Experimental certification of contextuality, coherence, and dimension in a programmable universal photonic processor.

Quantum superposition of high-dimensional states enables both computational speed-up and security in cryptographic protocols. However, the exponential complexity of tomographic processes makes certification of these properties a challenging task. In this work, we experimentally certify coherence witnesses tailored for quantum systems of increasing dimension using pairwise overlap measurements enabled by a six-mode universal photonic processor fabricated with a femtosecond laser writing technology. In particular, we show the effectiveness of the proposed coherence and dimension witnesses for qudits of dimensions up to 5. We also demonstrate advantage in a quantum interrogation task and show it is fueled by quantum contextuality. Our experimental results testify to the efficiency of this approach for the certification of quantum properties in programmable integrated photonic platforms.

Safety and effectiveness of prilocaine for spinal anesthesia in day surgery setting: a retrospective study on a sample of 3291 patients.

Spinal anesthesia is considered safe and reliable for most surgical procedures involving the lower part of the body, but its use in the ambulatory setting requires drugs with rapid onset and regression of the motor and sensory block-like prilocaine.The purpose of this study is to retrospectively analyze data from 3291 procedures recorded in our institutional database, to better define the safety profile of spinal prilocaine and the incidence of complications and side effects.All clinical data, prospectively collected from 2011 to 2019 in an Italian tertiary hospital, of patients treated with spinal anesthesia performed with 40 mg of hyperbaric 2% prilocaine, according to our internal protocol of day surgery, were analyzed.Surgical procedures included saphenectomy (28.5%, n = 937), knee arthroscopy (26.8%, n = 882), proctologic surgery (15.16%, n = 499), and inguinal canal surgery (14.9%, n = 491).Anesthesia-related complication was represented by urinary retention (1.09%, n = 36), lipotimia (0.75%, n = 25), and postoperative nausea (0.33%, n = 11); arrhythmic events were uncommon (0.18%, n = 6). One case of persistent hypotension and 2 cases of persistent hypertension were reported.Persistent motor or sensory block (lasting more than 5 h) was experienced by 7 patients. One patient (0.03%), who underwent knee arthroscopy, experienced pelvic pain lasting for 6 h, compatible with a transient neurological symptom.Proctologic surgery was a factor associated with unplanned admission due to anesthesia-related complications (OR = 4.9; 95% CI: 2-14%).The number of complications related to the method was low as well as the need for hospitalization. This drug is valid and safe for the most performed day surgery procedures; however, further trials are needed to investigate the incidence of complications in the days following the procedure.

Inadvertent intra-arterial catheterisation using ultrasound guidance and endocavitary electrocardiography in a paediatric patient.

Venous access in small infants is difficult and central venous catheter placed into the brachiocephalic vein is often the preferred approach. Ultrasound guided vein cannulation is standard practice and endocavitary electrocardiography is a reliable catheter tip location method. We report a not immediately recognised 2 month old case of inadvertent intra-arterial catheterisation with a 3 Fr - 8 cm catheter during right innominate vein cannulation under ultrasound guidance. Endocavitary electrocardiography showed an increased amplitude P wave with a low P/R wave ratio but further insertion of the catheter resulted in a reduction of the P wave amplitude. At ultrasound re-evaluation of the innominate vein, the catheter seemed to be inside the vessel into the proximal part of the vein, but distally appeared to surpass the vein to get into the brachiocephalic artery at the level of the bifurcation of the right common carotid artery and the right subclavian artery. Cardiac ultrasound from the suprasternal notch view identified the catheter into the aortic arch. Contrast-enhanced CT scan with 3D reconstruction confirmed the intra-arterial catheterisation and showed that the innominate vein was shifted and partially compressed but not transfixed by the catheter. The catheter was non-surgically removed uneventfully. During innominate vein cannulation the catheter cannot always be visualised into the distal tract of the vein and the maximal P wave may have a low P/R ratio; a chest X-ray can identify intra-arterial but false negative results are possible. We recommend always using a real time ultrasound tip navigation and location protocol, like the Neo-ECHOTIP protocol, to confirm the correct position of the guidewire and the catheter. If the catheter cannot be identified inside the venous system, we suggest systematically visualising the aortic arch from the suprasternal notch view and the aortic root from the parasternal view to identify arterial malposition.

Editorial for the Special Issue on Femtosecond Laser Micromachining for Photonics Applications.

Femtosecond laser pulses have proven, in the recent years, their formidable potential as a micromachining tool applicable to a variety of materials [...].

Resonant opto-mechanical modulators and switches by femtosecond laser micromachining.

In this work we demonstrate novel integrated-optics modulators and switches, realized in a glass substrate by femtosecond laser pulses. These devices are based on oscillating microcantilevers, machined by water-assisted laser ablation. Single-mode optical waveguides are laser-inscribed inside the cantilever beam and continue in the substrate beyond the cantilever's tip. By exciting the resonant oscillation of the mechanical structure, coupling between the waveguide segments is varied in time. Operation frequencies are in the range of tens of kilohertz, thus they markedly overcome the response-time limitation of other glass-based modulators, which rely on the thermo-optic effect. These components may be integrated in more complex waveguide circuits or optofluidic lab-on-chips, to provide periodic and high-frequency modulation of the optical signals.

Integrated Optofluidic Chip for Oscillatory Microrheology.

We propose and demonstrate an on-chip optofluidic device allowing active oscillatory microrheological measurements with sub-µL sample volume, low cost and high flexibility. Thanks to the use of this optofluidic microrheometer it is possible to measure the viscoelastic properties of complex fluids in the frequency range 0.01-10 Hz at different temperatures. The system is based on the optical forces exerted on a microbead by two counterpropagating infrared laser beams. The core elements of the optical part, integrated waveguides and an optical modulator, are fabricated by fs-laser writing on a glass substrate. The system performance is validated by measuring viscoelastic solutions of aqueous worm-like micelles composed by Cetylpyridinium Chloride (CPyCl) and Sodium Salicylate (NaSal).

Computed Tomography Angiography Combined With Knowledge-Based Iterative Algorithm for Transcatheter Aortic Valve Implantation Planning: Image Quality and Radiation Dose Exposure With Low-kV and Low-Contrast-Medium Protocol.

OBJECTIVE: To evaluate image quality and radiation dose exposure of low-kV setting and low-volume contrast medium (CM) computed tomography angiography (CTA) protocol for transcatheter aortic valve implantation (TAVI) planning in comparison with standard CTA protocol. METHODS: Sixty-patients were examined with 256-row MDCT for TAVI planning: 32 patients (study group) were evaluated using 80-kV electrocardiogram-gated protocol with 60 mL of CM and IMR reconstruction; 28 patients underwent a standard electrocardiogram-gated CTA study (100 kV; 80 mL of CM; iDose4 reconstruction). Subjective and objective image quality was evaluated in each patient at different aortic levels. Finally, we collected radiation dose exposure data (CT dose index and dose-length product) of both groups. RESULTS: In study protocol, significant higher mean attenuation values were achieved in all measurements compared with the standard protocol. There were no significant differences in the subjective image quality evaluation in both groups. Mean dose-length product of study group was 56% lower than in the control one (P < 0.0001). CONCLUSION: Low-kV and low-CM volume CTA, combined with IMR, allows to correctly performing TAVI planning with high-quality images and significant radiation dose reduction compared with standard CTA protocol.

Model observers for Low Contrast Detectability evaluation in dynamic angiography: A feasible approach.

PURPOSE: To evaluate the feasibility of spatio-temporal generalisation of mathematical methods for protocol optimisation in interventional radiology. MATERIALS AND METHODS: Two model observers were considered:Furthermore, Low Contrast Detectability (LCD) was evaluated with a generalised statistical method by taking into account the noise integration capability of the human eye. A series of two alternative force choices (2AFC) experiments performed by four observers were used to evaluate the reliability of the proposed models. The evaluation of the mathematical methods was performed by comparing their results to the human observer performances in two steps: 1. Firstly, a series of simulated images were used to tune the models 2. In the second phase, tuned models were applied both to simulated images and actual images obtained with a commercial phantom to evaluate detectability scores. RESULTS: Evaluation with simulated images shows a good agreement with 2AFC results (RMSE < 10%). Phantom-based evaluations show a general decrease of such agreement, characterized by an RMSE lower than 16%. CONCLUSIONS: The agreement with human observer experiments supports the feasibility of the proposed generalisations. Thus, they could be introduced in quality control programmes for a deeper protocol-characterisation or for clinical protocol-optimization when dynamic images are involved.

Postoperative analgesia and early functional recovery after day-case anterior cruciate ligament reconstruction: a randomized trial on local anesthetic delivery methods for continuous infusion adductor canal block.

BACKGROUND: This study assessed the effects of different local anesthetic delivery techniques for continuous adductor canal block, after arthroscopic day-case anterior cruciate ligament reconstruction (ACLR). METHODS: We enrolled 80 patients to randomly receive a ropivacaine 0.2% infusion 6 mL per hour through an adductor canal catheter by an electronic pump as follow: intermittent automatic bolus (intermittent group, N.=40) versus continuous infusion (continuous group, N.=40). Patient controlled bolus was 4 mL, lock out 20 minutes. Primary endpoint was postoperative pain by a numerical rating scale (NRS), secondary endpoints were rescue local anesthetic dose, opioid consumption, and physical performance at 72 h. A P<0.05 was considered significant. RESULTS: No difference was found between the groups in NRS, opioid consumption, and physical performance at 72 h. The intermittent group required significantly less local anesthetic than continuous group throughout the postoperative period; the median [IQR (range)] at 24 h was 149 [140-164 (140-227)] mL in the intermittent group versus 165 [147-210 (140-280)] mL in the continuous group (P=0.004). At 48 h it was 295 [284-310 (280-367)] mL in the intermittent group versus 308 [296-367 (284-500)] mL in the continuous group (P=0.002), while at 72 h it was 432 [426-450 (320-528)] mL in the intermittent group and 452 [436-487 (412-671)] mL in the continuous group respectively (P<0.001). CONCLUSIONS: Intermittent boluses did not provide superior analgesia over continuous infusion for adductor canal block after outpatient ACLR, but significantly decreased the local anesthetic consumption. Both techniques are suitable for the early functional recovery.

Experimental Investigation of Quantum Decay at Short, Intermediate, and Long Times via Integrated Photonics.

The decay of an unstable system is usually described by an exponential law. Quantum mechanics predicts strong deviations of the survival probability from the exponential: Indeed, the decay is initially quadratic, while at very large times it follows a power law, with superimposed oscillations. The latter regime is particularly elusive and difficult to observe. Here we employ arrays of single-mode optical waveguides, fabricated by femtosecond laser direct inscription, to implement quantum systems where a discrete state is coupled and can decay into a continuum. The optical modes correspond to distinct quantum states of the photon, and the temporal evolution of the quantum system is mapped into the spatial propagation coordinate. By injecting coherent light states in the fabricated photonic structures and by measuring a small scattered fraction of such light with an unprecedented dynamic range, we are able to experimentally observe not only the exponential decay regime, but also the quadratic Zeno region and the power-law decay at long evolution times.

Treatment response assessment in [18F]FDG-PET/CT oncology scans: Impact of count statistics variation and reconstruction protocol.

PURPOSE: To investigate influences of reconstruction algorithms and count statistics variation on quantification and treatment response assessment in cancer patients, by using a large field of view-FOV scanner. METHODS: 54 cancer patients underwent PET/CT scan: 1) at baseline: 1.5 min/FOV, reconstructed by ordered-subset expectation maximization + point-spread-function-OSEM-PSF and bayesian penalised-likelihood-BPL algorithm 2) at restaging: 2 min/FOV, reconstructed also at 1.5 and 1 min/FOV, using OSEM-PSF and BPL. SUL (lean-body mass SUV) peak and max were measured for each target-lesion (n = 59). Differences in quantification obtained from datasets with different reconstruction algorithms and different time/FOV were evaluated. For any pair of PET datasets, metabolic response was assessed by using SULpeak, with a threshold of 30% in variation considered as significant. RESULTS: Both at baseline and restaging, SULpeak and max values were higher in BPL reconstructions than in OSEM-PSF (p < 0.0001). SULpeak at different time/FOV reconstructions showed no statistically significant differences both with OSEM-PSF and BPL; SULmax depended on acquisition time (p < 0.05). In 56/59 lesions (95%) therapy response was concordant regardless count statistics variation and reconstruction algorithm; 2/59 (3%) showed different responses according to count statistics, both for OSEM-PSF and BPL; in 1/59 lesion (2%) response was different depending on reconstruction algorithm used. CONCLUSIONS: BPL provided higher SULpeak and max than OSEM-PSF. With a large FOV/high sensitivity scanner, variation of time/FOV in restaging PET scans gave stable and reproducible results in terms of SULpeak, both for OSEM-PSF and BPL. Thus, metabolic response defined by SULpeak variation proved to be quite independent from count statistics.

Evaluation of image quality and radiation dose saving comparing knowledge model-based iterative reconstruction on 80-kV CT pulmonary angiography (CTPA) with hybrid iterative reconstruction on 100-kV CT.

OBJECTIVES: To evaluate dose reduction and image quality of 80-kV CT pulmonary angiography (CTPA) reconstructed with knowledge model-based iterative reconstruction (IMR), and compared with 100-kV CTPA with hybrid iterative reconstruction (iDose4). MATERIALS AND METHODS: One hundred and fifty-one patients were prospectively investigated for pulmonary embolism; a study group of 76 patients underwent low-kV setting (80 kV, automated mAs) CTPA study, while a control group of 75 patients underwent standard CTPA protocol (100 kV; automated mAs); all patients were examined on 256 MDCT scanner (Philips iCTelite). Study group images were reconstructed using IMR while the control group ones with iDose4. CTDIvol, DLP, and ED were evaluated. Region of interests placed in the main pulmonary vessels evaluated vascular enhancement (HU); signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. RESULTS: Compared to iDose4-CTPA, low-kV IMR-CTPA presented lower CTDIvol (6.41 ± 0.84 vs 9.68 ± 3.5 mGy) and DLP (248.24 ± 3.2 vs 352.4 ± 3.59 mGy × cm), with ED of 3.48 ± 1.2 vs 4.93 ± 1.8 mSv. Moreover, IMR-CTPA showed higher values of attenuation (670.91 ± 9.09 HU vs 292.61 ± 15.5 HU) and a significantly higher SNR (p < 0.0001) and CNR (p < 0.0001).The subjective image quality of low-kV IMR-CTPA was also higher compared with iDose4-CTPA (p < 0.0001). CONCLUSIONS: Low-dose CTPA (80 kV and automated mAs modulation) reconstructed with IMR represents a feasible protocol for the diagnosis of pulmonary embolism in the emergency setting, achieving high image quality with low noise, and a significant dose reduction within adequate reconstruction times(≤ 120 s).

Diagnostic efficacy of model-based iterative reconstruction algorithm in an assessment of coronary artery in comparison with standard hybrid-Iterative reconstruction algorithm: dose reduction and image quality.

PURPOSE: To evaluate the image quality and radiation dose exposure of low-dose coronary CTA (cCTA) study, reconstructed with the new model-based iterative reconstruction algorithm (IMR), compared with standard hybrid-iterative reconstruction (iDose4) cCTA in patients with suspected coronary artery disease. MATERIALS AND METHODS: Ninety-eight patients with an indication for coronary CT study were prospectively enrolled. Fifty-two patients (study group) underwent 256-MDCT low-dose cCTA (80 kV; automated-mAs; 60 mL of CM, 350 mgL/mL) with prospective ECG-triggering acquisition and IMR. A control group of 46 patients underwent 256-MDCT standard prospective ECG-gated protocol (100 kV; automated-mAs; 70 mL of CM, 400 mgL/mL; iDose4). Subjective and objective image quality (attenuation value, SD, SNR and CNR) were evaluated by two radiologists subjectively. Radiation dose exposure was quantified as DLP, CTDIvol and ED. RESULTS: Mean values of mAs were significantly lower for IMR-cCTA (167 ± 62 mAs) compared to iDose-cCTA (278 ± 55 mAs), p < 0.001. With a significant reduction of 38% in radiation dose exposure (DLP: IMR-cCTA 91.7 ± 26 mGy cm vs. iDose-cCTA 148.6 ± 35 mGy cm; p value < 0.001), despite the use of different CM, we found higher mean attenuation values of the coronary arteries in IMR group compared to iDose4 (mean density in LAD: 491HU IMR-cCTA vs. 443HU iDose-cCTA; p = 0.03). We observed a significant higher value of SNR and CNR in study group due to a lower noise level. Qualitative analysis did not reveal any significant differences between the two groups (p = 0.23). CONCLUSIONS: Low-dose cCTA study combined with IMR reconstruction allows to correctly evaluate coronary arteries disease, offering high-quality images and significant radiation dose exposure reduction (38%), as compared to standard cCTA protocol.

Quantum interference of topological states of light.

Topological insulators are materials that have a gapped bulk energy spectrum but contain protected in-gap states appearing at their surface. These states exhibit remarkable properties such as unidirectional propagation and robustness to noise that offer an opportunity to improve the performance and scalability of quantum technologies. For quantum applications, it is essential that the topological states are indistinguishable. We report high-visibility quantum interference of single-photon topological states in an integrated photonic circuit. Two topological boundary states, initially at opposite edges of a coupled waveguide array, are brought into proximity, where they interfere and undergo a beamsplitter operation. We observe Hong-Ou-Mandel interference with 93.1 ± 2.8% visibility, a hallmark nonclassical effect that is at the heart of linear optics-based quantum computation. Our work shows that it is feasible to generate and control highly indistinguishable single-photon topological states, opening pathways to enhanced photonic quantum technology with topological properties, and to study quantum effects in topological materials.

Symmetric polarization-insensitive directional couplers fabricated by femtosecond laser writing.

We study analytically the polarization behaviour of directional couplers composed of birefringent waveguides, showing that they can induce polarization transformations that depend on the specific input-output path considered. On the basis of this study, we propose and demonstrate experimentally, by femtosecond laser writing, directional couplers that yield a polarization-independent power splitting and, at the same time, preserve the polarization state of the propagating light. More in detail, we devise two different approaches to realize such devices: the first one is based on local birefringence engineering by additional refractive index modification tracks, while the second one exploits ultra-low birefringence waveguides (b = 1.2 × 10-6), obtained by thermal annealing.

Motion Management in PET/CT: Technological Solutions.

BACKGROUND AND OBJECTIVE: Motion due to patient's breathing can introduce heavy bias in PET/CT, both in image quality and quantitation. This paper is a review of the main technical solutions available to manage movement in PET/CT studies: a) Respiratory Gated (RG), b) Motion Free (MF), c) End Expiration (EE), d) Banana Artefact Management (BAM) and e) Data Driven Gating (DDG). METHODS: The most diffused solutions (RG, MF and EE) are based on LIST mode acquisition of a PET Field of View (4D FOV), centered on the anatomical region of interest; to link PET data not only to time and to spatial position but also to the corresponding breathing phase, the synchronized acquisition of the patient's breathing curve is performed by an external tracking device. Different commercial tools to track and to record patient breathing cycle are available to associate the internal organ motion with a measurable external parameter; for example these systems can measure the pressure on a chest elastic belt, the air flow trough patient nose, the breath-in and breath-out air temperature or the markers movement on the thorax/ abdominal region. Recently DDG techniques are developed to correct respiratory motion without the help of external motion tracking devices and to obtain a comparable result to that based on standard RG protocols. RESULTS: The final result of an RG or DDG protocol is a sequence of 3D images showing organs and lesions movement; using the other motion management options a single 3D motion-free image is obtained without motion artefacts and degradation. Compared to the previously described options the BAM solution is not a real motion management protocol but just a Banana Artefact correction technique obtained using an Attenuation Correction Map calculated merging the Whole Body Helical CT with a Cine CT on the diaphragm area. CONCLUSION: The motion management in PET/CT imaging shows benefits in terms of image quality, quantification and lesion detectability and it is useful both in diagnostic and radiotherapy planning.

Optimal photonic indistinguishability tests in multimode networks.

Particle indistinguishability is at the heart of quantum statistics that regulates fundamental phenomena such as the electronic band structure of solids, Bose-Einstein condensation and superconductivity. Moreover, it is necessary in practical applications such as linear optical quantum computation and simulation, in particular for Boson Sampling devices. It is thus crucial to develop tools to certify genuine multiphoton interference between multiple sources. Our approach employs the total variation distance to find those transformations that minimize the error probability in discriminating the behaviors of distinguishable and indistinguishable photons. In particular, we show that so-called Sylvester interferometers are near-optimal for this task. By using Bayesian tests and inference, we numerically show that Sylvester transformations largely outperform most Haar-random unitaries in terms of sample size required. Furthermore, we experimentally demonstrate the efficacy of the transformation using an efficient 3D integrated circuits in the single- and multiple-source cases. We then discuss the extension of this approach to a larger number of photons and modes. These results open the way to the application of Sylvester interferometers for optimal assessment of multiphoton interference experiments.

Experimental nonlocality-based network diagnostics of multipartite entangled states.

We introduce a novel diagnostic scheme for multipartite networks of entangled particles, aimed at assessing the quality of the gates used for the engineering of their state. Using the information gathered from a set of suitably chosen multiparticle Bell tests, we identify conditions bounding the quality of the entangled bonds among the elements of a register. We illustrate the effectiveness of our proposal by characterizing a quantum resource engineered combining two-photon hyperentanglement and photonic-chip technology. Our approach opens up future studies on medium-sized networks due to the intrinsically modular nature of cluster states, and paves the way to section-by-section analysis of larger photonics resources.

Single-Photon Quantum Contextuality on a Chip.

In classical physics, properties of objects exist independently of the context, i.e., whether and how measurements are performed. Quantum physics showed this assumption to be wrong, and that Nature is indeed "contextual". Contextuality has been observed in the simplest physical systems, such as single particles, and plays fundamental roles in quantum computation advantage. Here, we demonstrate for the first time quantum contextuality in an integrated photonic chip. The chip implements different combinations of measurements on a single photon delocalized on four distinct spatial modes, showing violations of a Clauser-Horne-Shimony-Holt (CHSH)-like noncontextuality inequality. This paves the way to compact and portable devices for contextuality-based quantum-powered protocols.

Learning an unknown transformation via a genetic approach.

Recent developments in integrated photonics technology are opening the way to the fabrication of complex linear optical interferometers. The application of this platform is ubiquitous in quantum information science, from quantum simulation to quantum metrology, including the quest for quantum supremacy via the boson sampling problem. Within these contexts, the capability to learn efficiently the unitary operation of the implemented interferometers becomes a crucial requirement. In this letter we develop a reconstruction algorithm based on a genetic approach, which can be adopted as a tool to characterize an unknown linear optical network. We report an experimental test of the described method by performing the reconstruction of a 7-mode interferometer implemented via the femtosecond laser writing technique. Further applications of genetic approaches can be found in other contexts, such as quantum metrology or learning unknown general Hamiltonian evolutions.