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Background In the present study, we set out to compare patient-reported outcomes with professional judgment about cosmesis after breast-conserving therapy (bct) and to evaluate which items (position of the nipple, color, scar, size, shape, and firmness) correlate best with subjective outcome. Methods Dutch patients treated with bct between 2008 and 2009 were analyzed. Exclusion criteria were prior amputation or bct of the contralateral breast, metastatic disease, local recurrence, or any prior cosmetic breast surgery. Structured questionnaires and standardized six-view photographs were obtained with a minimum of 3 years' follow-up. Cosmetic outcome was judged by the patients and, based on photographs, by 5 different medical professionals using 3 different scoring systems: the Harvard scale, the Sneeuw questionnaire, and a numeric rating scale. Agreement was scored using the intraclass correlation coefficient (icc). The association between items of the Sneeuw questionnaire and a fair-poor Harvard score was estimated using logistic regression analysis. Results The study included 108 female patients (age: 40-91 years). Based on the Harvard scale, agreement on cosmetic outcome between the professionals was good (icc: 0.78). In contrast, agreement between professionals as a group compared with the patients was found to be fair to moderate (icc range: 0.38-0.50). The items "size" and "shape" were identified as the strongest determinants of cosmetic outcome. Conclusions Cosmetic outcome was scored differently by patients and professionals. Agreement was greater between the professionals than between the patients and the professionals as a group. In general, size and shape were the most prominent items on which cosmetic outcome was judged by patients and professionals alike. [ABSTRACT FROM AUTHOR]

We investigated the effects of two 5-wk periods of intermittent hypoxia on running economy (RE). 11 male and female middle-distance runners were randomly assigned to the intermittent hypoxia group (IHG) or to the control group (CG). All athletes trained for a 13-wk period starting at pre-season until the competition season. The IHG spent additionally 2 h at rest on 3 days/wk for the first and the last 5 weeks in normobaric hypoxia (15-11% FiO2). RE, haematological parameters and body composition were determined at low altitude (600m) at baseline, after the 5th, the 8th and the 13th week of training. RE, determined by the relative oxygen consumption during submaximal running, (-2.3±1.2 vs. -0.3±0.7 ml/min/kg, P<0.05) and total running time ( + 1.0±0.9 vs. +0.4±0.5min, P<0.05) changed significantly between the IHG and CG only during the first 5-wk period. Haematological and cardiorespiratory changes indicate that the improved RE was associated with decreased cardiorespiratory costs and greater reliance on carbohydrate. Intermittent hypoxia did not affect RE during the second 5-wk period. These findings suggest that the effects of intermittent hypoxia on RE strongly depend on the training phase. [ABSTRACT FROM AUTHOR]

OBJECTIVE: In response to findings from a statewide survey of hospital nurses, the authors designed, conducted, and evaluated a 'Back to Sleep' nursing curriculum and training program in Missouri hospitals using two distinct training formats. This article evaluates the initial and follow-up outcomes for training participants and assesses the impact of training format on participant outcomes. METHODS: Participants selected training format by hospital site. In each training format, participants responded to a pre and post test questionnaire measuring knowledge, beliefs, and current infant care behaviors as well as satisfaction with the training. Three months after completion of all statewide trainings, the authors also conducted a follow-up survey. RESULTS: Nurses who participated in the training reported statistically significant improvements in knowledge and 'Back to Sleep' adherent beliefs. Over 98% of participants (N = 515) intended to place infants in back-only sleep positions following the training. Knowledge, attitudes, and practice intentions were significantly improved across both training formats. Additionally, follow-up survey respondents statewide (N = 295) reported lasting improvements, including 63% of nurses reportedly using supine-only sleep position for infants after the first 24 h of life, compared to 28% in the original statewide survey. CONCLUSIONS: Further research is needed to determine the long-term impact of this intervention and assess its applicability beyond this initial implementation. Ultimately, the findings from the evaluation of this pilot intervention and nursing-specific 'Back to Sleep' curriculum demonstrate that it has a promising effect on risk-reduction adherence in hospital settings where parent observations of safe sleep behavior first occur. [ABSTRACT FROM AUTHOR]

Abstract: A biodegradable, β-emitting implant has been developed and successfully tested which prevents fresh intraocular pressure increase after glaucoma filtering surgery. Ion implantation has been used to load the polymeric implants with the β-emitter 32P. The influence of ion implantation and gamma sterilisation on degradation and 32P-fixation behavior has been studied by ion beam and chemical analysis. Irradiation effects due to the applied ion fluence (1015 ions/cm2) and gamma dose (25kGy) are found to be tolerable. [Copyright &y& Elsevier]

A novel synthetic route for preparation of amphiphilic heteroleptic ruthenium(II) complexes of the type [Ru(H2dcbpy)Cl(cymene)]NO3 (1) [Ru(H2dcbpy)(dmbpy)(NCS)2] (2), [Ru(H2dcbpy)(dhbpy)(NCS)2] (3) [Ru(H2dcbpy)(dnbpy)(NCS)2] (4) and [Ru(H2dcbpy)(dtdbpy)(NCS)2] (5) have been developed starting from dichloro(p-cymene)ruthenium(II) dimer. The performance of these complexes as charge-transfer photosensitizers in nanocrystalline TiO2-based solar cells was studied. When anchored complexes 2–5 onto a 12+4 μm thick nanocrystalline TiO2 films achieve very efficient sensitization over 85±5% incident photon-to-current efficiencies (IPCEs) in the visible region. Under standard AM 1.5 sunlight, using an electrolyte consisting of 0.6 M BMII; 0.05 M I2; 0.1 M LiI; 0.5 M tert-butyl pyridine in 1:1 acetonitrile + valeronitrile the films yielded a short circuit photocurrent density of 16±0.5 mA/cm2 and the open circuit voltage was 700±50 mV and a fill factor of 0.75±0.05, corresponding to an overall conversion efficiency of 8.6%. Solar cells based on amphiphilic sensitizers show remarkable stability under both thermal stress and light soaking matching the durability criteria applied to silicon solar cells for outdoor applications. [Copyright &y& Elsevier]