Undergraduate medical textbooks do not provide adequate information on intravenous fluid therapy: a systematic survey and suggestions for improvement

<b>Background</b><p></p> Inappropriate prescribing of intravenous (IV) fluid, particularly 0.9% sodium chloride, causes post-operative complications. Fluid prescription is often left to junior medical staff and is frequently poorly managed. One reason for poor intravenous fluid prescribing practices could be inadequate coverage of this topic in the textbooks that are used.<p></p> <b>Methods</b><p></p> We formulated a comprehensive set of topics, related to important common clinical situations involving IV fluid therapy, (routine fluid replacement, fluid loss, fluids overload) to assess the adequacy of textbooks in common use. We assessed 29 medical textbooks widely available to students in the UK, scoring the presence of information provided by each book on each of the topics. The scores indicated how fully the topics were considered: not at all, partly, and adequately. No attempt was made to judge the quality of the information, because there is no consensus on these topics.<p></p> <b>Results</b><p></p> The maximum score that a book could achieve was 52. Three of the topics we chose were not considered by any of the books. Discounting these topics as “too esoteric”, the maximum possible score became 46. One textbook gained a score of 45, but the general score was poor (median 11, quartiles 4, 21). In particular, coverage of routine postoperative management was inadequate.<p></p> <b>Conclusions</b><p></p> Textbooks for undergraduates cover the topic of intravenous therapy badly, which may partly explain the poor knowledge and performance of junior doctors in this important field. Systematic revision of current textbooks might improve knowledge and practice by junior doctors. Careful definition of the remit and content of textbooks should be applied more widely to ensure quality and “fitness for purpose”, and avoid omission of vital knowledge

Conditional control of the quantum states of remote atomic memories for quantum networking

Quantum networks hold the promise for revolutionary advances in information processing with quantum resources distributed over remote locations via quantum-repeater architectures. Quantum networks are composed of nodes for storing and processing quantum states, and of channels for transmitting states between them. The scalability of such networks relies critically on the ability to perform conditional operations on states stored in separated quantum memories. Here we report the first implementation of such conditional control of two atomic memories, located in distinct apparatuses, which results in a 28-fold increase of the probability of simultaneously obtaining a pair of single photons, relative to the case without conditional control. As a first application, we demonstrate a high degree of indistinguishability for remotely generated single photons by the observation of destructive interference of their wavepackets. Our results demonstrate experimentally a basic principle for enabling scalable quantum networks, with applications as well to linear optics quantum computation.Comment: 10 pages, 8 figures; Minor corrections. References updated. Published at Nature Physics 2, Advanced Online Publication of 10/29 (2006

Generalized iterated wreath products of symmetric groups and generalized rooted trees correspondence

Consider the generalized iterated wreath product $S_{r_1}\wr \ldots \wr S_{r_k}$ of symmetric groups. We give a complete description of the traversal for the generalized iterated wreath product. We also prove an existence of a bijection between the equivalence classes of ordinary irreducible representations of the generalized iterated wreath product and orbits of labels on certain rooted trees. We find a recursion for the number of these labels and the degrees of irreducible representations of the generalized iterated wreath product. Finally, we give rough upper bound estimates for fast Fourier transforms.Comment: 18 pages, to appear in Advances in the Mathematical Sciences. arXiv admin note: text overlap with arXiv:1409.060

Quantum Storage of Photonic Entanglement in a Crystal

Entanglement is the fundamental characteristic of quantum physics. Large experimental efforts are devoted to harness entanglement between various physical systems. In particular, entanglement between light and material systems is interesting due to their prospective roles as "flying" and stationary qubits in future quantum information technologies, such as quantum repeaters and quantum networks. Here we report the first demonstration of entanglement between a photon at telecommunication wavelength and a single collective atomic excitation stored in a crystal. One photon from an energy-time entangled pair is mapped onto a crystal and then released into a well-defined spatial mode after a predetermined storage time. The other photon is at telecommunication wavelength and is sent directly through a 50 m fiber link to an analyzer. Successful transfer of entanglement to the crystal and back is proven by a violation of the Clauser-Horne-Shimony-Holt (CHSH) inequality by almost three standard deviations (S=2.64+/-0.23). These results represent an important step towards quantum communication technologies based on solid-state devices. In particular, our resources pave the way for building efficient multiplexed quantum repeaters for long-distance quantum networks.Comment: 5 pages, 3 figures + supplementary information; fixed typo in ref. [36

A soliton menagerie in AdS

We explore the behaviour of charged scalar solitons in asymptotically global AdS4 spacetimes. This is motivated in part by attempting to identify under what circumstances such objects can become large relative to the AdS length scale. We demonstrate that such solitons generically do get large and in fact in the planar limit smoothly connect up with the zero temperature limit of planar scalar hair black holes. In particular, for given Lagrangian parameters we encounter multiple branches of solitons: some which are perturbatively connected to the AdS vacuum and surprisingly, some which are not. We explore the phase space of solutions by tuning the charge of the scalar field and changing scalar boundary conditions at AdS asymptopia, finding intriguing critical behaviour as a function of these parameters. We demonstrate these features not only for phenomenologically motivated gravitational Abelian-Higgs models, but also for models that can be consistently embedded into eleven dimensional supergravity.Comment: 62 pages, 21 figures. v2: added refs and comments and updated appendice

Experimental demonstration of a BDCZ quantum repeater node

Quantum communication is a method that offers efficient and secure ways for the exchange of information in a network. Large-scale quantum communication (of the order of 100 km) has been achieved; however, serious problems occur beyond this distance scale, mainly due to inevitable photon loss in the transmission channel. Quantum communication eventually fails when the probability of a dark count in the photon detectors becomes comparable to the probability that a photon is correctly detected. To overcome this problem, Briegel, D\"{u}r, Cirac and Zoller (BDCZ) introduced the concept of quantum repeaters, combining entanglement swapping and quantum memory to efficiently extend the achievable distances. Although entanglement swapping has been experimentally demonstrated, the implementation of BDCZ quantum repeaters has proved challenging owing to the difficulty of integrating a quantum memory. Here we realize entanglement swapping with storage and retrieval of light, a building block of the BDCZ quantum repeater. We follow a scheme that incorporates the strategy of BDCZ with atomic quantum memories. Two atomic ensembles, each originally entangled with a single emitted photon, are projected into an entangled state by performing a joint Bell state measurement on the two single photons after they have passed through a 300-m fibre-based communication channel. The entanglement is stored in the atomic ensembles and later verified by converting the atomic excitations into photons. Our method is intrinsically phase insensitive and establishes the essential element needed to realize quantum repeaters with stationary atomic qubits as quantum memories and flying photonic qubits as quantum messengers.Comment: 5 pages, 4 figure

Efficient and long-lived quantum memory with cold atoms inside a ring cavity

Quantum memories are regarded as one of the fundamental building blocks of linear-optical quantum computation and long-distance quantum communication. A long standing goal to realize scalable quantum information processing is to build a long-lived and efficient quantum memory. There have been significant efforts distributed towards this goal. However, either efficient but short-lived or long-lived but inefficient quantum memories have been demonstrated so far. Here we report a high-performance quantum memory in which long lifetime and high retrieval efficiency meet for the first time. By placing a ring cavity around an atomic ensemble, employing a pair of clock states, creating a long-wavelength spin wave, and arranging the setup in the gravitational direction, we realize a quantum memory with an intrinsic spin wave to photon conversion efficiency of 73(2)% together with a storage lifetime of 3.2(1) ms. This realization provides an essential tool towards scalable linear-optical quantum information processing.Comment: 6 pages, 4 figure

Mapping photonic entanglement into and out of a quantum memory

Recent developments of quantum information science critically rely on entanglement, an intriguing aspect of quantum mechanics where parts of a composite system can exhibit correlations stronger than any classical counterpart. In particular, scalable quantum networks require capabilities to create, store, and distribute entanglement among distant matter nodes via photonic channels. Atomic ensembles can play the role of such nodes. So far, in the photon counting regime, heralded entanglement between atomic ensembles has been successfully demonstrated via probabilistic protocols. However, an inherent drawback of this approach is the compromise between the amount of entanglement and its preparation probability, leading intrinsically to low count rate for high entanglement. Here we report a protocol where entanglement between two atomic ensembles is created by coherent mapping of an entangled state of light. By splitting a single-photon and subsequent state transfer, we separate the generation of entanglement and its storage. After a programmable delay, the stored entanglement is mapped back into photonic modes with overall efficiency of 17 %. Improvements of single-photon sources together with our protocol will enable "on demand" entanglement of atomic ensembles, a powerful resource for quantum networking.Comment: 7 pages, and 3 figure

Recombination rate and selection strength in HIV intra-patient evolution

The evolutionary dynamics of HIV during the chronic phase of infection is driven by the host immune response and by selective pressures exerted through drug treatment. To understand and model the evolution of HIV quantitatively, the parameters governing genetic diversification and the strength of selection need to be known. While mutation rates can be measured in single replication cycles, the relevant effective recombination rate depends on the probability of coinfection of a cell with more than one virus and can only be inferred from population data. However, most population genetic estimators for recombination rates assume absence of selection and are hence of limited applicability to HIV, since positive and purifying selection are important in HIV evolution. Here, we estimate the rate of recombination and the distribution of selection coefficients from time-resolved sequence data tracking the evolution of HIV within single patients. By examining temporal changes in the genetic composition of the population, we estimate the effective recombination to be r=1.4e-5 recombinations per site and generation. Furthermore, we provide evidence that selection coefficients of at least 15% of the observed non-synonymous polymorphisms exceed 0.8% per generation. These results provide a basis for a more detailed understanding of the evolution of HIV. A particularly interesting case is evolution in response to drug treatment, where recombination can facilitate the rapid acquisition of multiple resistance mutations. With the methods developed here, more precise and more detailed studies will be possible, as soon as data with higher time resolution and greater sample sizes is available.Comment: to appear in PLoS Computational Biolog

Ectopic A-lattice seams destabilize microtubules

Natural microtubules typically include one A-lattice seam within an otherwise helically symmetric B-lattice tube. It is currently unclear how A-lattice seams influence microtubule dynamic instability. Here we find that including extra A-lattice seams in GMPCPP microtubules, structural analogues of the GTP caps of dynamic microtubules, destabilizes them, enhancing their median shrinkage rate by >20-fold. Dynamic microtubules nucleated by seeds containing extra A-lattice seams have growth rates similar to microtubules nucleated by B-lattice seeds, yet have increased catastrophe frequencies at both ends. Furthermore, binding B-lattice GDP microtubules to a rigor kinesin surface stabilizes them against shrinkage, whereas microtubules with extra A-lattice seams are stabilized only slightly. Our data suggest that introducing extra A-lattice seams into dynamic microtubules destabilizes them by destabilizing their GTP caps. On this basis, we propose that the single A-lattice seam of natural B-lattice MTs may act as a trigger point, and potentially a regulation point, for catastrophe