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We prove that, on the infinite Sierpiński gasket graph SG , rotor walk with random initial configuration of rotors is recurrent. We also give a necessary condition for an i.i.d. sandpile to stabilize. In particular, we prove that an i.i.d. sandpile with expected number of chips per site greater or equal to three does not stabilize almost surely. Furthermore, the proof also applies to divisible sandpiles and shows that divisible sandpile at critical density one does not stabilize almost surely on SG. [ABSTRACT FROM AUTHOR]

We provide a thorough comparison of the GMHD3D code and the PLUTO4.4 code for both two- and three-dimensional hydrodynamic and magnetohydrodynamic problems. The open-source finite-volume solver PLUTO4.4 and the in-house developed pseudo-spectral multi-GPU solver GMHD3D both can be used to model the dynamics and turbulent motions of astrophysical plasmas. Although GMHD3D and PLUTO4.4 utilize different implementations, it is found that simulation results for hydrodynamic and magnetohydrodynamic problems, such as the rate of instability growth, 3-dimensional turbulent dynamics, oscillation of kinetic & magnetic energy, and recurrence dynamics, are remarkably similar. However, it is shown that the pseudo spectral solver GMHD3D is significantly more superior than the grid based solver PLUTO4.4 for certain category of physics problems. • A new GPU-based 3D MHD solver is compared to a well-established open source solver. • In-house pseudo-spectral solver GMHD3D is compared to finite volume solver PLUTO4.4. • In most of the MHD problems, GMHD3D and PLUTO4.4 perform comparably. • GMHD3D is found to outerform the grid-based one for a subclass of physics problems. [ABSTRACT FROM AUTHOR]

In this article, we formulate the problem of satisfying a linear temporal logic formula on a linear plant with output feedback, through a recent hybrid systems formalism. We relate this problem to the notion of recurrence introduced for the considered formalism, and we then extend Lyapunov-like conditions for recurrence of an open, unbounded set. One of the proposed relaxed conditions allows certifying recurrence of a suitable set, and this guarantees that the high-level evolution of the plant satisfies the formula, without relying on discretizations of the plant. Simulations illustrate the proposed approach. [ABSTRACT FROM AUTHOR]

Die Scarf Osteotomie ist zum einen eine sehr versatile und intrinsisch stabile zum anderen eine Osteotomie, die zahlreiche Fehlerquellen in der Durchführung in sich birgt. So kann es postoperativ zu Frakturen mit Höhertreten des MT I Köpfchens sowie Verkippung und Malrotation des Fragments kommen. Die verschiedenen Komplikationsmechanismen werden aufgezeigt und eine mögliche Korrekturoperation beschrieben. The Scarf osteotomy is a versatile osteotomy with high intrinsic stability. Still the Scarf osteotomy bears a lot of risks while performed. The consequence of it could be a fracture with elevation of the MT I head with a possible malrotation and varisation or valgisation. The mechanism of failure and possible surgical revision techniques will be discussed. [ABSTRACT FROM AUTHOR]

Copyright of Tandlaegebladet is the property of Tandlaegeforeningen and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Tandlaegebladet is the property of Tandlaegeforeningen and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Tandlaegebladet is the property of Tandlaegeforeningen and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The issue of a recurrence of modulationally unstable water wave trains within the framework of the fully nonlinear potential Euler equations is addressed. It is examined, in particular, if a modulation, which appears from nowhere (i.e., is infinitesimal initially) and generates a rogue wave, can disappear with no trace. If so, this wave solution would be a breather solution of the primitive hydrodynamic equations. It is shown with the help of the fully nonlinear numerical simulation that when a rogue wave emerges from a uniform Stokes wave train, it excites other waves which have different lengths. This process prevents the complete recurrence and, eventually, results in a quasi-periodic breathing of the wave envelope. Meanwhile the discovered effects are rather small in magnitude, and the period of the modulation breathing may be thousands of the dominant wave periods. Thus, the obtained solution may be called a quasi-breather of the Euler equations. [ABSTRACT FROM AUTHOR]

A curious aspect of the evolution of the hypnozoite theory of malarial relapse is its transmogrification from theory into 'fact', this being of historical, linguistic, scientific and sociological interest. As far as it goes, the hypnozoite explanation for relapse is almost certainly correct. I contend, however, that many of the genotypically homologous, non-reinfection, relapse-like Plasmodium vivax recurrences that researchers ascribe to hypnozoite activation are probably hypnozoite-independent. Indeed, some malariologists are starting to recognize that homologous P. vivax recurrences have most likely been overattributed to activation of hypnozoites. Hitherto identified, non-hypnozoite, possible plasmodial sources of recurrence that must be considered, besides circulating erythrocytic stages, include parasites in splenic dendritic cells, other cells in the spleen (in addition to infected erythrocytes there), bone marrow (importantly) and the skin. I argue that we need to take into account the possibility of a dual or multiple extra-vascular origin of P. vivax non-reinfection recurrences, not arbitrarily discount it. The existence of a P. vivax reservoir(s) is a topical subject and one of practical importance for malaria eradication. Pertinent drug-associated matters are also discussed, as is the dormancy-related significance of clues provided by blood-stage-induced malarial infection. [ABSTRACT FROM AUTHOR]

Is soy consumption linked to breast cancer? Preventative mastectomy on the rise. [ABSTRACT FROM AUTHOR]

Reoperative central neck dissection requires a concise set of steps to complete a comprehensive dissection of recurrent lymphadenopathy seen in thyroid cancer. The main considerations take into account the recurrent laryngeal nerve and the parathyroid glands. This chapter specifies those steps from a preoperative evaluation to the pearls during dissection to ensure a complete reoperative dissection that removes all residual thyroid tissue and lymphadenopathy while ensuring the best outcomes. [ABSTRACT FROM AUTHOR]

Background: Drug-induced autoimmune hepatitis (DI-AIH) has been proposed as a distinct phenotype of drug-induced liver injury (DILI), and frequently has been associated with specific drugs, such as minocycline and nitrofurantoin. However, no clear definition of DI-AIH has been established thus far., Objectives: We aimed to identify features distinguishing DI-AIH from DILI and idiopathic autoimmune hepatitis (AIH) in an attempt to further define a DI-AIH phenotype., Method: A cohort of 38 previously reported DILI and AIH patients who were prospectively recruited at our tertiary centre and who received corticosteroid was analysed regarding the phenotypical presentation and outcome of DI-AIH, DILI, and AIH., Results: AIH (n = 19), DILI (n = 8), and DI-AIH (n = 11) patients presented with similar clinical features at onset, with the only difference being a higher Roussel Uclaf Causality Assessment Method (RUCAM) score in the DILI and DI-AIH patients. Post-treatment AIH scores were lower and a more rapid decrease of alanine aminotransferase in the first week of corticosteroid treatment was observed in both DILI groups when compared to AIH patients, while no significant differences were observed between DI-AIH and DILI patients. Relapse occurred in DI-AIH but not in DILI patients (36% vs. 0%) with a more frequent need for long-term immunosuppression (27% vs. 13%)., Conclusions: Our data show that relapse after cessation of corticosteroids and need for further immunosuppressive treatment does occur in a substantial proportion of DI-AIH patients. However, no other phenotypical differences between DILI due to agents commonly associated with DI-AIH and DILI due to other drugs were identified., (© 2023 S. Karger AG, Basel.)

Background: Electrical cardioversion (ECV) is a common procedure to terminate persistent atrial fibrillation (AF). The recurrence rate is high, and the patients often fail to recognize AF recurrence., Objectives: The aim of the study was to evaluate the feasibility of patient-managed electrocardiography (ECG) to detect the time to AF recurrence after ECV., Methods: PRE-ELECTRIC (predictors for recurrence of atrial fibrillation after electrical cardioversion) is a prospective, observational study. Patients ≥18 years of age scheduled for ECV of persistent AF at Bærum Hospital were eligible for inclusion in the study. Time to recurrence of AF was detected by thumb ECG, recorded twice daily and whenever experiencing symptoms. The observation period was 28 days. We defined adherence as the observed number of days with ECG recordings divided by the expected number of days with ECG recordings. Study personnel contacted the participants by phone to assess their awareness of AF recurrence after a recurrence was detected in the thumb ECG., Results: The study enrolled 200 patients scheduled for ECV of persistent AF at Bærum Hospital between 2018 and 2022. The mean age was 66.2 ± 9.3 years, and 21.0% (42/200) were women. The most frequent comorbidities were hypertension (n = 94, 47.0%) and heart failure (n = 51, 25.5%). A total of 164 participants underwent ECV of AF. The procedure was initially successful in 90.9%, of which 50.3% had a recurrence of AF within 4 weeks. The median time to recurrence was 5 days. Among the cardioverted participants, 123 (75.0%) had no missing days of thumb ECG recording during the observation period, and 97.0% had ≤3 missing days. More than a third (37.3%) of the participants with AF recurrence were unaware of the recurrence at the time of contact. Women were older and more symptomatic than men but had similar outcomes after ECV., Conclusions: Recurrence of AF after ECV was common. Using patient-managed thumb ECG was a feasible method to detect AF recurrence following ECV. Further studies are needed to investigate whether patient-managed ECG after ECV can optimize AF treatment., (© 2023 The Author(s). Published by S. Karger AG, Basel.)

Osimertinib, A New Drug to Extend Life of Advanced Lung Cancer Patients. Cancer: Fighting an Informed Battle. [ABSTRACT FROM AUTHOR]

In this paper, we establish results similar in nature to the invariance principle for a class of stochastic hybrid systems modeled by set-valued mappings. In particular, we characterize the set to which bounded random solutions converge in terms of a new concept called weak total recurrence. A refinement of the result under the existence of a non-increasing on average Lyapunov-like function is also established. A comparison between weak total recurrence and the frequently studied invariance concepts are presented. Finally, application of the main results to establish weak sufficient conditions for certifying stochastic stability properties like uniform global asymptotic stability in probability for compact sets and uniform global recurrence for open, bounded sets are discussed. [ABSTRACT FROM PUBLISHER]

The problem of recurrence for quantum Markov chains on trees (QMCT), is more subtle than for 1D quantum Markov chains (QMC); it involves infinitely many rays due to the exponential growth of ramifications on the Cayley trees and their relevant constraints. We study criteria for recurrence of QMCT based on the correlations functions and boundary conditions. These represent a bridge between recurrence and phase transitions. Furthermore, we illustrate our results through an Ising model with competing interactions. [ABSTRACT FROM AUTHOR]

Chaotic systems are ubiquitous in the real world, but often analytical models remain inaccessible. We find that a machine-learning method known as "reservoir computing" provides an alternative feasible way for modeling chaotic systems rather than conventional dynamical equations. Specifically, we show that recurrence in temporal and spatial scales of the trained reservoir system are indistinguishable from that of an observed chaotic system. Furthermore, by sharing a common signal, dual synchronization between a chaotic system and its learned reservoir system can be achieved successfully. In the same manner, we show that the identical synchronization also emerges on their coupled system. These findings reveal that reservoir computing approach would be excellent candidate for modeling a great variety of chaotic systems. • We find that machine learning approach provides an alternative way of modeling chaotic systems. • We show that recurrence in temporal and spatial scales of reservoir computering model are indistinguishable from that of an observed chaotic system. • We realize dual synchronization between a chaotic system and its learned reservoir system. [ABSTRACT FROM AUTHOR]

This paper proves a necessary and sufficient condition for martingale convergence to hold with positive probability to a finite limit. Our results apply to vector-valued martingale sequences not necessarily L 1 -bounded. [ABSTRACT FROM AUTHOR]

The present paper makes three distinct improvements over an earlier investigation of Kalpathy and Ward. We analyze the length of the entire election process (not just one participant’s duration), for a randomized election algorithm, with a truncated geometric number of survivors in each round. We not only analyze the mean and variance; we analyze the asymptotic distribution of the entire election process. We also introduce a new variant of the election that guarantees a unique winner will be chosen; this methodology should be more useful in practice than the previous methodology. The method of analysis includes a precise analytic (complex-valued) approach, relying on singularity analysis of probability generating functions. [ABSTRACT FROM AUTHOR]

Two-color triangular urn models have been investigated recently. Moments of ball counts of a particular color have been obtained exactly and asymptotically in a number of sources (Janson, 2006, Kuba and Panholzer, 2014, and Flajolet et al., 2006). Exact factorial moments are in Kuba and Panholzer (2014). While Flajolet et al. (2006) gives an exact distribution, finding the exact moments from it is daunting. The asymptotic moments in Janson (2006) are derived by heavy machinery—the limit distribution in Janson (2006) is extracted from complicated characteristic functions in the form of integrals that they themselves include functions given by complicated integrals. The methods used in most of these investigations are quite sophisticated. In this note, we characterize the exact moments via an elementary approach. The formulas for the exact moments include Stirling’s numbers of second kind and the asymptotic moments follow effortlessly. [ABSTRACT FROM AUTHOR]

Abstract: Recent work of Kalpathy and Mahmoud (in press) gives very general results for a broad class of fair leader election algorithms. They study the duration of contestants, i.e., the number of rounds a randomly selected contestant stays in the competition and another parameter for the associated tree structure. They present a unifying treatment for leader election algorithms, and they show how perpetuities naturally come about. Their theory, however, produces only trivial asymptotic results for the duration of election for some distributions, such as a truncated geometric distribution. In the case of a truncated geometric distribution, the limiting distribution of the duration of contestants is degenerate, and the method of Kalpathy and Mahmoud (in press) does not yield the precise asymptotics. The goal of this short note is to use an alternative method–namely, the -series methodology–to make a very precise asymptotic analysis of the rate of decay of the mean and the variance of the duration of the election. [Copyright &y& Elsevier]

Abstract: Beginning with the first mode as the initial condition, long-term evolutions of gravity waves in shallow water are simulated based on the full nonlinear Boussinesq model. Evident recurrence is observed in long basins with appropriate initial amplitudes. Equipartition can be obtained in the case of a long basin, large initial amplitude or a long evolution time. Well-defined solitary waves are present during the recurrence stage and completely lost at the equipartition stage. The transition from regular to chaotic motion is conjectured to be related to the ratio of the dispersion and nonlinearity of the initial condition. For short basins with small initial amplitudes, nonlinearity is much smaller than dispersion, energy transfer is weak, and no recurrence can be observed. If dispersion and nonlinearity are chosen to be the same order in the initial condition, recurrence clearly emerges. However, if nonlinearity is chosen to be larger than dispersion, recurrence is absent and the system reaches equipartition rapidly. [Copyright &y& Elsevier]

Abstract: A sequence of random variables is called regenerative if it can be broken up into iid components. The problem addressed in this paper is that of determining under what conditions a Markov chain is regenerative. It is shown that an irreducible Markov chain with a countable state space is regenerative for any initial distribution if and only if it is recurrent (null or positive). An extension of this to the general state space case is also discussed. [Copyright &y& Elsevier]

Abstract: We consider a kind of Collision Branching Processes with Immigration (CBIP). Some important properties of the generating functions for the CBI -matrix were first investigated in detail. Then for any given CBI -matrix, the existence and uniqueness of CBIP is proved, and sufficient and easily checked conditions for the CBIP to be recurrent are given. Moreover, the exact value of the decay parameter is obtained and expressed explicitly for the communicating class in the case that the immigration is independent of states. It is shown that this can be directly obtained from the generating functions of the corresponding -matrix. Finally, the invariant vectors and invariant measures are considered. [Copyright &y& Elsevier]

Abstract: We discuss a new non-linear PDE, , invariant under scaling of dependent variable and referred to here as SIdV. It is one of the simplest such translation and space–time reflection-symmetric first order advection–dispersion equations. This PDE (with dispersion coefficient unity) was discovered in a genetic programming search for equations sharing the KdV solitary wave solution. It provides a bridge between non-linear advection, diffusion and dispersion. Special cases include the mKdV and linear dispersive equations. We identify two conservation laws, though initial investigations indicate that SIdV does not follow from a polynomial Lagrangian of the KdV sort. Nevertheless, it possesses solitary and periodic travelling waves. Moreover, numerical simulations reveal recurrence properties usually associated with integrable systems. KdV and SIdV are the simplest in an infinite dimensional family of equations sharing the KdV solitary wave. SIdV and its generalizations may serve as a testing ground for numerical and analytical techniques and be a rich source for further explorations. [Copyright &y& Elsevier]

Abstract: In this short paper, problems with existing algorithms for computing spherical Bessel functions of complex arguments are reported. As a remedy, a revised algorithm based on the recurrence is proposed. The upper and lower limits for the starting order that can be used in the backward recurrence to reach a desired accuracy are given. The proposed algorithm is stable and is capable of computing a wide range of arguments approaching machine accuracy. [ABSTRACT FROM AUTHOR]

Abstract: Non-physical effects of discretization schemes on simulations of plasma microturbulence are investigated, and different types of hyperdiffusion terms in the gyrokinetic Vlasov equation are employed to cancel or mitigate these effects. Widely applicable rules on how to operate parallel spatial and velocity space diffusion – to avoid numerically excited high- modes and recurrence phenomena, respectively – are presented. The impact of diffusion terms on and the applicability of these findings to results obtained in the context of a benchmark scenario are demonstrated. [Copyright &y& Elsevier]

Abstract: We derive a customized solution to the diffusion equation in a heterogeneous slab with an arbitrary contiguous source. While aspects of solution have previously been reported in the literature, its full explicit form as presented here by solving a 3-term recurrence, has not. We conclude with a series of exercises demonstrating the utility of the solution. [Copyright &y& Elsevier]

Hyperparathyroidism is an uncommon disease, that is, usually diagnosed after a patient is found to have repeatedly elevated calcium levels on routine blood testing. Some patients may experience problems with recurrent kidney stones, memory difficulty, constipation, osteoporosis, or chronic fatigue. Patients exhibit chronic calcium and parathyroid hormone elevation, often undiagnosed for several years. Surgery is the definitive intervention, resulting in cure in 95% of patients when performed by an experienced parathyroid surgeon. Unfortunately, many patients initially receive surgical exploration by surgeons with limited experience, resulting in biochemical cure rates as low as 60%-70%. Unfortunately, recurrence may occur due to failed exploration, a second adenoma, or multigland hyperplasia. Resolution of the hyperparathyroid state requires additional surgery to remove any overactive parathyroid tissue. Reoperative surgery inherently brings increased surgical risks and decreased surgical success of cure. Hence, a focused and organized approach to this patient population is essential for optimizing the outcome of revision parathyroid surgery. [ABSTRACT FROM AUTHOR]

Abstract: We investigate the applicability of Poincaré’s and the quantum recurrence theorems to the physical systems such as a container filled with a gas from a physical perspective. We discuss certain difficulties with regard to the definition of the Hamiltonian for such systems and the existence of one-to-one mappings as solutions to the equations of motion. We examine a typical proof of Poincaré’s recurrence theorem and notice that a key part of the proof appeals to the motion of a neighborhood of finite volume in a phase space and this neighborhood possesses infinite kinetic energy, raising another question concerning the applicability of the theorem to physical systems. The same situations also present themselves in the application of Liouville’s theorem. [Copyright &y& Elsevier]

This paper extends the classical variational formula of capacity for symmetric Markov chains in Kemeny et al. (1976) to the asymmetric ones, both transient and recurrent. [ABSTRACT FROM AUTHOR]

In this randomized controlled trial of 228 women, Lactobacillus crispatus CTV-05 (Lactin-V) applied vaginally for 11 weeks reduced the incidence of recurrent bacterial vaginosis from 45% in the placebo arm to 30% in the Lactin-V arm. [ABSTRACT FROM AUTHOR]

Copyright of Acta Endoscopica is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Fuss & Sprunggelenk is the property of Elsevier GmbH, Urban & Fischer Verlag and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: For any recurrent random walk on , there are increasing sequences converging to infinity for which has at least one finite accumulation point. For one class of random walks, we give a criterion on and the distribution of determining the set of accumulation points for . This extends, with a simpler proof, a result of Chung and Erdös. Finally, for recurrent, symmetric random walks, we give a criterion characterizing the increasing sequences of positive numbers for which . [Copyright &y& Elsevier]

Copyright of Fuss & Sprunggelenk is the property of Elsevier GmbH, Urban & Fischer Verlag and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper describes a code for evaluating exponentially decaying negative energy Coulomb functions and their first derivatives with respect to the radial variable. The functions, which correspond to Whittaker functions of the second kind, are obtained to high accuracy for a wide range of parameters using recurrence techniques.: Program summaryTitle of program: whittaker_wCatalog identifier: ADSZProgram summary URL: http://cpc.cs.qub.ac.uk/summaries/ADSZProgram obtainable from: CPC Program Library, Queen''s University of Belfast, N. IrelandComputer: Cray T3E, Sun Ultra-5_10 sparc, Origin2000, Compaq EV67, IBM SP3, Toshiba 460CDTOperating systems under which the program has been tested: Windows NT4, Redhat Linux, SunOS 5.8Programming language used: Fortran 95Memory required to run with typical data: 500 KBNumber of bytes in distributed program, including test data, etc.: 39728Number of lines in distributed program, including test data, etc.: 2900Distribution format: tar gzip fileNature of physical problem: The closed-channel components of the asymptotic radial wave function corresponding to electron or positron scattering by atomic or molecular ions may be expressed in terms of negative energy Coulomb functions. The scattering observables are obtained from S or T matrices which in turn are obtained by matching the radial and asymptotic wavefunctions at a finite radial point. Recent large scale scattering calculations have required accurate values of the Coulomb functions at smaller ρ values and larger negative η values than previous work. The present program is designed to extend the range of parameters for which the function may be calculated.Method of solution: Recurrence relations, power series expansion, numerical quadrature.Restrictions on the complexity of the problem: The program has been tested for the parameter ranges: 0<ρ&les;1000, &z.sfnc;η&z.sfnc;&les;120 and 0&les;l&les;100. These ranges may, with appropriate scaling to avoid underflow and overflow, be extended.References: A. Sunderland, C.J. Noble, P.G. Burke, V.M. Burke, Comp. Phys. Commun. 145 (2002) 311. [Copyright &y& Elsevier]

We describe a mathematical model and simulation study for Jackpot Keno, as implemented by Jupiters Network Gaming (JNG) in the Australian state of Queensland, and as controlled by the Queensland Office of Gaming Regulation (QOGR) (http://www.qogr.qld.gov.au/keno.shtml). The recurrences for the house net hold are derived and it is seen that these are piecewise linear with a ternary domain split, and further, the split points are stochastic in nature. Since this structure is intractable (Brockett and Levine, Statistics & Probability & their Applications, CBS College Publishing, 1984), estimation of house net hold obtained through an appropriately designed simulator using a random number generator with desirable properties is described.Since the model and simulation naturally derives hold given payscale, but JNG and QOGR require payscale given hold, an inverse problem was required to be solved. This required development of a special algorithm, which may be described as a stochastic binary search.Experimental results are presented, in which the simulator is used to determine jackpot payscales so as to satisfy legal requirements of approximately 75% of net revenue returned to the players, i.e., 25% net hold for the house (JNG). Details of the algorithm used to solve this problem are presented here, and notwithstanding the stochastic nature of the simulation, convergence to a specified hold for the inverse problem has been achieved to within 0.1% in all cases of interest to date. [Copyright &y& Elsevier]

There has been sustained focus on the secondary prevention of coronary heart disease and heart failure; yet, apart from stroke prevention, the evidence base for the secondary prevention of atrial fibrillation (AF) recurrence, AF progression, and AF-related complications is modest. Although there are multiple observational studies, there are few large, robust, randomized trials providing definitive effective approaches for the secondary prevention of AF. Given the increasing incidence and prevalence of AF nationally and internationally, the AF field needs transformative research and a commitment to evidenced-based secondary prevention strategies. We report on a National Heart, Lung, and Blood Institute virtual workshop directed at identifying knowledge gaps and research opportunities in the secondary prevention of AF. Once AF has been detected, lifestyle changes and novel models of care delivery may contribute to the prevention of AF recurrence, AF progression, and AF-related complications. Although benefits seen in small subgroups, cohort studies, and selected randomized trials are impressive, the widespread effectiveness of AF secondary prevention strategies remains unknown, calling for development of scalable interventions suitable for diverse populations and for identification of subpopulations who may particularly benefit from intensive management. We identified critical research questions for 6 topics relevant to the secondary prevention of AF: (1) weight loss; (2) alcohol intake, smoking cessation, and diet; (3) cardiac rehabilitation; (4) approaches to sleep disorders; (5) integrated, team-based care; and (6) nonanticoagulant pharmacotherapy. Our goal is to stimulate innovative research that will accelerate the generation of the evidence to effectively pursue the secondary prevention of AF.

Copyright of Acta Endoscopica is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)