Title: Gradual prolongation of PR interval followed by a pause. What’s the mechanism?

We review theories of polyelectrolyte (PE) coacervation, which is the spontaneous association of oppositely charged units of PEs and phase separation into a polymer-dense phase in aqueous solution. The simplest theories can be divided into “physics-based” and “chemistry-based” approaches. In the former, polyelectrolytes are treated as charged, long-chain, molecules, defined by charge level, chain length, and chain flexibility, but otherwise lacking chemical identity, with electrostatic interactions driving coacervation. The “chemistry-based” approaches focus on the local interactions between the species for which chemical identity is critical, and describe coacervation as the result of competitive local binding interactions of monomers and salts. In this article, we show how these approaches complement each other by presenting recent approaches that take both physical and chemical effects into account. Finally, we suggest future directions towards producing theories that are made quantitatively predictive by accounting for both long range electrostatic and local chemically specific interactions.

Arthropods are recognised as potential mechanical and biological vectors for infectious diseases in outdoor environments. However, a comprehensive understanding of the indoor arthropod community diversity and of the role that their associated microbiota may have as disease vectors is largely unexplored. Here, we study the arthropod community and the associated microbiota diversity of twenty indoor environments, sampled over a period of twelve months from urban and suburban households by citizen scientists in the West Midlands (UK). We compare the arthropods diversity between environments and over the sampling months. We characterize the exogenous (exoskeleton) and endogenous (gut) bacterial communities associated with all specimens of arthropods actively captured using both a traditional culture-based and an unbiased metabarcoding approach. For the first time, we describe the exogenous and endogenous microbiota composition and diversity of 14 arthropod families found in indoor environments. We find that both the exogenous and the endogenous microbiota are potential carriers of human opportunistic pathogens, with potential implications for public health. We discover that many bacteria families are shared across the exogenous microbiota of arthropods, likely influenced by the bacteria present in the environment. Conversely, the endogenous microbiota composition is unique to the arthropod families, and likely genetically determined. We show that the metabarcoding unbiased approach is a superior tool to characterize the microbiota associated with each arthropod family. This study provides new insights into bacterial carriage in household arthropods as potential reservoirs of infectious disease.

 In the first chapter we will present the definitions,history,relations and arithmetics approximations of Archimedes constant π,golden ratio φ,Euler's number e and imaginary number i. A total of 220 expressions. In the second chapter we will present exact expressions between Archimedes constant π,golden ratio φ,Euler's number e and imaginary number i. A total of 127 expressions. In the third chapter we will present approximations expressions between Archimedes' constant π,the golden ratio φ,the number Euler e and the imaginary number i. A total of 112 expressions.

A document by Taylor Joyal. Click on the document to view its contents.

Background: Persistent atrial fibrillation (PsAF) is a complex arrhythmia and achieving a high rate of freedom from recurrence of AF by catheter ablation has been challenging. CARTO® Ripple map has previously been identified as one possible method to improve ablation outcomes. Objective: To evaluate the relationship of AF termination and 18-month freedom from AF with Ripple Frequency measured via a novel CARTO® software algorithm. Methods: PsAF patients who underwent first time ablation were included. PV antral isolation was performed followed by locations with visually identified fast Ripple activations until AF termination. Patients were followed for 18 months. Retrospective analysis was performed using a novel CARTO® software algorithm to analyze Ripple Frequency. The Ripple Frequency algorithm quantifies amplitude changes in the bipolar electrogram over time. Results: 82 maps from 54 patients (mean age 65.4, 67% male) were analyzed. The top quartile of Ripple Frequency corresponded to a visual reference with 96.1% sensitivity and 84.7% specificity. AF terminated during ablation in 90.7% of patients: PV antrum alone (14.8%), or PV plus non-antral sites (85.2%). The top quartile of Ripple frequency was present in non-antral sites associated with AF termination with an 89.6% sensitivity and 87.7% specificity. After 18 months and a mean of 1.2 ablations, 53/54 patients (98.1%) were free of AF and 85.2% were free of any atrial arrhythmia. Conclusion: Automated analysis of CARTO® Ripple Frequency demonstrated good sensitivity and specificity for detecting atrial regions in PsAF where ablation is associated with AF termination and freedom from AF after 18 months.

Respiratory syncytial virus (RSV) hospitalizations disappeared in 2020. Now, with southern hemisphere 2021 winter behind us, RSV has returned. Despite it is difficult to weigh the impact of pandemic mitigation measures on common respiratory virus circulation, it appears that acute respiratory infections in children are returning to their usual epidemiology.

Il fastidio provocato da cattivi odori emanati degli impianti industriali è una problematica sempre più trattata negli ultimi anni; infatti l’esposizione prolungata ad odori sgradevoli può provocare problemi ben più gravi del semplice fastidio, come stress emozionale, disagio, mal di testa, depressione, irritazione oculare, problemi respiratori, nausea e vomito. La problematica maggiore è come definire in modo preciso ed univoco la pressione esercitata dagli odori sull’ambiente, molte metodologie di definizione dell’impatto non sono sempre applicabili, per problematiche dovute al breve periodo di analisi e la scarsezza dei dati da analizzare. Il documento contiene diversi metodi in uso che cercano di avvicinarsi ad una definizione oggettiva del fastidio, andando ad integrare nuovi metodi di valutazione alle metodologie classiche o utilizzando tecniche e strumenti evoluti.

Background: While the high burden of illness caused by seasonal influenza in children and the elderly is well-recognized, less is known about the burden in adults 50-64 years of age. The lack of data for this age group is a key challenge in evaluating the cost-effectiveness of vaccination programs. We aimed to assess influenza-associated hospitalization and mortality rates, and case fatality rates for hospitalized cases among adults aged 50-64 years. Methods: This review was conducted according to the PRISMA: we searched MEDLINE, EMBASE, Cochrane, Web of Science, and grey literature for articles and reports published since 2010. Studies reporting rates of hospitalization and/or mortality associated with laboratory-confirmed influenza among adults 50-64 or 45-64 years of age for the 2010-11 through 2019-20 seasons were included. Results: Twenty studies from 13 countries were included. Reported hospitalization rates associated with laboratory-confirmed influenza 5.7 to 112.8 per 100,000. Rates tended to be higher in 2015-2019 compared to 2010-2014, and were higher in studies reporting data from high income versus low and middle-income countries. Mortality rates were reported in only one study, with rates ranging from 0.8-3.5 per 100,000 in four different seasons. The case fatality rate among those hospitalized with influenza, as reported by population-based studies, ranged from 1.3% to 5.6%. Conclusions: Seasonal influenza imposes a significant burden of morbidity in adults 50-64 years of age, but with high heterogeneity across seasons and geographic regions. Ongoing surveillance is required to improve estimates of burden to better inform influenza vaccination and other public health policy.

Background: Human respiratory syncytial virus (HRSV) is a major cause of severe viral acute respiratory illness and contributes significantly to severe pneumonia cases in Africa. Little is known about its spatial-temporal distribution as defined by its genetic diversity. Methods: A retrospective study conducted utilizing archived nasopharyngeal specimens from patients attending outpatient clinics in hospitals located in five demographically and climatically distinct regions of Kenya; Coast, Western, Highlands, Eastern and Nairobi. The viral total RNA was extracted and tested using multiplex real time RT-PCR (reverse transcriptase polymerase chain reaction). A segment of the G-gene was amplified using one-step RT-PCR and sequenced by Sanger di-deoxy method. Bayesian analysis of phylogeny was utilized and subsequently median joining methods for haplotype network reconstruction. Results: Three genotypes of HRSVA were detected; GA5 (14.0%), GA2 (33.1%) and NA1 (52.9%). HRSVA prevalence varied by location from 33% to 13.2% in the Highlands and the Eastern regions respectively. The mean nucleotide diversity (Pi(π)) varied by genotype: highest of 0.018 for GA5 and lowest of 0.005 for NA1. A total of 58 haplotypes were identified (GA5 10; GA2 20; NA1 28). These haplotypes were introduced into the population locally by single haplotypes and additional subsidiary seeds amongst the GA2 and the NA1 haplotypes. Conclusions: HRSVA was found across all the regions throughout the study period and comprised three genotypes; GA5, GA2 and NA1 genotypes. The genotypes were disproportionately distributed across the regions with GA5 gradually increasing towards the Western zones and decreasing towards the Eastern zones of the country.

Background: Data on disease burden of respiratory syncytial virus (RSV) associated acute lower respiratory infection (ALRI) among young children are limited in China. This study aimed to estimate the hospitalization rate of RSV-associated ALRI (RSV-ALRI) among children aged 0~59 months in Suzhou, China. Methods: We retrospectively identified all hospitalized ALRI children aged 0~59 months in Suzhou University Affiliated Children’s Hospital during January 2010 to December 2014. Detailed diagnosis and treatment data were collected by individual medical chart review. Referring to WHO influenza disease burden estimation method, we estimated the hospitalization rate of RSV-ALRI among children aged 0~59 months in Suzhou, China. Results: Among 28,209 ALRI cases, 19,317 (68.5%) were tested for RSV and the RSV positive proportion was 21.3% (4,107/19,317). The average hospitalization rate of RSV-ALRI for children aged 0~59 months was 14 (95% confidence interval [CI]:14~14)/1,000 children-years, for children aged 0~5, 6~11, 12~23, and 24~59 months were 70 (95%CI: 67~73), 31 (95%CI: 29~33), 11 (95%CI: 10~12), and 3 (95%CI: 3~3) /1,000 children-years, respectively. Conclusion: There is considerable RSV-ALRI hospitalization among children aged 0~59 months, particularly among children aged <1 years. An effective monoclonal antibody or vaccine is urgently needed to address the substantial hospitalization burden owing to RSV infection. Key words: Respiratory syncytial virus, Hospitalization rate, Acute lower respiratory infection, Children, China

This case is about a child who had a ventriculoperitoneal shunt due to a hydrocephalus related to a cystic craniopharyngioma. Postoperative, he presented abdominal distension and meningismus. Imaging showed regression of the tumor. The cyst was drained by the shunt. No previous similar situations was reported in the literature.

Il presente lavoro affronta, attraverso un lavoro di sintesi e ricerche bibliografiche, le problematiche relative alla contaminazione delle acque da metalli pesanti e i relativi processi per il trattamento degli stessi.  Si spiega innanzitutto cosa sono i metalli pesanti, si informa circa l’esistenza di vari processi per il trattamento delle acque reflue e si approfondiscono i processi che prevedono l’utilizzo di membrane. Si effettua prima una panoramica generale sui processi a membrana, in particolare, la filtrazione, andando anche ad analizzare quello che è il problema del fouling della membrana. Successivamente si analizza l’ultrafiltrazione applicata alla rimozione degli ioni metallici, andando a sottolineare la non efficacia di questo processo se non attraverso l’aggiunta di polielettroliti potenziati. Successivamente si affronta l’adsorbimento e si parla dell’utilizzo di membrane e del fatto che la capacità adsorbente dipende anche dal tipo di adsorbito oltre al fatto che sempre più spesso si utilizzano membrane composite e si è analizzata l’effettiva efficacia del fosfato di zirconio come nanorimpietivo funzionalizzato incorporato in membrane a matrice mista.

In this work the boundaries of small-scale yielding (SSY) and large-scale yielding (LSY) have been experimentally evaluated from the analysis of crack tip opening displacement (CTOD) measured by Digital Image Correlation (DIC). The approach published in a previous numerical work [18] has been used to define the boundaries of SSY and LSY. According to this approach, CTOD must be resolved into its elastic and plastic components, analysing the ratio between the elastic CTOD range and the total CTOD range ( Δδe/ Δδt) to define the boundary where SSY conditions can be established. Three materials have been studied, commercially pure titanium and 2024-T3 and 7050-T6 aluminium alloys, tested at different stress ratio values (0.1 and 0.6 for titanium, and 0.1, 0.3 and 0.5 for the aluminium alloys). SSY conditions are shown to dominate when Δδe/ Δδt≥79% and ≥78% for titanium and the two aluminium alloys, respectively. In addition, LSY can be established when Δδe/ Δδt≤66.3% and ≤67.2% for titanium and for 2024-T3 and 7050-T6 aluminum alloys, respectively. Transition or LSY conditions are more probable in fatigue tests conducted at low R-ratio than in tests at high R-ratio. In addition, crack lengths above 40% with respect to the width of the specimen promote transition or LSY conditions. The results obtained in this work can assist to a better understanding of the mechanisms driving fatigue crack growth.

Primary oral mucosal melanoma is a rare disease. Etiopathogenesis of oral mucosal melanoma (OMM) is inadequately understood. The prognosis of OMM is very poor . Due to its low incidence and late recognition, the optimal treatment modality is not well established. Surgery with free margins is the mainstay of treatment.

Ossification of stylohyoid chain corresponds to the ossification of stylohyoid ligament that can vary from thin short to thick long ossification and can be associated with other calcifications. We report in this case a bilateral non painful complete ossification of the stylohyoid complex extended to the thyrohyoidien ligament.

Objective: The implantation depth and membranous septum (MS) length are established as the predictors of new-onset conduction disturbance (CD) after transcatheter aortic valve replacement (TAVR) for tricuspid aortic valve (TAV) stenosis. However, little is known about the predictors with bicuspid aortic valve (BAV). This study investigated the role of MS length and implantation depth in predicting CD following TAVR with a balloon-expandable valve in patients with BAV. Methods and results: This retrospective study analyzed 169 patients who underwent TAVR for BAV with balloon-expandable valve, and TAV cohort was established as a control group using propensity score (PS) matching. The primary endpoint was in-hospital new-onset CD (new-onset left bundle branch block or new permanent pacemaker implantation). New-onset CD developed in 37 patients (21.9%). Multivariate analysis revealed severe LVOT calcification (Odds ratio [OR]: 5.83, 95% confidence interval [CI]: 1.08 – 31.5, p = 0.0407) and implantation depth – MS length (OR: 1.30, 95% CI: 1.12 – 1.51, p = 0.0005) as the predictors of new-onset CD within BAV cohort. The matched comparison between BAV and TAV groups showed similar MS length (3.0 vs 3.2mm, p = 0.5307), but valves were implanted deeper in BAV than TAV group (3.9 vs 3.0mm, p < .0001). New-onset CD was more frequent in patients having BAV (22.3% vs 13.9%, p = 0.0458). Conclusion: The implantation depth - MS length, and severe LVOT calcification predicted new-onset CD following TAVR in BAV with balloon-expandable valve. High implantation technique could be considered to avoid new-onset CD in BAV anatomy.

Restoration is the natural and intervention-assisted set of processes designed to promote and facilitate the recovery of an ecosystem that has been degraded, damaged, or destroyed. Therefore, the need to assess an ecological restoration project is a critical step to evaluate its success and identify best management practices. We performed a meta-analysis concerning the environmental outcomes during the years 2000 to 2015 resulting from the “Grain for Green” Project (GFGP) implementation in the Loess Plateau (LP). Data were collected in 48 English-language peer-reviewed papers selected from a pool of 332 papers. The results showed that, on average, GFGP increased forest coverage by 35.7% (95% CI: 24.15-47.52%), and grassland by 1.05% (95% CI: 0.8-1.28%). At the same time, GFGP has a positive impact on soil carbon (C) sequestration, net ecosystem production (NEP), and net primary production (NPP), from the years 2000 to 2015 by an average of 36% (95% CI: 28.96-43.18%), 22.7% (95% CI: 9.10-36.79%), and 13.5% (95% CI: 9.44-17.354%), respectively. Soil erosion, sediment load, runoff coefficient and water yield reduced by 13.3% (95% CI: 0.27%-25.76), 21.5% (95% CI: 1.50-39.99%), 22.4% (95% CI: 5.28-40.45%) and 43.3% (95% CI: 27.03%-82.86%), respectively, from the years 2000 to 2015. Our results indicate that water supply decreased with restoration age. Therefore, GFGP policies and strategies should be adjusted to balance the need for green space and grain trade by recovering, enhancing, and maintaining more resilient landscapes.

We report narrowband orthogonally polarized optical RF single sideband generators as well as dual-channel RF equalization, both based on high-Q integrated ring resonators. The devices operate in the optical telecommunications C-band and enable RF operation over a range of either fixed or thermally tunable frequencies. They operate via TE/TM mode birefringence in the resonator. We achieve a very large dynamic tuning range of over 55 dB for both the optical carrier-to-sideband ratio and the dual-channel RF equalization for both the fixed and tunable devices.

We review recent work on broadband RF channelizers based on integrated optical frequency Kerr micro-combs combined with passive micro-ring resonator filters, with microcombs having channel spacings of 200GHz and 49GHz. This approach to realizing RF channelizers offers reduced complexity, size, and potential cost for a wide range of applications to microwave signal detection.

Packing size effects on the fluid dynamics in an external-loop packed bubble column with Raschig rings of three different effective diameters (5, 14 and 41 mm) in the riser were investigated. The overall gas holdup, liquid circulating velocity and gas-liquid mass transfer coefficient were respectively measured by volume expansion method, tracer-response method and dynamic oxygen-absorption technique. CFD simulation with the Euler-Euler two-fluid method was used to predict the liquid circulating velocity by treating the packing as a porous medium. Compared to the empty column, the gas holdup was found to increase with the presence of packing, however, the liquid circulating velocity and gas-liquid mass transfer coefficient may increase or decrease. Specifically, the gas holdup increases with the decrease of packing size, while the liquid circulating velocity is on the contrary, which induces the maximal gas-liquid mass transfer rate at packing diameter of 14 mm.

Purpose:Atrial fibrillation(AF) causes structural, electrical, and cellular remodeling in the atrium. Evaluation of intra- and interatrial conduction time, which is measured by tissue doppler echocardiography, indicates structural and electrical remodeling in the atrium. The aim of this study was to evaluate the effect of pulmonary vein isolation applied with RF ablation therapy on intra- and interatrial conduction time and to investigate the structural and electrically remodeling after treatment. Methods:Fifty-two patients with symptomatic PAF despite at least one antiarrhythmic drug and without structural heart disease were included in the study. Two patients were excluded because of complications developed during and after the operation. Fifty patients (28 female; mean age: 51.68 ± 11.731; mean left atrial diameter: 36.79 ± 4.318) who underwent CARTO® 3D pulmonary vein isolation applied with the RF ablation system were followed-up. Intra- and the inter-atrial electromechanical delay was measured in all patients by tissue doppler echocardiography before and three months after RF ablation. Results:All intra- and interatrial conduction times were significantly decreased 3 months after RF ablation procedure(PA lateral p = 0.022; PA septum p = 0.002; PA tricuspid p = 0.019, interatrial conduction delay p= 0,012, intra-atrial conduction delay p = 0.029). Conclusion:The results of our study suggest that providing stable sinus rhythm by the elimination of the AF triggering mechanisms with RF ablation of pulmonary vein isolation may slow down,stop or even improve structural remodeling at substrate level secondary to AF even in patients who did not yet develop atrial fibrosis and permanent structural changes.

Authors:1. Ar. Raja Singh*, M.Arch (NIT Trichy; Energy Efficient and Sustainable Architecture)Research Scholar and Visiting Faculty,  Department of Architecture, School of Planning and Architecture, NewDelhi.2. Prof. Dr. Anil Dewan (PhD, SPA Delhi)Professor and Head, Department of Architecture, School of Planning and Architecture, New Delhi.*Corresponding author. Email: rajaphd@spa.ac.in mobile: +91 9888312502 Address: Department of Architecture, 4 Block B, IP Estate, New Delhi 110002.

Epicardial exclusion of LAA has gained increasing popularity since its introduction in 2009. While the clip has demonstrated a success rate ranging from 93.9-100% in excluding the LAA, one significant complication is incomplete exclusion due to residual stump (> 1 cm) as a result of the clip being deployed too distally. We describe here the first reported case of implanting a second clip underneath the first clip to obliterate the residual stump for a 71-year-old male with AF evaluated for intervention for stroke risk reduction.