Search

Introduction Methods Results Conclusion The anterior and lateral position of the anterolateral papillary muscle (ALPM) has found to be reached with better catheter stability and less mechanical bumping via the transseptal (TS) compared to the retrograde aortic (RA) approach. The aim of this study is to compare the TS and RA approaches on mapping and ablation of ventricular arrhythmias (VAs) arising from ALPMs.Thirty‐two patients with ALPM‐VAs undergoing mapping and ablation via the TS approach were included and compared with 31 patients via the RA approach within the same period. Acute success was compared, as well as other outcomes including misinterpreted mapping results due to bumping, radiofrequency (RF) attempts, procedural time and success rate at 12‐month follow‐up.Acute success was achieved in more cases in the TS group (96.4% vs. 72.0%, p = .020). During activation mapping, bump‐provoked premature ventricular complexes (PVCs) misinterpreted as clinical PVCs were more common in the RA group (30.0% vs. 58.3%, p = .036), leading to more RF attempts (3.5 ± 2.7 vs. 7.2 ± 6.8, p = .006). Suppression of VAs were finally achieved in the unsuccessful cases by changing to the alternative approach, but the procedural time was significantly less in the TS group (90.0 ± 33.0 vs. 113.7 ± 41.1 min, p = .027) with less need to change the approach, although follow‐up success rates were similar (75.0% vs. 71.0%, p = .718).A TS rather than RA approach as the initial approach appears to facilitate mapping and ablation of ALPM‐VAs, specifically by decreasing the possibility of misleading mapping results caused by bump‐provoked PVC, and increase the acute success rate thereby. [ABSTRACT FROM AUTHOR]

Interpolation of probability distributions can be formulated as an optimal transport problem. Positive matrix, which can be viewed as the generalization of probability distribution to higher dimension, is used in quantum theory to describe the state of a quantum system. Here, a quantum‐inspired method for the interpolation of positive matrices is proposed. Particularly, this method employs the quantum state purification of the positive matrices in an extended space. Since pure state controllability can be easily achieved using open‐loop coherent control, the continuous interpolation of positive matrices is given as a completely positive map induced by simulating the optimal control for pure state transfer. The quantum‐inspired interpolation is shape‐preserving with applications to tensor field processing. [ABSTRACT FROM AUTHOR]

Persistent luminescence (PersL) phosphors are considered as promising candidates for the next generation of information storage medium. Mg4Ga4Ge3O16 (MGG) is an electron trapping material which exhibits defect luminescence, and the luminescent properties are easily tuned via doping various activated ions. In this work, undoped and Mn2+/Pr3+/Tb3+ single‐doped MGG phosphors were synthesized via high temperature solid phase reactions. X‐ray diffraction and scanning electron microscope results confirm that the activated ions tend to occupy Mg2+ sites. Excited at 265 nm, the MGG host exhibits a defect emission band peaked at 450 nm. Red, pink and green emissions are observed in the Mn2+/Pr3+/Tb3+ single‐doped MGG samples, which are ascribed to the Mn2+: 4T1(G) → 6A1(S), Pr3+: 1D2 → 3H4 and Tb3+: 5D4 → 7F5 transitions, respectively. All the samples exhibit bright PersL for minutes after the cessation of excitation. The energy transfer, concentration quenching, luminescence decay and afterglow mechanisms are also discussed in detail. The phosphors exhibit efficient thermal and optical stimuli response, showing great potentials in the optical information storage. [ABSTRACT FROM AUTHOR]

Recent studies have identified G protein‐coupled receptor 40 (GPR40) as a promising target for treating type 2 diabetes mellitus, and GPR40 agonists have several superior effects over other hypoglycemic drugs, including cardiovascular protection and suppression of glucagon levels. In this study, we constructed an up‐to‐date GPR40 ligand dataset for training models and performed a systematic optimization of the ensemble model, resulting in a powerful ensemble model (ROC AUC: 0.9496) for distinguishing GPR40 agonists and non‐agonists. The ensemble model is divided into three layers, and the optimization process is carried out in each layer. We believe that these results will prove helpful for both the development of GPR40 agonists and ensemble models. All the data and models are available on GitHub. (https://github.com/Jiamin‐Yang/ensemble_model) [ABSTRACT FROM AUTHOR]

Background: The study aims to evaluate the performance of three advanced machine learning algorithms and a traditional Cox proportional hazard (CoxPH) model in predicting the overall survival (OS) of patients with pancreatic neuroendocrine neoplasms (PNENs). Method: The clinicopathological dataset obtained from the Surveillance, Epidemiology, and End Results database was randomly assigned to the training set and testing set at a ratio of 7:3. The concordance index (C‐index) and integrated Brier score (IBS) were used to compare the predictive performance of the models. The accuracy of the model in predicting the 5‐year and 10‐year survival rates was compared using the receiver operating characteristic curve, decision curve analysis (DCA) and calibration curve. Results: This study included 3239 patients with PNENs in total. The DeepSurv model had the highest C‐index of 0.7882 in the testing set and training set and the lowest IBS of 0.1278 in the testing set compared with the CoxPH, neural multitask logistic and random survival forest models (C‐index = 0.7501, 0.7616, and 0.7612, respectively; IBS = 0.1397, 0.1418, and 0.1432, respectively). Moreover, the DeepSurv model had the highest accuracy in predicting 5‐ and 10‐year OS rates (area under the curve: 0.87 and 0.90). DCA showed that the DeepSurv model had high potential for clinical decisions in 5‐ and 10‐year OS models. Finally, we developed an online application based on the DeepSurv model for clinical use (https://whuh‐ml‐neuroendocrinetumor‐app‐predict‐oyw5km.streamlit.app/). Conclusions: All four models analyzed above can predict the prognosis of PNENs well, among which the DeepSurv model has the best prediction performance. [ABSTRACT FROM AUTHOR]

Background: Debates exist in the repeat ablation strategy for patients with recurrence presenting as persistent atrial fibrillation (AF) after initial persistent AF ablation. Objective: To compare the outcome between the "2C3L" and "extensive ablation" approach in patients undergoing repeat procedures for recurrent persistent AF. Methods: Propensity‐score matching was performed in 196 patients with AF recurrence undergoing repeat ablation, and 79 patients treated with "2C3L" strategy were matched to 79 patients treated with "extensive ablation" strategy. The "2C3L" approach included pulmonary vein isolation, mitral isthmus, left atrial roof, and cavotricuspid isthmus ablation, while the "extensive ablation" strategy included extensive ablation of a variety of other targets aiming to terminate the AF. The primary outcome was freedom from any atrial tachyarrhythmia after 24‐h ambulatory monitoring follow‐up for 12 months. Results: No statistically significant difference was found between the primary outcome between the "2C3L" and the "extensive ablation" group [70.9% vs. 69.6%, p =.862; 95% confidence interval (CI) ‐12.8 to 15.3], although the "extensive ablation" group had a significantly high proportion of AF termination (19.0% for "2C3L" vs. 41.8% for "extensive ablation" group, p =.002; 95% CI 8.5–35.9). And AF termination was not related to the primary outcome in multifactorial regression. At 40 ± 22 months after the repeat procedure, the primary outcome was also comparable (57.0 % for "2C3L" vs. 48.1% for "extensive ablation" group, p =.265; 95% CI ‐6.6 to 23.7). Conclusion: The outcome between the "2C3L" and "extensive ablation" approaches was comparable in patients undergoing repeat procedures for recurrent persistent AF. [ABSTRACT FROM AUTHOR]

The advent of ultra‐precise photometry space missions enables the possibility of investigating stellar interiors with mixed modes. The structural variations induced by the discontinuity of the chemical composition left behind during the first dredge–up is an important feature in the stellar mid‐layers located between the hydrogen‐burning shell and the base of the convective zone of red giants, as the mixed‐mode properties can be significantly affected by these variations. In this paper, the contributing factors to variations of the mixed‐mode coupling factor, q, are discussed with stellar models. In general, the structural variations give rise to a subtle displacement in the Lamb frequency and a sharp change in the buoyancy frequency, which lead to variations in the value of q computed using the asymptotic formalisms that assume a smooth background free of structural variations. The impact of these two factors can be felt in detectable mixed modes in low‐luminosity red giants. Furthermore, the different nature of variations of the two characteristic frequencies with a radius near the base of the convective zone produces a sudden increase in q in evolved red giants. This is followed by a quick drop in q as the star evolves further along the red giant branch. [ABSTRACT FROM AUTHOR]

Here, a morphologically based approach is used for the in situ characterization of 3D growth rates of facetted crystals from the solution phase. Crystal images of single crystals of the β‐form of l‐glutamic acid are captured in situ during their growth at a relative supersaturation of 1.05 using transmission optical microscopy. The crystal growth rates estimated for both the {101} capping and {021} prismatic faces through image processing are consistent with those determined using reflection light mode [Jiang, Ma, Hazlehurst, Ilett, Jackson, Hogg & Roberts (2024). Cryst. Growth Des.24, 3277–3288]. The growth rate in the {010} face is, for the first time, estimated from the shadow widths of the {021} prismatic faces and found to be typically about half that of the {021} prismatic faces. Analysis of the 3D shape during growth reveals that the initial needle‐like crystal morphology develops during the growth process to become more tabular, associated with the Zingg factor evolving from 2.9 to 1.7 (>1). The change in relative solution supersaturation during the growth process is estimated from calculations of the crystal volume, offering an alternative approach to determine this dynamically from visual observations. [ABSTRACT FROM AUTHOR]

Inhibition of the human ether‐à‐go‐go‐related gene (hERG) ion channel may lead to prolonged QT interval and even fatal ventricular arrhythmia. Therefore, evaluating the hERG liability has become a mandatory requirement for drug development and drug safety process. However, standard experimental assays are complex, expensive and time‐consuming. Various in silico tools have been developed to identify potential hERG blockers and reduce in advance the risk of cardiotoxicity‐related attritions during the early drug discovery phase. In this review, we first outlined the structure and gating properties of the hERG channel briefly. Then analyzed the advantages of computational technology, and comprehensively summarized the in silico methods of hERG‐related cardiotoxicity, including ligand‐based and structure‐based methods. Additionally, the current predictive models in prediction of hERG blockage were emphatically reviewed. Finally, issues involved in the current computational methods, as well as the future direction for developing reliable models of hERG channel blockers, are discussed. [ABSTRACT FROM AUTHOR]

Circular RNA (circRNA) have been found to play an important role in the progression of many diseases, including interstitial cystitis (IC). However, the role of circTHBS1 in IC progression is still unclear. Exploring the role and potential molecular mechanism of circTHBS1 in the development of IC. The enzyme‐linked immunosorbent assay was used to assess the levels of inflammatory cytokines. The expression levels of circTHBS1, microRNA (miR)‐139‐5p, and mitofusin 2 (MFN2) were evaluated using quantitative real‐time PCR. Cell proliferation and migration were determined using MTT assay, Edu staining, and transwell assay. The protein levels of epithelial‐mesenchymal transition (EMT) markers and MFN2 were examined using western blot analysis. The relationship between miR‐139‐5p and circTHBS1 or MFN2 was confirmed using the dual‐luciferase reporter assay and RIP assay. CircTHBS1 was highly repressed in IC tissues and cells, and its expression was positively correlated with the inflammatory response of IC patients. CircTHBS1 could promote the proliferation, migration, EMT process, and inflammation of IC cells, while its knockdown had an opposite effect. CircTHBS1 could serve as a sponge of miR‐139‐5p, and miR‐139‐5p could participate in the regulation of circTHBS1 on IC cell progression. In addition, miR‐139‐5p could target MFN2, and it could inhibit the progression of IC cells by targeting MFN2. Furthermore, circTHBS1 sponged miR‐139‐5p to positively regulate MFN2. CircTHBS1 promoted IC cell proliferation, migration, EMT process, and inflammation by regulating the miR‐139‐5p/MFN2 axis indicating that circTHBS1 might be a potential target for IC treatment. [ABSTRACT FROM AUTHOR]

The study examined the relationship between chronic regulatory focus, L2 self‐guides, L2 anxiety, and motivated behavior. Questionnaire data were collected from 161 English learners in a foreign language context. Multiple regression results showed that the participants' promotion focus (concerned with accomplishments and achievements) strongly and negatively predicted their L2 anxiety whereas their prevention focus (concerned with safety and obligations) was unrelated to L2 anxiety. Additionally, ought L2 self/own and ought L2 self/other, which have a prevention focus, positively predicted L2 anxiety, whereas ideal L2 self/own, which has a promotion focus, was a negative predictor. L2 anxiety was not directly related to motivated behavior for either promotion‐focused or prevention‐focused learners. The results suggest that a promotion‐focused approach in L2 learning and teaching might minimize L2 anxiety. [ABSTRACT FROM AUTHOR]

The senescence of aortic valve interstitial cells (VICs) plays a critical role in the progression of calcific aortic valve disease (CAVD). However, the precise mechanisms underlying the senescence of VICs remain unclear, demanding the identification of a novel target to mitigate this process. Previous studies have highlighted the anti‐aging potential of morusin. Thus, this study aimed to explore the therapeutic potential of morusin in CAVD. Cellular experiments reveal that morusin effectively suppresses cellular senescence and cause a shift toward osteogenic differentiation of VICs in vitro. Mechanistically, morusin activate the Nrf2‐mediated antiaging signaling pathway by downregulating CCND1 expression and aiding Keap1 degradation through Trim 25. This activation lead to the upregulated expression of antioxidant genes, thus reducing reactive oxygen species production and thereby preventing VIC osteogenic differentiation. In vivo experiments in ApoE−/− mice on a high‐fat Western diet demonstrate the positive effect of morusin in mitigating aortic valve calcification. These findings emphasize the antiaging properties of morusin and its potential as a therapeutic agent for CAVD. [ABSTRACT FROM AUTHOR]

Fibroblast growth factor receptor 1 (FGFR1) is involved in the process of cell proliferation, differentiation and function, especially in bone skeletal development. It is a potential new therapeutic target for osteoporosis and other skeletal‐related diseases. In this study, we aim to identify FGFR1 inhibitors from Traditional Chinese Medicine (TCM) database by the structure‐based virtual screening and MM/GBSA scoring. First, 26450 compounds were filtered by Lipinski rules of five, followed by a hierarchy virtual screen workflow which includes glide docking, ranking, cluster analysis and visual inspection to afford 40 potential compound candidates. Finally, 6 candidates were selected based on MM/GBSA binding energy analysis of the with FGFR1 protein. Our modelling study would provide some clues to the discovery of novel FGFR1 inhibitors as potential therapeutic drugs for osteoporosis. In addition, given multipotency characteristic of FGFR1, these potential inhibitors might provide some reference to other related diseases, such as non‐small cell lung cancer and squamous cell lung cancer. [ABSTRACT FROM AUTHOR]

Objectives: 5α‐reductase inhibitor (5‐ARI) is a commonly used medicine in the treatment of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Our study mainly focuses on the mechanism of BPH development after 5ARI treatment. Materials and Methods: Prostate specimens from patients were collected. Insulin‐like growth factor 1 (IGF‐1), Beclin‐1, LC3 levels, was analysed by immunohistochemistry. The role IGF‐1 on autophagic flux in prostate epithelial cells was studied. Additionally, effect of autophagy on recombinant grafts consisting of prostate stromal and epithelial cells in nude mice was investigated. Results: We demonstrated that IGF‐1 expression is down‐regulated in prostate fibroblasts after long‐term 5‐ARI application. A decrease in IGF‐1 levels was found to activate autophagic flux through the mTOR pathway in prostate epithelial cells, while the inhibition of IGF‐1 receptor function induced autophagy in prostate epithelial cells. In addition, we revealed that blocking autophagic flux initiation can reduce the volume of recombinant grafts in vivo. Finally, our findings suggest that long‐term 5‐ARI application reduces IGF‐1 secretion by prostatic stromal cells, thereby inducing autophagy of prostatic epithelial cells, which is one of the mechanisms underlying BPH pathogenesis and progression. Conclusions: Focusing on the autophagy induced by low levels of IGF‐1 in prostatic epithelial cells, after elucidating AR signalling impairment of prostate stromal cells, might provide a novel strategy for the treatment and prevention of BPH development. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the associations of cytokine concentrations in aqueous humour with the severity of retinal vascular abnormalities, exudation and fibrosis in patients with Coats' disease. Methods: Aqueous humour samples were collected in 23 paediatric patients (23 eyes) with Coats' disease and six age‐matched control patients (six eyes) with congenital cataract in this cross‐sectional, case–control study. Through Cytometric Bead Array technology, six angiogenic, inflammatory and fibrotic cytokines were measured for their concentrations in aqueous humour. Ophthalmologic characteristics including retinal vessel abnormalities, exudation and fibrosis of Coats' disease were also clinically evaluated for analysis. Results: The aqueous levels of vascular endothelial growth factor (VEGF) (p = 0.006) and monocyte chemoattractant protein‐1 (MCP‐1) (p < 0.001) were significantly higher in the Coats' disease group than in the control group. The concentrations of angiogenin were peaked in eyes with first‐grade vessels tortuosity (p < 0.001), and also positively correlated with the severity of retinal capillary abnormalities (r = 0.910, p < 0.001). The concentrations of MCP‐1 (r = 0.966, p < 0.001) and VEGF (r = 0. 765, p = 0.002) were significantly correlated with the extent of retinal exudation. The aqueous humour transforming growth factor‐β (TGFβ) concentrations were higher in eyes with retinal fibrosis than in non‐fibrotic eyes with Coats' disease (p = 0.004). Conclusion: In Coats' disease, angiogenin may act as a potential biomarker for retinal vascular abnormalities. The concentrations of VEGF and MCP‐1 may positively correlate with the severity of retinal exudation. [ABSTRACT FROM AUTHOR]

Background: There are no guidelines on the surgical management for ischemic cardiomyopathy (ICM) patients with severe left ventricular dysfunction. The present study aims to assess the long‐term survival of these patients treated with two different surgical techniques, coronary artery bypass grafting (CABG) and heart transplantation (HTx). Methods: This retrospective study included 218 ICM patients with left ventricular ejection fraction (LVEF) ≤35% who underwent CABG (n = 106) and HTx (n = 112) from 2011 to 2021 in a single center. After propensity adjustment analysis each group consisted of 51 patients. Clinical characteristics were evaluated for all‐cause follow‐up mortality by the Cox proportional hazards regression model. A risk prediction model was generated from multivariable‐adjusted Cox regression analysis and applied to stratify patients with different clinical risks. The long‐term survival was estimated by Kaplan–Meier analysis for different surgery groups. Results: Long‐term survival was comparable between CABG and HTx groups. After being stratified into different risk subgroups according to risk predictors, the HTx group exhibited superior survival outcomes compared to the CABG group among the high‐risk patients (67.8% vs 44.4%, 64.1% vs 38.9%, and 64.1% vs 33.3%, p = 0.047) at 12, 36, and 60 months respectively, while the survival was comparable between HTx and CABG groups among low‐risk patients (87.0% vs 97.0%, 82.4% vs 97.0%, and 70.2% vs 91.6%, p = 0.11) at 12, 36, and 60 months respectively in the PSM cohort. Conclusion: Long‐term survival in ICM patients with severe left ventricular dysfunction who received CABG or HTx was comparable in general. Nonetheless, a favorable outcome of HTx surgery compared to CABG was observed among high‐risk patients. [ABSTRACT FROM AUTHOR]

ABSTRACT A compact asymmetric coplanar strip (ACS)-fed monopole antenna for miniaturized communication systems is proposed. It consists of an ACS-fed 7-shaped monopole, a partial ground plane, and an FR4 substrate. The proposed antenna occupies a very compact size of only 30 × 13 mm2 which accords with the development trend toward miniaturized electronic components. The 7-shaped monopole can be considered as a combination of three parts-a rectangular strip on the top, a trapezoidal strip in the center, and a straight microstrip feed line at the bottom-which generates two separate resonant frequency bands. By introducing an open-ended T-shaped slot in the rectangular strip, a new resonant mode can be excited. Detailed descriptions of the design evolution as well as the parametric study are given to better understand the mechanisms of the proposed antenna. Experimental results demonstrate that it can provide a triple-band frequency range compatible with the 2.4/5.2/5.8 GHz WLAN (2.4-2.485, 5.15-5.35, and 5.725-5.825 GHz) and 3.5/5.5 GHz WiMAX (3.4-3.7 and 5.25-5.85 GHz) operating bands. Furthermore, stable radiation patterns with satisfactory gains make it a good candidate as an internal antenna for compact multiband communication systems. © 2016 Wiley Periodicals, Inc. Microwave Opt Technol Lett 58:1566-1572, 2016 [ABSTRACT FROM AUTHOR]

ABSTRACT A novel design of planar balance-shaped slot antenna suitable for triple-band WLAN/WiMAX applications is proposed in this article. It consists of a slotted ground plane, an FR4 substrate, and an L-shaped microstrip feedline. The radiating element of the proposed antenna is composed of a horizontal H-shaped slot and an M-shaped slot, like a balance. The horizontal H-shaped slot mainly contributes to the 2.4- and 3.4-GHz resonant modes while the resonant modes at 5.4 and 5.8 GHz are generated by the M-shaped slot. The overall size of the proposed antenna is only 30 × 28 mm2, very compact, making it easy to be integrated with other RF front-end circuits. The measured results agree well with the simulated ones and demonstrate that the antenna has a triple-band characteristic entirely covering the 2.4/5.2/5.8-GHz WLAN and 2.5/3.5/5.5-GHz WiMAX operating bands. Furthermore, monopole-like radiation patterns with acceptable gains make it a good candidate as an internal antenna for WLAN/WiMAX applications. © 2016 Wiley Periodicals, Inc. Microwave Opt Technol Lett 58:1078-1082, 2016 [ABSTRACT FROM AUTHOR]

Receptor-mediated endocytosis plays an important role in albumin reabsorption by renal proximal tubule epithelial cells. Kidney injury molecule-1 (KIM-1) is a scavenger receptor that is upregulated on the apical membrane of proximal tubules in proteinuric kidney disease. In this study, we examined the cellular localization and functional role of KIM-1 in cultured renal tubule epithelial cells (TECs). Confocal immunofluorescence microscopy reveals intracellular and cell surface localization of KIM-1 in primary renal TECs. Albumin stimulation resulted in a redistribution of KIM-1 and tight junction protein zonula occludens-1 in primary TEC monolayer. An increase in albumin internalization was observed in both primary TECs expressing endogenous KIM-1 and rat kidney cell line (NRK-52E) overexpressing exogenous KIM-1. KIM-1-induced albumin accumulation was abolished by its specific antibody. Moreover, endocytosed KIM-1 and its cargo proteins were delivered from endosomes to lysosomes for degradation in a clathrin-dependent pathway. Supportive evidence includes (1) detection of KIM-1 in Rab5-positive early endosomes, Rab7-positive late endosomes/multivesicular bodies, and LAMP1- positive lysosomes, (2) colocalization of KIM-1 and clathrin in the intracellular vesicles, and (3) blockade of KIM-1-mediated albumin internalization by chlorpromazine, an inhibitor of clathrin-dependent endocytosis. KIM-1 expression was upregulated by albumin but downregulated by transforming growth factor-b1. Taken together, our data indicate that KIM-1 increases albumin endocytosis in renal tubule epithelial cells, at least partially via a clathrin-dependent mechanism. [ABSTRACT FROM AUTHOR]

ABSTRACT In this article, two novel printed anchor-shaped slot antennas for multiband wireless applications are proposed. The first proposed anchor-shaped slot antenna (ASA1) can generate two wide bands centered at about 2.5-GHz and 5.5-GHz, covering the 2.4/5.2/5.8-GHz WLAN bands (2.4-2.484, 5.15-5.35, and 5.725-5.825 GHz) and 2.5/5.5-GHz WiMAX bands (2.50-2.69 and 5.25-5.85 GHz). The second proposed design is established on the basis of ASA1. By introducing a pair of F-shaped slits, an extra resonant mode will be excited at 3.5-GHz. Therefore, it can be converted to a triple-band anchor-shaped slot antenna (ASA2) supporting 2.4/5.2/5.8-GHz WLAN and 2.5/3.5/5.5-GHz WiMAX (2.50-2.69, 3.30-3.70, and 5.25-5.85 GHz) applications without changing other original design parameters of ASA1. From the aspect of system design, a platform using the proposed antennas would exhibit more flexibility and expansibility. Having overall dimensions of 35 × 30 mm2, the proposed antennas can be easily integrated into portable devices. Monopole-like radiation patterns almost remain unchanged in the E- and H-planes over the operating bands and sufficient gains are also obtained. Good agreement can be observed between the simulated and measured results. © 2016 Wiley Periodicals, Inc. Microwave Opt Technol Lett 58:521-526, 2016 [ABSTRACT FROM AUTHOR]

BACKGROUND Bevacizumab is associated with an increased risk of arterial thromboembolism (ATE); however, its effect on venous thromboembolism (VTE) remains controversial. Scant data exist on the factors that increase the risk of ATE/VTE in patients with prostate cancer. The authors investigated the association of bevacizumab treatment and clinical factors with ATE/VTE risk in patients who were treated on Cancer and Leukemia Group B (CALGB) trial 90401. METHODS Patients with metastatic, castration-resistant prostate cancer were randomized to receive docetaxel and prednisone with or without bevacizumab once every 21 days. Cycle-to-event Cox regression models were used to investigate the association of bevacizumab with the incidence of grade 3 or greater (≥3) ATE and VTE. Age, prior ATE/VTE, baseline antiplatelet/anticoagulant use, and VTE risk score (based on leukocyte count, hemoglobin, platelet count, body mass index, and tumor location) were evaluated in univariate and multivariable analyses. RESULTS Of 1008 randomized patients, the odds of experiencing grade ≥3 ATE were significantly greater in those who received bevacizumab compared with those who received placebo (odds ratio, 2.79; P = .02), whereas an opposite trend was noted for grade ≥3 VTE (odds ratio, 0.60; P = .08). In the multivariable analysis, bevacizumab treatment (hazard ratio [HR], 3.00; P = .01) and age (HR, 1.06; P = .02) were significantly associated with the risk of ATE; whereas age (HR, 1.05; P = .01) and VTE risk score (HR, 1.83; P = .03) were significantly associated with the risk of VTE. CONCLUSIONS Bevacizumab was significantly associated with a greater risk of ATE in patients with metastatic, castration-resistant prostate cancer, but it was not significantly associated with the risk of VTE. Understanding clinical factors that increase the risk for experiencing ATE/VTE is essential to mitigate the risks and reduce the burden of these prevalent complications in cancer care. Cancer 2015;121:1025-1031. © 2014 American Cancer Society. [ABSTRACT FROM AUTHOR]

Primary gastrointestinal (GI) lymphomas are uncommon diseases that can involve the whole GI tract. The etiologies of the disease remain unclear, and potential risk factors include celiac disease, Helicobacter pylori infection, use of immunosuppressive agents, human immunodeficiency virus (HIV) or Epstein-Barr virus (EBV) infection and inflammatory bowel disease, etc. Diffuse large B-cell lymphoma (DLBCL) and mucosa-associated lymphoid tissue (MALT) lymphoma are the most common subtypes of GI lymphomas. B-cell lymphomas of the GI tract are more common in Western countries, while in Asia-Pacific region T-cell lymphomas are more frequently reported. In this review, lymphomas in the esophagus, stomach and intestine are described, including their epidemiology, histology, clinical manifestations, endoscopic findings, radiological features and treatment. [ABSTRACT FROM AUTHOR]

The smoothed FEM (S-FEM) is firstly extended to explore the behavior of 3D anisotropic large deformation of rabbit ventricles during the passive filling process in diastole. Because of the incompressibility of myocardium, a special method called selective face-based/node-based S-FEM using four-node tetrahedral elements (FS/NS-FEM-TET4) is adopted in order to avoid volumetric locking. To validate the proposed algorithms of FS/NS-FEM-TET4, the 3D Lame problem is implemented. The performance contest results show that our FS/NS-FEM-TET4 is accurate, volumetric locking-free and insensitive to mesh distortion than standard linear FEM because of absence of isoparametric mapping. Actually, the efficiency of FS/NS-FEM-TET4 is comparable with higher-order FEM, such as 10-node tetrahedral elements. The proposed method for Holzapfel myocardium hyperelastic strain energy is also validated by simple shear tests through the comparison outcomes reported in available references. Finally, the FS/NS-FEM-TET4 is applied in the example of the passive filling of MRI-based rabbit ventricles with fiber architecture derived from rule-based algorithm to demonstrate its efficiency. Hence, we conclude that FS/NS-FEM-TET4 is a promising alternative other than FEM in passive cardiac mechanics. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Plasmonic effects in Au–Ag nanostructures are utilized to realize novel electrochromic device. A quasi ordered Au–Ag core–shell nanoparticle array is realized by thermal evaporation of Au and electrochemical deposition of Ag into a SiO2 hole array assisted by anodic aluminium oxide membranes. The thickness of the Ag shell could be changed by alternating the electrochemical deposition time: as a result, the color of the device can be widely and quasi‐reversibly tuned through this electrical control. [ABSTRACT FROM AUTHOR]

Anti-tumor necrosis factor (TNF)-α agents emerge as the hot spot in the last decade for treating patients with inflammatory bowel disease ( IBD). The effect of anti- TNF-α agents is satisfactory; however, some patients fail to achieve clinical response. Fortunately, in recent years, great efforts have been made and multiple novel therapies have been developed in the treatment for IBD. In this article, we aim to introduce anti- TNF-α drugs as well as other novel treatments currently undergoing clinical trials for IBD. [ABSTRACT FROM AUTHOR]

Background Objective Methods Results Conclusion The prevalence and impact of obesity on outcomes of atrial fibrillation (AF) ablation randomized controlled trials (RCTs) have not been well studied.To examine the proportion of participants with obesity enrolled in RCTs of AF ablation and outcomes of ablation when subgroup analysis of participants with obesity were available.We systematically searched PubMed and EMBASE for AF ablation RCTs published between January 1, 2015 to May 31, 2022. When body mass index (BMI) data were available, normal distribution was assumed and a z score was used to estimate the proportion of obesity. Results categorized by BMI or body weight status were reviewed. Authors were contacted for additional information.Of 148 eligible RCTs with 30174 participants, 144 (97.30%) RCTs did not report the proportion of participants with obesity, while published information regarding BMI was available in 63.51%. Three trials excluded patients based on BMI. Using reported BMI, we estimated the proportion of participants with obesity varied greatly across these trials, ranging from 5.82%–71.9% (median 38.02%, interquartile 29.64%, 49.10%). Patients with obesity were represented in a greater proportion among trials conducted in North America (50.23%) and Asia (44.72%), compared to others (32.16%), p < .001. Subgroup analysis or analysis adjusting for BMI was reported in only 13 (8.78%) RCTs; four (30.77%) of these suggested that BMI or body weight might negatively affect primary outcomes.Obesity is a common comorbidity among AF patients. However, most AF ablation RCTs underreported the proportion of participants with obesity and its impact on the primary outcomes. [ABSTRACT FROM AUTHOR]

Is Pulmonary Vein Firing an Epiphenomenon? Introduction Rapid firing in pulmonary veins (PVs) is a leading cause of paroxysmal atrial fibrillation. We hypothesized that PV firing (PV-F) should continue after circumferential PV isolation (CPVI) because the PV tissue responsible for PV-F remains intact. Methods and Results In Group-1 (n = 92), isoproterenol (ISP) and adenosine triphosphate (ATP) were co-administered to provoke PV-F before and after CPVI. The site of rapid focal discharge that initiated atrial fibrillation (AF) defined PV-F versus non-PV-F. Additional 17 patients with PV-F induced by ISP+ATP before CPVI were enrolled into Group-2 and various pacing maneuvers were used in conjunction to ISP+ATP to provoke PV-F after CPVI. In Group-1, AF was induced in 47/81 (58.0%) and 16/88 (18.2%) patients before and after CPVI, respectively (P < 0.01). Before CPVI, 43/47 (91.5%) of the rapid firing originated from PV. After successful CPVI, 88/92 patients were in sinus rhythm and non-PV-F was induced in 14/88 patients. PV-F was induced in 2/88 patients, which was eliminated by ganglionated plexus ablation outside the CPVI line. In Group-2, various pacing maneuvers with ISP+ATP only induced PV-F in 1/17 patients after CPVI. Conclusion Marked suppression of PV-F after CPVI strongly suggests that the real source of PV-F is located in the atrium. PV-F may be an epiphenomenon. [ABSTRACT FROM AUTHOR]

Summary: Morphological novelties, including formation of trait combinations, may result from de novo gene origination and/or co‐option of existing genes into other developmental contexts. A variety of shape–color combinations of capitular florets occur in Chrysanthemum and its allies. We hypothesized that co‐option of a carotenoid cleavage dioxygenase gene into the floral symmetry gene network would generate a white zygomorphic ray floret.We tested this hypothesis in an evolutionary context using species in Chrysanthemum sensu lato, a monophyletic group with diverse floral shape–color combinations, based on morphological investigation, interspecific crossing, molecular interaction and transgenic experiments.Our results showed that white color was significantly associated with floret zygomorphy. Specific expression of the carotenoid cleavage dioxygenase gene CCD4a in marginal florets resulted in white color. Crossing experiments between Chrysanthemum lavandulifolium and Ajania pacifica indicated that expression of CCD4a is trans‐regulated. The floral symmetry regulator CYC2g can activate expression of CCD4a with a dependence on TEOSINTE BRANCHED1/CYCLOIDEA/PROLIFERATING (TCP) binding element 8 on the CCD4a promoter.Based on all experimental findings, we propose that gene co‐option of carotenoid degradation into floral symmetry regulation, and the subsequent dysfunction or loss of either CYC2g or CCD4a, may have led to evolution of capitular shape–color patterning in Chrysanthemum sensu lato. See also the Commentary on this article by Zhang, 236: 800–802. [ABSTRACT FROM AUTHOR]

Atrial fibrillation (AF) was initiated by rapid firing from left superior pulmonary vein (PV) by administration of isoproterenol (ISP) and adenosine triphosphate (ATP) before ablation. After successful isolation of all PVs, ISP and ATP were administered again. PVs were still isolated but an episode of rapid firing was observed inside the left PV isolation line during sinus rhythm. Radiofrequency energy was then delivered to the areas of superior left ganglionated plexus (GP) and inferior left GP. Then, PV firing could no longer be initiated. It suggests additional GP ablation may have additional benefit to circumferential PV isolation, to reduce the incidence of AF recurrence. (PACE 2012; 35:e316-e319) [ABSTRACT FROM AUTHOR]

Background: This study aims to describe significant left atrial appendage activation following ablation of persistent atrial fibrillation, and explore its relationship with aggressive septal ablation. Methods and Results: Significant left atrial appendage activation delay was found in 23 out of 201 patients undergoing persistent atrial fibrillation ablation. Of them, 14 were found in their index procedures, of whom septal line ablation was performed in nine (odds ratio 15.2, 95% confidence interval 4.6–50.8, P < 0.001). Another nine were found during their redo procedures (including two with biatrial activation dissociation), all of whom received extensive left septal complex fractionated electrograms ablation in their prior procedures (P = 0.002) . Electrocardiograph showed split P wave with the latter component merged into the QRS wave. Activation mapping demonstrated the earliest breakthrough of the left atrium changed to coronary sinus in 18 (85.7%) patients. After 1 month, the mitral A wave velocity was 18.2 ± 17.0 cm/s, and decreased significantly as compared with preablation (20.2 ± 19.1 vs 58.2 ± 17.9 cm/s, P = 0.037) in patients undergoing redo procedures. Fourteen (60.9%) remained arrhythmia-free during follow-up for 10.6 ± 6.2 months. Conclusion: Septal line ablation and extensive septal complex fractionated electrograms ablation are correlated with significant left atrial activation delay or even biatrial activation dissociation, and should be performed with prudent consideration. (PACE 2010; 33:652–660) [ABSTRACT FROM AUTHOR]

Noninducibility of atrial fibrillation (AF) by additional electrograms-guided ablation may benefit the clinical outcome. This report illustrates the effect of adenosine triphosphate (ATP) injection on AF inducibility after pulmonary vein (PV) isolation. AF was triggered twice by ATP without PV reconnection. Meanwhile, complex fractionated atrial electrograms (CFAEs) were observed, and ablation targets on these sites appeared to be essential to the AF elimination. It suggests that CFAEs may contribute to the initiation of some AF. ATP may be useful to induce AF after proven PV isolation, and further ablation might be necessary to ensure efficacy after circumferential PV isolation. (PACE 2010; 33:248–251) [ABSTRACT FROM AUTHOR]

Introduction: Catheter ablation for paroxysmal AF (PAF) is limited by an unacceptable recurrence rate, mainly due to pulmonary vein (PV) reconnection. Strategies to minimize reconnection include adenosine infusion and also a waiting period of 30 minutes after PV isolation. The aim of the present study was to assess whether these two strategies revealed the same conduction gap. Methods and Results: In total, 88 consecutive patients (54 males, mean age of 60 years) with drug refractory PAF underwent circumferential PV isolation (CPVI). After isolation of ipsilateral PVs, with entry and exit block checked using a circular mapping catheter, 20 mg ATP was injected during isoproterenol infusion to reveal dormant conduction gap(s). Unless the reconnection revealed by ATP persisted, PVs were further remapped with the circular mapping catheter at 30 minutes postisolation. Totally, PV reconnection was observed in 56 (64%) patients. 24.3% veins (80/329) were found reconnected. Reassessment at 30 minutes postablation was more efficient as compared to ATP induction (19.8% vs 14.6% for ATP). The agreement between these 2 methods is moderate (kappa value = 0.50). In veins that transiently reconnected after ATP administration and later observed at 30 minutes postablation, 94% (17 of 19) of them were found being reconnected with the same gap. Conclusion: Acute PV reconnection is common, occurring in 64% of patients, as detected by adenosine infusion and waiting time. Each shows a unique quality as compared to one another. The combined use of these 2 methods may reduce the AF recurrence rate after CPVI. [ABSTRACT FROM AUTHOR]

The mechanical defects (scratches/cracks) originated from grinding processing need to be dislodged so that improving the optical performance of fused silica. In this paper, HF‐based (HF represents hydrofluoride acid) etchant was used as a subsequent fabrication for loose‐abrasive ground fused silica, and the surface morphology and characteristics of samples were evaluated, meanwhile, the electric/light field distribution around treated cracks was simulated using the finite difference time domain (FDTD) method. The results show that sufficient material removal amount blunts the cracks to be a series of parabolic‐shaped and smooth craters fused with each other, whose diameter and depth grow as a power function with etched depth. Triple subsurface defect depth should be removed so as to mitigate surface roughness to be ∼2.46 µm and promote transmission from initial 22.55%–54.02%. FDTD simulation results reveal that deep etching alleviates the light intensification factor (LIF) of craters within 1.8 as the diameter‐to‐depth ratio of craters is increased over 10. Moreover, a thickness removal model of ground fused silica involving the cracks distribution characteristics, cracks etching behavior as well as the LIF variation of craters is established, in which the supposed etched depth is determined to promote the manufacturing efficiency and laser damage resistance of the material. [ABSTRACT FROM AUTHOR]

A novel mathematical model for accurately calculating the currents flowing along the conductors of grounding system below high voltage a.c. substations and nearby floating metallic structure buried in horizontal multilayer earth model has been developed in this paper. Not only the mutual conductive and capacitive coupling influences of leakage currents, but also mutual inductive coupling influence of network currents flowing along the conductors of grounding system and nearby floating metallic structure in the horizontal multilayer earth model have been considered in this model, and only propagation effect of electromagnetic wave within limited area of the substation has been neglected. The quasi-static complex image method and closed form of Green's function are introduced into this model to accelerate the calculation. The model is then implemented in a computer program, which can be used to calculate currents distribution along the conductors of any configuration of grounding system, and with or without floating metallic structure under some hundreds of kHz frequency harmonic wave. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper studies the performance of radio assignment algorithms for portable access in cellular systems. Several channel access procedures are proposed and simulated using block oriented network simulator (BONeS) simulation of a model 36-port system. Simulation results exhibit that load-sharing system with LIBTA algorithm is better than directed retry system with the same algorithm by around 0.9 erlangs while better than quasi-fixed channel assignment (QFCA) system by around 2 erlangs if the grade of service (GOS) is constrained to less than 10 per cent. Plus, a hybrid time-slot selection procedure is proposed to enhance the system performance. It is observed that systems with hybrid time-slot selection perform better than those with LIBTA algorithm in GOS under heavy load. It is also observed that load sharing system with hybrid time-slot selection algorithm is better than directed retry system with the same algorithm by around 0.7 erlangs and better than QFCA system by around 2 erlangs. Copyright © 2001 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Tongue color is one of the important indices for tongue diagnosis in traditional Chinese medicine. This study aims to analyze tongue colors of computational tongue diagnosis in traditional Chinese medicine using scientific quantification and computational simulation. The tongue color data are established according to the experiment in which the doctors who use Chinese traditional medicine assessed standard Munsell color charts under the standard lighting environment. Tongue color is classified into six color names, which are pale red, light red, red, crimson, dark red, and purple. The doctors assessed Munsell color charts to find the corresponding color charts' distributions of each color name in tongue color. The hue‐lightness‐chroma data of the chosen Munsell color charts were transformed to CIE xyY using the look‐up table computation, then further were converted to CIELAB values and sRGB data. Based on the 95% confidence ellipses formed on CIELAB (a*, b*) plane and CIELAB (C*, L*) plane, the comparisons between tongue colors and general colors were analyzed. The computational tongue image simulation combining the elements of color, texture, and moisture was successfully established. This computational simulation method could potentially become a useful tool for teaching and learning diagnoses in the education of Chinese medicine. [ABSTRACT FROM AUTHOR]

Background: Left bundle branch block (LBBB) and atrial fibrillation (AF) are commonly coexisting conditions. The impact of LBBB on catheter ablation of AF has not been well determined. This study aims to explore the long‐term outcomes of patients with AF and LBBB after catheter ablation. Methods: Forty‐two patients with LBBB of 11,752 patients who underwent catheter ablation of AF from 2011 to 2020 were enrolled as LBBB group. After propensity score matching in a 1:4 ratio, 168 AF patients without LBBB were enrolled as non‐LBBB group. Late recurrence and a composite endpoint of stroke, all‐cause mortality, and cardiovascular hospitalization were compared between the two groups. Results: Late recurrence rate was significantly higher in the LBBB group than that in the non‐LBBB group (54.8% vs. 31.5%, p =.034). Multivariate analysis showed that LBBB was an independent risk factor for late recurrence after catheter ablation of AF (hazard ratio [HR] 2.19, 95% confidence interval [CI] 1.09–4.40, p =.031). LBBB group was also associated with a significantly higher incidence of the composite endpoint (21.4% vs. 6.5%, HR 3.98, 95% CI 1.64–9.64, p =.002). Conclusions: LBBB was associated with a higher risk for late recurrence and a higher incidence of composite endpoint in the patients underwent catheter ablation. [ABSTRACT FROM AUTHOR]

Glutamate excitotoxicity in cerebral ischemia/reperfusion is an important cause of neurological damage. The aim of this study was to investigate the mechanism of Na+, K+‐ATPase (NKA) involved in l ow concentration of ouabain (Oua, activating NKA)‐induced protection of rat cerebral ischemia‐reperfusion injury. The 2,3,5‐triphenyltetrazolium chloride (TTC) staining and neurological deficit scores (NDS) were performed to evaluate rat cerebral injury degree respectively at 2 h, 6 h, 1 d and 3 d after reperfusion of middle cerebral artery occlusion (MCAO) 2 h in rats. NKA α1/α2 subunits and glutamate transporter‐1 (GLT‐1) protein expression were investigated by Western blotting. The cerebral infarct volume ratio were evidently decreased in Oua group vs MCAO/R group at 1 d and 3 d after reperfusion of 2 h MCAO in rats (*p ＜ 0.05). Moreover, NDS were not significantly different (p ＞ 0.05). NKA α1 was decreased at 6 h and 1 d after reperfusion of 2 h MCAO in rats, and was improved in Oua group. However, NKA α1 and α2 were increased at 3 d after reperfusion of 2 h MCAO in rats, and was decreased in Oua group. GLT‐1 was decreased at 6 h, 1 d and 3 d after reperfusion of 2 h MCAO in rats, and was improved in Oua group. These data indicated that l ow concentration of Oua could improve MCAO/R injury through probably changing NKA α1/α2 and GLT‐1 protein expression, then increasing GLT‐1 function and promoting Glu transport and absorption, which could be useful to determine potential therapeutic strategies for patients with stroke. Low concentration of Oua improved rat MCAO/R injury via NKA α1/α2 and GLT‐1. [ABSTRACT FROM AUTHOR]

Background: Atrial esophageal fistula (AEF) is a lethal complication that can occur post atrial fibrillation (AF) ablation. Esophageal injury (EI) is likely to be the initial lesion leading to AEF. Endoscopic examination is the gold standard for a diagnosis of EI but extensive endoscopic screening is invasive and costly. This study was conducted to determine whether fecal calprotectin (Fcal), a marker of inflammation throughout the intestinal tract, may be associated with the existence of esophageal injury. Methods: This diagnostic study was conducted in a cohort of 166 patients with symptomatic AF undergoing radiofrequency catheter ablation from May 2020 to June 2021. Fcal tests were performed 1–7 days after ablation. All patients underwent endoscopic ultrasonography 1 or 2 days after ablation. Results: The levels of Fcal were significantly different between the EI and non‐EI groups (404.9 µg/g (IQR 129.6–723.6) vs. 40.4 µg/g (IQR 15.0–246.2), p <.001). Analysis of ROC curves revealed that a Fcal level of 125 µg/g might be the optimal cut‐off value for a diagnosis of EI, giving a 78.8% sensitivity and a 65.4% specificity. The negative predictive value of Fcal was 100% for ulcerated EI. Conclusions: The level of Fcal is associated with EI post AF catheter ablation. 125 µg/g might be the optimal cut‐off value for a diagnosis of EI. Negative Fcal could predict the absence of ulcerated EI, which could be considered a precursor to AEF. [ABSTRACT FROM AUTHOR]

Background and objective: Atrioesophageal fistula (AEF) is a rare but devastating complication with high mortality post atrial fibrillation (AF) ablation. The purpose of current study was to determine the epidemiology, clinical features, pathogenesis, and management of AEF after AF ablation. Methods and results: Patients with diagnosed AEF were included and retrospectively analyzed according to the registry of 11 centers in China from January 2010 to December 2019. A total of 16 AEF cases were identified from 44 794 patients who received a left atrial ablation procedure (0.035% per procedure). The interval from procedure to clinical onset of AEF averaged 18.3 days (3‐39 days). The fever ranked the most common symptom, occurred in 14 of the 16 cases, followed by neurological deficits (n = 11), chest pain (n = 5), and hematemesis (n = 4). Patients undergoing surgical repair had a better prognosis compared to those receiving nonsurgical management ([4 of 8] 50.0% vs [8 of 8] 100%, P <.05) with an overall mortality rate of 75.0%. Conclusion: AEF is highly characterized by varied manifestations. Early diagnosis and urgent surgical repair are vital to those patients and associated with improved survival rates. [ABSTRACT FROM AUTHOR]

Study Objectives: Immune checkpoint inhibitors have produced durable responses across a variety of cancers. Although programmed cell death protein 1 (PD‐1) and its ligand (PD‐L1) inhibitors activate T cells against tumor cells, they may also cause autoimmune‐like toxicities termed immune‐related adverse events (irAEs). Although much is known regarding irAEs that occur early during treatment, data on the long‐term toxicity profile of these agents are more limited. Our primary objective was to evaluate the frequency of patients receiving anti‐PD‐1/PD‐L1 therapy for at least 6 continuous months who experienced new or worsening irAEs requiring clinical interventions. Secondary objectives included assessment of other factors associated with clinically significant irAEs after at least 6 months of therapy. Design: Retrospective chart review. Setting: Large university‐affiliated National Cancer Institute–designated comprehensive cancer center. Patients: A total of 159 adults diagnosed with any malignancy who received a PD‐1/PD‐L1 inhibitor—nivolumab, pembrolizumab, or atezolizumab—as monotherapy or with concurrent cytotoxic agents, for at least 6 months, between January 1, 2014, and September 1, 2017. Measurements and Main Results: We collected information on the incidence and timing of irAEs, along with patient demographics and other treatment outcomes. Thirty‐eight patients (24%) experienced clinically significant, new, or worsening irAEs after 6 months of treatment with anti‐PD‐1/PD‐L1 therapy. Hypothyroidism was the most common irAE experienced (20 patients [12.6%]), followed by pneumonitis (5 patients [3%]); 2 patients died due to pneumonitis. Four patients (2.5%) had a deepened disease response beyond 6 months of treatment. Conclusion: Our results revealed that a significant proportion of patients continue to experience irAEs with long‐term use of PD‐1/PD‐L1 inhibitors. These results further contribute to the risk‐benefit understanding of chronic PD‐1/PD‐L1 antagonism and support discontinuation of these agents following deepest response. [ABSTRACT FROM AUTHOR]

Background: Data on management of maternal arrhythmia among Chinese were limited. Radiofrequency catheter ablation (RFCA) proved to be a reliable treatment choice for sustained tachyarrhythmia but it has rarely been performed during pregnancy due to radiation exposure. Objective: To investigate the incidence of idiopathic sustained maternal arrhythmia and the feasibility of RFCA in the pregnant patients without fluoroscopy. Methods: From January of 2015 to December of 2018, the medical records on pregnancy‐related admissions in Beijing Anzhen Hospital (Beijing, China) were retrospectively analyzed. Patients who had sustained tachyarrhythmia episodes without structural heart disease were identified. Catheter ablation was performed in those with drug resistant and severely frequent tachyarrhythmia under the guidance of electroanatomical mapping system and intracardiac echocardiography catheter (ICE), if appropriate. Results: During the study period, 12 584 consecutive pregnant women were admitted for pregnancy‐related reasons, 156 (1.2%) of them were identified as sustained maternal tachyarrhythmia. Twenty‐eight patients (age 21‐37 years) received catheter ablation because the arrhythmias were drug resistant and severely frequent. The RFCA was successfully performed in all patients with zero fluoroscopy after 72.4 ± 24.7 min. Transseptal puncture was performed in 11 patients under the guidance of ICE. In a median of 37 (interquartile range [IQR]: 34‐39) weeks' pregnancy, 28 healthy fetuses were delivered. No cardiac‐related adverse event occurred during delivery. During later follow‐up, all patients were free of arrhythmia, and all the infants were well developed. Conclusion: Sustained maternal tachyarrhythmia is not uncommon in the clinical practice. To those with drug resistant and severely frequent arrhythmia, RFCA with zero fluoroscopy could be safely performed with acceptable efficacy. [ABSTRACT FROM AUTHOR]

Background: Due to the anatomically adjacent relationship between the left atrium (LA) and esophagus, energy delivery on the posterior wall of LA is limited. The aim of this study was to evaluate the feasibility of a novel esophageal retractor (SAFER) with an inflatable C‐curve balloon during atrial fibrillation (AF) ablation. Method: Nine patients underwent AF ablation assisted with the SAFER. After inflation, the esophagus was deviated laterally away from the intended ablation site of the posterior wall under local anesthesia. The extent of mechanical esophageal deviation (MED) was evaluated under fluoroscopy, defined as the shortest distance from the trailing esophageal edge to the closest point of the ablation line. Gastroscopy was performed before and after ablation. The target ablation index used in all LA sites including the posterior wall was 400–450 after effective MED. All adverse events during the periprocedural period were recorded. Results: The mean deviation distance achieved 16.2 ± 9.6 mm away from the closest ablation point of the pulmonary vein lesion set. With respect to the individual left and right pulmonary vein lesion sets, the deviation distance was 19.7 ± 11.5 and 12.7 ± 6.8 mm, respectively. The extent of deviation was 0 to 5 mm, 5.1 to 10 mm, or >10 mm in 0(0%), 7(38.9%), and 11(61.1%), respectively. Procedural success was achieved in all patients without acute reconnection. There was only one esophageal complication which manifested as esophageal erosion and this patient experienced throat pain possibly related to the SAFER retractor with no clinical sequelae. Conclusion: Esophageal deviation with the novel eccentric balloon is a novel feasible choice during AF ablation, enabling adequate energy delivery to the posterior wall of LA. Additional prospective randomized controlled studies are required for further validation. [ABSTRACT FROM AUTHOR]

Background: Fasting blood glucose (FBG) variability, an emerging marker of glycemic control, has been shown to be related to the risk of cardiovascular events and all‐cause mortality in subjects with or without diabetes. However, whether FBG variability is independently associated with a higher all‐cause mortality in heart transplant recipients remains unknown. Methods: We performed a retrospective cohort study including 373 adult recipients who survived for at least 1 year after heart transplantation with a functioning graft and measured FBG more than three times within first year after transplantation. Multivariable adjusted Cox regression analyses were performed to assess the association between FBG variability and all‐cause mortality. Results: Patients were categorized into three groups according to the coefficient of variation of FBG level: ≤7.0%, 7.0%–13.5%, and >13.5%. During a median follow‐up of 44.4 months (interquartile range [IQR], 22.6–63.3 months), 31 (8.3%) participants died. In univariate analyses, FBG variability was associated with an increased all‐cause mortality (hazard ratio [HR]: 3.00, 95% confidence interval [CI]: 1.67, 5.38; p <.001). This association remained materially unchanged in the multivariable model adjusted for components of demographics, cardiovascular history and lifestyle, hospital information, immunosuppressive therapy, and post‐transplant renal function (HR: 2.75, 95% CI: 1.43, 5.28; p =.004). Conclusions: After heart transplantation, high FBG variability is strongly and independently associated with an increased risk of all‐cause mortality. Our findings suggest that FBG variability is a novel risk factor and prognostic marker for heart transplantation recipients in outpatient clinic. [ABSTRACT FROM AUTHOR]

A tunable helical bandpass filter with high selectivity designed for 30-88 MHz operation is presented. The two-pole tunable filter is discretely tuned by connecting PIN switched capacitor banks at the terminal ends of the helix. The filter schematic provides two finite transmission zeros located in the lower and upper stopbands, respectively. The experimental filter has an insertion loss between 1.65 and 2.75 dB with its return loss better than 13 dB. The 3-dB fractional bandwidth of the filter is 3.3%-3.7% and the shape factor (BW30 dB/BW3 dB) is smaller than 5.5 over the entire tuning range. The input power handling capability is greater than 45 dBm. The measured results show good agreement with the simulated ones. [ABSTRACT FROM AUTHOR]

The hyperproliferative tumor stroma of pancreatic ductal adenocarcinoma (PDAC) severely limits drug permeation and constructs an immunosuppressive microenvironment, causing resistance to chemotherapy and immunotherapy. Traditional nanomedicine mainly focuses on manipulating nanoparticles' particle size or electrical characteristics to penetrate deep PDAC through the paracellular pathway, but the transcellular pathway is often ignored. Therefore, a versatile drug‐polymer conjugate PODEA‐Gem‐HMI is prepared and assembled into nanoparticles for the codelivery of chemotherapy drug gemcitabine and focal adhesion kinase (FAK) inhibitor defactinib. While sensing the mild acidity in the tumor microenvironment, the nanoparticle will disintegrate and release defactinib to modulate the tumor stroma. The PODEA block of the conjugate can bind with cell membranes reversibly and trigger adsorption‐mediated transcytosis (AMT) for promoted tumor penetration and cellular uptake. The internalized conjugates will release gemcitabine responding to the overexpressed glutathione (GSH) for enhanced chemotherapy, and PHMI can condensate the STING monomers for prolonged spontaneous immune stimulation. [ABSTRACT FROM AUTHOR]

Glioblastoma (GBM) is the most frequent and deadly primary brain tumor in adults. Temozolomide (TMZ) is the standard systemic therapy in GBM but has limited and restricted efficacy. Better treatments are urgently needed. The role of endoplasmic reticulum stress (ER stress) is increasingly described in GBM pathophysiology. A key molecular mediator of ER stress, the spliced form of the transcription factor x‐box binding protein 1 (XBP1s) may constitute a novel therapeutic target; here we report XBP1s expression and biological activity in GBM. Tumor samples from patients with GBM (n = 85) and low‐grade glioma (n = 20) were analyzed by immunohistochemistry for XBP1s with digital quantification. XBP1s expression was significantly increased in GBM compared to low‐grade gliomas. XBP1s mRNA showed upregulation by qPCR analysis in a panel of patient‐derived GBM cell lines. Inhibition of XBP1 splicing using the small molecular inhibitor MKC‐3946 significantly reduced GBM cell viability and potentiated the effect of TMZ in GBM cells, particularly in those with methylated O6‐methylguanine‐DNA methyl transferase gene promoter. GBM cells resistant to TMZ were also responsive to MKC‐3946 and the long‐term inhibitory effect of MKC‐3946 was confirmed by colony formation assay. In conclusion, this data reveals that XBP1s is overexpressed in GBM and contributes to cancer cell growth. XBP1s warrants further investigation as a clinical biomarker and therapeutic target in GBM. [ABSTRACT FROM AUTHOR]

Abstract: 2D polymer sheets containing azobenzene are successfully prepared by a facile strategy of “2D self‐assembly polymerization (2DSP)” via free radical polymerization in solution. A bola amphiphile containing azobenzene as a novel monomer is designed and synthesized. The results indicate that single‐layer covalent pseudo‐2D polymers on a micrometer scale are obtained after polymerization with vinyl monomers. Moreover, the 2D polymer sheets are highly sensitive to UV light due to incorporation of azobenzene groups into the polymer. Upon alternative irradiation with UV and visible light, the morphological transformation between sheets and rolled‐up nanotubes can be achieved based on the reversible trans‐to‐cis photoisomerization of azobenzene units in the 2D polymer sheets. [ABSTRACT FROM AUTHOR]

Protective autophagy of mitochondria is an important cause of high mortality in glioblastoma (GBM). Because of its serious impact on the treatment effect, it is in urgent need of combined treatment. Based on the regulatory function of the tubulin system on autophagy and inspired by the natural characteristics of neurofilament regulating tubulin polymerization, an in situ self‐assembled "tubulin trap" is designed. Specifically, the system is a transformable block polymer, which can self‐assemble into spherical nanoparticles in water. After targeting GBM cells, they can transform into nanofibers under the intracellular GSH conditions, interfering with autophagy. The research shows that, in mouse GBM xenograft models, the transformable nanofibers with the function of destroying tubulin homeostasis can be combined with ceramide in the treatment of GBM. [ABSTRACT FROM AUTHOR]