Gigahertz Detection Rates and Dynamic Photon-Number Resolution with Superconducting Nanowire Arrays.

Superconducting nanowire single-photon detectors (SNSPDs) have enabled the realization of several quantum optics technologies thanks to their high system detection efficiency (SDE), low dark counts, and fast recovery time. However, the widespread use of linear optical quantum computing, quasi-deterministic single-photon sources, and quantum repeaters requires even faster detectors that can also distinguish between different photon-number states. Here, we present an SNSPD array composed of 14 independent pixels, achieving an SDE of 90% in the telecommunications band. By reading each pixel of the array independently, we show detection of telecommunication photons at 1.5 GHz with 45% absolute SDE. We exploit the dynamic photon-number resolution of the array to demonstrate accurate state reconstruction for a wide range of light inputs, including operation with long-duration light pulses, as obtained with some cavity-based sources. We show two-photon and three-photon fidelities of 74% and 57%, respectively, which represent state-of-the-art results for fiber-coupled SNSPDs.

[Cognitive impairment in multiple sclerosis: when to think about it?] / Troubles cognitifs dans la sclérose en plaques : quand y penser ?

Cognitive disorders are present in 30 to 45% of relapsing-remitting forms of multiple sclerosis and in up to 50-75% of progressive forms. They bear a negative impact on the quality of life and predict an unfavorable disease progression. According to guidelines, screening based on objective measurement such as the Single Digit Modality Test (SDMT) should be performed at the time of diagnosis and then on an annual basis. Confirmation of diagnosis and management are performed in collaboration with neuropsychologists. Increased awareness from patients and healthcare professionals is important to ensure earlier management and prevent negative consequences on the patients professional and family life.

Les troubles cognitifs sont présents chez 30 à 45 % des patients souffrant d'une forme poussée-rémission de sclérose en plaques (SEP) et chez jusqu'à 50-75 % de ceux souffrant des formes progressives. Ces troubles cognitifs impactent négativement la qualité de vie et sont associés à une progression défavorable de la SEP elle-même. Les recommandations proposent un dépistage au moment du diagnostic, puis annuellement, à l'aide d'un test objectif tel que le Single Digit Modality Test (SDMT) ou équivalents. La confirmation du diagnostic et la prise en charge se font en collaboration avec les neuropsychologues. Une meilleure sensibilisation des patients et des professionnels de santé est nécessaire pour assurer une prise en charge plus précoce et limiter les conséquences négatives sur la vie professionnelle et familiale des patients.

[Neurology 2019]. / Neurologie.

New studies confirm the possibility of late thrombolysis. Meta-analyses have confirmed that CGRP inhibitors are efficacious for migraines. Cladribine is a new oral treatment for relapsing-remitting multiple sclerosis. Limbic-predominant age-related TDP-43 encephalopathy (LATE) is a new clinical entity accounting for cognitive decline in old patients. The timing of levodopa introduction has no effect on the long-term course of idiopathic Parkinson's disease. Hypophosphatemia helps distinguish between seizures and syncopes in the emergency department. A second course of intravenous immunoglobulins provides no benefit for severe Guillain Barre syndrome. Outdoor therapy improves clinical scales in patients with disorder of consciousness. Ultrasound guided lumbar puncture improves the yield of the procedure.

De nouvelles études confirment la possibilité de thrombolyse tardive. Les méta-analyses confirment l'effet bénéfique des inhibiteurs du CGRP (calcitonin gene-related peptide) pour la migraine. La cladribine est un nouveau traitement oral pour la sclérose en plaque de type poussée-rémission. L'encéphalopathie à TDP-43 à prédominance limbique est une nouvelle entité en lien avec des troubles cognitifs de la personne âgée. Le délai d'introduction de la lévodopa n'a pas d'influence sur l'évolution à long terme de la maladie de Parkinson. L'hypophosphatémie aide à différencier les crises d'épilepsie des syncopes. Une deuxième cure d'immunoglobulines n'apporte pas de bénéfice dans le traitement du syndrome de Guillain-Barré. Les patients avec troubles de l'état de conscience bénéficient des thérapies à l'air libre. L'ultrason améliore le rendement de la ponction lombaire.

Secure Quantum Key Distribution over 421 km of Optical Fiber.

We present a quantum key distribution system with a 2.5 GHz repetition rate using a three-state time-bin protocol combined with a one-decoy approach. Taking advantage of superconducting single-photon detectors optimized for quantum key distribution and ultralow-loss fiber, we can distribute secret keys at a maximum distance of 421 km and obtain secret key rates of 6.5 bps over 405 km.

Levetiracetam circulating concentrations and response in status epilepticus.

INTRODUCTION: Intravenous levetiracetam (LEV) is broadly used in the treatment of status epilepticus (SE). A loading dose is usually infused, aiming to reach quickly the range of plasma concentrations considered as therapeutic (12-46 mg/l). The aim of the study was to evaluate the response to LEV in SE, correlated exposure assessed by plasma concentration monitoring, as well as calculated exposure parameters. MATERIALS & METHODS: We retrospectively analyzed a SE registry, including patients since 2015 with at least one available LEV plasma level measured less than 36 h after loading. A Bayesian maximum likelihood approach based on a population pharmacokinetic model was used to estimate LEV exposure parameters. We compared plasma levels and pharmacokinetics parameter estimates between responders and nonresponders. Therapeutic response was defined as SE cessation within 24 h following LEV introduction without a need for additional antiepileptic drug (AED). RESULTS: We included 29 patients (45 plasma levels). Variability was salient in LEV loading doses (ranging between 17 and 38 mg/kg) and monitoring practice. There was no difference in median plasma concentrations (19.5 versus 21.5 mg/l; p = 0.71), median estimated LEV exposure (25.8 versus 37.0 mg/l; p = 0.61), peak (30.4 versus 41.5 mg/l; p = 0.36), or residual levels after loading dose (14.4 versus 20.5 mg/l; p = 0.07) between responders and nonresponders. CONCLUSIONS: Levetiracetam exposure does not seem to differ significantly between responders and nonresponders; greater exposure was not associated with better outcome. Loading doses of 30 mg/kg seem, however, appropriate to quickly reach the target exposure level. The short LEV half-life makes standardized sampling measurement necessary to obtain directly interpretable LEV levels.

Combination of additive and subtractive laser 3D microprocessing in hybrid glass/polymer microsystems for chemical sensing applications.

We present a novel hybrid glass-polymer micromechanical sensor by combining two femtosecond laser direct writing processes: laser illumination followed by chemical etching of glass and two-photon polymerization. This incorporation of techniques demonstrates the capability of combining mechanical deformable devices made of silica with an integrated polymer structure for passive chemical sensing application. We demonstrate that such a sensor could be utilized for investigating the elastic properties of polymeric microstructures fabricated via the two-photon polymerization technique. Moreover, we show that polymeric microstructure stiffness increases when immersed in organic liquids.

Fast single-photon detectors and real-time key distillation enable high secret-key-rate quantum key distribution systems.

Quantum key distribution has emerged as the most viable scheme to guarantee information security in the presence of large-scale quantum computers and, thanks to the continuous progress made in the past 20 years, it is now commercially available. However, the secret key rates remain limited to just over 10 Mbps due to several bottlenecks on the receiver side. Here we present a custom multipixel superconducting nanowire single-photon detector that is designed to guarantee high count rates and precise timing discrimination. Leveraging the performance of the detector and coupling it to fast acquisition and real-time key distillation electronics, we remove two major roadblocks and achieve a considerable increase of the secret key rates with respect to the state of the art. In combination with a simple 2.5-GHz clocked time-bin quantum key distribution system, we can generate secret keys at a rate of 64 Mbps over a distance of 10.0 km and at a rate of 3.0 Mbps over a distance of 102.4 km with real-time key distillation.

Novel Treatment and New Drugs in Epilepsy Treatment.

We now get benefit from more than 20 antiepileptic drugs (AEDs) in the care of people with epilepsy. Newer generation of AED is associated with a more favourable tolerability profile than older generation AEDs which makes them easier to use, despite similar efficacy. In order to define the place of newer generation AEDs in the therapy, we review here the main current guidelines about their use for a special issue concerning antiepileptic drugs in neurosurgical practice. We also discuss how to tailor the treatment with newer generation AEDs according to the patient's needs and comorbid conditions. We review different common setting that may require specific therapeutic considerations, i.e. elderly, pregnancy, HIV infection, tumours and hospital/critical care use. We also discuss the current evidence regarding the use of newer generation AEDs in the neurosurgical practice. We present the most recent commercially available newer AEDs (ezogabine, perampanel, brivacetam, everolimus), describing their mechanism of action, adverse effects and indication according to the type of seizure. We finally describe the promising AEDs that are currently under development or testing. This article is a special issue concerning antiepileptic drugs in neurosurgical practice.

Intravenous lacosamide in status epilepticus: Correlation between loading dose, serum levels, and clinical response.

INTRODUCTION: Intravenous lacosamide (LCM) is increasingly used in the treatment of status epilepticus (SE), but optimal loading dose and target serum levels are unclear. We analysed the correlation between LCM serum levels after intravenous loading dose and clinical response. MATERIALS AND METHODS: Retrospective study in two centres from December 2014 to May 2016 including consecutive SE patients treated with LCM, in which trough serum levels after intravenous loading dose were available. Trough levels were correlated with the loading dose and the clinical response, defined as LCM introduction terminating SE without the need of further treatment. Correlations were adjusted for other SE characteristics. RESULTS: Among 40 patients, 16 (40%) responded to LCM. LCM serum concentrations within the reference interval (10-20mg/l) were associated with loading doses of >9mg/kg (p=0.003; χ2). However, we observed no difference between LCM serum levels in responders (median 10.4mg/l) versus non-responders (median 9.5mg/l; p=0.36; U test), even after adjusting for other predictors of clinical outcome (SE severity, aetiology, and number of previous treatment). DISCUSSION: High intravenous LCM loading doses (>9mg/kg) were associated with serum levels within the reference interval, there was however no correlation with the clinical response. Prospective studies are needed to evaluate the benefit of increasing the LCM loading dose in SE.

Antibodies to TRIM46 are associated with paraneoplastic neurological syndromes.

Paraneoplastic neurological syndromes (PNS) are often characterized by the presence of antineuronal antibodies in patient serum or cerebrospinal fluid. The detection of antineuronal antibodies has proven to be a useful tool in PNS diagnosis and the search for an underlying tumor. Here, we describe three patients with autoantibodies to several epitopes of the axon initial segment protein tripartite motif 46 (TRIM46). We show that anti-TRIM46 antibodies are easy to detect in routine immunohistochemistry screening and can be confirmed by western blotting and cell-based assay. Anti-TRIM46 antibodies can occur in patients with diverse neurological syndromes and are associated with small-cell lung carcinoma.