An essential review of Singapore’s response to out-of-hospital cardiac arrests: improvements over a ten-year period

Care for patients who experience out-of-hospital cardiac arrest (OHCA) has rapidly evolved in the past decade. Increased sophistication of care in the community, emergency medical services (EMS) and hospital setting is associated with improved patient-centred outcomes. Notably, Utstein survival doubled from 11.6% to 23.1% between 2011 and 2016. These achievements involved collaboration between policymakers, clinicians and researchers, and were made possible by a strategic interplay of policy, research and implementation. We review the development and current state of OHCA in Singapore using primary population-based data from the Pan-Asian Resuscitation Outcomes Study and an unstructured search of research databases. We discuss the roles of important milestones in policy, community, dispatch, EMS and hospital interventions. Finally, we relate these interventions to relevant processes and outcomes, such as the relationship between the strategic implementation of bystander cardiopulmonary resuscitation and placement of automated external defibrillator with return of spontaneous circulation, survival to discharge and survival with favourable neurological outcomes.

Clinical differentiation of psychogenic non-epileptic seizure: a practical diagnostic approach

Background Psychogenic non-epileptic seizure (PNES) has long been the counterpart of epileptic seizure (ES). Despite ample of evidence differentiating the two, PNES mistakenly diagnosed as ES was still common, resulting in unnecessary exposure to long-term antiepileptic medications and reduced patient’s and caregiver’s quality of life, not to mention the burgeoning financial costs. Objectives In this review, we aimed to elucidate various differences between PNES and epileptic seizure with respect to baseline characteristics, seizure semiology, EEG pattern, and other key hallmark features. Methods An unstructured search was carried out in PubMed, MEDLINE, and EMBASE using keywords pertinent to PNES and ES differentiation. Relevant information was subsequently summarized herein. Results PNES differs significantly with ES in terms of baseline characteristics, prodromal symptoms, seizure semiology, presence of pseudosleep, and other hallmark features (for instance provoking seizure with suggestion). The combined approach, if applied appropriately, can yield high diagnostic yield. Conclusions PNES can be clearly differentiated from ES via careful adherence to a set of valid clinical cues. The summarized clinical hallmarks is highly useful to prevent unnecessary ES diagnosis and treatment with AEDs.

Grover’s Search with Faults on Some Marked Elements

Grover’s algorithm is a quantum query algorithm solving the unstructured search problem of size [Formula: see text] using [Formula: see text] queries. It provides a significant speed-up over any classical algorithm [3]. The running time of the algorithm, however, is very sensitive to errors in queries. Multiple authors have analysed the algorithm using different models of query errors and showed the loss of quantum speed-up [2, 6]. We study the behavior of Grover’s algorithm in the model where the search space contains both faulty and non-faulty marked elements. We show that in this setting it is indeed possible to find one of marked elements in [Formula: see text] queries. We also analyze the limiting behavior of the algorithm for a large number of steps and show the existence and the structure of a limiting state [Formula: see text].

The Constant Speedup Mechanism on Adiabatic Quantum Computation

In the adiabatic quantum computation model, a computational procedure is described by the continuous time evolution of a time dependent Hamiltonian. Classically, the unstructured search problem can be solved only in a running time of order O(G). However, by modifying the structure of local Hamiltonian or using specific interpolating functions, it is possible to do the calculation in constant time for a quantum computer. This paper reveals the cause that lead to the speedup. We analyze two kinds of specific adiabatic quantum models, and conclude that the value of relevant elements in back-diagonal of the local Hamiltonian is the main factors affecting the time complexity of adiabatic quantum algorithms. According to the speedup mechanism, we have proposed two kinds of adiabatic quantum algorithms to make a constant time complexity.