Polarization-selective modulation of supercavity resonances originating from bound states in the continuum

Bound states in the continuum (BICs) are widely studied for their ability to confine light, produce sharp resonances for sensing applications and serve as avenues for lasing action with topological characteristics. Primarily, the formation of BICs in periodic photonic band gap structures are driven by symmetry incompatibility; structural manipulation or variation of incidence angle from incoming light. In this work, we report two modalities for driving the formation of BICs in terahertz metasurfaces. At normal incidence, we experimentally confirm polarization driven symmetry-protected BICs by the variation of the linear polarization state of light. In addition, we demonstrate through strong coupling of two radiative modes the formation of capacitively-driven Freidrich-Wintgen BICs, exotic modes which occur in off-Γ points not accessible by symmetry-protected BICs. The capacitance-mediated strong coupling at 0° polarization is verified to have a normalized coupling strength ratio of 4.17% obtained by the Jaynes-Cummings model. Furthermore, when the polarization angle is varied from 0° to 90° (0° ≤ ϕ \u3c 90°), the Freidrich-Wintgen BIC is modulated until it is completely switched off at 90°

Defects of B-cell terminal differentiation in patients with type-1 Kabuki syndrome

Kabuki syndrome (KS) is a complex multi-system developmental disorder associated with mutation of genes encoding histone-modifying proteins. In addition to craniofacial, intellectual, and cardiac defects, KS is also characterized by humoral immune deficiency and autoimmune disease, yet no detailed molecular characterization of the KS-associated immune phenotype has previously been reported

Dynamics of Outgassing and Plume Transport Revealed by Proximal Unmanned Aerial System (UAS) Measurements at Volcán Villarrica, Chile

Volcanic gas emissions are intimately linked to the dynamics of magma ascent and outgassing, and, on geological timescales, constitute an important source of volatiles to the Earth’s atmosphere. Measurements of gas composition and flux are therefore critical to both volcano monitoring and to determining the contribution of volcanoes to global geochemical cycles. However, significant gaps remain in our global inventories of volcanic emissions, (particularly for CO2, which requires proximal sampling of a concentrated plume) for those volcanoes where the near-vent region is hazardous or inaccessible. Unmanned Aerial Systems (UAS) provide a robust and effective solution to proximal sampling of dense volcanic plumes in extreme volcanic environments. Here, we present gas compositional data acquired using a gas sensor payload aboard a UAS flown at Volcán Villarrica, Chile. We compare UAS-derived gas timeseries to simultaneous crater rim multi-GAS data and UV camera imagery to investigate early plume evolution. SO2 concentrations measured in the young proximal plume exhibit periodic variations that are well-correlated with the concentrations of other species. By combining molar gas ratios (CO2/SO2 = 1.48–1.68, H2O/SO2 = 67–75 and H2O/CO2 = 45–51) with the SO2 flux (142 ± 17 t/day) from UV camera images, we derive CO2 and H2O fluxes of ~150 t/day and ~2850 t/day, respectively. We observe good agreement between time-averaged molar gas ratios obtained from simultaneous UAS- and ground-based Multi-GAS acquisitions. However, the UAS measurements made in the young, less diluted plume reveal additional short-term periodic structure that reflects active degassing through discrete, audible gas exhalations.Alfred P. Sloan Foundation; Leverhulme Trus

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

Background: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. Methods: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. Findings: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96–1·28). Interpretation: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. Funding: National Institute for Health Research Health Services and Delivery Research Programme

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

BACKGROUND: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. METHODS: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. FINDINGS: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96-1·28). INTERPRETATION: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. FUNDING: National Institute for Health Research Health Services and Delivery Research Programme

ENCORE: A randomized, controlled, open-label non-inferiority study comparing eliglustat to imiglucerase in Gaucher disease type 1 patients on enzyme replacement therapy who have reached therapeutic goals

Univ Cambridge, Addenbrookes Hosp, Cambridge CB2 2QQ, EnglandHosp Ninos Dr Ricardo Gutierrez, Buenos Aires, DF, ArgentinaHEMORIO, Rio de Janeiro, RJ, BrazilMt Sinai Hosp, New York, NY 10029 USACincinnati Childrens Hosp Med Ctr, Cincinnati, OH USAUniversidade Federal de São Paulo, São Paulo, BrazilMinist Publ Hlth Russia, Hematol Res Ctr, Moscow, RussiaCedars Sinai Tower Hematol Oncol, Beverly Hills, CA USAGenzyme, Cambridge, MA USAUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc