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Payment for performance (P4P) has been employed in low and middle-income (LMIC) countries to improve quality and coverage of maternal and child health (MCH) services. However, there is a lack of consensus on how P4P affects health systems. There is a need to evaluate P4P effects on health systems using methods suitable for evaluating complex systems. We developed a causal loop diagram (CLD) to further understand the pathways to impact of P4P on delivery and uptake of MCH services in Tanzania. The CLD was developed and validated using qualitative data from a process evaluation of a P4P scheme in Tanzania, with additional stakeholder dialogue sought to strengthen confidence in the diagram. The CLD maps the interacting mechanisms involved in provider achievement of targets, reporting of health information, and population care seeking, and identifies those mechanisms affected by P4P. For example, the availability of drugs and medical commodities impacts not only provider achievement of P4P targets but also demand of services and is impacted by P4P through the availability of additional facility resources and the incentivisation of district managers to reduce drug stock outs. The CLD also identifies mechanisms key to facility achievement of targets but are not within the scope of the programme; the activities of health facility governing committees and community health workers, for example, are key to demand stimulation and effective resource use at the facility level but both groups were omitted from the incentive system. P4P design considerations generated from this work include appropriately incentivising the availability of drugs and staffing in facilities and those responsible for demand creation in communities. Further research using CLDs to study heath systems in LMIC is urgently needed to further our understanding of how systems respond to interventions and how to strengthen systems to deliver better coverage and quality of care., Highlights • Holistic analysis key to avoiding suboptimal P4P performance. • Availability of drugs is influenced by P4P and affects success of P4P. • Need to incentivise groups outside facility that support service coverage.

Introduction : The preparations based on hydroxyquinoline, in various combinations, are used in medicine, being shown to have an inhibitory effect against bacteria, molds, fungi, parasites, and viruses, but also having other beneficial effects mentioned in other medical conditions (anti-cancer, anti-degenerative, anti-inflammatory). Aims : In vitro susceptibility testing of microorganisms: bacteria (Gram positive and Gram negative), yeast ( Candida spp.,) and unicellular algae ( Prototheca spp.) at the preparations based on hydroxyquinoline (HQ) and its cupric derivatives deposited on hydroxyapatite (HAP). Materials and methods : There were tested microbial strains of the following genera: Escherichia , Staphylococcus , Micrococcus , Bacillus , Candida , and Prototheca . The tested products (developed in the Laboratory for Nanobiomaterials Synthesis, Center of Physical Chemistry, Faculty of Chemistry and Chemical Engineering, UBB Cluj-Napoca) were developed in three versions: 1) HQ–Cu 2+ –HAP 1 ; 2) HQ–Cu 2+ –HAP 2 ; and 3) NHQ–Cu 2+ –HAP 2 , where NHQ stands for nitro hydroxyquinoline. Determination of the inhibitory effect was conducted by diffusion technique in nutrient agar, according to CLSI 2013 standards, with necessary adaptations for testing of products made in the form of suspensions. Results : Following interpretation, it was found that the inhibition zones, arising from the antimicrobial effect of the tested products showed variability in size, depending on the test product and the microbial strain: Escherichia coli (8-10 mm), Staphylococcus sp. (17.6 - 23.2 mm), Micrococcus spp. (24.4 - 27.6 mm), Bacillus spp. (14.0 - 16.0 mm), Candida spp. (20.4 - 25.2 mm), Prototheca spp. (20.8 - 30.0 mm). From the three tested products, the best efficacy was found at the product no. 3 (NHQ – Cu 2+ – HAP 2 ), followed by no. 1 (HQ– Cu 2+ –HAP 1 ) and no. 2 (HQ–Cu 2+ –HAP 2 ). Conclusions : The inhibitory effect was bactericidal, manifested more intensively against Gram-positive bacteria, yeasts, and prototheca. Such products, prepared in the form of suspensions, may have practical application in the prevention and treatment of skin or hooves disorders. No resistance phenomena are recorded. Keywords : copper, hydroxyapatite, hydroxyquinoline, microorganisms, sensitivity.

Purpose Compositional tailoring is gaining more attention in the development of advanced biomimetic nanomaterials. In this study, we aimed to prepare advanced multi-substituted hydroxyapatites (ms-HAPs), which show similarity with the inorganic phase of bones and might have therapeutic potential for bone regeneration. Materials Novel nano hydroxyapatites substituted simultaneously with divalent cations: Mg2+ (1.5%), Zn2+ (0.2%), Sr2+ (5% and 10%), and Si (0.2%) as orthosilicate (SiO44-) were designed and successfully synthesized for the first time. Methods The ms-HAPs were obtained via a wet-chemistry precipitation route without the use of surfactants, which is a safe and ecologically friendly method. The composition of synthesized materials was determined by inductively coupled plasma optical emission spectrometry (ICP-OES). The materials were characterized by X-ray powder diffraction (XRD), FT-IR and FT-Raman spectroscopy, BET measurements and by imaging techniques using high-resolution TEM (HR-TEM), FE-SEM coupled with EDX, and atomic force microscopy (AFM). The ion release was measured in water and in simulated body fluid (SBF). Results Characterization methods confirmed the presence of the unique phase of pure stoichiometric HAP structure and high compositional purity of all synthesized nanomaterials. The doping elements influenced the crystallite size, the crystallinity, lattice parameters, morphology, particle size and shape, specific surface area, and porosity. Results showed a decrease in both nanoparticle size and crystallinity degree, coupled with an increase in specific surface area of these advanced ms-HAP materials, in comparison with pure stoichiometric HAP. The release of biologically important ions was confirmed in different liquid media, both in static and simulated dynamic conditions. Conclusion The incorporation of the four substituting elements into the HAP structure is demonstrated. Synthesized nanostructured ms-HAP materials might inherit the in vivo effects of substituting functional elements and properties of hydroxyapatite for bone healing and regeneration. Results revealed a rational tailoring approach for the design of a next generation of bioactive ms-HAPs as promising candidates for bone regeneration.

This study reports the synthesis of new porous nanohydroxyapatites (HAPs) substituted with different Zn contents (HAP_Zn) employing calcium and zinc nitrates and diammonium hydrogen phosphate as precursors. The synthesis was conducted in the presence of a surfactant, L-asparagine, for controlling the pore size distribution and morphology of obtained nanopowders, using a co-precipitation route. Thus a new approach leading to HAP_Zn nanopowders with improved nucleation and crystallization ability was developed. After maturation treatment of dispersions and filtration, the precipitate was lyophilized and ground. Part of the samples was calcined at 300°C for 1 h. The zinc content in the nanoHAPs varies from 0.2 to 10 wt% (substitution degree of Ca by Zn from 0.3 to 15.8 mole %). XRD investigations indicated HAP as the unique phase present and the nanostructured nature of the obtained HAPs. FTIR spectra also confirmed the presence of HAP structure. TEM, SEM, and AFM images showed the morphology of the ...

Through the Comprehensive Primary Care (CPC) and Comprehensive Primary Care Plus (CPC+) programs, the Centers for Medicare & Medicaid Services (CMS) has encouraged primary care practices to invest in “comprehensive primary care” capabilities. Empirical evidence suggests these capabilities are under-reimbursed or not reimbursed under prevailing fee-for-service payment models. To help CMS design alternative payment models (APMs) that reimburse the costs of these capabilities, the authors developed a method for estimating related practice expenses. Fifty practices, sampled for diversity across CPC+ participation status, geographic region, rural status, size, and parent-organization affiliation, completed the study. Researchers developed a mixed-methods strategy, beginning with interviews of practice leaders to identify their capabilities and the types of costs incurred. This was followed by researcher-assisted completion of a workbook tailored to each practice, which gathered related labor and nonlabor costs. In a final interview, practice leaders reviewed cost estimates and made any needed corrections before approval. A main goal was to address a persistent question faced by CMS: When practices reported widely divergent costs for a given capability, was that divergence due to practices having different prices for the same capability or from their having substantially different capabilities? The cost estimation method developed in this project collected detailed data on practice capabilities and their costs. However, the small sample did not allow quantitative estimation of the contributions of service level and pricing to the variation in overall costs. This cost estimation method, deployed on a larger scale, could generate robust data to inform new payment models aimed at incentivizing and sustaining comprehensive primary care.

Introduction: This dissertation develops a grounded and dynamic theory of primary care transformation (PCT) in a health service delivery organization (HSDO) implementing the Patient-Centered Medical Home model, in the United States of America. The focus of this theory is on the structural facilitators and challenges to achieving and sustaining high quality primary care. Methodology: Fieldwork performed included semi-structured interviews conducted across the HSDO (n=82), direct observations (n=10 clinics) and archival review. This dissertation utilizes newly-developed methods for theory development and validation, in concert with existing system dynamics methods; with an improved potential to integrate findings across quantitative and qualitative research directions. Results: My theory illuminates how the actions of various stakeholders (medical assistants, managers, clinicians and patients) interact with each other and with the fundamental characteristics of primary care service delivery to create diverse transformation trajectories. Two types of leverage points are identified: policies and preferences. The latter are more difficult to modify as they require changing stakeholders’ mental models. It is the combination of policies and preferences interacting within the system structure that produces hoped-for and feared transformation trajectories. There is no policy that induces success regardless of stakeholder preferences. There are some preferences that induce success or failure regardless of the policies being implemented. Conclusion: Sustaining success requires understanding the system structure within which policies and preferences operate – how decisions are made, their consequences, and the delays involved. Otherwise, transformation risks being overwhelmed by unintended consequences, misunderstood system behavior or impatience. This work presents an improved understanding of what PCT involves, and of how operational and cognitive aspects intersect. Overall, this work is more than a study of transformation. It presents theory, methods and a case for the development of an integrative methodology and paradigm.

Novel [Fe(4-benzyl-2-hydroxyphenyl-propylidene)2ethylene-diamine], and [Fe (2,4,6-trihydroxy-benzyl-4-metoxiphenyl-methylidene)2ethylene-diamine] complexes were synthesized by reacting FeII salt with the indicated Schiff-base ligands. The compounds were characterized by57Fe Mossbauer spectroscopy, FTIR, UV-VIS, TG-DTA-DTG, MS, AFM, XRD, cyclic voltammetry and biological activity measurements. 295 K and 78 K Mossbauer spectra revealed that iron is dominantly in high spin FeII state in both complexes while simultaneously a minor low spin FeII was also present in both complexes, furthermore a minor high spin FeIII was observed in [Fe(2,4,6-trihydroxy-benzyl-4-metoxiphenyl- methylidene) 2ethylene-diamine], too.

Urban street dust (SD) represents a natural source of mineral floating particles (FP) in the atmosphere. The FP particles have usually a wide range of sizes. These particles were monitored and collected by automatic stations in Cluj-Napoca, Romania. The SD and FP samples were investigated by XRD and SEM-EDX analysis. The obtained results prove that both, SD and FP, have a similar composition, namely quartz, clay particles (e.g., muscovite, and kaolinite), calcite, and trace of lepidocrocite. Nanostructural features and fine micro-scaled particles are observed. Quartz and clay nanoparticles were found in SD samples as well as in FP samples. The AFM investigation reveals a nano-size range for quartz particles between 80–90 nm, and 40–60 nm diameter for clay particles. Similar values were obtained by TEM microscopy. The high resolution microscopy results were confirmed by the values obtained by Scherrer formula applied to the XRD patterns. Composition and dimensional similarities found for the nanopa...

The aim of the present study was to obtain and to investigate nano forsterite and nano forsterite biocomposites for biomedical application. New self-curing forsterite biocomposites were obtained by mixing nano forsterite powder (5, 15, 30, 50, 70 wt %) with 2,2-bis[4-(2-hydroxy-3-methacryloyloxypropoxy)-phenyl]propane (bis-GMA) and triethyleneglycol dimethacrylate (TEGDMA) monomers. The new nano forsterite biocomposites were investigated for mechanical properties: compressive strength (CS) (143-147.12 MPa), compressive modulus (CM) (1.67-2.75 GPa), diametral tensile strength (DTS) (27.33-31.55 MPa), flexural strength (FS) (59.47-83.20 MPa) and flexural modulus (FM) (2.05-8.60 GPa). Increases of CS, DTS, FS with increasing amount of forsterite were observed up to 50 wt %. The highest CM and FM values were registered for 70 wt % and a direct correlation between the forsterite volume fraction (%) was observed. SEM micrographs revealed the morphology of surface of fractured biocomposites after CS test. XPS indicated that these biocomposites promoted the hydroxyapatite formation on their surface immersed in simulated body fluid (SBF). AFM images showed that the growth of the hydroxyapatite layer occurs with a preferred orientation on the surface of forsterite biocomposites after immersion in SBF. Incorporation of nano forsterite in the polymer matrix (bis-GMA/TEGDMA) did show osteoblast adhesion and proliferation was improved on nano forsterite biocomposites. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1290-1301, 2016.

A series of novel [Fe(MeiPrGlyoxH)2(amine)2] complexes have been synthesized [(MeiPrGlyoxH2 = methylisopropylglyoxime, amine = 3,5-dimethylpyridine, 4-(dimethylamino)pyridine, 4-(phenylamino)phenol, 2-imidazolidone)] and characterized by 57Fe Mossbauer, FTIR, UV–Vis spectroscopy, mass spectrometry, AFM and thermoanalytical methods. Quantum chemical (DFT) computations of [Fe(MeiPrGlyoxH)2(3,5-dimethyl-Py)2] (Py = pyridine) complex were also performed. The square-planar structure of [Fe(MeiPrGlyoxH)2] moiety is similar to that of [Fe(MeEtGlyoxH)2]. The incorporation of branching alkyl chains (isopropyl) in the complexes alters the Fe–N bond length and results in high-spin iron(II) state.

Nanocrystalline forsterite (Mg2SiO4) was synthesized by the precipitation method using Mg(NO3)2∙6H2O, C8H20O4Si (TEOS) and sodium hydroxide as pH regulator as starting materials. The thermal behaviour of the mixture was investigated by a MOM derivatograh. According to DTA results the initial crystallization temperature of the forsterite is about 800oC. The powder calcined at 900oC was characterized by X ray diffraction (XRD). The forsterite was noticed as the main crystalline phase besides of small amounts of periclase (MgO). Polycrystalline forsterite with uniform sized particles and spherical shape is evidenced by electronic microscopy (TEM, SEM). Grain size of forsterite powder according to Counter Coulter-type laser granulometer results is in the range of 10 - 42 nm.

Improving interpersonal continuity of care—the personal relationship forged between a patient and their primary care provider (PCP) over time—is often considered a goal of primary care. Continuity of care is frequently assessed in terms of longitudinal continuity, or the proportion of encounters with one practitioner, overlooking aspects of the patient-provider relationship that are key to interpersonal continuity of care. Further, few studies explore patients’ perspectives regarding which care experiences enhance or detract from the patient-provider relationship. This study, using focus group interviews, a patient experience CAHPS-PCMH survey, and electronic medical records, explored how patients’ experiences at 10 primary care clinics influenced their perceptions of their relationship with their PCPs. Focus group interviews with 63 participants indicated that patients’ experiences in the clinics, such as wait-times, influenced their perceptions of the patient-provider relationship. The relationship between patient experience and interpersonal continuity was empirically assessed using survey responses and medical records (n=645). We used patients’ perceptions that their provider knows them as a person as a measure of interpersonal continuity. Logistic regression results indicated that being seen within 15 minutes, receiving visit reminders, effective provider communication, and satisfaction, positively influenced patient perceptions of the patient-provider relationship. Furthermore, patients’ care experiences shaped their perceptions of the patient-provider relationship independent of their satisfaction with care. The mixed methods design adds depth to our understanding of patients’ care experiences, and illustrates that these experiences are critical for understanding the patient-provider relationship. Future research on interpersonal continuity should take patient experiences into account.

Nano hydroxyapatite doped with zinc (0.2 wt%), silver (0.25 wt%) and gold (0.025 wt%), (HAP), has been obtained by an innovative wet chemical approach, coupled with a reduction process for silver and gold. The synthesized multi-substituted nano HAP was freeze-dried and calcined at 650 °C. Nano HAP has been characterized by XRD, FTIR spectroscopy and imaging techniques: TEM, SEM and AFM. Then, nano HAP was mixed with previously synthesized silver nanoparticles (AgNPs), in the amount of 9 wt%, to give a novel material (HAP-Ag). The AgNPs were prepared by the reduction of silver nitrate with glucose in alkaline medium. TEM and UV–Vis confirmed the formation of AgNPs with an average size of 12 nm. Further, organic matrix composites were obtained from a filler made of HAP and/or HAP-Ag and a mixture of monomers (such as bis-GMA and TEG-DMA), which were polymerized at various compositions in AgNPs content up to 5.4 wt%. Antibacterial activities of these composites were investigated against several different pathogenic species: Escherichia coli, Staphylococcus aureus, Staphylococcus spp., Bacillus cereus, and Candida albicans, using the Kirby–Bauer disk-diffusion method. Antibacterial activities are enhanced with increasing of silver content within composites. These effects clearly reveal that AgNPs can be effectively utilized in combination with multi-substituted HAP and polymeric matrix, both used as carriers, in order to improve their efficiency against various pathogenic species. These composites can be considered a promising antimicrobial material for coating of orthopedic and dental implants or used as bone cements in surgical applications.

Nanostructured calcium phosphates, such as nanohydroxyapatite (HAP) and HAP with silicon content (HAP-Si) of 0.47wt.% (1% SiO2), 2.34wt.% (5% SiO2) and 4.67wt.% (10% SiO2) in the final product, were synthesized by aqueous precipitation, freeze dried and then calcined at 650, 950 and 1150°C. The obtained materials were investigated by X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectrometry, transmission electron microscopy (TEM), scanning electron microscopy (SEM) and atomic force microscopy (AFM) imaging. From the analysis of the XRD patterns, the HAP and β-tricalcium phosphate (β-TCP) phases were identified and their amounts in the samples were estimated. The size of HAP and β-TCP crystallites was estimated to be in the nanocrystalline domain. FTIR spectra showed the presence of characteristic vibrations for P-O, H-O and Si-O groups and their modification with Si content and calcination temperature. TEM, SEM and AFM images also revealed the morphology of the particles and of their aggregates. These materials have been used to manufacture scaffolds which were tested for their influence on adhesion and proliferation of cells, in human osteoblast culture, considering their further use in bone reconstruction. It was found that an appropriate addition of silicon in nanocalcium phosphate scaffolds leads to an enhanced adhesion and proliferation of cells in osteoblasts in vitro.

A biogenic approach for the synthesis of gold nanoparticles (GNPs) by reducing chloroauric acid (HAuCl4) with three different plant extracts (from Angelica, Hypericum, and Hamamelis) is described. The content of reducing compounds (polyphenols) in each plant extract was determined by photometric dosing. The formation of GNPs was tracked by ultraviolet-visible spectroscopy and their characterization was performed using transmission electron microscopy (TEM) and atomic force microscopy (AFM) imaging and FTIR spectra. GNPs, with diameters ranging from about 4 nm to 8 nm, were obtained at room temperature and pH value about 8. They present various shapes from spherical, to ovals, heart or polyhedral forms. Generally, the GNPs colloidal dispersions are rather stable in time, and the self assembly of GNPs is sparsely observed. However, at lower concentration of the plant extract the tendency to self aggregation of the GNPs increased. The plant extracts contain reducing agents, compounds with stabilizing effect ...

The goal of this study was to analyze the response of osteoblasts cultured on strontium substituted hydroxyapatites (HAP-Sr) of well-defined high crystallinity deposited as thin films on glass plates. Up to now, this aspect has not been carefully investigated in the context of bio-ceramics. In this study, we present the osteoblasts activity on synthesized HAP-Sr for different amounts of strontium substitution for calcium within the hydroxyapatite (Ca10(PO4)6(OH)2, HAP) lattice, namely HAP-5%Sr, HAP-10%Sr, HAP-15%Sr and HAP-59.2%Sr (Sr-HAP, of formula Sr10(PO4)6(OH)2), in comparison with stoichiometric pure HAP, chosen as control. Each bio-ceramic was deposited as thin multilayers self-assembled substrate (scaffold) and chemically bonded to the surface of glass plates. These coatings revealed by AFM and SEM imaging a granular texture formed from bio-ceramic nanoparticles. They possessed a high degree of crystallinity, i.e. 68% to 86%, depending on the Sr amount within the HAP lattice, as judged by XRD. Osteoblasts were cultured up to 21days and displayed enhanced adhesion and proliferation particularly evidenced on relatively high strontium contents (especially 5 and 10 weight %, determined by SEM-EDX), where the alkaline phosphatase activity and type I collagen were strongly evidenced. These bio-ceramics showed a high in vitro biocompatibility stimulating the activity of osteoblasts in the process of bone formation. These nano biomaterials can have applications in orthopedic and dental surgery improving the osteointegration as coatings of bone implants as well as for bone repair and regeneration.

The kinetic analysis of the adsorption of two carotenoids (i.e., ethyl ester of beta-apo-8'-carotenoic acid and beta-carotene, all trans-isomers) from n-hexane solutions at the oil/water interface is presented for several carotenoid concentrations in the oil phase. A new kinetic approach is developed and it addresses the diffusion adsorption associated with a reversible interfacial reaction, which describes the reorientation of surfactant molecules between two conformations. This approach leads to a general analytical expression that contains four physical parameters and describes with high accuracy the experimental dynamic interfacial tensions for the two carotenoids, which independently adsorb from n-hexane phase to the n-hexane/water interface. The calculations give the characteristic times for the carotenoid adsorption at the oil/water interface in terms of diffusion relaxation and kinetic relaxation times. The results explain the long time effects on the adsorption of these carotenoids at the oil/water interface. The data are in substantial agreement with the molecular structure of these carotenoids and with the earlier data recorded for cholesterol adsorption at the n-heptane/water interface. Based on these findings, we propose a molecular mechanism for the interfacial transformation of carotenoid molecules at a hydrophobic/hydrophilic interface. (C) 2004 Elsevier B.V. All rights reserved.

Aurora Mocanu,1 Roxana Diana Pasca,1 Gheorghe Tomoaia,2 Corina Garbo,1 Petre T Frangopol,1 Ossi Horovitz,1 Maria Tomoaia-Cotisel11Chemical Engineering Department, Babes-Bolyai University, 2Orthopedic Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, RomaniaAbstract: Silver nanoparticles (AgNPs) were prepared in aqueous colloid dispersions by the reduction of Ag+ with glucose in alkaline medium. Tetraethyl orthosilicate and l-asparagine were added as stabilizers of NPs. The AgNPs were characterized, and their interaction with three local anesthetics (procaine, dibucaine, or tetracaine) was investigated. Optical spectra show the characteristic absorption band of AgNPs, due to surface plasmon resonance. Modifications in the position and shape of this band reflect the self-assembly of metal NPs mediated by anesthetic molecules and the progress in time of the aggregation process. Zeta-potential measuring was applied in order to characterize the electrostatic stability of the NPs. The size and shape of the AgNPs, as well as the features of the assemblies formed by their association in the presence of anesthetics, were evidenced by transmission electron microscopy images. Atomic force microscopy images showed the characteristics of the films of AgNPs deposited on glass support. The effect of the anesthetics could be described in terms of electrostatic forces between the negatively charged AgNPs and the anesthetic molecules, existing also in their cationic form at the working pH. But also hydrophobic and hydrogen bonding interactions between the coated nanoparticles and anesthetics molecular species should be considered.Keywords: self-assembled nanostructures, UV-vis spectra, TEM, AFM, zeta potential

Although total joint replacement surgery has become common in recent years, problems due to bacterial infection remain a significant complication following this procedure. One approach in our study was to obtain a self-cured bone cement based on hydroxyapatite with nanosilver (Hap-Ag) and ZrO2 and polymer matrix based on 2,2-bis[4-(2-hydroxy-3-methacryloyloxypropoxy)-phenyl]propane/triethyleneglycol dimethacrylate. New materials were tested for: in vitro silver release, compressive strength (CS), compressive modulus (CM), and radiopacity. In vitro silver release increased in time and depended of silver content in cement. The highest silver release was registered for the cement with 1.26 wt% silver content. The results reveal that the CS for bone cement was between 133.37 and 146.70 MPa and CM was between 1.68 and 1.82 GPa (p > 0.05). A slow increasing of CM was registered for samples with 1.5/1 powder/liquid ratio. Addition of nanosilver and ZrO2 increased radiopacity of experimental bone cement.

A series of new biomedical resin composites based on 2,2-bis[4-(2-hydroxy-3-methacryloyloxypropoxy)-phenyl]propane/triethyleneglycol dimethacrylate resin reinforced with alkaline resistant (AR) glass fibers and BaSO4 powder in different ratios were prepared. The mechanical properties—that is, compressive strength (CS), flexural strength (FS), and flexural modulus (FM)—were determined. The results showed an increase of FS and FM and a slight decrease of CS with an increasing amount of glass fibers. Results revealed that CS increases in the following order: light-curing composites < self-curing composites < dual-curing composites. Structure of the resin composites were investigated by scanning electron microscopy of the fractured surface of composites after the FS test at different fiber amounts. Atomic force microscopy images of the polished surface of composites showed an increasing surface roughness with increasing filler content.

Forsterite, a new biocompatible material was synthesized from Mg(NO3)2·6H2O and TEOS by using the sol–gel method. The material was then heated at 800, 900 and 1000 °C. The forsterite was noticed as the main crystalline phase in the material fired at 900 and 1000 °C, while periclase (MgO) was present in all the samples. The tests confirm that in the first two samples forsterite is present as crystallites

The basic of all proteins is constituted by approximately 20 common amino acids that differ only in the structure of their side chain. The purpose of our work was to use the overpressured layer chromatography (OPLC) technique for the separation and identification of the essential and non-essential amino acids from some most common proteins, like hen egg yolk protein, bovine serum albumin (BSA), and Type I Collagen from bovine achilles tendon. In this order, the target proteins were acid-hydrolyzed and derivatized. For the separation of essential amino acids from egg yolk, two successive OPLC developments (normal and overrunning) were performed, followed by direct derivatization with 4-hydroxybenzaldehyde and ninhydrin on the chromatoplate for identification. In the hydrolyzed egg yolk, nine essential amino acids were identified. Between lysine and histidine, a poor separation was obtained. The amino acids from BSA and Type I Collagen were separated and identified as phenylthiohydantoin (PTH) derivatives b...

In the present study a new strategy of synthesis was developed for nanostructured calcium phosphates, such as hydroxyapatite (HAP) or silicon, magnesium and zinc modified hydroxyapatites of controlled characteristics (such as the shape and size of nanoparticles, porosity and crystallinity) by precipitation reactions. These inorganic powders were jointly used with chitosan (CHI) and collagen type I (COL) to manufacture fibrous biocomposite scaffolds made of self-assembled layers by using layer by layer technique for cell cultures. The resulting materials were characterized by using X-ray diffraction, SEM, TEM and AFM. This work also reports the structural data obtained on the surface of the newly prepared nanostructured porous scaffolds made of self-assembled nanoHAP–Si(0.2%)–Mg(0.6%)–Zn(0.2%)/CHI/COL layers at 7 days in human osteoblastic cell culture. A new porous structure was found by SEM imaging on the surface of these scaffolds due to the cells and scaffold interactions. This structure is apparently similar to the bone tissue. Our data have indicated that the incorporation of small amounts of silicon, magnesium and zinc within the nanoHAP lattice improved the biological activity of human osteoblasts on these scaffolds, in vitro. The data have revealed the high importance of HAP nanostructure and its composition in the preparation of fibrous scaffolds with potential applications in particle technology, bone tissue engineering and nano medicine.

Care management (CM) is a promising team-based, patient-centered approach “designed to assist patients and their support systems in managing medical conditions more effectively.” As little is known about its implementation, this article describes CM implementation and associated lessons from 12 Agency for Healthcare Research and Quality–sponsored projects. Two rounds of data collection resulted in project-specific narratives that were analyzed using an iterative approach analogous to framework analysis. Informants also participated as coauthors. Variation emerged across practices and over time regarding CM services provided, personnel delivering these services, target populations, and setting(s). Successful implementation was characterized by resource availability (both monetary and nonmonetary), identifying as well as training employees with the right technical expertise and interpersonal skills, and embedding CM within practices. Our findings facilitate future context-specific implementation of CM within medical homes. They also inform the development of medical home recognition programs that anticipate and allow for contextual variation.