Pulsed Photoconductive Connected Slot Array Operating at the Sub-mm Wavelength Band

A novel pulsed photoconductive THz source is presented that is able to radiate mW-level average powers, over a large bandwidth by exploiting both the optical and electrical properties of photoconductive sources and the ultrawideband properties of connected antenna arrays. An optical system composed of a micro-lenses array splits the laser beam into N x N spots that host the active excitation of the antenna arrays. An “ad hoc” network has been adopted to bias the array active spots in order to implement a connected antenna array configuration. The array feeds a silicon lens to increase the directivity of the radiated THz beam. A slot array prototype has been designed, fabricated, and measured. The proposed solutions achieve excellent power radiation levels by making use of an accurate electromagnetic design. This solution can offer enhancements to any active system relying on pulsed photoconductive antennas

Carcínossarcoma uterino pós-radioterapia - Apresentação de um caso

O carcinossarcoma uterino é neoplasia rara; apresenta em sua estrutura elementos indiferenciados do estroma endometrial e elementos sarcomatosos homólogos ao útero. A taxa observada de aparecimento destas lesões na população é de 0,8 por 100 mil mulheres. Ocorre com freqüência maior entre as mulheres que se submeteram à radioterapia, atingindo a taxa de 4,3 por 100 mil mulheres nesta população selecionada. A relação entre a radioterapia e o desenvolvimento de carcinossarcoma uterino não pode ser comprovada estatisticamente, dada à raridade da neoplasia, mas provavelmente a radioterapia é um importante fator para o desenvolvimento posterior de tais tumores. Por essa razão, é fundamental o acompanhamento a longo prazo de mulheres que se submeteram à radioterapia pélvica. Apresentamos o caso de uma paciente tratada de câncer de colo uterino há 14 anos, com radioterapia exclusiva, e que retornou ao serviço apresentando carcinossarcoma uterino

Chiral superconductivity from repulsive interactions in doped graphene

Author Manuscript 17 Sep 2011Chiral superconductivity, which breaks time-reversal symmetry, can exhibit a wealth of fascinating properties that are highly sought after for nanoscience applications. We identify doped graphene monolayer as a system where chiral superconductivity can be realized. In this material, a unique situation arises at a doping where the Fermi surface is nested and the density of states is singular. In this regime, d-wave superconductivity can emerge from repulsive electron–electron interactions. Using a renormalization group method, we argue that superconductivity dominates over all competing orders for generic weak repulsive interactions. Superconductivity develops simultaneously in two degenerate d-wave pairing channels. We argue that the resulting superconducting state is of chiral type, with the phase of the superconducting order parameter winding by 4π around the Fermi surface. Realization of this state in doped graphene will prove that superconductivity can emerge from electron–electron repulsion, and will open the door to applications of chiral superconductivity

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to 300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m 2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial

Aims  The third Universal Definition of Myocardial Infarction (MI) Task Force classified MIs into five types: Type 1, spontaneous; Type 2, related to oxygen supply/demand imbalance; Type 3, fatal without ascertainment of cardiac biomarkers; Type 4, related to percutaneous coronary intervention; and Type 5, related to coronary artery bypass surgery. Low-density lipoprotein cholesterol (LDL-C) reduction with statins and proprotein convertase subtilisin–kexin Type 9 (PCSK9) inhibitors reduces risk of MI, but less is known about effects on types of MI. ODYSSEY OUTCOMES compared the PCSK9 inhibitor alirocumab with placebo in 18 924 patients with recent acute coronary syndrome (ACS) and elevated LDL-C (≥1.8 mmol/L) despite intensive statin therapy. In a pre-specified analysis, we assessed the effects of alirocumab on types of MI. Methods and results  Median follow-up was 2.8 years. Myocardial infarction types were prospectively adjudicated and classified. Of 1860 total MIs, 1223 (65.8%) were adjudicated as Type 1, 386 (20.8%) as Type 2, and 244 (13.1%) as Type 4. Few events were Type 3 (n = 2) or Type 5 (n = 5). Alirocumab reduced first MIs [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.77–0.95; P = 0.003], with reductions in both Type 1 (HR 0.87, 95% CI 0.77–0.99; P = 0.032) and Type 2 (0.77, 0.61–0.97; P = 0.025), but not Type 4 MI. Conclusion  After ACS, alirocumab added to intensive statin therapy favourably impacted on Type 1 and 2 MIs. The data indicate for the first time that a lipid-lowering therapy can attenuate the risk of Type 2 MI. Low-density lipoprotein cholesterol reduction below levels achievable with statins is an effective preventive strategy for both MI types.For complete list of authors see http://dx.doi.org/10.1093/eurheartj/ehz299</p