3,845 research outputs found
Screening and early psychological intervention for depression in schools: systematic review and meta-analysis.
Abstract Depression in children and adolescents is considerably undertreated, and the school may be a good setting for identifying and treating depression. We conducted a meta-analysis of studies in which students were screened for depression, and those with depressive symptoms were treated with a psychological intervention. Only randomised controlled trials were included. Eight studies met the inclusion criteria. Five studies focused on younger children (7–14 years) and three studies were aimed at adolescents (12–19 years). In total 5803 students were screened, of whom 7.2% were included in the intervention studies (95% CI: 7.1–7.3). The ‘numbers-needed-to-screen’ was 31 (95% CI: 27–32), which means that 31 students had to be screened in order to generate one successfully treated case of depression. The effects of the psychological treatments at posttest were compared to control conditions in the 8 studies comprising 12 contrast groups, with a total of 413 students. The mean effect size was 0.55 (95% CI: 0.35– 0.76). There were not enough studies to examine whether specific psychotherapies were superior to other psychotherapies. Although the number of studies is small and their quality is limited, screening and early intervention at schools may be an effective strategy to reduce the burden of disease from depression in children and adolescents. More research on the (negative) effects of these interventions is needed
Cardiorespiratory fitness is associated with hard and light intensity physical activity but not time spent sedentary in 10–14 year old schoolchildren: the HAPPY study
Sedentary behaviour is a major risk factor for developing chronic diseases and is associated with low cardiorespiratory fitness in adults. It remains unclear how sedentary behaviour and different physical activity subcomponents are related to cardiorespiratory fitness in children. The purpose of this study was to assess how sedentary behaviour and different physical activity subcomponents are associated with 10–14 year-old schoolchildren's cardiorespiratory fitness
The melanoma-specific graded prognostic assessment does not adequately discriminate prognosis in a modern population with brain metastases from malignant melanoma
The melanoma-specific graded prognostic assessment (msGPA) assigns patients with brain metastases from malignant melanoma to 1 of 4 prognostic groups. It was largely derived using clinical data from patients treated in the era that preceded the development of newer therapies such as BRAF, MEK and immune checkpoint inhibitors. Therefore, its current relevance to patients diagnosed with brain metastases from malignant melanoma is unclear. This study is an external validation of the msGPA in two temporally distinct British populations.Performance of the msGPA was assessed in Cohort I (1997-2008, n=231) and Cohort II (2008-2013, n=162) using Kaplan-Meier methods and Harrell's c-index of concordance. Cox regression was used to explore additional factors that may have prognostic relevance.The msGPA does not perform well as a prognostic score outside of the derivation cohort, with suboptimal statistical calibration and discrimination, particularly in those patients with an intermediate prognosis. Extra-cerebral metastases, leptomeningeal disease, age and potential use of novel targeted agents after brain metastases are diagnosed, should be incorporated into future prognostic models.An improved prognostic score is required to underpin high-quality randomised controlled trials in an area with a wide disparity in clinical care
Bistability in Apoptosis by Receptor Clustering
Apoptosis is a highly regulated cell death mechanism involved in many
physiological processes. A key component of extrinsically activated apoptosis
is the death receptor Fas, which, on binding to its cognate ligand FasL,
oligomerize to form the death-inducing signaling complex. Motivated by recent
experimental data, we propose a mathematical model of death ligand-receptor
dynamics where FasL acts as a clustering agent for Fas, which form locally
stable signaling platforms through proximity-induced receptor interactions.
Significantly, the model exhibits hysteresis, providing an upstream mechanism
for bistability and robustness. At low receptor concentrations, the bistability
is contingent on the trimerism of FasL. Moreover, irreversible bistability,
representing a committed cell death decision, emerges at high concentrations,
which may be achieved through receptor pre-association or localization onto
membrane lipid rafts. Thus, our model provides a novel theory for these
observed biological phenomena within the unified context of bistability.
Importantly, as Fas interactions initiate the extrinsic apoptotic pathway, our
model also suggests a mechanism by which cells may function as bistable
life/death switches independently of any such dynamics in their downstream
components. Our results highlight the role of death receptors in deciding cell
fate and add to the signal processing capabilities attributed to receptor
clustering.Comment: Accepted by PLoS Comput Bio
Thermodynamic Behavior of a Model Covalent Material Described by the Environment-Dependent Interatomic Potential
Using molecular dynamics simulations we study the thermodynamic behavior of a
single-component covalent material described by the recently proposed
Environment-Dependent Interatomic Potential (EDIP). The parameterization of
EDIP for silicon exhibits a range of unusual properties typically found in more
complex materials, such as the existence of two structurally distinct
disordered phases, a density decrease upon melting of the low-temperature
amorphous phase, and negative thermal expansion coefficients for both the
crystal (at high temperatures) and the amorphous phase (at all temperatures).
Structural differences between the two disordered phases also lead to a
first-order transition between them, which suggests the existence of a second
critical point, as is believed to exist for amorphous forms of frozen water.
For EDIP-Si, however, the unusual behavior is associated not only with the open
nature of tetrahedral bonding but also with a competition between four-fold
(covalent) and five-fold (metallic) coordination. The unusual behavior of the
model and its unique ability to simulation the liquid/amorphous transition on
molecular-dynamics time scales make it a suitable prototype for fundamental
studies of anomalous thermodynamics in disordeered systems.Comment: 48 pages (double-spaced), 13 figure
Adherence to secondary prophylaxis and disease recurrence in 536 Brazilian children with rheumatic fever
<p>Abstract</p> <p>Background</p> <p>More than 15 million people worldwide have rheumatic fever (RF) and rheumatic heart disease due to RF. Secondary prophylaxis is a critical cost-effective intervention for preventing morbidity and mortality related to RF. Ensuring adequate adherence to secondary prophylaxis for RF is a challenging task. This study aimed to describe the rates of recurrent episodes of RF, quantify adherence to secondary prophylaxis, and examine the effects of medication adherence to the rates of RF in a cohort of Brazilian children and adolescents with RF.</p> <p>Methods</p> <p>This retrospective study took place in the Pediatric Rheumatology outpatient clinic at a tertiary care hospital (Instituto de Puericultura e Pediatria Martagão Gesteira) in Rio de Janeiro, Brazil, and included patients with a diagnosis of RF from 1985 to 2005.</p> <p>Results</p> <p>536 patients with RF comprised the study sample. Recurrent episodes of RF occurred in 88 of 536 patients (16.5%). Patients with a recurrent episode of RF were younger (p < 0.0001), more frequently males (p = 0.003), and less adherent (p < 0.0001) to secondary prophylaxis than patients without RF recurrence. Non-adherence to medication at any time during follow-up was detected in 35% of patients. Rates of non-adherence were higher in the group of patients that were lost to follow-up (42%) than in the group of patients still in follow-up (32%) (p = 0.027). Appointment frequency was inadequate in 10% of patients. Higher rates of inadequate appointment frequency were observed among patients who were eventually lost to follow-up (14.5%) than in patients who were successfully followed-up (8%) (p = 0.022). 180 patients (33.5%) were lost to follow up at some point in time.</p> <p>Conclusions</p> <p>We recommend implementation of a registry, and a system of active search of missing patients in every service responsible for the follow-up of RF patients. Measures to increase adherence to secondary prophylaxis need to be implemented formally, once non-adherence to secondary prophylaxis is the main cause of RF recurrence. Detection of irregularity in secondary prophylaxis or in appointments should be an alert about the possibility of loss of follow-up and closer observation should be instituted.</p
Formation of Low-Mass X-Ray Binaries. II. Common Envelope Evolution of Primordial Binaries with Extreme Mass Ratios
We study the formation of low-mass X-ray binaries (LMXBs) through helium star
supernovae in binary systems that have each emerged from a common-envelope
phase. LMXB progenitors must satisfy a large number of evolutionary and
structural constraints, which imposed under the assumption of a symmetric
supernova explosion, prohibit the formation of short-period LMXBs transferring
mass at sub-Eddington rates through any channel in which the intermediate
progenitor of the neutron star is not completely degenerate. Barring
accretion-induced collapse, the existence of such systems therefore requires
that natal kicks be imparted to neutron stars. We use an analytical method to
synthesize the distribution of nascent LMXBs over donor masses and orbital
periods, and evaluate their birth rate and systemic velocity dispersion. Within
the limitations imposed by observational incompleteness and selection effects,
and our neglect of secular evolution in the LMXB state, we compare our results
with observations. However, our principal objective is to evaluate how basic
model parameters influence these results. We conclude that the characteristics
of newborn LMXBs are primarily determined by age and stability constraints and
the efficiency of magnetic braking, and are largely independent of the
primordial binary population and the evolutionary history of LMXB progenitors
(except for extreme values of the average kick magnitude or of the
common-envelope ejection efficiency). Theoretical estimates of total LMXB birth
rates are not credible, since they strongly depend on the observationally
indeterminate frequency of primordial binaries with extreme mass ratios in
long-period orbits.Comment: 31 pages, AASTeX, 14 Figures, 2 Tables, to be published in Ap
Time spent with cats is never wasted: Lessons learned from feline acromegalic cardiomyopathy, a naturally occurring animal model of the human disease
<div><p>Background</p><p>In humans, acromegaly due to a pituitary somatotrophic adenoma is a recognized cause of increased left ventricular (LV) mass. Acromegalic cardiomyopathy is incompletely understood, and represents a major cause of morbidity and mortality. We describe the clinical, echocardiographic and histopathologic features of naturally occurring feline acromegalic cardiomyopathy, an emerging disease among domestic cats.</p><p>Methods</p><p>Cats with confirmed hypersomatotropism (IGF-1>1000ng/ml and pituitary mass; n = 67) were prospectively recruited, as were two control groups: diabetics (IGF-1<800ng/ml; n = 24) and healthy cats without known endocrinopathy or cardiovascular disease (n = 16). Echocardiography was performed in all cases, including after hypersomatotropism treatment where applicable. Additionally, tissue samples from deceased cats with hypersomatotropism, hypertrophic cardiomyopathy and age-matched controls (n = 21 each) were collected and systematically histopathologically reviewed and compared.</p><p>Results</p><p>By echocardiography, cats with hypersomatotropism had a greater maximum LV wall thickness (6.5mm, 4.1–10.1mm) than diabetic (5.9mm, 4.2–9.1mm; Mann Whitney, p<0.001) or control cats (5.2mm, 4.1–6.5mm; Mann Whitney, p<0.001). Left atrial diameter was also greater in cats with hypersomatotropism (16.6mm, 13.0–29.5mm) than in diabetic (15.4mm, 11.2–20.3mm; Mann Whitney, p<0.001) and control cats (14.0mm, 12.6–17.4mm; Mann Whitney, p<0.001). After hypophysectomy and normalization of IGF-1 concentration (n = 20), echocardiographic changes proved mostly reversible. As in humans, histopathology of the feline acromegalic heart was dominated by myocyte hypertrophy with interstitial fibrosis and minimal myofiber disarray.</p><p>Conclusions</p><p>These results demonstrate cats could be considered a naturally occurring model of acromegalic cardiomyopathy, and as such help elucidate mechanisms driving cardiovascular remodeling in this disease.</p></div
Baryonic Popcorn
In the large N limit cold dense nuclear matter must be in a lattice phase.
This applies also to holographic models of hadron physics. In a class of such
models, like the generalized Sakai-Sugimoto model, baryons take the form of
instantons of the effective flavor gauge theory that resides on probe flavor
branes. In this paper we study the phase structure of baryonic crystals by
analyzing discrete periodic configurations of such instantons. We find that
instanton configurations exhibit a series of "popcorn" transitions upon
increasing the density. Through these transitions normal (3D) lattices expand
into the transverse dimension, eventually becoming a higher dimensional (4D)
multi-layer lattice at large densities.
We consider 3D lattices of zero size instantons as well as 1D periodic chains
of finite size instantons, which serve as toy models of the full holographic
systems. In particular, for the finite-size case we determine solutions of the
corresponding ADHM equations for both a straight chain and for a 2D zigzag
configuration where instantons pop up into the holographic dimension. At low
density the system takes the form of an "abelian anti-ferromagnetic" straight
periodic chain. Above a critical density there is a second order phase
transition into a zigzag structure. An even higher density yields a rich phase
space characterized by the formation of multi-layer zigzag structures. The
finite size of the lattices in the transverse dimension is a signal of an
emerging Fermi sea of quarks. We thus propose that the popcorn transitions
indicate the onset of the "quarkyonic" phase of the cold dense nuclear matter.Comment: v3, 80 pages, 18 figures, footnotes 5 and 7 added, version to appear
in the JHE
Preparation, structural characterisation and antibacterial properties of Ga-doped sol-gel phosphate-based glass
A sol-gel preparation of Ga-doped phosphate-based glass with potential application in antimicrobial devices has been developed. Samples of composition (CaO)(0.30)(Na2O)(0.20-x) (Ga2O3) (x) (P2O5)(0.50) where x = 0 and 0.03 were prepared, and the structure and properties of the gallium-doped sample compared with those of the sample containing no gallium. Analysis of the P-31 MAS NMR data demonstrated that addition of gallium to the sol-gel reaction increases the connectivity of the phosphate network at the expense of hydroxyl groups. This premise is supported by the results of the elemental analysis, which showed that the gallium-free sample contains significantly more hydrogen and by FTIR spectroscopy, which revealed a higher concentration of -OH groups in that sample. Ga K-edge extended X-ray absorption fine structure and X-ray absorption near-edge structure data revealed that the gallium ions are coordinated by six oxygen atoms. In agreement with the X-ray absorption data, the high-energy XRD results also suggest that the Ga3+ ions are octahedrally coordinated with respect to oxygen. Antimicrobial studies demonstrated that the sample containing Ga3+ ions had significant activity against Staphylococcus aureus compared to the control
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