Effective use of technology has led to medical advances that have not only extended life expectancy, but also fuelled an increasingly well informed public's desires to expect more and more from today's healthcare providers. A phenomenal amount of medical information is now present, facilitated by the virtually unrestricted ability to publish on the Internet. The WWW grows by roughly a million pages per day with a significant number devoted to some element of healthcare. As a consequence of the web's rapid, chaotic growth, the resulting network of information lacks organisation and structure and the quest for a method of finding relevant and reliable information quickly is spawning the growth of the Internet Portal Sites. The use of intranets confers some degree of organisation, allowing for structured growth of an organisation's web site but the majority of sites are not sheltered within an intranet. Millions of dollars are being invested in researching the technologies powering search engines and well designed portals, in the hope of imposing some kind of order on the existing chaos. The winner will most likely reap huge financial rewards as advertisers climb on board, hoping to gain massive exposure and the public will undoubtedly gain from relevant and timely answers to their searches and queries.Information is a valuable commodity, but the true value is seen only when it is organised into an accessible and useable form. The coming of age of the Internet has heralded radical changes in the fabric and economics of healthcare and as a consequence our expectations from professionals involved in this industry are greatly increased. Although significant challenges need to be overcome, there are huge benefits to be gained for consumers, although it remains to be seen whether the world becomes a more healthy place.


When the first issue of Cell Communication and Signaling was launched in 2003, I had the opportunity to discuss the potential implications of CCN proteins in the control of cell-cell communication that is required for balanced tissue organisation, organ development, and species communication with their surrounding medium .Since then, the CCN family of proteins has emerged as a central hub for extracellular matrix signaling and CCN proteins were found in different subcellular compartments where they interact with a variety of signaling ligands and receptors  as an essential media for the exchange and diffusion of scientific information regarding inter cellular signaling.The publication of the "Journal of cell Communication & Signaling [JCCS published by Springer]" as the official organ journal of ICCNS is major step along the establishment of the field.For ethical reasons, the editorial board of CCS and myself had to present our resignation to BMC, effective september 2007.We wish to inform that according to BMC policy manuscripts published in CCS will remain in the BMC database, and will remain freely accessible to readers.The editorial board and myself wish to thank all authors for their contribution and members of the publishing team at BMC for their expertise and support during all these years.Pr. Bernard PerbalEditor in Chief


Clinical Practice and Epidemiology in Mental Health will encompass all aspects of clinical and epidemiological research in psychiatry and mental health, and will aim to build a bridge between clinical and epidemiological research. There are several outstanding mental heath journals covering all aspects of this dynamic field, but none of these journals is devoted to bridging clinical and epidemiological research. The Open Access online distribution of the journal and its inclusion in the leading data bases  will ensure widespread and ready visibility, which are indispensable given the demand for immediate debate and comparison of scientific findings. This launch Editorial provides an overview of the field, and highlights some of the journal policies. Clinical Practice and Epidemiology in Mental Health (CPEMH).This editorial is designed to introduce the new online journal Mental health issues today can rely on medical model based researches, which are capable of providing reliable results following the introduction of descriptive diagnoses in psychiatry. This revolution (implying the use of a common language) took place as recently as the 1970's [Due to the current situation in psychiatric research, when providing a clinical definition for a disorder made up of a group of cases presenting a similar symptomatology and course, it may prove necessary to establish the degree of homogeneity revealed with regard to environmental and genetic risk factors. It would be of particular interest to evaluate whether the clinical homogeneity could also be extended to "conditions" identified in the general population receiving no psychiatric treatment.The association between clinical research and epidemiology is of considerable importance in the medical field, and at the current time is possibly even more so for the field of psychiatric research. Clinical Practice and Epidemiology in Mental Health will encompass all aspects of clinical and epidemiological research in psychiatry and mental health, and will aim to build a bridge between clinical and epidemiological research.CPEMH is aimed at clinicians and researchers focused on improving the knowledge base for the diagnosis, prognosis and treatment of mental health conditions; and improving the knowledge concerning frequencies and determinants of mental health conditions in the community and the populations at risk. The journal will also cover health services research and economic aspects of psychiatry, with special attention given to manuscripts presenting new results and methods in the important area of epidemiology of treatments in mental heath, particularly clinical epidemiologic investigation of psychotherapies and pharmaceutical agents.CPEMH's Open Access policy supports the changes in the way in which articles in mental health can be published [CPEMH articles are archived in the leading databases . Articles will be published online immediately upon acceptance and soon after listed in PubMed.Manuscripts submitted to the journal will be reviewed by expert reviewers in the field. Based on the above characteristics and by means of a series of commentaries on the current state of practice of different aspects of mental health, the journal will seek to stimulate discussion of the main psychiatric topics facing clinical and epidemiological research across the scientific community. An editorial board of international renown of about 50 members has been established . The memIt is no mere chance that the first commentary by Carta and Angst  deals wiThere are several outstanding mental heath journals covering all aspects of this dynamic field, but none of these journals is devoted to bridging clinical and epidemiological research. The Open Access online distribution of the journal and its inclusion in the leading databases  will ensure widespread and ready visibility, which are indispensable given the demand for immediate debate and comparison of scientific findings.We welcome any advice and input.CPEMH whose authors and readers will benefit from learning about mental health in regions of the world and in particular field of research (e.g psychotherapies vs pharmacoterapies) with limited financial resources. No member of the editorial or advisory boards of CPEMH or their Institutions will receive any portion of the article-processing charge.Critics of Open Access often suggest that Editors have a financial incentive to accept articles as more articles means more revenue. However, BioMed Central insists that decisions about a manuscript must be based on the quality of the work, not on whether the article-processing charge can be paid. This policy will certainly apply for


Detailed studies of the effects of misonidazole (MISO) on the pharmacokinetics of CCNU in the KHT tumour, bone marrow and the gut have been carried out in order to elucidate the mechanism of chemosensitisation by MISO, and the therapeutic gain often obtained due to the preferential enhancement of tumour toxicity. In experiments where CCNU concentration and growth delay were both measured in the same transplant group of tumours, we found that tumour response is well correlated with tumour peak CCNU concentration. Further, with MISO treatment the tumour peak CCNU concentration was increased such that the enhancement of tumour response can be entirely accounted for by this increase. The effects of MISO on the CCNU pharmacokinetics in bone marrow and in the gut were different from the tumour in that peak CCNU concentration was not increased. We suggest that this is the explanation for the therapeutic gain.


About 80% of neoplasias are epithelial in origin and, as such, understanding the molecular mechanisms involved in the development of epithelial tumours is vital to the diagnosis, prognosis and treatment of the vast majority of human cancers. Obviously this is no easy task but, as outlined above, great efforts are being made to identify important molecules involved in the progression of normal epithelial cells to carcinoma. The development of techniques to identify new oncogenes is of particular importance, and hopefully the cDNA expression cloning system of Stuart Aaronson will be a useful tool in this respect. The potential of some of these molecules to be used as therapeutic targets will require the development of suitable screening procedures, such as that being established by Chris Marshall for the ras-Map kinase pathway in yeast. It is encouraging that the immune response to virally (HPV) induced cancer is being carefully elucidated and the prospects of vaccine development for the treatment of cervical cancer coming nearer since this particular form of SCC is a major cancer globally. Finally it was fitting to end the meeting on an optimistic note with John Mendelsohn's EGFR monoclonal antibody therapy entering clinical trials, and hopefully this will prove efficacious in the treatment of human SSC.


It is well known that the control of follicular growth and development involves a complex exchange of signals between the pituitary gland and the ovary and among ovarian cells themselves. Although the roles for some hormones in regulating follicular growth are well established, recent research has led to the identification of new hormones and growth factors that regulate follicular development and ovulation rate, and to redefining the roles of some of the classic reproductive hormones. The purpose of this forum is to provide an update on the roles of some of these novel factors and as well some of the classic factors in regulating ovarian follicular development.The forum begins with a review by A Drummond regarding the role of steroids in ovarian follicular development, a classic hormone in which we are continuing to discover novel actions for. This is followed by a review by Abbott et al. who look at the consequences of an inappropriate exposure to steroids on the developing ovary and by H Fraser, who details the regulation of the development of the follicular vasculature. Next is a review by Thomas and Vanderhyden, who explore the interactions between the oocyte and the cumulus cells and the factors that regulate and are regulated by this communication. Following this is an article by Fabre et al., who discuss the use of sheep carrying single genetic mutation as models to elucidate mechanisms regulating ovulation rate. The next review by Kaivo-oja et al. covers the function of the Smad proteins, the signalling molecules for the transforming growth factor beta (TGFbeta) superfamily, in regulation of ovarian function. The final article by Kobayashi et al., investigates the concept that follicles may be selected for atresia as they are selected for ovulation and discusses the factors that may be involved in this "negative" selection.


After the publication of this work , we becaFor measurement, the cubic bone specimens were not immersed in Ringer's solution but only were kept moist all the time.Apart from these corrections concerning the methods and interpretation of the data, the results reported in our publication and the conclusions are absolutely correct.We apologize for the inconvenience that this inaccuracy may have caused.


The recommendations of the National Expert Panel on Community Health Promotion (expert panel) ,2, conveIn the 1980s, state health departments and CDC collaborated to produce state data that track behavioral risks for various health conditions by implementing the Behavioral Risk Factor Surveillance System (BRFSS). BRFSS and its companion, the Youth Risk Behavior Surveillance System (YRBSS), drew the attention of state and federal policy makers to behaviors that are risk factors for chronic disease. Policy makers responded by passing legislation and launching public health initiatives on issues ranging from reducing tobacco use to increasing seat belt use and from mandating insurance coverage for mammography to combating the obesity epidemic. However, as we deepen our understanding of how societal issues, public health interventions, and public policy decisions affect trends in health status, we must establish complementary data systems that assess and monitor these factors and the extent of their effect on population health.The expert panel recommends an increased commitment to community participation in public health research. Experience with the Prevention Research Centers and programs such as REACH  and Steps to a HealthierUS demonstrate that community engagement in the design and evaluation of prevention activities pays off by producing innovative approaches to improving people's health and reducing seemingly intractable health disparities. The challenge of the coming years will be to link lessons learned from involving communities in research with the daily work of programs throughout the field of public health.The expert panel confirmed that daily living conditions influence the ability to make healthy behavioral choices, which determines health status. However, it is not enough to document the impact of social factors on population health; action is necessary to promote protective factors and minimize the influence of social and environmental barriers to health. For example, public health programs that provide people with information about risky behaviors must be complemented by programs to design supportive social and physical environments . Although the ability of certain environmental and social changes to improve population health has long been recognized, the skills needed to bring about these changes are only now being learned and institutionalized. The expert panel calls for a renewed commitment to learn, teach, and establish institutional skills in preventing society-related illnesses.To achieve the societal and environmental changes that will improve population health requires an understanding of how to engage with organizations outside the purview of public health and influence their decisions, become an active participant in policy-making processes in a wide range of organizations and at all levels of government, and enable communities to implement strategies that will improve factors that contribute to good health. For many public health professionals, this is new territory. CDC's challenge will be to increase the effects of public health programs by seeking expanded skills and expertise in the theory and practice of social change and working to integrate that expertise into public health practice.The expert panel discussed some tensions that we have lived with for years, including the tension between a community's need for a comprehensive array of health interventions and Congress's penchant for categorical funding. The expert panel also reminded us of the need to address the conflict between the wellness of the whole person  and the limited models and resources available to meet these needs. Programs such as Steps to a HealthierUS, REACH, and the Preventive Health and Health Services Block Grant offer important and exciting opportunities to begin to fill these knowledge gaps.We are on the cusp of a transformation in public health from a field that focuses on the individual to one that focuses on the societal issues tied to health and illness. The recommendations of the expert panel will help to advance this new vision of public health action. We extend our sincere thanks to the members of the panel for their contributions and commitment.


Increasing economic globalization and mounting time and cost pressure on the development of new raw materials for the chemical industry as well as materials and environmental engineering constantly raise the demands on technologies to be used. Parallelization, miniaturization, and automation are the main concepts involved in increasing the rate of chemical and biological experimentation.


The effects of an aromatic retinoid, etretinate and a vinca alkaloid, vindesine were investigated by culture of malignant melanoma cells in vitro with these two agents; either separately or in combination. Etretinate inhibited growth of a murine melanoma but only minimal effects were recorded with two human melanomas. Vindesine however, was inhibitory for all of the cell lines and this effect was enhanced in the presence of the retinoid. Entry of 3H labelled vindesine or etretinate into drug free cells was followed in the absence or presence of unlabelled drug. It was found that etretinate enhanced cellular uptake of vindesine in two of the cell lines and this may be responsible for the enhanced toxicity of vindesine in the presence of etretinate. The human melanoma which did not exhibit retinoid stimulated vindesine uptake, appeared to be intrinsically sensitive to the vinca alkaloid. No effect on cellular retinoid uptake by vindesine was recorded in any of the melanomas. The results indicate that the intracellular concentrations combined with the intrinsic sensitivities of each cell line to etretinate and vindesine determines the toxic response.


We wish to respond to the paper by Rada  and accoWe hope to be republishing the revised review shortly. The revision will address issues of the review's scope and the pooling of data that were raised by peer reviewers and also by Eysenbach and Kummervold. We have been greatly assisted by comments from external statistical reviewers from the Cochrane Group and from an internal independent statistical advisor, who have reviewed our methodology. We anticipate and welcome a lively and ongoing debate on these methodological issues.In the meantime, we would like to correct three factual inaccuracies in Rada's paper. While Rada states that "the coauthors Nazareth and Tai [are] credited with doing the coding," we should clarify that Nazareth was not responsible for coding the data and is not credited with this in the review.  Secondly, Rada writes that the "UCL...news bulletin...remained [on the website]." We should point out that the UCL press release, while still available on the UCL website, is clearly linked to the retraction and subsequent press release summarizing the errors and steps taken to rectify the errors. Thirdly, the UCL press release did define interactive health communication applications, although Rada said it did not.We agree that the press coverage of the original report was not matched by coverage of the retraction, and we concur that this was unfortunate. However, the Cochrane Collaboration made two press releases advising all media outlets of the errors in October and December 2004.


The use of different expressions of mortality in prostate cancer can lead to difficulty in comparing reported data. We have used different measures of mortality in the same group of 438 patients presenting consecutively with histologically proven adenocarcinoma of the prostate, in order to assess the values and deficiencies of each method. The use of expected and relative survival is shown to be valuable in allowing indirect but objective assessment of disease specific mortality in prostatic cancer.


Journal of Brachial Plexus and Peripheral Nerve Injury [Today marks the publication date of the inaugural issue of the e Injury . My immeOur aim is that the journal will be the pre-eminent repository of knowledge for brachial plexus and peripheral nerve injury science. Injury in this context does not imply trauma alone, but any derangement of the anatomy, physiology or biochemistry that results in an altered state of functioning, truly an unlimited scope for a fascinating and important field.The journal is in open access format, in my view the only relevant such model in these times where information must be freely available to all. The traditional subscription-based model inherently denies free access to knowledge and seems contrary to the spirit of scientific thought. In support of this concept, we have arranged with BioMed Central to subsidize the costs of publication for the first two years of publication. Therefore, there are no barriers to publication of high quality science or to access to this knowledge.It is very important to note that all submissions, upon approval by our peer review process, are immediately indexed in PubMed and archived in PubMed Central, the full-text repository of the United States National Library of Science. Many other growing indexers such as Google Scholar will also display our articles, making them more widely read and accessible than any other system. Our goal is to have a rapid peer review process, and we will make every effort to make an initial decision within 6 weeks of submission.The peer review process will match knowledgeable reviewers with submitted manuscripts to produce high quality articles of interest and scientific merit. The process is confidential so that criticisms and revisions are made in the fairest manner possible. The final decision on publication will be made by the editors in chief.We will look for submissions of interesting and important scientific information that hopefully will have clinical application. This focus does not deny the relevance of basic research, it embraces it: the future of nerve injury management lies in manipulation of molecular mechanisms, less so in classic surgical and medicinal treatments. Whether there are obvious clinical implications or not, high quality research of all types will be nurtured and presented with pride in the journal.One of the main goals of our endeavor is to cultivate cross disciplinary dialogues to enhance our understanding of mechanisms and to develop strategies for treatment of various disorders. As an example, a neurologist may be interested to know the potential application of surgical techniques such as nerve transfer to upper motor neuron lesions like stroke that are not fully treatable with medicines; conversely, surgeons should be aware of potential sensory and motor imbalances typically see by neurologists which may be candidates for surgical treatment. And both groups will enhance their management of patients by knowledge of breakthroughs in underlying molecular mechanisms.Journal of Brachial Plexus and Peripheral Nerve Injury, there has been no single, dedicated place to discuss these critical issues. We have the opportunity to improve the quality of life of so many people in developing countries and otherwise disadvantaged situations. The talent and determination of our readers is a resource with unlimited potential and we have this as a motive to produce and foster new scientific thought for the benefit of the community affected by brachial plexus and nerve injury. This is the most exciting concept of all.Prior to today's inauguration Journal of Brachial Plexus and Peripheral Nerve Injury and for the International Society for Brachial Plexus and Peripheral Nerve Injury [I look forward to a most interesting future for e Injury . Our edi


The accuracy of cancer registration data in the East of Scotland (Tayside) Cancer Registry was audited by comparing 200 consecutive registrations  with the 'gold standard' of the Histopathology records. ICD codes were independently generated by a pathologist by examining final pathology reports and then compared to those codes given by the local cancer registrar. Discrepancies were graded by the pathologist and the epidemiologist according to severity. Major errors of coding were few. Minor and moderate differences in coding occurred because of the nature and structure of the coding system and the manner in which data are retrieved. The level of detail required by the Cancer Registry needs to be evaluated.


The Otto Warburg International Summer School and Workshop 2005, held in Berlin, Germany, focussed on the topic of "Networks and Regulation", which is a very active field of research these days. The lecturers at the school were asked to give tutorial introductions that would allow the students to follow a research talk presented towards the end of the workshop. Overall, these lectures presented material starting where the text books stop and bridged to the current research front. The lectures were very well received by the students, prompting the lecturers to jointly work on a volume introducing the current research in this area.) holds powerpoint presentations and video streams for most of the lectures.The papers presented here are more or less based on the oral lectures, with some of the papers sticking very closely to the material presented then, and others going into more depth on particular questions. Not all presentations are represented and, vice versa, one paper has been included now which did not arise from a lecture. We felt it was simply missing in the context of the summer school and the current volume gave us the chance to fill the gap. The web site of the summer school (The first paper by Silke Sperling  gives anA review of computational and statistical methods to reconstruct cellular networks is given by Florian Markowetz and Rainer Spang . The revGraph theoretical concepts and relationship to biological systems are further discussed by Wolfgang Huber et al . This reIt is our hope that this volume will serve as an introduction for researchers moving into the field of regulatory genomics and, in particular, will provide interested students with a resource, where to find the necessary background material to put current developments in a larger scientific context.


Recently published results of epidemiologic case-control studies in China and Italy on gastric carcinoma in relation to diet suggest that consuming garlic may reduce the risk of gastric cancer. Chemical constituents of garlic have been tested for their inhibiting effect on carcinogenesis, using in vitro and in vivo models. In most experiments inhibition of tumour growth was established using fresh garlic extract, garlic compounds or synthetically prepared analogs. In this review the strengths and weaknesses of the experiments are discussed and the outcomes are evaluated to assess the possible significance of garlic or garlic compounds for the prevention of cancer in humans. It is concluded that evidence from laboratory experiments and epidemiologic studies is presently not conclusive as to the preventive activity of garlic. However, the available evidence warrants further research into the possible role of garlic in the prevention of cancer in humans.


The title of this book shouts loud lofty aims. Does it fulfil them? It most certainly does, and in many ways it exceeds them. To whom is it of interest? Virtually everyone interested in spina bifida, be the reader a research worker, clinician, epidemiologist or anyone among a host of others concerned with spina bifida. By any standards it is a daunting task to cover one condition from its origin to treatment as the subtitle announces. The editor has chosen his contributors wisely, picking leaders in their fields that inevitably have given an account of their subject from a personal point of view. Most have also included for discussion, the apposing and sometimes the controversial views of others.The book is divided into three sections: Basic Principles, Treatment and Education, and Public Health Issues.The first section, Basic Principles, is further subdivided into four subsections, the first of which contains a group of papers, which are essential reading for anyone who wants or needs to update their knowledge of the embryology of neural tube development and the underlying biomolecular mechanisms. This is not easy reading but essential if one is to understand how and why things go wrong when spina bifida occurs. The second subsection deals with a variety of clinical features of neural tube defects. This subsection also includes papers concerned with the classification of the various manifestations of neural tube defects. Of particular interest are the myriads of syndromes that include spina bifida amongst their abnormalities. Do these conditions give a clue to the genetic defects in cases where spina bifida is the only abnormality? That is a hope not yet realised. Papers in the third subsection dedicated to the epidemiology of neural tube defects give a realistic view of the difficulties of collecting meaningful data and the strength and weaknesses of statistics based on these data. It is no longer a mystery why there is no consensus of opinion about whether the conception rate of spina bifida is increasing, staying the same or decreasing or indeed why the reported incidence of spina bifida in any particular country varies from one author to another. The last subsection deals with the genetics of neural tube defects. These chapters also do not make for easy reading for those not conversant with the names of the multitude of genes involved, but as future developments of the understanding, treatment and management of spina bifida are likely to come in this field of study, it is essential that all make themselves familiar with this work.The second section is concerned with the Treatment and Education of patients with spina bifida. In this section the whole life cycle of patients is covered from the fetus to the all too often ignored adult. The first paper is a discussion of fetal surgery for myelomeningocele. Is this the way forward for the treatment of spina bifida? The answer to that question is still on hold, for although the numbers of fetuses treated is now several hundred, many aspects of the outcome are yet to be assessed and await the results of the randomised, controlled Management of Myelomeningocele Study (MOMS). It is gratifying that several of the papers in this section are devoted to the older patient with spina bifida and the associated problems of growing older, with the attendant difficulties of learning, separation from their parents and carers, and developing a degree of independence. There are no holds barred when it comes to discussing in detail the multiplicity of difficulties encountered by young persons with spina bifida. These range from deficits in brain function that cause learning difficulties which are carried over into the work place making it hard for them to successfully perform relatively simple jobs, to the social stigma of being incontinent of urine and faeces and having sexuality problems that affect interaction with peer groups. In this section there are two subjects that are surprisingly not included. The first is hydrocephalus, it is discussed in passing but one might have expected to have a chapter devoted to its management. The other area not mentioned is the management of the patient with severe brain malfunction. Their care as they grow older is no less important and worthy of consideration than that of less severely affected patients.The third and last section in the book deals with the role of folic acid in the prevention of spina bifida and two other topics that are not unrelated to the former, namely the costs involved in the care of spina bifida patients and ethical issues raised by the condition.Everyone, no matter what their expertise is in the field, have something to learn from what is written between the covers of this remarkable book. Don't take my word for it, go and get a copy and find out for yourself.The author(s) declare that they have no competing interests.Sole author


The meeting was reviewed and summarised by Professor Herman Suit. He judged that the potential clinical gains from research in radiobiology were very great and likely to translate to improved cancer treatment in the near future. He was highly complimentary about the contribution of UK research in radiobiology and he indicated that this viewpoint was held widely in the United States, Europe and Japan. Radiobiological research was the basis for major clinical trials in radiotherapy undertaken by trial groups in all these countries. He felt that major contributions to current practice in radiotherapy had been the definition of dose response, the rationale for the use of radiotherapy against slowly responding tumours, and the understanding of repair differentials and of clonal proliferation in the design of clinical fractionation trials, leading to clear demonstration of benefit for altered fractionation in the treatment of head and neck cancer and in the treatment of bladder cancer. An important goal of research should be the development of predictive testing for radiation response employing multiple predictive tests of radiation sensitivity , cellular proliferation  and identification of hypoxic cells, together with physiological parameters such as blood flow intratumoral pressure, thiol metabolism and activation and status of repair genes. In terms of improving differential response between tumour and normal tissues, further refinement of dose fractionation patterns would be needed, but also research should continue on the modification of response using drug/radiation protocols, targeting techniques, growth factors and other biological response modifiers to support normal tissues, and modulation of DNA repair. Professor Suit felt that the pace of research in radiobiology was most encouraging for the field of radiotherapy. There was a consensus that support for radiobiology needed to be matched by support for academic radiotherapy if potential research gains were to be translated into advances in treatment. He shared the view expressed by the Committee of Cancer Experts of the EORTC that improvements in cancer cure over the next decade were likely to derive from improvements in radiotherapy.


Presentation of development and creation of a health care resources directory on the Web in the United States and Hungary.The presentation of health care directory on the Web is hampered by the disparate population in geographic and political subdivisions. A unique concept is developed to collect and present health care resources in sub-units of approximately 1 million people.To permit "needs"-based location of health care resources a list of items is created to present the providers of the desired services.The directory permits linking to the service provider's Web page for easy access of more detailed information.The system has been completed for a subdivision of California: Diablo Valley. List of institutions, individuals and businesses are listed in logical grouping. The "needs" list includes some 180 items, from "Abortion and Alternative" to "Zen Meditation". Similar lists of hospitals and department head physicians are completed for Hungary. This list will appear also in English and German.The free market requires free choice in health care as well. In order to make choice the alternatives have to be known. The Internet is the perfect approach to present those choices. The project also serves the scientists, practising physicians and other health carer professionals in their ability to communicate with each other.


Doubts have frequently been expressed about the effectiveness of the screening programme for cervical cancer in Britain. These doubts have been reinforced as a result of recent increases in mortality from this disease among younger women. In this paper we discuss trends in registration and mortality data, relate these to the level of screening, and conclude that screening may in fact have had a considerable impact on mortality rates. There is good evidence that in some age groups there has been a large increase in the incidence of carcinoma in situ of the cervix; it seems likely that the potential increase in cervical cancer incidence and mortality may have been partially prevented as a result of the screening programme. The extent of this effect cannot be quantified precisely because of uncertainties concerning the natural history of cervical cancer, differences in risk for different cohorts, and the possible effects of other factors. It is likely that incidence rates will continue to change, and it will be necessary to monitor these and the screening programme with some care in order to make the best use of the resources available for cervical cytology.


Stevia rebaudiana). The results show that the amount of available P and Zn content in soil has been found to increase initially and, thereafter, the amount of the same decreased with the progress of plant growth up to 60 days irrespective of treatments. The amount of P and Zn in soils showed an increase with their separate applications either as soil or foliar spray while that of the same value significantly decreased both in soils and plants due to their combined applications, suggesting a mutual antagonistic effect between Zn and P affecting each other's availability in soil and content in the stevia plant.A greenhouse experiment was conducted at the Indian Institute of Horticultural Research (IIHR), Bangalore to study the interaction effect between phosphorus and zinc on their availability in soil in relation to their contents in stevia (


Food safety: emerging issues, technologies, and systems is a food safety science book that proposes a structural approach to learning the basics of addressing and understanding some of the key intricate issues which have emerged around the food industry. The book offers the groundworks for real world understanding of safety rules and initiatives of food safety, how to deal with composite data and computer systems, handling issues of whole grain traceability, safety education, issues of processing and production compliance, and detection of food pathogens. The book encompasses recent scientific developments in the food industry, which have been explained by experts for the purpose of improving communication, awareness, and education of the same. This paper seeks to provide a review of this book with regards to its contents and the current community needs.salmonella chicken carcass contamination and using molecular approaches to trace foodborne pathogens.In essence, this book that is authoritative and attractively designed. The titles and chapters in the book are meaty but properly referenced and contain thorough information and a comprehensive introduction to every covered topic in the book. The content of the book is useful both for those looking to begin food science careers and to established specialists. Accordingly, this makes it to be an excellent book. Five out of the six chapters of the first section of this book were written by authors from the Arkansas University in Fayetteville. The approach to how these chapters are drafted and explained is international, though with an exception of the chapter on computer systems in traceability of whole grain in beef production systems since this one focuses on US practice exclusively. The section has other chapters which entails using numerical calculated modeling in biotracing, microbial cradle tracking by use of indicator organisms like in production of fresh produce, current, and probable future achievements in using the indicators of microbial process to address the Staphylococcus aureus, control of Salmonella in the United States and the consideration of antimicrobials as compared to antibiotics, the current perspectives on Campylobacter among others. There are three chapters written by Carol Philips, Jodie Score, Stephen Forsythe, and Katie Laird from various parts of Britain. These chapters cover Clostridium difficile, Cronobacter, Arcobacter, and Aeromonas.The next section of the book has eight chapters which deals with distinct pathogens and contemplates the usual suspects which are foodborne illness brought about by In the last section of the book, the emphasis is on training and education. To begin with, the first three chapters which are about education on retail food safety, food safety in markets of farmers, and food handler education. In this light, food handler education comprises of education through the media and education of senior school pupils and this is written from the perspective of the United States. Even with this being the case, the value of the potential readers of this book elsewhere is not diminished since the problems addressed by the authors and the solutions tend to have a universal application and thus proves useful to every nation around the globe. The book provides a comprehensive and detailed review of approaches for ensuring perfect food handler practice through several approaches especially training. The conclusion of the book is an account of concerns that surround beef production in the United States and an account on teaching and training on food safety in Europe and the United Kingdom. This is a title and a chapter which completes itself with a wide-ranging index and offers the best explanation which can be comprehended by anyone who can read English.Molecular methods of fingerprinting continue to develop at incredible speed as their cost fall more rapidly. In this regard, the challenge that evolution presents is as big as always and has to be dealt with since even the microbial adversaries are dynamically changing in an extremely unpredictable way. As such, it is paramount to ensure there is effective food handler training which will produce an impact required by microbiologists and sociologists.The ever-evolving world of food safety science requires people to be masters in almost everything and this book offers the required knowledge to attain the same. The three sections of the book offer comprehensive knowledge on several developments in food safety traceability and tracking. In addition, the authors have offered a green light on new developments in training, food systems and food safety education, and new strategies to study foodborne pathogen ecology. Hence, the book is a good companion to individuals dealing with food safety from around the globe.MI identified the book and wrote the review. YT and ZY reviewed and edited the manuscript. All authors read and approved the final manuscript.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


There are many conditions that can affect the normal structure of the urinary bladder wall and lead to the inadequate evacuation of urine or even disable urine excretion. In these cases, the essential task is to restore the function of the urinary bladder, most often through surgical intervention. Some of the disorders, such as bladder acontractility, bladder cancer, and inflammatory disease, represent a great challenge in practice due to the number of complications that can occur after the intervention and due to frequent relapses. The use of tissue engineering strategies that include the use of stem cells and artificially created scaffolds could give solutions for treatment of many disorders of the urinary bladder and transplantation therapies in the future. Although the research in this field is still in its infancy, there are some promising results that raise hope that the tissue engineering approach could offer long-term solutions for many issues in regenerative urology. This review summarizes the current achievements and perspectives in the use of stem cells and tissue engineering techniques in the field of urinary bladder regeneration.


We have become aware that a substantial part of the main text of  is copieNanomaterials that this case remained undetected until now. We sincerely appreciate the efforts of anyone who brings matters of plagiarism to our attention in an effort to maintain scientific integrity.MDPI is a member of the Committee on Publication Ethics (COPE) and takes the responsibility to enforce strict ethical policies and standards very seriously. We aim to ensure the publication only of truly original scientific works. MDPI would like to apologize to the readers of


In the original article, we neglected to include the funder German Research Foundation/DFG and the Chemnitz University of Technology, who accepted to fund our publication. Therefore, the following statement should be added to our article:“The publication costs of this article were funded by the German Research Foundation/DFG and the Chemnitz University of Technology in the funding program Open Access Publishing.”The authors apologize for this error and state that this does not change the scientific conclusions of the article in any way.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


Memory for the relative order of events is a critical feature of episodic remembering that is thought to rely on hippocampal processes  and those that are based on relative time or position  or differentiation (pattern dissimilarity).There is evidence supporting this associative account of recency discrimination in episodic memory from both behavioral and fMRI work. Behaviorally, intervening boundaries have been shown to disrupt associative binding  and the National Science Foundation (DGE 0813964).The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


Raphanus sativus have been used in various parts of the world to treat cancer and as antimicrobial and antiviral agents. The phytochemistry and pharmacology of this radish is reviewed. The structures of the compounds isolated and identified are listed and aspects of their chemistry and pharmacology are discussed. The compounds are grouped according to structural classes.Leaves and roots of


Acquired disorders of writing in the Russian language have been reported for more than a century. The study of these disorders reflects the history of Russian neuropsychology and is dominated by the syndrome approach most notably by the writings of Luria. Indeed, our understanding of acquired dysgraphia in Russian speakers is conceptualized according to the classical approach in Modern Russia. In this review, we describe the classical approach and compare it to the cognitive neuropsychological models of writing disorders that are developed to explain dysgraphia in English and in other Western European languages. We argue that the basic theoretical assumptions of the two approaches – cognitive and classical or syndrome approach – share similarities. It is therefore proposed that identification of acquired cases of dysgraphia in Russian could potentially benefit from taking the cognitive neuropsychological perspective. We also conclude that adopting elements of the syndrome approach would substantially enrich the understanding of acquired dysgraphia since these offer an insight into processes not described in the cognitive neuropsychological approach.


I recently came across an interesting and useful article on “Variability in the Branching Pattern of the Internal Iliac Artery in Indian Population and Its Clinical Importance,” by Sakthivelavan et al. . As a prIt was long believed that ligation of the hypogastric arteries would lead to complete cessation of blood flow in the area supplied by these vessels. Yet, owing to the activation of the anastomotic network immediately after ligation, blood is never completely drained from the hypogastric artery distally to the site of ligation as demonstrated by Burchell in 1968 [The use of IIA ligation in current obstetrics and gynecology is controversial due to the technical challenges the procedure involves and the variation in success rates. The efficacy of this procedure in controlling obstetrical hemorrhage has been reported to range within 42–75% . DespiteThough the IIA ligation is less performed these days, it still continues to be a surgical alternative in cases of pelvic hemorrhage and any surgeon who encounters this needs to be aware of the anatomy of the IIA and its regional variations so that the desired hemostasis is achieved with minimal complications.


The authors would like to indicate that Dr. Orazio Palmieri and Dr. Teresa Maria Creanza contributed equally to the work published in the International Journal of Molecular Sciences . For thiThe changes do not affect the scientific results. The manuscript will be updated and the original will remain online on the article webpage.


Rapid reviews are of increasing importance within health technology assessment due to time and resource constraints. There are many rapid review methods available although there is little guidance as to the most suitable methods. We present three case studies employing differing methods to suit the evidence base for each review and outline some issues to consider when selecting an appropriate method.Three recently completed systematic review short reports produced for the UK National Institute for Health Research were examined. Different approaches to rapid review methods were used in the three reports which were undertaken to inform the commissioning of services within the NHS and to inform future trial design. We describe the methods used, the reasoning behind the choice of methods and explore the strengths and weaknesses of each method.Rapid review methods were chosen to meet the needs of the review and each review had distinctly different challenges such as heterogeneity in terms of populations, interventions, comparators and outcome measures (PICO) and/or large numbers of relevant trials. All reviews included at least 10 randomised controlled trials (RCTs), each with numerous included outcomes. For the first case study , very diverse studies in terms of PICO were included. P-values and summary information only were presented due to substantial heterogeneity between studies and outcomes measured. For the second case study (premature ejaculation treatments), there were over 100 RCTs but also several existing systematic reviews. Data for meta-analyses were extracted directly from existing systematic reviews with new RCT data added where available. For the final case study (cannabis cessation therapies), studies included a wide range of interventions and considerable variation in study populations and outcomes. A brief summary of the key findings for each study was presented and narrative synthesis used to summarise results for each pair of interventions compared.Rapid review methods need to be chosen to meet both the nature of the evidence base of a review and the challenges presented by the included studies. Appropriate methods should be chosen after an assessment of the evidence base. Systematic reviews have long been a key component of evidence based medicine. The use of methods to expedite systematic reviews is ever increasing due to time and resource constraints as well as policy maker and clinical demand. Systematic reviews typically take at least 12 months to conduct with rapid reviews taking between 3 weeks and 6 months , reducedThere are many inherent limitations associated with the use of rapid reviews such as the risk of introducing publication bias due to reduced searching. Grant and Booth  suggest Recommendations for conducting rapid reviews include the need for replicability and transparency of methods . This inThe National Institute for Health Research (NIHR) within the United Kingdom commissions rapid reviews in the form of short reports on a range of topics. We present three case studies of recent rapid reviews undertaken for the NIHR programme undertaken by the authors of this paper. These reviews were each undertaken within 8–12 weeks  and all three reviews included almost entirely randomised controlled trials (RCTs) due to the limited time available to conduct the reviews. Three reviews from the same programme were chosen as they used identical processes for developing research questions, adherence to PRISMA reporting standards, report templates and peer review. Differences between the three reviews regarding the rapid review methods used arose from the differing evidence bases and challenges for each review. In this paper we present three distinctly different approaches to rapid reviewing and propose issues to consider when selecting appropriate rapid review methods for use in health technology assessments.The effectiveness of sexual health interventions for people with severe mental illness (SMI): a systematic review .Interventions to treat premature ejaculation: a systematic review short report .Psychological and psychosocial interventions for cannabis cessation in adults: A systematic review short report .The three most recently completed NIHR rapid reviews undertaken at the School of Health and Related Research, University of Sheffield, United Kingdom were included in these analyses. The three reports included in the analyses were:These three reviews were chosen as they had distinctly different evidence bases requiring different approaches to rapid review, thus enabling us to explore a range of rapid review approaches. The commissioning brief or questions to be answered by the reviews were set by the NIHR and it was a requirement that all interventions listed in the commissioning brief be included in the reviews. The protocols for all three reviews were developed from the NIHR commissioning briefs, peer reviewed, agreed with NIHR and registered on the PROSPERO website and published on the NIHR website. All three reviews were undertaken by at least two experienced systematic reviewers with an experienced information specialist undertaking the literature searches. All three reviews had extensive searching, data extraction and quality assessment, intensive input from clinical experts and all underwent peer review of the draft report by independent external reviewers as part of the standard NIHR peer review processes.Rapid review methods used .Research question and aims.Number of interventions and comparators.Number of included studies.Perceived reviewing challenges.Rationale for choice of review method in each case.Reported strengths of rapid review methods.Reported weaknesses of rapid review methods.The reviews all adhered to PRISMA reporting standards and are all published as part of the NIHR monograph series. For the present analyses, data were extracted from each of the short reports on the following variables:These variables were determined by the whole research team as they were deemed important in order to understand the approach and challenges of the chosen methods in each review. The authors of each of the three reviews contributed to the data extraction and interpretation for the reviews they authored.The three reviews included in these analyses all used rapid review methods due to the short time frame of this HTA process. The rapid review methods used in all three reviews were: the use of a focussed research question, partial double sifting of titles and abstracts and partial double data extraction by a second reviewer. Two reviews included only RCTs or existing systematic reviews of RCTs  14] whi whi14] wScoping searches, based on a simple search strategy, were done while developing the protocols to provide a quick overview of the potential evidence base in terms of existing reviews, approximate numbers of relevant studies, relevant interventions and comparators as well as types of outcomes reported. Scoping searches were essential in estimating the number of records that would be retrieved. This informed the development of the protocol and selection of rapid review methods. A brief summary of the comprehensive search strategies and search results for the three reviews can be found in Table There was a process of iteration for each of the reviews in the form of specific questions from the reviewers to the policy makers to ensure that the proposed methods would meet the needs of the policy makers. In addition, the policy makers were able to comment on the draft protocols and revisions to the protocol incorporated in the final version. The approaches chosen were in part in order to meet the requirements of the policy makers as set out in the commissioning briefs to look at all relevant interventions.Table The aim of this review was to evaluate the effectiveness of sexual health interventions for people with SMI, determine their applicability to the UK NHS setting, and to identify key areas for primary research. Thirteen RCTs were included in the review. The challenges for this review were the inclusion of very diverse studies in terms of populations, interventions, comparators and reported outcomes. There was a large volume of non RCT, uncontrolled study evidence identified in the initial scoping searches which was not included as this was considered to be lower quality evidence. A narrative synthesis approach was chosen as meta-analysis was deemed impossible due to the considerable study heterogeneity. Difficulties were encountered with defining “severe mental illness” which includes different conditions (such as major depression) in some countries but not others.The approach taken was to briefly report all relevant outcomes; grouped into categories including biological, behavioural and proxy (such as barriers and facilitators) categories. Information on effectiveness of interventions was presented by reporting the p-values for outcomes as reported in the individual studies as well as the study authors’ conclusions.The strengths of this approach were that only higher quality evidence was presented; a thorough assessment of quality was undertaken and key details for each included study were readily accessible, particularly information on outcomes. By using a focussed and previously agreed definition of severe mental illness, only studies with populations directly relevant to the needs of the policy makers were included. Limitations of the chosen approach were the exclusion of non-RCT evidence meaning that some information might have been lost, particularly that related to the description of interventions. It was also only possible to report limited quantitative outcome data. However, due to the nature of the evidence base more extensive quantitative synthesis would most likely not have been possible. Our chosen approaches allowed us to fulfil the review objectives in that an overview of the effectiveness of the included interventions was provided, despite not being able to report full quantitative data. In addition, areas for future research and trial design were identified and information on applicability to the UK NHS was provided.The aim of the review was to systematically review the evidence for the clinical effectiveness of behavioural, topical and systemic treatments for premature ejaculation. The main challenge for this review was the large number of interventions and very large number of relevant RCTs (over 100).The approach taken was to use meta-analysis where appropriate using data extracted from existing systematic reviews. Data from newer primary studies were added to the meta-analyses. The review included 102 controlled trials. Data from 65 of these RCTs were extracted from existing reviews and 37 directly from additional RCT publications. Meta-analysis was possible as most studies used the same primary outcome , in contrast to the other two short reports discussed here where outcome measures varied greatly across studies. Secondary outcomes were more varied and narrative synthesis was used for these. This approach had limitations as there was the potential for incorporation of synthesis errors from the original reviews. The methodological quality of studies extracted from the existing reviews was not assessed separately due to time constraints. Although the use of data from existing reviews saved some time, triangulation of data from multiple reviews was still time-consuming. The approaches chosen allowed us to provide up to date quantitative evidence on the effectiveness of a range of treatments for premature ejaculation.The aim of the review was to systematically review the effectiveness of psychological and psychosocial interventions for cannabis cessation in adults who use cannabis regularly and to identify key areas for primary research. This review included 33 RCTs. The cannabis cessation review included input from a service user who had previously received similar interventions to those included in the review. This individual provided feedback on the review protocol and final report; specifically, the included interventions, outcome measures and the lay person summary. The challenges associated with this review included a wide variation in study populations, such as the extent of cannabis dependence, interventions  and comparators. There was also very little consistency with regard to outcome measures, time points of measurement and statistics reported. Broad inclusion criteria were used as the commissioners requested the review to be inclusive of all relevant evidence.The approach taken was to present a narrative summary of outcomes reported for each intervention and comparison, stating how many showed a statistically significant effect. This enabled inclusion of the many relevant studies within the time constraints of the review. Due to the significant study heterogeneity, meta-analysis was not considered suitable. The approaches chosen in this review provided an overview of effectiveness of the interventions although it was not possible to report the quantitative data in full. This approach differed from that used in the first short report  in that due to the larger number of trials more limited outcome data was presented.Based on the diverse range of approaches used in these three rapid reviews we have identified issues that are important to reflect on when planning a rapid review. Table It is difficult to plan the review approach until there is a clear understanding of the type, amount and variation of evidence available and scoping searches are very useful for this. The incorporation of good quality existing systematic reviews may be considered. Presenting summaries of existing reviews and new studies or extracting data from existing reviews and incorporating into a meta-analysis with data from new studies are all options for consideration. Attention should be given to the most appropriate way to present the evidence, assessing both the amount of data to be presented and the most appropriate format. The level and type of evidence presented must be acceptable to both reviewers and policy makers. Clear communication with policy makers is crucial to ensure that the review being undertaken will address the question under consideration. This is especially important when using rapid reviews as the limited timeframe and available resources mean that there will be a trade-off between different aspects of the review such as thoroughness of searching, breadth of the research question and depth of analysis. It is essential that the methods used are clearly reported so that the reader is aware of the potential biases and limitations associated with chosen methods. Methods should be reported in enough detail so as to be reproducible and transparent.This paper presents three distinctly different approaches to the rapid review of evidence to address a pre-defined research question within a limited time frame. The approaches included a brief summary and grouping of results for the sexual health review , meta-anMethods chosen for the rapid review of evidence must be both feasible and appropriate taking into account the requirements of the commissioners, the quantity and nature of the evidence and the time and resources available to do the review. The methods chosen for these three reviews were deemed acceptable to the commissioners as they approved the protocols where the methods were described in detail. The reasons for the commissioning of the reviews varied and this fed into the choice of review methods. For the sexual health review, the majority of evidence was from North America and it was not known how transferable this might be to the UK. The aim of the review was to inform the design of a UK based trial. The aim of the premature ejaculation review was to identify the most effective treatment option or combinations of treatment and the aim of the cannabis cessation review was to evaluate interventions for cannabis use and to identify important evidence gaps that might require further research. In all three reviews alternative methods could have been chosen such as the inclusion of fewer interventions, comparators or fewer outcomes, restriction of study design or the updating of existing systematic reviews. However, all of these options would have meant that either the needs of the commissioners were not met or that the high standards of the NIHR were not adhered to.Policy makers require evidence to make decisions in a timely manner therefore choices need to be made as to how to select, analyse and present the evidence required. We chose the approaches presented here in part because other approaches were not acceptable to the policy makers (limiting the number of interventions considered). Research by Cameron et al.  comparinThe key factors identified in this study for consideration when selecting rapid review approaches include: an assessment of the evidence base, consideration of how to present the evidence, understanding the needs of the policy makers and adequate reporting of methods and their strengths and limitations. The range of reviewing options can then be considered by the reviewer once the size of the evidence base is ascertained including limiting the scope of the review  and strePrevious research has also highlighted the importance of reporting and communication with policy makers. Without a full description of methods the direction and magnitude of any risk of bias cannot be fully assessed . This haThere are several limitations to this research study. Only three rapid reviews were assessed, all from the same institution involving an overlap of reviewers. All three reviews were undertaken for the same HTA programme in the UK. Other programmes may have had other requirements and meant that other approaches were needed. Other reviewers from other organisations may have chosen different review methods. This limits the findings of the research. The authors of this paper were also the reviewers for the three case studies and therefore had in depth knowledge of the reasoning behind choices but other data extractors may have come to different conclusions compromising the replicability of this study. We deliberately looked at our own reviews so that we could provide an in depth description as to how and why decisions were made about which rapid review method to use, and what we found to be the strengths and limitations of these methods.More research is needed in this area to provide guidance to reviewers to enable them to choose the most appropriate rapid review methods. One possible approach would be to select a sample of rapid reviews produced by a range of groups that used the general approaches outlined in these case studies and then use this sample to compare both within and between the three case approaches to help establish best practice in this area. Another possible future research approach would be to compare the rapid review methods used with a full systematic review in the same area. We have recently published a paper comparing our chosen rapid review methods with a full review for one of the interventions from the premature ejaculation review . We founWe did not receive feedback on whether or not our reviews met the needs of the commissioners, although this was requested. We have suggested this become part of the NIHR peer review process in future. Future research is needed on how best to incorporate feedback from commissioners and policymakers as to how useful the reviews were for decision making as well as potential limitations due to the chosen review methods. There is now a considerable amount of literature available on the use of rapid reviews with details of the methods available and limitations associated with these. There is little guidance on how to choose the most appropriate method for the evidence base identified. It is crucial that commissioners and policy makers have sufficient information to make a judgement on whether or not the chosen review approaches may be considered appropriate and robust. They must also be made aware of what approaches are feasible, bearing in mind the quantity and nature of the evidence as well as the time and resource constraints of the review. Details of the strengths and the limitations of the methods chosen must also be presented to commissioners and policy makers and their potential impact on decision-making. This research goes some way in exploring possible approaches suitable in this context.There is no “one size fits all” to the use of rapid review methods. The analyses presented here suggest that the appropriate approach needs to be determined based on the evidence available, time constraints and the needs of policy makers and knowledge users. Authors need to be clear as to what approach was taken and the strengths and limitations of the rapid review methods chosen, how appropriate and robust these choices are and their potential impact on decision-making.


Understanding how the mappings between orthography and phonology in alphabetic languages are learned, represented and processed has been enhanced by the cognitive neuropsychological investigation of patients with acquired reading and writing disorders. During the past decade, this methodology has been extended to understanding reading and writing in Chinese leading to new insights about language processing, dyslexia and dysgraphia. The aim of this paper is to review reports of patients who have acquired dyslexia and acquired dysgraphia in Chinese and describe the functional architecture of the reading and writing system. Our conclusion is that the unique features of Chinese script will determine the symptoms of acquired dyslexia and dysgraphia in Chinese.


In the 2010 Australian Federal Budget funding was committed to establish an early psychosis service system based on the EPPIC model of early intervention for psychosis that was developed in Melbourne, Australia. This system was established by 2016. As part of the development of the system a fidelity scale was developed to measure the adherence to the model of the sites delivering the early psychosis services.The EPPIC Model Integrity Tool (EMIT) was developed as part of the national reforms around early psychosis. The EMIT is an 80 item assessment tool that maps onto the 16 core components of the EPPIC model. The tool is used by attending the sites and speaking with staff and young people as well as accessing documents, policies and high level data around client flow through the service. The first two rounds of fidelity assessment were conducted in July/August and October/November 2017Results of the first two rounds of fidelity testing demonstrate a level of fidelity to the model consistent with expectations of each site in relation to their phase of establishment. Data show that there are some components of the EPPIC model that are better implemented than others. These data will give an initial snapshot of the adherence of the sites to the EPPIC model. Also presented will be the means by which reporting back from the assessments to the sites will facilitate closer adherence to the model.Model fidelity is an increasingly recognised way to ensure that programs based on evidence continue to deliver high quality outcomes, and avoid drifting away from the model. This presentation will demonstrate the outcomes from the first two rounds of application of the EMIT and ways in which fidelity testing can help services to improve their support of young people with early psychosis.


Shim et al.  presenteProspectively guiding catheter ablation for AF by means of personalized computational models is a long desired (Krueger et al., The models used by Shim et al. were individualized only in terms of the anatomy of the endocardial wall. Differences in myocardial wall thickness have been reported to influence AF dynamics (Biktasheva et al., In addition to the possible improvements regarding model fidelity and personalization, the virtual ablation method and assessment of its success give opportunities for further optimization. The set of ablation strategies to choose from was rather limited in the study by Shim et al. and other approaches could be required to obtain optimal results (Bayer et al., In conclusion, we would like to point out that the work by Shim et al. is an outstanding example of translating computational modeling to the clinical environment and encourage everyone to follow down this road. On the other hand, we want to highlight that the results on efficacy of computationally guided ablation should be considered a lower bound rather than a representative example of what value personalized electrophysiological modeling can potentially add. We hope that the work by Shim et al. will fuel the development and facilitate the use of more sophisticated models under clinical constraints to leverage the full power of computational modeling approaches in the near future.All authors listed have made a substantial, direct and intellectual contribution to the work, and approved it for publication.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


The Journal and the authors retract the 9 February 2017 article cited above.Following article publication, the authors reported that the data upon which the study was based is inconsistent with their own archived data files. Since this discrepancy cannot be resolved by the authors, the authors request that the paper be retracted.The retraction of the article was approved by the Field Chief Editor of Frontiers in Molecular Biosciences.


In addiMaterials for any inconvenience caused.MDPI is a member of the Committee on Publication Ethics and takes the responsibility to enforce strict ethical policies and standards very seriously. To ensure the addition of only high quality scientific works to the field of scholarly publication,  is retra


We review key aspects of what is known about limb regeneration in urodele and anuran amphibians, with a focus on the early events of the process that lead to formation of the regeneration blastema. This includes the role of the nerves and wound epithelium, but also covers the inflammatory effects of the amputation trauma and their importance for regenerative growth. We propose that immunotolerance is important for limb regeneration and changes in its regulation may underlie the loss of regenerative capacity during anuran metamorphosis.


After publication of the original article , it cameDr Anna Wolska processed and analysed the NMR lipoprotein samples at the earliest stage of data analysis of this manuscript. Subsequently many other statistical analysis were performed and with the gap time between all the data to be analysed and the manuscript to be completed her important contribution was forgotten.Dr Wolska has no competing interests to declare.


The awareness of mental disorder or insight refers to the ability to perceive the disorder itself and the symptoms, the effects of the treatment and the social consequences of the disorder; and also the ability to attribute the symptoms to a mental disorder. Lack of insight is frequent in schizophrenia and is associated with a low adherence to the treatment and to a worse evolution. A greater insight has been associated with a lower psychopathological severity and with higher levels of depression.On the other hand, subjective insight refers not only to what happens to the patient but also to how he feels and to the perception of the changes that he undergoes during the psychotic experience. The subjective perception of change is a position that can easily lead to connect with painful and depressive feelings, so it can be assumed that subjective insight could be related more consistently with the depressive symptoms than the clinical insight.Observational cross-sectional study of a group of 114 schizophrenia patients treated in the psychiatry devices of the Parc de Salut Mar and Parc Taulí Instruments: SUMD, Markova and Berrios Scale and Calgary scale for depression in psychosis.Subjective insight is significantly correlated with Lindenmayer’s depressive factor and depression level measured by a Calgary scale.Clinical insight correlates with positive and excitatory symptoms. The time of evolution explains the non-awareness of the social consequences of the disease.The subjective insight into schizophrenia is mainly related to the depressive symptoms. The clinical insight into schizophrenia is related to positive symptoms.


The latter finding is of particular importance given the extent to which animal models are used in understanding the reward systems of the human mind. It is clear that further studies are needed to learn about the human reaction to reward in its entirety, including any distinctions between conscious and unconscious behaviours. We propose that studies of reward entail a measure of the animal's (human or nonhuman) knowledge of the reward and knowledge of its own behavioural outcome to achieve that reward.Animal models of reward processing have revealed an extensive network of brain areas that process different aspects of reward, from expectation and prediction to calculation of relative value. These results have been confirmed and extended in human neuroimaging to encompass secondary rewards more unique to humans, such as money. The majority of the extant literature covers the brain areas associated with rewards whilst neglecting analysis of the actual behaviours that these rewards generate. This review strives to redress this imbalance by illustrating the importance of looking at the behavioural outcome of rewards and the context in which they are produced. Following a brief review of the literature of reward-related activity in the brain, we examine the effect of reward context on actions. These studies reveal how the presence of reward vs. reward


Touching is often a forgotten part of medicine. The manual medicine or therapeutic touch (TT) is much more powerful than many modern, biomedically oriented physicians think. Pain and discomfort can be alleviated just by touching the sick area and in this way help the patient to be in better contact with the tissue and organs of their body. Lack of presence in the body seems to be connected with many symptoms that can be readily reversed simply by sensitive touch. When touch is combined with therapeutic work on mind and feelings, holistic healing seems to be facilitated and many problems can be solved in a direct and easy way in the clinic without drugs. This paper gives examples of the strength of manual medicine or therapeutic touch in its most simple form, and points to the power of physical contact between physician and his patient in the context of the theory and practice of holistic healing. Intimacy seems highly beneficial for the process of healing and it is very important to distinguish clearly between intimacy and sexuality for the physician and his patent to be able to give and receive touch without fear and without holding back emotionally.


Rett syndrome (RS) is a neurological disorder affecting mainly females. RS is considered the second most frequent cause for severe and complex neurological dysfunction in females after Down syndrome. Patients with RS are characterized by an array of neurological and orthopedic difficulties that mandate an intensive therapeutic intervention program for the duration of the individual's life. Many aspects of the clients well-being and functional status depend on the therapeutic intervention she receives and on her compliance to it. This article will briefly review common intervention approaches for individuals with RS and their present day's application. Due to the notion that individual intervention is the foundation on which progress and development of the functional gains rests, the present article will place basic guidelines for individual intervention with clients with RS. The article is mainly based on the clinical experience of the author and others working with individuals with RS.


It has been assumed that impaired intellectual capacity could act as a buffer to suicidality in the population of children and adolescents with intellectual disability. The few studies that have been conducted contest this assumption, and in fact, the findings showed that the characteristics of suicidality in the population of children and adolescents with intellectual disability are very similar to other adolescents without intellectual disability. This paper reviews the few studies conducted and describe the symptomatology in this population.


Suicide is today in the Western world one of the leading causes of death and most people have had suicidal ideation at some time during their life. In the population of persons with intellectual disability some researchers have thought that impaired intellectual capacity could act as a buffer to suicidal behavior, but the fact is that the few studies conducted in that population contest this assumption and showed that the characteristics of suicidality in this population are very similar to persons without intellectual disability. This paper reviews the studies conducted and describe the symptomatology in this population. Professionals working with this population should therefore be aware of and assess for this behavior. Sadness or depression are symptoms that could indicate later suicidal behavior.


Currently little is known about the prevalence and etiology of depression in the athletic population (Nixdorf et al., Mental health stigma is a hurdle that is prevalent in the sport context and one that is particularly challenging in the patriarchal culture of elite sport. This paper draws attention to the poignant issue that men's experience of gender role conflict may be associated with an increased endorsement of stigmatization around mental health concerns (Gulliver et al., As noted by Doherty et al. , public Doherty et al.  do not pExperiencing mental health problems may be described as clinical or sub-clinical, for example. If we truly view mental health as a continuum, then the quality of an individual's mental health needs may provide insight into the possible levels and layers of the construct. Depression is fraught with inherent operational definitional difficulties because of the multi-layered and multifaceted nature which requires additional research from the clinical domain but also the different contextual environments. These may additionally highlight when and how individuals withdraw from their work, how and why conflicts develop and indicate the pattern of avoidance of seeking help. The suppression of emotion may have been misinterpreted in previous literature as mood states and depression have become interchangeably linked (Lane and Terry, Arguably, there needs to be care with the interpretation of some of the findings. Many of the symptoms of depression experienced by the male athletes in this study have been negatively portrayed and it is not known, as the data is retrospective, if the individual's perception was distorted by decaying memories. It was not always clear of the timelines of the stressors they faced in relation to their depressive episodes. Triangulation of the data by interviewing others within their sporting system or members of their social support structure would have provided a more valid and accurate narrative to emerge.Athletes, particularly those recovering from injury, should be supported by all members of multi-disciplinary teams not just to seek help for mental disorders, but to develop their positive mental health through access to appropriate medical and sport science professionals. As a result, depression should be viewed as an inclusive challenge for all in high performance sport, from performers to practitioners. If we are to diminish the impact of mental health stigma then mental health is not simply an issue for an individual and their psychologist, but it is a challenge for sporting communities at large.The author confirms being the sole contributor of this work and approved it for publication.The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


Paediatric radiology is a unique field of radiology defined by age as opposed to regional or systemic anatomy. The European Society of Paediatric Radiology (ESPR) was founded in 1963 and its mission was to bring together physicians involved in imaging children, contribute to the progress of paediatric imaging, and encourage training and education [The ESPR decided to launch the diploma for a number of reasons. There is no set European reference standard for training in our subspecialty. Across many European countries, the training standard achieved is often assumed to be adequate, depending on the reputation of the institution where one undergoes their higher training. The level of such training can be very variable and reproducible evidence of the standard achieved is challenging. Paediatric radiology questions may constitute a minority in, or even be absent from, national radiology exams. The ESPR has a responsibility to ensure that this gap is filled. Acquisition of a standardised diploma confirms to the training specialists that they have followed a robust educational curriculum delivered by leaders in the field. Reassurance is also provided to their current or future employers through the knowledge that their employed paediatric radiologists are trained to a set standard and that such training has been accredited by the recognised specialist European body. The European Diploma in Paediatric Radiology is a measure of excellence, which certifies that the holder has a level of knowledge and competence in line with the requirements of the European Society of Radiology training curricula for paediatric radiology –4.The ESPR aims to target radiology residents, paediatric radiology fellows and junior faculty with an interest in paediatric radiology. Previous experience and training in paediatric radiology are practically mandatory for successful completion of the full cycle for the European Diploma in Paediatric Radiology. The ESPR Education and Professional Development Committee recommendation is that the diploma curriculum  would be ideally covered during subspecialty training. Consequently, candidates should preferably be in at least their third year of national radiology training at the time of their first course and examination.The European Course in Paediatric Radiology has been run successfully since 1992 through a rolling cycle of anatomically based topics  . After rAs the educational curriculum matures, more material will be delivered through online modules for ESPR members and European Course in Paediatric Radiology attendees. All steps required for completing the diploma are outlined in Fig. The European Course in Paediatric Radiology will remain accessible to individuals who are not intending to complete the diploma and would like to simply enhance or renew their knowledge by attending the individual courses and targeting the body systems in question. The ESPR remains committed to keeping both the location and the cost of the three European Course in Paediatric Radiology modules as accessible as possible. Geography or cost should not act as barriers to candidates who wish to complete this training.The first eligible European Course in Paediatric Radiology delivering a section of the newly mapped European Diploma in Paediatric Radiology curriculum was held in Utrecht, the Netherlands, on October 11–13, 2017. The course covered paediatric musculoskeletal imaging. An international specialist faculty kindly agreed to deliver this teaching material through didactic lectures and interactive sessions within the boundaries of the diploma curriculum. Sixty-one of the 150 course attendees participated in the examination at the end of the course.The inaugural assessment of the European Diploma in Paediatric Radiology will be held in June 2020 during the ESPR annual meeting and after completion of the first eligible European Course in Paediatric Radiology three-part cycle. Final assessment for the diploma will then be available at every ESPR annual meeting. It will be the responsibility of the Education and Professional Development Committee of the ESPR to run this assessment.With the launch of the European Diploma in Paediatric Radiology, the ESPR is providing a new European standard of competence and certification. We urge senior European paediatric radiologists and paediatric radiology experts outside Europe to embrace this initiative by encouraging trainees and fellows to attend the European Course in Paediatric Radiology cycle and, if called upon by the ESPR, through their delivery of lectures and educational material in line with the diploma curriculum.


In 1997, the European Paediatric Orthopaedic Society (EPOS) initiated an international survey of musculoskeletal problems in individuals with Down syndrome. The goals of the study were far-reaching and ambitious in order to obtain a clear picture of the variety of orthopedic problems associated with Down syndrome, to relate their occurrence to other medical conditions, and to record and compare methods of treatment. The survey was to be international in scope, including orthopedic surgeons and departments across Europe and outside Europe. The study was coordinated from the Tel Aviv University in Israel as a multicenter study using electronic technology. This paper describes the organization and implementation of the EPOS Down Syndrome Survey, with special emphasis on the sophisticated electronic data entry instrument that was developed especially for the survey. It is concluded that computerized data entry forms like the one that we developed for the EPOS Down Syndrome Survey are valuable tools for medical surveys. They are especially important for multicenter and multinational studies.