Journal articles on the topic 'Six Articles, 1539'

The Act of Six Articles of 1539 affirmed half a dozen key Catholic beliefs and their denial was made punishable by law: a heretic's death was automatically prescribed for repudiation of transubstantiation, and possible death as a felon for those who denied the divine authority of clerical celibacy, vows of chastity, private masses or the practical necessity of auricular confession. The measure was made even more severe as recantation was of no effect where transgression of the first article was concerned. Little wonder its detractors called the act ‘the whip with six strings’, or the ‘bloody statute’. From early on, the passage of the act was often seen in terms of a personal triumph for Bishop Stephen Gardiner of Winchester, along with Thomas Howard, duke of Norfolk, who piloted the measure through parliament. All of the allusions to Gardiner's involvement come from hostile sources, and most of these ascriptions are vague and lacking in circumstantial detail. William Turner, in The rescuyinge of the Romishe fox, referred to the act in a much quoted statement as ‘the six articles, otherwise called Gardiner's gospel’; it remains a moot point whether Winchester's enemy, Turner, was ascribing to Gardiner authorship of the act or merely endorsement of its orthodoxy. An unknown author, whose work is to be found in Narratives of…the Reformation, argued that the act stemmed from the king's anger against reformist bishops who quarrelled over his deployment of monastic wealth, so Henry, ‘being stirred thereunto by Winchester and other old papists in the next parliament, made vj new articles of our faithy.… The most comprehensive and detailed indictment of Winchester's involvement comes in a highly virulent, and extremely effective, piece of propaganda directed against the bishop.

AbstractThis article examines the brutal massacre of up to six hundred Spanish and Italian papal troops on the order of the English Lord Deputy Arthur Grey, 14th Baron de Wilton (1536–1593), at Dún An Óir (Forto del Oro), Smerwick, County Kerry, on 10 November 1580. The article investigates the relationship between the religious and juridical rationales for the massacre, shedding new light on the broader relationship between the early modern law of nations, Protestantism, and what Brendan Bradshaw has characterized as “catastrophic violence” in the Elizabethan military conquest of Ireland. While Vincent Carey has emphasized the virulently anti-Catholic character of Grey's rationales for the massacre, my argument instead emphasizes the role of the received laws of nations and of war in justifying Grey's actions both to Queen Elizabeth I (1533–1603) and to the English public, from the period immediately following the massacre until the writing of Edmund Spenser's pro-Grey apologetic, A View of the Present State of Ireland (ca. 1596). On this view, the papal troops at Smerwick were considered brigands, pirates, or, in Marcus Tullius Cicero's words, “communis hostis omnium”—a common enemy to all—and enjoyed no standing as lawful enemies under the law of nations. In the sixteenth century, the established law of nations was hardly a seamless web but manifested significant cleavages and fissures allowing for the construction of localized spheres of legal exception in which the ordinary rules of warfare did not apply, thus providing a convenient juridical rationale for atrocity.

Insertion loss is an important parameter used to characterize passive fiber-optic components, such as WDM couplers and variable optical attenuators. This article describes an automated insertion loss measurement system which incorporates 980 nm, 1310 nm, 1529 nm and 1561 nm DFB lasers and two internal fiber optic standards. Insertion loss measurements collected with the system for WDM couplers and internal standards are presented. The system repeatability was validated by measuring the insertion loss for a WDM coupler six times at 980 nm, 1310 nm, 1529 nm and 1561 nm over 3 days period. The standard deviation calculated for the insertion loss measurements is less than 0.11 dB and the %CV is less than 1%.

<p>The ACGME (Accreditation Council for Graduate Medical Education) in its description of its ‘Outcome Project’ notes that all training programs “must require its resident to obtain competencies in six areas to the level expected of a new practitioner” and these six competencies include: patient care and medical knowledge, interpersonal skills and professionalism, and systems based practice and practice based learning.</p><p>Furthermore, most hospital credentialing systems require evidence of successful adoption and practice of these same six competencies.</p><p>In his article entitled ‘Creating the Educated Surgeon of the 21^st Century’ Atul Gawande concludes “We are doctors, not technicians. We must educate ourselves accordingly.” </p><p>[Gawande, A. The American Journal of Surgery 181: 551–556, 2001] </p>

This article analyses the definition of sovereignty that Bodin provides in his 1576 Six livres de la république, which outlines sovereignty using French, Greek, Latin, Italian and Hebrew terms. It argues that, despite this attention to more than one language, Bodin wishes to present sovereignty as an unbound ideality beyond any and every language. Nevertheless, it is argued that Bodin in fact privileges the French souveraineté as that which sets up the analogical continuity between Greek, Latin, Italian and Hebrew. Accordingly, the article tracks the importance of French for Bodin in the wake of the 1539 Ordinance of Villers-Cotterêts, as well Bodin's claim that one of the ‘true marks of sovereignty’ is the power of the sovereign to change the language of his subjects. It ends by suggesting that the status of the exception in translation is not a species of sovereign exception, as Jean-Luc Nancy proposes, but a matter of linguistic justice.

In early 1529, the Protestant authorities of Constance executed Ludwig Hätzer for disobedience and moral depravity. Although the court documents avoided any reference to his religious teachings, contemporaries speculated about the role that perceptions—that he was an Anabaptist who espoused heretical opinions—played in his conviction. This article uses Hätzer’s trial and execution as an opportunity to reflect on two topics of interest in studies of the early Reformation: the reluctance of reformers to level charges of heresy against each other, and their re-evaluation of human sexuality resulting from the rejection of clerical celibacy. Au début de 1529, les autorités protestantes de Constance ont exécuté Ludwig Hätzer pour désobéissance et dépravation morale. Bien que les documents juridiques évitent toute référence à ses enseignements religieux, ses contemporains ont multiplié les conjectures au sujet du rôle qu’a joué dans sa condamnation la conviction qu’il était un anabaptiste ayant des croyances hérétiques. Cet article examine le procès et l’exécution de Hätzer afin de réfléchir à deux questions importantes pour les études du début de la Réforme : la résistance des réformateurs à engager des accusations d’hérésies contre d’autres tenants de la Réforme, et leur reconsidération de la sexualité suite au rejet du celibate sacerdotal.

El objetivo de este trabajo es realizar un análisis de las estrategias familiares llevadas a cabo por la oligarquía turolense durante la Baja Edad Media con el fin de evitar la disgregación de su patrimonio. Para ejemplificar las herramientas usadas por los linajes de esta élite se analizará un bien concreto, las rentas de la escribanía de Morella y sus aldeas, a lo largo de seis generaciones, desde su adquisición en 1328 hasta su enajenación en 1519. The aim of this article is to analyse the strategies that the Turolean urban oligarchy carried out during the late Middle Ages in order to avoid the disintegration of their patrimony. A specific property is analysed to illustrate the resources used by the lineages of this elite: the assets of the scribe’s court of Morella and its villages. The study covers six generations, from its acquisition in 1328 to its alienation in 1519.

Abstract: In 1539, Johann Bugenhagen wrote a book, Vom Ehebruch und weglauffen (“On adultery and desertion”), to advice King Christian III on the handling of marital cases. Based on Scripture, divorce is allowable only if a spouse commits adultery or runs away secretly. The article compares Bugenhagen’s two grounds for divorce with those found in Niels Hemmingsen’s Libellus de coniugio, repudio, et divortio from 1572 and in the Marriage Ordinance of King Frederik II of 1582. It is argued that Hemmingsen in allowing six grounds for divorce, including e.g. violence and impiety, follows Philipp Melanchthon, who not only accepted the two scriptural grounds, but also a number of additional grounds from Roman Law and Canon Law. With its three grounds for divorce – adultery, desertion, and impotence – the Marriage Ordinance of 1582 reflected legal practice developed in the law courts that had been handling marital cases since the introduction of the Reformation.

This article investigates retail development as a social problem, a political phenomenon, and an increasingly important form of urban development. I focus on mass retail, as exemplified by superstores. The data come from six case studies, carried out onsite, of local controversies over the siting of Wal‐Mart superstores. I analyze retail development and the conflicts that it may provoke in terms of six key categories: economic context, actors, dynamic, interests, ideology, and consumption. Throughout the analysis I critically engage the growth machine perspective and suggest how it may be modified to better account for the peculiarities of retail development. I argue that retail development does not necessarily lead to growth and that mass retail is driven by the pursuit of market share and profit, not growth. I also introduce several new concepts: the global development machine, which has taken over certain functions of the growth machine; the shoppers, a local group that appears to value shopping over broader community interests; and the ideology of shopping, which serves to promote retail development.

Some remarks on the origins and role of the Court of Session in the Kingdom of Scotland (1532–1707)The purpose of this article is to illustrate the origins and evolution of the central court of the Kingdom of Scotland from its inception in 1532 until the end of the Kingdom as an independent entity of international law following its establishment in 1707 of the United Kingdom of Great Britain. The analysis of the structure of the court is based on the laws of the old Scottish Parliament, and the main thesis of the study is the evolutionary nature of the provisions constituting the Court of Sessions which, on the one hand, were a continuation of the King’s previous jurisdictional powers and, on the other hand, were part of a wider trend towards separation of central courts from the royal councils in European monarchies. Einige Bemerkungen zur Genese und Bedeutung von "Court of Session" im Königreich Schottland (1532–1707)Gegenstand dieses Beitrages ist die Darstellung der Genese und der Evolution des zentralen Gerichtes im Königreich Schottland in der Zeit von seiner Entstehung im Jahre 1532 bis zum Ende des Königreiches als ein unabhängiges Subjekt des internationalen Rechtes, infolge der Entstehung im Jahre 1707 des Vereinigten Königreiches von Großbritannien. Grundlage der Analyse der Struktur des Gerichtes stellen die Gesetze des ehemaligen schottischen Parlamentes und die wichtigste These der Bearbeitung stellt der evolutionäre Charakter der Lösungen dar, die zur Gründung von Court of Session geführt haben. Diese stellten einerseits die Fortführung der früheren Befugnisse des Königs im Bereich Jurisdiktion, andererseits aber waren sie in den europäischen Monarchien ein Teil der umfassenderen Bewegung der Aussonderung der Zentralgerichte aus der Institution der königlichen Räte.

SUMMARY The paper explores three grammars of two indigenous languages of Brazil written in Portuguese during the colonial period: two grammars of the Tupi language composed by José Anchieta (1534–1597) in 1595 and Luís Figueira (1575–1643) in 1621 (2nd ed., 1687), and one grammar of the Kiriri language, written by Luis Vincêncio Mamiani (1652–1730) in 1699. Although most studies agree that these grammars were based on a Latin framework, they usually do not specify which grammar in particular served as a model. It is known, however, that the Latin grammar by Manuel Álvares (1526–1582), first published in 1572, became the main Latin school grammar for Jesuits all over the world. This article tries to give answers to questions such as why did the Jesuits favour this grammar, which grammars were used by them before 1572, how did the Portuguese missionaries in Brazil adapt or copy Álvares’ model, which parts of speech did they particularly use, and which definitions did they select and which elements did they discuss, add or omit?RÉSUMÉ Cet article étudie trois grammaires de deux langues indigènes du Brésil écrites en portugais durant l’époque coloniale: deux grammaires de la langue des Tupi ont été composées par Anchieta (1534–1597) en 1595 et Luís Figueira (1575–1643) en 1621 (2e éd. en 1687) et une grammaire de la langue des Kiriri, écrite par Luis Vincêncio Mamiani (1652–1730) en 1699. Bien que la plupart des études s’accordent pour dire que ces grammaires étaient fondées sur des structures latines, d’habitude elles ne fournissaient davantage de détails quant aux sources possibles. La grammaire latine de Manuel Álvares (1526–1582) fut publiée en 1572 pour la première fois et devint la grammaire scolaire latine des Jésuites dans le monde entier. Cet article tente d’apporter une réponse aux questions suivantes: pourquoi avaient-ils choisi cette grammaire, quelles grammaires étaient utilisées avant 1572, comment les missionnaires portugais au Brésil ont-ils adapté ou copié le modèle des Álvares, dans quelle mesure cette grammaire a-t-elle été particulièrement utilisée, quelles définitions ont-ils choisi et de quels éléments ont-ils discuté, et lesquels a-t-on ajouté ou omis?ZUSAMMENFASSUNG In dem Beitrag werden drei Grammtiken der Kolonialzeit analysiert, welche zwei Eingeborenensprachen Brasiliens beschreiben: zwei Grammatiken des Tupí, eine 1595 von José Anchieta (1534–1597) verfaßte und eine 1621 von Luís Figueira redigierte (2. Aufl., 1687), sowie eine Grammatik des Kiriri, die Luis Vincêncio Mamiani (1652–1730) 1699 erstellt hat. Auch wenn man üblicherweise davon ausgeht, daß diese Grammatiken auf dem Gedankengut lateinischer Grammatiken basieren, so wird doch nie präzisiert, welche lateinische Grammatik konkret als Modell gedient hat. Man weiß allerdings auch, daß die lateinische Grammatik von Manuel Álvares (1526–1582), welche 1572 zum erstenmal erschien, zur Standardgrammatik der Jesuiten in der ganzen Welt wurde. In diesem Beitrag wird versucht, Fragen zu beantworten wie: Warum favorisierten die Jesuiten diese Grammatik? Welche Grammatiken wurden von ihnen vor 1572 benutzt? Wie haben die Jesuiten Brasiliens die Grammatik von Álvares adaptiert bzw. kopiert? Welche Redeteile waren von besonderer Wichtigkeit für sie, welche Definitionen wählten sie aus und welche Details diskutierten sie vorrangig, bzw. welche ergänzten sie oder ließen sie ganz weg?

At Tiahuanaco, on the southern rim of Lake Titicaca, Bolivia, visitors encounter enormous stone slabs and carved building blocks dressed with astonishing skill. The stones are the visible remains of a culture that flourished there about a thousand years ago. Some six hundred kilometers to the northwest, in Cuzco (Peru), one finds the different yet equally remarkable masonry of the Incas, who dominated the Andean world from the middle of the fifteenth century to the Spanish conquest in 1532. Did the Inca stonemasons learn their skills from their predecessors at Tiahuanaco? A comparative study of Inca and Tiahuanaco construction techniques reveals fundamental differences between the architecture of the two cultures. In this article, we compare masonry bonds, design details, stone-cutting techniques, and the methods of fitting, laying, and handling of stones used by both cultures. The results of this comparison suggest that the ingenuity of Inca masonry originated with the Incas, and not with their predecessors.

Abstract Subchondral insufficiency fractures of the femoral head (SIFFH) are a cause of femoral head collapse leading to degenerative hip disease. SIFFH is often mistaken for osteonecrosis given similar clinical and radiographic features. These similarities often lead to missed or delayed diagnosis which can often delay or change management. The purpose of this article is to systematically review the spectrum of demographics, diagnostic and treatment options, including hip preservation in young patient populations. A systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. All related peer-reviewed publications from January 1999 to January 2019 were reviewed using the following databases: Medline, EMBASE, Scopus and Web of Science. The systematic review identified 54 articles, encompassing 482 patients (504 hips) diagnosed with SIFFH. One hundred and seventy-six (35%) males and 306 (63%) females were included, with a mean age of 53.6 ± 17.5 years and mean body mass index of 23.4 ± 4.0 kg/m2. Mean follow-up was 23.4 ± 15.9 months. Treatment decisions were 256 (55%) non-operative, 157 (34%) total hip arthroplasty (THA), 24 (5%) transtrochanteric anterior rotational osteotomy, 9 (2%) hip arthroscopy, 7 (2%) hip resurfacing, 3 (1%) bone grafting, 3 (1%) hemiarthroplasty and 1 (1%) tantalum rod insertion. Overall, 35% of SIFFH hips were converted to THA at latest follow-up. A majority of SIFFH patients had symptom resolution with non-operative management. Failure most often resulted in THA. In younger patients, hip preservation techniques have shown promising early results and should be considered as an alternative.

Oceanic waters are difficult to assess, and there are many gaps in knowledge regarding cetacean occurrence. To fill some of these gaps, this article provides important cetacean records obtained in the winter of 2010 during a dedicated expedition to collect visual and acoustic information in the Vitória-Trindade seamounts. We observed 19 groups of cetaceans along a 1300-km search trajectory, with six species being identified: the humpback whale (Megaptera novaeangliae, N = 9 groups), the fin whale (Balaenoptera physalus, N = 1), the Antarctic minke whale (Balaenoptera bonaerensis, N = 1), the rough-toothed dolphin (Steno bredanensis, N = 1), the bottlenose dolphin (Tursiops truncatus, N = 2), and the killer whale (Orcinus orca, N = 1). Most humpback whale groups (N = 7; 78%) were observed in the Vitória-Trindade seamounts, especially the mounts close to the Abrolhos Bank. Only one lone humpback whale was observed near Trindade Island after a search effort encompassing more than 520 km. From a total of 28 acoustic stations, humpback whale songs were only detected near the seamounts close to the Abrolhos Bank, where most groups of this species were visually detected (including a competitive group and groups with calves). The presence of humpback whales at the Trindade Island and surroundings is most likely occasional, with few sightings and low density. Finally, we observed a significant number of humpback whales along the seamounts close to the Abrolhos Bank, which may function as a breeding habitat for this species. We also added important records regarding the occurrence of cetaceans in these mounts and in the Western South Atlantic, including the endangered fin whale.

Workplace violence (WPV) has been extensively studied in hospitals, yet little is known about WPV in outpatient physician clinics. These settings and work tasks may present different risk factors for WPV compared to hospitals, including the handling/exchange of cash, and being remotely located without security presence. We conducted a systematic literature review to describe what is currently known about WPV in outpatient physician clinics. Six literature databases were searched and reference lists from included articles published from 2000–2019. Thirteen quantitative and five qualitative manuscripts were included which all focused on patient/family-perpetrated violence in outpatient physician clinics. No studies examined other violence types (e.g., worker-on-worker; burglary). The overall prevalence of Type II violence ranged from 9.5% to 74.6%, with the most common form being verbal abuse (42.1–94.3%), followed by threat of assault (14.0–57.4%), bullying (2.5–5.7%), physical assault, (0.5–15.9%) and sexual harassment/assault (0.2–9.3%). Worker consequences included reduced work performance, anger, and depression. Most workers did not receive training on how to manage a violent patient. More work is needed to examine the prevalence and risk factors of WPV in outpatient physician clinics for purposes of informing prevention efforts in these settings.

ABSTRACT Objective To assess knowledge, attitudes and practices among the dental graduate in relation to healthcare ethics and law. Materials and methods A cross-sectional study design was employed using a self-administered questionnaire. A 15 item questionnaire about law and ethics was devised; tested and made available to all levels of gradates including teaching staff, postgraduates and intern at dental college in Bengaluru. A total of 116 graduates participated, with a response rate of 96.5% (n = 112). Results Seventy-six percent of the participants said that they are legally bound to treat all the patients who approach them for the treatment. Nearly 32% of the participants have mentioned the various other reasons for the rejection apart from the reason like HIV+, poor patients and patients with the contagious disease. Conclusion The study points to the need for appropriate training among graduates including the professional staffs and other graduates, and to devise means to sensitize them to issues of law and ethics in the workplace. How to cite this article Dhanappa KB, Praveen MN, Ravi R, Jayachandra MG, Deshpande P, Biradar SM. Knowledge, Attitudes and Practice of Healthcare Ethics and Law among Dental Graduates at the RV Dental College, Bengaluru. J Contemp Dent Pract 2014;15(2):223-228.

Aims The purpose of this study was to analyze the incidence of the different ultrasound phenotypes of developmental dysplasia of the hip (DDH), and to determine their subsequent course. Patients and Methods A consecutive series of 28 092 neonates was screened and classified according to the Graf method as part of a nationwide surveillance programme, and then followed prospectively. Abnormal hips were followed until they became normal (Graf type I). Type IIb hips and higher grades were treated by abduction in a Tübinger orthosis until normal. Dislocated hips underwent closed or open reduction. Results Overall, 90.2% of hips were normal at birth. Type IIa hips (8.9%) became normal at a median of six weeks (interquartile range (IQR) 6 to 9). Type IIc and IId hips (0.67%) became normal after ten weeks (IQR 7 to 13). There were 19 type lll and eight type lV hips at baseline. There were 24 closed reductions and one open reduction. No late presentations of DDH were detected within the first five years of life. Conclusion The incidence of DDH was eight per 1000 live births. The treatment rate was 1% (n = 273). The rate of first operations on the newborn hip was 0.86, and rate of open surgery was 0.04. The cumulative rate of open surgery was 0.07. The authors take the view that early identification and treatment in abduction of all dysplastic hips in early childhood reduces the rate of open reduction and secondary DDH-related surgery later in life. Cite this article: Bone Joint J 2018;100-B:1399–1404.

In a newer debate on the criminalization of incest in Denmark, Vagn Greve hasargued that the criminalization of consensual sexual relations between adults canbe contributed to the German reformer Martin Luther. This article has investigatedthe impact of the reformation on the sexual offenses with emphasis on theirdefinition and punishment and the question of jurisdiction. The criminalization ofconsensual sex was not a new phenomenon after the Reformation. Before theReformation the sexual offences were primarily dealt with by the CatholicChurch through its system of penance and its judicial system. After the Reformationthe jurisdiction was transferred to the secular authority. For the sexualoffences the period 1536-1683 must be viewed as a process. During this periodthey were incorporated into the secular criminal law culminating with the promulgationof Danske Lov 1683. The following period has to a large extent lead tothe decriminalization of the sexual offences. In conclusion, the criminalization ofthe sexual offences cannot be contributed to the Reformation. It is, however, alegacy of the Reformation that the state assumed the responsibility to punish thesexual offences.

Aims The practice of overlapping surgery has been increasing in the delivery of orthopaedic surgery, aiming to provide efficient, high-quality care. However, there are concerns about the safety of this practice. The purpose of this study was to examine the safety and efficacy of a model of partially overlapping surgery that we termed ‘swing room’ in the practice of primary total hip (THA) and knee arthroplasty (TKA). Methods A retrospective review of prospectively collected data was carried out on patients who underwent primary THA and TKA between 2006 and 2017 in two academic centres. Cases were stratified as partially overlapping (swing room), in which the surgeon is in one operating room (OR) while the next patient is being prepared in another, or nonoverlapping surgery. The demographic details of the patients which were collected included operating time, length of stay (LOS), postoperative complications within six weeks of the procedure, unplanned hospital readmissions, and unplanned reoperations. Fisher's exact, Wilcoxon rank-sum tests, chi-squared tests, and logistic regression analysis were used for statistical analysis. Results A total of 12,225 cases performed at our institution were included in the study, of which 10,596 (86.6%) were partially overlapping (swing room) and 1,629 (13.3%) were nonoverlapping. There was no significant difference in the mean age, sex, body mass index (BMI), side, and LOS between the two groups. The mean operating time was significantly shorter in the swing room group (58.2 minutes) compared with the nonoverlapping group (62.8 minutes; p < 0.001). There was no significant difference in the rates of complications, readmission and reoperations (p = 0.801 and p = 0.300, respectively) after adjusting for baseline American Society of Anesthesiologists scores. Conclusion The new ‘swing room’ model yields similar short-term outcomes without an increase in complication rates compared with routine single OR surgery in patients undergoing primary THA or TKA. Cite this article: Bone Joint J 2020;102-B(7 Supple B):112–115.

This article analyses the statistical procedures used in the proceedings of the one of the psychology conferences regularly organized in Romania. 111 papers in six branches of applied psychology were scrutinized. The analysis was structured on descriptive statistics (numerical and graphical), and inferential statistics (parametric and nonparametric). Was also pursued the extent to which papers complied with APA recommendations on the reporting of confidence limits and size effect. Results: 64.9% of the papers reported statistical results. The sections with more statistical based papers are military psychology (85.7%) and industrial-organizational psychology (84%). On the other hand, only 52.4% papers on educational psychology reported statistics procedures. The average of the reported samples was 190 subjects (minimum 10, maximum 1519). A percentage of 26.4% of works includes at least one statistical descriptive indicator, while 31.9% of works containing statistics, have no descriptive indicators. The graphics used are mostly bar and pie. Regarding inferential statistics, 47.2% of work contains at least one statistical test, and 36.1% have none statistical test. The most frequent utilized tests are Pearson r and t tests. It was recorded no single case of reporting effect sizes and confidence limits. Conclusions: The results allow us to appreciate that the papers presented at scientific events, most of them by young psychologists, contain a relative insufficiently matured statistical analysis, and often insufficient connected to the problem studied. We must appreciate, however, as positive the interest in empirical research and statistical analysis of results.

ABSTRACT Sirenomelia is a rare anomaly of caudal region of the body presented with fusion of lower limbs, in which genitourinary, gastrointestinal, cardiovascular, and neural tube anomalies are found in most cases. It is a very rare disorder with prevalence of 1 in 100,000 live births with a total of 300 cases reported till today in which 9 are from India. The precise etiology of sirenomelia was not well understood. Many theories have been proposed but none of these is considered definitive. Most of the times, the condition is fatal for the baby, even after surgery, and it is much more common in identical twins. This rare case in identical twins with one surviving fetus and other having fused foot with multiple congenital anomalies such as undetermined sex and renal agenesis is being reported. How to cite this article Arora G, Bagga GR, Nandu VV. A Rare Case of Twin Gestation with Sirenomelia and a coexisting Normal Fetus. J South Asian Feder Obst Gynae 2017;9(4):360-362.

ABSTRACT Background Pressing esthetic demands of good looking make people undergo bleaching procedures. However, the effect of bleaching agents on esthetic restorative materials with different surface preparations has been poorly studied. Aim The aim of this study was to examine the effect of a homebleaching agent (carbamide peroxide: CP 38%) on the surface roughness of the polished fiber reinforced composite (FRC), overglazed, autoglazed, or polished ceramic samples. Materials and methods Twenty standardized cylindrical specimens were made of each of the following groups: overglazed, autoglazed, polished porcelain and also FRC. The test specimens exposed to the CP 38%, 15 minutes, twice a day for 2 weeks according to the manufacturer's recommendation. Six samples from each group were selected randomly to form negative controls. Surface roughness measurements (Ra, micrometer) for baseline, test and control specimens were performed by use of a profilometer. Paired t-test, Mann-Whitney test, and Kruskal-Wallis test were used for statistical analyses. Results The data showed that bleaching with CP 38% significantly increased the surface roughness of all the test samples (p < 0.05). The type of surface preparation caused significant differences between the susceptibility of porcelain subgroups to bleaching (p < 0.05). The polished porcelain specimens showed the highest changes after bleaching. Conclusion CP 38% significantly increases the surface roughness of the porcelains and FRC. The type of surface condition affects the amenability of the porcelain surface to the bleaching agent. Glazed porcelains were more resistant to roughness than the polished porcelains and also the composite. Clinical significance Roughening of porcelain and FRC occur following bleaching procedure. No special surface preparation of indirect esthetic restorative materials can completely preserve these materials from adverse effects of bleaching agents. How to cite this article Torabi K, Rasaeipour S, Khaledi AA, Vojdani M, Ghodsi S. Evaluation of the Effect of a Homebleaching Agent on the Surface Characteristics of Indirect Esthetic Restorative Materials: Part I—Roughness. J Contemp Dent Pract 2014;15(3):326-330.

A Review of: Hanneke, R., & O’Brien, K. K. (2016). Comparison of three web-scale discovery services for health sciences research. Journal of the Medical Library Association, 104(2), 109-117. http://dx.doi.org/10.3163/1536-5050.104.2.004 Abstract Objective – To compare the results of health sciences search queries in three web-scale discovery (WSD) services for relevance, duplicate detection, and retrieval of MEDLINE content. Design – Comparative evaluation and bibliometric study. Setting – Six university libraries in the United States of America. Subjects – Three commercial WSD services: Primo, Summon, and EBSCO Discovery Service (EDS). Methods – The authors collected data at six universities, including their own. They tested each of the three WSDs at two data collection sites. However, since one of the sites was using a legacy version of Summon that was due to be upgraded, data collected for Summon at this site were considered obsolete and excluded from the analysis. The authors generated three questions for each of six major health disciplines, then designed simple keyword searches to mimic typical student search behaviours. They captured the first 20 results from each query run at each test site, to represent the first “page” of results, giving a total of 2,086 total search results. These were independently assessed for relevance to the topic. Authors resolved disagreements by discussion, and calculated a kappa inter-observer score. They retained duplicate records within the results so that the duplicate detection by the WSDs could be compared. They assessed MEDLINE coverage by the WSDs in several ways. Using precise strategies to generate a relevant set of articles, they conducted one search from each of the six disciplines in PubMed so that they could compare retrieval of MEDLINE content. These results were cross-checked against the first 20 results from the corresponding query in the WSDs. To aid investigation of overall coverage of MEDLINE, they recorded the first 50 results from each of the 6 PubMed searches in a spreadsheet. During data collection at the WSD sites, they searched for these references to discover if the WSD tool at each site indexed these known items. Authors adopted measures to control for any customisation of the product setup at each data collection site. In particular, they excluded local holdings from the results by limiting the searches to scholarly, peer-reviewed articles. Main results – Authors reported results for 5 of the 6 sites. All of the WSD tools retrieved between 50-60% relevant results. EDS retrieved the highest number of relevant records (195/360 and 216/360), while Primo retrieved the lowest (167/328 and 169/325). There was good observer agreement (k=0.725) for the relevance assessment. The duplicate detection rate was similar in EDS and Summon (between 96-97% unique articles), while the Primo searches returned 82.9-84.9% unique articles. All three tools retrieved relevant results that were not indexed in MEDLINE, and retrieved relevant material indexed in MEDLINE that was not retrieved in the PubMed searches. EDS and Summon retrieved more non-MEDLINE material than Primo. EDS performed best in the known-item searches, with 300/300 and 299/300 items retrieved, while Primo performed worst with 230/300 and 267/300 items retrieved. The Summon platform features an “automated query expansion” search function, where user-entered keywords are matched to related search terms and these are automatically searched along with the original keyword. The authors observed that this function resulted in a wholly relevant first page of results for one of the search questions tested in Summon. Conclusion – While EDS performed slightly better overall, the difference was not great enough in this small sample of test sites to recommend EDS over the other tools being tested. The automated query expansion found in Summon is a useful function that is worthy of further investigation by the WSD vendors. The ability of the WSDs to retrieve MEDLINE content through simple keyword searches demonstrates the potential value of using a WSD tool in health sciences research, particularly for inexpert searchers.

Background Despite multiple factors correlating with the high prevalence of anaemia in heart failure, the prevailing mechanisms have yet to be established. The purpose of this study is to systematically review the literature and determine whether low circulating haemoglobin is primarily underlain by erythropoietin resistance or defective production in heart failure. Design and methods We conducted a systematic search of MEDLINE since its inception until May 2017 for articles reporting erythropoietin and haemoglobin concentrations in heart failure patients not treated with erythropoietin-stimulating agents. The primary outcome was the mean difference in observed/predicted (O/P) erythropoietin ratio between heart failure patients and normal reference values. Meta-regression analyses assessed the influence of potential moderating factors. Results Forty-one studies were included after systematic review, comprising a total of 3137 stable heart failure patients with mean age and left ventricular ejection fraction ranging from 52 years to 80 years and 21% to 59%. The O/P erythropoietin ratio was below reference values in 24 of 25 studies in anaemic heart failure patients ( n = 1094, range = 0.49–1.05), whereas only one out of 16 studies in non-anaemic heart failure patients presented a low O/P erythropoietin ratio ( n = 2043, range = 0.91–1.97). In studies comparing anaemic versus non-anaemic heart failure patients ( n = 1531), the mean O/P erythropoietin ratio was consistently reduced in anaemic heart failure patients (mean difference = –0.68, 95% confidence interval = −0.78, −0.57; p < 0.001). In meta-regression, the O/P erythropoietin ratio was negatively associated with age, female sex, left ventricular ejection fraction, inflammation and disease severity. Conclusion Anaemia in heart failure is overwhelmingly characterized by impaired erythropoietin production, which is exacerbated with age, female sex, left ventricular ejection fraction, inflammation and disease severity.

Abstract Establishing requirements for the survival of human immature B cells in vitro has proved elusive. In this article, we report prolonged survival of B-lineage leukemic cells on ‘feeder layers’ of bone marrow (BM)- derived stromal cells in a serum-free environment. In 15 of 18 cases of B-lineage acute lymphoblastic leukemia (ALL), there was a greater than 50% decrease in the number of viable cells after 72 hours of culture in medium alone. Cell loss was preceded by molecular and cellular changes characteristic of programmed cell death, or apoptosis, and was not suppressed by adding interleukin-7 to the tissue culture medium. By contrast, the use of allogeneic BM stromal cells as feeder layers prevented apoptosis in 10 of 12 cases of ALL, leading to extended survival of the blast cells. This method was not successful when the allogeneic marrow cells were replaced with established cell lines. In six of eight cases in which the numbers of intact CD19+ lymphoblasts were counted by flow cytometry after 7 days of culture, the proportion of such cells recovered in the presence of BM stromal cells was 68.8% to 124.7% (median, 95.3%) of that originally seeded, as opposed to the 0.3% to 15.9% fraction (median, 0.7%) obtained in the absence of stromal cells. Survival requirements of the B-lineage lymphoblasts appeared to be heterogeneous, as cells from 3 of the 18 cases studied showed no signs of apoptosis in serum-free tissue culture medium that lacked BM stromal cells. The only cells not giving rise to viable cultures were from two hyperdiploid (greater than 50 chromosomes) cases with identical karyotypes. The serum-free assay described here can be used to compare the survival requirements of normal and leukemic B-cell progenitors as well as to identify the molecules involved in the interaction between BM stroma and immature B cells.

Establishing requirements for the survival of human immature B cells in vitro has proved elusive. In this article, we report prolonged survival of B-lineage leukemic cells on ‘feeder layers’ of bone marrow (BM)- derived stromal cells in a serum-free environment. In 15 of 18 cases of B-lineage acute lymphoblastic leukemia (ALL), there was a greater than 50% decrease in the number of viable cells after 72 hours of culture in medium alone. Cell loss was preceded by molecular and cellular changes characteristic of programmed cell death, or apoptosis, and was not suppressed by adding interleukin-7 to the tissue culture medium. By contrast, the use of allogeneic BM stromal cells as feeder layers prevented apoptosis in 10 of 12 cases of ALL, leading to extended survival of the blast cells. This method was not successful when the allogeneic marrow cells were replaced with established cell lines. In six of eight cases in which the numbers of intact CD19+ lymphoblasts were counted by flow cytometry after 7 days of culture, the proportion of such cells recovered in the presence of BM stromal cells was 68.8% to 124.7% (median, 95.3%) of that originally seeded, as opposed to the 0.3% to 15.9% fraction (median, 0.7%) obtained in the absence of stromal cells. Survival requirements of the B-lineage lymphoblasts appeared to be heterogeneous, as cells from 3 of the 18 cases studied showed no signs of apoptosis in serum-free tissue culture medium that lacked BM stromal cells. The only cells not giving rise to viable cultures were from two hyperdiploid (greater than 50 chromosomes) cases with identical karyotypes. The serum-free assay described here can be used to compare the survival requirements of normal and leukemic B-cell progenitors as well as to identify the molecules involved in the interaction between BM stroma and immature B cells.

Aims The aim of this study was to report the initial results of the Exeter V40 stem, which became available in 2000. Patients and Methods A total of 540 total hip arthroplasties (THAs) were performed in our unit using this stem between December 2000 and May 2002. Our routine protocol is to review patients postoperatively and at one, five, and ten years following surgery. Results A total of 145 patients (26.9%) died before ten years and of the remaining 395 stems, 374 (94.7%) remain in situ. A total of 21 well-fixed stems (5.3%) were revised. Ten were exchanged using a cement-in-cement technique to facilitate acetabular revision. Three were revised for infection, one for instability, one for fracture of the stem, and six following a periprosthetic fracture. An additional 16 acetabular components (4.1%) were revised; five for aseptic loosening and 11 for instability. There were no revisions for aseptic loosening of the stem, and no evidence of aseptic loosening in any hip. The fate of every stem is known and all patients remain under review. Survivorship, with revision of the stem for aseptic loosening as the endpoint, was 100%. At 13.5 years, the Kaplan–Meier survival rate for all-cause revision of the stem was 96.8% (95% confidence interval (CI) 94.8 to 98.8) and all-cause revision (including acetabular revision, infection, and instability) was 91.2% (95% CI 88.3 to 94.1). Conclusion No stem was revised for aseptic loosening in this series. The contemporary Exeter V40 stem continues to perform well, and survival has remained comparable with that of the Exeter Universal stem. Cite this article: Bone Joint J 2018;100-B:1002–9.

The article presents the results of studies conducted in 2004-2010 at the experimental plot in the forest-steppe Volga region. The research investigated the impact of traditional (average) and differentiated use of mineral fertilizers in the field crop rotation (winter wheat (reconnaissance sowing) – spring wheat ‒ annual grass – spring barley – bare fallow– winter wheat – spring wheat) on the change of agrochemical properties of leached chernozem. It was established that the six-year use of fertilizers contributed to the improvement of the main indicators of top soil fertility regardless of application technology. On average, in 15 sectors (plots) of each variant, the content of mobile phosphorus per rotation of crop rotation increased with differentiated fertilization by 15.9%, potassium – by 15%, and in the traditional one – by 4.8 and 16.7% respectively, (control of 100.8 and 116.2 mg/kg of soil, respectively). In sectors where no fertilizer was applied, the content of mobile elements decreased by 2-7%. The nitrogen content in the soil directly depended on the timing of sampling and the amount of moisture in the soil, so it was difficult to track its change. The difference in the accumulation of mineral nitrogen between the technologies of fertilizer application was not observed. For organic matter in all variants of the experience over the years of research there was a decrease in the indicator. This was more noticeable in the control, where the value decreased by 2.7%. Here, the value of soil acidity increased by 0.12 units and became 4.7. In variants with fertilizers soil acidity remained the same (4.6-4.7). In general, the differentiated use of mineral fertilizers did not have a negative influence on the agrochemical composition of leached chernozem. There was a gradual equalization of soil fertility due to the residual amounts of phosphorus and potassium on low-fertile plots and some reduction of mobile elements in zones with high content.

Aims The Exeter V40 cemented femoral stem was first introduced in 2000. The largest single-centre analysis of this implant to date was published in 2018 by Westerman et al. Excellent results were reported at a minimum of ten years for the first 540 cases performed at the designer centre in the Exeter NHS Trust, with stem survivorship of 96.8%. The aim of this current study is to report long-term outcomes and survivorship for the Exeter V40 stem in a non-designer centre. Methods All patients undergoing primary total hip arthroplasty using the Exeter V40 femoral stem between 1 January 2005 and 31 January 2010 were eligible for inclusion. Data were collected prospectively, with routine follow-up at six to 12 months, two years, five years, and ten years. Functional outcomes were assessed using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores. Outcome measures included data on all components in situ beyond ten years, death occurring within ten years with components in situ, and all-cause revision surgery. Results A total of 829 stems in 745 patients were included in the dataset; 155 patients (20.8%) died within ten years, and of the remaining 664 stems, 648 stems (97.6%) remained in situ beyond ten years. For the 21 patients (2.5%) undergoing revision surgery, 16 femoral stems (1.9%) were revised and 18 acetabular components (2.2%) were revised. Indications for revision in order of decreasing frequency were infection (n = 6), pain (n = 6), aseptic component loosening (n = 3), periprosthetic fracture (n = 3), recurrent dislocation (n = 2), and noise production (ceramic-on-ceramic squeak) (n = 1). One patient was revised for aseptic stem loosening. The mean preoperative WOMAC score was 61 (SD 15.9) with a mean postoperative score of 20.4 (SD 19.3) (n = 732; 88.3%). Conclusion The Exeter V40 cemented femoral stem demonstrates excellent functional outcomes and survival when used in a high volume non-designer centre. Outcomes are comparable to those of its serially validated predecessor, the Exeter Universal stem. Cite this article: Bone Jt Open 2020;1-12:743–748.

ObjectiveTo analyse the incidence, risk factors and impact of acute kidney injury (AKI) on the prognosis of patients with COVID-19.DesignMeta-analysis.Data sourcesPubMed, Embase, CNKI and MedRxiv of Systematic Reviews from 1 January 2020 to 15 May 2020.Study selectionStudies examining the following demographics and outcomes were included: patients’ age; sex; incidence of and risk factors for AKI and their impact on prognosis; COVID-19 disease type and incidence of continuous renal replacement therapy (CRRT) administration during COVID-19 infection.ResultsA total of 79 research articles, including 49 692 patients with COVID-19, met the systemic evaluation criteria. The mortality rate and incidence of AKI in patients with COVID-19 in China were significantly lower than those in patients with COVID-19 outside China. A significantly higher proportion of patients with COVID-19 from North America were aged ≥65 years and also developed AKI. European patients with COVID-19 had significantly higher mortality and a higher CRRT rate than patients from other regions. Further analysis of the risk factors for COVID-19 combined with AKI showed that age ≥60 years and severe COVID-19 were independent risk factors for AKI, with an OR of 3.53, 95% CI (2.92–4.25) and an OR of 6.07, 95% CI (2.53–14.58), respectively. The CRRT rate in patients with severe COVID-19 was significantly higher than in patients with non-severe COVID-19, with an OR of 6.60, 95% CI (2.83–15.39). The risk of death in patients with COVID-19 and AKI was significantly increased, with an OR of 11.05, 95% CI (9.13–13.36).ConclusionAKI was a common and serious complication of COVID-19. Older age and having severe COVID-19 were independent risk factors for AKI. The risk of in-hospital death was significantly increased in patients with COVID-19 complicated by AKI.

ABSTRACT Aim The study was carried to find a relationship between the postextraction stable landmark, the incisive papilla, and the most labial position of the maxillary central incisor teeth, which occurred in Nepalese population. Materials and methods Casts of the subjects selected by nonprobability random sampling meeting the inclusion criteria were obtained. Each casts were standardized with respect to the occlusal plane and a photographic technique was used to measure the distance from the tangent of the labial surface of the central incisors to the posterior border of the incisive papilla. The measurements were made using Adobe Photoshop and results were analyzed by using appropriate statistical methods. Most appropriate software (SPSS) for the purpose was used to generate all desired values. Results The data obtained suggested that the distance from the labial surface of maxillary central incisors to the posterior border of the incisive papilla ranged from 9 to 15.9 mm with a mean of 11.59 mm (SD 1.3). Various other results were also found after evaluation of the arch forms in relation to sex and race. Conclusion Within the limitations of the study, these results suggested that there is a relationship between the maxillary central incisors and the incisive papilla aiding in the anteroposterior positioning of the anterior tooth. The clinical relevance of the study lies in application of the incisive papilla as a starting point in the preliminary location of maxillary incisors and canines during construction of the denture in absence of preextraction records. How to cite this article Shrestha S, Joshi SP, Yadav SK. Relationship of Incisive Papilla to Maxillary Incisors and Canines. J Contemp Dent Pract 2016;17(4):306-312.

Aims Access to joint replacement is being restricted for patients with comorbidities in a number of high-income countries. However, there is little evidence on the impact of comorbidities on outcomes. The purpose of this study was to determine the safety and effectiveness of hip and knee arthroplasty in patients with and without comorbidities. Methods In total, 312,079 hip arthroplasty and 328,753 knee arthroplasty patients were included. A total of 11 common comorbidities were identified in administrative hospital records. Safety risks were measured by assessing length of hospital stay (LOS) and 30-day emergency readmissions and mortality. Effectiveness outcomes were changes in Oxford Hip or Knee Scores (OHS/OKS) (scale from 0 (worst) to 48 (best)) and in health-related quality of life (EQ-5D) (scale from 0 (death) to 1 (full health)) from immediately before, to six months after, surgery. Regression analysis was used to estimate adjusted mean differences (LOS, change in OHS/OKS/EQ-5D) and risk differences (readmissions and mortality). Results Patients with comorbidities had a longer LOS and higher readmission and mortality rates than patients without. In hip arthroplasty patients with heart disease, for example, LOS was 1.20 days (95% confidence interval (CI) 1.15 to 1.25) longer and readmission rate was 1.52% (95% CI 1.34% to 1.71%) and mortality 0.19% (95% CI 0.15% to 0.23%) higher. Similar patterns were observed for knee arthroplasty patients. Patients without comorbidities reported large improvements in function (mean improvement OHS 21.3 (SD 9.91) and OKS 15.9 (SD 10.0)). Patients with comorbidities reported only slightly smaller improvements. In patients with heart disease, mean improvement in OHS was 0.39 (95% CI 0.27 to 0.51) and in OKS 0.56 (95% CI 0.45 to 0.67) less than in patients without comorbidities. There were no significant differences in EQ-5D improvement. Conclusion Comorbidities were associated with small increases in adverse safety risks but they have little impact on pain or function in patients undergoing hip or knee arthroplasty. These results do not support restricting access to hip and knee arthroplasty for patients with common comorbidities. Cite this article: Bone Joint J 2021;103-B(1):56–64.

OBJECTIVEDespite efforts toward achieving gender equality in clinical trial enrollment, females are often underrepresented, and gender-specific data analysis is often unavailable. Identifying and reducing gender bias in medical decision-making and outcome reporting may facilitate equitable healthcare delivery. Gender disparity in the utilization of surgical therapy has been exemplified in the orthopedic literature through studies of total joint arthroplasty. A paucity of literature is available to guide the management of lumbar degenerative disease, which stratifies on the basis of demographic factors. The objective of this study was to systematically map and synthesize the adult surgical literature regarding gender differences in pre- and postoperative patient-reported clinical assessment scores for patients with lumbar degenerative disease (disc degeneration, disc herniation, spondylolisthesis, and spinal canal stenosis).METHODSA systematic scoping review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. MEDLINE, Embase, and the Cochrane Registry of Controlled Trials were searched from inception to September 2018. Study characteristics including patient demographics, diagnoses, procedures, and pre- and postoperative clinical assessment scores (pain, disability, and health-related quality of life [HRQoL]) were collected.RESULTSThirty articles were identified, accounting for 32,951 patients. Six studies accounted for 84% of patients; 5 of the 6 studies were published by European groups. The most common lumbar degenerative conditions were disc herniation (59.0%), disc degeneration (20.3%), and spinal canal stenosis (15.9%). The majority of studies reported worse preoperative pain (93.3%), disability (81.3%), and HRQoL (75%) among females. The remainder reported equivalent preoperative scores between males and females. The majority of studies (63.3%) did not report preoperative duration of symptoms, and this represents a limitation of the data. Eighty percent of studies found that females had worse absolute postoperative scores in at least one outcome category (pain, disability, or HRQoL). The remainder reported equivalent absolute postoperative scores between males and females. Seventy-three percent of studies reported either an equivalent or greater interval change for females.CONCLUSIONSFemale patients undergoing surgery for lumbar degenerative disease (disc degeneration, disc herniation, spondylolisthesis, and spinal canal stenosis) have worse absolute preoperative pain, disability, and HRQoL. Following surgery, females have worse absolute pain, disability, and HRQoL, but demonstrate an equal or greater interval change compared to males. Further studies should examine gender differences in preoperative workup and clinical course.

Aims Rates of readmission and reoperation following primary total knee arthroplasty (TKA) are under scrutiny due to new payment models, which penalize these negative outcomes. Some risk factors are more modifiable than others, and some conditions considered modifiable such as obesity may not be as modifiable in the setting of advanced arthritis as many propose. We sought to determine whether controlling for hypoalbuminaemia would mitigate the effect that prior authors had identified in patients with obesity. Methods We reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database for the period of January 2008 to December 2016 to evaluate the rates of reoperation and readmission within 30 days following primary TKA. Multivariate logistic regression modelling controlled for preoperative albumin, age, sex, and comorbidity status. Results Readmission rates only differed significantly between patients with Normal Weight and Obesity Class II, with a decreased rate of readmission in this group (odds ratio (OR) 0.82; 95% confidence interval (CI) 0.71 to 0.96; p = 0.010). The only group demonstrating association with increased risk of reoperation within 30 days was the Obesity Class III group (OR 1.38; 95% CI 1.05 to 1.82; p = 0.022). Hypoalbuminaemia (preoperative albumin < 35 g/L) was significantly associated with readmission (OR 1.62; 95% CI 1.41 to 1.86; p < 0.001) and reoperation (OR 1.52; 95% CI 1.18 to 1.96; p = 0.001) within 30 days. Conclusion In this study, hypoalbuminaemia appears to be a more significant risk factor for readmission and reoperation than even the highest obesity categories. Future studies may assess whether preoperative albumin restoration or weight loss may improve outcomes for patients with hypoalbuminaemia. The implications of this study may allow surgeons to discuss risk of surgery with obese patients planning to undergo primary TKA procedures if other comorbidities are adequately controlled. Cite this article: Bone Joint J 2020;102-B(6 Supple A):31–35.

The article presents the results of research on the effect of cadmium load on the body of young cattle. The negative effect of Cadmium on the liver causes a wide range of pathological changes at different levels of its organization. The impact of heavy metals on the immune system is particularly significant, because it performs a leading role in maintaining health and is recognized as one of the most sensitive to adverse factors, even in relatively low concentrations. The aim of the study was to investigate the influence of cadmium on the cellular part of the immune system of young cattle. The research was carried out on 10 bulls of six months of age, Ukrainian black-and-white dairy breed, which were formed into 2 groups of 5 animals each: control and experimental. The bulls of the control group were on a normal diet. Animals of the experimental group were administered cadmium chloride at a dose of 0.04 mg/kg body weight of the animal. It was found that feeding bulls with a diet of cadmium chloride, the number of B-lymphocytes on the 5th day of the experiment was 17.54 ± 0.95 %. The lowest number of B-lymphocytes was on the 20th day of testing – 15.12 ± 0.37 %. The study of the number of T-lymphocytes shows that at the beginning of analysis the number of T-lymphocytes in the blood of animals of the control and experimental groups ranged from 40.70 ± 3.62 and 40.85 ± 2.54 %. Subsequently, the number of T-lymphocytes in the blood of the experimental group began to decline. The lowest number of T-lymphocytes was in the experimental group of animals on the 20th day of the research, compared with the control group, this figure decreased by 3.63 %. The state of immunity of animals under cadmium load significantly depends on the ratio of T-helpers to T-suppressors. It was found that the immunoregulatory index of blood of bulls of the experimental group probably decreased from 10 days of the research. The number of T-helper lymphocytes in the blood of the experimental group of bulls under cadmium loading is probably reduced by 15, 20 and 30 days of testing. A probable increase in the number of T-suppressors was noted in the bull's blood of the experimental group on the 20th day of the research. Immunoglobulins of different classes are crucial among bull’s serum proteins under cadmium loading. The concentration of immunoglobulins in the blood under cadmium load decreased by 15.9 % relative to the control group on the 20th day of analysis.

Background:The adverse events (AEs) associated with methotrexate (MTX) treatment for rheumatoid arthritis (RA) have been studied extensively, but precise estimates of the incidence and prevalence of AEs are lacking. There is also limited published data on the predictors of AEs.Objectives:To summarise and pool incidence and prevalence rates of AEs in patients treated with MTX for RA, and to identify treatment, clinical and disease related predictors of AEs.Methods:A systematic literature search was carried out using Embase, Medline, and CENTRAL databases to identify relevant studies published between 1/1/2005 and 12/2/2019. The eligibility criteria included RCTs, non-randomized trials, and observational studies of first-time users of MTX in adults (≥ 18 years old) with RA and reported incidence, prevalence or predictors of the most common MTX related AEs, including: any AE, serious AEs, discontinuation due to AEs, elevated liver enzymes, gastrointestinal (GI), mucocutaneous (MC), central nervous system (CNS), and pulmonary AEs. Pooled proportions of GI AEs and elevated liver enzymes of patients treated with MTX monotherapy were estimated using random effects meta-analysis.Results:Of 3142 records screened, we included 46 articles (35 clinical trials and 11 cohort studies) with a total of 9646 patients, and a mean follow-up duration of 70±35 weeks (range: 13 - 104 weeks for RCTs, 40 - 156 weeks for observational cohorts).Six studies reported incidence rate (IR) of any AE (range: 196 - 595 per 100 person-years), and eight studies reported IR of serious AEs (range: 3.7 - 15.9 per 100 person-years). The percentage of patients with any AE, reported in 32 studies, varied between 37% and 100% in RCTs, and between 13% and 34% in observational studies. Discontinuation of MTX due to AEs ranged between 1% and 29% in RCTs, and between 8% and 38% in observational studies. The reported prevalence of MC events (4% - 54%), CNS events (12% - 59%) and pulmonary events (10% - 67%) varied between studies.The estimated pooled prevalence from studies with a MTX monotherapy arm was 14% (95% CI: 9%, 19%; N=7 studies) for liver enzymes elevation (Figure 1), and 29% (95% CI: 13%, 44%; N=7 studies) for GI AEs (Figure 2).Figure 1.Forest plot of pooled prevalence of elevated liver enzymesFigure 2.Forest plot of pooled prevalence of gastrointestinal adverse eventsNo statistically significant predictors of “any AE” were identified. For discontinuation of MTX due to AEs, RF positivity was associated with lower risk of MTX discontinuation due to MTX (HR 0.37, 95%CI: 0.21, 0.64), while other studies found that baseline HAQ score (OR 1.87, 95%CI: 1.11, 3.15) and BMI (OR 1.21, 95%CI: 1.02, 1.44) were associated with increased risk of MTX discontinuation due to AEs. ACPA positivity (OR 1.8, 95%CI: 1.1, 3.1), and high baseline alanine aminotransferase (ALT) (OR 3.1, 95%CI: 1.6, 6.2) were both independent predictors of two-fold elevation of ALT in one paper, and baseline creatinine (OR 1.03, 95%CI: 1.00, 1.07) and high baseline ALT (OR 1.03, 95%CI: 1.00, 1.06) were associated with increased risk of elevated ALT above the upper limit of normal in a different study.Conclusion:These findings affirm the high prevalence of GI AEs and elevated liver enzymes among patients treated with MTX for RA. The identified predictors of MTX withdrawal and elevated ALTs may be useful for identifying future patients likely to experience these AEs early in the course of treatment. However, the results of the predictors should be interpreted with caution, and further work is needed to replicate the results in studies with larger sample sizes and to assess the prognostic value of established predictors.Disclosure of Interests:Ahmad Sherbini: None declared, Seema Sharma: None declared, James Gwinnutt Grant/research support from: BMS, Kimme Hyrich Grant/research support from: Pfizer, UCB, BMS, Speakers bureau: Abbvie, Suzanne Verstappen Grant/research support from: BMS, Consultant of: Celltrion, Speakers bureau: Pfizer

Introdução: a problemática central deste artigo é o cuidado. O cuidado não como expressão única do tecnicismo, mas em suas múltiplas dimensões. Objetivo: discutir o cuidado numa perspectiva ampliada, envolvendo suas expressões subjetivas, espirituais, corporais e ambientais. Metodologia: trata-se de uma revisão bibliográfica sobre as dimensões do cuidado, tendo como base autores da filosofia, sociologia, psicologia e enfermagem. Resultados: as múltiplas dimensões do cuidado foram estruturadas em cinco eixos epistemológicos, quais sejam, cuidar de si, cuidar do outro, cuidar da terra, cuidar da psique e cuidar do espírito. Conclusão: A partir das discussões desta investigação, é perceptível que os indivíduos, em sua magnitude, precisam adquirir uma nova postura diante do cenário atual que o mundo está passando, pois a problemática apontada requer uma visão multidimensional do cuidado.Palavras-chave: cuidado, enfermagem, tecnicismo e multidimensionalidade. Abstract: Introduction: the central proprosition of this article is the care. Care is not a unique expression of technicality, but in its multiple dimensions. Objective: to discuss care in an extended perspective, involving its subjective, spiritual, corporeal and environmental expressions. Methodology: this is a bibliographical review on the dimensions of care, based on authors of philosophy, sociology, psychology and nursing. Results: the multiple dimensions of care were structured in five epistemological axes, namely, caring for oneself, caring for others, caring for the earth, caring for the psyche and caring for the spirit. Conclusion: From the discussions of this research, it is noticeable that individuals, in their magnitude, need to acquire a new posture in view of the current scenario that the world is going through, since the problematic pointed out requires a multidimensional view of care. Keywords: care, nursing, technicality and multidimensionality. REFERÊNCIAS AMORIM, K. 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AbstractIn forensic science, signatures are identified by means of comparative handwriting analysis - not to be confused with graphological examination. To the authors' knowledge, no systematic investigation has hitherto taken place as to the effectiveness of subjecting signatures on old master paintings to such comparative analysis. Even when judgment is passed on signatures in art-historical publications, it is seldom based on an investigation which could stand up to the critical standards of handwriting experts. Partly due to insufficient knowledge of the relevant criteria, signature assessment therefore tends to be influenced in both a positive and a negative sense by opinions about the painting. (I.b.) This article describes the results of examinations of Rembrandt signatures on paintings from the period 1632-1642, conducted by a team of two forensic handwriting experts headed by the controller of the experiment. The Rembrandt Research Project team supplied a total of 123 photographs of signatures, 88 of which were deemed suitable for evaluation, 73 of them belonged to the 'Rembrandt' type, and 15 to the 'RHL van Rijn' type. Only aftcr our examination wcrc we able to confirm, on the basis of Vol umcs 11 and 111 of the Corpus, which of these signatures occur on paintings accepted by the RRP team as authentic Rembrandts, and which on de-attributed paintings. The monograms discussed in Volume I of the Corpus proved to be unsuitable for our investigation, due to the insufficient number of characteristics they yield. (I.d. and I.e.) In the examination of handwriting, the characteristics of a series of incontestably genuine signatures arc compared with the characteristics encountered in a series of signatures whose identity is to be established. This procedure was unfeasible for the examination in question, for, regardless of whether the usual methods of comparison can be applied to signatures rendered with a brush, the question arises as to which of the signatures on a paining are indisputably authentic. Reconnaissance of the signature problem shows that the art historian is unable, for various reasons, to quarantee that a painting established without a shadow of doubt as a Rembrandt actually bears the master's own signature. (I.c.) We therefore opted for a different procedure, but not until exploratory experiments had led us to expect that the usual methods of comparing handwriting would be feasible. (III.a.) Entirely ignorant of art-historical assessments of the paintings in question and their signatures, the hand writing experts analysed the available material on the basis of characteristics used in the comparison of normal signatures and handwriting (11.a.) The team's experiment-controller liaised with the art historians and evaluated the results statistically. (I.d.) The exploratory and statistical character of our investigation was one of the reasons for dispensing with a systematic enumeration of all the individual signature assessments. Working in this fashion, we selected a group of i 'Rembrandt'type signatures from the available material, signatures which formed a homogeneous group because of their shared characteristics. We called them the reference signatures. The homogeneous character of the reference group reflects, in our opinion, the recognizable and reproducible characteristics of Rembrandt's signature. The reference signatures are therefore assumed to have been executed by Rembrandt himself. With the aid of the group of reference signatures, the other material was further evaluated. The outcome was a list in which the signatures are graded as to their probable authenticity. In forensic handwriting comparison, probability gradations stem from the statistical character of the comparison process. (II.b.) They permit nuances to be made in the assessment of a signature. The extent to which identification criteria are satisfied, the consequences of restorations and other doubtful elements which are hard to assess, especially in the case of negative judgment (V.b.), are reflected in the individual probability gradations. Figures 1, 2 and 3 show three signatures from the reference group, accompanied by a number of shared characteristics occurring in the reference group. (IV.a) Figures 4 and 5 show signatures which have been assigned a lower probability gradation; one (figure 4) graded authentic, the other (figure 5) as not. (IV.b.) Only the first four letters of the signature in figure 7 are regarded as authentic; it is one of the seven examined signatures containing only a 't'. (V.b.) This procedure skirts the problem of non-guaranteed comparative signatures. Statistical evaluation of the results can also provide an insight into the question of whether the usual techniques for examining handwriting can be successfully applied to signatures on paintings. If the assessments thus obtained prove to be reliable, they may generate further valuable art-historical information. The results of the examination of the 73 'Rembrandt'-type signa tures are summarized in a table in which the signature assessments are related to the qualifications of the paintings as recorded in Volumes 11 and 111 of the Corpus. This table does not give the probability gradations, which arc however for the sake of convenience simply grouped into 'authentic' and 'non-authentic'. (V.a. and Table I) The table contains the most pertinent statistical data. In order to test thc reliability of the handwriting experts' assessment statistically, we employed a ratio based on signatures occurring on non-authentic paintings. Reliability proved to be almost 90%. Unfortunately, authentic paintings arc not suitable subjects for this kind of test. Evaluation of the results leads us to conclude that, under conditions to be described in greater detail, handwriting examination techniques arc in fact applicable to the assessment of signatures on paintings. The procedure described here only yields results when a large number of signatures with suflicient information content are available. The 73 'Rembrandt'-type signatures permitted the formation of a reference group, but the 15 'RHL van Rijn' specimens were not enough. (V.b.) On the assumption that the handwriting experts' judgment was reliable, only about 40% of the paintings established by the RRP team as authentic were actually signed by Rembrandt himself. It transpired that one of the reference signatures came from a pupil's work (figure 6), as did two others regarded as authentic, albeit with a lower probability gradation. The handwriting experts' results thus supply independent corroboration of the art-historical opinion that Rembrandt signed studio work. (V.b. and Table I) Comparison of the results of our investigation with corresponding assessments of 'Rembrandt'-type signatures by the RRP team yielded 11 controversial opinions: 8 among the 47 authentic paintings and 3 among the 26 unauthentic ones. (V.C.I.) Apart from the experience of the handwriting experts, controversies stem from the fundamentally different approaches of the two disciplines in forming their judgment by means of selecting reference signatures and evaluating characteristics. The fact that the handwriting experts reject more signatures on authentic paintings and accept more in the case of unauthentic ones than the art historians is due to the two disciplines' different kinds of knowledge about the relationship between signature and painting. (V.c.2.) Statistical evaluation of the collaboration of the two fields leads to the general conclusion that the intervention of the handwriting experts results in significantly more rejections of signatures on authentic paintings than has been previously established by the art historians. Moreover, on the basis of results obtained by the two disciplines in the case of the 47 authentic paintings, the statistical expectation is that of all the signed authentic paintings by Rembrandt, roughly half do not (any longer) bear his own signature. (V.c.3) It is to be expected that distinct photographic enlargements, in combination with in situ scientific examination of the material condition of the signature and its direct surroundings, will improve the reliability of signature assessment. Keith Moxey, Peasants, Warriors, and Wives. Popular Imagery in the Keformation, (The University of Chicago Press. Chicago and London, 1989). 165 Seiten mit 57 Schwarz-welß-Abbildungen. In den USA ist in den letzten Jahren eine zunehmende Aufmerksamkeit für die deutsche Kunst der Dürerzeit und speziell der Reichsstadt Nürnberg zu verzeichnen. Die bedeutenden Ausstellungen 'Gothic and Renaissance Art in Nuremberg 1300-1550' (1986) und 'The World in Miniature. Engravings by the German Little Masters' (1988/89) sowie eine Reihe von Dissertationen manifestieren dieses Interesse, dem auch das vorliegende Buch zu verdanken ist. Der Autor hat sich seit seiner Dissertation über Pieter Aertsen und Joachim Beuckelaer (1977) der Erforschung der profanen und populären Bildwclt des 15. und 16. Jahrhunderts in Deutschland und den Niederlanden gewidmet und dabei die Frage nach den gesellschaftlichen Funktionen und Intentionen solcher Darstellungen im Medium der Druckgraphik in den Mittelpunkt gerückt. Der vorliegende Band präsentiert drei Studien zu thematischen Schwerpunkten des Nürnberger Einblattholzschnitts im Zeitalter der Reformation, verbunden durch weitere Kapitel über die historische Situation Nürnbergs und über die medialen Charakteristika von Holzschnitt und Einblattdruck. Der wissenschaftliche Apparat belegt, daß Moxey die reiche deutschsprachige Literatur zur Nürnberger Kunst- und Lokalgeschichte gründlich studiert hat. Seine Übersetzungen der Texte der Einblattdrucke (in den Anmerkungen nach den Originalen transkribiert und zitiert) sind akzeptabel. Das Buch wird mit einer hermeneutischen Standorthestimmung eingeleitet, was angesichts des gegenwärtigen Pluralismus der Kunstbegriffe und Methodenansätze zunehmend zum Erfordernis wissenschaftlichen Verantwortungsbewußtseins wird. Der Versuch, Bedeutung und Funktion populärer Bildmedien der Vergangenheit und ihrer Darstellungen zu ermitteln, darf sich weder auf einen ästhetisch definierten Kunstbegriff verpflichten, noch sich auf Methoden verlassen, die an diesem Kunstbegriff ausgerichtet sind. Während zum Beispiel die Ikonologie Bilder als Dokumente weltanschaulicher Einstellungen betrachtet und ihre Bedeutung an die gcistesgeschichtliche Stellung ihrer inhaltlichen Aussagen bindet, stellt sich bei den populären Bildmedien der Reformationszeit die Frage nach ihrer nicht nur reflektierenden, sondern aktiv gestaltenden Rolle als Kommunikationsmittel bei der Artikulierung gesellschaftlicher Interessen und politischer Absichten. Damit gewinnen für den Kunsthistoriker Fragestellungen der Soziologie und der Semiotik vorrangige Bedeutung. Es ergibt sich aber das Problem, daß moderne Begriffe wie 'Klasse' oder 'Ideologie' die Rekonstruktion historischer Vcrständnishorizonte behindern können. Moxey sicht dieses Problem, neigt aber dazu, ihm in Richtung auf cincn meines Erachtens oberflächlichen Pragmatismus auszuweichen, wenn er mit Hayden White postuliert, der Historiker könne nur die Fragen stellen, die ihm seine eigene Zeit aufgibt. Es wird sich zeigen, daß diese Einstellung problematische Konsequenzen hat. Der Überblick über die historische Situation Nürnbergs (Kapitel i) hebt folgende Faktoren hervor: die oligarchische Herrschaft des Handelspatriziats mit rigider Kontrolle über alle Aktivitäten der unteren Bevölkerungsschichten; die Propagierung einer vom Patriziat definierten kulturellen Identität des Nürnberger Bürgertums durch öffentliche Darbietungen (Schembartlauf, Fastnachtsspiele), bei denen die Abgrenzung von unbürgerlichen Lebensformen, personifiziert durch Narren und Bauern, eine wesentliche Rolle spielt; die Verbundenheit des herrschenden Patriziats mit der kaiserlichen Sache trotz Religonskriegen und konfessionellen Gegensätzen; der Beitrag der nationalistischen Ideen der Nürnberger Humanisten zum rcichsstädtischcn Selbstverständnis ; die Lösung des Konflilzts zwischen protestantischem Bekenntnis und Kaisertreue mit Hilfe von Luthers Lehre der 'zwei Welten'. Kapitel 2 ('The Media: Woodcuts and Broadsheets') behandelt die Aufgaben des Holzschnitts, die Bedingungen seiner Herstellung und Verbreitung im Zusammenhang mit dem rasanten Auf-stieg des Buch- und Flugblattdrucks und einer auf Aktualität zielenden Publizistik, sowie die Stellung der Künstler als Vorlagenzeichner, die von den Druckern und Verlegern weitgehend abhängig waren. Bisherige Versuche, Holzschnitte und Illustrationen als Ausdruck persönlicher Überzeugungen der Vorlagen zeichner zu deuten, mußten daher in die Irre führen, wie Moxey am Beispiel der Brüder Beham belegt. Zu den Rahmenbedingungen der medialen Funktion Nürnberger Holzschnitte gehört aber noch ein weiterer Faktor, den Moxey nicht berücksichtigt: der deutliche Gegensatz zwischen Holzschnitt und Kupferstich im Hinblick auf Verbreitung, Themenwahl, Darstellungsweise, Verhältnis Bild-Text und Rezeptionsweise, der unter anderem dazu führt, daß an übereinstimmende Themen bei gleichen Künstlern unterschiedliche formale und inhaltliche Anforderungen gestellt werden, und daß sogar Motive bei der Übernahme aus einem Medium in das andere ihre Bedeutung ändern können. Dieser Gegensatz ist charakteristisch für die Nürnberger Graphik und ist weder in der Augsburger noch in der niederländischen Graphik dieser Zeit annähernd vergleichbar deutlich ausgeprägt. Kapitel 3 ('Festive Peasants and Social Order') ist die überarbeitete Fassung eines Aufsatzes, der in 'Simiolus' 12, 1981/2 unter dem Titel 'Sebald Beham's Church Anniversary Holidays: Festive Peasants as Instruments of Repressive Humour' erschienen ist. In die damals aktuelle, von Hessel Miedema und Svetlana Alpers ausgelöste Debatte über die Deutung von Bauernfest-Darstellungen und die Funktion des Komischen in Kunst und Dichtung des 16. Jahrhunderts hatte dieser Aufsatz wegweisende Argumente eingeführt, die mir bei meinen eigenen Forschungen über die 'Bauernsatiren' sehr nützlich und klärend waren. Abgesehen von einem knappen Hinweis Konrad Rengers (Sitzungsberichte der Kunstgeschichtlichen Gesellschaft zu Berlin, neue Folge, 20, 1971/72, 9-16) hatte Moxey als erster auf den Zusammenhang der Bauernfest-Holzschnitte mit der literarischen Tradition der Bauernsatire aufmerksam gemacht, welche durch die Behams in der Verbindung von Bild und Text und der Nähe zu Dichtungen des Hans Sachs für Nürnberg aktualisicrt wurde. Diese 'Bauernfeste' sind folglich keine Zeugnisse eines folkloristischen Realismus, sondern komplexe Übertragungen literarischer Stereotype in Bilder. Die Bauern und ihre Kirmessen und Hochzeiten sind weniger Gegenstände und Ziele dieser Darstellungen, sondern fungieren als Mittel der Stände- und Moralsatire. Lediglich in einem Punkt haben mich Moxey's Argumente nicht überzeugt: für ihn scheinen die feiernden Bauern der Behams tatsächlich die Dorf-bewohner des Nürnberger Umlandes aus der ideologischen Sicht der Patrizier darzustellen. Dies deutet er an, wenn er die Holzschnitte als 'visual vehicle for the expression of class ridicule' betrachtet und im - neu formulierten - Schluß des Kapitels bei Betrachtern aus dem Nürnberger Handwerkerstand sentimentale Erinnerungen an das 'freiere' Leben ihrer bäuerlichen Vorfahren vermutet. Zu Beginn des Kapitels setzt er sich mit zwei Richtungen der traditionellen Interpretation auseinander, welche diese Holzschnitte als unmittelbare oder mittelbare, d.h. ideologische Reflexe gesellschaftlicher Wirklichkeit betrachteten. Aber auch er löst sich nicht ganz von dieser Prämisse, wie der neuformuliertc Titel 'Festive Peasants and Social Order' bekräftigt. Dagegen habe ich einzuwenden, daß die literarische Tradition der Bauern-und Bauernfestsatire in keinem unmittelbaren Zusammenhang mit der Ständelehre steht, welche die Rechte und Pflichten des Bauernstandes festlegt. Deren Gegenstand ist vielmehr der Bauer als Ernährer der Gesellschaft, der arbeitet und Abgaben leistet oder sich dieser ihm von Gott zugewiesenen Rolle verweigert. Darauf nehmen die Bauernfest-Holzschnitte nur insofern Bezug, als Ausschweifungen, Luxus und bewaffneter Streit die Einhaltung dieser bäuerlichen Pflichten gefährden. Im Vordergrund steht aber die Funktion dieser Holzschnitte als satirischer Spiegel 'bäurischer' Unsitten, so daß der Titel besser lauten sollte 'Festive Peasants and Social Behaviour'. Hier rächt es sich, daß Moxey den modernen soziologischen Bcgriff 'Klasse' anstelle des historisch angemessenen Begriffs 'Stand' verwendet. 'Stand' impliziert eine Reihe theologischer und moralischer Wertsetzungen, die dem politisch-ökonomisch definierten Begriff 'Klasse' fehlen. Aber gerade mit diesen 'argumentieren' die Holzschnitte und die ihnen entsprechenden Texte, und auf dieser Ebene des Arguments nehmen sie auch Stellung zur politischen und konfessionellen Aktualität. Eine andere Frage ist, welche Aspekte der Bedeutung der zeitgenössische Betrachter wahrnahm: politische, moralische, konfessionelle, literarische, brauchtumsmäßige usw. Dies dürfte von seiner eigenen jeweiligen Position als Bürger von Nürnberg oder einer anderen Stadt, Humanist, Lutheraner, Grundbesitzer mitbestimmt worden sein. Die 'Multifunhtionalität' der Baucrnsatire, auf die vor mir schon Hessel Miedema und Paul Vandenbroeck hingewiesen haben,2 d.h. die gesellschaftliche Differenziertheit der Rezeptionsweise, der die Holzschnitte sichtlich Rechnung tragen, darf nicht außer Betracht bleiben. In Kapitel 4 legt Moxey die erste kunsthistorische Untersuchung der zahlreichen Darstellungen von Landsknechten im Nürnberger Holzschnitt vor. Ausgangspunkt ist Erhard Schöns großformatiger 'Zug der Landsknechte' (um 1532, Geisberg 1226-1234), den Moxey als Heroisierung der kaiserlichen Militärmacht und damit als Nümberger Propaganda für die kaiserliche Politik deutet. Aktueller Anlaß ist die Türkengefahr mit der Belagerung Wiens 1532. Dies ist eine begründete, aber nicht in jeder Hinsicht überzeugende Hypothese. In den Serien einzelner Landsknechts-Figurcn van Schön (Geisberg 1981ff) und Hans Sebald Beham (Geisberg 273ff) weisen beigegebene Texte wiederholt darauf hin, daß es sich um Teilnehmer an kaiserlichen Feldzügen handelt. Im 'Zug der Landsknechte' wird zwar eine burgundischhabsburgische Fahne entrollt, aber der Text von Hans Sachs läßt den Hauptmann an der Spitze des Zuges ausdrücklich sagen: 'Die Landsknecht ich byn nemcn an/Eynem Herren hie ungemelt', was angesichts der von Moxey vermuteten pro-kaiserlichen Propaganda zumindest erklärungsbedürftig ist. Den werbenden und heroisierenden Drucken stellt Moxey eine größere Zahl von Holzschnitten gegenüber, die nicht von den Leistungen, Ansprüchen und Verdiensten der Söldner, sondern von den negativen Aspekten des Landsknechtslebens und -charakters handeln. Todesbedrohung, Sittenlosigkeit, Aggressivität und Abkehr von ehrlichem Erwerb aus Gier nach schnellem Geld werden teils anklagend teils satirisch thematisiert. Diese Gespaltenheit des Bildes vom Landsknecht in verschiedenen Drucken derselben Verleger nach Vorlagen derselben Zeichner wird mit einer widersprüchlichen Einstellung zum Krieg und mit Luthers eschatologischer Deutung der Türkengefahr als 'Gottesgeißel' in Verbindung gebracht. Der Landsknecht erscheint einerseits als 'Mittel der Bekräftigung kaiserlicher Macht angesichts einer nationalen Bedrohung', anderseits als 'Mittel der Ermahnung, daß die Türkeninvasion eher eine moralische als eine militärische Notlage darstellt, und daß physische Gewalt das ungeeignete und unangemessene Mittel der Auseinandersetzung mit einer Züchtigung Gottes ist.' Den entscheidenden Beleg für diese Deutung findet Moxey in Erhard Schöns 'Landsknechtstroß vom Tod begleitet'. Die Hure am Arm des Fähnrichs und der Hahn auf dem Trainwagen bezeichnen die sexuelle Zügellosigkeit der Landsknechte, gefangene Türken und straffällige Söldner marschieren gefesselt hintereinander. Der neben dem Trainwagen reitende Tod mit erhobenem Stundenglas wird von zwei Skeletten begleitet, von denen eines als Landsknecht, das andere als Türke gekleidet ist. Moxey: 'Durch das Auslöschen der Unterschiede zwischen Türkc und Landsknecht leugnet der Tod die heroischen Eigenschaften, die dem Söldner in Werken wie 'Der Zug der Landshnechte' zugeschrieben werden. In diesem Zusammenhang erscheint die kaiserliche Sache nicht wertvoller als die der Feinde.' Einer Verallgemeinerung dieser Deutung und ihrer Übertragung auf die anderen negativen Landsknechtsdarstellungen ist cntgegenzuhalten, daß es in diesen keinerlei Anspielungen auf die Türken gibt. Das gilt insbesondere für einen 'Troß'-Holzschnitt des Hans Sebald Beham (Geisberg 269-272), der um 1530, d.h. vor Schöns 'Troß vom Tod begleitet' entstanden sein dürfte und mit diesem das Vorbild von Albrecht Altdorfers 'Troß' aus dem 'Triumphzug Kaiser Maximilians I.' teilt. Behams 'Troß' steht unter dem Kommando eines 'Hurnbawel' (Hurenwaibel), der den von einem Boten überbrachten Befehl zum Halten angesichts einer kommenden Schlacht weitergibt. Der Troß aus Karren und Weibern, begleitet von unheroischen, degeneriert aussehenden Landsknechten oder Troßbuben, führt vor allem Fässer, Flaschen und Geflügel mit. Die Fahne wird von einem Hahn als dem bedeutungsträchtigen Feldzeichen dieses zuchtlosen und lächerlichem Haufens überragt. Moxey hat diesen Holzschnitt nicht berücksichtigt. Mein Eindruck ist, daß eine religiös oder ethisch motivierte ambivalente Einstellung zur Kriegführung im Allgemeinen oder zum Türkenkrieg im Besonderen nicht die Gegensätzlichkeit des Landsknechtsbildes erklären kann. Ich sehe vielmehr eine Parallele zu dem ähnlich gespaltenen Bild vom Bauern in positive Ständevertreter und satirische Vertreter 'grober' bäurischer Sitten. Bei den Landsknechtsdarstellungen kann man zwischen werbenden und propagandistischen Bildern heroischer Streiter für die kaiserliche Sache und kritisch-satirischen Darstellungen der sittlichen Verkommenheit der Soldateska und der sozial schädlichen Attraktivität des Söldnerwesens für arme Handwerker unterscheiden. Kapitel 5 ('The Battle of the Sexes and the World Upside Down') behandelt eine Reihe von Drucken, welche die Herrschaft des Mannes über die Frau und die Pflicht des Mannes, diese Herrschaft durchzusetzen, zum Gegenstand haben. Die Fülle solcher Drucke im Nürnberg der Reformationszeit und die Brutalität, die den Männern empfohlen wird, erlauben es nicht, hier bloß eine Fortsetzung mittelalterlicher Traditionen frauenfeindlicher Satire zu sehen. Moxey erkennt die Ursachen für die besondere Aktualität und Schärfe dieser Bilder in den demographischen und sozialen Verhältnissen Nürnbergs (Verdrängung der Frauen aus dem Erwerbsleben im Zuge verschärfter Konkurrenzbedingungen) und im Einfluß der lutherischen Ehelehre. Die Familie wird als Keimzelle des Staates aufgefaßt, die Sicherung familiärer Herrschaftsstrukturen gilt als Voraussetzung für das Funktionieren staatlicher Autorität und ist daher Christenpflicht. Dieser Beitrag ist eine wertvolle Ergänzung der Untersuchungen zur Ikonologie des bürgerlichen Familienlebens in reformierten Ländern des 16. und 17. Jahrhunderts, die sich bisher auf die Niederlande konzentriert hatten.3 Die abschließenden 'Conclusions' versuchen, aus diesen Ergebnissen eine präzisere Charakterisierung der medialen Qualitäten Nürnberger Holzschnitte zu gewinnen. Ihr 'schlichter Stil' oder 'Modus' folgt aus einer bewußten Reduzierung der formalen Mittel der Graphik und ermöglicht eine Unterordnung des Bildes unter den Text. Einblattdrucke und Flugblätter stehen den Inkunabelillustrationen nahe, bei denen die 'Lesbarkeit' des Bildes die dominierende Form von Anschaulichkeit ist. Mit Norman Bryson spricht Moxey von 'diskursiven' Bildern, die keinen Anspruch auf künstlerischen Eigenwert machen und deren Informationsgehalt einseitig auf den Text bezogen ist. Die Reduktionen der formalen Mittel, d.h. die Verkürzung der Information verlangt von Betrachter die Auffüllung mit Bedeutungen, die dem Text oder - in dessen Abwesenheit - 'Zeichensvstemen anderer Ordnung', z.B. Fastnachtspielen zu entnehmen sind. Eine charakteristische Sonderform ist die Rcihung von einzelnen, relativ gleichförmigen Bildern zu Serien, zu einer friesartigen Gesamtkomposition. Moxey erklärt dieses Prinzip mit der Vorbildhaftigkeit der Riesenholzschnitte für Kaiser Maxmilian I., in denen Redundanz als Mittel propagandistischer Wirkungssteigerung fungiert. Dies scheint mir zu kurz gegriffen, den gcrade in Nürnberg dürfte die literarische und dramatische Form des 'Reihenspiels' (die einzelnen Darsteller treten wie in einer Rev ue nacheinander vor und sprechen ihren Text) ein noch wiehtigerer Ausgangspunkt gewesen sein, zumal diese literarische Form auch in den Texten vieler Einblattdrucke angewendet wird, vor allem von Hans Sachs. Der 'schlichte Stil' oder Modus läßt viel mehr Abstufungen und Variationen zu, als Moxey's 'Conclusions' zu erkennen geben. In Holzschnitten wie Hans Sebald Behams 'Großes Bauernfest' liegt eine komplexe Darstellungsweise vor, die die Bezeichnung 'schlicht' kaum mehr verdient. Moxey's Unterscheidung in einen lesbaren Vordergrund und einen 'malerischen' Hintergrund ist unangemessen. Ich gebe zu bedenken, daß durch das Wirken Dürers dem Nürnberger Holzschnitt auch spezifisch künstlerische Maßstäbe eröffnet worden sind. Dürer schreibt in seiner 'seltzame red' ausdrücklich, 'das manicher etwas mit der federn in eine tag auff ein halben bogen papirs reyst oder mit seim eyrsellein etwas in ein klein hoeltzlein versticht, daz wuert kuenstlicher und besser dann eins ändern grosses werck.'4 Unter Dürers Einfluß hat der Nürnberger Holzschnitt sich die Möglichkeiten des perspektivisch organisierten Bildraumes erschlossen. Das bedeutet, daß neben das herkömmliche Anschaulichkeitprinzip der 'Lesbarkeit' von Motiven, die auf einer Bildebene aufgereiht sind, das neue Anschaulichkeitprinzip der Perspektivität tritt, die nach den Begriffen der humanistischen Kunstlehre dem rhetorischen Ideal der 'perspicuitas' entspricht. Auch wenn die Einblattholzschnitte nur zu einem Teil und sichtlich unentschieden von dieser neuen Bildform Gebrauch machen, so steht doch fest: der 'schlichte Stil' läßt Veränderungen und Entwicklungen zu, in denen Raum für spezifisch künstlerische Faktoren ist. Moxey's Verzicht auf spezifisch kunsthistorische Fragestellungen enthält die Gefahr einer Verengung des Blickwinkels. Auch seine Einschätzung der bloß dienenden Rolle des Bildes gegenüber dem Text erscheint differenzierungsbedürftig. Indem die knappen und reduzierten Angaben des Bildes den Betrachter dazu veranlassen, sie mit Textinformationen aufzufüllen und zu ergänzen, wächst dem Bild eine aktive Rolle zu: es organisiert und strukturiert die Lektüre des Texts. Im Einblattdruck 'Zwölf Eigenschaften eines boshaften und verruchten Weibes' (Moxey Abb.5.16) zählt der Text von Hans Sachs auf: Vernachlässigung von Haushalt und Kindern, Naschhaftigkeit, Verlogenheit, Putz-sucht, Stolz, Streitsucht, Ungehorsam, Gewalt gegen den Ehe-mann, Verweigerung der ehelichen Pflicht, Ehebruch und schließlich Verleumdung des Ehemannes bei Gericht. Erhard Schöns Holzschnitt zeigt in der Öffnung der beiden Häuser die Punkte I und 12 der Anklage, unordentlichen Haushalt und Verleumdung vor Gericht. Im Vordergrund ist der gewalttätige Streit dargestellt, der das Zerbrechen der ehelichen Gemeinschaft und der familiären Ordnung offenbar eindeutiger zeigt als etwa der Ehebruch. Das Bild illustriert folglich nicht nur, es interpretiert und akzentuiert. Diese aktive Rolle des Bildes gegenüber dem Text ist eine bedeutende Funktionserweiterung des illustrativen Holzschnitts, als deren Erfinder wohl Sebastian Brant zu gelten hat.5 Nach Moxey's Überzeugung 'artilculiert' das in den Nürnberger Holzschnitten entwichelte 'kulturelle Zeichensystem' Vorstellungcn von gesellschaftlichen Beziehungen und Wertmaßstäben, die zutiefst von Luthers Soziallehre geprägt sind und als Maßgaben eines göttlichen Gebotes unverrückbar festgeschrieben und verteidigt werden. Es war im Interesse des Patriziats, diese Stabilität bei allen Bevölkerungsschichten durchzusetzen, und dabei spielten die Einblattdrucke und Holzschnitte eine aktive, gestaltende Rolle. Trotz mancher Einwände im Einzelnen glaube ich, daß diese Deutung grundsätzliche Zustimmung verdient.

The pandemic of COVID-19 has afflicted every individual and has initiated a cascade of directly or indirectly involved events in precipitating mental health issues. The human species is a wanderer and hunter-gatherer by nature, and physical social distancing and nationwide lockdown have confined an individual to physical isolation. The present review article was conceived to address psychosocial and other issues and their aetiology related to the current pandemic of COVID-19. The elderly age group has most suffered the wrath of SARS-CoV-2, and social isolation as a preventive measure may further induce mental health issues. Animal model studies have demonstrated an inappropriate interacting endogenous neurotransmitter milieu of dopamine, serotonin, glutamate, and opioids, induced by social isolation that could probably lead to observable phenomena of deviant psychosocial behavior. Conflicting and manipulated information related to COVID-19 on social media has also been recognized as a global threat. Psychological stress during the current pandemic in frontline health care workers, migrant workers, children, and adolescents is also a serious concern. Mental health issues in the current situation could also be induced by being quarantined, uncertainty in business, jobs, economy, hampered academic activities, increased screen time on social media, and domestic violence incidences. The gravity of mental health issues associated with the pandemic of COVID-19 should be identified at the earliest. Mental health organization dedicated to current and future pandemics should be established along with Government policies addressing psychological issues to prevent and treat mental health issues need to be developed. References World Health Organization (WHO) Coronavirus Disease (COVID-19) Dashboard. 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The Mono Lake case is a lodestar in public trust jurisprudence. This article discusses that case and explains how it revolutionized California water law. The article identifies six principles established by the decision that place it in the vanguard of public trust case law. It also examines some of the progeny of the Mono Lake decision, both in California and in other western states. The article claims that in the wake of Mono Lake, a half dozen western states have recognized the application of the public trust doctrine to water rights, although no other state has embraced all six of the tenets of the Mono Lake doctrine. The article concludes that the the public trust doctrine's deep historical roots and conceptual coherence make it a promising vehicle by which to moderate the excesses of the prior appropriation doctrine of western water law and replace that doctrine's "all or nothing" approach with what the article refers to as the "accommodation principle," under which both diversionary and instream uses of water will be accommodated wherever feasible.

Purpose: Sarcopenia is a major disease affecting mortality and quality of life in the elderly population. We performed a meta-analysis of studies on the community-dwelling population to investigate the prevalence of sarcopenia and its association with diabetes.Methods: Databases were searched for studies published up to February 3, 2021, reporting the prevalence of sarcopenia in patients with and without diabetes. Data extraction and quality assessment were performed according to the Newcastle-Ottawa scale.Results: Six articles were included in the systematic review. All the patients were Asian, aged ≥60 years (women 53.4%), and the diabetic and non-diabetic population was 1,537 and 5,485, respectively. In all six studies, the Asian Working Group for Sarcopenia criteria were used to diagnose sarcopenia. The prevalence of sarcopenia was 15.9% in diabetics and 10.8% in non-diabetics. Diabetics showed a significantly higher risk of sarcopenia than non-diabetics (pooled OR = 1.518, 95% CI = 1.110 to 2.076, Z-value = 2.611, p = 0.009).Conclusion: Among the Asian community-dwelling geriatric population, the prevalence of sarcopenia was significantly higher in diabetics than in non-diabetics. These results suggest that strategies for the management of sarcopenia are required in Asian elderly patients, especially with diabetes.

Objective: This study aimed to compare the clinical results and complications as well as patient satisfaction in patients with carpal tunnel syndrome operated with open carpal tunnel release (OCTR) or endoscopic carpal tunnel release (ECTR) techniques. Methods: This study conducted in Istanbul Training and Research Hospital between August 2016 and January 2018. A total of 54 patients were operated with the ECTR technique and 50 patients were operated with the OCTR technique after failing nonsurgical treatment. Patients functional scores are assessed with the carpal tunnel syndrome-functional status score (CTS-FSS) and carpal tunnel syndrome-symptom severity score (CTS-SSS). Operation time, incision length and complications of the two techniques were noted and compared. Results: The age, sex distribution, distribution of sides, and complaint period were not significant (p > 0.05) between the groups. The preoperative or postoperative CTS-SSS and CTS-FSS values did not differ significantly (p > 0.05). Incision length, time to return to work and return to daily life in the OCTR group was significantly higher than the ECTR group (p < 0.05). Conclusion: ECTR has similar results in terms of symptom relief, severity, functional status, pillar pain and complication rates compared to OCTR. However, it has the advantages of early return to daily life, early return to work and less incision length. doi: https://doi.org/10.12669/pjms.35.6.967 How to cite this:Gurpinar T, Polat B, Polat AE, Carkci E, Kalyenci AS, Ozturkmen Y. Comparison of open and endoscopic carpal tunnel surgery regarding clinical outcomes, complication and return to daily life: A prospective comparative study. Pak J Med Sci. 2019;35(6):1532-1537. doi: https://doi.org/10.12669/pjms.35.6.967 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract Background and Objective Maternal food intake during pregnancy can substantially interfere in the baby’s anthropometric measurements at birth. Our objective was to perform a systematic review that investigate the influence of nutrient intake via food during pregnancy on the baby’s anthropometric measurements at birth. Methods A search was performed without time limits on CINAHL, Embase, PubMed, Scopus and Web of Science databases and manual on studies references. All nutrients and baby’s anthropometric measurements at birth were included as descriptors. Results Thirty articles were included, the majority of prospective cohort studies, with 15.39 (2.36) quality points (maximum value: 22). Thirty-six results of associations were found, of which 17 studies had direct associations between nutrient intake and birth outcomes. Inverse associations were identified in 8 studies and 11 articles showed no significant associations in all analyses. Maternal food intake of vitamin C, calcium and magnesium during pregnancy seems to have a positive influence on the baby's birth weight, while carbohydrates intake have an inverse association with the same outcome. Conclusion It is suggested that vitamin C, calcium, magnesium and carbohydrates influence on baby’s birth weight. So, these specific nutrients need more attention to the consumption, in addition to carried out new studies, with robust methodologies for measuring maternal food consumption and considering the several factors that can interfere in this assessment. Registration This review has been registered to the PROSPERO (International prospective register of systematic reviews) (ID: CRD42020167889).

Abstract Background: Individuals with multiple sclerosis (MS) frequently report sexual dysfunction, a condition that may result in low sexual satisfaction and decreased quality of life. Although sexual dysfunction is usually treated pharmacologically, physical therapists, especially those trained in pelvic floor physical therapy (PT), are well-equipped to address a variety of impairments that contribute to poor sexual function. The current evidence for effectiveness of PT interventions in improving sexual dysfunction, sexual satisfaction, and the emotional well-being aspect of quality of life was analyzed. Methods: The PubMed, CINAHL, and PEDro databases were searched through December 2019. Articles were included if participants had a clinical diagnosis of MS, reported sexual dysfunction or pain with intercourse, and had an intervention within the PT scope that addressed sexual dysfunction. Means and SDs were extracted from each study independently by two authors. Effect sizes (d) and 95% CIs were calculated within and across studies. Results: Eight studies met the inclusion criteria. Combined effects were significant and large across six studies for sexual function (d = 0.82, 95% CI, 0.57–1.06), moderate across seven studies for sexual satisfaction (d = 0.65, 95% CI, 0.43–0.87), and moderately large across two studies for emotional well-being (d = 0.78, 95% CI, 0.17–1.40). Between-group differences reached significance for sexual satisfaction (d = 0.29, 95% CI, 0.03–0.55). Conclusions: Sexual function, sexual satisfaction, and emotional well-being can all be effectively addressed with various PT interventions. Highly effective interventions included pelvic floor muscle training and mindfulness. Future research should compare PT interventions with non-PT controls to determine best practice in this population.

About the painting “The Siege of Constantinople” as found on six churches from the 16th century in Moldavia. In the first decades of the 16th century the late Byzantine iconography flourished in Moldavia on church exteriors. On six churches within a radius of 30 kilometres are found a siege scene, “The Siege of Constantinople”, in connection with a painting of the Akathist Hymn. The article seeks the historical background of the painting in the siege of Constantinople by the Turkish army in 1453. In uncovers, through an interpretation of the painting from the Moldovita Monastery, the Moldavian painters’ knowledge of the fall of Constantinople. At the same time, this was the defeat of the centre of the Orthodox Church to which Moldavia belonged. From the connection with the Akathist Hymn and the explanatory text which follows the painting on the church in Arbore, the religious aspect of the paintings is connected to the Persian siege of Constantinople in 626, where an intervention by Virgin Mary was believed to have saved the city. During the Turkish pressure in the 1530’s, this tradition is moulded into an anti-Turkish ideological manifest in Moldavia. This takes place by altering the historical scene for the events in 626, and in this manner the situation of Moldovia is incorporated into the paintings. The church of Arbore has been painted as the last one and has an account which varies in considerable degree from the five others regarding the historical aspect, because at that time Turkish control of the area increased. However, its religious aspect is still Christian and anti-Turkish. After 1541 the picture is no longer painted, probably because of even stronger Turkish control.

“… Justification by faith” Calvin’s grounds for the Reformation ABSTRACT In 1539, at the young age of 30, Calvin wrote a letter to Cardinal Jacopo Sadoleto, an eminent scholar and proponent of the Roman Church, in answer to the latter’s letter earlier that year to Geneva. This answer of Calvin, as requested urgently by the City of Geneva, is very well-known for the way how Calvin refuted Sadoleto’s arguments against the Reformation and thus took up the cudgels for the very city that banned him only a year before. This Calvin did by justifying the quintessence of and necessity for the Reformation. Since then, this text has not only been known as one of the most famous defences of the principles of the Reformation of the six-teenth century but even has been described as probably the most powerful and sys-tematic successful apologetic Reformation writing of that age as such. In this article, Calvin’s analysis of the core of the Reformation is discussed against the background of his relation to Martin Luther and their appreciation for each other. According to Calvin the “heart” of the Reformation was justification by grace alone. Ultimately it is only a matter of faith in Christ alone. For his explanation of justification by grace and faith alone, Calvin refers consistently to Scripture as the Word of God. In this Chris-tological approach – for which Luther according to a witness expressed his apprecia-tion – Calvin and Luther are very close to each other indeed. Key concepts: Luther, Calvin, Sadoleto, justification, Reformation, grace alone, faith alone “… regverdigmaking deur die geloof” Calvyn se begronding van die Reformasie Opsomming Op die jong ouderdom van 30 skryf Calvyn in 1539 ’n brief aan Kardinaal Jacopo Sadoletus, beroemde geleerde en verteenwoordiger van die Roomse Kerk. Hierdie brief van Calvyn wat hy op die dringende smeekversoek van die stadsraad van Genève geskryf het, het hom baie roem laat inoes. Calvyn weerlê met hierdie skrywe Sadoletus se aanklagte teen die Reformasie en tree daarmee in die bresse vir die stad wat hom die jaar vantevore verban het. Daarby begrond hy die kern van die Reformasie en die noodsaak daarvoor. Sedertdien staan hierdie brief nie slegs bekend as een van die mees befaamde apologetiese geskrifte van die Reformasie nie maar is dit selfs beskryf as die mees kragtige en teologies suksesvolle verdediging daarvan in die sestiende eeu. In hierdie artikel word Calvyn se verklaring van die kern van die Reformasie bespreek teen die agtergrond van sy verhouding met Martin Luther en beide van hulle se respek vir mekaar. Volgens Calvyn is die hart van die Reformasie die regverdigmaking deur genade alleen. Dit gaan ten volle oor geloof in Christus alleen. Vir sy verklaring van die regverdigmaking deur genade en geloof alleen beroep Calvyn hom konsekwent op die Skrif as Woord van God. In hierdie Christologiese benadering – waarvoor Luther volgens ’n getuie waardering uitgespreek het – staan Calvyn en Luther dig bymekaar. Kernbegrippe: Luther, Calvyn, Sadoletus, regverdigmaking, Reformasie, genade alleen, geloof alleen