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Supplemental Digital Content is available in the text., Background. Regional variation in lung transplantation practices due to local coronavirus disease 2019 (COVID-19) prevalence may cause geographic disparities in access to lung transplantation. Methods. Using the United Network for Organ Sharing registry, we conducted a descriptive analysis of lung transplant volume, donor lung volume, new waitlist activations, and waiting list deaths at high-volume lung transplant centers during the first 3 months of the pandemic (March 1. 2020, to May 30, 2020) and we compared it to the same period in the preceding 5 years. Results. Lung transplant volume decreased by 10% nationally and by a median of 50% in high COVID-19 prevalence centers (range –87% to 80%) compared with a median increase of 10% (range –87% to 80%) in low prevalence centers (P-for-trend 0.006). Donation services areas with high COVID-19 prevalence experienced a greater decrease in organ availability (-28% range, –72% to –11%) compared with low prevalence areas (+7%, range –20% to + 55%, P-for-trend 0.001). Waiting list activations decreased at 18 of 22 centers. Waiting list deaths were similar to the preceding 5 years and independent of local COVID-19 prevalence (P-for-trend 0.36). Conclusions. Regional variation in transplantation and donor availability in the early months of the pandemic varied by local COVID-19 activity.

We report the realization of a superluminal laser in which the dip in the gain profile necessary for anomalous dispersion is produced via electromagnetically induced transparency caused by the optical pumping laser. This laser also creates the ground state population inversion necessary for generating Raman gain. Compared to a conventional Raman laser with similar operating parameters but without the dip in the gain profile, the spectral sensitivity of this approach is explicitly demonstrated to be enhanced by a factor of ∼12.7. Compared to an empty cavity, the peak value of the sensitivity enhancement factor under optimal operation parameters is inferred to be ∼360.

There are 2 main aims of lung transplantation for people with end-stage lung disease: (1) to extend life and (2) to improve its quality. Much consideration is given to how to support the longevity and functioning of the allograft, though less robust studies have been done on the quality of the recipients' lives. With an interest in providing compassionate and holistic patient-centered care, it is vital that the treatment providers accurately understand their patients' lived experience. This study aimed to describe the health-related quality of life experiences of lung transplant recipients. An interest was held for where patients may struggle, thus informing where support might be needed to achieve the best possible outcomes.This single-center study used a validated Lung Transplant Quality of Life questionnaire, which was sent in autumn of 2020 to all of the lung transplant recipients (n = 581) under the care of Columbia University Irving Medical Center (New York, NY)."Anxiety/Depression" had the highest concentration of struggle responses, followed closely by "Pulmonary Symptoms" and "Neuromuscular Symptoms." "Neuromuscular Problems" and "Sexual Problems" had the highest percentage of struggle responses. As the struggles increased, the overall quality of life rating dropped proportionately. There was no correlation between the overall quality of life and graft dysfunction, age, or time out from transplant date. All of the domains held an average rating of "Satisfactory," except "Treatment Burden," which was rated as "Favorable." Those ratings dropped for the cohort of patients who died during the study period.With the goal of providing comprehensive care at the forefront of transplant priorities, we found the newly developed questionnaire invaluable in targeting areas for quality improvements, mostly notably respecting recipient mental health.

We present a generalized echo squeezing protocol (GESP) as a generalization of the Schr\"odinger cat state protocol (SCSP) with the value of the squeezing parameter being an arbitrary number rather than pi/2. We show analytically that over a broad range of the squeezing parameter the sensitivity reaches the Heisenberg limit (HL) within a factor of root-2. For a large number of particles, N, this plateau interval is almost the whole range from zero to pi/2, and the sensitivity is independent of the parity of N. Therefore, it is possible to operate a sensor over a wide interval of the squeezing parameter without changing the sensitivity. This is to be contrasted with the conventional echo squeezing protocol (CESP) which only works for a very small interval. In contrast to the CESP, the sensitivity of the GESP is close to the quantum Cram\'er-Rao bound over the whole range of the squeezing parameter. The enhancement in sensitivity for the GESP is due to a combination of two parameters: the phase magnification factor (PMF) and the noise amplification factor (NAF). As the value of the squeezing parameter increases, both PMF and NAF increase, keeping the ratio of PMF/NAF constant, yielding an enhancement of sensitivity at the HL within a factor of root-2. Thus, the robustness of the GESP against excess noise easily exceeds that of the CESP for a broad range of values of the squeezing parameter. As such, in the context of an experimental study, it should be possible to achieve a net enhancement in sensitivity higher than that for the CESP, under typical conditions where the excess noise exceeds the unsqueezed quantum projection noise. Finally, we consider the fragility of the GESP against collisions with background particles, and show how a balance between the fragility and the robustness against excess noise would in practice determine the optimal choice of parameters for the GESP.

The safety and efficacy of tocilizumab for the treatment of severe respiratory symptoms due to COVID-19 remain uncertain, in particular among solid organ transplant (SOT) recipients. Thus, we evaluated the clinical characteristics and outcomes of 29 hospitalized SOT recipients who received tocilizumab for severe COVID-19, compared to a matched control group who did not. Among a total of 117 total SOT recipients hospitalized with COVID-19, 29 (24.8%) received tocilizumab. The 90-day mortality was significantly higher among patients who received tocilizumab (41%) compared to those who did not (20%, P = .03). When compared to control patients matched by age, hypertension, chronic kidney disease, and administration of high dose corticosteroids, there was no significant difference in mortality (41% vs 28%, P = .27), hospital discharge (52% vs 72%, P = .26), or secondary infections (34% vs 24%, P = .55). Among patients who received tocilizumab, there was also no difference in mortality based on the level of oxygen support (intubated vs not intubated) at the time of tocilizumab initiation. In this matched cohort study, tocilizumab appeared to be safe but was not associated with decreased 90-day mortality. Larger randomized studies are needed to identify whether there are subsets of SOT recipients who may benefit from tocilizumab for treatment of COVID-19.

Rationale: Obesity is associated with an increased risk of pulmonary hypertension (PH); however, regional adipose tissue deposition is heterogeneous with distinct cardiovascular phenotypes. Objectives: To determine the association of body mass index (BMI) and thoracic visceral and subcutaneous adipose tissue areas (VAT and SAT, respectively) with PH in patients with advanced lung disease referred for lung transplantation. Methods: We studied patients undergoing evaluation for lung transplantation at three centers from the Lung Transplant Body Composition Study. PH was defined as mean pulmonary artery pressure >20 mm Hg and pulmonary vascular resistance ≥3 Wood units. VAT and SAT were measured on chest computed tomography and normalized to height squared. Results: One hundred thirty-seven (34%) of 399 patients included in our study had PH. Doubling of thoracic VAT was associated with significantly lower pulmonary vascular resistance (β, −0.24; 95% confidence interval [95% CI], −0.46 to −0.02; P = 0.04), higher pulmonary arterial wedge pressure (β, 0.79; 95% CI, 0.32 to 1.26; P = 0.001), and decreased risk of PH (relative risk, 0.86; 95% CI, 0.74 to 0.99; P = 0.04) after multivariate adjustment. Vaspin levels were higher in patients without PH (median, 101.8 vs. 92.0 pg/ml; P

BACKGROUND Although single and double lung transplantation outcomes for chronic obstructive pulmonary disease (COPD) have been investigated, right and left single lung transplants have never been rigorously compared to evaluate disease-specific differences. Single lung transplants for COPD often have hyperinflation of the contralateral native lung, which may be more pronounced in left lung transplants. METHODS Using the United Network for Organ Sharing registry, we conducted a retrospective cohort study of 5,585 adults who underwent lung transplantation for COPD from May 4, 2005 to June 30, 2017. Subjects were followed until March 2019. Post-transplant survival was compared using Cox proportional hazards and Royston and Parmar's flexible parametric survival models. We adjusted for donor and recipient factors with known or plausible associations with survival. RESULTS Lung transplant recipients who received a left single lung transplant for COPD had an increased risk of post-transplant death when compared with those who received a right single lung transplant for COPD (hazard ratio [HR]: 1.24, 95% CI: 1.08–1.48, p = 0.002). Survival did not differ significantly between double lung transplant and right single lung transplant recipients (HR: 0.88, 95% CI: 0.77–1.02, p = 0.086). Adjusted 5-year survival was 57.8% (95% CI: 55.7–60.1) for double lung recipients, 56.7% (95% CI: 55.4–58.0) for right single lung recipients, and 50.9% (95% CI: 47.2–55.0) for left single lung recipients. CONCLUSIONS In COPD, right single lung transplantation was associated with improved post-transplant survival compared with left single lung transplantation, and no significant difference in post-transplant survival compared with double lung transplantation was found. In light of the ongoing donor lung shortage, preferential allocation of right single lungs to patients with COPD should be considered.

Lung cancer is the third most common malignancy that develops in patients following solid organ transplantation and is the leading cause of cancer deaths in the general population. The aims of this study are to examine the characteristics of patients who developed lung cancer following solid organ transplantation at our institution and to compare their outcomes to those of lung cancer patients without a history of transplant.We performed a single-institution retrospective study of 44 solid organ transplant recipients who developed lung cancer and compared their characteristics to a cohort of 74 lung cancer patients without a history of transplant. We performed propensity score weighted analyses to compare outcomes between the two groups, including a cox proportional hazards model of overall survival.52 % of post-transplant patients who developed lung cancer were diagnosed with stage III or IV disease. In the propensity score weighted analysis that accounted for age at diagnosis, sex, lung cancer stage at diagnosis, Charlson comorbidity index score, and ECOG performance score, post-transplant patients were more likely to have squamous cell histology (p 0.01) and had worse overall survival compared to the non-transplant cohort (HR = 1.88, 95 % CI 1.13-3.12, p = 0.02). The difference in survival remained significant after accounting for differences in lung cancer histology and treatment (HR = 2.40, 95 % CI 1.27-3.78, p 0.01).When compared to non-transplant patients with lung cancer, post-transplant patients have worse overall survival after accounting for differences in age, sex, lung cancer stage, comorbidities, and performance status. This survival difference is not solely attributable to differences in tumor histology and treatments received. This may suggest that post-transplant malignancies are more aggressive and difficult to treat.

Donation after Circulatory Death (DCD) is an alternative to Donation after Brain death (DBD), and is a growing strategy for organ procurement in the United States(US). The purpose of this analysis was to review the number and quality of hearts in one United Network for Organ Sharing (UNOS) Region that were not utilized as a potential consequence of nonheart DCD donation. We retrospectively identified all successful US DCD solid organ donors from 1/2011 to 3/1/2017, defined an ideal heart donor by age and left ventricular ejection fraction (LVEF), and then reviewed the donor charts of unused hearts in New York and Vermont (UNOS Region 9). Of 8302 successful DCD donors across the United States, 5033 (61%) were between 18 and 49 years of age, and 872 had a screening echocardiogram, with 573 (66%) measuring an EF >50%. Of these 573 potential donors, 44 (7.7%) were from Region 9. Detailed donor chart review identified 36 ideal heart donors, 24 (66.7%) with anoxic brain injury. Trends in Region 9 DCD donation increased from 4 unused hearts in 2011, to 13 in 2016. In the context of severe organ scarcity, these data indicate that implementation of DCD heart transplantation in the United States would improve overall donation rates and provide a pathway to utilize these ideal donor hearts.

Academic writing capabilities are a cornerstone of success in doctoral programs, yet prove to be a point of anxiety and apprehension for many students. Providing support for academic writing within interdisciplinary programs poses special considerations, as students in these programs are called upon to transcend single disciplinary perspectives to address a central area of research, and to integrate multiple different disciplinary perspectives that may be conflicting or overlapping. When treated as a social practice, writing can serve as a common interest that draws doctoral students to convene and develop in their learning. This article describes the development of a student writing group in an interdisciplinary doctoral program, considering how the characteristics and activities of the group create an environment that enables and encourages enhanced interdisciplinary learning. The article argues that, when delivered successfully, student writing groups have the potential to strengthen student writing skills and outputs, as well as deepen interdisciplinary learning. Drawing from Lattuca’s four aspects of interdisciplinary learning (relational, mediated, transformative and situated), the article illustrates ways that the writing group helped to promote each aspect of learning and benefit the overall student experience in the program. Reflecting on these experiences, the authors propose six practical considerations for establishing writing groups in interdisciplinary programs: vision and purpose; dedicated time and space; institutional support; readings or educational material; socialization opportunities; and shared responsibility. Administrators, students, faculty members and support staff involved in the delivery of interdisciplinary doctoral programs are called upon to consider the introduction and/or strengthening of writing groups for the purpose of enhanced interdisciplinary learning.

We report on the successful demonstration of PQ:PMMA transmission holograms with six channels for wavelength division multiplexing around 1550 nm with 2 nm channel spacings in a free-space optical communication system.

We show the feasibility of efficiently performing optical cross-correlations of 1D time-domain signals by transforming them into 2D signals through their spectrograms. The resulting images are compatible with current spatial light modulator resolutions.

We propose a technique that can control the macroscopic magnetization of an ensemble of atoms with a single atom. This technique can also be used for entangling two ensembles of atoms at a long distance.

We report on the demonstration of high-speed modality of the hybrid opto-electronic correlator for rotation, scale, and shift-invariant automatic target recognition via use of simultaneous detection of the relevant digital-holographic signals using six focal-plane arrays.

We realized superluminal Raman lasing via electromagnetically induced transparency. Compared to a conventional Raman laser with similar operating parameters, the spectral sensitivity of this approach is demonstrated to be enhanced by a factor of ~15.4.

The hybrid opto-electronic correlator (HOC) uses a combination of optics and electronics to perform target recognition. Achieving a stable output from this architecture has previously presented a significant challenge due to a high sensitivity to optical phase variations, limiting the real-world feasibility of the device. Here we present a modification to the architecture that essentially eliminates the dependence on optical phases, and demonstrate verification of the proposed approach. Experimental results are shown to agree with the theory and simulations, for scale, rotation and shift invariant image recognition. This approach represents a major innovation in making the HOC viable for real-world applications.