bluuebunny/crossref_metadata_2025_split huggingface dataset:
The procedural characteristics of radiofrequency ablation points in patients undergoing atrial fibrillation ablation: comparison between standard vs very high-power short-duration
Authors: Biagi A , Rossi L , Bolognesi M G , Gibiino F , Aschieri D 
Published: May 2024

Abstract

Introduction
Atrial fibrillation ablation has a central role in the treatment of atrial fibrillation.
Radiofrequency (RF) ablation is one of the possible energy sources used for the procedure.
Recently, the development of new catheters has made it possible to modify the amount of power delivered by moving from a standard ablation to a very high-power short-duration (VHPSD). The objective of the study is to compare the delivery features of the RF points between standard RF vs VHPSD.

Methods
All the patients underwent RF ablation of paroxysmal atrial fibrillation.
The procedure was performed using an electroanatomical mapping system under conscious sedation. All patient received a heparin bolus for ACT&gt;300. The anatomy of the left atrium was reconstructed with a high-density catheter. Radiofrequency (RF) was applied following a wide antral circumferential approach (WACA) obtaining the isolation of the veins. The use of the ablation catheter was at the discretion of the operator and the choice was between a standard open-irrigated catheter with force sensor (Smartouch SF) and an irrigated, temperature-controlled contact-force sensing capable of delivering VHPSD (QDOT MICRO). For every patient, data from each individual RF delivery point were collected and analysed.

Results
A total of 72 consecutive patients were collected (26 QDOT group vs 46 standard group).
Average total number of ablation point for obtaining complete pulmonary vein isolation with WACA was lower in the QDOT group (QDOT group 37,8±11 vs 42,1±18 standard group).
As expected, the average duration (QDOT group 3.9±0.1s vs 12.7±2.4s standard group) and the average power delivered was significantly different between the two group (QDOT group 89,8±0.8W vs 33.0±1.4W standard group).
Average basal impedence was similar (QDOT group 133.2±11,6 ohm vs 122.4±11,4ohm standard group) while impedence drop was significantly different (QDOT group 12.2±2.4 vs 9.9±2.4s standard group).

Conclusion
VHPSD ablation allows isolation of the pulmonary veins to be achieved with fewer ablation points and more quickly. It is also associated with a greater impedence drop during delivery. More studies are needed to see if this also corresponds to a lower number of recurrences after ablation.
Assessing the impact of 3D imaging assistance on efficiency and safety in atrial fibrillation cryoablation
Authors: Solana-Munoz J , Teres C , Luca A , Herrera-Siklody C , Domenichini G , Pascale P , Pruvot E , Le Bloa M 
Published: May 2024

Abstract

Introduction
Pulmonary vein (PV) isolation is a cornerstone therapy for symptomatic atrial fibrillation (AF). Current 3D-navigation technologies used with radiofrequency (RF) ablation allow drastic reduction of X-ray exposure and better anatomical characterization improving acute and long-term procedural results. Cryoballoon ablation (CA) procedures typically rely on conventional fluoroscopy, resulting in significant X-ray exposure. Although contemporary fluoroscopy technologies allow for potential 3D imaging integration, their specific utility in improving procedural guidance during CA remains undefined.

Method
Using semi-automatic segmentation obtained from pre-procedural cardiac computed tomography, 3D segmentations of the left atrium, including PV, spine and primary bronchi walls were fused on the real-time fluoroscopy acquisitions in three standard positions (AP, LAO, RAO), acquired at the beginning of the procedure (Figure1). We compared procedural characteristics of CA performed with 3D-fusion imaging to conventional fluoroscopy-guided procedures.

Results
Thirty-six patients (aged 60±13 yo, 85% male) with paroxysmal AF treated with CA were included in the study: 18 in the control group (conventional fluoroscopy) and 18 in the 3D-assisted group. Acute PV isolation was achieved in all patients. The 3D-assisted CA was associated with significantly shorter procedure duration (mean 97.8±15.5 vs 82.1±16.1 min, p=0.0048); left-sided dwelling time (mean 77±15.2 vs 65.1±14.4 min, p=0.0351); and lower X-ray energy delivered to the patient (Dose Area product) with mean 661±373.1 vs 378.1±316.8 cGy*cm2 (p=0.013). Interestingly, we found that 72.2% of 3D guided procedures were done in less than 90min, while 77.8% of conventional cases required more than 90min to be completed (Figure 2D).

Conclusion
3D-fusion imaging integration is feasible and allows for an exact PV anatomy depiction on fluoroscopy. Our data illustrates that it might significantly improve CA efficiency (shorter procedure duration) and safety (lower X-ray exposure and left-sided dwelling time). Our approach could also impact long-term results since it might reduce the likeability of missing intermediate PVs. Further research is needed to evaluate the incremental value of 3D imaging in long term efficacy.Figure 1Figure 2
Tachyarrhythmia during gestation: peculiarities of manifestations and clinic
Authors: Smagulova A , Ainabekova B , Albaev R , Abdrakhmanova Z H , Suleymen Z H , Abdrakhmanov A 
Published: May 2024

Abstract

Background
Arrhythmias can occur during gestation. The data of peculiarities of development and manifestations of arrhythmias in pregnant women are limited.

Purpose
To determine the peculiarities of diagnostic and clinic in pregnant women with arrhythmias.

Methods
In this single-center, prospectively study we consequently included 87 cases of arrhythmias in pregnant (mean age 26.7±3.5 years, mean gestation age 24.6 ±3.3 weeks). The main types of arrhythmias and peculiarities of clinical manifestations were studed.

Results
In 56% of cases, arrhythmia firstly occurred during current gestation. The most common symptoms of arrhythmia in pregnant women firstly occured in the second trimester at 16 (13;21) weeks of gestation. The most common symptoms of arrhythmia were palpitations (58.6%), general weakness (52.9%), dyspnoe (34%) and dizziness (29.8%). The most common types of arrhythmias were paroxysmal supraventricular tachycardia (54%) and premature contractions (39%). Ventricular tachycardia was diagnosed less frequently – in 7%. Dynamic observation was chosen in 17% in benign course of arrhythmia. Antiarrhythmic drugs were prescribed in 32% in women with severe symptoms and haemodynamic instability. In cases of drug refractory and severe arrhythmias electrophysiological examination and radiofrequency ablation without fluoroscopy were performed in 51%. Despite different arrhythmia management the further course of gestation was benign without major complication: cases of increased incidence of uterine contractile activity and placental abruption were rare (n=2). ). Neonatal outcomes characterized by normal range of fetal birth weight and 5 minute Apgar score. There was no incidence of maternal and fetal mortality and arrhythmia recurrence after ablation in follow-up.

Conclusion
Arrhythmias may occur for the first time in women during pregnancy. Manifestation and recurrence of arrhythmias are observed mainly in the second trimester at 16 weeks of gestation. The most frequent variants of cardiac arrhythmias are paroxysmal supraventricular tachycardia (54%) and premature contractions (39%), which have a favorable course and prognosis.
The efficacy of compression dressings to reduce haematoma post cardiac implantable electronic devices - a systematic review and meta-analysis
Authors: Nageswararajah D , Cho K , Cham J , Premawardhana U , Lee A , Tie H , Hopkins A , Nguyen T , Assad J , Dimitri H 
Published: May 2024

Abstract

Background
Pocket haematomas are one of the most common complications post cardiovascular implantable electronic device (CIED) implantation.

Objective
We explored the use of mechanical compression devices compared to the conventional dressings post CIED implantation, to reduce the incidence of pocket haematomas. Secondary outcomes were pain scores and wound scar or healing.

Methods
Five electronic databases were systematically searched from their inception to 1st November 2023, identifying all studies which explored compression dressings post CIED implantation. Data were independently extracted by investigators according to predefined clinical endpoints. We used a Random-effects model for data analysis based on event rates (ER) and 95% confidence interval (CI).

Results
Six studies (786 patients) were included in the meta-analysis, with 373 in the compression arm and 385 patients in the control groups across the studies. There was a total incidence of 82 haematomas, of which 24.4% were in the mechanical compression group and 75.6% in the conventional dressings group (RR 0.36, 95% CI 0.23- 0.57). One study suggested improved wound healing with the compression dressing arm (Manchester Scar Scale 9.5 at 2 weeks for the control group and 7.5 for the compression dressings group). Two studies suggested increased pain scores (using a visual analogue scale) shortly after dressing application. One study suggested improved comfort scores in the compression group compared to the control at 48 hours and 7 days.

Conclusion
This systematic review and meta-analysis suggests for patients post CIED implantation, the use of novel mechanical compression dressings, when compared to conventional dressings, reduces the risk of pocket haematoma.Forest plot
Engagement personas in patients living with atrial fibrillation and multimorbidity, and their caregivers: results from the AFFIRMO international online survey
Authors: Leo D , Trevisan C , Graffigna G , Bosio C , Lobban T , Lane D 
Published: May 2024

Abstract

Introduction
Patients with atrial fibrillation (AF) often experience concomitant long-term health conditions. Their level of engagement, defined as their active role in the management of their condition, is crucial in identifying strategies to improve their care and self-management; similarly, the engagement level of their caregivers is also important.

Purpose
The AFFIRMO study aims to examine ways of optimising care and self-management for AF patients with multimorbidity by identifying characteristics of engagement personas for patients and their caregivers.

Methods
An online survey, distributed between June 2022 and January 2023, open to AF patients and their caregivers in five countries (UK, Italy, Denmark, Romania and Spain) collected data related to patients and caregivers’ engagement in the healthcare process using the Patient Health Engagement Scale® (PHE-s), the Altarum Consumer Engagement (ACE), and the Caregiver Health Engagement Scale® (CHE-s). Patients and caregivers were grouped into ‘high’ and ‘low’ engagement groups, based on scale-specific cut-off values, and compared by age group, sex, level of education and country of recruitment, using Chi-square tests (p&lt;0.05).

Results
659 patients (311 (47.2%) male, 70.9 (10.2) years), and 201 caregivers (54 (26.9%) male, 58.3 (15.2) years) participated. Based on the PHE-s®, 428 (64.9%) were classified as ‘high’ engagement level. Patients in the high engagement group were significantly more likely to be male, aged &lt;75 years, have secondary level education or above, and have &lt;3 co-morbidities; no differences in engagement level based on country of recruitment. Based on the ACE scale, 369 (56.0%) were categorised as ‘high’ engagement level. Those with ‘high’ engagement were significantly more likely to be &lt;65 years old, living in Northern Europe, educated to degree level or above, and had &lt;3 co-morbidities, with no sex differences in engagement level. One hundred thirty-eight (68.7%) caregivers reported ‘high’ engagement. However, there were no significant differences between sex, age group, region of recruitment, or level of education between high and low engagement in caregivers.

Conclusions
Identification of engagement personas of patients and their caregivers could help to develop better management pathways for AF patients with multimorbidity.Table 1.Level of engagement
Cardiovascular crossroads - exploring the impact of atrial fibrillation on mitral valve regurgitation and MitraClip treatment
Authors: Cesnakova Konecna A , Jiravsky O , Hudec M , Januska S , Urban M , Chovancik J , Neuwirth R , Pleva L 
Published: May 2024

Abstract

Introduction
The use of the MitraClip technique is becoming increasingly popular as a treatment option for patients suffering from mitral valve regurgitation who are not suitable for surgery. It is unclear how pre-existing atrial fibrillation impacts patients during the procedure.

Purpose
The question arises: What is the underlying cause of atrial fibrillation in patients with significant mitral valve involvement and why do some patients remain unaffected? This study aims to compare and identify differences in cohorts of patients with and without atrial fibrillation before the MitraClip procedure.

Methods
We analyzed a register of 279 patients who underwent MitraClip treatment. The study classified the patients according to the presence (n=140, 50%) or absence (n=139, 50%) of atrial fibrillation prior to the procedure. We utilized univariate analysis to compare demographic, clinical, and echocardiographic parameters. Multivariate logistic regression was also performed to determine significant predictors.

Results
Both cohorts were of similar size, but there were significant differences in certain parameters. Women were more frequent in the group without atrial fibrillation (45% compared to 34%, p=0.045). The group with atrial fibrillation was slightly older (73 years compared to 70 years, p&lt;0.001) and had a lager body surface area (1.95 compared to 1.87, p=0.005). Parameters such as Euroscore II, NT-proBNP and creatinine levels were not significantly different. Nevertheless, it is important to note that the group with atrial fibrillation had a greater transverse dimension of the left atrium (55 compared to 50, p&lt;0.001). Additionally, the atrial fibrillation group exhibited a higher degree of tricuspid regurgitation (2.9 vs 2.0, p=0.007) and a slightly lower baseline VO2 max (11.63 vs 12.59, p&lt;0.001). Multivariate logistic regression revealed that baseline tricuspid regurgitation is a significant predictor of atrial fibrillation, with and odds ratio of 2.066 (95% CI: 1.041-4.097, p=0.038).

Conclusion
During the MitraClip procedure, patients with atrial fibrillation demonstrate certain specific characteristics, including older age, increased body surface area, larger left atrial size, and higher grade of tricuspid regurgitation. The significant association of tricuspid regurgitation with atrial fibrillation emphasizes its potential role in clinical evaluation and subsequent treatment.
Association of Cardiovascular Fibrosis, Remodeling, and Dysfunction With Frailty, Prefrailty, and Functional Performance: The Multi-Ethnic Study of Atherosclerosis
Authors: Sesso Jaclyn , Walston Jeremy , Bandeen-Roche Karen , Wu Colin , Bertoni Alain G , Shah Sanjiv , Lima Joao A C , Ambale-Venkatesh Bharath 
Published: May 2024

Abstract

Background
Cardiovascular disease is associated with higher incidence of frailty. However, the nature of the mechanisms underlying this association remains unclear. The purpose of this study is to identify cardiovascular phenotypes most associated with physical frailty and functional performance in the Multi-Ethnic Study of Atherosclerosis (MESA).

Methods
As part of the MESA study, 3 045 participants underwent cardiovascular magnetic resonance and computed tomography between 2010 and 2012. Of these, 1 743 completed a Six-Minute Walk test (6MWT) and questionnaires (follow-up exam: 2016–2018) which were used to generate a binary combined frail/prefrail versus robust score according to a modified FRAIL Scale (self-report questionnaire). Multivariable logistic (binary frail outcome) or linear (6MWT) regression assessed the association between frailty and cardiovascular structure and function, aortic stiffness, coronary artery calcium, and myocardial fibrosis (ECV, extracellular volume fraction).

Results
Participants were 66 ± 8 years, 52% female at the time of imaging, and 29.4% were classified as frail or prefrail. Older age and female gender were associated with greater odds of being in the frail/prefrail group. Concentric left ventricular remodeling (odds ratio [OR] 1.89, p = .008; Coef. −52.9, p &lt; .001), increased ECV (OR 1.10, p = .002; Coef. −4.0, p = .001), and worsening left atrial strain rate at early diastole (OR 1.56, p ≤ .001; Coef. −22.75, p = .027) were found to be associated with a greater likelihood of being in a frail state and lower 6MWT distance (m). All associations with 6MWT performance were attenuated with adjustments for risk factors whereas ECV and LA strain rate remained independently associated with frailty.

Conclusions
These findings suggest a significant overlap in pathways associated with subclinical cardiac dysfunction, cardiovascular fibrosis, and physical frailty.
JrGA20ox1-transformed rootstocks deliver drought response signals to wild-type scions in grafted walnut
Authors: Lou Heqiang , Wang Fengmin , Zhang Jiaqi , Wei Guangli , Wei Jingjing , Hu Hengkang , Li Yan , Wang Ketao , Wang Zhengjia , Huang Youjun , Wu Jiasheng , Pei Dong , Huang Jianqin , Zhang Qixiang 
Published: May 2024

Abstract
Targeted regulation using transgrafting technology has become a trend. However, the mechanisms of transgene-derived signal communication between rootstocks and scions remain unclear in woody plants. Here, we grafted wild-type (WT) walnut (Juglans regia L.) on WT (WT/WT), JrGA20ox1 (encodes a gibberellin 20-oxidase)-overexpressing (WT/OE), and JrGA20ox1-RNAi transformation (WT/RNAi) walnut in vitro. We aimed to elucidate the mechanisms of JrGA20ox1-derived signal communication under PEG-simulated drought stress between rootstocks and scions in walnut. We demonstrated that JrGA20ox1-OE and JrGA20ox1-RNAi rootstocks could transport active gibberellins (GAs) and JrGA20ox1-RNAi vector-produced sRNAs to WT scions under PEG-simulated drought stress, respectively. The movement of sRNAs further led to a successive decline in JrGA20ox1 expression and active GA content. Meanwhile, unknown mobile signals may move between rootstocks and scions. These mobile signals reduced the expression of a series of GA-responsive and GA-non-responsive genes, and induced ROS production in guard cells and an increase in ABA content, which may contribute to the drought tolerance of WT/RNAi, while the opposite occurred in WT/OE. The findings suggest that JrGA20ox1-derived rootstock-to-scion movement of signals is involved in drought tolerance of scions. Our research will provide a feasible approach for studying signal communication in woody plants.
In vivo and ex vivo study on cell wall components as part of the network in tomato fruit during the ripening process
Authors: Kutyrieva-Nowak Nataliia , Leszczuk Agata , Denic Dusan , Bellaidi Samia , Blazakis Konstantinos , Gemeliari Petroula , Lis Magdalena , Kalaitzis Panagiotis , Zdunek Artur 
Published: May 2024

Abstract
Ripening is a process involving various morphological, physiological, and biochemical changes in fruits. This process is affected by modifications in the cell wall structure, particularly in the composition of polysaccharides and proteins. The cell wall assembly is a network of polysaccharides and proteoglycans named the arabinoxylan pectin arabinogalactan protein1 (APAP1). The complex consists of the arabinogalactan protein (AGP) core with the pectin domain including arabinogalactan (AG) type II, homogalacturonan (HG), and rhamnogalacturonan I (RG-I). The present paper aims to determine the impact of a disturbance in the synthesis of one constituent on the integrity of the cell wall. Therefore, in the current work, we have tested the impact of modified expression of the SlP4H3 gene connected with proline hydroxylase (P4H) activity on AGP presence in the fruit matrix. Using an immunolabelling technique (CLSM), an immunogold method (TEM), molecular tools, and calcium mapping (SEM-EDS), we have demonstrated that disturbances in AGP synthesis affect the entire cell wall structure. Changes in the spatio-temporal AGP distribution may be related to the formation of a network between AGPs with other cell wall components. Moreover, the modified structure of the cell wall assembly induces morphological changes visible at the cellular level during the progression of the ripening process. These results support the hypothesis that AGPs and pectins are required for the proper progression of the physiological processes occurring in fruits.
Resident pharmacist participation in shared medical appointments in palliative care in São Paulo, Brazil: experience and contributions
Authors: da Silva Charles Henrique Carvalho , França Gustavo Galvão , Tenório Ingrid Alckmin Beltrão , Rotta Inajara , Gomes Ligia Ferreira , Visacri Marília Berlofa 
Published: May 2024

Abstract

Objective
To describe the resident pharmacist’s participation in Shared Medical Appointments (SMA) in palliative care.

Methods
The resident pharmacist participated in face-to-face SMA with the attending physician, medical and gerontology students, and a nurse.

Key findings
The resident pharmacist supported interdisciplinary discussions and performed pharmaceutical interventions. He helped raise awareness about the effective, safe, and convenient use of medicines, helping improve the quality of life of patients and caregivers.

Conclusions
Providing pharmaceutical care to patients in palliative care helped to improve the quality of clinical services offered to these patients, as well as adding value to resident pharmacists’ interprofessional practice.
Education and non-communicable diseases in India: an exploration of gendered heterogeneous relationships
Authors: Kundu Jhumki , Goli Srinivas , James K S 
Published: May 2024

Abstract

Background
While the association between education and non-communicable diseases (NCDs) is well established, it remains unclear whether this association varies by gender. The aim of this study was to examine two critical research questions: whether the association of education and NCDs is conditioned by gender and, if so, what are the factors contributing to this?

Methods
Data from the Longitudinal Aging Study in India Wave 1 (2017–2018) was used for the empirical analysis. The study employs bivariate, binary logistic regression and Oaxaca decomposition analyses.

Results
The results reveal that the net likelihood of having at least one chronic NCD increases with an increase in education level for men (&lt;5 y of schooling: odds ratio [OR] 1.18 [95% confidence interval {CI} 1.09 to 1.28]; ≥10 y of schooling: OR 1.43 [95% CI 1.33 to 1.53]). However, for women, the result showed a contrasting pattern. The decomposition analysis revealed that the distinctive roles of marital status and working status in the diagnosis of morbidity for men and women are the key factors behind the gendered heterogeneous relationship of education and NCDs in India.

Conclusions
The study found that it is important to acknowledge the potential impact of self-reporting bias in morbidity data while examining the relationship between education and NCDs.