A machine-learning approach to human ex vivo lung perfusion predicts transplantation outcomes and promotes organ utilization.

Ex vivo lung perfusion (EVLP) is a data-intensive platform used for the assessment of isolated lungs outside the body for transplantation; however, the integration of artificial intelligence to rapidly interpret the large constellation of clinical data generated during ex vivo assessment remains an unmet need. We developed a machine-learning model, termed InsighTx, to predict post-transplant outcomes using n = 725 EVLP cases. InsighTx model AUROC (area under the receiver operating characteristic curve) was 79 ± 3%, 75 ± 4%, and 85 ± 3% in training and independent test datasets, respectively. Excellent performance was observed in predicting unsuitable lungs for transplantation (AUROC: 90 ± 4%) and transplants with good outcomes (AUROC: 80 ± 4%). In a retrospective and blinded implementation study by EVLP specialists at our institution, InsighTx increased the likelihood of transplanting suitable donor lungs [odds ratio=13; 95% CI:4-45] and decreased the likelihood of transplanting unsuitable donor lungs [odds ratio=0.4; 95%CI:0.16-0.98]. Herein, we provide strong rationale for the adoption of machine-learning algorithms to optimize EVLP assessments and show that InsighTx could potentially lead to a safe increase in transplantation rates.

A biomarker assay to risk-stratify patients with symptoms of respiratory tract infection.

BACKGROUND: Patients who present to an emergency department (ED) with respiratory symptoms are often conservatively triaged in favour of hospitalisation. We sought to determine if an inflammatory biomarker panel that identifies the host response better predicts hospitalisation in order to improve the precision of clinical decision making in the ED. METHODS: From April 2020 to March 2021, plasma samples of 641 patients with symptoms of respiratory illness were collected from EDs in an international multicentre study: Canada (n=310), Italy (n=131) and Brazil (n=200). Patients were followed prospectively for 28 days. Subgroup analysis was conducted on confirmed coronavirus disease 2019 (COVID-19) patients (n=245). An inflammatory profile was determined using a rapid, 50-min, biomarker panel (RALI-Dx (Rapid Acute Lung Injury Diagnostic)), which measures interleukin (IL)-6, IL-8, IL-10, soluble tumour necrosis factor receptor 1 (sTNFR1) and soluble triggering receptor expressed on myeloid cells 1 (sTREM1). RESULTS: RALI-Dx biomarkers were significantly elevated in patients who required hospitalisation across all three sites. A machine learning algorithm that was applied to predict hospitalisation using RALI-Dx biomarkers had a mean±sd area under the receiver operating characteristic curve of 76±6% (Canada), 84±4% (Italy) and 86±3% (Brazil). Model performance was 82±3% for COVID-19 patients and 87±7% for patients with a confirmed pneumonia diagnosis. CONCLUSIONS: The rapid diagnostic biomarker panel accurately identified the need for inpatient care in patients presenting with respiratory symptoms, including COVID-19. The RALI-Dx test is broadly and easily applicable across many jurisdictions, and represents an important diagnostic adjunct to advance ED decision-making protocols.

Kinetic inductance driven nanoscale 2D and 3D THz transmission lines.

We examine the unusual dispersion and attenuation of transverse electromagnetic waves in the few-THz regime on nanoscale graphene and copper transmission lines. Conventionally, such propagation has been considered to be highly dispersive, due to the RC time constant-driven voltage diffusion below 1 THz and plasmonic effects at higher optical frequencies. Our numerical modeling across the microwave, THz, and optical frequency ranges reveals that the conductor kinetic inductance creates an ultra-broadband linear-dispersion and constant-attenuation region in the THz regime. This so-called LC region is an ideal characteristic that is known to be absent in macro-scale transmission lines. The kinetic-LC frequency range is dictated by the structural dimensionality and the free-carrier scattering rate of the conductor material. Moreover, up to 40x wavelength reduction is observed in graphene transmission lines.

Extraordinary wavelength reduction in terahertz graphene-cladded photonic crystal slabs.

Photonic crystal slabs have been widely used in nanophotonics for light confinement, dispersion engineering, nonlinearity enhancement, and other unusual effects arising from their structural periodicity. Sub-micron device sizes and mode volumes are routine for silicon-based photonic crystal slabs, however spectrally they are limited to operate in the near infrared. Here, we show that two single-layer graphene sheets allow silicon photonic crystal slabs with submicron periodicity to operate in the terahertz regime, with an extreme 100× wavelength reduction from graphene's large kinetic inductance. The atomically thin graphene further leads to excellent out-of-plane confinement, and consequently photonic-crystal-slab band structures that closely resemble those of ideal two-dimensional photonic crystals, with broad band gaps even when the slab thickness approaches zero. The overall photonic band structure not only scales with the graphene Fermi level, but more importantly scales to lower frequencies with reduced slab thickness. Just like ideal 2D photonic crystals, graphene-cladded photonic crystal slabs confine light along line defects, forming waveguides with the propagation lengths on the order of tens of lattice constants. The proposed structure opens up the possibility to dramatically reduce the size of terahertz photonic systems by orders of magnitude.

Robust reconfigurable electromagnetic pathways within a photonic topological insulator.

The discovery of topological photonic states has revolutionized our understanding of electromagnetic propagation and scattering. Endowed with topological robustness, photonic edge modes are not reflected from structural imperfections and disordered regions. Here we demonstrate robust propagation along reconfigurable pathways defined by synthetic gauge fields within a topological photonic metacrystal. The flow of microwave radiation in helical edge modes following arbitrary contours of the synthetic gauge field between bianisotropic metacrystal domains is unimpeded. This is demonstrated in measurements of the spectrum of transmission and time delay along the topological domain walls. These results provide a framework for freely steering electromagnetic radiation within photonic structures.

Topologically protected elastic waves in phononic metamaterials.

Surface waves in topological states of quantum matter exhibit unique protection from backscattering induced by disorders, making them ideal carriers for both classical and quantum information. Topological matters for electrons and photons are largely limited by the range of bulk properties, and the associated performance trade-offs. In contrast, phononic metamaterials provide access to a much wider range of material properties. Here we demonstrate numerically a phononic topological metamaterial in an elastic-wave analogue of the quantum spin Hall effect. A dual-scale phononic crystal slab is used to support two effective spins for phonons over a broad bandwidth, and strong spin-orbit coupling is realized by breaking spatial mirror symmetry. By preserving the spin polarization with an external load or spatial symmetry, phononic edge states are shown to be robust against scattering from discrete defects as well as disorders in the continuum, demonstrating topological protection for phonons in both static and time-dependent regimes.

Topologically robust sound propagation in an angular-momentum-biased graphene-like resonator lattice.

Topological insulators do not allow conduction in the bulk, yet they support edge modes that travel along the boundary only in one direction, determined by the carried electron spin, with inherent robustness to defects and disorder. Topological insulators have inspired analogues in photonics and optics, in which one-way edge propagation in topologically protected two-dimensional materials is achieved breaking time-reversal symmetry with a magnetic bias. Here, we introduce the concept of topological order in classical acoustics, realizing robust topological protection and one-way edge propagation of sound in a suitably designed resonator lattice biased with angular momentum, forming the acoustic analogue of a magnetically biased graphene layer. Extending the concept of an acoustic nonreciprocal circulator based on angular-momentum bias, time-reversal symmetry is broken here using moderate rotational motion of air within each element of the lattice, which takes the role of the electron spin in determining the direction of modal edge propagation.

Guiding electromagnetic waves around sharp corners: topologically protected photonic transport in metawaveguides.

The wave nature of radiation prevents its reflections-free propagation around sharp corners. We demonstrate that a simple photonic structure based on a periodic array of metallic cylinders attached to one of the two confining metal plates can emulate spin-orbit interaction through bianisotropy. Such a metawaveguide behaves as a photonic topological insulator with complete topological band gap. An interface between two such structures with opposite signs of the bianisotropy supports topologically protected surface waves, which can be guided without reflections along sharp bends of the interface.

Gyromagnetically induced transparency of metasurfaces.

We demonstrate that the presence of a (gyro) magnetic substrate can produce an analog of electromagnetically induced transparency in Fano-resonant metamolecules. The simplest implementation of such gyromagnetically induced transparency (GIT) in a metasurface, comprised of an array of resonant antenna pairs placed on a gyromagnetic substrate and illuminated by a normally incident electromagnetic wave, is analyzed. Time reversal and spatial inversion symmetry breaking introduced by the dc magnetization makes metamolecules bianisotropic. This causes Fano interference between the otherwise uncoupled symmetric and antisymmetric resonances of the metamolecules giving rise to a sharp transmission peak through the otherwise reflective metasurface. We show that, for an oblique wave incidence, one-way GIT can be achieved by the combination of spatial dispersion and gyromagnetic effect. These theoretically predicted phenomena pave the way to nonreciprocal switches and isolators that can be dynamically controlled by electric currents.

Inductive tuning of Fano-resonant metasurfaces using plasmonic response of graphene in the mid-infrared.

Graphene is widely known for its anomalously strong broadband optical absorptivity of 2.3% that enables seeing its single-atom layer with the naked eye. However, in the mid-infrared part of the spectrum graphene represents a quintessential lossless zero-volume plasmonic material. We experimentally demonstrate that, when integrated with Fano-resonant plasmonic metasurfaces, single-layer graphene (SLG) can be used to tune their mid-infrared optical response. SLG's plasmonic response is shown to induce large blue shifts of the metasurface's resonance without reducing its spectral sharpness. This effect is explained by a generalized perturbation theory of SLG-metamaterial interaction that accounts for two unique properties of the SLG that set it apart from all other plasmonic materials: its anisotropic response and zero volume. These results pave the way to using gated SLG as a platform for dynamical spectral tuning of infrared metamaterials and metasurfaces.

Photonic topological insulators.

Recent progress in understanding the topological properties of condensed matter has led to the discovery of time-reversal-invariant topological insulators. A remarkable and useful property of these materials is that they support unidirectional spin-polarized propagation at their surfaces. Unfortunately topological insulators are rare among solid-state materials. Using suitably designed electromagnetic media (metamaterials) we theoretically demonstrate a photonic analogue of a topological insulator. We show that metacrystals-superlattices of metamaterials with judiciously designed properties-provide a platform for designing topologically non-trivial photonic states, similar to those that have been identified for condensed-matter topological insulators. The interfaces of the metacrystals support helical edge states that exhibit spin-polarized one-way propagation of photons, robust against disorder. Our results demonstrate the possibility of attaining one-way photon transport without application of external magnetic fields or breaking of time-reversal symmetry. Such spin-polarized one-way transport enables exotic spin-cloaked photon sources that do not obscure each other.

Contrast between surface plasmon polariton-mediated extraordinary optical transmission behavior in epitaxial and polycrystalline Ag films in the mid- and far-infrared regimes.

In this Letter we report a comparative study, in the infrared regime, of surface plasmon polariton (SPP) propagation in epitaxially grown Ag films and in polycrystalline Ag films, all grown on Si substrates. Plasmonic resonance features are analyzed using extraordinary optical transmission (EOT) measurements, and SPP band structures for the two dielectric/metal interfaces are investigated for both types of film. At the Si/Ag interface, EOT spectra show almost identical features for epitaxial and polycrystalline Ag films and are characterized by sharp Fano resonances. On the contrary, at the air/Ag interface, dramatic differences are observed: while the epitaxial film continues to exhibit sharp Fano resonances, the polycrystalline film shows only broad spectral features and much lower transmission intensities. In corroboration with theoretical simulations, we find that surface roughness plays a critical role in SPP propagation for this wavelength range.

Improved electrical conductivity of graphene films integrated with metal nanowires.

Polycrystalline graphene grown by chemical vapor deposition (CVD) on metals and transferred onto arbitrary substrates has line defects and disruptions such as wrinkles, ripples, and folding that adversely affect graphene transport properties through the scattering of the charge carriers. It is found that graphene assembled with metal nanowires (NWs) dramatically decreases the resistance of graphene films. Graphene/NW films with a sheet resistance comparable to that of the intrinsic resistance of graphene have been obtained and tested as a transparent electrode replacing indium tin oxide films in electrochromic (EC) devices. The successful integration of such graphene/NW films into EC devices demonstrates their potential for a wide range of optoelectronic device applications.

Suppression of long-range collective effects in meta-surfaces formed by plasmonic antenna pairs.

The collective effects in a periodic array of plasmonic double-antenna meta-molecules are studied. We experimentally observe that the collective behavior in this structure substantially differs from the one observed in their single-antenna counterparts. This behavior is explained using an analytical dipole model. We find that in the double-antenna case the effective dipole-dipole interaction is significantly modified and the transverse long-range interaction is suppressed, giving rise to the disappearance of Wood's anomalies. Numerical calculations also show that such suppression of long-range interaction results in an anomalous spatial dispersion of the electric-dipolar mode, making it insensitive to the angle of incidence. In contrast, the quadrupolar mode of the antenna pair experiences strong spatial dispersion. These results show that collective effects in plasmonic metamaterials are very sensitive to the design and topology of meta-molecules. Our findings envision the possibility of suppressing the spatial dispersion effects to weaken the dependence of the metamaterials' response on the incidence angle.

Seeing protein monolayers with naked eye through plasmonic Fano resonances.

We introduce an ultrasensitive label-free detection technique based on asymmetric Fano resonances in plasmonic nanoholes with far reaching implications for point-of-care diagnostics. By exploiting extraordinary light transmission phenomena through high-quality factor (Q(solution) ∼ 200) subradiant dark modes, we experimentally demonstrate record high figures of merits (FOMs as high as 162) for intrinsic detection limits surpassing that of the gold standard prism coupled surface-plasmon sensors (Kretschmann configuration). Our experimental record high sensitivities are attributed to the nearly complete suppression of the radiative losses that are made possible by the high structural quality of the fabricated devices as well as the subradiant nature of the resonances. Steep dispersion of the plasmonic Fano resonance profiles in high-quality plasmonic sensors exhibit dramatic light intensity changes to the slightest perturbations within their local environment. As a spectacular demonstration of the extraordinary sensitivity and the quality of the fabricated biosensors, we show direct detection of a single monolayer of biomolecules with naked eye using these Fano resonances and the associated Wood's anomalies. To fabricate high optical-quality sensors, we introduce a high-throughput lift-off free evaporation fabrication technique with extremely uniform and precisely controlled nanofeatures over large areas, leading to resonance line-widths comparable to that of the ideally uniform structures as confirmed by our time-domain simulations. The demonstrated label-free sensing platform offers unique opportunities for point-of-care diagnostics in resource poor settings by eliminating the need for fluorescent labeling and optical detection instrumentation (camera, spectrometer, etc.) as well as mechanical and light isolation.

Bianisotropy and spatial dispersion in highly anisotropic near-infrared resonator arrays.

We measure, simulate, and analyze the optical transmission through arrays of Ag nanorod pairs and U-shaped nanostructures as a function of polarization and angle of incidence. The bianisotropic nature of the metamaterials is exhibited in data and in simulations, and we argue that the electric field rather than the magnetic field excites the low frequency "magnetic" mode. We also observe spatial dispersion in the form of frequency shifts as a function of incident angle which we attribute to coupling effects between neighboring structures. A simple model based upon coupled electromagnetic dipoles is found to provide a qualitative description for the main features observed in the spectra.

One-way extraordinary optical transmission and nonreciprocal spoof plasmons.

We introduce a concept of a nonreciprocal spoof surface plasmon: an electromagnetic wave supported by a structured conductor embedded in an asymmetric magneto-optical medium and exhibiting a nonreciprocal dispersion. It is demonstrated analytically and by first-principles electromagnetic simulations that, by breaking the time-reversal symmetry, nonreciprocal spoof surface plasmons enable a dramatic optical response: one-way extraordinary optical transmission.

Highly confined hybrid spoof surface plasmons in ultrathin metal-dielectric heterostructures.

Highly confined "spoof" surface plasmons (SSPs) are theoretically predicted to exist in a perforated metal film coated with a thin dielectric layer. Strong modes confinement results from the additional waveguiding by the layer. Spectral characteristics, field distribution, and lifetime of these SSPs are tunable by the holes' size and shape. SSPs exist both above and below the light line, offering two classes of applications: "perfect" far-field absorption and efficient emission into guided modes. It is experimentally shown that these plasmonlike modes can turn thin, weakly absorbing semiconductor films into perfect absorbers.