Electromagnetic-field quantization and spontaneous decay in left-handed media

We present a quantization scheme for the electromagnetic field interacting with atomic systems in the presence of dispersing and absorbing magnetodielectric media, including left-handed material having negative real part of the refractive index. The theory is applied to the spontaneous decay of a two-level atom at the center of a spherical free-space cavity surrounded by magnetodielectric matter of overlapping band-gap zones. Results for both big and small cavities are presented, and the problem of local-field corrections within the real-cavity model is addressed.Comment: 15 pages, 5 figures, RevTe

Effect of aliskiren on post-discharge outcomes among diabetic and non-diabetic patients hospitalized for heart failure: insights from the ASTRONAUT trial

Aims The objective of the Aliskiren Trial on Acute Heart Failure Outcomes (ASTRONAUT) was to determine whether aliskiren, a direct renin inhibitor, would improve post-discharge outcomes in patients with hospitalization for heart failure (HHF) with reduced ejection fraction. Pre-specified subgroup analyses suggested potential heterogeneity in post-discharge outcomes with aliskiren in patients with and without baseline diabetes mellitus (DM). Methods and results ASTRONAUT included 953 patients without DM (aliskiren 489; placebo 464) and 662 patients with DM (aliskiren 319; placebo 343) (as reported by study investigators). Study endpoints included the first occurrence of cardiovascular death or HHF within 6 and 12 months, all-cause death within 6 and 12 months, and change from baseline in N-terminal pro-B-type natriuretic peptide (NT-proBNP) at 1, 6, and 12 months. Data regarding risk of hyperkalaemia, renal impairment, and hypotension, and changes in additional serum biomarkers were collected. The effect of aliskiren on cardiovascular death or HHF within 6 months (primary endpoint) did not significantly differ by baseline DM status (P = 0.08 for interaction), but reached statistical significance at 12 months (non-DM: HR: 0.80, 95% CI: 0.64-0.99; DM: HR: 1.16, 95% CI: 0.91-1.47; P = 0.03 for interaction). Risk of 12-month all-cause death with aliskiren significantly differed by the presence of baseline DM (non-DM: HR: 0.69, 95% CI: 0.50-0.94; DM: HR: 1.64, 95% CI: 1.15-2.33; P < 0.01 for interaction). Among non-diabetics, aliskiren significantly reduced NT-proBNP through 6 months and plasma troponin I and aldosterone through 12 months, as compared to placebo. Among diabetic patients, aliskiren reduced plasma troponin I and aldosterone relative to placebo through 1 month only. There was a trend towards differing risk of post-baseline potassium ≥6 mmol/L with aliskiren by underlying DM status (non-DM: HR: 1.17, 95% CI: 0.71-1.93; DM: HR: 2.39, 95% CI: 1.30-4.42; P = 0.07 for interaction). Conclusion This pre-specified subgroup analysis from the ASTRONAUT trial generates the hypothesis that the addition of aliskiren to standard HHF therapy in non-diabetic patients is generally well-tolerated and improves post-discharge outcomes and biomarker profiles. In contrast, diabetic patients receiving aliskiren appear to have worse post-discharge outcomes. Future prospective investigations are needed to confirm potential benefits of renin inhibition in a large cohort of HHF patients without D

Guidelines for the management of biliary tract and ampullary carcinomas: surgical treatment

The only curative treatment in biliary tract cancer is surgical treatment. Therefore, the suitability of curative resection should be investigated in the first place. In the presence of metastasis to the liver, lung, peritoneum, or distant lymph nodes, curative resection is not suitable. No definite consensus has been reached on local extension factors and curability. Measures of hepatic functional reserve in the jaundiced liver include future liver remnant volume and the indocyanine green (ICG) clearance test. Preoperative portal vein embolization may be considered in patients in whom right hepatectomy or more, or hepatectomy with a resection rate exceeding 50%–60% is planned. Postoperative complications and surgery-related mortality may be reduced with the use of portal vein embolization. Although hepatectomy and/or pancreaticoduodenectomy are preferable for the curative resection of bile duct cancer, extrahepatic bile duct resection alone is also considered in patients for whom it is judged that curative resection would be achieved after a strict diagnosis of its local extension. Also, combined caudate lobe resection is recommended for hilar cholangiocarcinoma. Because the prognosis of patients treated with combined portal vein resection is significantly better than that of unresected patients, combined portal vein resection may be carried out. Prognostic factors after resection for bile duct cancer include positive surgical margins, especially in the ductal stump; lymph node metastasis; perineural invasion; and combined vascular resection due to portal vein and/or hepatic artery invasion. For patients with suspected gallbladder cancer, laparoscopic cholecystectomy is not recommended, and open cholecystectomy should be performed as a rule. When gallbladder cancer invading the subserosal layer or deeper has been detected after simple cholecystectomy, additional resection should be considered. Prognostic factors after resection for gallbladder cancer include the depth of mural invasion; lymph node metastasis; extramural extension, especially into the hepatoduodenal ligament; perineural invasion; and the degree of curability. Pancreaticoduodenectomy is indicated for ampullary carcinoma, and limited operation is also indicated for carcinoma in adenoma. The prognostic factors after resection for ampullary carcinoma include lymph node metastasis, pancreatic invasion, and perineural invasion

Preoperative percutaneous portal vein embolization: evaluation of adverse events in 188 patients.

PURPOSE: To retrospectively assess the frequency of adverse events related to percutaneous preoperative portal vein embolization (PPVE). MATERIALS AND METHODS: Institutional review board did not require its approval or patient informed consent for this study. The adverse events that occurred during PPVE or until planned hepatic surgery was performed or cancelled were retrospectively obtained from clinical, imaging, and laboratory data files in 188 patients (109 male and 79 female patients; mean age, 60 years; range, 16-78 years). Liver resection was planned for metastases (n = 137), hepatocarcinoma (n = 31), cholangiocarcinoma (n = 15), fibrolamellar hepatoma (n = 1), and benign disease (n = 4). PPVE was performed with a single-lumen 5-F catheter and a contralateral approach with n-butyl cyanoacrylate mixed with iodized oil as the main embolic agent. The rate of complications in patients with cirrhosis was compared with that in patients without cirrhosis by using the chi(2) test. RESULTS: Adverse events occurred in 24 (12.8%) of 188 patients, including 12 complications and 12 incidental imaging findings. Complications included thrombosis of the portal vein feeding the future remnant liver (n = 1); migration of emboli in the portal vein feeding the future remnant liver, which necessitated angioplasty (n = 2); hemoperitoneum (n = 1); rupture of a metastasis in the gallbladder (n = 1); transitory hemobilia (n = 1); and transient liver failure (n = 6). Incidental findings were migration of small emboli in nontargeted portal branches (n = 10) and subcapsular hematoma (n = 2). Among the 187 patients in whom PPVE was technically successful, there was a significant difference (P &lt; .001) between the occurrence of liver failure after PPVE in patients with cirrhosis (five of 30) and those without (one of 157). Sixteen liver resections were cancelled due to cancer progression (n = 12), insufficient hypertrophy of the nonembolized liver (n = 3), and complete portal thrombosis (n = 1). CONCLUSION: PPVE is a safe adjuvant technique for hypertrophy of the initially insufficient liver reserve. Post-PPVE transient liver failure is more common in patients with cirrhosis than in those without cirrhosis

Chemical composition of selected food-grade sorghum varieties grown under typical Mediterranean conditions

Sorghum is a staple food grain in many semi-arid and tropical areas of the world, notably in Sub-Saharan Africa due to its good agronomic properties in harsh environments. At present, sorghum is widely found in the dry areas of Asia (India and China), the Americas and Australia. Due to its properties as a wheat-free food, interest is increasing in cultivating sorghum in Mediterranean countries. However, little is known about how the environment of Mediterranean countries would influence the chemical composition of sorghum. Thus, research has been conducted to compare the composition of selected food-grade white sorghum hybrids grown in Foggia (southern Italy) to hybrids grown in one of the primary sorghum growing regions of the US; Kansas. The sorghum grown in Italy were found to have a higher protein content than the sample grown in Kansas, though overall grain quality was comparable between the two regions. Immunosorbent assays (ELISA) showed for all sorghum flour samples analyzed, the absence of proteins that are toxic for celiac patients

Reproducibility in density functional theory calculations of solids

NTRODUCTION The reproducibility of results is one of the underlying principles of science. An observation can only be accepted by the scientific community when it can be confirmed by independent studies. However, reproducibility does not come easily. Recent works have painfully exposed cases where previous conclusions were not upheld. The scrutiny of the scientific community has also turned to research involving computer programs, finding that reproducibility depends more strongly on implementation than commonly thought. These problems are especially relevant for property predictions of crystals and molecules, which hinge on precise computer implementations of the governing equation of quantum physics. RATIONALE This work focuses on density functional theory (DFT), a particularly popular quantum method for both academic and industrial applications. More than 15,000 DFT papers are published each year, and DFT is now increasingly used in an automated fashion to build large databases or apply multiscale techniques with limited human supervision. Therefore, the reproducibility of DFT results underlies the scientific credibility of a substantial fraction of current work in the natural and engineering sciences. A plethora of DFT computer codes are available, many of them differing considerably in their details of implementation, and each yielding a certain “precision” relative to other codes. How is one to decide for more than a few simple cases which code predicts the correct result, and which does not? We devised a procedure to assess the precision of DFT methods and used this to demonstrate reproducibility among many of the most widely used DFT codes. The essential part of this assessment is a pairwise comparison of a wide range of methods with respect to their predictions of the equations of state of the elemental crystals. This effort required the combined expertise of a large group of code developers and expert users. RESULTS We calculated equation-of-state data for four classes of DFT implementations, totaling 40 methods. Most codes agree very well, with pairwise differences that are comparable to those between different high-precision experiments. Even in the case of pseudization approaches, which largely depend on the atomic potentials used, a similar precision can be obtained as when using the full potential. The remaining deviations are due to subtle effects, such as specific numerical implementations or the treatment of relativistic terms. CONCLUSION Our work demonstrates that the precision of DFT implementations can be determined, even in the absence of one absolute reference code. Although this was not the case 5 to 10 years ago, most of the commonly used codes and methods are now found to predict essentially identical results. The established precision of DFT codes not only ensures the reproducibility of DFT predictions but also puts several past and future developments on a firmer footing. Any newly developed methodology can now be tested against the benchmark to verify whether it reaches the same level of precision. New DFT applications can be shown to have used a sufficiently precise method. Moreover, high-precision DFT calculations are essential for developing improvements to DFT methodology, such as new density functionals, which may further increase the predictive power of the simulations