Sinoatrial node function and the role of sinoatrial conduction in the typical atrial flutter substrate.

Background: Sinoatrial node (SAN) activation and sinoatrial conduction pathways (SACPs) have been assessed in animals but not in humans.

Objectives: We used ultrahigh-density mapping and simulated models to characterize the SAN and to investigate whether slowed SAN conduction may contribute to the atrial flutter (AFL) substrate.

Methods: Twenty-seven patients undergoing electrophysiologic procedures had right atrial mapping.

Remote myocardial fibrosis predicts adverse outcome in patients with myocardial infarction on clinical cardiovascular magnetic resonance imaging.

Background: Heart failure (HF) most commonly occurs in patients who have had a myocardial infarction (MI), but factors other than MI size may be deterministic. Fibrosis of myocardium remote from the MI is associated with adverse remodeling. We aimed to 1) investigate the association between remote myocardial fibrosis, measured using cardiovascular magnetic resonance (CMR) extracellular volume fraction (ECV), and HF and death following MI, 2) identify predictors of remote myocardial fibrosis in patients with evidence of MI and determine the relationship with infarct size.

PROTOCOL FOR HUMAN EXPOSURE TO OPIOIDS AND CONCENTRATED MEDETOMIDINE USED IN FIELD APPLICATIONS.

Wildlife professionals routinely use potent sedatives and anesthetics when chemically immobilizing wildlife and zoo species in remote environments. Accidental exposure to these prescription veterinary drugs is rare but could be rapidly fatal. Commonly used agents include opioids and α adrenoreceptor agonists.

Identification of heart failure hospitalization from NHS Digital data: comparison with expert adjudication.

Aims: Population-wide, person-level, linked electronic health record data are increasingly used to estimate epidemiology, guide resource allocation, and identify events in clinical trials. The accuracy of data from NHS Digital (now part of NHS England) for identifying hospitalization for heart failure (HHF), a key HF standard, is not clear. This study aimed to evaluate the accuracy of NHS Digital data for identifying HHF.

Orthogonal spatial coding with stimulated parametric down-conversion.

Orthogonal optical coding is widely used in classical multi-user communication networks. Using the phase conjugation property of stimulated parametric down-conversion, we extend the current time-domain orthogonal optical coding scheme to the spatial domain to encode and decode image information. In this process, the idler beam inherits the complex conjugate of the field information encoded in the seed beam.

Disease-specific therapy for the treatment of the cardiovascular manifestations of Fabry disease: a systematic review.

Objective: The cardiovascular manifestations of Fabry disease are common and represent the leading cause of death. Disease-specific therapy, including enzyme replacement therapy (ERT) and chaperone therapy (migalastat), is recommended for patients exhibiting cardiovascular involvement, but its efficacy for modulating cardiovascular disease expression and optimal timing of initiation remains to be fully established. We therefore aimed to systematically review and evaluate the effectiveness of disease-specific therapy compared with placebo, and to no intervention, for the cardiovascular manifestations of Fabry disease.

rWCVP: a companion R package for the World Checklist of Vascular Plants.

The World Checklist of Vascular Plants (WCVP) is an extremely valuable resource that is being used to address many fundamental and applied questions in plant science, conservation, ecology and evolution. However, databases of this size require data manipulation skills that pose a barrier to many potential users. Here, we present rWCVP, an open-source R package that aims to facilitate the use of the WCVP by providing clear, intuitive functions to execute many common tasks.

Generation of volumetrically full Poincaré beams.

Optical communications, remote sensing, particle trapping, and high-resolution imaging are a few research areas that benefit from new techniques to generate structured light. We present a method of generating polarization-structured laser beams that contain both full and partial polarization states. We demonstrate this method by generating an optical beam that contains every state of partial and full polarization.

Suppression of Nonlinear Optical Rogue Wave Formation Using Polarization-Structured Beams.

A nonlinear self-focusing material can amplify random small-amplitude phase modulations present in an optical beam, leading to the formation of amplitude singularities commonly referred to as optical caustics. By imposing polarization structuring on the beam, we demonstrate the suppression of amplitude singularities caused by nonlinear self-phase modulation. Our results are the first to indicate that polarization-structured beams can suppress nonlinear caustic formation in a saturable self-focusing medium and add to the growing understanding of catastrophic self-focusing effects in beams containing polarization structure.

Local impedance-guided ablation and ultra-high density mapping versus conventional or contact force-guided ablation with mapping for treatment of cavotricuspid isthmus dependent atrial flutter.

Introduction: - Local impedance (LI) guided ablation as a method of judging lesion effectiveness for cavotricuspid isthmus dependent atrial flutter (CTI-AFL), and ultra-high density (UHD) mapping when breakthrough occurred across an ablation line has not previously been assessed.

Methods: This retrospective observational study evaluated patients undergoing CTI-AFL ablation using conventional, contact force (CF) and LI guided strategies. Ablation metrics were collected, and in the LI cohort, the use of UHD mapping for breakthrough evaluated.

Refractory vasodilatory shock secondary to metformin overdose supported with VA ECMO.

Unlabelled: Metformin overdose may result in vasodilatory shock, lactic acidosis and death. Hemodialysis is an effective means of extracorporeal elimination, but may be insufficient in the shock setting. We present a case of a 39 yo male who presented with hypotension, coma, hypoglycemia, and lactate of 6.

Endothelial function and atrial fibrillation: A missing piece of the puzzle?

Endothelial dysfunction, a term used to describe both the physical damage and dysregulated physiology of this endothelial lining, is an increasingly recognized pathophysiological state shared by many cardiovascular diseases. Historically, the role of endothelial dysfunction in atrial fibrillation (AF) was thought to be limited to mediating atrial thromboembolism. However, there is emerging evidence that endothelial dysfunction both promotes and maintains atrial arrhythmic substrate, predicts adverse outcomes, and identifies patients at high risk of recurrence following cardioversion and ablation therapy.

The World Checklist of Vascular Plants, a continuously updated resource for exploring global plant diversity.

The World Checklist of Vascular Plants (WCVP) is a comprehensive list of scientifically described plant species, compiled over four decades, from peer-reviewed literature, authoritative scientific databases, herbaria and observations, then reviewed by experts. It is a vital tool to facilitate plant diversity research, conservation and effective management, including sustainable use and equitable sharing of benefits. To maximise utility, such lists should be accessible, explicitly evidence-based, transparent, expert-reviewed, and regularly updated, incorporating new evidence and emerging scientific consensus.

Turnover events of animal caretakers and its impact on productivity in swine farms.

Attracting and retaining quality animal caretaking personnel is one of most pressing issues the US swine industry currently faces. On-farm employee turnover can be costly and have an impact on productivity. The primary objectives of this study were to describe the amount of animal caretaker turnover events that occurred in a single year in eleven swine farms, and to investigate associations between employee turnover events and two subsequent production parameters of interest: number of pigs weaned per sow (PWS) and pre-weaning mortality (PWM).

A circadian clock in the sinus node mediates day-night rhythms in Hcn4 and heart rate.

Background: Heart rate follows a diurnal variation, and slow heart rhythms occur primarily at night.

Objective: The lower heart rate during sleep is assumed to be neural in origin, but here we tested whether a day-night difference in intrinsic pacemaking is involved.

Methods: In vivo and in vitro electrocardiographic recordings, vagotomy, transgenics, quantitative polymerase chain reaction, Western blotting, immunohistochemistry, patch clamp, reporter bioluminescence recordings, and chromatin immunoprecipitation were used.

Association between different types of within-farm worker movements and number of pigs weaned per sow in U.S. Swine farms.

The integration and intensification of modern swine production has amplified the importance of biosecurity, as diseases are more easily able to spread and persist in large swine farms, resulting in economic losses. Advancements in accessible technology and computational methods offer new applications for precision livestock farming, such as monitoring internal movements to better understand biosecurity compliance on farm. In this study, a beacon-sensor based internal movement system (PigChamp Pro Europa®) was utilized to investigate the association between weekly within-farm movements of workers and an important production parameter: average weekly number of pigs weaned per sow (PWS), on three US swine farms.

Quantum Nonlocal Aberration Cancellation.

Phase distortions, or aberrations, can negatively influence the performance of an optical imaging system. Through the use of position-momentum entangled photons, we nonlocally correct for aberrations in one photon's optical path by intentionally introducing the complementary aberrations in the optical path of the other photon. In particular, we demonstrate the simultaneous nonlocal cancellation of aberrations that are of both even and odd order in the photons' transverse degrees of freedom.

Total Hip Replacement in a Patient With a Fontan Circulation: A Case Report.

Anesthetic management of the adult patient with a Fontan circulation is complex and requires understanding of the specific physiology of the individual patient. Long-term survival in this cohort has increased to the point where patients are presenting for noncardiac surgery related to degenerative diseases of aging. We describe the perioperative management of a patient with a Fontan circulation undergoing total hip arthroplasty using combined spinal-epidural anesthesia and discuss the issues requiring special consideration for this surgical procedure in this group of patients.

The analgesic efficacy of the transversalis fascia plane block in iliac crest bone graft harvesting: a randomized controlled trial.

Background: Iliac crest bone graft (ICBG) harvesting is associated with significant perioperative pain and opioid consumption. This randomized controlled trial sought to determine if the transversalis fascia plane (TFP) block provides effective analgesia for anterior ICBG harvesting.

Methods: Fifty patients undergoing wrist fusion surgery with anterior ICBG harvesting were randomized to receive a TFP block with either 20 ml of 0.

Spread of dye injectate in the distal femoral triangle versus the distal adductor canal: a cadaveric study.

Background And Objectives: The nerve to vastus medialis (NVM) supplies sensation to important structures relevant to total knee arthroplasty via a medial parapatellar approach. There are opposing findings in the literature about the presence of the NVM within the adductor canal (AC). The objective of this cadaveric study is to compare the effect of injection site (distal femoral triangle (FT) vs distal AC) on injectate spread to the saphenous nerve (SN) and the NVM.