Thin-layer chromatographic separation of polyamines revealed greater ammonia, spermidine and an unknown polyamine accumulation in warm-incubated kernels. Thus, the declined rate of walnut kernel germination this website under warm conditions is mainly correlated with rapid inactivation of arginase, greater levels of ammonia and alterations in kernel polyamine composition. The enhanced activity of GDH in warm-incubated kernels

implies that catabolic deamination of amino acids and their subsequent respiration is the favored pathway ongoing under warm conditions. This situation compromises germination-specific metabolism of amino acids which likely to operate better at lower temperatures during cold mTOR inhibitor stratification of kernels.”
“A model of the niobium diselenide crystal lattice has been proposed. This model sufficiently

describes the vibrational characteristics of both bulk samples and nanofilms with a thickness beyond one three-layered structural element. Calculation of the local Green functions and mean-squared atom amplitudes have been performed using the Jacobi-matrix method.\n\nPhonon density of states features stipulated by acoustic branches and low-frequency low-dispersion optical modes crossover have been analyzed. (C) 2009 Elsevier Ltd. All rights reserved.”
“AimTo find out whether there was an association between when complementary feeding was introduced and the appearance of atopic eczema in children with a family history of allergy. MethodsThis prospective study followed 256 mother and child pairs until the child was four-years-old. Repeated skin prick testing was performed and a clinical diagnosis of eczema made by a physician. The mothers kept a continuous diary about the introduction of complementary

Sapitinib chemical structure feeding. To control the possible reverse causation of delaying complementary food introduction due to presumed child allergy, parental suspicions of allergic reactions were recorded. ResultsThe introduction of cereals and fish after seven-months-of-age was associated with an increased risk of atopic eczema. However, when the parents’ suspicions that their child might be exhibiting symptoms of allergic disease were taken into account, this effect was no longer significant. ConclusionWe found no evidence that the timing of the introduction of complementary feeding increased the risk of atopic eczema in a high-risk cohort, when parental suspicions were taken into account. Therefore, it seems that families with a history of allergy can safely comply with current feeding recommendations, although confirmation in further studies is warranted.”
“Clinician-scientists are becoming increasingly rare in medicine as a whole, but especially in ophthalmology.

Tan, L. T. et al. (2009). Clinical Oncology 21, 175-182 (C) 2008 The Royal College of Radiologists. Published by Elsevier Ltd. All. rights reserved.”
“Objective. The objectives of this study were to investigate the associations of key constructs of relationship quality (cohesion, consensus, and satisfaction) and perceived partner responses to pain behavior (e.g., solicitous and negative responses) with the outcomes of pain and disability Nepicastat concentration in those with long-term low back pain, and to explore the role of the patient’s depressive symptom mood state on those associations.\n\nMethods. Self-report questionnaires on pain intensity, disability, relationship quality, perceived partner reactions to pain, and depressive symptoms

SB203580 were collected from participants (N = 174) taking part in a longitudinal study on low back pain within a primary care sample.\n\nResults. Participants reporting more consensus (e. g., agreement about sexual intimacy, level of affection) in their relationships had significantly higher pain intensity (P = 0.03), and solicitous partner responses (P = 0.04) were significantly positively associated with disability levels. However, the findings for pain intensity were only present in those with higher levels of depression, while the association of solicitous responses with disability was

only significant in those with lower levels of depression, indicating a suppression effect of depression on pain and disability.\n\nConclusions. VX-680 molecular weight Depressive symptoms play a significant role in determining the associations between relationship quality, perceived partner reactions, and pain and disability. The relationship construct of consensus and perceived solicitous responses were associated with pain and disability. These findings illustrate the importance of social context and patient mood state on the outcomes for those with low back pain.”
“Stroke is the leading cause of disability in adults. In Germany an estimated 1.5 million stroke survivors have to cope with persisting sensorimotor or cognitive deficits and effective therapies are scarce. The idea of using non-invasive brain stimulation

to treat neuropsychiatric diseases was already born more than 2,000 years ago (Scribonius largus, 43-48 AD). However, only the development of modern non-invasive brain stimulation methods, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) has made it possible to evaluate these ideas. The therapeutic value of these non-invasive brain stimulation methods is currently under study for several neuropsychiatric diseases, mostly in a proof-of-principle fashion. In this article the focus will be on non-invasive brain stimulation to enhance functional regeneration after stroke.”
“Objective: To establish the efficacy of short-term outpatient pulmonary rehabilitation in patients with chronic pulmonary diseases.

Concurrent CT/TRT consisted of docetaxel 20 mg/m(2) and carboplatin AUC 2 weekly plus 60 Gy TRT. No

differences were found in ORR between the two arms (56% and 57%). Hematological toxicity was mild but significantly superior with consolidation Cl’; the esophagitis rate was similar in both arms (16% and 15%). Wlth a median follow-up of 57 months, no differences were found in median survival (13.07 and 13.8 months) or 5-year survival (16.4% and 22%). This regimen cannot be recommended as an alternative to platinum-based MEK inhibitor side effects CT/TRT although it has an acceptable toxicity profile and encouraging long-term survival data (ClinicalTrials.gov NCT01652820). (C) 2013 Elsevier Ireland Ltd. All rights reserved.”
“BACKGROUND: Glucose-regulated protein 78 (GRP78), a marker of endoplasmic reticulum stress, can prolong cell survival. Alternatively, CCAAT enhancer-binding protein homologous protein (CHOP), a transcription factor specific for endoplasmic reticulum stress, can cause cell cycle arrest and cell apoptosis.\n\nOBJECTIVE: To study the protective effects of serum containing natural cerebrolysin on endoplasmic reticulum stress

in tunicamycin-induced see more neuronal PC12 cells, and analyze the influence on GRP78 and CHOP expressions.\n\nDESIGN, TIME AND SETTING: A parallel controlled study was performed at the Institute of Integrated Western and Traditional Chinese Medicine, Shenzhen Hospital, Southern Medical University, between March 2006 and August 2008.\n\nMATERIALS: Adult Sprague-Dawley rats were perfused with natural Cerebrolysin aqueous extract (0.185 g/kg/d) to produce serum containing natural Cerebrolysin. Physiological saline was used to produce blank serum. PC12 cell line was provided by Shanghai Institute of Cell Biology, Chinese

Academy of Science. Tunicamycin was provided by Sigma (St. Louis, USA), and natural Cerebrolysin, containing ginseng, rhizoma gastrodiae, and gingko leaf (1:2:2), by Shengzhen Institute of Integrated Western and Traditional Chinese Medicine.\n\nMETHODS: PC12 cells were treated with DMEM culture media containing 10% blank serum (normal control group), tunicamycin (1 mu g/ml; model group), and 5%, 10%, and 15% serum containing natural cerebrolysin and tunicamycin (1 mu 9/mL; low-, moderate-, and high-dose serum containing natural cerebrolysin groups), for 2 hours.\n\nMAIN OUTCOME BEZ235 manufacturer MEASURES: PC12 cells were treated with tunicamycin for 48 hours after which apoptosis was measured using the TUNEL method to calculate apoptotic index. GRP78 expression was detected using immunocytochemistry. After 24 hours of treatment with tunicamycin, GRP78 and CHOP mRNA expressions were measured using RT-PCR.\n\nRESULTS: The apoptotic index and CHOP mRNA expression were in the model group and three cerebrolysin groups were significantly increased when compared to the normal control group (P < 0.05). In contrast, GRP78 mRNA and protein expressions were significantly decreased (P < 0.05).

Results from studies involving seagrass patch size and

edge effects on associated fauna have shown that patchy seagrass habitats can be either beneficial or detrimental. One reason for the variable results might be the existence of ecological trade-offs for species that associate with seagrass habitats. Bay scallops, Argopecten irradians, are useful model organisms for studying the response of a semi-mobile bivalve to changes in seagrass seascapes-they exhibit a strong habitat association and seagrass offers a predation refuge at a cost of reduced growth. This study investigated the potential ecological survival-growth trade-off for bay scallops living within a seagrass seascape. Scallop growth was consistently fastest in bare sand and slowest at patch centers, and survival showed the opposite STI571 trend. Scallops in patch edges displayed intermediate growth and survival. Using models for minimizing mortality (mu) to foraging (f) ratios, the data suggests seagrass edge habitat offered similar value to patch centers. Further, investigations of core-area index suggest GM6001 manufacturer that small, complex patches might offer scallops a balance between predation risk and maximized growth. Taken in sum, these results suggest that edge habitats may benefit organisms like bay scallops by maximizing risk versus reward and maximizing edge habitat.”
“Apomorphine (APO) is an anti-parkinsonian drug currently in use,

which provides relief of Parkinson’s symptoms. QNZ inhibitor However, the utility of APO is greatly hampered by its poor bioavailability and rapid metabolism. In the present study, O,O’-diacetyl-apomorphine, a prodrug of apomorphine, was synthesized and its biological

activity was examined. The prodrug induced fibroblast growth factor-2 production in astrocytic cultures similarly to apomorphine. However, its duration of action was significantly prolonged, and its resistance to oxidation was markedly enhanced compared to APO. O,O’-Diacetyl-apomorphine also induced MEK/MAPK signaling. These results suggest that O,O’-diacetyl-apomorphine can efficiently counteract oxidation and thereby enhance FGF-2 production in astrocytes. (c) 2008 Elsevier Inc. All rights reserved.”
“The novel HPV 9G DNAChips were developed for the detection and discrimination of the HPV genotypes in the clinical samples. The HPV 9G DNAChip established high SBR of 50-70 and 100% target-specific hybridization after 30 min hybridization and 2 x 2 min washing at 25 degrees C. We compared the genotyping results of the 959 HPV positive and 82 HPV negative clinical samples by the HPV 9G DNAChip and the sequencing; the results are in 100% agreement. The HPV 9G DNAChip efficiently discriminate 19 HPV genotypes in the 959 HPV positive clinical samples. The results of HPV 9G DNAChip were 100% identical with the sequencing analysis in the detection and discrimination of HPV genotypes in the HPV negative clinical samples.

Also, several possible proton entry points and proton-transfer pathways have been proposed. However, the mechanism of the proton transfer to QB remains unclear. The proton transfer to QB in the bRC of Blastochloris viridis is less explored. To analyze whether the bRCs of different species use the same key residues for proton transfer to QB, we determined the conservation of these residues. We performed a multiple-sequence alignment

based on profile hidden Markov models. Residues involved in proton transfer but not located at the protein surface are conserved or are only exchanged to functionally similar amino acids, whereas potential proton selleck inhibitor entry points are not conserved to the same extent. The analysis of the hydrogen-bond network of the bRC from R. sphaeroides and that from

B. viridis Histone Methyltransf inhibitor showed that a large network connects Q(B) with the cytoplasmic region in both bRCs. For both species, all non-surface key residues are part of the network. However, not all proton entry points proposed for the bRC of R. sphaeroides are included in the network in the bRC of B. viridis. From our analysis, we could identify possible proton entry points. These proton entry points differ between the two bRCs. Together, the results of the conservation analysis and the hydrogen-bond network analysis make it likely that the proton transfer to QB is not mediated by distinct pathways but by a large hydrogen-bond network. (C) 2009 Elsevier Ltd. All rights reserved.”
“In this study, we examined the effects of LY52, a caffeoyl pyrrolidine derivative designed to fit the S’1 active pocket of gelatinases, on the expressions of matrix metalloproteinases and invasion abilities of hepatocellular carcinoma cells.\n\nThe effects of LY52 on the proliferations of HepG2 (hepatitis B virus (HBV) negative) and HepG2.2.15 (HBV-producing) cells were detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Gelatin zymography was used to detect the effects of LY52 on matrix metalloproteinases expressions and Western blot was used to detect

matrix metalloproteinase-2 expressions. Transwell chamber assay was used to detect the effects of LY52 on invasion of the cells.\n\nGelatin LBH589 price zymography and Western blot showed that matrix metalloproteinase-2 expressions were inhibited by LY52 in a dose-dependent manner, and inhibitory rates of LY52 on HepG2 cells were higher than on HepG2.2.15 cells. Transwell chamber showed that LY52 could significantly inhibit the invasion of both cells, although the inhibitory effects of LY52 on HepG2.2.15 cells were was not as obvious as on HepG2 cells.\n\nThese results suggested that LY52 might inhibit the invasion of hepatocellular carcinoma cells by suppressing matrix metalloproteinase-2, although the inhibitory effects of LY52 on HBV-negative cells were more obvious than that of HBV-infected cells.

inornata. Body areas sampled included 6 locations from the fish epaxial and hypaxial muscles and 1 from each of the adductor mandibulae (cheek muscle), the cranial epaxial muscle, and the muscle of the caudal peduncle. Replicate samples were weighed and the number of plasmodia in each was recorded to determine the average density of plasmodia per gram of muscle in each area. The average density of plasmodia among fish was highly variable and was not correlated with fish size, age, or the homogeneity of distribution. Although the anterior hypaxial muscle (belly flap) was significantly more infected and the caudal peduncle less infected, when compared to all other areas examined in all fish combined,

10 out of 15 fish displayed an otherwise homogeneous distribution when data were analyzed fish by fish. Among the 5 fish with a nonuniform plasmodia distribution, 3 had a significantly higher burden in the belly flap, 1 in the area just posterior NU7441 supplier to the belly flap, and 1 in the cheek muscle. Based on these results, it was determined that hypaxial, caudal peduncle, and cheek muscles RG7440 contributed greatly to the overall variation in plasmodia distribution observed whereas any portion of the epaxial muscle, as well

as the cranial muscle, would be the least-variable areas to sample to determine the status of infection in any given fish.”
“The cause of fracture of the femoral neck after hip resurfacing is poorly understood. In order to evaluate the role of avascular necrosis we compared 19 femoral heads retrieved at revision for fracture of the femoral neck and 13 retrieved for other reasons.\n\nWe developed a new technique of assessing avascular necrosis in the femoral head by determining the percentage of empty osteocyte lacunae present. Femoral heads retrieved as controls at total hip replacement for

osteoarthritis and avascular necrosis had 9% (SD 4; n = 13) and 85% (SD 5; n = 10, p < 0.001) empty lacunae, respectively.\n\nIn the fracture group the percentage of empty lacunae was 71% (SD 22); in the other group it was 21% (SD 13). The differences between selleck compound the groups were highly significant (p < 0.001).\n\nWe conclude that fracture after resurfacing of the hip is associated with a significantly greater percentage of empty osteocyte lacunae within the trabecular bone. This indicates established avascular necrosis and suggests that damage to the blood supply at the time of surgery is a potent risk factor for fracture of the femoral neck after hip resurfacing.”
“Background and objectives Mortality from cardiovascular disease in the Middle East (ME) is projected to increase substantially by 2020. There are no large studies on the impact of risk factors for acute myocardial infarction (AMI) in the region. This is a report on the association of nine risk factors with AMI in the ME. Methods and results As part of the INTERHEART (IH) study, we enrolled 1364 cases of first AMI and 1525 matching controls from eight ME countries.

The pheasant coucal’s exceptional combination of classic

sex-roles and male-biased care for extra-pair young is hard to reconcile with current sexual selection theory, but may represent an intermediate stage in the evolution of polyandry or an evolutionary remnant of polyandry.”
“Percutaneous epicardial mapping GSK2245840 molecular weight and ablation is an emerging method to treat ventricular tachycardias (VT), premature ventricular complexes (PVC), and accessory pathways. The use of a remote magnetic navigation system (MNS) could enhance precision and maintain safety. This multiple case history demonstrates the feasibility and safety of the MNS-guided epicardial approach in mapping and ablation of ischaemic VT, outflow tract PVCs, and a left-sided accessory pathway. All patients had previously undergone endocardial mapping for the same arrhythmia. MNS could present an advantage from more precise navigation for mapping and maintaining catheter stability during energy application.”
“2-Spectrin is an actin-binding protein that plays an important role in membrane integrity and the transforming growth factor (TGF)- signalling pathway as an adaptor for Smads. Loss of 2-spectrin in mice (Spnb2(/)) results in embryonic lethality with

gastrointestinal, liver, neural, and heart abnormalities that are similar to those in Smad2(/)Smad3(/) mice. However, to date, the role of 2-spectrin in embryogenesis, particularly in heart development, has been poorly delineated. Here, we demonstrated that 2-spectrin is required for the learn more survival and differentiation of cardiomyocytes, and its loss resulted in defects in heart development with failure of ventricular wall thickening. Disruption of 2-spectrin in primary muscle cells not only inhibited TGF-/Smad signalling, but also reduced the

expression of the cardiomyocyte differentiation markers Nkx2.5, dystrophin, and -smooth muscle actin (-SMA). Furthermore, cytoskeletal networks of dystrophin, F-actin, and -SMA in cardiomyocytes were disorganized upon loss of 2-spectrin. In addition, deletion of 2-spectrin in mice (Spnb2(tm1a/tm1a)) prevented proper development of the heart in association with disintegration of dystrophin structure and markedly reduced survival. These data suggest that 2-spectrin deficiency leads to inactivation of SBE-β-CD clinical trial TGF-/Smad signalling and contributes to dysregulation of the cell cycle, proliferation, differentiation, and the cytoskeletal network, and it leads to defective heart development. Our data demonstrate that 2-spectrin is required for proper development of the heart and that disruption of 2-spectrin is a potential underlying cause of congenital heart defects.”
“Hantavirus hemorrhagic fever with renal syndrome is endemic in Europe and Asia, while hantavirus cardiopulmonary syndrome (HCPS) is endemic in Northern, Central and Southern America. The first case of imported HCPS involving an Italian traveller returning from Cuba is reported.

OBJECTIVE To evaluate

the association of the 2011 ACGME duty hour reforms with mortality and readmissions. DESIGN, SETTING, AND PARTICIPANTS Observational study of Medicare patient admissions (6 384 273 admissions from 2 790 356 patients) to short-term, acute care, nonfederal hospitals (n = 3104) with principal medical diagnoses of acute myocardial infarction, stroke, gastrointestinal Selleck GSK 3 inhibitor bleeding, or congestive heart failure or a Diagnosis Related Group classification of general, orthopedic, or vascular surgery. Of the hospitals, 96 (3.1%) were very major teaching, 138 (4.4%) major teaching, 442 (14.2%) minor teaching, 443 (14.3%) very minor teaching, and 1985 (64.0%) nonteaching. EXPOSURE Resident-to-bed ratio as a continuous measure of hospital teaching intensity. MAIN OUTCOMES AND MEASURES Change in 30-day all-location mortality and 30-day all-cause readmission, comparing patients in more intensive relative to less intensive teaching hospitals B-Raf assay before (July 1, 2009-June 30, 2011) and after (July 1, 2011-June 30, 2012) duty hour reforms, adjusting for patient comorbidities, time trends, and hospital site. RESULTS In the 2 years before duty hour reforms, there were 4 325 854 admissions with 288 422 deaths and 602 380 readmissions. In the first

year after the reforms, accounting for teaching hospital intensity, there were 2 058 419 admissions with 133 547 deaths and 272 938 readmissions. There were no significant postreform differences in mortality accounting for teaching hospital intensity for combined medical conditions (odds Nepicastat research buy ratio [OR], 1.00; 95% CI, 0.96-1.03), combined surgical categories (OR, 0.99; 95% CI, 0.94-1.04), or any of the individual medical conditions or surgical categories. There were no significant postreform differences in readmissions for combined medical conditions (OR, 1.00;

95% CI, 0.97-1.02) or combined surgical categories (OR, 1.00; 95% CI, 0.98-1.03). For the medical condition of stroke, there were higher odds of readmissions in the postreform period (OR, 1.06; 95% CI, 1.001-1.13). However, this finding was not supported by sensitivity analyses and there were no significant postreform differences for readmissions for any other individual medical condition or surgical category. CONCLUSIONS AND RELEVANCE Among Medicare beneficiaries, there were no significant differences in the change in 30-day mortality rates or 30-day all-cause readmission rates for those hospitalized in more intensive relative to less intensive teaching hospitals in the year after implementation of the 2011 ACGME duty hour reforms compared with those hospitalized in the 2 years before implementation. Copyright 2014 American Medical Association. All rights reserved.”
“OBJECTIVE.

The infectivity defects were correlated to the degree of INI1 interaction of the IID-IN mutants. Highly defective IID-IN mutants were blocked at early and late reverse transcription, whereas partially defective IID-IN mutants proceeded through reverse transcription and nuclear localization, but were partially impaired for integration. Electron microscopic analysis of mutant particles indicated that highly interaction-defective

IID-IN mutants produced morphologically aberrant virions, whereas the partially defective mutants produced normal virions. All of the IID-IN mutant particles exhibited normal capsid stability and reverse transcriptase activity in vitro.\n\nConclusions: Our results demonstrate that a severe defect in IN-INI1 interaction is associated with production

of defective particles and a subsequent defect in post-entry events. A partial defect Vactosertib clinical trial in IN-INI1 interaction leads to production of normal virions that are partially impaired for early events including integration. BLZ945 research buy Our studies suggest that proper interaction of INI1 with IN within Gag-Pol is necessary for proper HIV-1 morphogenesis and integration.”
“2,4,6-Trinitrophenyl (TNP) hapten-labeled peritoneal macrophages (Mf) given intravenously (iv) to recipients are poor inducers of contact sensitivity (CS) reactions unless Mf donors are pretreated with low doses of cyclophosphamide (CY), In vivo CY is converted into Sapanisertib nmr active alkylating metabolites, phosphoramide mustard (PM) and acrolein (ACR).\n\nOur experiments aimed to test how in vitro treatment of non-immunogenic Mf with different concentrations (10(-5) to 10(-7) M) of CY metabolites will influence their immunogenicity and other biological functions. Instead of chemically unstable PM, we used structurally and functionally similar nitrogen

mustard (NM).\n\nOur experiments show that treatment of Mf with ACR or NM stimulates the in vitro production of pro-inflammatory IL-6 and IL-12 and down-regulates anti-inflammatory IL-10 and TGF-beta cytokines. In vivo non-immunogenic TNP-Mf become capable of inducing CS reactions in two situations: first, after treatment with NM or ACR and second, when cell recipients are received iv before Mf transfer of monoclonal antibodies against IL-10 and/or TGF-beta (500 mu g per animal). Treatment with NM, but not with ACR, was also an efficient stimulus for production by Mf of significantly increased levels of reactive oxygen intermediates (ROIs).\n\nIn summary, our experiments show that CY metabolites can significantly increase the specific immune response as well as nonspecific innate reaction (ROIs production) and support the notion that CY and its metabolites can be a promising accessory tool when upregulation of the immune response is desired.

In the second (parallel) group, wins/losses of the performer were paralleled by similar wins and losses by the observer. In the third (reverse) group, wins of the performer led to a loss of the observer and vice versa.\n\nResults: ERPs of the performers showed a mediofrontal feedback related negativity (FRN) to losses. The neutral and parallel observer groups did similarly show an FRN response to the performer’s losses Quisinostat research buy with a topography indistinguishable from that seen in the performers. In the reverse group, however, the FRN occurred for wins of the performer which translated to losses for the observer.\n\nConclusions: Taking into account previous experiments, we suggest

that the FRN response in observers is driven by two evaluative processes (a) related to the benefit/loss for oneself and (b) related to the benefit/loss of another person.”
“It has been 21 years since the first successful use of umbilical cord blood as a source of donor cells for hematopoietic stem cell transplantation (HSCT). Over those years, cord blood transplantation (CBT) has shown marked success as an effective DMXAA price modality in the treatment of children and adults with hematologic malignancies, marrow failure, immunodeficiency,

hemoglobinopathy, and inherited metabolic diseases. Furthermore, transplantation without full human leukocyte antigen (HLA) matching is possible and, despite a lower incidence of graft-versus-host disease, graft-versus-leukemia effect is preserved. More than 20,000 CBTS have been performed worldwide. Ontario is the most populated province in Canada, and its CBT numbers have increased dramatically in recent years, but most of the umbilical cord blood units are purchased from unrelated international registries. There is no public cord

bank in Ontario, but there is a private cord banking option, and notably, Ontario has the largest number of live births PD-1/PD-L1 tumor in Canada [approximately 40% of all Canadian live births per year occur in Ontario (Statistics Canada, 2007)]. In this brief review, the pros and cons of private and public cord banking and the feasibility of starting an Ontario public cord bank are discussed.”
“Objectives: (1) Evaluate impact of FCR on provider satisfaction and collaboration. (2) Evaluate impact of FCR on parent satisfaction with provider communication. Methods: Collaboration and Satisfaction about Care Decisions (CSACD) questionnaire was given to staff on 4 patients 2 days a week for 5 weeks prior to and 6 months after implementation of FCR. Parents received a Parents Stress Scale and Neonatal Instrument of Parent Satisfaction before discharge, prior to and 6 months after starting FCR. Results: 278/288 (97%) staff surveys were completed, 142 pre and 136 post. On the CSACD survey NNPs and fellows showed increased (p < 0.05) collaboration and satisfaction post FCR. No group had decreased satisfaction. Twenty-eight of 45 (62%) parent surveys were completed, 12 pre and 16 post.