High-dose intravenous corticosteroid pulse therapy in alopecia areata: own experience compared with the literature

BACKGROUND: Seven prospective studies including 193 patients have been published on high-dose intravenous corticosteroid pulse therapy in alopecia areata (AA).We compare these data with a retrospective analysis of our own consecutive patients. PATIENTS AND METHODS: Between 1998 and 2002,25 patients with severe AA were treated at the Department of Dermatology, University of Bern, with infusions of 500 mg methylprednisolone on 3 consecutive days.In addition to the inpatient records, in 2004 all patients were followed up by a questionnaire. RESULTS: Four of 10 patients with multifocal AA and 3 of 9 patients with ophiasis-type AA had full re-growth of hair, whereas all 6 patients with AA totalis/universalis failed to respond. CONCLUSION: Intravenous corticosteroid pulse therapy may be helpful in the treatment of multifocal and ophiasis-type AA. Patients with an initial episode of short duration have better chances for success.

Antipredator defences of young are independently determined by genetic inheritance, maternal effects and own early experience in mouthbrooding cichlids.

1. Predation is a prime force of natural selection. Vulnerability to predation is typically highest early in life, hence effective antipredator defences should work already shortly after birth. Such early defences may be innate, transmitted through non-genetic parental effects or acquired by own early experience. 2. To understand potential joint effects of these sources of antipredator defences on pheno- typic expression, they should be manipulated within the same experiment. We investigated innate, parental and individual experience effects within a single experiment. Females of the African cichlid Simochromis pleurospilus were exposed to the offspring predator Ctenochromis horei or a benign species until spawning. Eggs and larvae were hand-reared, and larvae were then exposed to odour cues signalling the presence or absence of predators in a split-brood design. 3. Shortly after independence of maternal care, S. pleurospilus undergo a habitat shift from a deeper, adult habitat to a shallow juvenile habitat, a phase where young are thought to be par- ticularly exposed to predation risk. Thus, maternal effects induced by offspring predators pres- ent in the adult habitat should take effect mainly shortly after independence, whereas own experience and innate antipredator responses should shape behaviour and life history of S. pleurospilus during the later juvenile period. 4. We found that the manipulated environmental components independently affected different offspring traits. (i) Offspring of predator-exposed mothers grew faster during the first month of life and were thus larger at termination of maternal care, when the young migrate from the adult to the juvenile habitat. (ii) The offspring’s own experience shortly after hatching exerted lasting effects on predator avoidance behaviour. (iii) Finally, our results suggest that S. pleuro- spilus possess a genetically inherited ability to distinguish dangerous from benign species. 5. In S. pleurospilus, maternal effects were limited to a short but critical time window, when young undergo a niche shift. Instead, own environmental sampling of predation risk combined with an innate predisposition to correctly identify predators appears to prepare the young best for the environment, in which they grow up as juveniles.

Clinical aspects of gestational trophoblastic disease: A review based partly on 25-year experience of a statewide registry

Background: Gestational trophoblastic disease is a fascinating group of pregnancy disorders characterised by abnormal proliferation of trophoblast, ranging from benign to malignant. Because the disease is uncommon, there is a need to formulate management with the assistance of collective information. Methodology: A review of available information from English written literature was undertaken especially data reported by registries around the world (Charing Cross Hospital in England, the North-western University and the New England area in the USA as well as our own experience in Queensland, Australia). Where possible, collated data from relevant studies were analysed to answer some of the questions posed in clinical practice, with reference to metastatic disease to liver and brain, twinning of molar gestation and coexisting fetus, and placental-site tumour. Results: We found that molar gestation can be classified according to its clinical presentation which influences the time taken to reach human chorionic gonadotropin (HCG) 'negativity' and the risk of persisting disease. Categorisation of risk is the basis for choice of chemotherapy to achieve good outcomes. Metastases to liver and brain remain problems in management; the development of 'new' metastases during chemotherapy is a very poor prognostic factor. In the variant of twinning with molar gestation and coexisting fetus, it is important to elucidate the fetal karyotype in planning management: a 69XXX fetus is not salvageable but a normal 46XX or 46XY fetus faces the prospect of early preterm delivery. The placental-site tumour is very rare; localised disease is curable by surgery; chemotherapy is less effective in disseminated disease. From collated worldwide data, the recurrence rate after one mole is 1.3% and after two or more is 20%. Reproductive outcome in subsequent pregnancies, even after multidrug chemotherapy, is not different from the general population. Because of the increased risk long-term of second tumours after multidrug chemotherapy a closer surveillance of these patients is necessary Conclusion: In general, the disease in its persisting or malignant form is 'a cancer model par excellence' because of an identifiable precursor condition, a reliable HCG marker, and sensitivity of the disease to cytotoxic drugs. With current management, retention of fertility is possible and normal reproductive outcome assured.

A journey into narrative inquiry : one teacher's lived experience with eating disorders /

In "A Journey Into Narrative Inquiry: One Teacher's Lived Experience With Eating Disorders," an elementary teacher searches for answers regarding how education can help prevent eating disorders by journeying into her own experience of having had such a disorder. This qualitative study is a personal narrative based on an individual's experience, a method appropriate to the sharing of personal voices and stories told in education research. It is an attempt to address the gap found in the research on this topic by offering a subjective and unique perspective of what it is like to live within the nightmare of an eating disorder and by sharing the wisdom gained from having survived such an experience. This narrative inquiry explains how a teacher found herself at a stage where she was willing and ready to share her experience for the sake of research. The story of having had an eating disorder, consisting of both anorexia and bulimia, for over a decade is shared in a genuine, reflective manner. The researcher then shares the analysis of her own story, unpacking the themes of journeying toward voice, self-esteem, self-acceptance, and self and the completion of an M.Ed. degree. Bridges are made which connect these themes to the personal and professional life of the researcher, to the schools in terms of both curriculum and climate, to research directions, and to the larger culture. Suggestions are made for possible changes in educational settings that may help teachers in providing students with some tools and strategies to prevent turning to eating disorders as coping mechanisms. A literature review of eating disorders is included as well, as a guide for others to use when undertaking such qualitative studies.

In at the Deep End. Impressions of farming in a year gaining experience: 1952-3; 1978-85

The book describes a wide variety of students’ experiences in their practical year prior to entering University to study BSc Agriculture. Until comparatively recently it was the normal requirement for all such students, whether or not they already had home farming experience, to gain a full year’s experience of practical agriculture – and to write a report thereon. This record of 41 students’ reports of the pre-entry year begins with Paul’s own experience in the early 1950s before 41 reports from 30 or more years ago. The essays provide compelling and fascinating stories, well-articulated with clear acknowledgement for most part of the humanity and the warmth with which each student was treated by farmers and farm workers alike, despite the difference in both age and experience (considerable!). [This summary is an extract from the full overview which is archived here together with the book.]

Personal experience with whole-body, low-dosage, digital X-ray scanning (LODOX-Statscan) in trauma

BACKGROUND: Lodox-Statscan is a whole-body, skeletal and soft-tissue, low-dose X-ray scanner Anterior-posterior and lateral thoraco-abdominal studies are obtained in 3-5 minutes with only about one-third of the radiation required for conventional radiography. Since its approval by the Food and Drug Administration (FDA) in the USA, several trauma centers have incorporated this technology into their Advanced Trauma Life Support protocols. This review provides a brief overview of the system, and describes the authors' own experience with the system. METHODS: We performed a PubMed search to retrieve all references with 'Lodox' and 'Stat-scan' used as search terms. We furthermore used the google search engine to identify existing alternatives. To the best of our knowledge, this is the only FDA-approved device of its kind currently used in trauma. RESULTS AND CONCLUSION: The intention of our review has been to sensitize the readership that such alternative devices exist. The key message is that low dosage full body radiography may be an alternative to conventional resuscitation room radiography which is usually a prelude to CT scanning (ATLS algorithm). The combination of both is radiation intensive and therefore we consider any reduction of radiation a success. But only the future will show whether LS will survive in the face of low-dose radiation CT scanners and magnetic resonance imaging devices that may eventually completely replace conventional radiography.

Mesmerized by enlargement:the EU’s Eastern Neighborhood Policy and New Member State transition experience

The accession of the East-Central European (ECE) countries carried a promise of enhancing and enriching the EU’s Eastern policy. The new member states had the strongest interests among EU member states to ensure that countries in the East are prosperous, stable and democratic. Yet, EU’s Eastern policy has been largely criticised for its ineffectiveness. So why have they not been able to address the shortcomings in the EU’s Eastern policies? The article argues that the ECE countries supported the way the EU’s Eastern policies were conceived and implemented because they saw it as a potent vehicle to promote their own transition experience not only in the region but also within the EU. We argue that the ECE states have experienced three types of challenges when promoting their transition experience. First, uploading to the EU level remained largely at a rhetorical level. Second, there are conceptual and practical difficulties in defining what constitutes transition experience and harnessing it, as well as coordinating its transfer between the ECE states. Finally, while using transition experience as the basis for their development assistance strategies, the ECE countries actually insufficiently conceptualised the ‘development’ aspect in these policies. Being so driven by their own experience, they have not drawn the lessons from enlargement to use in a non-accession context, especially by incorporating the broader lessons with regard to development.

Laparoscopic approach in abdominal emergencies: a 5-year experience at a single center

Background. Laparoscopy is ever more common in both elective and emergency surgery. In fact, in abdominal emergencies it enables the resolution of preoperative diagnostic doubts as well as treatment of the underlying disease. We present a retrospective study of the results of a 5-year experience at a single center. Patients and methods. Between September 2006 and August 2011, 961 patients were treated via laparoscopy, including 486 emergency cases (15 gastroduodenal perforation; 165 acute cholecystitis; 255 acute appendicitis; 15 pelvic inflammatory disease and non-specific abdominal pain [NSAP]; 36 small bowel obstruction). All procedures were conducted by a team trained in laparoscopic surgery. Results. The conversion rate was 22/486 patients (4.53%). A definitive laparoscopic diagnosis was possible in over 96% of cases, and definitive treatment via laparoscopy was possible in most of these. Conclusions Our own experience confirms the literature evidence that laparoscopy is a valid option in the surgical treatment of abdominal emergencies. In any case, it must be performed by a dedicated and highly experienced team. Correct patient selection is also important, to enable the most suitable approach for each given situation.

Metodologia de ensino em educação fisica : contribuições de Vygotsky, para as reflexões sobre um modelo pedagogico

Universidade Estadual de Campinas. Faculdade de Educação Física

Learning business strategies for competitive electronic marketplaces

This paper presents a Multi-Agent Market simulator designed for developing new agent market strategies based on a complete understanding of buyer and seller behaviors, preference models and pricing algorithms, considering user risk preferences and game theory for scenario analysis. This tool studies negotiations based on different market mechanisms and, time and behavior dependent strategies. The results of the negotiations between agents are analyzed by data mining algorithms in order to extract rules that give agents feedback to improve their strategies. The system also includes agents that are capable of improving their performance with their own experience, by adapting to the market conditions, and capable of considering other agent reactions.

Agent-based simulation of electronic marketplaces with decision support

This paper presents a Multi-Agent Market simulator designed for analyzing agent market strategies based on a complete understanding of buyer and seller behaviors, preference models and pricing algorithms, considering user risk preferences and game theory for scenario analysis. The system includes agents that are capable of improving their performance with their own experience, by adapting to the market conditions, and capable of considering other agents reactions.

Multi-agent systems and birtual producers in electronic marketplaces

This paper presents an agent-based simulator designed for analyzing agent market strategies based on a complete understanding of buyer and seller behaviours, preference models and pricing algorithms, considering user risk preferences. The system includes agents that are capable of improving their performance with their own experience, by adapting to the market conditions. In the simulated market agents interact in several different ways and may joint together to form coalitions. In this paper we address multi-agent coalitions to analyse Distributed Generation in Electricity Markets

ISEM: a multi-agent system that simulates competitive electronic marketplaces

With the increasing importance of large commerce across the Internet it is becoming increasingly evident that in a few years the Iternet will host a large number of interacting software agents. a vast number of them will be economically motivated, and will negociate a variety of goods and services. It is therefore important to consider the economic incentives and behaviours of economic software agents, and to use all available means to anticipate their collective interactions. This papers addresses this concern by presenting a multi-agent market simulator designed for analysing agent market strategies based on a complete understanding of buyer and seller behaviours, preference models and pricing algorithms, consideting risk preferences. The system includes agents that are capable of increasing their performance with their own experience, by adapting to the market conditions. The results of the negotiations between agents are analysed by data minig algorithms in order to extract rules that give agents feedback to imprive their strategies.

Iniciação à ciência através da metodologia de trabalho de projeto – um contexto privilegiado para o desenvolvimento da linguagem no pré-escolar

A aprendizagem da Ciência tem-se revelado difícil, nos diferentes níveis de ensino, como tem mostrado a inúmera investigação educacional que tem vindo a ser realizada desde a década de sessenta do séc. XX. A Linguagem científica constitui uma (primeira) barreira para os aprendentes de Ciência. As dificuldades são de natureza diversa. No presente artigo procuraremos mostrar como uma iniciação à Ciência, através da Metodologia de Trabalho de Projeto, pode constituir uma metodologia privilegiada por permitir não só a aquisição de significado para termos técnicos, como também a atribuição de novos significados a palavras da linguagem corrente e a utilização de conectores lógicos. Recorreremos a exemplos recolhidos de situações de estágios profissionais que acompanhámos.