Optical Spin Waves.

Chirality is inherent to a broad range of systems, including solid-state and wave physics. The precession (chiral motion) of the magnetic moments in magnetic materials, forming spin waves, has various properties and many applications in magnetism and spintronics. We show that an optical analogue of spin waves can be generated in arrays of plasmonic nanohelices. Such optical waves arise from the interaction between twisted helix eigenmodes carrying spin and orbital angular momenta. We demonstrate that these optical spin waves are reflected at the interface between successive domains of enantiomeric nanohelices, forming a heterochiral lattice regardless of the wave propagation direction within the lattice. Optical spin waves may be applied in techniques involving photon spin, ranging from data processing and storage to quantum optics.

Application of Machine Learning Techniques to Assess Alpha-Fetoprotein at Diagnosis of Hepatocellular Carcinoma.

Hepatocellular carcinoma (HCC) is the most common primary liver tumor and is associated with high mortality rates. Approximately 80% of cases occur in cirrhotic livers, posing a significant challenge for appropriate therapeutic management. Adequate screening programs in high-risk groups are essential for early-stage detection. The extent of extrahepatic tumor spread and hepatic functional reserve are recognized as two of the most influential prognostic factors. In this retrospective multicenter study, we utilized machine learning (ML) methods to analyze predictors of mortality at the time of diagnosis in a total of 208 patients. The eXtreme gradient boosting (XGB) method achieved the highest values in identifying key prognostic factors for HCC at diagnosis. The etiology of HCC was found to be the variable most strongly associated with a poorer prognosis. The widely used Barcelona Clinic Liver Cancer (BCLC) classification in our setting demonstrated superiority over the TNM classification. Although alpha-fetoprotein (AFP) remains the most commonly used biological marker, elevated levels did not correlate with reduced survival. Our findings suggest the need to explore new prognostic biomarkers for individualized management of these patients.

Multipixel x ray detection integrated at the end of a narrow multicore fiber.

We introduce and demonstrate the concept of a multipixel detector integrated at the tip of an individual multicore fiber. A pixel consists here of an aluminum-coated polymer microtip incorporating a scintillating powder. Upon irradiation, the luminescence released by the scintillators is efficiently transferred into the fiber cores owing to the specifically elongated metal-coated tips that ensure efficient luminescence matching to the fiber modes. With each pixel being selectively coupled to one of the cores of the multicore optical fiber, the resulting fiber-integrated x ray detection process is totally free from inter-pixel cross talk. Our approach holds promise for fiber-integrated probes and cameras for remote x and gamma ray analysis and imaging in hard-to-reach environments.

Serum phosphate is associated with increased risk of bone fragility fractures in hemodialysis patients.

BACKGROUND: Bone fragility fractures are associated with high morbidity and mortality. This study analysed the association between the current biochemical parameters of CKD-MBD and bone fragility fractures in the COSMOS project. METHODS: COSMOS is a 3-year, multicentre, open cohort, prospective, observational study carried out in 6797 hemodialysis patients (227 centres from 20 European countries). The association of bone fragility fractures (outcome) with serum calcium, phosphate and PTH (exposure), was assessed using Standard Cox proportional hazards regression and Cox proportional hazards regression for recurrent events. Additional analyses were performed considering all-cause mortality as a competitive event for bone fragility fracture occurrence. Multivariable models were used in all strategies, with the fully adjusted model including a total of 24 variables. RESULTS: During a median follow-up of 24 months 252 (4%) patients experienced at least one bone fragility fracture (incident bone fragility fracture rate 28.5 per 1000 patient-years). In the fractured and non-fractured patients, the percentage of men was 43.7% and 61.4%, mean age 68.1 and 63.8 years and a haemodialysis vintage of 55.9 and 38.3 months respectively. Baseline serum phosphate > 6.1 mg/dL (reference value 4.3-6.1 mg/dL) was significantly associated with a higher bone fragility fracture risk in both regression models (HR: 1.53[95%CI: 1.10-2.13] and HR: 1.44[95%CI: 1.02-2.05]. The significant association persisted after competitive risk analysis (subHR: 1.42[95%CI: 1.02-1.98]) but the finding was not confirmed when serum phosphate was considered as a continuous variable. Baseline serum calcium showed no association with bone fragility fracture risk in any regression model. Baseline serum PTH > 800 pg/mL was significantly associated with a higher bone fragility fracture risk in both regression models, but the association disappeared after a competitive risk analysis. CONCLUSIONS: Hyperphosphatemia was independently and consistently associated with an increased bone fracture risk, suggesting serum phosphate could be a novel risk factor for bone fractures in hemodialysis patients.

A Machine Learning Method to Identify the Risk Factors for Liver Fibrosis Progression in Nonalcoholic Steatohepatitis.

AIM: Nonalcoholic fatty liver disease (NAFLD) is a silent epidemy that has become the most common chronic liver disease worldwide. Nonalcoholic steatohepatitis (NASH) is an advanced stage of NAFLD, which is linked to a high risk of cirrhosis and hepatocellular carcinoma. The aim of this study is to develop a predictive model to identify the main risk factors associated with the progression of hepatic fibrosis in patients with NASH. METHODS: A database from a multicenter retrospective cross-sectional study was analyzed. A total of 215 patients with NASH biopsy-proven diagnosed were collected. NAFLD Activity Score and Kleiner scoring system were used to diagnose and staging these patients. Noninvasive tests (NITs) scores were added to identify which one were more reliable for follow-up and to avoid biopsy. For analysis, different Machine Learning methods were implemented, being the eXtreme Gradient Booster (XGB) system the proposed algorithm to develop the predictive model. RESULTS: The most important variable in this predictive model was High-density lipoprotein (HDL) cholesterol, followed by systemic arterial hypertension and triglycerides (TG). NAFLD Fibrosis Score (NFS) was the most reliable NIT. As for the proposed method, XGB obtained higher results than the second method, K-Nearest Neighbors, in terms of accuracy (95.05 vs. 90.42) and Area Under the Curve (0.95 vs. 0.91). CONCLUSIONS: HDL cholesterol, systemic arterial hypertension, and TG were the most important risk factors for liver fibrosis progression in NASH patients. NFS is recommended for monitoring and decision making.

A Non Intrusive Human Presence Detection Methodology Based on Channel State Information of Wi-Fi Networks.

In recent times, we have been witnessing the development of multiple applications and deployment of services through the indoors location of people as it allows the development of services of interest in areas related mainly to security, guiding people, or offering services depending on their localization. On the other hand, at present, the deployment of Wi-Fi networks is so advanced that a network can be found almost anywhere. In addition, security systems are more demanded and are implemented in many buildings. Thus, in order to provide a non intrusive presence detection system, in this manuscript, the development of a methodology is proposed which is able to detect human presence through the channel state information (CSI) of wireless communication networks based on the 802.11n standard. One of the main contributions of this standard is multiple-input multiple-output (MIMO) with orthogonal frequency division multiplexing (OFDM). This makes it possible to obtain channel state information for each subcarrier. In order to implement this methodology, an analysis and feature extraction in time-domain of CSI is carried out, and it is validated using different classification models trained through a series of samples that were captured in two different environments. The experiments show that the methodology presented in this manuscript obtains an average accuracy above 90%.

Plasmonic Helical Nanoantenna As a Converter between Longitudinal Fields and Circularly Polarized Waves.

A wide variety of optical applications and techniques require control of light polarization. So far, the manipulation of light polarization relies on components capable of interchanging two polarization states of the transverse field of a propagating wave (e.g., linear to circular polarizations, and vice versa). Here, we demonstrate that an individual helical nanoantenna is capable of locally converting longitudinally oriented confined near-fields into a circularly polarized freely propagating wave, and vice versa. To this end, the nanoantenna is coupled to cylindrical surface plasmons bound to the top interface of a thin gold layer. Helices of constant and varying pitch lengths are experimentally investigated. The reciprocal conversion of an incoming circularly wave into diverging cylindrical surface plasmons is demonstrated as well. Interconnecting circularly polarized optical waves (carrying spin angular momentum) and longitudinal near-fields provides a new degree of freedom in light polarization control.

Revealing photonic symmetry-protected modes by the finite-difference-time-domain method.

This Letter is devoted to pointing out a specific feature of the finite-difference-time-domain (FDTD) method through the study of nano-structures supporting geometrical symmetry-protected modes that cannot be excited at certain conditions of illumination. The spatial discretization performed in the FDTD algorithm naturally leads to breaking this symmetry and allows the excitation of these modes. The quality factors of the corresponding resonances are then directly linked to the degree of symmetry breaking, i.e., the spatial grid dimension, even though the convergence criteria of the FDTD are fulfilled. This finding shows that the FDTD must be handled with great care and, more importantly, that very huge quality-factor resonances can be achieved at the cost of nanometer-scale mastered fabrication processes.

Miniaturized fiber dosimeter of medical ionizing radiations on a narrow optical fiber.

Fiber dosimeters have recently drawn much interest for measuring in vivo and in real time the dose of medical radiations. This paper presents the first miniaturized fiber dosimeter integrated at the end of a narrow 125 µm outer diameter optical fiber. Miniaturization is rendered possible by exploiting the concept of a leaky wave optical antenna for interfacing the scintillators and the fiber and by taking advantage of the low propagation loss of narrow silica fibers and high detection yield of single-pixel photon counters. Upon irradiation at 6 MV in air, our fiber probe leads to a linear detection response with a signal-to-noise ratio as high as 195. Although implemented with inorganic scintillators and fiber, our miniaturized fiber probe induces minimum screening effects on ionizing radiations over a negligible area (0.153 mm2). Our nano-optically driven approach may thus result in ultra-compact fiber dosimeters of negligible footprint in the radiotherapeutic processes, even with non-water equivalent fibers and scintillators. This opens new opportunities for a large panel of therapies relying on ionizing radiations (photons or charged particles).

Chiroptical transmission through a plasmonic helical traveling-wave nanoantenna, towards on-tip chiroptical probes.

Resonant plasmonic helices have been widely utilized for locally enhancing and tailoring optical chirality. Here we investigate their nonresonant operation through the recently introduced concept of a plasmonic helical "traveling-wave" nanoantenna. Relying on the coupling of a nonresonant plasmonic helix and a nano-aperture, the helical traveling-wave nanoantenna transmits circularly polarized light with the same handedness as the helix and blocks the other, with a measured dissymmetry factor larger than 1.92 (maximum value of 2). This chiroptical transmission is spatially localized, spectrally broadband, and background-free. Finally, we demonstrate the possibility to engineer such a plasmonic helical nanoantenna at the apex of a sharp tip typically used in scanning near-field microscopies, thus opening the route for moveable, broadband, and background-free chiroptical probes.

Disease-Free Survival for Patients with Thin Melanomas according to the American Joint Committee on Cancer 8th Edition.

BACKGROUND: The recently implemented AJCC 8th edition TNM staging system for malignant melanoma (MM) changed the definition for T1a and T1b tumours. OBJECTIVES: To analyse differences in disease-free survival (DFS) among patients with thin MM staged according to both AJCC 7th and 8th editions. METHODS: An observational study including 285 patients with cutaneous thin MM (thickness ≤1 mm). Cases were staged as T1a and T1b using both 7th and 8th editions. Neither regional nor visceral diseases were present at diagnosis. DFS curves were generated according to the Kaplan-Meier method. RESULTS: An 8% shift of patients from a T1a towards a T1b stage group was observed after applying the AJCC 8th edition. According to this 8th edition, DFS for T1a patients was significantly longer than for T1b patients (log-rank test; p = 0.005); 5-year DFS for T1a and T1b was 100 and 95%, respectively (Wilcoxon test; p = 0.002). According to the AJCC 7th edition, DFS did not significantly differ for T1a and T1b patients; 5-year DFS for T1a and T1b was 99 and 97%, respectively (p > 0.05). CONCLUSIONS: The AJCC 8th edition seems to be a better tool for staging thin melanomas.

IHDIP: a controlled randomized trial to assess the security and effectiveness of the incremental hemodialysis in incident patients.

BACKGROUND: Most people who make the transition to renal replacement therapy (RRT) are treated with a fixed dose thrice-weekly hemodialysis réegimen, without considering their residual kidney function (RKF). Recent papers inform us that incremental hemodialysis is associated with preservation of RKF, whenever compared with conventional hemodialysis. The objective of the present controlled randomized trial (RCT) is to determine if start HD with one sessions per week (1-Wk/HD), it is associated with better patient survival and other safety parameters. METHODS/DESIGN: IHDIP is a multicenter RCT experimental open trial. It is randomized in a 1:1 ratio and controlled through usual clinical practice, with a low intervention level and non-commercial. It includes 152 incident patients older than 18 years, with a RRF of ≥4 ml/min/1.73 m2, measured by renal clearance of urea (KrU). The intervention group includes 76 patients who will start with incremental HD (1-Wk/HD). The control group includes 76 patients who will start with thrice-weekly hemodialysis régimen. The primary outcome is assessing the survival rate, while the secondary outcomes are the morbidity rate, the clinical parameters, the quality of life and the efficiency. DISCUSSION: This study will enable to know the number of sessions a patient should receive when starting HD, depending on his RRF. The potentially important clinical and financial implications of incremental hemodialysis warrant this RCT. TRIAL REGISTRATION: U.S. National Institutes of Health, ClinicalTrials.gov . Number: NCT03239808 , completed 13/04/2017. SPONSOR: Foundation for Training and Research of Health Professionals of Extremadura.

Directing Nanoscale Optical Flows by Coupling Photon Spin to Plasmon Extrinsic Angular Momentum.

As any physical particle or object, light undergoing a circular trajectory features a constant extrinsic angular momentum. Within strong curvatures, this angular momentum can match the spin momentum of a photon, thus providing the opportunity of a strong spin-orbit interaction. Using this effect, we demonstrate tunable symmetry breaking in the coupling of light into a curved nanoscale plasmonic waveguide. The helicity of the impinging optical wave controls the power distribution between the two counter-propagating subwavelength guided modes including unidirectional waveguiding. We found experimentally that up to 95% of the incoupled light can be selectively directed into one of the two propagation directions of a nanoscale waveguide. This approach offers new degrees of freedom in the manipulation of subdiffraction optical modes and thus appealing new prospects for the development of advanced, deeply subwavelength optical functionalities.

Discrete Indoor Three-Dimensional Localization System Based on Neural Networks Using Visible Light Communication.

Indoor localization estimation has become an attractive research topic due to growing interest in location-aware services. Many research works have proposed solving this problem by using wireless communication systems based on radiofrequency. Nevertheless, those approaches usually deliver an accuracy of up to two metres, since they are hindered by multipath propagation. On the other hand, in the last few years, the increasing use of light-emitting diodes in illumination systems has provided the emergence of Visible Light Communication technologies, in which data communication is performed by transmitting through the visible band of the electromagnetic spectrum. This brings a brand new approach to high accuracy indoor positioning because this kind of network is not affected by electromagnetic interferences and the received optical power is more stable than radio signals. Our research focus on to propose a fingerprinting indoor positioning estimation system based on neural networks to predict the device position in a 3D environment. Neural networks are an effective classification and predictive method. The localization system is built using a dataset of received signal strength coming from a grid of different points. From the these values, the position in Cartesian coordinates ( x , y , z ) is estimated. The use of three neural networks is proposed in this work, where each network is responsible for estimating the position by each axis. Experimental results indicate that the proposed system leads to substantial improvements to accuracy over the widely-used traditional fingerprinting methods, yielding an accuracy above 99% and an average error distance of 0.4 mm.

Doubly Resonant Photonic Antenna for Single Infrared Quantum Dot Imaging at Telecommunication Wavelengths.

Colloidal quantum dots (CQDs) have drawn strong interest in the past for their high prospects in scientific, medical, and industrial applications. However, the full characterization of these quantum emitters is currently restricted to the visible wavelengths, and it remains a key challenge to optically probe single CQDs operating in the infrared spectral domain, which is targeted by a growing number of applications. Here, we report the first experimental detection and imaging at room temperature of single infrared CQDs operating at telecommunication wavelengths. Imaging was done with a doubly resonant bowtie nanoaperture antenna (BNA) written at the end of a fiber nanoprobe, whose resonances spectrally fit the CQD absorption and emission wavelengths. Direct near-field characterization of PbS CQDs reveal individual nanocrystals with a spatial resolution of 75 nm (λ/20) together with their intrinsic 2D dipolar free-space emission properties and exciton dynamics (blinking phenomenon). Because the doubly resonant BNA is strongly transmissive at both the CQD absorption and the emission wavelengths, we are able to perform all-fiber nanoimaging with a standard 20% efficiency InGaAs avalanche photodiode (APD). The detection efficiency is predicted to be 3000 fold larger than with a conventional circular aperture tip of the same transmission area. Double resonance BNA fiber probes thus offer the possibility of exploring extreme light-matter interaction in low band gap CQDs with current plug-and-play detection techniques, opening up new avenues in the fields of infrared light-emitting devices, photodetectors, telecommunications, bioimaging, and quantum information technology.

Association between intravenous acetaminophen and reduction in intraoperative opioid consumption during transsphenoidal surgery for pituitary tumors.

BACKGROUND AND AIMS: Pain during and after transsphenoidal surgeries originates from stimulation of branches of the trigeminal cranial nerve that supply the inner aspect of the nose cavity and dura mater. Thereby, patients undergoing transsphenoidal surgery may require moderate-to-large amounts of analgesics including opioids. Intravenous acetaminophen provides analgesia and reduces opioid consumption for a wide variety of surgeries. We hypothesized that the use of intravenous acetaminophen is associated with a reduction in intraoperative opioid consumption and provides significant analgesia during and after transsphenoidal surgery. MATERIAL AND METHODS: This retrospective study included 413 patients who underwent transsphenoidal surgery for pituitary adenomas. The primary outcome of this study was intraoperative opioid consumption. Secondary outcomes included pain intensity, Richmond Agitation Sedation Scale scores, and nausea and vomiting upon arrival to postoperative anesthesia care unit. Patients were divided into two groups based on the intraoperative acetaminophen use. A prospensity score matching analysis was used to balance for important variables between the two groups of treatment. Regression models were fitted after matching the covariates. A P < 0.05 was considered statistically significant. RESULTS: After matching, 126 patients were included in each group of treatment. Patients in the acetaminophen group required significantly less amount (a decrease by 14.9%) of opioids during surgery than those in the non-acetaminophen group. Postoperative pain, postoperative nausea and vomiting, and sedation scores were not significantly different between patients who received intravenous acetaminophen and those who did not. CONCLUSION: Intravenous acetaminophen is associated with a reduction in intraoperative opioids during transsphenoidal pituitary surgery.

Polarization controlled directional propagation of Bloch surface wave.

Bloch surface waves (BSWs) are recently developing alternative to surface plasmon polaritons (SPPs). Due to dramatically enhanced propagation distance and strong field confinement these surface states can be successfully used in on-chip all-optical integrated devices of increased complexity. In this work we propose a highly miniaturized grating based BSW coupler which is gathering launching and directional switching functionalities in a single element. This device allows to control with polarization the propagation direction of Bloch surface waves at subwavelength scale, thus impacting a large panel of domains such as optical circuitry, function design, quantum optics, etc.

Ultracompact x-ray dosimeter based on scintillators coupled to a nano-optical antenna.

We show that nano-optical antennas are capable of controlling the luminescence induced by the absorption of x rays into matter. The x-ray-excited luminescence from a tiny scintillation cluster coupled to a horn nano-optical antenna is highly directed and determined by the antenna's geometrical parameters. Directionality is sufficiently high to efficiently outcouple the x-ray-excited luminescence to a narrow single-mode optical fiber, thus enabling ultracompact fiber-integrated x-ray sensors. Our nano-optically driven approach offers the possibility of x-ray profiling and dosimetry in ultra-confined environments, opening up new avenues in the fields of x-ray imaging, as well as medical and industrial endoscopy. With this study, to the best of our knowledge, nano-optical antennas make a first key contribution to the development of x-ray sensing protocols and architectures.

Intention-to-treat survival analysis of hepatitis C virus/human immunodeficiency virus coinfected liver transplant: Is it the waiting list?

In human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfected patients, the accelerated severity of liver disease, associated comorbidities, and mortality on the waiting list could change the possibility and results of liver transplantation (LT). Intention-to-treat survival analysis (ITTA) can accurately estimate the applicability and efficacy of LT. The primary objective of this study was to compare the survival of patients with HCV with and without HIV infection. We analyzed a cohort of 199 patients with HCV infection enrolled for LT between 1998 and 2015; 17 were also infected with HIV. The patients with HCV/HIV coinfection had higher mortality on the waiting list than those with HCV monoinfection (35.3% versus 4.6%; P < 0.001). ITTA at 1, 3, and 4 years was 75%, 64%, and 57% for HCV monoinfection and 52%, 47%, and 39% for HCV/HIV coinfection, respectively (Wilcoxon test P < 0.05). The ITTA at 1, 3, 6, and 12 months was 96%, 91%, 87%, and 75% for HCV monoinfection and 76%, 70%, 64%, and 52% for HCV/HIV coinfection, respectively (log-rank P < 0.05; Wilcoxon test P < 0.01). A Cox regression analysis was carried out including all variables with predictive value in the univariate analysis, showing that only donor age > 70 years (hazard ratio [HR] = 3.12; P < 0.05), United Network for Organ Sharing status 1 (HR = 10.1; P < 0.01), Model for End-Stage Liver Disease (HR = 1.13; P < 0.001), and HIV coinfection (HR = 2.65; P < 0.05) had independent negative predictive value for survival. In conclusion, our study indicates that HIV coinfection is a factor in mortality prior to transplantation and associated with higher mortality on the waiting list. Liver Transplantation 22 1186-1196 2016 AASLD.

Simple production of membrane-based LiNbO3 micro-modulators with integrated tapers.

We report on free-standing electro-optical LiNbO3 waveguides with integrated tapers made by optical grade dicing. Membranes with a calibrated thickness are produced simultaneously with tapers acting as spot-size converters. Thereby, thicknesses from 450 to 500 µm can simply be achieved together with integrated tapers guaranteeing low insertion losses. These developments open the way to the low-cost production of compact and low-power-consuming electro-optical components. As an example, a 200 µm-long free-standing electro-optical Fabry-Perot is demonstrated with a figure of merit of only 0.19 V·cm in a 4.5 µm-thick membrane.