An electrocardiogram, used to not only assess the rate and rhythm of the heart but also to evaluate for injury to the heart, is performed by attaching 12 leads to the patient\'s body. A myocardial infarction can be mimicked by the misplacement of the leads. A 58-year-old man with long-distance running-associated bradycardia developed postoperative atrial fibrillation with a rapid ventricular response. He converted to normal sinus rhythm after a single oral dose of 30 milligrams of diltiazem; however, the automated reading of the electrocardiogram performed in the hospital showed new changes suggestive of a postero-lateral myocardial infarction, including Q waves in leads I and aVL, as well as early precordial R wave progression with R waves and positive T waves in V2 and V3, and a dominant R wave (R wave to S wave ratio greater than one) in V2. A cardiac work-up was entirely normal: serial troponin levels, thyroid stimulating hormone, echocardiogram, computerized tomography of the chest, and Doppler studies of the extremities. Lead misplacement during the electrocardiogram was suspected during the subsequent evaluation by an astute cardiologist; the findings were diagnostic for a left arm to right arm limb lead reversal. All the changes in myocardial infarction were absent when the electrocardiogram was repeated in the office. Misplacement of leads during an electrocardiogram is not a rare event; therefore, the clinician needs to consider the possibility of improper placement of the leads when evaluating an electrocardiogram. Indeed, emotional distress, additional diagnostic procedures, and potentially harmful procedures may be experienced by the patient from incorrect diagnoses based on electrode misplacement during an electrocardiogram; in addition, there are often increased costs to the patient and the healthcare system. Therefore, in the setting of an incorrect diagnosis attributed to lead misplacement during the performance of an electrocardiogram, the acronym MISFIT (which uses the first letters of the words \"myocardial infarction simulated from improper telemetry\") has been introduced. In conclusion, it is important to emphasize that a MISFIT is characterized by an electrocardiogram \'mis\'diagnosis of a myocardial infarction that does not \'fit\' with the clinical scenario.

The extraction of roadways from remote sensing imagery constitutes a pivotal task, with far-reaching implications across diverse domains such as urban planning, management of transportation systems, emergency response initiatives, and environmental monitoring endeavors. Satellite images captured during daytime have customarily served as the primary resource for this extraction process. However, the emergence of Nighttime Light (NTL) remote sensing data introduces an innovative dimension to this arena. The exploration of NTL data for road extraction remains in its nascent stage, and this study seeks to bridge this gap. We present a refined U-Net model (CA U-Net) integrated with Cross-Attention Mechanisms, meticulously designed to extract roads from Yangwang-1 NTL images. This model incorporates several enhancements, thereby improving its proficiency in identifying and delineating road networks. Through extensive experimentation conducted in the urban landscape of Wenzhou City, the model delivers highly accurate results, achieving an F1 score of 84.46%. These outcomes significantly surpass the performance benchmarks set by Support Vector Machines (SVM) and the Optimal Threshold (OT) method. This promising development paves the way towards maximizing the utility of NTL data for comprehensive mapping and analysis of road networks. Furthermore, the findings underscore the potential of utilizing Yangwang-1 data as a reliable source for road extraction and reaffirm the viability of deploying deep learning frameworks for road extraction tasks utilizing NTL data.

Urban vitality is the comprehensive form of regional development quality, sustainability, and attractiveness. Urban vitality of various regions within the cities has difference, and the quantitative evaluation of urban vitality within the cities can help guide to future city constructions. Evaluation of urban vitality needs the combination of multi-source data. Existing studies have developed index method and estimation models mainly based on geographic big data to evaluate urban vitality. This study aims to combine remote sensing data with geographic big data to evaluate urban vitality of Shenzhen at street block scale and build the estimation model by random forest method. Indexes and random forest model were built, and some further analyses were conducted. The results were: (1) urban vitality in Shenzhen was high in the coastal areas, business areas, and new towns; (2) compared to indexes, the estimation model had advantages of more accurate results, combination of various data, and the ability to analyze feature contributions; and (3) taxi trajectory, nighttime light, and housing rental data had the strongest influence on urban vitality.

Ventricular standstill is a rare cardiac event associated with a high mortality. It is considered a ventricular fibrillation equivalent. The longer the duration, the poorer the prognosis. It is therefore unusual for an individual to have recurrent episodes of standstill and survive, without morbidity and rapid mortality. Here, we report the unique case of a 67-year-old male, previously diagnosed with heart disease, requiring intervention, who lived with recurrent syncopal episodes for a decade. Though such occurrences have previously been documented, we seek to stress the importance of using clinical tools in assessing what could easily have been passed off as orthostatic in origin.

Exxon Neftegas Ltd. (ENL) carried out three 4D seismic surveys during the summer of 2015. Seismic operations in two of these fields (Odoptu and Chayvo) ensonified the nearshore feeding area of Korean-Okhotsk (western) gray whales (Eschrichtius robustus), potentially disturbing feeding activities. Following model-based optimization of the source design to minimize its lateral acoustic footprint, pre-season modeling was used to compute the acoustic exposure along each survey line. Real-time acoustic data facilitated implementation of mitigation measures aimed to minimize disturbance of whales. Acoustic data originated from underwater recorders deployed on the seafloor. Two complementary approaches were used to transmit recorded sound data to a computer housed at the Central Post (CP), where decisions regarding mitigation shut downs were made. In the first approach, a limited bandwidth (2-2000 Hz) sampling of the data was transmitted via cable to a surface buoy, which relayed these data to a shore station up to 15 km away via digital VHF telemetry. At the shore station, acoustic impulses from the seismic surveys were processed to compute impulse characteristics in the form of estimates of sound exposure level and peak sound pressure level, as well as one-minute-average 1/3-octave power spectral density coefficients, which were then transmitted to the CP via the internet. In the second, the pulse characteristics were computed through algorithms running on an onboard processor in each recorder\'s surface buoy and sent directly to the CP computer via an Iridium satellite uplink. Both methods of data transfer proved viable, but Iridium transmission achieved the goal without the need for any shore based relay stations and is therefore more operationally efficient than VHF transmission. At the CP, analysts used the real-time acoustic data to calibrate and adjust the output of pre-season acoustical model runs. The acoustic footprint for the active seismic source, advancing synchronously with the motion of the seismic vessel and changing as the sound propagation environment changed, was computed from the calibrated and adjusted model output and integrated through the software Pythagoras with locations of gray whales provided by shore-based observers. This enabled analysts to require air gun array shutdowns before whales were exposed to mean square sound pressure levels greater than the behavioral response threshold of 163 dB re 1 μPa2. The method described here provides a realistic means of mitigating the possible effects of air guns at a behavioral response level, whereas most seismic surveys rely on pre-established mitigation radii to manage the risk of injury to a whale.

In this study, we describe an inexpensive and rapid method of using video analysis and identity tracking to measure the effects of tag weight on insect movement. In a laboratory experiment, we assessed the tag weight and associated context-dependent effects on movement, choosing temperature as a factor known to affect insect movement and behavior. We recorded the movements of groups of flightless adult crickets Gryllus locorojo (Orthoptera:Gryllidae) as affected by no tag (control); by light, medium, or heavy tags (198.7, 549.2, and 758.6 mg, respectively); and by low, intermediate, or high temperatures (19.5, 24.0, and 28.3°C, respectively). Each individual in each group was weighed before recording and was recorded for 3 consecutive days. The mean (± SD) tag mass expressed as a percentage of body mass before the first recording was 26.8 ± 3.7% with light tags, 72 ± 11.2% with medium tags, and 101.9 ± 13.5% with heavy tags. We found that the influence of tag weight strongly depended on temperature, and that the negative effects on movement generally increased with tag weight. At the low temperature, nearly all movement properties were negatively influenced. At the intermediate and high temperatures, the light and medium tags did not affect any of the movement properties. The continuous 3-day tag load reduced the average movement speed only for crickets with heavy tags. Based on our results, we recommend that researchers consider or investigate the possible effects of tags before conducting any experiment with tags in order to avoid obtaining biased results.

The understanding of raised intracranial pressure (ICP) is increasing with the directed use of intracranial telemetric ICP monitors. This case uniquely observed ICP changes by telemetric monitoring in a patient with idiopathic intracranial hypertension (IIH), who developed rapid sight-threatening disease. A lumbar drain was inserted, as a temporising measure, and was clamped prior to surgery. This resulted in a rapid rise in ICP, which normalised after insertion of a ventriculoperitoneal shunt. This case highlighted the utility of the ICP monitor and the lumbar drain as a temporising measure to control ICP prior to a definitive procedure as recommended by the IIH consensus guidelines.

Indoor positioning technologies have gained great interest from both industry and academia. Variety of services and applications can be built based on the availability and accessibility of indoor positioning information, for example indoor navigation and various location-based services. Different approaches have been proposed to provide indoor positioning information to users, in which an underlying system infrastructure is usually assumed to be well deployed in advance to provide the position information to users. Among many others, one common strategy is to deploy a bunch of active sensor nodes, such as WiFi APs and Bluetooth transceivers, to the indoor environment to serve as reference landmarks. The user\'s current location can thus be obtained directly or indirectly according to the active sensor signals collected by the user. Different from conventional infrastructure-based approaches, which put additional sensor devices to the environment, we utilize available objects in the environment as location landmarks. Leveraging wildly available smartphone devices as customer premises equipment to the user and the cutting-edge deep-learning technology, we investigate the feasibility of an infrastructure-free intelligent indoor positioning system based on visual information only. The proposed scheme has been verified by a real case study, which is to provide indoor positioning information to users in Taipei Main Station, one of the busiest transportation stations in the world. We use available pedestrian directional signage as location landmarks, which include all of the 52 pedestrian directional signs in the testing area. The Google Objection Detection framework is applied for detection and recognition of the pedestrian directional sign. According to the experimental results, we have shown that the proposed scheme can achieve as high as 98% accuracy to successfully identify the 52 pedestrian directional signs for the three test data sets which include 6,341 test images totally. Detailed discussions of the system design and the experiments are also presented in the paper.

High grade atrioventricular (AV) block, defined as 2 or more non-conducted P waves, is a common indication for permanent pacemaker implantation and can be a cause of syncope or presyncope. A 61 year-old male presented to the emergency department with presyncopal symptoms and high grade AV block confirmed on electrocardiogram. Continuous cardiac telemetry monitoring did not trigger any alarm notification during episodes of AV block, due to T wave overcounting. The limitations of telemetry monitoring are rarely recognized and even more rarely reported in the literature.

Intracranial pressure (ICP) measurements are imperative for the proper diagnosis and treatment of several neurological disorders. Telemetric sensors have shown their utility for ICP estimation in short-term monitoring in humans. However, their long-term reliability is uncertain. The authors present the case of a 37-year-old woman diagnosed with benign intracranial hypertension and obesity. The patient underwent gastric bypass surgery for ICP control. In order to monitor ICP before and after bariatric surgery, a Neurovent-P-tel sensor was implanted in the left frontal lobe. After gastric bypass, normal ICP values were recorded, and the patient\'s visual fields improved. However, the patient experienced incapacitating daily headaches. The authors decided to implant a Codman Microsensor ICP transducer in the right frontal lobe to assess the long-term reliability of the Neurovent-P-tel measurements. A comparison of the recordings at 24 and 48 hours showed good correlation and reliability during long-term monitoring with the Neurovent-P-tel, with minimal zero drift after 11 months of implantation.