Stereotactic ablative body radiotherapy (SABR) is arising as a promising non-invasive alternative for the treatment of ventricular tachycardia. There are limited data concerning the radiobiologic changes occurring post-therapy. We report a challenging case of a patient undergoing a combined epicardial and endocardial ablation after SABR.

Acknowledgements: On behalf of the Steering Committee of the Medical Device Innovation Consortium Initiative on Early Feasibility Studies in Cardiac Electrophysiology

Phoretic mites have been found attached to different body parts of red palm weevil (RPW), Rhynchophorus ferrugineus (Olivier, 1790), to disperse. However, the question of how the patterns of attachment sites are formed remains intriguing. Here, we conducted the first study of RPW-associated phoretic mites in Portugal, particularly in the districts of Viana do Castelo, Braga, Porto and Aveiro in Northern Portugal (macrohabitat), and investigated the patterns of mite distribution on six body parts of RPW (microhabitat). At the macrohabitat level, we detected seven phoretic mite taxa actively using RPW host in each of the four studied districts, all documented for the first time in association with this invasive exotic species in Portugal. However, their relative abundance (species evenness) varied between districts, as did species diversity. All examined weevils carried mites, and the prevalence of the different taxa did not differ between districts or sex of weevils. Measured by mean abundance and degree of aggregation, Centrouropoda sp. proved to be the common dominant taxon, while Acarus sp. and C. rhynchoporus were considered common subordinate taxa and Uroovobella sp., Mesostigmata, N. extremica and Dendrolaelaps sp. sparse taxa. At the microhabitat level, all taxa were present in all body parts of the RPW; the highest abundance was in a region encompassing the inner surface of the elytra and the membranous hind wings (subelytral space). Analysis of niche overlap revealed that the distribution patterns of phoretic mite taxa on the RPW were not randomly structured. In the subelytral space, interspecific coexistence of mites increased as a function of body size difference with the dominant Centrouropoda sp. We conclude that the distribution patterns of RPW-associated phoretic mites show body size-dependent effects that resulted in the dominant taxon displacing similar size taxa and accepting taxa with which it has the greatest size difference as co-habitants.

GATAs are evolutionarily conserved zinc-finger transcription factors from eukaryotes. In plants, GATAs can be subdivided into four classes, A – D, based on their DNA-binding domain, and into further subclasses based on additional protein motifs. B-GATAs with a so-called LLM-domain can already be found in algae, but bryophytes and angiosperms also contain B-GATAs with a HAN-domain. The angiosperm B-GATA family is expanded and can be subdivided into family members with either a HAN- or an LLM-domain. The B-GATA family in the liverwort Marchantia polymorpha and the moss Physcomitrium patens is restricted to one and four family members, respectively, and all family members contain a HAN- as well as an LLM-domain. Here, we characterize mutants of the single B-GATA from Marchantia polymorpha. We reveal that this mutant has defects in thallus growth and in gemma formation. Transcriptomic studies uncover that the B-GATA mutant displays a constitutive high-light stress response, a phenotype that we then also confirm in mutants of Arabidopsis thaliana LLM-domain B-GATAs, suggesting that the B-GATAs have a protective role towards high-light stress.

Background and objectives: To re-activate infuneza sentinel surveillance system in Yemen after disruption related to repurposing for COVID-19 pandemic. WHO Country Office (CO) in collaboration with Yemen’s Ministry of Public Health and Population (MOPH&P) jointly conducted an assessment mission to assess the current situation of the influenza sentinel surveillance system and assess its capacity to detect influenza epidemics and monitor trends in circulating influenza and other respiratory viruses of epidemic and pandemic potential. This study presents the results of the assessment for three sentinel sites located in Aden, Taiz and Hadramout/Mukalla. Methodology: A mixed methods approach was used to guide the assessment process and to help achieve the objectives. Data was collected as follows: desk review of the sentinel sites records and data; interviews with stakeholders, including key informants and partners; and direct observation through field visits to the sentinel sites, MOPH&P and the Central Public Health Laboratory (CPHL). Two assessment checklists were used: assessment of sentinel sites for SARI surveillance, and checklist for assessment of availability of SARI sentinel surveillance. Results and conclusion: COVID19 has affected health systems and services, and this was demonstrated in this assessment. The influenza sentinel surveillance system in Yemen is not effectively functional, however there’s plenty of room for improvement if investment in the system’s restructuring, training, building technical and laboratory capacities, and conducting continuous and regular supervision visits.

Introduction Atrio-ventricular (AV) conduction abnormalities and subsequent permanent pacemaker (PPM) implantation frequently complicate Transcatheter Aortic Valve Replacement(TAVR). Current guidelines are still unclear in certain clinical scenarios. Methods and Results A 78 year-old with pre-existing Left Bundle Branch Block and 1 st degree AV block underwent TAVR complicated by transient complete heart block with no further prolongation of preexisting conduction. Electrophysiology study (otherwise not indicated based on guidelines), 3 days post-procedure revealed evidence of significant infra Hisian disease requiring PPM. Conclusion No specific guidelines are available at this stage and thus our report highlights need for further research into this patient subset.

Objective: To assess the impact of an oocyte retrieval simulation training program (ORSTP) on the clinical performance of residents. Design: Prospective comparative study. Setting: A tertiary care center. Population: All OR performed by residents between May 2018 and November 2021.  Methods & main outcome measures: The Simulation (S) group included oocyte retrieval (OR) performed by residents who had undergone an ORSTP before performing them on patients (n=422) and the control (C) group included OR performed by residents who had not received prior simulation training (n= 329). Our main outcome measure was the OR rate (ORR) (number of oocytes collected/number of follicles aspirated) during the first 3 months of the rotation. Results: In the S group, 6 residents aspirated 657 ovaries while in the C group, 5 residents aspirated 508 ovaries. The mean ORR during the first 3 months of rotation were comparable between the S and C groups (59% (2800/472) vs 58% (1910/3281)). ORR during the first and second month, and at the end of the rotation were also comparable between the S and C groups (54% vs 63%, 58% vs 59% and 58% vs 58%, respectively). There was no significant difference in the rate of failed OR (3.3% vs 1.8%) between the S and C groups. Finally, 16% of residents in the S group reported being stressed before their first OR compared to 40% in the C group. Conclusions: The ORSTP does not improve the residents’ clinical performance, but it could decrease their stress in clinical practice. Keywords: oocyte pick-up, infertility, simulation, education, student.

Purpose: Venous thromboembolism (VTE) is a leading cause of preventable morbidity and mortality, with total hip arthroplasty (THA) and total knee arthroplasty (TKA) at the highest risk. Safe and appropriate thromboprophylaxis is essential. However, investigations into prescribing practices have only had limited investigation. Aims: To describe current VTE prophylaxis regimens in Australian patients following an elective THA/TKA and compare these regimens to an international standard. Methods: A retrospective multisite cohort study of patients admitted for a THA/TKA in six tertiary hospitals in Queensland, Australia was conducted over 12 months. Patient and medication data were collected following surgery and for 60 days after discharge to determine changes to their thromboprophylaxis regimen. Results were summarised and compared to NICE guidelines. Results: 1,011 patients (43.1% THA, 56.9% TKA) were included and thromboprophylaxis was used in 98.1% of inpatients and in 94.3% of discharge patients for 5.2 (±5.23) and 29.2 (±15.9) days, respectively. Low-molecular-weight heparins were the primary drugs for inpatients (71.2%), and aspirin 150mg for discharge (42.0%), most commonly for 6 weeks (31.8%). Generally, a two-staged prophylaxis regimen was implemented; most commonly any anticoagulant as an inpatient, followed by rivaroxaban on discharge (32.7%) or an anticoagulant as an inpatient with aspirin on discharge (26.4%). Overall, adherence to NICE guidelines was low; THA: 8.7%, TKA: 5.9%. Conclusion: VTE prophylaxis regimens varied considerably and consequently, adherence to international guidelines was low. There is a need for local, peer-led guidelines to ensure consistent, safe, and effective prophylaxis.

A document by Pedro Toledo. Click on the document to view its contents.

This article presents the results of a spatiotemporal critical review of the scholarship surrounding Sámi women and the memories of the generational trauma and injustices, dispossession, and resilience of these women. Sámi women’s feminism and activism are often left out of the scholarly discussions surrounding fairness and equity for this indigenous population, and little research has focused on the voice or vocality of this target population outside of arts-based research. The article presents the historical context that may be used for contemporary interpretations of transdisciplinary research findings for this target population. The systematic critical review involved recursivity for a systematically selected sample of current peer-reviewed articles filtered for the constructs of memory, resilience, and voice for Sámi women in Finnmark, Norway.

As infrastructure develops and adoption of smart water meters increases, new techniques are needed to validate and learn from the large datasets they produce. Patterns of leading digits (i.e., first non-zero digits, 1 through 9) can support this task. This study examines leading digits in hourly smart meter readings from a western U.S. water utility with over 5,000 customer connections. Benford analysis, power law analysis, and leading-digit-frequency analysis all indicate that the readings tend toward values that start with 1. The findings suggest that readings from smart water meters - and, by extension, water use by individual customers - could be expected to follow a particular nonuniform pattern of leading digits and that deviation from the pattern may indicate data errors or abnormal water use. Applications are suggested for validating water use data, comparing multiple datasets, checking projections, and assessing meter performance. Additional work is needed to further explore the beneficial uses of leading-digit patterns and other data signatures in water use data from diverse datasets.

Measurement of time is a process that takes time. This creates a lag between the measurement and the flow of time. The lag emerges from the definition of time and is not due to any physical limitation. Perfect measurement of time, therefore, may not be logically possible.

A document by Keshav Nath. Click on the document to view its contents.

Current evidence indicates a modulating role of respiratory processes in cardiac interoception, yet whether altered breathing patterns can influence heartbeat-evoked potentials (HEP) remains inconclusive. Here, we examined the effects of voluntary hyperventilation (VH) on scalp-recorded HEPs in epilepsy patients (N = 80). Using cluster-based permutation analyses, HEP amplitudes were compared across pre-VH and post-VH conditions within young and elderly subgroups, as well as for the total sample. No HEP differences were detected for younger participants or across the full sample, but results showed an increased HEP amplitude at 530 – 560 ms after R-peak within the senior subgroup during pre-VH compared to post-VH, denoting decreased cardiac interoceptive processing as a function of breathing frequency in elderly individuals. The present study, thus, provides initial evidence of ventilatory-related HEP modulations in elderly epilepsy patients, emphasizing HEP’s utility as an interoceptive neural marker that could partially extend to the representation of pulmonary signaling. We speculate that aberrant CO2-chemosensing, coupled with disturbances in autonomic regulation, might constitute the underlying pathophysiological mechanism behind the obtained effect. Available databases involving patient records of routine VH assessment may constitute a valuable asset in disentangling the interplay of cardiac and ventilatory interoceptive information, providing thorough clinical data to parse, as well as increased statistical power and estimates of effects with higher precision through large-scale studies.

KEY POINTS 1. This is the first study to use a qualitative methodology to assess the potential advantages and disadvantages of the application of 3D endoscopes in pediatric otolaryngology surgery. 2. Open-ended, structured interviews were conducted with six pediatric Otolaryngologist operating at a tertiary pediatric centre, with a minimum one year of experience using a 3D endoscopy system. 3. Thematic analysis of the surgeon's responses identified 3D endoscopy to provide improved surgical field visualization which thus served as a valuable teaching tool. 4. The surgeons interviewed found 3D endoscopy to improve surgical outcomes in pediatric airway surgery, particularly in surgeries involving the larynx. 5. Further quantitative evaluation of patient outcomes could delineate the precise clinical role 3D endoscopy may hold in future pediatric Otolaryngology practice.

Introducing a uniform distribution of carbon nanotubes into a polymer matrix can yield property enhancements that go beyond that of a simple rule of mixtures. The challenge is to take full advantage of the exceptional properties of carbon nanotubes in the composite material. Carbon nanotubes are ideal reinforcing material for polymer matrices dur to their remarkable properties. However, property improvements are not significant due to poor interfacial bonding and severe agglomeration. The present study is focused primarily upon the mechanical properties of fiber-reinforced polymer composites containing graphene-carbon nanotube hybrid materials. The polymer composites utilize nanotechnology enhancements to provide advantageous durability and structural stability improvements over conventional fiber-reinforced polymer composites. The effect of hybrid material weight fraction on the modulus of elasticity and hardness is evaluated. Stress-strain responses of the composite tensile deformation are illustrated and the effect of strain on the bond order parameters is investigated. The present study aims to explore how to effectively improve the mechanical properties of polymers by utilizing graphene-carbon nanotube hybrid materials. Particular emphasis is placed upon the effect of weight fraction on the mechanical properties of polymer composites reinforced with graphene and carbon nanotubes. The results indicate that graphene-carbon nanotube multi-stack three-dimensional architectures can overcome the limitations and restricted performance typically encountered with carbon-based materials by using the combined strategies of three-dimensional architecture and low-dimensional nanomaterial characteristics. Poor dispersibility greatly affects the characteristics of the polymer composites. The modulus of elasticity of the polymer composite is enhanced as compared to the neat polymer. The hybrid material exhibits great improvements in hardness and yield strength and major deteriorations in strain at break. The carbon nanotubes exhibit no preferred orientation and are approximately random. The doping permanently increases the charge concentration in semiconducting carbon nanotubes present in the film, thereby decreasing the sheet resistance of the network. The ability to strengthen polymers is limited by the strength of interfacial bonding. The polymer composite differs from a conventional carbon-fiber composite where there is a much higher interface area between reinforcing carbon and polymer matrix phases.Keywords: Graphene; Carbon; Composites; Polymers; Fibers; Hardness

The operation theater is a very critical area and everything needs to be done in an ordinate manner to maintain efficacy. However, managers are needed to maintain the functionality of the OT suite. An OR manager is responsible for many things, like scheduling OT but most importantly, OT efficiency. An OR manager faces different challenges during management of an OR suite. These vary from organization to organization. The most common types of diversity found in OT are cultural diversity, religious diversity, organizational and environmental diversity, and so on. An OR manager should manage these diversities ethically and professionally to overcome an ethical dilemma. OR managers should encourage ethical behavior to improve OT efficacy and effectiveness, but change may reduce or hinder OT effectiveness due to resistance to change. Ideally, the OR manager should manage sustainability to reduce resistance to change without compromising OT efficacy or inducing socio-ethical conflicts among the OR team. For this, OR teams are managed in such a way to facilitate high-quality teamwork and promote good communication skills. However, many barriers hinder communication, which may cause misconceptions and compromise efficacy. Many tactics and strategies are used to reduce these conflicts peri-operatively and OT performance indicators are used to determine the efficiency. To increase productivity, efficiency, and effectiveness as needed while lowering personnel costs, an OR manager organizes and schedules the OT.

The thylakoid membrane is in a temperature-sensitive equilibrium that shifts repeatedly during the life cycle in response to ambient temperature or solar irradiance. Plants respond to seasonal temperature by changing their thylakoid lipid composition, while a more rapid mechanism for short-term heat exposure is required. The emission of the small organic molecule isoprene has been postulated as one such possible rapid mechanism. The protective mechanism of isoprene is not known, but some plants emit isoprene during periods of high-temperature stress. In this work, we investigate the dynamics and structure for lipids within a thylakoid membrane at different temperatures and varied isoprene content using classical molecular dynamics simulations. The results are compared with experimental findings from across the literature for temperature-dependent changes in the lipid composition and shape of thylakoids. We find that the surface area, volume, and flexibility of the membrane, as well as the lipid diffusion, increase with temperature, while the membrane thickness decreases. Saturated thylakoid 34:3 glycolipids derived from eukaryotic synthesis pathways exhibit significantly different dynamics than lipids from prokaryotic synthesis paths, which could explain the upregulation of specific lipid synthesis pathways at different temperatures. Increasing isoprene concentration was not observed to have a significant thermoprotective effect on the thylakoid membranes, and that isoprene readily permeated the membrane models tested here.

Healthcare is an important industry, which offers value-based care to millions of people, while at the same time becoming top revenue earners in many countries. The increasingly growing number of applications of machine learning in healthcare allows us to glimpse at a future where data, analysis, and innovation work hand-in-hand to help countless patients without them ever realizing it. In the fields of healthcare Machine learning is used for imaging and recognition of diseases. Due to the advancing speed Machine learning has gained an adverse field in the diagnostic process of diseases in healthcare. Since machine learning is an algorithm-based field, thus it helps in generating various algorithms based on healthcare and gives great information, ideology and technical abilities to the machines. It also helps in gathering data and follow ups it grips every possible information to develop human life. In this paper, we will compare different classification algorithms with which we can detect whether an individual can get affected by Alzheimer's disease in future or not. It can also detect in which phase the person is at present if the individual is suffering from Alzheimer's disease. Alzheimer is such a disease which cannot be classified or rather identified using any manual procedures. It has some critical values which determines various phases of the disease and the fluctuation of these phases are so sensitive which makes the disease harder to handle manually. We have used the oasis dataset to train the system to make the system responsive to sensitive changes by using classification processes and modified c clustering method which was proposed by us in our previous paper i.e. Brain Anomaly Detection. We have used a pure machine learning process to solve the Alzheimer detection and the probability of Alzheimer detection problem which is recently faced by doctors.

BACKGROUND: In 2022, monsoon rain and flood affected 23 districts in Sindh, Pakistan displacing six-million-people. Internally-displaced-persons-(IDPs) were prone to infectious- disease-outbreaks and acute-respiratory-infection-(ARI). Objectives of this study were to assess association between socio-demographic-characteristics, occurrence of ARI and compare pre-&-post health-education-effects on level of awareness regarding ARI. METHODS: Comparative cross-sectional-study carried-out in medical-camps of randomly selected seven-villages of District-Kharipur-Mirus. The 560 subjects were recruited through consecutive sampling. Health-education-sessions were taken & Behavior-Change-Communication tool (BCC) was applied. Epi-info was used to calculate frequencies, p-value and chi-square test was applied to determine associations RESULT: 560-patients were treated in medical-camps with different types of ARI. Among them females were 56%(n=312), ARI-cases were more predominate factor reported in medical-camps 41%(n=229) besides tonsillitis 25%(n=140), bronchitis13%(n=72), diarrhea11%(n=62) and severe-pneumonia4%(n=22). Before health-education-session 94%(n=529) affectees had no knowledge regarding ARI-prevention. The 57%(n=320) belonged to poor-family. After post-health-education-sessions 89%(n=499) peoples were sensitized regarding ARI-prevention methods. Among socio-demographic-variables, age-group(10-19years), hygiene-status & socioeconomic-status was strongly statistically associated with occurrence of upper-acute-respiratory-infection (p=0.01, p=0.04 & p=0.001) respectively. We didn’t find significant association between previous-history & occurrence of ARI (p=0.12). There was statistically significant difference between pre-&-post application of BCC tool on the level of awareness among IDPs(p=0.03). CONCLUSION: There is great impact of health-education on cumulatively raising level of awareness among displaced-population regarding control of infectious-diseases like ARI. Second decade of age, low socio-economic-status & bad-hygiene-status was identified as high-risk factors which can be addressed through health- education & behavior-change-communication.

In this paper, a low power transconductor-capacitor (Gm-C) filter with programmable cutoff frequency is designed for electroencephalogram (EEG), electrocardiogram (ECG), and surface electromyography (sEMG) biosignals. The second order Butterworth low pass filter (LPF) is designed as an interface between an instrumentation amplifier (IA) and analog to digital converter (ADC). The proposed Gm-C filter suppresses out of band components and also plays anti-aliasing role. With the variable transconductance based on flipped voltage follower (FVF), the cutoff frequencies of 100 Hz, 560 Hz, and 1.5 kHz are obtained for EEG, ECG, and sEMG, respectively. This structure has highly accurate by using a robust and low power common mode feedback (CMFB). With 0.8 V supply voltage, the total power consumption of the filter is only 56 nW, 100 nW, and 221 nW for cutoff frequencies of 100 Hz, 560 Hz, and 1.5 kHz, respectively. The proposed Gm-C filter is simulated in TSMC 65 nm CMOS technology and occupies an area of 0.12 mm2. The figure of merit (FOM) of the proposed filter is equal to 1.9 pW/pole.

Alpine meadow degradation, usually involving decreased soil N and patchy landscapes, is challenging for natural restoration. However, the mechanism underlying plant species coexistence during degradation is unclear. In this study, we evaluated plant N niche complementarity in degraded alpine meadows by a 15N-labeling (15NO3-, 15NH4+ and 15N-glycine) experiment. At the community level, the degraded alpine meadow showed larger root and all plant 15N concentrations and preferred glycine over NO3- compared with the undegraded alpine meadow. At the species level, dominant species in the undegraded alpine meadow consistently preferred NO3-. For the degraded alpine meadow, generalist species, common to both meadows, showed diverse preferences, while unique species generally preferred glycine, among which the uneven distribution could reduce glycine competition. We observed that differentiation in N sources and the uneven distribution of unique species may explain the stability of degraded alpine meadows. Our results suggested that plant spatial distribution could be powerful for community stability and emphasized the importance of considering fine-scale perspectives in studies of niche theory. This study have important implication for restoration of degraded alpine meadows.

Background: Is rumination always associated with poorer mental health? Although some work suggests that the answer to this question is “yes”, some studies suggest that there are adaptive and maladaptive types of rumination that have distinct influences on mental health. Moreover, a growing number of studies have now shown rumination to have weaker maladaptive effects among individuals from interdependent cultural contexts (e.g., Asian Americans). The current study examined ethnoracial group differences in the use and associations of rumination types (i.e., brooding, casual analysis, reflective pondering, and problem-solving analysis) with depressive symptoms and life satisfaction among a diverse sample of Asian Americans, Latinx Americans, and European Americans. Methods: 198 Asian Americans, 168 Latinx Americans, and 235 European Americans recruited from Amazon Mechanical Turk completed an online cross-sectional survey. Results: Controlling for other rumination types, brooding emerged as a maladaptive type of rumination with strong associations with greater depressive symptoms and lower life satisfaction among all ethnoracial groups. In contrast, problem-solving analysis emerged as an adaptive type of rumination with associations with lower depressive symptoms and greater life satisfaction among Asian and Latinx Americans only, whereas this relationship was not significant among European Americans. Discussion: Findings suggest the importance of considering culture in distinguishing between adaptive versus maladaptive types of rumination. The strength of the association of rumination types with psychological well-being varied by ethnoracial group in theoretically expected ways. Implications for culturally sensitive interventions are discussed.

Background and Purpose. Brain ischemia is one of the leading causes of death and long-term disability worldwide. Cessation of the blood supply to the brain directly stimulates many pathological events, including glutamate overload and neuroinflammation. Glial cell activation occurs shortly after ischemia onset, resulting in the release of proinflammatory cytokines and exacerbation of the detrimental effects of neuroinflammation. Proinflammatory signals influence the infiltration of a wide range of immune cells, including neutrophils, T cells and monocytes/macrophages. In this study, we aimed to verify the potential anti-inflammatory effect of Chicago Sky Blue 6B (CSB6B) in a rat model of focal cerebral ischemia (90-minute middle cerebral artery occlusion). Experimental approach. CSB6B was administered 2 h before ischemia induction (pretreatment) or 1.5 h after reperfusion onset (posttreatment). A model of ischemic preconditioning was used as the comparator to pretreatment with CSB6B. Key Results &Conclusions. The results of indicated that posttreatment with CSB6B had profound anti-inflammatory effects that were associated with reduced neurological deficits and a decreased infarct volume. At 24 h, 3 days and 7 days after brain ischemia, CSB6B administration reduced the protein levels of proinflammatory cytokines, such as Il1β, Il6, Il18 and TNFα, in the cerebral cortex and the dorsal striatum. Treatment with CSB6B also limited the scope of microglia and astrocyte activation and the infiltration of immune cells. Implications. Taken together, this study shows that compounds such as CSB6B might be promising pharmacological tools; however, further studies on the improvements in the drug-like properties of these compounds must be undertaken.