Hitting the Target: Developing High-quality Evidence for Proton Beam Therapy Through Randomised Controlled Trials

The National Health Service strategy for the delivery of proton beam therapy (PBT) in the UK provides a unique opportunity to deliver high-quality evidence for PBT through randomised controlled trials (RCTs). We present a summary of three UK PBT RCTs in progress, including consideration of their key design characteristics and outcome assessments, to inform and support future PBT trial development. The first three UK multicentre phase III PBT RCTs (TORPEdO, PARABLE and APPROACH), will compare PBT with photon radiotherapy for oropharyngeal squamous cell carcinoma, breast cancer and oligodendroglioma, respectively. All three studies were designed by multidisciplinary teams, which combined expertise from clinicians, clinical trialists and scientists with strong patient advocacy and guidance from national radiotherapy research networks and international collaborators. Consistent across all three studies is a focus on the reduction of long-term radiotherapy-related toxicities and an evaluation of patient-reported outcomes and health-related quality of life, which will address key uncertainties regarding the clinical benefits of PBT. Innovative translational components will provide insights into mechanisms of toxicity and help to frame the key future research questions regarding PBT. The UK radiotherapy research community is developing and delivering an internationally impactful PBT research portfolio. The combination of data from RCTs with prospectively collected data from a national PBT outcomes registry will provide an innovative, high-quality repository for PBT research and the platform to design and deliver future trials of PBT.

Similar long-term swallowing outcomes for accelerated, mildly-hypofractionated radiotherapy compared to conventional fractionation in oropharynx cancer: a multi-centre study

BACKGROUND AND PURPOSE

There is renewed interest in hypofractionated radiotherapy, but limited data and a lack of consensus to support use for head and neck cancer. In this multicentre analysis we compared outcomes for patients with oropharynx squamous cell carcinoma (OPSCC) treated with conventional and accelerated, mildly hypofractionated radiotherapy without chemotherapy.

MATERIALS AND METHODS

A multi-centre, observational study of consecutive OPSCCs treated between 2015 and 2018. Patients underwent curative-intent radiotherapy (oropharynx and bilateral neck) using conventionally fractionated (70 Gy in 35 fractions over 7 weeks, n = 97) or accelerated, mildly hypofractionated (65-66 Gy in 30 fractions over 6 weeks, n = 136) radiotherapy without chemotherapy. Locoregional control (LRC) and overall survival (OS) were compared. Patients alive and cancer-free at a minimum of 2 years post-radiotherapy (n = 151, 65%) were sent an MD Anderson Dysphagia Inventory (MDADI) questionnaire to assess swallow function.

RESULTS

LRC and OS were similar across schedules (p = 0.78 and 0.95 respectively, log-rank test). Enteral feeding rates during radiotherapy appeared higher in the 7-week group though this did not reach statistical significance (59% vs 48%, p = 0.08). Feeding rates were similar at 1 year post radiotherapy for both groups (10% vs 6%, p = 0.27). 107 patients returned MDADI questionnaires (71%); there were no differences between the 6- and 7-week groups for median global (60.0 vs 60.0, p = 0.99) and composite (65.8 vs 64.2, p = 0.44) MDADI scores.

CONCLUSION

Patients with OPSCC treated with radiotherapy alone have similar swallowing outcomes, LRC and OS following accelerated, mild hypofractionation and standard fractionation schedules, supporting its use as a standard-of-care option for patients unsuitable for concurrent chemotherapy.

Study into the spread of heat from thermo-optic silicon photonic elements

Phase modulators based upon the thermo-optic effect are used widely in silicon photonics for low speed applications such as switching and tuning. The dissipation of the heat produced to drive the device to the surrounding silicon is a concern as it can dictate how compact and tightly packed components can be without concerns over thermal crosstalk. In this paper we study through modelling and experiment, on various silicon on insulator photonic platforms, how close waveguides can be placed together without significant thermal crosstalk from adjacent devices.

Integration of low loss vertical slot waveguides on SOI photonic platforms for high efficiency carrier accumulation modulators

Silicon accumulation type modulators offer prospects of high power efficiency, large bandwidth and high voltage phase linearity making them promising candidates for a number of advanced electro-optic applications. A significant challenge in the realisation of such a modulator is the fabrication of the passive waveguide structure which requires a thin dielectric layer to be positioned within the waveguide, i.e. slotted waveguides. Simultaneously, the fabricated slotted waveguide should be integrated with conventional rib waveguides with negligible optical transition losses. Here, successful integration of polysilicon and silicon slot waveguides enabling a low propagation loss 0.4-1.2 dB/mm together with an ultra-small optical mode conversion loss 0.04 dB between rib and slot waveguides is demonstrated. These fabricated slot waveguide with dielectric thermal SiO₂ layer thicknesses around 6 nm, 8 nm and 10 nm have been characterized under transmission electron microscopy allowing for strong carrier accumulation effects for MOS-capacitor electro-optic modulators.

Nonconservative Coupling in a Passive Silicon Microring Resonator

The authors report on nonconservative coupling in a passive silicon microring between its clockwise and counterclockwise resonance modes. The coupling coefficient is adjustable using a thermo-optic phase shifter. The resulting resonance of the supermodes due to nonconservative coupling is predicted in theory and demonstrated in experiments. This Letter paves the way for fundamental studies of on-chip lasers and quantum photonics, and their potential applications.

Ultra-sharp asymmetric Fano-like resonance spectrum on Si photonic platform

In this paper, we report the generation of an ultra-sharp asymmetric resonance spectrum through Fano-like interference. This generation is accomplished by weakly coupling a high-quality factor (Q factor) Fabry-Pérot (FP) cavity and a low-Q factor FP cavity through evanescent waves. The high-Q FP cavity is formed by Sagnac loop mirrors, whilst the low-Q one is built by partially transmitting Sagnac loop reflectors. The working principle has been analytically established and numerically modelled by using temporal coupled-mode-theory (CMT), and verified using a prototype device fabricated on the 340 nm silicon-on-insulator (SOI) platform, patterned by deep ultraviolet (DUV) lithography. Pronounced asymmetric resonances with slopes up to 0.77 dB/pm have been successfully measured, which, to the best of our knowledge, is higher than the results reported in state-of-the-art devices in on-chip integrated Si photonic studies. The established theoretical analysis method can provide excellent design guidelines for devices with Fano-like resonances. The design principle can be applied to ultra-sensitive sensing, ultra-high extinction ratio switching, and more applications.

Silicon-on-insulator free-carrier injection modulators for the mid-infrared

Experimental demonstrations of silicon-on-insulator waveguide-based free-carrier effect modulators operating at 3.8 μm are presented. PIN diodes are used to inject carriers into the waveguides, and are configured to (a) use free-carrier electroabsorption to create a variable optical attenuator with 34 dB modulation depth and (b) use free-carrier electrorefraction with the PIN diodes acting as phase shifters in a Mach-Zehnder interferometer, achieving a V_πL_π of 0.052  V·mm and a DC modulation depth of 22 dB. Modulation is demonstrated at data rates up to 125 Mbit/s.

Single cell dielectrophoresis study of apoptosis progression induced by controlled starvation

Nutrient depletion in fed-batch cultures and at the end of batch cultures is among the main causes of stress on cells and a trigger of apoptosis. In this study, we investigated changes in the cytoplasm conductivity of Chinese hamster ovary (CHO) cells under controlled starvation. Employing a single-cell dielectrophoresis (DEP) cytometer, we measured the DEP response of CHO cells incubated in a medium without glucose and glutamine over a 48-h period. Using the measured data in conjunction with numerical simulations, we determined the cytoplasm conductivity of viable and apoptotic cell subpopulations. The results show that a small subpopulation of apoptotic cells emerges after 24 to 36 h of starvation and increases rapidly over a short period of time, <12 h. The apoptotic cells have a dramatically lower cytoplasm conductivity, ∼0.05 S/m, than viable cells, ∼0.45 S/m. Viability of starvation cultures was measured by fluorescent cytometry, DEP cytometry, and trypan blue exclusion assays. DEP, Annexin V, caspase-8, and 7-AAD assays show a similar decline in viability after 36 h of starvation and indicate a very low viability after 48 h. Trypan blue exclusion assay fails to detect early-stage viability decline and estimates a much higher viability after 48 h.

49.6 Gb/s direct detection DMT transmission over 40 km single mode fibre using an electrically packaged silicon photonic modulator

We present the characterization of a silicon Mach-Zehnder modulator with electrical packaging and show that it exhibits a large third-order intermodulation spurious-free dynamic range (> 100 dB Hz^2/3). This characteristic renders the modulator particularly suitable for the generation of high spectral efficiency discrete multi-tone signals and we experimentally demonstrate a single-channel, direct detection transmission system operating at 49.6 Gb/s, exhibiting a baseband spectral efficiency of 5 b/s/Hz. Successful transmission is demonstrated over various lengths of single mode fibre up to 40 km, without the need of any amplification or dispersion compensation.

Differential Ring Oscillator Based Capacitance Sensor for Microfluidic Applications

A simple high frequency capacitance sensor with 180 aF sensitivity is designed for a wide range of microfluidic applications. The sensor is implemented utilizing differential ring oscillators operating at [Formula: see text] MHz with a differential signal at [Formula: see text] MHz. The sensor occupies [Formula: see text] cm × 2 cm on a printed circuit board. The sensor is tuned using two precision variable capacitors and has a full scale range of [Formula: see text] pF. The sensor was able to detect less than 1% Isopropyl Alcohol in DI water and to detect 15 μm polystyrene spheres flowing over 25 μm lines and spaces coplanar electrodes in a microfluidic channel. The compact differential ring oscillator based architecture of the design makes it suitable to be integrated into microprocessor based systems for detection in Lab on Chip or Lab on Board applications.

Dielectrophoresis study of temporal change in internal conductivity of single CHO cells after electroporation by pulsed electric fields

Applying sufficiently strong pulsed electric fields to a cell can permeabilize the membrane and subsequently affect its dielectric properties. In this study, we employ a microfluidic dielectrophoresis cytometry technique to simultaneously electroporate and measure the time-dependent dielectric response of single Chinese hamster ovary cells. Using experimental measurements along with numerical simulations, we present quantitative results for the changes in the cytoplasm conductivity of single cells within seconds after exposure to 100 μs duration pulsed electric fields with various intensities. It is shown that, for electroporation in a medium with conductivity lower than that of the cell's cytoplasm, the internal conductivity of the cell decreases after the electroporation on a time scale of seconds and stronger pulses cause a larger and more rapid decrease. We also observe that, after the electroporation, the cell's internal conductivity is constrained to a threshold. This implies that the cell prevents some of the ions in its cytoplasm from diffusing through the created pores to the external medium. The temporal change in the dielectric response of each individual cell is continuously monitored over minutes after exposure to pulsed electric fields. A time constant associated with the cell's internal conductivity change is observed, which ranges from seconds to tens of seconds depending on the applied pulse intensity. This experimental observation supports the results of numerical models reported in the literature.

Dielectric model for Chinese hamster ovary cells obtained by dielectrophoresis cytometry

We present a dielectric model and its parameters for Chinese hamster ovary (CHO) cells based on a double-shell structure which includes the cell membrane, cytoplasm, nuclear envelope, and nucleoplasm. Employing a dielectrophoresis (DEP) based technique and a microfluidic system, the DEP response of many single CHO cells is measured and the spectrum of the Clausius-Mossotti factor is obtained. The dielectric parameters of the model are then extracted by curve-fitting to the measured spectral data. Using this approach over the 0.6-10 MHz frequency range, we report the values for CHO cells' membrane permittivity, membrane thickness, cytoplasm conductivity, nuclear envelope permittivity, and nucleoplasm conductivity. The size of the cell and its nuclei are obtained using optical techniques.

Monitoring the dielectric response of single cells following mitochondrial adenosine triphosphate synthase inhibition by oligomycin using a dielectrophoretic cytometer

One of the main uses of adenosine triphosphate (ATP) within mammalian cells is powering the Na(+)/K(+) ATPase pumps used to maintain ion concentrations within the cell. Since ion concentrations determine the cytoplasm conductivity, ATP concentration is expected to play a key role in controlling the cytoplasm conductivity. The two major ATP production pathways within cells are via glycolysis within the cytoplasm and via the electron transport chain within the mitochondria. In this work, a differential detector combined with dielectrophoretic (DEP) translation in a microfluidic channel was employed to observe single cell changes in the cytoplasm conductivity. The DEP response was made sensitive to changes in cytoplasm conductivity by measuring DEP response versus media conductivity and using double shell models to choose appropriate frequencies and media conductivity. Dielectric response of Chinese hamster ovary (CHO) cells was monitored following inhibition of the mitochondria ATP production by treatment with oligomycin. We show that in CHO cells following exposure to oligomycin (8 μg/ml) the cytoplasm conductivity drops, with the majority of the change occurring within 50 min. This work demonstrates that dielectric effects due to changes in ATP production can be observed at the single cell level.

Optical detection and modulation at 2µm-2.5µm in silicon

Recently the 2μm wavelength region has emerged as an exciting prospect for the next generation of telecommunications. In this paper we experimentally characterise silicon based plasma dispersion effect optical modulation and defect based photodetection in the 2-2.5μm wavelength range. It is shown that the effectiveness of the plasma dispersion effect is dramatically increased in this wavelength window as compared to the traditional telecommunications wavelengths of 1.3μm and 1.55μm. Experimental results from the defect based photodetectors show that detection is achieved in the 2-2.5μm wavelength range, however the responsivity is reduced as the wavelength is increased away from 1.55μm.

Mid-infrared wavelength division (de)multiplexer using an interleaved angled multimode interferometer on the silicon-on-insulator platform

A low-cost and high-performance wavelength division (de)multiplexing structure in the mid-IR wavelength range is demonstrated on the silicon-on-insulator platform using an interleaved angled multimode interferometer (AMMI). As compared to a single AMMI, the channel count was doubled and the channel spacing halved with negligible extra insertion loss and crosstalk and with only a slight increase in device footprint. The device requires only single lithography and etching steps for fabrication. Potential is also shown for achieving improved performance with further optimized design.

Planar surface implanted diffractive grating couplers in SOI

Grating couplers are used to efficiently couple light from an optical fibre to a silicon waveguide as they allow light to be coupled into or out from any location on the device without the need for cleaving. However, using the typical surface relief grating fabrication method reduces surface planarity and hence makes further processing more difficult. The ability to manufacture high quality material layers on top of a grating coupler allows multiple active optical layers to be realized for multi-layer integrated optical circuits, and may enable monolithic integration of optical and electronic circuits on separate layers. Furthermore, the nature of the refractive index change may enable removal via rapid thermal annealing for wafer scale testing applications. We demonstrate for the first time a coupling device utilising a refractive index change introduced by lattice disorder. Simulations show 44% of the power can be extracted from the waveguide by using uniform implanted gratings, which is not dissimilar to the performance of typical uniform surface relief gratings currently used. Losses determined empirically, of 5.5 dB per coupler have been demonstrated.

Differential electronic detector to monitor apoptosis using dielectrophoresis-induced translation of flowing cells (dielectrophoresis cytometry)

The instrument described here is an all-electronic dielectrophoresis (DEP) cytometer sensitive to changes in polarizability of single cells. The important novel feature of this work is the differential electrode array that allows independent detection and actuation of single cells within a short section ([Formula: see text]) of the microfluidic channel. DEP actuation modifies the altitude of the cells flowing between two altitude detection sites in proportion to cell polarizability; changes in altitude smaller than 0.25 μm can be detected electronically. Analysis of individual experimental signatures allows us to make a simple connection between the Clausius-Mossotti factor (CMF) and the amount of vertical cell deflection during actuation. This results in an all-electronic, label-free differential detector that monitors changes in physiological properties of the living cells and can be fully automated and miniaturized in order to be used in various online and offline probes and point-of-care medical applications. High sensitivity of the DEP cytometer facilitates observations of delicate changes in cell polarization that occur at the onset of apoptosis. We illustrate the application of this concept on a population of Chinese hamster ovary (CHO) cells that were followed in their rapid transition from a healthy viable to an early apoptotic state. DEP cytometer viability estimates closely match an Annexin V assay (an early apoptosis marker) on the same population of cells.

High-contrast 40 Gb/s operation of a 500 μm long silicon carrier-depletion slow wave modulator

In this Letter, we demonstrate a highly efficient, compact, high-contrast and low-loss silicon slow wave modulator based on a traveling-wave Mach-Zehnder interferometer with two 500 μm long slow wave phase shifters. 40  Gb/s operation with 6.6 dB extinction ratio at quadrature and with an on-chip insertion loss of only 6 dB is shown. These results confirm the benefits of slow light as a means to enhance the performance of silicon modulators based on the plasma dispersion effect.

Electronic detection of dielectrophoretic forces exerted on particles flowing over interdigitated electrodes

Dielectric particles flowing through a microfluidic channel over a set of coplanar electrodes can be simultaneously capacitively detected and dielectrophoretically (DEP) actuated when the high (1.45 GHz) and low (100 kHz-20 MHz) frequency electromagnetic fields are concurrently applied through the same set of electrodes. Assuming a simple model in which the only forces acting upon the particles are apparent gravity, hydrodynamic lift, DEP force, and fluid drag, actuated particle trajectories can be obtained as numerical solutions of the equations of motion. Numerically calculated changes of particle elevations resulting from the actuation simulated in this way agree with the corresponding elevation changes estimated from the electronic signatures generated by the experimentally actuated particles. This verifies the model and confirms the correlation between the DEP force and the electronic signature profile. It follows that the electronic signatures can be used to quantify the actuation that the dielectric particle experiences as it traverses the electrode region. Using this principle, particles with different dielectric properties can be effectively identified based exclusively on their signature profile. This approach was used to differentiate viable from non-viable yeast cells (Saccharomyces cerevisiae).

High-resolution imaging of gigahertz polarization response arising from the interference of reflected surface acoustic waves

The surface polarization caused by traveling SAWs at 1.585 GHz has been imaged using a dynamic homodyne electrostatic force microscope technique. Instead of measuring topographic changes caused by the SAW, the reported technique measures polarization in the piezoelectric substrate arising from mechanical stress caused by the SAW. The polarization associated with this stress field modulates the scanning probe cantilever deflection amplitude, which is extracted using a lock-in-based technique. High-resolution imaging is presented with images of the interference arising from a metal reflector on a SAW device. A mathematical model combining SAW generation and force interactions between the probe and the substrate was used to verify the experimental data. In addition to overcoming the challenge associated with detecting and imaging polarization effects at gigahertz frequencies, this imaging technique will greatly assist the development of SAW-based devices that exploit the reflection and interference of SAWs in areas as diverse as microfluidic mixing, cell sorting, and quantum entanglement.

Silicon slow-light-based photonic mixer for microwave-frequency conversion applications

We describe and demonstrate experimentally a method for photonic mixing of microwave signals by using a silicon electro-optical Mach-Zehnder modulator enhanced via slow-light propagation. Slow light with a group index of ~11, achieved in a one-dimensional periodic structure, is exploited to improve the upconversion performance of an input frequency signal from 1 to 10.25 GHz. A minimum transmission point is used to successfully demonstrate the upconversion with very low conversion losses of ~7 dB and excellent quality of the received I/Q modulated QPSK signal with an optimum EVM of ~8%.

Fabrication and optimization of a conducting polymer sensor array using stored grain model volatiles

During storage, grain can experience significant degradation in quality due to a variety of physical, chemical, and biological interactions. Most commonly, these losses are associated with insects or fungi. Continuous monitoring and an ability to differentiate between sources of spoilage are critical for rapid and effective intervention to minimize deterioration or losses. Therefore, there is a keen interest in developing a straightforward, cost-effective, and efficient method for monitoring of stored grain. Sensor arrays are currently used for classifying liquors, perfumes, and the quality of food products by mimicking the mammalian olfactory system. The use of this technology for monitoring of stored grain and identification of the source of spoilage is a new application, which has the potential for broad impact. The main focus of the work described herein is on the fabrication and optimization of a carbon black (CB) polymer sensor array to monitor stored grain model volatiles associated with insect secretions (benzene derivatives) and fungi (aliphatic hydrocarbon derivatives). Various methods of statistical analysis (RSD, PCA, LDA, t test) were used to select polymers for the array that were optimum for distinguishing between important compound classes (quinones, alcohols) and to minimize the sensitivity for other parameters such as humidity. The performance of the developed sensor array was satisfactory to demonstrate identification and separation of stored grain model volatiles at ambient conditions.

High speed silicon electro-optical modulators enhanced via slow light propagation

While current optical communication networks efficiently carry and process huge amounts of digital information over large and medium distances, silicon photonics technology has the capacity to meet the ceaselessly increasing demand for bandwidth via energy efficient, inexpensive and mass producible short range optical interconnects. In this context, handling electrical-to-optical data conversion through compact and high speed electro-optical modulators is of paramount importance. To tackle these challenges, we combine the attractive properties of slow light propagation in a nanostructured periodic waveguide together with a high speed semiconductor pn diode, and demonstrate a highly efficient and mass manufacturable 500 µm-long silicon electro-optical device, exhibiting error free modulation up to 20 Gbit/s. These results, supported by modulation rate capabilities reaching 40 Gbit/s, pave a foreseeable way towards dense, low power and ultra fast integrated networks-on-chip for future chip-scale high performance computing systems.

Dielectric response of particles in flowing media: the effect of shear-induced rotation on the variation in particle polarizability

When particles in liquid suspensions flow through channels and pipes in a laminar fashion, the resulting parabolic velocity profile gives rise to shear, which induces the particles to rotate. If flowing suspensions containing dielectric particles are immersed in an external electric field, the anisotropic polarization induced in rotating nonspherical particles will vary with the orientation of the particle with respect to the external field; what results is an uncertainty in experimental measurements that involve particle polarization. The present study establishes the limits of this uncertainty and shows that departure from spherical symmetry in individual particles can lead to a significant overlap in measurements attempting to discriminate between particle subpopulations in suspensions. For example, the uncertainty in signal amplitude for a population of activated T-lymphocytes can be as high as 20%. Such concerns arise in applications like field-flow fractionation, dielectrophoretic sorting of particles, flow impedance measurements and cytometry, and, most recently, isodielectric separation, all of which are used to separate particles in a flow based on their dielectric response. This paper considers axisymmetric particles as the first departure from the approximation of spherical symmetry, shows how to calculate an estimate of the size of the population overlap, and suggests possible strategies to minimize it.

40 Gb/s silicon photonics modulator for TE and TM polarisations

A key device in future high speed short reach interconnect technology will be the optical modulator. These devices, in silicon, have experienced dramatic improvements over the last 6 years and the modulation bandwidth has increased from a few tens of MHz to over 30 GHz. However, the demands of optical interconnects are significant. Here we describe an approach based on a self-aligned wrap around p-n junction structure embedded in a silicon waveguide that can produce high-speed optical phase modulation, whilst at the same time, capable of a high extinction ratio. An all-silicon optical modulator using a CMOS compatible fabrication process with a data rate of 40 Gb/s and extinction ratio up to approximately 6.5 dB for TE and TM polarisations is demonstrated. This technology is not only compatible with conventional complementary MOS (CMOS) processing, but is also intended to simplify and improve the reliability of, the fabrication process.

High contrast 40Gbit/s optical modulation in silicon

Data interconnects are on the verge of a revolution. Electrical links are increasingly being pushed to their limits with the ever increasing demand for bandwidth. Data transmission in the optical domain is a leading candidate to satisfy this need. The optical modulator is key to most applications and increasing the data rate at which it operates is important for reducing power consumption, increasing channel bandwidth limitations and improving the efficiency of infrastructure usage. In this work silicon based devices of lengths 3.5mm and 1mm operating at 40Gbit/s are demonstrated with extinction ratios of up to 10dB and 3.5dB respectively. The efficiency and optical loss of the phase shifter is 2.7V.cm and 4dB/mm (or 4.5dB/mm including waveguide loss) respectively.

Activated T lymphocytes migrate toward the cathode of DC electric fields in microfluidic devices

Immune cell migration is a fundamental process that enables immunosurveillance and immune responses. Understanding the mechanism of immune cell migration is not only of importance to the biology of cells, but also has high relevance to cell trafficking mediated physiological processes and diseases such as embryogenesis, wound healing, autoimmune diseases and cancers. In addition to the well-known chemical concentration gradient based guiding mechanism (i.e. chemotaxis), recent studies have shown that lymphocytes can respond to applied physiologically relevant direct current (DC) electric fields by migrating toward the cathode of the fields (i.e. electrotaxis) in both in vitro and in vivo settings. In the present study, we employed two microfluidic devices allowing controlled application of electric fields inside the microfluidic channel for quantitative studies of lymphocyte electrotaxis in vitro at the single cell level. The first device is fabricated by soft-lithography and the second device is made in glass with integrated on-chip electrodes. Using both devices, we for the first time showed that anti-CD3/CD28 antibodies activated human blood T cells migrate to the cathode of the applied DC electric field. This finding is consistent with previous electrotaxis studies on other lymphocyte subsets suggesting electrotaxis is a novel guiding mechanism for immune cell migration. Furthermore, the characteristics of electrotaxis and chemotaxis of activated T cells in PDMS microfluidic devices are compared.

Wireless Passive Sensor for Remote pH Monitoring

In this paper we describe a wireless passive pH sensor for high-resolution remote pH monitoring. The sensor is based on a passive LC coil resonator whose resonant frequency is monitored remotely by measuring the change in impedance of an interrogator coil coupled to the sensor coil. The sensor resonator consists of an inductive coil connected in parallel with a voltage dependent capacitor and a pH combination electrode. Change in the electrode potential in response to variations of the pH of the solution changes the capacitance, and therefore the resonant frequency of the sensor. A linear response with a 0.1 pH resolution is achieved over a 4–10 pH dynamic range. The response time of the sensor is demonstrated to be less than 30 s and is limited by the response time of the pH combination electrode. The described sensor technology is suitable for long-term remote pH monitoring in numerous fields such as biomedical sensing, environmental monitoring, industrial and chemical processing, and structural health monitoring.

High speed silicon optical modulator with self aligned fabrication process

With the imminent commercialisation of silicon photonic devices comes the requirement for a fabrication process capable of high yield and device performance repeatability. The precise alignment of the different elements of a device can be a major fabrication challenge for minimising performance variation or even device failure. In this paper a new design of high speed carrier depletion silicon optical modulator is introduced which features the use of a self-aligned fabrication process to form the pn junction. Experimental results are presented from an initial fabrication run, which has demonstrated a 6 dB modulation depth at 10 Gbit/s from a 3.5 m long device.

Field enhanced charge carrier reconfiguration in electronic and ionic coupled dynamic polymer resistive memory

Dynamic resistive memory devices based on a conjugated polymer composite (PPy(0)DBS(-)Li(+) (PPy: polypyrrole; DBS(-): dodecylbenzenesulfonate)), with field-driven ion migration, have been demonstrated. In this work the dynamics of these systems has been investigated and it has been concluded that increasing the applied field can dramatically increase the rate at which information can be 'written' into these devices. A conductance model using space charge limited current coupled with an electric field induced ion reconfiguration has been successfully utilized to interpret the experimentally observed transient conducting behaviors. The memory devices use the rising and falling transient current states for the storage of digital states. The magnitude of these transient currents is controlled by the magnitude and width of the write/read pulse. For the 500 nm length devices used in this work an increase in 'write' potential from 2.5 to 5.5 V decreased the time required to create a transient conductance state that can be converted into the digital signal by 50 times. This work suggests that the scaling of these devices will be favorable and that 'write' times for the conjugated polymer composite memory devices will decrease rapidly as ion driving fields increase with decreasing device size.

A microwave interferometric system for simultaneous actuation and detection of single biological cells

In biomedical applications ranging from the study of pathogen invasion to drug efficacy assays, there is a growing need to develop minimally invasive techniques for single-cell analysis. This has inspired researchers to develop optical, electrical, microelectromechanical and microfluidic devices for exploring phenomena at the single-cell level. In this work, we demonstrate an electrical approach for single-cell analysis wherein a 1.6 GHz microwave interferometer detects the capacitance changes (DeltaC) produced by single cells flowing past a coplanar interdigitated electrode pair. The experimental and simulated capacitance changes generated by yeast cells are in close agreement. By using the capacitance changes of uniform polystyrene spheres (diameter = 5.7 microm) for calibration purposes, we demonstrate a 0.65 aF sensitivity in a 10 ms response time. Using an RC circuit, a low frequency sinusoidal potential is simultaneously superimposed on the electrode pair to generate a dielectrophoretic force that translates cells. Specifically, when yeast cells suspended in a solution of 90 ppm NaCl in deionized water are exposed to 10 kHz and 3 MHz potentials (ranging from 1-3 V(pp)), they experience negative and positive dielectrophoresis, respectively. The corresponding changes in cell elevation above the interdigitated electrodes are detected using the asymmetry of the capacitance signature produced by the cell. Cell elevation changes can be detected in less than 80 ms. The minimum detectable change in elevation is estimated to be 0.22 microm. This approach will have applications in rapid single-cell dielectrophoretic analysis, and may also prove useful in conjunction with impedance spectroscopy.

Comment on "Fundamentals of pair diffusion in kinematic simulations of turbulence"

Osborne et al [Phys. Rev. E 74, 036309 (2006)] suggested that our conclusions on the ability of kinematic simulation to represent the t(3) Richardson law [Thomson and Devenish, J. Fluid Mech. 526, 277 (2005)] were an artifact of our choice of time step. Here we repeat some of the simulations with a small fixed time step, enabling us to confirm that our previous study was not compromised by the variable time step used.

Microwave frequency sensor for detection of biological cells in microfluidic channels

We present details of an apparatus for capacitive detection of biomaterials in microfluidic channels operating at microwave frequencies where dielectric effects due to interfacial polarization are minimal. A circuit model is presented, which can be used to adapt this detection system for use in other microfluidic applications and to identify ones where it would not be suitable. The detection system is based on a microwave coupled transmission line resonator integrated into an interferometer. At 1.5 GHz the system is capable of detecting changes in capacitance of 650 zF with a 50 Hz bandwidth. This system is well suited to the detection of biomaterials in a variety of suspending fluids, including phosphate-buffered saline. Applications involving both model particles (polystyrene microspheres) and living cells-baker's yeast (Saccharomyces cerevisiae) and Chinese hamster ovary cells-are presented.

Free carrier lifetime modification for silicon waveguide based devices

We investigate the effect of silicon ion irradiation on free carrier lifetime in silicon waveguides, and thus its ability to reduce the density of two-photon-absorption (TPA) generated free carriers. Our experimental results show that free carrier lifetime can be reduced significantly by silicon ion implantation. Associated excess optical absorption from the implanted ions can be reduced to an acceptable level if irradiation energy and dose are correctly chosen. Simulations of Raman scattering suggest that net gain can be achieved in certain cases without the need for an integrated diode in reverse bias to remove the photo-generated free carriers.

Microfluidic electromanipulation with capacitive detection for the mechanical analysis of cells

The mechanical behavior of cells offers insight into many aspects of their properties. We propose an approach to the mechanical analysis of cells that uses a combination of electromanipulation for stimulus and capacitance for sensing. To demonstrate this approach, polystyrene spheres and yeast cells flowing in a 25 mumx100 mum microfluidic channel were detected by a perpendicular pair of gold thin film electrodes in the channel, spaced 25 mum apart. The presence of cells was detected by capacitance changes between the gold electrodes. The capacitance sensor was a resonant coaxial radio frequency cavity (2.3 GHz) coupled to the electrodes. The presence of yeast cells (Saccharomyces cerevisiae) and polystyrene spheres resulted in capacitance changes of approximately 10 and 100 attoFarad (aF), respectively, with an achieved capacitance resolution of less than 2 aF in a 30 Hz bandwidth. The resolution is better than previously reported in the literature, and the capacitance changes are in agreement with values estimated by finite element simulations. Yeast cells were trapped using dielectrophoretic forces by applying a 3 V signal at 1 MHz between the electrodes. After trapping, the cells were displaced using amplitude and frequency modulated voltages to produce modulated dielectrophoretic forces. Repetitive displacement and relaxation of these cells was observed using both capacitance and video microscopy.

Optical fiber refractometer using narrowband cladding-mode resonance shifts

Short-period fiber Bragg gratings with weakly tilted grating planes generate multiple strong resonances in transmission. Our experimental results show that the wavelength separation between selected resonances allows the measurement of the refractive index of the medium surrounding the fiber for values between 1.25 and 1.44 with an accuracy approaching 1x10(-4). The sensor element is 10 mm long and made from standard single-mode telecommunication grade optical fiber by ultraviolet light irradiation through a phase mask.

Expression of Bcl-x, Bcl-2, Bax, and Bak in endarterectomy and atherectomy specimens

The regulation of apoptosis in atherosclerosis is not completely defined. The aim of this study was to determine the expression of Bcl-2, Bcl-x, Bax, and Bak in relation to apoptosis in advanced atherosclerotic lesions. In atherectomy (15), endarterectomy (10), and control non-atherosclerotic segments of renal (2) and of coronary and carotid (5) arteries, the extent of apoptosis was determined using TdT dUTP nick end labelling (TUNEL) and nuclear morphology (karyorrhexis/pyknosis) and expression of apoptosis regulators by immunohistochemistry and western blot analysis on paraffin-embedded material. In all specimens, the atherosclerotic involvement was advanced: grade V (n=18) and grade VI (n=7). The apoptotic index was high (mean 30%) in advanced lesions compared with controls (<2%) and smooth muscle cells (SMCs) were the predominant cell type undergoing apoptosis. In all TUNEL-positive apoptotic cells, Bax and Bak were present, while Bcl-x was absent. Bcl-2 was absent in a majority of these cells, but occasional TUNEL-positive cells expressed Bcl-2. In non-apoptotic cells, Bcl-x was present and western blot detected only the long isoform, Bcl-xL, from the plaques. In conclusion, increased Bax and Bak coupled with lack/paucity of Bcl-2 and Bcl-xL are associated with SMC apoptosis in advanced lesions. Bcl-xL in non-apoptotic cells appears to contribute to prolonged cell survival.

Medtronic Mosaic porcine bioprosthesis: midterm investigational trial results

BACKGROUND

The midterm clinical and hemodynamic performance of the Medtronic Mosaic porcine bioprosthesis was evaluated in a regulatory trial.

METHODS

In nine Canadian centers, 802 bioprostheses (560 aortic and 242 mitral) were implanted between September 1994 and April 1999 in patients with a mean age of 70 years.

RESULTS

Survival for aortic valve replacement at 4 years was 84.4%+/-3.1%. Freedom from valve-related or unexplained death was 95.6%+/-1.9%; structural valve deterioration, 100.0%; reoperation, 96.2%+/-1.7%; major thromboembolism, 96.1%+/-1.8%; and major antithrombotic-related hemorrhage, 96.4%+/-1.7%. Echocardiographic derived mean systolic gradient was 13.4 mm Hg at 4 years with an indexed effective orifice area of 0.7 to 0.8 cm2/m2. A significant decrease in left ventricular mass was shown over time in all valve sizes. Survival for mitral valve replacement at 4 years was 79.2%+/-6.8%. Freedom from valve-related or unexplained death was 96.5%+/-3.4%; structural valve deterioration, 100%; reoperation, 97.0%+/-3.2%; major thromboembolism, 95.7%+/-3.8%; and major antithrombotic-related hemorrhage, 95.0%+/-4.2%. Echocardiographically measured averaged mean diastolic gradient was 4.5 mm Hg.

CONCLUSIONS

The Medtronic Mosaic bioprosthesis is safe and effective in both the aortic and mitral positions. The valve has low gradients in both positions and excellent left ventricular mass regression in the patients with aortic valve replacement.

Impedance-matched absorbers for finite-difference parabolic equation algorithms

In this paper, a perfectly matched layer (PML) absorber, recently introduced into the electromagnetic propagation literature by Berenger [J. Comput. Phys. 114, 185-200 (1994)], is adapted for use with both paraxial and wide-angle acoustic parabolic equations (PEs). Our procedure incorporates an imaginary component into the transverse coordinate that mimics the introduction of a fictitious absorber on the edge of the computational grid. Use of such an impedance-matched layer can significantly reduce spurious reflections compared to physical absorbing layer methods and thus allows a smaller number of boundary points to be employed in PE calculations. Numerical results obtained with several higher-order propagator approximations confirm that such impedance-matched absorbers efficiently eliminate reflections.

Medtronic mosaic porcine bioprosthesis satisfactory early clinical performance

BACKGROUND

The Medtronic (Minneapolis, MN) Mosaic porcine bioprosthesis is an investigational prosthesis which incorporates zero-pressure fixation, aortic root predilation, low profile stent, and alpha oleic acid antimineralization treatment.

METHODS

From September 1994 to August 1996, 289 patients (mean age 70 years, range, 28 to 88 years) had 227 (78.5%) aortic valve replacements and 62 (21.5%) mitral valve replacements. Concomitant procedures were performed in 61.2% (139) of aortic valve replacements and 54.8% (34) of mitral valve replacements. Of the aortic valve replacement group 70 (30.8%) were in the 61 to 70 age group and 134 (59.0%) were 71 years or older. Of the mitral valve replacements, 23 (37.1%) were 61 to 70 years and 30 (48.4%) 71 years or older.

RESULTS

The early mortality, overall, was 4.2% (12 of 289); for aortic valve replacement it was 4.0% (9) and for mitral valve replacement it was 4.8% (3). The late mortality for aortic valve replacement was 2.6% per patient-year (3 events, 1.3% of total) and for mitral valve replacement it was 3.3% per patient-year (one event, 1.6% of total). The reoperative rate for aortic valve replacement was 3.0% per patient-year (4), while there were no mitral valve replacement reoperations. The freedom from major thromboembolism was 97.3%+/-1.6% for aortic valve replacement and 94.7%+/-3.0% for mitral valve replacement at 1 to 1.5 years. The freedom from reoperation was 96.7%+/-1.7% for aortic valve replacement; there was no reoperation for mitral valve replacement. There were no cases of structural valve deterioration. In the aortic position the mean systolic gradient was low, approximately 11 mm Hg, across all sizes (range 8 to 12 mm Hg at 3 months and 10 to 13 mm Hg at 12 months). In the mitral position the mean diastolic gradient was approximately 5 mm Hg (range, 2 to 6 mm Hg) for all sizes 25 to 31 mm at the early and 1 year follow-up echocardiographic assessment.

CONCLUSIONS

The early clinical performance and in vivo hemodynamics are encouraging.

High-resolution zero-dispersion wavelength mapping in single-mode fiber

We present a new noninvasive technique for measuring the spatial variation of the zero-dispersion wavelength (lambda(0)) in single-mode fibers. This technique uses low-power continuous-wave lasers and is simple to implement. When applying this technique to dispersion-shifted fibers, we can resolve subnanometer fluctuations in lambda(0) with a potential spatial resolution of better than 100 m. We also discuss and show the limits of this and other techniques that arise from polarization-mode dispersion in the fibers.

Dependence of global temperatures on atmospheric CO2 and solar irradiance

Changes in global average temperatures and of the seasonal cycle are strongly coupled to the concentration of atmospheric CO2. I estimate transfer functions from changes in atmospheric CO2 and from changes in solar irradiance to hemispheric temperatures that have been corrected for the effects of precession. They show that changes from CO2 over the last century are about three times larger than those from changes in solar irradiance. The increase in global average temperature during the last century is at least 20 times the SD of the residual temperature series left when the effects of CO2 and changes in solar irradiance are subtracted.

Deep hypothermic low flow cardiopulmonary bypass in small dogs

OBJECTIVE

To evaluate the feasibility of and morbidity and mortality associated with cardiopulmonary bypass (CPB) using deep hypothermia and low flow perfusion in adult dogs weighing less than 10 kg.

STUDY DESIGN

Prospective, descriptive study.

ANIMALS

Two groups of three dogs underwent CPB. Group 1 dogs underwent deep hypothermia (15 to 18 degrees C), 45 minutes of low perfusion flow (20 mL/kg/min) and 1 hour of aortic cross clamp time. In group 2, ultrafiltration of perfusate before discontinuation of bypass was added to the standard treatment. Complete blood counts, serum biochemistry, urine output, ejection fraction, and cardiac output were monitored before and for 7 days after surgery.

RESULTS

All dogs were successfully weaned from bypass. Four of six dogs survived, three without major complications. One dog developed and recovered from septic pleuritis. Two dogs died or were euthanatized after surgery because of respiratory or gastrointestinal complications. Minor complications included anemia, hypoproteinemia, and electrolyte disturbances. Transfusion requirements and edema formation were reduced by ultrafiltration.

CONCLUSIONS

The observations in this study support the feasibility of low flow hypothermic CPB. Meticulous tissue handling, precise equipment, ultrafiltration, and aggressive postoperative potassium supplementation are recommended for smaller patients.

CLINICAL RELEVANCE

Increased sensitivity to adverse sequelae of CPB may be associated with small patient size. Further evaluation is necessary before routine clinical application of low flow hypothermic CPB in this patient population.