Diagnostic and ethical challenges in disorders of consciousness and locked-in syndrome: a survey of German neurologists.

Diagnosis and decisions on life-sustaining treatment (LST) in disorders of consciousness, such as the vegetative state (VS) and the minimally conscious state (MCS), are challenging for neurologists. The locked-in syndrome (LiS) is sometimes confounded with these disorders by less experienced physicians. We aimed to investigate (1) the application of diagnostic knowledge, (2) attitudes concerning limitations of LST, and (3) further challenging aspects in the care of patients. A vignette-based online survey with a randomized presentation of a VS, MCS, or LiS case scenario was conducted among members of the German Society for Neurology. A sample of 503 neurologists participated (response rate 16.4%). An accurate diagnosis was given by 86% of the participants. The LiS case was diagnosed more accurately (94%) than the VS case (79%) and the MCS case (87%, p < 0.001). Limiting LST for the patient was considered by 92, 91, and 84% of the participants who accurately diagnosed the VS, LiS, and MCS case (p = 0.09). Overall, most participants agreed with limiting cardiopulmonary resuscitation; a minority considered limiting artificial nutrition and hydration. Neurologists regarded the estimation of the prognosis and determination of the patients' wishes as most challenging. The majority of German neurologists accurately applied the diagnostic categories VS, MCS, and LiS to case vignettes. Their attitudes were mostly in favor of limiting life-sustaining treatment and slightly differed for MCS as compared to VS and LiS. Attitudes toward LST strongly differed according to circumstances (e.g., patient's will opposed treatment) and treatment measures.

Divergent signal-to-noise ratio and stochastic resonance in monostable systems

We present a class of systems for which the signal-to-noise ratio always increases when increasing the noise and diverges at infinite noise level. This new phenomenon is a direct consequence of the existence of a scaling law for the signal-to-noise ratio and implies the appearance of stochastic resonance in some monostable systems. We outline applications of our results to a wide variety of systems pertaining to different scientific areas. Two particular examples are discussed in detail.

Dissipation, noise and vacuum decay in quantum field theory

We study the process of vacuum decay in quantum field theory focusing on the stochastic aspects of the interaction between long- and short-wavelength modes. This interaction results in a diffusive behavior of the reduced Wigner function describing the state of long-wavelength modes, and thereby to a finite activation rate even at zero temperature. This effect can make a substantial contribution to the total decay rate.

Long-tailed trapping times and Lévy flights in a self-organized critical granular system

We present a continuous time random walk model for the scale-invariant transport found in a self-organized critical rice pile [K. Christensen et al., Phys. Rev. Lett. 77, 107 (1996)]. From our analytical results it is shown that the dynamics of the experiment can be explained in terms of Lvy flights for the grains and a long-tailed distribution of trapping times. Scaling relations for the exponents of these distributions are obtained. The predicted microscopic behavior is confirmed by means of a cellular automaton model.

Percolation and epidemic thresholds in clustered networks

We develop a theoretical approach to percolation in random clustered networks. We find that, although clustering in scale-free networks can strongly affect some percolation properties, such as the size and the resilience of the giant connected component, it cannot restore a finite percolation threshold. In turn, this implies the absence of an epidemic threshold in this class of networks, thus extending this result to a wide variety of real scale-free networks which shows a high level of transitivity. Our findings are in good agreement with numerical simulations.

Mechanisms of synchronization and pattern formation in a lattice of pulse-coupled oscillators

We analyze the physical mechanisms leading either to synchronization or to the formation of spatiotemporal patterns in a lattice model of pulse-coupled oscillators. In order to make the system tractable from a mathematical point of view we study a one-dimensional ring with unidirectional coupling. In such a situation, exact results concerning the stability of the fixed of the dynamic evolution of the lattice can be obtained. Furthermore, we show that this stability is the responsible for the different behaviors.

Noise and periodic modulations in neural excitable medium

We have analyzed the interplay between noise and periodic modulations in a mean field model of a neural excitable medium. For this purpose, we have considered two types of modulations, namely, variations of the resistance and oscillations of the threshold. In both cases, stochastic resonance is present, irrespective of whether the system is monostable or bistable.

Random diffusion and leverage effect in financial markets

We prove that Brownian market models with random diffusion coefficients provide an exact measure of the leverage effect [J-P. Bouchaud et al., Phys. Rev. Lett. 87, 228701 (2001)]. This empirical fact asserts that past returns are anticorrelated with future diffusion coefficient. Several models with random diffusion have been suggested but without a quantitative study of the leverage effect. Our analysis lets us to fully estimate all parameters involved and allows a deeper study of correlated random diffusion models that may have practical implications for many aspects of financial markets.

Self and cross-velocity correlation functions and diffusion coefficients in liquids: a molecular dynamics study of binary mixtures of soft spheres

Molecular dynamics simulation is applied to the study of the diffusion properties in binary liquid mixtures made up of soft-sphere particles with different sizes and masses. Self- and distinct velocity correlation functions and related diffusion coefficients have been calculated. Special attention has been paid to the dynamic cross correlations which have been computed through recently introduced relative mean molecular velocity correlation functions which are independent on the reference frame. The differences between the distinct velocity correlations and diffusion coefficients in different reference frames (mass-fixed, number-fixed, and solvent-fixed) are discussed.

Meissner effect and critical fields in an inhomogeneous Ba2HoCu3O7-x high-Tc superconductor

The Meissner and diamagnetic shielding effects and the upper, lower, and thermodynamical critical fields have been studied in a Ba2HoCu3O7-x sample using magnetization measurements in fields up to 55 kOe. The diamagnetic shielding curve shows the existence of a transition at Tc=91.5 K followed by a broad transition extending from 85 to 25 K which may be related to inhomogeneities in the oxygen content of the sample. A rather low flux expulsion (13.5%) is observed which we attribute to flux pinning or trapping. We show that the coexistence of superconducting and nonsuperconducting regions within the sample at temperatures just below Tc leads to strong reductions in the critical magnetic fields.

Independent contribution of parental migrant status and educational level to adiposity and eating habits in preschool children.

Background/Objective:Little is known about the precise role of parental migrant status (MS) and educational level (EL) on adiposity and various eating habits in young children. Therefore, we assessed their independent contribution in preschoolers.Subjects/Methods:Of 655 randomly selected preschoolers, 542 (5.1±0.6 years; 71% of parental MS and 37% of low parental EL) were analysed. Body composition was measured by bioelectrical impedance. Eating habits were assessed using a semiqualitative food frequency questionnaire and analysed according to five messages developed by the Swiss Society for Nutrition, based on factors implicated in childhood obesity: (1) 'Drinking water and decreasing sweetened drinks', (2) 'Eating fruit and vegetables', (3) 'Decreasing breakfast skipping', (4) 'Reducing fatty and sweet foods' and (5) 'Reducing the intake of meals and snacks in front of television'.Results:Children of migrant and low EL parents had higher body fat, ate more meals and snacks while watching television and had more fruit and fatty foods compared with their respective counterparts (all P0.04). Children of low EL parents also consumed less water and vegetables compared with their counterparts (all P0.04). In most instances, we found an independent contribution of parental MS and EL to adiposity and eating habits. A more pronounced effect was found if both parents were migrants or of low EL. Differences in adiposity and eating habits were relatively similar to the joint parental data when assessed individually for maternal and paternal MS and EL.Conclusions:Parental MS and EL are independently related to adiposity and various eating habits in preschoolers.European Journal of Clinical Nutrition advance online publication, 3 November 2010; doi:10.1038/ejcn.2010.248.

Entropy change and magnetocaloric effect in Gd5(SixGe1-x)4

Isothermal magnetization curves up to 23 T have been measured in Gd5Si1.8Ge2.2. We show that the values of the entropy change at the first-order magnetostructural transition, obtained from the Clausius-Clapeyron equation and the Maxwell relation, are coincident, provided the Maxwell relation is evaluated only within the transition region and the maximum applied field is high enough to complete the transition. These values are also in agreement with the entropy change obtained from differential scanning calorimetry. We also show that a simple phenomenological model based on the temperature and field dependence of the magnetization accounts for these results.

Competing tunneling and capacitive paths in Co-ZrO2 granular thin films

The ac electrical response is studied in thin films composed of well-defined nanometric Co particles embedded in an insulating ZrO2 matrix which tends to coat them, preventing the formation of aggregates. In the dielectric regime, ac transport originates from the competition between interparticle capacitive Cp and tunneling Rt channels, the latter being thermally assisted. This competition yields an absorption phenomenon at a characteristic frequency 1/(RtCp), which is observed in the range 1010 000 Hz. In this way, the effective ac properties mimic the universal response of disordered dielectric materials. Temperature and frequency determine the complexity and nature of the ac electrical paths, which have been successfully modeled by an Rt-Cp network.