The Monterey event in the Mediterranean: A record from shelf sediments of Malta

Oligo-Miocene carbonate platform and shelf sediments outcropping on the Maltese Islands provide an excellent archive of the paleoceanography of the central Mediterranean. A sequence of shallow water limestones, than shelf limestones, and marls, followed again by shallow water limestones, reflects drowning of a carbonate platform, the establishment of a shelf environment and, in the late Miocene, renewed progradation and aggradation of shallow water carbonates. The sequence recording the deepening of the Maltese platform contains several phosphorite hardgrounds and phosphorite pebble beds. These phosphorites were dated with strontium isotopes. Major episodes of phosphogenesis occurred between 25 and 16 Ma, and they are coeval with those phosphorite events reported from Florida and North Carolina. A Miocene carbon isotope and oxygen isotope stratigraphy was established on planktic and benthic foraminifera and on bulk samples. A major carbon isotope excursion with an amplitude of up to +l‰ between 18 and 12.5 Ma can be correlated with the globally recognized Monterey carbon isotope excursion. This is the first record of this event both in shallow water sediments and in the Mediterranean. The carbon isotope excursion precedes an oxygen isotope excursion which also was recognized in deep-sea records. Major episodes of phosphogenesis and platform drowning preceded the carbon isotope excursion by up to millions of years

All-aromatic biphenylene end-capped polyquinoline and polyimide matrix resins

Biphenylene end-capped polyquinoline and polyimide resins afford low void content graphite-reinforced composites with good initial properties. However, with both resins, rapid degradation occurs during oxidative isothermal aging at elevated temperatures. The degradation is not observed during isothermal aging under a nitrogen atmosphere which suggests that the biphenylene end-cap (or the resulting crosslink/chain extension structures) is not particularly thermooxidatively stable. The nature of the thermooxidative instability is currently under investigation

Technology Assessment for Large Vertical-Lift Transport Tiltrotors

The technical community has identified rotor efficiency as a critical enabling technology for large vertical-lift transport (LVLT) rotorcraft. The size and performance of LVLT aircraft will be far beyond current aircraft capabilities, enabling a transformational change in cargo transport effectiveness. Two candidate approaches for achieving high efficiency were considered for LVLT applications: a variable-diameter tiltrotor (VDTR) and a variable-speed tiltrotor (VSTR); the former utilizes variable-rotor geometry and the latter utilizes variable-rotor speed. Conceptual aircraft designs were synthesized for the VDTR and VSTR and compared to a conventional tiltrotor (CTR). The aircraft were optimized to a common objective function and bounded by a set of physical- and requirements-driven constraints. The resulting aircraft were compared for weight, size, performance, handling qualities, and other attributes. These comparisons established a measure of the relative merits of the variable-diameter and -speed rotor systems as enabling technologies for LVLT capability

Methyl 4-(piperidin-1-ylcarbon­yl)benzoate

In the title compound, C14H17NO3, the piperidine ring has a chair conformation and an intra­molecular C—H⋯O inter­action stabilizes the mol­ecular conformation. In the crystal, weak inter­molecular C—H⋯O inter­actions occur

Retrospective Evaluation of Control Measures for Contacts of Patient with Marburg Hemorrhagic Fever

Measures had substantial effects on contacts and household members

Preparation of amino-substituted indenes and 1,4-dihydronaphthalenes using a one-pot multireaction approach: total synthesis of oxybenzo[c]phenanthridine alkaloids

Allylic trichloroacetimidates bearing a 2-vinyl or 2-allylaryl group have been designed as substrates for a one-pot, two-step multi-bond-forming process leading to the general preparation of aminoindenes and amino-substituted 1,4-dihydronaphthalenes. The synthetic utility of the privileged structures formed from this one-pot process was demonstrated with the total synthesis of four oxybenzo[c]phenanthridine alkaloids, oxychelerythrine, oxysanguinarine, oxynitidine, and oxyavicine. An intramolecular biaryl Heck coupling reaction, catalyzed using the Hermann–Beller palladacycle was used to effect the key step during the synthesis of the natural products

The breadth of primary care: a systematic literature review of its core dimensions

Background: Even though there is general agreement that primary care is the linchpin of effective health care delivery, to date no efforts have been made to systematically review the scientific evidence supporting this supposition. The aim of this study was to examine the breadth of primary care by identifying its core dimensions and to assess the evidence for their interrelations and their relevance to outcomes at (primary) health system level. Methods: A systematic review of the primary care literature was carried out, restricted to English language journals reporting original research or systematic reviews. Studies published between 2003 and July 2008 were searched in MEDLINE, Embase, Cochrane Library, CINAHL, King's Fund Database, IDEAS Database, and EconLit. Results: Eighty-five studies were identified. This review was able to provide insight in the complexity of primary care as a multidimensional system, by identifying ten core dimensions that constitute a primary care system. The structure of a primary care system consists of three dimensions: 1. governance; 2. economic conditions; and 3. workforce development. The primary care process is determined by four dimensions: 4. access; 5. continuity of care; 6. coordination of care; and 7. comprehensiveness of care. The outcome of a primary care system includes three dimensions: 8. quality of care; 9. efficiency care; and 10. equity in health. There is a considerable evidence base showing that primary care contributes through its dimensions to overall health system performance and health. Conclusions: A primary care system can be defined and approached as a multidimensional system contributing to overall health system performance and health

Primary care strategies to improve childhood immunisation uptake in developed countries: systematic review

OBJECTIVES: To conduct a systematic review of strategies to optimize immunisation uptake within preschool children in developed countries. DESIGN: Systematic review. SETTING: Developed countries PARTICIPANTS: Preschool children who were due, or overdue, one or more of their routine primary immunisations. MAIN OUTCOME MEASURES: Increase in the proportion of the target population up to date with standard recommended universal vaccinations. RESULTS: Forty-six studies were included for analysis, published between 1980 and 2009. Twenty-six studies were randomized controlled trials, 11 were before and after trials, and nine were controlled intervention trials. Parental reminders showed a statistically significant increase in immunisation rates in 34% of included intervention arms. These effects were reported with both generic and specific reminders and with all methods of reminders and recall. Strategies aimed at immunisation providers were also shown to improve immunisation rates with a median change in immunisation rates of 7% when reminders were used, 8% when educational programmes were used and 19% when feedback programmes were used. CONCLUSION: General practitioners are uniquely positioned to influence parental decisions on childhood immunisation. A variety of strategies studied in primary care settings have been shown to improve immunisation rates, including parental and healthcare provider reminders

Functionalized Poly(3-hexylthiophene)s via Lithium–Bromine Exchange

Poly(3-hexylthiophene) (P3HT) is one of the most extensively investigated conjugated polymers and has been employed as the active material in many devices including field-effect transistors, organic photovoltaics and sensors. As a result, methods to further tune the properties of P3HT are desirable for specific applications. Herein, we report a facile postpolymerization modification strategy to functionalize the 4-position of commercially available P3HT in two simple steps–bromination of the 4-position of P3HT (Br–P3HT) followed by lithium−bromine exchange and quenching with an electrophile. We achieved near quantitative lithium–bromine exchange with Br–P3HT, which requires over 100 thienyl lithiates to be present on a single polymer chain. The lithiated-P3HT is readily combined with functional electrophiles, resulting in P3HT derivatives with ketones, secondary alcohols, trimethylsilyl (TMS) group, fluorine, or an azide at the 4-position. We demonstrated that the azide-modified P3HT could undergo Cu-catalyzed or Cu-free click chemistry, significantly expanding the complexity of the structures that can be appended to P3HT using this method.National Science Foundation (U.S.) (ECCS-0939514

Infectious disease management in primary care: perceptions of GPs

<p>Abstract</p> <p>Background</p> <p>It is important to keep the level of antibiotic prescribing low to contain the development of resistant bacteria. This study was conducted to reveal new knowledge about how GPs think in relation to the prescribing of antibiotics - knowledge that could be used in efforts toward rational treatment of infectious diseases in primary care. The aim was to explore and describe the variations in GPs' perceptions of infectious disease management, with special reference to antibiotic prescribing.</p> <p>Methods</p> <p>Twenty GPs working at primary care centres in a county in south-west Sweden were purposively selected based on the strategy of including GPs with different kinds of experience. The GPs were interviewed and perceptions among GPs were analysed by a phenomenographic approach.</p> <p>Results</p> <p>Five qualitatively different perceptions of infectious disease management were identified. They were: (A) the GP must help the patient to achieve health and well-being; (B) the management must meet the GP's perceived personal, professional and organisational demands; (C) restrictive antibiotic prescribing is time-consuming; (D) restrictive antibiotic prescribing can protect the effectiveness of antibiotics; and (E) patients benefit personally from restrictive antibiotic prescribing.</p> <p>Conclusions</p> <p>Restrictive antibiotic prescribing was considered important in two perceptions, was not an issue as such in two others, and was considered in one perception although the actual prescribing was greatly influenced by the interaction between patient and GP. Accordingly, to encourage restrictive antibiotic prescribing several aspects must be addressed. Furthermore, different GPs need various kinds of support. Infectious disease management in primary care is complex and time-consuming, which must be acknowledged in healthcare organisation and planning.</p