Study of the finite temperature transition in 3-flavor QCD using the R and RHMC algorithms

We study the finite temperature transition in QCD with three flavors of equal masses using the R and RHMC algorithm on lattices with temporal extent N_{\tau}=4 and 6. For the transition temperature in the continuum limit we find r_0 T_c=0.429(8) for the light pseudo-scalar mass corresponding to the end point of the 1st order transition region. When comparing the results obtained with the R and RHMC algorithms for p4fat3 action we see no significant step-size errors down to a lightest pseudo-scalar mass of m_{ps} r_0=0.4.Comment: 13 pages, RevTeX, 10 figure

Molecular characterization of MRSA collected during national surveillance between 2008 and 2019 in the Netherlands

BACKGROUND: Although the Netherlands is a country with a low endemic level, methicillin-resistant Staphylococcus aureus (MRSA) poses a significant health care problem. Therefore, high coverage national MRSA surveillance has been in place since 1989. To monitor possible changes in the type-distribution and emergence of resistance and virulence, MRSA isolates are molecularly characterized.METHODS: All 43,321 isolates from 36,520 persons, collected 2008-2019, were typed by multiple-locus variable number tandem repeats analysis (MLVA) with simultaneous PCR detection of the mecA, mecC and lukF-PV genes, indicative for PVL. Next-generation sequencing data of 4991 isolates from 4798 persons were used for whole genome multi-locus sequence typing (wgMLST) and identification of resistance and virulence genes.RESULTS: We show temporal change in the molecular characteristics of the MRSA population with the proportion of PVL-positive isolates increasing from 15% in 2008-2010 to 25% in 2017-2019. In livestock-associated MRSA obtained from humans, PVL-positivity increases to 6% in 2017-2019 with isolates predominantly from regions with few pig farms. wgMLST reveals the presence of 35 genogroups with distinct resistance, virulence gene profiles and specimen origin. Typing shows prolonged persistent MRSA carriage with a mean carriage period of 407 days. There is a clear spatial and a weak temporal relationship between isolates that clustered in wgMLST, indicative for regional spread of MRSA strains.CONCLUSIONS: Using molecular characterization, this exceptionally large study shows genomic changes in the MRSA population at the national level. It reveals waxing and waning of types and genogroups and an increasing proportion of PVL-positive MRSA.</p

Pion structure from improved lattice QCD: form factor and charge radius at low masses

The charge form factor of the pion is calculated in lattice QCD. The non-perturbatively improved Sheikholeslami-Wohlert action is used together with the $\mathcal{O}(a)$ improved vector current. Other choices for the current are examined. The form factor is extracted for pion masses from 970 MeV down to 360 MeV and for momentum transfers $Q^2 \leq 2 \mathrm{GeV}^2$. The mean square charge radius is extracted, compared to previous determinations and its extrapolation to lower masses discussed.Comment: 12 pages REVTeX, 15 figures. Designation of currents clarified. Details concerning extraction of parameters added. Version accepted by Phys. Rev.

Reporting of euthanasia and physician-assisted suicide in the Netherlands: descriptive study

Background: An important principle underlying the Dutch Euthanasia Act is physicians' responsibility to alleviate patients' suffering. The Dutch Act states that euthanasia and physician-assisted suicide are not punishable if the attending physician acts in accordance with criteria of due care. These criteria concern the patient's request, the patient's suffering (unbearable and hopeless), the information provided to the patient, the presence of reasonable alternatives, consultation of another physician and the applied method of ending life. To demonstrate their compliance, the Act requires physicians to report euthanasia to a review committee. We studied which arguments Dutch physicians use to substantiate their adherence to the criteria and which aspects attract review committees' attention. Methods: We examined 158 files of reported euthanasia and physician-assisted suicide cases that were approved by the review committees. We studied the physicians' reports and the verdicts of the review committees by using a checklist. Results: Physicians reported that the patient's request had been well-considered because the patient was clear-headed (65%) and/or had repeated the request several times (23%). Unbearable suffering was often substantiated with physical symptoms (62%), function loss (33%), dependency (28%) or deterioration (15%). In 35%, physicians reported that there had been alternatives to relieve patients' suffering which were refused by the majority. The nature of the relationship with the consultant was sometimes unclear: the consultant was reported to have been an unknown colleague (39%), a known colleague (21%), otherwise (25%), or not clearly specified in the report (24%). Review committees relatively often scrutinized the consultation (41%) and the patient's (unbearable) suffering (32%); they had few questions about possible alternatives (1%). Conclusion: Dutch physicians substantiate their adherence to the criteria in a variable way with an emphasis on physical symptoms. The information they provide is in most cases sufficient to enable adequate review. Review committees' control seems to focus on (unbearable) suffering and on procedural issues

Non-filamentary (VMCO) memory : a two- and three-dimensional study on switching and failure modes

In this work, for the first time, a set of two-and three-dimensional (3D) analysis techniques are combined to clarify the nature of resistive switching (RS) in state-of-the-art TiO2-based vacancy modulated conductive oxide (VMCO) memory. (1) A non-filamentary switching mechanism is observed. (2) The role of oxygen incorporation and motion in the TiO2 is demonstrated. (3) The oxygen profile inside scaled cells is measured and a RS-model based on the modulation of oxygen inside the stack is proposed. In addition, we perform the tomographic analysis of fully-fabricated devices with Scalpel SPM, thus probing in 3D the entire stack and the contribution of TiO2 grain boundaries (GBs) to the switching operations. Finally, devices failed by breakdown (BD) during cycling are characterized, identifying the formation of parasitic filaments as root-cause of the failure

Two Decades of Research on Euthanasia from the Netherlands. What Have We Learnt and What Questions Remain?

Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life

The QCD Equation of State with almost Physical Quark Masses

We present results on the equation of state in QCD with two light quark flavors and a heavier strange quark. Calculations with improved staggered fermions have been performed on lattices with temporal extent Nt =4 and 6 on a line of constant physics with almost physical quark mass values; the pion mass is about 220 MeV, and the strange quark mass is adjusted to its physical value. High statistics results on large lattices are obtained for bulk thermodynamic observables, i.e. pressure, energy and entropy density, at vanishing quark chemical potential for a wide range of temperatures, 140 MeV < T < 800 MeV. We present a detailed discussion of finite cut-off effects which become particularly significant for temperatures larger than about twice the transition temperature. At these high temperatures we also performed calculations of the trace anomaly on lattices with temporal extent Nt=8. Furthermore, we have performed an extensive analysis of zero temperature observables including the light and strange quark condensates and the static quark potential at zero temperature. These are used to set the temperature scale for thermodynamic observables and to calculate renormalized observables that are sensitive to deconfinement and chiral symmetry restoration and become order parameters in the infinite and zero quark mass limits, respectively.Comment: 22 pages, 17 EPS-figures; revised version, updated references, data added in Tab.1, several smaller change

Guideline thyroid cancer including diagnostics of the nodule

Thyroid cancer is comparatively rare. Thyroid nodules, on the other hand, are frequently diagnosed as a result of increasing use of diagnostic imaging. Cytological investigation of small nodules that have been found by chance often reveals micropapillary carcinoma that is probably not clinically relevant. The new guideline 'Thyroid cancer' advises that cytological investigation of these non-palpable, incidentally discovered thyroid nodules should only be performed on indication. The standard treatment for patients with papillary or follicular thyroid cancer consists of thyroidectomy followed by, if indicated, lymph-node dissection, ablation therapy with radioactive iodine and TSH-suppression. The extent of this treatment is determined on the basis of known prognostic factors and the results of initial treatment. Targeted systemic therapy is available for patients with metastatic progressive disease. There is more focus on the effects of short- and long-term treatment, in order to optimise quality of life.</p

Foundation species enhance food web complexity through non-trophic facilitation

Food webs are an integral part of every ecosystem on the planet, yet understanding the mechanisms shaping these complex networks remains a major challenge. Recently, several studies suggested that non-trophic species interactions such as habitat modification and mutualisms can be important determinants of food web structure. However, it remains unclear whether these findings generalize across ecosystems, and whether non-trophic interactions affect food webs randomly, or affect specific trophic levels or functional groups. Here, we combine analyses of 58 food webs from seven terrestrial, freshwater and coastal systems to test (1) the general hypothesis that non-trophic facilitation by habitat-forming foundation species enhances food web complexity, and (2) whether these enhancements have either random or targeted effects on particular trophic levels, functional groups, and linkages throughout the food web. Our empirical results demonstrate that foundation species consistently enhance food web complexity in all seven ecosystems. Further analyses reveal that 15 out of 19 food web properties can be well-approximated by assuming that foundation species randomly facilitate species throughout the trophic network. However, basal species are less strongly, and carnivores are more strongly facilitated in foundation species’ food webs than predicted based on random facilitation, resulting in a higher mean trophic level and a longer average chain length. Overall, we conclude that foundation species strongly enhance food web complexity through non-trophic facilitation of species across the entire trophic network. We therefore suggest that the structure and stability of food webs often depends critically on non-trophic facilitation by foundation species.</p