The U wave in atrial fibrillation

The U wave in ECGs of patients is difficult to observe because it is hidden under the atrial fibrillatory wave. Measurement and characteristics of the U wave in atrial fibrillation have not previously been described. Beat averaging was used to reveal the U waves in 12-lead ECGs of 8 patients with atrial fibrillation taking account of heart rate dependency of U wave characteristics. U wave polarity and amplitude in 12-lead ECG and the amplitude ratio of U wave to atrial fibrillatory wave in lead VI were measured. U waves were measureable in all patients. U waves were predominantly positive in leads 1. 11. aVF. V2. V3, V4, V5 and V6, negative in leads aVR. Amplitudes were largest in the precordial leads measuring up to 55 fJ V. In lead VI the U wave amplitude was on average 0.17 (range 0.1 to 0.4) times the amplitude of the atrial fibrillatory wave. U waves can be measured by ventricular beat averaging in AF patients. U waves were normal in this small group of patients

A geometric and structural approach to the analysis and design of biological circuit dynamics: a theory tailored for synthetic biology

Much of the progress in developing our ability to successfully design genetic circuits with predictable dynamics has followed the strategy of molding biological systems to fit into conceptual frameworks used in other disciplines, most notably the engineering sciences. Because biological systems have fundamental differences from systems in these other disciplines, this approach is challenging and the insights obtained from such analyses are often not framed in a biologically-intuitive way. Here, we present a new theoretical framework for analyzing the dynamics of genetic circuits that is tailored towards the unique properties associated with biological systems and experiments. Our framework approximates a complex circuit as a set of simpler circuits, which the system can transition between by saturating its various internal components. These approximations are connected to the intrinsic structure of the system, so this representation allows the analysis of dynamics which emerge solely from the system's structure. Using our framework, we analyze the presence of structural bistability in a leaky autoactivation motif and the presence of structural oscillations in the Repressilator

Effect of catheter ablation on quality of life in patients with atrial fibrillation and its correlation with arrhythmia outcome

Objective To assess the effect of catheter ablation on atrial fibrillation (AF) symptoms and quality of life (QoL). Methods Patients with AF scheduled for ablation were recruited. Pulmonary vein isolation (PVI) was performed and complex fractionated atrial electrogram (CFAE)±linear ablation undertaken in patients in AF despite PVI. QoL and AF symptoms were assessed using SF-36 V2 and Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaires before and 3 months after ablation. Change in QoL scores after ablation was correlated with clinical parameters and the extent of ablation. Magnitude of QoL change was compared between AFEQT and SF-36 physical component summary (PCS) and mental component summary (MCS) scores and correlated with arrhythmia outcome. Results 80 patients were studied. Summative and individual health scores for both AFEQT (51.5±22.0 vs 81.3±18.2; p<0.01) and SF-36 (PCS 43.3±10.5 vs 47.9±11.3; p<0.01 and MCS 45.0±11.5 vs 51.5±9.4; p<0.01) improved significantly in patients who maintained sinus rhythm after ablation, but not in those with recurrent AF. Improvement in AFEQT (25.4±19) was significantly greater than change in PCS (6.8±6.4; p<0.01) and MCS (8.5±7.9; p<0.01) scores and correlated more closely with arrhythmia outcome (AFEQT r=0.55; PCS r=0.26; MCS r=0.30). Conclusions Patients who maintained sinus rhythm after ablation had a significant improvement in AF symptoms and QoL; however, no improvement was observed in patients with recurrent AF. QoL change after ablation did not correlate with baseline clinical parameters or ablation strategy. AF specific QoL scales are more responsive to change and correlate better with ablation outcome

Principal component analysis of atrial fibrillation: Inclusion of posterior ECG leads does not improve correlation with left atrial activity

Background Lead V? is routinely analysed due to its large amplitude AF waveform. V? correlates strongly with right atrial activity but only moderately with left atrial activity. Posterior lead V? correlates strongest with left atrial activity. Aims (1) To establish whether surface dominant AF frequency (DAF) calculated using principal component analysis (PCA) of a modified 12-lead ECG (including posterior leads) has a stronger correlation with left atrial activity compared to the standard ECG. (2) To assess the contribution of individual ECG leads to the AF principal component in both ECG configurations. Methods Patients were assigned to modified or standard ECG groups. In the modified ECG, posterior leads V? and V? replaced V? and V?. AF waveform was extracted from one-minute surface ECG recordings using PCA. Surface DAF was correlated with intracardiac DAF from the high right atrium (HRA), coronary sinus (CS) and pulmonary veins (PVs). Results 96 patients were studied. Surface DAF from the modified ECG did not have a stronger correlation with left atrial activity compared to the standard ECG. Both ECG configurations correlated strongly with HRA, CS and right PVs but only moderately with left PVs. V? contributed most to the AF principal component in both ECG configurations

Bayesian Learning and Predictability in a Stochastic Nonlinear Dynamical Model

Bayesian inference methods are applied within a Bayesian hierarchical modelling framework to the problems of joint state and parameter estimation, and of state forecasting. We explore and demonstrate the ideas in the context of a simple nonlinear marine biogeochemical model. A novel approach is proposed to the formulation of the stochastic process model, in which ecophysiological properties of plankton communities are represented by autoregressive stochastic processes. This approach captures the effects of changes in plankton communities over time, and it allows the incorporation of literature metadata on individual species into prior distributions for process model parameters. The approach is applied to a case study at Ocean Station Papa, using Particle Markov chain Monte Carlo computational techniques. The results suggest that, by drawing on objective prior information, it is possible to extract useful information about model state and a subset of parameters, and even to make useful long-term forecasts, based on sparse and noisy observations

An analysis of the fevers met with among Europeans in Calcutta: with a brief account of their clinical features and treatment

I propose to give here, a brief account of the most important fevers met with among Europeans resident in Calcutta.having been on the staff of the large European hospital there for over four years, I have had ample opportunity for studying clinically a large number of such cases, and it is chiefly from the clinical point of view that I wish to write, giving, at the same time examples of each type with the temperature charts.I need hardly say, that among medical cases, "fever" is by far the most common complaint for which a patient comes to hospital. Therefore it is important to be able to differentiate the various fever both from the point of view of treatment and prognosi There undoubtedly was, some years ago, and still is, but to a less extent I am glad to say, a tendency to consider all fevers malarial, and to dose the unfortunate patient with quinine. This is a most - valuable drug when given in suitable cases, but one which has, without doubt, been much abused in the tropics.The most important fevers met with are malaria and typhoid, others being kala-azar, heat -stroke, and a peculiar fever, resembling in some respects dengue, spoken of generally in Calcutta as "seven -day fever ". This name was first given to it by Major Rogers, I.N.S on account of its average duration to about seven days.There are still undifferentiated fevers to be me with, but more accurate methods of diagnosis have already, and will further, reduce their number

Defining the Costs of an Outbreak of Karnal Bunt of Wheat

In determining the economic impact of a possible outbreak of the quarantinable wheat disease Karnal Bunt, an examination was made of the detailed components of the costs involved. The costs were classified as: (a) Direct costs (yield and quality losses); (b) Reaction costs (export bans, quality down-grading, seed industry costs); and (c) Control costs (quarantine zones, fungicides, spore destruction). The relative importance of each of these cost components is measured for a hypothetical outbreak of Karnal Bunt in the European Union, as a means of ensuring that the policy responses to such an outbreak are appropriate considering the costs involved.disease, quarantine, cost, wheat, Agricultural and Food Policy, Crop Production/Industries,

Narrow-line Laser Cooling by Adiabatic Transfer

We propose and demonstrate a novel laser cooling mechanism applicable to particles with narrow-linewidth optical transitions. By sweeping the frequency of counter-propagating laser beams in a sawtooth manner, we cause adiabatic transfer back and forth between the ground state and a long-lived optically excited state. The time-ordering of these adiabatic transfers is determined by Doppler shifts, which ensures that the associated photon recoils are in the opposite direction to the particle's motion. This ultimately leads to a robust cooling mechanism capable of exerting large forces via a weak transition and with reduced reliance on spontaneous emission. We present a simple intuitive model for the resulting frictional force, and directly demonstrate its efficacy for increasing the total phase-space density of an atomic ensemble. We rely on both simulation and experimental studies using the 7.5~kHz linewidth $^1$S$_0$ to $^3$P$_1$ transition in $^{88}$Sr. The reduced reliance on spontaneous emission may allow this adiabatic sweep method to be a useful tool for cooling particles that lack closed cycling transitions, such as molecules.Comment: 5 pages, 4 figure