Gender-specific characteristics of 5-year-olds' play narratives and associations with behavior ratings

OBJECTIVES: To examine the content and structure of children's play narratives in a large sample of 5-year-olds in order to replicate previous findings, explore the role of gender differences, and identify a pattern that can provide useful information about children's behavior. METHOD: The MacArthur Story Stem Battery and coding system was used to code content themes and coherence from play narratives of 652 twins in a nonclinical sample. To measure behavior problems, parents completed the Child Behavior Checklist when their children were aged 5 and 7 years; teachers completed the Teacher's Report Form when the children were aged 7 years. RESULTS: Girls told more coherent narratives with less aggression than boys. Aggressive themes were found to correlate with behavior problems as in previous studies. Upon further examination, this correlation held for girls but not boys. Children who told repeated aggressive/incoherent narratives had more behavior problems than those who did not show this narrative pattern. CONCLUSIONS: The Story Stem methodology is useful for gaining access into the young child's inner world. The gender of the child, content of the story, and coherence of the story all provide useful information in identifying narratives that may indicate more risk for behavior problems.     

Treatment of breast cancer: from hormones to antibodies

Breast cancer, as one of the most frequent tumor entities, is the object of intensive research activity. Clinical research over the last few years has resulted in an increasing differentiation in treatment strategies in the adjuvant setting as well as in metastatic breast cancer. Treatment decision is guided by different risk groups, and relevant changes in clinical practice have arisen in hormonal treatment as well as in chemotherapy. Furthermore, new agents have shown clinical activity, in particular trastuzumab has emerged as standard treatment in HER2 positive breast cancer. It was even licensed in 2006 for adjuvant treatment.     

Effective Reserve: A Latent Variable to Improve Outcome Prediction in Stroke

Prediction of functional outcome after stroke based on initial presentation remains an open challenge, suggesting that an important aspect is missing from these prediction models. There exists the notion of a protective mechanism called brain reserve, which may be utilized to understand variations in disease outcome. In this work, we expand the concept of brain reserve (effective reserve) to improve prediction models of functional outcome after acute ischemic stroke (AIS). Consecutive AIS patients with acute brain magnetic resonance imaging (<48 hours) were eligible for this study. White matter hyperintensity and acute infarct volume were determined on T2 fluid attenuated inversion recovery and diffusion weighted images, respectively. Modified Rankin Scale scores were obtained at 90days poststroke. Effective reserve was defined as a latent variable using structural equation modeling by including age, systolic blood pressure, and intracranial volume measurements. Of 453 AIS patients (mean age 66.6 ± 14.7 years), 36% were male and 311 hypertensive. There was inverse association between effective reserve and 90-day modified Rankin Scale scores (path coefficient ?0.18 ± 0.01, P < .01). Compared to a model without effective reserve, correlation between predicted and observed modified Rankin Scale scores improved in the effective-reserve-based model (Spearman's ρ 0.29 ± 0.18 versus 0.15 ± 0.17, P < .001). Furthermore, hypertensive patients exhibited lower effective reserve (P < 10^?6). Using effective reserve in prediction models of stroke outcome is feasible and leads to better model performance. Furthermore, higher effective reserve is associated with more favorable functional poststoke outcome and might correspond to an overall better vascular health.     

Dermatology in the Darwin anniversary. Part 1: Evolution of the integument

The present review highlights the development of the integument and its adnexa from the primitive metazoans to man. The different stages of development represent independent, partially convergent evolutions rather than a continuous evolutionary line. The epidermis of the invertebrates (sponges, cnidaria, worms, echinoderms and arthropods) always consists of one layer of pluripotent cells. The barrier function of the integument at this level is achieved with physico‐chemical barriers, toxin production, fortification of the epidermis in the form of a cuticula, a syncytium or a neodermis. The lower vertebrates (cyclostoma, fishes and amphibians) have a stratified epidermis harboring many secretory cells. In terrestrial amphibians the outermost cell layer of the epidermis is cornified, and the secretory cells are relocated in the dermis. Terminal differentiation and cornification of the epidermis in the birds and mammals result in a more uniform shape of the epithelium. Stem cells are now restricted to some basal regions of the epithelium. In the mammals the glands are located in the deeper layers of the skin. In contrast to other vertebrate integuments the human skin does not possess specialized structures such as feathers, scales or coats. However, waiving specialization allows for unique universality of the human skin compared to other vertebrates.     

Hydrolytic stability of three-step etch-and-rinse adhesives in occlusal class-I cavities

Objectives

A dental adhesive without small and hydrophilic monomers such as 2-hydroxyethyl methacrylate (HEMA) and triethylene glycol dimethacrylate (TEGDMA) would be beneficial in order to avoid contact allergies. However, these monomers are important to increase infiltration and polymerization of the adhesive. Therefore, the purpose of this study was to evaluate the bonding effectiveness and bond durability of a more hydrophobic and biocompatible adhesive as compared to a conventional three-step etch-and-rinse adhesive.

Methods

Sixteen non-carious human third molars were used to determine the micro-tensile bond strength testing (μTBS) and interfacial ultrastructure by transmission electron microscopy (TEM) of the more hydrophobic cmf adhesive system (Saremco) adhesive as compared to the control OptiBond FL (Kerr).

Results

The more hydrophobic and biocompatible three-step etch-and-rinse adhesive was able to produce a reasonable short-time bonding effectiveness. In the long term, the collagen fibrils in the hybrid layer were not effectively protected and were prone to hydrolytic degradation. As a result, long-term bonding effectiveness of this novel adhesive was very low.

Conclusions

Application of a more hydrophobic adhesive without altering the application procedure considerably results in a reduced durability of the created bond

Clinical relevance

Omitting small and hydrophilic components from the adhesive formulation may impair the durability of your composite restoration.     

Perioperative factors influencing interleukin-10 release under cardiopulmonary bypass

BACKGROUND: The cytokine response to cardiopulmonary bypass (CPB) is complex and can be modified. Among several mediators, the anti-inflammatory interleukin-10 (IL-10, 'cytokine-secretion inhibitory factor') is particularly interesting because of its ability to counteract pro-inflammatory cytokines triggering endothelial and leukocyte activation in the immediate immune response to CPB. On the other hand, during the delayed phase of the immune response, IL-10 may act as a promotor of immunodeficiency in complicated courses. Therefore, it is of interest to investigate special conditions of CPB that may influence the extent of perioperative release of IL-10. METHODS: We analyzed 20 continuously registered parameters during CPB, including an analysis of subgroups in the case of application of aprotinin or steroids. 30 consecutive adult patients with coronary artery disease (CAD) and normal left-ventricular function undergoing elective CABG were prospectively studied. Arterial blood was sampled perioperatively and levels of IL-10 were determined using ELISA tests. For analysis, the time point of maximum IL-10 release was selected (30 min after end of CPB). Simultaneously, CPB-registration protocols were analyzed concerning standard parameters. RESULTS: We could state an exponential relationship between IL-10 levels 30 min after end of CPB and the ischemia time (r = 0.76), duration of CPB (r = 0.73) and the extent of negative base excess (BE, r = 0.66) in all subgroups. An inverse relationship could be seen between IL-10 plasma levels and venous O2 saturation: low values for O2 saturation correlated with high IL-10 levels as did low mean arterial pressure (MAP). Hypothermia reduced IL-10 release (r = 0.80), whereas a long duration correlated with high IL-10 release (r = 0.67). In the case of longer duration of hypothermia, the protective effect vanished. CONCLUSIONS: The results show a significant rise for IL-10 early after starting CPB. Low values for venous O2 saturation and low MAP correlated with high IL-10 levels. A good correlation could be seen between IL-10 plasma levels and the duration of CPB, ischemia time, and negative base excess. Because of the ability of persisting IL-10 production to induce a higher incidence of septic complications, all actions for maintaining an optimum of perfusion and oxygenation play an important role.