Search

Background: Well-conducted peer observation of teaching (POT) can be an effective tool in enhancing teaching quality and educator development in healthcare teaching including dentistry. Experience suggests that its effectiveness depends on the environment in which it is undertaken. A previous study investigated engagement with POT by a dental school faculty in the UK and identified barriers to its routine use for educator development. These barriers are particularly problematic for part-time educators who play an increasingly significant, but frequently underestimated role, in undergraduate dental teaching, complementing the teaching of full-time clinical academics. Owing to the part-time nature of their roles, opportunities for their teaching development are limited. This can lead to dissatisfaction and a lack of fulfillment, and ultimately their loss from teaching faculty. Aims: This study explores POT’s utility for the development of part-time dental educators’ (PTDEs). Specifically it (i) audited their engagement with POT, (ii) reviewed the design(s) employed, (iii) assessed participant’s perceived value of it and (iv) explored methods to maximize its utility for their teaching development. Method: Teaching roles and experience, current engagement and experience of POT of part-time educators employed in a UK dental school were explored using a mixed methodology survey. Free-text responses were subjected to thematic analysis and emerging themes were subsequently explored iteratively by undertaking observations of seven part-time educators in various dental teaching environments. A developmental POT approach was used to assess utility. Results: Of 44 surveys distributed, 27 (61%) completed surveys were returned. 24 (89%) respondents reported that POT was of some or high value and resulted in enhanced teaching quality. Respondents experienced difficulties undertaking POT annually with only 14 (52%) achieving this. Observer choice emerged as fundamental to its utility. Additionally, the study identified a number of barriers to its effective use.

Introduction/Background Whipps Cross University Hospital is a District General Hospital (DGH) in London. Children with musculoskeletal and rheumatic conditions are looked after by a paediatric multidisciplinary team (MDT). In approximately one third of cases (around 50 patients), care is shared with tertiary teams. It is widely cited in literature that patients with specialist conditions benefit from receiving specialist care. However, there are many positives of shared-care where patients also receive treatment in the local hospital. The provision of immunosuppressive treatment, regular blood monitoring, and appointments with MDT professionals (e.g. doctors/physiotherapists/ophthalmologists/community nurses) can add further complexities to shared-care. Description/Method Our objective was to identify the strengths and weaknesses of the current Paediatric Rheumatology shared-care service at our DGH and to provide an action plan for improving the service. Children and young people looked after by our DGH for a rheumatological condition, on immunosuppressants, whose care was shared with the tertiary centre were selected. Data collection was done via one-to-one telephone interviews with families based on a semi-structured questionnaire including the following four themes: 1. Views of shared care rheumatology. 2. Blood tests and the blood monitoring experience. 3. Medication related issues: obtaining, collecting and giving medication. 4. Views on transition to adult care. The questionnaire was produced jointly by a paediatric doctor, the lead paediatric pharmacist and the lead nurse for the paediatric day unit, who is involved in blood tests, blood monitoring and delivering immunosuppressant medication. The questionnaire was piloted and modified. Interviews were conducted by a doctor not involved in the routine shared-care service to encourage honest answers, and to reduce observer and investigator bias. After data collection, quantitative and qualitative analysis (thematic analysis) were performed. Strengths and weaknesses of the service were identified. Discussion/Results 20 patients met our selection criteria and all 20 responded. Questionnaires were completed between April and July 2020. On average, in the last year, patients visited their local DGH 2.5 times and their tertiary centre 2.9 times. 75% of these visits were outpatient appointments. Shared Care The following issues were identified by families through thematic analysis: 1. Proximity to home for appointments was important. The local team is responsive to their care. 2. Many appointments over both centres and missing school for appointments was a concern. 3. Local and tertiary centres don’t always share information. 4. Most families were happy to visit both hospitals. Blood Tests Blood testing was split between the GP, the local DGH, the tertiary hospital and community nurses. Blood tests were usually performed every 2-3 months. Families spoke positively about the blood testing experience. The suggested improvements were: 1. Proximity to home for blood tests to avoid missing school. 2. Better communication of results between hospitals. 3. A record of blood test results to keep at home. Medication-Related Issues 70% of our cohort were taking methotrexate, and 20% were taking biologic medications. Prescriptions were provided by the GP, the local DGH and the tertiary centre. Issues identified by families were: 1. Barriers to collecting medications (e.g. unhappy to leave the house due to COVID-19; unsure where to collect medication from; problems with obtaining prescriptions from the GP). 2. Better communication needed between hospitals about when new medication will start. 3. Patients would like to reduce the pain of the injection. 4. Methotrexate has too many side effects. Transitioning to Adult Care Most young people (60%) preferred to stay local to home and move to adult services at their local DGH, if there were to be an adolescent service with overlap between paediatric and adult services. Key learning points/Conclusion The strengths and weaknesses of shared-care rheumatology were identified by families at our DGH. Strengths were that families felt both the local and tertiary centres played a necessary role in care. Weaknesses were that families had many appointments over both centres and missing school was problematic. Some families reported communication between hospitals could be improved. The paediatric MDT proposed a list of quality improvement interventions: 1. Set up a one-stop Paediatric Rheumatology Super MDT clinic, to see the physiotherapist, ophthalmologist, paediatrician and pharmacist, if required, all in one morning. 2 one-stop clinics ran in March and May 2022. It is estimated that this super MDT clinic will save 3 to 4 DGH visits per year. 2. Obtain remote access to the tertiary hospital computer system for the local Paediatric Rheumatology team. This will improve communication between hospitals. 3. Encourage patients to view letters and results from the tertiary centre through the tertiary hospital patient app MyGOSH. This will improve timely information sharing. 4. Set up an MDT meeting with the day unit nurse and pharmacist every 2 months to discuss each patient requiring hospital prescribed medication. 5. The clinician to liaise with families around improving injection technique, and to discuss measures to mitigate side effects of medications. 6. Establish a system for posting medication to parents by pharmacy. This is in place as of August 2020 with an aim of reducing barriers to collecting medications. 7. Explore transitioning to alternative adolescent care closer to home. Our next steps will involve re-assessing if the interventions above have helped improve communication with the tertiary hospital, whether they have reduced the number of appointments, and whether medication concerns were resolved. We believe that this innovative project has improved patient access to appointments, as well as their experience of the shared-care service.

Purpose: To report a case of simultaneous chromosome 10 partial deletion and chromosome 6 partial duplication in a preterm infant. Methods: This is a retrospective case report followed with clinical observation, echocardiogram, and genetic testing. Results: A neonate with Tetralogy of Fallot, clubbed feet, low set ears, and webbed neck was found to have chromosomal abnormalities that are consistent with unbalanced translocation between chromosomes 6 and 10, resulting in a partial duplication of chromosome 6 and partial deletion of chromosome 10. Discussion: Chromosome microarray testing in a patient with multiple congenital anomalies can facilitate rapid diagnosis and treatment with the potential to improve the management of complications and subsequent development.

Purpose The purpose of this study is to develop a conceptual framework that identifies engaging CM practices, specifically how compelling content is created. Content marketing (CM) is fast becoming a key pillar in a company's marketing mix. It is also a requisite for companies seeking to modernise their marketing practices through digitalisation to enhance online branding. However, overlapping definitions and interchangeable terms arising from different perspectives and methodological practices confound what exactly constitutes CM. Although CM is generally accepted as sharing brand content via owned media to gain earned media, a strategic approach, based on evidence-driven research, is needed to navigate through the overwhelming confusion so that companies can better plan and implement CM. Design/methodology/approach This paper addresses the scarcity of work with regard to CM practices in Asia. To address this research gap, the study examines content creation practices of five successful companies, based in Singapore, through case studies, interviews and content analyses, to propose a CM capability development framework. Findings The findings point to the need for content creation to align with brand values and value creation to create and socialise compelling content for positive impact. Content created for audiences and marketed by brands can generate value when it is consumed and shared. The paper also provided much needed clarity in terms of how CM capability can be gained to minimise costly trial and error. Research limitations/implications The study is limited to companies operating in Asia. The framework will require implementation in other regions. Another limitation of the study was that it did not extend to how consumers responded to CM posts. This is an area for further research that can help validate the proposed framework. Practical implications The analytical framework adopted in this study can also be used as a functional CM model for marketing managers to construct better CM strategies and informed standards of practice by growing capabilities. Social implications CM is also a requisite for companies seeking to modernise their marketing practices through digitalisation to enhance online branding, particularly for small- and medium-sized companies. Originality/value This paper addresses the scarcity of work with regard to CM practices in Asia.

Emergence of SARS-CoV-2 variants of concern (VOC) with progressively increased transmissibility between humans is a threat to global public health. Omicron variant also evades immunity from natural infection or vaccines1. It is unclear whether its exceptional transmissibility is due to immune evasion or inherent virological properties.We compared the replication competence and cellular tropism of the wild type (WT) virus, D614G, Alpha, Beta, Delta and Omicron variants in ex vivo explant cultures of human bronchus and lung. Dependence on TMPRSS2 for infection was also evaluated. We show that Omicron replicated faster than all other SARS-CoV-2 in the bronchus but less efficiently in the lung parenchyma. All VOCs had similar cellular tropism as the WT. Delta was more dependent on serine protease than other VOCs tested.Our findings demonstrate that Omicron is inherently able to replicate faster than other variants known to date and this likely contributes to its inherently higher transmissibility, irrespective of its ability to evade antibody immunity. The lower replication competence of Omicron in human lung may be compatible with reduced severity but the determinants of severe disease are multifactorial. These findings provide important biological clues to the transmissibility and pathogenesis of SARS-CoV-2 VOCs.

Most aptamers targeting cell-expressed antigens are intended for in vivo application, however, these sequences are commonly generated in vitro against synthetic oligopeptide epitopes or recombinant proteins. As these in vitro analogues frequently do not mimic the in vivo target within an endogenous environment, the evolved aptamers are often prone to nonspecific binding. The presence of dead cells and cellular debris further complicate aptamer targeting, due to their high nonspecific affinities to single-stranded DNA. Despite these known limitations, assessment of cell viability and/or the removal of dead cells is rarely applied as part of the methodology during in vivo testing of aptamer binding. Furthermore, the extent and route(s) by which dead cells uptake existing aptamers remains to be determined in the literature. For this purpose, the previously reported aptamer sequences 5TR1, 5TR4, 5TRG2 and S22 - enriched against the MUC1 tumour marker of the mucin glycoprotein family - were used as model sequences to evaluate the influence of cell viability and the presence of nontarget cell-expressed protein on aptamer binding to the MUC1 expressing human cancer cell lines MCF-7, Hs578T, SW480, and SW620. From fluorescence microscopy analysis, all tested aptamers demonstrated extensive nonspecific uptake within the nuclei of dead cells with compromised membrane integrities. Using fluorescent-activated cell sorting (FACS), the inclusion of excess double-stranded DNA as a blocking agent showed no effect on nonspecific aptamer uptake by dead cells. Further nonspecific binding to cell-membrane bound and intracellular protein was evident for each aptamer sequence, as assessed by southwestern blotting and FACS. These factors likely contributed to the ∼120-fold greater binding response of the 5TR1 aptamer to dead MCF-7 cells over equivalent live cell populations. The identification of dead cells and cellular debris using viability stains and the subsequent exclusion of these cells from FACS analysis was identified as an essential requirement for the evaluation of aptamer binding specificity to live cell populations of the cancer cell lines MCF-7, Hs578T and SW480. The research findings stress the importance of dead cell uptake and more comprehensive cell viability screening to validate novel aptamer sequences for diagnostic and therapeutic application.

Background Influenza infections produce a spectrum of disease severity, ranging from a mild respiratory illness to respiratory failure and death. The host-response pathways associated with the progression to severe influenza disease are not well understood. Methods To gain insight into the disease mechanisms associated with progression to severe infection, we analyzed the leukocyte transcriptome in severe and moderate influenza patients and healthy control subjects. Pathway analysis on differentially expressed genes was performed using a topology-based pathway analysis tool that takes into account the interaction between multiple cellular pathways. The pathway profiles between moderate and severe influenza were then compared to delineate the biological mechanisms underpinning the progression from moderate to severe influenza. Results 107 patients (44 severe and 63 moderate influenza patients) and 52 healthy control subjects were included in the study. Severe influenza was associated with upregulation in several neutrophil-related pathways, including pathways involved in neutrophil differentiation, migration, degranulation and neutrophil extracellular trap (NET) formation. The degree of upregulation in neutrophil-related pathways were significantly higher in severely infected patients compared to moderately infected patients. Severe influenza was also associated with downregulation in immune response pathways, including pathways involved in antigen presentation such as CD4+ T-cell co-stimulation, CD8+ T cell and Natural Killer (NK) cells effector functions. Apoptosis pathways were also downregulated in severe influenza patients compare to moderate and healthy controls. Conclusions These findings showed that there are changes in gene expression profile that may highlight distinct pathogenic mechanisms associated with progression from moderate to severe influenza infection.

Pakistan is considered by the World Health Organization to currently have a "concentrated" HIV-1 epidemic due to a rapid rise in infections among people who inject drugs (PWID). Prevalence among the country's nearly 105,000 PWID is estimated to be 37.8% but has been shown to be higher in several large urban centers. A lack of public health resources, the common use of professional injectors and unsafe injection practices are believed to have fueled the outbreak. Here we evaluate the molecular characteristics of HIV-1 sequences (n = 290) from PWID in several Pakistani cities to examine transmission dynamics and the association between rates of HIV-1 transmission with regards to regional trends in opioid trafficking. Tip-to-tip (patristic) distance based phylogenetic cluster inferences and BEAST2 Bayesian phylodynamic analyses of time-stamped data were performed on HIV-1 pol sequences generated from dried blood spots collected from 1,453 PWID as part of a cross-sectional survey conducted in Pakistan during 2014/2015. Overall, subtype A1 strains were dominant (75.2%) followed by CRF02_AG (14.1%), recombinants/unassigned (7.2%), CRF35_AD (2.1%), G (1.0%) and C (0.3%). Nearly three quarters of the PWID HIV-1 sequences belonged to one of five distinct phylogenetic clusters. Just below half (44.4%) of individuals in the largest cluster (n = 118) did seek help injecting from professional injectors which was previously identified as a strong correlate of HIV-1 infection. Spikes in estimated HIV-1 effective population sizes coincided with increases in opium poppy cultivation in Afghanistan, Pakistan's western neighbor. Structured coalescent analysis was undertaken in order to investigate the spatial relationship of HIV-1 transmission among the various cities under study. In general terms, our analysis placed the city of Larkana at the center of the PWID HIV-1 epidemic in Pakistan which is consistent with previous epidemiological data.

Summary: Normal brain functions depend on the balanced development of excitatory and inhibitory synapses. Our knowledge of the molecular mechanisms underlying inhibitory synapse formation is limited. Neuroligin-2 (NL2), a transmembrane protein at inhibitory postsynaptic sites, is capable of initiating inhibitory synapse formation. In an effort to search for NL2 binding proteins and the downstream mechanisms responsible for inhibitory synapse development, we identify LHFPL4/GARLH4 as a major NL2 binding partner that is specifically enriched at inhibitory postsynaptic sites. LHFPL4/GARLH4 and NL2 regulate the protein levels and synaptic clustering of each other in the cerebellum. Lhfpl4/Garlh4−/− mice display profound impairment of inhibitory synapse formation as well as prominent motor behavioral deficits and premature death. Our findings highlight the essential role of LHFPL4/GARLH4 in brain functions by regulating inhibitory synapse formation as a major NL2 binding partner. : Wu et al. identify LHFPL4/GARLH4 as a major NL2 binding partner that is specifically enriched at inhibitory postsynaptic sites and regulates inhibitory synapse formation. Deletion of LHFPL4/GARLH4 in mice results in profound impairment of inhibitory synapse formation as well as prominent motor behavioral deficits and premature death. Keywords: LHFPL4/GARLH4, neuroligin-2, inhibitory synapse, GABAAR

Hospice care is most appropriate when a patient no longer benefits from curative treatment and has limited life expectancy. These patients may suffer from any type of life-limiting illness, including end-stage cancer, end-stage heart disease, end-stage renal failure, AIDS, and Alzheimer's disease, among other illnesses. Patients are managed on their pain and symptoms and home hospice care manages these patients in the comfort of their own home, enabling patients to spend their last days with dignity and have a good quality of life.To describe the home hospice patients at HCA Hospice Care (HHC) Singapore from 2000 to 2010. Description of home care patients in terms of their sociodemographic profile and diagnosis at admission. We reviewed the Electronic Medical Records of patients admitted into HHC from 2000 to 2010.Patients had multiple admissions into HHC home hospice as identified in the Electronic Medical Records (EMR) between January 1, 2000, and December 31, 2010, but we only selected patient's first admission into HHC home hospice for this analysis. Of the 25,065 patients in the entire samples, 47.3% were males, 65.2% were married, and 84.3% were Chinese. 50.9% of the patients died at home, 75.5% were referred from public hospitals, 53.9% of primary caregivers were children, and the mean age of the patients was 68.0 years. Among all cancer patients admitted into HHC home hospice, lung cancer (23.6%) was the most common principal diagnosis for admission, followed by colorectal (10.5%) and liver cancers (7.7%). Among noncancer patients, renal failure (7.0%) was the most common diagnosis. Among male patients admitted into HHC home hospice, lung cancer (29.6%) was the most common diagnosis, followed by liver cancer (10.8%), colorectal cancer (10.0%), and end-stage renal failure (5.5%). For female patients, lung cancer (16.9%) was the most common diagnosis, followed by breast cancer (15.9%), colorectal cancer (11.0%), and end-stage renal failure (8.7%). Ten-year trends of the sociodemographic profile and diagnosis at admission were further analyzed to determine home hospice services utilization and the needs of the home care patients.With an increasing emphasis to encourage aging and dying in the community and more attention given to building up the home hospice industry's capacity and capability, it is important to understand the profile of the patients who have been utilizing home hospice services. This also helps to plan and develop similar services in other parts of the world.

Histamine is an important biomarker in both biomedical and food quality assurance sectors. Current methods of monitoring this compound via fluorescent, electrochemical, and enzymatic means have several drawbacks, preventing routine detection. This work reports on the isolation of single-stranded DNA-based, histamine-targeting aptamers generated by the Systematic Evolution of Ligands by Exponential Enrichment (SELEX) and the characterisation of these candidates via bioinformatics analysis. Aptamer binding affinity was determined by magnetic bead-based enzyme linked oligonucleotide assays, followed by the detection of unmodified histamine at a physiological pH via electrochemical impedance spectroscopy (EIS). Aptamer H47 demonstrated the lowest apparent binding affinity (72.8 ± 13.9 nmol L−1) towards bead immobilised histamine. When immobilised to a gold surface, H47 demonstrated the largest biosensor response (ΔRct = 6.83 ± 2.00) compared to other single-stranded DNA sequences in the presence of dissolved histamine. The H47 EIS aptasensor also displayed a highly selective, concentration-dependent response towards histamine (linear range = 1 μmol L−1 - 5 mmol L−1), compared to other similar small molecules. Possessing an apparent binding affinity, limit of detection and limit of quantification of 7.80 ± 1.70 mmol L−1, 4.83 mmol L−1 and 16.08 mmol L−1, respectively, the H47 EIS aptasensor demonstrates promise towards the development of aptasensors in applications which require the rapid detection of histamine in solution.

AA5xxx series Al-Mg alloys possess good combination of high specific strength-to-weight ratio, formability and corrosion resistance, which makes them attractive to the automakers for their light weighting needs. Increasingly the automakers are demanding sustainable materials. Developing aluminum alloys with increased recycled content is becoming imperative. However, increasing the recycled content can negatively impact the overall formability and joinability of the alloy. Formability is important in the shaping of complex parts and it is a key requirement in automotive manufacturing. Similarly, the other key requirement for automotive sheet is joinability. Self-piercing riveting (SPR) technology is increasingly being used for joining. In this study, the process optimization of high recycle content AA5754 alloy’s for formability and rivetability will be discussed. Controlling the annealing heat treatment to produce optimum combination of grain size along with balanced recrystallized and rolling texture to improve the SPR joint configuration will be presented.

Assuming that large color gamut and therefore better color reproducibility will be a highly desired feature of all displays as we look to the near future, we make the case in this paper that quantum dots (QDs) are currently the down-conversion technology of choice that will allow liquid crystal display makers to cost-effectively reach and exceed 100% of the NTSC (National Television Standard Committee) and Adobe RGB color standards while achieving maximum system efficiency. We will discuss in detail the numerous fundamental advantages of QDs over phosphors, along with their scientific origins, and make the case that QDs are the ultimate light generating material for next-generation displays.

An audit was conducted within a district general hospital's orthodontic department to improve the quality of digital lateral cephalometric radiographs. The results of the audit show improvements in the quality of lateral cephalometric radiographs, following the introduction of a new picture archiving and communications system and charged coupling device cephalometric machine. Clinical Relevance: A Quality Assurance programme is one of the essential legal requirements of the Ionizing Radiations Regulations 1999 (IRR99). This article demonstrates a simple method to monitor the quality of lateral cephalometric radiographs, based on the Health Protection Agency ratings of radiographic quality.

(1) To undertake a service evaluation of the Index of Orthognathic Functional Treatment Need (IOFTN). (2) To determine its suitability to replace the Index of Orthodontic Treatment Need (IOTN) in the assessment of patients with dentofacial deformity.Laboratory- and questionnaire-based study.UK hospital-based orthodontic department.Cohen's Kappa was used to assess inter- and intra-operator reliability for the IOTN and the IOFTN against 30 orthognathic patients' models scored to a 'gold standard'. Questionnaires gathered feedback on ease of use of the IOFTN. Change in treatment need status for a further 60 orthognathic patients was estimated utilising the IOTN, the IOFTN and a modified IOTN (mIOTN).Inter-operator agreement with the 'gold standard' for the IOTN and the IOFTN ranged from 0.64-0.90 and 0.61-0.91, respectively. Intra-operator agreement for the IOTN and the IOFTN ranged from 0.46-1.00 to 0.59-0.95, respectively. Mean feedback score was 9.08 out of a maximum score of 10. Overall, 88.9% of patients scored grades 4 or 5 on the IOFTN (IOTN = 87.8%; mIOTN = 77.8%).The IOFTN is simple and reliable to use. It is an appropriate aid in the prioritisation of surgical patients. Further recommendations are given.

Assuming large color gamut and therefore better color reproducibility will be a highly desired feature of all displays as we look to the near future, we make the case in this paper that Quantum Dots (QDs) are currently the down-conversion technology of choice that will allow liquid crystal display (LCD) makers to cost-effectively reach and exceed 100% of the NTSC (National Television Standard Committee) standard while achieving maximum system efficiency. We will discuss in detail the numerous fundamental advantages of QDs over phosphors, along with their scientific origins, and make the case that QDs are the ultimate light generating material for next-generation displays.

Omohyoid muscle syndrome is a rare cause of an X-shaped bulging lateral neck mass that occurs on swallowing. This is a diagnostic case report of a 22-year-old mixed martial arts athlete who acquired this condition.

This work addresses an inverse heat conduction problem (IHCP) in a large planar slab receiving a certain heat flux at one surface while the other surface is thermally insulated. The two different heating conditions to be studied are: (1) constant heat flux and (2) a time-dependent triangular heat flux. For the IHCP, the temperature–time variations at the insulated surface of the large planar slab are obtained with a single temperature sensor. The two temperature–time histories are generated from the solutions of the direct heat conduction problem. The central objective of the paper is to implement the method of lines for the descriptive 1-D heat equation combined with numerical differentiation of: (1) the “measured” temperature–time history at the insulated surface and (2) the temperature–time history at other sub-surface locations. In the end, it is confirmed that excellent predictions of the temperature–time variations at the directly heated surface are obtainable for the two dissimilar heating conditions. This is accomplished with small systems of first-order differential-difference equations, one with two equations and the other with four equations.

Aclidinium bromide is a novel, inhaled long-acting muscarinic antagonist with low systemic activity developed for the treatment of COPD. It is an ester compound rapidly hydrolysed in plasma into inactive alcohol and acid metabolites. In this Phase I, open-label study, the rates and routes of elimination of radioactivity following intravenous administration of [14 C]-aclidinium bromide were determined. The metabolites of aclidinium were also characterized and identified in plasma and excreta. Twelve healthy males were randomized (1:1) to receive a single intravenous 400 µg dose of [phenyl-U-14 C]- or [glycolyl-U-14 C]-aclidinium bromide (via 5 min infusion) to label alcohol or acid metabolites of aclidinium, respectively. Safety and tolerability were assessed over a 9-day period. Following intravenous administration, the parent compound was rapidly hydrolysed into its acid and alcohol metabolites. Primary excretion routes for [phenyl-U-14 C]- and [glycolyl-U-14 C]-aclidinium were renal (urine: 65% and 54%, respectively; feces: 33% and 20%, respectively), with 1% excreted as unchanged aclidinium. A total of three treatment-emergent adverse events in two subjects were reported and were related to infusion site pain. Overall, aclidinium is rapidly hydrolysed into two main metabolites, which are predominantly excreted in urine. Aclidinium bromide 400 µg administered intravenously was safe and well tolerated in healthy subjects. Copyright © 2012 John Wiley & Sons, Ltd.

Based on the results of model tests, the deformation and facture mechanisms of brittle rockmass containing coplanar close intermittent joints under direct shear condition were analysed , then the incipient crack strength and communicating destruction criterion of such rockmass were proposed in this paper. It was shown that the computing results suited the real measuring values well by comparing them, which indicated the criterions was reasonable ,reliable and has both the theory and construction significances.

Host response biomarkers can accurately distinguish between influenza and bacterial infection. However, published biomarkers require the measurement of many genes, thereby making it difficult to implement them in clinical practice. This study aims to identify a single-gene biomarker with a high diagnostic accuracy equivalent to multi-gene biomarkers.In this study, we combined an integrated genomic analysis of 1071 individuals with

After almost two decades of consultation, the newly enacted Companies Ordinance (Cap 622) of Hong Kong eventually came into full force in March 2014. One of the major reforms made to the new legislation is the codification of the duty of care, skill and diligence for directors under section 465 which is based on section 174 of the UK Companies Act 2006. This article examines the reasons for this development in Hong Kong by drawing reference to the UK for adopting a dual objective/subjective standard in regulating directors’ duty. It argues that such an approach is beneficial to Hong Kong as it clarifies the law and enhances corporate governance.

Introduction: Cardiorespiratory fitness is inversely associated with morbidity and mortality even after adjustment for traditional risk factors. The biological mechanism for the protective effect of high fitness is largely unknown. Hypothesis: We hypothesized that high fitness would be associated with larger coronary artery diameters independent of traditional risk factors. Methods: In this study, 500 men with a coronary artery calcium score (CACS) < 10 were evaluated, with 100 from each age-adjusted fitness quintile (very poor, 1-20%; poor, 21-39%; fair, 40-59%; good, 60-79%; and excellent, 80-100%). Each participant had undergone fitness assessment with an exercise treadmill test on the day of CACS. Blinded to the fitness category, one of us measured the proximal diameters of the left main (LM), left anterior descending (LAD), left circumflex (LCx), and the right coronary (RCA) arteries. Spearman correlations were calculated for the diameters of each coronary artery with treadmill time and for the sum of artery diameters with treadmill time. Linear mixed-effects regression was used to estimate the association between fitness and coronary artery diameters while adjusting for potential confounders. Results: Each coronary artery diameter (LM r=0.12, p=0.009; LAD r=0.11, p=0.02; LCx r=0.10, p=0.02; RCA r=0.18, p Conclusion: Higher fitness is positively associated with larger coronary artery diameters.