Fragmented QRS: What Is The Meaning?

Fragmented QRS (fQRS) is a convenient marker of myocardial scar evaluated by 12-lead electrocardiogram (ECG) recording. fQRS is defined as additional spikes within the QRS complex. In patients with CAD, fQRS was associated with myocardial scar detected by single photon emission tomography and was a predictor of cardiac events. fQRS was also a predictor of mortality and arrhythmic events in patients with reduced left ventricular function. The usefulness of fQRS for detecting myocardial scar and for identifying high-risk patients has been expanded to various cardiac diseases, such as cardiac sarcoidosis, arrhythmogenic right ventricular cardiomyopathy, acute coronary syndrome, Brugada syndrome, and acquired long QT syndrome. fQRS can be applied to patients with wide QRS complexes and is associated with myocardial scar and prognosis. Myocardial scar detected by fQRS is associated with subsequent ventricular dysfunction and heart failure and is a substrate for reentrant ventricular tachyarrhythmias.     

Comparison of Injuries to Coyote From 3 Types of Cable Foot-Restraints

ABSTRACT We compared injury rates among captured coyotes (Canis latrans) to determine if modifications to cable foot-restraints would decrease resulting injuries. Mean International Standardization Organization's injury scores of coyotes caught in 3 types of cable foot-restraints were 22.2, 37.9, and 60.4 (F_2,41 = 4.63, P = 0.015) for a chain-loop, standard cable, and sleeved cable, respectively. These results may be important for trappers and researchers to consider when using a cable foot-restraint device to capture wildlife.     

EPID in vivo dosimetry in RapidArc technique

Aim

The aim of the study was to estimate the dose at the reference point applying an aSi-EPID device in the course of patient treatment.

Materials and methods

The method assumes direct proportionality between EPID signal and dose delivered to the patient reference point during the treatment session. The procedure consists of treatment plan calculation for the actual patient in the arc technique. The plan was realized with an elliptic water-equivalent phantom. An ionization chamber inside the phantom measured the dose delivered to the reference point. Simultaneously, the EPID matrix measured the CU distribution. EPID signal was also registered during patient irradiation with the same treatment plan. The formula for in vivo dose calculation was based on the CU(g) function, EPID signal registered during therapy and the relation between the dose and EPID signal level measured for the phantom. In vivo dose was compared with dose planned with the treatment planning system.Irradiation was performed with a Clinac accelerator by Varian Medical Systems in the RapidArc technique. The Clinac was equipped with an EPID matrix (electronic portal image device) of aSi-1000. Treatment plans were calculated with the Eclipse/Helios system. The phantom was a Scanditronix/Wellhöfer Slab phantom, and the ionization chamber was a 0.6 ccm PTW chamber.

Results

In vivo dose calculations were performed for five patients. Planned dose at the reference point was 2 Gy for each treatment plan. Mean in vivo dose was in the range of 1.96–2.09.

Conclusions

Our method was shown to be appropriate for in vivo dose evaluation in the RapidArc technique.     

Microfluidic separation of (S)-ibuprofen using enzymatic reaction

This study was investigated for the enantioselective separation of (S)-ibuprofen using the ionic liquid in the microfluidic device. A stable and thin ionic liquid flow (ILF) was made by controlling the flow rate of the ILF in the microfluidic channel. In addition, coupling lipase as a biocatalyst with the ILF based on the microfluidic device showed the facilitative and selective transport of (S)-ibuprofen across the ILF, indicating successful optical resolution of a racemic mixture. Subsequently, the enantioselectivity was evaluated in the transport ratio (η) of (R)- and (S)-ibuprofen, the optical resolution ratio () and enantiomeric excess of (S)-ibuprofen (ee_S).     

A single-cell surgery microfluidic device for transplanting tumor cytoplasm into dendritic cells without nuclei mixing

This study aimed to demonstrate the feasibility of generating tumor cell vaccine models by single-cell surgery in a microfluidic device that integrates one-to-one electrofusion, shear flow reseparation, and on-device culture. The device was microfabricated from polydimethylsiloxane (PDMS) and consisted of microorifices (aperture size: ∼3 μm) for one-to-one fusion, and microcages for on-device culture. Using the device, we could achieve one-to-one electrofusion of leukemic plasmacytoid dendritic cells (DC-like cells) and Jurkat cells with a fusion efficiency of ∼ 80%. Fusion via the narrow microorifices allowed DC-like cells to acquire cytoplasmic contents of the Jurkat cells while preventing nuclei mixing. After fusion, the DC-like cells were selectively reseparated from the Jurkat cells by shear flow application to generate tumor nuclei-free antigen-recipient DC-like (tarDC-like) cells. When cultured as single cells on the device, these cells could survive under gentle medium perfusion with a median survival time of 11.5 h, although a few cells could survive longer than 36 h. Overall, this study demonstrates single-cell surgery in a microfluidic device for potential generation of dendritic cell vaccines which are uncontaminated with tumor nucleic materials. We believe that this study will inspire the generation of safer tumor cell vaccines for cancer immunotherapy.     

Cardiomyocyte Ca2+ handling and structure is regulated by degree and duration of mechanical load variation

Cardiac transverse (t)‐tubules are altered during disease and may be regulated by stretch‐sensitive molecules. The relationship between variations in the degree and duration of load and t‐tubule structure remains unknown, as well as its implications for local Ca²⁺‐induced Ca²⁺ release (CICR). Rat hearts were studied after 4 or 8 weeks of moderate mechanical unloading [using heterotopic abdominal heart–lung transplantation (HAHLT)] and 6 or 10 weeks of pressure overloading using thoracic aortic constriction. CICR, cell and t‐tubule structure were assessed using confocal‐microscopy, patch‐clamping and scanning ion conductance microscopy. Moderate unloading was compared with severe unloading [using heart‐only transplantation (HAHT)]. Mechanical unloading reduced cardiomyocyte volume in a time‐dependent manner. Ca²⁺ release synchronicity was reduced at 8 weeks moderate unloading only. Ca²⁺ sparks increased in frequency and duration at 8 weeks of moderate unloading, which also induced t‐tubule disorganization. Overloading increased cardiomyocyte volume and disrupted t‐tubule morphology at 10 weeks but not 6 weeks. Moderate mechanical unloading for 4 weeks had milder effects compared with severe mechanical unloading (37% reduction in cell volume at 4 weeks compared to 56% reduction after severe mechanical unloading) and did not cause depression and delay of the Ca²⁺ transient, increased Ca²⁺ spark frequency or impaired t‐tubule and cell surface structure. These data suggest that variations in chronic mechanical load influence local CICR and t‐tubule structure in a time‐ and degree‐dependent manner, and that physiological states of increased and reduced cell size, without pathological changes are possible.     

The legs of “spider associated” parasitic primary larvae of Mantispa aphavexelte (Mantispidae,Neuroptera) – Attachment devices and phylogenetic implications

The legs of the primary larva of Mantispa aphavexelte, parasite in egg sacks of spiders, were examined using scanning electron microscopy (SEM), histology and confocal laser scanning microscopy (CLSM). The leg morphology is described in detail, including intrinsic muscles. Functional adaptations of the leg attachment devices are discussed, especially regarding the material composition. For example, a sole-like flexible ventral tarsal surface containing resilin is combined with sclerotized pseudo-claws. This likely enables the larvae to cope with surface structures on the spider's body, with substrates on the ground, and also with various structural elements in the spider's nest. The leg morphology is evaluated with respect to phylogenetic affinities. A trumpet-shaped, elongated empodium has likely evolved early in the evolution of Neuroptera and may consequently belong to the groundplan of a large subgroup of the order. It characterizes most groups of the hemerobiform lineage and is also present in the myrmeleontiform Psychopsidae. The presence of a tarsal protrusion resembling a pretarsus confirms the monophyletic origin of Mantispoidea. A single fixed tooth and a specific surface structure are potential autapomorphies of Mantispidae. A distal tibial subunit partly separated from the main part of the leg segment is an apomorphy only described for larvae of M. aphavexelte.     

Experimental quantification of the fluid dynamics in blood-processing devices through 4D-flow imaging: A pilot study on a real oxygenator/heat-exchanger module

The performance of blood-processing devices largely depends on the associated fluid dynamics, which hence represents a key aspect in their design and optimization. To this aim, two approaches are currently adopted: computational fluid-dynamics, which yields highly resolved three-dimensional data but relies on simplifying assumptions, and in vitro experiments, which typically involve the direct video-acquisition of the flow field and provide 2D data only. We propose a novel method that exploits space- and time-resolved magnetic resonance imaging (4D-flow) to quantify the complex 3D flow field in blood-processing devices and to overcome these limitations.We tested our method on a real device that integrates an oxygenator and a heat exchanger. A dedicated mock loop was implemented, and novel 4D-flow sequences with sub-millimetric spatial resolution and region-dependent velocity encodings were defined. Automated in house software was developed to quantify the complex 3D flow field within the different regions of the device: region-dependent flow rates, pressure drops, paths of the working fluid and wall shear stresses were computed.Our analysis highlighted the effects of fine geometrical features of the device on the local fluid-dynamics, which would be unlikely observed by current in vitro approaches. Also, the effects of non-idealities on the flow field distribution were captured, thanks to the absence of the simplifying assumptions that typically characterize numerical models.To the best of our knowledge, our approach is the first of its kind and could be extended to the analysis of a broad range of clinically relevant devices.     

Analysing the performance of a micro soil solution sampling device in a laboratory examination and a field experiment

The performance of a micro soil solution sampling device was tested in a laboratory examination and in a field experiment. The instrument allows detection of temporal and spatial changes in soil solution chemistry at a spatially high resolution. The flexible tube of the suction cell is made of a porous polymer with a diameter of 2.3 mm. To achieve more stability and to minimize disturbance of the instrument during field installation, the original device was modified by embedding the suction cell in a stainless steel and pressure absorbing corpus. During a laboratory test the new sampling system was compared to ceramic P-80 suction cells. Solution samples taken with the new device adapted more quickly to the given concentrations compared to the ceramic suction cells. In a field test, micro samplers were implanted in an existing soil solution monitoring plot, equipped with standard ceramic samplers. Bi-weekly sampling using the micro cells indicated high temporal and spatial variation, and in June 1995 it was possible, to identify a distinct nitrification. However, in a statistical comparison of the entire sampling period and respective sub-sampling areas the two sampler types indicated identical concentration ranges for nitrate. It is concluded that the new micro samplers can help to identify processes in soils which may cause short-term changes in the soil solution chemistry, whereas the standard sampling technique with ceramic cells seems to be still a suitable tool if long-term mean soil solution concentrations are to be measured.