Origin of anomalous magnetite properties in crystallographic matched heterostructures: Fe3O4(111)/MgAl2O4(111)

Magnetite films grown on crystallographically matched substrates such as MgAl2O4 are not expected to show anomalous properties such as negative magnetoresistance and high saturation fields. By atomic resolution imaging using scanning transmission electron microscopy we show direct evidence of anti-phase domain boundaries (APB) present in these heterostructures. Experimentally identified 1/4<101> shifts determine the atomic structure of the observed APBs. The dominant non-bulk superexchange interactions are between 180° octahedral-Fe/O/octahedral-Fe sites which provide strong antiferromagnetic coupling across the defect interface resulting in non-bulk magnetic and magnetotransport properties.

Primary tobacco prevention in China--a systematic review

OBJECTIVES

This systematic review of randomized controlled trials aims to identify and describe primary tobacco prevention programs conducted in China and to evaluate their quality and effectiveness.

METHODS

Published studies in English or Chinese were searched in MEDLINE, EMBASE, GLOBAL HEALTH, PsycINFO, Wanfang and CNKI. Eligible studies were randomized controlled trials tailored for a Chinese population. Primary preventive non-pharmacological interventions for smoking cessation or reduction were evaluated. Trials were included if they applied at least one predefined outcome suited for measuring the reduction of smoking rates or the reduction of smoking related morbidity. Two reviewers independently assessed studies for inclusion. The risk of bias in individual studies was evaluated by determining the adequacy of methodological quality criteria.

RESULTS

A total of 21 eligible studies investigating 53,520 patients (range 88 - 30,544) an age between 9.6 and 65 years were identified. All interventions were based on some kind of health education programs. In most cases standard health advice was given and booklets were distributed. The overall methodological quality of the studies was low. Seven studies (33%) showed a statistical significant effect of the described intervention in all predefined outcomes.

CONCLUSION

The documentation of smoking prevention interventions in China is not sufficient to develop effective and reliable action programs. A lack of quality in the design can be discerned rather than a lack in starting interventions. We therefore recommend future interventions to be planned, implemented and conducted in compliance with high quality standards for example Guideline for Good Clinical Practice. Furthermore for preparing reports of RCT findings we recommend the Consolidated Standards of Reporting Trials.

[IQWiG's methods for the cost-benefit assessment : Comparison with an international reference scenario]

Standardization of international health economic guidelines has been repeatedly requested. In this context, an international reference case was proposed, which constitutes an agreed approach for the key elements of health economic evaluation including study perspective, comparators, source of effectiveness data, role of modeling, main (economic) outcome, source of utilities, characterizing uncertainty. It is, however, questionable whether such a reference scenario can reasonably be applied across all health care systems. Our analysis pursues the question to which degree the Institute for Quality and Efficiency in Health Care's (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG) "General methods for evaluating the relation between cost and benefit" comply with the key elements of the reference case. In case of divergences, they will be described and discussed in light of the German social legislation and in consideration of current scientific evidence. In conclusion, the analysis revealed that IQWiG complied with the reference case in almost all aspects. Differences were found only with respect to the choice of main (economic) outcome and the source of utilities. These differences seem justified and well explained in the context of the German social legislation as well as in view of the weaknesses of the quality-adjusted life year (QALY) concept.

[Methods of health economic evaluation for health services research]

On August 30, 2010, the German Network for Health Services Research [Deutsches Netzwerk Versorgungsforschung e. V. (DNVF e. V.)] approved the Memorandum III "Methods for Health Services Research", supported by the member societies mentioned as authors and published in this Journal [Gesundheitswesen 2010; 72: 739-748]. The present paper focuses on methodological issues of economic evaluation of health care technologies. It complements the Memorandum III "Methods for Health Services Research", part 2. First, general methodological principles of the economic evaluations of health care technologies are outlined. In order to adequately reflect costs and outcomes of health care interventions in the routine health care, data from different sources are required (e. g., comparative efficacy or effectiveness studies, registers, administrative data, etc.). Therefore, various data sources, which might be used for economic evaluations, are presented, and their strengths and limitations are stated. Finally, the need for methodological advancement with regard to data collection and analysis and issues pertaining to communication and dissemination of results of health economic evaluations are discussed.

The nocebo effect: a reason for patients' non-adherence to generic substitution?

Substituting generic formulations of the same chemical agent is a common practice in German health care on the basis of so called rebate contracts. The substitution of a medication may affect the patients' adherence or result in adverse events. While adverse events which may be caused by the pharmacological activity of the agent itself can be explained, some non-specific side effects cannot be substantiated referring to pharmacological factors. These adverse reactions are summarized under the term nocebo effect. Since patients experiencing a nocebo effect can subsequently become non-adherent or even discontinue an appropiate therapy, the aim of this article is to study patients' adherence to generic substitution and the extent of the nocebo effect. In MEDLINE and EMBASE, a search was carried out for articles which were published between March 25th, 1989 and March 25th, 2009 by using the following search terms: generic substitution, adherence, non-adherence, non-persistence, rebate contracts, patients' attitude, nocebo, negative placebo effects, placebo adverse reactions, placebo induced side effects and negative placebo responses. In addition a manual search was performed in the reference lists of the articles retrieved. 14 studies met the inclusion and exclusion criteria and were included in this article. The generic substitution was generally accepted by over two thirds of the study populations. But up to 34% of patients being treated for psychological diseases confronted with a change of their medication had additional adverse events. On the basis of the studies analysed, the conclusion can be drawn that the nocebo effect can play a crucial role in the treatment of psychological diseases. Therefore, physicians and pharmacists should be responsible to prevent the nocebo effect through adequately educating the patients.

European Academy of Paediatrics Research in Ambulatory Setting network (EAPRASnet): a multi-national general paediatric research network for better child health

BACKGROUND

In 2008, the European Academy of Paediatrics launched a paediatric-based research network - EAPRASnet (European Academy of Paediatrics Research in Ambulatory Setting network). The network has recruited primary care and general paediatricians from European and Mediterranean countries.

METHODS

Every paediatrician joining the network has been asked to complete a recruitment survey. The aims of the survey were to characterize paediatrician's demographics, practice arrangements and patient's demographics, to define main incentives for research, and to learn what paediatricians view as unsolved issues that need to be studied.

RESULTS

A total of 156 paediatricians from 19 countries were recruited with 144 completing the questionnaire (92%). Majority of respondents (89%) were general paediatricians for more than half of their time. Practice arrangement of 47% of paediatricians was solo practice, with 40% in group practice. Electronic medical records were being used by 72% of respondents. Over 70% of the paediatricians had more than 1000 patients under their clinical care, and patients younger than 6 years old contributed nearly half of the patient population. Areas of most interest for research were: quality of care indicators, communication with parents, obesity, attention deficit hyperactivity disorder and effective well child care. Main incentives for participation in a research project were interest in the topic (81%) and effort to improve quality of care (71%). Lack of time was the leading reported obstacle for research activity (72%). EAPRASnet is growing, and the network's structure, operation and funding are described. Methods for joining the network and the process of study development are presented.

CONCLUSION

A core group of EAP general paediatricians are committed to research in their practices. The information gathered will serve for future planning of research projects in the EAPRASnet to harmonize and optimize the care given to children in the primary care setting in Europe.

Analysis of genotype by environment interaction for milk yield traits in first lactation of Simmental cattle

The breeding goal for Simmental cattle is derived for intensively managed dairy farms. Its suitability for extensive farms was addressed by analysing possible genotype by environment interaction (G x E) between the management levels for first lactation milk yield traits. A first analysis was performed with the data collected from 300 000 purebred daughters of 278 second crop bulls born in Bavaria in 1993 and 1994. The farms were classified by herd-year-effect, using the sum of fat and protein yields into two levels of management, either with 33 or 10% quantiles, corresponding to approximately 100 000 cows and 30 000 cows, respectively. The comparison was based on 'daughter yield' deviations (DYD). Correlations between DYD of extensive and intensive environments were 0.90, 0.91 and 0.87 for milk, fat and protein yield (kg) for 33% quantiles, respectively. Corresponding correlations for 10% quantiles were 0.85, 0.83 and 0.77. Despite high correlations, 50 out of 149 sires showed significant differences between DYD in different environments. Bulls with higher DYD for milk yield on intensive farms were superior in all environments. For the second analysis extensive and intensive farms in northern and southern Bavaria were chosen at random. Approximately 20 000 cows in each management class were used for the estimation of genetic parameters. In both regions phenotypic and additive-genetic variances were higher in the intensively managed herds. Likewise heritabilities were higher for fat and protein yield, but not for milk where higher heritabilities were observed in 33% quantiles. Genetic correlations between extensive and intensive environments were 0.97 and above (33% quantiles). Ten per cent quantiles led to lower genetic correlations (0.90-0.95). Although no serious re-ranking effects of sires were evident, the scale effect and the differences in genetic parameters should be taken into consideration in practical breeding.

[Diabetes insipidus in a Swiss Braunvieh heifer with internal hydrocephalus]

This case report describes the findings in a seven-month-old heifer with diabetes insipidus attributable to internal hydrocephalus. The heifer was referred to the clinic because of reduced appetite, polydipsia, decreased faecal output and weight loss. The heifer was examined daily for 8 days. She was thin and weak and had a dull dry hair coat and decreased appetite. The heifer urinated frequently; the urine was clear and yel low, had a specific gravity of 1.015. A complete blood cell count, biochemical profile and blood gas analysis revealed increased serum urea, increased serum creatinine, hypernatraemia, hyperchloraemia, hypercalcaemia and hypophosphataemia. The heifer received 10 litres of water and 3 litres of ruminal fluid from a healthy cow per os daily for 5 days. The heifer had access to fresh water ad libitum. The general condition of the heifer did not improve after this treatment. Although the concentration of serum urea and creatinine decreased, the concentrations of sodium, chloride and calcium remained higher than normal. Based on the findings, a diagnosis of diabetes insipidus was made and the heifer was euthanatized. Postmortem examination revealed severe internal hydrocephalus, and a definitive diagnosis of central diabetes insipidus attributable to internal hydrocephalus was made.

[Job satisfaction of hospital doctors. Results of a study of a national sample of hospital doctors in Germany]

AIMS

This paper presents the findings on the level of job satisfaction among hospital physicians in Germany and puts the results into relation to demographic variables and employment status.

METHODS

Data were collected as part of the survey "Work Life, Lifestyle and Health among Hospital Doctors in Germany 2006" using anonymous self-reporting questionnaires. Job satisfaction was scored using the scale according to Warr et al. It consists of 10 items with a seven-point Likert scale (1=dissatisfaction; 7=satisfaction), so the sum score ranks between 10 and 70. The following variables were correlated to job satisfaction: demographic variables (gender, age), and employment status (specialty, geographical localisation of hospital, hospital type, level of seniority, working time pattern).

RESULTS

The response rate was 58% (n=1917). Doctors reported an average job satisfaction of 44.3. Comparing different specialties, physicians in radiology had the highest (47.6) and in surgery (43.0) the lowest level of job satisfaction. Below-average job satisfaction could also be found in urology (43.5) and internal medicine (43.7). The regression analysis showed that the younger age group (B=-1.45; p=0.031) and those with a status as junior physician (B=-4.97; p=0.0001) were significantly dissatisfied. Out of the ten items assessed "working hours" (3.25), "payment" (3.59), "physical working conditions" (3.96) and "recognition for good work" (4.08) attained the lowest ratings.

CONCLUSIONS

Hospital doctors in Germany are moderately satisfied with their jobs - less satisfied than their colleagues in England, New Zealand and Norway. Improvement of job satisfaction and working conditions should be achieved via effective regulation of working hours and improvement of recognition for medical work regarding monetary and non-monetary factors such as payment and positive feedback for good work.

Offset reduction in Hall effect measurements using a nonswitching van der Pauw technique

A nonswitching van der Pauw technique, which uses two electrically isolated alternating current sources operating at two different frequencies and two lock-in amplifiers, is suggested for Hall effect measurements. Parasitic offset voltage, typical for this type of measurements, is reduced by averaging two sets of data accumulated simultaneously. Application of the technique is particularly useful when the offset changes on a time scale comparable to the measurement cycle.

Linear positive magnetoresistance and quantum interference in ferromagnetic metals

Positive, linear in field, and isotropic magnetoresistance in fields up to 60 T is found in geometrically constrained ferromagnets, such as thin films of iron, nickel, and cobalt and their granular mixtures with nonmagnetic materials. The resistivity measured as a function of temperature shows a minimum at temperatures reaching a remarkably high 92 K, followed by logarithmic dependence at low temperatures. We propose to explain both phenomena by a modified version of the quantum electron-electron interaction theory. The agreement is only qualitative while the observed magnitude of the magnetoresistance slope is much larger than the calculated one.

Fièvre intermittente: expression rare d'un adénocarcinome de l'ampoule de Vater

PURPOSE

Prolonged intermittent fevers are frequently seen in internal medicine and they constitute a real diagnosis challenge. Infection, auto-immune disease and neoplasy are the most common causes.

EXEGESIS

We report here a 48 year-old man with a prolonged intermittent fever. At first, all his assessments were negative and it's only secondary, as clinical and biological disturbances occur that the diagnosis of adenocarcinoma of the ampulla has been done.

CONCLUSION

Neoplasms represent a rare cause of intermittent prolonged fever, but we must always keep them in mind. In this case, any specific symptom was initially present to end up quickly to the solution.

Arthrite à pneumocoque révélant un myélome

INTRODUCTION

The most common presenting features of multiple myeloma are bone pain, anemia, renal failure or hypercalcemia. Bacterial infection as the initial presentation of this desease is rare.

CLINICAL CASE

We report the case of a 62-year-old man with pneumococcal septic arthritis of the knee revealing a multiple myeloma.

DISCUSSION

Pneumococcal infection should lead to a suspicion of underlying illness and especially the multiple myeloma.

Prevalence of chlamydiae in semen and genital tracts of bulls, rams and bucks

Chlamydiae infect male genital organs of ruminants. However, little is known about their prevalence. Hence, we investigated fresh and cryopreserved semen (bulls: n=304; rams: n=78; bucks: n=44) by polymerase chain reaction (PCR), as well as genital organs (bulls: n=13; rams: n=10; bucks: n=6) by immunohistochemistry (IHC) and PCR. Sera from bulls (n=104) and small ruminants (n=61) were tested by LPS and rMOMP (recombinant major outer membrane protein) ELISA and competitive ELISA (cELISA), respectively. Three PCR assays were compared in this study for detection of chlamydial DNA in semen: 16S rRNA, IGS-S (intergenic spacer 16S/23S-short), and IGS-L (intergenic spacer 16S/23S-long) PCRs. PCR sensitivity and inhibitory effects were determined by spiking semen with Chlamydophila (Cp.) abortus DNA. In bull semen, detection limits of the 16S, IGS-S and IGS-L PCRs were 10, 10, 100 templates, respectively. However, PCR sensitivity was reduced in ram and buck semen suggesting the presence of potential PCR inhibitors. Of 304 bull semen samples, the 16S PCR revealed DNA of chlamydiae in 20 samples (6.6%), including Cp. abortus (n=2), Cp. psittaci (n=1), Chlamydia suis (n=2), and Chlamydia-like organisms (n=15). In rams, one semen sample was positive for Chlamydia-like organism. All investigated male genital organs were negative for Chlamydia. Serology revealed 47.1% (49/104) positive bulls by LPS ELISA. Of these, 30 samples were positive by rMOMP ELISA, predominantly for Cp. pecorum. In small ruminants, cELISA displayed 34.8% (16/46) and 60% (9/15) positivity for Cp. abortus in rams and bucks, respectively. There was no correlation between serology and PCR of semen. The presence of chlamydiae in semen suggests the possibility of venereal transmission, although risk may be low in Switzerland.