222 research outputs found
Symmetry-protected nodal phases in non-Hermitian systems
Non-Hermitian (NH) Hamiltonians have become an important asset for the
effective description of various physical systems that are subject to
dissipation. Motivated by recent experimental progress on realizing the NH
counterparts of gapless phases such as Weyl semimetals, here we investigate how
NH symmetries affect the occurrence of exceptional points (EPs), that
generalize the notion of nodal points in the spectrum beyond the Hermitian
realm. Remarkably, we find that the dimension of the manifold of EPs is
generically increased by one as compared to the case without symmetry. This
leads to nodal surfaces formed by EPs that are stable as long as a protecting
symmetry is preserved, and that are connected by open Fermi volumes. We
illustrate our findings with analytically solvable two-band lattice models in
one and two spatial dimensions, and show how they are readily generalized to
generic NH crystalline systems.Comment: Editors' Suggestio
Impact of hypoxaemia on neuroendocrine function and catecholamine secretion in chronic obstructive pulmonary disease (COPD). Effects of long-term oxygen treatment
AbstractThe aim of the study was to investigate the effects of chronic hypoxaemia on neuroendocrine function in hypoxaemic chronic obstructive pulmonary disease (COPD). The stress level was assessed by measurement of daytime plasma catecholamine and nocturnal urinary catecholamine levels and endocrine function was assessed by measuring serum gonadotropins, peripheral sex hormones and peripheral thyroid hormones, and by measuring thyroid stimulating hormone (TSH), prolactin and growth hormone before and after thyroid releasing hormone challenge in 12 male, stable, hypoxaemic COPD patients before and after at least 4 months of long-term oxygen treatment (LTOT). Mean pre-treatment P aO2was 7·39±0·78 kPa and mean nocturnal arterial oxygen saturation (MSaO2) was 86·6±3·2%. Plasma norepinephrine (NE) levels were higher than normal, while all other pre-treatment hormone levels were within normal range. Low forced expiratory volume in 1sec (FEV1) was associated with low basal and stimulated TSH (P<0·01). Urinary NE excretion correlated positively to nocturnal time spent with SaO2<85% (P<0·05). In similarity with normal controls, positive correlations were found between sex hormone binding globulin and testosterone both before and after LTOT (P<0·01). No significant hormonal changes were noted following an average of 8 months of LTOT for the entire study group. However, in a subgroup (n=6) with an increase in MSaO2exceeding 7% points following LTOT, nocturnal excretion of NE and epinephrine were reduced by 30% (P<0·05) and S-free thyroxin by 20% (P<0·05).In conclusion, patients with chronic hypoxaemia secondary to COPD exhibit elevated plasma NE levels but otherwise normal endocrine levels, including a normal hypothalamic–pituitary–testicular axis. The severity of airway obstruction is associated with reduced basal and stimulated TSH. The endocrine function is not significantly changed following LTOT except for a subgroup with severe nocturnal hypoxaemia, where elevated nocturnal NE excretion was noted, which was reduced only if whole night oxygenation was normalized during oxygen therapy
Integrated healthcare and the dilemma of public health emergencies
Traditional healthcare services have demonstrated structural shortcomings in the delivery of patient care and enforced numerous elements of integration in the delivery of healthcare services. Integrated healthcare aims at providing all healthcare that makes humans healthy. However, with mainly chronically ill people and seniors, typically suffering from numerous comorbidities and diseases, being recruited for care, there is a need for a change in the healthcare service structure beyond direct-patient care to be compatible in peacetime and during public health emergencies. This article’s objective is to discuss the opportunities and obstacles for increasing the effectiveness of healthcare through improved integration. A rapid evidence review approach was used by performing a systematic followed by a non-systematic literature review and content analysis. The results confirmed that integrated healthcare systems play an increasingly important role in healthcare system reforms undertaken in European Union countries. The essence of these changes is the transition from the episodic treatment of acute diseases to the provision of coordinated medical services, focused on chronic cases, prevention, and ensuring patient continuity. However, integrated healthcare, at a level not yet fully defined, will be necessary if we are to both define and attain the integrated practice of both global health and global public health emergencies. This paper attains the necessary global challenges to integrate healthcare effectively at every level of society. There is a need for more knowledge to effectively develop, support, and disseminate initiatives related to coordinated healthcare in the individual healthcare systems
InP-based two-dimensional photonic crystals filled with polymers
Polymer filling of the air holes of Indium Phosphide based two-dimensional
photonic crystals is reported. After infiltration of the holes with a liquid
monomer and solidification of the infill in situ by thermal polymerization,
complete filling is proven using scanning electron microscopy. Optical
transmission measurements of a filled photonic crystal structure exhibit a
redshift of the air band, confirming the complete filling.Comment: To be published in Appl. Phys. Let
Don’t forget the porpoise: acoustic monitoring reveals fine scale temporal variation between bottlenose dolphin and harbour porpoise in Cardigan Bay SAC
Populations of bottlenose dolphin and harbour porpoise inhabit Cardigan Bay, which was designated a Special Area of Conservation (SAC), with bottlenose dolphin listed as a primary feature for its conservation status. Understanding the abundance, distribution and habitat use of species is fundamental for conservation and the implementation of management. Bottlenose dolphin and harbour porpoise usage of feeding sites within Cardigan Bay SAC was examined using passive acoustic monitoring. Acoustic detections recorded with calibrated T-PODs (acoustic data loggers) indicated harbour porpoise to be present year round and in greater relative abundance than bottlenose dolphin. Fine-scale temporal partitioning between the species occurred at three levels: (1) seasonal differences, consistent between years, with porpoise detections peaking in winter months and dolphin detections in summer months; (2) diel variation, consistent across sites, seasons and years, with porpoise detections highest at night and dolphin detections highest shortly after sunrise; and (3) tidal variation was observed with peak dolphin detections occurring during ebb at the middle of the tidal cycle and before low tide, whereas harbour porpoise detections were highest at slack water, during and after high water with a secondary peak recorded during and after low water. General Additive Models (GAMs) were applied to better understand the effects of each covariate. The reported abundance and distribution of the two species, along with the temporal variation observed, have implications for the design and management of protected areas. Currently, in the UK, no SACs have been formally designated for harbour porpoise while three exist for bottlenose dolphins. Here, we demonstrate a need for increased protection and species-specific mitigation measures for harbour porpoise
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Person-centred care in interventions to limit weight gain in pregnant women with obesity - a systematic review
Background
Person-centred care, asserting that individuals are partners in their care, has been associated with care satisfaction but the value of using it to support women with obesity during pregnancy is unknown. Excessive gestational weight gain is associated with increased risks for both mother and baby and weight gain therefore is an important intervention target. The aims of this review was to 1) explore to what extent and in what manner interventions assessing weight in pregnant women with obesity use person-centred care and 2) assess if interventions including aspects of person-centred care are more effective at limiting weight gain than interventions not employing person-centred care.
Methods
Ten databases were systematically searched in January 2014. Studies had to report an intervention offered to pregnant women with obesity and measure gestational weight gain to be included. All included studies were independently double coded to identify to what extent they included three defined aspects of person-centred care: 1) “initiate a partnership” including identifying the person’s circumstances and motivation; 2) “working the partnership” through sharing the decision-making regarding the planned action and 3) “safeguarding the partnership through documentation” of care preferences. Information on gestational weight gain, study quality and characteristics were also extracted.
Results
Ten studies were included in the review, of which five were randomised controlled trials (RCT), and the remaining observational studies. Four interventions included aspects of person-centred care; two observational studies included both “initiating the partnership”, and “working the partnership”. One observational study included “initiating the partnership” and one RCT included “working the partnership”. No interventions included “safeguarding the partnership through documentation”. Whilst all studies with person-centred care aspects showed promising findings regarding limiting gestational weight gain, so did the interventions not including person-centred care aspects.
Conclusions
The use of an identified person-centred care approach is presently limited in interventions targeting gestational weight gain in pregnant women with obesity. Hence to what extent person-centred care may improve health outcomes and care satisfaction in this population is currently unknown and more research is needed. That said, our findings suggest that use of routines incorporating person-centredness are feasible to include within these interventions
Attempting to Compensate for Reduced Neuronal Nitric Oxide Synthase Protein with Nitrate Supplementation Cannot Overcome Metabolic Dysfunction but Rather Has Detrimental Effects in Dystrophin-Deficient mdx Muscle
Can a person-centred-care intervention improve health-related quality of life in patients with head and neck cancer? A randomized, controlled study
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