bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac Troponin I kinetic after pulmonary vein isolation for atrial fibrillation ablation with pulsed-field ablation and cryo-energy
Authors: Majocchi B , Moltrasio M , Fassini G , Tundo F , Riva S , Vettor G , Sicuso R , Bianchini L , Malacrida M , Tondo C 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Previous studies have demonstrated that cardiac biomarkers elevate after both cryoballoon (CB) and radiofrequency atrial fibrillation (AF) ablation, depending on the amount of energy delivered and the site of ablation. To date no comparison has been made between these thermal energy source and a novel non-thermal pulsed-field ablation (PFA) technology based on cells electroporation.

Purpose
Our analysis aims to compare acute myocardial injury through cardiac troponin I variation after pulmonary vein isolation (PVI) performed with different technologies (PFA vs CB).

Methods
All consecutive patients undergoing paroxysmal AF ablation with CB and PFA at our center from July to November 2022 were included. Protocol-directed cryoablation (CBA) was delivered for 180 sec or 240 sec according to operator’s preference for isolation achieved in ≤60 sec, or 240 sec if isolation occurred &gt;60 sec or when time to isolation was not available. A standard PFA protocol-directed PVI was applied using 2kV with eight applications per vein (four applications each in the basket and flower poses). The ablation endpoint was PVI as assessed by entrance and exit block. Pre- and post-procedure samples of cardiac troponin I (CTpI) were collected before CBA/PFA and at 24h after ablation. Only patients with normal baseline values for myocardial injury were included.

Results
A total of 71 patients met inclusion criteria and were included in this analysis. The CBA group consists of 50 (70%) patients and the PFA group comprises 21 (30%) patients. The number of CBA applications to reach PVI was 5.0±1.4 and the number of PFA applications to achieve PVI was 32±4. All (100%) patients were in sinus rhythm at the time of the procedure. Evaluating the kinetic of CTpI, baseline values were homogeneous between CBA and PFA groups (p=0.979) whereas CTpI values significantly rose from baseline (7±2 ng/L) to 24h (8979±3691 ng/L, p&lt;0.0001) and were significantly different between groups after CBA/PFA (8148±3311 ng/L for CBA vs 11900±7143 ng/L for PFA, p=0.0056). PVI was achieved in all patients (100%) using only CB or PFA. No major procedure-related adverse events were reported.

Conclusion
Our preliminary results showed that cardiac troponin I enzyme level increased after PVI by means of both cryoballoon and pulsed-field ablation and were higher after cellular electroporation by PFA than cryoablation.
Preinterventional quantification of dense scar or borderline zone in patients undergoing ventricular tachycardia ablation
Authors: Oebel S R , Jahnke C , Paetsch I , Dagres N , Hindricks G , Dinov B , Arya A , Ter Bekke R , Vernooy K , Darma A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
This study sought to examine the prognostic role of quantifying areas of interest in preinterventional cardiac magnetic resonance (CMR) in patients with structural heart disease (SHD) referred for ablation of ventricular tachycardia (VT).

Background
The role of preinterventional CMR for the identification of scar areas, borderline zones and reentry channels in the ventricles has been well established. Whether the burden of dense scar or borderline tissue has a prognostic impact on the acute and the long-term ablation outcome in SHD patients is disputed.

Methods and results
We investigated 185 patients with SHD undergoing preinterventional CMR prior to VT-ablation. 38 patients were excluded because of poor imaging quality, leaving a cohort of 147 patients with positive late enhancement (LGE) imaging (mean age 62 years, 47% non-ischemic cardiomyopathy, mean left ventricle ejection fraction 38%, 96% with implanted ICD). The cohort was divided in ischemic (ICM) and non-ischemic (NICM) cardiomyopathy group and the results regarding burden of overall scar tissue, dense scar, borderline zone, as well as clinical and procedural characteristics, acute and long-term results of the two groups were compared. The ICM patients had more advanced NYHA stadium (p = 0.046), reduced left ventricular ejection fraction (LV-EF, p &lt;0.001) and higher left ventricular enddiastolic volume (LVEDV, p &lt;0.001). The NICM patients were more often under antiarrhythmic therapy (p = 0.005) and underwent more frequently epicardial ablation (p &lt;0.001). Although the overall scar burden war higher in ICM patients (p &lt;0.001), the groups showed no significant difference in borderline zone burden (p = 0.580). Furthermore, the two groups had similar results in number of inducible VTs (p = 0.054) and VT inducibility at the end of the procedure (p = 0.121). Nevertheless, the NICM group underwent overall more ablation procedures during the 19-month follow up (p = 0.023). Both groups showed similar results regarding assist device implantation, heart transplantation or death until the end of the follow up (p = 0.192).

Conclusion
While quantification of the scar tissue and the borderline zone is feasible in ICD patients with SHD, the scar or the borderline zone burden were not predictive of the VT ablation outcome.
Beat-to-beat variation of P-wave morphology immediately after ablation of persistent atrial fibrillation correlates with long-term clinical outcome
Authors: Luca A , Coudray E , Vesin J M , Le Bloa M , Teres C , Herrera C , Roten L , Kuehne M , Spies F , Knecht S , Sticherling C , Pascale P , Pruvot E 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
P-wave morphology on surface ECG reflects the atrial electrical remodelling, and is regarded as a predictor of ablation outcome for atrial fibrillation (AF).

Purpose
We sought to investigate whether morphological characteristics of P-waves immediately after a wide circumferential isolation of pulmonary veins (WPVI) in persistent AF (peAF) correlate with long-term maintenance of sinus rhythm (SR).

Methods
33 patients (63±10 y, sustained AF 11±7 months) underwent a de-novo WPVI. A second WPVI was performed in patients with recurrent AF in order to provide complete PV disconnection. We defined "success" as patients who remained in SR after one or two procedures, and "failure" otherwise. The average duration and amplitude of the P-waves, and the coefficient of variation (CoV = standard deviation/mean) of the beat-to-beat similarity between ≥30 successive P-waves per patient were computed on ECG lead II during SR after cardioversion. Panel A shows a group of successive P-waves synchronized with regard to their centers of gravity. The similarity between the shapes of two successive synchronized P-waves was assessed using the dynamic time warping distance. Panel B shows the time-evolution of beat-to-beat distance between the P-waves displayed in Panel A.

Results
Over a mean follow-up of 31±9 months, 21 patients remained free from AF off antiarrhythmics (success group), while 12 patients had AF recurrence after 2 WPVIs (failure group). The clinical characteristics (e.g. age, body mass index, left atrial volume or duration in sustained AF) were similar between groups (p&gt;0.05). The success group displayed significantly lower beat-to-beat variability of P-wave morphology than that of the failure group (p&lt;0.05, Panel C). No significant difference was found in P-wave duration and amplitude between the two groups (p&gt;0.05, Panel D and E).

Conclusion
Low P-wave beat-to-beat morphological variability immediately after WPVI for persistent AF is associated with long-term maintenance of sinus rhythm.
Prevalence and characteristics of arrhythmias during the pregnancy
Authors: Uzakova M , Babajanova G S , Uzokov J K 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Arrhythmias in pregnancy has been increasing due to the aging of the pregnant women and psychosocial and economic conditions in developing countries. Some of them are benign and do not require special treatment while others will be needed treatment in order to improve subjective feelings. Aim of the study was to evaluate the prevalence and characteristics of cardiac arrhythmias in pregnant women with hypertension and without other cardiac structural pathologies.

Material and Methods
110 pregnant women with hypertension were analyzed during 2018-2021 years. Mean age of the pregnant women were 28.65±11.45 years. Electrocardiogram, echocardiography and if necessary 24 hour Holter monitoring was recorded and analyzed along with other clinical and instrumental data. All statistical analysis were performed using STATA software.

Results
The most frequent type of heart rhythm disorder was supraventricular arrhythmia 34%, followed by premature contractures (24%) and paroxysmal atrial fibrillation (12%). 24% of supraventricular tachycardia was detected in the first trimester, 35% in second trimester and 41% in the last trimester. Among premature contractures only 26% was detected in the first trimester. 29% of premature contractures was detected in the second and 44% in the third trimester of the pregnancy. Regarding the atrial fibrillation, it was detected in 6 (46%) pregnant women in the first trimester, 4 (31%) in the second trimester and 3 (23%) in the third trimester. Pregnant women with supraventricular arrhythmias tended to have higher level of diastolic blood pressure than those without it (88.12±8.2 mmHG vs. 84.25±9.3 mmHg, P=0.034). Pregnant women with premature contractures tended to have higher level of systolic blood pressure than those without it (132.3±11.4 vs. 126.34±12.65 mmHg, P=0.031). Atrial fibrillation was not associated with blood pressure levels.

Conclusion
Supraventricular arrhythmias and premature contractures are common in the third trimester of the pregnancy. High systolic blood pressure is associated with premature contractures whilst high diastolic blood pressure with supraventricular arrhythmias.
Cyclic-di-AMP signalling in lactic acid bacteria
Authors: Turner Mark S , Xiang Yuwei , Liang Zhao-Xun , Marcellin Esteban , Pham Huong Thi 
Published: May 2023

AbstractCyclic dimeric adenosine monophosphate (cyclic-di-AMP) is a nucleotide second messenger present in Gram-positive bacteria, Gram-negative bacteria and some Archaea. The intracellular concentration of cyclic-di-AMP is adjusted in response to environmental and cellular cues, primarily through the activities of synthesis and degradation enzymes. It performs its role by binding to protein and riboswitch receptors, many of which contribute to osmoregulation. Imbalances in cyclic-di-AMP can lead to pleiotropic phenotypes, affecting aspects such as growth, biofilm formation, virulence, and resistance to osmotic, acid, and antibiotic stressors. This review focuses on cyclic-di-AMP signalling in lactic acid bacteria (LAB) incorporating recent experimental discoveries and presenting a genomic analysis of signalling components from a variety of LAB, including those found in food, and commensal, probiotic, and pathogenic species. All LAB possess enzymes for the synthesis and degradation of cyclic-di-AMP, but are highly variable with regards to the receptors they possess. Studies in Lactococcus and Streptococcus have revealed a conserved function for cyclic-di-AMP in inhibiting the transport of potassium and glycine betaine, either through direct binding to transporters or to a transcriptional regulator. Structural analysis of several cyclic-di-AMP receptors from LAB has also provided insights into how this nucleotide exerts its influence.
Epsilon Dichotomy for Linear Models: The Archimedean Case
Authors: Suzuki Miyu , Tamori Hiroyoshi 
Published: May 2023

Abstract
Let $G=\textrm {GL}_{2n}({\mathbb {R}})$ or $G=\textrm {GL}_n({\mathbb {H}})$ and $H=\textrm {GL}_n({\mathbb {C}})$ regarded as a subgroup of $G$. Here, ${\mathbb {H}}$ is the quaternion division algebra over ${\mathbb {R}}$. For a character $\chi $ on ${\mathbb {C}}^\times $, we say that an irreducible smooth admissible moderate growth representation $\pi $ of $G$ is $\chi _H$-distinguished if $\operatorname {Hom}_H(\pi , \chi \circ \det _H)\neq 0$. We compute the root number of a $\chi _H$-distinguished representation $\pi $ twisted by the representation induced from $\chi $. This proves an Archimedean analogue of the conjecture by Prasad and Takloo-Bighash (J. Reine Angew. Math., 2011). The proof is based on the analysis of the contribution of $H$-orbits in a flag manifold of $G$ to the Schwartz homology of principal series representations. A large part of the argument is developed for general real reductive groups of inner type. In particular, we prove that the Schwartz homology $H_\ast (H, \pi \otimes \chi )$ is finite-dimensional and hence it is Hausdorff for a reductive symmetric pair $(G, H)$ and a finite-dimensional representation $\chi $ of $H$.
Making Gender Known: Assembling Gender Expertise in International Organizations
Authors: Scott David , Olivius Elisabeth 
Published: May 2023

AbstractIn recent decades, gender equality goals have been adopted widely in global policymaking, creating a demand for specialized knowledge and evidence to support the design and implementation of gender equality policies. Bridging feminist scholarship on gender expertise and practice–theoretical literature on knowledge production, this article examines a knowledge production initiative of the World Bank, the Gender Innovation Laboratories (GILs). While research has examined the position of gender experts and the content of gender expertise in global governance, it has overlooked how knowledge about gender is produced. In this paper, we use a practice–theoretical approach—assemblage thinking—to study the practical work mobilized in the GILs to produce, maintain, and disseminate knowledge about gender inequality. Drawing on interviews with lab researchers, documents, and online materials, and focusing on the epistemic practice of impact evaluations, our analysis demonstrates the work invested in assembling them, such as forging alignments with and securing support among stakeholders, activating repertoires of expertise, and translating results into material objects. These practices produce gender inequality as a governance object, which is amenable to technical policy interventions, which facilitates certain forms of action to address it. Yet, they simultaneously silence more political solutions to gender inequalities.
Comparison of SIREN social needs screening tools and Simplified Omaha System Terms: informing an informatics approach to social determinants of health assessments
Authors: Holt Jeana M , Austin Robin R , Atadja Rivka , Cole Marsha , Noonan Theresa , Monsen Karen A 
Published: May 2023

Abstract

Objective
Numerous studies indicate that the social determinants of health (SDOH), conditions in which people work, play, and learn, account for 30%–55% of health outcomes. Many healthcare and social service organizations seek ways to collect, integrate, and address the SDOH. Informatics solutions such as standardized nursing terminologies may facilitate such goals. In this study, we compared one standardized nursing terminology, the Omaha System, in its consumer-facing form, Simplified Omaha System Terms (SOST), to social needs screening tools identified by the Social Interventions Research and Evaluation Network (SIREN).

Materials and Methods
Using standard mapping techniques, we mapped 286 items from 15 SDOH screening tools to 335 SOST challenges. The SOST assessment includes 42 concepts across 4 domains. We analyzed the mapping using descriptive statistics and data visualization techniques.

Results
Of the 286 social needs screening tools items, 282 (98.7%) mapped 429 times to 102 (30.7%) of the 335 SOST challenges from 26 concepts in all domains, most frequently from Income, Home, and Abuse. No single SIREN tool assessed all SDOH items. The 4 items not mapped were related to financial abuse and perceived quality of life.

Discussion
SOST taxonomically and comprehensively collects SDOH data compared to SIREN tools. This demonstrates the importance of implementing standardized terminologies to reduce ambiguity and ensure the shared meaning of data.

Conclusions
SOST could be used in clinical informatics solutions for interoperability and health information exchange, including SDOH. Further research is needed to examine consumer perspectives regarding SOST assessment compared to other social needs screening tools.
Quantifying land-use regulation and its determinants
Authors: Büchler Simon , v. Ehrlich Maximilian 
Published: May 2023

Abstract
We analyze land-use regulation and the determinants thereof across Swiss municipalities. We construct several residential development stringency indices based on a comprehensive survey. These indices capture various aspects of local regulation and land-use coordination across jurisdictions. Combining these indices, we construct an index that provides harmonized information about what local regulation entails and the local regulatory environment across municipalities. Our analysis shows that historical building density, natural amenities, socio-demographic factors, cultural aspects and municipal competition are important determinants of local land-use regulation. However, a large share of land-use regulation variation remains unexplained. Moreover, our results indicate that more stringent land-use regulation is associated with steeper house price increases but less urban sprawl.
Systematic Review of Instruments Assessing Psychosocial Adaptation and Outcomes Among Families of Children With Congenital Heart Disease
Authors: Eagleson Karen J , McCombs Desiree , Gerlich Tiffany M , Justo Robert N , Kasparian Nadine A , Bora Samudragupta 
Published: May 2023

AbstractObjectiveThis systematic review identified instruments quantitatively assessing psychosocial adaptation and outcomes in families of children with congenital heart disease (CHD) and evaluated instrument psychometrics.MethodsFollowing Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and a prospectively registered protocol, electronic databases (CINAHL, Embase, PubMed/MEDLINE, PsycINFO, and SCOPUS) were searched from inception until June 20, 2021 for peer-reviewed articles published in English, reporting quantitative data on psychosocial outcomes among parents/caregivers, siblings, or family system. Instrument characteristics and psychometrics were extracted, and adapted COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria were applied to assess instrument quality. Descriptive statistics and narrative synthesis were used for analysis.ResultsOverall, 108 articles reporting on 107 distinct samples across 26 countries met inclusion. Across those articles, 40 instruments assessed psychological functioning or distress, 12 assessed coping, 11 assessed quality of life constructs, 10 assessed parenting stress/caregiver burden, 10 assessed family functioning/impact, 10 assessed stress appraisal, 5 assessed sibling psychosocial outcomes, and 2 assessed couple relationship satisfaction/strain. Applying COSMIN criteria to available data on original instrument development articles/manuals for English language instruments (n = 54), 67% scored a positive property evidence rating for content validity, 39% for internal consistency, 4% for test–retest reliability, and 9% for responsiveness (longitudinal validity).ConclusionsStudies vary widely in instruments used to assess psychosocial adaptation and outcomes among families of children with CHD. Instrument selection informed by robust key psychometrics, increased psychometric reporting, development of both a “toolkit” approach and a comprehensive CHD-specific family instrument are among key recommendations.
A rare case of mixed gonadal dysgenesis in adulthood: diagnostic delay and unique outcomes
Authors: Rueangket Ploywarong , Phansenee Supreechaya , Laoharojvongsa Nutthaporn , Boonyachan Worawat 
Published: May 2023

Abstract
Mixed gonadal dysgenesis (MGD) is a rare sex development disorder, diagnosed by mosaic karyotype of 45,X/46,XY (classical form) with the presence of Müllerian structures, unilateral testis and contralateral streak gonad. MGD expresses diverse phenotypes, from female phenotype with virilization or turner stigmata, to ambiguous genitalia or male phenotype. Early diagnosis is crucial for effective correction of height, sexual development and cancer prevention. The study reports on a case of a 25-year-old patient, reared as female, presenting a large abdominal mass later confirmed as a mixed germ cell tumor. Associated findings were primary amenorrhea, ambiguous genitalia, short statue, gender dysphoria and hyperlipidemia. The study is the first to report on hyperlipidemia in MGD.
Spontaneous knee dislocation: a rare and dreadful complication of septic arthritis
Authors: Alshahir Alwaleed Abdullah , AlNaqa Faisal Hamad , Benmeakel Mohammed Abdulrahman , Alsheikh Khalid Abdullatif 
Published: May 2023

Abstract
Spontaneous knee dislocation without a history of trauma is a rare entity to witness. Herein, we report a case of a patient who presented to the emergency department (ED) with a history of fever, chills and vomiting associated with progressive right knee swelling, pain and impaired range of motion (ROM). Physical exam of her right knee showed symmetrical swelling with diffuse tenderness and limited ROM due to pain. Joint aspirate and full septic workup confirmed the diagnosis of septic arthritis. Following her management and two events of irrigation and debridement of the septic knee, the patient was discharged. However, after 1-week from discharge, she presented to ED with right leg swelling and tenderness despite being bedbound for 3 months and denying any history of trauma with radiographs showing a posterior knee dislocation. This report aimed to shed a light on this dreadful complication of septic arthritis and highlights the importance of early recognition and management.