Combining clinical factors and quantitative ultrasound improves the detection of women both at low and high risk for hip fracture

Summary: We hypothesized that combining clinical risk factors (CRF) with the heel stiffness index (SI) measured via quantitative ultrasound (QUS) would improve the detection of women both at low and high risk for hip fracture. Categorizing women by risk score improved the specificity of detection to 42.4%, versus 33.8% using CRF alone and 38.4% using the SI alone. This combined CRF-SI score could be used wherever and whenever DXA is not readily accessible. Introduction and hypothesis: Several strategies have been proposed to identify women at high risk for osteoporosis-related fractures; we wanted to investigate whether combining clinical risk factors (CRF) and heel QUS parameters could provide a more accurate tool to identify women at both low and high risk for hip fracture than either CRF or QUS alone. Methods: We pooled two Caucasian cohorts, EPIDOS and SEMOF, into a large database named "EPISEM”, in which 12,064 women, 70 to 100years old, were analyzed. Amongst all the CRF available in EPISEM, we used only the ones which were statistically significant in a Cox multivariate model. Then, we constructed a risk score, by combining the QUS-derived heel stiffness index (SI) and the following seven CRF: patient age, body mass index (BMI), fracture history, fall history, diabetes history, chair-test results, and past estrogen treatment. Results: Using the composite SI-CRF score, 42% of the women who did not report a hip fracture were found to be at low risk at baseline, and 57% of those who subsequently sustained a fracture were at high risk. Using the SI alone, corresponding percentages were 38% and 52%; using CRF alone, 34% and 53%. The number of subjects in the intermediate group was reduced from 5,400 (including 112 hip fractures) and 5,032 (including 111 hip fractures) to 4549 (including 100 including fractures) for the CRF and QUS alone versus the combination score. Conclusions: Combining clinical risk factors to heel bone ultrasound appears to correctly identify more women at low risk for hip fracture than either the stiffness index or the CRF alone; it improves the detection of women both at low and high ris

Large-Cavity Coronoids with Different Inner and Outer Edge Structures

Coronoids, polycyclic aromatic hydrocarbons with geometrically defined cavities, are promising model structures of porous graphene. Here, we report the on-surface synthesis of C168 and C140 coronoids, referred to as [6]- and [5]coronoid, respectively, using 5,9-dibromo-14-phenylbenzo[m]tetraphene as the precursor. These coronoids entail large cavities (>1 nm) with inner zigzag edges, distinct from their outer armchair edges. While [6]coronoid is planar, [5]coronoid is not. Low-temperature scanning tunneling microscopy/spectroscopy and noncontact atomic force microscopy unveil structural and electronic properties in accordance with those obtained from density functional theory calculations. Detailed analysis of ring current effects identifies the rings with the highest aromaticity of these coronoids, whose pattern matches their Clar structure. The pores of the obtained coronoids offer intriguing possibilities of further functionalization toward advanced host-guest applications

Indication of Superconductivity at 35 K in Graphite-Sulfur Composites

We report magnetization measurements performed on graphite--sulfur composites which demonstrate a clear superconducting behavior below the critical temperature T$_{c0}$ = 35 K. The Meissner-Ochsenfeld effect, screening supercurrents, and magnetization hysteresis loops characteristic of type-II superconductors were measured. The results indicate that the superconductivity occurs in a small sample fraction, possibly related to the sample surface.Comment: published versio

Formation of 0D and 1D Graphene-based Nanostructures by [2+2] Cycloaddition of Ortho-dihalogen Aromatics

Trabajo presentado en la conferencia Fuerzas y Túnel (FyT2016), celebrada en Girona del 5 al 7 de septiembre de 2016.During the last decade, on-surface chemistry has experienced a significant development driven by the necessity of finding novel tools for the fabrication of new (macro)molecular structures with novel properties. Several synthetic reactions commonly used in traditional solution-based chemistry have recently been applied to on-surface chemistry [1-3]. This approach has allowed for the fabrication of novel structures with fascinating properties such as metal-organic frameworks, covalent organic frameworks (COF) or graphene nanoribbons, to name only some of them. However, there is still a wide variety of coupling reactions that are well-known in solution-based chemistry but which have not yet been explored with respect to on-surface chemistry. This is the case, for example, of the [2+2] cycloaddition for the controlled formation of carbon tetragons. In this talk, we will present the on-surface synthesis of 0D and 1D graphene-based nanostructures via [2+2] cycloaddition of halogen-functionalized precursor monomers. For this purpose, we have used aromatic precursors which have been functionalized at orthopositions, a novel approach in on-surface reactions. We will show, by means of highresolution scanning tunnelling microscopy and non-contact atomic force microscopy, that these precursor monomers afford the formation of carbon tetragons. Furthermore, we show that the functionalization pattern of the precursor monomers allows for the selective formation of either 0D or 1D nanostructures.N

Electron Wave Function in Armchair Graphene Nanoribbons

By using analytical solution of a tight-binding model for armchair nanoribbons, it is confirmed that the solution represents the standing wave formed by intervalley scattering and that pseudospin is invariant under the scattering. The phase space of armchair nanoribbon which includes a single Dirac singularity is specified. By examining the effects of boundary perturbations on the wave function, we suggest that the existance of a strong boundary potential is inconsistent with the observation in a recent scanning tunneling microscopy. Some of the possible electron-density superstructure patterns near a step armchair edge located on top of graphite are presented. It is demonstrated that a selection rule for the G band in Raman spectroscopy can be most easily reproduced with the analytical solution.Comment: 7 pages, 4 figure

On-surface activation of benzylic C-H bonds for the synthesis of pentagon-fused graphene nanoribbons

Graphene nanoribbons (GNRs) have potential for applications in electronic devices. A key issue, thereby, is the fine-tuning of their electronic characteristics, which can be achieved through subtle structural modifications. These are not limited to the conventional armchair, zigzag, and cove edges, but also possible through incorporation of non-hexagonal rings. On-surface synthesis enables the fabrication and visualization of GNRs with atomically precise chemical structures, but strategies for the incorporation of non-hexagonal rings have been underexplored. Herein, we describe the on-surface synthesis of armchair-edged GNRs with incorporated five-membered rings through the C-H activation and cyclization of benzylic methyl groups. Ortho-Tolyl-substituted dibromobianthryl was employed as the precursor monomer, and visualization of the resulting structures after annealing at 300 °C on a gold surface by high-resolution noncontact atomic force microscopy clearly revealed the formation of methylene-bridged pentagons at the GNR edges. These persisted after annealing at 340 °C, along with a few fully conjugated pentagons having singly-hydrogenated apexes. The benzylic methyl groups could also migrate or cleave-off, resulting in defects lacking the five-membered rings. Moreover, unexpected and unique structural rearrangements, including the formation of embedded heptagons, were observed. Despite the coexistence of different reaction pathways that hamper selective synthesis of a uniform structure, our results provide novel insights into on-surface reactions en route to functional, non-benzenoid carbon nanomaterials

Fluoride supplements (tablets, drops, lozenges or chewing gums) for preventing dental caries in children.

BACKGROUND: Dietary fluoride supplements were first introduced to provide systemic fluoride in areas where water fluoridation is not available. Since 1990, the use of fluoride supplements in caries prevention has been re-evaluated in several countries. OBJECTIVES: To evaluate the efficacy of fluoride supplements for preventing dental caries in children. SEARCH METHODS: We searched the Cochrane Oral Health Group's Trials Register (to 12 October 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 3), MEDLINE via OVID (1950 to 12 October 2011), EMBASE via OVID (1980 to 12 October 2011), WHOLIS/PAHO/MEDCARIB/LILACS/BBO via BIREME (1982 to 12 October 2011), and Current Controlled Trials (to 12 October 2011). We handsearched reference lists of articles and contacted selected authors. SELECTION CRITERIA: We included randomised or quasi-randomised controlled trials comparing, with minimum follow-up of 2 years, fluoride supplements (tablets, drops, lozenges) with no fluoride supplement or with other preventive measures such as topical fluorides in children less than 16 years of age at the start. The main outcome was caries increment measured by the change in decayed, missing and filled tooth surfaces (DMFS). DATA COLLECTION AND ANALYSIS: Two review authors, independently and in duplicate, assessed the eligibility of studies for inclusion, and carried out risk of bias assessment and data extraction. In the event of disagreement, we sought consensus and consulted a third review author. We contacted trial authors for missing information. We used the prevented fraction (PF) as a metric for evaluating the efficacy of the intervention. The PF is defined as the mean caries increment in controls minus mean caries increment in the treated group divided by mean caries increment in controls. We conducted random-effects meta-analyses when data could be pooled. We assessed heterogeneity in the results of the studies by examining forest plots and by using formal tests for homogeneity. We recorded adverse effects (fluorosis) when the studies provided relevant data. MAIN RESULTS: We included 11 studies in the review involving 7196 children.In permanent teeth, when fluoride supplements were compared with no fluoride supplement (three studies), the use of fluoride supplements was associated with a 24% (95% confidence interval (CI) 16 to 33%) reduction in decayed, missing and filled surfaces (D(M)FS). The effect of fluoride supplements was unclear on deciduous or primary teeth. In one study, no caries-inhibiting effect was observed on deciduous teeth while in another study, the use of fluoride supplements was associated with a substantial reduction in caries increment.When fluoride supplements were compared with topical fluorides or with other preventive measures, there was no differential effect on permanent or deciduous teeth.The review found limited information on the adverse effects associated with the use of fluoride supplements. AUTHORS' CONCLUSIONS: This review suggests that the use of fluoride supplements is associated with a reduction in caries increment when compared with no fluoride supplement in permanent teeth. The effect of fluoride supplements was unclear on deciduous teeth. When compared with the administration of topical fluorides, no differential effect was observed. We rated 10 trials as being at unclear risk of bias and one at high risk of bias, and therefore the trials provide weak evidence about the efficacy of fluoride supplements

Self-reported smoking cessation activities among Swiss primary care physicians

ABSTRACT: BACKGROUND: Individual counselling, pharmacotherapy, and group therapy are evidence-based interventions that help patients stop smoking. Acupuncture, hypnosis, and relaxation have no demonstrated efficacy on smoking cessation, whereas self-help material may only have a small benefit. The purpose of this study is to assess physicians' current clinical practice regarding smokers motivated to stop smoking. METHODS: The survey included 3385 Swiss primary care physicians. Self-reported use of nine smoking cessation interventions was scored. One point was given for each positive answer about practicing interventions with demonstrated efficacy, i.e. nicotine replacement therapy, bupropion, counselling, group therapy, and smoking cessation specialist. No points were given for the recommendation of acupuncture, hypnosis, relaxation, and self-help material. Multivariable logistic analysis was performed to identify factors associated with a good practice score, defined as >1. RESULTS: The response rate was 55%. Respondents were predominately over the age of 40 years (88%), male (79%), and resided in urban areas (74%). Seventeen percent reported being smokers. Most of the physicians prescribed nicotine replacement therapy (84%), bupropion (65%), or provided counselling (70%). A minority of physicians recommended acupuncture (26%), hypnosis (8%), relaxation (7%), or self-help material (24%). A good practice score was obtained by 85% of respondents. Having attended a smoking cessation training program was the only significant predictor of a good practice score (odds ratio: 6.24 , 95% CI 1.95-20.04). CONCLUSION: The majority of respondents practice recommended smoking cessation interventions. However, there is room for improvement and implementing an evidence-based smoking cessation-training program could provide additional benefit

Detachment Dynamics of Graphene Nanoribbons on Gold

Metal-surface physisorbed graphene nanoribbons (GNRs) constitute mobile nanocontacts whose interest is simultaneously mechanical, electronic, and tribological. Previous work showed that GNRs adsorbed on Au(111) generally slide smoothly and superlubrically owing to the incommensurability of their structures. We address here the nanomechanics of detachment, as realized when one end is picked up and lifted by an AFM cantilever. AFM nanomanipulations and molecular-dynamics (MD) simulations identify two successive regimes, characterized by (i) a progressively increasing local bending, accompanied by the smooth sliding of the adhered part, followed by (ii) a stick-slip dynamics involving sudden bending relaxation associated with intermittent jumps of the remaining adhered GNR segment and tail end. AFM measurements of the vertical force exhibit oscillations which, compared with MD simulations, can be associated with the successive detachment of individual GNR unit cells of length 0.42 nm. Extra modulations within one single period are caused by steplike advancements of the still-physisorbed part of the GNR. The sliding of the incommensurate moir\ue9 pattern that accompanies the GNR lifting generally yields an additional long-period oscillation: while almost undetectable when the GNR is aligned in the standard "R30" orientation on Au(111), we predict that such feature should become prominent in the alternative rotated "R0" orientation on the same surface, or on a different surface, such as perhaps Ag(111)