Extended Bose-Hubbard model with dipolar excitons.

The Hubbard model constitutes one of the most celebrated theoretical frameworks of condensed-matter physics. It describes strongly correlated phases of interacting quantum particles confined in lattice potentials1,2. For bosons, the Hubbard Hamiltonian has been deeply scrutinized for short-range on-site interactions3-6. However, accessing longer-range couplings has remained elusive experimentally7. This marks the frontier towards the extended Bose-Hubbard Hamiltonian, which enables insulating ordered phases at fractional lattice fillings8-12. Here we implement this Hamiltonian by confining semiconductor dipolar excitons in an artificial two-dimensional square lattice. Strong dipolar repulsions between nearest-neighbour lattice sites then stabilize an insulating state at half filling. This characteristic feature of the extended Bose-Hubbard model exhibits the signatures theoretically expected for a chequerboard spatial order. Our work thus highlights that dipolar excitons enable controlled implementations of boson-like arrays with strong off-site interactions, in lattices with programmable geometries and more than 100 sites.

Clinical implications of high-sensitivity cardiac troponins.

Cardiac troponin assays have become more sensitive over the years leading to the clinical introduction of high-sensitivity cardiac troponin assays in 2010. Their use has revolutionized the assessment of patients with chest pain in the emergency department by allowing earlier rule-in and rule-out of myocardial infarction leading to shorter stays in the emergency department and reduced admissions for chest pain. The incidence of myocardial infarction has increased slightly, and patients with myocardial infarction diagnosed with high-sensitivity cardiac troponins have been found to have a reduced risk of reinfarction, though without an impact on survival. High-sensitivity cardiac troponins are powerful predictors of long-term mortality and cardiovascular disease in the general population as well as in patients with chest pain with or without cardiovascular disease. The increase in risk for death and cardiovascular disease associated with high-sensitivity cardiac troponins is graded and starts already at detectable levels, well below the upper normal level. The aim of this review was to describe the clinical use and consequences of the introduction of high-sensitivity cardiac troponins. In addition, the importance of persistently elevated troponin levels for prognosis and what investigations may be appropriate to perform in patients with stable troponin elevations are discussed.

The use of a Swedish telephone medical advice service by the elderly - a population-based study.

OBJECTIVE: The present study aimed to describe contact made by the elderly to Sweden's nationwide medical helpline, Healthcare Guide 1177 by Phone (HGP). Other objectives were to study potential gender differences and the association between different HGP referral levels and acute visits to hospital-based emergency departments and acute visits to primary care centres. DESIGN: De-identified data from recorded calls to HGP was extracted for analysis (n = 7477 for the oldest age group). Information about acute visits to emergency departments and to primary care reception was extracted from the patient administration system. SETTING: Västerbotten County, Sweden. SUBJECTS: Patients over 80 years. MAIN OUTCOME MEASURES: Calling and visiting frequencies for different age groups as well as reasons for contact and individual recommendations. RESULTS: The utilisation rate of the telephone advice service for the oldest age group was high, with an incidence rate of 533 per 1000 person-years. Women had a 1.17 times higher incidence rate compared with men. The most common reason for contact was drug-related questions (17% of all contacts). Calls that were recommended to care by a medical specialist correlated with total emergency department visits (r = 0.30, p < 0.05) and calls that were given advice correlated with acute primary healthcare visits (r = 0.38, p = 0.005). CONCLUSION: The high utilisation of the telephone advice service by the elderly gives the telephone advice service a unique ability to function as a gatekeeper to further healthcare. Our data suggest that with the telephone advice service's present guidelines, a significant proportion of all calls are being directed to further medical help. The high frequency of drug-related questions raises concerns about the elderly's medication regimens. Key points Patients over 80 years of age had a high utilisation of the telephone medical advice service compared with other age groups. Drug-related questions were the most common reason for contact. A significant proportion of all calls made resulted in further heatlhcare contacts.

Low fructosamine and mortality - A long term follow-up of 215,011 non-diabetic subjects in the Swedish AMORIS study.

BACKGROUND AND AIMS: Both high and low fasting glucose has been associated with an increased mortality among individuals without diabetes. This J-shaped association has also been shown for HbA1c in relation to all-cause mortality. High fructosamine is associated with increased mortality. In this study we aim to evaluate if low fructosamine is also associated with increased mortality in non-diabetic subjects. METHODS AND RESULTS: We included 215,011 subjects from the AMORIS cohort undergoing occupational health screening or primary care in Stockholm, Sweden. Cause specific mortality was obtained from the Swedish Cause-of-Death Register by record linkage. Hazard ratios for the lowest decile of fructosamine were estimated by Cox regression for all-cause (n = 41,388 deaths) and cause-specific mortality during 25 years of follow-up. We observed gradually increased mortality with lower fructosamine in a large segment of the population. In the lowest decile of fructosamine the sex, age, social class and calendar adjusted hazard ratio was 1.20 (95% CI; 1.18-1.27) compared to deciles 2-9. This increased mortality was attenuated after adjustment for six other biomarkers (HR = 1.11 (95% CI; 1.07-1.15)). Haptoglobin, an indicator of chronic inflammation, made the greatest difference in the point estimate. In sensitivity analyses we found an association between low fructosamine and smoking and adjustment for smoking further attenuated the association between low fructosamine and mortality. CONCLUSION: Low levels of fructosamine in individuals without diabetes were found to be associated with increased mortality. Smoking and chronic inflammation seem to at least partially explain this association but an independent contribution by low fructosamine cannot be excluded.

Observation of the Berezinskii-Kosterlitz-Thouless Phase Transition in an Ultracold Fermi Gas.

We experimentally investigate the first-order correlation function of a trapped Fermi gas in the two-dimensional BEC-BCS crossover. We observe a transition to a low-temperature superfluid phase with algebraically decaying correlations. We show that the spatial coherence of the entire trapped system can be characterized by a single temperature-dependent exponent. We find the exponent at the transition to be constant over a wide range of interaction strengths across the crossover. This suggests that the phase transitions in both the bosonic regime and the strongly interacting crossover regime are of Berezinskii-Kosterlitz-Thouless type and lie within the same universality class. On the bosonic side of the crossover, our data are well described by the quantum Monte Carlo calculations for a Bose gas. In contrast, in the strongly interacting regime, we observe a superfluid phase which is significantly influenced by the fermionic nature of the constituent particles.

Hartree-Fock ground state phase diagram of jellium.

We calculate the ground state phase diagram of the homogeneous electron gas in three dimensions within the Hartree-Fock approximation and show that broken symmetry states are energetically favored at any density against the homogeneous Fermi gas state with isotropic Fermi surface. At high density, we find metallic spin-unpolarized solutions where electronic charge and spin density form an incommensurate crystal having more crystal sites than electrons. For r(s)→0, our solutions approach pure spin-density waves, whereas the commensurate Wigner crystal is favored at lower densities, r(s)≳3.4. Decreasing the density, the system undergoes several structural phase transitions with different lattice symmetries. The polarization transition occurs around r(s)≈8.5.

Electrical readout of individual nuclear spin trajectories in a single-molecule magnet spin transistor.

We present the electrical readout of time trajectories obtained from an isolated nuclear spin. The device, a TbPc(2) single-molecule magnet spin transistor, detects the four different nuclear spin states of the Tb(3+) ion with fidelities better than 69%, allowing us to measure individual relaxation times (T(1)) of several tens of seconds. A good agreement with quantum Monte Carlo simulations suggests that the relaxation times are limited by the current tunneling through the transistor, which opens up the possibility to tune T(1) electrically by means of bias and gate voltages.

Lactate production as a response to intrapartum hypoxia in the growth-restricted fetus.

OBJECTIVE: To analyse whether the increase in lactate in response to intrapartum hypoxia differs between small- (SGA), appropriate- (AGA) and large-for-gestational-age (LGA) fetuses. DESIGN: Observational cohort study. SETTING: Ten obstetric units in Sweden. POPULATION: A cohort of 1496 women. METHODS: A secondary analysis of a randomised controlled trial, in which 1496 women with fetal heart rate abnormalities, indicating fetal scalp blood sampling, were randomised to lactate analyses. After delivery, the neonates were divided according to birthweight for gestational age into SGA, AGA and LGA groups. MAIN OUTCOME MEASURE: Lactate concentration in fetal scalp blood. SECONDARY OUTCOME MEASURES: Acid-base balance in cord artery blood and Apgar score <7 at 5 minutes. RESULTS: Median lactate concentrations in the SGA, AGA and LGA groups were 3.8, 3.0 and 2.2 mmol/l, respectively (SGA versus AGA, P = 0.017; LGA versus AGA, P = 0.009). In the subgroups with scalp lactate >4.8 mmol/l (lactacidaemia), the corresponding median (range) values were 6.2 (4.9-14.6), 5.9 (4.9-15.9) and 5.7 mmol/l (5.0-7.9 mmol/l), respectively (no significant differences between the groups). The proportions of neonates with cord artery pH < 7.00, metabolic acidaemia or Apgar score <7 at 5 minutes were similar in all weight groups. CONCLUSION: SGA fetuses with fetal heart rate abnormalities have the same ability to produce lactate as a response to intrapartum hypoxia as AGA and LGA fetuses. The risk of a poor outcome associated with high lactate concentration is the same in SGA, AGA and LGA fetuses. Scalp blood lactate analysis is therefore a reliable method for intrapartum fetal surveillance of suspected growth-restricted fetuses scheduled for vaginal delivery at ≥ 34 weeks of gestation.

Renal function assessed by two different formulas and incidence of myocardial infarction and death in middle-aged men and women.

BACKGROUND: Chronic kidney disease predicts mortality in the general population, but less is known about the association with incidence of first myocardial infarction. We evaluated glomerular filtration rates (GFR) estimated by the Modification of Diet in Renal Disease study (GFR-MDRD) equation and the Mayo formula (GFR-Mayo) as predictors of myocardial infarction and death. METHODS: In 571 353 Swedish men and women, undergoing health controls, with mean age 45 years, and no previous myocardial infarction, hazard ratios were calculated to assess the association between renal function and incidence of myocardial infarction and all-cause mortality, respectively. Glomerular filtration rate 60-90, 30-60 and <30 mL per minute per 1.73 m(2), was defined as mildly, moderately and severely decreased GFR, respectively. RESULTS: There were 19 510 myocardial infarctions and 56 367 deaths during 11.6 years of follow-up. Hazard ratios (and 95% confidence intervals) for myocardial infarction, using GFR-Mayo were 1.11 (1.06-1.16) for mildly, 1.32 (1.18-1.48) for moderately and 2.54 (1.90-3.40) for severely decreased GFR. The corresponding figures for GFR-MDRD were 1.01 (0.96-1.05), 1.23 (1.14-1.32) and 2.49 (1.85-3.35). Mortality was increased at all levels of reduced GFR-Mayo and at moderately or severely decreased GFR-MDRD. CONCLUSIONS: Already mildly decreased GFR increase the risk of myocardial infarction and death in the general population. The association with adverse outcomes is stronger when GFR-Mayo rather than GFR-MDRD is used to assess renal function.

Selective zircon accumulation in a new benthic foraminifer, Psammophaga zirconia, sp. nov.

Benthic foraminifera are single-celled eukaryotes that make a protective organic, agglutinated or calcareous test. Some agglutinated, single-chambered taxa, including Psammophaga Arnold, 1982, retain mineral particles in their cytoplasm, but the selective mechanism of accumulation is not clear. Here, we report the ability of a foraminiferal species to select and accumulate zircons and other heavy minerals in their cytoplasm. In particular, the use of Scanning Electron Microscope coupled with an Energy Dispersive X-ray microanalysis system (SEM-EDS) enabled a representative overview of the mineral diversity and showed that the analysed Psammophaga zirconia sp. nov. individuals contained dominantly crystals of zircon (51%), titanium oxides (27%), and ilmenite (11%) along with minor magnetite and other minerals. The studied specimens occur in the shallow central Adriatic Sea where the sediment has a content of zircon below 1% and of other heavy minerals below 4%. For that reason we hypothesize that: (i) P. zirconia may be able to chemically select minerals, specifically zircon and rutile; (ii) the chemical mechanism allowing the selection is based on electrostatic interaction, and it could work also for agglutinated foraminifera (whether for ingestion, like Xenophyophores, or incorporation in the test as in many other described taxa). In particular, this aptitude for high preferential uptake and differential ingestion or retention of zircon is reported here for the first time, together with the selection of other heavy minerals already described in members of the genus Psammophaga. They are generally counted among early foraminifera, constructing a morphologically simple test with a single chamber. Our molecular phylogenetic study confirms that P. zirconia is a new species, genetically distinctive from other Psammophaga, and occurs in the Adriatic as well as in the Black Sea.

Skin oxygen permeability in premature infants.

While 24 newborn infants (ages, 2 to 48 hours; gestational ages, 24 to 42 weeks) breathed various concentrations of oxygen, the PO2 values on their unheated skin surface were measured by an unheated microcathode electrode for transcutaneous PO2 monitoring. In infants with arterial PO2 values in the range of 50 to 100 torr and with similar skin temperatures, the mean surface PO2 of unheated skin was inversely related to birth weight: 27.2 torr in infants weighing less than 1,500 gm, 14.3 torr in infants weighing 1,500 to 2,500gm, and 2.9 torr in infants weighing more than 2,500 gm. In the smallest infants, the skin surface PO2 was significantly related to arterial PO2: it was about one third of arterial PO2 as estimated by a second electrode for transcutaneous PO2 monitoring heated to 44 degrees C. Phototherapy, crying, or blood transfusion increased the surface PO2 of unheated skin, but not the tcPO2 measured at 44 degrees C. These findings suggest that blood flow to the skin in excess of its metabolic needs due to immature control of cutaneous circulation, along with low resistance to oxygen diffusion, determines the high oxygen permeability of skin in premature infants.

Morphological and molecular characterization of a new terrestrial allogromiid species: Edaphoallogromia australica gen. et spec. nov. (Foraminifera) from Northern Queensland (Australia).

The foraminiferal family Allogromiidae occurs mainly in marine environments, although some genera are described from brackish and freshwater habitats. We report here the occurrence of a terrestrial allogromiid foraminiferan. Phylogenetic relationships were investigated by sequencing part of the SSU rDNA. DNA sequence analysis confirms a close relationship of the new species to the genus Allogromia. Morphological studies corroborate the affiliation to the family Allogromiidae but the lack of an entosolenian tube and an internal septum as well as the different ecology do not allow a classification into a known genus of this family. Taking the molecular, morphological and ecological differences into account, a new genus Edaphoallogromia with the type species E. australica is erected.

Bose-einstein condensation in quasi-2D trapped gases

We discuss Bose-Einstein condensation (BEC) in quasi-2D trapped gases and find that well below the transition temperature T(c) the equilibrium state is a true condensate, whereas at intermediate temperatures T

Circadian variation of the phagocytic activity of polymorphonuclear leukocytes and of various other parameters in 13 healthy male adults.

Twenty-four different laboratory parameters including the phagocytic activity (phagocytic index) of polymorphonuclear leukocytes (PMNs) and various hematologic variables were investigated in 13 young healthy men during Spring 1988 in Munich, Germany. Venous blood of these volunteers was obtained under standardized conditions at 4-h intervals over a 24-h span. All parameters were analyzed by the single cosinor method and by a Kruskal-Wallis analysis of variance (ANOVA). Statistically significant circadian rhythms were found for the number of circulating lymphocytes and leukocytes (WBCs), potassium, systolic blood pressure, phagocytic index, Quick test, heart rate, and rectal body temperature (p less than 0.05; single cosinor). For all of these parameters except WBCs, rectal body temperature, and Quick test, a temporal variation was confirmed by the ANOVA (p less than 0.05; phagocytic index: p = 0.05). The circadian acrophases of WBC, number of circulating lymphocytes, and phagocytic index were all found at about 01:00 h. This temporal coincidence of the acrophases of the phagocytic index and the number of circulating lymphocytes may reflect the modulation of phagocytosis by T lymphocytes that release cytokines known to stimulate the phagocytic activity of PMNs.

Backflow correlations for the electron gas and metallic hydrogen.

We justify and evaluate backflow three-body wave functions for a two-component system of electrons and protons. Based on the generalized Feynman-Kacs formula, many-body perturbation theory, and band structure calculations, we analyze the use and the analytical form of the backflow function from different points of view. The resulting wave functions are used in variational and diffusion Monte Carlo calculations of the electron gas and of solid and liquid metallic hydrogen. For the electron gas, the purely analytic backflow and three-body form gives lower energies than those of previous calculations. For bcc hydrogen, analytical and optimized backflow-three-body wave functions lead to energies nearly as low as those from using local density approximation orbitals in the trial wave function. However, compared to wave functions constructed from density functional solutions, backflow wave functions have the advantage of only few parameters to estimate, the ability to include easily and accurately electron-electron correlations, and that they can be directly generalized from the crystal to a disordered liquid of protons.

Results of five randomized studies on the immunomodulatory activity of preparations of Echinacea.

This article describes and discusses five placebo-controlled randomized studies investigating the immunomodulatory activity of preparations containing extracts of Echinacea in healthy volunteers. A total of 134 (18 female and 116 male) healthy volunteers between 18 and 40 years of age were studied. Two studies tested intravenous homeopathic complex preparations containing Echinacea angustifolia D1 (study 1) and D4 (study 5). Two studies (2 and 3a) tested oral alcoholic extracts of roots of E. purpurea, one study an extract of E. pallida roots (study 3b), and one study an extract of E. purpurea herb (study 4). Test and placebo preparations were applied for four (study 5) or five (studies 1-4) consecutive days. The primary outcome measure for immunomodulatory activity was the relative phagocytic activity of polymorphonuclear neutrophil granulocytes (PNG), measured in studies 1 and 2 with a microscopic method and in studies 3, 4, and 5 with two different cytometric methods. The secondary outcome measure was the number of leukocytes in peripheral venous blood. Safety was assessed by a screening program of blood and other objective parameters as well as by documentation of all subjective side effects. In studies 1 and 2 the phagocytic activity of PNG was significantly enhanced compared with placebo [maximal stimulation 22.7% (95% confidence interval 17.5-27.9%) and 54.0% (8.4-99.6%), respectively], while in the other studies no significant effects were observed. Analysis of intragroup differences revealed significant changes in phagocytic activity during the observation periods in five test and three control groups. Leukocyte number was not influenced significantly in any study. Side effects due to the test preparations could not be detected. Our studies provide evidence for immunomodulatory activity of the homeopathic combination tested in study 1 and the E. purpureae radix extract tested in study 2. The negative results of the other three studies are difficult to interpret due to the different methods for measuring phagocytosis, the relevant changes in phagocytic activity within most placebo and treatment groups during the observation period, and the small sample sizes. Future studies should be performed on patients rather than healthy volunteers and use standardized or chemically defined monopreparations of Echinacea.

[The reliability of radiologic findings for differential diagnosis of vertebral osteoporosis]. / Die Reliabilität radiologischer Befunde zur Differentialdiagnose der vertebralen Osteoporose.

BACKGROUND: Radiologically identified vertebral deformities, e.g. wedge-, fish-, or crush-vertebrae are not always a consequence of local osteoporosis. Other frequent pathomechanisms include Morbus Scheuermann, degenerative changes, overt trauma, and congenital dysplasia. This requires differential diagnosis of vertebral deformities. Radiological classification criteria have to satisfy various methodological requirements to ensure reliability of the results. METHODS: Inter-rater reliability of more than 30 radiological findings was assessed in 4 German centres of the European Vertebral Osteoporosis Study (EVOS). One hundred randomly selected EVOS cases from the West-Berlin population, each contributing 2 lateral X-rays from the thoracic and lumbar spine respectively, were independently evaluated by 7 observers. All observers were medical doctors, 4 of them heads or members of clinical radiological departments. Thus each observer read 200 radiographs. Radiological alterations in the form and structure of 13 vertebrale which were considered to be relevant for the differential diagnosis of osteoporosis were recorded in a standardized documentation form. Additionally global judgements (e. g. "osteoporotic spine" yes/no) were required. To quantify agreement Fleiss' kappa (kappa) for nominal data and multiple observers was used.

[Thrombosis of mechanical tricuspid valve. Thrombolysis should be considered as a first line approach]. / Trombotiserad mekanisk trikuspidalklaff. Trombolys bör övervägas i första hand.

This report describes a 60-year old man who three years earlier, due to tricuspid endocarditis, had undergone surgery entailing insuturation of a Carbomedic valve prosthesis. He was admitted via the emergency room with clinical signs of right heart failure, and he reported that he had not heard the valve sound for two to three weeks. Cineradiography revealed a dysfunction of the tricuspid valve prosthesis, with the bileaflet tilting disc closed in the opening position. Thrombolytic therapy was successful. We review the literature on obstructed mechanical prosthetic valves and on the use of thrombolysis.