Comparison between pre-mortem and post-mortem cadaveric images for use with augmented reality headsets during dissection.

PURPOSE: Medical training has undergone many transformations to incorporate diagnostic imaging along side anatomical education. Post-mortem computed tomography (CT) scanning of body donors prior to dissection has been proposed. However, it poses challenges secondary to the embalming process and other post-mortem physiological changes that significantly alter the imaging quality. The purposes of this study were to compare the accuracy of pathology identification on pre- and post-mortem CT scans of body donors and to assess the integration of those scans in a dissection-based course, where these images were overlaid onto body donors using augmented reality (AR). METHODS: Participants in this study included 35 fourth year medical students, 5 radiology residents and 3 radiologists. A convergent, parallel mixed methods design was employed with quantitative measures that included statistical analyses of a double-blinded comparison of pathological lesions recognition, on both image sets, the group responses to a study participant survey and the login access data from imaging repository. The study also included qualitative analysis of post-elective structured interviews. RESULTS: The double-blinded comparison revealed that staff radiologists can only identify, on post-mortem images, 54.8% of the pathologies that they were able to detect on the pre-mortem scans. Analyses of the surveys and login access data reveal that 60% of radiology residents and 56% of students preferred pre-mortem scans and used those scans more often than post-mortem scans (67 access vs 36, respectively). However, post-mortem scans were significantly preferred when used to overlay onto body donors using AR (p = 0.0047). CONCLUSION: These results show that post-mortem imaging can be valuable alongside pre-mortem imaging, as they represent the most concordance between the anatomical structures and pathologies seen on the images and what is being dissected.

Evaluating the integration of body donor imaging into anatomical dissection using augmented reality.

Augmented reality (AR) has recently been utilized as an integrative teaching tool in medical curricula given its ability to view virtual objects while interacting with the physical environment. The evidence for AR in medical training, however, is limited. For this reason, the purpose of this mixed method study was to evaluate the implementation of overlaying donor-specific diagnostic imaging (DSDI) onto corresponding body donors in a fourth-year, dissection-based, medical elective course entitled anatomy for surgeons (AFS). Students registered in AFS course were separated into groups, receiving either DSDI displayed on Microsoft HoloLens AR head-mounted display (n = 12) or DSDI displayed on iPad (n = 15). To test for the change in spatial ability, students completed an anatomical mental rotation test (AMRT) prior to and following the AFS course. Students also participated in a focus group discussion and completed a survey at the end of AFS, analyzed through thematic triangulation and an unpaired, Mann Whitney U test respectively, both addressing dissection experience, DSDI relevancy to dissection, and use of AR in anatomical education. Although statistically significant differences were not found when comparing student group AMRT scores, survey and discussion data suggest that the HoloLens had improved the students' understanding of, and their spatial orientation of, anatomical relationships. Trunk dissection quality grades were significantly higher with students using the HoloLens. Although students mentioned difficulties with HoloLens software, with faculty assistance, training, and enhanced software development, there is potential for this AR tool to contribute to improved dissection quality and an immersive learning experience.

A programmable qudit-based quantum processor.

Controlling and programming quantum devices to process quantum information by the unit of quantum dit, i.e., qudit, provides the possibilities for noise-resilient quantum communications, delicate quantum molecular simulations, and efficient quantum computations, showing great potential to enhance the capabilities of qubit-based quantum technologies. Here, we report a programmable qudit-based quantum processor in silicon-photonic integrated circuits and demonstrate its enhancement of quantum computational parallelism. The processor monolithically integrates all the key functionalities and capabilities of initialisation, manipulation, and measurement of the two quantum quart (ququart) states and multi-value quantum-controlled logic gates with high-level fidelities. By reprogramming the configuration of the processor, we implemented the most basic quantum Fourier transform algorithms, all in quaternary, to benchmark the enhancement of quantum parallelism using qudits, which include generalised Deutsch-Jozsa and Bernstein-Vazirani algorithms, quaternary phase estimation and fast factorization algorithms. The monolithic integration and high programmability have allowed the implementations of more than one million high-fidelity preparations, operations and projections of qudit states in the processor. Our work shows an integrated photonic quantum technology for qudit-based quantum computing with enhanced capacity, accuracy, and efficiency, which could lead to the acceleration of building a large-scale quantum computer.

Evaluating the integration of pre-mortem body donor imaging into a dissection-based medical anatomy course.

BACKGROUND: Medical faculties are currently embracing a modernistic approach to anatomical education that integrates diagnostic imaging largely through post-mortem computed tomography scanning of body donors. Post-mortem imaging, however, poses a multitude of challenges. The purpose of this study was to assess the implementation of pre-mortem donor-specific diagnostic imaging on student learning and dissection experience in addition to understanding the potential impact on students' preparation for clinical practice. METHODS: Students in a fourth-year medicine elective course were divided into groups; group 1 received pre-mortem donor-specific diagnostic imaging, while group 2 received pathology-specific diagnostic imaging, a collection of images relating to the type(s) of pathologies the donors exhibited, though not specific to the donors themselves. Both groups also received a donor-specific case vignette. A convergent, parallel mixed methods design was employed. This included integrating data from group responses to a study participant survey and students' academic assessment scores analyzed quantitatively through statistical analyses with data from focus group sessions investigating the psychosocial aspects of the student dissection experience and perceptions of the imaging use in the course analyzed qualitatively. RESULTS: As compared to students receiving pathology-specific diagnostic imaging, the quantitative results demonstrated that students receiving pre-mortem donor-specific diagnostic imaging more positively supported the relevancy of diagnostic imaging to their understanding of anatomy, valued the integration for future practice, and suggested an earlier integration within their medical curriculum. Qualitatively, two main themes were observed: the influence of diagnostic imaging integration on dissection experience and on professional mindset. Although both student groups received imaging corresponding to their body donor, consideration towards the humanistic nature of the body donor as a patient with a history was limited to student feedback from the donor- specific diagnostic imaging group. CONCLUSION: Overall the integration of pre-mortem donor-specific diagnostic imaging into anatomical dissection provided students with practical skill development, an enhanced dissection experience, and reinforced personal qualities critical for future practice.

Quantum Optical Metrology of Correlated Phase and Loss.

Optical absorption measurements characterize a wide variety of systems from atomic gases to in vivo diagnostics of living organisms. Here we study the potential of nonclassical techniques to reduce statistical noise below the shot-noise limit in absorption measurements with concomitant phase shifts imparted by a sample. We consider both cases where there is a known relationship between absorption and a phase shift, and where this relationship is unknown. For each case we derive the fundamental limit and provide a practical strategy to reduce statistical noise. Furthermore, we find an intuitive correspondence between measurements of absorption and of lossy phase shifts, which both show the same analytical form for precision enhancement for bright states. Our results demonstrate that nonclassical techniques can aid real-world tasks with present-day laboratory techniques.

Exo-selective, Reductive Heck Derived Polynorbornenes with Enhanced Molecular Weights, Yields, and Hydrocarbon Gas Transport Properties.

Next-generation membranes use highly engineered polymeric structures with enhanced chain rigidity, yet difficulties in polymerization often limit molecular weights required for film formation. Addition-type polynorbornenes are promising materials for industrial gas separations, but suffer from these limitations owing to endo-exo monomeric mixtures that restrict polymerization sites. In this work, a synthetic approach employing the reductive Mizoroki-Heck reaction resulted in exo-selective products that polymerized up to >99% yields for ROMP and addition-type polymers, achieving molecular weights an order of magnitude higher than addition-type polymers from endo-exo mixtures and impressive side group stereoregularity. Due to this increased macromolecular control, these polynorbornenes demonstrate unique solubility-selective permeation with mixed gas selectivities that exceed commercially used PDMS. In addition to thermal and structural characterization, XRD and computational studies confirmed the results of pure and mixed-gas transport testing, which show highly rigid membranes with favorably disrupted chain packing.

Simulating the vibrational quantum dynamics of molecules using photonics.

Advances in control techniques for vibrational quantum states in molecules present new challenges for modelling such systems, which could be amenable to quantum simulation methods. Here, by exploiting a natural mapping between vibrations in molecules and photons in waveguides, we demonstrate a reprogrammable photonic chip as a versatile simulation platform for a range of quantum dynamic behaviour in different molecules. We begin by simulating the time evolution of vibrational excitations in the harmonic approximation for several four-atom molecules, including H2CS, SO3, HNCO, HFHF, N4 and P4. We then simulate coherent and dephased energy transport in the simplest model of the peptide bond in proteins-N-methylacetamide-and simulate thermal relaxation and the effect of anharmonicities in H2O. Finally, we use multi-photon statistics with a feedback control algorithm to iteratively identify quantum states that increase a particular dissociation pathway of NH3. These methods point to powerful new simulation tools for molecular quantum dynamics and the field of femtochemistry.

Multidimensional quantum entanglement with large-scale integrated optics.

The ability to control multidimensional quantum systems is central to the development of advanced quantum technologies. We demonstrate a multidimensional integrated quantum photonic platform able to generate, control, and analyze high-dimensional entanglement. A programmable bipartite entangled system is realized with dimensions up to 15 × 15 on a large-scale silicon photonics quantum circuit. The device integrates more than 550 photonic components on a single chip, including 16 identical photon-pair sources. We verify the high precision, generality, and controllability of our multidimensional technology, and further exploit these abilities to demonstrate previously unexplored quantum applications, such as quantum randomness expansion and self-testing on multidimensional states. Our work provides an experimental platform for the development of multidimensional quantum technologies.

Witnessing eigenstates for quantum simulation of Hamiltonian spectra.

The efficient calculation of Hamiltonian spectra, a problem often intractable on classical machines, can find application in many fields, from physics to chemistry. We introduce the concept of an "eigenstate witness" and, through it, provide a new quantum approach that combines variational methods and phase estimation to approximate eigenvalues for both ground and excited states. This protocol is experimentally verified on a programmable silicon quantum photonic chip, a mass-manufacturable platform, which embeds entangled state generation, arbitrary controlled unitary operations, and projective measurements. Both ground and excited states are experimentally found with fidelities >99%, and their eigenvalues are estimated with 32 bits of precision. We also investigate and discuss the scalability of the approach and study its performance through numerical simulations of more complex Hamiltonians. This result shows promising progress toward quantum chemistry on quantum computers.

Structural and electrostatic effects at the surfaces of size- and charge-selected aqueous nanodrops.

The effects of ion charge, polarity and size on the surface morphology of size-selected aqueous nanodrops containing a single ion and up to 550 water molecules are investigated with infrared photodissociation (IRPD) spectroscopy and theory. IRPD spectra of M(H2O) n where M = La3+, Ca2+, Na+, Li+, I-, SO42- and supporting molecular dynamics simulations indicate that strong interactions between multiply charged ions and water molecules can disrupt optimal hydrogen bonding (H-bonding) at the nanodrop surface. The IRPD spectra also reveal that "free" OH stretching frequencies of surface-bound water molecules are highly sensitive to the ion's identity and the OH bond's local H-bond environment. The measured frequency shifts are qualitatively reproduced by a computationally inexpensive point-charge model that shows the frequency shifts are consistent with a Stark shift from the ion's electric field. For multiply charged cations, pronounced Stark shifting is observed for clusters containing ∼100 or fewer water molecules. This is attributed to ion-induced solvent patterning that extends to the nanodrop surface, and serves as a spectroscopic signature for a cation's ability to influence the H-bond network of water located remotely from the ion. The Stark shifts measured for the larger nanodrops are extrapolated to infinite dilution to obtain the free OH stretching frequency of a surface-bound water molecule at the bulk air-water interface (3696.5-3701.0 cm-1), well within the relatively wide range of values obtained from SFG measurements. These cluster measurements also indicate that surface curvature effects can influence the free OH stretching frequency, and that even nanodrops without an ion have a surface potential that depends on cluster size.

High-extinction ratio integrated photonic filters for silicon quantum photonics.

We present the generation of quantum-correlated photon pairs and subsequent pump rejection across two silicon-on-insulator photonic integrated circuits. Incoherently cascaded lattice filters are used to provide over 100 dB pass-band to stop-band contrast with no additional external filtering. Photon pairs generated in a microring resonator are successfully separated from the input pump, confirmed by temporal correlations measurements.

Optimizing MRI Logistics: Focused Process Improvements Can Increase Throughput in an Academic Radiology Department.

OBJECTIVE: The purpose of this study was to describe and evaluate the effect of focused process improvements on protocol selection and scheduling in the MRI division of a busy academic medical center, as measured by examination and room times, magnet fill rate, and potential revenue increases and cost savings to the department. MATERIALS AND METHODS: Focused process improvements, led by a multidisciplinary team at a large academic medical center, were directed at streamlining MRI protocols and optimizing matching protocol ordering to scheduling while maintaining or improving image quality. Data were collected before (June 2013) and after (March 2015) implementation of focused process improvements and divided by subspecialty on type of examination, allotted examination time, actual examination time, and MRI parameters. Direct and indirect costs were compiled and analyzed in consultation with the business department. Data were compared with evaluated effects on selected outcome and efficiency measures, as well as revenue and cost considerations. Statistical analysis was performed using a t test. RESULTS: During the month of June 2013, 2145 MRI examinations were performed at our center; 2702 were performed in March 2015. Neuroradiology examinations were the most common (59% in June 2013, 56% in March 2015), followed by body examinations (25% and 27%). All protocols and parameters were analyzed and streamlined for each examination, with slice thickness, TR, and echo train length among the most adjusted parameters. Mean time per examination decreased from 43.4 minutes to 36.7 minutes, and mean room time per patient decreased from 46.3 to 43.6 minutes (p = 0.009). Potential revenue from increased throughput may yield up to $3 million yearly (at $800 net revenue per scan) or produce cost savings if the facility can reduce staffed scanner hours or the number of scanners in its fleet. Actual revenue and expense impacts depend on the facility's fixed and variable cost structure, payer contracts, MRI fleet composition, and unmet MRI demand. CONCLUSION: Focused process improvements in selecting MRI protocols and scheduling examinations significantly increased throughput in the MRI division, thereby increasing capacity and revenue. Shorter scan and department times may also improve patient experience.

Photon pair generation in hydrogenated amorphous silicon microring resonators.

We generate photon pairs in a-Si:H microrings using a CW pump, and find the Kerr coefficient of a-Si:H to be 3.73 ± 0.25 × 10-17m2/W. By measuring the Q factor with coupled power we find that the loss in the a-Si:H micro-rings scales linearly with power, and therefore cannot originate from two photon absorption. Theoretically comparing a-Si:H and c-Si micro-ring pair sources, we show that the high Kerr coefficient of this sample of a-Si:H is best utilized for microrings with Q factors below 103, but that for higher Q factor devices the photon pair rate is greatly suppressed due to the first order loss.

Quantum Logic with Cavity Photons From Single Atoms.

We demonstrate quantum logic using narrow linewidth photons that are produced with an a priori nonprobabilistic scheme from a single ^{87}Rb atom strongly coupled to a high-finesse cavity. We use a controlled-not gate integrated into a photonic chip to entangle these photons, and we observe nonclassical correlations between photon detection events separated by periods exceeding the travel time across the chip by 3 orders of magnitude. This enables quantum technology that will use the properties of both narrow-band single photon sources and integrated quantum photonics.

Efficient quantum walk on a quantum processor.

The random walk formalism is used across a wide range of applications, from modelling share prices to predicting population genetics. Likewise, quantum walks have shown much potential as a framework for developing new quantum algorithms. Here we present explicit efficient quantum circuits for implementing continuous-time quantum walks on the circulant class of graphs. These circuits allow us to sample from the output probability distributions of quantum walks on circulant graphs efficiently. We also show that solving the same sampling problem for arbitrary circulant quantum circuits is intractable for a classical computer, assuming conjectures from computational complexity theory. This is a new link between continuous-time quantum walks and computational complexity theory and it indicates a family of tasks that could ultimately demonstrate quantum supremacy over classical computers. As a proof of principle, we experimentally implement the proposed quantum circuit on an example circulant graph using a two-qubit photonics quantum processor.

Modelling superconducting nanowire single photon detectors in a waveguide cavity.

In this work we report on a single photon detector system which offers near-unity detection efficiency using waveguide-coupled superconducting nanowires with lengths on the order of 1 µm. This is achieved by embedding the nanowires in a racetrack resonator where the interaction time with the photons trapped in the cavity is increased, thereby allowing for shorter nanowires. We expect this to lead to a higher fabrication yield as the amount of inhomogeneities decreases for shorter nanowires. Our simulations show a system with a 1 µm long superconducting nanowire single photon detector (SNSPD) operating at near-unity detection efficiency using design parameters that can be realistically achieved with conventional fabrication processes. The resonant cavity introduces spectral selectivity to the otherwise broad-band SNSPDs and the cavity induced timing jitter is shown to be insignificant for SNSPDs longer than 1 µm.

QUANTUM OPTICS. Universal linear optics.

Linear optics underpins fundamental tests of quantum mechanics and quantum technologies. We demonstrate a single reprogrammable optical circuit that is sufficient to implement all possible linear optical protocols up to the size of that circuit. Our six-mode universal system consists of a cascade of 15 Mach-Zehnder interferometers with 30 thermo-optic phase shifters integrated into a single photonic chip that is electrically and optically interfaced for arbitrary setting of all phase shifters, input of up to six photons, and their measurement with a 12-single-photon detector system. We programmed this system to implement heralded quantum logic and entangling gates, boson sampling with verification tests, and six-dimensional complex Hadamards. We implemented 100 Haar random unitaries with an average fidelity of 0.999 ± 0.001. Our system can be rapidly reprogrammed to implement these and any other linear optical protocol, pointing the way to applications across fundamental science and quantum technologies.

Ambient infrared laser ablation mass spectrometry (AIRLAB-MS) of live plant tissue with plume capture by continuous flow solvent probe.

A new experimental setup for spatially resolved ambient infrared laser ablation-mass spectrometry (AIRLAB-MS) that uses an infrared microscope with an infinity-corrected reflective objective and a continuous flow solvent probe coupled to a Fourier transform ion cyclotron resonance mass spectrometer is described. The efficiency of material transfer from the sample to the electrospray ionization emitter was determined using glycerol/methanol droplets containing 1 mM nicotine and is ∼50%. This transfer efficiency is significantly higher than values reported for similar techniques. Laser desorption does not induce fragmentation of biomolecules in droplets containing bradykinin, leucine enkephalin and myoglobin, but loss of the heme group from myoglobin occurs as a result of the denaturing solution used. An application of AIRLAB-MS to biological materials is demonstrated for tobacco leaves. Chemical components are identified from the spatially resolved mass spectra of the ablated plant material, including nicotine and uridine. The reproducibility of measurements made using AIRLAB-MS on plant material was demonstrated by the ablation of six closely spaced areas (within 2 × 2 mm) on a young tobacco leaf, and the results indicate a standard deviation of <10% in the uridine signal obtained for each area. The spatial distribution of nicotine was measured for selected leaf areas and variation in the relative nicotine levels (15-100%) was observed. Comparative analysis of the nicotine distribution was demonstrated for two tobacco plant varieties, a genetically modified plant and its corresponding wild-type, indicating generally higher nicotine levels in the mutant.

Fast electrical switching of orbital angular momentum modes using ultra-compact integrated vortex emitters.

The ability to rapidly switch between orbital angular momentum modes of light has important implications for future classical and quantum systems. In general, orbital angular momentum beams are generated using free-space bulk optical components where the fastest reconfiguration of such systems is around a millisecond using spatial light modulators. In this work, an extremely compact optical vortex emitter is demonstrated with the ability to actively tune between different orbital angular momentum modes. The emitter is tuned using a single electrically contacted thermo-optical control, maintaining device simplicity and micron scale footprint. On-off keying and orbital angular momentum mode switching are achieved at rates of 10 µs and 20 µs respectively.

An improved high yield total synthesis and cytotoxicity study of the marine alkaloid neoamphimedine: an ATP-competitive inhibitor of topoisomerase IIα and potent anticancer agent.

Recently, we characterized neoamphimedine (neo) as an ATP-competitive inhibitor of the ATPase domain of human Topoisomerase IIα. Thus far, neo is the only pyridoacridine with this mechanism of action. One limiting factor in the development of neo as a therapeutic agent has been access to sufficient amounts of material for biological testing. Although there are two reported syntheses of neo, both require 12 steps with low overall yields (≤6%). In this article, we report an improved total synthesis of neo achieved in 10 steps with a 25% overall yield. In addition, we report an expanded cytotoxicity study using a panel of human cancer cell lines, including: breast, colorectal, lung, and leukemia. Neo displays potent cytotoxicity (nM IC50 values) in all, with significant potency against colorectal cancer (lowest IC50 = 6 nM). We show that neo is cytotoxic not cytostatic, and that neo exerts cytotoxicity by inducing G2-M cell cycle arrest and apoptosis.