Pitfall of vertebral artery insonation: Bidirectional flow without subclavian artery pathology

SummaryBackgroundA bidirectional flow pattern within the intracranial segment of the vertebral artery (V4–VA) should be indicative of a proximal steno-occlusive disorder of the ipsilateral subclavian artery (SA). Here we present two patients revealing this ultrasound finding without evidence of a specific SA pathology.Methods/case reportsIn case 1 duplex sonography revealed a diameter of the left V2–VA of 3.3mm and 2.7mm on the right side. Normal flow signals were detected in the left V2–VA, a systolic flow deceleration was seen on the right side. Intracranially, a biphasic flow pattern was observed in the right V4–VA. The left V4–VA, the basilar artery and the brachial arteries (BrA) as well as the cuff-test were normal. Conventional angiography ruled out a SA or VA pathology. A bilateral fetal-type posterior cerebral artery (FT-PCA) was seen. CT angiography demonstrated a small diameter of the right intracranial V4–VA close to the basilar confluens.In case 2 VA diameter of the left and right V2–VA was 3.3 and 2.3mm, respectively. Flow signals, similar to case 1 were observed in the non-dominant V2–VA and V4–VA segment. The remaining vessels and the cuff-test were normal. MR angiography demonstrated a FT-PCA and an incomplete posterior inferior cerebellar artery (PICA)-ending VA on the right side.ConclusionsA bidirectional flow in V4–VA can not prove a subclavian steal phenomenon. A normal triphasic flow signal of the brachial artery excludes a relevant proximal obstruction of the SA. Also, diameter measurements of the VA are mandatory.It seems that physiological variants of the vertebrobasilar circulation like a VA hypoplasia, PICA-ending VA or FT-PCA might also cause the above type of VA flow pattern

Pattern of Activated Pathways and Quality of Collateral Status in Patients with Symptomatic Internal Carotid Artery Occlusion

Background: Internal carotid artery occlusion (ICAO) is an important risk factor for stroke. Cerebral hemodynamics in patients with ICAO depends on the individual capacity to activate sufficient collateral pathways. Therefore, the assessment of intracranial collaterals is essential for the acute and long-term management of these patients and accurate estimation of further stroke risk. Methods: Acute stroke patients with unilateral ICAO were prospectively enrolled. We assessed the following collaterals by transcranial color-coded sonography (TCCS): the anterior and posterior communicating artery (ACoA, PCoA), the ophthalmic artery (OA), and leptomeningeal collaterals of the posterior cerebral artery (LMC). We subdivided the flow pattern of the Doppler spectrum in the middle cerebral artery (MCA) into 3 categories: (1) good, (2) moderate, and (3) bad according to the hemodynamic effects on the ipsilateral MCA flow. Finally, we compared the individual TCCS results with the stroke pattern detected on CT or MRI scan. Results: One hundred thirteen patients (age 66 +/- 12 years; female 24) were included. The collateral status was good, moderate, and bad in 59 (52%), 37 (33%), and 17 (15%) patients, respectively. The ACoA collateral was most frequently activated (81%), followed by the OA (63%), the PCoA (53%), and the LMC (22%). The quality of the collateral status was determined by the type (p = 0.0003) but not by the number (p = 0.19) of activated collateral pathways. Good collateral function was highly associated with primary collaterals (ACoA > PCoA). Best parameter for a good collateral status was an antegrade flow in the OA, indicating a high blood supply via the communicating arteries. Conclusions: TCCS allows the assessment of intracranial collaterals and their hemodynamic capacity. Prevalence of collateral sufficiency in ICAO seems to be higher than previously reported. ACoA cross flow is essential for the optimal hemodynamic compensation of ICAO. Antegrade OA flow indicates good collateral status

Effect of the quantum well thickness on the performance of InGaN photovoltaic cells

International audienceWe report on the influence of the quantum well thickness on the effective band gap and conversion efficiency of In0.12Ga0.88N/GaN multiple quantum well solar cells. The band-to-band transition can be redshifted from 395 to 474 nm by increasing the well thickness from 1.3 to 5.4 nm, as demonstrated by cathodoluminescence measurements. However, the redshift of the absorption edge is much less pronounced in absorption: in thicker wells, transitions to higher energy levels dominate. Besides, partial strain relaxation in thicker wells leads to the formation of defects, hence degrading the overall solar cell performance. InGaN alloys are considered as promising candidates for high-efficiency photovoltaic devices [1-4] since their band gap spans almost the whole solar spectrum from 0.7 eV (InN) to 3.4 eV (GaN). This makes theoretically possible the development of all-InGaN multijunction solar cells with a freely customizable number of junctions to enhance the overall efficiency. However, the large lattice mismatch between GaN and InN has led several groups to study the possibility of hybrid integration, combining an InGaN cell in a tandem device with silicon [5,6] or other non-III-nitride [7] photovoltaic cells. The difficulty of growing high-quality InGaN layers increases with the In content. Reports of InGaN-based junctions with an In mole fraction exceeding 0.3 are rare [1]; the best external quantum efficiencies (EQEs) exceeding 0.7 are obtained at around 400 nm and quickly drop for longer wavelengths [8-10]. The main challenges are the large dislocation density and In-clustering, caused by the strong tendency to phase separation during growth. Absorbing layers in the form of a multiple quantum well (MQW) structure are often used to delay strain relaxation. Furthermore, the quantum confined Stark effect (QCSE) associated to the strong piezoelectric fields in the InGaN/GaN system [11] offers the possibility to tune the effective band gap of the structure by adjusting the quantum well (QW) and barrier thickness (tQW and tB, respectively). The effect of tuning tB in InGaN/GaN MQW photovoltaic devices has been studied by Wierer et al. [12] and Watanabe et al. [13]. According to their results, the absorption cutoff of the solar cells redshifts with decreasing tB. However, this does not always translate in enhanced overall cell efficiency, since the short circuit current density (Jsc) and open circuit voltage (Voc) also depend on tB. In this paper, we focus on the influence of the QW thickness on the effective band gap of the junction and its impact on the overall cell efficiency. We experimentally demonstrate that the band-to-band transition in InGaN QWs can be significantly redshifted in larger QWs. However, this redshift appears linked to a dramatic enlargement of the Stokes shift, so that increasing the tQW above a few nm is n

Influence of the AlN interlayer thickness on the photovoltaic properties of in-rich AlInN on Si heterojunctions deposited by RF sputtering

8 pags., 5 figs., 1 tab.We report the influence of the AlN interlayer thickness (0-15 nm) on the photovoltaic properties of AlInN on Si heterojunction solar cells deposited by radio frequency sputtering. The poor junction band alignment and the presence of a 2-3 nm thick amorphous layer at the interface mitigates the response in devices fabricated by direct deposition of n-AlInN on p-Si(111). Adding a 4-nm-thick AlN buffer layer improves the AlInN crystalline quality and the interface alignment leading to devices with a conversion efficiency of 1.5% under 1-sun AM1.5G illumination. For thicker buffers the performance lessens due to inefficient tunnel transport through the AlN. These results demonstrate the feasibility of using In-rich AlInN alloys deposited by radio frequency sputtering as novel electron-selective contacts to Si-heterojunction solar cells.Support from projects NitPho (TEC2014-60483-R), ANOMALOS (TEC2015- 71127-C2-2-R), INFRASIL (TEC 2013-41730-R), SINFOTON (S2013/MIT 2790), MADRID-PV (2013/MAE-2780), PhotoAl (CCG2015/EXP-014), PAI research group (TEP-946 INNANOMAT), and FEDER-EU is acknowledged. TEM data were taken at DME-SC-ICyT-UCA. A. Nuñez- ˜ Cascajero thanks her grant to the University of Alcala and D. Montero acknowledges his contract ´ BES-2014-067585

Influence of the AlN interlayer thickness on the photovoltaic properties of In-rich AlInN on Si heterojunctions deposited by RF sputtering

We report the influence of the AlN interlayer thickness (0-15 nm) on the photovoltaic properties of Al0.37In0.63N on Si heterojunction solar cells deposited by radio frequency sputtering. The poor junction band alignment and the presence of a 2-3 nm thick amorphous layer at the interface mitigates the response in devices fabricated by direct deposition of n-AlInN on p-Si(111). Adding a 4-nm-thick AlN buffer layer improves the AlInN crystalline quality and the interface alignment leading to devices with a conversion efficiency of 1.5% under 1-sun AM1.5G illumination. For thicker buffers the performance lessens due to inefficient tunnel transport through the AlN. These results demonstrate the feasibility of using In-rich AlInN alloys deposited by radio frequency sputtering as novel electron-selective contacts to Si-heterojunction solar cells

An anatomy-based lumped parameter model of cerebrospinal venous circulation: can an extracranial anatomical change impact intracranial hemodynamics?

Background The relationship between extracranial venous system abnormalities and central nervous system disorders has been recently theorized. In this paper we delve into this hypothesis by modeling the venous drainage in brain and spinal column areas and simulating the intracranial flow changes due to extracranial morphological stenoses. Methods A lumped parameter model of the cerebro-spinal venous drainage was created based on anatomical knowledge and vessels diameters and lengths taken from literature. Each vein was modeled as a hydraulic resistance, calculated through Poiseuille’s law. The inputs of the model were arterial flow rates of the intracranial, vertebral and lumbar districts. The effects of the obstruction of the main venous outflows were simulated. A database comprising 112 Multiple Sclerosis patients (Male/Female = 42/70; median age ± standard deviation = 43.7 ± 10.5 years) was retrospectively analyzed. Results The flow rate of the main veins estimated with the model was similar to the measures of 21 healthy controls (Male/Female = 10/11; mean age ± standard deviation = 31 ± 11 years), obtained with a 1.5 T Magnetic Resonance scanner. The intracranial reflux topography predicted with the model in cases of internal jugular vein diameter reduction was similar to those observed in the patients with internal jugular vein obstacles. Conclusions The proposed model can predict physiological and pathological behaviors with good fidelity. Despite the simplifications introduced in cerebrospinal venous circulation modeling, the key anatomical feature of the lumped parameter model allowed for a detailed analysis of the consequences of extracranial venous impairments on intracranial pressure and hemodynamics

Gazpacho consumption is associated with lower blood pressure and reduced hypertension in a high cardiovascular risk cohort. Cross-sectional study of the PREDIMED trial

(R.M. Lamuela-Raventos). + MODEL Please cite this article in press as: Medina-Remón A, et al., Gazpacho consumption is associated with lower blood pressure and reduced hypertension in a high cardiovascular risk cohort. Abstract Background and aim: Hypertension is a major public health problem and a leading cause of death and disability in both developed and developing countries, affecting onequarter of the world's adult population. Our aim was to evaluate whether the consumption of gazpacho, a Mediterranean vegetable-based cold soup rich in phytochemicals, is associated with lower blood pressure (BP) and/or reduced prevalence of hypertension in individuals at high cardiovascular risk. Methods and results: We selected 3995 individuals (58% women, mean age 67 y) at high cardiovascular risk (81% hypertensive) recruited into the PREDIMED study. BP, weight, and dietary and physical activity data were collected. In multivariate linear regression analyses, after adjustment, moderate and high gazpacho consumption categories were associated with reduced mean systolic BP of À1.9 mm Hg [95% confidence interval (CI): À3.4; À0.6] and À2.6 mm Hg (CI: À4.2; À1.0), respectively, and reduced diastolic BP of À1.5 mm Hg (CI: À2.3; À0.6) and À1.9 mm Hg (CI: À2.8; À1.1). By multiple-adjusted logistic regression analysis, gazpacho consumption was associated with a lower prevalence of hypertension, with OR Z 0.85 (CI: 0.73; 0.99) for each 250 g/week increase and OR Z 0.73 (CI: 0.55; 0.98) for high gazpacho consumption groups compared to the no-consumption group. Conclusions: Gazpacho consumption was inversely associated with systolic and diastolic BP and prevalence of hypertension in a cross-sectional Mediterranean population at high cardiovascular risk. The association between gazpacho intake and reduction of BP is probably due to synergy among several bioactive compounds present in the vegetable ingredients used to make the recipe.