Ocular Lateral Deviation as a Vestibular Clinical Sign of Medial Posterior Inferior Cerebellar Artery Strokes: A Case Report.

We report a case of posterior circulation stroke that presented with a unique ocular vestibular sign called Ocular Lateral Deviation (OLD). OLD is eye deviation to one side that is made more prominent by brief eye closure. OLD has been reported to occur ipsilesional in a third of medullary strokes, and occasionally in other posterior fossa strokes. Here we report a case of acute stroke that presented with contralesional eye deviation consistent with OLD due to inferior vermis stroke. To our knowledge, this presentation has not been reported before. Clinicians should be aware of potential ocular manifestations of posterior circulation strokes, as these syndromes may not generate significant NIHSS scores and may be missed.

Subtle ocular movements in a patient with brain death.

Introduction and Case Presentation: Brain death can be associated with limb movements that are attributed to spinal reflexes. Although head/face movements have been rarely reported, no case of overt eye movements in brain death has been documented. We report a case of a patient with subtle eye movements whose exam was otherwise consistent with brain death. The presence of eye movements delayed pronouncing the patient as brain dead and delayed organ donation. We agree with American Academy of Neurology Position statement from 2019 that brain death does not mean demise of every neuron. Discussion: This case raises important questions about the types of movements that should be "allowed" during the determination of brain death to avoid delays in diagnosis.

Demonstration of post-growth wavelength setting of VCSELs using high-contrast gratings.

We demonstrate, for the first time, post-growth wavelength setting of electrically-injected vertical-cavity surface-emitting lasers (VCSELs) by using high-contrast gratings (HCGs) with different grating parameters. By fabricating HCGs with different duty cycle and period, the HCG reflection phase can be varied, in effect giving different optical cavity lengths for HCG-VCSELs with different grating parameters. This enables fabrication of monolithic multi-wavelength HCG-VCSEL arrays for wavelength-division multiplexing (WDM). The GaAs HCG is suspended in air by removing a sacrificial layer of InGaP. Electrically-injected 980-nm HCG-VCSELs with sub-mA threshold currents indicate high reflectivity from the GaAs HCGs. Lasing over a wavelength span of 15 nm was achieved, enabling a 4-channel WDM array with 5 nm channel spacing. A large wavelength setting span was enabled by an air-coupled cavity design and the use of only the HCG as top mirror.

Electric field enhancement between two Si microdisks.

The field enhancement in the gap between two Si microdisks is theoretically investigated using the finite difference time domain method. We show that the electric field within this gap increases as the distance between the two disks decreases, and it can be enhanced by as much as two orders of magnitude. By perturbing the Si microdisks to force the field leakage into an ever smaller volume, the field enhancement can reach a value as high as 238 with a deep sub-wavelength mode volume. This behavior is comparable to what can be observed in gap plasmons between metal nanoparticles, but is produced here in purely dielectric structures.

Rapidly progressive fatal bihemispheric infarction secondary to Moyamoya syndrome in association with Graves thyrotoxicosis.

Moyamoya syndrome is the secondary form of intracranial arterial occlusive diseases that produces collateral vessels from the base of brain. We report a case of Moyamoya syndrome developing in association with Graves thyrotoxicosis; as a result of its rapid progression and severe global ischemia, it was ultimately fatal. Because of the rarity of this association, we reviewed the literature in an attempt to establish possible demographic and clinical characteristics that may suggest putative mechanisms of pathogenesis.

Steroid-responsive charles bonnet syndrome in temporal arteritis.

The authors report a patient with biopsy-proven temporal arteritis who manifested Charles Bonnet syndrome (CBS). Treatment with steroid resulted in prompt resolution of visual hallucinations, despite persistent visual loss, suggesting that cerebral ischemia is a cofactor for the development of CBS.

Quantum teleportation with a quantum dot single photon source.

We report the experimental demonstration of a quantum teleportation protocol with a semiconductor single photon source. Two qubits, a target and an ancilla, each defined by a single photon occupying two optical modes (dual-rail qubit), were generated independently by the single photon source. Upon measurement of two modes from different qubits and postselection, the state of the two remaining modes was found to reproduce the state of the target qubit. In particular, the coherence between the target qubit modes was transferred to the output modes to a large extent. The observed fidelity is 80%, in agreement with the residual distinguishability between consecutive photons from the source. An improved version of this teleportation scheme using more ancillas is the building block of the recent Knill, Laflamme, and Milburn proposal for efficient linear optics quantum computation.

Hemiplegic migraine induced by exertion.

BACKGROUND: It is known that exertion can aggravate migraine headache. However, the relationship between exertion and migraine aura is unknown. OBJECTIVE: To study the relationship between exertion and migraine aura. DESIGN: Case report. SETTING: Tertiary care hospital. PATIENT: A 67-year-old man presented with recurrent attacks of exertion-induced hemiplegic migraine. Since the hemiparetic attacks were exertion induced, they were initially ascribed to recurrent transient ischemic attacks. However, the clinical picture, normal findings on cerebral angiography and neuroimaging (during the period of hemiparesis), lack of response to treatment with antiplatelets and anticoagulants, and successful treatment with verapamil suggested that the hemiparesis was not due to ischemia, but was indeed a migraine aura. We suggest that exertion induced the aura of hemiparesis by lowering the threshold for the development of cortical spreading depression. Even though our patient had no family history of hemiplegic migraine, a mutation in an ion channel gene (eg, the CACNA1A gene on chromosome 19) might account for his episodic attacks. CONCLUSION: Migraine aura should be included in the differential diagnosis of exertion-induced focal neurologic deficit.

Mean-field calculations of chain packing and conformational statistics in lipid bilayers: comparison with experiments and molecular dynamics studies.

A molecular, mean-field theory of chain packing statistics in aggregates of amphiphilic molecules is applied to calculate the conformational properties of the lipid chains comprising the hydrophobic cores of dipalmitoyl-phosphatidylcholine (DPPC), dioleoyl-phosphatidylcholine (DOPC), and palmitoyl-oleoyl-phosphatidylcholine (POPC) bilayers in their fluid state. The central quantity in this theory, the probability distribution of chain conformations, is evaluated by minimizing the free energy of the bilayer assuming only that the segment density within the hydrophobic region is uniform (liquidlike). Using this distribution we calculate chain conformational properties such as bond orientational order parameters and spatial distributions of the various chain segments. The lipid chains, both the saturated palmitoyl (-(CH2)14-CH3) and the unsaturated oleoyl (-(CH2)7-CH = CH-(CH2)7-CH3) chains are modeled using rotational isomeric state schemes. All possible chain conformations are enumerated and their statistical weights are determined by the self-consistency equations expressing the condition of uniform density. The hydrophobic core of the DPPC bilayer is treated as composed of single (palmitoyl) chain amphiphiles, i.e., the interactions between chains originating from the same lipid headgroup are assumed to be the same as those between chains belonging to different molecules. Similarly, the DOPC system is treated as a bilayer of oleoyl chains. The POPC bilayer is modeled as an equimolar mixture of palmitoyl and oleoyl chains. Bond orientational order parameter profiles, and segment spatial distributions are calculated for the three systems above, for several values of the bilayer thickness (or, equivalently, average area/headgroup) chosen, where possible, so as to allow for comparisons with available experimental data and/or molecular dynamics simulations. In most cases the agreement between the mean-field calculations, which are relatively easy to perform, and the experimental and simulation data is very good, supporting their use as an efficient tool for analyzing a variety of systems subject to varying conditions (e.g., bilayers of different compositions or thicknesses at different temperatures).

A molecular model for lipid-protein interaction in membranes: the role of hydrophobic mismatch.

The interaction free energy between a hydrophobic, transmembrane, protein and the surrounding lipid environment is calculated based on a microscopic model for lipid organization. The protein is treated as a rigid hydrophobic solute of thickness dP, embedded in a lipid bilayer of unperturbed thickness doL. The lipid chains in the immediate vicinity of the protein are assumed to adjust their length to that of the protein (e.g., they are stretched when dP > doL) in order to bridge over the lipid-protein hydrophobic mismatch (dP-doL). The bilayer's hydrophobic thickness is assumed to decay exponentially to its asymptotic, unperturbed, value. The lipid deformation free energy is represented as a sum of chain (hydrophobic core) and interfacial (head-group region) contributions. The chain contribution is calculated using a detailed molecular theory of chain packing statistics, which allows the calculation of conformational properties and thermodynamic functions (in a mean-field approximation) of the lipid tails. The tails are treated as single chain amphiphiles, modeled using the rotational isometric state scheme. The interfacial free energy is represented by a phenomenological expression, accounting for the opposing effects of head-group repulsions and hydrocarbon-water surface tension. The lipid deformation free energy delta F is calculated as a function of dP-doL. Most calculations are for C14 amphiphiles which, in the absence of a protein, pack at an average area per head-group ao approximately equal to 32 A2 (doL approximately 24.5 A), corresponding to the fluid state of the membrane. When dP = doL, delta F > 0 and is due entirely to the loss of conformational entropy experienced by the chains around the protein. When dP > doL, the interaction free energy is further increased due to the enhanced stretching of the tails. When dP < doL, chain flexibility (entropy) increases, but this contribution to delta F is overcounted by the increase in the interfacial free energy. Thus, delta F obtains a minimum at dP-doL approximately 0. These qualitative interpretations are supported by detailed numerical calculations of the various contributions to the interaction free energy, and of chain conformational properties. The range of the perturbation of lipid order extends typically over few molecular diameters. A rather detailed comparison of our approach to other models is provided in the discussion.