Effects of domain walls on hole motion in the two-dimensional t-J model at finite temperature

The t-J model on the square lattice, close to the t-J_z limit, is studied by quantum Monte Carlo techniques at finite temperature and in the underdoped regime. A variant of the Hoshen-Koppelman algorithm was implemented to identify the antiferromagnetic domains on each Trotter slice. The results show that the model presents at high enough temperature finite antiferromagnetic (AF) domains which collapse at lower temperatures into a single ordered AF state. While there are domains, holes would tend to preferentially move along the domain walls. In this case, there are indications of hole pairing starting at a relatively high temperature. At lower temperatures, when the whole system becomes essentially fully AF ordered, at least in finite clusters, holes would likely tend to move within phase separated regions. The crossover between both states moves down in temperature as doping increases and/or as the off-diagonal exchange increases. The possibility of hole motion along AF domain walls at zero temperature in the fully isotropic t-J is discussed.Comment: final version, to appear in Physical Review

Birth and early evolution of a planetary nebula

The final expulsion of gas by a star as it forms a planetary nebula --- the ionized shell of gas often observed surrounding a young white dwarf --- is one of the most poorly understood stages of stellar evolution. Such nebulae form extremely rapidly (about 100 years for the ionization) and so the formation process is inherently difficult to observe. Particularly puzzling is how a spherical star can produce a highly asymmetric nebula with collimated outflows. Here we report optical observations of the Stingray Nebula which has become an ionized planetary nebula within the past few decades. We find that the collimated outflows are already evident, and we have identified the nebular structure that focuses the outflows. We have also found a companion star, reinforcing previous suspicions that binary companions play an important role in shaping planetary nebulae and changing the direction of successive outflows.Comment: 9 pages + 3 figures. To appear in Nature, 2 April 199

Elementos esenciales de los entornos profesionales enfermeros en Atencion Primaria y su influencia en la calidad del cuidado

Objectives Nursing work environments are key determinants of care quality. Our study aimed to evaluate the characteristics of nursing environments in primary care settings in the Canary Islands, and identify crucial components of such environments to improve quality. Method We conducted a cross-sectional study in primary care organisations using the Practice Environment Scale - Nursing Work Index tool. We collected sociodemographic variables, scores, and selected the essential items conducive to optimal care. Appropriate parametric and non-parametric statistical tests were used to analyse relations between variables (CI = 95%, error = 5%). Results One hundred and forty-four nurses participated. The mean total score was 81.6. The results for the five dimensions included in the Practice Environment Scale - Nursing Work Index ranged from 2.25 - 2.92 (Mean). Twelve key items for quality of care were selected; six were positive in the Canary Islands, two were mixed, and four negative. 7/12 items were included in Dimension 2 (fundamentals of nursing). Being a manager was statistically associated with higher scores (p<.000). Years of experience was inversely associated with scores in the 12 items (p<.021). Conclusions Nursing work environments in primary care settings in the Canary Islands are comparable to others previously studied in Spain. Areas to improve were human resources and participation of nurses in management decisions. Nurse managers must be knowledgeable about their working environments so they can focus on improvements in key dimensions

Proposal of an extended t-J Hamiltonian for high-Tc cuprates from ab initio calculations on embedded clusters

A series of accurate ab initio calculations on Cu_pO-q finite clusters, properly embedded on the Madelung potential of the infinite lattice, have been performed in order to determine the local effective interactions in the CuO_2 planes of La_{2-x}Sr_xCuO_4 compounds. The values of the first-neighbor interactions, magnetic coupling (J_{NN}=125 meV) and hopping integral (t_{NN}=-555 meV), have been confirmed. Important additional effects are evidenced, concerning essentially the second-neighbor hopping integral t_{NNN}=+110meV, the displacement of a singlet toward an adjacent colinear hole, h_{SD}^{abc}=-80 meV, a non-negligible hole-hole repulsion V_{NN}-V_{NNN}=0.8 eV and a strong anisotropic effect of the presence of an adjacent hole on the values of the first-neighbor interactions. The dependence of J_{NN} and t_{NN} on the position of neighbor hole(s) has been rationalized from the two-band model and checked from a series of additional ab initio calculations. An extended t-J model Hamiltonian has been proposed on the basis of these results. It is argued that the here-proposed three-body effects may play a role in the charge/spin separation observed in these compounds, that is, in the formation and dynamic of stripes.Comment: 24 pages, 4 figures, submitted to Phys. Rev.

On the stability of 2 \sqrt{2} x 2 \sqrt{2} oxygen ordered superstructures in YBa2Cu3O6+x

We have compared the ground-state energy of several observed or proposed " 2 \sqrt{2} x 2 \sqrt{2} oxygen (O) ordered superstructures " (from now on HS), with those of "chain superstructures" (CS) (in which the O atoms of the basal plane are ordered in chains), for different compositions x in YBa2Cu3O6+x. The model Hamiltonian contains i) the Madelung energy, ii) a term linear in the difference between Cu and O hole occupancies which controls charge transfer, and iii) covalency effects based on known results for $t-J$ models in one and two dimensions. The optimum distribution of charge is determined minimizing the total energy, and depends on two parameters which are determined from known results for x=1 and x=0.5. We obtain that on the O lean side, only CS are stable, while for x=7/8, a HS with regularly spaced O vacancies added to the x=1 structure is more stable than the corresponding CS for the same x. We find that the detailed positions of the atoms in the structure, and long-range Coulomb interactions, are crucial for the electronic structure, the mechanism of charge transfer, the stability of the different phases, and the possibility of phase separation.Comment: 24 text pages, Latex, one fig. included as ps file, to be publisheb in Phys. Rev.

Grading systems in head and neck dysplasia: their prognostic value, weaknesses and utility

Contains fulltext : 80594.pdf (publisher's version ) (Open Access)ABSTRACT: BACKGROUND: Grading of dysplasia, including head and neck lesions, continues to be a hotly debated subject. It is subjective and lacks intra- and inter-observer reproducibility due to the insufficiency of validated morphological criteria and the biological nature of dysplasia. Moreover, due to the absence of a consensus, several systems are currently employed. OBJECTIVES: The aims of this review are to:1) Highlight the significance of dysplasia and the importance of a valid method for assessing precursor lesions of the head and neck.2) Review the different histopathological classification systems for grading intraepithelial lesions of the head and neck.3) Discuss and review quality requirements for these grading systems. CONCLUSION: Regarding the different classification systems, data concerning the WHO classification system are the most available in current literature. There is no simple relationship or overlapping between the classification systems. Further studies should be done to see whether other systems have advantages above the current WHO system and to discover indications that could lead to an universal classification system for intraepithelial lesions of the head and neck

The clinical features of the piriformis syndrome: a systematic review

Piriformis syndrome, sciatica caused by compression of the sciatic nerve by the piriformis muscle, has been described for over 70 years; yet, it remains controversial. The literature consists mainly of case series and narrative reviews. The objectives of the study were: first, to make the best use of existing evidence to estimate the frequencies of clinical features in patients reported to have PS; second, to identify future research questions. A systematic review was conducted of any study type that reported extractable data relevant to diagnosis. The search included all studies up to 1 March 2008 in four databases: AMED, CINAHL, Embase and Medline. Screening, data extraction and analysis were all performed independently by two reviewers. A total of 55 studies were included: 51 individual and 3 aggregated data studies, and 1 combined study. The most common features found were: buttock pain, external tenderness over the greater sciatic notch, aggravation of the pain through sitting and augmentation of the pain with manoeuvres that increase piriformis muscle tension. Future research could start with comparing the frequencies of these features in sciatica patients with and without disc herniation or spinal stenosis

Untreated Human Infections by Trypanosoma brucei gambiense Are Not 100% Fatal

The final outcome of infection by Trypanosoma brucei gambiense, the main agent of sleeping sickness, has always been considered as invariably fatal. While scarce and old reports have mentioned cases of self-cure in untreated patients, these studies suffered from the lack of accurate diagnostic tools available at that time. Here, using the most specific and sensitive tools available to date, we report on a long-term follow-up (15 years) of a cohort of 50 human African trypanosomiasis (HAT) patients from the Ivory Coast among whom 11 refused treatment after their initial diagnosis. In 10 out of 11 subjects who continued to refuse treatment despite repeated visits, parasite clearance was observed using both microscopy and polymerase chain reaction (PCR). Most of these subjects (7/10) also displayed decreasing serological responses, becoming progressively negative to trypanosome variable antigens (LiTat 1.3, 1.5 and 1.6). Hence, in addition to the “classic” lethal outcome of HAT, we show that alternative natural progressions of HAT may occur: progression to an apparently aparasitaemic and asymptomatic infection associated with strong long-lasting serological responses and progression to an apparently spontaneous resolution of infection (with negative results in parasitological tests and PCR) associated with a progressive drop in antibody titres as observed in treated cases. While this study does not precisely estimate the frequency of the alternative courses for this infection, it is noteworthy that in the field national control programs encounter a significant proportion of subjects displaying positive serologic test results but negative results in parasitological testing. These findings demonstrate that a number of these subjects display such infection courses. From our point of view, recognising that trypanotolerance exists in humans, as is now widely accepted for animals, is a major step forward for future research in the field of HAT

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty