Quantum Computing and Quantum Algorithms

The field of quantum computing and quantum algorithms is studied from the ground up. Qubits and their quantum-mechanical properties are discussed, followed by how they are transformed by quantum gates. From there, quantum algorithms are explored as well as the use of high-level quantum programming languages to implement them. One quantum algorithm is selected to be implemented in the Qiskit quantum programming language. The validity and success of the resulting computation is proven with matrix multiplication of the qubits and quantum gates involved

The Right to Counsel in Prosecutorial Interrogations

NOTE: A printing error labeled this issue Spring 1982, it should have been labeled Summer 198

The Right to Counsel in Prosecutorial Interrogations

NOTE: A printing error labeled this issue Spring 1982, it should have been labeled Summer 198

Changing Methodologies in Financial Audit and Their Impact on Information Systems Audit

This paper tries to provide a better understanding of the relation between financial audit and information systems audit and to assess the influence the change in financial audit methodologies had on IS audit. We concluded that the COSO Internal Control – Integrated Framework was the starting point for fundamental changes in both financial and IS audit and that the Sarbanes-Oxley Act should be viewed as an enabler rather than an enforcer in establishing strong governance models. Finally, our research suggests that there is a direct causality effect between the employment of BRA (business risk audit) methodologies and the growing importance of IS audit

Management of intramedullary astrocytomas

Primitive IMT represent 8-10% of all primary tumors of the spinal cord. Only 2-4% of all CNS tumors in adults are IMT. Adult astrocytomas are 25-35% of total IMT (1). We prospectively analyzed clinical, imaging and pathological data from all consecutive patients operated for intramedullary tumors in our department (Neurosurgery I Clinic, Ward II) between January 2003 and August 2009 (80 months). All surgical interventions were performed by the same surgical team. We emphasized the technical difficulties raised by ablation of IMT depending on the type of the tumor and postoperative neurological outcome

Perioperative use of steroids in neonatal heart surgery:Evidence based practice or tradition?

A best evidence topic was written according to a structured protocol. The question addressed was: Is the use of prophylactic, perioperative steroids associated with better clinical outcomes following heart surgery in neonates? Altogether, 194 papers were found using the reported search, of which 8 represented the best evidence to answer the clinical question. One study found improved hospital survival in the group without steroids. Steroids increased infection in one large retrospective study. Incidence of hyperglycaemia was increased in the steroid group in 2 out of 5 studies. Use of steroids was associated with a shorter duration of ventilation and better oxygenation in one study. Postoperative steroid infusion was associated with reduced low cardiac output syndrome, inotrope requirement and less fluid retention in two controlled trials in which all patients received preoperative steroid. High dose steroid was associated with renal dysfunction in one study, comparing single versus double dose steroid prophylaxis. Steroid non-recipients had a shorter intensive care length of stay in 2 out of 7 studies. We conclude that use of steroids perioperatively does not unequivocally improve clinical outcome in neonatal heart surgery. A large, multicentre prospective randomized controlled trial is needed to clarify the role of steroids in paediatric heart surgery

Impact of risk factors on the evolution of severe acute pancreatitis

Introduction. Severe acute pancreatitis (SAP) is an acute inflammatory condition of the pancreas with increasing incidence and mortality rates in recent years. The aim of this study was to evaluate the impact of age, comorbidities, and different scoring systems on the complications and outcomes of SAP. Materials and Methods. A retrospective study was conducted on 161 patients diagnosed and treated for SAP at the Bucharest University Hospital in the intensive care unit (ICU), in the period 2014-2021. The impact of risk factors for the development of SAP, occurrence of complications (respiratory, cardiac, etc.), length of hospital stays and mortality was analyzed using several scores (BISAP, Ranson, Apache II and SOFA) or modified computed tomography severity index. Preexisting chronic conditions were assessed using the Charlson Comorbidity Index (CCI). Multivariate statistics and non-parametric univariate were calculated in statistical analysis. Odds ratios with 95% confidence intervals were used. Results. Risk factors such as age, diet, medication, alcohol consumption, genetic factors and patient comorbidities contribute significantly to the development of a severe form of acute pancreatitis with critical course and high mortality. Conclusions. In our study, CCI was the most important factor correlated with death and duration of ICU treatment

Validation of a New Prognostic Score in Patients with Ovarian Adenocarcinoma

Background and Objectives: This study aimed to assess the impact of clinical prognostic factors and propose a prognostic score that aids the clinician’s decision in estimating the risk for patients in clinical practice. Materials and Methods: The study included 195 patients diagnosed with ovarian adenocarcinoma. The therapeutic strategy involved multidisciplinary decisions: surgery followed by adjuvant chemotherapy (80%), neoadjuvant chemotherapy followed by surgery (16.4%), and only chemotherapy in selected cases (3.6%). Results: After a median follow-up of 68 months, in terms of progression-free survival (PFS) and overall survival (OS), Eastern Cooperative Oncology Group (ECOG) performance status of 1 and 2 vs. 0 (hazard ratio—HR = 2.71, 95% confidence interval—CI, 1.96–3.73, p < 0.001 for PFS and HR = 3.19, 95%CI, 2.20–4.64, p < 0.001 for OS), menopausal vs. premenopausal status (HR = 2.02, 95%CI, 1.35–3,0 p < 0.001 and HR = 2.25, 95%CI = 1.41–3.59, p < 0.001), ascites (HR = 1.95, 95%CI 1.35–2.80, p = 0.03, HR = 2.31, 95%CI = 1.52–3.5, p < 0.007), residual disease (HR = 5.12, 95%CI 3.43–7.65, p < 0.0001 and HR = 4.07, 95%CI = 2.59–6.39, p < 0.0001), and thrombocytosis (HR = 2.48 95%CI = 1.72–3.58, p < 0.0001, HR = 3.33, 95%CI = 2.16–5.13, p < 0.0001) were associated with a poor prognosis. An original prognostic score including these characteristics was validated using receiver operating characteristic (ROC) curves (area under the curve—AUC = 0.799 for PFS and AUC = 0.726 for OS, p < 0.001). The median PFS for patients with none, one, two, three, or four (or more) prognostic factors was not reached, 70, 36, 20, and 12 months, respectively. The corresponding median overall survival (OS) was not reached, 108, 77, 60, and 34 months, respectively. Conclusions: Several negative prognostic factors were identified: ECOG performance status ≥ 1, the presence of ascites and residual disease after surgery, thrombocytosis, and menopausal status. These led to the development of an original prognostic score that can be helpful in clinical practice

ACUTE SPINAL EPIDURAL HEMATOMA, CLINICAL AND ETIOPATHOGENIC DIAGNOSTIC DIFFICULTIES – CASE PRESENTATION AND SYNTHESIS OF THE LITERATURE

Introduction: Epidural hematoma has a double anatomopathological topography: intracranial and/ or spinal. Its etiology is complex: post-traumatic (spinal trauma, or lumbar puncture), iatrogenic (secondary to an inadequate anticoagulation or antiplatelet treatment), congenital or acquired disorders of coagulation (leukemia, hepatic cirrhosis), secondary to intense Valsalva maneuvers (e.g. during labor, or an intense physical effort), and idiopathic. The purpose of this article is to present a clinical case of acute spinal epidural hematoma (SEDH) with atypical clinical picture and a puzzled pathophysiological mechanism, and also a brief review of the relevant literature. Case presentation: An 80-years-old male patient, with locomotor disability (bilateral congenital foot deformity), and multiple cardiovascular comorbidities (chronic atrial fibrillation (AF), dilated cardiomyopathy and contractile dysfunction (chronic heart failure, with left ventricle ejection fraction 40 %), chronically anticoagulated with a vitamin K antagonist (acenocumarol). The elderly submitted a body-level fall without cranial trauma, event followed by a short loss of consciousness (without convulsions or sphincter relaxation). He suffered a low-energy cervical fracture (C7 vertebral injury) and a posterolateral acute SEDH at C3-Th2 vertebral levels. Decompressive hemilaminectomy at the C4-Th2 levels and evacuation of the SEDH, was performed during the early sub-acute phase. The patient was transferred in our rehabilitation clinic as C4 AIS-C tetraplegia (global motor score 50/100), neurogenic bladder and bowel, with post surgical wound dehiscence (healed per secundam). The subject had a favorable neurological evolution and was discharged as C7 AIS-D tetraplegia (global motor score 81/100). Discussion: The case particularity consists in a puzzled etiopathogenetic mechanisms and difficulty to accurately indicate the chronological chain of events generating the acute SEDH. An overdosed anticoagulant therapy might be incriminated as an iatrogenic cause for a “spontaneous” SEDH, but most probably its etiology is complex, probably traumatic, consequence of the cervical spine fracture due the low-intensity biomechanical impact. The complex predisposing circumstances to accidental fall in our elderly patient were due to the: - impaired, unstable locomotor function, secondary to his bilateral congenital clubfoot deformity / disability - chronic AF, contractile dysfunction and hypodiastolic phenomena, with cardiogenic syncope and global brain ischemia or transient ischemic cerebral attack. Despite the good immediate outcomes, his future functional prognosis might be poor, due to the advanced age, severe cardiovascular pathology and the complex disturbances of the neuro-myo-artro-kinetic apparatus (major impediments of the somatic / body functions and structure). This health-related condition had severe repercussions on the subject`s activity (related to tasks and basic activities of daily living) and participation, affecting the outcome of rehabilitation, and his quality of life. Conclusions: Clinicians should consider the remote risk of SEDH (even with atypical clinical presentation) in patients with AF and anticoagulant medication. Despite a postponed decompressive intervention (imposed by the severe comorbidities), our patient neurologically improved without recurrence, following a complex neurorehabilitation program

The Peacock study:feasibility of the dynamic characterisation of the paediatric hypothalamic-pituitary-adrenal function during and after cardiac surgery

An amendment to this paper has been published and can be accessed via the original article