839 research outputs found
Comparing three short questionnaires to detect psychosocial dysfunction among primary school children: a randomized method
BACKGROUND: Good questionnaires are essential to support the early identification of children with psychosocial dysfunction in community based settings. Our aim was to assess which of three short questionnaires was most suitable for this identification among school-aged children METHODS: A community-based sample of 2,066 parents of children aged 7-12 years (85% of those eligible) filled out the Child Behavior Checklist (CBCL) and - randomly determined - one of three questionnaires to be compared: the Strengths and Difficulties Questionnaire with Impact Supplement (SDQ), the Pediatric Symptom Checklist (PSC) and the PSYBOBA, a Dutch-origin questionnaire. Preventive Child Healthcare professionals assessed children's psychosocial functioning during routine health examinations. We assessed the scale structure (by means of Structural Equation Modelling), validity (correlation coefficients, sensitivity and specificity) and usability (ratings by parents and professionals) of each questionnaire and the degree to which they could improve the identification based only on clinical assessment (logistic regression). RESULTS: For the three questionnaires, Cronbach's alphas varied between 0.80 and 0.89. Sensitivities for a clinical CBCL at a cut off point with specificity = 0.90 varied between 0.78 and 0.86 for the three questionnaires. Areas under the Receiver Operating Curve, using the CBCL as criterion, varied between 0.93 and 0.96. No differences were statistically significant. All three questionnaires added information to the clinical assessment. Odds ratios (95% confidence intervals) for added information were PSC: 29.3 (14.4-59.8), SDQ: 55.0 (23.1-131.2) and PSYBOBA: 68.5 (28.3-165.6). Parents preferred the SDQ and PSYBOBA. Preventive Child Health Care professionals preferred the SDQ. CONCLUSIONS: This randomized comparison of three questionnaires shows that each of the three questionnaires can improve the detection of psychosocial dysfunction among children substantially
Structure and stability of finite gold nanowires
Finite gold nanowires containing less than 1000 atoms are studied using the
molecular dynamics simulation method and embedded atom potential. Nanowires
with the face-centered cubic structure and the (111) oriented cross-section are
prepared at T=0 K. After annealing and quenching the structure and vibrational
properties of nanowires are studied at room temperature. Several of these
nanowires form multi-walled structures of lasting stability. They consist of
concentrical cylindrical sheets and resemble multi-walled carbon nanotubes.
Vibrations are investigated by diagonalization of the dynamical matrix. It was
found that several percents of vibrational modes are unstable because of
uncompleted restructuring of initial fcc nanowires.Comment: 4 figures in gif forma
Thermodynamics of Na_8 and Na_{20} clusters studied with ab-initio electronic structure methods
We study the thermodynamics of Na_8 and Na_{20} clusters using
multiple-histogram methods and an ab initio treatment of the valence electrons
within density functional theory. We consider the influence of various electron
kinetic-energy functionals and pseudopotentials on the canonical ionic specific
heats. The results for all models we consider show qualitative similarities,
but also significant temperature shifts from model to model of peaks and other
features in the specific-heat curves. The use of phenomenological
pseudopotentials shifts the melting peak substantially (~ 50--100 K) when
compared to ab-initio results. It is argued that the choice of a good
pseudopotential and use of better electronic kinetic-energy functionals has the
potential for performing large time scale and large sized thermodynamical
simulations on clusters.Comment: LaTeX file and EPS figures. 24 pages, 13 figures. Submitted to Phys.
Rev.
Classification of phase transitions in small systems
We present a classification scheme for phase transitions in finite systems
like atomic and molecular clusters based on the Lee-Yang zeros in the complex
temperature plane. In the limit of infinite particle numbers the scheme reduces
to the Ehrenfest definition of phase transitions and gives the right critical
indices. We apply this classification scheme to Bose-Einstein condensates in a
harmonic trap as an example of a higher order phase transitions in a finite
system and to small Ar clusters.Comment: 12 pages, 4 figures, accepted for publication in Phys. Rev. Let
Thermal expansion in small metal clusters and its impact on the electric polarizability
The thermal expansion coefficients of clusters with and , and
are obtained from {\it ab initio} Born-Oppenheimer LDA molecular dynamics.
Thermal expansion of small metal clusters is considerably larger than that in
the bulk and size-dependent. We demonstrate that the average static electric
dipole polarizability of Na clusters depends linearly on the mean interatomic
distance and only to a minor extent on the detailed ionic configuration when
the overall shape of the electron density is enforced by electronic shell
effects. The polarizability is thus a sensitive indicator for thermal
expansion. We show that taking this effect into account brings theoretical and
experimental polarizabilities into quantitative agreement.Comment: 4 pages, 2 figures, one table. Accepted for publication in Physical
Review Letters. References 10 and 23 update
FANCD2 re-expression is associated with glioma grade and chemical inhibition of the Fanconi Anaemia pathway sensitises gliomas to chemotherapeutic agents.
Brain tumours kill more children and adults under 40 than any other cancer. Around half of primary brain tumours are glioblastoma multiforme (GBMs) where treatment remains a significant challenge. GBM survival rates have improved little over the last 40 years, thus highlighting an unmet need for the identification/development of novel therapeutic targets and agents to improve GBM treatment. Using archived and fresh glioma tissue, we show that in contrast to normal brain or benign schwannomas GBMs exhibit re-expression of FANCD2, a key protein of the Fanconi Anaemia (FA) DNA repair pathway, and possess an active FA pathway. Importantly, FANCD2 expression levels are strongly associated with tumour grade, revealing a potential exploitable therapeutic window to allow inhibition of the FA pathway in tumour cells, whilst sparing normal brain tissue. Using several small molecule inhibitors of the FA pathway in combination with isogenic FA-proficient/deficient glioma cell lines as well as primary GBM cultures, we demonstrate that inhibition of the FA pathway sensitises gliomas to the chemotherapeutic agents Temozolomide and Carmustine. Our findings therefore provide a strong rationale for the development of novel and potent inhibitors of the FA pathway to improve the treatment of GBMs, which may ultimately impact on patient outcome
On the Temperature Dependence of the Lifetime of Thermally Isolated Metastable Clusters
The temperature dependence of the lifetime of the thermally isolated
metastable N8 cubane up to its decay into N2 molecules has been calculated by
the molecular dynamics method. It has been demonstrated that this dependence
significantly deviates from the Arrhenius law. The applicability of the finite
heat bath theory to the description of thermally isolated atomic clusters has
been proved using statistical analysis of the results obtained.Comment: 14 pages, 4 figure
Spontaneous alloying in binary metal microclusters - A molecular dynamics study -
Microcanonical molecular dynamics study of the spontaneous alloying(SA),
which is a manifestation of fast atomic diffusion in a nano-sized metal
cluster, is done in terms of a simple two dimensional binary Morse model.
Important features observed by Yasuda and Mori are well reproduced in our
simulation. The temperature dependence and size dependence of the SA phenomena
are extensively explored by examining long time dynamics. The dominant role of
negative heat of solution in completing the SA is also discussed. We point out
that a presence of melting surface induces the diffusion of core atoms even if
they are solid-like. In other words, the {\it surface melting} at substantially
low temperature plays a key role in attaining the SA.Comment: 15 pages, 12 fgures, Submitted to Phys.Rev.
Thermal Degradation of Adsorbed Bottle-Brush Macromolecules: Molecular Dynamics Simulation
The scission kinetics of bottle-brush molecules in solution and on an
adhesive substrate is modeled by means of Molecular Dynamics simulation with
Langevin thermostat. Our macromolecules comprise a long flexible polymer
backbone with segments, consisting of breakable bonds, along with two side
chains of length , tethered to each segment of the backbone. In agreement
with recent experiments and theoretical predictions, we find that bond cleavage
is significantly enhanced on a strongly attractive substrate even though the
chemical nature of the bonds remains thereby unchanged.
We find that the mean bond life time decreases upon adsorption by
more than an order of magnitude even for brush molecules with comparatively
short side chains $N=1 \div 4$. The distribution of scission probability along
the bonds of the backbone is found to be rather sensitive regarding the
interplay between length and grafting density of side chains. The life time
declines with growing contour length as ,
and with side chain length as . The probability
distribution of fragment lengths at different times agrees well with
experimental observations. The variation of the mean length of the
fragments with elapsed time confirms the notion of the thermal degradation
process as a first order reaction.Comment: 15 pages, 7 figure
Using Clinical Decision Support Within the Electronic Health Record to Reduce Incorrect Prescribing for Acute Sinusitis
Purpose: Acute sinusitis has viral etiology in more than 90% of cases, but antibiotics are prescribed for more than 80% of adults in the United States. While applications of computer-assisted guidelines have been found effective in reducing inaccurate prescribing for acute respiratory infections, there is a paucity of research focused specifically on the utilization of electronic best practice alerts (BPA) in improving treatment for acute sinusitis. Methods: This observational cohort study examined prescribing behavior for sinusitis at a single Federally Qualified Health Center 1 year prior and during the first year of implementation of a BPA in the electronic health record (EHR) reminding providers of the recommended treatment of sinusitis. The advisory included a link to national guidelines and a note template was installed to assist providers in documentation. The BPA appeared on the providers’ screen when an ICD-9 code of acute or bacterial sinusitis was entered during the patient visit. Results: After adjusting for select patient and provider factors, the computer-assisted guidelines effectively reduced the overall antibiotic prescribing among these patients by 31% (relative risk: 0.69, 95% confidence interval: 0.51–0.95) and reduced incorrect prescribing from 88.5% to 78.7% (P = 0.02). Conclusions: Clinical reminders within the EHR can be an effective tool to reduce inappropriate antibiotic use and improve providers’ decisions regarding the correct antibiotic choices for patients with acute sinusitis
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