Ebstein anomaly is frequently associated with accessory pathways, including Mahaim atriofascicular fibres. We herein illustrate successful Mahaim fibre ablation in Ebstein anomaly by targeting the ventricular insertion site below the tricuspid ridge.

In the ablation zone of glacier habitats, cryoconite holes are known to harbor diverse microbial communities, including unique diatom floras distinct from those of surrounding aquatic and terrestrial systems. Besides descriptive studies, little is known about the diversity of cryoconite diatoms and their response to environmental stressors, particularly in low-latitude glaciers. This paper documents an extremely diversified diatom community in Antisana Glacier (Ecuador), reporting 278 taxa found in 54 surface holes, although with low individual abundances. Contrary to our expectations, assemblage structure did not respond to water physical or chemical characteristics, nor to cryoconite hole morphology, but to elevation. We demonstrate that elevation is a driver of diatom assemblages. Both alpha diversity (measured as Fisher's index) and species richness (corrected for unequal sample sizes) correlated negatively with elevation, suggesting a replacement toward simplified, poorer communities along this gradient. The taxonomic composition also changed significantly, as revealed by multivariate statistics. In summary, cryoconite holes are sites of high taxonomic diversity composed of taxa that are allochthonous in origin.

There is minimal data regarding antegrade-only accessory pathways in young patients. Given evolving recommendations and treatments, retrospective analysis of the clinical and electrophysiologic properties of antegrade-only pathways in patients <21 years old was performed, with subsequent comparison of electrophysiology properties to age-matched controls with bidirectional pathways. Of 522 consecutive young patients with ventricular pre-excitation referred for electrophysiology study, 33 (6.3%) had antegrade-only accessory pathways. Indications included palpitations (47%), chest pain (25%), and syncope (22%). The shortest value for either the accessory pathway effective refractory period or the pre-excited R-R interval was taken for each patient, with the median of the antegrade-only group significantly greater than shortest values for the bidirectional group (310 [280–360] ms versus 270 [240–302] ms, p < 0.001). However, the prevalence of pathways with high-risk properties (effective refractory period or shortest pre-excited R-R interval <250 ms) was similar in both study patients and controls (13% versus 21%) (p = 0.55). Sixteen patients had a single antegrade-only accessory pathway and no inducible arrhythmia. Six patients had Mahaim fibres, all right anterolateral with inducible antidromic reciprocating tachycardia. However, 11 patients with antegrade-only accessory pathways and 3 with Mahaim fibres had inducible tachycardia due to a second substrate recognised at electrophysiology study. These included concealed accessory pathways (7), bidirectional accessory pathways (5), and atrioventricular node re-entry (2). Antegrade-only accessory pathways require comprehensive electrophysiology evaluation as confounding factors such as high-risk conduction properties or inducible Supraventricular Tachycardia (SVT) due to a second substrate of tachycardia are often present.

Multifocal atrial tachycardia has certain electrocardiographic similarities to atrial fibrillation. The mechanism of atrial fibrillation is heterogenous but in some cases may arise from a single ectopic driver with fibrillatory conduction to the rest of the atria. This has led to the speculation that multifocal atrial tachycardia may have a similar mechanistic unifocal site that disperses through the atrium in a fibrillatory pattern. Ivabradine has been reported to be efficacious in an adult with paroxysmal atrial fibrillation as well as in children with junctional or ectopic atrial tachycardias. This is the first report of successfully using ivabradine, a novel anti-arrhythmic If blocking agent, to convert multifocal atrial tachycardia in a 5-month-old critically ill infant to a pattern indicating a single ectopic atrial focus. This allowed the patient’s single atrial focus to be ablated with return to sinus rhythm and decannulation from ventriculoarterial extracorporeal membrane oxygenation. This case suggests that multifocal atrial tachycardia may arise from a single automatic focus with downstream fibrillatory conduction to the atria.

As a kind of flash heat source, intense pulsed ion beam (IPIB) can be used for material surface modification. The ablation effect has important influence on interaction between IPIB and material. Therefore, the understanding of ablation mechanism is of great significance to IPIB application. In this work, pure zinc targets were irradiated and ablated by IPIB. In the ablation process under the different ion beam energy densities, the ablation products were collected by a monocrystalline silicon substrate. By analyzing the ablation products with scanning electron microscope and energy-dispersive spectrometer, the surface morphology, and the spatial distribution of ablation products quantity were obtained. The results are useful for clearing the ablation process and the influence of beam parameter on the ablation effect.

Issues in traditional cross-section sampling of paintings and other cultural artifacts with a scalpel, such as crumbling, delamination and paint compression, can deter conservators from sampling fragile paint layers. Often, such sampling carries the risk of causing further damage from a scalpel, which outweighs the benefits of scientific investigation. Here, we show that femtosecond lasers offer a viable alternative to obtaining cross-sections with minimal damage to the surrounding artwork. A Regenerative Ti:Sapphire amplifier system with a pulse duration of 70 femtoseconds, a few milliwatts of average power and a repetition rate of 1 kHz (1000 pulses/sec) was used for the study. Tests were performed on oil paintings ranging in age from the 19th century to late 20th century. Effective settings were determined to be 2 mW of power at a speed of 10mm/sec using an 800nm laser. Preliminary results suggest femtosecond lasers could be a viable alternative for obtaining paint cross-sections when traditional sampling methods cause unnecessary damage to fragile materials.

Femtosecond laser direct writing (FsLDW) in transparent materials is a laser-based precise three-dimensional (3D) micro/nanofabrication method that has shown great potential for applications. The advantages of FsLDW originate in the nonlinear nature of absorption in the multiphoton absorption process. Over the past few years, transparent material micro/nanofabrication using FsLDW has seen several developments in materials and applications. Specifically, two-photon polymerization has been widely used as a precision direct-writing process for fabrication of polymeric 3D micro/nanostructures; internal/surface ablation of polymer 3D structures based on multiphoton absorption has been demonstrated and developed as a promising subtractive manufacturing technique; and femtosecond laser multiphoton modification in glass has been intensively studied for refractive-index change and generation of nanogratings and microvoids. This article describes the latest research on FsLDW in polymers and glasses with specific applications for large-dimension fabrication, microelectromechanical systems, microphotonics, and microfluidics.

In current practice, children with anatomically normal hearts routinely undergo fluoroscopy-free ablations. Infants and children with congenital heart disease (CHD) represent the most difficult population to perform catheter ablation without fluoroscopy. We report two neonatal patients with CHD in whom cardiac ablations were performed without fluoroscopy. The first infant had pulmonary atresia with intact ventricular septum with refractory supraventricular tachycardia, and the second infant presented with Ebstein’s anomaly of the tricuspid valve along with persistent supraventricular tachycardia. Both patients underwent uncomplicated, successful ablation without recurrence of arrhythmias. These cases suggest that current approaches to minimising fluoroscopy may be useful even in challenging patients such as neonates with CHD.

A 16-year-old patient underwent successful ablation of ventricular arrhythmia originating from the aortic sinus of Valsalva following surgical unroofing of an anomalous right coronary artery. This case illustrates the complexity of decision making in the management of patients with anomalous coronary arteries and the importance of keeping an open mind when determining ventricular arrhythmia aetiology and origin.

Models and experiments were developed to study femtosecond laser ablation of silicon using 800 nm, 40 fs pulses with fluences ranging from 0.5 to 35 J/cm2. At low fluences, ablation was found to occur due to bubble formation and splashing within the melt layer. At higher fluences, it was found that the ablation depth exceeded the melt layer depth due to shockwave ablation. The variation in ion flux and ion velocity was also studied both experimentally and theoretically. It was found that the variation in ion flux is mainly dependent on the variation in the average charge state, with only a small variation in the total number of ions above $\sim \!\!1.5\; \,{\rm J/c}{{\rm m}^2}$. Comparisons between the theoretical and experimental ion flux showed that higher charge state ions received greater portion of the laser energy compared with lower charge state ions.

This study reports on the preparation of cobalt doped zinc oxide (Co:ZnO) filmsvia pulsed electron beam ablation (PEBA) from a single target containing 20 w%Co on sapphire (0001) and silicon (100) substrates. The films have beendeposited at various temperatures (350оC,400оC, 450оC) and pulsefrequencies (2 Hz, 4 Hz), under a background argon (Ar) pressure of about 3mtorr, and an accelerating voltage of 14 kV. The surface morphology has beenexamined by atomic force microscopy (AFM) and scanning electron microscopy(SEM). According to SEM analysis, the films consist of nano-globules whose sizeis in the range of 80-178 nm. Energy dispersive x-ray spectroscopy (EDX) revealsthat deposition is congruent and the prepared films contain∼20±5 w% cobalt. It has been found that the nano-globules inthe deposited films are cobalt-rich zones containing ∼70 w% Co. Fromx-ray photoelectron spectroscopy (XPS) analysis, Co 2p3/2 peaksindicate that the deposited films contain CoO (binding energy = 780.5eV) as well as metallic Co (binding energy = 778.1-778.5 eV). X-raydiffraction (XRD) analysis supports the presence of metallic Co hcp phase(2ϴ = 44.47° and 47.43°) in the films.

At present, three-dimensional mapping is often used during cardiac ablations with an explicit goal of decreasing radiation exposure; three-dimensional mapping was introduced in our institution in 2007, but not specifically to decrease fluoroscopy time. We document fluoroscopy use and catheterisation times in this setting. Data were obtained retrospectively from patients who underwent ablation for atrioventricular nodal re-entrant tachycardia from January, 2004 to December, 2011. A total of 93 patients were included in the study. Among them, 18 patients who underwent radiofrequency ablation without three-dimensional mapping were included in Group 1, 13 patients who underwent cryoablation without three-dimensional mapping were included in Group 2, and 62 patients who underwent cryoablation with three-dimensional mapping were included in Group 3. Mean fluoroscopy times differed significantly (34.3, 23.4, and 20.3 minutes, p<0.001) when all the groups were compared. Group 3 had a shorter average fluoroscopy time that did not reach significance when compared directly with Group 2 (p=0.29). An unadjusted linear regression model showed a progressive decrease in fluoroscopy time (p=0.002). Mean total catheterisation times differed significantly (180, 211, and 210 minutes, p=0.02) and were related to increased ablation times inherent to cryoablation techniques. Acute success was achieved in 89, 100, and 97% of patients (p=0.25), and chronic success was achieved in 80, 92, and 93% of patients (p=0.38). Complication rates were similar (17, 23, and 7%, p=0.14). In conclusion, three-dimensional mapping systems decrease fluoroscopy times even without an explicit goal of zero fluoroscopy. Efficacy and safety of the procedure have not changed.

Nanocrystalline diamond films have been deposited by pulsed electron beam ablation from a single target and on different substrates at room temperature and under argon background gas at 0.5 Pa. The films have been deposited from a highly ordered pyrolytic graphite target on four different substrate materials, which include silicon, stainless steel, sapphire, and cubic boron nitride. Based on experimental measurement data, obtained from various analytical techniques, it has been observed that sp3 bonded carbon content, grain size, film roughness, and nanocrystalline fraction of the films do not seem to be much affected by the type of substrate material used. The thickness of the films, in the range of ∼70–90 nm, seems to be relatively the same irrespective of the substrate material. Hardness measurements have shown that film hardness, ranging between 18.5 and 19.5 GPa, is not remarkably influenced by the type of substrate material.

We report a highly sensitive pressure sensor fabricated by photo-thermally reduced Graphene oxide (GO) with silver nano wires (AgNWs). Pressure sensors are fabricated in form of the inter-digitated capacitors (IDC) composed of two finger electrodes with pattern width of 500 µm. The fabricated IDCs are compared to the previously reported MEMS-based pressure sensors' sensitivity. The fabricated sensor is easily attachable on any surface for monitoring applied forces or pressure and maintains excellent electrical conductivity under high mechanical stress and thus holds promise for durable bio-medical sensors.