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This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the efficacy and safety of different methods of surgical excision for skin cancer involving the nail unit.

We started with a medium throughput screen of heterocyclic compounds without basic amine groups to avoid hERG and β-blocker activity and identified [1,2,4]triazolo[4,3-a]pyridine as an early lead. Optimization of substituents for Late INa current inhibition and lack of Peak INa inhibition led to the discovery of 4h (GS-458967) with improved anti-arrhythmic activity relative to ranolazine. Unfortunately, 4h demonstrated use dependent block across the sodium isoforms including the central and peripheral nervous system isoforms that is consistent with its low therapeutic index (approximately 5-fold in rat, 3-fold in dog). Compound 4h represents our initial foray into a 2nd generation Late INa inhibitor program and is an important proof-of-concept compound. We will provide additional reports on addressing the CNS challenge in a follow-up communication.

We started with a medium throughput screen of heterocyclic compounds without basic amine groups to avoid hERG and β-blocker activity and identified [1,2,4]triazolo[4,3-a]pyridine as an early lead. Optimization of substituents for Late INa current inhibition and lack of Peak INa inhibition led to the discovery of 4h (GS-458967) with improved anti-arrhythmic activity relative to ranolazine. Unfortunately, 4h demonstrated use dependent block across the sodium isoforms including the central and peripheral nervous system isoforms that is consistent with its low therapeutic index (approximately 5-fold in rat, 3-fold in dog). Compound 4h represents our initial foray into a 2nd generation Late INa inhibitor program and is an important proof-of-concept compound. We will provide additional reports on addressing the CNS challenge in a follow-up communication.

Heteroepitaxial growth of high-quality II-VI-alloy materials on Si substrates is a well-established commercial growth process for infrared (IR) detector devices. However, it has only recently been recognized that these same processes may have important applications for production of high-efficiency photovoltaic devices. This submission reviews the process developments that have enabled effective heteroepitaxy of II-VI alloy materials on lattice-mismatched Si for IR detectors as a foundation to describe recent efforts to apply these insights to the fabrication of multijunction Si/CdZnTe devices with ultimate conversion efficiencies >40%. Reviewed photovoltaic studies include multijunction Si/CdZnTe devices with conversion efficiency of ~17%, analysis of structural and optoelectrical quality of undoped CdTe epilayer films on Si, and the effect that a Te-rich growth environment has on the structural and optoelectronic quality of both undoped and As-doped heteroepitaxial CdTe.

Dislocation cores have long dominated the electronic and optical behaviors of semiconductor devices and detailed atomic characterization is required to further explore their effects. Miniaturization of semiconductor devices to nanometre scale also puts emphasis on a material's mechanical properties to withstand failure due to processing or operational stresses. Sessile junctions of dislocations provide barriers to propagation of mobile dislocations and may lead to work-hardening. The sessile Lomer–Cottrell and Hirth lock dislocations, two stable lowest elastic energy stair-rods, are studied in this paper. More specifically, using atomic resolution high-angle annular dark-field imaging and atomic-column-resolved X-ray spectrum imaging in an aberration-corrected scanning transmission electron microscope, dislocation core structures are examined in zinc-blende CdTe. A procedure is outlined for atomic scale analysis of dislocation junctions which allows determination of their identity with specially tailored Burgers circuits and also formation mechanisms of the polar core structures based on Thompson's tetrahedron adapted to reactions of polar dislocations as they appear in CdTe and other zinc-blende solids. Strain fields associated with the dislocations calculatedviageometric phase analysis are found to be diffuse and free of `hot spots' that reflect compact structures and low elastic energy of the pure-edge stair-rods.

The authors of the primary articles in this special edition provide early and promising evidence that developmentally sensitive psychotherapeutic interventions and integrated care systems improve the lives of children who have been exposed to abuse or neglect. Why, then, do so many children in the social welfare system receive care that is not fostering their potential? This response highlights other perspectives about where we stand today in regard to the care of children that enter out of home placements, highlighting some of our grand achievements and our current failures. Even as the debates about government debt and fiscal responsibility mount, what is clearly required is the transcendence of our current system to one that is developmentally sensitive, integrated, evidence-based, and sustainable.

Much clinical work in infant mental health includes working with families of young children involved in the complex arenas of the legal and child protection systems. These systems have their own distinctive languages, cultures, and values, but they share a concern with clinicians about the best interest of the child. This special issue explores selected topics in this area, calling attention to research, policy, and clinical issues in forensic infant mental health. The purpose of the issue is to stimulate additional thinking and additional scholarly attention to these vital issues that have such importance for families around the world.

Systematic research and practice guidelines addressing preschool psychopharmacological treatment in very young children are limited, despite evidence of increasing clinical use of medications in this population. The Preschool Psychopharmacology Working Group (PPWG) was developed to review existing literature relevant to preschool psychopharmacology treatment and to develop treatment recommendations to guide clinicians considering psychopharmacological treatment in very young children. This article reviews the developmental considerations related to preschool psychopharmacological treatment, presents current evidence bases for specific disorders in early childhood, and describes the recommended algorithms for medication use. The purpose of this effort is to promote responsible treatment of young children, recognizing that this will sometimes involve the use of medications.

Crystalline CdTe layers have been grown heteroepitaxially onto crystalline Si substrates to establish material parameters needed for advanced photovoltaic (PV) device development and related simulation. These studies suggest that additional availability of the intrinsic anion (i.e., Te) during molecular beam epitaxy deposition can improve structural and optoelectronic quality of the epilayer and the interface between Si substrate and the epilayer. This is seen most notably for thin CdTe epitaxial films (< ∼10 µm). Although these observations are foundationally important, they are also relevant to envisioned high-performance multijunction II–VI alloy PV devices—where thin layers will be required to achieve production costs aligned with market constraints.

Standard nosologies of psychiatric disorders have made preliminary efforts to accommodate developmental differences in symptom manifestation by young children. Significant gaps remain in the validation of disorders for this age group. The DC: 0–3 represents an alternative nosology for disorders of infancy that attempts to complement existing approaches and assist clinicians and researchers. In this commentary we review research on two disorders of early childhood—Posttraumatic Stress Disorder (PTSD), and Reactive Attachment Disorder (RAD)—to illustrate the promises and problems of the DSM-IV and DC: 0–3 approach to definition and conceptualization of these disorders. In addition we review what is known about RAD and PTSD with regard to key areas of controversy in early childhood psychopathology: (1) continuous versus categorical conceptualization, (2) developmental considerations, and (3) the relationship context. Recommendations are made for future editions of the DSM-IV and DC: 0–3, as well as for validity research in early childhood disorders. ©2003 Michigan Association for Infant Mental Health.

Open circuit voltages in CdTe based solar photovoltaics can be improved through increasing the acceptor carrier concentration in the absorber. Arsenic doped heteroepitaxial CdTe layers deposited by MBE are investigated as a means to understand the viability of arsenic as an alternative dopant source without the complication of polycrystalline grain boundaries or high temperature deposition processes. Crystal quality, thickness, and minority carrier lifetimes are correlated with arsenic incorporation and p-type carrier concentrations for both doped and undoped films. Films with carrier concentrations greater than 1015 cm−3 have been produced using both an arsenic cracker source and a Cd3As2 effusion source though incorporation differs drastically between these two. As previous work has found, arsenic incorporation is shown to degrade crystal quality. Despite the lower crystal quality, minority carrier lifetimes greater than 1 ns have been achieved in samples with high carrier concentrations when the Cd 3 As 2 source is used suggesting the benefit of cadmium overpressure. While the feasibility of arsenic doping during high temperature CdTe deposition processes is still not known, arsenic is shown to be a viable dopant source for continued investigation of heteroepitaxial model systems.

Objective To determine whether pediatric continuity clinics integrate mental health (MH) services into care delivery; and to determine whether the level of MH integration is related to access to MH services, types of MH screening performed, self-efficacy, satisfaction with referral sites, and communication with the primary care provider. Methods Pediatric Residency Integrated Survey of Mental Health in Primary Care (PRISM_PC) is a newly designed cross-sectional, Web-based survey of continuity clinic directors participating in a national network of pediatric continuity clinics (CORNET). Definitions of MH models included integrated or nonintegrated MH models or traditional care. The survey included questions regarding access, screening that was performed at sites, comfort with MH management as well as provider satisfaction and communication with referral sites. Results Seventy-eight percent (57 of 73) of CORNET site directors responded, representing input from 30% of US pediatric residency continuity programs. Thirty-five percent (n = 20) reported an integrated MH model while 65% (n = 37) reported a nonintegrated MH model. Seventy-nine percent screened for attention-deficit/hyperactivity disorder, 44% for behavioral-emotional issues, and 19% for pediatric depression. No differences were found in terms of screening or tools used on the basis of the level of MH integration. Those with integrated programs were more likely to have access to an on-site psychologist ( P = .001) or psychiatrist ( P = .006). Conclusions Directors from one-third of training programs surveyed reported some level of MH integration in their primary care teaching clinics. Future studies are needed to compare patient and resident education outcomes between integrated and nonintegrated sites.

Chronic prenatal stress contributes to poor birth outcomes for women and infants. Importantly, poor birth outcomes are most common among minority and low income women. To investigate underlying mechanisms, we tested the hypothesis that chronic stress related to minority or low income status is associated with glucocorticoid resistance as indicated by disruption in the cytokine-glucocorticoid feedback circuit. Home visits were conducted during which 3rd trimester pregnant women completed stress and depression surveys and provided blood for pro- and anti-inflammatory cytokines. Saliva was collected 5 times the preceding day for diurnal cortisol levels. For statistical analyses, women were grouped 3 ways, by race, income, and the presence or absence of either of those risk factors; this last group was labeled high or low general risk. Immune regulation was evaluated by evidence of a functioning negative feedback relationship between cytokines and cortisol. Of 96 participants, 18 were minority, 22 of low income, and 29 either minority or low income (high general risk). Pearson partial correlation identified a significant negative relationship between cortisol area under the curve (AUC) and pro- to anti-inflammatory cytokine ratios in the low general risk women (i.e., Caucasian, higher income) including IFNγ/IL10 (r = −0.73, p < 0.0001), IL6/IL10 (r = 0.38, p = 0.01), IL1β/IL10 (r = −0.44, p = −0.004) and TNFα/IL10 (r = −0.41; p = 0.005); no such correlations existed in the high general risk women (i.e., minority, low income) for (IFNγ/IL10: r = −0.25, p = 0.43; IL6/IL10:r = 0.12, p = 0.70; IL1 β/IL10: r = 0.05, p = 0.87; TNFα/IL10: r = 0.10; p = 0.75), suggestive of glucocorticoid resistance. Cortisol levels throughout the day also were higher in minority and high general risk groups (p < 0.05). Without cytokine glucocorticoid feedback, a pregnant woman’s ability to regulate inflammation is limited, potentially contributing to adverse maternal and infant outcomes.

Video studies, gait analysis, footprint tracks, and observa- tional scan sampling show that, in comparably furnished enclosures, Leonto- pithecus rosalia and Callimico goeldii are superficially similar in their use of predefined locomotor patterns but differ profoundly in many underlying de- tails which reflect differences in postcranial morphology. Each uses pro- nograde arboreal quadrupedal walking, quadrupedal bounding, and vertical climbing with comparable frequency, and both shift to bounding while moving quadrupedally at high speeds. In walking, both species use a diagonal se- quence gait. However, in Callimico the distance per bout traveled while walk- ing or running is shorter than in L. rosalia and there is an emphasis on leaping (from a stationary position) and bounding-leaps (saltational exten- sions of pronograde quadrupedalism), in contrast with the basically quadru- pedal style ofL. rosalia. This dichotomy is consistent with anatomical special- izations, such as forelimb elongation in Leontopithecus and hindlimb elongation in Callimico. In vivo hand- and footprint studies demonstrate grasping halluces in both species while walking. Limb stances in L. rosalia during "transaxial bounding" involve an overstriding hindlimb, a predomi- nance of oblique rather than in-line travel, and unique hand and foot posi- tions. Anatomically, this locomotor style may be associated with reduced dexterity of the elongate hands and a relatively short hallux. The captive locomotor profiles for both species probably reflect biased samples of the locomotor repertoire of their wild counterparts. Nevertheless, these data re- flect species-specific integrations of locomotor behavior and morphology, and corroborate expectations of locomotor diversity among callitrichine primates, even those of similar body size. It is suggested, however, that conventional quantitative studies of locomotor profiles may prove inadequate for resolving subtle aspects of locomotor morphology and behavior. o 1994 Wiley-Liss, Inc.

Postpartum depression (PPD) is a serious mood disorder that may carry life-long consequences for a woman and her family. Multiple risk factors for PPD have been identified, including psychosocial, situational, and biological stimuli, several of which are experienced by most, if not all, postpartum women. Given the commonality of these risk factors, it is unclear why fewer than 20% of postpartum women actually develop PPD. In this review, we suggest that different susceptibility to PPD among postpartum women may be explained by the presence or absence of genetic variants that confer increased risk. We review three categories of genes known to code for proteins associated with depression in the general population or proteins known to be affected by childbirth for their possible association with PPD, including genes related to central nervous system monoamine availability, proinflammatory cytokines, and brain neuropeptides. Only two studies are available in the literature to date specifically looking at polymorphisms in postpartum women as related to PPD; both are concerned with monoamine availability. These are discussed in further depth. Conclusions regarding the contribution of genetic polymorphisms to the development of PPD are mixed. Ultimately, the complexity of the disorder and the interrelationships among different genes thought to contribute to depression suggest that much more research is required to understand the heritability of PPD. The complexity of the disorder also suggests that epigenetic influences must be considered as well when discussing susceptibility.

The dramatic surge in diversity in the western world requires a commitment by pediatric providers to understand unique psychosocial presentations of distress, as well as to have an understanding of normative cultural values and health-seeking behaviors. We report a case of apparent recurrent abdominal pain that evolved into a unique culturally salient presentation of obsessive compulsive disorder in a 6-year-old young girl. Access to integrated mental health professionals assisted in the identification of this disorder, if not success in referral and treatment.

OBJECTIVE. Screening for maternal depression is gaining acceptance as a standard component of well-child care. We tested the feasibility of this policy and determined the prevalence and incidence of maternal depression at well-child visits during the first 6 months of life. METHODS. Providers in an adolescent-oriented maternity program were cued electronically, when they opened the electronic medical records of 0- to 6-month-old infants to conduct well-child visits, to ask the mothers to complete the Edinburgh Postpartum Depression Scale. Incident cases represented mothers who crossed the referral threshold (score of ≥10) after the first screening. RESULTS. Mothers usually brought their infants to the clinic, and none refused screening. Providers could act on 99% of the 418 screening cues; they administered the Edinburgh Postpartum Depression Scale 98% of the time and always referred mothers with scores of ≥10. Overall, 20% of the mothers scored ≥10. Scores were unstable at ≤3 postpartum weeks (κ = 0.2). Thereafter, the prevalence and incidence of scores of ≥10 decreased from 16.5% at 2 months to 10.3% and 5.7%, respectively, at 4 months. Prevalence increased to 18.5% at the 6-month visit, and incidence decreased to 1.9%. Repeat screening detected only 2 mothers (5.7%) with scores of ≥10. CONCLUSIONS. Electronic cueing improved compliance with the detection and referral phases of screening for maternal depression at well-child visits. Screening 2 months after delivery detects most mothers who become depressed during the first 6 postpartum months, and screening at the 6-month well-child visit is preferable to screening at the 4-month visit.