A novel image integration technology mapping system significantly reduces radiation exposure during ablation for a wide spectrum of tachyarrhythmias in children.

Objective: Radiofrequency catheter ablation (RFCA) has evolved into an effective and safe technique for the treatment of tachyarrhythmia in children. Concerns about children and involved medical staff being exposed to radiation during the procedure should not be ignored. "Fluoroscopy integrated 3D mapping", a new 3D non-fluoroscopic navigation system software (CARTO Univu Module) could reduce fluoroscopy during the procedure. However, there are few studies about the use of this new technology on children. In the present study, we analyzed the impact of the CARTO Univu on procedural safety and fluoroscopy in a wide spectrum of tachyarrhythmias as compared with CARTO3 alone. Methods: The data of children with tachyarrhythmias who underwent RFCA from June 2018 to December 2021 were collected. The CARTO Univu was used for mapping and ablation in 200 cases (C3U group) [boys/girls (105/95), mean age (6.8 ± 3.7 years), mean body weight (29.4 ± 7.9 kg)], and the CARTO3 was used in 200 cases as the control group (C3 group) [male/female (103/97), mean age (7.2 ± 3.9 years), mean body weight (32.3 ± 19.0 kg)]. The arrhythmias were atrioventricular reentrant tachycardia (AVRT, n = 78), atrioventricular node reentrant tachycardia (AVNRT, n = 35), typical atrial flutter (AFL, n = 12), atrial tachycardia (AT, n = 20) and ventricular arrhythmias [VAs, premature ventricular complexes or ventricular tachycardia, n = 55]. Results: ① There was no significant difference in the acute success rate, recurrence rate, and complication rate between the C3 and C3U groups [(94.5% vs. 95.0%); (6.3% vs. 5.3%); and (2.0% vs. 1.5%); P > 0.05]. ② The CARTO Univu reduced radiation exposure: fluoroscopy time: AVRT C3: 8.5 ± 7.2 min vs. C3U: 4.5 ± 2.9 min, P < 0.05; AVNRT C3: 10.7 ± 3.2 min vs. C3U: 4.3 ± 2.6 min, P < 0.05; AT C3: 15.7 ± 8.2 min vs. C3U: 4.5 ± 1.7 min, P < 0.05; AFL C3: 8.7 ± 3.2 min vs. C3U: 3.7 ± 2.7 min, P < 0.05; VAs C3: 7.7 ± 4.2 min vs. C3U: 3.9 ± 2.3 min, P < 0.05. Corresponding to the fluoroscopy time, the fluoroscopy dose was also reduced significantly. ③ In the C3U group, the fluoroscopy during VAs ablation was lower than that of other arrhythmias (P < 0.05). Conclusion: The usage of the "novel image integration technology" CARTO Univu might be safe and effective in RFCA for a wide spectrum of tachyarrhythmias in children, which could significantly reduce fluoroscopy and has a more prominent advantage for VAs ablation.

Gene selection for optimal prediction of cell position in tissues from single-cell transcriptomics data.

Single-cell RNA-sequencing (scRNAseq) technologies are rapidly evolving. Although very informative, in standard scRNAseq experiments, the spatial organization of the cells in the tissue of origin is lost. Conversely, spatial RNA-seq technologies designed to maintain cell localization have limited throughput and gene coverage. Mapping scRNAseq to genes with spatial information increases coverage while providing spatial location. However, methods to perform such mapping have not yet been benchmarked. To fill this gap, we organized the DREAM Single-Cell Transcriptomics challenge focused on the spatial reconstruction of cells from the Drosophila embryo from scRNAseq data, leveraging as silver standard, genes with in situ hybridization data from the Berkeley Drosophila Transcription Network Project reference atlas. The 34 participating teams used diverse algorithms for gene selection and location prediction, while being able to correctly localize clusters of cells. Selection of predictor genes was essential for this task. Predictor genes showed a relatively high expression entropy, high spatial clustering and included prominent developmental genes such as gap and pair-rule genes and tissue markers. Application of the top 10 methods to a zebra fish embryo dataset yielded similar performance and statistical properties of the selected genes than in the Drosophila data. This suggests that methods developed in this challenge are able to extract generalizable properties of genes that are useful to accurately reconstruct the spatial arrangement of cells in tissues.

Importance and benefits of dietary sodium restriction in the management of chronic kidney disease patients: experience from a single Chinese center.

AIM: Several studies have suggested that sodium intake may affect blood pressure (BP), proteinuria, and intrarenal transforming growth factor-ß1 (TGF-ß1) production in patients and animal models with chronic kidney disease (CKD). The Chinese population has a high prevalence of CKD and is well known for consuming salty foods. This study will investigate the role of dietary sodium intake on BP control among non-dialysis Chinese CKD patients. METHODS: A cross-sectional study was carried out in a cohort of 176 non-dialysis hypertensive CKD patients to investigate their sodium intake and its effect on BP control by measuring 24-h urine sodium excretion (24-h UNa). A total of 20 patients with immunoglobulin A nephropathy (IgAN) participated in a 7-day sodium restriction study (100 mmol/day). Their changes in BP, proteinuria, and urinary TGF-ß1 excretion were subsequently analyzed. Another 23 IgAN patients without salt restriction were included as controls. RESULTS: The average 24-h UNa of the study cohort was 149.0 ± 66.4 mmol/day. Only 31.8% patients had a 24-h UNa less than 100 mmol/day. The OR for each 17 mmol increment in 24-h UNa (salt 1 g/day) for BP > 130/80 mmHg was 1.26 (95% CI 1.10-1.44, P = 0.001). The sodium restriction group achieved significantly more reduction in SBP (-11.1 mmHg vs. -5.0 mmHg, P = 0.022), DBP (-9.4 mmHg vs. -2.1 mmHg, P = 0.009), and urine protein excretion [-465 (-855 to -340) mg/day vs. -150 (-570 to 40) mg/day, P = 0.024]. A positive correlation was observed between the change of 24-h UNa and the change of SBP (r = 0.450, P = 0.047) in the sodium restriction group. The change of 24-h UNa was also correlated with the 24-h TGF-ß1 excretion (r = 0.558, P = 0.011) in these patients. CONCLUSION: Dietary sodium intake restriction should be monitored and intensified in the treatment of Chinese CKD patients.