Reduced healthcare utilisation following successful HCV treatment in HIV co-infected patients with mild liver disease

New direct-acting antivirals (DAA) for hepatitis C virus (HCV) infection have achieved high cure rates in many patient groups previously considered difficult-to-treat, including those HIV/HCV co-infected. The high price of these medications is likely to limit access to treatment, at least in the short term. Early treatment priority is likely to be given to those with advanced disease, but a more detailed understanding of the potential benefits in treating those with mild disease is needed. We hypothesized that successful HCV treatment within a co-infected population with mild liver disease would lead to a reduction in the use and costs of healthcare services in the 5 years following treatment completion. We performed a retrospective cohort study of HIV/HCV-co-infected patients without evidence of fibrosis/cirrhosis who received a course of HCV therapy between 2004 and 2013. Detailed analysis of healthcare utilization up to 5 years following treatment for each patient using clinical and electronic records was used to estimate healthcare costs. Sixty-three patients were investigated, of whom 48 of 63 (76.2%) achieved sustained virological response 12 weeks following completion of therapy (SVR12). Individuals achieving SVR12 incurred lower health utilization costs (£5000 per-patient) compared to (£10 775 per-patient) non-SVR patients in the 5 years after treatment. Healthcare utilization rates and costs in the immediate 5 years following treatment were significantly higher in co-infected patients with mild disease that failed to achieve SVR12. These data suggest additional value to achieving cure beyond the prevention of complications of disease

Decimation and Harmonic Inversion of Periodic Orbit Signals

We present and compare three generically applicable signal processing methods for periodic orbit quantization via harmonic inversion of semiclassical recurrence functions. In a first step of each method, a band-limited decimated periodic orbit signal is obtained by analytical frequency windowing of the periodic orbit sum. In a second step, the frequencies and amplitudes of the decimated signal are determined by either Decimated Linear Predictor, Decimated Pade Approximant, or Decimated Signal Diagonalization. These techniques, which would have been numerically unstable without the windowing, provide numerically more accurate semiclassical spectra than does the filter-diagonalization method.Comment: 22 pages, 3 figures, submitted to J. Phys.

Semiclassical Quantization by Pade Approximant to Periodic Orbit Sums

Periodic orbit quantization requires an analytic continuation of non-convergent semiclassical trace formulae. We propose a method for semiclassical quantization based upon the Pade approximant to the periodic orbit sums. The Pade approximant allows the re-summation of the typically exponentially divergent periodic orbit terms. The technique does not depend on the existence of a symbolic dynamics and can be applied to both bound and open systems. Numerical results are presented for two different systems with chaotic and regular classical dynamics, viz. the three-disk scattering system and the circle billiard.Comment: 7 pages, 3 figures, submitted to Europhys. Let

Entropy of seismic electric signals: Analysis in natural time under time-reversal

Electric signals have been recently recorded at the Earth's surface with amplitudes appreciably larger than those hitherto reported. Their entropy in natural time is smaller than that, $S_u$, of a ``uniform'' distribution. The same holds for their entropy upon time-reversal. This behavior, as supported by numerical simulations in fBm time series and in an on-off intermittency model, stems from infinitely ranged long range temporal correlations and hence these signals are probably Seismic Electric Signals (critical dynamics). The entropy fluctuations are found to increase upon approaching bursting, which reminds the behavior identifying sudden cardiac death individuals when analysing their electrocardiograms.Comment: 7 pages, 4 figures, copy of the revised version submitted to Physical Review Letters on June 29,200

Exceptional Points for Nonlinear Schroedinger Equations Describing Bose-Einstein Condensates of Ultracold Atomic Gases

The coalescence of two eigenfunctions with the same energy eigenvalue is not possible in Hermitian Hamiltonians. It is, however, a phenomenon well known from non-hermitian quantum mechanics. It can appear, e.g., for resonances in open systems, with complex energy eigenvalues. If two eigenvalues of a quantum mechanical system which depends on two or more parameters pass through such a branch point singularity at a critical set of parameters, the point in the parameter space is called an exceptional point. We will demonstrate that exceptional points occur not only for non-hermitean Hamiltonians but also in the nonlinear Schroedinger equations which describe Bose-Einstein condensates, i.e., the Gross-Pitaevskii equation for condensates with a short-range contact interaction, and with additional long-range interactions. Typically, in these condensates the exceptional points are also found to be bifurcation points in parameter space. For condensates with a gravity-like interaction between the atoms, these findings can be confirmed in an analytical way

The dilatancy-diffusion hypothesis and earthquake predictability

The dilatancy-diffusion hypothesis was one of the first attempts to predict the form of potential geophysical signals that may precede earthquakes, and hence provide a possible physical basis for earthquake prediction. The basic hypothesis has stood up well in the laboratory, where catastrophic failure of intact rocks has been observed to be associated with geophysical signals associated both with dilatancy and pore pressure changes. In contrast, the precursors invoked to determine the predicted earthquake time and event magnitude have not stood up to independent scrutiny. There are several reasons for the lack of simple scaling between the laboratory and the field scales, but key differences are those of scale in time and space and in material boundary conditions, coupled with the sheer complexity and non-linearity of the processes involved. 'Upscaling' is recognized as a difficult task in multi-scale complex systems generally and in oil and gas reservoir engineering specifically. It may however provide a clue as to why simple local laws for dilatancy and diffusion do not scale simply to bulk properties at a greater scale, even when the fracture system that controls the mechanical and hydraulic properties of the reservoir rock is itself scaleinvariant. © The Geological Society of London 2012

Bifurcations, order, and chaos in the Bose-Einstein condensation of dipolar gases

We apply a variational technique to solve the time-dependent Gross-Pitaevskii equation for Bose-Einstein condensates in which an additional dipole-dipole interaction between the atoms is present with the goal of modelling the dynamics of such condensates. We show that universal stability thresholds for the collapse of the condensates correspond to bifurcation points where always two stationary solutions of the Gross-Pitaevskii equation disappear in a tangent bifurcation, one dynamically stable and the other unstable. We point out that the thresholds also correspond to "exceptional points," i.e. branching singularities of the Hamiltonian. We analyse the dynamics of excited condensate wave functions via Poincare surfaces of section for the condensate parameters and find both regular and chaotic motion, corresponding to (quasi-) periodically oscillating and irregularly fluctuating condensates, respectively. Stable islands are found to persist up to energies well above the saddle point of the mean-field energy, alongside with collapsing modes. The results are applicable when the shape of the condensate is axisymmetric.Comment: 10 pages, 4 figures, minor changes in the text and additional reference adde

Contribution of forbidden orbits in the photoabsorption spectra of atoms and molecules in a magnetic field

In a previous work [Phys. Rev. A \textbf{66}, 0134XX (2002)] we noted a partial disagreement between quantum R-matrix and semiclassical calculations of photoabsorption spectra of molecules in a magnetic field. We show this disagreement is due to a non-vanishing contribution of processes which are forbidden according to the usual semiclassical formalism. Formulas to include these processes are obtained by using a refined stationary phase approximation. The resulting higher order in $\hbar$ contributions also account for previously unexplained ``recurrences without closed-orbits''. Quantum and semiclassical photoabsorption spectra for Rydberg atoms and molecules in a magnetic field are calculated and compared to assess the validity of the first-order forbidden orbit contributions.Comment: 12 pages, 6 figure

The Hydrogen Atom in Combined Electric and Magnetic Fields with Arbitrary Mutual Orientations

For the hydrogen atom in combined magnetic and electric fields we investigate the dependence of the quantum spectra, classical dynamics, and statistical distributions of energy levels on the mutual orientation of the two external fields. Resonance energies and oscillator strengths are obtained by exact diagonalization of the Hamiltonian in a complete basis set, even far above the ionization threshold. At high excitation energies around the Stark saddle point the eigenenergies exhibit strong level repulsions when the angle between the fields is varied. The large avoided crossings occur between states with the same approximately conserved principal quantum number, n, and this intramanifold mixing of states cannot be explained, not even qualitatively, by conventional perturbation theory. However, it is well reproduced by an extended perturbation theory which takes into account all couplings between the angular momentum and Runge-Lenz vector. The large avoided crossings are interpreted as a quantum manifestation of classical intramanifold chaos. This interpretation is supported by both classical Poincar\'e surfaces of section, which reveal a mixed regular-chaotic intramanifold dynamics, and the statistical analysis of nearest-neighbor-spacingComment: two-column version, 10 pages, REVTeX, 10 figures, uuencoded, submitted to Rhys. Rev.