Enhanced Thromboresistance and Endothelialization of a Novel Fluoropolymer-Coated Left Atrial Appendage Closure Device.

BACKGROUND: Device-related thrombus (DRT) after left atrial appendage closure (LAAC) procedures is a rare but potentially serious event. Thrombogenicity and delayed endothelialization play a role in the development of DRT. Fluorinated polymers are known to have thromboresistant properties that may favorably modulate the healing response to an LAAC device. OBJECTIVES: The goal of this study was to compare the thrombogenicity and endothelial coverage (EC) after LAAC between the conventional uncoated WATCHMAN FLX (WM) and a novel fluoropolymer-coated WATCHMAN FLX (FP-WM). METHODS: Canines were randomized for implantation with WM or FP-WM devices and given no postimplant antithrombotic/antiplatelet agents. The presence of DRT was monitored by using transesophageal echocardiography and verified histologically. The biochemical mechanisms associated with coating were assessed by using flow loop experiments to quantify albumin adsorption, platelet adhesion, and porcine implants to quantify EC and the expression of markers of endothelial maturation (ie, vascular endothelial-cadherin/p120-catenin). RESULTS: Canines implanted with FP-WM exhibited significantly less DRT at 45 days than those implanted with WM (0% vs 50%; P < 0.05). In vitro experiments showed significantly greater albumin adsorption (52.8 [IQR: 41.0-58.3] mm2 vs 20.6 [IQR: 17.2-26.6] mm2; P = 0.03) and significantly less platelet adhesion (44.7% [IQR: 27.2%-60.2%] vs 60.9% [IQR: 39.9%-70.1%]; P < 0.01) on FP-WM. Porcine implants showed significantly greater EC by scanning electron microscopy (87.7% [IQR: 83.4%-92.3%] vs 68.2% [IQR: 47.6%-72.8%]; P = 0.03), and higher vascular endothelial-cadherin/p120-catenin expression after 3 months on FP-WM compared with WM. CONCLUSIONS: The FP-WM device showed significantly less thrombus and reduced inflammation in a challenging canine model. Mechanistic studies indicated that the fluoropolymer-coated device binds more albumin, leading to reduced platelet binding, less inflammation, and greater EC.

Cardiac computed tomography following Watchman FLX implantation: device-related thrombus or device healing?

AIMS: Cardiac computed tomography (CT) is increasingly utilized during follow-up after left atrial appendage closure (LAAC). Hypoattenuated thickening (HAT) is a common finding and might represent either benign device healing or device-related thrombosis (DRT). The appearance and characteristics of HAT associated with the Watchman FLX have not been previously described. Therefore, we sought to investigate cardiac CT findings during follow-up after Watchman FLX implantation with a focus on HAT and DRT. METHODS AND RESULTS: Retrospective single-centre, observational study including all patients with successful Watchman FLX implantation and follow-up cardiac CT between March 2019 and September 2021 (n = 244). Blinded analysis of CT images was performed describing the localization, extent, and morphology of HAT and correlated to imaging and histology findings in a canine model. Relevant clinical and preclinical ethical approvals were obtained.Overall, HAT was present in 156 cases (64%) and could be classified as either subfabric hypoattenuation (n = 59), flat sessile HAT (n = 78), protruding sessile HAT (n = 16), or pedunculated HAT (n = 3). All cases of pedunculated HAT and five cases of protruding sessile HAT were considered as high-grade HAT (n = 7). Subfabric hypoattenuation and flat sessile HAT correlated with device healing and endothelialization in histological analysis of explanted devices. CONCLUSION: Subfabric hypoattenuation and flat sessile HAT are frequent CT findings for Watchman FLX, likely representing benign device healing and endothelialization. Pedunculated HAT and protruding HAT are infrequent CT findings that might represent DRT.

Teleportation of entanglement over 143 km.

As a direct consequence of the no-cloning theorem, the deterministic amplification as in classical communication is impossible for unknown quantum states. This calls for more advanced techniques in a future global quantum network, e.g., for cloud quantum computing. A unique solution is the teleportation of an entangled state, i.e., entanglement swapping, representing the central resource to relay entanglement between distant nodes. Together with entanglement purification and a quantum memory it constitutes a so-called quantum repeater. Since the aforementioned building blocks have been individually demonstrated in laboratory setups only, the applicability of the required technology in real-world scenarios remained to be proven. Here we present a free-space entanglement-swapping experiment between the Canary Islands of La Palma and Tenerife, verifying the presence of quantum entanglement between two previously independent photons separated by 143 km. We obtained an expectation value for the entanglement-witness operator, more than 6 SDs beyond the classical limit. By consecutive generation of the two required photon pairs and space-like separation of the relevant measurement events, we also showed the feasibility of the swapping protocol in a long-distance scenario, where the independence of the nodes is highly demanded. Because our results already allow for efficient implementation of entanglement purification, we anticipate our research to lay the ground for a fully fledged quantum repeater over a realistic high-loss and even turbulent quantum channel.

Quantum erasure with causally disconnected choice.

The counterintuitive features of quantum physics challenge many common-sense assumptions. In an interferometric quantum eraser experiment, one can actively choose whether or not to erase which-path information (a particle feature) of one quantum system and thus observe its wave feature via interference or not by performing a suitable measurement on a distant quantum system entangled with it. In all experiments performed to date, this choice took place either in the past or, in some delayed-choice arrangements, in the future of the interference. Thus, in principle, physical communications between choice and interference were not excluded. Here, we report a quantum eraser experiment in which, by enforcing Einstein locality, no such communication is possible. This is achieved by independent active choices, which are space-like separated from the interference. Our setup employs hybrid path-polarization entangled photon pairs, which are distributed over an optical fiber link of 55 m in one experiment, or over a free-space link of 144 km in another. No naive realistic picture is compatible with our results because whether a quantum could be seen as showing particle- or wave-like behavior would depend on a causally disconnected choice. It is therefore suggestive to abandon such pictures altogether.

Cyclic (amino)(imino)carbene complexes by borylene transfer to isocyanides.

Here we report the facile formation of boron-containing cyclic (amino)(imino)carbene complexes by reaction of a chromium borylene complex [(OC)(5)Cr=B=N(SiMe(3))(2)] with isocyanides.

Experimental quantum teleportation over a high-loss free-space channel.

We present a high-fidelity quantum teleportation experiment over a high-loss free-space channel between two laboratories. We teleported six states of three mutually unbiased bases and obtained an average state fidelity of 0.82(1), well beyond the classical limit of 2/3. With the obtained data, we tomographically reconstructed the process matrices of quantum teleportation. The free-space channel attenuation of 31 dB corresponds to the estimated attenuation regime for a down-link from a low-earth-orbit satellite to a ground station. We also discussed various important technical issues for future experiments, including the dark counts of single-photon detectors, coincidence-window width etc. Our experiment tested the limit of performing quantum teleportation with state-of-the-art resources. It is an important step towards future satellite-based quantum teleportation and paves the way for establishing a worldwide quantum communication network.

Quantum teleportation over 143 kilometres using active feed-forward.

The quantum internet is predicted to be the next-generation information processing platform, promising secure communication and an exponential speed-up in distributed computation. The distribution of single qubits over large distances via quantum teleportation is a key ingredient for realizing such a global platform. By using quantum teleportation, unknown quantum states can be transferred over arbitrary distances to a party whose location is unknown. Since the first experimental demonstrations of quantum teleportation of independent external qubits, an internal qubit and squeezed states, researchers have progressively extended the communication distance. Usually this occurs without active feed-forward of the classical Bell-state measurement result, which is an essential ingredient in future applications such as communication between quantum computers. The benchmark for a global quantum internet is quantum teleportation of independent qubits over a free-space link whose attenuation corresponds to the path between a satellite and a ground station. Here we report such an experiment, using active feed-forward in real time. The experiment uses two free-space optical links, quantum and classical, over 143 kilometres between the two Canary Islands of La Palma and Tenerife. To achieve this, we combine advanced techniques involving a frequency-uncorrelated polarization-entangled photon pair source, ultra-low-noise single-photon detectors and entanglement-assisted clock synchronization. The average teleported state fidelity is well beyond the classical limit of two-thirds. Furthermore, we confirm the quality of the quantum teleportation procedure without feed-forward by complete quantum process tomography. Our experiment verifies the maturity and applicability of such technologies in real-world scenarios, in particular for future satellite-based quantum teleportation.

Calibrating the interaction matrix for the LINC-NIRVANA high layer wavefront sensor.

LINC-NIRVANA is a near-infrared Fizeau interferometric imager that will operate at the Large Binocular Telescope. In preparation for the commissioning of this instrument, we conducted experiments for calibrating the high-layer wavefront sensor of the layer-oriented multi-conjugate adaptive optics system. For calibrating the multi-pyramid wavefront sensor, four light sources were used to simulate guide stars. Using this setup, we developed the push-pull method for calibrating the interaction matrix. The benefits of this method over the traditional push-only method are quantified, and also the effects of varying the number of push-pull frames over which aberrations are averaged is reported. Finally, we discuss a method for measuring mis-conjugation between the deformable mirror and the wavefront sensor, and the proper positioning of the wavefront sensor detector with respect to the four pupil positions.

First laboratory results with the LINC-NIRVANA high layer wavefront sensor.

In the field of adaptive optics, multi-conjugate adaptive optics (MCAO) can greatly increase the size of the corrected field of view (FoV) and also extend sky coverage. By applying layer oriented MCAO (LO-MCAO) [4], together with multiple guide stars (up to 20) and pyramid wavefront sensors [7], LINC-NIRVANA (L-N for short) [1] will provide two AO-corrected beams to a Fizeau interferometer to achieve 10 milliarcsecond angular resolution on the Large Binocular Telescope. This paper presents first laboratory results of the AO performance achieved with the high layer wavefront sensor (HWS). This sensor, together with its associated deformable mirror (a Xinetics-349), is being operated in one of the L-N laboratories. AO reference stars, spread across a 2 arc-minute FoV and with aberrations resulting from turbulence introduced at specific layers in the atmosphere, are simulated in this lab environment. This is achieved with the Multi-Atmosphere Phase screen and Stars (MAPS) [2] unit. From the wavefront data, the approximate residual wavefront error after correction has been calculated for different turbulent layer altitudes and wind speeds. Using a somewhat undersampled CCD, the FWHM of stars in the nearly 2 arc-minute FoV has also been measured. These test results demonstrate that the high layer wavefront sensor of LINC-NIRVANA will be able to achieve uniform AO correction across a large FoV.

Violation of local realism with freedom of choice.

Bell's theorem shows that local realistic theories place strong restrictions on observable correlations between different systems, giving rise to Bell's inequality which can be violated in experiments using entangled quantum states. Bell's theorem is based on the assumptions of realism, locality, and the freedom to choose between measurement settings. In experimental tests, "loopholes" arise which allow observed violations to still be explained by local realistic theories. Violating Bell's inequality while simultaneously closing all such loopholes is one of the most significant still open challenges in fundamental physics today. In this paper, we present an experiment that violates Bell's inequality while simultaneously closing the locality loophole and addressing the freedom-of-choice loophole, also closing the latter within a reasonable set of assumptions. We also explain that the locality and freedom-of-choice loopholes can be closed only within nondeterminism, i.e., in the context of stochastic local realism.

Chemoselective boron-carbon bond cleavage by hydroboration of borirenes.

We report on the hydroboration of 1-[bis(trimethylsilyl)amino]-2,3-diethylborirene (3) with 9-borabicyclo[3.3.1]nonane (9-BBN), which led through ring-opening to an amino(vinyl)borane. The viscous borane was subsequently converted into a crystalline borate on treatment with MeLi. Both compounds were fully characterized by multinuclear NMR spectroscopy and in case of the latter by single-crystal X-ray diffraction analysis. To elucidate the reaction mechanism of the unexpected boron-carbon bond cleavage, DFT calculations of energy minima and transition states for the hydroboration were carried out.

Histopathologic description of Wingspan stent in acute ischemic stroke.

OBJECTIVE AND IMPORTANCE: We report the histopathologic examination of Wingspan stent in acute ischemic stroke. CLINICAL PRESENTATION: A 75-year-old female presented with acute left-hemiplegia due to right carotid terminus occlusion. Mechanical embolectomy was unsuccessful. INTERVENTION: A Wingspan stent was placed from the distal intracranial carotid artery to the proximal middle cerebral artery stem and established partial antegrade flow. The patient died of malignant infarction on post-stroke day 7. At autopsy, embolized calcified atherosclerotic plaque fragments were noted within a non-occlusive thrombus over which the Wingspan stent was deployed. There was no evidence of intimal or media dissection or perforator ostium occlusion. CONCLUSION: Our case provides a rare pathological description of intracranial stent placement in the setting of acute ischemic stroke.

Comparison of inflammatory response after implantation of sirolimus- and paclitaxel-eluting stents in porcine coronary arteries.

BACKGROUND: Although both sirolimus (CYPHER) and paclitaxel (TAXUS) drug-eluting stents have demonstrated efficacy and safety in clinical trials, human autopsy data have raised concerns about long-term healing and the potential for local inflammatory reactions. METHODS AND RESULTS: Overlapping stents (CYPHER drug-eluting stents, Bx SONIC bare metal stents, TAXUS drug-eluting stents, and Liberté bare metal stents) were implanted in noninjured coronary arteries of 58 domestic swine. Histopathological evaluation of proximal, overlapped, and distal stented segments was determined with emphasis on inflammation at 30, 90, and 180 days. Circumferential granulomatous inflammation in all stented segments was defined as inflammation consisting of macrophages, multinucleated giant cells, lymphocytes, and granulocytes, including many eosinophils, adjacent to almost all struts. Circumferential granulomatous inflammation was more prevalent in CYPHER (9 of 23, 39%) compared with TAXUS (1 of 21, 5%; P=0.01) and control bare metal stents (0 of 44) in the combined 90- and 180-day cohorts. Only CYPHER specimens showed marked adventitial inflammation (P=0.0025) and fibrosis (P=0.0055) accompanied by extensive remodeling. Fibrin deposition within neointima and medial smooth muscle cell death were greater (both P<0.001) in TAXUS than CYPHER at 30 days, with more fibrin in TAXUS than CYPHER through 90 days (P<0.05). CONCLUSIONS: Although these data cannot be directly extrapolated to humans, the high prevalence in this porcine model of diffuse granulomatous inflammation seen with CYPHER stents, persisting at 180 days and associated with extensive remodeling of the artery, and persistent para-strut fibrin deposition with TAXUS stents emphasize the need for further investigation of biocompatibility with these and other novel combination drug/polymer drug-eluting stents.

Borylene-based direct functionalization of organic substrates: synthesis, characterization, and photophysical properties of novel pi-conjugated borirenes.

Room temperature photolysis of aminoborylene complexes, [(CO)(5)M=B=N(SiMe(3))(2)] (1: M = Cr, 2: Mo) in the presence of a series of alkynes and diynes, 1,2-bis(4-methoxyphenyl)ethyne, 1,2-bis(4-(trifluoromethyl)phenyl)ethyne, 1,4-diphenylbuta-1,3-diyne, 1,4-bis(4-methoxyphenyl)buta-1,3-diyne, 1,4-bis(trimethylsilylethynyl)benzene and 2,5-bis(4-N,N-dimethylaminophenylethynyl)thiophene led to the isolation of novel mono and bis-bis-(trimethylsilyl)aminoborirenes in high yields, that is [(RC=CR)(mu-BN(SiMe(3))(2)], (3: R = C(6)H(4)-4-OMe and 4: R = C(6)H(4)-4-CF(3)); [{(mu-BN(SiMe(3))(2)(RC=C-)}(2)], (5: R = C(6)H(5) and 6: R = C(6)H(4)-4-OMe); [1,4-bis-{(mu-BN(SiMe(3))(2)(SiMe(3)C=C)}benzene], 7 and [2,5-bis-{(mu-BN(SiMe(3))(2) ((C(6)H(4)NMe(2))C=C)}-thiophene], 8. All borirenes were isolated as light yellow, air and moisture sensitive solids. The new borirenes have been characterized in solution by (1)H, (11)B, (13)C NMR spectroscopy and elemental analysis and the structural types were unequivocally established by crystallographic analysis of compounds 6 and 7. DFT calculations were performed to evaluate the extent of pi-conjugation between the electrons of the carbon backbone and the empty p(z) orbital of the boron atom, and TD-DFT calculations were carried out to examine the nature of the electronic transitions.

Group VI metal aminoborylene complex-catalyzed demercuration reactions of bis(alkynyl)mercurials.

The first catalytic application of the Group VI metal borylene complexes [(CO)(5)M[double bond]BN(SiMe(3))(2)] involves the demercuration reaction of bis(alkynyl)mercurials, [Hg(C[triple bond]CR)(2)], with formation of a series of buta-1,3-diynes.

A wavelength-tunable fiber-coupled source of narrowband entangled photons.

We demonstrate a wavelength-tunable, fiber-coupled source of polarization- entangled photons with extremely high spectral brightness and quality of entanglement. Using a 25 mm PPKTP crystal inside a polarization Sagnac interferometer we detect a spectral brightness of 273000 pairs (s mW nm)(-1), a factor of 28 better than comparable previous sources while state tomography showed the two-photon state to have a tangle of T = 0.987. This improvement was achieved by use of a long crystal, careful selection of focusing parameters and single-mode fiber coupling. We demonstrate that, due to the particular geometry of the setup, the signal and idler wavelengths can be tuned over a wide range without loss of entanglement.