Distribution of Entropy Production in a Single-Electron Box

Recently, the fundamental laws of thermodynamics have been reconsidered for small systems. The discovery of the fluctuation relations has spurred theoretical and experimental studies on thermodynamics of systems with few degrees of freedom. The concept of entropy production has been extended to the microscopic level by considering stochastic trajectories of a system coupled to a heat bath. However, the experimental observation of the microscopic entropy production remains elusive. We measure distributions of the microscopic entropy production in a single-electron box consisting of two islands with a tunnel junction. The islands are coupled to separate heat baths at different temperatures, maintaining a steady thermal non-equilibrium. As Jarzynski equality between work and free energy is not applicable in this case, the entropy production becomes the relevant parameter. We verify experimentally that the integral and detailed fluctuation relations are satisfied. Furthermore, the coarse-grained entropy production from trajectories of electronic transitions is related to the bare entropy production by a universal formula. Our results reveal the fundamental roles of irreversible entropy production in non-equilibrium small systems

Cervical dystonia:effectiveness of a standardized physical therapy program; study design and protocol of a single blind randomized controlled trial

<p>Background: Cervical dystonia is characterized by involuntary muscle contractions of the neck and abnormal head positions that affect daily life activities and social life of patients. Patients are usually treated with botulinum toxin injections into affected neck muscles to relief pain and improve control of head postures. In addition, many patients are referred for physical therapy to improve their ability to perform activities of daily living. A recent review on allied health interventions in cervical dystonia showed a lack of randomized controlled intervention studies regarding the effectiveness of physical therapy interventions.</p><p>Methods/design: The (cost-) effectiveness of a standardized physical therapy program compared to regular physical therapy, both as add-on treatment to botulinum toxin injections will be determined in a multi-centre, single blinded randomized controlled trial with 100 cervical dystonia patients. Primary outcomes are disability in daily functioning assessed with the disability subscale of the Toronto Western Spasmodic Torticollis Rating Scale. Secondary outcomes are pain, severity of dystonia, active range of motion of the head, quality of life, anxiety and depression. Data will be collected at baseline, after six months and one year by an independent blind assessor just prior to botulinum toxin injections. For the cost effectiveness, an additional economic evaluation will be performed with the costs per quality adjusted life-year as primary outcome parameter.</p><p>Discussion: Our study will provide new evidence regarding the (cost-) effectiveness of a standardized, tailored physical therapy program for patients with cervical dystonia. It is widely felt that allied health interventions, including physical therapy, may offer a valuable supplement to the current therapeutic options. A positive outcome will lead to a greater use of the standardized physical therapy program. For the Dutch situation a positive outcome implies that the standardized physical therapy program forms the basis for a national treatment guideline for cervical dystonia.</p>