Excitonic Photoluminescence in Semiconductor Quantum Wells: Plasma versus Excitons

Time-resolved photoluminescence spectra after nonresonant excitation show a distinct 1s resonance, independent of the existence of bound excitons. A microscopic analysis identifies excitonic and electron-hole plasma contributions. For low temperatures and low densities the excitonic emission is extremely sensitive to even minute optically active exciton populations making it possible to extract a phase diagram for incoherent excitonic populations.Comment: 9 pages, 4 figure

Comparing laparoscopic antireflux surgery with esomeprazole in the management of patients with chronic gastro-oesophageal reflux disease: a 3-year interim analysis of the LOTUS trial

BACKGROUND: With the introduction of laparoscopic antireflux surgery (LARS) for gastro-oesophageal reflux disease (GORD) along with the increasing efficacy of modern medical treatment, a direct comparison is warranted. The 3-year interim results of a randomised study comparing both the efficacy and safety of LARS and esomeprazole (ESO) are reported. METHODS: LOTUS is an open, parallel-group multicentre, randomised and controlled trial conducted in dedicated centres in 11 European countries. LARS was completed according to a standardised protocol, comprising a total fundoplication and a crural repair. Medical treatment comprised ESO 20 mg once daily, which could be increased stepwise to 40 mg once daily and then 20 mg twice daily in the case of incomplete GORD control. The primary outcome variable was time to treatment failure (Kaplan-Meier analysis). Treatment failure was defined on the basis of symptomatic relapse requiring treatment beyond that stated in the protocol. RESULTS: 554 patients were randomised, of whom 288 were allocated to LARS and 266 to ESO. The two study arms were well matched. The proportions of patients who remained in remission after 3 years were similar for the two therapies: 90% of surgical patients compared with 93% medically treated for the intention to treat population, p = 0.25 (90% vs 95% per protocol). No major unexpected postoperative complications were experienced and ESO was well tolerated. However, postfundoplication complaints remain a problem after LARS. CONCLUSIONS: Over the first 3 years of this long-term study, both laparoscopic total fundoplication and continuous ESO treatment were similarly effective and well-tolerated therapeutic strategies for providing effective control of GORD

Angle-resonant stimulated polariton amplifier

We experimentally demonstrate resonant coupling between photons and excitons in microcavities which can efficiently generate enormous single-pass optical gains approaching 100. This new parametric phenomenon appears as a sharp angular resonance of the incoming pump beam, at which the moving excitonic polaritons undergo very large changes in momentum. Ultrafast stimulated scattering is clearly identified from the exponential dependence on pump intensity. This device utilizes boson amplification induced by stimulated energy relaxation

Comparative Effectiveness of a Technology-Facilitated Depression Care Management Model in Safety-Net Primary Care Patients With Type 2 Diabetes: 6-Month Outcomes of a Large Clinical Trial.

BACKGROUND: Comorbid depression is a significant challenge for safety-net primary care systems. Team-based collaborative depression care is effective, but complex system factors in safety-net organizations impede adoption and result in persistent disparities in outcomes. Diabetes-Depression Care-management Adoption Trial (DCAT) evaluated whether depression care could be significantly improved by harnessing information and communication technologies to automate routine screening and monitoring of patient symptoms and treatment adherence and allow timely communication with providers. OBJECTIVE: The aim of this study was to compare 6-month outcomes of a technology-facilitated care model with a usual care model and a supported care model that involved team-based collaborative depression care for safety-net primary care adult patients with type 2 diabetes. METHODS: DCAT is a translational study in collaboration with Los Angeles County Department of Health Services, the second largest safety-net care system in the United States. A comparative effectiveness study with quasi-experimental design was conducted in three groups of adult patients with type 2 diabetes to compare three delivery models: usual care, supported care, and technology-facilitated care. Six-month outcomes included depression and diabetes care measures and patient-reported outcomes. Comparative treatment effects were estimated by linear or logistic regression models that used generalized propensity scores to adjust for sampling bias inherent in the nonrandomized design. RESULTS: DCAT enrolled 1406 patients (484 in usual care, 480 in supported care, and 442 in technology-facilitated care), most of whom were Hispanic or Latino and female. Compared with usual care, both the supported care and technology-facilitated care groups were associated with significant reduction in depressive symptoms measured by scores on the 9-item Patient Health Questionnaire (least squares estimate, LSE: usual care=6.35, supported care=5.05, technology-facilitated care=5.16; P value: supported care vs usual care=.02, technology-facilitated care vs usual care=.02); decreased prevalence of major depression (odds ratio, OR: supported care vs usual care=0.45, technology-facilitated care vs usual care=0.33; P value: supported care vs usual care=.02, technology-facilitated care vs usual care=.007); and reduced functional disability as measured by Sheehan Disability Scale scores (LSE: usual care=3.21, supported care=2.61, technology-facilitated care=2.59; P value: supported care vs usual care=.04, technology-facilitated care vs usual care=.03). Technology-facilitated care was significantly associated with depression remission (technology-facilitated care vs usual care: OR=2.98, P=.04); increased satisfaction with care for emotional problems among depressed patients (LSE: usual care=3.20, technology-facilitated care=3.70; P=.05); reduced total cholesterol level (LSE: usual care=176.40, technology-facilitated care=160.46; P=.01); improved satisfaction with diabetes care (LSE: usual care=4.01, technology-facilitated care=4.20; P=.05); and increased odds of taking an glycated hemoglobin test (technology-facilitated care vs usual care: OR=3.40, P\u3c.001). CONCLUSIONS: Both the technology-facilitated care and supported care delivery models showed potential to improve 6-month depression and functional disability outcomes. The technology-facilitated care model has a greater likelihood to improve depression remission, patient satisfaction, and diabetes care quality

Myocardial perfusion scintigraphy: the evidence: A consensus conference organised by the British Cardiac Society, the British Nuclear Cardiology Society and the British Nuclear Medicine Society, endorsed by the Royal College of Physicians of London and the Royal College of Radiologists

This review summarises the evidence for the role of myocardial perfusion scintigraphy (MPS) in patients with known or suspected coronary artery disease. It is the product of a consensus conference organised by the British Cardiac Society, the British Nuclear Cardiology Society and the British Nuclear Medicine Society and is endorsed by the Royal College of Physicians of London and the Royal College of Radiologists. It was used to inform the UK National Institute of Clinical Excellence in their appraisal of MPS in patients with chest pain and myocardial infarction. MPS is a well-established, non-invasive imaging technique with a large body of evidence to support its effectiveness in the diagnosis and management of angina and myocardial infarction. It is more accurate than the exercise ECG in detecting myocardial ischaemia and it is the single most powerful technique for predicting future coronary events. The high diagnostic accuracy of MPS allows reliable risk stratification and guides the selection of patients for further interventions, such as revascularisation. This in turn allows more appropriate utilisation of resources, with the potential for both improved clinical outcomes and greater cost-effectiveness. Evidence from modelling and observational studies supports the enhanced cost-effectiveness associated with MPS use. In patients presenting with stable or acute chest pain, strategies of investigation involving MPS are more cost-effective than those not using the technique. MPS also has particular advantages over alternative techniques in the management of a number of patient subgroups, including women, the elderly and those with diabetes, and its use will have a favourable impact on cost-effectiveness in these groups. MPS is already an integral part of many clinical guidelines for the investigation and management of angina and myocardial infarction. However, the technique is underutilised in the UK, as judged by the inappropriately long waiting times and by comparison with the numbers of revascularisations and coronary angiograms performed. Furthermore, MPS activity levels in this country fall far short of those in comparable European countries, with about half as many scans being undertaken per year. Currently, the number of MPS studies performed annually in the UK is 1,200/million population/year. We estimate the real need to be 4,000/million/year. The current average waiting time is 20 weeks and we recommend that clinically appropriate upper limits of waiting time are 6 weeks for routine studies and 1 week for urgent studies

Influence of Coulomb and Phonon Interaction on the Exciton Formation Dynamics in Semiconductor Heterostructures

A microscopic theory is developed to analyze the dynamics of exciton formation out of incoherent carriers in semiconductor heterostructures. The carrier Coulomb and phonon interaction is included consistently. A cluster expansion method is used to systematically truncate the hierarchy problem. By including all correlations up to the four-point (i.e. two-particle) level, the fundamental fermionic substructure of excitons is fully included. The analysis shows that the exciton formation is an intricate process where Coulomb correlations rapidly build up on a picosecond time scale while phonon dynamics leads to true exciton formation on a slow nanosecond time scale.Comment: 18 pages, 7 figure

Direct evidence of reduced dynamic scattering in the lower polariton of a semiconductor microcavity

The temperature dependent linewidths of homogeneously broadened GaAs/AlxGa1-xAs microcavity polaritons are investigated. The linewidths of the lower, middle, and upper polariton resonances are measured directly from reflection spectra at normal incidence (k‖=0). The linewidth of the lower polariton is found to be smaller than the linewidths of the middle and upper polaritons at all investigated temperatures ranging from 11 to 100 K. The results clearly show the reduction of dynamic scattering processes in the lower polariton compared to the middle and upper polaritons, in agreement with theoretical predictions in literature. A nontrivial temperature dependence of the linewidth is found and its physical origin is discussed

Bose-Einstein statistics in thermalization and photoluminescence of quantum well excitons

Quasi-equilibrium relaxational thermodynamics is developed to understand LA-phonon-assisted thermalization of Bose-Einstein distributed excitons in quantum wells. We study the quantum-statistical effects in the relaxational dynamics of the effective temperature of excitons $T = T(t)$. When $T$ is less than the degeneracy temperature $T_0$, well-developed Bose-Einstein statistics of quantum well excitons leads to nonexponential and density-dependent thermalization. At low bath temperatures $T_b \to 0$ the thermalization of quantum-statistically degenerate excitons effectively slows down and $T(t) \propto 1 / \ln t$. We also analyze the optical decay of Bose-Einstein distributed excitons in perfect quantum wells and show how nonclassical statistics influences the effective lifetime $\tau_{opt}$. In particular, $\tau_{opt}$ of a strongly degenerate gas of excitons is given by $2 \tau_R$, where $\tau_R$ is the intrinsic radiative lifetime of quasi-two-dimensional excitons. Kinetics of resonant photoluminescence of quantum well excitons during their thermalization is studied within the thermodynamic approach and taking into account Bose-Einstein statistics. We find density-dependent photoluminescence dynamics of statistically degenerate excitons. Numerical modeling of the thermalization and photoluminescence kinetics of quasi-two-dimensional excitons are given for GaAs/AlGaAs quantum wells.Comment: 19 pages, 9 figures. Phys. Rev. B (accepted for publication