Implantation of a Resynchronization Implantable Cardioverter Defibrillator in a Patient with Persistent Left Superior Vena Cava

Implantation of resynchronization implantable cardioverter defibrillator was performed in a patient with persistent left superior vena cava. A dual coil defibrillation lead was inserted in the right ventricle apex via a small innominate vein. Left ventricular and atrial leads were implanted through persistent left superior vena cava. Left ventricular lead was easily implanted into the postero lateral vein. Pacing thresholds and sensing values were excellent and remained stable at 18 months follow-up

An Unusual Occurrence of Arthrophycus Alleghaniensis(?) on the Shawangunk Ridge, Lower Mid-Hudson Valley, New York

The Shawangunk Formation is a medial Silurian conglomerate that crops out from near Rosendale, south through Wurtsboro, New York, High Point State Park and the Delaware Water Gap in New Jersey, and at Lehigh Gap, Pennsylvania after which it continues into Maryland and Virginia. The formation overall is interpreted to primarily represent a braided stream environment with flowage from mountains to the east that arose during the Taconic Orogeny into a basin toward the west. The trace fossil Arthrophycus was found in the upper-middle part of the formation on the Shawangunk Ridge at Mohonk, near New Paltz, New York. Arthrophycus is normally found on the bottom of beds, however these specimens occur in place on the top of a bed. The trace consists of simple burrows lacking in ornamentation and medial ridge due to weathering; the cross sectional outline is not preserved. Arthrophycus is extremely rare in the Shawangunk Formation, with the only previous know occurrence of the trace reported in a single reference from 1928. While it is possible that the trace maker was terrigenous, the depositional environment of these traces was likely estuarine. Sea level rise or tidal ebbs and flows would have enabled marine burrowers to form traces in the conglomerate which, in these beds, is sandier with no large pebbles. This is supported by the occurrence of eurypterids in the formation that were euryhaline and lived in a wide range of salinities

Readiness of Quantum Optimization Machines for Industrial Applications

There have been multiple attempts to demonstrate that quantum annealing and, in particular, quantum annealing on quantum annealing machines, has the potential to outperform current classical optimization algorithms implemented on CMOS technologies. The benchmarking of these devices has been controversial. Initially, random spin-glass problems were used, however, these were quickly shown to be not well suited to detect any quantum speedup. Subsequently, benchmarking shifted to carefully crafted synthetic problems designed to highlight the quantum nature of the hardware while (often) ensuring that classical optimization techniques do not perform well on them. Even worse, to date a true sign of improved scaling with the number of problem variables remains elusive when compared to classical optimization techniques. Here, we analyze the readiness of quantum annealing machines for real-world application problems. These are typically not random and have an underlying structure that is hard to capture in synthetic benchmarks, thus posing unexpected challenges for optimization techniques, both classical and quantum alike. We present a comprehensive computational scaling analysis of fault diagnosis in digital circuits, considering architectures beyond D-wave quantum annealers. We find that the instances generated from real data in multiplier circuits are harder than other representative random spin-glass benchmarks with a comparable number of variables. Although our results show that transverse-field quantum annealing is outperformed by state-of-the-art classical optimization algorithms, these benchmark instances are hard and small in the size of the input, therefore representing the first industrial application ideally suited for testing near-term quantum annealers and other quantum algorithmic strategies for optimization problems.Comment: 22 pages, 12 figures. Content updated according to Phys. Rev. Applied versio

Ex vivo innate immune cytokine signature of enhanced risk of relapsing brucellosis.

BackgroundBrucellosis, a zoonotic infection caused by one of the Gram-negative intracellular bacteria of the Brucella genus, is an ongoing public health problem in Perú. While most patients who receive standard antibiotic treatment recover, 5-40% suffer a brucellosis relapse. In this study, we examined the ex vivo immune cytokine profiles of recovered patients with a history of acute and relapsing brucellosis.Methodology/principal findingsBlood was taken from healthy control donors, patients with a history of acute brucellosis, or patients with a history of relapsing brucellosis. Peripheral blood mononuclear cells were isolated and remained in culture without stimulation or were stimulated with a panel of toll-like receptor agonists or heat-killed Brucella melitensis (HKBM) isolates. Innate immune cytokine gene expression and protein secretion were measured by quantitative real-time polymerase chain reaction and a multiplex bead-based immunoassay, respectively. Acute and relapse patients demonstrated consistently elevated cytokine gene expression and secretion levels compared to controls. Notably, these include: basal and stimulus-induced expression of GM-CSF, TNF-α, and IFN-γ in response to LPS and HKBM; basal secretion of IL-6, IL-8, and TNF-α; and HKBM or Rev1-induced secretion of IL-1β, IL-2, GM-CSF, IFN-Υ, and TNF-α. Although acute and relapse patients were largely indistinguishable by their cytokine gene expression profiles, we identified a robust cytokine secretion signature that accurately discriminates acute from relapse patients. This signature consists of basal IL-6 secretion, IL-1β, IL-2, and TNF-α secretion in response to LPS and HKBM, and IFN-γ secretion in response to HKBM.Conclusions/significanceThis work demonstrates that informative cytokine variations in brucellosis patients can be detected using an ex vivo assay system and used to identify patients with differing infection histories. Targeted diagnosis of this signature may allow for better follow-up care of brucellosis patients through improved identification of patients at risk for relapse