Quantum Contextuality Provides Communication Complexity Advantage.

Despite the conceptual importance of contextuality in quantum mechanics, there is a hitherto limited number of applications requiring contextuality but not entanglement. Here, we show that for any quantum state and observables of sufficiently small dimensions producing contextuality, there exists a communication task with quantum advantage. Conversely, any quantum advantage in this task admits a proof of contextuality whenever an additional condition holds. We further show that given any set of observables allowing for quantum state-independent contextuality, there exists a class of communication tasks wherein the difference between classical and quantum communication complexities increases as the number of inputs grows. Finally, we show how to convert each of these communication tasks into a semi-device-independent protocol for quantum key distribution.

The impact of signposting and group support pathways on a community-based physical activity intervention grounded in motivational interviewing.

BACKGROUND: Brief advice is recommended to increase physical activity (PA) within primary care. This study assessed change in PA levels and mental well-being after a motivational interviewing (MI) community-based PA intervention and the impact of signposting (SP) and social action (SA) (i.e. weekly group support) pathways. METHODS: Participants (n = 2084) took part in a community-based, primary care PA programme using MI techniques. Self-reported PA and mental well-being data were collected at baseline (following an initial 30-min MI appointment), 12 weeks, 6 months and 12 months. Participants were assigned based upon the surgery they attended to the SP or SA pathway. Multilevel models derived point estimates and 95% confidence intervals for outcomes at each time point and change scores. RESULTS: Participants increased PA and mental well-being at each follow-up time point through both participant pathways and with little difference between pathways. Retention was similar between pathways at 12 weeks, but the SP pathway retained more participants at 6 and 12 months. CONCLUSIONS: Both pathways produced similar improvements in PA and mental well-being; however, the addition of a control would have provided further insight as to the effectiveness. Due to lower resources yet similar effects, the SP pathway could be incorporated to support PA in primary care settings.

An evaluation of the feasibility and validity of a patient-administered malnutrition universal screening tool ('MUST') compared to healthcare professional screening in an inflammatory bowel disease (IBD) outpatient clinic.

BACKGROUND: Malnutrition is common in inflammatory bowel disease (IBD) and is associated with poor health outcomes. Despite this, screening for malnutrition in the outpatient-setting is not routine and research in the area is limited. The present study aimed to evaluate whether agreement between malnutrition screening completed by patients and healthcare professionals (HCPs) could be achieved by comparing patient self-administered 'MUST' ('MUST'-P) with HCP administered 'MUST' ('MUST'-HCP) in a single tertiary IBD outpatient clinic. METHODS: We conducted a feasibility and validity study on adult outpatients with IBD. We collected anthropometric, nutritional and clinical data from patients. All patients completed 'MUST'-P using a self-administered questionnaire, followed by 'MUST'-HCP. 'MUST'-P was timed and feedback on ease-of-use was obtained. The risk of malnutrition was classified as low (score = 0), medium (score = 1) and high (score ≥ 2) and agreement was tested using kappa statistics (κ). RESULTS: Eighty patients were recruited (Crohn's disease: n = 49, ulcerative colitis: n = 29, unclassified: n = 2), with a mean (SD) age of 39.9 (15.1) years (51.2% were males). Seventy-one (92%) of patients found 'MUST'-P either easy or very easy. The mean (SD) time to complete 'MUST'-P was 3.1  (1.8) min (range 1-10 min). Sixty-eight (85%) of patients were at low risk of malnutrition when screened by the HCP. There was moderate agreement (κ = 0.486, P < 0.001) between 'MUST'-P and 'MUST'-HCP, with 100% agreement in scoring for medium- and high-risk categories. CONCLUSIONS: The results of the present study suggests that self-screening using 'MUST' could be effectively used in an IBD outpatient clinic to identify those at medium and high risk of malnutrition. The patient friendly version of 'MUST' ('MUST'-P) was considered quick and easy to use by patients. Implementation of self-screening with 'MUST' could improve the nutritional management of IBD patients.

Associations between markers of colorectal cancer stem cells, mutation, microRNA and the clinical features of ulcerative colitis.

AIM: Several factors have been implicated in the pathogenesis of colorectal cancer (CRC) associated with ulcerative colitis (UC). We investigated markers of cancer cell pluripotency, including CD44 and CD166, microRNA-21 (miR-21) and microRNA-215 (miR-215), and APC, K-ras and DCC mutations in biopsy specimens from patients with UC to evaluate any correlations with clinical risk factors. METHOD: We observed 18 patients with UC and collected two biopsy specimens from each patient at diagnosis and at a follow-up end-point. We examined the expression of CD44, CD166, miR-21 and miR-215, and APC, K-ras and DCC mutations. We compared these markers at the two time points and assessed their associations with clinical characteristics, including the duration of colitis, histological alterations and the age of the patient at the onset of UC. RESULTS: Most (16/18) patients had alleviation of mucosal inflammation or remained stable during follow-up; one patient developed dysplasia and one had severe aggravation of the lesion during follow-up. Enhanced expression of CD44, CD166 and miR-21 with miR-215 was found in the specimens obtained at follow-up, despite alleviation of mucosal lesions. Coherence of cancer stem cell markers and miRNAs was seen in patients who had significant worsening of inflammation, dysplasia and a long duration of colitis. APC mutation occurred in only one patient; this patient had the longest duration of UC (23 years). CONCLUSION: Enhanced markers of CRC in follow-up colonic mucosal samples support the conclusion that the duration of UC plays the most important role in UC-related carcinogenesis.

Towards building a trustworthy pipeline integrating Neuroscience Gateway and Open Science Chain.

When the scientific dataset evolves or is reused in workflows creating derived datasets, the integrity of the dataset with its metadata information, including provenance, needs to be securely preserved while providing assurances that they are not accidentally or maliciously altered during the process. Providing a secure method to efficiently share and verify the data as well as metadata is essential for the reuse of the scientific data. The National Science Foundation (NSF) funded Open Science Chain (OSC) utilizes consortium blockchain to provide a cyberinfrastructure solution to maintain integrity of the provenance metadata for published datasets and provides a way to perform independent verification of the dataset while promoting reuse and reproducibility. The NSF- and National Institutes of Health (NIH)-funded Neuroscience Gateway (NSG) provides a freely available web portal that allows neuroscience researchers to execute computational data analysis pipeline on high performance computing resources. Combined, the OSC and NSG platforms form an efficient, integrated framework to automatically and securely preserve and verify the integrity of the artifacts used in research workflows while using the NSG platform. This paper presents the results of the first study that integrates OSC-NSG frameworks to track the provenance of neurophysiological signal data analysis to study brain network dynamics using the Neuro-Integrative Connectivity tool, which is deployed in the NSG platform. Database URL: https://www.opensciencechain.org.

Fine-grained lower limit of entropic uncertainty in the presence of quantum memory.

The limitation on obtaining precise outcomes of measurements performed on two noncommuting observables of a particle as set by the uncertainty principle in its entropic form can be reduced in the presence of quantum memory. We derive a new entropic uncertainty relation based on fine graining, which leads to an ultimate limit on the precision achievable in measurements performed on two incompatible observables in the presence of quantum memory. We show that our derived uncertainty relation tightens the lower bound set by entropic uncertainty for members of the class of two-qubit states with maximally mixed marginals, while accounting for the recent experimental results using maximally entangled pure states and mixed Bell-diagonal states. An implication of our uncertainty relation on the security of quantum key generation protocols is pointed out.

Targeted gene knockout mediated by triple helix forming oligonucleotides.

Triple helix forming oligonucleotides (TFOs) recognize and bind sequences in duplex DNA and have received considerable attention because of their potential for targeting specific genomic sites. TFOs can deliver DNA reactive reagents to specific sequences in purified chromosomal DNA (ref. 4) and nuclei. However, chromosome targeting in viable cells has not been demonstrated, and in vitro experiments indicate that chromatin structure is incompatible with triplex formation. We have prepared modified TFOs, linked to the DNA-crosslinking reagent psoralen, directed at a site in the Hprt gene. We show that stable Hprt-deficient clones can be recovered following introduction of the TFOs into viable cells and photoactivation of the psoralen. Analysis of 282 clones indicated that 85% contained mutations in the triplex target region. We observed mainly deletions and some insertions. These data indicate that appropriately constructed TFOs can find chromosomal targets, and suggest that the chromatin structure in the target region is more dynamic than predicted by the in vitro experiments.

The impact of strenuous physical activity on the development of pelvic organ prolapse.

Pelvic organ prolapse is a common gynaecological problem and the mechanisms underlying prolapse development are not yet clear but it is thought that increases in abdominal pressure, such as those routinely involved in heavy lifting and long periods of standing, may cause progressive pelvic floor damage over time. The aim of this study was to investigate the effects of strenuous physical activity on the development of prolapse. A narrative literature review was carried out to investigate the effects of occupation and recreational activity on the pathogenesis of pelvic organ prolapse. A marked paucity of literature relevant to the research question makes it difficult to draw firm conclusions. Further research is greatly needed to explore potentially preventable factors in this frequently occurring condition. The review reveals some evidence linking strenuous physical activity with pelvic organ prolapse but this is neither consistent nor adequately powered to reach any firm conclusions.

[Quality of life in the focus of quality audits in long-term care]. / Lebensqualität im Fokus des Qualitätsaudits in der Langzeitpflege.

Quality of life - an important outcome factor of long-term care - development and psychometric testing of an audit instrument, the Quality of Life Index, (QoL index"), to assess the consideration for individual quality of life aspects during the care process in long-term care settings is evaluated - even for clients with limited communication skills.A stratified random sample of n=209 residents was drawn out of the population of N=1 128 residents of 8 nursing homes and their individual QoL-aspects were assessed with SEIQoL-DW or in difficult communication situations with "LQ-Index-Informationssammlung". The LQ-Index's new items were validated via a parallel testing with the reference instrument SEIQoL-DW, the split half-reliability, the interrater reliability (Kappa) and a structured expert review according to the cognitive interview technique.All 209 participants were assessed via LQ-Index. The SEIQoL-Interview was completed and estimated valid by 18 (8.61%) residents. The psychometric testing results and the expert review indicate high feasibility, good reliability, validity and objectivity of the instrument "LQ-Index".As a result of this study a feasible and valid instrument is now available to assess the consideration for individual quality of life aspects during the care process in long-term care settings - even for clients with limited communication skills.

Entanglement witness operator for quantum teleportation.

The ability of entangled states to act as a resource for teleportation is linked to a property of the fully entangled fraction. We show that the set of states with their fully entangled fraction bounded by a threshold value required for performing teleportation is both convex and compact. This feature enables the existence of Hermitian witness operators, the measurement of which could distinguish unknown states useful for performing teleportation. We present an example of such a witness operator illustrating it for different classes of states.

Induction of cytotoxic T cell responses and tumor immunity against unrelated tumors using telomerase reverse transcriptase RNA transfected dendritic cells.

The polypeptide component of telomerase (TERT) is an attractive candidate for a broadly expressed tumor rejection antigen because telomerase is silent in normal tissues but is reactivated in more than 85% of cancers. Here we show that immunization against TERT induces immunity against tumors of unrelated origin. Immunization of mice with TERT RNA-transfected dendritic cells (DC) stimulated cytotoxic T lymphocytes (CTL), which lysed melanoma and thymoma tumor cells and inhibited the growth of three unrelated tumors in mice of distinct genetic backgrounds. TERT RNA-transfected human DC stimulated TERT-specific CTL in vitro that lysed human tumor cells, including Epstein Barr virus (EBV)-transformed B cells as well as autologous tumor targets from patients with renal and prostate cancer. Tumor RNA-transfected DC were used as surrogate targets in the CTL assays, obviating the difficulties in obtaining tumor cells from cancer patients. In one instance, where a tumor cell line was successfully established in culture from a patient with renal cancer, the patient's tumor cells were efficiently lysed by the CTL. Immunization with tumor RNA was generally more effective than immunization with TERT RNA, suggesting that an optimal immunization protocol may have to include TERT as well as additional tumor antigens.

COL4A1 mutations associated with a characteristic pattern of intracranial calcification.

Intracranial calcification (ICC) is a relatively common radiological finding in children undergoing investigation for neurological disorders. Many causes are recognised, and ICC is often regarded as a non-specific sign.From an ongoing study of ICC, we identified 5 patients with characteristic radiological features, in whom a mutation in the COL4A1 gene was found.All patients had CT and MR imaging. MR images demonstrated features of periventricular leukomalacia with irregular dilatation of the lateral ventricles with or without porencephaly, loss of hemispheric white matter volume, and high signal on T2 and FLAIR sequences within periventricular and deep white matter. Calcification was apparent on MR in 4 patients. CT scans demonstrated spot and linear calcification in the subependymal region and around areas of porencephaly. Calcification was also visible in the deep cerebral white matter and basal ganglia. 1 patient showed calcification in the central pons.ICC occurs in COL4A1-related disease. The radiological features are distinct from other conditions demonstrating recognisable patterns of ICC, such as congenital cytomegalovirus infection and Aicardi-Goutiéres syndrome. In the absence of a known risk factor for periventricular leukomalacia, the presence of these radio-logical findings should suggest the possibility of COL4A1-related disease.

Targeting of an interrupted polypurine:polypyrimidine sequence in mammalian cells by a triplex-forming oligonucleotide containing a novel base analogue.

The DNA triple helix consists of a third strand of nucleic acid lying in the major groove of an intact DNA duplex. The most stable triplexes form on polypurine:polypyrimidine sequences, and pyrimidine interruptions in the purine strand are destabilizing. Sequence stringency is imparted by specific Hoogsteen hydrogen bonds between third strand bases and the purine bases in the duplex. Appropriate base and sugar modifications of triple helix-forming oligonucleotides (TFOs) confer chromosome targeting activity in living cells. However, broad utilization of TFOs as gene targeting reagents in mammalian cells has been limited by the requirement for homopurine target sequences. Although there have been a number of base analogues described that appear to be promising as candidates for triplex target expansion, none has been examined in a biological system. We have employed a postsynthetic strategy to prepare a collection of TFOs with base analogues at a defined position. Following assessment of affinity for a triplex target with a single C:G inversion, TFOs with a second generation of analogues were synthesized. One of these, TFO-5a, with 2'-OMe-guanidinylethyl-5-methylcytosine at the position corresponding to the C:G interruption in the target sequence, was further modified to confer bioactivity. The activity of this TFO, linked to psoralen, was measured in a mammalian cell line that was engineered by directed sequence conversion to carry a triplex target with a single C:G interruption. TFO-5a was active against this target and inactive against the corresponding target with an uninterrupted polypurine:polypyrimidine sequence.

Identification of a 107-kD glycoprotein that mediates adhesion between stromal cells and hematolymphoid cells.

The mechanism of cell complex formation between lymphocytes and stromal cells was investigated. We found that lymphoid lines of both T and B lineages could form cell complexes with stromal cells from the thymus as well as bone marrow but not with macrophages or typical fibroblast lines. Formation of these cell complexes is temperature dependent and requires the presence of Mg2+, active cellular metabolism, and microfilament assembly of cytoskeleton. We raised an antiserum against a thymic stromal cell clone (BATE-2) in rats and found that, after absorption, this serum could effectively block cell complex formation between lymphocytes and stromal cells from both thymus and bone marrow. An efficient blocking was obtained only when the antiserum was added at the initial stage of cell interaction. From the blocking experiments and the SDS-PAGE analysis of immunoprecipitated materials from the stromal cell surface, we identified a unique 107-kD glycoprotein on the stromal cells as a molecule for mediating stromal cell-lymphocyte interaction. This is further supported by the findings that an antiserum raised in hamsters against the excised gel band corresponding to 107 kD, which specifically immunoprecipitated the 107-kD molecule, effectively blocked the lymphocyte-stromal cell interaction. The possible function of this molecule in hematolymphoid development is discussed.

Unexpected effects of the severe combined immunodeficiency mutation on murine lymphomagenesis.

Strain C.B17 scid/scid (SCID) mice, which lack functional T and B lymphocytes, show heightened susceptibility to the induction of thymic lymphomas by x-irradiation. Susceptibility is highest in thymus-chimeric SCID-BL mice (thymectomized SCID mice bearing a C57BL thymus graft). All SCID-BL lymphomas originate in the cells of the thymic graft (C57BL type) and lack murine leukemia virus expression. Both SCID and SCID-BL lymphomas are phenotypically CD4-8+ and/or CD4+8+, but only the SCID-BL tumors express CD3. Injection of C57BL or BALB/c bone marrow into irradiated SCID-BL mice prevents lymphoma development, but SCID marrow is completely ineffective. The results suggest that the scid condition enhances the activity of a putative lymphomagenic agent induced in the bone marrow by x-irradiation and that C57BL thymic cells are highly sensitive targets. Moreover, the failure of SCID bone marrow to protect against lymphomagenesis vs. the efficacy of marrow from immunocompetent donors points to involvement of T or B lineage cells in this process.

Differentiation of CD3-4-8- thymocytes in short-term thymic stromal cell culture.

We have investigated the ability of a heterogeneous thymic stromal cell (HTSC) culture system to promote in vitro differentiation of CD3-4-8- thymocytes. Culture of purified murine CD3-4-8- thymocytes on HTSC for 1 d resulted in the appearance of CD4+8+ cells, which did not occur when the sorted cells were maintained in medium alone. It is remarkable that when the culture period was extended to 2 d, CD3-4-8- progenitors differentiated further to CD4+8- and CD4-8+ cells, which also expressed high levels of TCR-CD3. This rapid differentiation on stroma in vitro appears to outpace parallel development in vivo. The differentiation potential of a subset of CD3-4-8- thymocytes that express high levels of a marker of normal and neoplastic thymic progenitors, the 1C11 antigen, was examined next. 1C11hiCD3-4-8- cells also gave rise to CD4-8+ and CD4+8+ populations after 1 d of culture on HTSC. Extending the culture period to 2 d resulted in a significant percentage of CD3-expressing cells that were CD4+8+, CD4+8- and CD4-8+ cells. These results suggest that in the in vitro HTSC culture system, various subsets of immature thymocytes can differentiate into all the mature phenotypes of cells normally found in the adult mouse thymus. This may provide a novel and rapid assay for thymic progenitors.

Failure to recognise the impact of 'moderate' obesity (BMI 30-40) on adverse obstetric outcomes.

Obesity is a growing epidemic in the western world. We carried out a comparative analysis of the incidence of obstetric morbidity in three BMI categories in the ranges 30-40 to identify which BMI category was associated with greatest risk. This identification could help target limited maternity care resources to the group of women who would benefit most. There exists a scale continuum of risk of obstetric morbidity with maternal obesity: the greater the BMI, the greater the risk. However, pregnant women with mild or moderate obesity are still at significant risk of having pre-existing co-morbidities of developing antenatal complications and of being delivered by caesarean section than women with BMIs within the normal range. These women, at the time of antenatal booking, are currently not perceived by healthcare providers as having at-risk pregnancies and are therefore potentially denied access to best care.

Use of balloon catheter tamponade for massive postpartum haemorrhage.

Haemorrhage is one of the leading global causes of maternal mortality. The Rüsch balloon has been used in the treatment of postpartum haemorrhage (PPH) after failure of medical management. It is often effective in tamponading uterine bleeding, thus providing an alternative to hysterectomy. We describe a series of 22 cases in which we used the Rüsch balloon to control massive obstetric haemorrhage after failure to control haemorrhage by medical means. In our study, 13 out of 22 patients (59.1%) required no further interventions after balloon tamponade. Seven patients (31.8%) required hysterectomy to control the bleeding. We include a review of the current literature on balloon tamponade for PPH, including analysis of six relevant case series. This demonstrates a variety of methods based on tamponade to terminate uterine haemorrhage. Our study highlights the benefit of balloon tamponade for massive PPH and the importance of its involvement in labour ward protocols.

Microalbuminuria: An inexpensive, non invasive bedside tool to predict outcome in critically ill patients.

This study was conducted to evaluate whether microalbuminuria on admission and after 24 hrs of admission to intensive care unit (ICU) predicts outcome as well as the Acute Physiology and Chronic Health Evaluation (APACHE) II severity illness score, the current accepted method of doing so. The study was carried out in a 20 bed mixed medical-surgical ICU of a tertiary care hospital. Of 525 consecutive adult patients with ICU stay of more than 24 hrs, 238 were included for the study. Patients with pregnancy, menstruation, anuria, macroscopic hematuria, urinary tract infection, marked proteinuria due to renal and post-renal structural diseases, were excluded. Spot urine samples were collected on admission to ICU and 24 hrs thereafter. Urine albumincreatinine ratio (ACR) was measured on ICU admission (ACR1) and after 24 hrs (ACR2) and expressed in mg/g. Patient demographics were noted on admission. For disease severity scoring, APACHE II scores were calculated. Each patient was followed up throughout their ICU stay for a maximum of 28 days and the following outcome data were obtained: ICU length of stay and ICU mortality. Of the 238 patients, 196 survived while 42 patients died in the ICU. Non-survivors had a significantly higher median ACR2 [162.7 mg/g (IQR 69.5-344.3)] in comparison to the survivors who had a median ACR2 = 54.4 mg/g (IQR 19.0-129.1) (P< 0.0001). The median ACR1 [161.0 mg/g (IQR 29.0-369.3)] of non-survivors was higher than the median ACR1 [80.4 mg/g (IQR 35.1-167.6)] of survivors but failed to reach statistical significance (P= 0.0948). In a receiver operating characteristic curve (ROC) analysis, ACR2 emerged as the best indicator of mortality [(area under curve (AUC) of ACR2 = 0.71 > AUC (ACR1) =0.58 > AUC (ΔACR) =0.55] similar to the currently used APACHE II scores (AUC = 0.78) (P=0.3). At a cutoff of 101 mg/g, ACR2 had a sensitivity of 69%, specificity of 67%, positive predictive value of 31% and a negative predictive value of 91% for predicting mortality in the critically ill patients. Absence of significant microalbuminuria at 24 hrs of ICU admission may help to predict survival in the ICU.

Use of a chalazion clamp for intraoral biopsies: a technical note.

Oral biopsies are common diagnostic and therapeutic procedures in oral and maxillofacial surgical (OMFS) outpatient departments. The chalazion clamp is similar to a pair of forceps. One extension has a flat, solid, oval plate, the other, a ring-like structure that is used to clamp and retract soft tissues. We highlight the benefits of using this simple, widely-available tool during oral biopsies. We find that the clamp increases effectiveness and efficiency for the clinician and assistant. We recommend its use in daily OMFS practice.