Extension of the Morris-Shore transformation to multilevel ladders

We describe situations in which chains of N degenerate quantum energy levels, coupled by time-dependent external fields, can be replaced by independent sets of chains of length N, N-1,...,2 and sets of uncoupled single states. The transformation is a generalization of the two-level Morris-Shore transformation [J.R. Morris and B.W. Shore, Phys. Rev. A 27, 906 (1983)]. We illustrate the procedure with examples of three-level chains

Counterintuitive transitions between crossing energy levels

We calculate analytically the probabilities for intuitive and counterintuitive transitions in a three-state system, in which two parallel energies are crossed by a third, tilted energy. The state with the tilted energy is coupled to the other two states in a chainwise linkage pattern with constant couplings of finite duration. The probability for a counterintuitive transition is found to increase with the square of the coupling and decrease with the squares of the interaction duration, the energy splitting between the parallel energies, and the tilt (chirp) rate. Physical examples of this model can be found in coherent atomic excitation and optical shielding in cold atomic collisions

Delineating COVID-19 subgroups using routine clinical data identifies distinct in-hospital outcomes

The COVID-19 pandemic has been a great challenge to healthcare systems worldwide. It highlighted the need for robust predictive models which can be readily deployed to uncover heterogeneities in disease course, aid decision-making and prioritise treatment. We adapted an unsupervised data-driven model-SuStaIn, to be utilised for short-term infectious disease like COVID-19, based on 11 commonly recorded clinical measures. We used 1344 patients from the National COVID-19 Chest Imaging Database (NCCID), hospitalised for RT-PCR confirmed COVID-19 disease, splitting them equally into a training and an independent validation cohort. We discovered three COVID-19 subtypes (General Haemodynamic, Renal and Immunological) and introduced disease severity stages, both of which were predictive of distinct risks of in-hospital mortality or escalation of treatment, when analysed using Cox Proportional Hazards models. A low-risk Normal-appearing subtype was also discovered. The model and our full pipeline are available online and can be adapted for future outbreaks of COVID-19 or other infectious disease

Saliency maps for finding changes in visual scenes?

Sudden changes in the environment reliably summon attention. This rapid change detection appears to operate in a similar fashion as pop-out in visual search, the phenomenon that very salient stimuli are directly attended, independently of the number of distracting objects. Pop-out is usually explained by the workings of saliency maps, i.e., map-like representations that code for the conspicuity at each location of the visual field. While past research emphasized similarities between pop-out search and change detection, our study highlights differences between the saliency computations in the two tasks: in contrast to pop-out search, saliency computation in change detection (i) operates independently across different stimulus properties (e.g., color and orientation), and (ii) is little influenced by trial history. These deviations from pop-out search are not due to idiosyncrasies of the stimuli or task design, as evidenced by a replication of standard findings in a comparable visual-search design. To explain these results, we outline a model of change detection involving the computation of feature-difference maps, which explains the known similarities and differences with visual search

Automated airway quantification associates with mortality in idiopathic pulmonary fibrosis

OBJECTIVES: The study examined whether quantified airway metrics associate with mortality in idiopathic pulmonary fibrosis (IPF). METHODS: In an observational cohort study (n = 90) of IPF patients from Ege University Hospital, an airway analysis tool AirQuant calculated median airway intersegmental tapering and segmental tortuosity across the 2nd to 6th airway generations. Intersegmental tapering measures the difference in median diameter between adjacent airway segments. Tortuosity evaluates the ratio of measured segmental length against direct end-to-end segmental length. Univariable linear regression analyses examined relationships between AirQuant variables, clinical variables, and lung function tests. Univariable and multivariable Cox proportional hazards models estimated mortality risk with the latter adjusted for patient age, gender, smoking status, antifibrotic use, CT usual interstitial pneumonia (UIP) pattern, and either forced vital capacity (FVC) or diffusion capacity of carbon monoxide (DLco) if obtained within 3 months of the CT. RESULTS: No significant collinearity existed between AirQuant variables and clinical or functional variables. On univariable Cox analyses, male gender, smoking history, no antifibrotic use, reduced DLco, reduced intersegmental tapering, and increased segmental tortuosity associated with increased risk of death. On multivariable Cox analyses (adjusted using FVC), intersegmental tapering (hazard ratio (HR) = 0.75, 95% CI = 0.66-0.85, p < 0.001) and segmental tortuosity (HR = 1.74, 95% CI = 1.22-2.47, p = 0.002) independently associated with mortality. Results were maintained with adjustment using DLco. CONCLUSIONS: AirQuant generated measures of intersegmental tapering and segmental tortuosity independently associate with mortality in IPF patients. Abnormalities in proximal airway generations, which are not typically considered to be abnormal in IPF, have prognostic value. CLINICAL RELEVANCE STATEMENT: Quantitative measurements of intersegmental tapering and segmental tortuosity, in proximal (second to sixth) generation airway segments, independently associate with mortality in IPF. Automated airway analysis can estimate disease severity, which in IPF is not restricted to the distal airway tree. KEY POINTS: • AirQuant generates measures of intersegmental tapering and segmental tortuosity. • Automated airway quantification associates with mortality in IPF independent of established measures of disease severity. • Automated airway analysis could be used to refine patient selection for therapeutic trials in IPF

The difference between drugs of the same category in the treatment of psoriasis: an economic analysis

Psoriasis is one of the most common chronic dermatosis, which affects from 1 to 5% of the world's population. The article discusses the current views on the pathogenesis, the methods of treatment and drugs necessary for this and the economic analysis of the ratio of prices and effectiveness of treatment.Псориаз - один из самых распространенных хроничеcких дерматозов, которым страдает от 1 до 5 % населения планеты. В статье обсуждаются современные взгляды на патогенез, представлены методы лечения и лекарственные средства, необходимые для этого и проведен экономический анализ соотношения цен и эффективности лечения

Constraining globular cluster formation through studies of young massive clusters - V. ALMA observations of clusters in the Antennae

Some formation scenarios that have been put forward to explain multiple populations within Globular Clusters (GCs) require that the young massive cluster have large reservoirs of cold gas within them, which is necessary to form future generations of stars. In this paper we use deep observations taken with Atacama Large Millimeter/sub-millimeter Array (ALMA) to assess the amount of molecular gas within 3 young (50 − 200 Myr) massive (� 106 M⊙) clusters in the Antennae galaxies. No significant CO(3–2) emission was found associated with any of the three clusters. We place upper limits for the molecular gas within these clusters of � 1 × 105 M⊙ (or < 9% of the current stellar mass). We briefly review different scenarios that propose multiple episodes of star formation and discuss some of their assumptions and implications. Our results are in tension with the predictions of GC formation scenarios that expect large reservoirs of cool gas within young massive clusters at these ages

Self-Assembly in Monoelaidin Aqueous Dispersions: Direct Vesicles to Cubosomes Transition

Background: In the present study, synchrotron small-angle X-ray scattering (SAXS) and Cryo-TEM were used to characterize the temperature-induced structural transitions of monoelaidin (ME) aqueous dispersion in the presence of the polymeric stabilizer F127. We prove that the direct transition from vesicles to cubosomes by heating this dispersion is possible. The obtained results were compared with the fully hydrated bulk ME phase. Methodology/principal findings: Our results indicate the formation of ME dispersion, which is less stable than that based on the congener monoolein (MO). In addition, the temperature-dependence behavior significantly differs from the fully hydrated bulk phase. SAXS findings indicate a direct L(alpha)-V(2) internal transition in the dispersion. While the transition temperature is conserved in the dispersion, the formed cubosomes with internal Im3m symmetry clearly contain more water and this ordered interior is retained over a wider temperature range as compared to its fully hydrated bulk system. At 25 degrees C, Cryo-TEM observations reveal the formation of most likely closely packed onion-like vesicles. Above the lamellar to non-lamellar phase transition at 65 degrees C, flattened cubosomes with an internal nanostructure are observed. However, they have only arbitrary shapes and thus, their morphology is significantly different from that of the well-shaped analogous MO cubosome and hexosome particles. Conclusions/significance: Our study reveals a direct liposomes-cubosomes transition in ME dispersion. The obtained results suggest that the polymeric stabilizer F127 especially plays a significant role in the membrane fusion processes. F127 incorporates in considerable amount into the internal nanostructure and leads to the formation of a highly swollen Im3m phase

Effect of SGLT2 inhibitors on stroke and atrial fibrillation in diabetic kidney disease: Results from the CREDENCE trial and meta-analysis

BACKGROUND AND PURPOSE: Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) and a meta-Analysis of large cardiovascular outcome trials (CVOTs) of SGLT2i in type 2 diabetes mellitus. METHODS: CREDENCE randomized 4401 participants with type 2 diabetes mellitus and chronic kidney disease to canagliflozin or placebo. Post hoc, we estimated effects on fatal or nonfatal stroke, stroke subtypes, and intermediate markers of stroke risk including AF/AFL. Stroke and AF/AFL data from 3 other completed large CVOTs and CREDENCE were pooled using random-effects meta-Analysis. RESULTS: In CREDENCE, 142 participants experienced a stroke during follow-up (10.9/1000 patient-years with canagliflozin, 14.2/1000 patient-years with placebo; hazard ratio [HR], 0.77 [95% CI, 0.55-1.08]). Effects by stroke subtypes were: ischemic (HR, 0.88 [95% CI, 0.61-1.28]; n=111), hemorrhagic (HR, 0.50 [95% CI, 0.19-1.32]; n=18), and undetermined (HR, 0.54 [95% CI, 0.20-1.46]; n=17). There was no clear effect on AF/AFL (HR, 0.76 [95% CI, 0.53-1.10]; n=115). The overall effects in the 4 CVOTs combined were: Total stroke (HRpooled, 0.96 [95% CI, 0.82-1.12]), ischemic stroke (HRpooled, 1.01 [95% CI, 0.89-1.14]), hemorrhagic stroke (HRpooled, 0.50 [95% CI, 0.30-0.83]), undetermined stroke (HRpooled, 0.86 [95% CI, 0.49-1.51]), and AF/AFL (HRpooled, 0.81 [95% CI, 0.71-0.93]). There was evidence that SGLT2i effects on total stroke varied by baseline estimated glomerular filtration rate (P=0.01), with protection in the lowest estimated glomerular filtration rate (45 mL/min/1.73 m2]) subgroup (HRpooled, 0.50 [95% CI, 0.31-0.79]). CONCLUSIONS: Although we found no clear effect of SGLT2i on total stroke in CREDENCE or across trials combined, there was some evidence of benefit in preventing hemorrhagic stroke and AF/AFL, as well as total stroke for those with lowest estimated glomerular filtration rate. Future research should focus on confirming these data and exploring potential mechanisms