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3. Nonlinear down-conversion in a single quantum dot

Author

Jonas, B., Heinze, D., Schöll, E., Kallert, P., Langer, T., Krehs, S., Widhalm, A., Jöns, K. D., Reuter, D., Schumacher, S., and Zrenner, A.

Subjects
Quantum Physics, Physics - Optics
Abstract

Photonic quantum technologies$^1$, with applications in quantum communication, sensing as well as quantum simulation and computing, are on the verge of becoming commercially available. One crucial building block are tailored nanoscale integratable quantum light sources, matching the specific needs of use-cases. Several different approaches to realize solid-state quantum emitters$^2$ with high performance$^3$ have been pursued. However, the properties of the emitted single photons are always defined by the individual quantum light source and despite numerous quantum emitter tuning techniques$^{4-7}$, scalability is still a major challenge. Here we show an emitter-independent method to tailor and control the properties of the single photon emission. We demonstrate a laser-controlled down-conversion process from an excited state of a quantum three-level system$^8$. Starting from a biexciton state, a tunable control laser field defines a virtual state in a stimulated process. From there, spontaneous emission to the ground state leads to optically controlled single photon emission. Based on this concept, we demonstrate energy tuning of the single photon emission with a control laser field. The nature of the involved quantum states furthermore provides a unique basis for the future control of polarization and bandwidth, as predicted by theory$^{9,10}$. Our demonstration marks an important step towards tailored single photon emission from a photonic quantum system based on quantum optical principles.

Published
2021
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4. A patient-specific approach for quantitative and automatic analysis of computed tomography images in lung disease: application to COVID-19 patients

Author

Berta, L., De Mattia, C., Rizzetto, F., Carrazza, S., Colombo, P. E., Fumagalli, R., Langer, T., Lizio, D., Vanzulli, A., and Torresin, A.

Subjects
Physics - Medical Physics, Statistics - Machine Learning
Abstract

Quantitative metrics in lung computed tomography (CT) images have been widely used, often without a clear connection with physiology. This work proposes a patient-independent model for the estimation of well-aerated volume of lungs in CT images (WAVE). A Gaussian fit, with mean (Mu.f) and width (Sigma.f) values, was applied to the lower CT histogram data points of the lung to provide the estimation of the well-aerated lung volume (WAVE.f). Independence from CT reconstruction parameters and respiratory cycle was analysed using healthy lung CT images and 4DCT acquisitions. The Gaussian metrics and first order radiomic features calculated for a third cohort of COVID-19 patients were compared with those relative to healthy lungs. Each lung was further segmented in 24 subregions and a new biomarker derived from Gaussian fit parameter Mu.f was proposed to represent the local density changes. WAVE.f resulted independent from the respiratory motion in 80% of the cases. Differences of 1%, 2% and up to 14% resulted comparing a moderate iterative strength and FBP algorithm, 1 and 3 mm of slice thickness and different reconstruction kernel. Healthy subjects were significantly different from COVID-19 patients for all the metrics calculated. Graphical representation of the local biomarker provides spatial and quantitative information in a single 2D picture. Unlike other metrics based on fixed histogram thresholds, this model is able to consider the inter-and intra-subject variability. In addition, it defines a local biomarker to quantify the severity of the disease, independently of the observer., Comment: 31 pages, 7 figures, accepted in EJMP

Published
2021

5. VersKiK: Study protocol of an observational registry-based study on the current state of follow-up care and adherence to follow-up guidelines after cancer in childhood or adolescence

Author

Aleshchenko, E., Apfelbacher, C., Baust, K., Calaminus, G., Droege, P., Glogner, J., Horenkamp-Sonntag, D., Ihle, P., Kaatsch, P., Klein, M., Kloppe, T., Kuepper-Nybelen, J., Langer, T., Luepkes, C., Marschall, U., Meier, I., Merzenich, H., Spix, C., Swart, E., and Trocchi, P.

Published
2023
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6. InAs Heteroepitaxy on Nanopillar-Patterned GaAs (111)A

Author

Kunnathully, V. S., Riedl, T., Trapp, A., Langer, T., Reuter, D., and Lindner, J. K. N.

Subjects
Condensed Matter - Materials Science
Abstract

Heteroepitaxy on nanopatterned substrates is a means of defect reduction at semiconductor heterointerfaces by exploiting substrate compliance and enhanced elastic lattice relaxation resulting from reduced dimensions. We explore this possibility in the InAs/GaAs(111)A system using a combination of nanosphere lithography and reactive ion etching of the GaAs(111)A substrate for nano-patterning of the substrate, yielding pillars with honeycomb and hexagonal arrangements and varied nearest neighbor distances. Substrate patterning is followed by MBE growth of InAs at temperatures of 150 - 350 C and growth rates of 0.011 nm/s and 0.11 nm/s. InAs growth in the form of nano-islands on the pillar tops is achieved by lowering the adatom migration length by choosing a low growth temperature of 150 C at the growth rate 0.011 nm/s. The choice of a higher growth rate of 0.11 nm/s results in higher InAs island nucleation and the formation of hillocks concentrated at the pillar bases due to a further reduction of adatom migration length. A common feature of the growth morphology for all other explored conditions is the formation of merged hillocks or pyramids with well-defined facets due to the presence of a concave surface curvature at the pillar bases acting as adatom sinks.

Published
2019
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7. Strain-driven InAs island growth on top of GaAs(111) nanopillars

Author

Riedl, T., Kunnathully, V. S., Trapp, A., Langer, T., Reuter, D., and Lindner, J. K. N.

Subjects
Condensed Matter - Materials Science
Abstract

We analyze the shape and position of heteroepitaxial InAs islands on the top face of cylindrical GaAs(111)A nanopillars experimentally and theoretically. Catalyst-free molecular beam epitaxial growth of InAs at low temperatures on GaAs nanopillars results in InAs islands with diameters < 30 nm exhibiting predominantly rounded triangular in-plane shapes. The islands show a tendency to grow at positions displaced from the center towards the pillar edge. Atomistic molecular statics simulations evidence that triangular-prismatic islands centered to the pillar axis with diameters smaller than that of the nanopillars are energetically favored. Moreover, we reveal the existence of minimum-energy states for off-axis island positions, in agreement with the experiment. These findings are interpreted by evaluating the spatial strain distributions and the number of broken bonds of surface atoms as a measure for the surface energy. The preferred off-axis island positions can be understood in terms of an increased compliancy of the GaAs nanopillar beneath the island because of the vicinity of free surfaces, leading to a reduction of strain energy. The influence of surface steps on the energy of the system is addressed as well., Comment: 18 pages, 4 figures. Paper updated to match published version

Published
2019
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8. Complications related to short peripheral intravenous catheters in patients with acute stroke: a prospective, observational, single-cohort study

Author

Privitera, D, Geraneo, A, Li Veli, G, Parravicini, G, Mazzone, A, Rossini, M, Sanfilippo, M, Gubertini, A, Airoldi, C, Capsoni, N, Busca, E, Bassi, E, Langer, T, Dal Molin, A, Privitera D., Geraneo A., Li Veli G., Parravicini G., Mazzone A., Rossini M., Sanfilippo M., Gubertini A., Airoldi C., Capsoni N., Busca E., Bassi E., Langer T., Dal Molin A., Privitera, D, Geraneo, A, Li Veli, G, Parravicini, G, Mazzone, A, Rossini, M, Sanfilippo, M, Gubertini, A, Airoldi, C, Capsoni, N, Busca, E, Bassi, E, Langer, T, Dal Molin, A, Privitera D., Geraneo A., Li Veli G., Parravicini G., Mazzone A., Rossini M., Sanfilippo M., Gubertini A., Airoldi C., Capsoni N., Busca E., Bassi E., Langer T., and Dal Molin A.

Abstract

Patients with acute stroke often require venous access to facilitate diagnostic investigations or intravenous therapy. The primary aim of this study was to describe the rate and type of complications associated with the placement of a short peripheral catheter (SPC) in patients with acute ischemic or hemorrhagic stroke. A prospective, observational, single-cohort study was conducted at Niguarda Hospital, Italy, with enrolment in the Emergency Department. Adult patients with an ischemic or hemorrhagic stroke requiring an SPC were enrolled. Complications, such as infiltration, occlusion, phlebitis and dislodgment, were recorded daily. Descriptive statistics were used, and the incidence rate ratio (IRR) was estimated to assess the difference in complications, considering catheter calibre, dominant side, exit site, limb, and limb mobility, ictus type (ischemic/haemorrhagic), impairment deficit (language, motor, visual) and EA-DIVA score. A total of 269 participants and 755 SPC were analysed. Removal of SPC due to at least one local complication occurred in 451 (60%). Dislodgment was the major cause of SPC removal (31%), followed by infiltration (18%), occlusion (6%), and phlebitis (5%). The SPC calibre (22G), exit-site other than antecubital and forearm, visual deficit and EA-DIVA ≥ 8 were associated with a higher rate of SPC complications: IRR, 1.71 [1.31; 2.31]; 1.27 [1.01; 1.60], 1.38 [1.06; 1.80], 1.30 [1.04; 1.64], respectively. No other differences in complication rates were observed according to the insertion site, i.e. dominant side, left side, plegic/hyposthenic limb, or exit site. This study provides novel insights into the frequency and types of complications associated with SPC in patients with acute stroke. Compared to the literature, a higher dislodgment rate was observed, being the first cause of SPC removal, whereas no differences in the number of infiltrations, occlusions, and phlebitis were recorded.

Published
2024

10. Ventilation distribution during changes in trunk inclination in ARDS patients

Author

Marrazzo, F, Spina, S, Zadek, F, Forlini, C, Bassi, G, Giudici, R, Bellani, G, Fumagalli, R, Langer, T, Marrazzo F., Spina S., Zadek F., Forlini C., Bassi G., Giudici R., Bellani G., Fumagalli R., Langer T., Marrazzo, F, Spina, S, Zadek, F, Forlini, C, Bassi, G, Giudici, R, Bellani, G, Fumagalli, R, Langer, T, Marrazzo F., Spina S., Zadek F., Forlini C., Bassi G., Giudici R., Bellani G., Fumagalli R., and Langer T.

Published
2024

12. Long-term care, care needs and wellbeing of individuals after cancer in childhood or adolescence (VersKiK): study protocol of a large scale multi-methods non-interventional study

Author

Aleshchenko, E., Swart, E., Spix, C., Voigt, M., Trocchi, P., Langer, T., Calaminus, G., Baust, K., Glogner, J., Ihle, P., Küpper-Nybelen, J., Lüpkes, C., Kloppe, T., Horenkamp-Sonntag, D., Meier, I., Marschall, U., Dröge, P., Klein, M., Weiss, A., and Apfelbacher, C.

Published
2022
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17. Kardiologische Spätfolgen bei Überlebenden nach einer Krebserkrankung im Kindes- oder Jugendalter - Ergebnisse der VersKiK-Studie

Author

Merzenich, H, Trocchi, P, Spix, C, Alshchenko, E, Lüpkes, C, Ihle, P, Küpper-Nybelen, J, Calaminus, G, Baust, K, Langer, T, Horenkamp-Sonntag, D, Meier, I, Dröge, P, Ruhnke, T, Marschall, U, Klein, M, Ronckers, CM, Swart, E, Merzenich, H, Trocchi, P, Spix, C, Alshchenko, E, Lüpkes, C, Ihle, P, Küpper-Nybelen, J, Calaminus, G, Baust, K, Langer, T, Horenkamp-Sonntag, D, Meier, I, Dröge, P, Ruhnke, T, Marschall, U, Klein, M, Ronckers, CM, and Swart, E

Published
2024

18. Umsetzung der Implementierungsstudie des EU Projektes PanCareSurPass in Deutschland

Author

Neumann, A, Filbert, AL, Walz, D, Knörr, L, Csipak, A, Richter, F, Gebauer, J, Langer, T, Ingenerf, J, Schladetzky, J, Saraceno, D, Cangioli, G, Haupt, R, Grabow, D, Kock-Schoppenhauer, AK, Neumann, A, Filbert, AL, Walz, D, Knörr, L, Csipak, A, Richter, F, Gebauer, J, Langer, T, Ingenerf, J, Schladetzky, J, Saraceno, D, Cangioli, G, Haupt, R, Grabow, D, and Kock-Schoppenhauer, AK

Published
2024

20. Hörschäden, Krankheiten der Schilddrüse und sonstiger endokrinen Drüsen bei Langzeit-Überlebenden einer Krebserkrankung im Kindes- oder Jugendalter - Ergebnisse der VersKiK-Studie

Author

Trocchi, P, Merzenich, H, Spix, C, Alshchenko, E, Lüpkes, C, Ihle, P, Küpper-Nybelen, J, Calaminus, G, Baust, K, Langer, T, Gebauer, J, Horenkamp-Sonntag, D, Dröge, P, Ruhnke, T, Marschall, U, Klein, M, Ronckers, CM, Swart, E, Trocchi, P, Merzenich, H, Spix, C, Alshchenko, E, Lüpkes, C, Ihle, P, Küpper-Nybelen, J, Calaminus, G, Baust, K, Langer, T, Gebauer, J, Horenkamp-Sonntag, D, Dröge, P, Ruhnke, T, Marschall, U, Klein, M, Ronckers, CM, and Swart, E

Published
2024

21. Development and testing of a tool to foster shared decision-making between patients and healthcare professionals in clinical practice guidelines

Author

Fischer, L, Scheibler, F, Schaefer, C, Karge, T, Langer, T, Schewe, LV, Florez, ID, Li, S, Maes-Carballo, M, Munn, Z, Perestelo-Perez, L, Puljak, L, Stiggelbout, A, Pieper, D, Fischer, L, Scheibler, F, Schaefer, C, Karge, T, Langer, T, Schewe, LV, Florez, ID, Li, S, Maes-Carballo, M, Munn, Z, Perestelo-Perez, L, Puljak, L, Stiggelbout, A, and Pieper, D

Published
2024

23. VersKiK: Evaluation der medizinischen Versorgung bei Personen nach einer Krebserkrankung im Kindes- oder Jugendalter mit GKV-Abrechnungsdaten

Author

Trocchi, P, Merzenich, H, Ronckers, C, Spix, C, Ihle, P, Küpper-Nybelen, J, Lüpkes, C, Horenkamp-Sonntag, D, Dröge, P, Ruhnke, T, Baust, K, Calaminus, G, Langer, T, Aleshchenko, E, Swart, E, Trocchi, P, Merzenich, H, Ronckers, C, Spix, C, Ihle, P, Küpper-Nybelen, J, Lüpkes, C, Horenkamp-Sonntag, D, Dröge, P, Ruhnke, T, Baust, K, Calaminus, G, Langer, T, Aleshchenko, E, and Swart, E

Published
2024

24. Oxygen-Sparing Anesthesia with Electrically Controlled Ventilators: A Bench Study with Implications for Clinical Practice and Resource Management

Author

Torrano, V, Zadek, F, Abbiati, G, Deli, C, Fumagalli, R, Langer, T, Torrano, Vito, Zadek, Francesco, Giacomo, Abbiati, Deli, Chiara, Fumagalli, Roberto, Langer, Thomas, Torrano, V, Zadek, F, Abbiati, G, Deli, C, Fumagalli, R, Langer, T, Torrano, Vito, Zadek, Francesco, Giacomo, Abbiati, Deli, Chiara, Fumagalli, Roberto, and Langer, Thomas

Published
2024

25. Successful Versus Failed Transition From Controlled Ventilation to Pressure Support Ventilation in COVID-19 Patients: A Retrospective Cohort Study

Author

Polo Friz, M, Rezoagli, E, Safaee Fakhr, B, Florio, G, Carlesso, E, Giudici, R, Forlini, C, Tardini, F, Langer, T, Laratta, M, Casella, G, Forastieri Molinari, A, Protti, A, Cecconi, M, Cabrini, L, Biagioni, E, Berselli, A, Mirabella, L, Tonetti, T, De Robertis, E, Grieco, D, Antonelli, M, Citerio, G, Fumagalli, R, Foti, G, Zanella, A, Grasselli, G, Bellani, G, Polo Friz, Melisa, Rezoagli, Emanuele, Safaee Fakhr, Bijan, Florio, Gaetano, Carlesso, Eleonora, Giudici, Riccardo, Forlini, Clarissa, Tardini, Francesca, Langer, Thomas, Laratta, Matteo, Casella, Giampaolo, Forastieri Molinari, Andrea, Protti, Alessandro, Cecconi, Maurizio, Cabrini, Luca, Biagioni, Emanuela, Berselli, Angela, Mirabella, Lucia, Tonetti, Tommaso, De Robertis, Edoardo, Grieco, Domenico Luca, Antonelli, Massimo, Citerio, Giuseppe, Fumagalli, Roberto, Foti, Giuseppe, Zanella, Alberto, Grasselli, Giacomo, Bellani, Giacomo, Polo Friz, M, Rezoagli, E, Safaee Fakhr, B, Florio, G, Carlesso, E, Giudici, R, Forlini, C, Tardini, F, Langer, T, Laratta, M, Casella, G, Forastieri Molinari, A, Protti, A, Cecconi, M, Cabrini, L, Biagioni, E, Berselli, A, Mirabella, L, Tonetti, T, De Robertis, E, Grieco, D, Antonelli, M, Citerio, G, Fumagalli, R, Foti, G, Zanella, A, Grasselli, G, Bellani, G, Polo Friz, Melisa, Rezoagli, Emanuele, Safaee Fakhr, Bijan, Florio, Gaetano, Carlesso, Eleonora, Giudici, Riccardo, Forlini, Clarissa, Tardini, Francesca, Langer, Thomas, Laratta, Matteo, Casella, Giampaolo, Forastieri Molinari, Andrea, Protti, Alessandro, Cecconi, Maurizio, Cabrini, Luca, Biagioni, Emanuela, Berselli, Angela, Mirabella, Lucia, Tonetti, Tommaso, De Robertis, Edoardo, Grieco, Domenico Luca, Antonelli, Massimo, Citerio, Giuseppe, Fumagalli, Roberto, Foti, Giuseppe, Zanella, Alberto, Grasselli, Giacomo, and Bellani, Giacomo

Abstract

OBJECTIVES: In patients with COVID-19 respiratory failure, controlled mechanical ventilation (CMV) is often necessary during the acute phases of the disease. Weaning from CMV to pressure support ventilation (PSV) is a key objective when the patient’s respiratory functions improve. Limited evidence exists regarding the factors predicting a successful transition to PSV and its impact on patient outcomes. DESIGN: Retrospective observational cohort study. SETTING: Twenty-four Italian ICUs from February 2020 to May 2020. PATIENTS: Mechanically ventilated ICU patients with COVID-19-induced respiratory failure. INTERVENTION: The transition period from CMV to PSV was evaluated. We defined it as “failure of assisted breathing” if the patient returned to CMV within the first 72 hours. MEASUREMENTS AND MAIN RESULTS: Of 1260 ICU patients screened, 514 were included. Three hundred fifty-seven patients successfully made the transition to PSV, while 157 failed. Pao2/Fio2 ratio before the transition emerged as an independent predictor of a successful shift (odds ratio 1.00; 95% CI, 0.99–1.00; p = 0.003). Patients in the success group displayed a better trend in Pao2/Fio2, Paco2, plateau and peak pressure, and pH level. Subjects in the failure group exhibited higher ICU mortality (hazard ratio 2.08; 95% CI, 1.42–3.06; p < 0.001), an extended ICU length of stay (successful vs. failure 21 ± 14 vs. 27 ± 17 d; p < 0.001) and a longer duration of mechanical ventilation (19 ± 18 vs. 24 ± 17 d, p = 0.04). CONCLUSIONS: Our study emphasizes that the Pao2/Fio2 ratio was the sole independent factor associated with a failed transition from CMV to PSV. The unsuccessful transition was associated with worse outcomes.

Published
2024

26. Validation of Indirect Calorimetry in Children Undergoing Single-Limb Non-Invasive Ventilation: A Proof of Concept, Cross-Over Study

Author

D’Oria, V, Spolidoro, G, Agostoni, C, Montani, C, Ughi, L, Villa, C, Marchesi, T, Babini, G, Scalia Catenacci, S, Donà, G, Guerrini, M, Chidini, G, Calderini, E, Langer, T, D’Oria, Veronica, Spolidoro, Giulia Carla Immacolata, Agostoni, Carlo Virginio, Montani, Cinzia, Ughi, Ludovica, Villa, Cristina, Marchesi, Tiziana, Babini, Giovanni, Scalia Catenacci, Stefano, Donà, Giada, Guerrini, Marta, Chidini, Giovanna, Calderini, Edoardo, Langer, Thomas, D’Oria, V, Spolidoro, G, Agostoni, C, Montani, C, Ughi, L, Villa, C, Marchesi, T, Babini, G, Scalia Catenacci, S, Donà, G, Guerrini, M, Chidini, G, Calderini, E, Langer, T, D’Oria, Veronica, Spolidoro, Giulia Carla Immacolata, Agostoni, Carlo Virginio, Montani, Cinzia, Ughi, Ludovica, Villa, Cristina, Marchesi, Tiziana, Babini, Giovanni, Scalia Catenacci, Stefano, Donà, Giada, Guerrini, Marta, Chidini, Giovanna, Calderini, Edoardo, and Langer, Thomas

Abstract

Background: The accurate assessment of resting energy expenditure (REE) is essential for personalized nutrition, particularly in critically ill children. Indirect calorimetry (IC) is the gold standard for measuring REE. This methodology is based on the measurement of oxygen consumption (VO2) and carbon dioxide production (VCO2). These parameters are integrated into the Weir equation to calculate REE. Additionally, IC facilitates the determination of the respiratory quotient (RQ), offering valuable insights into a patient's carbohydrate and lipid consumption. IC validation is limited to spontaneously breathing and mechanically ventilated patients, but it is not validated in patients undergoing non-invasive ventilation (NIV). This study investigates the application of IC during NIV-CPAP (continuous positive airway pressure) and NIV-PS (pressure support). Methods: This study was conducted in the Pediatric Intensive Care Unit of IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, between 2019 and 2021. Children < 6 years weaning from NIV were enrolled. IC was performed during spontaneous breathing (SB), NIV-CPAP, and NIV-PS in each patient. A Bland-Altman analysis was employed to compare REE, VO2, VCO2, and RQ measured by IC. Results: Fourteen patients (median age 7 (4; 18) months, median weight 7.7 (5.5; 9.7) kg) were enrolled. The REE, VO2, VCO2, and RQ did not differ significantly between the groups. The Limits of Agreement (LoA) and bias of REE indicated good agreement between SB and NIV-CPAP (LoA +28.2, -19.4 kcal/kg/day; bias +4.4 kcal/kg/day), and between SB and NIV-PS (LoA -22.2, +23.1 kcal/kg/day; bias 0.4 kcal/kg/day). Conclusions: These preliminary findings support the accuracy of IC in children undergoing NIV. Further validation in a larger cohort is warranted.

Published
2024

27. Uncomplicated calcium-citrate anticoagulation during continuous renal replacement therapy in two other patients with metformin accumulation

Author

Brunoni, B, Zadek, F, Protti, A, Cecconi, M, Fumagalli, R, Langer, T, Brunoni, Beatrice, Zadek, Francesco, Protti, Alessandro, Cecconi, Maurizio, Fumagalli, Roberto, Langer, Thomas, Brunoni, B, Zadek, F, Protti, A, Cecconi, M, Fumagalli, R, Langer, T, Brunoni, Beatrice, Zadek, Francesco, Protti, Alessandro, Cecconi, Maurizio, Fumagalli, Roberto, and Langer, Thomas

Published
2024

28. Hematocrit: The Neglected Variable of Extracorporeal CO2 Removal

Author

Vivona, L, Battistin, M, Carlesso, E, Florio, G, Todaro, S, Colombo, S, Zadek, F, Grasselli, G, Zanella, A, Langer, T, Vivona, Luigi, Battistin, Michele, Carlesso, Eleonora, Florio, Gaetano, Todaro, Serena, Colombo, Sebastiano M, Zadek, Francesco, Grasselli, Giacomo, Zanella, Alberto, Langer, Thomas, Vivona, L, Battistin, M, Carlesso, E, Florio, G, Todaro, S, Colombo, S, Zadek, F, Grasselli, G, Zanella, A, Langer, T, Vivona, Luigi, Battistin, Michele, Carlesso, Eleonora, Florio, Gaetano, Todaro, Serena, Colombo, Sebastiano M, Zadek, Francesco, Grasselli, Giacomo, Zanella, Alberto, and Langer, Thomas

Published
2024

29. Quantitative CT scan and response to pronation in COVID-19 ARDS

Author

Zadek, F, Berta, L, Zorzi, G, Ubiali, S, Bonaiuti, A, Tundo, G, Brunoni, B, Marrazzo, F, Giudici, R, Rossi, A, Rizzetto, F, Bernasconi, D, Vanzulli, A, Colombo, P, Fumagalli, R, Torresin, A, Langer, T, Zadek, Francesco, Berta, Luca, Zorzi, Giulia, Ubiali, Stefania, Bonaiuti, Amos, Tundo, Giulia, Brunoni, Beatrice, Marrazzo, Francesco, Giudici, Riccardo, Rossi, Anna, Rizzetto, Francesco, Bernasconi, Davide Paolo, Vanzulli, Angelo, Colombo, Paola Enrica, Fumagalli, Roberto, Torresin, Alberto, Langer, Thomas, Zadek, F, Berta, L, Zorzi, G, Ubiali, S, Bonaiuti, A, Tundo, G, Brunoni, B, Marrazzo, F, Giudici, R, Rossi, A, Rizzetto, F, Bernasconi, D, Vanzulli, A, Colombo, P, Fumagalli, R, Torresin, A, Langer, T, Zadek, Francesco, Berta, Luca, Zorzi, Giulia, Ubiali, Stefania, Bonaiuti, Amos, Tundo, Giulia, Brunoni, Beatrice, Marrazzo, Francesco, Giudici, Riccardo, Rossi, Anna, Rizzetto, Francesco, Bernasconi, Davide Paolo, Vanzulli, Angelo, Colombo, Paola Enrica, Fumagalli, Roberto, Torresin, Alberto, and Langer, Thomas

Abstract

Background: The use of the prone position (PP) has been widespread during the COVID-19 pandemic. While it has demonstrated benefits, including improved oxygenation and lung aeration, the factors influencing the response in terms of gas exchange to PP remain unclear. In particular, the association between baseline quantitative Computed Tomography (qCT) scan results and gas exchange response to PP in intubated, mechanically ventilated subjects with COVID-19 ARDS is unknown. The present study aimed to compare baseline qCT results between subjects responding to PP in terms of oxygenation or carbon dioxide (CO2) clearance and those who did not.Methods: This was a single-center, retrospective observational study, including critically ill, intubated, mechanically ventilated subjects with COVID-19 related acute respiratory distress syndrome admitted to the ICUs of Niguarda Hospital between March 2020 and November 2021. Blood-gas samples were collected before and after PP. Subjects in whom the PaO2/FiO2 increase was ≥ 20 mmHg after PP were defined as Oxygen responders (Oxy-R). CO2-responders (CO2R) were defined when the ventilatory ratio (VR) decreased during PP. Automated qCT analyses were performed to obtain tissue mass and density of the lungs.Results: One hundred twenty-five subjects were enrolled, of which 116 (93%) were Oxy-R and 51 (41%) CO2R. No difference in qCT characteristics and oxygen were observed between Oxy-R and Oxygen Non Responders (Tissue mass 1532 ±396 vs. 1654 ±304 g, p= .28; density -544±109 vs. -562±58 HU, p= .42). Similar findings were observed when dividing the population according to CO2 response (Tissue mass 1551±412 vs. 1534±377 g, p= .89; density -545±123 vs. -546±94 HU, p= .99).Conclusions: Most COVID-19 related ARDS subjects improve their oxygenation at the first pronation cycle. The study suggests that baseline qCT scan data are not associated with the response to PP in oxygenation or CO2 in mechanically ventilated COVID-19 related ARDS subje

Published
2024

34. Alactic base excess in trauma patients: a simple clinical tool to identify the presence of unmeasured anions

Author

Brunoni, B, Altomare, A, Zadek, F, Bulian, M, Baccoli, F, Bernareggi, A, Cioffi, S, Cimbanassi, S, Chiara, O, Langer, T, Fumagalli, R, Brunoni, B., Altomare, A., Zadek, F., Bulian, M., Baccoli, F., Bernareggi, A., Cioffi, SPB., Cimbanassi, S., Langer, T., Fumagalli, R., Brunoni, B, Altomare, A, Zadek, F, Bulian, M, Baccoli, F, Bernareggi, A, Cioffi, S, Cimbanassi, S, Chiara, O, Langer, T, Fumagalli, R, Brunoni, B., Altomare, A., Zadek, F., Bulian, M., Baccoli, F., Bernareggi, A., Cioffi, SPB., Cimbanassi, S., Langer, T., and Fumagalli, R.

Published
2023

35. Enhanced perioperative care in emergency general surgery: the WSES position paper

Author

Ceresoli, M, Braga, M, Zanini, N, Abu-Zidan, F, Parini, D, Langer, T, Sartelli, M, Damaskos, D, Biffl, W, Amico, F, Ansaloni, L, Balogh, Z, Bonavina, L, Civil, I, Cicuttin, E, Chirica, M, Cui, Y, De Simone, B, Di Carlo, I, Fette, A, Foti, G, Fogliata, M, Fraga, G, Fugazzola, P, Galante, J, Beka, S, Hecker, A, Jeekel, J, Kirkpatrick, A, Koike, K, Leppaniemi, A, Marzi, I, Moore, E, Picetti, E, Pikoulis, E, Pisano, M, Podda, M, Sakakushev, B, Shelat, V, Tan, E, Tebala, G, Velmahos, G, Weber, D, Agnoletti, V, Kluger, Y, Baiocchi, G, Catena, F, Coccolini, F, Ceresoli M., Braga M., Zanini N., Abu-Zidan F. M., Parini D., Langer T., Sartelli M., Damaskos D., Biffl W. L., Amico F., Ansaloni L., Balogh Z. J., Bonavina L., Civil I., Cicuttin E., Chirica M., Cui Y., De Simone B., Di Carlo I., Fette A., Foti G., Fogliata M., Fraga G. P., Fugazzola P., Galante J. M., Beka S. G., Hecker A., Jeekel J., Kirkpatrick A. W., Koike K., Leppaniemi A., Marzi I., Moore E. E., Picetti E., Pikoulis E., Pisano M., Podda M., Sakakushev B. E., Shelat V. G., Tan E., Tebala G. D., Velmahos G., Weber D. G., Agnoletti V., Kluger Y., Baiocchi G., Catena F., Coccolini F., Ceresoli, M, Braga, M, Zanini, N, Abu-Zidan, F, Parini, D, Langer, T, Sartelli, M, Damaskos, D, Biffl, W, Amico, F, Ansaloni, L, Balogh, Z, Bonavina, L, Civil, I, Cicuttin, E, Chirica, M, Cui, Y, De Simone, B, Di Carlo, I, Fette, A, Foti, G, Fogliata, M, Fraga, G, Fugazzola, P, Galante, J, Beka, S, Hecker, A, Jeekel, J, Kirkpatrick, A, Koike, K, Leppaniemi, A, Marzi, I, Moore, E, Picetti, E, Pikoulis, E, Pisano, M, Podda, M, Sakakushev, B, Shelat, V, Tan, E, Tebala, G, Velmahos, G, Weber, D, Agnoletti, V, Kluger, Y, Baiocchi, G, Catena, F, Coccolini, F, Ceresoli M., Braga M., Zanini N., Abu-Zidan F. M., Parini D., Langer T., Sartelli M., Damaskos D., Biffl W. L., Amico F., Ansaloni L., Balogh Z. J., Bonavina L., Civil I., Cicuttin E., Chirica M., Cui Y., De Simone B., Di Carlo I., Fette A., Foti G., Fogliata M., Fraga G. P., Fugazzola P., Galante J. M., Beka S. G., Hecker A., Jeekel J., Kirkpatrick A. W., Koike K., Leppaniemi A., Marzi I., Moore E. E., Picetti E., Pikoulis E., Pisano M., Podda M., Sakakushev B. E., Shelat V. G., Tan E., Tebala G. D., Velmahos G., Weber D. G., Agnoletti V., Kluger Y., Baiocchi G., Catena F., and Coccolini F.

Abstract

Enhanced perioperative care protocols become the standard of care in elective surgery with a significant improvement in patients’ outcome. The key element of the enhanced perioperative care protocol is the multimodal and interdisciplinary approach targeted to the patient, focused on a holistic approach to reduce surgical stress and improve perioperative recovery. Enhanced perioperative care in emergency general surgery is still a debated topic with little evidence available. The present position paper illustrates the existing evidence about perioperative care in emergency surgery patients with a focus on each perioperative intervention in the preoperative, intraoperative and postoperative phase. For each item was proposed and approved a statement by the WSES collaborative group.

Published
2023

36. Helmet continuous positive airway pressure for patients’ transport using a single oxygen cylinder: A bench study

Author

Capsoni, N, Zadek, F, Privitera, D, Parravicini, G, Zoccali, G, Galbiati, F, Bombelli, M, Fumagalli, R, Langer, T, Capsoni, N., Zadek, F., Privitera, D., Parravicini, G., Zoccali, G. V., Galbiati, F., Bombelli, M., Fumagalli, R., Langer, T., Capsoni, N, Zadek, F, Privitera, D, Parravicini, G, Zoccali, G, Galbiati, F, Bombelli, M, Fumagalli, R, Langer, T, Capsoni, N., Zadek, F., Privitera, D., Parravicini, G., Zoccali, G. V., Galbiati, F., Bombelli, M., Fumagalli, R., and Langer, T.

Abstract

Background: Continuous positive airway pressure (CPAP) is frequently used to treat patients with acute respiratory failure in out-of-hospital settings. Compared to a facemask, the helmet has many advantages for the patient but requires a minimum gas flow of 60 L/min to avoid CO2 rebreathing. The aim of the present bench study was to evaluate the performance of four Venturi devices, connected to a single oxygen cylinder, in delivering helmet-CPAP with clinically relevant gas flow, fraction of inspired oxygen (FiO2), and positive end-expiratory pressure (PEEP) values. Methods: Three double-inlet Venturi systems (EasyVent, Ventuplus, Compact-HAR) were connected to full 5-L oxygen cylinders using a double flowmeter, and their oxygen requirements to reach different setups (flow 60-80 L/min; FiO2 0.4-0.5-0.6, PEEP 7.5-10-12.5 cmH2O) were tested. The fourth Venturi system (O2-MAX) was directly attached to the tank, and the flow and FiO2 delivered at preset FiO2 0.3 and 0.6 were recorded. The runtime of the cylinder was assessed. Results: EasyVent, Ventuplus, and O2-MAX were able to deliver helmet-CPAP with clinically useful setups when connected to a single oxygen cylinder, while Compact-HAR did not. The runtime of the cylinders ranged between 28 and 60 minutes according to the preset flow and FiO2. The delivered gas flow decreased slowly and linearly with the drop in cylinder pressure until its exhaustion. Conclusions: Helmet-CPAP might be provided using portable Venturi systems connected to an oxygen cylinder, but not all of them are able to deliver it. The use of a double flowmeter allows delivery of both high flow and high FiO2 when double-inlet Venturi systems are used. Due to the flow drop observed during the cylinder consumption, a flow >60 L/min should be set when helmet-CPAP is started. Considering the flow drop phenomenon, the estimated duration of the tank runtime can be used with a margin of safety when planning patient transport.

Published
2023

37. Correction: Intravenous fluid therapy in patients with severe acute pancreatitis admitted to the intensive care unit: a narrative review (Annals of Intensive Care, (2022), 12, 1, (98), 10.1186/s13613-022-01072-y)

Author

Crosignani A., Crosignani, A, Spina, S, Marrazzo, F, Cimbanassi, S, Malbrain, M, Van Regenmortel, N, Fumagalli, R, Langer, T, Crosignani A., Spina S., Marrazzo F., Cimbanassi S., Malbrain M. L. N. G., Van Regenmortel N., Fumagalli R., Langer T., Crosignani A., Crosignani, A, Spina, S, Marrazzo, F, Cimbanassi, S, Malbrain, M, Van Regenmortel, N, Fumagalli, R, Langer, T, Crosignani A., Spina S., Marrazzo F., Cimbanassi S., Malbrain M. L. N. G., Van Regenmortel N., Fumagalli R., and Langer T.

Published
2023

39. Field test of quantum key distribution in the Tokyo QKD Network

Author

Sasaki, M., Fujiwara, M., Ishizuka, H., Klaus, W., Wakui, K., Takeoka, M., Tanaka, A., Yoshino, K., Nambu, Y., Takahashi, S., Tajima, A., Tomita, A., Domeki, T., Hasegawa, T., Sakai, Y., Kobayashi, H., Asai, T., Shimizu, K., Tokura, T., Tsurumaru, T., Matsui, M., Honjo, T., Tamaki, K., Takesue, H., Tokura, Y., Dynes, J. F., Dixon, A. R., Sharpe, A. W., Yuan, Z. L., Shields, A. J., Uchikoga, S., Legre, M., Robyr, S., Trinkler, P., Monat, L., Page, J. -B., Ribordy, G., Poppe, A., Allacher, A., Maurhart, O., Langer, T., Peev, M., and Zeilinger, A.

Subjects
Quantum Physics
Abstract

A novel secure communication network with quantum key distribution in a metropolitan area is reported. Different QKD schemes are integrated to demonstrate secure TV conferencing over a distance of 45km, stable long-term operation, and application to secure mobile phones., Comment: 21 pages, 19 figures

Published
2011
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40. Monopole and multipole plasmons in a two-dimensional system

Author

Pfnür, H., Langer, T., Baringhaus, J., and Tegenkamp, C.

Subjects
Condensed Matter - Mesoscale and Nanoscale Physics
Abstract

Using monolayer graphene as a model system for a purely two-dimensional (2D) electron gas, we show by energy electron loss spectroscopy, highly resolved both in energy and momentum, that there is a significant probability for the excitation of not only one but two dispersing losses. The appearance of both losses is independent of the substrate (we tested graphene on the Si face of 6H-SiC(0001), and on Ir(111) without and with intercalated Na layer), and the ratio of the slope in the dispersion curves varies between 1.4 (SiC) and 2. While the lower dispersion curve can be attributed to the excitation of the monopole plasmon, in agreement with theoretical model calculations, the upper dispersion branch has not been identified before for plasmonic excitations in a 2D electron gas, and we assign it to the excitation of a multipole sheet plasmon., Comment: 6 pages, 3 figures

Published
2011

41. Plasmon electron-hole resonance in epitaxial graphene

Author

Tegenkamp, C., Pfnuer, H., Langer, T., Baringhaus, J., and Schumacher, H. W.

Subjects
Condensed Matter - Strongly Correlated Electrons
Abstract

The quasiparticle dynamics of the sheet plasmons in epitaxially grown graphene layers on SiC(0001) have been studied systematically as a function of temperature, intrinsic defects, influence of multilayers and carrier density. The opening of the inter-band loss channel appears as a characteristic upward shift in the plasmon dispersion and a dip in the width of the loss peak, which is explained as a resonance effect in the formation of electron-hole pairs. Despite the existence of strong electronic correlations, the plasmon dispersion can be quantitatively described within the framework of a nearly free electron gas.

Published
2010

42. A SOFTWARE FOR EXTRACTING QUANTITATIVE METRICS AND RADIOMIC FEATURES IN CT IMAGES OF THE LUNG: TOOL DEVELOPMENT AND CLINICAL APPLICATIONS

Author

Berta, L., primary, Zorzi, G., additional, Rizzetto, F., additional, Sala, A., additional, Carrazza, S., additional, Cicolari, D., additional, De Mattia, C., additional, Felisi, M.M.J., additional, Zadek, F., additional, Langer, T., additional, Lizio, D., additional, Lenardi, C., additional, Vanzulli, A., additional, Torresin, A., additional, and Colombo, P.E., additional

Published
2023
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46. Comprehensive assessments and related interventions to enhance the long-term outcomes of child, adolescent and young adult cancer survivors – presentation of the CARE for CAYA-Program study protocol and associated literature review

Author

Salchow, J., Mann, J., Koch, B., von Grundherr, J., Jensen, W., Elmers, S., Straub, L. A., Vettorazzi, E., Escherich, G., Rutkowski, S., Dwinger, S., Bergelt, C., Sokalska-Duhme, M., Bielack, S., Calaminus, G., Baust, K., Classen, C. F., Rössig, C., Faber, J., Faller, H., Hilgendorf, I., Gebauer, J., Langer, T., Metzler, M., Schuster, S., Niemeyer, C., Puzik, A., Reinhardt, D., Dirksen, U., Sander, A., Köhler, M., Habermann, J. K., Bokemeyer, C., and Stein, A.

Published
2020
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