Duration to Establish an Emergency Vascular Access and How to Accelerate It: A Simulation-Based Study Performed in Real-Life Neonatal Resuscitation Rooms

Objectives: To compare the duration to establish an umbilical venous catheter and an intraosseous access in real hospital delivery rooms and as a secondary aim to assess delaying factors during establishment and to provide recommendations to accelerate vascular access in neonatal resuscitation. Design: Retrospective analysis of audio-video recorded neonatal simulation training. Settings: Simulation training events in exact replications of actual delivery/resuscitation rooms of 16 hospitals with different levels of care (Austria and Germany). Equipment was prepared the same way as for real clinical events. Subjects: Medical teams of four to five persons with birth-related background (midwives, nurses, neonatologists, and anesthesiologists) in a realistic team composition. Interventions: Audio-video recorded mannequin-based simulated resuscitation of an asphyxiated newborn including the establishment of either umbilical venous catheter or intraosseous access. Measurements and Main Results: The duration of access establishment (time from decision to first flush/aspiration), preparation (decision to start of procedure), and the procedure itself (start to first flush/aspiration) was significantly longer for umbilical venous catheter than for intraosseous access (overall duration 199 vs 86 s). Delaying factors for umbilical venous catheter establishment were mainly due to the complex approach itself, the multitude of equipment required, and uncertainties about necessary hygiene standards. Challenges in intraosseous access establishment were handling of the unfamiliar material and absence of an intraosseous access kit in the resuscitation room. There was no significant difference between the required duration for access establishment between large centers and small hospitals, but a trend was observed that duration for umbilical venous catheter was longer in small hospitals than in centers. Duration for intraosseous access was similar in both hospital types. Conclusions: Vascular access establishment in neonatal resuscitation could be accelerated by infrastructural improvements and specific training of medical teams. In simulated in situ neonatal resuscitation, intraosseous access is faster to establish than umbilical venous catheter. Future studies are required to assess efficacy and safety of both approaches in real resuscitation settings

Measuring a photonic qubit without destroying it

Measuring the polarisation of a single photon typically results in its destruction. We propose, demonstrate, and completely characterise a \emph{quantum non-demolition} (QND) scheme for realising such a measurement non-destructively. This scheme uses only linear optics and photo-detection of ancillary modes to induce a strong non-linearity at the single photon level, non-deterministically. We vary this QND measurement continuously into the weak regime, and use it to perform a non-destructive test of complementarity in quantum mechanics. Our scheme realises the most advanced general measurement of a qubit: it is non-destructive, can be made in any basis, and with arbitrary strength.Comment: 4 pages, 3 figure

Guiding neutral atoms around curves with lithographically patterned current-carrying wires

Laser-cooled neutral atoms from a low-velocity atomic source are guided via a magnetic field generated between two parallel wires on a glass substrate. The atoms bend around three curves, each with a 15-cm radius of curvature, while traveling along a 10-cm-long track. A maximum flux of 2*10^6 atoms/sec is achieved with a current density of 3*10^4 A/cm^2 in the 100x100-micrometer-cross-section wires. The kinetic energy of the guided atoms in one transverse dimension is measured to be 42 microKelvin.Comment: 9 page

Versorgung und Reanimation des reifen Neugeborenen nach der Geburt : Basierend auf der aktuellen Leitlinie des European Resuscitation Council 2021

Zusammenfassung Die volle Reanimation eines Neugeborenen mit Beatmungen, Thoraxkompressionen und der Gabe von Medikamenten ist ein äußerst seltenes Ereignis, das selbst neonatologische Teams immer wieder vor Herausforderungen stellt. Gerade in diesen seltenen und häufig dramatischen Situationen ist schnelles und umsichtiges Handeln im Team gefragt. Dabei ist die effektivste und meist einzig notwendige Maßnahme für die erfolgreiche Versorgung eines nicht spontan atmenden Neugeborenen eine suffiziente Maskenbeatmung. Wird diese effektiv durchgeführt, sind beim Neugeborenen in den seltensten Fällen tatsächlich Thoraxkompressionen notwendig. Im März 2021 wurde vom European Resuscitation Council (ERC) die neue Leitlinie zur Reanimation von Neugeborenen publiziert. Auf Basis dieser Leitlinie beschreibt der vorliegende Beitrag detailliert den im Algorithmus der Versorgung und Reanimation von reifen Neugeborenen dargestellten Handlungsablauf. Er richtet sich damit einerseits insbesondere an NichtneonatologInnen, die für die Versorgung v. a. von reifen Neugeborenen nach der Geburt verantwortlich sind. Andererseits soll er auch jenen zur Unterstützung dienen, die medizinisches Personal in der Versorgung von lebensbedrohten Neugeborenen trainieren und den Algorithmus der Neugeborenenreanimation als didaktisches Konzept vermitteln. Abstract The resuscitation of a neonate with the need for ventilation, chest compressions and the administration of drugs is an extremely rare event that repeatedly challenges even neonatal teams. It is precisely in these rare and often dramatic situations that rapid and prudent team action is required. The most effective and usually the only necessary measure for the successful resuscitation of a neonate who is not breathing spontaneously is sufficient mask ventilation. If ventilation is performed effectively, chest compressions are rarely necessary in the neonate. In March 2021, the European Resuscitation Council (ERC) published the new guidelines for neonatal resuscitation. Based on these guidelines, this article describes in detail the course of action outlined in the algorithm for the stabilisation and resuscitation of term neonates. On the one hand, it is aimed at non-neonatologists who are responsible for the care of term neonates after birth. On the other hand, it is also intended to support those who train medical personnel in the care of life-threatened neonates and teach the algorithm of neonatal resuscitation as a didactic concept

Brane-bulk matter relation for a purely conical codimension-2 brane world

We study gravity on an infinitely thin codimension-2 brane world, with purely conical singularities and in the presence of an induced gravity term on the brane. We show that in this approximation, the energy momentum tensor of the bulk is strongly related to the energy momentum tensor of the brane and thus the gravity dynamics on the brane are induced by the bulk content. This is in contrast with the gravity dynamics on a codimension-1 brane. We show how this strong result is relaxed after including a Gauss-Bonnet term in the bulk.Comment: 12 pages, mistake corrected, references adde

Cosmological Evolution of a Purely Conical Codimension-2 Brane World

We study the cosmological evolution of isotropic matter on an infinitely thin conical codimension-two brane-world. Our analysis is based on the boundary dynamics of a six-dimensional model in the presence of an induced gravity term on the brane and a Gauss-Bonnet term in the bulk. With the assumption that the bulk contains only a cosmological constant Lambda_B, we find that the isotropic evolution of the brane-universe imposes a tuned relation between the energy density and the brane equation of state. The evolution of the system has fixed points (attractors), which correspond to a final state of radiation for Lambda_B=0 and to de Sitter state for Lambda_B>0. Furthermore, considering anisotropic matter on the brane, the tuning of the parameters is lifted, and new regions of the parametric space are available for the cosmological evolution of the brane-universe. The analysis of the dynamics of the system shows that, the isotropic fixed points remain attractors of the system, and for values of Lambda_B which give acceptable cosmological evolution of the equation of state, the line of isotropic tuning is a very weak attractor. The initial conditions, in this case, need to be fine tuned to have an evolution with acceptably small anisotropy.Comment: 20 pages, 4 figures, typo correcte

Cold atoms in videotape micro-traps

We describe an array of microscopic atom traps formed by a pattern of magnetisation on a piece of videotape. We describe the way in which cold atoms are loaded into one of these micro-traps and how the trapped atom cloud is used to explore the properties of the trap. Evaporative cooling in the micro-trap down to a temperature of 1 microkelvin allows us to probe the smoothness of the trapping potential and reveals some inhomogeneity produced by the magnetic film. We discuss future prospects for atom chips based on microscopic permanent-magnet structures.Comment: Submitted for EPJD topical issue "Atom chips: manipulating atoms and molecules with microfabricated structures

Magnetothermodynamics of BPS baby skyrmions

The magnetothermodynamics of skyrmion type matter described by the gauged BPS baby Skyrme model at zero temperature is investigated. We prove that the BPS property of the model is preserved also for boundary conditions corresponding to an asymptotically constant magnetic field. The BPS bound and the corresponding BPS equations saturating the bound are found. Further, we show that one may introduce pressure in the gauged model by a redefinition of the superpotential. Interestingly, this is related to non-extremal type solutions in the so-called fake supersymmetry method. Finally, we compute the equation of state of magnetized BSP baby skyrmions inserted into an external constant magnetic field $H$ and under external pressure $P$, i.e., $V=V(P,H)$, where $V$ is the "volume" (area) occupied by the skyrmions. We show that the BPS baby skyrmions form a ferromagnetic medium.Comment: Latex, 39 pages, 14 figures. v2: New results and references added, physical interpretation partly change

Quantitative wave-particle duality and non-erasing quantum erasure

The notion of wave-particle duality may be quantified by the inequality V^2+K^2 <=1, relating interference fringe visibility V and path knowledge K. With a single-photon interferometer in which polarization is used to label the paths, we have investigated the relation for various situations, including pure, mixed, and partially-mixed input states. A quantum eraser scheme has been realized that recovers interference fringes even when no which-way information is available to erase.Comment: 6 pages, 4 figures. To appear in Phys. Rev.

An interferometric complementarity experiment in a bulk Nuclear Magnetic Resonance ensemble

We have experimentally demonstrated the interferometric complementarity, which relates the distinguishability $D$ quantifying the amount of which-way (WW) information to the fringe visibility $V$ characterizing the wave feature of a quantum entity, in a bulk ensemble by Nuclear Magnetic Resonance (NMR) techniques. We primarily concern on the intermediate cases: partial fringe visibility and incomplete WW information. We propose a quantitative measure of $D$ by an alternative geometric strategy and investigate the relation between $D$ and entanglement. By measuring $D$ and $V$ independently, it turns out that the duality relation $D^{2}+V^{2}=1$ holds for pure quantum states of the markers.Comment: 13 page, 5 PS figure