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We propose a universal, on-chip quantum transducer based on surface acoustic waves in piezoactive materials. Because of the intrinsic piezoelectric (and/or magnetostrictive) properties of the material, our approach provides a universal platform capable of coherently linking a broad array of qubits, including quantum dots, trapped ions, nitrogen-vacancy centers, or superconducting qubits. The quantized modes of surface acoustic waves lie in the gigahertz range and can be strongly confined close to the surface in phononic cavities and guided in acoustic waveguides. We show that this type of surface acoustic excitation can be utilized efficiently as a quantum bus, serving as an on-chip, mechanical cavity-QED equivalent of microwave photons and enabling long-range coupling of a wide range of qubits.

The development of precise atomic clocks plays an increasingly important role in modern society. Shared timing information constitutes a key resource for navigation with a direct correspondence between timing accuracy and precision in applications such as the Global Positioning System. By combining precision metrology and quantum networks, we propose a quantum, cooperative protocol for operating a network of geographically remote optical atomic clocks. Using nonlocal entangled states, we demonstrate an optimal utilization of global resources, and show that such a network can be operated near the fundamental precision limit set by quantum theory. Furthermore, the internal structure of the network, combined with quantum communication techniques, guarantees security both from internal and external threats. Realization of such a global quantum network of clocks may allow construction of a real-time single international time scale (world clock) with unprecedented stability and accuracy. A proposed network of atomic clocks—using non-local entangled states—could achieve unprecedented stability and accuracy in time-keeping, as well as being secure against internal or external attack.

In order to best meet the needs of their clientele, practitioners in memory clinics need information about the characteristics of patients who do not meet the criteria for diagnosis of an organic mental disorder such as vascular dementia, Alzheimer's disease (AD), or mild cognitive impairment (MCI). In particular, concern about having or developing dementia may prompt ``cognitively healthy’’ people to visit memory clinics. In a pilot study, we investigated ``dementia worry’’ (DW) in addition to the socio-demographic characteristics, physical health risk-factors and psychological symptoms of memory clinic patients for whom dementia and MCI diagnoses were excluded after a comprehensive diagnostic work-up. Dementia worry has recently been defined as an “emotional reaction to the perceived threat of developing dementia” (Kessler et al., 2012). Accordingly, DW consists of both emotions (e.g. fear) and cognitions (e.g. thoughts, ruminations) regarding the perceived threat of developing dementia. Our study was evaluated by the Ethical Committee of the Medical Faculty Mannheim, University of Heidelberg.

Background There is a need to improve psychotherapeutic approaches to treatment for vulnerable older adults with depression in terms of both clinical practice and health care supply. Against this background, PSY-CARE is testing the feasibility and effectiveness of outpatient psychotherapy for home-living older adults in need of care with depression in Berlin, Germany, and neighboring suburban areas. Methods In a two-arm single-center pragmatic randomized controlled trial (RCT), manual-guided outpatient psychotherapy will be compared to brief psychosocial counseling. The study population will be compromised of older adults with clinically significant depressive symptoms who have a long-term care grade, as assessed by the German compulsory state nursing care insurance. In the intervention group, individual cognitive-behavioral psychotherapy tailored to the specific needs of this population will be offered by residential psychotherapists as part of the regular healthcare service. In the active control group, participants will receive individual psychosocial telephone counselling and a self-help guide. The planned sample size is N  = 130 ( n  = 65 participants per group). The reduction of depressive symptoms (primary outcome) as well as the maintaining of activities of daily living, quality of life, and functioning will be assessed with questionnaires provided at baseline, after the end of the intervention and after three months. Feasibility and process evaluation will be conducted qualitatively based on documentation and interviews with psychotherapists, gatekeepers and the participants. Discussion PSY-CARE investigates the potentials and limitations of providing outpatient psychotherapeutic treatment meeting the demands of vulnerable home-living older adults with depression under the real conditions of the health care system. The study will provide practical implications to improve access to and quality of outpatient psychotherapy for this poorly supplied population. Trial registration The trial is registered at ISRCTN55646265 ; February 15, 2019.

Clinical practice guidelines recommend antiplatelet and statin therapies as well as blood pressure control and tobacco cessation for secondary prevention in patients with established atherosclerotic cardiovascular diseases (ASCVDs). However, these strategies for risk modification are underused, especially in rural communities. Moreover, resources to support the delivery of preventive care to rural patients are fewer than those for their urban counterparts. Transformative interventions for the delivery of tailored preventive cardiovascular care to rural patients are needed. A multidisciplinary team developed a rural-specific, team-based model of care intervention assisted by clinical decision support (CDS) technology using participatory design in a sociotechnical conceptual framework. The model of care intervention included redesigned workflows and a novel CDS technology for the coordination and delivery of guideline recommendations by primary care teams in a rural clinic. The design of the model of care intervention comprised 3 phases: problem identification, experimentation, and testing. Input from team members (n=35) required 150 hours, including observations of clinical encounters, provider workshops, and interviews with patients and health care professionals. The intervention was prototyped, iteratively refined, and tested with user feedback. In a 3-month pilot trial, 369 patients with ASCVDs were randomized into the control or intervention arm. New workflows and a novel CDS tool were created to identify patients with ASCVDs who had gaps in preventive care and assign the right care team member for delivery of tailored recommendations. During the pilot, the intervention prototype was iteratively refined and tested. The pilot demonstrated feasibility for successful implementation of the sociotechnical intervention as the proportion of patients who had encounters with advanced practice providers (nurse practitioners and physician assistants), pharmacists, or tobacco cessation coaches for the delivery of guideline recommendations in the intervention arm was greater than that in the control arm. Participatory design and a sociotechnical conceptual framework enabled the development of a rural-specific, team-based model of care intervention assisted by CDS technology for the transformation of preventive health care delivery for ASCVDs.

We propose a protocol for creating a fully entangled GHZ-type state of neutral atoms in spatially separated optical atomic clocks. In our scheme, local operations make use of the strong dipole-dipole interaction between Rydberg excitations, which give rise to fast and reliable quantum operations involving all atoms in the ensemble. The necessary entanglement between distant ensembles is mediated by single-photon quantum channels and collectively enhanced light-matter couplings. These techniques can be used to create the recently proposed quantum clock network based on neutral atom optical clocks. We specifically analyze a possible realization of this scheme using neutral Yb ensembles.

We propose and analyze heralded quantum gates between qubits in optical cavities. They employ an auxiliary qubit to report if a successful gate occurred. In this manner, the errors, which would have corrupted a deterministic gate, are converted into a non-unity probability of success: once successful the gate has a much higher fidelity than a similar deterministic gate. Specifically, we describe that a heralded , near-deterministic controlled phase gate (CZ-gate) with the conditional error arbitrarily close to zero and the success probability that approaches unity as the cooperativity of the system, C, becomes large. Furthermore, we describe an extension to near-deterministic N- qubit Toffoli gate with a favorable error scaling. These gates can be directly employed in quantum repeater networks to facilitate near-ideal entanglement swapping, thus greatly speeding up the entanglement distribution.

Empirical studies in several disciplines including sociology, psychology and communications science have investigated images of older people in the mass media, but analyses to date have failed systematically to apply gerontological concepts and to compare the portrayal of old age with ‘real-world’ evidence. A model of older people's internal and external resources was used to assess the portrayal of older people in prime-time television drama series. Three hours of programmes broadcast over six weeks in 2001 of 32 prime-time television series on the four German networks with the largest market shares were examined. The age of 355 portrayed characters were estimated, and the socio-economic, health-related and psychological resources of the 30 characters rated as 60 years or older were assessed. Observational categories and rating dimensions were developed on the basis of the resource model. Older people were heavily under-represented, especially women and those of advanced old age. Furthermore, the representation of older people's social participation and financial resources was overly positive. Finally, older women and men were portrayed in traditional gender roles. The antecedents and consequences of the biased portrayals (of old and young people) are discussed from a psychological perspective.

IntroductionClinical practice guidelines facilitate optimal clinical practice. Point of care access, interpretation and application of such guidelines, however, is inconsistent. Informatics-based tools may help clinicians apply guidelines more consistently. We have developed a novel clinical decision support tool that presents guideline-relevant information and actionable items to clinicians at the point of care. We aim to test whether this tool improves the management of hyperlipidaemia, atrial fibrillation and heart failure by primary care clinicians.Methods/analysisClinician care teams were cluster randomised to receive access to the clinical decision support tool or passive access to institutional guidelines on 16 May 2016. The trial began on 1 June 2016 when access to the tool was granted to the intervention clinicians. The trial will be run for 6 months to ensure a sufficient number of patient encounters to achieve 80% power to detect a twofold increase in the primary outcome at the 0.05 level of significance. The primary outcome measure will be the percentage of guideline-based recommendations acted on by clinicians for hyperlipidaemia, atrial fibrillation and heart failure. We hypothesise care teams with access to the clinical decision support tool will act on recommendations at a higher rate than care teams in the standard of care arm.Ethics and disseminationThe Mayo Clinic Institutional Review Board approved all study procedures. Informed consent was obtained from clinicians. A waiver of informed consent and of Health Insurance Portability and Accountability Act (HIPAA) authorisation for patients managed by clinicians in the study was granted. In addition to publication, results will be disseminated via meetings and newsletters.Trial registration number NCT02742545.

The exciton-polariton modes of a quantum dot lattice embedded in a planar optical cavity are theoretically investigated. Umklapp terms, in which an exciton interacts with many cavity modes differing by reciprocal lattice vectors, appear in the Hamiltonian due to the periodicity of the dot lattice. We focus on Bragg polariton modes obtained by tuning the exciton and the cavity modes into resonance at high symmetry points of the Brillouin Zone. Depending on the microcavity design these polaritons modes at finite in-plane momentum can be guided and can have long lifetimes. Moreover, their effective mass can be extremely small, of the order of \\(10^{-8} m_0\\) (\\(m_0\\) is the bare electron mass), and they constitute the lightest exciton-like quasi-particles in solids.