Observing dynamical phases of BCS superconductors in a cavity QED simulator.

In conventional Bardeen-Cooper-Schrieffer superconductors1, electrons with opposite momenta bind into Cooper pairs due to an attractive interaction mediated by phonons in the material. Although superconductivity naturally emerges at thermal equilibrium, it can also emerge out of equilibrium when the system parameters are abruptly changed2-8. The resulting out-of-equilibrium phases are predicted to occur in real materials and ultracold fermionic atoms, but not all have yet been directly observed. Here we realize an alternative way to generate the proposed dynamical phases using cavity quantum electrodynamics (QED). Our system encodes the presence or absence of a Cooper pair in a long-lived electronic transition in 88Sr atoms coupled to an optical cavity and represents interactions between electrons as photon-mediated interactions through the cavity9,10. To fully explore the phase diagram, we manipulate the ratio between the single-particle dispersion and the interactions after a quench and perform real-time tracking of the subsequent dynamics of the superconducting order parameter using nondestructive measurements. We observe regimes in which the order parameter decays to zero (phase I)3,4, assumes a non-equilibrium steady-state value (phase II)2,3 or exhibits persistent oscillations (phase III)2,3. This opens up exciting prospects for quantum simulation, including the potential to engineer unconventional superconductors and to probe beyond mean-field effects like the spectral form factor11,12, and for increasing the coherence time for quantum sensing.

Hydroclimatic vulnerability of peat carbon in the central Congo Basin.

The forested swamps of the central Congo Basin store approximately 30 billion metric tonnes of carbon in peat1,2. Little is known about the vulnerability of these carbon stocks. Here we investigate this vulnerability using peat cores from a large interfluvial basin in the Republic of the Congo and palaeoenvironmental methods. We find that peat accumulation began at least at 17,500 calibrated years before present (cal. yr BP; taken as AD 1950). Our data show that the peat that accumulated between around 7,500 to around 2,000 cal. yr BP is much more decomposed compared with older and younger peat. Hydrogen isotopes of plant waxes indicate a drying trend, starting at approximately 5,000 cal. yr BP and culminating at approximately 2,000 cal. yr BP, coeval with a decline in dominant swamp forest taxa. The data imply that the drying climate probably resulted in a regional drop in the water table, which triggered peat decomposition, including the loss of peat carbon accumulated prior to the onset of the drier conditions. After approximately 2,000 cal. yr BP, our data show that the drying trend ceased, hydrologic conditions stabilized and peat accumulation resumed. This reversible accumulation-loss-accumulation pattern is consistent with other peat cores across the region, indicating that the carbon stocks of the central Congo peatlands may lie close to a climatically driven drought threshold. Further research should quantify the combination of peatland threshold behaviour and droughts driven by anthropogenic carbon emissions that may trigger this positive carbon cycle feedback in the Earth system.

Exploring dynamical phase transitions with cold atoms in an optical cavity.

Interactions between atoms and light in optical cavities provide a means of investigating collective (many-body) quantum physics in controlled environments. Such ensembles of atoms in cavities have been proposed for studying collective quantum spin models, where the atomic internal levels mimic a spin degree of freedom and interact through long-range interactions tunable by changing the cavity parameters1-4. Non-classical steady-state phases arising from the interplay between atom-light interactions and dissipation of light from the cavity have previously been investigated5-11. These systems also offer the opportunity to study dynamical phases of matter that are precluded from existence at equilibrium but can be stabilized by driving a system out of equilibrium12-16, as demonstrated by recent experiments17-22. These phases can also display universal behaviours akin to standard equilibrium phase transitions8,23,24. Here, we use an ensemble of about a million strontium-88 atoms in an optical cavity to simulate a collective Lipkin-Meshkov-Glick model25,26, an iconic model in quantum magnetism, and report the observation of distinct dynamical phases of matter in this system. Our system allows us to probe the dependence of dynamical phase transitions on system size, initial state and other parameters. These observations can be linked to similar dynamical phases in related systems, including the Josephson effect in superfluid helium27, or coupled atomic28 and solid-state polariton29 condensates. The system itself offers potential for generation of metrologically useful entangled states in optical transitions, which could permit quantum enhancement in state-of-the-art atomic clocks30,31.

Recommendations for clinical implementation of blood-based biomarkers for Alzheimer's disease.

Blood-based biomarkers (BBM) for Alzheimer's disease (AD) are being increasingly used in clinical practice to support an AD diagnosis. In contrast to traditional diagnostic modalities, such as amyloid positron emission tomography and cerebrospinal fluid biomarkers, BBMs offer a more accessible and lower cost alternative for AD biomarker testing. Their unique scalability addresses the anticipated surge in demand for biomarker testing with the emergence of disease-modifying treatments (DMTs) that require confirmation of amyloid pathology. To facilitate the uptake of BBMs in clinical practice, The Global CEO Initiative on Alzheimer's Disease convened a BBM Workgroup to provide recommendations for two clinical implementational pathways for BBMs: one for current use for triaging and another for future use to confirm amyloid pathology. These pathways provide a standardized diagnostic approach with guidance on interpreting BBM test results. Integrating BBMs into clinical practice will simplify the diagnostic process and facilitate timely access to DMTs for eligible patients.

Considerations for widespread implementation of blood-based biomarkers of Alzheimer's disease.

Diagnosing Alzheimer's disease (AD) poses significant challenges to health care, often resulting in delayed or inadequate patient care. The clinical integration of blood-based biomarkers (BBMs) for AD holds promise in enabling early detection of pathology and timely intervention. However, several critical considerations, such as the lack of consistent guidelines for assessing cognition, limited understanding of BBM test characteristics, insufficient evidence on BBM performance across diverse populations, and the ethical management of test results, must be addressed for widespread clinical implementation of BBMs in the United States. The Global CEO Initiative on Alzheimer's Disease BBM Workgroup convened to address these challenges and provide recommendations that underscore the importance of evidence-based guidelines, improved training for health-care professionals, patient empowerment through informed decision making, and the necessity of community-based studies to understand BBM performance in real-world populations. Multi-stakeholder engagement is essential to implement these recommendations and ensure credible guidance and education are accessible to all stakeholders.

Simulating carbon accumulation and loss in the central Congo peatlands.

Peatlands of the central Congo Basin have accumulated carbon over millennia. They currently store some 29 billion tonnes of carbon in peat. However, our understanding of the controls on peat carbon accumulation and loss and the vulnerability of this stored carbon to climate change is in its infancy. Here we present a new model of tropical peatland development, DigiBog_Congo, that we use to simulate peat carbon accumulation and loss in a rain-fed interfluvial peatland that began forming ~20,000 calendar years Before Present (cal. yr BP, where 'present' is 1950 CE). Overall, the simulated age-depth curve is in good agreement with palaeoenvironmental reconstructions derived from a peat core at the same location as our model simulation. We find two key controls on long-term peat accumulation: water at the peat surface (surface wetness) and the very slow anoxic decay of recalcitrant material. Our main simulation shows that between the Late Glacial and early Holocene there were several multidecadal periods where net peat and carbon gain alternated with net loss. Later, a climatic dry phase beginning ~5200 cal. yr BP caused the peatland to become a long-term carbon source from ~3975 to 900 cal. yr BP. Peat as old as ~7000 cal. yr BP was decomposed before the peatland's surface became wetter again, suggesting that changes in rainfall alone were sufficient to cause a catastrophic loss of peat carbon lasting thousands of years. During this time, 6.4 m of the column of peat was lost, resulting in 57% of the simulated carbon stock being released. Our study provides an approach to understanding the future impact of climate change and potential land-use change on this vulnerable store of carbon.

Predicting adverse outcomes in pregnant patients positive for SARS-CoV-2: a machine learning approach- a retrospective cohort study.

BACKGROUND: Pregnant people are particularly vulnerable to SARS-CoV-2 infection and to ensuing severe illness. Predicting adverse maternal and perinatal outcomes could aid clinicians in deciding on hospital admission and early initiation of treatment in affected individuals, streamlining the triaging processes. METHODS: An international repository of 1501 SARS-CoV-2-positive cases in pregnancy was created, consisting of demographic variables, patient comorbidities, laboratory markers, respiratory parameters, and COVID-19-related symptoms. Data were filtered, preprocessed, and feature selection methods were used to obtain the optimal feature subset for training a variety of machine learning models to predict maternal or fetal/neonatal death or critical illness. RESULTS: The Random Forest model demonstrated the best performance among the trained models, correctly identifying 83.3% of the high-risk patients and 92.5% of the low-risk patients, with an overall accuracy of 89.0%, an AUC of 0.90 (95% Confidence Interval 0.83 to 0.95), and a recall, precision, and F1 score of 0.85, 0.94, and 0.89, respectively. This was achieved using a feature subset of 25 features containing patient characteristics, symptoms, clinical signs, and laboratory markers. These included maternal BMI, gravidity, parity, existence of pre-existing conditions, nicotine exposure, anti-hypertensive medication administration, fetal malformations, antenatal corticosteroid administration, presence of dyspnea, sore throat, fever, fatigue, duration of symptom phase, existence of COVID-19-related pneumonia, need for maternal oxygen administration, disease-related inpatient treatment, and lab markers including sFLT-1/PlGF ratio, platelet count, and LDH. CONCLUSIONS: We present the first COVID-19 prognostication pipeline specifically for pregnant patients while utilizing a large SARS-CoV-2 in pregnancy data repository. Our model accurately identifies those at risk of severe illness or clinical deterioration, presenting a promising tool for advancing personalized medicine in pregnant patients with COVID-19.

Cavity-QED Quantum Simulator of Dynamical Phases of a Bardeen-Cooper-Schrieffer Superconductor.

We propose to simulate dynamical phases of a BCS superconductor using an ensemble of cold atoms trapped in an optical cavity. Effective Cooper pairs are encoded via the internal states of the atoms, and attractive interactions are realized via the exchange of virtual photons between atoms coupled to a common cavity mode. Control of the interaction strength combined with a tunable dispersion relation of the effective Cooper pairs allows exploration of the full dynamical phase diagram of the BCS model as a function of system parameters and the prepared initial state. Our proposal paves the way for the study of the nonequilibrium features of quantum magnetism and superconductivity by harnessing atom-light interactions in cold atomic gases.

Cross Attention Squeeze Excitation Network (CASE-Net) for Whole Body Fetal MRI Segmentation.

Segmentation of the fetus from 2-dimensional (2D) magnetic resonance imaging (MRI) can aid radiologists with clinical decision making for disease diagnosis. Machine learning can facilitate this process of automatic segmentation, making diagnosis more accurate and user independent. We propose a deep learning (DL) framework for 2D fetal MRI segmentation using a Cross Attention Squeeze Excitation Network (CASE-Net) for research and clinical applications. CASE-Net is an end-to-end segmentation architecture with relevant modules that are evidence based. The goal of CASE-Net is to emphasize localization of contextual information that is relevant in biomedical segmentation, by combining attention mechanisms with squeeze-and-excitation (SE) blocks. This is a retrospective study with 34 patients. Our experiments have shown that our proposed CASE-Net achieved the highest segmentation Dice score of 87.36%, outperforming other competitive segmentation architectures.

Protocol for Precise Field Sensing in the Optical Domain with Cold Atoms in a Cavity.

In the context of quantum metrology, optical cavity-QED platforms have primarily been focused on the generation of entangled atomic spin states useful for next-generation frequency and time standards. Here, we report a complementary application: the use of optical cavities to generate nonclassical states of light for electric field sensing below the standard quantum limit. We show that cooperative atom-light interactions in the strong collective coupling regime can be used to engineer generalized atom-light cat states which enable quantum enhanced sensing of small displacements of the cavity field even in the presence of photon loss. We demonstrate that metrological gains of 10-20 dB below the standard quantum limit are within reach for current cavity-QED systems operating with long-lived alkaline-earth atoms.

Optimizing likelihood models for particle trajectory segmentation in multi-state systems.

Particle tracking offers significant insight into the molecular mechanics that govern the behavior of living cells. The analysis of molecular trajectories that transition between different motive states, such as diffusive, driven and tethered modes, is of considerable importance, with even single trajectories containing significant amounts of information about a molecule's environment and its interactions with cellular structures. Hidden Markov models (HMM) have been widely adopted to perform the segmentation of such complex tracks. In this paper, we show that extensive analysis of hidden Markov model outputs using data derived from multi-state Brownian dynamics simulations can be used both for the optimization of likelihood models describing the states of the system and for characterization of the technique's failure mechanisms. The major drivers of HMM failure were found to be likelihood overlap, which was visualized using the Bhattacharyya coefficient, and state mixing caused by state transitions that occur between time points in a particle's trajectory both of which are intrinsically associated with the multi-state nature of the data. This approach provides critical information for the visualization of HMM failure and successful design of particle tracking experiments where trajectories contain multiple mobile states.

Diagnosis of placenta accreta spectrum using ultrasound texture feature fusion and machine learning.

INTRODUCTION: Placenta accreta spectrum (PAS) is an obstetric disorder arising from the abnormal adherence of the placenta to the uterine wall, often leading to life-threatening complications including postpartum hemorrhage. Despite its significance, PAS remains frequently underdiagnosed before delivery. This study delves into the realm of machine learning to enhance the precision of PAS classification. We introduce two distinct models for PAS classification employing ultrasound texture features. METHODS: The first model leverages machine learning techniques, harnessing texture features extracted from ultrasound scans. The second model adopts a linear classifier, utilizing integrated features derived from 'weighted z-scores'. A novel aspect of our approach is the amalgamation of classical machine learning and statistical-based methods for feature selection. This, coupled with a more transparent classification model based on quantitative image features, results in superior performance compared to conventional machine learning approaches. RESULTS: Our linear classifier and machine learning models attain test accuracies of 87 % and 92 %, and 5-fold cross validation accuracies of 88.7 (4.4) and 83.0 (5.0), respectively. CONCLUSIONS: The proposed models illustrate the effectiveness of practical and robust tools for enhanced PAS detection, offering non-invasive and computationally-efficient diagnostic tools. As adjunct methods for prenatal diagnosis, these tools can assist clinicians by reducing the need for unnecessary interventions and enabling earlier planning of management strategies for delivery.

Acceptable performance of blood biomarker tests of amyloid pathology - recommendations from the Global CEO Initiative on Alzheimer's Disease.

Anti-amyloid treatments for early symptomatic Alzheimer disease have recently become clinically available in some countries, which has greatly increased the need for biomarker confirmation of amyloid pathology. Blood biomarker (BBM) tests for amyloid pathology are more acceptable, accessible and scalable than amyloid PET or cerebrospinal fluid (CSF) tests, but have highly variable levels of performance. The Global CEO Initiative on Alzheimer's Disease convened a BBM Workgroup to consider the minimum acceptable performance of BBM tests for clinical use. Amyloid PET status was identified as the reference standard. For use as a triaging test before subsequent confirmatory tests such as amyloid PET or CSF tests, the BBM Workgroup recommends that a BBM test has a sensitivity of ≥90% with a specificity of ≥85% in primary care and ≥75-85% in secondary care depending on the availability of follow-up testing. For use as a confirmatory test without follow-up tests, a BBM test should have performance equivalent to that of CSF tests - a sensitivity and specificity of ~90%. Importantly, the predictive values of all biomarker tests vary according to the pre-test probability of amyloid pathology and must be interpreted in the complete clinical context. Use of BBM tests that meet these performance standards could enable more people to receive an accurate and timely Alzheimer disease diagnosis and potentially benefit from new treatments.

Delayed Onset of Peroneal Nerve Palsy After Total Knee Arthroplasty.

Peroneal nerve palsy (PNP) and peroneal nerve dysfunction (PND) are rare complications after total knee arthroplasty (TKA). Although PND tends to manifest as transient lateral leg paresthesias that are associated with knee motion, PNP has characteristic motor deficits, including loss of ankle dorsiflexion and eversion strength. Although PND can manifest days, weeks, or months after surgery, delayed cases of PNP have not been well documented. We describe a 72-year-old woman with a delayed case of sudden-onset PNP 10 weeks after TKA. She had no neurologic deficits preoperatively and was recovering uneventfully at 2 and 6 weeks postoperatively. At 10 weeks, she reported insidious onset of drop foot and sensory changes to the lateral leg and dorsum of the foot. Motor deficits included significant loss of ankle dorsiflexion and eversion strength. After a diagnosis of PNP was confirmed with electrodiagnostic studies and lumbar pathology was ruled out with lumbar magnetic resonance imaging, surgical decompression of the peroneal nerve was performed. By 7 weeks after surgical decompression, she had no sensory deficits and nearly full strength in ankle dorsiflexion and eversion. This case shows that PNP can occur several weeks to months outside of the currently documented timeline. Although PNP is an uncommon risk of TKA, it is important to recognize and treat it when it occurs among patients with significant motor and sensory deficits along the distribution of the peroneal nerve postoperatively. [Orthopedics. 2022;45(6):e342-e344.].

Artificial Intelligence and Surgical Education: A Systematic Scoping Review of Interventions.

OBJECTIVE: To synthesize peer-reviewed evidence related to the use of artificial intelligence (AI) in surgical education DESIGN: We conducted and reported a scoping review according to the standards outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis with extension for Scoping Reviews guideline and the fourth edition of the Joanna Briggs Institute Reviewer's Manual. We systematically searched eight interdisciplinary databases including MEDLINE-Ovid, ERIC, EMBASE, CINAHL, Web of Science: Core Collection, Compendex, Scopus, and IEEE Xplore. Databases were searched from inception until the date of search on April 13, 2021. SETTING/PARTICIPANTS: We only examined original, peer-reviewed interventional studies that self-described as AI interventions, focused on medical education, and were relevant to surgical trainees (defined as medical or dental students, postgraduate residents, or surgical fellows) within the title and abstract (see Table 2). Animal, cadaveric, and in vivo studies were not eligible for inclusion. RESULTS: After systematically searching eight databases and 4255 citations, our scoping review identified 49 studies relevant to artificial intelligence in surgical education. We found diverse interventions related to the evaluation of surgical competency, personalization of surgical education, and improvement of surgical education materials across surgical specialties. Many studies used existing surgical education materials, such as the Objective Structured Assessment of Technical Skills framework or the JHU-ISI Gesture and Skill Assessment Working Set database. Though most studies did not provide outcomes related to the implementation in medical schools (such as cost-effective analyses or trainee feedback), there are numerous promising interventions. In particular, many studies noted high accuracy in the objective characterization of surgical skill sets. These interventions could be further used to identify at-risk surgical trainees or evaluate teaching methods. CONCLUSIONS: There are promising applications for AI in surgical education, particularly for the assessment of surgical competencies, though further evidence is needed regarding implementation and applicability.

A cautionary tale about using the apparent carbon accumulation rate (aCAR) obtained from peat cores.

The carbon (C) accumulation histories of peatlands are of great interest to scientists, land users and policy makers. Because peatlands contain more than 500 billion tonnes of C, an understanding of the fate of this dynamic store, when subjected to the pressures of land use or climate change, is an important part of climate-change mitigation strategies. Information from peat cores is often used to recreate a peatland's C accumulation history from recent decades to past millennia, so that comparisons between past and current rates can be made. However, these present day observations of peatlands' past C accumulation rates (known as the apparent rate of C accumulation - aCAR) are usually different from the actual uptake or loss of C that occurred at the time (the true C balance). Here we use a simple peatland model and a more detailed ecosystem model to illustrate why aCAR should not be used to compare past and current C accumulation rates. Instead, we propose that data from peat cores are used with existing or new C balance models to produce reliable estimates of how peatland C function has changed over time.

Mechanical properties of P-selectin PSGL-1 bonds.

The accurate determination of the mechanical properties of P-selectin and PSGL-1 is crucial for design and optimization of applications utilizing such bonds, e.g. biosensors and targeted drug delivery systems, as adhesion and mechanical interactions play a critical role in several key functions of biological cells. In current work, the spring constant and rupture force of a single P-selectin PSGL-1 ligand receptor bond and the Young's modulus of a layer made of these ligand receptors are reported. The work-of-adhesion of the P-selectin PSGL-1 interface is also characterized. In the reported experiments, PSGL-1 coated particles are deposited on a P-selectin coated substrate and their transient nanometer scale out-of-plane displacements are acquired employing a laser Doppler vibrometer as they are excited by an ultrasonic field. From the spectral response of a single particle, the resonance frequencies of its vibrational motion are identified, and with help of a particle adhesion model, the average rupture force and stiffness of a single P-selectin PSGL-1 ligand receptor are determined as Frupt = 171 ± 56 pN and kb = 0.56 ± 0.04 mN/m, respectively. Furthermore, the Young's modulus and work-of-adhesion of a layer of P-selectin PSGL-1 ligand receptors are extracted as E = 28.74 ± 3.96 MPa and WA = 70.0 ± 8.0 mJ/m2, respectively. Unlike Atomic Force Microscopy (AFM) and other probe-based techniques, the reported approach eliminates the need for direct contact with the sample, which could compromise the accuracy of the results by imposing unspecified additional contact interactions. Further, the current technique can be employed for measurements under various fluid flow conditions.

Driving complex flow waveforms with a linear voice coil actuator.

Oscillatory and pulsatile fluid flows for use in microfluidic applications were generated using a deformable chamber driven by a low cost linear voice coil actuator. Compliance in the fluidic system originating in the deformable chamber and the fluidic tubing produced a strong frequency dependence in the relationship between the system's input and the output flow rate. The effects of this frequency dependence were overcome by precise system calibration, enabling on-demand generation of sinusoidal oscillations in the fluid flow rate with a controlled amplitude in the range from 0.1 to over 1 ml/min across a frequency range from 0.1 Hz to 10 Hz. The calibration data further enabled the optimization of a multistage exponential smoothing model of the system that allowed the generation of arbitrary complex waveforms. This was demonstrated by combining flow modulation with a constant background flow generated by a syringe pump to mimic the pulsatile flow found in the human vascular system.

Misinterpreting carbon accumulation rates in records from near-surface peat.

Peatlands are globally important stores of carbon (C) that contain a record of how their rates of C accumulation have changed over time. Recently, near-surface peat has been used to assess the effect of current land use practices on C accumulation rates in peatlands. However, the notion that accumulation rates in recently formed peat can be compared to those from older, deeper, peat is mistaken - continued decomposition means that the majority of newly added material will not become part of the long-term C store. Palaeoecologists have known for some time that high apparent C accumulation rates in recently formed peat are an artefact and take steps to account for it. Here we show, using a model, how the artefact arises. We also demonstrate that increased C accumulation rates in near-surface peat cannot be used to infer that a peatland as a whole is accumulating more C - in fact the reverse can be true because deep peat can be modified by events hundreds of years after it was formed. Our findings highlight that care is needed when evaluating recent C addition to peatlands especially because these interpretations could be wrongly used to inform land use policy and decisions.