Bimodal release ondansetron for acute gastroenteritis among adolescents and adults: A randomized clinical trial

Importance: Vomiting resulting from acute gastroenteritis is commonly treated with intravenous antiemetics in acute care settings. If oral treatment were beneficial, patients might not need intravenous administered hydration or medication. Furthermore, a long-acting treatment could provide sustained relief from nausea and vomiting. Objective: To determine whether an experimental long-acting bimodal release ondansetron tablet decreases gastroenteritis-related vomiting and eliminates the need for intravenous therapy for 24 hours after administration. Design, Setting, and Participants: This placebo-controlled, double-blind, randomized clinical trial included patients from 19 emergency departments and 2 urgent care centers in the United States from December 8, 2014, to February 17, 2017. Patients 12 years and older with at least 2 vomiting episodes from presumed gastroenteritis in the previous 4 hours and symptoms with less than 36 hours\u27 duration were randomized using a 3:2 active to placebo ratio. Analyses were performed on an intent-to-treat basis and conducted from June 1, 2017, to November 1, 2017. Intervention: Bimodal release ondansetron tablet containing 6 mg of immediate release ondansetron and 18 mg of a 24-hour release matrix for a total of 24 mg of ondansetron. Main Outcomes and Measures: Treatment success was defined as no further vomiting, no need for rescue medication, and no intravenous hydration for 24 hours after bimodal release ondansetron administration. Results: Analysis included 321 patients (mean [SD] age, 29.0 [11.1] years; 195 [60.7%] women), with 192 patients in the bimodal release ondansetron group and 129 patients in the placebo group. Treatment successes were observed in 126 patients in the bimodal release ondansetron group (65.6%) compared with 70 patients in the placebo group (54.3%), with an 11.4% (95% CI, 0.3%-22.4%) absolute probability difference. The proportion of treatment success was 21% higher among patients who received bimodal release ondansetron compared with those who received a placebo (relative risk, 1.21; 95% CI, 1.00-1.46; P = .04). In an analysis including only patients with a discharge diagnosis of acute gastroenteritis and no major protocol violations, there were 123 treatment successes (69.5%) in the bimodal release ondansetron group compared with 67 treatment successes (54.9%) in the placebo group (relative risk, 1.27; 95% CI, 1.05-1.53; P = .01). Adverse effects were infrequent and similar to the known safety profile of ondansetron. Conclusions and Relevance: This randomized clinical trial found that a long-acting bimodal release oral ondansetron tablet was an effective antiemetic among adolescents and adults with moderate to severe vomiting from acute gastroenteritis. The drug benefits extended to 24 hours after administration. Bimodal release ondansetron may decrease the need for intravenous access and emergency department care to manage acute gastroenteritis. Trial Registration: ClinicalTrials.gov identifier: NCT02246439

Demonstrating a superconducting dual-rail cavity qubit with erasure-detected logical measurements

A critical challenge in developing scalable error-corrected quantum systems is the accumulation of errors while performing operations and measurements. One promising approach is to design a system where errors can be detected and converted into erasures. A recent proposal aims to do this using a dual-rail encoding with superconducting cavities. In this work, we implement such a dual-rail cavity qubit and use it to demonstrate a projective logical measurement with erasure detection. We measure logical state preparation and measurement errors at the $0.01\%$-level and detect over $99\%$ of cavity decay events as erasures. We use the precision of this new measurement protocol to distinguish different types of errors in this system, finding that while decay errors occur with probability $\sim 0.2\%$ per microsecond, phase errors occur 6 times less frequently and bit flips occur at least 170 times less frequently. These findings represent the first confirmation of the expected error hierarchy necessary to concatenate dual-rail erasure qubits into a highly efficient erasure code

Mechanical reinforcement in a polyisoprene rubber by hybrid nanofillers

Melt blending of hybrid nanofillers with rubber matrices could make rubber nanocomposites more attractive for industrial applications. In this work, the low-amplitude dynamic shear modulus of polyisoprene rubber filled with carbon nanotubes or nano-graphite, individually or in combination with carbon black, was measured. A rationalisation of the results highlighted interactive effects of carbon allotropes on the mechanical reinforcement of rubber nanocomposites. The filler–matrix interfacial area was identified as a parameter able to correlate the moduli values of different fillers, by reducing them to a common master curve

Error-Detectable Bosonic Entangling Gates with a Noisy Ancilla

Bosonic quantum error correction has proven to be a successful approach for extending the coherence of quantum memories, but to execute deep quantum circuits, high-fidelity gates between encoded qubits are needed. To that end, we present a family of error-detectable two-qubit gates for a variety of bosonic encodings. From a new geometric framework based on a “Bloch sphere” of bosonic operators, we construct ZZ_{L}(θ) and exponential-swap(θ) gates for the binomial, four-legged cat, dual-rail, and several other bosonic codes. The gate Hamiltonian is simple to engineer, requiring only a programmable beam splitter between two bosonic qubits and an ancilla dispersively coupled to one qubit. This Hamiltonian can be realized in circuit QED hardware with ancilla transmons and microwave cavities. The proposed theoretical framework was developed for circuit QED but is generalizable to any platform that can effectively generate this Hamiltonian. Crucially, one can also detect first-order errors in the ancilla and the bosonic qubits during the gates. We show that this allows one to reach error-detected gate fidelities at the 0.01% level with today’s hardware, limited only by second-order hardware errors