Permanent Nonselective His Bundle Pacing in an Adult with L-Transposition of the Great Arteries and Complete AV Block

We report the placement of a permanent transvenous nonselective His bundle pacing lead in conjunction with a transvenous pacemaker/implantable cardioverter-defibrillator in an adult with Levo-Transposition of the Great Arteries (L-TGA) and a stenotic coronary sinus (CS) ostium, which would not accommodate a transvenous left ventricular (LV) pacing lead. Nonselective His bundle pacing provided a nearly identical ventricular activation pattern in this previously unpaced patient. Many L-TGA patients will have an eventual need for permanent pacing and, given the challenges of CS cannulation, His bundle pacing may represent a preferred modality rather than pure morphologic LV pacing or surgical systemic ventricular lead placement to achieve optimal electrical synchrony

Lamellipodium extension and membrane ruffling require different SNARE-mediated trafficking pathways

<p>Abstract</p> <p>Background</p> <p>Intracellular membrane traffic is an essential component of the membrane remodeling that supports lamellipodium extension during cell adhesion. The membrane trafficking pathways that contribute to cell adhesion have not been fully elucidated, but recent studies have implicated SNARE proteins. Here, the functions of several SNAREs (SNAP23, VAMP3, VAMP4 and syntaxin13) are characterized during the processes of cell spreading and membrane ruffling.</p> <p>Results</p> <p>We report the first description of a SNARE complex, containing SNAP23, syntaxin13 and cellubrevin/VAMP3, that is induced by cell adhesion to an extracellular matrix. Impairing the function of the SNAREs in the complex using inhibitory SNARE domains disrupted the recycling endosome, impeded delivery of integrins to the cell surface, and reduced haptotactic cell migration and spreading. Blocking SNAP23 also inhibited the formation of PMA-stimulated, F-actin-rich membrane ruffles; however, membrane ruffle formation was not significantly altered by inhibition of VAMP3 or syntaxin13. In contrast, membrane ruffling, and not cell spreading, was sensitive to inhibition of two SNAREs within the biosynthetic secretory pathway, GS15 and VAMP4. Consistent with this, formation of a complex containing VAMP4 and SNAP23 was enhanced by treatment of cells with PMA. The results reveal a requirement for the function of a SNAP23-syntaxin13-VAMP3 complex in the formation of lamellipodia during cell adhesion and of a VAMP4-SNAP23-containing complex during PMA-induced membrane ruffling.</p> <p>Conclusions</p> <p>Our findings suggest that different SNARE-mediated trafficking pathways support membrane remodeling during ECM-induced lamellipodium extension and PMA-induced ruffle formation, pointing to important mechanistic differences between these processes.</p

Management of Complications Caused By a Massive Left Ventricle Tumor in a Neonate

We report a case of a neonate born with a giant fibroma occupying the entirety of her left ventricle. Due to the extensive resection, her postoperative course was complicated by severely diminished left ventricular function and complete heart block necessitating extracorporeal support. Ultimately, cardiac resynchronization therapy was employed, after which the infant’s ventricular function gradually improved and she was successfully discharged to home

Measuring Basal Force Fluctuations of Debris Flows Using Seismic Recordings and Empirical Green's Functions

We present a novel method for measuring the fluctuating basal normal and shear stresses of debris flows by using along‐channel seismic recordings. Our method couples a simple parameterization of a debris flow as a seismic source with direct measurements of seismic path effects using empirical Green's functions generated with a force hammer. We test this method using two large‐scale (8 and 10 m³) experimental flows at the U.S. Geological Survey debris‐flow flume that were recorded by dozens of three‐component seismic sensors. The seismically derived basal stress fluctuations compare well in amplitude and timing to independent force plate measurements within the valid frequency range (15–50 Hz). We show that although the high‐frequency seismic signals provide band‐limited forcing information, there are systematic relations between the fluctuating stresses and independently measured flow properties, especially mean basal shear stress and flow thickness. However, none of the relationships are simple, and since the flow properties also correlate with one another, we cannot isolate a single factor that relates in a simple way to the fluctuating forces. Nevertheless, our observations, most notably the gradually declining ratio of fluctuating to mean basal stresses during flow passage and the distinctive behavior of the coarse, unsaturated flow front, imply that flow style may be a primary control on the conversion of translational to vibrational kinetic energy. This conversion ultimately controls the radiation of high‐frequency seismic waves. Thus, flow style may provide the key to revealing the nature of the relationship between fluctuating forces and other flow properties

Measuring Basal Force Fluctuations of Debris Flows Using Seismic Recordings and Empirical Green's Functions

We present a novel method for measuring the fluctuating basal normal and shear stresses of debris flows by using along‐channel seismic recordings. Our method couples a simple parameterization of a debris flow as a seismic source with direct measurements of seismic path effects using empirical Green's functions generated with a force hammer. We test this method using two large‐scale (8 and 10 m³) experimental flows at the U.S. Geological Survey debris‐flow flume that were recorded by dozens of three‐component seismic sensors. The seismically derived basal stress fluctuations compare well in amplitude and timing to independent force plate measurements within the valid frequency range (15–50 Hz). We show that although the high‐frequency seismic signals provide band‐limited forcing information, there are systematic relations between the fluctuating stresses and independently measured flow properties, especially mean basal shear stress and flow thickness. However, none of the relationships are simple, and since the flow properties also correlate with one another, we cannot isolate a single factor that relates in a simple way to the fluctuating forces. Nevertheless, our observations, most notably the gradually declining ratio of fluctuating to mean basal stresses during flow passage and the distinctive behavior of the coarse, unsaturated flow front, imply that flow style may be a primary control on the conversion of translational to vibrational kinetic energy. This conversion ultimately controls the radiation of high‐frequency seismic waves. Thus, flow style may provide the key to revealing the nature of the relationship between fluctuating forces and other flow properties

The effects of changes in the order of verbal labels and numerical values on children's scores on attitude and rating scales

Research with adults has shown that variations in verbal labels and numerical scale values on rating scales can affect the responses given. However, few studies have been conducted with children. The study aimed to examine potential differences in children’s responses to Likert-type rating scales according to their anchor points and scale direction, and to see whether or not such differences were stable over time. 130 British children, aged 9 to 11, completed six sets of Likert-type rating scales, presented in four different ways varying the position of positive labels and numerical values. The results showed, both initially and 8-12 weeks later, that presenting a positive label or a high score on the left of a scale led to significantly higher mean scores than did the other variations. These findings indicate that different arrangements of rating scales can produce different results which has clear implications for the administration of scales with children

Ultracold Fermions in a Graphene-Type Optical Lattice

Some important features of the graphene physics can be reproduced by loading ultracold fermionic atoms in a two-dimensional optical lattice with honeycomb symmetry and we address here its experimental feasibility. We analyze in great details the optical lattice generated by the coherent superposition of three coplanar running laser waves with respective angles $2\pi/3$. The corresponding band structure displays Dirac cones located at the corners of the Brillouin zone and close to half-filling this system is well described by massless Dirac fermions. We characterize their properties by accurately deriving the nearest-neighbor hopping parameter $t_0$ as a function of the optical lattice parameters. Our semi-classical instanton method proves in excellent agreement with an exact numerical diagonalization of the full Hamilton operator in the tight-binding regime. We conclude that the temperature range needed to access the Dirac fermions regime is within experimental reach. We also analyze imperfections in the laser configuration as they lead to optical lattice distortions which affect the Dirac fermions. We show that the Dirac cones do survive up to some critical intensity or angle mismatches which are easily controlled in actual experiments. In the tight-binding regime, we predict, and numerically confirm, that these critical mismatches are inversely proportional to the square-root of the optical potential strength. We also briefly discuss the interesting possibility of fine-tuning the mass of the Dirac fermions by controlling the laser phase in an optical lattice generated by the incoherent superposition of three coplanar independent standing waves with respective angles $2\pi/3$