Use of the AO plate for immediate mandibular reconstruction in cancer patients

Free vascularized bone grafts have revolutionized mandibular reconstruction, yet their use in all mandibulectomy patients is not always necessary. A recently developed alternative to bony reconstruction has been the use of the AO reconstruction plate. We compared the use of the AO reconstruction plate with immediate free bone graft mandibular reconstruction in 31 patients. Reconstruction plates were used in 20 and immediate free bone grafts were used in 11 patients. The overall success rate for use of the plate was 15 of 20 (75 percent). There were 6 anterior reconstructions, of which only 2 (33 percent) were successful. This is opposed to 13 of 14 (93 percent) lateral reconstructions that were successful in lateral plate placements. There were 11 immediate composite free flaps: 4 iliac crest, 4 scapula, 2 fibula, and 1 composite radial forearm flaps. Six repairs were for anterior defects, and there were 5 full-thickness defects, 3 of which were in the anterior position. All 11 flaps were successful. In conclusion, we believe the reconstruction plates are a useful adjunct for mandibular replacement in the head and neck cancer patient but should be reserved for lateral defects. For anterior reconstructions, even in patients with locally advanced disease, free-tissue transfer of composite osteocutaneous flaps is the reconstructive method of choice.     

Selecting flagships for invertebrate conservation

Invertebrates have a low public profile and are seriously underrepresented in global conservation efforts. The promotion of flagship species is one way to generate interest in invertebrate conservation. Butterflies are frequently labeled invertebrate flagships, but clear definitions of the conservation actions they are meant to catalyze, and empirical assessments of their popularity amongst non-Western audiences are lacking. To improve the use of invertebrate flagships, we examine how butterflies compare with other taxa in terms of popularity. We then identify characteristics of individual species that are appealing and explore whether these may be used to derive a set of guidelines for selecting invertebrate flagships. We conducted questionnaire-based surveys amongst two target audiences: rural residents (n = 255) and tourists (n = 105) in northeast India. Invertebrates that were aesthetically appealing, or those that provided material benefits or ecological services were liked. Butterflies were the most popular group for both audiences, followed by dragonflies, honeybees and earthworms. A combination of large size and bright colours led to high popularity of individual species, whilst butterflies with unique features were liked by tourists but not rural residents. These results provide empirical evidence that butterflies appeal to diverse audiences and have the potential to be deployed as flagships in different contexts. However, prior to promoting invertebrate flagships, their intended uses need to be specified. Here we define an invertebrate flagship as an invertebrate species or group that resonates with a target audience and stimulates awareness, funding, research and policy support for the conservation of invertebrate diversity. In conclusion we outline a set of heuristic guidelines for selecting flagships to raise awareness of invertebrate diversity and conservation.     

Selecting candidates for radical prostatectomy

Men with clinically localized prostate cancer and their physicians are faced with the management decision of radical prostatectomy, radiation therapy, or watchful waiting. Who is the best candidate for radical prostatectomy? Is cure the only relevant outcomes parameter? Does age make a difference? Are imaging studies necessary? This review provides answers, step-by-step, in the decision-making process.     

Selecting Trade Books for Elementary Science Units

Understanding the concept of electromagnetic radiation (EMR) and its interaction with matter (absorption, reflection, and transmission) can be difficult for students in seventh and eighth grade physical science classes. This inquiry-based activity (IBA) is aimed at improving their understanding of these concepts by exploring the interaction of EMR with leaves of different plant species or health conditions. Incorporating at least two different types of leaves from the local environment and measuring their interaction with EMR peaks student interest in this activity. After completing this IBA, students will see how objects interact in different regions of the electromagnetic spectrum and gain a better understanding of phenomena such as reflection and absorption. Further, this IBA can help them understand how human eyes perceive different colors. This activity can be expanded by a biology teacher to include a discussion about leaf pigments and how their interaction with EMR determines the colors of leaves. Concepts covered in this IBA can be related to remote sensing science and how sensors on board satellites collect Earth Observation data.     

Selecting shelter dogs for service dog training

Service dogs are an essential aid to persons with disabilities, providing independence, mobility, and improved self-esteem. Because of these proven benefits, the growing use of service dogs is creating a demand and supply crisis. One major cause is the 50% average dropout rate for dogs selected for training. Weiss and Greenber (1997) recently found that a dog, successful on the most commonly used selection test items, was as likely to be either a poor or a good candidate for service work. The experiment presented here evaluated test items developed by the author in 15 years of experience with dogs. The test items were administered to 75 dogs from the Kansas Humane Society. Once tested, the dogs received obedience and retrieval training. The experiment assessed each dog on behavior over 5 weeks of training versus performance on each selection test item. A subset of the selection items, combined in a regression analysis, accounted for 36.4% of the variance with R = 0.603. This research also revealed a reliable test for dog aggression without risking injury to dog or tester. Items for testing included fear, motivation, and submission. Another set of selection items reliably predicted the trait of “high energy ”commonly described as “high strung. ”Future research should involve investigating the effectiveness of both cortisol levels and blood pressure in predicting traits to help strengthen the predictive value of the tool and then testing on dogs trained to be full service dogs.     

Selecting a medical therapy for overactive bladder

Immediate-release oxybutynin was the gold standard for pharmacologic treatment of overactive bladder for nearly 30 years. Intolerable systemic side effects, in particular dry mouth, limited its clinical utility, resulting in poor patient compliance with dosing regimens. Multiple studies have demonstrated the vastly superior tolerability of tolterodine, extended-release tolterodine, and extended-release oxybutynin over that of immediate-release oxybutynin at equivalent doses, and in the case of extended-release oxybutynin even to twice the dose of the original immediate-release form. With different drug delivery systems and, perhaps, with better bladder selectivity, these new oral agents have favorable side effect profiles, which translate into higher patient compliance and fewer treatment withdrawals or dosage reductions.     

Selection criteria for successful immediate breast reconstruction

To evaluate the factors leading to success in immediate breast reconstruction after mastectomy, 176 consecutive immediate reconstructions done with implants or expanders over a 5-year period were analyzed. None of these 176 had "complete muscle coverage." There were only five failures: four with implant loss (one involving radiation) and one removed electively. The failures were 1 in 40 regular implants, 4 in 77 temporary expanders, and 0 in 59 long-term expanders. There is no other report in the literature comparing these different types of implants. Various hypotheses for failure are reviewed. It is concluded that failure in immediate reconstruction is not related to use of drains, bilaterality, or lack of "complete muscle coverage." It is concluded that failure is related to implant type, prior radiation, and most of all to suboptimal patient selection. Specific selection criteria and operative techniques are discussed.