Impact of treatment planning target volumen (PTV) size on radiation induced diarrhoea following selenium supplementation in gynecologic radiation oncology - a subgroup analysis of a multicenter, phase III trial

Background: In a previous analysis (Int J Radiat Oncol Biol Phys 70:828-835,2010), we assessed whether an adjuvant supplementation with selenium (Se) improves Se status and reduces the radiation-induced side-effects of patients treated by adjuvant radiotherapy (RT) for cervical and uterine cancer. Now, a potential relation between the planning target volume (PTV) of the RT and the Se effect concerning radiation induced diarrhoea was evaluated in detail. Methods: Whole blood Se concentrations had been measured in patients with cervical (n=11) and uterine cancer (n=70) after surgical treatment, during, and at the end of RT. Patients with initial Se concentrations of less than 84 μg/l were categorized as Se-deficient and randomized before RT to receive Se (as sodium selenite) per os on the days of RT, or to receive no supplement during RT. Diarrhoea was graded according to the Common Toxicity Criteria system (CTC, Version 2a). The evaluation of the PTV of the RT was ascertained with the help of a specialised computer-assisted treatment planning software used for radiation planning procedure. Results: A total of 81 patients had been randomized for the initial supplementation study, 39 of which received Se [selenium group, SeG] and 42 serving as controls [control group, CG]. Mean Se levels did not differ between SeG and CG upon study initiation, but were significantly higher in the SeG compared to the CG at the end of RT. The actuarial incidence of at least CTC 2 radiation induced diarrhoea in the SeG was 20.5% compared to 44.5% in the CG (p=0.04). The median PTV in both groups was 1302 ml (916–4608). With a PTV of 1302 ml (n=40) the actuarial incidence of at least CTC 2 diarrhoea in the SeG was 19.1% (4 of 21 patients) versus 52.6% (10 of 19 patients) in the CG (p=0.046). Conclusions: Se supplementation during RT was effective to improve blood Se status in Se-deficient cervical and uterine cancer patients, and reduces episodes and severity of RT-induced diarrhoea. This effect was most pronounced and significant in patients with large PTV (> 1302 ml)

International Control of Illicit Movement of the Cultural Heritage: the 1970 UNESCO Convention and Some Possible Alternatives

The author argues that it is necessary to use international law to prevent the illicit transfer of the cultural heritage of the nations of the world; utilizing the 1970 UNESCO Convention on the Means of Prohibiting and Preventing the Illicit Import, Export and Transfer of Ownership of Cultural Property; as well as other measures to accomplish this

Behavioral phenotype in five individuals with de novo mutations within the GRIN2B gene

Background: Intellectual disability (ID) is often associated with behavioral problems or disorders. Mutations in the GRIN2B gene (MRD6, MIM613970) have been identified as a common cause of ID (prevalence of 0.5 – 1% in individuals with ID) associated with EEG and behavioral problems. Methods: We assessed five GRIN2B mutation carriers aged between 3 and 14 years clinically and via standardized questionnaires to delineate a detailed behavioral phenotype. Parents and teachers rated problem behavior of their affected children by completing the Developmental Behavior Checklist (DBC) and the Conners’ Rating Scales Revised (CRS-R:L). Results: All individuals had mild to severe ID and needed guidance in daily routine. They showed characteristic behavior problems with prominent hyperactivity, impulsivity, distractibility and a short attention span. Stereotypies, sleeping problems and a friendly but boundless social behavior were commonly reported. Conclusion: Our observations provide an initial delineation of the behavioral phenotype of GRIN2B mutation carriers

Expanding the clinical spectrum associated with defects in CNTNAP2 and NRXN1

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.Abstract Background Heterozygous copy-number and missense variants in CNTNAP2 and NRXN1 have repeatedly been associated with a wide spectrum of neuropsychiatric disorders such as developmental language and autism spectrum disorders, epilepsy and schizophrenia. Recently, homozygous or compound heterozygous defects in either gene were reported as causative for severe intellectual disability. Methods 99 patients with severe intellectual disability and resemblance to Pitt-Hopkins syndrome and/or suspected recessive inheritance were screened for mutations in CNTNAP2 and NRXN1. Molecular karyotyping was performed in 45 patients. In 8 further patients with variable intellectual disability and heterozygous deletions in either CNTNAP2 or NRXN1, the remaining allele was sequenced. Results By molecular karyotyping and mutational screening of CNTNAP2 and NRXN1 in a group of severely intellectually disabled patients we identified a heterozygous deletion in NRXN1 in one patient and heterozygous splice-site, frameshift and stop mutations in CNTNAP2 in four patients, respectively. Neither in these patients nor in eight further patients with heterozygous deletions within NRXN1 or CNTNAP2 we could identify a defect on the second allele. One deletion in NRXN1 and one deletion in CNTNAP2 occurred de novo, in another family the deletion was also identified in the mother who had learning difficulties, and in all other tested families one parent was shown to be healthy carrier of the respective deletion or mutation. Conclusions We report on patients with heterozygous defects in CNTNAP2 or NRXN1 associated with severe intellectual disability, which has only been reported for recessive defects before. These results expand the spectrum of phenotypic severity in patients with heterozygous defects in either gene. The large variability between severely affected patients and mildly affected or asymptomatic carrier parents might suggest the presence of a second hit, not necessarily located in the same gene.Peer Reviewe

Exploring, Overreaching, Giving Up: The UN and International Conflict Management in Kashmir, Congo, and East Pakistan

This essay examines the attempts of the United Nations (UN) to become an active force in Cold War politics. It explores three major moments of crisis that triggered UN involvement: Kashmir (1947–1949), Congo (1960–1965), and East Pakistan (1971). The essay demonstrates how in the Kashmir crisis, UN negotiators initially benefited from a malleable international environment and sincere support by both India and Pakistan to solve their territorial dispute. Yet as the UN explored its role as conflict “manager”, it soon faced the limits of both its power and its legitimacy in attempting to overcome national suspicion and the insistence on state sovereignty. In contrast to Kashmir, the Congo Crisis was a case of overreach. Under the lead of UN Secretary-General Dag Hammarskjöld, UN officials transformed an intervention to assist the Congolese government in ending Belgian interference to an overly ambitious exercise in state-building. The East Pakistan crisis reveals that the UN had by then given up on playing an active overt role in the political settlement of international crises. As millions of East Pakistanis, accused of separatism, fled a massive military crackdown by the West Pakistani government into neighbouring India, the UN confined its reaction to expressions of concern, offers of mediation, and provision of humanitarian aid. UN officials’ subsequent attempts to use humanitarian assistance and impartiality as a cover to achieve a covert solution deepened the crisis rather than contributing to solving it. The essay argues that by the early 1970s, the UN’s ambitious approach to international conflict management and foreign intervention had given way to a pragmatic focus on the “humanitarian” aspect. This adaptation by the UN to a difficult international environment in shying away from the overt pursuit of political solutions has had lasting consequences for the UN’s role in the international system

Gewerkschaftssektretär als Beruf: Berufliche Perspektiven von Stipendiatinnen und Stipendiaten der Hans-Böckler-Stiftung im Kontext von Studium und sozialer Herkunft

Was haben Studium, Beruf und Gewerkschaften lebensgeschichtlich für Stipendiatinnen und Stipendiaten der Hans-Böckler-Stiftung gegenwärtig miteinander zu tun? Auf diese generelle Frage sucht der vorliegende Bericht eines empirischen Forschungsprojekts einige Antworten. Bevor ich inhaltliche Ausgangspunkte, hypothetische Vorüberlegungen und methodische Anlage des Vorhabens erläutere, will ich kurz an eigene Erinnerungen anknüpfen, die in die frühen siebziger Jahre zurückreichen. Als einer der Vertreter der Vertrauensdozenten im Auswahlausschuss für Studienförderung der 'Stiftung Mitbestimmung' hatte ich zweimal im Jahr große Mengen von Bewerbungsunterlagen zu sichten. Weil die Zahl der Anträge auf Studienförderung die verfügbaren Aufnahmekapazitäten häufig deutlich überschritt, standen wir in den Ausschusssitzungen regelmäßig vor schwierigen Auswahlentscheidungen. Letztlich gab in der großen Mehrzahl der Fälle die 'Papierform' im Kontext der einschlägigen Förderungskriterien den Ausschlag für sofortige Aufnahme, Zurückstellung oder Ablehnung des Antrags. Schulzeugnisse, Lebensläufe, Bescheinigungen über berufliche Werdegänge und gewerkschaftliches Engagement sowie nicht zuletzt gutachterliche Stellungnahmen sollten ein möglichst überzeugendes Gesamtbild einer Person vermitteln. Bewusst oder unbewusst haben wir uns in Zweifelsfällen häufig von dieser Frage leiten lassen: Symbolisiert die „Papierform“ ein in sich stimmiges biographisches Muster, das einerseits ein erfolgreiches Studium mit mutmaßlich tragfähigen beruflichen Perspektiven und andererseits die Kontinuität des bisherigen gesellschaftspolitischen oder gewerkschaftlichen Engagements erwarten lässt? Hinter diesem impliziten Prüfkriterium verbergen sich mindestens zwei Annahmen, die mir heute, im Licht turbulenter Vorgänge des sozialen Wandels, problematisch erscheinen. [...

Beruf, Studium und Gewerkschaften: Abschlußbericht des Projektes "Die Gewerkschaften und der DGB als potentielles Berufsfeld für Stipendiatinnen und Stipendiaten der Hans-Böckler-Stiftung"

Was haben Studium, Beruf und Gewerkschaften lebensgeschichtlich für Stipendiaten/innen der Hans-Böckler-Stiftung miteinander zu tun? Auf diese generelle Frage sucht der vorliegende Bericht eines empirischen Forschungsprojekts Antworten

A Stress Test for German Nationalism:Protective Custody in Alsace-Lorraine during the First World War

When the First World War broke out, the French government declared the return of Alsace-Lorraine its only public war aim, arguing that the population was ‘French in spirit’. In an age rife with claims of national self-determination, trapped in a protracted war of attrition and facing a nationally ambivalent population, the German state soon came under enormous pressure to ensure the loyalty and patriotism of the inhabitants of its western borderland. This article examines why Imperial Germany failed to meet this ‘stress test’. It focuses on the crucial but hitherto neglected issue of protective custody (Schutzhaft), whereby police and military authorities were able to arrest and detain ‘suspect’ civilians without charge or trial. The article finds that protective custody, an emergency measure under martial law, played a central role in the failure of German policy in Alsace-Lorraine: it undermined the rule of law, shifted the focus onto national dissent and gave rise to an atmosphere of suspicion and fear. The article also demonstrates that the Reichstag successfully put limits on protective custody in the second half of the war. Yet leaving the authoritarian doctrine of enforcing national loyalty in place, the more lenient administrative approach had a disintegrative rather than a stabilizing effect, preparing the ground for widespread disaffection with German rule months before the war ended

Pedagogija: umjetnost nošenja s rizikom, a ne njegovog izbjegavanja

Tijekom planiranja odgoja i obrazovanja koje bi se trebalo odvijati negdje između permisivnosti i pretjerane zaštite, moraju se uvažavati prilike koje potiču razvoj

‘We have to tread warily’:East Pakistan, India and the pitfalls of foreign intervention in the Cold War

This article examines the East Pakistan crisis of 1971 as a watershed moment in Cold War humanitarian politics. It argues that the absence of an effective international framework of multilateral foreign intervention or peacekeeping forced the key external actors to resort to covert forms of intervention, while publicly pledging adherence to non-interference in the domestic affairs of Pakistan. The article demonstrates that covert intervention by India, the United States and the United Nations not only undermined the credibility of the Cold War international system, but also fuelled the drift to the Indo-Pakistani war that ultimately ended the crisis