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We submerged map turtles (Graptemys geographica) from Wisconsin in water equilibrated with air (normoxic) and in water equilibrated with nitrogen (anoxic) at 3 [degrees] C. Before submergence and for periods up to 150 days of submergence, plasma [PO.sub.2], [PCO.sub.2], pH, [[Cl.sup.-]], [[Na.sup.+]], [[K.sup.+], total Mg, total Ca, lactate, glucose, and osmolality were measured; hematocrit and body mass were determined, and plasma [MATHEMATICAL EXPRESSION NOT REPRODUCIBLE IN ASCII] was calculated. Turtles in anoxic water developed a severe metabolic acidosis, accumulating lactate from a predive value of 1.7 to 116 mmol/L, associated with a fall in pH from 8.010 to 7.128. Total calcium and magnesium rose from 3.5 and 2.0 to 25.7 and 7.6 mmol/L, respectively, helping to buffer the accumulating lactate. Plasma [MATHEMATICAL EXPRESSION NOT REPRODUCIBLE IN ASCII] was titrated from 44.7 to 4.3 mmol/L in anoxic turtles. Only minor disturbances occured in those turtles submerged in normoxic water; there was a marked increase in hematocrit from 31.1 to 51.9%. We suggest that map turtles have an obligatory requirment for a hibernaculum that provides well-oxygenated water and that this requirement is important in determining their distribution.

Quantum entanglement is the central resource behind quantum information science, from quantum computation and simulation to enhanced metrology and secure communication. These applications require the quantum control of large networks of qubits to realize gains and speed increases over conventional devices. However, propagating entanglement becomes difficult or impossible as the system grows in size. Here, we demonstrate the first step in a modular approach to scaling entanglement by using complementary quantum buses on a collection of three atomic ion qubits stored in two remote ion trap modules. Entanglement within a module is achieved with deterministic near-field interactions through phonons, and remote entanglement between modules is achieved with a probabilistic interaction through photons. This minimal system allows us to address generic issues in the synchronization of entanglement with multiple buses. It points the way towards a modular large-scale quantum information architecture that promises less spectral crowding and thus potentially less decoherence as the number of qubits increases. We generate this modular entanglement faster than the observed remotely entangled qubit-decoherence rate, showing that entanglement can be scaled simply by adding more modules. [ABSTRACT FROM AUTHOR]

Background: Recovery from critical illness can be prolonged and can result in a number of significant short- and long-term psychological consequences. These may be associated with the patient's perception of the intensive care experience. Aim: The aims of the study were to assess patients' perceptions of their intensive care unit (ICU) experience and the effect of these on anxiety, depression and post-traumatic stress up to 6 months after discharge. Method: One hundred and three participants were recruited from six ICUs from one Critical Care Network in the United Kingdom. A prospective, longitudinal study was designed to assess anxiety, depression, post-traumatic stress symptomatology and patients' perceptions of their intensive care experience. Data were collected on three occasions: after intensive care discharge and before hospital discharge, and 2 months and 6 months later. Measures included the impact of events scale, hospital anxiety and depression scale and intensive care experience questionnaire. Results: Anxiety, depression, avoidance and intrusion scores did not significantly reduce over time. At hospital discharge there was a significant association between patients' perceptions of their intensive care experience and anxiety, depression, avoidance and intrusion scores at hospital discharge. Conclusion: Standardised assessment of an intensive care experience is important. It provides information about the patient experience which can inform care practice within ICU, following discharge to the ward and, in the longer term, rehabilitation. [ABSTRACT FROM AUTHOR]

Aim: The aim of the research was to understand how nurses used technology to wean patients from mechanical ventilation. Background: The literature concerned with the development of critical care centres on the role of technology with little emphasis on the nursing contribution. Design: An ethnographic approach was used to understand how nurses used technology to wean patients from mechanical ventilation. Methods: Data were gathered by participant observation and interviewing over a 6-month period. In total, 250 h of field notes were recorded. Results: Data were analysed by the content analysis method. Knowing the patient was a central theme identified. Three sub-themes were identified: ways of knowing, continuity of care and the role of the patient in the weaning trajectory. Conclusion: 'Knowing the patient' was implied during the interviews as essential to the delivery of patient-centred care. There were two main factors that needed to be present in order for nurses to know their patients: continuity of care and expertise. 'Ways of knowing' was reliant on gaining information about the patient. The role of the patient was a passive recipient of treatment. Implications for practice: Knowing the patient has been defined as a characteristic of expert nursing. To be truly patient-centred nursing needs to address the barriers that prevent nurses from getting to 'know' their patients. [ABSTRACT FROM AUTHOR]