1,604 research outputs found
Discrimination of Optical Coherent States using a Photon Number Resolving Detector
The discrimination of non-orthogonal quantum states with reduced or without
errors is a fundamental task in quantum measurement theory. In this work, we
investigate a quantum measurement strategy capable of discriminating two
coherent states probabilistically with significantly smaller error
probabilities than can be obtained using non-probabilistic state
discrimination. We find that appropriate postselection of the measurement data
of a photon number resolving detector can be used to discriminate two coherent
states with small error probability. We compare our new receiver to an optimal
intermediate measurement between minimum error discrimination and unambiguous
state discrimination.Comment: 5 pages, 4 figure
Are pharmacy students adequately prepared to work in healthcare teams?
Collaborative practice and integrated healthcare are a key focus of healthcare provision internationally. Key attributes of healthcare teams are well documented in the literature and team-working skills have been incorporated into education standards for undergraduate pharmacy students in the United Kingdom (UK). The aim of this research is to explore pharmacy studentsā understanding of team-working attributes and their preparedness for their future careers in integrated healthcare teams. Participants were recruited via convenience sampling and four focus groups were conducted. Thematic analysis identified a number of team attributes including communication, clear roles and responsibilities, team dynamics and leadership. Communication and leadership skills were perceived to be the most important attributes in team-working and it is clear from the findings of this research that, in preparation for future practice, students would like to develop these skills through further exposure to opportunities that are incorporated into the undergraduate degree programme
ciliaFA : a research tool for automated, high-throughput measurement of ciliary beat frequency using freely available software
Background: Analysis of ciliary function for assessment of patients suspected of primary ciliary dyskinesia (PCD) and
for research studies of respiratory and ependymal cilia requires assessment of both ciliary beat pattern and beat
frequency. While direct measurement of beat frequency from high-speed video recordings is the most accurate and
reproducible technique it is extremely time consuming. The aim of this study was to develop a freely available
automated method of ciliary beat frequency analysis from digital video (AVI) files that runs on open-source software
(ImageJ) coupled to Microsoft Excel, and to validate this by comparison to the direct measuring high-speed video
recordings of respiratory and ependymal cilia. These models allowed comparison to cilia beating between 3 and 52 Hz.
Methods: Digital video files of motile ciliated ependymal (frequency range 34 to 52 Hz) and respiratory epithelial cells
(frequency 3 to 18 Hz) were captured using a high-speed digital video recorder. To cover the range above between 18
and 37 Hz the frequency of ependymal cilia were slowed by the addition of the pneumococcal toxin pneumolysin.
Measurements made directly by timing a given number of individual ciliary beat cycles were compared with those
obtained using the automated ciliaFA system.
Results: The overall mean difference (Ā± SD) between the ciliaFA and direct measurement high-speed digital imaging
methods was ā0.05 Ā± 1.25 Hz, the correlation coefficient was shown to be 0.991 and the Bland-Altman limits of
agreement were from ā1.99 to 1.49 Hz for respiratory and from ā2.55 to 3.25 Hz for ependymal cilia.
Conclusions: A plugin for ImageJ was developed that extracts pixel intensities and performs fast Fourier
transformation (FFT) using Microsoft Excel. The ciliaFA software allowed automated, high throughput measurement of
respiratory and ependymal ciliary beat frequency (range 3 to 52 Hz) and avoids operator error due to selection bias. We
have included free access to the ciliaFA plugin and installation instructions in Additional file 1 accompanying this
manuscript that other researchers may use
Are interprofessional healthcare teams meeting patient expectations? An exploration of the perceptions of patients and informal caregivers
Poor teamwork skills in healthcare have been found to be a contributing cause of negative incidents in patient care, whilst effective teamwork has been linked to more positive patient outcomes. The aim of this research is to explore views of patients and informal caregivers on the key characteristics of effective healthcare teams and their experiences of healthcare teams using a qualitative approach. A focus group schedule was developed from existing literature to explore this. Topics included the purpose and value of teams in patient care, key attributes and their impact on patient care. Patients and informal caregivers were recruited via convenience sampling. Three focus groups were conducted. Thematic analysis identified a number of themes associated with effective teams. These themes included the perceived purpose of teams, perceptions about the structure of a team, team-based communication, the role of patients, delivery of care. Research participants noted the importance of key characteristics in effective teams, but felt that these were not always consistently present. Communication was considered to be the most important attribute in team working and also appeared to be the area in which the patient experience can be significantly improved. It is clear from the findings of this research that further improvements in teamwork skills in healthcare are needed to achieve effective collaborative practice, sustainable service delivery models and optimal patient care
Near-Surface Te+ 125 Spins with Millisecond Coherence Lifetime
Impurity spins in crystal matrices are promising components in quantum technologies, particularly if they can maintain their spin properties when close to surfaces and material interfaces. Here, we investigate an attractive candidate for microwave-domain applications, the spins of group-VI Te+125 donors implanted into natural Si at depths as shallow as 20 nm. We show that surface band bending can be used to ionize such near-surface Te to spin-active Te+ state, and that optical illumination can be used further to control the Te donor charge state. We examine spin activation yield, spin linewidth, and relaxation (T1) and coherence times (T2) and show how a zero-field 3.5 GHz "clock transition"extends spin coherence times to over 1 ms, which is about an order of magnitude longer than other near-surface spin systems
Strain in heterogeneous quantum devices with atomic layer deposition
Abstract
We investigated the use of dielectric layers produced by atomic layer deposition (ALD) as an approach to strain mitigation in composite silicon/superconductor devices operating at cryogenic temperatures. We show that the addition of an ALD layer acts to reduce the strain of spins closest to silicon/superconductor interface where strain is highest. We show that appropriately biasing our devices at the hyperfine clock transition of bismuth donors in silicon, we can remove strain broadening and that the addition of ALD layers left T
2 (or temporal inhomogeneities) unchanged in these natural silicon devices.</jats:p
Creativity and Autonomy in Swarm Intelligence Systems
This work introduces two swarm intelligence algorithms -- one mimicking the behaviour of one species of ants (\emph{Leptothorax acervorum}) foraging (a `Stochastic Diffusion Search', SDS) and the other algorithm mimicking the behaviour of birds flocking (a `Particle Swarm Optimiser', PSO) -- and outlines a novel integration strategy exploiting the local search properties of the PSO with global SDS behaviour. The resulting hybrid algorithm is used to sketch novel drawings of an input image, exploliting an artistic tension between the local behaviour of the `birds flocking' - as they seek to follow the input sketch - and the global behaviour of the `ants foraging' - as they seek to encourage the flock to explore novel regions of the canvas. The paper concludes by exploring the putative `creativity' of this hybrid swarm system in the philosophical light of the `rhizome' and Deleuze's well known `Orchid and Wasp' metaphor
The Impact of NOD2 Variants on Fecal Microbiota in Crohn's Disease and Controls Without Gastrointestinal Disease.
BACKGROUND/AIMS: Current models of Crohn's disease (CD) describe an inappropriate immune response to gut microbiota in genetically susceptible individuals. NOD2 variants are strongly associated with development of CD, and NOD2 is part of the innate immune response to bacteria. This study aimed to identify differences in fecal microbiota in CD patients and non-IBD controls stratified by NOD2 genotype. METHODS: Patients with CD and non-IBD controls of known NOD2 genotype were identified from patients in previous UK IBD genetics studies and the Cambridge bioresource (genotyped/phenotyped volunteers). Individuals with known CD-associated NOD2 mutations were matched to those with wild-type genotype. We obtained fecal samples from patients in clinical remission with low fecal calprotectin (<250 Āµg/g) and controls without gastrointestinal disease. After extracting DNA, the V1-2 region of 16S rRNA genes were polymerase chain reaction (PCR)-amplified and sequenced. Analysis was undertaken using the mothur package. Volatile organic compounds (VOC) were also measured. RESULTS: Ninety-one individuals were in the primary analysis (37 CD, 30 bioresource controls, and 24 household controls). Comparing CD with nonIBD controls, there were reductions in bacterial diversity, Ruminococcaceae, Rikenellaceae, and Christensenellaceae and an increase in Enterobacteriaceae. No significant differences could be identified in microbiota by NOD2 genotype, but fecal butanoic acid was higher in Crohn's patients carrying NOD2 mutations. CONCLUSIONS: In this well-controlled study of NOD2 genotype and fecal microbiota, we identified no significant genotype-microbiota associations. This suggests that the changes associated with NOD2 genotype might only be seen at the mucosal level, or that environmental factors and prior inflammation are the predominant determinant of the observed dysbiosis in gut microbiota.Funding was supported by CORE, the Digestive Diseases Foundation and the Wellcome Trust [grant number 097943 to NAK, 093885 to CAL and 098051 to Alan W Walker and Julian Parkhill . Dr. Walker receives core funding support from the Scottish Government Rural and Environmental Science and Analysis Service (RESAS). We also acknowledge the NIHR Biomedical Research Centre awards to Addenbrookeās Hospital/University of Cambridge School of Clinical Medicine and acknowledge the NIHR Newcastle Biomedical Research Centre
Targeted hepatitis C antibody testing interventions: a systematic review and meta-analysis
Testing for hepatitis C virus (HCV) infection may reduce the risk of liver-related morbidity, by facilitating earlier access to treatment and care. This review investigated the effectiveness of targeted testing interventions on HCV case detection, treatment uptake, and prevention of liver-related morbidity. A literature search identified studies published up to 2013 that compared a targeted HCV testing intervention (targeting individuals or groups at increased risk of HCV) with no targeted intervention, and results were synthesised using meta-analysis. Exposure to a targeted testing intervention, compared to no targeted intervention, was associated with increased cases detected [number of studies (n)Ā =Ā 14; pooled relative risk (RR) 1.7, 95Ā % CI 1.3, 2.2] and patients commencing therapy (nĀ =Ā 4; RR 3.3, 95Ā % CI 1.1, 10.0). Practitioner-based interventions increased test uptake and cases detected (nĀ =Ā 12; RR 3.5, 95Ā % CI 2.5, 4.8; and nĀ =Ā 10; RR 2.2, 95Ā % CI 1.4, 3.5, respectively), whereas media/information-based interventions were less effective (nĀ =Ā 4; RR 1.5, 95Ā % CI 0.7, 3.0; and nĀ =Ā 4; RR 1.3, 95Ā % CI 1.0, 1.6, respectively). This meta-analysis provides for the first time a quantitative assessment of targeted HCV testing interventions, demonstrating that these strategies were effective in diagnosing cases and increasing treatment uptake. Strategies involving practitioner-based interventions yielded the most favourable outcomes. It is recommended that testing should be targeted at and offered to individuals who are part of a population with high HCV prevalence, or who have a history of HCV risk behaviour
Mechanisms and management of loss of response to anti-TNF therapy for patients with Crohn's disease: 3-year data from the prospective, multicentre PANTS cohort study.
BACKGROUND: We sought to report the effectiveness of infliximab and adalimumab over the first 3 years of treatment and to define the factors that predict anti-TNF treatment failure and the strategies that prevent or mitigate loss of response. METHODS: Personalised Anti-TNF therapy in Crohn's disease (PANTS) is a UK-wide, multicentre, prospective observational cohort study reporting the rates of effectiveness of infliximab and adalimumab in anti-TNF-naive patients with active luminal Crohn's disease aged 6 years and older. At the end of the first year, sites were invited to enrol participants still receiving study drug into the 2-year PANTS-extension study. We estimated rates of remission across the whole cohort at the end of years 1, 2, and 3 of the study using a modified survival technique with permutation testing. Multivariable regression and survival analyses were used to identify factors associated with loss of response in patients who had initially responded to anti-TNF therapy and with immunogenicity. Loss of response was defined in patients who initially responded to anti-TNF therapy at the end of induction and who subsequently developed symptomatic activity that warranted an escalation of steroid, immunomodulatory, or anti-TNF therapy, resectional surgery, or exit from study due to treatment failure. This study was registered with ClinicalTrials.gov, NCT03088449, and is now complete. FINDINGS: Between March 19, 2014, and Sept 21, 2017, 389 (41%) of 955 patients treated with infliximab and 209 (32%) of 655 treated with adalimumab in the PANTS study entered the PANTS-extension study (median age 32Ā·5 years [IQR 22Ā·1-46Ā·8], 307 [51%] of 598 were female, and 291 [49%] were male). The estimated proportion of patients in remission at the end of years 1, 2, and 3 were, for infliximab 40Ā·2% (95% CI 36Ā·7-43Ā·7), 34Ā·4% (29Ā·9-39Ā·0), and 34Ā·7% (29Ā·8-39Ā·5), and for adalimumab 35Ā·9% (95% CI 31Ā·2-40Ā·5), 32Ā·9% (26Ā·8-39Ā·2), and 28Ā·9% (21Ā·9-36Ā·3), respectively. Optimal drug concentrations at week 14 to predict remission at any later timepoints were 6Ā·1-10Ā·0 mg/L for infliximab and 10Ā·1-12Ā·0 mg/L for adalimumab. After excluding patients who had primary non-response, the estimated proportions of patients who had loss of response by years 1, 2, and 3 were, for infliximab 34Ā·4% (95% CI 30Ā·4-38Ā·2), 54Ā·5% (49Ā·4-59Ā·0), and 60Ā·0% (54Ā·1-65Ā·2), and for adalimumab 32Ā·1% (26Ā·7-37Ā·1), 47Ā·2% (40Ā·2-53Ā·4), and 68Ā·4% (50Ā·9-79Ā·7), respectively. In multivariable analysis, loss of response at year 2 and 3 for patients treated with infliximab and adalimumab was predicted by low anti-TNF drug concentrations at week 14 (infliximab: hazard ratio [HR] for each ten-fold increase in drug concentration 0Ā·45 [95% CI 0Ā·30-0Ā·67], adalimumab: 0Ā·39 [0Ā·22-0Ā·70]). For patients treated with infliximab, loss of response was also associated with female sex (vs male sex; HR 1Ā·47 [95% CI 1Ā·11-1Ā·95]), obesity (vs not obese 1Ā·62 [1Ā·08-2Ā·42]), baseline white cell count (1Ā·06 [1Ā·02-1Ā·11) per 1āĆā109 increase in cells per L), and thiopurine dose quartile. Among patients treated with adalimumab, carriage of the HLA-DQA1*05 risk variant was associated with loss of response (HR 1Ā·95 [95% CI 1Ā·17-3Ā·25]). By the end of year 3, the estimated proportion of patients who developed anti-drug antibodies associated with undetectable drug concentrations was 44Ā·0% (95% CI 38Ā·1-49Ā·4) among patients treated with infliximab and 20Ā·3% (13Ā·8-26Ā·2) among those treated with adalimumab. The development of anti-drug antibodies associated with undetectable drug concentrations was significantly associated with treatment without concomitant immunomodulator use for both groups (HR for immunomodulator use: infliximab 0Ā·40 [95% CI 0Ā·31-0Ā·52], adalimumab 0Ā·42 [95% CI 0Ā·24-0Ā·75]), and with carriage of HLA-DQA1*05 risk variant for infliximab (HR for carriage of risk variant: infliximab 1Ā·46 [1Ā·13-1Ā·88]) but not for adalimumab (HR 1Ā·60 [0Ā·92-2Ā·77]). Concomitant use of an immunomodulator before or on the day of starting infliximab was associated with increased time without the development of anti-drug antibodies associated with undetectable drug concentrations compared with use of infliximab alone (HR 2Ā·87 [95% CI 2Ā·20-3Ā·74]) or introduction of an immunomodulator after anti-TNF initiation (1Ā·70 [1Ā·11-2Ā·59]). In years 2 and 3, 16 (4%) of 389 patients treated with infliximab and 11 (5%) of 209 treated with adalimumab had adverse events leading to treatment withdrawal. Nine (2%) patients treated with infliximab and two (1%) of those treated with adalimumab had serious infections in years 2 and 3. INTERPRETATION: Only around a third of patients with active luminal Crohn's disease treated with an anti-TNF drug were in remission at the end of 3 years of treatment. Low drug concentrations at the end of the induction period predict loss of response by year 3 of treatment, suggesting higher drug concentrations during the first year of treatment, particularly during induction, might lead to better long-term outcomes. Anti-drug antibodies associated with undetectable drug concentrations of infliximab, but not adalimumab, can be predicted by carriage of HLA-DQA1*05 and mitigated by concomitant immunomodulator use for both drugs. FUNDING: Guts UK, Crohn's and Colitis UK, Cure Crohn's Colitis, AbbVie, Merck Sharp and Dohme, Napp Pharmaceuticals, Pfizer, and Celltrion Healthcare
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