Frequency of excisions and yields of malignant skin tumors in a population-based screening intervention of 360 288 whole-body examinations

Objective To explore the frequency of excisions and yields of histopathologically confirmed skin cancer.

Design A population-based skin cancer screening intervention (the SCREEN project) in the German state of Schleswig-Holstein (July 1, 2003, to June 30, 2004).

Setting Physician offices. Participants could choose between nondermatologist physicians and dermatologists for their initial whole-body skin examination. All screening physicians received a mandatory 8-hour training course.

Participants Inhabitants of Schleswig-Holstein 20 years or older with statutory health insurance (N = 360 288).

Main Outcome Measures Frequency of excisions and yields of malignant skin tumors (malignant melanomas [MMs], basal cell carcinomas [BCCs], and squamous cell carcinomas [SCCs]), stratified by sex and age.

Results Overall, 15 983 excisions were performed (1 of 23 screenees). A total of 3103 malignant skin tumors were diagnosed in 2911 persons: 585 MMs, 1961 BCCs, 392 SCCs, and 165 other malignant skin tumors. Overall, 116 persons (3103 of 360 288) had to be screened to find 1 malignant tumor, with 1 of 620 for MM, 1 of 184 for BCC, and 1 of 920 for SCC. Twenty excisions were performed to find 1 melanoma in men 65 years and older, but more than 50 excisions were required to find 1 melanoma in men aged between 20 and 49 years.

Conclusions The results of SCREEN suggest a high yield of malignant skin tumors in a large-scale population-based screening project. We found that a high number of excisions was performed in the youngest screenees with an associated low yield, suggesting a need in screener training to emphasize a more conservative attitude toward excisions in young screenees.

Aggregate uncertainty in the citizen candidate model yields extremist parties

We extend the citizen candidate model of electoral competition with sincere voting to allow for k ≥ 2 states of aggregate uncertainty. We discuss and characterize the equilibrium set in this framework. We provide conditions for the existence of two-party equilibria when k = 2 and show that the policies of the two parties in any such equilibrium are not only divergent but that the parties are extremist: when the political mood is left-wing, the left-wing party wins decisively with a platform that is to the left of the left-wing median voter, while when the political mood is right-wing, the right-wing party wins decisively with a platform that is to the right of the right-wing median voter. We then provide conditions under which such equilibria remain robust for an arbitrary value of k.

The production and potential of biofertilizers to improve crop yields

Extensive interactions of plant roots with soil microorganisms affect plant nutrition either directly by influencing mineral nutrient availability or indirectly through enhanced uptake efficiency via plant root growth promotion. Beneficial microbial interactions with roots may be either endophytic or associative and can be symbiotic, mutualistic, or incidental in nature. The increased understanding of the role of root – or rhizosphere –associated with microbes in the nutrition and/or yield of agricultural crops in particular has resulted in promotion of their use in agricultural production as alternatives or supplements to mineral or organic fertilizers. Despite this, there is an obvious lack of market penetration of microbial inoculants. This review specifically focuses on microbial inoculants, collectively termed biofertilizers, used to improve nutrition and yields of grain, legume, oil, tuber, and other crops. A vast number of commercial biofertilizers are available worldwide; however, the quality and efficacy of many of them are not proven or tested. In the absence of efficacious biofertilizers of good and consistent quality, the dependence on the use of mineral fertilizers is not likely to decrease. Thus the availability of high-quality biofertilizers must be priority particularly in countries where crop plant production plays a key role in the economy and food security.