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Objective: Repetitive atrial activation patterns (RAAPs) during complex atrial tachycardia could be associated with localized mechanisms that can be targeted. Clinically available electroanatomical mapping systems are limited by either the spatial coverage or electrode density of the mapping catheters, preventing the adequate visualization of transiently occurring RAAPs. This work proposes a technique to overcome this shortcoming by stitching spatially overlapping conduction patterns together to a larger image- called a composite map., Methods: Simulated stable mechanisms and meandering reentries are sequentially mapped (4x4 grid, 3mm spacing) and then reconstructed back to the original sizes with the proposed recurrence plot-based algorithm., Results: The reconstruction of single linear waves presents minimal errors (local activation time (LAT) difference: 3.2 [1.6-4.9] ms, conduction direction difference: 5.2 [2.3-8.0] degrees). Errors significantly increase (p<0.05) for more complex patterns, being the highest with unstable reentries (LAT difference: 10.3 [3.5-16.2] ms, conduction direction difference: 18.2 [6.7-29.7] deg). In a second part of the analysis, 111 meandering reentries are reconstructed. Mapping 30 locations overlappingly around each reentry core was found to be the optimal mapping strategy. For this optimal setting, LAT, conduction direction, and core localization errors are low (6.1 [4.2-8.6] ms, 11.2 [8.6-15.5] deg and 4.1 [2.9-4.9] mm, respectively) and are weakly correlated with the degree of the meander ( ρ=0.41, ρ=0.40 and ρ=0.20, respectively)., Conclusion: Our findings underline the feasibility of generating composite maps by stitching spatially overlapping recordings., Significance: Composite maps can be instrumental in personalized ablation strategies.

Objective: This study assesses changes and challenges within the nursing curriculum in the Brazilian context, focusing on addressing contemporary professional and societal demands., Design: A systematic literature review (SLR) was conducted to identify and analyze the changes in Brazil's nursing curricula over time., Data Sources: Articles published between 1987 and 2023 were selected from Scopus and Web of Science databases for the systematic review., Review Methods: A hybrid review approach was employed, integrating Systematic Literature Review (SLR), Bibliometrics, and metanarrative. The study adhered to the SPAR-4-SLR (Scientific Procedures and Rationale for Systematic Literature Reviews) protocol, involving three main stages: (i) aggregation, (ii) organization, and (iii) evaluation. The analysis primarily focused on identifying emerging trends and evaluating curricular changes over the specified timeframe., Results: Analysis of the selected literature identified four principal thematic groups that emerged during the review period: (i) longitudinal curriculum assessment, (ii) biological and health sciences, (iii) human and social sciences, and (iv) nursing sciences. Noteworthy trends included the integration of emerging topics like mental health and care for victims of violence, coupled with a notable increase in emphasis on transformative and competency-based education. Nevertheless, significant gaps were observed in the existing literature, particularly concerning the absence of perspectives from students and recent graduates and limited research on vulnerabilities within the curriculum structure., Conclusions: This study underscores the imperative for flexible and adaptable nursing curricula that effectively address Brazil's diverse regional and social realities. It emphasizes the significance of adopting a holistic and inclusive approach to nursing education, preparing professionals to confront contemporary health challenges in a nation characterized by extensive cultural diversity and vast geographical dimensions. Further research and input from students and recent graduates are indispensable to rectify the gaps and ensure the continuous evolution of nursing education in Brazil., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests or personal relationships that could influence the findings reported in this paper. Hence, the authors declare that they have no conflict of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Purpose: Atrial tachycardia (AT), flutter (AFL) and fibrillation (AF) are very common cardiac arrhythmias and are driven by localized sources that can be ablation targets. Non-invasive body surface potential mapping (BSPM) can be useful for early diagnosis and ablation planning. We aimed to characterize and differentiate the arrhythmic mechanisms behind AT, AFL and AF from the BSPM perspective using basic features reflecting their electrophysiology., Methods: 19 simulations of 567-lead BSPMs were used to obtain dominant frequency (DF) maps and estimate the atrial driving frequencies using the highest DF (HDF). Regions with |DF-HDF|≤1Hz were segmented and characterized (size, area); the spatial distribution of the differences |DF-atrialHDFestimate| was qualitatively analyzed. Phase singularity points (SPs) were detected on maps generated with Hilbert transform after band-pass filtering around the HDF (±1Hz). Connected SPs along time (filaments) and their histogram (heatmaps) were used for rotational activity characterization (duration, spatiotemporal stability). Results were reproduced in clinical layouts (252 to 12 leads) and with different rotations and translations of the atria within the torso, and compared with the original 567-lead outcomes using structural similarity index (SSIM) between maps, sensitivity and precision in SP detection and direct feature comparison. Random forest and least-square based algorithms were used to classify the arrhythmias and their mechanisms' location, respectively, based on the obtained features., Results: Frequency and phase analyses revealed distinct behavior between arrhythmias. AT and AFL presented uniform DF maps with low variance, while AF maps were more heterogeneous. Lower differences from the atrial HDF regions correlated with the driver location. Rotational activity was most stable in AFL, followed by AT and AF. Features were robust to lower spatial resolution layouts and modifications in the atrial geometry; DF and heatmaps presented decreasing SSIM along the layouts. The classification of the arrhythmias and their mechanisms' location achieved balanced accuracy of 72.0% and 73.9%, respectively., Conclusion: Non-invasive characterization of AT, AFL and AF based on realistic models highlights intrinsic differences between the arrhythmias, enhancing the BSPM utility as an auxiliary clinical tool., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objective: Atrial dominant frequency (DF) maps undergoing atrial fibrillation (AF) presented good spatial correlation with those obtained with the non-invasive body surface potential mapping (BSPM). In this study, a robust BSPM-DF calculation method based on wavelet analysis is proposed., Approach: Continuous wavelet transform along 40 scales in the pseudo-frequency range of 3-30 Hz is performed in each BSPM signal using a Gaussian mother wavelet. DFs are estimated from the intervals between the peaks, representing the activation times, in the maximum energy scale. The results are compared with the traditionally widely applied Welch periodogram and the robustness was tested on different protocols: increasing levels of white Gaussian noise, artificial DF harmonics presence and reduction in the number of leads. A total of 11 AF simulations and 12 AF patients are considered in the analysis. For each patient, intracardiac electrograms were acquired in 15 locations from both atria. The accuracy of both methods was assessed by calculating the absolute errors of the highest DF BSPM (HDF BSPM ) with respect to the atrial HDF, either simulated or intracardially measured, and assumed correct if ≤1 Hz. The spatial distribution of the errors between torso DFs and atrial HDFs were compared with atria driving mechanism locations. Torso HDF regions, defined as portions of the maps with [Formula: see text] Hz were identified and the percentage of the torso occuping these regions was compared between methods. The robustness of both methods to white Gaussian noise, ventricular influence and harmonics, and to lower spatial resolution BSPM lead layouts was analyzed: computer AF models (567 leads vs 256 leads down to 16 leads) and patient data (67 leads vs 32 and 16 leads)., Main Results: The proposed method allowed an improvement in non-invasive estimation of the atria HDF. For the models the median relative errors were 7.14% for the wavelet-based algorithm vs 60.00% for the Welch method; in patients, the errors were 10.03% vs 12.66%, respectively. The wavelet method outperformed the Welch approach in correct estimations of atrial HDFs in models (81.82% vs 45.45%, respectively) and patients (66.67% vs 41.67%). A low positive BSPM-DF map correlation was seen between the techniques (0.47 for models and 0.63 for patients), highlighting the overall differences in DF distributions. The wavelet-based algorithm was more robust to white Gaussian noise, residual ventricular activity and harmonics, and presented more consistent results in lead layouts with low spatial resolution., Significance: Estimation of atrial HDFs using BSPM is improved by the proposed wavelet-based algorithm, helping to increase the non-invasive diagnostic ability in AF.

In this study, the effect of α-eleostearic acid (α-ESA) on the lipid peroxidation of soybean asolectin (ASO) liposomes was investigated. This effect was correlated to changes caused by the fatty acid in the membrane dynamics. The influence of α-ESA on the dynamic properties of liposomes, such as hydration, mobility and order, were followed by horizontal attenuated total reflection Fourier transform infrared spectroscopy (HATR-FTIR), nuclear magnetic resonance (NMR), differential scanning calorimetry (DSC) and UV-vis techniques. The α-ESA showed an in vitro antioxidant activity against the damage induced by hydroxyl radical (OH) in ASO liposomes. The analysis of HATR-FTIR frequency shifts and bandwidths and (1)H NMR spin-lattice relaxation times, related to specific lipid groups, showed that α-ESA causes an ordering effect on the polar and interfacial regions of ASO liposomes, which may restrict the OH diffusion in the membrane. The DSC enthalpy variation analysis suggested that the fatty acid promoted a disordering effect on lipid hydrophobic regions, which may facilitate interactions between the reactive specie and α-ESA. Turbidity results showed that α-ESA induces a global disordering effect on ASO liposomes, which may be attributed to a change in the lipid geometry and shape. Results of this study may allow a more complete view of α-ESA antioxidant mode of action against OH, considering its influence on the membrane dynamics., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Aging causes several physiological alterations, including alterations in sleep. It is possible that difficulty sleeping can be exacerbated by increased inflammation in older individuals. Moderate exercise training may be a modality of non-pharmacological treatment for sleep disorders and inflammation. We aimed to assess the effects of moderate exercise training on sleep in elderly people as well as their cytokine profiles. Additionally, we examined the effect of exercise training on quality of life parameters using a SF-36 questionnaire. Twenty-two male, sedentary, healthy, elderly volunteers performed moderate training for 60 min/day, 3 days/week for 24 week at a work rate equivalent to their ventilatory aerobic threshold. The environment was kept at a temperature of 23 ± 2°C, with a humidity of 60 ± 5%. Blood and polysomnograph were collected twice: at baseline (1 week before training began) and after 6 months of training. Training increased aerobic capacity parameters (p<0.0001), decreased REM latency (p<0.02), and decreased time awake (p<0.05). After training, the levels of IL-6 (p<0.0001) and TNF-α (p<0.0001) and the ratio of TNF-α/IL-10 (p<0.0001) were decreased, whereas IL-10 levels were increased after training (p<0.001). Furthermore, exercise training was shown to improve quality of life parameters. Our results suggest that 6 months of training can improve sleep in the elderly and is related to the anti-inflammatory effect of moderate training, which modifies cytokine profiles., (Copyright © 2012 Elsevier Ltd. All rights reserved.)