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Locoregional failure (LRF) in patients with breast cancer post-surgery and post-irradiation is linked to a dismal prognosis. In a refined new model, we identified ectonucleotide pyrophosphatase/phosphodiesterase 1/CD203a (ENPP1) to be closely associated with LRF. ENPP1hi circulating tumor cells (CTC) contribute to relapse by a self-seeding mechanism. This process requires the infiltration of polymorphonuclear myeloid-derived suppressor cells and neutrophil extracellular trap (NET) formation. Genetic and pharmacologic ENPP1 inhibition or NET blockade extends relapse-free survival. Furthermore, in combination with fractionated irradiation, ENPP1 abrogation obliterates LRF. Mechanistically, ENPP1-generated adenosinergic metabolites enhance haptoglobin (HP) expression. This inflammatory mediator elicits myeloid invasiveness and promotes NET formation. Accordingly, a significant increase in ENPP1 and NET formation is detected in relapsed human breast cancer tumors. Moreover, high ENPP1 or HP levels are associated with poor prognosis. These findings unveil the ENPP1/HP axis as an unanticipated mechanism exploited by tumor cells linking inflammation to immune remodeling favoring local relapse.Significance:CTC exploit the ENPP1/HP axis to promote local recurrence post-surgery and post-irradiation by subduing myeloid suppressor cells in breast tumors. Blocking this axis impairs tumor engraftment, impedes immunosuppression, and obliterates NET formation, unveiling new opportunities for therapeutic intervention to eradicate local relapse and ameliorate patient survival.This article is highlighted in the In This Issue feature, p. 1171

Supplementary Data from Tumor ENPP1 (CD203a)/Haptoglobin Axis Exploits Myeloid-Derived Suppressor Cells to Promote Post-Radiotherapy Local Recurrence in Breast Cancer

Supplementary Figure from Tumor ENPP1 (CD203a)/Haptoglobin Axis Exploits Myeloid-Derived Suppressor Cells to Promote Post-Radiotherapy Local Recurrence in Breast Cancer

Abstract Locoregional failure (LRF) in patients with breast cancer post-surgery and post-irradiation is linked to a dismal prognosis. In a refined new model, we identified ectonucleotide pyrophosphatase/phosphodiesterase 1/CD203a (ENPP1) to be closely associated with LRF. ENPP1hi circulating tumor cells (CTC) contribute to relapse by a self-seeding mechanism. This process requires the infiltration of polymorphonuclear myeloid-derived suppressor cells and neutrophil extracellular trap (NET) formation. Genetic and pharmacologic ENPP1 inhibition or NET blockade extends relapse-free survival. Furthermore, in combination with fractionated irradiation, ENPP1 abrogation obliterates LRF. Mechanistically, ENPP1-generated adenosinergic metabolites enhance haptoglobin (HP) expression. This inflammatory mediator elicits myeloid invasiveness and promotes NET formation. Accordingly, a significant increase in ENPP1 and NET formation is detected in relapsed human breast cancer tumors. Moreover, high ENPP1 or HP levels are associated with poor prognosis. These findings unveil the ENPP1/HP axis as an unanticipated mechanism exploited by tumor cells linking inflammation to immune remodeling favoring local relapse. Significance: CTC exploit the ENPP1/HP axis to promote local recurrence post-surgery and post-irradiation by subduing myeloid suppressor cells in breast tumors. Blocking this axis impairs tumor engraftment, impedes immunosuppression, and obliterates NET formation, unveiling new opportunities for therapeutic intervention to eradicate local relapse and ameliorate patient survival. This article is highlighted in the In This Issue feature, p. 1171

A new low-profile flexible RFID tag antenna operating in the ultra-high frequency (UHF) European band (865 MHz–868 MHz) is proposed for blood bag traceability. Its structure combines inductive and capacitive parts with nested slots allowing for the achieving of conjugate impedance matching with the IC-chip. The whole electrical parameters of the environment (substrate, bag, and blood) were considered for the design of the tag antenna. A good agreement was obtained between the measurements and electromagnetic simulations for the input impedance of the tag antenna in the UHF band. A reading range close to 2.5 m was experimentally obtained. Therefore, this tag antenna could be effective and useful in future RFID systems for blood bag monitoring, thus improving patient safety in healthcare infrastructures.

This work presents a novel low-pass filter based on using dielectric materials, in the critical areas of the structure, to prevent high-power space condition adverse effects, like multipactor breakdown. It is shown that the use of dielectric pieces in the inverters of the filter leads to increased gaps between metallic parts in the irises. In addition, by completely filling up the air space in critical gaps, the multipactor breakdown thresholds can be increased. Moreover, they also lead to a volume reduction, increasing compactness of the structure. To demonstrate the proposed concept, a prototype has been manufactured with an aluminum housing and a Teflon dielectric material, and tested for multipactor effect at ESA-VSC Laboratory. Tests confirmed that the manufactured filter has good electrical performance with cut-off frequency 13.6 GHz, insertion losses 0.32 dB, return losses better than 15 dB, and additionally does not show multipactor breakdown up to the maximum power tested in the experimental facility (5.5 kW). This research work has been financially supported by the Spanish Ministerio de Ciencia e Innovación in the frame of the project “Green an Efficient Technologies for Advanced Telecommunication Systems (GRETAS)” with Ref. TPID2019-103982RB-C42.

Compact double notch coplanar and microstrip bandstop filters are described. They are based on a version of the open interconnected split ring resonator (OISRR) integrated in microstrip or coplanar waveguides. The OISRR introduces an RLC resonator connected in parallel with the propagating microstrip line. Therefore, this resonator can be modeled as a shunt circuit to ground, with the R, L and C elements connected in series. The consequence for the frequency response of the device is a notch band at the resonant frequency of the RLC shunt circuit. The number of notch bands can be controlled by adding more OISRRs, since each pair of rings can be modeled as a shunt circuit and therefore introduces an additional notch band. In this paper, we demonstrate that these additional rings can be introduced in a concentric way in the same cell, so the size of the device does not increase and a compact multi-notch bandstop response is achieved, with the same number of notch bands as pairs of concentric rings, plus an additional spurious band at a higher frequency. The authors gratefully acknowledge financial support from Agencia Estatal de Investigación (AEI) of Spain (grant no.: PID2019-103982RB-C42/AEI/10.13039/ 501100011033).

Background Cytotoxic chemotherapy can cure advanced germ cell tumors. Nevertheless, cancer treatment may induce cellular senescence and accelerate molecular aging. The aging process implies an increase of cells expressing p16INK4a and changes in lymphocyte subpopulations. Our aim was to study the potential induction of premature immunosenescence in testicular cancer survivors (TCS) exposed to chemotherapy. Methods Case-control exploratory study of TCS treated with chemotherapy (≥3 BEP cycles, disease-free ≥3 months) compared with age matched healthy controls. Peripheral blood mononuclear cells were isolated, and lymphocyte subpopulations were analyzed by flow cytometry. CDKN2A/p16INK4a expression in T cells was measured using qPCR. The percentage of lymphocyte subpopulations and the CDKN2A/p16INK4a expression in TCS were compared with the control group using the Wilcoxon signed-rank test. Results We included 16 cases and 16 controls. The median age was 27 years (minimum 24, maximum 54) and the median time on surveillance was 26.5 months (minimum 3, maximum192). TCS had a lower percentage of total T cells and CD4+ T cells in total lymphocytes. Among the CD4+ T lymphocytes, TCS had less naïve CD4+ and increased memory CD4+ cells. Within the CD8+ T lymphocytes, TCS exhibited a decrease in the percentage of naïve cells and an increase in CD8 + CD45RA + CD57+ cells. TCS also exhibited decreased memory CD19+ B cells compared to the controls. The relative expression of CDKN2A/p16INK4a in T cells was increased in TCS (mean 1.54; 95% CI of the mean: 1.074–2.005; p = 0.048). Conclusion In this exploratory study, TCS showed increased expression of CDKN2A/p16INK4a and a lymphocyte phenotype that has been associated with immunosenescence. Further studies are warranted to define the clinical implications of these alterations in TCS.

A shunt RLC resonant circuit obtained from a broadside-coupled open split ring resonator (BC-OSRR) is proposed. This BC-OSRR cell allows a parallel connection with planar waveguides. Hence, it has been applied to a half-mode substrate integrated waveguide (HMSIW) section. The analysis of the frequency response and electromagnetic field distribution of the HMSIW structure loaded with an appropriate BC-OSRR cell have shown two main behaviors. The first characteristic is a high-pass frequency response inherent to the HMSIW and the second is a transmission zero in the passband of the HMSIW, which is due to the resonance of the BC-OSRR cell. The First- and second-order prototypes have been designed and fabricated. The measured bandstop HMSIW filters using BC-OSRR achieve a 3-dB stopband bandwidth around 10% with more than 21-dB insertion loss. This BC-OSRR cell with low undesired radiation loss can be a new alternative for the implementation of compact bandstop filters in the planar technology.

We present a method for the teaching of Electronics, defined as the scientific discipline that studies the movement and behavior of electrons in semiconductor materials and in vacuum. Electronics can be considered as a science with a solid physical foundation. Within the field of Electronics there are different disciplines, some of them can be considered as pure science, while some others are more oriented to applications. Our methodology has been applied to the wide range of courses that develop the different approaches to Electronics, from the physics of semiconductors or the physics of microelectronic devices, generally taught at physics faculties, to microelectronic fabrication technology or microelectronic design, subjects that typically have a more application-oriented character. To ensure an effective learning of these subjects, a teaching-learning model has been established. This model involves the criteria for developing the programs and defining objectives according to the curricular competences, as well as the development of a series of activities in which the methods, techniques, forms of presentation and didactic resources most useful to achieve the proposed objectives will be used. An evaluation system that assesses the effectiveness of the educational process and detects its anomalies is also included. The impact of this method on the effectiveness of the teaching-learning process was evaluated by a comparative analysis of the results of the surveys distributed by the university to the students for the assessment of quality, together with surveys to the lecturers of the subjects of Electronics

Low-cost and flexible radio frequency identification (RFID) tag for automatic identification, tracking, and monitoring of blood products is in great demand by the healthcare industry. A robust performance to meet security and traceability requirements in the different blood sample collection and analysis centers is also required. In this paper, a novel low-cost and flexible passive RFID tag is presented for blood sample collection tubes. The tag antenna is based on two compact symmetrical capacitive structures and works at the ultra-high frequency (UHF) European band (865 MHz&ndash, 868 MHz). The tag antenna is designed considering the whole dielectric parameters such as the blood, substrate and tube. In this way, it operates efficiently in the presence of blood, which has high dielectric permittivity and loss. Measurement results of the proposed tag have confirmed simulation results. The measured performance of the tag shows good matching in the desired frequency band, leading to reading ranges up to 2.2 m, which is 4.4 times higher than typical commercial tags. The potential of this tag as a sensor to monitor the amount of blood contained in clinic tubes is also demonstrated. It is expected that the proposed tag can be useful and effective in future RFID systems to introduce security and traceability in different blood sample collection and analysis centers.

In this contribution, we describe the design of bandpass filters using evanescent mode waveguides and dielectric resonators implemented with additive manufacturing techniques. Two C-band Chebyshev evanescent mode waveguide filters of order five have been designed using a low cost commercial dielectric material (ABSplus), widely used by Fused Deposition Modeling (FDM) 3D printers. The housings of the filters have been manufactured using traditional computer numerical control (CNC) machining techniques. Practical manufacturing considerations are also discussed, including the integration of dielectric and metallic parts. We first discuss two breadboards using two different resonator geometries. We then demonstrate how different transfer functions can be easily implemented by changing the 3D printed parts in the same metallic housing. Breadboards show fractional bandwidths between 3% and 4.6% with return losses better than RL=18dB, and spurious free ranges of SFR=1GHz. Insertion losses are better than IL=4.3dB. Even though dielectric losses from the plastic material are shown to be high, the measured results are quite satisfactory, thereby clearly showing that this strategy maybe useful for the fast production of low cost microwave filters implementing complex geometries., 9 pages, 15 figures

This study presents electromagnetic bandgap (EBG) structures in microstrip technology based on one-dimensional Koch fractal patterns (Koch fractal EBG (KFEBG)). This fractal geometry allows to adjust the radius r and distance a between patterns so that a low-pass filter response is obtained when the ratio r/a is higher than 0.5. However, in such case undesired strong ripples appear in the low bandpass region. We demonstrate that the performance in the passband of this filter can be improved by applying a tapering function to the Koch fractal dimensions and to the width of the microstrip line, while simultaneously chirping (modulating) the Koch fractal periodic pattern distance (a) so as to maintain a constant r/a ratio. Several tapering functions scaled by a factor K are presented, and the results of their application to the KFEBG microstrip structure are compared by means of relevant characteristic parameters. Optimal performance has been obtained for the Kaiser and Cauchy distributions applied to the Koch fractal pattern, combined with a rectangular and Cauchy distribution applied to the microstrip width, respectively.

An open ring resonator (ORR) loaded with a varactor diode is designed and implemented in order to achieve high-performance tunable band-stop filters in planar technology with a compact size. This varactor-loaded ORR (VLORR) is versatile. It allows a shunt connection with different planar waveguide sections. In this paper, it has been connected to a coplanar waveguide (CPW) and a half-mode substrate integrated waveguide (HMSIW). As a reverse bias voltage is applied to the VLORR, a continuous tuning over the resulting stop-band can be achieved. To illustrate the possibilities of the VLORR, three prototypes have been designed, fabricated, and characterized. The three prototypes show an outstanding performance, with a rejection level at the resonant frequency and a tuning range greater than 12 dB and 85%, respectively. This VLORR has high potential value in microwave communication systems to eliminate unwanted signals. This work was supported by Ministerio de Economía y Competitividad, Fundación Séneca (Murcia) of Spain and European Regional Development Funds under grants TEC2016-75934-C04-4-R, 19494/PI/14 and 20147/EE/17.

A new low-pass waveguide filter topology is proposed based on capacitive posts using rounded shapes. The new structure is designed using a technique that benefits from a full-wave integral equation simulation tool for arbitrarily shaped capacitive microwave circuits. This integral equation method enables one to apply an efficient filter design technique employing iris geometries other than rectangular discontinuities, such as the one based on rounded posts proposed in this work. A prototype using circular posts has been manufactured and measured obtaining excellent results as compared with predictions, thus demonstrating the practical feasibility of the new proposed filtering structure. A new filter using elliptic capacitive posts was compared in terms of multipactor risk against similar filters based on traditional rectangular windows and on rectangular posts. Simulation results indicate that the new proposed concept using rounded shapes leads to geometries that can double multipactor thresholds as compared with traditional filters.

High-performance bandpass filters (BPFs) based on substrate integrated waveguide (SIW) and half mode SIW (HMSIW) with Koch fractal electromagnetic bandgap (KFEBG) patterns etched on the waveguide surface are proposed. These BPFs are designed using a new methodology. The BPF responses are improved by applying a chirped and tapered technique to the KFEBG patterns which exhibit a radius-to-period ratio $r/a \geq 0.5$ . Simulation results and experimental verification are presented. Good values for insertion losses and stopband rejection are achieved.

In this article, we show that the dielectric constant of lead-free ferroelectric ceramics based on the solid solution (1-x)(Bi0.5Na0.5)TiO3-xBaTiO3, with compositions at or near the morphotropic phase boundary (MPB), can be tuned by a local applied electric field. Two compositions have been studied, one at the MPB, with x = 0.06 (BNBT6), and another one nearer the BNT side of the phase diagram, with x = 0.04 (BNBT4). The tunability of the dielectric constant is measured at microwave frequencies between 100 MHz and 3 GHz by a nonresonant method and simultaneously applying a dc electric field. As expected, the tunability is higher for the composition at the MPB (BNBT6), reaching a maximum value of 60% for an electric field of 900 V/cm, compared with the composition below this boundary (BNBT4), which saturates at 40% for an electric field of 640 V/cm. The high tunability in both cases is attributed to the fine grain and high density of the samples, which have a submicrometer homogeneous grain structure with grain size of the order of a few hundred nanometers. Such properties make these ceramics attractive for microwave tunable devices. Finally, we have tested these ceramics for their application as infrared pyroelectric detectors and we have found that the pyroelectric figure of merit is comparable to traditional lead-containing pyroelectrics.

An open interconnected split ring resonator (OISRR) is proposed for use in compact microstrip notch filters. This OISRR behaves as a shunt series L C resonant circuit and allows a parallel connection with a microstrip line. This cell presents half the resonant frequency of the split ring resonator (SRR) and, therefore, is electrically very small. The measured results show a 3 dB stop-band bandwidth lower than 2 % with more than 10 dB insertion loss in the stop band. This OISRR can be useful in microwave communication systems This work was supported by of Spain and by FEDER (TEC2010-21520-C04-04/TCM).

A 1-D Koch fractal electromagnetic bandgap (KFEBG) microstrip structure is proposed. It is conceived by replacing the conventional holes etched in the ground plane of a microstrip line by level-1 Koch fractal cell geometries, which have been obtained from a hexagonal shape. In the case of the conventional 1-D EBG microstrip structure with periodic hole pattern, the design is limited to r / a ratios lower than 0.45, while the proposed pattern allows achieving r / a ratios higher than 0.5. It is shown the conventional EBG and KFEBG microstrip structures behave as a stopband filter as r / a ≤ 0.45 . However, for r/ a = 0.55, the measurements have confirmed that the 1-D KFEBG microstrip structure presents a ultrawide stopband and, therefore, the proposed structure with r / a > 0.5 can be useful for the design of low-pass filters.

This letter presents a novel electromagnetic band-gap (EBG) structure in microstrip technology based on nonuniform one-dimensional (1-D) Koch fractal patterns whose dimensions and period are modulated by a tapering function that significantly improves the width of the band-gap. This wide band-gap is achieved by maintaining the radius-to-period (r/a) ratio of the Koch fractal patterns larger than 0.5 in the whole structure. In the passband region, an improved flat response is obtained by tapering the dimensions of the Koch fractal patterns etched in the ground plane, together with the width of the microstrip line, with a Kaiser distribution that also modulates the periodicity of the fractals. A major consequence of this modulation of the periodicity of the pattern is that this structure is much more compact than a uniform conventional one.

In this paper, an efficient optimization technique aligning three-dimensional (3-D) electromagnetic simulator responses with two-dimensional (2-D) electromagnetic simulator responses around space mapped solution, for the electromagnetic design of radiofrequency and microwave 3-D circuits is presented. The interface between 2-D and 3-D electromagnetic simulators is obtained from an inverse linear input space-mapping approach and an output modeling process based on a fuzzy logic technique. It is shown that the technique provides a highly accurate estimation of the 3-D design parameter space of the 3-D radiofrequency and microwave circuits to be designed, for initially fixed design specifications. Designs of first-order, second-order and sixth-order C-band 3-D evanescent rectangular waveguide bandpass filters with dielectric posts show the performance of our approach.

In this article, an optimization procedure is described to align electromagnetic (EM) three-dimensional (3D) models with two-dimensional (2D) models for the design of RF/microwave circuits. The optimization procedure is realized from a modified standard space mapping (SM) approach. The mapping function between the 2D and 3D parameter spaces is directly obtained from a linear iterated prediction method, which reduces the computational cost and also avoids inverse transformations. The linear iterated prediction 2D to 3D SM optimization of evanescent rectangular waveguide bandpass filters with inductive posts for the 2D models and non-inductive posts for the 3D models illustrate the advantages and the challenges of this approach. The proposed method is simple to be implemented, it requires a reduced computational cost and it can be useful for CAD environment with 2D and 3D circuit structure electromagnetic (EM) analysis. © 2009 Wiley Periodicals, Inc. Microwave Opt Technol Lett 51: 1979–1983, 2009; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.24459

Accurate and efficient empirical model generation techniques of microwave devices, for a large range of geometric and material parameters opportunely chosen, are presented. The empirical models are based on multiple linear regression approach, which compensates the error between an initial inaccurate empirical model and an electromagnetic (EM) full-wave solver (or measurement data). The aim of these techniques is to generate accurate empirical models, which are computationally very efficient with respect to any EM technique. These simple models could be integrated in a toolbox of any commercially available computed-aided design tools for RF/microwave circuits. Comparisons with artificial neural networks and linear-regression-based models are listed and discussed for the dispersion of a microstrip transmission line propagating the quasi-TEM mode and a microwave tunable phase shifter propagating the even mode.

Atrial fibrillation (AF) is the most prevalent arrhythmia in hospital emergency departments and is a serious disease associated with a twofold increase in morbidity and a high mortality rate. However, the management of AF in this scenario is variable and frequently inadequate. This is probably a consequence of the diverse clinical aspects and therapeutic options to consider in the management of patients with AF. Therefore, implementation of specific, coordinated management strategies by the different care providers involved is needed to improve the quality of care and optimize the use of human and material resources. This document presents the guidelines recommended by the Spanish Society of Cardiology (SEC) and the Spanish Society of Emergency Medicine (SEMES) for the management of AF in hospital emergency departments. These guidelines are based on published scientific evidence and are applicable to most emergency departments in Spain. Specific management strategies are proposed for the conversion and maintenance of sinus rhythm, heart rate control during AF, prophylaxis for thrombi and emboli, and hospital admission and discharge protocols.

In this article, we show that the dielectric constant of lead-free ferroelectric ceramics based on the solid solution (1-x)(Bi(0.5)Na(0.5))TiO(3)-xBaTiO(3), with compositions at or near the morphotropic phase boundary (MPB), can be tuned by a local applied electric field. Two compositions have been studied, one at the MPB, with x = 0.06 (BNBT6), and another one nearer the BNT side of the phase diagram, with x = 0.04 (BNBT4). The tunability of the dielectric constant is measured at microwave frequencies between 100 MHz and 3 GHz by a nonresonant method and simultaneously applying a dc electric field. As expected, the tunability is higher for the composition at the MPB (BNBT6), reaching a maximum value of 60% for an electric field of 900 V/cm, compared with the composition below this boundary (BNBT4), which saturates at 40% for an electric field of 640 V/cm. The high tunability in both cases is attributed to the fine grain and high density of the samples, which have a submicrometer homogeneous grain structure with grain size of the order of a few hundred nanometers. Such properties make these ceramics attractive for microwave tunable devices. Finally, we have tested these ceramics for their application as infrared pyroelectric detectors and we have found that the pyroelectric figure of merit is comparable to traditional lead-containing pyroelectrics.

A shunt series LC resonant circuit based on an open version of an interconnected split ring resonator (OISRR) is proposed. This OISRR exhibits half the resonant frequency of the split ring resonator, allows a parallel connection with a coplanar waveguide (CPW) section and according to its frequency response is an attractive cell for compact CPW notch filter design. 3 dB stop-band bandwidth lower than 4.5% with more than 11 dB insertion loss in the stop-band can be achieved with a CPW loaded with a single OISRR. The experimental results have confirmed the possibilities of this OISRR, which can be easily connected to CPW antennas to reject undesirable signals The authors gratefully acknowledge Ministerio de Ciencias e Innovación of Spain and FEDER for the financial support of this work under the grant no.: TEC2010‐21520‐C04‐04/TCM.

Background Malaria in pregnancy is associated with maternal and foetal morbidity and mortality in endemic areas, but information on imported cases to non-endemic areas is scarce. The aim of this study was to describe the clinical and epidemiological characteristics of malaria in pregnancy in two general hospitals in Madrid, Spain. Methods Retrospective descriptive study of laboratory-confirmed malaria in pregnant women at the Fuenlabrada University Hospital and the Príncipe de Asturias University Hospital, in Madrid, over a six- and 11-year period, respectively. Relevant epidemiological, clinical and laboratory data was obtained from medical records. Results There were 19 pregnant women among 346 malaria cases (5.4%). The average age was 27 years. The gestational age (trimester) was: 53% 3rd, 31% 1st, 16% 2nd. All but one were multigravidae. Three were HIV positive. All were sub-Saharan immigrants: two were recently arrived immigrants and seventeen (89%) had visited friends and relatives. None had taken prophylaxis nor seeked pre-travel advice. Presentation: 16 symptomatic patients (fever in fourteen, asthenia in two), three asymptomatic. Median delay in diagnosis: 7.5 days. Laboratory tests: anaemia (cut off Hb level 11 g/dl) 78.9% (mild 31.6%, moderate 31.6%, severe 15.8%) thrombocytopaenia 73.7%, hypoglycaemia 10.5%. All cases were due to Plasmodium falciparum, one case of hyperparasitaemia. Quinine + clindamycin prescribed in 84%. Outcomes: no severe maternal complications or deaths, two abortions, fifteen term pregnancies, no low-birth-weight newborns, two patients were lost to follow-up. Conclusions Though cases of malaria in pregnancy are uncommon, a most at risk group is clearly defined: young sub-Saharan mothers visiting friends and relatives without pre-travel counselling and recently-arrived immigrants. The most common adverse maternal and foetal effects were anaemia and stillbirth. Given that presentation can be asymptomatic, malaria should always be considered in patients with unexplained anaemia arriving from endemic areas. These findings could help Maternal Health programme planners and implementers to target preventive interventions in the immigrant population and should create awareness among clinicians.

A metamaterial structure, called the double-sided open split ring resonator (DOSRR), which combines two open split ring resonators (OSRRs) aligned over the opposite faces of the substrate in an inverted fashion is presented. A study of this resonator from full-wave electromagnetic and circuit simulations is performed. As with the OSRR cell, the DOSRR cell allows a series connection along a microstrip transmission line and it has a small electrical size. Moreover, the DOSRR cell has the ability to add a transmission zero in the out-of-band region without increasing its size. This DOSRR cell is used for the design of compact microstrip slow-wave type band-pass filters. Two strategies based on circular windows etched in the bottom plane instead of square windows and U-shape slots etched in the microstrip transmission line are designed to increase the stop band and to add extra zeros in order to suppress the spurious band. The experimental results have confirmed the possibilities of this electrically small resonator (DOSRR) and the efficiency of both strategies to improve the out-of-band rejection. The authors gratefully acknowledge Ministerio de Ciencias e Innovación of Spain for financial support of this work under the grant no.: TEC2010-21520-C04-04/TCM.

An approach for applying fuzzy logic for accurate CAD of microwave circuits is presented. Our proposed method combines space-mapping (SM) technology and multiple adaptive neuro-fuzzy inference systems (MANFIS) for the modeling of microwave devices. MANFIS is trained to predict a nonlinear vector multidimensional mapping function, which is obtained from SM approach. Optimization by micro-genetic algorithm is used to find nonlinear vector multidimensional mapping function for singular systems. This approach is applied to a shielded microstrip line within a region of interest. The parameter values (ε reff ( f ) , Zc ( f )) computed with our proposed method are in excellent agreement with those obtained from electromagnetic simulations.

A broad band electromagnetic extraction method of the dielectric tensor for nematic liquid crystals, associated to a measuring cell, is presented. The dielectric tensor is computed from S-parameter measurements obtained at the input planes of a coplanar waveguide supporting the nematic liquid crystal to be characterized, which is used as measuring cell. The extraction method of the dielectric tensor is based on the propagation of the dominant mode in the measuring cell. It is fast and easy. It uses analytical relationships, which are presented in this paper. The simulations results have demonstrated the validity of this extraction method in the 1GHz-40GHz frequency range for the electromagnetic characterization of nematic liquid crystals. J. Hinojosa is grateful to Ministerio de Ciencia y Technología and Region de Murcia Fundación Séneca of Spain for the grants TIC2002-01266 and PB/39/FS/02, which have allowed the present research activity.

Atrial fibrillation (AF) is the most prevalent arrhythmia in hospital emergency departments and is a serious disease associated with a twofold increase in morbidity and a high mortality rate. However, the management of AF in this scenario is variable and frequently inadequate. This is probably a consequence of the diverse clinical aspects and therapeutic options to consider in the management of patients with AF. Therefore, implementation of specific, coordinated management strategies by the different care providers involved is needed to improve the quality of care and optimize the use of human and material resources. This document presents the guidelines recommended by the Spanish Society of Cardiology (SEC) and the Spanish Society of Emergency Medicine (SEMES) for the management of AF in hospital emergency departments. These guidelines are based on published scientific evidence and are applicable to most emergency departments in Spain. Specific management strategies are proposed for the conversion and maintenance of sinus rhythm, heart rate control during AF, prophylaxis for thrombi and emboli, and hospital admission and discharge protocols.

A high-quality ridged waveguide to microstrip transition for determining the electromagnetic characteristics of thin-film materials in the V-band is presented. Complex permittivity and permeability are computed from S-parameter measurements of a microstrip cell propagating the dominant mode. Measurements in V-band of alumina show good agreement between measured and predicted values.

A very broadband method for determining the electromagnetic properties of isotropic thin planar materials, which uses a coplanar line as a cell, is presented. The complex permittivity is quickly computed from S-parameter measurements of coplanar cells propagating the dominant mode by using analytical equations. Measurements between 0.05 and 75 GHz of alumina and doped silicon show good agreement between measured and predicted values.

Patients with pneumonia treated in the internal medicine department (IMD) are often at risk of healthcare-associated pneumonia (HCAP). The importance of HCAP is controversial. We invited physicians from 72 IMDs to report on all patients with pneumonia hospitalized in their department during 2weeks (one each in January and June 2010) to compare HCAP with community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP). We analysed 1002 episodes of pneumonia: 58.9% were CAP, 30.6% were HCAP and 10.4% were HAP. A comparison between CAP, HCAP and HAP showed that HCAP patients were older (77, 83 and 80.5years; p