283 research outputs found

    Ground-state characterization of Nb charge-phase Josephson qubits

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    We present investigations of Josephson charge-phase qubits inductively coupled to a radio-frequency driven tank-circuit enabling the readout of the states by measuring the Josephson inductance of the qubit. The circuits including junctions with linear dimensions of 60 nm and 80 nm are fabricated from Nb trilayer and allowing the determination of relevant sample parameters at liquid helium temperature. The observed partial suppression of the circulating supercurrent at 4.2 K is explained in the framework of a quantum statistical model. We have probed the ground-state properties of qubit structures with different ratios of the Josephson coupling to Coulomb charging energy at 20 mK, demonstrating both the magnetic control of phase and the electrostatic control of charge on the qubit island.Comment: 8 pages, 8 figure

    Model Kebijakan Penanggulangan Korupsi di Universitas Negeri YOGYAKARTA

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    Penelitian ini bertujuan untuk mengetahui kebijakan Universitas Negeri Yogyakarta dalam menanggulangi korupsi dan menemukan model kebijakan yang diinginkan Universitas Negeri Yogyakarta dalam menanggulangi korupsi. Penelitian ini adalah penelitian survei dengan pendekatan kuantitatif dan kualitatif. Sampel penelitian ditentukan secara multy stage sampling dengan teknik pengumpulan data dengan angket, dokumen dan diperkuat dengan pengumpulan data melalui Focus Group Discussion (FGD), dan validasi instrumen melalui validitas isi (content validity). Data dianalisis secara deskriptif. Hasil penelitian menunjukkan bahwa kebijakan penanggulangan korupsi di UNY tidak ada secara khusus dikeluarkan. Kebijakan yang ada mengikuti dan mempertahankan kebijakan yang lebih tinggi, yaitu dari Pemerintah. Model kebijakan penangggulangan korupsi di UNY yang digunakan adalah Model Rasional, yaitu kebijakan penanggulangan korupsi yang dikeluarkan merupakan aspirasi semua staf yang ada di unit kerja dan harus menekankan pada aspek efisiensi atas beban kerja pada unit kerja yang bersangkutan. Adapun kebijakan yang sudah ada yang berasal dari Pemerintah pusat dijadikan pedoman

    CD4 cell count and the risk of AIDS or death in HIV-Infected adults on combination antiretroviral therapy with a suppressed viral load: a longitudinal cohort study from COHERE.

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    BACKGROUND: Most adults infected with HIV achieve viral suppression within a year of starting combination antiretroviral therapy (cART). It is important to understand the risk of AIDS events or death for patients with a suppressed viral load. METHODS AND FINDINGS: Using data from the Collaboration of Observational HIV Epidemiological Research Europe (2010 merger), we assessed the risk of a new AIDS-defining event or death in successfully treated patients. We accumulated episodes of viral suppression for each patient while on cART, each episode beginning with the second of two consecutive plasma viral load measurements 500 copies/µl, the first of two consecutive measurements between 50-500 copies/µl, cART interruption or administrative censoring. We used stratified multivariate Cox models to estimate the association between time updated CD4 cell count and a new AIDS event or death or death alone. 75,336 patients contributed 104,265 suppression episodes and were suppressed while on cART for a median 2.7 years. The mortality rate was 4.8 per 1,000 years of viral suppression. A higher CD4 cell count was always associated with a reduced risk of a new AIDS event or death; with a hazard ratio per 100 cells/µl (95% CI) of: 0.35 (0.30-0.40) for counts <200 cells/µl, 0.81 (0.71-0.92) for counts 200 to <350 cells/µl, 0.74 (0.66-0.83) for counts 350 to <500 cells/µl, and 0.96 (0.92-0.99) for counts ≥500 cells/µl. A higher CD4 cell count became even more beneficial over time for patients with CD4 cell counts <200 cells/µl. CONCLUSIONS: Despite the low mortality rate, the risk of a new AIDS event or death follows a CD4 cell count gradient in patients with viral suppression. A higher CD4 cell count was associated with the greatest benefit for patients with a CD4 cell count <200 cells/µl but still some slight benefit for those with a CD4 cell count ≥500 cells/µl

    Antitubercular therapy decreases nitric oxide production in HIV/TB coinfected patients

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    BACKGROUND: Nitric oxide (NO) production is increased among patients with human immunodeficiency virus (HIV) infection and also among those with tuberculosis (TB). In this study we sought to determine if there was increased NO production among patients with HIV/TB coinfection and the effect of four weeks chemotherapy on this level. METHODS: 19 patients with HIV/TB coinfection were studied. They were treated with standard four drug antitubercular therapy and sampled at baseline and four weeks. 20 patients with HIV infection, but no opportunistic infections, were disease controls and 20 individuals were healthy controls. Nitrite and citrulline, surrogate markers for NO, were measured spectrophotometrically. RESULTS: The mean age of HIV/TB patients was 28.4 ± 6.8 years and CD4 count was 116 ± 36.6/mm. Mean nitrite level among HIV/TB coinfected was 207.6 ± 48.8 nmol/ml. This was significantly higher than 99.7 ± 26.5 nmol/ml, the value for HIV infected without opportunistic infections and 46.4 ± 16.2 nmol/ml, the value for healthy controls (p value < 0.01). The level of HIV/TB coinfected NO in patients declined to 144.5 ± 34.4 nmol/ml at four weeks of therapy (p value < 0.05). Mean citrulline among HIV/TB coinfected was 1446.8 ± 468.8 nmol/ml. This was significantly higher than 880.8 ± 434.8 nmol/ml, the value for HIV infected without opportunistic infections and 486.6 ± 212.5 nmol/ml, the value for healthy controls (p value < 0.01). Levels of citrolline in HIV/TB infected declined to 1116.2 ± 388.6 nmol/ml at four weeks of therapy (p value < 0.05). CONCLUSIONS: NO production is elevated among patients with HIV infection, especially so among HIV/TB coinfected patients, but declines significantly following 4 weeks of antitubercular therapy

    Antiretroviral pill count and clinical outcomes in treatment-naive patients with HIV infection

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    Objectives: Treatment guidelines recommend single-tablet regimens for patients with HIV infection starting antiretroviral therapy. These regimens might be as effective and cost less if taken as separate drugs. We assessed whether the one pill once a day combination of efavirenz, emtricitabine and tenofovir reduces the risk of disease progression compared with multiple-pill formulations of the same regimen. Methods: We selected treatment-naïve patients starting one-, two- or three-pill formulations of this regimen in data from the Antiretroviral Therapy Cohort Collaboration. These patients were followed until an AIDS event or death or until they modified their regimen. We analysed these data using Cox regression models, then used our models to predict the potential consequences of exposing a future population to either a one-pill regimen or a three-pill regimen. Results: Among 11 739 treatment-naïve patients starting the regimen, there were 386 AIDS events and 87 deaths. Follow-up often ended when patients switched to the same regimen with fewer pills. After the first month, two pills rather than one was associated with an increase in the risk of AIDS or death [hazard ratio (HR) 1.39; 95% confidence interval (CI) 1.01-1.91], but three pills rather than two did not appreciably add to that increase (HR 1.19; 95% CI 0.84-1.68). We estimate that 77 patients would need to be exposed to a one-pill regimen rather than a three-pill regimen for 1 year to avoid one additional AIDS event or death. Conclusions: This particular single-tablet regimen is associated with a modest decrease in the risk of AIDS or death relative to multiple-pill formulations

    Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies

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    BACKGROUND: Health care for people living with HIV has improved substantially in the past two decades. Robust estimates of how these improvements have affected prognosis and life expectancy are of utmost importance to patients, clinicians, and health-care planners. We examined changes in 3 year survival and life expectancy of patients starting combination antiretroviral therapy (ART) between 1996 and 2013. METHODS: We analysed data from 18 European and North American HIV-1 cohorts. Patients (aged ≥16 years) were eligible for this analysis if they had started ART with three or more drugs between 1996 and 2010 and had at least 3 years of potential follow-up. We estimated adjusted (for age, sex, AIDS, risk group, CD4 cell count, and HIV-1 RNA at start of ART) all-cause and cause-specific mortality hazard ratios (HRs) for the first year after ART initiation and the second and third years after ART initiation in four calendar periods (1996–99, 2000–03 [comparator], 2004–07, 2008–10). We estimated life expectancy by calendar period of initiation of ART. FINDINGS: 88 504 patients were included in our analyses, of whom 2106 died during the first year of ART and 2302 died during the second or third year of ART. Patients starting ART in 2008–10 had lower all-cause mortality in the first year after ART initiation than did patients starting ART in 2000–03 (adjusted HR 0·71, 95% CI 0·61–0·83). All-cause mortality in the second and third years after initiation of ART was also lower in patients who started ART in 2008–10 than in those who started in 2000–03 (0·57, 0·49–0·67); this decrease was not fully explained by viral load and CD4 cell count at 1 year. Rates of non-AIDS deaths were lower in patients who started ART in 2008–10 (vs 2000–03) in the first year (0·48, 0·34–0·67) and second and third years (0·29, 0·21–0·40) after initiation of ART. Between 1996 and 2010, life expectancy in 20-year-old patients starting ART increased by about 9 years in women and 10 years in men. INTERPRETATION: Even in the late ART era, survival during the first 3 years of ART continues to improve, which probably reflects transition to less toxic antiretroviral drugs, improved adherence, prophylactic measures, and management of comorbidity. Prognostic models and life expectancy estimates should be updated to account for these improvements

    Risk of tuberculosis after initiation of antiretroviral therapy among persons with HIV in Europe

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    Objectives: Tuberculosis (TB) risk after initiation of antiretroviral treatment (ART) is not well described in a European setting, with an average TB incidence of 25/105 in the background population. Methods: We included all adult persons with HIV starting ART in the RESPOND cohort between 2012 and 2020. TB incidence rates (IR) were assessed for consecutive time intervals post-ART initiation. Risk factors for TB within 6 months from ART initiation were evaluated using Poisson regression models. Results: Among 8441 persons with HIV, who started ART, 66 developed TB during 34,239 person-years of follow-up (PYFU), corresponding to 1.87/10 0 0 PYFU (95% confidence interval [CI]: 1.47-2.37). TB IR was highest in the first 3 months after ART initiation (14.41/10 0 0 PY (95%CI 10.08-20.61]) and declined at 3-6, 6-12, and &gt; 12 months post-ART initiation (5.89 [95%CI 3.35-10.37], 2.54 [95%CI 1.36-4.73] and 0.51 [95%CI 0.30-0.86]), respectively. Independent risk factors for TB within the first 6 months after ART initiation included follow-up in Northern or Eastern Europe region, African origin, baseline CD4 count &lt; 200 cells/mm(3), HIV RNA &gt; 100,000 copies/mL, injecting drug use , heterosexual transmission. Conclusions: TB IR was highest in the first 3 months post-ART initiation and was associated with baseline risk factors, highlighting the importance of thorough TB risk assessment at ART initiation. (c) 2024 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases

    Longitudinal trends in causes of death among adults with HIV on antiretroviral therapy in Europe and North America from 1996 to 2020: a collaboration of cohort studies

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    Background Mortality rates among people with HIV have fallen since 1996 following the widespread availability of effective antiretroviral therapy (ART). Patterns of cause-specific mortality are evolving as the population with HIV ages. We aimed to investigate longitudinal trends in cause-specific mortality among people with HIV starting ART in Europe and North America. Methods In this collaborative observational cohort study, we used data from 17 European and North American HIV cohorts contributing data to the Antiretroviral Therapy Cohort Collaboration. We included data for people with HIV who started ART between 1996 and 2020 at the age of 16 years or older. Causes of death were classified into a single cause by both a clinician and an algorithm if International Classification of Diseases, Ninth Revision or Tenth Revision data were available, or independently by two clinicians. Disagreements were resolved through panel discussion. We used Poisson models to compare cause-specific mortality rates during the calendar periods 1996-99, 2000-03, 2004-07, 2008-11, 2012-15, and 2016-20, adjusted for time-updated age, CD4 count, and whether the individual was ART -naive at the start of each period. Findings Among 189 301 people with HIV included in this study, 16 832 (8 center dot 9%) deaths were recorded during 1 519 200 person-years of follow-up. 13 180 (78 center dot 3%) deaths were classified by cause: the most common causes were AIDS (4203 deaths; 25 center dot 0%), non-AIDS non -hepatitis malignancy (2311; 13 center dot 7%), and cardiovascular or heart-related (1403; 8 center dot 3%) mortality. The proportion of deaths due to AIDS declined from 49% during 1996-99 to 16% during 2016-20. Rates of all-cause mortality per 1000 person-years decreased from 16 center dot 8 deaths (95% CI 15 center dot 4-18 center dot 4) during 1996-99 to 7 center dot 9 deaths (7 center dot 6-8 center dot 2) during 2016-20. Rates of all-cause mortality declined with time: the average adjusted mortality rate ratio per calendar period was 0 center dot 85 (95% CI 0 center dot 84-0 center dot 86). Rates of cause-specific mortality also declined: the most pronounced reduction was for AIDS-related mortality (0 center dot 81; 0 center dot 79-0 center dot 83). There were also reductions in rates of cardiovascular-related (0 center dot 83, 0 center dot 79-0 center dot 87), liver-related (0 center dot 88, 0 center dot 84-0 center dot 93), non-AIDS infectionrelated (0 center dot 91, 0 center dot 86-0 center dot 96), non-AIDS-non-hepatocellular carcinoma malignancy-related (0 center dot 94, 0 center dot 90-0 center dot 97), and suicide or accident-related mortality (0 center dot 89, 0 center dot 82-0 center dot 95). Mortality rates among people who acquired HIV through injecting drug use increased in women (1 center dot 07, 1 center dot 00-1 center dot 14) and decreased slightly in men (0 center dot 96, 0 center dot 93-0 center dot 99). Interpretation Reductions of most major causes of death, particularly AIDS-related deaths among people with HIV on ART, were not seen for all subgroups. Interventions targeted at high-risk groups, substance use, and comorbidities might further increase life expectancy in people with HIV towards that in the general population. Funding US National Institute on Alcohol Abuse and Alcoholism. Copyright (c) 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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