[Knowledge and attitude of oral care providers in the Netherlands on skin lesions]. / Kennis en attitude van mondzorgverleners over huidafwijkingen.

To gain insight into the current knowledge of oral care providers in the Netherlands on facial skin lesions, a survey was distributed to 7,670 oral care providers. Their knowledge was tested by means of 4 multiple-choice questions and on the basis of 5 cases. The survey was completed in full by 90 respondents. The median age was 50.3 years and 62.2% were female. During dental check-ups, 55.6% always examined the face and 41.1% sometimes did so. Compared to the group 41 years old and older, the group 21-40 years of age alerted their patients more often to skin lesions (p = 0.017), was more afraid a specialist would find the referral useless (p < 0.001) and was more in need of a guideline (p = 0.049). The respondents scored 1.90 out of 4 correct answers to the knowledge questions. On the case studies, they scored 1.46 out of 5 for the correct diagnosis, 3.48 out of 5 for the correct choice of policy and 1.01 out of 5 for the combination correct diagnosis and correct policy. The total score was 2.91 out of 9. The results indicate that knowledge on aspects of skin lesions is limited and additional training and the availability of a guideline are necessary.

Whole-genome and transcriptome analysis enhances precision cancer treatment options.

BACKGROUND: Recent advances are enabling delivery of precision genomic medicine to cancer clinics. While the majority of approaches profile panels of selected genes or hotspot regions, comprehensive data provided by whole-genome and transcriptome sequencing and analysis (WGTA) present an opportunity to align a much larger proportion of patients to therapies. PATIENTS AND METHODS: Samples from 570 patients with advanced or metastatic cancer of diverse types enrolled in the Personalized OncoGenomics (POG) program underwent WGTA. DNA-based data, including mutations, copy number and mutation signatures, were combined with RNA-based data, including gene expression and fusions, to generate comprehensive WGTA profiles. A multidisciplinary molecular tumour board used WGTA profiles to identify and prioritize clinically actionable alterations and inform therapy. Patient responses to WGTA-informed therapies were collected. RESULTS: Clinically actionable targets were identified for 83% of patients, of which 37% of patients received WGTA-informed treatments. RNA expression data were particularly informative, contributing to 67% of WGTA-informed treatments; 25% of treatments were informed by RNA expression alone. Of a total 248 WGTA-informed treatments, 46% resulted in clinical benefit. RNA expression data were comparable to DNA-based mutation and copy number data in aligning to clinically beneficial treatments. Genome signatures also guided therapeutics including platinum, poly-ADP ribose polymerase inhibitors and immunotherapies. Patients accessed WGTA-informed treatments through clinical trials (19%), off-label use (35%) and as standard therapies (46%) including those which would not otherwise have been the next choice of therapy, demonstrating the utility of genomic information to direct use of chemotherapies as well as targeted therapies. CONCLUSIONS: Integrating RNA expression and genome data illuminated treatment options that resulted in 46% of treated patients experiencing positive clinical benefit, supporting the use of comprehensive WGTA profiling in clinical cancer care.

Tournament ABC analysis of the western Palaearctic population history of an oak gall wasp, Synergus umbraculus.

Approximate Bayesian computation (ABC) is a powerful and widely used approach in inference of population history. However, the computational effort required to discriminate among alternative historical scenarios often limits the set that is compared to those considered more likely a priori. While often justifiable, this approach will fail to consider unexpected but well-supported population histories. We used a hierarchical tournament approach, in which subsets of scenarios are compared in a first round of ABC analyses and the winners are compared in a second analysis, to reconstruct the population history of an oak gall wasp, Synergus umbraculus (Hymenoptera, Cynipidae) across the Western Palaearctic. We used 4,233 bp of sequence data across seven loci to explore the relationships between four putative Pleistocene refuge populations in Iberia, Italy, the Balkans and Western Asia. We compared support for 148 alternative scenarios in eight pools, each pool comprising all possible rearrangements of four populations over a given topology of relationships, with or without founding of one population by admixture and with or without an unsampled "ghost" population. We found very little support for the directional "out of the east" scenario previously inferred for other gall wasp community members. Instead, the best-supported models identified Iberia as the first-regional population to diverge from the others in the late Pleistocene, followed by divergence between the Balkans and Western Asia, and founding of the Italian population through late Pleistocene admixture from Iberia and the Balkans. We compare these results with what is known for other members of the oak gall community, and consider the strengths and weaknesses of using a tournament approach to explore phylogeographic model space.

Control of spontaneous emission of quantum dots using correlated effects of metal oxides and dielectric materials.

We study the emission dynamics of semiconductor quantum dots in the presence of the correlated impact of metal oxides and dielectric materials. For this we used layered material structures consisting of a base substrate, a dielectric layer, and an ultrathin layer of a metal oxide. After depositing colloidal CdSe/ZnS quantum dots on the top of the metal oxide, we used spectral and time-resolved techniques to show that, depending on the type and thickness of the dielectric material, the metal oxide can characteristically change the interplay between intrinsic excitons, defect states, and the environment, offering new material properties. Our results show that aluminum oxide, in particular, can strongly change the impact of amorphous silicon on the emission dynamics of quantum dots by balancing the intrinsic near band emission and fast trapping of carriers. In such a system the silicon/aluminum oxide charge barrier can lead to large variation of the radiative lifetime of quantum dots and control of the photo-ejection rate of electrons in quantum dots. The results provide unique techniques to investigate and modify physical properties of dielectrics and manage optical and electrical properties of quantum dots.

Biodesulphurization of gasoline by Rhodococcus erythropolis supported on polyvinyl alcohol.

A new biodesulphurization (BDS) method has been considered using Rhodococcus erythropolis supported on polyvinyl alcohol (PVA) for BDS of thiophene as a gasoline sulphur model compound in n-hexane as the solvent, subsequently this biocatalyst has been applied to BDS of gasoline samples. The obtained results according to UV-Spectrophotometer analysis at 240 nm showed that 97·41% of thiophene at the optimum condition of primary concentration 80 mg l-1 , pH = 7, by 0·1 g of biocatalyst in 30°C and after 20 h of contact time has been degraded. These optimum conditions have been applied to gasoline BDS and the biodegradation of gasoline thiophenic compounds have been investigated by gas chromatography-mass spectrometry (GC-MS). According to GC-MS, thiophene and its 2-methyl, 3-methyl and 2- ethyl derivatives had acceptable biodegradation efficiencies of about 26·67, 21·03, 23·62% respectively. Also, benzothiophene that has been detected in a gasoline sample had 38·89% biodegradation efficiency at optimum conditions, so biomodification of PVA by R. erythropolis produces biocatalysts with an active metabolism that facilitates the interaction of bacterial strain with gasoline thiophenic compounds. The morphology and surface functional groups of supported R. erythropolis on PVA have been investigated by scanning electron microscope (SEM) and FT-IR spectroscopy respectively. SEM images suggest some regular layered shape for the supported bacteria. FT-IR spectra indicate a desirable interaction between bacterial cells and polymer supports. Also, the recovery of biocatalyst has been investigated and after three times of using in BDS activity, its biocatalytic ability had no significant decreases. SIGNIFICANCE AND IMPACT OF THE STUDY: The biomodification of polyvinyl alcohol by Rhodococcus erythropolis described herein produces a new biocatalyst which can be used for significantly reducing the thiophenic compounds of gasoline and other fossil fuels. The immobilization process is to increase the biodegradation efficiency of cells and accelerating the biodesulphurization process.

Health risk assessment of exposure to the Middle-Eastern Dust storms in the Iranian megacity of Kermanshah.

OBJECTIVE: This study assessed the effects of particulate matter (PM), equal or less than 10 µm in aerodynamic diameter (PM10), from the Middle-Eastern Dust events on public health in the megacity of Kermanshah (Iran). STUDY DESIGN: This study used epidemiological modeling and monitored ambient air quality data to estimate the potential PM10 impacts on public health. METHODS: The AirQ2.2.3 model was used to calculate mortality and morbidity attributed to PM10 as representative of dust events. Using Visual Basic for Applications, the programming language of Excel software, hourly PM10 concentrations obtained from the local agency were processed to prepare input files for the AirQ2.2.3 model. RESULTS: Using baseline incidence, defined by the World Health Organization, the number of estimated excess cases for respiratory mortality, hospital admissions for chronic obstructive pulmonary disease, for respiratory diseases, and for cardiovascular diseases were 37, 39, 476, and 184 persons, respectively, from 21st March, 2014 to 20th March, 2015. Furthermore, 92% of mortality and morbidity cases occurred in days with PM10 concentrations lower than 150 µg/m3. The highest percentage of person-days occurred for daily concentrations range of 100-109 µg/m3, causing the maximum health end-points among the citizens of Kermanshah. CONCLUSIONS: Calculating the number of cumulative excess cases for mortality or morbidity attributed to PM10 provides a good tool for decision and policy-makers in the field of health care to compensate their shortcomings particularly at hospital and healthcare centers for combating dust storms. To diminish these effects, several immediate actions should be managed in the governmental scale to control dust such as spreading mulch and planting new species that are compatible to arid area.

Long-term outcomes after adjuvant treatment of sequential versus combination docetaxel with doxorubicin and cyclophosphamide in node-positive breast cancer: BCIRG-005 randomized trial.

BACKGROUND: The optimal regimen for adjuvant breast cancer chemotherapy is undefined. We compared sequential to concurrent combination of doxorubicin and cyclophosphamide with docetaxel chemotherapy in women with node-positive non-metastatic breast cancer. We report the final, 10-year analysis of disease-free survival (DFS), overall survival (OS), and long-term safety. PATIENTS AND METHODS: A total of 3298 women with HER2 nonamplified breast cancer were randomized to doxorubicin and cyclophosphamide every 3 weeks for four cycles followed by docetaxel (AC → T) every 3 weeks for four cycles or docetaxel, doxorubicin, and cyclophosphamide (TAC) every 3 weeks for six cycles. The patients received standard radiotherapy and endocrine therapy and were followed up for 10 years with annual clinical evaluation and mammography. RESULTS: The 10-year DFS rates were 66.5% in the AC → T arm and 66.3% in the TAC arm (P = 0.749). OS was 79.9% in the AC → T arm and 78.9% in the TAC arm (P = 0.506). TAC was associated with higher rates of febrile neutropenia, although G-CSF primary prophylaxis greatly reduced this risk. AC → T was associated with a higher rate of myalgia, hand-foot syndrome, fluid retention, and sensory neuropathy. CONCLUSION: This 10-year analysis of the BCIRG-005 trial confirmed that the efficacy of TAC was not superior to AC → T in women with node-positive early breast cancer. The toxicity profiles differ between arms and were consistent with previous reports. The TAC regimen with G-CSF support provides shorter adjuvant treatment duration with less toxicity. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT00312208.

Interactions between Metopolophium festucae cerealium (Hemiptera: Aphididae) and Barley yellow dwarf virus (BYDV-PAV).

Interactions between an invasive aphid, Metopolophium festucae (Theobald) subsp. cerealium, and Barley yellow dwarf virus (BYDV-PAV) were studied under laboratory conditions. M. festucae cerealium is an economic pest of wheat and barley that has recently been found in high population densities in wheat in the Pacific Northwest of the United States. BYDV-PAV is the most prevalent and injurious species of BYDV worldwide and in the Pacific Northwest. Although M. festucae sensu stricto (Theobald 1917) has been reported previously as a vector of some BYDV isolates, there is no confirmed transmission of BYDV by M. festucae cerealium. Two experiments examined the ability of M. festucae cerealium to transmit BYDV-PAV. The first used single aphids caged to indicator plants of a BYDV-susceptible winter wheat cultivar and the second used multiple aphids on each test plant. M. festucae cerealium did not transmit BYDV-PAV in either experiment, whereas transmission by a known BYDV vector, Rhopalosiphum padi L., was consistently high (≥ 93%). A third experiment compared the intrinsic growth rate, days until first reproduction and daily reproduction by M. festucae cerealium on sham-inoculated and BYDV-PAV-infected wheat, but detected no differences. The findings are reviewed in light published data on M. festucae species, BYDV transmission, and the potential pest status of this new invading aphid.

Undamped ultrafast pulsation of plasmonic fields via coherent exciton-plasmon coupling.

We show that under certain conditions the plasmonic field of a hybrid system consisting of a metallic nanoparticle and a semiconductor quantum dot can be converted into ultrashort stationary pulses with temporal widths as short as 300 ps. This happens as this system interacts with an infrared and visible laser fields, both with time-independent amplitudes. These fields generate quantum coherence via simultaneous interband and intersubband transitions of the quantum dot, forcing the polarization dephasing rate of the quantum dot to become negative during the plasmon pulses. This makes the amplitudes of such pulses time-independent (undamped), indicating total suppression of quantum decoherence of the quantum dot. These results suggest that hybrid quantum dot-metallic nanoparticle systems can act as undamped coherent-plasmonic oscillators.

Dynamics of plasmonic field polarization induced by quantum coherence in quantum dot-metallic nanoshell structures.

When a hybrid system consisting of a semiconductor quantum dot and a metallic nanoparticle interacts with a laser field, the plasmonic field of the metallic nanoparticle can be normalized by the quantum coherence generated in the quantum dot. In this Letter, we study the states of polarization of such a coherent-plasmonic field and demonstrate how these states can reveal unique aspects of the collective molecular properties of the hybrid system formed via coherent exciton-plasmon coupling. We show that transition between the molecular states of this system can lead to ultrafast polarization dynamics, including sudden reversal of the sense of variations of the plasmonic field and formation of circular and elliptical polarization.

Synchronization of delayed coupled neurons in presence of inhomogeneity.

In principle, two directly coupled limit cycle oscillators can overcome mismatch in intrinsic rates and match their frequencies, but zero phase lag synchronization is just achievable in the limit of zero mismatch, i.e., with identical oscillators. Delay in communication, on the other hand, can exert phase shift in the activity of the coupled oscillators. In this study, we address the question of how phase locked, and in particular zero phase lag synchronization, can be achieved for a heterogeneous system of two delayed coupled neurons. We have analytically studied the possibility of inphase synchronization and near inphase synchronization when the neurons are not identical or the connections are not exactly symmetric. We have shown that while any single source of inhomogeneity can violate isochronous synchrony, multiple sources of inhomogeneity can compensate for each other and maintain synchrony. Numeric studies on biologically plausible models also support the analytic results.

Enhancement of emission efficiency of colloidal CdSe quantum dots on silicon substrate via an ultra-thin layer of aluminum oxide.

We demonstrate that an ultra-thin layer of aluminum oxide can significantly enhance the emission efficiency of colloidal quantum dots on a Si substrate. For an ensemble of single quantum dots, our results show that this super brightening process can increase the fluorescence of CdSe quantum dots, forming well-resolved spectra, while in the absence of this layer the emission remains mostly at the noise level. We demonstrate that this process can be further enhanced with irradiation of the quantum dots, suggesting a significant photo-induced fluorescence enhancement via considerable suppression of non-radiative decay channels of the quantum dots. We study the impact of the Al oxide thickness on Si and interdot interactions, and discuss the results in terms of photo-induced catalytic properties of the Al oxide and the effects of such an oxide on the Coulomb blockade responsible for suppression of photo-ionization of the quantum dots.

Severity of symptoms, physical functioning and satisfaction in patients with lumbar spinal stenosis: a validation study of the Iranian version of the Swiss Spinal Stenosis Score.

AIM: A common cause of low back pain is lumbar spinal stenosis (LSS). The Swiss Spinal Stenosis Score (SSS) is a well-known questionnaire that measures the severity of symptoms, physical functioning and patient's satisfaction in lumbar spinal stenosis. This study aimed to translate and validate the SSS in Iran. METHODS: A prospective clinical validation study was performed. Forward-backward procedure was applied to translate the original questionnaires into Persian. A sample of patients with lumbar spinal stenosis completed the questionnaire twice: at pre- and postoperative (6 months follow-up) assessments. To test reliability the internal consistency was assessed by the Cronbach's alpha coefficient. Validity was evaluated using the known groups comparison. In addition the Oswestry Disability Index was used to perform convergent validity. RESULTS: In all 121 patients were entered into the study. The mean age of patients was 62.3 (SD=10.2) years. The Cronbach's alpha coefficient for the SSS was 0.88. Validity was performed by known groups analysis and showed satisfactory results. The instrument discriminated well between the subgroups of patients who differed in age, severity of lumbar spinal stenosis, and the Self-Paced Walking Test (SPWT). The change in the Oswestry Disability Index strongly correlated with the change in patients' scores on the SSS; lending support to its good convergent validity (r=0.82; P<0.001). CONCLUSION: The Iranian version of Swiss Spinal Stenosis Score performed well and the findings suggest that it is a valid measure of symptoms, physical functioning and satisfaction among patients with lumbar spinal stenosis.

Coherent confinement of plasmonic field in quantum dot-metallic nanoparticle molecules.

Interaction of a hybrid system consisting of a semiconductor quantum dot and a metallic nanoparticle (MNP) with a laser beam can replace the intrinsic plasmonic field of the MNP with a coherently normalized field (coherent-plasmonic or CP field). In this paper we show how quantum coherence effects in such a hybrid system can form a coherent barrier (quantum cage) that spatially confines the CP field. This allows us to coherently control the modal volume of this field, making it significantly smaller or larger than that of the intrinsic plasmonic field of the MNP. We investigate the spatial profiles of the CP field and discuss how the field barrier depends on the collective states of the hybrid system.

A sustainable hydrometallurgical strategy for recycling efficiently platinum from spent reforming petroleum catalyst.

Platinum (Pt) is one of the most precious metals with a variety of unique industrial applications, particularly in catalytic reactions, being its recovery, after use, essential. Therefore, this work proposes a simplified hydrometallurgical strategy to recover Pt efficiently from the original (no milling) spent petrochemical Pt catalyst using an economical and environmentally sustainable process. To that end, the effectiveness of a two-step workflow constituted by one microwave-assisted leaching step using a mixture of hydrochloric acid (HCl) and hydrogen peroxide (H2O2) followed by one ion-exchange purification step was developed and optimized. It was found that complete dissolution of Pt plus aluminum (Al) and iron (Fe) from the roasted original size catalyst was achieved after microwave-assisted leaching with 25% (v/v) HCl and 2% (v/v) H2O2 during 2 cycles of 60 s. Furthermore, a strong anionic exchange (Purogold™ A194) resin used for subsequent selective purification of Pt from Al and Fe was capable of effective separation of the metals: Pt in the eluate presented a purity of 98.1%, while Al, in the raffinate, presented a purity of 99.8%. In summation, it can be concluded that the overall process is a potentially good addition to a more circular economy as it manages to recover high-quality Pt for being reused as well as other by-products, whilst minimizing the consume of reagents, leaching time (and, thus, energy), and environmental impacts.

Coherent molecular resonances in quantum dot-metallic nanoparticle systems: coherent self-renormalization and structural effects.

It is known that surface-plasmon resonances of metallic nanoparticles can significantly enhance the field experienced by semiconductor quantum dots. In this paper we show that, when quantum dots are in the vicinity of metallic nanoparticles and interact with coherent light sources (laser fields), coherent exciton-plasmon coupling (quantum coherence effects) can increase the amount of the plasmonic field enhancement significantly. We also study how the coherent molecular resonances generated by such a coupling process are influenced by the self-renormalization of the plasmonic fields and the structural parameters of the systems, particularly the size and shape of the metallic nanoparticle. The renormalization process happens via mutual impacts of the radiative decay rate of excitons and the coherent exciton-plasmon coupling on each other. Our results highlight the conditions where the molecular resonances become very sharp, offering optical switching processes with high extinction ratio and wide ranging device applications.

Identification of chemical constituents and larvicidal activity of Kelussia odoratissima Mozaffarian essential oil against two mosquito vectors Anopheles stephensi and Culex pipiens (Diptera: Culicidae).

The larvicidal activity of essential oil extracted from an indigenous plant, Kelussia odoratissima Mozaffarian was evaluated against two mosquito species, Anopheles stephensi and Culex pipiens. The chemical composition of the essential oil obtained by hydrodistillation from branch tips and leaf of this plant was determined by GC and GC/MS analysis. Forty-nine constituents were identified in the oil. The main constituents of the oil were Z-ligustilide (77.73%), 2-octen-1-ol acetate (6.27%), E-ligustilide (2.27%) and butylidene phthalide (1.97%). Five different logarithmic concentrations of essential oil were evaluated against the 4th instar larvae of An. Stephensi and Cx. pipiens. The LC(50) and LC(90) values against An. stephensi larvae were 4.88 and 9.60 ppm and for Cx. pipiens were 2.69 and 7.90 ppm, respectively. These properties suggest that K. odoratissima oil has potential source of valuable larvicidal compounds for mosquito larval control. This plant which causes high mortality at lower dose could be considered as a highly active plant. In this paper a guideline suggested for larvicidal activity of plant essential oils.

Physician burnout, a new term, a well-known concept in the medieval era: a thematic review of Ruhawi's Adab al-Tabib.

In 1974, Herbert Freudenberger introduced the phrase 'Burnout in Healing Professional Workers'. Despite the existence of numerous investigations on physician burnout, only a few studies on its historical aspects can be found. This is the first research to present historical evidence on 'physician burnout' as pointed out in the book 'Adab al-Tabib' written by Ruhawi (9th century AD). He is shown to have an understanding of this concept by talking about job stress in his book, although he offers no exact equivalent definition for this state. In fact, finding an equivalent term to 20th century burnout in a book written a thousand years ago is almost impossible. Most interestingly, the same preventive strategies for physician burnout and its causes as those scientifically discovered in recent years can be evidenced to have been introduced by Ruhawi. Hence, 'Adab al-Tabib' is an outstanding work on physician burnout in the medieval era.

Photo-induced suppression of plasmonic emission enhancement of CdSe/ZnS quantum dots.

Emission of semiconductor quantum dots can be increased via two fundamentally different processes: (i) surface plasmon resonances (plasmonic emission enhancement) and (ii) irradiation with light (photo-induced fluorescence enhancement). In this paper we theoretically and experimentally study the mutual impacts of these processes on each other in quantum dot solids. We show that when thin films of colloidal quantum dots are placed in the vicinity of Au nano-islands, the plasmonic enhancement of the radiative decay rates of quantum dots and Forster energy transfer can hinder the photo-induced fluorescence enhancement of these films. This in turn leads to significant suppression of their plasmonic emission enhancement when they are irradiated with a laser beam. We investigate the impact of the sizes and shapes of the metallic nanoparticles in this process and theoretically analyze how plasmons and energy transfer can hinder the electrostatic barrier responsible for photo-induced fluorescence enhancement.

Gastro-oesophageal reflux symptoms and the risks of oesophageal cancer: are the effects modified by smoking, NSAIDs or acid suppressants?

OBJECTIVE: To measure the extent to which risks of oesophageal cancers associated with gastro-oesophageal reflux (GOR) are modified by common factors including smoking, non-steroidal anti-inflammatory drugs (NSAIDs) and acid suppressant medications. DESIGN AND SETTING: Population-based case-control study. PARTICIPANTS: Cases were patients with oesophageal (OAC; n = 365) or gastro-oesophageal junction (GOJAC; n = 426) adenocarcinomas, or squamous cell carcinomas (OSCC; n = 303). Controls were sampled from a population register (n = 1580). MAIN OUTCOME MEASURE: Odds ratio and 95% confidence interval. RESULTS: Frequent (at least weekly) symptoms of GOR were associated with significant 6.4-fold, 4.6-fold and 2.2-fold increased risks of OAC, GOJAC and OSCC, respectively. Under models examining effects of combined exposure, patients with frequent GOR symptoms who were also heavy smokers had markedly higher OAC risks (OR = 12.3, 95% CI 6.3 to 24.0) than those with frequent GOR who did not smoke (OR = 6.8, 95% CI 3.6 to 12.9). Similar patterns were observed for GOJAC and OSCC. Among people with frequent GOR symptoms, regular use of aspirin/NSAIDs was associated with almost two-thirds lower OAC risks (OR = 4.8, 95% CI 2.5 to 9.2) than non-users (13.9, 95% CI 6.5 to 30.0). In contrast, among those with frequent GOR symptoms, users of acid suppressants had similar OAC risks (OR 7.8, 95% CI 5.2 to 11.8) to non-users (OR 5.3, 95% CI 3.2 to 9.0). CONCLUSIONS: People experiencing frequent GOR symptoms have markedly increased risks of OAC and GOJAC, and this effect may be greater amongst smokers. Use of aspirin and NSAIDs, but not acid suppressants, significantly reduced the risks of oesophageal cancers associated with GOR.