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Background: Pulsed-field ablation (PFA) using a pentaspline-catheter for the treatment of atrial fibrillation (AF) is performed in a standardized fashion. Whether a reduced number of applications results in similar clinical outcomes has not been fully investigated., Objectives: To assess a simplified PFA-dosing protocol for pulmonary vein isolation (PVI) compared to a standard protocol., Method: consecutive Patients undergoing their first PVI using PFA were enrolled. In the simple PFA-group, patients received 4 applications/PV (2x basket and 2x flower configuration) whereas 8 applications/PV (4x basket and 4x flower configuration) were used in the standard PFA-group., Results: We included 245 patients (32% female, median age 66 years): 96 patients were in the simple PFA-group (39%) and 149 in the standard PFA-group (61%). Median procedure duration, left atrial dwell time and fluoroscopy time were significantly shorter in the simple-PFA group compared to the standard PFA-group with 40 [25-55] min vs. 53 [41-67] min (p<0.001); 22 [13-37] min vs. 37 [27-50] min (p<0.001); 9 [7-12] min vs. 11 [9-14] min (p<0.001), respectively. First pass isolation was similar for the simple PFA and the standard PFA-group (95% vs. 95%, p>0.999). Overall, 4 procedural complications were observed, all in the standard PFA-group (p=0.303). During a median follow-up of 373 days, freedom from atrial arrhythmias was 79% in the simple PFA-group and 77% in the standard PFA-group (p=0.767), respectively. Findings were confirmed when only comparing patients who received PVI with/without EAM., Conclusion: In conclusion, the novel simplified PFA-protocol was associated with increased procedural efficiency while maintaining non-inferior efficacy and safety compared to the standard PFA-protocol., (Copyright © 2024. Published by Elsevier Inc.)

Aquaculture is expected to play a vital role in solving the challenge of sustainably providing the growing world population with healthy and nutritious food. Pathogen outbreaks are a major risk for the sector, so early detection and a timely response are crucial. This can be enabled by monitoring the pathogen levels in aquaculture facilities. This paper describes a photonic biosensing platform based on silicon nitride waveguide technology with integrated active components, which could be used for such applications. Compared to the state of the art, the current system presents improvements in terms of miniaturization of the Photonic Integrated Circuit (PIC) and the development of wafer-level processes for hybrid integration of active components and for material-selective chemical and biological surface modification. Furthermore, scalable processes for integrating the PIC in a microfluidic cartridge were developed, as well as a prototype desktop readout instrument. Three bacterial aquaculture pathogens ( Aeromonas salmonicida , Vagococcus salmoninarum , and Yersinia ruckeri ) were selected for assay development. DNA biomarkers were identified, corresponding primer-probe sets designed, and qPCR assays developed. The biomarker for Aeromonas was also detected using the hybrid PIC platform. This is the first successful demonstration of biosensing on the hybrid PIC platform.

Introduction: Atrial fibrillation (AF) and heart failure (HF) frequently coexist. Prediction of left ventricular ejection fraction (LVEF) recovery after catheter ablation (CA) for AF remains difficult., Objectives: To evaluate the value of biomarkers, alone and in conjunction with the Antwerp score to predict LVEF recovery after CA for AF., Methods: Patients undergoing CA for AF with depressed LVEF(<50%) were included. Plasma levels of 13 biomarkers were measured immediately prior to CA. Patients were categorized into "responders" and "non-responders" in similar fashion to the Antwerp score derivation and validation cohorts. The predictive power of the biomarkers alone and combined in outcome prediction was evaluated., Results: 208 patients with depressed LVEF were included (median age 63 years, 19% female, median LAVI 42 ml/m2, median LVEF 43%). At a median follow-up time of 30 months, 161 (77%) were responders and 47 (23%) were non-responders. Of 13 biomarkers, four (ANG2, GDF15, FGF23 and MyBPC3) were significantly different between responders and non-responders (p ≤0.001) and combined could predict the endpoint with an AUC of 0.72 (95%CI 0.64-0.81) overall, 0.69 (95%CI 0.59-0.78) in HFmrEF and 0.88 (95%CI 0.77-0.98) in HFrEF. Only ANG2 and GDF15 remained significantly associated with LVEF recovery after adjustment for age, sex and Antwerp score and significantly improved the accuracy of the Antwerp score predictions (p<0.001). The AUC of the Antwerp score in the outcome prediction improved from 0.75 (95% CI 0.67-0.83) to 0.78 (95% CI 0.70-0.86) CONCLUSION: A biomarker panel (ANG2, GDF15) significantly improved the accuracy of the Antwerp Score., (Copyright © 2024. Published by Elsevier Inc.)

We report our experience with the endoscopic treatment of vesicoureteral reflux by submucosal injection of Teflon (STING) in children. Since December of 1992, 45 children and a total of 67 ureters were treated. The overall success rate was 90% after one injection and 95% after two injections. The success rate was better in primary reflux with 95%, 87.5% in duplicated ureters and 75% in secondary reflux after one injection. Actually we treat the reflux grade II and III with STING when it doesn't improve after one year with medical treatment.