bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reorganizing the device clinic: remote monitoring-only of cardiac implantable electronic devices during the Covid-19 pandemic
Authors: Ebrille E , Amellone C , Lucciola M T , Suppo M , Antonacci G , Gotta F , Birolo M , Giammaria M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
COVID-19 pandemic has caused a necessary reorganization of the elective outpatient device clinic. Remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) has already been validated as a safe and effective tool to follow patients, limiting the need for in-person visits. Aim of our study was providing a snapshot of the current clinical practice in a tertiary electrophysiology center in Italy and suggesting a potential model of care for patients with CIEDs.

Methods and Results
Before the COVID-19 pandemic, patients with implantable cardioverter defibrillators/cardiac resynchronization therapy (ICD/CRTs) were evaluated in the device clinic twice a year and patients with pacemakers (PMs) once a year; loop recorder (ILR) patients were followed remotely only. In the COVID-19 period (March 2020-February 2021) RM was implemented for all compatible CIEDs. Patients with RM were not seen in clinic anymore and were followed with RM.
In the COVID-19 period, 100% of newly implanted devices received RM (82 ILR, 194 PMs, 80 ICDs/CRTs), compared to 68% in the same months of 2019 (106/106 ILR, 83/203 PMs, 78/82 ICD/CRTs), p&lt;0.01. In addition, 502 previously implanted patients with RM compatible devices were contacted and received RM in the COVID-19 period.
By the end of February 2021, a total of 1676 patients were remotely monitored at our Institution, with a potential saving of outpatient visits of 1683 visits/year, against an average of 8514 RM transmissions/year needing evaluation.
During the study period, we observed 213 clinical events that triggered an urgent manual transmission and/or required physician’s intervention (table 1), successfully resolved over the following 24 h. None of the 1676 patients presented to the emergency room with a problem that went unnoticed by the RM system.

Conclusion
RM of CIEDs is an essential tool to reduce in-person visits during the COVID-19 pandemic and seems to be safe in terms of events detection. The potential for elective outpatient appointments reduction has to be counterbalanced by the sustainability of a large number of transmissions and data to analyze.
Pulsed-field ablation in patients with permanent pacemaker or implantable cardioverter defibrillator: Is it safe?
Authors: Lennerz C , Oconnor M , Schaarschmidt C , Reents T , Bourier F , Lengauer S , Bahlke F , Krafft H , Knoll K , Englert F , Telishevska M , Hessling G , Kolb C , Deisenhofer I , Kottmaier M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Aims
Pulse field ablation (PFA) is a novel catheter ablation technology with safety benefits due to its tissue selectivity. The risk of physical damage or electromagnetic interference (EMI) of PFA with cardiac implantable electronic devices (CIEDs) is unknown. The aim of our study was to assess the risk of PFA for CIEDs.

Methods
PFA lesions (45 per CIED) were applied to CIEDs (&lt;5cm from the lead tip and &lt;15cm from the generator). All devices were checked before and after PFA application for sensing and pacing parameters as well as integrity of shock circuits in ICDs using a heart simulator. Devices were interrogated for any spontaneous reprogramming, mode switching or other EMI effects.

Results
In total, 44 CIEDs were tested (16 pacemaker, 21 ICDs, 7 CRT-P/D) with 1,980 PFA applications. There was no change in device settings, functionality, electrical parameters and there was no visible damage to the CIEDs or leads. The risk on a device-based analysis is 0/44 (95% CI 0%-8%) and on a PFA pulse-based analysis is 0/1,980 (95% CI 0%-0.2%). Clinically relevant EMI appeared with oversensing and pacing inhibition, but not tachycardia detection.

Conclusions
Bipolar PFA appears safe and does not result in damage to CIEDs or leads. Clinically relevant EMI does occur, but appropriate peri-procedural programming may mitigate this. In-vivo studies are needed to confirm our findings.
Implantable cardioverter-defibrillator implantation should be considered in high-risk patients with apical hypertrophic cardiomyopathy as the same manner with the septal type
Authors: Park Y M , Seo J , Shim J , Choi J I , Park S W , Kim Y H , Choi I S 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Apical hypertrophic cardiomyopathy (HCM) is considered to have a benign prognosis in terms of cardiovascular mortality. Sudden cardiac arrest and ventricular fibrillation (VF) in patients with apical HCM is rarely reported.

Methods
Between July 2001 and May 2021, 96 HCM patients who had undergone implantable cardioverter-defibrillator (ICD) implantation from three tertiary hospitals were reviewed. We evaluated the prevalence of aborted sudden cardiac death and/or documented VF in apical HCM and known risk markers for sudden cardiac death in those populations.

Result
Fifteen patients (15.6%) were apical HCM in total population. Among apical HCM, seven patients (40.0%) presented with aborted sudden cardiac death or documented VF, therefore received ICD implantation for the secondary prevention. All seven patients had at least one risk marker suggested either 2020 ACC/AHA guideline or 2014 ESC guideline. One patient had three risk factors and two patients had two risk factors and four patients had one risk factor. Late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR), personal history of unexplained syncope and non-sustained ventricular tachycardia (VT) were the common risk factors.

Conclusions
Clinical outcomes in patients with apical HCM are not always as benign as previously thought. ICD implantation should be considered in high-risk patients with apical HCM as the same manner with the septal type of HCM according to the current guideline recommendations.
The feasibility of utilising a cloud-based storage and analysis software in multicentre clinical electrophysiology research
Authors: Kailey B S , Calvert P , Wood M , Tyler A , Stewart R , Morgan M , Kemp I , Golosovs A , Balasundram A , Ganesananthan S , Borbas Z , Whitaker J , Kanagaratnam P , Gupta D , Luther V 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): BioSense Webster Investigator Initiated Study (IIS) Grant.

Introduction
The COVID-19 pandemic enforced long-term changes in healthcare towards remote working, implementing digital systems that support the safe online sharing of clinical information. A cloud-based storage and analysis software has been developed that uploads 3D mapping cases within the CARTO-3 system for remote review. In addition, it uses artificial intelligence/ machine learning to analyse large procedural datasets. We tested the feasibility of this technology as a future research tool in analysing the first 8 cases recruited to the Ripple AT PLUS study.

Methods
The Ripple AT PLUS trial is a planned multicentre randomised trial comparing ablation outcomes in scar based atrial tachycardia (AT) using different CARTO mapping approaches. The study recently commenced recruitment (September 2022). The CARTO files for the first 8 cases recruited into this study from different hospitals were securely transferred from CARTO 3 workstations to the Siemens teamplay gateway. Patient identifiers were removed, and anonymized datasets were successfully uploaded onto CARTONET Microsoft Azure cloud. A secure Web-site (https://eu.cartonet.net/login) was accessed for remote review by the research team.

Results
Uploaded study cases were readily separated from other clinical cases using a research filter. Figure 1 summarises graphical datasets for these study cases presented by CARTONET, (including total procedural duration, mapping vs ablation times, ablation lesions). Their corresponding numerical values were exportable as a Microsoft Excel spreadsheet for individualised review. More detailed mapping and ablation analytics within each case was feasible – this is exemplified in figure 2A, which presents a histogram of the proportion of acquired electrogram bipolar voltages below a modifiable cut-off (0.20mV in this example). Individual case data was easily extracted and combined from all study cases to test different hypothesis – again exemplified in figure 2B, which ascertains how tissue voltage might affect the amount of ablation delivered.

Conclusion
CARTONET is a secure, simple to use, and efficient cloud-based AI/machine learning system that offers access to clinically relevant data-sets from the CARTO system remotely from the hospital premises. This allows for a variety of rapid analytics, with the potential to improve the efficiency of multicentre clinical electrophysiology research collaboration.
Very-early detection of atrial fibrillation in patients after ablation evaluated by a home-based wearable ECG-patch
Authors: Marques Antunes M , Silva Cunha P , Lacerda Teixeira B , Alves S , Portugal G , Valente B , Delgado A S , Bras M , Coutinho Cruz M , Paulo M , Lousinha A , Guerra C , Cruz Ferreira R , Martins Oliveira M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Evaluation of atrial fibrillation (AF) recurrence after AF ablation has been validated by routine ECG and ambulatory 24-h Holter monitoring after a 3-month blanking period. However, assessment of heart rhythm after AF ablation, conducted with the use of intermittent or continuous recording systems, has shown that early recurrences are common, often asymptomatic, and may predict late AF recurrences. The E-Patch (Bio Tel Heart) is an innovative thin, single-use adhesive electrode with extended continuous ECG monitoring for up to 120 hours.

Aim
To describe and characterize predictors of early AF recurrence based on the very- early blanking period after AF ablation.

Methods
Single-centre, prospective, longitudinal study, including consecutive patients (P), 24 hours after AF ablation, monitored with the E- patch. Baseline characteristics at the time of AF ablation as well as the effectiveness of the device in continuously recording within 5 days after ablation were analyzed. A logistic regression model was used to derive predictors of very-early AF recurrence.

Results
A total of 40P were included (60% male, 62±9 years). AF ablation was performed with radiofrequency energy in 23P and with cryoballoon in 17P. All P were in sinus rhythm at the beginning of the E- patch recording. The mean number of hours of recording was 113±18. During E-patch recording
11P (27.5%) presented AF (AF burden 27.4% of the recording, IQR 5.5-32.3%) and 7P (18%) had sinus pauses. In a multivariate logistic regression model, a higher CHADS2VAS2C index and a higher average heart were associated with an OR 3.0 (95% CI 1.13-8.1, p = 0.027) and OR 1.23 (95% CI 1.02-1.48, p = 0.025) for AF recurrence, respectively. No significant differences were found between ablation modalities. There were no complaints about discomfort in the use of the device, and there were no artefacts compromising the quality or the interpretation.

Conclusions
The use of the E-patch recording very-early after AF ablation is effective for AF detection. A higher CHADS2VAS2C index and average heart appear to be significantly predictive of very-early AF recurrence post-ablation.
Lesion formation in irrigated RF-ablation is not linear, but monoexponential
Authors: Bahlke F , Wachter A , Krafft H , Popa M , Englert F , Erhard N , Risse E , Telishevska M , Lengauer S , Lennerz C , Reents T , Hessling G , Deisenhofer I , Bourier F 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Radiofrequency ablation remains one of the most important ablation techniques in the EP lab. Creating durable lesion is difficult, as progression of lesion formation cannot be observed directly. Surrogate parameters, as force-time-integral and indices, as the ablation index or lesion size index, help distinguishing the efficacy of a RF-application, but several deficiencies are known. The aim of this study was to further investigate dynamic changes in ablation parameters and lesion growth in RF-ablation.

Methods
RF-lesions were created using an ex vivo porcine cardiac model with a force and local impedance sensing catheter. A second catheter was used for lesions up to 70 Watts. The experimental setup consisted of a saline-filled container, a dispersive electrode, a heated thermostat and a circulation pump to imitate in vivo conditions. Global impedance was kept at 120 Ohm as well as the temperature at 37°C. RF-lesions were created using identic values of RF duration and electrode tissue coupling. RF power of 20W, 30W, 40W, and 50W was used in the local impedance sensing catheter, while RF power of 30W, 40W, 50W, 60W, and 70W were used in the second catheter.
All parameters (power, temperature, global impedance, ETC, lesion diameter and lesion depth) were measured once per second during application of RF-current, enabling real-time correlation of RF parameters and lesion size. In case of an audible steam pop, RF application was stopped.

Results
In total, 61 lesions were included in the analysis. Due to at least 60 measurements per lesion, 3321 data points with all ablation parameters (power, temperature, global impedance, lesion diameter and lesion depth) were collected and analyzed.
Throughout the application, lesion progression was highest in the first seconds of RF application and showed a slowing approximation to a maximum (Figure 1 and 2). Potential maximum lesion size seems to be defined by selected power level (s. Figure 3). Interestingly, these findings were seen in all power levels from 20 – 70 W (s. Figure 3).
75 % of final lesion size was achieved after 12-25 seconds, depending on selected power levels (s. Figure 4). In high power ablation (&gt; 50 W), 75% of final lesion size was reached significantly earlier compared to lower power levels (20-40 W, s. Figure 4).

Conclusion
In RF-ablation, lesion growth is not linear. A slowing approximation of lesion diameter and depth to a maximum is observed. This finding should be considered in clinical settings to avoid steam pops and collateral damage due to a long RF duration despite little changes in lesion size. Further investigation is needed for a surrogate parameter, which is able to assess declining lesion growth after the first seconds of RF-application.
Evolutionary barriers to horizontal gene transfer in macrophage-associatedSalmonella
Authors: Bhatia Rama P , Kirit Hande Acar , Lewis Cecil M , Sankaranarayanan Krithivasan , Bollback Jonathan P 
Published: May 2023

AbstractHorizontal gene transfer (HGT) is a powerful evolutionary force facilitating bacterial adaptation and emergence of novel phenotypes. Several factors, including environmental ones, are predicted to restrict HGT, but we lack systematic and experimental data supporting these predictions. Here, we address this gap by measuring the relative fitness of 44 genes horizontally transferred from Escherichia coli to Salmonella enterica in infection-relevant environments. We estimated the distribution of fitness effects in each environment and identified that dosage-dependent effects across different environments are a significant barrier to HGT. The majority of genes were found to be deleterious. We also found longer genes had stronger negative fitness consequences than shorter ones, showing that gene length was negatively associated with HGT. Furthermore, fitness effects of transferred genes were found to be environmentally dependent. In summary, a substantial fraction of transferred genes had a significant fitness cost on the recipient, with both gene characteristics and the environment acting as evolutionary barriers to HGT.
The Sources of Bacillus cereus Contamination and their Association with Cereulide Production in Dairy and Cooked Rice Processing Lines
Authors: Yang Shuo , Wang Yating , Ren Fanchong , Wang Xu , Zhang Wantong , Pei Xiaoyan , Dong Qingli 
Published: May 2023

Abstract
Bacillus cereus, a spore-forming bacterium and frequent cause of food poisoning, poses a safety threat to dairy and rice industries due to its high contamination rates and ability to produce toxins such as cereulide. Because of widespread presence and thermal resistance of the spores, B. cereus cannot be eliminated from the environment and may survive in processing plants. Surviving spores can develop into vegetative cells, leading to a heightened risk of cereulide production in the processing environment. Both spores and vegetative cells have the ability to adhere to the surfaces of dairy plants and form biofilms, serving as the site for cereulide production and accumulation. Therefore, it is crucial for the food industry to address potential sources and pathways of B. cereus contamination and their connections to cereulide production in processing lines. In this review, sources of contamination of B. cereus, including spores, vegetative cells, and biofilms and their potential role in cereulide production at each stage of dairy and cooked rice processing were analyzed. In addition, control methods to prevent B. cereus contamination and cereulide production in processing lines were proposed, offering valuable insights for improving microbial risk management in the food industry.
Effects of Healthy and Neuropathological Aging on Autobiographical Memory: A Meta-Analysis of Studies Using the Autobiographical Interview
Authors: Simpson Stephanie , Eskandaripour Mona , Levine Brian 
Published: May 2023

Abstract

Objectives
A meta-analytic review was conducted to assess the effects of healthy aging, amnestic mild cognitive impairment (MCI), and Alzheimer’s disease (AD) on naturalistic autobiographical memory using the Autobiographical Interview, a widely used, standardized assessment that derives measures of internal (episodic) and external (nonepisodic) details from freely recalled autobiographical narratives.

Methods
A comprehensive literature search identified 21 aging, 6 MCI, and 7 AD studies (total N = 1,556 participants). Summary statistics for internal and external details for each comparison (younger vs older or MCI/AD vs age-matched comparison groups) and effect size statistics were extracted and summarized using Hedges’ g (random effects model) and adjusted for the presence of publication bias.

Results
The pattern of reduced internal and elevated external details in aging was robust and consistent across nearly all 21 studies. MCI and—to a greater extent—AD were associated with reduced internal details, whereas the external detail elevation faded with MCI and AD. Although there was evidence of publication bias on reporting of internal detail effects, these effects remained robust after correction.

Discussion
The canonical changes to episodic memory observed in aging and neurodegenerative disease are mirrored in the free recall of real-life events. Our findings indicate that the onset of neuropathology overwhelms the capacity of older adults to draw upon distributed neural systems to elaborate on past experiences, including both episodic details specific to identified events and nonepisodic content characteristic of healthy older adults’ autobiographical narratives.
Simulation-based training in cardiac surgery: a systematic review
Authors: Arjomandi Rad Arian , Hajzamani Dorfam , Sardari Nia Peyman 
Published: May 2023

Abstract

OBJECTIVES
The increase in the complexity of operations, the rising quest for improved outcomes and the scrutiny of surgical practice and its associated complications have led to a decreased educational value of in-patient surgical training within cardiac surgery. Simulation-based training has emerged as an adjunct to the apprenticeship model. In the following review, we aimed to evaluate the currently available evidence regarding simulation-based training in cardiac surgery.

METHODS
A systematic database search was conducted as per PRISMA guidelines, of original articles that explored the use of simulation-based training in adult cardiac surgery programs in EMBASE, MEDLINE, Cochrane database and Google Scholar, from inception to 2022. Data extraction covered the study characteristics, simulation modality, main methodology and main outcomes.

RESULTS
Our search yielded 341 articles, of which 28 studies were included in this review. Three main areas of focus were identified: (i) validity testing of the models; (ii) impact on surgeons’ skills; and (iii) impact on clinical practice. Fouteen studies reported animal-based models and 14 reported on non-tissue-based models covering a wide spectrum of surgical operations. The results of the included studies suggest that validity assessment is scarce within the field, being carried out for only 4 of the models. Nonetheless, all studies reported improvement in trainees’ confidence, clinical knowledge and surgical skills (including accuracy, speed, dexterity) of trainees both at senior and junior levels. The direct clinical impact included initiation of minimally invasive programmes and improved board exam pass rates, and creating positive behavioural changes to minimize further cardiovascular risk.

CONCLUSIONS
Surgical simulation has been shown to provide substantial benefits to trainees. Further evidence is needed to explore its direct impact on clinical practice.
Improved uniform error bounds on time-splitting methods for the long-time dynamics of the weakly nonlinear Dirac equation
Authors: Bao Weizhu , Cai Yongyong , Feng Yue 
Published: May 2023

Abstract
Improved uniform error bounds on time-splitting methods are rigorously proven for the long-time dynamics of the weakly nonlinear Dirac equation (NLDE), where the nonlinearity strength is characterized by a dimensionless parameter $\varepsilon \in (0, 1]$. We adopt a second-order Strang splitting method to discretize the NLDE in time, and combine with the Fourier pseudospectral method in space for the full-discretization. By employing the regularity compensation oscillation (RCO) technique, where the high frequency modes are controlled by the regularity of the exact solution, and the low frequency modes are analyzed by phase cancellation and energy method, we establish improved uniform error bounds at $O(\varepsilon ^{2}\tau ^{2})$ and $O(h^{m-1}+ \varepsilon ^{2}\tau ^{2})$ for the second-order Strang splitting semidiscretization and full-discretization up to the long-time $T_{\varepsilon } = T/\varepsilon ^{2}$ with $T&gt;0$ fixed, respectively. Furthermore, the numerical scheme and error estimates are extended to an oscillatory NLDE, which propagates waves with $O(\varepsilon ^{2})$ wavelength in time and at $O(\varepsilon ^{-2})$ wave speed in space. Finally, numerical examples verifying our analytical results are given.