Outcomes of the metabolically healthy obese

Introduction: Obesity is a worldwide epidemic, Metabolic Healthy Obesity (MHO) is a vital subcohort of obesity that needs to be further investigated and epidemiologically defined. This has not received the clinical and public health attention it deserves and would help in targeting lifestyle and interventions (surgery) to those best suited. Methods: This thesis utilised long term primary care follow up using the Clinical Practice Research Datalink (CPRD) to quantify prevalence, investigate transition, investigate all-cause mortality in the sub-cohort and study intervention outcomes in the United Kingdom. Results: Total number of 414,522 patients were extracted, of which 231,399 (55.8%) had a body mass index (BMI) recorded. This thesis utilised 180,560 patients after exclusions. The prevalence of MHO in the UK population was 128,191/180,560 (71.0%), of which 71,485/128,191 (55.8%) remained healthy (p=<0.01) with a mean follow-up of 68.2 months. There was a 3.7% mortality rate in the MHO vs the metabolically unhealthy cohort 7.1% with an increased risk of mortality associated with a high BMI, late age at diagnosis and male gender. Frequency of bariatric surgery was generally was performed more in the metabolically healthy than unhealthy, 2.2% vs 1.9%. On Cox regression analysis, bariatric surgery remained a nonsignificant independent factor of survival within both the metabolically healthy and unhealthy obese. Conclusion: The implication of this study is that a diagnosis of obesity as an independent factor for immediate determination of impending complications. It is imperative that the body mass index of an obese patient is laid side by side with their metabolic rate indices. On the grounds of conclusions from this thesis, further studies into the pathophysiology of metabolically unhealthy obesity are necessary, with a close reference to the presence or absence of comorbidity.Open Acces

On single-crystal solid-state NMR based quantum information processing

Quantum information processing devices promise to solve some problems more efficiently than their classical counterparts. The source of the speedup is the structure of quantum theory itself. In that sense, the physical units that are the building blocks of such devices are its power. The quest then is to find or manufacture a system that behaves according to quantum theory, and yet is controllable in such a way that the desired algorithms can be implemented. Candidate systems are benchmarked against general criteria to evaluate their success. In this thesis, I advance a particular system and present the progress made towards each of these criteria. The system is a three-qubit 13C solid-state nuclear magnetic resonance (NMR) based quantum processor. I report results concerning system characterization and control, pseudopure state preparation, and quantum error correction. I also report on using the system to test a central question in the foundation of quantum mechanics

Protective effect of erdosteine against methotrexateinduced hepatotoxicity in rats

Purpose: To study the possible mitigating effect of erdosteine (ERD) against methotrexate (MTX)-induced liver toxicity.Methods: Male albino Sprague-Dawley rats were randomly assigned to four groups of 8 rats each, viz, vehicle control, MTX (20 mg/kg i.p.), MTX (20 mg/kg i.p.) + ERD (300 mg/kg) and ERD (300 mg/kg) groups. Serum levels of alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were determined by enzymatic colorimetric commercial kits while Hepatic tissue content of malondialdehyde (MDA), reduced glutathione (GSH), SOD and catalase (CAT) were also evaluated. In addition, measurement of the inflammatory cytokine, TNF-α, as well as histopathological&nbsp; examination and histochemical assessment were carried out.Results: The results indicate that, compared to the control group, MTX group showed a remarkable elevation in oxidative stress as indicated by significantly lower levels of SOD, CAT and reduced glutathione, and increased tissue malondialdehyde (p &lt; 0.05). MTX group exhibited significantly higher blood activities of ALT, AST and TNF-α, reflective of hepatocyte damage and inflammation (p &lt; 0.05). In MTX group, significant hepatic degenerative changes were detected on histological examination, while marked apoptotic alternations were observed following&nbsp; immunohistochemical analysis of caspase-3 expression, when compared to control group. However, administration of ERD to rats ameliorated thechanges in these parameters (p &lt; 0.05).Conclusion: Treatment with ERD in rats produced alleviation in hepatic oxidative stress, apoptosis, inflammation, and histological damage, when compared to MTX group. This study is the first to demonstrate the potentially protective effect of ERD-pretreatment against hepatotoxicity associated with MTX. Keywords: Erdosteine, Methotrexate, Hepatotoxicity, Oxidant, Anti-oxidant &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp

Practical experimental certification of computational quantum gates via twirling

Due to the technical difficulty of building large quantum computers, it is important to be able to estimate how faithful a given implementation is to an ideal quantum computer. The common approach of completely characterizing the computation process via quantum process tomography requires an exponential amount of resources, and thus is not practical even for relatively small devices. We solve this problem by demonstrating that twirling experiments previously used to characterize the average fidelity of quantum memories efficiently can be easily adapted to estimate the average fidelity of the experimental implementation of important quantum computation processes, such as unitaries in the Clifford group, in a practical and efficient manner with applicability in current quantum devices. Using this procedure, we demonstrate state-of-the-art coherent control of an ensemble of magnetic moments of nuclear spins in a single crystal solid by implementing the encoding operation for a 3 qubit code with only a 1% degradation in average fidelity discounting preparation and measurement errors. We also highlight one of the advances that was instrumental in achieving such high fidelity control.Comment: 7 pages, 6 figure

Selective allocation of patients with vaginal apical prolapse to either mesh augmented open abdominal repair or vaginal sacrospinous colpopexy improve functional and anatomical outcomes

Background: To evaluate the functional and anatomical outcomes after allocation of patients with apical vaginal prolapse to either mesh augmented abdominal repair or vaginal sacrospinous-colpopexy based on proposed selection criteria.Methods: A non-randomized trial was conducted at Ain-Shams university maternity hospital on patients with apical vaginal prolapse stage ≥2 based on pelvic organ prolapse quantification system. Certain criteria were proposed for patient selection to either mesh augmented abdominal repair or vaginal sacrospinous-colpopexy. Seventy-eight patients were assigned for sacrospinous-colpopexy and 47-patients for abdominal repair. Primary outcomes were the functional outcome using urogenital distress inventory questionnaire and patient global impression of improvement (PGI-I). Both were measured at 1-year’s follow-up. Secondary outcomes involved the anatomical success (defined as no apical prolapse ≥POP-Q stage 2), perioperative data and long-term complications.Results: There was improvement in all UDI domains for sacrospinous-colpopexy and abdominal repair groups with genital prolapse domain of median (interquartile range) 0 (0-10), 0 (0-0) respectively. Eighty-nine percent of abdominal repair group and 85% of sacrospinous-colpopexy group reported scale of 1 or 2 on PGI-I scale at 1-year follow-up. PGI-I score and improvements in UDI domains were maintained till 5-year follow-up. The anatomic success rate at 1-year follow-up was 97.9% in abdominal repair group and 78.2% in the sacrospinous-colpopexy group. No long-term mesh complications were detected in mesh augmented abdominal repair over the whole follow-up periods.Conclusion: The resulting meritorious functional and anatomical outcomes favor adoption of our proposed selection criteria in the initiation of guidelines and recommendations for managing vaginal apical prolapse

Quantum data bus in dipolar coupled nuclear spin qubits

We implement an iterative quantum state transfer exploiting the natural dipolar couplings in a spin chain of a liquid crystal NMR system. During each iteration a finite part of the amplitude of the state is transferred and by applying an external operation on only the last two spins the transferred state is made to accumulate on the spin at the end point. The transfer fidelity reaches one asymptotically through increasing the number of iterations. We also implement the inverted version of the scheme which can transfer an arbitrary state from the end point to any other position of the chain and entangle any pair of spins in the chain, acting as a full quantum data bus.Comment: published in PR