Coexistence and management of abdominal aortic aneurysm and coronary artery disease

Background: Abdominal aortic aneurysm (AAA) and coronary atherosclerosis share common risk factors. In this study, a single-center management experience of patients with a coexistence of AAA and coronary artery disease (CAD) is presented.Methods: 271 consecutive patients who underwent elective AAA repair were reviewed. Coronary imaging in 118 patients was considered suitable for exploration of AAA coexistence with CAD.Results: Significant coronary stenosis (> 70%) were found in 65.3% of patients. History of cardiac revascularization was present in 26.3% of patients, myocardial infarction (MI) in 31.4%, and 39.8% had both. In a subgroup analysis, prior history of percutaneous coronary intervention (PCI) (OR = 6.9, 95% CI 2.6–18.2, p < 0.001) and patients’ age (OR = 1.1, 95% CI 1.0–1.2, p = 0.007) were independent predictors of significant coronary stenosis. Only 52.0% (40/77) of patients with significant coronary stenosis underwent immediate coronary revascularization prior to aneurysm repair: PCI in 32 cases (4 drug-eluting stents and 27 bare metal stents), coronary artery bypass graft in 8 cases. Patients undergoing revascularization prior to surgery had longer mean time from coronary imaging to AAA repair (123.6 vs. 58.1 days, p < 0.001). Patients undergoing coronary artery evaluation prior to AAA repair had shorter median hospitalization (7 [2–70] vs. 7 [3–181] days, p = 0.007) and intensive care unit stay (1 [0–9] vs. 1 [0–70] days, p = 0.014) and also had a lower rate of major adverse cardiovascular events or multiple organ failure (0% vs. 3.9%, p = 0.035). A total of 11.0% of patients had coronary artery aneurysms.Conclusions: Patients with AAA might benefit from an early coronary artery evaluation strategy

Robust mapping of electrical properties of graphene from terahertz time-domain spectroscopy with timing jitter correction

We demonstrate a method for reliably determining the electrical properties of graphene including the carrier scattering time and carrier drift mobility from terahertz time- domain spectroscopy measurements (THz-TDS). By comparing transients originating from directly transmitted pulses and the echoes from internal reflections in a substrate, we are able to extract electrical properties irrespective of random time delays between pulses emitted in a THz-TDS setup. If such time delays are not accounted for they can significantly influence the extracted properties of the material. The technique is useful for a robust determination of electrical properties from THz-TDS measurements and is compatible with substrate materials where transients from internal reflections are well-separated in time.Innovation Fund Denmark (0603-005668B); Danish National Research Foundation (DNRF103); EU Horizon 2020 (696656); Danish Council for Independent Research (64092); EPSRC Doctoral Training Award (EP/M506485/1)

Temporal changes in the pattern of invasive angiography use and its outcome in suspected coronary artery disease : implications for patient management and healthcare resource utilization

Introduction: Invasive coronary angiography (CAG), the ‘gold standard’ in coronary artery disease (CAD) diagnosis, requires hospitalization, is not risk-free, and engages considerable healthcare resources. Aim: To assess recent (throught out 10 years) evolution of ‘significant’ (≥ 50% stenosis(es)) CAD prevalence in subjects undergoing CAG for CAD diagnosis in a high-volume tertiary referral center. Material and methods: Anonymized medical records were compared from the last vs. the first 2-years of the decade (June 2007 to May 2018). Referrals for suspected CAD were 2067 of 4522 hospitalizations (45.7%) and 1755 of 5196 (33.8%) respectively (p < 0.001). Results: The median patient age (64 vs. 68 years) and the prevalence of heart failure (24.1% vs. 42.2%) increased significantly (p < 0.001). The CAG atherosclerotic lesions, for all stenosis categories (< 50%; ≥ 50%; ≥ 70%; occlusion(s)), were significantly more prevalent in men. The proportion of subjects with any atherosclerosis on CAG increased (80.7% vs. 77.6%, p = 0.015). However, in the absence of any gross change in, for instance, the fraction of women (40.4% vs. 41.8%), the proportion of CAGs with significant CAD (lesion(s) ≥ 50%) decreased from 55.2% in 2007/2008 to below 1 in every 2 angiograms (48.9%) in 2017/2018 (p < 0.001). This unexpected finding occurred consistently across nearly all CAG referral categories. Conclusions: Despite more advanced age and a higher proportion of subjects with ‘any’ coronary atherosclerosis on CAG, the likelihood of a ‘negative’ angiogram (lesion(s) < 50%; no further evaluation/intervention) has increased significantly over the last decade. The exact nature of this phenomenon requires further investigation, particularly as a reverse trend would be expected with the growing role (and current high penetration) of contemporary non-invasive diagnostic tools to rule out significant CAD

Terahertz metamaterials on flexible polypropylene substrate

The final publication is available at Springer via http://dx.doi.org/10.1007/s11468-014-9724-1In this work, we present a metamaterial working at terahertz frequencies made over a flexible polypropylene sub-strate. The experimental measurements, in accordance with the numerical calculations, show the metamaterial reliance on the impinging electric field polarization. The structure s symmetry yields purely electrical resonant responses eliminating bianisotropy effects. The widely used bendable polypropylene polymer may promote the insertion of metamaterial-based structures with special electromagnetic response in a number of objects of our daily lives such as textiles, automotive components, and sensingThis work was supported by the Spanish MICINN under contracts CONSOLIDER EMET CSD2008-00066 and TEC2011-28664-C02-02 and by the Universitat Politecnica de Valencia under the program INNOVA 2011.Ortuño Molinero, R.; García Meca, C.; Martínez Abietar, AJ. (2014). 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Robust mapping of electrical properties of graphene from terahertz time-domain spectroscopy with timing jitter correction

We demonstrate a method for reliably determining the electrical properties of graphene including the carrier scattering time and carrier drift mobility from terahertz time- domain spectroscopy measurements (THz-TDS). By comparing transients originating from directly transmitted pulses and the echoes from internal reflections in a substrate, we are able to extract electrical properties irrespective of random time delays between pulses emitted in a THz-TDS setup. If such time delays are not accounted for they can significantly influence the extracted properties of the material. The technique is useful for a robust determination of electrical properties from THz-TDS measurements and is compatible with substrate materials where transients from internal reflections are well-separated in time

Terahertz field enhancement to the MV/cm regime in a tapered parallel plate waveguide

We investigate field enhancement properties of a tapered parallel plate waveguide for ultrashort terahertz (THz) pulses. We use two independent methods, air biased coherent detection inside the waveguide and free-space electro-optic sampling, respectively, which enables a calibrated, quantitative measurement of the field strength at the output of the waveguide. Field enhancement factors greater than 20 are demonstrated and record-high field strengths of &gt; 1.4 MV/cm are reached. We find an excellent agreement between the two independent methods of field measurement and a numerical 3D full-vectorial time-domain simulations