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Objective: To explore the feasibility of conducting a randomized controlled trial (RCT) designed to compare the performance of digital fetal scalp stimulation (dFSS) and fetal blood sampling (FBS) as second-line tests of fetal wellbeing in Labor.Design: A feasibility study included 66 women who consented to both dFSS and FBS performed contemporaneously. A pilot randomized controlled trial included 50 women who were randomized to either dFSS or FBS.Setting: University-affiliated maternity hospital.Population: Women in Labor who required second-line testing of fetal well-being following abnormal fetal heart rate monitoring.Outcome Measures: The primary outcome of interest was delivery by emergency cesarean section. Secondary outcomes included maternal and perinatal morbidity outcomes and procedural factors.Results: Of the 66 women recruited to the feasibility study 50 (76%) received the two interventions as per protocol. The demographic data indicated that future RCT should be limited to nulliparous women. After initial training and reminders, the dFSS procedure appeared to be acceptable to patients and clinicians and was interpreted appropriately. Recruitment of eligible women to the pilot RCT was successful (88%) with 50 of 63 eligible women randomized (79%) and no drop-outs. The cesarean section rate was high in both arms as expected with a cohort of women requiring second-line tests for abnormal fetal heart rate monitoring in Labor (5/25; 20% dFSS versus 13/25; 52% FBS, p = .018). Conservative estimates suggest that a sample size of 2500 randomized women would be required for a definitive RCT.Conclusions: This study suggests that dFSS, which has the potential to be a reliable alternative to FBS, could be evaluated in a well-designed randomized controlled trial.Trial Registration: The definitive trial has been registered ISRCTN 13295826. [ABSTRACT FROM AUTHOR]

Purpose: To investigate men's experiences of receiving external-beam radiotherapy (EBRT) with neoadjuvant Androgen Deprivation Therapy (ADT) for localized prostate cancer (LPCa) in the ProtecT trial.Methods: A longitudinal qualitative interview study was embedded in the ProtecT RCT. Sixteen men with clinically LPCa who underwent EBRT in ProtecT were purposively sampled to include a range of socio-demographic and clinical characteristics. They participated in serial in-depth qualitative interviews for up to 8 years post-treatment, exploring experiences of treatment and its side effects over time.Results: Men experienced bowel, sexual, and urinary side effects, mostly in the short term but some persisted and were bothersome. Most men downplayed the impacts, voicing expectations of age-related decline, and normalizing these changes. There was some reticence to seek help, with men prioritizing their relationships and overall health and well-being over returning to pretreatment levels of function. Some unmet needs with regard to information about treatment schedules and side effects were reported, particularly among men with continuing functional symptoms.Conclusions: These findings reinforce the importance of providing universal clear, concise, and timely information and supportive resources in the short term, and more targeted and detailed information and care in the longer term to maintain and improve treatment experiences for men undergoing EBRT. [ABSTRACT FROM AUTHOR]

Postpartum women sleep less during the early days following delivery. Long-term sleep disturbance and fatigue can have significant implications for physical and mental health, relationships, employment and parental competence. Most studies focus on the quality and quantity of maternal sleep between weeks one and six postpartum. We explored sleep patterns and reasons for wakefulness of first-time mothers immediately following delivery. Thirty first-time mothers completed a postnatal sleep questionnaire, detailing their total sleep time (TST), the reasons for being awake and their level of fatigue. The logs were completed in real time during the first 48 h postpartum, while they were still in a hospital environment. The data collected from the mothers in the study indicated that the mean TST in the first 48 h was 9.7 h. Of the factors explored only breastfeeding influenced the TST. Breastfeeding women slept on average 2.6 h longer than women who bottle-fed (p = .042). Impact statement What is already known on this subject: Childbearing affects women's sleep in many ways. Hormonal changes during pregnancy and postpartum as well as physiological and anatomical alterations, and the process of adaptation to the new parent's responsibilities contribute to changes in sleep architecture. Since first study of sleep and pregnancy published in 1968 there have been very few publications addressing maternal sleep postpartum. Most studies which have focussed on quality of maternal sleep in the first 6-months postpartum period describe the relationships between poor maternal sleep and postpartum depression and other mental health outcomes. What the results of this study add: We explored sleep patterns and reasons for wakefulness of first-time mothers immediately following delivery while they remained in the hospital environment. We found that environmental factors such as background noise, shared rooms, type of delivery, feeding and worrying about the neonate did not influence the total sleep time, however, the main outcome of our study is that breastfeeding promotes maternal sleep. What the implications are of these findings for clinical practice and/or further research: We believe that this study would be of interest to many obstetricians, general practitioners, nurses and midwives as well as to the general public. Appropriate counselling of patients early in postnatal period can improve their sleep patterns and reduce the risk of depression and other abnormal physical, psychological and social outcomes. [ABSTRACT FROM AUTHOR]

Presents a study that investigated the far infrared photoconductivity of gallium arsenide (GaAs)/AlGaAs multiquantum wells (MQW) doped with silicon. Information on the binding energy of an electron to a hydrogen like impurity in an MQW; Details of the continuous wave magnetospectroscopy measurement; Assessment of the time-resolved response of an MQW specimen to short impulses.

Objective. The aim of the review was to compare the use of finasteride to placebo in patients undergoing TURP procedures. Material & Methods. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966-November 2011), EMBASE (1980-November 2011), CINAHL, Clinicaltrials.gov, Google Scholar, reference lists of articles, and abstracts from conference proceedings without language restriction for studies comparing finasteride to placebo patients needing TURPs. Results. Four randomised controlled trials were included comparing finasteride to a placebo. A meta-analysis was not conducted due to the disparity present in the results between the studies. Three of the studies found that finasteride could reduce either intra- or postoperative bleeding after TURP. One study found finasteride to significantly lower the microvessel density (MVD) and vascular endothelial growth factor (VEGF). None of the studies reported any long-term complications related to either the medication or the procedure. Conclusion. finasteride reduces bleeding either during or after TURP. [ABSTRACT FROM AUTHOR]

Objective. The aim of the review was to compare the use of finasteride to placebo in patients undergoing TURP procedures. Material & Methods. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966-November 2011), EMBASE (1980-November 2011), CINAHL, Clinicaltrials.gov, Google Scholar, reference lists of articles, and abstracts from conference proceedings without language restriction for studies comparing finasteride to placebo patients needing TURPs. Results. Four randomised controlled trials were included comparing finasteride to a placebo. A meta-analysis was not conducted due to the disparity present in the results between the studies. Three of the studies found that finasteride could reduce either intra- or postoperative bleeding after TURP. One study found finasteride to significantly lower the microvessel density (MVD) and vascular endothelial growth factor (VEGF). None of the studies reported any long-term complications related to either the medication or the procedure. Conclusion. finasteride reduces bleeding either during or after TURP. [ABSTRACT FROM AUTHOR]

Background:No consensus exists on optimal treatment for Graves’ disease once anti-thyroid medication fails to induce remission. Total thyroidectomy is a more cost-effective treatment than radioactive iodine or life-long anti-thyroid medication, but hypocalcaemia is an important complication, leading to longer hospital admissions and increased prescription costs. This study aimed to compare the relative risk of hypocalcaemia requiring medical treatment for patients with Graves’ disease.Methods:Prospective cohort study of patients undergoing total thyroidectomy for Graves’ disease and for multinodular goitre, calculating serum calcium levels 24-hours post-operatively and prescription rates.Results:Mean corrected calcium concentrations 24 hours post-operatively were 2.05 mmol/l for Graves’ disease patients and 2.14 mmol/l for multinodular goitre patients (p = 0.003). Biochemical hypocalcaemia developed in 92 per cent (n = 34) of Graves’ disease patients and 71 per cent (n = 43) of multinodular goitre patients (p = 0.012). Graves’ disease patients were more likely to be prescribed calcium supplementation pre-discharge (p = 0.037).Conclusion:Total thyroidectomy for Graves’ disease carries an increased risk of hypocalcaemia at 24 hours, and of calcium supplementation pre-discharge. Graves’ disease patients should be informed of the increased risk of hypocalcaemia associated with total thyroidectomy, and this risk must be factored into future cost-effectiveness analysis. [ABSTRACT FROM PUBLISHER]

Aims: The authors sought to identify the initial expectations held by potential participants of a residential pain management programme. Drawing on existing placebo literature, it was anticipated that such insight would provide greater opportunities to secure positive outcomes for participants. Methods: Focus groups and questionnaires were undertaken with 17 potential participants of the programme, to explore their pre-programme expectations. Data were thematically summarized. Findings: Participants provided a wealth of information about their hopes from the programme. Thematic analysis revealed that participants were not, however, describing their expectations of their own potential achievements from participating in the programme. Conclusions: The data provided by the participants highlighted the relevance of self-efficacy in interpreting their current potential for change. It is recommended that researchers should exercise caution when selecting the methods and language for qualitative approaches, particularly around 'hopes' and 'expectations'. These findings may have clinical implications for the evaluation of patients' preparedness for engaging in treatment in this area. [ABSTRACT FROM AUTHOR]

This article describes results of year-1 implementation of the Salud Para Su Corazón (Health For Your Heart)-National Council of la Raza (NCLR) promotora (lay health worker) program for promoting heart-healthy behaviors among Latinos. Findings of this community outreach initiative include data from promotora pledges and self-skill behaviors, cardiovascular disease risk factors of Latino families, family heart-health education delivery, and program costs associated with promotora time. Participation included 29 trained promotoras serving 188 families from three NCLR affiliates in Escondido, California; Chicago, Illinois; and Ojo Caliente, New Mexico. Using several evaluation tools, the results showed that the promotora approach worked based on evidence obtained from the following indicators: changes in promotora's pre-post knowledge and performance skills, progress toward their pledge goals following training, recruiting and teaching families, providing follow-up, and organizing or participating in community events. Strengths and limitations of the promotora model approach are also discussed. [ABSTRACT FROM AUTHOR]

Methacrylate-type poly(vinylidene fluoride) macromonomer was synthesized from vinylidene fluoride via hydroxy-ended poly(vinylidene fluoride). The macromonomer copolymerized easily with methyl methacrylate, but homopolymerization did not proceed completely. [ABSTRACT FROM AUTHOR]

This article outlines very briefly our present state of knowledge concerning the growth and characterization of group III-nitrides by plasma assisted molecular beam epitaxy (PA-MBE) and also discusses the application of MBE for devices. We begin with a discussion of our current knowledge of the growth kinetics for both binary compounds (AlN, GaN and InN) and for alloys with mixed group III (InGaN and AlGaN) and group V (AlAsN and GaAsN) elements. We emphasize the important role that the choice of substrates, stoichiometry and buffer layers play in determining the morphology of GaN. We comment briefly on the problems of doping group III-nitrides, particularly p-type, and finally we mention the present status of devices grown by MBE compared with similar devices grown by metal-organic vapour phase epitaxy (MOVPE). © 1998 Chapman & Hall [ABSTRACT FROM AUTHOR]

Transitional cell carcinoma of the bladder is the fifth commonest cause of death from cancer in men in the United Kingdom. Most patients present early with superficial disease, though with current treatment up to 20% progress to invasive disease, which has a poor prognosis. Better local treatments are required to limit this tumour progression. The ease of access to the bladder via a catheter provides the ideal opportunity for antibody (Ab) targeted therapy. We have previously shown that indium-111 labelled anti-MUC1 mucin Ab C595 selectively localises to bladder tumours after intravesical administration. We have selected copper-67 as an alternative radiolabel with suitable physical characteristics for radioimmunotherapy. This communication demonstrates that C595 can be reproducibly labelled with [sup 67]Cu and that the radioimmunoconjugate is both stable and maintains high immunoreactivity. Pilot studies on cystectomy specimens in a novel ex vivo system and in one patient confirmed the ability of this conjugate to localise to tumour after intravesical administration. On the basis of these studies we are now in a position to study the intravesical administration of [sup 67]Cu-labelled C595 in patients with bladder cancer with a view to a therapeutic trial. [ABSTRACT FROM AUTHOR]

Magnetoquantum oscillations in the tunnel current of double-barrier n-GaAs/(AlGa)As/GaAs/(AlGa)As/GaAs resonant tunneling devices reveal evidence of sequential tunneling in the voltage range corresponding to the resonance when electrons tunnel into the second subband of the GaAs quantum well. The sequential tunneling arises from intersubband scattering between two quasi-bound states of the well. Near this resonance, the charge buildup in the well can be estimated from the magnetoquantum oscillations. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Ties and white coats, to wear or not to wear? Patients' attitude to doctors' appearance in the otolaryngology outpatient clinic," by Hathorn and colleagues in a 2008 issue.

We observed significant piezoelectric activity in cast films of poly(1-bicyclobutanecarbonitrile). [ABSTRACT FROM AUTHOR]

Objectives. We aim to establish whether in vivo confocal endomicroscopy (1) delivers a clear image of subcellular structures within the upper airway mucosa and (2) allows leucocytes to be identified using topical antibodies against CD45, the common leucocyte antigen. Methods. Endoscopic confocal images were captured from the supraglottic and tracheal mucosa in anaesthetised Landrace–Large white hybrid pigs using a rigid endoscope (Optiscan, Melbourne, Auctralia). 10% fluroscein was administered intravenously as contrast; 30 min later 0.05% acriflavine was applied as a topical contrast to the mucosa immediately prior to imaging of two pigs. In a further two pigs, 10% fluorescently labelled anti-CD45 antibody was applied topically immediately prior to imaging. Images were captured and reviewed on a computer screen at the time of examination. Results. High-resolution (x1000 magnification) images of the nuclei and cytoplasm of individual cells within the stratified squamous and respiratory epithelium of the supraglottis and trachea were captured using concurrent fluroscein and acriflavine staining. Intravenous fluroscein highlighted subsurface capillaries within which individual erythrocytes appeared as unstained shadows. Discrete leucocytes were clearly visible within the mucosa following topical application of anti-CD45 antibody. Conclusion. In vivo confocal endomicroscopy allows examination of the upper airway mucosa at cellular resolution in real time. We have, for the first time, combined in vivo confocal imaging with antibody targeting of specific cell markers in the upper airway in large animals. Combining confocal endomicroscopy with topical antibodies against tumour markers (e.g. EGFR and p53) may allow tumours to be diagnosed and characterised during endoscopic examination without taking a biopsy. [ABSTRACT FROM AUTHOR]