Exploratory insights from the right-sided electrocardiogram following prolonged endurance exercise

Background: Prolonged strenuous exercise has a profound effect on cardiac function. The right heart may be more susceptible to this imposition; yet, right-sided chest leads have not been utilised in this setting. Methods: Thirty highly trained athletes at the 2014 Western States 100-mile Endurance Run from Squaw Valley to Auburn, California (body mass 68?±?12?kg, age 45?±?10?years, 57?±?15?miles per week) were recruited for the study. Pre- and post-race, a right-sided 12-lead ECG was obtained and data were extracted for P, R and S waves, J point, ST segment and T wave amplitude. Data were compared using Students T-test and statistical significance set as P?Results: There was a significant increase in P wave amplitude (29%) and QTc interval (4%) pre- to post-race from standard 12-lead ECG. From the right-sided12-lead ECG, a 23% (P?=?.01) and 38% (P?=?.03) increase in J point amplitude in V1R and V2R and a 22% (P?=?.05) increase in ST segment integral in V2R and V3R were evident. T wave inversion was evident in leads V2R–V6R in 50–90% of athletes, respectively. Close examination revealed marked heterogeneity in individual ECGs. Conclusions: Completion of a 100-mile ultra-marathon resulted in significant changes in the right-sided ECG alongside more marked responses in specific individuals. P wave, ST segment and T wave changes post-race are indicative of acute exercise-induced right heart electrical adaptation.     

Antagonistic effect of FePP on the ethanol mediated induction of hepatic, renal and splenic δ-amino levulinic acid synthase activityin vivo in rats

In the current study, we report perturbations in hepatic, renal and splenic heme synthesis at the level of the rate limiting enzyme, δ-amino levulinic acid synthase (ALA-S) on ethanol administration independently and in conjunction with iron-protoporphyrin (FePP) in male Wistar rats. Excessive ethanol administration (5 ml/kg bw) resulted in a significant induction of hepatic, splenic and renal ALA-S activity. Simultaneous administration of FePP (50 μmol/kg bw) reverted the observed induction response to a sharp decline. The features of the action of ethanol and FePP togetherin vivo, i.e. a substantial inhibition of ALA-S is suggestive of the beneficial effects of this formulation in acute attacks of porphyria.     

Evaluation of the Kirkwood approximation for the diffusivity of channel-confined DNA chains in the de Gennes regime

We use Brownian dynamics with hydrodynamic interactions to calculate both the Kirkwood (short-time) diffusivity and the long-time diffusivity of DNA chains from free solution down to channel confinement in the de Gennes regime. The Kirkwood diffusivity in confinement is always higher than the diffusivity obtained from the mean-squared displacement of the center-of-mass, as is the case in free solution. Moreover, the divergence of the local diffusion tensor, which is non-zero in confinement, makes a negligible contribution to the latter diffusivity in confinement. The maximum error in the Kirkwood approximation in our simulations is about 2% for experimentally relevant simulation times. The error decreases with increasing confinement, consistent with arguments from blob theory and the molecular-weight dependence of the error in free solution. In light of the typical experimental errors in measuring the properties of channel-confined DNA, our results suggest that the Kirkwood approximation is sufficiently accurate to model experimental data.     

Intergroup,Interpersonal, and Intercultural Nature of Patient–Provider Communication: A Comparison of IMG and USMG Physicians

Using communication accommodation theory as a framework, this study explores and compares communication patterns of international medical graduate (IMG) physicians and United States medical graduate (USMG) physicians in intergroup, interpersonal, and intercultural context. Given that every fourth doctor practicing medicine in the U.S. is an internationally trained physician (AMA-IMG, 2010) an examination of the influence on patient-provider communication involving IMG physician and comparison with USMG physician is warranted. In a national survey of IMG and USMG physicians, the participants self-reported their perceptions of communication behaviors they used during a medical interaction. Although no difference was found between IMG and USMG physicians use of communication accommodation strategies during medical interaction, IMG physicians reported practicing significantly more relational communication than their U.S. counterparts. USMG physicians reported greater difficulty in communication owing to differences in culture than IMG physicians. Implication of findings for patient-centered communication, patient-physician relationship, and communication skills training is discussed.     

Trajectory-based real-time control of an electrical circuit against unknown faults

This paper presents a trajectory-based online control reconfiguration mechanism against unknown fault occurring in an electric circuit. First, we demonstrate the modeling of an electric circuit by taking the time-trajectory viewpoint, where no a priori input–output partition has been made. The uniqueness of this viewpoint lies in the fact that it deals only with variables that describe the system without any dedicated (external or internal -type) representation. Subsequently, we illustrate a novel real-time fault-tolerant control (FTC) strategy based on this trajectory standpoint, which does not require an explicit model-based fault diagnosis unit. Instead, the controller is reconfigured directly based on the trajectories generated by the system in real-time, and the given control specifications. In this way, we efficiently excrete the shortcomings that are often seen in model-based fault-tolerant systems. The proposed FTC method is effectively demonstrated on an RLC circuit.     

C-Reactive Protein and Uric Acid Levels in Patients with Psoriasis

Serum CRP and uric acid levels were estimated in twenty-five patients with psoriasis (group III) before and after 12 weeks of treatment. Results were compared with a group of 25 normal subjects (group I) and a group of 25 patients of various skin diseases other than psoriatic lesion (group II). Mean value for CRP was found to be increased by more than 20 folds in patients with psoriasis, which was subsequently reduced to nearly 50% of the initial value after 12 weeks of treatment. These patients also showed hyperuricemia. Nearly 25% of these patients also exhibited arthritis. It is thus suggested that both CRP and uric acid levels should be monitored in patients with psoriasis.     

Extra Pulmonary Tuberculosis: A Diagnostic Dilemma

Tuberculosis remains a major public health problem globally, with India being one of the high burden countries. The common causative agent is Mycobacterium tuberculosis but in developing countries M. bovis is reported as a potential human pathogen. Almost 20% of all reported cases of tuberculosis are of extra pulmonary form of disease. Diagnosis of extra pulmonary tuberculosis (EPTB) is not always possible with conventional methods, due to the long time required and the paucibacillary nature of samples; hence the need of rapid molecular methods. A prospective study was conducted on 300 patients of EPTB over a period of 5 years. These patients were suspected cases of tubercular meningitis, tubercular ascites and tubercular lymphadenitis. Samples analyzed were cerebrospinal fluid, ascitic fluid and lymph node fine needle aspirate. A two step PCR targeting hup B gene was used. Clinical response to anti tubercular therapy (ATT) was taken as positive (gold standard). PCR for hup B gene was positive in 147 samples out of 155 ATT responders. Of these 85.71% were infected with M. tuberculosis, 9.52% with M. bovis alone and 4.76% showed co infection with both M.tb and M. bovis. The sensitivity and specificity of PCR was 90.32 and 94.48% respectively.