Modeling, design and experimental characterization of Micro-Electro-Mechanical-Systems for gas chromatographic applications

Design parameters, process flows, electro-thermal-fluidic simulations and experimental characterizations of Micro-Electro-Mechanical-Systems (MEMS) suited for gas-chromatographic (GC) applications are presented and thoroughly described in this thesis, whose topic belongs to the research activities the Institute for Microelectronics and Microsystems (IMM)-Bologna is involved since several years, i.e. the development of micro-systems for chemical analysis, based on silicon micro-machining techniques and able to perform analysis of complex gaseous mixtures, especially in the field of environmental monitoring. In this regard, attention has been focused on the development of micro-fabricated devices to be employed in a portable mini-GC system for the analysis of aromatic Volatile Organic Compounds (VOC) like Benzene, Toluene, Ethyl-benzene and Xylene (BTEX), i.e. chemical compounds which can significantly affect environment and human health because of their demonstrated carcinogenicity (benzene) or toxicity (toluene, xylene) even at parts per billion (ppb) concentrations. The most significant results achieved through the laboratory functional characterization of the mini-GC system have been reported, together with in-field analysis results carried out in a station of the Bologna air monitoring network and compared with those provided by a commercial GC system. The development of more advanced prototypes of micro-fabricated devices specifically suited for FAST-GC have been also presented (silicon capillary columns, Ultra-Low-Power (ULP) Metal OXide (MOX) sensor, Thermal Conductivity Detector (TCD)), together with the technological processes for their fabrication. The experimentally demonstrated very high sensitivity of ULP-MOX sensors to VOCs, coupled with the extremely low power consumption, makes the developed ULP-MOX sensor the most performing metal oxide sensor reported up to now in literature, while preliminary test results proved that the developed silicon capillary columns are capable of performances comparable to those of the best fused silica capillary columns. Finally, the development and the validation of a coupled electro-thermal Finite Element Model suited for both steady-state and transient analysis of the micro-devices has been described, and subsequently implemented with a fluidic part to investigate devices behaviour in presence of a gas flowing with certain volumetric flow rates.

Determinants of child undernutrition in India. A micro-case study to operationalize the Capability Approach

The present research aims at shedding light on the demanding puzzle characterizing the issue of child undernutrition in India. Indeed, the so called ‘Indian development paradox’ identifies the phenomenon according to which higher level of income per capita is recorded alongside a lethargic reduction in the proportion of underweight children aged below three years. Thus, in the time period occurring from 2000 to 2005, real Gross Domestic Production per capita has annually grown at 5.4%, whereas the proportion of children who are underweight has declined from 47% to 46%, a mere one point percent. Such trend opens up the space for discussing the traditionally assumed linkage between income-poverty and undernutrition as well as food intervention as the main focus of policies designed to fight child hunger. Also, it unlocks doors for evaluating the role of an alternative economic approach aiming at explaining undernutrition, such as the Capability Approach. The Capability Approach argues for widening the informational basis to account not only for resources, but also for variables related to liberties, opportunities and autonomy in pursuing what individuals value.The econometric analysis highlights the relevance of including behavioral factors when explaining child undernutrition. In particular, the ability of the mother to move freely in the community without the need of asking permission to her husband or mother-in-law is statistically significant when included in the model, which accounts also for confounding traditional variables, such as economic wealth and food security. Also, focusing on agency, results indicates the necessity of measuring autonomy in different domains and the need of improving the measurement scale for agency data, especially with regards the domain of household duties. Finally, future research is required to investigate policy venues for increasing agency in women and in the communities they live in as viable strategy for reducing the plague of child undernutrition in India.

Micro-simulation models at neighbourhood scale: the interplay of agents, buildings, activities and transport.

Urban systems consist of several interlinked sub-systems - social, economic, institutional and environmental – each representing a complex system of its own and affecting all the others at various structural and functional levels. An urban system is represented by a number of “human” agents, such as individuals and households, and “non-human” agents, such as buildings, establishments, transports, vehicles and infrastructures. These two categories of agents interact among them and simultaneously produce impact on the system they interact with. Try to understand the type of interactions, their spatial and temporal localisation to allow a very detailed simulation trough models, turn out to be a great effort and is the topic this research deals with. An analysis of urban system complexity is here presented and a state of the art review about the field of urban models is provided. Finally, six international models - MATSim, MobiSim, ANTONIN, TRANSIMS, UrbanSim, ILUTE - are illustrated and then compared.

Implications of regional fault distribution and kinematics for the uplift of rift flanks around the Rwenzori Mountains, Southwestern Uganda

Das Ziel dieser Arbeit bestand in der Untersuchung der Störungsverteilung und der Störungskinematik im Zusammenhang mit der Hebung der Riftschultern des Rwenzori Gebirges.rnDas Rwenzori Gebirge befindet sich im NNE-SSWbis N-S verlaufenden Albertine Rift, des nördlichsten Segments des westlichen Armes des Ostafrikanischen Grabensystems. Das Albertine Rift besteht aus Becken unterschiedlicher Höhe, die den Lake Albert, Lake Edward, Lake George und Lake Kivu enthalten. Der Rwenzori horst trennt die Becken des Lake Albert und des Lake Edward. Es erstreckt sich 120km in N-S Richtung, sowie 40-50km in E-W Richtung, der h¨ochste Punkt befindet sich 5111 ü. NN. Diese Studie untersucht einen Abschnitt des Rifts zwischen etwa 1°N und 0°30'S Breite sowie 29°30' und 30°30' östlicher Länge ersteckt. Auch die Feldarbeit konzentrierte sich auf dieses Gebiet.rnrnHauptzweck dieser Studie bestand darin, die folgende These auf ihre Richtigkeit zu überprüfen: ’Wenn es im Verlauf der Zeit tatsächlich zu wesentlichen Änderungen in der Störungskinematik kam, dann ist die starke Hebung der Riftflanken im Bereich der Rwenzoris nicht einfach durch Bewegung entlang der Graben-Hauptst¨orungen zu erklären. Vielmehr ist sie ein Resultat des Zusammenspiels mehrerer tektonische Prozesse, die das Spannungsfeld beeinflussen und dadurch Änderungen in der Kinematik hervorrufen.’ Dadurch konzentrierte sich die Studie in erster Linie auf die Störungsanalyse.rnrnDie Kenntnis regionaler Änderungen der Extensionsrichtung ist entscheidend für das Verständnis komplexer Riftsysteme wie dem Ostafrikanischen Graben. Daher bestand der Kern der Untersuchung in der Kartierung von Störungen und der Untersuchung der Störungskinematik. Die Aufnahme strukturgeologischer Daten konzentrierte sich auf die Ugandische Seite des Rifts, und Pal¨aospannungen wurden mit Hilfe von St¨orungsdaten durch Spannungsinversion rekonstruiert.rnDie unterschiedliche Orientierung spr¨oder Strukturen im Gelände, die geometrische Analyse der geologischen Strukturen sowie die Ergebnisse von Mikrostrukturen im Dünnschliff (Kapitel 4) weisen auf verschiedene Spannungsfelder hin, die auf mögliche Änderungen der Extensionsrichtung hinweisen. Die Resultate der Spannungsinversion sprechen für Ab-, Über- und Blattverschiebungen sowie für Schrägüberschiebungen (Kapitel 5). Aus der Orientierung der Abschiebungen gehen zwei verschiedene Extensionsrichtungen hervor: im Wesentlichen NW-SE Extension in fast allen Gebieten, sowie NNE-SSW Extension im östlichen Zentralbereich.rnAus der Analyse von Blattverschiebungen ergaben sich drei unterschiedliche Spannungszustände. Zum Einen NNW-SSE bis N-S Kompression in Verbindung mit ENE-WSW bzw E-W Extension wurde für die nördlichen und die zentralen Ruwenzoris ausgemacht. Ein zweiter Spannungszustand mit WNW-ESE Kompression/NNE-SSW Extension betraf die Zentralen Rwenzoris. Ein dritter Spannungszustand mit NNW-SSE Extension betraf den östlichen Zentralteil der Rwenzoris. Schrägüberschiebungen sind durch dazu schräge Achsen charakterisiert, die für N-S bis NNW-SSE Kompression sprechen und ausschließlich im östlichen Zentralabschnitt auftreten. Überschiebungen, die hauptsächlich in den zentralen und den östlichen Rwenzoris auftreten, sprechen für NE-SW orientierten σ2-Achsen und NW-SE Extension.rnrnEs konnten drei unterschiedliche Spannungseinflüsse identifiziert werden: auf die kollisionsbedingte Bildung eines Überschiebungssystem folgte intra-kratonische Kompression und schließlich extensionskontrollierte Riftbildung. Der Übergang zwischen den beiden letztgenannten Spannungszuständen erfolgte Schrittweise und erzeugte vermutlich lokal begrenzte Transpression und Transtension. Gegenw¨artig wird die Störungskinematik der Region durch ein tensiles Spannungsregime in NW-SE bis N-S Richtung bestimmt.rnrnLokale Spannungsvariationen werden dabei hauptsächlich durch die Interferenzrndes regionalen Spannungsfeldes mit lokalen Hauptst¨orungen verursacht. Weitere Faktoren die zu lokalen Veränderungen des Spannungsfeldes führen können sind unterschiedliche Hebungsgeschwindigkeiten, Blockrotation oder die Interaktion von Riftsegmenten. Um den Einfluß präexistenter Strukturen und anderer Bedingungen auf die Hebung der Rwenzoris zu ermitteln, wurde der Riftprozeß mit Hilfe eines analogen ’Sandbox’-Modells rekonstruiert (Kapitel 6). Da sich die Moho-Diskontinuität im Bereich des Arbeitsgebietes in einer Tiefe von 25 km befindet, aktive Störungen aber nur bis zu einer Tiefe von etwa 20 km beobachtet werden können (Koehn et al. 2008), wurden nur die oberen 25 km im Modell nachbebildet. Untersucht und mit Geländebeobachtungen verglichen wurden sowohl die Reihenfolge, in der Riftsegmente entstehen, als auch die Muster, die sich im Verlauf der Nukleierung und des Wachstums dieser Riftsegmente ausbilden. Das Hauptaugenmerk wurde auf die Entwicklung der beiden Subsegmente gelegt auf denen sich der Lake Albert bzw. der Lake Edward und der Lake George befinden, sowie auf das dazwischenliegende Rwenzori Gebirge. Das Ziel der Untersuchung bestand darin herauszufinden, in welcher Weise das südwärts propagierende Lake Albert-Subsegment mit dem sinistral versetzten nordwärts propagierenden Lake Edward/Lake George-Subsegment interagiert.rnrnVon besonderem Interesse war es, in welcherWeise die Strukturen innerhalb und außerhalb der Rwenzoris durch die Interaktion dieser Riftsegmente beeinflußt wurden. rnrnDrei verschiedene Versuchsreihen mit unterschiedlichen Randbedingungen wurden miteinander verglichen. Abhängig vom vorherrschenden Deformationstyp der Transferzone wurden die Reihen als ’Scherungs-dominiert’, ’Extensions-dominiert’ und als ’Rotations-dominiert’ charakterisiert. Die Beobachtung der 3-dimensionalen strukturellen Entwicklung der Riftsegmente wurde durch die Kombination von Modell-Aufsichten mit Profilschnitten ermöglicht. Von den drei genannten Versuchsreihen entwickelte die ’Rotationsdominierten’ Reihe einen rautenförmiger Block im Tranferbereich der beiden Riftsegmente, der sich um 5−20° im Uhrzeigersinn drehte. DieserWinkel liegt im Bereich des vermuteten Rotationswinkel des Rwenzori-Blocks (5°). Zusammengefasst untersuchen die Sandbox-Versuche den Einfluss präexistenter Strukturen und der Überlappung bzw. Überschneidung zweier interagierender Riftsegmente auf die Entwicklung des Riftsystems. Sie befassen sich darüber hinaus mit der Frage, welchen Einfluss Blockbildung und -rotation auf das lokale Stressfeld haben.

Assessing Food Security in Selected Mediterranean Countries

Food Security has become an important issue in the international debate, particularly during the latest economic crisis. It relevant issue also for the Mediterranean Countries (MCs), particularly those of the southern shore, as they are is facing complex economic and social changes. On the one hand there is the necessity to satisfy the increasing and changing food demand of the growing population; on the other hand it is important to promote economic growth and adjust the agricultural production to food demand in a sustainable perspective. The assessment of food security conditions is a challenging task due to the multi-dimensional nature and complexity of the matter. Many papers in the scientific literature focus on the nutritional aspects of food security, while its economic issues have been addressed less frequently and only in recent times. Thus, the main objective of the research is to assess food (in)security conditions in the MCs. The study intends to identify and implement appropriate theoretical concepts and methodological tools to be used in the assessment of food security, with a particular emphasis on its economic dimension within MCs. The study follows a composite methodological approach, based on the identification and selection of a number of relevant variables, a refined set of indicators is identified by means of a two-step Principal Component Analysis applied to 90 countries and the PCA findings have been studied with particular attention to the MCs food security situation. The results of the study show that MCs have an higher economic development compared to low-income countries, however the economic and social disparities of this area show vulnerability to food (in)security, due to: dependency on food imports, lack of infrastructure and agriculture investment, climate condition and political stability and inefficiency. In conclusion, the main policy implications of food (in)security conditions in MCs are discussed.

Global and regional sea level variations in the recent past and future: insight from observations and modeling

This work is focused on the analysis of sea–level change (last century), based mainly on instrumental observations. During this period, individual components of sea–level change are investigated, both at global and regional scales. Some of the geophysical processes responsible for current sea-level change such as glacial isostatic adjustments and current melting terrestrial ice sources, have been modeled and compared with observations. A new value of global mean sea level change based of tide gauges observations has been independently assessed in 1.5 mm/year, using corrections for glacial isostatic adjustment obtained with different models as a criterion for the tide gauge selection. The long wavelength spatial variability of the main components of sea–level change has been investigated by means of traditional and new spectral methods. Complex non–linear trends and abrupt sea–level variations shown by tide gauges records have been addressed applying different approaches to regional case studies. The Ensemble Empirical Mode Decomposition technique has been used to analyse tide gauges records from the Adriatic Sea to ascertain the existence of cyclic sea-level variations. An Early Warning approach have been adopted to detect tipping points in sea–level records of North East Pacific and their relationship with oceanic modes. Global sea–level projections to year 2100 have been obtained by a semi-empirical approach based on the artificial neural network method. In addition, a model-based approach has been applied to the case of the Mediterranean Sea, obtaining sea-level projection to year 2050.

Aesthetic outcome and oncological safety of nipple-areola complex replantation after mastectomy and immediate breast reconstruction

Immediate breast reconstruction (IBR) has become an established procedure for women necessitating mastectomy. Traditionally, the nipple-areola complex (NAC) is resected during this procedure. The NAC, in turn, is a principal factor determining aesthetic outcome after breast reconstruction, and due to its particular texture and shape, a natural-looking NAC can barely be reconstructed with other tissues. The aim of this study was to assess the oncological safety as well as morbidity and aesthetic outcome after replantation of the NAC some days after IBR. Retrospective analysis of 85 patients receiving 88 mastectomies and IBR between 1998 and 2007 was conducted. NAC (n=29) or the nipple alone (n=23) were replanted 7 days (median, range 2-10 days) after IBR in 49 patients, provided the subareolar tissue was histologically negative for tumour infiltration. Local recurrence rate was assessed after 49 months (median, range 6-120 months). Aesthetic outcome was evaluated by clinical assessment during routine follow-up at least 12 months after the last intervention. Malignant involvement of the subareolar tissue was found in eight cases (9.1%). Patients qualifying for NAC replantation were in stage 0 in 29%, stage I in 15%, stage IIa in 31%, stage IIb in 17% and stage III in 8%. Total or partial necrosis occurred in 69% and 26% if the entire NAC or only the nipple were replanted, respectively (P<0.01). Depigmentation was seen in 52% and corrective surgery was done in 11 out of 52 NAC or nipple replantations. Local recurrence and isolated regional lymph node metastasis were observed in one single case each. Another 5.8% of the patients showed distant metastases. We conclude that the replantation of the NAC in IBR is oncologically safe, provided the subareolar tissue is free of tumour. However, the long-term aesthetic outcome of NAC replantation is not satisfying, which advocates replanting the nipple alone.

Climate change: an additional risk factor for agriculture and food security in the South

Climate change is expected to have far-reaching negative effects on agricultural production and food security in developing and transition countries. What do we know about these expected impacts, what are the factors that might affect production, and what are the implications for agricultural extension systems?

PM(10) remote sensing from geostationary SEVIRI and polar-orbiting MODIS sensors over the complex terrain of the European Alpine region

The subject of this study is to investigate the capability of spaceborne remote sensing data to predict ground concentrations of PM10 over the European Alpine region using satellite derived Aerosol Optical Depth (AOD) from the geostationary Spinning Enhanced Visible and InfraRed Imager (SEVIRI) and the polar-orbiting MODerate resolution Imaging Spectroradiometer (MODIS). The spatial and temporal resolutions of these aerosol products (10 km and 2 measurements per day for MODIS, ∼ 25 km and observation intervals of 15 min for SEVIRI) permit an evaluation of PM estimation from space at different spatial and temporal scales. Different empirical linear relationships between coincident AOD and PM10 observations are evaluated at 13 ground-based PM measurement sites, with the assumption that aerosols are vertically homogeneously distributed below the planetary Boundary Layer Height (BLH). The BLH and Relative Humidity (RH) variability are assessed, as well as their impact on the parameterization. The BLH has a strong influence on the correlation of daily and hourly time series, whilst RH effects are less clear and smaller in magnitude. Despite its lower spatial resolution and AOD accuracy, SEVIRI shows higher correlations than MODIS (rSEV∼ 0.7, rMOD∼ 0.6) with regard to daily averaged PM10. Advantages from MODIS arise only at hourly time scales in mountainous locations but lower correlations were found for both sensors at this time scale (r∼ 0.45). Moreover, the fraction of days in 2008 with at least one satellite observation was 27% for SEVIRI and 17% for MODIS. These results suggest that the frequency of observations plays an important role in PM monitoring, while higher spatial resolution does not generally improve the PM estimation. Ground-based Sun Photometer (SP) measurements are used to validate the satellite-based AOD in the study region and to discuss the impact of aerosols' micro-physical properties in the empirical models. A lower error limit of 30 to 60% in the PM10 assessment from space is estimated in the study area as a result of AOD uncertainties, variability of aerosols properties and the heterogeneity of ground measurement sites. It is concluded that SEVIRI has a similar capacity to map PM as sensors on board polar-orbiting platforms, with the advantage of a higher number of observations. However, the accuracy represents a serious limitation to the applicability of satellites for ground PM mapping, especially in mountainous areas.

Integrated Geophysical Investigation of the St. James Fault Complex: A Case Study

We noninvasively detected the characteristics and location of a regional fault in an area of poor bedrock exposure complicated by karst weathering features in the subsurface. Because this regional fault is associated with sinkhole formation, its location is important for hazard avoidance. The bedrock lithologies on either side of the fault trace are similar; hence, we chose an approach that capitalized on the complementary strengths of very low frequency (VLF) electromagnetic, resistivity, and gravity methods. VLF proved most useful as a first-order reconnaissance tool, allowing us to define a narrow target area for further geophysical exploration. Fault-related epikarst was delineated using resistivity. Ultimately, a high-resolution gravity survey and subsequent inverse modeling using the results of the resistivity survey helped to further constrain the location and approximate orientation of the fault. The combined results indicated that the location of the fault trace needed to be adjusted 53 m south of the current published location and was consistent with a north-dipping thrust fault. Additionally, a gravity low south of the fault trace agreed with the location of conductive material from the resistivity and VLF surveys. We interpreted these anomalies to represent enhanced epikarst in the fault footwall. We clearly found that a staged approach involving a progression of methods beginning with a reconnaissance VLF survey, followed by high-resolution gravity and electrical resistivity surveys, can be used to characterize a fault and fault-related karst in an area of poor bedrock surface exposure.

OPTIMIZING A SHORT-END ELECTROPHORETICALLY MEDIATED MICRO-ANALYSIS (EMMA) ASSAY FOR CREATININE

In this work electrophoretically mediated micro-analysis (EMMA) is used in conjunction with short end injection to improve the in-capillary Jaffé assay for creatinine. Key advances over prior work include (i) using simulation to ensure intimate overlap of reagent plugs, (ii) using OH- to drive the reaction, (iii) using short-end injection to minimize analysis time and in-line product degradation. The potential-driven overlapping time with the EMMA approach, as well as the borate buffer background electrolyte (BGE) concentration and pH are optimized with the short end approach. The best conditions for short-end analyses would not have been predicted by the prior long end work, owing to a complex interplay of separation time and product degradation rates. Raw peak areas and flow-adjusted peak areas for the Jaffé reaction product (at 505 nm) are used to assess the sensitivity of the short-end EMMA approach. Optimal overlap conditions depend heavily on local conductivity differences within the reagent zone(s), as these differences cause dramatic voltage field differences, which effect reagent overlap dynamics. Simul 5.0, a dynamic simulation program for capillary electrophoresis (CE) systems, is used to understand the ionic boundaries and profiles that give rise to the experimentally obtained data for EMMA analysis. Overall, fast migration of hydroxide ions from the picrate zone makes difficult reagent overlap. In addition, the challenges associated with the simultaneous overlapping of three reagent zones are considered, and experimental results validate the predictions made by the simulation. With one set of “optimized” conditions including OH- (253 mM) as the third reagent zone the response was linear with creatinine concentration (R2 = 0.998) and reproducible over the clinically relevant range (0.08 to 0.1 mM) of standard creatinine concentrations. An LOD (S/N = 3) of 0.02 mM and LOQ (S/N=10) of 0.08 mM were determined. A significant improvement (43%) in assay sensitivity was obtained compared to prior work that considered only two reagents in the overlap.

Late Quaternary paleosols and their paleoenvironmental significance along the Andean piedmont, Eastern Bolivia

The Andean piedmont of eastern Bolivia is situated at the southern margin of Amazonia characterized by an overall humid climate regime with a marked contrast between the rainy and dry seasons. The nearby Subandean foothills deliver abundant sandy sediments to the piedmont, leading to a complex array of sediments and paleosol horizons. Within this setting, the presented study analyzes four profiles of paleosol-sediment-sequences along incised ephemeral streams near Santa Cruz de la Sierra with a focus on past pedogenic variability in the context of the regional late Quaternary geomorphic and environmental evolution. Based on field observations, micromorphological analysis, geochemical and clay mineralogical data five classes of paleosol horizons could be distinguished. The individual paleosol horizons as well as the sediments, in which they developed, were interpreted regarding their paleoenvironmental significance, taking into consideration the various controls on soil formation with particular focus on changes of local environmental conditions through time. Thus, three different pathways of soil formation were established. On the late Quaternary timescale, the results suggest a strong relation between paleoenvironmental conditions (climate, vegetation etc.), soil environment (soil water flow, micro-environment) and the type of paleosol horizons developed in the study area. The formation of “red beds” (Bw horizons) implies very dry soil environments under dominantly dry conditions, which seem to have prevailed in the study area some time before ∼ 18 cal ka BP. Moderately dry but markedly seasonal environmental conditions with a long dry season and strong seasonal contrasts in soil water flow could explain the formation of moderately developed Bwt horizons around ∼ 18 cal ka BP and much of the mid-Holocene. The formation of Bt horizons and/or clay lamellae in relation to intense neoformation of clay and dominant clay illuviation by soil water points to wet conditions similar to today, which have probably prevailed in the study area before ∼ 8 cal ka BP and since ∼ 5 cal ka BP.

In vitro biomechanical testing of a micro external skeletal fixator

OBJECTIVE To biomechanically test the properties of three different Universal Micro External Fixator (UMEX™) configurations with regard to their use in very small animals (<5kg) and compare the UMEX system to the widely used IMEX External Skeletal Fixation (SK™) system in terms of stiffness, space needed for pin placement and weight. METHODS Three different UMEX configurations (type Ia, type Ib, and type II modified) and one SK configuration type Ia were used to stabilize Delrin plastic rods in a 1 cm fracture gap model. These constructs were tested in axial compression, craniocaudal bending, mediolateral bending, and torsion. Testing was conducted within the elastic range and mean stiffness in each mode was determined from the slope of the linear portion of the load-deformation curve. A Kruskal Wallis one-way analysis of variance on ranks test was utilized to assess differences between constructs (p <0.05). RESULTS The UMEX type II modified configuration was significantly stiffer than the other UMEX configurations and the SK type Ia, except in craniocaudal bending, where the SK type Ia configuration was stiffer than all UMEX constructs. The UMEX type Ia configuration was significantly the weakest of those frames. The UMEX constructs were lighter and smaller than the SK, thus facilitating closer pin placement. CONCLUSIONS Results supported previous reports concerning the superiority of more complex constructs regarding stiffness. The UMEX system appears to be a valid alternative for the treatment of long-bone fractures in very small animals.

Regional myocardial wall thinning at multidetector computed tomography correlates to arrhythmogenic substrate in postinfarction ventricular tachycardia: assessment of structural and electrical substrate

BACKGROUND A majority of patients undergoing ablation of ventricular tachycardia have implanted devices precluding substrate imaging with delayed-enhancement MRI. Contrast-enhanced multidetector computed tomography (MDCT) can depict myocardial wall thickness with submillimetric resolution. We evaluated the relationship between regional myocardial wall thinning (WT) imaged by MDCT and arrhythmogenic substrate in postinfarction ventricular tachycardia. METHODS AND RESULTS We studied 13 consecutive postinfarction patients undergoing MDCT before ablation. MDCT data were integrated with high-density 3-dimensional electroanatomic maps acquired during sinus rhythm (endocardium, 509±291 points/map; epicardium, 716±323 points/map). Low-voltage areas (<1.5 mV) and local abnormal ventricular activities (LAVA) during sinus rhythm were assessed with regard to the WT. A significant correlation was found between the areas of WT <5 mm and endocardial low voltage (correlation-R=0.82; P=0.001), but no such correlation was found in the epicardium. The WT <5 mm area was smaller than the endocardial low-voltage area (54 cm(2) [Q1-Q3, 46-92] versus 71 cm(2) [Q1-Q3, 59-124]; P=0.001). Among a total of 13 060 electrograms reviewed in the whole study population, 538 LAVA were detected and analyzed. LAVA were located within the WT <5 mm (469/538 [87%]) or at its border (100% within 23 mm). Very late LAVA (>100 ms after QRS complex) were almost exclusively detected within the thinnest area (93% in the WT<3 mm). CONCLUSIONS Regional myocardial WT correlates to low-voltage regions and distribution of LAVA critical for the generation and maintenance of postinfarction ventricular tachycardia. The integration of MDCT WT with 3-dimensional electroanatomic maps can help focus mapping and ablation on the culprit regions, even when MRI is precluded by the presence of implanted devices.