Harmonic and Subharmonic RF Injection Locking of THz Metasurface Quantum-Cascade VECSEL.

Harmonic and subharmonic RF injection locking is demonstrated in a terahertz (THz) quantum-cascade vertical-external-cavity surface-emitting laser (QC-VECSEL). By tuning the RF injection frequency around integer multiples and submultiples of the cavity round-trip frequency, different harmonic and subharmonic orders can be excited in the same device. Modulation-dependent behavior of the device has been studied with recorded lasing spectral broadening and locking bandwidths in each case.

Ethical Concerns Regarding the Timing of Written Consent.

Unlabelled: AbstractObjective: Thorough informed consent requires decision-making capacity, adequate information, lack of coercion, and an appropriate environment. Consent obtained in the preoperative area is hurried, limiting the quality of informed consent and the opportunity for patient reflection, characteristics inconsistent with patient-centered practice. The incidence of obtaining consent immediately prior to surgery is unknown.

Alternative discharge destination following lobectomy: Analysis of a national quality improvement database.

Objective: To determine factors significantly associated with alternative discharge destination (ADCD) following lobectomy, including the modified 5-item Frailty Index (mFI-5).

Methods: Patients in the 2017-2020 NSQIP who underwent elective lobectomy and were admitted from home were included, with ADCD defined as a patient who was discharged to any nonhome location. Four multivariable logistic regression models for ADCD were evaluated for predictive power.

Living on the edge: Role of adjuvant therapy after resection of primary lung cancer within 2 millimeters of a T-stage cutoff.

Objectives: To evaluate the use of systemic therapy and overall survival in patients with resected non-small cell lung cancer whose pathologic tumor size was within 2 mm of a T-stage cutoff.

Methods: This was retrospective cohort study using the National Cancer Database of patients who underwent resection of tumors within 2 mm of the T1c/T2a, T2a/T2b, and T2b/T3 T-stage cutoffs. Patients with nodal involvement or whose T stage was determined on the basis of pathologic features other than tumor size were excluded.

Prevalence and Determinants of Prehospital Impression of Stroke in Ischemic Stroke Patients.

Background: Emergency Medical Services (EMS) clinicians are front-line in evaluating patients with stroke in the community. Their ability to correctly identify stroke influences downstream management decisions. We sought to use a large national database of prehospital clinical data to determine risk factors associated with missed EMS stroke identification.

Outcomes of single-lung retransplantation after double-lung transplantation.

Objective: To compare outcomes of single-lung retransplantation (SLRTx) and double-lung retransplantation (DLRTx) after an initial double-lung transplantation.

Methods: The Organ Procurement and Transplantation Network/United Network for Organ Sharing database between May 2005 and December 2022 was retrospectively analyzed. Multiorgan transplantations, repeated retransplantations, and lung retransplantations when the status of the initial transplantation was unknown were excluded.

Geographic Access to High-Volume Mechanical Thrombectomy Centers in Florida, 2019.

Background And Objectives: Mechanical thrombectomy (MT) improves outcomes for acute ischemic stroke (AIS) due to large vessel occlusion, but is time sensitive and requires specialized infrastructure. Professional organizations and certification bodies have promulgated minimum procedural volume standards for centers and for individual proceduralists but it is unclear whether enforcing these requirements would decrease geographic access to MT. Therefore, we sought to evaluate the potential impact of applying a minimum procedural volume threshold on geographic access to MT.

Mesenchymal Stromal Cell Implants for Chronic Motor Deficits After Traumatic Brain Injury: Post Hoc Analysis of a Randomized Trial.

Background And Objectives: Traumatic brain injury (TBI) is frequently characterized by chronic motor deficits. Therefore, this clinical trial assessed whether intracranial implantation of allogeneic modified mesenchymal stromal (SB623) cells can improve chronic motor deficits after TBI.

Methods: Post hoc analysis of the double-blind, randomized, prospective, surgical sham-controlled, phase 2, STEMTRA clinical trial (June 2016 and March 2019) with 48 weeks of follow-up was conducted.

Initial management and outcomes of nonmalignant esophageal perforations: A Nationwide Inpatient Sample analysis.

Background: Management of esophageal perforation includes open surgery, minimally invasive surgery, and endoscopic stent placement. This study analyzed initial treatment and the associated short-term outcomes.

Methods: A retrospective study using the National Inpatient Sample between October 2015 and December 2019 identified adults >18 years with esophageal perforation undergoing an initial nonelective esophageal procedure categorized into either open surgery, minimally invasive surgery, or endoscopic stent placement.

The 2023 American Association for Thoracic Surgery (AATS) Expert Consensus Document: Management of subsolid lung nodules.

Objective: Lung cancers that present as radiographic subsolid nodules represent a subtype with distinct biological behavior and outcomes. The objective of this document is to review the existing literature and report consensus among a group of multidisciplinary experts, providing specific recommendations for the clinical management of subsolid nodules.

Methods: The American Association for Thoracic Surgery Clinical Practice Standards Committee assembled an international, multidisciplinary expert panel composed of radiologists, pulmonologists, and thoracic surgeons with established expertise in the management of subsolid nodules.

Multi-bounce self-mixing in terahertz metasurface external-cavity lasers.

The effects of optical feedback on a terahertz (THz) quantum-cascade metasurface vertical-external-cavity surface-emitting laser (QC-VECSEL) are investigated via self-mixing. A single-mode 2.80 THz QC-VECSEL operating in continuous-wave is subjected to various optical feedback conditions (i.

Toward the scale-up production of polymeric nanotherapeutics for cancer clinical trials.

Nanotherapeutics have gained significant attention for the treatment of numerous cancers, primarily because they can accumulate in and/or selectively target tumors leading to improved pharmacodynamics of encapsulated drugs. The flexibility to engineer the nanotherapeutic characteristics including size, morphology, drug release profiles, and surface properties make nanotherapeutics a unique platform for cancer drug formulation. Polymeric nanotherapeutics including micelles and dendrimers represent a large number of formulation strategies developed over the last decade.

Continuous-wave GaAs/AlGaAs quantum cascade laser at 5.7 THz.

Design strategies for improving terahertz (THz) quantum cascade lasers (QCLs) in the 5-6 THz range are investigated numerically and experimentally, with the goal of overcoming the degradation in performance that occurs as the laser frequency approaches the band. Two designs aimed at 5.4 THz were selected: one optimized for lower power dissipation and one optimized for better temperature performance.

Heterogeneity of State Stroke Center Certification and Designation Processes.

Background: Stroke centers are critical for the timely diagnosis and treatment of acute stroke and have been associated with improved treatment and outcomes; however, variability exists in the definitions and processes used to certify and designate these centers. Our study categorizes state stroke center certification and designation processes and provides examples of state processes across the United States, specifically in states with independent designation processes that do not rely on national certification.

Methods: In this cross-sectional study from September 2022 to April 2023, we used peer-reviewed literature, primary source documents from states, and communication with state officials in all 50 states to capture each state's process for stroke center certification and designation.

Association between underweight status and chylothorax after esophagectomy for esophageal cancer: A propensity score-matched analysis.

Objective: To use a nationwide database of hospitalizations to investigate underweight status as a risk factor for postesophagectomy complications.

Methods: We identified all patients who underwent esophagectomy with a diagnosis of esophageal cancer and known body mass index in the 2018-2020 Nationwide Readmissions Database. All hospital visits for esophagectomy and within 30 days of initial discharge were analyzed for postoperative complications, including chylothorax.

Baseline Stroke Risk and Efficacy of Dual-Antiplatelet Therapy: A Post Hoc Analysis of the POINT Trial.

Background: High-risk transient ischemic attacks and minor ischemic strokes are followed by a variable risk of ischemic stroke. We aimed to determine how baseline stroke risk modified the efficacy of clopidogrel-aspirin (referred to here as dual-antiplatelet therapy [DAPT]) for transient ischemic attack and minor ischemic stroke.

Methods: We performed an unplanned secondary analysis of the POINT trial (Platelet-Oriented Inhibition in New Transient Ischemic Attack and Minor Ischemic Stroke).