1,263 research outputs found
Tube Width Fluctuations in F-Actin Solutions
We determine the statistics of the local tube width in F-actin solutions,
beyond the usually reported mean value. Our experimental observations are
explained by a segment fluid theory based on the binary collision approximation
(BCA). In this systematic generalization of the standard mean-field approach
effective polymer segments interact via a potential representing the
topological constraints. The analytically predicted universal tube width
distribution with a stretched tail is in good agreement with the data.Comment: Final version, 5 pages, 4 figure
GPs views on transfer of information about terminally ill patients to the out-of-hours co-operative
<p>Abstract</p> <p>Background</p> <p>In the Netherlands, the increase in of out-of-hours care that is provided by GP co-operatives is challenging the continuity of care for the terminally ill in general practice. Aim of this study is to investigate the views of general practitioners (GPs) on the transfer of information about terminally ill patients to the GP co-operatives. GPs were asked to give their view from two different perspectives: as a GP in their daily practice and as a locum in the GP co-operative.</p> <p>Methods</p> <p>Retrospective web based questionnaire sent to all 424 GPs in the Amsterdam region.</p> <p>Results</p> <p>With a response rate of 42%, 177 physicians completed the questionnaire. Transfer of information to the GP co-operative about most of their terminally ill patients was reported by 82% of the GPs and 5% did not do so for any of their patients. A faster than foreseen deterioration of the patient's situation was the most frequently reported reason for not transferring information.</p> <p>Of those who transferred information to the GP co-operative, more than 95% reported that they provided information about the diagnosis and terminally ill status of the patient. Information about medication, patient wishes regarding treatment, and prognosis was reported by respectively 90%, 87%, and 74% of the GPs. Less than 50% of the GPs reported that they transferred information about the patient's awareness of both the diagnosis and the prognosis, about the psychosocial context, and intolerances.</p> <p>In their role as locum, over 90% of the GPs wanted to receive information about the diagnosis, the terminally ill status of the patient, the medication and the patient's wishes regarding treatment.</p> <p>Conclusions</p> <p>Although most GPs reported that they transferred information about their terminally ill patients to the GP co-operative, the content of this information varies considerably. Only 21% of the GPs, working out of hours as a locum, were satisfied with the quality of the information transferred.</p
Zeegrasmitigaties Oosterschelde. Proeven met verplaatsen van Klein zeegras (Zostera noltii) in de Oosterschelde: mitigatiemaatregel bij dijkwerkzaamheden ZLD-6606A. Eindrapport, aangevuld met metingen 2014 en 2015
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The Effects of Next-Nearest-Neighbor Interactions on the Orientation Dependence of Step Stiffness: Reconciling Theory with Experiment for Cu(001)
Within the solid-on-solid (SOS) approximation, we carry out a calculation of
the orientational dependence of the step stiffness on a square lattice with
nearest and next-nearest neighbor interactions. At low temperature our result
reduces to a simple, transparent expression. The effect of the strongest trio
(three-site, non pairwise) interaction can easily be incorporated by modifying
the interpretation of the two pairwise energies. The work is motivated by a
calculation based on nearest neighbors that underestimates the stiffness by a
factor of 4 in directions away from close-packed directions, and a subsequent
estimate of the stiffness in the two high-symmetry directions alone that
suggested that inclusion of next-nearest-neighbor attractions could fully
explain the discrepancy. As in these earlier papers, the discussion focuses on
Cu(001).Comment: 8 pages, 3 figures, submitted to Phys. Rev.
Using the Wigner-Ibach Surmise to Analyze Terrace-Width Distributions: History, User's Guide, and Advances
A history is given of the applications of the simple expression generalized
from the surmise by Wigner and also by Ibach to extract the strength of the
interaction between steps on a vicinal surface, via the terrace width
distribution (TWD). A concise guide for use with experiments and a summary of
some recent extensions are provided.Comment: 11 pages, 4 figures, reformatted (with revtex) version of refereed
paper for special issue of Applied Physics A entitled "From Surface Science
to Device Physics", in honor of the retirements of Prof. H. Ibach and Prof.
H. L\"ut
Measurement of the 187Re({\alpha},n)190Ir reaction cross section at sub-Coulomb energies using the Cologne Clover Counting Setup
Uncertainties in adopted models of particle+nucleus optical-model potentials
directly influence the accuracy in the theoretical predictions of reaction
rates as they are needed for reaction-network calculations in, for instance,
{\gamma}-process nucleosynthesis. The improvement of the {\alpha}+nucleus
optical-model potential is hampered by the lack of experimental data at
astrophysically relevant energies especially for heavier nuclei. Measuring the
Re187({\alpha},n)Ir190 reaction cross section at sub-Coulomb energies extends
the scarce experimental data available in this mass region and helps
understanding the energy dependence of the imaginary part of the
{\alpha}+nucleus optical-model potential at low energies. Applying the
activation method, after the irradiation of natural rhenium targets with
{\alpha}-particle energies of 12.4 to 14.1 MeV, the reaction yield and thus the
reaction cross section were determined via {\gamma}-ray spectroscopy by using
the Cologne Clover Counting Setup and the method of {\gamma}{\gamma}
coincidences. Cross-section values at five energies close to the
astrophysically relevant energy region were measured. Statistical model
calculations revealed discrepancies between the experimental values and
predictions based on widely used {\alpha}+nucleus optical-model potentials.
However, an excellent reproduction of the measured cross-section values could
be achieved from calculations based on the so-called Sauerwein-Rauscher
{\alpha}+nucleus optical-model potential. The results obtained indicate that
the energy dependence of the imaginary part of the {\alpha}+nucleus
optical-model potential can be described by an exponential decrease. Successful
reproductions of measured cross sections at low energies for {\alpha}-induced
reactions in the mass range 141{\leq}A{\leq}187 confirm the global character of
the Sauerwein-Rauscher potential
Transition strategies for metropolitan food clusters
Metropolitan food clusters entail the development of a new agri logistic system and promises to produce gains for people, planet, and profit. Establishing a transition towards system innovations like metropolitan food clusters needs strategies to overcome the challenges actors face, because transitions are complex processes which are difficult to manage. To define major challenges and strategies to cope with them a literature study into transition, complexity, and learning theories was conducted. The findings where used in analyzing the case study Greenpark, which is located in an emerging economy. In this article it is concluded that system innovations like metropolitan food clusters need the establishment of niches in which they can foster in an environment based on trust and learning and in which a management style is used which manages order and disorder, aims for innovation, and provides room for self organization. When scaling up to the regime level the challenge arises how to push through existing practices and rules and in this context, the support of an influential actor network is essential. This means connections are necessary between the innovation process inside a niche and people and organizations outside the niche with executive power and involving potential executers of metropolitan food clusters in the design process is a suited way of doing this. The challenge however is to understand and prevent the innovative potential of the niche from weakening because of a management style that is based on hierarchy and control
Low-Energy Electron Microscopy Studies of Interlayer Mass Transport Kinetics on TiN(111)
In situ low-energy electron microscopy was used to study interlayer mass
transport kinetics during annealing of three-dimensional (3D) TiN(111) mounds,
consisting of stacked 2D islands, at temperatures T between 1550 and 1700 K. At
each T, the islands decay at a constant rate, irrespective of their initial
position in the mounds, indicating that mass is not conserved locally. From
temperature-dependent island decay rates, we obtain an activation energy of
2.8+/-0.3 eV. This is consistent with the detachment-limited decay of 2D TiN
islands on atomically-flat TiN(111) terraces [Phys. Rev. Lett. 89 (2002)
176102], but significantly smaller than the value, 4.5+/-0.2 eV, obtained for
bulk-diffusion-limited spiral step growth [Nature 429, 49 (2004)]. We model the
process based upon step flow, while accounting for step-step interactions, step
permeability, and bulk mass transport. The results show that TiN(111) steps are
highly permeable and exhibit strong repulsive temperature-dependent step-step
interactions that vary between 0.003 and 0.076 eV-nm. The rate-limiting process
controlling TiN(111) mound decay is surface, rather than bulk, diffusion in the
detachment-limited regime.Comment: 26 pages, 5 figure
Predicting sepsis-related mortality and ICU admissions from telephone triage information of patients presenting to out-of-hours GP cooperatives with acute infections:A cohort study of linked routine care databases
BackgroundGeneral practitioners (GPs) often assess patients with acute infections. It is challenging for GPs to recognize patients needing immediate hospital referral for sepsis while avoiding unnecessary referrals. This study aimed to predict adverse sepsis-related outcomes from telephone triage information of patients presenting to out-of-hours GP cooperatives.MethodsA retrospective cohort study using linked routine care databases from out-of-hours GP cooperatives, general practices, hospitals and mortality registration. We included adult patients with complaints possibly related to an acute infection, who were assessed (clinic consultation or home visit) by a GP from a GP cooperative between 2017–2019. We used telephone triage information to derive a risk prediction model for sepsis-related adverse outcome (infection-related ICU admission within seven days or infection-related death within 30 days) using logistic regression, random forest, and neural network machine learning techniques. Data from 2017 and 2018 were used for derivation and from 2019 for validation.ResultsWe included 155,486 patients (median age of 51 years; 59% females) in the analyses. The strongest predictors for sepsis-related adverse outcome were age, type of contact (home visit or clinic consultation), patients considered ABCD unstable during triage, and the entry complaints”general malaise”, “shortness of breath” and “fever”. The multivariable logistic regression model resulted in a C-statistic of 0.89 (95% CI 0.88–0.90) with good calibration. Machine learning models performed similarly to the logistic regression model. A “sepsis alert” based on a predicted probability >1% resulted in a sensitivity of 82% and a positive predictive value of 4.5%. However, most events occurred in patients receiving home visits, and model performance was substantially worse in this subgroup (C-statistic 0.70).ConclusionSeveral patient characteristics identified during telephone triage of patients presenting to out-of-hours GP cooperatives were associated with sepsis-related adverse outcomes. Still, on a patient level, predictions were not sufficiently accurate for clinical purposes
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