Fentanyl patches: Use and Misuse.

Transdermal fentanyl is a well-used and highly effective form of opioid analgesia for patients suffering with severe chronic pain. It is also an opioid that is widely abused. Acute clinicians need to be aware of the methods by which fentanyl patches may be used both therapeutically and illicitly as well as the impact this can have in managing a patient's period of intoxication.

Evolution of Nanowire Transmon Qubits and Their Coherence in a Magnetic Field.

We present an experimental study of flux- and gate-tunable nanowire transmons with state-of-the-art relaxation time allowing quantitative extraction of flux and charge noise coupling to the Josephson energy. We evidence coherence sweet spots for charge, tuned by voltage on a proximal side gate, where first order sensitivity to switching two-level systems and background 1/f noise is minimized. Next, we investigate the evolution of a nanowire transmon in a parallel magnetic field up to 70 mT, the upper bound set by the closing of the induced gap. Several features observed in the field dependence of qubit energy relaxation and dephasing times are not fully understood. Using nanowires with a thinner, partially covering Al shell will enable operation of these circuits up to 0.5 T, a regime relevant for topological quantum computation and other applications.

Experimentally simulating the dynamics of quantum light and matter at deep-strong coupling.

The quantum Rabi model describing the fundamental interaction between light and matter is a cornerstone of quantum physics. It predicts exotic phenomena like quantum phase transitions and ground-state entanglement in ultrastrong and deep-strong coupling regimes, where coupling strengths are comparable to or larger than subsystem energies. Demonstrating dynamics remains an outstanding challenge, the few experiments reaching these regimes being limited to spectroscopy. Here, we employ a circuit quantum electrodynamics chip with moderate coupling between a resonator and transmon qubit to realise accurate digital quantum simulation of deep-strong coupling dynamics. We advance the state of the art in solid-state digital quantum simulation by using up to 90 second-order Trotter steps and probing both subsystems in a combined Hilbert space dimension of ∼80, demonstrating characteristic Schrödinger-cat-like entanglement and large photon build-up. Our approach will enable exploration of extreme coupling regimes and quantum phase transitions, and demonstrates a clear first step towards larger complexities such as in the Dicke model.

Enhancing multiphoton rates with quantum memories.

Single photons are a vital resource for optical quantum information processing. Efficient and deterministic single photon sources do not yet exist, however. To date, experimental demonstrations of quantum processing primitives have been implemented using nondeterministic sources combined with heralding and/or postselection. Unfortunately, even for eight photons, the data rates are already so low as to make most experiments impracticable. It is well known that quantum memories, capable of storing photons until they are needed, are a potential solution to this "scaling catastrophe." Here, we analyze in detail the benefits of quantum memories for producing multiphoton states, showing how the production rates can be enhanced by many orders of magnitude. We identify the quantity ηB as the most important figure of merit in this connection, where η and B are the efficiency and time-bandwidth product of the memories, respectively.

The medico-legal significance of pharmacokinetic interactions with ethanol.

In the UK, the maximal permitted ethanol concentration for driving is 80 mg ethanol/100 mL blood, 35 µg ethanol/100 mL breath or 107 mg ethanol/100 mL urine. Drivers exceeding the prescribed limit face severe penalties, which they are often anxious to avoid, either by acquittal or by putting forward 'special reasons' why they should not be disqualified from driving. One frequently explored defence is that the accused was taking prescribed medication. Defence solicitors often ask the question whether the prescribed medication could have caused significantly altered blood ethanol concentrations. This paper reviews the impact of various medications and how they can influence the blood ethanol concentration. Although many drugs can interact with ethanol at a pharmacodynamic level, causing increased impairment, relatively few drugs interact with ethanol pharmacokinetically leading to significantly altered blood ethanol concentrations.

Multipulse addressing of a Raman quantum memory: configurable beam splitting and efficient readout.

Quantum memories are vital to the scalability of photonic quantum information processing (PQIP), since the storage of photons enables repeat-until-success strategies. On the other hand, the key element of all PQIP architectures is the beam splitter, which allows us to coherently couple optical modes. Here, we show how to combine these crucial functionalities by addressing a Raman quantum memory with multiple control pulses. The result is a coherent optical storage device with an extremely large time bandwidth product, that functions as an array of dynamically configurable beam splitters, and that can be read out with arbitrarily high efficiency. Networks of such devices would allow fully scalable PQIP, with applications in quantum computation, long distance quantum communications and quantum metrology.

Adaptive slit beam shaping for direct laser written waveguides.

We demonstrate an improved method for fabricating optical waveguides in bulk materials by means of femtosecond laser writing. We use an LC spatial light modulator (SLM) to shape the beam focus by generating adaptive slit illumination in the pupil of the objective lens. A diffraction grating is applied in a strip across the SLM to simulate a slit, with the first diffracted order mapped onto the pupil plane of the objective lens while the zeroth order is blocked. This technique enables real-time control of the beam-shaping parameters during writing, facilitating the fabrication of more complicated structures than is possible using nonadaptive methods. Waveguides are demonstrated in fused silica with a coupling loss to single-mode fibers in the range of 0.2 to 0.5 dB and propagation loss <0.4 dB/cm.

A patient's perspective: the impact of adverse drug reactions on patients and their views on reporting.

WHAT IS KNOWN AND OBJECTIVE: Adverse drug reactions to prescribed medication are relatively common events. However, the impact such reactions have on patients and their attitude to reporting such events have only been poorly explored. Previous studies relying on self-reporting patients indicate that altruism is an important factor. In the United Kingdom, patient reporting started in 2005; though, numbers of serious reports remain low. METHOD: A purposive sample of fifteen patients who had been admitted to an inner city hospital with an adverse drug reaction were interviewed using a semi-structured questionnaire. Patients were asked to relate in their own words their experience of an adverse drug reaction. Patient's reactions to the information leaflet, adherence to treatment and use of other sources of information on medication were assessed. Interviews were recorded, and a thematic analysis of patients' responses was performed. RESULTS AND DISCUSSION: Analysis of the patient interviews demonstrated the reality of being admitted to hospital is often a frightening process with a significant emotional cost. Anger, isolation, resentment and blame were common factors, particularly when medicines had been prescribed for acute conditions. For patients with chronic conditions, a more phlegmatic approach was seen especially with conditions with a strong support networks. Patients felt that communication and information should have been more readily available from the health care professional who prescribed the medication, although few had read the patient information leaflet. Only a minority of patients linked the medication they had taken to the adverse event, although some had received false reassurance that the drug was not related to their illness creating additional barriers. In contrast to previous studies, many patients felt that adverse drug reporting was not their concern, particularly as they obtained little direct benefit from it. The majority of patients were unaware of the Yellow Card Scheme in the UK for patient reporting. Even when explained, the scheme was felt too cold and impersonal and not a patient's 'job'. WHAT IS NEW AND CONCLUSION: Patients having a severe adverse drug reaction following an acute illness felt negative emotions towards their health care provider. Those with a chronic condition rationalized the event and coped better with its impact. Neither group felt that reporting the adverse reaction was their responsibility. Encouraging patients to report remains important but expecting patients to report solely for altruistic purposes may be unrealistic.

Entangling macroscopic diamonds at room temperature.

Quantum entanglement in the motion of macroscopic solid bodies has implications both for quantum technologies and foundational studies of the boundary between the quantum and classical worlds. Entanglement is usually fragile in room-temperature solids, owing to strong interactions both internally and with the noisy environment. We generated motional entanglement between vibrational states of two spatially separated, millimeter-sized diamonds at room temperature. By measuring strong nonclassical correlations between Raman-scattered photons, we showed that the quantum state of the diamonds has positive concurrence with 98% probability. Our results show that entanglement can persist in the classical context of moving macroscopic solids in ambient conditions.

Efficient quantum computing using coherent photon conversion.

Single photons are excellent quantum information carriers: they were used in the earliest demonstrations of entanglement and in the production of the highest-quality entanglement reported so far. However, current schemes for preparing, processing and measuring them are inefficient. For example, down-conversion provides heralded, but randomly timed, single photons, and linear optics gates are inherently probabilistic. Here we introduce a deterministic process--coherent photon conversion (CPC)--that provides a new way to generate and process complex, multiquanta states for photonic quantum information applications. The technique uses classically pumped nonlinearities to induce coherent oscillations between orthogonal states of multiple quantum excitations. One example of CPC, based on a pumped four-wave-mixing interaction, is shown to yield a single, versatile process that provides a full set of photonic quantum processing tools. This set satisfies the DiVincenzo criteria for a scalable quantum computing architecture, including deterministic multiqubit entanglement gates (based on a novel form of photon-photon interaction), high-quality heralded single- and multiphoton states free from higher-order imperfections, and robust, high-efficiency detection. It can also be used to produce heralded multiphoton entanglement, create optically switchable quantum circuits and implement an improved form of down-conversion with reduced higher-order effects. Such tools are valuable building blocks for many quantum-enabled technologies. Finally, using photonic crystal fibres we experimentally demonstrate quantum correlations arising from a four-colour nonlinear process suitable for CPC and use these measurements to study the feasibility of reaching the deterministic regime with current technology. Our scheme, which is based on interacting bosonic fields, is not restricted to optical systems but could also be implemented in optomechanical, electromechanical and superconducting systems with extremely strong intrinsic nonlinearities. Furthermore, exploiting higher-order nonlinearities with multiple pump fields yields a mechanism for multiparty mediation of the complex, coherent dynamics.

Single-photon-level quantum memory at room temperature.

Room-temperature, easy-to-operate quantum memories are essential building blocks for future long distance quantum information networks operating on an intercontinental scale, because devices like quantum repeaters, based on quantum memories, will have to be deployed in potentially remote, inaccessible locations. Here we demonstrate controllable, broadband and efficient storage and retrieval of weak coherent light pulses at the single-photon level in warm atomic cesium vapor using the robust far off-resonant Raman memory scheme. We show that the unconditional noise floor of this technically simple quantum memory is low enough to operate in the quantum regime, even in a room-temperature environment.

Therapeutic misadventure.

Therapeutic misadventure can be defined as an injury or an adverse event caused by medical management rather than by an underlying disease. Within the National Health Service there were over 86,000 reported adverse incidents in 2007. In the USA medication errors have been rated as the fourth highest cause of death. Unfortunately one of the greatest contributors to iatrogenic injury is human error. The potential types of misadventure are infinite. Medication errors are a major part of this, being responsible for over 70% of cases that cause serious harm. However, many medication errors caused by slips, lapses, technical errors and mistakes are preventable; intentional violations of safe operating procedures are not. While medication errors were tolerated by society in the past, the readiness to institute criminal proceedings against health-care professionals has increased greatly in the UK over the last decade. The medication process consists of writing prescriptions, dispensing the product, administering it and monitoring its effects. Prescription errors arise owing to incomplete information, lack of appropriate labelling, environmental factors and human blunders. Even with a perfect prescription the right medication must be dispensed and appropriately labelled. Dispensing errors are not uncommon and may be compounded by non-clinical considerations. Administration of a drug by injection is one of the most dangerous aspects of the medication process, especially in inexperienced hands. The final component of medication supply is monitoring the effect of the medication. With short courses of medication such monitoring is easy, but with long-term medication, particularly with potent drugs where the margin between efficacy and toxicity is small, active procedures may be required to ensure toxicity does not ensue. Despite the endeavour of health-care professions to stick to the rule of 'first, do no harm', in reality this is difficult to achieve all of the time. When errors occur the natural thoughts of wanting to blame an individual at the sharp end (active error) should be tempered. Identifying and correcting system (latent) errors will, in the end, provide a safer health-care system.

Discrete tunable color entanglement.

Although frequency multiplexing of information has revolutionized the field of classical communications, the color degree of freedom (DOF) has been used relatively little for quantum applications. We experimentally demonstrate a new hybrid quantum gate that transfers polarization entanglement of nondegenerate photons onto the color DOF. We create, for the first time, high-quality, discretely color-entangled states (with energy band gap up to 8.4 THz) without any spectrally selective filtering, and unambiguously verify and quantify the amount of entanglement (tangle, 0.611 +/- 0.009) by reconstructing a restricted density matrix; we generate a range of maximally entangled states, including a set of mutually unbiased bases for an encoded qubit space. The technique can be generalized to transfer polarization entanglement onto other photonic DOFs, like orbital angular momentum.

Manipulating biphotonic qutrits.

Quantum information carriers with higher dimension than the canonical qubit offer significant advantages. However, manipulating such systems is extremely difficult. We show how measurement-induced nonlinearities can dramatically extend the range of possible transforms on biphotonic qutrits-three-level quantum systems formed by the polarization of two photons in the same spatiotemporal mode. We fully characterize the biphoton-photon entanglement that underpins our technique, thereby realizing the first instance of qubit-qutrit entanglement. We discuss an extension of our technique to generate qutrit-qutrit entanglement and to manipulate any bosonic encoding of quantum information.

Ethnicity and other risk factors for acute lower limb cellulitis: a U.K.-based prospective case-control study.

BACKGROUND: Acute lower limb cellulitis is a common yet potentially serious condition. Previous studies have identified risk factors in the non-U.K. population. Ethnicity has been postulated as a possible risk factor but has not previously been investigated. OBJECTIVES: To identify risk factors for acute lower limb cellulitis in the U.K. population. METHODS: One hundred and fifty consecutive patients with cellulitis requiring hospital admission and 300 controls were recruited to this prospective case-control study. Controls were matched for age and sex. RESULTS: Strongly predictive risk factors for acute lower limb cellulitis in the U.K. include being of white ethnicity and preceding episodes of injury to the affected leg. No systemic illnesses were identified as increasing an individual's risk of presenting with cellulitis. CONCLUSIONS: This study has identified that patients of white ethnicity are at higher risk of developing acute lower limb cellulitis compared with other ethnic groups. The importance of local risk factors has also been shown in the U.K. population.

Entanglement generation by Fock-state filtration.

We demonstrate a Fock-state filter which is capable of preferentially blocking single photons over photon pairs. The large conditional nonlinearities are based on higher-order quantum interference, using linear optics, an ancilla photon, and measurement. We demonstrate that the filter acts coherently by using it to convert unentangled photon pairs to a path-entangled state. We quantify the degree of entanglement by transforming the path information to polarization information; applying quantum state tomography we measure a tangle of T=(20+/-9)%.

Experimental demonstration of a compiled version of Shor's algorithm with quantum entanglement.

Shor's powerful quantum algorithm for factoring represents a major challenge in quantum computation. Here, we implement a compiled version in a photonic system. For the first time, we demonstrate the core processes, coherent control, and resultant entangled states required in a full-scale implementation. These are necessary steps on the path towards scalable quantum computing. Our results highlight that the algorithm performance is not the same as that of the underlying quantum circuit and stress the importance of developing techniques for characterizing quantum algorithms.

Application of a quantum cascade laser for time-resolved, in situ probing of CH4/H2 and C2H2/H2 gas mixtures during microwave plasma enhanced chemical vapor deposition of diamond.

First illustrations of the utility of pulsed quantum cascade lasers for in situ probing of the chemistry prevailing in microwave plasma activated hydrocarbon/Ar/H2 gas mixtures used for diamond thin film growth are reported. CH4 and C2H2 molecules, and their interconversion, have been monitored by line-of-sight single pass absorption methods, as a function of process conditions (e.g., choice of input hydrocarbon (CH4 or C2H2), hydrocarbon mole fraction, total gas pressure, and applied microwave power). The observed trends can be rationalized, qualitatively, within the framework of the previously reported modeling of the gas-phase chemistry prevailing in hot filament activated hydrocarbon/H2 gas mixtures (Ashfold et al. Phys. Chem. Chem. Phys. 2001, 3, 3471). Column densities of vibrationally excited C2H2(v5=1) molecules at low input carbon fractions are shown to be far higher than expected on the basis of local thermodynamic equilibrium. The presence of vibrationally excited C2H2 molecules (C2H2(double dagger)) can be attributed to the exothermicity of the C2H3 + H <==> C2H2 + H2 elementary reaction within the overall multistep CH4 --> C2H2 conversion. Diagnostic methods that sample just C2H2(v=0) molecules thus run the risk of underestimating total C2H2 column densities in hydrocarbon/H2 mixtures operated under conditions where the production rate of C2H2(double dagger) molecules exceeds their vibrational relaxation (and thermal equilibration) rates.

Demonstration of a simple entangling optical gate and its use in bell-state analysis.

We demonstrate a new architecture for an optical entangling gate that is significantly simpler than previous realizations, using partially polarizing beam splitters so that only a single optical mode-matching condition is required. We demonstrate operation of a controlled-z gate in both continuous-wave and pulsed regimes of operation, fully characterizing it in each case using quantum process tomography. We also demonstrate a fully resolving, nondeterministic optical Bell-state analyzer based on this controlled-z gate. This new architecture is ideally suited to guided optics implementations of optical gates.