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Rendering materials combine two fundamental functions – create protective layers on a substrate and provide decorative and architectural appear of a building’s facade. In particular, many historical buildings are unique with their facades due to the incorporation of different decorative elements, such as plinths, lining cronies, reliefs etc. The composition of mortars used for renders contained many different components in view of binders and filler materials in the past. This fact in combination with conditions which are facades exhibited (weathering, increased moisture and others) effect their appear and overall durability. This paper is focused on the collection procedure of historical renders from two buildings located in the South bohemian region, and further the description and discussion of physical and mechanical properties of rendering materials samples are provided. These pilot data showed that one of examined buildings to some repairs were subjected historically, and for the second one partially different materials from the point of in their quality were used, although the outer facade layer (stucco) was uniform. The mapping of historical renders properties is essential for obtaining important data set for formulation of compatible composites intended for renovation interventions and local repairs.

This paper presents the possibilities of using light microscopy (LM), scanning electron microscopy (SEM), and energy dispersive spectroscopy (EDS) to characterize historical lime-based plasters from the first half of the 20th century. The paper compares these methods and evaluates the advantages and limitations of each technique. The experiments carried out showed that, in addition to determining the elemental composition in specific layers and phases of the plaster, other important information can be analyzed by electron microscopy. It is also possible to identify admixtures or detect cracks, which is necessary to assess the effect of aging on the plaster and ensure its proper renovation.

Ewan Pearson, Kathleen Giacomini and the Metformin Genetics Consortium perform a genome-wide association study for glycemic response to the antidiabetic drug metformin. They find an intronic allele of the GLUT2 glucose transporter gene that associates with greater metformin action, an effect that is more pronounced in obese individuals. Metformin is the first-line antidiabetic drug with over 100 million users worldwide, yet its mechanism of action remains unclear 1 . Here the Metformin Genetics (MetGen) Consortium reports a three-stage genome-wide association study (GWAS), consisting of 13,123 participants of different ancestries. The C allele of rs8192675 in the intron of SLC2A2 , which encodes the facilitated glucose transporter GLUT2, was associated with a 0.17% ( P = 6.6 × 10 −14 ) greater metformin-induced reduction in hemoglobin A1c (HbA1c) in 10,577 participants of European ancestry. rs8192675 was the top cis expression quantitative trait locus ( cis -eQTL) for SLC2A2 in 1,226 human liver samples, suggesting a key role for hepatic GLUT2 in regulation of metformin action. Among obese individuals, C-allele homozygotes at rs8192675 had a 0.33% (3.6 mmol/mol) greater absolute HbA1c reduction than T-allele homozygotes. This was about half the effect seen with the addition of a DPP-4 inhibitor, and equated to a dose difference of 550 mg of metformin, suggesting rs8192675 as a potential biomarker for stratified medicine.

Abstract Context The Roche prolactin immunoassay is used throughout the world. It reports higher values than the Siemens immunoassay but the manufacturer-defined reference intervals are similar. Patient results are often above the Roche upper limit but within the Siemens interval, causing diagnostic confusion. Objective Establish new reference intervals for the Roche and Siemens prolactin immunoassays. Methods We established new reference intervals for the Roche and Siemens immunoassays using 374 specimens from healthy outpatients. We performed chart review for unnecessary testing and treatment for 298 patients in a 6-month period with at least 1 Roche prolactin value above the manufacturer-defined upper limit and below our new upper limit. Results The new upper limit for the Roche assay was 37.8 ng/mL (females) and 22.8 ng/mL (males). The manufacturer-defined limits were 23.3 ng/mL and 15.2 ng/mL, respectively. New intervals for the Siemens assay matched the manufacturer. No cases of clinically significant pathophysiologic prolactin excess were identified in patients with values between the manufacturer-defined upper reference limit and our new Roche upper limit. Unnecessary further evaluation in these patients included 459 repeat prolactin measurements, 57 macroprolactin measurements, 39 magnetic resonance imaging studies, and 28 endocrine referrals. Eleven patients received dopamine agonists. The minimum cost of excess care using Medicare reimbursement rates was $34 134, with substantially higher amounts billed to patients and their insurance providers. Conclusion Adoption of new upper reference limits for the Roche prolactin assay of 37.8 ng/mL (females) and 22.8 ng/mL (males) would not delay diagnosis or necessary intervention in patients with clinically significant pituitary tumors but would reduce unnecessary evaluation in patients without pathophysiologic prolactin excess.

The purpose of this study was to investigate metacognitive self-regulated learning (SRL) differences in computer- and paper-based reading assignments across elementary students. Students in two after-school programs in a southeastern U.S. public school district were recruited. The final sample consisted of 48 students in Grades 2--5 who participated in two counterbalanced conditions involving a computer- and a paper-based reading assignment. The study employed a 2 x 4 (condition-by-grade) mixed-model analysis of variance (ANOVA) and follow-up tests to examine metacognitive SRL differences between conditions and grades. The results indicate that elementary students used various metacognitive SRL skills across both conditions. The mixed-model ANOVA results show a significant interaction in control processes in paper-based reading for students in fifth grade, a significant main effect of condition in evaluation practices in computer-based reading for all grades, and a significant main effect of condition in conditional knowledge in the paper reading assignment for all grades. The results suggest that students can benefit from focused instruction to apply metacognitive SRL skills between the two reading formats.

Cardiac output (CO) is commonly measured using the thermodilution technique at the time of right heart catheterisation (RHC). However inter-operator variability, and the operator characteristics which may influence that, has not been quantified. Therefore, this study aimed to assess inter-operator variability with the thermodilution technique using a mock circulation loop (MCL) with calibrated flow sensors. Participants were blinded and asked to determine 4 levels of CO using the thermodilution technique, which was compared with the MCL calibrated flow sensors. The MCL was used to randomly generate CO between 3.0 and 7.0 L/min through changes in heart rate, contractility and vascular resistance with a RHC inserted through the MCL pulmonary artery. Participant characteristics including gender, specialty, age, height, weight, body-mass index, grip strength and RHC experience were recorded and compared to determine their relationship with CO measurement accuracy. In total, there were 15 participants, made up of consultant cardiologists (6), advanced trainees in cardiology (5) and intensive care consultants (4). The majority (9) had performed 26–100 previous RHCs, while 4 had performed more than 100 RHCs. Compared to the MCL-measured CO, participants overestimated CO using the thermodilution technique with a mean difference of +0.75 ± 0.71 L/min. The overall r2 value for actual vs measured CO was 0.85. The difference between MCL and thermodilution derived CO declined significantly with increasing RHC experience (P < 0.001), increasing body mass index (P < 0.001) and decreasing grip strength (P = 0.033). This study demonstrated that the thermodilution technique is a reasonable method to determine CO, and that operator experience was the only participant characteristic related to CO measurement accuracy. Our results suggest that adequate exposure to, and training in, the thermodilution technique is required for clinicians who perform RHC.

Proponents of the concept of learning disabilities (LD) assume that students classified as LD and those with IQ‐achievement discrepancies have more severe native language and foreign language learning problems than students not classified as LD. Two studies that included high school students classified as “at‐risk” for learning a foreign language (FL) investigated these assumptions. The first study compared “at‐risk” students classified as learning disabled (LD) with “at‐risk” students not classified as LD. Results showed no significant differences between the two groups on measures of native language skill, FL aptitude, and FL learning and proficiency. The second study examined only the students classified as LD and compared students with and without discrepancies between their scores on measures of intelligence (IQ) and academic achievement. Results showed no significant differences between the two groups on measures of FL learning and proficiency. Findings suggest that students classified as LD and non‐LD do not exhibit cognitive, academic achievement, and FL aptitude differences, or differences in their FL learning and proficiency after two years of FL study. The findings of both studies are contrary to the LD concept. The studies demonstrate the importance of providing verifiable evidence to substantiate claims that a student meets criteria for classification as LD. Implications focus on use of the LD label and IQ‐achievement discrepancies for determining which students may have problems with FL learning.

Premature programmed cell death or apoptosis of cells is a strategy utilized by multicellular organisms to counter microbial threats. Tanapoxvirus (TPV) is a large double-stranded DNA virus belonging to the poxviridae that causes mild Monkeypox-like infections in humans and primates. TPV encodes for a putative apoptosis inhibitory protein 16L. We now show that TPV16L is able to bind to a range of peptides spanning the BH3 motif of human pro-apoptotic Bcl-2 proteins, and is able to counter growth arrest of yeast induced by human Bak and Bax. We then determined the crystal structures of TPV16L bound to three identified interactors, Bax, Bim and Puma BH3. TPV16L adopts a globular Bcl-2 fold comprising 7 α-helices, and utilizes the canonical Bcl-2 binding groove to engage pro-apoptotic host cell Bcl-2 proteins. Unexpectedly, TPV16L is able to adopt both a monomeric as well as a domain-swapped dimeric topology where the α1 helix from one protomer is swapped into a neighbouring unit. Despite adopting two different oligomeric forms, the canonical ligand binding groove in TPV16L remains unchanged from monomer to domain-swapped dimer. Our results provide a structural and mechanistic basis for tanapoxvirus mediated inhibition of host cell apoptosis, and reveal the capacity of Bcl-2 proteins to adopt differential oligomeric states whilst maintaining the canonical ligand binding groove in an unchanged state.

LEARNING OUTCOME: To evaluate the impact of group cluster intervention in achieving increased self-efficacy in using diabetes management tools, e.g., blood glucose monitoring, food, stress triggers, and exercise logs. Purpose:In one northern California region health medical organization diabetes registry, there are 90,000 members with diabetes accounting for 13% of all outpatient visits and 13% of all inpatient admissions. A multi-disciplinary interactive program may prove to decrease additional utilization of health care resources. Preliminary data indicate high patient satisfaction, increased self-efficacy, and improved glycosylated hemoglobin A 1C (HgbAlC) lab values with the Diabetes Cooperative Care Clinic program. Setting/Characteristics: A model of delivery of care is developed for adult members with diabetes who are taking insulin and/or oral agents. The criterion for inclusion is a HgbAlC of 8.5% or greater within the last two months. The team is composed of an internist, podiatrist, diabetes nurse educator, registered dietitian diabetes educator, psychologist, research assistant-certified medical assistant, exercise physiologist, and pharmacist The delivery of care is provided by six monthly group sessions with telephone and individual follow-up. The two hour group sessions, consisting of 15 -20 members, incorporates division of the group to clusters for specified interests and needs, e.g., foot exams, food log/blood sugar/medication review, and blood pressure monitoring. The database programmed for this type of setting includes labs, weight, medication, and action plan. In establishing topics during the first clinic, nutrition information has been in high demand. Dining out, exercise, shopping, label reading, and meal planning are popular topics. Dietary changes have included the following: adding just a one fruit or vegetable, less refined flour products, and less fat and fast food intake. The psychologist provides tips on assertiveness and goal setting strategies. The nurse reviews blood sugar and medication interaction and recommends changes. Concerns of the members are addressed and participants are empowered to improve their individual glycemic control. Evaluation: Previous to the first clinic and repeated before the final clinic, patients completed a health questionnaire (Diabetes 2.1 form, self-efficacy, diabetes health care practices assessment, modified Gladys Block food frequency questionnaire), HgbAlC, fructosamine, utilization data (emergency visits, urgent care visit and hospitalization), and patient and provider satisfaction.