Percutaneous Catheter Ablation of Epicardial Accessory Pathways.

Radiofrequency (RF) catheter ablation is the treatment of choice in patients with accessory pathways (APs) and Wolff-Parkinson-White syndrome. Endocardial catheter ablation has limitations, including the inability to map and ablate intramural or subepicardial APs. Some of these difficulties can be overcome using an epicardial approach performed through the epicardial venous system or by percutaneous catheterisation of the pericardial space. When a suspected left inferior or infero-paraseptal AP is refractory to ablation or no early activation is found at the endocardium, a transvenous approach via the coronary sinus is warranted because such epicardial pathways can be in close proximity to the coronary venous system. Associated congenital abnormalities, such as right atrial appendage, right ventricle diverticulum, coronary sinus diverticulum and absence of coronary sinus ostium, may also hamper a successful outcome. Percutaneous epicardial subxiphoid approach should be considered when endocardial or transvenous mapping and ablation fails. Epicardial mapping may be successful. It can guide and enhance the effectiveness of endocardial ablation. The finding of no epicardial early activation leads to a more persistent new endocardial attempt. When both endocardial and epicardial ablation are unsuccessful, open-chest surgery is the only option to eliminate the AP.info:eu-repo/semantics/publishedVersio

Gene expression differs in susceptible and resistant amphibians exposed to Batrachochytrium dendrobatidis.

Chytridiomycosis, the disease caused by the fungal pathogen Batrachochytrium dendrobatidis (Bd), has devastated global amphibian biodiversity. Nevertheless, some hosts avoid disease after Bd exposure even as others experience near-complete extirpation. It remains unclear whether the amphibian adaptive immune system plays a role in Bd defence. Here, we describe gene expression in two host species-one susceptible to chytridiomycosis and one resistant-following exposure to two Bd isolates that differ in virulence. Susceptible wood frogs (Rana sylvatica) had high infection loads and mortality when exposed to the more virulent Bd isolate but lower infection loads and no fatal disease when exposed to the less virulent isolate. Resistant American bullfrogs (R. catesbeiana) had high survival across treatments and rapidly cleared Bd infection or avoided infection entirely. We found widespread upregulation of adaptive immune genes and downregulation of important metabolic and cellular maintenance components in wood frogs after Bd exposure, whereas American bullfrogs showed little gene expression change and no evidence of an adaptive immune response. Wood frog responses suggest that adaptive immune defences may be ineffective against virulent Bd isolates that can cause rapid physiological dysfunction. By contrast, American bullfrogs exhibited robust resistance to Bd that is likely attributable, at least in part, to their continued upkeep of metabolic and skin integrity pathways as well as greater antimicrobial peptide expression compared to wood frogs, regardless of exposure. Greater understanding of these defences will ultimately help conservationists manage chytridiomycosis

Sulfadoxine-Pyrimethamine Exhibits Dose-Response Protection Against Adverse Birth Outcomes Related to Malaria and Sexually Transmitted and Reproductive Tract Infections

: We conducted a prospective cohort study in Zambia among pregnant women who received intermittent preventive treatment using sulfadoxine-pyrimethamine (IPTp-SP). : We calculated the odds ratios (ORs) of adverse birth outcomes by IPTp-SP exposure, 0-1 dose (n = 126) vs ≥2 doses (n = 590) and ≥2 doses (n = 310) vs ≥3 doses (n = 280) in 7 categories of malaria infection and sexually transmitted and reproductive tract infections (STIs/RTIs). : We found no significant differences in baseline prevalence of infection across IPTp-SP exposure groups. However, among women given 2 doses compared to 0-1 dose, the odds of any adverse birth outcome were reduced 45% (OR, 0.55; 95% confidence interval [CI], 0.36, 0.86) and 13% further with ≥3 doses (OR, 0.43; 95% CI, 0.27, 0.68). Two or more doses compared to 0-1 dose reduced preterm delivery by 58% (OR, 0.42; 95% CI, 0.27, 0.67) and 21% further with ≥3 doses (OR, 0.21; 95% CI, 0.13, 0.35). Women with malaria at enrollment who received ≥2 doses vs 0-1 had 76% lower odds of any adverse birth outcome (OR, 0.24; 95% 0.09, 0.66), and Neisseria gonorrhoeae and/or Chlamydia trachomatis had 92% lower odds of any adverse birth outcome (OR, 0.08; 95% CI, 0.01, 0.64). Women with neither a malaria infection nor STIs/RTIs who received ≥2 doses had 73% fewer adverse birth outcomes (OR, 0.27; 95% CI, 0.11, 0.68). : IPTp-SP appears to protect against malaria, STIs/RTIs, and other unspecified causes of adverse birth outcome.<br/

From BIM to BEMS, covering the design- to operational-phase interoperability gap

This paper deals with the FP7 EU project “Building as a Service” (BaaS). The BaaS project is a research initiative which aims at providing a generic solution for delivering standardization and interoperability concepts for building data and open middleware platform covering the Design- and Operational-Phase In-teroperability Gap in the application domain of “non-residential buildings.” There are two important phases in the building life-cycle: the design phase and the operational phase. Development and integration of ICT tech-nologies can help best coordinate the building design and operation phases. Overcoming interoperability gaps between both phases so as providing a way of integration to use existing and future tools and services would help to enhance building operations and controls. Better design, standardization and interoperability can con-tribute themselves to the goals of improving energy efficiency. Interoperable components working as services at the building level, will lead naturally to the concept of the Building as a Service ecosystem. This paper aims at analyzing some of the BaaS project topics: (1) building data management and interoperability: data warehouse to collect, organize, store and aggregate static and dynamic data from various in- and out-of-building sources; an IFC-based BIM will act as a central repository for all static building data, and a data warehouse will be used for dynamic data, both schemes mapped using a unique vocabulary. (2) Integration of building energy management Services using Open Service Middleware Platform technologies. A service middleware platform to abstract the building physical devices, support high level services on the cloud and facili-tate secure two-way communication between the physical and ICT layers (building) with high level services (cloud)

Cultivars of Codiaeum variegatum (L.) Blume (Euphorbiaceae) show variability in phytochemical and cytological characteristics

In the course of their evolution, plant developed chemical defences when attacked. These phytochemicals inadvertently protect humans against pathogens as antimicrobial medicines. Thus, six clone cultivars of Codiaeum variegatum (Spirale, Royal, Broad Spotted Guinea, Punctatum, Sunray and Royal-like) were chemically and cytologically investigated to evaluate their therapeutic potentials, values and variability. The shoots were relatively rich in alkaloids, cardiac glycosides, saponins, tannins, cardenolides, steroids, and phyllates. Flavonoids, phlobatannins, phenols and anthraquinoneswere sparingly present. Anthraquinones and cardenolides were absent in ‘Spirale’ while ‘Sunray’ lacked tannins, phlobatannins and phenols. Terpenes were found only in ‘Sunray’. Overall, alkaloids were themost abundant with the highest mean value of 1.46% in ‘Royal’ while flavonoids and anthraquinones were trace, 0.002 and 0.003%, in ‘Sunray’ and ‘Royal-like’. Five pigments, carotene (yellow-orange),phaeophytin (grey), chlorophyll a (blue-green) and b (green), and xanthophyll (yellow) were determined. ‘Spirale’, ‘Royal’, ‘Broad Spotted Guinea’ and ‘Punctatum’ had diploid chromosme number of 2n = 60while ‘Sunray’ and ‘Royal-like’ possessed 2n = 30 and 24 respectively. ‘Spirale’ and ‘Sunray’ appeared to have reasonably diverged from the rest. Genetic mutation and chromosomes variability couldaccount for the wide morphological variation and morphotypes in this plant species

Microwave Oscillations of a Nanomagnet Driven by a Spin-Polarized Current

We describe direct electrical measurements of microwave-frequency dynamics in individual nanomagnets that are driven by spin transfer from a DC spin-polarized current. We map out the dynamical stability diagram as a function of current and magnetic field, and we show that spin transfer can produce several different types of magnetic excitations, including small-angle precession, a more complicated large-angle motion, and a high-current state that generates little microwave signal. The large-angle mode can produce a significant emission of microwave energy, as large as 40 times the Johnson-noise background.Comment: 12 pages, 3 figure