Magnetic resonance imaging to assess cartilage invasion in recurrent laryngeal carcinoma after transoral laser microsurgery

Objective: To evaluate the diagnostic performance of magnetic resonance (MR) with surface coils in assessing cartilage invasion in recurrent laryngeal carcinoma after carbon dioxide transoral laser microsurgery (CO2 TOLMS). Methods: Two expert head and neck radiologists assessed cartilage invasion (infiltrated or non-infiltrated) in submucosal recurrences of laryngeal carcinoma after CO2 TOLMS: results were compared with histopathological report after salvage laryngectomy. Results: Thirty patients met the inclusion criteria and 90 cartilages were assessed. Overall sensitivity, specificity, and positive and negative predictive values for cartilage infiltration were 76, 93, 72 and 94%, respectively; for thyroid cartilage, the values were 82, 79, 69 and 88% respectively; for cricoid cartilage, all values were 100%; and for arytenoids, the values were 33, 96, 56 and 93% respectively. Conclusions: MR with surface coils was able to detect most thyroid and cricoid infiltration in the complex setting of post-CO2 TOLMS laryngeal carcinoma recurrence. In particular, the optimal performance in assessing cricoid invasion can be valuable in choosing the most appropriate treatment among total laryngectomy, open partial horizontal laryngectomies and non-surgical strategies

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

The last 40 ka evolution of the Central Po Plain between the Adda and Serio rivers

We reconstructed the geological evolution and the history of the fluvial network in the central part of the Po Plain in Lombardy, northern Italy, since the Middle Würm. We focused on evidences of dissection and incision of former rivers into the large outwash fans originating from piedmont glaciers of the southern Alps in the Last Glacial Maximum. The studied area is located between the Po River and the Alps north of the Adda/Serio river confluence, around the town of Crema. Morphometric analysis and stratigraphic investigation were carried out, supported by palaeobotany, sand petrography and radiometric dating. The obtained stratigraphic framework is presented by cross sections and by a geological map. During the Middle Würm, an alluvial fan of the Adda River oriented NWN-SSE occupied the area, feeding south and west the Romanengo hill. A substantial reorganisation of the fluvial network occurred during the Last Glacial Maximum. Since 32-30 ka cal. BP, the area was fed by two outwash rivers, originated from the Adda and the Oglio piedmont glaciers, both characterised by a prevalent southward drainage, 160°-170° S in the LGM. After the LGM the fan-head was dissected by trunk channels and, at the downslope fan limit, the southward flow shifted to a southeastern direction. Thereafter, major dissection and downcutting occurred in the Lateglacial, confining the major rivers into large alluvial corridors, further shaped by lateral erosion during the Holocene. The Late Holocene history of the Serio River is marked by fluvial floods during the late Roman Age, and by a capture of the lower reach by the Adda River. The geomorphological evidence supports the historically inferred age assignment of the diversion to 12th-14th c. AD.L’évolution géologique et l’histoire du réseau fluvial dans la partie centrale de la plaine du Pô en Lombardie ont été reconstituées à partir du Würm moyen. Le territoire environnant la ville de Crema entre les rivières Adda et Serio est caractérisé par des paléovallées encaissées dans de grands cônes en lien avec les glaciers du piémont méridional des Alpes pendant la dernière glaciation. L’étude morphométrique et stratigraphique a été supportée par les analyses paléobotaniques, pétrographiques sur sables et galets et par plusieurs déterminations radiométriques. Au Würm moyen, un cône alluvial mis en place par la rivière Adda s’orientait NWN-SSE et occupait la région étudiée, s’appuyant sur la colline de Romanengo au sud et à l’ouest. A partir de 32-30 ka cal. BP [i.e., au début du Dernier Maximum Glaciaire (DMG)], une réorganisation importante du réseau hydrographique (orientation nettement sud) est forcée par le développement de deux sandurs des domaines glaciaires de l’Adda et de l’Oglio. Le sommet des cônes est creusé par les paléochenaux post-DMG, lorsque, à la base des cônes, la direction des paléochenaux, qui était 160-170° pendant la dernière phase d’aggradation, devient sud-ouest. Ce nouveau système de drainage est fossilisé par une phase d’incision importante au Tardiglaciaire, avant que les rivières soient confinées dans des corridors alluviaux et sujets à l’érosion latérale au cours de l’Holocène. L’histoire de la rivière Serio est marquée par des phénomènes d’alluvionnement au cours de l’Antiquité tardive puis par la capture de son cours inférieur par la rivière Adda. Les preuves géomorphologiques concordent avec les sources écrites, suggérant que le changement de tracé se produit entre le XIIe s. et le XIVe s. apr. J.-C

Coherent perfect absorption in metamaterials with entangled photons

Quantum nonlocality, i.e., the presence of strong correlations in spatially separated systems that are forbidden by local realism, lies at the heart of quantum communications and quantum computing. Here, we use polarization-entangled photon pairs to demonstrate a nonlocal interaction of light with a plasmonic structure. Through the detection of one photon with a polarization-sensitive device, we can prevent or allow absorption of a second, remotely located photon. We demonstrate this with pairs of entangled photons in polarization, one of which is coupled into a plasmon of a thin metamaterial absorber in the path of a standing wave of an interferometer. Thus, we realize a quantum eraser experiment using photons and plasmonic resonances from metamaterials that promises opportunities for probabilistic quantum gating and controlling plasmon–photon conversion and entanglement. Moreover, by using the so-called coherent perfect absorption effect, we can expect near-perfect interaction

Quantum super-oscillation of a single photon

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'Remote Control' of Coherent Light Absorption with Entangled Photons

Using a source of entangled photons we show that polarization-sensitive detection of the photons can be used to switch 'on' and 'off' absorption of the other photon in a thin plasmonic metamaterial film

Hot exciton cooling and multiple exciton generation in PbSe quantum dots

9 p.Multiple exciton generation (MEG) is a promising process to improve the power conversion efficiency of solar cells. PbSe quantum dots (QDs) have shown reasonably high MEG quantum yield (QY), although the photon energy threshold for this process is still under debate. One of the reasons for this inconsistency is the complicated competition of MEG and hot exciton cooling, especially at higher excited states. Here, we investigate MEG QY and the origin of the photon energy threshold for MEG in PbSe QDs of three different sizes by studying the transient absorption (TA) spectra, both at the band gap (near infrared, NIR) and far from the band gap energy (visible range). The comparison of visible TA spectra and dynamics for different pump wavelengths, below, around and above the MEG threshold, provides evidence of the role of the Σ transition in slowing down the exciton cooling process that can help MEG to take over the phonon relaxation process. The universality of this behavior is confirmed by studying QDs of three different sizes. Moreover, our results suggest that MEG QY can be determined by pump–probe experiments probed above the band gap.MOE (Min. of Education, S’pore)Accepted versio

Ultrafast surface state dynamics of topological insulators metamaterials at optical frequencies

We report time-resolved pump-probe and ARPES measurements of topological insulator crystals and nanoslit metamaterials of BixSb1-xTeySe1-y (BSTS) at optical frequencies, which reveal the ultrafast dynamics of topological surface states at room temperature

Persistent Infection with Rotavirus Vaccine Strain in Severe Combined Immunodeficiency (SCID) Child: Is Rotavirus Vaccination in SCID Children a Janus Face?

We report the first case, to our knowledge, in Italy, of a severe combined immunodeficiency patient with a persistent rotavirus infection due to a vaccine derived strain. Rotavirus was detected by enzyme immunoassays and RT-PCR in stool specimens for five months. The persistent infection was resolved after complete immune reconstitution achieved by hematopoietic stem cell transplantation. This case underlines the importance of neonatal SCID_screening