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Voltage-Tuned Anomalous-Metal to Metal Transition in Hybrid Josephson Junction Arrays
No full textWe report on voltage-tuned phase transitions in arrays of hybrid semiconductor-superconductor islands arranged in a square lattice. A double-layer electrostatic gate geometry enables independent tuning of interisland coupling and proximity-induced superconductivity. This design enables access to the superconductor-insulator, superconductor-metal, and metal-insulator transitions in a single device, revealing critical points and emergent intermediate phases. We find that the superconductor-insulator transition is interrupted by an anomalous metallic phase with saturating low-temperature resistivity. Across gate voltages, this regime extends over 3 orders of magnitude in resistivity and can be continuously tuned into the conventional metallic phase. The signature of the anomalous metallic phase is suppressed by magnetic frustration
Plant conservation hologenomics:integrating population genomics with mycobiome assessments for protected orchid species
No full textGrowing evidence of the microbiome’s importance for plant ecology highlights the need for conservation strategies that consider both plants and their microbial partners, the holobiont. Population genomics are valuable tools for designing conservation strategies but rarely accounts for host- or site-specific microbial interactions. Orchids, with their dependence on specific mycorrhizal fungi, exemplify the need to include the microbiome in conservation planning. We here combine population genomics with exploration of root mycobiomes for three closely related orchid taxa (Platanthera chlorantha, P. bifolia var. bifolia and P. bifolia var. latissima) across 22 populations in Denmark to identify ecologically and evolutionary significant units. Our data revealed that Platanthera chlorantha and P. bifolia s.l. hosted different mycobiomes, suggesting a strong host effect on the fungal symbionts. Population genomic analyses identified three different clusters, one matching P. bifolia var. bifolia and two clusters dividing P. chlorantha into two geographically separate units. The genomic profile of P. bifolia var. latissima was similar to that of P. bifolia var. bifolia but indicated some introgression from P. chlorantha. By combining the mycobiome and population genomic data we reveal that the three detected clusters were associated with different mycobiomes, resulting in a significant correlation between host genomics and mycobiome. Root mycobiomes were correlated with variation in soil nutrients, suggesting a role of the orchids’ fungal partners in adaptation to local edaphic conditions. We propose to identify evolutionary significant units in Platanthera in Denmark based on the novel combination of host genomic and mycobiome profiles, in a conservation hologenomics approach
Matrix product state classification of one-dimensional multipole symmetry-protected topological phases
No full textSpatially modulated symmetries are one of the new types of symmetries the symmetry actions of which are position dependent. Yet exotic phases resulting from these spatially modulated symmetries are not fully understood and classified. In this work, we systematically classify one-dimensional bosonic symmetry-protected topological phases of multipole symmetries by employing the matrix product state formalism. The symmetry action induces projective representations at the ends of an open chain, which we identify via group cohomology. In particular, for r-pole symmetries-for instance, r = 0 (global), 1 (dipole), and 2 (quadrupole)-the classification is determined by distinct components of second cohomology groups that encode the boundary projective representations
Overdiagnosis in screening for gestational diabetes:A scoping review
No full textBackgroundScreening for gestational diabetes mellitus (GDM) in healthy pregnancies is disputed, and rising GDM incidence calls for an investigation into the potential for overdiagnosis.AimTo identify and map empirical evidence on overdiagnosis in GDM screening and explore how different screening strategies impact overdiagnosis.MethodsThis review adheres to the JBI Manual and PRISMA-ScR guidelines. Systematic searches were performed on September 10th, 2024, without date, language, or geography restrictions, in Medline, Embase, CINAHL, Cochrane Library, and Web of Science. One search targeted studies explicitly addressing overdiagnosis through primary empirical analyses, while a second search included RCTs evaluating GDM screening programmes. Evidence screening and selection were carried out independently by two authors.FindingsWe included ten studies with varying designs in Search 1 and nine RCTs in Search 2. In Search 1, only one study defined overdiagnosis. In Search 2, seven of nine RCTs show an increased incidence with intensified screening. Of these, six evaluated universal screening and showed no accompanying benefits, suggesting overdiagnosis. Variations in strategies and outcomes complicate comparisons. Additionally, no RCTs compare screening to no screening or risk-based to universal screening, raising uncertainties about the effects of different screening programmes and practices.DiscussionOur analysis of RCT data demonstrates that intensifying screening led to increased incidence without corresponding beneficial effects, indicating overdiagnosis. Few studies have assessed overdiagnosis empirically, and no established framework currently guides the definition or operationalisation of overdiagnosis in GDM screening research.ConclusionData from RCTs indicate overdiagnosis in universal GDM screening.BACKGROUND: Screening for gestational diabetes mellitus (GDM) in healthy pregnancies is disputed, and rising GDM incidence calls for an investigation into the potential for overdiagnosis.AIM: To identify and map empirical evidence on overdiagnosis in GDM screening and explore how different screening strategies impact overdiagnosis.METHODS: This review adheres to the JBI Manual and PRISMA-ScR guidelines. Systematic searches were performed on September 10th, 2024, without date, language, or geography restrictions, in Medline, Embase, CINAHL, Cochrane Library, and Web of Science. One search targeted studies explicitly addressing overdiagnosis through primary empirical analyses, while a second search included RCTs evaluating GDM screening programmes. Evidence screening and selection were carried out independently by two authors.FINDINGS: We included ten studies with varying designs in Search 1 and nine RCTs in Search 2. In Search 1, only one study defined overdiagnosis. In Search 2, seven of nine RCTs show an increased incidence with intensified screening. Of these, six evaluated universal screening and showed no accompanying benefits, suggesting overdiagnosis. Variations in strategies and outcomes complicate comparisons. Additionally, no RCTs compare screening to no screening or risk-based to universal screening, raising uncertainties about the effects of different screening programmes and practices.DISCUSSION: Our analysis of RCT data demonstrates that intensifying screening led to increased incidence without corresponding beneficial effects, indicating overdiagnosis. Few studies have assessed overdiagnosis empirically, and no established framework currently guides the definition or operationalisation of overdiagnosis in GDM screening research.CONCLUSION: Data from RCTs indicate overdiagnosis in universal GDM screening.</p
Ward Nurses' Use of Epidural Analgesia When Treating Breakthrough Pain:A National Survey Study
No full textINTRODUCTION: Epidural analgesia is an effective postoperative pain treatment reducing the administration of systemic opioids and improving postoperative outcomes. Evidence suggests that epidural analgesia improves pain management, improves physical function, reduces nausea and sedation, and patients have a better recovery. Still studies have shown ward nurses lack education in epidural pain treatment. Our study investigated ward nurses' use of in situ epidural catheter for pain treatment when patients experience breakthrough pain. Furthermore, we explored if educational programs are available, and the barriers experienced by ward nurses when treating breakthrough pain in patients with an epidural catheter.METHODS: Our study is a Danish nationwide electronic survey targeting all abdominal and orthopedic surgical wards. Head nurses from each ward appointed two ward nurses to answer the questionnaire. The survey took place from March to July 2023.RESULTS: In all, 104 of 121 (86%) ward nurses completed the questionnaire. Seventy-five (72.1%) respondents reported using epidural bolus as a first-line treatment for breakthrough pain. Education in epidural analgesia was available at 98% of the surgical wards. Further, 47% reported getting formalized education, with 37 (36%) receiving it from a nurse or doctor from either the anesthesiology department or pain team. The most frequent barriers to using epidural bolus were organizational (56%) and lack of competence (42%).CONCLUSION: Our study found that 72% of the respondents used epidural analgesia as first-line treatment. Our study also found that 47% of the respondents received formalized education, and the main reported barriers to using epidural bolus were organizational and lack of competence. The high rate of epidural bolus as first-line treatment might reflect best practice in the involved departments.</p
A New Research Agenda on the History of the EU::The Eastern Enlargement
No full textThe eastern enlargement of the EU during the early 2000s was driven by the urgent need to find an effective response to the fall of the Berlin Wall. Despite persistent challenges to the rule of law in Poland and Hungary, the expansion of the Union has sustained democratic and economic development across the Central and Eastern Europe region. However, deep structural problems related to the enlargement process that were perfectly foreseeable and even intensely debated during the early 2000s were never adequately addressed. This negligence, this chapter holds, has had a negative, yet largely overlooked, impact on the overall functioning of the main institutions of the European Union; as a result, it is now difficult for Member States to agree on the essential next steps towards further European integration identified in other chapters of this book. Possibly nowhere is this problem more evident than in the field of European security
The association between self-reported frailty status and 1-year all-cause mortality and readmission following PCI:A prospective multi-centre cohort study, CONCARD<sup>PCI</sup>
No full textBACKGROUND: In older adults with ischemic heart disease, frailty status may better reflect biological than chronological age. The objective was to investigate the association between self-reported frailty status at discharge and a composite endpoint of 1-year mortality or all-cause readmission after percutaneous coronary intervention (PCI).METHODS: A multi-centre prospective cohort study of patients undergoing PCI. Self-reported frailty status was assessed using the Study of Osteoporotic Fractures (SOF) Frailty Index ("robust", "prefrail", and "frail"). The association between frailty status and the composite endpoint was investigated using Cox regression analysis in adjusted models (Model 1 sociodemographic, Model 2 + clinical variables), reported as hazard ratios (HR) and 95 % confidence intervals (CI).RESULTS: In total, 2831 patients (median age 66 years IQR 57-73, 21 % women) reported their frailty status post-PCI: 18 % were frail, 33 % prefrail, and 48 % robust. Among frail patients, a higher proportion (45 %) experienced the composite endpoint during the 1-year follow-up (vs robust 33 % and prefrail 35 %). Frailty status was not significantly associated with the composite endpoint. Post-hoc exploratory analyses showed that the SOF question about unintended weight loss was significantly associated with the composite endpoint among frail patients (adjHR 1.19 95 % CI 1.02-1.38 Model 1, adjHR 1.20 95 % CI 1.03-1.40 Model 2), driven by readmissions. Chair rise was associated with reduced mortality (Model 2 HR 0.32 95 % CI 0.11-0.92).CONCLUSION: Frailty status was not associated with the composite endpoint of 1-year mortality or readmission. However, unintended weight loss might be an important prognostic indicator for readmission and chair rise for mortality.</p
Movement Strategies of Neotropical Nectarivorous Birds:Insights From High-Andean Hummingbirds and Flowerpiercers
No full textTropical nectarivorous birds should have flexible movement behaviors in response to the spatiotemporal availability of flowers. In the Neotropics, hummingbirds (Trochilidae) have diet breadths constrained by trait-matching with flowers, while nectar-robbing flowerpiercers (Thraupidae) typically drink nectar from holes pierced at the flower's base. Distinct movement patterns for these two bird families would be expected from optimal foraging theory due to differences in dietary specialization and behavioral flexibility, yet little is known about the daily movement patterns of tropical nectarivores. We used fine-resolution tracking data from an automated radio telemetry grid to compare movement patterns between hummingbirds and flowerpiercers in high-Andean mountain ecosystems, and obtained an accumulated total of 435,513 location estimates and 452 tracking days from 22 individuals across six bird species. Our results indicate that hummingbirds exhibit a greater diversity of movement behaviors compared to flowerpiercers, with varying space use and recursion patterns that are characteristic of sedentary, commuting/traplining and exploratory strategies, whereas most species of flowerpiercers were classified as central-place foragers. However, there is substantial variation in daily movement metrics and hierarchical clustering does not necessarily group together bird families, species, nor even individuals as more similar to each other. Flexibility in movement behaviors has seldom been described for neotropical nectarivorous birds in the wild. It emerges as an important trait to adjust behavior to variable local contexts, and may be adaptive for the persistence of pollinators in challenging mountain ecosystems, where weather conditions are harsh and floral resources are seasonal.</p