bluuebunny/crossref_metadata_2025 huggingface dataset:
LINGUAGEM E VERDADE EM LEIBNIZ
Authors: Faria Chaianne Maria da Silva
Published: January 2017

Nos ensaios em que discute o aperfeiçoamento da língua alemã, Leibniz destaca o papel desempenhado pelos signos em geral para a construção das ciências, opondo-se aos que defendem ser preciso sempre a considerar a coisa mesma a fim de descobrir suas propriedades. Para o filósofo, se não houvesse signos capazes de substituir a coisa e a ideia que temos dela, e tivéssemos de remontar continuamente à natureza visada e refazer sua definição, não haveria escolha senão cessar o próprio diálogo com o outro e a própria reflexão. E o que torna um signo apto a ocupar o lugar de uma realidade e se prestar à constituição de conhecimento racional acerca das coisas é que ele exprima, em sua disposição e nas relações que estabelece com outros caracteres, as relações e propriedades que constam da coisa da qual é signo, de sorte que a partir de seu emprego seja possível chegar à coisa mesma. Isto posto, nosso objetivo será discutir o papel da linguagem para raciocinar, bem como a natureza dos termos e essa sua relação com as coisas que significam e pelas quais supõem, a fim de entender como Leibniz pode definir as proposições verdadeiras como aquelas em que há uma ligação coerente entre os termos e simultaneamente afirmar que é preciso encontrar na própria coisa um fundamento apto a justificar a proposição e demonstrá-la a priori.
LEIBNIZ: DEFINIÇÃO NOMINAL DE “SUBSTÂNCIA INDIVIDUAL” E DEFINIÇÕES NOMINAIS DE SUBSTÂNCIAS INDIVIDUAIS
Authors: Scaramal Elliot Santovich
Published: January 2017

No presente artigo, pretendemos oferecer uma análise da explication nominal de Leibniz do que é “ser uma substância individual” oferecida em Discurso de Metafísica §8, assim como (subsidiariamente) uma concernindo o entendimento leibniziano do que sejam definições nominais em geral. O presente artigo será dividido em quatro partes: Em primeiro lugar, tentaremos argumentar contra uma interpretação tradicional e bem-estabelecida, embora não completamente incontroversa, da explication de Leibniz em Discurso de Metafísica §8. Em segundo lugar, tentaremos abordar o entendimento geral de Leibniz de uma definição nominal, ao passo que argumentamos a favor da implicação mútua entre as duas definições disponíveis no corpus leibnitianum. Em terceiro lugar, pretendemos apresentar uma interpretação alternativa positiva da explication de Leibniz. Finalmente, tentaremos lidar com um aparente problema de tal interpretação concernindo ao comprometimento existencial presente na mesma por meio de uma análise do uso estrito por parte de Leibniz do termo “substância”.
A RELAÇÃO ENTRE CIBERNÉTICA E METAFISICA E SUAS CONSEQUÊNCIAS NA VIDA SOCIAL A PARTIR DA MONADOLOGIA DE G. W. LEIBNIZ
Authors: De Luca Felipe A.
Published: January 2017

É amplo o estudo sobre Leibniz hoje: conhecemo-lo como o filósofo metafísico de tendências religiosas, como opositor de Descartes, como vitalista, matemático etc.; mas a pergunta que orienta nossa pesquisa busca deslindar novos horizontes: é possível encontrar elementos em sua metafísica que nos permitam pensar o cenário social contemporâneo? A partir das ferramentas conceituais criadas pelo filósofo pensamos que a resposta seja positiva.
A TEORIA CARTESIANA DAS VERDADES ETERNAS NA INTERPRETAÇÃO DE ESPINOSA
Authors: Gatto Alfredo
Published: January 2017

O artigo tem como objetivo investigar a recepção da teoria cartesiana das verdades eternas no pensamento de Espinosa. Como é demonstrado por várias ocorrências presentes nas suas obras, o filósofo holandês tinha um conhecimento profundo e articulado da doutrina de Descartes. Contrariamente à maioria dos filósofos mais importantes do período, Espinosa não se limitou a rejeitar a teoria, mas tentou incorporá-la e integrá-la na sua reflexão para mudá-la no interior: ao aceitar uma parte dos seus pressupostos – centralidade da causação eficiente de Deus, criação da essência e da existência das coisas –, Espinosa acabava assim por negar as suas consequências metafísicas.
CIÊNCIA INTUITIVA, FILOSOFIA DA PRAXIS E POIESIS NO TRATADO TEOLÓGICO POLÍTICO
Authors: Rocha André Menezes
Published: January 2017

Nosso propósito é investigar o sentido das afirmações de Espinosa no Tratado Político em torno da praxis e da política como ciência prática. Iniciaremos por indicar como Espinosa reformula a divisão clássica entre as ciências teóricas, práticas e poiéticas a partir de uma leitura crítica de Bacon no contexto mais amplo da gênese da filosofia moderna no século XVII. O foco inicial se encontra na dissolução da oposição abstrata entre teoria e prática. Em seguida, passamos à questão da poiesis para verificar de que maneira as artes da produção são repensadas por Espinosa a partir da nova maneira de pensar os vínculos entre teoria e prática. Dessa maneira esperamos contribuir para as investigações acerca da política de Espinosa como “ciência prática”.
Goa no itinerário íntimo dos poetas portugueses contemporâneos
Authors: Almeida Catarina Nunes de
Published: January 2017

Entre os séculos XX e XXI, o Oriente e os espaços ultramarinos são revisitados pela poesia através dum conjunto de imagens e de conceitos que vão ao encontro do longínquo Império quinhentista. O interesse pelos momentos inaugurais desse encontro revela uma discreta mas consequente permanência do tópico na literatura portuguesa. A redescoberta da Índia constitui um verdadeiro exercício de amplitude estética: alegoriza uma aprendizagem do olhar e inaugura itinerários íntimos, entre o vivido e o sonhado. Propomos uma aproximação aos textos onde a Índia ou Goa surgem como topos centrais, com vista a interpretar o peso simbólico que a “viagem à Índia” assume na poesia portuguesa dos nossos dias.
Goa na Diaspóra e na Literatura Indiana em Língua inglesa
Authors: Passos Joana
Published: January 2017

Resumo: Este artigo apresenta um breve enquadramento histórico do aparecimento de literatura goesa em língua inglesa, apontando algumas das suas caraterísticas. Em segundo lugar, aborda-se a literatura goesa da diáspora, visto que a literatura goesa em inglês está intrinsecamente associada às rotas de emigração da comunidade goesa. Por outro lado, aborda-se um dos mais reconhecidos romances da literatura goesa em língua inglesa, sobre Goa na atualidade. Trata-se de Skin (2010) de Margaret Mascarenhas. Por fim, analisamos dois romances do autor indiano Amitav Gosh, sobre as comunidades de marinheiros e migrantes do Oceano Índico, entre os quais se conta a comunidade goesa.
ŚRĪ ŚĀNTĀDURGĀ DEVĪ: análise preliminar das fontes textuais goesas em Língua Portuguesa
Authors: Aldrovandi Cibele Elisa Viegas
Published: January 2017

O presente artigo é uma análise preliminar da paisagem sagrada associada à deusa Śrī Śāntādurgā nas Velhas Conquistas, durante o advento colonial português em Goa. No século XVI, esse território foi profundamente modificado e os templos hindus destruídos. Um levantamento minucioso dos antigos Forais de Ilhas, Salcete e Bardez foi realizado com vistas a recuperar informações sobre a extensão dos cultos às divindades femininas naquele período, com ênfase na sua deusa mais popular, Santeri – Śāntādurgā. A interdiscursividade presente nessa estratigrafia textual, de caráter ambivalente, fornece um retrato indireto e detalhado das transformações em curso naquela época.
Reverse Cholesterol Transport Is Increased in Germ-Free Mice—Brief Report
Authors: Mistry Rima H. , Verkade Henkjan J. , Tietge Uwe J.F.
Published: January 2017

Objective—

The intestinal microbiota is emerging as a clinically relevant modulator of atherosclerotic risk. Reverse cholesterol transport (RCT) is an atheroprotective metabolic pathway. How the microbiota impacts RCT has not been investigated. Therefore, the aim of this study was to characterize (cholesterol) metabolism and RCT in germ-free mice compared with conventional mice.

Approach and Results—

In chow-fed germ-free mice, plasma cholesterol was unchanged, whereas liver cholesterol content was higher (1.5-fold;
P
<0.05) than in conventional controls. Biliary secretion of cholesterol (2-fold;
P
<0.001) and bile acids (3-fold;
P
<0.001) was substantially increased in the germ-free model, whereas fecal neutral sterol excretion was unaltered, and fecal bile acid excretion was decreased (
P
<0.01). However, fecal bile acid profiles of germ-free mice were dominated by the presence of β-muricholic acid (
P
<0.001), pointing toward a higher contribution of the alternative acidic pathway to total bile acid synthesis in these mice. As expected, secondary bile acids were absent in the germ-free model. In vivo macrophage-to-feces RCT was increased >2-fold (
P
<0.01) in the absence of intestinal bacteria.

Conclusions—

These data demonstrate that the absence of the intestinal microbiota stimulates RCT >2-fold. Thereby, our results support the importance of intestinal bacteria for metabolic regulation and indicate that specific targeting of the microbiota bears therapeutic potential to prevent and treat cardiovascular disease.
12/15-Lipoxygenase Inhibition or Knockout Reduces Warfarin-Associated Hemorrhagic Transformation After Experimental Stroke
Authors: Liu Yu , Zheng Yi , Karatas Hulya , Wang Xiaoying , Foerch Christian , Lo Eng H. , van Leyen Klaus
Published: January 2017

Background and Purpose—

For stroke prevention, patients with atrial fibrillation typically receive oral anticoagulation. The commonly used anticoagulant warfarin increases the risk of hemorrhagic transformation (HT) when a stroke occurs; tissue-type plasminogen activator treatment is therefore restricted in these patients. This study was designed to test the hypothesis that 12/15-lipoxygenase (12/15-LOX) inhibition would reduce HT in warfarin-treated mice subjected to experimental stroke.

Methods—

Warfarin was dosed orally in drinking water, and international normalized ratio values were determined using a Coaguchek device. C57BL6J mice or 12/15-LOX knockout mice were subjected to transient middle cerebral artery occlusion with 3 hours severe ischemia (model A) or 2 hours ischemia and tissue-type plasminogen activator infusion (model B), with or without the 12/15-LOX inhibitor ML351. Hemoglobin was determined in brain homogenates, and hemorrhage areas on the brain surface and in brain sections were measured. 12/15-LOX expression was detected by immunohistochemistry.

Results—

Warfarin treatment resulted in reproducible increased international normalized ratio values and significant HT in both models. 12/15-LOX knockout mice suffered less HT after severe ischemia, and ML351 reduced HT in wild-type mice. When normalized to infarct size, ML351 still independently reduced hemorrhage. HT after tissue-type plasminogen activator was similarly reduced by ML351.

Conclusions—

In addition to its benefits in infarct size reduction, 12/15-LOX inhibition also may independently reduce HT in warfarin-treated mice. ML351 should be further evaluated as stroke treatment in anticoagulated patients suffering a stroke, either alone or in conjunction with tissue-type plasminogen activator.
Case Study: The Development and Evolution of the Creative Arts Practice-led PhD at the University of Melbourne, Victorian College of the Arts
Authors: Zeeuw Diane
Published: January 2017

Many art academics within U.S. institutions have little understanding of the Creative Arts PhD. Moreover, this has lead to the proliferation of a great deal of misinformation as U.S. academics struggle to sift through a growing body of literature on the subject. The author, who believes there is a very real and demonstrated need for more critical “nuts and bolts” or basic information on how such programs have been developed, implemented, staffed and legitimated, created a case study that focuses upon the developmental path and outcomes of a practice-led Creative Arts PhD program. A primary goal of the study was to critically assess the viability of applying the gathered data/findings toward the development of an appropriately adjusted program within a specific U.S. institution. Access to the complete “Case Study: The Development and Evolution of the Creative Arts Practice-led PhD at the University of Melbourne, Victorian College of the Arts” is available on www.mitpressjournals.org/toc/leon/50/5 .
Spontaneous brain network activity: Analysis of its temporal complexity
Authors: Pedersen Mangor , Omidvarnia Amir , Walz Jennifer M. , Zalesky Andrew , Jackson Graeme D.
Published: January 2017

The brain operates in a complex way. The temporal complexity underlying macroscopic and spontaneous brain network activity is still to be understood. In this study, we explored the brain’s complexity by combining functional connectivity, graph theory, and entropy analyses in 25 healthy people using task-free functional magnetic resonance imaging. We calculated the pairwise instantaneous phase synchrony between 8,192 brain nodes for a total of 200 time points. This resulted in graphs for which time series of clustering coefficients (the “cliquiness” of a node) and participation coefficients (the between-module connectivity of a node) were estimated. For these two network metrics, sample entropy was calculated. The procedure produced a number of results: (1) Entropy is higher for the participation coefficient than for the clustering coefficient. (2) The average clustering coefficient is negatively related to its associated entropy, whereas the average participation coefficient is positively related to its associated entropy. (3) The level of entropy is network-specific to the participation coefficient, but not to the clustering coefficient. High entropy for the participation coefficient was observed in the default-mode, visual, and motor networks. These results were further validated using an independent replication dataset. Our work confirms that brain networks are temporally complex. Entropy is a good candidate metric to explore temporal network alterations in diseases with paroxysmal brain disruptions, including schizophrenia and epilepsy.
Procedural Developments at the International Criminal Court (2015)
Authors: Le Floch Guillaume , Lemey Marie , Paiola Lucie
Published: January 2017

The current column covers some selected procedural developments at the International Criminal Court (“icc”) in 2015. During the reporting period, the Court faced a heavy workload; and, as in recent years, the Court has delivered numerous decisions, taking such opportunities to clarify certain aspects of proceedings before the Court.
Fagopyrum longzhoushanense, a new species of Polygonaceae from Sichuan, China
Authors: WANG CHENG-LONG , LI ZHI-QIANG , DING MENG-QI , TANG YU , ZHU XUE-MEI , LIU JIAN-LIN , SHAO JI-RONG , ZHOU MEI-LIANG
Published: January 2017

Fagopyrum longzhoushanense (Polygonaceae) is here described and illustrated as a new species from Longzhoushan (Puge County, Sichuan Province, China) on the basis of morphological, caryological and molecular analyses. The new species is morphologically similar to F. gracilipes from which it differs in having densely pubescent or villose parts, thicker and red-brown stems and branches, dense nodes, rugulose and small postulate leaf blade on the surface, stamens longer than pistils. Another similar species is F. densovillosum from which F. longzhoushanense differs by the winged and greater achenes, and the stamens which are longer than the pistils. From the caryioogical point of view F. longzhoushanense is a diploid species with 2n=2x=16 and a karyotype of 16 metacentric chromosomes, while F. gracilipes is tetraploid, 4n=4x=32, with a karyotype of 30 metacentric and 2 submetacentric chromosomes. The results of molecular marker analysis (matK) also highlight the distinction of the new species.
The Critique of Regression
Authors: Rizzolo Gregory S.
Published: January 2017

The term regression refers to the idea that a person can return to earlier phases of mental development and the primitive modes of functioning associated with them. A core concept in both conflict and deficit models of development, the idea has nonetheless come under increasing scrutiny from critics who argue that it misleads us into a genetic fallacy whereby we reduce the issues of adolescent and adult development to their childhood precursors. Inderbitzen and Levy (2000) suggest that we focus on transformations, or shifts, in mental organization, instead of on regressions. But discarding the concept of regression has theoretical implications: to adopt instead a focus on shifts in mental organization we must (1) consider our object of study to be the meaning-making person, not isolated instincts or needs; (2) understand conscious and unconscious mental life to be embedded in the here-and-now relational field; and (3) adopt a lifespan model of development. The aim here is to outline a theoretical framework in which we can more fully explore the possibility of discarding “regression” in favor of a focus on transformations in the developmental present.
Will This Case Count? The Influence of Training on Treatment
Authors: Blakeman Rachel , Goldberger Marianne
Published: January 2017

Mandated use of the couch—whether specifically stated or tacitly communicated by supervisors and colleagues—to fulfill requirements for graduation or certification is a significant disservice to candidates and their patients. In its training standards, it is argued, APsaA and its member institutes should state explicitly that a treatment can qualify as a psychoanalysis, regardless of whether the patient is using the couch, as long as the process is analytic and the candidate’s thinking is demonstrably analytic. The mandate, however conveyed, that one must use the couch interferes with candidates’ optimal analytic functioning, jeopardizing their patients’ analyses. Data from infant observation, neuroscience, and facial expression studies—unavailable to earlier generations of analysts—support a more nuanced view of use of the couch. Each analysis is unique, and some analyses might well benefit from use of both the couch and the chair at different phases of treatment, but unless this is spelled out by ApsaA and its member institutes, candidates and junior analysts will be prevented from freely contemplating the clinical benefits or detriments of their use in specific cases.
Classification of Chronic Venous Insufficiency: A Review
Authors: Antignani Pier Luigi
Published: January 2017

Chronic venous insufficiency (CVI) is a very variable and complex entity that has stimulated different attempts at classification. Several proposals have been made in recent years, based on objective and anatomical criteria, most of them incomplete and unsatisfactory. Finally the CEAP classification was presented in 1994. This certainly is the most nearly complete classi fication, since it takes into consideration not only the main aspects of CVI: Clinical, Etiological, Anatomical, and Pathophysiological, but also the degrees of severity, reported in the form of scores. It is now accepted internationally although it still has some flaws (such as the absence of the corona phlebectactica sign) and inaccuracies (above all in the clinical part and the scoring). Recently, some members of the Promoting Committee proposed a substantial modi fication of the part on scores, coming closest to the clinical reality, instrumental diagnosis, and current therapies. The characteristics of CEAP enable us to affirm that this represents the most original and useful classification, not only for clinical studies, but also in the assessment of therapeutic results and in patient follow-up. Like all classifications, CEAP also needs to be validated by means of clinical studies in order to demonstrate its applicability. For this purpose, a European Working Group was set up in 1997. The first interesting results of 872 dossiers collected by means of a computerized program (European Phlebological File) were presented at several international congresses and concentrated on the consistency and reproducibility of the clinical part of the CEAP classification in different clinical settings.
Clinical Benefits of Daflon 500 mg in the Most Severe Stages of Chronic Venous Insufficiency
Authors: Ramelet Albert Adrien
Published: January 2017

Chronic venous insufficiency (CVI) affects a large number of people in Western countries, and is responsible for considerable inconvenience, discomfort, suffering, and costs.

Micronized purified flavonoid fraction (MPFF, 450 mg diosmin plus 50 mg hesperidin- Daflon 500 mg) is a potent venotropic drug used in the treatment of venous insufficiency. Pharmacological and clinical studies demonstrated the comprehensive mode of action of Daflon 500 mg: it increases venous tone, it improves lymph drainage, and it protects the microcircu lation. Clinical international, prospective, multicenter, randomized, controlled studies versus placebo studies documenting the effects of Daflon 500 mg in CVI at advanced stages with edema, skin changes, and venous leg ulcer are reviewed. In edema, one of the most frequent complaints of patients, Daflon 500 mg brings about a significant reduction in leg circumference, thanks to its capacity to inhibit inflammatory reactions and to decrease capillary hyperper meability. The rationale for the use of Daflon 500 mg for treatment of skin disorders and venous leg ulcer is its action on the microcirculation-damaging processes. Regarding skin changes, Daflon 500 mg has been shown to improve venous trophic disorders, like gravitational (stasis) dermatitis, and dermatofibrosclerosis. In venous leg ulcer, Daflon 500 mg's clinical efficacy has been demonstrated in addition to standard treatment or versus standard treatment alone.

Daflon 500 mg, thanks to its comprehensive mode of action on the veins, lymphatics, and microcirculation, is the method of choice not only in the early stages of CVI treatment, but also in the severe stages of this condition, in combination with compression treatment, scle rotherapy, and surgery if appropriate.
Microcirculation After Standardized Application of Essaven Gel on Normal Skin
Authors: Incandela L. , Belcaro G. , Nicolaides A.N. , Geroulakos G. , Cesarone M.R. , De Sanctis M.T.
Published: January 2017

Essaven gel (EG) is a naturally derived compound indicated for the treatment of impaired venous circulation and, in microcirculatory disorders, hematomas, swelling, sprains, and all minor sport injuries. The aim of this randomized, placebo-controlled, double-blind study was to evaluate the standardized application of EG on normal skin and its effects on the microcircu lation. Standardization of gel application (particularly EG) has been recently described (in healthy subjects and in clinical studies) in defined steps. The results of this study indicate that topical treatment with EG is effective in improving or positively altering the microcircu lation in normal skin both at the deeper capillary levels (thermoregulatory, whole-thickness capillary bed [as shown by laser Doppler flowmetry] as well as at the nutritional capillary layer (as shown by PO2). The application of EG can be standardized to obtain consistent results with topical treatment.
Microvascular Alterations in Diabetic Microangiopathy: Topical Treatment with Essaven Gel
Authors: Incandela L. , Belcaro G. , Cesarone M.R. , De Sanctis M.T. , Griffin M.
Published: January 2017

The involvement of the microcirculation in diabetic microangiopathy (DM) may be cause of severe invalidity and ulceration. Diabetic microangiopathy (DM) is characterized by a diffuse increase in skin flux, reduction in venoarteriolar response, and increased capillary permeability resulting in edema; skin PO2 is decreased and CO2 increased. In this condition, capillary exchanges are altered and nutritional alterations eventually lead to skin lesions and ulcers. The aim of this randomized, placebo-controlled study was to evaluate the effect of local foot care and treatment with Essaven gel (EG) in 30 subjects with DM and neuropathy and localized, small (<0.5 cm in maximum diameter) ulcers treated with a single acute application of EG. Measurements of laser Doppler (LDF) flux, PO2 and PCO2 in standardized conditions showed positive microcirculatory changes (a significant decrease of the abnormally increased flux and CO2 while PO2 increased) in the active EG group lasting for at least 6 hours after application. Changes in the control group were not significant. In the placebo group variations were limited, mainly associated with skin manipulation and gel application. In conclusion, local treatment with one single standardized application of Essaven gel, in comparison with placebo, acutely improves the microcirculation in subjects with DM and small ulceration even with a single acute application. The microcirculatory changes are detectable even 10 hours after application.
Treatment of Superficial Vein Thrombophlebitis of the Arm with Essaven Gel
Authors: De Sanctis M.T. , Cesarone M.R. , Incandela L. , Belcaro G. , Griffin M.
Published: January 2017

The aim of this randomized, placebo-controlled study was to evaluate the effect of local treatment with Essaven gel (EG), in comparison with placebo and with a group of controls in 23 patients with superficial vein thrombophlebitis (SVTPH) of the arms. SVTPH was conse quent to infusional treatment with an intravenous catheter. The 4-week study evaluated the average skin temperature and an analogue symptomatic score. In patients treated with active EG, the decrease in score and in composite skin temperature was significantly larger than in the placebo and control groups. No intolerance was observed. The decrease in score and temperature in the placebo group was mainly due to skin manipulation and massage and to spontaneous resolution. In conclusion treatment with EG in arm SVTPH improves signs /symptoms and decreases skin temperature faster. This study confirms earlier observations on the effective, local use of EG in SVTPH.
Chronic Venous Insufficiency: The Genetic Influence
Authors: Pistorius Marc-Antoine
Published: January 2017

Many contributing factors are involved in the genesis of varicose disease of the lower limbs such as age, sex, heredity, sedentary life style among others. For physicians the decisive role played by heredity leaves no doubt. Few studies have, however, attempted to prove the impor tance of the hereditary factor on a clinical level, and no study has been conducted in molecular genetics. The impact of the hereditary factor is variably estimated and its nature is open to discussion. Despite the numerous limits of the research focusing on the hereditary aspect of varicose disease, the authors can nevertheless claim that the genetic factor definitively exists and has a great impact. There are few studies conducted among twins. The data collected in these studies point to the reality of various types of heredity. With the predominant impact of the hereditary factor, and despite the role played by environmental factors, it can be supposed that a single genetic anomaly may be the determining factor of the disease in a given family. Thus we have conducted an original study in order to identify one or several mutations predis posing to varicose disease, based on the approach called "reverse genetic" and linkage study. The study of a first family whose varicose disease segregates in an autosomal dominant manner allowed us to identify 3 potential loci, if we accept the hypothesis of 2 or 3 pheno copies. No candidate gene has been singled out in these regions in the first analysis. The study of a second family whose phenotype of the varicose disease is particularly homogeneous and segregates in an autosomal dominant manner did not confirm any of the previously identified loci, probably related to a genetic heterogeneity of the varicose disease. As a consequence, the second part of this study was devoted to determining the complete genotype of each indi vidual within this family, in order to identify new loci of interest. A potential locus has just been identified. The third part of this research, currently being pursued, is devoted to the sequencing of potential genes. In parallel, the analysis of new large families is underway. The presentation will include an update on the hereditary and genetic aspects of varicose disease, and secondly identify the limits and difficulties of the genetic study of the families.
The Influence of Environmental Factors in Chronic Venous Insufficiency
Authors: Jawien Arkadiusz
Published: January 2017

The present article focuses on the prevalence and risk factors for varicose veins and the severe stage of chronic venous insufficiency (CVI). The evaluation was made by reviewing the results of specific well-designed studies performed on the general population (case-control studies, cross-sectional studies, and large case series). Data from the literature were compared with the results of a recent multicenter cross-sectional study in Poland, in which 40,095 indi viduals from 803 registers of primary care physicians were clinically examined and assigned a clinical CEAP class. Analysis of the associations between varicose veins or severe CVI preva lence and factors that are usually considered as representing a risk for the development of CVI was performed. In Poland, a prevalence of varicose veins and severe CVI (skin changes, leg ulcer) similar to that observed in the other developed countries was reported. It was more common in women, but female sex was not found to be a strong risk factor. Among the risk factors most closely associated with CVI were age, family history of varicose veins, and consti pation, whatever the sex. This is in keeping with findings from recent epidemiologic studies. Obesity and lack of physical activity were strongly associated with CVI in women, more so than in men. The number of pregnancies (more than 2 pregnancies) significantly distinguished between women with and without CVI. Regarding these latter risk factors, the Polish results do not contradict the commonly held beliefs that are found in the literature. A modest asso ciation was found with female sex, previous injury in legs (DVT), and remaining in the standing position for a long time, although these parameters are usually among those mostly agreed as being risk factors. The role of the prolonged sitting position was not established. The Polish epidemiologic survey provided updated figures on the prevalence of and risk factors for varicose veins and severe CVI, using clear and globally accepted clinical definitions for the venous disease based on the CEAP classification.
From Skin Disorders to Venous Leg Ulcers: Pathophysiology and Efficacy of Daflon 500 mg in Ulcer Healing
Authors: Smith Philip D. Coleridge
Published: January 2017

The standard treatments for venous diseases of the lower limb include compression bandaging and stockings as well as surgical removal of varicose veins. There are a number of conditions in which these conventional treatments are ineffective, particularly in the management of leg ulceration. Drug treatments for healing venous leg ulcers have yet to be developed to the stage of good clinical efficacy, but these may assist in the management of patients. Flavonoid drugs have been widely used in the management of the symptoms of venous disease for many years and have recently been studied in some detail to assess their effects on the microcir culation. Work in animal models of ischemia-reperfusion show that MPFF (micronized purified flavonoid fraction) modulates leukocyte adhesion and prevents endothelial damage. Similar biochemical effects have been observed in patients with venous disease and may explain the efficacy of this drug in the management of edema and other symptoms of venous disease. There is clinical evidence that MPFF modifies venous leg ulcer healing.
Fifteen Years of Experience in Treating 2177 Episodes of Foot and Leg Lesions with the Circulator Boot
Authors: Dillon Richard S.
Published: January 2017

Objective. To determine the clinical effectiveness of the end-diastolic pneumatic compres sion boot and of local antibiotics in treating limb lesions associated with diabetes and peripheral arterial, venous, and neuropathic disease.

Research Design and Methods. Office and hospital data were kept over 15 years on 2177 episodes of leg problems classified by the Wagner method for 1514 legs of 1035 patients largely referred because of failure of standard therapies. The fate of the untreated legs served as a controls when possible.

Results. Healing or improvement of treated legs was seen above that in the literature in all Wagner categories and was significant (P < 0.001) compared to the "control" leg, which deteriorated in 38.7% of patients. Significant risk factors against a successful outcome included smoking, inability to walk, increased home distance from the boot center, loss to treatment, hemodialysis, a Wagner 4-5 classification, inoperable iliac occlusions, vascular procedures before or after referral for boot therapy, and an aggres- sive vascular surgeon. Neuropathy allowed successful treatment of lesions nondiabetic patients could not tolerate. Relapse was significantly more frequent in arteriosclerosis obliterans (ASO) patients with diabetes than without diabetes and in patients with neuropathy than in those with ASO. Diabetes did not affect the relapse rate in stasis disease. The overall percentage of legs having major amputations was low: 2.5% for diabetic legs at the initial treatment episode, 1.6% at the time of a relapse, and 4.1% after seeking treatment elsewhere. For nondiabetic patients, the respective risks were similar: 2.0%, 1.2%, and 2.9%.
Patient Assessment and Examples Patient Assessment and Examples of a Method of Treatment
Authors: Dillon Richard S.
Published: January 2017

Effective peripheral blood flow is positively related to cardiac output and gravity (part dependent) and inversely related to gravity (part elevated), venous pressure, interstitial fluid pressure, degree of peripheral neuropathy, arteriosclerotic and thrombotic arterial obstructions, and infection. These factors are considered in the operation of the end- diastolic pneumatic boot in the treatment of illustrative patients with lymphedema, venous stasis disease, peripheral arteriosclerosis obliterans, peripheral neuropathy, cellulitis, and osteomyelitis and the failing heart. A method of treatment that includes the use of the boot and the injection of local antibiotics is described.
Temporal Bone Studies of the Human Peripheral Vestibular System
Authors: Merchant Saumil N. , Tsuji Kojiro , Wall Conrad , Velázquez-Villaseñor Luis , Glynn Robert J. , Rauch Steven D.
Published: January 2017

Quantitative studies of the vestibular system with serially sectioned human temporal bones have been limited because of difficulty in distinguishing hair cells from supporting cells and type I from type II hair cells. In addition, there is only a limited amount of normative data available regarding vestibular hair cell counts in humans. In this study, archival temporal bone sections were examined by Nomarski (differential interference contrast) microscopy, which permitted visualization of the cuticular plate and stereociliary bundle so as to allow unambiguous identification of hair cells. The density of type I, type II, and total numbers of vestibular hair cells in each of the 5 sense organs was determined in a set of 67 normal temporal bones that ranged from birth through 100 years of age. The mean total densities at birth were 76 to 79 cells per 0.01 mm2 in the cristae, 68 cells per 0.01 mm2 in the utricle, and 61 cells per 0.01 mm2 in the saccule. The ratio of type I to type II hair cells at birth was 2.4:1 in the cristae and 1.3:1 in the maculae. There was a highly significant age-related decline in all sense organs for total, type I, and type II hair cell densities that was best fit by a linear regression model. The cristae lost type I cells with advancing age at a significantly greater rate than the maculae, whereas age-related losses for type II cells occurred at the same rate for all 5 sense organs. Hair cell densities in the cristae were significantly higher at the periphery than at the center. There were no significant sex or interaural differences for any of the counts. Mathematical models were developed to calculate the mean and 95% prediction intervals for the total, type I, and type II hair cell densities in each sense organ on the basis of age. There was overall good agreement between the hair cell densities determined in this study and those reported by others using surface preparation techniques. Our data and related models will serve as a normative database that will be useful for comparison to counts made from subjects with known vestibular disorders.
Temporal Bone Studies of the Human Peripheral Vestibular System
Authors: Tsuji Kojiro , Rauch Steven D. , Wall Conrad , Velázquez-Villaseñor Luis , Glynn Robert J. , Merchant Saumil N.
Published: January 2017

Quantitative assessments of vestibular hair cells and Scarpa's ganglion cells were performed on temporal bones from 24 patients with well-documented Meniere's disease. Of these, 18 had unilateral disease and 6 had bilateral disease. Vestibular hair cell counts were made in each of the 5 sense organs by Nomarski (differential interference contrast) microscopy. Hair cell counts were expressed as densities: number of cells per 0.01 mm2 surface area of the sensory epithelium. The results were compared with age- and sex-matched normal data. The type I hair cell densities for all vestibular sense organs were within the range for normative data. On the other hand, there was a significant loss (p < .01) of type II hair cells for all 3 cristae and both maculae. There was also a significant loss of Scarpa's ganglion cells (p < .001) when compared with normative data. The findings indicate a selective loss of type II hair cells and Scarpa's ganglion cells in Meniere's disease. These new observations have implications regarding the pathophysiological mechanism and clinical manifestations of Meniere's disease.
Ambulatory pH Monitoring Methodology
Authors: Postma Gregory N.
Published: January 2017

Twenty-four-hour ambulatory double-probe pH monitoring is the current “gold standard” for the evaluation of gastroesophageal and extraesophageal reflux. The following article seeks to characterize some of the areas of controversy and describes the methodology of ambulatory pH monitoring used at the Center for Voice Disorders of Wake Forest University.
Endoscopic Evaluation of Swallowing as an Alternative to 24-Hour pH Monitoring for Diagnosis of Extraesophageal Reflux
Authors: Aviv Jonathan E. , Fellowes Jennifer , Parides Michael , Close Lanny G.
Published: January 2017

Patients with symptoms of extraesophageal reflux may not be eager to undergo 24-hour pH probe monitoring for the sake of a definitive diagnosis. It has been anecdotally noted that extraesophageal reflux can be detected during an endoscopic swallowing evaluation. The purpose of this pilot study was to demonstrate that flexible endoscopic evaluation of swallowing with sensory testing (FEESST) can be implemented to identify and subsequently treat patients with extraesophageal reflux. Over a 6-month period, FEESST was prospectively performed in 20 healthy control subjects and in 20 patients with dysphagia. The dysphagic patients did not have a history of stroke or chronic neurologic disease. Attention was specifically directed toward noting the presence or absence of reflux into the laryngopharynx during the endoscopic swallowing evaluation. None of the control subjects were noted to have reflux during FEESST, but 18 of the 20 patients with dysphagia were found to have reflux during the evaluation; this difference was statistically significant (p < .001, Fisher's exact test). We conclude that FEESST is useful as a means of diagnosing extraesophageal reflux in patients with dysphagia.
Novel Intracochlear Electrode Positioner: Effects on Electrode Position
Authors: Yang Nathaniel W. , Hodges Annelle V. , Balkany Thomas J.
Published: January 2017

Spiral ganglion cells, located in the cochlear modiolus, are widely thought to be the neural elements stimulated by cochlear implants (CIs). Positioning CI electrodes adjacent to the modiolus may allow delivery of more focused, discrete fields of electrical stimulation, reducing both current requirements and the channel interaction associated with simultaneous stimulation. In order to provide greater consistency in positioning CI electrodes against the modiolus, Advanced Bionics Corporation has designed a silicone intracochlear positioner that is inserted alongside the electrode. Placed against the outer wall of the scala tympani, it directs the electrode array toward the modiolus. Five fresh-frozen temporal bones were studied to validate enhanced electrode placement. Electrode position was documented with image-enhanced digital fluoroscopy, and the distance to the modiolus was measured with computer-assisted morphometrics. The electrode positioner was highly effective in positioning the electrodes closer to the modiolus (p < .001).
Mastoiditis and Acute Otitis Media in Children with Cochlear Implants: Recommendations for Medical Management
Authors: Kempf Hans-Georg , Stöver Timo , Lenarz Thomas
Published: January 2017

Acute otitis media (OM) or mastoiditis is a very dangerous condition for the ear after cochlear implantation. However, acute OM is very common in childhood and can occasionally occur in an implanted ear. Most cases of acute OM can be successfully treated with intravenous high-dosage antibiotics. In cases of mastoiditis and clinical signs of mastoid abscess, retroauricular drainage is necessary to prevent infection of the implant bed. In a series of 366 children given implants (1 to 14 years), acute OM occurred in 5.6% during a follow-up period of 1 to 8 years. Seven ears had to be opened by means of myringotomy. Five ears were opened by retroauricular incision with mastoid revision on the implanted side. Adenoidectomy and use of ventilation tubes before cochlear implantation, as well as careful subtotal mastoidectomy during the implantation, can reduce the incidence of acute OM in children after implantation. Early and subsequent treatment with operative mastoid drainage can prevent implant loss and should be performed at the implantation center.
Relative Importance of Rate and Place: Experiments Using Pitch Scaling Techniques with Cochlear Implant Recipients
Authors: Fearn Robert , Wolfe Joe
Published: January 2017

Pitch scaling was used to determine the dependence of perceived pitch on rate and place of stimulation in postlingually deafened adult subjects using cochlear implants. For stimulation rates below about 500 pulses per second (pps), perceived pitch is a strong function of both rate and place. In this range, perceived pitch increases logarithmically with stimulation rate, but decreases with distance from the round window. A 2-mm displacement into the cochlea has an effect similar to that of halving the stimulation rate. Place resolution in this context is comparable with the interelectrode spacing (0.75 mm). At rates approaching 1,000 pps, rate has little effect on perceived pitch. An average of bipolar quality judgments showed that periodic pulsatile stimulation is least pleasant when low frequencies are applied to the region closest to the window.
Changes in Stimulation Levels over Time in Nucleus 22 Cochlear Implant Users
Authors: Butts Stacy L. , Hodges Annelle V. , Dolan-Ash Shelly , Balkany Thomas J.
Published: January 2017

The purpose of this study was to evaluate changes that occur over time in the electrical stimulation levels of cochlear implant users. A retrospective review of program summaries for 26 postlingually deafened adult Nucleus cochlear implant users was completed. Program summaries were used to assess changes in electrical stimulation at threshold (T) and maximum comfort (C) levels. Comparisons were made at intervals including the subject's initial stimulation and 2-week, 3-month, 6-month, 1-year, and most recent programming sessions. Five patients had 5 years or more of implant use; 8 patients had 3 to 5 years or more of implant use; and the remainder had been using their implant for 2 to 3 years. No patient with less than 2 years of implant use was included. Results indicated that changes in stimulation levels occur gradually over time. Although the changes in stimulation levels from one programming session to the next were not significant, the changes in current requirements for both T and C levels were found to be significant when we compared the 6-month and most recent programming intervals.
Maturation of Human Auditory Cortex: Implications for Speech Perception
Authors: Moore Jean K.
Published: January 2017

This project traced the maturation of the human auditory cortex from midgestation to young adulthood, using immunostaining of axonal neurofilaments to determine the time of onset of rapid conduction. The study identified 3 developmental periods, each characterized by maturation of a different axonal system. During the perinatal period (3rd trimester to 4th postnatal month), neurofilament expression occurs only in axons of the marginal layer. These axons drive the structural and functional development of cells in the deeper cortical layers, but do not relay external stimuli. In early childhood (6 months to 5 years), maturing thalamocortical afferents to the deeper cortical layers are the first source of input to the auditory cortex from lower levels of the auditory system. During later childhood (5 to 12 years), maturation of commissural and association axons in the superficial cortical layers allows communication between different subdivisions of the auditory cortex, thus forming a basis for more complex cortical processing of auditory stimuli.
Multiple Auditory Steady-State Responses
Authors: Picton Terence W. , Dimitrijevic Andrew , John M. Sasha
Published: January 2017

Steady-state responses are evoked potentials that maintain a stable frequency content over time. In the frequency domain, responses to rapidly presented stimuli show a spectrum with peaks at the rate of stimulation and its harmonics. Auditory steady-state responses can be reliably evoked by tones that have been amplitude-modulated at rates between 75 and 110 Hz. These responses show great promise for objective audiometry, because they can be readily recorded in infants and are unaffected by sleep. Responses to multiple tones presented simultaneously can be independently assessed if each tone is modulated at a different modulation frequency. This ability makes it possible to estimate thresholds at several audiometric frequencies in both ears at the same time. Because amplitude-modulated tones are not significantly distorted by free-field speakers or microphones, they can also be used to evaluate the performance of hearing aids. Responses to amplitude and frequency modulation may also become helpful in assessing suprathreshold auditory processes, such as those necessary for speech perception.
Electrical Stimulation of the Auditory Nerve via Cochlear Implants in Patients with Auditory Neuropathy
Authors: Sininger Yvonne S. , Trautwein Patricia
Published: January 2017

Auditory neuropathy (AN) is a term used to describe an auditory disorder in which there is evidence of normal outer hair cell function (otoacoustic emissions and/or cochlear microphonics) and poor function of the auditory nerve (absent or highly distorted auditory brain stem response starting with wave I). Many of these patients have evidence of generalized peripheral nerve disease, leading to an assumption that the peripheral portion of the auditory nerve is the most likely site of lesion. A small group of these patients has received cochlear implants, and the majority of them achieve average to above-average performance. Although this outcome may seem incongruous with neural disease, average performance by patients with AN may be a result of the reintroduction of neural synchrony by electrical stimulation and/or the fact that most deaf patients have poor nerve survival. Although cochlear implants are promising for deaf patients with AN, more study of the disorder is needed.