Charge melting and polaron collapse in La1.2Sr1.8Mn2O7La_{1.2}Sr_{1.8}Mn_{2}O_{7}

X-ray and neutron scattering measurements directly demonstrate the existence of polarons in the paramagnetic phase of optimally-doped colossal magnetoresistive oxides. The polarons exhibit short-range correlations that grow with decreasing temperature, but disappear abruptly at the ferromagnetic transition because of the sudden charge delocalization. The "melting" of the charge ordering as we cool through $T_C$ occurs with the collapse of the quasi-static polaron scattering, and provides important new insights into the relation of polarons to colossal magnetoresistance.Comment: 4 pages (RevTex), 3 postscript-formatted figures (Figs. 1 and 2 are color figures

Density dependent composition of InAs quantum dots extracted from grazing incidence x-ray diffraction measurements.

Epitaxial InAs quantum dots grown on GaAs substrate are being used in several applications ranging from quantum communications to solar cells. The growth mechanism of these dots also helps us to explore fundamental aspects of self-organized processes. Here we show that composition and strain profile of the quantum dots can be tuned by controlling in-plane density of the dots over the substrate with the help of substrate-temperature profile. The compositional profile extracted from grazing incidence x-ray measurements show substantial amount of inter-diffusion of Ga and In within the QD as a function of height in the low-density region giving rise to higher variation of lattice parameters. The QDs grown with high in-plane density show much less spread in lattice parameter giving almost flat density of In over the entire height of an average QD and much narrower photoluminescence (PL) line. The results have been verified with three different amounts of In deposition giving systematic variation of the In composition as a function of average quantum dot height and average energy of PL emission.The authors would like to acknowledge the support of Department of Science and Technology (DST) for carrying out synchrotron experiments at Petra III, DESY, Germany through the DST-DESY project and the EPSRC, UK for financial support.This is the final version of the article. It first appeared from NPG via http://dx.doi.org/10.1038/srep1573

Crisis management in Finnish hospital pharmacies during the COVID-19 pandemic

Background: Although hospital pharmacies have played a central role in managing the COVID-19 pandemic, there is a lack of crisis management theory-based empirical research on the topic. The purpose of this study was to fill this gap in the Finnish context and identify areas for development to improve future crisis preparedness. Methods: A national cross-sectional survey was developed based on crisis management process models and sent to all hospital pharmacy heads (n = 21) during the second wave of the pandemic in October–November 2020. Descriptive statistics were calculated, and qualitative data from open-ended responses were studied using deductive content analysis. The results were confirmed and enriched through data triangulation with six semi-structured interviews of purposively selected hospital pharmacy heads in March–May 2021. Results: The response rate was 57% (n = 12). Following the onset of the pandemic, the risk perception of a crisis concerning pharmaceutical supply chain rose from 58 to 100%. A pre-existing pandemic preparedness plan was available in four (25%) pharmacies. Seven (58%) pharmacies developed a new plan. A pandemic crisis team was established in four (33%) pharmacies. Changes in internal communication and management (92%), clinical pharmacy services (67%), medicine supply (58%), procurement (42%), and pharmaceutical production operations (25%) were implemented. Collaboration with peers or other actors in the pharmaceutical supply chain increased or improved in nine (75%) hospital pharmacies, whereas in three (25%), it decreased or was unchanged. Mandatory reserve stockpiles provided a buffer for the increased need for emergency medicines. Positive and negative experiences of the pharmaceutical supply chain’s crisis response indicated an unequal distribution of medicines and crisis management-related information. Conclusions: Crisis management process models provided a holistic framework for analysing the pandemic response in hospital pharmacies. The study provided an alternative data collection approach by utilising process models in the development of the survey instrument. Preparedness of hospital pharmacies could be improved with pre-established crisis teams and plans, and data management systems providing easily accessible information to support decision-making. Developing prerequisites for coordinated information sharing and equitable distribution of medicines is essential to ensure effective crisis response, equitable medicine availability among hospitals and patient safety

Crisis management in the pharmaceutical industry during the COVID-19 pandemic

Despite the vulnerabilities of the pharmaceutical industry and its critical role in functioning healthcare systems, no previous crisis management theory–based empirical studies focusing on this field during the COVID-19 pandemic has been published. The present study aims to fill this gap and identify areas for development to improve future crisis preparedness. Organisational crisis management process models provided a theoretical framework. A cross-sectional survey study was conducted during the second wave of the pandemic (October–November 2020). This online survey was developed based on the crisis management process models and sent to managing directors working in the pharmaceutical and wholesale companies (n = 73) in Finland. Descriptive statistics were calculated, and open-field responses were analysed qualitatively using content analysis. Nine semi-structured interviews with industry leaders and managers conducted in March–May 2021 were utilised in data triangulation. The results revealed that crisis preparedness improved concurrently during the pandemic due to increased risk perception, updated preparedness plans and operational changes. Crisis decision-making was made via teams or shared efforts between key persons. Anticipation of and responses to increased demand and stocking, coordination and collaboration among pharmaceutical supply chain stakeholders were identified as key challenges. The study extends crisis management process models to the pharmaceutical industry context and advances this research field by drawing on a novel approach for data collection utilising crisis management process models for survey development. Practical implications for improving future preparedness are suggested

Organisation of cross-sector collaboration and its influence on crisis management effectiveness among pharmaceutical supply chain stakeholders during the COVID-19 pandemic

Objectives: To investigate the organisation of cross-sector collaboration and how it influenced crisis management effectiveness among pharmaceutical supply chain stakeholders in Finland during the COVID-19 pandemic. Study design: Qualitative semi-structured interview study. Methods: Purposeful selection was used to obtain the study sample consisting of leaders and specialists from the pharmaceutical industry and wholesalers (n = 9), community pharmacy owners (n = 9), hospital pharmacy heads (n = 6), government agency directors and officials (n = 5) and advocacy organisation representatives (n = 2). Inductive content analysis was performed to examine the data from the semi-structured individual (n = 29) and paired (n = 2) interviews in March–May 2021. Results: A new conceptual model was developed to describe the organisation of collaborative crisis management. Without a predefined crisis management organisation, cross-sector collaboration was organised based on previous collaboration structures, channels and relationships and through the establishment of issue-specific groups by government agencies as per legal mandates. Crisis dynamics and related issues guided the group formation and meeting frequency. Advocacy organisations and government agencies acted in bridging role between stakeholders. Shared knowledge among pharmaceutical supply chain stakeholders enabled anticipation and preparedness during crisis; shared resources fostered maintenance of core functions; and shared problem-solving facilitated cross-sectoral solutions. Conclusion: This was the first study exploring cross-sector collaboration among pharmaceutical supply chain stakeholders during a crisis. Sharing knowledge, resources and problem-solving increased the crisis management effectiveness. The study presented a new illustration of organising for collaborative crisis management and added knowledge about private-third sector collaboration and issue-specific groups to the cross-sector collaboration and crisis management literature

The impact of a history of status epilepticus for epilepsy surgery outcome.

Patients with focal drug resistant epilepsy are excellent candidates for epilepsy surgery. Status epilepticus (SE) and seizure clusters (SC), described in a subset of patients, have both been associated with extended epileptogenic cerebral networks within one or both hemispheres. In this retrospective study, we were interested to determine if a history of SE or SC is associated with a worse surgical outcome. Data of 244 patients operated between 2000 to 2018 were reviewed, with a follow-up of at least 2 years. Patients with a previous history of SE or SC were compared to operated patients without these conditions (control group, CG). We identified 27 (11%) and 38 (15.5%) patients with history of SE or SC, respectively. No difference in post-operative outcome was found for SE and SC patients. Compared to the control group, patients with a history of SE were diagnosed and operated significantly at earlier age(p = 0.01), and after a shorter duration of the disease (p = 0.027), but with a similar age of onset. A history of SE or SC was not associated with a worse post-operative prognosis. Earlier referral of SE patients for surgery suggests a heightened awareness regarding serious complications of recurrent SE by the referring neurologist or neuropediatrician. While the danger of SE is evident, policies to underline the impact for SC or very frequent seizures might be an efficient approach to accelerate patient referral also for this patient group

Direction-specific motion blindness induced by focal stimulation of human extrastriate cortex

Motion blindness (MB) or akinetopsia is the selective disturbance of visual motion perception while other features of the visual scene such as colour and shape are normally perceived. Chronic and transient forms of MB are characterized by a global deficit of direction discrimination (pandirectional), which is generally assumed to result from damage to, or interference with, the motion complex MT+/V5. However, the most characteristic feature of primate MT-neurons is not their motion specificity, but their preference for one direction of motion (direction specificity). Here, we report that focal electrical stimulation in the human posterior temporal lobe selectively impaired the perception of motion in one direction while the perception of motion in other directions was completely normal (unidirectional MB). In addition, the direction of MB was found to depend on the brain area stimulated. It is argued that direction specificity for visual motion is not only represented at the single neuron level, but also in much larger cortical units

Hypoalbuminemia in status epilepticus is a biomarker of short- and long-term mortality: A 9-year cohort study.

Outcome prediction in Status epilepticus (SE) aids in clinical decision-making, yet existing scores have limitations due to SE heterogeneity. Serum albumin is emerging as a readily available prognostic biomarker in various clinical conditions. This study evaluates hypoalbuminemia in predicting short- and long-term mortality. Observational cohort study including non-hypoxic SE adult patients admitted to the University Hospital of Geneva (Switzerland) between 2015 and 2023. Primary outcomes were in-hospital and 6-month mortality. Four hundred and ninety-six patients were included, 46 (9.3%) died in hospital; 6-month outcome was available for 364 patients, 86 (23.6%) were not alive at follow-up. Hypoalbuminemia was associated with older age and patients' comorbidities. Binomial regression showed an independent correlation between hypoalbuminemia and short- (p = 0.005, OR = 3.35, 95% CI = 1.43-7.86) and long-term mortality (p = 0.001, OR = 3.59,95% CI = 1.75-7.35). The Status Epilepticus Severity Score (STESS) had an overall AUC of 0.754 (95% CI = 0.656-0.836) for predicting in-hospital mortality and of 0.684 (95% CI = 0.613-0.755) for 6-month mortality. Through an exploratory analysis, we replaced age with hypoalbuminemia in the STESS, creating the Albumin-STESS (A-STESS) score (0-6). The global A-STESS AUC significantly improved for both in-hospital (0.837, 95% CI = 0.760-0.916, p = 0.002) and 6-month (0.739, 95% CI = 0.688-0.826; p = 0.033) mortality prediction. A-STESS-3 cutoff demonstrated a strong sensitivity-specificity balance for both in-hospital (sensitivity = 0.88, specificity = 0.68, accuracy = 0.70) and 6-month (sensitivity = 0.67, specificity = 0.73, accuracy = 0.72) mortality. Hypoalbuminemia is an easily measurable biomarker reflecting the overall patient's condition and is independently related to short- and long-term SE mortality. Integrating hypoalbuminemia into the STESS (A-STESS) significantly enhances mortality prediction. Future studies are needed to externally validate the A-STESS and evaluate the benefits of albumin supplementation in SE patient prognosis

Importance of access to epilepsy monitoring units during the COVID-19 pandemic: Consensus statement of the International League against epilepsy and the International Federation of Clinical Neurophysiology

Restructuring of healthcare services during the COVID-19 pandemic has led to lockdown of Epilepsy Monitoring Units (EMUs) in many hospitals. The ad-hoc taskforce of the International League Against Epilepsy (ILAE) and the International Federation of Clinical Neurophysiology (IFCN) highlights the detrimental effect of postponing video-EEG monitoring of patients with epilepsy and other paroxysmal events. The taskforce calls for action to continue functioning of Epilepsy Monitoring Units during emergency situations, such as the COVID-19 pandemic. Long-term video-EEG monitoring is an essential diagnostic service. Access to video-EEG monitoring of the patients in the EMUs must be given high priority. Patients should be screened for COVID-19, before admission, according to the local regulations. Local policies for COVID-19 infection control should be adhered to during the video-EEG monitoring. In cases of differential diagnosis where reduction of antiseizure medication is not required, consider home video-EEG monitoring as an alternative in selected patients

Temporal dynamics of amygdala response to emotion- and action-relevance

It has been proposed that the human amygdala may not only encode the emotional value of sensory events, but more generally mediate the appraisal of their relevance for the individual's goals, including relevance for action or task-based needs. However, emotional and non-emotional/action-relevance might drive amygdala activity through distinct neural signals, and the relative timing of both kinds of responses remains undetermined. Here, we recorded intracranial event-related potentials (iERPs) from nine amygdalae of patients undergoing epilepsy surgery, while they performed variants of a Go/NoGo task with faces and abstract shapes, where emotion- and action-relevance were orthogonally manipulated. Our results revealed early amygdala responses to emotion facial expressions starting ~130ms after stimulus-onset. Importantly, the amygdala responded to action-relevance not only with face stimuli but also with abstract shapes (squares), and these relevance effects consistently occurred in later time-windows (starting ~220ms) for both faces and squares. A similar dissociation was observed in gamma activity. Furthermore, whereas emotional responses habituated over time, the action-relevance effect increased during the course of the experiment, suggesting progressive learning based on the task needs. Our results support the hypothesis that the human amygdala mediates a broader relevance appraisal function, with the processing of emotion-relevance preceding temporally that of action-relevance