摘要：关键点政策决策者在设计改善医疗的政策时,需要超越传统的财务激励。卫生专业人员受到一系列因素的激励,既有外在因素,也有内在因素。专注于这些其他激励措施或对激励进行组合可能更为有效。Mylène Lagarde、Luis Huicho和Irene Papanicolas探讨了政策决策者可以采取的不同政策激励医务人员改善医疗质量。

摘要：Purpose: To define the level of quality of life in an elderly population and to investigate the effects of selected variables, such as anemia, fatigue, depression and sleep disorders, on the quality of life. Design and Methods: The study was conducted in Gazio?lu Nursing Home, located in the city center of Kayseri, on 136 subjects ≥65 in the year 2008-2009. Data were collected using the Geriatric Depression Scale (GDS), Fatigue Severity Scale (FSS), Pittsburgh Sleep Quality Index (PSQI) and the World health Organization Quality of Life-OLD (WHOQOL- OLD) Module. In the statistical analysis mean ± standard deviation, student’s t-test, ANOVA and Spearman correlation analysis were used. Re- sults: The mean total score of quality of life was 43.45 ± 10.30. Of the residents 47.0% had a poor quality of life. Autonomy had the lowest (35.70 ± 19.96) and intimacy had the highest (48.75 ± 17.96) subdomain scores. Fatigue significantly decreased the total and autonomy, social par- ticipation and death and dying subdomain scores. Anemia had a significant adverse effect on intimacy, depression on autonomy and intimacy and sleep disorder on death and dying. There were negative correlations between fatigue with past-present-future activities and social participation, depression with social participation, intimacy, death and dying and glucose levels with social participation and intimacy. Implications: About half of the subjects had a poor quality of life. Fatigue was the sole factor to negatively affect the total score in WHOQOL-OLD. Depression, anemia and sleep disorder adversely affected the autonomy, social participation, intimacy, death and dying subdomain scores but not in all.

摘要：DNA methyl transferase(DNMT) and histone deacetylase(HDAC) are well recognized epigenetic targets for discovery of antitumor *** this study,we designed and synthesized a series of nucleoside base hydroxamic acid derivatives as DNMT and HDAC dual *** assays and enzymatic inhibitory activity tests indicated that compound 204 exhibited potent DNMT1 and HDAC1/6 inhibitory potency simultaneously in enzymatic levels and at cellular levels,inducing hypomethylation of p16 and hyperacetylation of histones H_(3) K9 and H4 ***,204 remarkably inhibited proliferation against cancer cells U937 by prompting G0/G1 cell cycle *** docking models explained the functional mechanism of 204 inhibiting DNMT1 and *** studies on metabolic profiles revealed that 204 showed desirable stability in liver *** study suggested that 204 inhibiting DNMT and HDAC concurrently can be a potential lead compound for epigenetic cancer therapy.

摘要：With rapid spread of HIV(human immunodeficiency virus) on a global scale and increasingly severe drug-resistance of it,it is urgently necessary to develop novel effective anti-HIV ***-nucleoside reverse transcriptase inhibitor(NNRTIs)is one of the most significant antiretroviral drugs for fighting against HIV infection due to their various structures,unique mode of action,good efficacy and low *** derivatives,a type of NNRTIs,have been reported to achieve remarkable development in the past few *** this review,we summarized current drug design and medicinal chemistry efforts toward the development of next-generation pyridinones as HIV-1 NNRTIs.

摘要：Purpose： This study aimed to examine the extent to which the quality physical education teaching （QPET） practices contributed to improving 4th- and 5th-grade students＇ manipulative skill competency. Methods： Participants were 9 elementary physical education （PE） teachers and their 4th- and 5th-grade students （n = 2709 3420）. The students＇ skill competency was assessed with 3 manipulative skills using PE metrics assessment rubrics. The PE teachers＇ levels of QPET were assessed by coding 63 videotaped lessons using the assessing quality teaching rubrics （AQTR）, which consisted of 4 essential dimensions including task design, task presentation, class management, and instructional guidance. Codes were confirmed through inter-rater reliability （82.4%, 84.5%, and 94%）. Data were analyzed through descriptive statistics, multiple R2 regression models, and independent sample t tests. Results： This study indicated that the 4 essential dimensions of QPET were all significant contributors to students＇ manipulative skill competency. These predictors were significantly higher for boys than for girls in soccer and striking skills, while they were significantly higher for girls than for boys in throwing skill competency. Of the 4 essential dimensions of QPET, task presentation played the most significant role in contributing to all 3 skill competencies for both boys and girls. Further, students who experienced high QPET were significantly more skillfully competent than those students who did not have this experience. Conclusion： It was concluded that the QPET practices played a significantly critical role in contributing to students＇ manipulative skill competency.

摘要：INTRODUCTION: Lateral epicondylosis is a common cause of lateral elbow pain, however, some patients fail conservative management. One reason, many pathologies have similar presentations. There are no valid and reliable clinical tests to differentiate between tendopathy and arthropathy. This single case design looks at the utilization of the humeroradial joint (HRJ) distraction test to diagnose HRJ chondropathy. CASE SUMMARY: 38-year-old male recreational athlete with persistent lateral elbow pain, impaired motion, crepitus and locking. Disability of the Arm Shoulder Hand Questionnaire (DASH): 13.33/100. DASH Sport Module, 68.75/100. Differential Diagnosis: Chondropathy of the HRJ with loose body, based on history of elbow pain and locking, non-capsular pattern of limitation of motion and a positive HRJ distraction test. Intervention: loose body manipulation improved pain free range of motion with continued remarkable HRJ distraction test;referral to orthopedic surgeon. Plain radiographs and CT demonstrated a loose body and marked cartilage thinning within the HRJ. Arthroscopic removal of the loose body and plica resection was performed. Surgical exploration confirmed Grade 3 cartilage lesions within the radial head without involvement of the extensor muscle group. Post-operative physical therapy focused on restoration of accessory joint motion and education on return to functional and recreational activity. OUTCOMES: Full range and normal joint accessory motion, DASH score and DASH Sport Module score reduced to 8.33 and 25, 12-weeks post-operative. CONCLUSION: Arthroscopic exploratory surgery is recommended for chronic lateral elbow pain resistant to conservative management;however, patients who present with pain in the absence of a positive clinical examination and radiographic findings benefit least from arthroscopic evaluation. No clinical test(s) have been validated in the literature to diagnose HRJ lesions. This report is the first to propose the use of a new c

摘要：Peptide inhibition of the interactions of the tumor suppressor protein P53 with its negative regulators MDM2 and MDMX activates P53 in vitro and in vivo,representing a viable therapeutic strategy for cancer *** phage display techniques,we previously identified a potent peptide activator of P53,termed PMI(TSFAEYWNLLSP),with binding affinities for both MDM2 and MDMX in the low nanomolar concentration *** we report an ultrahigh affinity,dual-specificity peptide antagonist of MDM2 and MDMX obtained through systematic mutational analysis and additivitybased molecular *** assays of over 100 peptide analogs of PMI using surface plasmon resonance and fluorescence polarization techniques yielded a dodecameric peptide termed PMI-M3(LTFLEYWAQLMQ)that bound to MDM2 and MDMX with K_(d)values in the low picomolar concentration range as verified by isothermal titration ***-crystal structures of MDM2 and of MDMX in complex with PMI-M3 were solved at 1.65 and 3.0 A resolution,*** to PMI,PMI-M3 occupied the P53-binding pocket of MDM2/MDMX,which was dominated energetically by intermolecular interactions involving Phe3,Tyr6,Trp7,and Leu *** differences in binding between PMI-M3 and PMI were observed at other positions such as Leu4 and Met11 with MDM2,and Leu1 and Met11 with MDMX,collectively contributing to a significantly enhanced binding affinity of PMI-M3 for both *** adding lysine residues to both ends of PMI and PMI-M3 to improve their cellular uptake,we obtained modified peptides termed PMI-2K(KTSFAEYWNLLSPK)and M3-2K(KLTFLEYWAQLMQK).Compared with PMI-2K,M3-2K exhibited significantly improved antitumor activities in vitro and in vivo in a P53-dependent *** super-strong peptide inhibitor of the P53-MDM2/MDMX interactions may become,in its own right,a powerful lead compound for anticancer drug development,and can aid molecular design of other classes of P53 activators as well for anticancer therapy.

摘要：剂量-反应评估作为风险评估中的关键定量步骤,其作用是确定安全剂量水平。与传统最大无害剂量方法相比,基准剂量(BMD)法促进了3R原则(减少、替代和优化)在毒理试验中的使用。本文综述了BMD法特性,包括对研究设计的依赖性较小、在起始点中更好地量化不确定性及整合额外信息能力等;总结了BMD法基于剂量-反应评估和数据整合在减少动物使用方面的作用。

摘要：Purpose:The aim of this study was to evaluate the program"No more smoking!It’s time for physical activity",with a mixed methods design,in order to collect information to improve the program for future ***:Forty patients across five anti-smoking clinics in Central Greece completed the ***’records and participants’questionnaires and interviews were used as data in order to evaluate the programs’process and ***:Quantitative measures before and after the program revealed significant differences on smoking behavior,physical activity(PA)behavior,self-efficacy,and smoking habit *** data implied that the promotion of PA as a cessation aid was perceived as positive by the participants and both participants’and counselors’statements were encouraging for the effectiveness of PA promotion during the program as a cessation-aid ***:Evaluation of the"No more smoking!It’s time for physical activity"program showed encouraging *** who try to quit smoking can become more physically active through targeted intervention and they regard PA as a significant aid in their efforts to quit smoking.

摘要：The development of well-defined TiO2 nanoarchitectures is a versatile strategy to achieve high-efficiency photocatalytic *** this study,mesoporous TiO2 nanofibers consisting of oriented nanocrystals were fabricated by a facile vapothermal-assisted topochemical transformation of preformed H-titanate *** vapothermal temperature is crucial in tuning the microstructures and photocatalytic redox properties of the resulting mesoporous TiO2 *** microstructures were characterized with XRD,TEM,XPS and nitrogen adsorption-desorption isotherms,*** photocatalytic activities were evaluated by photocatalytic oxidation of organic pollutant(Rhodamine B as an example)as well as photocatalytic reduction of water to generate hydrogen(H2).The nanofibers vapothermally treated at 150°C showed the highest photocatalytic activity in both oxidation and reduction reactions,2 times higher than that of *** oriented alignment and suitable mesoporosity in the resulting nanofiber architecture were crucial for enhancing photocatalytic *** oriented alignment of anisotropic anatase nanocrystals shall facilitate faster vectorial charge transportation along the nanofibers ***,the suitable mesoporosity and high surface area would also effectively enhance the mass exchange during photocatalytic *** also demonstrate that efficient energy-recovering photocatalytic water treatments could be accomplished by a cascading oxic-anoxic process where the dye is degraded in the oxic phase and hydrogen is generated in the successive anoxic *** study showcases a novel and facile method to fabricate mesoporous TiO2 nanofibers with high photocatalytic activity for both clean energy production and environmental purification.