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Objective: Aortoesophageal fistula is a rare, life-threatening condition. There is no consensus regarding the surgical management of the esophagus in this condition. Methods: We retrospectively evaluated 13 patients diagnosed with aortoesophageal fistulas at a single institution from 2003 to 2021. Descriptive statistics were used to analyze patient characteristics, operative characteristics, and patient outcomes. Kaplan–Meier survival analysis was performed. Results: Patients’ mean age was 63.5 years, and 6 (46.2%) were female. The most common presenting symptoms were hemoptysis/hematemesis (69.2%), chest/back pain (46.2%), and fever (38.5%). Twelve patients (92.3%) had a history of aortic procedures. The median time between the index operation and repair of the secondary aortoesophageal fistula in the 12 patients was 5 months. The index operation was a thoracic endovascular aortic repair in 10 of 12 patients (83.3%). Eleven patients (84.6%) underwent primary esophageal repair with flap coverage (omentum or muscle). One of these patients needed an esophagectomy within 1 year. The primary surgical management of the aorta was graft excision and replacement, aside from 1 patient who underwent primary repair. The 30-day survival was 69.2%, and 1-year and 5-year survivals were 31.7%. There were no recurrent infections at the esophageal fistula site. Conclusions: Aortoesophageal fistula remains a rare condition, but its case numbers have increased with thoracic endovascular aortic repair. It continues to be a difficult condition to manage and has a high fatality rate. Esophageal-preserving surgery may be a safe and less-invasive option for patients with a small defect.

Abstract. Background:. Despite the recent emphasis on promoting international collaborations within orthopaedic surgery, criteria for determining the strengths of such partnerships has not been established. The purpose of this study was to evaluate orthopaedic experts' perceptions of the most valuable characteristics of international academic partnerships. Methods:. This study was conducted using a modified Delphi methodology. Experts were identified through the Consortium of Orthopaedic Academic Traumatologists (COACT). Responses were collected from February to September 2022. Three rounds of surveys listing possible topics on a 5-point Likert scale were used to develop consensus among a group of experts. Consensus criteria for topic inclusion in the final scale was determined as a rating of “strongly agree” or “agree” by ≥70% of the participants in the third survey. Results:. The Round 1 survey was distributed to 96 invited participants within the COACT network, of which 50 experts (52.1%) completed the first survey. Consensus was reached on 54 topics organized into the following 5 categories: Research, Advocacy/Leadership, Training/Surgical Skills, Education/Knowledge Exchange, and Sustainability and Safety (RATES Criteria). Conclusions:. Determining the most valuable characteristics of successful international academic partnerships can lead to more sustainable, mutually beneficial collaborations. The criteria identified in this study can provide the foundation for developing new partnerships and assessing existing ones.

Summary:. Deep inferior epigastric perforator (DIEP) flaps are becoming the most frequent choice for autologous breast reconstruction. There are many benefits to DIEP flaps, but the procedures can be lengthy and have a steep learning curve. The balance of efficiency and education can be difficult to achieve. A framework was implemented to focus on both efficiency and education at each stage of the DIEP flap procedure. The author’s methods to improve efficiency include a two-team approach with assigned roles for faculty and residents. The roles are consistent across the institution. Methods to enhance education include practice in a laboratory-based microsurgical training course and assigning goals for the rotation. Trainees include independent and integrated plastic surgery residents without microsurgical fellows. Bilateral DIEPs are performed with two attendings, and unilateral DIEPs, with one attending. A retrospective review identified patients undergoing DIEP flap reconstruction from 2017 to 2020. Outcome measures include operative time and complications, which are comparable to previously published data. Focusing on education allows residents to learn each stage of the case. The authors present a framework for training residents in DIEP flap reconstruction to optimize efficiency and education.

Introduction: This study evaluated patient preference of physician attire both before and after the coronavirus disease 2019 (COVID-19) global pandemic began. The primary outcome was patient preference of physician attire in 2017 compared to 2022 survey cohorts. Methods: An observational cross-sectional study performed at a single-site academic institution in the United States using patient survey materials. In total, 339 patients were included in the study, 161 from 2017 and 178 from 2022. Key Points: There was a statistically significant decrease in patient preference for formal attire in the clinical settings of primary care, hospital, and overall. Male patient preference for formal attire declined in primary care, emergency room, and overall; whereas female patient preference for formal attire declined in the hospital setting. For all genders, the odds ratio was statistically significantly lower in the settings of primary care clinic, hospital, and overall clinical settings. Conclusions: Patient preference for physicians wearing formal attire has decreased significantly since the COVID-19 global pandemic began.

Objective: To assess the association between vitamin B12 (B12) deficiency and the prevalence of fatigue and prespecified neurologic symptoms in patients with fibromyalgia. Patients and Methods: A retrospective chart analysis of patients diagnosed with fibromyalgia in the years 2015-2020 was performed. The values of B12 were collected. The chart reviews assessed reported fatigue and neurologic symptoms, including brain fog, memory loss, cognitive impairment, paresthesias, numbness, and tingling, to assess their correlation with B12 levels. Concurrent vitamin D and thyroid-stimulating hormone levels were reviewed to assess their association with fibromyalgia. Results: A total of 2142 patients with fibromyalgia with documented levels of B12 and vitamin D were included. Of them, 42.4% had B12 deficiency (

Objective: To outline a consensus-designed process for triaging and managing patients with post-coronavirus disease (COVID-19) syndrome at Mayo Clinic. Patients and Methods: We convened a central multidisciplinary team including members from the departments of general internal medicine, occupational medicine, physical medicine and rehabilitation, psychology, allergy and immunology, infectious disease, pulmonology, neurology, cardiology, and pediatrics and otorhinolaryngology with membership from all Mayo Clinic sites in Arizona, Florida, Iowa, Minnesota, and Wisconsin. Results: Consensus recommendations were made for the best practice guidelines on triaging and managing patients. Several innovations were agreed upon, including a postacute sequelae of COVID-19-specific appointment request form for data collection, a bioregistry, a biorepository, and a postacute sequelae of COVID-19-specific treatment program. Conclusion: Given that each clinical site had individual clinical practices, these recommendations were implemented using different models, which may provide broad applicability to other clinical settings.

Here we describe two, separate, and unique radiological findings in two distinct patients, sequelae from prior silicone oil injection for management of retinal detachment. In both cases we present bilateral, frontal horn hyperdense “masses” without appreciable enhancement or surrounding vasogenic edema. Both cases serve as important reminders of the potential for silicone oil migration and its unique radiological presentation, which has the potential to be a radiologic mimic of intracerebral hemorrhage and significantly change medical management of individuals presenting with transient ischemic attack or cerebrovascular accident.

Background:. The brachial plexus consists of an intricate array of nerves originating from the C5–T1 ventral rami of the spinal cord. Their course is complex and can be substantially distorted after injury. Thus, dissection of the brachial plexus can be difficult. Here, we present a practical approach to the supraclavicular dissection of the brachial plexus, with emphasis on relevant anatomy and surgical landmarks. Methods:. This anatomical review was prepared using intraoperative surgical imaging. In addition, illustrations are used to display the images in schematic form. We present a stepwise surgical approach to the supraclavicular dissection of the brachial plexus. We highlight the differences between pre- and postganglionic nerve root injuries, and also relevant anatomical variants of the brachial plexus. Results:. Eleven steps are recommended to facilitate the supraclavicular approach to the brachial plexus. Conclusion:. The supraclavicular dissection of the brachial plexus is reliable with consistent landmarks and can be carried out in a stepwise fashion.

Fear of acquiring severe acute respiratory syndrome coronavirus-2 infection is a major contributor to underutilization of the health care system during the current pandemic. In this report, we describe 4 cases of unexpected deaths that occurred within a short time period in patients with adult congenital heart disease without warning symptoms. (Level of Difficulty: Intermediate.)

Introduction: BRAF mutations are rare in patients with NSCLC, and treatment options are limited. Dabrafenib plus trametinib (dab-tram) was approved for BRAFV600-mutated advanced NSCLC (aNSCLC), based on results from a phase 2 study (NCT01336634). This retrospective analysis compared the effectiveness of dab-tram, based on previously reported clinical trial data, versus real-world standard of care in patients with BRAF-mutated aNSCLC. Methods: Real-world cohorts were derived from a deidentified real-world database (2011–2020) and included patients with BRAF-mutated aNSCLC receiving first-line platinum-based chemotherapy (PBC), first-line immune checkpoint inhibitors (ICIs) plus PBC, or second-line ICIs. Weighting by odds was used to estimate the average treatment effect of the treated. Results: For first-line dab-tram versus PBC, the hazard ratio (HR; 95% confidence interval) for death in unweighted and weighted analyses was 0.65 (0.39–1.1) and 0.51 (0.29–0.92; p = 0.03), respectively; unweighted and weighted median overall survival was 17.3 (12.3–40.2) versus 14.5 (9.2–19.6) months and 17.3 (14.6-not reached) versus 9.7 (6.4–19.6) months, respectively. Hazard ratio of death in unweighted and weighted analyses was 0.56 (0.29–1.1) and 0.57 (0.28–1.17), respectively, with first-line dab-tram versus PBC plus ICI, and 0.65 (0.39–1.07) and not reported (Cox proportional-hazards assumption violated), respectively, with second-line dab-tram versus ICI. Conclusions: In this indirect comparison in patients with BRAF-mutated aNSCLC, the risk of death was lower and median overall survival was longer with first-line dab-tram versus PBC. In analyses of dab-tram versus first-line PBC plus ICI or second-line ICI, sample sizes were small and findings were inconclusive with overlapping confidence intervals. Despite some limitations, the study provides useful data for this rare patient population.

Purpose: This study aimed to analyze the potential clinical impact of the differences between planned and accumulated doses on the development and use of normal tissue complication probability (NTCP) models. Methods and Materials: Thirty patients who were previously treated with stereotactic body radiation therapy for liver cancer and for whom the accumulated dose was computed were assessed retrospectively. The linear quadratic equivalent dose at 2 Gy per fraction and generalized equivalent uniform dose were calculated for planned and accumulated doses. Stomach and duodenal Lyman-Kutcher-Burman NTCP models (α/β = 2.5; n = .09) were developed on the basis of planned and accumulated generalized equivalent uniform doses and the differences between the models assessed. In addition, the error in determining the probability of toxicity on the basis of the planned dose was evaluated by comparing planned doses in the NTCP model that were created from accumulated doses. Results: The standard, planned-dose NTCP model overestimates toxicity risk for both the duodenal and stomach models at doses that are below approximately 20 Gy (6 fractions) and underestimates toxicity risk for doses above approximately 20 Gy (6 fractions). Building NTCP models with accumulated rather than planned doses changes the predicted risk by up to 16% (mean: 6%; standard deviation: 7%) for duodenal toxicity and 6% (mean: 2%; standard deviation: 2%) for stomach toxicity. For a protocol that plans a 10% iso-toxicity risk to the duodenum, a 15.7 Gy (6 fractions) maximum dose constraint would be necessary when using standard NTCP models on the basis of a planned dose and a 17.6 Gy (6 fractions) maximum dose would be allowed when using NTCP models on the basis of accumulated doses. Conclusions: Assuming that accumulated dose is a more accurate representation of the true delivered dose than the planned dose, this simulation study indicates the need for prospective clinical trials to evaluate the impact of building NTCP models on the basis of accumulated doses.

Objectives: To evaluate the feasibility of 4-dimensional perfusion computed tomography (CT) as an imaging biomarker for patients with hepatocellular carcinoma and metastatic liver disease. Methods and materials: Patients underwent volumetric dynamic contrast-enhanced CT on a 320-slice scanner before and during stereotactic body radiation therapy and sorafenib, and at 1 and 3 months after treatment. Quiet free breathing was used in the CT acquisition and multiple techniques (rigid or deformable registration as well as outlier removal) were applied to account for residual liver motion. Kinetic modeling was performed on a voxel-by-voxel basis in the gross tumor volume and normal liver resulting in 3-dimensional parameter maps of blood perfusion, capillary permeability, blood volume, and mean transit time. Perfusion characteristics in the tumor and adjacent liver were correlated with radiation dose distributions to evaluate dose-response. Paired t tests assessed change in spatial and histogram parameters from baseline to different time points during and after treatment. Technique reproducibility as well as the impact of arterial and portal vein input functions was also investigated using intra- and inter-subject variance and Bland-Altman analysis. Results: Quantitative perfusion parameters were reproducible (±5.7%; range, 2%-10%) depending on tumor/normal liver type and kinetic parameter. Statistically significant reductions in tumor perfusion were measurable over the course of treatment and as early as 1 week after sorafenib administration (P < .05). Marked liver parenchyma perfusion reduction was seen with a strong dose-response effect (R2 = 0.95) that increased significantly over the course treatment. Conclusions: The proposed methodology demonstrated feasibility of evaluating spatiotemporal changes in liver tumor perfusion and normal liver function following antiangiogenic therapy and radiation treatment warranting further evaluation of biomarker prognostication.

Purpose: Liver tumors are challenging to visualize on cone beam computed tomography (CBCT) without intravenous (IV) contrast. Image guidance for liver cancer stereotactic body ablative radiation therapy (SABR) could be improved with the direct visualization of hepatic tumors and vasculature. This study investigated the feasibility of the use of IV contrast-enhanced CBCT (IV-CBCT) as a means to improve liver target visualization. Methods and Materials: Patients on a liver SABR protocol underwent IV-CBCT before 1 or more treatment fractions in addition to a noncontrast CBCT. Image acquisition was initiated 0 to 30 seconds following injection and acquired over 60 to 120 seconds. “Stop and go” exhale breath-hold CBCT scans were used whenever feasible. Changes in mean CT number in regions of interest within visible vasculature, tumor, and adjacent liver were quantified between CBCT and IV-CBCT. Results: Twelve pairs of contrast and noncontrast CBCTs were obtained in 7 patients. Intravenous-CBCT improved hepatic tumor visibility in breath-hold scans only for 3 patients (2 metastases, 1 hepatocellular carcinoma). Visible tumors ranged in volume from 124 to 564 mL. Small tumors in free-breathing patients did not show enhancement on IVCBT. Conclusions: Intravenous-CBCT may enhance the visibility of hepatic vessels and tumor in CBCT scans obtained during breath hold. Optimization of IV contrast timing and reduction of artifacts to improve tumor visualization warrant further investigation.

Objective: The healthcare chart is becoming ever more complex, serving clinicians, patients, third party payers, regulators, and even medicolegal parties. The purpose of this study was to identify our emergency medicine (EM) resident and attending physicians’ current knowledge and attitudes about billing and documentation practices. We hypothesized that resident and attending physicians would identify billing and documentation as an area in which residents need further education.Methods: We gave a 15-question Likert survey to resident and attending physicians regarding charting practices, knowledge of billing and documentation, and opinions regarding need for further education.Results: We achieved a 100% response rate, with 47% (16/34) of resident physicians disagreeing or strongly disagreeing that they have adequate training in billing and documentation, while 91% (31/34) of residents and 95% (21/22) of attending physicians identified this skill as important to a resident’s future practice. Eighty-two percent (28/34) of resident physicians and 100% of attending physicians recommended further education for residents.Conclusion: Residents in this academic EM department identified a need for further education in billing and documentation practices. [West J Emerg Med. 2010;11(2): 116-119.]

Planar 45 o turning mirrors with metal coating embedded in SU8 polymer waveguides enable waveguide to vertical mode coupling across a broad range of wavelengths from the visible to IR. The fabrication of these 2.5D structures is achieved using relatively simple grayscale lithography in thin film resists, compatible with standard planar lithography methods. Mirror losses of <1 dB are measured from 516 -1630 nm, and direct coupling to single mode fibre is achieved.

Objective. Optogenetics allows the manipulation of neural circuits in vivo with high spatial and temporal precision. However, combining this precision with control over a significant portion of the brain is technologically challenging (especially in larger animal models). Approach. Here, we have developed, optimised, and tested in vivo , the Utah Optrode Array (UOA), an electrically addressable array of optical needles and interstitial sites illuminated by 181 μ LEDs and used to optogenetically stimulate the brain. The device is specifically designed for non-human primate studies. Main results. Thinning the combined μ LED and needle backplane of the device from 300 μ m to 230 μ m improved the efficiency of light delivery to tissue by 80%, allowing lower μ LED drive currents, which improved power management and thermal performance. The spatial selectivity of each site was also improved by integrating an optical interposer to reduce stray light emission. These improvements were achieved using an innovative fabrication method to create an anodically bonded glass/silicon substrate with through-silicon vias etched, forming an optical interposer. Optical modelling was used to demonstrate that the tip structure of the device had a major influence on the illumination pattern. The thermal performance was evaluated through a combination of modelling and experiment, in order to ensure that cortical tissue temperatures did not rise by more than 1 °C. The device was tested in vivo in the visual cortex of macaque expressing ChR2-tdTomato in cortical neurons. Significance. It was shown that the UOA produced the strongest optogenetic response in the region surrounding the needle tips, and that the extent of the optogenetic response matched the predicted illumination profile based on optical modelling-demonstrating the improved spatial selectivity resulting from the optical interposer approach. Furthermore, different needle illumination sites generated different patterns of low-frequency potential activity., (Creative Commons Attribution license.)

Electron backscatter diffraction and cathodoluminescence are complementary scanning electron microscopy modes widely used in the characterisation of semiconductor films, respectively revealing the strain state of a crystalline material and the effect of this strain on the light emission from the sample. Conflicting beam, sample and detector geometries have meant it is not generally possible to acquire the two signals together during the same scan. Here, we present a method of achieving this simultaneous acquisition, by collecting the light emission through a transparent sample substrate. We apply this combination of techniques to investigate the strain field and resultant emission wavelength variation in a deep-ultraviolet micro-LED. For such compatible samples, this approach has the benefits of avoiding image alignment issues and minimising beam damage effects., (Creative Commons Attribution license.)

Achieving high frame-rate operation in single pixel imaging schemes normally demands significant compromises in the flexibility of the imaging system, requiring either complex optical setups or a hardware-limited pattern mask set. Here, we demonstrate a single pixel imaging capability with pattern frame-rates approaching 400 kfps with a recently developed microLED light projector and an otherwise simple optical setup. The microLED array has individually addressable pixels and can operate significantly faster than digital micromirror devices, allowing flexibility with regards to the pattern masks employed for imaging even at the fastest frame-rates. Using a full set of Hadamard or Noiselet patterns, we demonstrate 128 × 128 pixel images being generated at 7.3 fps. We generate a pattern set specifically for the light projector using deep learning tools and use these patterns to demonstrate single pixel imaging at almost 800 fps.

The therapeutic application of blue light (380 - 500nm) has garnered considerable attention in recent years as it offers a non-invasive approach for the management of prevalent skin conditions including acne vulgaris and atopic dermatitis. These conditions are often characterised by an imbalance in the microbial communities that colonise our skin, termed the skin microbiome. In conditions including acne vulgaris, blue light is thought to address this imbalance through the selective photoexcitation of microbial species expressing wavelength-specific chromophores, differentially affecting skin commensals and thus altering the relative species composition. However, the abundance and diversity of these chromophores across the skin microbiota remains poorly understood. Similarly, devices utilised for studies are often bulky and poorly characterised which if translated to therapy could result in reduced patient compliance. Here, we present a clinically viable micro-LED illumination platform with peak emission 450 nm (17 nm FWHM) and adjustable irradiance output to a maximum 0.55 ± 0.01 W/cm 2 , dependent upon the concentration of titanium dioxide nanoparticles applied to an accompanying flexible light extraction substrate. Utilising spectrometry approaches, we characterised the abundance of prospective blue light chromophores across skin commensal bacteria isolated from healthy volunteers. Of the strains surveyed 62.5% exhibited absorption peaks within the blue light spectrum, evidencing expression of carotenoid pigments (18.8%, 420-483 nm; Micrococcus luteus , Kocuria spp.), porphyrins (12.5%, 402-413 nm; Cutibacterium spp.) and potential flavins (31.2%, 420-425 nm; Staphylococcus and Dermacoccus spp.). We also present evidence of the capacity of these species to diminish irradiance output when combined with the micro-LED platform and in turn how exposure to low-dose blue light causes shifts in observed absorbance spectra peaks. Collectively these findings highlight a crucial deficit in understanding how microbial chromophores might shape response to blue light and in turn evidence of a micro-LED illumination platform with potential for clinical applications., Competing Interests: The authors declare no potential conflicts of interest with respect to the authorship and/or publication of this article., (© 2024 The Author(s).)

Optogenetics has transformed studies of neural circuit function, but remains challenging to apply to non-human primates (NHPs). A major challenge is delivering intense, spatiotemporally-precise, patterned photostimulation across large volumes in deep tissue. Such stimulation is critical, for example, to modulate selectively deep-layer corticocortical feedback circuits. To address this need, we have developed the Utah Optrode Array (UOA), a 10×10 glass needle waveguide array fabricated atop a novel opaque optical interposer, and bonded to an electrically addressable µLED array. In vivo experiments with the UOA demonstrated large-scale, spatiotemporally precise, activation of deep circuits in NHP cortex. Specifically, the UOA permitted both focal (confined to single layers/columns), and widespread (multiple layers/columns) optogenetic activation of deep layer neurons, as assessed with multi-channel laminar electrode arrays, simply by varying the number of activated µLEDs and/or the irradiance. Thus, the UOA represents a powerful optoelectronic device for targeted manipulation of deep-layer circuits in NHP models., (© 2024. The Author(s).)

Supraparticle (SP) microlasers fabricated by the self-assembly of colloidal nanocrystals have great potential as coherent optical sources for integrated photonics. However, their deterministic placement for integration with other photonic elements remains an unsolved challenge. In this work, we demonstrate the manipulation and printing of individual SP microlasers, laying the foundation for their use in more complex photonic integrated circuits. We fabricate CdS x Se 1-x /ZnS colloidal quantum dot (CQD) SPs with diameters from 4 to 20 μm and Q-factors of approximately 300 via an oil-in-water self-assembly process. Under a subnanosecond-pulse optical excitation at 532 nm, the laser threshold is reached at an average number of excitons per CQD of 2.6, with modes oscillating between 625 and 655 nm. Microtransfer printing is used to pick up individual CQD SPs from an initial substrate and move them to a different one without affecting their capability for lasing. As a proof of concept, a CQD SP is printed on the side of an SU-8 waveguide, and its modes are successfully coupled to the waveguide., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

Effective light extraction from optically active solid-state spin centers inside high-index semiconductor host crystals is an important factor in integrating these pseudo-atomic centers in wider quantum systems. Here, we report increased fluorescent light collection efficiency from laser-written nitrogen-vacancy (NV) centers in bulk diamond facilitated by micro-transfer printed GaN solid immersion lenses. Both laser-writing of NV centers and transfer printing of micro-lens structures are compatible with high spatial resolution, enabling deterministic fabrication routes toward future scalable systems development. The micro-lenses are integrated in a noninvasive manner, as they are added on top of the unstructured diamond surface and bonded by van der Waals forces. For emitters at 5 μm depth, we find approximately 2× improvement of fluorescent light collection using an air objective with a numerical aperture of NA = 0.95 in good agreement with simulations. Similarly, the solid immersion lenses strongly enhance light collection when using an objective with NA = 0.5, significantly improving the signal-to-noise ratio of the NV center emission while maintaining the NV's quantum properties after integration., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

A fluorescence sensor with the capability for spatially multiplexed measurements utilizing smartphone detection is presented. Bioconjugated quantum dots are used as the fluorescent tag and are excited using a blue-emitting microLED (µLED). The 1-dimensional GaN µLED array is butt-coupled to one edge of the glass slide to take advantage of total internal reflection fluorescence (TIRF) principles. The bioassays on the top surface of the glass waveguide are excited and the resultant fluorescence is detected with the smartphone. The red, green, and blue channels of the digital image are utilized to spectrally separate the excitation light from the fluorescence for analysis. Using a biotin-functionalized glass slide as proof of principle, we have shown that streptavidin conjugated quantum dots can be detected down to a concentration of 8 nM., Competing Interests: The authors declare no conflicts of interest., (Published by Optica Publishing Group under the terms of the Creative Commons Attribution 4.0 License. Further distribution of this work must maintain attribution to the author(s) and the published article’s title, journal citation, and DOI.)

We demonstrate the use of deep ultraviolet (DUV) micro-light-emitting diodes (LEDs) for long-distance line-of-sight optical wireless communications. With a single 285 nm-emitting micro-LED, we have respectively achieved data rates greater than 6.5 Gb/s at a distance of 10 m and 4 Gb/s at 60 m. Moreover, we obtained >1 Gb/s data rates at a distance of 116 m. To our knowledge, these results are the highest data rates at such distances thus far reported using DUV micro-LEDs and the first demonstration of Gb/s communication at >100 m using any micro-LED-based transmitter.

The SARS-CoV-2 pandemic is currently causing an unprecedented global health emergency since its emergence in December 2019. In December 2021, the FDA granted emergency use authorization to nirmatrelvir, a SARS-CoV-2 main protease inhibitor, for treating infected patients. This peptidomimetic is designed with a nitrile warhead, which forms a covalent bond to the viral protease. Herein, we investigate nirmatrelvir analogs with different warheads and their inhibitory activities. In addition, antiviral activities against human alphacoronavirus 229E was also investigated along with a cell-based assay. We discovered that the hydroxymethylketone and ketobenzothiazole warheads were equipotent to the nitrile warhead, suggesting that these analogs can also be used for treating coronavirus infections., Competing Interests: The authors declare no competing financial interest., (© 2022 American Chemical Society.)

Background: Patient-reported outcome measures (PROMs) assess health-related quality of life (HRQOL). These tools can facilitate assessment of weight-related successes and challenges., Objective: Implement surveys to better understand individual experiences with obesity and explore factors that may be associated with HRQOL., Methods: Patients completed Obesity and Weight Loss Quality of Life Instrument (OWLQOL) and Patient-Reported Outcomes Measurement Information System (PROMIS) Global-10 surveys. Three scores were calculated from survey results: global physical health (GPH), global mental health (GMH), and OWLQOL. The association between these scores and body mass index (BMI) was examined using multiple linear regression analyses., Results: 114 surveys were analyzed. GPH and OWLQOL scores were negatively associated with BMI. OWLQOL scores were higher in those who lost more than 10% body weight compared to those who lost less weight. OWLQOL scores for return patients were significantly higher than those for new patients., Conclusions: Various factors may affect HRQOL. Higher BMI may adversely affect HRQOL, but weight loss greater than 10% and an ongoing clinical relationship may have a positive effect.Implications for NursingThese surveys can promote quality care, providing relevant information to enhance the clinical visit and offering another means to evaluate interventions over time., (© Copyright 2022 Springer Publishing Company, LLC.)

We demonstrate a dual-material integrated photonic thermometer, fabricated by high accuracy micro-transfer printing. A freestanding diamond micro-disk resonator is printed in close proximity to a gallium nitride on a sapphire racetrack resonator, and respective loaded Q factors of 9.1 × 10 4 and 2.9 × 10 4 are measured. We show that by using two independent wide-bandgap materials, tracking the thermally induced shifts in multiple resonances, and using optimized curve fitting tools the measurement error can be reduced to 9.2 mK. Finally, for the GaN, in a continuous acquisition measurement we record an improvement in minimum Allan variance, occurring at an averaging time four times greater than a comparative silicon device, indicating better performance over longer time scales.

Time of flight and photometric stereo are two three-dimensional (3D) imaging techniques with complementary properties, where the former can achieve depth accuracy in discontinuous scenes, and the latter can reconstruct surfaces of objects with fine depth details and high spatial resolution. In this work, we demonstrate the surface reconstruction of complex 3D fields with discontinuity between objects by combining the two imaging methods. Using commercial LEDs, a single-photon avalanche diode camera, and a mobile phone device, high resolution of surface reconstruction is achieved with a RMS error of 6% for an object auto-selected from a scene imaged at a distance of 50 cm.

Small satellites have challenging size weight and power requirements for communications modules, which we address here by using chip-scale light-emitting diode (LED) transmitters and single-photon avalanche diode receivers. Data rates of 100 Mb/s have been demonstrated at a sensitivity of -55.2 dBm, and simulations with supporting experimental work indicate ranges in excess of 1 km are feasible with a directional gain of up to 52 dBi and comparatively modest pointing requirements. A 750 m, 20 Mb/s link using a single micro-LED has been demonstrated experimentally. The low electrical power requirements and compact, semiconductor nature of these devices offer high data rate, high sensitivity communications for small satellite platforms.

Three dimensional reconstruction of objects using a top-down illumination photometric stereo imaging setup and a hand-held mobile phone device is demonstrated. By employing binary encoded modulation of white light-emitting diodes for scene illumination, this method is compatible with standard lighting infrastructure and can be operated without the need for temporal synchronization of the light sources and camera. The three dimensional reconstruction is robust to unmodulated background light. An error of 2.69 mm is reported for an object imaged at a distance of 42 cm and with the dimensions of 48 mm. We also demonstrate the three dimensional reconstruction of a moving object with an effective off-line reconstruction rate of 25 fps.

We present multiplexer methodology and hardware for nanoelectronic device characterization. This high-throughput and scalable approach to testing large arrays of nanodevices operates from room temperature to milli-Kelvin temperatures and is universally compatible with different materials and integration techniques. We demonstrate the applicability of our approach on two archetypal nanomaterials-graphene and semiconductor nanowires-integrated with a GaAs-based multiplexer using wet or dry transfer methods. A graphene film grown by chemical vapor deposition is transferred and patterned into an array of individual devices, achieving 94% yield. Device performance is evaluated using data fitting methods to obtain electrical transport metrics, showing mobilities comparable to nonmultiplexed devices fabricated on oxide substrates using wet transfer techniques. Separate arrays of indium-arsenide nanowires and micromechanically exfoliated monolayer graphene flakes are transferred using pick-and-place techniques. For the nanowire array mean values for mobility μ FE = 880/3180 cm 2 V -1 s -1 (lower/upper bound), subthreshold swing 430 mV dec -1 , and on/off ratio 3.1 decades are extracted, similar to nonmultiplexed devices. In another array, eight mechanically exfoliated graphene flakes are transferred using techniques compatible with fabrication of two-dimensional superlattices, with 75% yield. Our results are a proof-of-concept demonstration of a versatile platform for scalable fabrication and cryogenic characterization of nanomaterial device arrays, which is compatible with a broad range of nanomaterials, transfer techniques, and device integration strategies from the forefront of quantum technology research.

The heterogeneous integration of micro- and nanoscale devices with on-chip circuits and waveguide platforms is a key enabling technology, with wide-ranging applications in areas including telecommunications, quantum information processing, and sensing. Pick and place integration with absolute positional accuracy at the nanoscale has been previously demonstrated for single proof-of-principle devices. However, to enable scaling of this technology for realization of multielement systems or high throughput manufacturing, the integration process must be compatible with automation while retaining nanoscale accuracy. In this work, an automated transfer printing process is realized by using a simple optical microscope, computer vision, and high accuracy translational stage system. Automatic alignment using a cross-correlation image processing method demonstrates absolute positional accuracy of transfer with an average offset of <40 nm (3σ < 390 nm) for serial device integration of both thin film silicon membranes and single nanowire devices. Parallel transfer of devices across a 2 × 2 mm 2 area is demonstrated with an average offset of <30 nm (3σ < 705 nm). Rotational accuracy better than 45 mrad is achieved for all device variants. Devices can be selected and placed with high accuracy on a target substrate, both from lithographically defined positions on their native substrate or from a randomly distributed population. These demonstrations pave the way for future scalable manufacturing of heterogeneously integrated chip systems., Competing Interests: The authors declare no competing financial interest.

Terahertz radiation encompasses a wide band of the electromagnetic spectrum, spanning from microwaves to infrared light, and is a particularly powerful tool for both fundamental scientific research and applications such as security screening, communications, quality control, and medical imaging. Considerable information can be conveyed by the full polarization state of terahertz light, yet to date, most time-domain terahertz detectors are sensitive to just one polarization component. Here we demonstrate a nanotechnology-based semiconductor detector using cross-nanowire networks that records the full polarization state of terahertz pulses. The monolithic device allows simultaneous measurements of the orthogonal components of the terahertz electric field vector without cross-talk. Furthermore, we demonstrate the capabilities of the detector for the study of metamaterials., (Copyright © 2020 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.)

Gallium nitride-based light-emitting diodes (LEDs) have revolutionized the lighting industry with their efficient generation of blue and green light. While broad-area (square millimetre) devices have become the dominant LED lighting technology, fabricating LEDs into micro-scale pixels (micro-LEDs) yields further advantages for optical wireless communications (OWC), and for the development of smart-lighting applications such as tracking and imaging. The smaller active areas of micro-LEDs result in high current density operation, providing high modulation bandwidths and increased optical power density. Fabricating micro-LEDs in array formats allows device layouts to be tailored for target applications and provides additional degrees of freedom for OWC systems. Temporal and spatial control is crucial to use the full potential of these micro-scale sources, and is achieved by bonding arrays to pitch-matched complementary metal-oxide-semiconductor control electronics. These compact, integrated chips operate as digital-to-light converters, providing optical signals from digital inputs. Applying the devices as projection systems allows structured light patterns to be used for tracking and self-location, while simultaneously providing space-division multiple access communication links. The high-speed nature of micro-LED array devices, combined with spatial and temporal control, allows many modes of operation for OWC providing complex functionality with chip-scale devices. This article is part of the theme issue 'Optical wireless communication'.

Full-color smart displays, which act both as a display and as a high-speed visible light communication (VLC) transmitter, can be realized by the integration of red-green-blue micron-sized light emitting diodes (micro-LEDs) onto a common platform. In this work, we report on the integration of aluminum gallium indium phosphide red micro-LEDs onto diamond and glass substrates by micro-transfer printing and their application in VLC. The device on-diamond exhibits high current density and bandwidth operation, enabled by diamond's superior thermal properties. Employing an orthogonal frequency division multiplexing modulation scheme, error-free data rates of 2.6 Gbps and 5 Gbps are demonstrated for a single micro-LED printed on-glass and on-diamond, respectively. In a parallel configuration, a 2x1 micro-LED array achieves error-free data rates of 3 Gbps and 6.6 Gbps, on-glass and on-diamond, respectively.

Semiconductor nanowire (NW) lasers are a promising technology for the realization of coherent optical sources with ultrasmall footprint. To fully realize their potential in on-chip photonic systems, scalable methods are required for dealing with large populations of inhomogeneous devices that are typically randomly distributed on host substrates. In this work two complementary, high-throughput techniques are combined: the characterization of nanowire laser populations using automated optical microscopy, and a high-accuracy transfer-printing process with automatic device spatial registration and transfer. Here, a population of NW lasers is characterized, binned by threshold energy density, and subsequently printed in arrays onto a secondary substrate. Statistical analysis of the transferred and control devices shows that the transfer process does not incur measurable laser damage, and the threshold binning can be maintained. Analysis on the threshold and mode spectra of the device populations proves the potential for using NW lasers for integrated systems fabrication.

We present integration of singulated micron-sized light emitting diodes (micro-LEDs) directly onto a silicon CMOS drive chip using a transfer printing method. An 8x8 micro-LED device array with individual control over each pixel is demonstrated with modulation bandwidths up to 50 MHz, limited by the large modulation depth of the driver chip. The 2 kHz frame rate CMOS driver also incorporates a Single Photon Avalanche Diode device thus allowing detection and transmission functionality on a single integrated chip. Visible light communications at data rates up to 1 Mbps, and time-of-flight ranging with cm-scale resolution are demonstrated using this hybrid integrated system.