Unipolar and bipolar electrogram characteristics of recurrent cases of idiopathic ventricular arrhythmias undergoing repeat catheter ablation

IntroductionActivation mapping guided catheter ablation (CA) of ventricular arrhythmias (VAs) is limited in some cases when it is only relied on bipolar electrogram (EGM). We hypothesized that activation mapping with use of combined bipolar and unipolar EGM facilitates to identify the focal origin of VAs and results in reduction of recurrence rate of CA of VAs.MethodsWe analyzed the data of patients undergoing repeat ablations for idiopathic out-flow tract VAs. The EGM of the 1 st and 2 nd ablations were compared for earliest local activation time (LAT), presence of discrete potentials, and polarity reversal, unipolar potential morphology (QS or non-QS), potential amplitude and activation slope.ResultsThirty-seven patients were included. The Local activation time was significantly earlier in the 2nd ablation as compared to the 1st procedure (36.90 msec vs 31.85 msec, P < 0.01). The incidence of discrete potentials and polarity reversal were similar in both procedures (51% vs 57%, P = 0.8 and 62% in both the occasions, respectively). The unipolar voltage was similar in both occasions (6.94 mV vs 7.22 mV in repeat ablations, P = 0.7). The recurrence rate (5.7%) was significantly lower with routine use of combined unipolar and bipolar EGMs, as compared to the use of bipolar EGM alone (16.7%)ConclusionsUse of both bipolar and unipolar electrograms helps in better delineation of the sites of earliest activation for effective ablation of VAs. Use of unipolar electrograms in addition to bipolar electrograms is associated with lower long term recurrence rate.     

Probe into a multi-protein prokaryotic organelle using thermal scanning assay reveals distinct properties of the core and the shell

BackgroundBacterial microcompartments represent the only reported category of prokaryotic organelles that are capable of functioning as independent bioreactors. In this organelle, a biochemical pathway with all the enzyme machinery is encapsulated within an all protein shell. The shell proteins and the enzymes have distinct structural features. It is hypothesized that flat shell proteins align sideways to form extended sheets and, the globular enzymes fill up the central core of the organelle.MethodsUsing differential scanning fluorimetry, we explored the structure and functional alteration of Pdu BMC, involving tertiary or quaternary structures.ResultsOur findings exhibit that these intact BMCs as a whole behave similar to a globular protein with a rich hydrophobic core, which is exposed upon thermal insult. The encapsulated enzymes itself have a strong hydrophobic core, which is in line with the hydrophobic-collapse model of protein folding. The shell proteins, on the other hand, do not have a strong hydrophobic core and show a significant portion of exposed hydrophobic patches.ConclusionWe show for the first time the thermal unfolding profile of the BMC domain proteins and the unique exposure of hydrophobic patches in them might be required for anchoring the enzymes leading to better packaging of the micro-compartments.General significanceThese observations indicate that the genesis of these unique bacterial organelles is driven by the hydrophobic interactions between the shell and the enzymes. Insights from this work will aid in the genetic and biochemical engineering of thermostable efficient enzymatic biomaterials.     

Is aspirin useful in patients on lithium? A pharmacoepidemiological study related to bipolar disorder

ObjectivesAdministration to rats of mood stabilizers approved for bipolar disorder (BD) downregulates markers of the brain arachidonic acid (AA, 20:4n-6) metabolic cascade, including phospholipase A₂ (PLA₂) and cyclooxygenase (COX) expression. We hypothesized that other agents that target the brain AA cascade, nonsteroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids, also would ameliorate BD symptoms.MethodsMedication histories on subjects who had been prescribed lithium were collected from the Netherlands PHARMO Record Linkage System. Data were stratified according to drug classes that inhibit PLA₂ and/or COX enzymes, and duration of use. Incidence density (ID) of medication events (dose increase or substance change) was used as a proxy for clinical worsening. ID ratios in patients with the inhibitors plus lithium were compared to ratios in patients using lithium alone.ResultsLow-dose acetylsalicylic acid (aspirin) significantly reduced the ID ratio of medication events, independent of use duration. The ID ratios of NSAIDs and glucocorticoids did not differ significantly from 1.0 if prescribed for ≥180 or ≥90 days, but exceeded 1.0 with shorter use. Selective COX-2 inhibitors had no significant effect and multiagent administration increased the ID ratio above 1.0.ConclusionsLow-dose aspirin produced a statistically significant duration-independent reduction in the relative risk of clinical deterioration in subjects on lithium, whereas other NSAIDs and glucocorticoids did not. These tentative findings could be tested on larger databases containing detailed information about diagnosis and disease course, as well as by controlled clinical trials.     

Les stratégies de débitage dans les industries lithiques archaïques des premiers habitants de l’Europe

Barranco León and Fuente Nueva 3 sites at Orce in the south of Spain, and Vallonnet cave in the south of France, are some of the oldest sites in Europe, testimonies of the first settlements of these territories. The Orce sites, dated around 1.3-1.2 Ma, have given away numerous lithic artifacts principally issued from an important débitage activity. The beginning of flake production processes is few represented into these two consummation sites. In return, full débitage flakes are in high proportion, with generally short dimensions, in consequence of which, in some case an intense core reduction. Two percussion methods are identified: with direct percussion or on anvil. Sometimes, there was débitage on flake, taking advantage of the inferior face natural convexity of the core-flake, permitting the maximal exploitation and the economy of the best raw materials. The bipolar percussion on anvil permitted the maximal exploitation of the short dimensions supports, often in naturally cubic or sub-cubic form. A lot of the producted flakes, sometimes called “pièces esquillées”, show some scales on the distal and/or proximal transversal edges, issued from this bipolar knapping method. In the Vallonnet cave, where the occupation levels are dated around 1 Ma, the lithic industry show a lot of percussion tools and hammerstone flakes, but also some core reduction flakes and some very rares cores, especially in flint. This good raw material was chosen for the débitage, and the flakes show on superior face several anterior removals, and a butt which could reveal a striking platform preparation. At the gates of Europe, in Georgia, Dmanisi site give away an abundant lithic industry associated with faunal and human remains, dated around 1.81 to 1.77 Ma. Amid the lithic assemblages, cores are rather frequent and are characterized by a poor degree of exploitation, most often unifacial, and high frequency of cortical striking platforms. Raw materials, essentially volcanic cobbles, were from local origin, and the knapped supports were often chosen for their angular morphology adequate to begin the débitage in easier way, débitage which was essentially by direct percussion.     

Allosteric inhibitors of calpains: Reevaluating inhibition by PD150606 and LSEAL

BackgroundThe mercaptoacrylate calpain inhibitor, PD150606, has been shown by X-ray crystallography to bind to a hydrophobic groove in the enzyme's penta-EF-hand domains far away from the catalytic cleft and has been previously described as an uncompetitive inhibitor of calpains. The penta-peptide LSEAL has been reported to be an inhibitor of calpain and was predicted to bind in the same hydrophobic groove. The X-ray crystal structure of calpain-2 bound to its endogenous calpain inhibitor, calpastatin, shows that calpastatin also binds to the hydrophobic grooves in the two penta-EF-hand domains, but its inhibitory domain binds to the protease core domains and blocks the active site cleft directly.MethodsThe mechanisms of inhibition by PD150606 and LSEAL were investigated using steady-state kinetics of cleavage of a fluorogenic substrate by calpain-2 and the protease core of calpain1, as well as by examining the inhibition of casein hydrolysis by calpain and the autoproteolysis of calpain.ResultsPD150606 inhibits both full-length calpain-2 and the protease core of calpain-1 with an apparent noncompetitive kinetic model. The penta-peptide LSEAL failed to inhibit either whole calpain or its protease core in vitro.ConclusionsPD150606 cannot inhibit cleavage by calpain-2 of small substrates via binding to the penta-EF-hand domain.General significancePD150606 is often described as a calpain-specific inhibitor due to its ability to target the penta-EF-hand domains of calpain, but we show that it must be acting at a site on the protease core domain instead.     

What explains the differences between centres in the European screening trial? A simulation study

BackgroundThe European Randomised study of Screening for Prostate Cancer (ERSPC) is a multicentre, randomised screening trial on men aged 55–69 years at baseline without known prostate cancer (PrCa) at randomisation to an intervention arm invited to screening or to a control arm. The ERSPC has shown a significant 21% reduction in PrCa mortality at 13 years of follow-up. The effect of screening appears to vary across centres, for which several explanations are possible. We set to assess if the apparent differences in PrCa mortality reduction between the centres can be explained by differences in screening protocols.MethodsWe examined the centre differences by developing a simulation model and estimated how alternative screening protocols would have affected PrCa mortality.ResultsOur results showed outcomes similar to those observed, when the results by centres were reproduced by simulating the screening regimens with PSA threshold of 3 versus 4 ng/ml, or screening interval of two versus four years. The findings suggest that the differences are only marginally attributable to the different screening protocols.ConclusionThe small screening impact in Finland was not explained by the differences in the screening protocols. A possible reason for it was the contamination of and the unexpectedly low PrCa mortality in the Finnish control arm.     

Morphology and wall ultrastructure of some Middle Devonian dispersed megaspores from northern Poland

Specimens of dispersed Middle Devonian megaspores have been isolated from core samples from the Miastko 1 borehole in Western Pomerania. Comprehensive investigations using light, scanning and transmission electron microscopy supplement previous information on morphology and gross structure and provide data on spore wall ultrastructure of four megaspore species. Corystisporites acutispinosus is azonate; the inner layer is laminate, and the lumen is lined by a thick, laterally continuous lamina. The outer layer consists of small, tangentially aligned tabular elements that become wider, more extensive and irregularly arranged toward the outside. Coronispora variabilis is a coronate megaspore; the inner layer appears homogenous and is probably lamellate. The outer layer consists of elongate, cylindrical, branching elements that are overlaid within the proximal part of the body by a lamellate, compact, almost homogenous layer. Grandispora ciliata is pseudosaccate. The inner body is laminate with laminae thickening and becoming less continuous and less tightly packed toward the outside. The outermost region of the inner body and the innermost region of the outer envelope consist of tabular and cylindrical elongate units. The bulk of the outer wall is almost homogenous, and near the surface it is granular. Pomeranisporites subtriangularis is pseudozonate. The inner layer appears homogenous except for the presence of a single innermost lamina. The inner part of the outer layer may represent small tabular and cylindrical elements, and the outer part comprises folded laminae. The megaspores studied share numerous features of morphology and wall ultrastructure with the lycopsids, putative lycopsids, and some enigmatic Devonian plants.     

Hippocampal CA1 Pyramidal Cell Size is Reduced in Bipolar Disorder

1. Schizophrenia and bipolar disorder are neurodevelopmental disorders with significant genetic vulnerabilities. Several trophic genes and/or proteins have been implicated in the causation for both disorders. 2. We hypothesized that these genes and/or proteins may impact neuronal growth in both disorders. 3. Hippocampal tissue sections from CA1 area of schizophrenic, bipolar, depressed, and controls subjects, matched for age, sex, PMI, drug exposure, and brain pH were prepared for cell size determination using the Stanley Medical Research Foundation postmortem brain collection. 4. Quantification of hippocampal CA1 pyramidal neuron size showed a significant 12% reduction in cell size (p < 0.05) in bipolar subjects vs. controls. There were nonsignificant trends for reduction in cell size in both schizophrenic and depressed subjects vs. controls. 5. These results indicate for the first time that pyramidal cell atrophy is present in hippocampus of subjects with bipolar disorder.     

The Relationship between Bipolar Disorder and Cannabis Use in Daily Life: An Experience Sampling Study

ObjectivesAlthough cannabis use is common in bipolar disorder and may contribute to worse clinical outcomes, little is understood about the relationship between this drug and bipolar disorder over the course of daily life. The aim of study was to examine the effect of cannabis on affect and bipolar symptoms in a group of individuals with bipolar disorder.MethodsTwenty-four participants with bipolar disorder type I or type II completed diaries for 6 days using Experience Sampling Methodology to investigate the temporal associations between cannabis, affect and bipolar disorder symptoms.ResultsThe results indicated that higher levels of positive affect increase the odds of using cannabis (OR:1.25 ,CI:1.06–1.47, P=0.008). However, neither negative affect, manic nor depressive symptoms predicted the use of cannabis. Cannabis use was associated with subsequent increases in positive affect (β=0.35, CI:0.20-0.51, P=0.000), manic symptoms (β=0.20,CI:0.05-0.34, P=0.009) and depressive symptoms (β= 0.17,CI:0.04-0.29, P=0.008).ConclusionThe findings indicate that cannabis use is associated with a number of subsequent psychological effects. However there was no evidence that individuals with BD were using cannabis to self-medicate minor fluctuations in negative affect or bipolar disorder symptoms over the course of daily life. The findings in relation to existing literature and clinical implications are discussed.     

TULIP study: Trail of Lurasidone in bipolar disorder in Pakistan

BackgroundThis study examined usefulness and efficiency of Lurasidone in appraisal with the placebo as for the treatment of Bipolar Disorders.MethodsSeven treatment centers in Pakistan were selected for the purpose of starting a six week-long control trial (randomized and double-blind placebo). 76 subjects, already diagnosed with Bipolar I or II based on DSM 5 diagnosis, were selected after randomization. Patients were allocated in one of the two groups. Primary efficacy of the drug was measured using Young Mania Rating Scale. Positive response of the drug was defined as 50% reduction in symptoms from the baseline/13 point less than the baseline score on Young Mania Rating Scale. Efficacy and safety of the drug was assessed using variety of markers such as administering extra-pyramidal symptoms rating scale, adverse side effects reported, electrocardiograms, body weight, vital signs changes, and laboratory investigations.ResultsPatients treated with Lurasidone showed enhanced improvement in their overall health and symptoms manifestation in comparison to patients who were given placebo. Lurasidone treated patients showed a better response to the drug (66%), in comparison with the placebo treated patients (42%).LimitationsStudy was conducted on small scale due to complexity.ConclusionPatients treated with Lurasidone showed reduction in bipolar symptoms and tolerate the drug well.     

A mechanistic damage model for ligaments

PurposeThe accuracy of biomechanical models is predicated on the realism by which they represent their biomechanical tissues. Unfortunately, most models use phenomenological ligament models that neglect the behaviour in the failure region. Therefore, the purpose of this investigation was to test whether a mechanistic model of ligamentous tissue portrays behaviour representative of actual ligament failure tests.ModelThe model tracks the time-evolution of a population of collagen fibres in a theoretical ligament. Each collagen fibre is treated as an independent linear cables with constant stiffness. Model equations were derived by assuming these fibres act as a continuum and applying a conservation law akin to Huxley’s muscle model. A breaking function models the rate of collagen fibre breakage at a given displacement, and was chosen to be a linear function for this preliminary analysis.MethodsThe model was fitted to experimental average curves for the cervical anterior longitudinal ligament. In addition, the model was cyclically loaded to test whether the tissue model behaves similarly.ResultsThe model agreed very well with experiment with an RMS error of 14.23 N and an R² of 0.995. Cyclic loading exhibited a reduction in force similar to experimental data.Discussion and conclusionThe proposed model showcases behaviour reminiscent of actual ligaments being strained to failure and undergoing cyclic load. Future work could incorporate viscous effects, or validate the model further by testing it in various loading conditions. Characterizing the breaking function more accurately would also lead to better results.     

Continuities in stone flaking technology at Liang Bua, Flores, Indonesia

This study examines trends in stone tool reduction technology at Liang Bua, Flores, Indonesia, where excavations have revealed a stratified artifact sequence spanning 95 k.yr. The reduction sequence practiced throughout the Pleistocene was straightforward and unchanging. Large flakes were produced off-site and carried into the cave where they were reduced centripetally and bifacially by four techniques: freehand, burination, truncation, and bipolar. The locus of technological complexity at Liang Bua was not in knapping products, but in the way techniques were integrated. This reduction sequence persisted across the Pleistocene/Holocene boundary with a minor shift favoring unifacial flaking after 11 ka. Other stone-related changes occurred at the same time, including the first appearance of edge-glossed flakes, a change in raw material selection, and more frequent fire-induced damage to stone artifacts. Later in the Holocene, technological complexity was generated by “adding-on” rectangular-sectioned stone adzes to the reduction sequence. The Pleistocene pattern is directly associated with Homo floresiensis skeletal remains and the Holocene changes correlate with the appearance of Homo sapiens. The one reduction sequence continues across this hominin replacement.     

Characterization of Lethal Zika Virus Infection in AG129 Mice

BackgroundMosquito-borne Zika virus (ZIKV) typically causes a mild and self-limiting illness known as Zika fever, which often is accompanied by maculopapular rash, headache, and myalgia. During the current outbreak in South America, ZIKV infection during pregnancy has been hypothesized to cause microcephaly and other diseases. The detection of ZIKV in fetal brain tissue supports this hypothesis. Because human infections with ZIKV historically have remained sporadic and, until recently, have been limited to small-scale epidemics, neither the disease caused by ZIKV nor the molecular determinants of virulence and/or pathogenicity have been well characterized. Here, we describe a small animal model for wild-type ZIKV of the Asian lineage.Conclusions/SignificanceFoot pad injection of AG129 mice with ZIKV represents a biologically relevant model for studying ZIKV infection and disease development following wild-type virus inoculation without the requirement for adaptation of the virus or intracerebral delivery of the virus. This newly developed Zika disease model can be exploited to identify determinants of ZIKV virulence and reveal molecular mechanisms that control the virus-host interaction, providing a framework for rational design of acute phase therapeutics and for vaccine efficacy testing.     

Removal of minute virus of mice-mock virus particles by nanofiltration of culture growth medium supplemented with 10% human platelet lysate

Background aimsPlatelet concentrates (PCs) are pooled to prepare human platelet lysate (HPL) supplements of growth media to expand primary human cells for transplantation; this increases the risk of contamination by known, emerging, and unknown viruses. This possibility should be of concern because viral contamination of cell cultures is difficult to detect and may have detrimental consequences for recipients of cell therapies. Viral reduction treatments of chemically defined growth media have been proposed, but they are not applicable when media contain protein supplements currently needed to expand primary cell cultures. Recently, we successfully developed a Planova 35NPlanova 20N nanofiltration sequence of growth media supplemented with two types of HPL. The nanofiltered medium was found to be suitable for mesenchymal Stromal cell (MSC) expansion.MethodsHerein, we report viral clearance achieved by this nanofiltration process used for assessing a new experimental model using non-infectious minute virus of mice-mock virus particle (MVM-MVP) and its quantification by an immunoqPCR. Then, high doses of MVM-MVP (1012 MVPs/mL) were spiked to obtain a final concentration of 1010 MVPs/mL in Planova 35N-nanofiltered growth medium supplemented with both types of HPLs [serum converted platelet lysate SCPL) and intercept human platelet lysate (I-HPL)] at 10% (v/v) and then filtering through Planova 20N.ResultsNo substantial interference of growth medium matrices by the immune-qPCR assay was first verified. Log reduction values (LRVs) were ≥ 5.43 and ≥ 5.36 respectively, SCPL and I-HPL media. MVM-MVPs were also undetectable by dynamic light scattering and transmission electron microscopy.ConclusionsThe nanofiltration of growth media supplemented with 10% HPL provides robust removal of small nonenveloped viruses, and is an option to improve the safety of therapeutic cells expanded using HPL supplements.     

Desert Truffles of the African Kalahari: Ecology,Ethnomycology, and Taxonomy

Desert Truffles of the African Kalahari: Ecology, Ethnomycology, and Taxonomy. The Khoisan people of the Kalahari Desert have used truffles for centuries. The extreme conditions in which desert truffles grow means that they fruit only sporadically when adequate and properly distributed rainfall occurs, and then only where suitable soil and mycorrhizal hosts occur. Truffles are hunted in the Kalahari by men and women; they look for cracks in the soil, often humped, caused by expansion of the truffles, which are then extracted with hands or digging sticks. The truffles are eaten raw or cooked (boiled, roasted over fire, or buried in hot ashes). Commercial harvest of Kalahari truffles has increased in the last decade and the quantities harvested have been observed to be declining where livestock have been concentrated.     

Thermoregulation in premature infants: A mathematical model

PurposeIn 2010, approximately 14.9 million babies (11.1%) were born preterm. Because preterm infants suffer from an immature thermoregulatory system they have difficulty maintaining their core body temperature at a constant level. Therefore, it is essential to maintain their temperature at, ideally, around 37 °C. For this, mathematical models can provide detailed insight into heat transfer processes and body-environment interactions for clinical applications.MethodsA new multi-node mathematical model of the thermoregulatory system of newborn infants is presented. It comprises seven compartments, one spherical and six cylindrical, which represent the head, thorax, abdomen, arms and legs, respectively. The model is customizable, i.e. it meets individual characteristics of the neonate (e.g. gestational age, postnatal age, weight and length) which play an important role in heat transfer mechanisms. The model was validated during thermal neutrality and in a transient thermal environment.ResultsDuring thermal neutrality the model accurately predicted skin and core temperatures. The difference in mean core temperature between measurements and simulations averaged 0.25±0.21 °C and that of skin temperature averaged 0.36±0.36 °C. During transient thermal conditions, our approach simulated the thermoregulatory dynamics/responses. Here, for all infants, the mean absolute error between core temperatures averaged 0.12±0.11 °C and that of skin temperatures hovered around 0.30 °C.ConclusionsThe mathematical model appears able to predict core and skin temperatures during thermal neutrality and in case of a transient thermal conditions.     

A Compendium of Radiocarbon Dates for Iowa Archaeological Sites

Abstract

This report represents a compendium of radiocarbon dates for archaeological sites in the state of Iowa. The compendium is in tabular form and contains the following information: (1) the site name and number; (2) the radiocarbon date in both BP and BC/AS; (3) the laboratory sample number; (4) the type of sample or material dated; (5) cultural affiliation; and (6) published and unpublished references pertaining to the date and to the site or culture.     

奥奈达希瓦氏菌CctA介导周质甲基橙还原的电子传递机理

电活性微生物奥奈达希瓦氏菌的胞外电子传递（extracellular electron transfer,EET）在污染物降解、环境修复、生物电化学传感、能源利用等方面具有广泛的应用潜力;四血红素细胞色素CctA （small tetraheme cytochrome）是希瓦氏菌周质空间中最丰富的蛋白质之一,能够参与多种氧化还原过程,但目前对CctA在EET中的行为和机理认识仍然有限。【目的】研究阐明CctA蛋白在希瓦氏菌模式菌株MR-1周质空间以偶氮染料作为电子受体的EET中的作用,补充和拓展希瓦氏菌的厌氧呼吸产能机制。【方法】以周质还原型偶氮染料甲基橙（methyl orange,MO）作为电子受体,在mteal reduction （Mtr）蛋白缺失菌株Δmtr中研究MO的周质还原特点,并通过基因敲除和回补表达研究CctA蛋白在周质电子传递中的作用。【结果】在缺失Mtr通道的情况下,细胞色素CctA可以介导周质空间的电子传递而还原MO。重组表达CctA在低水平时,MO在周质空间中的还原速率与其表达水平呈正相关,更高水平的CctA表达无助于进一步提高MO的还原速率。蛋白膜伏安结果展示了CctA与周质空间内其他高电位氧化还原蛋白的显著区别,可能参与构成一条低电位的MO还原通道。【结论】从分子动力学层面揭示了CctA在周质MO还原中的独特电子传递行为,为进一步推进对细菌周质电子传递机制的理解,以及通过合成生物学设计或改造胞外氧化还原系统、强化生物电化学在污染物降解中的应用提供了重要信息。