A web-based telemedicine system for low-resource settings 13 years on: insights from referrers and specialists

Background: One way to tackle health inequalities in resource-poor settings is to establish links between doctors and health professionals there and specialists elsewhere using web-based telemedicine. One such system run by the Swinfen Charitable Trust has been in existence for 13 years which is an unusually long time for such systems.

Objective: We wanted to gain some insights into whether and how this system might be improved.

Methods: We carried out a survey by questionnaire of referrers and specialists over a six months period.

Results: During the study period, a total of 111 cases were referred from 35 different practitioners, of whom 24% were not doctors. Survey replies were received concerning 67 cases, a response rate of 61 per cent. Eighty-seven per cent of the responding referrers found the telemedicine advice useful, and 78% were able to follow the advice provided. As a result of the advice received, the diagnosis was changed in 22% of all cases and confirmed in a further 18 per cent. Patient management was changed in 33 per cent. There was no substantial difference between doctors and non-doctors. During the study period, the 111 cases were responded to by 148 specialists, from whom 108 replies to the questionnaire were received, a response rate of 73 per cent. About half of the specialists (47%) felt that their advice had improved the management of the patients. There were 62 cases where it was possible to match up the opinions of the referrer and the consultants about the value of a specific teleconsultation. In 34 cases (55%) the referrers and specialists agreed about the value. However, in 28 cases (45%) they did not: specialists markedly underestimated the value of a consultation compared to referrers. Both referrers and specialist were extremely positive about the system which appears to be working well. Minor changes such as a clearer referral template and an improved web interface for specialists may improve it.

Experimental Quantum Networking Protocols via Four-Qubit Hyperentangled Dicke States

We report the experimental demonstration of two quantum networking protocols, namely quantum 1 -> 3 telecloning and open-destination teleportation, implemented using a four-qubit register whose state is encoded in a high-quality two-photon hyperentangled Dicke state. The state resource is characterized using criteria based on multipartite entanglement witnesses. We explore the characteristic entanglement-sharing structure of a Dicke state by implementing high-fidelity projections of the four-qubit resource onto lower-dimensional states. Our work demonstrates for the first time the usefulness of Dicke states for quantum information processing.

Tomographic characterisation of correlations in a photonic tripartite state

Starting from a four-partite photonic hyper-entangled Dicke resource, we report the full tomographic characterization of three-, two-, and one-qubit states obtained by projecting out part of the computational register. The reduced states thus obtained correspond to fidelities with the expected states larger than 87%, therefore certifying the faithfulness of the entanglement-sharing structure within the original four-qubit resource. The high quality of the reduced three-qubit state allows for the experimental verification of the Koashi-Winter relation for the monogamy of correlations within a tripartite state. We show that, by exploiting the symmetries of the three-qubit state obtained upon projection over the four-qubit Dicke resource, such relation can be experimentally fully characterized using only 5 measurement settings. We highlight the limitations of such approach and sketch an experimentally-oriented way to overcome them.

A balanced polymorphism in biomass resource allocation controlled by phosphate in grasses screened through arsenate tolerance

The response of arsenate and non-tolerant Holcus lanatus L. phenotypes, where tolerance is achieved through suppression of high affinity phosphate/arsenate root uptake, was investigated under different growth regimes to investigate why there is a polymorphism in tolerance found in populations growing on uncontaminated soil. Tolerant plants screened from an arsenic uncontaminated population differed, when grown on the soil from the populations origin, from non-tolerants, in their biomass allocation under phosphate fertilization: non-tolerants put more resources into tiller production and down regulated investment in root production under phosphate fertilization while tolerants tillered less effectively and did not alter resource allocation to shoot biomass under phosphate fertilization. The two phenotypes also differed in their shoot mineral status having higher concentrations of copper, cadmium, lead and manganese, but phosphorus status differed little, suggesting tight homeostasis. The polymorphism was also widely present (40%) in other wild grass species suggesting an important ecological role for this gene that can be screened through plant root response to arsenate.

Life Cycle Assessment guidelines for the sustainable production and recycling of aggregates:The Sustainable Aggregates Resource Management project (SARMa)

The mining/quarrying industry is a sector of industry where there are very few Life Cycle Assessment (LCA) tools, and where the role of LCA has been poorly investigated. A key issue is the integration of three inter-dependent life cycles: Project, Asset and Product. Given the unique features of mining LCAs, this Note from the Field presents a common methodology implemented within the Sustainable Aggregates Resource Management (SARMa) Project (www.sarmaproject.eu) in order to boost adoption of LCA in the aggregate industry in South Eastern Europe. The proposed methodology emphasises the importance of resource efficiency and recycling in the context of a Sustainable Supply Mix of aggregates for the construction industry. Through its adoption, aggregate producers, recyclers, and governmental planners would gain confidence with LCA tools and conduct consistent and meaningful life cycle analyses of natural and recycled aggregates. © 2011 Elsevier Ltd. All rights reserved.

The ParaPhrase Project:Parallel patterns for adaptive heterogeneous multicore systems

This paper describes the ParaPhrase project, a new 3-year targeted research project funded under EU Framework 7 Objective 3.4 (Computer Systems), starting in October 2011. ParaPhrase aims to follow a new approach to introducing parallelism using advanced refactoring techniques coupled with high-level parallel design patterns. The refactoring approach will use these design patterns to restructure programs defined as networks of software components into other forms that are more suited to parallel execution. The programmer will be aided by high-level cost information that will be integrated into the refactoring tools. The implementation of these patterns will then use a well-understood algorithmic skeleton approach to achieve good parallelism. A key ParaPhrase design goal is that parallel components are intended to match heterogeneous architectures, defined in terms of CPU/GPU combinations, for example. In order to achieve this, the ParaPhrase approach will map components at link time to the available hardware, and will then re-map them during program execution, taking account of multiple applications, changes in hardware resource availability, the desire to reduce communication costs etc. In this way, we aim to develop a new approach to programming that will be able to produce software that can adapt to dynamic changes in the system environment. Moreover, by using a strong component basis for parallelism, we can achieve potentially significant gains in terms of reducing sharing at a high level of abstraction, and so in reducing or even eliminating the costs that are usually associated with cache management, locking, and synchronisation. © 2013 Springer-Verlag Berlin Heidelberg.