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Intermediate-term mortality and incidence of ICD therapy in octogenarians after cardiac resynchronization therapy

Journal of Geriatric Cardiology 2014年第3期11卷 180-184页

作者： Heval Mohamed Kelli Faisal MMerchant Andenet Mengistu Mary Casey Michael Hoskins mikhael fel-chami Department of Medicine Emory University School of Medicine 1364 Clifton Road Atlanta GA 30322 USA Division of Cardiology Section of Electrophysiology Emory University School of Medicine Medical 0ffice Tower 550 Peachtree Street Atlanta GA 30308 USA Cardiology Clinical Databases Emory Healthcare 1364 Clifton Road F402 Atlanta GA 30322 USA Division of Cardiology Section of Electrophysiology Emory University School of Medicine 1364 Clifton Road Atlanta GA 30322 USA

Background Clinical outcomes of cardiac resynchronization therapy （CRT） in patients over the age of 80 have not been well *** retrospectively identified 96 consecutive patients≥ 80 years old who underwent an initial implant or an upgrade to CRT, with or without defibrillator （CRT-Dvs. CRT-P）, at our institution between January 2003 and July 2008. The control cohort consisted of 177 randomly selected patients 〈 80 years old undergoing CRT implant during the same time period. The primary efficacy endpoint was all-cause mortality at 36 months, assessed by Kaplan-Meier time to first event *** In the octogenarian cohort, mean age at CRT implant was 83.1 ± 2.9 yearsvs. 60.1 ± 8.8 years among controls （P 〈 0.001）. Across both groups, 70% were male, mean left ventricular ejection fraction （LVEF） was 24.8% ± 14.1% and QRS duration was 154 ± 24.8 ms, without significant differences between groups. Octo-genarians were more likely to have ischemic cardiomyopathy （74%vs. 37%,P 〈 0.001） and more likely to undergo upgrade to CRT instead of an initial implant （42%vs. 19%,P 〈 0.001）. The rate of appropriate defibrillator shocks was lower among octogenarians （14%vs. 27%,P = 0.02） whereas the rate of inappropriate shocks was similar （3%vs. 6%,P = 0.55）. At 36 months, there was no significant difference in the rate of all-cause mortality between octogenarians （11%） and controls （8%,P = 0.381）.ConclusionAppropriately selected octogenarians who are candidates for CRT have similar intermediate-term mortality compared to younger patients receiving CRT.

关键词： Octogenarians Cardiac resynchronization therapy Implantable cardioverter-defibrillator

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Leadless pacemakers： a contemporary review

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Journal of Geriatric Cardiology 2018年第4期15卷 249-253页

作者： Neal Bhatia mikhael El-chami Department of Medicine Division of Cardiology Section of Electrophysiology Emory University School of Medicine Atlanta USA

1 Introduction Over one million cardiac pacemakers are implanted every year worldwide,[11 of which approximately 200,000 are implanted in the United States alone.121 Combined with an aging population and increasing pacing indications, these numbers are expected to grow. Since the first pacemaker implantation in 1950s, cardiac pacemaker technology has rapidly advanced. Reduction in generator size, increased battery longevity, quality of pacemaker leads, algorithmic and rate responsive programming-all have revolutionized and transformed the implantation and management of transvenous cardiac pacemaker （TV-PPM）.

关键词： Leadless pacemakers Micra Nanostim Perforation

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The subcutaneous implantable cardioverter defibrillator—— review of the recent data

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Journal of Geriatric Cardiology 2018年第3期15卷 222-228页

作者： Stacy B Westerman mikhael El-chami Emory University School of Medicine Atlanta USA Division of Cardiology Section of Electrophysiology Emory University School of Medicine Atlanta USA

The subcutaneous implantable cardioverter defibrillators （SICD） is an altemative to the transvenous ICD for the prevention of sudden cardiac death （SCD）. Multiple studies have shown that the SICD is safe and effective in treating ventricular arrhythmias. While earlier stud- ies mainly enrolled younger patients with channelopathies, more recent reports included patients with ＂typical＂ indications for ICD therapy for the prevention of SCD. In this review we summarize the data available to date on the SICD while highlighting its pros and cons.

关键词： Inappropriate shocks Subcutaneous ICD Sudden Cardiac death Transvenous ICD

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Prospective evaluation of health status, quality of life and clinical outcomes following implantable defibrillator generator exchange

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Journal of Geriatric Cardiology 2021年第9期18卷 720-727页

作者： Faisal M Merchant John Larson Leon Darghosian Paige Smith Soroosh Kiani Stacy Westerman Anand D.Shah David S.Hirsh Michael S.Lloyd Angel R.Leon mikhael F.El-chami Section of Cardiac Electrophysiology Emory University School of MedicineAtlantaGAUSA Department of Medicine University of Michigan School of MedicineAnn ArborMIUSA Grady Health System AtlantaGAUSA

BACKGROUND Little is known about health status and quality of life(QoL)after implantable cardioverter-defibrillator(ICD)generator exchange(GE).METHODS We prospectively followed patients undergoing first-time ICD *** assessments of health status were performed by administering the 36-Item Short Form Survey(SF-36).RESULTS Mean age was 67.5±14.3 years,left ventricle ejection fraction(LVEF)was 36.5%±15.0%and over 40%of the cohort had improved LVEF to>35%at the time of ***-36 scores were significantly worse in physical/general health domains compared to domains of emotional/social well-being(P<0.001 for each comparison).Physical health scores were significantly worse among those with medical comorbidities including diabetes,chronic obstructive pulmonary disease and atrial *** follow-up was 1.6±0.5 years after *** SF-36 scores remained stable across all domains during *** at 3 years post-GE was estimated at 80%.Five patients died during follow-up and most deaths were adjudicated as non-arrhythmic in *** patients experienced appropriate ICD shocks after GE,three of whom had LVEF which remains impaired LVEF(i.e.,<35%)at the time of *** Patients undergoing ICD GE have significantly worse physical health compared to emotional/social well-being,which is associated with the presence of medical *** terms of clinical outcomes,the incidence of appropriate shocks after GE among those with improvement in LVEF is very low,and most deaths post-procedure appear to be non-arrhythmic in *** data represent an attempt to more fully characterize the spectrum of QoL and clinical outcomes after GE.

关键词： ICD quality of life and clinical outcomes following implantable defibrillator generator exchange Prospective evaluation of health status

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On the entangled fractional squeezing transformation

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Frontiers of physics 2015年第2期10卷 67-71页

作者： Hong-Yi Fan Jun-Hua Chen Peng-fel Zhang Department of Physics Ningbo University Ningbo 315211 China Department of Material Science and Engineering University of Science and Technology of China Hefei 230026 China Department of Modern Physics University of Science and Technology of China Hefei 230026 China

We propose an entangled fractional squeezing transformation （EFrST） generated by using two mu- tually conjugate entangled state representations with the following operator： e-iα（a1a2＋a1a2）eiπa2a2; this transformation sharply contrasts the complex fractional Fourier transformation produced by e-ia（a1a1＋a2a2）eiπa2a2 （see Front. Phys. DOI 10.1007/s11467-014-0445-x）. The EFrST is obtained by converting the triangular functions in the integration kernel of the usual fractional Fourier transformation into hyperbolic functions, i.e., tan α→ tanh α and sin α→ sinh α. The fractional property of the EFrST can be well described by virtue of the properties of the entangled state representations.

关键词： entangled fractional squeezing transformation entangled state representation squeezingoperator core operator

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Influence of ZnO/graphene nanolaminate periodicity on their structural and mechanical properties

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Journal of Materials Science & Technology 2018年第9期34卷 1487-1493页

作者： Igor Iatsunskyi Margarita Baitimirova Emerson Coy Luis Yate Roman Viter Arunas Ramanavicius Stefan Jurga mikhael Bechelany Donats Erts NanoBioMedical Centre. Adam Mickiewicz University 85 Urnultowska str. 61-614. Poznan Poland Institute of Chemical Physics and Institute of Atomic Physics and Spectroscopy University of Latvia 19 Raina Boulevard LV 1586 Riga Latvia Surface Analysis and Fabrication Platform CIC biomaGUNE Paseo Miramoin 182 20009 Donostia-San Sebastian Spain Department of Physical Chemistry Institute of Chemistry Faculty of Chemistry and Geosciences Vilnius UniversityNaugarduko str. 24 LT-03225 VilniusLithuania Institut Européen des Membranes IEM - UMR 5635 ENSCM CNRS Univ Montpellier Montpellier France

Structural, electronic and mechanical properties of ZnO/Graphene（ZnO/G） nanolaminates fabricated by low temperature atomic layer deposition（ALD） and chemical vapor deposition（CVD） were *** performed scanning and transmission electron microscopy（SEM/TEM）, X-ray diffraction（XRD）, electron energy loss spectroscopy（EELS）, Raman spectroscopy, X-Ray photoelectron spectroscopy（XPS） and nanoindentation to characterize the ZnO/G nanolaminates. The main structural and mechanical parameters of ZnO/G nanolaminates were calculated. The obtained results were analyzed and interpreted taking into account mechanical interaction and charge effects occurring at the G-ZnO interface. The influence of graphene sublayers number on the mechanical behavior of the ZnO/G nanolaminates was studied. By reducing the bilayer thickness, the mechanical parameters of the films can be tuned（Young＇s modulus100-200 GPa, hardness 3-9 GPa）. The softer response of the multilayers as compared to the single layers of ZnO and graphene was attributed to the structural changes in the ZnO layer and the interfaces. This study shows the mechanical behavior of ZnO/G nanolaminates and their influence on the development of novel electro-optical devices based on these structures.

关键词： Nanolaminate Graphene ZnO XPS Nanointendation Multilayers Atomic layer deposition Chemical vapor deposition

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Responsibility for Life： A Descriptive View on Hans Jonas＇ Ethics

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Journal of Philosophy Study 2016年第4期6卷 191-198页

作者： mikhael Dua Atma Jaya Catholic University of Indonesia

Among the few philosophers who dedicated philosophical reflection on the problem of technology, Hans Jonas would be the leading one. Still in a close affinity with Martin Heidegger, his teacher, Jonas argued that modem technology bore some annoying characters. In line of this anxiety, Jonas suggested the importance of protecting life as an integral part of the ethical project he intended to build. Departing from his basic notion that human life is never separated from other organic life, Jonas has opened a wider space for ethical responsibilities towards life of the whole cosmos. In what sense is his notion of the responsibility towards the whole life should be understood is one of the aim of this paper. Baring in mind that Jonas developed his concept on life and human responsibility towards it as an argumentation against the development of technology, the social context in which modem technology finds its root is worthed to be discussed. It is concluded that separating ethics from ontology as many theorists and philosophers did so far has strengthened the old notion of human autonomy with its defects, and by that, the destruction of life seemed to be accepted as a consequence of it.

关键词： Hans Jonas responsibility ontology of life technology

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主要培养能发展：在体外系统的神经和神经再生

主要培养能发展：在体外系统的神经和神经再生

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作者： Marwan chami 大连医科大学

学位级别：硕士

血脑屏障是高度分化的大脑神经血管系统中一种非常特殊的内皮结构。这种具有具有选择透过性的屏障，是由大脑微血管中的内皮细胞形成的。在体内环境中，内皮细胞、星形胶质细胞和神经元之间存在着密切的相互作用，这种相互作用对血脑屏... 详细信息

血脑屏障是高度分化的大脑神经血管系统中一种非常特殊的内皮结构。这种具有具有选择透过性的屏障，是由大脑微血管中的内皮细胞形成的。在体内环境中，内皮细胞、星形胶质细胞和神经元之间存在着密切的相互作用，这种相互作用对血脑屏障的形成及功能发挥起着重要作用。由于血脑屏障其重要生理功能，如很多神经变性疾病中，血脑屏障往往会成开放状态，因此在最近的十年中，更多的研究转移到了建立体外的血脑屏障模型。本次研究，我们首先获得原代SD大鼠大脑皮质毛细血管内皮细胞、星形胶质细胞和神经元。然后将毛细血管内皮细胞种植于内插小室（insert）的半透膜内室面上，其于半透膜微孔孔径为1μm。而星形胶质细胞种植与该内插小室的半透膜外室面上。再将生长有毛细血管内皮细胞和星形胶质细胞的insert放置于已长有神经元的24孔培养板底孔（well）上，最终形成EAN（endothelial cell, astrocyte,neuron）系统。系统建立完成后，我们首先通过免疫细胞化学技术对单独培养和共培养的细胞进行染色，并对其形态进行了分析。同时通过测定跨内皮细胞电阻及通透系数，来评估本次EAN体外系统中内皮细胞之间的紧密连接程度。本研究组建立的EAN体外系统能够对在生理、病例状态下各种物质通过血脑屏障的效率及差异作出评价。因此，体外EAN系统为更好的研究星形胶质细胞、神经元与大脑内皮细胞在神经退行性疾病中的功能及相互作用提供了平台。同时其在神经保护和神经再生研究中也有一定的潜在价值。

关键词：血脑屏障体外系统大鼠大脑皮质毛细血管内皮细胞 EAN系统原代培养

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Clinical and anatomic predictors of need for repeat atrial fibrillation ablation

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World Journal of Cardiology 2017年第9期9卷 742-748页

作者： Yaanik Desai Mathew R Levy Shahriar Iravanian Edward C Clermont Heval M Kelli Robert L Eisner mikhael F El-chami Angel R Leon David B Delurgio Faisal M Merchant Emory University School of Medicine Cardiology Division Department of MedicineEmory University School of Medicine Division of Cardiology Department of MedicineUniversity of Pennsylvania Department of Radiology Emory University School of Medicine

AIM To identify predictors of need for repeat procedures after initial atrial fibrillation(AF) ablation. METHODS We identified a cohort undergoing first time AF ablation at our institution from January 2004 to February 2014 who had cardiac magnetic resonance(CMR) imaging performed prior to ablation. Clinical variables and anatomic characteristics(determined from CMR) were assessed as predictors of need for repeat ablation. The decision regarding need for and timing of repeat ablation was at the discretion of the treating physician. RESULTS From a cohort of 331 patients, 142 patients(43%) underwent repeat ablation at a mean of 13.6 ± 18.4 mo afterthe index procedure. Both male gender(81% vs 71%, P = 0.05) and lower ejection fraction(57.4% ± 10.3% vs 59.8% ± 9.4%, P = 0.04) were associated with need for repeat ablation. On pre-ablation CMR, mean pulmonary vein(PV) diameters were significantly larger in all four PVs among patients requiring repeat procedures. In multivariate analysis, increased right superior PV diameter significantly predicted need for repeat ablation(odds ratio 1.08 per millimeter increase in diameter, 95%CI: 1.00-1.16, P = 0.05). There were also trends toward significance for increased left and right inferior PV sizes among those requiring repeat *** Increased PV size predicts the need for repeat AF ablation, with each millimeter increase in PV diameter associated with an approximately 5%-10% increased risk of requiring repeat procedures.

关键词： Atrial fibrillation ablation Repeat ablation Cardiac magnetic resonance imaging Pulmonary veins Imaging

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On the Pólya Enumeration Theorem

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Intelligent Information Management 2009年第3期1卷 172-173页

作者： L. G. fel 不详

Simple formulas for the number of different cyclic and dihedral necklaces containing nj beads of the j-th color, and , are derived, using the Pólya enumeration theorem.

关键词： permutations and cyclic invariance cycle index Pólya enumeration theorem

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