Second look Holter ECG in neurorehabilitation.

BACKGROUND: Many stroke survivors suffer recurrent stroke because paroxysmal atrial fibrillation (AF) was missed and no preventive anticoagulation initiated. This prospective cohort study determined the added diagnostic yield of second-look 24-h electrocardiographic recording (ECG) in a population at high risk for AF: patients who suffered a stroke of such severity that they require inpatient neurorehabilitation. METHODS: We enrolled 508 patients with ischemic stroke admitted to post-acute inpatient neurorehabilitation and determined whether AF was detected during acute care at the referring hospital. Second-look baseline and 24-h Holter ECG were then conducted during neurorehabilitation. Primary outcome was number of newly detected AF with duration of > 30 s; secondary outcomes were number of newly detected absolute arrhythmia of 10-30 s and < 10 s duration. For comparison, we further enrolled 100 patients with hemorrhagic stroke without history of AF (age = 72 + 11 years, 51% female). RESULTS: In 206 of the 508 ischemic stroke patients, AF had been detected during acute phase work-up (age = 78 + 10 years, 55% female). For the remaining 302 ischemic stroke patients, no AF was detected during acute phase work-up (age = 74 + 9 years; 47% female). Second-look 24-h ECG showed previously missed AF of > 30 s in 20 of these patients, i.e. 6.6% of the sample, and shorter absolute arrhythmia in 50 patients (i.e. 16.5%). CONCLUSIONS: Second-look 24-Hour ECG performed during post-acute inpatient neurorehabilitation has a high diagnostic yield and should become a standard component of recurrent stroke prevention.

The engineered eyeball, a tunable imaging system using soft-matter micro-optics.

We demonstrate a tunable imaging system based on the functionality of the mammalian eye using soft-matter micro-optical components. Inspired by the structure of the eye, as well as by the means through which nature tunes its optical behavior, we show that the technologies of microsystems engineering and micro-optics may be used to realize a technical imaging system whose biomimetic functionality is entirely distinct from that of conventional optics. The engineered eyeball integrates a deformable elastomeric refractive structure whose shape is mechanically controlled through application of strain using liquid crystal elastomer (LCE) actuators; two forms of tunable iris, one based on optofluidics and the other on LCEs with embedded heaters; a fixed lens arrangement; and a commercial imaging sensor chip. The complete microsystem, optimized to yield optical characteristics close to those of the human eye, represents the first fully functional, soft-matter-based tunable single-aperture eye-like imager.

Iris-like tunable aperture employing liquid-crystal elastomers.

A liquid-crystal elastomer (LCE) iris inspired by the human eye is demonstrated. With integrated polyimide-based platinum heaters, the LCE material is thermally actuated. The radial contraction direction, similar to a mammalian iris, is imprinted to the LCE by a custom-designed magnetic field. Actuation of the device is reproducible over multiple cycles and controllable at intermediate contraction states.

Miniaturized tunable imaging system inspired by the human eye.

We demonstrate the combination of a tunable lens and tunable aperture in a compact imaging system whose structure is inspired by the human eye. The concept is based on innovative optical materials and tuning mechanisms including an optofluidic iris for a tunable aperture and an elastomer lens for focal length tuning. Wavefront and modulation transfer function analysis reveals a high imaging performance of both the individual elements and the complete system. Most significantly, the wavefront is not degraded (ΔPV<λ/10) when tuning the focal length (Δf=5.36%).

Tunable solid-body elastomer lenses with electromagnetic actuation.

We present novel biconvex solid-body elastomer (polydimethylsiloxane) lenses, which can be tuned in focal length by using magnetic or mechanical actuation. The focal length change is induced by applying radial elastic strain and is investigated for different initial radii of curvature of the lenses and different actuation designs. In all cases, a linear correlation between induced strain and focal length tuning, in the range of about 10% (approximately 3 mm), is found. These results compare favorably with finite element simulations.