An update in breast cancer epidemiology and healthcare services in Malta

Cancer of the breast is the most common malignancy and the leading cause of cancer-related mortality in women. Over the past 20 years, mortality from breast cancer in Malta has shown a steady decline and survival from this disease has registered marked improvement, despite the fact that incidence continues to increase. Increased awareness as well as the development of specialized breast care health services have resulted in positive outcomes, with local mortality rates approaching that of the EU-15 average.peer-reviewe

A model study of the effects of climatic precipitation changes on ground temperatures

Temperature changes at the Earth surface propagate into the subsurface and leave a thermal signature in the underlying soil and rock. Inversions of subsurface temperature measurements yield reconstructions of ground surface temperature (GST) histories that provide estimates of climatic changes. A question remaining in the interpretation of reconstructed GST histories is the extent to which GST changes reflect changes principally in surface air temperature (SAT), or whether other factors may be significant. Here we use a Land Surface Processes (LSP) model to examine the influence of precipitation changes on GST and subsurface temperature and moisture fields on annual to decadal timescales. We model soil and vegetation conditions representative of a prairie region in the southern Great Plains of North America and force the model with meteorological data synthesized from a typical year in the region. Model responses are observed after changes in the amount of daily precipitation, the intensity and frequency of daily precipitation, and the diurnal and seasonal timing of precipitation. We show that: (1) increasing daily precipitation cools mean annual GST, (2) increasing the intensity and reducing the frequency of daily precipitation, while holding the annual amount of precipitation constant, cools mean annual GST, and (3) shifting maximum precipitation to occur in the warmest months cools mean annual GST. We compare modeled results to observed precipitation changes during the 20th century and conclude that the observed precipitation changes would cause only small changes to GST within the modeled region, on the order of 0.1 K or less

The Influence of Soil Moisture Upon the Geothermal Climate Signal

Estimates of regional climate warming over the past few hundred years are being obtained from profiles of borehole temperature versus depth. The assumptions in recovering mean annual Surface Air Temperature (SAT) are that the relationship between the Ground Surface Temperature (GST) and the temperature-depth profile is purely conductive, and that SAT is uniquely coupled to GST. While these assumptions have been demonstrated to be approximately valid, they ignore the role of moisture transport in soil between soil and atmosphere. In this study we examine the influence of climatic changes in precipitation upon mean annual GST with climatic SAT held constant. We use the most recent version of our Prairie SVAT model for a set of 80 years simulations. Our findings are 10 increasing precipitation reduces mean annual GST, 2) phasing maximum precipitation to occur during the warmest months reduces mean annual GST, and 3) increasing the variance of precipitation reduces mean annual GST. The amplitudes of the effects are small but potentially not insignificant fractions of the geothermal climate signal. One of the long-term objectives of this investigation is to use global EOS SAT and remotely sensed soil moisture to link region-specific, geothermal climate signal histories to evolution of regional climate

mechanistic promiscuity in hydrogen atom abstraction reactions

In addition to oxometal [Mn+[double bond, length as m-dash]O] and imidometal [Mn+[double bond, length as m-dash]NR] units, transient metal–iodosylarene [M(n−2)+–O[double bond, length as m-dash]IPh] and metal–iminoiodane [M(n−2)+–N(R)[double bond, length as m-dash]IPh] adducts are often invoked as a possible “second oxidant” responsible for the oxo and imido group transfer reactivity. Although a few metal–iodosylarene adducts have been recently isolated and/or spectroscopically characterized, metal–iminoiodane adducts have remained elusive. Herein, we provide UV-Vis, EPR, NMR, XAS and DFT evidence supporting the formation of a metal–iminoiodane complex 2 and its scandium adduct 2-Sc. 2 and 2-Sc are reactive toward substrates in the hydrogen-atom and nitrene transfer reactions, which confirm their potential as active oxidants in metal-catalyzed oxidative transformations. Oxidation of para-substituted 2,6-di-tert-butylphenols by 2 and 2-Sc can occur by both coupled and uncoupled proton and electron transfer mechanisms; the exact mechanism depends on the nature of the para substituent

Serum amyloid protein is associated with outcome following acute ischaemic stroke: data from the REmote ischaemic Conditioning After Stroke Trial (RECAST)

Background: Remote ischaemic per-conditioning (RIC) in experimental ischaemic stroke is neuroprotective. Several neurohumoral, vascular and inflammatory mediators are implicated. Methods: The REmote ischaemic Conditioning After Stroke Trial (RECAST) was a pilot blinded sham-controlled trial in patients with ischaemic stroke, randomised to receive four 5-minute cycles of RIC within 24 hours of ictus. Plasma taken pre-intervention, immediately post-intervention and on day 4 was analysed for nitric oxide (nitrate/nitrite) levels using chemiluminescence and other biomarkers were analysed by enzyme-linked immunosorbent assay (ELISA): alpha-2-macroglobulin (A2M), serum amyloid protein (SAP), e-selectin, vascular endothelial growth factor (VEGF). Biomarkers were correlated with outcome (Day 90 National Institutes of Health Stroke Scale [NIHSS], modified Rankin scale [mRS], Barthel index [BI]) using Pearson’s correlation coefficient. Results: In all 26 patients, an increase in SAP (pre- to post-intervention) positively correlated with worse day 90 mRS (r=0.429, p=0.029) and negatively with worse BI (r=-0.392, p=0.048), whilst an increase in SAP from day 0 to 4 positively correlated with worse day 90 NIHSS (r=0.400, p=0.043), mRS (r=0.505, p=0.008) and negatively with worse BI (r=-0.439, p=0.025). RIC reduced SAP levels from pre- to post-intervention (n=13, 2-way ANOVA, p<0.05), whilst sham did not. No significant changes over time or by treatment, or correlations with outcome were seen for A2M, e-selectin, nitric oxide or VEGF. Conclusion: Increased plasma levels of SAP are associated with worse clinical outcomes after ischaemic stroke. RIC reduced SAP levels from pre- to post-intervention. Larger studies assessing biomarkers and efficacy of RIC in acute ischaemic stroke are warranted

Mechanochemical Synthesis of Tripodal Tris4-(1,2,3-triazol-5-ylidene)methylamine Mesoionic Carbene Ligands and Their Complexation with Silver(I)

The conjugate acids of 1,2,3-triazolylidene mesoionic carbenes can be prepared in a straightforward fashion by alkylation of 1-substituted 1,2,3-triazoles. However, this becomes a much more challenging proposition when other nucleophilic centers are present, which has curtailed the development of ligands containing multiple 1,2,3-triazolylidene donors. Herein, methylation of a series of tris[(1-aryl-1,2,3-triazol-4-yl)methyl]amines possessing both electron-rich and electron-deficient aromatic substituents, using Me3OBF4, is shown to proceed with much higher chemoselectivity under mechanochemical conditions than when conducted in solution. This provides a means to reliably access a series of tricationic tris[4-(1,2,3-triazolium)methyl]amines in good yields. DFT calculations suggest that a potential reason for this change in regioselectivity is the difference between the background dielectric of the DCM solution versus the solid state, which is predicted to have a large effect on the relative thermodynamic driving force for alkylation of the tertiary amine center versus the triazole rings. Homoleptic silver complexes of the triazolylidene ligands derived therefrom, of formulas [Ag3(1a-d)2](X)3 (X- = BF4-, TfO-), have been isolated and fully characterized. In the case of the ligand bearing the smallest aryl substituents, 1b, argentophilic interactions yield a triangular Ag3 core. The [Ag3(1a-d)2](X)3 silver salts are viable agents for transmetalation to other transition metals, demonstrated here for cobalt. In the case of 1a, the complex [CoII(1a)(NCMe)](OTf)2 was obtained. Therein, the bulky mesityl substituents enforce a tetrahedral geometry, in which only the triazolylidene donors of 1a coordinate (i.e., it acts as a tridentate ligand). Transmetalation of the less sterically encumbered ligand 1b yields six-coordinate cobalt(III) complexes, [CoIII(1b)(Cl)(NCMe)](OTf)2 and [CoIII(1b)(NCMe)2](OTf)3, in which the ligand coordinates in a tetradentate fashion. These are the first examples of tris(1,2,3-triazolylidene) ligands containing an additional coordinating heteroatom and, more generally, of tetradentate 1,2,3-triazolylidene ligands. Crucially, we believe that the divergent chemoselectivity under mechanochemical conditions (vs conventional solution-based chemistry) demonstrated herein offers a pathway by which other challenging synthetic targets, including further multidentate carbene ligands, can be prepared in superior yields

Predictors and outcomes of neurological deterioration in intracerebral hemorrhage: results from the TICH-2 randomised controlled trial

Neurological deterioration is common after intracerebral hemorrhage (ICH). We aimed to identify the predictors and effects of neurological deterioration and whether tranexamic acid reduced the risk of neurological deterioration. Data from the Tranexamic acid in IntraCerebral Hemorrhage-2 (TICH-2) randomized controlled trial were analyzed. Neurological deterioration was defined as an increase in National Institutes of Health Stroke Scale (NIHSS) of ≥ 4 or a decline in Glasgow Coma Scale of ≥ 2. Neurological deterioration was considered to be early if it started ≤ 48 h and late if commenced between 48 h and 7 days after onset. Logistic regression was used to identify predictors and effects of neurological deterioration and the effect of tranexamic acid on neurological deterioration. Of 2325 patients, 735 (31.7%) had neurological deterioration: 590 (80.3%) occurred early and 145 (19.7%) late. Predictors of early neurological deterioration included recruitment from the UK, previous ICH, higher admission systolic blood pressure, higher NIHSS, shorter onset-to-CT time, larger baseline hematoma, intraventricular hemorrhage, subarachnoid extension and antiplatelet therapy. Older age, male sex, higher NIHSS, previous ICH and larger baseline hematoma predicted late neurological deterioration. Neurological deterioration was independently associated with a modified Rankin Scale of > 3 (aOR 4.98, 3.70–6.70; p [less than] 0.001). Tranexamic acid reduced the risk of early (aOR 0.79, 0.63–0.99; p = 0.041) but not late neurological deterioration (aOR 0.76, 0.52–1.11; p = 0.15). Larger hematoma size, intraventricular and subarachnoid extension increased the risk of neurological deterioration. Neurological deterioration increased the risk of death and dependency at day 90. Tranexamic acid reduced the risk of early neurological deterioration and warrants further investigation in ICH

Inducing Panchromatic Absorption and Photoconductivity in Polycrystalline Molecular 1D Lead-Iodide Perovskites through π-Stacked Viologens

As a consequence of their quantum- and electronically-confined inorganic lattices, molecular 1D lead-iodide perovskites are ill suited to photovoltaic (PV) applications. In order to circumvent these problems, we utilized electron accepting viologen (N,N'-dialkyl-4,4'-bipyridinium) dications incorporating hydrogen bond donor functionalities, which served to induce π-π stacking interactions. The resulting 'viologen dimers' display enhanced charge-transfer (CT) interactions with the 1D lead-iodide nanowires. This manifests in extended light absorption (up to 800 nm), reduced band gaps (1.74 eV to 1.77 eV), and longer photoluminescence lifetimes. More importantly, we demonstrate significant photoconductivity behavior in polycrystalline molecular 1D lead-iodide perovskites for the first time. Thus, this work offers a strategy for inducing the properties required for PV applications in molecular 1D lead-iodide perovskites. © 2018 American Chemical Society

FY13 High Performance EVA Glove (HPEG) Collaboration: Glove Injury Data Mining Effort - Training Data Overview

From the time hand-intensive tasks were first created for EVAs, discomforts and injuries have been noted.. There have been numerous versions of EVA gloves for US crew over the past 50 years, yet pain and injuries persist. The investigation team was tasked with assisting in a glove injury assessment for the High Performance EVA Glove (HPEG) project.center dot To aid in this assessment, the team was asked to complete the following objectives: - First, to develop the best current understanding of what glove-related injuries have occurred to date, and when possible, identify the specific mechanisms that caused those injuries - Second, to create a standardized method for comparison of glove injury potential from one glove to another. center dot The overall goal of the gloved hand injury assessment is to utilize ergonomics in understanding how these glove injuries are occurring, and to propose mitigations to current designs or design changes in the next generation of EVA gloves

Serum amyloid protein is associated with outcome following acute ischaemic stroke: data from the REmote ischaemic Conditioning After Stroke Trial (RECAST)

Background: Remote ischaemic per-conditioning (RIC) in experimental ischaemic stroke is neuroprotective. Several neurohumoral, vascular and inflammatory mediators are implicated. Methods: The REmote ischaemic Conditioning After Stroke Trial (RECAST) was a pilot blinded sham-controlled trial in patients with ischaemic stroke, randomised to receive four 5-minute cycles of RIC within 24 hours of ictus. Plasma taken pre-intervention, immediately post-intervention and on day 4 was analysed for nitric oxide (nitrate/nitrite) levels using chemiluminescence and other biomarkers were analysed by enzyme-linked immunosorbent assay (ELISA): alpha-2-macroglobulin (A2M), serum amyloid protein (SAP), e-selectin, vascular endothelial growth factor (VEGF). Biomarkers were correlated with outcome (Day 90 National Institutes of Health Stroke Scale [NIHSS], modified Rankin scale [mRS], Barthel index [BI]) using Pearson’s correlation coefficient. Results: In all 26 patients, an increase in SAP (pre- to post-intervention) positively correlated with worse day 90 mRS (r=0.429, p=0.029) and negatively with worse BI (r=-0.392, p=0.048), whilst an increase in SAP from day 0 to 4 positively correlated with worse day 90 NIHSS (r=0.400, p=0.043), mRS (r=0.505, p=0.008) and negatively with worse BI (r=-0.439, p=0.025). RIC reduced SAP levels from pre- to post-intervention (n=13, 2-way ANOVA, p<0.05), whilst sham did not. No significant changes over time or by treatment, or correlations with outcome were seen for A2M, e-selectin, nitric oxide or VEGF. Conclusion: Increased plasma levels of SAP are associated with worse clinical outcomes after ischaemic stroke. RIC reduced SAP levels from pre- to post-intervention. Larger studies assessing biomarkers and efficacy of RIC in acute ischaemic stroke are warranted