Optimization of Vascular Supply in Free Flaps for Head and Neck Reconstruction: Analysis of a Young Team's Experience.

Background: For head and neck reconstructive procedures, free flap survival depends on microsurgical and anatomical choices besides multimodal clinical management. The aim of the present study is to identify relevant variables for flap survival in our initial consecutive series. Methods: A single-center, novel reconstructive team consecutive surgical series was revised. The outcome was analyzed in terms of flap survival observing variables considered more relevant: flap type, recipient artery, vein(s), and graft interposition were discussed for facial thirds to be reconstructed. Statistical analysis was performed with Chi-square, Mann-Whitney, and Odds ratio. Results: A total of 118 free flaps were performed in 115 microsurgical procedures (93.9% for malignancies) on 109 patients, with a flap survival rate of 91.5%. For reconstruction of the middle and lower third of the face, the facial artery was privileged, because it was already transected during lymph node dissection in order to save the superior thyroid artery for further microsurgical needs. Flap failure was 50% venous. Double vein anastomosis was not related to flap survival. Deep venous drainage (as the internal jugular vein system) required fewer revisions. Half of the re-explorations saved the flap. Grafts were a risk for flap survival. Bony flaps were more critical. Conclusion: At comparable reconstructive quality, flap choice should avoid a vascular graft. The facial artery is a preferable recipient vessel, since it saves other arteries both in the case of an arterial revision and in the case of recurrence, for further free flap reconstruction. For venous anastomosis, a deep venous recipient is safer, since it offers the possibility to choose the level of anastomosis optimizing the vascular pedicle geometry. A close postsurgical flap monitoring is advisable up to 7 days postoperatively to allow for timely flap salvage.

Quantum Zeno and Anti-Zeno Probes of Noise Correlations in Photon Polarization.

We experimentally demonstrate, for the first time, noise diagnostics by repeated quantum measurements, establishing the ability of a single photon subjected to random polarization noise to diagnose non-Markovian temporal correlations of such a noise process. Both the noise spectrum and temporal correlations are diagnosed by probing the photon with frequent (partially) selective polarization measurements. We show that noise with positive temporal correlations corresponds to our single photon undergoing a dynamical regime enabled by the quantum Zeno effect (QZE), whereas noise characterized by negative (anti) correlations corresponds to regimes associated with the anti-Zeno effect (AZE). This is the first step toward a novel noise spectroscopy based on QZE and AZE in single-photon state probing able to extract information on the noise while protecting the probe state, a conceptual paradigm shift with respect to traditional interferometric measurements.

Emergence of Constructor-Based Irreversibility in Quantum Systems: Theory and Experiment.

How irreversibility arises in a universe with time-reversal symmetric laws is a central problem in physics. In this Letter, we discuss a radically different take on the emergence of irreversibility, adopting the recently proposed constructor theory framework. Irreversibility is expressed as the requirement that a task is possible, while its inverse is not. We prove the compatibility of such irreversibility with quantum theory's time-reversal symmetric laws, using a dynamical model based on the universal quantum homogenizer. We also test the physical realizability of this model by means of an experimental demonstration with high-quality single-photon qubits.

Temporal teleportation with pseudo-density operators: How dynamics emerges from temporal entanglement.

We show that, by using temporal quantum correlations as expressed by pseudo-density operators (PDOs), it is possible to recover formally the standard quantum dynamical evolution as a sequence of teleportations in time. We demonstrate that any completely positive evolution can be formally reconstructed by teleportation with different temporally correlated states. This provides a different interpretation of maximally correlated PDOs, as resources to induce quantum time evolution. Furthermore, we note that the possibility of this protocol stems from the strict formal correspondence between spatial and temporal entanglement in quantum theory. We proceed to demonstrate experimentally this correspondence, by showing a multipartite violation of generalized temporal and spatial Bell inequalities and verifying agreement with theoretical predictions to a high degree of accuracy, in high-quality photon qubits.

Anomalous weak values via a single photon detection.

Is it possible that a measurement of a spin component of a spin-1/2 particle yields the value 100? In 1988 Aharonov, Albert and Vaidman argued that upon pre- and postselection of particular spin states, weakening the coupling of a standard measurement procedure ensures this paradoxical result1. This theoretical prediction, called weak value, was realised in numerous experiments2-9, but its meaning remains very controversial10-19, since its "anomalous" nature, i.e., the possibility to exceed the eigenvalue spectrum, as well as its "quantumness" are debated20-22. We address these questions by presenting the first experiment measuring anomalous weak values with just a single click, without the need for statistical averaging. The measurement uncertainty is significantly smaller than the gap between the measured weak value and the nearest eigenvalue. Beyond clarifying the meaning of weak values, demonstrating their non-statistical, single-particle nature, this result represents a breakthrough in understanding the foundations of quantum measurement, showing unprecedented measurement capability for further applications of weak values to quantum photonics.

Microsurgical Three-Dimensional Reconstruction of Complex Nasal and Midfacial Defect: Multistep Procedure Respecting Aesthetic Unit Criteria.

ABSTRACT: Extended tumor resection in the middle third of the face leads to complex defects: wide, 3-dimensional, and multitissutal. Appropriate reconstruction is challenging but mandatory to obtain a functional and aesthetic outcome for the preservation of an acceptable quality of life. Three-dimensional combined flaps and multistep procedures concur to reach this scope.This is exemplified on the treatment of an invasive recurrent skin malignancy involving the cheek and maxillary bone in association with a full-thickness nasal defect. Reconstruction was performed with 3-dimensional multifolded anterolateral tigh chimeric flap, followed by multistep procedure respecting the aesthetic nasal reconstruction guidelines. Reconstructive surgery had the following targets: targets: rebuilding the oral and nasal lining, filling the paranasal cavities, covering the facial skin defect respecting the aesthetic unit concept and providing a proper support to the facial structures.The aesthetic unit concept has to be respected throughout all steps, from tumor debulking, to reconstruction and even for the management of complications.

Non-Monogamy of Spatio-Temporal Correlations and the Black Hole Information Loss Paradox.

Pseudo-density matrices are a generalisation of quantum states and do not obey monogamy of quantum correlations. Could this be the solution to the paradox of information loss during the evaporation of a black hole? In this paper we discuss this possibility, providing a theoretical proposal to extend quantum theory with these pseudo-states to describe the statistics arising in black-hole evaporation. We also provide an experimental demonstration of this theoretical proposal, using a simulation in optical regime, that tomographically reproduces the correlations of the pseudo-density matrix describing this physical phenomenon.

Optimal estimation of entanglement and discord in two-qubit states.

Recently, the fast development of quantum technologies led to the need for tools allowing the characterization of quantum resources. In particular, the ability to estimate non-classical aspects, e.g. entanglement and quantum discord, in two-qubit systems, is relevant to optimise the performance of quantum information processes. Here we present an experiment in which the amount of entanglement and discord are measured exploiting different estimators. Among them, some will prove to be optimal, i.e., able to reach the ultimate precision bound allowed by quantum mechanics. These estimation techniques have been tested with a specific family of states ranging from nearly pure Bell states to completely mixed states. This work represents a significant step towards the development of reliable metrological tools for quantum technologies.

Theoretical description and experimental simulation of quantum entanglement near open time-like curves via pseudo-density operators.

Closed timelike curves are striking predictions of general relativity allowing for time-travel. They are afflicted by notorious causality issues (e.g. grandfather's paradox). Quantum models where a qubit travels back in time solve these problems, at the cost of violating quantum theory's linearity-leading e.g. to universal quantum cloning. Interestingly, linearity is violated even by open timelike curves (OTCs), where the qubit does not interact with its past copy, but is initially entangled with another qubit. Non-linear dynamics is needed to avoid violating entanglement monogamy. Here we propose an alternative approach to OTCs, allowing for monogamy violations. Specifically, we describe the qubit in the OTC via a pseudo-density operator-a unified descriptor of both temporal and spatial correlations. We also simulate the monogamy violation with polarization-entangled photons, providing a pseudo-density operator quantum tomography. Remarkably, our proposal applies to any space-time correlations violating entanglement monogamy, such as those arising in black holes.

Investigating the Effects of the Interaction Intensity in a Weak Measurement.

Measurements are crucial in quantum mechanics, for fundamental research as well as for applicative fields like quantum metrology, quantum-enhanced measurements and other quantum technologies. In the recent years, weak-interaction-based protocols like Weak Measurements and Protective Measurements have been experimentally realized, showing peculiar features leading to surprising advantages in several different applications. In this work we analyze the validity range for such measurement protocols, that is, how the interaction strength affects the weak value extraction, by measuring different polarization weak values on heralded single photons. We show that, even in the weak interaction regime, the coupling intensity limits the range of weak values achievable, setting a threshold on the signal amplification effect exploited in many weak measurement based experiments.

Orbital Osteoblastoma: Technical Innovations in Resection and Reconstruction Using Virtual Surgery Simulation.

Osteoblastoma is a benign tumor of bone, representing less than 1% of bone tumors. Craniomaxillofacial localizations account for up to 15% of the total and frequently involve the posterior mandible. Endo-orbital localization is very rare, with most occurring in young patients. Very few of these tumors become malignant. Orbital localization requires radical removal of the tumor followed by careful surgical reconstruction of the orbit to avoid subsequent aesthetic or functional problems. Here, we present a clinical case of this condition and describe a surgical protocol that uses and integrates state-of-the art technologies to achieve orbital reconstruction.

Experimental reconstruction of photon statistics without photon counting.

Experimental reconstructions of photon number distributions of both continuous-wave and pulsed light beams are reported. Our scheme is based on on/off avalanche photo-detection assisted by maximum-likelihood estimation and does not involve photon counting. Reconstructions of the distribution for both semiclassical and quantum states of light are reported for single-mode as well as for multi-mode beams.