Correction of the pelvic incidence using a bilateral extending pelvic osteotomy: a proof of concept study.

INTRODUCTION: The aim of this proof of concept human cadaver study was to quantify the effect of a bilateral extending pelvic osteotomy (BEPO) on pelvic incidence (PI) as a potential alternative for a pedicle subtraction osteotomy (PSO) in patients with severe spinal sagittal malalignment. MATERIALS AND METHODS: 10 fresh frozen human cadavers were treated with the BEPO technique. CT images were made before and after the osteotomy and pure sagittal images were created on which PI was measured. RESULTS: The mean pre-osteotomy PI was 47.9° (range 36.4-63.9) and the mean post-osteotomy PI was 36.5° (range 22.1-54.4). The mean correction was - 10.4° with a range of - 8.4° to - 17.3° (p = 0.03), which resulted in a mean decrease of 23% in the PI (range 16-42). CONCLUSIONS: There was a feasible and effective correction of PI using the BEPO technique on the os ilium. This was a preliminary cadaveric study. No conclusions could be made on global sagittal alignment. We postulate that an extending osteotomy of the ilium could be a potential alternative for a PSO reducing the complexity of spine surgery in patients with severe spinal sagittal malalignment.

Directed delivery of terahertz frequency radiation from quantum cascade lasers within a dry 3He dilution refrigerator.

We present a scheme for the full integration of terahertz (THz) frequency quantum cascade lasers (QCLs) within a dilution refrigerator in order to provide a directed delivery of THz power into the sample space. We describe a successful operation of a 2.68 THz QCL located on the pulse tube cooler stage of the refrigerator, with its output coupled onto a two-dimensional electron gas (2DEG) located on a milli-kelvin sample stage via hollow metal waveguides and Hysol thermal isolators, achieving a total loss from QCL to the sample of ∼-9 dB. The thermal isolators limit heat leaks to the sample space, with a base temperature of ∼210 mK being achieved. We observe cyclotron resonance (CR) induced in the 2DEG by the QCL and explore the heating impact of the QCL on all stages of the refrigerator. The CR effect induced by the THz QCL is observable at electron temperatures as low as ∼430 mK. The results show a viable route for the exploitation of THz QCLs within the environment of a dilution refrigerator and for the THz power delivery in very low-temperature (<0.5 K) condensed matter experiments.

Terahertz magnetoplasmon resonances in coupled cavities formed in a gated two-dimensional electron gas.

We report on both experiments and theory of low-terahertz frequency range (up to 400 GHz) magnetoplasmons in a gated two-dimensional electron gas at low (<4K) temperatures. The evolution of magnetoplasmon resonances was observed as a function of magnetic field at frequencies up to ∼400 GHz. Full-wave 3D simulations of the system predicted the spatial distribution of plasmon modes in the 2D channel, along with their frequency response, allowing us to distinguish those resonances caused by bulk and edge magnetoplasmons in the experiments. Our methodology is anticipated to be applicable to the low temperature (<4K) on-chip terahertz measurements of a wide range of other low-dimensional mesoscopic systems.

Tunable broadband terahertz polarizer using graphene-metal hybrid metasurface.

We demonstrate an electrically tunable polarizer for terahertz (THz) frequency electromagnetic waves formed from a hybrid graphene-metal metasurface. Broadband (>3 THz) polarization-dependent modulation of THz transmission is demonstrated as a function of the graphene conductivity for various wire grid geometries, each tuned by gating using an overlaid ion gel. We show a strong enhancement of modulation (up to ∼17 times) compared to graphene wire grids in the frequency range of 0.2-2.5 THz upon introduction of the metallic elements. Theoretical calculations, considering both plasmonic coupling and Drude absorption, are in good agreement with our experimental findings.

Increasing the sensitivity of terahertz split ring resonator metamaterials for dielectric sensing by localized substrate etching.

We demonstrate a significant enhancement in the sensitivity of split ring resonator terahertz metamaterial dielectric sensors by the introduction of etched trenches into their inductive-capacitive gap area, both through finite element simulations and in experiments performed using terahertz time-domain spectroscopy. The enhanced sensitivity is demonstrated by observation of an increased frequency shift in response to overlaid dielectric material of thicknesses up to 18 µm deposited on to the sensor surface. We show that sensitivity to the dielectric is enhanced by a factor of up to ∼2.7 times by the incorporation of locally etched trenches with a depth of ∼3.4 µm, for example, and discuss the effect of the etching on the electrical properties of the sensors. Our experimental findings are in good agreement with simulations of the sensors obtained using finite element methods.

Non-universality of scaling exponents in quantum Hall transitions.

We have investigated experimentally the scaling behaviour of quantum Hall transitions in GaAs/AlGaAs heterostructures of a range of mobility, carrier concentration, and spacer layer width. All three critical scaling exponents γ, κ and p were determined independently for each sample. We measure the localization length exponent to be γ ≈ 2.3, in good agreement with expected predictions from scaling theory, but κ and p are found to possess non-universal values. Results obtained for κ range from κ = 0.16 ± 0.02 to κ = 0.67 ± 0.02, and are found to be Landau level (LL) dependent, whereas p is found to decrease with increasing sample mobility. Our results demonstrate the existence of two transport regimes in the LL conductivity peak; universality is found within the quantum coherent transport regime present in the tails of the conductivity peak, but is absent within the classical transport regime found close to the critical point at the centre of the conductivity peak. We explain these results using a percolation model and show that the critical scaling exponent depends on certain important length scales that correspond to the microscopic description of electron transport in the bulk of a two-dimensional electron system.

A low-power, high-speed, 9-channel germanium-silicon electro-absorption modulator array integrated with digital CMOS driver and wavelength multiplexer.

We demonstrate the first germanium-silicon C-band electro-absorption based waveguide modulator array and echelle-grating-based silicon wavelength multiplexer integrated with a digital CMOS driver circuit. A 9-channel, 10Gbps SiGe electro-absorption wavelength-multiplexed modulator array consumed a power of 5.8mW per channel while being modulated at 10.25Gbps by 40nm CMOS drivers delivering peak-to-peak voltage swings of 2V, achieving a modulation energy-efficiency of ~570fJ/bit including drivers. Performance up to 25Gbps on a single-channel SiGe modulator and CMOS driver is also reported.

On-chip terahertz spectroscopic techniques for measuring mesoscopic quantum systems.

We present the self-aligned fabrication of on-chip devices in which waveguides, incorporating integrated photoconductive switches, are combined with two-dimensional electron systems to allow probing of the ultrafast (terahertz frequency range) properties of confined semiconductor systems, both at cryogenic temperatures and in high magnetic fields. We demonstrate the direct injection of on-chip terahertz pulses into the mesoscopic system by femtosecond, near infra-red laser excitation of in-plane photoconductive switches formed on an epitaxially grown, low-temperature GaAs layer, which is integrated monolithically with a GaAs∕AlGaAs heterostructure containing a two-dimensional electron system. Both the input and output terahertz signals of an on-chip waveguide are sampled by altering dynamically the photoconductive excitation∕detection arrangement in situ on a single device. We also demonstrate a new method for sub-Kelvin excitation and detection of on-chip terahertz frequency radiation in a (3)He∕(4)He dilution refrigerator that allows the photocurrent and detected terahertz transient to be mapped as function of the near-infrared excitation position at the emitter and the detector, respectively. Furthermore, we demonstrate transmission of terahertz transients through a two-dimensional electron system in a coplanar waveguide under magnetic field at temperatures as low as 200 mK.

Power-efficient III-V/silicon external cavity DBR lasers.

We report the design and characterization of external-cavity DBR lasers built with a III-V-semiconductor reflective-SOA with spot-size converter edge-coupled to SOI waveguides containing Bragg grating mirrors. The un-cooled lasers have wall-plug-efficiencies of up to 9.5% at powers of 6 mW. The lasers are suitable for making power efficient, hybrid WDM transmitters in a CMOS-compatible SOI optical platform.

Measurement and analysis of the diffuse reflectance of powdered samples at terahertz frequencies using a quantum cascade laser.

We report terahertz (THz) diffuse reflectance measurements of bulk powdered samples at a frequency of 2.83 THz using a narrowband quantum cascade laser. Samples studied comprise polydisperse powders with absorption coefficients extending over two orders of magnitude from ∼3 cm(-1) to >200 cm(-1). Diffuse reflectance measurements are used to obtain the effective absorption coefficient of these samples from the backscattering cross-section, predicted under the quasi-crystalline approximation (QCA) in the T-matrix formulation and in conjunction with the Percus-Yevick pair distribution function. Results are compared with effective absorption coefficients obtained from THz time-domain spectroscopy measurements on pressed pellet samples, and show good agreement over the range of effective absorption coefficients studied. We observe that the backscattering cross-section predicted under the QCA is strongly dependent on both the real and imaginary components of the complex permittivity of the sample, and we show that reliable determination of the absorption coefficient from diffuse reflectance measurements therefore requires knowledge of the sample's refractive index. This work demonstrates the applicability of diffuse reflectance measurements, using a THz frequency quantum cascade laser, to the high-resolution spectroscopic analysis of bulk powdered samples at THz frequencies.

Wide bandwidth, low loss 1 by 4 wavelength division multiplexer on silicon for optical interconnects.

We demonstrate an add/drop filter based on coupled vertical gratings on silicon. Tailoring of the channel bandwidth and wavelength is experimentally demonstrated. The concept is extended to implement a 1 by 4 wavelength division multiplexer with 6 nm channel separation, 3 nm bandwidth, a flat top response with < 0.8 dB ripple within the 3 dB passband, 1 dB insertion loss and 16 dB crosstalk suppression. The device is ultracompact, having a footprint < 2 X 10(-9)/2.

Quality of life and lymphedema following breast cancer.

The aim of the study was to compare Quality of Life (QOL) of breast cancer patients with and without secondary lymphedema (SLE) using a cross-sectional design with a convenience sample. Research packets were mailed to 2088 breast cancer patients (BrCaPt). The QOL component of the study used the Quality of Life Instrument --Breast Cancer Patient Version for data collection. The sample (n = 537) was 12.9% African-American/Hispanic/Other (AA) and 87.1% European-American (EA). One hundred and twenty-two women (22.7%) reported SLE. Overall and subscale means were computed and ANOVA was determined for seven variables: age, marital status, educational level, race, type of surgery, time since diagnosis, and SLE. Women without SLE had a higher overall mean QOL score compared to women with SLE (p= 0.02). Women with a greater than high school education had a higher mean QOL score compared to women with high school or less education (p=0.05). SLE patients had poorer QOL in the physical (p<0.001), and social (p=0.004) subscales. Older women had a higher overall QOL compared to younger women (p<0.001). These results provide insight into the impact of SLE on women's QOL and pinpoint that physical and social well being are negatively influenced by SLE.

PAM-4 Signaling over VCSELs with 0.13microm CMOS Chip Technology.

We present results for VCSEL based links operating PAM-4 signaling using a commercial 0.13microm CMOS technology. We perform a complete link analysis of the Bit Error Rate, Q factor, random and deterministic jitter by measuring waterfall curves versus margins in time and amplitude. We demonstrate that VCSEL based PAM-4 can match or even improve performance over binary signaling under conditions of a bandwidth limited, 100meter multi-mode optical link at 5Gbps. We present the first sensitivity measurements for optical PAM-4 and compare it with binary signaling. Measured benefits are reconciled with information theory predictions.

Associations of short-term weight changes and weight cycling with incidence of essential hypertension in the EPIC-Potsdam Study.

The aim of this study was to examine the relationships of short-term weight gain, weight loss, and weight cycling on the odds of developing hypertension. Normotensive middle-aged German men and women (n=12,362) of the European Prospective Investigation into Cancer and Nutrition-Potsdam Study were assigned to categories of 2-year short-term weight changes that were self-reported to have occurred prior to recruitment into the study (gain only, loss only, weight cycling, stable). After 2 years of follow-up after recruitment, 180 cases of incident essential hypertension were identified. In logistic regression models, odds ratios were estimated for the associations between short-term weight changes and risk of developing hypertension. Obesity status (BMI>or=30 or BMI<30 kg/m2) modified the associations between short-term weight change and incidence of diagnosed hypertension. Among obese individuals, short-term weight gain occurring during the 2 years prior to recruitment (OR=2.79, 95% CI 1.19-6.56), weight loss (OR=6.74, 95% CI 2.58-17.6) and weight cycling (OR=4.29, 95% CI 1.55-11.9) were strongly positively associated with incident hypertension, adjusted for age and gender, compared to obese individuals with short-term stable weight. No significant associations between short-term weight changes and risk of diagnosed hypertension were detected among non-obese individuals. Short-term weight changes appeared to present strong risk factors for developing hypertension among obese individuals. The effect seen for weight cycling supports the hypothesis that weight cycling increases the risk of hypertension. The finding for short-term weight loss may be explained by subsequent weight regain and needs further investigation.

The macrobiotic diet in cancer.

Macrobiotics is one of the most popular alternative or complementary comprehensive lifestyle approaches to cancer. The centerpiece of macrobiotics is a predominantly vegetarian, whole-foods diet that has gained popularity because of remarkable case reports of individuals who attributed recoveries from cancers with poor prognoses to macrobiotics and the substantial evidence that the many dietary factors recommended by macrobiotics are associated with decreased cancer risk. Women consuming macrobiotic diets have modestly lower circulating estrogen levels, suggesting a lower risk of breast cancer. This may be due in part to the high phytoestrogen content of the macrobiotic diet. As with most aspects of diet in cancer therapy, there has been limited research evaluating the effectiveness of the macrobiotic diet in alleviating suffering or prolonging survival of cancer patients. The few studies have compared the experience of cancer patients who tried macrobiotics with expected survival rates or assembled series of cases that may justify more rigorous research. On the basis of available evidence and its similarity to dietary recommendations for chronic disease prevention, the macrobiotic diet probably carries a reduced cancer risk. However, at present, the empirical scientific basis for or against recommendations for use of macrobiotics for cancer therapy is limited. Any such recommendations are likely to reflect biases of the recommender. Because of its popularity and the compelling evidence that dietary factors are important in cancer etiology and survival, further research to clarify whether the macrobiotic diet or similar dietary patterns are effective in cancer prevention and treatment is warranted.

A case-control study of unilateral and bilateral breast carcinoma patients.

BACKGROUND: Women with unilateral breast carcinoma are at increased risk for developing contralateral disease. The clinical significance of bilateral breast carcinoma has not been fully defined, and the subset of patients who may benefit from medical or surgical risk-reduction intervention has not yet been characterized. The purpose of this study was to evaluate risk factors and outcomes for bilateral breast carcinoma. METHODS: A subject group of 70 bilateral breast carcinoma patients (62% metachronous) was matched by age and survival interval with a control group of 70 unilateral breast carcinoma patients. Median follow-up was 103 months. RESULTS: Eighty-two percent of the unilateral patients and 80% of the bilateral patients had Stage I or II disease at diagnosis. Median age at presentation was 53 years. In the bilateral group, the contralateral cancer was diagnosed at the same or earlier stage than the first cancer in 87% of cases. Bilateral patients were significantly more likely to have multicentric disease and to have a positive family history for breast carcinoma compared with the unilateral group. There were no significant differences regarding history of exogenous hormone exposure, lobular histology, hormone-receptor status, or HER-2/neu expression. Five-year disease-free survival was 94% for the unilateral breast carcinoma patients and 91% for the bilateral breast carcinoma patients (P = 0.16). CONCLUSIONS: Survival for patients with bilateral breast carcinoma is similar to that of patients with unilateral disease; however, prophylactic risk-reduction intervention for the contralateral breast should be considered in patients who have multicentric unilateral disease or a positive family history for breast carcinoma.

Generation of 90-nJ pulses with a 4-MHz repetition-rate Kerr-lens mode-locked Ti:Al(2)O(3) laser operating with net positive and negative intracavity dispersion.

We demonstrate the generation of high-energy pulses by using a low-repetition-rate Kerr-lens mode-locked laser. Repetition rates as low as 4 MHz were achieved with a long, multiple-pass cavity and a semiconductor saturable Bragg reflector. The laser generated pulses of 55-fs duration with a pulse energy of 48 nJ when it was mode locked in the net negative dispersion regime. Mode locking in the positive dispersion regime reduces instabilities and enables pulses to have durations of 80 fs and energies as high as 90 nJ. This is, to our knowledge, the highest pulse energy and the lowest repetition rate ever generated directly from a femtosecond laser resonator without cavity dumping.

Alterations of p53, cyclin D1, Rb, and H-ras in human oral carcinomas related to tobacco use.

BACKGROUND: Epidemiologic studies have indicated that environmental and personal habits, particularly tobacco use and alcohol abuse, are major etiologic factors in the induction and progression of head and neck squamous cell carcinomas (HNSCC). Molecular studies have focused on HNSCC related to smoking but not those associated with smokeless tobacco. METHODS: The authors studied immunohistochemical evidence of alterations of p53, cyclin D1, and Rb in 34 human oral carcinomas related to tobacco use. They also examined p53 and H-ras using single strand conformation polymorphism (SSCP) and sequencing analysis. RESULTS: Overexpression of cyclin D1 was found in 41% of cases, and accumulation of p53 was found in 59%. Only 9% of the samples did not show Rb staining. In SSCP and sequencing analysis, 17 cases showed mutations in the conserved region of the p53 gene. No mutations were detected in codons 12, 13, or 61 of the H-ras gene. CONCLUSIONS: Overexpression of cyclin D1 and p53 mutations are common alterations in HNSCC. In contrast, the loss of Rb function seems to occur infrequently, and mutations in the H-ras gene apparently do not play a role in this cancer. HNSCC associated with smokeless tobacco contained the same alterations as those related to smoking.

Dual-function detector-modulator smart-pixel module.

We describe a smart-pixel circuit that permits the use of a GaAs/AlGaAs multiple quantum well diode to be used both as a detector for data input and a modulator for data output. The module provides the ability to double the number of inputs or outputs to the array and is well suited to cascaded optoelectronic system architectures that require bidirectional communition.