Psychiatric Disorder Induced By Twiddler\u27s Syndrome May Pose Treatment Challenges In Clinical Practice

Twiddler’s syndrome is a rare condition caused by coiling of the leads, leading to a malfunction in the pacemaker or automated implantable cardioverter-defibrillator (AICD). It was first described by Bayliss in 1968 as a rare, but potentially fatal complication of pacemaker treatment1. Inappropriate shocks due to malfunctioning of the AICD can be devastating, traumatic, or fatal to the patient. With traumatic inappropriate shocks, patients can develop stress or anxiety disorders in association with their AICD. Treatment for anxiety or acute stress disorder with medications can be difficult due to a patient’s underlying pro-arrhythmic conditions. We are presenting a case report regarding a malfunctioning AICD that caused the patient to develop an acute stress disorder with worsening of her underlying anxiety disorder and the challenges posed by treating her

Assessing Regulatory Impact Analyses: The Failure of Agencies to Comply With Executive Order 12,866

None.Environment, Health and Safety, Regulatory Reform

Assessing the Quality of Regulatory Impact Analyses

This study provides the most comprehensive evaluation of the quality of recent economic analyses that agencies conduct before finalizing major regulations. We construct a new dataset that includes analyses of forty-eight major health, safety, and environmental regulations from mid-1996 to mid-1999. This dataset provides detailed information on a variety of issues, including an agency's treatment of benefits, costs, net benefits, discounting, and uncertainty. We use this dataset to assess the quality of recent economic analyses and to determine the extent to which they are consistent with President Clinton's Executive Order 12866 and the benefit-cost guidelines issued by the Office of Management and Budget (OMB). We find that economic analyses prepared by regulatory agencies typically do not provide enough information to make decisions that will maximize the efficiency or effectiveness of a rule. Agencies quantified net benefits for only 29 percent of the rules. Agencies failed to discuss alternatives in 27 percent of the rules and quantified costs and benefits of alternatives in only 31 percent of the rules. Our findings strongly suggest that agencies generally failed to comply with the executive order and adhere to the OMB guidelines. We offer specific suggestions for improving the quality of analysis and the transparency of the regulatory process, including writing clear executive summaries, making analyses available on the Internet, providing more careful consideration of alternatives to a regulation, and estimating net benefits of a regulation when data on costs and benefits are provided.

Outcomes of Transcutaneous Aortic Valve Replacement among high risk WV sample population.

Introduction:Transcatheter aortic valve replacement (TAVR) is a relatively new strategy for replacing the aortic valve. We elected to review our early experience to see if we could identify clinical characteristics at baseline or immediately following the procedure that would predict death within one year. Methods:Charts for all patients assigned to receive TAVR procedure at St Mary’s medical center, Huntington, West Virginia between April, 2013 till November, 2016 were identified and reviewed. A total of seventy-two (72) cases were included. Results: All cause mortality rate at index hospitalization, 30 days, and 12 months was 5.6%(N=4), 6.9%(N=5), 19.4%(N=14) respectively. Stroke rate at index hospitalization, 30 days, and 12 months was 2.8%(N=2), 2.8%(N=2), 8.3%(N=6) respectively. Major predictors of death were post procedure GFR, Contrast volume, and number of antiplatelet agents therapy (AUC= 0.638, 0.632, 0.637 respectively). Conclusion: We found that post procedure GFR, less number of antiplatelet agents post procedure, and contrast volume may predict mortality within first 12 months post TAVR. Further studies focused on the above factors may be warranted

Vision Issues and Space Flight: Evaluation of One-Carbon Metabolism Polymorphisms

Intermediates of the one-carbon metabolic pathway are altered in astronauts who experience vision-related issues during and after space flight. Serum concentrations of homocysteine, cystathionine, 2-methylcitric acid, and methylmalonic acid were higher in astronauts with ophthalmic changes than in those without (Zwart et al., J Nutr, 2012). These differences existed before, during, and after flight. Potential confounding factors did not explain the differences. Genetic polymorphisms could contribute to these differences, and could help explain why crewmembers on the same mission do not all have ophthalmic issues, despite the same environmental factors (e.g., microgravity, exercise, diet). A follow-up study was conducted to evaluate 5 polymorphisms of enzymes in the one-carbon pathway, and to evaluate how these relate to vision and other ophthalmic changes after flight. Preliminary evaluations of the genetic data indicate that all of the crewmembers with the MTRR GG genotype had vision issues to one degree or another. However, not everyone who had vision issues had this genetic polymorphism, so the situation is more complex than the involvement of this single polymorphism. Metabolomic and further data analyses are underway to clarify these findings, but the preliminary assessments are promising

Outcomes of Transcutaneous Aortic Valve Replacement among high risk WV sample population

Introduction:Transcatheter aortic valve replacement (TAVR) is a relatively new strategy for replacing the aortic valve. We elected to review our early experience to see if we could identify clinical characteristics at baseline or immediately following the procedure that would predict death within one year. Methods:Charts for all patients assigned to receive TAVR procedure at St Mary’s medical center, Huntington, West Virginia between April, 2013 till November, 2016 were identified and reviewed. A total of seventy-two (72) cases were included. Results: All cause mortality rate at index hospitalization, 30 days, and 12 months was 5.6%(N=4), 6.9%(N=5), 19.4%(N=14) respectively. Stroke rate at index hospitalization, 30 days, and 12 months was 2.8%(N=2), 2.8%(N=2), 8.3%(N=6) respectively. Major predictors of death were post procedure GFR, Contrast volume, and number of antiplatelet agents therapy (AUC= 0.638, 0.632, 0.637 respectively). Conclusion: We found that post procedure GFR, less number of antiplatelet agents post procedure, and contrast volume may predict mortality within first 12 months post TAVR. Further studies focused on the above factors may be warranted

Morphology of late Quaternary submarine landslides along the U.S. Atlantic continental margin

This paper is not subject to U.S. copyright. The definitive version was published in Marine Geology 264 (2009): 4-15, doi:10.1016/j.margeo.2009.01.009.The nearly complete coverage of the U.S. Atlantic continental slope and rise by multibeam bathymetry and backscatter imagery provides an opportunity to reevaluate the distribution of submarine landslides along the margin and reassess the controls on their formation. Landslides can be divided into two categories based on their source areas: those sourced in submarine canyons and those sourced on the open continental slope and rise. Landslide distribution is in part controlled by the Quaternary history of the margin. They cover 33% of the continental slope and rise of the glacially influenced New England margin, 16% of the sea floor offshore of the fluvially dominated Middle Atlantic margin, and 13% of the sea floor south of Cape Hatteras. The headwall scarps of open-slope sourced landslides occur mostly on the lower slope and upper rise while they occur mostly on the upper slope in the canyon-sourced ones. The deposits from both landslide categories are generally thin (mostly 20–40 m thick) and comprised primarily of Quaternary material, but the volumes of the open-slope sourced landslide deposits can be larger (1–392 km3) than the canyon-sourced ones (1–10 km3). The largest failures are located seaward of shelf-edge deltas along the southern New England margin and near salt domes that breach the sea floor south of Cape Hatteras. The spatial distribution of landslides indicates that earthquakes associated with rebound of the glaciated part of the margin or earthquakes associated with salt domes were probably the primary triggering mechanism although other processes may have pre-conditioned sediments for failure. The largest failures and those that have the potential to generate the largest tsunamis are the open-slope sourced landslides.The U.S. Nuclear Regulatory Commission and the U.S. Geological Survey are acknowledged for their support of this research.Work was funded by US Nuclear Regulatory Commission grant N6480 Physical study of tsunami sources

Abstracts from the NIHR INVOLVE Conference 2017

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Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Research and Design of a Routing Protocol in Large-Scale Wireless Sensor Networks

无线传感器网络，作为全球未来十大技术之一，集成了传感器技术、嵌入式计算技术、分布式信息处理和自组织网技术，可实时感知、采集、处理、传输网络分布区域内的各种信息数据，在军事国防、生物医疗、环境监测、抢险救灾、防恐反恐、危险区域远程控制等领域具有十分广阔的应用前景。 本文研究分析了无线传感器网络的已有路由协议，并针对大规模的无线传感器网络设计了一种树状路由协议，它根据节点地址信息来形成路由，从而简化了复杂繁冗的路由表查找和维护，节省了不必要的开销，提高了路由效率，实现了快速有效的数据传输。 为支持此路由协议本文提出了一种自适应动态地址分配算——ADAR（AdaptiveDynamicAddre...As one of the ten high technologies in the future, wireless sensor network, which is the integration of micro-sensors, embedded computing, modern network and Ad Hoc technologies, can apperceive, collect, process and transmit various information data within the region. It can be used in military defense, biomedical, environmental monitoring, disaster relief, counter-terrorism, remote control of haz...学位：工学硕士院系专业：信息科学与技术学院通信工程系_通信与信息系统学号：2332007115216