Pulsed Field Ablation to Treat Paroxysmal Atrial Fibrillation: Safety and Effectiveness in the AdmIRE Pivotal Trial.

Background: Evidence from clinical trials of early pulsed field ablation (PFA) systems in treating atrial fibrillation has demonstrated their promising potential to reduce complications associated with conventional thermal modalities while maintaining efficacy. However, the lack of a fully integrated mapping system, a staple technology of most modern electrophysiology procedures, poses limitations in lesion creation and workflow options. A novel variable-loop PFA catheter integrated with an electroanatomic mapping system has been developed that allows for real-time nonfluoroscopic procedural guidance and lesion indexing as well as feedback of tissue-to-catheter proximity.

A Comparison of Arterial Input Function Interpolation Methods for Patlak Plot Analysis of Ga-PSMA-11 PET Prostate Cancer Studies.

Positron emission tomography (PET) imaging enables quantitative assessment of tissue physiology. Dynamic pharmacokinetic analysis of PET images requires accurate estimation of the radiotracer plasma input function to derive meaningful parameter estimates, and small discrepancies in parameter estimation can mimic subtle physiologic tissue variation. This study evaluates the impact of input function interpolation method on the accuracy of Patlak kinetic parameter estimation through simulations modeling the pharmacokinetic properties of [68Ga]-PSMA-11.

Value-Based Health Care in Perioperative Medicine: Process Maps and Costing to Determine Best Practices.

Perioperative care in the United States is largely based on current fee-for-service models. Fee-for-service models are not based on the true cost of services provided, charges do not equal costs, and reimbursement varies based on insurer. Value-based health care is defined as patient-centered outcomes over cost of providing these services.

Necessary Products for the Prevention and Treatment of Pressure Injuries: Lessons Learned That Translate Beyond the COVID-19 Pandemic.

Objective: To identify the challenges encountered in obtaining the required support surfaces and products to meet pressure injury (PrI) prevention and treatment needs during COVID-19.

Methods: The authors used SurveyMonkey to gather data on healthcare perceptions and the challenges experienced regarding specific product categories deemed necessary for PrI prevention and treatment in US acute care settings during the pandemic. They created three anonymous surveys for the target populations of supply chain personnel and healthcare workers.

The EXO70 inhibitor Endosidin2 alters plasma membrane protein composition in Arabidopsis roots.

To sustain normal growth and allow rapid responses to environmental cues, plants alter the plasma membrane protein composition under different conditions presumably by regulation of delivery, stability, and internalization. Exocytosis is a conserved cellular process that delivers proteins and lipids to the plasma membrane or extracellular space in eukaryotes. The octameric exocyst complex contributes to exocytosis by tethering secretory vesicles to the correct site for membrane fusion; however, whether the exocyst complex acts universally for all secretory vesicle cargo or just for specialized subsets used during polarized growth and trafficking is currently unknown.

Co-occurrences of fall-related factors in adults aged 60 to 85 years in the United States National Health and Nutrition Examination Survey.

A broad set of factors are associated with falling (e.g., age, sex, physical activity, vision, health), but their co-occurrence is understudied.

Feature Selection Techniques for a Machine Learning Model to Detect Autonomic Dysreflexia.

Feature selection plays a crucial role in the development of machine learning algorithms. Understanding the impact of the features on a model, and their physiological relevance can improve the performance. This is particularly helpful in the healthcare domain wherein disease states need to be identified with relatively small quantities of data.

Driver Vigilance Decrement is More Severe During Automated Driving than Manual Driving.

Objective: The present study compared the performance, workload, and stress associated with driver vigilance in two types of vehicle: a traditional, manually operated vehicle, and a partially automated vehicle.

Background: Drivers of partially automated vehicles must monitor for hazards that constitute automation failures and the need for human intervention, but recent research indicates that a driver's ability to do so declines as a function of time. That research lacked a comparison measure of driving without vehicle automation, so it is unknown to what degree these effects are specific symptoms of monitoring the roadway during an automated drive.

Machine Learning Driven Contouring of High-Frequency Four-Dimensional Cardiac Ultrasound Data.

Automatic boundary detection of 4D ultrasound (4DUS) cardiac data is a promising yet challenging application at the intersection of machine learning and medicine. Using recently developed murine 4DUS cardiac imaging data, we demonstrate here a set of three machine learning models that predict left ventricular wall kinematics along both the endo- and epi-cardial boundaries. Each model is fundamentally built on three key features: (1) the projection of raw US data to a lower dimensional subspace, (2) a smoothing spline basis across time, and (3) a strategic parameterization of the left ventricular boundaries.

Rare case: Ureteropelvic junction complication presenting with bilateral labial abscesses and urosepsis requiring nephrectomy.

Ureteropelvic junction obstruction (UPJO) is the most common cause of urinary tract obstruction in pediatric patients. Debates in management include ureteral stent versus nephrostomy tube placement prior to surgical correction if intervention is warranted. We present a female patient with left UPJO, diagnosed at 15-years-old, treated with ureteral stent placement.

Decision Tree for Key Comparisons.

This contribution describes a Decision Tree intended to guide the selection of statistical models and data reduction procedures in key comparisons (KCs). The Decision Tree addresses a specific need of the Inorganic Analysis Working Group (IAWG) of the Consultative Committee (CC) for Amount of Substance, Metrology in Chemistry and Biology (CCQM), of the International Committee for Weights and Measures (CIPM), and it is likely to address similar needs of other working groups and consultative committees. Because the portfolio of KCs previously organized by the CCQM-IAWG affords a full range of opportunities to demonstrate the capabilities of the Decision Tree, the majority of the illustrative examples of application of the Decision Tree are from this working group.

Cannabidiol or CBD Oil: Help, Hope, and Hype for Psychiatric and Neurologic Conditions.

This article presents proven, promising, and potential therapeutic uses for cannabidiol (CBD) in the treatment of psychiatric and neurologic conditions and diseases. It presents popular, but scientifically unproven health and therapeutic claims of CBD supporting the beneficial homeostatic effects of the intrinsic or endogenous cannabinoid system. It includes a review of cannabinoid pharmacology; it compares properties and the legal status of CBD and THC (delta 9-tetrahydrocannabinol) as well as the hemp and marijuana varieties of , and it reviews the historic 2018 U.

Risk for Anaphylactic Reaction from Cardiac Catheterization in Patients Receiving β-Adrenergic Blockers or Angiotensin-Converting Enzyme-Inhibitors.

Background: β-Adrenergic blockers (BBs) have been associated with increased risk for severe anaphylactic reaction (AR) from contrast media; however, this was shown with intravenous contrast media, before widespread use of low osmolar contrast media, angiotensin-converting enzyme-inhibitors (ACE-Is), and cardioselective BBs.

Objective: To assess the risk for AR during cardiac catheterization (CC) associated with BB or ACE-I exposure.

Methods: Patients who experienced adverse reactions during CC from January 2004 to December 2013 were identified; 1 to 2 matched controls were assigned for each case.

Mean Kinetic Temperature for Controlled Room Temperature Drug Storage: Official Definitions and Example Calculations.

Mean kinetic temperature, a thermodynamically calculated average temperature that is used to determine whether or not the controlled room temperature drug storage limit has been maintained to ensure drug stability, first became official in the Ninth Supplement of the United States Pharmacopeia-National Formulary on November 15, 1993. The calculations involved may appear lengthy, and their mathematic solutions are presented in this article. Also included is a short history on the development of the Arrhenius equation, which is the basis for "mean kinetic temperature," and the accomplishments of Dr.

Maximal dose-response of vitamin-K2 (menaquinone-4) on undercarboxylated osteocalcin in women with osteoporosis.

Low concentrations of serum vitamin K accompany high concentrations of undercarboxylated osteocalcin (ucOC) and osteoporotic fractures. Although vitamin K2 (MK-4) is approved as a therapeutic agent for the treatment of osteoporosis in some countries, the dose-response is unknown. The objective of this study was to assess the improvement in carboxylation of osteocalcin (OC) in response to escalating doses of MK-4 supplementation.

Driver Vigilance in Automated Vehicles: Effects of Demands on Hazard Detection Performance.

Objective: The current study investigated driver vigilance in partially automated vehicles to determine whether increased task demands reduce a driver's ability to monitor for automation failures and whether the vigilance decrement associated with hazard detections is due to driver overload.

Background: Drivers of partially automated vehicles are expected to monitor for signs of automation failure. Previous research has shown that a driver's ability to perform this duty declines over time.

Driver Vigilance in Automated Vehicles: Hazard Detection Failures Are a Matter of Time.

Objective: The primary aim of the current study was to determine whether monitoring the roadway for hazards during automated driving results in a vigilance decrement.

Background: Although automated vehicles are relatively novel, the nature of human-automation interaction within them has the classic hallmarks of a vigilance task. Drivers must maintain attention for prolonged periods of time to detect and respond to rare and unpredictable events, for example, roadway hazards that automation may be ill equipped to detect.

Questionnaire survey of the pan-African trade in lion body parts.

The African lion is in decline across its range, and consumptive utilisation and trade of their body parts and skins has been postulated as a cause for concern. We undertook a pan-African questionnaire and literature survey to document informed opinion and evidence for the occurrence of domestic and international trade and consumption in African lion body parts across current and former range states. Sixty-five people from 18 countries participated in the online questionnaire survey (run from July 2014 to May 2015), with information provided for 28 countries (including 20 out of 24 countries believed to have extant populations).

A roaring trade? The legal trade in Panthera leo bones from Africa to East-Southeast Asia.

The African lion is the only big cat listed on CITES Appendix II, and the only one for which international commercial trade is legal under CITES. The trade in lion body parts, and especially the contentious trade in bones from South Africa to Asia, has raised concerns spanning continents and cultures. Debates were amplified at the 2016 CITES Conference of the Parties (CoP17) when a proposal to up-list lions to Appendix I was not supported and a compromise to keep them on Appendix II, with a bone trade quota for South Africa, was reached instead.

Does Your Drug Expertise Include Clinical Pharmaceutics?

Whose job is it to protect patients from harm from drug instabilities and incompatibilities and other aspects of clinical pharmaceutics? Pharmacists are better educated via multiple required general and organic chemistry prerequisite and professional curricula medicinal chemistry and pharmaceutics courses. Therefore, no healthcare professional other than pharmacists are nicknamed drug experts or are better formally educated to master drug chemistry in the bottle (i.e.

'Skullduggery': Lions Align and Their Mandibles Rock!

South Africa has legally exported substantial quantities of lion bones to Southeast Asia and China since 2008, apparently as part of the multinational trade substituting bones and body parts of other large cats for those of the tiger in wine and other health tonics. The legal sale of lion bones may mask an illegal trade, the size of which is only partially known. An observed component of the illegal trade is that quantities of skeletons are sometimes declared falsely/fraudulently on CITES export permits.