Ising spin glasses in two dimensions: Universality and nonuniversality.

Following numerous earlier studies, extensive simulations and analyses were made on the continuous interaction distribution Gaussian model and the discrete bimodal interaction distribution Ising spin glass (ISG) models in two dimensions [Lundow and Campbell, Phys. Rev. E 93, 022119 (2016)1539-375510.1103/PhysRevE.93.022119]. Here we further analyze the bimodal and Gaussian data together with data on two other continuous interaction distribution two-dimensional ISG models, the uniform and the Laplacian models, and three other discrete interaction distribution models, a diluted bimodal model, an "antidiluted" model, and a more exotic symmetric Poisson model. Comparisons between the three continuous distribution models show that not only do they share the same exponent η≡0 but that to within the present numerical precision they share the same critical exponent ν also, and so lie in a single universality class. On the other hand the critical exponents of the four discrete distribution models are not the same as those of the continuous distributions, and the present data strongly indicate that they differ from one discrete distribution model to another. This is evidence that discrete distribution ISG models in two dimensions have nonzero values of the critical exponent η and do not lie in a single universality class.

Ising spin glasses in dimension five.

Ising spin-glass models with bimodal, Gaussian, uniform, and Laplacian interaction distributions in dimension five are studied through detailed numerical simulations. The data are analyzed in both the finite-size scaling regime and the thermodynamic limit regime. It is shown that the values of critical exponents and of dimensionless observables at criticality are model dependent. Models in a single universality class have identical values for each of these critical parameters, so Ising spin-glass models in dimension five with different interaction distributions each lie in different universality classes. This result confirms conclusions drawn from measurements in dimension four and dimension two.

Bimodal and Gaussian Ising spin glasses in dimension two.

An analysis is given of numerical simulation data to size L=128 on the archetype square lattice Ising spin glasses (ISGs) with bimodal (±J) and Gaussian interaction distributions. It is well established that the ordering temperature of both models is zero. The Gaussian model has a nondegenerate ground state and thus a critical exponent η≡0, and a continuous distribution of energy levels. For the bimodal model, above a size-dependent crossover temperature T(*)(L) there is a regime of effectively continuous energy levels; below T(*)(L) there is a distinct regime dominated by the highly degenerate ground state plus an energy gap to the excited states. T(*)(L) tends to zero at very large L, leaving only the effectively continuous regime in the thermodynamic limit. The simulation data on both models are analyzed with the conventional scaling variable t=T and with a scaling variable τ(b)=T(2)/(1+T(2)) suitable for zero-temperature transition ISGs, together with appropriate scaling expressions. The data for the temperature dependence of the reduced susceptibility χ(τ(b),L) and second moment correlation length ξ(τ(b),L) in the thermodynamic limit regime are extrapolated to the τ(b)=0 critical limit. The Gaussian critical exponent estimates from the simulations, η=0 and ν=3.55(5), are in full agreement with the well-established values in the literature. The bimodal critical exponents, estimated from the thermodynamic limit regime analyses using the same extrapolation protocols as for the Gaussian model, are η=0.20(2) and ν=4.8(3), distinctly different from the Gaussian critical exponents.

Non-self-averaging in Ising spin glasses and hyperuniversality.

Ising spin glasses with bimodal and Gaussian near-neighbor interaction distributions are studied through numerical simulations. The non-self-averaging (normalized intersample variance) parameter U_{22}(T,L) for the spin glass susceptibility [and for higher moments U_{nn}(T,L)] is reported for dimensions 2,3,4,5, and 7. In each dimension d the non-self-averaging parameters in the paramagnetic regime vary with the sample size L and the correlation length ξ(T,L) as U_{nn}(ß,L)=[K_{d}ξ(T,L)/L]^{d} and so follow a renormalization group law due to Aharony and Harris [Phys. Rev. Lett. 77, 3700 (1996)PRLTAO0031-900710.1103/PhysRevLett.77.3700]. Empirically, it is found that the K_{d} values are independent of d to within the statistics. The maximum values [U_{nn}(T,L)]_{max} are almost independent of L in each dimension, and remarkably the estimated thermodynamic limit critical [U_{nn}(T,L)]_{max} peak values are also practically dimension-independent to within the statistics and so are "hyperuniversal." These results show that the form of the spin-spin correlation function distribution at criticality in the large L limit is independent of dimension within the ISG family. Inspection of published non-self-averaging data for three-dimensional Heisenberg and XY spin glasses the light of the Ising spin glass non-self-averaging results show behavior which appears to be compatible with that expected on a chiral-driven ordering interpretation but incompatible with a spin-driven ordering scenario.

Evidence for nonuniversal scaling in dimension-four Ising spin glasses.

The critical behavior of the Binder cumulant for Ising spin glasses in dimension four is studied through simulation measurements. Data for the bimodal interaction model are compared with those for the Laplacian interaction model. Special attention is paid to scaling corrections. The limiting infinite size value at criticality for this dimensionless variable is a parameter characteristic of a universality class. This critical limit is estimated to be equal to 0.523(3) in the bimodal model and to 0.473(3) in the Laplacian model.

Brief advice to tuberculosis patients in Nepal to stop smoking: a pilot study by the Britain Nepal Medical Trust.

SETTING: Tuberculosis (TB) treatment centres in Eastern Nepal. OBJECTIVE: To determine smoking cessation rates among TB patients advised to quit. DESIGN: One intervention and one control centre were studied. At the intervention centre, brief advice about smoking and cessation was given at the start of anti-tuberculosis treatment, and repeated 2 and 5 months later. After 6 months of standard treatment, patients were asked about quitting. Expired air carbon monoxide (CO) was measured in those claiming 6 months of abstinence. RESULTS: None of the 51 controls achieved 6 months of abstinence, whereas 77 (39%) of the 195 in the intervention group claimed at least 6 months of abstinence. All claims were verified by CO measurement in expired air (95%CI 31.4-47.6, P < 0.0001 for the difference in smoking cessation). CONCLUSION: Brief advice on smoking cessation to patients starting anti-tuberculosis treatment in the National Tuberculosis Programme (NTP) setting in Eastern Nepal led to 39% quitting for least 6 months. Our results should encourage randomised trials in smokers with TB in Nepal: if substantiated, smoking cessation advice should become a mandatory component of the NTP.

Ising ferromagnet in dimension five: link and spin overlaps.

In the simple [hyper]cubic five-dimension, near-neighbor-interaction Ising ferromagnet, extensive simulation measurements are made of the link overlap and the spin overlap distributions. These "two replica" measurements are standard in the spin glass context but are not usually recorded in ferromagnet simulations. The moments and moment ratios of these distributions (the variance, the kurtosis, and the skewness) show clear critical behaviors at the known ordering temperature of the ferromagnet. Analogous overlap effects can be expected quite generally in Ising ferromagnets in any dimension. The link overlap results in particular, with peaks at criticality in the kurtosis and the skewness, also have implications for spin glasses.

Fortuin-Kasteleyn and damage-spreading transitions in random-bond Ising lattices.

The Fortuin-Kasteleyn and heat-bath damage-spreading temperatures T(FK)(p) and T(DS)(p) are studied on random-bond Ising models of dimensions 2-5 and as functions of the ferromagnetic interaction probability p; the conjecture that T(DS)(p)~T(FK)(p) is tested. It follows from a statement by Nishimori that in any such system, exact coordinates can be given for the intersection point between the Fortuin-Kasteleyn T(FK)(p) transition line and the Nishimori line [p(NL,FK),T(NL,FK)]. There are no finite-size corrections for this intersection point. In dimension 3, at the intersection concentration [p(NL,FK)], the damage spreading T(DS)(p) is found to be equal to T(FK)(p) to within 0.1%. For the other dimensions, however, T(DS)(p) is observed to be systematically a few percent lower than T(FK)(p).

Hormone replacement therapy (HRT) or etidronate for osteoporosis in postmenopausal asthmatics on glucocorticoids: a randomised factorial trial.

INTRODUCTION: The study was designed to establish the effects of HRT on osteoporosis and fractures over five years in postmenopausal women with asthma receiving regular glucocorticoids and to compare with etidronate. METHODS: Postmenopausal patients receiving inhaled and/or oral glucocorticoids were randomly assigned to HRT, cyclical etidronate, HRT plus cyclical etidronate or no treatment for five years. The trial was multi-centre and aimed to recruit 750 patients. Outcomes were fractures and changes in bone mineral density (BMD). RESULTS: For reasons detailed in the discussion section of the text, only 50 patients were entered. Three did not fulfil the eligibility criteria and were excluded from the analysis. Among the remaining 47 patients, three (6%) experienced new, symptomatic fractures, one on etidronate and two in the no treatment group. New or worsening morphometric fractures of the thoracolumbar spine occurred in 50% of the 22 patients with spinal radiographs on entry and at five years (one HRT, three etidronate, two HRT plus etidronate and five on no treatment). BMD improved by approximately 1% per annum in those receiving HRT and/or etidronate; comparisons of HRT vs no HRT tended to favour HRT but were only statistically significant at proximal femur. The same trends emerged in the etidronate vs no etidronate comparison, but none reached the 5% level of statistical significance. DISCUSSION: For postmenopausal patients receiving glucocorticoids for asthma, HRT appears as effective as etidronate in preventing loss of BMD over five years and may have a similar effect on fracture prevention.

A re-appraisal of warfarin control in the treatment of deep vein thrombosis and / or pulmonary embolism.

BACKGROUND: Warfarin is commonly used for management of deep vein thrombosis (DVT) and pulmonary embolism (PE), controlling therapy by means of the International Normalized Ratio (INR). OBJECTIVES: To identify differences in INR results between patients with thromboembolic and haemorrhagic complications and controls. METHODS: Two nested case-control studies from within a controlled trial of the duration of warfarin therapy (47 thrombotic and 16 haemorrhagic complications). RESULTS: Patients whose thromboembolism failed to resolve during treatment or recurred during or after treatment had non-significantly lower INR levels than matched controls (geometric mean 2.2 versus 2.3, p = 0.12). Patients with haemorrhage also had not statistically significant lower INR levels than their matched controls (2.1 versus 2.3, p = 0.22). The variability of INR levels was similar in both case groups and controls. The mean percentage of INR levels in the therapeutic range 2 - 3 was almost identical in thrombotic cases and controls (56.5% versus 56.1%). Compared to the haemorrhagic group, better control was achieved in controls (61.5% versus 43.0%, p=0.01), but controls had slightly more INR values above the therapeutic range (12.1% versus 10.5%, p = 0.74) whilst haemorrhagic cases had more INR values below the therapeutic range (46.6% versus 26.4%, p = 0.03). CONCLUSION: In this study, higher INR levels were not associated with haemorrhage suggesting that, for patients being treated for DVT/PE, a modest increase in the target therapeutic range could be considered.

Clarithromycin vs ciprofloxacin as adjuncts to rifampicin and ethambutol in treating opportunist mycobacterial lung diseases and an assessment of Mycobacterium vaccae immunotherapy.

BACKGROUND: The mainstays of treatment for pulmonary disease caused by opportunist mycobacteria are rifampicin (R) and ethambutol (E). The role of macrolides, quinolones and immunotherapy with Mycobacterium vaccae is not clear. A trial was undertaken to compare clarithromycin (Clari) and ciprofloxacin (Cipro) as third drugs added to [corrected] 2 years of treatment with R and E for pulmonary disease caused by M avium-intracellulare (MAC), M malmoense and M xenopi (REClari and RECipro). An optional comparison of immunotherapy with M vaccae vs no immunotherapy was also performed. METHODS: Progress was monitored annually during the 2 years of treatment and for 3 years thereafter. If the patient was not improving at 1 year the regimen was supplemented by the addition of the drug not received in the original allocation of treatment. RESULTS: 371 patients (186 REClari, 185 RECipro) entered the study (170 MAC, 167 M malmoense, 34 M xenopi). All-cause mortality was high for both groups (44% REClari, 43% RECipro); for MAC it was higher with REClari than with RECipro (48% vs 29%) but for M malmoense (42% vs 56%) and M xenopi (29% vs 47%) it was higher with RECipro (p = 0.006). 3% died from their mycobacterial disease (REClari = RECipro). At the end of treatment, 4% of REClari and 10% of RECipro patients still had positive cultures. Among those with negative cultures at the end of treatment, 6% of the REClari group and 4% of the RECipro group had relapsed. At 5 years 30% of the REClari group were known to have completed treatment as allocated and to be alive and cured compared with 21% of the RECipro group (p = 0.04), but this difference was principally due to those with M malmoense (REClari 38%, RECipro 20%). Patients with MAC or M xenopi were more likely to have a poor outcome than those with M malmoense (p = 0.004), with no difference between REClari and RECipro. Overall, 20% in each group were unable to tolerate the regimen allocated, Cipro being associated with more unwanted effects than Clari (16% vs 9%, p = 0.05). No significant differences in outcomes were found between M vaccae-treated patients and those not treated with M vaccae immunotherapy. CONCLUSION: Considering all three species together, there were no differences in outcome between the REClari and RECipro groups. Immunotherapy did not improve outcome. New therapies, optimised management of co-morbid conditions and a more holistic approach must be explored in the hope of improving outcome.

Anticoagulation for three versus six months in patients with deep vein thrombosis or pulmonary embolism, or both: randomised trial.

OBJECTIVE: To determine the optimum duration of oral anticoagulant therapy after an episode of deep vein thrombosis or pulmonary embolism, or both. DESIGN: Multicentre, prospective, randomised study with follow-up for one year. SETTING: 46 hospitals in United Kingdom. PARTICIPANTS: Patients aged > or =18 with deep vein thrombosis or pulmonary embolism, or both. INTERVENTIONS: Three (n=369) or six months (n=380) of anticoagulation with heparin for five days accompanied and followed by warfarin, with a target international normalised ratio of 2.0-3.5. MAIN OUTCOME MEASURES: Death from deep vein thrombosis or pulmonary embolism; failure to resolve, extension, recurrence of during treatment; recurrence after treatment; and major haemorrhage during treatment. RESULTS: In the patients allocated to three months' treatment two died from deep vein thrombosis or pulmonary embolism during or after treatment, compared with three in the six month group. During treatment deep vein thrombosis or pulmonary embolism failed to resolve, extended, or recurred in six patients in the three month group without fatal consequences, compared with 10 in the six month group. After treatment there were 23 non-fatal recurrences in the three month group and 16 in the six month group. Fatal and non-fatal deep vein thrombosis or pulmonary embolism during treatment, and after treatment thus occurred in 31(8%) of those who had received three months' anticoagulation compared with 29 (8%) of those who had received six months' (P=0.80, 95% confidence interval for difference -3.1% to 4.7%). There were no fatal haemorrhages during treatment but there were eight major haemorrhages in those treated for six months and none in those treated for three months (P=0.008, -3.5% to -0.7%). Thus 31 (8%) of the patients receiving three months' anticoagulation experienced adverse outcomes as a result of deep vein thrombosis or pulmonary embolism or its treatment compared with 35 (9%) of those receiving six months' (P=0.79, -4.9% to 3.2%). CONCLUSION: For patients in the UK with deep vein thrombosis or pulmonary embolism and no known risk factors for recurrence, there seems to be little, if any, advantage in increasing the duration of anticoagulation from three to six months. Any possible advantage would be small and would need to be judged against the increased risk of haemorrhage associated with the longer duration of treatment with warfarin. TRIAL REGISTRATION: Clinical Trials NCT00365950 [ClinicalTrials.gov].

Extended scaling scheme for critically divergent quantities in ferromagnets and spin glasses.

From a consideration of high temperature series expansions in ferromagnets and in spin glasses, we propose an extended scaling scheme involving a set of scaling formulas which expresses to leading order the temperature (T) and the system size (L) dependences of thermodynamic observables over a much wider range of T than the corresponding one in the conventional scaling scheme. The extended scaling, illustrated by data on the canonical 2d ferromagnet and on the 3d bimodal Ising spin glass, leads to consistency in the estimates of critical parameters obtained from scaling analyses for different observables.

Active surveillance for tuberculosis in Wales: 1996-2003.

AIMS: To estimate the incidence of active tuberculosis (TB) and study the use of chemoprophylaxis for latent TB in children in Wales, and to identify potential areas for improving prevention and management. METHODS: Active surveillance for TB in children aged 0-15 years from July 1996 to December 2003, using the Welsh Paediatric Surveillance Scheme. RESULTS: A total of 232 children, 102 with active TB (2.3 per 100 000) and 130 with latent TB (2.9 per 100 000), were identified. Nearly half (45%) belonged to ethnic minorities (19% were of black African origin), a much higher proportion than the base population. Pulmonary disease was the most common presentation (47%), including six (9%) children who were sputum smear positive. There were 10 cases of disseminated TB, nearly all in white children under 10 years of age. Less than two thirds of eligible children (27/46, 59%) were known to have received BCG immunisation. The source of infection was an adult household contact in most cases, but was not known in 44 cases, particularly among teenagers. Four community outbreaks occurred during the surveillance period, including three in high schools. CONCLUSION: TB incidence in children in Wales remains low, but the epidemiology is changing with an increasing proportion of cases in black African children. The high proportion of patients with disseminated TB is of particular concern. TB in teenagers was often associated with school outbreaks. Many eligible children do not receive BCG immunisation, indicating further scope for prevention.

Five year study of etidronate and/or calcium as prevention and treatment for osteoporosis and fractures in patients with asthma receiving long term oral and/or inhaled glucocorticoids.

BACKGROUND: Glucocorticoids are associated with a reduction in bone density and an increased risk of fracture. Concurrent treatment with bisphosphonates reduces bone loss and may prevent fractures. A randomised study was performed to determine whether treatment with cyclical etidronate and/or calcium for 5 years prevents fractures or reverses/reduces bone loss in patients receiving glucocorticoid treatment for asthma. METHODS: A multicentre, randomised, parallel group comparison of etidronate alone, calcium alone, etidronate + calcium, and no treatment, with stratification according to level of glucocorticoid exposure was carried out in 39 chest clinics in the UK. Three hundred and forty nine postmenopausal female and male outpatients with asthma aged 50-70 years were randomised. The main outcome measures were fractures and changes in bone mineral density (BMD). RESULTS: Overall, 8% of the patients experienced symptomatic fractures and 17.5% developed either a symptomatic fracture and/or a semiquantitative vertebral fracture by the end of 5 years There were no significant differences between the four treatment groups. Comparing etidronate with no etidronate, the rates of new fractures were not significantly different for symptomatic fractures (OR 1.07 (95% CI 0.46 to 2.47)) or for any fractures (OR 0.82 (95% CI 0.45 to 1.47)). For the comparison of calcium with no calcium the corresponding ORs were 1.43 (95% CI 0.62 to 3.33) and 0.91 (95% CI 0.50 to 1.63). In post hoc analysis the effect of etidronate was greater in women than in men (interaction p value 0.02) with the fracture incidence roughly halved (OR 0.39, 95% CI 0.14 to 0.99). Etidronate increased BMD at the lumbar spine by 4.1% (p = 0.001) while calcium had no significant effect. At the proximal femur the effects of treatment were not significant (relative increases etidronate 1.6%; calcium 1.1%). The rate of new fractures in patients with fractures at entry (23.7%) was higher than in those without fractures at entry (14.3%): OR 1.87 (95% CI 1.06 to 3.07). No association was found between change in BMD and new fractures. CONCLUSIONS: In patients receiving glucocorticoids for asthma etidronate significantly increased BMD over 5 years at the lumbar spine but not at the hip and had little if any protective effect against fractures, except possibly in postmenopausal women. The effects of calcium were not significant. Combination treatment had no advantage but increased unwanted effects.

Pulmonary disease caused by Mycobacterium xenopi in HIV-negative patients: five year follow-up of patients receiving standardised treatment.

The literature concerning the management of pulmonary disease caused by Mycobacterium xenopi is scanty and consists of retrospective reports, mostly of small series of patients. Our aim was to document the clinical features and response to treatment of this rare but challenging disease. Patients were treated in a randomised, multi-centre trial with either rifampicin plus ethambutol or rifampicin, ethambutol and isoniazid. Clinical, bacteriological and radiological progress was monitored at set intervals for 5 years. As no differences emerged between the two groups, the results have been combined to provide this prospective survey. Forty-two patients were studied. Mean age was 65 years, three-quarters were male and two-thirds had other lung disease(s). Sputum was positive on direct smear in 62%. Cavitation was present in 81%, mostly large cavities, and disease was extensive in 38%. Despite good clinical response and little toxicity the death rate was high (69%), but less than 10% died primarily because of the M. xenopi disease. The failure of treatment/relapse rate was 12%. Only 11 (26%) were known to be alive at 5 years of whom seven (17%) were known to be cured. There was no correlation between failure of treatment/relapse and in vitro resistance. Better methods of susceptibility testing and more effective regimens are needed, but it is also evident that improved management of concomitant diseases and better general health will play a major part in increasing survival.

Controlled trial of three weeks nicotine replacement treatment in hospital patients also given advice and support.

BACKGROUND: Smoking is a major public health issue, estimated as causing 120 000 deaths in the UK per year. Smoking cessation is an important aspect of the treatment of many diseases. Nicotine replacement therapy (NRT) has been shown to increase cessation rates among healthy volunteers and in general practice, but it is not clear whether it has an effect in hospital patients. METHODS: Patients referred by their hospital doctor to the smoking cessation counsellor and who agreed to participate in the study were randomised to receive either NRT given as a nicotine patch daily and a nicotine inhalator on an as needed basis plus advice and support (AS+NRT), or to receive just advice and support (AS). Claims of smoking cessation were validated at 1 week, 3 months, 6 months, and 1 year by carbon monoxide (CO) breath testing. RESULTS: A total of 245 patients were randomised, 136 AS+NRT and 109 AS. There were no significant demographic differences between the two groups at baseline. At 1 year 35 (14%) had sustained cessation confirmed by a CO breath test, 20/136 (15%) AS+NRT and 15/109 (14%) AS, p=0.857. One hundred and ten patients gave up smoking for at least 1 week, 54% AS+NRT and 33% AS (p<0.001). By 6 months there was no significant difference between the two groups (22/136 (16%) AS+NRT and 15/109 (14%) AS). CONCLUSION: In hospital patients NRT, given as regular daily patches plus an inhalator to be used as needed, did not add to the smoking cessation rate achieved at 1 year by regular advice and support, despite significantly increasing the cessation rate at 1 week.