Advanced portable micro-SORS prototype coupled with SERDS for heritage science

We investigate the subsurface composition of turbid materials at the micro scale by means of a portable non-invasive technique, micro-spatially offset Raman spectroscopy (micro-SORS), combined with shifted excitation Raman difference spectroscopy (SERDS). This combination enables the microscale layer analysis and allows to deal effectively with highly fluorescing samples as well as ambient light, all in a form of an in-house portable prototype device optimised for applications in heritage science. The instrument comprises ability to simultaneously collect multiple spectra by means of an optical fibre bundle, thus reducing the dead time and simplifying the ease of deployment of the technique. The performance of the synergy between micro-SORS and 785 nm SERDS dual-wavelength diode laser is demonstrated on a stratified mock-up painting samples including highly fluorescing painted layers. This instrumental approach could be ground-breaking in heritage science, due to the largely unmet need of analysing the molecular composition of subsurface of artworks non-invasively and in situ, and in the presence of fluorescent background and ambient light. Moreover, many other fields are expected to benefit from this technological advancement such as solar energy, forensic and food analytical areas.

Hyperscaling in the Coherent Hyperspin Machine

Classical and quantum systems are used to simulate the Ising Hamiltonian, an essential component in large-scale optimization and machine learning. However, as the system size increases, devices like quantum annealers and coherent Ising machines face an exponential drop in their success rate. Here, we introduce a novel approach involving high-dimensional embeddings of the Ising Hamiltonian and a technique called "dimensional annealing" to counteract the decrease in performance. This approach leads to an exponential improvement in the success rate and other performance metrics, slowing down the decline in performance as the system size grows. A thorough examination of convergence dynamics in high-performance computing validates the new methodology. Additionally, we suggest practical implementations using technologies like coherent Ising machines, all-optical systems, and hybrid digital systems. The proposed hyperscaling heuristics can also be applied to other quantum or classical Ising devices by adjusting parameters such as nonlinear gain, loss, and nonlocal couplings.

Transient ischemic attack and minor stroke as "surgeons affairs": a narrative review

OBJECTIVE

The scope of this paper is to review the subtypes of transient ischemic attack (TIA) and minor stroke (mS) in which a surgical treatment is needed, discussing the importance and the timing of a multidisciplinary approach, in order to achieve an optimized management and prevent major strokes or other critical complications.

MATERIALS AND METHODS

The keywords "transient ischemic attack," "minor stroke," "surgical treatment," "vascular surgery," "heart surgery," "neurosurgery," and "multidisciplinary" were searched using MEDLINE, EMBASE, and Scopus. Relevant search results were discussed by the authors for references inclusion.

RESULTS

Notwithstanding that best medical therapy is usually the first choice for the most part of cases, there are specific but recurrent etiologies that must be properly recognized because of a potential surgical approach, even in urgency. In fact, symptomatic carotid stenosis, or particular cases of hemodynamic cerebrovascular events, should be promptly referred to vascular surgeon, since increasing evidences highlighted a benefit from an early artery revascularization. In addition, beyond arrhythmic causes, cardioembolic events due to bacterial endocarditis and atrial myxoma should be quickly diagnosed, possibly in emergency department, because they are a presumptive urgency for heart surgery. In addition to the above-mentioned conditions, in patients suffering from vertebrobasilar TIA or mS, clinicians should keep in mind the Bow Hunter disease, because surgical artery decompression can represent the only suitable treatment in selected cases.

CONCLUSIONS

TIA and mS require a multidisciplinary in order to discuss therapeutic options, comparing risks and benefits and determining the best timing for an optimized management.

Referenceless characterization of complex media using physics-informed neural networks

In this work, we present a method to characterize the transmission matrices of complex scattering media using a physics-informed, multi-plane neural network (MPNN) without the requirement of a known optical reference field. We use this method to accurately measure the transmission matrix of a commercial multi-mode fiber without the problems of output-phase ambiguity and dark spots, leading to up to 58% improvement in focusing efficiency compared with phase-stepping holography. We demonstrate how our method is significantly more noise-robust than phase-stepping holography and show how it can be generalized to characterize a cascade of transmission matrices, allowing one to control the propagation of light between independent scattering media. This work presents an essential tool for accurate light control through complex media, with applications ranging from classical optical networks, biomedical imaging, to quantum information processing.

Extreme transport of light in spheroids of tumor cells

Extreme waves are intense and unexpected wavepackets ubiquitous in complex systems. In optics, these rogue waves are promising as robust and noise-resistant beams for probing and manipulating the underlying material. Localizing large optical power is crucial especially in biomedical systems, where, however, extremely intense beams have not yet been observed. We here discover that tumor-cell spheroids manifest optical rogue waves when illuminated by randomly modulated laser beams. The intensity of light transmitted through bio-printed three-dimensional tumor models follows a signature Weibull statistical distribution, where extreme events correspond to spatially-localized optical modes propagating within the cell network. Experiments varying the input beam power and size indicate that the rogue waves have a nonlinear origin. We show that these nonlinear optical filaments form high-transmission channels with enhanced transmission. They deliver large optical power through the tumor spheroid, and can be exploited to achieve a local temperature increase controlled by the input wave shape. Our findings shed light on optical propagation in biological aggregates and demonstrate how nonlinear extreme event formation allows light concentration in deep tissues, paving the way to using rogue waves in biomedical applications, such as light-activated therapies.

CARDIOCARE: An integrated platform for the management of elderly multimorbid patients with breast cancer therapy induced cardiac toxicity

Breast cancer (BC) remains the most diagnosed cancer in women, accounting for 12% of new annual cancer cases in Europe and worldwide. Advances in surgery, radiotherapy and systemic treatment have resulted in improved clinical outcomes and increased survival rates in recent years. However, BC therapy-related cardiotoxicity, may severely impact short- and long-term quality of life and survival. This study presents the CARDIOCARE platform and its main components, which by integrating patient-specific data from different categories, data from patient-oriented eHealth applications and wearable devices, and by employing advanced data mining and machine learning approaches, provides the healthcare professionals with a valuable tool for effectively managing BC patients and preventing or alleviating treatment induced cardiotoxicity.Clinical Relevance- Through the adoption of CARDIOCARE platform healthcare professionals are able to stratify patients for their risk for cardiotoxicity and timely apply adequate interventions to prevent its onset.

Observation of terahertz transition from Fano resonances to bound states in the continuum

Bound states in the continuum (BIC) in metamaterials have recently attracted attention for their promising applications in photonics. Here, we investigate the transition from Fano resonances to BIC, at terahertz (THz) frequencies, of a one-dimensional photonic crystal slab made of rectangular dielectric rods. Simulations performed by an analytical exact solution of the Maxwell equations showed that symmetry-protected, high-quality factor (Q), BIC emerge at normal incidence. For non-normal incidence, BIC couple with the freely propagating waves and appear in the scattering field as a Fano resonance. Simulations were verified by realizing the photonic crystal slab by 3D-printing technique. THz time-domain spectroscopy measurements as a function of the incidence angle matched the simulation to good accuracy and confirmed the evolution of Fano resonances to high-Q resonances typical of BIC. These results point out the design of highly sensitive and low-cost THz devices for sensing for a wide range of applications.

Single-shot polarimetry of vector beams by supervised learning

States of light encoding multiple polarizations - vector beams - offer unique capabilities in metrology and communication. However, their practical application is limited by the lack of methods for measuring many polarizations in a scalable and compact way. Here we demonstrate polarimetry of vector beams in a single shot without any polarization optics. We map the beam polarization content into a spatial intensity distribution through light scattering and exploit supervised learning for single-shot measurements of multiple polarizations. We characterize structured light encoding up to nine polarizations with accuracy beyond 95% on each Stokes parameter. The method also allows us to classify beams with an unknown number of polarization modes, a functionality missing in conventional techniques. Our findings enable a fast and compact polarimeter for polarization-structured light, a general tool that may radically impact optical devices for sensing, imaging, and computing.

Cervical pessary for preterm birth prevention after an episode of arrested preterm labor: a retrospective cohort study with targeted maximum likelihood estimation of the average treatment effect

OBJECTIVE

To evaluate whether cervical pessary effectively reduces the preterm birth < 37 weeks rate in patients who have not delivered after an episode of arrested preterm labor.

PATIENTS AND METHODS

Retrospective cohort study was conducted on singleton pregnant patients admitted to our institution between January 2016 and June 2021 for threatened preterm labor and who had a cervical length < 25 mm. Women in whom a cervical pessary was placed were considered as exposed, while women in whom expectant management was preferred were considered as unexposed. The primary outcome was the rate of preterm birth before 37 weeks. A targeted maximum likelihood estimation was used to estimate the average treatment effect of cervical pessary by adjusting for a-priori-defined confounders.

RESULTS

A cervical pessary was placed in 152 (36.6%) patients (exposed), while the remaining 263 (63.4%) were managed expectantly (unexposed). The adjusted average treatment effect was -14% (-18 to -11%), -17% (-20 to -13%), and -16% (-20 to -12%) for preterm birth < 37 weeks, < 34 weeks, and < 32 weeks, respectively. The average treatment effect for adverse neonatal outcomes was -7% (-8 to -5%). No difference in gestational weeks at delivery between exposed and unexposed emerged when gestational age at first admission was > 30.1 gestational weeks.

CONCLUSIONS

The positioning of a cervical pessary placement may be evaluated to reduce the risk of a subsequent preterm birth after an episode of arrested preterm labor in pregnant patients with onset of symptoms before 30 gestational weeks.

Understanding Online Registry Facilitators and Barriers Experienced by Black Brain Health Registry Participants: The Community Engaged Digital Alzheimer's Research (CEDAR) Study

BACKGROUND

Failure of Alzheimer's disease and related diseases (ADRD) research studies to include and engage Black participants is a major issue, which limits the impact and generalizability of research findings. Little is known about participation of Black adults in online ADRD-related research registries.

OBJECTIVES

As part of the Community Engaged Digital Alzheimer's Research (CEDAR) Study, this study aims to increase our understanding of facilitators and barriers of Black adults to participating in ADRD-related online registries, as well as to understand their preferences for communication channels.

DESIGN, SETTING, PARTICIPANTS, MEASUREMENTS

We invited all Black participants enrolled in the Brain Health Registry (BHR) to complete a cross-sectional online survey. The survey consisted of rating scales and open-text questions asking about their attitudes towards brain health research, reasons for joining and continuing to participate in BHR, difficulties with participating, and preferences for modes of contact and website usage.

RESULTS

Of all invited Black BHR participants (N=3,636), 198 (5.5%) completed the survey. The mean age was 58.4 (SD=11.3), mean years of education were 16.3 (SD=2.4), and 85.5% identified as female. Reported facilitators for joining and continuing to participate in BHR were personal interest (e.g., learning more about own brain health) and altruism (e.g., helping research). Among additional registry features which could encourage return, receiving feedback or scores about BHR tasks was rated the highest. Of those who found BHR participation difficult (21%), the most frequent reason was time burden. The most preferred way of receiving study information was via email. Participants reported that the websites that they used the most were YouTube and Facebook.

DISCUSSION

The results of our study can inform the development of culturally-responsive registry features and engagement efforts to improve inclusion and participation of Black adults in online ADRD research. Providing participants with feedback about their registry performance and reducing the number of registry tasks are among the recommended strategies.

The Community Engaged Digital Alzheimer's Research (CEDAR) Study: A Digital Intervention to Increase Research Participation of Black American Participants in the Brain Health Registry

BACKGROUND

Although Black/African American older adults bear significant inequities in prevalence, incidence, and outcomes of Alzheimer's disease and related dementias, they are profoundly under-included in Alzheimer's Disease research. Community-Engaged Research (e.g., equitable community/science partnerships) is an evidence-based approach for improving engagement of underrepresented populations into Alzheimer's Disease research, but has lacked scalability to the national level. As internet use among older adults from underrepresented populations continues to grow, internet-based research shows promise as a feasible, valid approach to engagement and longitudinal assessment. The Community Engaged Digital Alzheimer's Research (CEDAR) study utilizes a community-engaged research approach to increase the engagement and research participation of Black/African American adults in the Brain Health Registry (BHR) and Alzheimer Disease clinical research.

OBJECTIVES

To describe the methods and evaluate the feasibility of the CEDAR culturally-informed digital platform within BHR.

DESIGN

All Black/African American participants in BHR were invited to enroll in CEDAR and to consider serving on a newly convened Community-Scientific Partnership Board to guide the study. The community board guided the development a culturally-informed cadre of engagement materials and strategies to increase research participation. Engagement strategies included incentives for study task completion, culturally-informed communications (e.g., landing page, emails and social media), resources about brain health, and video and written testimonials by CEDAR participants.

SETTING

BHR, an Internet-based registry and cohort.

PARTICIPANTS

BHR participants self-identifying as Black/African American were invited to enroll. All participants who signed an online informed consent document were enrolled.

MEASUREMENTS

We report the number of participants invited, enrolled, completed tasks, and volunteered to join the community board. We compared the demographics, cognitive profile, and baseline BHR task completion rates between CEDAR participants and all those invited to join the study.

RESULTS

Of 3738 invited, 349 (9.34%) enrolled in CEDAR. 134 (37% of CEDAR participants) volunteered to join the community board, of which 19 were selected for the community board. Compared to those invited, the CEDAR cohort had a higher percentage of female participants (84.5%) and a lower percentage of participants who identify as belonging to more than one ethnocultural group (21.8%). Compared to those did not enroll in CEDAR, those enrolled in CEDAR had a higher percentage of participants completing all BHR tasks (22%) and a higher percentage of participants completing at least one cognitive test (76%). Those enrolled in CEDAR also had a higher percentage of participants having an enrolled study partner (18%).

CONCLUSIONS

A culturally-informed Community-Engaged Research approach, including a remotely-convened community board, to engagement of Black/African American participants in an online research registry is feasible. This approach can be adapted for use in various clinical studies and other settings. Future studies will evaluate the effectiveness of the engagement strategies.

Multidimensional hyperspin machine

From condensed matter to quantum chromodynamics, multidimensional spins are a fundamental paradigm, with a pivotal role in combinatorial optimization and machine learning. Machines formed by coupled parametric oscillators can simulate spin models, but only for Ising or low-dimensional spins. Currently, machines implementing arbitrary dimensions remain a challenge. Here, we introduce and validate a hyperspin machine to simulate multidimensional continuous spin models. We realize high-dimensional spins by pumping groups of parametric oscillators, and show that the hyperspin machine finds to a very good approximation the ground state of complex graphs. The hyperspin machine can interpolate between different dimensions by tuning the coupling topology, a strategy that we call "dimensional annealing". When interpolating between the XY and the Ising model, the dimensional annealing substantially increases the success probability compared to conventional Ising simulators. Hyperspin machines are a new computational model for combinatorial optimization. They can be realized by off-the-shelf hardware for ultrafast, large-scale applications in classical and quantum computing, condensed-matter physics, and fundamental studies.

Terahertz waves dynamic diffusion in 3D printed structures

Applications of metamaterials in the realization of efficient devices in the terahertz band have recently been considered to achieve wave deflection, focusing, amplitude manipulation and dynamical modulation. Terahertz metamaterials offer practical advantages since their structures have typical sizes of hundreds microns and are within the reach of current three-dimensional (3D) printing technologies. Here, we propose terahertz photonic structures composed of dielectric rods layers made of acrylonitrile styrene acrylate realized by low-cost, rapid, and versatile fused deposition modeling 3D-printing. Terahertz time-domain spectroscopy is employed for the experimental study of their spectral and dynamic response. Measured spectra are interpreted by using simulations performed by an analytical exact solution of the Maxwell equations for a general incidence geometry, by a field expansion as a sum over reciprocal lattice vectors. Results show that the structures possess specific spectral forbidden bands of the incident THz radiation depending on their optical and geometrical parameters. We also find evidence of disorder in the 3D printed structure resulting in the closure of the forbidden bands at frequencies above 0.3 THz. The size disorder of the structures is quantified by studying the dynamics diffusion of THz pulses as a function of the numbers of layers of dielectric rods. Comparison with simulations of light diffusion in photonic crystals with increasing disorder allows estimating the size distributions of elements. By using a Mean Squared Displacement model, from the broadening of the pulses’ widths it is also possible to estimate the diffusion coefficient of the terahertz radiation in the photonic structures.

Metriplectic Structure of a Radiation–Matter-Interaction Toy Model

A dynamical system defined by a metriplectic structure is a dissipative model characterized by a specific pair of tensors, which defines a Leibniz bracket; and a free energy, formed by a “Hamiltonian” and an entropy, playing the role of dynamics generator. Generally, these tensors are a Poisson bracket tensor, describing the Hamiltonian part of the dynamics, and a symmetric metric tensor, that models purely dissipative dynamics. In this paper, the metriplectic system describing a simplified two-photon absorption by a two-level atom is disclosed. The Hamiltonian component is sufficient to describe the free electromagnetic radiation. The metric component encodes the radiation–matter coupling, driving the system to an asymptotically stable state in which the excited level of the atom is populated due to absorption, and the radiation has disappeared. First, a description of the system is used, based on the real–imaginary decomposition of the electromagnetic field phasor; then, the whole metriplectic system is re-written in terms of the phase–amplitude pair, named Madelung variables. This work is intended as a first result to pave the way for applying the metriplectic formalism to many other irreversible processes in nonlinear optics.

Droplet Lasers for Smart Photonic Labels

Microscopic lasers represent a promising tool for the development of cutting-edge photonic devices thanks to their ability to enhance light-matter interaction at the microscale. In this work, we realize liquid microlasers with tunable emission by exploiting the self-formation of three-dimensional liquid droplets into a polymeric matrix driven by viscoelastic dewetting. We design a flexible device to be used as a smart photonic label which is detachable and reusable on various types of substrates such as paper or fabric. The innovative lasing emission mechanism proposed here is based on whispering gallery mode emission coupled to random lasing, the latter prompted by the inclusion of dielectric compounds into the active gain medium. The wide possibility of modulating the emission wavelength of the microlasers by acting on different parameters, such as the cavity size, type and volume fraction of the dielectrics, and gain medium, offers a multitude of spectroscopic encoding schemes for the realization of photonic barcodes and labels to be employed in anticounterfeiting applications and multiplexed bioassays.

Evidence of Chaotic Dynamics in Three-Soliton Collisions

We observe chaotic optical wave dynamics characterized by erratic energy transfer and soliton annihilation and creation in the aftermath of a three-soliton collision in a photorefractive crystal. Irregular dynamics are found to be mediated by the nonlinear Raman effect, a coherent interaction that leads to nonreciprocal soliton energy exchange. Results extend the analogy between solitons and particles to the emergence of chaos in three-body physics and provide new insight into the origin of the irregular dynamics that accompany extreme and rogue waves.

Topological nanophotonics and artificial neural networks

We propose the use of artificial neural networks to design and characterize photonic topological insulators. As a hallmark, the band structures of these systems show the key feature of the emergence of edge states, with energies lying within the energy gap of the bulk materials and localized at the boundary between regions of distinct topological invariants. We consider different structures such as one-dimensional photonic crystals, [Formula: see text]-symmetric chains and cylindrical systems and show how, through a machine learning application, one can identify the parameters of a complex topological insulator to obtain protected edge states at target frequencies. We show how artificial neural networks can be used to solve the long-standing quest for a solution to inverse problems solution and apply this to the cutting edge topic of topological nanophotonics.

Sepsis due to Yersinia enterocolitica in an aborted equine fetus: case report

ABSTRACT Yersinia enterocolitica is a bacterium with zoonotic potential and there are no previous records of this bacteria being isolated from aborted foals. This report aims to describe a case of sepsis due to Y. enterocolitica in a seven month old aborted equine. The fequinoetus was submitted to necropsy and samples of all the organs were collected for the histological exam. Samples of liver, lung, placenta, and stomach contents were collected for bacterial culture. Macroscopically, the liver was enlarged with yellowish heterogeneous color, heart with pale myocardial areas; lungs not collapsed, heavy and shiny, thickened umbilical cord covered with fibrin and pus. Histopathologically, there was moderate multifocal necrosuppurative myocarditis and thrombosis, moderate diffuse suppurative bronchopneumonia, mild multifocal fibrinonecrotic hepatitis, and moderate diffuse necrosuppurative omphalitis with intralesional bacterial myriads and thrombosis. Mild multifocal suppurative placentitis, nephritis, myositis, cystitis, and dermatitis were also observed, in addition to mild diffuse lymphoid rarefaction. The microbiological evaluation identified Y. enterocolitica in the liver, lung, and stomach fluid. This is the first report of sepsis due to Y. enterocolitica causing an abortion in a horse. This bacterium has zoonotic importance; therefore, it should be investigated in abortion in this species, serving as a differential diagnosis in reproductive disorders.

Anisotropic Optical Shock Waves in Isotropic Media with Giant Nonlocal Nonlinearity

Dispersive shock waves in thermal optical media are nonlinear phenomena whose intrinsic irreversibility is described by time asymmetric quantum mechanics. Recent studies demonstrated that the nonlocal wave breaking evolves in an exponentially decaying dynamics ruled by the reversed harmonic oscillator, namely, the simplest irreversible quantum system in the rigged Hilbert spaces. The generalization of this theory to more complex scenarios is still an open question. In this work, we use a thermal third-order medium with an unprecedented giant Kerr coefficient, the m-cresol/nylon mixed solution, to access an extremely nonlinear, highly nonlocal regime and realize anisotropic shock waves with internal gaps. We compare our experimental observations to results obtained under similar conditions but in hemoglobin solutions from human red blood cells, and found that the gap formation strongly depends on the nonlinearity strength. We prove that a superposition of Gamow vectors in an ad hoc rigged Hilbert space, that is, a tensorial product between the reversed and the standard harmonic oscillators spaces, describes the beam propagation beyond the shock point. The anisotropy turns out from the interaction of trapping and antitrapping potentials. Our work furnishes the description of novel intriguing shock phenomena mediated by extreme nonlinearities.

Theory of Neuromorphic Computing by Waves: Machine Learning by Rogue Waves, Dispersive Shocks, and Solitons

We study artificial neural networks with nonlinear waves as a computing reservoir. We discuss universality and the conditions to learn a dataset in terms of output channels and nonlinearity. A feed-forward three-layered model, with an encoding input layer, a wave layer, and a decoding readout, behaves as a conventional neural network in approximating mathematical functions, real-world datasets, and universal Boolean gates. The rank of the transmission matrix has a fundamental role in assessing the learning abilities of the wave. For a given set of training points, a threshold nonlinearity for universal interpolation exists. When considering the nonlinear Schrödinger equation, the use of highly nonlinear regimes implies that solitons, rogue, and shock waves do have a leading role in training and computing. Our results may enable the realization of novel machine learning devices by using diverse physical systems, as nonlinear optics, hydrodynamics, polaritonics, and Bose-Einstein condensates. The application of these concepts to photonics opens the way to a large class of accelerators and new computational paradigms. In complex wave systems, as multimodal fibers, integrated optical circuits, random, topological devices, and metasurfaces, nonlinear waves can be employed to perform computation and solve complex combinatorial optimization.

Impact of visceral obesity and sarcobesity on surgical outcomes and recovery after laparoscopic resection for colorectal cancer

BACKGROUND & AIMS

Studies analyzing the impact of visceral fat excess on surgical outcomes after resection for colorectal cancer (CRC) have yielded conflicting results. Visceral obesity (VO) and sarcobesity (SO) have been recently addressed as risk factors for poor short-term results while no data are available for recovery goals after surgery. No data are available on the protective effect of ERAS in VO and SO patients. The aim of this study was to assess clinical implications of computed tomography (CT) assessed VO and SO on surgical and recovery outcomes after minimally invasive resection for CRC before and after ERAS protocol implementation.

METHODS

Visceral adipose tissue (VAT) and skeletal muscle area (SMA) were retrospectively assessed using pre-operative CT studies of 261 patients who underwent laparoscopic resection for CRC between January 2012 and April 2019; ERAS protocol was adopted in 160 patients operated on after March 2014. Patients' surgical and recovery outcomes were compared according to BMI categories, VO and SO which was defined using the VAT/SMA ratio (Sarcobesity Index). Predictive factors for poor surgical and recovery outcomes were evaluated by univariate and multivariate analyses.

RESULTS

Of the 261 patients, 12.6% were BMI obese while 68.6% presented visceral obesity. BMI was not associated to any of the outcomes considered. No differences in intra-operative results were found except for a lower number of retrieved lymph nodes both in VO and SO patients. While VO showed no impact on post-operative course, SO resulted an independent risk factor for cardiac complications and prolonged post-operative ileus (PPOI) at logistic regression analysis. Furthermore, sarcobese patients showed delayed recovery after surgery. Patients enrolled in the ERAS protocol showed improved recovery outcomes for both VO and SO groups, although ERAS did not result to be a protective factor for cardiac complications and PPOI.

CONCLUSIONS

A high Sarcobesity Index is a risk factor for developing cardiac complications and PPOI after laparoscopic resection for CRC. A reduced number of lymph nodes retrieved is associated to VO and SO. These conditions should then be considered in clinical practice for the risk of down staging the N stage. Effect of VO and SO on recovery items after surgery should be further investigated. ERAS protocol application should be implemented to improve recovery outcomes in VO and SO patients undergoing laparoscopic colorectal resection.

Programming multi-level quantum gates in disordered computing reservoirs via machine learning

Novel machine learning computational tools open new perspectives for quantum information systems. Here we adopt the open-source programming library TensorFlow to design multi-level quantum gates, including a computing reservoir represented by a random unitary matrix. In optics, the reservoir is a disordered medium or a multi-modal fiber. We show that trainable operators at the input and the readout enable one to realize multi-level gates. We study various qudit gates, including the scaling properties of the algorithms with the size of the reservoir. Despite an initial low slop learning stage, TensorFlow turns out to be an extremely versatile resource for designing gates with complex media, including different models that use spatial light modulators with quantized modulation levels.

Topological photonic crystal fibers and ring resonators

With an exact recursive approach, we study photonic crystal fibers and resonators with topological features induced by Aubry-Andre-Harper cladding modulation. We find nontrivial gaps and edge states at the interface between regions with different topological invariants. These structures show topological protection against symmetry-preserving local perturbations that do not close the gap and sustain strong field localization and energy concentration at a given radial distance. As topological light guiding and trapping devices, they may bring about many opportunities for both fundamentals and applications unachievable with conventional devices.

Nonlinear Optics: feature issue introduction

This joint issue of Optics Express and Optical Materials Express features 18 state-of-the art articles that witness actual developments in nonlinear optics, including those by authors who participated in the international conference Nonlinear Optics held in Waikoloa, Hawaii from July 15 to 19, 2019. As an introduction, the editors provide a summary of these articles that cover all aspects of nonlinear optics, from basic nonlinear effects and novel frequency windows to innovative nonlinear materials and devices, thereby paving the way for new nonlinear optical concepts and forthcoming applications.

Topological control of extreme waves

From optics to hydrodynamics, shock and rogue waves are widespread. Although they appear as distinct phenomena, transitions between extreme waves are allowed. However, these have never been experimentally observed because control strategies are still missing. We introduce the new concept of topological control based on the one-to-one correspondence between the number of wave packet oscillating phases and the genus of toroidal surfaces associated with the nonlinear Schrödinger equation solutions through Riemann theta functions. We demonstrate the concept experimentally by reporting observations of supervised transitions between waves with different genera. Considering the box problem in a focusing photorefractive medium, we tailor the time-dependent nonlinearity and dispersion to explore each region in the state diagram of the nonlinear wave propagation. Our result is the first realization of topological control of nonlinear waves. This new technique casts light on shock and rogue waves generation and can be extended to other nonlinear phenomena.

A five year retrospective study on Syphilis in the Sexual Transmitted Disease Centre (STDC) of the teaching Hospital Umberto I in Rome

OBJECTIVES

A retrospective study describing syphilis epidemiological and clinical features in patients referring to an infectious diseases centre in Rome, Italy.

METHODS

Between January 2011 and December 2015 demographic, behavioral and clinical data were collected from all adult patients attending the Sexually Transmitted Diseases Centre of the Teaching Hospital Umberto I in Rome.

RESULTS

Overall 723 patients, 495 males and 228 females, with syphilis infection diagnosis were included. Average age 39.6 ± 13.6 years (median 38) was higher in men than women (41.1 ± 13.6 vs. 36.3 ± 13.1; p<0.001). Patients were from Italy (486 or 67.2%), EU (90 or 12.4%), rest of Europe (38 or 5.3 %), Americas (46 or 6.4%), Africa (36 or 5.0%) and Asia (27 or 3.7%). One-hundred-twenty-three (17.0%) presented primary syphilis, 43 (5.9%) secondary syphilis, 8 (1.1%) tertiary syphilis, 246 (34.0%) serological syphilis, 80 (11.1%) preceding syphilis, 56 (7.7%) gravidic syphilis and 167 (23.1%) came to the Sexually Transmitted Diseases Centre to control a preceding syphilis treatment. Fifty-six (24.6%) women were diagnosed with syphilis during their pregnancies. Among Chinese female patients, those pregnant represented 87.5%. There were 100 subjects (13.8%) simultaneously HIV+ and 623 (86.2%) HIV- patients. HIV co-infection affected more frequently men (RR 5.30; CI 2.62 - 10.72; p<0.001). In males HIV co-infection affected more frequently homosexuals (RR 11.72; CI 6.72 - 20.45; p<0.001). Overall HIV co-infection affected more frequently foreign patients, specially from the Americas (26.1%), Africa (25.7%) and Asia (22.2%).

CONCLUSION

A serious problem of "gravidic syphilis" suggests the need for Public Health preventive action. Also an early diagnosis of both syphilis and HIV infection should be reinforced.

Nonlinear optical memory effect

Light propagating through random media produces characteristic speckle patterns, directly related to the large multitude of scattering events. These complex dynamics remarkably display robustness to perturbation of the incoming light parameters, maintaining correlation in the scattered wavefront. This behavior is known as the optical memory effect. Here we unveil the properties of the nonlinear optical memory effect, which occurs when an optothermal nonlinearity perturbs the random material. The effect is characterized through a series of pump and probe experiments in silica aerogel, in the visible range. This additional degree of freedom further generalizes the memory effect, opening the road to applications based on the nonlinear response of random media.

Large-Scale Photonic Ising Machine by Spatial Light Modulation

Quantum and classical physics can be used for mathematical computations that are hard to tackle by conventional electronics. Very recently, optical Ising machines have been demonstrated for computing the minima of spin Hamiltonians, paving the way to new ultrafast hardware for machine learning. However, the proposed systems are either tricky to scale or involve a limited number of spins. We design and experimentally demonstrate a large-scale optical Ising machine based on a simple setup with a spatial light modulator. By encoding the spin variables in a binary phase modulation of the field, we show that light propagation can be tailored to minimize an Ising Hamiltonian with spin couplings set by input amplitude modulation and a feedback scheme. We realize configurations with thousands of spins that settle in the ground state in a low-temperature ferromagneticlike phase with all-to-all and tunable pairwise interactions. Our results open the route to classical and quantum photonic Ising machines that exploit light spatial degrees of freedom for parallel processing of a vast number of spins with programmable couplings.

Flexible Organometal-Halide Perovskite Lasers for Speckle Reduction in Imaging Projection

Disorder is emerging as a strategy for fabricating random laser sources with very promising materials, such as perovskites, for which standard laser cavities are not effective or too expensive. We need, however, different fabrication protocols and technologies for reducing the laser threshold and controlling its emission. Here, we demonstrate an effectively solvent-engineered method for high-quality perovskite thin films on a flexible polyimide substrate. The fractal perovskite thin films exhibit excellent optical properties at room temperature and easily achieve lasing action without any laser cavity above room temperature with a low pumping threshold. The lasing action is also observed in curved perovskite thin films on flexible substrates. The lasing threshold can be further reduced by increasing the local curvature, which modifies the scattering strengths of the bent thin film. We also show that the curved perovskite lasers are extremely robust with respect to repeated deformations. Because of the low spatial coherence, these curved random laser devices are efficient and durable speckle-free light sources for applications in spectroscopy, bioimaging, and illumination.

Out-of-equilibrium electron dynamics of silver driven by ultrafast electromagnetic fields - a novel hydrodynamical approach

We investigate the ultrafast nonlinear response of silver upon excitation by infrared electromagnetic radiation pulses with a duration of a few femtoseconds. By adopting the Landau weak coupling approach to account for electron-electron and electron-phonon collisions, we solve the Boltzmann equation through the method of moments obtaining a novel set of hydrodynamical equations describing the ultrafast nonlinear dynamics of electrons in silver. While the novel hydrodynamical model that was obtained reduces to the Drude model for small intensities of the driving field, it predicts that absorption saturates for large but experimentally attainable peak intensities of the order of GW cm-2. Our results are important for absorption mitigation in plasmonic devices, with potential impact for low-loss plasmonic waveguides and interconnects.

Prognostic value of thrombocytosis in patients undergoing surgery for colorectal cancer with synchronous liver metastases

PURPOSE

The purpose of this study was to evaluate the prognostic role of thrombocytosis in patients with synchronous colorectal liver metastases (CRLM).

METHODS

Retrospective analysis of patients who underwent surgery for colorectal cancer with synchronous CRLM at the Division of General and Hepatobiliary Surgery, University of Verona Hospital Trust between 2005 and 2016.

RESULTS

One hundred and ninety-six patients met the inclusion criteria. High platelet count (H-PC) was found in 32%, and it was associated with a higher rate of palliative surgery (p < 0.001), extra-hepatic metastases (p < 0.001), bilobar liver disease (p = 0.007), presence of more than three metastases (p = 0.005), biggest metastasis larger than 5 cm (p < 0.001), and CEA level higher than 200 ng/mL (p = 0.035). H-PC was significantly associated with poorer 5-year overall survival (14.3% vs. 34.3%; p = 0.001). At the multivariate analysis on R0-1 cases, platelet count resulted the only independent predictor of survival (HR 2.07, p = 0.036).

CONCLUSION

H-PC correlates with the main negative clinical-pathological factors in patients with synchronous CRLM, as well as with overall survival. Moreover, it was the only independent prognostic factor in those who underwent curative surgery.

Control of soliton self-frequency shift dynamics via Airy soliton interaction

We investigate Airy-soliton interaction in a nonlinear fiber with Raman effect. We find that Airy solitons may fuse upon interaction at a position that can be controlled by a proper engineering of the Airy tail direction. This control allows us to generate Airy solitons with varying deceleration. At variance with the case of two solitons interaction, Raman-induced soliton self-frequency shift (SSFS) is strongly enhanced when the leading soliton is replaced with the accelerating Airy pulse and slightly suppressed for the decelerating one. These notable features are ascribed to the unique properties of asymmetrical Airy pulses with a switchable direction of the oscillatory tails. We show the way these processes are uncovered unambiguously by cross-correlation frequency resolved optical gating. We also investigate the impact of chirp imposed on the input pulse on the SSFS dynamics. Our results not only provide a new way to manipulate the SSFS, but may help to improve the control of soliton fusion events during supercontinuum generation, optical rogue waves and giant dispersive waves formation.

Graphene oxide coatings prevent Candida albicans biofilm formation with a controlled release of curcumin-loaded nanocomposites

AIM

Fabrication of graphene oxide (GO)-based medical devices coatings that limit adhesion of Candida albicans, a main issue of healthcare-associated infections.

METHODS

The GO composites noncovalently functionalized with curcumin (CU), a hydrophobic molecule with active antimicrobial action, polyethylene glycol (PEG) that hinders the absorption of biomolecules or a combination of CU and PEG (GO-CU-PEG) were drop-casted on surfaces and antifungal efficacy was assessed.

RESULTS

We demonstrate that GO-CU-PEG coatings can reduce fungal adhesion, proliferation and biofilm formation. Furthermore, in an aqueous environment, surfaces release curcumin-PEG nanocomposites that have a minimum inhibitory concentration of 9.25 μg/ml against C. albicans.

CONCLUSION

Prevention of early cell adhesion and creation of a proximal environment unfavorable for growth make these GO-supported biomaterials attractive for innovative medical device manufacturing.

Does the purinergic system affect extracellular matrix functions in the central nervous system?

Exracellular matrix (ECM) consists of a plethora of proteins and polysaccharides, which aggregate into an organized network connected to the surface of the producing cells. It is structurally and functionally present in all components of tissues and organs and represents the substrate on which cells adhere, migrate, proliferate and differentiate, influencing their survival, shape and function. In response to acute (trauma) or chronic (degenerative) insults, brain ECM modifies its composition and function, actively contributing to "scar forming" gliosis or tissue degeneration/remodelling. Moreover, morphological changes in dendritic spines associated with extracellular matrix remodeling play key roles in rewiring synaptic circuitry pertinent to memory formation. In the present report, we collected the main acquisitions on the functional interplay between ECM alterations and the adenine-/guaninebased purine system with particular regard on how purine compounds and their respective receptors may affect and be affected by changes of the cerebral ECM.

Graphene Oxide Induced Osteogenesis Quantification by In-Situ 2D-Fluorescence Spectroscopy

Graphene and graphene oxide can promote the adhesion, growth and differentiation of mesenchymal stem cells. Further, graphene surface coatings accelerate the differentiation of human mesenchymal stem cells acting as osteogenic inducers. Quantification of the osteogenic induction is conventionally performed with Alizarin Red S (ARS), an anthraquinone derivative used to identify calcium deposits in tissue sections and cell cultures. The ARS staining is quite versatile because the dye forms an Alizarin Red S⁻calcium complex that can be extracted from the stained monolayer of cells and readily assayed by absorbance measurements. Direct visualization of stained deposits is also feasible; however, an in-situ visualization and quantification of deposits is possible only on transparent supports and not on thick opaque materials like ceramics and graphene composites that are well-known inducers of osteogenesis. In this manuscript, the shape of the 2D-fluorescence spectra of the ARS-calcium complex is used to develop a method to detect and monitor the in-situ differentiation process occurring during the osteogenic induction mediated by opaque graphene oxide surfaces.

Curcumin-loaded graphene oxide flakes as an effective antibacterial system against methicillin-resistant Staphylococcus aureus

Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for serious hospital infections worldwide and represents a global public health problem. Curcumin, the major constituent of turmeric, is effective against MRSA but only at cytotoxic concentrations or in combination with antibiotics. The major issue in curcumin-based therapies is the poor solubility of this hydrophobic compound and the cytotoxicity at high doses. In this paper, we describe the efficacy of a composite nanoparticle made of curcumin (CU) and graphene oxide (GO), hereafter GOCU, in MRSA infection treatment. GO is a nanomaterial with a large surface area and high drug-loading capacity. GO has also antibacterial properties due mainly to a mechanical cutting of the bacterial membranes. For this physical mechanism of action, microorganisms are unlikely to develop resistance against this nanomaterial. In this work, we report the capacity of GO to support and stabilize curcumin molecules in a water environment and we demonstrate the efficacy of GOCU against MRSA at a concentration below 2 µg ml-1. Further, GOCU displays low toxicity on fibroblasts cells and avoids haemolysis of red blood cells. Our results indicate that GOCU is a promising nanomaterial against antibiotic-resistant MRSA.

Synchrotron resonant radiation from nonlinear self-accelerating pulses

Solitons and nonlinear waves emit resonant radiation in the presence of perturbations. This effect is relevant for nonlinear fiber optics, supercontinuum generation, rogue waves, and complex nonlinear dynamics. However, resonant radiation is narrowband, and the challenge is finding novel ways to generate and tailor broadband spectra. We theoretically predict that nonlinear self-accelerated pulses emit a novel form of synchrotron radiation that is extremely broadband and controllable. We develop an analytic theory and confirm the results by numerical analysis. This new form of supercontinuum generation can be highly engineered by shaping the trajectory of the nonlinear self-accelerated pulses. Our results may find applications in novel highly efficient classical and quantum sources for spectroscopy, biophysics, security, and metrology.

New concepts in neuroinflammation: mast cells pro-inflammatory and anti-inflammatory cytokine mediators

The activation of brain nociceptors and neurons may lead to neurogenic inflammation, an event that involves immune cells including mast cells (MCs). Microglia are similar to macrophages and secrete pro-inflammatory IL-1 family members and TNF. TNF is rapidly released (first 10 minutes from MC granules) and is subsequently secreted along with other pro-inflammatory cytokines with a new synthesis after several hours. MC-derived TNF is a very powerful pro-inflammatory cytokine which mediates sensitization of the meningeal nociceptors. Here, we report the involvement of MCs in neuroinflammation, the role of inflammatory cytokine IL-1 family members, and of TNF, as well as the potential inhibition of IL-37.

Promotion of hand hygiene: the experience of the orthopaedic hospital Gaetano Pini-CTO, Milan, Italy

BACKGROUND

Hand hygiene is the primary preventive measure against health care-associated infections in terms of cost-effectiveness. In 2005, the WHO proposed the "Global Patient Safety Challenge" campaign, with the aim of reducing the overall incidence of such infections, through multimodal programs and strategies, interactive training tools and standardised methods for monitoring compliance.

STUDY DESIGN

On the basis of project "Rimani", sponsored by the Health and Social Care Authority of Emilia-Romagna, the Istituto Ortopedico Gaetano Pini has implemented a project which seeks to increase healthcare staff's compliance with hand hygiene.

METHODS

A multidisciplinary working group was created to prepare the project documents. Starting from 5th April 2015, twenty operational units were asked to produce information and training material. On 5th May, during a conference, a committee selected the three best works. The material was distributed on a monthly basis to the various departments. In addition to the training, the specifically trained operators of the Medical Monitoring Department carried out direct hand washing tests, filling out appropriate checklists. Non-compliance relating to the technique recorded in 2014 and 2015 was compared and a statistical analysis was conducted using Student's t-test for paired data.

RESULTS

Three tests were carried out in 2014. Ninety-nine cases were monitored and 5 non-compliance cases were reported, concerning the execution of the procedural steps, the running time and closing the tap with one's hands at the end of the wash. In 2015 two tests, involving 30 operational units, were carried out. 60 observations were performed, and no non-conformities emerged concerning the technique. Statistical analysis showed a significant reduction of non-compliances between the 2014 and 2015 P = 0.000).

CONCLUSION

The results obtained agree with the main findings in literature. The comparison between the 2014 and 2015 tests shows a trend of improvement in the wash technique. This confirms the effectiveness of a multidisciplinary approach and recognises the active and participatory involvement suggested by the WHO.

Aumento da sustentabilidade da produção de raças suínas locais através do uso de rótulos de qualidade – estudo de caso e desenvolvimento de uma marca comercial no projecto TREASURE

O interesse pelos recursos genéticos tradicionais, neste caso de raças suínas locais, tem crescido nas últimas décadas. No entanto, a maior parte das raças locais necessita, ainda, de ser subsidiada para garantir a sua conservação. Contudo, a melhor estratégia a seguir parece-nos ser garantir que essas raças atinjam autossustentabilidade o que será possível com uma estratégia de marketing eficiente para os seus produtos. A maioria das raças estudadas no projeto TREASURE são inexploradas, portanto a ambição é criar uma marca comercial coletiva (trademark) que servisse de “chapéu” que agregasse todas as raças e criasse valor acrescentado para os seus produtos. Os principais aspetos socioeconómicos relacionados com a implementação da marca comercial coletiva incluem os direitos, responsabilidades, e valor acrescentado expectável para os seus utilizadores finais. Baseados nos resultados obtidos num inquérito interno realizado no TREASUE, identificaram-se as principais características dessa marca comercial colaborativa: 1) deve atrair utilizadores finais como os criadores, associações de criadores e processadores de carne; 2) deve ser desenvolvida e promovida por um comité operacional constituído por utilizadores finais sob a coordenação e supervisão do consórcio do TREASURE; 3) deve realçar que os recursos genéticos locais suínos são o ponto-chave comum, considerando também os sistemas de produção e a nutrição; 4) deve ser explorada a possível colaboração ou conflito com os produtos presentemente protegidos pela EU (PDO, PGI, TSG) de forma a promover melhor os produtos locais. Apresenta-se uma análise dos direitos de propriedade intelectual (IPR) no contexto das fileiras de suínos existentes na União Europeia e as perspetivas para a marca comercial TREASURE analisada.

Phase-matching-free parametric oscillators based on two-dimensional semiconductors

Optical parametric oscillators are widely used as pulsed and continuous-wave tunable sources for innumerable applications, such as quantum technologies, imaging, and biophysics. A key drawback is material dispersion, which imposes a phase-matching condition that generally entails a complex design and setup, thus hindering tunability and miniaturization. Here we show that the burden of phase-matching is surprisingly absent in parametric micro-resonators utilizing mono-layer transition-metal dichalcogenides as quadratic nonlinear materials. By the exact solution of nonlinear Maxwell equations and first-principle calculations of the semiconductor nonlinear response, we devise a novel kind of phase-matching-free miniaturized parametric oscillator operating at conventional pump intensities. We find that different two-dimensional semiconductors yield degenerate and non-degenerate emission at various spectral regions due to doubly resonant mode excitation, which can be tuned by varying the incidence angle of the external pump laser. In addition, we show that high-frequency electrical modulation can be achieved by doping via electrical gating, which can be used to efficiently shift the threshold for parametric oscillation. Our results pave the way for the realization of novel ultra-fast tunable micron-sized sources of entangled photons-a key device underpinning any quantum protocol. Highly miniaturized optical parametric oscillators may also be employed in lab-on-chip technologies for biophysics, detection of environmental pollution and security.