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Ancylostoma ceylanicum is the second most common hookworm infecting humans in the Asia-Pacific region. Recent reports suggest presence of the parasite in the Americas. We report A. ceylanicum infections in coyotes from the Guanacaste Conservation Area, Costa Rica. Our findings call for active surveillance in humans and animals.
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Ancylostoma , Anquilostomiasis , Coyotes , Zoonosis , Costa Rica/epidemiología , Animales , Anquilostomiasis/epidemiología , Anquilostomiasis/veterinaria , Anquilostomiasis/parasitología , Anquilostomiasis/diagnóstico , Ancylostoma/aislamiento & purificación , Zoonosis/parasitología , Coyotes/parasitología , HumanosRESUMEN
Controlling autonomous propulsion of microswimmers is essential for targeted drug delivery and applications of micro/nanomachines in environmental remediation and beyond. Herein, we report two-dimensional (2D) carbon nitride-based Janus particles as highly efficient, light-driven microswimmers in aqueous media. Due to the superior photocatalytic properties of poly(heptazine imide) (PHI), the microswimmers are activated by both visible and ultraviolet (UV) light in conjunction with different capping materials (Au, Pt, and SiO2) and fuels (H2O2 and alcohols). Assisted by photoelectrochemical analysis of the PHI surface photoreactions, we elucidate the dominantly diffusiophoretic propulsion mechanism and establish the oxygen reduction reaction (ORR) as the major surface reaction in ambient conditions on metal-capped PHI and even with TiO2-based systems, rather than the hydrogen evolution reaction (HER), which is generally invoked as the source of propulsion under ambient conditions with alcohols as fuels. Making use of the intrinsic solar energy storage ability of PHI, we establish the concept of photocapacitive Janus microswimmers that can be charged by solar energy, thus enabling persistent light-induced propulsion even in the absence of illumination-a process we call "solar battery swimming"-lasting half an hour and possibly beyond. We anticipate that this propulsion scheme significantly extends the capabilities in targeted cargo/drug delivery, environmental remediation, and other potential applications of micro/nanomachines, where the use of versatile earth-abundant materials is a key prerequisite.
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As covalent organic frameworks (COFs) are coming of age, the lack of effective approaches to achieve crystalline and centimeter-scale-homogeneous COF films remains a significant bottleneck toward advancing the application of COFs in optoelectronic devices. Here, we present the synthesis of colloidal COF nanoplates, with lateral sizes of â¼200 nm and average heights of 35 nm, and their utilization as photocathodes for solar hydrogen evolution. The resulting COF nanoplate colloid exhibits a unimodal particle-size distribution and an exceptional colloidal stability without showing agglomeration after storage for 10 months and enables smooth, homogeneous, and thickness-tunable COF nanofilms via spin coating. Photoelectrodes comprising COF nanofilms were fabricated for photoelectrochemical (PEC) solar-to-hydrogen conversion. By rationally designing multicomponent photoelectrode architectures including a polymer donor/COF heterojunction and a hole-transport layer, charge recombination in COFs is mitigated, resulting in a significantly increased photocurrent density and an extremely positive onset potential for PEC hydrogen evolution (over +1 V against the reversible hydrogen electrode), among the best of classical semiconductor-based photocathodes. This work thus paves the way toward fabricating solution-processed large-scale COF nanofilms and heterojunction architectures and their use in solar-energy-conversion devices.
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BACKGROUND: The objective of the FeminFER project was to assess the value of ferric carboxymaltose following a multicriteria decision analysis in obstetrics and gynaecology in Spain. METHODS: Ferric carboxymaltose (FCM) and ferrous sulphate were evaluated using the EVIDEM framework. Ten stakeholders participated to collect different perspectives. The framework was adapted considering evidence retrieved with a PICO-S search strategy and grey literature. Criteria/subcriteria were weighted by level of relevance and an evidence-based decision-making exercise was developed in each criterion; weights and scores were combined to obtain the value of intervention relative to each criterion/subcriterion, that were further combined into the Modulated Relative Benefit-Risk Balance (MRBRB). RESULTS: The most important criterion favouring FCM was Compared Efficacy/Effectiveness (0.183 ± 0.07), followed by Patient Preferences (0.059 ± 0.10). Only Direct medical costs criterion favoured FS (-0.003 ± 0.03). MRBRB favoured FCM; 0.45 ± 0.19; in a scale from -1 to + 1. CONCLUSIONS: In conclusion, considering the several criteria involved in the decision-making process, participants agreed with the use of FCM according to its MRBRB.
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Anemia Ferropénica/tratamiento farmacológico , Técnicas de Apoyo para la Decisión , Compuestos Férricos/uso terapéutico , Compuestos Ferrosos/uso terapéutico , Maltosa/análogos & derivados , Complicaciones Hematológicas del Embarazo/tratamiento farmacológico , Femenino , Humanos , Maltosa/uso terapéutico , Embarazo , Medición de Riesgo , España/epidemiología , Participación de los InteresadosRESUMEN
1D photonic crystals (1DPCs) are well known from a variety of applications ranging from medical diagnostics to optical fibers and optoelectronics. However, large-scale application is still limited due to complex fabrication processes and bottlenecks in transferring 1DPCs to arbitrary substrates and pattern creation. These challenges were addressed by demonstrating the transfer of millimeter- to centimeter-scale 1DPC sensors comprised of alternating layers of H3 Sb3 P2 O14 nanosheets and TiO2 nanoparticles based on a non-invasive chemical approach. By depositing the 1DPC on a sacrificial layer of lithium tin sulfide nanosheets and hydrophobizing only the 1DPC by intercalation of n-octylamine via the vapor phase the 1DPC can be detached from the substrate by immersing the sample in water. Upon exfoliation of the hydrophilic sacrificial layer, the freestanding 1DPC remains at the water-air interface. In a second step, it can be transferred to arbitrary surfaces such as curved glass. In addition, the transfer of patterned 1DPCs is demonstrated by combining the sacrificial layer approach with area-resolved intercalation and etching. The fact that the sensing capability of the 1DPC is not impaired and can be modified after transfer renders this method a generic platform for the fabrication of photonic devices.
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Óptica y Fotónica , Fotones , AguaRESUMEN
AIMS: Indications, methodology, and diagnostic criteria for carotid sinus massage (CSM) and tilt testing (TT) have been standardized by the 2018 Guidelines on Syncope of the European Society of Cardiology. Aim of this study was to assess their effectiveness in a large cohort which reflects the performance under 'real-world' conditions. METHODS AND RESULTS: We analysed all patients who had undergone CSM and TT in the years 2003-2019 for suspected reflex syncope. Carotid sinus massage was performed according to the 'Method of Symptoms'. Tilt testing was performed according to the 'Italian protocol' which consists of a passive phase followed by a sublingual nitroglycerine phase. For both tests, positive test was defined as reproduction of spontaneous symptoms in the presence of bradycardia and/or hypotension. Among 3293 patients (mean age 73 ± 12 years, 48% males), 2019 (61%) had at least one test positive. A bradycardic phenotype was found in 420 patients (13%); of these, 60% were identified by CSM, 37% by TT, and 3% had both test positive. A hypotensive phenotype was found in 1733 patients (53%); of these, 98% were identified by TT and 2% had both TT and CSM positive. CONCLUSION: The overall diagnostic yield of the tests in patients >40-year-old with suspected reflex syncope was 61%. Both CSM and TT are useful for identifying those patients with a bradycardic phenotype, whereas CSM has a limited value for identifying the hypotensive phenotype. Since the overlap of responses between tests is minimal, both CSM and TT should be performed in every patient over 40 years receiving investigation for unexplained but possible reflex syncope.
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Seno Carotídeo , Pruebas de Mesa Inclinada , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Femenino , Humanos , Italia , Masculino , Masaje , Persona de Mediana Edad , Reflejo , Síncope/diagnósticoRESUMEN
AIMS: The reproducibility of carotid sinus massage (CSM) is debated. The aim of this study was to assess the reproducibility according to the methodology and diagnostic criteria defined by the guidelines on syncope of the European Society of Cardiology. METHOD: Among 2800 patients with syncope who underwent CSM in the years 2005-2019, 109 patients (62 males; mean age 76 ± 10 years) had performed a second CSM after a median of 28 months. Carotid sinus hypersensitivity (CSH) was diagnosed when CSM elicited a pause of >3 s and/or a fall in systolic blood pressure >50 mm Hg without reproduction of spontaneous symptoms. Carotid sinus syndrome (CSS) was established when spontaneous symptoms were reproduced in the presence of bradycardia and/or hypotension. RESULTS: The reproducibility of CSM was 78% for 18 CSS patients, 41% for 29 CSH patients, and 77% for 62 negative patients. The corresponding interrater agreement was good for CSS (kappa = 0.66), moderate for negative CSM (kappa = 0.42), and poor for CSH (kappa = 0.30). Combining CSH and negative tests, their reproducibility rose to 90% with kappa = 0.66. CONCLUSION: CSS but not CSH has a good reproducibility. About half of patients with CSH had a negative response at the second test, thus suggesting a great overlap between them.
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Seno Carotídeo/fisiopatología , Síncope/diagnóstico , Síncope/fisiopatología , Anciano , Femenino , Humanos , Italia , Masculino , Reproducibilidad de los ResultadosRESUMEN
PURPOSE: The purpose of the current study is twofold. First, to investigate the variability of the petrotympanic fissure's (PTF) morphology in anatomized human cadaveric specimens using multi-detector computed tomography (MDCT), and second, to compare the resulting measurements to investigate the possibilities of applying MDCT in the determination of PTF morphology in living humans. METHODS: Specimens (n = 15) containing the temporal bone and TMJ were obtained from embalmed adult female (53.3%) and male (46.7%) cadavers and imaged using a helical 16-row scanner. Afterwards, cryosections were obtained and morphometric parameters were measured. Degree of agreement between both determinations was investigated and morphometric variables were also compared between PTF types. RESULTS: Three different types of PTF were identified. Type 1 was a wide tunnel-shaped structure. It was found in 20% of the cases. Type 2 was wide in the entrance but gradually narrows to the tympanic cavity. It was found in 46.7% of specimens. Finally, type 3, which was observed in 33.3% of the cases, was wide at the entrance of the mandibular fossa, followed by a middle region with flat-shaped tunnel structure and a narrow exit. The PTF's vertical diameters at the mandibular fossa, midpoint, and tympanic cavity and the width at the mandibular fossa all were significantly greater in type 1 specimens. CONCLUSIONS: MDCT is suitable for investigating the variable morphology of human PTF and its association with middle ear's and TMJ pathologies.
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Variación Anatómica , Hueso Temporal/anatomía & histología , Tomografía Computarizada por Rayos X/instrumentación , Anciano , Anciano de 80 o más Años , Cadáver , Enfermedades del Oído/diagnóstico , Enfermedades del Oído/etiología , Estudios de Factibilidad , Femenino , Humanos , Masculino , Hueso Temporal/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/etiologíaRESUMEN
Herein, we analyze the temporal evolution of the electroluminescence of light-emitting electrochemical cells (LECs), a thin-film light-emitting device, in order to maximize the luminous power radiated by these devices. A careful analysis of the spectral and angular distribution of the emission of LECs fabricated under the same experimental conditions allows describing the dynamics of the spatial region from which LECs emit, i.e. the generation zone, as bias is applied. This effect is mediated by dipole reorientation within such an emissive region and its optical environment, since its spatial drift yields a different interplay between the intrinsic emission of the emitters and the local density of optical states of the system. Our results demonstrate that engineering the optical environment in thin-film light-emitting devices is key to maximize their brightness.
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In the field of hybrid organic-inorganic perovskite based photovoltaics, there is a growing interest in the exploration of novel and smarter ways to improve the cells light harvesting efficiency at targeted wavelength ranges within the minimum volume possible, as well as in the development of colored and/or semitransparent devices that could pave the way both to their architectonic integration and to their use in the flowering field of tandem solar cells. The work herein presented targets these different goals by means of the theoretical optimization of the optical design of standard opaque and semitransparent perovskite solar cells. In order to do so, we focus on the effect of harmless, compatible and commercially available dielectric inclusions within the absorbing material, methylammonium lead iodide (MAPI). Following a gradual and systematic process of analysis, we are capable of identifying the appearance of collective and hybrid (both localized and extended) photonic resonances which allow to significantly improve light harvesting and thus the overall efficiency of the standard device by above 10% with respect to the reference value while keeping the semiconductor film thickness to a minimum. We believe our results will be particularly relevant in the promising field of perovskite solar cell based tandem photovoltaic devices, which has posed new challenges to the solar energy community in order to maximize the performance of semitransparent cells, but also for applications focusing on architectonic integration.
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AIMS: Although syncope is the main reason for cardiac pacing in â¼40% of patients affected by atrioventricular block (AVB), very few data are available on the benefit of cardiac pacing in preventing syncopal recurrences. METHODS AND RESULTS: We retrospectively evaluated 229 consecutive patients (124 males, age 80 ± 10 years) who had received a permanent pacemaker from January 2009 to December 2013 for AVB and syncope (94 patients, 41%) or AVB without syncope (135 patients, 59%). In patients with AVB and syncope, a third-degree or Mobitz II second-degree AVB had been documented in 73 and was only suspected in another 21, all of whom had bundle branch block. Follow-up was available in 223 patients. At 5 years, the actuarial syncope recurrence rate was 1% (95% CI, 0-3) in patients with documented AVB plus syncope and 3% (95% CI, 1-5) in those without syncope, whereas it was 14% (95% CI, 0-28) in patients with undocumented AVB plus syncope (P = 0.001). The actuarial combined recurrence rate of syncope and/or pre-syncope was 2% (95% CI, 0-4) in patients without syncope, 8% (95% CI, 0-17) in patients with documented AVB plus syncope, and 19% (95% CI, 1-37) in patients with undocumented AVB plus syncope, P = 0.002. All syncopes occurred in patients without overt structural heart disease (SHD), the corresponding actuarial estimate being 4% (95% CI, 0-6) at 1 year and 6% (95% CI, 4-8) at 5 years (P = 0.002 vs. patients with SHD). CONCLUSIONS: Cardiac pacing is highly effective in preventing syncopal recurrences when AVB is documented. Syncope may recur in a non-negligible minority of paced patients when AVB is suspected but not documented and in patients without SHD.
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Bloqueo Atrioventricular/terapia , Bloqueo de Rama/terapia , Estimulación Cardíaca Artificial , Marcapaso Artificial , Síncope/epidemiología , Síncope/prevención & control , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Italia , Masculino , Recurrencia , Estudios RetrospectivosRESUMEN
BACKGROUND: According to the ACC/AHA/HRS guidelines, cardiac pacing is reasonable in patients with bifascicular block (BF-B) and syncope when other causes have been excluded. The purpose of this study was to assess the long-term outcome of patients with BF-B and unexplained syncope following cardiac pacing. METHODS AND RESULTS: Between 2009 and 2015, we identified 43 consecutive patients (mean age of 78 ± 12 years, 64% males) who presented with syncope and BF-B and had received a pacemaker (PM). During a mean follow-up period of 31 ± 21 months, syncope recurred in seven patients (16%): 7% (95% standard error [SE] ± 3%) at 1 year and 18% (95% SE ± 7%) at 5 years. At univariable analysis, the only predictor of syncope recurrence was empiric pacing (P = 0.03). There were no syncope recurrences in the 12 patients who received a PM following a positive electrophysiological study (EPS) and the five patients with documentation of paroxysmal atrioventricular block (AVB) during cardiac monitoring (insertable loop recorder [ILR]), (EPS/ILR Group, n = 17) compared to seven of 26 (27%) patients who received empiric pacing (Empiric Group, n = 26; P = 0.02). Progression to high-degree AVB was documented during follow-up in 16 (37%) patients: nine of 17 (53%) patients in the EPS/ILR Group and seven of 26 (27%) patients in the Empiric Group (P = 0.11). There were no injuries reported during ILR monitoring. CONCLUSIONS: We have shown that syncope recurs not infrequently in patients with BF-B who received pacing for syncope. Nearly one in four patients who had empiric pacing suffered syncope recurrence compared to no recurrences in patients who received a PM following a positive EPS or documentation of transient AVB.
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Estimulación Cardíaca Artificial , Bloqueo Cardíaco/terapia , Síncope/terapia , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Bloqueo Cardíaco/complicaciones , Humanos , Masculino , Recurrencia , Resultado del TratamientoRESUMEN
Deterministic control on the dynamics of organic nanoemitters is achieved through precise control of its photonic environment. Resonators are fabricated by a combination of spin- and dip-coating techniques, which allows placement of the emitters at different positions within the sample, thus acting as a probe of the local density of states.
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Herein, we present a prototype of a photovoltaic module that combines a luminescent solar concentrator integrating one-dimensional photonic crystals and in-plane CuInGaSe2 (CIGS) solar cells. Highly uniform and wide-area nanostructured multilayers with photonic crystal properties were deposited by a cost-efficient and scalable liquid processing amenable to large-scale fabrication. Their role is to both maximize light absorption in the targeted spectral range, determined by the fluorophore employed, and minimize losses caused by emission at angles within the escape cone of the planar concentrator. From a structural perspective, the porous nature of the layers facilitates the integration with the thermoplastic polymers typically used to encapsulate and seal these modules. Judicious design of the module geometry, as well as of the optical properties of the dielectric mirrors employed, allows optimizing light guiding and hence photovoltaic performance while preserving a great deal of transparency. Optimized in-plane designs like the one herein proposed are of relevance for building integrated photovoltaics, as ease of fabrication, long-term stability and improved performance are simultaneously achieved. © 2015 The Authors. Progress in Photovoltaics: Research and Applications published by John Wiley & Sons Ltd.
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AIMS: The prevalence and outcome of carotid sinus syndrome (CSS) reported in the literature vary owing to differences in indications and methods of carotid sinus massage (CSM). METHODS AND RESULTS: We performed CSM on all patients aged 40 years and above with unexplained syncope after the initial evaluation. Carotid sinus massage was performed in the supine and standing positions on both sides for 10 s during continuous electrocardiogram and blood pressure monitoring; CSS was diagnosed in the event of an abnormal response to CSM in association with reproduction of spontaneous symptoms ('method of symptoms'). From July 2005 to July 2012, CSS was found in 164 (8.8%) of 1855 patients (mean age 77 ± 9 years, 73% males): 81% had an asystolic reflex (mean pause 7.6 ± 2.2 s) and 19% a vasodepressor reflex (mean lowest systolic blood pressure 65 ± 15 mmHg). Potential multifactorial causes of syncope (orthostatic hypotension, bundle branch block, bradycardia, tachyarrhythmias) were found in 74% of patients. One hundred forty-one patients received the proper care [advice on lifestyle measures in all, discontinuation (#40) or reduction (#17) of antihypertensive drugs, pacemaker implantation (#57)] and were followed up for 39 ± 25 months. Syncope recurred in 23 patients; the actuarial syncopal recurrence rate was 7% at 1 year and 26% at 5 years. Total syncopal episodes decreased from 91 per year during the 2 years before evaluation to 21 episodes per year during follow-up (P = 0.001). On Cox proportional-hazards regression, a mixed or vasodepressor response to tilt testing was the only independent predictor of syncopal recurrence (hazard ratio = 1.8; P = 0.01). CONCLUSION: Carotid sinus massage by means of the 'method of symptoms' indentifies a clinical syndrome with definite features and outcome. A treatment strategy involving lifestyle measures, reduction of antihypertensive drugs and cardiac pacing when appropriate is effective in reducing the syncopal recurrence rate.
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Enfermedades de las Arterias Carótidas/diagnóstico , Evaluación de Síntomas/métodos , Evaluación de Síntomas/estadística & datos numéricos , Síncope Vasovagal/diagnóstico , Pruebas de Mesa Inclinada/estadística & datos numéricos , Anciano , Femenino , Humanos , Italia , Masculino , Prevalencia , Pronóstico , Reproducibilidad de los Resultados , Medición de Riesgo/métodos , Medición de Riesgo/estadística & datos numéricos , Sensibilidad y Especificidad , Síncope Vasovagal/epidemiología , Síndrome , Pruebas de Mesa Inclinada/métodosRESUMEN
Background/Aim: In the past, the standard of care for women with abnormal cervical cytology has been the performance of colposcopically guided biopsy, followed by conization or large loop excision of the transition zone (LLETZ) where biopsy revealed pre-cancerous or cancerous areas. More straightforward protocols are emerging which advocate performing LLETZ in all women with highly suspicious cytology, suspicious colposcopic impression, or the presence of high-risk oncogenic human papilloma virus (HPV) strains in their cervical swabs. This, theoretically, would reduce the rate of false-negative diagnoses, but at the price of overtreating a significant number of healthy women. Patients and Methods: We retrospectively analyzed cervical cancer screening protocols in two large cohorts of women with high-risk HPV. The study compared outcomes between patients undergoing a colposcopically directed biopsy before LLETZ (n=683) and those proceeding directly to LLETZ without a biopsy (n=136). The primary focus was to assess whether intervening biopsies would reduce unnecessary ablative procedures without compromising the detection of high-grade lesions. Results: The biopsy group had a high false-negative rate, with several high-grade lesions (CIN3) and a case of invasive cancer initially underdiagnosed. Conversely, the direct-to-LLETZ approach, while ensuring no high-grade lesions were missed, led to overtreatment of lower grade lesions. Conclusion: These findings raise concern about the reliance on biopsy results for treatment decisions. Neither protocol was entirely satisfactory, although the more aggressive one avoided the potentially life-threatening consequence of false-negative results. Further research is mandatory to accurately diagnose all cases requiring aggressive treatment, without subjecting healthy women to ablative treatments they do not need.
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BACKGROUND: In spontaneous subarachnoid haemorrhage (SAH) accurate determination of the bleeding source is paramount to guide treatment. Traditionally, the bleeding pattern has been used to predict the aneurysm location. Here, we have tested a software-based tool, which quantifies the volume of intracranial blood and stratifies it according to the regional distribution, to predict the location of the ruptured aneurysm. METHODS: A consecutive series of SAH patients admitted to a single tertiary centre between 2012-2018, within 72 h of onset, harbouring a single intracranial aneurysm. A semi-automatized method of blood quantification, based on the relative density increase, was applied to initial non-contrast CTs. Five regions were used to define the bleeding patterns and to correlate them with aneurysm location: perimesencephalic, interhemispheric, right/left hemisphere and intraventricular. RESULTS: 68 patients were included for analysis. There was a strong association between the distribution of blood and the aneurysm location (p < 0.001). In particular: ACom and interhemispheric fissure (p < 0.001), MCA and ipsilateral hemisphere (p < 0.001), ICA and ipsilateral hemisphere and perimesencephalic cisterns (p < 0.001), PCom and hemispheric, perimesencephalic and intraventricular (p = 0.019), and PICA and perimesencephalic and intraventricular (p < 0.001). The internal diagnostic value was high (AUROC ≥ 0.900) for these locations. CONCLUSION: Regional automatised volumetry seems a reliable and objective tool to quantify and describe the distribution of blood within the subarachnoid spaces. This tool accurately predicts the location of the ruptured aneurysm; its use may be prospectively considered in the emergency setting when speed and simplicity are attained.
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Aneurisma Roto , Aneurisma Intracraneal , Hemorragia Subaracnoidea , Humanos , Hemorragia Subaracnoidea/diagnóstico por imagen , Aneurisma Roto/diagnóstico por imagen , Aneurisma Roto/complicaciones , Masculino , Femenino , Persona de Mediana Edad , Anciano , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/complicaciones , Estudios Retrospectivos , Adulto , Tomografía Computarizada por Rayos X , Programas InformáticosRESUMEN
Next-generation light-emitting applications such as displays and optical communications require judicious control over emitted light, including intensity and angular dispersion. To date, this remains a challenge as conventional methods require cumbersome optics. Here, we report highly directional and enhanced electroluminescence from a solution-processed quasi-2-dimensional halide perovskite light-emitting diode by building a device architecture to exploit hybrid plasmonic-photonic Tamm plasmon modes. By exploiting the processing and bandgap tunability of the halide perovskite device layers, we construct the device stack to optimise both optical and charge-injection properties, leading to narrow forward electroluminescence with an angular full-width half-maximum of 36.6° compared with the conventional isotropic control device of 143.9°, and narrow electroluminescence spectral full-width half-maximum of 12.1 nm. The device design is versatile and tunable to work with emission lines covering the visible spectrum with desired directionality, thus providing a promising route to modular, inexpensive, and directional operating light-emitting devices.
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INTRODUCTION: The long-term effects of atrial fibrillation (AF) on blood pressure (BP) in patients with hypertension (HTN) remain unclear. We hypothesized that restoration of normal sinus rhythm (NSR) results in a decrease in BP despite the expected increase in cardiac output. METHODS AND RESULTS: Twenty-four-hour BP measurements were obtained during AF, and on Day 1 and Day 30 post-successful cardioversion in 18 patients with AF and HTN (cardioversion group), and another 22 patients with AF and HTN with no immediate plans for cardioversion (control group). Except for the duration of AF, the clinical characteristics and use of medications were similar between the groups. In the cardioversion group, a significant decrease in diastolic blood pressure (DBP) and mean blood pressure (MBP) were noted on Day 1 post-cardioversion with no significant change in systolic blood pressure (SBP): 117/74/88 ± 13/9/9 mmHg during AF and 116/70/85 ± 13/9/10 mmHg during Day 1 post-cardioversion (P = 0.68; <0.01 and 0.04 for SBP, DBP, and MBP, respectively). In the 13 subjects who remained in NSR at Day 30, DBP and MBP decreased further on Day 30 when compared to Day 1 with no significant change in SBP: 118/76/90 ± 13/7/8 mmHg during AF; 119/72/88 ± 12/8/9 mmHg during Day 1; and 118/69/86 ± 10/8/7 mmHg during Day 30 post-cardioversion (P = 0.97; <0.001 and 0.03 for SBP, DBP, and MBP, respectively). In the control group, no significant changes in BP were noted. CONCLUSION: Restoring NSR in patients with AF and HTN resulted in a sustained decrease in DBP and MBP. To our knowledge, this is the first study to show that maintenance of NSR improves BP control in patients with AF and HTN.
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Fibrilación Atrial/terapia , Presión Sanguínea , Cardioversión Eléctrica , Frecuencia Cardíaca , Hipertensión/terapia , Anciano , Análisis de Varianza , Antiarrítmicos/uso terapéutico , Antihipertensivos/uso terapéutico , Fibrilación Atrial/complicaciones , Fibrilación Atrial/diagnóstico , Fibrilación Atrial/fisiopatología , Presión Sanguínea/efectos de los fármacos , Monitoreo Ambulatorio de la Presión Arterial , Gasto Cardíaco , Estudios de Casos y Controles , Electrocardiografía , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Hipertensión/complicaciones , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Italia , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Factores de Tiempo , Resultado del Tratamiento , UtahRESUMEN
The optical absorption of one-dimensional photonic crystal based resonators containing different types of gold nanoparticles is controllably modified by means of the interplay between planar optical cavity modes and localized surface plasmons. Spin-casting of metal oxide nanoparticle suspensions was used to build multilayered photonic structures that host (silica-coated) gold nanorods and spheres. Strong reinforcement and depletion of the absorptance was observed at designed wavelength ranges, thus proving that our method provides a reliable means to modify the optical absorption originated at plasmonic resonances of particles of arbitrary shape and within a wide range of sizes. These observations are discussed on the basis of calculations of the spatial and spectral dependence of the optical field intensity within the multilayers.