230 research outputs found
Mathematical description of bacterial traveling pulses
The Keller-Segel system has been widely proposed as a model for bacterial
waves driven by chemotactic processes. Current experiments on {\em E. coli}
have shown precise structure of traveling pulses. We present here an
alternative mathematical description of traveling pulses at a macroscopic
scale. This modeling task is complemented with numerical simulations in
accordance with the experimental observations. Our model is derived from an
accurate kinetic description of the mesoscopic run-and-tumble process performed
by bacteria. This model can account for recent experimental observations with
{\em E. coli}. Qualitative agreements include the asymmetry of the pulse and
transition in the collective behaviour (clustered motion versus dispersion). In
addition we can capture quantitatively the main characteristics of the pulse
such as the speed and the relative size of tails. This work opens several
experimental and theoretical perspectives. Coefficients at the macroscopic
level are derived from considerations at the cellular scale. For instance the
stiffness of the signal integration process turns out to have a strong effect
on collective motion. Furthermore the bottom-up scaling allows to perform
preliminary mathematical analysis and write efficient numerical schemes. This
model is intended as a predictive tool for the investigation of bacterial
collective motion
All eyes on the patient: the influence of oncologists’ nonverbal communication on breast cancer patients’ trust
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Improved Upper Limit on the Neutrino Mass from a Direct Kinematic Method by KATRIN.
We report on the neutrino mass measurement result from the first four-week science run of the Karlsruhe Tritium Neutrino experiment KATRIN in spring 2019. Beta-decay electrons from a high-purity gaseous molecular tritium source are energy analyzed by a high-resolution MAC-E filter. A fit of the integrated electron spectrum over a narrow interval around the kinematic end point at 18.57 keV gives an effective neutrino mass square value of (-1.0_{-1.1}^{+0.9}) eV^{2}. From this, we derive an upper limit of 1.1 eV (90% confidence level) on the absolute mass scale of neutrinos. This value coincides with the KATRIN sensitivity. It improves upon previous mass limits from kinematic measurements by almost a factor of 2 and provides model-independent input to cosmological studies of structure formation
Two-scale Moving Boundary Dynamics of Cancer Invasion:Heterotypic Cell Populations Evolution in Heterogeneous ECM
This book contains a collection of original research articles and review articles that describe novel mathematical modeling techniques and the application of those techniques to models of cell motility in a variety of contexts. The aim is to highlight some of the recent mathematical work geared at understanding the coordination of intracellular processes involved in the movement of cells. This collection will benefit researchers interested in cell motility as well graduate students taking a topics course in this area.
Tailoring communications to the evolving needs of patients throughout the cancer care trajectory: a qualitative exploration with breast cancer patients
Background: Doctor-patient communication is a crucial aspect of patient care. This study explored the communication experience of patients in a cancer consultation over the course of the cancer continuum. Methods: In-depth interviews with seven breast cancer patients were carried out. Results: Themes related to communication experiences across the five phases of cancer consultation, from diagnosis to recurrence, were identified. The most salient issue is that patients also perceived cancer as 'a disease of the mind', which is not adequately cared for in consultation. This highlights the notion that cancer care providers should provide appropriate care for the psychological dimensions of the cancer experience with an empathic and sincere attitude during consultations. To this end, non-verbal aspects of communication that convey caring, support, and respect seem important. Furthermore, patients perceived that the consultation time was far shorter then they needed and reported that they felt pressured for time. Moreover, the stance taken by patients and the needs and preferences of patients varied across the phases of the cancer trajectory. As patients progressed through the phases of their treatment, they assumed more active roles in the course of their care and the need for more detailed information and questioning increased. Thus, ensuring that patients have opportunities to ask questions in the consultation is important. Conclusion: Current findings suggest that the efficacy of communication varies depending on which phase patients are in and that effective communication should be tailored to these evolving needs and preferences of breast cancer patients. Also, patients perceived that the consultation did not adequately address their need for information related to their care or their emotional issues associated with the cancer experience. It is therefore important to address their needs by paying particular attention to non-verbal aspects of communication that convey empathy and respect toward patients, as well as allowing patients to ask questionsope
Conservative treatment of fractures of the clavicle
Background: In the treatment of clavicle fractures, the choice of procedure depends on the possibility of restoring
the anatomical functional integrity of the shoulder.
Methods: We examined 71 patients (51 males and 20 females, mean age 38.9 years) who were affected by clavicle
fracture sequelae. Demographic and clinical data and the site of the lesion were recorded for each partecipant. The
dissatisfaction of the patient was determined by the presence of 1 or more affirmative answers on the Simple
Shoulder Test. The Constant Shoulder Score was also included in the functional and clinical exams. We measured
the length of the healthy clavicle and the previously fractured clavicle, and we expressed the difference in length
in mm and in percentage shortening. We then examined the correlations between the shortening of the bone
and the clinical and functional outcomes of the patients.
Results: Sixty patients had a lesion of the diaphysis, 8 patients had a lesion of the lateral third of the clavicle, and
3 patients had a lesion of the medial third of the clavicle. The mean Constant Shoulder Score was 77.9, and 51 of
the 71 patients were satisfied with their treatment. Radiography showed a mean clavicle shortening of 10 mm
(mean percentage 6.5%). In the 20 dissatisfied patients, the mean clavicle shortening was 15.2 mm (9.7%). In these
patients, we found a highly significant association between dissatisfaction with treatment and the amount of bone
shortening, (p < 0.0001), as well as with a diaphyseal location (p < 0.05) and with the female sex (p = 0.004). No
other variable related to the patient, the type of treatment or the fracture characteristics correlated with the
treatment outcome.
Conclusions: In the literature, measurements of the shortening of the bone segment following a fracture range
between 15 and 23 mm, and marked shortening is correlated with the failure of conservative treatment. However,
these data need to be reinterpreted in light of the physiological variability of the clavicle length, which ranges
from 140 to 158 mm in the healthy population. Shortening of the bone by more than 9.7% should be the cut-off
for predicting failure of conservative treatment
Understanding patients' satisfaction with physician assistant/associate encounters through communication experiences: a qualitative study in acute hospitals in England.
BACKGROUND: Physician assistants/associates (PAs) are a recent innovation in acute hospital teams in England and many other countries worldwide. Although existing evidence indicates generally high levels of patient satisfaction with their PA hospital encounters, little is known about the factors associated with this outcome. There is a lack of evidence on the process of PA-patient communication in hospital encounters and how this might influence satisfaction. This study therefore aimed to understand patients' satisfaction with PA acute hospital encounters through PA-patient communication experiences. METHODS: A qualitative study was conducted among patients and representatives of patients seen by or receiving care from one of the PAs working in acute hospital services in England. Semi-structured interviews were undertaken face-to-face with study participants in the hospital setting and shortly after their PA encounter. Data were coded and analysed using thematic analysis. The study was framed within a theoretical model of core functions of medical encounter communication. RESULTS: Fifteen patients and patient representatives who had experienced a PA encounter participated in interviews, across five hospitals in England. Four interrelated communication experiences were important to participants who were satisfied with the encounter in general: feeling trust and confidence in the relationship, sharing relevant and meaningful information, experiencing emotional care and support, and sharing discussion on illness management and treatment. However, many participants misconceived PAs to be doctors, raising a potential risk of reduced trust in the PA relationship and negative implications for satisfaction with their PA encounter. Participants considered it beneficial that patients be informed about the PA role to prevent confusion. CONCLUSIONS: PA encounters offer a constructive example of successful clinician-patient communication experiences in acute hospital encounters from the patient's perspective. Study participants were generally naïve to the PA role. Hospital services and organisations introducing these mid-level or advanced care practitioner roles should consider giving attention to informing patients about the roles
Labelling effects and adolescent responses to peers with depression: an experimental investigation
Variation in diabetes care by age: opportunities for customization of care
BACKGROUND: The quality of diabetes care provided to older adults has usually been judged to be poor, but few data provide direct comparison to other age groups. In this study, we hypothesized that adults age 65 and over receive lower quality diabetes care than adults age 45–64 years old. METHODS: We conducted a cohort study of members of a health plan cared for by multiple medical groups in Minnesota. Study subjects were a random sample of 1109 adults age 45 and over with an established diagnosis of diabetes using a diabetes identification method with estimated sensitivity 0.91 and positive predictive value 0.94. Survey data (response rate 86.2%) and administrative databases were used to assess diabetes severity, glycemic control, quality of life, microvascular and macrovascular risks and complications, preventive care, utilization, and perceptions of diabetes. RESULTS: Compared to those aged 45–64 years (N = 627), those 65 and older (N = 482) had better glycemic control, better health-related behaviors, and perceived less adverse impacts of diabetes on their quality of life despite longer duration of diabetes and a prevalence of cardiovascular disease twice that of younger patients. Older patients did not ascribe heart disease to their diabetes. Younger adults often had explanatory models of diabetes that interfere with effective and aggressive care, and accessed care less frequently. Overall, only 37% of patients were simultaneously up-to-date on eye exams, foot exams, and glycated hemoglobin (A1c) tests within one year. CONCLUSION: These data demonstrate the need for further improvement in diabetes care for all patients, and suggest that customisation of care based on age and explanatory models of diabetes may be an improvement strategy that merits further evaluation
Antiangiogenic drugs in ovarian cancer
Ovarian cancer continues to be a major cause of morbidity and mortality in women. Antiangiogenic treatments have emerged as a promising strategy to treat ovarian cancer. This article reviews the rationale supporting the use of antiangiogenic treatments in ovarian cancer, the clinical development of this group of drugs and the toxicities specific to this modality of treatment
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