Background. Mechanical trauma occupies one of the leading places in forensic medical examination. The main task of the expert, when conducting this kind of examination, is to provide a scientifically ...based answer to the questions of the pre-trial investigation bodies or the court, which relate not only to the determination of the mechanism of the injury, but also to the time period of its occurrence. Traditional methods of morphological research and methods of laboratory analyzes cannot always provide comprehensive information, especially in cases of determining the age of mechanical trauma in the early Post-mortem period. Therefore, new methods of biochemical research are being actively introduced into forensic medical practice.
Aim: Analysis of the literature devoted to the application of various biochemical diagnostic methods in forensic medical practice to establish the antiquity of mechanical trauma.
Results. In pathological conditions, such as, for example, trauma, certain molecular changes occur in the human body, which are associated with a systemic reaction to a stress factor and are manifested before the appearance of morphological changes in tissues and organs. Therefore, the use of biochemical research methods will significantly expand the possibilities of forensic diagnostics. The publication shows promising directions for the application of the biochemical method for forensic trauma diagnosis. Issues of establishing the statute of limitations for mechanical injuries are considered. Today, scientific studies of the body's stress state in cases of fatal injuries are becoming more and more common. Which is of great importance for forensic medical expert practice. Therefore, the role of manifestations of the body's systemic response to trauma is described. The role of natriuretic peptides, creatine kinase and procalcitonin in diagnosing the duration of the traumatic process is also shown.
Conclusion. The relevance and practical significance of biochemical research for the forensic diagnosis of the time of occurrence of a mechanical injury, as well as the development of new diagnostic criteria for determining the body's systemic response to trauma, necessitated a deep and comprehensive study of the above problems.
InGaN nanowires are suitable building blocks for many future optoelectronic devices. We show that a linear grading of the indium content along the nanowire axis from GaN to InN introduces an internal ...electric field evoking a photocurrent. Consistent with quantitative band structure simulations we observe a sign change in the measured photocurrent as a function of photon flux. This negative differential photocurrent opens the path to a new type of nanowire-based photodetector. We demonstrate that the photocurrent response of the nanowires is as fast as 1.5 ps.
The eradication of ventricular tachycardia (VT) isthmus sites constitutes the minimal procedural endpoint for VT ablation procedures. Contemporary high-resolution computed tomography (CT) imaging, in ...combination with computer-assisted analysis and segmentation of CT data, facilitates targeted elimination of VT isthmi. In this context, inHEART offers digitally rendered three-dimensional (3D) cardiac models which allow preoperative planning for VT ablations in ischemic and non-ischemic cardiomyopathies. To date, almost no data have been collected to compare the outcomes of VT ablations utilizing inHEART with those of traditional ablation approaches.
The presented data are derived from a retrospective analysis of n = 108 patients, with one cohort undergoing VT ablation aided by late-enhancement CT and subsequent analysis and segmentation by inHEART, while the other cohort received ablation through conventional methods like substrate mapping and activation mapping. The ablations were executed utilizing a 3D mapping system (Carto3), with the mapping generated via the CARTO® PENTARAY™ NAV catheter and subsequently merged with the inHEART model, if available.
Results showed more successful outcome of ablations for the inHEART group with lower VT recurrence (27% vs. 42%, p < 0.06). Subsequent analyses revealed that patients with ischemic cardiomyopathies appeared to derive a significant benefit from inHEART-assisted VT ablation procedures, with a higher rate of successful ablation (p = 0.05).
Our findings indicate that inHEART-guided ablation is associated with reduced VT recurrence compared to conventional procedures. This suggests that employing advanced imaging and computational modeling in VT ablation may be valuable for VT recurrences.
We investigate the ultrafast optoelectronic properties of single Al0.3Ga0.7As/GaAs core–shell nanowires. The nanowires contain GaAs-based quantum wells. For a resonant excitation of the quantum ...wells, we find a picosecond photocurrent which is consistent with an ultrafast lateral expansion of the photogenerated charge carriers. This Dember-effect does not occur for an excitation of the GaAs-based core of the nanowires. Instead, the core exhibits an ultrafast displacement current and a photothermoelectric current at the metal Schottky contacts. Our results uncover the optoelectronic dynamics in semiconductor core–shell nanowires comprising quantum wells, and they demonstrate the possibility to use the low-dimensional quantum well states therein for ultrafast photoswitches and photodetectors.
We have produced networks of surface-oxidized and hydrogen-terminated silicon nanocrystals (Si-NCs), both intrinsic and n-type doped, on flexible plastic foil from nanoparticle inks. The charge ...transport in these networks was comprehensively studied by means of time-dependent conductivity, steady-state current versus voltage characteristics, and steady-state photocurrent measurements as a function of incident light intensity. These measurements were complemented by surface chemistry and structural/morphological analysis from Fourier transform infrared spectroscopy and electron microscopy. Whereas H-terminated Si-NC networks function as semiconductors (both in air and in vacuum), where conductivity enhancement upon impurity doping and photoconductivity were observed, these characteristics are not present in networks of surface-oxidized Si-NCs. For both network types, the observation of a power law behavior for steady-state current versus voltage and a current decaying with time at constant bias indicate that charge transport is controlled by space-charge-limited current (involving trap states) via percolation paths through the networks. We have also monitored the evolution of the networks (photo)conductivity when the internanocrystal separating medium formed by Si–H bonds is progressively replaced by a native oxide upon exposure to air. Although a decrease in the (photo)conductivity is observed, the networks still behave as semiconductors even after a long-term air exposure. From an analysis of all (photo)current data, we deduce that in networks of oxidized Si-NCs inter-NC charge transfer requires the participation of oxide-related electronic states, whereas in H-terminated Si-NC networks direct inter-NC charge transfer plays a major role in the overall long-range conduction process.
Erhard discusses the future demands on die casting and technical requirements for its profitability. The die casting process is a technically mature casting process that is excellently suited for the ...production of large series. The die casting process has been developed in order to analyze and to show the path to profitability, depending on the application.
Identification of dead persons in forensic medical practice is key one during the martial law in Ukraine. Nowadays, when new research methods and modern laboratory and instrumental equipment appear, ...there is a need to improve forensic diagnostics during the identification of unknown persons. The goal was to establish the peculiarity of the identification of dead persons during martial law, to provide practical recommendations for the selection and extraction of biological material during forensic medical examinations of corpses. The reliability of the results and conclusions is ensured by the use of general scientific empirical and theoretical research methods. With the help of the general scientific methods of research (analysis, synthesis, generalization), scientific and informational literary sources by the subject of research are characterized. The level of problematic issues in the profile information was determined and recommendations for solving problematic aspects related to the identification of dead persons were provided. A systematic approach to solving problematic issues made it possible to formulate conclusions to achieve the set goal. The necessity of training experts in the peculiarities of material selection for further DNA identification is substantiated. The need to provide forensic medical experts with the necessary consumables and equipment, as well as urgent revision of the normative acts regulating their activities, has been proven. The features of identification of putrefied persons are characterized, which consist in the possibility of DNA extraction from smears from the wall of the aorta, the wall of the urinary bladder, brain tissue and intact teeth. It is proven that the identification of dead persons during the martial law is complicated by the influence of the thermal factor, as well as pronounced putrefactive changes. In these cases, bones and teeth as the objects of DNA extraction should be preferential. The relevance and practical significance of the use of innovative technologies for the identification of dead persons during martial law have been established. Some issues of regulatory and legal provision of forensic medical identification of dead persons during martial law, the need to improve the procedure for taking biological samples in criminal proceedings, etc. were raised. Directions for their solution are proposed.
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
In persistent AF, outcomes after PVI alone is worse as the pathophysiology remains unclear. Prolonged AF duration is an ...independent predictor for worse success rates after catheter ablation. In this study, we investigated efficacy and safety of ablation of spatio-temporal dispersions, as additional ablation strategy after PVI in patients with long-standing persistent AF.
Methods
All consecutive patients with long-standing persistent AF treated with an AI-based algorithm for detection of spatio-temporal dispersion in our institution between 05/21 and 10/22 were included (n = 41, see table 1). The procedure was done using a high-density 3D-Map and an algorithm for detection of right and left atrial areas with spatio-temporal dispersion (DISPERS). Ablation of DISPERS was aiming at homogenizing, dissecting, isolating or connecting DISPERS areas to non-conducting structures. Follow-up contained regular visits at our out-patient-clinic and repetitive 7 day Holter ECGs. Late recurrence (LR) was defined as recurrence after 90 days or as recurrence, which caused further ablation. All complications requiring intervention or causing long-term sequelae were classified as major complications.
Results
In 24/41 pts (58.5%), the DISPERS guided ablation was the first AF ablation. Patients were suffering from very long-standing persistent AF with a mean AF duration of 64.89 ± 54.77 months. Additional to circumferential PVI, ablation of all detected left atrial (100%) and right atrial (68.3%) DISPERS areas was performed, leading to significant slowing of AF cycle length (mean 23.3%) or termination of AF to AT (5/41, 12.2%) or direct conversion to SR (6/41, 14.6%).
One major complication occurred (1/41 (2.4%), pseudoaneurysm, resolving after manual compression). Three patients (7.3%) required temporary external pacing due to delayed sinus recovery after the procedure. No patient was in need of permanent pacemaker implantation.
LR occurred in 25 patients (61.0 %): In 8/25 patients (32 %), LR was solely AF, whereas in 15/25 patients (60%) LR was a left AFlutt. In 2 patients (8%), AF and left AFlutt was detected.
During a follow-up of 231 ± 129 days, 72.9 % of patients remained in sinus rhythm undergoing 1.6 ± 0.68 ablations (s. Figure 1; 4,9% of patients on AAD). Additionally, Figure 2 illustrates the AF-free outcome in all patients.
Conclusion
Ablation of arrhythmogenic substrate identified by spatio-temporal dispersion yielded in this cohort of extensively long-standing persistent AF patients in high success rates regarding elimination of AF. Most arrhythmia recurrences were reentrant AT. After a total of 1.6 procedures, freedom from AF and AT was >72%. Despite prolonged procedure times, complication rates remained very low. Extending study population and follow-up is needed to evaluate long-term efficacy of dispersion-guided ablation.
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Radiofrequency ablation remains one of the most important ablation techniques in the EP lab. Creating durable lesion is ...difficult, as progression of lesion formation cannot be observed directly. Surrogate parameters, as force-time-integral and indices, as the ablation index or lesion size index, help distinguishing the efficacy of a RF-application, but several deficiencies are known. The aim of this study was to further investigate dynamic changes in ablation parameters and lesion growth in RF-ablation.
Methods
RF-lesions were created using an ex vivo porcine cardiac model with a force and local impedance sensing catheter. A second catheter was used for lesions up to 70 Watts. The experimental setup consisted of a saline-filled container, a dispersive electrode, a heated thermostat and a circulation pump to imitate in vivo conditions. Global impedance was kept at 120 Ohm as well as the temperature at 37°C. RF-lesions were created using identic values of RF duration and electrode tissue coupling. RF power of 20W, 30W, 40W, and 50W was used in the local impedance sensing catheter, while RF power of 30W, 40W, 50W, 60W, and 70W were used in the second catheter.
All parameters (power, temperature, global impedance, ETC, lesion diameter and lesion depth) were measured once per second during application of RF-current, enabling real-time correlation of RF parameters and lesion size. In case of an audible steam pop, RF application was stopped.
Results
In total, 61 lesions were included in the analysis. Due to at least 60 measurements per lesion, 3321 data points with all ablation parameters (power, temperature, global impedance, lesion diameter and lesion depth) were collected and analyzed.
Throughout the application, lesion progression was highest in the first seconds of RF application and showed a slowing approximation to a maximum (Figure 1 and 2). Potential maximum lesion size seems to be defined by selected power level (s. Figure 3). Interestingly, these findings were seen in all power levels from 20 – 70 W (s. Figure 3).
75 % of final lesion size was achieved after 12-25 seconds, depending on selected power levels (s. Figure 4). In high power ablation (> 50 W), 75% of final lesion size was reached significantly earlier compared to lower power levels (20-40 W, s. Figure 4).
Conclusion
In RF-ablation, lesion growth is not linear. A slowing approximation of lesion diameter and depth to a maximum is observed. This finding should be considered in clinical settings to avoid steam pops and collateral damage due to a long RF duration despite little changes in lesion size. Further investigation is needed for a surrogate parameter, which is able to assess declining lesion growth after the first seconds of RF-application.
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