Shannon and von Neumann entropies of multi-qubit Schrödinger's cat states.

Using IBM's publicly accessible quantum computers, we have analyzed the entropies of Schrödinger's cat states, which have the form Ψ = (1/2)1/2 [|0 0 0⋯0〉 + |1 1 1⋯1〉]. We have obtained the average Shannon entropy SSo of the distribution over measurement outcomes from 75 runs of 8192 shots, for each of the numbers of entangled qubits, on each of the quantum computers tested. For the distribution over N fault-free measurements on pure cat states, SSo would approach one as N → ∞, independent of the number of qubits; but we have found that SSo varies nearly linearly with the number of qubits n. The slope of SSoversus the number of qubits differs among computers with the same quantum volumes. We have developed a two-parameter model that reproduces the near-linear dependence of the entropy on the number of qubits, based on the probabilities of observing the output 0 when a qubit is set to |0〉 and 1 when it is set to |1〉. The slope increases as the error rate increases. The slope provides a sensitive measure of the accuracy of a quantum computer, so it serves as a quickly determinable index of performance. We have used tomographic methods with error mitigation as described in the qiskit documentation to find the density matrix ρ and evaluate the von Neumann entropies of the cat states. From the reduced density matrices for individual qubits, we have calculated the entanglement entropies. The reduced density matrices represent mixed states with approximately 50/50 probabilities for states |0〉 and |1〉. The entanglement entropies are very close to one.

Natural History of Aerosol-Induced Ebola Virus Disease in Rhesus Macaques.

Ebola virus disease (EVD) is a serious global health concern because case fatality rates are approximately 50% due to recent widespread outbreaks in Africa. Well-defined nonhuman primate (NHP) models for different routes of Ebola virus exposure are needed to test the efficacy of candidate countermeasures. In this natural history study, four rhesus macaques were challenged via aerosol with a target titer of 1000 plaque-forming units per milliliter of Ebola virus. The course of disease was split into the following stages for descriptive purposes: subclinical, clinical, and decompensated. During the subclinical stage, high levels of venous partial pressure of carbon dioxide led to respiratory acidemia in three of four of the NHPs, and all developed lymphopenia. During the clinical stage, all animals had fever, viremia, and respiratory alkalosis. The decompensatory stage involved coagulopathy, cytokine storm, and liver and renal injury. These events were followed by hypotension, elevated lactate, metabolic acidemia, shock and mortality similar to historic intramuscular challenge studies. Viral loads in the lungs of aerosol-exposed animals were not distinctly different compared to previous intramuscularly challenged studies. Differences in the aerosol model, compared to intramuscular model, include an extended subclinical stage, shortened clinical stage, and general decompensated stage. Therefore, the shortened timeframe for clinical detection of the aerosol-induced disease can impair timely therapeutic administration. In summary, this nonhuman primate model of aerosol-induced EVD characterizes early disease markers and additional details to enable countermeasure development.

High frequency of potential phosphodiesterase type 5 inhibitor drug interactions in males with HIV infection and erectile dysfunction.

OBJECTIVES: We sought to determine the prevalence of phosphodiesterase type 5 inhibitor (PDE-5) mediated drug-drug interactions (DDIs) in males with HIV infection receiving antiretroviral therapy (ART) and identify factors associated with PDE-5-mediated DDIs. METHODS: Male US Military HIV Natural History Study participants diagnosed with erectile dysfunction (ED) and having a PDE-5 inhibitor and potentially-interacting ART co-dispensed within 30 days were included. DDIs were defined according to criteria found in published guidelines and drug information resources. The primary outcome of interest was overall PDE-5 inhibitor-mediated DDI prevalence and episode duration. A secondary logistic regression analysis was performed on those with and without DDIs to identify factors associated with initial DDI episode. RESULTS: A total of 235 male participants with ED met inclusion criteria. The majority were White (50.6%) or African American (40.4%). Median age at medication co-dispensing (45 years), duration of HIV infection (14 years), and duration of ED (1 year) did not differ between the two groups (p>0.05 for all). PDE-5 inhibitors included sildenafil (n = 124), vardenafil (n = 99), and tadalafil (n = 14). ART regimens included RTV-boosted protease inhibitors (PIs) atazanavir (n = 83) or darunavir (n = 34), and COBI-boosted elvitegravir (n = 43). Potential DDIs occurred in 181 (77.0%) participants, of whom 122 (67.4%) had multiple DDI episodes. The median DDI duration was 8 (IQR 1-12) months. In multivariate analyses, non-statistically significant higher odds of DDIs were observed with RTV-boosted PIs or PI-based ART (OR 2.13, 95% CI 0.85-5.37) and in those with a diagnosis of major depressive disorder (OR 1.74, 95% CI 0.83-3.64). CONCLUSIONS: PDE-5-mediated DDIs were observed in the majority of males with HIV infection on RTV- or COBI-boosted ART in our cohort. This study highlights the importance of assessing for DDIs among individuals on ART, especially those on boosted regimens.

Outcomes of Coronavirus Disease 2019 Drive-Through Screening at an Academic Military Medical Center.

Drive-through coronavirus disease 2019 screening can evaluate large numbers of patients while reducing healthcare exposures and personal protective equipment use. We describe the characteristics of screened individuals as well as drive-through process and outcome measures. Optimal drive-through screening involves rapid turnaround of test results and linkage to follow-up care.

Mediastinal Actinomycosis After Esophagogastroduodenoscopy.

Actinomycosis is an uncommon bacterial infection that presents as an indolent, progressive disease that can affect multiple organ systems. We describe the case of a 66-year-old female with end-stage renal disease who presented to the emergency department after developing acute dyspnea and chest pain two weeks after undergoing a diagnostic esophagogastroduodenoscopy (EGD). A CT scan was obtained that revealed a large mediastinal mass, which was initially concerning for a potential malignancy. Biopsy of the mass and Gram stain was consistent with mediastinal actinomycosis. The patient was subsequently treated with an extended course of antibiotics that resulted in significant clinical improvement. Previously reported cases describing a correlation between EGD and mediastinal actinomycosis have been associated with invasive procedures such as esophageal stent placement and transesophageal biopsy. We describe a case of an uncommon infectious complication of a diagnostic EGD that was not associated with intentional mucosal disruption.

Case report: Hansen's disease in an active duty soldier presenting with type 1 reversal reaction.

Leprosy, or Hansen's disease (HD), is caused by the bacterium Mycobacterium leprae and is a significant cause of morbidity worldwide. Clinical manifestations range from isolated skin rash to severe peripheral neuropathy. Treatment involves a prolonged course of multiple antimicrobials. Although rare in the U.S., with only 168 new cases reported in 2016, HD remains a prevalent disease throughout the world, with 214,783 new cases worldwide that same year.1 It remains clinically relevant for service members born in and deployed to endemic regions. This report describes a case of HD diagnosed in an active duty soldier born and raised in Micronesia, a highly endemic region.