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Background: Tuberculosis is the leading infectious cause of death. Steep reductions in tuberculosis-related mortality are required to realize the World Health Organization's "End Tuberculosis Strategy." However, accurate mortality estimates are lacking in many countries, particularly following discharge from care. This study aimed to establish the mortality rate among patients with pulmonary tuberculosis in Vietnam and to quantify the excess mortality in this population., Methods: We conducted a prospective cohort study among adult patients treated for smear-positive pulmonary tuberculosis in 70 clinics across Vietnam. People living in the same households were recruited as controls. Participants were re-interviewed and their survival was established at least 2 years after their treatment with an 8-month standardized regimen. The presence of relapse was established by linking identifying data on patients and controls to clinic registries. Verbal autopsies were performed. The cumulative mortality among patients was compared to that among a control population, adjusting for age and gender., Results: We enrolled 10964 patients and 25707 household controls. Among enrolled tuberculosis patients, 9% of patients died within a median follow-up period of 2.9 years: 342 (3.1%) during treatment and 637 (5.8%) after discharge. The standardized mortality ratio was 4.0 (95% confidence interval 3.7-4.2) among patients with tuberculosis, compared to the control population. Tuberculosis was the likely cause of death for 44.7% of these deceased patients., Conclusions: Patients treated for tuberculosis had a markedly elevated risk of death, particularly in the post-treatment period. Interventions to reduce tuberculosis mortality must enhance the early detection of drug-resistance, improve treatment effectiveness, and address non-communicable diseases., (© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

Successful and sustained CD4 + T-cell reconstitution is associated with increased survival after hematopoietic cell transplantation (HCT), but opportunistic infections may adversely affect the time and extent of immune reconstitution. Human herpesvirus 6B (HHV-6B) efficiently infects CD4 + T cells and utilizes as a receptor CD134 (OX40), a member of the TNF superfamily that antagonizes regulatory T-cell (T reg ) activity. Reactivation of HHV-6B has been associated with aberrant immune reconstitution and acute graft-versus-host disease (aGVHD) after HCT. Given that T reg counts are negatively correlated with aGVHD severity, we postulate that one mechanism for the poor CD4 + T-cell reconstitution observed shortly after transplant may be HHV-6B infection and depletion of peripheral (extra-thymic) CD4 + T cells, including a subpopulation of T reg cells. In turn, this may trigger a series of adverse events resulting in poor clinical outcomes such as severe aGVHD. In addition, recent evidence has linked HHV-6B reactivation with aberrant CD4 + T-cell reconstitution late after transplantation, which may be mediated by a different mechanism, possibly related to central (thymic) suppression of T-cell reconstitution. These observations suggest that aggressive management of HHV-6B reactivation in transplant patients may facilitate CD4 + T-cell reconstitution and improve the quality of life and survival of HCT patients.

In order to determine the role of human herpesvirus 6 (HHV-6) in human disease, several confounding factors, including methods of detection, types of controls, and the ubiquitous nature of the virus, must be considered. This is particularly problematic in the case of cancer, in which rates of detection vary greatly among studies. To determine what part, if any, HHV-6 plays in oncogenesis, a review of the literature was performed. There is evidence that HHV-6 is present in certain types of cancer; however, detection of the virus within tumor cells is insufficient for assigning a direct role of HHV-6 in tumorigenesis. Findings supportive of a causal role for a virus in cancer include presence of the virus in a large proportion of cases, presence of the virus in most tumor cells, and virus-induced in-vitro cell transformation. HHV-6, if not directly oncogenic, may act as a contributory factor that indirectly enhances tumor cell growth, in some cases by cooperation with other viruses. Another possibility is that HHV-6 may merely be an opportunistic virus that thrives in the immunodeficient tumor microenvironment. Although many studies have been carried out, it is still premature to definitively implicate HHV-6 in several human cancers. In some instances, evidence suggests that HHV-6 may cooperate with other viruses, including EBV, HPV, and HHV-8, in the development of cancer, and HHV-6 may have a role in such conditions as nodular sclerosis Hodgkin lymphoma, gastrointestinal cancer, glial tumors, and oral cancers. However, further studies will be required to determine the exact contributions of HHV-6 to tumorigenesis.

Graft-versus-host disease (GVHD) is an important cause of morbidity and mortality after allogeneic hematopoietic cell transplantation (HCT). Many studies have suggested that human herpesvirus-6B (HHV-6B) plays a role in acute GVHD (aGVHD) after HCT. Our objective was to systematically summarize and analyze evidence regarding HHV-6B reactivation and development of aGVHD. PubMed and EMBASE databases were searched using terms for HHV-6, HCT, and aGVHD, yielding 865 unique results. Case reports, reviews, articles focusing on inherited chromosomally integrated HHV-6, poster presentations, and articles not published in English were excluded. The remaining 467 articles were reviewed for the following requirements: a statistical analysis of HHV-6B reactivation and aGVHD was described, HHV-6B reactivation was defined by PCR, and blood (plasma, serum, or peripheral blood mononuclear cells) was used for HHV-6B PCR. Data were abstracted from publications that met these criteria (n = 33). Publications were assigned to 1 of 3 groups: (1) HHV-6B reactivation was analyzed as a time-dependent risk factor for subsequent aGVHD (n = 14), (2) aGVHD was analyzed as a time-dependent risk factor for subsequent HHV-6B reactivation (n = 1), and (3) analysis without temporal specification (n = 18). A statistically significant association (P < .05) between HHV-6B reactivation and aGVHD was observed in 10 of 14 studies (71%) in group 1, 0 of 1 study (0%) in Group 2, and 8 of 18 studies (44.4%) in Group 3. Of the 14 studies that analyzed HHV-6B as a risk factor for subsequent aGVHD, 11 performed a multivariate analysis and reported a hazard ratio, which reached statistical significance in 9 of these studies. Meta-analysis of these 11 studies demonstrated a statistically significant association between HHV-6B and subsequent grades II to IV aGVHD (hazard ratio, 2.65; 95% confidence interval, 1.89 to 3.72; P < .001). HHV-6B reactivation is associated with aGVHD, and when studies have a temporal component to their design, HHV-6B reactivation is associated with subsequent aGVHD. Further research is needed to investigate whether antiviral prophylaxis reduces incidence or severity of aGVHD., (Copyright © 2018 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.)

Severe obesity defined as an age- and gender-specific body mass index ≥120% of the 95th percentile in children younger than 5 years is well recognized as a significant challenge for prevention and treatment. This article provides an overview of the prevalence, classification of obesity severity, patterns of weight gain trajectory, medical and genetic risk factors, and comorbid disorders among young children with an emphasis on severe obesity. Studies suggest rapid weight gain trajectory in infancy, maternal smoking, maternal gestational diabetes, and genetic conditions are associated with an increased risk for severe obesity in early childhood. Among populations of young children with severe obesity seeking care, co-morbid conditions such as dyslipidemia and fatty liver disease are present and families report behavioral concerns and developmental delays. Children with severe obesity by age 5 represent a vulnerable population of children at high medical risk and need to be identified early and appropriately managed.

Upconversion nanoparticles (UCNPs) possess a unique type of photoluminescence (PL) in which lower-energy excitation is converted into higher-energy emission via multi-photon absorption processes. In this work, we have used a facile one-step hydrothermal method promoted water solubility to synthesis NaLuGdF 4 :Yb 3+ /Er 3+ (Tm 3+ ) UCNPs coated with malonic acid (MA). Scanning electron microscopy images and X-ray diffraction patterns reveal sphere-shaped UCNPs with an average size of ~80nm crystallized in the cubic NaLuF 4 structure. The characteristic vibrations of cubic UCNPs have been taken into account by using Fourier-transform infrared spectroscopy. Based on PL studies, we have determined an optimal concentration of Gd 3+ doping. The dependence of upconversion PL intensity on Gd 3+ concentration is discussed via the results of magnetization measurements, which is related to the coupling/uncoupling of Gd 3+ ions. Particularly, our study reveals that carboxyl-functionalized NaLuGdF 4 :Yb 3+ /Er 3+ (Tm 3+ ) UCNPs have a relatively high cell viability with HeLa cells., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Hysteresis of ferromagnetic system exhibits a fundamental stimulus-response behavior, thereby casting all the important macromagnetic system parameters such as coercivity, nucleation field, saturation magnetization, and hysteresis loss. Recently, increasing attention has been paid to exploration of relatively less understood minor loop behavior, since faster operation of magnetic devices is inevitably accompanied by minor hysteresis behavior from cycling among unsaturated ferromagnetic states. Here, we report our microscopic investigation of unusual minor hysteresis loop behavior, represented by rounded or sharpened response of minor hysteresis loop of (CoFeB/Pd) 4 multilayer film. It is observed that rounded and sharpened response in the minor hysteresis response could be manifested under proper conditions. The minor loop behavior has been systematically investigated by direct microscopic magnetic domain observation using magneto-optical Kerr microscopy. The rounded response of magnetization at the reversing external field along the minor hysteresis curve, so far neglected or considered as one of 'unusual' behaviors, has been found to be elaborately controllable by tuning the reversing field strength and the field sweep rate for multilayers with low repeat numbers. Variable roundedness of the minor hysteresis loop is understandable based on the analysis of magnetic domain dynamics such as domain nucleation and the domain wall velocity.

Human herpesvirus 6 (HHV-6A and HHV-6B) can cause primary infection or reactivate from latency in liver transplant recipients, which can result in a variety of clinical syndromes, including fever, hepatitis, encephalitis and higher rates of graft dysfunction as well as indirect effects including increased risks of mortality, CMV disease, hepatitis C progression and greater fibrosis scores. Although HHV-6 infection is currently diagnosed by quantifying viral DNA in plasma or blood, biopsy to demonstrate histopathological effects of HHV-6 remains the gold standard for diagnosis of end-organ disease. HHV-6 reactivation may be restricted to the infected organ with no evidence of active infection in the blood. HHV-6 infections in liver transplant patients are mostly asymptomatic, but clinically significant tissue-invasive infections have been treated successfully with ganciclovir, foscarnet or cidofovir. Inherited chromosomally integrated HHV-6 (ciHHV-6), in either the recipient or the donor organ, may create confusion about systemic HHV-6 infection. Recipients with inherited ciHHV-6 may have an increased risk of opportunistic infection and graft rejection. This article reviews the current scientific data on the clinical effects, risk factors, pathogenesis, diagnosis and treatment of HHV-6 infections in liver transplant recipients., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

This study reports the fabrication of a Petri dish patterned with cylindrical micro-cavities that are produced using a one-step solvent-immersion phase-separation process. The developed 3D honeycomb Petri dish is coated with a Au film through a sputtering method to be an efficient Au-coated FTO-free electrode for quantum-dot-sensitized solar cells. Due to the high specific active surface area of the electrode with the Au-coated honeycomb structure, the energy conversion efficiency of devices that use this electrode is 5.2 % compared to 4.4 and 4.7 % by devices using an Au-coated flat Petri dish and an Au-coated FTO electrode, respectively. This design strategy offers excellent potential for the fabrication of highly efficient counter electrodes with FTO-free substrates of flexible photovoltaic devices., (© 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

We tested an inactivated egg-grown whole virus influenza A/H5N1 vaccine candidate developed by the Institute of Vaccines and Medical Biologicals (IVAC), a state-run vaccine manufacturer in Vietnam, in a Phase 1, placebo controlled, double blinded, randomized trial. The vaccine was adjuvanted with aluminum hydroxide. The trial enrolled 75 subjects who were randomized to receive two injections of one of the following: low-dose of vaccine (7.5 mcg HA), high-dose of vaccine (15 mcg HA), or placebo. The vaccine candidate was well tolerated with minimal local reactogenicity consisting of mild, short-lived injection site pain and/or tenderness. No systemic reactogenicity was observed other than transient low-grade fever in about 13% of the subjects and no unsolicited adverse events were attributable to product administration. Immune responses were assessed at baseline and after the first and second dose by hemagglutination inhibition (HAI) and microneutralization (MN) assays, with 72% of the high-dose and 68% of the low-dose vaccine recipients presenting a ⩾4-fold response in the HAI assay and 72% of the high-dose and 61% of the low-dose vaccine recipients exhibiting a ⩾4-fold response in the MN assay. These promising results support further development. ClinicalTrials.gov number NCT02171819, June 20, 2014., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

We used wet chemical methods to synthesize core-shell nanocrystalline samples CdS(d)/ZnSe N , where d = 3-6 nm and N = 1-5 are the size of CdS cores and the number of monolayers grown on the cores, respectively. By annealing typical CdS(d)/ZnSe N samples (with d = 3 and 6 nm and N = 2) at 300 °C for various times t an = 10-600 min, we created an intermediate layer composed of Zn1-x Cd x Se and Cd1-x Zn x S alloys with various thicknesses. The formation of core-shell structures and intermediate layers was monitored by Raman scattering and UV-vis absorption spectrometers. Careful photoluminescence studies revealed that the as-prepared CdS(d)/ZnSe N samples with d = 5 nm and N = 2-4, and the annealed samples CdS(3 nm)/ZnSe2 with t an ≤ 60 min and CdS(6 nm)/ZnSe2 with t an ≤ 180 min, show the emission characteristics of type-II systems. Meanwhile, the other samples show the emission characteristics of type-I systems. These results prove that the partial separation of photoexcited carriers between the core and shell is dependent strongly on the engineered core-shell nanostructures, meaning the sizes of the core, shell, and intermediate layers. With the tunable luminescence properties, CdS-ZnSe-based core-shell materials are considered as promising candidates for multiple-exciton generation and single-photon sources.

Objective: To describe ethnic disparities in parental confidence managing child weight-related behaviors., Methods: This was a cross-sectional survey of 59 parents of children with obesity between 4 and 7 years of age presenting to a tertiary care pediatric weight management clinic. Parents completed a validated measure assessing their confidence managing their child's weight-related behaviors (parent confidence score). Student's t-tests and linear regression analyses were used to determine parent and child characteristics associated with parent confidence score., Results: Families were ethnically diverse with half being of Hispanic ethnicity. Mean parent confidence score was 159 (SD 66) with 71% of parents with parent confidence scores below the clinical cut-off for the measure. Parent confidence score was lower among Hispanic (mean 133, SD 67) compared to non-Hispanic parents (mean 184, SD 55, p < 0.01). Parent confidence score was most strongly associated with parental ethnicity (β = -0.39, p = 0.002, adjusted R(2) = 0.14)., Conclusion: Parental confidence managing weight-related behaviors was low among parents of young obese children, especially those of Hispanic ethnicity., Practice Implications: This study highlights the need to assess parental confidence in managing weight-related behaviors as part of pediatric obesity care and to provide counseling to improve parental management of weight-related behaviors in a culturally-appropriate manner., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

We propose a simple model to interpret the optical absorption spectra of porphyrin in different solvents. Our model successfully explains the decrease in the intensity of optical absorption at maxima of increased wavelengths. We also prove the dependence of the intensity and peak positions in the absorption spectra on the environment. The nature of the Soret band is supposed to derive from π plasmon. Our theoretical calculations are consistent with previous experimental studies.

Room-temperature ferromagnetism was found in BaTi0.98Mn0.02O3 nanoparticles fabricated by solid-state reaction and mechanical-ball milling. The nature of ferromagnetism was systematically investigated by means of X-ray diffraction (XRD), electron spin resonance (ESR), superconducting quantum interference device (SQUID), and X-ray absorption (XAS). A weak ferromagnetism was found in the defect-rich samples with the milling time (t(m)) longer than 6 hrs (i.e., t(m) > 6 hrs), while defect-poor ones with t(m) = 0-6 hrs exhibited mainly the paramagnetic properties. Detailed analyses of ESR and XAFS data indicated the shift in the oxidation state of Mn from 4+ to 3+ after milling, and both Mn3+ and Mn4+ were incorporated into the Ti sites of the BaTiO3-tetragonal host lattice. With the results obtained, we believe that exchange interactions due to Mn(4+)-Mn4+ and/or Mn(3+)-Mn3+ dipole pairs are responsible for broad ESR signals in the Lorentzian shape and the paramagnetic behaviors of the samples. Meanwhile, the weak ferromagnetic interaction is generated from various point defects such as Ti-site cation vacancies or Ti(3+)-Ti3+ super-exchange interaction pairs.

The Maxwell relation, the Clausius-Clapeyron equation, and a non-iterative method to obtain the critical exponents have been used to characterize the magnetocaloric effect (MCE) and the nature of the phase transitions in Pr0.5Sr0.5MnO3, which undergoes a second-order paramagnetic to ferromagnetic (PM-FM) transition at TC ~ 247 K, and a first-order ferromagnetic to antiferromagnetic (FM-AFM) transition at TN ~ 165 K. We find that around the second-order PM-FM transition, the MCE (as represented by the magnetic entropy change, ΔSM) can be precisely determined from magnetization measurements using the Maxwell relation. However, around the first-order FM-AFM transition, values of ΔSM calculated with the Maxwell relation deviate significantly from those calculated by the Clausius-Clapeyron equation at the magnetic field and temperature ranges where a conversion between the AFM and FM phases occurs. A detailed analysis of the critical exponents of the second-order PM-FM transition allows us to correlate the short-range type magnetic interactions with the MCE. Using the Arrott-Noakes equation of state with the appropriate values of the critical exponents, the field- and temperature-dependent magnetization [Formula: see text] curves, and hence the [Formula: see text] curves, have been simulated and compared with experimental data. A good agreement between the experimental and simulated data has been found in the vicinity of the Curie temperature TC, but a noticeable discrepancy is present for [Formula: see text]. This discrepancy arises mainly from the coexistence of AFM and FM phases and the presence of ferromagnetic clusters in the AFM matrix.

Objective: To evaluate the association between the frequency of visits and glycated hemoglobin (GHb) measurements on glycemic control in youth with type 1 diabetes., Research Design and Methods: A retrospective longitudinal cohort study of 1,449 youth with type 1 diabetes (mean age 11.4 years, 50% female, 74% Caucasian, 24% with Medicaid) followed at five pediatric endocrinology clinics from the years 2008-2011 was conducted. By hierarchical cluster analysis, three homogeneous groups of patients were generated: those with a relative increase in GHb (worsened [n = 237]), no change in GHb (stable [n = 842]), and a decrease in GHb (improved [n = 370]) over the study period. The number of visits and GHb measurements per year were compared among the three groups by multinomial logistic regression analysis using one visit or GHb test per year as a reference and controlling for patient demographic and baseline characteristics., Results: Patients with quarterly visits were least likely to have worsened glycemic control (odds ratio 0.33, P < 0.05) and were most likely to have improved glycemic control (3.48, P < 0.01). Patients with four GHb tests a year (0.53, P < 0.05) were least likely to have worsened glycemic control., Conclusions: Quarterly visits and GHb testing are associated with glycemic control in youth with type 1 diabetes.

The electrostatic potential profile of a spherical soft particle is derived by solving the Poisson-Boltzmann equations on a spherical system both numerically and analytically. The soft particle is assumed to consist of an ion-permeable charged outer layer and a non-permeable charged core with constant charged density. The contribution of the core to the potential profile is calculated for different charges and dielectric constants. Our results show that the charged core heavily influences the local potential within the soft particle. By contrast, the potential distribution outside the particle in the salt solution is found to be weakly dependent on the core features. These findings are consistent with previous experiments showing the minor impact of the core of the MS2 virus on its overall electrical properties. Our studies also indicate that while a change in temperature from 290 K to 310 K only slightly varies the potential, the ionic strength in the range of 1-600 mM has a significant effect on the potential profile. Our studies would provide good understanding for experimental research in the field of biophysics and nanomedicine.

The van der Waals interaction between a lipid membrane and a substrate covered by a graphene sheet is investigated using the Lifshitz theory. The reflection coefficients are obtained for a layered planar system submerged in water. The dielectric response properties of the involved materials are also specified and discussed. Our calculations show that a graphene covered substrate can repel the biological membrane in water. This is attributed to the significant changes in the response properties of the system due to the monolayer graphene. It is also found that the van der Waals interaction is mostly dominated by the presence of graphene, while the role of the particular substrate is secondary.

Background: Rates of body mass index (BMI) calculation and plotting remain low. We examined whether providing a BMI wheel and brief education to pediatric residents and attendings would increase rates of "BMI recognition" and obesity-related counseling., Methods: A delayed-control design was used to evaluate a 20-minute intervention. A total of 1640 records of well-child visits were reviewed to determine the proportion of records in which BMI was calculated and plotted and counseling provided., Results: In clinic A, there was a significant increase in the proportion of records in which BMI was recognized from pre- to postintervention (P < .01). No changes in clinic B occurred until after the delayed intervention. Obesity-related counseling was more likely to occur if BMI was recognized., Conclusion: Brief education and BMI wheel increased rates of BMI recognition. BMI recognition was associated with increased obesity management. Additional efforts should be incorporated to further increase BMI recognition and assist providers in treating these children.

Background: Predicting weight loss after laparoscopic adjustable gastric banding (LAGB) from preoperative factors has been challenging. This study aimed to determine the relationship between weight loss from a preoperative low-calorie meal replacement diet (LCMRD) and weight loss after LAGB in a cohort of morbidly obese adolescents., Methods: Fifty-one subjects (86 % female, 61 % Caucasian, mean age 16 years, mean weight 140.1 kg) received 2 weeks of LCMRD prior to LAGB. We utilized Pearson's correlation coefficients to test the relationship between weight loss on a LCMRD and weight loss at 3, 6, and 12 months after LAGB., Results: Mean weight loss was 5.7 kg (standard deviation (SD) 2.5) during the LCMRD period and 17.4 kg (SD 12.4) at 1 year postoperatively. Having a higher baseline weight (p < 0.01) and losing less weight prior to LCMRD (p < 0.05) was associated with more weight loss during LCMRD. Weight loss during LCMRD was not significantly associated with postoperative weight loss at any time point., Conclusions: Weight loss during LCMRD was not significantly associated with postoperative weight loss in our study. Less variability in adherence, less influence of genetic and biological potential, and more diuresis during a short course of LCMRD compared to in the postoperative period may explain this lack of association.

Background: The use of bariatric surgery as treatment for morbid obesity in adolescents has nearly tripled in recent years. Intelligence is an important component to a patient's assent of surgery and maintenance of a healthy lifestyle. The objective of this study was to describe the intelligence testing performance of a cohort of adolescents seeking laparoscopic adjustable gastric banding (LAGB). Twenty-nine patients (93% female, 62% white) with a mean age of 16 years and mean body mass index (BMI) of 49 kg/m(2) were enrolled in an adolescent bariatric program in the United States., Methods: We conducted a cross-sectional analysis, evaluating patient intelligence at a single preoperative time point using the Weschler Intelligence Scale for Children-IV or Weschler Adult Intelligence Scale-IV. Intelligence quotient (IQ) scores were analyzed descriptively and in relationship to patient anthropometric measurements and characteristics., Results: Mean IQ was average for age (95, SD 16), although 21% of patients had an IQ<80 and no patients had an IQ>120. There was no significant association between IQ and BMI, weight, or waist circumference. Mean IQ was lower in patients who had failed a grade compared with those who had not failed a grade (P<.01) and in patients whose parents had not graduated college compared with those whose parents had (P< .05)., Conclusion: In our cohort of adolescents seeking LAGB, mean IQ was average for age, suggesting capability to understand the procedure and healthy lifestyle concepts. Patients who exhibit deficits in intellect prior to surgery may benefit from educational resources and clinician support tailored to their reasoning abilities., (Copyright © 2013 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)

Objective: To determine which anthropometric measure best correlates with change in fat mass (FM) over time., Methods: The authors performed a retrospective cohort study of 76 obese patients (mean body mass index [BMI] 38 kg/m(2) and mean age 13 years) presenting to an obesity clinic between 2005 and 2010. For each patient, during 2 visits, FM was measured by bioelectrical impedance analysis and the following measures obtained: BMI, waist circumference, hip circumference, and neck circumference. Correlation coefficients and linear regression analyses were calculated to examine the relationship between each measure and FM., Results: Change in BMI correlated better with change in FM than any other measure and had the strongest effect on change in FM (P < .01, R (2) = .887). The best regression model included BMI only (R (2) = .891); without BMI, the model was significantly worse (R (2) = .521)., Discussion: In the clinical management of obese children, BMI is an adequate measure of change in FM.

We studied diffusion of Mn in ZnO nanowires by means of field-emission scanning electron microscopy, transmission electron microscopy, X-ray diffraction, photoluminescence and Raman scattering spectroscopy. The Mn-diffused samples were prepared by covering synthesized ZnO nanowires with a Mn chip and then annealing at temperatures between 200 and 1000 degrees C for 1 h in air. Microstructural analyses, and photoluminescence and Raman studies revealed that Mn atoms started diffusing in ZnO nanowires at 800 degrees C. The annealing-temperature increase up to 1000 degrees C led to a strong diffusion of Mn in the ZnO host lattice, which caused the blueshift of the ultra-violet emission. Concurrently, recored Raman scattering spectra showed some additional Mn-related modes. The origin of these lines was discussed in detail.

We have investigated normal and resonant Raman scattering in Me-doped ZnO nanorods (Me = Mn, Co, Cu and Ni) prepared by thermal diffusion. Experimental results show that the normal Raman spectra consist of the conventional modes associated with wurtzite ZnO and impurity-related additional modes. Under resonant conditions, only longitudinal optical (LO) phonon scattering and its overtones are observed. The number of LO phonon lines and their relative intensity depend on the doping element and level. For the nanorods doped with Cu and Ni, we have observed LO phonon overtones up to eleventh order. This situation does not happen for the Mn-doped nanorods, which show only five LO phonon modes. By co-doping Mn and Co into the ZnO host lattice, however, the LO phonon overtones up to eleventh order are observed again. The nature of this phenomenon is explained by means of the study of XRD, TEM and photoluminescence.

A study was conducted in central Vietnam to measure the prevalence of reproductive tract infections among clients of a family planning clinic, and to determine the usefulness of simple, clinic-based diagnostic tests. The prevalence of such infections was moderate, with the majority being endogenous. Few cases of cervical infection were identified, and no clinical or sociodemographic variables proved to be good predictors of such infection. Most vaginal infections could be identified through simple, clinic-based diagnostic tests, although further research into the cost-effectiveness of establishing and maintaining these services would be useful. Comparison of the results from laboratory tests and the presumptive diagnosis of the clinician indicate that the current practice of presumptive treatment is leading to significant overtreatment. Use of the World Health Organization flowcharts would reduce the overtreatment of vaginal infection but not of cervical infection. The importance of adapting the flowcharts to local epidemiology is highlighted.

As elevated endothelin-1 (ET-1) levels have been reported in systemic inflammatory diseases, the role of ET-1 as a promoter of inflammatory reactions is currently under investigation. The purpose of this study was to investigate the potential influence of ET-1 on systemic vascular pressure and immune function in terms of blood clearance and organ distribution of injected Escherichia coli in a rabbit model. To enable quantification of the clearance process, defined numbers of exogenous E. coli (10(8) cfu) were injected intravenously 60 min after starting the infusion of ET-1 (0.2 microgram kg-1 min-1; n = 9) or after saline infusion (controls, n = 9). Parameters monitored were arterial blood pressure, airway pressure, serum lactate concentrations and rates of bacterial elimination from the blood. At 180 min after E. coli injection, the animals were killed, and tissue samples of liver, kidney, spleen and lung were collected for bacterial counts. ET-1 infusion produced an increase in mean arterial pressure (83.9 +/- 3.9 mmHg vs. 50.1 +/- 4.1 mmHg at 120 min; P < 0.01) associated with higher serum lactate concentrations (12.6 +/- 1.3 vs. 5.4 +/- 0.3 mg dL-1; P < 0.001) and a delayed bacterial elimination from the blood compared with controls. Furthermore, there was increased colonization of the lungs (3.6 +/- 0.5 x 10(3) cfu vs. 745 +/- 120 cfu; P < 0.01), spleen (142.4 +/- 45.4 x 10(3) cfu vs. 227 +/- 5.2 x 10(3) cfu; P < 0.05) and kidney (758 +/- 329 vs. 357 +/- 151 cfu; NS), reflecting a reduced bacterial killing function.