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IntroductionWe aimed to describe baseline amyloid-beta (Aβ) and tau-positron emission tomograrphy (PET) from Longitudinal Early-onset Alzheimer's Disease Study (LEADS), a prospective multi-site observational study of sporadic early-onset Alzheimer's disease (EOAD).MethodsWe analyzed baseline [18F]Florbetaben (Aβ) and [18F]Flortaucipir (tau)-PET from cognitively impaired participants with a clinical diagnosis of mild cognitive impairment (MCI) or AD dementia aged

Background: Interest in cardiac electrophysiology is increasing in sub-Saharan Africa, but the interpretation of results is poorly understood. Cardiac electrophysiology is the study of electrical activity of the heart by virtue of catheters that are positioned in the heart, as opposed to leads placed on the chest surface. It is useful in identifying sites of origin of various cardiac arrhythmias, diagnosing conduction abnormalities and treating various arrhythmias. Material and method: This study is a review of cardiac electrophysiology methods. It aims to help physicians understand and interpret cardiac electrophysiology reports.

The paper describes an algorithm to differentiate leads from sea ice using the dual polarization synthetic aperture radar (SAR) data from the Sentinel-1 satellite in an extrawide swath mode. The algorithm uses the polarimetric features of the sea surface signal obtained in the SAR images: the ratio between co- and cross-polarization. A technique is proposed for classifying the SAR images to identify discontinuities (cracks, leads) in drifting sea ice using the ratio and difference of polarizations together with texture features and the neural network implementation. The method was tested using the satellite data obtained over the Arctic seas in the Russian Federation. [ABSTRACT FROM AUTHOR]

Patients with early-onset Alzheimer's disease (EOAD) are commonly excluded from large-scale observational and therapeutic studies due to their young age, atypical presentation, or absence of pathogenic mutations. The goals of the Longitudinal EOAD Study (LEADS) are to (1) define the clinical, imaging, and fluid biomarker characteristics of EOAD; (2) develop sensitive cognitive and biomarker measures for future clinical and research use; and (3) establish a trial-ready network. LEADS will follow 400 amyloid beta (Aβ)-positive EOAD, 200 Aβ-negative EOnonAD that meet National Institute on Aging-Alzheimer's Association (NIA-AA) criteria for mild cognitive impairment (MCI) or AD dementia, and 100 age-matched controls. Participants will undergo clinical and cognitive assessments, magnetic resonance imaging (MRI), [18 F]Florbetaben and [18 F]Flortaucipir positron emission tomography (PET), lumbar puncture, and blood draw for DNA, RNA, plasma, serum and peripheral blood mononuclear cells, and post-mortem assessment. To develop more effective AD treatments, scientists need to understand the genetic, biological, and clinical processes involved in EOAD. LEADS will develop a public resource that will enable future planning and implementation of EOAD clinical trials.

The clinical utility of the Apple Inc.® smartwatch in scenarios beyond detecting atrial fibrillation has been debated. Although the device has the capability to record electrocardiograms (ECG) and detect arrhythmias, voltage limitations hinder its accuracy in measuring real voltage when recording precordial leads. This limitation poses challenges for its clinical use in diagnosing ischemia and screening cardiomyopathies. This review aims to analyze the ECG recording capacity of the Apple Watch, investigate the reasons for voltage limitations, and explore alternative approaches for its use in these clinical scenarios. A comprehensive literature review was conducted to examine the ECG recording capacity of the Apple Watch and the limitations encountered when recording precordial leads. Data in CSV format files were analyzed to gain insights into the underlying causes of voltage limitations. The Apple Watch demonstrates effectiveness in detecting cardiac arrhythmias such as atrial fibrillation using photoplethysmography and ECG recording. However, voltage limitations during precordial lead recordings impede accurate voltage measurement, thereby limiting its clinical utility. Analysis of the data stored in the CSV files revealed that these voltage limitations are primarily attributed to the presentation format. Exploring alternative approaches for data processing could potentially overcome this challenge. This review highlights the potential for addressing voltage limitations through alternative data processing approaches. Further research is necessary to identify suitable alternatives that enable the Apple Watch to be effectively utilized in these clinical scenarios. • The Apple Watch has demonstrated the capability to record ECGs from a single lead and detect atrial fibrillation using photoplethysmography. • Strategically placing the smartwatch on body parts allows recording up to 9 leads, mimicking a standard ECG's morphology. • The device's format limits voltage in precordial leads, leading to inaccuracies and reducing its clinical utility. • This review analyzes Apple Watch's ECG recording capacity and CSV file utilization to explore and mitigate this limitations. [ABSTRACT FROM AUTHOR]

Introduction: Naegleria fowleri is responsible for primary amebic meningoencephalitis (PAM) which has a fatality rate of >97%. Because of the rarity of the disease, pharmaceutical companies do not pursue new drug discovery for PAM. Yet, it is possible that the infection is underreported and finding a better drug would have an impact on people suffering from this deadly infection.Areas covered: This paper reports the efforts undertaken by different academic groups over the last 20 years to test different compounds against N. fowleri. The drug discovery research encompassed synthesis of new compounds, development and use of high-throughput screening methods and attempts to repurpose clinically developed or FDA-approved compounds for the treatment of PAM.Expert opinion: In absence of economic investment to develop new drugs for PAM, repurposing the FDA-approved drugs has been the best strategy so far to identify new leads against N. fowleri. Increasing use of high-throughput phenotypic screening has the potential to accelerate the identification of new leads, either in monotherapy or in combination treatment. Since phase II clinical trial is not possible for PAM, it is critical to demonstrate in vivo efficacy of a clinically safe compound to translate the discovery from lab to the clinic.

Russian Society of Cardiology (RSC)Developed with the special contribution of the Russian Functional Diagnostics Association, Russian Holter Monitoring and Non-invasive Electrophysiology Society, Russian Pediatric Cardiology Association.

A deep brain stimulator (DBS) device is a surgically implanted system that delivers electrical impulses to specific targets in the brain to treat abnormal movement disorders. A DBS is like a cardiac pacemaker, but instead of sending electrical signals to the heart, it sends them to the brain instead. When DBS leads and extension wires are exposed in the biological environment, this can adversely affect impedance and battery life, resulting in poor clinical outcomes. A posthumously extracted DBS device was evaluated using visual inspection and optical microscopy as well as electrical and mechanical tests to quantify the damage leading to its impairment. The implantable pulse generator (IPG) leads, a component of the DBS, contained cracks, delamination, exfoliations, and breakage. Some aspects of in vivo damage were observed in localized areas discussed in this paper. The duration of the time in months that the DBS was in vivo was estimated based on multiple regression analyses of mechanical property testing from prior research of pacemaker extensions. The test results of three DBS extensions, when applied to the regressions, were used to estimate the in vivo duration in months. This estimation approach may provide insight into how long the leads can function effectively before experiencing mechanical failure. Measurements of the extension coils demonstrated distortion and stretching, demonstrating the changes that may occur in vivo. These changes can alter the impedance and potentially reduce the effectiveness of the clinical treatment provided by the DBS system. Ultimately, as both DBSs and pacemakers use the same insulation and lead materials, the focus of this paper is to develop a proof of concept demonstrating that the mechanical properties measured from pacemaker extensions and leads extracted posthumously of known duration, measured in months while in vivo, can be used to predict the duration of DBS leads of unknown lifespan. The goal is to explore the validity of the proposed model using multiple regression of mechanical properties. [ABSTRACT FROM AUTHOR]

Abstract Background The standard configuration’s set of twelve electrocardiogram (ECG) leads is optimal for the medical diagnosis of diverse cardiac conditions. However, it requires ten electrodes on the patient’s limbs and chest, which is uncomfortable and cumbersome. Interlead conversion methods can reconstruct missing leads and enable more comfortable acquisitions, including in wearable devices, while still allowing for adequate diagnoses. Currently, methodologies for interlead ECG conversion either require multiple reference (input) leads and/or require input signals to be temporally aligned considering the ECG landmarks. Methods Unlike the methods in the literature, this paper studies the possibility of converting ECG signals into all twelve standard configuration leads using signal segments from only one reference lead, without temporal alignment (blindly-segmented). The proposed methodology is based on a deep learning encoder-decoder U-Net architecture, which is compared with adaptations based on convolutional autoencoders and label refinement networks. Moreover, the method is explored for conversion with one single shared encoder or multiple individual encoders for each lead. Results Despite the more challenging settings, the proposed methodology was able to attain state-of-the-art level performance in multiple target leads, and both lead I and lead II seem especially suitable to convert certain sets of leads. In cross-database tests, the methodology offered promising results despite acquisition setup differences. Furthermore, results show that the presence of medical conditions does not have a considerable effect on the method’s performance. Conclusions This study shows the feasibility of converting ECG signals using single-lead blindly-segmented inputs. Although the results are promising, further efforts should be devoted towards the improvement of the methodologies, especially the robustness to diverse acquisition setups, in order to be applicable to cardiac health monitoring in wearable devices and less obtrusive clinical scenarios.

Post-market evaluation is important to ensure the ongoing safety and effectiveness of cardiovascular implantable electronic device (CIED) leads. The Twenty-First Century Cures Act and subsequent Food and Drug Administrative (FDA) Guidance provide an opportunity to leverage real-world data sources for this purpose. The past 4 years have seen the development of EP PASSION: a multi-stakeholder, collaborative effort between the FDA, CIED manufacturers, Heart Rhythm Society, and academics. Using real-world data, EP PASSION enables longitudinal evaluation of the long-term safety of CIED leads, addressing limitations of current approaches to generate evidence that informs regulatory, clinical, and manufacturer decision-making. This state of the art article describes the impetus for and launch of EP PASSION, the lessons learned, its current state, the current analytic approach, and the strengths and limitations of leveraging extant data sources for post-market lead evaluation. We also compare EP PASSION to traditional post-approval studies and describe possible future directions. [ABSTRACT FROM AUTHOR]

In winter 2013, a sea ice breakout in the Beaufort Sea produced extensive fracturing and contributed to record ice export. Rheinlænder et al. (2022, https://doi.org/10.1029/2022GL099024) simulated this event using the neXtSIM sea ice model, reproducing a realistic progression of lead opening and ice drift following the track of an anticyclone. Their simulations indicate strong winds and thin ice are key factors in breakouts. We discuss observational records giving additional insight into the mechanisms controlling breakout events, including the role of wind direction. Breakouts are common and have occurred under weaker winds than in 2013 and in thicker ice of previous decades. During 2013 and other events, patterns of lead opening during breakout followed changes in wind direction relative to the coast with anticyclone position. For skillful predictions of future breakouts, models must reproduce this behavior, and their performance should be assessed across a range of wind and ice conditions. Plain Language Summary: In winter, the Beaufort Sea is covered by a layer of sea ice that is usually frozen against the southern and eastern coastlines that bound the sea. When winds continuously blow from east to west away from these boundaries, the ice cover can tear apart and rapidly drift away from the coasts in what is called a breakout event. The prediction of such dynamic events is important for those who navigate the region. Rheinlænder et al. (2022, https://doi.org/10.1029/2022GL099024) recently used the neXtSIM sea ice model to simulate realistic ice cracking and drift during an exceptionally strong breakout that occurred in 2013. The authors highlighted strong winds and thin sea ice as key factors for breakout. We use observational records to provide additional insight into processes during Beaufort breakouts. Records of many similar events demonstrate that breakouts are common under weather patterns that produce east‐to‐west winds, even for weaker winds and thicker ice than in 2013. Across observed events, wind direction influences sea ice fracturing patterns and breakout timing. To ensure that model predictions of future sea ice breakouts are accurate, simulations should be compared against observations of multiple recorded events that span a range of wind and ice conditions. Key Points: Observational data provide context for a 2013 Beaufort Sea (BS) breakout simulated with the neXtSIM model by Rheinlænder et al. (2022, https://doi.org/10.1029/2022GL099024)While the 2013 event was exceptional, winter sea ice breakout is common under anticyclonic winds including in years with thicker ice packsWind direction relative to the coast influences the timing and location of lead opening during breakout in the BS [ABSTRACT FROM AUTHOR]

The aim of the present research paper was to evaluate the main electrocardiogram parameters in goat. The electrocardiograms were performed on a batch of 20 Carpathian goats, using the Dubois lead system. By analysing the results obtained, we concluded that, using the Dubois lead system, the best method of performing the electrocardiogram in goats is using lead II, the amplitude values being 0.117 mV for the P wave, 0.310 mV for the ventricular complex and 0.386 mV for the T wave, while lead I is not suitable for the EKG exam in this species, due to the extremely low waves’ amplitude, resulting in an almost obscure recording. Regarding the duration of the electrocardiographic waves, the values obtained were 0.048±0.016 seconds for the P wave, 0.046±0.014 seconds for the QRS complex and 0.088±0.016 seconds for the T wave. As for the segments and intervals, the durations obtained were 0.062±0.020 seconds for the P-R segment, 0.246±0.014 seconds for the Q-T interval, 0.384±0.037 seconds for the P-T interval and 0.096±0.020 seconds for the T-P segment. The heart rate, electrographically calculated, was 128.5 bpm ± 12.215. [ABSTRACT FROM AUTHOR]

Background: The standard configuration's set of twelve electrocardiogram (ECG) leads is optimal for the medical diagnosis of diverse cardiac conditions. However, it requires ten electrodes on the patient's limbs and chest, which is uncomfortable and cumbersome. Interlead conversion methods can reconstruct missing leads and enable more comfortable acquisitions, including in wearable devices, while still allowing for adequate diagnoses. Currently, methodologies for interlead ECG conversion either require multiple reference (input) leads and/or require input signals to be temporally aligned considering the ECG landmarks.Methods: Unlike the methods in the literature, this paper studies the possibility of converting ECG signals into all twelve standard configuration leads using signal segments from only one reference lead, without temporal alignment (blindly-segmented). The proposed methodology is based on a deep learning encoder-decoder U-Net architecture, which is compared with adaptations based on convolutional autoencoders and label refinement networks. Moreover, the method is explored for conversion with one single shared encoder or multiple individual encoders for each lead.Results: Despite the more challenging settings, the proposed methodology was able to attain state-of-the-art level performance in multiple target leads, and both lead I and lead II seem especially suitable to convert certain sets of leads. In cross-database tests, the methodology offered promising results despite acquisition setup differences. Furthermore, results show that the presence of medical conditions does not have a considerable effect on the method's performance.Conclusions: This study shows the feasibility of converting ECG signals using single-lead blindly-segmented inputs. Although the results are promising, further efforts should be devoted towards the improvement of the methodologies, especially the robustness to diverse acquisition setups, in order to be applicable to cardiac health monitoring in wearable devices and less obtrusive clinical scenarios. [ABSTRACT FROM AUTHOR]

Sea ice leads, or fractures account for a small proportion of the Arctic Ocean surface area, but play a critical role in the energy and moisture exchanges between the ocean and atmosphere. As the sea ice area and volume in the Arctic has declined over the past few decades, changes in sea ice leads have not been studied as extensively. A recently developed approach uses artificial intelligence (AI) and satellite thermal infrared window data to build a twenty-year archive of sea ice lead detects with Moderate Resolution Imaging Spectroradiometer (MODIS) and later, an archive from Visible Infrared Imaging Radiometer Suite (VIIRS). The results are now available and show significant improvement over previously published methods. The AI method results have higher detection rates and a high level detection agreement between MODIS and VIIRS. Analysis over the winter season from 2002–2003 through to the 2021–2022 archive reveals lead detections have a small decreasing trend in lead area that can be attributed to increasing cloud cover in the Arctic. This work reveals that leads are becoming increasingly difficult to detect rather than less likely to occur. Although the trend is small and on the same order of magnitude as the uncertainty, leads are likely increasing at a rate of 3700 km2 per year with a range of uncertainty of 3500 km2 after the impact of cloud cover changes are removed. [ABSTRACT FROM AUTHOR]

Abstract Bikaner–Nagaur basin is located in the northwestern part of India and lies on the rising flank of Punjab platform of Middle Indus basin in Pakistan. Existence of Neoproterozoic-Cambrian petroleum system was confirmed by the exploration activities in the western periphery of the basin, whereas vast areas of central and eastern parts remain unexplored. Knowledge of petroleum system in this unexplored part of the basin is limited due to non-availability of data. Recently, 2525 line km of regional 2D seismic data acquired for the first time by Government of India under National Seismic Program (NSP) unlocks the opportunity for comprehensive understanding of subsurface geology in unexplored part of the basin. Present work aims to interpret recently acquired 2D seismic data and integrate with available surface (outcrop) data, gravity and well data (drilled in western part of basin) for unfolding the petroleum system elements, structural configurations and stratigraphic features in the hitherto central-eastern part of the basin. Two Neoproterozoic-Cambrian hydrocarbon plays: (1) Jodhpur and (2) overlying Bilara/Hanseran Evaporite Group (HEG) were envisaged. Both the plays depicted distinctive seismic characteristics, structural alignment and distribution of reservoir, source and seal. Fluvio-deltaic sandstone within Jodhpur group and shallow marine fractured dolomites within Bilara/HEG showed potential reservoir characteristics whereas organic rich laminated dolomites, stromatolites and argillaceous litho-units within Bilara/HEG group have been predicted as prospective source. The Halite layers within HEG group were considered as effective regional seals. Fault bounded anticlinal structures associated with Cambrian compression have been identified as the main entrapment for hydrocarbon accumulation. The basin witnessed long tectonostratigraphic history with two major compressional phases Structures formed by Cambrian compression are likely to be charged as the time of source maturity and peak expulsion was later, during early Mesozoic period. Overall, the study indicates new opportunities and potential accumulation of hydrocarbon in the unexplored part of the basin.

Bikaner–Nagaur basin is located in the northwestern part of India and lies on the rising flank of Punjab platform of Middle Indus basin in Pakistan. Existence of Neoproterozoic-Cambrian petroleum system was confirmed by the exploration activities in the western periphery of the basin, whereas vast areas of central and eastern parts remain unexplored. Knowledge of petroleum system in this unexplored part of the basin is limited due to non-availability of data. Recently, 2525 line km of regional 2D seismic data acquired for the first time by Government of India under National Seismic Program (NSP) unlocks the opportunity for comprehensive understanding of subsurface geology in unexplored part of the basin. Present work aims to interpret recently acquired 2D seismic data and integrate with available surface (outcrop) data, gravity and well data (drilled in western part of basin) for unfolding the petroleum system elements, structural configurations and stratigraphic features in the hitherto central-eastern part of the basin. Two Neoproterozoic-Cambrian hydrocarbon plays: (1) Jodhpur and (2) overlying Bilara/Hanseran Evaporite Group (HEG) were envisaged. Both the plays depicted distinctive seismic characteristics, structural alignment and distribution of reservoir, source and seal. Fluvio-deltaic sandstone within Jodhpur group and shallow marine fractured dolomites within Bilara/HEG showed potential reservoir characteristics whereas organic rich laminated dolomites, stromatolites and argillaceous litho-units within Bilara/HEG group have been predicted as prospective source. The Halite layers within HEG group were considered as effective regional seals. Fault bounded anticlinal structures associated with Cambrian compression have been identified as the main entrapment for hydrocarbon accumulation. The basin witnessed long tectonostratigraphic history with two major compressional phases Structures formed by Cambrian compression are likely to be charged as the time of source maturity and peak expulsion was later, during early Mesozoic period. Overall, the study indicates new opportunities and potential accumulation of hydrocarbon in the unexplored part of the basin. [ABSTRACT FROM AUTHOR]

Knowledge of the wintertime sea-ice production in Arctic polynyas is an important requirement for estimations of the dense water formation, which drives vertical mixing in the upper ocean. Satellite-based techniques incorporating relatively high resolution thermal-infrared data from MODIS in combination with atmospheric reanalysis data have proven to be a strong tool to monitor large and regularly forming polynyas and to resolve narrow thin-ice areas (i.e., leads) along the shelf-breaks and across the entire Arctic Ocean. However, the selection of the atmospheric data sets has a large influence on derived polynya characteristics due to their impact on the calculation of the heat loss to the atmosphere, which is determined by the local thin-ice thickness. In order to overcome this methodical ambiguity, we present a MODIS-assisted temperature adjustment (MATA) algorithm that yields corrections of the 2 m air temperature and hence decreases differences between the atmospheric input data sets. The adjustment algorithm is based on atmospheric model simulations. We focus on the Laptev Sea region for detailed case studies on the developed algorithm and present time series of polynya characteristics in the winter season 2019/2020. It shows that the application of the empirically derived correction decreases the difference between different utilized atmospheric products significantly from 49% to 23%. Additional filter strategies are applied that aim at increasing the capability to include leads in the quasi-daily and persistence-filtered thin-ice thickness composites. More generally, the winter of 2019/2020 features high polynya activity in the eastern Arctic and less activity in the Canadian Arctic Archipelago, presumably as a result of the particularly strong polar vortex in early 2020. [ABSTRACT FROM AUTHOR]

The main aspects of electronic processes in a pandemic, their features are considered in the article origin, existence and application, the world economy is studied in a pandemic. The impact of quarantine restrictions, both in Ukraine and in other countries of the world, have left their mark on economic performance of the enterprise, its efficiency, sales, and this all might not have affected the main macroeconomic indicators of the country. But, at this time, on economic space the startups come out with a fundamentally new look at economic processes and become successful precisely due to the scale of pandemics. A striking example of such an enterprise is a company which brought Zoom program to the market and has a daily audience of more than 10 million consumers. It should be noted that business processes are massively moving to the on-line space and use email marketing tools. In this regard, marketers and analysts are constantly improving their skills in using programs such as Google Analytics, Apps Advertising when setting up ads on social networks Fb and Instagram, Pixel Fb, Ads Manager, UTM tags and others. With the growing demand for the quality and number of offered functions, these programs are constantly updated and improving, meeting the needs of the market and leading the competition in this niche. Advertising companies of manufacturers and sellers of services / products massively moved to the Internet space. Due to the massive transition to on-line consumers, who, being at home, can visit on-line shops and make purchases thanks to electronic bank cards. Increase in advertising costs in 2020 has grown significantly. The use of targeted advertising (targeting) allowed us to optimize the advertising costs and narrow down ad impressions only to the selected target audience. The possibilities of detailed targeting in Fb allowed us to reach the target audience anywhere in the world or on a neighboring street, that is, such advertising can be global as well as and local. Thanks to this, you can optimally determine the budget of the advertising company, change advertising costs depending on the effectiveness of the advertising company, as well as calculate КРІ. This is possible thanks to the functions which provide analytical Internet systems: tracking the number of leads and conversions for each advertising company.

We analyzed data on the spatial distribution (density) of large breaks (gaps) in the drifting sea ice cover in the Western Arctic for the period from October 2005 to September 2017, obtained through decoding of lowresolution images from the NOAA satellites. The specific length of gaps, which is the total length of them over an area of 1 km2, is used as a characteristic of the spatial density. It was found that along the continental slope, approximately from the meridian 70° E to the Lincoln Sea, there is a well-defined area of high density, which remains throughout most part of the ice cycle. In this area, the values of the specific gap length averaged over two-month periods exceeded 24 m/km2. In the near-polar region, the density of breaks was smaller throughout the whole ice cycle. The least values of the specific length take place in May–June that is caused by changes in the general state of the ice cover. It was determined that the density of gaps in this area of the Arctic basin well correlated with the speed of wind drift of ice: the more intensive the drift, the larger the density. On the continental slope, two local zones with maximum values of the specific length of breaks reaching 32 m/km2 are considered. It is suggested that the stability of their location in space and time is connected with the increased influence of tidal processes on the deformation of the ice cover over local bottom elevations on the continental slope. A correlation between the bottom profile and the values of the specific length of the gaps along two conditional lines passing through the maximum value zones did show that the largest values of the density are noticed in areas with significant gradients of the depth.

The article develops the theoretical and methodological principles of messenger marketing, forms its scheme and proposes the main stages for use in the practice of business entities. It is noted that messenger marketing has become a trend in recent years and involves the use of messenger tools to better interact with the target audience to promote the company or its products and services. As a messenger tool, you can consider a wide selection of content that should be sent to users: videos, images, texts, animations, etc. In Ukraine, the most popular messengers are Viber, Facebook Messenger, Skype, Telegram, WhatsApp and others. A messenger marketing scheme has been developed, which includes processes in the sales department, processes in messengers and traffic channels. The processes in the sales departments of the companies are defined, which include the construction of the CRMsystem and the payment system, the site and the work of the sales managers. The main processes in messengers - funnels, chatbots and mailings are considered and given a brief description. The main stages for effective use of messenger marketing in practice are proposed, including the choice of messengers for communication with customers, the choice of a platform that will help automate communication, as well as collect data and segment and connect to this platform, integration of messengers with CRM-system. The main tasks of messenger marketing are defined: automation and optimization of managers' work, which makes it possible to minimize the response time to the application, qualification of potential customers (leads), optimization of advertising costs. The next step in solving this problem should be to reach a new level of communication with customers through messenger marketing. In the future, CRM-marketing is worth to be emphasized, when different channels and CRM-systems work, chatbots are created, which are actively beginning to integrate. [ABSTRACT FROM AUTHOR]

Due to genetic and epigenetic mechanisms, cancer have become a resistant disease and there is a need for new molecules having multiple targeting action that promotes apoptosis. Phyto-molecules having multiple targeting anticancer activity are in high demand and there is less documentation or information available on these metabolites. It is evident that mushrooms are became the store houses of new anticancer molecules and mushrooms like Agaricus blazei, Antrodia camphorate, Albatrellus confluens, Bolteus badius, Cordyceps militaris, Clitocybe maxima, Funalia trogii, Grifola frondosa, and Inocybe umbrinella, are some of the medicinal mushrooms reported for their cytotoxic activity. Cytotoxic molecules like lentinan, grifolin, illudin-S, psilocybin, ganoderic acid, theanine, and hispolon, have been isolated from various mushroom species. However, studies have been limited only to in vitro cytotoxic mechanisms and very few trials have been conducted to prove the clinical efficacy of these drug leads. Hence, the current review focuses on new anticancer metabolites isolated from various mushrooms having multiple targeting mechanisms in cancer. However, an extensive research is needed to define the biosynthesis and clinical mechanism of these multiple acting metabolites. This review provides a platform for researchers new anticancer drugs and to bring out potent multiple acting anticancer newer drugs.

Pacemakers, implantable cardiac defibrillators, and cardiac resynchronization therapy devices are potentially lifesaving treatments for a number of cardiac conditions but are not without risk. Most concerning is the risk of a cardiac implantable electronic device (CIED) infection, which is associated with significant morbidity, increased hospitalizations, reduced survival, and increased health care costs. Recommended preventive strategies such as administration of intravenous antibiotics before implantation are well-recognized. Uncertainties have remained about the role of various preventive, diagnostic, and treatment measures such as skin antiseptics, pocket antibiotic solutions, antibacterial envelopes, prolonged antibiotics post-implantation, and others. When compared with previous guidelines or consensus statements, the present consensus document gives guidance on the use of novel device alternatives, novel oral anticoagulants, antibacterial envelopes, prolonged antibiotics post-implantation, as well as definitions on minimum quality requirements for centres and operators and volumes. The recognition that an international consensus document focused on management of CIED infections is lacking, the dissemination of results from new important randomized trials focusing on prevention of CIED infections, and observed divergences in managing device-related infections as found in an European Heart Rhythm Association worldwide survey, provided a strong incentive for a Novel 2019 International State-of-the-art Consensus document on risk assessment, prevention, diagnosis, and treatment of CIED infections. [ABSTRACT FROM AUTHOR]

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Despite accounting for a small fraction of the surface area in the Arctic, long and narrow sea ice fractures, known as “leads”, play a critical role in the energy flux between the ocean and atmosphere. As the volume of sea ice in the Arctic has declined over the past few decades, it is increasingly important to monitor the corresponding changes in sea ice leads. A novel approach has been developed using artificial intelligence (AI) to detect sea ice leads using satellite thermal infrared window data from the Moderate Resolution Imaging Spectroradiometer (MODIS) and the Visible Infrared Imaging Radiometer Suite (VIIRS). In this new approach, a particular type of convolutional neural network, a U-Net, replaces a series of conventional image processing tests from our legacy algorithm. Results show the new approach has a high detection accuracy with F1 Scores on the order of 0.7. Compared to the legacy algorithm, the new algorithm shows improvement, with more true positives, fewer false positives, fewer false negatives, and better agreement between satellite instruments.

Lead Farmer Centered Extension Advisory and Delivery Services (LEADS) is a pilot extension project revolving around lead farmer – satellite farmer concept on an Agro Ecological Zone basis within in a district. Presently LEADS Project is being implemented in four districts of Kerala, namely Kollam, Palakkad, Kannur and Wayanad. The present study was conducted in the Kollam and Palakkad districts of Kerala. The study aimed to compare Social capital formed in Kollam and Palakkad districts as an impact of LEADS project. From the study conducted, it was clear that the social capital formed was found to be more in Kollam than in Palakkad district.

Due to genetic and epigenetic mechanisms, cancer have become a resistant disease and there is a need for new molecules having multiple targeting action that promotes apoptosis. Phyto-molecules having multiple targeting anticancer activity are in high demand and there is less documentation or information available on these metabolites. It is evident that mushrooms are became the store houses of new anticancer molecules and mushrooms like Agaricus blazei, Antrodia camphorate, Albatrellus confluens, Bolteus badius, Cordyceps militaris, Clitocybe maxima, Funalia trogii, Grifola frondosa, and Inocybe umbrinella, are some of the medicinal mushrooms reported for their cytotoxic activity. Cytotoxic molecules like lentinan, grifolin, illudin-S, psilocybin, ganoderic acid, theanine, and hispolon, have been isolated from various mushroom species. However, studies have been limited only to in vitro cytotoxic mechanisms and very few trials have been conducted to prove the clinical efficacy of these drug leads. Hence, the current review focuses on new anticancer metabolites isolated from various mushrooms having multiple targeting mechanisms in cancer. However, an extensive research is needed to define the biosynthesis and clinical mechanism of these multiple acting metabolites. This review provides a platform for researchers new anticancer drugs and to bring out potent multiple acting anticancer newer drugs. [ABSTRACT FROM AUTHOR]

Background: Implantable cardioverter-defibrillators (ICDs) use low-voltage measures of shock impedance (LVSZ) to monitor integrity of leads.Objective: To determine the separation distance between conductors required for LVSZ to detect insulation breaches that produce short circuits during shocks, causing failed defibrillation.Methods: We simulated in-pocket insulation breaches between the ICD generator (CAN) and cables to the distal coil of 10 leads from 2 manufacturers. The ICD and lead were placed in an electrolyte bath. Polystyrene sheets were used to control the breach-CAN separation. We determined both the maximum lead-CAN separation for shorts during 800 V shocks and the shock strength at which shorts occurred for a fixed separation. We also calculated breach impedance and measured it using a low-voltage instrument.Results: The maximum breach-CAN separation for shorting was 350-500 μm for all leads. The minimum shock strength to short varied from 650 to 771 V (24-32 J). LVSZ never triggered a warning, even with no separation between the cable's inner insulation and the CAN. Using low-voltage pulses, breach impedance was measured at approximately 500-1000 Ω.Conclusion: LVSZ is insensitive to insulation breaches that cause life-threatening, shorted shocks. The explanation likely relates to impedance differences between ionic conduction during LVSZ measurements and free-electron conduction in plasma discharges. [ABSTRACT FROM AUTHOR]

The aim of this research was to determine in which areas of the bovine body surface the electrodes should be placed to record T waves with stable polarity and morphology by using bipolar and unipolar leads to detect alterations in the conduction of the ventricular repolarization impulse. One hundred animals of both sexes from different age groups were used. Each T-wave form was numerically coded and its polarity was classified. Sixteen different forms of T waves were observed, presenting four types of polarity: positive, negative, biphasic +/- and biphasic -/+. In the bipolar shoulder lead IH, the T wave was largely negative or biphasic +/-; and it was positive or biphasic -/+ in the remaining bipolar leads. The T-wave was negative or in some cases biphasic +/- in the unipolar basal leads of the heart. Positive or biphasic polarity was always obtained in the apical leads -/+ and four to six different forms were recorded. It is concluded that, in the areas located towards the base or the apex of the heart, leads can be used originating electrocardiographic records with great stability in the polarity of the T wave and in which the quantity of different forms detected is very reduced, with great predominance of the pointed one, so that they become a very useful reference to diagnose the alterations in the conduction of the repolarization impulse through the cardiac ventricles. [ABSTRACT FROM AUTHOR]

Background: Internal insulation breaches (IBR) may result in implantable cardioverter-defibrillator lead failure and adverse clinical events. Concerns exist that the Durata lead may be prone to IBR.Objective: The goals of this study were to assess Durata failures in the Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database and compare them to failures in MAUDE for Endotak Reliance and Sprint Quattro Secure (QS) leads.Methods: We searched the MAUDE database from 2008 to 2018 for IBR and other failure modes. Included were explanted leads whose manufacturers found an insulation or conductor defect not caused by extrinsic factors.Results: The MAUDE search found 1011 qualifying leads. The cause of failure differed among leads (P < .001). The primary cause of Durata failure was IBR (293 of 316 leads [93%]), with IBR accounting for 47% (137 of 293); few QS (9 of 523 [1.7%]) and no Endotak Reliance leads failed because of IBR (P < .001). Durata IBR were responsible for 11 failures to treat ventricular tachycardia/ventricular fibrillation, and all were caused by high-voltage (HV) shorts between the proximal superior vena cava coil and a distal right ventricular coil cable (n = 10) or sensing conductor (n = 1); low values of HV impedance were found in these leads during defibrillation threshold testing (n = 3), after a shock or aborted shock (n = 7), and by an alert (n = 1). Inappropriate therapy was caused by 51 Durata IBR, but no QS IBR.Conclusion: Durata implantable cardioverter-defibrillator leads are susceptible to IBR that may result in failure to treat ventricular tachycardia/ventricular fibrillation or inappropriate therapy; such failures may occur without forewarning. HV testing of Durata leads may be indicated during pulse generator replacement or when an insulation defect is suspected. [ABSTRACT FROM AUTHOR]

Aims: Lead perforation is a rare, well-known complication of cardiac implantable electronic device (CIED) implants, whose management is mostly not evidence-based. Main management strategies include conservative approach based on clinical and lead function follow-up vs. routine invasive lead revision approach. This study compared the complications of both strategies by composite endpoint, including recurrent perforation-related symptoms, recurrent pericardial effusion (PEf), lead dysfunction, and device infection during 12 month follow-up.Methods and Results: Multicentre retrospective analysis, inquiring data from imaging studies, device interrogation, pericardiocentesis, and clinical charts of patients with suspected perforating leads between 2007 and 2014 in five hospitals. All cases were reviewed by electrophysiologist and defined as definite perforations by suggestive symptoms along with lead perforation on imaging, bloody PEf on pericardiocentesis shortly after implant, or right ventricular (RV) lead non-capture along with diaphragmatic stimulation upon bipolar pacing. Clinical outcomes associated with both management approaches were compared, with respect to the composite endpoint. The study included 48 definitive perforation cases: 22 managed conservatively and 26 via lead revision. Conservative management was associated with an increased composite endpoint compared with lead revision (8/22 vs. 1/26; P = 0.007). The dominant complication among the conservative cohort was appearance of cardiac tamponade during follow-up; 5/6 occurring in cases which presented with no or only mild PEf and were treated by antiplatelets/coagulants during or shortly after CIED implantation.Conclusion: A conservative management of CIED lead perforation is associated with increased complications compared with early lead revision. Lead revision may be the preferred management particularly in patients receiving antiplatelets/coagulants. [ABSTRACT FROM AUTHOR]