Manipulation of drugs to achieve the required dose is intrinsic to paediatric practice but is not supported by guidelines or evidence

Background: A lack of age-appropriate formulations can make it difficult to administer medicines to children. A manipulation of the dosage form may be required to achieve the required dose. This study aimed to describe medicines that are manipulated to achieve the required dose in paediatric practice.Method: A structured, undisguised observational study and postal survey. The observational study investigated drug manipulations occurring in clinical practice across three sites. The questionnaire, administered to a sample of paediatric nurses throughout the UK, surveyed manipulations conducted and nurses' experiences and views.Results: The observational study identified 310 manipulations, of which 62% involved tablets, 21% were intravenous drugs and 10% were sachets. Of the 54 observed manipulations 40 involved tablets with 65% of the tablets being cut and 30% dispersed to obtain a smaller dose. 188 manipulations were reported by questionnaire respondents, of these 46% involved tablets, 12% were intravenous drugs, and 12% were nebuliser solutions. Manipulations were predominantly, but not exclusively, identified in specialist clinical areas with more highly dependent patients. Questionnaire respondents were concerned about the accuracy of the dose achieved following manipulations and the lack of practice guidance.Conclusion: Manipulations to achieve the required dose occur throughout paediatric in-patient settings. The impact of manipulations on the efficacy of the drugs, the accuracy of the dose and any adverse effects on patients is not known. There is a need to develop evidence-based guidance for manipulations of medicines in children

New methods for chicken embryo manipulations

The capacity to image a growing embryo while simultaneously studying the developmental function of specific molecules provides invaluable information on embryogenesis. However, until recently, this approach was accomplished with difficulty both because of the advanced technology needed and because an easy method of minimizing damage to the embryo was unavailable. Here, we present a novel way of adapting the well-known EC culture of whole chick embryos to time-lapse imaging and to functional molecular studies using blocking agents. The novelty of our method stems from the ability to apply blocking agents ex ovo as well as in ovo. We were able to study the function of a set of molecules by culturing developing embryos ex ovo in tissue culture media containing these molecules or by injecting them underneath the live embryo in ovo. The in ovo preparation is particularly valuable, because it extends the period of time during which the developmental function of the molecule can be studied and it provides an easy, reproducible method for screening a batch of molecules. These new techniques will prove very helpful in visualizing and understanding the role of specific molecules during embryonic morphogenesis, including blood vessel formation

Quantum Manipulations of Small Josephson Junctions

Low-capacitance Josephson junction arrays in the parameter range where single charges can be controlled are suggested as possible physical realizations of the elements which have been considered in the context of quantum computers. We discuss single and multiple quantum bit systems. The systems are controlled by applied gate voltages, which also allow the necessary manipulation of the quantum states. We estimate that the phase coherence time is sufficiently long for experimental demonstration of the principles of quantum computation.Comment: RevTex, 15 pages,4 postscript figures, uuencoded, submitted to Phys. Rev. Lett., estimates of the experimental parameters correcte

Compound droplet manipulations on fiber arrays

Recent works demonstrated that fiber arrays may constitue the basis of an open digital microfluidics. Various processes, such as droplet motion, fragmentation, trapping, release, mixing and encapsulation, may be achieved on fiber arrays. However, handling a large number of tiny droplets resulting from the mixing of several liquid components is still a challenge for developing microreactors, smart sensors or microemulsifying drugs. Here, we show that the manipulation of tiny droplets onto fiber networks allows for creating compound droplets with a high complexity level. Moreover, this cost-effective and flexible method may also be implemented with optical fibers in order to develop fluorescence-based biosensor

Entanglement magnification induced by local manipulations

We study the entanglement capability of the evolution of a pair of qubits evolving under unitary dynamics, when the local dynamical parameters cannot be modified during the time-evolution. Unlike the fast local control regime, we find that local and non-local contributions to the dynamics are strictly interconnected. Moreover, it is possible to strongly increase the entanglement capability by suitably initializing the characteristic energies of the two parties.Comment: 4 page

Irreversibility in asymptotic manipulations of entanglement

We show that the process of entanglement distillation is irreversible by showing that the entanglement cost of a bound entangled state is finite. Such irreversibility remains even if extra pure entanglement is loaned to assist the distillation process.Comment: RevTex, 3 pages, no figures Result on indistillability of PPT states under pure entanglement catalytic LOCC adde

Coalitional manipulations in a bankruptcy problem

In a bankruptcy problem framework we consider rules immune to possible manipulations by the creditors involved in the problem via merging or splitting of their individual claims. The paper provides characterization theorems for the non manipulable rules, the no advantageous merging parametric rules and the no advantageous splitting parametric rules.Publicad