicardial LPs were recorded in 2/3 patients, more frequently in nonseptal myocardial segments and were abolished in 51%. Endocardial bipolar DS area >7 cm
2
and endocardial bipolar scar density >0.35 predicted epicardial LPs. Isolated LPs are located mainly epicardially and EPs endocardially. As a primary strategy, LPs and VT-mapping ablation occurred in 48%, only VT-mapping ablation in 27%, only LPs ablation in 17%, and EPs ablation in 6%. Endocardial LP abolition was associated with reduced VT recurrence and increased unipolar penumbra area predicted cardiac death.

Conclusions—

Endocardial scar extension and density predict scar transmurality and endo–epicardial presence of LPs, although DS is not always identified in postmyocardial infarction patients. LPs, most frequently located in nonseptal myocardial segments, were abolished in 51% resulting in improved outcome.
Intracellular Calcium Attenuates Late Current Conducted by Mutant Human Cardiac Sodium Channels
Authors: Potet Franck , Beckermann Thomas M. , Kunic Jennifer D. , George Alfred L.
Published: May 2015

Background—

Mutations of the cardiac voltage-gated sodium channel (
SCN5A
gene encoding voltage-gated sodium channel [Na
V
1.5]) cause congenital long-QT syndrome type 3 (LQT3). Most Na
V
1.5 mutations associated with LQT3 promote a mode of sodium channel gating in which some channels fail to inactivate, contributing to increased late sodium current (
I
NaL
), which is directly responsible for delayed repolarization and prolongation of the QT interval. LQT3 patients have highest risk of arrhythmia during sleep or during periods of slow heart rate. During exercise (high heart rate), there is elevated steady-state intracellular free calcium (Ca
2+
) concentration. We hypothesized that higher levels of intracellular Ca
2+
may lower arrhythmia risk in LQT3 subjects through effects on
I
NaL
.

Methods and Results—

We tested this idea by examining the effects of varying intracellular Ca
2+
concentrations on the level of
I
NaL
in cells expressing a typical LQT3 mutation, delKPQ, and another
SCN5A
mutation, R225P. We found that elevated intracellular Ca
2+
concentration significantly reduced
I
NaL
conducted by mutant channels but not wild-type channels. This attenuation of
I
NaL
in delKPQ expressing cells by Ca
2+
was not affected by the CaM kinase II inhibitor KN-93 but was partially attenuated by truncating the C-terminus of the channel.

Conclusions—

We conclude that intracellular Ca
2+
contributes to the regulation of I
NaL
conducted by Na
V
1.5 mutants and propose that, during excitation–contraction coupling, elevated intracellular Ca
2+
suppresses mutant channel
I
NaL
and protects cells from delayed repolarization. These findings offer a plausible explanation for the lower arrhythmia risk in LQT3 subjects during fast heart rates.
Left Ventricular T-Cell Recruitment Contributes to the Pathogenesis of Heart Failure
Authors: Nevers Tania , Salvador Ane M. , Grodecki-Pena Anna , Knapp Andrew , Velázquez Francisco , Aronovitz Mark , Kapur Navin K. , Karas Richard H. , Blanton Robert M. , Alcaide Pilar
Published: May 2015

Background—

Despite the emerging association between heart failure (HF) and inflammation, the role of T cells, major players in chronic inflammation, has only recently begun to be explored. Whether T-cell recruitment to the left ventricle (LV) participates in the development of HF requires further investigation to identify novel mechanisms that may serve for the design of alternative therapeutic interventions.

Methods and Results—

Real-time videomicroscopy of T cells from nonischemic HF patients or from mice with HF induced by transverse aortic constriction revealed enhanced adhesion to activated vascular endothelial cells under flow conditions in vitro compared with T cells from healthy subjects or sham mice. T cells in the mediastinal lymph nodes and the intramyocardial endothelium were both activated in response to transverse aortic constriction and the kinetics of LV T-cell infiltration was directly associated with the development of systolic dysfunction. In response to transverse aortic constriction, T cell–deficient mice (T-cell receptor, TCRα
−/−
) had preserved LV systolic and diastolic function, reduced LV fibrosis, hypertrophy and inflammation, and improved survival compared with wild-type mice. Furthermore, T-cell depletion in wild-type mice after transverse aortic constriction prevented HF.

Conclusions—

T cells are major contributors to nonischemic HF. Their activation combined with the activation of the LV endothelium results in LV T-cell infiltration negatively contributing to HF progression through mechanisms involving cytokine release and induction of cardiac fibrosis and hypertrophy. Reduction of T-cell infiltration is thus identified as a novel translational target in HF.
Thrombogenicity and Early Vascular Healing Response in Metallic Biodegradable Polymer-Based and Fully Bioabsorbable Drug-Eluting Stents
Authors: Koppara Tobias , Cheng Qi , Yahagi Kazuyuki , Mori Hiroyoshi , Sanchez Oscar David , Feygin Julia , Wittchow Eric , Kolodgie Frank D. , Virmani Renu , Joner Michael
Published: May 2015

Background—

Acute thrombogenicity and re-endothelialization represent clinically relevant end points pertaining to the safety of coronary stents, which have not been compared among biodegradable polymer-based drug-eluting metallic stents and fully bioabsorbable scaffolds to date.

Methods and Results—

We investigated comparative outcomes with respect to acute thrombogenicity and re-endothelialization among thin-strut biodegradable polymer metallic everolimus eluting stents (EES), thick-strut fully bioabsorbable EES, thick-strut biodegradable polymer metallic biolimus-eluting stents and control bare metal stents. An ex-vivo porcine arterio-venous shunt model was used to assess platelet aggregation, whereas a healthy rabbit model of iliofemoral stent implantation was used to assess re-endothelialization and inflammation. Confocal microscopy was used to detect fluorescently labeled antibody staining directed against CD61/CD42b for the identification of aggregated thrombocytes, CD14/PM-1, and RAM-11 for identification of neutrophils and monocytes/macrophages. Endothelial recovery was assessed by scanning electron microscopy, whereas CD31/PECAM-1 was used to confirm endothelial maturity. EES demonstrated significantly less acute thrombogenicity compared with bioabsorbable EES and biolimus-eluting stents. EES showed greater re-endothelialization at 28 days and reduced inflammatory cell adhesion of monocytes/macrophages at 14 days compared with bioabsorbable EES. Only bare metal stents showed complete re-endothelialization at 28 days.

Conclusions—

These outcomes indicate differential trends in thrombogenicity and vascular healing among contemporary stents used in clinical practice and suggest a need for long-term adjunct antithrombotic pharmacotherapy for bioabsorbable EES.
Fructosamine and Glycated Albumin and the Risk of Cardiovascular Outcomes and Death
Authors: Selvin Elizabeth , Rawlings Andreea M. , Lutsey Pamela L. , Maruthur Nisa , Pankow James S. , Steffes Michael , Coresh Josef
Published: May 2015

Background—

Hemoglobin A1c (HbA1c) is the standard measure to monitor glucose control in diabetes mellitus and is a marker of future cardiovascular risk. Fructosamine and glycated albumin are markers of short-term glycemic control, but their associations with cardiovascular outcomes are uncharacterized.

Methods and Results—

We measured glycated albumin and fructosamine in 11 104 participants with and without diabetes in the community-based Atherosclerosis Risk in Communities (ARIC) Study in 1990 to 1992 (baseline). We evaluated associations of fructosamine and glycated albumin with risk of coronary heart disease, ischemic stroke, heart failure, and mortality. We compared associations with those observed for HbA1c. During two decades of follow-up there were 1096 new cases of coronary heart disease, 605 of ischemic stroke, 1432 of heart failure, and 2860 deaths. Elevated baseline concentrations of fructosamine and glycated albumin were significantly associated with each of the outcomes even after adjustment for traditional cardiovascular risk factors, with especially strong associations in persons with diabetes mellitus. Associations were of similar magnitude to those observed for HbA1c and—as has been previously observed for HbA1c—the associations tended to be J-shaped, with an elevation of risk at the lowest levels of each biomarker.

Conclusions—

The acceptance of new measures of hyperglycemia is partly dependent on establishing their association with long-term outcomes. We found that fructosamine and glycated albumin were associated with vascular outcomes and mortality and that these associations were similar to those observed for HbA1c.
Different Imaging Strategies in Patients With Possible Basilar Artery Occlusion
Authors: Beyer Sebastian E. , Hunink Myriam G. , Schöberl Florian , von Baumgarten Louisa , Petersen Steffen E. , Dichgans Martin , Janssen Hendrik , Ertl-Wagner Birgit , Reiser Maximilian F. , Sommer Wieland H.
Published: May 2015

Background and Purpose—

This study evaluated the cost-effectiveness of different noninvasive imaging strategies in patients with possible basilar artery occlusion.

Methods—

A Markov decision analytic model was used to evaluate long-term outcomes resulting from strategies using computed tomographic angiography (CTA), magnetic resonance imaging, nonenhanced CT, or duplex ultrasound with intravenous (IV) thrombolysis being administered after positive findings. The analysis was performed from the societal perspective based on US recommendations. Input parameters were derived from the literature. Costs were obtained from United States costing sources and published literature. Outcomes were lifetime costs, quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios, and net monetary benefits, with a willingness-to-pay threshold of $80 000 per QALY. The strategy with the highest net monetary benefit was considered the most cost-effective. Extensive deterministic and probabilistic sensitivity analyses were performed to explore the effect of varying parameter values.

Results—

In the reference case analysis, CTA dominated all other imaging strategies. CTA yielded 0.02 QALYs more than magnetic resonance imaging and 0.04 QALYs more than duplex ultrasound followed by CTA. At a willingness-to-pay threshold of $80 000 per QALY, CTA yielded the highest net monetary benefits. The probability that CTA is cost-effective was 96% at a willingness-to-pay threshold of $80 000/QALY. Sensitivity analyses showed that duplex ultrasound was cost-effective only for a prior probability of ≤0.02 and that these results were only minimally influenced by duplex ultrasound sensitivity and specificity. Nonenhanced CT and magnetic resonance imaging never became the most cost-effective strategy.

Conclusions—

Our results suggest that CTA in patients with possible basilar artery occlusion is cost-effective.
Effect Size Estimates for the ESCAPE Trial
Authors: Sajobi Tolulope T. , Zhang Yukun , Menon Bijoy K. , Goyal Mayank , Demchuk Andrew M. , Broderick Joseph P. , Hill Michael D.
Published: May 2015

Background and Purpose—

Ordinal outcomes, such as modified Rankin Scale (mRS), are the standard primary end points in acute stroke trials. Regression models for assessing treatment efficacy after adjusting for baseline covariates have been developed for continuous, binary, or ordinal end points. There has been no consensus on the best choice of method for analyzing these data.

Methods—

We compared several regression models for assessing treatment efficacy in acute stroke trials using existing data sets from the Interventional Management of Stroke-III and Prolyse in Acute Cerebral Thromboembolism II (PROACT-2) trials. Patients with baseline non–contrast computed tomographic Alberta Stroke Program Early CT Score (ASPECTS) > 5, baseline computed tomographic angiography, or conventional angiogram showing an intracranial internal carotid artery or middle cerebral artery trunk (M-1) occlusion, adequate collateral circulation shown on computed tomographic angiography, and treatment times of non–contrast computed tomographic to groin puncture of ≤90 minutes, were included. Monte Carlo techniques were used to compare the statistical power of these regression models under a variety of simulated data analytic scenarios.

Results—

Binary logistic regression showed greater power when the treatment is predicted to show evidence of benefit on one end of the mRS with no other gains across other levels of the scale. Proportional odds regression showed greater power when the treatment is predicted to show evidence of improvement on both ends of the mRS.

Conclusions—

The mRS distribution for both treatment and control groups influences the power of the investigated statistical models to assess treatment efficacy. A careful evaluation of the expected outcome distribution across the mRS scale is required to determine the best choice of primary analysis.
Effect of Blood Pressure Lowering in Early Ischemic Stroke
Authors: Lee Meng , Ovbiagele Bruce , Hong Keun-Sik , Wu Yi-Ling , Lee Jing-Er , Rao Neal M. , Feng Wayne , Saver Jeffrey L.
Published: May 2015

Background and Purpose—

Elevated blood pressure is common in acute stage of ischemic stroke and the strategy to manage this situation is not well established. We therefore conducted a meta-analysis of randomized controlled trials comparing active blood pressure lowering and control groups in early ischemic stroke.

Methods—

Pubmed, EMBASE, and Clinicaltrials.gov from January 1966 to March 2015 were searched to identify relevant studies. We included randomized controlled trials with blood pressure lowering started versus control within 3 days of ischemic stroke onset. The primary outcome was unfavorable outcome at 3 months or at trial end point, defined as dependency or death, and the key secondary outcome was recurrent vascular events. Pooled relative risks and 95% confidence intervals were calculated using random-effects model.

Results—

The systematic search identified 13 randomized controlled trials with 12 703 participants comparing early blood pressure lowering and control. Pooling the results with the random-effects model showed that blood pressure lowering in early ischemic stroke did not affect the risk of death or dependency at 3 months or at trial end point (relative risk, 1.04; 95% confidence interval, 0.96–1.13;
P
=0.35). Also, blood pressure lowering also had neutral effect on recurrent vascular events, as well as on disability or death, all-cause mortality, recurrent stroke, and serious adverse events.

Conclusions—

This meta-analysis suggested blood pressure lowering in early ischemic stroke had a neutral effect on the prevention of death or dependency.
Finding the Prophetic in Failure
Authors: Ludwig Kathryn
Published: May 2015

In recent decades, a body of literary writing has emerged in which religious questions are foregrounded. This body of writing and the criticism connected with it is increasingly referred to as postsecular. In E. L. Doctorow’s City of God, the characters and the text perform the struggle of reading prophetically, as it is defined in the writings of Jewish philosopher Martin Buber. In his time, Buber urged not a return to existing models of the religious, but a turn toward prophetic reading, which is founded in relation. Literary writing of this postsecular moment, including City of God, is likewise engaged in a reconceptualization of the religious. Doctorow’s novel conveys the idea that engaging the religious involves failure, but that it is through failure that we are pushed to a new modality of reading.
Modernity From Below: The Amalgamated Oriental Carpet Manufacturers, Ltd. of Izmir, 1907-1922
Authors: Frangakis-Syrett Elena
Published: May 2015

Turkish carpet making and marketing, a rapidly expanding niche in the world market in the latter 19th and early 20th centuries, offers an excellent case study for modernity in a major Ottoman provincial urban center such as Izmir and its hinterland in western Anatolia. Representative of the changes that the city’s economy was undergoing was the Amalgamated Oriental Carpet Manufacturers Limited (ocm), which included multiethnic and multiconfessional actors similar to the city’s business sector and general population, as well as dual nodes of administration in London and Izmir. This case study of ocm (and of its emulators) reveals the degree of modernity that Izmir’s business circles were capable of at the turn of the century, and their ability to put together a trust and strategize accordingly along similar lines as the trusts in Europe or the us.
Mechanization of Agriculture: Implications for the Farming Community in India
Authors: Shukla Rahul , Mallick Sambit
Published: May 2015

Application of agricultural technologies has been supportive for fulfilling the requirements of food and raw material of an individual and an industry as well. But it has also injured the farming community in India without providing adequate treatment for physical and economic health. What are the measures available for the safety and social security of farming communities by which risk can be ameliorated? This paper examines such predicaments by locating the response of the scientific community engaged in the research and development of agricultural technologies. The discussion is based upon the transcript obtained after in-depth interviews of the scientific community. An effort has been made to interpret the empirical reality of occupational health hazards in farming relating to emerging social security measures.
A Study of Factors that Influence the Adoption of Solar Powered Lanterns in a Rural Village in Kenya
Authors: Tong T. M. , Asare J. , Rwenyagila E. R. , Anye V. , Oyewole O. K. , Fashina A. A. , Soboyejo W. O.
Published: May 2015

The problem of access to electricity is still a major challenge to about 2 billion people that still live in rural and urban off-grid areas on incomes of $1-2/day. Since the cost of linking these people to the grid is high, there is a need to explore the development of alternative energy solutions for the provision of electricity in such contexts. There is also a need to develop new insights for the formulation of evidence-based policy that could enable the development of strategies to provide electricity to people that live in off-grid areas. This paper presents the results of a survey that provides insights for the formulation of evidence-based policy for the adoption of solar lanterns into rural/urban off-grid areas. The two year questionnaire study was carried out in Mpala Village in the Laikipia district of Kenya. The study identifies the factors that resulted in the adoption rate of 96% and a decrease of 14.7% in annual family expenditures. The social and health impacts are also elucidated before discussing the implications of the results for the formulation of evidence-based solar energy policy in developing countries.
Sabbath Observance, Sabbath Innovation: The Hasmoneans and Their Legacy as Interpreters of the Law
Authors: Borchardt Francis
Published: May 2015

Both 1 Maccabees and 2 Maccabees portray the Sabbath law as a central point of contention during the struggle over Judean law and tradition in the second century bce (e.g., 1 Macc 1:41-50; 2 Macc 6:4-6). The Hasmonean family in particular is at times highlighted as holding the Sabbath in high regard (2 Macc 5:27). In every available source, there is no question of the commitment to the inherited traditions concerning the Sabbath. However, in two passages, 1 Macc 2:29-41 and 9:43-53, the Hasmoneans are portrayed as acting in a way supported by few extant writings associated with Judean legal tradition: they engage in battle on the Sabbath. First Maccabees presents this as innovation on the part of the Hasmoneans. Josephus, who summarizes these events based upon 1 Maccabees, even recognizes this decision as the basis for normative practice (Ant. 12.272-277). As several scholars (e.g., Bar Kochva, Weiss, Scolnic) have pointed out, this event could hardly have been the first time in Judean history the issue arose. They argue against this reading of the sources. This paper contends that the plain reading of the texts is correct and 1 Maccabees is being used as the basis for legal practice in Josephus’ writings.
A Jewish Epitaph from the Fayum
Authors: Blumell Lincoln H.
Published: May 2015

This paper presents an edition of a previously unpublished Ptolemaic Jewish epitaph from the Fayum (Egypt). The epitaph is stored in the Kom Aushim (Karanis) magazine and was discovered by the author in the spring of 2014 while working in the magazine. This is the first known Jewish epitaph from the Fayum region.
„Mein Gott, mein Gott, zu dir erhebe ich mich in der Früh‟ – Zwei Psalmpassagen in Inschriften aus Tyros und in der patristischen Tradition
Authors: Walser Andreas Victor
Published: May 2015

A revision of several painted inscriptions discovered in a late antique chamber tomb in Tyre shows that they recorded verses from two Psalms (3, 6 and 62, 2-3), both not otherwise attested epigraphically. The article subsequently examines how these verses were received and interpreted in early Christian literature and by the Greek Fathers of the Church: The popular verse 6 of Psalm 3, with its reference to sleep and awakening, was understood by most—but not all—commentators as a reference to the death and resurrection of Jesus Christ. The less famous first verses of Psalm 62 were usually just read as an expression of the longing for God. The juxtaposition of these two Psalms, which share the liturgical role of Morning Psalms, suggests that the verses from Psalm 62 as well as the one from Psalm 3 were understood as referring to the resurrection and used to express the deceased’s belief in salvation.
Singing Thomas: Anatomy of a Sympotic Scene in Acts of Thomas
Authors: Cosgrove Charles H.
Published: May 2015

This article examines one of the few musical scenes in ancient Christian literature, the description of a wedding banquet in act 1 of Acts of Thomas, in which a female piper pays special attention to Thomas, and Thomas sings a “hymn to the bride.” The inner dynamics of the scene are explored, and its contribution to the wider themes of Acts of Thomas is considered.
Flag Verification on the High Seas: Understanding Requirements for Masters and Commanders
Authors: Lewis Angeline
Published: May 2015

Operational reporting from the Middle East indicates that the exercise by warships of a right of visit on the high seas, in order to verify the flag of the boarded vessel, is an important part of contemporary maritime enforcement operations. However, this reliance on ‘flag verification boardings,’ pursuant to Article 110 of the United Nations Convention on the Law of the Sea 1982, challenges the proper balance of law enforcement authority against the traditional freedom of navigation. It is therefore necessary to establish clearly for both civilian masters and warship commanders where the evidentiary threshold for reasonable doubt as to the nationality of vessels lies, so as to justify non-consensual visit and search by a foreign warship. This article makes an objective, evidence-based assessment of the threshold, concluding with a caution against over-stretching the right of visit to accommodate law enforcement purposes not envisaged in the drafting of Article 110.
An Analysis of the Cooperation Regime of the International Criminal Court and its Effectiveness in the Court’s Objective in Securing Suspects in its Ongoing Investigations and Prosecutions
Authors: Mutyaba Rita
Published: May 2015

The International Criminal Court (ICC) has to rely on the cooperation of State Parties and non-party States in the arrest and surrender of accused persons who commit crimes within the court’s jurisdiction because it lacks an enforcement mechanism to apprehend those individuals. However, a State can refuse to cooperate with the Court based on competing requests for extradition of an accused, incompatibility of the cooperation request with international law, when the execution of the cooperation request is prohibited by national law, concern that the suspect’s human rights will be violated, the cooperation request has problems that may impede or prevent the State Party from executing the request; sovereignty claims. Notwithstanding these reasons, the cases before the Court show that the ICC has been largely successful in securing the arrest and surrender of accused persons. However, alternative enforcement mechanisms of cooperation requests should be considered as a means of apprehending suspects.
The Contribution of Striations to the Eddy Energy Budget and Mixing: Diagnostic Frameworks and Results in a Quasigeostrophic Barotropic System with Mean Flow
Authors: Chen Ru , Flierl Glenn R.
Published: May 2015

Low-frequency oceanic motions have banded structures termed “striations.” Since these striations embedded in large-scale gyre flows can have large amplitudes, the authors investigated the effect of mean flow on their directions as well as their contribution to energetics and mixing using a β-plane, barotropic, quasigeostrophic ocean model. In spite of the model simplicity, striations are always found to exist regardless of the imposed barotropic mean flow. However, their properties are sensitive to the mean flow. Rhines jets move with the mean flow and are not necessarily striations. If the meridional component of the mean flow is large, Rhines jets become high-frequency motions; low-frequency striations still exist, but they are nonzonal, have small magnitudes, and contribute little to energetics and mixing. Otherwise, striations are zonal, dominated by Rhines jets, and contribute significantly to energetics and mixing. This study extends the theory of β-plane, barotropic turbulence, driven by white noise forcing at small scales, to include the effect of a constant mean flow. Theories developed in this study, based upon the Galilean invariance property, illustrate that the barotropic mean flow has no effect on total mixing rates, but does affect the energy cascades in the frequency domain. Diagnostic frameworks developed here can be useful to quantify the striations’ contribution to energetics and mixing in the ocean and more realistic models. A novel diagnostic formula is applied to estimating eddy diffusivities.
Sensitivity of Limited-Area Hybrid Variational-Ensemble Analyses and Forecasts to Ensemble Perturbation Resolution
Authors: Schwartz Craig S. , Liu Zhiquan , Huang Xiang-Yu
Published: May 2015

Dual-resolution (DR) hybrid variational-ensemble analysis capability was implemented within the community Weather Research and Forecasting (WRF) Model data assimilation (DA) system, which is designed for limited-area applications. The DR hybrid system combines a high-resolution (HR) background, flow-dependent background error covariances (BECs) derived from a low-resolution ensemble, and observations to produce a deterministic HR analysis. As DR systems do not require HR ensembles, they are computationally cheaper than single-resolution (SR) hybrid configurations, where the background and ensemble have equal resolutions.

Single-observation tests were performed to document some characteristics of limited-area DR hybrid analyses. Additionally, the DR hybrid system was evaluated within a continuously cycling framework, where new DR hybrid analyses were produced every 6 h over ~3.5 weeks. In the DR configuration presented here, the deterministic backgrounds and analyses had 15-km horizontal grid spacing, but the 32-member WRF Model–based ensembles providing flow-dependent BECs for the hybrid had 45-km horizontal grid spacing. The DR hybrid analyses initialized 72-h WRF Model forecasts that were compared to forecasts initialized by an SR hybrid system where both the ensemble and background had 15-km horizontal grid spacing. The SR and DR hybrid systems were coupled to an ensemble adjustment Kalman filter that updated ensembles each DA cycle.

On average, forecasts initialized from 15-km DR and SR hybrid analyses were not statistically significantly different, although tropical cyclone track forecast errors favored the SR-initialized forecasts. Although additional studies over longer time periods and at finer grid spacing are needed to further understand sensitivity to ensemble perturbation resolution, these results suggest users should carefully consider whether SR hybrid systems are worth the extra cost.
Verbal Exuberance and Social Engineering
Authors: Lewis Justin Jaron
Published: May 2015

Ḥafetz Ḥayim, first published in 1873, is a renowned Jewish work on the sin of “evil speech.” It has the reputation of seeking to put a stop to derogatory gossip. Such an attempt would have been staggeringly difficult, especially since Yiddish-speaking Eastern European Jewish culture was known for its talkativeness, including negative gossip. In fact, however, Ḥafetz Ḥayim permits and even commands negative talk about certain categories of people. Based on the historical context, I argue that Ḥafetz Ḥayim seeks not to stop negative talk but to direct it against those who threaten nascent Orthodox Judaism. However, this goal does not appear to have been realized. Insight into this apparent failure can be gleaned from the social sciences and especially from Samuel Heilman’s Synagogue Life: derogatory gossip about one another actually connects people and strengthens their community. Thus, Ḥafetz Ḥayim’s attempt to turn such gossip into a weapon against outsiders was doomed to failure.