Pandora box: The eurozone and the euro crisis

YesThe global economy has experienced considerable turbulence since 2007. The financial crisis has been viewed as the trigger for a prolonged period of economic decline. This decline remains an issue for all member states of the European Union, the eurozone and beyond. We argue genesis of this crisis lies in the integration negotiations of 1991, ratified in 1992. These produced a flawed economic model within the eurozone. Given the seeds of decay were planted at origin; we argue the solution can be found through a reconstructed eurozone via looser integration, where countries less equipped to deal with the realities of closer integration will be economically independent

Management of shoulder pain by UK general practitioners (GPs): a national survey

OBJECTIVES: Studies in Canada, the USA and Australia suggested low confidence among general practitioners (GPs) in diagnosing and managing shoulder pain, with frequent use of investigations. There are no comparable studies in the UK; our objective was to describe the diagnosis and management of shoulder pain by GPs in the UK. METHODS: A national survey of a random sample of 5000 UK GPs collected data on shoulder pain diagnosis and management using two clinical vignettes that described primary care presentations with rotator cuff tendinopathy (RCT) and adhesive capsulitis (AdhC). RESULTS: Seven hundred and fourteen (14.7%) responses were received. 56% and 83% of GPs were confident in their diagnosis of RCT and AdhC, respectively, and a wide range of investigations and management options were reported. For the RCT presentation, plain radiographs of the shoulder were most common (60%), followed by blood tests (42%) and ultrasound scans (USS) (38%). 19% of those who recommended a radiograph and 76% of those who recommended a USS did so 'to confirm the diagnosis'. For the AdhC presentation, the most common investigations were blood tests (60%), plain shoulder radiographs (58%) and USS (31%). More than two-thirds of those recommending a USS did so 'to confirm the diagnosis'. The most commonly recommended treatment for both presentations was physiotherapy (RCT 77%, AdhC 71%) followed by non-steroidal anti-inflammatory drugs (RCT 58%, AdhC 74%). 17% opted to refer the RCT to secondary care (most often musculoskeletal interface service), compared with 31% for the AdhC. CONCLUSIONS: This survey of GPs in the UK highlights reliance on radiographs and blood tests in the management of common shoulder pain presentations. GPs report referring more than 7 out of 10 patients with RCT and AdhC to physiotherapists. These findings need to be viewed in the context of low response to the survey and, therefore, potential non-response bias

Direct observation of LO phonon-plasmon coupled modes in the infrared transmission spectra of n-GaAs and n-InxGa1-xAs epilayers

The infrared transmission spectrum of Si-doped molecular beam epitaxy (MBE)-grown GaAs epilayers, 2-2.5-mum thick, measured in the oblique (Berreman) geometry, revealed distinct minima in p polarization. Given epilayer thickness \u3c reststrahlen wavelength, the minima are identified as the zone-center transverse optic phonon (omega(TO)) and the high-frequency LO phonon-plasmon coupled mode (omega(+)). Analysis of the experimental data yielded free-carrier concentrations ranging from 2.5x10(17) to 1.4x10(18) cm(-3). The same technique with MBE-grown Si-doped In0.53Ga0.47As epilayers (0.5-1 mum thick) yielded omega(+) modes corresponding to free-carrier concentrations of 8.2x10(16)-2.7x10(19) cm(-3). The observations of the transmission minima in the Berreman geometry and their interpretation demonstrate a direct and simple method for deducing free-carrier concentrations over a wide range

Risk of adverse events in patients prescribed long‐term opioids: a cohort study in the UK Clinical Practice Research Datalink

Background Long‐term opioid prescribing for musculoskeletal pain is controversial due to uncertainty regarding effectiveness and safety. This study examined the risks of a range of adverse events in a large cohort of patients prescribed long‐term opioids using the UK Clinical Practice Research Datalink. Methods Patients with musculoskeletal conditions starting a new long‐term opioid episode (defined as ≥3 opioid prescriptions within 90 days) between 2002 and 2012 were included. Primary outcomes: major trauma and intentional overdose (any). Secondary outcomes: addiction (any), falls, accidental poisoning, attempted suicide/self‐harm, gastrointestinal pathology and bleeding, and iron deficiency anaemia. “Control” outcomes (unrelated to opioid use): incident eczema and psoriasis. Results A total of 98,140 new long‐term opioids users (median age 61, 41% male) were followed for (median) 3.4 years. Major trauma risk increased from 285 per 10,000 person‐years without long‐term opioids to 369/10,000 for a long‐term opioid episode (<20 mg MED), 382/10,000 (20–50 mg MED), and 424/10,000 (≥50 mg MED). Adjusted hazard ratios were 1.09 (95% CI; 1.04, 1.14 for <20 mg MED vs. not being in an episode of long‐term prescribing), 1.24 (95% CI; 1.16, 1.32: 20–50 mg MED) and 1.34 (95% CI; 1.20, 1.50: ≥50 mg MED). Significant dose‐dependent increases in the risk of overdose (any type), addiction, falls, accidental poisoning, gastrointestinal pathology, and iron deficiency anaemia were also found. Conclusions Patients prescribed long‐term opioids are vulnerable to dose‐dependent serious adverse events. Opioid prescribing should be reviewed before long‐term use becomes established, and periodically thereafter to ensure that patients are not being exposed to increased risk of harm, which is not balanced by therapeutic benefit. Significance Long‐term opioid use is associated with serious adverse events such as major trauma, addiction and overdose. The risk increases with higher opioid doses. Opioid prescribing should be reviewed before long‐term use becomes established, and periodically thereafter to assess ongoing effectiveness

High-pressure Raman scattering in wurtzite indium nitride

Copyright (2011) American Institute of Physics. This article may be downloaded for personal use only. Any other use requires prior permission of the author and the American Institute of Physics.We perform Raman-scattering measurements at high hydrostatic pressures on c-face and a-face InN layers to investigate the high-pressure behavior of the zone-center optical phonons of wurtzite InN. Linear pressure coefficients and mode Grneisen parameters are obtained, and the experimental results are compared with theoretical values obtained from ab initio lattice-dynamical calculations. Good agreement is found between the experimental and calculated results. © 2011 American Institute of Physics.Work supported by the Spanish MICINN (Projects MAT2010-16116, MAT2008-06873-C02-02, MAT2010-21270-C04-04, and CSD2007-00045), the Catalan Government (BE-DG 2009), and the Spanish Council for Research (PIE2009-CSIC).Ibanez, J.; Manjón Herrera, FJ.; Segura, A.; Oliva, R.; Cusco, R.; Vilaplana Cerda, RI.; Yamaguchi, T.... (2011). High-pressure Raman scattering in wurtzite indium nitride. Applied Physics Letters. 99:119081-119083. https://doi.org/10.1063/1.3609327S11908111908399Veal, T., McConville, C., & Schaff, W. (Eds.). (2009). Indium Nitride and Related Alloys. doi:10.1201/9781420078107Gallinat, C. S., Koblmüller, G., Brown, J. S., Bernardis, S., Speck, J. S., Chern, G. D., … Wraback, M. (2006). In-polar InN grown by plasma-assisted molecular beam epitaxy. Applied Physics Letters, 89(3), 032109. doi:10.1063/1.2234274Li, S. X., Wu, J., Haller, E. E., Walukiewicz, W., Shan, W., Lu, H., & Schaff, W. J. (2003). Hydrostatic pressure dependence of the fundamental bandgap of InN and In-rich group III nitride alloys. Applied Physics Letters, 83(24), 4963-4965. doi:10.1063/1.1633681Gorczyca, I., Plesiewicz, J., Dmowski, L., Suski, T., Christensen, N. E., Svane, A., … Speck, J. S. (2008). Electronic structure and effective masses of InN under pressure. Journal of Applied Physics, 104(1), 013704. doi:10.1063/1.2953094Domènech-Amador, N., Cuscó, R., Artús, L., Yamaguchi, T., & Nanishi, Y. (2011). Raman scattering study of anharmonic phonon decay in InN. Physical Review B, 83(24). doi:10.1103/physrevb.83.245203Serrano, J., Bosak, A., Krisch, M., Manjón, F. J., Romero, A. H., Garro, N., … Kuball, M. (2011). InN Thin Film Lattice Dynamics by Grazing Incidence Inelastic X-Ray Scattering. Physical Review Letters, 106(20). doi:10.1103/physrevlett.106.205501Pinquier, C., Demangeot, F., Frandon, J., Pomeroy, J. W., Kuball, M., Hubel, H., … Gil, B. (2004). Raman scattering in hexagonal InN under high pressure. Physical Review B, 70(11). doi:10.1103/physrevb.70.113202Pinquier, C., Demangeot, F., Frandon, J., Chervin, J.-C., Polian, A., Couzinet, B., … Maleyre, B. (2006). Raman scattering study of wurtzite and rocksalt InN under high pressure. Physical Review B, 73(11). doi:10.1103/physrevb.73.115211Yao, L. D., Luo, S. D., Shen, X., You, S. J., Yang, L. X., Zhang, S. J., … Xie, S. S. (2010). Structural stability and Raman scattering of InN nanowires under high pressure. Journal of Materials Research, 25(12), 2330-2335. doi:10.1557/jmr.2010.0290Cuscó, R., Ibáñez, J., Alarcón-Lladó, E., Artús, L., Yamaguchi, T., & Nanishi, Y. (2009). Raman scattering study of the long-wavelength longitudinal-optical-phonon–plasmon coupled modes in high-mobility InN layers. Physical Review B, 79(15). doi:10.1103/physrevb.79.155210Wagner, J.-M., & Bechstedt, F. (2003). First-principles study of phonon-mode softening under pressure: the case of GaN and AlN. physica status solidi (b), 235(2), 464-469. doi:10.1002/pssb.200301603Weinstein, B. A. (1977). Phonon dispersion of zinc chalcogenides under extreme pressure and the metallic transformation. Solid State Communications, 24(9), 595-598. doi:10.1016/0038-1098(77)90369-6Yakovenko, E. V., Gauthier, M., & Polian, A. (2004). High-pressure behavior of the bond-bending mode of AIN. Journal of Experimental and Theoretical Physics, 98(5), 981-985. doi:10.1134/1.1767565Reparaz, J. S., Muniz, L. R., Wagner, M. R., Goñi, A. R., Alonso, M. I., Hoffmann, A., & Meyer, B. K. (2010). Reduction of the transverse effective charge of optical phonons in ZnO under pressure. Applied Physics Letters, 96(23), 231906. doi:10.1063/1.3447798Perlin, P., Jauberthie-Carillon, C., Itie, J. P., San Miguel, A., Grzegory, I., & Polian, A. (1992). Raman scattering and x-ray-absorption spectroscopy in gallium nitride under high pressure. Physical Review B, 45(1), 83-89. doi:10.1103/physrevb.45.83Manjón, F. J., Errandonea, D., Romero, A. H., Garro, N., Serrano, J., & Kuball, M. (2008). Lattice dynamics of wurtzite and rocksalt AlN under high pressure: Effect of compression on the crystal anisotropy of wurtzite-type semiconductors. Physical Review B, 77(20). doi:10.1103/physrevb.77.205204Jephcoat, A. P., Hemley, R. J., Mao, H. K., Cohen, R. E., & Mehl, M. J. (1988). Raman spectroscopy and theoretical modeling of BeO at high pressure. Physical Review B, 37(9), 4727-4734. doi:10.1103/physrevb.37.4727Ibáñez, J., Segura, A., Manjón, F. J., Artús, L., Yamaguchi, T., & Nanishi, Y. (2010). Electronic structure of wurtzite and rocksalt InN investigated by optical absorption under hydrostatic pressure. Applied Physics Letters, 96(20), 201903. doi:10.1063/1.3431291Goñi, A. R., Siegle, H., Syassen, K., Thomsen, C., & Wagner, J.-M. (2001). Effect of pressure on optical phonon modes and transverse effective charges inGaNandAlN. Physical Review B, 64(3). doi:10.1103/physrevb.64.03520

Acceptability of a vocational advice service for patients consulting in primary care with musculoskeletal pain: A qualitative exploration of the experiences of general practitioners, vocational advisers and patients

Aims: To explore the experiences of GPs, vocational advisors and patients towards a new vocational advice (VA) service in primary care, using qualitative interviews. Methods This study was nested within the Study of Work And Pain (SWAP) cluster randomised controlled trial. The SWAP trial located a VA service within three general practices in Staffordshire. Interviews took place with 10 GPs 12 months after the introduction of the VA service, 4 vocational advisors whilst the VA service was running and 20 patients on discharge from the VA service. The data were analysed using the 'constant comparative' method, which is a variation of grounded theory. Results: The key factors determining the acceptability and perceived effectiveness of the VA service from the perspective of the three groups of stakeholders were 1) the timing of referrals to the VA, 2) the perceived lack of patient demand for the service, and 3) role uncertainty experienced by VAs. Conclusions: Early vocational intervention may not be appropriate for all musculoskeletal patients with work difficulties. Indeed, many patients felt they did not require the support of a VA, either because they had self-limiting work difficulties and/or already had support mechanisms in place to return to work. Future VA interventions may be better implemented in a targeted way so that appropriate patients are identified with characteristics which can best be addressed by the VA service

Electron-phonon renormalization of the absorption edge of the cuprous halides

Compared to most tetrahedral semiconductors, the temperature dependence of the absorption edges of the cuprous halides (CuCl, CuBr, CuI) is very small. CuCl and CuBr show a small increase of the gap $E_0$ with increasing temperature, with a change in the slope of $E_0$ vs. $T$ at around 150 K: above this temperature, the variation of $E_0$ with $T$ becomes even smaller. This unusual behavior has been clarified for CuCl by measurements of the low temperature gap vs. the isotopic masses of both constituents, yielding an anomalous negative shift with increasing copper mass. Here we report the isotope effects of Cu and Br on the gap of CuBr, and that of Cu on the gap of CuI. The measured isotope effects allow us to understand the corresponding temperature dependences, which we also report, to our knowledge for the first time, in the case of CuI. These results enable us to develop a more quantitative understanding of the phenomena mentioned for the three halides, and to interpret other anomalies reported for the temperature dependence of the absorption gap in copper and silver chalcogenides; similarities to the behavior observed for the copper chalcopyrites are also pointed out.Comment: 14 pages, 5 figures, submitted to Phys. Rev.

Multi-center evaluation of the hepatitis B surface antigen (HBsAg) assay and HbsAg confirmatory assay for the family of Access immunoassay systems

BACKGROUND: Accurate detection of Hepatitis B Surface Antigen (HBsAg) is an important aid in the diagnosis of patients infected with the hepatitis B virus (HBV). A multi-center study was conducted to characterize the performance of the HBsAg assay on the family of Access immunoassay systems from Beckman Coulter. METHODS: The Access HBsAg assay was characterized in a multi-center study and compared to the Abbott AxSYM* and PRISM* HBsAg assays. The bioMérieux VIDAS* assay was used to resolve discrepant results. Reproducibility studies (intra-assay, inter-assay and inter-lot) were performed with pooled serum samples (negative sample, close to cut off, low, medium and high positive samples). Analytical sensitivity, subtype and genotype detection were studied with various commercial panels (SFTS panel, WHO 80/549, WHO 00/588, Teragenix HBV Genotype panel). A panel of recombinant HBsAg mutant proteins was tested to investigate reactivity towards genetic mutations. Clinical sensitivity was verified with seroconversion panels and samples from subjects with known HBV infection. Analytical specificity was studied with samples from patients with potential cross-reactive infections. Clinical specificity was validated among blood donors and a hospitalized population. RESULTS: The imprecision was &lt; 10%. Analytical sensitivity was &lt; or = 0.1 ng/mL (SFTS panel), 0.020 PEI Units/mL (ad panel), 0.024 PEI Units/mL (ay panel), 0.092 IU/mL with WHO 80/549 and 0.056 IU/mL with WHO 00/588. All genotype samples and HBsAg mutants were reactive with the Access HBsAg assay. Seroconversion panels tested showed no significant difference with the reference method. Sensitivity for subjects with known HBV infection was 100%. No interference with potentially cross-reactive infections was observed after confirmatory testing. Specificity was 99.96% (100% after confirmatory testing) in a blood donor population and 99.5% (100% after confirmatory testing) in a hospitalized population. Excellent separation of positive and negative populations was observed. CONCLUSIONS: The Access HBsAg and HBsAg Confirmatory assays meet all clinical and analytical performance requirements of assays for the detection of HBsAg

Industrial relations in European hypermarkets: Home and host country influences

YesIn this article we examine the industrial relations practices of three large European food retailers when they transfer the hypermarket format to other countries. We ask, first, how industrial relations in hypermarkets differ from those in other food retailing outlets. Second, we examine how far the approach characteristic of each company’s country-of-origin (Germany, France and the UK) shapes the practices adopted elsewhere. Third, we ask how they respond to the specific industrial relations systems of each host country (Turkey, Poland, Ireland and Spain)

eXtraembryonic ENdoderm (XEN) Stem Cells Produce Factors that Activate Heart Formation

Initial specification of cardiomyocytes in the mouse results from interactions between the extraembryonic anterior visceral endoderm (AVE) and the nascent mesoderm. However the mechanism by which AVE activates cardiogenesis is not well understood, and the identity of specific cardiogenic factors in the endoderm remains elusive. Most mammalian studies of the cardiogenic potential of the endoderm have relied on the use of cell lines that are similar to the heart-inducing AVE. These include the embryonal-carcinoma-derived cell lines, END2 and PYS2. The recent development of protocols to isolate eXtraembryonic ENdoderm (XEN) stem cells, representing the extraembryonic endoderm lineage, from blastocyst stage mouse embryos offers new tools for the genetic dissection of cardiogenesis.Here, we demonstrate that XEN cell-conditioned media (CM) enhances cardiogenesis during Embryoid Body (EB) differentiation of mouse embryonic stem (ES) cells in a manner comparable to PYS2-CM and END2-CM. Addition of CM from each of these three cell lines enhanced the percentage of EBs that formed beating areas, but ultimately, only XEN-CM and PYS2-CM increased the total number of cardiomyocytes that formed. Furthermore, our observations revealed that both contact-independent and contact-dependent factors are required to mediate the full cardiogenic potential of the endoderm. Finally, we used gene array comparison to identify factors in these cell lines that could mediate their cardiogenic potential.These studies represent the first step in the use of XEN cells as a molecular genetic tool to study cardiomyocyte differentiation. Not only are XEN cells functionally similar to the heart-inducing AVE, but also can be used for the genetic dissection of the cardiogenic potential of AVE, since they can be isolated from both wild type and mutant blastocysts. These studies further demonstrate the importance of both contact-dependent and contact-independent factors in cardiogenesis and identify potential heart-inducing proteins in the endoderm