Multiple-photon bundle emission in the n-photon Jaynes-Cummings model.

We study the multiple-photon bundle emission in the n-photon Jaynes-Cummings model composed of a two-level system coupled to a single-mode optical field via the n-photon exciting process. Here, the two-level system is strongly driven by a near-resonant monochromatic field, and hence the system can work in the Mollow regime, in which a super-Rabi oscillation between the zero-photon state and the n-photon state can take place under proper resonant conditions. We calculate the photon number populations and the standard equal-time high-order correlation functions, and find that the multiple-photon bundle emission can occur in this system. The multiple-photon bundle emission is also confirmed by investigating the quantum trajectories of the state populations and both the standard and generalized time-delay second-order correlation functions for multiple-photon bundle. Our work paves the way towards the study of multiple-photon quantum coherent devices, with potential application in quantum information sciences and technologies.

Spectrometric detection of weak forces in cavity optomechanics.

We propose a spectrometric method to detect a classical weak force acting upon the moving end mirror in a cavity optomechanical system. The force changes the equilibrium position of the end mirror, and thus the resonance frequency of the cavity field depends on the force to be detected. As a result, the magnitude of the force can be inferred by analyzing the single-photon emission and scattering spectra of the optomechanical cavity. Since the emission and scattering processes are much faster than the characteristic mechanical dissipation, the influence of the mechanical thermal noise is negligible in this spectrometric detection scheme. We also extent this spectrometric method to detect a monochromatic oscillating force by utilizing an optomechanical coupling modulated at the same frequency as the force.

Protective effect of high concentration of BN52021 on retinal contusion in cat eyes.

BACKGROUND: Blunt injuries/contusion on eyes might cause retina blunt trauma. This study is to evaluate the protective function of BN52021 against retinal trauma. METHODS: A total of 70 cats, 6 months old, were divided into six groups: Group A to E (n = 12) and normal control (N) group (n = 10). The right eyes in Group A to E were contused. All experiments were performed under general anesthetization. Retrobulbar injections of medication in right eyes were performed. Cats were administrated with 0.5 mL of normal saline (NS), dimethyl sulphoxide, 0.2 g/L BN52021, 1 g/L BN52021 and 5 g/L BN52021, respectively. Cats in Group N were administrated with 0.5 mL of NS. Intraocular pressure (IOP), flash electroretinogram (ERG), and retinal nerve fiber layer (RNFL) thickness were measured. Hematoxylin and eosin (HE) staining and transmission electron microscope (TEM) were detected. RESULTS: No significant difference was observed in IOP levels among groups. Comparing with cats in Group N, those in Group A to E showed significant lower amplitudes of rod a- and b-waves (P < 0.05). Amplitudes of rod a- and b-waves were increased by administration of high concentration of BN52021 (≥ 1 g/L). Moreover, high concentration of BN52021 decreased the RNFL thickness increased by contusion. Axons in RNFL in Group E arranged neatly at 7 days after modeling. CONCLUSIONS: The degenerated axons caused by contusion were repaired by BN52021. The administration of high concentration of (≥ 1 g/L) BN52021 could partially repair retinal function in contused cat eyes.

Hepatitis B virus X protein (HBx)-related long noncoding RNA (lncRNA) down-regulated expression by HBx (Dreh) inhibits hepatocellular carcinoma metastasis by targeting the intermediate filament protein vimentin.

UNLABELLED: The hepatitis B virus X protein (HBx) has been implicated as an oncogene in both epigenetic modifications and genetic regulation during hepatocarcinogenesis, but the underlying mechanisms are not entirely clear. Long noncoding RNAs (lncRNAs), which regulate gene expression with little or no protein-coding capacity, are involved in diverse biological processes and in carcinogenesis. We asked whether HBx could promote hepatocellular carcinoma (HCC) by regulating the expression of lncRNAs. In this study we investigated the alteration in expression of lncRNAs induced by HBx using microarrays and real-time quantitative polymerase chain reaction (PCR). Our results indicate that HBx transgenic mice have a specific profile of liver lncRNAs compared with wildtype mice. We identified an lncRNA, down-regulated expression by HBx (termed lncRNA-Dreh), which can inhibit HCC growth and metastasis in vitro and in vivo, act as a tumor suppressor in the development of hepatitis B virus (HBV)-HCC. LncRNA-Dreh could combine with the intermediate filament protein vimentin and repress its expression, and thus further change the normal cytoskeleton structure to inhibit tumor metastasis. We also identified a human ortholog RNA of Dreh (hDREH) and found that its expression level was frequently down-regulated in HBV-related HCC tissues in comparison with the adjacent noncancerous hepatic tissues, and its decrement significantly correlated with poor survival of HCC patients. CONCLUSION: These findings support a role of lncRNA-Dreh in tumor suppression and survival prediction in HCC patients. This discovery contributes to a better understanding of the importance of the deregulated lncRNAs by HBx in HCC and provides a rationale for the potential development of lncRNA-based targeted approaches for the treatment of HBV-related HCC.

Compound heterozygosity for novel von Willebrand factor genetic variants associated with von Willebrand disease in two Chinese patients.

BACKGROUND: Von Willebrand factor (VWF) encodes a secreted glycoprotein involved in primary hemostasis. Genetic mutations in this gene leading to either quantitation or qualitative defects of VWF, result in von Willebrand disease (VWD), an inherited bleeding disorder. METHODS: In this study, two families with VWD were recruited and submitted to a series of clinical and genetic examinations. prothrombin time, activated partial thromboplastin time, thrombin time, factor VIII coagulant activity (FVIII:C), VWF antigen (VWF:Ag), VWF ristocetin cofactor (VWF:RCo) tests were measured in peripheral blood. F8, F9, and VWF genes were sequenced using next-generation sequencing, and Sanger sequencing was used as a validation method. RESULTS: Both families had a child suffered spontaneous bleeding. Patient 1 showed normal VWF:Ag, severely decreased FVIII:C and VWF:RCo. Patient 2 showed severely decreased FVIII:C, VWF:Ag, and VWF:RCo. Compound heterozygous mutations of VWF gene were identified in both patients. Patient 1 had a novel deletion variant c.1910_1932del (p.Gly637AlafsTer5) and a missense variant c.605G>A (p.Arg202Gln). Patient 2 had a novel missense variant c.4817T>A (p.Met1606Lys) and a novel missense variant c.5983C>T (p.Pro1995Ser). CONCLUSIONS: We described clinical and molecular features of VWD caused by compound heterozygous mutations in two Chinese patients. Our results expand the variation spectrum of the VWF gene and deepen the understanding of the relationship between the genotype and clinical characteristics of VWD.

Bioactive graphene oxide-functionalized self-expandable hydrophilic and osteogenic nanocomposite for orthopaedic applications.

Polymethyl methacrylate (PMMA) bone cement (PBC) is commonly used in orthopaedic surgery. However, polymerization volumetric shrinkage, exothermic injury, and low bioactivity prevent PBC from being an ideal material. The developed expandable P(MMA-AA-St) well overcomes the volumetric shrinkage of PBC. However, its biomechanical properties are unsatisfactory. Herein, graphene oxide (GO), a hydrophilic material with favourable biomechanics and osteogenic capability, was added to P(MMA-AA-St) to optimize its biomechanics and bioactivity. The GO-modified self-expandable P(MMA-AA-St)-GO nanocomposite (PGBCs) exhibited outstanding compressive strength (>70 â€‹MPa), water absorption, and volume expansion, as well as a longer handling time and a reduced setting temperature. The cytocompatibility of PGBCs was superior to that of PBC, as demonstrated by CCK-8 assay, live-dead cell staining, and flow cytometry. In addition, better osteoblast attachment was observed, which could be attributed to the effects of GO. The improved level of osteogenic gene and protein expression further illustrated the improved cell-material interactions between osteoblasts and PGBCs. The results of an in vivo study performed by filling bone defects in the femoral condyles of rabbits with PGBCs demonstrated promising intraoperative handling properties and convenient implantation. Blood testing and histological staining demonstrated satisfactory in vivo biosafety. Furthermore, bone morphological and microarchitecture analyses using bone tissue staining and micro-CT scanning revealed better bone-PGBCs contact and osteogenic capability. The results of this study indicate that GO modification improved the physiochemical properties, cytocompatibility, and osteogenic capability of P(MMA-AA-St) and overcame the drawbacks of PBC, allowing its material derivatives to serve as effective implantable biomaterials.

[Role of conventional pulmonary function tests and cardiopulmonary exercise test in the prediction of postoperative cardiopulmonary complications in high risk thoracic cancer patients].

OBJECTIVE: To evaluate and compare the value of cardiopulmonary exercise test and conventional pulmonary function tests in the prediction of postoperative cardiopulmonary complications in high risk patients with chest malignant tumors. METHODS: From January 2006 to January 2009, 216 consecutive patients with thoracic malignant tumors underwent conventional pulmonary function tests (PFT, spirometry + DLCOsb for diffusion capacity) and cardiopulmonary exercise test (CPET) preoperatively. The correlation of postoperative cardiopulmonary complications with the parameters of PFT and CPET were retrospectively analyzed using Chi-square test, independent sample t-test and logistic regression analysis. The P value < 0.05 was considered as statistically significant. RESULTS: Of the 216 patients, 57 did not receive operation due to advanced stage diseases or poor cardiopulmonary function in most of them. The remaining 159 underwent different modes of operations. Thirty-six patients (22.6%) in this operated group had postoperative cardiopulmonary complications and 10 patients (6.3%) developed operation-related complications. Three patients (1.9%) died of the complications within 30 days postoperatively. The patients were stratified into groups based on V(O(2)) max/pred (≥ 65.0%, < 65.0%); V(O(2)) max×kg(-1)×min(-1) (≥ 20 ml, 15 - 19.9 ml, < 15 ml) and FEV1 (≥ 2.0 L, 1.2 - 1.99 L, < 1.2 L) according to the criteria in reported papers. There was statistically significant difference among these groups in the parameters (P < 0.05), the rates of postoperative cardiopulmonary complications were much higher in the groups with poor cardiopulmonary function (V(O(2)) max/pred < 65.0%; V(O(2)) max×kg(-1)×min(-1) < 15 ml or FEV1 < 1.2 L). It was shown by logistic regression analysis that postoperative cardiopulmonary complications were significantly correlated with age, associated diseases, poor results of PFT or CPET, operation modes and operation-related complications. CONCLUSIONS: FEV1 in spirometry, V(O(2)) max×kg(-1)×min(-1) and V(O(2)) max/pred in cardiopulmonary exercise test can be used to stratify the patients' cardiopulmonary function status and is correlated well with FEV1. V(O(2)) max×kg(-1)×min(-1) is the best parameter among these three parameters to predict the risk of postoperative cardiopulmonary complications in patients with chest malignant tumors and borderline cardiopulmonary function.

[Comparison of the short-term outcomes of surgical treatment for non-small cell lung cancer via video assisted thoracoscopic surgery and open thoracotomy].

OBJECTIVE: To compare the short-term outcomes of surgical treatment for non-small cell lung cancer (NSCLC) by video-assisted thoracoscopic surgery (VATS) and open thoracotomy (OT). METHODS: Data of 737 consecutive NSCLC patients who underwent surgical treatment for non-small cell lung cancer by video-assisted thoracoscopic surgery and 630 patients who underwent pulmonary resection via open thoracotomy (as controls) in Cancer Institute & Hospital, Chinese Academy of Medical Sciences between January 2009 and August 2011 were retrospectively reviewed. The risk factors after lobectomy were also analyzed. RESULTS: In the 506 NSCLC patients who received VATS lobectomy, postoperative complications occurred in 13 patients (2.6%) and one patient died of acute respiratory distress syndrome (0.2%). In the 521 patients who received open thoracotomy (OT) lobectomy, postoperative complications occurred in 21 patients (4.0%) and one patient died of pulmonary infection (0.2%). There was no significant difference in the morbidity rate (P > 0.05) and mortality rate (P > 0.05) between the VATS group and OT group. In the 190 patients who received VATS wedge resections, postoperative complications occurred in 3 patients (1.6%). One hundred and nine patients received OT wedge resections. Postoperative complications occurred in 4 patients (3.7%). There were no significant differences for morbidity rate (P = 0.262) between these two groups, and there was no perioperative death in these two groups. Univariate and multivariate analyses demonstrated that age (OR = 1.047, 95%CI: 1.004 - 1.091), history of smoking (OR = 6.374, 95%CI: 2.588 - 15.695) and operation time (OR = 1.418, 95%CI: 1.075 - 1.871) were independent risk factors of postoperative complications. CONCLUSIONS: To compare with the NSCLC patients who should undergo lobectomy or wedge resection via open thoracotomy, a similar short-term outcome can be achieved via VATS approach.

[Effect of bivalent alkaline earth fluorides introduction on thermal stability and spectroscopic properties of Er3+/Tm3+ /Yb3+ co-doped oxyfluorogermanate glasses].

Transparent Er3+/Tm3+ /Yb3+ co-doped oxyfluorogermanate glasses alone containing MgF2, CaF2, SrF2 or BaF2 and nano-glass-ceramics only containing BaF2 were prepared. The thermal stabilities and the up-conversion emission properties of the samples were investigated. Analyses of absorbance spectra reveal that the UV cutoff band moves slightly to shortwave band with the doping bivalent cation mass increasing. The results show that the emission color can be adjusted by changing the alkaline earth cation species in the glass matrixes, especially as Mg2+ is concerned, and the emission intensity can increase notably by heating the glass containing alkaline-earth fluoride into glass ceramic containing alkaline-earth fluoride nanocrystals or increasing the content of bivalent alkaline earth fluorides.

Neurophysiological mechanisms of cancer-induced bone pain.

Background: Cancer-induced Bone Pain (CIBP) is an important factor affecting their quality of life of cancer survivors. In addition, current clinical practice and scientific research suggest that neuropathic pain is a representative component of CIBP. However, given the variability of cancer conditions and the complexity of neuropathic pain, related mechanisms have been continuously supplemented but have not been perfected. Aim of Review: Therefore, the current review highlights the latest progress in basic research on the field and proposes potential therapeutic targets, representative drugs and upcoming therapies. Key Scientific Concepts of Review: Notably, factors such as central sensitization, neuroinflammation, glial cell activation and an acidic environment are considered to be related to neuropathic pain in CIBP. Nonetheless, further research is needed to ascertain the mechanism of CIBP in order to develop highly effective drugs. Moreover, more attention needs to be paid to the care of patients with advanced cancer.

trans-Bis(2-acet-amido-5-methyl-benzoato-κO)tetra-aqua-zinc.

In the title compound, [Zn(C(10)H(10)NO(3))(2)(H(2)O)(4)], the Zn(II) atom lies on a crystallographic inversion center and is six-coordinated by two monodentate trans-related 2-(N-acetyl-amino)-5-methyl-benzoato ligands and four water mol-ecules, giving a slightly distorted octa-hedral geometry. There are two intra-molecular hydrogen bonds [amine N-H⋯O(carbox-yl) and water O-H⋯O(carbox-yl)], while extensive inter-molecular water O-H⋯O hydrogen-bonding inter-actions extend the complex units into a two-dimensional network structure along (100).

Prognostic Nomograms to Predict Overall Survival and Cancer-specific Survival in Sacrum/Pelvic Chondrosarcoma (SC) Patients: A Population-based Propensity Score-matched Study.

STUDY DESIGN: A longitudinal cohort study. OBJECTIVE: The objective of this study was to evaluate the prognostic factors and determine the difference between different surgery scopes. Nomograms were constructed and validated to predict overall survival (OS) and cancer-specific survival (CSS) of sacrum/pelvic chondrosarcoma (SC) patients. SUMMARY OF BACKGROUND DATA: Chondrosarcoma is a bone malignancy which is reported to be resistant to both chemotherapy and radiotherapy. Therefore, surgery is the most preferred treatment method. However, this remains a great challenge due to the complex anatomy of the area. MATERIALS AND METHODS: Data from the Surveillance, Epidemiology, and End Results (SEER) database of patients with conventional SC between 1998 and 2016 was retrieved for analysis. Cox analysis was used to estimate the mortality hazards ratios among patients. Propensity score matching was used to compare different surgery scope. Nomograms were constructed to predict the OS and CSS of patients with SC. RESULTS: A total of 377 patients were included in this study. The cutoff value for tumor size was considered to be 118 mm. The concordance indices (C-index) value for nomogram predictions of CSS were 0.871. Following propensity score matching, 158 patients were selected for the second time and its result showed no significant difference between the scope of surgery. CONCLUSIONS: Tumor size was considered to be closely related to the outcome of SC. There is no significant difference in the scope of surgery and limb salvage can be considered. The nomograms can precisely predict OS and CSS in patients with SC. These could help clinicians to perform survival assessments and identify patients at high risk. LEVEL OF EVIDENCE: Level IV.

Can Acupuncture Improve Chronic Spinal Pain? A Systematic Review and Meta-Analysis.

STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: To investigate the effect and safety of acupuncture for the treatment of chronic spinal pain. METHODS: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, the WHO Clinical Trial Registry, and the US National Library of Medicine clinical trial registry were searched from January 1, 2000, to November 1, 2019. Randomized controlled trials (RCTs) involving patients with chronic spinal pain treated by acupuncture versus sham acupuncture, no treatment, or another treatment were included. RESULTS: Data was extracted from 22 RCTs including 2588 patients. Pooled analysis revealed that acupuncture can reduce chronic spinal pain compared to sham acupuncture (weighted mean difference [WMD] -12.05, 95% confidence interval [CI] -15.86 to -8.24), mediation control (WMD -18.27, 95% CI -28.18 to -8.37), usual care control (WMD -9.57, 95% CI -13.48 to -9.44), and no treatment control (WMD -17.10, 95% CI -24.83 to -9.37). In terms of functional disability, acupuncture can improve physical function at immediate-term follow-up (standardized mean difference [SMD] -1.74, 95% CI -2.04 to -1.44), short-term follow-up (SMD -0.89, 95% CI -1.15 to -0.62), and long-term follow-up (SMD -1.25, 95% CI -1.48 to -1.03). CONCLUSION: In summary, compared to no treatment, sham acupuncture, or conventional therapy such as medication, massage, and physical exercise, acupuncture has a significantly superior effect on the reduction in chronic spinal pain and function improvement. Acupuncture might be an effective treatment for patients with chronic spinal pain and it is a safe therapy.

Controlled release of baricitinib from a thermos-responsive hydrogel system inhibits inflammation by suppressing JAK2/STAT3 pathway in acute spinal cord injury.

Aggressive inflammation is an important pathological process of secondary injury in acute spinal cord injury (SCI). However, traditional treatments of secondary injury in acute SCI have achieved little success. Novel biomaterials combined with small molecule drugs are considered as a potential treatment for SCI. Baricitinib, a highly selective JAK1/JAK2 inhibitor, can effectively inhibit the JAK2/STAT3 pathway involved in the modulation of inflammation. However, to evaluate Baricitinib's therapeutic effect on SCI remains to be confirmed. In this study, we designed an injectable PLGA-PEG-PLGA thermos-sensitive hydrogel with baricitinib (Bari-P hydrogel) and measured its efficacy, physical and biological properties in vitro. In the SCI rat, Bari-P hydrogel was injected into the injured spinal cord. Neuronal regeneration was evaluated at 3 days and 4 weeks after surgery by determining the inflammatory cytokine levels, behavioral tests, and histological analysis. The hydrogel can gel in the body, disintegrate almost within 72 h and achieve drug release. Baricitinib can effectively inhibit the JAK2/STAT3 pathway of microglia in vitro; while in vivo experiments show that Bari-P hydrogel treatment can inhibit the phosphorylation of JAK2, STAT3 and suppress the production of inflammatory cytokines, and reduces neuronal apoptosis. Histopathological analysis and behavioral tests showed that Bari-P hydrogel reduced neuronal apoptosis in the early stage of injury and later promoted functional recovery. In summary, Bari-P hydrogel reduced neuronal apoptosis and promoted functional recovery in spinal cord injured rats by inhibiting the JAK2-STAT3 pathway and controlling the expression of inflammatory cytokines in the early stages of injury.

Effects of Revision Rod Position on Spinal Construct Stability in Lumbar Revision Surgery: A Finite Element Study.

Revision surgery (RS) is a necessary surgical intervention in clinical practice to treat spinal instrumentation-related symptomatic complications. Three constructs with different configurations have been applied in RS. One distinguishing characteristic of these configurations is that the revision rods connecting previous segments and revision segments are placed alongside, outside, or inside the previous rods at the level of facetectomy. Whether the position of the revision rod could generate mechanical disparities in revision constructs is unknown. The objective of this study was to assess the influence of the revision rod position on the construct after RS. A validated spinal finite element (FE) model was developed to simulate RS after previous instrumented fusion using a modified dual-rod construct (DRCm), satellite-rod construct (SRC), and cortical bone trajectory construct (CBTC). Thereafter, maximum von Mises stress (VMS) on the annulus fibrosus and cages and the ligament force of the interspinous ligament, supraspinous ligament, and ligamentum flavum under a pure moment load and a follower load in six directions were applied to assess the influence of the revision rod position on the revision construct. An approximately identical overall reducing tendency of VMS was observed among the three constructs. The changing tendency of the maximum VMS on the cages placed at L4-L5 was nearly equal among the three constructs. However, the changing tendency of the maximum VMS on the cage placed at L2-L3 was notable, especially in the CBTC under right bending and left axial rotation. The overall changing tendency of the ligament force in the DRCm, SRC, and CBTC was also approximately equal, while the ligament force of the CBTC was found to be significantly greater than that of the DRCm and SRC at L1-L2. The results indicated that the stiffness associated with the CBTC might be lower than that associated with the DRCm and SRC in RS. The results of the present study indicated that the DRCm, SRC, and CBTC could provide sufficient stabilization in RS. The CBTC was a less rigid construct. Rather than the revision rod position, the method of constructing spinal instrumentation played a role in influencing the biomechanics of revision.

[Application of video assisted thoracic surgery for chest tumors: experience of 144 cases in a single institution].

OBJECTIVE: To evaluate the indication and safety of video assisted thoracic surgery (VATS) for chest tumors. METHODS: Data of 144 consecutive patients receiving VATS between January and November 2009 in Cancer hospital Chinese Academy of Medical Sciences were retrospectively reviewed. RESULTS: There was no conversion to open thoracotomy. Overall morbidity rate was 2.08% (3/144) and mortality rate was 0.69% (1/144). There were no significant differences for operative time, number of nodal dissection, morbidity rate, mortality rate, overall hospitalization and postoperative length of stay between VATS lobectomy group and open thoracotomy (OT) lobectomy group. Chest tube duration was shorter in the VATS lobectomy group than OT lobectomy group and more early-stage lung cancer patients were found in VATS group. There were no significant differences for number of nodal dissection, chest tube duration, morbidity rate, mortality rate, and postoperative length of stay between VATS lung wedge resection group and OT lung wedge resection group. Operative time and overall hospitalization were shorter in the VATS wedge resection group than OT wedge resection group. CONCLUSION: Morbidity and mortality rate of VATS were acceptable. VATS lobectomy can be used as an alternative surgical technique for early-stage lung cancer. For lung wedge resection, VATS was superior than OT.

Effects of preoperative warming on the occurrence of surgical site infection: A systematic review and meta-analysis.

OBJECTIVE: To determine whether preoperative warming can reduce the risk of surgical site infection (SSI) after surgery. BACKGROUND: Intraoperative hypothermia is a risk factor for the occurrence of SSI in patients after surgery. However, the effectiveness of preoperative warming in reducing the incidence of the condition remains unclear. MATERIALS AND METHODS: A systematic review was conducted using Medline, EMBASE, and the Cochrane Library to identify randomized controlled trials (RCTs) that evaluated the risk of SSI after surgery with and without the use of a preoperative warming protocol. The primary outcome measure was the diagnosis of SSI within 10-90 days of surgery. The pooled risk ratio was estimated with a fixed-effect meta-analysis. Sensitivity analyses were performed to examine the impact of the structural design of preoperative warming on the pooled risk of SSI. RESULTS: Of the 249 studies identified, seven RCTs representing 1086 patients were included in the present meta-analysis. The use of preoperative warming was associated with a significant decrease in SSI (RR = 0.60, 95% CI 0.42-0.87, P = 0.072). Specifically, we defined patients who used forced-air warming (FAW) and integrated measures such as liquid heating and warming blankets as the MIX group and patients who used only FAW as the FAW group. Patients who used MIX methods (temperature set <43 °C and 30-min prewarming) before surgery benefited more from prewarming. CONCLUSIONS: The results of this study suggest that preoperative warming can reduce rates of SSI after surgery. We, therefore, recommend the application of MIX warming methods before surgery.

Quantum entanglement maintained by virtual excitations in an ultrastrongly-coupled-oscillator system.

We study the effect of quantum entanglement maintained by virtual excitations in an ultrastrongly-coupled harmonic-oscillator system. Here, the quantum entanglement is caused by the counterrotating interaction terms and hence it is maintained by the virtual excitations. We obtain the analytical expression for the ground state of the system and analyze the relationship between the average excitation numbers and the ground-state entanglement. We also study the entanglement dynamics between the two oscillators in both the closed- and open-system cases. In the latter case, the quantum master equation is microscopically derived in the normal-mode representation of the coupled-oscillator system. This work will open a route to the study of quantum information processing and quantum physics based on virtual excitations.

Real-World Evidence in Prescription Medication Use Among U.S. Adults with Neck Pain.

INTRODUCTION: Neck pain is a common condition that leads to serious pain, disability, and increased healthcare costs worldwide. Pharmacotherapy is one of the most common strategies to reduce neck pain in patients. The aim of this study was to analyze the real-world pattern of drugs prescribed for patients with neck pain in the USA. METHODS: Data on individuals who reported current neck pain in the 2009-2010 US National Health and Nutrition Examination Survey (NHANES) and with a history of persistent pain for at least 6 weeks or 3 months were extracted from the NHANES database. Those included in the study were divided into three groups based on the duration of pain: the without neck pain group (Group A); subacute group (Group B) with a history of 6 weeks of neck pain; and the chronic neck pain group (Group C) with a history of 3 months of neck pain. The use and duration of medication prescribed for Group A, B, and C patients were compared. RESULTS: The analysis revealed that opioid use was significantly more prevalent in the subacute and chronic neck pain group than in the without neck pain group (Group A) (adjusted odds ratio [aOR] 4.20, 95% confidence interval [CI] 2.07-8.52 and aOR 7.00, 95% CI 4.32-11.33, respectively). The factors strongly associated with higher opioid use included older age, low education level, and low family income. In the chronic neck group, opioids, followed in decreasing order of frequency by acetaminophen and nonsteroidal anti-infammatory drugs, were the most common analgesics used in combination with other analgesics. CONCLUSION: Our analysis of the data shows that the long-term excessive use of opioids and the underutilization of other analgesics are two major issues in the treatment of neck pain in the USA. Possible improvements include improved education of patients by healthcare professionals on the use of opioids and more consideration given to non-pharmacotherapy options. Our results reveal the potential problem in pharmacotherapy choices for neck pain treatment and may help improve the current clinical practice in the USA and other countries.

The Characteristics and Mortality of Osteoporosis, Osteomyelitis, or Rheumatoid Arthritis in the Diabetes Population: A Retrospective Study.

BACKGROUND: Patients with diabetes mellitus are prone to develop osteoporosis, osteomyelitis, or rheumatoid arthritis (RA). Furthermore, the presence of these complications in those with diabetes may lead to higher mortality. The aim of our study was to assess characteristics and mortality of osteoporosis, osteomyelitis, or rheumatoid arthritis in individuals with diabetes. METHODS: We analyzed osteoporosis, osteomyelitis, and RA deaths associated with diabetes from 1999-2017 using the CDC WONDER system (CDC WONDER; https://wonder.cdc.gov). We used ICD-10 codes to categorize the underlying and contributing causes of death. Crude mortality rates (CMR) and age-adjusted mortality rates (AAMR) per 1,000,000 person-years were calculated. RESULTS: The AAMR for osteoporosis in the population with diabetes was significantly higher in females (AAMR: 4.17, 95% CI: 4.10-4.24) than in males (AAMR: 1.12, 95% CI: 1.07-1.16). Deaths due to osteoporosis increased gradually from 1999, peaked in 2003 (AAMR: 3.78, 95% CI: 3.55-4.00), and reached a nadir in 2016 (AAMR: 2.32, 95% CI: 2.15-2.48). The AAMR for RA associated with diabetes was slightly higher in females (AAMR: 4.04, 95% CI: 3.98-4.11) than in males (AAMR: 2.45, 95% CI: 2.39-2.51). The mortality rate due to RA increased slightly from 1999 (AAMR: 3.18, 95% CI: 2.97-3.39) to 2017 (AAMR: 3.20, 95% CI: 3.02-3.38). The AAMR for osteomyelitis associated with diabetes was higher in males (AAMR: 4.36, 95% CI: 4.28-4.44) than in females (AAMR: 2.31, 95% CI: 2.26-2.36). From 1999 to 2017, the AAMR from osteomyelitis in this population was 2.63 (95% CI: 2.44-2.82) per 1,000,000 person-years in 1999 and 4.25 (95% CI: 4.05-4.46) per 1,000,000 person-years in 2017. CONCLUSIONS: We found an increase in the age-adjusted mortality rates of RA and osteomyelitis and a decrease of osteoporosis associated with diabetes from 1999 to 2017. We suggest that increased attention should therefore be given to these diseases in the population with diabetes, especially in efforts to develop preventative and treatment strategies.