(C) 2011 American Institute of Physics [doi:10 1063/1 3562519]“<

(C) 2011 American Institute of Physics. [doi:10.1063/1.3562519]“
“In many angiosperm species, populations are reproductively subdivided into distinct sexual morphs including females, males and hermaphrodites. Sexual polymorphism

is maintained by frequency-dependent selection, leading to predictable sex ratios at equilibrium. Charles Darwin devoted much of his book ‘The Different Forms of Flowers on Plants of the Same Species’ (1877) to investigating plant sexual polymorphisms and laid the foundation for many problems addressed today by integrating selleck theory with empirical studies of the demography and genetics of populations. Here, we summarize our recent work on the ecological and genetic mechanisms influencing variation in sex ratios and their implications for evolutionary transitions among sexual systems. We present the results of a survey of sex ratios from 126 species from 47 angiosperm

families and then address two general problems using examples from diverse angiosperm taxa: (i) the mechanisms governing biased sex ratios in dioecious species; (ii) the origins and maintenance of populations composed of females, males and hermaphrodites. Several themes are emphasized, including the importance of non-equilibrium conditions, the role of life history and demography in affecting sex ratios, the value of theory for modelling the dynamics of sex ratio variation, and the utility of genetic markers for investigating evolutionary processes in sexually polymorphic

plant populations.”
“Oligoethers containing electroactive carbazolyl, IWR-1-endo ic95 indolyl or 2-phenylindolyl fragments were synthesized and characterized by NMR spectroscopy, elemental analysis and gel permeation chromatography. The oligomers represent ML323 Ubiquitin inhibitor amorphous materials of high thermal stability with glass transition temperatures of 107-161 degrees C. The electron photoemission spectra of layers of the synthesized oligomers showed ionization potentials of 5.9-5.95 eV. Some of the derivatives were tested as host materials in phosphorescent OLEDs with iridium(III) [bis(4,6-difluorophenyl)-pyridinato-N,C2']picolinate as the guest. The device based on oligomer containing carbazolyl fragments exhibited the best overall performance with a turn-on voltage of 3.5 V, maximum power efficiency of 4.1 lm/W and maximum brightness of 937 cd/m(2). (C) 2011 Wiley Periodicals, Inc. J Appl Polym Sci 122: 908-913, 2011″
“We report upon a theoretical study of collective magnonic modes in pairs of magnetic nano-elements with quasi-uniform magnetization. The mode spectrum and character are numerically computed for an individual isolated nano-element and then used to analytically calculate the splitting of the modes due to the inter-element magneto-dipole interaction.

The mean relative telomere length was measured by quantitative Re

The mean relative telomere length was measured by quantitative Real Time PCR (Q-PCR) based assay, which measures the average ratio of telomere repeat copy number to a single copy gene (36B4) copy number (T/S ratio) in each sample.

The check details relative leukocyte

mean telomere length (T/S) in both men and women from iRPL group was significantly lower (p < 0.05) when compared to controls. A significant (P < 0.05) negative correlation was found between age and leukocyte telomere length (T/S ratio). Among the sperm parameters seminal volume was found to be negatively (r = -0.4679) associated with the telomere T/S ratio. The DNA fragmentation index of sperm showed positive correlation (r = 0.4744) with telomere length. In this preliminary study, we found that

shorter telomere length in both men and women may be associated with early pregnancy loss.

In conclusion, shorter telomere length in both male and female partners appears to play a role in the idiopathic recurrent pregnancy loss. Loss of telomeric DNA due to oxidative stress needs further analysis. Analysis of telomere length in germ cells are needed to further substantiate the findings of this study.”
“Objective: The purpose of this study was to investigate Cilengitide the incidence of squamous cell carcinoma (SCC) of the anterior two thirds of the tongue in a population living in central and southern Portugal, all treated at Instituto Portugues de Oncologia de Lisboa, Francisco Gentil (IPOLFG).

Study Design: This study was a retrospective review of all patients who had a histopathological diagnosis of SCC of the anterior two

thirds of the tongue and had been treated in the Head and Neck Surgery Unit at the IPOLFG (Lisbon, Portugal), between 1st January 2001 and 31st December 2009. The risk factors evaluated were: LY294002 molecular weight gender; age; alcohol consumption; tobacco use; prosthesis use and the carcinoma site.

Results: Of the 424 cases analysed, 71% were men. Mean age of occurrence was in 5th decade for males and the 6th decade for females, and the border of the tongue was the most common location. Alcohol consumption and tobacco had a lower impact in women, being the most common aetiological factors in the male population. No significant association was observed between patients and the use of a prosthesis.

Conclusions: In spite of the consumption of aohol and tobacco starting to decline in certain parts of the world, our findings showed both factors still have a significant impact in male population. Further research should be done to determine aetiological factors in females.”
“Substantial scientific progress has been made in the past 50 years in delineating many of the biological mechanisms involved in the primary and secondary injuries following trauma to the spinal cord and brain. These advances have highlighted numerous potential therapeutic approaches that may help restore function after injury.

This is the first report of internal phloem in this genus “

This is the first report of internal phloem in this genus.”
“BACKGROUND: Non-adherence to tuberculosis (TB) treatment jeopardizes patient health and promotes disease transmission. In July 2011, Ecuador’s National Tuberculosis Program (NTP) enacted a monetary incentive program giving adherent drug-resistant TB (DR-TB) patients a US$240 bonus each month.

OBJECTIVE: To describe patients’ experiences with the program qualitatively, and to assess its effects on treatment adherence.

METHODS: We interviewed 92 current and five default patients about their treatment experience. NTP

data on DR-TB patients receiving treatment were used Stem Cells & Wnt inhibitor to compare 12-month default rates among the incentive program group and non-program controls.

RESULTS: Our interviews found SNDX-275 that patients are financially challenged and use the bonus for a variety of expenses, most commonly food. The most common complaint was that bonus payments were frequently delayed. The 1-year default rate among program patients (9.5%) was significantly

lower than the rate among pre-program patients (26.7%).

CONCLUSION: Ecuador’s monetary incentive program alleviates the economic burden placed by treatment on patients. The bonus does not, however, directly address other treatment barriers, including psychological distress and side effects. The program could benefit from timely delivery of payments. Further research is necessary to assess the program’s effect on default rates.”
“For the first time, the Canadian Hypertension Education Program has studied the evidence Supporting blood pressure control in people requiring renal replacement therapy for end-stage kidney disease, including chose oil dialysis and with renal transplants. According to the Canadian Organ Replacement Registry’s 2008 annual report, there were an estimated 33,832 people with end-stage renal disease in Canada at the end of 2006, an increase of 69.7% since 1997. Of these, 20,465 were oil dialysis and 13,367 were living with a functioning kidney transplant. Thus, it is becoming more likely that primary care practitioners will lie helping to care for these complex patients. With the lack of Large controlled

clinical trials, the consensus recommendation based oil interpretation ZD1839 manufacturer of the existing literature is that blood pressure Should be lowered to below 140/90 mmHg in hypertensive patients oil renal replacement therapy and to below 130/80 mmHg for renal transplant patients with diabetes or chronic kidney disease.”
“Background: A goal of anatomic anterior cruciate ligament (ACL) reconstruction should be to create a femoral tunnel aperture that resembles the native attachment site in terms of size and orientation. Aperture morphology varies as a function of the drill-bit diameter, the angle in the horizontal plane at which the drilled tunnel intersects the lateral notch wall (transverse drill angle), and the angle of knee flexion in the vertical plane during drilling.

Arrhenius expressions were adjusted for the seven kinetic constan

Arrhenius expressions were adjusted for the seven kinetic constants on the basis of measurements reported in the first part of this series. Even though the final products contain thousands of different Molecular species, 21 of them Constitute

more than 90% of the total weights. During the initial period with negligible condensation, the undissolved M distorts the distributions of molecular weights and functionalities; but the reversibility of methylolations corrects for Such distortion prior to the effective start of condensation. (C) 2009 Wiley Periodicals, Inc. J Appl Polym Sci 113: 1017-1029, 2009″
“In Arabidopsis, three receptors exist for the phytohormone gibberellin. Of the three, only a double MEK inhibitor loss-of-function mutant (atgid1a atgid1c) shows a dwarf phenotype, while other double and all single mutants show no abnormality in height. In this study we show that the expression of AtGID1b-GUS mRNA, driven by the AtGID1b promoter, is low in inflorescence stems, but may be 10% of AtGID1a-GUS

mRNA, driven by the AtGID1a promoter. However, AtGID1b-GUS enzymatic activity JQEZ5 in vivo does not exist in them. This factor strongly suggests that atgid1a atgid1c lacks sufficient AtGID1b protein for normal stem growth. In the stamens of pAtGID1c::AtGID1c-GUS transformants, we detected clear AtGID1c-GUS activity, while another atgid1a atgid1b, which has short stamens in its flowers, causes the adhesion of little https://www.selleckchem.com/products/ldn193189.html pollen to stigmas thus leading

to its low fertility. We then evaluated the affinity of the AtGID1-DELLA interaction by a competitive yeast three-hybrid system and also by QCM apparatus. AtGID1c showed a quite lower affinity to RGL2, the major DELLA protein in floral buds, than AtGID1a or AtGID1b. The low affinity of the AtGID1c-RGL2 interaction is likely to be responsible for the failure of AtGID1c to hold RGL2, which is required for normal stamen development. Taken together with expressional information of DELLA genes, we propose that in a double loss-of-function mutant of gibberellin receptors, the emergence of any phenotype(s) depends on the abundance of the remaining receptor and its preference to DELLA proteins existing at a target site.”
“This work investigates five reactions between melamine (M) and formaldehyde (F) at pH = 9.0, and with initial F : M ratios of 2. The samples were analyzed by size exclusion chromatography (SEC), volumetric techniques, and ((1)H and (13)C) NMR. Condensation was quantified by the SEC measurements. In the experiments at 38 and 48 degrees C, condensation was almost negligible, and the reversibility of methylolation reactions determined that equilibriums were reached in the ratios between primary, secondary, and tertiary amines. In the experiments at 60, 70, and 90 degrees C, condensation was significant, but in all cases, the mass fraction of single-ringed species was larger than that of species with two or more rings per molecule.

The mean total SRS score for the cohort was 99 4/120 None of the

The mean total SRS score for the cohort was 99.4/120. None of the deformity-related parameters in the multiple-regression were significant. However, patients with the

lowest postoperative major Cobb angles reported significantly higher SRS scores than those with the highest postoperative Cobb angles, but there was no difference on the basis of rib hump correction. There were no significant differences between patients with either rod fractures or screw-related complications compared to those without complications.

Conclusion. Patients undergoing thoracoscopic anterior scoliosis correction reported good SRS scores which are comparable with those in previous studies. Postoperative major Cobb angle is a significant predictor of patient satisfaction when comparing subgroups of patients with the highest AZD7762 mouse this website and

lowest postoperative Cobb angles.”
“Aquatic photosynthesis is responsible for about half of the global production and is undertaken by a huge phylogenetic diversity of algae that are poorly studied. The diversity of redox-regulation of phosphoribulokinase (PRK) and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) was investigated in a wide range of algal groups under standard conditions. Redox-regulation of PRK was greatest in chlorophytes, low or absent in a red alga and most chromalveolates, and linked to the number of amino acids between two regulatory cysteine residues. GAPDH regulation was not strongly-related to the different forms of this enzyme and was less variable than for PRK. Addition of recombinant CP12, a protein that forms a complex with PRK and GAPDH, to crude extracts inhibited GAPDH and PRK inversely in the Plantae, but in most chromalveolates

had little effect on GAPDH and inhibited or stimulated PRK depending on the species. Patterns of enzyme regulation were used to produce a phylogenetic tree in which cryptophytes and haptophytes, at the base of the chromalveolates, formed a distinct clade. A second clade comprised only chromalveolates. A third clade comprised a mixture of Plantae, an excavate and three chromalveolates: a marine diatom and two others (a xanthophyte and eustigmatophyte) check details that are distinguished by a low content of chlorophyll c and a lack of fucoxanthin. Regulation of both enzymes was greater in freshwater than in marine taxa, possibly because most freshwaters are more dynamic than oceans. This work highlights the importance of understanding enzyme regulation in diverse algae if their ecology and productivity is to be understood.”
“The second post-natal week in rat is the period of the most intense oligodendrocyte development and myelination. This period coincides with peak iron import by oligodendrocytes. During that time oligodendrocyte progenitors (OPCs) are sensitive to agents that may disturb normal iron homeostasis and assimilation of iron into these cells. One mechanism by which iron homeostasis can be disrupted is by environmental exposure to other metals.

94, 95% CIs [- 10 55, - 1 34] mm Hg, P = 0 01; DBP: – 3 35, 95% C

94, 95% CIs [- 10.55, - 1.34] mm Hg, P = 0.01; DBP: – 3.35, 95% CIs [-6.52, - 0.19] mm Hg, P = 0.04). In contrast, treatment with soy isoflavones did not lead to a significant reduction in blood pressure in normotensive subjects (6 trials; SBP: 0.29, 95% CIs [- 2.39, 2.97] mm Hg, P = 0.83; DBP: – 0.43, 95% CIs [- 1.66, 0.81] mm Hg, P = 0.50).

Conclusion: Soy isoflavones had an effect of lowering blood pressure in hypertensive subjects, but AC220 cost not in normotensive subjects. Larger trials need to be carried out to confirm the present findings. (C) 2010 Elsevier B. V. All rights reserved.”
“Numerous evolutionary innovations were required to enable freshwater

green algae to colonize terrestrial habitats and thereby initiate the evolution of land plants (embryophytes). These adaptations probably included changes in cell-wall composition and architecture that were to become essential for embryophyte development and radiation. However, it is not known to what extent the polymers that are characteristic of embryophyte cell walls, including pectins, hemicelluloses, glycoproteins and lignin, evolved in response to the demands of the

terrestrial environment or whether ERK inhibitor they pre-existed in their algal ancestors. Here we show that members of the advanced charophycean green algae (CGA), including the Charales, Coleochaetales and Zygnematales, but not basal CGA (Klebsormidiales and Chlorokybales), have cell walls that are comparable in several respects to the primary walls of embryophytes. Moreover, we KU-57788 mouse provide both chemical and immunocytochemical evidence that selected Coleochaete species have cell walls that contain small amounts of lignin or lignin-like polymers derived from radical coupling of hydroxycinnamyl alcohols. Thus, the ability to synthesize many of the components that characterize

extant embryophyte walls evolved during divergence within CGA. Our study provides new insight into the evolutionary window during which the structurally complex walls of embryophytes originated, and the significance of the advanced CGA during these events.”
“Sinus lifting and reconstruction of localized alveolar defects are often required after closure of a large oroantral fistula (OAF) to allow for subsequent implant installation. This study describes a combined surgical technique that involves sinus lifting, bony closure, and reconstruction of the alveolar defect at the site of an OAF. The sinus membrane was reconstructed as a continuous layer by combining the residual sinus membrane with a rotated part of oral mucosa around the OAF. Autogenous bone from the chin and/or ramus was grafted into the prepared sinus space and alveolar defect, and the graft was covered by a buccal advancement flap. This technique was used to treat 8 patients who had large OAFs in the posterior maxillary region.

It was found that the in situ prepared inorganic phase was hydrox

It was found that the in situ prepared inorganic phase was hydroxyapatite nano-fibers that were uniformly dispersed in the chitosan matrix. The average diameter of the fibers were about 3 nm, while the length of the fibers increases from 20 to 60 nm when the hydroxyapatite content increased from 10 to 70 wt %. The compressive strength and Young’s modulus of these nano-fibrous

HA/CS composites increased with the increasing HA content and reached the highest values of 170 and 1.7 GPa, respectively, at the HA content of 5070 wt %, which were much higher than the values of samples prepared by coprecipitation. (C) 2011 Wiley Periodicals, Inc. J Appl Polym Sci, 2012″
“Purpose: To introduce a new surgical approach for open reduction and internal fixation of condylar fracture.

Patients and Methods: Salubrinal In this study, 36 patients with condylar fractures (51 sides) and those of the mandibular ramus and coronoid process were treated using a modified

retromandibular approach indirectly from the anterior edge of the parotid gland. The degree and type of mouth opening, occlusal relationship, facial nerve function, and other complications in the patients were assessed and evaluated.

Results: During the follow-up conducted over 12 to 24 months, x-ray examinations revealed good fracture healing. The occlusal relationship and degree and type of mouth opening improved significantly over those before operation. During the final SNX-5422 cost follow-up at 24 months, no case of ankylosis and/or salivary fistula was observed. Major complications at 1 week postoperation included temporary injury to the facial YM155 order nerve branches in 4 cases; this condition improved after 1 to 3 months.

Conclusions: Open reduction and internal fixation of condylar fracture by using the modified retromandibular approach indirectly from the anterior edge of the parotid gland has many advantages. Compared with the traditional surgical incision, this method is simple and short, and the completely exposed operative field facilitates reduction and fixation. Compared with transparotid approaches, it substantially reduces

the risk to the facial nerve. At the same time, this method is not only suitable for the surgical treatment of condylar fractures but also for those of the mandibular ramus and coronoid process. (C) 2009 American Association of Oral and Maxillofacial Surgeons”
“Introducing a cluster formation model, we provide a rational fundamental viewpoint for the difficulty to achieve n-type doped diamond. We argue that codoping is the way forward to form appropriately doped shallow regions in diamond and other forms of carbon such as graphene. The electronegativities of the codopants are an important design criterion for the donor atom to efficiently donate its electron. We propose that the nearest neighbour codopants should be of a considerably higher electronegativity compared to the donor atom.

In contrast, the ureteroscopic reviews yielded no statistical dif

In contrast, the ureteroscopic reviews yielded no statistical difference in image, color, and overall (P=1, 0.203, and 0.120) quality. The overall cost of the Endockscope+iPhone was $154 compared with $46,623 for a standard HD system. The weight of the mobile-coupled system was 0.47 lb and

1.01 lb for the Storz HD camera. Conclusion: Endockscope demonstrated feasibility of coupling endoscopes to a smartphone. The lighter and inexpensive Endockscope acquired images of the same resolution and acceptable color resolution. When evaluated by expert endoscopists, the quality of the images overall were equivalent for flexible ureteroscopy and somewhat inferior, but still acceptable for flexible cystoscopy.”
“Morbid obesity is a known risk factor for developing symptoms of urinary incontinence. However, it is not known if this XMU-MP-1 in vivo leads to a high prevalence of perioperative incontinence and bladder retention after bariatric surgery because routine use of bladder catheterization is usual during this kind of surgery. The study was conducted at a general hospital in the Netherlands. Sixty morbidly obese female GPCR Compound Library in vivo patients undergoing laparoscopic gastric bypass surgery were included in the present study. Preoperative urinary incontinence and risk factors were investigated by use of questionnaires. The following perioperative parameters were collected: operation time, total amount of intravenous

fluids, preoperative urinary retention on the ward measured by bladder scan, postoperative urinary incontinence on the recovery room,

Vorasidenib purchase postoperative urinary retention on the ward after passing urine measured by bladder scan, and observed urination on the ward. The prevalence of preoperative incontinence was 43 %. Nine patients (15 %) had postoperative urinary incontinence including four patients with known incontinence and five patients without. There were no differences between the patients with and without postoperative incontinence with relation to age, body mass index, diabetes mellitus, operation time, received amount of intravenous fluids and pre- and postoperative bladder scan residual volumes. Although the prevalence of urinary incontinence is high among morbidly obese female patients seeking bariatric surgery, postoperative incontinence was only present in 15 % of patients, and there was no need for catheterization for bladder retention. Preoperative risk factors for developing this kind of complications could not be identified.”
“Increased atmospheric CO2-concentration is widely being considered as the main driving factor that causes the phenomenon of global warming. This paper attempts to shed more light on the role of atmospheric CO2 in relation to temperature-increase and, more generally, in relation to Earth’s life through the geological aeons, based on a review-assessment of existing related studies.

Results The patients’ mean age at the time of the procedure was

Results. The patients’ mean age at the time of the procedure was 79.7 +/- 3.7 years. Twenty-seven had R428 ischemic heart disease and six had dilated cardiomyopathy. Their mean left ventricular ejection fraction (LVEF) was 35.9 +/- 8.9%. Ablation of clinical VT was successful in 28 patients (84.8%). There were no statistically significant differences in the efficacy of ablation

between patients with post-infarction scars (88.9%) and those with dilated cardiomyopathy (66.7%; P=17). An ICD was implanted after the procedure in four patients. Complications associated with the procedure occurred in only three patients. Twenty patients were contacted later, after a mean follow-up period of 38.5 +/- 27.7 months. Nine (mean age, 82.2 +/- 4.6 years) were still alive and reported a good quality of life, without recurrent arrhythmias.

Conclusions. Catheter ablation of VT in elderly patients with structural heart disease appeared to be effective and relatively safe. It could provide an alternative to ICD implantation in this patient group.”
“Objective-To identify the prevalence of fragmentation of the proximal tubercle of the talus (FPTT) in a hospital population of horses, characterize

the anatomic features of the affected area and fragments, and describe clinical findings, diagnosis, treatment, and outcome for horses with FPTT.

Design-Retrospective case series.

Animals-9 horses with FPTT.

Procedures-2,543 radiographic views

of the tarsal region of 1,526 horses that were evaluated between June 2004 and December 2010 were reviewed. Medical case records for selleck horses with detectable FPTT were retrieved, and signalment, history, clinical signs, diagnostic methods, treatment, and outcome were recorded for assessment.

Results-9 horses (median age, 5 years; age range, 1 to 12 years) with FPTT were identified. Seven horses were warmbloods. Diagnosis was made on the basis of radiographic findings, occasionally along with results of ultrasonography and CT. The only horse that was lame in the affected Aurora Kinase inhibitor limb had a history of a prior traumatic event and resultant lateral tibial malleolus fracture. One horse underwent arthroscopy, but fragments were not found and were presumed to be extra-articular. Outcome was available for 7 horses; mean +/- SD duration of stable radiographic and clinical examination findings was 3 +/- 1 years (range, 1 to 4 years).

Conclusions and Clinical Relevance-FPTT appeared to occur more frequently in warmbloods and was not usually associated with lameness. Affected horses remained clinically and radiographically stable over time These data have provided some information regarding the importance of FPTT for practitioners who perform radiographic screenings during prepurchase examinations. (J Am Vet Med Assoc 2013;242:984-991)”
“Background: Evidence for a role of individual foods and nutrients in the causation of ovarian cancer is inconclusive.

Disulfiram use 1 year before cancer diagnosis and the correspondi

Disulfiram use 1 year before cancer diagnosis and the corresponding date for controls were disregarded. We estimated crude and adjusted odds ratios and 95% confidence intervals (CI) for cancer associated with long-term (>= 500 daily defined doses) versus one-time (one prescription) use of disulfiram. Among 53 856 disulfiram users, we identified 166, 644, and 464 cases, respectively, of melanoma, breast, or prostate cancer. Adjusted odds ratios for melanoma, breast, or prostate cancer associated with long-term disulfiram use were 1.04 (95% CI:

0.60-1.78), 0.92 (95% CI: 0.70-1.22), and 0.77 (95% CI: 0.56-1.06), respectively. For prostate cancer, dose-response analyses showed a further risk reduction with the highest cumulative dose level of disulfiram; however, the test for GSK2118436 trend did not reach statistical significance. Our study provides

some epidemiological support for a protective effect of disulfiram against prostate and breast cancer.”
“We investigated the localization of porcine reproductive and respiratory syndrome virus (PRRSV) in the mammary glands of experimentally infected sows using reverse transcription PCR and immunohistochemistry. Six pregnant sows were inoculated intranasally with PRRSV three weeks prior to the predicted farrowing date. The six PRRSV-infected sows and two uninfected negative control sows remained clinically healthy and farrowed normally. Milk samples were collected from MAPK inhibitor all sows on lactation days 1, 2, and 3. PRRSV was detected AZD2171 in milk as early as lactation day

1 in all of the PRRSV-infected sows, but not in the uninfected sows. PRRSV antigen was detected by immunohistochemistry in macrophage-like cells in the alveolar lumina of the mammary glands and in other tissues. Our results show that PRRSV is shed in the milk of infected sows, and that PRRSV antigen is present in the mammary glands of experimentally infected sows. (C) 2009 Elsevier Ltd. All rights reserved.”
“Hospitals nuclear pharmacies are sectors related to research, education and assistance of pharmacists and physicians, specially the ones who work with nuclear pharmacy. The education in nuclear pharmacy is one of the most important aspects in this field. Due to the hard conditions in operating nuclear pharmacies (i.e. dose exposition, radiation protection procedures) it is difficult in most of the cases show to the students this environment. An intelligent and innovative form to dribble this obstacle is the association of new technologies, like virtual reality to educate without expose the students to dangerous situation inherent to the radioisotope manipulation. In this direction this study made use of virtual realty applied to hospital nuclear pharmacies in a training-to-training model to make it easy and interactive.