The Impact of Nutritional Supplementation on Donor Kidneys During Oxygenated Ex Vivo Subnormothermic Preservation.

Evidence suggests that nutritional supplementation during normothermic ex vivo perfusion improves organ preservation. However, it is unclear whether the same benefit is observed during room temperature (subnormothermic) oxygenated perfusion. In this study, we tested the impact of providing complete nutrition during subnormothermic perfusion on kidney outcomes. Methods: Porcine kidneys were recovered after 30 min of cross clamping the renal artery in situ to simulate warm ischemic injury. After flushing with preservation solution, paired kidneys were cannulated and randomly assigned to perfusion with either (1) hemoglobin-carrier hemoglobin-based oxygen carrier or (2) hemoglobin-based oxygen carrier + total parenteral nutrition (TPN) for 12 h at 22 °C. To mimic reperfusion injury, all kidneys were reperfused with whole blood for an additional 4 h at 37 °C. Kidney function and damage were assessed. Results: Kidneys preserved with or without TPN performed equally well, showing similar renal function postreperfusion. Histological findings indicated similar levels of damage from apoptosis staining and acute tubular necrosis scores in both groups. Additionally, markers of renal damage (KIM-1) and inflammation (IL-6; high-mobility group box 1) were similar between the groups. Conclusions: Unlike other studies using normothermic oxygenated perfusion platforms, nutritional supplementation does not appear to provide any additional benefit during ex vivo kidney preservation over 12 h evaluated by whole blood-based reperfusion method at subnormothermic temperature. Further study should include a kidney autotransplant model to assess the role of TPN in vivo.

US drug shortages compared to the World Health Organization's Model List of Essential Medicines for Children: A cross-sectional study.

PURPOSE: To describe US drug shortages affecting medications on the 2019 World Health Organization (WHO) Model List of Essential Medicines for Children (EMLc). METHODS: Drug shortage data from January 2014 to December 2019 were obtained from the University of Utah Drug Information Service. Shortage data for drugs on the EMLc were analyzed for the type of drug, American Hospital Formulary Service category, reason for the shortage, duration of the shortage, marketing status (generic vs brand name), and whether the agent was a single- or multisource drug. RESULTS: From 2014 to 2019, a total of 209 drug shortages impacted medications on the EMLc, of which 77 (36.8%) remained unresolved by 2019. Of all active shortages, 13 (6.2%) began before 2014. Resolved shortages had a median duration of 5.9 months (interquartile range [IQR], 3.6-13.2 months) while active shortages had a median duration of 18.3 months (IQR, 10.9-33.5 months; P ≤ 0.0001). The therapeutic categories most impacted by drug shortages were anti-infective agents (27.3%), central nervous system agents (12.9%), and antineoplastic agents (11.0%). The reason for the shortage was not reported in 46.4% of cases. When a reason was provided, the most common reason was manufacturing problems (29.2%) followed by supply/demand mismatch (15.8%). CONCLUSION: US drug shortages affected many medications on the WHO EMLc. Future studies should examine the global shortage climate and implications for patient care.

Game Theory-Based Authentication Framework to Secure Internet of Vehicles with Blockchain.

The Internet of Vehicles (IoV) is a new paradigm for vehicular networks. Using diverse access methods, IoV enables vehicles to connect with their surroundings. However, without data security, IoV settings might be hazardous. Because of the IoV's openness and self-organization, they are prone to malevolent attack. To overcome this problem, this paper proposes a revolutionary blockchain-enabled game theory-based authentication mechanism for securing IoVs. Here, a three layer multi-trusted authorization solution is provided in which authentication of vehicles can be performed from initial entry to movement into different trusted authorities' areas without any delay by the use of Physical Unclonable Functions (PUFs) in the beginning and later through duel gaming, and a dynamic Proof-of-Work (dPoW) consensus mechanism. Formal and informal security analyses justify the framework's credibility in more depth with mathematical proofs. A rigorous comparative study demonstrates that the suggested framework achieves greater security and functionality characteristics and provides lower transaction and computation overhead than many of the available solutions so far. However, these solutions never considered the prime concerns of physical cloning and side-channel attacks. However, the framework in this paper is capable of handling them along with all the other security attacks the previous work can handle. Finally, the suggested framework has been subjected to a blockchain implementation to demonstrate its efficacy with duel gaming to achieve authentication in addition to its capability of using lower burdened blockchain at the physical layer, which current blockchain-based authentication models for IoVs do not support.

Understanding Health Economics in Joint Replacement Surgery.

The number of arthroplasty procedures has been rising at a significant rate, contributing to a notable portion of the nation's health care spending. This growth has contributed to an increase in the number of health care economic studies in the field of adult reconstruction surgery. Although these articles are filled with important information, they can be difficult to understand without a background in business or economics. The goal of this review is to define the common terminology used in health care economic studies, assess their value and benefit in the context of total joint arthroplasty, and highlight shortcomings in the current literature. [Orthopedics. 2022;45(4):e174-e182.].

Long-Term Safety of Prenatal and Neonatal Exposure to Paracetamol: A Systematic Review.

INTRODUCTION: Paracetamol is the most commonly used antipyretic and analgesic in pregnancy. It is also increasingly used off-label in the neonatal intensive care unit. Despite the frequent use of paracetamol, concerns have been raised regarding the high variability in neonatal dosing regimens and the long-term safety of early life exposure. OBJECTIVE: To investigate the available evidence on the long-term safety of prenatal and neonatal paracetamol exposure. METHODS: We conducted a systematic search of the electronic databases Ovid Medline, Ovid Embase and Web of Science from inception to August 2021 for original research studies of any design that described the use of paracetamol in the prenatal or neonatal (within the first four weeks of life) periods and examined the occurrence of neurodevelopmental, atopic or reproductive adverse outcomes at or beyond birth. RESULTS: We identified 1313 unique articles and included 30 studies in the final review. Of all studies, 27 (90%), two (7%) and one (3%) were on the long-term safety of prenatal, neonatal and both prenatal and neonatal exposure, respectively. Thirteen (46%), 11 (39%) and four (15%) studies examined neurodevelopmental, atopic and reproductive outcomes. Eleven (100%), 11 (100%), and three (27%) studies on prenatal exposure reported adverse neurodevelopmental, atopic and reproductive outcomes. Only one study found a possible correlation between neonatal paracetamol exposure and long-term adverse outcomes. CONCLUSIONS: The available evidence, although limited, suggests a possible association between prenatal paracetamol exposure and an increased risk of neurodevelopmental, atopic and reproductive adverse outcomes. There is an immediate need for robust data on the long-term safety of paracetamol exposure in the prenatal and neonatal periods.

Allergy to Peanuts imPacting Emotions And Life (APPEAL): The impact of peanut allergy on children, teenagers, adults and caregivers in the UK and Ireland.

The Allergy to Peanuts imPacting Emotions And Life study (APPEAL) explored the psychosocial burden of living with self-reported peanut allergy experienced by children, teenagers, adults and caregivers in the UK and Ireland. A two-stage (quantitative survey and qualitative interview [APPEAL-1]), cross-sectional study of the psychosocial burden of peanut allergy (APPEAL-2) was conducted. Quantitative data were evaluated using descriptive statistics and qualitative data were analysed using MAXQDA software. A conceptual model specific to UK and Ireland was developed using the concepts identified during the analysis. A total of 284 adults in the UK and Ireland completed the APPEAL-1 survey and 42 individuals participated in APPEAL-2. Respondents reported that peanut allergy restricts their choices in various situations, especially with regard to choosing food when eating out (87% moderately or severely restricted), choosing where to eat (82%), special occasions (76%) and when buying food from a shop (71%). Fifty-two percent of survey participants and 40% of interview participants reported being bullied because of PA. Psychological impact of peanut allergy included feeling at least moderate levels of frustration (70%), uncertainty (79%), and stress (71%). The qualitative analysis identified three different types of coping strategies (daily monitoring or vigilance, communication and planning) and four main areas of individuals' lives that are impacted by peanut allergy (social activities, relationships, emotions and work [adults and caregivers only]). The extent of the impact reported varied substantially between participants, with some reporting many negative consequences of living with peanut allergy and others feeling it has minimal impact on their health-related quality of life. This large survey and interview study highlight the psychosocial burden of peanut allergy for adults, teenagers, children and caregivers in the UK and Ireland. The analysis demonstrates the wide variation in level of impact of peanut allergy and the unmet need for those individuals who experience a substantial burden from living with peanut allergy.

Breeding for higher yield, early maturity, wider adaptability and waterlogging tolerance in soybean (Glycine max L.): A case study.

Breeding for higher yield and wider adaptability are major objectives of soybean crop improvement. In the present study, 68 advanced breeding lines along with seven best checks were evaluated for yield and attributing traits by following group balanced block design. Three blocks were constituted based on the maturity duration of the breeding lines. High genetic variability for the twelve quantitative traits was found within and across the three blocks. Several genotypes were found to outperform check varieties for yield and attributing traits. During the same crop season, one of the promising entries, NRC 128,was evaluated across seven locations for its wider adaptability and it has shown stable performance in Northern plain Zone with > 20% higher yield superiority over best check PS 1347. However, it produced 9.8% yield superiority over best check in Eastern Zone. Screening for waterlogging tolerance under artificial conditions revealed that NRC 128 was on par with the tolerant variety JS 97-52. Based on the yield superiority, wider adaptability and waterlogging tolerance, NRC 128 was released and notified by Central Varietal Release Committee (CVRC) of India, for its cultivation across Eastern and Northern Plain Zones of India.

Transpsoas Lumbar Interbody Fusion Without Psoas Stimulated Electromyography.

STUDY DESIGN: This is a retrospective case review. OBJECTIVE: The objective of this study was to present an anatomic approach to transpsoas interbody fusion without psoas stimulated electromyography (sEMG) and to evaluate the rate of neurological and approach-related complications. BACKGROUND: The transpsoas approaches have become commonly utilized for lumbar interbody fusion and may have certain advantages compared with other methods of interbody stabilization. Traditionally, transpsoas approaches have been performed utilizing sEMG as it has been purported to reduce the risk of injury to the lumbar plexus; however, an anatomic approach to transpsoas surgery is also possible as cadaveric studies have demonstrated the anatomy of the psoas muscle and lumbar plexus. METHODS: Patients who underwent transpsoas interbody fusion using an anatomic approach without psoas sEMG between 2005 and 2018 were enrolled in this study. The preoperative and postoperative medical records for this cohort were carefully reviewed to identify any new or persistent radicular symptoms, neurological deficits or approach-related complications. RESULTS: A total of 133 patients (48 males, 85 females) underwent transpsoas interbody fusion at 222 levels in this cohort-which had a mean age of 63 (61, 65) years and body mass index of 28.8 (27.8, 29.9). New neurological complications were seen in 5 patients (3.8%) and 5 patients (3.8%) were found to have new postoperative radicular pain, up to 3 months postoperatively. The total number of perioperative, approach-related complications was 7 (5.3%) for the entire cohort. CONCLUSION: An anatomic transpsoas approach to the interbody space without psoas sEMG demonstrated a rate of neurological and approach-related complications that was comparable or superior to the rate of complications reported using the traditional transpsoas approach with sEMG.

Allergy to Peanuts imPacting Emotions And Life (APPEAL): the impact of peanut allergy on children, adolescents, adults and caregivers in France.

BACKGROUND: Peanut allergy (PA) has increased in developed countries and can have a dramatic effect on quality of life but data surrounding this is limited in France. Allergy to Peanuts imPacting Emotions And Life study (APPEAL) investigated the experience and impact of living with PA in France. METHODS: Respondents affected by PA directly (children aged 8-12 years, teenagers aged 13-17 years, or adults aged ≥ 18 years) or indirectly (caregiver) completed either an online questionnaire (APPEAL-1, N = 198), or provided in-depth interviews (APPEAL-2, N = 32). Quantitative data was evaluated using descriptive statistics. Qualitative data was analysed thematically, using MAXQDA software. RESULTS: Of 198 responders in APPEAL-1, 88% stated that PA affects their daily activities, and 74% felt isolated as a result of living with PA. Feelings of worry about exposure to peanuts on social occasions where food is involved was reported by 91%. A total of 44% reported some restrictions in their job options, 85% in socializing. Psychological impact of PA included responders feeling emotions of frustration (89%), uncertainty (87%), and stress (93%) and 93% reporting encountering instances of feeling different due to their PA. Main factors that drove PA impact included social activities and relationships; whereas main coping strategies to avoid peanuts included monitoring, communication and planning. CONCLUSION: The analysis of French respondents from the APPEAL study demonstrates the impact and burden of PA on allergic children, teenagers, adults and their caregivers, and highlights the unmet need to be addressed.

APPEAL-1: A multiple-country European survey assessing the psychosocial impact of peanut allergy.

BACKGROUND: Peanut allergy (PA) is a common, potentially life-threatening and typically lifelong condition with a significant burden of illness. However, information is lacking on how persons with PA (PwPA) and their caregivers perceive the psychosocial impact of living with PA. The Allergy to Peanuts imPacting Emotions And Life 1 (APPEAL-1) survey, conducted across Europe, investigated the experience and impact of living with PA. Here, we report data evaluating the psychosocial impact of PA on PwPA and their caregivers. METHODS: Allergy to Peanuts imPacting Emotions And Life study 1 was an online survey conducted in eight European countries. Representatives of eight patient advocacy groups and five healthcare-research specialists developed the survey. Eligible respondent groups included the following: adults diagnosed with PA (self-report); parent/nonparent caregivers (proxy-report for a child with PA); and parent/nonparent caregivers (self-report of PA impact on themselves). RESULTS: Of 1846 total study respondents, 419 were adults with PA (self-report); 546 were parents/caregivers (proxy-report); and 881 were parents/caregivers (self-report). Most respondents reported lifestyle restrictions regarding food (84%-93%) and additional domains including parties and socializing, holiday activities and destinations, and taking public transport (53%-89%). Approximately 40% rated themselves as "very" frustrated and "very" stressed. Two-thirds (65%) felt socially isolated; 43% were bullied. Less than half felt confident in knowing when to use an adrenaline autoinjector. Several intercountry differences were observed such as high levels of uncertainty and stress in respondents from Ireland, highest rates of anxiety in respondents from Germany, and social exclusion and isolation most common in respondents from France. CONCLUSIONS: Peanut allergy imposes an adverse psychosocial impact on patients and caregivers, leading to frustration, stress and isolation. Attention to the impact of PA is needed in research and clinical practice to improve PA healthcare and public education programmes.

APPEAL-1: A pan-European survey of patient/caregiver perceptions of peanut allergy management.

BACKGROUND: Peanut allergy (PA) is associated with marked quality-of-life (QoL) impairment. However, data are lacking on the experience and impact of living with PA from the perspectives of persons with PA (PwPA) and their caregivers. Allergy to Peanuts imPacting Emotions And Life study 1 (APPEAL-1) was a pan-European survey investigating these perspectives. This first of two articles reports clinical characteristics of PwPA and PA management practices. METHODS: APPEAL-1 was a quantitative, online survey conducted in eight European countries, developed by eight representatives of patient advocacy groups and five healthcare professionals and researchers. Eligible participants included adults with PA and parents/caregivers of PwPA who responded by self-report and provided proxy-report for the PwPA under their care. Data were summarized using nonweighted descriptive statistics. RESULTS: Of 1846 completed/analysed questionnaires, 528 were from adults with PA (self-report); 437 by proxy for children with PA (34 aged 0-3 years, 287 aged 4-12 years, 116 aged 13-17 years) and 881 from parents/caregivers (self-report). Of PwPA (N = 965), 95% reported diagnosis by healthcare professionals, mostly by clinical history and peanut-specific allergy testing. Rates of allergic rhinitis, asthma and other food allergies in PwPA were 50%, 42% and 79%, respectively. Only 31% of PwPA received HCP advice/support following their worst allergic reaction, and 28% had not been prescribed an adrenaline auto-injector. Results were similar by country but varied by age group. CONCLUSIONS: The APPEAL-1 findings contribute to greater understanding of PA impact on PwPA, caregivers and family members and the need for improved PA management across Europe.

Unprecedented tetranuclear complexes with "weighing balance shaped" topology: single crystal structures, unusual EPR spectra, magnetic properties and antioxidant activity.

Using the 2-hydroxy-N'-[(E)-phenyl(pyridin-2-yl)methylidene]benzohydrazide ligand and dicarboxylate anions (succinate and malonate), two new copper(ii) complexes of formula [Cu4(µ-L)4(µ-CH2(COO)2)(H2O)3](NO3)2·4H2O (1) and [Cu4(µ-L)4(µ-CH2-CH2(COO)2)(H2O)](NO3)2] (2) have been synthesized and characterized by single crystal X-ray diffraction. Complexes 1 and 2 contain a dicarboxylate bridged tetranuclear Cu(ii) cationic unit with "weighing balance shaped" topology. These compounds have also been studied by variable temperature magnetic susceptibility measurements, X-band EPR spectroscopy and electrochemistry. The unprecedented tetranuclear copper complexes 1 and 2 exhibit antiferromagnetic interactions between adjacent copper(ii) centers with magnetic exchange coupling constants (J) of J1 = -6.8 cm-1, J2 = -20.6 cm-1 and g = 2.03 for 1 and J1 = -3.1 cm-1, J2 = -13.9 cm-1 and g = 2.02 for 2. The goal for our research work is to understand the factors that govern the stability of the Cu-O(-O-C-O-) bond towards reactive oxygen species (ROS) in Cu-containing mimics utilizing a systematic approach. The antioxidant superoxide dismutase measurements indicate that these complexes behave as superoxide dismutase mimics.

Spin-Polarized Tunneling through Chemical Vapor Deposited Multilayer Molybdenum Disulfide.

The two-dimensional (2D) semiconductor molybdenum disulfide (MoS2) has attracted widespread attention for its extraordinary electrical-, optical-, spin-, and valley-related properties. Here, we report on spin-polarized tunneling through chemical vapor deposited multilayer MoS2 (∼7 nm) at room temperature in a vertically fabricated spin-valve device. A tunnel magnetoresistance (TMR) of 0.5-2% has been observed, corresponding to spin polarization of 5-10% in the measured temperature range of 300-75 K. First-principles calculations for ideal junctions result in a TMR up to 8% and a spin polarization of 26%. The detailed measurements at different temperature, bias voltages, and density functional theory calculations provide information about spin transport mechanisms in vertical multilayer MoS2 spin-valve devices. These findings form a platform for exploring spin functionalities in 2D semiconductors and understanding the basic phenomena that control their performance.

Classical hydrogen bonding and stacking of chelate rings in new copper(ii) complexes.

Three new copper(ii) complexes, viz., [Cu(L)(NO3)(H2O)]H2O 1, [Cu(L)(H2O)2]NO32 and [Cu2(L)2(pyrazine)](ClO4)2·4H2O 3, were prepared using a biomimetic synthesis strategy [HL = 4-chloro-2-{(E)-[2-(pyridin-2-yl)hydrazinylidene]methyl}phenol]. Structural characterization revealed very different local geometries around copper(ii) ions, being square pyramidal for mononuclear complexes (τ5 = 0.021 for 1 and τ5 = 0.13 for 2) and square planar for homobinuclear pyrazine bridged complex 3 (τ4 = 0.06). In complex 3, stacking of chelate rings was observed. This insight was thought to provide new structural evidence for the stacking of the planar chelate rings. These π-interactions provide stability to the crystal structure of homobinuclear complex 3. Magnetic measurements of bulk materials 1, 2 and 3 revealed weak antiferromagnetic coupling in all complexes. The EPR spectra of complexes 1, 2 and 3 in polycrystalline state exhibited broad signals at g ≅ 2.15 owing to spin-spin interactions between two copper ions. The cyclic voltammograms of mononuclear complexes (1 and 2) in DMSO gave one CuII/CuI irreversible wave. On the other hand, pyrazine bridged binuclear complex 3 exhibited two waves, which correspond to CuIICuII/CuIICuI and CuIICuI/CuICuI redox processes. Differential pulse voltammetry (DPV) experiments also exhibited the same reduction behavior. These complexes displayed effective antioxidant SOD activity and exhibit the outlines of a structure-based cyclic mechanism. On the basis of experimental and theoretical DFT studies, the structure-activity relationships of these complexes have also been discussed.

HgsDb: Haplogroups Database to understand migration and molecular risk assessment.

UNLABELLED: HgsDb, a database is developed to organize the data under a single platform to facilitate easy access for researcher to get information on migration and molecular risk assessment. In past, human beings migrate from one place to other over the globe in search of food and better habitat, where they got adapted. These adaptations are visible in the form of change in color, facial pattern, average height, eye shape, hair texture, etc. This leads to origin of different race of human being. The adaptations are remarkable when move from equator to either poles. There are hundreds of different haplogroups reported on both maternal and paternal sites. This database provides overview of seventy-six major Haplogroup of mt-DNA and Y-DNA with their sub classes supplemented with structural information of individual Haplogroup responsible for various factor such molecular risk assessment, migration and origin. They help genealogist to gain deep insight information about their maternal and paternal patterns. , we had collected data from open source such as National Center for Biotechnology (NCBI), to develop this database for providing information, which Will helps the medical biology, molecular biology, genealogy and for designing personalized medicine. AVAILABILITY: www.gbpec.ac.in/research/HgsDb/.

Hit identification and optimization in virtual screening: practical recommendations based on a critical literature analysis.

A critical analysis of virtual screening results published between 2007 and 2011 was performed. The activity of reported hit compounds from over 400 studies was compared to their hit identification criteria. Hit rates and ligand efficiencies were calculated to assist in these analyses, and the results were compared with factors such as the size of the virtual library and the number of compounds tested. A series of promiscuity, druglike, and ADMET filters were applied to the reported hits to assess the quality of compounds reported, and a careful analysis of a subset of the studies that presented hit optimization was performed. These data allowed us to make several practical recommendations with respect to selection of compounds for experimental testing, definition of hit identification criteria, and general virtual screening hit criteria to allow for realistic hit optimization. A key recommendation is the use of size-targeted ligand efficiency values as hit identification criteria.

Retroperitoneoscopic living-donor nephrectomy and laparoscopic kidney transplantation: experience of initial 72 cases.

BACKGROUND: To evaluate the feasibility, safety, and outcome of laparoscopic kidney transplantation (LKT) after retroperitoneoscopic living-donor nephrectomy. METHODS: Between February 2010 and January 2012, a total of 217 renal transplantations were performed from living donors by a single surgical unit. All living-donor nephrectomies were performed by retroperitoneoscopic approach. Recipient surgery was performed either laparoscopically (n=72) or by conventional open approach (n=145). In the LKT group, a 5 to 6 cm Pfannenstiel incision was placed and the kidney was dropped into abdomen. Renal vessels were anastomosed by freehand suturing technique. Calcineurin inhibitor-based immunosuppressants were given. RESULTS: The mean operative time was 223.8 and 175.7 min (P=0.07) and the rewarming time was 60.3 and 30.3 min (P=0.03) in the LKT and open kidney transplantation (OKT) groups, respectively. The estimated glomerular filtration rate value on days 7 and 30 was significantly less in the LKT group, but no difference was found at 3, 6, 12, and 18 months. The mean wound length was 5.5 and 17.8 cm (P=0.0001) and the analgesic requirement was 1.4 and 3.2 mg morphine equivalent in first 24 hr (P=0.005) in the LKT and OKT groups, respectively. In the LKT group, four cases required conversion to open surgery due to vascular complications and one for urinary leak. Kaplan-Meier curve shows 86.5% and 94.6% (P=0.086) and patient survival is 94.1% and 94.7% (P=0.745) at 22.3 months of follow-up. CONCLUSIONS: LKT after living-donor nephrectomy is feasible, but it has steep learning curve. Graft fixation with peritoneal fold is necessary to avoid torsion and related graft loss. Pain after LKT is significantly less compared with conventional OKT.

Laparoscopic en bloc kidney transplantation.

Laparoscopic donor nephrectomy is well establish procedure and having advantages over open donor nephrectomy in terms of having less pain, early ambulation and rapid post operative recovery. To extend the advantages of laparoscopic surgery to the recipient, recently we have performed laparoscopic kidney transplantations when kidney was procured from deceased donors. As a further extension of the procedure, here we present a case of laparoscopic en bloc kidney transplantation in obese diabetic recipient who received kidneys from 70 year old non-heart beating donor.

Electrical creation of spin polarization in silicon at room temperature.

The control and manipulation of the electron spin in semiconductors is central to spintronics, which aims to represent digital information using spin orientation rather than electron charge. Such spin-based technologies may have a profound impact on nanoelectronics, data storage, and logic and computer architectures. Recently it has become possible to induce and detect spin polarization in otherwise non-magnetic semiconductors (gallium arsenide and silicon) using all-electrical structures, but so far only at temperatures below 150 K and in n-type materials, which limits further development. Here we demonstrate room-temperature electrical injection of spin polarization into n-type and p-type silicon from a ferromagnetic tunnel contact, spin manipulation using the Hanle effect and the electrical detection of the induced spin accumulation. A spin splitting as large as 2.9 meV is created in n-type silicon, corresponding to an electron spin polarization of 4.6%. The extracted spin lifetime is greater than 140 ps for conduction electrons in heavily doped n-type silicon at 300 K and greater than 270 ps for holes in heavily doped p-type silicon at the same temperature. The spin diffusion length is greater than 230 nm for electrons and 310 nm for holes in the corresponding materials. These results open the way to the implementation of spin functionality in complementary silicon devices and electronic circuits operating at ambient temperature, and to the exploration of their prospects and the fundamental rules that govern their behaviour.

Development of a district-wide teledermatology service.

Demand for dermatology services is increasing, resulting in changes in service provision and the role of nurses. Technological advances have led to the development of telemedicine. This article describes how four primary care trusts and the dermatology department at Queen's Medical Centre developed a district-wide teledermatology service. The service was led by nurses and a GP with a special interest in dermatology.