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Nitrogen is a plant growth limiting nutrient in natural ecosystems, however, many agricultural systems are saturated due to high fertilizer applications. This can lead to higher costs, nitrogen leakage into the environment and unnecessary GHG emissions that contribute to climate change. To avoid this, Neilson (2021) has proposed an approach based on minimal input agricultural systems (MIAS). MIAS seeks to grow crops with limited fertilizer inputs. This is accomplished through targeted/precision fertilizer placement, managing plant physiology to operate at higher efficiencies and adopting new varieties. To work optimally MIAS requires methods to quickly assess plant nutrient status and adjust fertilizer applications accordingly. This study tested remote sensing for detecting stress in potato plants, based on two separate and independent laboratory remote sensing experiments. The goal is to determine minimal input levels applied to a starvation agricultural system that provide yields equivalent (or perhaps even improving upon) those obtained using current excessive inputs, both in terms of yield and, importantly, quality. This research is at the front-end of a proposed paradigm shifting new approach to agriculture. We are being careful to start at first principles in this work; thus the study presented here is based on multiple trials and independent tests. Results testing experimental approaches and N deprivation assessment determined the optimal leaf density and timing of measurements and demonstrated a capability to detect vegetation stress and N deprivation in three potato varieties. These results will inform next steps for future RPAS/UAV/airborne/satellite studies and be used to develop other plant physiology assessment methods.

Background Data on the benefits of cardiac resynchronization therapy (CRT) in patients with severe heart failure symptoms are limited. We investigated the relative effects of CRT in patients with ambulatory New York Heart Association (NYHA) IV versus III functional class at the time of device implantation. Methods and Results In this meta‐analysis, we pooled patient‐level data from the MIRACLE (Multicenter InSync Randomized Clinical Evaluation), MIRACLE‐ICD (Multicenter InSync Implantable Cardioversion Defibrillation Randomized Clinical Evaluation), and COMPANION (Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure) trials. Outcomes evaluated were time to the composite end point of the first heart failure hospitalization or all‐cause mortality, and time to all‐cause mortality alone. The association between CRT and outcomes was evaluated using a Bayesian hierarchical Weibull survival regression model. We assessed if this association differed between NYHA III and IV groups by adding an interaction term between CRT and NYHA class as a random effect. A sensitivity analysis was performed by including data from RAFT (Resynchronization‐Defibrillation for Ambulatory Heart Failure). Our pooled analysis included 2309 patients. Overall, CRT was associated with a longer time to heart failure hospitalization or all‐cause mortality (adjusted hazard ratio [aHR], 0.79 [95% credible interval [CI], 0.64–0.99]; posterior probability or P=0.044), with a similar association with time to all‐cause mortality (aHR, 0.78 [95% CI, 0.59–1.03]; P=0.083). Associations of CRT with outcomes were not significantly different for those in NYHA III and IV classes (ratio of aHR, 0.72 [95% CI, 0.30–1.27]; P=0.23 for heart failure hospitalization/mortality; ratio of aHR, 0.70 [95% CI, 0.35–1.34]; P=0.27 for all‐cause mortality alone). The sensitivity analysis, including RAFT data, did not show a significant relative CRT benefit between NYHA III and IV classes. Conclusions Overall, there was no significant difference in the association of CRT with either outcome for patients in NYHA functional class III compared with functional class IV.

Abstract Cardiac physiologic pacing (CPP), encompassing cardiac resynchronization therapy (CRT) and conduction system pacing (CSP), has emerged as a pacing therapy strategy that may mitigate or prevent the development of heart failure (HF) in patients with ventricular dyssynchrony or pacing‐induced cardiomyopathy. This clinical practice guideline is intended to provide guidance on indications for CRT for HF therapy and CPP in patients with pacemaker indications or HF, patient selection, pre‐procedure evaluation and preparation, implant procedure management, follow‐up evaluation and optimization of CPP response, and use in pediatric populations. Gaps in knowledge, pointing to new directions for future research, are also identified.

Resumo Fundamento Apesar de progresso significativo na melhoria da qualidade do tratamento de doenças cardiovasculares, lacunas persistem em termos de falha na adesão às recomendações de diretrizes. Objetivo Este estudo avalia os efeitos da implementação de um programa de melhoria da qualidade adaptado do Programa Get with the guidelines® da American Heart Association sobre a adesão às diretrizes para síndrome coronária aguda (SCA), fibrilação atrial (FA) e insuficiência cardíaca (IC). Métodos Avaliamos dados demográficos, medidas de qualidade, e desfechos em curto prazo em pacientes com SCA, FA, e IC incluídos no programa Boas Práticas em Cardiologia (BPC) entre 2016 e 2022. Resultados Este estudo incluiu 12167 pacientes em 19 hospitais no Brasil. A idade média foi 62,5 [53,8-71] anos, 61,1% eram do sexo masculino, 68,7% apresentaram hipertensão, 32% diabetes mellitus, e 24,1% dislipidemia. Os escores médios compostos tiveram desempenho sustentável entre o período inicial e o último trimestre do seguimento: 65,8±36,2% a 73± 31,2% para FA (p=0,024); 81,0± 23,6% a 89,9 ± 19,3% para IC (p

Abstract Endothelial cells line all major blood vessels and serve as integral regulators of many functions including vessel diameter, cellular trafficking, and transport of soluble mediators. Despite similar functions, the phenotype of endothelial cells is highly organ-specific, yet our understanding of the mechanisms leading to organ-level differentiation is incomplete. We generated 3D microvessel networks by combining a common naïve endothelial cell with six different stromal cells derived from the lung, skin, heart, bone marrow, pancreas, and pancreatic cancer. Single cell RNA-Seq analysis of the microvessel networks reveals five distinct endothelial cell populations, for which the relative proportion depends on the stromal cell population. Morphologic features of the organotypic vessel networks inversely correlate with a cluster of endothelial cells associated with protein synthesis. The organotypic stromal cells were each characterized by a unique subpopulation of cells dedicated to extracellular matrix organization and assembly. Finally, compared to cells in 2D monolayer, the endothelial cell transcriptome from the 3D in vitro heart, skin, lung, and pancreas microvessel networks are more similar to the in vivo endothelial cells from the respective organs. We conclude that stromal cells contribute to endothelial cell and microvessel network organ tropism, and create an endothelial cell phenotype that more closely resembles that present in vivo.

Van der Waals magnetic materials are composed of atomically thin magnetically ordered layers stacked together. Here, aiming to control magnetism locally, Klein et al use an electron beam to create small regions where van der Waals layers are orientated perpendicular to the rest of the sample.

Light-induced superconductivity is a recent phenomenon where many aspects of the underlying physics are still to be fully understood. Here, the authors analyse coupled Ginzburg-Landau and Maxwell equations to investigate the dynamics of the quantum states when a superconductor is irradiated by a laser pulse.

Control of quantum matter through resonant electromagnetic cavities is a promising route towards establishing control over material phases and functionalities. Quantum paraelectric insulators—materials that are nearly ferroelectric—are particularly promising candidate systems for this purpose since they have strongly fluctuating collective modes that directly couple to the electric field. In this work, we explore this possibility in a system comprised of a quantum paraelectric sandwiched between two high-quality metal mirrors, realizing a Fabry-Perot-type cavity. By developing a full multimode, continuum description we are able to study the effect of the cavity in a spatially resolved way for a variety of system sizes and temperatures. Surprisingly, we find that once a continuum of transverse modes is included the cavity ends up suppressing ferroelectric correlations. This effect arises from the screening out of transverse photons at the cavity boundaries and, as a result, is confined to the surface of the paraelectric sample. We also explore the temperature dependence of this effect and find it vanishes at high temperatures, indicating it is a purely quantum mechanical effect. We connect our result to calculations of Casimir and Van der Waals forces, which we argue are closely related to the dipolar fluctuations in the quantum paraelectric. Our results are based on a general formalism and are expected to be widely applicable, paving the way towards studies of the quantum electrodynamics of heterostructures featuring multiple materials and phases.

Variations in unconventional superconductors are increasing in number and diversity in recent years, and so it is increasingly important to develop analytical methods to distinguish and categorise their different features. Here, the authors study two types of collective modes of the order parameter unique to time-reversal symmetry breaking superconductors and propose using them to identify these exotic states.

ABCA4 is an ATP-binding cassette (ABC) transporter that flips N-retinylidenephosphatidylethanolamine (N-Ret-PE) to the cytoplasmic leaflet of photoreceptor membranes. ABCA4 mutations are associated with loss of vision. Here, structures of ABCA4 with and without substrate bound provide insight into N-Ret-PE binding and suggest a lateral access mechanism.

Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia in clinical practice. Radiofrequency and cryoballoon catheter ablation are therapeutic options in addition to antiarrhythmic drug therapy for the treatment of AF. Ablation is effective at reducing recurrent atrial arrhythmias and also in the reduction of AF burden. Besides arrhythmia control, improvement in quality of life and clinical outcomes are also desirable goals with AF treatment. Randomized clinical trials have evaluated ablation in several patient populations, including symptomatic patients as first-line or second-line therapy, asymptomatic patients, and patients with heart failure. These trials clarify the durability of ablation in arrhythmia control, clarify quality-of-life improvement, and identify patient populations in whom ablation may be expected to improve clinical outcomes. In this review, we summarize the major clinical trials involving ablation; discuss the strengths, weakness, and clinical implications of these trials; and highlight the knowledge gaps in our current understanding of AF ablation for future clinical studies.

Resumo Fundamento Existem grandes oportunidades de melhoria da qualidade do cuidado cardiovascular em países em desenvolvimento por meio da implementação de um programa de qualidade. Objetivo Avaliar o efeito de um programa de Boas Práticas em Cardiologia (BPC) nos indicadores de desempenho e desfechos clínicos dos pacientes relacionados à insuficiência cardíaca, fibrilação atrial e síndromes coronarianas agudas em um subconjunto de hospitais públicos brasileiros. Métodos O programa Boas Práticas em Cardiologia (BPC) foi adaptado do programa Get With The Guidelines (GWTG) da American Heart Association (AHA) para ser utilizado no Brasil. O programa está sendo iniciado em três domínios de cuidado simultaneamente (síndrome coronariana aguda, fibrilação atrial e insuficiência cardíaca), o que consiste em uma abordagem nunca testada no GWTG. Existem seis eixos de intervenções utilizadas pela literatura sobre tradução do conhecimento que abordará barreiras locais identificadas por meio de entrevistas estruturadas e reuniões regulares para auditoria e feedback. Planeja-se incluir no mínimo 10 hospitais e 1500 pacientes por doença cardíaca. O desfecho primário inclui as taxas de adesão às medidas de cuidado recomendadas pelas diretrizes. Desfechos secundários incluem o efeito do programa sobre o tempo de internação, mortalidade global e específica, taxas de readmissão, qualidade de vida, percepção do paciente sobre saúde e adesão dos pacientes às intervenções prescritas. Resultados Espera-se, nos hospitais participantes, uma melhoria e a manutenção das taxas de adesão as recomendações baseadas em evidência e dos desfechos dos pacientes. Este é o primeiro programa em melhoria da qualidade a ser realizado na América do Sul, que fornecerá informações importantes de como programas de sucesso originados em países desenvolvidos como os Estados Unidos podem ser adaptados às necessidades de países com economias em desenvolvimento como o Brasil. Um programa bem sucedido dará informações valiosas para o desenvolvimento de programas de melhoria da qualidade em outros países em desenvolvimento. Conclusões Este estudo de mundo real proverá informações para a avaliação e aumento da adesão às diretrizes de cardiologia no Brasil, bem como a melhora dos processos assistenciais. (Arq Bras Cardiol. 2020; 115(1):92-99)

Background: Various methods have been implemented for screening of patients for atrial fibrillation (AF), but the yield has generally been low. Targeting high-risk patients may improve detection of asymptomatic AF, which could be of value if appropriate treatment could be initiated before a potential thromboembolic event. Objective: The purpose of this study was to test screening of high-risk nursing home residents having ≥2 risk factors for AF and no previous history of AF using a smartphone-based electrocardiographic (ECG) monitoring device to determine whether it is an accurate, easy-to-use method of screening for asymptomatic AF. Methods: Study participants had ≥2 risk factors, consisting of age ≥75 years, female sex, obstructive sleep apnea, peripheral vascular disease, diabetes mellitus, obesity, hypertension, and congestive heart failure. Using the monitoring device, 30-second heart rhythm recordings were obtained on 4 different occasions. All tracings were reviewed by a cardiologist and, if uncertain, by an electrophysiologist. The nursing facility was notified of any diagnosis of AF, prompting further evaluation by the primary physician. Results: Of the 245 residents screened, 18 (7.4%) had a diagnostic tracing for AF, 15 (83.3%) of whom had AF on the initial screen. There were no significant differences in demographics or individual risk factors between residents with and those without AF. Conclusion: Intermittent ECG screening of high-risk nursing home residents using a simple, handheld device provided a diagnostic yield in our population comparable to that observed in past studies. Such screening of high-risk individuals can aid in the early diagnosis of AF and initiation of appropriate treatment.

Background: Guideline-directed device therapies (GDDT) improve outcomes for eligible patients with heart failure (HF) with reduced ejection fraction (HFrEF). Utilization rates of device therapies in HFrEF after the 2012 ACCF/AHA/HRS Focused Update for Device-based Therapies of Cardiac Rhythm Abnormalities have not been well studied. Objective: Characterize the use of GDDT in newly indicated HFrEF patients from 2012 to 2019 using aggregated electronic health record (EHR) data. Methods: Computable phenotyping algorithms for implantable cardioverter defibrillator/cardiac resynchronization therapy-defibrillator (ICD/CRT-D) indications from the GuideLine Indications Detected in EHR for Heart Failure program (GLIDE-HF) used diagnoses, procedures, measures, prescriptions, and the output of natural language processed provider notes from de-identified Optum® EHR data. Patients had a diagnosis of HF, dilated cardiomyopathy, or prior infarct, and were included if they had HFrEF with >1 year of records prior to a new Class 1 or Class 2a indication for an ICD or cardiac resynchronization therapy with defibrillator (CRT-D) from 2012 to 2019. Results: Records showed 137,476 HFrEF patients were newly indicated for an ICD or CRT-D. GDDT was used in 14,892 of 36,358 (41.0%) CRT-D indicated patients and in 14,904 of 101,118 (14.7%) ICD-indicated patients. While GDDT use was low, 95.7% had echocardiography and 92.1% had prescriptions for beta-blockers or angiotensin-converting enzyme/angiotensin-receptor blockers medications. Conclusions: In this modern cohort of HF patients, a large proportion of eligible patients did not receive ICDs or CRT-Ds, while frequently receiving other indicated cardiovascular interventions and treatments.

By using intense coherent electromagnetic radiation, it may be possible to manipulate the properties of quantum materials very quickly, or even induce new and potentially useful phases that are absent in equilibrium. For instance, ultrafast control of magnetic dynamics is crucial for a number of proposed spintronic devices, and it can also shed light on the possible dynamics of correlated phases out of equilibrium. Inspired by recent experiments on spin-orbital ferromagnet YTiO_{3}, we consider the nonequilibrium dynamics of a Heisenberg ferromagnetic insulator with low-lying orbital excitations. We model the dynamics of the magnon excitations in this system following an optical pulse that resonantly excites infrared-active phonon modes. As the phonons ring down, they can dynamically couple the orbitals with the low-lying magnons, leading to a dramatically modified effective bath for the magnons. We show that this transient coupling can lead to a dynamical acceleration of the magnetization dynamics, which is otherwise bottlenecked by small anisotropy. Exploring the parameter space more, we find that the magnon dynamics can also even completely reverse, leading to a negative relaxation rate when the pump is blue-detuned with respect to the orbital bath resonance. We therefore show that by using specially targeted optical pulses, one can exert a much greater degree of control over the magnetization dynamics, allowing one to optically steer magnetic order in this system. We conclude by discussing interesting parallels between the magnetization dynamics we find here and recent experiments on photoinduced superconductivity, where it is similarly observed that depending on the initial pump frequency, an apparent metastable superconducting phase emerges.

The development of immune checkpoint inhibitors (ICIs) has revolutionized the treatment of patients with advanced stage cancers. However, immune-related adverse events are frequently observed. Cardiac toxicity from ICI therapy can range from asymptomatic troponin-I elevations to conduction abnormalities of the heart and even fulminant myocarditis. Although rare, myocarditis is a potentially fatal adverse effect of ICI therapy. We present a series of five cases of ICI-related cardio-toxicity diagnosed and managed at Roswell Park Comprehensive Cancer Center along with a review of published case reports in the literature. Our series highlights the importance of high clinical suspicion, early diagnosis of myocarditis, and prompt initiation of immunosuppressive therapy.

Background Immune checkpoint inhibitors (ICI) have emerged as a front-line therapy for a variety of solid tumors. With the widespread use of these agents, immune-associated toxicities are increasingly being recognized, including fatal myocarditis. There are limited data on the outcomes and prognostic utility of biomarkers associated with ICI-associated myocarditis. Our objective was to examine the associations between clinical biomarkers of cardiomyocyte damage and mortality in patients with cancer treated with ICIs.Methods We retrospectively studied 23 patients who developed symptomatic and asymptomatic troponin elevations while receiving ICI therapy at a National Cancer Institute-designated comprehensive cancer center. We obtained serial ECGs, troponin I, and creatine kinase-MD (CK-MB), in addition to other conventional clinical biomarkers, and compared covariates between survivors and non-survivors.Results Among patients with myocarditis, higher troponin I (p=0.037) and CK-MB (p=0.034) levels on presentation correlated with progression to severe myocarditis. Higher troponin I (p=0.016), CK (p=0.013), and CK-MB (p=0.034) levels were associated with increased mortality, while the presence of advanced atrioventricular block on presentation (p=0.088) trended toward increased mortality. Weekly troponin monitoring lead to earlier hospitalization for potential myocarditis (p=0.022) and was associated with decreased time to steroid initiation (p=0.053) and improved outcomes.Conclusions Routine troponin surveillance may be helpful in predicting mortality in ICI-treated patients with cancer in the early phase of ICI therapy initiation. Early detection of troponin elevation is associated with earlier intervention and improved outcomes in ICI-associated myocarditis. The recommended assessment and diagnostic studies guiding treatment decisions are presented.

To decrease diabetes morbidity and mortality rates, early interventions are needed to change lifestyles that are often cemented early, making school-based interventions important. However, with limited resources and lack of within-county diabetes data, it is difficult to determine which local areas require intervention. To identify at-risk school districts, this study mapped diabetes prevalence and related deaths by school district using geographic information systems (GIS). The 2010-2014 records of diabetes-related deaths were identified for 13 cities in Michigan, USA. Diabetes prevalence was estimated using the weighted average of population by school district from the ‘500 Cities Project’ of the Centres of Disease Control and prevention (CDC). Prevalence and mortality rates were mapped by school district and the correlation between diabetes prevalence and mortality rate analysed using the Spearman’s rank correlation. Years of potential life lost (YPLL) were calculated using a 75-year endpoint. The result indicated there were geographic variations in diabetes prevalence, mortality and YPLL across Michigan. Most census tracts in the cities of Detroit, Flint and downtown Grand Rapids had higher diabetes prevalence and mortality rate with rs (628)=0.52, P

Background Knowledge is scarce regarding how multimorbidity is associated with therapeutic decisions regarding oral anticoagulants (OACs) in patients with atrial fibrillation. Methods and Results We conducted a cross‐sectional study of hospitalized patients with atrial fibrillation using the Get With The Guidelines‐Atrial Fibrillation registry from 2013 to 2019. We identified patients ≥65 years and eligible for OAC therapy. Using 16 available comorbidity categories, patients were stratified by morbidity burden. A multivariable logistic regression model was used to determine the odds of receiving OAC prescription at discharge by morbidity burden. We included 34 174 patients with a median (interquartile range) age of 76 (71–83) years, 56.6% women, and 41.9% were not anticoagulated at admission. Of these patients, 38.6% had 0 to 2 comorbidities, 50.7% had 3 to 5 comorbidities, and 10.7% had ≥6 comorbidities. The overall discharge OAC prescription was high (85.6%). The prevalence of patients with multimorbidity increased from 59.7% in 2014 to 64.3% in 2019 (P trend=0.002). Using 0 to 2 comorbidities as the reference, the adjusted odds ratio (95% CI) of OAC prescription were 0.93 (0.82, 1.05) for patients with 3 to 5 comorbidities and 0.72 (0.60, 0.86) for patients with ≥6 comorbidities. In those with ≥6 comorbidities, the most common reason for nonprescription of OACs were frequent falls/frailty (31.0%). Conclusions In a contemporary quality‐of‐care database of hospitalized patients with atrial fibrillation eligible for OAC therapy, multimorbidity was common. A higher morbidity burden was associated with a lower odds of OAC prescription. This highlights the need for interventions to improve adherence to guideline‐recommended anticoagulation in multimorbid patients with atrial fibrillation.

Cavity control of quantum matter may offer new ways to study and manipulate many-body systems. A particularly appealing idea is to use cavities to enhance superconductivity, especially in unconventional or high-T_{c} systems. Motivated by this, we propose a scheme for coupling terahertz resonators to the antiferromagnetic fluctuations in a cuprate parent compound, which are believed to provide the glue for Cooper pairs in the superconducting phase. First, we derive the interaction between magnon excitations of the Neél order and polar phonons associated with the planar oxygens. This mode also couples to the cavity electric field, and in the presence of spin-orbit interactions mediates a linear coupling between the cavity and magnons, forming hybridized magnon-polaritons. This hybridization vanishes linearly with photon momentum, implying the need for near-field optical methods, which we analyze within a simple model. We then derive a higher-order coupling between the cavity and magnons, which is only present in bilayer systems, but does not rely on spin-orbit coupling. This interaction is found to be large, but only couples to the bimagnon operator. As a result, we find a strong, but heavily damped, bimagnon-cavity interaction which produces highly asymmetric cavity line shapes in the strong-coupling regime. To conclude, we outline several interesting extensions of our theory, including applications to carrier-doped cuprates and other strongly correlated systems with terahertz-scale magnetic excitations.

Land-atmosphere carbon exchange is known to be extremely heterogeneous in arctic ice-wedge polygonal tundra regions. In this study, a Kalman filter-based method was developed to estimate the spatio-temporal dynamics of daytime average net ecosystem exchange (NEEday) at 0.5-m resolution over a 550 m by 700 m study site. We integrated multi-scale, multi-type datasets, including normalized difference vegetation indices (NDVIs) obtained from a novel automated mobile sensor system (or tram system) and a greenness index map obtained from airborne imagery. We took advantage of the significant correlations between NDVI and NEEday identified based on flux chamber measurements. The weighted average of the estimated NEEday within the flux-tower footprint agreed with the flux tower data in term of its seasonal dynamics. We then evaluated the spatial variability of the growing season average NEEday, as a function of polygon geomorphic classes; i.e., the combination of polygon types—which are known to present different degradation stages associated with permafrost thaw—and microtopographic features (i.e., troughs, centers and rims). Our study suggests the importance of considering microtopographic features and their spatial coverage in computing spatially aggregated carbon exchange.

Photon blockade is the result of the interplay between the quantized nature of light and strong optical nonlinearities, whereby strong photon-photon repulsion prevents a quantum optical system from absorbing multiple photons. We theoretically study a single atom coupled to the light field, described by the resonantly driven Jaynes-Cummings model, in which case the photon blockade breaks down in a second-order phase transition at a critical drive strength. We show that this transition is associated to the spontaneous breaking of an antiunitary PT symmetry. Within a semiclassical approximation, we calculate the expectation values of observables in the steady state. We then move beyond the semiclassical approximation and approach the critical point from the disordered (blockaded) phase by reducing the Lindblad quantum master equation to a classical rate equation that we solve. The width of the steady-state distribution in Fock space is found to diverge as we approach the critical point with a simple power law, allowing us to calculate the critical scaling of steady-state observables without invoking mean-field theory. We propose a simple physical toy model for biased diffusion in the space of occupation numbers, which captures the universal properties of the steady state. We list several experimental platforms where this phenomenon may be observed.

Abstract Background There is sufficient evidence that monetary incentives are effective in increasing survey response rates in the general population as well as with physicians. The objective of this study was to assess the impact of a monetary incentive intended for administrative assistants on the survey response rate of physicians in leadership positions. Methods This was an ancillary study to a national survey of chairs of academic Departments of Medicine in the United States about measuring faculty productivity. We randomized survey participants to receive or not receive a $5 gift card enclosed in the survey package. The cover letter explained that the gift card was intended for the administrative assistants as a “thank you for their time.” We compared the response rates between the 2 study arms using the Chi-square test. Results Out of 152 participants to whom survey packages were mailed to, a total of 78 responses were received (51 % response rate). The response rates were 59 % in the incentive arm and 46 % in the no incentive arm. The relative effect of the incentive compared to no monetary incentive was borderline statistically significant (relative risk (RR) = 1.36, 95 % confidence interval (CI) 0.99 to 1.87; p = 0.055). Conclusion Monetary incentives intended for administrative assistants likely increase the response rate of physicians in leadership positions.

We use Nielsen's geometric approach to quantify the circuit complexity in a one-dimensional Kitaev chain across a topological phase transition. We find that the circuit complexities of both the ground states and nonequilibrium steady states of the Kitaev model exhibit nonanalytical behaviors at the critical points, and thus can be used to detect both equilibrium and dynamical topological phase transitions. Moreover, we show that the locality property of the real-space optimal Hamiltonian connecting two different ground states depends crucially on whether the two states belong to the same or different phases. This provides a concrete example of classifying different gapped phases using Nielsen's circuit complexity. We further generalize our results to a Kitaev chain with long-range pairing, and we discuss generalizations to higher dimensions. Our result opens up an avenue for using circuit complexity as a tool to understand quantum many-body systems.