Force‐sensing catheters during pediatric radiofrequency ablation: The FEDERATION Study

Background Based on data from studies of atrial fibrillation ablations, optimal parameters for the TactiCath (TC; St. Jude Medical, Inc) force‐sensing ablation catheter are a contact force of 20 g and a force‐time integral of 400 g·s for the creation of transmural lesions. We aimed to evaluate TC in pediatric and congenital heart disease patients undergoing ablation. Methods and Results Comprehensive chart and case reviews were performed from June 2015 to March 2016. Of the 102 patients undergoing electrophysiology study plus ablation, 58 (57%) underwent ablation initially with a force‐sensing catheter. Patients had an average age of 14 (2.4–23) years and weight of 58 (18–195) kg with 15 patients having abnormal cardiac anatomy. Electrophysiology diagnoses for the + TC group included 30 accessory pathway–mediated tachycardia, 24 atrioventricular nodal reentrant tachycardia, and 7 other. Baseline generator settings included a power of 20 W, temperature of 40°, and 6 cc/min flow during lesion creation with 11 patients (19%) having alterations to parameters. Seventeen patients (30%) converted to an alternate ablation source. A total of 516 lesions were performed using the TC with a median contact force of 6 g, force‐time integral of 149 g·s, and lesion size index of 3.3. Median‐term follow‐up demonstrated 5 (10%) recurrences with no acute or median‐term complications. Conclusions TactiCath can be effectively employed in the treatment of pediatric patients with congenital heart disease with lower forces than previously described in the atrial fibrillation literature. Patients with atrioventricular nodal reentrant tachycardia or atrioventricular reciprocating tachycardia may not require transmural lesions and the TC may provide surrogate markers for success during slow pathway ablation. </jats:sec

Role of Large Gluonic Excitation Energy for Narrow Width of Penta-Quark Baryons in QCD String Theory

We study the narrow decay width of low-lying penta-quark baryons in the QCD string theoryin terms of gluonic excitations. In the QCD string theory, the penta-quark baryon decays via a gluonic-excited state of a baryon and meson system, where a pair of Y-shaped junction and anti-junction is created. Since lattice QCD shows that the lowest gluonic-excitation energy takes a large value of about 1 GeV, the decay of the penta-quark baryon near the threshold is considered as a quantum tunneling process via a highly-excited state (a gluonic-excited state) in the QCD string theory. This mechanism strongly suppresses the decay and leads to an extremely narrow decay width of the penta-quark system.Comment: Talk given at International Conference on the Structure of Baryons (Baryons 04) October 25 - 29, 2004, Ecole Polytechnique, Palaiseau, Franc

An analytical study of resonant transport of Bose-Einstein condensates

We study the stationary nonlinear Schr\"odinger equation, or Gross-Pitaevskii equation, for a one--dimensional finite square well potential. By neglecting the mean--field interaction outside the potential well it is possible to discuss the transport properties of the system analytically in terms of ingoing and outgoing waves. Resonances and bound states are obtained analytically. The transmitted flux shows a bistable behaviour. Novel crossing scenarios of eigenstates similar to beak--to--beak structures are observed for a repulsive mean-field interaction. It is proven that resonances transform to bound states due to an attractive nonlinearity and vice versa for a repulsive nonlinearity, and the critical nonlinearity for the transformation is calculated analytically. The bound state wavefunctions of the system satisfy an oscillation theorem as in the case of linear quantum mechanics. Furthermore, the implications of the eigenstates on the dymamics of the system are discussed.Comment: RevTeX4, 16 pages, 19 figure

Casimir-Polder force density between an atom and a conducting wall

In this paper we calculate the Casimir-Polder force density (force per unit area acting on the elements of the surface) on a metallic plate placed in front of a neutral atom. To obtain the force density we use the quantum operator associated to the electromagnetic stress tensor. We explicitly show that the integral of this force density over the plate reproduces the total force acting on the plate. This result shows that, although the force is obtained as a sum of surface element-atom contributions, the stress-tensor method includes also nonadditive components of Casimir-Polder forces in the evaluation of the force acting on a macroscopic object.Comment: 5 page

On the vanishing viscosity limit in a disk

We say that the solution u to the Navier-Stokes equations converges to a solution v to the Euler equations in the vanishing viscosity limit if u converges to v in the energy norm uniformly over a finite time interval. Working specifically in the unit disk, we show that a necessary and sufficient condition for the vanishing viscosity limit to hold is the vanishing with the viscosity of the time-space average of the energy of u in a boundary layer of width proportional to the viscosity due to modes (eigenfunctions of the Stokes operator) whose frequencies in the radial or the tangential direction lie between L and M. Here, L must be of order less than 1/(viscosity) and M must be of order greater than 1/(viscosity)

Effective health care for older people resident in care homes: the optimal study protocol for realist review

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background: Care homes in the UK rely on general practice for access to specialist medical and nursing care as well as referral to therapists and secondary care. Service delivery to care homes is highly variable in both quantity and quality. This variability is also evident in the commissioning and organisation of care home-specific services that range from the payment of incentives to general practitioners (GPs) to visit care homes, to the creation of care home specialist teams and outreach services run by geriatricians. No primary studies or systematic reviews have robustly evaluated the impact of these different approaches on organisation and resident-level outcomes. Our aim is to identify factors which may explain the perceived or demonstrated effectiveness of programmes to improve health-related outcomes in older people living in care homes. Methods/Design: A realist review approach will be used to develop a theoretical understanding of what works when, why and in what circumstances. Elements of service models of interest include those that focus on assessment and management of residents’ health, those that use strategies to encourage closer working between visiting health care providers and care home staff, and those that address system-wide issues about access to assessment and treatment. These will include studies on continence, dignity, and speech and language assessment as well as interventions to promote person centred dementia care, improve strength and mobility, and nutrition. The impact of these interventions and their different mechanisms will be considered in relation to five key outcomes: residents’ medication use, use of out of hours’ services, hospital admissions (including use of Accident and Emergency) and length of hospital stay, costs and user satisfaction. An iterative three-stage approach will be undertaken that is stakeholder-driven and optimises the knowledge and networks of the research team. Discussion: This realist review will explore why and for whom different approaches to providing health care to residents in care homes improves access to health care in the five areas of interest. It will inform commissioning decisions and be the basis for further research. This systematic review protocol is registered on the PROSPERO database reference number: CRD42014009112NIHR Health Services & Delivery Research Programme. Project number 11/1021/0

Associations involving delays (particularly long delays) between certain weather parameters and geomagnetic activity

Four sunspot-minimum periods (1963-1966, 1971-1977, 1983-1987 and 1992-1997) have been examined for the results which are presented. Using several different weather parameters, tropospheric gravity waves, enhanced cold fronts and two rainfall data sets in Eastern Australia, associations at reasonably high levels of significance have been found with enhanced geomagnetic activity (EGA). Statistically this EGA involved either short delays of several days or long delays of about 20 days. The geomagnetic parameters used were (a) the AE index (b) the hourly H component for a number of stations and (c) the daily K-P-sum value. The K-P-sum analyses have shown that the EGA associated with the delays form part of four or five cycles of recurrent geomagnetic activity for 27-day periodicities. Furthermore statistically two recurrent cycles are found to exist concurrently, one apparently related to the short delays and the other to the long delays. Periodicities of 13.5 days are created because the two sets are displaced from each other by approximately this interval. A brief reference is made to the 13.5 periodicity known to exist for geomagnetic activity and the evidence in the literature for active regions on the sun to be displaced by 180 degrees of solar longitude

Nonlinear Scattering of a Bose-Einstein Condensate on a Rectangular Barrier

We consider the nonlinear scattering and transmission of an atom laser, or Bose-Einstein condensate (BEC) on a finite rectangular potential barrier. The nonlinearity inherent in this problem leads to several new physical features beyond the well-known picture from single-particle quantum mechanics. We find numerical evidence for a denumerably infinite string of bifurcations in the transmission resonances as a function of nonlinearity and chemical potential, when the potential barrier is wide compared to the wavelength of oscillations in the condensate. Near the bifurcations, we observe extended regions of near-perfect resonance, in which the barrier is effectively invisible to the BEC. Unlike in the linear case, it is mainly the barrier width, not the height, that controls the transmission behavior. We show that the potential barrier can be used to create and localize a dark soliton or dark soliton train from a phonon-like standing wave.Comment: 15 pages, 15 figures, new version includes clarification of definition of transmission coefficient in general nonlinear vs. linear cas

An Exactly Conservative Integrator for the n-Body Problem

The two-dimensional n-body problem of classical mechanics is a non-integrable Hamiltonian system for n > 2. Traditional numerical integration algorithms, which are polynomials in the time step, typically lead to systematic drifts in the computed value of the total energy and angular momentum. Even symplectic integration schemes exactly conserve only an approximate Hamiltonian. We present an algorithm that conserves the true Hamiltonian and the total angular momentum to machine precision. It is derived by applying conventional discretizations in a new space obtained by transformation of the dependent variables. We develop the method first for the restricted circular three-body problem, then for the general two-dimensional three-body problem, and finally for the planar n-body problem. Jacobi coordinates are used to reduce the two-dimensional n-body problem to an (n-1)-body problem that incorporates the constant linear momentum and center of mass constraints. For a four-body choreography, we find that a larger time step can be used with our conservative algorithm than with symplectic and conventional integrators.Comment: 17 pages, 3 figures; to appear in J. Phys. A.: Math. Ge