Pathophysiology, diagnosis and treatment of tachycardiomyopathy.

Tachycardiomyopathies (TCMP) are an important cause of left ventricular (LV) dysfunction that should be recognised by physicians as they are potentially reversible and have a significant impact on morbidity and prognosis. They are classically defined as the reversible impairment of ventricular function induced by persistent arrhythmia. However, it is becoming increasingly evident that they can be induced by atrial and ventricular ectopy promoting dyssynchrony and indeed the term ‘arrhythmia-induced cardiomyopathy’ is emerging to describe the phenomenon.1 2 A more current proposed definition highlights aetiology: ‘Atrial and/or ventricular dysfunction—secondary to rapid and/or asynchronous/irregular myocardial contraction, partially or completely reversed after treatment of the causative arrhythmia’ 3 (figure 1). Two categories of the condition exist: the arrhythmia is the only reason for ventricular dysfunction (arrhythmia-induced), and another where the arrhythmia exacerbates ventricular dysfunction and/or worsens heart failure (HF) in a patient with concomitant heart disease (arrhythmia-mediated).4 The exclusion of underlying structural heart disease can be challenging as current imaging techniques, for example, MRI cannot easily identify diffuse fibrosis which may itself be primary or secondary to the effects of arrhythmia promoting ventricular wall dyskinesis and stretch or valvular regurgitation

The Limits of In-run Calibration of MEMS and the Effect of New Techniques

Inertial sensors can significantly increase the robustness of an integrated navigation system by bridging gaps in the coverage of other positioning technologies, such as GNSS or Wi-Fi positioning [1]. A full set of chip-scale MEMS accelerometers and gyros can now be bought for less than $10, potentially opening up a wide range of new applications. However, these sensors require calibration before they can be used for navigation[2]. Higher quality inertial sensors may be calibrated “in-run” using Kalman filter-based estimation as part of their integration with GNSS or other position-fixing techniques. However, this approach can fail when applied to sensors with larger errors which break the Kalman filter due to the linearity and small-angle approximations within its system model not being valid. Possible solutions include: replacing the Kalman filter with a non-linear estimation algorithm, a pre-calibration procedure and smart array [3]. But these all have costs in terms of user effort, equipment or processing load. This paper makes two key contributions to knowledge. Firstly, it determines the maximum tolerable sensor errors for any in-run calibration technique using a basic Kalman filter by developing clear criteria for filter failure and performing Monte-Carlo simulations for a range of different sensor specifications. Secondly, it assesses the extent to which pre-calibration and smart array techniques enable Kalman filter-based in-run calibration to be applied to lower-quality sensors. Armed with this knowledge of the Kalman filter’s limits, the community can avoid both the unnecessary design complexity and computational power consumption caused by over-engineering the filter and the poor navigation performance that arises from an inadequate filter. By establishing realistic limits, one can determine whether real sensors are suitable for in-run calibration with simple characterization tests, rather than having to perform time-consuming empirical testing

Syncope in a young man: Role of Purkinje fibres in idiopathic ventricular fibrillation

A young man suffered cardiac arrests with polymorphic ventricular tachycardia (PVT) and ventricular fibrillation (VF) triggered by ventricular premature contractions (PVCs). The arrhythmia was resistant to anti-arrhythmics, so after ICD implantation he underwent successful ablation of the triggering VE beat, which was pace-mapped to the left posterior hemi-fascicle. We review the evidence for the role of the Purkinje network in the initiation and maintenance of PVT and VF, postulating a channelopathy as a possible underlying cause, and provide recommendations for PVC ablation

Organische Düngung intensiv genutzten Dauergrünlandes im Vergleich mit Mineraldüngung - Ergebnisse eines 22 jährigen Versuches auf Wiese und Mähweide.

In a 22-year-old experiment in Southwest Germany, the effects of different fertilization systems (organic and mineral fertilizers) on permanent grassland were investigated. The effects were investigated under cutting and mown pasture with two grazing periods per year. The experiment had 8 fertilizer treatments and 3 replications, the size of field plots were 25 m2 in area. Dry matter (DM) yields and mineral contents in soil and forage (P, K) were measured. The botanical composition was investigated each second year. Maximum DM yields were obtained by mineral NPK fertilization and a treatment called ‘alternating fertilizer’, with yearly alternating use of farmyard manure, liquid manure and mineral NPK. The application of composted farmyard manure reduced DM yields. The additional application of stone-meal and metallurgical lime to slurry did not increase the effects of untreated slurry on yield. Fertilization with slurry increased the proportions of grasses, whereas farmyard manure increased forbs. The proportion of legumes was increased by PK and by fertilization with slurry with lime

Whip Use by Jockeys in a Sample of Australian Thoroughbred Races—An Observational Study

The use of whips by jockeys is an issue. The current study viewed opportunistic high-speed footage of 15 race finishes frame-by-frame to examine the outcomes of arm and wrist actions (n = 350) on 40 horses viewed from the left of the field. Any actions fully or partially obscured by infrastructure or other horses were removed from the database, leaving a total of 104 non-contact sweeps and 134 strikes. For all instances of arm actions that resulted in fully visible whip strikes behind the saddle (n = 109), the outcomes noted were area struck, percentage of unpadded section making contact, whether the seam made contact and whether a visible indentation was evident on impact. We also recorded use of clockwise or counter-clockwise arm action from each jockey's whip, whether the whip was held like a tennis racquet or a ski pole, whether the hind leg on the side of the impact was in stance or swing phase and whether the jockey's arm was seen traveling above shoulder height. The goal of the study was to characterize the area struck and the visual impact of whip use at the level of the horse. We measured the ways in which both padded and unpadded sections of the whip made impact. There was evidence of at least 28 examples, in 9 horses, of breaches of the whip rules (one seam contact, 13 contacts with the head, and 14 arm actions that rose above the height of the shoulder). The whip caused a visible indentation on 83% of impacts. The unpadded section of the whip made contact on 64% of impacts. The results call into question the ability of Stewards to effectively police the rules concerning whip use and, more importantly, challenge the notion that padding the distal section of whips completely safeguards horses from any possible whip-related pain

jMOTU and Taxonerator: Turning DNA Barcode Sequences into Annotated Operational Taxonomic Units

BACKGROUND: DNA barcoding and other DNA sequence-based techniques for investigating and estimating biodiversity require explicit methods for associating individual sequences with taxa, as it is at the taxon level that biodiversity is assessed. For many projects, the bioinformatic analyses required pose problems for laboratories whose prime expertise is not in bioinformatics. User-friendly tools are required for both clustering sequences into molecular operational taxonomic units (MOTU) and for associating these MOTU with known organismal taxonomies. RESULTS: Here we present jMOTU, a Java program for the analysis of DNA barcode datasets that uses an explicit, determinate algorithm to define MOTU. We demonstrate its usefulness for both individual specimen-based Sanger sequencing surveys and bulk-environment metagenetic surveys using long-read next-generation sequencing data. jMOTU is driven through a graphical user interface, and can analyse tens of thousands of sequences in a short time on a desktop computer. A companion program, Taxonerator, that adds traditional taxonomic annotation to MOTU, is also presented. Clustering and taxonomic annotation data are stored in a relational database, and are thus amenable to subsequent data mining and web presentation. CONCLUSIONS: jMOTU efficiently and robustly identifies the molecular taxa present in survey datasets, and Taxonerator decorates the MOTU with putative identifications. jMOTU and Taxonerator are freely available from http://www.nematodes.org/

Human Cytomegalovirus: detection of congenital and perinatal infection in Argentina

BACKGROUND: Human cytomegalovirus (CMV) is one of the most commonly found agents of congenital infections. Primary maternal infection is associated with risk of symptomatic congenital diseases, and high morbidity is frequently associated with very low birth weight. Neonates with asymptomatic infection develop various sequelae during infancy. This is the first Argentine study performed in neonates with congenital and postnatal HCMV infection. The purpose of this study was to evaluate the performance of the polymerase chain reaction (PCR) technique with different pairs of primers, to detect cytomegalovirus isolated in tissue cultures and directly in urine and dried blood spot (DBS) specimens. Results were compared with IgM detection. METHODS: The study was performed between 1999 and 2001 on routine samples in the Laboratory. A total of 61 urine and 56 serum samples were selected from 61 newborns/infants, 33 patients whose samples were analyzed during the first two to three weeks of life were considered congenital infections; the remaining 28 patients whose samples were taken later than the third week were grouped as perinatal infections, although only in 4 the perinatal transmission of infection was determined unequivocally Cytomegalovirus diagnosis was made by isolating the virus from urine samples in human foreskin fibroblast cells. Three different primer pairs directed to IE, LA and gB genes were used for the HCMV PCR assay in viral isolates. Subsequently, PCR and nested PCR (nPCR) assays with gB primers were performed directly in urine and in 11 samples of dried blood spot (DBS) on Guthrie Card, these results were then compared with serology. RESULTS: The main clinical manifestations of the 33 patients with congenital infection were purpura, jaundice, hepatomegaly and anaemia. Three patients presented low birth weight as single symptom, 10, intracranial calcifications, and 2, kidney failure. In the 28 patients grouped as with perinatal infection, anaemia, hepatosplenomegaly and enzymatic alteration were predominant, and 4 patients were HIV positive. The primers used to amplify the gB region had a PCR positivity rate of 100%, whereas those that amplified IE and LA regions had a PCR positivity rate of 54% and 61% respectively, in CMV isolates. Amplification by PCR of urine samples (with no previous DNA extraction), using primers for the gB region, detected 34/61 positive samples. Out of the 33 samples from patients with congenital infection, 24 (73%) were positive. When nPCR was used in these samples, all were positive, whereas in the remaining 28 patients, two negative cases were found. Cytomegalovirus DNA detection in 11 samples was also carried out in DBS: 7 DBS samples were positive and 4 were negative. CONCLUSIONS: Primers directed to the gB fragment region were the best choice for the detection of CMV DNA in positive isolates. In congenital infections, direct PCR in urine was positive in a high percentage (73%) of samples; however, in patients grouped as with perinatal infection only 36% of the cases were positive. With n-PCR, total sample positivity reached 97%. PCR technique performed in DBS allowed identifying congenital infection in four patients and to be confirmed in 3. These results show the value of nPCR for the detection of all cases of CMV infection. The assay offers the advantage that it may be performed within the normal working day and provides reliable results in a much shorter time frame than that required for either traditional tissue culture or the shell-viral assay

Gut microbiota-derived propionate reduces cancer cell proliferation in the liver

Peer reviewedPublisher PD