Nonlinear Bloch wave dynamics in photonic Aharonov–Bohm cages

We study the properties of nonlinear Bloch waves in a diamond chain waveguide lattice in the presence of a synthetic magnetic flux. In the linear limit, the lattice exhibits a completely flat (wavevector k-independent) band structure, resulting in perfect wave localization, known as Aharonov-Bohm caging. We find that in the presence of nonlinearity, the Bloch waves become sensitive to k, exhibiting bifurcations and instabilities. Performing numerical beam propagation simulations using the tight-binding model, we show how the instabilities can result in either the spontaneous or controlled formation of localized modes, which are immobile and remain pinned in place due to the synthetic magnetic flux. © 2021 Author(s

30-day morbidity and mortality of sleeve gastrectomy, Roux-en-Y gastric bypass and one anastomosis gastric bypass: a propensity score-matched analysis of the GENEVA data

Background: There is a paucity of data comparing 30-day morbidity and mortality of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one anastomosis gastric bypass (OAGB). This study aimed to compare the 30-day safety of SG, RYGB, and OAGB in propensity score-matched cohorts. Materials and methods: This analysis utilised data collected from the GENEVA study which was a multicentre observational cohort study of bariatric and metabolic surgery (BMS) in 185 centres across 42 countries between 01/05/2022 and 31/10/2020 during the Coronavirus Disease-2019 (COVID-19) pandemic. 30-day complications were categorised according to the Clavien–Dindo classification. Patients receiving SG, RYGB, or OAGB were propensity-matched according to baseline characteristics and 30-day complications were compared between groups. Results: In total, 6770 patients (SG 3983; OAGB 702; RYGB 2085) were included in this analysis. Prior to matching, RYGB was associated with highest 30-day complication rate (SG 5.8%; OAGB 7.5%; RYGB 8.0% (p = 0.006)). On multivariate regression modelling, Insulin-dependent type 2 diabetes mellitus and hypercholesterolaemia were associated with increased 30-day complications. Being a non-smoker was associated with reduced complication rates. When compared to SG as a reference category, RYGB, but not OAGB, was associated with an increased rate of 30-day complications. A total of 702 pairs of SG and OAGB were propensity score-matched. The complication rate in the SG group was 7.3% (n = 51) as compared to 7.5% (n = 53) in the OAGB group (p = 0.68). Similarly, 2085 pairs of SG and RYGB were propensity score-matched. The complication rate in the SG group was 6.1% (n = 127) as compared to 7.9% (n = 166) in the RYGB group (p = 0.09). And, 702 pairs of OAGB and RYGB were matched. The complication rate in both groups was the same at 7.5 % (n = 53; p = 0.07). Conclusions: This global study found no significant difference in the 30-day morbidity and mortality of SG, RYGB, and OAGB in propensity score-matched cohorts

30-Day morbidity and mortality of bariatric metabolic surgery in adolescence during the COVID-19 pandemic – The GENEVA study

Background: Metabolic and bariatric surgery (MBS) is an effective treatment for adolescents with severe obesity. Objectives: This study examined the safety of MBS in adolescents during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This was a global, multicentre and observational cohort study of MBS performed between May 01, 2020, and October 10,2020, in 68 centres from 24 countries. Data collection included in-hospital and 30-day COVID-19 and surgery-specific morbidity/mortality. Results: One hundred and seventy adolescent patients (mean age: 17.75 ± 1.30 years), mostly females (n = 122, 71.8%), underwent MBS during the study period. The mean pre-operative weight and body mass index were 122.16 ± 15.92 kg and 43.7 ± 7.11 kg/m2, respectively. Although majority of patients had pre-operative testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (n = 146; 85.9%), only 42.4% (n = 72) of the patients were asked to self-isolate pre-operatively. Two patients developed symptomatic SARS-CoV-2 infection post-operatively (1.2%). The overall complication rate was 5.3% (n = 9). There was no mortality in this cohort. Conclusions: MBS in adolescents with obesity is safe during the COVID-19 pandemic when performed within the context of local precautionary procedures (such as pre-operative testing). The 30-day morbidity rates were similar to those reported pre-pandemic. These data will help facilitate the safe re-introduction of MBS services for this group of patients

Thermal characterisation of quantum cascade lasers with Fabry Perot modes

Quantum cascade lasers are coherent light sources that rely on intrersubband transition in periodic semiconductor quantum well structures. They operate at frequencies from mid-infrared to terahertz. In cases of long wavelength and typical low thermal conductivity of the active region, temperature rise in the active region during operation is a major concern. Thermal conductivity of QCL epi-layers differ significantly from the values of bulk semiconductors and measurement of the thermal conductivity of epi-layers is critical for design. It is well known that Fabry-Perot spectra of QCL cavities exhibit fine amplitude oscillations with frequency and can be used for real time in-situ temperature measurement. Phase of the modulation depends on the group refractive index of the cavity, which depends on the cavity temperature. We fabricated QCL devices with from 12, to 24 um mesa widths and 2mm cavity length and and measured high resolution, high speed time resolved spectra using a FTIR spectrometer in step scan mode in a liquid nitrogen cooled, temperature controlled dewar. We used the time resolved spectra of QCLs to measure average temperature of the active region of the laser as a function of time. We examined the effect of pulse width and duty cycle on laser heating. We measured the temperature derivative of group refractive index of the cavity. Building a numerical model, we estimated the thermal conductivity of active region and calculated the heating of the QCL active region in pulsed mode for various waveguide widths

Nonlinear compact localized modes in flux-dressed octagonal-diamond lattice

Tuning the values of artificial flux in the two-dimensional octagonal-diamond lattice drives topological phase transitions, including between singular and non-singular flatbands. We study the dynamical properties of nonlinear compact localized modes that can be continued from linear flatband modes. We show how the stability of the compact localized modes can be tuned by the nonlinearity strength or the applied artificial flux. Our model can be realized using ring resonator lattices or nonlinear waveguide arrays.Preprint version available at arXiv.org: [https://arxiv.org/pdf/2111.13387.pdf

Renin-angiotensin system activation: may it increase frequency of obstructive sleep apnea in patients with autosomal dominant polycystic kidney disease?

Purpose Renin-angiotensin system (RAS) hyperactivity is a common entity in both autosomal dominant polycystic kidney disease (ADPKD) and obstructive sleep apnea (OSA). We aimed to investigate the frequency of OSA in adults with ADPKD either with stages 3-4 or stages 1-2 chronic kidney disease (CKD) and evaluate the effect of RAS blockade on OSA in these patients. Methods This is a comparative, prospective, two-center clinical study. Eligible patients with ADPKD were enrolled in a polysomnography (PSG) study. Presence of OSA in patients with ADPKD was compared with individuals who underwent polisomnography study due to OSA symptoms. A subgroup analysis was performed in terms of the presence of OSA in ADPKD with eGFR values lower or higher than 60 ml/min/1.73 m(2) (stages 3-4 and stages 1-2 CKD, respectively). Results Frequency of OSA (65%) was higher than in the general population and similar between the two groups (p = 0.367). Patients with ADPKD and eGFR >= 60 ml/min/1.73 m(2) presented a similar frequency of OSA to the control group (p = 0.759). However, OSA was significantly more frequent in ADPKD with eGFR 60 ml/min/1.73 m(2)) 14/17 (82%) and 12/23 (52%), respectively (p: 0.048). Conclusion As kidney disease progresses, uremia and related factors of renal failure rather than RAS activation seem to play a more important role for the development of OSA in patients with ADPKD

Nonlinear Bloch wave dynamics in photonic Aharonov–Bohm cages

Summarization: We study the properties of nonlinear Bloch waves in a diamond chain waveguide lattice in the presence of a synthetic magnetic flux. In the linear limit, the lattice exhibits a completely flat (wavevector k-independent) band structure, resulting in perfect wave localization, known as Aharonov–Bohm caging. We find that in the presence of nonlinearity, the Bloch waves become sensitive to k, exhibiting bifurcations and instabilities. Performing numerical beam propagation simulations using the tight-binding model, we show how the instabilities can result in either the spontaneous or controlled formation of localized modes, which are immobile and remain pinned in place due to the synthetic magnetic flux.Presented on: APL Photonic