Valence modulations in CeRuSn

CeRuSn exhibits an extraordinary room temperature structure at 300~K with coexistence of two types of Ce ions, namely trivalent Ce$^{3+}$ and intermediate valent Ce$^{(4-\delta)+}$, in a metallic environment. The ordered arrangement of these two Ce types on specific crystallographic sites results in a doubling of the unit cell along the $c$-axis with respect to the basic monoclinic CeCoAl-type structure. Below room temperature, structural modulation transitions with very broad hysteresis have been reported from measurements of various bulk properties. X-ray diffraction revealed that at low temperatures the doubling of the CeCoAl type structure is replaced by a different modulated ground state, approximating a near tripling of the basic CeCoAl cell. The transition is accompanied by a significant contraction of the $c$ axis. We present new x-ray absorption near-edge spectroscopy data at the Ce L$_{3}$ absorption edge, measured on a freshly cleaved surface of a CeRuSn single crystal. In contrast to a previous report, the new data exhibit small but significant variations as function of temperature that are consistent with a transition of a fraction of Ce$^{3+}$ ions to the intermediate valence state, analogous to the $\gamma \rightarrow \alpha$ transition in elemental cerium, when cooling through the structural transitions of CeRuSn. Such results in a valence-modulated state

Complex charge ordering in CeRuSn

At ambient temperatures, CeRuSn exhibits an extraordinary structure with a coexistence of two types of Ce ions in a metallic environment, namely trivalent Ce3 and intermediate valent Ce 4 amp; 8722; amp; 948; . Charge ordering produces a doubling of the unit cell along the c axis with respect to the basic monoclinic CeCoAl type structure. Below room temperature, a phase transition with very broad hysteresis has been observed in various bulk properties like electrical resistivity, magnetic susceptibility, and specific heat. The present x ray diffraction results show that at low temperatures the doubling of the CeCoAl type structure is replaced by an ill defined modulated ground state. In this state, at least three different modulation periods compete, with the dominant mode close to a tripling of the basic cell. The transition is accompanied by a significant contraction of the c axis. XANES data suggest that the average Ce valence remains constant; thus the observed c axis contraction is not due to any valence transition. We propose a qualitative structure model with modified stacking sequences of Ce3 and Ce 4 amp; 8722; amp; 948; layers in the various modulated phases. Surprisingly, far below 100 K, the modulated state is sensitive to x ray irradiation at photon fluxes available at a synchrotron. With photon fluxes of order 1012 s amp; 8722;1, the modulated ground state can be destroyed on a time scale of minutes and the doubling of the CeCoAl cell observed at room temperature is recovered. The final state is metastable at 10 K. Heating the sample above 60 K again leads to a recovery of the modulated state. Thus CeRuSn exhibits both thermally and x ray induced reversible transformations of the Ce3 Ce 4 amp; 8722; amp; 948; charge ordering pattern. Such a behavior is unique among any known intermetallic compoun

Origin of the reduced exchange bias in epitaxial FeNi(111)/CoO(111) bilayer

We have employed Soft and Hard X-ray Resonant Magnetic Scattering and Polarised Neutron Diffraction to study the magnetic interface and the bulk antiferromagnetic domain state of the archetypal epitaxial Ni$_{81}$Fe$_{19}$(111)/CoO(111) exchange biased bilayer. The combination of these scattering tools provides unprecedented detailed insights into the still incomplete understanding of some key manifestations of the exchange bias effect. We show that the several orders of magnitude difference between the expected and measured value of exchange bias field is caused by an almost anisotropic in-plane orientation of antiferromagnetic domains. Irreversible changes of their configuration lead to a training effect. This is directly seen as a change in the magnetic half order Bragg peaks after magnetization reversal. A 30 nm size of antiferromagnetic domains is extracted from the width the (1/2 1/2 1/2) antiferromagnetic magnetic peak measured both by neutron and x-ray scattering. A reduced blocking temperature as compared to the measured antiferromagnetic ordering temperature clearly corresponds to the blocking of antiferromagnetic domains. Moreover, an excellent correlation between the size of the antiferromagnetic domains, exchange bias field and frozen-in spin ratio is found, providing a comprehensive understanding of the origin of exchange bias in epitaxial systems.Comment: 8 pages, 5 figures, submitte

Developing a macro cognitive common model test bed for real world expertise

A central challenge for the common model and for Artificial General Intelligence (AGI) is the development of functional human-like agents capable of performing complex tasks in dynamic real-world environments. The cognitive test-bed model approach is a method of applying Allen Newell's Single Complex Task Analysis method to create a human-like AGI. In addition to the environment, we include expertise in the test-bed. The expertise is placed in the agent, and the agent is placed within the environment and provided with complex tasks to perform. The agent development process and agent task performance was gauged for backwards compatibility in the performance of open-ended tasks

Towards actionable international comparisons of health system performance: expert revision of the OECD framework and quality indicators

Objective To review and update the conceptual framework, indicator content and research priorities of the Organisation for Economic Cooperation and Development's (OECD) Health Care Quality Indicators (HCQI) project, after a decade of collaborative work. Design A structured assessment was carried out using a modified Delphi approach, followed by a consensus meeting, to assess the suite of HCQI for international comparisons, agree on revisions to the original framework and set priorities for research and development. Setting International group of countries participating to OECD projects. Participants Members of the OECD HCQI expert group. Results A reference matrix, based on a revised performance framework, was used to map and assess all seventy HCQI routinely calculated by the OECD expert group. A total of 21 indicators were agreed to be excluded, due to the following concerns: (i) relevance, (ii) international comparability, particularly where heterogeneous coding practices might induce bias, (iii) feasibility, when the number of countries able to report was limited and the added value did not justify sustained effort and (iv) actionability, for indicators that were unlikely to improve on the basis of targeted policy interventions. Conclusions The revised OECD framework for HCQI represents a new milestone of a long-standing international collaboration among a group of countries committed to building common ground for performance measurement. The expert group believes that the continuation of this work is paramount to provide decision makers with a validated toolbox to directly act on quality improvement strategie

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Improved risk stratification of patients with atrial fibrillation: an integrated GARFIELD-AF tool for the prediction of mortality, stroke and bleed in patients with and without anticoagulation.

OBJECTIVES: To provide an accurate, web-based tool for stratifying patients with atrial fibrillation to facilitate decisions on the potential benefits/risks of anticoagulation, based on mortality, stroke and bleeding risks. DESIGN: The new tool was developed, using stepwise regression, for all and then applied to lower risk patients. C-statistics were compared with CHA2DS2-VASc using 30-fold cross-validation to control for overfitting. External validation was undertaken in an independent dataset, Outcome Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). PARTICIPANTS: Data from 39 898 patients enrolled in the prospective GARFIELD-AF registry provided the basis for deriving and validating an integrated risk tool to predict stroke risk, mortality and bleeding risk. RESULTS: The discriminatory value of the GARFIELD-AF risk model was superior to CHA2DS2-VASc for patients with or without anticoagulation. C-statistics (95% CI) for all-cause mortality, ischaemic stroke/systemic embolism and haemorrhagic stroke/major bleeding (treated patients) were: 0.77 (0.76 to 0.78), 0.69 (0.67 to 0.71) and 0.66 (0.62 to 0.69), respectively, for the GARFIELD-AF risk models, and 0.66 (0.64-0.67), 0.64 (0.61-0.66) and 0.64 (0.61-0.68), respectively, for CHA2DS2-VASc (or HAS-BLED for bleeding). In very low to low risk patients (CHA2DS2-VASc 0 or 1 (men) and 1 or 2 (women)), the CHA2DS2-VASc and HAS-BLED (for bleeding) scores offered weak discriminatory value for mortality, stroke/systemic embolism and major bleeding. C-statistics for the GARFIELD-AF risk tool were 0.69 (0.64 to 0.75), 0.65 (0.56 to 0.73) and 0.60 (0.47 to 0.73) for each end point, respectively, versus 0.50 (0.45 to 0.55), 0.59 (0.50 to 0.67) and 0.55 (0.53 to 0.56) for CHA2DS2-VASc (or HAS-BLED for bleeding). Upon validation in the ORBIT-AF population, C-statistics showed that the GARFIELD-AF risk tool was effective for predicting 1-year all-cause mortality using the full and simplified model for all-cause mortality: C-statistics 0.75 (0.73 to 0.77) and 0.75 (0.73 to 0.77), respectively, and for predicting for any stroke or systemic embolism over 1 year, C-statistics 0.68 (0.62 to 0.74). CONCLUSIONS: Performance of the GARFIELD-AF risk tool was superior to CHA2DS2-VASc in predicting stroke and mortality and superior to HAS-BLED for bleeding, overall and in lower risk patients. The GARFIELD-AF tool has the potential for incorporation in routine electronic systems, and for the first time, permits simultaneous evaluation of ischaemic stroke, mortality and bleeding risks. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier for GARFIELD-AF (NCT01090362) and for ORBIT-AF (NCT01165710)

Two-year outcomes of patients with newly diagnosed atrial fibrillation: results from GARFIELD-AF.

AIMS: The relationship between outcomes and time after diagnosis for patients with non-valvular atrial fibrillation (NVAF) is poorly defined, especially beyond the first year. METHODS AND RESULTS: GARFIELD-AF is an ongoing, global observational study of adults with newly diagnosed NVAF. Two-year outcomes of 17 162 patients prospectively enrolled in GARFIELD-AF were analysed in light of baseline characteristics, risk profiles for stroke/systemic embolism (SE), and antithrombotic therapy. The mean (standard deviation) age was 69.8 (11.4) years, 43.8% were women, and the mean CHA2DS2-VASc score was 3.3 (1.6); 60.8% of patients were prescribed anticoagulant therapy with/without antiplatelet (AP) therapy, 27.4% AP monotherapy, and 11.8% no antithrombotic therapy. At 2-year follow-up, all-cause mortality, stroke/SE, and major bleeding had occurred at a rate (95% confidence interval) of 3.83 (3.62; 4.05), 1.25 (1.13; 1.38), and 0.70 (0.62; 0.81) per 100 person-years, respectively. Rates for all three major events were highest during the first 4 months. Congestive heart failure, acute coronary syndromes, sudden/unwitnessed death, malignancy, respiratory failure, and infection/sepsis accounted for 65% of all known causes of death and strokes for <10%. Anticoagulant treatment was associated with a 35% lower risk of death. CONCLUSION: The most frequent of the three major outcome measures was death, whose most common causes are not known to be significantly influenced by anticoagulation. This suggests that a more comprehensive approach to the management of NVAF may be needed to improve outcome. This could include, in addition to anticoagulation, interventions targeting modifiable, cause-specific risk factors for death. CLINICAL TRIAL REGISTRATION: http://www.clinicaltrials.gov. Unique identifier: NCT01090362