Progress in Atomic Fountains at LNE-SYRTE

We give an overview of the work done with the Laboratoire National de M\'etrologie et d'Essais-Syst\`emes de R\'ef\'erence Temps-Espace (LNE-SYRTE) fountain ensemble during the last five years. After a description of the clock ensemble, comprising three fountains, FO1, FO2, and FOM, and the newest developments, we review recent studies of several systematic frequency shifts. This includes the distributed cavity phase shift, which we evaluate for the FO1 and FOM fountains, applying the techniques of our recent work on FO2. We also report calculations of the microwave lensing frequency shift for the three fountains, review the status of the blackbody radiation shift, and summarize recent experimental work to control microwave leakage and spurious phase perturbations. We give current accuracy budgets. We also describe several applications in time and frequency metrology: fountain comparisons, calibrations of the international atomic time, secondary representation of the SI second based on the 87Rb hyperfine frequency, absolute measurements of optical frequencies, tests of the T2L2 satellite laser link, and review fundamental physics applications of the LNE-SYRTE fountain ensemble. Finally, we give a summary of the tests of the PHARAO cold atom space clock performed using the FOM transportable fountain.Comment: 19 pages, 12 figures, 5 tables, 126 reference

Left atrial function after atrial fibrillation cryoablation concomitant to minimally invasive mitral valve repair: A pilot study on long-term results and clinical implications

Background and Objectives: Surgical atrial fibrillation (AF) ablation concomitant to minimally invasive mitral valve repair has been proven to offer improved short- and long-term sinus rhythm (SR) maintenance compared to mitral valve surgery only. The objective of the present study was to explore, by thorough echocardiographic assessment, long-term morphological and functional left atrial (LA) outcomes after this combined surgical procedure. Materials and Methods: From October 2006 to November 2015, 48 patients underwent minimally invasive mitral valve repair and concomitant surgical AF cryoablation. Results: After 3.8 ± 2.2 years, 30 (71.4%) of those completing the follow-up (n = 42, 87.5%) presented SR. During follow-up, four (9.5%) patients suffered from cerebrovascular accidents and two of these subjects had a long-standing persistent AF relapse and were in AF at the time of the event, while the other two were in SR. An echocardiographic study focused on LA characteristics was performed in 29 patients (69.0%). Atrial morphology and function (e.g., maximal LA volume indexed to body surface area and total LA emptying fraction derived from volumes) in patients with stable SR (60.6 ± 13.1 mL/mq and 25.1 ± 7.3%) were significantly better than in those with AF relapses (76.8 ± 16.2 mL/mq and 17.5 ± 7.4%; respectively, p = 0.008 and p = 0.015). At follow-up, patients who suffered from ischemic cerebral events had maximal LA volume indexed to body surface area 61 ± 17.8 mL/mq, with total LA emptying fraction derived from volumes 23.6 ± 13.7%; patients with strokes in SR showed very enlarged LA volume (>70 mL/mq). Conclusions: AF cryoablation concomitant with minimally invasive mitral valve repair provides a high rate of SR maintenance and this relates to improved long-term morphological and functional LA outcomes. Further prospective studies are needed to define the cut-off values determining an increase in the risk for thromboembolic complications in patients with restored stable SR

Optical frequency measurement of the 1S-3S two-photon transition in hydrogen

This article reports the first optical frequency measurement of the $1\mathrm{S}-3\mathrm{S}$ transition in hydrogen. The excitation of this transition occurs at a wavelength of 205 nm which is obtained with two frequency doubling stages of a titanium sapphire laser at 820 nm. Its frequency is measured with an optical frequency comb. The second-order Doppler effect is evaluated from the observation of the motional Stark effect due to a transverse magnetic field perpendicular to the atomic beam. The measured value of the $1\mathrm{S}_{1/2}(F=1)-3\mathrm{S}_{1/2}(F=1)$ frequency splitting is $2 922 742 936.729 (13) \mathrm{MHz}$ with a relative uncertainty of $4.5\times10^{-12}$. After the measurement of the $1\mathrm{S}-2\mathrm{S}$ frequency, this result is the most precise of the optical frequencies in hydrogen

Accurate spectroscopy of Sr atoms

We report the frequency measurement with an accuracy in the 100 kHz range of several optical transitions of atomic Sr : $^1S_0- ^3P_1$ at 689 nm, $^3P_1- ^3S_1$ at 688 nm and $^3P_0- ^3S_1$ at 679 nm. Measurements are performed with a frequency chain based on a femtosecond laser referenced to primary frequency standards. They allowed the indirect determination with a 70 kHz uncertainty of the frequency of the doubly forbidden 5s^2^1S_0- 5s5p^3P_0 transition of $^{87}$Sr at 698 nm and in a second step its direct observation. Frequency measurements are performed for $^{88}$Sr and $^{87}$Sr, allowing the determination of $^3P_0$, $^3P_1$ and $^3S_1$ isotope shifts, as well as the $^3S_1$ hyperfine constants.Comment: 12 pages, 16 figure

High-resolution microwave frequency dissemination on an 86-km urban optical link

We report the first demonstration of a long-distance ultra stable frequency dissemination in the microwave range. A 9.15 GHz signal is transferred through a 86-km urban optical link with a fractional frequency stability of 1.3x10-15 at 1 s integration time and below 10-18 at one day. The optical link phase noise compensation is performed with a round-trip method. To achieve such a result we implement light polarisation scrambling and dispersion compensation. This link outperforms all the previous radiofrequency links and compares well with recently demonstrated full optical links.Comment: 11 pages, 5 figure

Accuracy Evaluation of an Optical Lattice Clock with Bosonic Atoms

We report the first accuracy evaluation of an optical lattice clock based on the 1S0 - 3P0 transition of an alkaline earth boson, namely 88Sr atoms. This transition has been enabled using a static coupling magnetic field. The clock frequency is determined to be 429 228 066 418 009(32) Hz. The isotopic shift between 87Sr and 88Sr is 62 188 135 Hz with fractional uncertainty 5.10^{-7}. We discuss the conditions necessary to reach a clock accuracy of 10^{-17} or less using this scheme.Comment: 3 pages, 4 figures, uses ol.sty fil

The impact of COVID-19 pandemic on breast surgery in Italy: a multi-centric retrospective observational study

COVID-19 pandemic had an impact on surgical activities. The aim of this multi-centric, retrospective study was to evaluate the impact of the COVID-19 pandemic on breast surgery. The patients who operated during the pre-pandemic year 2019 were compared to those operated in 2020. Fourteen Breast Care Units provided data on breast surgical procedures performed in 2020 and 2019: total number of breast-conserving surgery (BCS), number of 1st level oncoplastic breast surgery (OBS), number of 2nd level OBS; total number of mastectomies, mastectomies without reconstruction, mastectomies with a tissue expander, mastectomies with direct to implant (DTI) reconstruction, mastectomies with immediate flap reconstruction; total number of delayed reconstructions, number of expanders to implant reconstructions, number of delayed flap reconstructions. Overall 20.684 patients were included: 10.850 (52.5%) operated during 2019, and 9.834 (47.5%) during 2020. The overall number of breast oncologic surgical procedures in all centers in 2020 was 8.509, compared to 9.383 in 2019 (- 9%). BCS decreased by 744 cases (- 13%), the overall number of mastectomies decreased by 130 cases (- 3.5%); mastectomy-BCS ratio was 39-61% in 2019, and 42-58% in 2020. Regarding immediate reconstructive procedures mastectomies with DTI reconstruction increased by 166 cases (+ 15%) and mastectomies with immediate expander reconstruction decreased by 297 cases (- 20%). Breast-delayed reconstructive procedures in all centers in 2020 were 142 less than in 2019 (- 10%). The outburst of the COVID-19 pandemic in 2020 determined an implemented number of mastectomies compared to BCS, an implemented number of immediate breast reconstructions, mainly DTI, and a reduction of expander reconstruction

Development of a novel nomogram-based online tool to predict axillary status after neoadjuvant chemotherapy in cN+ breast cancer: A multicentre study on 1,950 patients

Background: Type of axillary surgery in breast cancer (BC) patients who convert from cN + to ycN0 after neoadjuvant chemotherapy (NAC) is still debated. The aim of the present study was to develop and validate a preoperative predictive nomogram to select those patients with a low risk of residual axillary disease after NAC, in whom axillary surgery could be minimized. Patients and methods: 1950 clinically node-positive BC patients from 11 Breast Units, treated by NAC and subsequent surgery, were included from 2005 to 2020. Patients were divided in two groups: those who achieved nodal pCR vs. those with residual nodal disease after NAC. The cohort was divided into training and validation set with a geographic separation criterion. The outcome was to identify independent predictors of axillary pathologic complete response (pCR). Results: Independent predictive factors associated to nodal pCR were axillary clinical complete response (cCR) after NAC (OR 3.11, p < 0.0001), ER-/HER2+ (OR 3.26, p < 0.0001) or ER+/HER2+ (OR 2.26, p = 0.0002) or ER-/HER2- (OR 1.89, p = 0.009) BC, breast cCR (OR 2.48, p < 0.0001), Ki67 > 14% (OR 0.52, p = 0.0005), and tumor grading G2 (OR 0.35, p = 0.002) or G3 (OR 0.29, p = 0.0003). The nomogram showed a sensitivity of 71% and a specificity of 73% (AUC 0.77, 95%CI 0.75\u20130.80). After external validation the accuracy of the nomogram was confirmed. Conclusion: The accuracy makes this freely-available, nomogram-based online tool useful to predict nodal pCR after NAC, translating the concept of tailored axillary surgery also in this setting of patients