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Woodward–Hoffmann Selection Rules and Microscopic Reversibility01:34

Woodward–Hoffmann Selection Rules and Microscopic Reversibility

Electrocyclic reactions, cycloadditions, and sigmatropic rearrangements are concerted pericyclic reactions that proceed via a cyclic transition state. These reactions are stereospecific and regioselective. The stereochemistry of the products depends on the symmetry characteristics of the interacting orbitals and the reaction conditions. Accordingly, pericyclic reactions are classified as either symmetry-allowed or symmetry-forbidden. Woodward and Hoffmann presented the selection criteria for...
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Visual Agnosia

Visual agnosia is a condition characterized by the inability to recognize visually presented objects despite having normal vision. For instance, a person with visual agnosia can describe the shape and color of an object but cannot identify or name it. This impairment does not affect their visual field, acuity, color vision, brightness discrimination, language, or memory. An example of this condition in a social setting is someone at a dinner party asking for "that silver thing with a round end"...
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Unsymmetrical bending occurs when the bending moment applied to a structural member does not align with its principal axis. This misalignment leads to complex stress distributions and deflection patterns that differ from those in symmetrical bending, and are essential for designing structures to withstand different loading conditions. In unsymmetrical bending, the neutral axis—where stress is zero—does not necessarily align with the geometric axes of the cross-section. The orientation of the...
Angle of Twist: Problem Solving01:13

Angle of Twist: Problem Solving

An electric motor applies a torque of 700 N·m to an aluminum shaft, triggering a stable rotation. Two pulleys, B and C, are subjected to torques of 300 N·m and 400 N·m, respectively. The modulus of rigidity is provided as 25 GPa. With the knowledge of the length and diameter of each segment, the twist angle between the two pulleys can be computed. First, a section cut is made between pulleys B and C, and the cut cross-section is analyzed using a free-body diagram. Given that the torque exerted...
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Related Experiment Video

Updated: Jun 26, 2026

Inchworming: A Novel Motor Stereotypy in the BTBR T+ Itpr3tf/J Mouse Model of Autism
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Reverse Twiddler's syndrome.

Stephen C Vlay1

  • 1Stony Brook Arrhythmia and Sudden Death Prevention Center, Cardiology Division, Department of Medicine, Stony Brook University, Stony Brook, NY 11794-8167, USA. svlay@notes.cc.sunysb.edu

Pacing and Clinical Electrophysiology : PACE
|January 15, 2009
PubMed
Summary

Twiddler's syndrome involves pacemaker or defibrillator lead withdrawal due to arm motion. Reverse Twiddler's syndrome is the opposite lead advancement caused by similar repetitive movements.

Area of Science:

  • Cardiology
  • Medical Devices
  • Patient Safety

Background:

  • Pacemaker and defibrillator leads are crucial for cardiac rhythm management.
  • Lead dislodgement can compromise device efficacy and patient health.
  • Twiddler's syndrome describes lead withdrawal from repetitive arm movements.

Observation:

  • A novel phenomenon, Reverse Twiddler's syndrome, has been observed.
  • This involves the advancement of pacing or defibrillator leads into the heart.
  • The mechanism is similar repetitive arm motion, but in the opposite direction.

Findings:

  • Reverse Twiddler's syndrome represents lead advancement, contrasting with classical lead withdrawal.
  • Repetitive manipulation of the pulse generator site is implicated in both syndromes.

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  • Understanding these lead migration patterns is vital for clinical practice.

    • Implications:

    • Awareness of Reverse Twiddler's syndrome is essential for clinicians managing patients with cardiac implantable electronic devices.
    • Patient education on appropriate device site care may help prevent lead migration.
    • Further research is needed to fully elucidate the pathophysiology and long-term consequences of Reverse Twiddler's syndrome.