4,929 research outputs found

    Photonic crystals with controlled disorder

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    Photonic crystals are extremely sensitive to structural disorder even to the point of completely losing their functionalities. While, on one side, this can be detrimental for applications in traditional optical devices, on the other side, it gives also rise to very interesting new physics and maybe even new applications. We propose a route to introduce disorder in photonic crystals in a controlled way by creating a certain percentage of vacancies in the lattice. We show how the method works and what type of materials can be obtained this way. Also, we use this system to probe the role of disorder on the resulting transport properties from various points of view, including measurements of the transport and scattering mean free path and the diffusion constant

    Dynamic spatial dispersion of repolarization is present in regions critical for ischemic ventricular tachycardia ablation

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    Background: The presence of dynamic substrate changes may facilitate functional block and reentry in ventricular tachycardia (VT). Objective: We aimed to study dynamic ventricular repolarization changes in critical regions of the VT circuit during sensed single extrastimulus pacing known as the Sense Protocol (SP). Methods: Twenty patients (aged 67 ± 9 years, 17 male) underwent VT ablation. A bipolar voltage map was obtained during sinus rhythm (SR) and right ventricular SP pacing at 20 ms above ventricular effective refractory period. Ventricular repolarization maps were constructed. Ventricular repolarization time (RT) was calculated from unipolar electrogram T waves, using the Wyatt method, as the dV/dtmax of the unipolar T wave. Entrainment or pace mapping confirmed critical sites for ablation. Results: The median global repolarization range (max-min RT per patient) was 166 ms (interquartile range [IQR] 143-181 ms) during SR mapping vs 208 ms (IQR 182-234) during SP mapping (P = .0003 vs intrinsic rhythm). Regions of late potentials (LP) had a longer RT during SP mapping compared to regions without LP (mean 394 ± 40 ms vs 342 ± 25 ms, P < .001). In paired regions of normal myocardium there was no significant spatial dispersion of repolarization (SDR)/10 mm2 during SP mapping vs SR mapping (SDR 11 ± 6 ms vs 10 ± 6 ms, P = .54). SDR/10 mm2 was greater in critical areas of the VT circuit during SP mapping 63 ± 29 ms vs SR mapping 16 ± 9 ms (P < .001). Conclusion: Ventricular repolarization is prolonged in regions of LP and increases dynamically, resulting in dynamic SDR in critical areas of the VT circuit. These dynamic substrate changes may be an important factor that facilitates VT circuits

    Cost-effectiveness of ablation of ventricular tachycardia in ischaemic cardiomyopathy: Limitations in the trial evidence base

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    Objective: Catheter ablation is an important treatment for ventricular tachycardia (VT) that reduces the frequency of episodes of VT. We sought to evaluate the cost-effectiveness of catheter ablation versus antiarrhythmic drug (AAD) therapy. / Methods: A decision-analytic Markov model was used to calculate the costs and health outcomes of catheter ablation or AAD treatment of VT for a hypothetical cohort of patients with ischaemic cardiomyopathy and an implantable cardioverter-defibrillator. The health states and input parameters of the model were informed by patient-reported health-related quality of life (HRQL) data using randomised clinical trial (RCT)-level evidence wherever possible. Costs were calculated from a 2018 UK perspective. / Results: Catheter ablation versus AAD therapy had an incremental cost-effectiveness ratio (ICER) of £144 150 (€161 448) per quality-adjusted life-year gained, over a 5-year time horizon. This ICER was driven by small differences in patient-reported HRQL between AAD therapy and catheter ablation. However, only three of six RCTs had measured patient-reported HRQL, and when this was done, it was assessed infrequently. Using probabilistic sensitivity analyses, the likelihood of catheter ablation being cost-effective was only 11%, assuming a willingness-to-pay threshold of £30 000 used by the UK’s National Institute for Health and Care Excellence. / Conclusion: Catheter ablation of VT is unlikely to be cost-effective compared with AAD therapy based on the current randomised trial evidence. However, better designed studies incorporating detailed and more frequent quality of life assessments are needed to provide more robust and informed cost-effectiveness analyses

    Paroxysmal 1:1 narrow complex tachycardia: What is the mechanism?

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    Introduction: Narrow complex tachycardias with a 1:1 atrioventricular (AV) relationship have characteristic features on surface electrocardiogram (ECG) and at the time of electrophysiology (EP) study. Differential diagnostic pacing maneuvers at the time of EP study have been well established; on most occasions the diagnosis can be made rapidly if the tachycardia response meets a criterion for the suspected mechanism. On occasion the response to pacing maneuvers can be atypical. Careful analysis of all diagnostic pacing maneuvers during tachycardia can lead to the diagnosis of a rare mechanism for tachycardia

    Examining a staging model for anorexia nervosa: empirical exploration of a four stage model of severity.

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    Background: An illness staging model for anorexia nervosa (AN) has received increasing attention, but assessing the merits of this concept is dependent on empirically examining a model in clinical samples. Building on preliminary findings regarding the reliability and validity of the Clinician Administered Staging Instrument for Anorexia Nervosa (CASIAN), the current study explores operationalising CASIAN severity scores into stages and assesses their relationship with other clinical features. Method: In women with DSM-IV-R AN and sub-threshold AN (all met AN criteria using DSM 5), receiver operating curve (ROC) analysis (n = 67) assessed the relationship between the sensitivity and specificity of each stage of the CASIAN. Thereafter chi-square and post-hoc adjusted residual analysis provided a preliminary assessment of the validity of the stages comparing the relationship between stage and treatment intensity and AN sub-types, and explored movement between stages after six months (Time 3) in a larger cohort (n = 171). Results: The CASIAN significantly distinguished between milder stages of illness (Stage 1 and 2) versus more severe stages of illness (Stages 3 and 4), and approached statistical significance in distinguishing each of the four stages from one other. CASIAN Stages were significantly associated with treatment modality and primary diagnosis, and CASIAN Stage at Time 1 was significantly associated with Stage at 6 month follow-up. Conclusions: Provisional support is provided for a staging model in AN. Larger studies with longer follow-up of cases are now needed to replicate and extend these findings and evaluate the overall utility of staging as well as optimal staging models

    How and why DNA barcodes underestimate the diversity of microbial eukaryotes

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    Background: Because many picoplanktonic eukaryotic species cannot currently be maintained in culture, direct sequencing of PCR-amplified 18S ribosomal gene DNA fragments from filtered sea-water has been successfully used to investigate the astounding diversity of these organisms. The recognition of many novel planktonic organisms is thus based solely on their 18S rDNA sequence. However, a species delimited by its 18S rDNA sequence might contain many cryptic species, which are highly differentiated in their protein coding sequences. Principal Findings: Here, we investigate the issue of species identification from one gene to the whole genome sequence. Using 52 whole genome DNA sequences, we estimated the global genetic divergence in protein coding genes between organisms from different lineages and compared this to their ribosomal gene sequence divergences. We show that this relationship between proteome divergence and 18S divergence is lineage dependant. Unicellular lineages have especially low 18S divergences relative to their protein sequence divergences, suggesting that 18S ribosomal genes are too conservative to assess planktonic eukaryotic diversity. We provide an explanation for this lineage dependency, which suggests that most species with large effective population sizes will show far less divergence in 18S than protein coding sequences. Conclusions: There is therefore a trade-off between using genes that are easy to amplify in all species, but which by their nature are highly conserved and underestimate the true number of species, and using genes that give a better description of the number of species, but which are more difficult to amplify. We have shown that this trade-off differs between unicellular and multicellular organisms as a likely consequence of differences in effective population sizes. We anticipate that biodiversity of microbial eukaryotic species is underestimated and that numerous ''cryptic species'' will become discernable with the future acquisition of genomic and metagenomic sequences

    Gravitational Chern-Simons Lagrangians and black hole entropy

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    We analyze the problem of defining the black hole entropy when Chern-Simons terms are present in the action. Extending previous works, we define a general procedure, valid in any odd dimensions both for purely gravitational CS terms and for mixed gauge-gravitational ones. The final formula is very similar to Wald's original formula valid for covariant actions, with a significant modification. Notwithstanding an apparent violation of covariance we argue that the entropy formula is indeed covariant.Comment: 39 page

    Electrothermal Icing Protection of Aerosurfaces Using Conductive Polymer Nanocomposites

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    Ice protection systems (IPS) are critical components for many aerospace flight vehicles, including commercial transports and unmanned aerial systems (UAS), and can include anti-icing, de-icing, ice sensing, etc. Here, an IPS is created using nanomaterials to create a surface-modified external layer on an aerosurface based on observations that polymer nanocomposites have tailorable and attractive heating properties. The IPS uses Joule heating of aligned carbon nanotube (CNT) arrays to create highly efficient de-icing and anti-icing of aerosurfaces. An ice wind tunnel test of a CNT enhanced aerosurface is performed to demonstrate the system under a range of operating regimes (temperature, wind speed, water content in air) including operation down to -20.6°C (-5°F) at 55.9 m/s (125 mph) under heavy icing. Manufacturing, design considerations, and further improvements to the materials and systems are discussed.United States. Dept. of the Navy. Small Business Innovation Research (Contract N68335-11-C-0424)National Science Foundation (U.S.). Materials Research Science and Engineering Centers (Program) (Grant DMR-0819762
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