Distinctive ECG patterns in healthy black adults

Six ECG patterns are found more frequently in healthy black adults than in whites. These patterns are presumably benign, but also may resemble those of malignant disease. 1) Healthy black adults show higher QRS voltage, and more often meet ECG criteria for left ventricular hypertrophy (LVH). Associated repolarization abnormalities can produce ST segment elevation (STE) that resembles ST elevation MI (STEMI). 2) The pattern of benign anterior STE, seen often in males, is more common in black subjects. Similar to LVH, this pattern may falsely suggest STEMI. 3) Both early repolarization (ER) and benign inferolateral STE are more common in black patients. Although they may convey a higher risk of fatal arrhythmias or cardiac death in white populations, it does not appear that black subjects with these patterns show a similar risk. 4) The persistent juvenile T wave inversion pattern shows asymmetric T wave inversion (TWI) in V1-V4, without ST segment deviations. It is most common in black females, and is considered benign. However, this pattern can also resemble the anterior TWI of arrhythmogenic right ventricular cardiomyopathy (ARVC). 5) A pattern of anterior TWI with associated J point elevation is a common finding in the black population, especially athletes. It could suggest hypertrophic cardiomyopathy, but can be presumed to be a benign finding in black athletes, when TWI is limited to V1-V4 and preceded by J point elevation. 6) TWI in the lateral precordial leads, usually associated with end-QRS slurring or notches is seen much more often in apparently healthy black subjects than white subjects. Unlike the anterior TWI pattern, however, it cannot be presumed benign. In conclusion, awareness of these ECG patterns may help to avoid unnecessary diagnostic or therapeutic interventions, but also encourage appropriate investigations

Distinctive ECG patterns in healthy black adults

Six ECG patterns are found more frequently in healthy black adults than in whites. These patterns are presumably benign, but also may resemble those of malignant disease. 1) Healthy black adults show higher QRS voltage, and more often meet ECG criteria for left ventricular hypertrophy (LVH). Associated repolarization abnormalities can produce ST segment elevation (STE) that resembles ST elevation MI (STEMI). 2) The pattern of benign anterior STE, seen often in males, is more common in black subjects. Similar to LVH, this pattern may falsely suggest STEMI. 3) Both early repolarization (ER) and benign inferolateral STE are more common in black patients. Although they may convey a higher risk of fatal arrhythmias or cardiac death in white populations, it does not appear that black subjects with these patterns show a similar risk. 4) The persistent juvenile T wave inversion pattern shows asymmetric T wave inversion (TWI) in V1-V4, without ST segment deviations. It is most common in black females, and is considered benign. However, this pattern can also resemble the anterior TWI of arrhythmogenic right ventricular cardiomyopathy (ARVC). 5) A pattern of anterior TWI with associated J point elevation is a common finding in the black population, especially athletes. It could suggest hypertrophic cardiomyopathy, but can be presumed to be a benign finding in black athletes, when TWI is limited to V1-V4 and preceded by J point elevation. 6) TWI in the lateral precordial leads, usually associated with end-QRS slurring or notches is seen much more often in apparently healthy black subjects than white subjects. Unlike the anterior TWI pattern, however, it cannot be presumed benign. In conclusion, awareness of these ECG patterns may help to avoid unnecessary diagnostic or therapeutic interventions, but also encourage appropriate investigations

Outdoor PV Degradation Comparison

As photovoltaic (PV) penetration of the power grid increases, it becomes vital to know how decreased power output may affect cost over time. In order to predict power delivery, the decline or degradation rates must be determined accurately. At the Performance and Energy Rating Testbed (PERT) at the Outdoor Test Facility (OTF) at the National Renewable Energy Laboratory (NREL) more than 40 modules from more than 10 different manufacturers were compared for their long-term outdoor stability. Because it can accommodate a large variety of modules in a limited footprint the PERT system is ideally suited to compare modules side-by-side under the same conditions

Evaluation of Content and Accessibility of Orthopaedic Trauma Fellowship Websites

Background: Residents frequently use the internet to find material on fellowship programs. The Orthopaedic Trauma Association (OTA) website serves as a central hub for information on an orthopaedic trauma fellowship (OTF). This study aims to evaluate the accessibility, content, and perceived importance of OTF websites. Methods: We reviewed the 49 OTFs accredited by the OTA fellowship database as of January 2014. We searched for corresponding OTF websites by using the provided OTA hyperlinks and conducting a separate Google search of program location and institution. Links to websites of general orthopaedic programs were not counted. Content of OTF websites was analyzed by noting the presence or absence of specific items in fellow education (11 items) and recruitment (5 items). Results: Of 49 OTFs, a total of 39 (80%) websites specific to the fellowship were identified by searching the OTA database and Google browser. Seven (14%) programs listed on the OTA database provided links directly to fellowship programs. Most programs (28; 57%) did not provide links to specific OTFs or provided non-functional links on the OTA website. Of the 39 accessible OTF websites, a total of 24 (61%) had complete information regarding recruitment and 14 (36%) provided complete details on education. Conclusions: Most accredited OTFs do not adequately use the internet to provide easily accessible and complete information. Further details (especially regarding the role, education, and schedule) would help prospective candidates in thoroughly evaluating programs. The discrepancy in content and accessibility can hinder prospective fellows from appropriately investigating fellowship programs

MOVEABLE, DEPLOYABLE MICROGRID ANALYSIS

This report focuses on the assessment of the feasibility of Moveable, Deployable Microgrids (MODEMs) from an interoperability and sustainment perspective as an alternative solution to traditional backup power methods aimed at bringing critical loads back online after installation microgrid failures or operational energy needs. Prior research into microgrid solutions by MAJ Daniel Varley in his paper “Feasibility Analysis of a Mobile Microgrid Design to Support Department of Defense (DOD) Energy Resilience Goals” identified MODEM as a potential solution. This report utilized the work done by MAJ Varley and further assesses system feasibility. Base and operational energy managers will benefit from MODEMs by having access to multi-energy source systems that are both easily moveable and relatively simplistic in design. As concerns surrounding energy resiliency of defense critical infrastructure by both the DOD and Department of Energy (DOE) mount, as expressed in a March 2022 report by the Electricity Advisory Committee (EAC) titled “Strengthening the Resilience of Defense Critical Infrastructure”, there is a push to identify cost-effective solutions that utilize alternative energy sources in order to improve the overall resiliency of this infrastructure. The MODEM system has the potential to be a viable solution to the resiliency problem.Outstanding ThesisCivilian, Department of the NavyCivilian, Department of the NavyCivilian, Department of the NavyCivilian, Department of the NavyCivilian, Department of the NavyApproved for public release. Distribution is unlimited

Overexpression of CD44 in acquired tamoxifen-resistant breast cancer cells augments their migratory response to heregulin beta 1

Background Acquired endocrine resistance in breast cancer cells is accompanied by altered growth factor receptor signalling [1] and a highly migratory cell phenotype [2]. Interestingly, in tamoxifen-resistant (TamR) MCF7 cells, our microarray analysis has demonstrated elevated levels of CD44, a transmembrane glycoprotein known to interact with, and modulate the function of, growth factor receptors [3]. Here we have explored the role of CD44 as a modulator of heregulin beta-1-induced migratory signalling in TamR cells. Methods Expression of CD44 (standard and v3 isoforms) were confirmed by RT-PCR and western blotting and their association with erbB family members determined by both immunofluorescence microscopy and immunoprecipitation. Activation of intracellular signalling following heregulin beta 1 treatment (10 ng/ml) in the presence or absence of CD44 (using siRNA-mediated inhibition) was determined by western blotting using phosphospecific antibodies. Cellular migration was determined by seeding cells (control and CD44 siRNA-treated) into fibronectin-coated transwell chambers (8.0 μm pore size) in the presence or absence of heregulin beta 1. After 24 hours, migratory cells were fixed, stained with crystal violet and counted. Results Both standard and v3 isoforms of CD44 were overexpressed in TamR cells at both gene and protein levels (mean fold increase in CD44s protein (TamR versus MCF7): 4.26 ± 1.2, P < 0.05). Moreover, CD44s and v3 colocalised with Her2 and Her3 receptors at the cell surface and were also detectable in Her2/Her3 cellular immunoprecipitates. Treatment of TamR cells with heregulin resulted in phosphorylation of erbB receptors together with a number of downstream signalling intermediates, including Akt, Src and FAK, and resulted in enhanced cellular migration. Significantly, heregulin-induced intracellular signalling was dramatically reduced in cells in which the expression of CD44 was suppressed (via siRNA), with a corresponding loss of heregulin-induced migratory behaviour (mean fold change in cell migration versus untreated control: 6.7 ± 1.1, P < 0.05 (heregulin beta 1); 1.8 ± 0.9 (CD44 siRNA); 1.47 ± 0.6, P < 0.05 (heregulin beta 1 + CD44 siRNA)). Conclusion These data demonstrate a role for CD44 as a modulator of erbB receptor function in endocrine-resistant breast cancer cells, where it augments heregulin beta 1 migratory signalling

Methylation Pattern Detection in the Genome of Bacillus Pumilus Strain SAFR-032

Bacillus pumilus SAFR-032, an endospore-forming bacterial strain that was isolated from a spacecraft assembly facility (SAFR), was investigated to determine its methylation pattern (methylome) across the genome in comparison to the previously sequenced reference genome. In addition, a version of SAFR-032 that was flown as spores for 18 months on the International Space Station (ISS) was also investigated for possible genomic changes due to long-duration ISS-flight and to determine if methylation patterns may have changed. Both the genomics and methylomics were conducted using a Nanopore MinION sequencing device. In addition to the omics investigation, the two SAFR-032 strains, ISS flown and non-ISS flown, were compared phenotypically in chamber experiments testing individual environmental insults: ionizing radiation, UV exposure, and cold desiccation (i.e. freeze drying). Results from this study inform on Planetary Protection concerns and will reveal potential DNA damage associated with long-term spaceflight and how such damage may influence survivors after being transported to an extraterrestrial environment, such as Mars

'20 days protected learning' - students' experiences of an Overseas Nurses Programme - 4 years on: A retrospective survey

Background From September 2005 the Nursing and Midwifery Council (NMC) introduced new arrangements for the registration of non-EU overseas nurses which requires all applicants to undertake '20 days of protected learning' time in the UK and for some, a period of supervised practice. A survey was undertaken at Bournemouth University, which offers a '20 days protected learning only' programme, to elicit overseas nurses' demographic details, experiences in completing the programme and their 'final destinations' once registered. Methods An online survey was devised which contained a mixture of tick box and open ended questions which covered demographic details, views on the programme and final destinations This was uploaded to www.SurveyMonkey.com and sent out to nurses who had completed the Overseas Nurses Programme (ONP) with Bournemouth University (n=1050). Quantiative data were analysed using descriptive statistics and the qualitative data were coded and analysed using content analysis . Results There were 251 respondents (27.7% response rate). The typical 'profile' of a nurse who responded to the survey was female, aged 25-40 years and had been qualified for more than 5 years with a bachelors degree. The majority came from Australia on a 2 year working holiday visa and the key final destination in the UK, on registration with the NMC, was working for an agency. There were five key findings regarding experience of the programe. Of those surveyed 61.2% did not feel it necessary to undergo an ONP; 71.6% felt that they should be able to complete the programme on-line in their own country; 64.2% that the ONP should only contain information about delivery of healthcare in UK and Legal and professional (NMC) issues; 57% that European nurses should also undergo the same programme and sit an IELTS test; and 68.2% that the programme was too theory orientated; and should have links to practice (21%). Conclusions The NMC set the admissions criteria for entry to the register and Standards for an ONP. The findings of this survey raise issues regarding the percieved value and use of this approach for overseas nurses, and it may be helpful to take this into account when considering future policy