Hamiltonian Engineering with Multicolor Drives for Fast Entangling Gates and Quantum Crosstalk Cancellation.

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.

Demonstration of a High-Fidelity cnot Gate for Fixed-Frequency Transmons with Engineered ZZ Suppression.

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.

Tunable Coupling Architecture for Fixed-Frequency Transmon Superconducting Qubits.

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.

Ictus isquémico y disección bilateral de la arteria carótida interna: una manifestación rara del síndrome de eagle: reporte de un caso / Ischemic stroke and bilateral dissection of the internal carotid artery: a rare manifestation of the eagle syndrome: a case report

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

Piomiositis primaria del músculo esternocleidomastoideo: reporte de un caso y revisión de la literatura / Primary pyomyositis of the sternocleidomastoid muscle: a case report and review of the literature

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.

Miastenia gravis: un diagnóstico diferencial importante a la hora de evaluar a un paciente con sintomatología ORL / Myasthenia gravis: an important differential diagnosis when assessing a patient with ent symptomatology

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.

Chloroplast DNA phylogeography of European ashes, Fraxinus sp. (Oleaceae): roles of hybridization and life history traits.

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.

Estudio del foco en un caso de fasciolosis humana en Neuquén / A focus study from a case of human fascioliasis in Neuquén

El objetivo del trabajo fue realizar un estudio de foco relacionado con un caso de fasciolosis humana ocurrido en abril de 2002 en Loncopué, Neuquén, Argentina. La confirmación diagnóstica se efectuó en mayo de 2002 por el test de ELISA. En noviembre de 2002 se realizó un muestreo en el área rural donde se ubicaba la vivienda de la paciente, ya restablecida, y se le tomó una nueva muestra de sangre. El suero de la paciente continuó reactivo para antígenos de Fasciola hepatica. Se muestrearon plantas de berro para detectar metacercarias. Se recolectaron caracoles en cuatro canales de riego conectados a un canal principal. Los caracoles fueron trasladados vivos para su identificación, medición y examen de infección. Se recolectaron 35 muestras fecales de ganado de cría. No se observaron metacercarias en las hojas de berro examinadas (n=222). Se recolectaron 130 caracoles identificados como Lymnaea viatrix y 2 de 101 ejemplares (2%) estaban infectados con larvas de F. hepatica. Las prevalencias en el ganado adulto fueron: 100% (10/10) para caprinos, 82% (9/11) para ovinos y 86% (6/7) para bovinos. El número de huevos eliminados por las cabras (mediana = 20.7; Q1=6.2; Q3=34.5) y ovejas (4, 18, 13) infectadas, resultó mayor que el eliminado por vacas (0.3; 0.3; 1.7) (p<0.01). La práctica de control local no tuvo efecto aparente en este caso, por lo que deberían revisarse los calendarios de tratamiento y los antiparasitarios utilizados. Los resultados muestran que el ganado criado a pequeña escala por los pobladores debe incluirse en los programas de control. Se discute la posible importancia de la fasciolosis humana en Argentina.

Estudio del foco en un caso de fasciolosis humana en Neuquén / A focus study from a case of human fascioliasis in Neuquén

El objetivo del trabajo fue realizar un estudio de foco relacionado con un caso de fasciolosis humana ocurrido en abril de 2002 en Loncopué, Neuquén, Argentina. La confirmación diagnóstica se efectuó en mayo de 2002 por el test de ELISA. En noviembre de 2002 se realizó un muestreo en el área rural donde se ubicaba la vivienda de la paciente, ya restablecida, y se le tomó una nueva muestra de sangre. El suero de la paciente continuó reactivo para antígenos de Fasciola hepatica. Se muestrearon plantas de berro para detectar metacercarias. Se recolectaron caracoles en cuatro canales de riego conectados a un canal principal. Los caracoles fueron trasladados vivos para su identificación, medición y examen de infección. Se recolectaron 35 muestras fecales de ganado de cría. No se observaron metacercarias en las hojas de berro examinadas (n=222). Se recolectaron 130 caracoles identificados como Lymnaea viatrix y 2 de 101 ejemplares (2%) estaban infectados con larvas de F. hepatica. Las prevalencias en el ganado adulto fueron: 100% (10/10) para caprinos, 82% (9/11) para ovinos y 86% (6/7) para bovinos. El número de huevos eliminados por las cabras (mediana = 20.7; Q1=6.2; Q3=34.5) y ovejas (4, 18, 13) infectadas, resultó mayor que el eliminado por vacas (0.3; 0.3; 1.7) (p<0.01). La práctica de control local no tuvo efecto aparente en este caso, por lo que deberían revisarse los calendarios de tratamiento y los antiparasitarios utilizados. Los resultados muestran que el ganado criado a pequeña escala por los pobladores debe incluirse en los programas de control. Se discute la posible importancia de la fasciolosis humana en Argentina. (AU)

Cyclospora cayatanensis en pacientes con SIDA y diarrea crónica / Cyclospora cayetanensis in patients with AIDS and chronic diarrhea

Cyclospora spp. is a protozoan parasite responsible for significant gastrointestinal disease in patients infected with the human immunodeficiency virus. We report the clinical features of two patients with chronic diarrhea and intestinal cyclosporosis caused by Cyclospora cayetanensis. The average value for CD4 count in these patients was lower than or equal to 100 cells/mm3. The oocysts were detected in smears from stool samples stained with modified acid-fast or safranin technique. Light microscopy revealed parasites in the enterocytes and these parasites were associated with villous atrophy. Cyclospora cayetanensis infection might be an important cause of diarrhea in patients with AIDS in Argentina. (AU)

Cyclospora cayatanensis en pacientes con SIDA y diarrea crónica / Cyclospora cayetanensis in patients with AIDS and chronic diarrhea

Cyclospora spp. is a protozoan parasite responsible for significant gastrointestinal disease in patients infected with the human immunodeficiency virus. We report the clinical features of two patients with chronic diarrhea and intestinal cyclosporosis caused by Cyclospora cayetanensis. The average value for CD4 count in these patients was lower than or equal to 100 cells/mm3. The oocysts were detected in smears from stool samples stained with modified acid-fast or safranin technique. Light microscopy revealed parasites in the enterocytes and these parasites were associated with villous atrophy. Cyclospora cayetanensis infection might be an important cause of diarrhea in patients with AIDS in Argentina.

Immunodiagnosis of fasciolosis using recombinant procathepsin L cystein proteinase.

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.

Isosporosis and unizoite tissue cysts in patients with acquired immunodeficiency syndrome.

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.

Immunodiagnosis of human fascioliasis by an enzyme-linked immunosorbent assay (ELISA) and a micro-ELISA.

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.

Diagnosis of Enterocytozoon bieneusi by PCR in stool samples eluted from filter paper disks.

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.

In situ hybridization: a molecular approach for the diagnosis of the microsporidian parasite Enterocytozoon bieneusi.

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.

[Classic strategies for diagnosis of cryptosporidiosis in patients with AIDS and chronic diarrhea]. / Estrategias clásicas para el diagnóstico de criptosporidiosis en pacientes con SIDA y diarrea crónica.

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.