Chimera states in small disordered optomechanical arrays

Synchronization of weakly-coupled non-linear oscillators is a ubiquitous phenomenon that has been observed across the natural sciences. We study the dynamics of optomechanical arrays - networks of mechanically compliant structures that interact with the radiation pressure force - which are driven to self-oscillation. These systems offer a convenient platform to study synchronization phenomena and have potential technological applications. We demonstrate that this system supports the existence of long-lived chimera states, where parts of the array synchronize whilst others do not. Through a combined numerical and analytical analysis we show that these chimera states can only emerge in the presence of disorder.Comment: 4+ pages, 4 figures, comments very welcome

Validation of a Polymerase Chain Reaction technique for Kidd blood group genotyping

The Kidd blood group antigens, Jkª and Jkᵇ , are two of the main surface markers which are found on the membrane of red blood cells. The determination of whether a donor or a recipient has the Jkª and/or the Jkᵇ antigens is crucially important to have a successful transfusion without the development of adverse incompatibility-related reactions. In Malta, routine serological-based tests are applied with the purpose of differentiating between homozygous and heterozygous states for the Jk antigens respectively. Although these tests are highly specific and sensitive, there are particular clinical scenarios where haemagglutination assays are not suitable for determining the individual’s Kidd blood group status. Additionally, the alternative genotyping procedure has never been applied in Malta within the context of blood grouping. The current study was therefore carried out to determine whether a molecular-based technique such as Polymerase Chain Reaction – Restriction Fragment Length Polymorphism analysis (PCR-RFLP) is a suitable alternative procedure for distinguishing amongst the three different Kidd phenotypes. After extracting deoxyribonucleic acid (DNA) from 50 blood samples obtained from serologically-tested healthy blood donors who expressed at least one of the Kidd antigens, PCR-RFLP analyses were carried out. The results of the latter were then compared with those previously obtained with haemagglutination and a complete match was observed between the two. Therefore, this PCR-RFLP method was confirmed as a suitable alternative laboratory technique that can be used to determine efficiently the Kidd blood group of both donors and recipients, in an accurate manner without subjectivity as encountered in the case of haemagglutination. This research further facilitates the introduction of molecular-based techniques in molecular blood transfusion.peer-reviewe

Local attitudes in the treatment of low prognosis head and neck squamous cell carcinoma

The incidence of head and neck carcinoma in Malta is 2.44 per 100,000 population, with 5-year survival rate of 20%. International studies have however shown that head and neck squamous cell carcinoma (HNSCC) carries an average 30% survival rate. The cost of treatment of low prognosis HNSCC patients in Malta is roughly €62,500 per year per person and considering that 7 patients out of those diagnosed are treated curatively annually, the total cost would increase to nearly half a million Euros per annum. In view of this, one is bound to ask the question whether not treating patients with a 30% survival rate is justifiable, especially in view that surgical and oncologic treatment can result in severe disfigurement and poses great physical and psychological stress on patients. No studies about local decision-making with respect to HNSCC have been published. This study set out to explore this issue from the ethical point of view, taking into account a number of variables with respect to treatment and the patient factors. A pre-determined set of questions was formulated and these questions were tackled by ten medical professionals, nine of which had direct contact with HNSCC patients. Issues such as informed consent, old age, quality of life, social variables, autonomy, healthcare rationing, medico-legal problems and past experiences with patients have been identified and discussed with reference to the local situation. It was noted that the majority of interviewed professionals (70%), still emphasised the need to provide full treatment for low prognosis HNSCC.peer-reviewe

Floquet control of optomechanical bistability in multimode systems

Cavity optomechanical systems enable fine manipulation of nanomechanical degrees of freedom with light, adding operational functionality and impacting their appeal in photonic technologies. We show that distinct mechanical modes can be exploited with a temporally modulated laser drive to steer between bistable steady states induced by changes of cavity radiation pressure. We investigate the influence of thermo-optic nonlinearity on these Floquet dynamics and find that it can inhibit or enhance the performance of the coupling mechanism in contrast to their often performance limiting character. Our results provide new techniques for the characterization of thermal properties and the control of optomechanical systems in sensing and computational application

Impact of COVID-19 Pandemic on TAVR Activity: A Worldwide Registry

Background: The COVID-19 pandemic had a considerable impact on the provision of structural heart intervention worldwide. Our objectives were: 1) to assess the impact of the COVID-19 pandemic on transcatheter aortic valve replacement (TAVR) activity globally; and 2) to determine the differences in the impact according to geographic region and the demographic, development, and economic status of diverse international health care systems. Methods: We developed a multinational registry of global TAVR activity and invited individual TAVR sites to submit TAVR implant data before and during the COVID-19 pandemic. Specifically, the number of TAVR procedures performed monthly from January 2019 to December 2021 was collected. The adaptive measures to maintain TAVR activity by each site were recorded, as was a variety of indices relating to type of health care system and national economic indices. The primary subject of interest was the impact on TAVR activity during each of the pandemic waves (2020 and 2021) compared with the same period pre–COVID-19 (2019). Results: Data were received from 130 centers from 61 countries, with 14 subcontinents and 5 continents participating in the study. Overall, TAVR activity increased by 16.7% (2,337 procedures) between 2018 and 2019 (ie, before the pandemic), but between 2019 and 2020 (ie, first year of the pandemic), there was no significant growth (–0.1%; –10 procedures). In contrast, activity again increased by 18.9% (3,085 procedures) between 2020 and 2021 (ie, second year of the pandemic). During the first pandemic wave, there was a reduction of 18.9% (945 procedures) in TAVR activity among participating sites, while during the second and third waves, there was an increase of 6.7% (489 procedures) and 15.9% (1,042 procedures), respectively. Further analysis and results of this study are ongoing and will be available at the time of the congress. Conclusion: The COVID-19 pandemic initially led to a reduction in the number of patients undergoing TAVR worldwide, although health care systems subsequently adapted, and the number of TAVR recipients continued to grow in subsequent COVID-19 pandemic waves. Categories: STRUCTURAL: Valvular Disease: Aorti

European Society of Cardiology: Cardiovascular Disease Statistics 2017

Background: The European Society of Cardiology (ESC) Atlas has been compiled by the European Heart Agency to document cardiovascular disease (CVD) statistics of the 56 ESC member countries. A major aim of this 2017 data presentation has been to compare high income and middle income ESC member countries, in order to identify inequalities in disease burden, outcomes and service provision. Methods: The Atlas utilizes a variety of data sources, including the World Health Organization, the Institute for Health Metrics and Evaluation, and the World Bank to document risk factors, prevalence and mortality of cardiovascular disease and national economic indicators. It also includes novel ESC sponsored survey data of health infrastructure and cardiovascular service provision provided by the national societies of the ESC member countries. Data presentation is descriptive with no attempt to attach statistical significance to differences observed in stratified analyses. Results: Important differences were identified between the high income and middle income member countries of the ESC with regard to CVD risk factors, disease incidence and mortality. For both women and men, the age-standardised prevalence of hypertension was lower in high income countries (18.3% and 27.3%) compared with middle income countries (23.5% and 30.3%). Smoking prevalence in men (not women) was also lower (26% vs 41.3%), and together these inequalities are likely to have contributed to the higher CVD mortality in middle income countries. Declines in CVD mortality have seen cancer becoming a more common cause of death in a number of high income member countries, but in middle income countries declines in CVD mortality have been less consistent where CVD remains the leading cause of death. Inequalities in CVD mortality are emphasised by the smaller contribution they make to potential years of life lost in high income compared with middle income countries both for women (13% vs. 23%) and men (20% vs. 27%). The downward mortality trends for CVD may, however, be threatened by the emerging obesity epidemic that is seeing rates of diabetes increasing across all ESC member countries. Survey data from the National Cardiac Societies (n=41) showed that rates of cardiac catheterization and coronary artery bypass surgery, as well as the number of specialist centres required to deliver them, were greatest in the high income member countries of the ESC. The Atlas confirmed that these ESC member countries, where the facilities for the contemporary treatment of coronary disease were best developed, were often those in which declines in coronary mortality have been most pronounced. Economic resources were not the only driver for delivery of equitable cardiovascular healthcare, as some middle income ESC member countries reported rates for interventional procedures and device implantations that matched or exceeded the rates in wealthier member countries. Conclusion: In documenting national CVD statistics, the Atlas provides valuable insights into the inequalities in risk factors, healthcare delivery and outcomes of CVD across ESC member countries. The availability of these data will underpin the ESC’s ambitious mission “to reduce the burden of cardiovascular disease” not only in its member countries, but also in nation states around the world

Floquet phonon lasing in multimode optomechanical systems

Dynamical radiation pressure effects in cavity optomechanical systems give rise to self-sustained oscillations or `phonon lasing' behavior, producing stable oscillators up to GHz frequencies in nanoscale devices. Like in photonic lasers, phonon lasing normally occurs in a single mechanical mode. We show here that phase-locked, multimode phonon lasing can be established in a multimode optomechanical system through Floquet dynamics induced by a temporally modulated laser drive. We demonstrate this concept in a suitably engineered silicon photonic nanocavity coupled to multiple GHz-frequency mechanical modes. We find that the long-term frequency stability is significantly improved in the multimode lasing state as a result of the phase locking. These results provide a path towards highly stable ultra-compact oscillators, pulsed phonon lasing, coherent waveform synthesis, and emergent many-mode phenomena in oscillator arrays

Exposure to a heat wave under food limitation makes an agricultural insecticide lethal: a mechanistic laboratory experiment

Extreme temperatures and exposure to agricultural pesticides are becoming more frequent and intense under global change. Their combination may be especially problematic when animals suffer food limitation. We exposed Coenagrion puella damselfly larvae to a simulated heat wave combined with food limitation and subsequently to a widespread agricultural pesticide (chlorpyrifos) in an indoor laboratory experiment designed to obtain mechanistic insights in the direct effects of these stressors in isolation and when combined. The heat wave reduced immune function (activity of phenoloxidase, PO) and metabolic rate (activity of the electron transport system, ETS). Starvation had both immediate and delayed negative sublethal effects on growth rate and physiology (reductions in Hsp70 levels, total fat content, and activity levels of PO and ETS). Exposure to chlorpyrifos negatively affected all response variables. While the immediate effects of the heat wave were subtle, our results indicate the importance of delayed effects in shaping the total fitness impact of a heat wave when followed by pesticide exposure. Firstly, the combination of delayed negative effects of the heat wave and starvation, and the immediate negative effect of chlorpyrifos considerably (71%) reduced larval growth rate. Secondly and more strikingly, chlorpyrifos only caused considerable (ca. 48%) mortality in larvae that were previously exposed to the combination of the heat wave and starvation. This strong delayed synergism for mortality could be explained by the cumulative metabolic depression caused by each of these stressors. Further studies with increased realism are needed to evaluate the consequences of the here-identified delayed synergisms at the level of populations and communities. This is especially important as this synergism provides a novel explanation for the poorly understood potential of heat waves and of sublethal pesticide concentrations to cause mass mortality.status: publishe