Mach–Zehnder Modulator output in time and frequency domain—calculation and experimental confirmation

The Mach–Zehnder intensity Modulator (MZM), named after Ludwig Mach and Ludwig Zehnder, is based on the corresponding interferometer. It splits light into two counter-rotating partial beams, which are later recombined with a controlled phase difference. The output of the MZM depends on the phase difference of the interferometer paths. This phase difference is usually adjusted by an electrical voltage applied to a Phase Shifter (PS) placed in one of the interferometer arms. For MZM applications in which the wavelength is changing, the applied voltage must be adjusted accordingly. We derived the equations describing the MZM output in the frequency domain for the case of a triangular PS voltage (necessary for a sinusoidal output) and compared the analytical results with measurements. Our setup uses an Optical Parametric Oscillator (OPO) with a tunable wavelength from 3.2–3.5 μm as the light source and a Lithium Tantalate (LT)-PS for the MZM’s phase modulation. The novel insights enable new control methods for MZMs particularly suited for spectroscopic applications where the wavelength is scanned or otherwise altered.PeerReviewe

Standardisation of risk screening processes in healthcare through business rules management

In 2012, an audit held by the Netherlands Institute for Accreditation in Healthcare (NIAZ) at the ‘Rivierenland’ hospital in The Netherlands, concluded that their processes were not sufficiently standardised. One of the suggested improvements was to develop and implement a hospital-wide method for analysing and standardising care processes. This paper focuses on the standardisation of the risk screening process, which is used to assess a number of patient risk factors prior to treatments or hospital admissions. By separating the decision logic of the risk screening processes into a set of business rules, the screening process was standardised to be identical for each risk factor. This allows for the decision logic and the process to be changed independently of each other. Additional business rules were introduced to serve as constraints, thereby limiting the number of performed screening processes depending on the age of the patient and the duration of the treatment or admission. Based on historical data from the year 2013, a retrospective analysis demonstrated potential time savings of around 1600 hours on a yearly basis thanks to the introduction of the new standardised process incorporating business rules. Similar standardisation methods may be useful to other hospitals facing increasingly stringent demands for quality, safety and efficiency

Forensic tri-allelic SNP genotyping using nanopore sequencing

The potential and current state-of-the-art of forensic SNP genotyping using nanopore sequencing was investigated with a panel of 16 tri-allelic single nucleotide polymorphisms (SNPs), multiplexing five samples per sequencing run. The sample set consisted of three single-source human genomic reference control DNA samples and two GEDNAP samples, simulating casework samples. The primers for the multiplex SNP-loci PCR were taken from a study which researched their value in a forensic setting using conventional single-base extension technology. Workflows for multiplexed Oxford Nanopore Technologies 1D and 1D(2) sequencing were developed that provide correct genotyping of most SNP loci. Loci that are problematic for nanopore sequencing were characterized. When such loci are avoided, nanopore sequencing of forensic tri-allelic SNPs is technically feasible

Age- and gender-related normal left ventricular deformation assessed by cardiovascular magnetic resonance feature tracking

Background: Assessment of left (LV) ventricular function is one of the most important tasks of cardiovascular magnetic resonance (CMR). Impairment of LV deformation is a strong predictor of cardiovascular outcome in various cardiac diseases like ischemic heart disease or cardiomyopathies. The aim of the study was to provide reference values for myocardial deformation derived from the CMR feature tracking imaging (FTI) algorithm in a reference population of healthy volunteers. Methods: FTI was applied to standard short axis and 2-, 3- and 4-chamber views of vector-ECG gated CMR cine SSFP sequences of 150 strictly selected healthy volunteers (75 male/female) of three age tertiles (mean age 45.8yrs). Global peak and mean radial, circumferential and longitudinal endo- and myocardial systolic strain values as well as early diastolic strain rates were measured using FTI within a standard protocol on a 1.5T whole body MR scanner. Results: Global peak systolic values were 36.3 ± 8.7% for radial, −27.2 ± 4.0% for endocardial circumferential, −21.3 ± 3.3% for myocardial circumferential, −23.4 ± 3.4% for endocardial longitudinal and −21.6 ± 3.2% for myocardial longitudinal strain. Global peak values were -2.1 ± 0.5s−1 for radial, 2.1 ± 0.6s−1 for circumferential endocardial, 1.7 ± 0.5s−1 for circumferential myocardial, 1.8 (1.5-2.2)s−1 for longitudinal endocardial, 1.6 (1.4-2.0)s−1 for longitudinal myocardial early diastolic strain rates. Men showed a higher radial strain than women whereas the circumferential and longitudinal strains were lower resulting in less negative values. Circumferential and longitudinal strain rates were significantly higher in female subjects. Radial strain increased significantly with age whereas the diastolic function measured by the radial, circumferential and longitudinal strain rates showed a decrease. The coefficients of variation determined in ten further subjects, who underwent two CMR examinations within 12 days, were −4.8% for circumferential and −4.5% for longitudinal endocardial mean strains. Conclusions: Myocardial deformation analysis using FTI is a novel technique and robust when applied to standard cine CMR images providing the possibility of a reliable, objective quantification of global LV deformation. Since strain values and strain rates differed partly between genders as well as between age groups, the application of specific reference values as provided by this study is recommendable

Preoperative anaemia and outcome after elective cardiac surgery:a Dutch national registry analysis

Background: Previous studies have shown that preoperative anaemia in patients undergoing cardiac surgery is associated with adverse outcomes. However, most of these studies were retrospective, had a relatively small sample size, and were from a single centre. The aim of this study was to analyse the relationship between the severity of preoperative anaemia and short- and long-term mortality and morbidity in a large multicentre national cohort of patients undergoing cardiac surgery. Methods: A nationwide, prospective, multicentre registry (Netherlands Heart Registration) of patients undergoing elective cardiac surgery between January 2013 and January 2019 was used for this observational study. Anaemia was defined according to the WHO criteria, and the main study endpoint was 120-day mortality. The association was investigated using multivariable logistic regression analysis. Results: In total, 35 484 patients were studied, of whom 6802 (19.2%) were anaemic. Preoperative anaemia was associated with an increased risk of 120-day mortality (adjusted odds ratio [aOR] 1.7; 95% confidence interval [CI]: 1.4–1.9; P<0.001). The risk of 120-day mortality increased with anaemia severity (mild anaemia aOR 1.6; 95% CI: 1.3–1.9; P<0.001; and moderate-to-severe anaemia aOR 1.8; 95% CI: 1.4–2.4; P<0.001). Preoperative anaemia was associated with red blood cell transfusion and postoperative morbidity, the causes of which included renal failure, pneumonia, and myocardial infarction. Conclusions: Preoperative anaemia was associated with mortality and morbidity after cardiac surgery. The risk of adverse outcomes increased with anaemia severity. Preoperative anaemia is a potential target for treatment to improve postoperative outcomes

Innovations for Sustainability: Pathways to an efficient and post-pandemic future

3rd Report prepared by The World in 2050 initiativ