bluuebunny/crossref_metadata_2025 huggingface dataset:
Purtscher Retinopathy: To Treat or Not to Treat?
Authors: Gil Pedro , Pires Joana , Costa Esmeralda , Matos Rita , Cardoso Mariana Sá , Mariano Manuel
Published: May 2015

Purpose

To report a case of Purtscher retinopathy and its therapeutic approach.

Methods

In this observational case report, complete ophthalmologic examination was performed, including best-corrected visual acuity (BCVA) testing, slit-lamp biomicroscopy, dilated fundus examination, spectral-domain optical coherence tomography (OCT), fluorescein angiography (FA), and Humphrey 24–2 visual field testing.

Results

The patient complained of right eye diminished visual acuity 48 hours after a car accident, with severe thoracic and abdominal blunt trauma but no direct ocular trauma. The BCVA was counting fingers at 1 meter, anterior segment examination was unremarkable, and the fundus showed cotton-wool spots and Purtscher flecken. Macular OCT revealed subretinal fluid with neurosensorial retinal detachment. The FA showed peripapillary and parafoveal leakage and visual field testing presented a central scotoma. We opted for an observation-only approach. Follow-up revealed a progressive reabsorption of the subretinal fluid with complete resolution of the macular neurosensorial retinal detachment after 2 weeks. After 2 months of follow-up, BCVA was 20/25 and the OCT revealed atrophic changes, with no subretinal fluid. The favorable outcome in terms of BCVA persisted at 4 and 6 months follow-up, although the central scotoma did not improve significantly.

Conclusions

The characterization of both acute and late-stage lesions provides a valuable insight to a better characterization of this rare disease. Despite a favorable response with a conservative therapeutic approach, structural and functional late stage sequelae influence the final visual outcome.
Vogt-Koyanagi-Harada Disease after Stapedotomy
Authors: Accorinti Massimo , Gilardi Marta , Nardella Chiara , Amorelli Giulia Maria , Pesci Francesca Romana
Published: May 2015

Purpose

To report on Vogt-Koyanagi-Harada disease that occurred after stapedotomy.

Methods

Case report.

Results

A 46-year-old woman developed bilateral choroiditis, papillitis, and serous retinal detachment 10 days after an uneventful surgical stapedotomy. The diagnosis was confirmed on the basis of the clinical features, fundus fluorescein angiography and optical coherence tomography findings, and a clinical course with subsequent involvement of the anterior segment, uveitis relapses with serous retinal detachment, and negative laboratory work-up for uveitis.

Conclusions

Vogt-Koyanagi-Harada disease may appear after an uneventful surgical intervention of stapedotomy, suggesting that surgical trauma in the inner ear, a melanocyte-containing organ, may induce an inflammatory response within the eye.
Multimodality Imaging of Retinal Astrocytoma
Authors: Semenova Ekaterina , Veronese Chiara , Ciardella Antonio , Marcheggiani Eleonora Benedetta , Shah Sabah , De-Pablo-Gomez-de-Liaño Lucia , Finger Paul T.
Published: May 2015

Purpose

Cross-characterization of retinal astrocytomas (RA) using ocular diagnostic imaging techniques.

Methods

Fundus photography, fluorescein angiography, optical coherence tomography, fundus autofluorescence images, and ultrasonography were used to define characteristics of RA.

Results

Thirteen patients had sporadic RA and 12 had tuberous sclerosis. Of the latter, 1 patient had multiple (n = 14), bilateral tumors and was excluded so as not to skew the analysis. Of those patients with a solitary RA, 63% were juxtapapillary. All were white to yellow. A mulberry-shaped surface was observed in 33%. Fluorescein angiography revealed intrinsic tumor vessels and late diffuse tumor staining in 42%. Optical coherence tomography revealed cells spreading from the tumor surface into the vitreous (75%), intraretinal fluid (25%), and multiple, ovoid hypolucencies within the tumor stroma (54%). Fundus autofluorescent imaging revealed that hypolucencies were hyperautofluorescent and solid tumor stroma appeared hypoautofluorescent. B-scan imaging revealed moderate to high internal tumor reflectivity (100%) with orbital shadowing (46%). Optical coherence tomography revealed a mean tumor thickness of 0.8 mm. Ultrasound imaging showed a mean thickness of 1.4 mm (range 1.0–1.7). Of the 21 patients subsequently followed in our centers, no tumor growth was noted (mean 54 months, range 1–96).

Conclusions

This study reveals unique characteristics of RA and suggests that RA were most commonly amelanotic, moderate to high echoic, ≤1.7 mm in thickness, near the optic disc, and nonprogressive. When observed, a mulberry-shaped surface was pathognomonic.
Long-Term Result of Mosaicplasty for Femoral Head Osteochondral Lesion: A Case Report with 8 Years Follow-up
Authors: Kılıçoğlu Önder İsmet , Polat Gökhan , Erşen Ali , Birişik Fevzi
Published: May 2015

Purpose

Treatment of the chondral lesions of the hip joint is problematic due to its deep anatomy and complex biomechanical demands. The purpose of the study is to present the long-term result of a deep, large femoral head cartilage defect treated successfully with surgical safe dislocation of the hip and autologous osteochondral grafting.

Methods

A 27-year-old male patient was admitted to our clinic with left hip pain. On assessment, a large femoral head osteochondral defect was detected in his left hip. An open safe hip dislocation and autologous osteochondral grafting was performed due to the large size of the lesion and subchondral bone involvement.

Results

Using a Kocher-Langenbeck incision, the hip was dislocated after a trochanteric flip osteotomy. The defect was reconstructed with 3 × 13 mm and 1 × 11 mm osteochondral plug from the ipsilateral knee. We have not encountered any complication at the postoperative period. After 8 years follow-up his left hip range of motion was preserved and The Harris Hip Score was qualified as excellent with 96 points.

Conclusions

Chondral defects of the femoral head are still a challenging problem in orthopaedic practice. Mosaicplasty of the femoral head is a demanding procedure with safe dislocation of the hip. However, if successful it can provide satisfactory functional and radiological results in the long-term.
An Implication of Relationship between Tuberculosis and Primary Nephrotic Syndrome
Authors: Li Shu , Zhang Min , Chen Lina , Wang Zheng
Published: May 2015

Purpose

There have been few observations on the concurrence of tuberculosis (TB) and primary nephrotic syndrome (PNS). We try to define their relationship from multiple aspects.

Methods

Patients with PNS (n = 386), secondary nephrotic syndrome (SNS, n = 60), pneumonia (n = 196), and TB (n = 156) were enrolled. Through a novel evaluation system, the evidence of TB infection (clinical, laboratory, and radiographic evidence) was classified into 5 levels: lack of evidence (level 0), mild-to-moderate evidence (level 1–2), strong evidence (level 3–4). Additionally, whether TB infection was primary or secondary to long-term steroid therapy for PNS was recorded.

Results

Through the evaluation system, 42.24% (68/161) of PNS inpatients had evidence of TB level 1–4, more than those in SNS (23.33%, P = .788) or pneumonia (22.45%, P = .004); 9.32% (15/161) PNS inpatients had evidence of level 3–4, who should be considered as having TB; 13 of the 15 patients had TB before the onset of PNS; 61.75%(96/153) PNS inpatients were abnormal on chest imaging. In the TB group, 28.21% (44/156) patients had abnormal urinalysis, more than those in the pneumonia group (8.16%, 16/196, P<0.001). TB-related symptoms were seldom seen in PNS inpatients (cough 26.1%, fever 6.8%; night sweats, fatigue, and weight loss were negative).

Conclusions

Around 10% of PNS in children has an association with TB infection that preceded the onset of PNS.
Ultrasound Evaluation of Saphenous Vein for Peripheral Intravenous Cannulation in Adults
Authors: Jones Travis , Stea Nicholas , Stolz Uwe , Adhikari Srikar
Published: May 2015

Objectives

The objective of this study was to investigate variables that may affect sonographic cannulation of great saphenous vein and determine the ideal location for ultrasound-guided saphenous vein cannulation in adult emergency department (ED) patients.

Methods

A prospective observational study at an academic ED. The great saphenous vein was identified in adult subjects at three distinct sites after placing the tourniquet proximal to the vein: the ankle, mid-calf, and below the knee using a 10-5 MHz linear transducer. The depth of the saphenous vein from the skin surface and its diameter were measured in supine and reverse trendelenburg positions in both extremities.

Results

A total of 60 subjects (male 30, female 30) were enrolled in the study. The median age of the patients was 50.5 years [interquartile range (IQR) 34.5-67.5]. The median body mass index (BMI) was 27.3 (IQR, 24.2-31.8). The great saphenous vein was significantly superficial in location at the ankle level compared with the calf (p<0.001), knee (p<0.001), and left side compared with the right (p<0.001). The subject position was not significantly related to saphenous vein depth (p = 0.68). The saphenous vein diameter was significantly larger in the left lower extremity than the right side (p = 0.007), and at the ankle level compared with the calf (p<0.001) and knee (p<0.001). The diameter of the vein increased significantly when patient's position changed from supine to reverse Trendelenburg (p<0.001).

Conclusions

Our results support ultrasound evaluation of the course of great saphenous vein from the ankle to the knee for the selection of appropriate venipuncture site and cannulation.
Peroperative Electrocardiographic Control of Catheter Tip Position during Implantation of Femoral Venous Ports
Authors: Gibault Pierre , Desruennes Eric , Bourgain Jean-Louis
Published: May 2015

Purpose

Electrocardiographic (ECG) guidance has been shown to be as effective than fluoroscopy to position the tip of central venous devices close to the superior vena cava (SVC)–right atrium (RA) junction. When SVC access is contraindicated, a femoral access may be used. The aim of this prospective study is to evaluate the effectiveness of ECG guidance to position the tip of femoral ports at inferior vena cava (IVC)–RA junction.

Methods

Inclusion criterion was the need for femoral port implantation. After insertion of the dilator in the femoral vein, the catheter with the guide wire inside was introduced and the ECG signal collected at the tip of the guide (Celsite™ ECG, B. Braun, Germany) or via saline injected in the catheter (Nautilus™, Perouse, France). Fluoroscopy was performed at each change of the P-wave from IVC to RA. A final X-ray was performed after withdrawing the catheter 2 cm below the first P-wave change.

Results

A total of 18 patients were included between December 2011 and June 2013. The P-wave was most often negative in IVC, biphasic when the catheter entered RA and giant and positive at the top of RA. When the catheter was withdraw 2 cm below the first biphasic P-wave the tip was just below the IVC–RA junction in 17 patients. In one patient P-wave changes were not significant and the final position was adjusted under fluoroscopy.

Conclusions

ECG guidance is effective to assess catheter tip position during femoral port placement and avoids the need for radiological methods.
Innominate Vein Stenosis in Breast Cancer Patients after Totally Implantable Venous Access Port Placement
Authors: Song Myung Gyu , Seo Tae-Seok , Kang Eun Young , Yong Hwan Seok , Seo Jae Hong , Choi Yoon Young
Published: May 2015

Purpose

To evaluate the risk factors for central vein stenosis after placement of the totally implantable venous access ports (TIVPs) and the clinical relevance of this condition in breast cancer patients.

Materials and methods

TIVPs were placed in 191 women with breast cancer via the internal jugular vein (IJV) from January 2009 to December 2012 (mean age, 51.42 years) by left-side ( n = 102) and right-side ( n = 89) approaches. Medical records were retrospectively reviewed. The presence of significant central vein stenosis, tip location of the catheter and retrosternal space were evaluated on chest computed tomography images. Statistical analysis was performed.

Results

Central vein stenosis developed in 1 and 14 patients after placement via the right and left IJV, respectively. Differences in the cumulative incidence of central vein stenosis were statistically significant between left- and right-side approach groups (log rank test p-value: 0.009). In Cox regression analysis, the hazard ratio for central vein stenosis was 9.441 (p = 0.031) in the left-side approach. The distance between the sternum and the left innominate vein was found to be significantly and independently related to the development of central vein stenosis (p = 0.026). The hazard ratio of distances between the sternum and left innominate vein <16 mm was 10.133 (1.319-77.841).

Conclusions

The incidence of central vein stenosis in breast cancer patients was higher after placement of TIVPs via the left IJV. When left-side TIVP placement is required in a patient with right-side breast cancer, the possibilities of left innominate vein stenosis should be considered.
The Stuck Catheter: A Hazardous Twist to the Meaning of Permanent Catheters
Authors: Vellanki Venkat Sainaresh , Watson Diane , Rajan Dheeraj K. , Bhola Cynthia B. , Lok Charmaine E.
Published: May 2015

Introduction

Permanent central venous catheter use is associated with significant complications that often require their timely removal. An uncommon complication is resistant removal of the catheter due to adherence of the catheter to the vessel wall. This occasionally mandates invasive interventions for removal. The aim of this study is to describe the occurrence of this “stuck catheter” phenomenon and its consequences.

Methods

A retrospective review of all the removed tunneled hemodialysis catheters from July 2005 to December 2014 at a single academic-based hemodialysis center to determine the incidence of stuck catheters. Data were retrieved from a prospectively maintained computerized vascular access database and verified manually against patient charts.

Results

In our retrospective review of tunneled hemodialysis catheters spanning close to a decade, we found that 19 (0.92%) of catheters were retained, requiring endovascular intervention or open sternotomy. Of these, three could not be removed, with one patient succumbing to catheter-related infection. Longer catheter vintage appeared to be associated with ‘stuck catheter’.

Conclusions

Retention of tunneled central venous catheters is a rare but important complication of prolonged tunneled catheter use that nephrologists should be aware of. Endoluminal balloon dilatation procedures are the initial approach, but surgical intervention may be necessary.
Clinical Implications of Serum Hypoxia Inducible Factor-1α and Vascular Endothelial Growth Factor in Lung Cancer
Authors: Shen Hong , Feng Ganzhu , Cui Jin , Du Qiang , Qin Yong , Cai Jiankang , Shen Li , Zhu Yina
Published: May 2015

Aims and background

Hypoxia inducible factor 1α (HIF-1α) and vascular endothelial growth factor (VEGF) have been deemed as key in angiogenesis of lung cancer. The aim of this study was to investigate diagnostic and prognostic values of HIF-1α and VEGF in patients with lung cancer.

Methods

From May 1, 2011, to April 20, 2014, blood samples and/or pleural effusions were collected from 100 patients with lung cancer, 18 patients with tuberculosis, 47 patients with community-acquired pneumonia, and 29 healthy controls. The pretreatment levels of HIF-1α and VEGF were measured by enzyme-linked immunoassays. Patients with lung cancer were followed up during the period of this study and survival times were recorded for analysis.

Results

We detected that the levels of serum and pleural HIF-1α in lung cancer were significantly higher than those in the tuberculosis population, and that the VEGF expressions were not significantly different between malignancy and benign diseases. An area under the curve of pleural HIF-1α (0.877 ± 0.053) showed a high ability to differentiate lung cancer from benign diseases. The significant negative predictors of survival in the univariate analysis were performance status (>1), no anticancer therapy, low serum albumin, advanced stage, and serum high level of VEGF (>324.17 pg/mL), while in the multivariate Cox regression analysis, only the pretreatment serum level of VEGF, stage, and anticancer therapy were identified as independent prognostic factors.

Conclusions

The overexpression of HIF-1α especially in pleural effusion may be an angiogenic factor for distinguishing malignancy from tuberculosis, and the pretreatment level of serum VEGF may be an independent predictor of survival.
Inflammatory Pseudotumor (IPT) and Inflammatory Myofibroblastic Tumor (IMT): A Representative Literature Review Occasioned by a Rare IMT of the Transverse Colon in a 9-year-old Child
Authors: Höhne Sven , Milzsch Monika , Adams Johannes , Kunze Christian , Finke Rainer
Published: May 2015

Aims and Background

Inflammatory pseudotumor (IPT) and inflammatory myofibroblastic tumor (IMT) represent different entities. However, it is only in recent years that this has been taken into increasing consideration. Some authors still use both terms synonymously or interchangeably. Inflammatory myofibroblastic tumor is a real neoplasm because of the proliferation of myofibroblastic cells. Inflammatory pseudotumor is a more inflammatory reactive or regenerative entity and shows an overlapping with immunoglobulin G4-related disease.

Methods and Study Design

To analyze the current situation, 443 publications from the last 5 years (2009 to February 2014) were included. Reports involved 938 patients and 956 organ sites. The age distribution is twin peaked with one maximum in childhood and the other between 50 and 60 years of age. This distribution is questionable due to the more frequent occurrence of IPT in the liver and of IMT in the lung. Inflammatory pseudotumors mainly occur in older patients; IMTs in children and young adults.

Results and Conclusions

The liver and biliary tract were the most commonly affected of all body regions, at 32%. This was followed by the lung, including the respiratory tract, at 27%, and by the gastrointestinal tract, at 10%. Lesions of the large bowel, as in the present case of a 9-year-old boy, are very rare. There were organ-related as well as nonspecific clinical symptoms, such as fever, weight loss, and fatigue. Laboratory test results revealed anemia and elevated inflammation-dependent parameters. The patterns in medical imaging are variable and nonspecific. Morphology often suggests a malignant process. For this reason, therapy in most cases is surgical, but this is required more often in IMTs. Many IPTs could be treated conservatively.
A new look at an old case: An auto-anti-P with pseudo-LKE activity
Authors: Cooling Laura
Published: May 2015

Aims: LKE is a high-incidence, minor RBC glycosphingolipid, related to both Pk and P antigens. Approximately 1% individuals are LKE-negative. However, antibodies against LKE are rare, with only six cases mentioned in literature. Past examples of anti-LKE have relied on serologic testing, with no direct testing against RBC glycosphingolipid (GSL). To test a historical 'anti-LKE' against a panel of RBC and glycosphingolipid standards by high performance thin layer chromatography and standard serology. Methods: Serum samples included human polyclonal anti-LKE, alloanti-P, alloanti-PP1Pk and untransfused controls. Hemagglutination was performed by gel method with ficin-treated RBC of known LKE, P and P1 phenotype. P antigen expression was determined by titration with a well characterized alloanti-P. Antibody specificity was determined by incubating serum against glycosphingolipids on high performance thin layer chromatography plates. Results: The patient's serum reacted with most LKE+ RBC but not ficin-treated p, Pk, or LKE-negative donors, consistent with an anti-LKE. However, on direct testing, the patient's antibody failed to recognize monosialogalactosylgloboside, the LKE antigen. The patient's serum did recognize globoside (P) antigen. This was confirmed by hemagglutination, which showed a correlation between LKE phenotype, P antigen expression and serum reactivity. The patient's weak auto-anti-P was not inhibited by solubilized globoside. Conclusion: This historical anti-LKE is an auto-anti-P with 'pseudo-LKE' activity due to differences in P antigen expression between LKE+ and LKE-donors.
Improving care in surgery – a qualitative study of managers’ experiences of implementing evidence-based practice in the operating room
Authors: Erichsen Andersson Annette , Gifford Wendy , Nilsson Kerstin
Published: May 2015

Background: More knowledge is needed on the preconditions and circumstances for leading implementation of evidence based practice in the operating room (OR). Effective leadership support is critical to enhance the provision of safer care. The aim of this study was to explore managers’ and clinical leaders’ experiences of implementing evidence-based practice to increase patient safety in the operating room.Methods: The study had a qualitative descriptive design. In all, 25 managers were interviewed, with different surgical specialities (orthopedics, general and pediatric surgery) and operating room suites, from eight hospitals and 15 departments.Results: The organizational structures were defined as key obstacles to implementation. Specifically, lack of a common platform for cooperation between managers from different departments, organizational levels and professional groups impeded the alignment of shared goals and directions. In cases where implementation was successful, well-functioning and supportive relationships between the managers from different professions and levels were crucial along with a strong sense of ownership and control over the implementation process. Whilst managers expressed the conviction that safety was an important issue that was supported by top management, the goal was usually to “get through” as many operations as possible. This created conflicts between either prioritizing implementation of safety measures or production goals, which sometimes led to decisions that were counter to evidence-based practice (EBP). While evidence was considered crucial in all implementation efforts, it might be neglected and mistrusted if hierarchical boundaries between professional subgroups were challenged, or if it concerned preventive innovations as opposed to technical innovations.Conclusions: The preconditions for implementing EBP in the OR are suboptimal; thus addressing leadership, organizational and interprofessional barriers are of vital importance.
Prevalência sorológica e intensidade da resposta humoral entre indivíduos infectados com Vírus da Hepatite C
Authors: Leitemperguer Michele Rodrigues , Beck Sandra Trevisan
Published: May 2015

A infecção crônica pelo vírus da Hepatite C (HCV) é considerada grave, podendo progredir para cirrose e descompensação hepática. Objetivos: Verificar a prevalência da infecção pelo HCV entre os indivíduos triados, entre setembro de 2007 e setembro de 2009 determinando a correlação dos níveis séricos de anticorpos com presença do RNA viral. Métodos: Os resultados sorológicos da pesquisa de anticorpos anti HCV pelo método imunoenzimático ELISA (BioMérieux®) de 4536 indivíduos foram analisados retrospectivamente. O resultado da pesquisa molecular (COBAS AMPLICOR HCV Roche Diagnostics®) de 79 pacientes foi obtido através de registros médicos, sendo os genótipos 1 e 3 os mais frequentes. A probabilidade do resultado sorológico estar relacionado com a pesquisa molecular foi verificada através de curva ROC, construída para diferentes valores de Índex (DO amostra/DO ponto de corte do ELISA). Resultados: Das amostras para as quais foi realizado o teste molecular, 82,3% confirmaram presença de RNA HCV. Os Valores preditivos positivos (VPP) e Valores preditivos negativos (VPN) para presença de viremia, considerando valores de Índex 4,0 3,0 e 2,0 foram: para Índex 4,0 sensibilidade (S) de 62%, especificidade (E) 64%, VPP de 89%, VPN de 27%. Para Índex 3,0 S=93,0%; E=36,0%, VPP 87%, VPN 55%. Para Índex 2,0 S=100%, E=21%, VPP 85%; VPN 100%. Conclusão: Pode-se inferir que há grande probabilidade de pacientes com reação sorológica para pesquisa de anti-HCV reagente e Índex menor que 2,0, terem suprimido a infecção pelo HCV, e com Índex superior a 4,0 apresentarem viremia presente.
Promoção da saúde do trabalhador: análise das ações propostas por concluintes de um curso de capacitação (2012)
Authors: Bertusso Francielle , De Carvalho Manoela , Furtado Marcelo de Souza , Murofuse Neide Tiemi
Published: May 2015

A incorporação do conhecimento do trabalhador nas ações de promoção e prevenção da saúde pode potencializar a luta por melhores condições de trabalho e a defesa da saúde do trabalhador. Este estudo bibliográfico teve como objetivo analisar, a partir do referencial teórico da saúde do trabalhador, as ações propostas pelos concluintes de um curso de capacitação para a promoção da saúde do trabalhador da saúde, em 2012. Do total de 221 projetos analisados, os trabalhadores de saúde constituíram o público-alvo prioritário (84%), além dos gestores (12%), oriundos de várias regiões do país com predomínio das propostas das regiões sudeste (107 projetos) e nordeste (55 projetos), e com atuação em diversos locais de trabalho. As propostas de intervenção intentaram resolver ou minimizar três conjuntos de problemas: a) relacionados ao ambiente de trabalho, b) a gestão do trabalho e c) a saúde do trabalhador. A análise das propostas apontou para uma realidade de trabalho permeada por ocorrência de acidentes de trabalho por exposição a material biológico, perfurocortante, radiação ionizante e de agravos relacionados a sobrecarga osteomuscular, relacionados a saúde mental como o transtorno mental e comportamental, depressão, alcoolismo além de estresse, burnout e assédio moral. Entre as ações de enfrentamento constatou-se a presença significativa de propostas conformadas nos moldes das abordagens tradicionais da saúde e segurança no trabalho, junto com outras sustentadas nos pressupostos do campo da Saúde do Trabalhador. Considerando o referencial do campo da saúde do trabalhador, conclui-se que permanece o desafio pela superação da abordagem das relações trabalho e saúde-doença fundamentado na ideia cartesiana do corpo como máquina, vinculado à medicina do trabalho e saúde ocupacional, cujas propostas sugerem a supressão de agentes/fatores de risco ambiental como meio de promover a saúde no trabalho.
Redução da proteína bruta em rações sobre os balanços metabólicos de suínos mantidos em diferentes condições térmicas
Authors: Freitag Debora Cristiane , Klosowski Élcio Silvério , Pozza Paulo Cesar , Oliveira Aparecida da Costa , Tsutsumi Claudio Yuji , Nunes Ricardo Vianna , Sangali Cleiton Pagliari
Published: May 2015

O objetivo deste trabalho foi avaliar a redução da proteína bruta em rações sobre o balanço de nitrogênio, pH urinário e parâmetros sanguíneos de suínos na fase inicial. O peso médio inicial dos animais foi de 18,5 ± 0,73kg. Foram realizados dois experimentos de digestibilidade, sendo um em condições de ambiente de estresse (28,77?C) e outro conforto térmico (18,13?C). Em ambos os experimentos os animais foram distribuídos em um delineamento experimental de blocos ao acaso com quatro níveis de proteína bruta (20,5; 19,4; 18,3 e 17,2%) e quatro repetições, totalizando 16 unidades experimentais em cada experimento, sendo cada uma representada por um animal, totalizando 32 animais. A metodologia utilizada foi a coleta total de fezes, e a urina coletada e filtrada diariamente. Para avaliar os parâmetros sanguíneos, as amostras foram obtidas mediante punção na veia jugular. Os parâmetros avaliados foram nitrogênio ingerido, excretado nas fezes e na urina, absorvido, retido, retido/absorvido, excreção total, utilização líquida de proteína, pH da urina, colesterol, triglicerídeos, glicose, uréia e creatinina no plasma sanguíneo. Conclui-se que a redução do nível de proteína da dieta, de 20,5 a 17,2%; é uma alternativa eficiente para reduzir a quantidade de nitrogênio excretado pelos suínos em condição de estresse térmico. Para condição de conforto térmico os suínos apresentaram maiores concentrações de creatinina e colesterol plasmático.
Acadêmicos, a percepção sobre o papilomavírus humano e sua relação com o câncer cervical
Authors: Luz Nara Nyely Noronha , Lustosa Ítalo Rosal , Machado Kátia da Conceição , Pacheco Ana Carolina Landim , Peron Ana Paula , Ferreira Paulo Michel Pinheiro
Published: May 2015

Este trabalho avaliou o conhecimento dos alunos do Curso de Ciências Biológicas da Universidade Federal do Piauí, Campus Senador Helvídio Nunes de Barros sobre o Papilomavírus Humano (HPV). A maioria dos estudantes universitários (n=218) eram do sexo feminino (78%), com idade entre 17 e 34 anos (60%), onde 84% eram solteiros e com renda familiar entre 2-5 salários mínimos (64%). A partir dos resultados, verificou-se que 87% conhecem o HPV, 83% o consideram como uma DST, 68% acreditam que tanto o homem quanto a mulher pode transmitir e se infectar pelo HPV, 48% acreditam na possibilidade de transmissão vertical, 35% consideram que o HPV possa infectar genitálias, cabeça e pescoço, 60% dos universitários responderam que o exame laboratorial utilizado para a prevenção e detecção inicial da infecção é o Papanicolau. Em relação aos fatores de risco, 64% afirmaram ter vida sexual ativa, 50% iniciaram sua vida sexual entre 13 e 17 anos, 44% usam preservativo durante relações sexuais, 63% consomem bebidas alcoólicas e 94% não fumam. A maioria afirmou (64%) não existir vacina contra o HPV, 52% acreditam em uma relação entre o HPV e o câncer de colo uterino e 97% gostariam de ler mais informações sobre o HPV. Assim, verificou-se que os alunos universitários revelaram conhecimento primário sobre o HPV e sobre formas de prevenção da doença. No entanto, quase a metade dos entrevistados desconhece a gravidade da infecção ocasionada por HPV como causa elementar para o surgimento de cânceres de colo uterino.
Thrombozytenzerstörung bei ITP
Authors: Sachs Ulrich , Bakchoul Tamam
Published: May 2015

Die Immunthrombozytopenie (ITP) ist eine autoimmun bedingte Blutungsstörung, die durch isolierte Thrombozytopenie charakterisierte ist. Vermutlich ist die gestörte Bildung von autoreaktiven T-Zellen bei ITP Patienten für den Verlust der Selbsttoleranz gegenüber Plättchenantigenen verantwortlich. Bei ITPPatienten rufen autoreaktive T-Zellen eine unkontrollierte Proliferation von Autoantikörper bildenden B-Zellen hervor, die zu anhal-tender Autoimmunität gegen Plättchen führen. Die Autoimmunantwort bei ITP führt zu einer gesteigerten Plättchenzerstörung durch Antikörper vermittelte Phagozytose, Komplementaktivierung sowie durch T-Zell vermittelte Zytotoxizität. Zur Pathophysiologie der ITP tragen auch Anomalien in der Thrombopoese und eine durch Antikörper oder T-Zellen vermittelte Hemmung oder Zerstörung der Megakaryozyten bei. Diese Variabilität der Dysfunktionen der Effektorzellen könnte zur Heterogenität der klinischen Manifestation beitragen, aber auch zum Erfolg oder Versagen der Therapieverfahren. Das Verständnis der ITP-Pathomechanismen hilft, diagnostische und therapeutische Strategien zu optimieren.
Pursuing the Best Interest of Children in Non-Traditional Families
Authors: Amram Denise
Published: May 2015

Pursuing the Best Interest of Children in Non-Traditional Families: A Comparative Overview

The need to build a legal paradigm corresponding to the current evolution of society is one of the most important challenges that family lawyers are facing in the last years. In this regard, this paper illustrates the new Italian, French, and Irish reforms aimed at pursuing the best interest of the child within non-traditional families.
Out of the Box? Domestic and Private International Law Aspects of Gender Registration
Authors: van den Brink Marjolein , Reuß Philipp , Tigchelaar Jet
Published: May 2015

Out of the Box? Domestic and Private International Law Aspects of Gender Registration: A Comparative Analysis of Germany and the Netherlands

The legal regulation of gender identity seems to be in a state of flux. This paper compares the German and Dutch legal systems with regard to the registration of a person’s sex, focusing on the possibility in both countries not to register a baby’s sex until it can be clearly determined. In both systems, it has thus become possible that a person has no specified gender for a considerable period of time. These persons may encounter various kinds of legal problems, since the two jurisdictions have not been adapted to accommodate them. In addition, two potential problems regarding private international law issues are discussed.
Child Participation in Family Law Matters Affecting Children in South Africa
Authors: Cleophas Kelly-Anne , Assim Usang Maria
Published: May 2015

Child Participation in Family Law Matters Affecting Children in South Africa

The right of children to participate in all matters affecting them is considered to be one of the fundamental principles guiding the understanding, interpretation, and application of all children’s rights. In terms of international law, this right is contained in Article 12 of the United Nations Convention on the Rights of the Child. Similar provisions are contained in the African Charter on the Rights and Welfare of the Child. Child participation establishes the right of every child to freely express his or her views, in all matters affecting him or her, as well as the ‘subsequent right’ for those views to be given due weight, in line with the age and maturity of the child involved. The right of the child to be heard, as expressed in the Convention on the Rights of the Child represents a shift in perspectives from children as ‘incomplete human beings’ to children as subjects of rights and not merely objects of legal protection. This article provides an overview of the manner in which the principle of child participation is incorporated in some family law matters affecting children in South Africa.
Article 15 Brussels II-bis
Authors: Curry-Sumner Ian , Wright Maria
Published: May 2015

Article 15 Brussels II-bis: Two Views from Different Sides of the Channel

Article 15 Brussels II-bis provides for the transfer of jurisdiction from one Member State to another. This contribution examines the conditions and practice surrounding the application of Article 15 Brussels II-bis from two jurisdictions, namely the Netherlands, and England and Wales. From this comparison it is clear that there are evident divergent viewpoints as to the approach to be taken with Article 15 Brussels II-bis. This article is, therefore, aimed at bringing those differences in approach to the forefront so as to assist the European legislature in the ongoing evaluation of the Brussels II-bis Regulation.
Two new Thiratoscirtus species from Gabon (Araneae, Salticidae, Thiratoscirtinae)
Authors: Seiter Michael , Wesolowska Wanda
Published: May 2015

Two new species of jumping spiders, Thiratoscirtus oberleuthneri (♂) and Th. lamboji (♀), are described from Gabon, one of the least explored areas of the Afrotropics. Both species live in rainforest, at the forest floor. They are members of a very poorly known subfamily of salticids, the Thiratoscirtinae.
Rush to judgment: the STI‐treatment trials and HIV in sub‐Saharan Africa
Authors: Stillwaggon Eileen , Sawers Larry
Published: May 2015

Introduction

The extraordinarily high incidence of HIV in sub‐Saharan Africa led to the search for cofactor infections that could explain the high rates of transmission in the region. Genital inflammation and lesions caused by sexually transmitted infections (STIs) were a probable mechanism, and numerous observational studies indicated several STI cofactors. Nine out of the ten randomized controlled trials (RCTs), however, failed to demonstrate that treating STIs could lower HIV incidence. We evaluate all 10 trials to determine if their design permits the conclusion, widely believed, that STI treatment is ineffective in reducing HIV incidence.

Discussion

Examination of the trials reveals critical methodological problems sufficient to account for statistically insignificant outcomes in nine of the ten trials. Shortcomings of the trials include weak exposure contrast, confounding, non‐differential misclassification, contamination and effect modification, all of which consistently bias the results toward the null. In any future STI‐HIV trial, ethical considerations will again require weak exposure contrast. The complexity posed by HIV transmission in the genital microbial environment means that any future STI‐HIV trial will face confounding, non‐differential misclassification and effect modification. As a result, it is unlikely that additional trials would be able to answer the question of whether STI control reduces HIV incidence.

Conclusions

Shortcomings in published RCTs render invalid the conclusion that treating STIs and other cofactor infections is ineffective in HIV prevention. Meta‐analyses of observational studies conclude that STIs can raise HIV transmission efficiency two‐ to fourfold. Health policy is always implemented under uncertainty. Given the known benefits of STI control, the irreparable harm from not treating STIs and the likely decline in HIV incidence resulting from STI control, it is appropriate to expand STI control programmes and to use funds earmarked for HIV prevention to finance those programmes.
On the Southern Tang Imperial Genealogy
Authors: Kurz Johannes L.
Published: May 2015

The present essay deals with the fabrication of the imperial genealogy of the Southern Tang state (937–976). A means of linking the Southern Tang founder Li Bian (r. 937–943) to the Tang, it helped establish Southern Tang claims to the Tang heritage. Though no original fabricated genealogy survives, variant forms have been handed down through a number of texts starting in the early Northern Song period. These are discussed in terms of their plausibility, marking the Jiang- nan lu (979) by Xu Xuan (916–991) as the officially accepted description and the Zizhi tongjian (1184) version as the most “believable” of all fake Southern Tang genealogies.
Distribution of Personal Names in the Land of Israel and Transjordan during the Iron II Period
Authors: Golub Mitka
Published: May 2015

This study reports the geographical distribution of personal names in the Land of Israel and Transjordan during the Iron II Period (ca. tenth century B.C.E. to 586 B.C.E., according to the traditional chronology). In contrast with previous onomastic studies, the emphasis here is geographic and therefore only names from archaeological excavations are used. 799 names from 66 sites are collected and grouped as theophoric names, hypocoristic (abbreviated) theophoric names, or other. The theophoric names are further sorted into seven subgroups comprising the five theophoric elements yhw, yh, yw, bʿl, ʾl, divine appellatives, and god names other than Yahweh. Finally, the data are presented in a series of maps showing the geographic distribution of name types and its evolution over time. This work shows how names can be used to track historical ethnic trends. yhw and yh are unique Judean elements. Furthermore, names from major Judean sites show a characteristic mixture of theophoric elements that is substantially unchanged across all the Judean sites studied but different from that found in Samaria. Additionally, yw is an element unique to Israel and the bʿl element is also found there. ʾl is a dominant but not unique Ammonite element. Qws is a unique Edomite element. The use of god names other than Yahweh in ancient Israel was very limited.
Fragments of Arabic Poetry on Papyrus
Authors: Muehlhaeusler Mark
Published: May 2015

This article presents an edition of, and commentary on, a fragment of papyrus preserved in the collection of the J. Willard Marriott Library at the University of Utah (P.Utah 280). This well-preserved piece is a rare example of Arabic papyrus with lines of poetry. The text of the verses and their attribution in the papyrus will be studied in detail and traced through later sources, leading to a discussion on textual variation and authorship as well as on the value of papyrological evidence vis-à-vis the corpus of classical Arabic literature. It will be shown that lineages of text and attribution can be highly complex and therefore do not lend themselves to linear representation, e.g., in book form or simple HTML format. The article outlines the requirements for alternative means of representation for textual layers and points to existing tools in Arabic studies and other disciplines.
Ibn Mattawayh, al-Tadhkira fī aḥkām al-jawāhir wa-l-aʿrāḍ. Edited by Daniel Gimaret; and Kausalität in der muʿtazilitischen Kosmologie: Das Kitāb al-Muʾaṯṯirāt wa-miftāḥ al-muškilāt des Zayditen al-Ḥasan ar-Raṣṣāṣ (st. 584/1188)
Authors: Zysow Aaron
Published: May 2015

Ibn Mattawayh, al-Tadhkira fī aḥkām al-jawāhir wa-l-aʿrāḍ. Edited by Daniel Gimaret. 2 vols. Cairo: IFAO, 2009. Pp. 818. €89 (paper).

Kausalität in der muʿtazilitischen Kosmologie: Das Kitāb al-Muʾaṯṯirāt wa-miftāḥ al-muškilāt des Zayditen al-Ḥasan ar-Raṣṣāṣ (st. 584/1188). By Jan Thiele. Islamic Philosophy, Theology, and Science, vol. 84. Leiden: Brill, 2011. Pp. x + 155 + 57 (Arabic). $136.
Transmission and Dynamics of the Textual Sources of Islam: Essays in Honour of Harald Motzki. Edited by Nicolet Boekhoffvan dEr Voort, Kees Versteegh, and Joas Wagemakers
Authors: Lucas Scott C.
Published: May 2015

The Transmission and Dynamics of the Textual Sources of Islam: Essays in Honour of Harald Motzki. Edited by Nicolet Boekhoffvan dEr Voort, Kees Versteegh, and Joas Wagemakers. Islamic History and Civilization, vol. 89. Leiden: Brill, 2011. Pp. xvi + 494. $221.
God in the Courtroom: The Transformation of Courtroom Oath and Perjury between Islamic and Franco-Egyptian Law. By Guy Bechor
Authors: Voorhoeve Maaike
Published: May 2015

God in the Courtroom: The Transformation of Courtroom Oath and Perjury between Islamic and Franco-Egyptian Law. By Guy Bechor. Studies in Islamic Law and Society, vol. 34. Leiden: Brill, 2012. Pp. xv + 412. $196.
Back Matter
Authors: Editors
Published: May 2015

Back matter
POES MEPED differential flux retrievals and electron channel contamination correction
Authors: Peck E. D. , Randall C. E. , Green J. C. , Rodriguez J. V. , Rodger C. J.
Published: May 2015

A correction method to remove proton contamination from the electron channels of the Polar‐orbiting Operational Environmental Satellites Medium Energy Proton/Electron Detector (MEPED) is described. Proton contamination estimates are based on measurements in five of the MEPED proton spectral channels. A constrained inversion of the MEPED proton channel response function matrix is used to calculate proton differential flux spectra. In this inversion, the proton energy distribution is described by a weighted combination of exponential, power law, and Maxwellian distributions. Proton contamination in the MEPED electron spectral channels is derived by applying the electron channel proton sensitivities to the proton fluxes from the best fit proton spectra. Once the electron channel measurements are corrected for proton contamination, an inversion of the electron channel response function matrix is used to calculate electron differential flux spectra. A side benefit of the method is that it yields an estimate for the integrated electron flux in the energy range from 300 keV to 2.5 MeV with a center energy at ~800 keV. The final product is a differential spectrum of electron flux covering the energy range from about 10 keV to 2.5 MeV that is devoid of proton contamination except during large solar proton events. Comparisons of corrected MEPED differential fluxes to the Detection of Electromagnetic Emissions Transmitted from Earthquake Regions Instrument for Detecting Particles show that MEPED fluxes are greater than what is expected from altitude‐induced particle population changes; this is attributed at least partially to measurement differences in pitch angle range.
Measurement of the physical properties of the snowpack
Authors: Kinar N. J. , Pomeroy J. W.
Published: May 2015

This paper reviews measurement techniques and corresponding devices used to determine the physical properties of the seasonal snowpack from distances close to the ground surface. The review is placed in the context of the need for scientific observations of snowpack variables that provide inputs for predictive hydrological models that help to advance scientific understanding of geophysical processes related to snow in the near‐surface cryosphere. Many of these devices used to measure snow are invasive and require the snowpack to be disrupted, thereby precluding the possibility for multiple measurements to be made at the same sampling location. Moreover, many devices rely on the use of empirical calibration equations that may not be valid at all geographic locations. The spatial density of observations with most snow measurement devices is often inadequate. There is a need for improved automation of snowpack measurement instrumentation with an emphasis on field‐based feedback of measurement validity in lieu of postprocessing of samples or data at a lab or office location. The scientific future of snow measurement instrumentation thereby requires a synthesis between science and engineering principles that takes into consideration geophysics and the physics of device operation.
An Ethnography of Repatriation: Engagements with Erromango, Vanuatu
Authors: Bolton Lissant
Published: May 2015

The repatriation of objects from museums to source communities, and likewise the return of images and photographs, is something which is increasingly advocated and discussed in museum circles. This discussion looks at the longer‐term impact of such returns through an analysis of a series of returns of objects, images, and information to Erromango, Vanuatu, South Pacific. These returns have accumulated knowledge for Erromangans to the point where they have been able to revive lost skills, and to affirm their distinctive identity after a period of substantial cultural loss. Repatriation is generally discussed and effected through notions of the ownership of objects, but for people on Erromango it is the knowledge that museums hold that is of most importance, enabling them to piece together their past in order to modify their present.
The Last Frontier: Migratory Culture, Video, and Exhibiting without Voyeurism
Authors: Bal Mieke
Published: May 2015

In exhibitions, temporality, space, and culture are all three are unstably complicated factors. They are all both literally and figuratively central to the dynamic of exhibiting and visiting exhibitions. Temporality is not linear nor culture coherently singular. Hence, there can be neither a “last” nor an impermeable “frontier.” Space is social and does not abide by frontiers either. Rather than lines, frontiers are spaces within which negotiation can take place. Museums are such spaces, a frontierwithin, places within the (usually urban) social world where negotiations happen. In museums reflection, absorption, and the fictional enactment of alternative possibilities can take place. This chapter briefly reports on two museum experiments of my video work that built on this insight. The two almost simultaneous exhibitions in Finland and Russia addressed the impossible last frontier in two different social areas: madness and migration.
Museums, Women, and the Web
Authors: Greenberg Reesa
Published: May 2015

This chapter examines and assesses various web strategies created in relation to early twenty‐first‐century feminist exhibitions (Wack!,Global Feminisms,elles,Shifting the Gaze, andModern Women), and argues for the importance of stand‐alone or dedicated websites that document the artists, artworks, and exhibitions under consideration rather than museum inclusive websites as the optimal vehicle for maximizing presence and ensuring readily available documentation during and after an exhibition's run.