Quasiparticle Dynamics in a Superconducting Qubit Irradiated by a Localized Infrared Source.

A known source of decoherence in superconducting qubits is the presence of broken Cooper pairs, or quasiparticles. These can be generated by high-energy radiation, either present in the environment or purposefully introduced, as in the case of some hybrid quantum devices. Here, we systematically study the properties of a transmon qubit under illumination by focused infrared radiation with various powers, durations, and spatial locations. Despite the high energy of incident photons, our observations agree well with a model of low-energy quasiparticle dynamics dominated by trapping. This technique can be used for understanding and potentially mitigating the effects of high-energy radiation on superconducting circuits with a variety of geometries and materials.

Temperature variations during bone removal procedures similar to third molar extraction using different instruments.

Bone removal is commonly used in the extraction of third molars and the heat generated during the process can interfere with the repair of bone. The aim of this study was to evaluate the temperature variation presented in bone removal performed with a high-speed turbine (400000 rpm), implant motor with straight piece (100000 rpm), low-speed micromotor (20000 rpm) and piezoelectric saw (30 kHz) in pig mandibles. For this, bone removal was carried out around 20 posterior teeth, under constant saline solution irrigation with a syringe and needle. In addition, the time required to perform bone removal was recorded. The results indicated a mean (SD) temperature variation of 0.96 °C (0.6 °C) for the high-speed turbine, 1.38 °C (0.5 °C) with the implant motor, 2.22 °C (0.7 °C) for the low-speed micromotor and 2.90 °C (1.3 °C) for the piezoelectric saw. The conventional variance was calculated discounting the variation of time used for bone removal around the teeth. There was a statistically significant difference in temperature variation between the high-speed turbine vs the micromotor (p = 0.009) and the high speed micromotor vs the piezoelectric saw (p = 0.04). We conclude that there is a statistically significant difference in temperature variation between the instruments used in oral and maxillofacial surgery, with higher rotation speeds resulting in the lowest temperature variations and a reduced surgical time.

Perspectives from the 2nd International Post-Tuberculosis Symposium: mobilising advocacy and research for improved outcomes.

In 2020, it was estimated that there were 155 million survivors of TB alive, all at risk of possible post TB disability. The 2nd International Post-Tuberculosis Symposium (Stellenbosch, South Africa) was held to increase global awareness and empower TB-affected communities to play an active role in driving the agenda. We aimed to update knowledge on post-TB life and illness, identify research priorities, build research collaborations and highlight the need to embed lung health outcomes in clinical TB trials and programmatic TB care services. The symposium was a multidisciplinary meeting that included clinicians, researchers, TB survivors, funders and policy makers. Ten academic working groups set their own goals and covered the following thematic areas: 1) patient engagement and perspectives; 2) epidemiology and modelling; 3) pathogenesis of post-TB sequelae; 4) post-TB lung disease; 5) cardiovascular and pulmonary vascular complications; 6) neuromuscular & skeletal complications; 7) paediatric complications; 8) economic-social and psychological (ESP) consequences; 9) prevention, treatment and management; 10) advocacy, policy and stakeholder engagement. The working groups provided important updates for their respective fields, highlighted research priorities, and made progress towards the standardisation and alignment of post-TB outcomes and definitions.

En 2020, il est estimé qu'il y a 155 millions de survivants de la TB dans le monde, tous exposés à un risque d'invalidité post-TB. Le deuxième Symposium International Post-Tuberculose (Stellenbosch, Afrique du Sud) a été organisé dans le but de sensibiliser davantage à l'échelle mondiale et de permettre aux communautés touchées par la TB de contribuer activement à la mise en œuvre de l'agenda. De plus, nous avons entrepris de mettre à jour les connaissances sur la vie et les maladies post-TB, de déterminer les domaines de recherche prioritaires, d'établir des partenariats de recherche et de souligner l'importance d'intégrer les résultats sur la santé pulmonaire dans les essais cliniques et les services de soins de la TB. Le symposium était une réunion de travail pluridisciplinaire rassemblant des praticiens, des chercheurs, des personnes ayant survécu à la TB, des donateurs, des décideurs politiques et d'autres acteurs clés. Dix groupes de travail académiques ont établi leurs propres objectifs et ont abordé les sujets thématiques suivants : 1) engagement et perspectives des patients ; 2) épidémiologie et modélisation ; 3) pathogénie des séquelles post-TB ; 4) maladie pulmonaire post-TB (PTLD, pour l'anglais «post-TB lung disease ¼) ; 5) complications cardiovasculaires et vasculaires pulmonaires ; 6) complications neuromusculaires et squelettiques ; 7) complications pédiatriques ; 8) conséquences économiques, sociales et psychologiques (ESP, pour l'anglais «economic-social and psychological¼) ; 9) prévention, traitement et gestion ; 10) plaidoyer, politique et engagement des parties prenantes. Les groupes de travail académiques ont apporté des mises à jour significatives dans leurs domaines respectifs, ont mis en évidence les priorités de recherche et ont avancé vers la normalisation et l'harmonisation des résultats et des définitions de la post-TB.

The effect of TB treatment on health-related quality of life for people with advanced HIV.

BACKGROUND: Study A5274 was an open-label trial of people with HIV (PLHIV) with CD4 cell count <50 cells/µL who were randomized to empirical TB treatment vs. isoniazid preventive therapy (IPT) in addition to antiretroviral therapy (ART). We evaluated health-related quality of life (HRQoL) by study arm, changes over time, and association with sociodemographic and clinical factors.METHODS: Participants aged >13 years were enrolled from outpatient clinics in 10 countries. HRQoL was assessed at Weeks 0, 8, 24 and 96 with questions about daily activity, hospital or emergency room visits, and general health status. We used logistic regression to examine HRQoL by arm and association with sociodemographic and clinical factors.RESULTS: Among 850 participants (424 empiric arm, 426 IPT arm), HRQoL improved over time with no difference between arms. At baseline and Week 24, participants with WHO Stage 3 or 4 events, or those who had Grade 3 or 4 signs/symptoms, were significantly more likely to report poor HRQoL using the composite of four HRQoL measures.CONCLUSION: HRQoL improved substantially in both arms during the study period. These findings show that ART, TB screening, and IPT can not only reduce mortality, but also improve HRQoL in PLHIV with advanced disease.

Diffuse lung uptake of technetium-99m sulfur colloid in malaria.

Diffuse lung accumulation of colloid was seen on liver-spleen imaging in a patient during the acute stage of vivax malaria. A repeat study was performed following successful therapy and showed complete disappearance of lung uptake. Possible mechanisms for this unusual observation are discussed, with the conclusion that this phenomenon is probably related to increased reticuloendothelial system activity, due to a malaria-induced increase in the pulmonary macrophages.

Ascites and right pleural effusion: demonstration of a peritoneo-pleural communication.

A 54-yr-old female with known liver cirrhosis presented with a right transudative pleural effusion and ascites. To find the source of pleural fluid, [99mTc]sulfur colloid was injected intraperitoneally and a serial imaging study revealed its passage to the right pleural space on 2-hr and 24-hr images. Mechanisms proposed in the formation of pleural effusion in liver cirrhosis are (a) lymphatic drainage and (b) diaphragmatic defect. Radioisotope migration speed may be a clue for differentiating these two mechanisms, being more rapid in the presence of a diaphragmatic defect.

Gallium-67 thoracic scan and pleural disease in asbestos workers.

We have recently reported that 67Ga scanning in asbestos workers can document excessive uptake of the marker among workers without sufficient criteria for asbestosis, but in our initial report we could not exclude definitely that 67Ga uptake could be related to pleural disease. To further test this hypothesis, we analyzed the 67Ga thoracic scan in relation to profusion scores of pleural disease on chest roentgenogram and CT scan of the thorax in 171 asbestos workers. We found no significant correlation between the 67Ga lung uptake and the radiographic scores of pleural disease. We concluded that pleural plaques are not an active site of 67Ga accumulation and do not contribute significantly to the thoracic uptake of the marker.

Rapid washout of technetium-99m-MIBI from a large parathyroid adenoma.

We report a case of rapid 99mTc-methoxyisobutylisonitrile (MIBI) clearance from a parathyroid adenoma. A double-phase 99mTc-MIBI parathyroid scintigraphy was performed on a 62-yr-old female evaluated for primary hyperparathyroidism. A large parathyroid adenoma was visualized caudal to the left lobe of the thyroid gland with an unusually rapid washout of the tracer from tumor tissue. Histologic tissue examination confirmed the presence of a parathyroid adenoma and the absence of oxyphil cells. Care should be taken in interpretation of 99mTc-MIBI parathyroid scintigrams because some adenomas can present a rapid release of the radiotracer in a double-phase study. Technetium-99m-MIBI retention could be related to the number of mitochondria-rich cells in parathyroid adenomas or to hyperplasia.

Preoperative localization of parathyroid lesions in hyperparathyroidism: relationship between technetium-99m-MIBI uptake and oxyphil cell content.

UNLABELLED: The aim of this study was to assess the relationship between parathyroid oxyphil cell content and early or late phases of uptake of 99mTc-MIBI, a radioisotope preferentially retained in mitochondria-rich cells. METHODS: This study is a retrospective, single-blind analysis of all double-phase 99mTc-MIBI parathyroid scintigraphy studies performed before surgery in our institution between 1990 and 1995. A total of 18 parathyroid lesions in 14 patients were reviewed. This sample included 11 cases of primary hyperparathyroidism (8 adenomas, 1 adenocarcinoma and 2 hyperplasias) and 3 cases of tertiary hyperparathyroidism secondary to chronic renal failure. RESULTS: Uptake of 99mTc-MIBI in the early phase of scintigraphy was associated with larger parathyroid lesions (1.61 +/- 1.61 ml versus 0.33 +/- 0.27 ml; p < 0.02) and higher serum calcium levels (3.00 +/- 0.41 mM versus 2.67 +/- 0.14 mM; p < 0.02). More importantly, we found that a parathyroid oxyphil cell content greater than 25% was more often associated with a positive uptake of 99mTc-MIBI in the late phase of the test (positive late uptake in 78% of lesions with a high oxyphil cell content versus 33% in lesions with an oxyphil cell content between 1% and 25% and 0% in lesions with no oxyphil cells; p < 0.04). CONCLUSION: These findings suggest that the late retention of 99mTc-MIBI in double-phase scintigraphy is related to parathyroid oxyphil cell content.

Thallium-201-dipyridamole imaging: comparison between a standard dose and a high dose of dipyridamole in the detection of coronary artery disease.

UNLABELLED: The purpose of this study was to compare two different doses of dipyridamole as a pharmacologic stress test for 201Tl imaging. METHODS: Twenty-four patients with significant coronary artery disease (15 had undergone a coronary angiogram and 9 had undergone a previous 201Tl study with a significant lesion) were prospectively studied. Within 1 wk, all patients underwent two 201T-dipyridamole myocardial planar studies, one using a standard dose (STD) and the other, a high dose (HIGH) of dipyridamole. The protocol order was randomly assigned. The STD protocol used a dose of 0.14 mg/kg/min for a duration of 4 min (0.56 mg/kg), and the HIGH protocol used a dose of 0.14 mg/kg min for a duration of 6 min (0.84 mg/kg). The 201Tl was injected 3 min after the end of the dipyridamole infusion. Images, obtained 5 min and 4 hr later, were interpreted (divided into five segments each) by three blinded observers. RESULTS: The STD protocol showed normal, ischemia and scar in 252, 91 and 17 segments, respectively. The HIGH protocol detected 232, 118 and 10 segments, respectively. A side-by-side evaluation was done to evaluate the defect extent subjectively, which was greater with HIGH in 14, equal in six and smaller in four patients. One or more side effects were seen in 14 patients with STD and in 19 with HIGH. Increased heart rate (8 bpm for STD and 19 bpm for HIGH, p < 0.001) was the only significant change seen in the hemodynamic parameters. CONCLUSION: This preliminary study indicates that a high dose of dipyridamole seems to be safe and can be helpful to increase the sensitivity of 201Tl imaging.

Gallium-67 uptake in the lung of asbestos exposed sheep: early association with enhanced macrophage-derived fibronectin accumulation.

To evaluate the time course and mechanisms of enhanced 67Ga lung uptake in asbestosis, we exposed two groups of sheep every 2 wk to either 100 ml saline (controls) or 100 mg UICC chrysotile fibers in 100 ml saline. The sheep were evaluated periodically by pulmonary function tests (PFT), thoracic radiograph (TR), 67Ga lung scan bronchoalveolar lavage (BAL), and transbronchial lung biopsy (TLB). By month 24 of the study, 9/15 exposed sheep had developed the initial alveolitis and had significant changes in PFT, TR, and TLB. The other six exposed sheep differed from controls only by a 75% increase in BAL fibronectin until month 30, where significant changes in albumin occurred and 67Ga scan score increased. The nine sheep with alveolitis had significant sustained increases in 67Ga scan and BAL levels from month 6, associated with a 150% increase in BAL fibronectin and other parameters of disease activity changed from month 18 to 30. We concluded that in the sheep model of asbestosis, significant changes in 67Ga scan, 67Ga BAL counts, and excessive elevation of BAL fibronectin preceded other parameters of disease activity. The data suggest that excessively activated macrophages are primarily responsible for the early 67Ga lung uptake.

Quantitative gallium 67 lung scan to assess the inflammatory activity in the pneumoconioses.

Gallium 67 lung scan has recently become increasingly used to evaluate the biological activity of alveolitis of interstitial lung diseases and to stage the disease process. In order to have a more precise and objective indicator of the inflammatory activity in the lung, we and others have developed computer-based quantitative techniques to process the 67Ga scan. In this report, we compare the results of three such computer-based methods of analysis of the scans of 38 normal humans and 60 patients suspected to have pneumoconiosis. Results of previous investigations on the mechanisms of 67Ga uptake in interstitial lung disease are reviewed. These data strengthen the view that quantitative 67Ga lung scan has become a standard technique to assess inflammatory activity in the interstitial lung diseases and that computer-based method of analysis of the scan provides an index of inflammatory activity of the lung disease that correlates with lung lavage and biopsy indices of inflammation in the lung tissue.

Computer-based quantitative analysis of gallium-67 uptake in normal and diseased lungs.

To study the 67Ga lung uptake as an index of inflammatory activity, we developed a computer-based method to process the data obtained from the 67Ga scan. Background radioactivity below the kidneys was subtracted from counts in all areas and given a score of 0; the maximal liver uptake was scored as 16. Radioactivity over six lung fields was scored by the computer between 0 and 16 and averaged to yield a mean 67Ga lung uptake index. This index of 67Ga lung accumulation correlates with histopathologic scores of inflammation in lung tissue and with bronchoalveolar lavage (BAL) levels of 67Ga radioactivity retrieval. This study reports the quantitative analysis of 67Ga lung uptake in normal subjects and patients with various pulmonary diseases. This method provides an objective index of inflammatory activity in lung tissues, and it is simple, sensitive, and discriminative.

Spectrum of alveolitis in quartz-exposed human subjects.

To characterize silica-induced alveolitis in human subjects, we studied 22 workers in the granite stone cutting industry of Quebec and compared results with those of 22 manual workers without quartz exposure (group 1). All were nonsmokers and were of comparable age. On the basis of chest roentgenogram, seven were without disease (group 2), nine had silicosis without coalescence/conglomeration (group 3), and six had silicosis with coalescence/conglomeration (group 4). The alveolitis in subsets of silica-exposed workers with distinct clinical stages of disease was found to have distinct biologic characteristics.

Imaging the pneumoconioses: a multidisciplinary approach.

The initial early reaction of pulmonary tissue to inorganic dust inhalation is a fibrosing macrophagic alveolitis. This initial pulmonary lesion can be detected by an enhanced gallium 67 pulmonary uptake and analyses of bronchoalveolar lavage. These two techniques can document not only the increased proliferation of macrophages, but also the activation of macrophages to produce excessive amounts of fibronectin and other factors of fibroblastic growth implicated in the pathogenesis of the pneumoconioses. Of equal clinical interest is the development of computed tomography, which has permitted better characterization of the early stages of fibrosis in the pneumoconioses. These refinements in disease recognition will contribute to the earlier detection of pneumoconioses before they become incapacitating. Newer therapeutic methods are also under investigation that could permit inactivation of either the dust itself or the pulmonary macrophage. The coupling of these new diagnostic and therapeutic developments will bring in a new era in occupational pulmonary medicine.

Gallium-67 citrate accumulation in a mycotic popliteal artery aneurysm.

A 31-year-old man with bacterial endocarditis developed a mycotic popliteal aneurysm which presented clinically like an acute osteomyelitis. Bone and Ga-67 scanning played a major role in disclosing this unsuspected lesion. Various isotopic techniques proposed for the detection of mycotic aneurysm are reviewed. The potential usefulness of Ga-67 imaging in patients at risk of developing such lesions is discussed.

Massive hydrothorax complicating peritoneal dialysis. Isotopic investigation (peritoneopleural scintigraphy).

Massive hydrothorax occurring during continuous ambulatory peritoneal dialysis is a rare complication that may appear at any time during the course of the treatment. Most of the time, it is right-sided and is more frequent in female patients. A case is presented that was investigated by peritoneopleural scintigraphy. A rapid accumulation of the radiopharmaceutical over the right hemithorax was observed. To explain that finding, a macroscopic diaphragmatic defect was suspected. Different therapeutic approaches are presented.

[New methods in the early detection of pulmonary fibrosis in asbestosis and silicosis]. / Nouvelles méthodes de détection précoce de la fibrose pulmonaire dans l'asbestose et la silicose.

Much recent work in thoracic medicine has been slanted towards the early detection of respiratory disease and the prevention of disabling sequelae. In the field of pneumoconioses associated with inhalation of mineral dust the interest of research workers has been largely orientated towards the objectives of early detection and the prevention of fibrotic scarring. To achieve real progress the research workers have used new investigational techniques such as axial tomography of the thorax, quantitative scintigraphy using Gallium-67 and analyses of bronchiolar lavage in parallel with a traditional approach, namely: a clinical examination of the patient, a pulmonary radiograph and respiratory function tests. These studies have enabled further clarification of the specific value of each of these new methods of investigation, whether at the level of early detection, the early recognition of pulmonary fibrosis, the characterisation of the current state of the disease and the prediction of fibrogenic power. Several different forms of intervention on the fibrotic process are currently under trial and may contribute to the prevention of pulmonary fibrosis.

Impact of the human immunodeficiency virus on early multidrug-resistant tuberculosis treatment outcomes in Botswana.

SETTING: The impact of the human immunodeficiency virus (HIV) on multidrug-resistant tuberculosis (MDR-TB) treatment outcomes in sub-Saharan Africa, where extensive rollout of highly active antiretroviral therapy (HAART) has occurred, remains unclear. OBJECTIVE: To compare the time to initial culture conversion among patients with and those without HIV infection in a setting of individualized MDR-TB care in Botswana. DESIGN: Prospective cohort study of MDR-TB patients receiving ambulatory, integrated TB-HIV care at two public clinics in Botswana. The time to culture conversion was compared by HIV status using Cox proportional hazard ratios (HRs). RESULTS: A total of 40 HIV-infected and 30 non-HIV-infected patients with MDR-TB and follow-up cultures were identified. The median time to initial culture conversion was 78 days (interquartile range [IQR] 42-186) for HIV-infected and 95 days (IQR 70-133) for non-HIV-infected individuals (log rank P > 0.5; unadjusted HR 0.9, 95%CI 0.5-1.5). Adjusting for age, sex, treatment history and number of active anti-tuberculosis drugs did not change this result (adjusted HR 0.8, 95%CI 0.4-1.4). CONCLUSION: We found no difference in the proportion of or time to initial sputum culture conversion between an HIV-infected and a non-infected cohort of MDR-TB patients in Botswana, suggesting that outcomes may be comparable in similar settings with access to individualized anti-tuberculosis treatment and HAART.

Yield of contact tracing from pediatric tuberculosis index cases in Gaborone, Botswana.

SETTING: Contact tracing using pediatric index cases has not been adequately investigated in high tuberculosis (TB) and human immunodeficiency virus (HIV) prevalence settings. OBJECTIVE: To determine the yield of contact tracing in household contacts of pediatric TB index cases in Botswana. DESIGN: Index cases included all pediatric (age ≤ 13 years) TB admissions from January 2009 to December 2011 to Botswana's largest referral hospital. A contact tracing team identified cases, conducted home visits, symptom-screened contacts and referred those with ≥ 1 TB symptoms. The primary outcome was newly diagnosed TB in a contact. RESULTS: From 163 pediatric index cases, 548 contacts were screened (median 3 contacts/case, interquartile range [IQR] 2-4). Of these, 49 (9%) were referred for positive symptoms on screening and 27/49 (55%) were evaluated for active TB. Twelve new TB cases were diagnosed (12/548, 2.2%); the median age was 31 years (IQR 23-38); 11 (92%) were smear-positive. Ten (83%) had known HIV status: 7 (70%) were HIV-positive. To find one new TB case, the number needed to contact trace (index cases/new cases) was 13.6, and the number needed to screen (contacts/new cases) was 46. CONCLUSION: This yield of contact tracing using pediatric index cases is similar to the traditional adult index case approach. Improving the proportion of symptomatic contacts evaluated may increase yield.