Greenwoodottesen3059

Maltreatment allegations were substantiated at a slightly higher rate than for the general population.

Our study shows that maternal mental health is an important factor in child protection involvement. The level of risk varies across diagnostic groups. It is important that mothers with mental health issues are offered appropriate support and services. Adult mental health services should also be aware and discuss the impact of maternal mental health on the family and children's safety and well-being.

Our study shows that maternal mental health is an important factor in child protection involvement. The level of risk varies across diagnostic groups. It is important that mothers with mental health issues are offered appropriate support and services. Adult mental health services should also be aware and discuss the impact of maternal mental health on the family and children's safety and well-being.Quantum tunneling in plasmonic nanostructures has presented an interesting aspect of incorporating quantum mechanics into classical optics. However, the study has been limited to the subnanometer gap regime. Here, we newly extend quantum plasmonics to gap widths well over 1 nm by taking advantage of the low-frequency terahertz regime. Enhanced electric fields of up to 5 V/nm induce tunneling of electrons in different arrays of ring-shaped nanoslot antennas of gap widths from 1.5 to 10 nm, which lead to a significant nonlinear transmission decrease. These observations are consistent with theoretical calculations considering terahertz-funneling-induced electron tunneling across the gap.

The aim of this investigation was to evaluate the effect on the anatomic surgical success with the changeover from 20 Gauge (G) (n = 206) to 23 G (n = 107) pars plana vitrectomy (PPV) in rhegmatogenous retinal detachment.

313 consecutive patients were retrolective-prospectively analysed. Several parameters including lens status, number of retinal breaks, extent of retinal detachment, proliferative vitreoretinopathy (PVR) and refractive error were examined. Primary success rate was defined as anatomic success after a minimum follow-up of 6 months. The secondary success rate was determined as anatomic success after one further operation if necessary. Moreover recurring retinal detachment after initial success was registered. In additional to the analysis over all patients, cases were grouped according to the severity of the preoperative baseline situation.

Primary success rate was 87.4 % for 20 G PPV and 87.9 % for 23 G PPV, secondary success rate was 95.6 % for 20 G PPV and 94.4 % for 23 G PPV. 13.9 % (2t any disadvantage for the surgical success.

20 G PPV as well as 23 G PPV are good surgical techniques in rhegmatogenous retinal detachment. Overall the miniaturisation of surgical instruments seems to be without any disadvantage for the surgical success.New developments in retinal imaging have revolutionised ophthalmology in recent years. In particular, optical coherence tomography (OCT) provides highly resolved and well reproducible images and has rung in a new era in ophthalmological imaging. The technology was introduced in the early 1990 s, and has rapidly developed. There have been improvements in resolution, sensitivity and processing speed. There have also been developments in functional processing. OCT angiography is the first application in routine clinical work.Replica exchange molecular dynamics simulations are used to investigate the position-dependent densities of three small molecules dissolved in acetonitrile confined in nanoscale hydrophilic silica pores. The solutes, methanol, acetone, and carbon dioxide, differ in polarity and hydrogen-bonding properties. All three molecules are found preferentially near the pore interface at room temperature, but the surface affinity differs with the solute interactions. Methanol, in particular, exists in two distinct conformations that differ in the hydrogen-bonding state. Free energy profiles as a function of distance from the pore surface are decomposed into internal energy and entropic contributions. These reveal that entropy as well as hydrogen bonding can play important roles in determining the solute location and orientation. These and other relevant factors are examined to elucidate the origins of the solute density profiles within the pore.Iron-catalyzed oxidative α-cyanations at tertiary allylamines in the allylic position are followed by anti-Markovnikov additions of alcohols across the vinylic CC double bonds of the initially generated α-amino nitriles. These consecutive reactions generate 2-amino-4-alkoxybutanenitriles from three reactants (allylamines, trimethylsilyl cyanide, and alcohols) in one reaction vessel at ambient temperature.

Intermediate care (i.e., step-down or progressive care) is an alternative to the intensive care unit (ICU) for patients with moderate severity of illness. The adoption and current use of intermediate care is unknown.

To characterize trends in intermediate care use among U.S. hospitals.

We examined 135 million acute care hospitalizations among elderly individuals (≥65 yr) enrolled in fee-for-service Medicare (U.S. federal health insurance program) from 1996 to 2010. We identified patients receiving intermediate care as those with intensive care or coronary care room and board charges labeled intermediate ICU.

In 1996, a total of 960 of the 3,425 hospitals providing critical care billed for intermediate care (28%), and this increased to 1,643 of 2,783 hospitals (59%) in 2010 (P < 0.01). Only 8.2% of Medicare hospitalizations in 1996 were billed for intermediate care, but billing steadily increased to 22.8% by 2010 (P < 0.01), whereas the percentage billed for ICU care and ward-only care declined. Patients billed for intermediate care had more acute organ failures diagnoses codes compared with general ward patients (22.4% vs. 15.8%). When compared with patients billed for ICU care, those billed for intermediate care had fewer organ failures (22.4% vs. 43.4%), less mechanical ventilation (0.9% vs. 16.7%), lower mean Medicare spending ($8,514 vs. $18,150), and lower 30-day mortality (5.6% vs. 16.5%) (P < 0.01 for all comparisons).

Intermediate care billing increased markedly between 1996 and 2010. These findings highlight the need to better define the value, specific practices, and effective use of intermediate care for patients and hospitals.

Intermediate care billing increased markedly between 1996 and 2010. These findings highlight the need to better define the value, specific practices, and effective use of intermediate care for patients and hospitals.The host-guest chemistry of cucurbit[8]uril (CB[8]) and the layer-by-layer self-assembly technique are combined to obtain a molecular imprinted polyelectrolyte multilayer film for the recognition and binding of a guest molecule. Cucurbit[8]uril as a ready-made binding site is first associated with a polyelectrolyte and then assembled into a polyelectrolyte multilayer film via layer-by-layer deposition. A cationic guest is subsequently included into the nanocontainer due to specific host-guest interactions. The quantitative analysis of both CB[8] and the included guest molecule in dependence of the surface charge of the multilayer film identifies a high nanocontainer density as well as good to excellent binding efficiencies, therefore yielding a promising imprinted nanomaterial with potential applications in filtration or sensor technology. The investigation of the guest molecule uptake kinetics reveals two processes on different time scales, respectively, which are again related to the charge of the multilayer film surface. The combination of the results obtained from both ultraviolet spectroscopy and dissipative quartz crystal microbalance enables us to describe a full picture of several simultaneous processes initiated by the guest molecule.Physical and chemical characteristics of materials are important regulators of cell behavior. In particular, cell elasticity is a fundamental parameter that reflects the state of a cell. Surface topography finely modulates cell fate and function via adhesion mediated signaling and cytoskeleton generated forces. However, how topographies alter cell mechanics is still unclear. In this work we have analyzed the mechanical properties of peripheral and nuclear regions of NIH-3T3 cells on azopolymer substrates with different topographic patterns. Micrometer scale patterns in the form of parallel ridges or square lattices of surface elevations were encoded on light responsive azopolymer films by means of contactless optical methods. Cell mechanics was investigated by atomic force microscopy (AFM). Cells and consequently the cell cytoskeleton were oriented along the linear patterns affecting cytoskeletal structures, e.g., formation of actin stress fibers. E6446 Our data demonstrate that topographic substrate patterns are recognized by cells and mechanical information is transferred by the cytoskeleton. Furthermore, cytoskeleton generated forces deform the nucleus, changing its morphology that appears to be related to different mechanical properties in the nuclear region.

Sporadic breast cancer is frequently associated with aberrant DNA methylation patterns that are reversible and responsive to environmental factors, including diet. In the present study, we investigated the effects of sulforaphane (SFN), a phytochemical from cruciferous vegetables, on the methylation and expression of PTEN and RARbeta2 tumour suppressor genes as well as on the expression of regulators of DNA methylation reaction, DNMT1 , p53 , and p21 , in MCF-7 and MDA-MB-231 human breast cancer cells with different invasive potential. We also evaluate the role of SFN epigenetic effects in support of therapy with clofarabine (ClF) that was recently shown to modulate the epigenome as well.

Promoter methylation and gene expression were estimated using methylation-sensitive restriction analysis and real-time PCR, respectively.

In both MCF-7 and MDA-MB-231 cells, SFN at IC 50 (22 and 46 μ M , respectively) and a physiologically relevant 10 μ M concentration lead to hypomethylation of PTEN and RARbeta2 promoters with concomitant gene upregulation. The combination of SFN and ClF enhances these effects, resulting in an increase in cell growth arrest and apoptosis at a non-invasive breast cancer stage.

Our findings provide evidence that SFN activates DNA methylation-silenced tumour suppressor genes in breast cancer cells and may contribute to SFN-mediated support of therapy with an anti-cancer drug, ClF, increasing its applications in solid tumours.

Our findings provide evidence that SFN activates DNA methylation-silenced tumour suppressor genes in breast cancer cells and may contribute to SFN-mediated support of therapy with an anti-cancer drug, ClF, increasing its applications in solid tumours.

The need for routine use of preoperative biliary drainage (PBD) before major liver resection in jaundiced patients has recently been questioned. Our aim was to present our experience of patients with proximal bile duct cancer who undergo major liver resection without PBD and compare these results with patients without biliary obstruction who underwent major liver resection.

Eighty six consecutive jaundiced patients underwent major liver resection without PBD. The postoperative outcome was compared to the control group, which was the same size and matched.

A case-comparison study.

Fifty nine jaundiced patients (69%) and 22 non-jaundiced patients (25%) received blood transfusion (p = 0.04). Fifty-three patients (62%) in the jaundiced group and 17 (19%) in the non-jaundiced patients experienced postoperative complications (p = 0.003). A statistically significant difference could not be detected for mortality (6 vs. 2%) and transient liver failure (10 vs. 3%). Those patients who underwent extended right hemihepatectomy (with future liver remnant <50%) express high morbidity (55 vs.