The qualities people believe are important in selecting a marriage partner afford one domain for assessing human values. We examined the cultural evolution of these values over more than half a ...century. Building on existing data on mate preferences collected in 1939 (N = 628), 1956 (N = 120), 1967 (N = 566), and 1977 (N = 316), we collected data using the same instrument in 1984/1985 (N = 1,496) and in 1996 (N = 607) at geographically diverse locations. Several changes in values were documented across the 57-year span. Both sexes increased the importance they attach to physical attractiveness in a mate. Both sexes, but especially men, increased the importance they attach to mates with good financial prospects. Domestic skills in a partner plummeted in importance for men. Mutual attraction and love climbed in importance for both sexes. The sexes converged in the ordering of the importance of different mate qualities, showing maximum similarity in 1996. Discussion speculates about causes of the cultural evolution of values.
Amended Classification of the Open Abdomen Björck, M.; Kirkpatrick, A. W.; Cheatham, M. ...
Scandinavian journal of surgery,
03/2016, Letnik:
105, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Background:
In 2009, a classification system for the open abdomen was introduced. The aim of such a classification is to aid the (1) description of the patient’s clinical course; (2) standardization ...of clinical guidelines for guiding open abdomen management; and (3) facilitation of comparisons between studies and heterogeneous patient populations, thus serving as an aid in clinical research.
Methods:
As part of the revision of the definitions and clinical guidelines performed by the World Society of the Abdominal Compartment Syndrome, this 2009 classification system was amended following a review of experiences in teaching and research and published as part of updated consensus statements and clinical practice guidelines in 2013. Among 29 articles citing the 2009 classification system, nine were cohort studies. They were reviewed as part of the classification revision process. A total of 542 patients (mean: 60, range: 9–160) had been classified. Two problems with the previous classification system were identified: the definition of enteroatmospheric fistulae, and that an enteroatmospheric fistula was graded less severe than a frozen abdomen.
Results:
The following amended classification was proposed: Grade 1, without adherence between bowel and abdominal wall or fixity of the abdominal wall (lateralization), subdivided as follows: 1A, clean; 1B, contaminated; and 1C, with enteric leak. An enteric leak controlled by closure, exteriorization into a stoma, or a permanent enterocutaneous fistula is considered clean. Grade 2, developing fixation, subdivided as follows: 2A, clean; 2B, contaminated; and 2C, with enteric leak. Grade 3, frozen abdomen, subdivided as follows: 3A clean and 3B contaminated. Grade 4, an established enteroatmospheric fistula, is defined as a permanent enteric leak into the open abdomen, associated with granulation tissue.
Conclusions:
The authors believe that, with these changes, the requirements on a functional and dynamic classification system, useful in both research and training, will be fulfilled. We encourage future investigators to apply the system and report on its merits and constraints.
Wingless (Wg) is a morphogen required for the patterning of many
Drosophila tissues. Several lines of evidence implicate heparan sulfate-modified proteoglycans (HSPGs) such as Dally-like protein ...(Dlp) in the control of Wg distribution and signaling. We show that
dlp is required to limit Wg levels in the matrix, contrary to the expectation from overexpression studies.
dlp mutants show ectopic activation of Wg signaling at the presumptive wing margin and a local increase in extracellular Wg levels.
dlp somatic cell clones disrupt the gradient of extracellular Wg, producing ectopic activation of high threshold Wg targets but reducing the expression of lower threshold Wg targets where Wg is limiting.
Notum encodes a secreted protein that also limits Wg distribution, and genetic interaction studies show that
dlp and
Notum cooperate to restrict Wg signaling. These findings suggest that modification of an HSPG by a secreted hydrolase can control morphogen levels in the matrix.
We describe a series of experiments that compare 2D displays, 3D displays, and combined 2D/3D displays (orientation icon, ExoVis, and clip planes) for relative position estimation, orientation, and ...volume of interest tasks. Our results indicate that 3D displays can be very effective for approximate navigation and relative positioning when appropriate cues, such as shadows, are present. However, 3D displays are not effective for precise navigation and positioning except possibly in specific circumstances, for instance, when good viewing angles or measurement tools are available. For precise tasks in other situations, orientation icon and ExoVis displays were better than strict 2D or 3D displays (displays consisting exclusively of 2D or 3D views). The combined displays had as good or better performance, inspired higher confidence, and allowed natural, integrated navigation. Clip plane displays were not effective for 3D orientation because users could not easily view more than one 2D slice at a time and had to frequently change the visibility of individual slices. Major factors contributing to display preference and usability were task characteristics, orientation cues, occlusion, and spatial proximity of views that were used together.
The use of laparoscopic appendectomy for complicated appendicitis is controversial. Outcomes were compared between patients who had complicated appendicitis and those who had uncomplicated ...appendicitis.
Consecutive patients (n = 304) who underwent laparoscopic appendectomy were studied. Patients undergoing open appendectomies also were compared ad hoc. Analgesia use, length of hospital stay, return to activity, and complication rates for the complicated and uncomplicated appendicitis subgroups were analyzed.
Complete data were available for 243 patients (80%). There were no statistical differences in characteristics between the two groups. The operating times, lengths of hospital stay, return to activity times, complication rates, and analgesia requirements, both in the hospital and after discharge, were equivalent. A greater number of complicated cases required open conversion. Considering those with complicated appendicitis, the open group had a significantly longer mean hospital stay and a higher complication rate than those treated with laparoscopic appendectomy.
The minimally invasive laparoscopic technique is safe and efficacious. It should be the initial procedure of choice for most cases of complicated appendicitis.
Background: As a general rule, surgery whenever possible, followed by irradiation is considered to be the standard treatment for cancer of the hypopharynx, thus sacrificing natural speech. In most ...patients, surgery includes removal of the larynx. Purpose: A prospective, randomized phase III study was conducted by the European Organization for Research and Treatment of Cancer (EORTC) starting in 1990 to compare a larynx-preserving treatment (induction chemotherapy plus definitive, radiation therapy in patients who showed a complete response or surgery in those who did not respond) with conventional treatment (total laryngectomy with partial pharyngectomy, radical neck dissection, and postoperative irradiation) in previously untreated and operable patients with histologically proven squamous cell carcinomas of the pyriform sinus or aryepiglottic fold, but free of other cancers. Methods: Patients were randomly assigned to one of two treatment arms: 1) immediate surgery with postoperative radiotherapy (50–70 Gy) or 2) induction chemotherapy (cisplatin 100 mg/m2 given as a bolus intravenous injection on day 1, followed by infusion of fluorouracil 1000 mg/m2 per day on days 1–5). An endoscopic evaluation was performed after each cycle of chemotherapy. After two cycles, only partial and complete responders received a third cycle. Patients with a complete response after two or three cycles of chemotherapy were treated thereafter by irradiation (70 Gy); nonresponding patients underwent conventional surgery with postoperative radiation (50–70 Gy). Salvage surgery was also performed when patients relapsed after chemotherapy and irradiation. The trial was designed to test the equivalence of the two treatment arms; i.e., the induction chemotherapy treatment would be judged equivalent to immediate surgery if the relative risk of death for induction chemotherapy compared with immediate surgery was significantly less than 1.43 using a one-sided hypothesis test at the.05 level of significance. Results: Two hundred two patients entered the trial and were randomly assigned; only 194 were eligible for treatment (94 in the immediate-surgery arm and 100 in the induction-chemotherapy arm). In the induction-chemotherapy arm, complete response was seen in 52 (54%) of 97 patients with local disease (primary tumor) and in 31 (51%) of 61 patients with regional disease (involvement of the neck). Treatment failures at local, regional, and second primary sites occurred at approximately the same frequencies in the immediate-surgery arm (12%, 19%, and 16%, respectively) and in the induction-chemotherapy arm (17%, 23%, and 13%, respectively). In contrast, there were fewer failures at distant sites in the induction-chemotherapy arm than in the immediate-surgery arm (25% versus 36%, respectively; P =.041). The median duration of survival was 25 months in the immediate-surgery arm and 44 months in the induction-chemotherapy arm and, since the observed hazard ratio was 0.86 (logrank test, P =.006), which was significantly less than 1.43, the two treatments were judged to be equivalent. The 3- and 5-year estimates of retaining a functional larynx in patients treated in the induction chemotherapy arm were 42% (95% confidence interval = 31%-53%) and 35% (95% confidence interval = 22%-48%), respectively. Conclusions and Implications: Larynx preservation without jeopardizing survival appears feasible in patients with cancer of the hypopharynx. On the basis of these observations, the EORTC has now accepted the use of induction chemotherapy followed by radiation as the new standard treatment in its future phase III larynx preservation trials. J Natl Cancer Inst 1996; 88: 890–9
On the basis of 7 charismatic and transformational leadership theories, 3 core components (vision, vision implementation through task cues, and communication style) were identified. A laboratory ...simulation manipulated the 3 components in a completely crossed experimental design, where 2 trained actors portrayed the leader. Participants were 282 students in upper level business classes who performed a simulated production task. The vision of high quality weakly affected performance quality but significantly affected many attitudes. Vision implementation, in the form of task cues, affected performance quality and quantity. Charismatic communication style affected only the perception of charisma. Mediation was not found; rather, an exploratory path analysis found a 2-part causal sequence, where the vision of quality and vision implementation each affected self-set goals and self-efficacy, which, in turn, affected performance.
Summary Angular dermoid cysts are common peri-orbital tumours in children. Characteristically benign and slow growing, they are tumours of embryonic origin that arise along bony sutures as a result ...of abnormal ectodermal sequestration during development. Early surgical excision is recommended and performed in the majority of cases, particularly to restore facial cosmesis. We present a review of 25 cases, managed by our unit over the past 9 years, which underwent surgical excision by a single-stage procedure using the superior eyelid crease approach only. We show that despite the evolution of many techniques, including endoscopy, the superior eyelid crease remains superior in our opinion, affording simple complete excision with a well-concealed scar. Therefore, we recommend this technique as the optimal technique for lateral eyebrow dermoid cyst excision.
The Edinburgh randomised trial of breastcancer screening recruited women aged 45–64 years from 1978 to 1981 (cohort 1), and those aged 45–49 years during 1982–85 (cohorts 2 and 3). Results based on ...14 years of follow-up and 270 000 woman-years of observation are reported.
Breast-cancer mortality rates in the intervention group (28 628 women offered screening) were compared with those in the control group (26 026) with adjustment for socioeconomic status (SES) of general medical practices. Rate ratios were derived by means of logistic regression for the total trial population and for women first offered screening while younger than 50 years. Analyses were by intention to treat.
Initial unadjusted results showed a difference of just 13% in breast-cancer mortality rates between the intervention and control groups (156 deaths 5·18 per 10 000
vs 167 6·04 per 10 000; rate ratio 0·87 95% CI 0·70–1·06), but the results were influenced by differences in SES by trial group. After adjustment for SES, the rate ratio was 0·79 (95% CI 0·60–1·02). When deaths after diagnosis more than 3 years after the end of the study were censored the rat ratio became 0·71 (0·53–0·95). There was no evidence of heterogeneity by age at entry and no evidence that younger entrants had smaller or delayed benefit (rate ratio 0·70 0·41–1·20). No breast-cancer mortality benefit was observed for women whose breast cancers were diagnosed when they were younger than 50 years. Othercause mortality rates did not differ by trial group when adjusted for SES.
Our findings confirm results from randomised trials in Sweden and the USA that screening for breast cancer lowers breast-cancer mortality. Similar results are reported by the UK geographical comparison, UK Trial of Early Detection of Breast Cancer. The results for younger women suggest benefit from introduction of screening before 50 years of age.
Abstract The relationship between self-esteem and aggression has yielded mixed results and generated much recent debate in the social psychology literature. Based on an evolutionary-psychological ...theory of self-esteem, Kirkpatrick et al. Kirkpatrick, L. A., Waugh, C. E., Valencia, A., Webster, G., 2002. The functional domain-specificity of self-esteem and the differential prediction of aggression. Journal of Personality and Social Psychology 825, 756–767 showed that multiple, functionally distinct self-esteem mechanisms predict aggression differentially: e.g., “self-perceived superiority” is positively related, and “social inclusion” inversely related, to behavioral aggression. The present study extends this research by further differentiating two distinct forms of “superiority,” dominance and prestige Henrich, J., Gil-White, F. J. 2001. The evolution of prestige: Freely conferred deference as a mechanism for enhancing the benefits of cultural transmission. Evolution and Human Behavior 22, 165–196, in the prediction of aggression in men and women and testosterone levels (measured in saliva samples) in men. Dominance was positively related, but prestige was either unrelated or inversely related, to self-report aggression measures. Dominance was unrelated but prestige inversely related to testosterone levels in men, perhaps suggesting a method of testosterone inhibition in individuals attaining prestige-based superiority. In addition to contributing to the growing literature on the aggression–self-esteem link, the results provide validation for the prestige–dominance distinction and support, but also suggest an important refinement to, a theory of self-esteem as a collection of functionally distinct adaptations.
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