Healthcare stakeholders' perspective on barriers to integrated care in Switzerland: Results from the open-ended question of a nationwide survey.

We aimed to identify the main barriers to integrated care (IC) as reported by healthcare stakeholders from various linguistic regions and health system specificities, according to their reality of practice. Information was gathered through an open-ended question from a national survey conducted in Switzerland in 2019. Responses were analysed qualitatively with the IRaMuTeQ software. Answers from 410 respondents were obtained. Respondents reported barriers at two levels: the system and professional level. Threat to financial benefits, concerns for patient data sharing and tensions between quality of care and benefits for patients versus costs were mentioned at the professional level, in their activity and in patient care. At the system level, limitations at the political level due to federalism and the lack of support and training for professionals were important barriers, in addition to the lack of recognition and compensation for professionals and the fragmented functioning of the health care system. Our study underlines the importance of implementing innovative funding strategies and reimbursement schemes, as well as political willingness to move towards IC. The alignment between federal policies and cantonal specificities also appears as necessary to achieve involvement of professionals, promote integration of services and coordination of professionals for continuous and efficient care

Crustal Deformation and Fault Strength of the Sulawesi Subduction Zone

This paper investigates the seismicity and rheology of the North-Sulawesi subduction zone. Body-wave modeling is used to estimate focal mechanisms and centroid depths of moderate magnitude (M5–M6.5) earthquakes on the North Sulawesi megathrust and surrounding region. The slip vectors of megathrust earthquakes radiate outward from Sulawesi, indicating motion that is incompatible with the relative motion of two rigid plates. Instead, the observed deformation implies lateral spreading of high topography, controlled by gravitational potential energy contrasts. This finding suggests that the observed deformation of Sulawesi results from stresses transmitted through the lithosphere, rather than basal tractions due to circulation in the mantle. Our modeling of the force balance on the megathrust shows that the subduction megathrust is weak, with an average shear stress of ∼13 MPa and an effective coefficient of friction of 0.03. Elsewhere in Sulawesi, slip vectors of other earthquakes suggest similar potential-energy-driven deformation is present, but at significantly slower rates. Our results show the importance of lateral rheology contrasts in determining deformation rate, and hence seismic hazard, in response to a given driving force.Newton Institutional Links Leverhulme Fellowshi

A common deep source for upper-mantle upwellings below the Ibero-western Maghreb region from teleseismic P-wave travel-time tomography

Upper-mantle upwellings are often invoked as the cause of Cenozoic volcanism in the Ibero-western Maghreb region. However, their nature, geometry and origin are unclear. This study takes advantage of dense seismic networks, which cover an area extending from the Pyrenees in the north to the Canaries in the south, to provide a new high-resolution P-wave velocity model of the upper-mantle and topmost lower-mantle structure. Our images show three subvertical upper-mantle upwellings below the Canaries, the Atlas Ranges and the Gibraltar Arc, which appear to be rooted beneath the upper-mantle transition zone (MTZ). Two other mantle upwellings beneath the eastern Rif and eastern Betics surround the Gibraltar subduction zone. We propose a new geodynamic model in which narrow upper-mantle upwellings below the Canaries, the Atlas Ranges and the Gibraltar Arc rise from a laterally-propagating layer of material below the MTZ, which in turn is fed by a common deep source below the Canaries. In the Gibraltar region, the deeply rooted upwelling interacts with the Gibraltar slab. Quasi-toroidal flow driven by slab rollback induces the hot mantle material to flow around the slab, creating the two low-velocity anomalies below the eastern Betics and eastern Rif. Our results suggest that the Central Atlantic plume is a likely source of hot mantle material for upper-mantle upwellings in the Ibero-western Maghreb region

Frontiers of seismology

The British Seismology Meeting 2019 took place at the University of Edinburgh over three days, 4–6 September. The first British Seismology Meeting, BSM2017, was held in Reading in April 2017 (Lieser et al.2018); there had been earlier seismology meetings in the UK, but no wide-ranging cross-disciplinary meetings since Frontiers of Seismology in Edinburgh 2009 (Sargeant et al.2009). In his welcoming address at BSM2017, Dmitry Stor-chak expressed a wish that it would be the first in a series of such meetings, which he thought should become a regular event, perhaps every two years. At the end of the BSM2017 meeting, Anton Ziolkowski offered the University of Edinburgh as a potential venue for BSM2019.BSM2019: Frontiers of Seismology attracted about 70 scientists from the UK and abroad, to present and discuss seismological research, establish new contacts and strengthen existing links. A feature of the meeting was that all posters were available in a large space adjacent to the lecture theatre for viewing, presentation and discussion for the whole period, including coffee breaks, lunch and evening drinks. Feedback from the meeting was very positive. This article presents a brief summary of each session

Adult Rat Bones Maintain Distinct Regionalized Expression of Markers Associated with Their Development

The incidence of limb bone fracture and subsequent morbidity and mortality due to excessive bone loss is increasing in the progressively ageing populations of both men and women. In contrast to bone loss in the weight-bearing limb, bone mass in the protective skull vault is maintained. One explanation for this could be anatomically diverse bone matrix characteristics generated by heterogeneous osteoblast populations. We have tested the hypothesis that adult bones demonstrate site-specific characteristics, and report differences at the organ, cell and transcriptome levels. Limb bones contain greater amounts of polysulphated glycosaminoglycan stained with Alcian Blue and have significantly higher osteocyte densities than skull bone. Site-specific patterns persist in cultured adult bone-derived cells both phenotypically (proliferation rate, response to estrogen and cell volumes), and at the level of specific gene expression (collagen triple helix repeat containing 1, reelin and ras-like and estrogen-regulated growth inhibitor). Based on genome-wide mRNA expression and cluster analysis, we demonstrate that bones and cultured adult bone-derived cells segregate according to site of derivation. We also find the differential expression of genes associated with embryological development (Skull: Zic, Dlx, Irx, Twist1 and Cart1; Limb: Hox, Shox2, and Tbx genes) in both adult bones and isolated adult bone-derived cells. Together, these site-specific differences support the view that, analogous to different muscle types (cardiac, smooth and skeletal), skull and limb bones represent separate classes of bone. We assign these differences, not to mode of primary ossification, but to the embryological cell lineage; the basis and implications of this division are discussed

Post-subduction tectonics induced by extension from a lithospheric drip

Acknowledgements S.P. acknowledges support from the Natural Environmental Research Council (NERC) Grant NE/R013500/1 and from the European Union’s Horizon 2020 Research and Innovation Program under Marie Skłodowska-Curie Grant Agreement 790203. We thank the TanDEM-X Science Communication Team (German Aerospace Center (DLR) e.V.) for providing TanDEM topographic data. We thank the NERC Geophysical Equipment Facility for loan 1038. Numerical simulations were undertaken on the NCI National Facility in Canberra, Australia, which is supported by the Australian Commonwealth Government. A.G. was funded by an Independent Research Fellowship from the Royal Astronomical Society.Peer reviewedPostprin

Converting a series in \lambda to a series in \lambda^{-1}

We introduce a transformation for converting a series in a parameter, \lambda, to a series in the inverse of the parameter \lambda^{-1}. By applying the transform on simple examples, it becomes apparent that there exist relations between convergent and divergent series, and also between large- and small-coupling expansions. The method is also applied to the divergent series expansion of Euler-Heisenberg-Schwinger result for the one-loop effective action for constant background magnetic (or electric) field. The transform may help us gain some insight about the nature of both divergent (Borel or non-Borel summable series) and convergent series and their relationship, and how both could be used for analytical and numerical calculations.Comment: 7 pages, Latex, 3 figures; Typos corrected. To appear in Journal of Physics A: Math and Ge

SASSY21: A 3-D Seismic Structural Model of the Lithosphere and Underlying Mantle Beneath Southeast Asia From Multi-Scale Adjoint Waveform Tomography

Abstract: We present the first continental‐scale seismic model of the lithosphere and underlying mantle beneath Southeast Asia obtained from adjoint waveform tomography (often referred to as full‐waveform inversion or FWI), using seismic data filtered at periods from 20 to 150 s. Based on >3,000 hr of analyzed waveform data gathered from ∼13,000 unique source‐receiver pairs, we image isotropic P‐wave velocity, radially anisotropic S‐wave velocity and density via an iterative non‐linear inversion that begins from a 1‐D reference model. At each iteration, the full 3‐D wavefield is determined through an anelastic Earth, accommodating effects of topography, bathymetry and ocean load. Our data selection aims to maximize sensitivity to deep structure by accounting for body wave arrivals separately. SASSY21, our final model after 87 iterations across seven period bands, is able to explain true‐amplitude data from events and receivers not included in the inversion. The trade‐off between inversion parameters is estimated through an analysis of the Hessian‐vector product. SASSY21 reveals detailed anomalies down to the mantle transition zone, including multiple subduction zones. The most prominent feature is the (Indo‐)Australian plate descending beneath Indonesia, which is imaged as one continuous slab along the 180° curvature of the Banda Arc. The tomography confirms the existence of a hole in the slab beneath Mount Tambora and locates a high S‐wave velocity zone beneath northern Borneo that may be associated with subduction termination in the mid‐late Miocene. A previously undiscovered feature beneath the east coast of Borneo is also revealed, which may be a signature of post‐subduction processes, delamination or underthrusting from the formation of Sulawesi

Heat Pipe Solar Receiver Development Activities at Sandia National Laboratories

Over the past decade, Sandia National Laboratories has been involved in the development of receivers to transfer energy from the focus of a parabolic dish concentrator to the heater tubes of a Stirling engine. Through the isothermal evaporation and condensation of sodium. a heat-pipe receiver can efficiently transfer energy to an engine's working fluid and compensate for irregularities in the flux distribution that is delivered by the concentrator. The operation of the heat pipe is completely passive because the liquid sodium is distributed over the solar-heated surface by capillary pumping provided by a wick structure. Tests have shown that using a heat pipe can boost the system performance by twenty percent when compared to directly illuminating the engine heater tubes. Designing heat pipe solar receivers has presented several challenges. The relatively large area ({approximately}0.2 m{sup 2}) of the receiver surface makes it difficult to design a wick that can continuously provide liquid sodium to all regions of the heated surface. Selecting a wick structure with smaller pores will improve capillary pumping capabilities of the wick, but the small pores will restrict the flow of liquid and generate high pressure drops. Selecting a wick that is comprised of very tine filaments can increase the permeability of the wick and thereby reduce flow losses, however, the fine wick structure is more susceptible to corrosion and mechanical damage. This paper provides a comprehensive review of the issues encountered in the design of heat pipe solar receivers and solutions to problems that have arisen. Topics include: flow characterization in the receiver, the design of wick systems. the minimization of corrosion and dissolution of metals in sodium systems. and the prevention of mechanical failure in high porosity wick structures

Temperature dependence of the anomalous effective action of fermions in two and four dimensions

The temperature dependence of the anomalous sector of the effective action of fermions coupled to external gauge and pseudo-scalar fields is computed at leading order in an expansion in the number of Lorentz indices in two and four dimensions. The calculation preserves chiral symmetry and confirms that a temperature dependence is compatible with axial anomaly saturation. The result checks soft-pions theorems at zero temperature as well as recent results in the literature for the pionic decay amplitude into static photons in the chirally symmetric phase. The case of chiral fermions is also considered.Comment: RevTex, 19 pages, no figures. References adde