Johnstonhumphries4614

Three patients were reprogramed to the alternate vector with appropriate sensing. The S-ICD was either inactivated or replaced with a transvenous device in six patients. A single patient was left sensing in the alternate vector. There were no reports of inability to interrogate S-ICD systems in patients with LVADs. CONCLUSION The risk of inappropriate shocks from LVADs should be considered in pre-existing patients with S-ICD, particularly when the heartware ventricular assist device or HeartMate III LVAD device is present. Reprogramming of the sensing vector can occasionally avoid this issue but often the S-ICD needs to be inactivated. © 2020 Wiley Periodicals, Inc.BACKGROUND Interrupted inferior vena cava (IVC) is a rare venous anomaly that complicates the treatment of patients who require electrophysiology (EP) procedures. METHODS We describe five consecutive cases of patients with interrupted IVC who presented to the EP laboratory requiring interventional procedures including catheter ablation for atrial fibrillation and supraventricular tachycardia and left atrial appendage closure. All cases were successfully completed utilizing a variety of approaches to vascular access including transseptal puncture via transhepatic and internal jugular approaches. CONCLUSION Procedures in the EP lab can be performed successfully in patients with interrupted IVC. © 2020 Wiley Periodicals, Inc.Pathology is the cornerstone of cancer care. The need for accuracy in histopathologic diagnosis of cancer is increasing as personalized cancer therapy requires accurate biomarker assessment. The appearance of digital image analysis holds promise to improve both the volume and precision of histomorphological evaluation. Recently, machine learning, and particularly deep learning, has enabled rapid advances in computational pathology. The integration of machine learning into routine care will be a milestone for the healthcare sector in the next decade, and histopathology is right at the centre of this revolution. Examples of potential high-value machine learning applications include both model-based assessment of routine diagnostic features in pathology, and the ability to extract and identify novel features that provide insights into a disease. Recent groundbreaking results have demonstrated that applications of machine learning methods in pathology significantly improves metastases detection in lymph nodes, Ki67 scoring in breast cancer, Gleason grading in prostate cancer and tumour-infiltrating lymphocyte (TIL) scoring in melanoma. Furthermore, deep learning models have also been demonstrated to be able to predict status of some molecular markers in lung, prostate, gastric and colorectal cancer based on standard HE slides. Moreover, prognostic (survival outcomes) deep neural network models based on digitized HE slides have been demonstrated in several diseases, including lung cancer, melanoma and glioma. Selleckchem VX970 In this review, we aim to present and summarize the latest developments in digital image analysis and in the application of artificial intelligence in diagnostic pathology. © 2020 The Association for the Publication of the Journal of Internal Medicine.BACKGROUND Hutchinson-Gilford progeria syndrome is a rare disease in childhood that results in premature aging. The presence of multisystem derangements including skin, bone, and joint diseases and possibly a difficult airway makes the anesthetic management challenging. Because of the extremely low prevalence, experience is limited even for experienced pediatric anesthesiologists. OBJECTIVE To review the available literature on anesthesia for patients with Hutchinson-Gilford progeria syndrome and to give recommendations for establishing the best practice for patients with Hutchinson-Gilford progeria syndrome. DESIGN A narrative review of the rare existing literature. DATE SOURCES CENTRAL (Cochrane), EMBASE, Google Scholar, MEDLINE and PubMed. ELIGIBILITY CRITERIA Articles addressing anesthesia in patients with Hutchinson-Gilford progeria syndrome were included. RESULTS An overview of the current literature was made on anesthesia care for patients with Hutchinson-Gilford progeria syndrome. After screening the literature, only ten articles were found to be of interest and include some case reports and a correspondence. The focus points on how to perform anesthesia care in patients with Hutchinson-Gilford progeria syndrome and the entire perioperative care are suggested. The available data are limited and results need to be interpreted with caution. CONCLUSION The patients with Hutchinson-Gilford progeria syndrome are not just "frail" patients. Awareness concerning intubation difficulties is mandatory, and airway strategies must be addressed in advance. Although these patients present with the physiology of an elderly with accompanying comorbidities, emotionally they are only children and should be approached as such. © 2020 John Wiley & Sons Ltd.BACKGROUND AND PURPOSE Early white matter (WM) changes and cortical atrophy in Huntington's disease (HD) are often evident before disease onset and extend through the brain during manifest stages. The trajectory of these brain abnormalities in symptomatic stages remains relatively unexplored. The aim of this study is to investigate how the pattern of WM and gray matter (GM) alterations progress over time. METHODS We investigated alterations in brain WM, cortical thickness, and subcortical structures using diffusion and structural magnetic resonance imaging, in manifest HD patients (n = 13) compared to age-matched healthy controls (n = 11). Imaging and clinical data for the HD group were collected at follow-up (7 months) to explore possible longitudinal changes. RESULTS Cross-sectional analyses identified significant posterior cortical thinning (P  less then  .05) and symmetric fractional anisotropy (FA) reduction (P  less then  .01) in brain WM of HD group compared to HC. These changes were strongly correlated with impairment in motor symptoms and processing speed. Subcortical atrophy was significant in caudate, putamen, globus pallidus, and thalamus (P  less then  .001). Regions of interest analysis revealed a significant reduction in FA of the corpus callosum (CC) (-2.19%, P  less then  .05) upon follow-up, whereas no significant cortical thinning and subcortical atrophy was found. link2 CONCLUSIONS This study showed broad GM and WM abnormalities in manifest HD patients. Reductions in FA and cortical thinning correlated significantly with the disturbances of motor and cognitive processing that describe HD. Follow-up assessment showed that the CC is compromised in the absence of detectable GM changes or motor decline, suggesting it plays an important role in disease progression. © 2020 by the American Society of Neuroimaging.The Island of Borneo is a major biodiversity hotspot, and in the Malaysian state of Sabah, ultramafic soils are extensive and home to more than 31 endemic nickel hyperaccumulator plants. The aim of this study was to characterize the structure and the diversity of the rhizosphere bacterial communities of several of these nickel hyperaccumulator plants and factors that affect these bacterial communities in Sabah. link3 The most abundant phyla were Proteobacteria, Acidobacteria and Actinobacteria. At family level, Burkholderiaceae and Xanthobacteraceae (Proteobacteria phylum) were the most abundant families in the hyperaccumulator rhizospheres. Redundancy analysis based on soil chemical analyses and relative abundances of the major bacterial phyla showed that abiotic factors of the studied sites drove the bacterial diversity. For all R. aff. bengalensis rhizosphere soil samples, irrespective of studied site, the bacterial diversity was similar. Moreover, the Saprospiraceae family showed a high representativeness in the R. aff. bengalensis rhizosphere soils and was linked with the nickel availability in soils. The ability of R. aff. bengalensis to concentrate nickel in its rhizosphere appears to be the major factor driving the rhizobacterial community diversity unlike for other hyperaccumulator species. © 2020 Society for Applied Microbiology and John Wiley & Sons Ltd.Actively collecting the mechanical energy by efficient conversion to other forms of energy such as light opens a new possibility of energy-saving, which is of pivotal significance for supplying potential solutions for the present energy crisis. Such energy conversion has shown promising applications in modern sensors, actuators, and energy harvesting. However, the implementation of such technologies is being hindered because most luminescent materials show weak and non-recoverable emissions under mechanical excitation. Herein, a new class of heterojunctioned ZnS/CaZnOS piezophotonic systems is presented, which displays highly reproducible mechanoluminescence (ML) with an unprecedented intensity of over two times higher than that of the widely used commercial ZnS (the state-of-the-art ML material). Density functional theory calculations reveal that the high-performance ML originates from efficient charge transfer and recombination through offset of the valence and conduction bands in the heterojunction interface region. By controlling the ZnS-to-CaZnOS ratio in conjunction with manganese (Mn2+ ) and lanthanide (Ln3+ ) doping, tunable ML across the full spectrum is activated by a small mechanical stimulus of 1 N (10 kPa). The findings demonstrate a novel strategy for constructing efficient ML materials by leveraging interface effects and ultimately promoting practical applications for ML. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.AIMS The current study sought to assess the impact of the utilized energy source during index ablation on long-term clinical outcomes after repeat ablation of atrial fibrillation (AF). Index ablation procedures were either performed using radiofrequency current (RFC) (RFC group) or cryoballoon (CB) ablation (CB group). Repeat ablation was performed by the use of RFC. METHODS A total of 195 patients (138 RFC group; 57 CB group) with paroxysmal AF were included. All patients had a recurrence of AF following the index ablation procedure. Freedom from AF was estimated with the Kaplan-Meier method. RESULTS After a 3 years follow-up, the estimated arrhythmia-free survival did not differ between the two groups (RFC group 48% vs CB group 47%, P = .78). During index ablation, procedure times were significantly shorter in the CB group (95 [80, 140] vs 140 [115, 164] minutes, P ≤ .001), whereas fluoroscopy times (16 [11; 22] vs 19 [14; 25] minutes, P = .003), the dose area product (1862 [1203; 2922] vs 3148 [1756; 5888] cGycm2 , P ≤ .001) and the amount of contrast dye (92 ± 32 vs 123 ± 33 mL, P ≤ .001) were significantly lower in the RFC group. During repeat ablation, procedure times were significantly shorter in patients being initially treated with RFC (115 [85; 145] vs 125 [105; 150] minutes, P = .007). There was a trend towards a higher pulmonary vein reconnection rate in the RFC group without meeting statistical significance (P = .074). CONCLUSIONS In patients with repeat ablation of AF, index RFC or CB ablation are equally effective in terms of freedom from AF. Although CB ablation results in shorter index procedures times, durations of repeat ablation are significantly longer. © 2020 The Authors. Journal of Cardiovascular Electrophysiology published by Wiley Periodicals, Inc.