Microwave Susceptibility Observation of Interacting Many-Body Andreev States

Electrostatic charging affects the many-body spectrum of Andreev states, yet its influence on their microwave properties has not been elucidated. We developed a circuit quantum electrodynamics probe that, in addition to transition spectroscopy, measures the microwave susceptibility of different states of a semiconductor nanowire weak link with a single dominant (spin-degenerate) Andreev level. We found that the microwave susceptibility does not exhibit a particle-hole symmetry, which we qualitatively explain as an influence of Coulomb interaction. Moreover, our state-selective measurement reveals a large, π-phase shifted contribution to the response common to all many-body states which can be interpreted as arising from a phase-dependent continuum in the superconducting density of states.

Efficacy and Safety of Ensovibep for Adults Hospitalized With COVID-19 : A Randomized Controlled Trial

BACKGROUND

Ensovibep (MP0420) is a designed ankyrin repeat protein, a novel class of engineered proteins, under investigation as a treatment of SARS-CoV-2 infection.

OBJECTIVE

To investigate if ensovibep, in addition to remdesivir and other standard care, improves clinical outcomes among patients hospitalized with COVID-19 compared with standard care alone.

DESIGN

Double-blind, randomized, placebo-controlled, clinical trial. (ClinicalTrials.gov: NCT04501978).

SETTING

Multinational, multicenter trial.

PARTICIPANTS

Adults hospitalized with COVID-19.

INTERVENTION

Intravenous ensovibep, 600 mg, or placebo.

MEASUREMENTS

Ensovibep was assessed for early futility on the basis of pulmonary ordinal scores at day 5. The primary outcome was time to sustained recovery through day 90, defined as 14 consecutive days at home or place of usual residence after hospital discharge. A composite safety outcome that included death, serious adverse events, end-organ disease, and serious infections was assessed through day 90.

RESULTS

An independent data and safety monitoring board recommended that enrollment be halted for early futility after 485 patients were randomly assigned and received an infusion of ensovibep (n = 247) or placebo (n = 238). The odds ratio (OR) for a more favorable pulmonary outcome in the ensovibep (vs. placebo) group at day 5 was 0.93 (95% CI, 0.67 to 1.30; P = 0.68; OR > 1 would favor ensovibep). The 90-day cumulative incidence of sustained recovery was 82% for ensovibep and 80% for placebo (subhazard ratio [sHR], 1.06 [CI, 0.88 to 1.28]; sHR > 1 would favor ensovibep). The primary composite safety outcome at day 90 occurred in 78 ensovibep participants (32%) and 70 placebo participants (29%) (HR, 1.07 [CI, 0.77 to 1.47]; HR < 1 would favor ensovibep).

LIMITATION

The trial was prematurely stopped because of futility, limiting power for the primary outcome.

CONCLUSION

Compared with placebo, ensovibep did not improve clinical outcomes for hospitalized participants with COVID-19 receiving standard care, including remdesivir; no safety concerns were identified.

PRIMARY FUNDING SOURCE

National Institutes of Health.

Protocol and statistical analysis plan for the Pragmatic Investigation of optimaL Oxygen Targets (PILOT) clinical trial

INTRODUCTION

Mechanical ventilation of intensive care unit (ICU) patients universally involves titration of the fraction of inspired oxygen to maintain arterial oxygen saturation (SpO2). However, the optimal SpO2 target remains unknown.

METHODS AND ANALYSIS

The Pragmatic Investigation of optimaL Oxygen Targets (PILOT) trial is a prospective, unblinded, pragmatic, cluster-crossover trial being conducted in the emergency department (ED) and medical ICU at Vanderbilt University Medical Center in Nashville, Tennessee, USA. PILOT compares use of a lower SpO2 target (target 90% and goal range: 88%-92%), an intermediate SpO2 target (target 94% and goal range: 92%-96%) and a higher SpO2 target (target 98% and goal range: 96%-100%). The study units are assigned to a single SpO2 target (cluster-level allocation) for each 2-month study block, and the assigned SpO2 target switches every 2 months in a randomly generated sequence (cluster-level crossover). The primary outcome is ventilator-free days (VFDs) to study day 28, defined as the number of days alive and free of invasive mechanical ventilation from the final receipt of invasive mechanical ventilation through 28 days after enrolment.

ETHICS AND DISSEMINATION

The trial was approved by the Vanderbilt Institutional Review Board. The results will be submitted for publication in a peer-reviewed journal and presented at one or more scientific conferences.

TRIAL REGISTRATION NUMBER

The trial protocol was registered with ClinicalTrials.gov on 25 May 2018 prior to initiation of patient enrolment (ClinicalTrials.gov identifier: NCT03537937).

Coherent manipulation of an Andreev spin qubit

Two promising architectures for solid-state quantum information processing are based on electron spins electrostatically confined in semiconductor quantum dots and the collective electrodynamic modes of superconducting circuits. Superconducting electrodynamic qubits involve macroscopic numbers of electrons and offer the advantage of larger coupling, whereas semiconductor spin qubits involve individual electrons trapped in microscopic volumes but are more difficult to link. We combined beneficial aspects of both platforms in the Andreev spin qubit: the spin degree of freedom of an electronic quasiparticle trapped in the supercurrent-carrying Andreev levels of a Josephson semiconductor nanowire. We performed coherent spin manipulation by combining single-shot circuit-quantum-electrodynamics readout and spin-flipping Raman transitions and found a spin-flip time T _S = 17 microseconds and a spin coherence time T _2E = 52 nanoseconds. These results herald a regime of supercurrent-mediated coherent spin-photon coupling at the single-quantum level.

Regulation of inflammatory and catabolic responses to IL-1β in rat articular chondrocytes by microRNAs miR-122 and miR-451

OBJECTIVE

miR-122 stimulates proliferation of growth plate chondrocytes whereas miR-451 stimulates terminal differentiation and matrix turnover. Here, we examined the potential of these microRNA as regulators of articular chondrocytes using an in vitro model of osteoarthritis.

METHODS

miR-122 and miR-451 presence in rat articular cartilage was assessed using the anterior cruciate ligament transection model of OA. In vitro testing used first passage rat articular chondrocytes (rArCs) that were transfected with lipofectamine (Lipo) and miR-122 or miR-451 for 24-h, then treated with 10 ng/mL IL-1β in order to mimic an osteoarthritic environment. Conditioned media were collected and MMP13, PGE2 and OA-related cytokines were measured. Matrix vesicles were collected from cell layer lysates using ultra-centrifugation. Cells were treated with miR-122 or miR-451 inhibitors to verify miR-specific effects.

RESULTS

Both miR-122 and miR-451 were increased in the OA articular cartilage compared to healthy tissue; rArCs expressed both microRNAs in MVs. miR-122 prevented IL-1β-dependent increases in MMP-13 and PGE2, whereas miR-451 significantly increased the IL-1β effect. Multiplex data indicated that miR-122 reduced the stimulatory effect of IL-1β on IL-1α, IL-2, Il-4, IL-6, GM-CSF, MIP-1A, RANTES and VEGF. In contrast, IL-2, IL-4, IL-6, GM-CSF, and MIP-1A were increased by miR-451 while VEGF was decreased. Inhibiting miR-122 exacerbated the response to IL-1β indicating endogenous levels of miR-122 were present. There were no differences in MMP-13 or PGE2 with miR-451 Locked Nucleic Acid (LNA) inhibitor treatment.

CONCLUSIONS

Both miRs were elevated in OA in a rat bilateral anterior cruciate ligament transection (ACLT) model. miR-122 prevented, while miR-451 exacerbated the effects of IL-1β on rArCs.

Hot Nonequilibrium Quasiparticles in Transmon Qubits

Nonequilibrium quasiparticle excitations degrade the performance of a variety of superconducting circuits. Understanding the energy distribution of these quasiparticles will yield insight into their generation mechanisms, the limitations they impose on superconducting devices, and how to efficiently mitigate quasiparticle-induced qubit decoherence. To probe this energy distribution, we systematically correlate qubit relaxation and excitation with charge-parity switches in an offset-charge-sensitive transmon qubit, and find that quasiparticle-induced excitation events are the dominant mechanism behind the residual excited-state population in our samples. By itself, the observed quasiparticle distribution would limit T_{1} to ≈200  μs, which indicates that quasiparticle loss in our devices is on equal footing with all other loss mechanisms. Furthermore, the measured rate of quasiparticle-induced excitation events is greater than that of relaxation events, which signifies that the quasiparticles are more energetic than would be predicted from a thermal distribution describing their apparent density.

Direct Microwave Measurement of Andreev-Bound-State Dynamics in a Semiconductor-Nanowire Josephson Junction

The modern understanding of the Josephson effect in mesosopic devices derives from the physics of Andreev bound states, fermionic modes that are localized in a superconducting weak link. Recently, Josephson junctions constructed using semiconducting nanowires have led to the realization of superconducting qubits with gate-tunable Josephson energies. We have used a microwave circuit QED architecture to detect Andreev bound states in such a gate-tunable junction based on an aluminum-proximitized indium arsenide nanowire. We demonstrate coherent manipulation of these bound states, and track the bound-state fermion parity in real time. Individual parity-switching events due to nonequilibrium quasiparticles are observed with a characteristic timescale T_{parity}=160±10  μs. The T_{parity} of a topological nanowire junction sets a lower bound on the bandwidth required for control of Majorana bound states.

Delayed first injection of the once-a-month injectable contraceptive containing 25 mg medroxyprogesterone acetate and 5 mg estradiol-cypionate: effects on cervical mucus

The objectives of this study were to assess whether women who were administered the first injection of the once-a-month contraceptive containing estradiol cypionate and 25 mg depot-medroxyprogesterone acetate (MPA+E(2)C) on Day 7 of their menstrual cycle (delayed injection) exhibit the same degree of cervical mucus changes as women who receive it on Day 5 of their menstrual cycle. This was a multicenter, randomized, controlled clinical trial. A total of 158 women, aged between 18 and 38 years (inclusive), who, were willing to use MPA+E(2)C as their contraceptive method participated in the trial. Participants received a MPA+E(2)C injection on Day 5 (control group, n = 41) or Day 7 (delayed-injection group, n = 117) of their menstrual cycle. Participants who received MPA+E(2)C on Day 5 of their menstrual cycle (control group) exhibited fair or poor mucus quality and poor sperm penetration. Of those women who received MPA+E(2)C on Day 7 of their menstrual cycle (delayed-injection group), 3 (3%) showed good mucus or good sperm penetration at some time point during follow-up. It is possible to conclude that the first injection of MPA+E(2)C given on Day 7 of a menstrual cycle does not provide the same degree of inhibition of mucus quality and sperm penetration as that observed if it is administered on Day 5. However, the theoretical risk of pregnancy after receiving MPA+E(2)C on Day 7 would be expected to be low.

Delayed first injection of the once-a-month injectable contraceptive containing 25 mg of medroxyprogesterone acetate and 5 mg of E(2)-cypionate: effects on ovarian function

OBJECTIVE

To assess whether women who were administered the first injection of DMPA+E(2)C on day 7 of their menstrual cycle (delayed injection) exhibit the same degree of ovarian suppression as women who receive it on day 5 of their menstrual cycle.

DESIGN

Multicenter, randomized controlled trial.

SETTING

Reproductive health clinics.

PATIENT(S)

Women aged between 18 and 38 years (inclusive) willing to use DMPA+E(2)C as their method of contraception.

INTERVENTION(S)

Participants received a DMPA+E(2)C injection on day 5 (control group, n = 41) or day 7 (delayed-injection group, n = 117) of their menstrual cycle.

MAIN OUTCOME MEASURE(S)

Ovarian activity and follicular development determined by serial serum progesterone levels and vaginal ultrasound.

RESULT(S)

Participants who received DMPA+E(2)C on day 5 of their menstrual cycle (control group) exhibited no more than limited follicular growth (no follicle >16 mm). Of those women who received DMPA+E(2)C on day 7 of their menstrual cycle (delayed-injection group), 21 (18%) showed some follicular growth, of whom 4 (3%) ovulated.

CONCLUSION(S)

The first injection of DMPA+E(2)C given on day 7 of a menstrual cycle does not provide the same inhibition of ovarian activity as that observed when it is administered on day 5 of the menstrual cycle.

Biodistribution and dosimetry of pretargeted monoclonal antibody 2D12.5 and Y-Janus-DOTA in BALB/c mice with KHJJ mouse adenocarcinoma

Biodistribution and dosimetry of 88Y (and equimolar 90Y) Janus-dodecanetetraacetic acid (DOTA) were performed using a three-step pretargeting protocol in BALB/c mice bearing mouse mammary adenocarcinoma (KHJJ) implants. Pretargeting was performed with mouse monoclonal antibody (mAb) 2D12.5 specific for yttrium-DOTA, and the chase was Y-DOTA-human transferrin conjugate. In this article, we report extensive organ dosimetry and the theoretic limits of the radionuclide physical half-life (T(p)) for pretargeting.

METHODS

Organ biodistribution data were obtained from bioassays on tissue taken from tumor mice killed at 3, 24, 48, 72, 96, and 120 h after intravenous injection of 88Y-Janus-DOTA. Uptake and retention of 88Y as a function of time were described by nonlinear least squares fits of the tissue data to multiexponential functions. Radiation dose estimates for equivalent molar amounts of 90Y were subsequently derived from these time-integrated functions.

RESULTS

The results were as follows: rapid blood clearance of 88Y-Janus-DOTA; rapid uptake and slow clearance of 88Y-Janus-DOTA from the tumor over 5 d; rapid clearance from all organs and body; largest radiation absorbed dose (AD) per injected dose of 63.52 (cGy/MBq) to tumor; high therapeutic ratios (AD tumor/AD tissue), particularly for blood and bone; and optimal radionuclide T(p) range from 30 min to 10 d.

CONCLUSION

Although the absolute concentration of 90Y in the tumor is less using the hapten system than is achieved generally with the chelated radionuclide covalently attached to the mAb, the achievable tumor uptake of radioactivity, coupled with low radioactivity in bone, blood, and other organs, suggests that a three-step pretargeting protocol has considerable promise as a method for 90Y radioimmunotherapy.

Thoracic and lumbar spine trauma

Complete thoracolumbar trauma evaluation incorporates radiographs, computed tomography, and magnetic resonance imaging. Primarily to localize the level of injury, diagnosis of thoracolumbar spine trauma begins with radiographs. Computed tomography with sagittal reformatted images is more sensitive for identifying the full extent of injury and the degree of involvement of the bony posterior elements. Magnetic resonance imaging is used for evaluating the extent of soft tissue injury, including damage to ligaments, discs, and epidural spaces. Magnetic resonance imaging is most frequently performed when radiographs and computed tomography do not explain the patients' symptoms and when there is a possibility of epidural hematoma, traumatic disc herniation, or spinal cord injury.

Pregnancy rates among Chilean women who had non-surgical sterilization with quinacrine pellets between 1977 and 1989

We describe cumulative pregnancy probabilities among women who underwent quinacrine pellet sterilization in Chile between 1977 and 1989 (N = 1492). We interviewed the women or relatives in 1991-93 and 1994-96, and reviewed hospital records. Mean follow-up was 9.6 years (median 9 years). We recorded 120 pregnancies, including 40 that went to term or near-term. There were nine adverse outcomes in eight infants: one fetal death at 18 weeks gestation; three infants born prematurely; one stillbirth (placental infarct); and four infants with birth defects. There was no clustering of any particular kind of birth defect. For two insertions, the 10-year cumulative pregnancy probability was 8.9 (95% confidence interval 3. 7, 14.1). For 3 insertions, the 10-year rate was 7.0 (4.4, 9.5). For women who were under 35 years at insertion, the 10-year rate was 10. 7 (7.4, 14.1). For women who were 35 or older at insertion, the 10-year rate was 3.1 (0.6, 5.7). The pregnancy rate varied little for 2 vs. three insertions, but the rate did vary significantly by age, with women who received quinacrine at 35 years or older 0.3 (0. 2, 0.5) times as likely to become pregnant as younger women. The 10-year cumulative ectopic pregnancy probabilities for women with two and three insertions of quinacrine were 0.9 (<0.1, 2.6) and 0.5 (<0.1, 1.2), respectively. Pregnancy rates after quinacrine insertion are higher than after surgical sterilization, but ectopic pregnancy rates appear similar.

Provision of emergency contraceptive pills to spermicide users in ghana

This study evaluated the effect of two approaches to provision of emergency contraceptive pills (ECPs) on ECP use and unprotected intercourse among women relying on spermicides for contraception. The study enrolled 211 women at 4 family planning clinics in Ghana. At two clinics, participants were advised to return to the clinic within 3 days after unprotected intercourse to obtain ECPs. At the other two clinics, participants were given ECPs to take home for use if unprotected intercourse occurred. All participants were asked to maintain daily diaries for 8 weeks to record information on sexual activity, spermicide use, and ECP use. Women at all clinics used ECPs after at least 78% of unprotected coital acts. ECPs were used more promptly by women who had the pills at home. At three of the clinics, at most 1.3% of the coital acts were unprotected; at the fourth, 6.7% were unprotected. Our data did not suggest that the availability of ECPs increased the frequency of unprotected intercourse.

Provider knowledge about emergency contraception in Ghana

In 1996, the Ministry of Health in Ghana included emergency contraception (EC) in its newly issued National Reproductive Health Service Policy and Standards. A short survey was conducted in the summer of 1997 to evaluate health providers' knowledge of EC. Of the 325 providers interviewed, about one-third (34%) had heard of EC. No provider had sufficient knowledge to prescribe EC correctly. A well-coordinated training programme for providers will have to precede successful introduction of EC in Ghana. Moreover, a dedicated product may be critical for the successful introduction of EC in a country like Ghana, where provider knowledge is low.

Is incarceration during pregnancy associated with infant birthweight?

OBJECTIVES

This study examined whether incarceration during pregnancy is associated with infant birthweight.

METHODS

Multivariable analyses compared infant birthweight outcomes among three groups of women: 168 women incarcerated during pregnancy, 630 women incarcerated at a time other than during pregnancy, and 3910 women never incarcerated.

RESULTS

After confounders were controlled for, infant birthweights among women incarcerated during pregnancy were not significantly different from women never incarcerated; however, infant birthweights were significantly worse among women incarcerated at a time other than during pregnancy than among never-incarcerated women and women incarcerated during pregnancy.

CONCLUSIONS

Certain aspects of the prison environment (shelter, food, etc.) may be health-promoting for high-risk pregnant women.

Sensory impairments and physical disability in aged women living at home

BACKGROUND

Studies of the impact of visual or hearing impairments on physical disability in older people have provided conflicting results. Furthermore, the consequences of the loss of such visual functions as depth perception or contrast sensitivity have rarely been studied. We examined the relationship of visual acuity, depth perception, contrast sensitivity, and hearing difficulty to the ability of older women living at home to accomplish instrumental activities of daily living independently.

METHODS

Data on self-reported physical disability and hearing impairment, as well as objective measures of functional vision and physical ability were collected from a sample of 1210 community-dwelling women aged 75 years and older. Multivariate logistic regression modelling was used to assess the strength of the association between physical disability and sensory impairments, controlling for age, education level, motor limitations, and prevalent chronic diseases.

RESULTS

Women with low visual acuity or low contrast sensitivity were significantly more likely to be physically dependent than women with good vision. Contrast sensitivity was, however, a better predictor than functional acuity, after controlling for age, education level, motor limitations and chronic medical conditions (adjusted odds ratio: 5.1; 95% confidence interval: 2.0-12.9). Depth perception was not related to physical disability. Women with serious hearing difficulty had significantly increased odds of dependency (4.1; 1. 4-12.1).

CONCLUSIONS

Severe sensory impairments are strongly related to physical dependency in older women. It may be useful to add a test of contrast sensitivity to the traditional acuity test to predict better which elderly individuals may have difficulty carrying out routine daily activities.

Conformity of Workers' and Occupational Health Physicians' Descriptions of Working Conditions

To determine whether workers, describing their own work, and occupational physicians, describing typical workstations, would report the same working conditions, and whether the relationships between health status and working conditions described by these two sources would be similar. An epidemiologic survey was carried out in 1987-88 in 17 poultry slaughterhouses and six canneries in France. The data were collected in two ways: workers described their own working conditions, and occupational physicians described the working conditions at workstations in the same factories. The study included 507 workers who worked at fixed workstations that had been described by the 24 occupational physicians. Health data were obtained from the workers by the physicians during their annual visits. The agreement between workers and physicians in the descriptions of seven working conditions was analyzed. On the whole, the prevalences of exposures to the seven selected working conditions estimated by the two sources were similar. Nevertheless, the observed agreement was not necessarily high. When agreement existed about specific working conditions, the relationships observed between those conditions and workers' health were generally similar for the two sources. This result was stronger for physical health problems than for mental health problems. When both sources agreed that the worker was being exposed to a risk factor, the risk estimation was higher compared with the cases of discordant judgment. This study confirms the usefulness of information provided by experts but also the necessity to interview workers themselves about their working conditions.

Work in operating rooms and pregnancy outcome among nurses

The aim of this study was to analyse the relationship between work in an operating room and pregnancy outcome, as described by the rates of spontaneous abortion and of birth defects. The population comprised the female nurses of 17 hospitals in Paris, interviewed in 1987-1989. An exposed group included all operating room nurses, and a control group was composed of female nurses in other departments matched by hospital, age and duration of service. Each woman described all prior pregnancies. In total, 776 pregnancies were described by 418 nurses who were first pregnant in 1970 or thereafter; ectopic pregnancies, those terminated by voluntary induced abortion and those leading to multiple births were excluded. The rate of spontaneous abortion was significantly higher for pregnancies during which women worked in an operating room than for the other pregnancies. Birth defects were not significantly related to work in an operating room during pregnancy. These results are in agreement with others showing a significant relationship between occupational exposure to operating rooms and spontaneous abortion, although identification of the responsible factor remains difficult. They suggest that effective ventilating systems should be installed in all operating rooms and that special preventive measures must be taken for women of childbearing age.

Radioactive iodine therapy in cats with hyperthyroidism

Eleven cats with hyperthyroidism were treated with radioactive iodine (131I). Previous unsuccessful treatments for hyperthyroidism included hemithyroidectomy (2 cats) and an antithyroid drug (7 cats). Two cats had no prior treatment. Thyroid scans, using technetium 99m, showed enlargement and increased radionuclide accumulation in 1 thyroid lobe in 5 cats and in both lobes in 6 cats. Serum thyroxine concentrations were high and ranged from 4.7 to 18 micrograms/dl. Radioactive iodine tracer studies were used to determine peak radioactive iodine uptake (RAIU) and effective and biological half-lives. Activity of 131I administered was calculated from peak RAIU, effective half-life, and estimated thyroid gland weight. Activity of 131I administered ranged from 1.0 to 5.9 mCi. The treatment goal was to deliver 20,000 rad to hyperactive thyroid tissue. However, retrospective calculations based on peak RAIU and effective half-life obtained during the treatment period showed that radiation doses actually ranged from 7,100 to 64,900 rad. Complete ablation of the hyperfunctioning thyroid tissue and a return to euthyroidism were seen in 7 cats. Partial responses were seen in 2 cats, and 2 cats became hypothyroid. It was concluded that 131I ablation of thyroid tumors was a reasonable alternative in the treatment of hyperthyroidism in cats. The optimal method of dosimetry remains to be determined.