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Artificial cardiac pacemaker

A cardiac pacemaker, is a medical device that generates electrical impulses delivered by electrodes to cause the heart muscle chambers to contract and therefore pump blood. The primary purpose of a pacemaker is to maintain an adequate heart rate, either because the heart's natural pacemaker is not fast enough, or because there is a block in the heart's electrical conduction system. Modern pacemakers are externally programmable and allow a cardiologist a cardiac electrophysiologist to select the optimal pacing modes for individual patients. A specific type of pacemakers called defibrillator combines pacemaker and defibrillator functions in a single implantable device, which should be called only defibrillator, for clarity. Others, called biventricular pacemakers have multiple electrodes stimulating differing positions within the lower heart chambers to improve synchronization of the ventricles, the lower chambers of the heart. Percussive pacing known as transthoracic mechanical pacing, is the use of the closed fist on the left lower edge of the sternum over the right ventricle in the vena cava, striking from a distance of 20 – 30 cm to induce a ventricular beat.

This is an old procedure used only as a life saving means until an electrical pacemaker is brought to the patient. Transcutaneous pacing called external pacing, is recommended for the initial stabilization of hemodynamically significant bradycardias of all types; the procedure is performed by placing two pacing pads on the patient's chest, either in the anterior/lateral position or the anterior/posterior position. The rescuer selects the pacing rate, increases the pacing current until electrical capture is achieved, with a corresponding pulse. Pacing artifact on the ECG and severe muscle twitching may make this determination difficult. External pacing should not be relied upon for an extended period of time, it is an emergency procedure that acts as a bridge until transvenous pacing or other therapies can be applied. Temporary epicardial pacing is used during open heart surgery should the surgical procedure create atrio-ventricular block; the electrodes are placed in contact with the outer wall of the ventricle to maintain satisfactory cardiac output until a temporary transvenous electrode has been inserted.

Transvenous pacing, when used for temporary pacing, is an alternative to transcutaneous pacing. A pacemaker wire is placed into a vein, under sterile conditions, passed into either the right atrium or right ventricle; the pacing wire is connected to an external pacemaker outside the body. Transvenous pacing is used as a bridge to permanent pacemaker placement, it can be kept in place until a permanent pacemaker is implanted or until there is no longer a need for a pacemaker and it is removed. Permanent pacing with an implantable pacemaker involves transvenous placement of one or more pacing electrodes within a chamber, or chambers, of the heart, while the pacemaker is implanted inside the skin under the clavicle; the procedure is performed by incision of a suitable vein into which the electrode lead is inserted and passed along the vein, through the valve of the heart, until positioned in the chamber. The procedure is facilitated by fluoroscopy which enables the physician to view the passage of the electrode lead.

After satisfactory lodgement of the electrode is confirmed, the opposite end of the electrode lead is connected to the pacemaker generator. There are three basic types of permanent pacemakers, classified according to the number of chambers involved and their basic operating mechanism: Single-chamber pacemaker. In this type, only one pacing lead is placed into a chamber of the heart, either the atrium or the ventricle. Dual-chamber pacemaker. Here, wires are placed in two chambers of the heart. One lead paces one paces the ventricle; this type more resembles the natural pacing of the heart by assisting the heart in coordinating the function between the atria and ventricles. Biventricular pacemaker; this pacemaker has three wires placed in three chambers of the heart. One in the atrium and two in either ventricle, it is more complicated to implant. Rate-responsive pacemaker; this pacemaker has sensors that detect changes in the patient's physical activity and automatically adjust the pacing rate to fulfill the body's metabolic needs.

The pacemaker generator is a hermetically sealed device containing a power source a lithium battery, a sensing amplifier which processes the electrical manifestation of occurring heart beats as sensed by the heart electrodes, the computer logic for the pacemaker and the output circuitry which delivers the pacing impulse to the electrodes. Most the generator is placed below the subcutaneous fat of the chest wall, above the muscles and bones of the chest. However, the placement may vary on a case by case basis; the outer casing of pacemakers is so designed that it will be rejected by the body's immune system. It is made of titanium, inert in the body. Leadless pacemakers are devices that are small enough to allow the generator to be placed within the heart, therefore avoiding the need for pacing leads; as pacemaker leads can fail over time, a pacing system that avoids these components offers theoretical advantages. Leadless pacemakers can

Percy Crosby

Percy Lee Crosby was an American author and cartoonist best known for his comic strip Skippy. Adapted into movies, a novel and a radio show, Crosby's creation was commemorated on a 1997 U. S. Postal Service stamp. An inspiration for Charles Schulz's Peanuts, the strip is regarded by comics historian Maurice Horn as a "classic... which innovated a number of sophisticated and refined touches used by Charles Schulz and Bill Watterson." Humorist Corey Ford, writing in Vanity Fair, praised the strip as "America's most important contribution to humor of the century". Percy Crosby was born in Brooklyn, New York, prior to the 1898 incorporation of the five boroughs of New York City, he grew up in Richmond Hill, in what would be the borough of Queens but at the time was considered part of Long Island. His father, Thomas Francis Crosby, the son of Catholic immigrants from County Louth, was an amateur painter who ran an art supply business, his mother Frances, known as Fanny, was of Scottish descent. Percy had two younger sisters and Gladys.

Crosby quit high school during his sophomore year to take a job as an art department office boy at editor Theodore Dreiser's magazine The Delineator. He was promoted to artist, but the job ended after one issue; when he was 17, he sold a drawing to Life for $6. After delivering sandwiches and working as a magazine salesman, he found a position as an editorial cartoonist for the Socialist newspaper the New York Daily Call. There he published his first two comic strips and The Extreme Brothers—Laff and Sy, but readers became outraged at frivolity in the paper and the strips were pulled. Crosby next became a sports illustrator at The New York Globe. On the side, he produced comics used as occasional filler for the paper. Fired, he entered an Edison Company contest for the best cartoon on the use of electric light, he saw his cartoon appear in every newspaper in New York City. The exposure led to a job at the New York World, "at the time the promised land for aspiring cartoonists". After a few years, he left selling cartoons to World editor John Tennant.

In 1916, the George Matthew Adams Service syndicated Crosby's first feature, the daily and Sunday strip The Clancy Kids, earning Crosby a respectable $135 a week. While continuing on this first strip, Crosby studied at Manhattan's Art Students League under such instructors as George Bridgman, Frank DuMond, Joseph Pennell and Max Weber; the painter and League president Gifford Beal, recognizing Crosby's talent, invited him to spend the summer in Cape Cod, where Crosby made the acquaintance of Edwin Dickinson, Edward Hopper, Eugene O'Neill and other habitues of the Provincetown, Massachusetts artists colony. Back in New York, he fell in love with fellow League student Gertrude Volz, the artist-sculptor daughter of a well-to-do real-estate broker. After being commissioned a second lieutenant in the Officer Reserve Corps in 1916 and being called to active service the following year, serving for a time as a jiujitsu instructor, he and Volz eloped and were married at the training camp in Plattsburgh, New York, on July 7, 1917.

While in training, Crosby created a daily comic panel, That Rookie from the Thirteenth Squad, for the McClure Syndicate and drawing it from the front in France while serving as a first lieutenant in the 77th Division, AEF. The comic was collected into his first two books, That Rookie of the Thirteenth Squad and Between Shots. While at the Argonne front, Crosby was struck by shrapnel in the eye, suffering no permanent damage, earned the Purple Heart. Following the war, he resumed his studies and syndicated a series of panel cartoons from 1921 to 1925; these covered a variety of subjects, with some series, such as Who Cares for the Feelings of a Small Boy, The Local Boy, Back o' the Flats, The Little Girl Who Moved Away and Send a Poor Child to the Farm, featuring children from the slums. One such series, Always Belittlin', presaged Skippy with its star, a child with a striped shawl and a bonnet with a black pop-pom, whose thoughts consisted of the text's daily aphorism; this series and two others and Bug Lugs, would run as the supplemental topper feature accompanying the Skippy Sunday strip.

Crosby concurrently became a prolific contributor to Life, where several of his cartoons featured a child named Timmy, who became the prototype for Skippy Skinner when Crosby pitched art director Frank Casey about a regular feature. As Crosby recalled, "I drew up three pages and thought of forty-four names —Skippy last on the list. A minor editor suggested Tiny Tim. I bristled with such uncalled-for interference, and... the thought flashed through my mind:' had to be Skippy and nothing else!'"Following a full-page house ad in the March 15, 1923, Skippy premiered in Life and became a success. It became a syndicated comic strip two years initially by Johnson Features, Central Press Association and Editors Features Service, before publisher William Randolph Hearst signed Crosby to his King Features Syndicate. King distributed its first daily Skippy on October 7, 1926, its first Sunday on April 1, 1929. Crosby retained a rarity for strip artists of the time; the strip focused on a young boy living in the city.

Wearing an enormous collar and tie and a floppy checked hat, he was an odd mix of mischief and melancholy who might be found stealing from the corner fruit stand, failing to master skates or baseball, complaining about the adult world, or staring sadly at an old relative's grave: "And only last year she gave me a tie." The popular strip at one poi

Megunticook River

The Megunticook River is a short river in Camden, Maine. From the spillway of Megunticook Lake, the river runs 3.5 miles southeast through the town to West Penobscot Bay. The upper part of the river has raised water levels due to the Seabright dam. Below the dam the river runs as a mill stream into Camden village. In 2016 the Camden select board was alerted to low water levels above Seabright, it is considering grouting cracks in the rocks supporting the dam to address the problem. List of rivers of Maine "Megunticook River". Geographic Names Information System. United States Geological Survey. 30 September 1980. Retrieved 2010-10-01. Maine Streamflow Data from the USGS Maine Watershed Data From Environmental Protection Agency Funds to fix Seabright Dam discussed for next year's budget

Kingman, Kansas

Kingman is a city in and the county seat of Kingman County, United States. As of the 2010 census, the city population was 3,177. Kingman was laid out in 1874. Like Kingman County, it was named for chief justice of the supreme court. Kingman is located at 37°38′49″N 98°6′50″W. According to the United States Census Bureau, the city has a total area of 3.53 square miles, of which 3.52 square miles is land and 0.01 square miles is water. The climate in this area is characterized by hot, humid summers and mild to cool winters. According to the Köppen Climate Classification system, Kingman has a humid subtropical climate, abbreviated "Cfa" on climate maps; as of the census of 2010, there were 3,177 people, 1,346 households, 810 families living in the city. The population density was 902.6 inhabitants per square mile. There were 1,546 housing units at an average density of 439.2 per square mile. The racial makeup of the city was 96.7% White, 0.1% African American, 0.7% Native American, 0.4% Asian, 0.9% from other races, 1.2% from two or more races.

Hispanic or Latino of any race were 2.7% of the population. There were 1,346 households of which 29.3% had children under the age of 18 living with them, 46.7% were married couples living together, 9.7% had a female householder with no husband present, 3.9% had a male householder with no wife present, 39.8% were non-families. 35.0% of all households were made up of individuals and 18% had someone living alone, 65 years of age or older. The average household size was 2.29 and the average family size was 2.95. The median age in the city was 40.7 years. 24.9% of residents were under the age of 18. The gender makeup of the city was 52.3 % female. As of the census of 2000, there were 3,387 people, 1,407 households, 911 families living in the city; the population density was 975.8 people per square mile. There were 1,563 housing units at an average density of 450.3 per square mile. The racial makeup of the city was 97.67% White, 0.21% African American, 0.35% Native American, 0.50% Asian, 0.30% from other races, 0.97% from two or more races.

Hispanic or Latino of any race were 1.92% of the population. There were 1,407 households out of which 28.9% had children under the age of 18 living with them, 52.7% were married couples living together, 9.5% had a female householder with no husband present, 35.2% were non-families. 33.0% of all households were made up of individuals and 18.8% had someone living alone, 65 years of age or older. The average household size was 2.34 and the average family size was 2.95. In the city, the population was spread out with 26.4% under the age of 18, 7.1% from 18 to 24, 23.6% from 25 to 44, 20.2% from 45 to 64, 22.7% who were 65 years of age or older. The median age was 40 years. For every 100 females, there were 84.3 males. For every 100 females age 18 and over, there were 82.7 males. The median income for a household in the city was $36,018, the median income for a family was $42,813. Males had a median income of $32,000 versus $23,988 for females; the per capita income for the city was $19,286. About 10.3% of families and 12.2% of the population were below the poverty line, including 24.4% of those under age 18 and 7.0% of those age 65 or over.

The community is served by Kingman-Norwich USD 331 public school district, which operates 2 schools in Kingman. Kingman High School Kingman Elementary-Middle SchoolPrivate Schools Patrick Catholic School Bus service is provided daily eastward towards Wichita and westward towards Pueblo, Colorado by BeeLine Express. George Aiton, Major League Baseball player. Clyde Cessna, founder of the Cessna Aircraft Corporation. Martin Dewey, American orthodontist. Eugene John Gerber, Roman Catholic bishop. Don Lock, Major League Baseball player. Historic Images of Kingman, Special Photo Collections at Wichita State University Library CityCity of Kingman Kingman - Directory of Public OfficialsMapsKingman City Map, KDOT

Shahriar Kamali

Shahriar Kamali, known as King Kamali, is a retired IFBB professional bodybuilder. Nicknamed "The Persian Pearl" and "The Terminator", Kamali was born in Iran, now lives in West New York, New Jersey and New City, New York. Kamali has a Bachelor of Science degree in Exercise Physiology from George Mason University The resulting knowledge about human kinesiology and sport nutrition combined with his distinctive posing styles makes Kamali a sought out bodybuilder for seminars and guest appearances, he has been featured in many bodybuilding articles, as well as being on the cover of Muscle Magazine. Height: 5ft 10in Contest Weight: 225 lb Off-Season Weight: 310 lb Arms: 19 in Waist: 36 in Chest: 50 in Thighs: 30 in 1994 NPC Collegiate Nationals, Light-Heavyweight, 1st and Overall 1996 NPC Nationals, HeavyWeight, 10th tied 1997 NPC Nationals, HeavyWeight, 7th 1998 NPC Nationals, HeavyWeight, 3rd 1999 NPC Nationals, HeavyWeight, 1st 2001 Arnold Classic, 4th 2001 Ironman Pro Invitational, 3rd 2001 Mr. Olympia, 10th 2002 Mr. Olympia, 17th 2002 Show of Strength Pro Championship, 11th 2003 Night of Champions, 14th 2004 Arnold Classic, 8th 2004 Grand Prix Australia, 5th 2005 Arnold Classic, 11th 2005 Ironman Pro Invitational, 5th 2005 San Francisco Pro Invitational, 12th 2006 New York Pro Championships, 16th 2006 Europa Super Show, 11th 2006 Montreal Pro, 14th 2006 Atlantic City Pro, 15th Arnold Classic Ironman Pro Invitational List of male professional bodybuilders List of female professional bodybuilders New York Pro Championship Show of Strength Pro Championship

Kobi Station

Kobi Station is a railway station on the Takayama Main Line in the city of Minokamo, Gifu Prefecture, operated by Central Japan Railway Company. Kobi Station is served by the Takayama Main Line, is located 30.3 kilometers from the official starting point of the line at Gifu. Kobi Station has two opposed ground-level side platforms connected by a level crossing; the station is unattended. Kobi Station opened on November 25, 1922; the station was absorbed into the JR Central network upon the privatization of Japanese National Railways on April 1, 1987. A new station building was completed in March 2017. In fiscal 2016, the station was used by an average of 369 passengers daily. Kamo High School Kobi Post Office List of Railway Stations in Japan