Multiple sclerosis incidence in Tuscany from administrative data.

BACKGROUND: Italy is a high-risk area for multiple sclerosis with 110,000 prevalent cases estimated at January 2016 and 3400 annual incident cases. To study multiple sclerosis epidemiology, it is preferable to use population-based studies, e.g., with a registry. A valid alternative to obtain data on entire population is from administrative sources. OBJECTIVE: To estimate the incidence of multiple sclerosis in Tuscany using a case-finding algorithm based on administrative data. METHODS: In a previous study, we calculated the prevalence in Tuscany using a validated case-finding algorithm based on administrative data. Incident cases were identified as a subset of prevalent cases among those patients not traced in the years before the analysis period, and the date of the first multiple sclerosis-related claim was considered the incidence date of multiple sclerosis diagnosis. We examined the period 2011-2015. RESULTS: We identified 1147 incident cases with annual rates ranged from 5.60 per 100,000 in 2011 to 6.58 in 2015. CONCLUSIONS: We found a high incidence rate, similarly to other Italian areas, especially in women, that may explain the increasing prevalence in Tuscany. To confirm this data and to calculate the possible bias caused by our inclusion method, we will validate our algorithm for incident cases.

High-Q resonant cavities for terahertz quantum cascade lasers.

We report on the realization and characterization of two different designs for resonant THz cavities, based on wire-grid polarizers as input/output couplers, and injected by a continuous-wave quantum cascade laser (QCL) emitting at 2.55 THz. A comparison between the measured resonators parameters and the expected theoretical values is reported. With achieved quality factor Q ≈ 2.5 × 10(5), these cavities show resonant peaks as narrow as few MHz, comparable with the typical Doppler linewidth of THz molecular transitions and slightly broader than the free-running QCL emission spectrum. The effects of the optical feedback from one cavity to the QCL are examined by using the other cavity as a frequency reference.

Mid-infrared frequency comb for broadband high precision and sensitivity molecular spectroscopy.

We report on the experimental demonstration of the metrological and spectroscopic performances of a mid-infrared comb generated by a nonlinear downconversion process from a Ti:sapphire-based near-infrared comb. A quantum cascade laser at 4330 nm was phase-locked to a single tooth of this mid-infrared comb and its frequency-noise power spectral density was measured. The mid-infrared comb itself was also used as a multifrequency highly coherent source to perform ambient air direct comb spectroscopy with the Vernier technique, by demultiplexing it with a high-finesse Fabry-Perot cavity.

High-coherence mid-infrared frequency comb.

We report on the generation of a frequency comb around 4330 nm with an unprecedented coherence of the single teeth. Generating the comb within a Ti:sapphire laser cavity by a difference-frequency process and using a phase-lock scheme based on direct digital synthesis, we achieve a tooth linewidth of 2.0 kHz in a 1-s timescale (750 Hz in 20 ms). The generated per-tooth power of 1 µW ranks this comb among the best ever realized in the mid-infrared in terms of power spectral density.

Subkilohertz linewidth room-temperature mid-infrared quantum cascade laser using a molecular sub-Doppler reference.

We report on the narrowing of a room-temperature mid-IR quantum cascade laser by frequency locking it to a CO2 sub-Doppler transition obtained by polarization spectroscopy. A locking bandwidth of 250 kHz has been achieved. The laser linewidth is narrowed by more than two orders of magnitude below 1 kHz, and its absolute frequency is stabilized at the same level.

Phase-locking to a free-space terahertz comb for metrological-grade terahertz lasers.

Optical frequency comb synthesizers have represented a revolutionary approach to frequency metrology, providing a grid of frequency references for any laser emitting within their spectral coverage. Extending the metrological features of optical frequency comb synthesizers to the terahertz domain would be a major breakthrough, due to the widespread range of accessible strategic applications and the availability of stable, high-power and widely tunable sources such as quantum cascade lasers. Here we demonstrate phase-locking of a 2.5 THz quantum cascade laser to a free-space comb, generated in a LiNbO(3) waveguide and covering the 0.1-6 THz frequency range. We show that even a small fraction (<100 nW) of the radiation emitted from the quantum cascade laser is sufficient to generate a beat note suitable for phase-locking to the comb, paving the way to novel metrological-grade terahertz applications, including high-resolution spectroscopy, manipulation of cold molecules, astronomy and telecommunications.

Direct link of a mid-infrared QCL to a frequency comb by optical injection.

A narrow-linewidth comb-linked nonlinear source is used as master radiation to injection lock a room-temperature mid-infrared quantum cascade laser (QCL). This process leads to a direct lock of the QCL to the optical frequency comb, providing the unique features of narrow linewidth, absolute frequency, higher output power, and wide mode-hop-free tunability. The QCL reproduces the injected radiation within more than 94%, with a reduction of the frequency-noise spectral density by 3 to 4 orders of magnitude up to about 100 kHz, and a linewidth narrowing from a few MHz to 20 kHz.

Measuring frequency noise and intrinsic linewidth of a room-temperature DFB quantum cascade laser.

The frequency-noise power spectral density of a room-temperature distributed-feedback quantum cascade laser emitting at λ = 4.36 µm has been measured. An intrinsic linewidth value of 260 Hz is retrieved, in reasonable agreement with theoretical calculations. A noise reduction of about a factor 200 in most of the frequency interval is also found, with respect to a cryogenic laser at the same wavelength. A quantitative treatment shows that it can be explained by a temperature-dependent mechanism governing the transport processes in resonant tunnelling devices. This confirms the predominant effect of the heterostructure in determining shape and magnitude of the frequency noise spectrum in QCLs.

Molecular gas sensing below parts per trillion: radiocarbon-dioxide optical detection.

Radiocarbon ((14)C) concentrations at a 43 parts-per-quadrillion level are measured by using saturated-absorption cavity ringdown spectroscopy by exciting radiocarbon-dioxide ((14)C(16)O(2)) molecules at the 4.5 µm wavelength. The ultimate sensitivity limits of molecular trace gas sensing are pushed down to attobar pressures using a comb-assisted absorption spectroscopy setup. Such a result represents the lowest pressure ever detected for a gas of simple molecules. The unique sensitivity, the wide dynamic range, the compactness, and the relatively low cost of this table-top setup open new perspectives for ^{14}C-tracing applications, such as radiocarbon dating, biomedicine, or environmental and earth sciences. The detection of other very rare molecules can be pursued as well thanks to the wide and continuous mid-IR spectral coverage of the described setup.

Ti:sapphire laser intracavity difference-frequency generation of 30 mW cw radiation around 4.5 µm.

A cw mid-IR coherent source based on difference-frequency generation is designed and characterized. For mid-IR generation, a periodically poled MgO:LiNbO(3) crystal is placed inside a compact Ti:sapphire laser cavity. This provides high-power pump radiation for the nonlinear process. Optical injection by an external-cavity diode laser ensures single-frequency operation of the Ti:sapphire laser, while signal radiation is provided by a fiber-amplified Nd:YAG laser. Mid-IR radiation can be generated with 3850-4540 nm tuning range, narrow linewidth, Cs-standard traceability, and TEM(00) spatial mode. 30 mW power is obtained at 4510 nm.

Saturated-absorption cavity ring-down spectroscopy.

We report on a novel approach to cavity ring-down spectroscopy with the sample gas in saturated-absorption regime. This technique allows us to decouple and simultaneously retrieve the empty-cavity background and absorption signal, by means of a theoretical model that we developed and tested. The high sensitivity and frequency precision for spectroscopic applications are exploited to measure, for the first time, the hyperfine structure of an excited vibrational state of 17O12C16O in natural abundance with an accuracy of a few parts in 10{-11}.

Observing the intrinsic linewidth of a quantum-cascade laser: beyond the Schawlow-Townes limit.

A comprehensive investigation of the frequency-noise spectral density of a free-running midinfrared quantum-cascade laser is presented for the first time. It provides direct evidence of the leveling of this noise down to a white-noise plateau, corresponding to an intrinsic linewidth of a few hundred hertz. The experiment is in agreement with the most recent theory on the fundamental mechanism of line broadening in quantum-cascade lasers, which provides a new insight into the Schawlow-Townes formula and predicts a narrowing beyond the limit set by the radiative lifetime of the upper level.

Ultra-stable, widely tunable and absolutely linked mid-IR coherent source.

We report on a new coherent source that, using a phase-lock scheme to an optical frequency-comb synthesizer, achieves a 10-Hz intrinsic linewidth, is tunable from 4 to 4.5 microm with a presettable absolute frequency and, when coupled to a high-finesse cavity, can provide a short-term absorption sensitivity of 1.3 x 10(-11) cm(-1)Hz,(-1/2). These unique spectral features make this source a precise tool for molecular physics.

Doppler-free polarization spectroscopy with a quantum cascade laser at 4.3 microm.

We report on what we believe to be the first Doppler-free polarization spectroscopy with a quantum cascade laser. A hot-band CO(2) transition around 4.3 microm wavelength has been used to test the potential of the technique for high-resolution spectroscopy and wide-bandwidth quantum cascade laser frequency stabilization.

Lamb-dip-locked quantum cascade laser for comb-referenced IR absolute frequency measurements.

The frequency of a DFB quantum cascade laser (QCL) emitting at 4.3 microm has been long-term stabilized to the Lamb-dip center of a CO2 ro-vibrational transition by means of first-derivative locking to the saturated absorption signal. Thanks to the non-linear sum-frequency generation (SFG) process with a fiber-amplified Nd:YAG laser, the QCL mid-infrared (IR) radiation has been linked to an optical frequency-comb synthesizer (OFCS) and its absolute frequency counted with a kHz-level precision and an overall uncertainty of 75 kHz.

Frequency-comb-referenced quantum-cascade laser at 4.4 microm.

We report what we believe to be the first absolute frequency measurement performed using a quantum-cascade laser (QCL) referenced to an optical frequency comb synthesizer (OFCS). A QCL at 4.43 microm has been used for producing near-infrared radiation at 858 nm by means of sum-frequency generation with a Nd:YAG source in a periodically poled lithium niobate nonlinear crystal. The absolute frequency of the QCL source has been measured by detecting the beat note between the sum frequency and a diode laser at the same wavelength, while both the Nd:YAG and the diode laser were referenced to the OFCS. Doppler-broadened line profiles of (13)CO(2) molecular transitions have been recorded with such an absolute frequency reference.

Human herpesvirus-6B active infection associated with relapsing bilateral anterior optic neuritis.

BACKGROUND AND OBJECTIVES: Human herpesvirus-6 (HHV-6) is the causative agent of exanthem subitum. Both HHV-6 variants, A and B, have been associated with central nervous system (CNS) diseases, suggesting a wide neuropathogenic potential. We describe a case of recurrent bilateral anterior optic neuritis with HHV-6 active infection associated with clinical relapses. CASE REPORT: A 23-year old woman presented with progressive visual impairment, bilateral papillitis and painful ocular movements. Nested polymerase chain reaction (PCR) for DNA viruses, HHV-6 variant specific real time quantitative PCR, serological analysis and retrotranscription PCR (RT-PCR) for HHV-6 mRNA transcripts were performed. Nested PCR in PBMC and CSF samples was negative for all viruses but positive for HHV-6 DNA, subtyped as HHV-6B. The disease had a relapsing/remitting course. During relapses PBMC samples remained positive for HHV-6 DNA, and HHV-6 active infection was confirmed by the presence of anti-HHV-6 IgM and of HHV-6 U27 mRNA transcript. High viremia levels and relapses were overlapping. After the last relapse, the patient was successfully treated with gancyclovir. CONCLUSIONS: The case reported here suggests a possible association of HHV-6 in bilateral optic neuritis. HHV-6 could be monitored when bilateral optic neuritis is identified, in order to establish an appropriate antiviral therapy.

Polysomnographic characterization of pergolide-induced sleep attacks in idiopathic PD.

Both dopamine agonists and levodopa may induce episodes termed "sleep attacks" in patients with PD. These episodes are well detailed behaviorally, but little is known about their neurophysiologic characterization. The authors performed a 24-hour polysomnography (PSG) in a PD patient taking pergolide in combination with levodopa, in which four of these diurnal sleep episodes occurred. PSG findings were followed up after pergolide withdrawal. Sleep episodes shared with narcolepsy both behavioral and EEG findings. However, pergolide partly restored a more physiologic sleep architecture, which was disrupted during therapy with levodopa alone.

Obligatory cross-talk with the tyrosine kinases assembled with the TCR/CD3 complex in CD4 signal transduction.

Dissection of the CD4 signal transduction pathway has revealed striking similarities with the TCR/CD3 pathway. Furthermore, downstream signaling by CD4 is impaired in cells lacking surface TCR, suggesting a role for the TCR/CD3 complex in CD4 signal transduction. We have investigated the molecular basis for the dependence of CD4 signaling on TCR/CD3 expression. Using the phosphotyrosine binding domains of the Shc adaptor and the Fyn kinase, which both participate in CD4 signaling, as baits, we show that CD4 induces tyrosine phosphorylation of a subset of the proteins phosphorylated in response to TCR/CD3 engagement. The phosphoprotein patterns were dramatically altered in cells defective for TCR/CD3 expression, and were recoverable by reconstitution of correctly assembled TCR, suggesting that CD4 uses TCR/CD3-associated tyrosine kinases to signal. Among the tyrosine kinases associated with the resting TCR/CD3 complex, only Fyn is activated following CD4 engagement. The failure of Fyn to become phosphorylated in cells defective for TCR expression underlines the unique role of TCR/CD3 associated Fyn in CD4 signal transduction. While no calcium mobilization was measurable in cells defective for TCR/CD3 expression in response to CD4 engagement, the Ras/MAP kinase pathway could be partially activated. Thus, CD4 activates at least two signaling pathways, and tyrosine kinases associated with the TCR/CD3 complex are key components of one of these pathways.