Detection of hidden atrial fibrillation in primary care using a long-term band-based ECG registration system: The DESCUUBRE-FA study

OBJECTIVE

To assess whether the use of a band-based electrocardiographic (ECG) monitoring system improves the diagnostic accuracy of traditional diagnostic methods for the detection of atrial fibrillation (AF).

METHODS

Multicenter and observational study of primary care patients at risk of AF. To be included, patients had to be aged ≥70 years, with no known AF, and have at least 1 major criterion (obesity, hyperthyroidism, heart failure) or 2 minor criteria (hypertension, diabetes, female sex, ischemic stroke, transient ischemic attack or systemic embolism, COPD, dyslipidemia, ischemic heart disease, peripheral artery disease). All patients were monitored using the Nuubo™ system for a single 2-week period.

RESULTS

A total of 600 patients were included (median age 77 years; 70% women; 84.3% hypertension, 27.2% diabetes, 9.2% prior stroke). The global rate of diagnosis of new AF in the overall population was 2.83%. All patients with AF were anticoagulated. In numerical terms, patients with AF (vs no AF) had a higher number of supraventricular extrasystoles and episodes of supraventricular tachycardia, as well as longer P wave duration; however, these differences did not reach statistical significance. Overall, participants were very satisfied with the device, and no relevant limitations in daily activities were observed during the 2-week study period.

CONCLUSIONS

In an elderly population at risk of AF, a band-based ECG monitoring approach applied for only 2 weeks detected approximately 3% of new cases of AF, leading to a change in antithrombotic therapy. Most participants considered the device easy to use and comfortable.

Laser emission from mirrorless waveguides based on photosensitized polymers incorporating POSS

Laser emission from leaky waveguides based in dye-doped organic gain media incorporating Polyhedral Oligomeric Silsesquioxanes (POSS) nanoparticles is reported. The samples consist of thin film gain media deposited onto glass substrate defining a planar asymmetric slab waveguide, which does not incorporate any resonant substructure. The presence of POSS results in additional amplified spontaneous emission (ASE) spectral narrowing, and conditions have been found for which directional multimode laser emission is achieved. The spectral narrowing is ascribed to the photon path enlargement caused by a non-resonant feedback mechanism provided by individual scatterers, which enhances incoherently the magnitude of the amplification process. On the contrary, the appearance of multimode lasing is attributed to coherent random lasing from a many scatterers collective effect.

Enhanced laser action of Perylene-Red doped polymeric materials

The laser action of Perylene-Red doped in linear, crosslinked, fluorinated and sililated polymeric materials is reported. The purity of dye was found to be a key factor to enhance its solid-state laser behaviour. The samples were transversely pumped at 532 nm, with 5.5 mJ/pulse and 10 Hz repetition rate. Perylene-Red doped copolymers of methyl methacrylate with a 10 vol% proportion of 2,2,2-trifluoroethyl-methacrylate exhibited a lasing efficiency of 26% with a high photostability since the dye laser output remained at the same level after 100,000 pump pulses in the same position of the sample. This lasing behaviour is, to the best of our knowledge, the highest achieved to date for organic, inorganic, and hybrid materials doped with Perylene-Red.

Amplified spontaneous emission and optical gain measurements from pyrromethene 567--doped polymer waveguides and quasi-waveguides

Amplified spontaneous emission from planar waveguides and quasi-waveguides based on Pyrromethene 567-doped poly(methyl methacrylate) thin films deposited onto quartz and glass substrates is investigated. Films with different thickness were prepared and pumped optically at 532 nm with pulses of up to 8 MW/cm(2). Pump thresholds for the onset of ASE emission, optical gains and losses were assessed. Net gain coefficients were estimated by fitting the data provided by variable stripe length measurements with a theoretical expression which takes into account saturation. In this way, net gain coefficients of up to 56 +/- 9 cm(-1) at a pump intensity of 5.3 MW/cm(2) for quasi-waveguides and up to 20.6 +/- 2.7 cm(-1) at a pump intensity of 3.4 MW/cm2 for waveguides, were obtained. Loss coefficients in the waveguides were estimated to be 3.8 +/- 0.4 cm-1 and 6.1 +/- 1.3 cm(-1) for 15 microm and 5 microm thick films, respectively. The results obtained seem to indicate a stronger self-mode-restriction capability in the quasiwaveguides than in conventional total internal-reflection waveguides.

Synthesis, structure, and physical properties of hybrid nanocomposites for solid-state dye lasers

We report on the synthesis, structural characterization, physical properties, and lasing action of two organic dyes, Rhodamine 6G (Rh6G) and Pyrromethene 597 (PM597), incorporated into new hybrid organic-inorganic materials, where the organic component was either poly(2-hydroxyethyl-methacrylate) (PHEMA) or copolymers of HEMA with methyl methacrylate (MMA), and the inorganic counterpart consisted of silica derived from hydrolysis-condensation of methyltriethoxysilane (TRIEOS) in weight proportion of up to 30%. Lasing efficiencies of up 23% and high photostabilities, with no sign of degradation in the initial laser output after 100 000 pump pulses at 10 Hz, were demonstrated when pumping the samples transversely at 534 nm with 5.5 mJ/pulse. A direct relationship could be established between the structure of the hybrid materials, analyzed by solid-state NMR, and their laser behavior. An inorganic network dominated by di-/tri- substituted silicates in a proportion approximately 35:65, corresponding to samples of HEMA with 15 and 20 wt % proportion of TRIEOS, optimizes the lasing photostability. The thermal properties of these materials, together with the high homogeneity revealed by atomic force microscopy (AFM) images, even in compounds with high silica content, indicate their microstructure to be a continuous phase, corresponding to the polymer matrix, which "traps" the silica components at molecular level via covalent bonding, with few or no silica islands.

Polymer-Filled Nanoporous Silica Aerogels as Hosts for Highly Stable Solid-State Dye Lasers

New hybrid solid-state dye laser materials based on highly porous silica aerogels have been synthesized. The open porous network of the aerogel was saturated with laser dyes dissolved in appropriate organic monomers, and polymerization took place inside the silica structure. The resulting polymer-filled nanoporous aerogel (PFNPA) was cast in a cylindrical shape, forming monoliths that were used as gain media in solid-state dye lasers. When the PFNPA incorporated pyrromethene dyes, highly photostable laser emission with good lasing efficiency was obtained. Under the demanding conditions of tightly focused transversal pumping with 532 nm, 5 mJ pulses at 10 Hz repetition rate, the commercial dye Pyrromethene 567 exhibited laser action with only a 10% drop in the laser output after 10(6) pump pulses in the same position of the sample.

The efficiency of titanocene as photoinitiator in the polymerization of dental formulations

A comparative kinetic study of the polymerization of tetraethyleneglycol dimethacrylate (TEEGDM) under visible light irradiation was carried out in order to determine the effectiveness of titanocene as photoinitiator in this process. The pair camphorquinone/dimethylaminoethyl methacrylate, CQ/DMAEMA (0.5/0.5%, by weight), was used as a reference photoinitiatior system. The reactions were carried out both in the presence and absence of oxygen (in N2) and with variable and constant titanocene concentration and incident light intensity. It was observed that in both atmospheres the polymerization reaction commenced rapidly and its initial rate was comparable with that obtained in the presence of the classic initiation system. However, after reacting for a few seconds this process suffered abrupt deactivation, this tendency being more noticeable at low titanocene concentrations. To explain the observed kinetic behavior, the study of the photofragmentation of titanocene upon irradiation with visible light in both atmospheres was carried out. The quantum yield calculated in the presence of O2 (phifr = 8 at 465 nm) suggests the existence of a chain reaction with participation of oxygen, and this explains, in turn, the high value of the initial rate of polymerization and also the rapid disappearance of the photoinitiator. In an inert atmosphere the photofragmentation occurs in a conventional way, this being a very effective process with quantum yield of 0.7 at 465 nm. However, it seems that only a small part of the active species acts as initiating radicals and these are not sufficient to achieve the appropriate monomer conversion.

Photophysical and lasing properties of new analogs of the boron-dipyrromethene laser dye pyrromethene 567 incorporated into or covalently bounded to solid matrices of poly(methyl methacrylate)

The photophysical, lasing and thermostability properties of newly synthesized analogs of the commercial dye pyrromethene 567 (PM567) have been measured in polymeric matrices of poly(methyl methacrylate) both when used as a dopant and when covalently bounded to the polymeric chain. These analogs have an acetoxy or a polymerizable methacryloyloxy group at the end of a polymethylene chain at Position 8 of the PM567 chromophore core. Clear correlations between photophysical and lasing characteristics are observed. Linking chain lengths with three or more methylene units give the highest fluorescence quantum yields (as high as 0.89) and lasing efficiencies (as high as 41%). The covalent linkage of the chromophore to the polymeric chain via the methacryloyloxy group improves the photostability of the PM567 chromophore.

Photothermal characterization and stability analysis of polymeric dye lasers

The millisecond heat dissipation of pump energy in polymeric, solid-state dye lasers has been studied with photothermal deflection spectroscopy (PTDS) to determine the contribution of that process to photodegradation of the active material. The samples were solutions of Rhodamine 6G in 2-hydroxyethyl methacrylate copolymerized with various amounts of methyl methacrylate or ethylene glycol dimethylacrylate to change the microstructure properties of the matrix. Values of the thermal diffusivity measured with PTDS were in the range 0.6-1.1 x 10(-3) cm(2) s(-1) for all the compositions studied here. A comparison of these values with previous optical data on lasing efficiency and photostability for the same samples indicates that the macroscopic rate of thermal diffusion is not the key factor that limits the efficiency and stability of these lasers, at least for low pump repetition rates (<1 Hz).

Self-curing membranes of chitosan/PAA IPNs obtained by radical polymerization: preparation, characterization and interpolymer complexation

Chitosan/polyacrylic acid I PN's were prepared by radical polymerization of acrylic acid, AA, activated at low temperature, in an aqueous/alcoholic chitosan dispersion. AA monomer to polymer conversion and membrane compositions were determined by elemental analysis and FTIR. Evidences of interpolyelectrolite complex formation were found from the FTIR spectra as well. The gravimetric measurements and the elemental analysis after some exhaustive PAA extraction support the existence of some PAA grafting on the reactive amine group of the chitosan. Swelling degree of the membranes is highly dependent on pH and composition, showing a higher swelling in membranes richer in AA and increased pH due to the breaking of interpolyelectrolite salt bonds.

Development of new photopolymerizable dental sealants

This paper describes the results obtained in the optimization of the composition of dental sealants in relation to the nature and proportions of monomer mixtures and photoinitiating system employed. The quantification and variation of certain parameters which determine the quality of a dental sealant (such as viscosity and penetrating power, residual double bonds, solubility and absorption, volume shrinkage and certain specific mechanical properties) have resulted in the development of new formulations. The composition which has achieved the best results of all the above properties was that corresponding to the monomer mixture bis-GMA/tri(ethylene glycol) dimethacrylate (TEGDMA) 40/60 wt%, and the photoinitiating system camphorquinone (CQ) with co-initiators N,N,3,5-tetramethyaniline (TMA) or N,N-dimethyl-p-toluidine (DMPT) in the ratio 1:1. The final properties and characteristics of the obtained formulations are superior to those of commercial dental sealants currently in use.

Long-pulse narrow-linewidth dispersive solid-state dye-laser oscillator

We report on narrow-linewidth long-pulse laser emission from a dispersive solid-state dye-laser oscillator. Output energy was ~0.4 mJ/pulse at laser linewidths of 650 MHz and pulse lengths of 105 ns FWHM. The solid-state gain medium utilized was Rhodamine 6G dye-doped 2-hydroxyethyl methacrylate:methyl methacrylate.

Anticancer drug, ara-C, release from pHEMA hydrogels

This study investigates the controlled release of cytarabine (ara-C), an anticancer drug, from a polymeric matrix of lightly cross-linked poly(2-hydroxyethyl methacrylate) (pHEMA). The swelling of pHEMA discs in water was analysed as a function of temperature and thickness of xerogel discs. The fractional swelling was linear in (time)1/2 for short time periods. Drug release kinetics were examined as a function of temperature, initial drug load and thickness of pHEMA discs. The fraction of available drug release was also linear in (time)1/2 during the initial stages. These studies allow for the determination of diffusion coefficients for both the transport of water into the hydrogel and ara-C release from the polymer.

Proton-transfer lasers from solid polymeric chains with covalently bound 2-(2'-hydroxyphenyl) benzimidazole groups

The lasing properties of a number of newly synthesized 2-(2'-hydroxyphenyl) benzimidazole derivatives copolymerized with methyl methacrylate or dissolved in poly (methyl methacrylate) and pumped with an N(2) laser are reported. The radiation mechanism is based on the intramolecular proton-transfer in the electronic excited state. Both the lasing efficiency and the dye photostability increase significantly when the proton-transfer chromophore is covalently bound to the polymeric chain, and energy-conversion efficiencies comparable to those obtained in liquid solution are demonstrated.

New photopolymer used as a holographic recording material

The composition and the holographic behavior of a new photopolymer with high diffraction efficiencies (30% at 514 and 60% at 633 nm) are described.