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Nature provides powerful but as-yet largely unharnessed methods for low-cost, green synthesis of inorganic functional materials such as quantum dots. These materials have diverse applications from medicine to renewable energy. Harnessing nature's unique ability to achieve cost effective and scalable manufacturing solutions with reduced environmental impact is integral to realizing a future biomanufacturing economy. To address this challenge, a bacterial strain has been engineered to enable biosynthesis of CdS nanocrystals with extrinsic crystallite size control in the quantum confinement range. This strain yields extracellular, water-soluble quantum dots from low-cost precursors at ambient temperatures and pressure. The biomanufacturing approach demonstrated here produces CdS semiconductor nanocrystals with associated size-dependent band gap and photoluminescent properties.

The aim of this study was to examine the efficacy, safety, and tolerability of paroxetine in adolescents with unipolar major depression.Two hundred eighty-six (286) adolescents with unipolar major depression were randomly assigned to receive either paroxetine or placebo for 12 weeks.The proportion of Montgomery-Asberg Depression Rating Scale (MADRS) responders (at least 50% reduction from baseline) for paroxetine and placebo were similar and not statistically different at endpoint (p = 0.702). A similar result was obtained for change from baseline on the Kiddie-Schedule for Affective Disorders and Schizophrenia for School- Age Children (K-SADS-L) depression subscale. Among secondary endpoints, only a significantly higher Clinical Global Impression-Improvement (CGI-I) response rate was reported in paroxetine-treated patients versus placebo (69.2% versus 57.3%; p = 0.045). In general, results differed by age, with patients older than 16 years demonstrating a greater response to active treatment. This age group also reported more adverse experiences (AEs) relative to placebo than younger adolescents. Overall, paroxetine was generally well tolerated (11% discontinued owing to an AE versus 7% of placebo-treated patients). A post hoc analysis of AEs related to suicidal behavior suggested a greater incidence of these events for paroxetine than for placebo (4.4% versus 2.1%); however, this difference was not statistically significant (odds ratio, 2.15, 95% Confidence Interval 0.45, 10.33; p = 0.502).No statistically significant differences were observed for paroxetine compared with placebo on the two prospectively defined primary efficacy variables. Paroxetine at 20-40 mg/day administered over a period of up to 12 weeks was generally well tolerated.

Resume Nous avons etudie l'interet du dosage de la desoxypyridinoline urinaire (DPD) par immunochimiluminescence dans 168 cas de melanome. Les resultats sont exprimes sous forme de ratio DPD/creatinine urinaire (en nmol/mmol). Les patients etaient repartis en 5 groupes : patients sans metastases, patients avec metastases cutanees, patients avec metastases ganglionnaires, patients avec metastases viscerales et patients avec metastases osseuses. Parallelement, nous avons etudie un groupe temoin de 40 patients sains. La moyenne du ratio DPD/creatinine est significativement plus elevee pour les femmes presentant des metastases osseuses que pour le groupe controle (respectivement 16,7 nmol/mmol et 4,96 nmol/mmol, p = 0,003) avec une sensibilite de 62 % et une specificite de 98 %, pour un seuil que nous avons choisi a 15 nmol/mmol. Pour les hommes, les moyennes des differents groupes ne sont pas significativement differentes. En conclusion, pour les femmes, le dosage de la desoxypyridinoline urinaire pourrait etre un outil interessant, en association avec la scintigraphie osseuse, dans les cas d'interpretation delicate.

Objective. To assess the prevalence of depressive disorders among cancer patients attending the out-patient oncology clinic of a major hospital, and to initiate the development of a valid and practical psychological morbidity screening instrument suitable for local conditions. Design. Survey utilising self-report screening scales and full psychiatric interviews. Setting. Radiotherapy department, Groote Schuur Hospital. Patients. Breast cancer, head and neck cancer, and lymphoma patients attending out-patient oncology clinics. Results. A total of 456 patients completed the Hospital Anxiety and Depression Scale (HADS). Of that sample, 245 also completed the Beck Depression Inventory (BDI), and 100 were subjected to a structured psychiatric interview. The prevalence of depression in this population is approximately 14%, which is lower than estimates reported elsewhere. Only 14% of the interviewed depressed cases had been identified and treated by the existing health care system, highlighting the need for suitable screening tools. Appropriate screening tools and management strategies for this population are discussed. Conclusion. This study highlighted the need for routine screening for depression and the implementation of cost-effective management strategies in oncology settings. © 1998 John Wiley & Sons, Ltd.

In the psychopharmacological treatment of depression in cancer patients, mianserin appears to have advantages over other antidepressants. However, it is, claimed to be associated with an unacceptably high incidence of neutropenia. This claim was assessed by investigating the frequency of reported cases of mianserin-related neutropenia against the estimated prescription figures in South Africa. Simultaneously, a more specific assessment was carried out in the form of a 10-year retrospective analysis of all patients presenting with neutropenia to the Department of Haematology, Groote Schuur Hospital, South Africa. Ten patients (18% of the total) demonstrated a psychotropic drug-related neutropenia, and in no instance could mianserin be incriminated. The haematological lesion reversed upon withdrawal of the drug in eight out of these patients as opposed to 12 out of 22 in the non-drug-related, idiopathic group. It would appear that the incidence of mianserin-related neutropenia is no higher than with other psychotropic drugs and, similarly, the condition is reversible. It is concluded that mianserin would therefore be an appropriate first-line agent in the treatment of depression in cancer patients, subject to suggested conditions.

Delayed allergic skin reactions to drugs are common iatrogenic diseases mediated by activation of specific T cells in the skin.To better understand the role of T cells in these diseases, we developed a mouse model of drug allergy induced by skin sensitization to amoxicillin (amox), a penicillin antibiotic frequently involved in delayed drug allergy.Whereas wild-type mice could not be sensitized to amox, CD4+ T-cell-deficient mice developed an amox-specific allergic skin response, mediated by IFN-gamma-producing CD8+ T cells. Amox-specific CD8+ T cells, induced in lymphoid organs at a high frequency during sensitization, were recruited in the skin upon challenge. CD8+ T cells were effectors of the allergic skin reaction to amox as in vivo treatment with depleting anti-CD8 mAbs abrogated the skin inflammatory reaction and as purified CD8+ T cells could adoptively transfer the allergic response to naive recipients.CD8+ T cells mediate penicillin skin allergy.

Carboxymethylcellulose is a high-molecular-weight polysaccharide molecule used as a binding agent, for coating molecules and to increase the viscosity of formulations. It is present in a large number of pharmaceutical products but is also found in food and cosmetics.We report two cases of patients who presented anaphylactic reactions immediately after localised corticosteroid injections; intra-articular for the first and intralesional for the second. Allergological testing for different corticosteroids and carboxymethylcellulose by means of prick-tests and intradermal testing indicated that the immediate hypersensitivity reaction was caused by the excipient, carboxymethylcellulose. The excellent safety of oral reintroduction of carboxymethylcellulose in a pharmaceutical preparation in these two patients confirmed that this large molecule is not absorbed through the digestive system.The avoidance list of products containing carboxymethylcellulose could be greatly reduced and limited to only injectable pharmaceutical preparations containing carboxymethylcellulose and to oral contrast media containing large quantities of carboxymethylcellulose.

Although two reports have indicated benefits of oral steroids in acute urticaria, the 2003 French guidelines emphasized their inefficacy in the treatment of idiopathic chronic urticaria, and the lack of studies. We present the results of a prospective study in 17 patients presenting severe chronic urticaria who agreed to stop taking oral steroids over a one-year period.This single-centre prospective study included adults (1) presenting chronic urticaria as defined by the French consensus conference committee on chronic urticaria (2003), (2) exhibiting at least two of the following three criteria: sleep disturbance due to itching, repeated angioedema, general symptoms; (3) unresponsive or mildly improved by antihistaminic (anti-H1) therapy; (4) receiving oral steroids at least three days per month. After inclusion in the study, oral steroids were stopped either immediately or gradually, on a case-by-case basis. Two different anti-H1 agents were prescribed at inclusion with follow-up visits two, four and 12 months after complete withdrawal of oral steroids.Seventeen patients were included (M/F sex-ratio: 0.54; mean age: 40 years). General signs (fever, arthralgia, various pains), delayed pressure urticaria, and idiopathic cutaneous vasculitis were noted respectively, in seven, nine and three cases. Oral steroids had been taken for three to 30 days per month before inclusion. Three patients had received prior treatment (e.g., immunosuppressants), with no improvement. After withdrawal of oral steroids, (1) 47% of patients presented a short relapse and/or worsening of chronic urticaria, (2) three patients dropped out of the study at four months (persistence of chronic urticaria unacceptable to patients, despite a clinical score showing mild response), (3) six (35%) had complete remission of chronic urticaria at 12 months, with delayed pressure urticaria in three of these cases, (4) eight (47%) had partial remission, five of whom had delayed pressure urticaria, (5) lasting remission of general symptoms.Our study shows that most cases of chronic urticaria are managed without oral steroids since inefficacy of anti-H1 drugs is generally only temporary. After withdrawal of oral steroids, a short increase in chronic urticaria was frequently observed with constant remission from extracutaneous signs and/or histological evidence of vasculitis. We suggest an active role of oral steroids in the failure of anti-H1 therapy. Moreover, oral steroids do not seem to confer any benefits in delayed pressure urticaria, and pending further prospective controlled studies, we recommend that these drugs be prescribed sparingly in chronic urticaria.

Despite great promise of vision-based user interfaces, commercial employment of such systems remains marginal. Most vision-based interactive systems are one-time, "proof of concept" prototypes that demonstrate the interest of a particular image treatment applied to interaction. In general, vision systems require parameter tuning, both during setup and at runtime, and are thus difficult to handle by nonexperts in computer vision. In this paper, we present a pragmatic, developer-centric, service-oriented framework for the construction of vision-based interactive systems. Our framework is designed to allow developers unfamiliar with vision to use computer vision as an interaction modality. To achieve this goal, we address specific developer- and interaction-centric requirements during the design of our system. We validate our approach with an implementation of standard GUI widgets (buttons and sliders) based on computer vision.

Social anxiety disorder is a debilitating, highly prevalent disorder in children and adolescents. If left untreated, it can interfere with emotional, social, and school functioning.To evaluate the efficacy and tolerability of paroxetine in children and adolescents with social anxiety disorder.Multicenter, 16-week, randomized, double-blind, placebo-controlled, flexible-dose, parallel-group, outpatient study. Patients A total of 322 children (8-11 years of age) and adolescents (12-17 years of age) with social anxiety disorder as their predominant psychiatric illness. Intervention Eligible patients were randomized (1:1) to receive paroxetine (10-50 mg/d) or placebo.Four hundred twenty-five patients were screened, and 322 were randomized to treatment. Of these, 319 were included in the intention-to-treat population (paroxetine, n = 163; placebo, n = 156). At the week 16 last observation carried forward end point, the odds of responding (Clinical Global Impression-Improvement score of 1 or 2) were statistically significantly greater for paroxetine (77.6% response [125/161]) than for placebo (38.3% response [59/154]) (adjusted odds ratio, 7.02; 95% confidence interval, 4.07 to 12.11; P.001). The proportion of patients who were "very much" improved (Clinical Global Impression-Improvement score of 1) was 47.8% (77/161) for paroxetine compared with 14.9% (23/154) for placebo. Adverse events occurring at an incidence of 5% or greater for paroxetine and twice that for placebo were insomnia (14.1% vs 5.8%), decreased appetite (8.0% vs 3.2%), and vomiting (6.7% vs 1.9%). Withdrawals due to adverse events were infrequent (5.5% [9/163] for paroxetine and 1.3% [2/156] for placebo).Paroxetine is an effective, generally well-tolerated treatment for pediatric social anxiety disorder.

Adolescents with cancer need to cope with their disease and treatment while accomplishing the tasks unique to this developmental period. In this pilot study, the prevalence of psychological morbidity among adolescents with cancer was examined. In addition, assessment methods and risk factors were explored. Forty-three recently diagnosed adolescents with cancer completed the Hospital Anxiety and Depression Scale (HADS), the Beck Depression Inventory (BDI), and the Rotterdam Symptom Checklist (RSCL) and underwent a full psychiatric assessment. In the psychiatric interviews, 9% of the sample was diagnosed with a depressive mood disorder. Results suggest that self-report rating scales can be useful assessment instruments if used as complementary tools. Psychosocial assessment of the adolescent with cancer is nevertheless difficult. This appears to be due to an atypical symptomatology pattern and a tendency toward the masking of distress. Case examination of depressed patients suggests that illness and treatment factors may not be primary risk factors for the development of psychological morbidity. External stressors such as poor family support and past sexual abuse, when compounded by illness and treatment factors, may be more relevant.

Electrofluorination of benzoyl chloride-ring-UL-14C produced an isomer mixture of cyclic C6F11 carbonyl fluorides, principally 1,2,2,3,3,4,4,5,5,6,6-undecafluorocyclohexane-ring-UL14C carbonyl fluoride, which was derivatized with 2-bromo-4-nitroaniline and triethyl amine. The resultant carboxanilide mixture is designated as EL-499 labeled with 14C in the perfluoro alkyl ring for use in metabolic studies.

Using a tracer sectioning technique, the self-diffusion of Er in pure and HfO2-doped polycrystalline Er2O3 was measured at 1614° to 1900°C. Up to ≊ 10 mol% HfO2 dopant level, the Er self-diffusion coefficients followed a relation based on cation vacancies as the principal mobile defects present and available for cation diffusion. Above 10 mol% HfO2, deviation from this relation occurred, apparently due to clustering of cation vacancies and oxygen interstitials around the dopant hafnium ions. The activation energy for the self-diffusion of Er in pure Er2O3 was 82.2 kcal/mol and increased with the HfO2 dopant level present.

Tracer self-diffusion coefficients for Ca and Y were measured in pure and YF3-doped CaF2 crystals for dopant levels ranging from 2 to 10 mol% and temperatures between 960° and 1212°C. Coefficients for both cations increased approximately linearly with the square of the dopant concentration at constant temperature, with D*Ca>D*Y in doped crystals but D*Ca>D*Y in pure crystals. The activation energies for diffusion of both cations decreased with increasing dopant concentration. Atomic jump pathways are considered and the decrease in activation energy is explained in terms of reduction in the enthalpy of motion accompanying the formation of Willis anion defect clusters in the more heavily doped crystals.

An electron microprobe interdiffusion study was made in single crystals between 1200° and 1331°C over the solid-solution compositional range 0 to 20 mol% YF3 in CaF2. At constant temperature, the value of δ, the interdiffusion coefficient, increased approximately exponentially with increasing YF3 content. As YF3 content increased, the temperature dependence of δ decreased. Extrapolation of δ to 0% YF3 combined with consideration of the defect formation mechanism at mite dilution allowed estimation of the impurity diffusion coefficient for Y in essentially pure CaF2.

The dry abradability and diamond pyramid hardness of HfO2 fully-stabilized by variable additions of Er2O3 were determined on sintered polycrystalline specimens of near-theoretical densities. Measurements on fused silica and on a single crystal of Y2O3-stabilized ZrO2 were included for comparison. In general, the hardness was decreased and the abradability was increased by increasing additions of stabilizing oxide. These effects were attributed mainly to the increase in defect concentration of the anion sublattice with increasing amounts of modifier oxide. Solution of HfO2 in Er2O3 (rare-earth-oxide Type C structure) increased hardness and decreased abradability: effects which also seemed to be related to the defect concentration of the anion sublattice.

Hafnium diffusion was measured in polycrystalline Er2O3 with two impurity levels. A tracer sectioning technique was used and the diffusion coefficients were measured at 1601° to 1970°C. Volume diffusion of Hf showed both extrinsic and intrinsic behavior, with the transition temperature increasing with the impurity level present in Er2O3. The grain boundary diffusion was apparently extrinsic over the entire temperature interval.

The electrical properties of fluorite-structure solid solutions of HfO/sub 2/ fully stabilized by doping with Er/sub 2/O/sub 3/ were studied. The dependence of the total ac electrical conductivity and ionic transference number upon composition (10-50 mole percent (m/o) Er/sub 2/O/sub 3/), temperature (520/sup 0/-1070/sup 0/C), and oxygen partial pressure (1-10/sup -19/ atm) were investigated. Bulk electrical conductivities of polycrystalline specimens were separated from other polarizations by a complex impedance technique and were compared to conductivities of single crystals. The electrical conductivity generall decreased as the dopant level increased, although plateaus indicative of possible defect ordering were observed ove the composition range of 20-35 m/o Er/sub 2/O/sub 3/. The effects of surface finish, aspect ratio, and porosity of the specimens were negligible. All Er/sub 2/O/sub 3/ stabilized HfO/sub 2/ compositions were shown to be electrolytic conductors below 1070/sup 0/C for oxygen partial pressures less than 1 atm. Oxygen diffusion coefficients were calculated using the Nernst-Einstein equation.

Tracer self-diffusion coefficients for Er and Hf were measured in polycrystalline Er2O3-stabilized HfO2 (fluorite phase) at compositions between 10 and 40 mol% Er2O3 and temperatures between 1700° and 2033°C. In some instances, grain-boundary coefficients were also determined. The Hf volume coefficients were generally slightly smaller than Er coefficients, but neither showed a strong composition dependence, a finding most likely attributable to extensive clustering of charged defects which apparently rendered a large proportion of the “notional” defects essentially immobile. The activation energies for volume coefficients were very large, ranging from 630 to 760 kJ-mol−1, and generally decreased with increasing Er2O3 content.

A tracer sectioning technique was used to measure cation self-diffusion coefficients in fully dense polycrystalline YaO3 and Er2Os under oxidizing conditions. The results are described by the relations for Y2O3 (1400° to 1670°C), and for Er2O3 (1400° to 1700°C). The greater activation energy for erbium diffusion in erbia may be partly attributable to a mass effect.

The diffusion of oxygen in monocrystalline ScaO3, YzO3, Dy,O2, HosO3, Er2O3, Tm2O2, and Lu2O3 was measured by a thermobalance technique. The reoxidation of partially reduced crystals of these materials was treated as a diffusion-controlled process with a moving boundary. Large diffusion coefficients and fairly low activation energies were found for this process, in agreement with a proposed migration mechanism which involves the inherently defective anion sublattice of these materials.

Studies of the oxidation of Gd and Dy at PO2's from 10−0.3 to 10−14.5 atm and temperatures from 727° to 1327°C indicate both semiconducting and ionic-conducting domains in the sesquioxides formed. At higher temperatures, where dense coarsegrained oxide layers developed, the rate of oxidation in the high-P02 semiconducting domain yielded oxygen diffusion coefficients in Dy2O3 in excellent agreement with literature values derived from oxidation of partially reduced oxide single crystals. Under the same conditions, the oxidation of Gd yielded oxygen diffusion coefficients in cubic Gd2O3 which are considerably below literature values for monoclinic single-crystal Gd2O3. At lower temperatures, porous scales were formed, and apparent diffusion coefficients derived from oxidation rates show a smaller temperature dependence than the high-temperature data. At low PO2, the oxides behave as ionic conductors, and metal oxidation rates result in estimates of the electronic contribution to the electrical conductivity of the order of 10−6 to 10−7Ω−1 cm−1.

A microprobe study of interdiffusion between 1033° and 1238°C in the system SrF2-BaF2 was conducted using single crystals. The interdiffusion coefficient, D, generally decreased with increasing SrF2 concentration, but the composition dependence of D decreased with decreasing temperature. Extrapolation of D values to infinite dilution allowed the impurity cation self- diffusion coefficients: The values for DSr in BaF2 are in excellent agreement with tracer results. An analysis of the activation energies for cations diffusing in alkaline-earth fluorides shows a direct correlation between constriction ratio and migration energy for a single ion diffusing in different fluorides. An apparent anomaly arises when attempting to correlate migration energy with structural information for different cations diffusing in the same fluoride.