Impact of a nurse led telephone intervention on satisfaction and health outcomes of children with inflammatory rheumatic diseases and their families: a crossover randomized clinical trial.

Children suffering from rheumatic disease are faced with multidimensional challenges that affect their quality of life and family dynamics. Symptom management and monitoring of the course of the disease over time are important to minimize disability and pain. Poor disease control and anticipation of the need for treatment changes may be prompted by specialist medical follow-up and regular nurse-led consultations with the patient and families, in which information and support is provided. The purpose of this study was to evaluate the impact of a nurse-led telephone intervention or Telenursing (TN) compared to standard care (SC) on satisfaction and health outcomes of children with inflammatory rheumatic diseases and their parents. A multicentered, randomized, longitudinal, crossover trial was conducted with pediatrics outpatients newly diagnosed with inflammatory rheumatic diseases. Participants were randomly assigned to two groups TN and SC for 12 months and crossed-over for the following 12 months. TN consisted of providing individualized affective support, health information and aid to decision making. Satisfaction (primary outcome) and health outcomes were assessed with the Client Satisfaction Questionnaire-8 and the Juvenile Arthritis Multidimensional Assessment Report, respectively. A mixed effect model, including a group x time interaction, was performed for each outcome. Satisfaction was significantly higher when receiving TN (OR = 7.7, 95% CI: 1.8-33.6). Morning stiffness (OR = 3.2, 95% CI: 0.97-7.15) and pain (OR = 2.64, 95% CI: 0.97-7.15) were lower in the TN group. For both outcomes a carry-over effect was observed with a higher impact of TN during the 12 first months of the study. The other outcomes did not show any significant improvements between groups. TN had a positive impact on satisfaction and on morning stiffness and pain of children with inflammatory rheumatic diseases and their families. This highlights the importance of support by specialist nurses in improving satisfaction and symptom management for children with inflammatory rheumatisms and their families. ClinicalTrial.gov identifier: NCT01511341 (December 1st, 2012)

Fundamental aspects to localize self-catalyzed III-V nanowires on silicon

III-V semiconductor nanowires deterministically placed on top of silicon electronic platform would open many avenues in silicon-based photonics, quantum technologies and energy harvesting. For this to become a reality, gold-free site-selected growth is necessary. Here, we propose a mechanism which gives a clear route for maximizing the nanowire yield in the self-catalyzed growth fashion. It is widely accepted that growth of nanowires occurs on a layerby-layer basis, starting at the triple-phase line. Contrary to common understanding, we find that vertical growth of nanowires starts at the oxide-substrate line interface, forming a ring-like structure several layers thick. This is granted by optimizing the diameter/height aspect ratio and cylindrical symmetry of holes, which impacts the diffusion flux of the group V element through the well-positioned group III droplet. This work provides clear grounds for realistic integration of III-Vs on silicon and for the organized growth of nanowires in other material systems

POD-Spectral Decomposition for Fluid Flow Analysis and Model Reduction

Abstract We propose an algorithm that combines Proper Orthogonal Decomposition with a spectral method to analyse and extract from time data series of velocity fields, reduced order models of flows. The flows considered in this study are assumed to be driven by non linear dynamical systems exhibiting a complex behavior within quasi-periodic orbits in the phase space. The technique is appropiate to achieve efficient reduced order models even in complex cases for which the flow description requires a discretization with a fine spatial and temporal resolution. The proposed analysis enables to decompose complex flow dynamics into modes oscillating at a single frequency. These modes are associated with different energy levels and spatial structures. The approach is illustrated using time resolved PIV data of a cylinder wake flow with associated Reynolds number equal to 3900

J Alzheimers Dis

BACKGROUND: The frontal variant of Alzheimer's disease (fAD) is poorly understood and poorly defined. The diagnosis remains challenging. The main differential diagnosis is the behavioral variant of frontotemporal degeneration (bvFTD). For fAD, there is some dissociation between the clinical frontal presentation and imaging and neuropathological studies, which do not always find a specific involvement of the frontal lobes. DAPHNE is a behavioral scale, which demonstrated excellent performance to distinguish between bvFTD and AD. OBJECTIVE: The aim of the present study was to assess the reliability of this new tool to improve the clinical diagnosis of fAD. METHODS: Twenty fAD patients and their caregivers were prospectively included and were compared with 36 bvFTD and 22 AD patients. RESULTS: The three main behavioral disorders in the fAD patients were apathy, loss of empathy, and disinhibition. Three disorders were discriminant because they were less frequent and less severe in the fAD patients than in the bvFTD patients, namely hyperorality, neglect, and perseverations. This specific pattern of behavioral disorders was corroborated by SPECT or 18FDG PET-CT scan that showed that patients with fAD could have a medial frontal hypoperfusion, whereas in bvFTD patients the orbitofrontal cortex was the main involved region, with more diffuse hypoperfusion. CONCLUSION: We demonstrated that DAPHNE had good sensitivity and good specificity to discriminate between the three groups and in particular between fAD and bvFTD patients. DAPHNE is a quick tool that could help clinicians in memory clinics not only to differentiate bvFTD from typical AD but also from fAD