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Efficient generation of phonons is an important ingredient for a prospective electrically-driven phonon laser. Hybrid quantum systems combining cavity quantum electrodynamics and optomechanics constitute a novel platform with potential for operation at the extremely high frequency range (30–300 GHz). We report on laser-like phonon emission in a hybrid system that optomechanically couples polariton Bose-Einstein condensates (BECs) with phonons in a semiconductor microcavity. The studied system comprises GaAs/AlAs quantum wells coupled to cavity-confined optical and vibrational modes. The non-resonant continuous wave laser excitation of a polariton BEC in an individual trap of a trap array, induces coherent mechanical self-oscillation, leading to the formation of spectral sidebands displaced by harmonics of the fundamental 20 GHz mode vibration frequency. This phonon “lasing” enhances the phonon occupation five orders of magnitude above the thermal value when tunable neighbor traps are red-shifted with respect to the pumped trap BEC emission at even harmonics of the vibration mode. These experiments, supported by a theoretical model, constitute the first demonstration of coherent cavity optomechanical phenomena with exciton polaritons, paving the way for new hybrid designs for quantum technologies, phonon lasers, and phonon-photon bidirectional translators. Efficient generation of phonons is an important ingredient for a prospective electrically-driven phonon laser for coherent control of quantum systems. Here, the authors report on laser-like phonon emission in a hybrid semiconductor microcavity that optomechanically couples BEC polaritons with phonons.

The harmonic modulation of coherent systems gives rise to a wealth of physical phenomena, e.g., the AC-Stark effect and Mollow triplets, with important implications for coherent control and frequency conversion. Here, we demonstrate a novel regime of temporal coherence in oscillators harmonically driven at extreme energy modulation amplitudes relative to the modulation quantum. The studies were carried out by modulating a confined exciton-polariton Bose-Einstein condensate (BEC) by an acoustic wave. Features of the new regime are the appearance, in the spectral domain, of a comb of resonances termed acceleration beats with energy spacing tunable by the modulation amplitude and, in the time domain, of temporal correlations at time scales much shorter than the acoustic period, which also depend on the modulation amplitude. These features are quantitatively accounted for by a theoretical framework, which associates the beats with accelerated energy-change rates during the harmonic cycle. These observations are underpinned by the high sensitivity of the BEC energy to the acoustic driving, which simultaneously preserves the BEC’s temporal coherence. The acceleration beats are a general feature associated with accelerated energy changes: analogous features are thus also expected to appear under highly accelerated motion e.g., in connection with Cherenkov and Hawking radiation. The authors demonstrate a novel regime of coherent harmonic modulation yielding resonances (termed acceleration beats) with energy spacing and temporal correlations controlled by the modulation amplitude. These features are associated with accelerated energy-change rates during the harmonic cycle.

Microcavity polaritons are composite half-light half-matter quasiparticles, which have recently been demonstrated to exhibit rich physical properties, such as non-equilibrium condensation, parametric scattering and superfluidity. At the same time, polaritons have important advantages over photons for information processing, because their excitonic component leads to weaker diffraction and stronger interparticle interactions, implying, respectively, tighter localization and lower powers for nonlinear functionality. Here, we present the first experimental observations of bright polariton solitons in a strongly coupled semiconductor microcavity. The polariton solitons are shown to be micrometre-scale localized non-diffracting wave packets with a corresponding broad spectrum in momentum space. Unlike the solitons known in Bose condensed atomic gases, they are non-equilibrium and rely on a balance between losses and external pumping. Microcavity polariton solitons are excited on picosecond timescales, and thus have further benefits for information processing over light-only solitons in semiconductor cavity lasers, which have nanosecond response times. Scientists present the first experimental observations of bright polariton solitons in a strongly coupled semiconductor microcavity. The findings should pave the way to the investigation of a variety of fundamental phenomena, such as interactions between solitons with different spins and the formation of soliton molecules.

ObjectiveEndoscopic ultrasonography (EUS) and MRI are promising tests to detect precursors and early-stage pancreatic ductal adenocarcinoma (PDAC) in high-risk individuals (HRIs). It is unclear which screening technique is to be preferred. We aimed to compare the efficacy of EUS and MRI in their ability to detect clinically relevant lesions in HRI.DesignMulticentre prospective study. The results of 139 asymptomatic HRI (>10-fold increased risk) undergoing first-time screening by EUS and MRI are described. Clinically relevant lesions were defined as solid lesions, main duct intraductal papillary mucinous neoplasms and cysts ≥10 mm. Results were compared in a blinded, independent fashion.ResultsTwo solid lesions (mean size 9 mm) and nine cysts ≥10 mm (mean size 17 mm) were detected in nine HRI (6%). Both solid lesions were detected by EUS only and proved to be a stage I PDAC and a multifocal pancreatic intraepithelial neoplasia 2. Of the nine cysts ≥10 mm, six were detected by both imaging techniques and three were detected by MRI only. The agreement between EUS and MRI for the detection of clinically relevant lesions was 55%. Of these clinically relevant lesions detected by both techniques, there was a good agreement for location and size.ConclusionsEUS and/or MRI detected clinically relevant pancreatic lesions in 6% of HRI. Both imaging techniques were complementary rather than interchangeable: contrary to EUS, MRI was found to be very sensitive for the detection of cystic lesions of any size; MRI, however, might have some important limitations with regard to the timely detection of solid lesions.

Lattices of exciton-polariton condensates represent an attractive platform for the study and implementation of non-Hermitian bosonic quantum systems with strong non-linear interactions. The possibility to actuate on them with a time dependent drive could provide for example the means to induce resonant inter-level transitions, or to perform Floquet engineering or Landau-Zener-Stückelberg state preparation. Here, we introduce polaromechanical metamaterials, two-dimensional arrays of μ m-sized traps confining zero-dimensional light-matter polariton fluids and GHz phonons. A strong exciton-mediated polariton-phonon interaction induces a time-dependent inter-site polariton coupling J ( t ) with remarkable consequences for the dynamics. When locally perturbed by continuous wave optical excitation, a mechanical self-oscillation sets-in and polaritons respond by locking the energy detuning between neighbor sites at integer multiples of the phonon energy, evidencing asynchronous locking involving the polariton and phonon fields. These results open the path for the coherent control of dissipative quantum light fluids with hypersound in a scalable platform. Exciton-polariton condensates are hybrid systems with nonlinear interactions. Here the authors demonstrate metamaterials with inter-site polariton coupling and asynchronous locking of light fluids from neighbor sites at the energy detuning.

Weekly chemotherapy and concurrent radiotherapy for 5 weeks before curative resection in patients with esophageal or esophagogastric-junction cancer resulted in a pathologically complete response in 29% of patients and doubled the median overall survival to 4 years. With new diagnoses in more than 480,000 patients annually, esophageal cancer is the eighth most common cancer worldwide. 1 It is a highly lethal disease, causing more than 400,000 deaths per year. 2 The incidence of esophageal adenocarcinoma is rapidly rising, whereas that of squamous-cell carcinoma remains unchanged. 3 Despite adequate preoperative staging, 25% of patients treated with primary surgery have microscopically positive resection margins (R1), and the 5-year survival rate rarely exceeds 40%. 4 The role of neoadjuvant chemoradiotherapy has been debated for several decades. In most randomized trials, no survival benefit could be shown, and the trials were criticized for inadequate trial . . .

Sessile serrated polyps (SSPs) are suggested to be the precursors of 15-30% of all colorectal cancers (CRCs). Therefore, CRC screening modalities should also be designed to detect high-risk SSPs. We compared computed tomography colonography (CTC) with colonoscopy-based screening for the detection of high-risk SSPs in average-risk individuals. Data from a randomized controlled trial that compared CTC with colonoscopy for population screening were used for the analysis. Individuals diagnosed at CTC with a lesion ≥10 mm in size were referred for colonoscopy. Individuals with only 6-9 mm lesions were offered surveillance CTC. This surveillance CTC was followed by a colonoscopy when a lesion ≥6 mm was detected. Yield of both was accumulated to mimic current American College of Radiology CTC referral strategy (referral of individuals with any lesion ≥6 mm). Per participant detection of ≥1 high-risk (dysplastic and/or ≥10 mm) SSP was compared with colonoscopy using multiple logistic regression analysis. In total, 8,844 individuals were invited to participate (in 2:1 allocation), of which 1,276 colonoscopy and 982 CTC invitees participated in the study. In the colonoscopy arm, 4.3% of individuals were diagnosed with ≥1 high-risk SSP, compared with 0.8% in the CTC arm (odds ratio (OR) 5.5; 95% confidence interval (CI) 2.6-11.6; P<0.001). In total, 3.1% of individuals in the colonoscopy arm were diagnosed with high-risk SSPs as most advanced lesion, compared with 0.4% in the CTC arm (OR 7.7; 95% CI 2.7-21.6; P<0.001). The current CTC strategy showed a marked lower detection for especially flat high-risk SSPs (17 vs. 0), high-risk SSP located in the proximal colon (32 vs. 1), and SSPs with dysplasia (30 vs. 1). In a randomized controlled setting, the detection rate of high-risk SSPs was significantly higher with colonoscopy than CTC. These results might have implications for CTC as a CRC modality for opportunistic screening in average-risk adults.

Background Occasionally patients undergoing resection for presumed malignancy of the pancreatic head are diagnosed postoperatively with benign disease. Autoimmune pancreatitis (AIP) is a rare disease that mimics pancreatic cancer. We aimed to determine the prevalence of benign disease and AIP in patients who underwent pancreatoduodenectomy (PD) over a 9-year period, and to explore if and how surgery could have been avoided. Methods All patients undergoing PD between 2000 and 2009 in a tertiary referral centre were analyzed retrospectively. In cancer-negative cases, postoperative diagnosis was reassessed. Preoperative index of suspicion of malignancy was scored as non-specific, suggestive, or high. In AIP patients, diagnostic criteria systems were checked. Results A total of 274 PDs were performed for presumed malignancy. The prevalence of benign disease was 8.4 %, overall prevalence of AIP was 2.6 %. Based on preoperative index of suspicion of malignancy, surgery could have been avoided in 3 non-AIP patients. All AIP patients had sufficient index to justify surgery. If diagnostic criteria would have been checked; however, surgery could have been avoided in one to five AIP patients. Conclusions The prevalence of benign disease in patients who underwent PD for presumed malignancy was 8.4 %, nearly one-third attributable to AIP. Although misdiagnosis of AIP as carcinoma is a problem of limited quantitative importance, every effort to establish the correct diagnosis should be undertaken considering the major therapeutic consequences. IgG4 measurement and systematic use of diagnostic criteria systems are recommended for every candidate patient for PD when there is no histological proof of malignancy.

Background: Identification of tumour antigens is crucial for the development of vaccination strategies against hepatocellular carcinoma (HCC). Most studies come from eastern-Asia, where hepatitis-B is the main cause of HCC. However, tumour antigen expression is poorly studied in low-endemic, western areas where the aetiology of HCC differs. Methods: We constructed tissue microarrays from resected HCC tissue of 133 patients. Expression of a comprehensive panel of cancer-testis (MAGE-A1, MAGE-A3/4, MAGE-A10, MAGE-C1, MAGE-C2, NY-ESO-1, SSX-2, sperm protein 17), onco-fetal (AFP, Glypican-3) and overexpressed tumour antigens (Annexin-A2, Wilms tumor-1, Survivin, Midkine, MUC-1) was determined by immunohistochemistry. Results: A higher prevalence of MAGE antigens was observed in patients with hepatitis-B. Patients with expression of more tumour antigens in general had better HCC-specific survival ( P =0.022). The four tumour antigens with high expression in HCC and no, or weak, expression in surrounding tumour-free-liver tissue, were Annexin-A2, GPC-3, MAGE-C1 and MAGE-C2, expressed in 90, 39, 17 and 20% of HCCs, respectively. Ninety-five percent of HCCs expressed at least one of these four tumour antigens. Interestingly, GPC-3 was associated with SALL-4 expression ( P =0.001), an oncofetal transcription factor highly expressed in embryonal stem cells. SALL-4 and GPC-3 expression levels were correlated with vascular invasion, poor differentiation and higher AFP levels before surgery. Moreover, patients who co-expressed higher levels of both GPC-3 and SALL-4 had worse HCC-specific survival ( P =0.018). Conclusions: We describe a panel of four tumour antigens with excellent coverage and good tumour specificity in a western area, low-endemic for hepatitis-B. The association between GPC-3 and SALL-4 is a novel finding and suggests that GPC-3 targeting may specifically attack the tumour stem-cell compartment.

The complex structure of the valence band in many semiconductors leads to multifaceted and unusual properties for spin-3/2hole systems compared to common spin-1/2electron systems. In particular, two-dimensional hole systems show a highly anisotropic Zeeman interaction. We have investigated this anisotropy inGaAs/AlAsquantum well structures both experimentally and theoretically. By performing time-resolved Kerr rotation measurements, we found a nondiagonal tensorgthat manifests itself in unusual precessional motion, as well as distinct dependencies of hole-spin dynamics on the direction of the magnetic fieldB. We quantify the individual components of the tensorgfor [113]-, [111]-, and [110]-grown samples. We complement the experiments by a comprehensive theoretical study of Zeeman coupling in in-plane and out-of-plane fieldsB. To this end, we develop a detailed multiband theory for the tensorg. Using perturbation theory, we derive transparent analytical expressions for the components of the tensorgthat we complement with accurate numerical calculations based on our theoretical framework. We obtain very good agreement between experiment and theory. Our study demonstrates that the tensorgis neither symmetric nor antisymmetric. Opposite off-diagonal components can differ in size by up to an order of magnitude. The tensorgencodes not only the Zeeman energy splitting but also the direction of the axis about which the spins precess in the external fieldB. In general, this axis is not aligned withB. Hence our study extends the general concept of optical orientation to the regime of nontrivial Zeeman coupling.