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We propose and demonstrate a novel range of models to accurately determine the optical properties of nitrogen-free carbon quantum dots (CQDs) with ordered graphene layered structures. We confirm the results of our models against the full range of experimental results for CQDs available from an extensive review of the literature. The models can be equally applied to CQDs with varied sizes and with different oxygen content in the basal planes of the constituent graphenic sheets. We demonstrate that the experimentally observed blue fluorescent emission of nitrogen-free CQDs can be associated with either small oxidised areas on the periphery of the graphenic sheets, or with sub-nanometre non-functionalised islands of sp2-hybridised carbon with high symmetry confined in the centres of oxidised graphene sheets. Larger and/or less symmetric non-functionalised regions in the centre of functionalised graphene sheet are found to be sources of green and even red fluorescent emission from nitrogen-free CQDs. We also demonstrate an approach to simplify the modelling of the discussed sp2-islands by substitution with equivalent strained polycyclic aromatic hydrocarbons. Additionally, we show that the bandgaps (and photoluminescence) of CQDs are not dependent on either out-of-plane corrugation of the graphene sheet or the spacing between sp2-islands. Advantageously, our proposed models show that there is no need to involve light-emitting polycyclic aromatic molecules (nanographenes) with arbitrary structures grafted to the particle periphery to explain the plethora of optical phenomena observed for CQDs across the full range of experimental works., 32 pages, 6 figures, accepted to Nanoscale Research Letters

The aim of this study was to conduct item reduction of the Memory Assessment Clinics Self-Rating Scale (MAC-S) to create a briefer measure that can be used to quickly evaluate subjective memory com...

Low-grade glioma (LGG) exhibits longer median survival than high-grade brain tumors, and thus impact of our therapies on patient quality of life remains a crucial consideration. This study evaluated the effects of concurrent temozolomide-based chemoradiation (RT + TMZ) or observation on quality of life (QOL) in patients with low-grade glioma.We completed a retrospective cross-sectional study of adults with LGG who underwent surgery with known molecular classification from 1980 to 2018. Postoperatively, patients were either observed or received adjuvant concurrent temozolomide-based chemoradiation. EQ-5D and PHQ-9 depression screen were completed before outpatient visits every 2-3 months. Baseline score was defined as ± 30 days within initial operation.Of the 63 patients (mean age 44 ± 17 years, 51% female) with baseline EQ-5D or PHQ-9 depression screen data and at least one follow-up measure, 30 (48%) were observed and 33 (52%) received RT + TMZ. No significant decline was seen in EQ-5D or PHQ-9 scores at 3, 6, 9, 12, and 24 months compared to baseline scores for all patients. At each time point, there was no significant difference between those who were observed or received adjuvant therapy. The linear mixed model estimating PHQ-9 value or EQ-5D index demonstrated that there was no significant difference in PHQ-9 or EQ-5D index between treatment groups (p = 0.42 and p = 0.54, respectively) or time points (p = 0.24 and p = 0.99, respectively).Our study found no significant decline in patient QOL or depression scores as assessed by patient- reported outcome measures for patients with low-grade glioma up to 2 years following surgery. We found no difference between RT + TMZ compared to observation during this time frame. Additional follow-up can help identify the longer-term impact of treatment strategy on patient experience.

Ebstein anomaly is a form of congenital heart disease primarily affecting the tricuspid valve (TV) and right ventricle (RV) in 1 in 20,000 live births. The TV malformation and the clinical presentation are both variable. LV systolic dysfunction is uncommon with Ebstein anomaly. In a review of 106 consecutive patients with Ebstein anomaly at Mayo Clinic between July 1, 2001 and February 28, 2003, the authors reported prevalence of 7% LV systolic dysfunction, 18% LV noncompaction, and 36% LV diastolic dysfunction. However, on a 2017 PubMed review of literature searching for “Ebstein anomaly and Left ventricular systolic dysfunction” we found only one reported case in an adult with documented clinical impact. Here, we report a newborn baby girl with mild Ebstein anomaly who presented with severe respiratory failure and left ventricular systolic dysfunction. In our patient, the LV systolic dysfunction was reversible and of unknown etiology. Significant improvement in her respiratory and cardiac function were attributed to early correct diagnosis and aggressive supportive therapy, which hopefully can also be applied to similar neonates to reduce the mortality and morbidity of Ebstein anomaly.

The ALSYMPCA trial of the α-emitter

This retrospective, observational study investigated the relationship between objective naming decline and patient report of subjective decline in language functioning following epilepsy surgery. The role of depression in this relationship was also examined.A total of 429 adults with pharmacoresistant epilepsy completed the Boston Naming Test (BNT) and Memory Assessment Clinics Self-Rating Scale (MAC-S) before and after resective surgery. Multiple regression analyses were used to examine the relationship between objective naming decline and subjective language functioning, while controlling for the confounding effect of depression.Individuals who experienced moderate to severe naming decline (≥11 raw points on BNT) following surgery reported a decline in subjective language functioning (p .001) and endorsed problems with word-retrieval as well as more general semantic abilities. Those who experienced mild naming decline (5-10 raw points) also reported an increase in subjective language problems (p = .006). Complaints in this group were less severe than in those with more marked naming declines and were primarily related to word-retrieval. Both of these relationships remained significant after controlling for the confounding effect of depression (p .005-.014).Individuals with epilepsy who experience naming decline following surgery perceive these declines in their daily life, regardless of whether or not they are depressed. Findings support the utilization of risk models to predict naming outcome and the importance of counseling patients regarding the risk for naming decline following surgery.

Background Airway dehydration triggers exercise-induced bronchoconstriction in virtually all patients with active asthma. We are not aware of any investigations of airway dehydration in patients with naturally occurring asthma exacerbations. We wish to investigate whether airway dehydration occurs in acute asthmatic patients in the emergency department, and its functional significance. Methods In a pilot study on 10 asthmatic patients and 10 control subjects in the emergency department, respiratory rate was counted manually, and relative humidity of expired air was recorded using an air probe hygrometer. In parallel laboratory studies carried out over 2 consecutive days, 19 asthmatics and 10 control subjects were challenged initially with dry air, and on the second day with humidified air. FEV 1 and humidity measurements were made immediately before and after the tachypnea challenges. Results In the emergency department, the asthmatic group was more tachypneic (p 10% in FEV 1 from baseline. This bronchoconstriction was prevented by humidifying the inspired air; tachypnea with no water loss did not affect lung function in asthmatic subjects. Conclusions Dehydration of the expired air is present in asthmatic patients in the emergency department. The bronchoconstriction triggered by dry-air tachypnea challenge in the laboratory can be prevented by humidifying the inspired air. Airway rehydration merits further investigation as a potential adjunct to acute treatment of asthma exacerbations.

Treatment-resistant schizophrenia is a severely debilitating and costly disease. While clozapine is reported to be an effective therapy for treatment-resistant schizophrenia, it is nevertheless largely underutilised. A review of published cost-effectiveness studies of clozapine conducted in the USA, UK, Sweden and Canada, and employing a variety of study designs, reveals consistent reporting of clinical efficacy, cost and cost-effectiveness findings in favour of clozapine over conventional antipsychotics in the management of treatment-resistant schizophrenia. All reported economic evidence indicates that, despite its higher acquisition cost, clozapine nevertheless represents cost-effective therapy for treatment-resistant schizophrenia. Furthermore, the evidence indicates that, for many patients, clozapine may substantially reduce costs associated with treatment-resistant schizophrenia.

The t(5;14)(q31;q32) translocation from B-lineage acute lymphocytic leukemia with eosinophilia has been cloned from two leukemia samples. In both cases, this translocation joined the IgH gene and the interleukin-3 (IL-3) gene. In one patient, excess IL-3 mRNA was produced by the leukemic cells. In the second patient, serum IL-3 levels were measured and shown to correlate with disease activity. There was no evidence of excess granulocyte/macrophage colony stimulating factor (GM-CSF) or IL-5 expression. Our data support the formulation that this subtype of leukemia may arise in part because of a chromosome translocation that activates the IL-3 gene, resulting in autocrine and paracrine growth effects.

OrOnary artery disease (CAD) is the leading se of morbidity and mortality in the estern world and imposes an enormous financial burden on the healthcare system. It is therefore not surprising that much medical attention is focused on the treatment and prevention of CAD. Yet, because national healthcare costs are higher than ever before, physicians and healthcare administrators must increasingly address cost issues--in addition to traditional concerns of clinical efficacy and safety--when a patient's cholesterol level cannot be adequately controlled by lifestyle modification and medical intervention is indicated. Value for money has never been more important. This article discusses some recent research regarding important issues in the prevention of CAD, including: 1. The relation between cholesterol levels and CAD (which is stronger than formerly thought); 2. The benefits of cholesterol reduction (which are continuous and graded: there is no level of cholesterol at which further reduction is not associated with additional reduction of CAD risk and all-cause mortality); 3. The cost effectiveness of cholesterol-lowering with 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor therapy (which is more cost effective than shown by risk assessment models employing unadjusted formulae from the Framingham Heart Study, and which is also shown to be sensitive to change in therapy costs); 4. The benefits of secondary prevention of CAD (which are greater than for primary prevention over the short term because, while the relative benefit of risk reduction remains the same for both groups, the 5-fold higher coronary event rate in persons with existing CAD results in greater benefits over the short term; still, primary prevention should yield greater cost benefit over the long run). 1 Results of 28 randomized controlled trials of plasma cholesterol reduction, 3 international comparison studies, and 10 prospective cohort studies have all

Airway dehydration triggers exercise-induced bronchoconstriction in virtually all patients with active asthma. We are not aware of any investigations of airway dehydration in patients with naturally occurring asthma exacerbations. We wish to investigate whether airway dehydration occurs in acute asthmatic patients in the emergency department, and its functional significance.In a pilot study on 10 asthmatic patients and 10 control subjects in the emergency department, respiratory rate was counted manually, and relative humidity of expired air was recorded using an air probe hygrometer. In parallel laboratory studies carried out over 2 consecutive days, 19 asthmatics and 10 control subjects were challenged initially with dry air, and on the second day with humidified air. FEV(1) and humidity measurements were made immediately before and after the tachypnea challenges.In the emergency department, the asthmatic group was more tachypneic (p0.0001) and their expired air was drier (p0.0001) than the control group. Following a dry-air tachypnea challenge in the laboratory, which caused dehydration of the expired air in all subjects, half of the asthmatics, but none of the control subjects, demonstrated a fall of10% in FEV(1) from baseline. This bronchoconstriction was prevented by humidifying the inspired air; tachypnea with no water loss did not affect lung function in asthmatic subjects.Dehydration of the expired air is present in asthmatic patients in the emergency department. The bronchoconstriction triggered by dry-air tachypnea challenge in the laboratory can be prevented by humidifying the inspired air. Airway rehydration merits further investigation as a potential adjunct to acute treatment of asthma exacerbations.

Suicide is a significant cause of death among patients with schizophrenia and schizoaffective disorder, affecting some 10 to 15 percent of these patients. This study examined annual suicide rates over a two-year period (1993-1995) among more than 30,000 patients with schizophrenia and schizoaffective disorder who received services from the Texas Department of Mental Health and Mental Retardation and suicide rates over a six-year period (1991-1996) among a subgroup of patients treated with clozapine.The annual suicide rate for all patients with schizophrenia and schizoaffective disorder was 63.1 per 100,000 patients, approximately five times higher than in the general population. In contrast, only one suicide occurred in six years among patients treated with clozapine who were of similar diagnosis, age, and sex, for a suicide rate of about 12.7 per 100,000 patients per year. This rate is similar to the 15.7 per 100,000 patients per year for all U.S. patients treated with clozapine, calculated from data reported as of June 1996 to the clozapine national registry system maintained by Novartis Pharmaceuticals Corporation, the U.S. manufacturer of clozapine.The study results suggest that clozapine therapy is associated with a reduced risk of suicide among patients with schizophrenia and schizoaffective disorder.