The history of political events is made by people. From wars to elections to political protests, the choices we make, our actions, how we behave, dictate events. Not all individuals have the same impact on our world and our lives. Some peoples' choices alter the pathways that history takes. In particular, national chief executives play a large role in forging the destinies of the countries they lead. Why Leaders Fight is about those world leaders and how their beliefs, world views, and tolerance for risk and military conflict are shaped by their life experiences before they enter office - military, family, occupation, and more. Using in-depth research on important leaders and the largest set of data on leader backgrounds ever gathered, the authors of Why Leaders Fight show that - within the constraints of domestic political institutions and the international system - who ends up in office plays a critical role in determining when and why countries go to war.

Adapalene, a novel topical retinoid receptor agonist has been developed for the treatment of acne vulgaris by CIRD Galderma in France. It has been commercialised in Europe since 1995 as an aqueous gel (Differin 1 gel) and has shown good efficacy and tolerance in the topical treatment of acne vulgaris. 1±4 The profile of adapalene as a molecule is that of a retinoid, since it acts as a retinoid agonist, but the affinity profile for nuclear and cytosolic retinoic acid receptors is different from that of tretinoin. 5 Whereas tretinoin binds to all RARs (a, b and g) adapalene has selective affinity to RAR-b and RAR-g. Additionally, adapalene is very stable even in presence of a strong oxidizer and light and is highly lipophilic. 5 After application of an aqueous gel formulation, it shows high concentrations in the follicle 6 (Fig. 1).In clinical practice up to now, selection of the retinoid formulation is directly related to cutaneous adverse effects. Creams seem to be well tolerated, gels (alcoholic) and solutions tend to cause more irritation. Ideally, a non-greasy formulation, a gel or solution should provide the best balance of cosmetic acceptability and tolerance.This study was conducted to compare efficacy and safety of adapalene 0 . 1% solution in a large number of patients with acne vulgaris, with those of a marketed product, tretinoin 0 . 025% gel. Materials and methodsThis multicentre study was designed to evaluate and compare the safety and efficacy of adapalene 0 . 1% solution (Differin 1 0 . 1% solution, Galderma Lab) with tretinoin 0 . 025% gel (Retin A 1 0 . 025% gel, Johnson & Johnson) in patients with acne vulgaris. Two hundred and ninety-seven patients (149 receiving adapalene and 148 tretinoin) were enrolled by eight investigators in this randomized, investigator-masked, multicentre, parallel group comparison. All consentaged patients signed an IRB (Institutional Review Board) approved written informed consent form. Patients below the age of consent signed the consent form as did their parent(s) or guardian(s). At week 12, at five sites patients from both groups were given the option to continue under open label conditions with adapalene

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). CME Objectives: On completion of this article, the reader should be able to summarize the role of synthetic and biologic materials in the operative management of pelvic organ prolapse.Pelvic organ prolapse is a spectrum of anatomical abnormalities associated with pelvic floor dysfunction and abnormal descent of the rectum and other abdominal structures into the pelvis. It results from the loss of support to the structures contained within the bony pelvis: from anterior to posterior, the bladder, uterus, vagina, and rectum. Frequently, diastasis of the levator ani, an abnormally deep cul-de-sac, a redundant sigmoid colon, a patulous anal sphincter, and/or the loss of rectal sacral attachments are present.1-4 Enterocele, rectocele, rectal prolapse, and total pelvic organ prolapse are benign conditions, which cause significant morbidity including pelvic discomfort, chronic drainage of blood, and/or mucous from the anus as well fecal incontinence and constipation and obstructed defecation symptoms. 5-9The development of pelvic organ prolapse is multifactorial. A combination of genetic and acquired factors, including pregnancy, increased parity, hormonal deficiencies, myopathy, neuropathy, obesity, smoking, pulmonary disease, and obstipation, contributes to the weakening of the pelvic floor.10 Several studies have demonstrated that these factors disturb the pelvic floor tissues at a molecular level, altering the composition, quantity, and organization of collagen, elastin, and smooth muscle in the urogenital tissues. 11,12Several studies have demonstrated a total decrease in the overall collagen content within the supportive pelvic tissues of patients with pelvic organ prolapse. Additionally, the ratio of collagen III/I is altered favoring an increase in collagen III, which is more compliant and distensible. The increased turnover of immature collagen and decreased elastin levels Keywords ► pelvic organ prolapse ► ventral mesh rectopexy ► biologic mesh AbstractPelvic organ prolapse is a significant medical problem that poses a diagnostic and management dilemma. These diseases cause serious morbidity in those affected and treatment is sought for relief of pelvic pain, rectal bleeding, chronic constipation, obstructed defecation, and fecal incontinence. Numerous procedures have been proposed to treat these conditions; however, the search continues as colorectal surgeons attempt to find the procedure that would optimally treat these conditions. The use of prosthetics in the repair of pelvic organ prolapse has become prevalent as the benefits of their use are realized. While advances in biologic mesh and new surgical techniques promise improved functional outcomes with decreased complication rates without de novo symptoms, the debate concerning the best prosthetic material, synthetic or biologic, remains controversial. Furthermore, laparoscopic ventral mesh rectopexy has emerged as a procedure that could potentially fill this role and is rapidly becoming the procedure of choice for the surgical treatment of pelvic org...

Prediction markets are designed to aggregate the information of many individuals to forecast future events. These markets provide participants with an incentive to seek information and a forum for interaction, making markets a promising tool to motivate student learning. We carried out a quasi-experiment in an introductory political science class to study the effect of prediction markets on student engagement with the course topics. Although we found no significant improvement in students' enthusiasm or extent of topical reading, we did find that those students who were already reading broadly at the course start were more likely to trade actively in the markets. These findings indicate that prediction markets may be most successful as an education tool in settings, like graduate education, where individuals are already knowledgeable about the topics of the market, instead of an introductory learning context.