Supersensitive measurement of angular displacements using entangled photons

We show that the use of entangled photons having non-zero orbital angular momentum (OAM) increases the resolution and sensitivity of angular-displacement measurements performed using an interferometer. By employing a 4$\times$4 matrix formulation to study the propagation of entangled OAM modes, we analyze measurement schemes for two and four entangled photons and obtain explicit expressions for the resolution and sensitivity in these schemes. We find that the resolution of angular-displacement measurements scales as $Nl$ while the angular sensitivity increases as $1/(2Nl)$, where $N$ is the number of entangled photons and $l$ the magnitude of the orbital-angular-momentum mode index. These results are an improvement over what could be obtained with $N$ non-entangled photons carrying an orbital angular momentum of $l\hbar$ per photonComment: 6 pages, 3 figure

An unusual case of anti-neutrophilic cytoplasmic autoantibodies associated vasculitis with pauci-immune crescentic glomerulonephritis in young? Wegener’s? Churg Strauss

Anti-neutrophilic cytoplasmic autoantibodies-associated vasculitis (AAV) is very rare in India. It normally affects older population around 6th and 7th decade of life. The management of cases is also complicated. We present a case of 18 year old male patient who came with complaints of epistaxis and had hematuria and pain in the joints. He had sub conjunctival haemorrhage on presentation. On and off he had respiratory symptoms and epistaxis in the past for which he was treated as allergy and bronchial asthma. At admission he had high absolute eosinophil count and had blood 3+ positive in urine. Initially he was treated as post viral vasculitis. But patient had involvement of kidney, lung, skin, joints, eyes and on further evaluation he was found to have AAV. The case was unique due to the age of presentation and patient also had overlapping symptoms of both Wegner’s granulomatosis and Churg-Strauss syndrome

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Treatment approach and outcomes of patients with accelerated/blast-phase myeloproliferative neoplasms in the current era

Progression of myeloproliferative neoplasms (MPNs) to accelerated or blast-phase is associated with poor survival outcomes. Since 2017 there have been several therapies approved for use in acute myeloid leukemia (AML); these therapies have been incorporated into the management of accelerated/blast-phase MPNs (MPN-AP/BP). We performed a multi-center analysis to investigate outcomes of patients diagnosed with MPN-AP/BP in 2017 or later. Two-hundred two patients were identified; median overall survival (OS) was 0.86 years. We also analyzed patients based on first-line treatment; the three most common approaches were intensive chemotherapy (IC) (n=65), DNA methyltransferase inhibitor (DNMTi)-based regimens (n=65), and DNMTi + venetoclax (VEN)-based regimens (n=54). Median OS was not significantly different by treatment type. In addition, we evaluated response by 2017 European LeukemiaNet (ELN) AML criteria and 2012 MPN-BP criteria in an effort to understand the association of response with survival outcomes. We also analyzed outcomes in 65 patients that received allogeneic hematopoietic stem cell transplant (allo-HCT); median OS was 2.30 years from time of allo-HCT. Our study demonstrates that survival amongst patients with MPN-AP/BP is limited in the absence of allo-HCT even in the current era of therapeutics and underscores the urgent need for new agents and approaches

American Society of Echocardiography Cardiovascular Technology and Research Summit : a roadmap for 2020

To realize the great potential of ultrasound for improving patient outcomes and offering novel therapy, closer partnerships among scientists, engineers, and those involved with research funding are needed. Improvements in technology, developed with these partnerships, will be necessary to advance 3D echocardiography, deformation imaging, and the quantitative assessment of VHD. Stepwise research studies will advance the development of sonothrombolysis and drug and gene delivery. The development of intelligent software offers the potential to improve the quality and efficiency of echocardiographic examinations.With demonstration of the value, reproducibility, and feasibility of quantitative echocardiographic biomarkers, users can then make the strong argument that echocardiography is a superior technology as a research tool for clinical trials in which large numbers of subjects must be imaged efficiently, cost-effectively, and safely. The leadership of the ASE will discuss the recommendations put forth in this document and formulate an action plan. Research remains an important mission of ASE, and the society must find a way to continue to expand and advance this endeavor to meet the needs of our patients

Practice guidelines for endoscopic ultrasound-guided celiac plexus neurolysis

Objectives: The objective of guideline was to provide clear and relevant consensus statements to form a practical guideline for clinicians on the indications, optimal technique, safety and efficacy of endoscopic ultrasound guided celiac plexus neurolysis (EUS-CPN). Methods: Six important clinical questions were determined regarding EUS-CPN. Following a detailed literature review, 6 statements were proposed attempting to answer those questions. A group of expert endosonographers convened in Chicago, United States (May 2016), where the statements were presented and feedback provided. Subsequently a consensus group of 35 expert endosonographers voted based on their individual level of agreement. A strong recommendation required 80% voter agreement. The modified GRADE (Grading of Recommendations Assessment, Development, and Evaluation) criteria were used to rate the strength of recommendations and the quality of evidence. Results: Eighty percent agreement was reached on 5 of 6 consensus statements, 79.4% agreement was reached on the remaining one. Conclusions: EUS-CPN is efficacious, should be integrated into the management of pancreas cancer pain, and can be considered early at the time of diagnosis of inoperable disease. Techniques may still vary based on operator experience. Serious complications exist, but are rare

Practice guidelines for endoscopic ultrasound-guided celiac plexus neurolysis

Objectives: The objective of guideline was to provide clear and relevant consensus statements to form a practical guideline for clinicians on the indications, optimal technique, safety and efficacy of endoscopic ultrasound guided celiac plexus neurolysis (EUS-CPN). Methods: Six important clinical questions were determined regarding EUS-CPN. Following a detailed literature review, 6 statements were proposed attempting to answer those questions. A group of expert endosonographers convened in Chicago, United States (May 2016), where the statements were presented and feedback provided. Subsequently a consensus group of 35 expert endosonographers voted based on their individual level of agreement. A strong recommendation required 80% voter agreement. The modified GRADE (Grading of Recommendations Assessment, Development, and Evaluation) criteria were used to rate the strength of recommendations and the quality of evidence. Results: Eighty percent agreement was reached on 5 of 6 consensus statements, 79.4% agreement was reached on the remaining one. Conclusions: EUS-CPN is efficacious, should be integrated into the management of pancreas cancer pain, and can be considered early at the time of diagnosis of inoperable disease. Techniques may still vary based on operator experience. Serious complications exist, but are rare