Activity

We present the case of a 31-year-old soldier who developed three independent melanomas in only 2 years. We saw two mucosal melanomas and one nodular melanoma of the scalp. The last one led to a cerebral metastasis during the course of the follow-up. After complete resection and under ongoing immunotherapy with nivolumab, there was no progression of disease until December 2019. learn more The Karnofsky index remained at 100% and there were no side effects of therapy. Besides fair skin type, no other risk factors for the development of melanomas were identified, even after performing genetic analysis.The German Armed Forces evaluate the required health of candidates and military personnel by using specific examination standards. In particular cases, the examining physician can request consultation with a medical specialist. The Armed Forces dermatologists support the assessment of the skin, mucous membranes, neoplasms of the skin, and allergies. The following is a short review of the basic essential military dermatologic decision criteria including the currently valid regulations in order to make it easier to take into consideration the reports from pretreating civilian physicians and to improve their integration into the military medical assessment.The importance of place in landscape management and outdoor recreation has been prominent in the literature since the 1970s. As such, calls to incorporate place into the management of parks, forests, and other protected areas exist. However, little work explores how place attachment may complement existing management frameworks. Hence, the purpose of this investigation was to explore levels of visitors’ place attachment intensity across the six classes of the Recreation Opportunity Spectrum (ROS). Survey data collected in North America and Europe indicated there was more similarity in place attachment intensities among areas classified toward the less developed end of the ROS, while greater variation existed among the more developed sites. Observing place attachment across all six ROS classes allowed for a deeper understanding of the correlation between place and the management framework.Tropical forest landscapes are undergoing rapid transition. Rural development aspirations are rising, and land use change is contributing to deforestation, degradation, and biodiversity loss, which threaten the future of tropical forests. Conservation initiatives must deal with complex social, political, and ecological decisions involving trade-offs between the extent of protected areas and quality of conservation. In Cambodia, smallholders and industrial economic land concessions drive deforestation and forest degradation. Rural economic benefits have not kept pace with development aspirations and smallholders are gradually expanding agriculture into protected forests. We examine the drivers and effects of rural forest landscape transitions in Cambodia to identify trade-offs between conservation and development. Using historical trends analysis and information gathered through key informant interviews, we describe how local communities perceive social and ecological changes, and examine the implications of local development aspirations for conservation. We explore three scenarios for the future of conservation in Cambodia, each with different conservation and community development outcomes. We contend that conservation efforts should focus on strengthening governance to meet social and environmental requirements for sustainable forest landscapes. We suggest potential entry points for governance improvements, including working with local decision-makers and fostering collaboration between stakeholders. There is a need for realistic priority setting in contested tropical forest landscapes. Prosperous rural economies are a necessary but not sufficient condition for conservation.BACKGROUND The shoulder girdle is a chain of bones and joints which connect the upper extremity to the axial skeleton. The shoulder as a biomechanical unit has a remarkable range of motion and is therefore frequently prone to injuries of the three major joints (sternoclavicular joint, acromioclavicular joint, glenohumeral joint) and the bony elements (clavicle, scapula, humerus). Projection radiography is still the first imaging modality for injuries of the shoulder and usually sufficient for initial diagnosis and injury classification. Computed tomography (including 3D reconstructions) and magnetic resonance imaging provide additional useful information for the detection of accompanying soft-tissue injury, for surgical planning and in cases of complex anatomy (e.g., scapular fractures). PURPOSE We aim to describe the fundamentals of injuries of the shoulder girdle and the proximal humerus with special emphasis on radiological diagnostics. MATERIALS AND METHODS A selective PubMed literature search was performed using the following terms “sternoclavicular joint dislocation”, “clavicle fracture”, “acromioclavicular joint injury”, “scapular fracture”, “shoulder dislocation”, “proximal humerus fracture”, and “shoulder girdle injuries”. RESULTS The article describes the basics of the anatomy, the trauma mechanism and the epidemiology of the most common injuries of the shoulder girdle and the proximal humerus. Special emphasis is given to radiological diagnostics, including basic projection radiography and advanced cross-sectional imaging.Arm swing movement is coordinated with movement of the legs during walking, where the frequency of coordination depends on walking speed. At typical speeds, arm and leg movements, respectively, are frequency locked in a 11 ratio but at slow speeds this changes to a 21 ratio. It is unknown if the changes in interlimb ratio that accompany slow walking speeds alters regulation of somatosensory feedback. To probe the neural interactions between the arms and legs, somatosensory linkages in the form of interlimb cutaneous reflexes were examined. It was hypothesized that different interlimb frequencies and walking speeds would result in changes in the modulation of cutaneous reflexes between the arms and legs. To test this hypothesis, participants walked in four combinations of walking speed (typical, slow) and interlimb coordination (11, and 21), while cutaneous reflexes and background muscle activity were evaluated with stimulation applied to the superficial peroneal nerve at the ankle and superficial radial nerve at the wrist.