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Background: In several countries, the advanced practice provider (APP) is positioned as a clinician in an acute care setting. In the Netherlands, physician assistants (PAs), the equivalent of the APP, are increasingly being employed in ICUs. It is unknown to what extent PAs are present in Dutch ICUs, what they do and how they are appreciated. To provide a general overview, we conducted a survey. Methods: The survey was sent to intensivists and PAs working in ICUs in the Netherlands. The survey focused on familiarity with the PA, the underlying reasons for implementation and their tasks. Results: Sixty-five intensivists (representing 85% of all hospitals) and 43 of the 55 (78%) Dutch PAs responded. Twenty ICUs employed PAs and eight were considering doing so. In these ICUs, both intensivists and PAs were satisfied about their performance. Quality improvement and continuity of care were the main reasons mentioned for implementation. In 60% of the ICUs, the PAs performed medium complex tasks such as inserting central venous catheters, in 20% PAs performed complex tasks like treatment of unstable patients with intubation. The main reasons for not implementing PAs were: ‘the intensivist performed the care without residents’, ‘ICU care is too complex for PAs’, ‘no need for additional personnel, enough residents available’ and ‘too expensive’. Conclusion: ICUs in the Netherlands are recognising the potential of a PA on the ICU. Especially larger ICUs are already implementing PAs. Despite this, the majority of ICUs do not yet employ PAs. Presumptions about the profession sometimes inhibit acceptance of these professionals, although PAs are highly appreciated in the ICUs where they do work.

TGF-β1 is an important growth factor to promote the differentiation of T helper 17 (Th17) and regulatory T cells (Treg). The potential of TGF-β1 as therapeutic target in T cell-mediated diseases like rheumatoid arthritis (RA) is unclear. We investigated the effect of TGF-β1 inhibition on murine Th17 differentiation in vitro, on human RA synovial explants ex vivo, and on the development of experimental arthritis in vivo. Murine splenocytes were differentiated into Th17 cells, and the effect of the TGF-βRI inhibitor SB-505124 was studied. Synovial biopsies were cultured in the presence or absence of SB-505124. Experimental arthritis was induced in C57Bl6 mice and treated daily with SB-505124. Flow cytometry analysis was performed to measure different T cell subsets. Histological sections were analysed to determine joint inflammation and destruction. SB-505124 potently reduced murine Th17 differentiation by decreasing Il17a and Rorc gene expression and IL-17 protein production. SB-505124 significantly suppressed IL-6 production by synovial explants. In vivo, SB-505124 reduced Th17 numbers, while increased numbers of Tregs were observed. Despite this skewed Th17/Treg balance, SB-505124 treatment did not result in suppression of joint inflammation and destruction. Blocking TGF-β1 signalling suppresses Th17 differentiation and improves the Th17/Treg balance. However, local SB-505124 treatment does not suppress experimental arthritis.

In this paper we study LaAlO3/Eu1-xLaxTiO3/SrTiO3 structures with nominally x = 0, 0.1 and different thicknesses of the Eu1-xLaxTiO3 layer. We observe that both systems have many properties similar to previously studied LaAlO3/EuTiO3/SrTiO3 and other oxide interfaces, such as the formation of a two-dimensional electron liquid for two unit cells of Eu1-xLaxTiO3; a metal-insulator transition driven by the increase in thickness of the Eu1-xLaxTiO3 layer; the presence of an anomalous Hall effect when driving the systems above the Lifshitz point with a back-gate voltage; and a minimum in the temperature dependence of the sheet resistance below the Lifshitz point in the one-band regime, which becomes more pronounced with increasing negative gate voltage. However, and notwithstanding the likely presence of magnetism in the system, we do not attribute that minimum to the Kondo effect, but rather to the properties of the SrTiO3 crystal and the inevitable effects of charge trapping when using back gates.

BACKGROUND: The antigen CA125 is mainly known as a tumour marker in ovarian cancer, but may also be elevated in benign gynaecological disorders and non-gynaecological diseases. CASE DESCRIPTION: We examined a 21-year-old patient in the gynaecological oncology outpatient clinic, after she was referred with abnormal ovaries on ultrasound and a significantly elevated CA125. The patient had seen a gynaecologist four weeks earlier because of persistent abdominal pain, deep dyspareunia and vaginal bleeding after insertion of a Mirena IUD that has since been removed. The IUD turned out to be placed in the presence of an undiagnosed STD (Chlamydia), which seems to explain the abnormal ovaries and elevated tumour marker due to pelvic inflammatory disease (PID). CONCLUSION: PID can present atypically resembling ovarian carcinoma. Before inserting an IUD, evaluation of sexual history is essential to estimate the risk of an STI and, if necessary, to perform diagnostics.

The chiral p-wave order parameter in Sr2RuO4 would make it a special case amongst the unconventional superconductors. A consequence of this symmetry is the possible existence of superconducting domains of opposite chirality. At the boundary of such domains, the locally suppressed condensate can produce an intrinsic Josephson junction. Here, we provide evidence of such junctions using mesoscopic rings, structured from Sr2RuO4 single crystals. Our order parameter simulations predict such rings to host stable domain walls across their arms. This is verified with transport experiments on loops, with a sharp transition at 1.5 K, which show distinct critical current oscillations with periodicity corresponding to the flux quantum. In contrast, loops with broadened transitions at around 3 K are void of such junctions and show standard Little–Parks oscillations. Our analysis demonstrates the junctions are of intrinsic origin and makes a compelling case for the existence of superconducting domains.

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The electric-field tunable Rashba spin-orbit coupling at the LaAlO3/SrTiO3 interface shows potential applications in spintronic devices. However, different gate dependence of the coupling strength has been reported in experiments. On the theoretical side, it has been predicted that the largest Rashba effect appears at the crossing point of the $d_{xy}$ and $d_{xz,yz}$ bands. In this work, we study the tuneability of the Rashba effect in LaAlO3/SrTiO3 by means of back-gating. The Lifshitz transition was crossed multiple times by tuning the gate voltage so that the Fermi energy is tuned to approach or depart from the band crossing. By analyzing the weak antilocalization behavior in the magnetoresistance, we find that the maximum spin-orbit coupling effect occurs when the Fermi energy is near the Lifshitz point. Moreover, we find strong evidence for a single spin winding at the Fermi surface., 5 pages, 4 figures

In LaAlO3/SrTiO3 heterostructures, a still poorly understood phenomenon is that of electron trapping in back-gating experiments. Here, by combining magnetotransport measurements and self-consistent Schrödinger-Poisson calculations, we obtain an empirical relation between the amount of trapped electrons and the gate voltage. The amount of trapped electrons decays exponentially away from the interface. However, contrary to earlier observations, we find that the Fermi level remains well within the quantum well. The enhanced trapping of electrons induced by the gate voltage can therefore not be explained by a thermal escape mechanism. Further gate sweeping experiments strengthen that conclusion. We propose a new mechanism which involves the electromigration and clustering of oxygen vacancies in SrTiO3 and argue that such electron trapping is a universal phenomenon in SrTiO3-based two-dimensional electron systems.

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Item does not contain fulltext 23 Innovations in Digital Communication describes, criticizes and evaluates 23 digital innovations that are used in media and communication. Innovations that are not hypes, but that were implemented to reach permanent changes in media and communication. The innovations are supported by testimonials of professionals in the field and the scientific foundation of their mechanism of action. The impact and professional, scientific and social challenges coming with these innovations are discussed. Reading this book will render deep insights into how innovative digital media can be used to influence buying behaviour and decision-making. This book answers questions such as "How do I create a strong brand story?", "What are the effects of serious gaming?", "How can we use VR in our communication?", "How do consumers process emotional stories?" and "Is persuasion profiling unethical?" The answers to these questions are not only based on the authors knowledge and research, but each innovation is also discussed by top experts on that specific innovation. 340 p.