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We review the recent results from the computation of saturated next-to-leading order perturbative QCD minijet initial conditions combined with viscous hydrodynamical evolution of ultrarelativistic heavy-ion collisions at the LHC and RHIC. Comparison with experimental data is shown. [ABSTRACT FROM AUTHOR]

Abstract: We calculate initial conditions for the hydrodynamical evolution in ultrarelativistic heavy-ion collisions at the LHC and RHIC in an improved next-to-leading order perturbative QCD + saturation framework. Using viscous relativistic hydrodynamics, we show that we obtain a good simultaneous description of the centrality dependence of charged particle multiplicities, transverse momentum spectra and elliptic flow at the LHC and at RHIC. In particular, we discuss how the temperature dependence of the shear viscosity is constrained by these data. [Copyright &y& Elsevier]

Bacterial lung infections, particularly with methicillin-resistant Staphylococcus aureus (MRSA), increase mortality following influenza infection, but the mechanisms remain unclear. Here we show that expression of TLR9, a microbial DNA sensor, is increased in murine lung macrophages, dendritic cells, CD8+ T cells and epithelial cells post-influenza infection. TLR9-/- mice did not show differences in handling influenza nor MRSA infection alone. However, TLR9-/- mice have improved survival and bacterial clearance in the lung post-influenza and MRSA dual infection, with no difference in viral load during dual infection. We demonstrate that TLR9 is upregulated on macrophages even when they are not themselves infected, suggesting that TLR9 upregulation is related to soluble mediators. We rule out a role for elevations in interferon-γ (IFNγ) in mediating the beneficial MRSA clearance in TLR9-/- mice. While macrophages from WT and TLR9-/- mice show similar phagocytosis and bacterial killing to MRSA alone, following influenza infection, there is a marked upregulation of scavenger receptor A and MRSA phagocytosis as well as inducible nitric oxide synthase (Inos) and improved bacterial killing that is specific to TLR9-deficient cells. Bone marrow transplant chimera experiments and in vitro experiments using TLR9 antagonists suggest TLR9 expression on non-hematopoietic cells, rather than the macrophages themselves, is important for regulating myeloid cell function. Interestingly, improved bacterial clearance post-dual infection was restricted to MRSA, as there was no difference in the clearance of Streptococcus pneumoniae. Taken together these data show a surprising inhibitory role for TLR9 signaling in mediating clearance of MRSA that manifests following influenza infection., Competing Interests: The authors have declared that no competing interests exist.

Objective: The aim of this retrospective clinical study was to evaluate the survival and the occurrence of technical and biological complications of zirconia crowns and fixed dental prostheses made in the student clinic of Turku University, Finland, between April 2009 and September 2017., Materials and Methods: Twenty-seven patients (19 female, 8 male), with zirconia crowns or FDPs, participated in the follow-up investigation. The mean age of patients was 64.6 years. Of the 40 restorations, 17 were single crowns and 23 FDPs. Twenty-seven restorations were anterior and 13 posterior. Restorations were investigated according to modified USPHS criteria., Results: The survival rate of zirconia restorations after 2-8 years (average 5.7 years) of clinical use was 95%. Survival rate of single crowns was 94.2% and of FDPs 95.7%, respectively. The overall complication rate was 26% for FDPs and 5.8% for crowns. One posterior crown was lost due to a vertical root fracture and one FDP showed a framework fracture. Veneering ceramic fractures were detected in 12% of all cases (0% for crowns and 22% for FDPs). Bleeding on probing was present in 38.1% of restored teeth and 13.9% of control teeth. Embrasure space was insufficient in 52% of zirconia FDPs and 81% of these restorations showed elevated BOP values., Conclusions: Zirconia crowns and FDPs survived well in this retrospective follow-up study. Chipping of veneering ceramic and bleeding on probing were the most common complications. Thick connector areas made according to material demands resulted in insufficient embrasure spaces and inflammation of marginal gingiva., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Nurses sometimes lack the competence needed for recognising deterioration in patient conditions and this is often due to poor clinical reasoning. There is a need to develop new possibilities for learning this crucial competence area. In addition, educators need to be future oriented; they need to be able to design and adopt new pedagogical innovations. The purpose of the study is to describe the development process and to generate principles for the design of nursing simulation games., Method: A design-based research methodology is applied in this study. Iterative cycles of analysis, design, development, testing and refinement were conducted via collaboration among researchers, educators, students, and game designers., Results: The study facilitated the generation of reusable design principles for simulation games to guide future designers when designing and developing simulation games for learning clinical reasoning., Conclusion: This study makes a major contribution to research on simulation game development in the field of nursing education. The results of this study provide important insights into the significance of involving nurse educators in the design and development process of educational simulation games for the purpose of nursing education., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: Clinical reasoning is viewed as a problem-solving activity; in games, players solve problems. To provide excellent patient care, nursing students must gain competence in clinical reasoning. Utilising gaming elements and virtual simulations may enhance learning of clinical reasoning., Objectives: To investigate nursing students' experiences of learning clinical reasoning process by playing a 3D simulation game., Design: Cross-sectional descriptive study., Setting: Thirteen gaming sessions at two universities of applied sciences in Finland. The prototype of the simulation game used in this study was single-player in format. The game mechanics were built around the clinical reasoning process., Participants: Nursing students from the surgical nursing course of autumn 2014 (N=166)., Methods: Data were collected by means of an online questionnaire., Results: In terms of the clinical reasoning process, students learned how to take action and collect information but were less successful in learning to establish goals for patient care or to evaluate the effectiveness of interventions. Learning of the different phases of clinical reasoning process was strongly positively correlated. The students described that they learned mainly to apply theoretical knowledge while playing. The results show that those who played digital games daily or occasionally felt that they learned clinical reasoning by playing the game more than those who did not play at all., Conclusion: Nursing students' experiences of learning the clinical reasoning process by playing a 3D simulation game showed that such games can be used successfully for learning. To ensure that students follow a systematic approach, the game mechanics need to be built around the clinical reasoning process., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: Cardiovascular patients suffer from reduced blood flow leading to ischaemia and impaired tissue metabolism. Unfortunately, an increasing group of elderly patients cannot be treated with current revascularization methods. Thus, new treatment strategies are urgently needed. Hypoxia-inducible factors (HIFs) upregulate the expression of angiogenic mediators together with genes involved in energy metabolism and recovery of ischaemic tissues. Especially, HIF-2α is a novel factor, and only limited information is available about its therapeutic potential., Methods: Gene transfers with adenoviral HIF-1α and HIF-2α were performed into the mouse heart and rabbit ischaemic hindlimbs. Angiogenesis was evaluated by histology. Left ventricle function was analysed with echocardiography. Perfusion in rabbit skeletal muscles and energy recovery after electrical stimulation-induced exercise were measured with ultrasound and (31)P-magnetic resonance spectroscopy ((31)P-MRS), respectively., Results: HIF-1α and HIF-2α gene transfers increased capillary size up to fivefold in myocardium and ischaemic skeletal muscles. Perfusion in skeletal muscles was increased by fourfold without oedema. Especially, AdHIF-1α enhanced the recovery of ischaemic muscles from electrical stimulation-induced energy depletion. Special characteristic of HIF-2α gene transfer was a strong capillary growth in muscle connective tissue and that HIF-2α gene transfer maintained left ventricle function., Conclusions: We conclude that both AdHIF-1α and AdHIF-2α gene transfers induced beneficial angiogenesis in vivo. Transient moderate increases in angiogenesis improved energy recovery after exercise in ischaemic muscles. This study shows for the first time that a moderate increase in angiogenesis is enough to improve tissue energy metabolism, which is potentially a very useful feature for cardiovascular gene therapy., (© 2014 Stichting European Society for Clinical Investigation Journal Foundation.)

Aims: The aim of the study was to compare and analyse the differences in self-reported frequencies of visits paid to physicians and hospitalisation rates, as well as their association with socio-demographic factors and health status self-rated by elderly., Methods: A cross-sectional study was performed in eight districts of five European countries (Finland, Sweden, Ireland, Croatia, and Greece). A total of 3540 persons aged 70 or more were interviewed by trained interviewers. Healthcare service utilisation and its association with demographic characteristics and self-rated health were analysed using descriptive statistical methods, chi-square test, and logistic regression., Results: Almost 90% of elderly visited a physician in the past year; 50% visited a specialist, while 24% were hospitalised. A visit to a specialist was paid by 70% of the Greek, 50% to 60% of the Croatian, and around 40% of the Irish, the Finnish, and the Swedish elderly. The highest proportion of hospitalisations (32%) was encountered in Greece and the lowest one (20%) in Sweden. Self-rated poor health appears to be the only common denominator associated with increased healthcare utilisation. Younger age stood out as a statistically significant predictor of the likelihood of specialist consults, while older age, male gender, and the synergy of male gender and current single life were disclosed as the predictors of hospitalisation frequency., Conclusions: Healthcare service utilisation exercised by the elderly across European districts was found to be highly variable and showed a clear distinction between north-western and south-eastern Europe; this is in line with differences in self-rated health.

This open-label multicentre semi-naturalistic study in Finland assessed the impact of educational information on efficacy of 16-week treatment with escitalopram (5-20 mg/day) in a patient population suffering from depression. Patients were randomized single blind to receive educational information (n=79) or no information (n=78) in addition to open-label escitalopram treatment. Patients were assessed using the Montgomery-Asberg Depression Rating Scale (MADRS), Clinical Global Impression - Severity and - Improvement (CGI-S and CGI-I), Patient Global Evaluation (PGE), and Hopkins Symptom Checklist (SCL-90) scales. Tolerability was assessed by the incidence of adverse events (AEs). A total of 132 (84%) out of 157 patients completed the study, with similar completer rates in both groups. There was no statistically significant effect of educational information on the efficacy of escitalopram treatment, as measured by MADRS, CGI and PGE. Mean MADRS total score was 25.3 at baseline, corresponding to moderate to severe depression, and decreased to 7.9 at the end of the treatment for both groups. The response rate (> or = 50% reduction in MADRS total score from baseline) was 80% at the end of treatment for both groups. The clinical relevance of the improvement was seen in CGI-I and PGE scores and there was a strong correlation between the two scales, indicating agreement by both patients and investigators. AEs were mostly mild and transient and 11 patients (7.0%) dropped out of the study due to AEs, with similar incidence in both groups. Escitalopram was effective and well tolerated in the treatment of depression over a 16-week period in a semi-naturalistic setting, and an additional effect of educational information could not be shown, possibly due to the high response to treatment.

GATA-4 and GATA-6 are zinc finger transcription factors that regulate gene expression, differentiation, and cell proliferation in various tissues. These factors have been implicated in the development of endodermal derivatives, including epithelial cells in the yolk sac, lung, and stomach. In the present study, we have characterized the expression of GATA-4 and GATA-6 during development of another endodermal derivative, the mouse pancreas, using a combination of in situ hybridization and immunohistochemistry. Neither GATA-4 nor GATA-6 antigen was detected in E10.5 pancreatic epithelial buds expressing Pdx-1. By E15.5, GATA-4 mRNA and protein were evident in developing pancreatic acini, but not in ductal or endocrine cells of the pancreas; GATA-6 mRNA and protein were present in both endocrine and exocrine cell precursors. In the newborn and adult pancreas, GATA-4 protein was seen in acinar cells, while GATA-6 antigen was found mainly in islet beta-cells. The amphicrine pancreatic AR42J-B13 cell line was used to study the expression of GATA-4 and GATA-6 during the differentiation of these cells towards an endocrine phenotype. Endocrine differentiation was associated with marked increase in GATA-6 but not GATA-4 mRNA levels. We conclude that GATA-4 is a marker of exocrine pancreatic differentiation, whereas GATA-6 is a marker of endocrine pancreatic development.

In intact (type A) chloroplasts isolated from mesophyll protoplasts of maize (Zea mays L. convar. KSC 360) the flash-induced 515 nanometer absorbance change was much higher than in conventionally prepared (types B and C) chloroplasts. The 515 nanometer signal of type A chloroplasts exhibited a biphasic rise: the initial very fast rise (rise time <<1 millisecond) was followed by a slow increase of absorbance (rise time 10 to 20 milliseconds). With decreasing degree of envelope retention the slow phase disappeared. Thus the biphasic rise of the flash-induced 515 nanometer absorbance change can be regarded as an attribute of intact chloroplasts.The 515 nanometer signal of intact chloroplasts was studied at various pH values of the external medium, with various dark intervals between the flashes and at different temperatures. The absorbance change was probed with electron transport inhibitors and ionophores. The data show that the fast phase of the absorbance increase was similar in chloroplasts isolated from protoplasts and in conventional chloroplast preparations. The slow rise, which has not been hitherto recognized in isolated chloroplasts, can be due to a contribution of the proton pump to the electric field which is generated across the thylakoid membranes.