Analgesic Effect of Addition of Pectointercostal Block to Serratus Anterior Plane Block in Breast Surgeries: A Randomized, Controlled Trial.

BACKGROUND: Ultrasound-guided serratus anterior plane block (SAPB) is an efficient perioperative analgesic modality for breast surgeries. SAPB does not block the anterior cutaneous branches of the intercostal nerves; thus, it does not provide adequate analgesia for the parasternal region and the medial side of the breast. A new parasternal block, the pectointercostal fascial plane block (PIFB) has been developed to overcome this issue. OBJECTIVES: The study aimed to evaluate the perioperative analgesic effect of using PIFB in addition to SAPB. The primary outcome was to evaluate the postoperative pain score. The secondary outcomes were to assess perioperative opioid requirements, hemodynamic stability, and the satisfaction of the patient and surgeon. STUDY DESIGN: The current study was a prospective, double-blinded, randomized controlled study. The current study was registered at the Pan-African Clinical Trials Registry (PACTR202001789968542) and was designed after obtaining ethical institutional approval (Institutional Review Board No 00012098, Federalwide Assurance No 00018699). SETTING: The study involved 60 women between 21 and 69 years old with breast cancer who were scheduled for modified radical mastectomy or conservative breast surgeries in a university hospital. METHODS: After verbal and informed written consent, the patients were allocated to Group 1, which received SAPB, and Group 2, which received SAPB with PIFB. We assessed the Visual Analog Scale (VAS), perioperative opioid requirements, intraoperative hemodynamic stability, rescue analgesia, and complications. Patient and surgeon satisfaction were surveyed using a questionnaire where one is very dissatisfied and 5 is very satisfied. RESULTS: Intraoperative mean arterial blood pressure (MABP) and heart rate were significantly lower in Group 2 (SAPB+PIFB). The number of patients who needed intraoperative fentanyl was also significantly lower in Group 2 (SAPB+PIFB) (P value = 0.010). Postoperative VAS showed no significant difference in both groups. The number of patients who needed postoperative rescue morphine, time for the first rescue analgesia, first morphine dose (mg), and total opioid consumption were also comparable for both groups. Patient satisfaction and surgeon satisfaction were comparable for both groups (P values = 1.000 and 0.496, respectively). LIMITATIONS: VAS was not recorded during movements and no follow-up was done to detect the potential effect on chronic postmastectomy pain. Moreover, after reviewing the literature, there was no efficient data about adding PIFB with different regional blocks for breast surgery. CONCLUSIONS: The number of patients who needed intraoperative fentanyl, as well as the MABP and heart rate were significantly lower in Group 2 (SAPB+PIFB). Postoperative vital signs, VAS, postoperative analgesic requirements, and opioid consumption were comparable for both groups. Patient satisfaction was comparable for both groups, while surgeon satisfaction was higher in Group 2 (SAPB+PIFB) but statistically not significant.

Compact all-fiber quantum-inspired LiDAR with over 100 dB noise rejection and single photon sensitivity.

Entanglement and correlation of quantum light can enhance LiDAR sensitivity in the presence of strong background noise. However, the power of such quantum sources is fundamentally limited to a stream of single photons and cannot compete with the detection range of high-power classical LiDAR transmitters. To circumvent this, we develop and demonstrate a quantum-inspired LiDAR prototype based on coherent measurement of classical time-frequency correlation. This system uses a high-power classical source and maintains the high noise rejection advantage of quantum LiDARs. In particular, we show that it can achieve over 100dB rejection (with 100ms integration time) of indistinguishable (with statistically identical properties in every degree of freedom) in-band noise while still being sensitive to single photon signals. In addition to the LiDAR demonstration, we also discuss the potential of the proposed LiDAR receiver for quantum information applications. In particular, we propose the chaotic quantum frequency conversion technique for coherent manipulation of high dimensional quantum states of light. It is shown that this technique can provide improved performance in terms of selectivity and efficiency as compared to pulse-based quantum frequency conversion.

Egyptian Society of Liver Cancer Recommendation Guidelines for the Management of Hepatocellular Carcinoma.

Globally, hepatocellular carcinoma (HCC) is the fourth most common cause of death from cancer. The prevalence of this pathology, which has been on the rise in the last 30 years, has been predicted to continue increasing. HCC is the most common cause of cancer-related morbidity and mortality in Egypt and is also the most common cancer in males. Chronic liver diseases, including chronic hepatitis C, which is a primary health concern in Egypt, are considered major risk factors for HCC. However, HCC surveillance is recommended for patients with chronic hepatitis B virus (HBV) and liver cirrhosis; those above 40 with HBV but without cirrhosis; individuals with hepatitis D co-infection or a family history of HCC; and Nonalcoholic fatty liver disease (NAFLD) patients exhibiting significant fibrosis or cirrhosis. Several international guidelines aid physicians in the management of HCC. However, the availability and cost of diagnostic modalities and treatment options vary from one country to another. Therefore, the current guidelines aim to standardize the management of HCC in Egypt. The recommendations presented in this report represent the current management strategy at HCC treatment centers in Egypt. Recommendations were developed by an expert panel consisting of hepatologists, oncologists, gastroenterologists, surgeons, pathologists, and radiologists working under the umbrella of the Egyptian Society of Liver Cancer. The recommendations, which are based on the currently available local diagnostic aids and treatments in the country, include recommendations for future prospects.

Quantum and non-local effects offer over 40 dB noise resilience advantage towards quantum lidar.

Non-local effects have the potential to radically move forward quantum enhanced imaging to provide an advantage over classical imaging not only in laboratory environments but practical implementation. In this work, we demonstrate a 43dB higher signal-to-noise ratio (SNR) using a quantum enhanced LiDAR based on time-frequency entanglement compared with a classical phase-insensitive quantum imaging system. Our system can tolerate more than 3 orders of magnitude higher noise than classical single-photon counting quantum imaging systems before detector saturation with a detector dead time of 25ns. To achieve these advantages, we use non-local cancellation of dispersion to take advantage of the strong temporal correlations in photon pairs in spite of the orders of magnitude larger detector temporal uncertainty. We go on to incorporate this scheme with purpose-built scanning collection optics to image non-reflecting targets in an environment with noise.

Biphoton engineering using modal spatial overlap on-chip.

Photon pairs generated by spontaneous parametric downconversion are essential for optical quantum information processing, in which the quality of biphoton states is crucial for the performance. To engineer the biphoton wave function (BWF) on-chip, the pump envelope function and the phase matching function are commonly adjusted, while the modal field overlap has been considered as a constant in the frequency range of interest. In this work, by using modal coupling in a system of coupled waveguides, we explore the modal field overlap as a new degree of freedom for biphoton engineering. We provide design examples for on-chip generations of polarization entangled photons and heralded single photons. This strategy can be applied to waveguides of different materials and structures, offering new possibilities for photonic quantum state engineering.

Distributed feedback lasers using surface gratings in Bragg waveguides.

This Letter presents, to the best of our knowledge, the first report of a narrow-linewidth ∼790-800nm edge-emitting semiconductor distributed feedback Bragg reflection waveguide diode laser (DFB2RL). The DFB2RLs were fabricated using a ridge waveguide structure with 5th order, surface-etched grating forming the wavelength selective element. Unbonded devices with a 500 µm cavity length exhibited continuous wave threshold currents in the region of 25 mA with an output power of 2.5 mW per (uncoated) facet at 100 mA drive current. The devices operated in a single longitudinal mode, with side-mode suppression ratio (SMSR) as high as 49 dB and linewidths as low as 207 kHz. Devices maintained single mode operation with high SMSR over a 9 nm wavelength range as the temperature was swept from 15°C to 50°C.

Spectrally pure photon pair generation in asymmetric heterogeneously coupled waveguides.

In this work, we develop a design methodology to generate spectrally pure photon pairs in asymmetric heterogeneously coupled waveguides by spontaneous parametric down conversion. Mode coupling in a system of waveguides is used to directly tailor the group velocity of a supermode to achieve group velocity matching that is otherwise not allowed by material dispersion. Design examples based on thin film lithium niobate waveguides are provided, demonstrating high spectral purity and temperature tunability. This approach is a versatile strategy applicable to waveguides of different materials and structures, allowing more versatility in single-photon source designs.

Supermode Hybridization: A Material-Independent Route toward Record Schottky Detection Sensitivity Using <0.05 µm3 Amorphous Absorber Volume.

Schottky photodetectors are attractive for CMOS-compatible photonic integrated circuits, but the inability to simultaneously optimize the metal emitter thickness for photon absorption and hot carrier emission limits the detection efficiency and sensitivity. Here, we propose and experimentally demonstrate a supermode hybridization waveguiding effect that can overcome the trade-off. By introducing structural asymmetry into coupled plasmonic nanostructures, hybridization-induced field enhancement can help ultrathin metal emitters to achieve greater optical absorption than bulk counterparts. Despite the use of amorphous materials with higher transport losses, our hybridized Schottky detectors demonstrate higher responsivity per device volume compared to crystalline-based and unhybridized Schottky designs with broadband (1.5-1.6 µm) and athermal (15-100 °C) behavior as well as record sensitivity of -55 dBm that approaches Ge counterparts that are 36 times larger. The hybridization effect can be utilized across diverse nanomaterial platforms to facilitate light-matter interaction, paving the way toward backend-compatible, chip-integrated photonics with greater manufacturing flexibility.

Black indium oxide a photothermal CO2 hydrogenation catalyst.

Nanostructured forms of stoichiometric In2O3 are proving to be efficacious catalysts for the gas-phase hydrogenation of CO2. These conversions can be facilitated using either heat or light; however, until now, the limited optical absorption intensity evidenced by the pale-yellow color of In2O3 has prevented the use of both together. To take advantage of the heat and light content of solar energy, it would be advantageous to make indium oxide black. Herein, we present a synthetic route to tune the color of In2O3 to pitch black by controlling its degree of non-stoichiometry. Black indium oxide comprises amorphous non-stoichiometric domains of In2O3-x on a core of crystalline stoichiometric In2O3, and has 100% selectivity towards the hydrogenation of CO2 to CO with a turnover frequency of 2.44 s-1.

Single-mode Bragg ring laser diodes.

We have designed and fabricated a monolithic semiconductor ring laser based on a Bragg waveguide structure. Through careful control of the waveguiding, we have overcome the inherent "leaky" nature of this waveguide mode and demonstrated a ring laser lasing in the Bragg mode. Best behavior was obtained from lasers with a diameter of 400 µm, where they exhibited output power ${ \gt }{1}\;{\rm mW}$>1mW, in continuous wave (CW) operation. A tangent waveguide provided access to the ring cavity using two ports through evanescent coupling. To meet the stringent waveguiding requirements imposed by the Bragg structure, a two-step etching process, consisting of a shallow-etched coupler and a deep-etched bend section of the ring, was developed in order to reduce the bend and scattering losses. The laser showed a threshold current density of ${\sim}{2.2}\;{{\rm kA/cm}^2}$∼2.2kA/cm2 in CW operation with single longitudinal mode operation with a signal-to-noise ratio of 30 dBm obtained at 1.5 ${I_{\rm th}}$Ith. Broadband phase-matching of $\chi ^{(2)}$χ(2) nonlinearity is observed, offering self-pumped parametric C-band conversion ${ \gt }{40}\;{\rm nm}$>40nm with efficiency of ${142}\% \;{{\rm W}^{ - 1}}\;{{\rm cm}^{ - 2}}$142%W-1cm-2.

Monolithic Plasmonic Waveguide Architecture for Passive and Active Optical Circuits.

Guided-wave plasmonic circuits are promising platforms for sensing, interconnection, and quantum applications in the subdiffraction regime. Nonetheless, the loss-confinement trade-off remains a collective bottleneck for plasmonic-enhanced optical processes. Here, we report a unique plasmonic waveguide architecture that can alleviate such trade-off and improve the efficiencies of plasmonic-based emission, light-matter-interaction, and detection simultaneously. Specifically, record experimental attributes such as normalized Purcell factor approaching 104, 10 dB amplitude modulation with <1 dB insertion loss and fJ-level switching energy, and photodetection sensitivity and internal quantum efficiency of -54 dBm and 6.4% respectively have been realized within our amorphous-based, coupled-mode plasmonic structure. The ability to support multiple optoelectronic phenomena while providing performance gains over existing plasmonic and dielectric counterparts offers a clear path toward reconfigurable, monolithic plasmonic circuits.

Dynamically reconfigurable sources for arbitrary Gaussian states in integrated photonics circuits.

We present a modular design for integrated programmable multimode sources of arbitrary Gaussian states of light. The technique is based on current technologies, in particular recent demonstrations of on-chip photon manipulation and the generation of highly squeezed vacuum states in semiconductors. While the design is generic and independent of the choice of integrated platform, we adopt recent experimental results on compound semiconductors as a demonstrative example. Such a device would be valuable as a source for many quantum protocols that range from imaging to communication and information processing.

Photothermal Catalyst Engineering: Hydrogenation of Gaseous CO2 with High Activity and Tailored Selectivity.

This study has designed and implemented a library of hetero-nanostructured catalysts, denoted as Pd@Nb2O5, comprised of size-controlled Pd nanocrystals interfaced with Nb2O5 nanorods. This study also demonstrates that the catalytic activity and selectivity of CO2 reduction to CO and CH4 products can be systematically tailored by varying the size of the Pd nanocrystals supported on the Nb2O5 nanorods. Using large Pd nanocrystals, this study achieves CO and CH4 production rates as high as 0.75 and 0.11 mol h-1 gPd-1, respectively. By contrast, using small Pd nanocrystals, a CO production rate surpassing 18.8 mol h-1 gPd-1 is observed with 99.5% CO selectivity. These performance metrics establish a new milestone in the champion league of catalytic nanomaterials that can enable solar-powered gas-phase heterogeneous CO2 reduction. The remarkable control over the catalytic performance of Pd@Nb2O5 is demonstrated to stem from a combination of photothermal, electronic and size effects, which is rationally tunable through nanochemistry.

Size-Tunable Photothermal Germanium Nanocrystals.

Germanium nanocrystals (ncGe) have not received as much attention as silicon nanocrystals (ncSi). However, Ge has demonstrated superiority over Si nanomaterials in some applications. Examples include, high charge-discharge rate lithium-ion batteries, small band-gap opto-electronic devices, and photo-therapeutics. When stabilized in an oxide matrix (ncGe/GeOx ), its high charge-retention has enabled non-volatile memories. It has also found utility as a high-capacity anode material for Li-ion batteries with impressive stability. Herein, we report an organic-free synthesis of size-controlled ncGe in a GeOx matrix as well as freestanding ncGe, via the thermal disproportionation of GeO prepared from thermally induced dehydration of Ge(OH)2 . The photothermal effect of ncGe, quantified by Raman spectroscopy, is found to be size dependent and superior to ncSi. This advance suggests applications of ncGe in photothermal therapy, desalination, and catalysis.

Visible and Near-Infrared Photothermal Catalyzed Hydrogenation of Gaseous CO2 over Nanostructured Pd@Nb2O5.

The reverse water gas shift (RWGS) reaction driven by Nb2O5 nanorod-supported Pd nanocrystals without external heating using visible and near infrared (NIR) light is demonstrated. By measuring the dependence of the RWGS reaction rates on the intensity and spectral power distribution of filtered light incident onto the nanostructured Pd@Nb2O5 catalyst, it is determined that the RWGS reaction is activated photothermally. That is the RWGS reaction is initiated by heat generated from thermalization of charge carriers in the Pd nanocrystals that are excited by interband and intraband absorption of visible and NIR light. Taking advantage of this photothermal effect, a visible and NIR responsive Pd@Nb2O5 hybrid catalyst that efficiently hydrogenates CO2 to CO at an impressive rate as high as 1.8 mmol gcat-1 h-1 is developed. The mechanism of this photothermal reaction involves H2 dissociation on Pd nanocrystals and subsequent spillover of H to the Nb2O5 nanorods whereupon adsorbed CO2 is hydrogenated to CO. This work represents a significant enhancement in our understanding of the underlying mechanism of photothermally driven CO2 reduction and will help guide the way toward the development of highly efficient catalysts that exploit the full solar spectrum to convert gas-phase CO2 to valuable chemicals and fuels.

Heterogeneous reduction of carbon dioxide by hydride-terminated silicon nanocrystals.

Silicon constitutes 28% of the earth's mass. Its high abundance, lack of toxicity and low cost coupled with its electrical and optical properties, make silicon unique among the semiconductors for converting sunlight into electricity. In the quest for semiconductors that can make chemicals and fuels from sunlight and carbon dioxide, unfortunately the best performers are invariably made from rare and expensive elements. Here we report the observation that hydride-terminated silicon nanocrystals with average diameter 3.5 nm, denoted ncSi:H, can function as a single component heterogeneous reducing agent for converting gaseous carbon dioxide selectively to carbon monoxide, at a rate of hundreds of µmol h(-1) g(-1). The large surface area, broadband visible to near infrared light harvesting and reducing power of SiH surface sites of ncSi:H, together play key roles in this conversion. Making use of the reducing power of nanostructured hydrides towards gaseous carbon dioxide is a conceptually distinct and commercially interesting strategy for making fuels directly from sunlight.

Colloidal cholesteric liquid crystal in spherical confinement.

The organization of nanoparticles in constrained geometries is an area of fundamental and practical importance. Spherical confinement of nanocolloids leads to new modes of packing, self-assembly, phase separation and relaxation of colloidal liquids; however, it remains an unexplored area of research for colloidal liquid crystals. Here we report the organization of cholesteric liquid crystal formed by nanorods in spherical droplets. For cholesteric suspensions of cellulose nanocrystals, with progressive confinement, we observe phase separation into a micrometer-size isotropic droplet core and a cholesteric shell formed by concentric nanocrystal layers. Further confinement results in a transition to a bipolar planar cholesteric morphology. The distribution of polymer, metal, carbon or metal oxide nanoparticles in the droplets is governed by the nanoparticle size and yields cholesteric droplets exhibiting fluorescence, plasmonic properties and magnetic actuation. This work advances our understanding of how the interplay of order, confinement and topological defects affects the morphology of soft matter.

Monolithic semiconductor chips as a source for broadband wavelength-multiplexed polarization entangled photons.

Generating entangled photons from a monolithic chip is a major milestone towards real-life applications of optical quantum information processing including quantum key distribution and quantum computing. Ultrabroadband entangled photons are of particular interest to various applications such as quantum metrology and multi-party entanglement distribution. In this work, we demonstrate the direct generation of broadband wavelength-multiplexed polarization entangled photons from a semiconductor chip for the first time. Without the use of any off-chip compensation or interferometry, entangled photons with a signal-idler separation as large as 95 nm in the telecom band were observed. The highest concurrence of 0.98±0.01 achieved in this work is also the highest, to the best of our knowledge, comparing to all previously demonstrated semiconductor waveguide sources. This work paves the way for fully integrated, ultrabroadband sources of polarization entangled photons.

Multilayer Black Phosphorus as a Versatile Mid-Infrared Electro-optic Material.

We investigate the electro-optic properties of black phosphorus (BP) thin films for optical modulation in the mid-infrared frequencies. Our calculation indicates that an applied out-of-plane electric field may lead to red-, blue-, or bidirectional shift in BP's absorption edge. This is due to the interplay between the field-induced quantum-confined Franz-Keldysh effect and the Pauli-blocked Burstein-Moss shift. The relative contribution of the two electro-absorption mechanisms depends on doping range, operating wavelength, and BP film thickness. For proof-of concept, simple modulator configuration with BP overlaid over a silicon nanowire is studied. Simulation results show that operating BP in the quantum-confined Franz-Keldysh regime can improve the maximal attainable absorption as well as power efficiency compared to its graphene counterpart.

Silicon monoxide--a convenient precursor for large scale synthesis of near infrared emitting monodisperse silicon nanocrystals.

While silicon nanocrystals (ncSi) embedded in silicon dioxide thin films have been intensively studied in physics, the potential of batch synthesis of silicon nanocrystals from the solid-state disproportionation of SiO powder has not drawn much attention in chemistry. Herein we describe some remarkable effects observed in the diffraction, microscopy and spectroscopy of SiO powder upon thermal processing in the temperature range 850-1100 °C. Quantum confinement effects and structural changes of the material related to the size of the silicon nanocrystals nucleated and grown in this way were established by Photoluminescence (PL), Raman, FTIR and UV-Visible spectroscopy, PXRD and STEM, pinpointing that the most significant disproportionation transformations happened in the temperature range between 900 and 950 °C. With this know-how a high yield synthesis was developed that produced polydispersions of decyl-capped, hexane-soluble silicon nanocrystals predominantly with near infrared (NIR) PL. Using size-selective precipitation, these polydispersions were separated into monodisperse fractions, which allowed their PL absolute quantum yield (AQY) to be studied as a function of silicon nanocrystal size. This investigation yielded volcano-shaped plots for the AQY confirming the most efficient PL wavelength for ncSi to be located at around 820-830 nm, which corresponded to a size of 3.5-4.0 nm. This work provides opportunities for applications of size-selected near infrared emitting silicon nanocrystals in biomedical imaging and photothermal therapy.