Automatic Detection of Nuclear Spins at Arbitrary Magnetic Fields via Signal-to-Image AI Model

Quantum sensors leverage matter's quantum properties to enable measurements with unprecedented spatial and spectral resolution. Among these sensors, those utilizing nitrogen-vacancy (NV) centers in diamond offer the distinct advantage of operating at room temperature. Nevertheless, signals received from NV centers are often complex, making interpretation challenging. This is especially relevant in low magnetic field scenarios, where standard approximations for modeling the system fail. Additionally, NV signals feature a prominent noise component. In this Letter, we present a signal-to-image deep learning model capable of automatically inferring the number of nuclear spins surrounding a NV sensor and the hyperfine couplings between the sensor and the nuclear spins. Our model is trained to operate effectively across various magnetic field scenarios, requires no prior knowledge of the involved nuclei, and is designed to handle noisy signals, leading to fast characterization of nuclear environments in real experimental conditions. With detailed numerical simulations, we test the performance of our model in scenarios involving varying numbers of nuclei, achieving an average error of less than 2 kHz in the estimated hyperfine constants.

Prognosis of polymerase epsilon (POLE) mutation in high-grade endometrioid endometrial cancer: Systematic review and meta-analysis

BACKGROUND

POLE mutated endometrial carcinomas may represent a subspecific type of tumors harboring a more favorable prognosis. Grade 3 (G3 or high-grade) endometrioid endometrial carcinomas remain a clinical dilemma, with some tumors behaving as the low-grade counterparts and others presenting a more aggressive behavior.

OBJECTIVES

To determine the association between POLE mutational status and the overall-survival (OS) and progression-free-survival (PFS) of patients with G3 endometrioid endometrial cancer (EC). We also aimed to determine the prevalence of POLE mutations in G3 endometrioid EC.

METHODS

We conducted a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO No: CRD4202340008). We searched the following electronic databases: PubMed/Medline, EMBASE, Cochrane Library, Scopus, and Web of Science. For time-to-event data, the effect of POLE mutation in G3 EC was described using hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). Individual patient data for each study was investigated if available from the study authors. If individual patient data were not available, information regarding time-to-event outcomes was extracted using an appropriate methodology. OS and PFS were analyzed using both one-stage and two-stage approaches, the Kaplan-Meier method, and Cox-proportional hazards models.

RESULTS

This systematic review and meta-analysis included 19 studies with 3092 patients who had high-grade endometrioid EC. Patients with POLE mutations had lower risks of death (HR = 0.36, 95% CI 0.26 to 0.50, I2 = 0%, 10 trials) and disease progression (HR = 0.31, 95% CI 0.17 to 0.57, I2 = 33%, 10 trials). The pooled prevalence of POLE mutation was 11% (95% CI 9 to 13, I2 = 68%, 18 studies).

CONCLUSION

POLE mutations in high-grade endometrioid EC are associated with a more favorable prognosis with increased OS and PFS.

Quantum neural networks with multi-qubit potentials

We propose quantum neural networks that include multi-qubit interactions in the neural potential leading to a reduction of the network depth without losing approximative power. We show that the presence of multi-qubit potentials in the quantum perceptrons enables more efficient information processing tasks such as XOR gate implementation and prime numbers search, while it also provides a depth reduction to construct distinct entangling quantum gates like CNOT, Toffoli, and Fredkin. This simplification in the network architecture paves the way to address the connectivity challenge to scale up a quantum neural network while facilitating its training.

High-Resolution NMR Spectroscopy at Large Fields with Nitrogen Vacancy Centers

Ensembles of nitrogen-vacancy (NV) centers are used as sensors to detect nuclear magnetic resonance signals from micron-sized samples at room temperature. In this scenario, the regime of large magnetic fields is especially interesting as it leads to a large nuclear thermal polarization-thus, to a strong sensor response even in low concentration samples-while chemical shifts and J couplings become more accessible. Nevertheless, this regime remains largely unexplored owing to the difficulties of coupling NV-based sensors with high-frequency nuclear signals. In this Letter, we circumvent this problem with a method that maps the relevant energy shifts in the amplitude of an induced nuclear spin signal that is subsequently transferred to the sensor. This stage is interspersed with free-precession periods of the sample nuclear spins where the sensor does not participate. Thus, our method leads to high spectral resolutions ultimately limited by the coherence of the nuclear spin signal.

"Mesenteric stripping using a Veress needle: A creative approach to resect small bowel disease in advanced ovarian cancer"

Small bowel involvement in patients with advanced ovarian cancer has been associated with a worse prognosis and recent data suggests it can be an independent factor associated with shorter disease-free interval (Casales Campos et al., 2022). In the upfront cytoreductive setting, small bowel residual disease (serosa and mesentery) has been identified as the most common site of residual disease (Heitz et al., 2016). The morbidity associated with multiple small bowel resections and the length of the remaining small bowel constitute major limiting factors. As the surgical armamentarium of the gynecologic oncologist has considerably broaden to include more radical procedures, addressing miliary small bowel disease remains extremely important in the quest to achieve complete gross resection (CGR) and thus improving the overall prognosis (Jurado and Chiva, 2021). We present a case of a patient with stage IIIC high grade serous ovarian carcinoma that already had started neoadjuvant chemotherapy before presenting for surgical options. After 4 cycles of carboplatin and paclitaxel, the patient was offered interval cytoreductive surgery plus HIPEC with cisplatin. During surgical exploration, miliary small bowel mesenteric disease was noted but with a grossly intact jejunoileal serosa. The patient underwent bilateral diaphragmatic stripping, cholecystectomy, extraperitoneal hysterectomy and multiple parietal peritonectomies. A decision was made to perform a mesenterectomy using a Veress needle. A standard insuflator was utilized to a maximum pressure of 4 mmHg. CGR was achieved and the patient underwent HIPEC as per institution protocol. The post operative course was uneventful and the patient was discharged five days after surgery. She is currently free of disease (20 months after surgery).

Tailored ion beam for precise colour centre creation

We present an invariant-based quantum control scheme leading to a highly monochromatic ion beam from a Paul trap. Our protocol is implementable by supplying the segmented electrodes in the trap with voltages of the order of volts. This mitigates the impact of fluctuations in previous designs and leads to a low-dispersion beam of ions. Moreover, our proposal does not rely on sympathetically cooling ions, which bypasses the need of loading different species in the trap-namely, the propelled ion and, e.g. a [Formula: see text] to exert sympathetic cooling-significantly incrementing the repetition rate of the launching procedure. Our scheme is based on an invariant operator linear in position and momentum, which enables us to control the average extraction energy and the outgoing momentum spread. In addition, we propose a sequential operation to tailor the transversal properties of the beam before the ejection to minimize the impact spot and to increase the lateral resolution of the implantation. This article is part of the theme issue 'Shortcuts to adiabaticity: theoretical, experimental and interdisciplinary perspectives'.

A single-center comparison of our initial experiences in treating penile and urethral cancer with video-endoscopic inguinal lymphadenectomy (VEIL) and later experiences in melanoma cases

Background

Video-endoscopic inguinal lymphadenectomy (VEIL) is a minimally invasive approach that is increasingly indicated in oncological settings, with mounting evidence for its long-term oncological safety.

Objectives

To present our single-center experience of treating penile and urethral cancer with VEIL, as well as its more recent application in melanoma patients.

Methods

We prospectively recorded our experiences with VEIL from September 2010 to July 2018, registering the patient primary indication, surgical details, complications, and follow-up.

Results

Twenty-nine patients were operated in one (24) or both (5) groins; 18 had penile cancer, 1 had urethral cancer, and 10 had melanoma. A mean 8.62 ± 4.45 lymph nodes were removed using VEIL and of these, an average of 1.00 ± 2.87 were metastatic; 16 patients developed lymphocele and 10 presented some degree of lymphedema; there were no skin or other major complications. The median follow-up was 19.35 months; there were 3 penile cancer patient recurrences in the VEIL-operated side. None of the melanoma patients presented a lymphatic inguinal recurrence.

Conclusions

VEIL is a minimally invasive technique which appears to be oncologically safe showing fewer complications than open surgery. However, complications such as lymphorrhea, lymphocele, or lymphedema were not diminished by using VEIL.

Retroileal colorectal anastomosis after left-sided or transverse colectomy for advanced serous carcinoma of the ovary or uterus

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In advanced or recurrent ovarian and uterine cancer, the ability to achieve optimal cytoreduction is a prognostic factor.

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Colonic resections are commonly required to achieve minimal or no residual disease.

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The retroileal technique can be used to achieve complete gross resection in cytoreductive surgery for gynecologic malignancy.

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Lack of postoperative complications and acceptable time interval to return of bowel function suggest this technique is safe.

The ability to achieve complete or optimal cytoreduction in advanced or recurrent ovarian and uterine cancer is a well-established prognostic factor. Colonic resections are commonly required to achieve minimal or no residual disease. When multiple colonic resections are required there is a corresponding difficulty in obtaining sufficient colonic mobility to create tension-free anastomoses for restoration of gastrointestinal continuity; specifically, when a left hemicolectomy or a transverse colectomy is required in addition to a rectosigmoid resection, it may be difficult to achieve a tension-free colorectal anastomosis. We describe the use of retroileal routing of the colon to address this scenario in the context of gynecologic cancer debulking surgery. We report four cases in which the surgeon encountered limited colonic mobility after performing either a left hemicolectomy or a transverse colonic resection in addition to a rectosigmoid resection. In using a retroileal path to perform the colorectal anastomosis, we were able to achieve well-perfused and tension-free anastomoses. Complete gross resection was achieved in all four cases, with acceptable rates of perioperative complications.

Right upper quadrant cytoreductive procedures and cardiophrenic lymph node resection in primary debulkig surgery for ovarian cancer

Upfront debulking surgery followed by adjuvant chemotherapy still remains as the mainstay approach to patients with advanced ovarian cancer (Eisenhauer et al., 2006). Upper abdominal surgery is often required to achieve complete gross resection and there are several studies in the literature reporting increased survival, as well as a minimal but acceptable increase in morbidity, as a result of this shift in the surgical paradigm (Chi et al., 2009). Cardiophrenic lymph nodes (CPLNs), also referred to as paracardiac and supradiaphragmatic lymph nodes, are located just above the diaphragm. In diseases such as advanced ovarian cancer, where there is often considerable abdominal and peritoneal tumor burden, these lymph nodes can harbor metastases. These nodes are usually larger than 5 mm in diameter and are easily identified on computed tomography. Evidence suggests that this finding should not preclude primary debulking surgery (if resectable disease in the abdomen) as it is associated with an increased median overall survival even in stage IV disease (Cowan et al., 2017, Prader et al., 2016). We present a video highlighting one of the most commonly performed debulking procedures in the upper abdomen - right diaphragmatic peritoneal stripping (the patient had multiple small implants in both the diaphragmatic peritoneum and Morisońs Pouch peritoneum, so en bloc resection was performed) - followed by a transabdominal excision of an enlarged right cardiophrenic lymph node. The defect was closed with a 2-0 polypropylene running suture.

Speeding up quantum perceptron via shortcuts to adiabaticity

The quantum perceptron is a fundamental building block for quantum machine learning. This is a multidisciplinary field that incorporates abilities of quantum computing, such as state superposition and entanglement, to classical machine learning schemes. Motivated by the techniques of shortcuts to adiabaticity, we propose a speed-up quantum perceptron where a control field on the perceptron is inversely engineered leading to a rapid nonlinear response with a sigmoid activation function. This results in faster overall perceptron performance compared to quasi-adiabatic protocols, as well as in enhanced robustness against imperfections in the controls.

P704 Mechanical complications of acute myocardial infarction in the era of early reperfusion therapy: a case report

Introduction

Left ventricular pseudoaneurysm is a rare mechanical complication of myocardial infarction, and its incidence has decreased with the widespread use of reperfusion therapies. Pseudoaneurysm is the result of a free wall rupture contained by pericardial adherences and mural thrombi, which contain the bleeding and prevent cardiac tamponade.

Clinical Presentation

A 68-year-old woman who had hypertension, diabetes mellitus and chronic kidney disease (caused by diabetic nephropathy) was first admitted with acute myocardial infarction of the inferior wall. Emergent coronary angiography revealed proximal occlusion of the right coronary artery. Primary angioplasty was performed with three stents implantation. However due to transitory no reflow, verapamil, nitrate and intracoronary abciximab were administered with recovery of coronary flow. Patient remained stable, without recurrence of symptoms. Echocardiography, at discharge, showed normal biventricular function and no mechanical complications.

Two months later, the patient was readmitted in the emergency room with constant chest pain, fatigue, prostration and loss of appetite beginning ten days earlier and an episode of syncope. Physical examination revealed fever, cardiac auscultation was rhythmic and without murmurs or pericardial friction rub, and pulmonary auscultation revealed crackles in inferior hemithorax. 12-lead electrocardiogram showed sinus rhythm, Q waves and negative T waves in inferior leads. Blood tests revealed leucocytosis, high sensibility troponin I was 28,8 ng/L and brain natriuretic peptide was 264,9 pg/mL. Chest-X-ray demonstrated enlargement of the cardiac silhouette and echocardiography showed moderate to large pericardial effusion with large amounts of fibrin close to right cardiac chambers and a basal inferior pseudoaneurysm with 23 mm x 24 mm; intracavitary contrast was administered without opacification of pericardial space; biventricular function remained normal.

Patient was promptly admitted on Cardiac Intensive Care Unit with diagnosis of pseudoaneurysm due to myocardial infarction. Therapeutic with ticagrelor was suspended and surgical correction was proposed, after discussion in Heart Team. False aneurysm correction was performed with a bovine pericardial patch without complications, and the patient was discharged asymptomatic eight days later.

Conclusion

Even with lower incidence, pseudoaneurysms remains as a potential life-threatening due to its high risk of rupture. Prompt diagnosis, usually with echocardiography and surgical referral are crucial.

Abstract P704 Figure. Inferior Pseudoaneurysm

Modulated Continuous Wave Control for Energy-Efficient Electron-Nuclear Spin Coupling

We develop energy efficient, continuous microwave schemes to couple electron and nuclear spins, using phase or amplitude modulation to bridge their frequency difference. These controls have promising applications in biological systems, where microwave power should be limited, as well as in situations with high Larmor frequencies due to large magnetic fields and nuclear magnetic moments. These include nanoscale NMR where high magnetic fields achieves enhanced thermal nuclear polarization and larger chemical shifts. Our controls are also suitable for quantum information processors and nuclear polarization schemes.

Long-term oncological results of treatment for high-risk prostate cancer using radical prostatectomy in a cancer hospital

OBJECTIVES

To analyse the most relevant oncologic results of treatment using radical prostatectomy (RP) for high-risk prostate cancer (HRPC) in a specialist cancer hospital.

MATERIAL AND METHODS

A descriptive retrospective study of RP was conducted at our centre from 1986 to 2017 on HRPC whose primary objective was to determine overall survival (OS) and cancer-specific survival (CSS). The study's secondary objectives were to determine biochemical progression-free survival (BPFS), metastasis-free survival (MFS), rescue therapy-free survival (RTFS), hormone therapy-free survival (HTFS) and the development of castration-resistant prostate cancer. We performed a Cox regression analysis to establish predictive models and to better understand the weight of each variable that defines high risk.

RESULTS

A total of 2093 RPs were performed, 480 (22.9%) of which were for HRPC. The median follow-up for the overall series was 79.57 months (P_25-75 37.92-135.16). Lymphadenectomy was not performed in 6.5% of the cases. The lymphadenectomy was of the obturator type in 51.2% of the cases and extended in 42.3%. Overall survival at 5, 10 and 15 years was 89.8% (95% CI 86.7-92.9%), 73.3% (95% CI 68-78.6%) and 51.4% (95% CI 43.8-59%), respectively. CSS at 5, 10 and 15 years was 94.8% (95% CI 92.4-97.2%), 84.0% (95% CI 79.3-88.7%) and 75.5% (95% CI 68.8-82.2%), respectively. MFS at 5, 10 and 15 years was 87.4% (95% CI 84.1-90.7%), 72.2% (95% CI 66.7-77.7%) and 61.7% (95% CI 54.3-69.1%), respectively. A total of 120 patients of 477 analysed (25.1%) required rescue radiation therapy, and 293/477 never required hormone therapy (61.4%). Of the 93 pN1 patients, 33 (35.5%) did not require hormone therapy. The time from RP to biochemical progression was the variable with the greatest prognostic weight for MFS, CSS and overall survival.

CONCLUSIONS

RP plus extended lymphadenectomy should be the first therapeutic manoeuvre when feasible within a multimodal strategy. A longer follow-up of the series is needed to validate the hypothesis of better oncologic results based on the earlier implementation of rescue radiation therapy, extended lymphadenectomy and drugs that prolong survival in the CRPC phase.

Soft Quantum Control for Highly Selective Interactions among Joint Quantum Systems

We propose a quantum control scheme aimed at interacting systems that gives rise to highly selective coupling among their near-to-resonance constituents. Our protocol implements temporal control of the interaction strength, switching it on and off again adiabatically. This soft temporal modulation significantly suppresses off-resonant contributions in the interactions. Among the applications of our method we show that it allows us to perform an efficient rotating-wave approximation in a wide parameter regime, the elimination of side peaks in quantum sensing experiments, and selective high-fidelity entanglement gates on nuclear spins with close frequencies. We apply our theory to nitrogen-vacancy centers in diamond and demonstrate the possibility for the detection of weak electron-nuclear coupling under the presence of strong perturbations.

Late Retroperitoneal Hematoma with Abscess Formation Following Laparoscopic Staging of Endometrial Cancer

Herein, we report a case of a 63-year-old, nonobese, woman who underwent laparoscopic surgical staging for endometrial cancer with pelvic and para-aortic lymph node dissection. After being discharged, the patient presented to the emergency department with fever and abdominal pain, 1 week after the procedure. Abdominal tenderness, fever, and anemia were the key clinical and laboratory findings. A computed tomography (CT) scan revealed a cystic mass with air bubbles, located in the right iliopsoas region. The features were consistent with an infected hematoma at the right iliopsoas region, which was managed with antibiotics and CT-guided pigtail drainage. Laparoscopic surgical staging for endometrial cancer has been shown to have fewer early complications than open surgery. However, complications can still occur in the most experienced hands. Abscess arising from hematomas after laparoscopic surgical staging can be managed adequately with noninvasive CT-guided drainage.

PCA3 as a second-line biomarker in a prospective controlled randomized opportunistic prostate cancer screening programme

OBJECTIVES

PCA3 performance as a single second line biomarker is compared to the European Randomised Study of Screening for Prostate Cancer risk calculator model 3 (ERSPC RC-3) in an opportunistic screening in prostate cancer (PCa).

MATERIAL AND METHODS

5,199 men, aged 40-75y, underwent prostate-specific antigen (PSA) screening and digital rectal examination (DRE). Men with a normal DRE and PSA ≥3ng/ml had a PCA3 test done. All men with PCA3 ≥35 underwent an initial biopsy (IBx) -12 cores-. Men with PCA3 <35 were randomized 1:1 to either IBx or observation. We compared them to those obtained with ERSPC RC-3.

RESULTS

PCA3 test was performed on 838 men (16.1%). In PCA3(+) and PCA3(-) groups, global PCa detection rates were 40.9% and 14.7% with a median follow-up (FU) of 21.7 months (P<.001). In the PCA3(+) arm (n=301, 35.9%), PCa was identified in 115 men at IBx (38.2%). In the randomized arm, 256 underwent IBx and PCa was found in 46 (18.0%) (P<.001). The biopsy-sparing potential would have been 64.1% as opposed to 76.6% if we had used ERSPC RC-3. However, the estimated false negative cases for HGPCa would have been reduced by 37.1% (89 to 56 patients). Moreover, if we had applied PCA3-35 to avoid IBx, 14.7% PCa and 9.1% of clinical significant PCa patients would not have been diagnosed during this FU.

CONCLUSIONS

When PCA3-35 is used as a second-line biomarker when PSA ≥3ng/ml and DRE is normal, IBx could be avoided in 12.5% less than if ERSPC RC-3 is used and would reduce the false negative cases by 36.2%. At a FU of 21.7 months, this dual protocol would miss 9.1% of clinically significant PCa, so strict FU is mandatory with established biopsy criteria based on PSA and DRE in cases with PCA3 <35.

Extraskeletal osteosarcoma: A European Musculoskeletal Oncology Society study on 266 patients

PURPOSE

Prognosis of extraskeletal osteosarcoma (ESOS) is reported to be poorer than that of skeletal osteosarcoma. This multicenter retrospective study aimed to evaluate factors influencing ESOS prognosis.

PATIENTS AND METHODS

Members of the European Musculoskeletal Oncology Society (EMSOS) submitted institutional data on patients with ESOS.

RESULTS

Data from 274 patients treated from 1981 to 2014 were collected from 16 EMSOS centres; 266 patients were eligible. Fifty (18.7%) had metastases at diagnosis. Of 216 patients with localised disease, 211 (98%) underwent surgery (R0 = 70.6%, R1 = 27%). Five-year overall survival (OS) for all 266 patients was 47% (95% CI 40-54%). Five-year OS for metastatic patients was 27% (95% CI 13-41%). In the analysis restricted to the 211 localised patients who achieved complete remission after surgery 5-year OS was 51.4% (95% CI 44-59%) and 5-year disease-free survival (DFS) was 43% (95% CI 35-51%). One hundred twenty-one patients (57.3%) received adjuvant or neoadjuvant chemotherapy and 80 patients (37.9%) received radiotherapy. A favourable trend was seen for osteosarcoma-type chemotherapy versus soft tissue sarcoma-type (doxorubicin ± ifosfamide) regimens. For the 211 patients in complete remission after surgery, patient age, tumour size, margins and chemotherapy were positive prognostic factors for DFS and OS by univariate analysis. At multivariate analysis, patient age (≤40 years versus >40 years) (P = 0.05), tumour size (P = 0.0001) and receipt of chemotherapy (P = 0.006) were statistically significant prognostic factors for survival.

CONCLUSION

Patient age and tumour size are factors influencing ESOS prognosis. Higher survival was observed in patients who received perioperative chemotherapy with a trend in favour of multiagent osteosarcoma-type regimen which included doxorubicin, ifosfamide and cisplatin.

Congenital pulmonary lymphangiectasia and chylothorax - a case series

Congenital pulmonary lymphangiectasia (CPL) and chylothorax (CC) are rare lymphatic developmental disorders. We report six clinical cases of CPL and CC that were admitted to our level III neonatal intensive care unit over the last 20 years. One case of unilateral CC was successfully treated with pleuro-amniotic shunt; three cases of bilateral CC were associated to lung hypoplasia, hydrops fetalis, and generalized lymphangiectasias; one case of CPL was associated with obstructive congenital heart defect; one case of unilateral CC was successfully treated with thoracocentesis and medium-chain triglyceride diet. Mortality was high (66.6%).

Noise-Resilient Quantum Computing with a Nitrogen-Vacancy Center and Nuclear Spins

Selective control of qubits in a quantum register for the purposes of quantum information processing represents a critical challenge for dense spin ensembles in solid-state systems. Here we present a protocol that achieves a complete set of selective electron-nuclear gates and single nuclear rotations in such an ensemble in diamond facilitated by a nearby nitrogen-vacancy (NV) center. The protocol suppresses internuclear interactions as well as unwanted coupling between the NV center and other spins of the ensemble to achieve quantum gate fidelities well exceeding 99%. Notably, our method can be applied to weakly coupled, distant spins representing a scalable procedure that exploits the exceptional properties of nuclear spins in diamond as robust quantum memories.

Measuring Entanglement in a Photonic Embedding Quantum Simulator

Measuring entanglement is a demanding task that usually requires full tomography of a quantum system, involving a number of observables that grows exponentially with the number of parties. Recently, it was suggested that adding a single ancillary qubit would allow for the efficient measurement of concurrence, and indeed any entanglement monotone associated with antilinear operations. Here, we report on the experimental implementation of such a device-an embedding quantum simulator-in photonics, encoding the entangling dynamics of a bipartite system into a tripartite one. We show that bipartite concurrence can be efficiently extracted from the measurement of merely two observables, instead of 15, without full tomographic information.

Fermion-fermion scattering in quantum field theory with superconducting circuits

We propose an analog-digital quantum simulation of fermion-fermion scattering mediated by a continuum of bosonic modes within a circuit quantum electrodynamics scenario. This quantum technology naturally provides strong coupling of superconducting qubits with a continuum of electromagnetic modes in an open transmission line. In this way, we propose qubits to efficiently simulate fermionic modes via digital techniques, while we consider the continuum complexity of an open transmission line to simulate the continuum complexity of bosonic modes in quantum field theories. Therefore, we believe that the complexity-simulating-complexity concept should become a leading paradigm in any effort towards scalable quantum simulations.

Obligatory information that a patient diagnosed of prostate cancer and candidate for an active surveillance protocol must know

OBJECTIVES

To know the necessary information to reproduce the results found in the literature on active surveillance (AS) in prostate cancer (PCa) in our own center so that the information would be objective and correctly given to the patients. We have aimed to study the percentage of candidates for AS chosen in our setting, and the data on infrastaging, subgrading and prediction of insignificant PCa, debugging the predictive value of clinical variables to improve our selection criteria and finally to analyze the results of our patients enrolled in AS.

MATERIALS AND METHODS

A retro- and prospective review of our data bases was performed. A one-year period was analyzed to know AS candidates. Analysis of our radical prostatectomy specimens for infrastaging, subgrading and prediction of insignificant PCa (Epstein's criteria) was made as well as a uni/multivariate analysis of clinical variables in patients with insignificant PCa in the specimen. A prospective validation was performed with overall survival and survival free of active treatment (SFAT) as endpoints in patients enrolled in AS.

RESULTS

Between October-2010/October-2011, 44.7% of our PCa were candidates for AS, but only 11.2% choose it. The percentages found for infrastaging, subgrading and prediction of insignificant PCa were 14%, 31.4% and 55.7%, respectively. However, only just 6 patients (6.97%) had≥pT3a+Gleason≥7+volume>0.5cc PCa. The multivariate analysis showed that PSA density and number of affected cores were independent predictors of insignificant PCa. With a mean follow-up of 36±39months, 63 out of 232 patients enrolled in AS went on to active treatment (27.1%), with only 13 due to anxiety without pathologic progression. Median time of SFAT was 72.7 months (CI 95% 30.9-114.4). SFAT at 24 months was 76.4% (69.7-83.1%) and at 48 months 58.1% (48.8-67.4%). Only 10 patients died (4.3%), 9 due to causes different of PCa. Estimated overall survival at 5 years was 92.8% (CI 95% 86.7-98.9%).

CONCLUSIONS

It should be mandatory to have the exact knowledge of the local data of each Center in order to objectively inform patients about prostate biopsy efficiency, and if percentages of infrastaging, subgrading and prediction of insignificant PCa are in accordance with the literature. At 3 years, we reproduced the results of the longest series of AS, so we have ascertained that our AS protocol can be implemented with increasingly more patients.

Twin anemia polycythemia sequence: a report of three cases

BACKGROUND

Vascular anastomoses in monochorionic placentas are the key factor in the develop- ment of several complications, including twin anemiapolycythemia sequence (TAPS). TAPS is an uncommon form of chronic fetofetal transfusion, characterized by large intertwin hemoglobin (Hb) differences in the absence of amniotic fluid discordances.

CASE

We report 3 unusual cases of spontaneous TAPS. Looking to the intertwin Hb differences, each case fits in a different stage of postnatal twin anemia-polycythemia classification. Five of the 6 twins had a good outcome despite major hemodynamic changes.

CONCLUSION

Spontaneous TAPS is by far more infrequent than its postlaser counterpart. Our report is somewhat uncommon due to the fact that the 3 cases were spontaneous, consecutive, and each one fit as an example of the various degrees of severity according to the described classifications of this condition.

Efficient quantum algorithm for computing n-time correlation functions

We propose a method for computing n-time correlation functions of arbitrary spinorial, fermionic, and bosonic operators, consisting of an efficient quantum algorithm that encodes these correlations in an initially added ancillary qubit for probe and control tasks. For spinorial and fermionic systems, the reconstruction of arbitrary n-time correlation functions requires the measurement of two ancilla observables, while for bosonic variables time derivatives of the same observables are needed. Finally, we provide examples applicable to different quantum platforms in the frame of the linear response theory.

Optimizing prostate cancer screening; prospective randomized controlled study of the role of PSA and PCA3 testing in a sequential manner in an opportunistic screening program

OBJECTIVES

To reduce unnecessary biopsies (Bx) in an opportunistic screening programme of prostate cancer.

MATERIAL AND METHODS

We perform a prospective evaluation of PCA3 as a second line biomarker in an opportunistic screening for prostate cancer (PCa). From September-2010 until September-2012, 2,366 men, aged 40-74 years and with >10 years life expectancy, were initially screened with PSA/digital rectal examination (DRE). Men with previous Bx or with recent urine infections were excluded. Men with abnormal DRE and/or PSA >3 ng/ml were submitted for PCA3. All men with PCA3 ≥ 35 underwent an initial biopsy (IBx) -12cores-. Men with PCA3 < 35 were randomized 1:1 to either IBx or observation. Re-biopsy(16-18 cores) criteria were PSA increase >.5 ng/ml at 4-6 months or PSAv > .75 ng/ml/year.

RESULTS

With median follow-up (FU) of 10.1 months, PCA3 was performed in 321/2366 men (13.57%), 289 at first visit and 32 during FU. All 110 PCA3+ men (34.3%) were biopsied and PCa was identified in 43 men in IBx (39.1%). In the randomized arm, 110 were observed and 101 underwent biopsy, finding 12 PCa (11.9%), showing a statistically significant reduction of PCa detection rate in this cohort (P<.001). Global PCa detection rates were 40.9% and 9.5% for the PCA3+ and PCA3- branches, respectively (P<.001). Area under the curve for PSA and PCA3 were .601 and .74, respectively. This is an ongoing prospective study limited by its short follow-up period and still limited enrolment.

CONCLUSIONS

PCA3 as a second line biomarker within an opportunistic dual screening protocol, can potentially avoid 65.7% and 50.1% biopsies at first round and at median FU of 10.1 months, respectively, just missing around 3.2% of high grade PCa.

From transistor to trapped-ion computers for quantum chemistry

Over the last few decades, quantum chemistry has progressed through the development of computational methods based on modern digital computers. However, these methods can hardly fulfill the exponentially-growing resource requirements when applied to large quantum systems. As pointed out by Feynman, this restriction is intrinsic to all computational models based on classical physics. Recently, the rapid advancement of trapped-ion technologies has opened new possibilities for quantum control and quantum simulations. Here, we present an efficient toolkit that exploits both the internal and motional degrees of freedom of trapped ions for solving problems in quantum chemistry, including molecular electronic structure, molecular dynamics, and vibronic coupling. We focus on applications that go beyond the capacity of classical computers, but may be realizable on state-of-the-art trapped-ion systems. These results allow us to envision a new paradigm of quantum chemistry that shifts from the current transistor to a near-future trapped-ion-based technology.

Radical prostatectomy is a reasonable treatment for patients over 70 years of age

OBJECTIVE

To compare the tumor nature and oncological course of patients operated on by radical prostatectomy in three age groups.

MATERIAL AND METHOD

From the prospective completion of the data base of our department, we analyzed 1012 patients operated on between 1986 and December 2009. Patients with neo- or adjuvant treatment and those with pre-operative PSA over 50 were excluded. The sample was divided into three groups: younger than 60, 60 to 69 and over 70. The clinical, pathological variables, biochemical course and need for rescue treatment were analyzed. We consider biochemical relapse as when the PSA values reached values greater than 0.4 in two consecutive measurements. Rescue was defined as the need for hormone treatment or radiotherapy. We then made a comparative study, a univariate survival analysis by Kaplan and Meyer Curves and multivariate by Cox's regression.

RESULTS

The median follow-up was 55.1 months. Of the 1012 patients included in the study, 317 patients (31.3%) had biochemical progression and 259 (25.6%) required rescue treatment. We observed that the groups with the older age had a significantly higher PSA and higher stages than the rest. No differences were observed in the Gleason score of the surgical specimen or in the state of the surgical margins. Biochemical relapse free survival at 5 years was 72.3% (CI 66.4-78.2) in patients under 60 years, 65.3% (CI 60.6-70.0) for patients under 70 and 62.2% (CI 53.2-71.1) for patients of 70 years or older; P<.05. In the univariate study, age was a factor that was significantly associated to biochemical relapse. However, it loses interest in the multivariate study and PSA, pathological state and Gleason score regain interest. Rescue treatment free survival did not differ by age groups.

CONCLUSIONS

In the current study, worse biochemical evolution of patients over 70 was observed. However, this worse biochemical course was conditioned by clinically more aggressive tumors that, in our opinion, justifies the decision made in regards to the surgical approach taken with these patients.

Embedding quantum simulators for quantum computation of entanglement

We introduce the concept of embedding quantum simulators, a paradigm allowing the efficient quantum computation of a class of bipartite and multipartite entanglement monotones. It consists in the suitable encoding of a simulated quantum dynamics in the enlarged Hilbert space of an embedding quantum simulator. In this manner, entanglement monotones are conveniently mapped onto physical observables, overcoming the necessity of full tomography and reducing drastically the experimental requirements. Furthermore, this method is directly applicable to pure states and, assisted by classical algorithms, to the mixed-state case. Finally, we expect that the proposed embedding framework paves the way for a general theory of enhanced one-to-one quantum simulators.

Quantum simulation of noncausal kinematic transformations

We propose the implementation of Galileo group symmetry operations or, in general, linear coordinate transformations in a quantum simulator. With an appropriate encoding, unitary gates applied to our quantum system give rise to Galilean boosts or spatial and time parity operations in the simulated dynamics. This framework provides us with a flexible toolbox that enhances the versatility of quantum simulation theory, allowing the direct access to dynamical quantities that would otherwise require full tomography. Furthermore, this method enables the study of noncausal kinematics and phenomena beyond special relativity in a quantum controllable system.

Sustainable complete remission in recurrence yolk sac tumor patient treated with tandem high-dose chemotherapy and autologous stem cell

A 21-year-old lady diagnosed with Stage 3 ovarian yolk sac tumor (YST) underwent primary cytoreductive fertility sparing surgery, followed by conventional courses of platinum-based chemotherapy and etoposide. Recurrence at cul-da-sac was noted after a short period of remission and secondary debulking performed followed by four cycles of conventional chemotherapy. The patient's disease progressed despite courses of treatments. A joint team management including a hematologist was commenced following the failure of conventional chemotherapies. Two cycles of high-dose chemotherapy (HDCT) with ifosfamide/cisplatin/etoposide (ICE) regimen, followed by autologous stem cell transplantation (ASCT) were given. With this salvage treatment, she remained in complete remission and disease-free for more than 30 months, while maintaining her reproductive function. These approaches appear to be effective as a salvage treatment in selected cases of patients with ovarian germ cell tumor, especially those who failed primary conventional chemotherapy.

Digital quantum simulation of the Holstein model in trapped ions

We propose the implementation of the Holstein model by means of digital methods in a linear chain of trapped ions. We show how the simulation fidelity scales with the generation of phononic excitations. We propose a decomposition and a stepwise trapped-ion implementation of the Holstein Hamiltonian. Via numerical simulations, we study how the protocol is affected by realistic gates. Finally, we show how measurements of the size of the simulated polaron can be performed.