The potential negative impact of antibiotic pack on antibiotic stewardship in primary care in Switzerland: a modelling study.

BACKGROUND: In Switzerland, oral antibiotics are dispensed in packs rather than by exact pill-count. We investigated whether available packs support compliance with recommended primary care treatment regimens for common infections in children and adults. METHODS: Hospital-based guidelines for oral community -based treatment of acute otitis media, sinusitis, tonsillopharyngitis, community-acquired pneumonia and afebrile urinary tract infection were identified in 2017 in an iterative process by contacting hospital pharmacists and infectious diseases specialists. Furthermore, newly available national guidelines published in 2019 were reviewed. Available pack sizes for recommended solid, dispersible and liquid antibiotic formulations were retrieved from the Swiss pharmaceutical register and compared with recommended regimens to determine optimal (no leftovers) and adequate (optimal +/- one dose) matches. RESULTS: A large variety of recommended regimens were identified. For adults, optimal and adequate packs were available for 25/70 (36%) and 8/70 (11%) regimens, respectively. Pack-regimen matching was better for WHO Watch (optimal: 15/24, 63%) than Access antibiotics (optimal: 7/39, 18%). For the four paediatric weight-examples and 42 regimens involving child-appropriate formulations, optimal and adequate packs were available for only 14/168 (8%) and 27/168 (16%), respectively. Matching was better for older children with higher body and for longer treatment courses > 7 days. CONCLUSIONS: Fixed antibiotic packs often do not match recommended treatment regimens, especially for children, potentially resulting in longer than necessary treatments and leftover doses in the community. As part of national stewardship, a move to an exact pill-count system, including for child-appropriate solid formulations, should be considered

Unambiguous State Discrimination of Coherent States with Linear Optics: Application to Quantum Cryptography

We discuss several methods for unambiguous state discrimination of N symmetric coherent states using linear optics and photodetectors. One type of measurements is shown to be optimal in the limit of small photon numbers for any N. For the special case of N=4 this measurement can be fruitfully used by the receiving end (Bob) in an implementation of the BB84 quantum key distribution protocol using faint laser pulses. In particular, if Bob detects only a single photon the procedure is equivalent to the standard measurement that he would have to perform in a single-photon implementation of BB84, if he detects two photons Bob will unambiguously know the bit sent to him in 50% of the cases without having to exchange basis information, and if three photons are detected, Bob will know unambiguously which quantum state was sent.Comment: 5 RevTeX pages, 2 eps figure

Experimental demonstration of coupled optical springs

Optical rigidity will play an important role in improving the sensitivity of future generations of gravitational wave (GW) interferometers, which employ high laser power in order to reach and exceed the standard quantum limit. Several experiments have demonstrated the combined effect of two optical springs on a single system for very low-weight mirror masses or membranes. In this paper we investigate the complex interactions between multiple optical springs and the surrounding apparatus in a system of comparable dynamics to a large-scale GW detector. Using three 100 g mirrors to form a coupled cavity system capable of sustaining two or more optical springs, we demonstrate a number of different regimes of opto-mechanical rigidity and measurement techniques. Our measurements reveal couplings between each optical spring and the control loops that can affect both the achievable increase in sensitivity and the stability of the system. Hence this work establishes a better understanding of the realisation of these techniques and paves the way to their application in future GW observatories, such as upgrades to Advanced LIGO

Oscillator model for dissipative QED in an inhomogeneous dielectric

The Ullersma model for the damped harmonic oscillator is coupled to the quantised electromagnetic field. All material parameters and interaction strengths are allowed to depend on position. The ensuing Hamiltonian is expressed in terms of canonical fields, and diagonalised by performing a normal-mode expansion. The commutation relations of the diagonalising operators are in agreement with the canonical commutation relations. For the proof we replace all sums of normal modes by complex integrals with the help of the residue theorem. The same technique helps us to explicitly calculate the quantum evolution of all canonical and electromagnetic fields. We identify the dielectric constant and the Green function of the wave equation for the electric field. Both functions are meromorphic in the complex frequency plane. The solution of the extended Ullersma model is in keeping with well-known phenomenological rules for setting up quantum electrodynamics in an absorptive and spatially inhomogeneous dielectric. To establish this fundamental justification, we subject the reservoir of independent harmonic oscillators to a continuum limit. The resonant frequencies of the reservoir are smeared out over the real axis. Consequently, the poles of both the dielectric constant and the Green function unite to form a branch cut. Performing an analytic continuation beyond this branch cut, we find that the long-time behaviour of the quantised electric field is completely determined by the sources of the reservoir. Through a Riemann-Lebesgue argument we demonstrate that the field itself tends to zero, whereas its quantum fluctuations stay alive. We argue that the last feature may have important consequences for application of entanglement and related processes in quantum devices.Comment: 24 pages, 1 figur

Experimental test of higher-order Laguerre–Gauss modes in the 10 m Glasgow prototype interferometer

Brownian noise of dielectric mirror coatings is expected to be one of the limiting noise sources, at the peak sensitivity, of next generation ground based interferometric gravitational wave (GW) detectors. The use of higher-order Laguerre–Gauss (LG) beams has been suggested to reduce the effect of coating thermal noise in future generations of gravitational wave detectors. In this paper we describe the first test of interferometry with higher-order LG beams in an environment similar to a full-scale gravitational wave detector. We compare the interferometric performance of higher-order LG modes and the fundamental mode beams, injected into a 10 m long suspended cavity that features a finesse of 612, a value chosen to be typical of future gravitational wave detectors. We found that the expected mode degeneracy of the injected LG3, 3 beam was resolved into a multiple peak structure, and that the cavity length control signal featured several nearby zero crossings. The break up of the mode degeneracy is due to an astigmatism (defined as |Rcy − Rcx|) of 5.25 ± 0.5 cm on one of our cavity mirrors with a radius of curvature (Rc) of 15 m. This observation agrees well with numerical simulations developed with the FINESSE software. We also report on how these higher-order mode beams respond to the misalignment and mode mismatch present in our 10 m cavity. In general we found the LG3, 3 beam to be considerably more susceptible to astigmatism and mode mismatch than a conventional fundamental mode beam. Therefore the potential application of higher-order Laguerre–Gauss beams in future gravitational wave detectors will impose much more stringent requirements on both mode matching and mirror astigmatism

Coherent pulse implementations of quantum cryptography protocols resistant to photon number splitting attacks

A new class of quantum cryptography (QC) protocols that are robust against the most general photon number splitting attacks in a weak coherent pulse implementation has been recently proposed. In this article we give a quite exhaustive analysis of several eavesdropping attacks on these schemes. The eavesdropper (Eve) is supposed to have unlimited technological power while the honest parties (Alice and Bob) use present day technology, in particular an attenuated laser as an approximation of a single-photon source. They exploit the nonorthogonality of quantum states for decreasing the information accessible to Eve in the multi-photon pulses accidentally produced by the imperfect source. An implementation of some of these protocols using present day technology allow for a secure key distribution up to distances of $\sim$ 150 km. We also show that strong-pulse implementations, where a strong pulse is included as a reference, allow for key distribution robust against photon number splitting attacks.Comment: 16 pages, 11 figure

Field quantization in inhomogeneous anisotropic dielectrics with spatio-temporal dispersion

A quantum damped-polariton model is constructed for an inhomogeneous anisotropic linear dielectric with arbitrary dispersion in space and time. The model Hamiltonian is completely diagonalized by determining the creation and annihilation operators for the fundamental polariton modes as specific linear combinations of the basic dynamical variables. Explicit expressions are derived for the time-dependent operators describing the electromagnetic field, the dielectric polarization and the noise term in the latter. It is shown how to identify bath variables that generate the dissipative dynamics of the medium.Comment: 24 page

Interference in dielectrics and pseudo-measurements

Inserting a lossy dielectric into one arm of an interference experiment acts in many ways like a measurement. If two entangled photons are passed through the interferometer, a certain amount of information is gained about which path they took, and the interference pattern in a coincidence count measurement is suppressed. However, by inserting a second dielectric into the other arm of the interferometer, one can restore the interference pattern. Two of these pseudo-measurements can thus cancel each other out. This is somewhat analogous to the proposed quantum eraser experiments.Comment: 7 pages RevTeX 3.0 + 2 figures (postscript). Submitted to Phys. Rev.

Security against eavesdropping in quantum cryptography

In this article we deal with the security of the BB84 quantum cryptography protocol over noisy channels using generalized privacy amplification. For this we estimate the fraction of bits needed to be discarded during the privacy amplification step. This estimate is given for two scenarios, both of which assume the eavesdropper to access each of the signals independently and take error correction into account. One scenario does not allow a delay of the eavesdropper's measurement of a measurement probe until he receives additional classical information. In this scenario we achieve a sharp bound. The other scenario allows a measurement delay, so that the general attack of an eavesdropper on individual signals is covered. This bound is not sharp but allows a practical implementation of the protocol.Comment: 11 pages including 3 figures, contains new results not contained in my Phys. Rev. A pape