A hybrid topological quantum state in an elemental solid.

Topology1-3 and interactions are foundational concepts in the modern understanding of quantum matter. Their nexus yields three important research directions: (1) the competition between distinct interactions, as in several intertwined phases, (2) the interplay between interactions and topology that drives the phenomena in twisted layered materials and topological magnets, and (3) the coalescence of several topological orders to generate distinct novel phases. The first two examples have grown into major areas of research, although the last example remains mostly unexplored, mainly because of the lack of a material platform for experimental studies. Here, using tunnelling microscopy, photoemission spectroscopy and a theoretical analysis, we unveil a 'hybrid' topological phase of matter in the simple elemental-solid arsenic. Through a unique bulk-surface-edge correspondence, we uncover that arsenic features a conjoined strong and higher-order topology that stabilizes a hybrid topological phase. Although momentum-space spectroscopy measurements show signs of topological surface states, real-space microscopy measurements unravel a unique geometry of topologically induced step-edge conduction channels revealed on various natural nanostructures on the surface. Using theoretical models, we show that the existence of gapless step-edge states in arsenic relies on the simultaneous presence of both a non-trivial strong Z2 invariant and a non-trivial higher-order topological invariant, which provide experimental evidence for hybrid topology. Our study highlights pathways for exploring the interplay of different band topologies and harnessing the associated topological conduction channels in engineered quantum or nano-devices.

Characteristics of Bilateral Retinal Detachment.

INTRODUCTION: Rhegmatogenous retinal detachment (RD) is still a sight-threatening and potentially blinding disease, especially if both eyes are affected. The purpose of this study is analysing the specific characteristics of bilateral rhegmatogenous RD. METHODS: The files of all 5,791 consecutive eyes undergoing vitreoretinal surgery for uncomplicated RD in a single tertiary retinal centre between January 2005 and June 2021 were retrospectively reviewed. RESULTS: A total of 300 patients (600 eyes) had bilateral retinal detachment. Interval between initial and subsequent RD surgery was 2.6 ± 2.8 (mean ± SD, median 1.5) years. Symptoms were reported by the patients for 20 ± 75 (median 5) days before presentation in the initial eye and 12 ± 32 (median 4) days in the subsequent eye. 220 patients were male (73%), and mean age at initial RD was 55 years. 183 (61%) of the initial RD eyes were phakic. In the initial eye, more patients had a detached macula, worse visual acuity, and more quadrants involved. Primary anatomic success rate was higher in the subsequent eye (90%) compared to the initial eye (83%). There was no difference in the reattachment rate of fellow eyes with primary failure in the first eye (91%) compared to those with primary success in the first eye (90%). There was a high symmetry between the eyes in terms of type of retinal break, number of breaks, and presumed localization of the causative retinal break. CONCLUSION: Patients with bilateral RD were more commonly male and younger than the group of all RD patients. The proportion of pseudophakia was not different. The majority of fellow eye RD occurred within 2 years after the RD in the first eye. Second eye RD was less advanced and had a better anatomical repair rate. Despite their experience in the first eye and despite typical symptoms, patients presented only after a mean of 12 days with RD in the second eye. RD in the initial and the subsequent eye showed a high symmetry. The anatomic result in the first eye is not a predictor for the anatomic result in the subsequent eye.

Superfluid Weight Bounds from Symmetry and Quantum Geometry in Flat Bands.

Flat-band superconductivity has theoretically demonstrated the importance of band topology to correlated phases. In two dimensions, the superfluid weight, which determines the critical temperature through the Berezinksii-Kosterlitz-Thouless criteria, is bounded by the Fubini-Study metric at zero temperature. We show this bound is nonzero within flat bands whose Wannier centers are obstructed from the atoms-even when they have identically zero Berry curvature. Next, we derive general lower bounds for the superfluid weight in terms of momentum space irreps in all 2D space groups, extending the reach of topological quantum chemistry to superconducting states. We find that the bounds can be naturally expressed using the formalism of real space invariants (RSIs) that highlight the separation between electronic and atomic degrees of freedom. Finally, using exact Monte Carlo simulations on a model with perfectly flat bands and strictly local obstructed Wannier functions, we find that an attractive Hubbard interaction results in superconductivity as predicted by the RSI bound beyond mean field. Hence, obstructed bands are distinguished from trivial bands in the presence of interactions by the nonzero lower bound imposed on their superfluid weight.

Pairing Obstructions in Topological Superconductors.

The modern understanding of topological insulators is based on Wannier obstructions in position space. Motivated by this insight, we study topological superconductors from a position-space perspective. For a one-dimensional superconductor, we show that the wave function of an individual Cooper pair decays exponentially with separation in the trivial phase and polynomially in the topological phase. For the position-space Majorana representation, we show that the topological phase is characterized by a nonzero Majorana polarization, which captures an irremovable and quantized separation of Majorana Wannier centers from the atomic positions. We apply our results to diagnose second-order topological superconducting phases in two dimensions. Our work establishes a vantage point for the generalization of topological quantum chemistry to superconductivity.

Mixed uranyl and neptunyl cation-cation interaction-driven clusters: structures, energetic stability, and nuclear quadrupole interactions.

We present a state-of-the-art quantum chemical study of mixed cation-cation interaction (CCI) driven complexes composed of uranyl and neptunyl units. Specifically, we consider the stability of the D-shaped and T-shaped structural rearrangements in CCIs, various oxidation states of the uranium and neptunium atom (v and vi), as well as a different number of unpaired electrons. Furthermore, we scrutinize the nuclear quadrupole interactions of the bare actinyl subunits and the most stable mixed CCI clusters. The electric field gradients (and nuclear quadrupole coupling constants) of neptunyls are reported for the first time. The characteristic features of the nuclear quadrupole interactions for the bare neptunyl ions are very similar to those predicted for uranyls. When the CCI clusters are formed, a considerable asymmetry is introduced compared to the bare actinyl cations. Most importantly, we are able to distinguish different types of CCIs with respect to their structural arrangement and their total charge by analyzing the electric field gradients at the uranium and neptunium nuclei.

Topological quantum properties of chiral crystals.

Chiral crystals are materials with a lattice structure that has a well-defined handedness due to the lack of inversion, mirror or other roto-inversion symmetries. Although it has been shown that the presence of crystalline symmetries can protect topological band crossings, the topological electronic properties of chiral crystals remain largely uncharacterized. Here we show that Kramers-Weyl fermions are a universal topological electronic property of all non-magnetic chiral crystals with spin-orbit coupling and are guaranteed by structural chirality, lattice translation and time-reversal symmetry. Unlike conventional Weyl fermions, they appear at time-reversal-invariant momenta. We identify representative chiral materials in 33 of the 65 chiral space groups in which Kramers-Weyl fermions are relevant to the low-energy physics. We determine that all point-like nodal degeneracies in non-magnetic chiral crystals with relevant spin-orbit coupling carry non-trivial Chern numbers. Kramers-Weyl materials can exhibit a monopole-like electron spin texture and topologically non-trivial bulk Fermi surfaces over an unusually large energy window.

Topological minibands and interaction driven quantum anomalous Hall state in topological insulator based moiré heterostructures.

The presence of topological flat minibands in moiré materials provides an opportunity to explore the interplay between topology and correlation. In this work, we study moiré minibands in topological insulator films with two hybridized surface states under a moiré superlattice potential created by two-dimensional insulating materials. We show the lowest conduction (highest valence) Kramers' pair of minibands can be Z 2 non-trivial when the minima (maxima) of moiré potential approximately form a hexagonal lattice with six-fold rotation symmetry. Coulomb interaction can drive the non-trivial Kramers' minibands into the quantum anomalous Hall state when they are half-filled, which is further stabilized by applying external gate voltages to break inversion. We propose the monolayer Sb2 on top of Sb2Te3 films as a candidate based on first principles calculations. Our work demonstrates the topological insulator based moiré heterostructure as a potential platform for studying interacting topological phases.

Quetiapine as combination treatment with citalopram in unipolar depression with prominent somatic symptoms: a randomised, double-blind, placebo-controlled pilot study.

BACKGROUND: Patients with major depressive disorder (MDD) accompanied by physical symptoms may be less responsive to antidepressant treatment. Quetiapine has been evaluated in the treatment of bipolar depression and has been recently approved as an add-on therapy for unipolar depression. Less is known about the efficacy of combination therapies in patients suffering from MDD with somatic symptoms. The aim of the present study was to evaluate the efficacy of quetiapine as adjunctive therapy to the SSRI citalopram in patients with MDD and somatic complaints. SUBJECTS AND METHODS: 41 inpatients with nonpsychotic DSM-IV MDD experiencing significant symptoms of somatic distress as defined by a baseline score on the SCL-90-R somatization subscale greater one standard deviation above adult nonpatient norms were randomly assigned to receive either citalopram 40 mg/day plus placebo (n=20) or citalopram 40 mg/day plus quetiapine, 300 to 600 mg/day (n=21) for 6 weeks. The primary outcome measure was the Hamilton Depression Rating Scale (HDRS) score. RESULTS: Mean changes in HDRS scores from baseline to week 6 using last-observation-carried-forward methods were -12.3±6.2 and -10.7±5.1 in the citalopram-quetiapine and citalopram-placebo group, respectively. Remission rates were significant higher in the citalopram-quetiapine-group (41.1%) than in the citalopram-placebo-group (26.3%), respectively. CONCLUSIONS: Although quetiapine as add-on to citalopram did not separate statistically from placebo on the HDRS score in improving depressive symptoms and somatic symptoms in patients with MDD and prominent somatic complaints, higher remission rates and other second outcome parameters showed advantages for quetiapine. Larger, double-blind, placebo-controlled trials of quetiapine as augmentation therapy in MDD with somatic symptoms are warranted.

Topological zero-dimensional defect and flux states in three-dimensional insulators.

In insulating crystals, it was previously shown that defects with two fewer dimensions than the bulk can bind topological electronic states. We here further extend the classification of topological defect states by demonstrating that the corners of crystalline defects with integer Burgers vectors can bind 0D higher-order end (HEND) states with anomalous charge and spin. We demonstrate that HEND states are intrinsic topological consequences of the bulk electronic structure and introduce new bulk topological invariants that are predictive of HEND dislocation states in solid-state materials. We demonstrate the presence of first-order 0D defect states in PbTe monolayers and HEND states in 3D SnTe crystals. We relate our analysis to magnetic flux insertion in insulating crystals. We find that π-flux tubes in inversion- and time-reversal-symmetric (helical) higher-order topological insulators bind Kramers pairs of spin-charge-separated HEND states, which represent observable signatures of anomalous surface half quantum spin Hall states.

Stimulus pulse-frequency-dependent efficacy and cognitive adverse effects of ultrabrief-pulse electroconvulsive therapy in patients with major depression.

BACKGROUND: : Electroconvulsive therapy (ECT) is a highly effective treatment for major depression. New ECT devices with shorter pulse widths seem to induce seizures more effectively at a lower seizure threshold and with fewer cognitive adverse effects. Suprathreshold right unilateral (RUL) ultrabrief-pulse ECT with pulse widths between 0.25 and 0.30 millisecond seem to be especially effective with regard to efficacy and cognitive adverse effects. A lower pulse frequency (50 pulses per second) in RUL ECT was found to be more efficient than a higher pulse frequency (200 pulses per second) in inducing seizures. However, effective stimulus dose can often be achieved only with high stimulus frequency, whereas the impact of increased stimulus frequency on antidepressant efficacy and cognitive adverse effects is not known. METHODS: : Forty patients with major depression according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition were randomly assigned to 2 groups of 20 patients each and stimulated with either 40 or 100 Hz with equal initial stimulus doses in 9 sessions of suprathreshold RUL ultrabrief-pulse ECT. Depressive symptoms and measures of verbal and working memory were assessed for both groups. RESULTS: : Patients in the 40-Hz condition showed significantly more improvement in Hamilton Rating Scale for Depression scores compared with patients in the 100-Hz condition after 9 ECT sessions. Frequency group had no significant impact on measures of verbal and working memory. CONCLUSIONS: : Within the discussed limitations, our preliminary data suggest an advantage for administering stimulus dose in suprathreshold RUL ultrabrief-pulse ECT with a lower stimulus frequency (40 Hz) as compared with a higher frequency (100 Hz). Further studies are needed to assess whether increasing pulse widths or frequency is the better option for augmenting stimulus dose once other stimulus parameters are at a maximum.

Exceptional topological insulators.

We introduce the exceptional topological insulator (ETI), a non-Hermitian topological state of matter that features exotic non-Hermitian surface states which can only exist within the three-dimensional topological bulk embedding. We show how this phase can evolve from a Weyl semimetal or Hermitian three-dimensional topological insulator close to criticality when quasiparticles acquire a finite lifetime. The ETI does not require any symmetry to be stabilized. It is characterized by a bulk energy point gap, and exhibits robust surface states that cover the bulk gap as a single sheet of complex eigenvalues or with a single exceptional point. The ETI can be induced universally in gapless solid-state systems, thereby setting a paradigm for non-Hermitian topological matter.

Theory for the negative longitudinal magnetoresistance in the quantum limit of Kramers Weyl semimetals.

Negative magnetoresistance is rare in non-magnetic materials. Recently, negative magnetoresistance has been observed in the quantum limit of ß-Ag2Se, where only one band of Landau levels is occupied in a strong magnetic field parallel to the applied current. ß-Ag2Se is a material that hosts a Kramers Weyl cone with band degeneracy near the Fermi energy. Kramers Weyl cones exist at time-reversal invariant momenta in all symmorphic chiral crystals, and at a subset of these momenta, including the Γ point, in non-symmorphic chiral crystals. Here, we present a theory for the negative magnetoresistance in the quantum limit of Kramers Weyl semimetals. We show that, although there is a band touching similar to those in Weyl semimetals, negative magnetoresistance can exist without a chiral anomaly. We find that it requires screened Coulomb scattering potentials between electrons and impurities, which is naturally the case in ß-Ag2Se.

Higher-order topological insulators.

Three-dimensional topological (crystalline) insulators are materials with an insulating bulk but conducting surface states that are topologically protected by time-reversal (or spatial) symmetries. We extend the notion of three-dimensional topological insulators to systems that host no gapless surface states but exhibit topologically protected gapless hinge states. Their topological character is protected by spatiotemporal symmetries of which we present two cases: (i) Chiral higher-order topological insulators protected by the combination of time-reversal and a fourfold rotation symmetry. Their hinge states are chiral modes, and the bulk topology is Z2 -classified. (ii) Helical higher-order topological insulators protected by time-reversal and mirror symmetries. Their hinge states come in Kramers pairs, and the bulk topology is Z -classified. We provide the topological invariants for both cases. Furthermore, we show that SnTe as well as surface-modified Bi2TeI, BiSe, and BiTe are helical higher-order topological insulators and propose a realistic experimental setup to detect the hinge states.

Higher-Order Topology in Bismuth.

The mathematical field of topology has become a framework to describe the low-energy electronic structure of crystalline solids. A typical feature of a bulk insulating three-dimensional topological crystal are conducting two-dimensional surface states. This constitutes the topological bulk-boundary correspondence. Here, we establish that the electronic structure of bismuth, an element consistently described as bulk topologically trivial, is in fact topological and follows a generalized bulk-boundary correspondence of higher-order: not the surfaces of the crystal, but its hinges host topologically protected conducting modes. These hinge modes are protected against localization by time-reversal symmetry locally, and globally by the three-fold rotational symmetry and inversion symmetry of the bismuth crystal. We support our claim theoretically and experimentally. Our theoretical analysis is based on symmetry arguments, topological indices, first-principle calculations, and the recently introduced framework of topological quantum chemistry. We provide supporting evidence from two complementary experimental techniques. With scanning-tunneling spectroscopy, we probe the unique signatures of the rotational symmetry of the one-dimensional states located at step edges of the crystal surface. With Josephson interferometry, we demonstrate their universal topological contribution to the electronic transport. Our work establishes bismuth as a higher-order topological insulator.

Lithium versus lamotrigine augmentation in treatment resistant unipolar depression: a randomized, open-label study.

Treatment-resistant depression affects up to 70% of patients. In our 8-week, randomized, open-label, prospective study of 34 treatment-resistant depression patients lamotrigine-add-on was compared with lithium-augmentation. Both treatments resulted in clinically significant reduction in Hamilton rating scale for depression score: mean Hamilton rating scale for depression-score declined from 22.7 (SD 3.9) to 11.7 (SD 4.2) in the lamotrigine group and from 21.5 (SD 3.8) to 13.3 (SD 5.7) in the lithium (Li) group. No significant differences were seen in Hamilton rating scale for depression scores between treatment groups at baseline (P=0.82) and after 8 weeks (P=0.11). Twenty-three percent of the lamotrigine group (n=4) and 18% (n=3) of the Li group achieved remission, 53% of the lamotrigine group (n=9) responded to treatment vs. 41% in the Li group (n=7) and 47% of the lamotrigine group (n=8) vs. 35% of the Li group (n=6) showed at least a partial response. Lamotrigine-augmentation was well tolerated. In conclusion, this study demonstrated that the add-on of lamotrigine to antidepressive medication revealed comparable results in most outcome measures as a lithium augmentation. Owing to small sample size no conclusions regarding similar efficacy can be drawn from our data. Larger trials that should include a placebo arm are needed to further investigate lamotriginés role in treatment-resistant depression.