Polarization meta-converter for dynamic polarization states shifting with broadband characteristic.

Polarization, as an important property of light, has been widely discussed in modern detecting and radar systems. A polarization converter that can be used to achieve dynamic control is regarded as an excellent alternative for implementing the integrated functionalities of communication and stealth. In this work, we propose a paradigm of meta-converter for dynamic polarization states shifting from linear-to-linear (LTL) to linear-to-circular (LTC) polarization. The strategy is achieved by loading voltage-controlled PIN diodes on the double-arrows metallic meta-resonators. The operation modes can be switched by changing the bias voltage. When the PIN diodes are turned on, the polarization meta-converter (PMC) will reflect and convert a linearly polarized electromagnetic (EM) wave into a circularly polarized one in 5.6-15.5 GHz with an axial ratio (AR) below 3dB. When the PIN diodes are turned off, the PMC will reflect and convert a linearly polarized EM wave into the orthogonal counterpart in 7.6-15.5 GHz with a polarization conversion ratio (PCR) over 88%. Simulations and experimental results show a good agreement, which manifests the feasibility of our proposed meta-converter. Moreover, the proposed PMC has great potential for polarization-dependent communication and stealth systems.

Absorptive frequency selective surface with two alternately switchable transmission/reflection bands.

The traditional frequency selective surface (FSS) needs further improvement with the development of stealth technology, and the design of multifunctional FSSs is essential. In this letter, an active absorptive FSS (AFSS) has been designed based on the absorption structure of the spoof surface plasmon polariton (SSPP) and the switching activity of the active FSS. The active FSS embedded with PIN diodes realizes the shift of two transmission/reflection frequency bands by controlling the bias voltage of the feed network, which switches from one band-pass response (at around 3.06 GHz) to the other (at around 4.34 GHz). And when one of the transmission windows switches to the other, the original transmission window closes. The upper plasmonic structure achieves a continuous and efficient absorption band from 6.31 to 8.34 GHz. A sample was also fabricated and carried out to verify the numerical simulation, and the experimental and simulation results are consistent. This work provides new ideas for the design of active AFSS and promotes its application in common aperture radome, antenna isolation, and electromagnetic shielding.

Circular dichroism assisted metadevice for efficient transmission and broadband absorption.

Owing to the intriguing capability of manipulating electromagnetic (EM) properties, the metasurface has aroused great attention of researchers and promoted its applications in EM invisibility. However, there are strong demands to provide an efficient transparent window for signals transmitting in EM invisibility devices. Here, we propose a scheme of a circular dichroism assisted metadevice to provide efficient transmission and broadband absorption in microwave frequencies. By employing chiral meta-atoms to introduce a strong asymmetric response for circularly polarized waves, a chiral metadevice for spin-selective absorption with an efficient transmission is presented. Then, we couple four chiral atoms into a polarization-insensitive atom pair, thus the achiral metadevice presents an identical high-efficiency absorption for both the x- and y-polarized wave. Here, both the chiral and achiral metadevices are realized by loading the metasurface-based absorber on a bandpass frequency selective surface. A proof-of-prototype is fabricated to verify the achiral design. The simulated and experimental results have demonstrated wideband, high-efficiency, polarization-insensitive absorption and high in-band transmission. Interestingly, the proposed paradigm can not only provide the potential for chirality-enhanced absorber design but also may trigger applications in spin-dependent systems, stealth antenna systems, and EM camouflage devices.

Efficacy and safety of dofetilide and sotalol in patients with hypertrophic cardiomyopathy.

BACKGROUND: Professional society practice guidelines conflict regarding their recommendations of dofetilide (DOF) and sotalol (STL) for treatment of arrhythmias in hypertrophic cardiomyopathy (HCM), and supporting data is sparse. We aim to assess safety and efficacy of DOF and STL on arrhythmias in HCM. METHODS: This was an observational study of HCM patients treated with DOF or STL for atrial fibrillation (AF) and ventricular arrhythmias (VA). Outcomes of drug discontinuation and arrhythmia recurrence were compared at 1 year and latest follow-up by Kaplan-Meier analysis. Predictors of drug failure were studied using uni- and multi-variable analyses. Drug-related adverse events were quantitated. RESULTS: Here we show that of our cohort of 72 patients (54 ± 14 years old, 75% male), 21 were prescribed DOF for AF, 52 STL for AF, and 18 STL for VA. At 1 year, discontinuation and recurrence rates were similar for DOF-AF (38% and 43%) and STL-AF (29% and 44%) groups. Efficacy data was similar at long-term follow-up of 1603 (IQR 994-4131) days, and for STL-VA. Drug inefficacy was the most common reason for discontinuation (28%) followed by side-effects (13%). Incidences of heart failure hospitalization (5%) and mortality (3%) were low. One STL-AF patient developed non-sustained torsades de pointes in the setting of severe pneumonia and acute kidney injury, but there were no other drug-related serious adverse events. CONCLUSIONS: DOF and STL demonstrate modest efficacy and satisfactory safety when used for AF and VA in HCM patients.

Hypertrophic cardiomyopathy (HCM) is a genetic condition that affects the heart muscle by making it abnormally thick. It often also causes abnormalities in the heartbeat, known as arrhythmias, which can cause symptoms such as dizziness and shortness of breath, or death. Historically it has been advised that some drugs that can affect the heartbeat should not be used in those with HCM, leaving people with HCM to be treated with other drugs that have undesirable side effects. We studied HCM patients who had been prescribed two of the drugs that were advised not to be used, called dofetilide and sotalol. The drugs were found to have been safe and effective over a 4-year period. These results suggest that clinical guidelines should be updated to support the use of these drugs for the treatment of arrhythmias in patients with HCM.

Dual-Channel Surface Waves Directional Radiation with Customizable Intensity and Switchable Pattern.

Achieving the conversion from surface waves (SWs) to propagating waves has captivated long-standing interest, and various ingenious metasurfaces benefiting from the powerful control capability for electromagnetic waves are able to realize efficient SWs directional radiation. Nevertheless, most existing schemes still suffer from the bottlenecks of single radiation channel, uncontrollable radiation intensity, and immutable radiation pattern, which immensely hinder their practical application in high-integration intelligent devices. Herein, a series of appealing strategies are proposed to achieve the dual-channel SWs directional radiation with customizable radiation intensity and switchable radiation pattern. The dual-channel SWs radiation metadevice based on the phase modulation metasurface is designed to directionally radiate SWs in left-handed circular polarized channel and right-handed circular polarized channel and possesses the broadband frequency scanning characteristic. More strikingly, the intensity-customizable dual-channel SWs radiation metadevice loaded with lumped resistors can control the realized gain of two circular polarized radiation beams, and the pattern-switchable dual-channel SWs radiation metadevice loaded with PIN diodes can dynamically adjust the radiation direction of the radiation beams. Numerous simulations and experiments of the proof-of-concept prototypes with modular design corroborate the theoretical predictions. Our methodology shows unprecedented flexibility in regulating SWs directional radiation and has enormous potential in engineering applications.

Navigating the Complex Web of Prescribing Amyloidosis Therapeutics: A Primer.

Advancement in the diagnosis and treatment of transthyretin amyloid cardiomyopathy has made great strides in recent years. Novel therapeutics for transthyretin amyloidosis such as tafamidis, patisiran, and inotersen have shown significant benefits in a not-so-rare disease but come with high listing price tags ranging from a quarter to more than a half million dollars per year. These costs create significant financial barriers for the majority of patients, especially those with existing Medicare insurance plans. Of 72 patients reviewed, 67% were Medicare beneficiaries. Financial assistance was explored for the majority, and 37 (51%) patients with Medicare Part D received financial assistance that reduced their copayments to $0. Only one-third of our patients were able to afford these medications without any forms of financial assistance. Of these patients, 4 (6%) had the highest copayments ranging from $13 000 to $15 000 per year. To navigate the complexities of prescribing and affordability in amyloidosis, a multidisciplinary team including a dedicated clinical pharmacist is crucial in guaranteeing patients' success to secure these novel therapeutics. In this article, we discuss our experiences with prescribing, acquiring insurance authorizations, and financing these life-saving medications based on patient-specific insurance plans and socioeconomic status.

Single-layer metasurface for ultra-wideband polarization conversion: bandwidth extension via Fano resonance.

In this paper, we propose a method of designing ultra-wideband single-layer metasurfaces for cross-polarization conversion, via the introduction of Fano resonances. By adding sub-branches onto the unit cell structure, the induced surface currents are disturbed, leading to coexistence of both bright and dark modes at higher frequencies. Due to the strong interaction between the two modes, Fano resonance can be produced. In this way, five resonances in all are produced by the single-layer metasurface. The first four are conventional and are generated by electric and magnetic resonances, whereas the fifth one is caused by Fano resonance, which further extends the bandwidth. A prototype was designed, fabricated and measured to verify this method. Both the simulated and measured results show that a 1:4.4 bandwidth can be achieved for both x- and y-polarized waves, with almost all polarization conversion ratio (PCR) above 90%. This method provides an effective alternative to metasurface bandwidth extension and can also be extended to higher bands such as THz and infrared frequencies.

High-efficiency tri-band quasi-continuous phase gradient metamaterials based on spoof surface plasmon polaritons.

A high-efficiency tri-band quasi-continuous phase gradient metamaterial is designed and demonstrated based on spoof surface plasmon polaritons (SSPPs). High-efficiency polarizaiton conversion transmission is firstly achieved via tailoring phase differece between the transmisive SSPP and the space wave in orthogonal directions. As an example, a tri-band circular-to-circular (CTC) polarization conversion metamateiral (PCM) was designed by a nonlinearly dispersive phase difference. Using such PCM unit cell, a tri-band quasi-continuous phase gradient metamaterial (PGM) was then realized by virtue of the Pancharatnam-Berry phase. The distribution of the cross-polarization transmission phase along the x-direction is continuous except for two infinitely small intervals near the phases 0° and 360°, and thus the phase gradient has definition at any point along the x-direction. The simulated normalized polarization conversion transmission spectrums together with the electric field distributions for circularly polarized wave and linearly polarized wave demonstrated the high-efficiency anomalous refraction of the quasi-continuous PGM. The experimental verification for the linearly polarized incidence was also provided.