This model was applied to assess HiAP growth processes within 16

This model was applied to assess HiAP growth processes within 16 municipalities in the Netherlands. We used municipal policies on health inequalities as a case. Empirical data was gathered based on document analysis, a questionnaire and interviews.

Results: Using this model we were able to classify HiAP growth processes by several characteristics, such as the recognition of the importance of HiAP (Stage I; four municipalities), HiAP described in policy documents and collaboration with sectors present (Stage

II; seven municipalities), concrete collaboration agreements and structural consultations forms (Stage III; four municipalities), and a broad, shared vision on HiAP (Stage IV; two municipalities). Examples of necessary conditions

were sufficient support and resources.

Conclusions: This study shows that it is possible to apply a maturity model to classify stages of HiAP in municipalities. Use of the MM-HiAP as a formal measuring instrument depends on further operationalization and validation. (C) 2013 Elsevier Ireland Ltd. All rights reserved.”

A retrospective study, based on 60 990 farrowing records from 35 commercial herds, 3-MA concentration was performed to determine the incidence of early parturition (< 114d) and to investigate the relationship between early parturition and total number of piglets born, number of piglets born alive and percentage of stillborn piglets per litter. The mean gestation length was 115.4 +/- 1.62d, and early parturition occurred in 10% of all farrowing records. Sows with early parturition had significantly more stillborn piglets and a larger litter size compared to sows with a normal gestation length (114-117d). Sows with a gestation length < 114d were 1.2 times (95% CI: 1.19-1.21; p < 0.001) more likely to have an

early parturition at the subsequent parity. A second study was performed in four herds (n = 329) to investigate the efficacy of altrenogest administration on 110-112d (T112) or 111-113d (T113) of gestation for preventing early parturition and to investigate the effect of this treatment on the reproductive performance of sows. The interval between the last altrenogest treatment and the onset of parturition was 3.3 +/- 1.32 (T112) BMS-754807 mw or 2.0 +/- 0.89 (T113) days. The gestation length of sows of the altrenogest group (T112 + T113) (115.3 +/- 1.23d) was significantly longer compared to gestation length of the non-treated sows (114.7 +/- 1.69d) (p < 0.01). Altrenogest treatment had no negative effect on the reproductive performances of the sows. In conclusion, the administration of altrenogest in late gestation is an effective and safe method to prevent early parturition and can counteract the reproductive losses because of premature farrowing, which may occur in a substantial part of the farrowing events.

In this article, we discuss the challenges to accurate nodal stag

In this article, we discuss the challenges to accurate nodal staging of patients with rectal cancer, and demonstrate how USPIO may be applied to rectal cancer imaging to identify nodal involvement.”
“Diazoxide is the main therapeutic agent for persistent hyperinsulinemic

hypoglycemia. Generally, it is tolerated well, but rarely it can cause severe life-threatening complications. We report a neonate who was treated with diazoxide for hyperinsulinemic hypoglycemia. On the 6th buy EVP4593 day of the treatment we observed sepsis-mimicking symptoms, mild pulmonary hypertension, and re-opening of the ductus arteriosus. All these findings resolved dramatically shortly after discontinuation of treatment. To our knowledge, this is the first reported case of re-opening of the ductus arteriosus this website due to diazoxide toxicity.”
“The interictal EEG is a noninvasive and useful test for selecting candidates for resective epilepsy surgery, although it has many pitfalls. It is an essential test for the most common drug-resistant epilepsy, mesial temporal sclerosis, and predicts good

outcome when interictal epileptiform discharges are concordant with unilateral hippocampal atrophy or sclerosis, and predicts poor outcome when interictal epileptic discharges are discordant with the lesion. Its role in other types of epilepsy surgery, including nonlesional cases and corpus callosotomy, is less clear. Future research gathering large multicenter prospective data is needed to maximize the role of this classic neurophysiological test in the evaluation of candidates

for epilepsy surgery. (C) 2010 Elsevier Inc. All rights reserved.”
“A group of eight patients Selleck LY333531 with severe depression lasting 6 years or longer were treated with anterior capsulotomy and followed prospectively. Stereotactic surgery was used to produce radiofrequency lesions in the anterior limbs of both internal capsules. For all patients, there are follow-up data for at least 24 months. At 24-to-36 months postoperatively, four patients were either not-depressed or mildly depressed; one was mildly-to-moderately depressed; one was moderately-to-severely depressed; and only one remained severely depressed. One patient developed a progressive vascular dementia with parkinsonism caused by autopsy-proven arteriolosclerosis. (The Journal of Neuropsychiatry and Clinical Neurosciences 2012; 24:176-182)”
“Study Design. To examine the effects of a tumor necrosis factor (TNF)-alpha antagonist (etanercept) on rat spinal cord injury and identify a possible mechanism for its action.

Objective. To elucidate the contribution of etanercept to the pathologic cascade in spinal cord injury and its possible suppression of neuronal and oligodendroglial apoptosis.

Summary of Background Data.

The other 5 patients, three males and two females [median age of

The other 5 patients, three males and two females [median age of 60.5 (range MCC950 in vitro 39 to 75) years]

underwent en bloc anatomical lung resection in addition to chest wall excision and reconstruction for T3N0 lung cancer.

In these five cases the chest wall opening was restricted to the extent of the rib excision, and the pulmonary resection was performed via the existing chest wall opening without requiring extension of the thoracotomy or any rib spreading.

Minimally invasive techniques aid to delineate the boundaries of chest wall involvement of lung cancer and intraoperative staging. This helped tailoring the surgical approach and location of the thoracotomy, and prevented rib-spreading or additional thoracotomies in our cases.”
“A variety of microorganism species are able naturally to produce 2,3-butanediol (2,3-BDO), although only a few of them are suitable for consideration as having potential for mass production purposes. Klebsiella pneumoniae (K. pneumoniae) is one such strain which has been widely studied and used industrially to produce 2,3-BDO. BYL719 price In the central carbon metabolism of K. pneumoniae, the 2,3-BDO synthesis pathway is dominated by three essential enzymes, namely acetolactate decarboxylase, acetolactate synthase, and butanediol dehydrogenase, which are encoded by the budA, budB, and budC genes, respectively. The mechanisms

of the three enzymes have been characterized with regard to their function and roles in 2,3-BDO synthesis and cell growth (Blomqvist et al. in J Bacteriol 175(5):1392-1404, 1993), buy PFTα while a few studies have focused on the cooperative mechanisms of the three enzymes and their mutual interactions. Therefore, the K. pneumoniae KCTC2242::Delta wabG wild-type strain was utilized to reconstruct seven new mutants by single, double, and triple overexpression of the three enzymes key to this study. Subsequently, continuous cultures were performed to obtain steady-state metabolism in

the organisms and experimental data were analyzed by metabolic flux analysis (MFA) to determine the regulation mechanisms. The MFA results showed that the seven overexpressed mutants all exhibited enhanced 2,3-BDO production, and the strain overexpressing the budBA gene produced the highest yield. While the enzyme encoded by the budA gene produced branched-chain amino acids which were favorable for cell growth, the budB gene enzyme rapidly enhanced the conversion of acetolactate to acetoin in an oxygen-dependent manner, and the budC gene enzyme catalyzed the reversible conversion of acetoin to 2,3-BDO and regulated the intracellular NAD(+)/NADH balance.”
“The acute anti-inflammatory properties of a fraction rich in the chalcones lonchocarpin and derricin, from the roots of Lonchocarpus sericeus (HFLS), were studied for the first time, using a paw oedema model induced in rats by various stimuli.

We analyzed pump flow, driving pressure, and vacuum of the Thorat

We analyzed pump flow, driving pressure, and vacuum of the Thoratec driving console and recovery of kidney (creatinine, blood urea nitrogen) and liver function (bilirubin).

RESULTS: Mean duration of BiVAD support was 84 +/- 72 days. BiVAD weaning was successful in 4 of 31 patients (13%), 12 underwent cardiac transplantation (39%), and 15 (48%) died. We observed significantly higher pump flow of the LVAD and RVAD in patients after biapical cannulation compared with

those with conventional cannulation (LVAD, 5.6 +/- 0.4 vs 5.1 +/- 0.3 liters/min, p = 0.002; and RVAD: 4.9 +/- 0.3 vs 4.2 +/- 0.3 liters/min, p < 0.001). This superior circulatory support correlated with faster recovery of kidney function.

CONCLUSION: Cardiac support Selleck MS-275 with a BiVAD is hemodynamically more effective after biventricular apical cannulation compared with conventional right atrial

cannulation. Consequently, higher pump flow results in better end-organ recovery using biapical cannulation. J Heart Lung Transplant 2011;30:1011-7 (C) 2011 International Society for Heart and Lung Transplantation. All rights reserved.”
“We experimentally demonstrate the absorption properties of designed metamaterial absorbers in the near-infrared ON-01910 nmr wavelength regime. For the rectangular-shaped case, we demonstrate its polarization dependent absorbance at various incident angles. For each polarization, the absorbance is insensitive to the incident angle (up to 60 degrees) and a maximum absorbance of 0.95 is obtained. Of particular interest we experimentally observe an absorption peak corresponding to a high-order resonance at 60 degrees with an absorbance of 0.68 excited by the TM

polarization. For the square-shaped case, we show its polarization-independent absorption property. A maximum absorbance around 0.65 is achieved at normal incidence and it remains high for incidence angles up to 50 degrees. (C) 2011 American Institute of Physics. [doi:10.1063/1.3573495]“
“Objective. GSK2118436 purchase The aim of this study was to classify the opening of the midpalatal suture (MPS) after surgically assisted rapid maxillary expansion (SARME) with disjunction of the pterygomaxillary suture through computed tomography (CT) analysis.

Study design. Seventy adults with bilateral transverse deficiency of the maxilla underwent SARME with pterygomaxillary disjunction. Seventy tomographies were performed before the surgery and 70 were performed after the final activation. The Hass appliance was used in 29 patients and Hyrax in 41 patients. The MPS opening was classified into 2 types: type I, total MPS opening from the anterior nasal spine to the posterior nasal spine, and type II, total MPS opening from the anterior nasal spine to the transverse palatine suture, with partial or nonexistent opening posterior to transverse palatine suture.


Use of antiplatelet agents (44%), angiotensin blockade (56%), or

Use of antiplatelet agents (44%), angiotensin blockade (56%), or statins (44%) was low in patients with newly diagnosed PAD and without other CVD.

Conclusions: About 1 in 20 ambulatory persons > 50 years of age screened had PAD. All cases of PAD that we found were previously undiagnosed, and there was a large treatment gap for those without concomitant CVD.”

DAPT Proteases inhibitor in water productivity and yield arise from interactions between varieties (G) and their management (M). Most GxM interactions considered by breeders and physiologists focus on in-crop management (e.g. sowing time, plant density, N management). However, opportunities exist to capture more water and use it more effectively that involve judicious management of prior crops and fallows (e.g. crop sequence, weed control, residue

management). The dry-land wheat production system of southern Australia, augmented by simulation studies, is used to demonstrate the relative impacts and interactions of a range of pre-crop and in-crop management decisions on water productivity. A specific case study reveals how a novel genetic trait, long coleoptiles that enable deeper sowing, can interact with different management options to increase the Selleck ZVADFMK water-limited yield of wheat from 1.6 t ha(-1) to 4.5 t ha(-1), reflecting the experience of leading growers. Understanding such interactions will be necessary to capture benefits from new varieties within the farming

systems of the future.”
“Blends of linear polyethylene (PE) and isotactic polypropylene (iPP) with different average molar masses and a series of ethylene-propylene (EP) copolymers with different chemical composition as well as blends of PE, Ipp, and EP copolymers were separated using a carbon-column packing (Hypercarb (R)) and gradients of 1-decanol or 2-ethyl-1-hexanol -> 1,2,4-trichlorobenzene (TCB). The separation is based on full adsorption of linear PE on the carbon selleck kinase inhibitor sorbent at temperature 160 degrees C. However, iPP is not adsorbed and elutes in size exclusion mode. The random EP copolymers have been adsorbed in the column packing and separated according to their average chemical composition after application of the gradient starting with alcohol and ending with pure TCB. The elution volumes of the copolymers depended linearly on the average concentration of ethylene in the copolymers. The HPLC elution profiles were correlated with the CRYSTAF elution profiles. In contrast to CRYSTAF, fully amorphous polyolefin samples were separated with the high-temperature adsorption liquid chromatography. (C) 2011 Wiley Periodicals, Inc. J Appl Polym Sci 122: 3211-3217, 2011″
“Background: Our objective was to demonstrate wave propagation and reflection in the canine aorta. Recently we proposed that aortic pressure is the instantaneous sum of wave-related or “”excess”" pressure and reservoir or windkessel pressure.

Furthermore, the effect of ligand and solvent choice is often sub

Furthermore, the effect of ligand and solvent choice is often subtle and unpredictable. This perspective describes how two statistical techniques, design of experiments (DoE) and principal component analysis (PCA), can be combined to guide the decision-making process. The general approach to using these techniques is described, and illustrated with a brief worked example on challenging ‘borrowing hydrogen’ chemistry. The unique combination of DoE and PCA is a useful decision-making tool to support the selection of ligands and solvents for challenging catalytic reactions. (c) 2014 Society of Chemical Industry”
“The find more effects of electronic wave function hybridization are studied in In (Ga)As/GaAs dot

chain samples by means of continuous wave and time resolved photoluminescence BI6727 (PL). A set of wetting layer (WL) states strongly coupled with the quantum dot (QD) heavy hole states is revealed in the PL. The hybridization of states is favored by the presence of a specific one-dimensional postwetting layer that strings together the QDs in each chain. It is demonstrated that the strength of hybridization is significantly weakened for states deep in the WL gap. The hybridization of the WL states and the QD hole

states substantially affects the rates of carrier trapping by the QDs and the carrier distribution. Specific convex shape of the PL transients is related to the presence of long living localized states in the WL energy gap. (c) 2009 American Institute of Physics. [DOI: 10.1063/1.3151707]“
“Tissue engineered bone grafts have the potential to be used to treat large bone defects check details due to congenital abnormalities, cancer resections, or traumatic incidents. Recent studies have shown that perfusion bioreactors can be

used to generate grafts of clinically relevant sizes and shapes. Despite these scientific and technological successes, there is uncertainty regarding the translational utility of bioreactor-based approaches due to the perceived high costs associated with these procedures. In fact, experiences over the past two decades have demonstrated that the widespread application of cell-based therapies is heavily dependent on the commercial viability. In this article, we directly address the question of whether bioreactors used to create bone grafts have the potential to be implemented in clinical approaches to bone repair and regeneration. We provide a brief review of tissue engineering approaches to bone repair, clinical trials that have employed cell-based methods, and advances in bioreactor technologies over the past two decades. These analyses are combined to provide a perspective on what is missing from the scientific literature that would enable an objective baseline for weighing the benefit of extended in vitro cultivation of cells into functional bone grafts against the cost of additional cultivation.

The procedure is performed without cardiopulmonary bypass (CPB) a

The procedure is performed without cardiopulmonary bypass (CPB) and with minimal narcotic and anesthetic exposure. Patients typically do not require blood transfusions or inotropic Support and are extubated at either the end of the procedure or within 24 h of ICU admission. In our experience, the anesthetic management of patients undergoing

the hybrid procedure is straightforward and requires relatively few interventions when compared to traditional neonatal surgical repairs. Deferring the risks of anesthesia, CPB, hypothermic circulatory arrest, and prolonged postoperative sedation may yield developmental advantages to patients born with HLHS.”
“BACKGROUND: Confirmation of cure for multidrug-resistant tuberculosis (MDR-TB) patients requires laboratory tests for Mycobacterium tuberculosis growth on culture media. Outcome decisions dictate patient management, and inaccuracies place patients at an increased risk of morbidity and mortality, and may contribute to continued transmission of MDR-TB.

OBJECTIVE: To examine concordance between programmatic and laboratory-based MDR-TB treatment outcomes.

METHODS: The study population included 1658 MDR-TB patients in

Peru treated between 1996 and 2002 with both program and laboratory-based outcomes. Laboratory-based outcomes Selleckchem Sapanisertib were assigned according to international standards requiring at least five consecutive negative cultures in the last 12 months of treatment to confirm cure.

RESULTS: Compared to the global culture-defined standard classification, only 1.1% of treatment successes, but 54.3% of failures, were misclassified programmatically.

Overall, 10.4% of patients identified by a clinician as having a successful treatment outcome still had cultures positive for MDR-TB.

CONCLUSION: Most patients with successful find protocol treatment outcomes by strict culture definitions were also classified by clinicians as having successful outcomes. However, many culture-confirmed failures were missed. In light of delays and incomplete access to culture in MDR-TB programs, efforts should be made to improve the accuracy of programmatically determined treatment outcomes.”
“Anterior cervical fixation is a procedure widely employed in medical practice, with different fixation systems in use. This study aimed to perform a systematic review of the literature comparing the use of rigid and dynamic cervical plates regarding the fusion rate and complications.

A search was conducted in PubMed, Lilacs, and Cochrane databases and selecting comparative studies on the use of rigid and dynamic cervical plates. Prospective randomized studies were selected to describe the final results regarding the clinical and radiological outcomes; comparative observational studies were also cited. Complications of using the dynamic cervical plate were also evaluated.

Seven comparative studies were included in the review.


0 8 mu m thick films exhibit strong enhancement of th


0.8 mu m thick films exhibit strong enhancement of the critical current density, reaching a maximum of 4.2 MA/cm(2) at 77 K. The result emphasizes the critical role of catalysis for synthesis of novel complex materials. (C) 2010 American Institute of Physics. [doi: 10.1063/1.3517467]“
“Tumor-induced osteomalacia (TIO) is a rare acquired paraneoplastic disease characterized by renal phosphate wasting and hypophosphatemia. Recently, it was reported that tumors associated with TIO produce fibroblast growth factor (FGF) 23, identified as the last member PDGFR inhibitor of the FGF family and of which excessive action causes several hypophosphatemic diseases whereas deficient FGF23 activity results in hyperphosphatemic tumoral calcinosis. In this case, although it was difficult to locate the associated tumor, an abnormal mass in the left maxilla was detected by imaging. The tumor was removed by partial resection of the left maxillary alveolar region. Thereafter, serum level of FGF23 rapidly decreased, hypophosphatemia improved, and the clinical symptoms greatly improved. Histopathologic diagnosis of the tumor was phosphaturic mesenchymal tumor, mixed connective tissue variant. Immunohistochemical findings confirmed that the removed tumor produced FGF23. These results indicate that development of osteomalacia in this patient was related to the maxillary tumor, which overexpressed

Momelotinib in vivo FGF23. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109: e57-e63)”
“The development of metallocene-based catalysts is an important advance on the study of polyolefinic materials. However, due to the rather different conditions that are established in actual applications, only around 3% of these polymers are obtained from metallocene technology. In view of this, novel strategies must be developed to produce metallocene-based catalysts that are more thermally stable, which is a fundamental requirement to establish metallocene technologies.

Homogeneous and heterogeneous polymerizations of ethylene were compared, using the Ph2C(Cp)(Flu)ZrCl2/MAO system. Homogeneous polymerizations were more active than the corresponding supported reactions. At low ethylene pressure, the addition of 1-hexene increases the activity under homogeneous conditions. Nevertheless, this is not observed on the respective supported systems. At higher pressure conditions, all polymerizations attained higher yields. However, when the reaction temperature increases the activity significantly decreases under homogeneous conditions. Furthermore, when the polymerization was performed under heterogeneous conditions the deactivation was lower. The homogeneous and supported catalytic systems show different characteristics and, in all attempted reactions, immobilization of the molecular catalyst reduces the activity. However, the deactivation ratio was lower when the polymerization was performed under heterogeneous conditions.

OBJECTIVE: To provide a narrative of the bank’s development and d

OBJECTIVE: To provide a narrative of the bank’s development and discuss lessons learned, the bank’s limitations and potential future applications.

RESULTS: Collection sites were selected in high- and low-prevalence settings. Patients with TB symptoms, consenting to participate and to undergo

human immunodeficiency virus testing were enrolled and diagnosed. Serum, sputum, saliva and urine samples were collected and sent to the bank’s repositories. The bank has stocked 41437 samples from 2524 patients at 11 sites worldwide. Ninety-five requests for specimens have been reviewed and 67 sets have been approved. Approved applicants have received sets of 20 or 200 samples. The bank allowed an evaluation of 19 commercial lateral flow tests and showed that none of them had broad global utility for TB diagnosis.

CONCLUSIONS: The establishment and development of the specimen bank have provided a wealth of experience. Selleckchem Semaxanib It is fulfilling a need to provide quality specimens, but the type and number of samples may not fulfil the demands of future end-users. Plans are underway to review the mechanisms of specimen collection and distribution to maximise their impact on product development.”
“The primary objective of this study was to describe the impact of 22q11.2 deletion

(del22q11) on the clinical characteristics, postoperative course, and short-term outcomes of children undergoing surgery for congenital heart disease. The charts of all children ages 1 day-18 years Selleck VX 809 who received cardiac surgery for interrupted aortic arch (IAA), tetralogy of Fallot (TOF), or truncus arteriosus (TA) repair from 1 January 2001 to 31 December 2011 were

retrospectively reviewed. The patients were divided into two groups: the 22q11 group including children with del22q11 undergoing surgery for TOF, IAA, or TA and the non-22q11 or control group including children with no chromosomal or genetic abnormality undergoing surgery for TOF, IAA, or TA. Demographic information, cardiac diagnoses, noncardiac abnormalities, preoperative factors, intraoperative details, surgical procedures performed, postoperative complications, and in-hospital deaths were collected. The outcome data collected included days of Selleck DAPT inotrope use, need for dialysis, length of mechanical ventilation, intensive care unit (ICU) length of stay (LOS), hospital LOS, and mortality. The study enrolled 173 patients: 65 patients in the 22q11 group and 108 patients in the control group. Of the 65 patients in the 22q11 group, 36 (55 %) underwent repair for TOF, 13 (20 %) for IAA, and 16 (25 %) for TA. The two groups did not differ in terms of age or weight. The preexisting conditions were similar in the two groups. Unplanned noncardiac operations were more common in the children with del22q11, but delayed chest closure was similar in the two groups.

001) Regression analysis revealed that external locus of control

001). Regression analysis revealed that external locus of control and coping by accepting NVP-BKM120 responsibility accounted for 67% of the variance in parenting stress. Other styles of coping, child behaviour problems and the amount of time since diagnosis were not found to be predictive of levels of parenting stress.

Conclusions: There was a high prevalence of parenting stress in caregivers of children with a brain tumour. An external locus of control and coping by accepting responsibility increased the likelihood of elevated

levels of stress. Results emphasised the importance of ongoing support for parents of children with brain tumours. Intervention might helpfully be centred on strategies to increase parents’ internal locus of control. Copyright (C) 2012 John Wiley & Sons, Ltd.”
“Background: Malaria in pregnancy is associated with increased risks of maternal and foetal complications. Currently, intermittent

preventive treatment (IPT) of malaria during pregnancy with sulphadoxine-pyrimethamine (SP) is recommended by the WHO as part of a package of interventions also including insecticide-treated nets and effective case management. However, with increasing resistance to SP, the effectiveness of SP-IPT has been questioned. A randomized controlled trial (RCT) p38 MAPK inhibitor to investigate the relative efficacy of an alternative strategy of intermittent screening and treatment (IST), which involves a rapid diagnostic test for malaria at scheduled ANC visits and treatment of women only TEW-7197 if positive, versus SP-IPT has been conducted in Ashanti region, Ghana. This paper reports on a complementary study investigating the acceptability of the different strategies to women enrolled in the trial.


Data were collected through twelve focus group discussions with women selected at random from the different arms of the RCT, exploring their experiences and perceptions about antenatal care and their involvement in the trial. Content analysis was used to identify relevant themes to structure the results.

Results: Five main themes emerged from participants’ experiences of ANC and the RCT that would influence their acceptability of malaria prevention strategies during pregnancy: health benefits; drugs received; tests received; other services received; and health worker attitude. Their own health and that of their baby were strong motivations for attending ANC, and reported favourably as an outcome of being in the RCT. Women were not always clear on the biomedical function of drugs or blood tests but generally accepted them due to strong trust in the health staff. Home visits by staff and free ITNs as part of the trial were appreciated. Politeness and patience of health staff was a very strong positive factor.

Conclusions: Overall, both intermittent screening and treatment and intermittent preventive treatment appeared equally acceptable to pregnant women as strategies for the control of malaria in pregnancy.