Intraoperative pelvic neuromonitoring based on bioimpedance signals: a new method analyzed on 30 patients.

PURPOSE: Increasing importance has been attributed in recent years to the preservation of the pelvic autonomic nerves during rectal resection to achieve better functional results. In addition to improved surgical techniques, intraoperative neuromonitoring may be useful. METHODS: This single-arm prospective study included 30 patients who underwent rectal resection performed with intraoperative neuromonitoring by recording the change in the tissue impedance of the urinary bladder and rectum after stimulation of the pelvic autonomic nerves. The International Prostate Symptom Score, the post-void residual urine volume and the Low Anterior Resection Syndrome Score (LARS score) were assessed during the 12-month follow-up period. RESULTS: A stimulation-induced change in tissue impedance was observed in 28/30 patients (93.3%). In the presence of risk factors such as low anastomosis, neoadjuvant radiotherapy and a deviation stoma, an average increase of the LARS score by 9 points was observed 12 months after surgery (p = 0,04). The function of the urinary bladder remained unaffected in the first week (p = 0,7) as well as 12 months after the procedure (p = 0,93). CONCLUSION: The clinical feasibility of the new method for pelvic intraoperative neuromonitoring could be verified. The benefits of intraoperative pelvic neuromonitoring were particularly evident in difficult intraoperative situations with challenging visualization of the pelvic nerves.

Microsphere kinematics from the polarization of tightly focused nonseparable light.

Recently, it was shown that vector beams can be utilized for fast kinematic sensing via measurements of their global polarization state [Optica2, 864 (2015)10.1364/OPTICA.2.000864]. The method relies on correlations between the spatial and polarization degrees of freedom of the illuminating field which result from its nonseparable mode structure. Here, we extend the method to the nonparaxial regime. We study experimentally and theoretically the far-field polarization state generated by the scattering of a dielectric microsphere in a tightly focused vector beam as a function of the particle position. Using polarization measurements only, we demonstrate position sensing of a Mie particle in three dimensions. Our work extends the concept of back focal plane interferometry and highlights the potential of polarization analysis in optical tweezers employing structured light.

Quantum technologies in space.

Recently, the European Commission supported by many European countries has announced large investments towards the commercialization of quantum technology (QT) to address and mitigate some of the biggest challenges facing today's digital era - e.g. secure communication and computing power. For more than two decades the QT community has been working on the development of QTs, which promise landmark breakthroughs leading to commercialization in various areas. The ambitious goals of the QT community and expectations of EU authorities cannot be met solely by individual initiatives of single countries, and therefore, require a combined European effort of large and unprecedented dimensions comparable only to the Galileo or Copernicus programs. Strong international competition calls for a coordinated European effort towards the development of QT in and for space, including research and development of technology in the areas of communication and sensing. Here, we aim at summarizing the state of the art in the development of quantum technologies which have an impact in the field of space applications. Our goal is to outline a complete framework for the design, development, implementation, and exploitation of quantum technology in space.

Distillation of squeezing using an engineered pulsed parametric down-conversion source.

Hybrid quantum information processing combines the advantages of discrete and continues variable protocols by realizing protocols consisting of photon counting and homodyne measurements. However, the mode structure of pulsed sources and the properties of the detection schemes often require the use of optical filters in order to combine both detection methods in a common experiment. This limits the efficiency and the overall achievable squeezing of the experiment. In our work, we use photon subtraction to implement the distillation of pulsed squeezed states originating from a genuinely spatially and temporally single-mode parametric down-conversion source in non-linear waveguides. Due to the distillation, we witness an improvement of 0.17 dB from an initial squeezing value of -1.648 ± 0.002 dB, while achieving a purity of 0.58, and confirm the non-Gaussianity of the distilled state via the higher-order cumulants. With this, we demonstrate the source's suitability for scalable hybrid quantum network applications with pulsed quantum light.

[Influence of Local Insufflation of Warm Humidified CO2 on the Wound Surface and Body Core Temperature as well as on Wound Healing in Open Colorectal Surgery]. / Einfluss einer lokalen Insufflation von befeuchtetem und erwärmtem CO2 auf die Wundoberflächen- und Körperkerntemperatur sowie auf die Wundheilung in der offenen Kolorektalchirurgie.

BACKGROUND: Perioperative hypothermia may lead to serious complications. This study aims to investigate whether intraoperative insufflation of warmed and humidified carbon dioxide (W-H-CO2) into the open wound during open colorectal surgery influences body core and wound surface temperatures or the incidence of wound healing disorders (WHD). METHODS: Between 02/2018 and 07/2019, 50 patients intended to undergo open resection for colorectal cancer were recruited and randomised to a control group (n = 25) and an experimental group (n = 25). In the experimental group, a device for insufflation of W-H-CO2 was used. Body core and wound surface temperatures were recorded at the beginning and before finishing the procedure. IL-6 serum levels were determined preoperatively and during the postoperative course. Clinical observation of wound healing was performed until the 30th day post-op. RESULTS: Both groups were homogeneous in terms of risk factors for WHD. In the control group, the median body core temperature (1. quartile/3. quartile) was 36.2 °C (36/36.4 °C) when the operation started and 36.2 °C (35.9/36.45 °C) at the end, while in the experimental group it was initially 36.2 °C (35.7/36.4 °C) and 36.4 °C (36/36.7 °C) at the end. There was no significant difference between the two groups (p = 0.08). The wound temperature in the control group dropped from 32.8 °C (median; 31.85/34.05 °C) to 30.7 °C (median; 29.85/32.15 °C). In the experimental group, we recorded a drop from 31.9 °C (median; 30.25/32.95 °C) to 31.6 °C (median; 30.25/31.85 °C), which was statistically significant (p = 0.000475). The dynamic of the IL-6 serum levels in both groups suggest that there was no significant difference (p = 0.66; p = 0.88; p = 0.88). In the control group, 8 patients experienced superficial WHD, 2 anastomotic leakages (AL), while in the experimental group, superficial WHD were observed in 5 patients and AL in 1 patient. This differences between the groups regarding in WHD were not significant (p = 0.42). CONCLUSION: The established measures for prevention of perioperative hypothermia in elective procedures are sufficient. However, the local wound surface temperature is not preserved satisfactorily. Deployment of a device for intraoperative insufflation of W-H-CO2 into open wounds may be suitable for maintaining local normothermia. Further studies are needed to determine the influence of warm and humid CO2 on wound healing.

Stabilization of transmittance fluctuations caused by beam wandering in continuous-variable quantum communication over free-space atmospheric channels.

Transmittance fluctuations in turbulent atmospheric channels result in quadrature excess noise which limits applicability of continuous-variable quantum communication. Such fluctuations are commonly caused by beam wandering around the receiving aperture. We study the possibility to stabilize the fluctuations by expanding the beam, and test this channel stabilization in regard of continuous-variable entanglement sharing and quantum key distribution. We perform transmittance measurements of a real free-space atmospheric channel for different beam widths and show that the beam expansion reduces the fluctuations of the channel transmittance by the cost of an increased overall loss. We also theoretically study the possibility to share an entangled state or to establish secure quantum key distribution over the turbulent atmospheric channels with varying beam widths. We show the positive effect of channel stabilization by beam expansion on continuous-variable quantum communication as well as the necessity to optimize the method in order to maximize the secret key rate or the amount of shared entanglement. Being autonomous and not requiring adaptive control of the source and detectors based on characterization of beam wandering, the method of beam expansion can be also combined with other methods aiming at stabilizing the fluctuating free-space atmospheric channels.

Quantum cryptography with twisted photons through an outdoor underwater channel.

Quantum communication has been successfully implemented in optical fibres and through free-space. Fibre systems, though capable of fast key and low error rates, are impractical in communicating with destinations without an established fibre link. Free-space quantum channels can overcome such limitations and reach long distances with the advent of satellite-to-ground links. However, turbulence, resulting from local fluctuations in refractive index, becomes a major challenge by adding errors and losses. Recently, an interest in investigating the possibility of underwater quantum channels has arisen. Here, we investigate the effect of turbulence on an underwater quantum channel using twisted photons in outdoor conditions. We study the effect of turbulence on transmitted error rates, and compare different quantum cryptographic protocols in an underwater quantum channel, showing the feasibility of high-dimensional encoding schemes. Our work may open the way for secure high-dimensional quantum communication between submersibles, and provides important input for potential submersibles-to-satellite quantum communication.

Single-mode squeezing in arbitrary spatial modes.

As the generation of squeezed states of light has become a standard technique in laboratories, attention is increasingly directed towards adapting the optical parameters of squeezed beams to the specific requirements of individual applications. It is known that imaging, metrology, and quantum information may benefit from using squeezed light with a tailored transverse spatial mode. However, experiments have so far been limited to generating only a few squeezed spatial modes within a given setup. Here, we present the generation of single-mode squeezing in Laguerre-Gauss and Bessel-Gauss modes, as well as an arbitrary intensity pattern, all from a single setup using a spatial light modulator (SLM). The degree of squeezing obtained is limited mainly by the initial squeezing and diffractive losses introduced by the SLM, while no excess noise from the SLM is detectable at the measured sideband. The experiment illustrates the single-mode concept in quantum optics and demonstrates the viability of current SLMs as flexible tools for the spatial reshaping of squeezed light.

Experimental generation of amplitude squeezed vector beams.

We present an experimental method for the generation of amplitude squeezed high-order vector beams. The light is modified twice by a spatial light modulator such that the vector beam is created by means of a collinear interferometric technique. A major advantage of this approach is that it avoids systematic losses, which are detrimental as they cause decoherence in continuous-variable quantum systems. The utilisation of a spatial light modulator (SLM) gives the flexibility to switch between arbitrary mode orders. The conversion efficiency with our setup is only limited by the efficiency of the SLM. We show the experimental generation of Laguerre-Gauss (LG) modes with radial indices 0 or 1 and azimuthal indices up to 3 with complex polarization structures and a quantum noise reduction up to -0.9dB±0.1dB. The corresponding polarization structures are studied in detail by measuring the spatial distribution of the Stokes parameters.

Free-Space Quantum Signatures Using Heterodyne Measurements.

Digital signatures guarantee the authorship of electronic communications. Currently used "classical" signature schemes rely on unproven computational assumptions for security, while quantum signatures rely only on the laws of quantum mechanics to sign a classical message. Previous quantum signature schemes have used unambiguous quantum measurements. Such measurements, however, sometimes give no result, reducing the efficiency of the protocol. Here, we instead use heterodyne detection, which always gives a result, although there is always some uncertainty. We experimentally demonstrate feasibility in a real environment by distributing signature states through a noisy 1.6 km free-space channel. Our results show that continuous-variable heterodyne detection improves the signature rate for this type of scheme and therefore represents an interesting direction in the search for practical quantum signature schemes. For transmission values ranging from 100% to 10%, but otherwise assuming an ideal implementation with no other imperfections, the signature length is shorter by a factor of 2 to 10. As compared with previous relevant experimental realizations, the signature length in this implementation is several orders of magnitude shorter.

Quantum uncertainty in the beam width of spatial optical modes.

We theoretically investigate the quantum uncertainty in the beam width of transverse optical modes and, for this purpose, define a corresponding quantum operator. Single mode states are studied as well as multimode states with small quantum noise. General relations are derived, and specific examples of different modes and quantum states are examined. For the multimode case, we show that the quantum uncertainty in the beam width can be completely attributed to the amplitude quadrature uncertainty of one specific mode, which is uniquely determined by the field under investigation. This discovery provides us with a strategy for the reduction of the beam width noise by an appropriate choice of the quantum state.

Depolarized guided acoustic wave Brillouin scattering in hollow-core photonic crystal fibers.

By performing quantum-noise-limited optical heterodyne detection, we observe polarization noise in light after propagation through a hollow-core photonic crystal fiber (PCF). We compare the noise spectrum to the one of a standard fiber and find an increase of noise even though the light is mainly transmitted in air in a hollow-core PCF. Combined with our simulation of the acoustic vibrational modes in the hollow-core PCF, we are offering an explanation for the polarization noise with a variation of guided acoustic wave Brillouin scattering (GAWBS). Here, instead of modulating the strain in the fiber core as in a solid core fiber, the acoustic vibrations in hollow-core PCF influence the effective refractive index by modulating the geometry of the photonic crystal structure. This induces polarization noise in the light guided by the photonic crystal structure.

Entangling the Whole by Beam Splitting a Part.

A beam splitter is a basic linear optical element appearing in many optics experiments and is frequently used as a continuous-variable entangler transforming a pair of input modes from a separable Gaussian state into an entangled state. However, a beam splitter is a passive operation that can create entanglement from Gaussian states only under certain conditions. One such condition is that the input light is suitably squeezed. We demonstrate, experimentally, that a beam splitter can create entanglement even from modes which do not possess such a squeezing provided that they are correlated to, but not entangled with, a third mode. Specifically, we show that a beam splitter can create three-mode entanglement by acting on two modes of a three-mode fully separable Gaussian state without entangling the two modes themselves. This beam splitter property is a key mechanism behind the performance of the protocol for entanglement distribution by separable states. Moreover, the property also finds application in collaborative quantum dense coding in which decoding of transmitted information is assisted by interference with a mode of the collaborating party.

Biotechnologically produced microbial alginate dressings show enhanced gel forming capacity compared to commercial alginate dressings of marine origin.

Marine alginate fibre dressings are well established in wound management. Alginate fibres can absorb plenty of wound exudate due to their gel forming abilities and ion exchange. Alginates from bacteria have never been studied for medical applications so far, although the microbial polymer raises expectations for improved gelling capacity due to its unique O-acetylation. To prove the gelling capacity of bacterial alginate, we extracted the co-polymer from fermentation of the soil bacterium Azotobacter vinelandii ATCC 9046, cultivated on crude glycerol as an alternative carbon source. Bacterial alginate was isolated in high purity and extruded by a wet spinning method. Fibre structure and properties were characterised by infrared spectroscopy, NMR, GPC, scanning electron microscopy and tensile testing. The fibres could be processed into biocompatible needle web dressings, which showed more than twice the gel formation in saline compared to commercial dressings made of marine alginates. Gelled dressings of bacterial alginate formed stable hydrogels of sufficient shape and strength for wound healing applications. This work suggests that the increased gel formation of bacterial alginate from A. vinelandii may be optimal for the preparation of novel wound dressings.

Atomic mercury vapor inside a hollow-core photonic crystal fiber.

We demonstrate high atomic mercury vapor pressure in a kagomé-style hollow-core photonic crystal fiber at room temperature. After a few days of exposure to mercury vapor the fiber is homogeneously filled and the optical depth achieved remains constant. With incoherent optical pumping from the ground state we achieve an optical depth of 114 at the 6(3)P(2) - 6(3)D(3) transition, corresponding to an atomic mercury number density of 6 × 10(10) cm(-3). The use of mercury vapor in quasi one-dimensional confinement may be advantageous compared to chemically more active alkali vapor, while offering strong optical nonlinearities in the ultraviolet region of the optical spectrum.

Identifying modes of large whispering-gallery mode resonators from the spectrum and emission pattern.

Identifying the mode numbers in whispering-gallery mode resonators (WGMRs) is important for tailoring them to experimental needs. Here we report on a novel experimental mode analysis technique based on the combination of frequency analysis and far-field imaging for high mode numbers of large WGMRs. The radial mode numbers q and the angular mode numbers p = ℓ-m are identified and labeled via far-field imaging. The polar mode numbers ℓ are determined unambiguously by fitting the frequency differences between individual whispering gallery modes (WGMs). This allows for the accurate determination of the geometry and the refractive index at different temperatures of the WGMR. For future applications in classical and quantum optics, this mode analysis enables one to control the narrow-band phase-matching conditions in nonlinear processes such as second-harmonic generation or parametric down-conversion.

Observation of the geometric spin Hall effect of light.

The spin Hall effect of light (SHEL) is the photonic analogue of the spin Hall effect occurring for charge carriers in solid-state systems. This intriguing phenomenon manifests itself when a light beam refracts at an air-glass interface (conventional SHEL) or when it is projected onto an oblique plane, the latter effect being known as the geometric SHEL. It amounts to a polarization-dependent displacement perpendicular to the plane of incidence. In this work, we experimentally investigate the geometric SHEL for a light beam transmitted across an oblique polarizer. We find that the spatial intensity distribution of the transmitted beam depends on the incident state of polarization and its centroid undergoes a positional displacement exceeding one wavelength. This novel phenomenon is virtually independent from the material properties of the polarizer and, thus, reveals universal features of spin-orbit coupling.

Distribution of squeezed states through an atmospheric channel.

Continuous variable quantum states of light are used in quantum information protocols and quantum metrology and known to degrade with loss and added noise. We were able to show the distribution of bright polarization squeezed quantum states of light through an urban free-space channel of 1.6 km length. To measure the squeezed states in this extreme environment, we utilize polarization encoding and a postselection protocol that is taking into account classical side information stemming from the distribution of transmission values. The successful distribution of continuous variable squeezed states is accentuated by a quantum state tomography, allowing for determining the purity of the state.

Automatic muscle impedance and nerve analyzer (AMINA) as a novel approach for classifying bioimpedance signals in intraoperative pelvic neuromonitoring.

Frequent complications arising from low anterior resections include urinary and fecal incontinence, as well as sexual disorders, which are commonly associated with damage to the pelvic autonomic nerves during surgery. To assist the surgeon in preserving pelvic autonomic nerves, a novel approach for intraoperative pelvic neuromonitoring was investigated that is based on impedance measurements of the innervated organs. The objective of this work was to develop an algorithm called AMINA to classify the bioimpedance signals, with the goal of facilitating signal interpretation for the surgeon. Thirty patients included in a clinical investigation underwent nerve-preserving robotic rectal surgery using intraoperative pelvic neuromonitoring. Contraction of the urinary bladder and/or rectum, triggered by direct stimulation of the innervating nerves, resulted in a change in tissue impedance signal, allowing the nerves to be identified and preserved. Impedance signal characteristics in the time domain and the time-frequency domain were calculated and classified to develop the AMINA. Stimulation-induced positive impedance changes were statistically significantly different from negative stimulation responses by the percent amplitude of impedance change Amax in the time domain. Positive impedance changes and artifacts were distinguished by classifying wavelet scales resulting from peak detection in the continuous wavelet transform scalogram, which allowed implementation of a decision tree underlying the AMINA. The sensitivity of the software-based signal evaluation by the AMINA was 96.3%, whereas its specificity was 91.2%. This approach streamlines and automates the interpretation of impedance signals during intraoperative pelvic neuromonitoring.

An optimized photon pair source for quantum circuits.

We implement an ultrafast pulsed type-II parametric down conversion source in a periodically poled KTP waveguide at telecommunication wavelengths with almost identical properties between signal and idler. As such, our source resembles closely a pure, genuine single mode photon pair source with indistinguishable modes. We measure the joint spectral intensity distribution and second order correlation functions of the marginal beams and find with both methods very low effective mode numbers corresponding to a Schmidt number below 1.16. We further demonstrate the indistinguishability as well as the purity of signal and idler photons by Hong-Ou-Mandel interferences between signal and idler and between signal/idler and a coherent field, respectively. Without using narrowband spectral filtering, we achieve a visibility for the interference between signal and idler of 94.8% and determine a purity of more than 80% for the heralded single photon states. Moreover, we measure raw heralding efficiencies of 20.5% and 15.5% for the signal and idler beams corresponding to detector-loss corrected values of 80% and 70%.