Entanglement Rate for Gaussian Continuous Variable Beams

We derive a general expression that quantifies the total entanglement production rate in continuous variable systems, where a source emits two entangled Gaussian beams with arbitrary correlators.This expression is especially useful for situations where the source emits an arbitrary frequency spectrum,e.g. when cavities are involved. To exemplify its meaning and potential, we apply it to a four-mode optomechanical setup that enables the simultaneous up- and down-conversion of photons from a drive laser into entangled photon pairs. This setup is efficient in that both the drive and the optomechanical up- and down-conversion can be fully resonant.Comment: 18 pages, 6 figure

Pattern phase diagram for 2D arrays of coupled limit-cycle oscillators

Arrays of coupled limit-cycle oscillators represent a paradigmatic example for studying synchronization and pattern formation. They are also of direct relevance in the context of currently emerging experiments on nano- and optomechanical oscillator arrays. We find that the full dynamical equations for the phase dynamics of such an array go beyond previously studied Kuramoto-type equations. We analyze the evolution of the phase field in a two-dimensional array and obtain a "phase diagram" for the resulting stationary and non-stationary patterns. The possible observation in optomechanical arrays is discussed briefly

Geometric phases in astigmatic optical modes of arbitrary order

The transverse spatial structure of a paraxial beam of light is fully characterized by a set of parameters that vary only slowly under free propagation. They specify bosonic ladder operators that connect modes of different order, in analogy to the ladder operators connecting harmonic-oscillator wave functions. The parameter spaces underlying sets of higher-order modes are isomorphic to the parameter space of the ladder operators. We study the geometry of this space and the geometric phase that arises from it. This phase constitutes the ultimate generalization of the Gouy phase in paraxial wave optics. It reduces to the ordinary Gouy phase and the geometric phase of non-astigmatic optical modes with orbital angular momentum states in limiting cases. We briefly discuss the well-known analogy between geometric phases and the Aharonov-Bohm effect, which provides some complementary insights in the geometric nature and origin of the generalized Gouy phase shift. Our method also applies to the quantum-mechanical description of wave packets. It allows for obtaining complete sets of normalized solutions of the Schr\"odinger equation. Cyclic transformations of such wave packets give rise to a phase shift, which has a geometric interpretation in terms of the other degrees of freedom involved.Comment: final versio

Rotationally induced vortices in optical cavity modes

We show that vortices appear in the modes of an astigmatic optical cavity when it is put into rotation about its optical axis. We study the properties of these vortices and discuss numerical results for a specific realization of such a set-up. Our method is exact up to first order in the time-dependent paraxial approximation and involves bosonic ladder operators in the spirit of the quantum-mechanical harmonic oscillator.Comment: 8 pages, 5 figures. Accepted for publication in a special issue (singular optics 2008) of Journal of Optics A: Pure and Applied Optic

Rotational stabilization and destabilization of an optical cavity

We investigate the effects of rotation about the axis of an astigmatic two-mirror cavity on its optical properties. This simple geometry is the first example of an optical system that can be destabilized and, more surprisingly, stabilized by rotation. As such, it has some similarity with both the Paul trap and the gyroscope. We illustrate the effects of rotational (de)stabilization of a cavity in terms of the spatial structure and orbital angular momentum of its modes.Comment: 5 pages, 3 figures. Accepted for publication in Physical Review

Practical robustness evaluation in radiotherapy - A photon and proton-proof alternative to PTV-based plan evaluation

Background and purpose: A planning target volume (PTV) in photon treatments aims to ensure that the clinical target volume (CTV) receives adequate dose despite treatment uncertainties. The underlying static dose cloud approximation (the assumption that the dose distribution is invariant to errors) is problematic in intensity modulated proton treatments where range errors should be taken into account as well. The purpose of this work is to introduce a robustness evaluation method that is applicable to photon and proton treatments and is consistent with (historic) PTV-based treatment plan evaluations. Materials and methods: The limitation of the static dose cloud approximation was solved in a multi-scenario simulation by explicitly calculating doses for various treatment scenarios that describe possible errors in the treatment course. Setup errors were the same as the CTV-PTV margin and the underlying theory of 3D probability density distributions was extended to 4D to include range errors, maintaining a 90% confidence level. Scenario dose distributions were reduced to voxel-wise minimum and maximum dose distributions; the first to evaluate CTV coverage and the second for hot spots. Acceptance criteria for CTV D98 and D2 were calibrated against PTV-based criteria from historic photon treatment plans. Results: CTV D98 in worst case scenario dose and voxel-wise minimum dose showed a very strong correlation with scenario average D98 (R-2 > 0.99). The voxel-wise minimum dose visualised CTV dose conformity and coverage in 3D in agreement with PTV-based evaluation in photon therapy. Criteria for CTV D98 and D2 of the voxel-wise minimum and maximum dose showed very strong correlations to PTV D98 and D2 (R-2 > 0.99) and on average needed corrections of -0.9% and +2.3%, respectively. Conclusions: A practical approach to robustness evaluation was provided and clinically implemented for PTV-less photon and proton treatment planning, consistent with PTV evaluations but without its static dose cloud approximation. (C) 2019 The Authors. Published by Elsevier B.V

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Transarterial Chemoembolization With Drug-Eluting Beads Versus Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma: Outcomes From a Multicenter, Randomized, Phase 2 Trial (the TRENDY Trial)

Purpose: To compare transarterial chemoembolization delivered with drug eluting beads (TACE-DEB) with stereotactioc body radiation therapy (SBRT) in patients with hepatocellular carcinoma (HCC) in a multicenter randomized trial. Methods and Materials: Patients were included if they were eligible for TACE. They could also be recruited if they required treatment prior to liver transplantation. A maximum of four TACE-DEB procedures and ablation after incomplete TACE-DEB were both allowed. SBRT was delivered in six fractions of 8-9Gy. Primary end point was time to progression (TTP). Secondary endpoints were local control (LC), overall survival (OS), response rate (RR), toxicity, and quality of life (QoL). The calculated sample size was 100 patients. Results: Between May 2015 and April 2020, 30 patients were randomized to the study. Due to slow accrual the trial was closed prematurely. Two patients in the SBRT arm were considered ineligible leaving 16 patients in the TACE-DEB arm and 12 in the SBRT arm. Median follow-up was 28.1 months. Median TTP was 12 months for TACEDEB and 19 months for SBRT (p=0.15). Median LC was 12 months for TACE-DEB and >40 months (not reached) for SBRT (p=0.075). Median OS was 36.8 months for TACEDEB and 44.1 months for SBRT (p=0.36). A post-hoc analysis showed 100% for SBRT 1- and 2-year LC, and 54.4% and 43.6% for TACE-DEB (p=0.019). Both treatments resulted in RR>80%. Three episodes of possibly related toxicity grade ≥3 were observed after TACE-DEB. No episodes were observed after SBRT. QoL remained stable after both treatment arms. Conclusions: In this trial, TTP after TACE-DEB was not significantly improved by SBRT, while SBRT showed higher local antitumoral activity than TACE-DEB, without detrimental effects on OS, toxicity and QoL. To overcome poor accrual in randomized trials that include SBRT, and to generate evidence for including SBRT in treatment guidelines, international cooperation is needed