Coronary intravascular lithotripsy and rotational atherectomy for severely calcified stenosis: Results from the ROTA.shock trial.

BACKGROUND: Severely calcified coronary lesions present a particular challenge for percutaneous coronary intervention. AIMS: The aim of this randomized study was to determine whether coronary intravascular lithotripsy (IVL) is non-inferior to rotational atherectomy (RA) regarding minimal stent area (MSA). METHODS: The randomized, prospective non-inferiority ROTA.shock trial enrolled 70 patients between July 2019 and November 2021. Patients were randomly (1:1) assigned to undergo either IVL or RA before percutaneous coronary intervention of severely calcified coronary lesions. Optical coherence tomography was performed at the end of the procedure for primary endpoint analysis. RESULTS: The primary endpoint MSA was lower but non-inferior after IVL (mean: 6.10 mm2 , 95% confidence interval [95% CI]: 5.32-6.87 mm2 ) versus RA (6.60 mm2 , 95% CI: 5.66-7.54 mm2 ; difference in MSA: -0.50 mm2 , 95% CI: -1.52-0.52 mm2 ; non-inferiority margin: -1.60 mm2 ). Stent expansion was similar (RA: 0.83 ± 0.10 vs. IVL: 0.82 ± 0.11; p = 0.79). There were no significant differences regarding contrast media consumption (RA: 183.1 ± 68.8 vs. IVL: 163.3 ± 55.0 mL; p = 0.47), radiation dose (RA: 7269 ± 11288 vs. IVL: 5010 ± 4140 cGy cm2 ; p = 0.68), and procedure time (RA: 79.5 ± 34.5 vs. IVL: 66.0 ± 19.4 min; p = 0.18). CONCLUSION: IVL is non-inferior regarding MSA and results in a similar stent expansion in a random comparison with RA. Procedure time, contrast volume, and dose-area product do not differ significantly.

Human cytomegalovirus seropositivity is associated with reduced patient survival during sepsis.

BACKGROUND: Sepsis is one of the leading causes of death. Treatment attempts targeting the immune response regularly fail in clinical trials. As HCMV latency can modulate the immune response and changes the immune cell composition, we hypothesized that HCMV serostatus affects mortality in sepsis patients. METHODS: We determined the HCMV serostatus (i.e., latency) of 410 prospectively enrolled patients of the multicenter SepsisDataNet.NRW study. Patients were recruited according to the SEPSIS-3 criteria and clinical data were recorded in an observational approach. We quantified 13 cytokines at Days 1, 4, and 8 after enrollment. Proteomics data were analyzed from the plasma samples of 171 patients. RESULTS: The 30-day mortality was higher in HCMV-seropositive patients than in seronegative sepsis patients (38% vs. 25%, respectively; p = 0.008; HR, 1.656; 95% CI 1.135-2.417). This effect was observed independent of age (p = 0.010; HR, 1.673; 95% CI 1.131-2.477). The predictive value on the outcome of the increased concentrations of IL-6 was present only in the seropositive cohort (30-day mortality, 63% vs. 24%; HR 3.250; 95% CI 2.075-5.090; p < 0.001) with no significant differences in serum concentrations of IL-6 between the two groups. Procalcitonin and IL-10 exhibited the same behavior and were predictive of the outcome only in HCMV-seropositive patients. CONCLUSION: We suggest that the predictive value of inflammation-associated biomarkers should be re-evaluated with regard to the HCMV serostatus. Targeting HCMV latency might open a new approach to selecting suitable patients for individualized treatment in sepsis.

Universal magnetic proximity effect in ferromagnet-semiconductor quantum well hybrid structures.

Hybrid ferromagnet-semiconductor systems possess new outstanding properties, which emerge when bringing magnetic and semiconductor materials into contact. In such structures, the long-range magnetic proximity effect couples the spin systems of the ferromagnet and semiconductor on distances exceeding the carrier wave function overlap. The effect is due to the effective p-d exchange interaction of acceptor-bound holes in the quantum well with d-electrons of the ferromagnet. This indirect interaction is established via the phononic Stark effect mediated by the chiral phonons. Here, we demonstrate that the long-range magnetic proximity effect is universal and observed in hybrid structures with diverse magnetic components and potential barriers of various thicknesses and compositions. We study hybrid structures consisting of a semimetal (magnetite Fe3O4) or dielectric (spinel NiFe2O4) ferromagnet and a CdTe quantum well separated by a nonmagnetic (Cd,Mg)Te barrier. The proximity effect is manifested in the circular polarization of the photoluminescence corresponding to the recombination of photoexcited electrons with holes bound to shallow acceptors in the quantum well induced by magnetite or spinel itself, in contrast to interface ferromagnet in case of metal-based hybrid systems. A nontrivial dynamics of the proximity effect is observed in the studied structures due to recombination-induced dynamic polarization of electrons in the quantum well. It enables the determination of the exchange constant Δexch ≈ 70 µeV in a magnetite-based structure. The universal origin of the long-range exchange interaction along with the possibility of its electrical control offers prospects for the development of low-voltage spintronic devices compatible with existing solid-state electronics.

Dynamic Polarization of Electron Spins Interacting with Nuclei in Semiconductor Nanostructures.

We suggest a new spin orientation mechanism for localized electrons: dynamic electron spin polarization provided by nuclear spin fluctuations. The detrimental effect of nuclear spin fluctuations can be harnessed and employed to provide angular momentum for the electrons via the hyperfine interaction in a weak magnetic field. For this, the sample is illuminated by an unpolarized light, which directly polarizes neither the electrons nor the nuclei. We predict that, for the electrons bound in localized excitons, 100% spin polarization can be reached in longitudinal magnetic fields of a few millitesla. The proof of principle experiment is performed on momentum-indirect excitons in (In,Al)As/AlAs quantum dots, where in a magnetic field of 17 mT the electron spin polarization of 30% is measured.

Giant Rydberg excitons in the copper oxide Cu2O.

A highly excited atom having an electron that has moved into a level with large principal quantum number is a hydrogen-like object, termed a Rydberg atom. The giant size of Rydberg atoms leads to huge interaction effects. Monitoring these interactions has provided insights into atomic and molecular physics on the single-quantum level. Excitons--the fundamental optical excitations in semiconductors, consisting of an electron and a positively charged hole--are the condensed-matter analogues of hydrogen. Highly excited excitons with extensions similar to those of Rydberg atoms are of interest because they can be placed and moved in a crystal with high precision using microscopic energy potential landscapes. The interaction of such Rydberg excitons may allow the formation of ordered exciton phases or the sensing of elementary excitations in their surroundings on a quantum level. Here we demonstrate the existence of Rydberg excitons in the copper oxide Cu2O, with principal quantum numbers as large as n = 25. These states have giant wavefunction extensions (that is, the average distance between the electron and the hole) of more than two micrometres, compared to about a nanometre for the ground state. The strong dipole-dipole interaction between such excitons is indicated by a blockade effect in which the presence of one exciton prevents the excitation of another in its vicinity.

Tracking Dark Excitons with Exciton Polaritons in Semiconductor Microcavities.

Dark excitons are of fundamental importance for a wide variety of processes in semiconductors but are difficult to investigate using optical techniques due to their weak interaction with light fields. We reveal and characterize dark excitons nonresonantly injected into a semiconductor microcavity structure containing InGaAs/GaAs quantum wells by a gated train of eight 100 fs pulses separated by 13 ns by monitoring their interactions with the bright lower polariton mode. We find a surprisingly long dark exciton lifetime of more than 20 ns, which is longer than the time delay between two consecutive pulses. This creates a memory effect that we clearly observe through the variation of the time-resolved transmission signal. We propose a rate equation model that provides a quantitative agreement with the experimental data.

Nanosecond Spin Coherence Time of Nonradiative Excitons in GaAs/AlGaAs Quantum Wells.

We report on the experimental evidence for a nanosecond timescale spin memory based on nonradiative excitons with large in-plane wave vector. The effect manifests itself in magnetic-field-induced oscillations of the energy of the optically active (radiative) excitons. The oscillations detected by a spectrally resolved pump-probe technique applied to a GaAs/AlGaAs quantum well structure in a transverse magnetic field persist over a timescale, which is orders of magnitude longer than the characteristic decoherence time in the system. The effect is attributed to the spin-dependent electron-electron exchange interaction of the optically active and inactive excitons. The spin relaxation time of the electrons belonging to nonradiative excitons appears to be much longer than the hole spin relaxation time.

Rydberg Excitons in the Presence of an Ultralow-Density Electron-Hole Plasma.

We study the Rydberg exciton absorption of Cu_{2}O in the presence of free carriers injected by above-band-gap illumination. Already at plasma densities ρ_{EH} below one hundredth electron-hole pair per µm^{3}, exciton lines are bleached, starting from the highest observed principal quantum number, while their energies remain constant. Simultaneously, the band gap decreases by correlation effects with the plasma. An exciton line loses oscillator strength when the band gap approaches its energy, vanishing completely at the crossing point. Adapting a plasma-physics description, we describe the observations by an effective Bohr radius that increases with rising plasma density, reflecting the Coulomb interaction screening by the plasma.

Picosecond Control of Quantum Dot Laser Emission by Coherent Phonons.

A picosecond acoustic pulse can be used to control the lasing emission from semiconductor nanostructures by shifting their electronic transitions. When the active medium, here an ensemble of (In,Ga)As quantum dots, is shifted into or out of resonance with the cavity mode, a large enhancement or suppression of the lasing emission can dynamically be achieved. Most interesting, even in the case when gain medium and cavity mode are in resonance, we observe an enhancement of the lasing due to shaking by coherent phonons. In order to understand the interactions of the nonlinearly coupled photon-exciton-phonon subsystems, we develop a semiclassical model and find an excellent agreement between theory and experiment.

Signatures of Quantum Coherences in Rydberg Excitons.

Coherent optical control of individual particles has been demonstrated both for atoms and semiconductor quantum dots. Here we demonstrate the emergence of quantum coherent effects in semiconductor Rydberg excitons in bulk Cu_{2}O. Because of the spectral proximity between two adjacent Rydberg exciton states, a single-frequency laser may pump both resonances with little dissipation from the detuning. As a consequence, additional resonances appear in the absorption spectrum that correspond to dressed states consisting of two Rydberg exciton levels coupled to the excitonic vacuum, forming a V-type three-level system, but driven only by one laser light source. We show that the level of pure dephasing in this system is extremely low. These observations are a crucial step towards coherently controlled quantum technologies in a bulk semiconductor.

Polaron-induced lattice distortion of (In,Ga)As/GaAs quantum dots by optically excited carriers.

We report on a high resolution x-ray diffraction study unveiling the effect of carriers optically injected into (In,Ga)As quantum dots on the surrounding GaAs crystal matrix. We find a tetragonal lattice expansion with enhanced elongation along the [001] crystal axis that is superimposed on an isotropic lattice extension. The isotropic contribution arises from excitation induced lattice heating as confirmed by temperature dependent reference studies. The tetragonal expansion on the femtometer scale is tentatively attributed to polaron formation by carriers trapped in the quantum dots.

Influence of the Nuclear Electric Quadrupolar Interaction on the Coherence Time of Hole and Electron Spins Confined in Semiconductor Quantum Dots.

The real-time spin dynamics and the spin noise spectra are calculated for p and n-charged quantum dots within an anisotropic central spin model extended by additional nuclear electric quadrupolar interactions and augmented by experimental data. Using realistic estimates for the distribution of coupling constants including an anisotropy parameter, we show that the characteristic long time scale is of the same order for electron and hole spins strongly determined by the quadrupolar interactions even though the analytical form of the spin decay differs significantly consistent with our measurements. The low frequency part of the electron spin noise spectrum is approximately 1/3 smaller than those for hole spins as a consequence of the spectral sum rule and the different spectral shapes. This is confirmed by our experimental spectra measured on both types of quantum dot ensembles in the low power limit of the probe laser.

Photon-Statistics Excitation Spectroscopy of a Quantum-Dot Micropillar Laser.

We introduce photon-statistics excitation spectroscopy and exemplarily apply it to a quantum-dot micropillar laser. Both the intensity and the photon number statistics of the emission from the micropillar show a strong dependence on the photon statistics of the light used for excitation of the sample. The results under coherent and pseudothermal excitation reveal that a description of the laser properties in terms of mean input photon numbers is not sufficient. It is demonstrated that the micropillar acts as a superthermal light source when operated close to its threshold. Possible applications for important spectroscopic techniques are discussed.

Observation of High Angular Momentum Excitons in Cuprous Oxide.

The recent observation of dipole-allowed P excitons up to principal quantum numbers of n=25 in cuprous oxide has given insight into exciton states with unprecedented spectral resolution. While so far the exciton description as a hydrogenlike complex has been fully adequate for cubic crystals, we demonstrate here distinct deviations: The breaking of rotational symmetry leads to mixing of high angular momentum F and H excitons with the P excitons so that they can be observed in absorption. The F excitons show a threefold splitting that depends systematically on n, in agreement with theoretical considerations. From detailed comparison of experiment and theory we determine the cubic anisotropy parameter of the Cu(2)O valence band.

Direct observation of correlations between individual photon emission events of a microcavity laser.

Lasers are recognized for coherent light emission, the onset of which is reflected in a change in the photon statistics. For many years, attempts have been made to directly measure correlations in the individual photon emission events of semiconductor lasers. Previously, the temporal decay of these correlations below or at the lasing threshold was considerably faster than could be measured with the time resolution provided by the Hanbury Brown/Twiss measurement set-up used. Here we demonstrate a measurement technique using a streak camera that overcomes this limitation and provides a record of the arrival times of individual photons. This allows us to investigate the dynamical evolution of correlations between the individual photon emission events. We apply our studies to micropillar lasers with semiconductor quantum dots as the active material, operating in the regime of cavity quantum electrodynamics. For laser resonators with a low cavity quality factor, Q, a smooth transition from photon bunching to uncorrelated emission with increasing pumping is observed; for high-Q resonators, we see a non-monotonic dependence around the threshold where quantum light emission can occur. We identify regimes of dynamical anti-bunching of photons in agreement with the predictions of a microscopic theory that includes semiconductor-specific effects.

Reference values of osteocalcin and procollagen type I N-propeptide plasma levels in a healthy Central European population aged 0-18 years.

UNLABELLED: The aim of this study was to assess the relationships between both a marker of bone formation and a marker of bone turnover and age, sex, and pubertal stage in a group (n = 439) of healthy children and adolescents. These reference data should be instrumental in interpretation of results. INTRODUCTION: The skeletal system has high metabolic activity. In children, bone markers may be useful in diagnostics and treatment management of skeletal diseases but there could be difficulties with interpretation of results. Compared with adults, children have elevated bone marker levels due to high skeletal growth velocity and rapid bone turnover. Thus, valid age- and sex-specific reference data should be obtained for each pediatric population living in a particular climate and with a similar lifestyle. The aim of this study was to assess the relationships between both a marker of bone formation (procollagen type I N-terminal propeptide [PINP]) and a marker of bone turnover (osteocalcin [OC]) and age, sex, and pubertal stage in a group of healthy children and adolescents. METHODS: Four hundred thirty-nine healthy Caucasian children participated. Their height, weight, and pubertal stage were recorded. Fasting PINP and OC were measured using a morning blood sample. RESULTS: The highest levels of PINP were observed during the first year of life. There is no OC postnatal peak, but levels are higher than the adult reference interval throughout childhood. OC peaks with the pubertal growth spurt at second-third Tanner stage of breast development in girls and at second-third Tanner stage of genital development in boys. PINP peaks during second-third Tanner stage of breast development in girls and at third Tanner stage of genital development in boys. CONCLUSION: This study provides reference data for OC and PINP in healthy Caucasian children from a Central European population.

Spin noise spectroscopy beyond thermal equilibrium and linear response.

Per the fluctuation-dissipation theorem, the information obtained from spin fluctuation studies in thermal equilibrium is necessarily constrained by the system's linear response functions. However, by including weak radio frequency magnetic fields, we demonstrate that intrinsic and random spin fluctuations even in strictly unpolarized ensembles can reveal underlying patterns of correlation and coupling beyond linear response, and can be used to study nonequilibrium and even multiphoton coherent spin phenomena. We demonstrate this capability in a classical vapor of (41)K alkali atoms, where spin fluctuations alone directly reveal Rabi splittings, the formation of Mollow triplets and Autler-Townes doublets, ac Zeeman shifts, and even nonlinear multiphoton coherences.

Quantum-memory effects in the emission of quantum-dot microcavities.

The experimentally measured input-output characteristics of optically pumped semiconductor microcavities exhibits unexpected oscillations modifying the fundamentally linear slope in the excitation power regime below lasing. A systematic microscopic analysis reproduces these oscillations, identifying them as a genuine quantum-memory effect, i.e., a photon-density correlation accumulated during the excitation. With the use of projected quantum measurements, it is shown that the input-output oscillations can be controlled and enhanced by an order of magnitude when the quantum fluctuations of the pump are adjusted.

Coherent coupling of excitons and trions in a photoexcited CdTe/CdMgTe quantum well.

We present zero-, one-, and two-quantum two-dimensional coherent spectra of excitons and trions in a CdTe/(Cd,Mg)Te quantum well. The set of spectra provides a unique and comprehensive picture of the coherent nonlinear optical response. Distinct peaks in the spectra are manifestations of exciton-exciton and exciton-trion coherent coupling. Excellent agreement using density matrix calculations highlights the essential role of many-body effects on the coupling. Strong exciton-trion coherent interactions open up the possibility for novel conditional control schemes in coherent optoelectronics.

Ageing is associated with diminished muscle re-growth and myogenic precursor cell expansion early after immobility-induced atrophy in human skeletal muscle.

Recovery of skeletal muscle mass from immobilisation-induced atrophy is faster in young than older individuals, yet the cellular mechanisms remain unknown. We examined the cellular and molecular regulation of muscle recovery in young and older human subjects subsequent to 2 weeks of immobility-induced muscle atrophy. Retraining consisted of 4 weeks of supervised resistive exercise in 9 older (OM: mean age) 67.3, range 61-74 yrs) and 11 young (YM: mean age 24.4, range 21-30 yrs) males. Measures of myofibre area (MFA), Pax7-positive satellite cells (SCs) associated with type I and type II muscle fibres, as well as gene expression analysis of key growth and transcription factors associated with local skeletal muscle milieu, were performed after 2 weeks immobility (Imm) and following 3 days (+3d) and 4 weeks (+4wks) of retraining. OM demonstrated no detectable gains in MFA (vastus lateralis muscle) and no increases in number of Pax7-positive SCs following 4wks retraining, whereas YM increased their MFA (P < 0.05), number of Pax7-positive cells, and had more Pax7-positive cells per type II fibre than OM at +3d and +4wks (P < 0.05). No age-related differences were observed in mRNA expression of IGF-1Ea, MGF, MyoD1 and HGF with retraining, whereas myostatin expression levels were more down-regulated in YM compared to OM at +3d (P < 0.05). In conclusion, the diminished muscle re-growth after immobilisation in elderly humans was associated with a lesser response in satellite cell proliferation in combination with an age-specific regulation of myostatin. In contrast, expression of local growth factors did not seem to explain the age-related difference in muscle mass recovery.