Heat and Work Along Individual Trajectories of a Quantum Bit.

We use a near quantum limited detector to experimentally track individual quantum state trajectories of a driven qubit formed by the hybridization of a waveguide cavity and a transmon circuit. For each measured quantum coherent trajectory, we separately identify energy changes of the qubit as heat and work, and verify the first law of thermodynamics for an open quantum system. We further establish the consistency of these results by comparison with the master equation approach and the two-projective-measurement scheme, both for open and closed dynamics, with the help of a quantum feedback loop that compensates for the exchanged heat and effectively isolates the qubit.

Information Gain and Loss for a Quantum Maxwell's Demon.

We use continuous weak measurements of a driven superconducting qubit to experimentally study the information dynamics of a quantum Maxwell's demon. We show how information gained by a demon who can track single quantum trajectories of the qubit can be converted into work using quantum coherent feedback. We verify the validity of a quantum fluctuation theorem with feedback by utilizing information obtained along single trajectories. We demonstrate, in particular, that quantum backaction can lead to a loss of information in imperfect measurements. We furthermore probe the transition between information gain and loss by varying the initial purity of the qubit.

Evaluation and management of chemotherapy-induced cardiotoxicity in breast cancer: a Delphi study.

PURPOSE: While much progress has been made in the treatment of breast cancer, cardiac complications resulting from therapy remain a significant concern. Both anthracyclines and novel targeted agents can inflict cardiac damage. The present study aimed to evaluate the difference between what it is currently done and what standards of care should be used to minimizing and managing cardiac toxicity in breast cancer survivors. METHODS: A two-round multicenter Delphi study was carried out. The panel consisted of 100 oncologists who were asked to define the elected therapies for breast cancer patients, the clinical definition and patterns of cancer drug-derived cardiac toxicity, and those protocols focused on early detection and monitoring of cardiovascular outcomes. RESULTS: Experts agreed a more recent definition of cardiotoxicity. Around 38 % of patients with early-stage disease, and 51.3 % cases with advanced metastatic breast cancer had preexisting risk factors for cardiotoxicity. Among risk factors, cumulative dose of anthracycline ≥450 mg/m2 and its combination with other anticancer drugs, and a preexisting cardiovascular disease were considered the best predictors of cardiotoxicity. Echocardiography and radionuclide ventriculography have been the proposed methods for monitoring changes in cardiac structure and function. Breast cancer is generally treated with anthracyclines (80 %), so that the panel strongly stated about the need to plan a strategy to managing cardiotoxicity. A decline of left ventricular ejection fraction (LVEF) >10 %, to an LVEF value <53 % was suggested as a criterion for changing the dose schedule of anthracyclines, or suspending the treatment of chemotherapy plus trastuzumab until the normalization of the left ventricular function. The use of liposomal anthracyclines was strongly suggested as a treatment option for breast cancer patients. CONCLUSIONS: The present report is the first to produce a set of statements on the prevention, evaluation and monitoring of chemotherapy-induced cardiac toxicity in breast cancer patients.

Effects of intertidal seagrass habitat fragmentation on turbulent diffusion and retention time of solutes.

An in-depth knowledge of solutes advection and turbulent diffusion is crucial to estimate dispersion area and retention time (t(R)) of pollutants within seagrass habitats. However, there is little knowledge on the influence of seagrass habitat fragmentation on such mechanisms. A set of dye tracer experiments and acoustic Doppler velocimeter measurements (ADV) were conducted. Solute transport conditions were compared in between fragmented (FM) vs homogeneous (HM) intertidal meadows, and in vertical gradients (canopy vs overlaying flow). Results showed the highest horizontal diffusion coefficient (K(y), c.a. 10(-3)m(2)s(-1)) on FM and at the canopy-water column interface, whereas t(R) (2.6-5.6 min) was not affected by fragmentation. It suggests that (1) FM are more vulnerable to pollution events in terms of dispersion area and (2) at low tide, advection rather than turbulent diffusion determines t(R). Furthermore, Taylor's theorem is revealed as a powerful tool to analyze vertical gradients on K(y) within seagrass canopies.

Metabolic syndrome in patients with systemic lupus erythematosus from Southern Spain.

The aim of this cross-sectional study was to establish the frequency, phenotype and characteristics of metabolic syndrome (MS), as defined by the Adult Treatment Panel III, in a cohort of patients with systemic lupus erythematosus (SLE) and its possible association with cardiovascular diseases (CVD). A total of 160 patients with SLE and 245 age, sex, educational level and ethnically matched controls were included. Association with cardiovascular risk factors, SLE features, treatment of SLE and history of CVD were assessed in patients with SLE and controls with and without MS. MS was non-significantly increased in patients with SLE (20%) compared with controls (13%; P = 0.083). It was more commonly observed in patients with SLE < or =40 years old (15.8%) than in controls of the same age group (4.2%; P < 0.001). The mean number of MS criteria was significantly higher among patients with SLE than in controls. The frequency of CVD was also 28-fold higher among patients with SLE (11.3%) than in controls (0.4%). SLE with MS presented higher levels of inflammatory markers than SLE without MS. In a multivariate analysis, educational level, serum triglycerides, HDL-cholesterol and C3 serum levels and hydroxychloroquine use were independently associated with MS.

[Bortezomib in relapsed or refractory multiple myeloma: results in a cohort of 39 patients]. / Bortezomib en mieloma múltiple en recidiva o refractario: resultados en una cohorte de 39 pacientes.

INTRODUCTION: Bortezomib has presently become a significant rescue treatment in multiple myeloma (MM) due to its observed effectiveness and safety in multicenter trials. We have aimed to verify both aspects in a setting of non-selected patients. PATIENTS AND METHODS: This is an observational, prospective study of the cohort of relapsed or refractory MM patients treated with bortezomib in our Department. The variables analyzed were response, its duration, time to the treatment failure (TTF), overall survival (OS), response related conditions and toxicity. Statistical methods used were Fisher's exact test, log rank-test and Kaplan-Meier survival tables. RESULTS: A total of 39 patients, 25 relapsed and 14 refractory to chemotherapy, started the treatment. The mean number of previous treatment was 2.3 and they received an average of 5.8 cycles of bortezomib. Complete response was achieved in 14 patients (36%), partial response in 12 (31%) and minor or no response in 13 ones (33%). Median duration of response was 8 months, median TTF was 10 months and median OS, from the onset of bortezomib was 16.5 months, with a median observation of live patients of 12.5 months. The response was more frequent in males (p = 0.019) and in patients with one previous treatment (p = 0.15). There were no significant differences regarding to TTF when we considered the cause of treatment (relapse or no response to chemotherapy) nor in the number of previous treatment regimes. The most frequent adverse events were reversible thrombocytopenia (31%), polyneuropathy (28%) and asthenia-anorexia (23%). CONCLUSIONS: In our cohort of non-selected, relapsed or refractory MM patients, the observations found in the multicenter randomized trials results regarding response rate and duration, TTF OS and safety of bortezomib therapy were verified.

Bone fractures after cardiac transplantation.

OBJECTIVE: Bone loss and bone fractures are disabling complications after heart transplantation. Severe bone loss happens mainly during the first year posttransplantation. Steroids and cyclosporine alter bone metabolism in several ways. To counterbalance these effects, antiresorptive therapy is provided to these patients. The objective of this study was to assess the frequency of bone fractures after heart transplantation, considering previous comorbidities, immunosuppressive therapy, and osteoprotective treatment. METHODS: From 1993 to 2005, 443 consecutive heart transplant recipients were followed for the occurrence of bone fractures, immunosuppressive therapy, clinical conditions, and antiresorptive treatment. RESULTS: There were 41 fractures in 34 patients (7.6%, group I). The remainder of patients formed group II. Fractures commonly involved the lumbar spine. Postmenopausal women had more fractures than other patients (20.6% vs 7.8%, P = .02). When the initial immunosuppressive regimen included tacrolimus, fractures did not happen (P = .01, vs other regimens). Osteoprotective therapy was administered to 91.2% of patients in group I and 79% in group II (P = .08). Mean interval from transplantation to the first fracture was 1131.5 days. Overweight patients had a 61.8% incidence of fracture. CONCLUSIONS: Our series showed a low frequency of bone fractures. Postmenopausal women and overweight patients had more fractures. An initial immunosuppressive regimen using tacrolimus was associated with lower fracture rates.

Characterization of the mean degree of polymerization of proanthocyanidins in red wines using liquid chromatography-mass spectrometry (LC-MS).

An HPLC-MS method for the characterization of proanthocyanidins (PA) has been refined. Further application to red wines provided interesting conclusions about the composition of the flavanol fraction and PA extractability during winemaking. The yield in PA extraction increases with the length of the postfermentative maceration (PFM), as well as the mean degree of polymerization (mDP) of wine flavanols. In early winemaking events mostly monomers to trimers are extracted from grape solids, whereas PFM is required for the significant extraction of higher oligomers. Nevertheless, at the end of a regular process of elaboration the mDP is not very high and does not usually exceed a value of 2.3, dimers and trimers being the predominant flavanols in red wines. With regard to groups of compounds, gallocatechins and prodelphinidins (located in the skins) are extracted rapidly in the first stages of the winemaking. On the contrary, long postfermentative macerations are required for the extraction of galloyled derivatives from the seeds. PA extractability is also dependent on the grape variety used for winemaking. Thus, wines made with Graciano grapes were found to require a longer process of PFM than those made from Tempranillo grapes to obtain similar yields in the extraction of flavanols.

Magnetic long-range order induced by quantum relaxation in single-molecule magnets.

Can magnetic interactions between single-molecule magnets (SMMs) in a crystal establish long-range magnetic order at low temperatures deep in the quantum regime, where the only electron spin fluctuations are due to incoherent magnetic quantum tunneling (MQT)? Put inversely: can MQT provide the temperature dependent fluctuations needed to destroy the ordered state above some finite T(c), although it should basically itself be a T-independent process? Our experiments on two novel Mn4 SMMs provide a positive answer to the above, showing at the same time that MQT in the SMMs has to involve spin-lattice coupling at a relaxation rate equaling that predicted and observed recently for nuclear-spin-mediated quantum relaxation.

Dietary supplements for lactating goats by polyunsaturated fatty acid-rich protected fat. Effects after supplement withdrawal.

The objective of this study was to investigate the persistence of the effects of supplements after they were withdrawn. Two groups of 12 goats were maintained under semiextensive breeding conditions; they were fed indoors with a concentrate with alfalfa hay and olivetree leaves. Goats were in their sixth month of lactation at initiation of the study. During the first month of the trials, the concentrate supplied to the goats was either nonsupplemented (group 1) or supplemented with 9% polyunsaturated fatty acids (PUFA)-rich protected fat (group 2). After this period, the 2 groups were given the nonsupplemented until the average daily production of milk per animal within each group had decreased to 300 g or less. The fat supplementation supplied increased milk production and also improved fat and protein yield. These effects persisted after the supplement was withdrawn. The supplement, moreover, produced noticeable changes in the fatty acids profile of the milk fat, namely a reduction in the concentration of saturated fatty acids and an increase in that of PUFA. In contrast to the effects on milk production and on the yield of its main constituents, the effects on fat composition disappeared when the supplement was withdrawn.

Tunnel window's imprint on dipolar field distributions.

We have performed Monte Carlo simulations of interacting dipoles that relax through quantum tunneling. We aim to mimic tunneling experiments on crystals of magnetic clusters, such as Fe(8), at very low temperatures. Accordingly, we allow spin flips only if the corresponding energy change is less than some 2 delta h(hf). Time evolutions of the dipolar field distribution P(t)(H) are studied. As in experiments, a "hole" develops in P(t)(H). The half-width W of incipient holes of weakly polarized systems are, under certain conditions, simply related to delta h(hf). For k(B)T less than approximately 0.5 delta h(hf) and delta h(hf) smaller than approximately 1/10 of the half-width of the dipolar field distributions of disordered systems, W approximately equal to 0.75 delta h(hf).

[Study of cobalamin deficiency in gastrectomized and aged subjects]. / Estudio del déficit de cobalaminas en sujetos gastrectomizados y de edad avanzada.

OBJECTIVE: The objective of this study were: a) to investigate vitamin B12 deficiency among and advanced aged, clinically healthy, asymptomatic population, presumably with a high prevalence of vitamin B12 deficiency. This deficiency was defined as an increase in the MMA/creatinine ratio in urine and/or basal plasma HT levels which normalize after the administration of vitamin B12; b) its relationship with plasma vitamin B12 levels. SUBJECTS AND METHODS: A total of 45 subjects were studied, 19 in the Group of Gastrectomized patients, who were selected on the basis of an age over 60 years and partial gastrectomy of more than five years, and 26 in the Geriatric Group selected in two nursing homes. All of them were asymptopatic and "healthy" according to data in the clinical records and clinical examination, analytical studies, and none of them was taking any drug that might alter results. After basal analytical studies, which included B12, folates, metilmalonic acid/creatinine (MMA/creatinine) in urine and total plasma homocysteine (TH), i.m. vitamin B12 was administered for 15 days to the gastrectomized patients and oral B12 for 28 days with 2.5 mg folic acid for the last 14 days to the patients in the Geriatric Group. Basal analytical studies were repeated at the end of the study. RESULTS: Basal analytical studies were normal with the exception of two subjects with low levels of hemoglobin and 8 with decreased MCV. Only one subject had decreased serum cobalamines. Nine subjects (20%) were identified with increased basal levels of MMA/creatinine which normalized after decreasing between 97% and 12% after the administration of vitamin B12. TH and MCV also decreased significantly. Basal levels of vitamin B12 ranged from 244 pg/ml to 483 pg/ml (n = 220 pg/ml-980 pg/ml). CONCLUSIONS: Vitamin B12 deficiency, defined as an increase in the MMA/creatinine ratio and TH normalized with B12, is highly prevalent among elderly subjects and may occur in absence of clinical and/or analytical manifestations. Given the widespread recommendation of quantitating MMA and TH for the diagnosis of borderline cases of vitamin B12 deficiency, such disturbance may occur in clinically and biochemically normal subjects. Thus, a special caution should be exerted, given the existing comorbidity in advanced ages, before attributing B12 deficiency to a condition which may be the expression of another concomitant condition.

Gas chromatographic analysis of total fatty acids in cider.

This paper reports the composition of total fatty acids in an apple beverage, cider. Fatty acids are present in the free or esterified form and contribute to both the flavor and foam properties of cider. Fatty acids were separated and identified as methyl esters by GC-MS, and 12 of these were subsequently determined by GC-FID. The major fatty acids found in cider were caproic, caprylic, capric, and palmitic acid, the saturated acids predominating over the unsaturated ones. The proposed method was applied to 59 ciders from three consecutive harvests (1996, 1997, and 1998), which were made by 19 cider-makers from the region of Asturias (Spain). Linear discriminant analysis of fatty acids in these samples allowed selection of palmitoleic, pentadecanoic, linoleic, myristic, and linolenic acid as the most predictive variables to differentiate ciders made from apples grown in the Asturias region (1997 harvest) and ciders made from apples grown outside this region (1996 and 1998 harvests).

[The practical clinical guidelines of the Sociedad Española de Cardiología on interventional cardiology: coronary angioplasty and other technics]. / Guías de práctica clínica de la Sociedad Española de Cardiología en cardiología intervencionista: angioplastia coronaria y otras técnicas.

Interventional cardiology has had an extraordinary expansion in last years. This clinical guideline is a review of the scientific evidence of the techniques in relation to clinical and anatomic findings. The review includes: 1. Coronary arteriography. 2. Coronary balloon angioplasty. 3. Coronary stents. 4. Other techniques: directional atherectomy, rotational atherectomy, transluminal extraction atherectomy, cutting balloon, laser angioplasty and transmyocardial laser and endovascular radiotherapy. 5. Platelet glycoprotein IIb/IIIa inhibitors. 6. New diagnostic techniques: intravascular ultrasound, coronary angioscopy, Doppler and pressure wire. For the recommendations we have used the classification system: class I, IIa, IIb, III like in the guidelines of the American College of Cardiology and the American Heart Association.

[The practical clinical guidelines of the Sociedad Española de Cardiología on coronary surgery]. / Guías de práctica clínica de la Sociedad Española de Cardiología en cirugía coronaria.

Surgery in coronary disease, including myocardial revascularization and the surgery of mechanical complications of acute myocardial infarction, has shown to improve the symptoms, quality of life and/or prognosis in certain groups of patients. The expected benefit in each patient depend on many well-known factors among which the appropriateness of the indication for surgery is fundamental. The objective of these guidelines is to review current indications for cardiac surgery in patients with coronary heart disease through an evaluation of the degree of evidence of effectiveness in the light of current knowledge (systematic review of bibliography) and expert opinion gathered from various reports. Indications and the degree of recommendation for conventional coronary artery bypass grafting have been established for each of the most frequent anatomo-clinical situations defined by clinical symptoms (stable angina, unstable angina and acute myocardial infarction) as well as by left ventricular function and extend of coronary disease. Furthermore, the subgroups with the greatest surgical risk and stratification models are described to aid the decision making process. Also we analyse the rational basis and indication for the new surgical techniques such as minimally invasive coronary surgery and total arterial revascularization. Finally, the indication and timing of surgery in patients with mechanical complications of acute myocardial infarction are considered.