RESUMO
Quantum computers built with superconducting artificial atoms already stretch the limits of their classical counterparts. While the lowest energy states of these artificial atoms serve as the qubit basis, the higher levels are responsible for both a host of attractive gate schemes as well as generating undesired interactions. In particular, when coupling these atoms to generate entanglement, the higher levels cause shifts in the computational levels that lead to unwanted ZZ quantum crosstalk. Here, we present a novel technique to manipulate the energy levels and mitigate this crosstalk with simultaneous off-resonant drives on coupled qubits. This breaks a fundamental deadlock between qubit-qubit coupling and crosstalk. In a fixed-frequency transmon architecture with strong coupling and crosstalk cancellation, additional cross-resonance drives enable a 90 ns CNOT with a gate error of (0.19±0.02)%, while a second set of off-resonant drives enables a novel CZ gate. Furthermore, we show a definitive improvement in circuit performance with crosstalk cancellation over seven qubits, demonstrating the scalability of the technique. This Letter paves the way for superconducting hardware with faster gates and greatly improved multiqubit circuit fidelities.
RESUMO
Improving two-qubit gate performance and suppressing cross talk are major, but often competing, challenges to achieving scalable quantum computation. In particular, increasing the coupling to realize faster gates has been intrinsically linked to enhanced cross talk due to unwanted two-qubit terms in the Hamiltonian. Here, we demonstrate a novel coupling architecture for transmon qubits that circumvents the standard relationship between desired and undesired interaction rates. Using two fixed frequency coupling elements to tune the dressed level spacings, we demonstrate an intrinsic suppression of the static ZZ while maintaining large effective coupling rates. Our architecture reveals no observable degradation of qubit coherence (T_{1},T_{2}>100 µs) and, over a factor of 6 improvement in the ratio of desired to undesired coupling. Using the cross-resonance interaction, we demonstrate a 180 ns single-pulse controlled not (cnot) gate, and measure a cnot fidelity of 99.77(2)% from interleaved randomized benchmarking.
RESUMO
Implementation of high-fidelity 2-qubit operations is a key ingredient for scalable quantum error correction. In superconducting qubit architectures, tunable buses have been explored as a means to higher-fidelity gates. However, these buses introduce new pathways for leakage. Here we present a modified tunable bus architecture appropriate for fixed-frequency qubits in which the adiabaticity restrictions on gate speed are reduced. We characterize this coupler on a range of 2-qubit devices, achieving a maximum gate fidelity of 99.85%. We further show the calibration is stable over one day.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/complicações , Ductos Biliares/parasitologia , Criptosporidiose/complicações , Duodeno/parasitologia , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Infecções Oportunistas Relacionadas com a AIDS/parasitologia , Adulto , Anticorpos Antiprotozoários/imunologia , Antígenos de Protozoários/imunologia , Ductos Biliares/anormalidades , Cryptosporidium/classificação , Cryptosporidium/imunologia , Duodeno/anormalidades , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Microsporidia are emerging as opportunistic pathogens in patients with acquired immunodeficiency syndrome (AIDS). Enterocytozoon bieneusi is the most commonly reported microsporidium that is detected in gastrointestinal specimens. This report describes an in situ hybridization technique with a 30-base specific synthetic DNA probe for detection of E bieneusi by light microscopy. Formalin-fixed paraffin-embedded duodenal biopsy specimens from three patients with AIDS, chronic diarrhea, and E bieneusi infection confirmed by electron microscopy were used in this study. Light microscopic examination after colorimetric detection allowed the identification of different stages of the pathogen's life cycle in the cytoplasm of enterocytes. No cross-reactivity was noted between the probe and human DNA. Our study underscores the applicability of a synthetic-labeled oligonucleotide for the detection and identification of E bieneusi in clinical samples.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , DNA de Protozoário/análise , Encephalitozoon/genética , Encefalitozoonose/diagnóstico , Hibridização In Situ/métodos , Enteropatias Parasitárias/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/parasitologia , Animais , Sondas de DNA/química , Duodeno/parasitologia , Duodeno/patologia , Encephalitozoon/ultraestrutura , Encefalitozoonose/parasitologia , Enteropatia por HIV/diagnóstico , Humanos , Técnicas Imunoenzimáticas , Enteropatias Parasitárias/parasitologia , Reação em Cadeia da PolimeraseRESUMO
Isospora belli, a coccidian parasite in humans, has been described as causing chronic diarrhea and acalculous cholecystitis in patients with the acquired immunodeficiency syndrome (AIDS). Diagnosis can be made at the tissue level in the epithelium of the small bowel and by fecal examination. Disseminated extraintestinal forms are uncommon. We studied 118 adult patients with AIDS and chronic diarrhea using stool analysis and endoscopy with duodenal biopsy specimen collection. These samples were processed by routine histology and transmission electron microscopy. Isosporosis was diagnosed in 8 cases. In 2 of them, unizoite tissue cysts were present in the lamina propria, with negative results in stool materials. The cysts were located within a large parasitophorous vacuole. There were no structural means of differentiating the species level of Isospora based on morphology using light or electron microscopy. We believe further work should be done to determine if unizoite tissue cysts are part of the cycle of I belli or of other species of Isospora that could be pathogenic in immunocompromised hosts.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Isospora/isolamento & purificação , Isosporíase/diagnóstico , Adulto , Animais , Diarreia , Duodeno/parasitologia , Duodeno/patologia , Epitélio/parasitologia , Fezes/parasitologia , Feminino , Humanos , Enteropatias Parasitárias/complicações , Enteropatias Parasitárias/diagnóstico , Enteropatias Parasitárias/patologia , Mucosa Intestinal/patologia , Isosporíase/complicações , Isosporíase/patologia , Masculino , Microscopia EletrônicaRESUMO
Cathepsin L1, a cysteine protease secreted by the gastrodermis of juvenile and adult Fasciola hepatica, was expressed in Escherichia coli as a fusion protein containing the proregion, supplied with six histidyl residues at the N-terminal end (rproCL1). In this study we tested its potential as antigen for the serologic diagnosis of F. hepatica infections by enzyme-linked immunosorbent assay (ELISA). The analyzed human sera included 16 positive samples, 99 negative controls and 111 from individuals affected by other parasitic and non parasitic diseases. The sensitivity and specificity of the rproCL1-ELISA were 100%. We also assessed the ability to detect antibodies in sera from 10 experimentally infected sheep, obtaining preliminary results that shown a response since the third week post infection in all the studied animals. Therefore, the recombinant rproCL1-based ELISA could be a standardized test for the accurate diagnosis of fasciolosis.
Assuntos
Anticorpos Anti-Helmínticos/sangue , Catepsinas/imunologia , Cisteína Endopeptidases/imunologia , Precursores Enzimáticos/imunologia , Fasciola hepatica/imunologia , Fasciolíase/diagnóstico , Sequência de Aminoácidos , Animais , Anticorpos Anti-Helmínticos/biossíntese , Catepsina L , Catepsinas/biossíntese , Catepsinas/química , Cisteína Endopeptidases/biossíntese , Cisteína Endopeptidases/química , Precursores Enzimáticos/biossíntese , Precursores Enzimáticos/química , Ensaio de Imunoadsorção Enzimática , Fasciola hepatica/isolamento & purificação , Fasciolíase/imunologia , Fasciolíase/veterinária , Humanos , Imunoglobulina G/sangue , RNA de Helmintos , Proteínas Recombinantes de Fusão/imunologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Sensibilidade e Especificidade , Ovinos , Doenças dos Ovinos/imunologiaRESUMO
Microsporidia are protozoan parasites responsible for significant gastrointestinal disease in patients infected with the human immunodeficiency virus. We report the clinical features of three patients with chronic diarrhea and intestinal microsporidiosis caused by Enterocytozoon bieneusi. The average value for CD4 in these patients was < or = 50 cells/mm3. The spores were detected in smears from stool samples and duodenal aspirates stained with trichrome blue in all patients. Light microscopy of semi-thin plastic sections revealed parasites and spores in the enterocytes and were associated with villous atrophy (2 out of 3). Thin section-electron microscopy showed a variety of developmental stages of the microsporidio. Patients treated with Albendazole had an unsatisfactory clinical response to therapy. Enterocytozoon bieneusi infection may be an important cause of diarrhea in patients with AIDS in our country.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/parasitologia , Diarreia/parasitologia , Microsporídios/ultraestrutura , Microsporidiose/parasitologia , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Adulto , Animais , Doença Crônica , Diarreia/diagnóstico , Feminino , Humanos , Masculino , Microscopia Eletrônica , Microscopia de Fluorescência , Microsporidiose/diagnósticoRESUMO
Cryptosporidium sp., a protozoa organism, has been increasingly recognized in association with severe enteritis in patients with the Acquired Immunodeficiency Syndrome. The studied subjects included 84 adult patients with AIDS and chronic diarrhea. We describe 14 patients with intestinal infection caused by Cryptosporidium sp. The mean CD4 count in these patients was < or = 300 cells/mm3 (7 out of 14). Examination of duodenal aspirates and feces included dimethylsulfoxide, auramine and acid-fast preparation of concentrated samples. We carried out videoesophagogastroduodenoscopy (VEDA) to visually inspect the mucosa and obtain biopsy specimens. VEDA revealed granular duodenum in ten patients and jasper duodenum in one of them. Duodenal biopsy specimens were stained with hematoxylin-eosin, Giemsa and Azure II. Histologic changes included atrophy (3/14), duodenitis (2/14) or both (3/14). Transmission electron microscopy was used for the identification of developmental stages of Cryptosporidium sp.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Criptosporidiose/diagnóstico , Cryptosporidium/isolamento & purificação , Diarreia/parasitologia , Infecções Oportunistas Relacionadas com a AIDS/parasitologia , Adulto , Animais , Doença Crônica , Cryptosporidium/ultraestrutura , Feminino , Humanos , MasculinoRESUMO
RESUMEN Un síndrome caracterizado por dolor cervical y un apófisis estiloides alargado fue descrito por primera vez por Watt Eagle en 1937. Aunque el síndrome de Eagle en su variante vascular es raro y no es reconocido como causa clara de disección carotídea, en los últimos años ha sido reportado un incremento del número de casos de disección carotídea causada por una apófisis estiloides alargada. Paciente de 56 años que acudió al servicio de urgencias por paresia facial izquierda aguda y habla confusa. Presentaba dolor cervical de dos días de evolución, relacionado con un ataque de tos. Se activó el código ictus y la tomografía computarizada (TC) mostró isquemia del lóbulo temporal derecho y disección bilateral de la arteria carótida interna. La angio-TC de los troncos supraaórticos con reconstrucción tridimensional, identificó una apófisis estiloides alargado en ambos lados. El paciente fue sometido a una angioplastía con colocación de dos stents. Debido al alto riesgo de padecer nuevo ictus, se decidió realizar tratamiento quirúrgico. Para el lado derecho se realizó un abordaje transoral y en el izquierdo un abordaje abierto. La apófisis estiloides alargado es una causa importante de disección carotídea y de las complicaciones cerebrovasculares relacionadas.
ABSTRACT A syndrome characterized by cervical pain and an abnormally elongated styloid process was first described by Watt Eagle in 1937. Even though vascular Eagle syndrome is uncommon and is not well recognized as a cause for carotid artery dissection, in the last few years there have been an increasing number of case reports of carotid artery dissection caused by an elongated styloid process. A 56 years old man presented to the emergency department with acute left facial weakness and slurred speech. He complained of two days neck pain, related to a coughing fit. The code stroke protocol was activated and imaging showed a right temporal bone stroke and a bilateral internal carotid artery dissection. A scan angiography of the supra-aortic vessels with 3D reconstruction was performed showing a bilateral abnormally elongated styloid process. The patient underwent angioplasty with two stent placements. Due to the high risk of recurrent strokes, the patient was evaluated in the otolaryngology department for styloid process resection. Finally a transoral approach for the right side and an open approach for the left side were performed. We have to consider an elongated styloid process as an important cause of carotid artery dissection and subsequent cerebrovascular complications
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Ossificação Heterotópica/complicações , Dissecação da Artéria Carótida Interna/etiologia , Dissecação da Artéria Carótida Interna/terapia , Acidente Vascular Cerebral/etiologia , Osso Temporal/anormalidades , Tomografia Computadorizada por Raios X , Angioplastia , Cervicalgia/etiologia , Dissecação da Artéria Carótida Interna/diagnóstico por imagemRESUMO
RESUMEN La piomiositis es una infección bacteriana del músculo estriado, siendo extremadamente rara la afectación de la musculatura cervical. Se ha asociado en nuestro medio a enfermedades crónicas como la diabetes y a la inmunodepresión. Presentamos a un paciente de 67 años que acude al servicio de urgencias por tumoración laterocervical de rápido crecimiento, negando antecedentes de interés a excepción de diabetes mellitus tipo II. Se le realizó estudio de imagen con tomografía computarizada con contraste, observándose aumento de volumen del músculo esternocleidomastoideo izquierdo y se empezó tratamiento empírico con antibióticos endovenosos. Dada la evolución tórpida finalmente se realizó drenaje quirúrgico bajo anestesia general con mejoría de los parámetros clínicos y analíticos. La piomiositis de los músculos cervicales es muy rara (0,4%-1% de todos los casos) siendo el esternocleidomastoideo el músculo del cuello más frecuentemente afectado. La tomografía computarizada representa la prueba de imagen de elección, permitiendo un rápido diagnóstico llegando a poder diferenciar este cuadro de otros similares. Considerando que muchos de estos pacientes presentan comorbilidades asociadas y/o inmunosupresión, es de extrema importancia diagnosticarlos precozmente y empezar un tratamiento adecuado que dependerá del grado y extensión de la infección. A pesar de ser una entidad poco frecuente, su incidencia está en aumento en nuestro medio asociada a la infección por VIH y otras condiciones de inmunodepresión. Hay que tenerla en mente en el diagnóstico diferencial de las tumoraciones laterocervicales porque solo con una alta sospecha clínica se podrá llevar al cabo un diagnóstico precoz y un tratamiento adecuado.
ABSTRACT Pyomyositis is a bacterial infection of the striated muscle that may affect the cervical musculature in very few cases. In the occidental world it has been associated with chronic diseases as diabetes and immunosuppression. We present a 67 years old patient attended to the Emergency Department because of a laterocervical fast growth tumor, without an interesting clinical history with the exception of type II diabetes mellitus. A CT scan with contrast showed an increased volume in the left sternocleidomastoid muscle, so an empiric treatment with intravenous antibiotics was started. Because of a bad evolution we finally performed a surgical drainage of the abscess under general anesthesia with an improvement of symptoms and laboratory markers. The pyomyositis of cervical muscles is very rare (0.4-1% of all cases) and the sternocleidomastoid muscle is the most commonly affected cervical muscle. CT scan is the gold standard imaging technique, because it allows to diagnose this disease and rule out other similar entities. If we consider that many patients present with associated comorbidities and/ or immunosuppression, it's very important to perform a rapid diagnosis and to begin a correct treatment that depends on the grade and extension of the infection. Although polymyositis of the sternocleidomastoid muscle is rare, its incidence is increasing associated to HIV infection and other immunosuppressive conditions. We have to keep in mind this pathology in the differential diagnosis of laterocervical tumors because high clinical suspicion is necessary to make a rapid diagnosis and a correct treatment.
Assuntos
Humanos , Masculino , Idoso , Miosite/microbiologia , Miosite/diagnóstico por imagem , Músculos do Pescoço/patologia , Staphylococcus aureus , Tomografia Computadorizada por Raios X , Drenagem , Resultado do Tratamento , Antibacterianos/uso terapêutico , Músculos do Pescoço/diagnóstico por imagemAssuntos
Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Doença de Chagas/diagnóstico , Enteropatias Parasitárias/diagnóstico , Trypanosoma cruzi/isolamento & purificação , Infecções Oportunistas Relacionadas com a AIDS/parasitologia , Adulto , Animais , Doença de Chagas/parasitologia , Estudos de Coortes , Humanos , Enteropatias Parasitárias/parasitologiaAssuntos
Colestase/diagnóstico , Hepatite A/diagnóstico , Ferro , Icterícia/diagnóstico , Cirrose Hepática/diagnóstico , Compostos de Amônio Quaternário , Testes Sorológicos , Adolescente , Adulto , Idoso , Bilirrubina , Eletroforese das Proteínas Sanguíneas , Citratos , Ensaios Enzimáticos Clínicos , Diagnóstico Diferencial , Feminino , Humanos , Testes de Função Hepática , Masculino , Pessoa de Meia-IdadeRESUMO
La miastenia gravis (MG) es una enfermedad autoinmune que afecta a la unión neuromuscular, y que se caracteriza por la presencia de autoanticuerpos dirigidos contra los receptores de membrana postsinápticos, bloqueando así la transmisión neuromuscular, y logrando de esta forma un descenso en el número de receptores en la placa neuromotora. Se presenta clínicamente como una debilidad muscular focalizada, de algunos grupos musculares, o generalizada. En el contexto ORL las presentaciones más clásicas afectan a la musculatura bulbar, presentándose como disfonía, disfagia, debilidad de la musculatura facial o la combinación de todas ellas. Presentamos 2 casos clínicos de pacientes con manifestaciones totalmente distintas de la misma enfermedad. En el primer caso se presenta a una paciente con compromiso leve de la musculatura bulbar y en el segundo, un paciente con una miastenia generalizada que es internado grave en la UCI por una crisis miasténica. Realizamos una revisión bibliográfica de las últimas pruebas diagnósticas y tratamientos para la MG, y tratamos de definir los signos y síntomas que nos ayudarán como otorrinolaringólogos a un diagnóstico y tratamiento oportuno.
Myasthenia gravis is an autoimmune disease of the neuromuscular junction, characterized by the presence of autoantibodies directed against the postsynaptic membrane receptors, blocking neuromuscular transmission in skeletal striated muscles, leading to a decrease in the number of receptors at the motor neuroplate. Clinically, myasthenia gravis presents as focalized or generalized muscle weakness. For the ENT the most frequent presentation is the bulbar involvement which presents as dysphonia, dysphagia, weakness of facial musculature or a combination of all. We report 2 cases of patients with completely different manifestations of the same disease. The first case is a patient with mild bulbar musculature compromise and the other, is a patient with severe generalized myasthenia who had to be admitted to the ICU for a myasthenic crisis.
Assuntos
Humanos , Masculino , Feminino , Idoso , Transtornos de Deglutição/etiologia , Disartria/etiologia , Disfonia/etiologia , Miastenia Gravis/complicaçõesRESUMO
We investigated range-wide phylogeographic variation in three European ash species (Fraxinus sp., Oleaceae). Chloroplast DNA (cpDNA) microsatellites were typed in the thermophilous Fraxinus angustifolia and Fraxinus ornus and the observed haplotypes and the geographic distribution of diversity were compared to cpDNA data previously obtained in the more cold-tolerant Fraxinus excelsior. We found wide-ranging haplotype sharing between the phylogenetically close F. angustifolia and F. excelsior, suggesting hybridization (i) in common glacial refuges in the Iberian Peninsula, northern Italy, the eastern and/or Dinaric Alps and the Balkan Peninsula, and/or (ii) during postglacial recolonization. The data allowed us to propose additional glacial refuges for F. angustifolia in southern Italy and in Turkey, and populations from the latter region were particularly polymorphic. There was evidence for refuge areas in Italy, the Balkan Peninsula and Turkey for F. ornus, which did not share any single chloroplast haplotype with the other species. In both F. angustifolia and F. ornus, cpDNA diversity (h(S) = 0.027 and h(S) = 0.009, respectively) was lower and fixation levels (G(ST) = 0.964 and G(ST) = 0.983, respectively) higher than in sympatric F. excelsior (h(S) = 0.096, G(ST) = 0.870). These diversity patterns could be due to temperature tolerance or the demographic history.
Assuntos
DNA de Cloroplastos/genética , Fraxinus/genética , Hibridização Genética , Filogenia , Europa (Continente) , Variação Genética , Genética Populacional , Haplótipos/genética , Repetições de Microssatélites/genéticaRESUMO
We report a PCR-based assay for the detection of Enterocytozoon bieneusi. We extracted DNA from feces which had been applied to filter paper disks and evaluated four preserving solutions. Infected specimens were identified by electrophoresis of amplicons from concentrated formalin-fixed samples and unconcentrated fresh feces. Our findings demonstrate that this methodology is effective for sample collection, mailing, and diagnosis of this pathogen.
Assuntos
DNA de Protozoário/análise , Fezes/parasitologia , Microsporida/genética , Microsporida/isolamento & purificação , Microsporidiose/diagnóstico , Reação em Cadeia da Polimerase/métodos , Animais , DNA de Protozoário/isolamento & purificação , Diarreia/diagnóstico , Diarreia/parasitologia , Eletroforese em Gel de Ágar , Filtração , Fixadores , Formaldeído , Humanos , Microsporidiose/imunologia , PapelRESUMO
Enzyme-linked immunosorbent assay (ELISA) and micro-ELISA were evaluated for their ability to detect anti-Fasciola hepatica antibodies in humans by using excretory-secretory antigen. The sensitivity of each method was 100%, but the specificity was 100% for ELISA and 97% for micro-ELISA. The micro-ELISA could be used as a screening assay and ELISA could be used as a confirmatory method for the serodiagnosis of human fascioliasis.
Assuntos
Anticorpos Anti-Helmínticos/sangue , Ensaio de Imunoadsorção Enzimática/métodos , Fasciolíase/diagnóstico , Animais , Anticorpos Anti-Helmínticos/imunologia , Antígenos de Helmintos/imunologia , Bovinos , Fasciolíase/sangue , Fasciolíase/imunologia , Humanos , Testes Imunológicos/métodosRESUMO
Microsporidia are protozoa parasites responsible for significant gastrointestinal disease in patients infected with human immunodeficiency virus. We evaluated a PCR assay of stool samples, duodenal aspirates, and biopsy specimens from patients with Enterocytozoon bieneusi infection. A 210-bp DNA fragment of the unique rRNA intergenic spacer could be amplified from all samples infected with E. bieneusi, but no amplification was seen by using DNA purified from samples with Septata intestinalis or other parasites and from negative control human cells. These results suggest that the PCR in stool samples may be a useful tool for the diagnosis of intestinal microsporidiosis in patients with AIDS.