Inverse design of omnidirectional coherent absorbers for optical power beaming applications.

An efficient photovoltaic power converter is a critical element in laser power beaming systems for maximizing the end-to-end power transfer efficiency while minimizing beam reflections from the receiver for safety considerations. We designed a multilayer absorber that can efficiently trap monochromatic light from broad incident angles. The proposed design is built on the concept of a one-way coherent absorber with inverse-designed aperiodic multilayer front- and back-reflectors that enable maximal optical absorption in a thin-film photovoltaic material for broad angles. We argue that the broad bandwidth is achieved through an optimization search process that automatically engineers the modal content of the cavity to create multiple overlapping resonant modes at the desired angle or frequency range. A realistic design is provided based on GaAs thin films with inverse-designed multilayer binary AlAs/AlGaAs mirrors. The proposed device can pave the way for efficient optical power beaming systems.

Designer Topological Insulator with Enhanced Gap and Suppressed Bulk Conduction in Bi2Se3/Sb2Te3 Ultrashort-Period Superlattices.

A novel approach to suppress bulk conductance in three-dimensional (3D) topological insulators (TIs) using short-period superlattices (SLs) of two TIs is presented. Evidence for superlattice gap enhancement (SGE) was obtained from the reduction of bulk background doping from 1.2 × 1020 cm-3 to 8.5 × 1018 cm-3 as the period of Bi2Se3/Sb2Te3 SLs is decreased from 12 nm to 5 nm. Tight binding calculations show that, in the ultrashort-period regime, a significant SGE can be achieved for the resulting SL. Ultrathin short-period SLs behave as new designer TIs with bulk bandgaps up to 60% larger than the bandgap of the constituent layer of largest bandgap, while retaining topological surface features. Evidence for gap formation was obtained from ellipsometric measurements. Analysis of the weak antilocalization cusp in low-temperature magneto-conductance confirms that the top and bottom surfaces of the SL structure behave as Dirac surfaces. This approach represents a promising platform for building truly insulating TIs.

Growth and properties of wide bandgap (MgSe)n(ZnxCd1-xSe)m short-period superlattices.

We report the molecular beam epitaxy (MBE) growth and properties of (MgSe)n(ZnxCd1-x Se)m short-period superlattices(SPSLs) for potential application in II-VI devices grown on InP substrates. SPSL structures up to 1 µm thick with effective bandgaps ranging from 2.6 eV to above 3.42 eV are grown and characterized, extending the typical range possible for the ZnxCdyMg1-x-ySe random alloy beyond 3.2 eV. Additionally, ZnxCd1-xSe single and multiple quantum well structures using the SPSL barriers are also grown and investigated. The structures are characterized utilizing reflection high-energy electron diffraction, X-ray reflectance, X-ray diffraction and photoluminescence. We observed layer-by-layer growth and smoother interfaces in the QWs grown with SPSL when compared to the ZnxCdyMg1-x-ySe random alloy. The results indicate that this materials platform is a good candidate to replace the random alloy in wide bandgap device applications.

Bi2Se3 van der Waals Virtual Substrates for II-VI Heterostructures.

We report on the growth and characterization of optical quality multiple quantum well structures of Zn x Cd1-x Se/Zn x Cd y Mg1-x-y Se on an ultra-thin Bi2Se3/CdTe virtual substrate on c-plane Al2O3 (sapphire). Excellent quality highly oriented films grown along the (111) direction were achieved as evidenced by reflection high energy electron diffraction and X-ray diffraction studies. We also observed room temperature and 77 K photoluminescence emission with peak energies at 77 K of 2.407 eV and linewidths of 56 meV comparable to those achieved on structures grown on InP. Exfoliation of the structures is also possible due to the van der Waals bonding of Bi2Se3. Exfoliated (substrate free) films exhibit photoluminescence emission nearly identical to that of the supported film. Additionally, contactless electroreflectance measurements show good agreement with simulations of the multiple quantum well structure as well as evidence of excited state levels. These results open new avenues of research for substrate independent epitaxy and the possibility of ultra-thin electronics.

Robust Topological Interfaces and Charge Transfer in Epitaxial Bi2Se3/II-VI Semiconductor Superlattices.

Access to charge transport through Dirac surface states in topological insulators (TIs) can be challenging due to their intermixing with bulk states or nontopological two-dimensional electron gas (2DEG) quantum well states caused by bending of electronic bands near the surface. The band bending arises via charge transfer from surface adatoms or interfaces and, therefore, the choice of layers abutting topological surfaces is critical. Here we report molecular beam epitaxial growth of Bi2Se3/ZnxCd1-xSe superlattices that hold only one topological surface channel per TI layer. The topological nature of conducting channels is supported by π-Berry phase evident from observed Shubnikov de Haas quantum oscillations and by the associated two-dimensional (2D) weak antilocalization quantum interference correction to magnetoresistance. Both density functional theory (DFT) calculations and transport measurements suggest that a single topological Dirac cone per TI layer can be realized by asymmetric interfaces: Se-terminated ZnxCd1-xSe interface with the TI remains "electronically intact", while charge transfer occurs at the Zn-terminated interface. Our findings indicate that topological transport could be controlled by adjusting charge transfer from nontopological spacers in hybrid structures.

II-VI Quantum Cascade emitters in the 6-8µm range.

We present the growth and characterization of ZnCdSe/ZnCdMgSe quantum cascade (QC) heterostructures grown by molecular beam epitaxy (MBE) and designed to operate at 6-8µm. These structures utilize the better-understood ZnCdMgSe with InP lattice matched compositions yielding a bandgap of 2.80 eV as compared to previous work which used ZnCdMgSe compositions with bandgaps at 3.00 eV. Grown structures posses good structural and optical properties evidenced in X-ray diffraction and photoluminescence studies. Fabricated mesa devices show temperature dependent I-V measurements with differential resistance of 3.6 Ω, and a turn on voltage of 11V consistent with design specifications. Electroluminescence was observed in these devices up to room temperature with emission centered at 7.1 µm and line widths of ∼16%(ΔE/E) at 80K. The results show that these are well-behaved electroluminescent structures. Addition of waveguide layers and further improvements in well barrier interfaces are being pursued in efforts to demonstrate lasing.

High Curie temperature ferromagnetic structures of (Sb2Te3)1-x(MnSb2Te4)x with x = 0.7-0.8.

Magnetic topological materials are promising for realizing novel quantum physical phenomena. Among these, bulk Mn-rich MnSb2Te4 is ferromagnetic due to MnSb antisites and has relatively high Curie temperatures (TC), which is attractive for technological applications. We have previously reported the growth of materials with the formula (Sb2Te3)1-x(MnSb2Te4)x, where x varies between 0 and 1. Here we report on their magnetic and transport properties. We show that the samples are divided into three groups based on the value of x (or the percent septuple layers within the crystals) and their corresponding TC values. Samples that contain x < 0.7 or x > 0.9 have a single TC value of 15-20 K and 20-30 K, respectively, while samples with 0.7 < x < 0.8 exhibit two TC values, one (TC1) at ~ 25 K and the second (TC2) reaching values above 80 K, almost twice as high as any reported value to date for these types of materials. Structural analysis shows that samples with 0.7 < x < 0.8 have large regions of only SLs, while other regions have isolated QLs embedded within the SL lattice. We propose that the SL regions give rise to a TC1 of ~ 20 to 30 K, and regions with isolated QLs are responsible for the higher TC2 values. Our results have important implications for the design of magnetic topological materials having enhanced properties.

Latest Developments in Robotic Percutaneous Coronary Interventions.

Since the first robotic-assisted percutaneous coronary intervention procedure (R-PCI) was performed in 2004, there has been a steady evolution in robotic technology, combined with a growth in the number of robotic installations worldwide and operator experience. This review summarises the latest developments in R-PCI with a focus on developments in robotic technology, procedural complexity, tele-stenting and training methods, which have all contributed to the global expansion in R-PCI.

Endothelial dysfunction in patients with angina and non-obstructed coronary arteries is associated with an increased risk of mayor cardiovascular events. Results of the Spanish ENDOCOR registry.

BACKGROUND: Coronary endothelial dysfunction and vasospasm are potential causes of ischemia in patients without obstructive coronary stenoses (INOCA). OBJECTIVE: To evaluate the prevalence of endothelial dysfunction and the clinical profile of patients with INOCA in Spain, as well as to identify the predictors and the prognostic impact of endothelial dysfunction in this scenario. METHODS: A total of 438 consecutive patients with INOCA in whom the acetylcholine test was performed were prospectively enrolled. Patients were followed up at 1 and 2 years. RESULTS: Mean age was 62 ± 11 years with 60% female. Clinical presentation comprised 52.6% angina at rest, 61.2% exertional angina, and 31.7% dyspnea. There were no major complications of the acetylcholine test. Endothelial dysfunction was observed in 198 (45%) of patients, with severe vasoconstriction (defined as over 70% constriction), being observed in 101 (23%). Multivariable regression analysis showed that endothelial dysfunction was predicted by the presence of exertional angina (OR 2.2; CI95%1.01-2.55; p = 0.02), prior coronary disease (OR 2.46; CI95% 1.57-3.89; p < 0.01), and coronary intramyocardial bridging (2.35; CI95% 1.02-5.60; p = 0.04). Patients with endothelial dysfunction presented with worsening angina compared to those without endothelial dysfunction (25.6% vs. 12.8%) and also presented with increased levels of minimal effort angina (40% vs. 26,7%, p = 0.03) more frequently during the follow up than those without endothelial dysfunction. Endothelial dysfunction was also an independent predictor of the occurrence of myocardial infarction or unstable angina at one year (OR 2.85, CI 95% 1.01-9.25; p = 0.03). CONCLUSIONS: Endothelial dysfunction is present in almost half of patients with INOCA and is associated with worsening symptoms, as well as with a higher rate of adverse events.

Increased Chamber Resting Tone Is a Key Determinant of Left Ventricular Diastolic Dysfunction.

BACKGROUND: Twitch-independent tension has been demonstrated in cardiomyocytes, but its role in heart failure (HF) is unclear. We aimed to address twitch-independent tension as a source of diastolic dysfunction by isolating the effects of chamber resting tone (RT) from impaired relaxation and stiffness. METHODS: We invasively monitored pressure-volume data during cardiopulmonary exercise in 20 patients with hypertrophic cardiomyopathy, 17 control subjects, and 35 patients with HF with preserved ejection fraction. To measure RT, we developed a new method to fit continuous pressure-volume measurements, and first validated it in a computational model of loss of cMyBP-C (myosin binding protein-C). RESULTS: In hypertrophic cardiomyopathy, RT (estimated marginal mean [95% CI]) was 3.4 (0.4-6.4) mm Hg, increasing to 18.5 (15.5-21.5) mm Hg with exercise (P<0.001). At peak exercise, RT was responsible for 64% (53%-76%) of end-diastolic pressure, whereas incomplete relaxation and stiffness accounted for the rest. RT correlated with the levels of NT-proBNP (N-terminal pro-B-type natriuretic peptide; R=0.57; P=0.02) and with pulmonary wedge pressure but following different slopes at rest and during exercise (R2=0.49; P<0.001). In controls, RT was 0.0 mm Hg and 1.2 (0.3-2.8) mm Hg in HF with preserved ejection fraction patients and was also exacerbated by exercise. In silico, RT increased in parallel to the loss of cMyBP-C function and correlated with twitch-independent myofilament tension (R=0.997). CONCLUSIONS: Augmented RT is the major cause of LV diastolic chamber dysfunction in hypertrophic cardiomyopathy and HF with preserved ejection fraction. RT transients determine diastolic pressures, pulmonary pressures, and functional capacity to a greater extent than relaxation and stiffness abnormalities. These findings support antimyosin agents for treating HF.

ZnCdSe/ZnCdMgSe quantum well infrared photodetector.

We report the design, fabrication and characterization of a II-VI Zn(0.51)Cd(0.49)Se / Zn_{0.45(Cd)0.42(Mg)(0.13)Se-based quantum well infrared photodetector (QWIP) with a bound to quasi-bound transition centered at 8.7 µm. The good growth quality of the epitaxial layers was verified by x-ray diffraction measurements. Absorption and photocurrent measurements yield results consistent with conventional III-V QWIPs. Photocurrent measurements reveal an exponential decrease with temperature. In addition, we also observe more than 4 orders of magnitude increase in photocurrent with applied bias. By compensating the drop in temperature performance with an increase in applied bias, we achieve an operating temperature of up to 140K and a responsivity of 1-10 µA/W.}

Hypertrophic cardiomyopathy: an up-to-date snapshot of the clinical drug development pipeline.

INTRODUCTION: Hypertrophic cardiomyopathy (HCM) is a complex cardiac disease with highly variable phenotypic expression and clinical course most often caused by sarcomeric gene mutations resulting in left ventricular hypertrophy, fibrosis, hypercontractility, and diastolic dysfunction. For almost 60 years, HCM has remained an orphan disease and still lacks a disease-specific treatment. AREAS COVERED: This review summarizes recent preclinical and clinical trials with repurposed drugs and new emerging pharmacological and gene-based therapies for the treatment of HCM. EXPERT OPINION: The off-label drugs routinely used alleviate symptoms but do not target the core pathophysiology of HCM or prevent or revert the phenotype. Recent advances in the genetics and pathophysiology of HCM led to the development of cardiac myosin adenosine triphosphatase inhibitors specifically directed to counteract the hypercontractility associated with HCM-causing mutations. Mavacamten, the first drug specifically developed for HCM successfully tested in a phase 3 trial, represents the major advance for the treatment of HCM. This opens new horizons for the development of novel drugs targeting HCM molecular substrates which hopefully modify the natural history of the disease. The role of current drugs in development and genetic-based approaches for the treatment of HCM are also discussed.

Association of age with clinical features and ablation outcomes of paroxysmal supraventricular tachycardias.

OBJECTIVE: The role of age in clinical characteristics and catheter ablation outcomes of atrioventricular nodal re-entrant tachycardia (AVNRT) or orthodromic atrioventricular re-entrant tachycardia (AVRT) has been assessed in retrospective studies categorising age by arbitrary cut-offs, but contemporary analyses of age-related trends are lacking. We aimed to study the relationship of age with epidemiological, clinical features and catheter ablation outcomes of AVNRT and AVRT. METHODS: We recruited 600 patients (median age 56 years, 60% female) with a confirmed diagnosis of AVNRT (n=455) or AVRT (n=145) by means of an electrophysiological study. They were interrogated for arrhythmia-related symptoms with a structured questionnaire and followed up to 1 year. We analysed age as a continuous variable using regression models and adjusting for relevant covariables. RESULTS: Both typical and atypical forms of AVNRT upraised with age while AVRT decreased (p<0.001 by regression). Female sex predominance in AVNRT was not observed in older patients. Overall, these tachycardias became more symptomatic with ageing despite a longer tachycardia cycle length (p<0.001) and regardless of the presence of structural heart disease, with a higher proportion of dizziness, syncope, chest pain or dyspnoea (p<0.005 for all) and a lower presence of palpitations or neck pounding (p<0.001 for both). Age was not associated with catheter ablation acute success, periprocedural complications or 1-year recurrence rates (p>0.05 for all). CONCLUSIONS: Age, evaluated as a continuous variable, had a significant association with the clinical profile of patients with AVNRT and AVRT. Nevertheless, catheter ablation outcomes and complications were not significantly related to patients' age.

Founder mutation in myosin-binding protein C with an early onset and a high penetrance in males.

OBJECTIVE: One of the challenges in hypertrophic cardiomyopathy (HCM) is to determine the pathogenicity of genetic variants and to establish genotype/phenotype correlations. This study aimed to: (1) demonstrate that MYBPC3 c.2149-1G>A is a founder pathogenic variant, (2) describe the phenotype and clinical characteristics of mutation carriers and (3) compare these patients with those with the most frequent pathogenic HCM variants: MYBPC3 p.Arg502Trp/Gln. METHODS: We reviewed genetic tests performed in HCM probands at our institution. We carried out transcript analyses to demonstrate the splicing effect, and haplotype analyses to support the founder effect of MYBPC3 c.2149-1G>A. Carriers with this mutation were compared with those from MYBPC3 p.Arg502Trp/Gln in terms of presentation features, imaging and outcomes. RESULTS: MYBPC3 c.2149-1G>A was identified in 8 of 570 probands and 25 relatives. Penetrance was age and sex dependent, 50.0% of the carriers over age 36 years and 75.0% of the carriers over 40 years showing HCM. Penetrance was significantly higher in males: in carriers older than 30 years old, 100.0% of males vs 50.0% of females had a HCM phenotype (p=0.01). Males were also younger at diagnosis (32±13 vs 53±10 years old, p<0.001). MYBPC3 c.2149-1G>A resulted in an abnormal transcript that led to haploinsufficiency and was segregated in two haplotypes. However, both came from one founder haplotype. Affected carriers showed a better functional class and higher left ventricular ejection fraction (LVEF) than patients with MYBPC3 p.Arg502Trp/Gln (p<0.05 for both). Nevertheless, the rate of major adverse outcomes was similar between the two groups. CONCLUSIONS: MYBPC3 c.2149-1G>A splicing variant is a founder mutation. Affected males show an early onset of HCM and with higher penetrance than women. Carriers show better functional class and higher LVEF than MYBPC3 p.Arg502Trp/Gln carriers, but a similar rate of major adverse outcomes.

Functional mitral regurgitation and left atrial myopathy in heart failure with preserved ejection fraction.

AIMS: Mild to moderate functional mitral regurgitation (MR) is common in patients with heart failure and preserved ejection fraction (HFpEF) where it is usually considered as an innocent bystander. We hypothesized that MR in HFpEF reflects greater left atrial (LA) myopathy, leading to more adverse haemodynamics and poorer exercise reserve. METHODS AND RESULTS: Patients with HFpEF (n = 280) with and without MR underwent echocardiography, invasive haemodynamic exercise testing, and expired gas analysis. As compared to non-MR-HFpEF (n = 163), patients with MR-HFpEF (n = 117; 78 mild and 39 moderate, central jet in 90%) were older, more likely female, with lower body mass and higher prevalence of atrial fibrillation (AF). HFpEF patients with MR displayed greater LA volume, reduced LA strain and compliance, and greater mitral annular dilatation, which was strongly correlated with LA dilatation (r = 0.63, P < 0.0001) but was only weakly related to left ventricular remodelling (r = 0.37). Patients with MR-HFpEF displayed worse biventricular function, more adverse pulmonary haemodynamics, impaired pulmonary vasodilatation, blunted right ventricular reserve, and reduced cardiac output with exercise as compared to non-MR-HFpEF. Importantly, these findings were maintained after excluding patients with HFpEF and AF, suggesting a role for LA myopathy in contributing to MR in HFpEF, independent of rhythm. CONCLUSIONS: Functional MR in patients with HFpEF reflects LA myopathy, even in the absence of AF, and is associated with greater haemodynamic severity of disease and poorer functional capacity. Further study is required to better define causal mechanisms and potential treatments for MR and LA dysfunction in patients with HFpEF.

The p.P888L SAP97 polymorphism increases the transient outward current (Ito,f) and abbreviates the action potential duration and the QT interval.

Synapse-Associated Protein 97 (SAP97) is an anchoring protein that in cardiomyocytes targets to the membrane and regulates Na+ and K+ channels. Here we compared the electrophysiological effects of native (WT) and p.P888L SAP97, a common polymorphism. Currents were recorded in cardiomyocytes from mice trans-expressing human WT or p.P888L SAP97 and in Chinese hamster ovary (CHO)-transfected cells. The duration of the action potentials and the QT interval were significantly shorter in p.P888L-SAP97 than in WT-SAP97 mice. Compared to WT, p.P888L SAP97 significantly increased the charge of the Ca-independent transient outward (Ito,f) current in cardiomyocytes and the charge crossing Kv4.3 channels in CHO cells by slowing Kv4.3 inactivation kinetics. Silencing or inhibiting Ca/calmodulin kinase II (CaMKII) abolished the p.P888L-induced Kv4.3 charge increase, which was also precluded in channels (p.S550A Kv4.3) in which the CaMKII-phosphorylation is prevented. Computational protein-protein docking predicted that p.P888L SAP97 is more likely to form a complex with CaMKII than WT. The Na+ current and the current generated by Kv1.5 channels increased similarly in WT-SAP97 and p.P888L-SAP97 cardiomyocytes, while the inward rectifier current increased in WT-SAP97 but not in p.P888L-SAP97 cardiomyocytes. The p.P888L SAP97 polymorphism increases the Ito,f, a CaMKII-dependent effect that may increase the risk of arrhythmias.

Acute Coronary Syndrome Following Transcatheter Aortic Valve Replacement.

BACKGROUND: Scarce data exist on coronary events following transcatheter aortic valve replacement (TAVR), and no study has determined the factors associated with poorer outcomes in this setting. This study sought to determine the clinical characteristics, outcomes, and prognostic factors of acute coronary syndrome (ACS) events following TAVR. METHODS: Multicenter cohort study including a total of 270 patients presenting an ACS after a median time of 12 (interquartile range, 5-17) months post-TAVR. Post-ACS death, myocardial infarction, stroke, and overall major adverse cardiovascular or cerebrovascular events were recorded. RESULTS: The ACS clinical presentation consisted of non-ST-segment-elevation myocardial infarction (STEMI) type 2 (31.9%), non-STEMI type 1 (31.5%), unstable angina (28.5%), and STEMI (8.1%). An invasive strategy was used in 163 patients (60.4%), and a percutaneous coronary intervention was performed in 97 patients (35.9%). Coronary access issues were observed in 2.5% and 2.1% of coronary angiography and percutaneous coronary intervention procedures, respectively. The in-hospital mortality rate was 10.0%, and at a median follow-up of 17 (interquartile range, 5-32) months, the rates of death, stroke, myocardial infarction, and major adverse cardiovascular or cerebrovascular events were 43.0%, 4.1%, 15.2%, and 52.6%, respectively. By multivariable analysis, revascularization at ACS time was associated with a reduction of the risk of all-cause death (hazard ratio, 0.54 [95% CI, 0.36-0.81] P=0.003), whereas STEMI increased the risk of all-cause death (hazard ratio, 2.06 [95% CI, 1.05-4.03] P=0.036) and major adverse cardiovascular or cerebrovascular events (hazard ratio, 1.97 [95% CI, 1.08-3.57] P=0.026). CONCLUSIONS: ACS events in TAVR recipients exhibited specific characteristics (ACS presentation, low use of invasive procedures, coronary access issues) and were associated with a poor prognosis, with a very high in-hospital and late death rate. STEMI and the lack of coronary revascularization determined an increased risk. These results should inform future studies to improve both the prevention and management of ACS post-TAVR.

Self-assembled Bismuth Selenide (Bi2Se3) quantum dots grown by molecular beam epitaxy.

We report the growth of self-assembled Bi2Se3 quantum dots (QDs) by molecular beam epitaxy on GaAs substrates using the droplet epitaxy technique. The QD formation occurs after anneal of Bismuth droplets under Selenium flux. Characterization by atomic force microscopy, scanning electron microscopy, X-ray diffraction, high-resolution transmission electron microscopy and X-ray reflectance spectroscopy is presented. Raman spectra confirm the QD quality. The quantum dots are crystalline, with hexagonal shape, and have average dimensions of 12-nm height (12 quintuple layers) and 46-nm width, and a density of 8.5 × 109 cm-2. This droplet growth technique provides a means to produce topological insulator QDs in a reproducible and controllable way, providing convenient access to a promising quantum material with singular spin properties.