Broadband stimulated four-wave parametric conversion on a tantalum pentoxide photonic chip

We exploit the large third order nonlinear susceptibility (?(3) or “Chi 3”) of tantalum pentoxide (Ta2O5) planar waveguides and realize broadband optical parametric conversion on-chip. We use a co-linear pump-probe configuration and observe stimulated four wave parametric conversion when seeding either in the visible or the infrared. Pumping at 800 nm we observe parametric conversion over a broad spectral range with the parametric idler output spanning from 1200 nm to 1600 nm in infrared wavelengths and from 555 nm to 600 nm in visible wavelengths. Our demonstration of on-chip stimulated four wave parametric conversion introduces Ta2O5 as a novel material for broadband integrated nonlinear photonic circuit applications

Laparoscopic removal of mullerian duct remnants in boys

Abstract: Purpose: Mullerian duct remnants (MDRs) are present in a male pseudohermaphroditic form characterized by failure of the mullerian duct to regress due to insufficient production or peripheral action of mullerian inhibiting substance. The MDR can be asymptomatic but it often results in infections, stones and voiding troubles. Furthermore, it may develop into a neoplasm. Therefore, surgery is mandatory for large MDRs and symptomatic patients. Laparoscopic removal is described. Materials and Methods: Six males were treated from February 1998 to February 2003. Age at surgery was between 3 and 18 years (mean 8.6). All patients showed severe hypospadias and 2 had mixed gonadal dysgenesis with ambiguous genitalia. Three patients presented with urogenital infections and all had a large MDR. Laparoscopic procedures, which were preceded by cystoscopy, were performed using a 10 mm umbilical trocar for the camera and 3, 5 mm trocars for instruments placed in the suprapubic region and iliac fossa bilaterally. The remnants were ligated with endoscopic loops or an endoscopic GIA stapler and cut. Results: Mean operative time was 2 hours. We noted no complications. In 2 cases there was deferential ectopia and in another of mixed gonadal dysgenesis bilateral gonadectomy was performed because of the risk of degeneration. Feeding started on postoperative day I and the patients were discharged home on day 5. After a followup of 8 months to 4 years all boys were healthy. Conclusions: Multiple approaches are used in traditional surgery, often leading to complications. Laparoscopy improves the view, decreases surgical risk and operative time, avoids large scars and allows more rapid hospital discharge

Testosterone decreases adiponectin levels in female to male transsexuals

Aim: To evaluate the effect of testosterone (T) on adiponectin serum levels in transsexual female patients. Methods: We measured adiponectin, leptin, luteinizing hormone and follicle stimulating hormone, T, estradiol, lipid profile, biochemical parameters and body composition in 16 transsexual female patients at baseline and after 6 months of T treatment (100 mg Testoviron Depot /10 days, i.m.). Results: Adiponectin levels were 16.9 ± 7.3 mg/mL at baseline and 13.5 ± 7.4 mg/mL at month 6 of T treatment (P < 0.05). Leptin and high-density lipoprotein cholesterol decreased significantly, whereas body mass index, waist circumference and lean body mass increased significantly after 6 months of T treatment. No changes in insulin or Homeostasis Model Assessment were detected. Conclusion: T can significantly reduce adiponectin serum levels in transsexual female patients

Theory of Slow Light Enhanced Four-Wave Mixing in Photonic Crystal Waveguides

The equations for Four-Wave-Mixing in a Photonic Crystal waveguide are derived accurately. The dispersive nature of slow-light enhancement, the impact of Bloch mode reshaping in the nonlinear overlap integrals and the tensor nature of the third order polarization are therefore taken into account. Numerical calculations reveal substantial differences with simpler models, which increase with decreasing group velocity. We predict that the gain for a 1.3 mm long, unoptimized GaInP waveguide will exceed 10 dB if the pump power exceeds 1 W.Comment: 6 pages, 4 figures; submitted to Optics Expres

The role of male hypogonadism, aging, and chronic diseases in characterizing adult and elderly men with erectile dysfunction: a cross-sectional study

BackgroundErectile function depends on a complex interaction between demographic, metabolic, vascular, hormonal, and psychological factors that trigger erectile dysfunction (ED). In the present study we carried out a cross-sectional study assessing the impact of non-communicable chronic diseases (NCDs), male hypogonadism, and demographic factors in characterizing men with ED. Four hundred thirty-three consecutive outpatients with ED were extracted from the electronic database from January 2017 to December 2019. The International Index of Erectile Function (IIEF) 5 score was used to diagnose ED and stratify its severity, standardized values of serum testosterone (10.5 nM/L) and luteinizing hormone (LH 9.4 IU/L) to diagnose and classify male hypogonadism and the Charlson Comorbidity Index (CCI) to weigh the role of each NCD on ED. ResultsForty-six percent of participants were eugonadal (EuG), 13% had organic hypogonadism (OrH), and the remaining 41% had functional hypogonadism (FuH). Hypogonadal men had a significantly lower IIEF 5 score (p &lt; .0001) than EuG. FuH had a higher CCI than OrH and EuG (all p &lt; .0001). In a multivariable model, only free T (FT) and Sex Hormone Binding Globulin (SHBG) showed a direct correlation with the IIEF 5 score (all p &lt; .0001). Age and CCI had an inverse correlation with IIEF 5 score (all p &lt; .0001).ConclusionSerum FT, SHBG, and CCI are the leading determinants of ED severity. Besides overt hypogonadism, a relevant burden of severe NTCDs in middle-aged or older adults features the patient's characteristics who will suffer from severe ED. Appropriate clinical approaches and, when necessary, treatments are required in these clusters of patients

Broadband wavelength conversion at 40Gb/s using long serpentine As2S3 planar waveguides

We demonstrate broadband wavelength conversion of a 40 Gb/s return-to-zero signal by cross-phase modulation in a newly developed chalcogenide glass waveguide based photonic chip. These new serpentine As2S3 waveguides offer a nonlinear coefficient ≈1700 W-1km-1 with 5× lower propagation loss over a length of 22.5 cm which ensures the full propagation length contributes towards the nonlinear process. This reduces the peak operating power thereby allowing a ×4 increase in the data rate compared with previous results. Spectral measurements show the device operates over a span of 40 nm while system measurements show just over 1 dB of power penalty at a bit-error rate of 10-9. This is primarily due to the compact planar waveguide design which minimizes the effect of groupvelocity dispersion

Long, low loss etched As2S3 chalcogenide waveguides for all-optical signal regeneration

We report on the fabrication and optical properties of etched highly nonlinear As2S3 chalcogenide planar rib waveguides with lengths up to 22.5 cm and optical losses as low as 0.05 dB/cm at 1550 nm - the lowest ever reported. We demonstrate strong spectral broadening of 1.2 ps pulses, in good agreement with simulations, and find that the ratio of nonlinearity and dispersion linearizes the pulse chirp, reducing the spectral oscillations caused by self-phase modulation alone. When combined with a spectrally offset band-pass filter, this gives rise to a nonlinear transfer function suitable for all-optical regeneration of high data rate signals

Adrenal Insufficiency with Anticancer Tyrosine Kinase Inhibitors Targeting Vascular Endothelial Growth Factor Receptor: Analysis of the FDA Adverse Event Reporting System

Background: We described clinical features of adrenal insufficiency (AI) reported with tyrosine kinase inhibitors (TKIs) targeting vascular endothelial growth factor receptor (VEGFR) in the Food and Drug Administration Adverse Event Reporting System (FAERS). Methods: Reports of AI recorded in FAERS (January 2004–March 2022) were identified through the high-level term “adrenal cortical hypofunctions”. Demographic and clinical features were inspected, and disproportionality signals were detected through the Reporting Odds Ratio (ROR) and Information Component (IC) with relevant 95% confidence/credibility interval (CI), using different comparators and adjusting the ROR for co-reported corticosteroids and immune checkpoint inhibitors (ICIs). Results: Out of 147,153 reports with VEGFR-TKIs, 314 cases of AI were retained, mostly of which were serious (97.1%; hospitalization recorded in 44.9%). In a combination regimen with ICIs (43% of cases), VEGFR-TKIs were discontinued in 52.2% of the cases (26% as monotherapy). The median time to onset was 72 days (IQR = 14–201; calculated for 189 cases). A robust disproportionality signal emerged, also in comparison with other anticancer drugs (ROR = 2.71, 95%CI = 2.42–3.04; IC = 0.25, 95%CI = 0.07–0.39). Cabozantinib, sunitinib and axitinib generated robust disproportionality even after ROR adjustment. Conclusions: We call pharmacologists, internists, oncologists and endocrinologists to raise awareness of serious AI with VEGFR-TKIs, and to develop dedicated guidelines, especially for combination regimens with immunotherapy

Prevalence and Determinants of Liver Disease in Relatives of Italian Patients With Advanced MASLD

Background & Aims: Metabolic dysfunction associated steatotic liver disease (MASLD) has a strong genetic component. The aim of this study was to examine noninvasively the prevalence of MASLD and of advanced fibrosis in relatives of patients with advanced MASLD and the risk factors for liver involvement, with a focus on the contribution of common genetic risk variants. Methods: We prospectively enrolled 98 consecutive probands with advanced fibrosis and/or hepatocellular carcinoma caused by MASLD and 160 nontwin first-degree relatives noninvasively screened for MASLD and advanced fibrosis at 4 Italian centers. We evaluated common genetic determinants and polygenic risk scores of liver disease. Results: Among relatives, prevalence of MASLD was 56.8% overall, whereas advanced fibrosis was observed in 14.4%. At multivariable analysis in relatives, MASLD was associated with body mass index (odds ratio [OR], 1.31 [1.18–1.46]) and tended to be associated with diabetes (OR, 5.21 [0.97–28.10]), alcohol intake (OR, 1.32 [0.98–1.78]), and with female sex (OR, 0.54 [0.23–1.15]), whereas advanced fibrosis was associated with diabetes (OR, 3.13 [1.16–8.45]) and nearly with body mass index (OR, 1.09 [1.00–1.19]). Despite that the PNPLA3 risk variant was enriched in probands (P =.003) and overtransmitted to relatives with MASLD (P =.045), evaluation of genetic risk variants and polygenic risk scores was not useful to guide noninvasive screening of advanced fibrosis in relatives. Conclusions: We confirmed that about 1 in 7 relatives of patients with advanced MASLD has advanced fibrosis, supporting clinical recommendations to perform family screening in this setting. Genetic risk variants contributed to liver disease within families but did not meaningfully improve fibrosis risk stratification