Rethinking Responsibility for Patient Injury: Accelerated-Compensation Events, a Malpractice and Quality Reform Ripe for a Test

The accelerated-compensation events (ACE) approach in medical malpractice reform was studied. Reforms based on ACE best address the twin goals of making compensation more equitable and avoiding bad outcomes in medical care

Circuit quantum acoustodynamics with surface acoustic waves

The experimental investigation of quantum devices incorporating mechanical resonators has opened up new frontiers in the study of quantum mechanics at a macroscopic level$^{1,2}$. Superconducting microwave circuits have proven to be a powerful platform for the realisation of such quantum devices, both in cavity optomechanics$^{3,4}$, and circuit quantum electro-dynamics (QED)$^{5,6}$. While most experiments to date have involved localised nanomechanical resonators, it has recently been shown that propagating surface acoustic waves (SAWs) can be piezoelectrically coupled to superconducting qubits$^{7,8}$, and confined in high-quality Fabry-Perot cavities up to microwave frequencies in the quantum regime$^{9}$, indicating the possibility of realising coherent exchange of quantum information between the two systems. Here we present measurements of a device in which a superconducting qubit is embedded in, and interacts with, the acoustic field of a Fabry-Perot SAW cavity on quartz, realising a surface acoustic version of cavity quantum electrodynamics. This quantum acoustodynamics (QAD) architecture may be used to develop new quantum acoustic devices in which quantum information is stored in trapped on-chip surface acoustic wavepackets, and manipulated in ways that are impossible with purely electromagnetic signals, due to the $10^{5}$ times slower speed of travel of the mechanical waves.Comment: 12 pages, 9 figures, 1 tabl

Double-sided coaxial circuit QED with out-of-plane wiring

Superconducting circuits are well established as a strong candidate platform for the development of quantum computing. In order to advance to a practically useful level, architectures are needed which combine arrays of many qubits with selective qubit control and readout, without compromising on coherence. Here we present a coaxial circuit QED architecture in which qubit and resonator are fabricated on opposing sides of a single chip, and control and readout wiring are provided by coaxial wiring running perpendicular to the chip plane. We present characterisation measurements of a fabricated device in good agreement with simulated parameters and demonstrating energy relaxation and dephasing times of $T_1 = 4.1\,\mu$s and $T_2 = 5.7\,\mu$s respectively. The architecture allows for scaling to large arrays of selectively controlled and measured qubits with the advantage of all wiring being out of the plane.Comment: 4 pages, 3 figures, 1 tabl

Elimination of visually evoked BOLD responses during carbogen inhalation: Implications for calibrated MRI

Breathing a mixture of 10% CO2 with 90% O2 (referred to here as carbogen-10) increases blood flow due to the vasodilatory effect of CO2, and raises blood O2 saturation due to the enriched oxygen level. These effects both tend to reduce the level of deoxygenated hemoglobin in brain tissues, thereby reducing the potential for further increases in BOLD contrast. In the present study, blocks of intense visual stimulation (60 s) were presented amid longer blocks (180 s) during which subjects breathed various fractional concentrations (0–100%) of carbogen-10 diluted with medical air. When breathing undiluted carbogen-10, the BOLD response to visual stimulation was reduced below the level of noise against the background of the carbogen-10 response. At these concentrations, the total (visual+carbogen) BOLD response amplitude (7.5±1.0%, n=6) converged toward that seen with carbogen alone (7.5 ± 1.0%, n = 6). In spite of the almost complete elimination of the visual BOLD response, pseudo-continuous arterial spin-labeling on a separate cohort indicated a largely preserved perfusion response (89±34%, n=5) to the visual stimulus during inhalation of carbogen-10. The previously discussed observations suggest that venous saturation can be driven to very high levels during carbogen inhalation, a finding which has significant implications for calibrated MRI techniques. The latter methods involve estimation of the relative change in venous O2 saturation by expressing activation-induced BOLD signal increases as a fraction of the maximal BOLD signal M that would be observed as venous saturation approaches 100%. While the value of M has generally been extrapolated from much smaller BOLD responses induced using hypercapnia or hyperoxia, our results suggest that these effects could be combined through carbogen inhalation to obtain estimates of M based on larger BOLD increases. Using a hybrid BOLD calibration model taking into account changes in both blood flow and arterial oxygenation, we estimated that inhalation of carbogen-10 led to an average venous saturation of 91%, allowing us to compute an estimated M value of 9.5%

Cardiorespiratory fitness and sports activities in children and adolescents with solitary functioning kidney

Background: An increasing number of children with chronic disease require a complete medical examination to be able to practice physical activity. Particularly children with solitary functioning kidney (SFK) need an accurate functional evaluation to perform sports activities safely. The aim of our study was to evaluate the influence of regular physical activity on the cardiorespiratory function of children with solitary functioning kidney. Method: Twenty-nine patients with congenital SFK, mean age 13.9 ± 5.0 years, and 36 controls (C), mean age 13.8 ± 3.7 years, underwent a cardiorespiratory assessment with spirometry and maximal cardiopulmonary exercise testing. All subjects were divided in two groups: sedentary (S) and trained (T) patients, by means of a standardized questionnaire about their weekly physical activity. Results: We found that mean values of maximal oxygen consumption (VO2max) and exercise time (ET) were higher in T subjects than in S subjects. Particularly SFK-T presented mean values of VO2max similar to C-T and significantly higher than C-S (SFK-T: 44.7 ± 6.3 vs C-S: 37.8 ± 3.7 ml/min/kg; p < 0.0008). We also found significantly higher mean values of ET (minutes) in minutes in SFK-T than C-S subjects (SFK-T: 12.9 ± 1.6 vs C-S: 10.8 ± 2.5 min; p <0.02). Conclusion: Our study showed that regular moderate/high level of physical activity improve aerobic capacity (VO2max) and exercise tolerance in congenital SFK patients without increasing the risks for cardiovascular accidents and accordingly sports activities should be strongly encouraged in SFK patients to maximize health benefit

Cholesterol depletion inhibits synaptic transmission and synaptic plasticity in rat hippocampus.

Several neurodegenerative disorders are associated with impaired cholesterol homeostasis in the nervous system where cholesterol is known to play a role in modulating synaptic activity and stabilizing membrane microdomains. In the present report, we investigated the effects of methyl-beta-cyclodextrin-induced cholesterol depletion on synaptic transmission and on the expression of 1) paired-pulse facilitation (PPF); 2) paired-pulse inhibition (PPI) and 3) long-term potentiation (LTP) in the CA1 hippocampal region. Results demonstrated that cyclodextrin strongly reduced synaptic transmission and blocked the expression of LTP, but did not affect PPF and PPI. The role of glutamatergic and GABAergic receptors in these cholesterol depletion-mediated effects was evaluated pharmacologically. Data indicate that, in cholesterol depleted neurons, modulation of synaptic transmission and synaptic plasticity phenomena are sustained by AMPA-, kainate-and NMDA-receptors but not by GABA-receptors. The involvement of AMPA-and kainate-receptors was confirmed by fluorimetric analysis of intracellular calcium concentrations in hippocampal cell cultures. These data suggest that modulation of receptor activity by manipulation of membrane lipids is a possible therapeutic strategy in neurodegenerative disease

Indigenous Arbuscular Mycorrhizal Fungal Assemblages Protect Grassland Host Plants from Pathogens

Plant roots can establish associations with neutral, beneficial and pathogenic groups of soil organisms. Although it has been recognized from the study of individual isolates that these associations are individually important for plant growth, little is known about interactions of whole assemblages of beneficial and pathogenic microorganisms associating with plants