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Modern imaging lymph node staging of the head and neck region.

The aim of this paper is to describe the modern imaging methods, their techniques, ability, and performance in staging head and neck lymph nodes. Also, the imaging morphologies of benign and malignant lymph nodes according to the different imaging techniques will be delineated. The imaging techniques of ultrasound including contrast-enhanced ultrasound, computed tomography and magnetic resonance imaging (MRI) including diffusing weighted imaging and contrast-enhanced iron oxide MRI are explained. Imaging examples of the different modalities of benign and malignant transformed lymph nodes will be demonstrated. Furthermore, the diagnostic sensitivity of each modality will be delineated and further aspects of modern lymph node staging of the head and neck region such as those with special contrast agents will be described. These modern imaging modalities have sensitivity rates of 70-80% depending on the technical equipment and ability and on the experience of the investigator. The technique of near-infrared-imaging will be mentioned in another article in this journal. Also the value of biopsy techniques including recently developed ultrasonography guided needle biopsy with molecular analysis of the cells of about 97-100% accuracy in diagnosing benign from malignant lymph nodes will be mentioned. Overall, the reader will get an overview of the present imaging modalities to potentially stage correctly lymph nodes in the head and neck region to facilitate the therapeutic procedure.

Biopsy, Needle↗

Ontogenetic migration of the mental foramen in Neandertals and modern humans.

Since the nineteenth century, researchers have noted that Neandertal and modern human adults differ in mental foramen position, although the ontogenetic changes in the position of this feature have only recently come under the scrutiny of paleoanthropologists. Research on mental foramen position has focused on whether this feature is inferior to a particular tooth. However, tooth position may not be a reliable indicator of mental foramen position because of variability in tooth size within and between taxa and during eruption events. As opposed to observing the mental foramen with respect to the postcanine teeth, we examined linear distances from the mental foramen to other mandibular landmarks. Modern human adults may appear truncated, or paedomorphic, in mental foramen position with respect to Neandertal adults. However, infants of the two taxa differ substantially in anterior mandibular form. The initial differences in the shape of the mental region may be related to the embryological position of the mental foramen in modern humans and its role in the development of the mental trigone. The shape changes that accrue thereafter, possibly from faster mandibular growth rates in Neandertals, further distinguish the adults from one another. Although mandibular shape differences exist from early infancy onwards, adults of the two taxa are broadly similar in bi-mental foramen breadth with respect to mandibular size. For this reason, qualitative assessments of mental foramen position may provide less taxonomic information than previously thought.

Adult↗

Modern health worries in medical students.

OBJECTIVE: The aim of this study was to investigate the association between modern health worries (MHW), subjective health complaints, and use of health care services in first-year Dutch medical students, and to compare MHW in Dutch and New Zealand cohorts. METHODS: Two hundred and twenty-seven Dutch first-year medical students completed questionnaires assessing MHW, subjective health complaints, positive and negative affect (PA and NA, respectively), and use of health care services. RESULTS: Dutch medical students were most concerned about drug resistant bacteria and least concerned about vaccination programmes. Overall, female students were more concerned about modern health issues than were male students. Students' scores on the MHW scale were significantly associated with subjective health complaints. Subjective health complaints were also significantly related to the use of health care services. The factor structure of the MHW scale was replicated. Respondents reported significantly lower scores on all MHW items than did New Zealand students. CONCLUSIONS: Worries about modernity are reliably associated with subjective health complaints and use of health care services in Dutch medical students.

Adolescent↗

The rise of the boy-genius: psychological neoteny, science and modern life.

The mid-20th century saw the rise of the boy-genius, probably because a personality type characterized by prolonged youthfulness is advantageous both in science and modern life generally. This is the evolution of 'psychological neoteny', in which ever-more people retain for ever-longer the characteristic behaviours and attitudes of earlier developmental stages. Whereas traditional societies are characterized by initiation ceremonies marking the advent of adulthood, these have now dwindled and disappeared. In a psychological sense, some contemporary individuals never actually become adults. A child-like flexibility of attitudes, behaviours and knowledge is probably adaptive in modern society because people need repeatedly to change jobs, learn new skills, move to new places and make new friends. It seems that this adaptation is achieved by the expedient of postponing cognitive maturation - a process that could be termed psychological neoteny. ('Neoteny' refers to the biological phenomenon whereby development is delayed such that juvenile characteristics are retained into maturity.) Psychological neoteny is probably caused by the prolonged average duration of formal education, since students' minds are in a significant sense 'unfinished'. Since modern cultures favour cognitive flexibility, 'immature' people tend to thrive and succeed, and have set the tone of contemporary life: the greatest praise of an elderly person is to state that they retain the characteristics of youth. But the faults of youth are retained with well as its virtues: short attention span, sensation- and novelty-seeking, short cycles of arbitrary fashion and a sense of cultural shallowness. Nonetheless, as health gets better and cosmetic technologies improve, future humans may become somewhat like an axolotl - the cave-dwelling salamander which retains its larval form until death.

Beginning of Human Life↗

Cortical activation during reading of ancient versus modern Japanese texts: fMRI study.

The purpose of this study was to investigate human brain activity during the reading of ancient Japanese texts using functional magnetic resonance imaging. Thirty right-handed normal Japanese subjects performed two reading tasks: covert reading of (1) ancient and (2) modern Japanese text. Common areas are activated during both tasks. Activity in the left inferior frontal cortices increased during the reading of ancient Japanese text compared with the reading of modern Japanese text, whereas occipital activity increased during the reading of modern Japanese text. Our results indicate that ancient Japanese language may be processed as a foreign language.

Adolescent↗

Classical and modern prejudice: attitudes toward people with intellectual disabilities.

In two studies, Study 1 and Study 2, we examine whether attitudes toward people with intellectual disabilities, like sexism and racism, consist of two forms-a classical and a modern, where the classical is overt and blatant and the modern is more subtle and covert. Self-report scales tapping these two forms were developed in Study 1. Based on confirmatory factor analyses, the results in Study 1 supported our hypothesis and revealed that the modern and classical forms are correlated but distinguishable. This outcome was replicated in Study 2. Construct and discriminatory validations of the scales provided further support for the distinction. The theoretical and practical importance of the results is discussed in relation to previous research on attitudes toward people with intellectual disabilities and other social outgroups.

Adolescent↗

Malaria treatment in remote areas of Mali: use of modern and traditional medicines, patient outcome.

Use of official health services often remains low despite great efforts to improve quality of care. Are informal treatments responsible for keeping a number of patients away from standard care, and if so, why? Through a questionnaire survey with proportional cluster samples, we studied the case histories of 952 children in Bandiagara and Sikasso areas of Mali. Most children with reported uncomplicated malaria were first treated at home (87%) with modern medicines alone (40%), a mixture of modern and traditional treatments (33%), or traditional treatment alone (27%). For severe episodes (224 cases), a traditional treatment alone was used in 50% of the cases. Clinical recovery after uncomplicated malaria was above 98% with any type of treatment. For presumed severe malaria, the global mortality rate was 17%; it was not correlated with the type of treatment used (traditional or modern, at home or elsewhere). In the study areas, informal treatments divert a high proportion of patients away from official health services. Patients' experience that outcome after standard therapeutic itineraries is not better than after alternative care may help to explain low use of official health services. We need to study whether some traditional treatments available in remote villages should be considered real, recommendable first aid.

Adolescent↗

Prognostic significance of clinicopathologic and deoxyribonucleic acid flow cytometric variables in non-metastatic renal cell carcinoma in the modern era.

OBJECTIVE: The prognostic value of deoxyribonucleic acid (DNA) ploidy in renal cell carcinoma (RCC) is not well-defined among modern surgical nephrectomy series. We sought to determine which variables correlated with overall survival and recurrence-free survival in the modern era. METHODS: We reviewed all patients from 1992 to 2000, who prospectively had DNA ploidy analysis of their primary tumor determined at the time of nephrectomy for nonmetastatic RCC. Variables examined included age, gender, ethnicity, presentation (incidental vs. symptomatic), preoperative laboratory studies, American Society for Anesthesiology class, tumor size, tumor-nodes-metastasis stage, histology, Fuhrman grade, and diploid versus nondiploid tumor. Statistical analyses of overall survival and recurrence-free survival were performed using the Kaplan-Meier method, log-rank test, and Cox regression model using commercially available software. RESULTS: Sixty men and 41 women, median age 61 years (range, 23-85), were included. Pathologic stage included T1 (54 patients), T2 (14), and T3 (33). Eighty-four patients had conventional RCC. A total of 58 patients had well-differentiated (Fuhrman Grade 1 [12] or Grade 2 [46]), 28 had moderately differentiated (Grade 3), 12 had poorly differentiated tumors (Grade 4), and 3 were not specified. There were 52 patients who had diploid tumors, and 49 had aneuploid tumors. Median follow-up was 39 months (range, 0-109). Actuarial 5-year overall survival was 70%, and 5-year recurrence-free survival was 76%. Diploid tumors were significantly associated with better recurrence-free survival (P = 0.02) but not overall survival (P = 0.17). On multivariate analysis, the American Society for Anesthesiology class (P = 0.01), abnormal preoperative platelet count (P = 0.03), and tumor differentiation (P = 0.01) were independent predictors of overall survival, whereas only tumor differentiation (P = 0.05) was an independent predictor of recurrence-free survival. CONCLUSIONS: In the modern era, DNA ploidy is not an independent predictor of either overall survival or recurrence-free survival in patients with nonmetastatic RCC. The most important predictor of recurrence-free survival is tumor differentiation.

Adult↗

Comparing two evolutionary mechanisms of modern tRNAs.

All modern tRNA gene families have a high similarity in their primary structure, and share the same cloverleaf secondary structure and an inverted L tertiary structure, which provide the clues for the study of their origin and evolution. There are two important mechanisms of the tRNA sequences evolution. One is point mutation, another is complementary duplication method. Both of them are supported by some specific examples. To find out the superior one of the two mechanisms or find out the most suitable mechanism for modern tRNAs evolution, we constructed two types of networks, parallel and antiparallel networks, based on the two mechanisms respectively, and then compared the degree distribution and clustering coefficient of networks constructed by the tRNA sequences of the single anticodon group, single isoaccepting group, and the whole tRNAs group of the two types of networks. The result of the comparison seems consistent with the idea that modern tRNA sequences evolved primarily by the mechanism of complementary method, and point mutation is an important and indispensable auxiliary mechanism during the evolutionary event.

Base Pairing↗

Modern oral contraceptives and cardiovascular disease.

We reviewed evidence that bears on the cardiovascular safety of combined oral contraceptives containing second- and third-generation progestogens and < 50 micrograms of estrogen. Recent epidemiologic studies indicate that current use of these formulations is associated with a smaller increase in the incidence of venous thromboembolism than earlier formulations. In some studies the increase for third-generation formulations containing desogestrel or gestodene was about 1.5 to 2 times that for second-generation formulations, but there is evidence that differences between users in underlying risk and likelihood of being diagnosed contributed to this result. Recent studies of myocardial infarction suggest a smaller increase in risk associated with modern formulations than with earlier ones; one study suggests a threefold increase for second-generation formulations and no increase for third-generation formulations, but the finding requires confirmation. Recent studies of stroke indicate little or no increase in risk for modern formulations among women without risk factors. We conclude that modern combined oral contraceptives are safer than earlier formulations with respect to cardiovascular disease, which occurs rarely in young women.

Cardiovascular Diseases↗

An investigation into fractured surfaces of enamel of modern human teeth: a combined SEM and computer visualisation study.

It has long been recognised that the enamel microstructure may hold important information with regards to phylogeny and masticatory biomechanics. Further, the biophysical and adaptive processes involved in enamel formation and in the creation of different microstructures are poorly understood. This lack of understanding is in part due to technical difficulties when visualising the 3D structure of enamel. Using modern visualisation techniques, models of various regions of different modern human teeth were created. Underlying these models are consistent mathematical representations of the interplay between cell-to-cell adhesion, integrity of the advancing enamel front and (potentially decreasing) constraints on the prism course from the dentino-enamel junction (DEJ) to the outer surface. Seven modern human teeth (I1, 1 lower C, 1 P4, 1 M2, 2 M2 and 1 M3) were fractured longitudinally and formed the basis for the creation of the models. For validation purposes the teeth were then fractured transversely, thus allowing quantitative comparisons between the prism pathways on the newly fractured transverse plane and the transverse pathways as predicted by the model. It was found that these predictions were fairly accurate provided that (a) the light position with respect to the model corresponds with the beam position with respect to the scanned surface and (b) the path of prisms was carefully reconstructed/extrapolated from SEM in cases where prisms were broken. Given that these predictions were based on the mechanisms governing enamel formation as applied to the model, it is suggested that such theories must be reasonable. In other words, biophysical processes, rather than complicated (genetic) positional information, suffice to create different enamel microstructures. In addition, systematic differences were found in prism deviation from their c-axis in different enamel pieces. Given the nature of these differences it is suggested that enamel formation is not only the result of biophysical processes (proximal causes), but could be due to the structures having been selected for in order to counteract masticatory stress exerted during the lifetime of the species (ultimate causes). As to whether and to what extent this may be the case is not yet clear but it is apparent that computer visualisation does have potential to quantify enamel microstructure and to address such questions. Given its non-destructive nature, computer modelling could have particular relevance for studying fragmented fossilised remains.

Dental Enamel↗

Radiocarbon dating the appearance of modern humans and timing of cultural innovations in Europe: new results and new challenges.

New radiocarbon dates from the sites of Bockstein-Törle, Geissenklösterle, Hohle Fels, Hohlenstein-Stadel, Sirgenstein, and Vogelherd in the Swabian Jura of southwestern Germany indicate that the Aurignacian of the region spans the period from ca. 40-30ka BP. If the situation at Vogelherd, in which skeletal remains from modern humans underlie an entire Aurignacian sequence, is viewed as representative for the region, the dates from the Swabian Jura support the hypothesis that populations of modern humans entered the region by way of the "Danube Corridor." The lithic technology from the lower Aurignacian of Geissenklösterle III is fully developed, and classic Aurignacian forms are well represented. During the course of the Aurignacian, numerous assemblages rich in art works, jewelry, and musical instruments are documented. By no later than 29ka BP the Gravettian was well established in the region. These dates are consistent with the "Kulturpumpe" hypothesis that important cultural innovations of the Aurignacian and Gravettian in Swabia predate similar developments in other regions of Europe. The radiocarbon dates from Geissenklösterle corroborate observations from other non-archaeological data sets indicating large global fluctuations in the atmospheric concentrations of radiocarbon between 30 and 50ka calendar years ago. These fluctuations lead to complications in building reliable chronologies during this period and cause the "Middle Paleolithic Dating Anomaly" and the "Coexistence Effect," which tend to exaggerate the temporal overlap between Neanderthals and modern humans.

Animals↗

Intrinsic qualities of primate bones as predictors of skeletal element representation in modern and fossil carnivore feeding assemblages.

Plio-Pleistocene faunal assemblages from Swartkrans Cave (South Africa) preserve large numbers of primate remains. Brain, C.K., 1981. The Hunters or the Hunted? An Introduction to African Cave Taphonomy. University of Chicago Press, Chicago suggested that these primate subassemblages might have resulted from a focus by carnivores on primate predation and bone accumulation. Brain's hypothesis prompted us to investigate, in a previous study, this taphonomic issue as it relates to density-mediated destruction of primate bones (J. Archaeol. Sci. 29, 2002, 883). Here we extend our investigation of Brain's hypothesis by examining additional intrinsic qualities of baboon bones and their role as mediators of skeletal element representation in carnivore-created assemblages. Using three modern adult baboon skeletons, we collected data on four intrinsic bone qualities (bulk bone mineral density, maximum length, volume, and cross-sectional area) for approximately 81 bones per baboon skeleton. We investigated the relationship between these intrinsic bone qualities and a measure of skeletal part representation (the percentage minimum animal unit) for baboon bones in carnivore refuse and scat assemblages. Refuse assemblages consist of baboon bones not ingested during ten separate experimental feeding episodes in which individual baboon carcasses were fed to individual captive leopards and a spotted hyena. Scat assemblages consist of those baboon bones recovered in carnivore regurgitations and feces resulting from the feeding episodes. In refuse assemblages, volume (i.e., size) was consistently the best predictor of element representation, while cross-sectional area was the poorest predictor in the leopard refuse assemblage and bulk bone mineral density (i.e., a measure of the proportion of cortical to trabecular bone) was the poorest predictor in the hyena refuse assemblage. In light of previous documentation of carnivore-induced density-mediated destruction to bone assemblages, we interpret the current findings as suggestive of the secondary importance of bulk bone mineral density to other intrinsic qualities of skeletal elements (e.g., size, maximum dimension, and average cross-sectional area). It is only when skeletal elements are too large for consumption (e.g., many long bones) that they are fragmented following intra-element patterns of density-mediated carnivore destruction. There appears to be a size threshold beneath which bulk bone mineral density contributes little to mediating carnivore destruction of carcasses. Thus, depending on body size of the predator, body size of the prey, and specific size of the element, bulk bone mineral density may play little or no role of primary importance in mediating the destruction of skeletal elements. We compare patterns in modern comparative assemblages to patterns in primate fossil assemblages from Swartkrans. One of the fossil assemblages, Swartkrans Member 1, Hanging Remnant, most closely approximates a hyena (possibly refuse) assemblage pattern, while the Swartkrans Member 2 assemblage most closely approximates a leopard (possibly scat) assemblage pattern. The Swartkrans Member 1, Lower Bank, assemblage does not closely approximate any of our modern comparative assemblage patterns.

Animals↗

Neandertal DNA sequences and the origin of modern humans.

DNA was extracted from the Neandertal-type specimen found in 1856 in western Germany. By sequencing clones from short overlapping PCR products, a hitherto unknown mitochondrial (mt) DNA sequence was determined. Multiple controls indicate that this sequence is endogenous to the fossil. Sequence comparisons with human mtDNA sequences, as well as phylogenetic analyses, show that the Neandertal sequence falls outside the variation of modern humans. Furthermore, the age of the common ancestor of the Neandertal and modern human mtDNAs is estimated to be four times greater than that of the common ancestor of human mtDNAs. This suggests that Neandertals went extinct without contributing mtDNA to modern humans.

Animals↗

Marcello Malpighi and the difficult birth of modern life sciences.

All his life, Marcello Malpighi (1628-1694), the founder of modern microscopic anatomy, was unwillingly involved in difficult debates within a reactionary medical milieu that questioned the significance of modern science and its utility to medicine. Malpighi's responses to his detractors, included in posthumous works first published in 1697 by the Royal Society, offer an important insight into a critical phase of scientific progress in the 17th century and help to reveal the prevailing conception of science. In some ways, Malpighi's views predate important ideas in modern biology.

Anatomy↗

Explaining disablement in modern times: hand-injured workers' accounts of their injuries in Hong Kong.

In this paper, an attempt is made to explore how people respond to injuries at work among a group of hand-injured workers in the context of contemporary Hong Kong society. Qualitative research methods were adopted. A "focused interview" by means of open-ended questions was employed to investigate those workers who have suffered from work-related injury for over 10 years. Concerning the perceived cause of the injury, the industrial production process such as machine defects, piecework, limited working experience, and lack of supervision triggered the onset of the injuries which resulted in permanent disability. At the same time, respondents tellingly explained their injury in terms of magical-religious forces such as fate and luck. This kind of understanding is embraced in cultural beliefs that are commonly found among Chinese. Such understandings appear fatalistic but allow the individual to actively cope with such misfortune. The emphasis on harmony and stability among Chinese also affected what action they took against the employer for negligence. It was shown that in general many respondents were bound by kuan-hsi (personal relationship) and tended to preserve the harmony between themselves and their employer. In modern societies like Hong Kong, traditional values and modern practices are complementary to each other in coping with life stresses such as disablement. Modernity does not provide a solid means for people to have more control over their lives. Many people still stick to their habituated lifestyle as a guiding light in day-to-day matters. Concerning risk assessment in relation to work safety, workers' value systems and practices on the shopfloor should be taken into consideration.

Accidents, Occupational↗

Environmental impacts of modern agricultural technology diffusion in Bangladesh: an analysis of farmers' perceptions and their determinants.

Farmers' perception of the environmental impacts of modern agricultural technology diffusion and factors determining such awareness were examined using survey data from 21 villages in three agro-ecological regions of Bangladesh. Results reveal that farmers are well aware of the adverse environmental impacts of modern agricultural technology, although their awareness remains confined within visible impacts such as soil fertility, fish catches, and health effects. Their perception of intangible impacts such as, toxicity in water and soils is weak. Level and duration of modern agricultural technology adoption directly influence awareness of its adverse effects. Education and extension contacts also play an important role in raising awareness. Awareness is higher among farmers in developed regions, fertile locations and those with access to off-farm income sources. Promotion of education and strengthening extension services will boost farmers' environmental awareness. Infrastructure development and measures to replenish depleting soil fertility will also play a positive role in raising awareness.

Agriculture↗

Homeopathic use of modern medicines: utilisation of the curative rebound effect.

Homeopathy is a therapeutic method based on the application of the similitude principle, utilising medicinal substances that produce effects that are similar to the symptoms being treated. In this process, the organism is stimulated to react against its own disturbances through a vital (paradoxical, secondary or homeostatic) reaction, oriented by the primary effect of the used drug. This effect should have properties that are similar to the symptom that is being treated. This secondary reaction of the organism to a medicinal stimulus is observed in hundreds of modern drugs, and is referred to as a rebound effect. In this study we propose the utilisation of modern drugs according to the principle of homeopathic cure, employing the rebound effect as a curative reaction. For that we suggest the compilation of a Common Materia Medica that would group all symptoms produced by the medications in human individuals (therapeutic, adverse and side effects), utilising them, a posteriori, following a partial or total similitude, in minimal or ponderous doses. By doing that, we can take advantage of the numerous modern pharmacological compendiums, amplifying the spectrum of homeopathic cure with a wide range of new symptoms and medications.

Complementary Therapies↗