111 research outputs found

    Avoided crossing resonances: structural and dynamical aspects

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    We examine structural and dynamical properties of quantum resonances associated with an avoided crossing and identify the parameter shifts where these properties attain maximal or extreme values, first at a general level, and then for a two-level system coupled to a harmonic oscillator, of the type commonly found in quantum optics. Finally the results obtained are exemplified and applied to optimize the fidelity and speed of quantum gates in trapped ions.Comment: 4 pages, 1 figur

    The evaluation of animal bite treatment centers in the Philippines from a patient perspective

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    BACKGROUND: The Philippines has built an extensive decentralised network of Animal Bite Treatment Centers (ABTCs) to help bite victims receive timely rabies post-exposure prophylaxis (PEP) at little cost. This study surveyed patients in the community and at ABTCs of three provinces to assess animal bite/scratch incidence, health-seeking behaviour and PEP-related out-of pocket expenses (OOPE). METHODOLOGY AND PRINCIPAL FINDINGS: During community surveys in 90 barangays (neighbourhoods), 53% of households reported at least one animal bite /scratch injury over the past 3 years, similar across urban and rural barangays. Overall bite/scratch incidences in 2016-17 were 67.3, 41.9 and 48.8 per 1,000 population per year for Nueva Vizcaya, Palawan and Tarlac respectively. Incidences were around 50% higher amongst those under 15 years of age, compared to -those older than 15. Household awareness of the nearest ABTCs was generally over 80%, but only 44.9% sought proper medical treatment and traditional remedies were still frequently used. The proportion of patients seeking PEP was not related to the distance or travel time to the nearest ABTC. For those that did not seek medical treatment, most cited a lack of awareness or insufficient funds and almost a third visited a traditional healer. No deaths from bite/scratch injuries were reported. A cohort of 1,105 patients were interviewed at six ABTCs in early 2017. OOPE varied across the ABTCs, from 5.53 USD to 37.83 USD per patient, primarily dependent on the need to pay for immunization if government supplies had run out. Overall, 78% of patients completed the recommended course, and the main reason for non-completion was a lack of time, followed by insufficient funds. Dog observation data revealed that 85% of patients were not truly exposed to rabies, and education in bite prevention might reduce provoked bites and demand for PEP. An accompanying paper details the ABTC network from the health provider's perspective.S1 Checklist. STROBE checklist. https://doi.org/10.1371/journal.pone.0200873.s001S1 Fig. Locations of ABTCs in (A) Nueva Vizcaya, (B) Palawan, and (C) Tarlac. https://doi.org/10.1371/journal.pone.0200873.s002S1 Table. Number of animal bites and scratches recorded by community surveys by province and by year. https://doi.org/10.1371/journal.pone.0200873.s003S2 Table. Additional reasons given in the community survey for not seeking medical treatment for wounds. https://doi.org/10.1371/journal.pone.0200873.s004S3 Table. Reasons for patients not completing the PEP series. https://doi.org/10.1371/journal.pone.0200873.s005S4 Table. Total Out-of-Pocket Expenses, ABTC patient survey, 2017. https://doi.org/10.1371/journal.pone.0200873.s006S5 Table. Biting animal status at day 28 follow-up. https://doi.org/10.1371/journal.pone.0200873.s007S6 Table. PEP completion status of patients bitten by animals that died or were of unknown status. https://doi.org/10.1371/journal.pone.0200873.s008GlaxoSmithKline Biologicals SA (Belgium)http://www.plosone.orgVeterinary Tropical Disease

    Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

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    Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

    Use of anticoagulants and antiplatelet agents in stable outpatients with coronary artery disease and atrial fibrillation. International CLARIFY registry