Topographic Evolution in the Atomic Scale Growth and Erosion Continuum

This review gives a detailed survey of the range of fascinating surface features which develop under growth or erosion conditions under the combined influence of thermal and more energetic atomic particle fluxes. Collisionally induced atomic ejection and migration, and thermally and radiation induced atom and defect diffusion processes are outlined and their relevance to topographic initiation and evolution explored. A range of experimental observations of surface feature elaboration is discussed from net growth to net erosion conditions and models for their explanation are considered. It is concluded that while much data have been accumulated, much of these have been in so diverse experimental conditions that precise modelling in atomic terms is difficult and generalisations are treacherous. A clear need for structured, extensive studies exists with very precise parameter definition and control

Population genetics in compressible flows

We study competition between two biological species advected by a compressible velocity field. Individuals are treated as discrete Lagrangian particles that reproduce or die in a density-dependent fashion. In the absence of a velocity field and fitness advantage, number fluctuations lead to a coarsening dynamics typical of the stochastic Fisher equation. We then study three examples of compressible advecting fields: a shell model of turbulence, a sinusoidal velocity field and a linear velocity sink. In all cases, advection leads to a striking drop in the fixation time, as well as a large reduction in the global carrying capacity. Despite localization on convergence zones, one species goes extinct much more rapidly than in well-mixed populations. For a weak harmonic potential, one finds a bimodal distribution of fixation times. The long-lived states in this case are demixed configurations with a single boundary, whose location depends on the fitness advantage.Comment: 10 pages, 5 figures, submitte

Femtosecond spectral and anisotropy study of excitation energy transfer between neighbouring α-80 and β-81 chromophores of allophycocyanin trimers

Polarization pump-probe femtosecond spectroscopy was used to investigate photoinduced optical density changes in allophycocyanin (APC) trimers at 635–690 nm after excitation with 230-fs pulses at 618 nm. The initial bleaching observed at λ < 645 nm is followed by subpicosecond absorption recovery corresponding to 430 ± 40 fs recovery kinetics measured at 615 nm with 70-fs pulses. Only the red part of the APC absorption band remains strongly bleached at 3 ps after excitation. The spectral and kinetic results can be described in terms of two different models of interaction between neighbouring α-80 and β-81 chromophores of APC trimers. According to the first one, the observed subpicosecond kinetics corresponds to relaxation between the levels of excitonically coupled, spectrally identical α-80 and β-81 chromophores. Excited state absorption to doubly excited excitonic state should in this case contribute to the measured difference spectra. According to the second one, the femtosecond excitation energy transfer in APC trimers takes place between a donor chromophore absorbing predominantly at 620 nm and an acceptor chromophore absorbing at 650 nm. The high anisotropy value observed at 615 nm during the first 1.2 ps is in good agreement with the donor-acceptor model. Anisotropy values calculated in the 635–675 nm spectral region at 3 ps after excitation are in the 0.1–0.25 range corresponding to an angle of 30°–45° between donor and acceptor transition dipole orientations. The high anisotropy obtained at 658 nm during the excitation is probably due to stimulated emission of the donor chromophore

Diagnosis and management of Bartter syndrome: executive summary of the consensus and recommendations from the European Rare Kidney Disease Reference Network Working Group for Tubular Disorders

Bartter syndrome is a rare inherited salt-losing renal tubular disorder characterized by secondary hyperaldosteronism with hypokalemic and hypochloremic metabolic alkalosis and low to normal blood pressure. The primary pathogenic mechanism is defective salt reabsorption predominantly in the thick ascending limb of the loop of Henle. There is significant variability in the clinical expression of the disease, which is genetically heterogenous with 5 different genes described to date. Despite considerable phenotypic overlap, correlations of specific clinical characteristics with the underlying molecular defects have been demonstrated, generating gene-specific phenotypes. As with many other rare disease conditions, there is a paucity of clinical studies that could guide diagnosis and therapeutic interventions. In this expert consensus document, the authors have summarized the currently available knowledge and propose clinical indicators to assess and improve quality of care

The Cochrane Skin Group: a vanguard for developing and promoting evidence-based dermatology

Aim The Cochrane Skin Group (CSG) is part of the international Cochrane Collaboration (http://www.cochrane.org/). The CSG prepares, maintains and disseminates high quality evidence-based summaries on the prevention, diagnosis and treatment of skin diseases. We present a synopsis of the history, scope and priorities of the CSG. In addition, we report outcomes of CSG reviews and critically assess clinical value. Methods Descriptive analysis of systematic reviews published by the CSG since its inception including output, impact factor, associated methodological studies, and influence in clinical guidelines, promoting patient and public engagement and in triggering new primary research. Results The CSG started in 1997, and has published 61 reviews, 34 protocols and 31 registered titles by August 2013. The CSG scope includes 1000 skin diseases; 80% of reviews cover the top ten diagnoses and 40% of reviews provide clear guidance for clinical practice. CSG reviews had an impact factor of 6.1 in 2011 which places it alongside top dermatology journals. CSG reviews are typically broad in focus and have been shown to be of better quality than non-Cochrane reviews. They are highly cited in clinical guidelines. Several reviews have identified evidence gaps that have led to better primary research. Conclusions The CSG has emerged as a vanguard of evidence-based dermatology by growing a community interested in applying best external evidence to the care of skin patients and by identifying topics for research. CSG reviews are high impact, clinically relevant and have tangibly influenced international dermatology clinical practice guidelines and new research

Factors affecting the implementation of complex and evolving technologies: multiple case study of intensity-modulated radiation therapy (IMRT) in Ontario, Canada

<p>Abstract</p> <p>Background</p> <p>Research regarding the decision to adopt and implement technological innovations in radiation oncology is lacking. This is particularly problematic since these technologies are often complex and rapidly evolving, requiring ongoing revisiting of decisions regarding which technologies are the most appropriate to support. Variations in adoption and implementation decisions for new radiation technologies across cancer centres can impact patients' access to appropriate and innovative forms of radiation therapy. This study examines the key steps in the process of adopting and implementing intensity modulated radiation therapy (IMRT) in publicly funded cancer centres and identifies facilitating or impeding factors.</p> <p>Methods</p> <p>A multiple case study design, utilizing document analysis and key informant interviews was employed. Four cancer centres in Ontario, Canada were selected and interviews were conducted with radiation oncologists, medical physicists, radiation therapists, and senior administrative leaders.</p> <p>Results</p> <p>Eighteen key informants were interviewed. Overall, three centres made fair to excellent progress in the implementation of IMRT, while one centre achieved only limited implementation as of 2009. Key factors that influenced the extent of IMRT implementation were categorized as: 1) leadership, 2) training, expertise and standardization, 3) collaboration, 4) resources, and 5) resistance to change.</p> <p>Conclusion</p> <p>A framework for the adoption and implementation of complex and evolving technologies is presented. It identifies the key factors that should be addressed by decision-makers at specific stages of the adoption/implementation process.</p

Video game discourses and implications for game-based education

Increasingly prevalent educational discourses promote the use of video games in schools and universities. At the same time, populist discourses persist, particularly in print media, which condemn video games because of putative negative effects on behaviour and socialisation. These contested discourses, we suggest, influence the acceptability of games and limit critical analysis of their effectiveness as pedagogic tools. This article focuses on the representation of video games in media discourse. We present insights from a small-scale study of the construction of video game discourses in the UK print media in 2013, and discuss three areas that emerged. First, the assumptions inherent in the representation of the ‘video game’; second, the implied lack of agency in the behaviour of ‘the gamer’; and third, the way in which blame is manipulated. Finally, we consider the implications for game-based education

Postoperative stereotactic radiosurgery compared with whole brain radiotherapy for resected metastatic brain disease (NCCTG N107C/CEC·3): a multicentre, randomised, controlled, phase 3 trial

Background Whole brain radiotherapy (WBRT) is the standard of care to improve intracranial control following resection of brain metastasis. However, stereotactic radiosurgery (SRS) to the surgical cavity is widely used in an attempt to reduce cognitive toxicity, despite the absence of high-level comparative data substantiating efficacy in the postoperative setting. We aimed to establish the effect of SRS on survival and cognitive outcomes compared with WBRT in patients with resected brain metastasis. Methods In this randomised, controlled, phase 3 trial, adult patients (aged 18 years or older) from 48 institutions in the USA and Canada with one resected brain metastasis and a resection cavity less than 5·0 cm in maximal extent were randomly assigned (1:1) to either postoperative SRS (12–20 Gy single fraction with dose determined by surgical cavity volume) or WBRT (30 Gy in ten daily fractions or 37·5 Gy in 15 daily fractions of 2·5 Gy; fractionation schedule predetermined for all patients at treating centre). We randomised patients using a dynamic allocation strategy with stratification factors of age, duration of extracranial disease control, number of brain metastases, histology, maximal resection cavity diameter, and treatment centre. Patients and investigators were not masked to treatment allocation. The co-primary endpoints were cognitive-deterioration-free survival and overall survival, and analyses were done by intention to treat. We report the final analysis. This trial is registered with ClinicalTrials.gov, number NCT01372774. Findings Between Nov 10, 2011, and Nov 16, 2015, 194 patients were enrolled and randomly assigned to SRS (98 patients) or WBRT (96 patients). Median follow-up was 11·1 months (IQR 5·1–18·0). Cognitive-deterioration-free survival was longer in patients assigned to SRS (median 3·7 months [95% CI 3·45–5·06], 93 events) than in patients assigned to WBRT (median 3·0 months [2·86–3·25], 93 events; hazard ratio [HR] 0·47 [95% CI 0·35–0·63]; p&lt;0·0001), and cognitive deterioration at 6 months was less frequent in patients who received SRS than those who received WBRT (28 [52%] of 54 evaluable patients assigned to SRS vs 41 [85%] of 48 evaluable patients assigned to WBRT; difference −33·6% [95% CI −45·3 to −21·8], p&lt;0·00031). Median overall survival was 12·2 months (95% CI 9·7–16·0, 69 deaths) for SRS and 11·6 months (9·9–18·0, 67 deaths) for WBRT (HR 1·07 [95% CI 0·76–1·50]; p=0·70). The most common grade 3 or 4 adverse events reported with a relative frequency greater than 4% were hearing impairment (three [3%] of 93 patients in the SRS group vs eight [9%] of 92 patients in the WBRT group) and cognitive disturbance (three [3%] vs five [5%]). There were no treatment-related deaths. Interpretation Decline in cognitive function was more frequent with WBRT than with SRS and there was no difference in overall survival between the treatment groups. After resection of a brain metastasis, SRS radiosurgery should be considered one of the standards of care as a less toxic alternative to WBRT for this patient population. Funding National Cancer Institute