New design of polyphenylene dendrimers for full-color light-emitting diodes

Dendritic systems, and in particular polyphenylene dendrimers, have recently attracted considerable attention from the synthetic organic chemistry community, as well as from photophysicists, particularly in view of the search for synthetic model analogies to photoelectric materials to fabricate organic light-emitting diodes (OLEDs), and even more advanced areas of research such as light-harvesting system, energy transfer and non-host device. Geometrically, dendrimers are unique systems that consist of a core, one or more dendrons, and surface groups. The different parts of the macromolecule can be selected to give the desired optoelectronic and processing properties. Compared to small molecular or polymeric light-emitting materials, these dendritic materials can combine the benefits of both previous classes. The high molecular weights of these dendritic macromolecules, as well as the surface groups often attached to the distal ends of the dendrons, can improve the solution processability, and thus can be deposited from solution by simple processes such as spin-coating and ink-jet printing. Moreover, even better than the traditional polymeric light-emitting materials, the well-defined monodisperse distributed dendrimers possess a high purity comparable to that of small molecules, and as such can be fabricated into high performance OLEDs. Most importantly, the emissive chromophores can be located at the core of the dendrimer, within the dendrons, and/or at the surface of the dendrimers because of their unique dendritic architectures. The different parts of the macromolecule can be selected to give the desired optoelectronic and processing properties. Therefore, the main goals of this thesis are the design and synthesis, characterization of novel functional dendrimers, e.g. polytriphenylene dendrimers for blue fluorescent, as well as iridium(III) complex cored polyphenylene dendrimers for green and red phosphorescent light emitting diodes. In additional to the above mentioned advantages of dendrimer based OLEDs, the modular molecular architecture and various functionalized units at different locations in polyphenylene dendrimers open up a tremendous scope for tuning a wide range of properties in addition to color, such as intermolecular interactions, charge mobility, quantum yield, and exciton diffusion. In conclusion, research into dendrimer containing OLEDs combines fundamental aspects of organic semiconductor physics, novel and highly sophisticated organic synthetic chemistry and elaborate device technology.rn

Investigations on asymptotic safety of metric, tetrad and Einstein-Cartan gravity

Among the different approaches for a construction of a fundamental quantum theory of gravity the Asymptotic Safety scenario conjectures that quantum gravity can be defined within the framework of conventional quantum field theory, but only non-perturbatively. In this case its high energy behavior is controlled by a non-Gaussian fixed point of the renormalization group flow, such that its infinite cutoff limit can be taken in a well defined way. A theory of this kind is referred to as non-perturbatively renormalizable. In the last decade a considerable amount of evidence has been collected that in four dimensional metric gravity such a fixed point, suitable for the Asymptotic Safety construction, indeed exists. This thesis extends the Asymptotic Safety program of quantum gravity by three independent studies that differ in the fundamental field variables the investigated quantum theory is based on, but all exhibit a gauge group of equivalent semi-direct product structure. It allows for the first time for a direct comparison of three asymptotically safe theories of gravity constructed from different field variables. The first study investigates metric gravity coupled to SU(N) Yang-Mills theory. In particular the gravitational effects to the running of the gauge coupling are analyzed and its implications for QED and the Standard Model are discussed. The second analysis amounts to the first investigation on an asymptotically safe theory of gravity in a pure tetrad formulation. Its renormalization group flow is compared to the corresponding approximation of the metric theory and the influence of its enlarged gauge group on the UV behavior of the theory is analyzed. The third study explores Asymptotic Safety of gravity in the Einstein-Cartan setting. Here, besides the tetrad, the spin connection is considered a second fundamental field. The larger number of independent field components and the enlarged gauge group render any RG analysis of this system much more difficult than the analog metric analysis. In order to reduce the complexity of this task a novel functional renormalization group equation is proposed, that allows for an evaluation of the flow in a purely algebraic manner. As a first example of its suitability it is applied to a three dimensional truncation of the form of the Holst action, with the Newton constant, the cosmological constant and the Immirzi parameter as its running couplings. A detailed comparison of the resulting renormalization group flow to a previous study of the same system demonstrates the reliability of the new equation and suggests its use for future studies of extended truncations in this framework.

A study of extended radio galaxies in the Shapley concentration core

Extended cluster radio galaxies show different morphologies com- pared to those found isolated in the field. Indeed, symmetric double radio galaxies are only a small percentage of the total content of ra- dio loud cluster galaxies, which show mainly tailed morphologies (e.g. O’Dea & Owen, 1985). Moreover, cluster mergers can deeply affect the statistical properties of their radio activity. In order to better understand the morphological and radio activity differences of the radio galaxies in major mergeing and non/tidal-merging clusters, we performed a multifrequency study of extended radio galax- ies inside two cluster complexes, A3528 and A3558. They belong to the innermost region of the Shapley Concentration, the most massive con- centration of galaxy clusters (termed supercluster) in the local Universe, at average redshift z ≈ 0.043. We analysed low frequency radio data performed at 235 and 610 MHz with Giant Metrewave Radio Telescope (GMRT) and we combined them with proprietary and literature observations, in order to have a wide frequency range (150 MHz to 8.4 GHz) to perform the spectral analysis. The low frequency images allowed us to carry out a detailed study of the radio tails and diffuse emission found in some cases. The results in the radio band were also qualitatively compared with the X-ray information coming from XMM-Newton observations, in order to test the interaction between radio galaxies and cluster weather. We found that the brightest central galaxies (BCGs) in the A3528 cluster complex are powerful and present substantial emission from old relativistic plasma characterized by a steep spectrum (α > 2). In the light of observational pieces of evidence, we suggest they are possible re-started radio galaxies. On the other hand, the tailed radio galaxies trace the host galaxy motion with respect to the ICM, and our find- ings is consistent with the dynamical interpretation of a tidal interaction (Gastaldello et al. 2003). On the contrary, the BCGs in the A3558 clus- ter complex are either quiet or very faint radio galaxies, supporting the hypothesis that clusters mergers quench the radio emission from AGN.

The Next 10 years in the Management of Peripheral Artery Disease: Perspectives from The 'PAD 2009' Conference

OBJECTIVES: To briefly inform on the conclusions from a conference on the next 10 years in the management of peripheral artery disease (PAD). DESIGN OF THE CONFERENCE: International participation, invited presentations and open discussion were based on the following issues: Why is PAD under-recognised? Health economic impact of PAD; funding of PAD research; changes of treatment options? Aspects on clinical trials and regulatory views; and the role of guidelines. RESULTS AND CONCLUSIONS: A relative lack of knowledge about cardiovascular risk and optimal management of PAD patients exists not only among the public, but also in parts of the health-care system. Specialists are required to act for improved information. More specific PAD research is needed for risk management and to apply the best possible evaluation of evidence for treatment strategies. Better strategies for funding are required based on, for example, public/private initiatives. The proportion of endovascular treatments is steadily increasing, more frequently based on observational studies than on randomised controlled trials. The role of guidelines is therefore important to guide the profession in the assessment of most relevant treatment.

Comparison of randomized treatments for late whiplash

BACKGROUND: To compare 4 different treatment strategies in patients with late whiplash syndrome. METHODS: Patients were randomly assigned to one of the following treatment groups: infiltration, physiotherapy, or medication. Group allocation was stratified according to gender, age, and education. Additionally, patients of each group were randomized 1:1 to cognitive-behavioral therapy (CBT) or no CBT. Patients were assessed at baseline, after an 8-week treatment period, and 3 and 6 months later. Main outcome measures were subjective outcome rating, pain intensity, and working ability. RESULTS: Of 91 enrolled patients, 73 completed the study; 62% were women. After treatment, 47 patients (64%) were subjectively improved (48%), or free of symptoms (16%), with a preponderance of women (73% vs 50%, p = 0.047). There was no difference regarding outcomes among the 3 treatment groups in men and women. The most robust difference was achieved with CBT, associated with a higher rate of recovery (23% vs 9%), and improvement (53% vs 42%) (p = 0.024), and with a gender difference (p = 0.01). All treatments significantly improved pain intensity and working ability. CONCLUSION: Intensive therapy in late whiplash syndrome can achieve improvement of different outcome measures including working ability in two-thirds of patients, more effective in women, persisting beyond 6 months in half. Additional cognitive-behavioral therapy was the most effective treatment modality. Classification of evidence: This interventional study provides Class III evidence that CBT used as an adjunct to infiltration, medication, or physiotherapy increases improvement rates in persons with late whiplash syndrome.

Assessment of publication bias in dental specialty journals

OBJECTIVE: The purpose of this study was to investigate the presence of publication bias (acceptance of articles indicating statistically significant results). METHODS: The journals possessing the highest impact factor (2008 data) in each dental specialty were included in the study. The content of the 6 most recent issues of each journal was hand searched and research articles were classified into 4 type categories: cross-sectional, case-control, cohort, and interventional (nonrandomized clinical trials and randomized controlled trials). In total, 396 articles were included in the analysis. Descriptive statistics and univariate and multivariate logistic regression was used to examine the association between article-reported statistical significance (dependent variable) and journal impact factor and article study type subject area (independent variables). RESULTS: A statistically significant acceptance rate of positive result was found, ranging from 75% to 90%, whereas the value of impact factor was not related to publication bias among leading dental journals. Compared with other research designs, clinical intervention studies (randomized or nonrandomized) presented the highest percentage of nonsignificant findings (20%); RCTs represented 6% of the examined investigations. CONCLUSIONS: Compared with the Journal of Clinical Periodontology, all other subspecialty journals, except the Journal of Oral and Maxillofacial Surgery, showed significantly decreased odds of publishing an RCT, which ranged from 60% to 93% (P < .05).

Benchmarking in the SWISSspine registry: results of 52 Dynardi lumbar total disc replacements compared with the data pool of 431 other lumbar disc prostheses

The SWISSspine registry is the first mandatory registry of its kind in the history of Swiss orthopaedics and it follows the principle of "coverage with evidence development". Its goal is the generation of evidence for a decision by the Swiss federal office of health about reimbursement of the concerned technologies and treatments by the basic health insurance of Switzerland. Recently, developed and clinically implemented, the Dynardi total disc arthroplasty (TDA) accounted for 10% of the implanted lumbar TDAs in the registry. We compared the outcomes of patients treated with Dynardi to those of the recipients of the other TDAs in the registry. Between March 2005 and October 2009, 483 patients with single-level TDA were documented in the registry. The 52 patients with a single Dynardi lumbar disc prosthesis implanted by two surgeons (CE and OS) were compared to the 431 patients who received one of the other prostheses. Data were collected in a prospective, observational multicenter mode. Surgery, implant, 3-month, 1-year, and 2-year follow-up forms as well as comorbidity, NASS and EQ-5D questionnaires were collected. For statistical analyses, the Wilcoxon signed-rank test and chi-square test were used. Multivariate regression analyses were also performed. Significant and clinically relevant reduction of low back pain and leg pain as well as improvement in quality of life was seen in both groups (P < 0.001 postop vs. preop). There were no inter-group differences regarding postoperative pain levels, intraoperative and follow-up complications or revision procedures with a new hospitalization. However, significantly more Dynardi patients achieved a minimum clinically relevant low back pain alleviation of 18 VAS points and a quality of life improvement of 0.25 EQ-5D points. The patients with Dynardi prosthesis showed a similar outcome to patients receiving the other TDAs in terms of postoperative low back and leg pain, complications, and revision procedures. A higher likelihood for achieving a minimum clinically relevant improvement of low back pain and quality of life in Dynardi patients was observed. This difference might be due to the large number of surgeons using other TDAs compared to only two surgeons using the Dynardi TDA, with corresponding variations in patient selection, patient-physician interaction and other factors, which cannot be assessed in a registry study.

Population based screening - the difficulty of how to do more good than harm and how to achieve it

Screening people without symptoms of disease is an attractive idea. Screening allows early detection of disease or elevated risk of disease, and has the potential for improved treatment and reduction of mortality. The list of future screening opportunities is set to grow because of the refinement of screening techniques, the increasing frequency of degenerative and chronic diseases, and the steadily growing body of evidence on genetic predispositions for various diseases. But how should we decide on the diseases for which screening should be done and on recommendations for how it should be implemented? We use the examples of prostate cancer and genetic screening to show the importance of considering screening as an ongoing population-based intervention with beneficial and harmful effects, and not simply the use of a test. Assessing whether screening should be recommended and implemented for any named disease is therefore a multi-dimensional task in health technology assessment. There are several countries that already use established processes and criteria to assess the appropriateness of screening. We argue that the Swiss healthcare system needs a nationwide screening commission mandated to conduct appropriate evidence-based evaluation of the impact of proposed screening interventions, to issue evidence-based recommendations, and to monitor the performance of screening programmes introduced. Without explicit processes there is a danger that beneficial screening programmes could be neglected and that ineffective, and potentially harmful, screening procedures could be introduced.

Sonographic follow-up of patients with carpal tunnel syndrome undergoing surgical or nonsurgical treatment: prospective cohort study

Purpose To compare changes in the largest cross-sectional area (CSA) of the median nerve in wrists undergoing surgical decompression with changes in wrists undergoing non-surgical treatment of carpal tunnel syndrome (CTS). Methods This study was a prospective cohort study in 55 consecutive patients with 78 wrists with established CTS, including 60 wrists treated with surgical decompression and 18 wrists with non-surgical treatment. A sonographic examination was scheduled before and 4 months after initiation of treatment. We compared changes in CSA of the median nerve between wrists with surgical treatment and wrists with non-surgical treatment using linear regression models. Results Decreases in CSA of the median nerve were more pronounced in wrists with CTS release than in wrists undergoing nonsurgical treatment (difference in means, 1.0 mm2; 95% confidence interval, 0.3–1.8 mm2). Results were robust to the adjustment for age, gender, and neurological severity at baseline. Among wrists with CTS release, those with postoperative CSA of 10 mm2 or less tended to have better clinical outcomes than those with postoperative CSA of greater than 10 mm2 (p=.055). Postoperative sonographic workup in the 3 patients with unfavorable outcome or recurrence identified likely causes for treatment failure in 2 patients. Conclusions In this observational study, surgical decompression was associated with a greater decrease in median nerve CSA than was nonsurgical treatment. Smaller postoperative CSAs may be associated with better clinical outcomes. Additional randomized trials are necessary to determine the optimal treatment strategy in different subgroups of patients with CTS. Type of study/level of evidence Therapeutic III.

Presentation and outcome of patients with acute coronary syndromes in eastern Nepal

The burden of ischemic heart disease (IHD) in developing countries is on the rise, due to urbanisation, industrialisation and the low availability of evidence based therapies and interventions.

Reporting of research quality characteristics of studies published in 6 major clinical dental specialty journals

The objective of this article was to record reporting characteristics related to study quality of research published in major specialty dental journals with the highest impact factor (Journal of Endodontics, Journal of Oral and Maxillofacial Surgery, American Journal of Orthodontics and Dentofacial Orthopedics; Pediatric Dentistry, Journal of Clinical Periodontology, and International Journal of Prosthetic Dentistry). The included articles were classified into the following 3 broad subject categories: (1) cross-sectional (snap-shot), (2) observational, and (3) interventional. Multinomial logistic regression was conducted for effect estimation using the journal as the response and randomization, sample calculation, confounding discussed, multivariate analysis, effect measurement, and confidence intervals as the explanatory variables. The results showed that cross-sectional studies were the dominant design (55%), whereas observational investigations accounted for 13%, and interventions/clinical trials for 32%. Reporting on quality characteristics was low for all variables: random allocation (15%), sample size calculation (7%), confounding issues/possible confounders (38%), effect measurements (16%), and multivariate analysis (21%). Eighty-four percent of the published articles reported a statistically significant main finding and only 13% presented confidence intervals. The Journal of Clinical Periodontology showed the highest probability of including quality characteristics in reporting results among all dental journals.

On The Choice and Impacts of Innovative International Food Assistance Instruments

The rise of new food assistance instruments, including local and regional procurement, cash, and vouchers, has surpassed increase in understanding of the tradeoffs among and impacts of these options relative to traditional food aid. Response choices rarely appear to result from systematic response analyses. Further, impacts along multiple dimensions-timeliness, cost-effectiveness, local market effects, recipient satisfaction, food quality, impact on smallholder suppliers, etc.-may be competing or synergistic. No single food assistance tool is always and everywhere preferable. A growing body of evidence, including the papers in this special section, nonetheless demonstrates the clear value-added of new food assistance instruments. (C) 2013 Elsevier Ltd. All rights reserved.

Phosphatidylethanol (PEth) as a Biomarker of Alcohol Consumption in HIV-Positive Patients in Sub-Saharan Africa

Background:  Alcohol is heavily consumed in sub-Saharan Africa and affects HIV transmission and treatment and is difficult to measure. Our goal was to examine the test characteristics of a direct metabolite of alcohol consumption, phosphatidylethanol (PEth). Methods:  Persons infected with HIV were recruited from a large HIV clinic in southwestern Uganda. We conducted surveys and breath alcohol concentration (BRAC) testing at 21 daily home or drinking establishment visits, and blood was collected on day 21 (n = 77). PEth in whole blood was compared with prior 7-, 14-, and 21-day alcohol consumption. Results:  (i) The receiver operator characteristic area under the curve (ROC-AUC) was highest for PEth versus any consumption over the prior 21 days (0.92; 95% confidence interval [CI]: 0.86 to 0.97). The sensitivity for any detectable PEth was 88.0% (95% CI: 76.0 to 95.6) and the specificity was 88.5% (95% CI: 69.8 to 97.6). (ii) The ROC-AUC of PEth versus any 21-day alcohol consumption did not vary with age, body mass index, CD4 cell count, hepatitis B virus infection, and antiretroviral therapy status, but was higher for men compared with women (p = 0.03). (iii) PEth measurements were correlated with several measures of alcohol consumption, including number of drinking days in the prior 21 days (Spearman r = 0.74, p < 0.001) and BRAC (r = 0.75, p < 0.001). Conclusions:  The data add support to the body of evidence for PEth as a useful marker of alcohol consumption with high ROC-AUC, sensitivity, and specificity. Future studies should further address the period and level of alcohol consumption for which PEth is detectable.

[Integrating psychotherapeutic treatment of severe mental illness: between desirability and clinical practice]

Psychiatric care for severe and persistent mentally ill individuals has considerably changed over the last three decades. Striving for improvement in services provision for these patients has led to the emergence of various specialized community services, suited housing and supported work offers. Moreover, community-based treatment is also offered during acute episodes of mental illness. At the same time a range of evidence-based psychotherapeutic approaches targeting treatment needs of people with severe mental illness were developed in a process independent of the rise of community psychiatry. At present, however, a sufficient level of coordination of psychiatric services and integration of evidence-based psychological treatment into psychiatric care has not been achieved. Thus, these issues represent important steps in the further development.This paper discusses recent developments in psychiatric care of people with severe mental illness and reviews the evidence-based psychotherapy approaches suited to fit the needs of patient-centered integrated care.

Guidance for the preparation of neurological management guidelines by EFNS scientific task forces - revised recommendations 2012

This paper is meant to provide guidance to anyone wishing to write a neurological guideline for diagnosis or treatment, and is directed at the Scientist Panels and task forces of the European Federation of Neurological Societies (EFNS). It substitutes the previous guidance paper from 2004. It contains several new aspects: the guidance is now based on a change of the grading system for evidence and for the resulting recommendations, and has adopted The Grading of Recommendations, Assessment, Development and Evaluation system (GRADE). The process of grading the quality of evidence and strength of recommendations can now be improved and made more transparent. The task forces embarking on the development of a guideline must now make clearer and more transparent choices about outcomes considered most relevant when searching the literature and evaluating their findings. Thus, the outcomes chosen will be more critical, more patient-oriented and easier to translate into simple recommendations. This paper also provides updated practical recommendations for planning a guideline task force within the framework of the EFNS. Finally, this paper hopes to find the approval also by the relevant bodies of our future organization, the European Academy of Neurology.