Early diagnosis and treatment of a stroke improves patient outcomes, and knowledge of the cause of the initial event is crucial to identification of the appropriate therapy to maximally reduce risk ...of recurrence. Assumptions based on historical frequency of ischemic subtypes may need revision if stroke subtypes are changing as a result of recent changes in therapy, such as increased use of statins.
We analyzed secular trends in stroke risk factors and ischemic stroke subtypes among patients with transient ischemic attack or minor or moderate stroke referred to an urgent transient ischemic attack clinic from 2002 to 2012.
There was a significant decline in low-density lipoprotein cholesterol and blood pressure, associated with a significant decline in large artery stroke and small vessel stroke. The proportion of cardioembolic stroke increased from 26% in 2002 to 56% in 2012 (P<0.05 for trend). Trends remained significant after adjusting for population change.
With more intensive medical management in the community, a significant decrease in atherosclerotic risk factors was observed, with a significant decline in stroke/transient ischemic attack caused by large artery atherosclerosis and small vessel disease. As a result, cardioembolic stroke/transient ischemic attack has increased significantly. Our findings suggest that more intensive investigation for cardiac sources of embolism and greater use of anticoagulation may be warranted.
Posterior variants of abdominal wall block include the quadratus lumborum type I, quadratus lumborum type II and quadratus lumborum transmuscular blocks. Our objectives were to compare the spread of ...injectate and nerve involvement, after conducting blocks using ultrasound guidance in soft embalmed cadavers.
After randomization, an experienced anaesthetist conducted three quadratus lumborum 1, three quadratus lumborum 2 and four transmuscular blocks on the left or right sides of five cadavers. All cadavers were placed in the lateral position and the quadratus lumborum muscle seen using a 3–9 MHz ultrasound probe placed in the flank. For each block, a 20 ml mixture of 17.75 ml water, 2 mls latex and 0.25 ml India ink was injected. The lumbar region and abdominal flank were dissected 72 h later.
We conducted 10 blocks. Two quadratus lumborum 1 and two quadratus lumborum 2 blocks were associated with spread of dye within the TAP plane. One quadratus lumborum 1 block spread to the deep muscles of the back and one quadratus lumborum 2 block dispersed within the subcutaneous tissue surrounding the abdominal flank. All transmuscular quadratus lumborum blocks spread consistently to L1 and L3 nerve roots and within psoas major and quadratus lumborum muscles.
Consistent spread to lumbar nerve roots was achieved using the transmuscular approach through the quadratus lumborum.
In many parts of the world, incidence of papillary thyroid cancer is increasing faster than any other malignancy. Most papillary thyroid cancers that are diagnosed are small and are generally ...regarded as being low risk, with little or no effect on mortality. Papillary thyroid cancer is a clinical challenge because it is difficult to prove benefit from the traditional therapeutic triad for this disorder (ie, total thyroidectomy with or without prophylactic central neck dissection, radioiodine remnant ablation, and suppression of serum thyroid-stimulating hormone with levothyroxine). However, risk of disease recurrence might be reduced by these therapies in a subset of patients with more aggressive disease. In the past decade, professional societies and other groups have established evidence-based clinical practice guidelines for management of papillary thyroid cancer, but these efforts have been made difficult by a paucity of randomised controlled trials. In this review, we summarise epidemiological data for disease incidence, discuss some controversies in disease management, and outline a therapeutic framework founded in the best available medical evidence and existing recommendations from clinical practice guidelines.
Plasmon polaritons are hybrid excitations of light and mobile electrons that can confine the energy of long-wavelength radiation at the nanoscale. Plasmon polaritons may enable many enigmatic quantum ...effects, including lasing
, topological protection
and dipole-forbidden absorption
. A necessary condition for realizing such phenomena is a long plasmonic lifetime, which is notoriously difficult to achieve for highly confined modes
. Plasmon polaritons in graphene-hybrids of Dirac quasiparticles and infrared photons-provide a platform for exploring light-matter interaction at the nanoscale
. However, plasmonic dissipation in graphene is substantial
and its fundamental limits remain undetermined. Here we use nanometre-scale infrared imaging to investigate propagating plasmon polaritons in high-mobility encapsulated graphene at cryogenic temperatures. In this regime, the propagation of plasmon polaritons is primarily restricted by the dielectric losses of the encapsulated layers, with a minor contribution from electron-phonon interactions. At liquid-nitrogen temperatures, the intrinsic plasmonic propagation length can exceed 10 micrometres, or 50 plasmonic wavelengths, thus setting a record for highly confined and tunable polariton modes. Our nanoscale imaging results reveal the physics of plasmonic dissipation and will be instrumental in mitigating such losses in heterostructure engineering applications.
Organometallic lead halide perovskites seem to be on the threshold of becoming viable commercial photovoltaics; however, further improvements to the stability of these materials must be made before ...they can compete with existing photovoltaic technologies. Of the organometallic lead halide perovskites used in photovoltaics, methylammonium lead triiodide perovskite (MAPI) is perhaps the most studied, and understanding how MAPI degrades is crucial for developing strategies to improve stability. We discuss the experimental evidence behind several possible routes for MAPI to degrade into PbI2 and various organics, and how the decomposition path of MAPI may strongly depend on substrate, precursors, intrinsic organic defects, and morphology. Exploring the conditions required for MAPI to degrade according to a particular pathway is important not only from a fundamental materials chemistry perspective, but also for understanding intrinsic instability in MAPI-based photovoltaics and to develop strategies to improve stability.
Graphene is an atomically thin plasmonic medium that supports highly confined plasmon polaritons, or nano-light, with very low loss. Electronic properties of graphene can be drastically altered when ...it is laid upon another graphene layer, resulting in a moiré superlattice. The relative twist angle between the two layers is a key tuning parameter of the interlayer coupling in thus-obtained twisted bilayer graphene (TBG). We studied the propagation of plasmon polaritons in TBG by infrared nano-imaging. We discovered that the atomic reconstruction occurring at small twist angles transforms the TBG into a natural plasmon photonic crystal for propagating nano-light. This discovery points to a pathway for controlling nano-light by exploiting quantum properties of graphene and other atomically layered van der Waals materials, eliminating the need for arduous top-down nanofabrication.
Surface plasmons are collective oscillations of electrons in metals or semiconductors that enable confinement and control of electromagnetic energy at subwavelength scales. Rapid progress in ...plasmonics has largely relied on advances in device nano-fabrication, whereas less attention has been paid to the tunable properties of plasmonic media. One such medium--graphene--is amenable to convenient tuning of its electronic and optical properties by varying the applied voltage. Here, using infrared nano-imaging, we show that common graphene/SiO(2)/Si back-gated structures support propagating surface plasmons. The wavelength of graphene plasmons is of the order of 200 nanometres at technologically relevant infrared frequencies, and they can propagate several times this distance. We have succeeded in altering both the amplitude and the wavelength of these plasmons by varying the gate voltage. Using plasmon interferometry, we investigated losses in graphene by exploring real-space profiles of plasmon standing waves formed between the tip of our nano-probe and the edges of the samples. Plasmon dissipation quantified through this analysis is linked to the exotic electrodynamics of graphene. Standard plasmonic figures of merit of our tunable graphene devices surpass those of common metal-based structures.
Abstract
An ever-increasing population of patients with papillary thyroid cancer is engaging with health care systems around the world. Numerous questions about optimal management have arisen that ...challenge conventional paradigms. This is particularly the case for patients with low-risk disease, who comprise most new patients. At the same time, new therapies for patients with advanced disease are also being introduced, which may have the potential to prolong life. This review discusses selected controversial issues in adult papillary thyroid cancer management at both ends of the disease spectrum. These topics include: (i) the role of active surveillance for small papillary cancers; (ii) the extent of surgery in low-risk disease (lobectomy vs total thyroidectomy); (iii) the role of postoperative remnant ablation with radioiodine; (iv) optimal follow-up strategies in patients, especially those who have only undergone lobectomy; and (v) new therapies for advanced disease. Although our current management is hampered by the lack of large randomized controlled trials, we are fortunate that data from ongoing trials will be available within the next few years. This information should provide additional evidence that will decrease morbidity in low-risk patients and improve outcomes in those with distant metastatic disease.
We report on nano-infrared (IR) imaging studies of confined plasmon modes inside patterned graphene nanoribbons (GNRs) fabricated with high-quality chemical-vapor-deposited (CVD) graphene on Al2O3 ...substrates. The confined geometry of these ribbons leads to distinct mode patterns and strong field enhancement, both of which evolve systematically with the ribbon width. In addition, spectroscopic nanoimaging in the mid-infrared range 850–1450 cm–1 allowed us to evaluate the effect of the substrate phonons on the plasmon damping. Furthermore, we observed edge plasmons: peculiar one-dimensional modes propagating strictly along the edges of our patterned graphene nanostructures.
Fizeau drag in graphene plasmonics Dong, Y; Xiong, L; Phinney, I Y ...
Nature (London),
06/2021, Letnik:
594, Številka:
7864
Journal Article
Recenzirano
Odprti dostop
Dragging of light by moving media was predicted by Fresnel
and verified by Fizeau's celebrated experiments
with flowing water. This momentous discovery is among the experimental cornerstones of ...Einstein's special relativity theory and is well understood
in the context of relativistic kinematics. By contrast, experiments on dragging photons by an electron flow in solids are riddled with inconsistencies and have so far eluded agreement with the theory
. Here we report on the electron flow dragging surface plasmon polaritons
(SPPs): hybrid quasiparticles of infrared photons and electrons in graphene. The drag is visualized directly through infrared nano-imaging of propagating plasmonic waves in the presence of a high-density current. The polaritons in graphene shorten their wavelength when propagating against the drifting carriers. Unlike the Fizeau effect for light, the SPP drag by electrical currents defies explanation by simple kinematics and is linked to the nonlinear electrodynamics of Dirac electrons in graphene. The observed plasmonic Fizeau drag enables breaking of time-reversal symmetry and reciprocity
at infrared frequencies without resorting to magnetic fields
or chiral optical pumping
. The Fizeau drag also provides a tool with which to study interactions and nonequilibrium effects in electron liquids.
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