A telehealth approach to improving clinical trial access for infants with tuberous sclerosis complex.

BackgroundResearch in rare genetic syndromes associated with ASD is often hampered by the wide geographic distribution of families and the presence of medical comorbidities, such as epilepsy, that may preclude travel to clinical sites. These challenges can limit the sample size and generalizability of the cohorts included in both natural history studies and clinical trials. Tuberous sclerosis complex (TSC) is a rare genetic syndrome that confers an elevated risk for autism spectrum disorder (ASD), with social communication delays identified in this population as early as 12 months of age. Early identification of risk necessitates parallel testing of early intervention, prompting the first randomized controlled clinical trial of behavioral intervention for infants with TSC (NCT03422367). However, considerable early recruitment challenges have mandated the systematic identification of enrollment barriers followed by modification of the study design to address these barriers.MethodsCaregivers were interviewed regarding barriers to enrollment (phase 1). Adaptations to the intervention were made to address these barriers (phase 2). Outcomes based on this modification to the study design were defined by enrollment rate and participant demographics.ResultsQualitative reports from caregivers indicated that distance and time were the primary barriers to clinical trial enrollment. The intervention was then modified to a remote model, with at-home, parent-delivered intervention, and weekly video conferencing with interventionists at the study sites. Enrollment increased 10-fold (from 3 to 30 participants) within 1 year and included a more diverse and clinically representative cohort of infants.ConclusionThe design and implementation of more scalable methods to disseminate research remotely can substantially improve access to clinical trials in rare neurodevelopmental disorders. The lessons learned from this trial can serve as a model for future studies not only in rare conditions, but in other populations that lack adequate access, such as families with limited financial or clinical resources. Continued efforts will further refine delivery methods to enhance efficiency and ease of these delivery systems for families

Near-Infrared Spectroscopy Shows Right Parietal Specialization for Number in Pre-Verbal Infants

Bilateral regions of the intraparietal sulcus (IPS) appear to be functionally selective for both rudimentary non-symbolic number tasks and higher-level symbolic number tasks in adults and older children. Furthermore, the ability to mentally represent and manipulate approximate non-symbolic numerical quantities is present from birth. These factors leave open whether the specialization of the IPS develops through the experience of learning a symbolic number system or if it is already specialized before symbolic number acquisition. Using the newly emerging technique of functional Near-Infrared Spectroscopy (fNIRS) over left and right parietal and lateral occipital regions, we show right parietal specialization for number in 6-month-old infants. These results extend the current literature in three ways: by successfully implementing an event-related NIRS design in infants, by showing parietal specialization for number occurs before the acquisition of language, and by suggesting number representation may be initially right lateralized and become bilateral through experience.Psycholog

Spectroscopic Study of a Possible Λ Resonance and a Pair of (e, e\u27K⁺) Reaction With a Tritium Target

A mass spectroscopy experiment with a pair of nearly identical high-resolution spectrometers and a tritium target was performed in Hall A at Jefferson Lab. Utilizing the (e,e′K+) reaction, enhancements, which may correspond to a possible Λnn resonance and a pair of ΣNN states, were observed with an energy resolution of about 1.21 MeV (σ), although greater statistics are needed to make definitive identifications. An experimentally measured Λnn state may provide a unique constraint in determining the Λn interaction, for which no scattering data exist. In addition, although bound A = 3 and 4 Σ hypernuclei have been predicted, only an A=4 Σ hypernucleus (4ΣHe) was found, utilizing the (K−,π−) reaction on a 4He target. The possible bound ΣNN state is likely a Σ⁰nn state, although this has to be confirmed by future experiments

Determination of the Argon Spectral Function From (e, e\u27p) Data

The E12-14-012 experiment, performed in Jefferson Lab Hall A, has measured the (e,e′p) cross section in parallel kinematics using a natural argon target. Here, we report the full results of the analysis of the data set corresponding to beam energy 2.222 GeV, and spanning the missing momentum and missing energy range 15 ≲ pm ≲ 300  MeV /c and 12 ≲ Em ≲ 80  MeV. The reduced cross section, determined as a function of pm and Em with ≈ 4% accuracy, has been fitted using the results of Monte Carlo simulations involving a model spectral function and including the effects of final state interactions. The overall agreement between data and simulations turns out to be quite satisfactory (χ2/d. o. f. =1.9). The resulting spectral function will provide valuable new information, needed for the interpretation of neutrino interactions in liquid argon detectors

Measuring Recoiling Nucleons From the Nucleus with the Future Electron Ion Collider

Short range correlated nucleon-nucleon (NN) pairs are an important part of the nuclear ground state. They are typically studied by scattering an electron from one nucleon in the pair and detecting its spectator correlated partner (“spectator-nucleon tagging”). The Electron Ion Collider (EIC) should be able to detect these nucleons, since they are boosted to high momentum in the laboratory frame by the momentum of the ion beam. To determine the feasibility of these studies with the planned EIC detector configuration, we have simulated quasielastic scattering for two electron and ion beam energy configurations: 5 GeV e− and 41 GeV/A ions, and 10 GeV e− and 110 GeV/A ions. We show that the knocked-out and recoiling nucleons can be detected over a wide range of initial nucleon momenta. We also show that these measurements can achieve much larger momentum transfers than current fixed target experiments. By detecting both low and high initial-momentum nucleons, the planned EIC has the potential to provide the data that should allow scientists to definitively show if the European Muon Collaboration effect and short-range correlation are connected, and to improve our understanding of color transparency

First Measurement of the Ar (e,e\u27)X Cross Section at Jefferson Laboratory

The success of the ambitious programs of both long- and short-baseline neutrino-oscillation experiments employing liquid-argon time-projection chambers will greatly rely on the precision with which the weak response of the argon nucleus can be estimated. In the E12-14-012 experiment at Jefferson Lab Hall A, we studied the properties of the argon nucleus by scattering a high-quality electron beam off a high-pressure gaseous argon target. Here, we present the measured 40Ar(e,e\u27) double differential cross section at incident electron energy E=2.222 GeV and scattering angle Θ = 15.54°. The data cover a broad range of energy transfers, where quasielastic scattering and delta production are the dominant reaction mechanisms. The result for argon is compared to our previously reported cross sections for titanium and carbon, obtained in the same kinematical setup

Probing High-Momentum Protons and Neutrons in Neutron-Rich Nuclei

The atomic nucleus is one of the densest and most complex quantum-mechanical systems in nature. Nuclei account for nearly all the mass of the visible Universe. The properties of individual nucleons (protons and neutrons) in nuclei can be probed by scattering a high-energy particle from the nucleus and detecting this particle after it scatters, often also detecting an additional knocked-out proton. Analysis of electron- and proton-scattering experiments suggests that some nucleons in nuclei form close-proximity neutron–proton pairs with high nucleon momentum, greater than the nuclear Fermi momentum. However, how excess neutrons in neutron-rich nuclei form such close-proximity pairs remains unclear. In this study we measure protons and, for the first time, neutrons knocked out of medium-to-heavy nuclei by high-energy electrons and show that the fraction of high-momentum protons increases markedly with the neutron excess in the nucleus, whereas the fraction of high-momentum neutrons decreases slightly. This effect is surprising because in the classical nuclear shell model, protons and neutrons obey Fermi statistics, have little correlation and mostly fill independent energy shells. These high-momentum nucleons in neutron-rich nuclei are important for understanding nuclear parton distribution functions (the partial momentum distribution of the constituents of the nucleon) and changes in the quark distributions of nucleons bound in nuclei (the EMC effect). They are also relevant for the interpretation of neutrino-oscillation measurements and understanding of neutron-rich systems such as neutron stars

First Light from the Far-Infrared Spectroscopy of the Troposphere (FIRST) Instrument

We present first light spectra from the new Far-Infrared Spectroscopy of the Troposphere (FIRST) instrument. FIRST is a Fourier Transform Spectrometer developed to measure accurately the far-infrared (15 to 100 micrometers; 650 to 100 wavenumbers) emission spectrum of the Earth and its atmosphere. The observations presented here were obtained during a high altitude balloon flight from Ft. Sumner, New Mexico on 7 June 2005. The flight data demonstrate the instrument's ability to observe the entire energetically significant infrared emission spectrum (50 to 2000 wavenumbers) at high spectral and spatial resolution on a single focal plane in an instrument with one broad spectral bandpass beamsplitter. Comparisons with radiative transfer calculations demonstrate that FIRST accurately observes the very fine spectral structure in the far-infrared. Comparisons of the atmospheric window radiances measured by FIRST and by instruments on the NASA Aqua satellite that overflew FIRST are in excellent agreement. FIRST opens a new window on the spectrum that can be used for studying atmospheric radiation and climate, cirrus clouds, and water vapor in the upper troposphere

Effects of a Nighttime Multi-Ingredient Supplement on Recovery from a Damaging Exercise Protocol

International Journal of Exercise Science 9(4): 471-481, 2016. The purpose of this study was to determine the efficacy of a nighttime multi-ingredient supplement on noninvasive markers of recovery in resistance trained and untrained individuals. Forty-nine participants, both trained (n=25) and untrained (n=24) completed the randomized, double blind, placebo-controlled study. Trained participants were randomly divided into supplement (n=12) and placebo (n=13) groups. Untrained participants were randomly divided into supplement (n=14) and placebo (n=10) groups. Two, 2 (supplement group) x 2 (training status) x 5 (time points) repeated measures analysis of variance (ANOVA) were utilized to determine if an interaction for supplement group and training status existed for peak force (PForce) and delayed onset muscle soreness (DOMS). Four, 2 (supplement group) x 2 (training status) x 4 (time points) repeated measures ANOVAs was employed for SWVL-Long, SWVL-Tera, SWVL-Trans and ROM to determine interactions for supplement group and training status. For significant main effects, pairwise comparisons were utilized to determine at what time-points significant differences occurred. There were no significant interactions for either DOMS or PForce. However, significant main effects of time were observed for both variables (p\u3c0.001). No significant interactions were determined for either training group, or supplement group for SWVL-Tera, SWVL-Trans, SWVL-Long, or ROM. Although the SWVL-Long had a significant main effect of time (p=0.033), post-hoc pairwise comparisons revealed no significant differences between time points. There was no effect of the nighttime multi-ingredient supplement for attenuation of symptoms associated with acute exercise induced muscle damage

Deep Exclusive Electroproduction of \u3ci\u3eπ\u3c/i\u3e\u3csup\u3e0\u3c/sup\u3e at High \u3ci\u3eQ\u3c/i\u3e\u3csup\u3e2\u3c/sup\u3e in the Quark Valence Regime

We report measurements of the exclusive neutral pion electroproduction cross section off protons at large values of B (0.36, 0.48, and 0.60) and Q2 (3.1 to 8.4  GeV2) obtained from Jefferson Lab Hall A experiment E12-06-014. The corresponding structure functions dσT/dt+εdσL/dt, dσTT/dt, dσLT/dt, and dσLT′/dt are extracted as a function of the proton momentum transfer t−tmin. The results suggest the amplitude for transversely polarized virtual photons continues to dominate the cross section throughout this kinematic range. The data are well described by calculations based on transversity generalized parton distributions coupled to a helicity flip distribution amplitude of the pion, thus providing a unique way to probe the structure of the nucleon