Lundgaardbeasley3677
In order to document arrhythmias, indicated due to symptoms or for prognostic purposes, both invasive and noninvasive possibilities for ECG monitoring are available. The choice of the device for monitoring depends mainly on the frequency of arrhythmias. If they occur less than once a month, long-term monitoring becomes necessary which either continuously monitors the rhythm by an implantable device (implantables) or by wearable systems (wearables) which usually register the ECG discontinuously. Because wearables, e.g. smartphones, are basically ubiquitously available, they may be used for ECG monitoring. This paper comments on the use of implantables and wearables for the detection of atrial fibrillation and the documentation of symptomatic arrhythmias in syncope or palpitations.
To review the epidemiology, pathogenesis, diagnosis using emerging imaging modalities, management strategy, and prevention of recurrent spontaneous coronary artery dissection (SCAD) and provide a more extensive review of the current data.
SCAD generally affects women without conventional cardiovascular risk factors. Diagnosis and management of SCAD are challenging due to heterogeneity, undefined mechanisms, differing phenotypes, and a lack of strong clinical evidence. After reviewing the current evidence to date, we recommend conservative management, including cardiac rehabilitation for SCAD with low-risk features, while coronary revascularization should be considered in SCAD with high-risk features. Non-invasive imaging (e.g., coronary computed tomography angiography, cardiac magnetic resonance, myocardial perfusion imaging) should be considered in diagnosing specific SCAD phenotypes. The standard guideline-based medical therapy for acute coronary syndrome, in the absence of contraindications, should be notypes. Discharge counseling and follow-up using emerging imaging modalities should be based on individuals' profiles and approached on a case by case basis.The broad spectrum of health benefits attributed to probiotics has contributed to a rapid increase in the value of the probiotic market. Probiotic health benefits can be strain specific. Thus, strain-level identification of probiotic strains is of paramount importance to ensure probiotic efficacy. Both Lactobacillus gasseri BNR17 and Lactobacillus reuteri LRC (NCIMB 30242) strains have clinically proven health benefits; however, no assays were developed to enable strain-level identification of either of these strains. The objective of this study is to develop strain-specific PCR-based methods for Lactobacillus gasseri BNR17 and Lactobacillus reuteri LRC strains, and to validate these assays according to the guidelines for validating qualitative real-time PCR assays. Using RAST (Rapid Annotation using Subsystem Technology), unique sequence regions were identified in the genome sequences of both strains. Probe-based assays were designed and validated for specificity, sensitivity, efficiency, repeatability, and reproducibility. Both assays were specific to target strain with 100% true positive and 0% false positive rates. Reaction efficiency for both assays was in the range of 90 to 108% with R square values > 0.99. Repeatability and reproducibility were evaluated using five samples at three DNA concentrations each and relative standard deviation was less then 4% for repeatability and less then 8% for reproducibility. Both of the assays developed and validated in this study for the specific identification of Lactobacillus gasseri BNR17 and Lactobacillus reuteri LRC strains are specific, sensitive, and precise. These assays can be applied to evaluate and ensure compliance in probiotic products.Accumulating evidence over the last two decades has established the causal role of a unidirectional orthography in shaping speakers' mental representations of time. Casasanto and Bottini (Journal of Experimental Psychology General, 143, 473-479, 2014) extended previous findings by showing that exposure to mirror-reversed orthography of speakers' native language could completely redirect their mental timelines within minutes. However, the question of whether such a causal effect of writing direction on temporal cognition can be identified in speakers whose native languages adopt bidirectional orthographies remains underexplored in the literature. To address this issue, the present study focused on Japanese which uses bidirectional writing systems, one proceeding horizontally from left to right (HLR) and one vertically from top to bottom (VTB). Two experiments were performed, and the tasks asked participants to process standard/mirror orthography prime questions about time arranged horizontally or vertically, followed by horizontal or vertical arrays of pictorial target stimuli about temporal relations. Results demonstrated that Japanese speakers encoded passage of time into a top-to-bottom linear path commensurate with the VTB writing direction, but they did not align their mental representations of time with the HLR writing orientation. Accordingly, exposure to mirror-reversed bidirectional orthographies redirected Japanese speakers' vertical but not horizontal space-time mappings. Theoretical implications concerning the causal effects of bidirectional orthographies and the generalizability of the representational flexibility of time maintained by Casasanto and Bottini (Journal of Experimental Psychology General, 143, 473-479) are discussed.Guidelines recommend surveillance colonoscopy for patients with an ulcerative colitis (UC) duration of 8-10 years. We experienced a patient who had not undergone UC surveillance. A 35-year-old Japanese woman developed diarrhea and abdominal pain in January 2018 and was diagnosed with UC. She underwent medical therapy, and 18 months after onset of UC colonoscopy indicated that her UC activity was remission and showed no cancer lesions. Twenty-four months after onset, colonoscopy revealed a tumor in the ascending colon, and the biopsy revealed tubular adenocarcinoma. She had no family history of colorectal cancer. There were no findings of distant metastases or primary sclerosing cholangitis. Laparoscopy-assisted anus-preserving total proctocolectomy, the creation of a J-type ileal pouch, ileal pouch anal anastomosis, and the creation of an ileostomy were performed. The pathological report was type 3, 30 × 27-mm, adenocarcinoma (por2 > tub2), pT4a, Ly1a, V1a, budding grade 3, pN0, M0, Stage IIb. Some colitic cancers such as our patient's may not conform to the existing guidelines. When a colonoscopy is being performed for a UC patient, even if its timing is less less then 8 years since the UC onset, suspicious lesions should be biopsied considering the possibility of cancer.The increase in complexity of treatment plans over time through modalities such as intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) has often not been met with an increase in capability of the secondary dose calculation checking systems typically used to verify the treatment planning system. Monte Carlo (MC) codes such as EGSnrc have become easily available and are capable of performing calculations of highly complex radiotherapy treatments. This educational note demonstrates a method for implementing and using a fully automated system for performing and analysing full MC calculations of conformal, IMRT and VMAT radiotherapy plans. Example calculations were based on BEAMnrc/DOSXYZnrc and are performed automatically after either uploading exported plan DICOM data through a Python-based web interface, or exporting DICOM data to a monitored network location. This note demonstrates how completed MC calculations can then be analysed using an automatically generated dose point comparison report, or easily re-imported back into the treatment planning system. Agreement between the TPS and MC calculation was an improvement on agreement between RadCalc and the TPS, with differences ranging from 1.2 to 5.5% between RadCalc and the treatment planning system (TPS), and 0.1-1.7% between MC and TPS. Comparison of the dose-volume histogram (DVH) parameters [Formula see text], [Formula see text], [Formula see text], and [Formula see text] for the example VMAT plans showed agreement for the mean planning target volume dose within [Formula see text], [Formula see text] and [Formula see text] generally within [Formula see text] with the exception of a brain case, and [Formula see text] within [Formula see text]. Overall, this note provides a demonstration of a system that has been integrated well into existing clinical workflow, and has been shown to be a valuable additional tool in the secondary checking of treatment plan calculations.
Chloroquine/hydroxychloroquine has recently been the subject of intense debate regarding its potential antiviral activity against SARS-Cov-2, the etiologic agent of COVID-19. Some report possible curative effects; others do not.Therefore, the objective of this study was tosimulate possible scenarios of response to hydroxychloroquine in COVID-19 patients usingmathematical modeling.
To shed some light on this controversial topic, we simulatedhydroxychloroquine-based interventions on virus/host cell dynamics using a basic system of previously published differential equations.Mathematical modeling was implemented using Python programming language v 3.7.
According to mathematical modeling, hydroxychloroquine may have an impact on the amplitude of the viral load peak and viral clearance if the drug is administered early enough (i.e., when the virus is still confined within the pharyngeal cavity). The effects of chloroquine/hydroxychloroquine may be fully explained only when also considering the capacity of this drug to increase the death rate of SARS-CoV-2-infected cells, in this case by enhancing the cell-mediated immune response.
These considerations may not only be applied to chloroquine/hydroxychloroquine but may have more general implications for development of anti-COVID-19 combination therapies and prevention strategies through an increased death rate of the infected cells.
These considerations may not only be applied to chloroquine/hydroxychloroquine but may have more general implications for development of anti-COVID-19 combination therapies and prevention strategies through an increased death rate of the infected cells.
Craniosynostosis is the premature closure of cranial sutures and it continues to be a therapeutic challenge due to the diversity and complexity of the syndrome. Bibliometric analysis is a study of ranking citations and exploring the most impactful articles in a respective discipline. It also demonstrates the chronological trends of publications.
In May 2020, we performed a title-specific search of the Scopus database using "craniosynostosis" as our query term without publication date restrictions. The top 100 articles in craniosynostosis were retrieved and analyzed.
The top 100 most-cited articles in craniosynostosis received a total 13,826 citations, and an average of 138 citations per paper. The publication dates ranged from 1920 to 2015, with a peak period of top publications between 1996 and 2005. The most common category is clinical, followed by neurogenetics. The top cited article received 540 citation counts and 19.29 citations per year. The USA was the most contributing country to the list. The Journal of Plastic and Reconstructive Surgery published the largest number of top cited articles.