723 research outputs found
Entanglement fluctuation theorems
Pure-state entanglement transformations have been thought of as irreversible, with reversible transformations generally only possible in the limit of many copies. Here, we show that reversible entanglement transformations do not require processing on the many-copy level but can instead be undertaken on individual systems, provided the amount of entanglement which is produced or consumed is allowed to fluctuate. We derive necessary and sufficient conditions for entanglement manipulations in this case. As a corollary, we derive an equation which quantifies the fluctuations of entanglement, which is formally identical to the Jarzynski fluctuation equality found in thermodynamics. One can also relate a forward entanglement transformation to its reverse process in terms of the entanglement cost of such a transformation, in a manner equivalent to the Crooks relation. We show that a strong converse theorem for entanglement transformations is formally related to the second law of thermodynamics, while the fact that the Schmidt rank of an entangled state cannot increase is related to the third law of thermodynamics. Achievability of the protocols is done by introducing an entanglement battery, a device which stores entanglement and uses an amount of entanglement that is allowed to fluctuate but with an average cost which is still optimal. This allows us to also solve the problem of partial entanglement recovery, and in fact, we show that entanglement is fully recovered. Allowing the amount of consumed entanglement to fluctuate also leads to improved and optimal entanglement dilution protocols
Erratum to: The impact of common co-morbidities (as measured using the Charlson index) on hip fracture risk in elderly men: a population-based cohort study
Impact of a National Enhanced Recovery After Surgery Programme on Patient Outcomes of Primary total Knee Replacement: an Interrupted Time Series Analysis from âThe National Joint Registry of England, Wales, Northern Ireland and the Isle of Manâ
Objective
We aimed to test whether a national Enhanced Recovery After Surgery (ERAS) Programme in total knee replacement (TKR) had an impact on patient outcomes. Design Natural-experiment (April 2008-December 2016). Interrupted time-series regression assessed impact on trends before-during-after ERAS implementation.
Setting
Primary operations from the UK National Joint Registry were linked with Hospital Episode Statistics data which contains inpatient episodes undertaken in NHS trusts in England, and PROMs. Participants Patients undergoing primary planned TKR aged â„18 years. Intervention ERAS implementation (April 2009-March 2011).
Outcomes
Regression coefficients of monthly means of LOS, bed day costs, change in Oxford knee scores (OKS) 6-months after surgery, complications (at 6 months), and rates of revision surgeries (at 5 years). Results 486,579 primary TKRs were identified. Overall LOS and bed-day costs decreased from 5.8 days to 3.7 and from ÂŁ7607 to ÂŁ5276, from April 2008 to December 2016. OKS change improved from 15.1 points in April 2008 to 17.1 points in December 2016. Complications decreased from 4.1 % in April 2008 to 1.7 % March 2016. 5-year revision rates remained stable at 4.8 per 1000 implants years in April 2008 and December 2011. After ERAS, declining trends in LOS and bed costs slowed down; OKS improved, complications remained stable, and revisions slightly increased.
Conclusions
Different secular trends in outcomes for patients having TKR have been observed over the last decade. Although patient outcomes are better than a decade ago ERAS did not improve them at national level
Socio-economic status and the risk of developing hand, hip or knee osteoarthritis: a region-wide ecological study
SummaryObjectiveTo determine the association between socio-economic status (SES) and risk of hand, hip or knee osteoarthritis (OA) at a population level.DesignRetrospective ecological study using the System for the Development of Research in Primary Care (SIDIAP) database (primary care anonymized records for >5 million people in Catalonia (Spain)). Urban residents >15 years old (2009â2012) were eligible. Outcomes: Validated area-based SES deprivation index MEDEA (proportion of unemployed, temporary workers, manual workers, low educational attainment and low educational attainment among youngsters) was estimated for each area based on census data as well as incident diagnoses (ICD-10 codes) of hand, hip or knee OA (2009â2012). Zero-inflated Poisson models were fitted to study the association between MEDEA quintiles and the outcomes.ResultsCompared to the least deprived, the most deprived areas were younger (43.29 (17.59) vs 46.83 (18.49), years (Mean SD), had fewer women (49.1% vs 54.8%), a higher percentage of obese (16.2% vs 8.4%), smokers (16.9% vs 11.9%) and high-risk alcohol consumption subjects (1.5% vs 1.3%). Compared to the least deprived, the most deprived areas had an excess risk of OA: age-sex-adjusted Incidence Rate Ratio (IRR) 1.26 (1.11â1.42) for hand, 1.23 (1.17â1.29) hip, and 1.51 (1.45â1.57) knee. Adjustment for obesity attenuated this association: 1.06 (0.93â1.20), 1.04 (0.99â1.09), and 1.23 (1.19â1.28) respectively.ConclusionsDeprived areas have higher rates OA (hand, hip, knee). Their increased prevalence of obesity accounts for a 50% of the excess risk of knee OA observed. Public health interventions to reduce the prevalence of obesity in this population could reduce health inequalities
Secular trends in the initiation of therapy in secondary fracture prevention in Europe : a multi-national cohort study including data from Denmark, Catalonia, and the United Kingdom
Altres ajuts: UCB funded this study. All analyses were conducted independently by the academic researchers involved. MKJ is supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC).This paper demonstrates a large post-fracture anti-osteoporosis treatment gap in the period 2005 to 2015. The gap was stable in Denmark at around 88-90%, increased in Catalonia from 80 to 88%, and started to increase in the UK towards the end of our study. Improved post-fracture care is needed. Patients experiencing a fragility fracture are at high risk of subsequent fractures, particularly within the first 2 years after the fracture. Previous studies have demonstrated that only a small proportion of fracture patients initiate therapy with an anti-osteoporotic medication (AOM), despite the proven fracture risk reduction of such therapies. The aim of this paper is to evaluate the changes in this post-fracture treatment gap across three different countries from 2005 to 2015. This analysis, which is part of a multinational cohort study, included men and women, aged 50 years or older, sustaining a first incident fragility fracture. Using routinely collected patient data from three administrative health databases covering Catalonia, Denmark, and the United Kingdom, we estimated the treatment gap as the proportion of patients not treated with AOM within 1 year of their first incident fracture. A total of 648,369 fracture patients were included. Mean age 70.2-78.9 years; 22.2-31.7% were men. In Denmark, the treatment gap was stable at approximately 88-90% throughout the 2005 to 2015 time period. In Catalonia, the treatment gap increased from 80 to 88%. In the UK, an initially decreasing treatment gap-though never smaller than 63%-was replaced by an increasing gap towards the end of our study. The gap was more pronounced in men than in women. Despite repeated calls for improved secondary fracture prevention, an unacceptably large treatment gap remains, with time trends indicating that the problem may be getting worse in recent years. The online version of this article (10.1007/s00198-020-05358-4) contains supplementary material, which is available to authorized users
Adult Hypophosphatasia : a disease where the clinical complications could be avoided by careful evaluation of patients
This is the author accepted manuscript. The final version is available from Springer via the DOI in this recordOsteoporosis Conference 2018 Birmingham, UK 2 â 4 December 201
Quantum Fluctuation Theorems
Recent advances in experimental techniques allow one to measure and control
systems at the level of single molecules and atoms. Here gaining information
about fluctuating thermodynamic quantities is crucial for understanding
nonequilibrium thermodynamic behavior of small systems. To achieve this aim,
stochastic thermodynamics offers a theoretical framework, and nonequilibrium
equalities such as Jarzynski equality and fluctuation theorems provide key
information about the fluctuating thermodynamic quantities. We review the
recent progress in quantum fluctuation theorems, including the studies of
Maxwell's demon which plays a crucial role in connecting thermodynamics with
information.Comment: As a chapter of: F. Binder, L. A. Correa, C. Gogolin, J. Anders, and
G. Adesso (eds.), "Thermodynamics in the quantum regime - Fundamental Aspects
and New Directions", (Springer International Publishing, 2018
Geographic variation in secondary fracture prevention after a hip fracture during 1999-2013:a UK study
Purpose
To describe the geographic variation in anti-osteoporosis drug therapy prescriptions before and after a hip fracture during 1999-2013 in the UK.
Methods
We used primary care data (Clinical Practice Research Datalink) to identify patients with a hip fracture and primary care prescriptions of any anti-osteoporosis drugs prior to the index hip fracture and up to five years after. Geographic variations in prescribing before and after availability of generic oral bisphosphonates were analysed. Multivariable logistic regression models were adjusted for gender, age and body mass index (BMI).
Results
13,069 patients (76% female) diagnosed with a hip fracture during 1999-2013 were identified. 11% had any anti-osteoporosis drug prescription in the six months prior to the index hip fracture. In the 0-4 months following a hip fracture 5% of patients were prescribed anti-osteoporosis drugs in 1999, increasing to 51% in 2011 to then decrease to 39% in 2013.
The independent predictors (OR (95%CI)) of treatment initiation included gender (male:0.42 (0.36-0.49)), BMI (0.98 per kg/m2 increase (0.97-1.00)) and geographic region (1.29 (0.89-1.87) North East vs. 0.56(0.43-0.73) South Central region). Geographic differences in prescribing persisted over the 5-year follow-up. If all patients were treated at the rate of the highest performing region, then nationally an additional 3,214 hip fracture patients would be initiated on therapy every year.
Conclusions
Significant geographic differences exist in prescribing of anti-osteoporosis drugs after hip fracture despite adjustment for potential confounders. Further work examining differences in health care provision may inform strategies to improve secondary fracture prevention after hip fracture. </p
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