Mammographic features and risk of breast cancer death among women with invasive screen-detected cancer in BreastScreen Norway 1996-2020.

OBJECTIVES: We explored associations between mammographic features and risk of breast cancer death among women with small (<15 mm) and large (≥15 mm) invasive screen-detected breast cancer. METHODS: We included data from 17,614 women diagnosed with invasive breast cancer as a result of participation in BreastScreen Norway, 1996-2020. Data on mammographic features (mass, spiculated mass, architectural distortion, asymmetric density, density with calcification and calcification alone), tumour diameter and cause of death was obtained from the Cancer Registry of Norway. Cox regression was used to estimate hazard ratios (HR) with 95% confidence intervals (CI) for breast cancer death by mammographic features using spiculated mass as reference, adjusting for age, tumour diameter and lymph node status. All analyses were dichotomised by tumour diameter (small versus large). RESULTS: Mean age at diagnosis was 60.8 (standard deviation, SD=5.8) for 10,160 women with small tumours and 60.0 (SD=5.8) years for 7454 women with large tumours. The number of breast cancer deaths was 299 and 634, respectively. Mean time from diagnosis to death was 8.7 (SD=5.0) years for women with small tumours and 7.2 (4.6) years for women with large tumours. Using spiculated mass as reference, adjusted HR for breast cancer death among women with small tumours was 2.48 (95% CI 1.67-3.68) for calcification alone, while HR for women with large tumours was 1.30 (95% CI 1.02-1.66) for density with calcification. CONCLUSIONS: Small screen-detected invasive cancers presenting as calcification and large screen-detected cancers presenting as density with calcification were associated with the highest risk of breast cancer death. CLINICAL RELEVANCE STATEMENT: Small tumours (<15 mm) presented as calcification alone and large tumours (≥ 15 mm) presented as density with calcification were associated with the highest risk of breast cancer death among women with screen-detected invasive breast cancer diagnosed 1996-2020. KEY POINTS: • Women diagnosed with invasive screen-detected breast cancer 1996-2020 were analysed. • Small screen-detected cancers presenting as calcification alone resulted in the highest risk of breast cancer death. • Large screen-detected cancers presenting as density with calcification resulted in the highest risk of breast cancer death.

[Clinical radiological evaluation of teeth-part 2 : Caries, inflammatory dental changes and important differential diagnoses]. / Klinisch-radiologische Beurteilung der Zähne ­ Teil 2 : Karies, entzündliche Zahnveränderungen und wichtige Differenzialdiagnosen.

Inflammatory diseases of the teeth and periodontium are widespread and are frequent secondary diagnoses in head and neck examinations. Periapical inflammation can be the cause of sinusitis or abscess formation in the oral and maxillofacial region. Early detection is important for the patient's course of treatment. For further diagnostics, a dental presentation should be carried out. Dental radiological examinations, such as panoramic radiographs and dental films are used for specific diagnostics. This article is intended to provide an overview of the different stages of caries, the most important inflammatory dental changes and their most frequent differential diagnoses.

[Clinical radiological evaluation of teeth-part 1 : Anatomy and anomalies]. / Klinisch-radiologische Beurteilung der Zähne ­Teil 1 : Anatomie und Anomalien.

Radiological assessment of the teeth and periodontium is often left to the dentist. Nevertheless, it is useful to know the anatomy and possible anomalies of the teeth in order to correctly assess pathological processes in both projection radiographic and slice imaging. Dental radiological examinations, such as panoramic slice imaging (PSA) and dental film are used for targeted diagnostics. In the case of incidental findings, a dental presentation should be made for further clarification. This article first provides an overview of the anatomy and anomalies of teeth.

Engineering atomic-scale magnetic fields by dysprosium single atom magnets.

Atomic scale engineering of magnetic fields is a key ingredient for miniaturizing quantum devices and precision control of quantum systems. This requires a unique combination of magnetic stability and spin-manipulation capabilities. Surface-supported single atom magnets offer such possibilities, where long temporal and thermal stability of the magnetic states can be achieved by maximizing the magnet/ic anisotropy energy (MAE) and by minimizing quantum tunnelling of the magnetization. Here, we show that dysprosium (Dy) atoms on magnesium oxide (MgO) have a giant MAE of 250 meV, currently the highest among all surface spins. Using a variety of scanning tunnelling microscopy (STM) techniques including single atom electron spin resonance (ESR), we confirm no spontaneous spin-switching in Dy over days at ≈ 1 K under low and even vanishing magnetic field. We utilize these robust Dy single atom magnets to engineer magnetic nanostructures, demonstrating unique control of magnetic fields with atomic scale tunability.

[The effect of mobile air filter systems on aerosol concentrations in large volume scenarios against the background of the risk of infection of COVID-19. Can classroom teaching be resumed?] / Der Effekt von mobilen Luftfiltersystemen auf die Aerosolbelastung in Großraumszenarien vor dem Hintergrund des Infektionsrisikos der COVID-19-Erkrankung. Kann die Präsenzlehre wieder aufgenommen werden?

BACKGROUND: As a consequence of the corona pandemic, universities nationwide had stopped classroom teaching by the start of the summer semester 2020. As part of the second lockdown, in many states schools and day care centers were also closed or reduced to a minimum. In this context the effect of room air filters has already been discussed multiple times; however, mobile devices for air filtration are currently not recommended by the German Federal Environment Agency. The following investigation shows the real effects of mobile air filters on aerosol concentrations when used in lecture theaters, canteens or school learning centers. METHODS: The effects of a mobile air purifier (DEMA-airtech, Stuttgart, Germany) were measured in three large rooms (a lecture theater, a company canteen and a learning center of a grammar school). Aerosol and carbon dioxide concentrations were determined with devices from the company Palas (Karlsruhe, Germany). RESULTS: All three scenarios showed a relevant and permanent decrease in aerosol concentrations through the use of air filters. The effect partly even surpassed the effectiveness of simple ventilation by opening the windows. CONCLUSION: In addition to social distancing and wearing highly efficient face masks, the use air filters is recommended. This measure could enable classroom teaching to be resumed.

Does it matter for the radiologists' performance whether they read short or long batches in organized mammographic screening?

OBJECTIVE: To analyze the association between radiologists' performance and image position within a batch in screen reading of mammograms in Norway. METHOD: We described true and false positives and true and false negatives by groups of image positions and batch sizes for 2,937,312 screen readings performed from 2012 to 2018. Mixed-effects models were used to obtain adjusted proportions of true and false positive, true and false negative, sensitivity, and specificity for different image positions. We adjusted for time of day and weekday and included the individual variation between the radiologists as random effects. Time spent reading was included in an additional model to explore a possible mediation effect. RESULT: True and false positives were negatively associated with image position within the batch, while the rates of true and false negatives were positively associated. In the adjusted analyses, the rate of true positives was 4.0 per 1000 (95% CI: 3.8-4.2) readings for image position 10 and 3.9 (95% CI: 3.7-4.1) for image position 60. The rate of true negatives was 94.4% (95% CI: 94.0-94.8) for image position 10 and 94.8% (95% CI: 94.4-95.2) for image position 60. Per 1000 readings, the rate of false negative was 0.60 (95% CI: 0.53-0.67) for image position 10 and 0.62 (95% CI: 0.55-0.69) for image position 60. CONCLUSION: There was a decrease in the radiologists' sensitivity throughout the batch, and although this effect was small, our results may be clinically relevant at a population level or when multiplying the differences with the number of screen readings for the individual radiologists. KEY POINTS: • True and false positive reading scores were negatively associated with image position within a batch. • A decreasing trend of positive scores indicated a beneficial effect of a certain number of screen readings within a batch. • False negative scores increased throughout the batch but the association was not statistically significant.

Forensic postmortem computed tomography in suspected unnatural adult deaths.

PURPOSE: Our study sought to evaluate validity of forensic postmortem CT in establishing cause of death (COD) in suspected unnatural adult death based on the reference standard of autopsy. METHODS: In our prospective, single-center study, 64 of 94 consecutive corpses (70.7 % male, mean age: 47.4 years) who underwent CT and autopsy between November 2013 and April 2019 were included in the analysis. Primary objective was agreement between CT and autopsy on primary COD using kappa statistics. Secondary objectives were competing COD and specific pathological findings. RESULTS: Agreement on primary COD between forensic CT and autopsy without or in consideration of toxicological and histological findings was strong (85.9 % [55 of 64 corpses]; κ = 0.83 [95 %CI: 0.74 to 0.93] and 95.3 % [61 of 64 corpses]; κ = 0.94 [95 %CI: 0.84-1.04], respectively, McNemar p = 0.03). Sensitivity and specificity of CT in identification of acute heart failure, intracranial bleeding, burns and heat shocks, gunshot wounds, polytrauma, cranio-cerebral trauma, and strangulation or hanging was 100 %, each. Acute respiratory failure was detected with a sensitivity and specificity of 100 % and 96.8 %, cuts and stab wounds with 95.2 % and 100 %, and intoxication, pneumonia, or gastrointestinal bleeding with 60.0 % and 100 %, respectively. Agreement on competing COD was moderate (51.6 %, [33 of 64 corpses]; κ = 0.47 [95 %CI: 0.40 to 0.53], p < 0.001). CONCLUSIONS: Forensic postmortem CT, complemented by external, toxicological, and histological examination was sufficiently valid to assess primary COD in the majority of suspected unnatural deaths with few restrictions.

Time of day and mammographic reader performance in a population-based breast cancer screening programme.

OBJECTIVES: To analyse how reader performance varied by time during the day in a population-based breast cancer screening programme. METHODS: A total of 2,937,312 readings from 148 radiologists and 1,468,656 women were included in this study from Norway. Number and percentages of mammographic readings, positive scores, true and false positive readings, true and false negative readings, sensitivity and specificity were presented for categories of time of day and for each day of the week. Multilevel mixed effect logistic regression models with restricted cubic splines were fitted to the data, and used to predict the odds ratio of the different performance measures. RESULTS: The following distribution was found for the performance measures during the study period: true positive: 12,463 (0.4%); false positive: 128,419 (4.4%); true negative: 2,794,636 (95.1%); and false negative: 1794 (0.06%). The percentage of positive readings (true positive and false positive) was highest before lunch and in the early afternoon (4.9%): false positive was highest in both periods (4.5%) and true positive was highest in the early afternoon (0.5%). The percentage of true negative was highest in the evening (95.6%), and of false negative was highest at lunchtime (0.07%). This corresponds to a gradually decreasing predicted sensitivity throughout the day. The opposite was observed for specificity. CONCLUSIONS: Screen-reading early versus late during the day resulted in higher sensitivity, although at the cost of specificity. Despite small differences in the performance measures during the day, the results may be important in the discussion of optimal management of screening programmes.

[Chronic nonbacterial osteomyelitis : Imaging and differential diagnoses]. / Chronische nichtbakterielle Osteomyelitis : Bildgebung und Differenzialdiagnosen.

Chronic nonbacterial osteomyelitis (CNO) is an autoinflammatory bone disease in childhood and adolescence with a preference for the female gender. It is manifested with multiple osseous lesions, with a predilection for the metaphyseal end zones of the long bones of the lower extremities. These bone lesions usually occur multifocally, can recur and develop a different appearance depending on the bone structure affected. Patients present with a longer disease history, changing clinical symptoms and unspecific paraclinical signs. Magnetic resonance imaging (MRI) is the imaging of choice and particularly as a whole body examination can speed up the diagnosis and is an important component of follow-up controls. Differential diagnoses include numerous inflammatory, benign and malignant bone diseases. Therefore, it is essential to know the diagnosis of CNO and to take it into consideration in cases of an unclear inflammatory bone process in young patients.

Essential roles of interstitial cells in testicular development and function.

BACKGROUND: Testicular architecture and sperm production are supported by a complex network of communication between various cell types. These signals ensure fertility by: regulating spermatogonial stem/progenitor cells; promoting steroidogenesis; and driving male-specific differentiation of the gonad. Sertoli cells have long been assumed to be the major cellular player in testis organogenesis and spermatogenesis. However, cells in the interstitial compartment, such as Leydig, vascular, immune, and peritubular cells, also play prominent roles in the testis but are less well understood. OBJECTIVES: Here, we aim to outline our current knowledge of the cellular and molecular mechanisms by which interstitial cell types contribute to spermatogenesis and testicular development, and how these diverse constituents of the testis play essential roles in ensuring male sexual differentiation and fertility. METHODS: We surveyed scientific literature and summarized findings in the field that address how interstitial cells interact with other interstitial cell populations and seminiferous tubules (i.e., Sertoli and germ cells) to support spermatogenesis, male-specific differentiation, and testicular function. These studies focused on 4 major cell types: Leydig cells, vascular cells, immune cells, and peritubular cells. RESULTS AND DISCUSSION: A growing number of studies have demonstrated that interstitial cells play a wide range of functions in the fetal and adult testis. Leydig cells, through secretion of hormones and growth factors, are responsible for steroidogenesis and progression of spermatogenesis. Vascular, immune, and peritubular cells, apart from their traditionally acknowledged physiological roles, have a broader importance than previously appreciated and are emerging as essential players in stem/progenitor cell biology. CONCLUSION: Interstitial cells take part in complex signaling interactions with both interstitial and tubular cell populations, which are required for several biological processes, such as steroidogenesis, Sertoli cell function, spermatogenesis, and immune regulation. These various processes are essential for testicular function and demonstrate how interstitial cells are indispensable for male fertility.

Enhanced quantum coherence in exchange coupled spins via singlet-triplet transitions.

Manipulation of spin states at the single-atom scale underlies spin-based quantum information processing and spintronic devices. These applications require protection of the spin states against quantum decoherence due to interactions with the environment. While a single spin is easily disrupted, a coupled-spin system can resist decoherence by using a subspace of states that is immune to magnetic field fluctuations. Here, we engineered the magnetic interactions between the electron spins of two spin-1/2 atoms to create a "clock transition" and thus enhance their spin coherence. To construct and electrically access the desired spin structures, we use atom manipulation combined with electron spin resonance (ESR) in a scanning tunneling microscope. We show that a two-level system composed of a singlet state and a triplet state is insensitive to local and global magnetic field noise, resulting in much longer spin coherence times compared with individual atoms. Moreover, the spin decoherence resulting from the interaction with tunneling electrons is markedly reduced by a homodyne readout of ESR. These results demonstrate that atomically precise spin structures can be designed and assembled to yield enhanced quantum coherence.

Signatures of transient Wannier-Stark localization in bulk gallium arsenide.

Many properties of solids result from the fact that in a periodic crystal structure, electronic wave functions are delocalized over many lattice sites. Electrons should become increasingly localized when a strong electric field is applied. So far, this Wannier-Stark regime has been reached only in artificial superlattices. Here we show that extremely transient bias over the few-femtosecond period of phase-stable mid-infrared pulses may localize electrons even in a bulk semiconductor like GaAs. The complicated band structure of a three-dimensional crystal leads to a strong blurring of field-dependent steps in the Wannier-Stark ladder. Only the central step emerges strongly in interband electro-absorption because its energetic position is dictated by the electronic structure at an atomic level and therefore insensitive to the external bias. In this way, we demonstrate an extreme state of matter with potential applications due to e.g., its giant optical non-linearity or extremely high chemical reactivity.

[Weaning Unit of the University Medicine Greifswald - Institutional Structure and Weaning Results from Prolonged Ventilation over 10 Years]. / Weaningzentrum Greifswald ­ Struktur und Ergebnisse bei der Entwöhnung von der Langzeitbeatmung über zehn Jahre.

The increasing importance of intensive care medicine including mechanical ventilation has been accompanied by the demand of weaning opportunities for patients undergoing prolonged mechanical ventilation. Consequently, specialised clinical institutions, focusing on the weaning from mechanical ventilation, have been established since the 1980 s.The present article illustrates the structural development and results of such a specialised institution at the University Medicine Greifswald, using data of 616 patients collected within the past ten years (2006 - 2015). Across the years, a shift in the underlying disease leading to mechanical ventilation can be found, with rising numbers of patients suffering from pneumonia/sepsis and declining numbers of patients who underwent cardiac surgery in advance. The days with mechanical ventilation outside (p = 0.004) and within the investigated institution (p = 0.02) are significantly declining. The percentage of successfully weaned patients increased from 62.7 % (2006 - 2010) to 77.3 % (2011 - 2015), p < 0.001. Consecutively, the percentage of patients who remained mechanically ventilated decreased from 16.4 % to 9.6 % (p < 0.001) and the share of in-hospital deceased patients significantly declined from 20.9 % to 13.0 % (p < 0.001). Furthermore, the one-year-survival after hospital discharge in successful weaned patients was 72 percent. The present data, collected at the University Medicine Greifswald are quite comparable to data of other German institutions that are specialised on weaning from mechanical ventilation.

Leaching and selective zinc recovery from acidic leachates of zinc metallurgical leach residues.

Zinc (Zn) leaching yields and kinetics from three different zinc plant leach residues (ZLR) generated in different periods (ZLR1>30 years, ZLR2 5-30 years and ZLR3<2 years) were investigated. The factors affecting the Zn leaching rate such as solid to liquid ratio, temperature, acid concentration and agitation were optimized. Under optimum conditions, 46.2 (±4.3), 23.3 (±2.7) and 17.6 (±1.2) mg of Zn can be extracted per gram of ZLR1, ZLR2 and ZLR3, respectively. The Zn leaching kinetics of ZLRs follow the shrinking core diffusion model. The activation energy required to leach Zn from ZLR1, ZLR2 and ZLR3 were estimated to be 2.24kcal/mol, 6.63kcal/mol and 11.7kcal/mol, respectively, by the Arrhenius equation. The order of the reaction with respect to the sulfuric acid concentration was also determined as 0.20, 0.56, and 0.87 for ZLR1, ZLR2 and ZLR3, respectively. Zn was selectively recovered from the leachates by adjusting the initial pH and by the addition of sodium hydroxide and sodium sulfide. More than 90% of Zn was selectively recovered as sphalerite from the ZLR polymetallic leachates by chemical sulfide precipitation.

Moraxella catarrhalis induces CEACAM3-Syk-CARD9-dependent activation of human granulocytes.

The human restricted pathogen Moraxella catarrhalis is an important causal agent for exacerbations in chronic obstructive lung disease in adults. In such patients, increased numbers of granulocytes are present in the airways, which correlate with bacteria-induced exacerbations and severity of the disease. Our study investigated whether the interaction of M. catarrhalis with the human granulocyte-specific carcinoembryonic antigen-related cell adhesion molecule (CEACAM)-3 is linked to NF-κB activation, resulting in chemokine production. Granulocytes from healthy donors and NB4 cells were infected with M. catarrhalis in the presence of different inhibitors, blocking antibodies and siRNA. The supernatants were analysed by enzyme-linked immunosorbent assay for chemokines. NF-κB activation was determined using a luciferase reporter gene assay and chromatin-immunoprecipitation. We found evidence that the specific engagement of CEACAM3 by M. catarrhalis ubiquitous surface protein A1 (UspA1) results in the activation of pro-inflammatory events, such as degranulation of neutrophils, ROS production and chemokine secretion. The interaction of UspA1 with CEACAM3 induced the activation of the NF-κB pathway via Syk and the CARD9 pathway and was dependent on the phosphorylation of the CEACAM3 ITAM-like motif. These findings suggest that the CEACAM3 signalling in neutrophils is able to specifically modulate airway inflammation caused by infection with M. catarrhalis.

Leaching and selective copper recovery from acidic leachates of Três Marias zinc plant (MG, Brazil) metallurgical purification residues.

Zinc plant purification residue (ZPR), a typical Zn-hydrometallurgical waste, was collected from the Três Marias Zn plant (MG, Brazil). ZPR was characterized for its metal content and fractionation, mineralogy, toxicity and leachability. Toxicity characteristics leaching procedure (TCLP) and European Community Bureau of Reference (BCR) sequential extraction results revealed that this ZPR displays high percentages of metals (Cd, Cu, Zn and Pb) in the highly mobilizable fractions, increasing its hazardous potential. Bulk chemical analysis, pH dependent leaching and acid (H2SO4) leaching studies confirm that the ZPR is polymetallic, rich in Cd, Cu and Zn. The sulfuric acid concentration (1 M), agitation speed (450 rpm), temperature (40 °C) and pulp density (20 g L(-1)) were optimized to leach the maximum amount of heavy metals (Cd, Cu and Zn). Under optimum conditions, more than 50%, 70% and 60% of the total Cd, Cu and Zn present in the ZPR can be leached, respectively. The metals in the acid leachates were investigated for metal sulfide precipitation with an emphasis on selective Cu recovery. Metal sulfide precipitation process parameters such as initial pH and Cu to sulfide ratio were optimized as pH 1.5 and 1:0.5 (Cu:sulfide) mass ratio, respectively. Under optimum conditions, more than 95% of Cu can be selectively recovered from the polymetallic ZPR leachates. The Cu precipitates characterization studies reveal that they are approximately 0.1 µm in diameter and mainly consist of Cu and S. XRD analysis showed covellite (CuS), chalcanthite (CuSO4·5H2O) and natrochalcite (NaCu2(SO4)2(OH)·H2O) as the mineral phases. ZPRs can thus be considered as an alternative resource for copper production.

Fractionation and leachability of heavy metals from aged and recent Zn metallurgical leach residues from the Três Marias zinc plant (Minas Gerais, Brazil).

Various mineral processing operations to produce pure metals from mineral ores generate sludges, residues, and other unwanted by-products/wastes. As a general practice, these wastes are either stored in a reservoir or disposed in the surrounding of mining/smelting areas, which might cause adverse environmental impacts. Therefore, it is important to understand the various characteristics like heavy metal leaching features and potential toxicity of these metallurgical wastes. In this study, zinc plant leach residues (ZLRs) were collected from a currently operating Zn metallurgical industry located in Minas Gerais (Brazil) and investigated for their potential toxicity, fractionation, and leachability. Three different ZLR samples (ZLR1, ZLR2, and ZLR3) were collected, based on their age of production and deposition. They mainly consisted of Fe (6-11.5 %), Zn (2.5 to 5.0 %), and Pb (1.5 to 2.5 %) and minor concentrations of Al, Cd, Cu, and Mn, depending on the sample age. Toxicity Characteristic Leaching Procedure (TCLP) results revealed that these wastes are hazardous for the environment. Accelerated Community Bureau of Reference (BCR) sequential extraction clearly showed that potentially toxic heavy metals such as Cd, Cu, Pb, and Zn can be released into the environment in high quantities under mild acidic conditions. The results of the liquid-solid partitioning as a function of pH showed that pH plays an important role in the leachability of metals from these residues. At low pH (pH 2.5), high concentrations of metals can be leached: 67, 25, and 7 % of Zn can be leached from leach residues ZLR1, ZLR2, and ZLR3, respectively. The release of metals decreased with increasing pH. Geochemical modeling of the pH-dependent leaching was also performed to determine which geochemical process controls the leachability/solubility of the heavy metals. This study showed that the studied ZLRs contain significant concentrations of non-residual extractable fractions of Zn and can be seen as a potential secondary resource for Zn.

ATP-Evoked Intracellular Ca²âº Signaling of Different Supporting Cells in the Hearing Mouse Hemicochlea.

Hearing and its protection is regulated by ATP-evoked Ca(2+) signaling in the supporting cells of the organ of Corti, however, the unique anatomy of the cochlea hampers observing these mechanisms. For the first time, we have performed functional ratiometric Ca(2+) imaging (fura-2) in three different supporting cell types in the hemicochlea preparation of hearing mice to measure purinergic receptor-mediated Ca(2+) signaling in pillar, Deiters' and Hensen's cells. Their resting [Ca(2+)]i was determined and compared in the same type of preparation. ATP evoked reversible, repeatable and dose-dependent Ca(2+) transients in all three cell types, showing desensitization. Inhibiting the Ca(2+) signaling of the ionotropic P2X (omission of extracellular Ca(2+)) and metabotropic P2Y purinergic receptors (depletion of intracellular Ca(2+) stores) revealed the involvement of both receptor types. Detection of P2X2,3,4,6,7 and P2Y1,2,6,12,14 receptor mRNAs by RT-PCR supported this finding and antagonism by PPADS suggested different functional purinergic receptor population in pillar versus Deiters' and Hensen's cells. The sum of the extra- and intracellular Ca(2+)-dependent components of the response was about equal with the control ATP response (linear additivity) in pillar cells, and showed supralinearity in Deiters' and Hensen's cells. Calcium-induced calcium release might explain this synergistic interaction. The more pronounced Ca(2+) leak from the endoplasmic reticulum in Deiters' and Hensen's cells, unmasked by cyclopiazonic acid, may also suggests the higher activity of the internal stores in Ca(2+) signaling in these cells. Differences in Ca(2+) homeostasis and ATP-induced Ca(2+) signaling might reflect the distinct roles these cells play in cochlear function and pathophysiology.

Origin of Perpendicular Magnetic Anisotropy and Large Orbital Moment in Fe Atoms on MgO.

We report on the magnetic properties of individual Fe atoms deposited on MgO(100) thin films probed by x-ray magnetic circular dichroism and scanning tunneling spectroscopy. We show that the Fe atoms have strong perpendicular magnetic anisotropy with a zero-field splitting of 14.0±0.3 meV/atom. This is a factor of 10 larger than the interface anisotropy of epitaxial Fe layers on MgO and the largest value reported for Fe atoms adsorbed on surfaces. The interplay between the ligand field at the O adsorption sites and spin-orbit coupling is analyzed by density functional theory and multiplet calculations, providing a comprehensive model of the magnetic properties of Fe atoms in a low-symmetry bonding environment.