Caregivers' perception of adults with Down syndrome willingness to participate in research

BACKGROUND

Historically, individuals with Down syndrome have been excluded from clinical research. Our objective was to assess the degree of interest adults with Down syndrome have in participating in research from the perspective of the caregivers who care for them.

METHODS

We conducted an online survey of N = 390 caregivers of adults with Down syndrome and asked about interest in research participation and demographics.

RESULTS

Caregivers were mostly family members, older than 55 years, and White. Caregivers reported that the adult with Down syndrome that they cared for would be more comfortable participating in research that was physiological, such as research involving fit bits (70.2% would participate), exercise (63.3%) or diet apps (53.9%), whereas they would be less likely to participate in clinical trials involving more invasive procedures such as injections (10.9%) and laboratory exams like MRIs (32.0%). We found little difference by age or gender of the adult with Down syndrome or by caregiver education level.

CONCLUSIONS

Our survey identified high interest for less invasive studies, illustrating acceptability of observational and lifestyle studies. More effort may be needed to understand fear and barriers to participation and to create tools and methods to increase interest in more invasive studies.

Reproducibility of lung perfusion and ventilation derived using phase-resolved functional lung (PREFUL) MRI imaging

Background

There is a growing demand for non-invasive imaging biomarkers of lung function, allowing more sensitive and timely decision making to achieve better patient outcomes. Recently developed Fourier decomposition MRI methods enable quantitative assessment of lung performance.

Objectives

To assess intra- and inter-observer agreement of lung perfusion and ventilation derived using the free-breathing, contrast agent-free, phase-resolved functional lung (PREFUL) imaging.

Methods

Fifty patients with acute ST-segment elevation myocardial infarction underwent CMR imaging using a 3 T MRI scanner (MAGNETOM Skyra). Coronal images were acquired during free breathing, covering the entire lung using a phase-resolved functional lung 2D FLASH sequence. The main scan parameters were: temporal resolution = 2.1 ms, number of measurements = 250. The lung perfusion and ventilation maps were generated (Figure 1). The analysis of the images was performed using prototype software (MR Lung Prototype version 2.0) by two independent observers. Analysis was repeated after four weeks to assess intra-observer agreement.

Results

PREFUL imaging and analysis were fast with a 35 second scan time and up to one minute post-processing time for a complete quantitative assessment. The lung perfusion and ventilation demonstrated excellent intra-observer (ICC 0.928 (0.870 to 0.959) and 0.994 (0.990 to 0.997) for mean perfusion and ventilation respectively) and inter-observer agreement (ICC 0.966 (0.940 to 0.981) and 0.992 (0.985 to 0.996) for mean perfusion and ventilation respectively). Bland-Altman plots demonstrate intra- and inter-observer reproducibility for lung perfusion and ventilation (Figure 2).

Conclusion

The lung perfusion and ventilation derived using phase-resolved functional lung (PREFUL) MRI imaging are highly reproducible. The Fourier decomposition method may allow fast quantitative evaluation of lung function.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): Hospital of Lithuanian University of Health Sciences

Impact of weight loss on cardiac function: improvement in left ventricular global longitudinal strain following metabolic surgery

Introduction

Obesity leads to an increased risk of cardiovascular disease (CVD) morbidity and mortality and is associated with the metabolic risk factors such as hypertension, diabetes mellitus, hyperlipidemia [1]. Metabolic surgery has been proven to be the most effective long term weight management tool and has known benefits in CVD prevention [2]. Global longitudinal strain (GLS) is an effective quantitative measurement of left ventricular (LV) function that is also a powerful predictor of future CVD events and mortality [3]. The impact of metabolic surgery on LV structure and function is unknown.

Purpose

This study investigated the changes in cardiac structure and function after metabolic surgery, including GLS. To our knowledge there has not been a study investigating this relationship previously reported.

Methods

Consecutive patients undergoing metabolic surgery at our center between March 2005 and February 2019 were recruited. Patients with transthoracic echocardiographic imaging (TTE) pre and post metabolic surgery (May 2005 to January 2019) were included. Electronic medical records were searched to obtain demographic, surgical and clinical data. GLS was calculated with Velocity Vector Imaging (VVI, Siemens, v2.0, Pennsylvania, USA). Averaged GLS values were derived from 4 chamber, 2 chamber and 3 chamber calculations.

Results

398 patients with pre- and post-operative cardiac imaging were included. Please see Table 1 for the baseline demographics of our study population. The mean age was 60.0 years with 70% being female. There were significant rates of CVD risk factors such as: hypertension (76.4%), diabetes mellitus (58.8%) and hyperlipidemia (76.4%).

The clinical and echocardiographic changes noted post metabolic surgery are detailed in Table 2. Along with decreases in weight post operatively, there were significant improvements in the markers of CVD risk factors such as mean blood pressure (134/75 to 129/72 mmHg, p value <0.001), mean gylcated hemoglobin levels (7.0 to 6.1%, p value <0.001) and mean low density lipoprotein (LDL) levels (97.7 to 88.2 mg/dl, p value <0.001).

There were a number of statistically significant positive changes in the left ventricular structure and function. The mean LV ejection fraction increased from 56.3% to 57.4% (p=0.008); left ventricular mass decreased from 238.2 g to 179.3 g (p value <0.001), and both septal and posterior wall thicknesses decreased significantly (p value <0.001). The LV mass indexed to body surface area (BSA) also decreased from 93.5 g/m2 to 83.1 g/m2.

The average global LV GLS was −15.7% pre-operatively, improving significantly to −17.9% post-operatively (p<0.001).

Conclusion

Our study has shown for the first time the impact of metabolic surgery on ventricular structure and function, with reduction in LV mass and improvement in LV GLS. These novel findings lends further support to the cardiovascular benefits of metabolic surgery.

Funding Acknowledgement

Type of funding sources: None.

Resonantly Interacting Fermi-Fermi Mixture of ^{161}Dy and ^{40}K

We report on the realization of a Fermi-Fermi mixture of ultracold atoms that combines mass imbalance, tunability, and collisional stability. In an optically trapped sample of ^{161}Dy and ^{40}K, we identify a broad Feshbach resonance centered at a magnetic field of 217 G. Hydrodynamic expansion profiles in the resonant interaction regime reveal a bimodal behavior resulting from mass imbalance. Lifetime studies on resonance show a suppression of inelastic few-body processes by orders of magnitude, which we interpret as a consequence of the fermionic nature of our system. The resonant mixture opens up intriguing perspectives for studies on novel states of strongly correlated fermions with mass imbalance.

Accurate Determination of the Dynamical Polarizability of Dysprosium

We report a measurement of the dynamical polarizability of dysprosium atoms in their electronic ground state at the optical wavelength of 1064 nm, which is of particular interest for laser trapping experiments. Our method is based on collective oscillations in an optical dipole trap, and reaches unprecedented accuracy and precision by comparison with an alkali atom (potassium) as a reference species. We obtain values of 184.4(2.4) and 1.7(6) a.u. for the scalar and tensor polarizability, respectively. Our experiments have reached a level that permits meaningful tests of current theoretical descriptions and provides valuable information for future experiments utilizing the intriguing properties of heavy lanthanide atoms.

Ultracold Dipolar Molecules Composed of Strongly Magnetic Atoms

In a combined experimental and theoretical effort, we demonstrate a novel type of dipolar system made of ultracold bosonic dipolar molecules with large magnetic dipole moments. Our dipolar molecules are formed in weakly bound Feshbach molecular states from a sample of strongly magnetic bosonic erbium atoms. We show that the ultracold magnetic molecules can carry very large dipole moments and we demonstrate how to create and characterize them, and how to change their orientation. Finally, we confirm that the relaxation rates of molecules in a quasi-two-dimensional geometry can be reduced by using the anisotropy of the dipole-dipole interaction and that this reduction follows a universal dipolar behavior.

Anisotropic relaxation dynamics in a dipolar Fermi gas driven out of equilibrium

We report on the observation of a large anisotropy in the rethermalization dynamics of an ultracold dipolar Fermi gas driven out of equilibrium. Our system consists of an ultracold sample of strongly magnetic 167Er fermions, spin polarized in the lowest Zeeman sublevel. In this system, elastic collisions arise purely from universal dipolar scattering. Based on cross-dimensional rethermalization experiments, we observe a strong anisotropy of the scattering, which manifests itself in a large angular dependence of the thermal relaxation dynamics. Our result is in good agreement with recent theoretical predictions. Furthermore, we measure the rethermalization rate as a function of temperature for different angles and find that the suppression of collisions by Pauli blocking is not influenced by the dipole orientation.

Reaching Fermi degeneracy via universal dipolar scattering

We report on the creation of a degenerate dipolar Fermi gas of erbium atoms. We force evaporative cooling in a fully spin-polarized sample down to temperatures as low as 0.2 times the Fermi temperature. The strong magnetic dipole-dipole interaction enables elastic collisions between identical fermions even in the zero-energy limit. The measured elastic scattering cross section agrees well with the predictions from the dipolar scattering theory, which follow a universal scaling law depending only on the dipole moment and on the atomic mass. Our approach to quantum degeneracy proceeds with very high cooling efficiency and provides large atomic densities, and it may be extended to various dipolar systems.

Bose-Einstein condensation of erbium

We report on the achievement of Bose-Einstein condensation of erbium atoms and on the observation of magnetic Feshbach resonances at low magnetic fields. By means of evaporative cooling in an optical dipole trap, we produce pure condensates of 168Er, containing up to 7×10(4) atoms. Feshbach spectroscopy reveals an extraordinary rich loss spectrum with six loss resonances already in a narrow magnetic-field range up to 3 G. Finally, we demonstrate the application of a low-field Feshbach resonance to produce a tunable dipolar Bose-Einstein condensate and we observe its characteristic d-wave collapse.

Universality of the three-body parameter for Efimov states in ultracold cesium

We report on the observation of triatomic Efimov resonances in an ultracold gas of cesium atoms. Exploiting the wide tunability of interactions resulting from three broad Feshbach resonances in the same spin channel, we measure magnetic-field dependent three-body recombination loss. The positions of the loss resonances yield corresponding values for the three-body parameter, which in universal few-body physics is required to describe three-body phenomena and, in particular, to fix the spectrum of Efimov states. Our observations show a robust universal behavior with a three-body parameter that stays essentially constant.

Hydrodynamic expansion of a strongly interacting fermi-fermi mixture

We report on the expansion of an ultracold Fermi-Fermi mixture of (6)Li and (40)K under conditions of strong interactions controlled via an interspecies Feshbach resonance. We study the expansion of the mixture after release from the trap and, in a narrow magnetic-field range, we observe two phenomena related to hydrodynamic behavior. The common inversion of the aspect ratio is found to be accompanied by a collective effect where both species stick together and expand jointly despite of their widely different masses. Our work constitutes a major experimental step for a controlled investigation of the many-body physics of this novel strongly interacting quantum system.

Neutral and acidic oligosaccharides in Holstein-Friesian colostrum during the first 3 days of lactation measured by high performance liquid chromatography on a microfluidic chip and time-of-flight mass spectrometry

Oligosaccharides (OS) from bovine milk are a class of bioactive molecules that are receiving increasing commercial attention for their potential health benefits. In the present work we measured, comprehensively and systematically, free milk OS in the colostrum of 7 Holstein-Friesian cows during the first 3 d of lactation in 12-h intervals by HPLC-chip/time-of-flight mass spectrometry to determine the biological variation of free milk OS in early lactation. The high sensitivity and resolution of the analytical technique made it possible to monitor all OS species, thus providing a comprehensive and quantitative analysis of OS variations during colostrum production. This study confirmed that although sialyllactose is the major OS in bovine colostrum, several neutral OS species are present in significant abundance even at the third day of lactation. Furthermore, variation in terms of OS species and relative abundances of OS between cows suggest individual animal variation. These variations are likely due to genetic factors because environmental factors such as nutrition, lactation number, and accommodation were the same for all cows. This investigation revealed that colostrum milk from Holstein-Friesian cows is a rich source of neutral and acidic OS for the food and pharmaceutical industries.

Effects of anemia and uremia and a combination of both on cardiovascular structures

BACKGROUND

Cardiovascular complications are a major cause of morbidity and mortality in chronic renal failure (CRF) patients. Chronic anemia is a complication of CRF and a cardiovascular risk factor per se. It was the aim of the present study to clarify whether uremia and anemia are additive or supra-additive with respect to cardiovascular alterations.

METHODS

Thirty SD rats were sham operated (sham) or subtotally nephrectomized (SNX). Both groups were subdivided into anemic (target hemoglobin 10 g/dl, by tail artery punctures) and untreated animals. Blood pressure, echocardiographic measurements and morphometric investigations were performed. The study was terminated after 16 weeks.

RESULTS

Heart rate and blood pressure were similar in all groups. Anemia was comparable in sham+anemia and SNX+anemia. Left ventricular end-diastolic pressure was significantly higher in untreated SNX and SNX+anemia than in sham. Anemia and SNX caused comparable left ventricular hypertrophy (LVH), which was significantly higher in SNX+anemia. In sham animals, anemia induced thickening of intramyocardial arteries, which was significantly more pronounced in SNX with no additional effect of anemia.

CONCLUSIONS

Experimentally, anemia and CRF induced LVH and intramyocardial arteriolar thickening. If both are combined, the increase in LVH is even more marked, whereas there are no additional effects on intramyocardial structural alterations.

Magnetically controlled exchange process in an ultracold atom-dimer mixture

We report on the observation of an elementary exchange process in an optically trapped ultracold sample of atoms and Feshbach molecules. We can magnetically control the energetic nature of the process and tune it from endoergic to exoergic, enabling the observation of a pronounced threshold behavior. In contrast to relaxation to more deeply bound molecular states, the exchange process does not lead to trap loss. We find excellent agreement between our experimental observations and calculations based on the solutions of three-body Schrödinger equation in the adiabatic hyperspherical representation. The high efficiency of the exchange process is explained by the halo character of both the initial and final molecular states.

Collisional stability of 40K immersed in a strongly interacting Fermi gas of 6Li

We investigate the collisional stability of a sample of 40K atoms immersed in a tunable spin mixture of 6Li atoms. In this three-component Fermi-Fermi mixture, we find very low loss rates in a wide range of interactions as long as molecule formation of 6Li is avoided. The stable fermionic mixture with two resonantly interacting spin states of one species together with another species is a promising system for a broad variety of phenomena in few- and many-body quantum physics.

Evidence for universal four-body states tied to an Efimov trimer

We report on the measurement of four-body recombination rate coefficients in an atomic gas. Our results obtained with an ultracold sample of cesium atoms at negative scattering lengths show a resonant enhancement of losses and provide strong evidence for the existence of a pair of four-body states, which is strictly connected to Efimov trimers via universal relations. Our findings confirm recent theoretical predictions and demonstrate the enrichment of the Efimov scenario when a fourth particle is added to the generic three-body problem.

Ultracold triplet molecules in the rovibrational ground state

We report here on the production of an ultracold gas of tightly bound Rb2 triplet molecules in the rovibrational ground state, close to quantum degeneracy. This is achieved by optically transferring weakly bound Rb2 molecules to the absolute lowest level of the ground triplet potential with a transfer efficiency of about 90%. The transfer takes place in a 3D optical lattice which traps a sizeable fraction of the tightly bound molecules with a lifetime exceeding 200 ms.

Collisions between tunable halo dimers: exploring an elementary four-body process with identical bosons

We study inelastic collisions in a pure, trapped sample of Feshbach molecules made of bosonic cesium atoms in the quantum halo regime. We measure the relaxation rate coefficient for decay to lower-lying molecular states and study the dependence on scattering length and temperature. We identify a pronounced loss minimum with varying scattering length along with a further suppression of loss with decreasing temperature. Our observations provide insight into the physics of a few-body quantum system that consists of four identical bosons at large values of the two-body scattering length.

Low NaCl intake elevates renal medullary endothelin-1 and endothelin A (ETA) receptor mRNA but not the sensitivity of renal Na+ excretion to ETA receptor blockade in rats

AIMS

This study was performed to investigate the effects of NaCl intake on renal mRNA expression of pre-pro-endothelin-1 (ET-1), endothelin A (ET(A)) and endothelin B (ET(B)) receptors as well as on renal ET-1 content in rats. We further tested for NaCl intake-dependent differences in the contribution of the ET system to renal sodium handling.

METHODS

Male Sprague-Dawley rats with telemetric devices were randomized to 0.15%, 0.60% and 1.80% NaCl diets with or without losartan. Renal sodium balance and arterial pressure were monitored. Renal blood flow and fractional sodium excretion (FENa) were measured in response to acute infusion of ET(A) and ET(B) blockers into the inner stripe of the outer renal medulla.

RESULTS

Medullary pre-pro-ET-1, ET(A) and ET(B) receptor mRNA was 50%, 81% and 33% higher in rats on 0.15% vs. 1.80% NaCl. Losartan reduced medullary gene expression in rats on 0.15% NaCl. Medullary ET-1 content was 983 +/- 88 and 479 +/- 42 ng mg(-1) protein in rats on 0.15% and 1.80% NaCl (P < 0.001). Chronic ET(A) receptor blocker treatment reduced arterial pressure by 8-10 mmHg in rats on 0.15% vs. 1.80% NaCl without affecting renal sodium balances. Acute medullary ET(A) or ET(B) receptor blockade did not alter medullary blood flow and FENa in animals on either diet.

CONCLUSION

In rats renal medullary ET-1 content and mRNA expression of three ET system components are inversely related to NaCl intake. Higher expression levels on low NaCl intake are AT(1) receptor dependent but are not associated with increased sensitivity of renal sodium handling to ET(A) receptor blockade.

Metastable feshbach molecules in high rotational states

We experimentally demonstrate Cs2 Feshbach molecules well above the dissociation threshold, which are stable against spontaneous decay on the time scale of 1 s. An optically trapped sample of ultracold dimers is prepared in a high rotational state and magnetically tuned into a region with a negative binding energy. The metastable character of these molecules arises from the large centrifugal barrier in combination with negligible coupling to states with low rotational angular momentum. A sharp onset of dissociation with increasing magnetic field is mediated by a crossing with a lower rotational dimer state and facilitates dissociation on demand with a well-defined energy.

Exploring an ultracold fermi-fermi mixture: interspecies feshbach resonances and scattering properties of 6Li and 40K

We report on the observation of Feshbach resonances in an ultracold mixture of two fermionic species, (6)Li and (40)K. The experimental data are interpreted using a simple asymptotic bound state model and full coupled channels calculations. This unambiguously assigns the observed resonances in terms of various s- and p-wave molecular states and fully characterizes the ground-state scattering properties in any combination of spin states.

Finite-temperature collective dynamics of a Fermi gas in the BEC-BCS crossover

We report on experimental studies on the collective behavior of a strongly interacting Fermi gas with tunable interactions and variable temperature. A scissors mode excitation in an elliptical trap is used to characterize the dynamics of the quantum gas in terms of hydrodynamic or near-collisionless behavior. We obtain a crossover phase diagram for collisional properties, showing a large region where a nonsuperfluid strongly interacting gas shows hydrodynamic behavior. In a narrow interaction regime on the BCS side of the crossover, we find a novel temperature-dependent damping peak, suggesting a relation to the superfluid phase transition.

"Stückelberg interferometry" with ultracold molecules

We report on the realization of a time-domain "Stückelberg interferometer", which is based on the internal-state structure of ultracold Feshbach molecules. Two subsequent passages through a weak avoided crossing between two different orbital angular momentum states in combination with a variable hold time lead to high-contrast population oscillations. This allows for a precise determination of the energy difference between the two molecular states. We demonstrate a high degree of control over the interferometer dynamics. The interferometric scheme provides new possibilities for precision measurements with ultracold molecules.

Coherent optical transfer of Feshbach molecules to a lower vibrational state

Using the technique of stimulated Raman adiabatic passage (STIRAP) we have coherently transferred ultracold (87)Rb(2) Feshbach molecules into a more deeply bound vibrational quantum level. Our measurements indicate a high transfer efficiency of up to 87%. Because the molecules are held in an optical lattice with not more than a single molecule per lattice site, inelastic collisions between the molecules are suppressed and we observe long molecular lifetimes of about 1 s. Using STIRAP we have created quantum superpositions of the two molecular states and tested their coherence interferometrically. These results represent an important step towards Bose-Einstein condensation of molecules in the vibrational ground state.

Precision measurements of collective oscillations in the BEC-BCS crossover

We report on precision measurements of the frequency of the radial compression mode in a strongly interacting, optically trapped Fermi gas of (6)Li atoms. Our results allow for a test of theoretical predictions for the equation of state in the BEC-BCS crossover. We confirm recent quantum Monte Carlo results and rule out simple mean-field BCS theory. Our results show the long-sought beyond-mean-field effects in the strongly interacting Bose-Einstein condensation (BEC) regime.

Repulsively bound atom pairs in an optical lattice

Throughout physics, stable composite objects are usually formed by way of attractive forces, which allow the constituents to lower their energy by binding together. Repulsive forces separate particles in free space. However, in a structured environment such as a periodic potential and in the absence of dissipation, stable composite objects can exist even for repulsive interactions. Here we report the observation of such an exotic bound state, which comprises a pair of ultracold rubidium atoms in an optical lattice. Consistent with our theoretical analysis, these repulsively bound pairs exhibit long lifetimes, even under conditions when they collide with one another. Signatures of the pairs are also recognized in the characteristic momentum distribution and through spectroscopic measurements. There is no analogue in traditional condensed matter systems of such repulsively bound pairs, owing to the presence of strong decay channels. Our results exemplify the strong correspondence between the optical lattice physics of ultracold bosonic atoms and the Bose-Hubbard model-a link that is vital for future applications of these systems to the study of strongly correlated condensed matter and to quantum information.

Evidence for Efimov quantum states in an ultracold gas of caesium atoms

Systems of three interacting particles are notorious for their complex physical behaviour. A landmark theoretical result in few-body quantum physics is Efimov's prediction of a universal set of bound trimer states appearing for three identical bosons with a resonant two-body interaction. Counterintuitively, these states even exist in the absence of a corresponding two-body bound state. Since the formulation of Efimov's problem in the context of nuclear physics 35 years ago, it has attracted great interest in many areas of physics. However, the observation of Efimov quantum states has remained an elusive goal. Here we report the observation of an Efimov resonance in an ultracold gas of caesium atoms. The resonance occurs in the range of large negative two-body scattering lengths, arising from the coupling of three free atoms to an Efimov trimer. Experimentally, we observe its signature as a giant three-body recombination loss when the strength of the two-body interaction is varied. We also detect a minimum in the recombination loss for positive scattering lengths, indicating destructive interference of decay pathways. Our results confirm central theoretical predictions of Efimov physics and represent a starting point with which to explore the universal properties of resonantly interacting few-body systems. While Feshbach resonances have provided the key to control quantum-mechanical interactions on the two-body level, Efimov resonances connect ultracold matter to the world of few-body quantum phenomena.

Long-lived Feshbach molecules in a three-dimensional optical lattice

We have created and trapped a pure sample of Feshbach molecules in a three-dimensional optical lattice. Compared to previous experiments without a lattice, we find dramatic improvements such as long lifetimes of up to 700 ms and a near unit efficiency for converting tightly confined atom pairs into molecules. The lattice shields the trapped molecules from collisions and, thus, overcomes the problem of inelastic decay by vibrational quenching. Furthermore, we have developed an advanced purification scheme that removes residual atoms, resulting in a lattice in which individual sites are either empty or filled with a single molecule in the vibrational ground state of the lattice.

Atom-molecule dark states in a Bose-Einstein condensate

We have created a dark quantum superposition state of a Rb Bose-Einstein condensate and a degenerate gas of Rb2 ground-state molecules in a specific rovibrational state using two-color photo-association. As a signature for the decoupling of this coherent atom-molecule gas from the light field, we observe a striking suppression of photo-association loss. In our experiment the maximal molecule population in the dark state is limited to about 100 Rb2 molecules due to laser induced decay. The experimental findings can be well described by a simple three mode model.

Observation of Feshbach-like resonances in collisions between ultracold molecules

We observe magnetically tuned collision resonances for ultracold Cs2 molecules stored in a CO2-laser trap. By magnetically levitating the molecules against gravity, we precisely measure their magnetic moment. We find an avoided level crossing which allows us to transfer the molecules into another state. In the new state, two Feshbach-like collision resonances show up as strong inelastic loss features. We interpret these resonances as being induced by Cs4 bound states near the molecular scattering continuum. The tunability of the interactions between molecules opens up novel applications such as controlled chemical reactions and synthesis of ultracold complex molecules.