Detailed history taking is of paramount importance to establish a reliable diagnosis in patients with transient loss of consciousness. In this article the clinical symptoms and signs of the ...successive phases of a syncopal episode are reviewed. A failure of the systemic circulation to perfuse the brain sufficiently results in a stereotyped progression of neurological symptoms and signs culminating in loss of consciousness; when transient, this is syncope. Prior to loss of consciousness the affected individual tends to exhibit unclear thinking, followed by fixation of the eyes in the midline and a ‘frozen’ appearance. Narrowing of the field of vision with loss of colour vision (‘greying’ out) and finally a complete loss of vision (hence ‘blacking’ out) occurs. Hearing loss may occur following loss of vision. This process may take as little as ∼7 s in cases of sudden complete circulatory arrest (e.g. abrupt asystole), but in other circumstances it may take longer depending on the rate and depth of cerebral hypoperfusion. Complete loss of consciousness occurs with the ‘turning up’ of the eyeballs. Profound cerebral hypoperfusion may be accompanied by myoclonic jerks.
The first highly enantioselective intermolecular Stetter reaction using simple enones is reported. A series of novel chiral BAC structures were designed and prepared. They were tested in the Stetter ...reaction with simple aldehydes and enones. The products were generated in excellent yields and enantioselectivities (up to 94% ee). Surprisingly, a substoichiometric amount of water was crucial to obtain high enantioselectivities. Chiral BACs were also shown to catalyze 1,6-conjugate addition reactions with paraquinone methides enantioselectively.
We introduce information-theoretic definitions for noise and disturbance in quantum measurements and prove a state-independent noise-disturbance tradeoff relation that these quantities have to ...satisfy in any conceivable setup. Contrary to previous approaches, the information-theoretic quantities we define are invariant under the relabelling of outcomes and allow for the possibility of using quantum or classical operations to "correct" for the disturbance. We also show how our bound implies strong tradeoff relations for mean square deviations.
A strong converse theorem for the classical capacity of a quantum channel states that the probability of correctly decoding a classical message converges exponentially fast to zero in the limit of ...many channel uses if the rate of communication exceeds the classical capacity of the channel. Along with a corresponding achievability statement for rates below the capacity, such a strong converse theorem enhances our understanding of the capacity as a very sharp dividing line between achievable and unachievable rates of communication. Here, we show that such a strong converse theorem holds for the classical capacity of all entanglement-breaking channels and all Hadamard channels (the complementary channels of the former). These results follow by bounding the success probability in terms of a “sandwiched” Rényi relative entropy, by showing that this quantity is subadditive for all entanglement-breaking and Hadamard channels, and by relating this quantity to the Holevo capacity. Prior results regarding strong converse theorems for particular covariant channels emerge as a special case of our results.
The dual of an entanglement-assisted quantum error-correcting (EAQEC) code is defined from the orthogonal group of a simplified stabilizer group. From the Poisson summation formula, this duality ...leads to the MacWilliams identities and linear programming bounds for EAQEC codes. We establish a table of upper and lower bounds on the minimum distance of any maximal-entanglement EAQEC code with length up to 15 channel qubits.
Epidemiology of inherited arrhythmias Offerhaus, Joost A; Bezzina, Connie R; Wilde, Arthur A M
Nature reviews cardiology,
04/2020, Volume:
17, Issue:
4
Journal Article
Peer reviewed
The primary electrical disorders are a group of inherited cardiac ventricular arrhythmias that are a major cause of sudden cardiac death in young individuals. Inherited ventricular arrhythmias result ...from mutations in genes encoding cardiac ion channels or their modulatory subunits. Advances in genetic screening in the past three decades have led to the assembly of large patient cohorts with these disorders. Studies in these patients, as well as in the general population, have striven to define the prevalence of these inherited arrhythmias and the characteristics of patients with different genetic subtypes of the disease. In this Review, we provide a comprehensive update on the epidemiology of inherited ventricular arrhythmias, focusing on natural history, prevalence and patient demographics. In addition, we summarize the various founder populations (groups of individuals with a disease that is caused by a genetic defect inherited from a common ancestor) that have been identified for some of these disorders and which lead to increased prevalence in some geographical regions. To date, although numerous studies have markedly increased our understanding of the epidemiology of these disorders, demographic data, especially from non-Western countries, remain scarce. Furthermore, defining the true prevalence of these disorders remains challenging. International collaboration will undoubtedly accelerate the collection of demographic information and improve the accuracy of prevalence data.
Entanglement-Assisted Quantum Turbo Codes Wilde, Mark M.; Min-Hsiu Hsieh; Babar, Zunaira
IEEE transactions on information theory,
02/2014, Volume:
60, Issue:
2
Journal Article
Peer reviewed
Open access
An unexpected breakdown in the existing theory of quantum serial turbo coding is that a quantum convolutional encoder cannot simultaneously be recursive and non-catastrophic. These properties are ...essential for quantum turbo code families to have a minimum distance growing with blocklength and for their iterative decoding algorithm to converge, respectively. Here, we show that the entanglement-assisted paradigm simplifies the theory of quantum turbo codes, in the sense that an entanglement-assisted quantum (EAQ) convolutional encoder can possess both of the aforementioned desirable properties. We give several examples of EAQ convolutional encoders that are both recursive and non-catastrophic and detail their relevant parameters. We then modify the quantum turbo decoding algorithm of Poulin , in order to have the constituent decoders pass along only extrinsic information to each other rather than a posteriori probabilities as in the decoder of Poulin , and this leads to a significant improvement in the performance of unassisted quantum turbo codes. Other simulation results indicate that entanglement-assisted turbo codes can operate reliably in a noise regime 4.73 dB beyond that of standard quantum turbo codes, when used on a memoryless depolarizing channel. Furthermore, several of our quantum turbo codes are within 1 dB or less of their hashing limits, so that the performance of quantum turbo codes is now on par with that of classical turbo codes. Finally, we prove that entanglement is the resource that enables a convolutional encoder to be both non-catastrophic and recursive because an encoder acting on only information qubits, classical bits, gauge qubits, and ancilla qubits cannot simultaneously satisfy them.
The purpose of this study was to determine risk factors that predict malignant ventricular arrhythmias (MVA) in Lamin A/C (LMNA) mutation carriers.
LMNA mutations cause a variety of clinical ...phenotypes, including dilated cardiomyopathy and conduction disease. Many LMNA mutation carriers have a poor prognosis, because of a high frequency of MVA and progression to end-stage heart failure. However, it is unclear how to identify mutation carriers that are at risk for MVA.
In this multicenter cohort of 269 LMNA mutation carriers, we evaluated risk factors for MVA, defined as sudden cardiac death, resuscitation, and appropriate implantable cardioverter-defibrillator (ICD) treatment.
In a median follow-up period of 43 months (interquartile range: 17 to 101 months), 48 (18%) persons experienced a first episode of MVA: 11 persons received successful cardiopulmonary resuscitation, 25 received appropriate ICD treatment, and 12 persons died suddenly. Independent risk factors for MVA were nonsustained ventricular tachycardia, left ventricular ejection fraction <45% at the first clinical contact, male sex, and non-missense mutations (ins-del/truncating or mutations affecting splicing). MVA occurred only in persons with at least 2 of these risk factors. There was a cumulative risk for MVA per additional risk factor.
Carriers of LMNA mutations with a high risk of MVA can be identified using these risk factors. This facilitates selection of LMNA mutation carriers who are most likely to benefit from an ICD.
Catecholaminergic polymorphic ventricular tachycardia (CPVT) and short QT syndrome (SQTS) are inherited arrhythmogenic disorders that can cause sudden death. Numerous genes have been reported to ...cause these conditions, but evidence supporting these gene-disease relationships varies considerably. To ensure appropriate utilization of genetic information for CPVT and SQTS patients, we applied an evidence-based reappraisal of previously reported genes.
Three teams independently curated all published evidence for 11 CPVT and 9 SQTS implicated genes using the ClinGen gene curation framework. The results were reviewed by a Channelopathy Expert Panel who provided the final classifications. Seven genes had definitive to moderate evidence for disease causation in CPVT, with either autosomal dominant (RYR2, CALM1, CALM2, CALM3) or autosomal recessive (CASQ2, TRDN, TECRL) inheritance. Three of the four disputed genes for CPVT (KCNJ2, PKP2, SCN5A) were deemed by the Expert Panel to be reported for phenotypes that were not representative of CPVT, while reported variants in a fourth gene (ANK2) were too common in the population to be disease-causing. For SQTS, only one gene (KCNH2) was classified as definitive, with three others (KCNQ1, KCNJ2, SLC4A3) having strong to moderate evidence. The majority of genetic evidence for SQTS genes was derived from very few variants (five in KCNJ2, two in KCNH2, one in KCNQ1/SLC4A3).
Seven CPVT and four SQTS genes have valid evidence for disease causation and should be included in genetic testing panels. Additional genes associated with conditions that may mimic clinical features of CPVT/SQTS have potential utility for differential diagnosis.
This paper studies the difficulty of discriminating between an arbitrary quantum channel and a “replacer" channel that discards its input and replaces it with a fixed state. The results obtained here ...generalize those known in the theory of quantum hypothesis testing for binary state discrimination. We show that, in this particular setting, the most general adaptive discrimination strategies provide no asymptotic advantage over non-adaptive tensor-power strategies. This conclusion follows by proving a quantum Stein’s lemma for this channel discrimination setting, showing that a constant bound on the Type I error leads to the Type II error decreasing to zero exponentially quickly at a rate determined by the maximum relative entropy registered between the channels. The strong converse part of the lemma states that any attempt to make the Type II error decay to zero at a rate faster than the channel relative entropy implies that the Type I error necessarily converges to one. We then refine this latter result by identifying the optimal strong converse exponent for this task. As a consequence of these results, we can establish a strong converse theorem for the quantum-feedback-assisted capacity of a channel, sharpening a result due to Bowen. Furthermore, our channel discrimination result demonstrates the asymptotic optimality of a non-adaptive tensor-power strategy in the setting of quantum illumination, as was used in prior work on the topic. The sandwiched Rényi relative entropy is a key tool in our analysis. Finally, by combining our results with recent results of Hayashi and Tomamichel, we find a novel operational interpretation of the mutual information of a quantum channel
N
as the optimal Type II error exponent when discriminating between a large number of independent instances of
N
and an arbitrary “worst-case” replacer channel chosen from the set of all replacer channels.
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