Force‐sensing catheters during pediatric radiofrequency ablation: The FEDERATION Study

Background Based on data from studies of atrial fibrillation ablations, optimal parameters for the TactiCath (TC; St. Jude Medical, Inc) force‐sensing ablation catheter are a contact force of 20 g and a force‐time integral of 400 g·s for the creation of transmural lesions. We aimed to evaluate TC in pediatric and congenital heart disease patients undergoing ablation. Methods and Results Comprehensive chart and case reviews were performed from June 2015 to March 2016. Of the 102 patients undergoing electrophysiology study plus ablation, 58 (57%) underwent ablation initially with a force‐sensing catheter. Patients had an average age of 14 (2.4–23) years and weight of 58 (18–195) kg with 15 patients having abnormal cardiac anatomy. Electrophysiology diagnoses for the + TC group included 30 accessory pathway–mediated tachycardia, 24 atrioventricular nodal reentrant tachycardia, and 7 other. Baseline generator settings included a power of 20 W, temperature of 40°, and 6 cc/min flow during lesion creation with 11 patients (19%) having alterations to parameters. Seventeen patients (30%) converted to an alternate ablation source. A total of 516 lesions were performed using the TC with a median contact force of 6 g, force‐time integral of 149 g·s, and lesion size index of 3.3. Median‐term follow‐up demonstrated 5 (10%) recurrences with no acute or median‐term complications. Conclusions TactiCath can be effectively employed in the treatment of pediatric patients with congenital heart disease with lower forces than previously described in the atrial fibrillation literature. Patients with atrioventricular nodal reentrant tachycardia or atrioventricular reciprocating tachycardia may not require transmural lesions and the TC may provide surrogate markers for success during slow pathway ablation. </jats:sec

Percutaneous pulmonary valve implantation alters electrophysiologic substrate

BACKGROUND: Percutaneous pulmonary valve implantation (PPVI) is first‐line therapy for some congenital heart disease patients with right ventricular outflow tract dysfunction. The hemodynamics improvements after PPVI are well documented, but little is known about its effects on the electrophysiologic substrate. The objective of this study is to assess the short‐ and medium‐term electrophysiologic substrate changes and elucidate postprocedure arrhythmias. METHODS AND RESULTS: A retrospective chart review of patients undergoing PPVI from May 2010 to April 2015 was performed. A total of 106 patients underwent PPVI; most commonly these patients had tetralogy of Fallot (n=59, 55%) and pulmonary insufficiency (n=60, 57%). The median follow‐up time was 28 months (7‐63 months). Pre‐PPVI, 25 patients (24%) had documented arrhythmias: nonsustained ventricular tachycardia (NSVT) (n=9, 8%), frequent premature ventricular contractions (PVCs) (n=6, 6%), and atrial fibrillation/flutter (AF/AFL) (n=10, 9%). Post‐PPVI, arrhythmias resolved in 4 patients who had NSVT (44%) and 5 patients who had PVCs (83%). New arrhythmias were seen in 16 patients (15%): 7 NSVT, 8 PVCs, and 1 AF/AFL. There was resolution at medium‐term follow‐up in 6 (86%) patients with new‐onset NSVT and 7 (88%) patients with new‐onset PVCs. There was no difference in QRS duration pre‐PPVI, post‐PPVI, and at medium‐term follow‐up (P=0.6). The median corrected QT lengthened immediately post‐PPVI but shortened significantly at midterm follow‐up (P<0.01). CONCLUSIONS: PPVI reduced the prevalence of NSVT. The majority of postimplant arrhythmias resolve by 6 months of follow‐up

Golgi Apparatus in Airway Secretory Cells

https://openworks.mdanderson.org/sumexp22/1068/thumbnail.jp

Top quark mass definition and top quark pair production near threshold at the NLC

We suggest an infrared-insensitive quark mass, defined by subtracting the soft part of the quark self energy from the pole mass. We demonstrate the deep relation of this definition with the static quark-antiquark potential. At leading order in 1/m this mass coincides with the PS mass which is defined in a completely different manner. Going beyond static limit, the small normalization point introduces recoil corrections which are calculated here as well. Using this mass concept and other concepts for the quark mass we calculate the cross section of e+ e- -> t t-bar near threshold at NNLO accuracy adopting three alternative approaches, namely (1) fixing the pole mass, (2) fixing the PS mass, and (3) fixing the new mass which we call the PS-bar mass. We demonstrate that perturbative predictions for the cross section become much more stable if we use the PS or the PS-bar mass for the calculations. A careful analysis suggests that the top quark mass can be extracted from a threshold scan at NLC with an accuracy of about 100-200 MeV.Comment: published version, 21 pages in LaTeX including 11 PostScript figure

Pathways to folding, nucleation events and native geometry

We perform extensive Monte Carlo simulations of a lattice model and the Go potential to investigate the existence of folding pathways at the level of contact cluster formation for two native structures with markedly different geometries. Our analysis of folding pathways revealed a common underlying folding mechanism, based on nucleation phenomena, for both protein models. However, folding to the more complex geometry (i.e. that with more non-local contacts) is driven by a folding nucleus whose geometric traits more closely resemble those of the native fold. For this geometry folding is clearly a more cooperative process.Comment: Accepted in J. Chem. Phy

The Higgs Sector of the Minimal 3 3 1 Model Revisited

The mass spectrum and the eigenstates of the Higgs sector of the minimal 3 3 1 model are revisited in detail. There are discrepancies between our results and previous results by another author.Comment: 20 pages, latex, two figures. One note and one reference are adde

Increase on the Initial Soluble Heme Levels in Acidic Conditions Is an Important Mechanism for Spontaneous Heme Crystallization In Vitro

BACKGROUND: Hemozoin (Hz) is a heme crystal that represents a vital pathway for heme disposal in several blood-feeding organisms. Recent evidence demonstrated that β-hematin (βH) (the synthetic counterpart of Hz) formation occurs under physiological conditions near synthetic or biological hydrophilic-hydrophobic interfaces. This seems to require a heme dimer acting as a precursor of Hz crystals that would be formed spontaneously in the absence of the competing water molecules bound to the heme iron. Here, we aimed to investigate the role of medium polarity on spontaneous βH formation in vitro. METHODOLOGY/PRINCIPAL FINDINGS: We assessed the effect of water content on spontaneous βH formation by using the aprotic solvent dimethylsulfoxide (DMSO) and a series of polyethyleneglycols (PEGs). We observed that both DMSO and PEGs (3.350, 6.000, 8.000, and 22.000) increased the levels of soluble heme under acidic conditions. These compounds were able to stimulate the production of βH crystals in the absence of any biological sample. Interestingly, the effects of DMSO and PEGs on βH formation were positively correlated with their capacity to promote previous heme solubilization in acidic conditions. Curiously, a short chain polyethyleneglycol (PEG 300) caused a significant reduction in both soluble heme levels and βH formation. Finally, both heme solubilization and βH formation strongly correlated with reduced medium water activity provided by increased DMSO concentrations. CONCLUSIONS: The data presented here support the notion that reduction of the water activity is an important mechanism to support spontaneous heme crystallization, which depends on the previous increase of soluble heme levels

Radio observations of the double-relic galaxy cluster Abell 1240

We present LOFAR 120 − 168 MHz images of the merging galaxy cluster Abell 1240 that hosts double radio relics. In combination with the GMRT 595 − 629 MHz and VLA 2 − 4 GHz data, we characterised the spectral and polarimetric properties of the radio emission. The spectral indices for the relics steepen from their outer edges towards the cluster centre and the electric field vectors are approximately perpendicular to the major axes of the relics. The results are consistent with the picture that these relics trace large-scale shocks propagating outwards during the merger. Assuming diffusive shock acceleration (DSA), we obtain shock Mach numbers of M = 2.4 and 2.3 for the northern and southern shocks, respectively. For M ≲ 3 shocks, a pre-existing population of mildly relativistic electrons is required to explain the brightness of the relics due to the high (> 10 per cent) particle acceleration efficiency required. However, for M ≳ 4 shocks the required efficiency is ≳ 1% and ≳ 0.5%, respectively, which is low enough for shock acceleration directly from the thermal pool. We used the fractional polarization to constrain the viewing angle to ≥ 53 ± 3° and ≥ 39 ± 5° for the northern and southern shocks, respectively. We found no evidence for diffuse emission in the cluster central region. If the halo spans the entire region between the relics (∼1.8 Mpc) our upper limit on the power is P1.4 GHz = (1.4 ± 0.6) × 1023 W Hz−1 which is approximately equal to the anticipated flux from a cluster of this mass. However, if the halo is smaller than this, our constraints on the power imply that the halo is underluminous

Positronium Hyperfine Splitting in Non-commutative Space at the Order α6\alpha^6

We obtain positronium Hyperfine Splitting owing to the non-commutativity of space and show that, in the leading order, it is proportional to $\theta \alpha^6$ where, $\theta$ is the parameter of non-commutativity. It is also shown that spatial non-commutativity splits the spacing between $n=2$ triplet excited levels $E(2^3S_1)\to E(2^3P_2)$ which provides an experimental test on the non-commutativity of space.Comment: 7 pages, 2 figures, to appear in Phys. Rev.

On the form of growing strings

Patterns and forms adopted by Nature, such as the shape of living cells, the geometry of shells and the branched structure of plants, are often the result of simple dynamical paradigms. Here we show that a growing self-interacting string attached to a tracking origin, modeled to resemble nascent polypeptides in vivo, develops helical structures which are more pronounced at the growing end. We also show that the dynamic growth ensemble shares several features of an equilibrium ensemble in which the growing end of the polymer is under an effective stretching force. A statistical analysis of native states of proteins shows that the signature of this non-equilibrium phenomenon has been fixed by evolution at the C-terminus, the growing end of a nascent protein. These findings suggest that a generic non-equilibrium growth process might have provided an additional evolutionary advantage for nascent proteins by favoring the preferential selection of helical structures.Comment: 4 pages, 3 figures. Accepted for publication in Phys. Rev. Let