In vivo measurements of atrial repolarization alternans based on standard pacemaker technology

It has been shown that repolarization alternans, a beat-to-beat alternation in action potential duration, enhances dispersion of repolarization above a critical heart rate and promotes susceptibility to ventricular arrhythmias. It is unknown whether repolarization alternans is measurable in the atria using standard pacemakers and whether it plays a role in promoting atrial fibrillation. In this work, atrial repolarization alternans amplitude and periodicity are studied in a sheep model of pacing-induced atrial fibrillation. Two pacemakers, each with one right atrial and ventricular lead, were implanted in 4 male sheep after ablation of the atrioventricular junction. The first one was used to deliver rapid pacing for measurements of right atrial repolarization alternans and the second one to record a unipolar electrogram. Atrial repolarization alternans appeared rate-dependent and its amplitude increased as a function of pacing rate. Repolarization alternans was intermittent but no periodicity was detected. An increase of repolarization alternans preceding episodes of non-sustained atrial fibrillation suggests that repolarization alternans is a promising parameter for assessment of atrial fibrillation susceptibility.

Accuracy of plant assemblage predictions from species distribution models varies along environmental gradients

Aim: Climatic niche modelling of species and community distributions implicitly assumes strong and constant climatic determinism across geographic space. This assumption had however never been tested so far. We tested it by assessing how stacked-species distribution models (S-SDMs) perform for predicting plant species assemblages along elevation. Location: Western Swiss Alps. Methods: Using robust presence-absence data, we first assessed the ability of topo-climatic S-SDMs to predict plant assemblages in a study area encompassing a 2800 m wide elevation gradient. We then assessed the relationships among several evaluation metrics and trait-based tests of community assembly rules. Results: The standard errors of individual SDMs decreased significantly towards higher elevations. Overall, the S-SDM overpredicted far more than they underpredicted richness and could not reproduce the humpback curve along elevation. Overprediction was greater at low and mid-range elevations in absolute values but greater at high elevations when standardised by the actual richness. Looking at species composition, the evaluation metrics accounting for both the presence and absence of species (overall prediction success and kappa) or focusing on correctly predicted absences (specificity) increased with increasing elevation, while the metrics focusing on correctly predicted presences (Jaccard index and sensitivity) decreased. The best overall evaluation - as driven by specificity - occurred at high elevation where species assemblages were shown to be under significant environmental filtering of small plants. In contrast, the decreased overall accuracy in the lowlands was associated with functional patterns representing any type of assembly rule (environmental filtering, limiting similarity or null assembly). Main Conclusions: Our study reveals interesting patterns of change in S-SDM errors with changes in assembly rules along elevation. Yet, significant levels of assemblage prediction errors occurred throughout the gradient, calling for further improvement of SDMs, e.g., by adding key environmental filters that act at fine scales and developing approaches to account for variations in the influence of predictors along environmental gradients.

Ruling out coronary heart disease in primary care: external validation of a clinical prediction rule.

BACKGROUND: The Marburg Heart Score (MHS) aims to assist GPs in safely ruling out coronary heart disease (CHD) in patients presenting with chest pain, and to guide management decisions. AIM: To investigate the diagnostic accuracy of the MHS in an independent sample and to evaluate the generalisability to new patients. DESIGN AND SETTING: Cross-sectional diagnostic study with delayed-type reference standard in general practice in Hesse, Germany. METHOD: Fifty-six German GPs recruited 844 males and females aged ≥ 35 years, presenting between July 2009 and February 2010 with chest pain. Baseline data included the items of the MHS. Data on the subsequent course of chest pain, investigations, hospitalisations, and medication were collected over 6 months and were reviewed by an independent expert panel. CHD was the reference condition. Measures of diagnostic accuracy included the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, likelihood ratios, and predictive values. RESULTS: The AUC was 0.84 (95% confidence interval [CI] = 0.80 to 0.88). For a cut-off value of 3, the MHS showed a sensitivity of 89.1% (95% CI = 81.1% to 94.0%), a specificity of 63.5% (95% CI = 60.0% to 66.9%), a positive predictive value of 23.3% (95% CI = 19.2% to 28.0%), and a negative predictive value of 97.9% (95% CI = 96.2% to 98.9%). CONCLUSION: Considering the diagnostic accuracy of the MHS, its generalisability, and ease of application, its use in clinical practice is recommended.

Is the function of the serratus anterior muscle disturbed following division during a standard thoracotomy?

In a prospective study the functional results after dissection or preservation of the serratus anterior muscle in the postero-lateral standard thoracotomy were evaluated. In 14 patients of our clinic with dissection and suture and in 14 patients with preservation of the serratus muscle the muscle function was assessed and compared preoperatively, within the first two post-operative weeks, and three months after the operation by the same physiotherapists. The two groups were blinded in regard to age, original disease, and mode of intervention. We compared the wing position of the scapula in the sitting position and the positioning of the scapula at fixation of the shoulder joint in the sitting and in the supine position. Using a four-grade function assessment scheme, both groups obtained the same functional results. There was no seroma in either group. After 2.8 (2.5 to 3.0) years all the surviving patients described symmetric functional conditions. We therefore conclude that in order to achieve a better view of the operative field the serratus muscle may be dissected close to the origin if it is then readapted.

Evolution of gene expression in fire ants: the effects of developmental stage, caste, and species.

Ants provide remarkable examples of equivalent genotypes developing into divergent and discrete phenotypes. Diploid eggs can develop either into queens, which specialize in reproduction, or workers, which participate in cooperative tasks such as building the nest, collecting food, and rearing the young. In contrast, the differentiation between males and females generally depends upon whether eggs are fertilized, with fertilized (diploid) eggs giving rise to females and unfertilized (haploid) eggs giving rise to males. To obtain a comprehensive picture of the relative contributions of gender (sex), caste, developmental stage, and species divergence to gene expression evolution, we investigated gene expression patterns in pupal and adult queens, workers, and males of two species of fire ants, Solenopsis invicta and S. richteri. Microarray hybridizations revealed that variation in gene expression profiles is influenced more by developmental stage than by caste membership, sex, or species identity. The second major contributor to variation in gene expression was the combination of sex and caste. Although workers and queens share equivalent diploid nuclear genomes, they have highly distinctive patterns of gene expression in both the pupal and the adult stages, as might be expected given their extraordinary level of phenotypic differentiation. Overall, the difference in the proportion of differentially expressed genes was greater between workers and males than between workers and queens or queens and males, consistent with the fact that workers and males share neither gender nor reproductive capability. Moreover, between-species comparisons revealed that the greatest difference in gene expression patterns occurred in adult workers, a finding consistent with the fact that adult workers most directly experience the distinct external environments characterizing the different habitats occupied by the two species. Thus, much of the evolution of gene expression in ants may occur in the worker caste, despite the fact that these individuals are largely or completely sterile. Analyses of gene expression evolution revealed a combination of positive selection and relaxation of stabilizing selection as important factors driving the evolution of such genes.

The Iowa State Capitol Fire 1904, November 2012

The twenty-first century Iowa State Capitol contains state-of-the-art fire protection. Sprinklers and smoke detectors are located in every room and all public hallways are equipped with nearby hydrants. The Des Moines Fire Department is able to fight fires at nearly any height. However, on Monday morning, January 4, 1904, the circumstances were much different. By the beginning of 1904, the Capitol Improvement Commission had been working in the Capitol for about two years. The commissioners were in charge of decorating the public areas of the building, installing the artwork in the public areas, installing a new copper roof, re-gilding the dome, replacing windows, and connecting electrical lines throughout. Electrician H. Frazer had been working that morning in Committee Room Number Five behind the House Chamber, drilling into the walls to run electrical wires and using a candle to light his way. The investigating committee determined that Frazer had left his work area and had neglected to extinguish his candle. The initial fire alarm sounded at approximately 10 a.m. Many citizen volunteers came to help the fire department. Capitol employees and state officials also assisted in fighting the fire, including Governor Albert Cummins. The fire was finally brought under control around 6 p.m., although some newspaper accounts at the time reported that the fire continued smoldering for several days. Crampton Linley was the engineer working with the Capitol Improvement Commission. He was in the building at the time of the fire and was credited with saving the building. Linley crawled through attic areas to close doors separating wings of the Capitol, an action which smothered the flames and brought the fire under control. Sadly, Linley did not live long enough to be recognized for his heroism. The day after the fire, while examining the damage, Linley fell through the ceiling of the House Chamber and died instantly from severe head injuries. The flames had burned through the ceiling and caused much of it to collapse to the floor below, while the lower areas of the building had been damaged by smoke and water. Elmer Garnsey was the artist hired by the Capitol Improvement Commission to decorate the public areas of the building. Therefore, he seemed the logical candidate to be given the additional responsibility of redecorating the areas damaged by the fire. Garnsey had a very different vision for the decoration, which is why the House Chamber, the old Supreme Court Room, and the old Agriculture offices directly below the House Chamber have a design that is very different from the areas of the building untouched by the fire.

Load Ratings for Standard Bridges, HR-239 Phase IV, 2008

In this report, sixteen secondary and primary bridge standards for two types of bridges are rated for AASHTO HS20-44 vehicle configuration utilizing Load Factor methodology. The ratings apply only to those bridges which: (1) are built according to the applicable bridge standard plans, (2) have no structural deterioration or damage, and (3) have no added wearing surface in excess of one-half inch integral wearing surface.

Load Ratings for Standard Bridges, HR-239 Phase III, 1998

In this report, 25 secondary bridge standards for three types of bridges are rated for the AASHTO HS20-44 vehicle configuration and five typical Iowa legal vehicles. The ratings apply only to those bridges which: (1) are built according to the applicable bridge standard plans, (2) have no structural deterioration or damage, and (3) have no added wearing surface in excess of 0.5-in. (1.27-cm) integral wearing surface. Appendix A contains the results of the original October 1982 report on load ratings for standard bridges.

ISBN (international standard book number) -an international perspective

Esitelmä Suomen ISBN-keskus 30 vuotta -juhlassa Helsingin yliopistossa 7.11.2002

R functions for quantifying nonindependence in standard dyadic and SRM designs

Interdependence is the main feature of dyadic relationships and, in recent years, various statistical procedures have been proposed for quantifying and testing this social attribute in different dyadic designs. The purpose of this paper is to develop several functions for this kind of statistical tests in an R package, known as nonindependence, for use by applied social researchers. A Graphical User Interface (GUI) is also developed to facilitate the use of the functions included in this package. Examples drawn from psychological research and simulated data are used to illustrate how the software works.