Smoothing the trail for dissemination of evidence-based practices for youth: Flexibility within fidelity.

The role and implementation of evidence-based practice and empirically supported treatments has been hotly contested among researchers and practitioners. Using examples of and from various empirically supported treatments the authors offer suggestions for smoothing the pathway for dissemination of evidence-based practice with children and adolescents. The authors underscore that mediational analyses, treatment process studies, and the continued creation of flexible treatment manuals are important components of successful dissemination. Flexibility within fidelity is proposed as the preferred perspective that eases the transition and dissemination of empirically supported treatments from research clinics to service clinics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Targeted,Needle‐Free Vaccinations in Skin using Multilayered,Densely‐Packed Dissolving Microprojection Arrays

Targeting of vaccines to abundant immune cell populations within our outer thin skin layers using miniaturized devices—much thinner than a needle and syringe, could improve the efficacy of vaccines (and other immunotherapies). To meet this goal, a densely packed dissolving microprojection array (dissolving Nanopatch) is designed, achieving functional miniaturization by 1) formulating small microneedles (two orders of magnitude smaller than a standard needle and syringe) and 2) multiple layering of the payload within microprojections with tight tolerances (of the order of a micrometer). The formulation method is suitable to many vaccines because it is without harsh or complex chemical processes, and it is performed at low temperatures and at a neutral pH. When the formulated dNPs are applied to skin, consistent and robust penetration is achieved, rapidly targeting the skin strata of interest (<5 min; significantly faster than larger dissolving microneedles that have been previously reported). Resultant diffusion is significantly enhanced within the dermis compared with the epidermis. Using two different antigens (ovalbumin and a commercial trivalent influenza vaccine [Fluvax2008]), the administration of these dissolving patches generate robust systemic immune responses in a mouse model. To the authors' knowledge, this is the first report of successful vaccination with any form of dissolving microneedles. The patches made by this method therefore have the potential for pain‐free, needle‐free, and effective vaccination in humans.     

Ceramic fuel cells to replace metal burners

Global warming is thought to result from emissions largely caused by combustion reactions. Designs of burners and specifications of their materials are therefore of primary importance in restraining the warming phenomena. This paper proposes a new type of ceramic burner which incorporates many of the innovations which are needed to improve burner performance, including catalytic combustion, premixed fuel/air, recuperation of combustion heat, recycling of reaction products, electric-ignition and electron extraction. The key problems of fuel variation and thermal shock resistance of the ceramic are addressed through the concept of 'reaction gradient' in which the rich sequence of oxidation reactions during combustion is spread through three extended catalytic regimes along the isothermal ceramic device. It is evident that ceramic burners are necessary to provide catalytic activity and to promote electron transfer. The conclusion is that ceramic will ultimately replace metal in burners requiring low emissions and high exergy output.     

Nuclear Morphometry in Normal and SV-40 Transformed Human Diploid Fibroblasts

These experiments were designed to compare the densitometric, morphometric, and texture characteristics of intact nuclei from stationary WI-38 human diploid fibroblasts and their stationary SV40-transformed counterparts (2RA cells) by means of automated image analysis and to compare the differences in template activity of the chromatins isolated from the two cell lines. While the frequency distributions of directly measured parameters as area and IOD show a substantial overlap between WI-38 and 2RA cells, average optical density parameter derived as IOD per unit area, yields two distinctly separated distributions, which permit objective identifications of individual SV40 transformed cells. Chromatin of the stationary 2RA cells appears more condensed than that of the confluent WI-38 cells, quite compatible with the decreased template activity of chromatin from transformed cells.     

Overcoming language barriers when teaching the Advanced Trauma Life Support course

OBJECTIVES: To determine whether blurred vision caused by exposure to triethylamine (TEA) can be detected by the measurement of contrast sensitivity. METHODS: 41 cold box core makers of three foundries and 82 control workers were examined. A detailed ocular and medical history was obtained from the subjects. The contrast sensitivity of the core makers was measured on Monday and Friday of the same week both before and immediately after work and also on a third day, when air samples of TEA were collected. Contrast sensitivity and visual acuity were measured by optotype figures at full contrast, 2.5% contrast, and 0.6% contrast. The changes in contrast sensitivity were used for the analysis. The results of binocular vision and the results of the dominant eye were analysed. Urine specimens for the analysis of TEA were collected on every occasion when contrast sensitivity was measured. RESULTS: 78% of the core makers had had symptoms of blurred vision, and 31% had had trouble driving or working. The breathing zone eight hour time weighted average TEA concentrations were 0.3-60 mg/m3. The mean urinary TEA concentration after the shift was 35 mmol/mol creatinine. Continuous monitoring showed high peaks of TEA leakage at a core making machine. Changes in binocular visual acuity did not differ between the exposed and unexposed workers. The contrast sensitivity decreased in 49% of the core makers and 21% of the controls (P = 0.002). CONCLUSIONS: The blurred vision caused by exposure to TEA can be documented by measuring contrast sensitivity. The mechanism by which TEA produces symptoms remains an issue of further study.     

A comparison of the effectiveness of malignancy detection in body fluid examination by the cytopathology and hematology laboratories

BACKGROUND: Body fluid specimens in many institutions are submitted for cytologic examination as well as for examination in a clinical microscopy or hematology laboratory. The cytology laboratory is generally seen as the standard for detection of malignancy, whereas the clinical microscopy laboratory is often depended on predominantly for cell counting and categorization. METHODS: To analyze the effectiveness of the hematology laboratory at detecting malignant fluids, this study retrospectively analyzed reports on 397 body fluid specimens (cerebrospinal, pericardial, peritoneal, and pleural) that were concurrently submitted over a 12-month period to both the cytopathology laboratory and the hematology laboratory. RESULTS: Thirty-seven (9.3%) of the cases were diagnosed as malignant by at least one of the two examinations. The cytopathology examination reported 27 (73%) of the 37 malignant cases as malignant and 30 (81.1%) as at least atypical (27 malignant and 3 inconclusive), and the hematology examination reported 34 (91.9%) as malignant and 36 (97.3%) as at least atypical. A concordant malignant diagnosis was given by both laboratories in 24 (64.9%) of the 37 cases. CONCLUSIONS: These results show that examination of specimens by the hematology laboratory can provide a highly sensitive diagnostic evaluation in addition to its more customary role of providing timely cell counts.