Non-equilibrium dynamics of a system with Quantum Frustration

Using flow equations, equilibrium and non-equilibrium dynamics of a two-level system are investigated, which couples via non-commuting components to two independent oscillator baths. In equilibrium the two-level energy splitting is protected when the TLS is coupled symmetrically to both bath. A critical asymmetry angle separates the localized from the delocalized phase. On the other hand, real-time decoherence of a non-equilibrium initial state is for a generic initial state faster for a coupling to two baths than for a single bath.Comment: 22 pages, 9 figure

High survivin expression as a risk factor in patients with anal carcinoma treated with concurrent chemoradiotherapy

Purpose: To investigate the prognostic value of survivin expression in pretreatment specimens from patients with anal cancer treated with concurrent 5-FU and mitomycin C-based chemoradiation (CRT). Material and methods: Immunohistochemical staining for survivin was performed in pretreatment biopsies of 62 patients with anal carcinoma. Survivin expression was correlated with clinical and histopathological characteristics as well as local failure free- (LFFS), distant metastases free- (DMFS), cancer specific- (CSS), and overall survival (OS). Results: Survivin staining intensity was weak in 10%, intermediate in 48% and intense in 42% of the patients. No association between survivin expression and clinicopathologic factors (tumor stage, age and HIV status) could be shown. In univariate analysis, the level of survivin staining was significantly correlated with DMFS (low survivin vs. high survivin: 94% vs. 74%, p=0.04). T-stage, N-stage and the tumor grading were significantly associated with OS and CSS and with DMFS and LFFS, respectively. In multivariate analysis, survivin was confirmed as independent prognostic parameter for DMFS (RR, 0.04; p=0.02) and for OS (RR, 0.27; p=0.04). Conclusion: Our results demonstrated that the level of pretreatment survivin is correlated with the clinical outcome in patients with anal carcinoma treated with concurrent CRT. Further studies are warranted to elucidate the complex role of survivin for the oncologic treatment and to exploit the protein as a therapeutic target in combined modality treatment of anal cancer

Health system support and health system strengthening: two key facilitators to the implementation of ambulatory tuberculosis treatment in Uzbekistan

Uzbekistan inherited a hospital-based health system from the Soviet Union. We explore the health system-related challenges faced during the scale-up of ambulatory (outpatient) treatment for drug-susceptible and drug-resistant tuberculosis (TB) in Karakalpakstan in Uzbekistan. Semi-structured interviews were conducted with key informants of the TB services, the ministries of health and finance, and their TB control partners. Structural challenges and resource needs were both discussed as obstacles to the expansion of ambulatory TB treatment. Respondents stated need for revising the financing mechanisms of the TB services to incentivize referral to ambulatory TB treatment. An increased workload and need for transportation in ambulatory TB care were also pointed out by respondents, given the quickly rising outpatient numbers but per capita financing of outpatient care. Policy makers showed strong interest in good practice examples for financing ambulatory-based management of TB in comparable contexts and in guidance for revising the financing of the TB services in a way that strengthens ambulatory TB treatment. To facilitate changing the model of care, TB control strategies emphasizing ambulatory care in hospital-oriented health systems should anticipate health system support and strengthening needs, and provide a plan of action to resolve both. Addressing both types of needs may require not only involving TB control and health financing actors, but also increasing knowledge about viable and tested financing mechanisms that incentivize the adoption of new models of care for TB

Fairness vs. Social Welfare in Experimental Decisions

Experimental evidence from modified dictator games and simple choice situations indicates that concern for overall welfare is an important motive in human decision making. Models of inequality averse agents, as suggested by Fehr and Schmidt (1999) or Bolton and Ockenfels (2000), fall short in explaining behavior of proposers, who reduce their payoff below a fair split of the endowment to maximize social welfare, while other types of social preferences do well on these data. This has created the impression that inequality aversion is a misguided concept. This paper presents a formal model and shows that a combination of welfare concern and inequality aversion changes this result in favor of inequality aversion. It also establishes a unique link between altruism and social welfare in the proposed model.Social Preferences, Inequality Aversion, Welfare Concern, Reciprocity

Prolonged Outbreak of Mycobacterium chimaera Infection After Open-Chest Heart Surgery

A thorough epidemiological and microbiological investigation of this prolonged outbreak involving 6 open-chest heart surgery patients provided evidence for the airborne transmission of Mycobacterium chimaera, a slow-growing nontuberculous mycobacteria, from contaminated heater-cooler unit water tank

Enactment and Embodiment Impact the Recall of Object-Location Associations

The role of self-generated movement in memory retrieval has been demonstrated in enactment paradigms. However, in the context of object-location memory, the impact of action during learning has not yet been investigated, despite the ecological relevance of such behaviors. In the current project, we present new evidence that actively placing an object in a target location during learning leads to more precise, and faster, subsequent recall of the object-location associations than simply observing this placement. We further demonstrate differences in object- location memory depending on the category of stimuli that participants are engaging with by showing that images of objects with high manipulability are placed more precisely, more quickly, and more directly (mouse-tracking) than images of objects with low manipulability. We suggest that these latter differences are due to the motor information implicitly activated during processing of high manipulability items, and reflect the embodied nature of concepts. Although both enactment and manipulability impacted object-location recall, they did not interact. This research extends findings on enactment to associative encoding processes, and informs our understanding of the relationship between enactment and embodiment in human memory

Guilt causes equal or unequal division in alternating-offer bargaining

Parties in a bargaining situation may perceive guilt, a utility loss caused by receiving the larger share that is modeled in some social preferences. I extend Rubinstein (1982)'s solution of the open-ended alternating-offer bargaining problem for self-interested bargainers to a game with equally patient bargainers that exhibit a similar degree of guilt. The bargaining parties still reach agreement in the first period. If guilt is strong, they split the bargaining surplus equally. In contrast, if guilt is weak, the bargaining outcome is tilted away from the Rubinstein division towards a more unequal split. As both bargainers sensation of guilt diminishes, the bargaining outcome converges to the Rubinstein division

Inequality aversion causes equal or unequal division in alternating-offer bargaining

This note presents a solution to Rubinstein (1982)'s open-ended, alternating-offer bargaining problem for two equally patient bargainers that exhibit similar degrees of inequality aversion. Inequality-averse bargainers may perceive envy if being worse off and guilt if being better off, but they still reach agreement in the first period under complete information. If the perceived guilt is strong, then the inequality-averse bargainers split the bargaining surplus equally regardless of their degree of envy. If guilt is weak, then the agreed split is tilted away from the Rubinstein division towards a more unequal split. Envy and weak guilt have opposite effects on the bargaining outcome, and envy has a greater marginal impact than weak guilt. Similarly inequality-averse bargainers agree on the Rubinstein division if the strength of envy equals the discounted strength of guilt. As both bargainers sensation of inequality aversion diminishes, the bargaining outcome converges to the Rubinstein division