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PubMed1998

Modern life' in the epidemiology of inflammatory bowel disease: a case-control study with special emphasis on nutritional factors.

OBJECTIVE: The rising incidence of inflammatory bowel disease (IBD) since the Second World War coincides with profound changes of the dietary pattern. The aim of the study was to investigate the possible pathogenic role of some characteristic 'modern life' dietary factors in IBD. DESIGN: Case-control, studying risk factors in recently diagnosed cases, 290 with Crohn's disease and 398 with ulcerative colitis, compared with 616 population controls. Smoking, age, gender and education were taken into account by using logistic regression analysis. SETTING: Hospital cases and population controls. INTERVENTIONS: Questionnaires. MAIN OUTCOME MEASURES: Logistic regression-derived odds ratios. RESULTS: A positive association with cola drinks [OR: 2.2 (95% CI 1.5-3.1)], chewing gum [OR: 1.5 (95% CI: 1.1-2.1)] and chocolate consumption [OR: 2.5 (95% CI: 1.8-3.5)] and a negative association with citrus fruit consumption [OR: 0.5 (95% CI 0.3-0.7)] and the development of Crohn's disease were found. Consumption of cola drinks [OR: 1.6 (95% CI 1.1-2.3)] and chocolate consumption [OR: 2.5 (95% CI 1.8-3.5)] were positively associated with developing ulcerative colitis. There was a negative association between the intake of citrus fruits [OR: 0.5 (95% CI 0.4-0.8)] and 'having a stuffed pet' for a period longer than 5 years [OR: 0.6 (95% CI 0.4-0.9)] and developing the disorder. No association with the frequency of tooth brushing and developing IBD was found. CONCLUSION: All the nutritional items mentioned may be true risk factors or they just might be the expression of a modern life-style also involving other risk factors for the development of IBD which at the present are still unknown.

Adult↗
PubMed2005

Accuracy of tympanometric middle ear pressure determination: the role of direction and rate of pressure change with a fast, modern tympanometer.

HYPOTHESIS: Modern tympanometers run at higher rates of pressure change than older tympanometers, which increases the inaccuracy of determining the middle ear pressure. BACKGROUND: Tympanometric middle ear pressure may be susceptible to both the direction as well as the rate of pressure change, which is reflected by two different pressure peaks in a bidirectional recording. The resulting peak pressure difference results in an inaccuracy, which can amount to 25 daPa in older instruments with slower rates of pressure change. However, modern instruments often apply much faster rates, which may increase the peak pressure difference and thus the inaccuracy of middle ear pressure. METHODS: Middle ear pressure was measured for a negative and positive direction of pressure change at four different rates (50, 100, 200, and 400 daPa/s) in 38 normal adults. The peak pressure difference was calculated by the middle ear pressure determined in positive minus negative direction. RESULTS: The mean peak pressure differences ranged between 10 and 12 daPa (standard deviation = 8-11) in the four groups and were independent of the rate of pressure change (p = 0.321). CONCLUSION: The peak pressure differences found by the current tympanometer were consistently small for all rates of pressure change and were thus independent of the rate. This means that high rates can be used without decreasing accuracy, and the mean error is only 5 to 6 daPa, corresponding to the intrinsic hysteresis of the middle ear system.

Acoustic Impedance Tests↗
PubMed2007

Professionalism in modern medicine: does the emperor have any clothes?

The virtues that constitute medical professionalism have been aptly described in multiple position statements from professional organizations and individuals. These professional virtues depend on particular moral community traditions to undergird and sustain them. Attempts to ground these virtues in narratives intrinsic to medical practice--in the moral consensus of physicians or patients, in the self-regulating character of medicine as a profession, in the Hippocratic tradition, or in the physician-patient encounter--have been unsuccessful. Modern medicine must, therefore, look outside its own methodological and clinical practices for grounding narratives sufficient to sustain the professional virtues set forth in the recently published professionalism statements. These professionalism statements are written to capture consensus, and they rarely acknowledge the external moral traditions on which the virtues depend, because doing so would, in a pluralistic culture, entail the risk of moral disagreement and division. The authors argue that meaningful education in professionalism must look beyond the consensus statements and deeply engage the particular cultural traditions external to the practice of medicine that sustain the professional virtues. Medical professionalism curricula should embody an open pluralism, giving voice to diverse moral communities, encouraging critical self-exploration and discussion about the truth claims of these communities, and, if possible, facilitating the integration of students' professional development with their ongoing participation in these communities. Engagement with and participation in these sustaining moral communities would promote the cultivation of virtue capable of withstanding the economic and social threats to professionalism that are inherent in modern medical practice.

Cultural Diversity↗
PubMed2005

Backside wear is low in retrieved modern, modular, and nonmodular acetabular liners.

UNLABELLED: Modern modular components with maximized conformity between liner and shell, improved locking mechanisms, and smooth inner surfaces should have less backside wear than first-generation modular designs. Also, nonmodular components should show no backside wear in vivo. We compared the backside wear of retrieved liners from nonmodular and modular components from first-generation and second-generation designs. We matched for time in situ, patient age and weight for nine retrieved Harris-Galante Type 1 liners, nine Harris-Galante Type 2 liners, nine Trilogy liners, and nine Implex nonmodular liners. The backside of the liners was divided in quadrants, examined under a x10 binocular loupe, and rated by a score of 0 (absence of wear) to 3 (severe backside wear) for a total ranging from 0 to 12. The average total backside wear score was 8.4 for the Harris-Galante Type 1 liner, 7.3 for the Harris-Galante Type 2 liner, 3.7 for the Trilogy liner, and 2.3 for the Implex liner. We observed a significant reduction in the backside wear of modern modular and nonmodular acetabular components (Trilogy(R) and Implex) when compared with first-generation modular designs (Harris-Galante Types 1 and 2). Nonmodular acetabular cups had a low backside wear in vivo. LEVEL OF EVIDENCE: Therapeutic study, Level III (retrospective comparative study). See the Guidelines for Authors for a complete description of levels of evidence.

Acetabulum↗
PubMed2007

Modern scleral lenses part II: patient satisfaction.

PURPOSE: To evaluate the subjective performance of modern scleral lenses in patients of the clinics of Visser Contact Lens Practice. METHODS: In this cross-sectional survey, all the necessary data were collected at the first follow-up visit during the 5-month study period. In accordance with the preformed fitting technique developed at Visser Contact Lens Practice, four types of scleral lenses were used: spherical, front-surface toric, back-surface toric, and bitoric. Subjective performance was investigated during an interview that included the use of a five-point Likert scale and by means of a questionnaire supplemented by a 100-mm visual analog scale (VAS). RESULTS: The interview and questionnaire showed high scores for patient satisfaction with the current scleral lens in the 178 patients (284 eyes) (median score, 4; range Likert scale, 1-5; median score, >or=75; range VAS, 1-100). Significant increases in scores were seen with the current scleral lens compared to the former correction: 78.9% for comfort, 78.2% for visual quality, and 87.7% for overall satisfaction (n=284 eyes) (P<0.001). In the 99 eyes that switched from back-surface spherical to back-surface toric designs, the following significant increases were seen: 61.6%, 37.4%, and 65.7%, respectively (P<0.001). CONCLUSIONS.: High patient satisfaction was seen with all the modern scleral lens designs in the management of several forms of corneal abnormality. The interview showed differences in comfort, visual quality, and overall satisfaction in favor of the back-surface toric designs compared to the back-surface spherical designs.

Contact Lenses↗
PubMed2007

Modern scleral lenses part I: clinical features.

PURPOSE: To evaluate the indications for modern scleral lenses and their clinical performance in patients who were fitted with scleral lenses at the authors' practices. METHODS: In this cross-sectional survey, all the necessary data were obtained at the first follow-up visit during the 5-month study period. There were four types of scleral lenses: spherical, front-surface toric, back-surface toric, and bitoric. The preformed scleral lens fitting technique developed at Visser Contact Lens Practice was used in all patients. The lenses were cut by precise Sub Micron Lathing from a Boston Equalens II blank at Procornea. Visual acuity and slitlamp findings were recorded. A specially designed classification for scleral lens fitting was used to investigate clinical performance. RESULTS: The largest proportion of the 178 patients (284 eyes) were diagnosed with keratoconus (143 [50.4%] eyes) followed by postpenetrating keratoplasty (56 [19.7%] eyes). The remaining diagnoses were irregular astigmatism, keratitis sicca, corneal dystrophy, and multiple diagnoses. The ratio of spherical to back-surface toric designs was 1:1.1. Clinical examination showed sharp increases in visual acuity (median increase, 0.45) and safe physiologic responses of the anterior eye. All the patients could continue to wear scleral lenses, with 79.2% with the same lens parameters. CONCLUSIONS: Several types of corneal abnormality were managed successfully with modern scleral lenses. The main indication was optical correction of an irregular corneal surface. Satisfactory clinical performance meant that all the patients could continue to wear their scleral lenses.

Adolescent↗
PubMed2005

Modern surgical treatment of complex facial fractures: a 6-year review.

Open reduction and internal fixation (ORIF) with refined titanium plates and screws have revolutionized the surgical treatment of complex facial fractures, but its outcome remains relatively unknown. The purpose of this study is to review the results of modern surgical treatment of complex facial fractures involving at least two of the three zones of the face. From 1996 to 2002, 54 consecutive patients (41 males, 13 females; age 5-74 years) with complex facial fractures were treated by the plastic surgery service in our institution. All patients had their fractures repaired within 10 days after injury. ORIF of the fractures was performed through standard surgical approaches for the upper, middle, or lower face in a preferred sequence. Multiple rigid fixations were completed with current titanium plates and screws. Postoperative functional problems, residual cosmetic deformities, and reoperations for any complications in each patient were evaluated. All patients have been followed for up to 5 years. Overall, of the 54 consecutive patients in this study, 8 (14.8%) patients had postoperative functional problems, and 7 (13.0%) developed variable postoperative cosmetic deformities. Only nine (16.7%) patients underwent a subsequent reoperation for correction of the functional or cosmetic concern. Thus, we believe that modern surgical treatment of complex facial fractures by way of open treatment and rigid fixation with refined titanium plates and screws has resulted in overall good to excellent outcomes and a relatively low postoperative complication rate.

Adolescent↗
PubMed1992

Electron spin resonance (ESR) dating of the origin of modern man.

Many materials found in archaeological sites are able to trap electronic charges as a result of bombardment by radioactive radiation from the surrounding sediment. The presence of these trapped charges can be detected by electron spin resonance (ESR) spectroscopy: the intensity of the ESR signal is a measure of the accumulated dose and thus of the age. Tooth enamel is ubiquitous at archaeological sites and is well suited for ESR dating, with a precision of about 10-20%. This method has now been used to date many sites critical to the biological and cultural evolution of modern man. Dates for sites in Israel and Africa have demonstrated the existence of anatomically modern humans more than 100 ka ago.

Animals↗
PubMed1992

The role of western Asia in modern human origins.

Western Asia provides the best collection of human skeletal remains relevant to the two basic models for the emergence of modern humans, namely the 'rapid replacement' and the 'regional continuity' models. Regardless of the taxonomies of particular hominids, their chronology is of crucial importance. Thermoluminescence (TL) and electron spin resonance (ESR) dates demonstrate that the Acheulo-Yabrudian and Mousterian entities and their associated fossils (Zuttiyeh, Tabun, Skhul, Qafzeh, Kebara, Shanidar, Amud) span the late Middle and Upper Pleistocene period. These new dates initiated major chronological revisions and renewed discussion of the cultural-archaeological implications. One of the most important conclusions is that the Middle to Upper Palaeolithic transition (or Revolution) 45-40 ka ago has nothing to do with the appearance of anatomically early modern humans in western Asia, which occurred some 100 ka ago or more. The Levant, the coastal region of the eastern Mediterranean, was both a corridor for movement of humans and animals as well as a refugium during climatically harsh periods. The mixture of morphological characteristics among the available Middle Palaeolithic human fossils is interpreted as reflecting the presence of immigrant and local populations. Archaeologically observable behavioural changes are taken as hints to the pre-adaptations of the Middle to Upper Palaeolithic revolution. The archaeological record of western Asia can contribute significantly to explaining the Middle to Upper Palaeolithic revolution. This region was the core area where the 'Neolithic Revolution' took place. The shift to systematic cultivation and the domestication of animals occurred within a short time.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1998

Four geographically distinct genotypes of JC virus are prevalent in China and Mongolia: implications for the racial composition of modern China.

JC polyomavirus (JCV) is ubiquitous in humans, persisting in renal tissue and excreting progeny in urine. It has been shown that the genotyping of urinary JCV offers a novel means of tracing human migrations. This approach was used to elucidate the racial composition of modern China. JCV isolates in the Old World were previously classified into nine distinct genotypes. One of them (B1) has a wide domain, encompassing part of Europe and the entirety of Asia. By constructing a neighbour-joining phylogenetic tree, all B1 isolates detected so far were classified into four distinct groups (B1-a to -d), each occupying unique domains in the world. According to this revised classification system of JCV DNAs, four genotypes (CY, SC, B1-a and -b) were found to be prevalent in China and Mongolia (Mongolia was studied instead of Inner Mongolia, which is part of China). There was a remarkable variation in the incidence of genotypes among the sites of sample collection. CY was more frequently detected in Northern China, SC was predominant in Southern China and B1-b was detected only in Mongolia. B1-a was spread throughout China. These data were statistically analysed and the observed regional differences in the incidence of genotypes were found to be significant. It is likely that these differences in JCV distribution in China reflect the intermingling of different population groups that constitute modern China.

Base Sequence↗
PubMed1991

Modern spectral analysis techniques for blood flow velocity and spectral measurements with pulsed Doppler ultrasound.

Four spectral analysis techniques were applied to pulsed Doppler ultrasonic quadrature signals to compare the relative merits of each technique for estimation of flow velocity and Doppler spectra. The four techniques were 1) the fast Fourier transform method, 2) the maximum likelihood method, 3) the Burg autoregressive algorithm, and 4) the modified covariance approach to autoregressive modeling. Both simulated signals and signals obtained from an in vitro flow system were studied. Optimal parameter values (e.g., model orders) were determined for each method, and the effects of signal-to-noise ratio and signal bandwidth were investigated. The modern spectral analysis techniques were shown to be superior to Fourier techniques in most circumstances, provided the model order was chosen appropriately. Robustness considerations tended to recommend the maximum likelihood method for both velocity and spectral estimation. Despite the restrictions of steady laminar flow, the results provide important basic information concerning the applicability of modern spectral analysis techniques to Doppler ultrasonic evaluation of arterial disease.

Algorithms↗
PubMed2006

Font adaptive word indexing of modern printed documents.

We propose an approach for the word-level indexing of modern printed documents which are difficult to recognize using current OCR engines. By means of word-level indexing, it is possible to retrieve the position of words in a document, enabling queries involving proximity of terms. Web search engines implement this kind of indexing, allowing users to retrieve Web pages on the basis of their textual content. Nowadays, digital libraries hold collections of digitized documents that can be retrieved either by browsing the document images or relying on appropriate metadata assembled by domain experts. Word indexing tools would therefore increase the access to these collections. The proposed system is designed to index homogeneous document collections by automatically adapting to different languages and font styles without relying on OCR engines for character recognition. The approach is based on three main ideas: the use of Self Organizing Maps (SOM) to perform unsupervised character clustering, the definition of one suitable vector-based word representation whose size depends on the word aspect-ratio, and the run-time alignment of the query word with indexed words to deal with broken and touching characters. The most appropriate applications are for processing modern printed documents (17th to 19th centuries) where current OCR engines are less accurate. Our experimental analysis addresses six data sets containing documents ranging from books of the 17th century to contemporary journals.

Abstracting and Indexing↗
PubMed2003

Jung's view on myth and post-modern psychology.

Post-modern psychology embodies two core themes, the social mind and the narrative self. Whereas the social-mind thesis seems diametrically opposed to Jung's position regarding human nature, the narrative-self thesis is associated with research and theorizing about personal myth and mythmaking in ways that could make contact with Jung's concerns. Jung's view is examined here with particular attention to McAdams' theory of narrative identity. It is suggested that the ostensible differences between Jung and post-modern psychology might reflect divergent interests, rather than necessarily irreconcilable worldviews.

Austria↗
PubMed1999

Relating the classical covariance adjustment techniques of multivariate growth curve models to modern univariate mixed effects models.

The relationship between the modern univariate mixed model for analyzing longitudinal data, popularized by Laird and Ware (1982, Biometrics 38, 963-974), and its predecessor, the classical multivariate growth curve model, summarized by Grizzle and Allen (1969, Biometrics 25, 357-381), has never been clearly established. Here, the link between the two methodologies is derived, and balanced polynomial and cosinor examples cited in the literature are analyzed with both approaches. Relating the two models demonstrates that classical covariance adjustment for higher-order terms is analogous to including them as random effects in the mixed model. The polynomial example clearly illustrates the relationship between the methodologies and shows their equivalence when all matrices are properly defined. The cosinor example demonstrates how results from each method may differ when the total variance-covariance matrix is positive definite, but that the between-subjects component of that matrix is not so constrained by the growth curve approach. Additionally, advocates of each approach tend to consider different covariance structures. Modern mixed model analysts consider only those terms in a model's expectation (or linear combinations), and preferably the most parsimonious subset, as candidates for random effects. Classical growth curve analysts automatically consider all terms in a model's expectation as random effects and then investigate whether "covariance adjusting" for higher-order terms improves the model. We apply mixed model techniques to cosinor analyses of a large, unbalanced data set to demonstrate the relevance of classical covariance structures that were previously conceived for use only with completely balanced data.

Biometry↗
PubMed2005

Modern external beam radiation therapy for refractory dissecting cellulitis of the scalp.

BACKGROUND: Dissecting cellulitis of the scalp can be an extremely painful and disfiguring dermatological condition. The associated pain can be severe enough in some cases to require opioid analgesics, and this pain in conjunction with the disfigurement can induce significant emotional distress. Conservative treatments often fail to provide relief. Radiation therapy has been successfully used in the past but with outdated equipment and techniques. OBJECTIVES: To evaluate the efficacy and toxicity of modern external beam radiation therapy techniques for the treatment of dissecting cellulitis of the scalp. METHODS: Four patients with intractable dissecting cellulitis of the scalp were treated with electrons or a combination of electrons and photons to the entire scalp. Daily fraction sizes were 2.5 or 3 Gy and initially prescribed to 15-21 Gy. Patients were re-evaluated 3-4 weeks after completion of therapy. Any residual hair growth was treated with additional radiation treatments to ensure full epilation, up to a maximum dose of 35 Gy. RESULTS: Rapid resolution of pain was seen in all patients with pain. Regression of nodules and decreased discharge was seen in all patients following treatment and cosmesis was subjectively improved. No long-term toxicity has been observed. CONCLUSIONS: Using modern techniques and equipment, radiation therapy appears to be a reasonable option for patients with severe/refractory dissecting cellulitis of the scalp. Acute effects are mild and well tolerated. Aside from alopecia, which was present to some extent in all patients before treatment, no long-term complications have been observed.

Adult↗
PubMed2006

Professionalizing action research--a meaningful strategy for modernizing services?

BACKGROUND: This paper outlines how a specific action research approach can be used to secure practice development in services which have found sustained change difficult. For the purpose of this paper discussion focuses upon using professionalizing action research (a form of action research) to secure transformation in acute inpatient mental health services. This speciality has experienced long-term difficultly in meaningful practice change. Not limited to this context parallels can be made with other health and social care services requiring significant modernization. AIM: The aim is to critically discuss the use of professionalizing action research as an approach to sustainable change. DISCUSSION: clarifies whether this method is a suitable vehicle for change, which is ideally suited to services which have a poor record of practice development. METHOD: A review of action research and practice development literature forms the basis of this paper. The literature is sourced through bulletin boards, electronic databases and the British Library Classification Scheme. Keywords searched are action research, team learning, managing change and practice development. Following definition; the components of professionalizing action research are analysed using the themes of educative base, problem focus, improvement and involvement. FINDINGS: The educative base of professionalizing action research is collaborative reflective practice which is used to initiate meaningful change, rooted in everyday practice. The benefit of this is that change actions are based in real-time situations. The problem focus component of professionalizing action research is used to emphasize the views of service users and carers. This is positive in terms of the patient and public involvement agenda although this theme does emphasize limitations of the approach. The final components are involvement and improvement, these are debated as pluralistic notions and the implications of this are acknowledged. CONCLUSION: Reviewing the literature and theoretical application indicates the value of professionalizing action research as a process for modernization. The strength of the approach lies in the opportunity for team learning and change which is grounded in the context of services and pursued through collaboration.

Acute Disease↗
PubMed2005

The development and application of the modern reproductive technologies to horse breeding.

Although the horse was probably the first animal to experience and benefit from artificial insemination, it trailed the field somewhat with regard to the application of embryo transfer and other oocyte and embryo-related modern breeding technologies. But with a late run it is now back in mid-field and gaining fast on the other large domestic species in the application of the many technological advances of the past 20 years to sound breeding practice. Improvements in extenders and cryoprotectants have resulted in a veritable upsurge in the transport and insemination of cooled and frozen stallion semen, and parallel improvements in ovulation induction and synchrony, exogenous gonadotrophic stimulation of multiple fertile ovulations and simplified, more efficient methods for non-surgical transfer of embryos to recipient mares, coupled with relaxation of breed society registration restrictions, have together contributed to a similar upsurge in the application of embryo transfer to all breeds and athletic types of horses worldwide, with the continuing and notable exception of the Thoroughbred. Although conventional in vitro fertilization remains something of an unjumped fence in equids, other modern breeding technologies like hysteroscopic low-dose insemination, fluorescence-activated sex sorting of stallion spermatozoa, between-species embryo transfer, embryo freezing and bisection, transvaginal ultrasound-guided oocyte collection, intracytoplasmic sperm injection for fertilization (ICSI), gamete intrafallopian transfer (GIFT) and now nuclear transfer (cloning), have all been applied to equids with encouraging success. Cloning, especially, holds enormous promise for the Sporthorse industry to re-create champion geldings in stallion form for breeding purposes.

Animals↗
PubMed1997

How to apply modern scientific and technological advances to the practice of clinical gastroenterology in Vietnam.

There are some differences between the spectrum of gastroenterological diseases in Vietnam compared with those of more developed countries. These may be due to different living standards, quality of nutrition, and different infection rates of intestinal parasites and hepatotropic viruses. Gastric carcinoma and hepatocellular carcinoma (HCC) are leading malignancies, while colorectal cancer is less frequent. Bile duct stones often have Ascaris eggs in the centre, and they prevail in incidence over gall-bladder stones. The majority of digestive cancers are detected at a very late stage. The Vietnamese Association of Gastroenterology aims to contribute to the development of modern gastroenterology (GE) in Vietnam, to study and apply recent advances in imaging technology, such as fibre-optic diagnostic and therapeutical endoscopy, ultrasonography, laparoscopic surgery etc. and to do further work in molecular biology. For this purpose, besides our self-reliance, we need, and ask for, support and assistance from the Japanese Society of GE (JSGE), the Asian Pacific Association of GE (APAGE) and the Organisation Mondiale de GE (OMEGE). At the same time, we suggest a choice be made among the different technologies, bearing in mind their cost-effectiveness, and to give preference to measures for the primary prevention and early detection of the diseases. Japanese experience in the early detection of gastric cancer and HCC, and in the Percutaneous Ethanol Injection Therapy (PEIT) for treatment of HCC, are highly appreciated. We recommend also a judicious and scientific combination of traditional medicine and modern technology in the research and the struggle against digestive diseases.

Developing Countries↗