Challenges to Ethically Managing Parkinson Disease: An Interview Study of Patient Perspectives

This study investigated the current ethical issues in relation to recognizing and managing Parkinson disease (PD) from the patient’s perspective. Methods: Twelve patients living with PD who were from the medical school’s Patients as Educators program were recruited. Semistructured interviews were conducted to record patient experiences in order to identify potential ethical issues in relation to recognizing and managing PD. Thematic analysis was applied to the interview transcripts. Results: Four key themes emerged from the interviews. These were information giving, coping, identity, and future medical treatment. These data indicate variable experiences in relation to communication between patient and health-care professional, better support for both planning end-of-life decisions and in coping with the disease’s impacts on their identity. Patients with PD also struggle with access to support services and support for main carer. Implications: To ensure ethical practice in supporting patients with PD, these emerging themes need further investigation; and management guidelines relevant to PD must be informed by research in this area to ensure ethical care of patients with PD, their carers, and families

Near-optimal mean value estimates for multidimensional Weyl sums

We obtain sharp estimates for multidimensional generalisations of Vinogradov's mean value theorem for arbitrary translation-dilation invariant systems, achieving constraints on the number of variables approaching those conjectured to be the best possible. Several applications of our bounds are discussed

Psychological Health and Smoking in Young Adulthood

Introduction: Young adulthood is a critical time for the emergence of risk behaviors including smoking. Psychological health is associated with smoking, but studies rarely track both over time. We used longitudinal data to assess whether average patterns of psychological health influenced average patterns of smoking and whether short-term fluctuations in psychological health influenced fluctuations in smoking. Method: Young adults aged 18–30 from the Panel Study of Income Dynamics were followed from 2007 to 2013, and mean trajectories of smoking were modeled. Psychological health variables included ever having a mental health diagnosis and time-varying distress. Results: In regression models, individuals with poorer psychological health (higher distress or a diagnosis) were more likely to be smokers and to smoke greater number of cigarettes. The association of diagnosis with number of cigarettes smoked increased with age. Conclusions: Smoking-related interventions should target individuals with poorer psychological health, even if they have no formal mental health diagnosis

Effects of various generations of iterative CT reconstruction algorithms on low-contrast detectability as a function of the effective abdominal diameter: A quantitative task-based phantom study.

To investigate how various generations of iterative reconstruction (IR) algorithms impact low-contrast detectability (LCD) in abdominal computed tomography (CT) for different patient effective diameters, using a quantitative task-based approach. Investigations were performed using an anthropomorphic abdominal phantom with two optional additional rings to simulate varying patient effective diameters (25, 30, and 35 cm), and containing multiple spherical targets (5, 6, and 8 mm in diameter) with a 20-HU contrast difference. The phantom was scanned using routine abdominal protocols (CTDI <sub>vol</sub> , 5.9-16 mGy) on four CT systems from two manufacturers. Images were reconstructed using both filtered back-projection (FBP) and various IR algorithms: ASiR 50%, SAFIRE 3 (both statistical IRs), ASiR-V 50%, ADMIRE 3 (both partial model-based IRs), or Veo (full model-based IR). Section thickness/interval was 2/1 mm or 2.5/1.25 mm, except 0.625/0.625 mm for Veo. We assessed LCD using a channelized Hotelling observer with 10 dense differences of Gaussian channels, with the area under the receiver operating characteristic curve (AUC) as a figure of merit. For the smallest phantom (25-cm diameter) and smallest lesion size (5-mm diameter), AUC for FBP and the various IR algorithms did not significantly differ for any of the tested CT systems. For the largest phantom (35-cm diameter), Veo yielded the highest AUC improvement (8.5%). Statistical and partial model-based IR algorithms did not significantly improve LCD. In abdominal CT, switching from FBP to IR algorithms offers limited possibilities for achieving significant dose reductions while ensuring a constant objective LCD

Disproportional decrease in office blood pressure compared with 24-hour ambulatory blood pressure with antihypertensive treatment: dependency on pretreatment blood pressure levels

The long-term relationship between 24-hour ambulatory blood pressure (ABP) and office BP in patients on therapy is not well documented. From a registry we included all patients in whom antihypertensive therapy needed to be uptitrated. Drug treatment included the direct renin inhibitor aliskiren or an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker or drugs not blocking the renin-angiotensin system, alone or on top of an existing drug regimen. In all patients, office BP and 24-hour ABP were obtained at baseline and after 1 year with validated devices. In the study population of 2722 patients, there was a good correlation between the change in office BP and 24-hour ABP (systolic: r=0.39; P<0.001; diastolic: r=0.34; P<0.001). However, the numeric decrease in office BP did not correspond to the decrease in ABP in a 1:1 fashion, for example, a decrease of 10, 20, and 30 mm Hg corresponded to a decrease of ~7.2, 10.5, and 13.9 mm Hg in systolic ABP, respectively. The disproportionally greater decrease in systolic office BP compared with ABP was dependent on the level of the pretreatment BP, which was consistently higher for office BP than ABP. The white coat effect (difference between office BP and ABP) was on average 10/5 mm Hg lower 1 year after intensifying treatment and the magnitude of that was also dependent on pretreatment BP. There was a disproportionally greater decrease in systolic office BP than in ABP, which for both office BP and ABP seemed to depend on the pretreatment BP level

The response function of a sphere in a viscoelastic two-fluid medium

In order to address basic questions of importance to microrheology, we study the dynamics of a rigid sphere embedded in a model viscoelastic medium consisting of an elastic network permeated by a viscous fluid. We calculate the complete response of a single bead in this medium to an external force and compare the result to the commonly-accepted, generalized Stokes-Einstein relation (GSER). We find that our response function is well approximated by the GSER only within a particular frequency range determined by the material parameters of both the bead and the network. We then discuss the relevance of this result to recent experiments. Finally we discuss the approximations made in our solution of the response function by comparing our results to the exact solution for the response function of a bead in a viscous (Newtonian) fluid.Comment: 12 pages, 2 figure

Parametric Polyhedra with at least kk Lattice Points: Their Semigroup Structure and the k-Frobenius Problem

Given an integral $d \times n$ matrix $A$, the well-studied affine semigroup \mbox{ Sg} (A)=\{ b : Ax=b, \ x \in {\mathbb Z}^n, x \geq 0\} can be stratified by the number of lattice points inside the parametric polyhedra $P_A(b)=\{x: Ax=b, x\geq0\}$. Such families of parametric polyhedra appear in many areas of combinatorics, convex geometry, algebra and number theory. The key themes of this paper are: (1) A structure theory that characterizes precisely the subset \mbox{ Sg}_{\geq k}(A) of all vectors b \in \mbox{ Sg}(A) such that $P_A(b) \cap {\mathbb Z}^n$ has at least $k$ solutions. We demonstrate that this set is finitely generated, it is a union of translated copies of a semigroup which can be computed explicitly via Hilbert bases computations. Related results can be derived for those right-hand-side vectors $b$ for which $P_A(b) \cap {\mathbb Z}^n$ has exactly $k$ solutions or fewer than $k$ solutions. (2) A computational complexity theory. We show that, when $n$, $k$ are fixed natural numbers, one can compute in polynomial time an encoding of \mbox{ Sg}_{\geq k}(A) as a multivariate generating function, using a short sum of rational functions. As a consequence, one can identify all right-hand-side vectors of bounded norm that have at least $k$ solutions. (3) Applications and computation for the $k$-Frobenius numbers. Using Generating functions we prove that for fixed $n,k$ the $k$-Frobenius number can be computed in polynomial time. This generalizes a well-known result for $k=1$ by R. Kannan. Using some adaptation of dynamic programming we show some practical computations of $k$-Frobenius numbers and their relatives

Vortex dynamics and states of artificially layered superconducting films with correlated defects

Linear resistances and $IV$-characteristics have been measured over a wide range in the parameter space of the mixed phase of multilayered a-TaGe/Ge films. Three films with varying interlayer coupling and correlated defects oriented at an angle $\approx 25$ from the film normal were investigated. Experimental data were analyzed within vortex glass models and a second order phase transition from a resistive vortex liquid to a pinned glass phase. Various vortex phases including changes from three to two dimensional behavior depending on anisotropy have been identified. Careful analysis of $IV$-characteristics in the glass phases revealed a distinctive $T$ and $H$-dependence of the glass exponent $\mu$. The vortex dynamics in the Bose-glass phase does not follow the predicted behavior for excitations of vortex kinks or loops.Comment: 16 pages, 10 figures, 3 table

Coherent spin valve phenomena and electrical spin injection in ferromagnetic/semiconductor/ferromagnetic junctions

Coherent quantum transport in ferromagnetic/ semiconductor/ ferromagnetic junctions is studied theoretically within the Landauer framework of ballistic transport. We show that quantum coherence can have unexpected implications for spin injection and that some intuitive spintronic concepts which are founded in semi-classical physics no longer apply: A quantum spin-valve (QSV) effect occurs even in the absence of a net spin polarized current flowing through the device, unlike in the classical regime. The converse effect also arises, i.e. a zero spin-valve signal for a non-vanishing spin-current. We introduce new criteria useful for analyzing quantum and classical spin transport phenomena and the relationships between them. The effects on QSV behavior of spin-dependent electron transmission at the interfaces, interface Schottky barriers, Rashba spin-orbit coupling and temperature, are systematically investigated. While the signature of the QSV is found to be sensitive to temperature, interestingly, that of its converse is not. We argue that the QSV phenomenon can have important implications for the interpretation of spin-injection in quantum spintronic experiments with spin-valve geometries.Comment: 15 pages including 11 figures. To appear in PR

Low temperature electronic properties of Sr_2RuO_4 II: Superconductivity

The body centered tetragonal structure of Sr_2RuO_4 gives rise to umklapp scattering enhanced inter-plane pair correlations in the d_{yz} and d_{zx} orbitals. Based on symmetry arguments, Hund's rule coupling, and a bosonized description of the in-plane electron correlations the superconducting order parameter is found to be a orbital-singlet spin-triplet with two spatial components. The spatial anisotropy is 7%. The different components of the order parameter give rise to two-dimensional gapless fluctuations. The phase transition is of third order. The temperature dependence of the pair density, specific heat, NQR, Knight shift, and susceptibility are in agreement with experimental results.Comment: 20 pages REVTEX, 3 figure