Third-order nonlinearity with subradiance dark-state in ultra-strong excitons and surface plasmon coupling using self-antiaggregation organic dye

A strong coupling regime with dressed states is formed when a propagating surface plasmon (PSP) mode coherently exchanges energy with an ensemble of excitons at a rate faster than the system's losses. These states are superpositions of superradiance excitons and PSP modes, accompanied by remaining subradiance or 'dark' exciton states. Dark-states are ubiquitous, especially in disordered systems, and they rise in number as the number of excitons increases. Here, the ultra-strong coupling regime was experimentally observed with the coupling strength to bare energy as high as g/${E}_{exciton}\,$∼ 0.23 using a self-antiaggregation organic dye, BOBzBT2 in an Otto-SPR configuration. We show that the hybrid system of excitons in a nonlinear organic dye layer and a PSP mode can be described by employing dark-state in a theory of nonlinear third-order sum-frequency generation (TSFG). Close agreement between the theory and the experiment has been demonstrated. The study opens up a new perspective for establishing a relationship between the optical properties of a third-order nonlinear material and the extent of strong coupling

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Exploiting a strong coupling regime of organic pentamer surface plasmon resonance based on the Otto configuration for creatinine detection

The sandwiched material-analyte layer in the surface plasmon resonance (SPR)-Otto configuration emulates an optical cavity and, coupled with large optical nonlinearity material, the rate of light escaping from the system is reduced, allowing the formation of a strong coupling regime. Here, we report an organic pentamer SPR sensor using the Otto configuration to induce a strong coupling regime for creatinine detection. Prior to that, the SPR sensor chip was modified with an organic pentamer, 1,4-bis[2-(5-thiophene-2-yl)-1-benzothiopene]-2,5-dioctyloxybenzene (BOBzBT2). To improve the experimental calibration curve, a normalisation approach based on the strong coupling-induced second dip was also developed. By using this procedure, the performance of the sensor improved to 0.11 mg/dL and 0.36 mg/dL for the detection and quantification limits, respectively