Tomographic index as auxiliary criteria for surgery indication in fracture dislocation of acetabulum posterior wall

There are situations which the tomographic exam is done on the affected hip or situations where the contralateral hip presents abnormalities that make it impossible to compare. In this study we aimed to evaluate a tomographic index that does not require comparison between the both hips. Twenty two patients with unilateral acetabular fracture dislocation with fracture of posterior wall were studied. We established the relationship between the remaining posterior wall and the femoral head diameter (head/wall index-H/W index). We evaluated 45 two-dimensional computed tomography scan in normal hips and established the H/W index. In 45 normal hips we simulated a posterior wall fracture with involvement of 25% and 30% of the posterior wall and calculated the H/W index. We divided into five groups with five different H/W index (fractured group with non surgical treatment; fractured group; normal group; normal group with simulated fracture of 25% and; 30% of the posterior wall). 2.4 was the lowest limit of confidence interval of the group with 25% of the posterior wall fracture. When we analyzed the confidence interval of the 30% fracture group the upper limit of the confidence interval was 2.7, close to the lower limit of the surgical group that was 2.9. Thus, we suggest the 2.4 the H/W index limit as an auxiliary criteria to indicate whether or not to operate. H/W index is helpful to decide whether or not surgery indication in the fracture dislocation of the posterior wall of the acetabulum. © 2012 Fujiki et al.; licensee BioMed Central Ltd.

Inconsistent-tolerant base revision through Argument Theory Change

Reasoning and change over inconsistent knowledge bases (KBs) is of utmost relevance in areas like medicine and law. Argumentation may bring the possibility to cope with both problems. Firstly, by constructing an argumentation framework (AF) from the inconsistent KB, we can decide whether to accept or reject a certain claim through the interplay among arguments and counterarguments. Secondly, by handling dynamics of arguments of the AF, we might deal with the dynamics of knowledge of the underlying inconsistent KB. Dynamics of arguments has recently attracted attention and although some approaches have been proposed, a full axiomatization within the theory of belief revision was still missing. A revision arises when we want the argumentation semantics to accept an argument. Argument Theory Change (ATC) encloses the revision operators that modify the AF by analyzing dialectical trees-arguments as nodes and attacks as edges-as the adopted argumentation semantics. In this article, we present a simple approach to ATC based on propositional KBs. This allows to manage change of inconsistent KBs by relying upon classical belief revision, although contrary to it, consistency restoration of the KB is avoided. Subsequently, a set of rationality postulates adapted to argumentation is given, and finally, the proposed model of change is related to the postulates through the corresponding representation theorem. Though we focus on propositional logic, the results can be easily extended to more expressive formalisms such as first-order logic and description logics, to handle evolution of ontologies.

Identification of target genes of the T-box proteins in Drosophila melanogaster

In a prior bioinformatic analysis by Hüyseyin Binbas, potential Tbx targets sequences in wing-related genes have been identified. Guided by this information, enhancer trap/reporter lacZ insertions were characterized by X-gal staining first in wildtype and then in l(1)omb imaginal discs.rnIn several lines I observed an increase in reporter expression in a l(1)omb mutant background. Since Omb is assumed to function predominantly as a transcriptional repressor, this may indicate direct regulation. Repression by Omb was observed e.g. for brk and tkv. These genes are negatively regulated by Dpp, while omb is induced by Dpp. Omb which mediates the effects of Dpp on proliferation could, thus, also mediate the Dpp effect on patterning of the wing disc. However, brk and tkv were not completely derepressed in l(1)omb indicating that Dpp represses these genes also by an Omb-independent mechanism.rnMore frequently I observed loss of reporter expression in an l(1)omb mutant background. In these cases, regulation by Omb presumably is indirect. For example, STAT92E-lacZ expression in the wildtype eye was symmetrically expressed at the dorsal and ventral margins. In l(1)omb, ventral expression was selectively lost. Loss of omb is known to cause ventral overproliferation of the eye by activation of the Jak/STAT pathway. STAT92E expression is negatively regulated by Jak/STAT signaling suggesting that loss of omb activates Jak/STAT further upstream in the pathway.rnRegional overproliferation of eye and wing in the l(1)omb mutant background proved a complicating issue in the search for Omb targets. This effect made it difficult to decide whether an expanded reporter expression pattern was due to tissue expansion or reporter gene derepression. For instance hth-lacZ appeared to expand along the ventral eye disc margin in l(1)omb. Without addtional experiments it cannot be concluded whether this is due to de-repression or to activation in association with the proliferative state. Parallel to my experiments, evidence accumulated in our laboratory that loss of omb may attenuate Wg and Hegehog signaling. Since these diffusible proteins are the main patterning molecules in the wing imaginal disc, with dpp being downstream of Hh, many of the observed effects could be secondary to reduced Wg and Hh activity. Examples are ab-lacZ, Dll-lacZ and vgBE-lacZ (reduced expression on the dorso-ventral boundary) and inv-lacZ (late larval expression in the anterior wing disc compartment is lost) or sal-lacZ. Epistasis experiment will be required to clarifiy these issues.rnFurthermore, loss of omb appeared to induce cell fate changes. It was reported previously that in an omb null mutant, the dorsal determinant apterous (ap) is ectopically expressed in the ventral compartment (an effect I did not observe with the strongly hypomorphic l(1)omb15, indicating strong dose dependence). Ventral repression of ap is maintained by epigenetic mechanisms. The patchy and variable nature of ectopic expression of ap or grn-1.1-lacZ points to an effect of omb on epigenetic stability.rnIn the second part of my thesis, an analysis of Omb expression in the Drosophila embryonic ventral nervous system was performed. Omb was found co-expressed with Eve in the medial aCC and RP2 motorneurons as well as the fpCC interneuron and the mediolateral CQ neurons. Additionally, Omb was detected in the Eg positive NB7-3 GW serotonergic motoneuron and the N2-4 neurons. Omb was not found in Repo positive glial cells. During embryonic stage 14, Omb showed some coepression with Dpn or Pros. At the embryonic stage 16, Omb was expressed in minor subset of Mid and Wg positive cells.

MoVimento 5 Stelle - Fortführung des italienischen Rechtspopulismus?

In der vorliegenden Arbeit wird analysiert, ob die neue italienische Partei MoVimento 5 Stelle (M5S) eine rechtspopulistische Partei ist. Darüber hinaus wird mithilfe eines Vergleichs mit Berlusconis Partei Popolo della libertà (PDL) erörtert, ob das M5S den italienischen Rechtspopulismus fortführt. Das M5S wurde im Jahre 2009 von dem italienischen Komiker Beppe Grillo gegründet und zog nach seiner ersten Teilnahme an nationalen Wahlen im Jahre 2013 als zweitstärkste Partei in das italienische Parlament ein. Mit seiner Anti-Establishment-Programmatik und der Ablehnung der etablierten Parteien ähnelt das M5S nicht nur Berlusconis Partei PDL, sondern auch den rechtspopulistischen Parteien, die seit den 1980er Jahren in Westeuropa beständig an Relevanz gewonnen haben. Diese Parteien polemisieren gegen Politiker und Parteien, stellen die Legitimität von Minderheitenrechten und die Prinzipien der repräsentativen Demokratie in Frage. Organisatorisch gruppieren sie sich um einen charismatischen Anführer, dessen Anspruch es ist, die ‚Stimme des Volkes‘ zu repräsentieren. Diese und andere zentrale Charakteristika sind Gegenstand des theoretischen Teils dieser Arbeit. Die Analysedimension sind ‚Programmatik‘ und ‚Organisation‘. Die letztgenannte Kategorie wird in ‚interne Organisationsstruktur‘ und ‚Kommunikation‘ unterteilt. Die Basis der Analyse bilden Parteidokumente (Wahl- und Parteiprogramme, Parteistatuten, Blogeinträge), Experteneinschätzungen und die Forschungsliteratur. Die Untersuchung kommt zu dem Ergebnis, dass es sich beim M5S nicht um eine rechtspopulistische, sondern um eine populistische Partei mit linken Elementen handelt. Den italienischen Rechtspopulismus, wie ihn Berlusconis Partei pflegt, führt sie folglich nicht fort. Sie zeigt in der Organisation starke Parallelen, da beide Parteien von ihren Anführern dominiert werden. Aber das M5S hat eine stark web-basierte Organisationsform und vertritt Umweltthemen, was keine typischen Merkmale rechtspopulistischer Parteien sind. Darüber hinaus vertritt es keine nationalistischen Position, was hingegen konstitutiv für Rechtspopulismus ist.

Rebranding feminism: An analysis of present-day feminism

The purpose of this dissertation is to reflect on the meaning of feminism in order to decide whether the movement needs a rebranding. The first part will focus on the history of feminism to clarify its beliefs and goals. The following part will highlight how feminism gained a bad reputation over time and will show Elle’s attempt in November 2013 to launch a project to rebrand the movement. The last part will explain what present-day feminism consists of by listing some of the latest projects and the most important issues the movement has to tackle. My analysis will finally show that the F-movement needs a rebranding and, in order to be effective, men should join women’s fight for equality. “We should all be feminists”.

Fatal thoracic impalement on postmortem imaging

In the present paper, the authors describe a case of fatal thoracic impalement in a victim of a road traffic accident, by penetration of a metal handrail. The driver lost control of his car while overtaking three cars. Due to the force of the vehicle collision with a metal railing, the upper cross bar penetrated the front of the car and subsequently the driver was pierced by the center-pillar in the car. Death occurred at the scene of the accident. Postmortem, computed tomography, computed tomography angiography and a magnetic resonance tomography were performed and revealed severe heart destruction and hemorrhage as cause of death. The present case report shows that postmortem imaging might have value as a screening method to decide whether arising forensic questions can be answered just by imaging like in the presented case or if further examinations such as conventional autopsy are required.

Because someone has recommended it - Patients’ reasons for choosing acupuncture or qigong

Question: Recent research has indicated a considerable contribution of placebo effects to the outcome of acupuncture treatments: especially patients’ expectations seem to have an influence [1] and [2]. In this context it is important to better understand the patient–practitioner relationship. The aim of this study was to investigate why patients in Switzerland choose acupuncture or qigong, and what they expect from the treatment and the practitioners [3]. Methods: A qualitative survey with open questions was performed among 38 patients newly enrolled for treatment in 7 different practices for Traditional Chinese Medicine ((TCM); 6 practices for acupuncture, 1 for qigong). Questions aimed to identify reasons for choosing TCM, knowledge about its range of indications, and patients’ expectations towards method and therapist. Answers were categorised and analysed by frequency. Results: The most common reasons for choosing TCM were recommendation by acquaintances, the idea of trying a new treatment and the perception of TCM as being a gentle method. The majority of respondents had poor knowledge about the range of conditions to be treated with TCM: pain of the musculoskeletal system, headaches and chronic problems were considered as main indications. Surprisingly, gynaecological or gastro-intestinal diseases were not mentioned by the respondents. Practitioners were expected to have professional competence, provide information, empathy and understanding. Conclusions: The most striking result of this survey was the fact that patients knew very little about TCM and its indications. Thus, more precise information about TCM and other complementary methods should be offered to the general public, which would help patients to decide whether to consider TCM for the treatment of their disease. And, on the other hand, for the therapists it is important to better understand and respond to patients’ expectations in order to achieve better treatment results. The results of this qualitative survey were briefly discussed with the participating practitioners, who found them remarkable and support further quantitative studies. We plan to further investigate this topic. References 1. J. Pariente, P. White, R.S.J. Frackowiak, G. Lewith. Neuroimage, 25 (2005), pp. 1161–1167 2. M. Karst, D. Schneidewind, D. Scheinichen. Forsch Komplementmed, 17 (2010), pp. 21–27 3. S.D. Klein. Dt Ztschr f Akup, 52 (2009), pp. 18–23

Accuracy and consistency of the visual diagnosis of exposed dentine on worn occlusal/incisal surfaces

Most indices for the assessment of wear of various aetiologies include the distinction between 'enamel still present' and 'dentine exposed' for grading. Since the visual diagnosis of exposed dentine has not yet been validated, the present study is a first attempt to investigate its accuracy and consistency. Sixty-one examiners (23 scientists, 18 university dentists and 20 dental students) were asked to diagnose 49 tooth areas with different grades of wear and to decide whether dentine was exposed (positive test) or not (negative test). Afterwards, the teeth were histologically evaluated. In 44 areas, dentine (also in all cases with minor wear) was exposed, and in 5 areas enamel was present. Overall sensitivity was 0.65, specificity 0.88 and the proportion of correct diagnoses was 0.67. The diagnosis 'dentine is exposed' was about 5 times as likely and the diagnosis 'dentine is not exposed' half as likely to come from an area with exposed dentine than from an enamel-covered area. The closeness of the visual diagnosis to the histological findings was only fair (kappa=0.27), no significant impact of professional experience was found. For inter- and intra-examiner agreement, kappa was 0.28 and 0.55, respectively. It was concluded that the diagnosis of exposed dentine is difficult.

Tactile sensibility of single-tooth implants and natural teeth

AIM: The purpose of this randomized split-mouth clinical trial was to determine the active tactile sensibility between single-tooth implants and opposing natural teeth and to compare it with the tactile sensibility of pairs of natural teeth on the contralateral side in the same mouth (intraindividual comparison). MATERIAL AND METHODS: The hypothesis was that the active tactile sensibilities of the implant side and control side are equivalent. Sixty two subjects (n=36 from Bonn, n=26 from Bern) with single-tooth implants (22 anterior and 40 posterior dental implants) were asked to bite on narrow copper foil strips varying in thickness (5-200 microm) and to decide whether or not they were able to identify a foreign body between their teeth. Active tactile sensibility was defined as the 50% threshold of correct answers estimated by means of the Weibull distribution. RESULTS: The results obtained for the interocclusal perception sensibility differed between subjects far more than they differed between natural teeth and implants in the same individual [implant/natural tooth: 16.7+/-11.3 microm (0.6-53.1 microm); natural tooth/natural tooth: 14.3+/-10.6 microm (0.5-68.2 microm)]. The intraindividual differences only amounted to a mean value of 2.4+/-9.4 microm (-15.1 to 27.5 microm). The result of our statistical calculations showed that the active tactile sensibility of single-tooth implants, both in the anterior and posterior region of the mouth, in combination with a natural opposing tooth is similar to that of pairs of opposing natural teeth (double t-test, equivalence margin: +/-8 microm, P<0.001, power >80%). Hence, the implants could be integrated in the stomatognathic control circuit.

Herman D. Stein

Herman Stein, President of the International Association of Schools of Social Work from 1968 - 1976, has for more than sixty years excelled as an educator, scholar, internationalist, university administrator, and leader in a variety of professional associations. From almost the beginning of his career, the world has been the stage on which he has played those many roles, all of them with an abundance of talent. In fact, while he was in the graduate program of what is now the Columbia University School of Social Work, he had to decide whether to become a social worker or an actor. As an undergraduate he became involved in student theatrical productions, where he teamed up with the famous comedian, Danny Kaye, who became a life-long companion and friend. At the end of Steins first year in the social work program, he was invited to join an off-Broadway variety show that helped to launch Kaye on his meteoric rise on both stage and screen. "If I´d joined," Stein has said, "the theater probably was going to be where I would make my career as a character actor." Fortunately for social work and social work education, he chose instead to continue his studies at the School of Social Work, from which he received his master's degree in 1941 and the doctoral degree in 1958. While the world has been his stage, education has been at the heart of his manifold activities. Following a period of direct service practice as a caseworker in a well-known private agency in New York City, he was recruited by the Columbia School of Social Work in 1945 as a faculty member. With an interruption for a significant overseas assignment from 1947 to 1950, he continued at Columbia for another fourteen years, rising through all professorial ranks to Professor and Director of the School's Research Center.

Purchase decision-making is modulated by vestibular stimulation

Purchases are driven by consumers’ product preferences and price considerations. Using caloric vestibular stimulation (CVS), we investigated the role of vestibular-affective circuits in purchase decision-making. CVS is an effective noninvasive brain stimulation method, which activates vestibular and overlapping emotional circuits (e.g., the insular cortex and the anterior cingulate cortex (ACC)). Subjects were exposed to CVS and sham stimulation while they performed two purchase decision-making tasks. In Experiment 1 subjects had to decide whether to purchase or not. CVS significantly reduced probability of buying a product. In Experiment 2 subjects had to rate desirability of the products and willingness to pay (WTP) while they were exposed to CVS and sham stimulation. CVS modulated desirability of the products but not WTP. The results suggest that CVS interfered with emotional circuits and thus attenuated the pleasant and rewarding effect of acquisition, which in turn reduced purchase probability. The present findings contribute to the rapidly growing literature on the neural basis of purchase decision-making.

"Because someone has recommended it" - patients' reasons for choosing acupuncture or qigong

Background Recent research has indicated a considerable contribution of placebo effects to the outcome of acupuncture treatments: especially patients’ expectations seem to have an influence [1, 2]. In this context it is important to better understand the patient-practitioner relationship. The aim of this study was to investigate why patients in Switzerland choose acupuncture or qigong, and what they expect from the treatment and the practitioners [3]. Method A qualitative survey with open questions was performed among 38 patients newly enrolled for treatment in 7 different practices for Traditional Chinese Medicine ((TCM); 6 practices for acupuncture, 1 for qigong). Questions aimed to identify reasons for choosing TCM, knowledge about its range of indications, and patients’ expectations towards method and therapist. Answers were categorised and analysed by frequency. Results The most common reasons for choosing TCM were recommendation by acquaintances, the idea of trying a new treatment and the perception of TCM as being a gentle method. The majority of respondents had poor knowledge about the range of conditions to be treated with TCM: pain of the musculoskeletal system, headaches and chronic problems were considered as main indications. Surprisingly, gynaecological or gastro-intestinal diseases were not mentioned by the respondents. Practitioners were expected to have professional competence, provide information, empathy and understanding. Discussion The most striking result of this survey was the fact that patients knew very little about TCM and its indications. Thus, more precise information about TCM and other complementary methods should be offered to the general public, which would help patients to decide whether to consider TCM for the treatment of their disease. And, on the other hand, for the therapists it is important to better understand and respond to patients’ expectations in order to achieve better treatment results. The results of this qualitative survey were briefly discussed with the participating practitioners, who found them remarkable and support further quantitative studies. We plan to further investigate this topic. Literature 1 Pariente J et al., Neuroimage 2005;25:1161-67 2 Karst M et al., Forsch Komplementmed 2010;17:21-7 3 Klein SD., Dt Ztschr f Akup. 2009;52:18-23

Soziales und moralisches Denken von Kindern über den Ein- und Ausschluss behinderter Kinder

Die Studie untersucht, wie 70 Kindergartenkinder im Vergleich zu 71 Fünft- und Sechstklässler über Situationen denken, in welchen sich ein Protagonist für die Wahl eines behinderten oder nicht behinderten Kindes in seine Gruppe entscheiden musste. Die Situationen wurden nach Behinderungsform des behinderten Kindes (geistig behindert, körperbehindert) und nach Gruppenaktivität (schulisch, sozial, sportlich) variiert. Die Kinder sollten die Wahl des Protagonisten vorhersagen und die Wahl begründen. Die älteren Kinder berücksichtigten in ihren Überlegungen stärker den situativen Kontext als die jüngeren Kinder. Allerdings erwarteten sie weniger häufig den Einschluss des geistig behinderten Kindes als den Einschluss des körperbehinderten Kindes. Die Ergebnisse der Studie werden vor dem Hintergrund von Forschung zur Entwicklung sozialen und moralischen Denkens über Ein- und Ausschluss diskutiert.

Clinical and haematological predictors of antibiotic prescribing for acute cough in adults in Swiss practices - an observational study.

BackgroundAcute cough is a common problem in general practice and is often caused by a self-limiting, viral infection. Nonetheless, antibiotics are often prescribed in this situation, which may lead to unnecessary side effects and, even worse, the development of antibiotic resistant microorganisms worldwide. This study assessed the role of point-of-care C-reactive protein (CRP) testing and other predictors of antibiotic prescription in patients who present with acute cough in general practice.MethodsPatient characteristics, symptoms, signs, and laboratory and X-ray findings from 348 patients presenting to 39 general practitioners with acute cough, as well as the GPs themselves, were recorded by fourth-year medical students during their three-week clerkships in general practice. Patient and clinician characteristics of those prescribed and not-prescribed antibiotics were compared using a mixed-effects model.ResultsOf 315 patients included in the study, 22% were prescribed antibiotics. The two groups of patients, those prescribed antibiotics and those treated symptomatically, differed significantly in age, demand for antibiotics, days of cough, rhinitis, lung auscultation, haemoglobin level, white blood cell count, CRP level and the GP¿s license to self-dispense antibiotics. After regression analysis, only the CRP level, the white blood cell count and the duration of the symptoms were statistically significant predictors of antibiotic prescription.ConclusionsThe antibiotic prescription rate of 22% in adult patients with acute cough in the Swiss primary care setting is low compared to other countries. GPs appear to use point-of-care CRP testing in addition to the duration of clinical symptoms to help them decide whether or not to prescribe antibiotics.

Europeanization in parliament and in the press

Europeanization challenges national democratic systems. As part and parcel of the broader internationalization of politics, Europeanization is associated with a shift from policymaking within majoritarian, elected representative bodies towards technocratic decisions among non-majoritarian and non-elected bodies (Kohler-Koch and Rittberger 2008, Lavenex 2013). It is thus said to weaken the influence of citizens and parliaments on the making of policies and to undermine democratic collective identity (Lavenex 2013, Schimmelfennig 2010). The weakening of national parliaments has been referred to as “de-parliamentarisation” (Goetz and Meyer-Sahling 2008) and has nurtured a broader debate regarding the democratic deficit in the EU. While not being a member of the EU, Switzerland has not remained unaffected by these changes. As discussed in the contribution by Fischer and Sciarini, state executive actors take the lead in Switzerland's European policy. They are responsible for the conduct of international negotiations, they own the treaty making power, and it is up to them to decide whether they wish to launch a negotiation with the EU. In addition, the strong take-it or leave-it character of Europeanized acts limits the room for manoeuver of the parliamentary body also in the ratification phase. Among the public, the rejection of the treaty on the European constitution has definitely closed the era of “permissive consensus” (Hooghe and Marks 2009). However, the process of European unification remains far remote from the European public. In Switzerland, the strongly administrative character of international legislation hinders public discussion (Vögeli 2007). In such a context, the media may serve as cue for the public: By delivering information about the extent and nature of Europeanized policymaking, the media enable citizens to form their own opinions and to hold their representatives accountable. In this sense media coverage may not only be considered an indicator of the information delivered to the public, but it may also enhance the democratic legitimacy of Europeanized policymaking (for a similar argument, see Tresch and Jochum 2005). While the previous contributions to this debate have examined the Europeanization of Swiss (primary and secondary) legislation, we take a closer look at two additional domestic arenas that are both supposed to be under pressure due to Europeanization: The parliament and the media. To that end, we rely on data gathered in a research project that two of us carried out in the context of the NCCR Democracy.1 While this project was primarily interested in the mediatization of decision-making processes in Switzerland, it also investigated the conditional role played by internationalization/Europeanization. For our present purposes, we shall exploit the two data-sets that were developed as part of a study of the political agenda-setting power of the media (Sciarini and Tresch 2012, 2013, Tresch et al. 2013): A data-set on issue attention in parliamentary interventions (initiatives, motions, postulates,2 interpellations and questions) and a data-set on issue attention in articles from the Neue Zürcher Zeitung (NZZ). The data covers the years 1995 to 2003 and the coding of issues followed the classification system developed in the “Policy Agendas Project” (Baumgartner and Jones 1993).