Erratum: Coherent Excitation of the Highly Forbidden Electric Octupole Transition in

This corrects the article DOI: 10.1103/PhysRevLett.125.163001.

Coherent Excitation of the Highly Forbidden Electric Octupole Transition in

We report on the first coherent excitation of the highly forbidden ^{2}S_{1/2}→^{2}F_{7/2} electric octupole (E3) transition in a single trapped ^{172}Yb^{+} ion, an isotope without nuclear spin. Using the transition in ^{171}Yb^{+} as a reference, we determine the transition frequency to be 642 116 784 950 887.6(2.4) Hz. We map out the magnetic field environment using the forbidden ^{2}S_{1/2}→^{2}D_{5/2} electric quadrupole (E2) transition and determine its frequency to be 729 476 867 027 206.8(4.4) Hz. Our results are a factor of 1×10^{5} (3×10^{5}) more accurate for the E2 (E3) transition compared to previous measurements. The results open up the way to search for new physics via precise isotope shift measurements and improved tests of local Lorentz invariance using the metastable ^{2}F_{7/2} state of Yb^{+}.

Comparison of Magnetic Auriculotherapy, Laser Auriculotherapy and Their Combination for Treatment of Insomnia in the Elderly: A Double-Blinded Randomised Trial.

BACKGROUND: Insomnia is common amongst the elderly. With the adverse effects of prolonged use of hypnotics, the exploration of noninvasive and nonpharmacological complementary methods for insomnia is warranted. Auriculotherapy (AT) is a therapeutic approach where specific points on the auricle are stimulated to manage various physiological disorders. The purpose of this study is to determine the desirable treatment modality using AT to improve the sleep conditions of the elderly. METHODS: A three-arm double-blinded randomised trial was conducted on 145 eligible subjects. This study investigated three minimally invasive procedures, namely, laser auriculotherapy (LAT), magneto-auriculotherapy (MAT), and their combination. Seven auricular points were used. Treatment was performed three times a week, for six weeks. Subjects were assessed at baseline, six weeks, and follow-up after six weeks, three months, and six months. Generalised estimating equations were used to evaluate interactions amongst the groups over time based on the Pittsburgh Sleep Quality Index (PSQI), sleep parameters using actigraphic monitoring, health-related quality of life (HRQOL) using SF-12, and PHQ-9 for depression status. RESULTS: The treatment effects of the three procedures were comparable. Significant improvements were found in all of the subjective measures (PSQI, HRQOL, and PHQ-9) for individual groups over time. Improvements in the objective sleep parameters using actigraphic monitoring were detected in subjects who received MAT procedures but not in those who received LAT. The combined MAT and LAT approach did not show any advantage over MAT. CONCLUSIONS: The treatment effects of the three procedures were comparable in subjective parameters but not by objective measures using actigraphic monitoring. Longer therapeutic course and more frequent administration of LAT may be considered in future trials to achieve the optimal treatment effect. TRIAL REGISTRATION: This trial is registered with ClinicalTrials.gov: NCT02970695, registered May 2016.

Donor-Transmitted Bacterial Infection in Deceased Donor Liver Transplantation: Experience of Southern Taiwan Medical Center.

BACKGROUND: Bacterial Infection is the most important source of mortality and morbidity in liver transplantation recipients. Donor transmitted bacterial infection is rare but one of the most important infection sources. This kind of infection is difficult to identify, causing treatment dilemma. PATIENTS AND METHODS: In this article, we retrospectively reviewed our deceased donor liver transplants performed from January 2014 to December 2016. Forty-two recipients in Kaohsiung Chang Gung Memorial Hospital receiving liver grafts from 35 deceased liver donors were evaluated. The demography, donor transmitted infection, and outcomes were evaluated. RESULT: Two patients had probable donor transmitted bacterial infection and 1 patient died of suspected transmitted infection. CONCLUSION: Early identification of donor infection and adequate antibiotic treatment for the donor and recipient are the keys to preventing donor transmitted bacterial infection. Donor infection is not an absolute contraindication for organ donation in the area of organ shortage. Organ procurement organizations or similar authorities may establish the platform for sharing the data about donor and recipient infections.

Video-tactile pneumatic sensor for soft tissue elastic modulus estimation.

BACKGROUND: A new sensor for estimating elasticity of soft tissues such as a liver was developed for minimally invasive surgery application. METHODS: By measuring deformation and adjusting internal pressure of the pneumatic sensor head, the sensor can be used to do palpation (indentation) of tissues with wide range of stiffness. A video camera installed within the sensor shell is used to register the radius of the contact area. Based on finite element model simulations and the measured data, elastic modulus of the indented soft tissue can be calculated. RESULTS AND CONCLUSIONS: Three phantom materials, namely plastic, silicone and gelatin, with varied stiffness were tested. The experimental results demonstrated that the new sensor can obtain highly reliable data with error less than 5%. The new sensor might be served as an instrument in laparoscopic surgery for diagnosis of pathological tissues or internal organs.

Prophylactic Dual Catheter Technique to Prevent Side Branch Snowplowing Complications during Angioplasty and Stenting.

OBJECTIVE: Angioplasty and Stenting of intracranial atherosclerotic lesions have a higher complication rate and a large proportion of this is attributable to side branch arterial occlusion from forceful displacement of the atheroma into the ostia or snowplowing effect. This can result in severe disabilities when it result in small infarcts involving eloquent areas in the posterior circulation or the motor tracts. MATERIALS AND METHODS: We present a series of 6 cases utilizing a new dual catheter technique for maintaining the patency of at-risk vessels during angioplasty and stenting. There are several methods previously described to help reduce the incidence of stroke but because they do not have a physical presence in the ostia to protect it, they are unable to guarantee the patency of the vessel. RESULTS: All 6 patients underwent angioplasty and stenting with the technique. The patients were assessed for complications with post-procedure magnetic resonance imaging and no complications were found. CONCLUSION: In this preliminary series, the dual catheter technique appears to safe and effective in preventing occlusion of the adjacent branch arteries. This technique may facilitate the use of the Wingspan stent in the treatment of intracranial atherosclerotic stenotic segments by reducing the risk of peri-procedural stroke.

The upper-limb volumetric changes in breast cancer survivors with axillary web syndrome.

Whether upper-limb swelling is associated with axillary web syndrome (AWS) is unknown. We recruited unilateral breast cancer (BC) patients who were scheduled for surgical intervention and lymph node dissection. The pre-operative assessment and post-operative assessment 3-4 weeks after surgery evaluated the upper-limb circumferential measurements, segmental limb volume, pain scores, grasp, shoulder range of motion (ROM), shoulder muscle power and quality-of-life scores. In the control group, the peri-elbow volume and upper-arm volume were significantly higher post-operatively than pre-operatively. In the AWS group, no significant difference was found. In comparison with the control group, the AWS group had significantly more pain, less active ROM in shoulder abduction and a lower upper-limb volume at 0-10 cm proximal to the lateral epicondyle. The incidence of lymphedema was 9.9% and was not associated with AWS. AWS is a common morbidity of lymph node dissection and causes significant pain and restricted shoulder abduction in the affected limb in BC survivors. This study is the first to investigate post-operative upper-limb volumetric changes in BC survivors with and without AWS. Our findings are of great value for the clinical effect of AWS in BC survivors, for patient education, and for developing diagnostic tools for detecting AWS.

MRI audit of complications in intracranial stenosis treated with Wingspan device.

OBJECTIVES: To evaluate the safety and efficacy of the Wingspan device for the treatment of symptomatic intracranial atherosclerotic stenosis (ICAS). METHODS: We audited a prospective ongoing database of consecutive patients who received Wingspan stenting between January 2013 and December 2015. All patients underwent MRI to audit any complications during the early follow-up period. We focused on the clinical demographics, lesion characteristics, treatment results, and periprocedural complications. Functional outcomes were measured with the modified Rankin Scale (mRS) at discharge and after 3 months. RESULTS: Intracranial stenting was performed in 50 patients (100%). Mean stenosis pre-stenting was 76.5±13.1% and post-stenting residual stenosis was 19.8±13.8%. The overall 30-day rate of procedure-related complications was 6.0% (3/50). Two patients (4%) developed in-stent restenosis, one of whom had a dissection at the middle cerebral artery. Interestingly, on the follow-up MRI scan there was a high incidence of asymptomatic diffusion-weighted imaging (DWI) hyperintensities, 46% (23/50) presumed to be due to microembolic causes. At the 90-day, 180-day, and 1-year follow-up, three patients had further strokes resulting in a total complication rate of 12%. 92% had excellent outcomes (mRS 0-1) and only one patient had deterioration of his mRS score. CONCLUSIONS: ICAS treated by Wingspan stenting using pre-placement balloon angioplasty appears safe and effective with a high technical success rate and favorable outcomes. There is a high incidence of asymptomatic DWI hyperintensites post-procedure, but these do not appear to result in long-term sequelae.

Role of microRNAs in Vascular Remodeling.

Besides being involved in the gradual formation of blood vessels during embryonic development, vascular remodeling also contributes to the progression of various cardiovascular diseases, such as; myocardial infarction, heart failure, atherosclerosis, pulmonary artery hypertension, restenosis, aneurysm, etc. The integrated mechanisms; proliferation of medial smooth muscle cell, dysregulation of intimal endothelial cell, activation of adventitial fibroblast, inflammation of macrophage, and the participation of extracellular matrix proteins are important factors in vascular remodeling. In the recent studies, microRNAs (miRs) have been shown to be expressed in all of these cell-types and play important roles in the mechanisms of vascular remodeling. Therefore, some miRs may be involved in prevention and others in the aggravation of the vascular lesions. miRs are small, endogenous, conserved, single-stranded, non-coding RNAs; which degrade target RNAs or inhibit translation post-transcriptionally. In this paper, we reviewed the function and mechanisms of miRs, which are highly expressed in various cells types, especially endothelial and smooth muscle cells, which are closely involved in the process of vascular remodeling. We also assess the functions of these miRs in the hope that they may provide new possibilities of diagnosis and treatment choices for the related diseases.

Coding for stable transmission of W-band radio-over-fiber system using direct-beating of two independent lasers.

We demonstrate experimentally Manchester (MC) coding based W-band (75 - 110 GHz) radio-over-fiber (ROF) system to reduce the low-frequency-components (LFCs) signal distortion generated by two independent low-cost lasers using spectral shaping. Hence, a low-cost and higher performance W-band ROF system is achieved. In this system, direct-beating of two independent low-cost CW lasers without frequency tracking circuit (FTC) is used to generate the millimeter-wave. Approaches, such as delayed self-heterodyne interferometer and heterodyne beating are performed to characterize the optical-beating-interference sub-terahertz signal (OBIS). Furthermore, W-band ROF systems using MC coding and NRZ-OOK are compared and discussed.

OFDM RF power-fading circumvention for long-reach WDM-PON.

We propose and demonstrate an orthogonal frequency division multiplexing (OFDM) radio-frequency (RF) power-fading circumvention scheme for long-reach wavelength-division-multiplexed passive-optical-network (LR-WDM-PON); hence the same capacity of 40 Gb/s can be provided to all the optical-networking-units (ONUs) in the LR-WDM-PON. Numerical analysis and proof-of-concept experiment are performed.

Conduction control at ferroic domain walls via external stimuli.

Intriguing functionalities at nano-sized domain walls have recently spawned a new paradigm for developing novel nanoelectronics due to versatile characteristics. In this study, we explore a new scenario to modulate the local conduction of ferroic domain walls. Three controlling parameters, i.e., external electrical field, magnetic field and light, are introduced to the 90° domain walls (90° DWs) of BiFeO3. Electrical modulation is realized by electrical transport, where the mobility of 90° DWs can be altered by gating voltage. We further use the ferromagnetic/antiferromagnetic coupling to reveal the inherent magnetism at the DWs. With an established magnetic nature, magnetotransport has been conducted to introduce magnetic controlling parameter, where a giant positive magnetoresistance change can be observed up to 200%. In addition, light modulated conduction, a core factor for multifunctional applications, is successfully demonstrated (current enhancement by a factor of 2 with 11 W white lamp). These results offer new insights to discover the tunability of domain wall nanoelectronics.

A scalable and continuous-upgradable optical wireless and wired convergent access network.

In this work, a scalable and continuous upgradable convergent optical access network is proposed. By using a multi-wavelength coherent comb source and a programmable waveshaper at the central office (CO), optical millimeter-wave (mm-wave) signals of different frequencies (from baseband to > 100 GHz) can be generated. Hence, it provides a scalable and continuous upgradable solution for end-user who needs 60 GHz wireless services now and > 100 GHz wireless services in the future. During the upgrade, user only needs to upgrade their optical networking unit (ONU). A programmable waveshaper is used to select the suitable optical tones with wavelength separation equals to the desired mm-wave frequency; while the CO remains intact. The centralized characteristics of the proposed system can easily add any new service and end-user. The centralized control of the wavelength makes the system more stable. Wired data rate of 17.45 Gb/s and w-band wireless data rate up to 3.36 Gb/s were demonstrated after transmission over 40 km of single-mode fiber (SMF).

Adaptive 84.44-190 Mbit/s phosphor-LED wireless communication utilizing no blue filter at practical transmission distance.

We propose and experimentally demonstrate a white-light phosphor-LED visible light communication (VLC) system with an adaptive 84.44 to 190 Mbit/s 16 quadrature-amplitude-modulation (QAM) orthogonal-frequency-division-multiplexing (OFDM) signal utilizing bit-loading method. Here, the optimal analogy pre-equalization design is performed at LED transmitter (Tx) side and no blue filter is used at the Rx side. Hence, the ~1 MHz modulation bandwidth of phosphor-LED could be extended to 30 MHz. In addition, the measured bit error rates (BERs) of < 3.8 × 10(-3) [forward error correction (FEC) threshold] at different measured data rates can be achieved at practical transmission distances of 0.75 to 2 m.

A new method for detecting urinary bladder cancer by using FDG PET/CT.

To evaluate the accuracy of a new fluorine-18-2-fluoro-2-deoxy-d-glucose ((18)F-FDG) positron emission tomography (PET)/computed tomography (CT) method when applying an increased upper limit of the image threshold (IULIT) to detect bladder cancer. All patients with an unknown history of bladder tumors were retrospectively included for analysis. Applying an IULIT in PET showed a hypermetabolic focus. (18)F-FDG accumulation in the bladder that was higher or lower than the urinary level of (18)F-FDG was considered an abnormal focus. In 12 of the 28,767 patients with bladder cancer, applying an IULIT in PET allowed the visualization of the contrast between lesion and urinary activity. The proposed method could increase the accuracy of detection of bladder cancer.

Wired and wireless convergent extended-reach optical access network using direct-detection of all-optical OFDM super-channel signal.

We propose and demonstrate the feasibility of using all-optical orthogonal frequency division multiplexing (AO-OFDM) for the convergent optical wired and wireless access networks. AO-OFDM relies on all-optically generated orthogonal subcarriers; hence, high data rate (> 100 Gb/s) can be easily achieved without hitting the speed limit of electronic digital-to-analog and analog-to-digital converters (DAC/ADC). A proof-of-concept convergent access network using AO-OFDM super-channel (SC) is demonstrated supporting 40 - 100 Gb/s wired and gigabit/s 100 GHz millimeter-wave (MMW) ROF transmissions.

The impact of abnormal muscle tone from hemiplegia on reclining wheelchair positioning: a sliding and pressure evaluation.

BACKGROUND: Little is known about the influence of existing muscle tone abnormality on the sitting posture of stroke patients in reclining wheelchairs. AIM: To investigate the impact of muscle tone abnormality from hemiplegia on the forward sliding and pressure of stroke patients while sitting in reclining wheelchairs. DESIGN: Experimental study. SETTING: The Assistive Devices/Technology Center at the Rehabilitation Department of hospital. POPULATION: 14 able-bodied elders and nonambulatory elderly stroke patients with flaccid (N.=12) or spastic hemiplegia (N.=13) participated in this study. Of the 12 patients with flaccid hemiplegia, 8 suffered from left-sided hemiplegia and 4 from right-sided hemiplegia. Of the 13 patients with spastic hemiplegia, 6 suffered from left-sided hemiplegia and 7 from right-sided hemiplegia. METHODS: We performed 3 reclining cycles in wheelchairs with conventional seats and V-shaped seats for each participant. The sliding along the backrest (BS) plane and the seat (SS) plane, mean sitting pressure (MP), and sacral peak pressure (SPP) of the participants were recorded. The Kruskal-Wallis test was used to compare the difference in BS, SS, MP, and SPP between able-bodied elders and stroke patients. RESULTS: The BS, SS, and SPP during repetitive reclining were generally greatest in flaccid hemiplegic participants, followed by spastic hemiplegic participants, and finally by able-bodied participants. There was no significant difference in MP among three subject groups on both conventional seats and V-shaped seats in most comparisons. Able-bodied participants' buttocks tended to slide forward on conventional seats but backward on V-shaped seats, whereas hemiplegic participants' buttocks slid forward on both seat types. CONCLUSION: Stroke patients with flaccid hemiplegia are the most vulnerable to sacral sitting and higher sacral pressure in reclining wheelchairs, followed by patients with spastic hemiplegia. There is a difference in the displacement pattern between participants with normal muscle tone and those with abnormal muscle tone during wheelchair positioning. People who have hemiplegia with spasticity do not have incremental forward sliding with repetitive reclining in the same way as those who have a flaccid hemiplegia. CLINICAL REHABILITATION IMPACT: The findings are valuable for wheelchair prescription and caregiver education.

Potent cardioprotection from ischemia-reperfusion injury by a two-domain fusion protein comprising annexin V and Kunitz protease inhibitor.

BACKGROUND: Considerable evidence suggests that coagulation proteases (tissue factor [TF]/activated factor VII [FVIIa]/FXa/thrombin) and their target protease activated receptors (PAR-1/PAR-2) play important roles in myocardial ischemia-reperfusion (I-R) injury. We hypothesized that localized inhibition of TF/FVIIa on the membrane surfaces of ischemic cells could effectively block coagulation cascade and subsequent PAR-1/PAR-2 cell signaling, thereby protecting the myocardium from I-R injury. OBJECTIVES: We recently developed an annexin V-Kunitz inhibitor fusion protein (ANV-6L15) that could specifically bind to anionic phospholipids on the membrane surfaces of apoptotic cells and efficiently inhibit the membrane-anchored TF/FVIIa. In this study, we investigated the cardioprotective effect of ANV-6L15 in a rat cardiac I-R model in comparison with that of hirudin. METHODS: Left coronary artery occlusion was maintained for 45 min followed by 4 h of reperfusion in anesthetized Sprague-Dawley rats. One minute before or 2 min after coronary ligation, rats received an intravenous bolus injection of ANV-6L15 (2.5-250 µg kg(-1) ), vehicle, or hirudin via bolus injection and continuous infusion. RESULTS AND CONCLUSIONS: ANV-6L15 dose-dependently reduced infarct size by up to 87% and decreased plasma levels of cardiac troponin I, tumor necrosis factor-α, and soluble intercellular adhesion molecule-1, by up to 97%, 96%, and 66%, respectively, with little impact on the coagulation parameters. ANV-6L15 also ameliorated hemodynamic derangements, attenuated neutrophil infiltration and reduced Terminal deoxynucleotidyl transferase dUTP nick end labeling-positive apoptotic cardiomyocytes. Hirudin was less efficacious even at supraclinical dose. ANV-6L15 confers exceptionally potent cardioprotection and is a promising drug candidate for the prevention of myocardial I-R injury.

Stable and wavelength-tunable silicon-micro-ring-resonator based erbium-doped fiber laser.

In this work, we propose and demonstrate a stable and wavelength-tunable erbium-doped fiber (EDF) ring laser. Here, a silicon-on-insulator (SOI)-based silicon-micro-ring-resonator (SMRR) is used as the wavelength selective element inside the fiber ring cavity. A uniform period grating coupler (GC) is used to couple between the SMRR and single mode fiber (SMF) and serves also as a polarization dependent element in the cavity. The output lasing wavelength of the proposed fiber laser can be tuned at a tuning step of 2 nm (defined by the free spectral range (FSR) of the SMRR) in a bandwidth of 35.2 nm (1532.00 to 1567.20 nm), which is defined by the gain of the EDF. The optical-signal-to-noise-ratio (OSNR) of each lasing wavelength is larger than 42.0 dB. In addition, the output stabilities of power and wavelength are also discussed.

Anterior ilioinguinal incision for drainage of high-located perianal abscess.

Most perianal abscesses originate from infected anal glands at the base of the anal crypts. Most abscesses below are usually drained through perianal incision and can be treated successfully. However, when perianal abscesses extend to the high intrapelvic cavity, it may be inadequate treatment through a single route incision through a perianal approach. The aim of this technical note is to show that combined anterior ilioinguinal and perianal incisions may provide optimal surgical field and multiple drainages. Here, we report a 56-year-old male patient with perianal-originating parapsoas abscesses. Residual abscess still remained after initial perianal incision and drainage after 1-month treatment. We presented combined anterior ilioinguinal and perianal incision technique methods for proper drainage in this complicated case. No recurrent or residual abscess remained after 2 weeks of operation. So, combined anterior ilioinguinal incision is feasible for high-located perianal abscess.