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Background Adherence to DMARDs such as methotrexate and biologics is critical for patients with Juvenile Idiopathic Arthritis (JIA). Notwithstanding, few studies exists on that topic and we lack information to understand the grounds for adherence. Objectives The RUMAJI study aims, among others, to understand and decipher the parents and children adherence mechanisms and practices. Methods Qualitative methods were chosen in order to investigate parents’ and children’s everyday life with JIA and its treatment. An ethnographic study was designed by a multidisciplinary team including rheumatologists, paediatricians, patient associations members and anthropologists. The study involved 15 families (enough to reach saturation), recruited from 5 centres by diversity of clinical and sociological profiles. The panel included 17 children with JIA, 11 girls and 6 boys, median age 10,3; 17 median disease duration 2.5.1; 15 4 children were treated with conventional DMARDs in monotherapy, 4 with biologic DMARDs in monotherapy, 5 with cDMARD-bDMARD association and 4 with NSAIDs only. Interviews were conducted by anthropologists at family’s home using in-depth semi directive and biographic methods. 3 fields were explored: organisation of everyday life with JIA, treatment practices, impact on school and social activities. Interviews were recorded and transcribed for analysis. Results Adherence results from an appropriation process of the JIA and treatment that require both an active role from parents and children, even before the transition. This active role played by children could be either stimulated or inhibited at home according to the family’s structure, social background and parents’ attitudes toward their child (participation to the decision, explanation of the disease). Children’s active role includes in particular: 1) negotiations with parents and physician, 2) experiments with the treatment (forgetting or involuntary switch from the parents, changing the dosage on their own initiative) and 3) participation to the treatment administration and ritualization. The manner children consider and manage their DMARDs is the result of an arbitration depending on the positive (a) and side effects (b) they felt in their body and the effects noted by the doctors (c) during the examinations and test results. Dealing with these 3 dimensions requires to link together both a theoretical and practical knowledge of JIA. Thus, children build their own and singular knowledge of their disease and treatment, which is a source of control of their body and their life. Conclusions Qualitative methods, through an ethnographic study starting from children’s point of view, underline the active role they play in their care. Adherence to DMARDs could be improved by supporting children’s implication as soon as the beginning of JIA. Acknowledgements This work was supported by an institutionnal grant from NORDIC Pharma to ANDAR. All medical and patient experts volunteers. Disclosure of Interest None declared

Current-voltage, admittance spectroscopy, and drive-level capacitance profiling measurements were taken on Cu(In1−xGax)(Se1−ySy)2 solar cell devices. The devices were made using two different types of absorbers. One set of absorbers was deposited via physical vapor deposition, while the other set of absorbers was made by selenization of metal precursors. Additionally, each type of absorber was completed with one of two different types of buffer treatments: a CdS layer or a cadmium partial electrolyte surface modification. The devices with the evaporated absorbers had larger values of VOC, higher carrier densities, lower densities of trapping defects, and likely shallower gap states. Results were qualitatively similar for the CdS and partial electrolyte buffers. Copyright © 2005 John Wiley & Sons, Ltd.

The deep defect distributions affecting majority carrier trapping in polycrystalline CuIn 1− x Ga x Se 2 (CIGS) have been studied using drive level capacitance profiling. This technique provides, a spatial and energetic profile of sub-band gap defect transitions in the CIGS layer of working photovoltaic devices, while remaining insensitive to surface states. The bulk response was dominated by a defect which varied between 0.1 and 0.3 eV, according to the Meyer-Neldel rule. Devices grown at reduced substrate temperatures had smaller grain sizes and additional defect response. The effect of a light-soaking treatment, using near-band gap optical excitation, was studied. Both the free carrier density and the density of deeper defects were increased by this treatment. Device quality was degraded, predominantly due to a decreased fill factor.

The density and distribution of point defects in Cu(In,Ga)Se (CIGS) layers used for solar cell applications is critical to the 2 resulting device performance.These devices are generally thought to be limited by recombination in the space-charge region of the collecting heterojunction.The situation is complicated by the presumed presence of an n-type surface layer on the CIGS absorber.Both the surface inversion and space-charge recombination processes are intimately tied to near-surface point defects. Here, we overview recent results on surface chemistry, transient photocapacitance spectroscopy (TPC) and depth-resolved cathodoluminescence (CL) for polycrystalline device layers from two laboratories, and single crystal epitaxial layers of three orientations.The results are combined with device modeling to provide a picture of the near-surface defect structures in these materials.The TPC results show deep defect levels ;0.7 and 0.9 eV above the valence band. CL shows evidence of subgap radiative recombination, which increases dramatically near the sample surfaces.The results point to a near-surface Cd-containing layer, which could be responsible for the surface carrier type inversion, a near-surface region containing an elevated defect density, possibly near the valence band edge, and deep hole traps near the conduction band.Implementation of the results in a device model provides reasonable fits to the device performances. 2003 Elsevier Science B.V. All rights reserved.

The four national amorphous silicon research teams held their 8th guidance team and technical team meetings in conjunction with the 25th Anniversary Symposium of the Institute of Energy Conversion at the University of Delaware. The teams were formed in 1992 and represent a success story of teamed photovoltaics research, integrating the efforts of industrial groups, universities and national laboratories (NIST and NREL). In this paper, we will make an attempt to summarize the accomplishments and the lessons learned during this period. © 1997 John Wiley & Sons, Ltd.

Objectives Preterm delivery is the leading cause of major perinatal morbidity and mortality associated with triplet pregnancies. The objective of this study was to evaluate the efficacy of ultrasound-indicated cervical cerclage in triplet pregnancies that are diagnosed with cervical shortening on biweekly transvaginal sonography (TVS). Methods A retrospective review of all triplets who were followed with biweekly TVS for measurement of cervical length was conducted. Cervical shortening was defined as cervical length ⩽ 2.5 cm. Outcomes of interest included cervical cerclage placement, gestational age at delivery and birth weight. Results In our population of 24 triplet pregnancies, 13 had cervical shortening. Of these, 54% underwent cervical cerclage at a mean gestational age of 20 weeks. Overall, patients without cervical shortening delivered on average 17 days later than those with cervical shortening (32 + 2 weeks vs. 29 + 6 weeks, P = 0.034). Moreover, infants of patients without cervical shortening weighed on average 456 g more at birth than did those with cervical shortening (1751 g vs. 1295 g, P = 0.039) and had a lower percentage of very low birth weight infants (30.3% vs. 69.2%, P = 0.002). Within the subset of patients with cervical shortening, there was no statistical difference in any of the outcomes studied between patients who underwent cervical cerclage and those who did not. Conclusions Triplet pregnancies complicated by cervical shortening diagnosed on biweekly TVS surveillance do not appear to benefit from placement of cervical cerclage, based on assessment of gestational age at delivery, birth weight and incidence of very low birth weight infants. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.

SummaryIn rheumatoid arthritis (RA) there are currently no good indicators to predict a clinical response to rituximab. The purpose of this study was to monitor and determine the role of peripheral blood cytokine profiling in differentiating between a good versus poor response to rituximab in RA. Blood samples were collected at baseline and at 3 months from 46 RA patients who were treated with rituximab. Responders are defined by the presence of three of four American College of Rheumatology criteria: ≥ 20% decrease in C-reactive protein, visual analogical score of disease activity, erythrocyte sedimentation rate and improvement of the disease activity score (28) (four values) by ≥ 1·2 obtained at 3 months. Twelve cytokines were measured from serum collected on days 0 and 90 by proteomic array, including interleukin-6 (IL-6), tumour necrosis factor-α, IL-1a, IL-1b, IL-2, IL-8, interferon-γ, IL-4, IL-10, monocyte chemoattractant protein-1, epidermal growth factor and vascular growth factor. We showed that C-reactive protein and IL-6 levels decrease significantly at 3 months in the responder group compared with baseline. At day 90 we identified a cytokine profile which differentiates responders and non-responders. High serum levels of two proinflammatory cytokines, monocyte chemoattractant protein-1 and epidermal growth factor, were significantly higher in the responder group at day 90 compared with non-responders. However, we were not able to identify a baseline cytokine profile predictive of a good response at 3 months. These findings suggest that cytokine profiling by proteomic analysis may be a promising tool for monitoring rituximab and may help in the future to identify responder RA patients.

This report summarizes the development and evaluation of higher-bandgap absorbers in the CIS alloy system. The major effort focused on exploring suitable absorbers with significant sulfur alloying in collaboration with Shafarman's group at the Institute of Energy Conversion. Three series of samples were examined; first, a series of quaternary CuIn(SeS)2-based devices without Ga; second, a series of devices with pentenary Cu(InGa)(SeS)2 absorbers in which the Se-to-S and In-to-Ga ratios were chosen to keep the bandgap nearly constant, near 1.52 eV. Third, based on the most-promising samples in those two series, we examined a series of devices with pentenary Cu(InGa)(SeS)2 absorbers with roughly 25 at.% S/(Se+S) ratios and varying Ga fractions. We also characterized electronic properties of several wide-bandgap CuGaSe2 devices from both IEC and NREL. The electronic properties of these absorbers were examined using admittance spectroscopy, drive-level capacitance profiling, transient photocapacitance, and transient photocurrent optical spectroscopies. The sample devices whose absorbers had Ga fraction below 40 at.% and S fractions above 20 at.% but below 40% exhibited the best electronic properties and device performance.

SummaryIn rheumatoid arthritis (RA) there are currently no useful indicators to predict a clinical response to tumour necrosis factor-α (TNF-α) blockade. The purpose of this study was to determine the role of peripheral blood cytokine profiling in differentiating between a good versus poor response to etanercept in RA. Peripheral blood samples were collected at baseline and at 3 months from 33 patients with active disease who were treated twice weekly by etanercept therapy. Responders are defined by the presence of three of four American College of Rheumatology criteria: ≥20% decrease in C-reactive protein (CRP), visual analogue score of disease activity, erythrocyte sedimentation rate and improvement of the disease activity score (28; four values) by ≥1·2 obtained at 3 months. Twelve cytokines were measured from serum collected on days 0 and 90 by proteomic array (protein biochip array, Investigator Evidence, Randox France), including interleukin (IL)-6, TNF-α, IL-1a, IL-1b, IL-2, IL-8, interferon-γ, IL-4, IL-10, monocyte chemoattractant protein (MCP)-1, epidermal growth factor (EGF) and vascular endothelium growth factor. Our results showed that high serum levels of MCP-1 and EGF were associated with a response to etanercept. In addition, the increase of two combined parameters CRP and EGF was predictive of a response to etanercept treatment at 3 months (sensitivity: 87·5% and specificity: 75%, accuracy: 84·4%). These findings suggest that cytokine profiling by proteomic analysis before treatment initiation may help to identify a responder patient to TNF-α blocking agents in RA.

We have used sustained light-soaking in the near-infrared (780 nm wavelength) to modify the properties of the absorber layer in CIGS solar cells, and thus study the relationship between the absorber electronic properties and the device performance. Through this light-soaking treatment we can increase the hole carrier density in the CIGS absorber, as well as the density of the commonly observed 0.3 eV bulk deep acceptor, by up to a factor of 5. The device performance was periodically recorded under the same 780 nm light, and was found to degrade due to a reduction in fill factor and short circuit current. We demonstrate that these changes can be largely attributed to a reduction in the photogenerated carrier collection, due to a decrease in the depletion width. Based on these data, we estimate the minority carrier diffusion length to be about 0.2 ?m. At the same time, no change in open circuit voltage was observed, indicating that the recombination rate through the dominant recombination channel remained nearly constant. This means that it cannot be the 0.3 eV bulk defect. Detailed SCAPS modeling was carried out and reinforces this conclusion.

We have used electronic and optical techniques to characterize alloys of the Cu(In,Ga)(S,Se)2 material system. The alloys were prepared such that the bandgap of the resultant materials was near 1.5 eV. These materials are interesting as the absorber layer of thin-film solar cell devices, and were studied in a solar cell device configuration. Electronic characterization techniques included admittance spectroscopy and drive-level capacitance profiling (DLCP). Optical techniques included transient-photocapacitance and transient-photocurrent spectroscopies. From these measurements we were able to determine defect activation energies and profiles, Urbach energies, and information about deeper (optical) defect positions and widths. These data are used to suggest a model of a deep electron trap 200 meV to 300 meV below the conduction band that is filled optically and emptied thermally, and may affect solar cell device performance.

Voltage-pulse stimulated capacitance transient measurements on a series a-Si:H/a-Si, Ge:H devices disclose a large density of hole traps at or very close to the heterojunction interface. The transient signal magnitude is independent of temperature or applied bias, ruling out charge polarization effects or a defect creation process caused by the filling pulse. While the areal density of such hole traps is considerable (within a factor of 2 of 1011 cm−2 for all samples) these traps do not appear to behave as recombination centers. Also, the treatment of the a-Si:H/a-Si,Ge:H interface during growth can significantly alter the concentration of these traps.

We report the deposition of improved hydrogenated amorphous silicon germanium (a-SiGe:H) films by the hot wire CVD (HWCVD) technique using a tantalum filament operating at a low temperature. We gauge the material quality of the a-SiGe:H films by comparing infrared, small angle X-ray scattering (SAXS), photocapacitance and conductivity measurements to earlier results, and fabricate single junction n-i-p solar cell devices using these i-layers.

Sodium reduction is efficacious for primary prevention of hypertension, but the feasibility of achieving this effect is unclear. The objective of the paper is detailed analyses of adherence to and effects of the sodium reduction intervention among overweight adults in the Trials of Hypertension Prevention, Phase II. Sodium reduction (comprehensive education and counselling about how to reduce sodium intake) was tested vs no dietary intervention (usual care) for 36-48 months. A total of 956 white and 203 black adults, ages 30-54 years, with diastolic blood pressure 83-89 mmHg, systolic blood pressure (SBP)

Sub-bandgap defect densities and minority carrier collection properties have been characterized for a series of CuIn/sub 1-x/Ga/sub x/Se/sub 2/ devices with varying device efficiencies. Samples fabricated using reduced substrate temperatures during growth have also been studied, and show additional defect response. Transient photocapacitance and photocurrent spectroscopies were employed to deduce the defect distributions and minority carrier mobilities. Drive-level capacitance profiling was used to determine the spatial and thermal energy distributions of the majority carrier traps. Photovoltaic device parameters were determined for all samples. It appears that the device efficiency is not clearly controlled by any single sub-bandgap defect population.

Metabolic stress, a result of the rapidly changing and complex nature of severe illness, is common in critically ill patients. Although the importance of nutritional support has received increasing interest over recent years, this is usually provided in an empiric manner without necessarily taking into account the specific nutritional and, especially, energy requirements of a particular patient. These factors may be of considerable importance to patients in the intensive care unit (ICU). Under-nutrition, as indicated by a severely negative energy balance (>10000 kCal during the ICU stay) has been associated with a higher mortality in critically ill patients at risk for developing multiple organ failure (MOF) [1], while over-nutrition in artificially-fed patients especially with carbohydrates may increase postoperative length of stay, increase rates of infection and mortality [2]. It would, therefore, seem that an accurate daily and individualized evaluation of energy expenditure would be the best way to administer appropriate energy support in these metabolically brittle patients.

Rituximab is a chimeric human/mouse monoclonal anti-CD20 antibody approved for the treatment of rheumatoid arthritis (RA) refractory to anti-tumour necrosis factor (TNF) therapy.1 Rituximab seems to be efficient in other diseases such as autoimmune cytopoenia,2 systemic lupus erythaematosus (SLE),3 dermatomyositis4 and Sjogren syndrome.5 To our knowledge, no case of psoriatic arthritis (PsA) treated by rituximab has been reported. Nevertheless, a partial remission of psoriasis following rituximab therapy for non-Hodgkin’s lymphoma has been reported.6 We describe the case of a man with severe PsA with dramatic improvement after rituximab treatment. A 62-year-old Caucasian male had PsA since 2001 with asymmetrical arthritis involving distal interphalangeal arthritis, wrist, knee and ankle joint, and dactylitis. He has a personal (15 years ago) and …

Background Alopecia areata (AA) is an autoimmune disorder targeting the hair follicle, more frequently observed in patients with Pso, RA or IBD. While high amount of TNF is found in the hair follicle at the AA acute phase, TNF blockers have not demonstrated efficacy in its treatment. On the other hand, cases of AA occurring during TNF blockade have been reported. Objectives To characterize the clinical features and the associated symptoms of AA occurring during TNF blockade and its outcome; to study the relationship between TNF blockade and occurrence of AA. Methods From January 1 st 2011 to December 31 th 2012, French physicians prescribing TNF blockers (dermatologists, rheumatologists, gastroenterologists) were regularly asked, via their respective academic societies, to report all cases of AA appeared during anti-TNF therapy. Diagnosis of AA should be certified by a dermatologist. Results Twenty-five patients were included (15 men, mean age: 39.4 years): 10 Pso (2 with associated PsA), 5 AS, 4 RA, 4 Crohn’s diseases (1 associated with AS) and 2 ulcerative colitis. Eight patients (32%) had a personal or family autoimmune background (AA and/or vitiligo). Six patients (24%) had previously received biotherapy (anti-TNF or efalizumab) without developing AA, with a mean exposure duration of 5.8 months (mo). The TNF blocker prescribed at the time of AA onset was infliximab (INF) (n=9), adalimumab (ADA) (n=8) or etanercept (ETA) (n=8). The mean duration of exposure was 23.7 mo (1-89) (INF: 17.9; ADA: 16; ETA: 38 mo). The underlying inflammatory disorder was completely controlled in all patients, except 2. Clinical presentation of AA was mostly plaque-type of the scalp or the beard (n=21; 84%). Concomitantly, 7 patients (28%) developed vitiligo, psoriasiform eruptions or Hashimoto’s thyroiditis. TNF blockers were stopped after AA onset in 11 cases and maintained in 14 cases. Among those who stopped the treatment, 3 (27%) had a worsening or stability of AA, whereas 8 patients (73%) had a partial or complete remission. Among those who maintained it, 4 (28%) had an unfavorable evolution while 9 patients improved (72%). One patient relapsed from AA after switching from ETA to ADA but healed again 2 weeks after stopping ADA. Mean follow-up duration was 27 mo. Conclusions Occurrence of AA during TNF blockade may be considered as an incidentally autoimmune manifestation in patients with immune-mediated inflammatory disorders or as a new autoimmune-induced side effect of TNF blockers. This latter hypothesis is supported by the concurrent development of autoimmune symptoms in one quarter of our patients, a delay of onset after exposure to TNF blockers similar to the ones of other autoimmune-induced side effects and the relapse of AA after TNF blocker restart in one patient. Clinicians should be aware that AA might occur in patients receiving anti-TNF treatment. Withdrawal of treatment should not be systematic, especially if AA presentation is mild. Disclosure of Interest None Declared

Background Rheumatoid arthritis (RA) is a chronic disease, which management benefits from Patient Education Programs (PEP). According to national health authority recommendations, French patients are encouraged to help in designing and implementing PEP. With the support of the French Society of Rheumatology, ANDAR, the national patient organization against RA, decided to implement a one-year pilot program of Peer Patient Educators (PPE) within hospitals. This pilot program was selected by the French Ministry of Health and extended to other hospitals for an additional year. Objectives The objectives were to recruit, train, and integrate PPE within multidisciplinary teams and to evaluate their involvement. Methods This was a multicenter national study, over two years, supervised by a steering committee composed of patient representatives, rheumatologists, a psychotherapist and a consultant agency specialized in PEP. PPE candidates were recruited by healthcare professionals within each hospital unit caseload. Candidates were screened by ANDAR and the consulting agency. Candidates underwent 42 hours of training (PEP basics, confidentiality, facilitation, active listening, and group animation skills medical knowledge). After discussion among project organizers, trainees were integrated within their hospital unit PEP where they had the opportunity to participate in program design, educational diagnosis and workshop animation. For the first year, evaluation included the acceptability of the PPE within PEP and their involvement extent. Recommendations were made as to best practices for PEP. Results 11 rheumatology units were involved, 21 PPE trained and 19 involved Year 1: 5 units approached, 4 involved; 8 PPE selected and trained, 6 finally involved (1 disease aggravation, 1 unavailable) Activities: Educative diagnosis and PEP workshop animation (1), PEP workshop animation (4), interplay patients/educators (1) Evaluation I- Acceptability High acceptance of the PPE by other patients; Good acceptance from healthcare professionals despite a few instances of resistance II – Feasibility Favorable conditions: PEP experience within the unit, Recognition of added values brought by patients, PPE selection by the units themselves, Early information of the unit team about the project, Quality of the training provided, Innovative project, Acceptance of patient organization involvement within the healthcare system Blocks: Units understaffing, Previous unsuccessful collaborating experiences with patients, Resistance to change, Doubts about PPE emotional resilience, Fears around sharing confidential medical information with PPE Year-1 evaluation allowed us to improve our selection criteria for candidates as well as our training program. Year 2 9 units approached, 7 involved; 14 PPE selected, 13 trained; 13 involved Activities: PEP workshop animation (13) Conclusions We fulfilled the objective of integrating trained PPE with hospital-run RA PEP, and evaluation shows strong commitment of PPE. The second year confirms the project feasibility. Today, PPE commitment and beneficial input keep growing. New PEP units willing to join the program in following years. Disclosure of Interest None Declared

Although a-Si,Ge:H alloys have been increasingly studied in recent years because of their desired tunable band gaps for application in tandem solar cells, the relation between the mid gap defects with solar cell performance is still not completely clear. The authors have characterized the defect state structure in a series of device quality glow discharge produced a-Si,Ge:H alloys with Ge content ranging from 30 at.% to 50 at.% using capacitance profiling, modulated photocurrent, transient junction photocurrent and photocapacitance measurements. As previously reported, these methods allows one to identify two types of thermally induced defect transitions plus two types of optical transitions from deep defects. In the current study the authors have examined the changes in these defects, along with the changes in the hole mobility-time products, that result from prolonged light exposure. By comparing these changes in the annealed state and light soaked state of the same sample, they attempt to correlate the changes in defects with the hole mobility-time product. In general, although all of the defect bands are found to increase after light soaking, the relative factor is found to be different for the various defect transitions within the same sample. The authors also try to identify amore » defect bands may be acting as a safe electron trap, enhancing the lifetime of the minority carriers. They propose that the observed decrease of this defect band relative to the midgap defect band with light soaking could be a significant factor in determining the degradation of these a-Si,Ge:H alloys in the device performance.« less

Etanercept, a soluble tumour necrosis factor α (TNFα) receptor fusion protein, may be combined with methotrexate (MTX) in severe rheumatoid arthritis (RA).1 Etanercept is generally given to patients treated with MTX who have an inadequate response. However, MTX could be introduced to patients who have already been treated with etanercept and who initially had a good response but subsequently a secondary failure. It was decided to evaluate, in an open prospective study, the clinical, biological, and functional benefit of the secondary addition of MTX in patients with RA with an inadequate response to etanercept alone. A cohort of 93 patients with active and severe RA was observed for a mean duration of 8 months (range 1–20). The group comprised 75 women, 18 men, with an average age of 49.5 years (range 17–75), and positive rheumatoid factor …

This report describes works to use transient photocapacitance and photocurrent measurements to determine the deep defect distribution and processes in low-band-gap a-Si,Ge:H alloys. Samples for these studies were produced by the photochemical vapor deposition (photo-CVD) growth method and were obtained through a collaboration with researchers at the University of Delaware. This report discusses how a detailed comparison between the photocapacitance and photocurrent spectra can be used to separately examine the majority and minority carrier processes. The results are as follows: (1) The midgap defect densities in the alloy regime near 1.3 eV can be as low as 5 {times} 10{sup 16} cm{sup {minus}3} in such photo-CVD samples. (2) There exists a second defect band roughly 0.4 eV below E{sub c} of a similar magnitude to the midgap defect density that exhibits significant lattice relaxation behavior in its electron trapping dynamics. (3) The hole {mu}{tau} products determined for the lowest defect sample are roughly 5 {times} 10{sup {minus}10} cm{sup 2}/V, comparable with the highest hole {mu}{tau} products reported in sandwich geometry measurements for alloys in this composition range. (4) The hole {mu}{tau} is found to be roughly inversely proportional to the midgap defect density for the samples studied. This is consistentmore » with the fact that the effective minority carrier lifetime for such measurements is limited by the deep state trapping time.« less

Summary A previously healthy young male developed unilateral pulmonary oedema immediately after re-expansion of an intentionally collapsed lung after transaxillary sympathectomy. The pulmonary oedema was localised to the contralateral, uncollapsed lung.

The patient characteristics and outcomes were studied in the 318 patients who survived open label drug titration in the Cardiac Arrhythmia Suppression Trial (CAST) and who were not randomized to double-blind therapy and in 942 patients, who were randomized to double-blind placebo therapy. The patients randomized to placebo therapy had a lower total mortality or resuscitated cardiac arrest rate (4% vs. 8.5%). However, at baseline, nonrandomized patients were dissimilar from patients randomized to placebo in the following ways: older; lower left ventricular ejection fraction; greater use of digitalis, diuretic drugs and antihypertensive agents; lesser use of beta-adrenoceptor blocking agents and more frequent prior cardiac problems, including runs of ventricular tachycardia and left bundle branch block.A matched comparison that took these inequities into account showed no significant differences in mortality or rate of resuscitation from cardiac arrest between nonrandomized patients and clinically equivalent patients randomized to placebo. Cox regression analysis indicated that two factors significantly increased the hazard ratio for arrhythmic death or resuscitated cardiac arrest in the nonrandomized patients: female gender (4.7, p < 0.05) and electrocardiographic events (ventricular tachycardia, proarrhythmia, widened QRS complex, heart block, bradycardia) during open label titration (7.0, p < 0.005). However, some potentially important differences between men and women were not included in the Cox regression model. Of the nonrandomized patients, approximately 70% were not randomized because of lack of suppression of ventricular premature depolarizations or adverse events, or both, and the remaining 30% because of patient or private physician request with no indication of another reason.In conclusion, nonrandomized patients had more extensive coronary heart disease and experienced higher mortality and resuscitated cardiac arrest rates than did patients randomized to placebo. This finding at least partly explains the low mortality rate in the CAST patients randomized to placebo. Events such as proarrhythmia during drug titration portend a high risk of arrhythmic death. Many of the patients who most need antiarrhythmic benefit are unable to tolerate these drugs. In CAST, virtually all patients who could and would be treated with an antiarrhythmic drug were randomized.

Capacitance vs. temperature, deep-level transient spectroscopy (DLTS), and transient photocapacitance spectroscopy have been used to investigate the amorphous-crystalline silicon interface region of a device made of hydrogenated amorphous silicon deposited on a lightly doped n-type crystalline silicon.By comparing our results between substrates with and without oxide contamination with those in a earlier study, we have been able to correlate the effects of substrate preparation on the density of interface states.

5589 Background: Ovarian cancer patients are a difficult to treat population as most of them have been previously treated by a combination of chemotherapeutic agents and at least a platinum and taxane based regimen. Several studies have suggested that pegylated liposomal doxorubicin (PLD) administered at cumulative dose of less than 550 mg/m2 appears to be effective and with reduced risk of cardiotoxicity. Although the cumulative dose in these patients typically has been

The Synoptic Problem in Rabbinic Literature, edited by Shaye J. D. Cohen. BJS 326. Providence: Brown University Press, 2000. Pp. xiii + 167. $60.00. Talmudic Stories: Narrative Art, Composition, and Culture, by Jeffrey Rubenstein. Baltimore: Johns Hopkins University Press, 1999. Pp. xvi + 436. $55.00. Shaye Cohen's edited volume The Synoptic Problem in Rabbinic Literature and Jeffrey Rubenstein's Talmudic Stories: Narrative Art, Composition, and Culture are major contributions to the field of rabbinics, the former for its explicit attempt to deal with methodological issues pertaining to the study of this literature, the latter for the ways in which it analyzes several notable rabbinic stories in a fresh and detailed manner. While prima facie these works are different in terms of style and scholarly agenda, each nonetheless deals with the question of the extent to which rabbinic literature can be used to enhance our understanding of the rabbis, and of Palestinian and Babylonian Jews of late antiquity. The Synoptic Problem in Rabbinic Literature comprises six papers given at a small conference held at Brown University in 1998. Topics included the relationship of the Mishnah to the Tosefta, the relationship of these texts to Tannaitic midrashim and beraitot, the relationship of the Bavli (Babylonian Talmud) to the Yerushalmi (Palestinian Talmud), the relationship of the Talmuds to both the Tosefta and the Tannaitic midrashim, and the relationship of the Yerushalmi to Genesis Rabbah, Leviticus Rabbah, and Lamentations Rabbah. Given the caliber of the participants, undoubtedly this was an intellectual feast for those interested in current trends in rabbinic scholarship. While the collection covers a variety of topics and raises many methodological issues, its cohesion lies in its attempt to debunk the documentary hypothesis. As Robert Goldenberg refers to it, the Documentary Premise, espoused by Jacob Neusner, is an approach to rabbinic documents that treats rabbinic texts only on the redactional level with no serious regard for either earlier sources found within a work, or for similar sources found in other compilations. Each document must be understood on its own terms and as such tells us a great deal about the redactor of the compilation. That is to say, documents such as the Mishnah, Genesis Rabbah, the Tosefta, or the Yerushalmi are discrete works that attest to the coherent Weltanschauung of their respective redactors who intentionally shape their sources accordingly. Indeed, as Shaye Cohen avers, "Much of ancient rabbinic literature is as synoptic as Matthew, Mark, and Luke; because of their extensive parallels in structure, content, and wording, rabbinic texts should be `seen together (p. vii). It should be noted, however, that the synoptic problem in rabbinic literature is in many respects more complex and unwieldy than in the Gospels. While the Synoptic Gospels are more or less contemporaneous, rabbinic literature spans several centuries. In this instance, the synoptic problem does not deal with three Gospels, a commonly recognized Q source and two other putative sources, but rather it involves numerous iterations of similar stories, sayings and dicta in more than one corpus (for that matter in more than one type of corpus), which, depending on the corpus itself, could very well have undergone several layers of redaction. Cohen's collection of essays, despite lacking a synthesizing conclusion, offers the reader access into the complicated nature of the synoptic problem in rabbinic literature. Each of the six chapters merits a more detailed treatment than space allows. With this in mind, I will discuss briefly the main thrust of each paper and occasionally will make some general observations. In the first paper of the series, Robert Goldenberg sets the stage for the ensuing engagement with and criticism of Neusner's documentarian approach, which he considers a "deeply problematic stance. …

Jacob Neusner's Are there really tannaitic parallels to the Gospels ? (South Florida Studies in the History of Judaism. Atlanta : Scholars Press, 1993) pretends to be a scholarly refutation of Morton Smith's Tannaitic parallels to the Gospels (1951), but is in reality abusive polemic. It is Neusner's obituary for Smith, bringing closure to an intense but troubled relationship. Because of its careless scholarship and vindictive tone, the book should not have been published without major editing, and, by publishing it in this form, Scholars Press has served as the author's vanity press

The relationship between diuretic therapy and possible increased risk of coronary heart disease (CHD), especially sudden death, is controversial. The initial report from the Multiple Risk Factor Intervention Trial (MRFIT) raised the possibility that the increased CHD mortality observed in a subset of special intervention men with hypertension and certain electrocardiographic abnormalities on their baseline examination might be an unexpected adverse effect of diuretic therapy. Subsequent reports from the MRFIT have revealed a stronger association of CHD mortality to hydrochlorothiazide than to chlorthalidone. There was no consistent relationship of CHD mortality to the dose of either drug, to the most recent serum potassium level, or to the presence of ventricular premature beats. Unfavorable trends of the same magnitude were also seen among similar white men in the Hypertension Detection and Follow-up Program and in the Oslo hypertension trial, although the sample sizes in these two studies were too small to yield clearcut conclusions. Clinical studies have shown an increased risk of CHD death among hypertensive men with left ventricular hypertrophy. Such men are also noted to have a higher frequency of ventricular premature beats, even in the absence of diuretic therapy. Other studies have shown that diuretic-induced hypokalemia is accentuated in the presence of epinephrine and that low potassium levels decrease the threshold for ventricular fibrillation. Thus, although the evidence is still incomplete, it is possible that the excess CHD mortality among MRFIT special intervention men with electrocardiographic abnormalities may have been caused by a combination of increased left ventricular mass in the presence of coronary atherosclerosis, and hypokalemia caused by good compliance with diuretic therapy and accentuated by stress-induced increases in circulating catecholamines. Given the very large population of patients receiving diuretic therapy, further evaluation of this possibility is important.

We have observed a reversible photoinduced modification of the bulk density of gap states in a‐Si:H associated with the Staebler–Wronski effect. A detailed numerical analysis of diode admittance and deep level transient spectroscopy measurements shows that the changes in these properties after illumination can be explained by a lowering of the bulk Fermi level and an increase in the density of states below midgap.

We have developed a new method of capacitance profiling which is greatly superior to standard profiling techniques for materials like amorphous silicon that contain high densities of deep gap states. This technique, which makes use of the variation of the junction capacitance with the alternating voltage amplitude, is largely immune to the effects of surface states and is readily interpreted in terms of a simple integral over the density of states, g(E). This method is applicable to both doped and semi‐insulating undoped samples.

Cigarette smoking histories were compared to carboxyhemoglobin and serum thiocyanate concentrations obtained from 426 smokers and 191 non-smokers. The mean levels of both carboxyhemoglobin and serum thiocyanate wefe significantly higher among cigarette smokers and correlated with number of cigarettes smoked per day. The specificity of both procedures was 81 per cent, and serum thiocyanate had a higher sensitivity (93 per cent vs. 83 per cent), making it potentially more suitable for use as an index of cigarette smoking.

A survey of first and second year medical students at Saint Louis University revealed that only 6 per cent were current cigarette smokers. This represents a continuation of a downward trend in the percentage of smokers among American medical students as reported in earlier, independent surveys. Implications for improved health status and for better preventive care for patients by these future physicians are discussed.

A novel a-Si:H/c-Si Schottky diode heterostructure device premits the study of the capacitive response to relatively low temperatures (25 K) and also allows fast pulse filling capture measurements of electrons from the c-Si substrate into a-Si:H defect states. These latter measurements, as well as capacitance vs. temperature measurements on these diodes, indicate a nearly zero conduction band offset (50±50 meV). We also have observed trapping of holes at the a-Si:H/c-Si valence band discontinuity ΔEv. A clear threshold for the subsequent optical release of these trapped holes by sub-bandgap light yields a value of ΔEv = 0.58±0.02 eV. Finally, photocapacitance spectra along with thermally stimulated capacitance (TSCAP) measurements indicate an anomalously large (l×1018/cm3) Gaussian-shaped defect band located a Ec - 0.88 eV with a FWHM of 0.46 eV. Model calculations of the high temperature capacitance-voltage dependence indicate these defects lie predominately within 350 Å of the a-Si:H/c-Si interface.

Amorphous-crystalline heterostructures composed of sub-micron thick undoped amorphous hydrogenated silicon deposited on lightly doped n-type crystalline silicon substrates have been studied by capacitance techniques. Capacitance vs. temperature scans along with model calculations on these samples are used to investigate the amorphous-crystalline silicon interface region. We deduce the existence of an anomalously defective a-Si:H region extending roughly 1000 Angstroms from the growth interface. We also deduce considerable fluctuations in the interface potential which indicate lateral variations of ±20% in the defect distritribution over a 1000 Angstrom scale.

Une observation - Malade de 67 ans diabetique, sous insuline depuis 15 ans, atteint d'une brulure du pied infectee. Le traitement par ofloxacine provoque une eruption purpurique prurigineuse, qui s'efface apres cessation du traitement et recidive apres reprise. Il s'agit d'une vasculite d'hypersensibilite, curable par prednisone

An elective course focusing on exercise physiology and cardiovascular fitness has been offered since 1984 to a limited number of freshman and sophomore students at Saint Louis University School of Medicine. The course consists of a series of weekly lectures. Following each lecture, the students participate in a self-designed fitness program and agree to follow the program on their own time at least two days per week. Using bicycle ergometry testing, the instructors estimated the maximum oxygen consumption for each student before and after completion of the course, and the results over the four years indicate an average increase of 15 percent. The students' evaluation of the course has been favorable. The potential benefits of such a course are discussed.

A full numerical analysis of the nonequilibrium response of a Schottky‐barrier space charge region for an arbitrary density of states, g (E), has been developed. We apply these methods to our measurements of Deep Level Transient Spectroscopy (DLTS) in n‐type a–Si:H. This gives a quantitative picture of g (E) extending, in some cases, over 70% of the mobility gap. This analysis gives qualitative agreement to our previous interpretation of similar data but produces more reliable quantitative results and, in addition, discloses features in g (E) not apparant from our simpler approach. In particular it identifies the correct value of the thermal emission energy gap (near 2.0 eV).

This report contains results of Phase II of research to investigate metastable defect creation processes in hydrogenated amorphous silicon. The study relied primarily on junction capacitance methods to monitor the changes in deep defect distribution. Results obtained applying capacitance profiling methods to the study of undoped samples are summarized and indicate a significant role of extrinsic impurities in the degree of light-induced degradation that occurred. Photocapacitance transient measurements were taken to investigate changes in undoped a-Si:H. Studies were also begun of metastable changes in n-type doped a-Si:H samples by using both the drive-level capacitance profiling technique and transient photocapacitance methods, and results are described. 22 refs., 10 figs., 1 tab.