Safety assessment of plant food supplements (PFS)

Botanicals and botanical preparations, including plant food supplements (PFS), are widely used in Western diets. The growing use of PFS is accompanied by an increasing concern because the safety of these PFS is not generally assessed before they enter the market. Regulatory bodies have become more aware of this and are increasing their efforts to ensure the safety of PFS. The present review describes an overview of the general framework for the safety assessment of PFS, focusing on the different approaches currently in use to assess the safety of botanicals and/or botanical compounds, including their history of safe use, the tiered approach proposed by the European Food Safety Authority (EFSA), the Threshold of Toxicological Concern (TTC) and the...

"Mi bèl pawòl, mi!" Rappresentazione delle lingue e della parola nella narrativa di Patrick Chamoiseau e Raphael Confiant (1986-1994)

From 1986 to 1994, Patrick Chamoiseau and Raphaël Confiant published a series of fictional and non-fictional writings focusing on language issues. Interest in these themes can certainly in part be explained by the "surconscience linguistique" that Lise Gauvin attributes to Francophone authors: a linguistic over-awareness which, in the case of these two Martiniquais writers, may be attributed to their Creole-French diglossia. Although we might believe that the idea of Gauvin is right, it doesn't seem enough to explain why the linguistic theme plays such a central role in Chamoiseau's and Confiant's works. Deeply influenced by Glissant's theories on Creole popular culture and Antillean literature (Le discours antillais), they conceived a "Créolité" poetics based on a primarly identity-based and geopolitical discourse. Declaring the need to build an authentically Creole literary discourse, one that finally expresses the Martiniquais reality, Chamoiseau and Confiant (as well as Bernabé, third and last author of Éloge de la créolité) found the «foundations of [their] being» in orality and its poetics in the Creole language. This belief was maily translated into their works in two ways: by representing the (diglossic) relationships occurring between their first languages (Creole and French) and by representing the Creole parole (orality) and its function. An analysis of our authors' literary and theoretical writings will enable us to show how two works that develop around the same themes and thesis have in fact produced very divergent results, which were perhaps already perceivable in the main ambiguities of their common manifestos.

Arnt van Tricht : Werkkatalog eines Bildhauers am Niederrhein im 16. Jahrhundert

Arnt van Tricht, gest. 1570, unterhielt bis in die späten 50er Jahre des 16. Jahrhunderts, wahrschein-lich aus Antwerpen kommend, in Kalkar am Niederrhein eine sehr erfolgreiche Werkstatt. Die bis dahin vorherrschende spätgotische Formensprache der langjährig ansässigen Bildhauer löste er durch die der Renaissance ab, führte jedoch deren Arbeitsfelder und Materialwahl weiter. Arnt van Tricht schuf Arbeiten sowohl religiöser als auch profaner Natur innerhalb des Gebiets der damals sehr bedeutenden Vereinigten Herzogtümer Kleve-Mark-Jülich-Berg und Geldern. Seine wohlhabenden Auftraggeber entstammten dem Klerus, der Bürgerschaft und dem Adel.rnIm Rahmen der Arbeit zeigte sich, dass sich für den Künstler die Verlegung der herzoglichen Residenz nach Düsseldorf und der wirtschaftliche Niedergang der Region letztlich stärker auswirkte als die religiösen Veränderungen durch die Reformation.rnArnt van Tricht schuf die meisten seiner religiösen Bildwerke für die Stiftskirche St. Viktor in Xanten, die durch die Bürgerschaft ausgestattete Pfarrkirche von St. Nicolai in Kalkar und umliegende Gemeinden. Einzelne Stücke sind, wohl über familiäre Verflechtungen vermittelt, in einem weiteren Radius zu finden. Van Tricht arbeitete Schnitzretabel mitsamt ihrer ornamentalen und figuralen Aus-stattung sowie Skulpturen(-gruppen) in Eichenholz. Daneben finden sich im Werk zahlreiche in Sandstein gearbeitete Skulpturen, die teilweise an Pfeilern und Portalen der Kirchen architektur-gebunden sind. Neben diesen rundplastischen Werken schuf Arnt van Tricht eine große Anzahl an steinernen Reliefarbeiten. Hierbei nehmen die überwiegend für die lokalen Kanoniker gearbeiteten Epitaphien mit biblischem Reliefbild in Ornamentrahmen den größten Teil ein.rnEin zweiter, gleichwertiger Werkkomplex, überwiegend in Sandstein gearbeitet, ist profaner Natur und fällt durch die Größe der Aufträge ins Gewicht. Arnt van Tricht war an einigen groß angelegten Modernisierungsprojekten an Stadthäusern und Kastellen des lokalen Adels beschäftigt. Für mehrere aufwendig gestaltete Fassadendekorationen arbeitete er Architekturglieder mit figürlicher Darstellung oder Ornament, Büsten und freiplastische Skulpturen. Arnt van Tricht war aber auch an der Aus-gestaltung der Innenräume beteiligt. Aufwendig skulptierte und reliefverzierte Kaminverkleidungen stehen dabei neben reduzierteren Arbeiten für offensichtlich weniger repräsentative Räume. Neben in Eichenholz gearbeiteter Vertäfelung schuf Arnt van Tricht hölzerne figurale Handtuchhalter. Diese zeigen, wie auch die Reliefbilder der Kamine, die darüber hinaus Wappen und Porträts der Bauherren aufnehmen, eine religiöse oder profane, auch antikisierende Thematik, bei der ein moralisierender Unterton mitschwingt.rnIn dieser Arbeit werden erstmals alle Werkstücke des Künstlers zusammengeführt dargestellt, so dass ein Werkkatalog mit einem Überblick über das sehr breit gefächerte Spektrum des Opus Arnt van Trichts vorliegt. Häufig durch bloße Nennung mit Arnt van Tricht in Verbindung gebrachte Arbeiten werden bewertet und die Zu- oder Abschreibung begründet. Auch können einige Stücke neu zugeschrieben werden.

Electronic properties of Van der Waals heterostructures

L’interazione spin-orbita (SOI) nel grafene è attualmente oggetto di intensa ricerca grazie alla recente scoperta di una nuova classe di materiali chiamati isolanti topologici. Questi materiali, la cui esistenza è strettamente legata alla presenza di una forte SOI, sono caratterizzati dall’interessante proprietà di avere un bulk isolante ed allo stesso tempo superfici conduttrici. La scoperta teorica degli isolanti topologici la si deve ad un lavoro nato con l’intento di studiare l’influenza dell’interazione spin-orbita sulle proprietà del grafene. Poichè questa interazione nel grafene è però intrinsecamente troppo piccola, non è mai stato possibile effettuare verifiche sperimentali. Per questa ragione, vari lavori di ricerca hanno recentemente proposto tecniche volte ad aumentare questa interazione. Sebbene alcuni di questi studi abbiano mostrato un effettivo aumento dell’interazione spin-orbita rispetto al piccolo valore intrinseco, sfortunatamente hanno anche evidenziato una consistente riduzione della qualità del grafene. L’obbiettivo che ci si pone in questa tesi è di determinare se sia possibile aumentare l’interazione spin-orbita nel grafene preservandone allo stesso tempo le qualità. La soluzione proposta in questo lavoro si basa sull’utilizzo di due materiali semiconduttori, diselenio di tungsteno WSe2 e solfuro di molibdeno MoS2, utilizzati da substrato su cui sopra verrà posizionato il grafene formando così un’eterostruttura -nota anche di “van der Waal” (vdW)-. Il motivo di questa scelta è dovuto al fatto che questi materiali, appartenenti alla famiglia dei metalli di transizione dicalcogenuri (TMDS), mostrano una struttura reticolare simile a quella del grafene, rendendoli ideali per formare eterostrutture e ancora più importante, presentano una SOI estremamente grande. Sostanzialmente l’idea è quindi di sfruttare questa grande interazione spin-orbita del substrato per indurla nel grafene aumentandone così il suo piccolo valore intrinseco.

An optical coherence tomography study of a biodegradable vs. durable polymer-coated limus-eluting stent: a LEADERS trial sub-study

Incomplete endothelialization has been found to be associated with late stent thrombosis, a rare but devastating phenomenon, more frequent after drug-eluting stent implantation. Optical coherence tomography (OCT) has 10 times greater resolution than intravascular ultrasound and thus appears to be a valuable modality for the assessment of stent strut coverage. The LEADERS trial was a multi-centre, randomized comparison of a biolimus-eluting stent (BES) with biodegradable polymer with a sirolimus-eluting stent (SES) using a durable polymer. This study sought to evaluate tissue coverage and apposition of stents using OCT in a group of patients from the randomized LEADERS trial.

The impact of body mass index on the one year outcomes of patients treated by percutaneous coronary intervention with Biolimus- and Sirolimus-eluting stents (from the LEADERS Trial)

The aim of this analysis was to assess the effect of body mass index (BMI) on 1-year outcomes in patients enrolled in a contemporary percutaneous coronary intervention trial comparing a sirolimus-eluting stent with a durable polymer to a biolimus-eluting stent with a biodegradable polymer. A total of 1,707 patients who underwent percutaneous coronary intervention were randomized to treatment with either biolimus-eluting stents (n = 857) or sirolimus-eluting stents (n = 850). Patients were assigned to 1 of 3 groups according to BMI: normal (<25 kg/m(2)), overweight (25 to 30 kg/m(2)), or obese (>30 kg/m(2)). At 1 year, the incidence of the composite of cardiac death, myocardial infarction, and clinically justified target vessel revascularization was assessed. In addition, rates of clinically justified target lesion revascularization and stent thrombosis were assessed. Cox proportional-hazards analysis, adjusted for clinical differences, was used to develop models for 1-year mortality. Forty-five percent of the patients (n = 770) were overweight, 26% (n = 434) were obese, and 29% (n = 497) had normal BMIs. At 1-year follow-up, the cumulative rate of cardiac death, myocardial infarction, and clinically justified target vessel revascularization was significantly higher in the obese group (8.7% in normal-weight, 11.3% in overweight, and 14.5% in obese patients, p = 0.01). BMI (hazard ratio 1.47, 95% confidence interval 1.02 to 2.14, p = 0.04) was an independent predictor of stent thrombosis. Stent type had no impact on the composite of cardiac death, myocardial infarction, and clinically justified target vessel revascularization at 1 year in the 3 BMI groups (hazard ratio 1.08, 95% confidence interval 0.63 to 1.83, p = 0.73). In conclusion, BMI was an independent predictor of major adverse cardiac events at 1-year clinical follow-up. The higher incidence of stent thrombosis in the obese group may suggest the need for a weight-adjusted dose of clopidogrel.

Relationship between the logistic EuroSCORE and the Society of Thoracic Surgeons Predicted Risk of Mortality score in patients implanted with the CoreValve ReValving system--a Bern-Rotterdam Study

Background Surgical risk scores, such as the logistic EuroSCORE (LES) and Society of Thoracic Surgeons Predicted Risk of Mortality (STS) score, are commonly used to identify high-risk or “inoperable” patients for transcatheter aortic valve implantation (TAVI). In Europe, the LES plays an important role in selecting patients for implantation with the Medtronic CoreValve System. What is less clear, however, is the role of the STS score of these patients and the relationship between the LES and STS. Objective The purpose of this study is to examine the correlation between LES and STS scores and their performance characteristics in high-risk surgical patients implanted with the Medtronic CoreValve System. Methods All consecutive patients (n = 168) in whom a CoreValve bioprosthesis was implanted between November 2005 and June 2009 at 2 centers (Bern University Hospital, Bern, Switzerland, and Erasmus Medical Center, Rotterdam, The Netherlands) were included for analysis. Patient demographics were recorded in a prospective database. Logistic EuroSCORE and STS scores were calculated on a prospective and retrospective basis, respectively. Results Observed mortality was 11.1%. The mean LES was 3 times higher than the mean STS score (LES 20.2% ± 13.9% vs STS 6.7% ± 5.8%). Based on the various LES and STS cutoff values used in previous and ongoing TAVI trials, 53% of patients had an LES ≥15%, 16% had an STS ≥10%, and 40% had an LES ≥20% or STS ≥10%. Pearson correlation coefficient revealed a reasonable (moderate) linear relationship between the LES and STS scores, r = 0.58, P < .001. Although the STS score outperformed the LES, both models had suboptimal discriminatory power (c-statistic, 0.49 for LES and 0.69 for STS) and calibration. Conclusions Clinical judgment and the Heart Team concept should play a key role in selecting patients for TAVI, whereas currently available surgical risk score algorithms should be used to guide clinical decision making.

The twelve-month outcomes of a biolimus eluting stent with a biodegradable polymer compared with a sirolimus eluting stent with a durable polymer

This study reports the 12-month clinical outcomes of the LEADERS clinical trial which compared a biolimus eluting stent with a biodegradable polymer (BES) to a sirolimus eluting stent with a durable polymer (SES).

A comparative assessment by optical coherence tomography of the performance of the first and second generation of the everolimus-eluting bioresorbable vascular scaffolds

The first generation of the everolimus-eluting bioresorbable vascular scaffold (BVS 1.0) showed an angiographic late loss higher than the metallic everolimus-eluting stent Xience V due to scaffold shrinkage. The new generation (BVS 1.1) presents a different design and manufacturing process than the BVS 1.0. This study sought to evaluate the differences in late shrinkage, neointimal response, and bioresorption process between these two scaffold generations using optical coherence tomography (OCT).

Temporal changes of coronary artery plaque located behind the struts of the everolimus eluting bioresorbable vascular scaffold

Implantation of a coronary stent results in a mechanical enlargement of the coronary lumen with stretching of the surrounding atherosclerotic plaque. Using intravascular ultrasound virtual-histology (IVUS-VH) we examined the temporal changes in composition of the plaque behind the struts (PBS) following the implantation of the everolimus eluting bioresorbable vascular scaffold (BVS). Using IVUS-VH and dedicated software, the composition of plaque was analyzed in all patients from the ABSORB B trial who were imaged with a commercially available IVUS-VH console (s5i system, Volcano Corporation, Rancho Cordova, CA, USA) post-treatment and at 6-month follow-up. This dedicated software enabled analysis of the PBS after subtraction of the VH signal generated by the struts. The presence of necrotic core (NC) in contact with the lumen was also evaluated at baseline and follow-up. IVUS-VH data, recorded with s5i system, were available at baseline and 6-month follow-up in 15 patients and demonstrated an increase in both the area of PBS (2.45 ± 1.93 mm(2) vs. 3.19 ± 2.48 mm(2), P = 0.005) and the external elastic membrane area (13.76 ± 4.07 mm(2) vs. 14.76 ± 4.56 mm(2), P = 0.006). Compared to baseline there was a significant progression in the NC (0.85 ± 0.70 mm(2) vs. 1.21 ± 0.92 mm(2), P = 0.010) and fibrous tissue area (0.88 ± 0.79 mm(2) vs. 1.15 ± 1.05 mm(2), P = 0.027) of the PBS. The NC in contact with the lumen in the treated segment did not increase with follow-up (7.33 vs. 6.36%, P = 0.2). Serial IVUS-VH analysis of BVS-treated lesions at 6-month demonstrated a progression in the NC and fibrous tissue content of PBS.

Value of the SYNTAX score for risk assessment in the all-comers population of the randomized multicenter LEADERS (Limus Eluted from A Durable versus ERodable Stent coating) trial

OBJECTIVES: We aimed to assess the predictive value of the SYNTAX score (SXscore) for major adverse cardiac events in the all-comers population of the LEADERS (Limus Eluted from A Durable versus ERodable Stent coating) trial. BACKGROUND: The SXscore has been shown to be an effective predictor of clinical outcomes in patients with multivessel disease undergoing percutaneous coronary intervention. METHODS: The SXscore was prospectively collected in 1,397 of the 1,707 patients enrolled in the LEADERS trial (patients after surgical revascularization were excluded). Post hoc analysis was performed by stratifying clinical outcomes at 1-year follow-up, according to 1 of 3 SXscore tertiles. RESULTS: The 1,397 patients were divided into tertiles based on the SXscore in the following fashion: SXscore8 and 16 (SXhigh) (n=461). At 1-year follow-up, there was a significantly lower number of patients with major cardiac event-free survival in the highest tertile of SXscore (SXlow=92.2%, SXmid=91.1%, and SXhigh=84.6%; p<0.001). Death occurred in 1.5% of SXlow patients, 2.1% of SXmid patients, and 5.6% of SXhigh patients (hazard ratio [HR]: 1.97, 95% confidence interval [CI]: 1.29 to 3.01; p=0.002). The myocardial infarction rate tended to be higher in the SXhigh group. Target vessel revascularization was 11.3% in the SXhigh group compared with 6.3% and 7.8% in the SXlow and SXmid groups, respectively (HR: 1.38, 95% CI: 1.1 to 1.75; p=0.006). Composite of cardiac death, myocardial infarction, and clinically indicated target vessel revascularization was 7.8%, 8.9%, and 15.4% in the SXlow, SXmid, and SXhigh groups, respectively (HR: 1.47, 95% CI: 1.19 to 1.81; p<0.001). CONCLUSIONS: The SXscore, when applied to an all-comers patient population treated with drug-eluting stents, may allow prospective risk stratification of patients undergoing percutaneous coronary intervention. (LEADERS Trial Limus Eluted From A Durable Versus ERodable Stent Coating; NCT00389220).

Comparison of zotarolimus-eluting and everolimus-eluting coronary stents

New-generation coronary stents that release zotarolimus or everolimus have been shown to reduce the risk of restenosis. However, it is unclear whether there are differences in efficacy and safety between the two types of stents on the basis of prospectively adjudicated end points endorsed by the Food and Drug Administration.

The outcome of bifurcation lesion stenting using a biolimus-eluting stent with a bio-degradable polymer compared to a sirolimus-eluting stent with a durable polymer

This study investigated the differences in clinical outcomes between patients with bifurcation lesions (BL) treated with a biolimus-eluting stent (BES) with a biodegradable polymer, and a sirolimus-eluting stent (SES) with a durable polymer.