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Relevance. New data on the content of lanthanides in the water–rock system are important for understanding the behavior of rare-earth elements in the environment, open up the possibility of using them as indicators of geochemical processes and anthropogenic factor, taking into account the specialities of their migration and fractionation. Aim. Assessment of the quantitative content and distribution of rare-earth elements (La, Ce, Pr, Nd, Pm, Sm, Eu, Gd, Tb, Dy, Ho, Er, Tm, Yb, Lu) in the surface and underground waters of Khanty-Mansiysk to identify the main patterns of their behavior. Objects. Surface and underground waters of the natural reserve Samarovsky Chugas, as well as ground deposits and products of secondary mineral formation. Methods. The bulk analysis of water is performed by a standard set of spectral and electrochemical methods. The rare-earth content was determined by inductively coupled plasma mass spectrometry. Chemical composition of ground deposits and secondary mineral formation products – by neutron activation analysis. Results. The paper demonstrates rare-earth elements behavior in aqueous medium, ground deposits and products of secondary mineral formation. Different approaches to rare-earth elements rationing in waters and solid sediments showed comparability of lanthanide distribution spectra to each other and made it possible to identify some features of the rare-earth elements distribution pattern in different environments. In the waters, there are positive anomalies of europium and gadolinium and negative anomaly of cesium. Gadolinium anomalies were detected in ground deposits, and europium in secondary mineral formation products. The high migration activity of the entire considered series of rare-earth elements in the solution coming from the holding deposits was established. During following geochemical processes, mainly middle lanthanides (Sm, Eu, Gd, and Tb) fall out of the solution in the form of secondary mineral formation products.

Brugada syndrome (BrS) is an inherited cardiac channelopathy with variable expressivity that can lead to sudden cardiac arrest (SCA). Studies worldwide suggest that BrS and Brugada pattern (BrP) have low prevalences in general. However, studies also note that BrS is most prevalent among certain Asian populations. Among the different global regions, the highest prevalence is believed to be in Southeast Asia, followed by the Middle East, South Asia, East Asia, Europe, and North America. It is not only important to recognize such varying degrees of BrS prevalence within Asia but also to understand that there may be significant differences in terms of presenting symptoms, occult risk factors, and the impact on clinical outcomes. The importance of identifying such differences lies in the necessity to develop improved risk assessment strategies to guide secondary prevention and treatment for these patients. Specifically, the decision to pursue placement of an implantable cardiac defibrillator (ICD) can be lifesaving for high-risk BrS patients. However, there remains a significant lack of consensus on how to best risk stratify BrS patients. While the current guidelines recommend ICD implantation in patients with spontaneous Type 1 ECG pattern BrS who present with syncope, there may still exist additional clinical factors that may serve as better predictors or facilitate more refined risk stratification before malignant arrhythmias occur. This carries huge relevance given that BrS patients often do not have any preceding symptoms prior to SCA. This review seeks to delineate the differences in BrS presentation and prevalence within the Asian continent in the hope of identifying potential risk factors to guide better prognostication and management of BrS patients in the future.

The article deals with the features of the manifestation of mental states in minor suspects, accused and convicted persons, depending on the presence at a certain stage of preventive measures selected against the subject. The relevance of this issue is due to the need to take into account mental states for the prevention of destructive behavior (suicides, escapes, group disobedience, mass riots, conflicts with cellmates, conflicts with employees of the institution) in the pre-trial detention center and educational colony. The article describes some features of adolescence that affect the mental state of minor suspects, accused, and convicted. The publication presents the theoretical analysis of the concept of "mental state", briefly describes "the crisis points" faced by people from the moment of stay in pre-trial detention center prior to the incarceration in education colony (inclusive), describes the factors of the prison environment that affect the subject and the most frequently occurring mental condition in dependence on location at a certain "critical" point (location in a pre-trial detention center, in the courtroom (sentencing), detention in education colony and release).

Aims Traditional atrial fibrillation (AF) recurrence after catheter ablation is reported as a binary outcome. However, a paradigm shift towards a more granular definition, considering arrhythmic or symptomatic burden, is emerging. We hypothesize that ablation reduces AF burden independently of conventional recurrence status in patients with persistent AF, correlating with symptom burden reduction. Methods and results Ninety-eight patients with persistent AF from the DECAAF II trial with pre-ablation follow-up were included. Patients recorded daily single-lead electrocardiogram (ECG) strips, defining AF burden as the proportion of AF days among total submitted ECG days. The primary outcome was atrial arrhythmia recurrence. The AF severity scale was administered pre-ablation and at 12 months post-ablation. At follow-up, 69 patients had atrial arrhythmia recurrence and 29 remained in sinus rhythm. These patients were categorized into a recurrence (n = 69) and a no-recurrence group (n = 29). Both groups had similar baseline characteristics, but recurrence patients were older (P = 0.005), had a higher prevalence of hyperlipidaemia (P = 0.007), and had a larger left atrial (LA) volume (P = 0.01). There was a reduction in AF burden in the recurrence group when compared with their pre-ablation burden (65 vs. 15%, P < 0.0001). Utah Stage 4 fibrosis and diabetes predicted less improvement in AF burden. The symptom severity score at 12 months post-ablation was significantly reduced compared with the pre-ablation score in the recurrence group, and there was a significant correlation between the reduction in symptom severity score and the reduction in AF burden (R = 0.39, P = 0.001). Conclusion Catheter ablation reduces AF burden, irrespective of arrhythmia recurrence post-procedure. There is a strong correlation between AF burden reduction and symptom improvement post-ablation. Notably, elevated LA fibrosis impedes AF burden decrease following catheter ablation. [ABSTRACT FROM AUTHOR]

Background Esophageal thermal injury (ETI) is a byproduct of atrial fibrillation (AF) ablation using thermal sources. The most severe form of ETI is represented by atrioesophageal fistula, which has a high mortality rate. Late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) allows identification of ETI. Hence, we sought to evaluate the utility of LGE‐MRI as a method to identify ETI across the entire spectrum of severity. Methods and Results All AF radiofrequency ablations performed at the University of Utah between January 2009 and December 2017 were reviewed. Patients with LGE‐MRI within 24 hours following AF ablation as well as patients who had esophagogastroduodenoscopy in addition to LGE‐MRI were identified. An additional patient with atrioesophageal fistula who had AF ablation at a different institution and had MRI and esophagogastroduodenoscopy at the University of Utah was identified. A total of 1269 AF radiofrequency ablations were identified. ETI severity was classified on the basis of esophageal LGE pattern (none, 60.9%; mild, 27.5%; moderate, 9.9%; severe, 1.7%). ETI resolved in most patients who underwent repeat LGE‐MRI at 3 months. All patients with esophagogastroduodenoscopy‐confirmed ETI had moderate‐to‐severe LGE 24 hours after ablation MRI. Moderate‐to‐severe LGE had 100% sensitivity and 58.1% specificity in detecting ETI, and a negative predictive value of 100%. Atrioesophageal fistula was visualized by both computed tomography and LGE‐MRI in one patient. Conclusions LGE‐MRI is useful in detecting and characterizing ETI across the entire severity spectrum. LGE‐MRI exhibits an extremely high sensitivity and negative predictive value in screening for ETI after AF ablation.

Aim: To evaluate the effectiveness of using a smartphone-based electrocardiography (ECG) monitoring device (ECG Check) on the frequency of clinic or emergency room visits in patients who underwent ablation of atrial fibrillation (AF). Methods: Two groups of patients were identified and compared: The conventional monitoring group (CM group) included patients who were prescribed conventional event monitoring or Holter monitoring systems. The ECG Check group (EC group) included patients who were prescribed the ECG Check device for continuous monitoring in addition to conventional event monitoring. The primary outcome was the number of patient visits to clinic or emergency room. The feasibility, accuracy, and detection rate of mobile ECG Check were also evaluated. Results: Ninety patients were studied (mean age: 66.2 ± 11 years, 64 males, mean CHA 2 DS 2 -VASc score: 2.6 ± 2). In the EC group, forty-five patients sent an average of 52.8 ± 6 ECG records for either routine monitoring or symptoms of potential AF during the follow-up period. The rhythm strips identified sinus rhythm (84.7%), sinus tachycardia (8.4%), AF (4.2%), and atrial flutter (0.9%). Forty-two EC transmissions (1.8%) were uninterpretable. Six patients (13%) in the EC group were seen in the clinic or emergency room over a 100-day study period versus 16 (33%) in the standard care arm ( P value

We used mathematical modeling to compare the stress and deformation in a Bi0.4Sb1.6Te3 solid solution base thermoelectric material for extrusion through different diameter dies. The results show that extrusion through a 20 mm diameter die produces a more inhomogeneous deformation compared with extrusion through a 30 mm diameter die. Extrusion through a die of a larger diameter produces a structure that is coarser but has a more homogeneous grain size distribution. The degree of preferential grain orientation is higher for extrusion through a larger diameter die. We found a change in the lattice parameter of the solid solution along the extruded rod, correlating with detect formation during extrusion. The concentration of vacancies is higher for extrusion through a smaller diameter die. This difference between the structures results from a more intense dynamic recrystallization for a smaller diameter die. Increasing the die diameter and lowering the extrusion temperature allow retaining the thermoelectric properties of the material due to a better texture.