Boundary critical behaviour of two-dimensional random Ising models

Using Monte Carlo techniques and a star-triangle transformation, Ising models with random, 'strong' and 'weak', nearest-neighbour ferromagnetic couplings on a square lattice with a (1,1) surface are studied near the phase transition. Both surface and bulk critical properties are investigated. In particular, the critical exponents of the surface magnetization, 'beta_1', of the correlation length, 'nu', and of the critical surface correlations, 'eta_{\parallel}', are analysed.Comment: 16 pages in ioplppt style, 7 ps figures, submitted to J. Phys.

Diagnósticos enfermeros en UFISS, UGA, Traumatología y CIR.

In 2006, after the addition of a new nurse in UFISS (Social-Sanitary Functional Interdisciplinary Unit), is detected the need of a common language for all nurses with which to conduct a data collection for the nursing reports. The aim of this study is to know the main nursing diagnoses in UFISS, Geriatrics, Traumatology and Surgery units, using the NANDA (North American Nursing Diagnosis Association) nursing diagnostic terminology. We performed a retrospective study of all the medical reports at UFISS in 2006, a prospective study of all medical reports at Geriatrics and geriatric patients at Traumatology and Surgery in various periods between 2008 and 2009. According to the results, the use of a validated method like NANDA diagnoses, has enabled to nurses to identify common altered needs and after that, to define Nursing Diagnoses and develop the optimal care plan for the patientIntroducción: La utilización de un método validado, ha permitido detectar las necesidades alteradas en relación a su etiología, definiendo los DdE (Diagnósticos de Enfermería) (3).La utilización de la Taxonomía NANDA 2 asegura la definición de la respuesta humana a un problema tanto dentro del marco profesional como jurídico, así mismo permite un lenguaje común en la práctica enfermera (6).Objetivos. Identificar los DdE más prevalentes en la población atendida por la UFISS (Unidad Funcional Interdisciplinar Socio-Sanitaria), UGA (Unidad de Geriatría Aguda), TRAUMATOLOGÍA y CIRUGÍA de la FHAG (Fundación Hospital Asilo de Granollers) utilizando la taxonomía NANDA.Métodos.UFFIS. Se estudian retrospectivamente todas las historias de la UFISS del año 2006. (674 consultas, entrando en estudio N= 390 estudiadas).Se estudian prospectivamente:COT (Cirugía Ortopédica Traumatológica). 24 pacientes geriátricos de la unidad de trauma ingresados durante los meses de Agosto-Septiembre 2008UGA. 49 pacientes ingresados durante los meses de Septiembre-Diciembre 2008CIR. 36 pacientes ingresados en mayo 2009.Valoración paciente: Abordaje Bio-Psico-Social (Entrevista enfermera al paciente y al cuidador principal).Funcional (Barthel). Instrumentales (Lawton). Cognitivo (Pfeiffer). Riesgo de úlceras (EMINA). Dolor (EVA)Resultados.UFISS: Se detectan 18 diagnósticos, como los más prevalentes valorados en la UFISS,COT: Se detectan 26 diagnósticos, 16 son comunes a los recogidos por la enfermera de la UFISS, los 10 restantes son los específicos detectados en el paciente orto geriátrico:UGA: Se detectan 30 diagnósticos, de los cuales 18 son comunes a la UFISS y los 12 restantes son específicos en el paciente geriátrico.CIR: Se detectan alrededor de 50 diagnósticos; pendiente tabulación final.Conclusiones: Se han definido los diagnósticos más prevalentes determinando los comunes a las diferentes áreas asistenciales. Dado que en nuestra institución la formación es mayoritariamente básica, con este estudio hemos conseguido: 1) difundir el lenguaje NANDA, 2) asegurar el dominio de estos diagnósticos, 3) que el profesional trabaje de forma más segura utilizando un lenguaje validado y entendible y 4) orientar a la futura implantación informática

The <i>Herschel</i> view of the massive star-forming region NGC 6334

Aims: Fundamental to any theory of high-mass star formation are gravity and turbulence. Their relative importance, which probably changes during cloud evolution, is not known. By investigating the spatial and density structure of the high-mass star-forming complex NGC 6334 we aim to disentangle the contributions of turbulence and gravity. Methods: We used Herschel PACS and SPIRE imaging observations from the HOBYS key programme at wavelengths of 160, 250, 350, and 500 μm to construct dust temperature and column density maps. Using probability distribution functions (PDFs) of the column density determined for the whole complex and for four distinct sub-regions (distinguished on the basis of differences in the column density, temperature, and radiation field), we characterize the density structure of the complex. We investigate the spatial structure using the Δ-variance, which probes the relative amount of structure on different size scales and traces possible energy injection mechanisms into the molecular cloud. Results: The Δ-variance analysis suggests that the significant scales of a few parsec that were found are caused by energy injection due to expanding HII regions, which are numerous, and by the lengths of filaments seen everywhere in the complex. The column density PDFs have a lognormal shape at low densities and a clearly defined power law at high densities for all sub-regions whose slope is linked to the exponent α of an equivalent spherical density distribution. In particular with α = 2.37, the central sub-region is largly dominated by gravity, caused by individual collapsing dense cores and global collapse of a larger region. The collapse is faster than free-fall (which would lead only to α = 2) and thus requires a more dynamic scenario (external compression, flows). The column density PDFs suggest that the different sub-regions are at different evolutionary stages, especially the central sub-region, which seems to be in a more evolved stage

A primary care, multi-disciplinary disease management program for opioid-treated patients with chronic non-cancer pain and a high burden of psychiatric comorbidity

BACKGROUND: Chronic non-cancer pain is a common problem that is often accompanied by psychiatric comorbidity and disability. The effectiveness of a multi-disciplinary pain management program was tested in a 3 month before and after trial. METHODS: Providers in an academic general medicine clinic referred patients with chronic non-cancer pain for participation in a program that combined the skills of internists, clinical pharmacists, and a psychiatrist. Patients were either receiving opioids or being considered for opioid therapy. The intervention consisted of structured clinical assessments, monthly follow-up, pain contracts, medication titration, and psychiatric consultation. Pain, mood, and function were assessed at baseline and 3 months using the Brief Pain Inventory (BPI), the Center for Epidemiological Studies-Depression Scale scale (CESD) and the Pain Disability Index (PDI). Patients were monitored for substance misuse. RESULTS: Eighty-five patients were enrolled. Mean age was 51 years, 60% were male, 78% were Caucasian, and 93% were receiving opioids. Baseline average pain was 6.5 on an 11 point scale. The average CESD score was 24.0, and the mean PDI score was 47.0. Sixty-three patients (73%) completed 3 month follow-up. Fifteen withdrew from the program after identification of substance misuse. Among those completing 3 month follow-up, the average pain score improved to 5.5 (p = 0.003). The mean PDI score improved to 39.3 (p < 0.001). Mean CESD score was reduced to 18.0 (p < 0.001), and the proportion of depressed patients fell from 79% to 54% (p = 0.003). Substance misuse was identified in 27 patients (32%). CONCLUSIONS: A primary care disease management program improved pain, depression, and disability scores over three months in a cohort of opioid-treated patients with chronic non-cancer pain. Substance misuse and depression were common, and many patients who had substance misuse identified left the program when they were no longer prescribed opioids. Effective care of patients with chronic pain should include rigorous assessment and treatment of these comorbid disorders and intensive efforts to insure follow up

A multi-component flood risk assessment in the Maresme coast (NW Mediterranean)

Coastal regions are the areas most threatened by natural hazards, with floods being the most frequent and significant threat in terms of their induced impacts, and therefore, any management scheme requires their evaluation. In coastal areas, flooding is a hazard associated with various processes acting at different scales: coastal storms, flash floods, and sea level rise (SLR). In order to address the problem as a whole, this study presents a methodology to undertake a preliminary integrated risk assessment that determines the magnitude of the different flood processes (flash flood, marine storm, SLR) and their associated consequences, taking into account their temporal and spatial scales. The risk is quantified using specific indicators to assess the magnitude of the hazard (for each component) and the consequences in a common scale. This allows for a robust comparison of the spatial risk distribution along the coast in order to identify both the areas at greatest risk and the risk components that have the greatest impact. This methodology is applied on the Maresme coast (NW Mediterranean, Spain), which can be considered representative of developed areas of the Spanish Mediterranean coast. The results obtained characterise this coastline as an area of relatively low overall risk, although some hot spots have been identified with high-risk values, with flash flooding being the principal risk process

Predictors of opioid misuse in patients with chronic pain: a prospective cohort study

BACKGROUND: Opioid misuse can complicate chronic pain management, and the non-medical use of opioids is a growing public health problem. The incidence and risk factors for opioid misuse in patients with chronic pain, however, have not been well characterized. We conducted a prospective cohort study to determine the one-year incidence and predictors of opioid misuse among patients enrolled in a chronic pain disease management program within an academic internal medicine practice. METHODS: One-hundred and ninety-six opioid-treated patients with chronic, non-cancer pain of at least three months duration were monitored for opioid misuse at pre-defined intervals. Opioid misuse was defined as: 1. Negative urine toxicological screen (UTS) for prescribed opioids; 2. UTS positive for opioids or controlled substances not prescribed by our practice; 3. Evidence of procurement of opioids from multiple providers; 4. Diversion of opioids; 5. Prescription forgery; or 6. Stimulants (cocaine or amphetamines) on UTS. RESULTS: The mean patient age was 52 years, 55% were male, and 75% were white. Sixty-two of 196 (32%) patients committed opioid misuse. Detection of cocaine or amphetamines on UTS was the most common form of misuse (40.3% of misusers). In bivariate analysis, misusers were more likely than non-misusers to be younger (48 years vs 54 years, p < 0.001), male (59.6% vs. 38%; p = 0.023), have past alcohol abuse (44% vs 23%; p = 0.004), past cocaine abuse (68% vs 21%; p < 0.001), or have a previous drug or DUI conviction (40% vs 11%; p < 0.001%). In multivariate analyses, age, past cocaine abuse (OR, 4.3), drug or DUI conviction (OR, 2.6), and a past alcohol abuse (OR, 2.6) persisted as predictors of misuse. Race, income, education, depression score, disability score, pain score, and literacy were not associated with misuse. No relationship between pain scores and misuse emerged. CONCLUSION: Opioid misuse occurred frequently in chronic pain patients in a pain management program within an academic primary care practice. Patients with a history of alcohol or cocaine abuse and alcohol or drug related convictions should be carefully evaluated and followed for signs of misuse if opioids are prescribed. Structured monitoring for opioid misuse can potentially ensure the appropriate use of opioids in chronic pain management and mitigate adverse public health effects of diversion

Molecular Basis of Ligand Dissociation in β-Adrenergic Receptors

The important and diverse biological functions of β-adrenergic receptors (βARs) have promoted the search for compounds to stimulate or inhibit their activity. In this regard, unraveling the molecular basis of ligand binding/unbinding events is essential to understand the pharmacological properties of these G protein-coupled receptors. In this study, we use the steered molecular dynamics simulation method to describe, in atomic detail, the unbinding process of two inverse agonists, which have been recently co-crystallized with β1 and β2ARs subtypes, along four different channels. Our results indicate that this type of compounds likely accesses the orthosteric binding site of βARs from the extracellular water environment. Importantly, reconstruction of forces and energies from the simulations of the dissociation process suggests, for the first time, the presence of secondary binding sites located in the extracellular loops 2 and 3 and transmembrane helix 7, where ligands are transiently retained by electrostatic and Van der Waals interactions. Comparison of the residues that form these new transient allosteric binding sites in both βARs subtypes reveals the importance of non-conserved electrostatic interactions as well as conserved aromatic contacts in the early steps of the binding process

Improving virtual screening of G protein-coupled receptors via ligand-directed modeling

G protein-coupled receptors (GPCRs) play crucial roles in cell physiology and pathophysiology. There is increasing interest in using structural information for virtual screening (VS) of libraries and for structure-based drug design to identify novel agonist or antagonist leads. However, the sparse availability of experimentally determined GPCR/ligand complex structures with diverse ligands impedes the application of structure-based drug design (SBDD) programs directed to identifying new molecules with a select pharmacology. In this study, we apply ligand-directed modeling (LDM) to available GPCR X-ray structures to improve VS performance and selectivity towards molecules of specific pharmacological profile. The described method refines a GPCR binding pocket conformation using a single known ligand for that GPCR. The LDM method is a computationally efficient, iterative workflow consisting of protein sampling and ligand docking. We developed an extensive benchmark comparing LDM-refined binding pockets to GPCR X-ray crystal structures across seven different GPCRs bound to a range of ligands of different chemotypes and pharmacological profiles. LDM-refined models showed improvement in VS performance over origin X-ray crystal structures in 21 out of 24 cases. In all cases, the LDM-refined models had superior performance in enriching for the chemotype of the refinement ligand. This likely contributes to the LDM success in all cases of inhibitor-bound to agonist-bound binding pocket refinement, a key task for GPCR SBDD programs. Indeed, agonist ligands are required for a plethora of GPCRs for therapeutic intervention, however GPCR X-ray structures are mostly restricted to their inactive inhibitor-bound state

Differential Modulation of Beta-Adrenergic Receptor Signaling by Trace Amine-Associated Receptor 1 Agonists

Trace amine-associated receptors (TAAR) are rhodopsin-like G-protein-coupled receptors (GPCR). TAAR are involved in modulation of neuronal, cardiac and vascular functions and they are potentially linked with neurological disorders like schizophrenia and Parkinson's disease. Subtype TAAR1, the best characterized TAAR so far, is promiscuous for a wide set of ligands and is activated by trace amines tyramine (TYR), phenylethylamine (PEA), octopamine (OA), but also by thyronamines, dopamine, and psycho-active drugs. Unfortunately, effects of trace amines on signaling of the two homologous β-adrenergic receptors 1 (ADRB1) and 2 (ADRB2) have not been clarified yet in detail. We, therefore, tested TAAR1 agonists TYR, PEA and OA regarding their effects on ADRB1/2 signaling by co-stimulation studies. Surprisingly, trace amines TYR and PEA are partial allosteric antagonists at ADRB1/2, whereas OA is a partial orthosteric ADRB2-antagonist and ADRB1-agonist. To specify molecular reasons for TAAR1 ligand promiscuity and for observed differences in signaling effects on particular aminergic receptors we compared TAAR, tyramine (TAR) octopamine (OAR), ADRB1/2 and dopamine receptors at the structural level. We found especially for TAAR1 that the remarkable ligand promiscuity is likely based on high amino acid similarity in the ligand-binding region compared with further aminergic receptors. On the other hand few TAAR specific properties in the ligand-binding site might determine differences in ligand-induced effects compared to ADRB1/2. Taken together, this study points to molecular details of TAAR1-ligand promiscuity and identified specific trace amines as allosteric or orthosteric ligands of particular β-adrenergic receptor subtypes

Packages of Care for Alcohol Use Disorders in Low- And Middle-Income Countries

In the fourth in a series of six articles on packages of care for mental disorders in low- and middle-income countries, Vivek Benegal and colleagues discuss the treatment of alcohol use disorders