Search

Background Burn infliction techniques are poorly described in rat models. An accurate study can only be achieved with wounds that are uniform in size and depth. We describe a simple reproducible method for creating consistent burn wounds in rats. Methods Ten male Sprague-Dawley rats were anesthetized and dorsum shaved. A 100 g cylindrical stainless-steel rod (1 cm diameter) was heated to 100℃ in boiling water. Temperature was monitored using a thermocouple. We performed two consecutive toe-pinch tests on different limbs to assess the depth of sedation. Burn infliction was limited to the loin. The skin was pulled upwards, away from the underlying viscera, creating a flat surface. The rod rested on its own weight for 5, 10, and 20 seconds at three different sites on each rat. Wounds were evaluated for size, morphology and depth. Results Average wound size was 0.9957 cm2 (standard deviation [SD] 0.1845) (n=30). Wounds created with duration of 5 seconds were pale, with an indistinct margin of erythema. Wounds of 10 and 20 seconds were well-defined, uniformly brown with a rim of erythema. Average depths of tissue damage were 1.30 mm (SD 0.424), 2.35 mm (SD 0.071), and 2.60 mm (SD 0.283) for duration of 5, 10, 20 seconds respectively. Burn duration of 5 seconds resulted in full-thickness damage. Burn duration of 10 seconds and 20 seconds resulted in full-thickness damage, involving subjacent skeletal muscle. Conclusions This is a simple reproducible method for creating burn wounds consistent in size and depth in a rat burn model.

This action research was to answer the pedagogical question: How effective can a branching story approach be as a motivational tool for elementary reading instruction? A branching story was created with hyperlinks built into a Powerpoint story. The young readers could interact with options at different turning points of the story, which activated the readers’ curiosity, and promoted their decision making and thinking skills. The study was carried out in an all girl school, Saudi Arabia. A class of 20 fourth-graders participated in the study. For data collection and analyses, the students were assigned into four groups based on their previous reading achievements and interests. Students’ responses to comprehension questions were tabulated. The unit-end survey results were analyzed. A majority of the participating students overwhelmingly enjoyed the experience.

This action research was to answer the pedagogical question: How effective can a branching story approach be as a motivational tool for elementary reading instruction? A branching story was created with hyperlinks built into a Powerpoint story. The young readers could interact with options at different turning points of the story, which activated the readers’ curiosity, and promoted their decision making and thinking skills. The study was carried out in an all girl school, Saudi Arabia. A class of 20 fourth-graders participated in the study. For data collection and analyses, the students were assigned into four groups based on their previous reading achievements and interests. Students’ responses to comprehension questions were tabulated. The unit-end survey results were analyzed. A majority of the participating students overwhelmingly enjoyed the experience. They were motivated to achieve the project goals sooner than planned. Kinesthetic learners demonstrated their academic potentials well beyond their performance under the traditional reading instruction.

O abuso de drogas tornou-se um grave problema de saúde pública, tanto pela sua epidemiologia como pelas suas consequências no meio social, sendo o tratamento considerado um desafio. Objetivou-se conhecer a percepção dos usuários sobre as drogas. A pesquisa é de abordagem qualitativa, descritiva exploratória. Os dados foram produzidos por meio de uma entrevista com oito usuários de álcool e outras drogas, em tratamento em uma Comunidade Terapêutica de um município de pequeno porte da Região Noroeste do Rio Grande do Sul, Brasil. Foi realizada a análise de conteúdo temática. Os resultados mostraram que a busca dos usuários pelas drogas está relacionada com a incapacidade de lidar com as crises e frustrações; ainda, pode levá-los a perder objetos, valores e a própria família. Concluiu-se que é importante desenvolver essa temática na formação do enfermeiro para que este possa prestar um cuidado humanizado e efetivo.

The isolation of hematopoietic stem and progenitor cells (HSPCs) is critical for transplantation therapy and HSPC research, however current isolation techniques can be prohibitively expensive, time-consuming, and produce variable results. Selectin-coated microtubes have shown promise in rapidly isolating HSPCs from human bone marrow, but further purification of HSPCs remains a challenge. Herein, a biomimetic device for HSPC isolation is presented to mimic the acidic vascular microenvironment during trauma, which can enhance the binding frequency between L-selectin and its counter-receptor PSGL-1 and HSPCs. Under acidic pH conditions, L-selectin coated microtubes enhanced CD34+ HSPC adhesion, as evidenced by decreased cell rolling velocity and increased rolling flux. Dynamic light scattering was utilized as a novel sensor to confirm an L-selectin conformational change under acidic conditions, as previously predicted by molecular dynamics. These results suggest that mimicking the acidic conditions of trauma can induce a conformational extension of L-selectin, which can be utilized for flow-based, clinical isolation of HSPCs.

Background Our objective was to compare the complication rates of two common breastreconstruction techniques performed at our hospital and the cost-effectivenessfor each testgroup.Methods All patients who underwent deep inferior epigastric perforator (DIEP) flap andtransverse rectus abdominis myocutaneous (TRAM) flap by the same surgeon were selectedand matched according to age and mastectomy with or without axillary clearance. Patientsfrom each resultant group were selected, with the patients matched chronologically. Theremainder were matched for by co-morbidities. Sixteen patients who underwent immediatebreast reconstruction with pedicled TRAM flaps and 16 patients with DIEP flaps from 1999to 2006 were accrued. The average total hospitalisation cost, length of hospitalisation, andcomplicationsin the 2 year duration aftersurgery for each groupwere compared.Results Complications arising from both the pedicled TRAM flaps and DIEP flaps includedfat necrosis(TRAM, 3/16; DIEP, 4/16) and otherminor complications(TRAM, 3/16; DIEP, 1/16).The mean hospitalstaywas 7.13 days(range, 4 to 12 days)forthe pedicled TRAM group and7.56 (range, 5 to 10 days)fortheDIEP group.Neitherthe difference in complication rates norin hospital stay duration were statistically significant. The total hospitalisation cost for theDIEP groupwassignificantly higherthan that ofthe pedicled TRAMgroup (P< 0.001).Conclusions Based on ourstudy,the pedicled TRAM flap remains a cost-effective techniquein breastreconstructionwhen compared to the newer,more expensive and tediousDIEP flap.

Background Our objective was to compare the complication rates of two common breast reconstruction techniques performed at our hospital and the cost-effectiveness for each test group. Methods All patients who underwent deep inferior epigastric perforator (DIEP) flap and transverse rectus abdominis myocutaneous (TRAM) flap by the same surgeon were selected and matched according to age and mastectomy with or without axillary clearance. Patients from each resultant group were selected, with the patients matched chronologically. The remainder were matched for by co-morbidities. Sixteen patients who underwent immediate breast reconstruction with pedicled TRAM flaps and 16 patients with DIEP flaps from 1999 to 2006 were accrued. The average total hospitalisation cost, length of hospitalisation, and complications in the 2 year duration after surgery for each group were compared. Results Complications arising from both the pedicled TRAM flaps and DIEP flaps included fat necrosis (TRAM, 3/16; DIEP, 4/16) and other minor complications (TRAM, 3/16; DIEP, 1/16). The mean hospital stay was 7.13 days (range, 4 to 12 days) for the pedicled TRAM group and 7.56 (range, 5 to 10 days) for the DIEP group. Neither the difference in complication rates nor in hospital stay duration were statistically significant. The total hospitalisation cost for the DIEP group was significantly higher than that of the pedicled TRAM group (P

Prospective parents widely use education to gain information about, e.g., labour and parenting skills. It is unknown if antenatal education in small classes is more beneficial for parenting stress and parenting alliance compared with other types of antenatal education. In the present randomised trial, we examined the effect of antenatal education in small classes versus auditorium-based lectures on perceived stress, parenting stress, and parenting alliance. A total of 1,766 pregnant women were randomised to receive: antenatal education in small classes three times in pregnancy and one time after delivery, each session lasted 2.5 hours, versus standard care consisting of two times two hours auditorium-based lectures. Previous analysis of the primary outcome showed no difference between intervention and control group. Here we conduct an exploratory analysis of three secondary outcomes. Effects of the interventions on parents' global feelings of stress at 37 weeks gestation and nine weeks and six months postpartum and parenting stress nine weeks and six months postpartum were examined using linear regression analyses and mixed models with repeated measurements. The effect on parenting alliance six months postpartum was examined using the non-parametric Wilcoxon rank-sum test. Antenatal education in small classes had a small beneficial main effect on global feelings of stress six months postpartum and a statistically significant interaction between time and group favoring antenatal education in small classes. The P values of intervention effects on parenting stress and parenting alliance were all larger than the threshold value (0.05).

O artigo reúne informações e análises que pretendem demonstrar a importância do Código Florestal para a conservação das importantes reservas de áreas preservadas que ainda temos no Brasil, bem como a necessidade e os caminhos para sua revisão, visando alcançar o possível e plausível equilíbrio entre o respeito à natureza e o desenvolvimento agrícola.The article offers information and analysis that intend to demonstrate the importance of the Brazilian Forest Act for the protection of the remaining preserved natural vegetation in Brazil, as well as the reasons and guidelines for its revision, in order to reach the possible and desired balance between respect to the natural environment and improved agricultural development.

Dengue virus, the causative agent for the dengue fever, infects approximately 50–100 million people worldwide per year. The high incidence of dengue fever, along with its potential to develop into a severe, life-threatening form, resulted in great interest in the discovery of an antiviral against it. In this study, we constructed a DENV2-EGFP infectious clone, established a fluorescence-based, high-throughput screening platform, and conducted a screen for anti-DENV compounds on a flavonoid-derivative library, Amongst the hits identified, ST081006 was found to be a strong inhibitor of the DENV replication. Time-course studies suggest that the presence of ST081006 is necessary to inhibit successive rounds of virus replication. Further investigations demonstrated that ST081006 affects the synthesis of both viral protein and viral RNA, and one anti-DENV mechanism is the direct inhibition of viral protein synthesis. The replication of all dengue serotypes, along with that of the enterovirus EV-A71, was shown to be affected by ST081006. Attempts to generate ST081006-resistant DENV were unsuccessful, and thus hints at host factors as potential drug target. Together, these results suggest that ST081006 affect DENV replication, likely by acting on a target involved in the viral protein and/or RNA synthesis pathway. • A DENV2-EGFP infectious clone was constructed and a high-throughput, drug-screening platform was established. • Nine hits were identified from a flavonoid-derivative library screen for compounds against the DENV. • ST081006, a synthetic flavan, was found to a strong inhibitor of the DENV. • Experiments suggest that ST081006 is likely to act on DENV through at least a direct action on viral protein synthesis. • ST081006 also affects the replication of other dengue serotypes, and of the enterovirus EV-A71. [ABSTRACT FROM AUTHOR]

Microvascular reconstruction is often limited by the availability and length of the pedicle. The harvesting of autologous vein grafts adds morbidity and may not provide a good match. Expanded polytetrafluoroethylene (ePTFE) grafts have been used routinely in macrovascular surgery. However, there are no conclusive data on the performance of small-diameter PTFE grafts for pedicle lengthening in free flaps in a low-pressure situation. In this study, we evaluated the efficacy of 3-mm diameter stretch ePTFE grafts to lengthen the venous pedicle of a free flap. Methods: Fifteen male New Zealand white rabbits were operated on under sterile conditions. Using an operating microscope, an epigastric flap was raised and the pedicle was exposed and dissected to its origin from the superficial femoral vessels. A segment of the vein of 1cm to 3cm was replaced with a stretch ePTFE graft. Microsurgical anastomoses were performed using 9-0 nylon sutures. Four weeks postoperatively, the flaps were raised again with the pedicles re-explored. The graft was then removed and examined histologically. Results: All the grafts demonstrated immediate patency. There were no cases of flap loss on the control side at 4 weeks postoperatively. When re-explored, the patent ePTFE grafts appeared to be covered by connective tissue. Light microscopy showed neoendothelialization with fibrovascular ingrowth. Conclusion: From this study, we can conclude that 3-mm diameter stretch ePTFE grafts can be used successfully as an alternative to bridging autologous vein grafts in free-flap pedicles.

A revista Annaes de Enfermagem foi criada para publicar idéias, conceitos, resultados da produção científica, reflexões e, principalmente, o de expor e discutir o Projeto Político Profissional da Associação Nacional de Enfermeiras Diplomadas Brasileiras (ANEDB). Este estudo teve como objetivo descrever e caracterizar estes elementos presentes na referida revista no período de 1932 a 1941. Trata-se de um estudo de abordagem qualitativa pelo método histórico. Os principais elementos do projeto político compreendem os atributos desejáveis no enfermeiro como altruísmo, abnegação, patriotismo, senso humanitário, progresso profissional ligado à educação, arte, ideal, ética e componentes da religião cristã. Todos estes elementos fizeram parte de um projeto político que visava a integração da enfermagem no contexto de saúde nacional da época. (118 palavras).El periódico Annaes de Enfermagem fue creado para publicar ideas, conceptos, resultados de la producción cientifica, reflexiones y principalmente o de presentar y discutir el proyecto politico profesional de la Asociación Nacional de Enfermeras Graduadas Brasileras. Este estudio tuvo como objectivo decribir y caracterizar estos elementos presentes en este periódico en lo periodo de 1932 hasta 1941. Tratase de um estudio de abordaje cualitativa por lo metodo historico. Lo principales elementos del proyecto politico compreenden los atributos desejables en lo enfermero como el altruismo, abnegación, patriotismo, senso humaño, progreso profesional junto com la educación, arte, ideal, etica y componentes de la religión cristiana. Todos los elementos hicierón parte del proyecto politico que objectivó la integración de la enfermería en el contexto de salud en ámbito nacional a la epoca.The journal Annaes de Enfermagem was created to publish ideas, concepts, results of scientific production, reflections and, meanly to expose the Political Professional Project of the Associação Nacional de Enfermeiras Diplomadas Brasileiras (Brazilian Graduate Nurses National Association). This study aimed at describing and characterizing that elements as they were present in the referred journal in the periodo from 1932 up to 1941. This is a qualitative study based on the historical method. Main elements of the political project comprehends the desired attributes for the nurse as altruism, abnegation, patriotism, humantary sense, professional progress linked to education, art, ideal, ethics and components of Christian religion. These elements made part of a political project that aimed at integrating nursing in the health national context by that time.

Retropharyngeal and mediastinal emphysema is associated with traumatic aerodigestive tract injury, and may be associated with potentially severe and even life-threatening complications. Retropharyngeal emphysema or pneumomediastinum, in the absence of severe trauma to the visceral organs, is rare following facial fractures. We report a case of extensive subcutaneous emphysema extending to the retropharyngeal space and mediastinum following an orbitozygomatic fracture.

Hydrocephalic females reaching childbearing age is increasing due to treatment advances. It has been suggested that ventriculo-atrial (VA) shunts be preferred over ventriculo-peritoneal (VP) shunts during pregnancy. We present a case with multiple VA shunt malfunctions during two separate pregnancies. We treated the patient with a valveless VA shunt during both and were able to achieve near-term deliveries. During the second pregnancy the patient had an emergent caesarian section due to severe hydrocephalus and stunted fetal growth. Delivering the child also relieved her hydrocephalus. Of unclear reasons the right atrium failed as a distal absorption site during both pregnancies, and we must conclude that VA shunts do not necessarily alleviate problems regarding pressure at the distal end of the shunt system but never the less should be considered a treatment option on a case-by-case basis. Furthermore we conclude that a valveless shunt should be considered in select cases of maternal shunt malfunction where valves exert to high pressure resistance.

Immunological disturbances are hypothesised to play a role in recurrent miscarriage (RM) and therefore intravenous immunoglubulins (IVIg) have been tested in RM patients.The objectives were to investigate the benefits and harms of IVIg versus placebo, no intervention, or treatment as usual in women with RM.We searched the published literature in all relevant databases.Randomised trials investigating IVIg versus placebo, no intervention, or treatment as usual in women with RM.We undertook meta-analyses of aggregated data and individual patient data using a two-step approach, and we conducted bias domain assessments and trial sequential analyses to assess the risks of systematic and random errors.We identified 11 randomised clinical trials. No significant difference in the frequency of no live birth was found when IVIg was compared with placebo or treatment as usual (RR 0.92, 95% CI 0.75-1.12, p = 0.42). Trial sequential analysis showed that the required information size of 1,008 participants was not obtained. IVIg compared with placebo seems to increase the risk of adverse events. Subgroup analysis suggests that women with RM after a birth (secondary RM) seemed most likely to obtain a potential beneficial effect of IVIg (RR for no live birth 0.77, 95%CI 0.58-1.02, p = 0.06), however, trial sequential analysis showed that insufficient information is presently accrued.We cannot recommend or refute IVIg in women with RM. IVIg should therefore be assessed in further randomised clinical trials with positive outcomes before any clinical use is considered.

This study examines meteorological impacts on seasonal variation of fine particulate matter (PM2.5) in southern Ontario, Canada. After analyzing PM2.5 data at 12 cities in the region in 2006, we found that PM2.5 concentrations were 30–40% higher in summer (7–15 μg/m3) than in winter (4–11 μg/m3). High PM2.5 episodes occurred more frequently in warmer seasons. Analyses of surface meteorology, weather maps, and airflow trajectories suggest that these PM2.5 episodes were often related to synoptic transport of pollutants from highly polluted areas in the United States. The southerly or southwesterly winds associated with midlatitude cyclones play an important role in such transport. A typical weather pattern favoring the transport is suggested. When it was hot, humid, and stagnant with southerly or southwesterly winds, the likelihood of high PM2.5 occurrences was high. The Greater Golden Horseshoe and Southwestern Ontario regions had higher PM2.5 (6–12 μg/m3 annually) than the northern region (4–6 μg/m3), reflecting combined effects of meteorology, regional transport, and local emissions. In the future, PM2.5 transport from the United States will likely increase in abundance because of possible prolonged accumulation at the pollution sources as the frequency of the midlatitude cyclones may reduce under climate change.

Preclinical and clinical studies demonstrate the feasibility of treating β-thalassemia and Sickle Cell Disease (SCD) by lentiviral-mediated transfer of the human β-globin gene. However, previous studies have not addressed whether the ability of lentiviral vectors to increase hemoglobin synthesis might vary in different patients.We generated lentiviral vectors carrying the human β-globin gene with and without an ankyrin insulator and compared their ability to induce hemoglobin synthesis in vitro and in thalassemic mice. We found that insertion of an ankyrin insulator leads to higher, potentially therapeutic levels of human β-globin through a novel mechanism that links the rate of transcription of the transgenic β-globin mRNA during erythroid differentiation with polysomal binding and efficient translation, as reported here for the first time. We also established a preclinical assay to test the ability of this novel vector to synthesize adult hemoglobin in erythroid precursors and in CD34(+) cells isolated from patients affected by β-thalassemia and SCD. Among the thalassemic patients, we identified a subset of specimens in which hemoglobin production can be achieved using fewer copies of the vector integrated than in others. In SCD specimens the treatment with AnkT9W ameliorates erythropoiesis by increasing adult hemoglobin (Hb A) and concurrently reducing the sickling tetramer (Hb S).Our results suggest two major findings. First, we discovered that for the purpose of expressing the β-globin gene the ankyrin element is particularly suitable. Second, our analysis of a large group of specimens from β-thalassemic and SCD patients indicates that clinical trials could benefit from a simple test to predict the relationship between the number of vector copies integrated and the total amount of hemoglobin produced in the erythroid cells of prospective patients. This approach would provide vital information to select the best candidates for these clinical trials, before patients undergo myeloablation and bone marrow transplant.

BACKGROUND: The pathogenesis related protein PR10 (TcPR-10), obtained from the Theobroma cacao-Moniliophthora perniciosa interaction library, presents antifungal activity against M. perniciosa and acts in vitro as a ribonuclease. However, despite its biotechnological potential, the TcPR-10 has the P-loop motif similar to those of some allergenic proteins such as Bet v 1 (Betula verrucosa) and Pru av 1 (Prunus avium). The insertion of mutations in this motif can produce proteins with reduced allergenic power. The objective of the present work was to evaluate the allergenic potential of the wild type and mutant recombinant TcPR-10 using bioinformatics tools and immunological assays. METHODOLOGY/PRINCIPAL FINDINGS: Mutant substitutions (T10P, I30V, H45S) were inserted in the TcPR-10 gene by site-directed mutagenesis, cloned into pET28a and expressed in Escherichia coli BL21(DE3) cells. Changes in molecular surface caused by the mutant substitutions was evaluated by comparative protein modeling using the three-dimensional structure of the major cherry allergen, Pru av 1 as a template. The immunological assays were carried out in 8-12 week old female BALB/c mice. The mice were sensitized with the proteins (wild type and mutants) via subcutaneous and challenged intranasal for induction of allergic airway inflammation. CONCLUSIONS/SIGNIFICANCE: We showed that the wild TcPR-10 protein has allergenic potential, whereas the insertion of mutations produced proteins with reduced capacity of IgE production and cellular infiltration in the lungs. On the other hand, in vitro assays show that the TcPR-10 mutants still present antifungal and ribonuclease activity against M. perniciosa RNA. In conclusion, the mutant proteins present less allergenic potential than the wild TcPR-10, without the loss of interesting biotechnological properties.

BACKGROUND: Major depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Interpersonal psychotherapy and other psychodynamic therapies may be effective interventions for major depressive disorder, but the effects have only had limited assessment in systematic reviews. METHODS/PRINCIPAL FINDINGS: Cochrane systematic review methodology with meta-analysis and trial sequential analysis of randomized trials comparing the effect of psychodynamic therapies versus 'treatment as usual' for major depressive disorder. To be included the participants had to be older than 17 years with a primary diagnosis of major depressive disorder. Altogether, we included six trials randomizing a total of 648 participants. Five trials assessed 'interpersonal psychotherapy' and only one trial assessed 'psychodynamic psychotherapy'. All six trials had high risk of bias. Meta-analysis on all six trials showed that the psychodynamic interventions significantly reduced depressive symptoms on the 17-item Hamilton Rating Scale for Depression (mean difference -3.12 (95% confidence interval -4.39 to -1.86;P

BackgroundMajor depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Cognitive therapy may be an effective treatment option for major depressive disorder, but the effects have only had limited assessment in systematic reviews.Methods/principal findingsCochrane systematic review methodology, with meta-analyses and trial sequential analyses of randomized trials, are comparing the effects of cognitive therapy versus 'treatment as usual' for major depressive disorder. To be included the participants had to be older than 17 years with a primary diagnosis of major depressive disorder. Altogether, we included eight trials randomizing a total of 719 participants. All eight trials had high risk of bias. Four trials reported data on the 17-item Hamilton Rating Scale for Depression and four trials reported data on the Beck Depression Inventory. Meta-analysis on the data from the Hamilton Rating Scale for Depression showed that cognitive therapy compared with 'treatment as usual' significantly reduced depressive symptoms (mean difference -2.15 (95% confidence interval -3.70 to -0.60; PDiscussionCognitive therapy might not be an effective treatment for major depressive disorder compared with 'treatment as usual'. The possible treatment effect measured on the Hamilton Rating Scale for Depression is relatively small. More randomized trials with low risk of bias, increased sample sizes, and broader more clinically relevant outcomes are needed.

BACKGROUND: Major depressive disorder afflicts an estimated 17% of individuals during their lifetimes at tremendous suffering and costs. Cognitive therapy may be an effective treatment option for major depressive disorder, but the effects have only had limited assessment in systematic reviews. METHODS/PRINCIPAL FINDINGS: We used The Cochrane systematic review methodology with meta-analyses and trial sequential analyses of randomized trials comparing the effects of cognitive therapy versus 'no intervention' for major depressive disorder. Participants had to be older than 17 years with a primary diagnosis of major depressive disorder to be eligible. Altogether, we included 12 trials randomizing a total of 669 participants. All 12 trials had high risk of bias. Meta-analysis on the Hamilton Rating Scale for Depression showed that cognitive therapy significantly reduced depressive symptoms (four trials; mean difference -3.05 (95% confidence interval (Cl), -5.23 to -0.87; P

Abstract Education in substance use disorders remains inadequate in medical training curricula. Although it is a growing health problem, prescription drug abuse is specifically addressed even less comprehensively. This curriculum module provides an overview of prescription drug abuse framed within the common clinical scenario of chronic pain management in the outpatient setting. It is targeted toward resident physicians in internal medicine and family medicine and also toward medical students on clinical rotations. The information may also be adapted for training of pediatric residents, particularly those who care for patients most at risk for chronic pain, such as those with sickle cell anemia or chronic bone and joint problems. The module consists of a 2-hour lecture and accompanying slide-show presentation, with detailed lecture notes that allow the lecturer to explain more fully the information contained in each slide, as well as a faculty guide focused on implementation. This module was piloted in a noon lecture targeting first-, second-, and third-year internal medicine residents, as well as with medical students rotating on the inpatient internal medicine service. Evaluations completed by attendees noted increased confidence in their ability to select patients with chronic pain for long-term opioid therapy, manage patients on long-term opioids, and identify and manage patients with prescription drug abuse.

A comparison of the testing movements in China and Washington State reveals a strange irony. While education in Washington, under State and National imperatives, is becoming test driven, China is trying to move away from 14 centuries of test driven education to promote the development of the student as an entire person. This article compares and contrasts the Washington Assessment of Student Learning Tests and fourth and seventh grade examinations used in Baoding, China in terms of content, administration, evolution, and curriculum standards guiding the test content. Curriculum Guides and Assessment Manuals are compared. The historical practice of high stakes testing in China is analyzed and examined to elucidate the growing high stakes testing and accountability movement in America.

The purpose of this study was to compare and contrast philosophical beliefs commonly shared among American pre-service and in-service teachers and their Chinese counterparts. A total of 100 responses was included in this study. A philosophical inventory with 34 items was used. The causes for the similarities and differences as indicated in the findings were examined. This study pointed out the danger of stereotyping people based on cultural backgrounds. lt also encouraged teacher educators to challenge our own habitual view and vision of our practice.

The purpose of this study was to experiment and analyze the effectiveness of children s literature in promoting mathematics learning in a second grade classroom. The focus of this project was to address the following questions: How does children s literature help with mathematics understanding? To what extent does the literature help students increase interest in mathematics? What possible impact does integrating the literature have on students' mathematics achievements?

The impact of the East Asian monsoon (EAM) on climatology and interannual variability of tropospheric ozone (O _3 ) over the coastal South China was investigated by analyzing 11 years of ozonesonde data over Hong Kong with the aid of Lagrangian dispersion modeling of carbon monoxide and calculation of an EAM index. It was found that the seasonal cycle of O _3 in the lower troposphere is highly related to the EAM over the study region. Ozone enhancements in the free troposphere are associated with the monsoon-induced transport of pollutants of continental anthropogenic and biomass burning origins. Lower tropospheric O _3 levels showed high interannual variability, with an annual averaged amplitude up to 61% of averaged concentrations in the boundary layer (0–1 km altitudes) and 49% below 3 km altitude. In spring and autumn, the interannual variability in boundary layer O _3 levels was predominately influenced by the EAM intensity, with high O _3 mixing ratios associated with northeasterly circulation anomalies.

The effect of water sorption on the mobility of molecules on the surface of a crystalline anhydrous solid was investigated to understand the mechanism of its transformation to the corresponding hydrate. Theophylline was chosen as the model compound. The transition water activity for anhydrate to hydrate transformation, RHT, and the deliquescence RH, RH0, was determined to be 62% and 99%, respectively (25°C). Atomic force microscopy (AFM) was used to study the surface changes of theophylline above and below the transition water activity. Contact-mode AFM showed that the jump-to-contact distance increased appreciably above RHT, suggesting formation of solution on the surface. At RHT < RH < RH0, using dynamic (AC/“tapping” mode) AFM, the movements of surface steps were visualized. These results from AFM indicated that, below RH0, the formation of a thin solution film significantly increased surface mobility. Furthermore, when the anhydrate crystal surface was seeded with the hydrate, the propagation of a new hydrate phase was observed by polarized light microscopy. In conclusion, atomic force microscopy provided direct evidence that the phase transformation of anhydrous theophylline to theophylline monohydrate in the solid-state is mediated by a surface solution as a result of water adsorption. © 2010 Wiley-Liss, Inc. and the American Pharmacists Association J Pharm Sci 99:4032–4041, 2010 [ABSTRACT FROM AUTHOR]

PTEN mutations are the most common genetic alterations in endometrial cancer. Loss of PTEN and subsequent AKT activation stimulate estrogen receptor a--dependent pathways that play an important role in endometrial tumorigenesis. The major pathologic phenomenon of endometrial cancer is the loss of ovarian steroid hormone control over uterine epithelial cell proliferation and apoptosis. However, the precise mechanism of PTEN/AKT signaling in endometrial cancer remains poorly understood. The progesterone signaling mediator MIG-6 suppresses estrogen signaling and it has been implicated previously as a tumor suppressor in endometrial cancer. In this study, we show that MIG-6 also acts as a tumor suppressor in endometrial cancers associated with PTEN deficiency. Transgenic mice, where Mig-6 was overexpressed in progesterone receptor-expressing cells, exhibited a relative reduction in uterine tumorigenesis caused by Pten deficiency. ERK1/2 was phosphorylated in uterine tumors and administration of an ERK1/2 inhibitor suppressed cancer progression in PRcre/+Ptenf/f mice. In clinical specimens of endometrial cancer, MIG-6 expression correlated inversely with ERK1/2 phosphorylation during progression. Taken together, our findings suggest that Mig-6 regulates ERK1/2 phosphorylation and that it is crucial for progression of PTEN-mutant endometrial cancers, providing a mechanistic rationale for the evaluation of ERK1/2 inhibitors as a therapeutic treatment in human endometrial cancer. [ABSTRACT FROM AUTHOR]