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During cardiac resynchronization therapy (CRT) pacemaker implantation in a 54-year-old female patient, removing the stylet resulted in repeated left ventricular (LV) lead dislodgment. Lead stability was achieved by retaining the stylet within the lead lumen. Two years after cardiac resynchronization therapy, a LV lead fracture near the connector pin occurred. The proximal lead segment was removed, and a new connector pin was attached. Two years after that, the same lead fractured in the right atrium with the stylet penetrating the lung. The LV lead and retained stylet were successfully extracted. LV lead dislodgment is a limitation of CRT, but using the retained stylet technique to achieve lead stability is potentially dangerous and is not recommended.
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Recovering a certain degree of mimicry after sacrifice of the facial nerve is a clinically recognized finding. The authors report a case of hemifacial reanimation suggesting a phenomenon of neurotization from muscle-to-nerve.
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The optimal pacing modality after atrioventricular junction (AVJ) ablation remains unclear. Herein, we describe the case of a heart failure patient who had AVJ ablation for chronic atrial fibrillation and received a cardiac resynchronization therapy defibrillator device. Because of the lack of clinical response to biventricular pacing, the device was revised with the addition of direct His bundle pacing, which resulted in significant improvement in functional status and left ventricular indices. This case illustrated direct His bundle pacing as an alternative for conventional biventricular pacing in some cardiac resynchronization therapy nonresponders who undergo AVJ ablation for atrial fibrillation and have an intact distal conduction system.
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Minimally invasive cardiac surgery techniques offer better cosmesis, quicker recovery and shorter hospital stay when compared to sternotomy. Large cardiac tumours have been traditionally resected via sternotomy to provide adequate surgical exposure, complete surgical resection and prevent tumour fragmentation. We describe a patient with advanced multiple sclerosis and wheelchair dependence with a massive obstructive left atrial tumour who underwent successful minimally invasive en bloc resection with an uncomplicated postoperative course.
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Automated microscopy image restoration, especially in Differential Interference Contrast (DIC) imaging modality, has attracted increasing attentions since it greatly facilitates long-term living cell analysis without staining. Although the previous work on DIC image restoration is able to restore the nuclei regions of living cells, it is still challenging to reconstruct the unnoticeable cytoplasm details in DIC images. In this paper, we propose to extract the tiny movement information of living cells in DIC images and reveal the hidden details in DIC images by magnifying the cells’ motion as well as attenuating the intensity variation from the background. From our restored images, we can clearly observe the previously-invisible details in DIC images. Experiments on two DIC image datasets show that the motion-based restoration method can reveal the hidden details of living cells. In addition, we demonstrate our restoration method can also be applied to other imaging modalities such as the phase contrast microscopy to enhance cells’ details. Furthermore, based on the pixel-level restoration results, we can obtain the object-level segmentation by leveraging a label propagation approach, providing promising results on facilitating the cell shape and behavior analysis. The proposed algorithm can be a software module to enhance the visualization capability of microscopes.
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A three-dimensional and highly porous polypyrrole (PPy) film was successfully coated onto a copper interdigital electrode (Cu-IDE) surface by electrospinning of soluble PPy nanoparticles. The chemical composition of PPy nanoparticles was analyzed using X-ray photoelectron spectroscopy (XPS) and fourier transform infrared spectroscopy (FT-IR). The Brunauer–Emmett–Teller (BET) analysis confirmed the porous nature of PPy nanoparticles. The field emission scanning electron microscopy (FE-SEM) images of polymer coated Cu-IDE revealed that PPy nanoparticles were assembled by electrical forces to form an outstanding honeycomb-like architecture. As a proof-of-concept demonstration of the functional properties of the electrospun PPy (Es-PPy) film, the polymer coated Cu-IDE was investigated as a sensing device for gas sensor. The as-prepared Es-PPy film proved to be a viable aliphatic amines sensing material with large response, low detection limit, fast response and good repeatability at a low operating temperature of 150°C. Moreover, the sensor demonstrated an extremely high sensitivity and selectivity to n-butylamine. The calibration sensitivity to n-butylamine is up to three orders of magnitude higher than that of other common aliphatic amines. The detection limit and linear range for determination of n-butylamine were 0.42ppm and 10.54-21.08ppm, respectively. Es-PPy gas sensor exhibited good repeatability with RSD≤8% at temperature ranges 90–200°C. The response of the Es-PPy sensor to n-butylamine was compared with electrochemically and drop coated sensors and found that it has an extremely higher response. Finally, the Es-PPy gas sensor was successfully applied to real well water sample analysis.
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Ceria is an important material for chemical conversion processes in catalysis. Its intrinsic properties as a reducible oxide can be exploited to achieve catalytic selectivity and activity. However, numerous phenomenological characteristics of ceria remain unknown and its active nature is ever slowly being unraveled. Well defined models of ceria (111) are an important way to systematically study these properties and take advantage of new in situ methods that require pristine materials that allow for the interrogation of the most fundamental traits of this material. The ceria-Ru(0001) model is now the most well studied model surface with numerous aspects of its preparation, atomic structure and reactivity studied by several groups. The preparation of CeOx structures oriented with a (111) surface termination can be achieved through molecular beam deposition, facilitating the growth of well-defined nanostructures, microparticles, and films on the Ru(0001) surface. The growth mechanism exploits the epitaxial relationship between CeOx and Ru to form a carpet mode of well oriented layers of OCeO. These models can be studied to unravel the atomic structure and the oxidation state (Ce4+ and Ce3+), as prepared and under redox conditions (reduction/oxidation) or with reaction using reactants (e.g., H2, methanol). Here, we present a discussion of these most recent observations pertaining to the growth mode, arrangement of atoms on the surface, characteristic chemical state, and redox chemistry of the CeOx-Ru surface. With insights from these studies we propose new strategies to further unravel the chemistry of ceria.
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The medial prefrontal cortex (mPFC) subserves complex cognition and is impaired by stress. Corticotropin-releasing hormone (CRH), through the CRH-receptor 1 (CRHR1), constitutes a key element of the stress response. However, its contribution to the effects of stress in the mPFC remains unclear.
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Trichinella pseudospiralis is one of the three species whose larvae do not encapsulate after muscle cell differentiation, and the only one infecting both mammals and birds. More than 40 years after its discovery, the epidemiology remains, at least in part, still enigmatic. The aim of this work was to reconsider the current knowledge on the T. pseudospiralis epidemiology by collecting the information available in the literature and in the website of the International Trichinella Reference Center. Over the last decade, there was an increasing number of reports of T. pseudospiralis due to the increased use of the digestion tests. T. pseudospiralis was detected in 18 mammalian species (3 species of Dasyuridae; 2 species of Muridae; 4 species of Canidae; 3 species of Felidae; 2 species of Mustelidae; 1 species of Procyonidae; 1 species of Ursidae; and swine) including humans, and 8 avian species (3 species of Accipitridae; 1 species of Cathartidae; 1 species of Corvidae; 1 species of Tytonidae; 2 species of Strigidae) for a total of 249 isolates from Asia, America, Australia, and Europe. In the European Union, T. pseudospiralis has been documented in 19 out of 28 countries. The zoonotic role of this parasite was documented in 128 persons with trichinellosis. The number of mammals tested for Trichinella spp. by digestion has been much higher than that of birds, thus the role played by birds in the epidemiology of T. pseudospiralis still needs to be elaborated in more detail. The results may suggest that T. pseudospiralis, allowing to make up for the lower prevalence than that of the encapsulated species in the host populations, uses a wider host range.
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We present the findings from a Dutch field study of a representative sample of 30 outsourcing deals totaling to more than 100 million Euro, where both customers, corresponding IT-outsourcing providers and their intermediaries (if present) participated. Of the 30 deals, 18 were successful. As the sample is representative for the 700 Dutch IT-outsourcing deals between 2007–2010, the Dutch success rate was about 60% at that time. The main objective of the study was to examine what made some a success and some a failure and how to influence the outcome if possible. From a number of well-known factors we investigated whether they discriminate between IT-outsourcing success and failure in the early phase of service delivery and determined their impact on the chance on a successful deal. We investigated controllable factors to increase the odds during sourcing and rigid factors as a warning sign before closing a deal.
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