bluuebunny/crossref_metadata_2025 huggingface dataset:
‘Like I said about culture. You don't talk about mental health’: An interpretative phenomenological analysis of the experience of first‐episode psychosis in South Asian individuals
Authors: Patel Krisna , Cardno Alastair , Isherwood Tom
Published: January 2023

Background

There is strong evidence of inequalities in mental healthcare access, experiences and outcomes for service users belonging to Black and Asian Minority Ethnic groups experiencing psychosis. Clinicians and academics have speculated that cultural variation in conceptualisations of psychosis, alongside inequitable service provision may explain disparities. There is, however, a dearth of literature exploring this in a South Asian population, despite this ethnic group being the second largest in the United Kingdom. The present study aimed to explore how people from this minority group have experienced and made sense of first‐episode psychosis (FEP).

Methods

A qualitative approach was used to explore the lived experience and sense‐making of South Asian individuals experiencing FEP and accessing early intervention services. Eight people were interviewed using a semi‐structured format. The data were analysed using Interpretative Phenomenological Analysis.

Results

Three superordinate themes were identified in the group analysis: (1) Disconnection from self and others (2) Doubt and dispute (3) Power and shame.

Conclusions

Distinctive ethnic, cultural and systemic influences were strongly evident in how people conceptualized their experiences, how they managed their sense‐making and where they sought support. Experiences were discussed in the context of power and shame, and this research proposes that socio‐cultural context and racialised discourses have an impact on self‐concept, the experiences of help‐seeking (formal and informal), and fundamentally how services help individuals from marginalized communities.
Exploring digital cognitive behavioural therapy for insomnia in an early intervention in psychosis service – A study protocol for an initial feasibility study with process evaluation
Authors: Beattie Louise , Robb Fiona , Spanswick Mairi , Henry Alasdair L. , Waxmonsky Jeanette , Gumley Andrew
Published: January 2023

Aim

Early psychosis may be a critical time at which clinical trajectories are still evolving, and sleep interventions hold promise to improve outcomes at this stage. Although cognitive behavioural therapy (CBT) for insomnia shows promise in psychosis, there has been limited evaluation of delivery within current care. This study aims to evaluate the feasibility and acceptability of providing fully‐automated digital CBT for insomnia (CBT‐I) within an early intervention in psychosis service.

Methods

We will conduct a single‐arm feasibility trial within an early psychosis intervention service, and up to 40 individuals experiencing a first episode of psychosis and with evidence of insomnia can be enrolled (May 2021 – August 2022). Additional service user inclusion criteria are capacity to consent and access to a suitable technological device to access digital CBT. Participants will be offered access to a fully‐automated digital CBT‐I program (Sleepio) delivered using web and/or mobile app. The study comprises pre‐ and post‐ intervention questionnaire assessments and interviews with service users and staff to provide initial outcome signals.

Results

Quantitative questionnaire data will be analysed descriptively, alongside rates of eligibility, consent, uptake and completion. Qualitative data will be analysed using thematic analysis. Results will be used to develop a logic model describing feasibility and implementation.

Conclusions

From this study, we hope to better understand how to deliver digital CBT for insomnia within an early intervention in psychosis service. This study will help inform further research, including how best to support staff in using Sleepio, and inform the design of subsequent trials in this area.
The ‘Parma At‐Risk mental states’ (PARMS) program: General description and process analysis after 5 years of clinical activity
Authors: Pelizza Lorenzo , Leuci Emanuela , Quattrone Emanuela , Paulillo Giuseppina , Pellegrini Pietro
Published: January 2023

Aim

From January 2016, the Parma Department of Mental Health developed a specialized care protocol – the ‘Parma At‐Risk Mental States’ (PARMS) program – as a diffused service for early intervention in individuals at Clinical High Risk for Psychosis (CHR‐P). The aims of this investigation were (1) to describe the PARMS structural organization and (2) to examine specific process indicators during the first 5 years of its clinical activity.

Methods

All participants were adolescent and young adult help‐seekers (aged 12–25 years) at CHR‐P in accordance with well‐defined psychometric criteria.

Results

At entry, 52 subjects were provided with a dedicated protocol of care and only 14 dropped out during the first year of treatment. The Duration of Untreated Illness (DUI) overall decreased over time. Most of CHR‐P participants suffered from ‘Attenuated Psychotic Symptoms’ and ‘Brief, Limited, Intermittent Psychotic Symptoms’ in the same percentage (48.1% [n = 25]). The most common DSM‐IV‐TR diagnosis was schizotypal personality disorder, followed by borderline personality disorder and brief psychotic disorder.

Conclusions

A specialized, evidence‐based care protocol for CHR‐P individuals within Italian adult and child/adolescent psychiatric services is feasible, also in adolescents, who have a high risk of falling through the child/adult service gap.
Pharmacokinetic and pharmacodynamic study of three products of epoetin alfa as single subcutaneous dose in healthy volunteers
Authors: di Girolamo Guillermo , Keller Guillermo A. , Beider Lara , González Claudio D. , González Bagnes María F. , González Eliseo , Fornari M. Cecilia , Diez Roberto A.
Published: January 2023

Hemax® is an epoetin alfa product developed by Biosidus S.A. in Argentina at the end of the 1980s and has been present in that market since 1991. The initial presentation was a lyophilized powder containing albumin as stabilizer, to best adapt to environmental conditions in developing countries; more recently, a prefilled syringe, albumin‐free presentation was developed, since this presentation has become the preferred standard in many markets. The primary objective was to compare the pharmacokinetic profile of different formulations of epoetin alfa after a single subcutaneous administration to healthy volunteers of 40 000 IU of Eprex/Erypo® and Hemax® PFS. This clinical trial was conceived following an open‐label, randomized, three‐way three‐period cross‐over balanced, and sequential design. The study was conducted on 24 healthy volunteers. To analyze similarity between Hemax® PFS and the innovator product, Eprex®, area under the curve (AUC) and Cmax of both products have been compared. The 90% CI lower limit for the geometric mean ratios was higher than 80% for any comparisons, and the 90% CI upper limit for these geometric ratios was below 125% for all the comparisons made, thus demonstrating equivalence between both products. The comparison between Hemax® PFS and Eprex® resulted in similar 90% CI for Cmax, AUC(0–120 h) and AUC(0‐inf) ratios, all of them within the 80–125% interval, with a power above 95% for each ratio. These findings suggest biosimilar patterns for absorption velocity (with Tmax close to 15 h), absorption extent, and elimination (with an elimination half‐life close to 25–30 h for each formulation).
Comparative analysis of first and second stage data envelopment approaches: Performance of marine capture fisheries in the European Union
Authors: Tunca Sezgin
Published: January 2023

I explored harvest productivity and economic efficiency of marine fisheries across European Union member states using comparative first and second‐stage data envelopment analyses, linear programming, and econometric models, based on a panel data set of technical, social, and economic data between 2008 and 2020 when the first implications of the global Covid‐19 outbreak began in the European Union. During the period, harvest productivity increased for 52 percent of the 21 member states between 2008 and 2020, with an average economic efficiency of 0.76. The economic efficiency and harvest productivity of European Union member states' fisheries fluctuated, with noticeable declines throughout the study period. Gross domestic product per capita, population size, and aquaculture production were related to performance metrics. The results are aimed to guide European Union fisheries managers to better understand how improvements in harvest productivity and economically efficient performance are achieved without constant reliance on subsidization, over‐allocation, and overexploitation.
Effect of the Lactiplantibacillus plantarum and Lentilactobacillus buchneri on corn and sorghum silage quality and sheep energy partition under tropical conditions
Authors: de Assis Pires Frederico Patrus Ananias , Tomich Thierry Ribeiro , Pereira Luiz Gustavo Ribeiro , Machado Fernanda Samarini , Campos Mariana Magalhães , de Oliveira Alan Figueiredo , Menezes Guilherme Lobato , de Menezes Rafael Araújo , de Sousa Pamella Grossi , Jayme Diogo Gonzaga , Gonçalves Lúcio Carlos
Published: January 2023

This study aimed to evaluate the silage quality, ingestive behaviour, and sheep energy partition fed corn and sorghum silages, with or without inoculation with Lactiplantibacillus plantarum and Lentilactobacillus buchneri. Whole plants of one dent corn hybrid (DCS), one flint corn hybrid (FCS), and one forage sorghum hybrid (SS) were ensiled with or without an inoculant containing L. plantarum and L. buchneri (4 × 105 CFU g−1), totalling six treatments (3 × 2 factorial scheme). The treatments were ensiled in metal drums with 200 L capacity. The lactic acid concentrations in the inoculated FCS and DCS were higher by 13.4% and 12.8%, respectively, than those in the non‐inoculated plants. In contrast, the lactic acid concentration in the inoculated SS was 23.1% lower than that in the non‐inoculated SS. Furthermore, there were differences in pH and acetic acid concentrations only in SS, which were 2.3% and 45.2% higher, respectively, in inoculated silage than in non‐inoculated silage. In inoculated DCS and SS, propionic acid concentrations were 1.7 times higher (for both silages), and 1‐propanol was 3.7 and 1.8 times higher compared than those in non‐inoculated silages. There was a main effect of the inoculant on 1,2‐propanediol concentrations, which were 37.5% higher in inoculated silages than in non‐inoculated silages. However, ingestive behaviour, heat and methane production, and silage net energy concentrations were not affected by inoculant use. Fermentative modifications caused by inoculation with L. plantarum and L. buchneri in whole plant corn or sorghum silage did not modify sheep energy partition.
Egg shape variation across the distribution of the partially migratory fork‐tailed flycatcher Tyrannus savana
Authors: Gómez‐Bahamón Valentina , Chen Elizabeth R. , Tuero Diego T. , Sabio María de las Nieves , Tkach Kevin , Assis Marcelo , Heming Neander M. , Marini Miguel Â. , Bates John M.
Published: January 2023

The evolution of egg shape across birds has been associated with breeding ecology, body shape constraints and nest microclimate, among other factors. We model the effects of migratory status, climate, clutch size and egg volume on egg shape variation over the distribution of fork‐tailed flycatchers Tyrannus savana. Although migratory status and climatic variables appear to be influencing intraspecific egg shape, these effects are not significant when accounting for nest identity as a random factor (i.e. eggs from the same clutch are more similar than to other clutches). Moreover, the differences that we observe in egg shape are not explained by variation in egg size. Finally, within a breeding population of migratory fork‐tailed flycatchers, egg shape does not vary with respect to egg‐laying order and/or female wing length (standardized by weight). Egg shape is highly variable within populations of fork‐tailed flycatchers but not within clutches, suggesting that female traits, apart from migratory status and wing morphology, constrain egg shape variation.
Performance of an implantable cardioverter‐defibrillator lead family
Authors: Klampfleitner Stefanie , Mundel Markus , Schinke Karin , Neuberger Hans‐Ruprecht
Published: January 2023

Background

Lead failure is the major limitation in implantable cardioverter‐defibrillator (ICD) therapy. Long‐term follow‐up data for Biotronik Linox ICD leads are limited. Therefore, we analyzed the performance of all these leads implanted at our institution.

Materials and Methods

All Linox and Linox Smart ICD leads implanted between 2006 and 2015 were identified. Lead failure was defined as electrical dysfunction (oversensing, abnormal impedance, exit block). Lead survival was described, according to Kaplan–Meier. Associations between lead failure and specific variables were examined. p < .05 was considered significant.

Results

We included 417 ICD leads. The median follow‐up time for Linox (n = 205) was 81 months and for Linox Smart (n = 212) 75 months. During that follow‐up time, 30 Linox (14.6%) and 16 Linox Smart leads (7.6%) showed a malfunction. The 5‐year lead survival probability was 97.4% for Linox and 95.2% for Linox Smart (log‐rank test, p = .19). The 6‐ and 8‐year lead survival probability for Linox was 93.6% and 84.6%, and for Linox Smart 93% and 91.9%. The only factor significantly associated with lead failure was younger patient age at implantation (hazard ratio/year: 0.97, 95% CI: 0.94–0.99, p = .002).

Conclusion

This relatively large study with a long follow‐up period highlights a relevant failure rate of Biotronik Linox leads. The performance of Linox versus Linox Smart ICD leads was comparable. Although we show an acceptable 5‐year lead survival probability, we observed a marked drop after just 1 more year of follow‐up. In an era of improving heart failure survival probability, a prolonged follow‐up of ICD leads is increasingly clinically relevant.
Increasing time between first diagnosis of atrial fibrillation and catheter ablation adversely affects long‐term outcomes in patients with and without structural heart disease
Authors: Sessions Andrew J. , May Heidi T. , Crandall Brian G. , Day John D. , Cutler Michael J. , Groh Christopher A. , Navaravong Leenapong , Ranjan Ravi , Steinberg Benjamin A. , J. Bunch Thomas
Published: January 2023

Introduction

Atrial Fibrillation (AF) is a common arrhythmia often comorbid with systolic or diastolic heart failure (HF). Catheter ablation is a more effective treatment for AF with concurrent left ventricular dysfunction, however, the optimal timing of use in these patients is unknown.

Methods

All patients that received a catheter ablation for AF(n = 9979) with 1 year of follow‐up within the Intermountain Healthcare system were included. Patients with were identified by the presence of structural disease by ejection fraction (EF): EF ≤ 35% (n = 1024) and EF > 35% (n = 8955). Recursive partitioning categories were used to separate patients into clinically meaningful strata based upon time from initial AF diagnosis until ablation: 30–180(n = 2689), 2:181–545(n = 1747), 3:546–1825(n = 2941), and 4:>1825(n = 2602) days.

Results

The mean days from AF diagnosis to first ablation was 3.5 ± 3.8 years (EF > 35%: 3.5 ± 3.8 years, EF ≤ 35%: 3.4 ± 3.8 years, p = .66). In the EF > 35% group, delays in treatment (181–545 vs. 30–180, 546–1825 vs. 30–180, >1825 vs. 30–180 days) increased the risk of death with a hazard ratio (HR) of 2.02(p < .0001), 2.62(p < .0001), and 4.39(p < .0001) respectively with significant risks for HF hospitalization (HR:1.44–3.69), stroke (HR:1.11–2.14), and AF recurrence (HR:1.42–1.81). In patients with an EF ≤ 35%, treatment delays also significantly increased risk of death (HR 2.07–3.77) with similar trends in HF hospitalization (HR:1.63–1.09) and AF recurrence (HR:0.79–1.24).

Conclusion

Delays in catheter ablation for AF resulted in increased all‐cause mortality in all patients with differential impact observed on HF hospitalization, stroke, and AF recurrence risks by baseline EF. These data favor earlier use of ablation for AF in patients with and without structural heart disease.
Ripple mapping in ventricular tachycardia substrate mapping and ablation of nonischemic ventricular tachycardia
Authors: Gilge Jasen L. , Joshi Sandeep A. , Nair Girish V. , Clark Bradley A. , Prystowsky Eric N. , Patel Parin J.
Published: January 2023

Introduction

Substrate‐based ablation for ventricular tachycardia (VT) using Ripple map (RM) is an effective treatment strategy for patients with ischemic cardiomyopathy but has yet to be evaluated in patients with nonischemic cardiomyopathy (NICMO). The aim of this study is to determine the feasibility and effectiveness of an RM‐based ablation for NICMO patients.

Methods and Results

This was a single‐center, retrospective study including all NICMO patients undergoing VT ablation at St Vincent Hospital between January 1, 2018 and January 12, 2019. Retrospective RM analysis was performed on those that had a substrate‐based ablation to identify the location and number of Ripple channels as well as their proximity to ablation lesions. Thirty‐three patients met the inclusion criteria and had a median age of 65 (58, 73.5) with 15.2% of the population being female, and were followed for a median duration of 451 (217.5, 586.5) days. Of these patients, 23 (69.7%) had a substrate‐based ablation with a median procedural duration of 196.4 (186.8, 339) min, 1946 (517, 2750) points collected per map, and 277 (141, 554) points were within the scar. Two (8.6%) procedural complications occurred, and 7 (30.4%) patients had VT recurrence during follow‐up. RM analysis revealed an average of two Ripple channels and the patients without VT recurrence had ablation performed closer to the Ripple channels: 0 (0, 4.7) versus 14.3 (0, 23.5) cm; p = .02.

Conclusion

An RM‐based substrate ablation can be performed in NICMO patients and ablation within Ripple channels is a predictor of VT freedom.
Assisted reality device to guide cardiac implantable device programming in distant rural areas
Authors: Diaz Juan C. , Cañas Felipe , Duque Mauricio , Aristizabal Julian , Niño Cesar , Bastidas Oriana , Marin Jorge , Rivera Estefania , Hoyos Carolina , Matos Carlos , Peralta Adelqui , Martin David T. , Romero Jorge
Published: January 2023

Background

Patients with cardiac implantable electronic devices (CIEDs) living in rural areas have difficulty obtaining follow‐up visits for device interrogation and programming in specialized healthcare facilities.

Objective

To describe the use of an assisted reality device designed to provide front‐line workers with real‐time online support from a remotely located specialist (Realwear HTM‐1; Realwear) during CIED assistance in distant rural areas.

Methods

This is a prospective study of patients requiring CIED interrogation using the Realwear HMT‐1 in a remote rural population in Colombia between April 2021 and June 2022. CIED interrogation and device programming were performed by a general practitioner and guided by a cardiac electrophysiologist. Non‐CIED‐related medical interventions were allowed and analyzed. The primary objective was to determine the incidence of clinically significant CIED alerts. Secondary objectives were the changes medical interventions used to treat the events found in the device interrogations regarding non‐CIED related conditions.

Results

A total of 205 CIED interrogations were performed on 139 patients (age 69 ± 14 years; 54% female). Clinically significant CIED alerts were reported in 42% of CIED interrogations, consisting of the detection of significant arrhythmias (35%), lead malfunction (3%), and device in elective replacement interval (3.9%). Oral anticoagulation was initiated in 8% of patients and general medical/cardiac interventions unrelated to the CIED were performed in 52% of CIED encounters.

Conclusion

Remote assistance using a commercially available assisted reality device has the potential to provide specialized healthcare to patients in difficult‐to‐reach areas, overcoming current difficulties associated with RM, including the inability to change device programming. Additionally, these interactions provided care beyond CIED‐related interventions, thus delivering significant social and clinical impact to remote rural populations.
Risk factors associated with higher mortality in patients with cardiac implantable electronic device infection
Authors: Kalot Mohamad A. , Bahuva Ronak , Pandey Rohan , Farooq Waseem , Mir Ali , Khan Aalia , Kerling David , Aftab Hamza , Kovacs Alexander , Gupta Shilpi , Smith Morgan , Tian Lili , Amuthan Ram , Sharma Umesh C.
Published: January 2023

Introduction

Cardiac Implantable Electronic Devices (CIEDs) are widely used for the management of advanced heart failure and ventricular arrhythmias. CIED‐Infection (CIED‐I) has very high mortality, especially in the subsets of patients with limited health‐care access and delayed presentation. The purpose of this study is to identify the risk‐predictors mortality in subjects with CIED‐I.

Methods

We performed a retrospective cohort study of a regional database in patients presenting with CIED infections to tertiary care medical centers across Western New York, USA from 2012 to 2020. The clinical outcomes included recurrent device infection (any admission for CIED‐I after the first hospitalization for device infection), septic complications (pulmonary embolism, respiratory failure, septic shock, decompensated HF, acute kidney injury) and mortality outcomes (death during hospitalization, within 30 days from CIED‐I, and within 1 year from CIED‐I). We studied associations between categorical variables and hard outcomes using χ2 tests and used one‐way analysis of variance to measure between‐groups differences.

Results

We identified 296 patients with CIED‐I, among which 218 (74%) were male, 237 (80%) were white and the mean age at the time of infection was 69.2 ± 13.7 years. One‐third of the patients were referred from the regional facilities. Staphylococcus aureus was responsible for most infections, followed by Enterococcus fecalis. On multivariate analysis, the covariates associated with significantly increased mortality risk included referral from regional facility (OR: 2.0;1.0–4.0), hypertension (Odds ratio, OR: 3.2;1.3–8.8), right ventricular dysfunction (OR: 2.6;1.2–5.1), end‐stage renal disease (OR: 2.6;1.1–6.2), immunosuppression (OR: 11.4;2.5–53.3), and septic shock as a complication of CIED‐I (OR: 3.9;1.3–10.8).

Conclusion

Hypertension, right ventricular dysfunction, immunosuppression, and end‐stage renal disease are associated with higher mortality after CIED‐I. Disproportionately higher mortality was also noted in subjects referred from the regional facilities. This underscores the importance of early clinical risk‐assessment, and the need for a robust referral infrastructure to improve patient outcomes.
A Single‐lead ECG algorithm to differentiate right from left manifest accessory pathways: A reappraisal of the P‐Delta interval
Authors: Ali Hussam , De Lucia Carmine , Cristiano Ernesto , Lupo Pierpaolo , Foresti Sara , De Ambroggi Guido , Turturiello Dario , Paganini Edoardo Maria , Bessi Riccardo , Farghaly Ahmad Abdelrady Abdelsalam , Francia Pietro , Cappato Riccardo
Published: January 2023

Introduction

Despite numerous ECG algorithms being developed to localize the site of manifest accessory pathways (AP), they often require stepwise multiple‐lead analysis with variable accuracy, limitations, and reproducibility. The study aimed to develop a single‐lead ECG algorithm incorporating the P‐Delta interval (PDI) as an adjunct criterion to discriminate between right and left manifest AP.

Methods

Consecutive WPW patients undergoing electrophysiological study (EPS) were retrospectively recruited and split into a derivation and validation group (1:1 ratio). Sinus rhythm ECG analysis in lead V1 was performed by three independent investigators blinded to the EPS results. Conventional ECG parameters and PDI were assessed through the global cohort.

Results

A total of 140 WPW patients were included (70 for each group). A score‐based, single‐lead ECG algorithm was developed through derivation analysis incorporating the PDI, R/S ratio, and QRS onset polarity in lead V1. The validation group analysis confirmed the proposed algorithm's high accuracy (95%), which was superior to the previous ones in predicting the AP side (p < 0.05). A score of ≤+1 was 96.5% accurate in predicting right AP while a score of ≥+2 was 92.5% accurate in predicting left AP. The new algorithm maintained optimal performance in specific subgroups of the global cohort showing an accuracy rate of 90%, 92%, and 96% in minimal pre‐excitation, posteroseptal AP, and pediatric patients, respectively.

Conclusions

A novel single‐lead ECG algorithm incorporating the PDI interval with previous conventional criteria showed high accuracy in differentiating right from left manifest AP comprising pediatric and minimal pre‐excitation subgroups in the current study.
Implementation of an intravenous sotalol initiation protocol: Implications for feasibility, safety, and length of stay
Authors: Liu Albert Y. , Charron Jessica , Fugaro Dana , Spoolstra Scott , Kaplan Rachel , Lohrmann Graham , Gao Xu , Gay Hawkins , Passman Rod , Kim Susan , Lin Albert C. , Chicos Alexandru , Arora Rishi , Patil Kaustubha , Pfenniger Anna , Knight Bradley P. , Verma Nishant
Published: January 2023

Introduction

Oral sotalol initiation requires a multiple‐day, inpatient admission to monitor for QT prolongation during loading. A 1‐day intravenous (IV) sotalol loading protocol was approved by the United States Food and Drug Administration in March 2020, but limited data on clinical use and administration currently exists. This study describes implementation of an IV sotalol protocol within an integrated health system, provides initial efficacy and safety outcomes, and examines length of stay (LOS) compared with oral sotalol initiation.

Methods

IV sotalol was administered according to a prespecified initiation protocol to adult patients with refractory atrial or ventricular arrhythmias. Baseline characteristics, safety and feasibility outcomes, and LOS were compared with patients receiving oral sotalol over a similar time period.

Results

From January 2021 to June 2022, a total of 29 patients (average age 66.0 ± 8.6 years, 27.6% women) underwent IV sotalol load and 20 patients (average age 60.4 ± 13.9 years, 65.0% women) underwent oral sotalol load. The load was successfully completed in 22/29 (75.9%) patients receiving IV sotalol and 20/20 (100%) of patients receiving oral sotalol, although 7/20 of the oral sotalol patients (35.0%) required dose reduction. Adverse events interrupting IV sotalol infusion included bradycardia (seven patients, 24.1%) and QT prolongation (three patients, 10.3%). No patients receiving IV or oral sotalol developed sustained ventricular arrhythmias before discharge. LOS for patients completing IV load was 2.6 days shorter (mean 1.0 vs. 3.6, p < .001) compared with LOS with oral load.

Conclusion

IV sotalol loading has a safety profile that is similar to oral sotalol. It significantly shortens hospital LOS, potentially leading to large cost savings.
Differential gap location after radiofrequency versus cryoballoon pulmonary vein isolation: Insights from a randomized trial with protocol‐mandated repeat procedure
Authors: Sørensen Samuel K. , Johannessen Arne , Worck René , Hansen Morten L. , Ruwald Martin H. , Hansen Jim
Published: January 2023

Introduction

Reconnections to pulmonary vein (PV) triggers of atrial fibrillation (AF) are the primary cause of AF recurrence after PV isolation (PVI) with radiofrequency (RF) or cryoballoon catheter ablation (CRYO), but method‐specific contributions to PV reconduction pattern and conductive gap location are incompletely understood.

Methods

The objective of this radiofrequency versus cryoballoon catheter ablation for paroxysmal atrial fibrillation substudy was to determine procedure‐specific patterns of PV reconduction in a randomized population with protocol‐mandated repeat procedures, irrespective of AF recurrence. Each PV was assessed in turn and PV reconnection sites were identified by high‐density electroanatomical mapping and locating the earliest activation site. Gap locations were verified by PV re‐isolation.

Results

In 98 patients, 81% versus 76% previously isolated PVs remained isolated after CRYO versus RF (risk ratio [RR]: 1.06; 95% confidence interval [CI]: 0.96–1.18; p = .28). There were no significant differences for any PV: left superior PV: 90% versus 80%; left inferior PV: 80% versus 78%; right superior PV: 81% versus 80%, and right inferior PV: 76% versus 73%. For each reconnected PV, 34% of ipsilateral PVs were also reconnected after CRYO compared with 64% after RF (RR: 0.54; 95% CI: 0.32–0.90; p = .01). After RF, gaps were clustered by the carina and adjacent segments, whereas they were more heterogeneously distributed after CRYO.

Conclusion

Although RF and CRYO produce similar proportions of durably isolated PVs, gap locations appear to develop in procedure‐specific patterns. After RF, ipsilateral PV reconduction is more frequent and gap sites cluster by the carina, suggesting that this region should be selectively ablated for more durable PVI.
Protocol for the implementation and evaluation of a community‐based behavior change intervention to reduce dietary salt intake in India
Authors: Johnson Claire , Thout Sudhir Raj , Nidhuram Spoorthi , Hart Ashleigh , Hoek Annet C. , Rogers Kris , Shivashankar Roopa , Ide Nicole , Chatterjee Susmita , Webster Jacqui , Praveen Devarsetty
Published: January 2023

Excess dietary salt intake is well established as a leading cause of high blood pressure and associated cardiovascular disease, yet current salt intake in India is nearly 11 g per day, more than twice World Health Organization maximum recommended intake of 5 g per day. Although dietary survey data from India indicate that the main sources of dietary salt are salt added during cooking at home, and few salt reduction efforts have focused on interventions at the household level. As a result, there is little evidence of the effectiveness of behavior change programs to reduce salt intake at the household level. The study aims to develop and implement a community based behavioral change intervention to reduce salt intake delivered by front line community‐based health volunteers; and evaluate the preliminary effectiveness, acceptability, and feasibility of delivering a salt reduction behavior change program and potential to support future scale‐up. The study is a pre‐post intervention design, and outcomes will be evaluated from a random sample of 1500 participants from 28 villages in two primary health centers in Siddipet, Telangana. Primary outcome is change in salt‐related KAB (knowledge, attitude, and behavior) score, and secondary outcomes will be changes in salt intake measured by 24 h urinary sodium excretion and change in scores using the subscales of the COM‐B (“capability”, “opportunity”, “motivation” and “behavior”) tool. Findings will be used to inform future public health policies to support implementation of scalable community‐based interventions to reduce salt intake and control hypertension, the leading‐cause of death in India.
Progress in genetics of type 2 diabetes and diabetic complications
Authors: Shojima Nobuhiro , Yamauchi Toshimasa
Published: January 2023

Type 2 diabetes results from a complex interaction between genetic and environmental factors. Precision medicine for type 2 diabetes using genetic data is expected to predict the risk of developing diabetes and complications and to predict the effects of medications and life‐style intervention more accurately for individuals. Genome‐wide association studies (GWAS) have been conducted in European and Asian populations and new genetic loci have been identified that modulate the risk of developing type 2 diabetes. Novel loci were discovered by GWAS in diabetic complications with increasing sample sizes. Large‐scale genome‐wide association analysis and polygenic risk scores using biobank information is making it possible to predict the development of type 2 diabetes. In the ADVANCE clinical trial of type 2 diabetes, a multi‐polygenic risk score was useful to predict diabetic complications and their response to treatment. Proteomics and metabolomics studies have been conducted and have revealed the associations between type 2 diabetes and inflammatory signals and amino acid synthesis. Using multi‐omics analysis, comprehensive molecular mechanisms have been elucidated to guide the development of targeted therapy for type 2 diabetes and diabetic complications.
Subinhibitory concentrations of florfenicol increase the biofilm formation of Piscirickettsia salmonis
Authors: Oliver Cristian , Céspedes Constanza , Santibañez Natacha , Ruiz Pamela , Romero Alex
Published: January 2023

Public health is facing a new challenge due to the increased bacterial resistance to most of the conventional antibacterial agents. Inadequate use of antibiotics in the Chilean aquaculture industry leads to the generation of multidrug resistance bacteria. Many fish pathogenic bacteria produce biofilm upon various sources of stress such as antibiotics, which provides several survival advantages for the bacterial life in community and can constitute a reservoir of pathogens in the marine environment. Being florfenicol a broad‐spectrum antibiotic commonly used to treat infections in aquaculture, the aim of this study was to assess whether this antibiotic modulates in vitro the biofilm formation in several isolates of Piscirickettsia salmonis. Standard antibiotic‐micro broth 96‐flat well plates were used to determinate the minimal inhibitory concentration of florfenicol in eight different P. salmonis isolates. In vitro findings, with P. salmonis growing in the presence and absence of the antibiotic, exhibited a statistically significantly increase (p < .05) in biofilm formation in all the bacterial isolates cultivated with sub‐MIC (defined as the half of the minimal inhibitory concentration in the presence of antibiotic) of florfenicol compared with controls (antibiotic‐free broth). In conclusion, sub‐MIC of florfenicol induced an increased biofilm formation in all P. salmonis isolates tested.
A novel paper based loop mediated isothermal amplification and lateral flow assay (LAMP‐LFA) for point‐of‐care detection of buffalo tissue origin in diverse foods
Authors: Jawla Jyoti , Kumar Rajiv Ranjan , Mendiratta Sanjod Kumar , Agarwal Ravi Kant , Singh Praveen , Saxena Vikas , Kumari Sarita , Kumar Dhananjay
Published: January 2023

In this study, we have designed a paper based loop‐mediated isothermal amplification‐lateral flow (LAMP‐LF) Assay that integrated the use of self‐designed lyophilized paper LAMP buttons as ready‐made LAMP master‐mix for on‐site detection of tissue of buffalo origin. Based on mitochondrial cytochrome b gene sequences, a pair of LAMP primers and probes were selected and designed, respectively. Herein, we optimized LAMP reaction components and thermal protocol to evaluate LAMP amplification in various paper matrices frequently used in diagnostics (cellulose, glass fiber, and nitrocellulose). The hybridization conditions of probes, as well as other components of paper LAMP‐LF Assay, were further optimized. Our low‐cost paper based system demonstrated high specificity and was able to detect as low as 10 fg of target DNA. The efficiency and accuracy of the assay were determined targeting coded meat/tissue samples, binary meat admixture, processed meat samples, Phire Animal Tissue Direct PCR kit, and by investigating the consistency between paper based LAMP‐LFA and conventional PCR outcomes. Furthermore, the paper platform was allowed for refrigeration‐temperature storage to determine its ability for deployment in low settings areas. In the current investigation, the time required from sample collection to detection was approximately 2–3 hr.
The battle of crops against drought: Genetic dissection and improvement
Authors: Yang Zhirui , Qin Feng
Published: January 2023

With ongoing global climate change, water scarcity‐induced drought stress remains a major threat to agricultural productivity. Plants undergo a series of physiological and morphological changes to cope with drought stress, including stomatal closure to reduce transpiration and changes in root architecture to optimize water uptake. Combined phenotypic and multi‐omics studies have recently identified a number of drought‐related genetic resources in different crop species. The functional dissection of these genes using molecular techniques has enriched our understanding of drought responses in crops and has provided genetic targets for enhancing resistance to drought. Here, we review recent advances in the cloning and functional analysis of drought resistance genes and the development of technologies to mitigate the threat of drought to crop production.
Moderated mediation approach to determine the effect of natural packaging factors on intention to purchase natural skincare products among the population of Klang Valley, Malaysia
Authors: Najm Ahmed Abdulkareem , Salih Sarah Abdulkareem , Fazry Shazrul , Law Douglas , Azfaralariff Ahmad
Published: January 2023

The trends for health and pro‐environmental behaviors led to motivating consumers' attention to use natural skincare products. Purchase intention for natural skincare products can be influenced by several environmental, behavioral, and external factors. In line with global trends, the current study aims to determine the moderated mediation path in the relationship between the aspects of natural packaging of natural skincare products (environmental concerns, packaging design, and printed information), and the intention to purchase natural skincare products purchase intention. A web‐based survey was used to gather quantitative data from a convenience sample of 330 participants from Klang Valley, Malaysia. The study outcomes revealed that personal attitude significantly mediated the effect of environmental concerns, natural packaging design, and package printed information on purchase intention. Most importantly, the product safety certificate had a significant moderated mediation effect on the model of environmental concerns, natural packaging design, and purchase intention for natural skincare products. The results contributed to the information and recommendations for stakeholders to consider the packaging factors and safety certificates in the purchase behavior models in promoting the natural skincare products' marketing and industry.

Practical Application

The significance of the study lies in the linkage of graphic design to sustainability and marketing management research.
Robert Greville on Sins, Privations, and Dialetheism
Authors: Connolly Patrick J.
Published: January 2023

In the history of Western philosophy, dialetheism – the view that some sentences are both true and false – has been unpopular. This paper recovers a previously overlooked episode in the history of dialetheism. Specifically, it reconstructs a section of Robert Greville's The Nature of Truth (1640) in order to show that he was a dialetheist. Greville's consideration of the view that evil is a privation led him to endorse the claim that sinful acts are contradictory; they are the subjects of both being and non‐being. The paper also explores responses to Greville from John Wallis and Nathaniel Culverwell.
Vows without a self
Authors: Berryman Kevin , Chadha Monima , Nichols Shaun
Published: January 2023

Vows play a central role in Buddhist thought and practice. Monastics are obliged to know and conform to hundreds of vows. Although it is widely recognized that vows are important for guiding practitioners on the path to enlightenment, we argue that they have another overlooked but equally crucial role to play. A second function of the vows, we argue, is to facilitate group harmony and cohesion to ensure the perpetuation of the dhamma and the saṅgha. However, the prominence of vows in the Buddhist tradition seems at odds with another central part of the doctrine. For vows, like other promises, seem to involve representing a persisting self as the individual who undertakes the vow. And to explicitly appeal to a persisting self conflicts with one of the most important philosophical commitments of Buddhism – the no self view. We argue though that once we articulate the details of how vows generate behavior that conforms to them, we can see that no appeal to the self is required to internalize and act on vows.
Bill of lading data in international trade research with an application to the COVID‐19 pandemic
Authors: Flaaen Aaron , Haberkorn Flora , Lewis Logan , Monken Anderson , Pierce Justin , Rhodes Rosemary , Yi Madeleine
Published: January 2023

We evaluate high‐frequency bill of lading data for international trade research. These data offer some advantages over both other publicly accessible trade data and confidential datasets, but they also have drawbacks. We analyze three aspects of trade during the COVID‐19 pandemic. First, we show how the high‐frequency data capture the within‐month collapse of trade between the United States and India that are not observable in official monthly data. Second, we demonstrate how U.S. buyers shifted their purchases across suppliers over time during the recovery. And third, we show how the data can measure vessel delivery bottlenecks in near real time.
Performance evaluation of an oily industrial wastewater treatment system using the application of activated sludge model No. 3
Authors: Ayoub Mohamed
Published: January 2023

The purpose of the present study was to adapt the activated sludge model No. 3 (ASM3) to the characteristics of oily industrial wastewater, determining the utmost significant and appropriate kinetic as well as stoichiometric parameters. An oily industrial wastewater treatment system was simulated to assess ASM3 validation and perform sensitivity analysis using the STOAT program. The obtained results revealed that the ASM3 model, which was calibrated after adding the Arrhenius equation into consideration, provided strong correlations with the analytical results of chemical oxygen demand (COD), total suspended solids (TSS), mixed liquor volatile suspended solids (MLVSS) and total suspended solids in the return activated sludge flow (TSS in RAS) concentrations. The values of modelled effluent COD and TSS are very close to those corresponding real values of the treated wastewater by a difference of between 0.5% and 1.5%. Thus, this model becomes successful in representing oily industrial wastewater treatment as a new trend added to the traditional modelling of sewage treatment.
Training Periodization, Intensity Distribution, and Volume in Trained Cyclists: A Systematic Review
Authors: Galán-Rioja Miguel Ángel , Gonzalez-Ravé José María , González-Mohíno Fernando , Seiler Stephen
Published: January 2023

A well-planned periodized approach endeavors to allow road cyclists to achieve peak performance when their most important competitions are held. Purpose: To identify the main characteristics of periodization models and physiological parameters of trained road cyclists as described by discernable training intensity distribution (TID), volume, and periodization models. Methods: The electronic databases Scopus, PubMed, and Web of Science were searched using a comprehensive list of relevant terms. Studies that investigated the effect of the periodization of training in cyclists and described training load (volume, TID) and periodization details were included in the systematic review. Results: Seven studies met the inclusion criteria. Block periodization (characterized by employment of highly concentrated training workload phases) ranged between 1- and 8-week blocks of high-, medium-, or low-intensity training. Training volume ranged from 8.75 to 11.68 h·wk–1 and both pyramidal and polarized TID were used. Traditional periodization (characterized by a first period of high-volume/low-intensity training, before reducing volume and increasing the proportion of high-intensity training) was characterized by a cyclic progressive increase in training load, the training volume ranged from 7.5 to 10.76 h·wk–1, and pyramidal TID was used. Block periodization improved maximum oxygen uptake (VO2max), peak aerobic power, lactate, and ventilatory thresholds, while traditional periodization improved VO2max, peak aerobic power, and lactate thresholds. In addition, a day-by-day programming approach improved VO2max and ventilatory thresholds. Conclusions: No evidence is currently available favoring a specific periodization model during 8 to 12 weeks in trained road cyclists. However, few studies have examined seasonal impact of different periodization models in a systematic way.
The Built Environment and Population Physical Activity: Methods for Mapping the Relevant Laws
Authors: Nau Tracy , Bellew William , Giles-Corti Billie , Bauman Adrian , Smith Ben J.
Published: January 2023

Background: The development of policies that promote and enable physical activity (PA) is a global health priority. Laws are an important policy instrument that can enable enduring beneficial outcomes for individuals, organizations, and environments through multiple mechanisms. This article presents a systematic process for mapping laws relevant to PA, which can be used to understand the role of laws as a powerful PA policy lever. Methods: Building on methods used in public health law research, we developed a protocol for scientific mapping of laws influencing the built environment for PA in Australia. The MonQcle online legal research platform was used for data coding, analysis, and presentation. Results: We describe the 10 key stages of legal mapping that we applied to examine state and territory laws that influence walking and cycling in Australia. Conclusions: Law is a neglected element of policy research for PA. There is a need for accessible legal data to drive the design, investment, and implementation of legal interventions to improve population PA. Legal mapping is a first step toward evaluation of such laws for PA. This paper provides a practical case study and guidance for the 10 stages in legal mapping of laws that influence the built environment for PA.
Associational Resistance to Predation by Protists in a Mixed Species Biofilm
Authors: Goh Yu Fen , Røder Henriette L. , Chan Siew Herng , Ismail Muhammad Hafiz , Madsen Jonas S. , Lee Kai Wei Kelvin , Sørensen Søren J. , Givskov Michael , Burmølle Mette , Rice Scott A. , McDougald Diane
Published: January 2023

Biofilms have been shown to protect bacterial cells from predation by protists. Biofilm studies have traditionally used single species systems, which have provided information on the mechanisms and regulation of biofilm formation and dispersal, and the effects of predation on these biofilms.
Contribution of PCR to Differential Diagnosis between Patients with Whipple Disease and Tropheryma whipplei Carriers
Authors: Meyer Sylvain , Puéchal Xavier , Quesne Gilles , Marques Isabelle , Jamet Anne , Ferroni Agnès
Published: January 2023

Differentiation between Whipple disease (WD) patients and patients carrying
Tropheryma
whipplei
but suffering from disease other than WD (“carriers”) remains complex. We aimed to evaluate
T. whipplei
PCR among patients with WD and carriers in a large cohort at our referral clinical microbiology laboratory. This is an observational retrospective cohort study, including all patients between 2008 and 2020 with at least one positive result for
T. whipplei
using the real-time PCR RealCycler TRWH-UX kit. A total of 233 patients were included: 197 were considered carriers, and 36 had WD.
Genome Sequence of “
Caldinitratiruptor microaerophilus
,” a Unique Microaerophilic Bacterium Closely Related to
Symbiobacterium
Authors: Nishiyama Tatsuya , Mukaiyama Riku , Ueda Kenji
Published: January 2023

We present the genome sequence of “
Caldinitratiruptor microaerophilus
” JCM16183, isolated by Fardeau et al. from a French hot spring. This microaerophilic bacterium represents a novel taxon related to the genus
Symbiobacterium
. The high (71%) G+C content of its 3.60-Mb circular genome supports the divergence of this bacterium from
Clostridia
.