Caracterización cinemática, electromiográfica y mediante ecodoppler del retorno venoso durante la marcha humana normal / Kinematic, electromyographic and Doppler ultrasound characteristics of venous return during the normal human gait

Objetivos: La marcha es la forma de desplazamiento del ser humano. La interrelación fisiológica entre el sistema muscular y vascular ha sido poco estudiada. Conocemos la importancia de la bomba soleogemelar sobre el sistema venoso durante la marcha, por lo que proponemos un método de estudio de la hemodinámica venosa durante la marcha, un estudio que trata de correlacionar los hallazgos hemodinámicos con la secuencia de contracción y relajación muscular durante la marcha. Material y métodos: Realizamos un estudio descriptivo prospectivo sobre un total de 50 adultos sanos en el Laboratorio de Análisis del Movimiento del Hospital Universitario Infantil Niño Jesús de Madrid. El sistema de captura del movimiento fue el SMART-D de BTS Bioengineering, formado por 8 cámaras optoeléctricas y un software para reconstrucción en 3 D. Se realizó EMG de superficie (EMGs) (Free EMG 300 de BTS Bioengineering) de los músculos gastrocnemio medial y lateral, y de los músculos tibial anterior y posterior. Los sujetos caminaron sobre una cinta sin fin BH (modelo Marathon) y se realizó ecodoppler venoso poplíteo (Nemio MX Toshiba) durante la marcha. Resultados: Se estudió a 29 varones (58%) y a 21 (42%) mujeres, con una media de edad de 32 años. Se realizó el análisis y correlación del estudio de la marcha con la EMGs y el ecodoppler venoso y se obtuvo una onda positiva en el ecodoppler que se correlaciona con la contracción excéntrica del músculo gastrocnemio medial, que estabiliza la rodilla; una segunda onda de presión negativa como consecuencia del cierre valvular y relajación muscular y una tercera onda de presión positiva correlacionada con la contracción concéntrica del músculo gastrocnemio medial durante la flexión plantar y de la rodilla durante la fase de despegue de la marcha. Conclusiones: Describimos un método de análisis de la bomba muscular gemelar en relación con la hemodinámica venosa y el efecto fisiológico de la bomba muscular sobre el sistema venoso profundo

Objectives: The gait is the pattern of movement of the human being. The physiological interrelation between the muscular and vascular system has not been sufficiently studied. The importance of the soleus-calf muscle pump on the venous system during walking is known; therefore a method is proposed in order to study venous haemodynamics during walking. The aim of the study is to correlate the haemodynamic findings with the muscle contraction and relaxation sequence during walking. Material and methods: A prospective descriptive study was conducted on a total of 50 healthy adults in the Movement Analysis Laboratory of the Niño Jesús Children's University Hospital in Madrid. The movement capture system was the SMART-D of BTS-Bioengineering, consisting of 8 optoelectronic cameras and software for 3 D reconstruction. A surface electromyography (EMGs) was performed, using a Free EMG 300 (BTS Bioengineering) of the medial and lateral gastrocnemius muscle and the anterior and posterior muscle. The subjects walked on a treadmill (BH Marathon) and a popliteal venous Doppler ultrasound (Nemio MX Toshiba) was performed whilst walking. Results: The study included a total of 50 participants, with a mean age of 32 years, and 29 (58%) men and 21 (42%) women. The analysis and correlation of the study was performed, with the EMGs and the venous Doppler ultrasound, with a positive wave being obtained with the Doppler ultrasound that correlated with the eccentric contraction of medial gastrocnemius muscle, stabilising the knee. There was a second wave of negative pressure as a consequence of valvular closure and muscle relaxation. A third wave of positive pressure was then recorded that correlated with the concentric contraction of the medial gastrocnemius muscle during plantar and knee flexion during the take-off phase of the gait. Conclusions: The haemodynamic evaluation of the venous system by non-invasive tests can provide an objective basis for the diagnosis, evolution, and prognosis of patients with chronic venous insufficiency

Hidden Magnetic States Emergent Under Electric Field, In A Room Temperature Composite Magnetoelectric Multiferroic.

The ability to control a magnetic phase with an electric field is of great current interest for a variety of low power electronics in which the magnetic state is used either for information storage or logic operations. Over the past several years, there has been a considerable amount of research on pathways to control the direction of magnetization with an electric field. More recently, an alternative pathway involving the change of the magnetic state (ferromagnet to antiferromagnet) has been proposed. In this paper, we demonstrate electric field control of the Anomalous Hall Transport in a metamagnetic FeRh thin film, accompanying an antiferromagnet (AFM) to ferromagnet (FM) phase transition. This approach provides us with a pathway to "hide" or "reveal" a given ferromagnetic region at zero magnetic field. By converting the AFM phase into the FM phase, the stray field, and hence sensitivity to external fields, is decreased or eliminated. Using detailed structural analyses of FeRh films of varying crystalline quality and chemical order, we relate the direct nanoscale origins of this memory effect to site disorder as well as variations of the net magnetic anisotropy of FM nuclei. Our work opens pathways toward a new generation of antiferromagnetic - ferromagnetic interactions for spintronics.

Competition between Polar and Nonpolar Lattice Distortions in Oxide Quantum Wells: New Critical Thickness at Polar Interfaces.

Two basic lattice distortions permeate the structural phase diagram of oxide perovskites: antiferrodistortive (AFD) rotations and tilts of the oxygen octahedral network and polar ferroelectric modes. With some notable exceptions, these two order parameters rarely coexist in a bulk crystal, and understanding their competition is a lively area of active research. Here we demonstrate, by using the LaAlO_{3}/SrTiO_{3} system as a test case, that quantum confinement can be a viable tool to shift the balance between AFD and polar modes and selectively stabilize one of the two phases. By combining scanning transmission electron microscopy (STEM) and first-principles-based models, we find a crossover between a bulklike LaAlO_{3} structure where AFD rotations prevail, to a strongly polar state with no AFD tilts at a thickness of approximately three unit cells; therefore, in addition to the celebrated electronic reconstruction, our work unveils a second critical thickness, related not to the electronic properties but to the structural ones. We discuss the implications of these findings, both for the specifics of the LaAlO_{3}/SrTiO_{3} system and for the general quest towards nanoscale control of material properties.

Mn 3d bands and Y-O hybridization of hexagonal and orthorhombic YMnO3 thin films.

We report here the O K-edge x-ray absorption spectra of hexagonal and orthorhombic YMnO3 thin films, aiming at comparing the changes in the Mn 3d bands as well as the role of Y 4d-O 2p hybridization. The experimental results were analyzed using first principles (GGA) band structure calculations. The spectra present clear differences in the Mn 3d bands, which are attributed to changes in the Mn-O coordination and symmetry. A strong Y 4d-O 2p hybridization is observed in both the hexagonal and orthorhombic films, and its possible role on the occurrence of the observed ferroelectricity is discussed.

Evidence of a minority monoclinic LaNiO2.5 phase in lanthanum nickelate thin films.

LaNiO3 (LNO) thin films of 14 nm and 35 nm thicknesses grown epitaxially on LaAlO3 (LAO) and (LaAlO3)0.3(Sr2TaAlO6)0.7 (LSAT) substrates are studied using High Resolution Transmission Electron Microscopy (HRTEM) and High Angle Annular Dark Field (HAADF) imaging. The strain state of the films is studied using Geometric Phase Analysis (GPA). Results show the successful in-plane adaptation of the films to the substrates, both in the compressive (LAO) and tensile (LSAT) cases. Through the systematic analysis of HRTEM superstructure contrast modulation along different crystal orientations, localized regions of the monoclinic LaNiO2.5 phase are detected in the 35 nm films.

Two-dimensional electron gases at LaAlO3/SrTiO3 interfaces: orbital symmetry and hierarchy engineered by crystal orientation.

Recent findings show the emergence of two-dimensional electron gases (2DEGs) at LaAlO(3)/SrTiO(3) interfaces along different orientations; yet details on band reconstructions have remained so far unknown. Via x-ray linear dichroism spectroscopy, we demonstrate that crystal symmetry imposes distinctive 2DEG orbital hierarchies on (001)-and (110)-oriented quantum wells, allowing selective occupancy of states of different symmetry. Such orientational tuning expands the possibilities for electronic engineering of 2DEGs and opens up enticing opportunities to understand the link between orbital symmetry and complex correlated states at LaAlO(3)/SrTiO(3) quantum wells.

Anisotropic magnetoresistance in an antiferromagnetic semiconductor.

Recent studies in devices comprising metal antiferromagnets have demonstrated the feasibility of a novel spintronic concept in which spin-dependent phenomena are governed by an antiferromagnet instead of a ferromagnet. Here we report experimental observation of the anisotropic magnetoresistance in an antiferromagnetic semiconductor Sr2IrO4. Based on ab initio calculations, we associate the origin of the phenomenon with large anisotropies in the relativistic electronic structure. The antiferromagnet film is exchange coupled to a ferromagnet, which allows us to reorient the antiferromagnet spin-axis in applied magnetic fields via the exchange spring effect. We demonstrate that the semiconducting nature of our AFM electrode allows us to perform anisotropic magnetoresistance measurements in the current-perpendicular-to-plane geometry without introducing a tunnel barrier into the stack. Temperature-dependent measurements of the resistance and anisotropic magnetoresistance highlight the large, entangled tunabilities of the ordinary charge and spin-dependent transport in a spintronic device utilizing the antiferromagnet semiconductor.

El acceso femoral anterógrado: soluciones simples a problemas comunes / Anterograde femoral access: Simple solutions to common problems

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Electric control of magnetism at the Fe/BaTiO3 interface.

Interfacial magnetoelectric coupling is a viable path to achieve electrical writing of magnetic information in spintronic devices. For the prototypical Fe/BaTiO3 system, only tiny changes of the interfacial Fe magnetic moment upon reversal of the BaTiO3 dielectric polarization have been predicted so far. Here, by using X-ray magnetic circular dichroism in combination with high-resolution electron microscopy and first principles calculations, we report on an undisclosed physical mechanism for interfacial magnetoelectric coupling in the Fe/BaTiO3 system. At this interface, an ultrathin oxidized iron layer exists, whose magnetization can be electrically and reversibly switched on and off at room temperature by reversing the BaTiO3 polarization. The suppression/recovery of interfacial ferromagnetism results from the asymmetric effect that ionic displacements in BaTiO3 produces on the exchange coupling constants in the interfacial-oxidized Fe layer. The observed giant magnetoelectric response holds potential for optimizing interfacial magnetoelectric coupling in view of efficient, low-power spintronic devices.

Room-temperature antiferromagnetic memory resistor.

The bistability of ordered spin states in ferromagnets provides the basis for magnetic memory functionality. The latest generation of magnetic random access memories rely on an efficient approach in which magnetic fields are replaced by electrical means for writing and reading the information in ferromagnets. This concept may eventually reduce the sensitivity of ferromagnets to magnetic field perturbations to being a weakness for data retention and the ferromagnetic stray fields to an obstacle for high-density memory integration. Here we report a room-temperature bistable antiferromagnetic (AFM) memory that produces negligible stray fields and is insensitive to strong magnetic fields. We use a resistor made of a FeRh AFM, which orders ferromagnetically roughly 100 K above room temperature, and therefore allows us to set different collective directions for the Fe moments by applied magnetic field. On cooling to room temperature, AFM order sets in with the direction of the AFM moments predetermined by the field and moment direction in the high-temperature ferromagnetic state. For electrical reading, we use an AFM analogue of the anisotropic magnetoresistance. Our microscopic theory modelling confirms that this archetypical spintronic effect, discovered more than 150 years ago in ferromagnets, is also present in AFMs. Our work demonstrates the feasibility of fabricating room-temperature spintronic memories with AFMs, which in turn expands the base of available magnetic materials for devices with properties that cannot be achieved with ferromagnets.

Ti diffusion in (001) SrTiO3-CoFe2O4 epitaxial heterostructures: blocking role of a MgAl2O4 buffer.

Titanium diffusion from (001) SrTiO3 (STO) substrates into CoFe2O4 (CFO) films grown using pulsed laser deposition is reported. To elucidate the reasons for Ti interdiffusion, a comparative study of CFO films grown on MgAl2O4 (MAO) and STO substrates, buffered by thin STO and MAO layers, has been made. It is shown that whereas bottom STO layers always result in Ti migration, a thin MAO layer, only 8 nm thick, is effective in blocking it. We argue that this success relies on the lower mobility of Ti ions in the MAO lattice compared to that of CFO. This result should contribute to the development of high quality epitaxial heterostructures of dissimilar complex oxides.

The direct magnetoelectric effect in ferroelectric-ferromagnetic epitaxial heterostructures.

Ferroelectric (FE) and ferromagnetic (FM) materials engineered in horizontal heterostructures allow interface-mediated magnetoelectric coupling. The so-called converse magnetoelectric effect (CME) has been already demonstrated by electric-field poling of the ferroelectric layers and subsequent modification of the magnetic state of adjacent ferromagnetic layers by strain effects and/or free-carrier density tuning. Here we focus on the direct magnetoelectric effect (DME) where the dielectric state of a ferroelectric thin film is modified by a magnetic field. Ferroelectric BaTiO3 (BTO) and ferromagnetic CoFe2O4 (CFO) oxide thin films have been used to create epitaxial FE/FM and FM/FE heterostructures on SrTiO3(001) substrates buffered with metallic SrRuO3. It will be shown that large ferroelectric polarization and DME can be obtained by appropriate selection of the stacking order of the FE and FM films and their relative thicknesses. The dielectric permittivity, at the structural transitions of BTO, is strongly modified (up to 36%) when measurements are performed under a magnetic field. Due to the insulating nature of the ferromagnetic layer and the concomitant absence of the electric-field effect, the observed DME effect solely results from the magnetostrictive response of CFO elastically coupled to the BTO layer. These findings show that appropriate architecture and materials selection allow overcoming substrate-induced clamping in multiferroic multi-layered films.

Surface symmetry-breaking and strain effects on orbital occupancy in transition metal perovskite epitaxial films.

The electron occupancy of 3d-orbitals determines the properties of transition metal oxides. This can be achieved, for example, through thin-film heterostructure engineering of ABO(3) oxides, enabling emerging properties at interfaces. Interestingly, epitaxial strain may break the degeneracy of 3d-e(g) and t(2g) orbitals, thus favoring a particular orbital filling with consequences for functional properties. Here we disclose the effects of symmetry breaking at free surfaces of ABO(3) perovskite epitaxial films and show that it can be combined with substrate-induced epitaxial strain to tailor at will the electron occupancy of in-plane and out-of-plane surface electronic orbitals. We use X-ray linear dichroism to monitor the relative contributions of surface, strain and atomic terminations to the occupancy of 3z(2)-r(2) and x(2)-y(2) orbitals in La(2/3)Sr(1/3)MnO(3) films. These findings open the possibility of an active tuning of surface electronic and magnetic properties as well as chemical properties (catalytic reactivity, wettability and so on).

High mobility conduction at (110) and (111) LaAlO3/SrTiO3 interfaces.

In recent years, striking discoveries have revealed that two-dimensional electron liquids (2DEL) confined at the interface between oxide band-insulators can be engineered to display a high mobility transport. The recognition that only few interfaces appear to suit hosting 2DEL is intriguing and challenges the understanding of these emerging properties not existing in bulk. Indeed, only the neutral TiO(2) surface of (001)SrTiO(3) has been shown to sustain 2DEL. We show that this restriction can be surpassed: (110) and (111) surfaces of SrTiO(3) interfaced with epitaxial LaAlO(3) layers, above a critical thickness, display 2DEL transport with mobilities similar to those of (001)SrTiO(3). Moreover we show that epitaxial interfaces are not a prerequisite: conducting (110) interfaces with amorphous LaAlO(3) and other oxides can also be prepared. These findings open a new perspective both for materials research and for elucidating the ultimate microscopic mechanism of carrier doping.

A phase transition close to room temperature in BiFeO3 thin films.

BiFeO3 (BFO) multiferroic oxide has a complex phase diagram that can be mapped by using appropriately substrate-induced strain in epitaxial films. By using Raman spectroscopy, we conclusively show that films of the so-called supertetragonal T-BFO phase, stabilized under compressive strain, display a reversible temperature-induced phase transition at about 100 °C, and thus close to room temperature.

Guía de seguimiento no invasivo del tratamiento endovascular del aneurisma de aorta abdominal / Guidelines for the non-invasive follow-up of abdominal aortic aneurysm treatment

El tratamiento endovascular del aneurisma de aorta abdominal (EVAR) representa uno de los grandes avances de la cirugía vascular en los últimos 50 años. A diferencia del tratamiento abierto, el EVAR precisa un seguimiento postoperatorio estricto. Durante el seguimiento, la imagen del dispositivo y del aneurisma son de extrema importancia para identificar pacientes en riesgo que precisan una intervención secundaria. Ello ha conducido a protocolos de seguimiento rigurosos basados en estudios con angio-TC. El empleo de estos protocolos de seguimiento tan intensivos son criticados actualmente tanto por la alta radiación administrada al paciente como por el empleo de medios de contraste nefrotóxicos. Los programas de seguimiento postoperatorios menos intensivos y basados en ultrasonidos parecen ser seguros en la mayoría de los pacientes. Proponemos un régimen de seguimiento postoperatorio del EVAR que varía la intensidad y frecuencia de los estudios de imagen postoperatorios en función de los hallazgos(AU)

Endovascular aneurysm repair (EVAR) is one of the greatest advances in vascular surgery over the past 50 years. In contrast to conventional aneurysm repair, EVAR requires stringent posoperative surveillance. Imaging of the graft and aneurysm is of utmost importance during follow-up to identify patients in need of secondary intervention. This has led to rigorous follow-up protocols based on regular CT examinations. The use of these intense follow-up protocols has recently been questioned due to the high radiation doses and the frequent use of nephrotoxic contrast agents. Less intensive follow-up based on ultrasound examination appears to be safe in the vast majority of patients. We suggest an EVAR surveillance regimen that regulates the frequency and intensity of postoperative imaging based on the outcomes(AU)

Magnetization reversal by electric-field decoupling of magnetic and ferroelectric domain walls in multiferroic-based heterostructures.

We demonstrate that the magnetization of a ferromagnet in contact with an antiferromagnetic multiferroic (LuMnO(3)) can be speedily reversed by electric-field pulsing, and the sign of the magnetic exchange bias can switch and recover isothermally. As LuMnO(3) is not ferroelastic, our data conclusively show that this switching is not mediated by strain effects but is a unique electric-field driven decoupling of the ferroelectric and antiferromagnetic domain walls. Their distinct dynamics are essential for the observed magnetic switching.

Chiral domains in cycloidal multiferroic thin films: switching and memory effects.

Cycloidal magnetic order occurring in some AMnO(3) perovskites is known to induce ferroelectricity. The polarization is perpendicular to the propagation vector direction of the cycloid and its chirality, and therefore it is directly related to the chiral domain structure. We show that the switching process of chiral domains is sensitively dependent on the magnetoelectric history of the sample. Moreover, by appropriate field cycling, magnetic order can display partial chiral memory. We argue that memory results from electric field coupling of cycloidal domain and nucleation and pinning of chiral domain walls, much like the domain structure in other ferroic systems.

A prospective evaluation of cerebral infarction following transcervical carotid stenting with carotid flow reversal.

OBJECTIVE: Cerebral embolisation constitutes the main source of complications during transfemoral carotid artery stenting (CAS) and is associated with a high incidence of silent brain infarction. The goal of this study is to evaluate the incidence of new ischaemic cerebral lesions following transcervical CAS with carotid flow reversal for neuroprotection. MATERIALS AND METHODS: Thirty-one consecutive patients underwent transcervical CAS with carotid flow reversal. A stroke scale and diffusion-weighted magnetic resonance imaging (DW-MRI) were performed within 24 h before and after the procedure. DW-MRI studies were compared blindly by two independent neuroradiologists. New hyper-intense DW signals were interpreted as ischaemic infarcts. The progress of all patients was followed for at least 30 days following intervention. RESULTS: All procedures were technically successful. Nineteen (61%) patients were symptomatic Mean carotid flow reversal time was 22 min. There were no major adverse events at 30 days. All patients remained neurologically intact without increase in the stroke scale. Thirty subjects had paired DW-MRI studies. Post-procedural DW-MRI ischaemic infarcts were found in four (12.5%) patients, all ipsilateral to the treated hemisphere and asymptomatic. During follow-up, all stents remained patent and all patients remained stroke-free. CONCLUSIONS: These data suggest that transcervical carotid stenting with carotid flow reversal carries a low incidence of new ischaemic infarcts, significantly lower than that reported with transfemoral CAS. The transcervical approach with carotid flow reversal may improve the safety of CAS and has the potential to produce results comparable to those of carotid endarterectomy.