Development of clinical pharmacy in Belgian hospitals through pilot projects funded by the government.

Objectives The goal is to develop clinical pharmacy in the Belgian hospitals to improve drug efficacy and to reduce drug-related problems. Methods From 2007 to 2014, financial support was provided by the Belgian federal government for the development of clinical pharmacy in Belgian hospitals. This project was guided by a national Advisory Working Group. Each funded hospital was obliged to describe yearly its clinical pharmacy activities. Results In 2007, 20 pharmacists were funded in 28 pilot hospitals; this number was doubled in 2009 to 40 pharmacists over 54 institutions, representing more than half of all acute Belgian hospitals. Most projects (72%) considered patient-related activities, whereas some projects (28%) had a hospital-wide approach. The projects targeted patients at admission (30%), during hospital stay (52%) or at discharge (18%). During hospital stay, actions were mainly focused on geriatric patients (20%), surgical patients (15%), and oncology patients (9%). Experiences, methods, and tools were shared during meetings and workshops. Structure, process, and outcome indicators were reported and strengths, weaknesses, opportunities, and threats were described. The yearly reports revealed that the hospital board was engaged in the project in 87% of the cases, and developed a vision on clinical pharmacy in 75% of the hospitals. In 2014, the pilot phase was replaced by structural financing for clinical pharmacy in all acute Belgian hospitals. Conclusion The pilot projects in clinical pharmacy funded by the federal government provided a unique opportunity to launch clinical pharmacy activities on a broad scale in Belgium. The results of the pilot projects showed clear implementation through case reports, time registrations, and indicators. Tools for clinical pharmacy activities were developed to overcome identified barriers. The engagement of hospital boards and the results of clinical pharmacy activities persuaded the government to start structural financing of clinical pharmacy.

Improving the quality of the intensive care follow-up of ventilated patients during a national registration program.

OBJECTIVES: The Belgian Public Health Organization is concerned with rates of hospital-acquired infections like ventilator-associated pneumonia (VAP). Implementing best practice guidelines for these nosocomial infections has variable success in the literature. This retrospective study was undertaken to see whether implementation of the evidence-based practices as a bundle was feasible, would influence compliance, and could reduce the rates of VAP. STUDY DESIGN: We utilized easily collectable data about regular care to rapidly assess whether interventions already in place were effectively successfully applied. This avoided cumbersome data collection and review. METHODS: Retrospective compliance rates and VAP ratios were compared using z tests with P-values < 0.05 considered statistically significant. This data review attempted to examine the impact of education campaigns, staff meetings, in-services, physician checklist, nurse checklist, charge nurse checklist implementation, systematic VAP bundle application, and systematic protocols for oral care and sedation protocols. Additionally, VAP ratio could be registered by the participating centers. RESULTS: A total of 10,211 intensive care unit (ICU) patients were included in the study which represents 66,817 ICU days under artificial ventilation with an endotracheal tube. The general compliance for VAP bundle raised from VAP was 61% in February 2012 and 74.16% in December 2012 (P < 0.001). The incidence rate of VAP went from 8.34 occurrences/1000 vent days in 2009 to 4.78 occurrences/1000 vent days in 2012 (P < 0.001-Pearson test). CONCLUSIONS: Efforts to improve physician and staff education, and checklist implementation resulted in an increase in compliance for VAP bundle and a decrease in VAP ratio. This study confirms the applicability of best practice guidelines about regular care but results on VAP incidence have to be confirmed.

Optoelectronic reservoir computing.

Reservoir computing is a recently introduced, highly efficient bio-inspired approach for processing time dependent data. The basic scheme of reservoir computing consists of a non linear recurrent dynamical system coupled to a single input layer and a single output layer. Within these constraints many implementations are possible. Here we report an optoelectronic implementation of reservoir computing based on a recently proposed architecture consisting of a single non linear node and a delay line. Our implementation is sufficiently fast for real time information processing. We illustrate its performance on tasks of practical importance such as nonlinear channel equalization and speech recognition, and obtain results comparable to state of the art digital implementations.

Experimental demonstration of the oscillatory snake instability of the bright soliton of the (2+1)D hyperbolic nonlinear Schrödinger equation.

The transition between the standard snake instability of bright solitons of the hyperbolic nonlinear Schrödinger equation and the recently theoretically predicted oscillatory snake instability is experimentally demonstrated. The existence of this transition is proven on the basis of spatiotemporal spectral features of bright soliton laser beams propagating in normally dispersive Kerr-type nonlinear planar waveguides.

Oscillatory neck instability of spatial bright solitons in hyperbolic systems.

The breakup of spatial bright optical solitons due to oscillatory neck instability is experimentally studied by propagating a laser beam in normally dispersive and self-focusing Kerr media. This intriguing and unusual phenomenon, recently predicted for solitons of the (2+1)-dimensional hyperbolic nonlinear Schrödinger (NLS) equation, is observed in the spatially resolved temporal spectrum. The snake instability that is known to occur in hyperbolic systems is also demonstrated to validate our experimental approach. Our results not only apply to photonics but also to other fields of physics, such as hydrodynamics or plasma physics, in which the hyperbolic NLS equation is used as a canonical model.

Ultrafast transverse undulation of self-trapped laser beams.

The propagation of a self-trapped laser beam in a planar waveguide that exhibits a Kerr nonlinearity and a normal chromatic dispersion is considered. We demonstrate experimentally for the first time to our knowledge that such a beam undergoes an undulation responsible for ultrafast transverse oscillations of its axis. This phenomenon, called ???snake instability???, was predicted theoretically in 1973 by Zakharov and Rubenchik on the basis of a study of the soliton solutions of the hyperbolic nonlinear Schr odinger equation. The signature of this instability is observed in the spatially resolved temporal spectrum.

Induced modulation instability and recurrence in nematic liquid crystals.

We study induced modulation instability in a nematic liquid crystal cell. Two broad elliptical beams along one direction are launched into the cell. The two beams have slightly different angle in order to create a sinusoidally varying intensity at the entrance of the cell. In this way, the gain of perturbations with different spatial frequency is investigated. The evolution of the optical pattern, for certain conditions, shows a recurrence of the signal. We believe that this is the manifestation of the Fermi-Pasta- Ulam recurrence and to the best of our knowledge, the first experimental observation of this phenomenon in the spatial optical domain. Numerical simulations show a good agreement with the experimental findings.

Observation of the snake instability of a spatially extended temporal bright soliton.

The transverse snake instability of the bright soliton solution of the (2+1)-dimensional hyperbolic nonlinear Schrödinger equation is experimentally studied. We observed this instability in the spatial distribution of the temporal spectrum of spatially extended femtosecond pulses propagating in normally dispersive self-defocusing planar semiconductor waveguide.

Experimental error filtration for quantum communication over highly noisy channels.

Error filtration is a method for encoding the quantum state of a single particle into a higher dimensional Hilbert space in such a way that it becomes less sensitive to noise. We have realized a fiber optics demonstration of this method and illustrated its potentialities by carrying out the optical part of a quantum key distribution scheme over a line whose phase noise is too high for a standard implementation of BB84 to be secure. By filtering out the noise, a bit error rate of 15.3% +/- 0.1%, which is beyond the security limit, can be reduced to 10.6% +/- 0.1%, thereby guaranteeing the cryptographic security.

Vector modulation instability induced by vacuum fluctuations in highly birefringent fibers in the anomalous-dispersion regime.

We report a detailed experimental study of vector modulation instability in highly birefringent optical fibers in the anomalous-dispersion regime. We prove that the observed instability is mainly induced by vacuum fluctuations. The detuning of the spectral peaks agrees with linear perturbation analysis. The exact shape of the spectrum is well reproduced by numerical integration of stochastic nonlinear Schrödinger equations describing quantum propagation.

Observation of resonance soliton trapping due to a photoinduced gap in wave number.

We investigate the nonlinear propagation of two forward propagating modes coupled by a resonant traveling-wave grating, which is photoinduced by illuminating an optical fiber with a beat signal. This interaction, representative of systems whose dispersion relation K=K(Omega) exhibits a gap in momentum K, shows evidence of localization mediated by resonance solitons. The signature of a still (in the grating frame) soliton is grating-induced cancellation of modal group-velocity mismatch.

Snake instability of a spatiotemporal bright soliton stripe.

We study experimentally the snake instability of the bright soliton stripe of the (2+1)-dimensional hyperbolic nonlinear Schrödinger equation. The instability is observed, through spectral measurements, on spatially extended femtosecond pulses propagating in a normally dispersive self-defocusing semiconductor planar waveguide.

Fiber-optics implementation of the Deutsch-Jozsa and Bernstein-Vazirani quantum algorithms with three qubits.

We report on a fiber-optics implementation of the Deutsch-Jozsa and Bernstein-Vazirani quantum algorithms for 8-point functions. The measured visibility of the 8-path interferometer is about 97.5%. Potential applications of our setup to quantum communication or cryptographic protocols using several qubits are discussed.

Symmetry-breaking instability of multimode vector solitons.

We show experimentally that the two-component multimode spatial optical vector soliton, i.e., a two-hump self-guided laser beam, exhibits in Kerr media a sharp space-inversion symmetry-breaking instability. The experiment is performed in a CS2 planar waveguide using the orthogonal circular polarization states of light as the two components of the vector soliton.

Domain wall solitons in binary mixtures of Bose-Einstein condensates.

The structure and dynamics of the domain walls separating segregated condensates in trapped mixtures of repulsive Bose-Einstein condensates are studied. Our work reveals that, under fairly general conditions, these domain walls behave as independent dynamical entities, which allows us to identify them as constituting a novel class of multicomponent solitons in Bose-Einstein condensates.

Experimental demonstration of the Fermi-Pasta-Ulam recurrence in a modulationally unstable optical wave.

Through a detailed spectral analysis of the propagation of square-shaped laser pulses in optical fibers, we provide the experimental demonstration of the Fermi-Pasta-Ulam recurrence phenomenon in modulationally unstable optical waves ruled by the nonlinear Schrödinger equation.

Influence of walk-off, dispersion, and diffraction on the coherence of parametric fluorescence.

We consider the basic problem of spontaneous parametric generation from quantum noise fluctuations in the presence of a continuous plane-wave pump. We show, both numerically and analytically, that the walk-off between the down-converted fields is the key ingredient that leads to the generation of coherent fields in the parametric process. Along these lines, our theory reveals that, in the absence of walk-off, diffraction and chromatic dispersion in usual quadratically nonlinear materials only lead to incoherent erratic dynamics. Moreover, a two-dimensional study shows that, when the walk-off is exclusively temporal (or spatial), the parametric process is not able to yield the generation of spatially (or temporally) coherent fields. This study sheds light on the problem of coherence in parametric fluorescence and, in particular, allows us to explain various recent experimental observations.

Parametric three-wave soliton generated from incoherent light.

We show analytically and numerically that, under certain conditions, coherent localized structures can be generated and sustained from an incoherent source in quadratic nonlinear media. This phenomenon, which relies on the convection between the waves interacting in the medium, leads to the formation of a novel type of three-wave parametric soliton composed of both coherent and incoherent fields.

Continuous-wave ultrahigh-repetition-rate pulse-train generation through modulational instability in a passive fiber cavity.

Thanks to a passive cavity configuration, modulational instability in fibers is successfully observed, for the first time to our knowledge, in the continuous-wave regime. Our technique provides a new means of generating all-optically ultrahigh-repetition-rate pulse trains and opens up new possibilities for the fundamental study of modulational instability and related phenomena.