Observation of three-body correlations for photons coupled to a Rydberg superatom

We report on the experimental observation of non-trivial three-photon correlations imprinted onto initially uncorrelated photons through interaction with a single Rydberg superatom. Exploiting the Rydberg blockade mechanism, we turn a cold atomic cloud into a single effective emitter with collectively enhanced coupling to a focused photonic mode which gives rise to clear signatures in the connected part of the three-body correlation function of the out-going photons. We show that our results are in good agreement with a quantitative model for a single, strongly coupled Rydberg superatom. Furthermore, we present an idealized but exactly solvable model of a single two-level system coupled to a photonic mode, which allows for an interpretation of our experimental observations in terms of bound states and scattering states

I (don\u27t) see what you typed there! Shoulder-surfing resistant password entry on gamepads

Using gamepad-driven devices like games consoles is an activity frequently shared with others. Thus, shoulder-surfing is a serious threat. To address this threat, we present the first investigation of shoulder-surfing resistant text password entry on gamepads by (1) identifying the requirements of this context; (2) assessing whether shoulder-surfing resistant authentication schemes proposed in non-gamepad contexts can be viably adapted to meet these requirements; (3) proposing ``Colorwheels\u27\u27, a novel shoulder-surfing resistant authentication scheme specifically geared towards this context; (4) using two different methodologies proposed in the literature for evaluating shoulder-surfing resistance to compare ``Colorwheels\u27\u27, on-screen keyboards (the de facto standard in this context), and an existing shoulder-surfing resistant scheme which we identified during our assessment and adapted for the gamepad context; (5) evaluating all three schemes regarding their usability. Having applied different methodologies to measure shoulder-surfing resistance, we discuss their strengths and pitfalls and derive recommendations for future research

Probabilistic tractography in the ventrolateral thalamic nucleus: cerebellar and pallidal connections

The ventrolateral thalamic nucleus (VL), as part of the ‘motor thalamus’, is main relay station of cerebellar and pallidal projections. It comprises anterior (VLa) and posterior (VLpd and VLpv) subnuclei. Though the fibre architecture of cerebellar and pallidal projections to of the VL nucleus has already been focus in a numerous amount of in vitro studies mainly in animals, probabilistic tractography now offers the possibility of an in vivo comparison in healthy humans. In this study we performed a (a) qualitative and (b) quantitative examination of VL-cerebellar and VL-pallidal pathways and compared the probability distributions between both projection fields in the VL after an (I) atlas-based and (II) manual-based segmentation procedure. Both procedures led to high congruent results of cerebellar and pallidal connectivity distributions: the maximum of pallidal projections was located in anterior and medial parts of the VL nucleus, whereas cerebellar connectivity was more located in lateral and posterior parts. The median connectivity for cerebellar connections in both approaches (manual and atlas-based segmentation) was VLa > VLpv > VLpd, whereas the pallidal median connectivity was VLa ~ VLpv > VLpd in the atlas-based approach and VLpv > VLa > VLpd in the manual approach.Peer reviewe

Individualised nutritional support in medical inpatients: a practical guideline

Malnutrition has been defined as a “state resulting from lack of uptake or intake of nutrition, leading to altered body composition and body cell mass, as well as to diminished physical and mental function and impaired clinical outcome from disease.” Particularly for the multimorbid medical inpatient, there are multiple research studies linking malnutrition to adverse clinical outcomes independent of type of acute and chronic illnesses. Importantly, recent trials have shown that malnutrition is indeed a modifiable risk factor with specific individualised nutritional support interventions started at hospital admission having positive effects on the risk of complications, mortality, functional outcomes, rehospitalisation and quality of life. Understanding the optimal use of nutritional support in patients with acute illness is complex – as timing, route of delivery, and the amount and type of nutrients can all affect patient outcome. The aim of this narrative review is to provide a practical guideline for pragmatic and evidence-based assessment and treatment of medical inpatients at nutritional risk. We thereby focus on screening, patient assessment, definition of individual nutritional goals and nutritional support interventions that help patients to reach these goals. Keywords: nutrition, malnutrition, nutritional suppor

Nutritional support in hospitalised patients with diabetes and risk for malnutrition: a secondary analysis of an investigator-initiated, Swiss, randomised controlled multicentre trial.

OBJECTIVES The main objective of this study was to investigate the effects of nutritional support on mortality in hospitalised patients with diabetes and nutritional risk participating in the Effect of early nutritional support on Frailty, Functional Outcomes, and Recovery of malnourished medical inpatients Trial (EFFORT) trial. DESIGN Secondary analysis of a Swiss-wide multicentre, randomised controlled trial. PARTICIPANTS Patients with diabetes and risk for malnutrition. INTERVENTIONS Individualised nutritional support versus usual care. PRIMARY OUTCOME MEASURE 30-day all-cause mortality. RESULTS Of the 2028 patients included in the original trial, 445 patients were diagnosed with diabetes and included in this analysis. In terms of efficacy of nutritional therapy, there was a 25% lower risk for mortality in patients with diabetes receiving nutritional support compared with controls (7% vs 10%, adjusted HR 0.75 (95% CI 0.39 to 1.43)), a finding that was not statistically significant but similar to the overall trial effects with no evidence of interaction (p=0.92). Regarding safety of nutritional therapy, there was no increase in diabetes-specific complications associated with nutritional support, particularly there was no increase in risk for hyperglycaemia (adjusted OR 0.97, 95% CI 0.56 to 1.67 p=0.90). CONCLUSION Patients with diabetes and malnutrition in the hospital setting have a particularly high risk for adverse outcomes and mortality. Individualised nutritional support reduced mortality in this secondary analysis of a randomized trial, but this effect was not significant calling for further large-scale trials in this vhighly ulnerable patient population. TRIAL REGISTRATION NUMBER NCT02517476

Stichprobenziehung für Migrantenpopulationen in fünf Ländern: eine Darstellung des methodischen Vorgehens im PIONEUR-Projekt

'Dieser Artikel stellt eine innovative Form der Stichprobenziehung für Migrantenpopulationen dar, die bei der Durchführung einer Telefonumfrage des von der Europächen Kommission im 5. Rahmenprogramm geförderten Projekts PIONEUR ('Pioneers of Europe's Integration 'from below': Mobility and the emergence of European Identity among National and Foreign Citizens in the EU') zur Anwendung kam. Das Grundprinzip besteht aus der Bestimmung der häufigsten Namen für die einzelnen Migrantengruppen über eine statistische Analyse der Telefonbücher der Herkunftsländer und der anschließenden Identifikation dieser Gruppen in den Telefonbüchern der Zielländer. Die Qualität der resultierenden Nettostichprobe wird für Deutschland im Vergleich zu Daten des Mikrozensus 2004 evaluiert.' (Autorenreferat)'This article describes the innovative way of sampling migrant populations that was used for a telephone survey of the PIONEUR project ('Pioneers of Europe's Integration 'from below': Mobility and the emergence of European Identity among National and Foreign Citizens in the EU'), funded by the European Commission in the 5th Framework Programme. The basic principle consists of determining the most frequent names for the different migrant groups by a statistical analysis of the telephone directories of the countries of origin and a subsequent identification of these groups in the telephone directories of the countries of residence. The quality of the resulting net sample for Germany is evaluated by a comparison with data of the Microcensus 2004.' (author's abstract)

Handgrip Strength Values Depend on Tumor Entity and Predict 180-Day Mortality in Malnourished Cancer Patients.

BACKGROUND Cancer-related malnutrition is a prevalent condition associated with a loss of muscle mass and impaired functional status, leading to immunodeficiency, impaired quality of life and adverse clinical outcomes. Handgrip strength (HGS) is a practical measure to assess muscle strength in individual patients during clinical practice. However, HGS reference values refer to populations of healthy people, and population-specific values, such as those in the population of cancer patients, still need to be defined. METHODS Within a secondary analysis of a previous randomized controlled nutritional trial focusing on hospitalized cancer patients at risk for malnutrition, we investigated sex-specific HGS values stratified by age and tumor entity. Additionally, we examined the association between HGS and 180-day all-cause mortality. RESULTS We included data from 628 cancer patients, which were collected from eight hospitals in Switzerland. Depending on the age of patients, HGS varied among female patients from 7 kg to 26 kg and among male patients from 20.5 kg to 44 kg. An incremental decrease in handgrip strength by 10 kg resulted in a 50% increase in 180-day all-cause mortality (odds ratio 1.52 (95%CI 1.19 to 1.94), p = 0.001). CONCLUSION Our data provide evidence of the prognostic implications of HGS measurement in cancer patients and validate the prognostic value of handgrip strength in regard to long-term mortality. In addition, our results provide expected HGS values in the population of hospitalized malnourished cancer patients, which may allow better interpretation of values in individual patients

Association of admission cortisol levels with outcomes and treatment response in patients at nutritional risk : A secondary analysis of a randomized clinical trial.

INTRODUCTION Cortisol is a metabolically active stress hormone that may play a role in the pathogenesis of malnutrition. We studied the association between admission cortisol levels and nutritional parameters, disease severity, and response to nutritional support among medical inpatients at nutritional risk. METHODS Admission cortisol was measured in a subset of 764 patients participating in the Effect of Early Nutritional Support on Frailty, Functional Outcomes, and Recovery of Malnourished Medical Inpatients Trial (EFFORT), a multicentre, randomized-controlled trial that compared individualized nutritional support with usual nutritional care. RESULTS Overall, mean cortisol levels were 570 (± 293) nmol/L and significantly higher in patients with high nutritional risk (NRS ≥ 5) and in patients reporting loss of appetite. Cortisol levels in the highest quartile (> 723 nmol/l) were associated with adverse outcomes including mortality at 30 days and 5 years (adjusted HR 2.31, [95%CI 1.47 to 3.62], p = 0.001 and 1.51, [95%CI 1.23 to 1.87], p < 0.001). Nutritional treatment tended to be more effective regarding mortality reduction in patients with high vs. low cortisol levels (adjusted OR of nutritional support 0.54, [95%CI 0.24 to 1.24] vs. OR 1.11, [95%CI 0.6 to 2.04], p for interaction = 0.134). This effect was most pronounced in the subgroup of patients with severe malnutrition (NRS 2002 ≥ 5, p for interaction = 0.047). CONCLUSION This secondary analysis of a randomized nutritional trial suggests that cortisol levels are linked to nutritional and clinical outcome among multimorbid medical patients at nutritional risk and may help to improve risk assessment, as well as response to nutritional treatment. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02517476

Site-selective modification of proteins for the synthesis of structurally defined multivalent scaffolds

Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG geförderten) Allianz- bzw. Nationallizenz frei zugänglich.This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.A combination of classical site-directed mutagenesis, genetic code engineering and bioorthogonal reactions delivered a chemically modified barstar protein with one or four carbohydrates installed at specific residues. These protein conjugates were employed in multivalent binding studies, which support the use of proteins as structurally defined scaffolds for the presentation of multivalent ligands.DFG, SFB 765, Multivalenz als chemisches Organisations- und Wirkprinzip: Neue Architekturen, Funktionen und Anwendunge

management and grading of egfr inhibitor induced cutaneous toxicity

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