Semiclassical theory of quasiparticles in the superconducting state

We have developed a semiclassical approach to solving the Bogoliubov - de Gennes equations for superconductors. It is based on the study of classical orbits governed by an effective Hamiltonian corresponding to the quasiparticles in the superconducting state and includes an account of the Bohr-Sommerfeld quantisation rule, the Maslov index, torus quantisation, topological phases arising from lines of phase singularities (vortices), and semiclassical wave functions for multi-dimensional systems. The method is illustrated by studying the problem of an SNS junction and a single vortex.Comment: 74 pages, 19 figures, 3 tables. Submitted to Academic Press for possible publicatio

Quadriceps volumes are reduced in people with patellofemoral joint osteoarthritis

Objectives: This study aimed to (1) compare the volumes of vastus medialis (VM), vastus lateralis (VL), vastus intermedius and rectus femoris and the ratio of VM/VL volumes between asymptomatic controls and patellofemoral joint osteoarthritis (PFJ OA) participants; and (2) assess the relationships between cross-sectional area (CSA) and volumes of the VM and VL in individuals with and without PFJ OA. Methods: Twenty-two participants with PFJ OA and 11 controls aged ≥40 years were recruited from the community and practitioner referrals. Muscle volumes of individual quadriceps components were measured from thigh magnetic resonance (MR) images. The CSA of the VM and lateralis were measured at 10 equally distributed levels (femoral condyles to lesser femoral trochanter). Results: PFJ OA individuals had smaller normalized VM (mean difference 0.90 cm ·kg , α = 0.011), VL (1.50 cm ·kg , α = 0.012) and rectus femoris (0.71 cm ·kg , α = 0.009) volumes than controls. No differences in the VM/VL ratio were observed. The CSA at the third level (controls) and fourth level (PFJ OA) above the femoral condyles best predicted VM volume, whereas the VL volume was best predicted by the CSA at the seventh level (controls) and sixth level (PFJ OA) above the femoral condyles. Conclusion: Reduced quadriceps muscle volume was a feature of PFJ OA. Muscle volume could be predicted from CSA measurements at specific levels in PFJ OA patients and controls

Unmixing in Random Flows

We consider particles suspended in a randomly stirred or turbulent fluid. When effects of the inertia of the particles are significant, an initially uniform scatter of particles can cluster together. We analyse this 'unmixing' effect by calculating the Lyapunov exponents for dense particles suspended in such a random three-dimensional flow, concentrating on the limit where the viscous damping rate is small compared to the inverse correlation time of the random flow (that is, the regime of large Stokes number). In this limit Lyapunov exponents are obtained as a power series in a parameter which is a dimensionless measure of the inertia. We report results for the first seven orders. The perturbation series is divergent, but we obtain accurate results from a Pade-Borel summation. We deduce that particles can cluster onto a fractal set and show that its dimension is in satisfactory agreement with previously reported in simulations of turbulent Navier-Stokes flows. We also investigate the rate of formation of caustics in the particle flow.Comment: 39 pages, 8 figure

Correction: Surface enhanced Raman scattering for the multiplexed detection of pathogenic microorganisms: towards point-of-use applications

Correction for 'Surface enhanced Raman scattering for the multiplexed detection of pathogenic microorganisms: towards point-of-use applications' by Matthew E. Berry et al., Analyst, 2021, DOI: 10.1039/D1AN00865J

Exploration into Expanding the Burlington SASH (Seniors Aging Safely at Home) Program

Background: In 2009, the Cathedral Square Corporation partnered with community provider organizations* to design a model for in-home services and support known as Seniors Aging Safely at Home (SASH). This comprehensive program, implemented at Heineberg Senior Housing in the New North End of Burlington, VT., combines health support, education, and social activities to create a safe and fulfilling environment for participants. Cathedral Squareplans to extend their SASH program to New North End (NNE) seniors residing in their own homes. However, the current and future needs of the NNE senior population (defined here as individuals age 50 and older) are not well known. NORCs are communities in which the population has aged in place, resulting in a high proportion of seniors living in one area. Neighborhoods with this dynamic have begun to organize programs which provide a variety of services to their seniors, including yard-work, educational workshops, social opportunities, and access to health care services. Village models are similar, but tend to be designed more intentionally as senior-supporting neighborhoods rather than arising naturally as the local population ages. By looking into current community models and by investigating the needs of the NNE senior population, Cathedral Square will be further equipped to offer important services to those who are interested.https://scholarworks.uvm.edu/comphp_gallery/1050/thumbnail.jp

The impact of ambidexterity on enterprise performance: evidence from 15 countries and 14 sectors

The assumption made by research on ambidexterity is that enterprises operating ambidextrously perform better as a result. Similarly, the beneficial effects of ambidexterity are often assumed to be invariant across different contexts, such as sector. However, as is widely acknowledged in the literature, there is a paucity of evidence on which to base these assumptions. To address this issue, in this note we examine evidence from the Community Innovation Survey covering 15 countries and 45,113 enterprises. The paper shows a strong, positive effect on growth in sales turnover from ambidexterity in the manufacturing and the scientific and technical services sectors

Implementing pelvic floor muscle training for women with pelvic organ prolapse: a realist evaluation of different delivery models.

Background Pelvic Floor Muscle Training (PFMT) has been shown to be effective for pelvic organ prolapse in women, but its implementation in routine practice is challenging due to lack of adequate specialist staff. It is important to know if PFMT can be delivered by different staff skill mixes, what barriers and facilitators operate in different contexts, what strategies enable successful implementation and what are the underlying mechanisms of their action. PROPEL intervention was designed to maximise the delivery of effective PFMT in the UK NHS using different staff skill mixes. We conducted a realist evaluation (RE) of this implementation to understand what works, for whom, in what circumstances and why. Methods Informed by the Realist and RE-AIM frameworks, the study used a longitudinal, qualitative, multiple case study design. The study took place in five, purposively selected, diverse NHS sites across the UK and proceeded in three phases to identify, test and refine a theory of change. Data collection took place at 4 time points over an 18 month implementation period using focus groups and semi-structured interviews with a range of stakeholders including service leads/managers, senior practitioners, newly trained staff and women receiving care in the new service models. Data were analysed using thematic framework approach adapted to identify Context, Mechanism and Outcome (CMO) configurations of the RE. Results A heightened awareness of the service need among staff and management was a mechanism for change, particularly in areas where there was a shortage of skilled staff. In contrast, the most established specialist physiotherapist-delivered PFMT service activated feelings of role protection and compromised quality, which restricted the reach of PFMT through alternative models. Staff with some level of prior knowledge in women’s health and adequate organisational support were more comfortable and confident in new role. Implementation was seamless when PFMT delivery was incorporated in newly trained staff’s role and core work. Conclusion Roll-out of PFMT delivery through different staff skill mixes is possible when it is undertaken by clinicians with an interest in women’s health, and carefully implemented ensuring adequate levels of training and ongoing support from specialists, multi-disciplinary teams and management

Pelvic floor muscle training for women with pelvic organ prolapse: the PROPEL realist evaluation

Background Pelvic organ prolapse is estimated to affect 41–50% of women aged > 40 years. A multicentre randomised controlled trial of individualised pelvic floor muscle training found that pelvic floor muscle training was effective in reducing symptoms of prolapse, improved quality of life and showed clear potential to be cost-effective. Provision of pelvic floor muscle training for prolapse has continued to vary across the UK, with limited availability of specialist physiotherapists to deliver it. Objectives This project aimed to study the implementation and outcomes of different models of delivery to increase the service provision of pelvic floor muscle training, and to follow up treatment outcomes for the original trial participants. Design A realist evaluation of pelvic floor muscle training implementation conducted within three full case study sites and two partial case study sites; an observational prospective cohort study comparing patient-reported outcomes pre and post intervention in all five sites; and a long-term follow-up study linking previous trial participants to routine NHS hospital data. Setting The setting for the realist evaluation was pelvic floor muscle training service delivery models in three NHS sites. The setting for the patient-reported outcome measures study was pelvic floor muscle training services in five NHS sites. Methods Realist evaluation qualitative data were collected at four time points in three case study sites to understand the implementation models, uptake, adherence and impact. Interviews involved service managers/leads, consultants, staff delivering pelvic floor muscle training and women receiving pelvic floor muscle training. Main outcomes measures Patient-reported outcomes were collected at baseline and at 6 and 12 months across five sites, including the Pelvic Organ Prolapse Symptom Score, health-related quality of life (measured using the EuroQol-5 Dimensions, five-level version, questionnaire), prolapse severity (measured using the Pelvic Organ Prolapse Quantification System), urinary incontinence (measured using International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form) and need for further treatment. Results A total of 102 women were recruited to the patient-reported outcome measures cohort study (target, n = 120), and 65 women had matched baseline and 6-month Pelvic Organ Prolapse Symptom Scores. The mean Pelvic Organ Prolapse Symptom Score was 10.18 (standard deviation 5.63) at baseline and 6.98 (standard deviation 5.23) at 6 months, representing a statistically significant and clinically meaningful difference. There was no statistically significant difference between the outcomes obtained from delivery by specialist physiotherapists and the outcomes obtained from delivery by other health-care professionals (mean change in Pelvic Organ Prolapse Symptom Score: –3.95 vs. –2.81, respectively). Services delivered using higher-band physiotherapists only were more costly than services delivered using other staff mixes. The effect of the original pelvic floor muscle training intervention, over a post-intervention period of > 10 years, was a reduction in the odds of any treatment during follow-up (odds ratio 0.61, 95% confidence interval 0.37 to 0.99). The realist evaluation revealed stark differences in implementation. The site with a specialist physiotherapy service resisted change because of perceived threats to the specialist role and concerns about care quality. Pelvic floor muscle training delivery by other health-care staff was easier when there was a lack of any existing specialist service; staff had prior training and interest in pelvic health; staff had support, autonomy, time and resources to deliver pelvic floor muscle training as part of their core role; and surrounding services supported a flow of pelvic floor muscle training referrals. Limitations The number of available matched pre and post outcomes for women and the lack of Pelvic Organ Prolapse Quantification System examinations were limitations of this study. Conclusions It is possible to train different staff to effectively deliver pelvic floor muscle training to women. Women’s self-reported outcomes significantly improved across all service models. Training should be adequately tailored to differential skill mix needs. Future work Future work should include further implementation of pelvic floor muscle training and should include pre- and post-outcome data collection using the Pelvic Organ Prolapse Symptom Score