Can Abbreviated Cardiac Magnetic Resonance Imaging Adequately Support Clinical Decision Making After Repair of Tetralogy of Fallot?

Quantification of pulmonary regurgitation (PR), pulmonary flow distribution, and ventricular function is important for clinical surveillance in repaired Tetralogy of Fallot (TOF). Cardiovascular magnetic resonance (CMR) is the established reference, but cost, test duration, and patient discomfort are potential limitations to its serial use. We investigated whether an Abbreviated CMR protocol would alter clinical decisions in TOF from those that would have been made using a full protocol. Patients > 7 years with repaired TOF were identified. CMR was performed according to standard complete imaging protocol. CMRs were prepared in two ways, Full and Abbreviated and submitted for review by two imaging specialists. In conjunction with clinical information and case-specific quantitative CMR data (PR fraction, ventricular volumes, ejection fraction, branch pulmonary artery flow), Full and Abbreviated image sets were anonymized and uploaded for review. For the first half, Imager 1 received Abbreviated, and Imager 2 Full and for the remaining, Imager 1 received Full and Imager 2 received Abbreviated. Blinded to the other’s choices, Imagers provided clinical decisions. Inter-rater agreement for each decision was measured. In all, 124 studies from 80 patients (mean 17.8 years) were analyzed. For ‘intervention versus no-intervention’ decision, the inter-rater agreement was strong [κ 0.75, p < 0.0001, 95% CI (0.630, 0.869)]. Agreement for recommended timing of follow-up imaging was good (κ 0.64, p < 0.0001, 95% CI (0.474, 0.811)] in the ‘no-intervention’ group. When raters were asked whether or not further imaging was necessary, agreement was modest [κ 0.363 (p < 0.0001), 95% CI (0.038, 0.687)]. In conclusion, Abbreviated CMR yield decisions for clinical care similar to those made using the standard full protocol. These results suggest a potential enhancement of clinical practice in which efficiency and cost saving might be achieved using Abbreviated CMR for routine follow-up surveillance of TOF

Revised estimates of ocean-atmosphere CO2 flux are consistent with ocean carbon inventory

This is the final version. Available from the publisher via the DOI in this record.The ocean is a sink for ~25% of the atmospheric CO2 emitted by human activities, an amount in excess of 2 petagrams of carbon per year (PgC yr−1 ). Time-resolved estimates of global ocean-atmosphere CO2 flux provide an important constraint on the global carbon budget. However, previous estimates of this flux, derived from surface ocean CO2 concentrations, have not corrected the data for temperature gradients between the surface and sampling at a few meters depth, or for the effect of the cool ocean surface skin. Here we calculate a time history of ocean-atmosphere CO2 fluxes from 1992 to 2018, corrected for these effects. These increase the calculated net flux into the oceans by 0.8–0.9 PgC yr−1 , at times doubling uncorrected values. We estimate uncertainties using multiple interpolation methods, finding convergent results for fluxes globally after 2000, or over the Northern Hemisphere throughout the period. Our corrections reconcile surface uptake with independent estimates of the increase in ocean CO2 inventory, and suggest most ocean models underestimate uptake.European Space AgencyEuropean CommissionBONUS Secretariat (EEIG

Experimental violation of a Bell's inequality in time with weak measurement

The violation of J. Bell's inequality with two entangled and spatially separated quantum two- level systems (TLS) is often considered as the most prominent demonstration that nature does not obey ?local realism?. Under different but related assumptions of "macrorealism", plausible for macroscopic systems, Leggett and Garg derived a similar inequality for a single degree of freedom undergoing coherent oscillations and being measured at successive times. Such a "Bell's inequality in time", which should be violated by a quantum TLS, is tested here. In this work, the TLS is a superconducting quantum circuit whose Rabi oscillations are continuously driven while it is continuously and weakly measured. The time correlations present at the detector output agree with quantum-mechanical predictions and violate the inequality by 5 standard deviations.Comment: 26 pages including 10 figures, preprint forma

Coupling Superconducting Qubits via a Cavity Bus

Superconducting circuits are promising candidates for constructing quantum bits (qubits) in a quantum computer; single-qubit operations are now routine, and several examples of two qubit interactions and gates having been demonstrated. These experiments show that two nearby qubits can be readily coupled with local interactions. Performing gates between an arbitrary pair of distant qubits is highly desirable for any quantum computer architecture, but has not yet been demonstrated. An efficient way to achieve this goal is to couple the qubits to a quantum bus, which distributes quantum information among the qubits. Here we show the implementation of such a quantum bus, using microwave photons confined in a transmission line cavity, to couple two superconducting qubits on opposite sides of a chip. The interaction is mediated by the exchange of virtual rather than real photons, avoiding cavity induced loss. Using fast control of the qubits to switch the coupling effectively on and off, we demonstrate coherent transfer of quantum states between the qubits. The cavity is also used to perform multiplexed control and measurement of the qubit states. This approach can be expanded to more than two qubits, and is an attractive architecture for quantum information processing on a chip.Comment: 6 pages, 4 figures, to be published in Natur

Variability of North Atlantic CO2 fluxes for the 2000-2017 period estimated from atmospheric inverse analyses

This is the final version. Available on open access from the European Geosciences Union via the DOI in this recordData availability: The data sources are the following: (i) Atmospheric CO2 measurements were taken from obspack_co2_1_GLOBALVIEWplus_v4.2_2019-03-19 (https://gml.noaa.gov/ccgg/obspack/data.php?id=obspack_co2_1_GLOBALVIEWplus_v4.2_2019-03-19, (ObsPack, Cooperative Global Atmospheric Data Integration Project, 2018, last access: 14 October 2020); (ii) Prior ocean flux oc_v1.7 from Rödenbeck et al. (2013) were taken from http://www.bgc-jena.mpg.de/CarboScope/ (last access: 5 June 2020). Prior ocean flux from Landschützer et al. (2016) were taken from https://www.ncei.noaa.gov/access/ocean-carbon-data-system/oceans/SPCO2_1982_present_ETH_SOM_FFN.html (last access: 6 May 2020). Prior ocean flux from Takahashi et al. (2009) were taken from ftp://ftp.as.harvard.edu/gcgrid/geos-chem (last access: 9 July 2018). (iii) CarbonTracker CT2019 results were provided by NOAA ESRL, Boulder, Colorado, USA, from the website at http://carbontracker.noaa.gov (Jacobson et al., 2020, last access: 15 May 2020). CTE flux estimates were downloaded from ftp://ftp.wur.nl/carbontracker/data/fluxes/data_flux1x1_monthly/ (van der Laan-Luijkx et al., 2017, last access: 24 November 2020). The flux estimates from CAMS (v18r2) were taken from https://apps.ecmwf.int/datasets/data/cams-ghg-inversions/ (Chevallier et al., 2019, last access: 6 December 2019). (iv) The model CO2 fluxes for JULES (land) and GOBMs (ocean) were taken from Le Quéré et al. (2018). Time series of reconstructed surface ocean pCO2 and CO2 fluxes (LSCE-FFNN) from Denvil-Sommer et al. (2019) are the first version of CMEMS, downloaded from https://resources.marine.copernicus.eu/?option=com_csw&task=results (last access: 14 January 2021). The products from Iida et al. (2015) were downloaded from http://www.data.jma.go.jp/gmd/kaiyou/english/co2_flux/co2_flux_data_en.html (last access: 14 January 2021). The products from Zeng et al. (2015) were downloaded from https://db.cger.nies.go.jp/DL/10.17595/20201020.001.html.en (last access: 14 January 2021). The products from CMEMS, CSIR, and Watson were taken from Friedlingstein et al. (2020).We present new estimates of the regional North Atlantic (15–80∘ N) CO2 flux for the 2000–2017 period using atmospheric CO2 measurements from the NOAA long-term surface site network in combination with an atmospheric carbon cycle data assimilation system (GEOS-Chem–LETKF, Local Ensemble Transform Kalman Filter). We assess the sensitivity of flux estimates to alternative ocean CO2 prior flux distributions and to the specification of uncertainties associated with ocean fluxes. We present a new scheme to characterize uncertainty in ocean prior fluxes, derived from a set of eight surface pCO2-based ocean flux products, and which reflects uncertainties associated with measurement density and pCO2-interpolation methods. This scheme provides improved model performance in comparison to fixed prior uncertainty schemes, based on metrics of model–observation differences at the network of surface sites. Long-term average posterior flux estimates for the 2000–2017 period from our GEOS-Chem–LETKF analyses are −0.255 ± 0.037 PgC yr−1 for the subtropical basin (15–50∘ N) and −0.203 ± 0.037 PgC yr−1 for the subpolar region (50–80∘ N, eastern boundary at 20∘ E). Our basin-scale estimates of interannual variability (IAV) are 0.036 ± 0.006 and 0.034 ± 0.009 PgC yr−1 for subtropical and subpolar regions, respectively. We find statistically significant trends in carbon uptake for the subtropical and subpolar North Atlantic of −0.064 ± 0.007 and −0.063 ± 0.008 PgC yr−1 decade−1; these trends are of comparable magnitude to estimates from surface ocean pCO2-based flux products, but they are larger, by a factor of 3–4, than trends estimated from global ocean biogeochemistry models.Natural Environment Research Council (NERC

Observation of squeezed light from one atom excited with two photons

Single quantum emitters like atoms are well-known as non-classical light sources which can produce photons one by one at given times, with reduced intensity noise. However, the light field emitted by a single atom can exhibit much richer dynamics. A prominent example is the predicted ability for a single atom to produce quadrature-squeezed light, with sub-shot-noise amplitude or phase fluctuations. It has long been foreseen, though, that such squeezing would be "at least an order of magnitude more difficult" to observe than the emission of single photons. Squeezed beams have been generated using macroscopic and mesoscopic media down to a few tens of atoms, but despite experimental efforts, single-atom squeezing has so far escaped observation. Here we generate squeezed light with a single atom in a high-finesse optical resonator. The strong coupling of the atom to the cavity field induces a genuine quantum mechanical nonlinearity, several orders of magnitude larger than for usual macroscopic media. This produces observable quadrature squeezing with an excitation beam containing on average only two photons per system lifetime. In sharp contrast to the emission of single photons, the squeezed light stems from the quantum coherence of photon pairs emitted from the system. The ability of a single atom to induce strong coherent interactions between propagating photons opens up new perspectives for photonic quantum logic with single emittersComment: Main paper (4 pages, 3 figures) + Supplementary information (5 pages, 2 figures). Revised versio

Circuit Quantum Electrodynamics: Coherent Coupling of a Single Photon to a Cooper Pair Box

Under appropriate conditions, superconducting electronic circuits behave quantum mechanically, with properties that can be designed and controlled at will. We have realized an experiment in which a superconducting two-level system, playing the role of an artificial atom, is strongly coupled to a single photon stored in an on-chip cavity. We show that the atom-photon coupling in this circuit can be made strong enough for coherent effects to dominate over dissipation, even in a solid state environment. This new regime of matter light interaction in a circuit can be exploited for quantum information processing and quantum communication. It may also lead to new approaches for single photon generation and detection.Comment: 8 pages, 4 figures, accepted for publication in Nature, embargo does apply, version with high resolution figures available at: http://www.eng.yale.edu/rslab/Andreas/content/science/PubsPapers.htm

Multidecadal changes in biology influence the variability of the North Atlantic carbon sink

This is the final version. Available from IOP Publishing via the DOI in this record. Data availability statement: The data that support the findings of this study are available upon reasonable request from the authors. The datasets that support the findings of this study are available through the following listed websites; the carbon observation data were obtained from the SOCAT (www.socat.info), the biological data were obtained from the CPR Survey (www.cprsurvey.org), SST data were obtained from the ICOADS (1◦ enhanced data, www.esrl. noaa.gov/psd/data/gridded/data.coads.1deg.html). The satellite derived estimate of sea surface chl-a was obtained from the OC-CCI dataset version 4.1 (esa-oceancolour-cci.org) [35]. MLD was obtained from the global ocean and sea-ice reanalysis products (ORAS5: Ocean Reanalysis System 5) prepared by the European Centre for Medium-Range Weather Forecasts (ECMWF www.ecmwf.int/node/18519) [37].The North Atlantic Ocean is the most intense marine sink for anthropogenic carbon dioxide (CO2) in the world’s oceans, showing high variability and substantial changes over recent decades. However, the contribution of biology to the variability and trend of this sink is poorly understood. Here we use in situ plankton measurements, alongside observation-based sea surface CO2 data from 1982 to 2020, to investigate the biological influence on the CO2 sink. Our results demonstrate that long term variability in the CO2 sink in the North Atlantic is associated with changes in phytoplankton abundance and community structure. These data show that within the subpolar regions of the North Atlantic, phytoplankton biomass is increasing, while a decrease is observed in the subtropics, which supports model predictions of climate-driven changes in productivity. These biomass trends are synchronous with increasing temperature, changes in mixing and an increasing uptake of atmospheric CO2 in the subpolar North Atlantic. Our results highlight that phytoplankton play a significant role in the variability as well as the trends of the CO2 uptake from the atmosphere over recent decades.Natural Environment Research CouncilNatural Environment Research CouncilMax Planck Society for the Advancement of Scienc

Multidecadal changes in biology influence the variability of the North Atlantic carbon sink

The North Atlantic Ocean is the most intense marine sink for anthropogenic carbon dioxide (CO2)in the world’s oceans, showing high variability and substantial changes over recent decades. However, the contribution of biology to the variability and trend of this sink is poorly understood. Here we use in situ plankton measurements, alongside observation-based sea surface CO2 data from 1982 to 2020, to investigate the biological influence on the CO2 sink. Our results demonstrate that long term variability in the CO2 sink in the North Atlantic is associated with changes in phytoplankton abundance and community structure. These data show that within the subpolar regions of the North Atlantic, phytoplankton biomass is increasing, while a decrease is observed in the subtropics, which supports model predictions of climate-driven changes in productivity. These biomass trends are synchronous with increasing temperature, changes in mixing and an increasing uptake of atmospheric CO2 in the subpolar North Atlantic. Our results highlight that phytoplankton play a significant role in the variability as well as the trends of the CO2 uptake from the atmosphere over recent decades

High-Grade Osteosarcoma of the Foot: Presentation, Treatment, Prognostic Factors, and Outcome of 23 Cooperative Osteosarcoma Study Group COSS Patients

Osteosarcoma of the foot is a very rare presentation of a rare tumor entity. In a retrospective analysis, we investigated tumor- and treatment-related variables and outcome of patients registered in the Cooperative Osteosarcoma Study Group (COSS) database between January 1980 and April 2016 who suffered from primary high-grade osteosarcoma of the foot. Among the 23 eligible patients, median age was 32 years (range: 6-58 years), 10 were female, and 13 were male. The tarsus was the most commonly affected site (n=16). Three patients had primary metastases. All patients were operated: 5 underwent primary surgery and 18 received surgery following preoperative chemotherapy. In 21 of the 23 patients, complete surgical remission was achieved. In 4 of 17 patients, a poor response to neoadjuvant chemotherapy was observed in the resected primary tumors. Median follow-up was 4.2 years (range: 0.4-18.5). At the last follow-up, 15 of the 23 patients were alive and 8 had died. Five-year overall and event-free survival estimates were 64% (standard error (SE) 12%) and 54% (SE 13%), which is similar to that observed for osteosarcoma in general. Event-free and overall survival correlated with primary metastatic status and completeness of surgery. Our findings show that high-grade osteosarcoma in the foot has a similar outcome as osteosarcoma of other sites