Fault slip-rate variations during crustal-scale strain localisation, central Italy

Rates of plate motion are generally uniform over 10–102 Myrs timescales. Faults between tectonic plates might, therefore, be expected to show temporally-uniform slip-rates if the same number of faults remain active. For an extending region of the Eurasia-Africa plate boundary, Italy, finite throw values (vertical component of the slip) for seismogenic normal faults are less than that predicted when recent throw-rates are extrapolated over the fault lifetimes. The effect correlates with distance from the fault system tips and demonstrates that the slip-rates on centrally-located faults have increased with time. Neighbouring normal faults were active in the Quaternary but show no signs of surface faulting during the latest Pleistocene to Holocene. Death of these faults has provided the extra strain per unit time to drive the increased slip-rates measured on other faults. Thus, fault interaction and death modify slip-rates and seismic hazards associated with plate tectonics

Simulation of hydrogenated graphene Field-Effect Transistors through a multiscale approach

In this work, we present a performance analysis of Field Effect Transistors based on recently fabricated 100% hydrogenated graphene (the so-called graphane) and theoretically predicted semi-hydrogenated graphene (i.e. graphone). The approach is based on accurate calculations of the energy bands by means of GW approximation, subsequently fitted with a three-nearest neighbor (3NN) sp3 tight-binding Hamiltonian, and finally used to compute ballistic transport in transistors based on functionalized graphene. Due to the large energy gap, the proposed devices have many of the advantages provided by one-dimensional graphene nanoribbon FETs, such as large Ion and Ion/Ioff ratios, reduced band-to-band tunneling, without the corresponding disadvantages in terms of prohibitive lithography and patterning requirements for circuit integration

Helical edge states in multiple topological mass domains

The two-dimensional topological insulating phase has been experimentally discovered in HgTe quantum wells (QWs). The low-energy physics of two-dimensional topological insulators (TIs) is described by the Bernevig-Hughes-Zhang (BHZ) model, where the realization of a topological or a normal insulating phase depends on the Dirac mass being negative or positive, respectively. We solve the BHZ model for a mass domain configuration, analyzing the effects on the edge modes of a finite Dirac mass in the normal insulating region (soft-wall boundary condition). We show that at a boundary between a TI and a normal insulator (NI), the Dirac point of the edge states appearing at the interface strongly depends on the ratio between the Dirac masses in the two regions. We also consider the case of multiple boundaries such as NI/TI/NI, TI/NI/TI and NI/TI/NI/TI.Comment: 11 pages, 15 figure

Helical edge states in multiple topological mass domains

The two-dimensional topological insulating phase has been experimentally discovered in HgTe quantum wells (QWs). The low-energy physics of two-dimensional topological insulators (TIs) is described by the Bernevig-Hughes-Zhang (BHZ) model, where the realization of a topological or a normal insulating phase depends on the Dirac mass being negative or positive, respectively. We solve the BHZ model for a mass domain configuration, analyzing the effects on the edge modes of a finite Dirac mass in the normal insulating region (soft-wall boundary condition). We show that at a boundary between a TI and a normal insulator (NI), the Dirac point of the edge states appearing at the interface strongly depends on the ratio between the Dirac masses in the two regions. We also consider the case of multiple boundaries such as NI/TI/NI, TI/NI/TI and NI/TI/NI/TI.Comment: 11 pages, 15 figure

P298 Comparison between clinical and patient-reported symptoms among Crohn's disease and ulcerative colitis patients

Background: There is no symptom-based patient-reported outcomes (PRO) measurement available in IBD. Disease scores contain a mixture of PRO and physician's observations and have shown serious limitations in clinical trials. Comparison between healthcare professionals (HCP) and patient (P) reports on scores' items is a first step toward disease scores refinement. In our IBD cohort study, we were able to collect P and HCP-reported symptoms independently. We assessed the agreement between both measures, and tested the correlation between the general well-being item (GWB) and two health-related quality of life (HRQoL) measures. Methods: Between 2012 and 2015, we collected CDAI and MTWAI items 1) during follow-up medical visits, 2) through P self-reported follow-up questionnaire, except lab values. We compared items independently reported by HCP and P, stratified by diagnostic and Δt HCP-P reports. We calculated the Cohen's kappa (κ) statistic for agreement. A quadratic weight was applied for more severely serious disagreements. For EIM & complications, we computed a pooled κ based on the average between observed and expected probability of agreement over sub-items. A pooled κ was computed to summarize agreement over all examined variables. We also collected SF-36 and IBDQ scores. Pearson correlation coefficients r were calculated between both scores and GWB reports of HCP and P. Results: 2427 reports could be evaluated (Δt: 537<1 month, 390 1–2, 1500 2–6), referring to 1385 patients (52% females, 58% CD)

Trauma ICU Prevalence Project: the diversity of surgical critical care.

Background:Surgical critical care is crucial to the care of trauma and surgical patients. This study was designed to provide a contemporary assessment of patient types, injuries, and conditions in intensive care units (ICU) caring for trauma patients. Methods:This was a multicenter prevalence study of the American Association for the Surgery of Trauma; data were collected on all patients present in participating centers' trauma ICU (TICU) on November 2, 2017 and April 10, 2018. Results:Forty-nine centers submitted data on 1416 patients. Median age was 58 years (IQR 41-70). Patient types included trauma (n=665, 46.9%), non-trauma surgical (n=536, 37.8%), medical (n=204, 14.4% overall), or unspecified (n=11). Surgical intensivists managed 73.1% of patients. Of ICU-specific diagnoses, 57% were pulmonary related. Multiple high-intensity diagnoses were represented (septic shock, 10.2%; multiple organ failure, 5.58%; adult respiratory distress syndrome, 4.38%). Hemorrhagic shock was seen in 11.6% of trauma patients and 6.55% of all patients. The most common traumatic injuries were rib fractures (41.6%), brain (38.8%), hemothorax/pneumothorax (30.8%), and facial fractures (23.7%). Forty-four percent were on mechanical ventilation, and 17.6% had a tracheostomy. One-third (33%) had an infection, and over half (54.3%) were on antibiotics. Operations were performed in 70.2%, with 23.7% having abdominal surgery. At 30 days, 5.4% were still in the ICU. Median ICU length of stay was 9 days (IQR 4-20). 30-day mortality was 11.2%. Conclusions:Patient acuity in TICUs in the USA is very high, as is the breadth of pathology and the interventions provided. Non-trauma patients constitute a significant proportion of TICU care. Further assessment of the global predictors of outcome is needed to inform the education, research, clinical practice, and staffing of surgical critical care providers. Level of evidence:IV, prospective observational study

Exact states and spectra of vibrationally dressed polaritons

Strong coupling between light and matter is possible with a variety of organic materials. In contrast to the simpler inorganic case, organic materials often have a complicated spectrum, with vibrationally dressed electronic transitions. Strong coupling to light competes with this vibrational dressing and, if strong enough, can suppress the entanglement between electronic and vibrational degrees of freedom. By exploiting symmetries, we can perform exact numerical diagonalization to find the polaritonic states for intermediate numbers of molecules and use these to define and validate accurate expressions for the lower polariton states and strong-coupling spectrum in the thermodynamic limit. Using this approach, we find that vibrational decoupling occurs as a sharp transition above a critical matter-light coupling strength. We also demonstrate how the polariton spectrum evolves with the number of molecules, recovering classical linear optics results only at large N

Patient self-reported concerns in inflammatory bowel diseases: A gender-specific subjective quality-of-life indicator.

Patient-reported disease perceptions are important components to be considered within a holistic model of quality of care. Gender may have an influence on these perceptions. We aimed to explore gender-specific concerns of patients included in a national bilingual inflammatory bowel disease cohort. Following a qualitative study, we built a questionnaire comprising 37 items of concern. Answers were collected on a visual analog scale ranging from 0 to 100. Principal axis factor analysis was used to explore concern domains. Linear multiple regressions were conducted to assess associations with patient characteristics. Of 1102 patients who replied to the survey, 54% were female and 54% had Crohn's disease. We identified six domains of concern: socialization and stigmatization, disease-related constraints and uncertainty, symptoms and their impact on body and mind, loss of body control (including sexuality), disease transmission, and long-term impact of the disease. Cancer concerns were among the highest scored by all patients (median 61.8). Severity of symptoms was the only factor associated with concerns, unrelated to dimension and gender (p<0.015). In women, being >40 years decreased disease-related constraints and uncertainty concerns, and being at home or unemployed increased them. Treatments were associated with increased socialization and stigmatization and with increased disease-related constraints and uncertainty concerns in men. Overall, psychosomatic characteristics were highly associated with concerns for both men and women. Depending on the concern dimensions, increased levels of concern were associated with the highest signs of anxiety in women or depression in men, as well as lower health-related quality of life in men. Patients have numerous concerns related to their illness that need to be reassessed regularly. Concerns differ between men and women, suggesting that information and communication about the disease should take gender differences and subjective perceptions of quality of life into consideration

Information Needs and Concerns of Patients with Inflammatory Bowel Disease: What Can We Learn from Participants in a Bilingual Clinical Cohort?

BACKGROUND: Inflammatory Bowel Disease (IBD) patients are confronted with needs and concerns related to their disease. AIM: To explore information expectations of patients included in a national bilingual IBD cohort in Switzerland (SIBDC). METHODS: This is a mixed-methods study, comprising 1) a semi-narrative survey sent to 1506 patients from the SIBDC and 2) two focus groups conducted with 14 patients to explore and assess the relevance of the survey's findings. Data collected within the framework of the SIBDC was used to characterize survey's responders. RESULTS: 728 patients (48%) replied to the survey: 52.5% females, 56% Crohn's disease (CD), 87% secondary/tertiary level educated, 70% full/part-time employed. On average, 47% of patients sought for information, regardless of the disease stage; 27% of them were dissatisfied with information received at the time of first symptoms. During flares, 43% were concerned about drugs and therapies; in remission, 57% had concerns on research and developments; 27% searched for information linked to daily disease management. Information-seeking increased when active disease, for CD with high levels of perceived stress (OR = 2.47; p = 0.003), and for all with higher posttraumatic stress symptoms. The focus groups confirmed a perceived lack of information about general functioning, disease course, treatments and their risks, extra-intestinal symptoms and manifestations. CONCLUSIONS: Information remains insufficient for IBD patients. Lack of information in specific domains can potentially cause stress and hinder detection of symptoms. Better information should be considered as a potentially important component in improving patients' outcomes in IBD