A new approach to scoring systems to improve identification of acute medical admissions that will require critical care

Removal of the intensive care unit (ICU) at the Vale of Leven Hospital mandated the identification and transfer out of those acute medical admissions with a high risk of requiring ICU. The aim of the study was to develop triaging tools that identified such patients and compare them with other scoring systems. The methodology included a retrospective analysis of physiological and arterial gas measurements from 1976 acute medical admissions produced PREEMPT-1 (PRE-critical Emergency Medical Patient Triage). A simpler one for ambulance use (PREAMBLE-1 [PRE-Admission Medical Blue-Light Emergency]) was produced by the addition of peripheral oxygen saturation to a modification of MEWS (Modified Early Warning Score). Prospective application of these tools produced a larger database of 4447 acute admissions from which logistic regression models produced PREEMPT-2 and PREAMBLE-2, which were then compared with the original systems and seven other early warning scoring systems. Results showed that in patients with arterial gases, the area under the receiver operator characteristic curve was significantly higher in PREEMPT-2 (89·1%) and PREAMBLE-2 (84.4%) than all other scoring systems. Similarly, in all patients, it was higher in PREAMBLE-2 (92·4%) than PREAMBLE-1 (88·1%) and the other scoring systems. In conclusion, risk of requiring ICU can be more accurately predicted using PREEMPT-2 and PREAMBLE-2, as described here, than by other early warning scoring systems developed over recent years

Feedback-control of quantum systems using continuous state-estimation

We present a formulation of feedback in quantum systems in which the best estimates of the dynamical variables are obtained continuously from the measurement record, and fed back to control the system. We apply this method to the problem of cooling and confining a single quantum degree of freedom, and compare it to current schemes in which the measurement signal is fed back directly in the manner usually considered in existing treatments of quantum feedback. Direct feedback may be combined with feedback by estimation, and the resulting combination, performed on a linear system, is closely analogous to classical LQG control theory with residual feedback.Comment: 12 pages, multicol revtex, revised and extende

Impact of protists on a hydrocarbon-degrading bacterial community from deep-sea Gulf of Mexico sediments: A microcosm study

In spite of significant advancements towards understanding the dynamics of petroleum hydrocarbon degrading microbial consortia, the impacts (direct or indirect via grazing activities) of bacterivorous protists remain largely unknown. Microcosm experiments were used to examine whether protistan grazing affects the petroleum hydrocarbon degradation capacity of a deep-sea sediment microbial community from an active Gulf of Mexico cold seep. Differences in n-alkane content between native sediment microcosms and those treated with inhibitors of eukaryotes were assessed by comprehensive two-dimensional gas chromatography following 30-90 day incubations and analysis of shifts in microbial community composition using small subunit ribosomal RNA gene clone libraries. More biodegradation was observed in microcosms supplemented with eukaryotic inhibitors. SSU rRNA gene clone libraries from oil-amended treatments revealed an increase in the number of proteobacterial clones (particularly γ-proteobacteria) after spiking sediments with diesel oil. Bacterial community composition shifted, and degradation rates increased, in treatments where protists were inhibited, suggesting protists affect the hydrocarbon degrading capacity of microbial communities in sediments collected at this Gulf of Mexico site

Selective quantum evolution of a qubit state due to continuous measurement

We consider a two-level quantum system (qubit) which is continuously measured by a detector. The information provided by the detector is taken into account to describe the evolution during a particular realization of measurement process. We discuss the Bayesian formalism for such ``selective'' evolution of an individual qubit and apply it to several solid-state setups. In particular, we show how to suppress the qubit decoherence using continuous measurement and the feedback loop.Comment: 15 pages (including 9 figures

Squeezing via feedback

We present the quantum theory of optical cavity feedback mediated by homodyne detection, with an arbitrary time delay. We apply this theory to a system with nonclassical dynamics, a sub-Poissonian pumped laser. By using the feedback to phase lock the laser it is possible to produce output light which exhibits perfect quadrature squeezing on resonance, rather than just sub-Poissonian intensity statistics. However, we also show that feedback mediated by homodyne detection (or any other extracavity measurement) cannot produce nonclassical light unless the cavity dynamics can do so without feedback. Furthermore, in systems which already exhibit squeezing, such feedback can only degrade the squeezing in the output. With feedback mediated by an intracavity measurement, these theorems do not apply. We show that an (admittedly unrealistic) intracavity quantum nondemolition quadrature measurement allows arbitrary squeezing to be produced by controlling the amplitude of a coherent driving field

Cavity QED analog of the harmonic-oscillator probability distribution function and quantum collapses

We establish a connection between the simple harmonic oscillator and a two-level atom interacting with resonant, quantized cavity and strong driving fields, which suggests an experiment to measure the harmonic-oscillator's probability distribution function. To achieve this, we calculate the Autler-Townes spectrum by coupling the system to a third level. We find that there are two different regions of the atomic dynamics depending on the ratio of the: Rabi frequency Omega (c) of the cavity field to that of the Rabi frequency Omega of the driving field. For Omega (c

Creating number states in the micromaser using feedback

We use the quantum theory of feedback developed by Wiseman and Milburn [Phys. Rev. Lett. 70, 548 (1993)] and Wiseman [Phys. Rev. A 49, 2133 (1994)] to investigate the photon-number noise properties of the micromaser with direct detection feedback. We find that the feedback can significantly reduce the amount of noise in the photon number. Under the right conditions the feedback locks the systems onto a number state. As opposed to other schemes in the past [P. Meystre, Opt. Lett. 12, 669 (1987); J. Krause, M. O. Scully, and H. Walther, Phys. Rev. A 36, 4547 (1987)], we can fix the number states to which the system evolves. We also simulate the micromaser using the quantum-trajectories method and show that these results agree with the quantum theory of feedback. We show that the noise of quantum island states [P. Bogar, J. A. Bergou, and M. Hillary, Phys. Rev. A 50, 754 (1994)] can be significantly reduced by the feedback

Global stabilization of feedforward systems under perturbations in sampling schedule

For nonlinear systems that are known to be globally asymptotically stabilizable, control over networks introduces a major challenge because of the asynchrony in the transmission schedule. Maintaining global asymptotic stabilization in sampled-data implementations with zero-order hold and with perturbations in the sampling schedule is not achievable in general but we show in this paper that it is achievable for the class of feedforward systems. We develop sampled-data feedback stabilizers which are not approximations of continuous-time designs but are discontinuous feedback laws that are specifically developed for maintaining global asymptotic stabilizability under any sequence of sampling periods that is uniformly bounded by a certain "maximum allowable sampling period".Comment: 27 pages, 5 figures, submitted for possible publication to SIAM Journal Control and Optimization. Second version with added remark

The RNA chaperone Hfq is essential for the virulence of Salmonella typhimurium

The RNA chaperone, Hfq, plays a diverse role in bacterial physiology beyond its original role as a host factor required for replication of Qβ RNA bacteriophage. In this study, we show that Hfq is involved in the expression and secretion of virulence factors in the facultative intracellular pathogen, Salmonella typhimurium. A Salmonella hfq deletion strain is highly attenuated in mice after both oral and intraperitoneal infection, and shows a severe defect in invasion of epithelial cells and a growth defect in both epithelial cells and macrophages in vitro. Surprisingly, we find that these phenotypes are largely independent of the previously reported requirement of Hfq for expression of the stationary phase sigma factor, RpoS. Our results implicate Hfq as a key regulator of multiple aspects of virulence including regulation of motility and outer membrane protein (OmpD) expression in addition to invasion and intracellular growth. These pleiotropic effects are suggested to involve a network of regulatory small non-coding RNAs, placing Hfq at the centre of post-transcriptional regulation of virulence gene expression in Salmonella. In addition, the hfq mutation appears to cause a chronic activation of the RpoE-mediated envelope stress response which is likely due to a misregulation of membrane protein expression

Gene expression changes and community turnover differentially shape the global ocean metatranscriptome

Ocean microbial communities strongly influence the biogeochemistry, food webs, and climate of our planet. Despite recent advances in understanding their taxonomic and genomic compositions, little is known about how their transcriptomes vary globally. Here, we present a dataset of 187 metatranscriptomes and 370 metagenomes from 126 globally distributed sampling stations and establish a resource of 47 million genes to study community-level transcriptomes across depth layers from pole-to-pole. We examine gene expression changes and community turnover as the underlying mechanisms shaping community transcriptomes along these axes of environmental variation and show how their individual contributions differ for multiple biogeochemically relevant processes. Furthermore, we find the relative contribution of gene expression changes to be significantly lower in polar than in non-polar waters and hypothesize that in polar regions, alterations in community activity in response to ocean warming will be driven more strongly by changes in organismal composition than by gene regulatory mechanisms