Coherent Pathways Research Articles

Modelling ambitious climate mitigation pathways for Australia's built environment

• We model operational and embodied GHG emissions for Australia's built environment. • The scope includes residential and commercial buildings. • A high ambition scenario delivers a 94% reduction in emissions compared to BAU. • Includes renewables, electrification, efficiency and material replacement. • Novel pathways analysis highlights options for net zero and net negative emissions. Achieving net zero operational and embodied greenhouse gas (GHG) emissions in the built environment is recognised in Australia and globally as a key strategy to address climate change and achieve the United Nations Sustainable Development Goals (SDGs). However, gaps in knowledge remain regarding potential national pathways to achieve this outcome in Australia. This study further extends and applies a national-scale integrated macroeconomic simulation model to explore coherent pathways to net zero emissions in the built environment sector by 2050. The scope of the study includes residential and commercial buildings and both operational and embodied emissions. It applies scenario analysis incorporating different levels of climate ambition, including a shift to renewable energy, electrifying buildings, improving energy efficiency and replacing carbon-intensive materials. We find that a high ambition scenario (Scenario 2) delivers a 94% reduction in GHG emissions by 2050 when compared against business-as-usual, placing a net-zero target within reach. Improvements on Australia's SDGs performance are also attained. Through subsequent pathways analysis we find that achieving net zero or even net negative operational and embodied emissions is feasible with more ambitious action in key areas, including increasing the share of mass-timber buildings and reducing end-of-life losses in sequestered carbon.

Submesoscale Vorticity and Divergence in the Alboran Sea: Scale and Depth Dependence

The statistics of submesoscale divergence and vorticity (kinematic properties, KPs) in the Alboran Sea (Mediterranean Sea) are investigated, using data from drifters released during two experiments in June 2018 and April 2019 in the framework of the Coherent Lagrangian Pathways from the Surface Ocean to Interior (CALYPSO) project. Surface drifters sampling the first meter of water (CARTHE and CODE) and 15 m drifters (SVP) are considered. The area of interest is dominated by processes of strong frontogenesis and eddy formation as well as mixing, related to the high lateral gradients between Mediterranean and Atlantic waters. Drifter coverage and distribution allow to investigate the dependence of KPs on horizontal scales in a range between 1 and 16 km, that effectively bridges submesoscale and mesoscale processes, and at two depths, of 1 and 15 m. For both experiments, the surface flow is highly ageostrophic at 1 km scale, with positive vorticity skewness indicating the presence of submesoscale features. Surface divergence quickly decreases at increasing scales with a slope compatible with a turbulent process with broadband wavenumber spectrum, suggesting the influence of surface boundary layer processes such as wind effects, waves and Langmuir cells at the smaller scales. Vorticity, on the other hand, has a significantly slower decay, suggesting interaction between submesoscale and mesoscale dynamics. Results at 15 m are characterized by reduced ageostrophic dynamics with respect to the surface, especially for divergence. Submesoscale processes are present but appear attenuated in terms of KP magnitude and skewness. The results are generally consistent for the two experiments, despite the observed differences in the mixed layer stratification, suggesting that submesoscale instabilities occur mostly at surface fronts associated with filaments of Atlantic and Mediterranean waters that are present in both cases. The results are compared with previous literature results in other parts of the world ocean and a synthesis is provided. Good agreement with previous surface results is found, suggesting some general properties for divergence and vorticity scale dependence. The importance of further investigating very high resolution frontal processes at scales of tens of meters, as well as processes of interaction with high wind effects is highlighted.

CALYPSO: Observing Coherent Pathways from the Surface Ocean to the Interior

CALYPSO: Observing Coherent Pathways from the Surface Ocean to the Interior

Coherent Pathways for Subduction From the Surface Mixed Layer at Ocean Fronts

AbstractIn frontal zones, water masses that are tens of kilometers in extent with origins in the mixed layer can be identified in the pycnocline for days to months. Here, we explore the pathways and mechanisms of subduction, the process by which water from the surface mixed layer makes its way into the pycnocline, using a submesoscale‐resolving numerical model of a mesoscale front. By identifying Lagrangian trajectories of water parcels that exit the mixed layer, we study the evolution of dynamical properties from a statistical standpoint. Velocity‐ and buoyancy‐gradients increase as water parcels experience both mesoscale (geostrophic) and submesoscale (ageostrophic) frontogenesis and subduct beneath the mixed layer into the stratified pycnocline along isopycnals that outcrop in the mixed layer. Subduction is transient and occurs in coherent regions along the front, the spatial and temporal scales of which influence the scales of the subducted water masses in the pycnocline. An examination of specific subduction events reveals a range of submesoscale features that support subduction. Contrary to the forced submesoscale processes that sequester low potential vorticity (PV) anomalies in the interior, we find that PV can be elevated in subducting water masses. The rate of subduction is of similar magnitude to previous studies (∼100 m/year), but the Lagrangian evolution of properties on water parcels and pathways that are unraveled in this study emphasize the role of submesoscale dynamics coupled with mesoscale frontogenesis.

Frontal Convergence and Vertical Velocity Measured by Drifters in the Alboran Sea

AbstractHorizontal and vertical motions associated with mesoscale (10–100 km) and submesoscale (1–10 km) features, such as fronts, meanders, eddies, and filaments, play a critical role in redistributing physical and biogeochemical properties in the ocean. This study makes use of a multiplatform data set of 82 drifters, a Lagrangian float, and profile timeseries of temperature and salinity, obtained in a ∼1‐m/s semipermanent frontal jet in the Alboran Sea as part of CALYPSO (Coherent Lagrangian Pathways from the Surface Ocean to Interior). Drifters drogued at ∼1‐m and 15‐m depth capture the mesoscale and submesoscale circulation aligning along the perimeter of fronts due to horizontal shear. Clusters of drifters are used to estimate the kinematic properties, such as vorticity and divergence, of the flow by fitting a bivariate plane to the horizontal drifter velocities. Clusters with submesoscale length scales indicate normalized vorticity ζ/f > 1 with Coriolis frequency f and normalized divergence of (1) occurring in patches along the front, with error variance around 10%. By computing divergence from drifter clusters at two different depths, we estimate minimum vertical velocity of (−100 m day−1) in the upper 10 m of the water column. These results are at least twice as large as previous estimates of vertical velocity in the region. Location, magnitude, and timing of the convergence are consistent with behavior of a Lagrangian float subducting in the center of a drifter cluster. These results improve our understanding of frontal subduction and quantify convergence and vertical velocity using Lagrangian tools.

Sustainability Narratives as Transformative Solution Pathways: Zooming in on the Circular Economy

The circular economy can be understood as one of the sustainability narratives (along with, e.g., the bioeconomy, the green economy and the sharing economy), currently relevant in academia, business and policymaking. Sustainability narratives are characterized by a distinctive set of transferable and scalable solutions, addressing resource/services use and distribution in social-ecological-technical systems. Core solutions in the circular economy are technologically-driven improvements towards reductions of inputs/outputs in production and consumption systems. However, the conceptual diversity of the circular economy is such that it can, like other sustainability narratives, serve multiple sustainability discourses (e.g., ecological modernization, sustainable development and degrowth). In order to cater to societal needs within the planet’s biophysical boundaries, the contribution of the circular economy needs to be strengthened in regard to the protection of biodiversity and ecosystems and to the just distribution of resources, opportunities and prosperity. Socio-cultural change should be understood as complementary to technology- and private sector-driven solutions. While circular economy principles are meant to be translated into tailored micro- and macro- level strategies based on context-specific characteristics and needs, the causal connections between units or geographical regions are a crucial issue for sustainability. The overall co-evolution and harmonization of multiple narratives towards coherent sustainability pathways should strive towards decreasing dependence on fossil resources, reversing biodiversity loss and ecosystems degradation and enabling a quality life for all people. The conclusions of this article provide key points that can further guide analyses and implementation of the circular economy in the context of sustainability transformations.

Switching of the mechanism of charge transport induced by phase transitions in tunnel junctions with large biomolecular cages

This work gives new insights in the conduction mechanisms across biomolecular junctions and demonstrates that proteins can reversibly change between in- and coherent tunnelling pathways defined by the protein cage and the amount of co-factor.

The bio-based economy, 2030 Agenda, and strong sustainability – A regional-scale assessment of sustainability goal interactions

Policy-makers face the challenge of assessing and implementing sustainability measures, while also dealing with parallel and sometimes conflicting policy agendas, long-term policy impacts, and contested interpretations of sustainability. To support evidence-based decision-making in this context, this paper presents the results from an integrated assessment of sustainability goal interactions. Links between the bio-based economy, the 2030 Agenda, and the so-called strong sustainability paradigm were explored in a regional-scale case. The analysis focused primarily on developments in the forestry and energy sectors. Direct trade-offs and synergies as well as broader systemic impacts were identified. The results show how goals from the bio-based economy, 2030 Agenda and strong sustainability paradigm are mutually interacting. Positive interactions were found within two clusters of goals, offering coherent and synergetic transition pathways within these. The first cluster encompasses developments toward intensified forestry, renewable energy, and closed-loop production systems. The second pathway supports diversified forestry and protection of critical natural capital. However, while internally coherent, trade-offs were identified between these goal clusters, demonstrating the difficulty in simultaneously making progress on goals belonging to different sustainability agendas. The results also stress the need for disaggregation and long-term assessments to identify trade-offs and synergies. Finally, the analysis highlights the theoretical potential but practical challenges of implementing the bio-based economy and 2030 Agenda in a way that adheres to strong sustainability. The analytical framework used in the present study may be adapted and applied to other decision-making contexts. It is particularly useful in settings characterized by uncertainty and unstructured problem spaces.

Neuroprotective effects of human amniotic fluid stem cells-derived secretome in an ischemia/reperfusion model.

Stem cells offer the basis for the promotion of robust new therapeutic approaches for a variety of human disorders. There are still many limitations to be overcome before clinical therapeutic application, including a better understanding of the mechanism by which stem cell therapies may lead to enhanced recovery. In vitro investigations are necessary to dissect the mechanisms involved and to support the potential development in stem cell‐based therapies. In spite of growing interest in human amniotic fluid stem cells, not much is known about the characteristics of their secretome and regarding the potential neuroprotective mechanism in different pathologies, including stroke. To get more insight on amniotic fluid cells therapeutic potential, signal transduction pathways activated by human amniotic fluid stem cells (hAFSCs)‐derived secretome in a stroke in vitro model (ischemia/reperfusion [I/R] model) were investigated by Western blot. Moreover, miRNA expression in the exosomal fraction of the conditioned medium was analyzed. hAFSCs‐derived secretome was able to activate pro‐survival and anti‐apoptotic pathways. MicroRNA analysis in the exosomal component revealed a panel of 16 overexpressed miRNAs involved in the regulation of coherent signaling pathways. In particular, the pathways of relevance in ischemia/reperfusion, such as neurotrophin signaling, and those related to neuroprotection and neuronal cell death, were analyzed. The results obtained strongly point toward the neuroprotective effects of the hAFSCs‐conditioned medium in the in vitro stroke model here analyzed. This can be achieved by the modulation and activation of pro‐survival processes, at least in part, due to the activity of secreted miRNAs.

Investigating the Formation of Submesoscale Structures along Mesoscale Fronts and Estimating Kinematic Quantities Using Lagrangian Drifters

Much of the vertical transport near the surface of the ocean, which plays a critical role in the transport of dissolved nutrients and gases, is thought to be associated with ageostrophic submesoscale phenomena. Vertical velocities are challenging not only to model accurately, but also to measure because of how difficult they are to locate in the surface waters of the ocean. Using unique massive drifter releases during the Lagrangian Submesoscale Experiment (LASER) campaign in the Gulf of Mexico and the Coherent Lagrangian Pathways from the Surface Ocean to the Interior (CALYPSO) experiment in the Mediterranean Sea, we investigate the generation of submesoscale structures along two different mesoscale fronts. We use a novel method to project Lagrangian trajectories to Eulerian velocity fields, in order to calculate horizontal velocity gradients at the surface, which are used as a proxy for vertical transport. The velocity reconstruction uses a squared-exponential covariance function, which characterizes velocity correlations in horizontal space and time, and determines the scales of variation using the data itself. SST and towed CTD measurements support the findings revealed by the drifter data. Due to the production of a submesoscale instability eddy in the Gulf of Mexico, convergence magnitudes of up to ∼20 times the planetary vorticity, f, are observed, the value of which is almost 3 times larger than that found in the mesoscale dominated Western Mediterranean Sea.

Coherent Pathways for Vertical Transport from the Surface Ocean to Interior

CALYPSO is a Departmental Research Initiative (DRI) funded by the U.S. Office of Naval Research (ONR)

SAT0610-HPR COHERENT REHABILITATION – EXPERIENCES OF PEOPLE WITH INFLAMMATORY ARTHRITIS

Background:20-40% of patients with inflammatory arthritis (IA) do not tolerate or do not have sufficient effect of the medication and experience considerable problems in their everyday lives. For these patients multidisciplinary rehabilitation and coherence in healthcare are of utmost importance (1). However, only little is known about coherence in healthcare among patients with inflammatory arthritisObjectives:To explore how persons with IA experience coherence in their rehabilitation pathwaysMethods:Semi-structured individual interviews with 11 persons with IA who had experience with rehabilitation across primary and secondary health care. Interviews were conducted in the patients’ home before admission to an inpatient rehabilitation stay, during the admission and 2-3 weeks and 4-6 months after discharge. In addition, participant observations and informal interviews were performed during admission. The analysis involved case descriptions (2) and interpretation in a thematic analysis (3).Results:The analysis derived a main theme“a person centered approach”, representing the importance for the person to meet professionals who listen and acknowledge the persons own views rather than focusing on the “system”, regulations and standards. In addition, 4 sub-themes were identified: 1)“empowerment and disempowerment”,covering how most patients want to be in control and take action but they may lack the energy and ability to express their needs and thus give up; 2)“Lack of communication and coordination”, involving processes between the staff in the same department, between departments or sectors. Patients feel forced to take on coordinating tasks themselves, which they do not feel qualified to perform; 3)“Interventions meant as help may be felt as restrictions”, which encompass i.e. free physical therapy delivered at times not appropriate for the patient and types of support which can lead to a feeling of social control, and finally, 4)“The system is difficult to get through”.Information about possible support are provided at random and some ask for a coordinating person.Conclusion:Facilitators for coherent pathways among people with IA encompass dedicated professionals working with a person-centered approach aiming to empower people. This encompass to provide relevant knowledge and enable the person to ask for the right type of help. A coordinator may facilitate coherence.

Translational gene regulation in plants: A green new deal.

The molecular machinery for protein synthesis is profoundly similar between plants and other eukaryotes. Mechanisms of translational gene regulation are embedded into the broader network of RNA-level processes including RNA quality control and RNA turnover. However, over eons of their separate history, plants acquired new components, dropped others, and generally evolved an alternate way of making the parts list of protein synthesis work. Research over the past 5 years has unveiled how plants utilize translational control to defend themselves against viruses, regulate translation in response to metabolites, and reversibly adjust translation to a wide variety of environmental parameters. Moreover, during seed and pollen development plants make use of RNA granules and other translational controls to underpin developmental transitions between quiescent and metabolically active stages. The economics of resource allocation over the daily light-dark cycle also include controls over cellular protein synthesis. Important new insights into translational control on cytosolic ribosomes continue to emerge from studies of translational control mechanisms in viruses. Finally, sketches of coherent signaling pathways that connect external stimuli with a translational response are emerging, anchored in part around TOR and GCN2 kinase signaling networks. These again reveal some mechanisms that are familiar and others that are different from other eukaryotes, motivating deeper studies on translational control in plants. This article is categorized under: Translation > Translation Regulation RNA Structure and Dynamics > Influence of RNA Structure in Biological Systems RNA Interactions with Proteins and Other Molecules > Protein-RNA Interactions: Functional Implications.

Rethinking rehabilitation after percutaneous coronary intervention: a protocol of a multicentre cohort study on continuity of care, health literacy, adherence and costs at all care levels (the CONCARDPCI)

IntroductionPercutaneous coronary intervention (PCI) aims to provide instant relief of symptoms, and improve functional capacity and prognosis in patients with coronary artery disease. Although patients may experience a quick recovery,...

Research under Attack: A Framework for Prospective Cross-European Research in the Wake of Terrorism

Abstract This presentation will propose a framework for prospective cross-European research study that may provide unique knowledge about the health effects of terror attacks and the challenges they impose to the health services. Terror attacks devastatingly affect individuals and societies worldwide. Unfortunately, unmet needs are frequently reported by those impacted. How to design and implement efficient psychosocial care, and reach affected individuals and communities, is a challenge for researchers, clinicians and policy makers alike. There is an urgent need for coordinated efforts to develop scientifically based guidelines for psychosocial support and health services after terrorism, and thus strengthen our public health preparedness to such events. Examples will be given on how accurate register-based and administrative claims data on primary and secondary health service utilization before and after attacks can be linked with terror-exposed individuals’ own reports of their perceived health, social support and other factors that are important to consider in the planning and implementation of post-attack healthcare. Cross-country comparisons may provide new insight about cultural, structural and organizational factors that may impede or promote coherent patient pathways in the wake of terror attacks. A long-term goal is to develop a sound research methodology that allows for international comparisons of healthcare delivery in the context of different types of trauma. During the presentation, methodological challenges in current trauma-focused studies and suggestions for strengthening future research concerning healthcare to trauma-exposed populations will be discussed.

The human sensorimotor cortex fosters muscle synergies through cortico-synergy coherence

In neuromotor control, the dimensionality of complex muscular activation patterns is effectively reduced through the emergence of muscle synergies. Muscle synergies are tailored to task-specific biomechanical needs. Traditionally, they are considered as low-dimensional neural output of the spinal cord and as such their coherent cortico-muscular pathways have remained underexplored in humans. We investigated whether muscle synergies have a higher-order origin, especially, whether they are manifest in the cortical motor network. We focused on cortical muscle synergy representations involved in balance control and examined changes in cortico-synergy coherence accompanying short-term balance training. We acquired electromyography and electro-encephalography and reconstructed cortical source activity using adaptive spatial filters. The latter were based on three muscle synergies decomposed from the activity of nine unilateral leg muscles using non-negative matrix factorization. The corresponding cortico-synergy coherence displayed phase-locked activity at the Piper rhythm, i.e., cortico-spinal synchronization around 40 Hz. Our study revealed the presence of muscle synergies in the motor cortex, in particular, in the paracentral lobule, known for the representation of lower extremities. We conclude that neural oscillations synchronize between the motor cortex and spinal motor neuron pools signifying muscle synergies. The corresponding cortico-synergy coherence around the Piper rhythm decreases with training-induced balance improvement.

Real-Time Student Assessment: Meeting the Imperative for Improved Time to Degree, Closing the Opportunity Gap, and Assuring Student Competencies for 21st Century Needs by Peggy L. Maki

Reviewed by: Real-Time Student Assessment: Meeting the Imperative for Improved Time to Degree, Closing the Opportunity Gap, and Assuring Student Competencies for 21st Century Needs by Peggy L. Maki Gavin Henning Real-Time Student Assessment: Meeting the Imperative for Improved Time to Degree, Closing the Opportunity Gap, and Assuring Student Competencies for 21st Century Needs Peggy L. Maki Sterling, VA: Stylus Publishing, 2017, 188 pages, $29.95 (softcover) Peggy Maki argues that the current state of assessment is not fulfilling its intended purpose of improving students’ learning because it is still too frequently motivated by external forces without an internal commitment to improve student learning for current students. Assessment practice must change now to account for the increasing diversification of students on campus, address persistence gaps in degree completion rates for minoritized students, ensure a global citizenry that is educated and can meet the needs of a global economy and solve problems that have not yet arisen. While more colleges and universities are using nationally recognized student outcomes frameworks—such as the Essential Learning Outcomes by the Association of American Colleges and Universities (n.d.) and the Degree Qualification Profile by the Lumina Foundation (2018)—to guide education programs, few institutions are assessing student progress towards achievement of these outcomes in order to benefit current students. Rather, assessment is implemented in a more periodic fashion with the goal of program improvement to benefit future students. Maki argues that what is needed to ensure equitable attainment of the identified student outcomes is continuous assessment that capitalizes on opportunities to identify students who are struggling and addresses, in real-time, the obstacles current students face to help them succeed. This approach is what she terms “real-time assessment.” Recent texts outline how to implement assessment (Banta & Palomba, 2014; Henning & Roberts, 2016; Kuh et al., 2015; Schuh, Biddix, Dean, & Kinzie, 2016; Suskie, 2014, 2018) or discuss specific assessment tools or methods to employ (Barkley & Major, 2016; Massa & Kasimatis, 2017). Maki’s book differs in that it deepens the assessment conversation, providing direction regarding how to implement assessment in the present to improve programs and services to benefit students now. Through the six chapters in the book, Maki provides a guide for real-time assessment. In chapter 1, she articulates why equity matters in higher education by providing evidence to demonstrate disparities in retention and graduation rates for students across demographic categories. She continues by positing the needs for a diverse, educated citizenry who can meet the requirements of a global society. In the second chapter, Maki describes a few nationally recognized outcomes frameworks that provide the foundation for effective assessment practice, and she articulates how these can offer scaffolding for coherent degree pathways for students. Maki provides guidance in chapter 3 regarding learner-centered commitments that institutions must make to develop clear and coherent degree pathways supported and informed by real-time student assessment. These commitments are: [End Page 134] Commitment 1: Shared commitment to close existing achievement and graduation gaps measurably Commitment 2: Agreement on language of outcomes and scoring rubrics to identify patterns of performance and underperformance continuously Commitment 3: Coherence across the curriculum, cocurriculum, and other educational experiences Commitment 4: Alignment of courses, educational experiences, and assignments with outcomes and standards and criteria of judgment Commitment 5: Faculty collaboration with the institution’s network of experts Transitioning from foundational commentary to concrete directions, Maki discusses guiding principles for implementing real-time assessment at the program and institutional levels in chapter 4. The principles she outlines include: Principle 1: Internally driven and motivated Principle 2: Inclusive of internal stakeholders Principle 3: Bolstered by collaboration that harnesses others’ expertise and practices Principle 4: Anchored in continuous reporting and interrogation of assessment results Principle 5: Responsive to students’ needs in the present tense Principle 6: Valued by the institution This chapter includes two institutional and two program case studies, which bring the principles to life by providing concrete examples. Additionally, in chapter 4, Maki provides an instructive table that compares characteristics of real-time assessment with point-in-time assessment approaches. Maki uses chapter 5 to outline types of technology that are useful for implementing real-time assessment, describing the purposes of...

75 - Independent regulation of thioredoxin-1 and glutathione in UVB-irradiated keratinocytes (HaCaT)

Oxidative stress has long been defined as an imbalance of intracellular oxidizing and reducing equivalents in favor of the former. However, the last 15 years have seen substantial research revealing that the endogenous antioxidant response is more complex than previously imagined. In the present study, we show that two thiol/disulfide couples with important antioxidant functions, glutathione (GSH) and thioredoxin-1 (Trx1), are regulated independent of one another in UVB-irradiated human keratinocytes (HaCaT), supporting the notion that oxidative stress is not defined by a global imbalance of oxidants and antioxidants, but by disruptions to specific redox pathways. In keratinocytes treated with 30 mJ/cm2 of UVB radiation, GSH steady-state redox potentials (Eh) shift from -241 mV to -177 mV at 1 hour post-treatment; this shift corresponds with a similar shift in the redox state of glutaredoxin, a GSH-dependent couple containing a thioredoxin motif. Significantly, Trx1 redox state does not show a positive shift following UVB treatment, but a negative shift toward a more reducing potential, suggesting that Trx1 is resistant to UVB-induced oxidation in spite of being upregulated post-treatment. These data indicate that GSH and Trx1 operate within discrete pathways under non-reciprocal regulation. We further demonstrate that GSH operates within specific pathways incident to different oxidant exposures. Distinct S-glutathionylated protein targets exist for UVB and H2O2 treatment groups and untreated controls, as shown via western blot. Protein targets were identified with mass spectrometry, producing unique sets of GSH interactors for the three different treatment groups. Each set of interactors contains significant numbers of proteins involved in coherent molecular pathways as determined by STRING pathway analysis, reinforcing a paradigm where oxidative stress is marked principally by disruptions to specific redox pathways, not a general oxidant/antioxidant equilibrium.

Quantum coherence of multiple excitons governs absorption cross-sections of PbS/CdS core/shell nanocrystals

Multiple excitons in semiconductor nanocrystals have been extensively studied with respect to unique carrier dynamics including quantized Auger recombination and implementation in optoelectronic devices such as solar cells and photodetectors. However, the generation mechanism of multiple excitons still remains unclear. Here, we study instantaneous and delayed multiple exciton generation processes in PbS/CdS core/shell nanocrystals. The absorption cross-sections of biexcitons and triexcitons are identical to that of single excitons under instantaneous excitation with a single pulse. In contrast, the delayed excitation using double pulses shows a reduction of the biexciton and triexciton absorption cross-sections. Our theoretical analysis reveals that the excitonic coherence assists the generation of multiple excitons and that the reduction of multiple exciton absorption cross-sections is caused by the reduction of coherent excitation pathways. We clarify that exciton coherences play a key role in multiple exciton generation processes and seamlessly connect the identical and reduced multiple exciton absorption cross-sections.

Policies Make Coherent Care Pathways a Personal Responsibility for Clinicians: A Discourse Analysis of Policy Documents about Coordinators in Hospitals.

Introduction:In response to increase of patients with complex conditions, policies prescribe measures for improving continuity of care. This study investigates policies introducing coordinator roles in Norwegian hospitals that have proven challenging to implement.Methods:This qualitative study of policy documents employed a discourse analysis inspired by Carol Bacchi’s ‘What‘s the problem represented to be?’. We analysed six legal documents (2011–2016) and selected parts of four whitepapers presenting the statutory patient care coordinator and contact physician roles in hospitals.Results:The ‘problem’ represented in the policies is lack of coherent pathways and lack of stable responsible professionals. Extended personal responsibility for clinical personnel as coordinators is the prescribed solution. Their duties are described in terms of ideals for coherent pathways across conditions and contexts. System measures to support and orchestrate the individual patient’s pathway (e.g. resources, infrastructure) are scarcely addressed.Conclusions and Discussion:We suggest that the policies’ construction of the ‘problem’ as a responsibility issue, result in that neither diversity of patients’ coordination needs, nor heterogeneity of hospital contexts regarding necessary system support for coordinators, is set on the agenda. Adoption of rhetoric from diagnosis-specific standardized pathways obscures unique challenges in creating coherent pathways for patients with complex needs.