Benchmarking Neural Networks For Quantum Computations.

The power of quantum computers is still somewhat speculative. Although they are certainly faster than classical ones at some tasks, the class of problems they can efficiently solve has not been mapped definitively onto known classical complexity theory. This means that we do not know for which calculations there will be a "quantum advantage," once an algorithm is found. One way to answer the question is to find those algorithms, but finding truly quantum algorithms turns out to be very difficult. In previous work, over the past three decades, we have pursued the idea of using techniques of machine learning to develop algorithms for quantum computing. Here, we compare the performance of standard real- and complex-valued classical neural networks with that of one of our models for a quantum neural network, on both classical problems and on an archetypal quantum problem: the computation of an entanglement witness. The quantum network is shown to need far fewer epochs and a much smaller network to achieve comparable or better results.

Electrophysiology of esmolol.

The electrophysiologic characteristics of esmolol were studied in 14 patients. Ten men and 4 women, mean age 57 years, were electrophysiologically evaluated at baseline, and also at 4 to 8 minutes after the administration of a maintenance infusion of esmolol. Plasma samples for esmolol blood levels were drawn at 10 minutes of the maintenance infusion, at the end of the maintenance infusion and 30 minutes after the maintenance infusion was discontinued. Results of this study showed that esmolol has typical beta-blocker electrophysiologic effects. Its major action was on sinus node function; it prolonged this basic sinus cycle length but had no significant effect on intrinsic automaticity as reflected by the corrected sinus node recovery time and sinoatrial conduction. Direct effects on atrioventricular (AV) nodal function were reflected by effects on AV nodal conduction and refractoriness. There was no direct effect on atrial function and, as expected, no effect on His-Purkinje or ventricular function. The intensity of esmolol's electrophysiologic effects on sinus node function, AV nodal conduction and AH interval is comparable to those of other beta blockers.

Effects of intravenous infusion of esmolol and propranolol on biventricular performance at rest and during exercise as assessed by quantitative radionuclide angiography.

This double-blind, randomized, crossover study examined the effects of intravenous infusion of esmolol (a new ultra-short-acting beta-receptor blocking agent) and propranolol on cardiovascular performance at rest and during peak upright exercise in 15 patients. Biventricular function was assessed by means of first-pass radionuclide ventriculography with a computerized multicrystal camera. At rest, significant treatment differences between esmolol and propranolol vs baseline were found for the heart rate, systolic blood pressure, double product, left ventricular ejection fraction (EF), systolic blood pressure to end-systolic volume ratio, cardiac index and right ventricular EF. During exercise, significant treatment differences were also found for the heart rate, systolic blood pressure, double product, right ventricular EF and cardiac index. The mean baseline measurements were higher than the mean treatment measurements, but no significant differences were found between mean esmolol and mean propranolol measurements at rest and during exercise except for the exercise systolic blood pressure, which was lower during esmolol infusion. The magnitude of drug effect was greater at the time of exercise than at rest. The blood level of esmolol decreased markedly by 30 minutes after infusion. Esmolol was well tolerated, with no important local, systemic or laboratory abnormalities. Thus, the effects of esmolol on cardiovascular performance at rest and exercise are similar to those of propranolol.

Effects of esmolol on airway function in patients with asthma.

In a double-blind, randomized, crossover study in ten patients with asthma, the effects on specific airway resistance of esmolol, a new ultra-short-acting beta 1-selective adrenoceptor blocker, were compared with those of placebo. Specific airway resistance was measured during increasing doses of esmolol infusion, during dry air provocation tests, and following isoproterenol inhalation. These same studies were later carried out on six of ten patients following intravenous propranolol infusion. All patients were able to tolerate the maximum dose of esmolol (300 micrograms/kg/min); treatment differences between esmolol and placebo were not found. In contrast, intravenous propranolol produced marked symptomatic bronchoconstriction after the lowest dose (1 mg) in two of six patients. Esmolol produced slight but statistically significant enhancement of patients' sensitivity to dry air provocation. Similarly, a slight but significant inhibition of bronchomotor sensitivity to isoproterenol was noted during esmolol infusion. After infusion of 5 mg of intravenous propranolol, one of four patients had a clinically significant increase in sensitivity to dry air. It is concluded that esmolol, because of its short duration of action and relative lack of effect on airway resistance, may be preferred over propranolol in patients with asthma who require treatment with an intravenous beta-blocking agent.

Cardiovascular and neuromuscular effects of esmolol during induction of anesthesia.

Sixteen subjects scheduled for surgical procedures under general anesthesia participated in an investigation of the effects of esmolol on the transient hypertension and tachycardia that was observed during endotracheal intubation and on the duration of succinylcholine-induced neuromuscular blockade. In eight subjects, infusion of esmolol was begun five minutes before induction of anesthesia and continued for 12 minutes after induction. In the remaining subjects, an equivalent volume of solvent (D5W) was infused for 12 minutes. Infusion of esmolol significantly attenuated the cardioacceleration observed during intubation without any significant effect on the pressor effects of the procedure. Esmolol delayed the recovery from succinylcholine-induced neuromuscular blockade by less than three minutes. The mechanism of this delay remains to be investigated, although such a delay does not have clinical significance. Esmolol-induced attenuation of the tachycardia seen during intubation may offer a protective effect on the myocardium, especially in elderly subjects and patients with coronary artery disease.

Anterior cervical corpectomy for cervical spondylotic myelopathy.

OBJECTIVE: To evaluate the efficacy of anterior surgery for the treatment of cervical spondylotic myelopathy, we have reviewed our experience with anterior cervical corpectomy (ACC) at the University of Florida, specifically analyzing neurological outcomes and complications. These results have been compared with historical control subjects receiving laminectomy or "no treatment." METHODS: Between 1982 and 1992, 93 ACC operations were performed for the primary diagnosis of cervical spondylotic myelopathy. This consecutive series of patients was reviewed retrospectively. Age, gender, pre- and postoperative myelopathy severity, number of levels decompressed, and neurological complications were assessed. Myelopathy severity was graded using the Nurick myelopathy grading system. The average follow-up period was 39 months (range, 2-137 mo). RESULTS: Symptomatic improvement was achieved for 92% of patients (F = 28.9, df = 2172, P < 0.001). Nurick scores reflected improvement for 86% of patients, with the conditions of 13% remaining unchanged and only one patient showing worsening. Preoperative myelopathy severity was weakly correlated with age (P < 0.05) but was not correlated with gender or number of levels decompressed. Similarly, postoperative myelopathy severity was not significantly correlated with age, gender, preoperative myelopathy severity, or number of levels decompressed. ACC-treated patients showed an average improvement of 1.24 points on the Nurick scale, compared with an improvement of 0.07 points for patients treated with laminectomy (P < 0.001) and a deterioration of 0.23 points for patients undergoing conservative treatment (P < 0.001). Complications were slightly more likely to occur in older patients (P < 0.05). The number of levels decompressed was not significantly correlated with complications. Only one permanent neurological complication was seen in this series of patients. CONCLUSION: We conclude that ACC is a safe and effective treatment for cervical spondylotic myelopathy. In an average of 39 months, ACC showed improved results in terms of myelopathy scores, compared with historical control subjects receiving either no treatment or laminectomy. Age, gender, preoperative myelopathy severity, and extent of disease were not negative predictors of clinical outcomes.

Posterolateral approach to intradural extramedullary thoracic tumors.

Six ventrally located intradural thoracic tumors were successfully resected through the posterolateral approach. This approach allows direct visualization of the ventral and dorsal boundaries of the tumor with minimal manipulation of the spinal cord. Compared to the traditional laminectomy, the operative time is increased but visualization of the tumor and spinal cord is markedly improved. Compared to the transthoracic approach, the posterolateral approach has fewer potential complications and eliminates the necessity of vertebrectomy. Neurological improvement occurred in all six patients. It is believed that this approach offers significant advantages for the treatment of ventrally located intradural thoracic tumors, and should be considered an alternative to the transthoracic approach.

Cerebral autoregulation of preterm neonates--a non-linear control system?

The low frequency cerebral blood flow velocity (CBFV) oscillations in neonates are commonly attributed to an under-dampened immature linear type cerebral autoregulation, and the 'instability' is regarded as causative for peri-intraventricular haemorrhage/periventricular leukomalacia. In contrast, oscillations susceptible to frequency entrainment are a fundamental part of the stable function of non-linear control systems. To classify the autoregulation an observational study was done on the relationship between CBFV oscillations, heart rate variability, and artificial ventilation. In 10 preterm neonates (gestational age 26 to 35 weeks) we serially Doppler traced arterial CBFV continuously for 12 minutes between days 1 and 49 of life. The individual time series of CBFV and heart rate were subjected to spectral analysis. Forty six of 47 tracings showed significant low frequency CBFV oscillations. Low frequency heart rate oscillations were not a prerequisite thereof. All patients with < 30% of total power in the low frequency band of CBFV oscillations were on the ventilator. Three of them demonstrated a shift of spectral power from low frequency to a frequency equal or harmonic to the ventilator rate indicating entrainment. The findings of CBFV oscillations combined with entrainment classify the autoregulation as a non-linear system. It is suggested that entrainment by periodic high amplitude stimuli might challenge the regulatory capacity to its limits thus increasing the risk for cerebral damage.

Ethanol, stroke, brain damage, and excitotoxicity.

The N-methyl-d-aspartate (NMDA)-glutamate receptor could contribute to stroke, trauma, and alcohol-induced brain damage through activation of nitric oxide formation and excitotoxicity. In rat primary cortical cultures NMDA was more potent at activating nitric oxide formation than triggering excitotoxicity. Ethanol dose dependently inhibited both responses. In contrast, treatment of neuronal cultures with ethanol (100 mM) for 4 days significantly increased NMDA stimulated nitric oxide formation and excitotoxicity. These findings suggest that ethanol acutely inhibits but chronically causes supersensitivity to NMDA-induced excitotoxicity in neuronal cultures. To investigate ethanol's interaction with stroke induced damage models of global cerebral ischemia were studied. Transient global ischemia resulted in a loss of hippocampal CA1 pyramidal neurons over a 3- to 5-day period. Determinations of the NMDA receptor ligand binding stoichiometry or postischemic receptor binding changes did not show differences between neurons that undergo delayed neuronal death following ischemia and those that show no toxicity, for example, CA1 and dentate gyrus, respectively. Acute ethanol (3 g/kg) was found to protect against ischemia-induced CA1 hippocampal damage by lowering body temperature, but not under temperature controled conditions. These studies indicate that the factors contributing to stroke-induced brain damage are complex, although they are consistent with chronic ethanol increasing stroke-induced brain damage by increasing NMDA excitotoxicity.

Studies of the interaction of the maltose-binding protein of Escherichia coli, a closed-groove binder, with 4,6-O-ethylidenemalto-oligosaccharides (dp 2-5) and its regioselective labelling with 3-azibutyl 1-thio-alpha-(6-3H)maltoside.

Four malto-oligosaccharides (dp 2-5), each with a 4,6-O-ethylidene group on the glucosyl unit at the non-reducing terminus, were synthesised and used to prove that the maltose-binding protein (MBP) of E. coli is a closed-groove binder. alpha-D-Glucosylation of 3-azibutyl 1-thio-alpha-D-(6-3H)glucopyranoside yielded a 3H-labelled, photolabile 1-thiomaltoside derivative that was used to chemically modify the binding site of MBP. The 3H-labelled peptide containing 83% of the total radioactivity, which was isolated after tryptic cleavage of the modified MBP and sequenced, is part of the closed end of the MBP groove.

Strong competitive inhibition of porcine pancreatic alpha-amylase by aminodeoxy derivatives of maltose and maltotriose.

The syntheses are described of 6-amino-6-deoxymaltose (2), the 6-amino-6-deoxy (4), 6'-amino-6'-deoxy (6), and 6"-amino-6"-deoxy (8) derivatives of maltotriose, and the methyl alpha- (10) and beta-glycoside (12) and the 1-deoxy derivative (16) of 4. The Ki values (microM) of these competitive inhibitors of porcine pancreatic alpha-amylase were: 2, 88; 4, 1.9; 6, 2.0; 8, 175; 10, 360; 12, 9000; 16, 7600 (cf. 1800 for maltotriose and 3000 for methyl alpha-maltotrioside). The low values for 4 and 6 reflect reinforcement of the normal binding by ionic attraction and, possibly, interaction of the reducing end groups with the protein.

Photolabile derivatives of maltose and maltotriose as ligands for the affinity labelling of the maltodextrin-binding site in porcine pancreatic alpha-amylase.

The 3-azibutyl group was linked through sulfur to the anomeric position of maltose and maltotriose to yield the photolabile thioglycosides 3-azibutyl 1-thio-alpha-maltoside (11) and 3-azibutyl 1-thio-alpha-maltotrioside (12), and to the 4'- and 6'-position of maltose to give the thioethers 4'-S-(3-azibutyl)-4'-thiomaltose (8) and 6'-S-(3-azibutyl)-6'-thiomaltose (15). All four compounds were good competitive inhibitors of the action of porcine pancreatic alpha-amylase. Compound 12 irreversibly deactivated the enzyme to approximately 100% when irradiated together with the protein. The other compounds were much less effective. It is likely that separate areas of the enzyme binding site are chemically modified by the different ligands.

Malto-oligosaccharide homologues of 3,7-anhydro-2-azi-1,2-dideoxy-D-glycero-D-gulo-octitol+ ++: improved photoaffinity reagents for labelling the malto-oligosaccharide-binding protein of Escherichia coli.

3,7-Anhydro-2-azi-1,2-dideoxy-D-glycero-D-gulo-octitol (2) was synthesized as a beta-D-glucopyranosyl analogue, which could be converted into a series of malto-oligosaccharide derivatives (3-7) by cyclodextrinase-catalyzed glucosyl transfer from alpha-cyclodextrin (cyclomaltohexaose). The pure analogues 3-7 containing 1-5 (1----4)-linked alpha-D-glucose residues inhibited the uptake of maltose via the maltose-binding protein-dependent transport system in Escherichia coli. The concentration of half-maximal inhibition of maltose transport at 60nM decreases with increasing chain-length of the analogue, reaching a minimum at 0.02 mM for 6 (4 glucose residues). 3H-Labelled alpha-cyclodextrin was prepared by partial oxidation and reduction of the aldehyde groups with NaB3H4. Radiolabelled 5a was used to photolabel the binding site of the maltose-binding protein.

Spacer-modified disaccharide and pseudo-trisaccharide methyl glycosides that mimic maltotriose, as competitive inhibitors for pancreatic alpha-amylase: a demonstration of the "clustering effect".

The synthesis is reported of methyl 4,4'-dithio-alpha-maltotrioside (12) and the spacer-modified disaccharide glycosides methyl 4-S-(4-alpha-D-glucopyranosylthio-2-hydroxybutyl)-4-thio-alpha -D-glucopyranoside (20) and methyl 4-S-[(1,5/4,6)- and (4,6/1,5)-4-alpha-D-glucopyranosylthio-5,6-dihydroxy-2- cyclohexen-1-yl]-4-thio-alpha-D-glucopyranoside (29a/b), which are analogues of methyl alpha-maltotrioside. The Ki values for alpha-amylase for these compounds were determined as were those of methyl alpha-maltotrioside and maltose.

Stereotactic biopsy of brainstem mass lesions.

BACKGROUND: Appropriate therapy of brainstem lesions is guided by accurate diagnosis. Because the majority of brainstem lesions are not amenable to surgical resection, stereotactic biopsy is an attractive method of obtaining pathological tissue. METHODS: We reviewed the medical records of all patients who underwent stereotactic biopsy of brainstem mass lesions at our institution by the senior author (WAF) over a 10-year period ending in December 1993. RESULTS: Twenty-four patients ranging in age from 3 to 68 years underwent stereotactic biopsy of brainstem mass lesions at our institution by the senior author (WAF) over a 10-year period ending in December 1993. RESULTS: Twenty-four patients ranging in age from 3 to 68 years underwent stereotactic biopsy of mass lesions of the brainstem. Sixteen lesions were located primarily in the pons, 7 in the midbrain, and 1 in the medulla. Twenty-two of the biopsies were approached transfrontally and two were approached via the suboccipital transcerebellar route. Pathological diagnosis was made in 23 of the 24 patients. The histologic diagnosis was astrocytoma in 16 patients, metastasis in 3, lymphoma in 1, germinoma in 1, chordoma in 1, progressive multifocal leukencephalopathy in 1, and was nondiagnostic in 1. Complications included 1 case of increased hemiparesis, 1 case of obstructive hydrocephalus, and 1 death. Six patients were less than 20 years of age and in each of these patients the preoperative diagnosis was astrocytoma. In all of these patients the pathology revealed astrocytoma. In the adult patients the pathology was more varied, with 7 of the 18 patients having tumors or pathology other than astrocytoma. CONCLUSIONS: The data suggest that, in adult patients, brainstem lesions are of varied pathology and stereotactic biopsy can provide adequate tissue for diagnosis. The data also suggest that the diagnosis of brainstem glioma in children can often be made without submitting the patient to the risk of surgery.

Reinforcement and backpropagation training for an optical neural network using self-lensing effects.

The optical bench training of an optical feedforward neural network, developed by the authors, is presented. The network uses an optical nonlinear material for neuron processing and a trainable applied optical pattern as the network weights. The nonlinear material, with the applied weight pattern, modulates the phase front of a forward propagating information beam by dynamically altering the index of refraction profile of the material. To verify that the network can be trained in real time, six logic gates were trained using a reinforcement training paradigm. More importantly, to demonstrate optical backpropagation, three gates were trained via optical error backpropagation. The output error is optically backpropagated, detected with a CCD camera, and the weight pattern is updated and stored on a computer. The obtained results lay the ground work for the implementation of multilayer neural networks that are trained using optical error backpropagation and are able to solve more complex problems.

Predictors of cochlear implant use in children.

The purpose of this study was to identify predictors of effective use of a cochlear implant in a sample of 29 profoundly deaf children, who had been using their devices an average of 2 years. The relationship between the variables of age of onset of deafness, etiology, and communication mode measured prior to implant surgery were correlated with a behavioral measure of cochlear implant use in everyday situations. In addition, in a subset of the full sample, nonverbal intelligence subtest scores calculated prior to implant surgery were evaluated for their contribution to subsequent use of the cochlear implant. The results suggested that communication mode, time using the implant device, and performance on two subsets from the Wechsler Intelligence Scale for Children-Revised (WISC-R) accounted for substantial proportions of the variance in parent ratings of implant usage. The implications of these findings, as well as directions for future research, are discussed.

Long Z-osteotomy: a review and new modification to correct troughing.

The long Z-osteotomy (scarf) has proven to be an effective procedure for correction of the metatarsus primus varus component of the hallux abducto valgus deformity. An historical review and technical considerations of the procedure are described. Although technically demanding, it offers the advantages of superior strength with internal fixation, early range of motion, and early weightbearing. An uncommon but challenging intraoperative complication of the procedure is troughing (channeling). The author describes a technique that involves transfer of the adductor hallucis tendon through the horizontal aspect of the osteotomy when troughing is encountered. The benefits and potential complications are discussed. Although it occurs infrequently, this new modification has the potential to salvage a potentially debilitating complication.

Cochlear implants in children: a study of parental stress and adjustment.

A contextual model of stress was employed to examine the impact of cochlear implantation on parents' levels of stress and psychological adjustment. This model provided a framework for identifying stressors tied directly to the situation, and pointed to important life roles that may be altered. Twenty-four mothers of children implanted with cochlear implants completed a series of questionnaires assessing stressors related to daily parenting tasks, time demands, and childhood deafness. Standardized measures of depression, anxiety, and somatic complaints were also administered. The results provided preliminary evidence that parents of children receiving cochlear implants experience higher levels of stress and poorer psychological adjustment than parents of normally hearing children. Greater parenting stress and emotional distress were reported by parents of children using multichannel as opposed to single-channel devices, with little evidence that this was related strongly to length of time using the devices. Finally, in analyses controlling for type of device and length of use, parenting stress as measured in the current study, accounted for substantial proportions of the variance in psychological distress. The implications of these findings, as well as directions for future research, are discussed.

Are adult transcranial Doppler systems suitable for application in neonates?

UNLABELLED: Transcranial Doppler systems have not been available for monitoring of cerebral blood flow velocities in neonates because of potential hazardous effects of energy output from standard instruments developed for adult application. Aim of the study was to test commercially available transcranial Doppler instruments for their applicability in neonates and to develop guidelines for adaptation for safe neonatal use. Energy output of five commercially available transcranial Doppler instruments was measured with a hydrophone system and a radiation force balance. At the highest setting and at the nominal 10% attenuation level, five out of five and two out of five instruments, respectively, had an energy output above the recommended limits. Power reduction was not linear in one instrument. Evaluation of safety devices (alarm, freeze mode, energy reduction facilities, display of energy values) showed that none of the tested instruments had an optimal setting for safe neonatal application. CONCLUSION: Commercially available transcranial Doppler instruments should be evaluated critically for their energy output prior to their application in neonates. Special software for neonatal application of transcranial Doppler systems should be developed in order to provide extremely low energy output levels and devices for indication of duration of Doppler insonation and energy output.