All-optical switching in lithium niobate directional couplers with cascaded nonlinearity

We report on intensity-dependent switching in lithium niobate directional couplers. Large nonlinear phase shifts that are due to cascading detune the coupling between the coupler branches, which makes all-optical switching possible. Depending on the input intensity, the output could be switched between the cross and the bar coupler branches with a switching ratio of 1:5 and a throughput of 80%

Algorithms and literate programs for weighted low-rank approximation with missing data

Linear models identification from data with missing values is posed as a weighted low-rank approximation problem with weights related to the missing values equal to zero. Alternating projections and variable projections methods for solving the resulting problem are outlined and implemented in a literate programming style, using Matlab/Octave's scripting language. The methods are evaluated on synthetic data and real data from the MovieLens data sets

Mouse precision-cut liver slices as an ex vivo model to study drug-induced cholestasis

Drugs are often withdrawn from the market due to the manifestation of drug-induced liver injury (DILI) in patients. Drug-induced cholestasis (DIC), defined as obstruction of hepatic bile flow due to medication, is one form of DILI. Because DILI is idiosyncratic, and the resulting cholestasis complex, there is no suitable in vitro model for early DIC detection during drug development. Our goal was to develop a mouse precision-cut liver slice (mPCLS) model to study DIC and to assess cholestasis development using conventional molecular biology and analytical chemistry methods. Cholestasis was induced in mPCLS through a 48-h-incubation with three drugs known to induce cholestasis in humans, namely chlorpromazine (15, 20, and 30 µM), cyclosporin A (1, 3, and 6 µM) or glibenclamide (25, 50, and 65 µM). A bile-acid mixture (16 µM) that is physiologically representative of the human bile-acid pool was added to the incubation medium with drug, and results were compared to incubations with no added bile acids. Treatment of PCLS with cholestatic drugs increased the intracellular bile-acid concentration of deoxycholic acid and modulated bile-transporter genes. Chlorpromazine led to the most pronounced cholestasis in 48 h, observed as increased toxicity; decreased protein and gene expression of the bile salt export pump; increased gene expression of multidrug resistance-associated protein 4; and accumulation of intracellular bile acids. Moreover, chlorpromazine-induced cholestasis exhibited some transition into fibrosis, evidenced by increased gene expression of collagen 1A1 and heatshock protein 47. In conclusion, we demonstrate that mPCLS can be used to study human DIC onset and progression in a 48 h period. We thus propose this model is suited for other similar studies of human DIC

How Well Can we Diagnose Autism in Adults? Evaluating an Informant-based Interview: The Dutch Developmental, Dimensional and Diagnostic Interview – Adult Version (3Di-Adult)

The current study evaluated a brief, informant-based autism interview: the Developmental, Dimensional and Diagnostic Interview – Adult Version (3Di-Adult). Feasibility, reliability and validity of the Dutch 3Di-Adult was tested amongst autistic participants (n = 62) and a non-autistic comparison group (n = 30) in the Netherlands. The 3Di-Adult consists of two scales based on DSM-5 criteria: A scale ‘Social communication and social interaction’ and B scale ‘Restricted, repetitive patterns of behavior, interests or activities’. ROC curves were used to determine cut-off scores for the A and the B scale, using an ASD diagnosis made by an independent clinician as the criterion. Mean administration time was 42 min. Internal consistency of the A scale (α = 0.92) and the B scale (α = 0.85) were good. Inter-rater reliability (ICCs = 0.99) and inter-rater agreement (ICCs ≥ 0.90) were promising. The 3Di-Adult showed good sensitivity (80.6%) and specificity (93.3%). Positive and negative predictive value were 96.2% and 70.0% respectively. Comparisons with the Autism-Spectrum Quotient-Short to investigate the convergent validity showed moderate, significant correlations with the 3Di-Adult in the total sample. Males, as compared to females, displayed significantly more autistic features on the 3Di-Adult. No relationship was found of the 3Di-Adult with education level, intelligence and age of the participants or informants. The feasibility and psychometric properties of the Dutch 3Di-Adult are promising, indicating that it can be a time-efficient, valid and reliable tool to use in diagnosing autism in adults according to DSM-5 criteria

Applications of cascading nonlinear optics to all-optical devices

The application of a cascaded phase shift to a fully integrated nonlinear directional coupler (NLDC) and Mach-Zehnder interferometer (MZI) is presented. It shows that for MZI, the input power was increased and the throughput was modulated between 80% and 20% of the input. For the NLDC, the switching from the cross to the bar states is clear

Reliability of the Q Force; a mobile instrument for measuring isometric quadriceps muscle strength

BACKGROUND: The ability to generate muscle strength is a pre-requisite for all human movement. Decreased quadriceps muscle strength is frequently observed in older adults and is associated with a decreased performance and activity limitations. To quantify the quadriceps muscle strength and to monitor changes over time, instruments and procedures with a sufficient reliability are needed. The Q Force is an innovative mobile muscle strength measurement instrument suitable to measure in various degrees of extension. Measurements between 110 and 130° extension present the highest values and the most significant increase after training. The objective of this study is to determine the test-retest reliability of muscle strength measurements by the Q Force in older adults in 110° extension. METHODS: Forty-one healthy older adults, 13 males and 28 females were included in the study. Mean (SD) age was 81.9 (4.89) years. Isometric muscle strength of the Quadriceps muscle was assessed with the Q Force at 110° of knee extension. Participants were measured at two sessions with a three to eight day interval between sessions. To determine relative reliability, the intraclass correlation coefficient (ICC) was calculated. To determine absolute reliability, Bland and Altman Limits of Agreement (LOA) were calculated and t-tests were performed. RESULTS: Relative reliability of the Q Force is good to excellent as all ICC coefficients are higher than 0.75. Generally a large 95 % LOA, reflecting only moderate absolute reliability, is found as exemplified for the peak torque left leg of -18.6 N to 33.8 N and the right leg of -9.2 N to 26.4 N was between 15.7 and 23.6 Newton representing 25.2 % to 39.9 % of the size of the mean. Small systematic differences in mean were found between measurement session 1 and 2. CONCLUSION: The present study shows that the Q Force has excellent relative test-retest reliability, but limited absolute test-retest reliability. Since the Q Force is relatively cheap and mobile it is suitable for application in various clinical settings, however, its capability to detect changes in muscle force over time is limited but comparable to existing instruments

The value of computed tomography in detecting distal radioulnar joint instability after a distal radius fracture

This study evaluated the value of computed tomography scans for the diagnosis of distal radioulnar joint instability. A total of 46 patients, conservatively treated for a unilateral distal radius fracture, were evaluated. Clinical instability was tested using the stress test and clunk test. A computed tomography scan of both wrists was performed in pronation and supination. Two independent observers reviewed the computed tomography scans using: the radioulnar line, subluxation ratio, epicentre and radioulnar ratio methods. Radiological distal radioulnar joint instability was assessed by comparing the measurements of the injured wrist with those of the contralateral uninjured wrists. A

A stepwise transformation:description and outcome of perioperative procedures in patients receiving a total knee arthroplasty

Aims To investigate the impact of consecutive perioperative care transitions on in-hospital recovery of patients who had primary total knee arthroplasty (TKA) over an 11-year period. Methods This observational cohort study used electronic health record data from all patients undergoing preoperative screening for primary TKA at a northern netherlands hospital between 2009 and 2020. In this timeframe, three perioperative care transitions were divided into four periods: Baseline care (Joint Care, n = 171; May 2009 to August 2010), Function-tailored (n = 404; September 2010 to October 2013), Fast-track (n = 721; november 2013 to May 2018), and Prehabilitation (n = 601; June 2018 to December 2020). In-hospital recovery was measured using inpatient recovery of activities (IROA), length of stay (LOS), and discharge to preoperative living situation (PLS). Multivariable regression models were used to analyze the impact of each perioperative care transition on in-hospital recovery. Results The four periods analyzed involved 1,853 patients (65.9% female (1,221/1,853); mean age 70.1 years (SD 9.0)). IROA improved significantly with each transition: Function-tailored (0.9 days; p &lt; 0.001 (95% confidence interval (CI) -0.32 to -0.15)), Fast-track (0.6 days; p &lt; 0.001 (95% CI -0.25 to -0.16)), and Prehabilitation (0.4 days; p &lt; 0.001 (95% CI -0.18 to -0.10)). LOS decreased significantly in Function-tailored (1.1 days; p = 0.001 (95% CI -0.30 to -0.06)), Fast-track (0.6 days; p &lt; 0.001 (95% CI -0.21 to -0.05)), and Prehabilitation (0.6 days; p &lt; 0.001 (95%CI -0.27 to -0.11)). Discharge to PLS increased in Function-tailored (77%), Fast-track (91.6%), and Prehabilitation (92.6%). Post-hoc analysis indicated a significant increase after the transition to the Fast-track period (p &lt; 0.001 (95% CI 3.19 to 8.00)). Conclusion This study highlights the positive impact of different perioperative care procedures on in-hospital recovery of patients undergoing primary TKA. Assessing functional recovery, LOS, and discharge towards PLS consistently, provides hospitals with valuable insights into postoperative recovery. This can potentially aid planning and identifying areas for targeted improvements to optimize patient outcomes.</p

Mechanical tuning of optical race-track ring resonators

This paper presents the fabrication and mechanical characterization of electrostatically actuated micro bimorphs integrated with race-track ring resonators, for optical tuning applications. The bimorphs, having an upward deflection in the off-state, are integrated by surface micromachining techniques with race-track ring resonators fabricated on Silicon On Insulator (SOI) wafers. Using electrostatic actuation, these bimorphs are pulled into the evanescent field of the ring resonator thereby modulating the propagation properties. Pull-in voltages of the bimorphs have been measured statically and the effect of electrostatic spring softening (ESS) on the resonance frequency has been measured dynamically. The resonance wavelength of the optical ring resonator could be tuned by 50 pm by applying an 8.5 V DC voltage to a 40 μm long bimorph, bringing it into close proximity of the ring resonator waveguide. To the best of our knowledge, this is the first experimental demonstration of tuning of race track ring resonators by integrated, electrostatically actuated bimorphs.\ud \u