Tilted-potential photonic crystal cavities for integrated quantum photonics

We propose and investigate a new type of photonic crystal (PhC) cavity for integrated quantum photonics, which provides tailored optical modes with both confined and extended spatial components. The structures consist of elongated PhC cavities in which the effective index of refraction is varied quasi-linearly along their axis, implemented by systematic lateral shifts of the PhC holes. The confined modes have approximately Airy-function envelopes, exhibiting single peaks and extended tails, which is useful for optimizing single photon extraction and transmission in integrated quantum photonic devices. The measured spectrally resolved near-field patterns of such devices show the expected spatial and resonance wavelength behavior, in agreement with numerical simulations of the Airy-Bloch modes. The effects of fabrication-induced disorder on the mode features are also analyzed and discussed. Selective excitation of specific Airy-Bloch modes using integrated, site-controlled quantum dots as localized light sources is demonstrated. Based on the tilted-potential cavity, multiple-QD single photon emitters exploiting wavelength division multiplexing are proposed.

Deterministic radiative coupling of two semiconductor quantum dots to the optical mode of a photonic crystal nanocavity

A system of two site-controlled semiconductor quantum dots (QDs) is deterministically integrated with a photonic crystal membrane nano-cavity. The two QDs are identified via their reproducible emission spectral features, and their coupling to the fundamental cavity mode is established by emission co-polarization and cavity feeding features. A theoretical model accounting for phonon interaction and pure dephasing reproduces the observed results and permits extraction of the light-matter coupling constant for this system. The demonstrated approach offers a platform for scaling up the integration of QD systems and nano-photonic elements for integrated quantum photonics applications.

Effect of Pure Dephasing and Phonon Scattering on the Coupling of Semiconductor Quantum Dots to Optical Cavities

Using site-controlled semiconductor quantum dots (QDs) free of multiexcitonic continuum states, integrated with photonic crystal membrane cavities, we clarify the effects of pure dephasing and phonon scattering on exciton-cavity coupling in the weak-coupling regime. In particular, the observed QD-cavity copolarization and cavity mode feeding versus QD-cavity detuning are explained quantitatively by a model of a two-level system embedded in a solid-state environment.

Legal Aspects in Obstetric Anesthesia

Obstetric anesthesia is a particularly high-risk sub-specialty of anesthesia and may lead to serious morbidities and even mortality. Good doctor-patient relation from the time of admission till discharge is the most important factor to avert future litigations. Any procedure done or planned should be clearly documented. Documentation should start with a valid consent in the patient’s own language, and have all three components of voluntariness, capacity and knowledge. A ‘Surgical Safety’ checklist is particularly helpful in documentation and decreasing errors. Safety of the mother (and her child) is paramount. Both regional as well as general anesthesia, either inadvertently or if not administered properly may be associated with morbidities like headache, pain and emotional distress. However, deaths do occur and general anesthesia is associated with care should be routine practice and inculcated by everyone involved in patient care.

1D and 2D arrays of coupled photonic crystal cavities with a site-controlled quantum wire light source

We investigated experimentally 1D and 2D arrays of coupled L3 photonic crystal cavities. The optical modes of the coupled cavity arrays are fed by a site-controlled quantum wire light source. By performing photoluminescence measurements and relying on near-field calculation of the cavitiy modes, we evidence optical coupling between the cavities as well as supermode delocalization. In particular, for small cavity separations, fabrication induced disorder effects are shown to be negligible compared to optical coupling between cavities.

Comparison of transcriptional response to phorbol ester, bryostatin 1, and bryostatin analogs in LNCaP and U937 cancer cell lines provides insight into their differential mechanism of action

Bryostatin 1, like the phorbol esters, binds to and activates protein kinase C (PKC) but paradoxically antagonizes many but not all phorbol ester responses. Previously, we have compared patterns of biological response to bryostatin 1, phorbol ester, and the bryostatin 1 derivative Merle 23 in two human cancer cell lines, LNCaP and U937. Bryostatin 1 fails to induce a typical phorbol ester biological response in either cell line, whereas Merle 23 resembles phorbol ester in the U937 cells and bryostatin 1 in the LNCaP cells. Here, we have compared the pattern of their transcriptional response in both cell lines. We examined by qPCR the transcriptional response as a function of dose and time for a series of genes regulated by PKCs. In both cell lines bryostatin 1 differed primarily from phorbol ester in having a shorter duration of transcriptional modulation. This was not due to bryostatin 1 instability, since bryostatin 1 suppressed the phorbol ester response. In both cell lines Merle 23 induced a pattern of transcription largely like that of phorbol ester although with a modest reduction at later times in the LNCaP cells, suggesting that the difference in biological response of the two cell lines to Merle 23 lies downstream of this transcriptional regulation. For a series of bryostatins and analogs which ranged from bryostatin 1-like to phorbol ester-like in activity on the U937 cells, the duration of transcriptional response correlated with the pattern of biological activity, suggesting that this may provide a robust platform for structure activity analysis.

End of life issues in the intensive care units

A structured discussion of End-of-Life (EOL) issues is a relatively new phenomenon in India. Personal beliefs, cultural and religious influences, peer, family and societal pressures affect EOL decisions. Indian law does not provide sanction to contentious issues such as do-not-resuscitate (DNR) orders, living wills, and euthanasia. Finally, published data on EOL decisions in Indian ICUs is lacking. What is needed is a prospective determination of which patients will benefit from aggressive management and life-support. A consensus regarding the concept of Medical Futility is necessary to give impetus to further discussion on more advanced policies including ideas such as Managed Care to restrict unnecessary health care costs, euthanasia, the principle of withhold and/or withdraw, ethical and moral guidelines that would govern decisions regarding futile treatment, informed consent to EOL decisions and do-not-resuscitate orders. This review examines the above concepts as practiced worldwide and looks at some landmark judgments that have shaped current Indian policy, as well as raising talking points for possible legislative intervention in the field.

Ordered systems of site-controlled pyramidal quantum dots incorporated in photonic crystal cavities

The coupling of a prescribed number of site-controlled pyramidal quantum dots (QDs) with photonic crystal (PhC) cavities was studied by polarization and power-dependent photoluminescence measurements. The energy of the cavity mode could be readily tuned, making use of the high spectral uniformity of the QDs and designing PhC cavities with different hole radii. Efficient coupling of the PhC cavity modes both to the ground state and to the excited state transitions of the QDs was observed, whereas no evidence for far off-resonant coupling was found.

Symmetries and the polarized optical spectra of exciton complexes in quantum dots

A systematic and simple theoretical approach is proposed to analyze true degeneracies and polarized decay patterns of exciton complexes in semiconductor quantum dots. The results provide reliable spectral signatures for efficient symmetry characterization, and predict original features for low C(2v) and high C(3v) symmetries. Excellent agreement with single quantum dot spectroscopy of real pyramidal InGaAs/AlGaAs quantum dots grown along [111] is demonstrated. The high sensitivity of biexciton quantum states to exact high symmetry can be turned into an efficient uninvasive postgrowth selection procedure for quantum entanglement applications.

Phonon-mediated coupling of InGaAs/GaAs quantum-dot excitons to photonic crystal cavities

We demonstrate that the emission characteristics of site-controlled InGaAs/GaAs single quantum dots embedded in photonic crystal slab cavities correspond to single confined excitons coupled to cavity modes, unlike previous reports of similar systems based on self-assembled quantum dots. By using polarization-resolved photoluminescence spectroscopy at different temperatures and a theoretical model, we show that the exciton-cavity interaction range is limited to the phonon sidebands. Photon-correlation and pump-power dependence experiments under nonresonant excitation conditions further establish that the cavity is fed only by a single exciton.

Obstructive sleep apnoea and anaesthesia

Obstructive sleep apnoea (OSA) correlates positively with obesity and age, both of which are becoming increasingly prevalent. Obstructive sleep apnoea occurs much more frequently in clinical practice than formerly diagnosed, and that this condition represents complex challenges for difficulty in mask ventilation, laryngoscopic intubation, accelerated arterial desaturation, postoperative monitoring and discharge status. In this review article pathophysiology, diagnosis, and perioperative management of this group of patients have been discussed in detail.

Obstructive sleep apnoea syndrome in children and anaesthesia

Obstructive sleep apnoea syndrome (OSAS) is a common medical disorder among adults, which is increasingly being recognized in children too. It is a breathing disorder characterized by upper airway obstruction with or without intermittent complete obstruction that disrupts normal breathing during sleep. Anatomical and neuromuscular disorders are mainly responsible for this disorder. This disorder leads to a state of chronic hypoxemia, which has significant cardiac, pulmonary and central nervous system implications. Diagnosis of OSAS is based on thorough history and clinical examination along with appropriate sleep studies including polysomnography. The mainstay of treatment of paediatric OSAS is adenotonsillectomy. Good anaesthetic practice in Paediatric patients with OSAS revolves around good and ideal airway management. Early detection of airway obstruction, intense monitoring to warn of impending airway problems and appropriate and early intervention of airway compromise are good anaesthetic practices. Coexisting medical problems should be adequately addressed and safe analgesic techniques in the perioperative period go towards improving outcomes in patients with paediatric OSAS.

Dense arrays of ordered pyramidal quantum dots with narrow linewidth photoluminescence spectra

Arrays of site-controlled, pyramidal InGaAs/GaAs quantum dots (QDs) grown by organo-metallic chemical vapour deposition with densities comparable to those of self-assembled QDs (5 x 10(9) cm(-2)) are demonstrated. The QDs exhibit high quality photoluminescence spectra with inhomogeneous broadening of only 6.5 meV. The QD dipole moment was estimated through the analysis of time-resolved photoluminescence measurements. Such ordered QD arrays should be useful for applications in active nanophotonic systems such as QD lasers, modulators and switches requiring high overlap of the optical modes with the QD active region.

Amniotic fluid embolism

The disastrous entry of amniotic fluid into the maternal circulation leads to dramatic sequelae of clinical events, characteristically referred to as Amniotic fluid embolism (AFE). The underlying mechanism for AFE is still poorly understood. Unfortunately, this situation has very grave maternal and fetal consequences. AFE can occur during labor, caesarean section, dilatation and evacuation or in the immediate postpartum period. The pathophysiology is believed to be immune mediated which affects the respiratory, cardiovascular, neurological and hematological systems. Undetected and untreated it culminates into fulminant pulmonary edema, intractable convulsions, disseminated intravascular coagulation (DIC), malignant arrhythmias and cardiac arrest. Definite diagnosis can be confirmed by identification of lanugo, fetal hair and fetal squamous cells (squames) in blood aspirated from the right ventricle. Usually the diagnosis is made clinically and by exclusion of other causes. The cornerstone of management is a multidisciplinary approach with supportive treatment of failing organs systems. Despite improved modalities for diagnosing AFE, and better intensive care support facilities, the mortality is still high.

Prophylactic granisetron vs pethidine for the prevention of postoperative shivering: a randomized control trial

SUMMARY

Shivering-the "Big Little Problem" has an incidence of 60% in early recovery phase following general anaesthesia. A number of techniques have been tried to prevent postoperative shivering. Previous study showed that, ondansetron in higher doses reduces postoperative shivering. Therefore, this study was done to compare the efficacy of prophylactic granisetron, pethidine and placebo in preventing postoperative shivering. Ninety patients aged 20-60yrs, ASA physical status I and II, scheduled for laparoscopic surgery under general anaesthesia were randomly allocated to receive either normal saline (Group S, n=30) as negative control, pethidine 25mg (Group P, n=30) as positive control or granisetron 40mcg.kg(-1) (Group G, n=30) intravenously before induction. The anaesthesia was induced with fentanyl 2mcg.kg(-1), propofol 2mg.kg(-1) and atracurium 0.5mg.kg(-1) and maintained with sevoflurane 1 - 1.5%. Nasopharyngeal temperature was measured throughout the procedure. An investigator, blinded to the treatment group, graded postoperative shivering in a scale of 0 to 4. (0= no shivering, 1= piloerection or peripheral vasoconstriction but no visible shivering, 2= muscle activity in only one muscle group 3= muscle activity in more than one muscle group, 4= shivering involving the whole body). Prophylaxis was regarded as ineffective if shivering was greater than grade 3 and intravenous pethidine 25 mg was administered as rescue medication. The three groups did not differ significantly regarding patient characteristics. The numbers of patients shivering on arrival in the recovery room at 15 minutes after operation were significantly less in Group P (7%) and Group G (17%) than in Group S (60%). Groups P and G differ significantly than in Group S (p<0.05). However, the difference between Groups P and G was not statistically significant (p>0.05). The prophylactic use of granisetron (40mcg.kg(-1)) and pethidine(25mg) intravenous were found to be effective in preventing postoperative shivering.

Luttinger-liquid behavior in weakly disordered quantum wires

We have measured the temperature dependence of the conductance in long V-groove quantum wires fabricated in GaAs/AlGaAs heterostructures. Our data are consistent with recent theories developed within the framework of the Luttinger-liquid model, in the limit of weakly disordered wires. We show that, for the relatively low level of disorder in our quantum wires, the value of the interaction parameter g congruent with 0.66, which is the expected value for GaAs. However, samples with a higher level of disorder show conductance with stronger temperature dependence, which does not allow their treatment in the framework of perturbation theory. Fitting such data with perturbation-theory models leads inevitably to wrong (lower) values of g.

Anaesthesia-related maternal mortality

Complications of anaesthesia leading to death in young pregnant women might be prevented if more experienced personnel could be entrusted with the job. The contribution of anaesthesia to maternal mortality in the United Kingdom is 1.7 per million pregnancies with almost similar incidence from United States. The commonest single factor responsible for anaesthesia-related death is difficult or failed intubation. A pregnant woman with a potentially difficult airway should receive aspiration prophylaxis (mechanical or pharmacological) as soon as operative delivery is anticipated. Anaesthetists should make a plan that comes into effect as soon as failure to view the larynx or to intubate the trachea becomes evident. Unsuspected difficult airway can be managed if the skill of the anaesthetists is of high standard. Pulmonary aspiration is one cause of death in obstetric anaesthesia. Regurgitation and vomiting prevention can minimise pulmonary aspiration. In regional anaesthesia, local anaesthetics toxicity is another cause of concern. This should be tackled with some safe local anaesthetics. Preventing a high spinal or epidural block involves ways to detect inadvertent injection of local anaesthetic into the cerebrospinal fluid. Postoperative care after anaesthesia in obstetric cases is very important.

Caudal Additives in Pediatrics: A Comparison Among Midazolam, Ketamine, and Neostigmine Coadministered with Bupivacaine

Single-shot "kiddie caudal" with bupivacaine alone is losing popularity because of its duration of 4-8 h. In a prospective randomized double-blind clinical study, we assessed and compared the efficacy of ketamine, midazolam, and neostigmine coadministered with bupivacaine in a caudal epidural to provide intraoperative and postoperative pain relief. Eighty children (ASA status I) aged 5-10 yr undergoing unilateral inguinal herniotomy were allocated randomly in equal numbers (n = 20) into 4 groups to receive a caudal injection of 0.25% bupivacaine (1 mL/kg) with or without ketamine (0.5 mg/kg), midazolam (50 microg/kg), and neostig-mine (2 microg/kg), after the induction of standardized general anesthesia without premedication. Monitoring for pain, sedation, postoperative nausea/vomiting, dizziness, and pruritus was performed by anesthesiologists blinded to the study allocation. The time to first analgesic administration (paracetamol syrup) was longer (P < 0.05) in the bupivacaine-neostigmine group and the bupivacaine-midazolam group than in the other groups. Undesirable effects, such as emesis, pruritus, and dizziness, were comparable in all groups. However, the incidence of hallucination was more frequent in the bupivacaine-ketamine group compared with the other groups. This study shows that single-shot caudal coadministration of bupivacaine-neostigmine and bupivacaine-midazolam was associated with an extended duration of postoperative pain relief.