His Bundle Recordings

When we record atrial activity on the His bundle electrogram we are recording from the area of the atrium which is around the tricuspid valve, that is, the lower part of the right atrium. The normal range of conduction time from the region of the sinus node to the low right atrium is about 25 to 45 milliseconds

Power quality improvements of arc welding power supplies by modified bridgeless SEPIC PFC converter

This paper proposes an efficient bridgeless power factor corrected (PFC) modified single ended primary inductor converter (SEPIC) for arc welding power supplies (AWPS). The overall configuration is composed of two converters: (1) a modified bridgeless SEPIC PFC converter, which is controlled by a PI controller to achieve a high power factor and fast response; and (2) a full bridge buck converter with high-frequency transformer for high-frequency isolation to ensure arc welding stability. The proposed system is simulated under different operating conditions of an AWPS. It is also tested in real time by a hardware-in-the-loop system based on a dSPACE DS1103 control board. The system performances are evaluated based on power quality indices such as power factor, total harmonic distortions of the AC grid current, and voltage regulation. The obtained results show that the proposed controller enhances the weld bead quality by keeping a constant current at the output and a stable arc, meet the international power quality standards and robustness for voltage regulation

Disintegration, modularity and entry mode choice: Mirroring technical and organizational architectures in business functions offshoring

We study the relationship between modularity and entry mode choice in the context of business functions offshoring. We define the degree of modularity of an activity as technical architecture (whether it can be detached from the rest of the value chain without loss of synergies). We refer to the entry mode chosen as organizational architecture (whether a captive solution, a partnership or outsourcing). We propose that the selection of entry mode should reflect the alignment of the technical and organizational architectures: that is, they need to be ‘mirrored’. Modular activities are more likely to be outsourced, as modularity decreases transaction costs and knowledge leakages risks, while not-modular activities reflect captive entry modes. Based on the analysis of 486 business function offshoring initiatives, we also argue that firms can “break” the mirror as the entry choice is contingent upon the level of disintegration of the value chain and the offshoring experience of the firms

Salvia miltiorrhiza water-soluble extract, but not its constituent salvianolic acid B, abrogates LPS-induced NF-kappaB signalling in intestinal epithelial cells

Herbal medicine has become an increasing popular therapeutic alternative among patients suffering from various inflammatory disorders. The Salvia miltiorrhizae water-soluble extract (SME) have been shown to possess antioxidant and anti-inflammatory properties in vitro. However, the mechanism of action and impact of SME on LPS-induced gene expression is still unknown. We report that SME significantly abrogated LPS-induced IκB phosphorylation/degradation, NF-κB transcriptional activity and ICAM-1 gene expression in rat IEC-18 cells. Chromatin immunoprecipitation assay demonstrated that LPS-induced RelA recruitment to the ICAM-1 gene promoter was inhibited by SME. Moreover, in vitro kinase assay showed that SME directly inhibits LPS induced IκB kinase (IKK) activity in IEC-18 cells. To investigate the physiological relevance of SME inhibitory activity on NF-κB signalling, we used small intestinal explants and primary intestinal epithelial cells derived from a transgenic mouse expressing the enhanced green fluorescent protein (EGFP) under the transcriptional control of NF-κB cis-elements (cis-NF-κBEGFP). SME significantly blocked LPS-induced EGFP expression and IκBα phosphorylation in intestinal explants and primary IECs, respectively. However, salvianolic acid B, an activate component of SME did not inhibit NF-κB transcriptional activity and IκB phosphorylation/degradation in IEC-18 cells. These results indicate that SME blocks LPS-induced NF-κB signalling pathway by targeting the IKK complex in intestinal epithelial cells. Modulation of bacterial product-mediated NF-κB signalling by natural plant extracts may represent an attractive strategy towards the prevention and treatment of intestinal inflammation

Bevacizumab-Induced Pneumonitis in a Patient With Metastatic Colon Cancer: A Case Report

© The Author(s) 2020. Bevacizumab is a vascular endothelial growth factor–directed humanized monoclonal antibody used to treat many types of cancer and some eye diseases. Due to inhibition of angiogenesis, many adverse reactions such as bowel necrosis, nasal septal perforation, and renal thrombotic microangiopathy have been described. However, its association with interstitial pneumonitis is scarcely reported in the literature. We report a case of a 79-year-old woman with metastatic colon cancer who presented with cough and dyspnea on exertion the day after initiation of bevacizumab. She was found to have bilateral airspace opacities on imaging. Infectious and cardiogenic etiologies of dyspnea were ruled out. Due to the temporal relationship with the initiation of chemotherapy, she was suspected to have developed bevacizumab-induced interstitial pneumonitis. She improved rapidly with high-dose steroids. Follow-up imaging showed resolution of infiltrates. This is the first reported case in the literature that directly links bevacizumab to interstitial pneumonitis

Neuromuscular Complications With SARS-COV-2 Infection: A Review

© Copyright © 2020 Katyal, Narula, Acharya and Govindarajan. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases were first reported in Wuhan, Hubei province of China in December, 2019. SARS- COV-2 primarily affects the cardio-respiratory system. Over the last few months, several studies have described various neurological sequelae of SARS-COV-2 infection. Neurological complications are more frequent in patients with severe respiratory infections. In this review, we have analyzed the current literature on neuromuscular complications associated with SARS-COV-2 and highlighted possible mechanisms of neuromuscular invasion. We reviewed 11 studies describing 11 cases of Guillain Barre syndrome (GBS), and 1 case each of Miller Fisher syndrome, Polyneuritis Cranialis, Acute myelitis, Oculomotor paralysis and Bell\u27s Palsy associated with SARS-COV-2 infection. Mean age of patients with GBS was 61.54 years, with standard deviation (SD) 14.18 years. Majority patients had fever and cough as the first symptom of SARS COV-2 infection. Mean time for onset of neurological symptoms from initial symptoms in 11 patients was 8.18 days, with SD of 2.86 days. Mean time to performing electrodiagnostic study from onset of neurological symptom was 6 days with standard deviation of 3.25. Six patients had demyelinating pattern, three had acute sensory motor axonal neuropathy, and one had acute motor axonal neuropathy on electrodiagnostic studies

A study on clinical attachment loss and gingival inflammation as etiologic factors in pathologic tooth migration

Background: Several etiologic factors have been listed for pathologic migration of periodontally involved teeth based mainly on clinical observations with scarce scientific evidence. Present study was carried out to find out relationship of clinical attachment loss and gingival inflammation with pathologic tooth migration.Materials and Methods: A total of 37 patients having 50 pairs of migrated and non-migrated contralateral teeth were taken into consideration.Results: Mean total attachment loss per tooth in migrated and non migrated tooth is 13.32 ± 0.74 S.E. and 8.34 ± 0.58 S.E., respectively (P < 0.001), which reveals a positive correlation. There seems to be an association between frequency of migration and severity of attachment loss since highest percentage of migrations were seen in maximum total attachment loss group. Relationship could not be established between severity of attachment loss and severity of migration for which more data may be required. Also, it was seen that gingival index was significantly higher in migrated group.Conclusion: Findings suggest that there exists a direct relationship between pathologic migration and clinical attachment loss as well as gingival inflammation. Clinical relevance: Results emphasize the importance of early treatment of periodontitis to curb inflammation, which seems to be more important since it is completely reversible, and attachment loss also in order to prevent unaesthetic complications. Moreover bleeding along with recent change in position of teeth should be considered as important sign of active, moderate to severe periodontal disease by general dentists and hygienists so that they can refer for specialist consultation