Identification of a second glycoform of the clinically prevalent O1 antigen from Klebsiella pneumoniae

Carbapenemase and extended β-lactamase-producing Klebsiella pneumoniae isolates represent a major health threat, stimulating increasing interest in immunotherapeutic approaches for combating Klebsiella infections. Lipopolysaccharide O antigen polysaccharides offer viable targets for immunotherapeutic development, and several studies have described protection with O-specific antibodies in animal models of infection. O1 antigen is produced by almost half of clinical Klebsiella isolates. The O1 polysaccharide backbone structure is known, but monoclonal antibodies raised against the O1 antigen showed varying reactivity against different isolates that could not be explained by the known structure. Reinvestigation of the structure by NMR spectroscopy revealed the presence of the reported polysaccharide backbone (glycoform O1a), as well as a previously unknown O1b glycoform composed of the O1a backbone modified with a terminal pyruvate group. The activity of the responsible pyruvyltransferase (WbbZ) was confirmed by western immunoblotting and in vitro chemoenzymatic synthesis of the O1b terminus. Bioinformatic data indicate that almost all O1 isolates possess genes required to produce both glycoforms. We describe the presence of O1ab-biosynthesis genes in other bacterial species and report a functional O1 locus on a bacteriophage genome. Homologs of wbbZ are widespread in genetic loci for the assembly of unrelated glycostructures in bacteria and yeast. In K. pneumoniae, simultaneous production of both O1 glycoforms is enabled by the lack of specificity of the ABC transporter that exports the nascent glycan, and the data reported here provide mechanistic understanding of the capacity for evolution of antigenic diversity within an important class of biomolecules produced by many bacteria.

[Perioperative lethality after endovascular and open repair of ruptured abdominal aortic aneurysms: An analysis of administrative data of the AOK health insurance fund]

OBJECTIVE

In this paper we will report the perioperative outcome after endovascular (EVAR) and open (OAR) repair of ruptured abdominal aortic aneurysms (rAAA) in Germany based on data of the AOK health insurance fund.

METHODS

Anonymised data of all patients with rAAA (n = 3,227) who were treated from 01/01/2010 to 12/31/2016 were analysed, using SPSS 27 (IBM Deutschland GmbH, Ehningen, Germany).

RESULTS

41.9% (1,353/3,227) of the patients were treated with EVAR and 58.1% (1,874/3,227) with OAR. Patients ≥80 years made up 38.4% for EVAR and 32.9% for OAR (p = 0.002). The proportion of patients undergoing surgery within 24 hours after admission was significantly higher for OAR (87.8%) than for EVAR (73.0%) (p = 0.000). The perioperative lethality rate for OAR was 42.4%, and thus almost twice as high as for EVAR with 21.3% (p = 0.000). Women had higher perioperative lethality rates for both EVAR (perioperative lethality 24.6%) and OAR (perioperative lethality 51.7%) compared to men with 20.6% (EVAR) and 40.2% (OAR), respectively. With EVAR, 35.8% of the patients showed a complication-free postoperative course, with OAR it was 17.7% (p = 0.000). Blood transfusions (whole blood, red cell concentrates, and autotransfusions) were administered in 57.6% of the patients with EVAR, but in 92.3% with OAR (p = 0.000). The highest perioperative lethality was found in EVAR and OAR patients who received both surgery within 24 hours after admission and blood transfusions (perioperative lethality EVAR 36.0%, OAR 46.0%; p = 0.000). In contrast, patients who did not require blood transfusions and were treated later than 24 hours after admission had the lowest perioperative lethality with 3.2% for EVAR vs. 5.4% for OAR (p = 0.623).

CONCLUSION

The data confirm the observation that the perioperative mortality of rAAA patients is lower with EVAR than with OAR. However, strict attention must be paid to the time of the intervention. The low perioperative lethality of patients who were treated later than 24 hours after hospital admission and who did not require blood transfusions indicates that cases of symptomatic AAA without rupture have also been recorded in this administrative database under the diagnosis rAAA. One point of criticism is that the decision not to adjust for the patient groups with EVAR and with OAR in order to be able to better analyse the properties of routine data includes a considerable risk of bias in the statements of this work due to confounding variables.

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.

The development and characterization of an E. coli O25B bioconjugate vaccine

Extraintestinal pathogenic Escherichia coli (ExPEC) cause a wide range of clinical diseases such as bacteremia and urinary tract infections. The increase of multidrug resistant ExPEC strains is becoming a major concern for the treatment of these infections and E. coli has been identified as a critical priority pathogen by the WHO. Therefore, the development of vaccines has become increasingly important, with the surface lipopolysaccharide constituting a promising vaccine target. This study presents genetic and structural analysis of clinical urine isolates from Switzerland belonging to the serotype O25. Approximately 75% of these isolates were shown to correspond to the substructure O25B only recently described in an emerging clone of E. coli sequence type 131. To address the high occurrence of O25B in clinical isolates, an O25B glycoconjugate vaccine was prepared using an E. coli glycosylation system. The O antigen cluster was integrated into the genome of E. coli W3110, thereby generating an E. coli strain able to synthesize the O25B polysaccharide on a carrier lipid. The polysaccharide was enzymatically conjugated to specific asparagine side chains of the carrier protein exotoxin A (EPA) of Pseudomonas aeruginosa by the PglB oligosaccharyltransferase from Campylobacter jejuni. Detailed characterization of the O25B-EPA conjugate by use of physicochemical methods including NMR and GC-MS confirmed the O25B polysaccharide structure in the conjugate, opening up the possibility to develop a multivalent E. coli conjugate vaccine containing O25B-EPA.

Comparison of open and endovascular repair of juxtarenal abdominal aortic aneurysms

BACKGROUND

This study compares the perioperative outcome in elective repair of the juxtarenal abdominal aortic aneurysm (AAA), depending upon whether patients received an open (OAR) or endovascular procedure (EVAR).

METHODS

The database stems from the 2013-2017 AAA registry of the German Institute for Vascular Health Research (DIGG) of the German Society for Vascular Surgery and Vascular Medicine (DGG), with a total of 1603 juxtarenal AAAs. 786 patients (49.0%) were treated with an endovascular (EVAR) procedure, and 817 (51.0%) with an open (OAR) procedure.

RESULTS

Patients receiving EVAR had a median age of 73 years and those receiving OAR a median age of 71 years (p < 0.001). The proportion of patients over 80 years of age was 17.0% for EVAR and 9.9% for OAR (p < 0.001). The proportion of women receiving EVAR (16.9%) was slightly lower than that receiving OAR (18.6%). Aneurysm diameter differed significantly (EVAR mean 57.80 mm, OAR 59.07 mm; p = 0.038). Preoperatively impaired renal function stages 3 to 5 were not significantly different (EVAR 12.5%, OAR 14.4%, p = 0.158). Postoperative complications were significantly less with EVAR (31%) than with OAR at 45.7% (p = 0.001). In regard to MACE (major adverse cardiac events = perioperative death, stroke, or myocardial infarction), there were no significant differences between EVAR (8.8%) and OAR (10.3%) (p = 0.191). Hospital mortality was only in trend lower with EVAR than with OAR (5.7% vs. 7.7%, respectively; p = 0.068). This held true for the hospital mortality in the group above 80 years of age as well. Inpatient stay was 9 (13.3) days for EVAR and 14 (18.8) days for OAR (p < 0.001). The hospital mortality for women receiving EVAR was 10.5%, and significantly higher (p = 0.008) than that for men (4.7%). The same held true for OAR (hospital mortality for women was 11.8%, for men 6.8%; p = 0.030).

CONCLUSION

In terms of perioperative outcome, the endovascular procedure for treating juxtarenal AAA is more favorable than that documented for OAR. Further investigation is necessary to determine whether EVAR is comparable with OAR in the long term when treating juxtarenal AAA.

[The DIGG risk score : A risk predictive model of perioperative mortality after elective treatment of intact abdominal aortic aneurysms in the DIGG register]

OBJECTIVE

The aim of the study was to develop a specific risk score for the aortic register of the German Institute for Vascular Health Care Research (DIGG) of the German Society for Vascular Surgery and Vascular Medicine (DGG) for the prediction of postoperative mortality in elective treatment of intact abdominal aortic aneurysms (iAAA). The score should also enable a risk-adjusted presentation of the register results in the near future.

METHODS

The method of binary logistic regression analysis was used to calculate the model. The data from 10,404 patients were included in the analysis, of whom 7870 (75.6%) were treated by endovascular (EVAR) and 2534 (24.4%) by open (OR) aortic repair. It was examined which factors have an independent influence on hospital mortality and the effect size was determined as a score.

RESULTS

For EVAR, the influencing factors with their effect sizes (score in brackets) were: age >85 years (2), female gender (2), juxtarenal AAA (5), maximum diameter >65 mm (2), diabetes mellitus (2), American Society of Anesthesiologists (ASA) score >3 (2), cardiac comorbidities (3) and renal insufficiency stage >3 (5). For OR the factors were: age >80 years (2), female gender (2), juxtarenal AAA (2), ASA score >3 (3), previous myocardial infarction (2), renal comorbidities (3) and previous stroke (2). The estimated hospital mortality was calculated for the individual case from the sum of the risk factors (scores). The accuracy of the model (correlation between observed and expected results) was determined using the receiver operating characteristic (ROC) curve. An area under the curve (AUC) of 0.817 (confidence interval 0.789-0.844) demonstrated an excellent discrimination. In a validation group of 3831 patients, the good agreement between observed and calculated results was confirmed.

CONCLUSION

The DIGG risk score can predict risk-adjusted hospital mortality after EVAR and OR of iAAA in the DIGG register. Improvements with respect to the prediction are desirable for OR and should be strived for by extending the model in the future.

Characterization and immunogenicity of a Shigella flexneri 2a O-antigen bioconjugate vaccine candidate

Shigellosis remains a major cause of diarrheal disease in developing countries and causes substantial morbidity and mortality in children. Vaccination represents a promising preventive measure to fight the burden of the disease, but despite enormous efforts, an efficacious vaccine is not available to date. The use of an innovative biosynthetic Escherichia coli glycosylation system substantially simplifies the production of a multivalent conjugate vaccine to prevent shigellosis. This bioconjugation approach has been used to produce the Shigella dysenteriae type O1 conjugate that has been successfully tested in a phase I clinical study in humans. In this report, we describe a similar approach for the production of an additional serotype required for a broadly protective shigellosis vaccine candidate. The Shigella flexneri 2a O-polysaccharide is conjugated to introduced asparagine residues of the carrier protein exotoxin A (EPA) from Pseudomonas aeruginosa by co-expression with the PglB oligosaccharyltransferase. The bioconjugate was purified, characterized using physicochemical methods and subjected to preclinical evaluation in rats. The bioconjugate elicited functional antibodies as shown by a bactericidal assay for S. flexneri 2a. This study confirms the applicability of bioconjugation for the S. flexneri 2a O-antigen, which provides an intrinsic advantage over chemical conjugates due to the simplicity of a single production step and ease of characterization of the homogenous monomeric conjugate formed. In addition, it shows that bioconjugates are able to raise functional antibodies against the polysaccharide antigen.

A biosynthetic route for polysialylating proteins in Escherichia coli

Polysialic acid (polySia) is a posttranslational modification found on only a handful of proteins in the central nervous and immune systems. The addition of polySia to therapeutic proteins improves pharmacokinetics and reduces immunogenicity. To date, polysialylation of therapeutic proteins has only been achieved in vitro by chemical or chemoenzymatic strategies. In this work, we develop a biosynthetic pathway for site-specific polysialylation of recombinant proteins in the cytoplasm of Escherichia coli. The pathway takes advantage of a bacterial cytoplasmic polypeptide-glycosyltransferase to establish a site-specific primer on the target protein. The glucose primer is extended by glycosyltransferases derived from lipooligosaccharide, lipopolysaccharide and capsular polysaccharide biosynthesis from different bacterial species to synthesize long chain polySia. We demonstrate the new biosynthetic route by modifying green fluorescent proteins and a therapeutic DARPin (designed ankyrin repeat protein).

Neuroimaging in former preterm children who received erythropoiesis stimulating agents

BackgroundIn premature children, erythropoiesis-stimulating agents (ESAs) may improve developmental outcome. It is not clear which of the several potential mechanisms are responsible for this improvement. High-resolution MRI and diffusion tensor imaging characterize brain structure and white matter organization, offering possible insight into the long-term effect of ESAs on brain development.MethodsMRI scans were performed at 3.5-4 years of age on former preterm infants treated with ESAs or placebo, and on healthy term controls. Mean cortical thickness, surface area, and fractional anisotropy (FA) were compared across study groups, and were correlated with general IQ measures.ResultsUnivariate analysis found no significant effect of ESAs on cortical thickness (P=0.366), surface area (P=0.940), or FA (P=0.150); however, there was a greater increase in FA among ESA-treated girls. Group analysis found significant correlations between FA and Full-Scale IQ (P=0.044) and Verbal IQ (P=0.036), although there was no significant relationship between Full-Scale IQ and FA among just the preterm children.ConclusionESA treatment may have a preferential effect on white matter development in girls, although factors other than just whole-brain FA are involved in mediating cognitive outcome.

Secondary diamines as a monomer from bis-hydroaminomethylation of industrial cyclic dienes

Acetic acid gives amines wings: bis-hydroaminomethylation of dienes to provide industrial secondary diamine monomers. Application of reactive extraction as a recycling method for the rhodium catalyst.

Experimental Demonstration of a Resonator-Induced Phase Gate in a Multiqubit Circuit-QED System

The resonator-induced phase (RIP) gate is an all-microwave multiqubit entangling gate that allows a high degree of flexibility in qubit frequencies, making it attractive for quantum operations in large-scale architectures. We experimentally realize the RIP gate with four superconducting qubits in a three-dimensional circuit-QED architecture, demonstrating high-fidelity controlled-z (cz) gates between all possible pairs of qubits from two different 4-qubit devices in pair subspaces. These qubits are arranged within a wide range of frequency detunings, up to as large as 1.8 GHz. We further show a dynamical multiqubit refocusing scheme in order to isolate out 2-qubit interactions, and combine them to generate a 4-qubit Greenberger-Horne-Zeilinger state.

The mitogenome of the bed bug Cimex lectularius (Hemiptera: Cimicidae)

We report the extraction of a bed bug mitogenome from high-throughput sequencing projects originally focused on the nuclear genome of Cimex lectularius. The assembled mitogenome has a similar AT nucleotide composition bias found in other insects. Phylogenetic analysis of all protein-coding genes indicates that C. lectularius is clearly a member of a paraphyletic Cimicomorpha clade within the Order Hemiptera.

Preschool Assessment of Preterm Infants Treated With Darbepoetin and Erythropoietin

BACKGROUND

We previously reported improved neurodevelopmental outcomes at 2 years among infants treated with the erythropoiesis-stimulating agents (ESAs) darbepoetin alfa (darbepoetin) or erythropoietin. Here we characterize 4-year outcomes.

METHODS

Former preterm infants randomly assigned to receive darbepoetin (10 μg/kg, once per week), erythropoietin (400 U/kg, 3 times/week), or placebo through 35 weeks' postconceptual age were evaluated at 3.5 to 4 years of age. For comparison, healthy children formerly delivered full term (term controls [TCs]) were also recruited. All participants were assessed by using measures of full-scale IQ (FSIQ) and general language from the Wechsler Preschool and Primary Scale of Intelligence, Third Edition, and an overall measure of executive function, on the basis of tests evaluating inhibitory control and spatial working memory. Rates of neurodevelopmental impairment were compared across groups.

RESULTS

Multivariate analysis of variance compared children randomly assigned to ESAs (n = 39), placebo (n =14), and TCs (n = 24). FSIQ and performance IQ were significantly higher in the ESA group than in the placebo group (FSIQ: 91.1 ± 17.5 vs 79.2 ± 18.5, P = .036; performance IQ: 93.0 ± 17.0 vs 79.5 ± 19.5, P = .018). Follow-up analyses revealed that the children receiving ESAs performed better than those who received placebo on executive function tasks. The ESA group's performance was below that of TCs, but the results did not reach significance on executive function. The incidence of neurodevelopmental impairment was greater in the placebo group than in the ESA group.

CONCLUSIONS

ESA-treated infants had better cognitive outcomes and less developmental impairment at 3.5 to 4 years of age compared with placebo-treated infants. ESAs show promise in improving long-term cognitive outcomes of infants born prematurely.

Purification and characterization of a Shigella conjugate vaccine, produced by glycoengineering Escherichia coli

Shigellosis remains a major cause of diarrheal disease in developing countries and causes substantial morbidity and mortality in children. Glycoconjugate vaccines consisting of bacterial surface polysaccharides conjugated to carrier proteins are the most effective vaccines for controlling invasive bacterial infections. Nevertheless, the development of a multivalent conjugate vaccine to prevent Shigellosis has been hampered by the complex manufacturing process as the surface polysaccharide for each strain requires extraction, hydrolysis, chemical activation and conjugation to a carrier protein. The use of an innovative biosynthetic Escherichia coli glycosylation system substantially simplifies the production of glycoconjugates. Herein, the Shigella dysenteriae type 1 (Sd1) O-polysaccharide is expressed and its functional assembly on an E. coli glycosyl carrier lipid is demonstrated by HPLC analysis and mass spectrometry. The polysaccharide is enzymatically conjugated to specific asparagine residues of the carrier protein by co-expression of the PglB oligosaccharyltransferase and the carrier protein exotoxin A (EPA) from Pseudomonas aeruginosa. The extraction and purification of the Shigella glycoconjugate (Sd1-EPA) and its detailed characterization by the use of physicochemical methods including NMR and mass spectrometry is described. The report shows for the first time that bioconjugation provides a newly developed and improved approach to produce an Sd1 glycoconjugate that can be characterized using state-of-the-art techniques. In addition, this generic process together with the analytical methods is ideally suited for the production of additional Shigella serotypes, allowing the development of a multivalent Shigella vaccine.

Demonstration of a quantum error detection code using a square lattice of four superconducting qubits

The ability to detect and deal with errors when manipulating quantum systems is a fundamental requirement for fault-tolerant quantum computing. Unlike classical bits that are subject to only digital bit-flip errors, quantum bits are susceptible to a much larger spectrum of errors, for which any complete quantum error-correcting code must account. Whilst classical bit-flip detection can be realized via a linear array of qubits, a general fault-tolerant quantum error-correcting code requires extending into a higher-dimensional lattice. Here we present a quantum error detection protocol on a two-by-two planar lattice of superconducting qubits. The protocol detects an arbitrary quantum error on an encoded two-qubit entangled state via quantum non-demolition parity measurements on another pair of error syndrome qubits. This result represents a building block towards larger lattices amenable to fault-tolerant quantum error correction architectures such as the surface code.

The physical realization of a quantum computer requires built-in error-correcting codes that compensate the disruption of quantum information arising from noise. Here, the authors demonstrate a quantum error detection scheme for arbitrary single-qubit errors on a four superconducting qubit lattice.

Prevention of Staphylococcus aureus infections by glycoprotein vaccines synthesized in Escherichia coli

BACKGROUND

Staphylococcus aureus is a leading cause of superficial and invasive human disease that is often refractory to antimicrobial therapy. Vaccines have the potential to reduce the morbidity, mortality, and economic impact associated with staphylococcal infections. However, single-component vaccines targeting S. aureus have failed to show efficacy in clinical trials.

METHODS

A novel glycoengineering technology for creation of a multicomponent staphylococcal vaccine is described. Genes encoding S. aureus capsular polysaccharide (CP) biosynthesis, PglB (a Campylobacter oligosaccharyl transferase), and a protein carrier (detoxified Pseudomonas aeruginosa exoprotein A or S. aureus α toxin [Hla]) were coexpressed in Escherichia coli. Recombinant proteins N-glycosylated with S. aureus serotype 5 or 8 CPs were purified from E. coli.

RESULTS

Rabbits and mice immunized with the glycoprotein vaccines produced antibodies that were active in vitro in functional assays. Active and passive immunization strategies targeting the CPs protected mice against bacteremia, and vaccines targeting Hla protected against lethal pneumonia. The CP-Hla bioconjugate vaccine protected against both bacteremia and lethal pneumonia, providing broad-spectrum efficacy against staphylococcal invasive disease.

CONCLUSIONS

Glycoengineering technology, whereby polysaccharide and protein antigens are enzymatically linked in a simple E. coli production system, has broad applicability for use in vaccine development against encapsulated microbial pathogens.

Entanglement of two superconducting qubits in a waveguide cavity via monochromatic two-photon excitation

We report a system where fixed interactions between noncomputational levels make bright the otherwise forbidden two-photon |00}→|11} transition. The system is formed by hand selection and assembly of two discrete component transmon-style superconducting qubits inside a rectangular microwave cavity. The application of a monochromatic drive tuned to this transition induces two-photon Rabi-like oscillations between the ground and doubly excited states via the Bell basis. The system therefore allows all-microwave two-qubit universal control with the same techniques and hardware required for single qubit control. We report Ramsey-like and spin echo sequences with the generated Bell states, and measure a two-qubit gate fidelity of F(g)=90% (unconstrained) and 86% (maximum likelihood estimator).

Characterization of addressability by simultaneous randomized benchmarking

The control and handling of errors arising from cross talk and unwanted interactions in multiqubit systems is an important issue in quantum information processing architectures. We introduce a benchmarking protocol that provides information about the amount of addressability present in the system and implement it on coupled superconducting qubits. The protocol consists of randomized benchmarking experiments run both individually and simultaneously on pairs of qubits. A relevant figure of merit for the addressability is then related to the differences in the measured average gate fidelities in the two experiments. We present results from two similar samples with differing cross talk and unwanted qubit-qubit interactions. The results agree with predictions based on simple models of the classical cross talk and Stark shifts.

Engineering, conjugation, and immunogenicity assessment of Escherichia coli O121 O antigen for its potential use as a typhoid vaccine component

State-of-the-art production technologies for conjugate vaccines are complex, multi-step processes. An alternative approach to produce glycoconjugates is based on the bacterial N-linked protein glycosylation system first described in Campylobacter jejuni. The C. jejuni N-glycosylation system has been successfully transferred into Escherichia coli, enabling in vivo production of customized recombinant glycoproteins. However, some antigenic bacterial cell surface polysaccharides, like the Vi antigen of Salmonella enterica serovar Typhi, have not been reported to be accessible to the bacterial oligosaccharyltransferase PglB, hence hamper development of novel conjugate vaccines against typhoid fever. In this report, Vi-like polysaccharide structures that can be transferred by PglB were evaluated as typhoid vaccine components. A polysaccharide fulfilling these requirements was found in Escherichia coli serovar O121. Inactivation of the E. coli O121 O antigen cluster encoded gene wbqG resulted in expression of O polysaccharides reactive with antibodies raised against the Vi antigen. The structure of the recombinantly expressed mutant O polysaccharide was elucidated using a novel HPLC and mass spectrometry based method for purified undecaprenyl pyrophosphate (Und-PP) linked glycans, and the presence of epitopes also found in the Vi antigen was confirmed. The mutant O antigen structure was transferred to acceptor proteins using the bacterial N-glycosylation system, and immunogenicity of the resulting conjugates was evaluated in mice. The conjugate-induced antibodies reacted in an enzyme-linked immunosorbent assay with E. coli O121 LPS. One animal developed a significant rise in serum immunoglobulin anti-Vi titer upon immunization.

Efficient measurement of quantum gate error by interleaved randomized benchmarking

We describe a scalable experimental protocol for estimating the average error of individual quantum computational gates. This protocol consists of interleaving random Clifford gates between the gate of interest and provides an estimate as well as theoretical bounds for the average error of the gate under test, so long as the average noise variation over all Clifford gates is small. This technique takes into account both state preparation and measurement errors and is scalable in the number of qubits. We apply this protocol to a superconducting qubit system and find a bounded average error of 0.003 [0,0.016] for the single-qubit gates X(π/2) and Y(π/2). These bounded values provide better estimates of the average error than those extracted via quantum process tomography.

Universal quantum gate set approaching fault-tolerant thresholds with superconducting qubits

We use quantum process tomography to characterize a full universal set of all-microwave gates on two superconducting single-frequency single-junction transmon qubits. All extracted gate fidelities, including those for Clifford group generators, single-qubit π/4 and π/8 rotations, and a two-qubit controlled-not, exceed 95% (98%), without (with) subtracting state preparation and measurement errors. Furthermore, we introduce a process map representation in the Pauli basis which is visually efficient and informative. This high-fidelity gate set serves as a critical building block towards scalable architectures of superconducting qubits for error correction schemes and pushes up on the known limits of quantum gate characterization.

[Long-term effectiveness of psychodynamic outpatient treatment of addiction]

BACKGROUND

The aim of this study is to make an evaluation of the effectiveness of long-term outpatient treatment for addiction on the basis of abstinence, cognitive functions, and changes in personality structure.

METHODS

This is a prospective cohort study of 259 patients with registration of the German core data set "addiction", a 12-month follow-up and neuropsychological testing (personality inventory, intelligence and cognitive functions).

RESULTS

One year after the end of the long-term treatment we see an abstinence rate (DGSS4) of 57.5 %. The most substantial factors in abstinence are the participation in a self-help-group (β = 0.734, p < 0.0001). Known negative predictors such as unemployment (β = - 0.093, p < 0.01) and problematic debts over 15,000 $ (β = - 0.104, p < 0.01 just show a small negative correlation with abstinence. The results seems to indicate that patients have better overall performance and achieve better results in the neuropsychological testing at the end of the rehabilitation. The ideal and self-image may be changed positively. We see also unspecific changes classified by a reduction of the psychological test values regarding conversion symptoms, depressive mood, psychasthenia and social isolation. At the end of the long-term treatment the patients show significantly better cognitive functions and an improvement in their ideals and self-images. Conversion symptoms, depressive mood and reduced values for psychasthenia and social isolation can be decreased.

DISCUSSION

These results of a psycho-dynamic outpatient treatment of addiction seem to show its high effectiveness in terms of abstinence and processing of drug structures. The cognitive functions could increase. This could be determinate of a condition for the conservation and restoration of working capacity. Further studies should differentiate the effect of insight into the dependency structure from the abstinence as an specific or unspecific effect.

A toolkit for forward/inverse problems in electrocardiography within the SCIRun problem solving environment

Computational modeling in electrocardiography often requires the examination of cardiac forward and inverse problems in order to non-invasively analyze physiological events that are otherwise inaccessible or unethical to explore. The study of these models can be performed in the open-source SCIRun problem solving environment developed at the Center for Integrative Biomedical Computing (CIBC). A new toolkit within SCIRun provides researchers with essential frameworks for constructing and manipulating electrocardiographic forward and inverse models in a highly efficient and interactive way. The toolkit contains sample networks, tutorials and documentation which direct users through SCIRun-specific approaches in the assembly and execution of these specific problems.

Simple all-microwave entangling gate for fixed-frequency superconducting qubits

We demonstrate an all-microwave two-qubit gate on superconducting qubits which are fixed in frequency at optimal bias points. The gate requires no additional subcircuitry and is tunable via the amplitude of microwave irradiation on one qubit at the transition frequency of the other. We use the gate to generate entangled states with a maximal extracted concurrence of 0.88, and quantum process tomography reveals a gate fidelity of 81%.

Investigation of smoothness-increasing accuracy-conserving filters for improving streamline integration through discontinuous fields

Streamline integration of fields produced by computational fluid mechanics simulations is a commonly used tool for the investigation and analysis of fluid flow phenomena. Integration is often accomplished through the application of ordinary differential equation (ODE) integrators--integrators whose error characteristics are predicated on the smoothness of the field through which the streamline is being integrated--smoothness which is not available at the inter-element level of finite volume and finite element data. Adaptive error control techniques are often used to ameliorate the challenge posed by inter-element discontinuities. As the root of the difficulties is the discontinuous nature of the data, we present a complementary approach of applying smoothness-enhancing accuracy-conserving filters to the data prior to streamline integration. We investigate whether such an approach applied to uniform quadrilateral discontinuous Galerkin (high-order finite volume) data can be used to augment current adaptive error control approaches. We discuss and demonstrate through numerical example the computational trade-offs exhibited when one applies such a strategy.

Mobile noncontact monitoring of heart and lung activity

This paper describes two methods for noncontact monitoring of heart and lung activity, namely magnetic bioimpedance monitoring and capacitive electrocardiogram (ECG) recording. In principle, both methods bear the potential for mobile application in a personal healthcare scenario. To illustrate their performance, prototypes for both methods have been developed and first results are presented. Finally, the fundamental drawbacks and limitations of these methods are discussed, including a detailed stability analysis of the capacitively coupled ldquoright legrdquo in capacitive ECG measurements with mismatching electrode capacities and the development of an adaptive noise canceller for magnetic bioimpedance monitoring based on a nonlinear signal coupling model.

Treatment of chronic hepatitis C with consensus interferon in relapsers and non-responders to interferon-based therapy

Over the last decade, enormous advances have been achieved in the treatment of chronic hepatitis C. However, the success of the established standard therapy with PEG-IFN and ribavirin is limited and needs further therapeutic options especially for the difficult-to-treat patients with genotype 1, patients with liver cirrhosis, patients with relapse or breakthrough and non-responders after a PEG-IFN/ribavirin combination therapy. In those cases, a daily treatment with CIFN/ribavirin could be a promising concept, before considering non-curable concepts as the long-term IFN maintenance therapy, especially in cases with advanced liver fibrosis. Daily treatments need high motivated and compliant patients. Concepts to optimize current therapies as the use of CIFN or the high dose PEG-IFN therapy are necessary until new kinds of therapy are available.

Metal Clip as a nidus for formation of common bile duct stone following laparascopic cholecystectomy

A 83-year-old woman came to our hospital with fever up to 38.5 degrees C, abdominal pain and jaundice. She had undergone a cholecystectomy for symptomatic gallstones in 1992. The endoscopic retrograde cholangiography showed a dilated common bile duct with a free floating surgical clip with stone formation around this foreign body. After endoscopic sphincterotomy the extraction of the foreign body was successful. We found a two cm cholesterol stone the nidus of which was built by a Filshie-clip. The post endoscopic course was uneventful.

Lassen sich auditive Verarbeitungs- und Wahrnehmungsstörungen (AVWS) bei Kindern mit Lese-Rechtschreib-Störungen nachweisen?

BACKGROUND

In this paper the dichotic tests and the CERA (Cortical Evoked Response Audiometry) of children with dyslexia had been examined, in order to find out if there are auditory processing and perception disorders.

PATIENTS AND METHODS

33 children with dyslexia had been compared with 28 children without problems of writing and reading. The mean age of the children was 9 years. All of the children had been examined by the following audiometric measurements: tympanometry, pure-tone-audiometry, speech-audiometry, dichotic Tests by Uttenweiler and Feldmann and the Cortical Evoked Response Audiometry (CERA) rated according to Esser.

RESULTS

The intelligence quotients were in the group of dyslexic children significantly lower. The Uttenweiler and Feldmann tests were in dyslexic children significantly lower in the control group as well. The late cortical responses ware normal or near normal in both groups.

CONCLUSION

Dichotic speech tests indicate central auditory processing and perception deficits in dyslexia. These tests are confounded, however, by attention and memory deficits. The CERA rated according to Esser does not point out to these auditory disorders in dyslexia.

Voltage-clamp analysis and computational model of dopaminergic neurons from mouse retina

Isolated dopaminergic amacrine (DA) cells in mouse retina fire rhythmic, spontaneous action potentials and respond to depolarizing current with trains of low-frequency action potentials. To investigate the roles of voltage-gated ion channels in these processes, the transient A-type K+ current (IK,A) and Ca2+ current (ICa) in isolated mouse DA cells were analyzed by voltage clamp. The IK,A activated at −60 mV and inactivated rapidly. ICa activated at around −30 mV and reached a peak at 10 mV without apparent inactivation. We also extended our previous computational model of the mouse DA cell to include the new electrophysiological data. The model consisted of a membrane capacitance in parallel with eight currents: Na+ transient (INa,T), Na+ persistent (INa,P), delayed rectifier potassium (IKdr), IK,A, calcium-dependent potassium (IK,Ca), L-type Ca2+ ICa, hyperpolarization-activated cation current (Ih), and a leak current (IL). Hodgkin-Huxley type equations were used to define the voltage- and time-dependent activation and inactivation. The simulations were implemented using the neurosimulator SNNAP. The model DA cell was spontaneously active from a wide range of initial membrane potentials. The spontaneous action potentials reached 35 mV at the peak and hyperpolarized to −76 mV between spikes. The spontaneous firing frequency in the model was 6 Hz. The model DA cell responded to prolonged depolarizing current injection by increasing its spiking frequency and eventually reaching a depolarization block at membrane potentials greater than −10 mV. The most important current for determining the firing rate was IK,A. When the amplitude of IK,A was decreased, the firing rate increased. ICa and IK,Ca also affected the width of action potentials but had only minor effects on the firing rate. Ih affected the firing rate slightly but did not change the waveform of the action potentials.

Isolation of Carnobacterium piscicola from human pus--case report

Carnobacterium piscicola was first described in 1984. These bacteria are often isolated from fish afflicted with bacterial infections. To date, there has been no reported isolation of this bacterium from human specimens. We report here the isolation of C. piscicola from the pus following traumatic amputation of the right hand in the wrist of a 35-year-old man. The traumatic amputation occurred with an industrial water sawmill. The identity of the human strain was determined biochemically, by 16S rDNA sequence similarity and by fatty-acid methyl-ester profile from bacterial cell.

[Critical infusion incident caused by incorrect use of a patient-controlled analgesia pump]

We report on the case of a 17-year-old male patient who received a PCA pump after nephrectomy for postoperative analgesia. The syringe of the PCA pump was filled with 50 mg morphine and positioned about 25 cm above the heart. Since the piston of the syringe was not bolted while the pump was switched off, an unnoticed accidental evacuation of the whole content of the syringe into the intravenous line of the patient occurred because of gravity. This problem exists not only with PCA pumps, but can happen with syringe pumps in general. The incident, which can only be explained by strongly reduced venous pressure, was detected by chance. No harm resulted for the patient, but under different conditions it could have been lethal. This critical incident was caused by various factors: incorrect application in combination with insufficient experience or training, stress, inadequate handing-over of the patient and a lack of arrangements and instructions for procedures in routine situations. Suggestions for preventing such dangerous critical incidents are made and discussed. In particular, an algorithm for the correct procedure when inserting or changing the syringe of a syringe pump is presented.

Experimental realization of Shor's quantum factoring algorithm using nuclear magnetic resonance

The number of steps any classical computer requires in order to find the prime factors of an l-digit integer N increases exponentially with l, at least using algorithms known at present. Factoring large integers is therefore conjectured to be intractable classically, an observation underlying the security of widely used cryptographic codes. Quantum computers, however, could factor integers in only polynomial time, using Shor's quantum factoring algorithm. Although important for the study of quantum computers, experimental demonstration of this algorithm has proved elusive. Here we report an implementation of the simplest instance of Shor's algorithm: factorization of N = 15 (whose prime factors are 3 and 5). We use seven spin-1/2 nuclei in a molecule as quantum bits, which can be manipulated with room temperature liquid-state nuclear magnetic resonance techniques. This method of using nuclei to store quantum information is in principle scalable to systems containing many quantum bits, but such scalability is not implied by the present work. The significance of our work lies in the demonstration of experimental and theoretical techniques for precise control and modelling of complex quantum computers. In particular, we present a simple, parameter-free but predictive model of decoherence effects in our system.

Childhood outcome after early high-frequency oscillatory ventilation for neonatal respiratory distress syndrome

OBJECTIVE

In a previous multicenter controlled clinical trial, we randomly assigned surfactant-treated premature newborns with moderate to severe respiratory distress syndrome to early treatment with high-frequency oscillatory ventilation (HFOV) or to conventional ventilation (CV). Compared with control infants who were treated with CV, neonates who were treated with HFOV using a strategy designed to recruit and maintain lung volume and minimize oxygen exposure had clinical evidence of improved pulmonary outcome and less lung injury. We report a follow-up study designed to determine whether clinical differences persisted between these study groups.

METHODS

Patients were recruited from 81 survivors at 1 center (Provo, Utah) and evaluated for sociodemographic and health history, growth, mental development, motor proficiency, and pulmonary function.

RESULTS

Eighty-seven percent of the cohort who originally were assigned to treatment with HFOV (n = 36) or CV (n = 33) were seen in follow-up at a mean age of 77 months (6.4 years). There were no differences in the frequency of hospitalization, pulmonary illness, asthma, or disabilities. Growth, verbal IQ, and motor development were appropriate for age and not different between groups. Patients who initially were randomized to treatment with CV showed pulmonary function evidence of decreased peak expiratory flow, increased residual lung volume, and maldistribution of ventilation.

CONCLUSION

Neurodevelopmental childhood outcome after early intervention HFOV was normal and not different compared with patients who were treated with CV. Surfactant replacement combined with early HFOV using a lung recruitment strategy ameliorates the acute lung injury in respiratory distress syndrome that predisposes some preterm infants to develop chronic lung disease.

Metabolism of S-nitrosoglutathione in intact mitochondria

S-nitrosation of protein thiol groups by nitric oxide (NO*) is a widely recognized protein modification. Only few intracellular S-nitrosated proteins have been identified and it has been reported that S-nitrosation/denitrosation can serve as a regulatory process in signal-transduction pathways. Given the potential physiological importance of S-nitrosothiols, and considering that mitochondria are endowed with high levels of thiols and the biochemical requisites for synthesizing NO*, we examined the occurrence of S-nitrosoglutathione (GSNO) in intact, coupled rat liver mitochondria. These organelles contained 0.34 nmol of GSNO/mg of protein, detected by HPLC with UV-visible and electrochemical detections. This concentration was dynamically modulated by the availability of NO*; its decay was affected mainly by GSH and superoxide dismutase in a reaction that entailed the generation of GSSG. On the basis of the relatively long half-life of GSNO and the negligible recovery of NO* during its decay, roles for GSNO as a storage and transport molecule for NO* are discussed. Moreover, the formation of GSNO and its reaction with GSH can be considered to be partly responsible for the catabolism of NO* via a complex mechanism that might result in the formation of hydroxylamine, nitrite or nitrous oxide depending upon the availability of oxygen, superoxide dismutase and glutathione. Finally, the high concentrations of GSH in the cytosol and mitochondria might favour the formation of GSNO by reacting with NO* 'in excess', thereby avoiding damaging side reactions (such as peroxynitrite formation), and facilitate the inactivation of NO* by generating other nitrogen-related species without the chemical properties characteristic of NO*.

Motility factors identified in supernatants of human cholangiocarcinoma cell lines

Motility factors, e.g. SF/HGF (scatter factor/hepatocyte growth factor) or AMF (autocrine motility factor) can influence the migration of tumor cells in vitro and may facilitate invasive growth and metastases in vivo. The production of motility factors was studied in cell lines derived from human cholangiocarcinomas. Culture supernatants from 5 different cholangiocarcinoma cell lines (EGI-1, RPMI 7451, MZ CHA-1, MZ CHA-2 and MZ CHA-3) were analyzed in scatter assays with NRK and MDCK cells as indicator cells which react with cellular migration in the presence of motility factors. Culture supernatants from 4 of the 5 cell lines investigated induced migration of the indicator cells thus demonstrating the production of motility factors. Three of the cell lines (MZ CHA-1, MZ CHA-2, RPMI 7451) produced a factor with a molecular weight ranging between 50 and 100 kDa, EGI-1 cells secreted a factor with a molecular weight >100 kDa. None of the factors was identical to HGF as demonstrated by the lacking reactivity in a HGF specific ELISA and by the inability to induce scattering of HPAF indicator cells like HGF. Similar to SF/HGF, the activity of the EGI-1 factor was inhibited by the proteoglycan heparin and stimulated the chemotactic cell migration, but in contrast to SF/HGF it could not induce invasive growth of NRK cells. The production of scatter factors could be involved in tumor progression and formation of metastases of cholangiocarcinomas.

Limits of photosynthesis in extrasolar planetary systems for earth-like planets

We present a general modeling scheme for investigating the possibility of photosynthesis-based life on extrasolar planets. The scheme focuses on the identification of the habitable zone in main-sequence-star planetary systems with planets of Earth mass and size. Our definition of habitability is based on the long-term possibility of photosynthetic biomass production as a function of mean planetary surface temperature and atmospheric CO2-content. All the astrophysical, climatological, biogeochemical, and geodynamic key processes involved in the generation of photosynthesis-driven life conditions are taken into account. Implicitly, a co-genetic origin of the central star and the orbiting planet is assumed. The numerical solution of an advanced geodynamic model yields realistic look-up diagrams for determining the limits of photosynthesis in extrasolar planetary systems, assuming minimum CO2 levels set by the demand of C4 photosynthesis.

Experimental realization of an order-finding algorithm with an NMR quantum computer

We report the realization of a nuclear magnetic resonance quantum computer which combines the quantum Fourier transform with exponentiated permutations, demonstrating a quantum algorithm for order finding. This algorithm has the same structure as Shor's algorithm and its speed-up over classical algorithms scales exponentially. The implementation uses a particularly well-suited five quantum bit molecule and was made possible by a new state initialization procedure and several quantum control techniques.

IFN-gamma-induced change in microtubule organization and alpha-tubulin expression during growth inhibition of lung squamous carcinoma cells

In cultures of KNS-62 cells derived from a human lung squamous cell carcinoma, the initial growth arrest in the continuous presence of interferon-gamma (IFN-gamma) turned to cytopathic effects after 2 days of treatment. The remaining viable cells showed grossly distorted morphology, with enlargement and extensions up to 5 cell diameters. The presence of apoptotic cells was shown 3 days after treatment with IFN-gamma. Immunocytochemically, the microtubular structures appeared augmented and highly aggregated. The level of alpha-tubulin-specific mRNA was distinctly increased after administration of IFN-gamma, and the amount of extractable alpha-tubulin protein was reduced. In parallel kinetics experiments, growth arrest by serum depletion or by contact inhibition during confluence resulted in reduced levels of alpha-tubulin-specific mRNA and in slightly elevated alpha-tubulin protein. The IFN-gamma-induced effects suggest interference with assembly or maintenance of the tubulin cable network, presumably associated with cell deformation and cytotoxicity.

Simultaneous soft pulses applied at nearby frequencies

The rotation of a spin subject to an on-resonance soft pulse and simultaneously to a soft pulse at a nearby frequency may strongly deviate from the desired rotation expected for a single on-resonance pulse. The deviation is the result of transient frequency shifts of the spin caused by the off-resonance irradiation. We show that the resulting error can be corrected by shifting the frequency of the on-resonance pulse in such a way that it tracks the shift of the spin frequency. Experimentally, the effectiveness of this simple and intuitive method is demonstrated for simultaneous inversions at nearby frequencies in the case of both coupled and uncoupled spins. Simulations predict that the correction technique is effective for arbitrary pulse shapes and tip angles and is particularly useful when the frequency window of the shaped pulse is two to eight times the frequency separation between the chemical shifts of the two spins. Copyright 2000 Academic Press.

Cultivatable microbial biodiversity: gnawing at the Gordian knot

Rapid and inexpensive sorting of bacterial isolates may be achieved using Fourier transform infrared spectroscopy (FT-IR), a method that has hitherto been applied to identification and classification. The comprehensive characterization of environmental samples requires the isolation of large numbers of isolates using different growth media and growth conditions. In such cases, sorting the isolates is critical before isolates are subjected to more detailed studies. Using FT-IR, isolates are grown under standardized conditions, and 100 strains can be tested within less than 8 h. Chemotaxonomic and molecular characterization of members of clusters emerging from FT-IR analysis either at a level of spectral distance values below 20-30 (analysis of region 600-800 cm(-1), average linkage algorithm) or at spectral heterogeneity values below 75 (regions 1,200-900, 3,000-2,798 and 901-698, scaling to first region, Ward's algorithm) reveals great similarities in fatty acids and 16S rDNA sequences. As judged from riboprinting analyses and fatty acid analyses, FT-IR analysis is able to unravel intraspecific subclustering. The example used in this study of 100 isolates from a mat system, Lake Fryxell, Dry Valleys, Antarctica, selected from a larger number of isolates, picked mainly on the basis of colony pigmentation and form, reveals the utility of the method for identifying the number of putative species quickly. The method described is able to select strains rapidly that represent clusters at the specific and intraspecific level for subsequent characterization.

Mycophenolate mofetil: lack of efficacy in chronic active inflammatory bowel disease

BACKGROUND

Mycophenolate mofetil (MMF) is a new immunosuppressant with pharmacodynamic properties comparable to azathioprine. Recent reports found MMF to be effective in inflammatory bowel disease (IBD).

METHODS

An open-label prospective and uncontrolled multicentre 6 month trial of MMF in combination with steroids was conducted in 24 chronic active IBD patients. A daily steroid demand of >/= 10 mg prednisone in the preceding 2 months and a Crohn's disease activity index (CDAI) > 150, or moderate to severe activity according to Truelove, served as criteria for chronic activity. The treatment consisted of a steroid pulse and tapering protocol in combination with MMF 2 g/day. A prednisone dose of 5 mg/day was maintained during months 4-6. The primary end-point was induction and maintenance of remission.

RESULTS

Only 10 of 24 patients had achieved remission after 3 months. All but one Crohn's disease patient had relapsed by the end of the study at 6 months. Depression and migraine necessitated drug withdrawal in two patients.

CONCLUSION

In conclusion, MMF 2 g/day was unable to induce and maintain remission for a period of 6 months in 23 of 24 chronic active IBD patients. Further controlled investigations are required in view of recent conflicting reports.

Serum levels of stem cell factor in patients during transplantation of bone marrow or peripheral blood stem cells

Stem cell factor (SCF) synergizes with other cytokines in vitro to stimulate the proliferation and differentiation of cells of the myeloid, megakaryocytic, erythroid, and lymphoid lineages. In vivo, it may play a role in engraftment after transplantation of bone marrow (BM) or peripheral blood stem cells (PBSC). Serum levels of SCF were closely monitored in 82 patients before and after allogeneic (n = 38), autologous (n = 6), or syngeneic (n = 1) BM transplantation (BMT) or autologous PBSC transplantation (PBSCT) (n = 37), respectively. SCF serum levels fluctuated around a mean in patients after allogeneic or autologous BMT or after PBSCT. In two patient subgroups (5 patients with acute myeloid leukemia [AML] and 6 patients with chronic myelogenous leukemia [CML]) with identical pretransplant conditioning regimen followed by allogeneic BMT, serum IL-6 levels significantly increased up to day +14 (p < 0.05). Correlation was not found between SCF serum levels and leukocyte or thrombocyte counts or the day of engraftment of these cell types. These data are a basis for further studies and constitute a further mosaic stone in understanding the changes in the complex cytokine network during engraftment.