Contribution à l'intégration d'un isolateur optique sur verre : fonctions réciproques et non réciproques de contrôle de la polarisation

For the past forty years, the growth of fiber telecommunications has led to the development of integrated optical components. However, due to technological issues, a device has not yet been realized: the optical isolator, which propagates light in a single direction. Our work fits into this context. It deals with the integration of an isolator using the Na+/Ag+ ion-exchange technology. The configuration we adopted consists of three elements on chip: a polarization splitter and two 45 ° polarization rotators, one is reciprocal and the other is not. The polarization splitter has been realized in the shape of an asymmetrical Y junction. After a theoretical study, we present the fabrication process and experimental results. State-of-the-art diaphonies of (31.1 ± 0.4) dB and (32.7 ± 0.4) dB have been measured in TE and TM mode over a bandwidth larger than 70 nm. The magneto-optical part of the study has been undertaken in collaboration with the Laboratoire Télécom Claude Chappe (LT2C) from Saint Etienne, France. The Faraday rotator is a selectively buried waveguide on which a magneto-optical material has been deposited using a sol-gel process. A non-reciprocal rotation of 50 ° has been measured, hence validating the hybrid approach. A novel fabrication process is presented for a reciprocal mode-evolution polarization rotator. The process consists in the burring of a waveguide under an electric field presenting a transverse inhomogeneity. We finally propose a fabrication method of the complete optical isolator. It is based on the monolithic integration of the three elements.L'essor des télécommunications sur fibres a conduit depuis quarante ans au développement des composants optiques intégrés. Cependant, en raison de difficultés technologiques, un dispositif n'a pas encore été réalisé de façon satisfaisante : il s'agit de l'isolateur optique, dont la fonction est de propager la lumière dans un seul sens. Ces travaux s'inscrivent dans cette problématique puisqu'ils visent à l'intégration d'un isolateur grâce à la technologie de l'échange d'ions Na+/Ag+ sur verre. La configuration adoptée se compose de trois éléments sur puce : un séparateur de polarisation et deux rotateurs de polarisation à 45 °, l'un réciproque et l'autre non. Le séparateur de polarisation a été réalisé sous la forme d'une jonction Y asymétrique. Après une étude théorique, nous présentons le procédé de fabrication ainsi que les résultats expérimentaux obtenus. Les diaphonies mesurées sont à l'état de l'art, elles dépassent (31,1 ± 0,4) dB et (32,7 ± 0,4) dB en mode TE et TM sur une plage spectrale supérieure à 70 nm. Nous avons mené l'étude du rotateur Faraday en collaboration avec le Laboratoire Télécom Claude Chappe de Saint Etienne pour la partie magnéto-optique. La structure employée est un guide d'onde à enterrage différentiel sur lequel est déposé un matériau magnéto-optique par un procédé sol-gel. Un angle de rotation non-réciproque de 50 ° a été mesuré, validant ainsi l'approche hybride. Un nouveau procédé de fabrication est également présenté pour un rotateur réciproque à évolution de mode adiabatique. Celui-ci consiste en un enterrage sous champ présentant une inhomogénéité transverse. Nous proposons finalement une méthode de fabrication de l'isolateur complet basée sur l'intégration monolithique des différents éléments

An Adaptive Computational Intelligence Approach to Personalised Health Assessment and Immune Age Characterisation from Common Haematological Markers

We introduce an approach to creating a simulated digital twin of the health of an individual based on a learning adaptive algorithm that learns the optimal reference values of the blood panel over time and associates an immune age score to compare with where if the biological age is lower than the score, an indication of wellness is provided. The score may also be useful for classification purposes. We demonstrate its efficacy against real and synthetic data from medically relevant cases, extreme cases, and empirical blood cell count data from 100K data records in the CDC NHANES survey that spans 13 years, from 2003 to 2016. We find that the score we introduce is informative when distinguishing healthy individuals from those with diseases, both self-reported and abnormal blood tests manifested, providing an entry-level score for patient triaging. We show that the score varies over time and is correlated with biological age, leading to the definition of an immune age as the inverse function of this relationship when different sets of analytes are taken only based on the results of an FBC or CBC test, providing clinical evidence of its potential relevance to the results of the CBC test, providing precision medicine and for personalised predictive healthcare.Comment: 30 pages + appendi

Immunological considerations and challenges for regenerative cellular therapies.

Funder: Wellcome TrustThe central goal of regenerative medicine is to replace damaged or diseased tissue with cells that integrate and function optimally. The capacity of pluripotent stem cells to produce unlimited numbers of differentiated cells is of considerable therapeutic interest, with several clinical trials underway. However, the host immune response represents an important barrier to clinical translation. Here we describe the role of the host innate and adaptive immune responses as triggers of allogeneic graft rejection. We discuss how the immune response is determined by the cellular therapy. Additionally, we describe the range of available in vitro and in vivo experimental approaches to examine the immunogenicity of cellular therapies, and finally we review potential strategies to ameliorate immune rejection. In conclusion, we advocate establishment of platforms that bring together the multidisciplinary expertise and infrastructure necessary to comprehensively investigate the immunogenicity of cellular therapies to ensure their clinical safety and efficacy

Pancreatic Allograft Thrombosis: Suggestion for a CT grading system and management algorithm

Pancreatic allograft thrombosis (PAT) remains the leading cause of non-immunological graft failure. Herein we propose a new CT grading system of PAT to identify risk factors for allograft loss and outline a management algorithm by retrospective review of consecutive pancreatic transplants between 2009-2014. Triple-phase CT scans were graded independently by two radiologists as; Grade 0 – no thrombosis, Grade 1 – peripheral thrombosis, Grade 2 – intermediate non-occlusive thrombosis and Grade 3 – central occlusive thrombosis. Twenty-four of 103 (23.3%) recipients were diagnosed with PAT (including grade 1). Three grafts (2.9%) were lost due to portal vein thrombosis. On multivariate analysis, pancreas after SPK/PAK transplant, acute rejection and CT finding peri-pancreatic oedema and/or inflammatory change were significant risk factors of PAT. Retrospective review of CT images revealed more grade 1 and 2 thromboses than were initially reported. There was no significant difference in graft or patient survival, post-operative stay or morbidity of recipients with grade 1 or 2 thrombosis who were or were not anticoagulated. Our data suggest that therapeutic anticoagulation is not necessary for grade 1 and 2 arterial and grade 1 venous thrombosis. The proposed grading system can assist clinicians in decision making and provide standardised reporting for future studies

Qualitative exploration of the renal stone patients' experience and development of the renal stone-specific patient-reported outcome measure

OBJECTIVES: To investigate the experience of patients living with renal calculi via a qualitative methodology, aiming to develop and validate a disease-specific patient-reported outcome measure (PROM) for renal stones, the Cambridge Renal Stone PROM (CReSP). PATIENTS, SUBJECTS AND METHODS: Patients with radiologically confirmed renal calculi who had undergone a range of management options were invited to focus groups or semi-structured interviews to elicit patient input and generate the PROM content. The developed renal stone PROM underwent validity studies included Cronbach's α for internal consistency, Spearman's and Pearson's correlation coefficients for test-retest reliability. Discriminant validity was assessed by Pearson's correlation coefficients vs the EuroQol five-dimensional five-level questionnaire (EQ-5D-5L). Our project has Health and Social Care Research Ethics Committee approval. RESULTS: A total of 106 subjects participated in creating the newly developed PROM. In all, 36 patients were invited to 22 semi-structured interviews and four focus groups, until reaching saturation. Major issues reported, and themes selected for the renal stone PROM included pain, anxiety, limitations to social life and tiredness, urinary symptoms, dietary changes' impacts, and gastrointestinal tract symptoms. Reliability analysis for 30 patients to determine internal consistency using Cronbach's α with a mean (range) of 0.91 (0.90-0.93) within domains and Cronbach's α between domains was 0.92. Average inter-item Pearson's and Spearman's correlation within domains was performed, with a Pearson's correlation mean (range) of 0.77 (0.73-0.85) and Spearman's correlation mean (range) of 0.72 (0.63-0.77). The test-retest Pearson's correlation mean (range) was 0.85 (0.57-0.95). Validity assessment was performed for 20 patients vs 20 controls. Pearson's correlation with EQ-5D-5L was -0.74, showing the newly developed PROM successfully discriminated patients with kidney stones. Our final renal stone PROM consists of 14 questions that are rated on a Likert scale; the higher the score, the worse the effect on a patient's quality of life. CONCLUSIONS: Although pain was the most frequent symptom, other health-related and social well-being issues significantly impacted patients' lives. Our validated patient-derived CReSP is a new instrument, specifically tailored to measure renal stone disease health outcomes from the patient's point of view

Development of an objective, standardized tool for surgical assessment of deceased donor kidneys: the Cambridge Kidney Assessment Tool

Quality assessment in kidney transplantation involves inspection to identify negative markers of organ quality. However, there is a paucity of evidence guiding surgical appraisal, and currently there is no evidence to differentiate important features from those that can be safely ignored. We propose a method to standardize surgical assessment and derived a simple rule to rapidly identify kidneys suitable for transplantation. Donor and recipient data were recorded alongside clinical outcomes in a prospectively maintained database. We developed a proforma (Cambridge Kidney Assessment Tool, CKAT) and used it to assess deceased donor kidney transplants. Factors predictive of utilization were identified by multivariate and univariate logistic regression analysis of CKAT-assessment scores, and test performance was evaluated using standard 2 × 2 contingency tables. Ninety-seven kidneys were included at a single center (2013-2014), and 184 CKAT assessments were performed. A CKAT threshold of “Carrell + Perfusion >3” was highly specific (99%) and performed favorably to consultant opinion (specificity 95%). 96% of the kidneys implanted in accordance with the rule survived to 1 year (mean eGFR 45.3 mL/min/1.73 m2). To our knowledge, this is the first attempt to objectively define macroscopic features that are relevant to kidney utilization. Common language could support training in organ assessment and ultimately help address unnecessary discard of donor kidneys

Hybrid magneto-optical mode converter made with a magnetic nanoparticles-doped SiO2/ZrO2 layer coated on an ion-exchanged glass waveguide

International audienceThis paper describes the possibility to achieve a TE-TM mode conversion in a magneto-optical hybrid waveguide operating at k¼1550 nm. This hybrid device is made by coating a SiO2/ZrO2 layer doped with magnetic nanoparticles on an ion-exchanged glass waveguide. Soft annealing (90 C) and UV treatment, both compatible with the ion exchange process, have been implemented to finalize the magneto-optical film. Optical characterizations that have been carried out demonstrated the efficiency of these hybrid structures in terms of lateral confinement and mode conversion. Indeed, TE to TM mode conversion has been observed when a longitudinal magnetic field is applied to the device. The amount of this conversion is discussed taking into account the distribution of light between the layer and the guide, and the modal birefringence of the structure