Viscoelastic optical nonlocality of low-loss epsilon-near-zero nanofilms

Optical nonlocalities are elusive and hardly observable in traditional plasmonic materials like noble and alkali metals. Here we report experimental observation of viscoelastic nonlocalities in the infrared optical response of doped cadmium-oxide, epsilon-near-zero nanofilms. The nonlocality is detectable thanks to the low damping rate of conduction electrons and the virtual absence of interband transitions at infrared wavelengths. We describe the motion of conduction electrons using a hydrodynamic model for a viscoelastic fluid, and find excellent agreement with experimental results. The electrons elasticity blue-shifts the infrared plasmonic resonance associated with the main epsilon-near-zero mode, and triggers the onset of higher-order resonances due to the excitation of electron-pressure modes above the bulk plasma frequency. We also provide evidence of the existence of nonlocal damping, i.e., viscosity, in the motion of optically-excited conduction electrons using a combination of spectroscopic ellipsometry data and predictions based on the viscoelastic hydrodynamic model.Comment: 19 pages, 5 figure

The actual challenges of financial literacy

In our always-evolving world, financial literacy and inclusion are crucial in the development of sustainable welfare and a more transparent and fairer society. We cannot forget that the subprime mortgage crisis of 2008 that has continued across the world to this day has financial illiteracy as one of the most aggravating factors. The main challenge for many consumers worldwide is that the requirements of adequate financial literacy skills have been steadily increasing over time. Individuals have to take a wide range of financial decisions and unfortunately, they sometimes overlook or simply do not know the risk attached with the decisions they are making until it is too late. The main challenges for financial literacy at the micro-level, meso-level, and macro-level are over deference to the financial industry, lack of financial knowledge, overconfidence about financial knowledge, lack of government initiatives, frameworks and regulations, lack of life-cycle planning and interesting and fascinating ways to teach financial literacy skills

Cross-cultural evaluation of the relevance of the HCAHPS survey in five European countries

Objective To describe the systematic language translation and cross-cultural evaluation process that assessed the relevance of the Hospital Consumer Assessment of Healthcare Providers and Systems survey in five European countries prior to national data collection efforts. Design An approach involving a systematic translation process, expert review by experienced researchers and a review by ‘patient' experts involving the use of content validity indexing techniques with chance correction. Setting Five European countries where Dutch, Finnish, French, German, Greek, Italian and Polish are spoken. Participants ‘Patient' experts who had recently experienced a hospitalization in the participating country. Main OutcomeMeasure(s) Content validity indexing with chance correction adjustment providing a quantifiable measure that evaluates the conceptual, contextual, content, semantic and technical equivalence of the instrument in relationship to the patient care experience. Results All translations except two received ‘excellent' ratings and no significant differences existed between scores for languages spoken in more than one country. Patient raters across all countries expressed different concerns about some of the demographic questions and their relevance for evaluating patient satisfaction. Removing demographic questions from the evaluation produced a significant improvement in the scale-level scores (P= .018). The cross-cultural evaluation process suggested that translations and content of the patient satisfaction survey were relevant across countries and languages. Conclusions The Hospital Consumer Assessment of Healthcare Providers and Systems survey is relevant to some European hospital systems and has the potential to produce internationally comparable patient satisfaction score

The effects of acute dopamine reuptake inhibition on performance

Introduction: Acute bupropion (BUP; dopamine/noradrenaline reuptake inhibitor) administration significantly improved time trial performance and increased core temperature in the heat (30°C). Purpose: The present study was performed to examine the effect of a dopaminergic reuptake inhibitor on exercise capacity and thermoregulation during prolonged exercise in temperate and warm conditons. Methods: Eight healthy well-trained male cyclists participated in this study. Subjects ingested either a placebo (PLAC; lactose; 20mg) or Ritalin (RIT; methylphenidate (MPH); 20mg) one hour before the start of exercise in temperate (18°C) or warm (30°C) conditions and cycled for 60 min at 55% Wmax, immediately followed by a time trial (TT; pla18 and rit18; pla30 and rit30) to measure exercise performance. Results: Ritalin did not influence TT performance at 18oC (P=0.397). TT was completed 16% faster in rit30 (38.1±6.4min) than in pla30 (45.4±7.3min; p=0.049). Power output was higher in rit30, compared to pla30 (p<0.05). In the heat Tcore was significantly higher at rest (p=0.009), at the start of exercise and throughout rit30 (p<0.05). Throughout rit30 heart rates were significantly higher (p<0.05). Prolactin concentrations decreased after one hour cycling in 18°C (p=0,036) and at rest in 30°C (p=0,007) after RIT administration. Conclusions: These results show that RIT has a clear ergogenic effect that was not apparent in 18°C. The combination of a dopamine reuptake inhibitor and exercise in the heat clearly improved performance and appeared to increase metabolic heat production, suggesting an important role for dopamine in the fatigue process

Enhanced third harmonic generation from the epsilon-near-zero modes of ultrathin films

We experimentally demonstrate efficient third harmonic generation from an indium tin oxide (ITO) nanofilm (lambda/42 thick) on a glass substrate for a pump wavelength of 1.4 um. A conversion efficiency of 3.3x10^-6 is achieved by exploiting the field enhancement properties of the epsilon-near-zero (ENZ) mode with an enhancement factor of 200. This nanoscale frequency conversion method is applicable to other plasmonic materials and reststrahlen materials in proximity of the longitudinal optical phonon frequencies.Comment: 13 pages, 5 figure

Effects of Mental Fatigue on Endurance Performance in the Heat

PURPOSE: Mental fatigue is a psychobiological state caused by prolonged periods of demanding cognitive activity and has been observed to decrease time-trial (TT) endurance performance by ~3,5% in normal ambient temperatures. Recently it has been suggested that heat may augment the negative effect of mental fatigue on cognitive performance, raising the question whether it may also amplify the effect of mental fatigue on TT-performance. METHODS: In 30 °C and 30% relative humidity, ten endurance-trained male athletes (Age: 22 ± 3 y; Wmax: 332 ± 41 W) completed two experimental conditions: intervention (I; 45-min Stroop task) and control (C; 45-min documentary). Pre and post intervention/control, cognitive performance was followed up with a 5-min Flanker task. Thereafter subjects cycled for 45 min at a fixed pace equal to 60%-Wmax, immediately followed by a self-paced TT in which they had to produce a fixed amount of work (equal to cycling 15 min at 80%-Wmax) as fast as possible. RESULTS: Self-reported mental fatigue was significantly higher after I compared to C (P<0.05). Moreover electroencephalographic measures also indicated the occurrence of mental fatigue during the Stroop (P<0.05). TT-time did not differ between conditions (I: 906 ± 30 s, C: 916 ± 29 s). Throughout exercise, physiological (heart rate, blood lactate, core and skin temperature) and perceptual measures (perception of effort and thermal sensation) were not affected by mental fatigue. CONCLUSION: No negative effects of mild mental fatigue were observed on performance and the physiological and perceptual responses to endurance exercise in the heat. Most plausibly mild mental fatigue does not reduce endurance performance when the brain is already stressed by a hot environment

Presence of Anti-Microbial Antibodies in Liver Cirrhosis – A Tell-Tale Sign of Compromised Immunity?

Bacterial translocation plays important role in the complications of liver cirrhosis. Antibody formation against various microbial antigens is common in Crohn's disease and considered to be caused by sustained exposure to gut microflora constituents. We hypothesized that anti-microbial antibodies are present in patients with liver cirrhosis and may be associated with the development of bacterial infections.<0.001, OR:2.02) by Cox-regression analysis.The present study suggests that systemic reactivity to microbial components reflects compromised mucosal immunity in patients with liver cirrhosis, further supporting the possible role of bacterial translocation in the formation of anti-microbial antibodies

Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study

Background Austerity measures and health-system redesign to minimise hospital expenditures risk adversely affecting patient outcomes. The RN4CAST study was designed to inform decision making about nursing, one of the largest components of hospital operating expenses. We aimed to assess whether differences in patient to nurse ratios and nurses' educational qualifications in nine of the 12 RN4CAST countries with similar patient discharge data were associated with variation in hospital mortality after common surgical procedures. Methods For this observational study, we obtained discharge data for 422 730 patients aged 50 years or older who underwent common surgeries in 300 hospitals in nine European countries. Administrative data were coded with a standard protocol (variants of the ninth or tenth versions of the International Classification of Diseases) to estimate 30 day in-hospital mortality by use of risk adjustment measures including age, sex, admission type, 43 dummy variables suggesting surgery type, and 17 dummy variables suggesting comorbidities present at admission. Surveys of 26 516 nurses practising in study hospitals were used to measure nurse staffing and nurse education. We used generalised estimating equations to assess the effects of nursing factors on the likelihood of surgical patients dying within 30 days of admission, before and after adjusting for other hospital and patient characteristics. Findings An increase in a nurses' workload by one patient increased the likelihood of an inpatient dying within 30 days of admission by 7% (odds ratio 1·068, 95% CI 1·031–1·106), and every 10% increase in bachelor's degree nurses was associated with a decrease in this likelihood by 7% (0·929, 0·886–0·973). These associations imply that patients in hospitals in which 60% of nurses had bachelor's degrees and nurses cared for an average of six patients would have almost 30% lower mortality than patients in hospitals in which only 30% of nurses had bachelor's degrees and nurses cared for an average of eight patients. Interpretation Nurse staffing cuts to save money might adversely affect patient outcomes. An increased emphasis on bachelor's education for nurses could reduce preventable hospital deaths. Funding European Union's Seventh Framework Programme, National Institute of Nursing Research, National Institutes of Health, the Norwegian Nurses Organisation and the Norwegian Knowledge Centre for the Health Services, Swedish Association of Health Professionals, the regional agreement on medical training and clinical research between Stockholm County Council and Karolinska Institutet, Committee for Health and Caring Sciences and Strategic Research Program in Care Sciences at Karolinska Institutet, Spanish Ministry of Science and Innovation

In patient stroke rehabilitation efficiency: Influence of organization of service delivery and staff numbers

<p>Abstract</p> <p>Background</p> <p>Outcomes of inpatient stroke rehabilitation need to be reviewed in terms of optimal resource utilization (staff time, service organization, and duration of stay). We compared FIM efficiency scores between three hospitals, and also variation in FIM scores over a ten year period in one hospital undergoing reduction in staff numbers, to examine the relationship between outcome and service characteristics.</p> <p>Method</p> <p>This is a retrospective study comparing the mean FIM efficiency for stroke patients (FIM score – FIM admission score) divided by duration of stay for 2005 among three rehabilitation hospitals adjusting for age and baseline FIM score, and a longitudinal study of changes in mean FIM efficiency during a ten year period in one hospital, to examine the effects of different service organization and staff numbers.</p> <p>Results</p> <p>FIM efficiency (FIMEG) was inversely associated with age, and positively associated with admission FIM score. FIMEG was higher in the hospital with a coordinated care plan involving medical, nursing, occupational, physiotherapy staff and other healthcare providers working as a team, with a seamless interface with community rehabilitation services. Over a ten year period, reduction in staff numbers was associated with reduction in FIMEG, which may be offset to some extent by service re-engineering.</p> <p>Conclusion</p> <p>Within hospital organization of stroke rehabilitation services may influence outcome. A critical number of staff may be identified for the provision of services, below which rehabilitation efficiency may be affected.</p