Extracorporeal membrane oxygenation with multiple-organ failure: Can molecular adsorbent recirculating system therapy improve survival?

BACKGROUND: Liver dialysis, molecular adsorbent recirculating system (MARS) particularly, has been used in liver failure to bridge to transplantation. We expanded the indication for MARS to patients with acute shock liver failure and cardiopulmonary failure on extracorporeal membrane oxygenation (ECMO), aiming to improve survival to wean from ECMO. METHODS: Retrospective chart analysis of patients on ECMO between 2010 and 2015 found 28 patients who met the criteria for acute liver failure, diagnosed by hyperbilirubinemia (total bilirubin ≥10 mg/dl) or by elevated transaminase (alanine transaminase \u3e1,000 IU/liter). Of these patients, 14 underwent MARS treatment (Group M), and 14 were supported with optimal medical treatment without MARS (Group C). Patient characteristics, liver function, and survival were compared between groups. RESULTS: Demographics, clinical risk factors, and pre-ECMO laboratory data were identical between the groups. MARS was used continuously for 8 days ± 9 in Group M. Total bilirubin, alanine transaminase, and international normalized ratio were improved significantly in Group M. There were no MARS-related complications. Survival to wean from ECMO for Group M was 64% (9/14) vs 21% (3/14) for Group C (p = 0.02). Mortality related to worsening liver dysfunction during ECMO was 40% (2/5 deaths) in Group M and 100% (11/11 deaths) in Group C (p = 0.004). The 30-day survival after ECMO was 43% (6/14) in Group M and 14% (2/14) in Group C (p = 0.09). CONCLUSIONS: MARS therapy in patients on ECMO safely accelerated recovery of liver function and improved survival to wean from ECMO, without increasing complications

HST and Spitzer point source detection and optical extinction in powerful narrow-line radio galaxies

We present the analysis of infrared HST and Spitzer data for a sample of 13 FRII radio galaxies at 0.03<z<0.11 that are classified as narrow-line radio galaxies (NLRG). In the context of the unified schemes for active galactic nuclei (AGN), our direct view of the AGN in NLRG is impeded by a parsec-scale dusty torus structure. Our high resolution infrared observations provide new information about the degree of extinction induced by the torus, and the incidence of obscured AGN in NLRG. We find that the point-like nucleus detection rate increases from 25 per cent at 1.025$\mu$m, to 80 per cent at 2.05$\mu$m, and to 100 per cent at 8.0$\mu$m. This supports the idea that most NLRG host an obscured AGN in their centre. We estimate the extinction from the obscuring structures using X-ray, near-IR and mid-IR data. We find that the optical extinction derived from the 9.7$\mu$m silicate absorption feature is consistently lower than the extinction derived using other techniques. This discrepancy challenges the assumption that all the mid-infrared emission of NLRG is extinguished by a simple screen of dust at larger radii. This disagreement can be explained in terms of either weakening of the silicate absorption feature by (i) thermal mid-IR emission from the narrow-line region, (ii) non-thermal emission from the base of the radio jets, or (iii) by direct warm dust emission that leaks through a clumpy torus without suffering major attenuation.Comment: 18 pages, 7 figures, 8 tables, accepted for publication in MNRA

Weakly Coupled Motion of Individual Layers in Ferromagnetic Resonance

We demonstrate a layer- and time-resolved measurement of ferromagnetic resonance (FMR) in a Ni81Fe19 / Cu / Co93Zr7 trilayer structure. Time-resolved x-ray magnetic circular dichroism has been developed in transmission, with resonant field excitation at a FMR frequency of 2.3 GHz. Small-angle (to 0.2 degree), time-domain magnetization precession could be observed directly, and resolved to individual layers through elemental contrast at Ni, Fe, and Co edges. The phase sensitivity allowed direct measurement of relative phase lags in the precession oscillations of individual elements and layers. A weak ferromagnetic coupling, difficult to ascertain in conventional FMR measurements, is revealed in the phase and amplitude response of individual layers across resonance.Comment: 22 pages, 6 figures submitted to Physical Review

Strength and Failure of Fibrin Fiber Branch Points

Blood clots form rapidly in the event of vascular injury, to prevent blood loss. They may also form in undesired places, causing heart attacks, strokes, and other diseases. Blood clots can rupture, and fragments of the clotmay lodge in distal blood vessels, causing, for example, ischemic strokes or embolisms. Thus, there has been great interest in understanding the mechanical behavior and failure mechanisms of blood clots and their constituents. To develop a mechanically realistic model of a blood clot, knowledge of the mechanical properties of its constituents is required. The major structural component providing mechanical strength to the clot is a mesh of fibrin fibers. Principally, three pieces of information are needed to develop realistic (fibrin fiber) network models: (i) the architecture of the network; (ii) the properties of the single fibers; and (iii) the properties of the fiber branchpoints

The Mechanical Properties of Single Fibrin Fibers

Background: Blood clots perform the mechanical task of stemming the flow of blood. Objectives: To advance understanding and realistic modeling of blood clot behavior we determined the mechanical properties of the major structural component of blood clots, fibrin fibers. Methods: We used a combined atomic force microscopy (AFM)/fluorescence microscopy technique to determine key mechanical properties of single crosslinked and uncrosslinked fibrin fibers. Results and conclusions: Overall, full crosslinking renders fibers less extensible, stiffer, and less elastic than their uncrosslinked counterparts. All fibers showed stress relaxation behavior (time-dependent weakening) with a fast and a slow relaxation time, 2 and 52 s. In detail, crosslinked and uncrosslinked fibrin fibers can be stretched to 2.5 and 3.3 times their original length before rupturing. Crosslinking increased the stiffness of fibers by a factor of 2, as the total elastic modulus, E0, increased from 3.9 to 8.0 MPa and the relaxed, elastic modulus, E∞, increased from 1.9 to 4.0 MPa upon crosslinking. Moreover, fibers stiffened with increasing strain (strain hardening), as E0 increased by a factor of 1.9 (crosslinked) and 3.0 (uncrosslinked) at strains ε \u3e 110%. At low strains, the portion of dissipated energy per stretch cycle was small (\u3c 10%) for uncrosslinked fibers, but significant (approximately 40%) for crosslinked fibers. At strains \u3e 100%, all fiber types dissipated about 70% of the input energy. We propose a molecular model to explain our data. Our single fiber data can now also be used to construct a realistic, mechanical model of a fibrin network

Two qubits entanglement dynamics in a symmetry-broken environment

We study the temporal evolution of entanglement pertaining to two qubits interacting with a thermal bath. In particular we consider the simplest nontrivial spin bath models where symmetry breaking occurs and treat them by mean field approximation. We analytically find decoherence free entangled states as well as entangled states with an exponential decay of the quantum correlation at finite temperature.Comment: 10 pages, 2 figure

Quantum Interference in Single Molecule Electronic Systems

We present a general analytical formula and an ab initio study of quantum interference in multi-branch molecules. Ab initio calculations are used to investigate quantum interference in a benzene-1,2-dithiolate (BDT) molecule sandwiched between gold electrodes and through oligoynes of various lengths. We show that when a point charge is located in the plane of a BDT molecule and its position varied, the electrical conductance exhibits a clear interference effect, whereas when the charge approaches a BDT molecule along a line normal to the plane of the molecule and passing through the centre of the phenyl ring, interference effects are negligible. In the case of olygoynes, quantum interference leads to the appearance of a critical energy $E_c$, at which the electron transmission coefficient $T(E)$ of chains with even or odd numbers of atoms is independent of length. To illustrate the underlying physics, we derive a general analytical formula for electron transport through multi-branch structures and demonstrate the versatility of the formula by comparing it with the above ab-initio simulations. We also employ the analytical formula to investigate the current inside the molecule and demonstrate that large counter currents can occur within a ring-like molecule such as BDT, when the point charge is located in the plane of the molecule. The formula can be used to describe quantum interference and Fano resonances in structures with branches containing arbitrary elastic scattering regions connected to nodal sites.Comment: 12 pages, 11 figure