Cutaneous sarcoid-like reaction in a patient treated with target therapy for metastatic melanoma: the hue is the clue

Cutaneous sarcoid-like reaction in a patient treated with target therapy for metastatic melanoma: the hue is the clu

Selectra 3D- guided conduction system pacing: single-center experience

Abstract Background Conduction system pacing (CSP)is becoming increasingly popular thanks to the ability to both maintain physiological electrical activation in patients with narrow QRS and restore ventricular synchrony in patients with bundle branch block (BBB). The Selectra3D introducer is a new tool able to support the correct positioning and screwing of the catheter on the bundle of His (HBP) or on the left branch (LBBP). It does exist in 3 different shapes: S, M, L (Fig. 1) based on the radius of main curvature. The internal diameter of 7.3 Fr allows it to support both the 3830 lumen-less catheter historically used for CSP, as well as standard 6Fr stylet-driven leads. Objective To evaluate the effectiveness of the Selectra3D introducer for CSP (including both HBP and LBBP), considering the procedural success rate and the lead stability (stability of electrical parameters or need for implant revision) in the medium-term follow-up. Methods and results The Selectra3D introducer was used in 56 patients' candidates for CSP (mean age 80±6 years). Pacing indications included A-V block in 21 patients, AF with slow ventricular response in 9 patients; SND in 8 patients and HF and severe ventricular dysfunction in 18 patients (of which 4 were PICM). The mean baseline EF was 40±15%. A PM was implanted in 40 patients and an ICD in 16. A standard stylet-driven lead was used in 48 cases, a fixed exposed screw lead was used in 8 patients. HBP was obtained in 21 cases and LBBP in 30 cases, while in 5 cases (8.9%) neither HBP nor LBBP could be obtained. Implants were performed via a left-sided approach in 55 cases and a right-sided approach in 1 case. The baseline QRS duration was 144±38 ms and the paced QRS duration was 118±21 ms. The electrical parameters were optimal with sensing 8.7±8 mV; impedance 625±276 ohm; threshold 1±0.5 V. During follow-up, 2 lead dislodgement (3.9%) (1 HBP and 1 LBBP) were recorded, both within 7 days after implantation. All the others showed stability of the electrical parameters at a mean follow-up of 8.4±4.2 months. Conclusions The new Selectra3D introducer supports effectively and safely the lead implant on conduction system catheters (HBP and LBBP), allowing the implant of both exposed fixed screw leads and standard stylet-driven leads, leading to procedural success>90%. The electrical parameters were optimal at implantation and remained stable during follow-up. Funding Acknowledgement Type of funding sources: None. Figure

Extreme Communication in 6G: Vision and Challenges for ‘in-X’ Subnetworks

The 6th Generation (6G) radio access technology is expected to support extreme communication requirements in terms of throughput, latency and reliability, which can only be achieved by providing capillary wireless coverage. In this paper, we present our vision for short-range low power 6G ‘in-X’ subnetworks, with the ‘X’ standing for the entity in which the cell in which the subnetwork is deployed, e.g., a production module, a robot, a vehicle, a house or even a human body. Such cells can support services that can be life-critical and that traditionally relied on wired systems. We discuss potential deployment options, as well as candidate air interface components and spectrum bands. Interference management is identified as a major challenge in dense deployments, which needs to handle also non-cellular types of interference like jamming attacks and impulsive noise. A qualitative example of interference-robust system design is also presented

The Mixed Vector Current Correlator <0|T(V^3_\mu V^8_\nu )|0> To Two Loops in Chiral Perturbation Theory

The isospin-breaking correlator of the product of flavor octet vector currents, $V^3_\mu$ and $V^8_\nu$, $\Pi^{38}_{\mu\nu}(q^2)$ is computed to next-to-next- to-leading (two-loop) order in Chiral Perturbation Theory. Large corrections to both the magnitude and $q^2$-dependence of the one-loop result are found, and the reasons for the slow convergence of the chiral series for the correlator given. The two-loop expression involves a single ${\cal O}(q^6)$ counterterm, present also in the two-loop expressions for $\Pi^{33}_{\mu\nu}(q^2)$ and $\Pi^{88}_{\mu\nu}(q^2)$, which counterterm contributes a constant to the scalar correlator $\Pi^{38}(q^2)$. The feasibility of extracting the value of this counterterm from other sources is discussed. Analysis of the slope of the correlator with respect to $q^2$ using QCD sum rules is shown to suggest that, even to two-loop order, the chiral series for the correlator may not yet be well-converged.Comment: 32 pages, uses REVTEX and epsfig.sty with 7 uuencoded figures. Entire manuscript available as a ps file at http://www.physics.adelaide.edu.au/theory/home.html Also available via anonymous ftp at ftp://adelphi.adelaide.edu.au/pub/theory/ADP-95-27.T181.p

Factor graph based detection approach for high-mobility OFDM systems with large FFT modes

In this article, a novel detector design is proposed for orthogonal frequency division multiplexing (OFDM) systems over frequency selective and time varying channels. Namely, we focus on systems with large OFDM symbol lengths where design and complexity constraints have to be taken into account and many of the existing ICI reduction techniques can not be applied. We propose a factor graph (FG) based approach for maximum a posteriori (MAP) symbol detection which exploits the frequency diversity introduced by the ICI in the OFDM symbol. The proposed algorithm provides high diversity orders allowing to outperform the free-ICI performance in high-mobility scenarios with an inherent parallel structure suitable for large OFDM block sizes. The performance of the mentioned near-optimal detection strategy is analyzed over a general bit-interleaved coded modulation (BICM) system applying low-density parity-check (LDPC) codes. The inclusion of pilot symbols is also considered in order to analyze how they assist the detection process

Mitochondrial ATP synthase: architecture, function and pathology

Human mitochondrial (mt) ATP synthase, or complex V consists of two functional domains: F1, situated in the mitochondrial matrix, and Fo, located in the inner mitochondrial membrane. Complex V uses the energy created by the proton electrochemical gradient to phosphorylate ADP to ATP. This review covers the architecture, function and assembly of complex V. The role of complex V di-and oligomerization and its relation with mitochondrial morphology is discussed. Finally, pathology related to complex V deficiency and current therapeutic strategies are highlighted. Despite the huge progress in this research field over the past decades, questions remain to be answered regarding the structure of subunits, the function of the rotary nanomotor at a molecular level, and the human complex V assembly process. The elucidation of more nuclear genetic defects will guide physio(patho)logical studies, paving the way for future therapeutic interventions