Perturbation theory for anisotropic dielectric interfaces, and application to sub-pixel smoothing of discretized numerical methods

We derive a correct first-order perturbation theory in electromagnetism for cases where an interface between two anisotropic dielectric materials is slightly shifted. Most previous perturbative methods give incorrect results for this case, even to lowest order, because of the complicated discontinuous boundary conditions on the electric field at such an interface. Our final expression is simply a surface integral, over the material interface, of the continuous field components from the unperturbed structure. The derivation is based on a "localized" coordinate-transformation technique, which avoids both the problem of field discontinuities and the challenge of constructing an explicit coordinate transformation by taking a limit in which a coordinate perturbation is infinitesimally localized around the boundary. Not only is our result potentially useful in evaluating boundary perturbations, e.g. from fabrication imperfections, in highly anisotropic media such as many metamaterials, but it also has a direct application in numerical electromagnetism. In particular, we show how it leads to a sub-pixel smoothing scheme to ameliorate staircasing effects in discretized simulations of anisotropic media, in such a way as to greatly reduce the numerical errors compared to other proposed smoothing schemes.Comment: 10 page

Tunable photonic elements at the surface of an optical fiber with piezoelectric core

Tunable photonic elements at the surface of an optical fiber with piezoelectric core are proposed and analyzed theoretically. These elements are based on whispering gallery modes whose propagation along the fiber is fully controlled by nanoscale variation of the effective fiber radius, which can be tuned by means of a piezoelectric actuator embedded into the core. The developed theory allows one to express the introduced effective radius variation through the shape of the actuator and the voltage applied to it. In particular, the designs of a miniature tunable optical delay line and a miniature tunable dispersion compensator are presented. The potential application of the suggested model to the design of a miniature optical buffer is also discussed

Modeled Health and Economic Impact of Team-Based Care for Hypertension

IntroductionTeam-based interventions for hypertension care have been widely studied and shown effective in improving hypertension outcomes. Few studies have evaluated long-term effects of these interventions; none have assessed broad-scale implementation. This study estimates the prospective health, economic, and budgetary impact of universal adoption of a team-based care intervention model that targets people with treated but uncontrolled hypertension in the U.S.MethodsAnalysis was conducted in 2014−2015 using a microsimulation model, constructed with various data sources from 1948 to 2014, designed to evaluate prospective cardiovascular disease (CVD)−related interventions in the U.S. population. Ten-year primary outcomes included prevalence of uncontrolled hypertension; incident myocardial infarction, stroke, CVD events, and CVD-related mortality; intervention and net medical costs by payer; productivity; and quality-adjusted life years.ResultsAbout 4.7 million (13%) fewer people with uncontrolled hypertension and 638,000 prevented cardiovascular events would be expected over 10 years. Assuming $525 per enrollee, implementation would cost payers$22.9 billion, but $25.3 billion would be saved in averted medical costs. Estimated net cost savings for Medicare approached$5.8 billion. Net costs were especially sensitive to intervention costs, with break-even thresholds of $300 (private),$450 (Medicaid), and $750 (Medicare).ConclusionsNationwide adoption of team-based care for uncontrolled hypertension could have sizable effects in reducing CVD burden. Based on the study’s assumptions, the policy would be cost saving from the perspective of Medicare and may prove to be cost effective from other payers’ perspectives. Expected net cost savings for Medicare would more than offset expected net costs for all other insurers

Growth and wall-transpiration control of nonlinear unsteady Gortler vortices forced by free-stream vortical disturbances

The generation, nonlinear evolution, and wall-transpiration control of unsteady Gortler vortices in ¨ an incompressible boundary layer over a concave plate is studied theoretically and numerically. Gortler rolls are initiated and driven by free-stream vortical perturbations of which only the low- ¨ frequency components are considered because they penetrate the most into the boundary layer. The formation and development of the disturbances are governed by the nonlinear unsteady boundaryregion equations with the centrifugal force included. These equations are subject to appropriate initial and outer boundary conditions, which account for the influence of the upstream and free-stream forcing in a rigorous and mutually consistent manner. Numerical solutions show that the stabilizing effect on nonlinearity, which also occurs in flat-plate boundary layers, is significantly enhanced in the presence of centrifugal forces. Sufficiently downstream, the nonlinear vortices excited at different free-stream turbulence intensities Tu saturate at the same level, proving that the initial amplitude of the forcing becomes unimportant. At low Tu, the disturbance exhibits a quasi-exponential growth with the growth rate being intensified for more curved plates and for lower frequencies. At higher Tu, in the typical range of turbomachinery applications, the Gortler vortices do not undergo a modal stage ¨ as nonlinearity saturates rapidly, and the wall curvature does not affect the boundary-layer response. Good quantitative agreement with data from direct numerical simulations and experiments is obtained. Steady spanwise-uniform and spanwise-modulated zero-mass-flow-rate wall transpiration is shown to attenuate the growth of the Gortler vortices significantly. A novel modified version of the Fukagata- ¨ Iwamoto-Kasagi identity, used for the first time to study a transitional flow, reveals which terms in the streamwise momentum balance are mostly affected by the wall transpiration, thus offering insight into the increased nonlinear growth of the wall-shear stress

BLUF Domain Function Does Not Require a Metastable Radical Intermediate State

BLUF (blue light using flavin) domain proteins are an important family of blue light-sensing proteins which control a wide variety of functions in cells. The primary light-activated step in the BLUF domain is not yet established. A number of experimental and theoretical studies points to a role for photoinduced electron transfer (PET) between a highly conserved tyrosine and the flavin chromophore to form a radical intermediate state. Here we investigate the role of PET in three different BLUF proteins, using ultrafast broadband transient infrared spectroscopy. We characterize and identify infrared active marker modes for excited and ground state species and use them to record photochemical dynamics in the proteins. We also generate mutants which unambiguously show PET and, through isotope labeling of the protein and the chromophore, are able to assign modes characteristic of both flavin and protein radical states. We find that these radical intermediates are not observed in two of the three BLUF domains studied, casting doubt on the importance of the formation of a population of radical intermediates in the BLUF photocycle. Further, unnatural amino acid mutagenesis is used to replace the conserved tyrosine with fluorotyrosines, thus modifying the driving force for the proposed electron transfer reaction; the rate changes observed are also not consistent with a PET mechanism. Thus, while intermediates of PET reactions can be observed in BLUF proteins they are not correlated with photoactivity, suggesting that radical intermediates are not central to their operation. Alternative nonradical pathways including a keto–enol tautomerization induced by electronic excitation of the flavin ring are considered

Analytic philosophy for biomedical research: the imperative of applying yesterday's timeless messages to today's impasses

The mantra that "the best way to predict the future is to invent it" (attributed to the computer scientist Alan Kay) exemplifies some of the expectations from the technical and innovative sides of biomedical research at present. However, for technical advancements to make real impacts both on patient health and genuine scientific understanding, quite a number of lingering challenges facing the entire spectrum from protein biology all the way to randomized controlled trials should start to be overcome. The proposal in this chapter is that philosophy is essential in this process. By reviewing select examples from the history of science and philosophy, disciplines which were indistinguishable until the mid-nineteenth century, I argue that progress toward the many impasses in biomedicine can be achieved by emphasizing theoretical work (in the true sense of the word 'theory') as a vital foundation for experimental biology. Furthermore, a philosophical biology program that could provide a framework for theoretical investigations is outlined

Identifying strategies to maximise recruitment and retention of practices and patients in a multicentre randomised controlled trial of an intervention to optimise secondary prevention for coronary heart disease in primary care

<p>Abstract</p> <p>Background</p> <p>Recruitment and retention of patients and healthcare providers in randomised controlled trials (RCTs) is important in order to determine the effectiveness of interventions. However, failure to achieve recruitment targets is common and reasons why a particular recruitment strategy works for one study and not another remain unclear. We sought to describe a strategy used in a multicentre RCT in primary care, to report researchers' and participants' experiences of its implementation and to inform future strategies to maximise recruitment and retention.</p> <p>Methods</p> <p>In total 48 general practices and 903 patients were recruited from three different areas of Ireland to a RCT of an intervention designed to optimise secondary prevention of coronary heart disease. The recruitment process involved telephoning practices, posting information, visiting practices, identifying potential participants, posting invitations and obtaining consent. Retention involved patients attending reviews and responding to questionnaires and practices facilitating data collection.</p> <p>Results</p> <p>We achieved high retention rates for practices (100%) and for patients (85%) over an 18-month intervention period. Pilot work, knowledge of the setting, awareness of change in staff and organisation amongst participant sites, rapid responses to queries and acknowledgement of practitioners' contributions were identified as being important. Minor variations in protocol and research support helped to meet varied, complex and changing individual needs of practitioners and patients and encouraged retention in the trial. A collaborative relationship between researcher and practice staff which required time to develop was perceived as vital for both recruitment and retention.</p> <p>Conclusion</p> <p>Recruiting and retaining the numbers of practices and patients estimated as required to provide findings with adequate power contributes to increased confidence in the validity and generalisability of RCT results. A continuous dynamic process of monitoring progress within trials and tailoring strategies to particular circumstances, whilst not compromising trial protocols, should allow maximal recruitment and retention.</p> <p>Trial registration</p> <p>ISRCTN24081411</p

Radiofrequency-based treatment in therapy-related clinical practice – a narrative review. Part I : acute conditions

This is an Accepted Manuscript of an article published by Taylor & Francis Group in Physical Therapy Reviews on 24 June 2015, available online at: https://www.tandfonline.com/doi/full/10.1179/1743288X15Y.0000000016Background: Radiofrequency electromagnetic field (RFEMF or simply RF)-based electrophysical agents (EPAs) have been employed in therapy-related clinical practice for several decades. They are used to reduce pain and inflammation and enhance tissue healing. Although these agents have generally become less popular in contemporary therapy practice, surveys have shown that some of these modalities are still reasonably widely used. Objective: To review the evidence for the use of non-invasive low frequency RFs (30 kHz–30 MHz) in therapy-related clinical practice. Major findings: All peer reviewed therapy-related clinical studies published in English and concerning low frequency RF were sought. Identified literature was divided into acute and chronic segments based on their clinical area and analysed to assess the volume and scope of current evidence. The studies on acute conditions were reviewed in detail for this paper. One hundred twenty clinical studies were identified, of which 30 related to acute conditions. The majority of studies employed Pulsed Shortwave Therapy (PSWT). Twenty-two studies out of 30 were related to conditions of pain and inflammation, seven to tissue healing and one to acute pneumothorax. No studies were identified on frequencies other than shortwave. Conclusions: Evidence for and against RF-based therapy is available. There is reasonable evidence in support of PSWT to alleviate postoperative pain and promote postoperative wound healing. Evidence for other acute conditions is sparse and conflicting. A general lack of research emphasis in the non-shortwave RF band is evident, with studies on acute conditions almost non-existent. Further and wider research in this area is warranted.Peer reviewe