The value of kinetic glomerular filtration rate estimation on medication dosing in acute kidney injury.

BackgroundIn acute kidney injury (AKI), medication dosing based on Cockcroft-Gault creatinine clearance (CrCl) or Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) estimated glomerular filtration rates (eGFR) are not valid when serum creatinine (SCr) is not in steady state. The aim of this study was to determine the impact of a kinetic estimating equation that incorporates fluctuations in SCrs on drug dosing in critically ill patients.MethodsWe used data from participants enrolled in the NIH Acute Respiratory Distress Syndrome Network Fluid and Catheters Treatment Trial to simulate drug dosing category changes with the application of the kinetic estimating equation developed by Chen. We evaluated whether kinetic estimation of renal function would change medication dosing categories (≥60, 30-59, 15-29, and <15mL/min) compared with the use of CrCl or CKD-EPI eGFR.ResultsThe use of kinetic CrCl and CKD-EPI eGFR resulted in a large enough change in estimated renal function to require medication dosing recategorization in 19.3% [95 CI 16.8%-21.9%] and 23.4% [95% CI 20.7%-26.1%] of participants, respectively. As expected, recategorization occurred more frequently in those with AKI. When we examined individual days for those with AKI, dosing discordance was observed in 8.5% of total days using the CG CrCl and 10.2% of total days using the CKD-EPI equation compared with the kinetic counterparts.ConclusionIn a critically ill population, use of kinetic estimates of renal function impacted medication dosing in a substantial proportion of AKI participants. Use of kinetic estimates in clinical practice should lower the incidence of medication toxicity as well as avoid subtherapeutic dosing during renal recovery

Recursive Encoding and Decoding of Noiseless Subsystem and Decoherence Free Subspace

When the environmental disturbace to a quantum system has a wavelength much larger than the system size, all qubits localized within a small area are under action of the same error operators. Noiseless subsystem and decoherence free subspace are known to correct such collective errors. We construct simple quantum circuits, which implement these collective error correction codes, for a small number $n$ of physical qubits. A single logical qubit is encoded with $n=3$ and $n=4$, while two logical qubits are encoded with $n=5$. The recursive relations among the subspaces employed in noiseless subsystem and decoherence free subspace play essential r\^oles in our implementation. The recursive relations also show that the number of gates required to encode $m$ logical qubits increases linearly in $m$.Comment: 9 pages, 3 figure

Nanocalorimetric Evidence for Nematic Superconductivity in the Doped Topological Insulator Sr0.1_{0.1}Bi2_{2}Se3_{3}

Spontaneous rotational-symmetry breaking in the superconducting state of doped $\mathrm{Bi}_2\mathrm{Se}_3$ has attracted significant attention as an indicator for topological superconductivity. In this paper, high-resolution calorimetry of the single-crystal $\mathrm{Sr}_{0.1}\mathrm{Bi}_2\mathrm{Se}_3$ provides unequivocal evidence of a two-fold rotational symmetry in the superconducting gap by a \emph{bulk thermodynamic} probe, a fingerprint of nematic superconductivity. The extremely small specific heat anomaly resolved with our high-sensitivity technique is consistent with the material's low carrier concentration proving bulk superconductivity. The large basal-plane anisotropy of $H_{c2}$ is attributed to a nematic phase of a two-component topological gap structure $\vec{\eta} = (\eta_{1}, \eta_{2})$ and caused by a symmetry-breaking energy term $\delta (|\eta_{1}|^{2} - |\eta_{2}|^{2}) T_{c}$. A quantitative analysis of our data excludes more conventional sources of this two-fold anisotropy and provides the first estimate for the symmetry-breaking strength $\delta \approx 0.1$, a value that points to an onset transition of the second order parameter component below 2K

Quantum key distribution with "dual detectors"

To improve the performance of a quantum key distribution (QKD) system, high speed, low dark count single photon detectors (or low noise homodyne detectors) are required. However, in practice, a fast detector is usually noisy. Here, we propose a "dual detectors" method to improve the performance of a practical QKD system with realistic detectors: the legitimate receiver randomly uses either a fast (but noisy) detector or a quiet (but slow) detector to measure the incoming quantum signals. The measurement results from the quiet detector can be used to bound eavesdropper's information, while the measurement results from the fast detector are used to generate secure key. We apply this idea to various QKD protocols. Simulation results demonstrate significant improvements in both BB84 protocol with ideal single photon source and Gaussian-modulated coherent states (GMCS) protocol; while for decoy-state BB84 protocol with weak coherent source, the improvement is moderate. We also discuss various practical issues in implementing the "dual detectors" scheme.Comment: 22 pages, 9 figure

How to share a quantum secret

We investigate the concept of quantum secret sharing. In a ((k,n)) threshold scheme, a secret quantum state is divided into n shares such that any k of those shares can be used to reconstruct the secret, but any set of k-1 or fewer shares contains absolutely no information about the secret. We show that the only constraint on the existence of threshold schemes comes from the quantum "no-cloning theorem", which requires that n < 2k, and, in all such cases, we give an efficient construction of a ((k,n)) threshold scheme. We also explore similarities and differences between quantum secret sharing schemes and quantum error-correcting codes. One remarkable difference is that, while most existing quantum codes encode pure states as pure states, quantum secret sharing schemes must use mixed states in some cases. For example, if k <= n < 2k-1 then any ((k,n)) threshold scheme must distribute information that is globally in a mixed state.Comment: 5 pages, REVTeX, submitted to PR

Pancreatic cysts suspected to be branch duct intraductal papillary mucinous neoplasm without concerning features have low risk for development of pancreatic cancer.

BackgroundThe risk of developing pancreatic cancer is uncertain in patients with clinically suspected branch duct intraductal papillary mucinous neoplasm (BD-IPMN) based on the "high-risk stigmata" or "worrisome features" criteria proposed in the 2012 international consensus guidelines ("Fukuoka criteria").MethodsRetrospective case series involving patients referred for endoscopic ultrasound (EUS) of indeterminate pancreatic cysts with clinical and EUS features consistent with BD-IPMN. Rates of pancreatic cancer occurring at any location in the pancreas were compared between groups of patients with one or more Fukuoka criteria ("Highest-Risk Group", HRG) and those without these criteria ("Lowest-Risk Group", LRG).ResultsAfter exclusions, 661 patients comprised the final cohort (250 HRG and 411 LRG patients), 62% female with an average age of 67 years and 4 years of follow up. Pancreatic cancer, primarily adenocarcinoma, occurred in 60 patients (59 HRG, 1 LRG). Prevalent cancers diagnosed during EUS, immediate surgery, or first year of follow up were found in 48/661 (7.3%) of cohort and exclusively in HRG (33/77, 42.3%). Using Kaplan-Meier method, the cumulative incidence of cancer at 7 years was 28% in HRG and 1.2% in LRG patients (P&lt;0.001).ConclusionsThis study supports using Fukuoka criteria to stratify the immediate and long-term risks of pancreatic cancer in presumptive BD-IPMN. The risk of pancreatic cancer was highest during the first year and occurred exclusively in those with "high-risk stigmata" or "worrisome features" criteria. After the first year all BD-IPMN continued to have a low but persistent cancer risk

Di-electron and two-photon widths in charmonium

The vector and pseudoscalar decay constants are calculated in the framework of the Field Correlator Method. Di-electron widths: $\Gamma_{ee}(J/\psi)=5.41$ keV, $\Gamma_{ee}(\psi'(3686))=2.47$ keV, $\Gamma_{ee}(\psi''(3770))=0.248$ keV, in good agreement with experiment, are obtained with the same coupling, $\alpha_s=0.165$, in QCD radiative corrections. We show that the larger $\alpha_s=0.191\pm 0.004$ is needed to reach agreement with experiment for $\Gamma_{\gamma\gamma}(\eta_c)=7.22$ keV, $\Gamma_{\gamma\gamma} (\chi(^3P_0))=3.3$ keV, $\Gamma_{\gamma\gamma}(\chi(^3P_2))= 0.54$ keV, and also for $\Gamma(J/\psi\to 3g)=59.5$ keV, $\Gamma(J/\psi\to \gamma 2g)=5.7$ keV. Meanwhile even larger $\alpha_s=0.238$ gives rise to good description of $\Gamma(\psi'\to 3g)=52.7$ keV, $\Gamma(\psi'\to \gamma 2g)= 3.5$ keV, and provides correct ratio of the branching fractions: $\frac{\mathcal{B}(J/\psi\to light hadrons)}{\mathcal{B}(\psi'\to light hadrons)}=0.24.$Comment: 8 pages, no figure

Nonet Symmetry and Two-Body Decays of Charmed Mesons

The decay of charmed mesons into pseudoscalar (P) and vector (V) mesons is studied in the context of nonet symmetry. We have found that it is badly broken in the PP channels and in the P sector of the PV channels as expected from the non-ideal mixing of the \eta and the \eta'. In the VV channels, it is also found that nonet symmetry does not describe the data well. We have found that this discrepancy cannot be attributed entirely to SU(3) breaking at the usual level of 20--30%. At least one, or both, of nonet and SU(3) symmetry must be very badly broken. The possibility of resolving the problem in the future is also discussed.Comment: 9 pages, UTAPHY-HEP-

Iterative in Situ Click Chemistry Assembles a Branched Capture Agent and Allosteric Inhibitor for Akt1

We describe the use of iterative in situ click chemistry to design an Akt-specific branched peptide triligand that is a drop-in replacement for monoclonal antibodies in multiple biochemical assays. Each peptide module in the branched structure makes unique contributions to affinity and/or specificity resulting in a 200 nM affinity ligand that efficiently immunoprecipitates Akt from cancer cell lysates and labels Akt in fixed cells. Our use of a small molecule to preinhibit Akt prior to screening resulted in low micromolar inhibitory potency and an allosteric mode of inhibition, which is evidenced through a series of competitive enzyme kinetic assays. To demonstrate the efficiency and selectivity of the protein-templated in situ click reaction, we developed a novel QPCR-based methodology that enabled a quantitative assessment of its yield. These results point to the potential for iterative in situ click chemistry to generate potent, synthetically accessible antibody replacements with novel inhibitory properties