Atomic Displacements Enabling the Observation of the Anomalous Hall Effect in a Non-Collinear Antiferromagnet

Antiferromagnets with non-collinear spin structures display various properties that make them attractive for spintronic devices. Some of the most interesting examples are an anomalous Hall effect despite negligible magnetization and a spin Hall effect with unusual spin polarization directions. However, these effects can only be observed when the sample is set predominantly into a single antiferromagnetic domain state. This can only be achieved when the compensated spin structure is perturbed and displays weak moments due to spin canting that allows for external domain control. In thin films of cubic non-collinear antiferromagnets, this imbalance is previously assumed to require tetragonal distortions induced by substrate strain. Here, it is shown that in Mn₃ SnN and Mn₃ GaN, spin canting is due to structural symmetry lowering induced by large displacements of the magnetic manganese atoms away from high-symmetry positions. These displacements remain hidden in X-ray diffraction when only probing the lattice metric and require measurement of a large set of scattering vectors to resolve the local atomic positions. In Mn₃ SnN, the induced net moments enable the observation of the anomalous Hall effect with an unusual temperature dependence, which is conjectured to result from a bulk-like temperature-dependent coherent spin rotation within the kagome plane.

Assessing What Matters to People Affected by Alzheimer's Disease: A Quantitative Analysis

INTRODUCTION

In this phase of the ongoing What Matters Most study series, designed to evaluate concepts that are meaningful to people affected by Alzheimer's disease (AD), we quantified the importance of symptoms, impacts, and outcomes of AD to people at risk for or with AD and care partners of people with AD.

METHODS

We administered a web-based survey to individuals at risk for or with AD (Group 1: unimpaired cognition with evidence of AD pathology; Group 2: AD risk factors and subjective cognitive complaints/mild cognitive impairment; Group 3: mild AD) and to care partners of individuals with moderate AD (Group 4) or severe AD (Group 5). Respondents rated the importance of 42 symptoms, impacts, and outcomes on a scale ranging from 1 ("not at all important") to 5 ("extremely important").

RESULTS

Among the 274 respondents (70.4% female; 63.1% white), over half of patient respondents rated all 42 items as "very important" or "extremely important," while care partners rated fewer items as "very important" or "extremely important." Among the three patient groups, the minimum (maximum) mean importance rating for any item was 3.4 (4.6), indicating that all items were at least moderately to very important. Among care partners of people with moderate or severe AD, the minimum (maximum) mean importance rating was 2.1 (4.4), indicating that most items were rated as at least moderately important. Overall, taking medications correctly, not feeling down or depressed, and staying safe had the highest importance ratings among both patients and care partners, regardless of AD phase.

CONCLUSION

Concepts of importance to individuals affected by AD go beyond the common understanding of "cognition" or "function" alone, reflecting a desire to maintain independence, overall physical and mental health, emotional well-being, and safety. Preservation of these attributes may be key to understanding whether interventions deliver clinically meaningful outcomes.

Varicella in the Neonatal ICU due to the Varicella Vaccine Oka Strain

BACKGROUND

Varicella vaccination of non-immune post-partum women is recommended to reduce the risk of chickenpox in mothers and their infants. Though rare, transmission of the varicella vaccine strain vOka can occur from recent vaccinees to non-immune contacts who usually develop mild chickenpox.

METHODS/RESULTS

Here we describe an infant hospitalized in the neonatal ICU with vaccine-strain varicella due to transmission from their mother who received the varicella vaccine post-partum. We describe the infection prevention and control strategies implemented to prevent further transmission.

CONCLUSION

Vaccine-strain varicella transmission from mother to infant is a rare event and its occurrence in the neonatal ICU setting can be challenging. Anticipatory guidance for mothers vaccinated in the postpartum period and support of parents of an infected infant are recommended.

Setting of the magnetic structure of chiral kagome antiferromagnets by a seeded spin-orbit torque

The current-induced spin-orbit torque switching of ferromagnets has had huge impact in spintronics. However, short spin-diffusion lengths limit the thickness of switchable ferromagnetic layers, thereby limiting their thermal stability. Here, we report a previously unobserved seeded spin-orbit torque (SSOT) by which current can set the magnetic states of even thick layers of the chiral kagome antiferromagnet Mn₃Sn. The mechanism involves setting the orientation of the antiferromagnetic domains in a thin region at the interface with spin currents arising from an adjacent heavy metal while also heating the layer above its magnetic ordering temperature. This interface region seeds the resulting spin texture of the entire layer as it cools down and, thereby, overcomes the thickness limitation of conventional spin-orbit torques. SSOT switching in Mn₃Sn can be extended beyond chiral antiferromagnets to diverse magnetic systems and provides a path toward the development of highly efficient, high-speed, and thermally stable spintronic devices.

Intrinsic 2D-XY ferromagnetism in a van der Waals monolayer

[Figure: see text].

Dosimetric Comparisons of Simulation Techniques for Left-Sided Breast Cancer in the COVID-19 Era: Techniques to Reduce Viral Transmission and Respect the Therapeutic Ratio

Background

The COVID-19 pandemic challenges our ability to safely treat breast cancer patients and requires revisiting current techniques to evaluate optimal strategies. Potential long-term sequelae of breast radiation have been addressed by deep inspiration breath-hold (DIBH), prone positioning, and four-dimensional computed tomography (4DCT) average intensity projection (AveIP)-based planning techniques. Dosimetric comparisons to determine the optimal technique to minimize the normal tissue dose for left-sided breast cancers have not been performed.

Methods

Ten patients with left-sided, early-stage breast cancer undergoing whole breast radiation were simulated in the prone position, supine with DIBH, and with a free-breathing 4DCT scan. The target and organs at risk (OAR) contours were delineated in all scans. Target volume coverage and OAR doses were assessed. One-way analysis of variance (ANOVA) and Kruskal-Wallis one-way ANOVA were used to detect differences in dosimetric parameters among the different treatment plans. Significance was set as p < 0.05.

Results

We demonstrate differences in heart and lung dose by the simulation technique. The mean heart doses in the prone, DIBH, and AveIP plans were 129 cGy, 154 cGy, and 262 cGy, respectively (p=0.02). The lung V20 in the prone, DIBH, and AveIP groups was 0.5%, 10.3% and 9.5%, respectively (p <0.001). Regardless of technique, lumpectomy planning target volume (PTV) coverage did not differ between the three plans with 95% of the lumpectomy PTV volume covered by 100.4% in prone plans, 98.5% in AveIP plans, and 99.3% in DIBH plans (p=0.7).

Conclusions

Prone positioning provides dosimetric advantages as compared to DIBH. When infection risks are considered as in the current coronavirus disease 2019 (COVID-19) pandemic, prone plans have advantages in reducing the risk of disease transmission. In instances where prone positioning is not feasible, obtaining an AveIP simulation may be useful in more accurately assessing heart and lung toxicity and informing a risk/benefit discussion of DIBH vs free breath-hold techniques.

Prophylactic cranial irradiation or MRI surveillance for extensive stage small cell lung cancer

The treatment paradigm for extensive stage small cell lung cancer (ES-SCLC) is evolving. Prophylactic cranial irradiation (PCI) has long been considered a component of standard treatment in patients with extensive stage disease who respond to chemotherapy. However, in the modern era of magnetic resonance imaging, the role of PCI has become an area of controversy following conflicting level I evidence. Due to conflicting data and toxicity concerns, the routine use of PCI has declined. Recent improvements in systemic disease control with the use of immunotherapy and reductions in the toxicity attributable to PCI with hippocampal avoidance and memantine have reignited the discussion. As such, we present here a narrative review of PCI with a focus on historical milestones, randomized data, risk mitigation and future directions.

The Impact of Prostate Cancer Treatment on Quality of Life: A Narrative Review with a Focus on Randomized Data

Despite excellent oncologic outcomes, the management of localized prostate cancer remains complex and is dependent on multiple factors, including patient life expectancy, medical comorbidities, tumor characteristics, and genetic risk factors. Decades of iterative clinical trials have improved the optimization and utilization of surgical and radiation-based modalities, as well as their combinatorial use with anti-androgen and systemic therapies. While cure rates are high and converging on equivalent disease control should an upfront surgical or radiotherapeutic approach be optimized, the long-term side effects of surgical and radiation-based treatments can differ significantly in nature. Decisions regarding the selection of therapy are therefore best made in an informed and shared medical decision-making process between clinician and patient with respect to cancer control as well as adverse effects. We outline in this narrative review an understanding regarding implications of surgical and radiation treatment on quality of life after treatment, and how these data may be considered in the context of advising patients regarding the selection of therapy. This narrative review largely focuses on the quality of life data obtained from prospective randomized trials of men treated for prostate cancer. We believe this provides the best assessment of the quality of life and can be used to inform patients when making treatment decisions.

Topological Hall Signatures of Two Chiral Spin Textures Hosted in a Single Tetragonal Inverse Heusler Thin Film

Magnetic skyrmions and antiskyrmions are observed in material classes with different crystal symmetries, where the Dzyaloshinskii-Moriya interaction stabilizes either skyrmions or antiskyrmions. Here, we report the observation of two distinct peaks in the topological Hall effect in a thin film of Mn₂RhSn. Utilizing a phenomenological approach and electronic transport simulations, these topological Hall effect features are attributed to be direct signatures of two topologically distinct chiral spin objects, namely, skyrmions and antiskyrmions. Topological Hall effect studies allow us to determine the existence of these two topological objects over a wide range of temperature and magnetic fields. In particular, we find skyrmions to be stable at low temperatures, suggesting the increased importance of dipolar interactions.

Impact of Sarcopenia on Survival in Patients With Early-Stage Lung Cancer Treated With Stereotactic Body Radiation Therapy

Background

Sarcopenia has been associated with poor survival among cancer patients. Normalized total psoas area (NTPA) has been used as a surrogate for defining sarcopenia. Few data exist characterizing the impact of sarcopenia and other metrics of fitness on clinical outcomes in patients with early-stage non-small cell lung cancer (NSCLC) treated non-invasively with stereotactic body radiotherapy (SBRT).

Methods

To assess the association between sarcopenia and clinical outcomes, we conducted a retrospective analysis of consecutive patients treated with SBRT from 2013 to 2019 . Overall survival (OS), local failure free survival (LFS), distant failure free survival (DFS), NTPA, body mass index (BMI), and Charlson comorbidity index (CCI) were included for analysis. NTPA was calculated by measuring the psoas volume at the L3 vertebra and normalizing for patient height and gender. Survival functions were evaluated using the Kaplan-Meier method. Log-rank test and Cox-proportional hazards were performed for categorical and continuous variables, respectively. Significance was set as p < 0.05.

Results

A total of 91 patients met the criteria. The median age was seven years and Karnofsky Performance Status score (KPS) was 80 (range: 60-100). Approximately 79% of patients had T1 tumors. Median radiation dose and number of fractions were 60 Gy (range: 45-60) and 5 fractions (range: 3-5). Median NTPA was 531.16 mm²/m² (range: 90.4-1356.2). After normalization (sarcopenia: <385 mm²/m², female; <585 mm²/m^2, male), 39 patients (42.8%) had sarcopenia. NTPA had no association with OS (p = 0.7), LFS (p = 0.9), or DFS (p = 0.5). Increasing BMI was associated with improved OS (HR 0.90, 95% CI 0.83-0.98). With a median follow-up of 23.4 months, median OS was 60, 60, and 45.9 months (p = 0.37) in all patients, non-sarcopenic patients, and sarcopenic patients, respectively.

Conclusion

Sarcopenia was not associated with OS, LFS, or DFS. Increasing BMI is associated with improved OS. Future, prospective work is needed to define the impact of sarcopenia and other fitness metrics on clinical outcomes among NSCLC patients treated non-invasively with SBRT.

Target treatment with stereotactic radiation for recurrent gliomas

High grade gliomas (HGG) have a propensity to recur locally and have poor outcomes. As such, safe and effective treatment is paramount. Target treatment with stereotactic radiation allows safe re-irradiation through minimizing normal brain tissue radiation due to its high precision. In this review, we evaluated the clinical experiences using SRS and FSRT for re-irradiation in HGG. We report the radiobiological advantages and disadvantages of both modalities as well as the safety and efficacy published in current literature.

The Underappreciated Role of the Humoral Immune System and B Cells in Tumorigenesis and Cancer Therapeutics: A Review

The advent of immunotherapy has ushered in a new era in both cancer research and cancer treatment strategies. Published reviews have described potential mechanisms for therapeutic synergisms from the combination of radiation therapy and immunotherapy, largely overlooking the role of humoral immunity by only focusing on cellular immunity. Given that these 2 branches of the immune system are highly interdependent, in this review we detail both what has already been established regarding the role of humoral immunity in cancer and propose potential avenues that are ripe for further investigation and potential clinical applications.

Identification of CD37, cystatin A, and IL-23A gene expression in association with brain metastasis: analysis of a prospective trial

PURPOSE/OBJECTIVES

We aimed to assess the predictive value of a lung cancer gene panel for the development of brain metastases.

MATERIALS/METHODS

Between 2011 and 2015, 102 patients with lung cancer were prospectively enrolled in a clinical trial in which a diagnostic fine-needle aspirate was obtained. Gene expression was conducted on all samples that rendered a diagnosis of non-small cell lung cancer (NSCLC). Subsequent retrospective analysis of brain metastases-related outcomes was performed by reviewing patient electronic medical records. A competing risk multivariable regression was performed to estimate the adjusted hazard ratio for the development of brain metastases and non-brain metastases from NSCLC.

RESULTS

A total of 49 of 102 patients had died by the last follow-up. Median time of follow-up was 13 months (range 0.23-67 months). A total of 17 patients developed brain metastases. Median survival time after diagnosis of brain metastases was 3.58 months (95% confidence interval (CI) 2.17, not available). A total of 30 patients developed metastases without any evidence of brain metastases until the time of death or last follow-up. Competing risk analysis identified three genes that were downregulated differentially in the patients with brain metastases versus non-brain metastatic disease: CD37 (0.017), cystatin A (0.022), and IL-23A (0.027). Other factors associated with brain metastases include: stage T ( P ⩽ 8.3e^-6) and stage N ( P= 6.8e^-4).

CONCLUSIONS

We have identified three genes, CD37, cystatin A, and IL-23A, for which downregulation of gene expression was associated with a greater propensity for developing brain metastases. Validation of these biomarkers could have implications on surveillance patterns in patients with brain metastases from NSCLC.

Gamma Knife Stereotactic Radiosurgery for the Treatment of Brain Metastases from Primary Tumors of the Urinary Bladder

BACKGROUND/AIMS

Brain metastases from bladder cancer are rare and published outcomes data are sparse. To date, no institutions have reported a series of patients with brain metastases from bladder cancer treated with stereotactic radiosurgery (SRS). Our aim was to identify patients with brain metastases from bladder primaries treated with SRS with or without surgical resection and report the clinical outcomes.

METHODS

Patients meeting eligibility criteria at our institution between 2000 and 2017 were included. The clinical variables of interest, including overall survival (OS), local recurrence, V12, distant brain failure (DBF), and initial brain metastases velocity, were calculated. Cox proportional hazards analysis was performed to identify predictors of time-to-event outcomes.

RESULTS

A total of 14 patients were included. The median OS from the time of treatment was 2.1 months. Factors predictive of OS include intracranial resection (HR 0.21, p = 0.03). The cumulative incidence of local failure was 21% at 6 months and 30% at 12 months. The cumulative incidence of DBF at 6 and 12 months was 23 and 31%, respectively.

CONCLUSIONS

The prognosis in this patient population remains guarded. Factors associated with improved survival include intracranial resection. Future, prospective work is needed to further define optimal management.

Efimov States of Strongly Interacting Photons

We demonstrate the emergence of universal Efimov physics for interacting photons in cold gases of Rydberg atoms. We consider the behavior of three photons injected into the gas in their propagating frame, where a paraxial approximation allows us to consider them as massive particles. In contrast to atoms and nuclei, the photons have a large anisotropy between their longitudinal mass, arising from dispersion, and their transverse mass, arising from diffraction. Nevertheless, we show that, in suitably rescaled coordinates, the effective interactions become dominated by s-wave scattering near threshold and, as a result, give rise to an Efimov effect near unitarity. We show that the three-body loss of these Efimov trimers can be strongly suppressed and determine conditions under which these states are observable in current experiments. These effects can be naturally extended to probe few-body universality beyond three bodies, as well as the role of Efimov physics in the nonequilibrium, many-body regime.

Threshold Dynamics of a Semiconductor Single Atom Maser

We demonstrate a single atom maser consisting of a semiconductor double quantum dot (DQD) that is embedded in a high-quality-factor microwave cavity. A finite bias drives the DQD out of equilibrium, resulting in sequential single electron tunneling and masing. We develop a dynamic tuning protocol that allows us to controllably increase the time-averaged repumping rate of the DQD at a fixed level detuning, and quantitatively study the transition through the masing threshold. We further examine the crossover from incoherent to coherent emission by measuring the photon statistics across the masing transition. The observed threshold behavior is in agreement with an existing single atom maser theory when small corrections from lead emission are taken into account.

Precise spatio-temporal control of rapid optogenetic cell ablation with mem-KillerRed in Zebrafish

The ability to kill individual or groups of cells in vivo is important for studying cellular processes and their physiological function. Cell-specific genetically encoded photosensitizing proteins, such as KillerRed, permit spatiotemporal optogenetic ablation with low-power laser light. We report dramatically improved resolution and speed of cell targeting in the zebrafish kidney through the use of a selective plane illumination microscope (SPIM). Furthermore, through the novel incorporation of a Bessel beam into the SPIM imaging arm, we were able to improve on targeting speed and precision. The low diffraction of the Bessel beam coupled with the ability to tightly focus it through a high NA lens allowed precise, rapid targeting of subsets of cells at anatomical depth in live, developing zebrafish kidneys. We demonstrate that these specific targeting strategies significantly increase the speed of optoablation as well as fish survival.

Intolerance of uncertainty predicts increased striatal volume

Oversensitivity to uncertain future threat is usefully conceptualized as intolerance of uncertainty (IU). Neuroimaging studies of IU to date have largely focused on its relationship with brain function, but few studies have documented the association between IU and the quantitative properties of brain structure. Here, we examined potential gray and white-matter brain structural correlates of IU from 61 healthy participants. Voxel-based morphometric analysis highlighted a robust positive correlation between IU and striatal volume, particularly the putamen. Conversely, tract-based spatial statistical analysis showed no evidence for a relationship between IU and the structural integrity of white-matter fiber tracts. Current results converge upon findings from individuals with anxiety disorders such as obsessive-compulsive disorder (OCD) or generalized anxiety disorder (GAD), where abnormally increased IU and striatal volume are consistently reported. They also converge with neurobehavioral data implicating the putamen in predictive coding. Most notably, the relationship between IU and striatal volume is observed at a preclinical level, suggesting that the volumetric properties of the striatum reflect the processing of uncertainty per se as it relates to this dimensional personality characteristic. Such a relationship could then potentially contribute to the onset of OCD or GAD, rather than being unique to their pathophysiology. (PsycINFO Database Record

Observation of optomechanical buckling transitions

Correlated phases of matter provide long-term stability for systems as diverse as solids, magnets and potential exotic quantum materials. Mechanical systems, such as buckling transition spring switches, can have engineered, stable configurations whose dependence on a control variable is reminiscent of non-equilibrium phase transitions. In hybrid optomechanical systems, light and matter are strongly coupled, allowing engineering of rapid changes in the force landscape, storing and processing information, and ultimately probing and controlling behaviour at the quantum level. Here we report the observation of first- and second-order buckling transitions between stable mechanical states in an optomechanical system, in which full control of the nature of the transition is obtained by means of the laser power and detuning. The underlying multiwell confining potential we create is highly tunable, with a sub-nanometre distance between potential wells. Our results enable new applications in photonics and information technology, and may enable explorations of quantum phase transitions and macroscopic quantum tunnelling in mechanical systems.

Optomechanical systems could form logic gates, but key requirements are two stable static states and the ability to switch between them. Here, the authors observe radiation-pressure induced buckling transitions in an optomechanical system, and control this transition by varying laser power and detuning.

Oral health and human papillomavirus-associated head and neck squamous cell carcinoma

BACKGROUND

Indicators of poor oral health, including smoking, have been associated with increased risk of head and neck squamous cell carcinoma, especially oropharyngeal squamous cell carcinoma (OPSCC), yet few studies have examined whether this association is modified by human papillomavirus (HPV) status.

METHODS

Data from interviews and tumor HPV status from a large population-based case-control study, the Carolina Head and Neck Cancer Study (CHANCE), were used to estimate the association between oral health indicators and smoking among 102 HPV-positive patients and 145 HPV-negative patients with OPSCC and 1396 controls. HPV status was determined by p16INK4a (p16) immunohistochemistry. Unconditional, multinomial logistic regression was used to estimate odds ratios (ORs) for all oral health indictors adjusting for important covariates.

RESULTS

Routine dental examinations were associated with a decreased risk of both HPV-negative OPSCC (OR, 0.52; 95% confidence interval [CI], 0.35-0.76) and HPV-positive OPSCC (OR, 0.55; 95% CI, 0.36-.86). Tooth mobility (a proxy for periodontal disease) increased the risk of HPV-negative disease (OR, 1.70; 95% CI, 1.18-2.43) slightly more than the risk for HPV-positive disease (OR, 1.45; 95% CI, 0.95-2.20). Ten or more pack-years of cigarette smoking were strongly associated with an increased risk of HPV-negative OPSCC (OR, 4.26; 95% CI, 2.85-6.37) and were associated less with an increased risk of HPV-positive OPSCC (OR, 1.62; 95% CI, 1.10-2.38).

CONCLUSIONS

Although HPV-positive and HPV-negative HNSCC differ significantly with respect to etiology and tumorigenesis, the current findings suggest a similar pattern of association between poor oral health, frequency of dental examinations, and both HPV-positive and HPV-negative OPSCC. Future research is required to elucidate interactions between poor oral health, tobacco use, and HPV in the development of OPSCC. Cancer 2017;71-80. © 2016 American Cancer Society.

The Inverse Relationship between the Microstructural Variability of Amygdala-Prefrontal Pathways and Trait Anxiety Is Moderated by Sex

Anxiety impacts the quality of everyday life and may facilitate the development of affective disorders, possibly through concurrent alterations in neural circuitry. Findings from multimodal neuroimaging studies suggest that trait-anxious individuals may have a reduced capacity for efficient communication between the amygdala and the ventral prefrontal cortex (vPFC). A diffusion-weighted imaging protocol with 61 directions was used to identify lateral and medial amygdala-vPFC white matter pathways. The structural integrity of both pathways was inversely correlated with self-reported levels of trait anxiety. When this mask from our first dataset was then applied to an independent validation dataset, both pathways again showed a consistent inverse relationship with trait anxiety. Importantly, a moderating effect of sex was found, demonstrating that the observed brain-anxiety relationship was stronger in females. These data reveal a potential neuroanatomical mediator of previously documented functional alterations in amygdala-prefrontal connectivity that is associated with trait anxiety, which might prove informative for future studies of psychopathology.

Prognostic significance of non-HPV16 genotypes in oropharyngeal squamous cell carcinoma

OBJECTIVES

Recent studies have found that cases with oropharyngeal squamous cell carcinoma (OPSCC) positive for HPV16 genotype have better overall survival compared with cases positive for other HPV genotypes. We sought to further replicate these studies and determine if this relationship is modified by expression of p16 tumor suppressor protein.

MATERIAL AND METHODS

We identified 238 OPSCC cases from the Carolina Head and Neck Cancer Study (CHANCE) study, a population based case-control study. Tumors that tested positive solely for HPV16 genotype and no other genotypes with PCR were classified as HPV16-positive. Tumors positive for any other high-risk HPV genotype were classified as non-HPV16-positive. Expression of p16 in the tumor was determined with immunohistochemistry. Follow-up time was calculated from the date of diagnosis to date of death or December 31, 2013. Overall survival was compared with the Kaplan-Meier curves and log-rank test. Hazard ratios (HR) adjusted for smoking, alcohol use, sex, race, and age was calculated with the Cox proportional hazard regression.

RESULTS

Cases with HPV16-positive OPSCC had better overall survival than cases with non-HPV16-positive OPSCC (log-rank p-value: 0.010). When restricted to OPSCC cases positive for p16 expression, the same trend continued (log-rank p-value: 0.002). In the adjusted model, cases with non-HPV16-positive OPSCC had greater risk of death compared to cases with HPV16-positive tumors (HR: 1.92; 95% CI: 1.03, 3.60).

CONCLUSIONS

This finding indicates that HPV genotyping carries valuable prognostic significance in addition to p16 status and future survival studies of OPSCC should take into account differing HPV genotypes.

Sisyphus Thermalization of Photons in a Cavity-Coupled Double Quantum Dot

We investigate the nonclassical states of light that emerge in a microwave resonator coupled to a periodically driven electron in a nanowire double quantum dot (DQD). Under certain drive configurations, we find that the resonator approaches a thermal state at the temperature of the surrounding substrate with a chemical potential given by a harmonic of the drive frequency. Away from these thermal regions we find regions of gain and loss, where the system can lase, or regions where the DQD acts as a single-photon source. These effects are observable in current devices and have broad utility for quantum optics with microwave photons.

Bisexual Galton–Watson branching processes with superadditive mating functions

For a bisexual Galton–Watson branching process with superadditive mating function there is a simple criterion for determining whether or not the process becomes extinct with probability 1, namely, that the asymptotic growth rate r should not exceed 1. When extinction is not certain (equivalently, r > 1), simple upper and lower bounds are established for the extinction probabilities. An example suggests that in the critical case that r = 1, some condition like superadditivity is essential for ultimate extinction to be certain. Some illustrative numerical comparisons of particular mating functions are made using a Poisson offspring distribution.

Optical Control of Donor Spin Qubits in Silicon

We show how to achieve optical, spin-selective transitions from the ground state to excited orbital states of group-V donors (P, As, Sb, Bi) in silicon. We consider two approaches based on either resonant, far-infrared (IR) transitions of the neutral donor or resonant, near-IR excitonic transitions. For far-IR light, we calculate the dipole matrix elements between the valley-orbit and spin-orbit split states for all the goup-V donors using effective mass theory. We then calculate the maximum rate and amount of electron-nuclear spin-polarization achievable through optical pumping with circularly polarized light. We find this approach is most promising for Bi donors due to their large spin-orbit and valley-orbit interactions. Using near-IR light, spin-selective excitation is possible for all the donors by driving a two-photon Λ-transition from the ground state to higher orbitals with even parity. We show that externally applied electric fields or strain allow similar, spin-selective Λ-transition to odd-parity excited states. We anticipate these results will be useful for future spectroscopic investigations of donors, quantum control and state preparation of donor spin qubits, and for developing a coherent interface between donor spin qubits and single photons.

Injection Locking of a Semiconductor Double Quantum Dot Micromaser

Emission linewidth is an important figure of merit for masers and lasers. We recently demonstrated a semiconductor double quantum dot (DQD) micromaser where photons are generated through single electron tunneling events. Charge noise directly couples to the DQD energy levels, resulting in a maser linewidth that is more than 100 times larger than the Schawlow-Townes prediction. Here we demonstrate a linewidth narrowing of more than a factor 10 by locking the DQD emission to a coherent tone that is injected to the input port of the cavity. We measure the injection locking range as a function of cavity input power and show that it is in agreement with the Adler equation. The position and amplitude of distortion sidebands that appear outside of the injection locking range are quantitatively examined. Our results show that this unconventional maser, which is impacted by strong charge noise and electron-phonon coupling, is well described by standard laser models.

Tibiotalocalcaneal arthrodesis with a compressive retrograde nail: A retrospective study of 59 nails

BACKGROUND

Tibiotalocalcaneal arthrodesis is an important salvage method for patients with complex hindfoot problems. This study reports the elective results of combined subtalar and ankle arthrodesis using one design of retrograde intramedullary compression nail.

METHODS

Retrospective review identified 58 patients undergoing 59 tibiotalocalcaneal arthrodesis procedures. Mean follow up was 9.15 (3-36) months with average age 60.7 (22-89) years. A function and subjective patient satisfaction questionnaire was achieved in 89%.

RESULTS

53 patients (93%) achieved union at a mean time of 4.17 months. Four patients (8%) subjectively thought the procedure was of no benefit while 42 (84%) had an excellent or good result. The mean visual analogue scale (VAS) score for preoperative functional pain was 7.46 compared to 1.98 post-operatively (p<0.001).

CONCLUSIONS

This device and technique offers an effective treatment of hindfoot pathology giving reliable compression and subsequent fusion with excellent patient satisfaction and pain relief.

LEVEL OF EVIDENCE

IV case series.

Neuroimaging and Anxiety: the Neural Substrates of Pathological and Non-pathological Anxiety

Advances in the use of noninvasive neuroimaging to study the neural correlates of pathological and non-pathological anxiety have shone new light on the underlying neural bases for both the development and manifestation of anxiety. This review summarizes the most commonly observed neural substrates of the phenotype of anxiety. We focus on the neuroimaging paradigms that have shown promise in exposing this relevant brain circuitry. In this way, we offer a broad overview of how anxiety is studied in the neuroimaging laboratory and the key findings that offer promise for future research and a clearer understanding of anxiety.

Phonon-assisted gain in a semiconductor double quantum dot maser

We develop a microscopic model for the recently demonstrated double-quantum-dot maser. In characterizing the gain of this device we find that, in addition to the direct stimulated emission of photons, there is a large contribution from the simultaneous emission of a photon and a phonon, i.e., the phonon sideband. We show that this phonon-assisted gain typically dominates the overall gain, which leads to masing. Recent experimental data are well fit with our model.

BRAIN REWARD ACTIVITY TO MASKED IN-GROUP SMILING FACES PREDICTS FRIENDSHIP DEVELOPMENT

This study examined whether neural responses in the ventral striatum (VS) to in-group facial expressions-presented without explicit awareness-could predict friendship patterns in newly arrived individuals from China six months later. Individuals who initially showed greater VS activity in response to in-group happy expressions during functional neuroimaging later made considerably more in-group friends, suggesting that VS activity might reflect reward processes that drive in-group approach behaviors.

Transcription of the Rous sarcoma virus genome in vitro and in vivo

RNA-directed DNA synthesis by detergent-disrupted virions of Rous sarcoma virus (RSV) initiates by the covalent attachment of pdA to the 3'-terminal rA of a 4S RNA hydrogen-bonded to the 70S RNA template. This 4S "primer" has structural features of tRNA and can be aminoacylated with methionine. Synthesis and integration of provirus DNA can be monitored in both permissive (duck) and nonpermissive (mouse) cells acutely infected with RSV. The results of these studies, as well as data obtained with RSV-infected mammalian cells which have reverted from a transformed to a pheno-typically normal state, indicate that integration of viral genes into the host chromosome is not sufficient cause for transformation. Pertinent features of virus-specific RNA-directed DNA synthesis in vitro and in vivo are reviewed and compared.

Smoking, internalized heterosexism, and HIV disease management among male couples

High rates of cigarette smoking have been observed among HIV-positive individuals. Smoking has been linked to HIV-related medical complications and non-AIDS defining cancers and negatively impacts on immune function and virologic control. Although internalized heterosexism has been related to smoking behaviors, little is known about associations between partners' reports of smoking, internalized heterosexism, and HIV medication management in male couples with HIV. A sample of 266 male couples completed baseline assessments for a cohort study examining relationship factors and HIV treatment. A computer-based survey assessed self-reported smoking behaviors, alcohol use, internalized heterosexism, and antiretroviral therapy (ART) adherence. HIV-positive men also provided blood samples to assess viral load. Approximately 30% of the sample reported that they are currently smoking cigarettes. After adjusting for demographic characteristics, men in a primary relationship with a partner who reported currently smoking had more than five-fold greater odds of reporting smoking. Higher levels of internalized heterosexism and financial hardship were each independently associated with greater odds of reporting smoking. Among HIV-positive men on ART (n = 371), having a partner who reported smoking was associated with almost three-fold greater odds of having a detectable viral load. Our findings add new support to the evidence of romantic partners influencing each other's health behaviors, and demonstrate an association between smoking and disease management within male couples. Future research should explore the interpersonal and social contexts of smoking in order to develop interventions that meet the unique needs of male couples.

Topologically robust transport of photons in a synthetic gauge field

Electronic transport is localized in low-dimensional disordered media. The addition of gauge fields to disordered media leads to fundamental changes in the transport properties. We implement a synthetic gauge field for photons using silicon-on-insulator technology. By determining the distribution of transport properties, we confirm that waves are localized in the bulk and localization is suppressed in edge states. Our system provides a new platform for investigating the transport properties of photons in the presence of synthetic gauge fields.

Photon emission from a cavity-coupled double quantum dot

We study a voltage biased InAs double quantum dot (DQD) that is coupled to a superconducting transmission line resonator. Inelastic tunneling in the DQD is mediated by electron phonon coupling and coupling to the cavity mode. We show that electronic transport through the DQD leads to photon emission from the cavity at a rate of 10 MHz. With a small cavity drive field, we observe a gain of up to 15 in the cavity transmission. Our results are analyzed in the context of existing theoretical models and suggest that it may be necessary to account for inelastic tunneling processes that proceed via simultaneous emission of a phonon and a photon.

Fearful, but not angry, expressions diffuse attention to peripheral targets in an attentional blink paradigm

We previously demonstrated that fearful facial expressions implicitly facilitate memory for contextual events whereas angry facial expressions do not. The current study sought to more directly address the implicit effect of fearful expressions on attention for contextual events within a classic attentional paradigm (i.e., the attentional blink) in which memory is tested on a trial-by-trial basis, thereby providing subjects with a clear, explicit attentional strategy. Neutral faces of a single gender were presented via rapid serial visual presentation (RSVP) while bordered by four gray pound signs. Participants were told to watch for a gender change within the sequence (T1). It is critical to note that the T1 face displayed a neutral, fearful, or angry expression. Subjects were then told to detect a color change (i.e., gray to green; T2) at one of the four peripheral pound sign locations appearing after T1. This T2 color change could appear at one of six temporal positions. Complementing previous attentional blink paradigms, participants were told to respond via button press immediately when a T2 target was detected. We found that, compared with the neutral T1 faces, fearful faces significantly increased target detection ability at four of the six temporal locations (all ps < .05) whereas angry expressions did not. The results of this study demonstrate that fearful facial expressions can uniquely and implicitly enhance environmental monitoring above and beyond explicit attentional effects related to task instructions.

Ultra-sensitive chip-based photonic temperature sensor using ring resonator structures

Resistance thermometry provides a time-tested method for taking temperature measurements. However, fundamental limits to resistance-based approaches has produced considerable interest in developing photonic temperature sensors to leverage advances in frequency metrology and to achieve greater mechanical and environmental stability. Here we show that silicon-based optical ring resonator devices can resolve temperature differences of 1 mK using the traditional wavelength scanning methodology. An even lower noise floor of 80 μK for measuring temperature difference is achieved in the side-of-fringe, constant power mode measurement.

Personal or relational? Examining sexual health in the context of HIV serodiscordant same-sex male couples

Couples' ability to adopt a "we" orientation has been associated with optimal health outcomes. This study examined how personal and relational motivations are uniquely associated with unprotected anal intercourse (UAI), protected anal intercourse (PAI), and the absence of sexual activity within HIV-serodiscordant same-sex male couples. HIV-positive men and their HIV-negative partners (N = 116 couples, 232 men) completed questionnaires and HIV-positive men had blood drawn for viral load. Results of a multinomial logistic regression illustrated that sexual satisfaction was positively associated with PAI among HIV-negative partners and negatively associated with PAI among HIV-positive partners. Endorsing a "we" orientation was positively associated with PAI among HIV-positive partners. Findings suggest that HIV-positive partners who espouse a "we" orientation may be willing to forgo their personal interests to protect their HIV-negative partners from HIV transmission. Couples-based interventions are warranted to help strengthen relationship dynamics to enhance the sexual health of serodiscordant couples.

Personal or relational? Examining sexual health in the context of HIV serodiscordant same-sex male couples

Couples' ability to adopt a "we" orientation has been associated with optimal health outcomes. This study examined how personal and relational motivations are uniquely associated with unprotected anal intercourse (UAI), protected anal intercourse (PAI), and the absence of sexual activity within HIV-serodiscordant same-sex male couples. HIV-positive men and their HIV-negative partners (N = 116 couples, 232 men) completed questionnaires and HIV-positive men had blood drawn for viral load. Results of a multinomial logistic regression illustrated that sexual satisfaction was positively associated with PAI among HIV-negative partners and negatively associated with PAI among HIV-positive partners. Endorsing a "we" orientation was positively associated with PAI among HIV-positive partners. Findings suggest that HIV-positive partners who espouse a "we" orientation may be willing to forgo their personal interests to protect their HIV-negative partners from HIV transmission. Couples-based interventions are warranted to help strengthen relationship dynamics to enhance the sexual health of serodiscordant couples.

Long-term clinical and functional outcome following treatment for Paget–Schroetter syndrome

Background

Effort-related thrombosis of the axillosubclavian vein (Paget–Schroetter syndrome, PSS) is uncommon. It tends to affect young, active individuals and yet consensus on management is lacking. The aim here was to analyse late outcomes in a series of patients treated for PSS using a standard protocol.

Methods

The medical records of patients treated for PSS over 16 years were analysed. Patients were divided into four groups according to their management. Clinical and functional outcomes were analysed regarding residual venous defects after treatment, and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire scores, respectively.

Results

Some 117 patients (52 men and 65 women, mean age 32 years) were included. Catheter-directed thrombolysis was successful in 42 of 56 treated patients. Thoracic outlet decompression surgery was performed in 95 patients. DASH scores improved significantly in patients treated surgically (P &lt; 0.001 to P = 0·009); early surgery had a better outcome than delayed surgery (P = 0·040). Patients who were managed conservatively showed no improvement (P = 0·116). Where venoplasty was necessary, it was successful in 18 of 25 patients. A short duration of lysis (less than 24 h) increased the risk of rethrombosis (P = 0·020). The method of postoperative anticoagulation had no influence on the rate of rethrombosis.

Conclusion

Patients treated surgically for PSS had better functional outcomes than those managed conservatively. Prompt thrombolysis and surgery was superior to delayed management with respect to rethrombosis and functional outcome.

Self-consistent measurement and state tomography of an exchange-only spin qubit

Quantum-dot spin qubits characteristically use oscillating magnetic or electric fields, or quasi-static Zeeman field gradients, to realize full qubit control. For the case of three confined electrons, exchange interaction between two pairs allows qubit rotation around two axes, hence full control, using only electrostatic gates. Here, we report initialization, full control, and single-shot readout of a three-electron exchange-driven spin qubit. Control via the exchange interaction is fast, yielding a demonstrated 75 qubit rotations in less than 2 ns. Measurement and state tomography are performed using a maximum-likelihood estimator method, allowing decoherence, leakage out of the qubit state space, and measurement fidelity to be quantified. The methods developed here are generally applicable to systems with state leakage, noisy measurements and non-orthogonal control axes.

Electrically protected resonant exchange qubits in triple quantum dots

We present a modulated microwave approach for quantum computing with qubits comprising three spins in a triple quantum dot. This approach includes single- and two-qubit gates that are protected against low-frequency electrical noise, due to an operating point with a narrowband response to high frequency electric fields. Furthermore, existing double quantum dot advances, including robust preparation and measurement via spin-to-charge conversion, are immediately applicable to the new qubit. Finally, the electric dipole terms implicit in the high frequency coupling enable strong coupling with superconducting microwave resonators, leading to more robust two-qubit gates.

Quantum-dot-based resonant exchange qubit

We introduce a solid-state qubit in which exchange interactions among confined electrons provide both the static longitudinal field and the oscillatory transverse field, allowing rapid and full qubit control via rf gate-voltage pulses. We demonstrate two-axis control at a detuning sweet spot, where leakage due to hyperfine coupling is suppressed by the large exchange gap. A π/2-gate time of 2.5 ns and a coherence time of 19 μs, using multipulse echo, are also demonstrated. Model calculations that include effects of hyperfine noise are in excellent quantitative agreement with experiment.

Performance of coagulation tests in patients on therapeutic doses of dabigatran: a cross-sectional pharmacodynamic study based on peak and trough plasma levels

BACKGROUND

Knowledge of anticoagulation status during dabigatran therapy may be desirable in certain clinical situations.

OBJECTIVE

To determine the coagulation tests that are most useful for assessing dabigatran's anticoagulant effect.

METHODS

Peak and trough blood samples from 35 patients taking dabigatran 150 mg twice daily, and one sample each from 30 non-anticoagulated individuals, were collected. Mass spectrometry and various coagulation assays were performed. 'Therapeutic range' was defined as the range of plasma dabigatran concentrations determined by mass spectrometry between the 2.5th and 97.5th percentiles of all values.

RESULTS

The therapeutic range was 27-411 ng mL(-1) . The prothrombin time (PT) and activated partial thromboplastin time (APTT), determined with multiple reagents, and activated clotting time (ACT) were insensitive to therapeutic dabigatran: 29%, 18% and 40% of samples had a normal PT, APTT, and ACT, respectively. However, normal PT, ACT and APTT ruled out dabigatran levels above the 75th percentile. The thrombin clotting time (TCT) correlated well and linearly with dabigatran levels below the 50th percentile, but was unmeasurable above it. The dilute thrombin time, ecarin clotting time and ecarin chromogenic assay showed linear correlations with dabigatran levels over a broad range, and identified therapeutic and supratherapeutic levels.

CONCLUSIONS

The prothrombin time, APTT and ACT are often normal in spite of therapeutic dabigatran plasma levels. The TCT is useful for detecting minimal dabigatran levels. The dilute thrombin time and chromogenic and clotting ecarin assays accurately identify therapeutic and supratherapeutic dabigatran levels. This trial is registered at www.clinicaltrials.gov (#NCT01588327).

The nucleus accumbens is involved in both the pursuit of social reward and the avoidance of social punishment

Human social motivation is characterized by the pursuit of social reward and the avoidance of social punishment. The ventral striatum/nucleus accumbens (VS/Nacc), in particular, has been implicated in the reward component of social motivation, i.e., the 'wanting' of social incentives like approval. However, it is unclear to what extent the VS/Nacc is involved in avoiding social punishment like disapproval, an intrinsically pleasant outcome. Thus, we conducted an event-related functional magnetic resonance imaging (fMRI) study using a social incentive delay task with dynamic video stimuli instead of static pictures as social incentives in order to examine participants' motivation for social reward gain and social punishment avoidance. As predicted, the anticipation of avoidable social punishment (i.e., disapproval) recruited the VS/Nacc in a manner that was similar to VS/Nacc activation observed during the anticipation of social reward gain (i.e., approval). Stronger VS/Nacc activity was accompanied by faster reaction times of the participants to obtain those desired outcomes. This data support the assumption that dynamic social incentives elicit robust VS/Nacc activity, which likely reflects motivation to obtain social reward and to avoid social punishment. Clinical implications regarding the involvement of the VS/Nacc in social motivation dysfunction in autism and social phobia are discussed.

Cardiac damage induced by immunization with heat-killed Trypanosoma cruzi is not antibody mediated

Cardiac inflammation that develops during infection with Trypanosoma cruzi may result in part from autoimmunity, which may occur after bystander activation, after parasite-induced cardiomyocyte damage, or molecular mimicry. A/J mice infected with T. cruzi or immunized with heat-killed T. cruzi (HKTC) develop strong autoimmunity accompanied by cardiac damage. To determine whether this cardiac damage occurs via an antibody-dependent mechanism, we analysed T. cruzi-infected and HKTC-immunized mice for the presence of autoantibodies, cardiac antibody deposition, and serum cardiac troponin I as a measure of cardiac damage. We also performed a serum transfer experiment in which sera from T. cruzi-infected and T. cruzi-immunized mice (and controls) were transferred into naïve recipients, which were then analysed for the presence of antibodies and serum troponin. Unlike T. cruzi-infected mice, T. cruzi-immunized mice did not show significant antibody deposition in the myocardium. These results indicate that antibody deposition does not precede cardiac damage and inflammation in mice immunized with or infected with T. cruzi. Serum adoptive transfer did not induce cardiac damage in any recipients. Based on these findings, we conclude that the cardiac damage induced by immunization with HKTC is not mediated by antibodies.

Simultaneous spin-charge relaxation in double quantum dots

We investigate phonon-induced spin and charge relaxation mediated by spin-orbit and hyperfine interactions for a single electron confined within a double quantum dot. A simple toy model incorporating both direct decay to the ground state of the double dot and indirect decay via an intermediate excited state yields an electron spin relaxation rate that varies nonmonotonically with the detuning between the dots. We confirm this model with experiments performed on a GaAs double dot, demonstrating that the relaxation rate exhibits the expected detuning dependence and can be electrically tuned over several orders of magnitude. Our analysis suggests that spin-orbit mediated relaxation via phonons serves as the dominant mechanism through which the double-dot electron spin-flip rate varies with detuning.

Nonlinear optics quantum computing with circuit QED

One approach to quantum information processing is to use photons as quantum bits and rely on linear optical elements for most operations. However, some optical nonlinearity is necessary to enable universal quantum computing. Here, we suggest a circuit-QED approach to nonlinear optics quantum computing in the microwave regime, including a deterministic two-photon phase gate. Our specific example uses a hybrid quantum system comprising a LC resonator coupled to a superconducting flux qubit to implement a nonlinear coupling. Compared to the self-Kerr nonlinearity, we find that our approach has improved tolerance to noise in the qubit while maintaining fast operation.

Quantum interface between an electrical circuit and a single atom

We show how to bridge the divide between atomic systems and electronic devices by engineering a coupling between the motion of a single ion and the quantized electric field of a resonant circuit. Our method can be used to couple the internal state of an ion to the quantized circuit with the same speed as the internal-state coupling between two ions. All the well-known quantum information protocols linking ion internal and motional states can be converted to protocols between circuit photons and ion internal states. Our results enable quantum interfaces between solid state qubits, atomic qubits, and light, and lay the groundwork for a direct quantum connection between electrical and atomic metrology standards.