Topological enhancement of non-normality in non-Hermitian skin effects

The non-Hermitian skin effects are representative phenomena intrinsic to non-Hermitian systems: the energy spectra and eigenstates under the open boundary condition (OBC) drastically differ from those under the periodic boundary condition (PBC). Whereas a non-trivial topology under the PBC characterizes the non-Hermitian skin effects, their proper measure under the OBC has not been clarified yet. This paper reveals that topological enhancement of non-normality under the OBC accurately quantifies the non-Hermitian skin effects. Correspondingly to spectrum and state changes of the skin effects, we introduce two scalar measures of non-normality and argue that the non-Hermitian skin effects enhance both macroscopically under the OBC. We also show that the enhanced non-normality correctly describes phase transitions causing the non-Hermitian skin effects and reveals the absence of non-Hermitian skin effects protected by average symmetry. The topological enhancement of non-normality governs the perturbation sensitivity of the OBC spectra and the anomalous time-evolution dynamics through the Bauer-Fike theorem.Comment: 33 pages, 14 figure

Perspective on Reversible to Irreversible Transitions in Periodic Driven Many Body Systems and Future Directions For Classical and Quantum Systems

Reversible to irreversible (R-IR) transitions arise in numerous periodically driven collectively interacting systems that, after a certain number of driving cycles, organize into a reversible state where the particle trajectories repeat, or remain irreversible with chaotic motion. R-IR transitions were first systematically studied for periodically sheared dilute colloids, and appear in a wide variety of both soft and hard matter systems, including amorphous solids, crystals, vortices in type-II superconductors, and magnetic textures. In some cases, the reversible transition is an absorbing phase transition with a critical divergence in the organization time scale. R-IR systems can store multiple memories and exhibit return point memory. We give an overview of R-IR transitions including recent advances in the field, and discuss how the general framework of R-IR transitions could be applied to a much broader class of periodically driven nonequilibrium systems, including soft and hard condensed matter systems, astrophysics, biological systems, and social systems. Some likely candidate systems are commensurate-incommensurate states, systems exhibiting hysteresis or avalanches, and nonequilibrium pattern forming states. Periodic driving could be applied to hard condensed matter systems to see if R-IR transitions occur in metal-insulator transitions, semiconductors, electron glasses, electron nematics, cold atom systems, or Bose-Einstein condensates. R-IR transitions could also be examined in dynamical systems where synchronization or phase locking occurs. We discuss the use of complex periodic driving such as changing drive directions or multiple frequencies as a method to retain complex multiple memories. Finally, we describe features of classical and quantum time crystals that could suggest the occurrence of R-IR transitions in these systems.Comment: 25 pages, 27 figure

Teratogenic risk and contraceptive counselling in psychiatric practice: analysis of anticonvulsant therapy

<p>Background: Anticonvulsants have been used to manage psychiatric conditions for over 50 years. It is recognised that some, particularly valproate, carbamazepine and lamotrigine, are human teratogens, while others including topiramate require further investigation. We aimed to appraise the documentation of this risk by psychiatrists and review discussion around contraceptive issues.</p> <p>Methods: A retrospective review of prescribing patterns of four anticonvulsants (valproate, carbamazepine, lamotrigine and topiramate) in women of child bearing age was undertaken. Documented evidence of discussion surrounding teratogenicity and contraceptive issues was sought.</p> <p>Results: Valproate was most commonly prescribed (n=67). Evidence of teratogenic risk counselling at medication initiation was sub-optimal – 40% of individuals prescribed carbamazepine and 22% of valproate. Documentation surrounding contraceptive issues was also low- 17% of individuals prescribed carbamazepine and 13% of valproate.</p> <p>Conclusion: We found both low rates of teratogenic risk counselling and low rates of contraception advice in our cohort. Given the high rates of unplanned pregnancies combined with the relatively high risk of major congenital malformations, it is essential that a detailed appraisal of the risks and benefits associated with anticonvulsant medication occurs and is documented within patients’ psychiatric notes.</p&gt

Ultrametric spaces of branches on arborescent singularities

Let $S$ be a normal complex analytic surface singularity. We say that $S$ is arborescent if the dual graph of any resolution of it is a tree. Whenever $A,B$ are distinct branches on $S$, we denote by $A \cdot B$ their intersection number in the sense of Mumford. If $L$ is a fixed branch, we define $U_L(A,B)= (L \cdot A)(L \cdot B)(A \cdot B)^{-1}$ when $A \neq B$ and $U_L(A,A) =0$ otherwise. We generalize a theorem of P{\l}oski concerning smooth germs of surfaces, by proving that whenever $S$ is arborescent, then $U_L$ is an ultrametric on the set of branches of $S$ different from $L$. We compute the maximum of $U_L$, which gives an analog of a theorem of Teissier. We show that $U_L$ encodes topological information about the structure of the embedded resolutions of any finite set of branches. This generalizes a theorem of Favre and Jonsson concerning the case when both $S$ and $L$ are smooth. We generalize also from smooth germs to arbitrary arborescent ones their valuative interpretation of the dual trees of the resolutions of $S$. Our proofs are based in an essential way on a determinantal identity of Eisenbud and Neumann.Comment: 37 pages, 16 figures. Compared to the first version on Arxiv, il has a new section 4.3, accompanied by 2 new figures. Several passages were clarified and the typos discovered in the meantime were correcte

Stigma-directed services (Stig2Health) to improve 'linkage to care' for people living with HIV in rural Tanzania: study protocol for a nested pre-post implementation study within the Kilombero and Ulanga Antiretroviral Cohort

Background: HIV-related stigma is a major barrier to the timely linkage and retention of patients in HIV care in sub-Saharan Africa, where most people living with HIV/AIDS reside. In this implementation study we aim to evaluate the effect of stigma-directed services on linkage to care and other health outcomes in newly diagnosed HIV-positive patients. Methods: In a nested project of the Kilombero and Ulanga Antiretroviral Cohort in rural Tanzania, we conduct a prospective observational pre-post study to assess the impact of a bundle of stigma-directed services for newly diagnosed HIV positive patients. Stigma-directed services, delivered by a lay person living with HIV, are i) post-test counseling, ii) post-test video-assisted teaching, iii) group support therapy and group health education, and iv) mobile health. Patients receiving stigma services (enrolled from 1 (st) February 2020 to 31 (st) August 2021) are compared to a historical control receiving the standard of care (enrolled from 1 (st) July 2017 to 1 (st) February 2019). The primary outcome is 'linkage to care'. Secondary endpoints are retention in care, viral suppression, death and clinical failure at 6-12 months (up to 31 (st) August 2022). Self-reported stigma and depression are assessed using the Berger Stigma scale and the PHQ-9 questionnaire, respectively. The sample size calculation was based on cohort data from 2018. Assuming a pre-intervention cohort of 511 newly diagnosed adults of whom 346 (68%) were in care and on antiretroviral treatment (ART) at 2 months, a 10% increase in linkage (from 70 to 80%), a two-sided type I error rate of 5%, and 90% power, 321 adults are required for the post-implementation group. Discussion: We expect that integration of stigma-directed services leads to an increase of proportions of patients in care and on ART. The findings will provide guidance on how to integrate stigma-directed services into routine care in rural sub-Saharan Africa

Osmoregulators proline and glycine betaine counteract salinity stress in canola

Salt inundation leads to increased salinization of arable land in many arid and semi-arid regions. Until genetic solutions are found farmers and growers must either abandon salt-affected fields or use agronomic treatments that alleviate salt stress symptoms. Here, field experiments were carried out to study the effect of the osmoregulators proline at 200 mg L-1 and glycine betaine at 400 mg L-1 in counteracting the harmful effect of soil salinity stress on canola plants grown in Egypt. We assessed growth characteristics, yield and biochemical constituents. Results show first that all growth characters decreased with increasing salinity stress but applied osmoregulators alleviated these negative effects. Second, salinity stress decreased photosynthetic pigments, K and P contents, whilst increasing proline, soluble sugars, ascorbic acid, Na and Cl contents. Third, application of osmoregulators without salt stress increased photosynthetic pigments, proline, soluble sugars, N, K and P contents whilst decreasing Na and Cl contents. It is concluded that the exogenously applied osmoregulators glycine betaine and proline can fully or partially counteract the harmful effect of salinity stress on growth and yield of canola.© INRA and Springer-Verlag, France 2012

Tissue Microenvironments Define and Get Reinforced by Macrophage Phenotypes in Homeostasis or during Inflammation, Repair and Fibrosis

Current macrophage phenotype classifications are based on distinct in vitro culture conditions that do not adequately mirror complex tissue environments. In vivo monocyte progenitors populate all tissues for immune surveillance which supports the maintenance of homeostasis as well as regaining homeostasis after injury. Here we propose to classify macrophage phenotypes according to prototypical tissue environments, e.g. as they occur during homeostasis as well as during the different phases of (dermal) wound healing. In tissue necrosis and/or infection, damage- and/or pathogen-associated molecular patterns induce proinflammatory macrophages by Toll-like receptors or inflammasomes. Such classically activated macrophages contribute to further tissue inflammation and damage. Apoptotic cells and antiinflammatory cytokines dominate in postinflammatory tissues which induce macrophages to produce more antiinflammatory mediators. Similarly, tumor-associated macrophages also confer immunosuppression in tumor stroma. Insufficient parenchymal healing despite abundant growth factors pushes macrophages to gain a profibrotic phenotype and promote fibrocyte recruitment which both enforce tissue scarring. Ischemic scars are largely devoid of cytokines and growth factors so that fibrolytic macrophages that predominantly secrete proteases digest the excess extracellular matrix. Together, macrophages stabilize their surrounding tissue microenvironments by adapting different phenotypes as feed-forward mechanisms to maintain tissue homeostasis or regain it following injury. Furthermore, macrophage heterogeneity in healthy or injured tissues mirrors spatial and temporal differences in microenvironments during the various stages of tissue injury and repair. Copyright (C) 2012 S. Karger AG, Base

Intranasal Administration of poly(I:C) and LPS in BALB/c Mice Induces Airway Hyperresponsiveness and Inflammation via Different Pathways

BACKGROUND: Bacterial and viral infections are known to promote airway hyperresponsiveness (AHR) in asthmatic patients. The mechanism behind this reaction is poorly understood, but pattern recognizing Toll-like receptors (TLRs) have recently been suggested to play a role. MATERIALS AND METHODS: To explore the relation between infection-induced airway inflammation and the development of AHR, poly(I:C) activating TLR3 and LPS triggering TLR4, were chosen to represent viral and bacterial induced interactions, respectively. Female BALB/c or MyD88-deficient C57BL/6 mice were treated intranasally with either poly(I:C), LPS or PBS (vehicle for the control group), once a day, during 4 consecutive days. RESULTS: When methacholine challenge was performed on day 5, BALB/c mice responded with an increase in airway resistance. The maximal resistance was higher in the poly(I:C) and LPS treated groups than among the controls, indicating development of AHR in response to repeated TLR activation. The proportion of lymphocytes in broncheoalveolar lavage fluid (BALF) increased after poly(I:C) treatment whereas LPS enhanced the amount of neutrophils. A similar cellular pattern was seen in lung tissue. Analysis of 21 inflammatory mediators in BALF revealed that the TLR response was receptor-specific. MyD88-deficient C57BL/6 mice responded to poly (I:C) with an influx of lymphocytes, whereas LPS caused no inflammation. CONCLUSION: In vivo activation of TLR3 and TLR4 in BALB/c mice both caused AHR in conjunction with a local inflammatory reaction. The AHR appeared to be identical regardless of which TLR that was activated, whereas the inflammation exhibited a receptor specific profile in terms of both recruited cells and inflammatory mediators. The inflammatory response caused by LPS appeared to be dependent on MyD88 pathway. Altogether the presented data indicate that the development of AHR and the induction of local inflammation might be the result of two parallel events, rather than one leading to another

Epidemiology of community-onset Staphylococcus aureus infections in pediatric patients: an experience at a Children's Hospital in central Illinois

<p>Abstract</p> <p>Background</p> <p>The nation-wide concern over methicillin-resistant <it>Staphylococcus aureus </it>(MRSA) has prompted many clinicians to use vancomycin when approaching patients with suspected staphylococcal infections. We sought to characterize the epidemiology of community-onset <it>S. aureus </it>infections in hospitalized children to assist local clinicians in providing appropriate empiric antimicrobial therapy.</p> <p>Methods</p> <p>From January 2005–June 2008, children (0–18 years old) admitted to the Children's Hospital of Illinois with community-onset <it>S. aureus </it>infections were identified by a computer-assisted laboratory-based surveillance and medical record review.</p> <p>Results</p> <p>Of 199 patients, 67 (34%) had invasive infections, and 132 (66%) had skin and soft tissue infections (SSTIs). Among patients with invasive infections, <it>S. aureus </it>isolates were more likely to be susceptible to methicillin (MSSA 63% vs. MRSA 37%), whereas patients with SSTIs, <it>S. aureus </it>isolates were more likely to be resistant to methicillin (MRSA 64% vs. MSSA 36%). Bacteremia and musculoskeletal infections were the most common invasive infections in both groups of <it>S. aureus</it>. Pneumonia with empyema was more likely to be caused by MRSA (<it>P </it>= 0.02). The majority (~90%) of MRSA isolates were non-multidrug resistant, even in the presence of healthcare-associated risk factors.</p> <p>Conclusion</p> <p>Epidemiological data at the local level is important for antimicrobial decision-making. MSSA remains an important pathogen causing invasive community-onset <it>S. aureus </it>infections among hospitalized children. In our hospital, nafcillin in combination with vancomycin is recommended empiric therapy in critically ill patients with suspected invasive staphylococcal infections. Because up to 25% of MSSA circulating in our area are clindamycin-resistant, clindamycin should be used cautiously as empiric monotherapy in patients with suspected invasive staphylococcal infections.</p