Complete transection of permanent pacemaker lead by a dislocated left shoulder prosthesis

A case of complete transection of the leads of a permanent pacemaker (PPM) by a dislocated left shoulder prosthesis is reported. An 86 year old woman with a history of B-cell lymphoma diagnosed subsequent to a pathological fracture of the humerus in 2010 was managed by a left shoulder replacement. Subsequently, she underwent chemotherapy for the B-cell lymphoma and the malignant lesion was reported to have resolved. In addition, she further went on to have a PPM- left sided DDDR inserted in 2015 for chronotropic incompetence. Following a mechanical fall she had in 2021, it was found that the PPM leads had been damaged, transected, potentially infected and failing to capture along with a displaced left shoulder prosthesis which was the likely culprit for the PPM damage. A decision was made to not remove the dislocated prosthesis by the multidisciplinary team managing her. This case highlights the importance of an understanding of the complications of shoulder surgeries, including approach adopted for surgery in patients with pacemaker in-situ and the need for regular follow up and imaging

FABRIC AS STORAGE TO AVOID DOWNLOAD FAILURE ON MULTIPLE DEVICES AT BRANCH/DATA CENTERS

Presented herein are techniques to transmit virtual machine (VM) images from a controller to a switch fabric, based on capacity, and to distribute the VM images to a virtual network infrastructure, as needed

Composite iron oxide–Prussian blue nanoparticles for magnetically guided T1-weighted magnetic resonance imaging and photothermal therapy of tumors

Theranostic nanoparticles offer the potential for mixing and matching disparate diagnostic and therapeutic functionalities within a single nanoparticle for the personalized treatment of diseases. In this article, we present composite iron oxide-gadolinium-containing Prussian blue nanoparticles (Fe3O4@GdPB) as a novel theranostic agent for T1-weighted magnetic resonance imaging (MRI) and photothermal therapy (PTT) of tumors. These particles combine the well-described properties and safety profiles of the constituent Fe3O4 nanoparticles and gadolinium-containing Prussian blue nanoparticles. The Fe3O4@GdPB nanoparticles function both as effective MRI contrast agents and PTT agents as determined by characterizing studies performed in vitro and retain their properties in the presence of cells. Importantly, the Fe3O4@GdPB nanoparticles function as effective MRI contrast agents in vivo by increasing signal:noise ratios in T1-weighted scans of tumors and as effective PTT agents in vivo by decreasing tumor growth rates and increasing survival in an animal model of neuroblastoma. These findings demonstrate the potential of the Fe3O4@GdPB nanoparticles to function as effective theranostic agents

Towards spin-polarized two-dimensional electron gas at a surface of an antiferromagnetic insulating oxide

The surfaces of transition-metal oxides with the perovskite structure are fertile grounds for the discovery of novel electronic and magnetic phenomena. In this article, we combine scanning transmission electron microscopy (STEM) with density functional theory (DFT) calculations to obtain the electronic and magnetic properties of the (001) surface of a ( LaFe O 3 ) 8 / ( SrFe O 3 ) 1 superlattice film capped with four layers of LaFe O 3 . Simultaneously acquired STEM images and electron-energy-loss spectra reveal the surface structure and a reduction in the oxidation state of iron from F e 3 + in the bulk to F e 2 + at the surface, extending over several atomic layers, which signals the presence of oxygen vacancies. The DFT calculations confirm the reduction in terms of oxygen vacancies and further demonstrate the stabilization of an exotic phase in which the surface layer is half metallic and ferromagnetic, while the bulk remains antiferromagnetic and insulating. Based on the calculations, we predict that the surface magnetism and conductivity can be controlled by tuning the partial pressure of oxygen

Towards spin-polarized two-dimensional electron gas at a surface of an antiferromagnetic insulating oxide

The surfaces of transition-metal oxides with the perovskite structure are fertile grounds for the discovery of novel electronic and magnetic phenomena. In this article, we combine scanning transmission electron microscopy (STEM) with density functional theory (DFT) calculations to obtain the electronic and magnetic properties of the (001) surface of a ( LaFe O 3 ) 8 / ( SrFe O 3 ) 1 superlattice film capped with four layers of LaFe O 3 . Simultaneously acquired STEM images and electron-energy-loss spectra reveal the surface structure and a reduction in the oxidation state of iron from F e 3 + in the bulk to F e 2 + at the surface, extending over several atomic layers, which signals the presence of oxygen vacancies. The DFT calculations confirm the reduction in terms of oxygen vacancies and further demonstrate the stabilization of an exotic phase in which the surface layer is half metallic and ferromagnetic, while the bulk remains antiferromagnetic and insulating. Based on the calculations, we predict that the surface magnetism and conductivity can be controlled by tuning the partial pressure of oxygen

Mucoactive agents for acute respiratory failure in the critically ill: a systematic review and meta-analysis

Purpose Acute respiratory failure (ARF) is a common cause of admission to intensive care units (ICUs). Mucoactive agents are medications that promote mucus clearance and are frequently administered in patients with ARF, despite a lack of evidence to underpin clinical decision making. The aim of this systematic review was to determine if the use of mucoactive agents in patients with ARF improves clinical outcomes. Methods We searched electronic and grey literature (January 2020). Two reviewers independently screened, selected, extracted data and quality assessed studies. We included trials of adults receiving ventilatory support for ARF and involving at least one mucoactive agent compared with placebo or standard care. Outcomes included duration of mechanical ventilation. Meta-analysis was undertaken using random-effects modelling and certainty of the evidence was assessed using Grades of Recommendation, Assessment, Development and Evaluation. Results Thirteen randomised controlled trials were included (1712 patients), investigating four different mucoactive agents. Mucoactive agents showed no effect on duration of mechanical ventilation (seven trials, mean difference (MD)-1.34, 95% CI-2.97 to 0.29, I 2 =82%, very low certainty) or mortality, hospital stay and ventilator-free days. There was an effect on reducing ICU length of stay in the mucoactive agent groups (10 trials, MD-3.22, 95% CI-5.49 to-0.96, I 2 =89%, very low certainty). Conclusion Our findings do not support the use of mucoactive agents in critically ill patients with ARF. The existing evidence is of low quality. High-quality randomised controlled trials are needed to determine the role of specific mucoactive agents in critically ill patients with ARF. PROSPERO registration number CRD42018095408