[Influence of chronic, structural changes of the muscle-tendon unit on the indication and technique of rotator cuff reconstruction]

Rotator cuff lesions are common and the incidence increases with age. After tendon rupture of the rotator cuff, the muscle-tendon unit retracts, which is accompanied by muscle fatty infiltration, atrophy, and interstitial fibrosis of the musculature, thus, fundamentally changing the muscle architecture. These changes are important prognostic factors for the operative rotator cuff reconstruction outcome. Selection of the correct time point for reconstruction as well as the optimal mechanical fixation technique are decisive for successful attachment at the tendon-to-bone insertion site. Thus, knowledge of the pathophysiological processes plays an important role. The goal of this article is to establish a relationship between currently existing evidence with respect to the preoperatively existing changes of the muscle-tendon unit and the choice of the time for the operation and the operative technique.

Echinococcus multilocularis and its intermediate host: a model of parasite-host interplay

Host-parasite interactions in the E. multilocularis-intermediate host model depend on a subtle balance between cellular immunity, which is responsible for host's resistance towards the metacestode, the larval stage of the parasite, and tolerance induction and maintenance. The pathological features of alveolar echinococcosis. the disease caused by E. multilocularis, are related both to parasitic growth and to host's immune response, leading to fibrosis and necrosis, The disease spectrum is clearly dependent on the genetic background of the host as well as on acquired disturbances of Th1-related immunity. The laminated layer of the metacestode, and especially its carbohydrate components, plays a major role in tolerance induction. Th2-type and anti-inflammatory cytokines, IL-10 and TGF-beta, as well as nitric oxide, are involved in the maintenance of tolerance and partial inhibition of cytotoxic mechanisms. Results of studies in the experimental mouse model and in patients suggest that immune modulation with cytokines, such as interferon-alpha, or with specific antigens could be used in the future to treat patients with alveolar echinococcosis and/or to prevent this very severe parasitic disease.

Erlotinib and sorafenib in an orthotopic rat model of hepatocellular carcinoma

The combination of erlotinib with sorafenib is currently being investigated in a phase III RCT. We studied the effect of erlotinib and sorafenib on HCC in a preclinical model.

Teacher resistance to school-based consultation with the school psychologist: An analysis according to school level and model of identification for special education services

Consultation is promoted throughout school psychology literature as a best practice in service delivery. This method has numerous benefits including being able to work with more students at one time, providing practitioners with preventative rather than strictly reactive strategies, and helping school professionals meet state and federal education mandates and initiatives. Despite the benefits of consultation, teachers are sometimes resistant to this process.This research studies variables hypothesized to lead to resistance (Gonzalez, Nelson, Gutkin, & Shwery, 2004) and attempts to distinguish differences between school level (elementary, middle and high school) with respect to the role played by these variables and to determine if the model used to identify students for special education services has an influence on resistance factors. Twenty-sixteachers in elementary and middle schools responded to a demographicquestionnaire and a survey developed by Gonzalez, et al. (2004). This survey measures eight variables related to resistance to consultation. No high school teachers responded to the request to participate. Results of analysis of variance indicated a significant difference in the teaching efficacy subscale with elementary teachers reporting more efficacy in teaching than middle school teachers. Results also indicate a significant difference in classroom managementefficacy with teachers who work in schools that identify students according to a Response to Intervention model reporting higher classroom management efficacy than teachers who work in schools that identify students according to a combined method of refer-test-place/RtI combination model. Implications, limitations and directions for future research are discussed.

Coping With a Family Member's Death: Parenting, Religiosity, and Parent-Child Communication

The present study had three major aims. First, this study was a basic descriptive exploration of the frequency and nature of parent-child communication about death. Second, this study conducted a quantitative analysis to identify predictors of communication and bereaved children¿s emotional and behavioral problems. Third, this study was also a qualitative analysis of parents¿ descriptions of how religious views shape conversations about death and how conversations are beneficial. Based on prior research, it was predicted that positive child outcomes would be associated with parental warmth, religiosity, adaptive coping, positive religious coping, and frequent parent-child communication about death. Conversely, it was predicted that negative child outcomes would be associated with parental psychological control, maladaptive coping, negative religious coping, and less frequent parent-child communication about death. Additionally, it was hypothesized that parents¿ religious and spiritual views would shape parent-child communication about death, and parents would describe numerous benefits of discussing death with children. Parents completed a series of survey measures assessing their religiosity, coping strategies, parent-child communication about death, and their children¿s emotional and behavioral symptoms. Almost 80% of parent-child dyads discussed death at least once a week, and children initiated approximately half of these conversations. Parent-child communication about death was predicted by parents¿ warmth toward and acceptance of their children and inversely predicted by children¿s hyperactivity and social problem solving. Higher levels of children¿s social problem solving could predict lower frequency of parent-child communication about death if children were holding frequent, meaningful, and comforting conversations with friends and other adults. Higher levels of parents¿ psychological control predicted more emotional and behavioral problems in the child. Parents¿ adaptive coping had significant relationships with all of the dimensions of parent-child communication about death. Qualitative analyses revealed that parents perceived their religious beliefs as shaping conversations about death and grief as an individualized journey. A majority of parents described the emotional, social, and intellectual benefits of holding parent-child conversations about death. This study contributes to the literature by further describing parent-child communication about death, identifying its predictors, and investigating parents¿ religiosity and coping strategies in relation to child well-being. Overall, this study revealed the importance of assessing global parenting characteristics (i.e., warmth/acceptance and psychological control) when examining parent-child relationships and communication about death. Furthermore, this unique study illustrates the value of qualitative data when examining parent-child communication about death and religiosity.

Design-based stereology to quantify structural properties of artificial and natural snow using thin sections

The quantification of the structural properties of snow is traditionally based on model-based stereology. Model-based stereology requires assumptions about the shape of the investigated structure. Here, we show how the density, specific surface area, and grain boundary area can be measured using a design-based method, where no assumptions about structural properties are necessary. The stereological results were also compared to X-ray tomography to control the accuracy of the method. The specific surface area calculated with the stereological method was 19.8 ± 12.3% smaller than with X-ray tomography. For the density, the stereological method gave results that were 11.7 ± 12.1% larger than X-ray tomography. The statistical analysis of the estimates confirmed that the stereological method and the sampling used are accurate. This stereological method was successfully tested on artificially produced ice beads but also on several snow types. Combining stereology and polarisation microscopy provides a good estimate of grain boundary areas in ice beads and in natural snow, with some limitatio