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Adherence to medication in children and adolescents with asthma: methods for monitoring and intervention
Introduction: Poor adherence in children with asthma is a major cause of asthma attacks and poor control, leads to large health-care costs, and has been identified as a factor in asthma deaths. However, it is difficult to detect and frequently overlooked leading to inappropriate escalation of asthma treatment. There is a need for cost effective ways to monitor adherence in order to intervene to change this modifiable behavior.
Areas covered: Several measurement tools have been developed to assess adherence in adults and children with asthma. The current methods for measuring adherence, both subjective and objective, have several flaws and even the current gold standard, electronic monitoring devices (EMDs), has limitations. This review will outline and critique the adherence monitoring tools and highlight ways in which they have been used for the purpose of intervention.
Expert commentary: Although advances have been made in adherence monitoring, we still have some way to go in creating the ideal monitoring tool. There are no validated tailored self-monitoring questionnaires for children with asthma and most objective measures, such as prescription refill rate and weighing canisters, overestimate adherence. Current EMDs, although useful, need improved accuracy to ensure that both actuation and inhalation are measured, and the devices need to be affordable for use in routine health-care practice
On the structure of the scalar mesons and
We investigate the structure of the scalar mesons and
within realistic meson-exchange models of the and
interactions. Starting from a modified version of the J\"ulich model for
scattering we perform an analysis of the pole structure of the
resulting scattering amplitude and find, in contrast to existing models, a
somewhat large mass for the ( MeV,
MeV). It is shown that our model provides a description of
data comparable in quality with those of
alternative models. Furthermore, the formalism developed for the
system is consistently extended to the interaction leading to a
description of the as a dynamically generated threshold effect
(which is therefore neither a conventional state nor a
bound state). Exploring the corresponding pole position the
is found to be rather broad ( MeV,
MeV). The experimentally observed smaller width results from the influence of
the nearby threshold on this pole.Comment: 25 pages, 15 Postscript figure
Reinstatement of long-term memory following erasure of its behavioral and synaptic expression in Aplysia.
Long-term memory (LTM) is believed to be stored in the brain as changes in synaptic connections. Here, we show that LTM storage and synaptic change can be dissociated. Cocultures of Aplysia sensory and motor neurons were trained with spaced pulses of serotonin, which induces long-term facilitation. Serotonin (5HT) triggered growth of new presynaptic varicosities, a synaptic mechanism of long-term sensitization. Following 5HT training, two antimnemonic treatments-reconsolidation blockade and inhibition of PKM--caused the number of presynaptic varicosities to revert to the original, pretraining value. Surprisingly, the final synaptic structure was not achieved by targeted retraction of the 5HT-induced varicosities but, rather, by an apparently arbitrary retraction of both 5HT-induced and original synapses. In addition, we find evidence that the LTM for sensitization persists covertly after its apparent elimination by the same antimnemonic treatments that erase learning-related synaptic growth. These results challenge the idea that stable synapses store long-term memories
Heating of the Intracluster Gas in the Triangulum Australis Cluster
ASCA and ROSAT X-ray data are used to obtain two-dimensional maps of the gas
temperature, pressure and specific entropy in the Triangulum Australis cluster
of galaxies. We find that this hot (T_e=10.3+-0.8 keV) system probably has a
temperature peak (T_e>12 keV) at the cluster core, which approximately
corresponds to the adiabatic relation. An underdense gas sector, found in the
ROSAT cluster image eastward of the core, has a higher temperature than average
at that radius. At this higher temperature, the gas pressure in this region is
equal to that of the rest of the cluster at the same radius, but the specific
entropy of this gas is significantly higher (although the temperature
difference itself is only marginally significant). We speculate that the
existence of this region of underdense high-entropy gas, as well as the
adiabatic central temperature peak, indicate recent or ongoing heating of the
intergalactic medium in this cluster. The most probable source of such heating
is a subcluster merger, for which the hydrodynamic simulations predict a
qualitatively similar temperature structure. We point out that entropy maps can
provide a physically meaningful way of diagnosing merging clusters and
comparing the predictions of merger simulations to the data.Comment: Text revised to give more technical details and clarify discussion.
Accepted for ApJ Letters. Latex, 5 pages incl. figures, macros include
Direct measurements of the polarization of terrestrial kilometric radiation from Voyagers 1 and 2
Terrestrial radiation measurements obtained with planetary radio astronomy experiments on Voyager-1 and 2 during the early portions of each flight show the signals to be predominantly left-hand circularly polarized. Since these emissions were most probably generated above the Northern Hemisphere auroral zone, it is concluded that the radiation is emitted primarily in the extraordinary mode
Root Growth and Development of Float Tobacco Transplants Before and After Transplanting
In the production of float tobacco transplants, the seedling produces at least two different kinds of roots. The “media” roots are those that grow in the soilless medium within the float tray cell. They have a normal branched appearance similar to roots produced on soil-bed grown transplants. The “water” roots grow through the soilless medium in tray cells and into the nutrient solution below the float tray. They tend to be very fragile and less branched than roots growing in the soilless medium. In removal of seedlings from tray cells during transplanting, “water” roots are usually badly damaged or destroyed, which could affect establishment of transplants in the field since the most critical period in the development of tobacco plants occurs immediately after transplanting. When these young plants are removed from the protective environment of the float bed system and are subjected to radically different and sometimes adverse field conditions, stress on the juvenile plants is created. Field establishment of these young plants is dependent upon growth or new formation of the “media” and “water” roots.
To maximize establishment of transplants, it is important to know how the \u27\u27water roots and the media roots develop in the float system and their contribution to transplant establishment during the first few weeks after transplanting. The objectives of this study were: 1) to characterize the growth of media and \u27\u27water roots on tobacco seedlings in the float system, and 2) to assess tobacco transplant growth with or without \u27\u27water\u27\u27 roots, at two and four weeks after transplanting
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