Equilibrium shapes and faceting for ionic crystals of body-centered-cubic type

A mean field theory is developed for the calculation of the surface free energy of the staggered BCSOS, (or six vertex) model as function of the surface orientation and of temperature. The model approximately describes surfaces of crystals with nearest neighbor attractions and next nearest neighbor repulsions. The mean field free energy is calculated by expressing the model in terms of interacting directed walks on a lattice. The resulting equilibrium shape is very rich with facet boundaries and boundaries between reconstructed and unreconstructed regions which can be either sharp (first order) or smooth (continuous). In addition there are tricritical points where a smooth boundary changes into a sharp one and triple points where three sharp boundaries meet. Finally our numerical results strongly suggest the existence of conical points, at which tangent planes of a finite range of orientations all intersect each other. The thermal evolution of the equilibrium shape in this model shows strong similarity to that seen experimentally for ionic crystals.Comment: 14 Pages, Revtex and 10 PostScript figures include

Depression symptomatology and diagnosis: discordance between patients and physicians in primary care settings

<p>Abstract</p> <p>Background</p> <p>To examine the agreement between depression symptoms using an assessment tool (PHQ-9), and physician documentation of the same symptoms during a clinic visit, and then to examine how the presence of these symptoms affects depression diagnosis in primary care settings.</p> <p>Methods</p> <p>Interviewer administered surveys and medical record reviews. A total of 304 participants were recruited from 2321 participants screened for depression at two large urban primary care community settings.</p> <p>Results</p> <p>Of the 2321 participants screened for depression 304 were positive for depression and of these 75.3% (n = 229) were significantly depressed (PHQ-9 score ≥ 10). Of these, 31.0% were diagnosed by a physician with a depressive disorder. A total of 57.6% (n = 175) of study participants had both significant depression symptoms and functional impairment. Of these 37.7% were diagnosed by physicians as depressed. Cohen's Kappa analysis, used to determine the agreement between depression symptoms elicited using the PHQ-9 and physician documentation of these symptoms showed only slight agreement (0.001–0.101) for all depression symptoms using standard agreement rating scales. Further analysis showed that only suicidal ideation and hypersomnia or insomnia were associated with an increased likelihood of physician depression diagnosis (OR 5.41 P sig < .01 and (OR 2.02 P sig < .05 respectively). Other depression symptoms and chronic medical conditions had no affect on physician depression diagnosis.</p> <p>Conclusion</p> <p>Two-thirds of individuals with depression are undiagnosed in primary care settings. While functional impairment increases the rate of physician diagnosis of depression, the agreement between a structured assessment and physician elicited and or documented symptoms during a clinical encounter is very low. Suicidality, hypersomnia and insomnia are associated with an increase in the rate of depression diagnosis even when physician and self report of the symptom differ. Interventions that emphasize the use of routine structured screening of primary care patients might also improve the rate of diagnosis of depression in these settings. Further studies are needed to explore depression symptom assessment during physician patient encounter in primary care settings.</p

Associations between depressive symptoms and disease progression in older patients with chronic kidney disease: results of the EQUAL study

Background Depressive symptoms are associated with adverse clinical outcomes in patients with end-stage kidney disease; however, few small studies have examined this association in patients with earlier phases of chronic kidney disease (CKD). We studied associations between baseline depressive symptoms and clinical outcomes in older patients with advanced CKD and examined whether these associations differed depending on sex. Methods CKD patients (&gt;= 65 years; estimated glomerular filtration rate &lt;= 20 mL/min/1.73 m(2)) were included from a European multicentre prospective cohort between 2012 and 2019. Depressive symptoms were measured by the five-item Mental Health Inventory (cut-off &lt;= 70; 0-100 scale). Cox proportional hazard analysis was used to study associations between depressive symptoms and time to dialysis initiation, all-cause mortality and these outcomes combined. A joint model was used to study the association between depressive symptoms and kidney function over time. Analyses were adjusted for potential baseline confounders. Results Overall kidney function decline in 1326 patients was -0.12 mL/min/1.73 m(2)/month. A total of 515 patients showed depressive symptoms. No significant association was found between depressive symptoms and kidney function over time (P = 0.08). Unlike women, men with depressive symptoms had an increased mortality rate compared with those without symptoms [adjusted hazard ratio 1.41 (95% confidence interval 1.03-1.93)]. Depressive symptoms were not significantly associated with a higher hazard of dialysis initiation, or with the combined outcome (i.e. dialysis initiation and all-cause mortality). Conclusions There was no significant association between depressive symptoms at baseline and decline in kidney function over time in older patients with advanced CKD. Depressive symptoms at baseline were associated with a higher mortality rate in men

Truncation of Titin's Elastic PEVK Region Leads to Cardiomyopathy With Diastolic Dysfunction

RATIONALE: The giant protein titin plays key roles in myofilament assembly and determines the passive mechanical properties of the sarcomere. The cardiac titin molecule has two mayor elastic elements, the N2B and the PEVK region. Both have been suggested to determine the elastic properties of the heart with loss of function data only available for the N2B region. OBJECTIVE: Investigate the contribution of titin’s PEVK region to biomechanics and growth of the heart. METHODS AND RESULTS: We removed a portion of the PEVK segment (exons 219–225; 282aa) that corresponds to the PEVK element of N2B titin, the main cardiac titin isoform. Adult homozygous PEVK knockout (KO) mice developed diastolic dysfunction, as determined by pressure-volume loops, echocardiography, isolated heart experiments, and muscle mechanics. Immunoelectron microscopy revealed increased strain of the N2B element, a spring region retained in the PEVK-KO. Interestingly, the PEVK-KO mice had hypertrophied hearts with an induction of the hypertrophy and fetal gene response that includes upregulation of FHL proteins. This contrasts the cardiac atrophy phenotype with decreased FHL2 levels that result from the deletion of the N2B element. CONCLUSIONS: Titin’s PEVK region contributes to the elastic properties of the cardiac ventricle. Our findings are consistent with a model in which strain of the N2B spring element and expression of FHL proteins trigger cardiac hypertrophy. These novel findings provide a molecular basis for the future differential therapy of isolated diastolic dysfunction versus more complex cardiomyopathies

Depression and play in early childhood. Play behavior of depressed and nondepressed 3- to 6-year olds in various play situations

Item does not contain fulltextThe behavior of seven depressed and seven nondepressed 3- to 6-year-olds was compared in three play situations: solitary free play, interactive free play, and play narratives. Depressed children played significantly less than their nondepressed controls. This was mainly due to differences in symbolic play. The groups did not differ with regard to manipulative play. The differences between depressed and nondepressed children varied across play situations. Depressed children showed significantly more nonplay behavior than their nondepressed counterparts. In addition, the behavior of depressed children showed less coherence than the behavior of the nondepressed children. Finally, mood induction proved to have no differential effect on the play behavior of depressed and nondepressed children

Altered contractility of skeletal muscle in mice deficient in titin's M-Band region

We investigated the contractile phenotype of skeletal muscle deficient in the titin's M-band exons MEx1 and MEx2 (KO) by using the cre-lox recombination system and a multidisciplinary physiological approach to study skeletal muscle contractile performance. At a maximal tetanic stimulation frequency, intact KO EDL muscle was able to produce wildtype levels of force. However, at submaximal stimulation frequency force was reduced in KO mice giving rise to a rightward shift of the force-frequency curve. This rightward shift of the force-frequency curve could not be explained by altered sarcoplasmic reticulum Ca(2+)handling as indicated by analysis of Ca(2+)transients in intact myofibers and expression of Ca(2+)handling proteins, but can be explained by the reduced myofilament Ca(2+)sensitivity of force generation that we found. Western blotting experiments suggested that the excision of titin exons MEx1 and MEx2 did not result in major changes in expression of titin M-band binding proteins or phosphorylation level of the thin filament regulatory proteins, but rather in a shift towards expression of slow isoforms of the thick filament-associated protein myosin binding protein-C (MyBP-C). Extraction of MyBP-C from skinned muscle normalized myofilament Ca(2+)sensitivity of KO EDL muscle. Thus, our data suggest that the M-band region of titin affects the expression of genes involved in the regulation of skeletal muscle contraction