120 research outputs found
The Multifragmentation Freeze--Out Volume in Heavy Ion Collisions
The reduced velocity correlation function for fragments from the reaction Fe
+ Au at 100 A~MeV bombarding energy is investigated using the
dynamical--statistical approach QMD+SMM and compared to experimental data to
extract the Freeze--Out volume assuming simultaneous multifragmentation.Comment: 8 pages; 3 uuencoded figures available with figures command, LateX,
UCRL-J-1157
Evidence-based decision support for pediatric rheumatology reduces diagnostic errors.
BACKGROUND: The number of trained specialists world-wide is insufficient to serve all children with pediatric rheumatologic disorders, even in the countries with robust medical resources. We evaluated the potential of diagnostic decision support software (DDSS) to alleviate this shortage by assessing the ability of such software to improve the diagnostic accuracy of non-specialists.
METHODS: Using vignettes of actual clinical cases, clinician testers generated a differential diagnosis before and after using diagnostic decision support software. The evaluation used the SimulConsult® DDSS tool, based on Bayesian pattern matching with temporal onset of each finding in each disease. The tool covered 5405 diseases (averaging 22 findings per disease). Rheumatology content in the database was developed using both primary references and textbooks. The frequency, timing, age of onset and age of disappearance of findings, as well as their incidence, treatability, and heritability were taken into account in order to guide diagnostic decision making. These capabilities allowed key information such as pertinent negatives and evolution over time to be used in the computations. Efficacy was measured by comparing whether the correct condition was included in the differential diagnosis generated by clinicians before using the software ( unaided ), versus after use of the DDSS ( aided ).
RESULTS: The 26 clinicians demonstrated a significant reduction in diagnostic errors following introduction of the software, from 28% errors while unaided to 15% using decision support (p \u3c 0.0001). Improvement was greatest for emergency medicine physicians (p = 0.013) and clinicians in practice for less than 10 years (p = 0.012). This error reduction occurred despite the fact that testers employed an open book approach to generate their initial lists of potential diagnoses, spending an average of 8.6 min using printed and electronic sources of medical information before using the diagnostic software.
CONCLUSIONS: These findings suggest that decision support can reduce diagnostic errors and improve use of relevant information by generalists. Such assistance could potentially help relieve the shortage of experts in pediatric rheumatology and similarly underserved specialties by improving generalists\u27 ability to evaluate and diagnose patients presenting with musculoskeletal complaints.
TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT02205086
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Numerical analysis of nanograin collision by classical molecular dynamics
Interstellar dust grains [1] comprise only 1% of the mass in the molecular clouds of galaxies and yet catalyze the formation of many gas phase molecules, in particular H2 [2], which allows for the cooling and collapse of these clouds and the formation of stars and planets. High-energy radiation and particles from hot stars, supernovae, or active black holes can alter the physical properties of dust grains and thereby affect their role in these processes. There is no experimental study on grain-grain collisions, for grain smaller than tens of microns, except for clusters with less than 100 atoms. Studies at the mm/cm scale can be roughly understood by continuum models, but these models might break down at the nanometer scale. There are many atomistic molecular dynamics (MD) simulations on the destruction of 3D droplets due to large temperature input [3], 2D solids [4, 5], or collision of disks [6], but there are very few simulations on grain-grain collisions, never going beyond tens of atoms [7, 8]. Here we demonstrate how MD simulations of grain-grain collisions for grain with more than 100 atoms can be used to understand what happens for nanometer-sized grains, colliding at relatively low velocities
An investigation of standard thermodynamic quantities as determined via models of nuclear multifragmentation
Both simple and sophisticated models are frequently used in an attempt to
understand how real nuclei breakup when subjected to large excitation energies,
a process known as nuclear multifragmentation. Many of these models assume
equilibriumthermodynamics and produce results often interpreted as evidence of
a phase transition. This work examines one class of models and employs standard
thermodynamical procedure to explore the possible existence and nature of a
phase transition. The role of various terms, e.g. Coulomb and surface energy,
is discussed.Comment: 19 two-column format pages with 24 figure
Досвід лапароскопічних операцій у хворих на жовчнокам’яну хворобу
У статті узагальнено досвід лікування хворих на жовчнокам’яну хворобу (ЖКХ) та відомості про ускладнення, які вини-кають під час здійснення лапароскопічних операцій. За 18 років (1997–2015) у Центрі виконано 10 849 лапароскопічниххолецистектомій (ЛХЕ). Проведений аналіз результатів операційного лікування 9047 (83,4 %) пацієнтів із хронічнимкалькульозним холециститом (ХКХ) та 1802 (16,6 %) пацієнтів із гострим калькульозним холециститом (ГКХ). Ретро-спективно виконання ЛХЕ у Центрі ми поділили на три періоди: 1997–2002 рр. – освоєння методики ЛХЕ, 2003–2008 рр.– період розширення діапазону ЛХЕ (збільшення кількості хворих із деструктивними формами ГКХ), 2009–2015 рр. –період вдосконалення ЛХЕ та впровадження власних технічних підходів у хворих із ЖКХ, розширення можливостейлапароскопії. Показник інтраопераційних ускладнень загалом за весь дослідний період становив 4,95 %, за періодамицей показник був 9,4 %; 5,1 %; 1,2 %. Загальна частота післяопераційних ускладнень склала 1,16 %, за періодами –2,19 %; 1,08 %; 0,38 %. Післяопераційна летальність становила 0,04 % (4 хворих) та виникла у перші два періоди. У242 (5,19 %) пацієнтів виконано симультанні операції. Серед проведених ЛХЕ повністю лапароскопічно симультанніоперації було виконано в 70 (28,9 %) пацієнтів. 130 (53,7 %) хворих перенесли симультанні комбіновані лапароскопічніоперації на органах черевної порожнини, 42 (17,4 %) пацієнти перенесли симультанні поєднані операції, які покращилибезпосередні та віддалені результати хірургічного лікування хворих. Середній термін лікування хворих після ЛХЕ завесь період спостереження склав (3,27±0,81) дня, до операції – (0,83±0,33) дня
Plant based dietary supplement increases urinary pH
<p>Abstract</p> <p>Background</p> <p>Research has demonstrated that the net acid load of the typical Western diet has the potential to influence many aspects of human health, including osteoporosis risk/progression; obesity; cardiovascular disease risk/progression; and overall well-being. As urinary pH provides a reliable surrogate measure for dietary acid load, this study examined whether a plant-based dietary supplement, one marketed to increase alkalinity, impacts urinary pH as advertised.</p> <p>Methods</p> <p>Using pH test strips, the urinary pH of 34 healthy men and women (33.9 +/- 1.57 y, 79.3 +/- 3.1 kg) was measured for seven days to establish a baseline urinary pH without supplementation. After this initial baseline period, urinary pH was measured for an additional 14 days while participants ingested the plant-based nutritional supplement. At the end of the investigation, pH values at baseline and during the treatment period were compared to determine the efficacy of the supplement.</p> <p>Results</p> <p>Mean urinary pH statistically increased (p = 0.03) with the plant-based dietary supplement. Mean urinary pH was 6.07 +/- 0.04 during the baseline period and increased to 6.21 +/- 0.03 during the first week of treatment and to 6.27 +/- 0.06 during the second week of treatment.</p> <p>Conclusion</p> <p>Supplementation with a plant-based dietary product for at least seven days increases urinary pH, potentially increasing the alkalinity of the body.</p
Statistical signatures of critical behavior in small systems
The cluster distributions of different systems are examined to search for
signatures of a continuous phase transition. In a system known to possess such
a phase transition, both sensitive and insensitive signatures are present;
while in systems known not to possess such a phase transition, only insensitive
signatures are present. It is shown that nuclear multifragmentation results in
cluster distributions belonging to the former category, suggesting that the
fragments are the result of a continuous phase transition.Comment: 31 pages, two columns with 30 figure
A Conserved Stem Loop Motif in the 5′Untranslated Region Regulates Transforming Growth Factor-β1 Translation
Transforming growth factor-β1 (TGF-β1) regulates cellular proliferation, differentiation, migration, and survival. The human TGF-β1 transcript is inherently poorly translated, and translational activation has been documented in relation to several stimuli. In this paper, we have sought to identify in cis regulatory elements within the TGF-β1 5′Untranslated Region (5′UTR). In silico analysis predicted formation of stable secondary structure in a G/C-rich element between nucleotides +77 to +106, and demonstrated that this element is highly conserved across species. Circular dichroism spectroscopy confirmed the presence of secondary structure in this region. The proximal 5′UTR was inhibitory to translation in reporter gene experiments, and mutation of the secondary structure motif increased translational efficiency. Translational regulation of TGF-β1 mRNA is linked to altered binding of YB-1 protein to its 5′UTR. Immunoprecipitation-RT-qPCR demonstrated a high basal association of YB-1 with TGF-β1 mRNA. However, mutation of the secondary structure motif did not prevent interaction of YB-1 with the 5′UTR, suggesting that YB-1 binds to this region due to its G/C-rich composition, rather than a specific, sequence-dependent, binding site. These data identify a highly conserved element within the TGF-β1 5′UTR that forms stable secondary structure, and is responsible for the inherent low translation efficiency of this cytokine
Enhancement of a modified Mediterranean-style, low glycemic load diet with specific phytochemicals improves cardiometabolic risk factors in subjects with metabolic syndrome and hypercholesterolemia in a randomized trial
<p>Abstract</p> <p>Background</p> <p>As the worldwide dietary pattern becomes more westernized, the metabolic syndrome is reaching epidemic proportions. Lifestyle modifications including diet and exercise are recommended as first-line intervention for treating metabolic syndrome. Previously, we reported that a modified Mediterranean-style, low glycemic load diet with soy protein and phytosterols had a more favorable impact than the American Heart Association Step 1 diet on cardiovascular disease (CVD) risk factors. Subsequently, we screened for phytochemicals with a history of safe use that were capable of increasing insulin sensitivity through modulation of protein kinases, and identified hops <it>rho </it>iso-alpha acid and acacia proanthocyanidins. The objective of this study was to investigate whether enhancement of a modified Mediterranean-style, low glycemic load diet (MED) with specific phytochemicals (soy protein, phytosterols, <it>rho </it>iso-alpha acids and proanthocyanidins; PED) could improve cardiometabolic risk factors in subjects with metabolic syndrome and hypercholesterolemia.</p> <p>Methods</p> <p>Forty-nine subjects with metabolic syndrome and hypercholesterolemia, aged 25–80, entered a randomized, 2-arm, 12-week intervention trial; 23 randomized to the MED arm; 26 to the PED arm. Forty-four subjects completed at least 8 weeks [MED (<it>n </it>= 19); PED (<it>n </it>= 25)]. All subjects were instructed to follow the same aerobic exercise program. Three-day diet diaries and 7-day exercise diaries were assessed at each visit. Fasting blood samples were collected at baseline, 8 and 12 weeks for analysis.</p> <p>Results</p> <p>Both arms experienced equal weight loss (MED: -5.7 kg; PED: -5.9 kg). However, at 12 weeks, the PED arm experienced greater reductions (<it>P </it>< 0.05) in cholesterol, non-HDL cholesterol, triglycerides (TG), cholesterol/HDL and TG/HDL compared with the MED arm. Only the PED arm experienced increased HDL (<it>P </it>< 0.05) and decreased TG/HDL (<it>P </it>< 0.01), and continued reduction in apo B/apo A-I from 8 to 12 weeks. Furthermore, 43% of PED subjects vs. only 22% of MED subjects had net resolution of metabolic syndrome. The Framingham 10-year CVD risk score decreased by 5.6% in the PED arm (<it>P </it>< 0.01) and 2.9% in the MED arm (<it>P </it>< 0.05).</p> <p>Conclusion</p> <p>These results demonstrate that specific phytochemical supplementation increased the effectiveness of the modified Mediterranean-style low glycemic load dietary program on variables associated with metabolic syndrome and CVD.</p
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