Long-time behavior and relaxation of power-law correlation in one-dimensional self-gravitating system

Long-time behavior of spatial power-law correlation in one-dimensional self-gravitating system is numerically investigated. It is found that the power-law structure persists even after the system is virialized. The structure gradually disappears owing to energy exchange among particles. Energy distribution is quasi-stationary after the system is virialized.Comment: 10 pages, 6 figures, to appear Physics Letters

Effects of Gifted Peers Tutoring Struggling Reading Peers

This study examined the effects of a peer tutoring program that used a Direct Instruction (DI) reading curriculum. Students identified as gifted and talented delivered instruction, using the DI reading program, to their struggling reading peers. The students used a cross-skill peer tutoring instructional format. The results indicated that all of the students who received tutoring increased their reading rates and that most made gains pretest to posttest on a standardized measure. Additionally, the tutors demonstrated that they were able to implement the DI program with fidelity and proved to be effective instructors

Framing Clement III, (Anti)Pope, 1080-1100. Preface

La vicenda terrena dell’(anti)papa Clemente III e gli sviluppi postumi della sua memoria sono esplorati per mettere in luce sia le complesse dinamiche in cui si inserisce questo ecclesiastico di rango assurto al soglio pontificio in una fase cruciale della riforma della Chiesa, sia le implicazioni legate al prefisso "anti"

Linker Functionalization of a Bivalent Ligand for the Study of the 5-HT2AR/ 5-HT2CR Heterodimer

G-protein-coupled receptors (GPCRs) are important pharmaceutical targets. In recent years, it has been found that GPCRs can function as homo- and hetero- dimers. The serotonin receptors 5-HT2AR and 5-HT2CR have been shown to form a heterodimer. These two receptors regulate impulsivity and cue reactivity, two factors that can lead to drug addiction relapse. A synergistic effect of the 5-HT2AR antagonist M100907 and the 5-HT2CR agonist WAY163909 in the suppression of impulsivity and cue reactivity has been reported. A bivalent ligand containing these two pharmacophores, linked by a polyethylene glycol chain and a triazole, has been developed. In this thesis, attempts to functionalize the linker portion of the bivalent ligand for the addition of a fluorophore are reported. The first approach was to functionalize the triazole portion of the linker via the iodoalkyne-azide cycloaddition reaction; however, it was determined that this method was unsuitable due to challenges with purity and yield. The second approach was to functionalize the polyethylene glycol portion of the linker by replacing an oxygen atom with a nitrogen atom, allowing for tertiary substitution at the nitrogen. A linker was synthesized containing a tertiary amine in which an ester side-chain was included. This ester serves as a handle for incorporation of a fluorophore via amide coupling. A fluorophore-tagged bivalent ligand will open the door to cellular imaging of the 5-HT2AR/5-HT2CR GPCR heterodimer.Chemistry, Department o

Knowledge and attitudes of family physicians coming to COPD continuing medical education

Barbara P Yawn, Peter C WollanOlmsted Medical Center, Research Department, Rochester, MN, USAPurpose: COPD remains under-recognized and under-treated. Much of early COPD care is given by primary care physicians but only when COPD is recognized. This survey explores the attitudes, beliefs, and knowledge related to COPD recognition, diagnosis, and treatment from family physicians and nurse practitioners (NPs) and physician assistants (PAs) working in primary care.Methods: We completed a survey of family physicians, and NPs/PAs attending one of three CME programs on five common chronic conditions including COPD.Results: Return rate was 62% (n = 284) including 178 physicians and 100 NPs/PAs. Fewer than half of the respondents reported knowledge of or use of COPD guidelines. The barriers to recognition and diagnosis of COPD they reported included the multiple morbidities of most COPD patients, failure of patients to report COPD symptoms, as well as lack of knowledge and inadequate training in COPD diagnosis and management. Three quarters (74%) of respondents reported use of spirometry to diagnose COPD but only 32% said they included reversibility assessment. COPD was incorrectly assessed as a disease primarily of men (78% of respondents) that appeared after age 60 (61%). Few respondents reported that they believed COPD treatment was useful or very useful for improving symptoms (15%) or decreasing exacerbations (3%) or that pulmonary rehabilitation was helpful (3%), but 13% reported they thought COPD treatment could extend longevity.Conclusions: Primary care physicians and NPs/PAs working in primary care continue to report lack of awareness and use of COPD guidelines, as well as correct information related to COPD epidemiology or potential benefits of available treatments including pulmonary rehabilitation. It is unlikely that diagnosis and management of COPD will improve in primary care until these knowledge gaps and discrepancies with published efficacy of therapy issues are addressed.Keywords: COPD treatment, diagnosis, management, patients, family physician

Management of patients during and after exacerbations of chronic obstructive pulmonary disease: the role of primary care physicians

Current treatments have failed to stem the continuing rise in health care resource use and fatalities associated with exacerbations of chronic obstructive pulmonary disease (COPD). Reduction of severity and prevention of new exacerbations are therefore important in disease management, especially for patients with frequent exacerbations. Acute exacerbation treatment includes short-acting bronchodilators, systemic corticosteroids, and antibiotics if bacterial infections are present. Oxygen and/or ventilatory support may be necessary for life-threatening conditions. Rising health care costs have provided added impetus to find novel therapeutic approaches in the primary care setting to prevent and rapidly treat exacerbations before hospitalization is required. Proactive interventions may include risk reduction measures (eg, smoking cessation and vaccinations) to reduce triggers and supplemental pulmonary rehabilitation to prevent or delay exacerbation recurrence. Long-term treatment strategies should include individualized management, addressing coexisting nonpulmonary conditions, and the use of maintenance pharmacotherapies, eg, long-acting bronchodilators as monotherapy or in combination with inhaled corticosteroids to reduce exacerbations. Self-management plans that help patients recognize their symptoms and promptly access treatments have the potential to prevent exacerbations from reaching the stage that requires hospitalization

Educational Salvation: Integrating Critical Spirituality in Educational Leadership

Improving education for students in K-12 urban settings remains a slow-paced and difficult task, with many successes in student learning being episodic at best. Disconnect between government mandates to improve schools and persistent societal issues of poverty and inequity act to increase stress on teachers and educational leaders working in urban schools. Drawing upon the strengths of the African-American community and its collective historical experiences, this study explores creative ways to integrate spirituality in the education of students in urban schools. The authors begin by addressing the contextual and structural issues facing urban schools. They then explain the benefits of integrating the four elements of critical spirituality—critical self-reflection; deconstructive interpretation; performative creativity; and, transformative action—in educational leadership to enhance their work in urban communities

GOLD in Practice: Chronic Obstructive Pulmonary Disease Treatment and Management in the Primary Care Setting

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality. Early detection and appropriate treatment and management of COPD can lower morbidity and perhaps mortality. Clinicians in the primary care setting provide the majority of COPD care and are pivotal in the diagnosis and management of COPD. In this review, we provide an overview of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2020 report, with a focus on the management of COPD in the primary care setting. We discuss the pathophysiology of COPD; describe COPD risk factors, signs, and symptoms that may facilitate earlier diagnosis of COPD; and reinforce the importance of spirometry use in establishing the diagnosis of COPD. Disease monitoring, as well as a review of the 2020 GOLD treatment recommendations, is also discussed. Patients and families are important partners in COPD management; therefore, we outline simple steps that may assist them in caring for those affected by COPD. Finally, we discuss nonpharmacological treatment options for COPD, COPD monitoring tools that may aid in the evaluation of disease progression and response to therapy, and the importance of developing a COPD action plan on an individualized basis