Herein a case of a 35-year-old woman with a history of Behçet's disease, who presented with swelling and redness of her right eye with increasing pain, is reported. Computed tomography and magnetic resonance imaging showed enlargement of the right lacrimal gland and contrast enhancement of the extraocular muscles. A diagnosis of orbital inflammation was made and the patient was treated with corticosteroids, with prompt resolution of symptoms and clinical signs. Orbital inflammation should be considered as an ophthalmic manifestation of Behçet's disease.

Controllable integration of noble metals (e.g., Au, Ag, Pt, and Pd) and metal oxides (e.g., TiO₂, CeO₂, and ZrO₂) into single nanostructures has attracted immense research interest in heterogeneous catalysis, because they not only combine the properties of both noble metals and metal oxides, but also bring unique collective and synergetic functions in comparison with single-component materials. Among many strategies recently developed, one of the most efficient ways is to encapsulate and protect individual noble metal nanoparticles by a metal oxide shell of a certain thickness to generate the core-shell or yolk-shell structure, which exhibits enhanced catalytic performance compared with conventional supported catalysts. In this review article, we summarize the state-of-the art progress in synthesis and catalytic application of noble metal nanoparticle@metal oxide core/yolk-shell nanostructures. We hope that this review will help the readers to obtain better insight into the design and application of well-defined nanocomposites in both the energy and environmental fields.

Scanning-tunneling microscopy and density-functional theory have been employed to identify the spatial correlation between an oxygen vacancy and the associated Ce(3+) ion pair in a defective CeO(2)(111) film. The two Ce(3+) ions can occupy different cationic shells around the vacancy. The resulting variation in the chemical environment leads to a splitting of the filled Ce(3+) f levels, which is detected with STM spectroscopy. The position of the Ce(3+) ion pair is reflected in characteristic defect patterns observed in empty-state STM images, which arise from the bright appearance of Ce(4+) ions next to the defect while the Ce(3+) remain dark. Both findings demonstrate that at least one excess electron localizes in a Ce ion that is not adjacent to the O vacancy.

Management of health care organizations must improve to meet the well-documented challenges of quality improvement and cost control. Other industries have developed the tools--entry education, mentoring, planned mid-career formal education and experience, and special programs for senior management. The purpose of this paper is to pilot test an alternative method to identify competencies and performance of health care executives. We propose using formal lists of technical, interpersonal, and strategic competencies and specific real events chosen by the respondent to identify and prioritize competencies. Results of a trial with 30 large health care system CEOs and 15 early careerists demonstrate that the method reveals useful depth and detail about managers' educational needs. The results suggest that current thinking about managerial education and learning patterns may be seriously inadequate in several respects. The continued improvement of U.S. health care is a pressing national concern. Quality of care is highly variable and substantially deficient in many institutions (Chassin and Galvin 1998; Committee on Quality of Health Care in America 2001). "Quality improvement should be the essential business strategy for healthcare in the 21st century (Kizer 2001)." Productivity improvements will be essential to balance cost pressures from an aging population and growing technology (Heffler, et al. 2002). Skillful management is necessary to improve quality and productivity. Teams of dozens of caregivers are often required to improve a patient's health. The organizations that provide care have grown larger in response to the greater cost, complexity of operation and finance, and evidence of the success of scale in other industries. While many small professional practices, hospitals, and nursing homes remain, consolidation has created a few dozen provider and intermediary organizations exceeding a billion dollars a year in expenditures. These large health care organizations are, or should be, modern corporate organizations at least as effective as their counterparts in manufacturing, retailing, or finance. To achieve that goal, they will require managers with comparable ability, motivation, and preparation. The National Summit on The Future Of Health Management and Policy Education emphasized the development of "evidence-based management education" by identifying, prioritizing, and measuring mastery of specific skills, knowledge, and abilities (Griffith 2001). Faculty of Association of University Programs in Health Administration (AUPHA) are working with practitioners to identify and prioritize specific learning competencies at the graduate degree level. Their effort focuses on skills teachable in the classroom, and it is expected to lead to measured performance of graduate school cohorts (Griffith 2001). The purpose of this paper is to pilot test an alternative method to identify competencies and performance of health care executives. Although it deliberately draws competency elements from academic sources, it supplements the teachable skills approach with a questionnaire that asks practitioner respondents to identify the skills and knowledge necessary to manage a specific management event and to evaluate the performance of an anonymous colleague against these skills and knowledge.

The centralized management of manual and automated information systems in hospitals, including the medical record, is usually delegated to administrators rather than to physicians. It is also likely that the importance of automated information systems will increase rapidly as the medical record is electronified. Many significant changes have occurred in recent years relating to the manner in which information systems are managed in hospitals. To address the challenge of this new information environment, hospital Chief Executive Officers (CEOs) have begun to create a new executive hospital position called the Chief Information Officer (CIO). CIOs are included in the hospital executive cabinet and commonly direct all hospital information systems, telecommunications, and management engineering. Although the model of the physician-director of an information system is common at the departmental level with the Laboratory Information System as one example, physicians rarely serve within the central hospital administration as information specialists such as the CIO. Although many physicians would be suitably qualified to serve in this capacity, another option for them would be the position of Chief Medical Information Officer (CMIO) with responsibility for utilization review, medical records, and quality assurance. The CMIO would serve centrally on a part-time basis, continuing to practice simultaneously in a medical specialty. The medical information specialist must not be insulated from the flow of clinical information and discourse with medical colleagues because of the increasing use of information systems for improving work efficiency and the pursuit of quality goals.

OBJECTIVE

To compare perceptions and perspectives of medical school deans and hospital chief executive officers (CEOs) regarding roles, responsibilities, and attributes of effective clinical department chairs.

METHODS

In 2009, the authors surveyed the deans of 126 U.S. medical schools and the CEOs of the primary teaching hospitals in the schools' academic health centers. All were queried on 34 items about clinical department chair performance in six categories (mission prioritization, leadership responsibilities, leadership values, skill sets, barriers to success, and competitive differentiators).

RESULTS

Eighty-four deans (67%) and 57 CEOs (45%) responded. Both groups ranked ensuring good patient care as the chair's primary responsibility; agreement between CEOs on that responsibility was much stronger than among deans (P < .01). CEOs placed greater emphasis on getting results (P < .01), whereas mentoring was a higher priority for deans (P < .01). CEOs identified the inability to work within budgeted resources as a barrier to chair success more than did deans (P < .01). CEOs reported that high-quality care and cutting-edge hospital technologies were keys to competitive distinction, whereas deans put more weight on clinical and translational research and educating future physicians. The majority of deans and CEOs rated the alignment and relationship between themselves and their counterpart as "excellent" or "good."

CONCLUSIONS

Deans and their "partner" hospital CEOs agreed on most of the attributes, skills, and responsibilities characterizing the successful clinical department chair. CEOs were biased toward patient care, clinical quality, and results, whereas deans placed more emphasis on research, education, and mentoring.

Purpose. The relationship between hospitals' organizational characteristics and adoption of restrictive smoking policies was examined. Design. Self-administered questionnaires and telephone interviews were conducted prior to and following the target date for policy implementation. Setting. The Director of Regional Medical Services of a community network of hospitals requested in the summer of 1989 that the 57 member hospitals voluntarily implement a policy prohibiting all smoking in hospital buildings as of January 1, 1990. Subjects. Subjects were the 49 hospital CEOs (86%) who provided data at both time points. Intervention. The Director of Regional Medical Services made a personal request of the CEO during a routine visit at each hospital. Measures. Measures included structural aspects of the hospitals (e.g., number of employees, number of beds, presence of chemical dependency and psychiatric units); orientation toward employee health; support for smoking restrictions among various groups; and extent of CEO authority to set smoking policy. Results. Fifty-one percent of hospitals increased the restrictiveness of their smoking policy; 35% adopted a complete indoor smoking ban. Stepwise multiple regression analysis demonstrated that adoption of additional smoking restrictions was related to CEOs' and perceived board of directors' support of smoking restrictions, absence of a chemical dependency unit, and experience of financial difficulties in the previous two years. Conclusions. It is important to educate top decision makers as to the necessity of restrictive smoking policies. Barriers to smoking restrictions in organizations with chemical dependency units deserve particular attention from health promotion practitioners and researchers.

Various procedures have been used to establish and increase manual signed and spoken requesting with individuals who are intellectually disabled. A few studies have used the so-called blockable response conditioned establishing operation (BR-CEO) as a stimulus control procedure to increase requesting. A variation on the BR-CEO is the interrupted chain procedure, in which requesting for the activity that had been interrupted is reinforced by continuation of the activity. Rather than interrupting an ongoing activity, six individuals who are severely/profoundly intellectually disabled were studied with respect to the differential effectiveness of presenting them incomplete versus complete referents (i.e. activity and objects) as a consequence of their requesting on their rate of requesting. Data were collected within a reversal design. The results show that five out of six individuals more than doubled their rate of requesting. Incomplete presentation of referents may be a practical procedure to increase requesting.

In this paper, we report a method of precise and fast absolute x-ray energy calibration over a wide energy range using an iterative x-ray diffraction based method. Although accurate x-ray energy calibration is indispensable for x-ray energy-sensitive scattering and diffraction experiments, there is still a lack of effective methods to precisely calibrate energy over a wide range, especially when normal transmission monitoring is not an option and complicated micro-focusing optics are fixed in place. It is found that by using an iterative algorithm the x-ray energy is only tied to the relative offset of sample-to-detector distance, which can be readily varied with high precision of the order of 10(-5) -10(-6) spatial resolution using gauge blocks. Even starting with arbitrary initial values of 0.1 Å, 0.3 Å, and 0.4 Å, the iteration process converges to a value within 3.5 eV for 31.122 keV x-rays after three iterations. Different common diffraction standards CeO(2), Au, and Si show an energy deviation of 14 eV. As an application, the proposed method has been applied to determine the energy-sensitive first sharp diffraction peak of network forming GeO(2) glass at high pressure, exhibiting a distinct behavior in the pressure range of 2-4 GPa. Another application presented is pair distribution function measurement using calibrated high-energy x-rays at 82.273 keV. Unlike the traditional x-ray absorption-based calibration method, the proposed approach does not rely on any edges of specific elements, and is applicable to the hard x-ray region where no appropriate absorption edge is available.

Organizational theorists have traditionally focused attention on the relationship between chief executive officer (CEO) succession and strategic change. This study extends that perspective and explores the effects of changes in an organization's management, ownership, and board of directors on the process of strategic change. The results of this research suggest that changes in ownership and board have significant independent and interactive effects on strategic change.

BACKGROUND

There is an emerging body of literature suggesting that the evidence-practice divide in health policy is complex and multi-factorial but less is known about the processes by which health policy-makers use evidence and their views about the specific features of useful evidence. This study aimed to contribute to understandings of how the most influential health policy-makers view useful evidence, in ways that help explore and question how the evidence-policy divide is understood and what research might be supported to help overcome this divide.

METHODS

A purposeful sample of 18 national and state health agency CEOs from 9 countries was obtained. Participants were interviewed using open-ended questions that asked them to define specific features of useful evidence. The analysis involved two main approaches 1)quantitative mapping of interview transcripts using Bayesian-based computational linguistics software 2)qualitative critical discourse analysis to explore the nuances of language extracts so identified.

RESULTS

The decision-making, conclusions-oriented world of policy-making is constructed separately, but not exclusively, by policy-makers from the world of research. Research is not so much devalued by them as described as too technical- yet at the same time not methodologically complex enough to engage with localised policy-making contexts. It is not that policy-makers are negative about academics or universities, it is that they struggle to find complexity-oriented methodologies for understanding their stakeholder communities and improving systems. They did not describe themselves as having a more positive role in solving this challenge than academics.

CONCLUSIONS

These interviews do not support simplistic definitions of policy-makers and researchers as coming from two irreconcilable worlds. They suggest that qualitative and quantitative research is valued by policy-makers but that to be policy-relevant health research may need to focus on building complexity-oriented research methods for local community health and service development. Researchers may also need to better explain and develop the policy-relevance of large statistical generalisable research designs. Policy-makers and public health researchers wanting to serve local community needs may need to be more proactive about questioning whether the dominant definitions of research quality and the research funding levers that drive university research production are appropriately inclusive of excellence in such policy-relevant research.

This study was conducted to characterize infectious laryngotracheitis (ILT) viruses isolated from poultry in South Korea using RFLP analysis of PCR products. Seven wild-type Korean isolates from commercial chicken farms collected between 1986 and 2012 were compared with 3 imported commercial vaccine strains [LT Blen (Hudson strain, United States), Laryngo Vac (Cover strain, United States), and Nobilis ILT (Serva strain, France)] and a Korean chicken embryo origin (CEO) vaccine strain [ILT-VAC (Gyeonggi97 strain, Korea)]. Six of the field isolates were highly virulent viruses, and the Kr12AD37 isolate was considered an attenuated type according to Han's RFLP method. These virulent Korean ILT viruses were divided into 3 classes (class I, II, and III). The Kr12AD37 isolate was found to have the same RFLP pattern as the Korean CEO vaccine strain, and both of these strains were different from the 3 foreign vaccine strains. The results suggest that the Korean CEO vaccine strain has been responsible for recent outbreaks, and the characterization of ILT viruses by RFLP was useful for diagnosis by providing epidemiological information.

Scanning tunneling microscopy (STM) combined with density functional theory (DFT) are used to analyze the structural and electronic properties of step edges on the surface of CeO(2)(111) films grown on Ru(0001). Depending on the preparation conditions, 211 or 110-oriented steps develop on the surface, which results in the formation of ceria ad-islands with hexagonal or triangular shapes. STM conductance spectroscopy reveals pronounced differences in the electronic properties of the step edges, as reflected in different onset positions of the ceria conduction band. The band shifts are related to the development of distinct edge electronic states that split-off from the ceria conduction band, as shown with DFT calculations. The separation of the edge states from the main band is governed by the atom-coordination and local charge-distribution along the edge, the latter giving rise to the development of electrostatic dipoles. We expect that the observed edge morphologies determine not only the electronic properties but also the adsorption behavior of step edges on the CeO(2)(111) surface.

Nanomaterials are finding application in many different environmentally relevant products and processes due to enhanced catalytic, antimicrobial, and oxidative properties of materials at this scale. As the market share of nano-functionalized products increases, so too does the potential for environmental exposure and contamination. This study presents some exposure ranking methods that consider potential metallic nanomaterial surface water exposure and fate, due to nano-functionalized products, through a number of exposure pathways. These methods take into account the limited and disparate data currently available for metallic nanomaterials and apply variability and uncertainty principles, together with qualitative risk assessment principles, to develop a scientific ranking. Three exposure scenarios with three different nanomaterials were considered to demonstrate these assessment methods: photo-catalytic exterior paint (nano-scale TiO₂), antimicrobial food packaging (nano-scale Ag), and particulate-reducing diesel fuel additives (nano-scale CeO₂). Data and hypotheses from literature relating to metallic nanomaterial aquatic behavior (including the behavior of materials that may relate to nanomaterials in aquatic environments, e.g., metals, pesticides, surfactants) were used together with commercial nanomaterial characteristics and Irish natural aquatic environment characteristics to rank the potential concentrations, transport, and persistence behaviors within subjective categories. These methods, and the applied scenarios, reveal where data critical to estimating exposure and risk are lacking. As research into the behavior of metallic nanomaterials in different environments emerges, the influence of material and environmental characteristics on nanomaterial behavior within these exposure- and risk-ranking methods may be redefined on a quantitative basis.

According to Lucian Leape, patient safety in hospitals is improving, and it is now possible to get to a level of zero defects. Growing recognition of the need for team training, use of trigger tools, improving the competency of physicians, and full disclosure and compensation to injured patients exemplify positive developments. Yet formidable barriers remain, including separatism in how doctors, nurses, and pharmacists learn; inadequate instruction in communication and team-building skills; poorly developed quality and safety curricula; lack of leadership among CEOs and hospital boards; physician apathy; absence of effective systems for accountability; and failure to believe in the possibility of eliminating medical errors and injuries.

Natalizumab [AN 100226, anti-alpha4 integrin monoclonal antibody, Antegren] is a humanised monoclonal antibody that blocks alpha4beta1 integrin-mediated leukocyte migration. Natalizumab is in phase III trials for the treatment of multiple sclerosis in North America and the UK, and for the treatment of Crohn's disease also in the UK. It may have potential in the treatment of other immune-related inflammatory disease. Elan Corporation intends to examine the potential of natalizumab in rheumatoid arthritis and ulcerative colitis. 4beta1 integrin on circulating leukocytes binds to vascular cell adhesion molecule-1, which is expressed at high levels in the blood vessels in the CNS during exacerbations of multiple sclerosis. This allows leukocytes expressing alpha4beta1 integrin (very late antigen-4) to move from the peripheral blood into the CNS. Inflammatory proteins and other factors released from lymphocytes in the brain lead to the progression of symptoms. A limitation of natalizumab is that it must be injected and cannot be administered orally. Scientists have transformed the large anti-alpha4 monoclonal antibody into much smaller, drug-like molecules suitable for oral administration. Protein Design Labs has granted a worldwide nonexclusive licence under its antibody humanisation patents to Elan Pharmaceuticals for natalizumab. Biogen Inc. has entered into an agreement with Elan for a worldwide exclusive collaboration to develop, manufacture and commercialise natalizumab for multiple sclerosis and Crohn's disease and rheumatoid arthritis. Development of natalizumab is also being funded, in part, by Axogen (acquired by Elan in 1999). In November 2003, Biogen and IDEC Pharmaceuticals merged to form Biogen Idec. Elan repurchased royalty rights on a package of products, including natalizumab, from Autoimmune Disease Research Company. Elan and Genzyme Transgenics Corporation signed an agreement to produce natalizumab in GTC's genetically engineered goats, which will express the compound in their milk. Genzyme Transgenics Corporation changed its name to GTC Biotherapeutics in June 2002; it is no longer a subsidiary of Genzyme Corporation. Following discussions with the US FDA, Elan completed enrolment in a second phase III trial, involving approximately 420 patients with Crohn's disease. This Evaluation of Natalizumab as Continuous Therapy-2 (ENACT-2) trial evaluated the effect of natalizumab on duration of response and remission in patients with Crohn's disease. In January 2004, Elan Corporation and Biogen Idec announced that the phase III, ENACT-2 maintenance trial of natalizumab in Crohn's disease met the primary endpoint of maintenance of response. Elan and Biogen Idec will discuss these data with regulatory authorities in both the US and Europe and determine the appropriate path forward for natalizumab in Crohn's disease. An NDA for Antegren in Crohn's disease was expected to be filed at the end of 2003; however, due to failing to meet the primary endpoint in the induction trial, Elan is unable to predict when and if a regulatory filing will be made. Earlier, on 23 January 2001, the Wall Street Journal reported that the Biogen CEO expects Antegren to become a blockbuster drug, with sales of at least $US1 billion. He also predicted that Antegren could be on the market as early as 2003 for the indication of Crohn's disease and in 2004 for multiple sclerosis. The Journal stated that Biogen is under pressure to develop new drugs since its flagship product Avonex will be losing its US Orphan Drug Act protection in 2003. Antegren has a different mechanism to that of Avonex and could be used either alone or as a combination therapy.

Pt-based nanocomposites have been of great research interest. In this paper, we design an efficient MO/rGO/Pt sandwich nanostructure as an anodic electrocatalyst for DMFCs with combination of the merits of rigid structure of metallic oxides (MOs) and excellent electronic conductivity of reduced oxidized graphene (rGO) as well as overcoming their shortcomings. In this case, the CeO(2)/rGO/Pt sandwich nanostructure is successfully fabricated through a facile hydrothermal approach in the presence of graphene oxide and CeO(2) nanoparticles. This structure has a unique building architecture where rGO wraps up the CeO(2) nanoparticles and Pt nanoparticles are homogeneously dispersed on the surface of rGO. This novel structure endows this material with great electrocatalytic performance in methanol oxidation: it reduces the overpotential of methanol oxidation significantly and its electrocatalytic activity and stability are much enhanced compared with Pt/rGO, CeO(2)/Pt and Pt/C catalysts. This work supplies a unique MO/rGO/Pt sandwich nanostructure as an efficient way to improve the electrocatalytic performance, which will surely shed some light on the exploration of some novel structures of electrocatalyst for DMFCs.

To describe the aggregation kinetics of nanoparticles (NPs) in aqueous dispersions, a new equation for predicting the attachment efficiency is presented. The rationale is that at nanoscale, random kinetic motion may supersede the role of interaction energy in governing the aggregation kinetics of NPs, and aggregation could occur exclusively among the fraction of NPs with the minimum kinetic energy that exceeds the interaction energy barrier (E(b)). To justify this rationale, we examined the evolution of particle size distribution (PSD) and frequency distribution during aggregation, and further derived the new equation of attachment efficiency on the basis of the Maxwell-Boltzmann distribution and Derjaguin-Landau-Verwey-Overbeek (DLVO) theory. The new equation was evaluated through aggregation experiments with CeO(2) NPs using time-resolved-dynamic light scattering (TR-DLS). Our results show that the prediction of the attachment efficiencies agreed remarkably well with experimental data and also correctly described the effects of ionic strength, natural organic matter (NOM), and temperature on attachment efficiency. Furthermore, the new equation was used to describe the attachment efficiencies of different types of engineered NPs selected from the literature and most of the fits showed good agreement with the inverse stability ratios (1/W) and experimentally derived results, although some minor discrepancies were present. Overall, the new equation provides an alternative theoretical approach in addition to 1/W for predicting attachment efficiency.

Cumulus cells (CCs) are of great importance in oocyte development and maturation in many species, but detailed influence of CCs has not been extensively examined, especially on rabbit. The present study was designed to investigate the effects of CCs and the elongation of in vitro maturation (IVM) time on rabbit oocyte nuclear and ooplasmic maturation and survival. Cumulus oocyte complexes (COCs) and naked oocytes (NOs) were recovered directly from rabbits super-ovulated with eCG. Corona-enclosed oocytes (COs) and denuded oocytes (DOs) were obtained from COCs after removing a part or whole of CCs. The oocytes were cultured in the following seven groups. (i) Cumulus cell enclosed oocytes (CEOs) were cultured alone (CEOs); (ii) COs were cultured alone (COs); (iii) DOs were cultured alone (DOs); (iv) NOs were cultured alone; (v) DOs were co-cultured with COCs [DOs(COCs)]; (vi) DOs were co-cultured with CCs [DOs(CCs)]; (vii) NOs were co-cultured with CCs [NOs(CCs)]. After the oocytes were cultured for 24 and 30 h, the nuclear maturation was evaluated by first polar body (PB1) extrusion while the ooplasmic maturation was evaluated by the cleavage rate after parthenogenetic activation. The results showed that the nuclear maturation rate of CEOs, COs, DOs(COCs) and DOs(CCs) after 24 h incubation were significantly different from each other (p < or = 0.05), the rate of DOs(CCs) was similar to that of DOs (p>> or = 0.05). The cleavage rates in the first two groups were significantly higher than those of the others (p < 0.05). For oocytes cultured for 30 h, the nuclear maturation rates were significantly different for each culture model (p < 0.05). The cleavage rates in first two groups were significantly higher than those of others (p < 0.05). Both the nuclear and cleavage rates significantly increased when the culture time of DOs(COCs) was prolonged from 24 to 30 h. DOs(CCs) nuclear maturation was significantly improved when the culture time was prolonged from 24 to 30 h, but the ooplasmic maturation was not. Few NOs incubated with or without CCs accomplished nuclear maturation (approximately 2% both), even when the culture time was prolonged from 24 to 30 h. The oocyte degeneration rates were significantly different for each culture model after both 24 and 30 h incubation (p < or = 0.05). There was no significant difference in oocyte degeneration in the same groups between 24 and 30 h incubation (p>> 0.05). The results suggest that rabbit CCs affect oocyte nuclear and ooplasmic maturation, and their survival. The prolongation of the culture time of rabbit oocyte from 24 to 30 h improves the nuclear and ooplasmic maturation differently in the present system. Rabbit oocytes free of CCs, especially NOs, show weak meiotic resumption potential and compromised viability, which cannot be improved by co-culture with dispersed CCs. The degeneration mostly happens at early time of IVM.

The performances of a newly developed 80-200 kV cold field emission gun (CFEG) transmission electron microscope (TEM) integrating a spherical aberration corrector for a TEM image-forming lens have been evaluated. To begin, we show that the stability of both emission and probe currents makes use of this new CFEG much friendlier. The energy spread of electrons emitted from the CFEG has been measured as a function of emission current and shows a very last 0.26 eV energy resolution at 200 kV and even 0.23 eV at 80 kV. The combination of the CFEG and the CEOS™ aberration corrector, associated with enhanced mechanical and electrical stabilities of this new microscope, allows reaching an information transfer below 75 pm at 200 and 80 pm at 80 kV. This unseen resolution at 200 kV has allowed us to study the structure of CoPt nanoparticles by observing direct images of their atomic arrangement along the high indexes zone axis. We have evidenced the presence of defects in these nanostructures that are not parallel to the electron beam. The precise stoichiometry of two iron oxides, FeO and Fe2O3, has been determined from an analysis of iron valence state that was obtained from a direct analysis of EELS fine structures spectrum of the two oxides.

The dental erosion or decalcification of enamel is a significant clinical problem. Apple acidic beverages are thought to increase the potential for dental erosion. The purpose of this in vitro study was to investigate the effect of clove essential oil (CEO) and its active principles on tooth decalcification of apple juices. On GC-MS analysis, CEO showed a high content of eugenol (58.29%) and eugenyl acetate (19.10%). Teeth specimens were randomly divided into 5 treatment groups: control, CEO, eugenol, eugenyl-acetate, and fluoride. The specimens were exposed for 24 h and were analyzed for calcium contents using Inductively Coupled Plasma with Optical Emission Spectroscopy (ICP-OES). Data were analyzed using student t-test (P < 0.05). CEO, eugenol, and eugenyl-acetate significantly decreased the decalcification of tooth by the apple juice to only 17, 24, and 21 mgL(-1), respectively. Hemolytic activity on human erythrocytes was studied to exclude the possibility of further associated cytotoxicity. It was observed that the CEO and its two lead molecules inhibit the decalcification and/or promote the remineralization caused by the apple juices. The effect of the test compounds appears to be distinct like that of fluoride treatment. CEO may, therefore, serve to be a promising adjunct to fluoride in the treatment of root caries during minimally invasive therapy.

CeO(2) nanotubes have been synthesized with a simple solid-liquid interface reaction route in the absence of any surfactants. Although the basic reaction principles are similar, two kinds of nanotubes with completely different morphologies and structures can be generated by slightly tuning the postprocessing conditions. The first formation involves employing Ce(OH)CO(3) nanorods as both the physical and chemical templates, and the other requires layered Ce(OH)3 as an anisotropic intermediate species. During this process, NaOH and reaction temperature were demonstrated as the key factors responsible for the formation of Ce(OH)(3) intermediate and final CeO(2) nanotubes with well-defined structures. The structural details were provided by a combination of XRD, SEM, TEM, and HRTEM investigations. Catalytic measurement shows that both nanotubes are very active for CO oxidation, and at 250 degrees C, the conversion rates of CeO(2) nanotubes are 3 times higher than that of the bulk counterpart.

In this paper, CeO(2) nanotubes based on the Kirkendall effect (for simplicity, this type of nanotubes is denoted as K-type CeO(2) nanotubes) are fabricated through a solid-liquid interface reaction between Ce(OH)CO(3) nanorods and NaOH solutions. Our studies indicate the formation mechanism of K-type CeO(2) nanotubes is quite different from those of CeO(2) nanotubes subjected to template (T-type CeO(2) nanotubes) and lamellar rolling (L-type CeO(2) nanotubes) reported previously by our group. The K-type CeO(2) nanotubes are prepared by congregating Kirkendall voids and subsequent calcinations. The time evolution processes are imaged by TEM, and the results show that as the reaction processes, interior spaces are formed and enlarged in Ce(OH)CO(3) nanorods to form K-type CeO(2) nanotubes. In contrast, the interior space in T-type CeO(2) nanotubes decreases with reaction time. XRD is applied to study the phase transformation in the formation process of K-type CeO(2) nanotubes. Our study also indicates NaOH and reaction temperature are two key factors responsible for formation of K-type CeO(2) nanotubes. Combined with the T- and L-type nanotubes, three types of CeO(2) nanotubes with different formation mechanisms are successfully synthesized in one reaction system, which might afford some guidance for the synthesis of other inorganic nanotubes.

The main objective of this paper is to describe how indicators of the equity of access to health care according to socioeconomic conditions may be included in a performance evaluation system (PES) in the regional context level and in the planning and strategic control system of healthcare organisations. In particular, the paper investigates how the PES adopted, in the experience of the Tuscany region in Italy, indicators of vertical equity over time. Studies that testify inequality of access to health services often remain just a research output and are not used as targets and measurements in planning and control systems. After a brief introduction to the concept of horizontal and vertical equity in health care systems and equity measures in PES, the paper describes the 'equity process' by which selected health indicators declined by socioeconomic conditions were shared and used in the evaluation of health care institutions and in the CEOs' rewarding system, and subsequently analyses the initial results. Results on the maternal and child path and the chronicity care path not only show improvements in addressing health care inequalities, but also verify whether the health system responds appropriately to different population groups.