University of Southern California

Cryogenic computing systems often require communication between single flux quantum (SFQ) circuits at 4 K and CMOS circuits at a higher temperature stage. Interface circuits such as a 4JL (four-junction logic) gate and a SQUID (superconducting quantum interference device) stack have previously been used for SFQ-CMOS data links, but they have only been used for systems contained at 4 K. When communicating with CMOS circuits at a higher temperature stage, these interface circuits must be implemented in accordance with a holistic analysis of the entire cryogenic computing system. We have conducted an analysis in which we compare the impact of a 4JL gate and a SQUID stack on a system designed for the HYPRES ICE-T. For our analysis, we use the CORE e4 RSFQ microprocessor as the SFQ circuitry at 4 K. We provide guidelines for deciding between a 4JL gate and a SQUID stack as superconductor-semiconductor interface circuits in hybrid computing systems with multiple temperature stages.

<h2>Abstract:</h2> Despite advances in endovascular repair of aortic arch pathologies, the gold standard remains open surgical repair. Two single-branched options for zone 0 exist in the United States for high-risk patients. Both systems require adjunctive multiple cervical debranching, which carries significant morbidity. We describe a practical endovascular solution that simplifies modification, implantation, and adjunctive cervical debranching, by performing a single left carotid transposition and creating an additional fenestration within the existing Gore TBE platform (FEN-TBE). We present our initial series of 6 patients.

To evaluate the outcomes of a street medicine intervention offering syphilis testing and treatment to people experiencing homelessness in South Los Angeles, California-a population disproportionately affected by syphilis and underserved by traditional healthcare systems. From September 2024 to January 2025, a multidisciplinary street medicine team provided testing and treatment for syphilis during outreach visits to patients experiencing homelessness. A total of 99 patients were tested using the reverse syphilis testing algorithm. Demographic data included gender, race/ethnicity, substance use disorder, mental illness and HIV status. χ2 tests were used to evaluate associations between syphilis diagnosis and each demographic characteristic. Thirty-six (36.4%) of the 99 patients had reactive syphilis test results, with 94.4% (n=34) classified as late-stage infections. Of those diagnosed, 72.2% (n=26) were treated during follow-up visits. Statistically significant associations were found between syphilis diagnosis and gender (p=0.002), substance use disorder (p=0.008) and HIV status (p=0.020). Patients identifying as female or transgender female, and those with cooccurring substance use disorder or HIV, were more likely to be diagnosed with syphilis. This study demonstrates the feasibility and outcomes of delivering sexually transmitted infection care through street medicine. The high prevalence of late-stage syphilis and its syndemic overlap with substance use disorder and HIV underscores the need for low-barrier, community-based services. Street medicine interventions should be recognised and resourced as essential tools in public health responses to rising syphilis rates, particularly among unhoused populations.

The goal of this study was to assess the effect of enteral feeding on aspiration risk and progression of respiratory failure in adults on high-flow nasal cannula (HFNC) oxygen therapy. Single-center retrospective cohort study. Keck Hospital of the University of Southern California, a tertiary care academic hospital. Hospitalized adults treated with HFNC between January 1, 2020, and December 31, 2022, were included. Exclusion criteria were chronic total parenteral nutrition, chronic tracheostomy, history of total laryngectomy, and "Do Not Intubate" code status. None. The primary outcome was the progression of respiratory failure from HFNC to noninvasive positive pressure ventilation, mechanical ventilation, or extracorporeal membrane oxygenation. We included 220 patients in the primary analysis. The median age was 62.6 years, 54.1% of patients were male, and 43.6% of patients were White. The primary outcome of progression of respiratory failure occurred in 57 patients, of whom 19 (33.3%) were feeding enterally and 38 (66.7%) were NPO at the time of progression. Patients feeding enterally were less likely than those who were NPO to have progression of respiratory failure in a multivariate mixed effects linear regression model (odds ratio [OR], 0.33; 95% CI, 0.18-0.58; p < 0.001). Patients feeding enterally remained less likely to have progression of respiratory failure in a propensity score-matched analysis (OR, 0.30; 95% CI, 0.15-0.58; p < 0.001). In this single-center, retrospective cohort, enteral nutrition in patients on HFNC was associated with lower risk of progression of respiratory failure and was not associated with increased risk of poor clinical outcomes. Prospective multicenter studies are needed to confirm these findings.