Long-term outcome of high-power ablation guided by ablation index in the treatment of atrial fibrillation.

Objective: High-power ablation has been widely used in atrial fibrillation (AF). However, there were many studies observed the outcomes of the short-term follow-up. This study aims to the long-term results of high-power ablation guided by ablation index (AI) in patients with AF. Methods: Analysis of patients with AF, who first received high-power (40-50 W) ablation, to pulmonary vein isolation (PVI) in the Second Hospital of Shanxi Medical University from May 2020 to March 2022. All patients were managed perioperatively according to the routine treatment procedures. High-power ablation was conducted under the guidance of our conventional power AI and baseline data, first-pass PVI rate, ablation time, operative time, and long-term surgical success rate were analyzed. Results: A total of 83 patients with atrial fibrillation were enrolled in the study, with an average age of 61.62 ± 9.04 years, 47 male patients, and 49 paroxysmal atrial fibrillation. All patients achieved PVI, and the rate of first pass was 82%. The ablation time of the left atrial was 28.54 ± 9.11 min. There were no serious complications related to ablation, and only a small amount of pericardial effusion was found in 4 patients. During the follow-up period of 26.36 ± 6.11 months, 8 patients were lost to follow-up and the overall success rate was 84%, including 91% for paroxysmal AF and 71% for persistent AF. Conclusion: High-power ablation long-term results appear a high freedom atrial arrhythmia, but further expanded samples are needed for controlled studies.

Pathogenic role of different phenotypes of immune cells in airway allergic diseases: a study based on Mendelian randomization.

Background: Airway allergic disease (AAD) is a class of autoimmune diseases with predominantly Th2-type inflammation, mainly including allergic rhinitis (AR), allergic asthma (AS), and chronic sinusitis (CRS). There are very complex regulatory mechanisms between immune cells and AAD; however, previous reports found that the functions of the same immune cells in AAD are not identical. Objective: The aim of this study was to explore the causal relationship between different phenotypic immune cells and their association with AAD. Method: Utilizing the publicly available Genome-Wide Association Studies (GWAS) database, this study conducted a bidirectional Mendelian randomization (MR) to assess the causal relationship between immune cells of 731 different immunophenotypes and AAD. The primary assessment methods included inverse variance weighting, weighted median, and MR Egger. Additionally, sensitivity analyses such as MR-PRESSO, leave-one-out, and scatter plots were employed to eliminate the interference of heterogeneity and pleiotropy, ensuring the stability of the causal inference. Result: A total of 38 immune cells with different immunophenotypes were found to be positively and causally associated with AR, of which 26 were protective factors and 12 were risk factors. Positive associations were found between 33 immune cells and AS, of which 14 were protective factors and 19 were risk factors, as well as between 39 immune cells and CRS, of which 22 were protective factors and 17 were risk factors. Finally, the results of all relevant immune cells for the three diseases were taken and intersected, and it was found that CD3 on CD39+-activated Treg (IVWAR = 0.001, IVWCRS = 0.043, IVWAS = 0.027) may be the key immune cell that inhibits the development of AAD (ORAR = 0.940, ORAS = 0.967, ORCRS = 0.976). Conclusion: This study reveals that different immune phenotypes of immune cells are closely related to AAD at the genetic level, which provides a theoretical basis for future clinical studies.

Pauling-Type Adsorption of O2 Induced by Heteroatom Doped ZnIn2 S4 for Boosted Solar-Driven H2 O2 Production.

Breaking the trade-off between activity and selectivity has perennially been a formidable endeavor in the field of hydrogen peroxide (H2 O2 ) photosynthesis, especially the side-on configuration of oxygen (O2 ) on the catalyst surface will cause the cleavage of O-O bonds, which drastically hinders the H2 O2 production performance. Herein, we present an atomically heteroatom P doped ZnIn2 S4 catalyst with tunable oxygen adsorption configuration to accelerate the ORR kinetics essential for solar-driven H2 O2 production. Indeed, the spectroscopy characterizations (such as EXAFS and in situ FTIR) and DFT calculations reveal that heteroatom P doped ZnIn2 S4 at substitutional and interstitial sites, which not only optimizes the coordination environment of Zn active sites, but also facilitates electron transfer to the Zn sites and improves charge density, avoiding the breakage of O-O bonds and reducing the energy barriers to H2 O2 production. As a result, the oxygen adsorption configuration is regulated from side-on (Yeager-type) to end-on (Pauling-type), resulting in the accelerated ORR kinetics from 874.94 to 2107.66 µmol g-1 h-1 . This finding offers a new avenue toward strategic tailoring oxygen adsorption configuration by the rational design of doped photocatalyst.

The neutrophil-to-lymphocyte ratio is a potential biomarker for the occurrence of atrial fibrillation in patients with obstructive sleep apnea: A BIOMARKER OF AF IN OSA PATIENTS.

BACKGROUND: Obstructive sleep apnea (OSA) affects the occurrence of atrial fibrillation (AF) and usually coexists with AF. Chronic inflammation has been identified as an important factor in the development of AF, and the neutrophil-to-lymphocyte ratio (NLR) has been identified as a biomarker that positively correlates with the degree of inflammation. However, little information regarding how NLR correlates with AF in OSA patients. METHODS: Our study enrolled 368 patients with OSA between September 2018 and April 2023. All data were collected after admission. Independently associated factors were assessed by multivariate logistic regression and then constructed a nomogram to predict AF risk. Nomogram's calculation model was evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). The correlation between CHA2DS2-VASc scores and NLR was assessed using Spearman correlation. RESULTS: Multivariate logistic regression showed that high level log-transformed NLR (OR, 1.664; 95% CI, 1.026-2.699; P = 0.039) was independently associated with the presence of AF in patients with OSA. The concordance index (0.817, 95% CI, 0.770-0.864), ROC curve, calibration curve, and DCA of the nomogram indicated this model had well clinical utility. Also, the nomogram's calculation model could identify patients who are at a higher risk of developing AF, and the CHA2DS2-VASc score was positively correlated with NLR in patients with AF (P < 0.05). CONCLUSION: The elevated NLR may serve as a promising biomarker for assessing the risk of AF in individuals with OSA. The nomogram's calculation model may be utilized as a tool to estimate the probability of AF occurrence in OSA patients.

Correlation between the triglyceride-glucose index and the onset of atrial fibrillation in patients with non-alcoholic fatty liver disease.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is associated with atrial fibrillation (AF). Insulin resistance (IR) is the main cause of the high prevalence of AF in NAFLD patients. The triglyceride-glucose index (TyG) is a novel IR-related indicator implicated in the incidence and severity of NAFLD. However, the role of TyG in determining the risk for AF in patients with NAFLD remains unclear. METHODS: A retrospective study was conducted on 912 patients diagnosed with NAFLD via ultrasonography. These patients were divided into two groups: (1) NAFLD+ AF and (2) NAFLD+ non-AF. Least Absolute Shrinkage and Selection Operator (LASSO) regression was used to assess the correlation between the TyG index and the high risk for AF. A receiver operating characteristic (ROC) curve was constructed to evaluate the predictive value for the TyG index for AF. Restricted cubic splines (RCS) were used to test the linear correlation between TyG and the risk for AF. RESULTS: A total of 204 patients with AF and 708 patients without AF were included in this study. The LASSO logistic regression analysis showed that TyG was an independent risk factor for AF (odds ratio [OR] = 4.84, 95% confidence interval [CI] 2.98-7.88, P < 0.001). The RCS showed that the risk for AF increased linearly with TyG over the entire TyG range; this risk was also evident when the patients were analyzed based on sex (P for nonlinear > 0.05). In addition, the correlation between TyG and AF was a consistent finding in subgroup analysis. Furthermore, ROC curve analysis showed that TyG levels combined with traditional risk factors improved the predictive value for atrial fibrillation. CONCLUSION: The TyG index is useful in assessing the risk for atrial fibrillation in patients with NAFLD. Patients with NAFLD and increased TyG indices have higher risks for atrial fibrillation. Therefore, TyG indices should be assessed when managing patients with NAFLD.

The monocyte-to-high-density lipoprotein ratio is associated with the occurrence of atrial fibrillation among NAFLD patients: A propensity-matched analysis.

Background: Accumulating evidence suggests that patients with nonalcoholic fatty liver disease (NAFLD) have a significantly high risk of incident atrial fibrillation (AF). Systemic inflammation, metabolic disorders and oxidative stress could be the potential mechanisms by which NAFLD drives AF. Monocyte-to- high-density lipoprotein ratio (MHR) has emerged as a novel biomarker of inflammation and oxidative stress that has not been studied in AF with NAFLD patients. We aimed to investigate the relationship between MHR and the risk of AF among NAFLD patients. Methods: A retrospective analysis was performed for the clinical data of the patients with NAFLD in the Second Hospital of Shanxi Medical University from January 2019 to October 2022, among whom 204 patients with AF were enrolled as NAFLD+AF group and 613 patients without AF were enrolled as NAFLD control, and 152 patients were selected from each group based on propensity score matching (PSM) at a ratio of 1:1 to balance the covariates between groups. The t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. Logistic regression analysis was performed to identify the independent predictor for occurrence of AF among NAFLD patients. Trend chi-square test to analyze the prevalence of AF among MHR tertiles, and then the correlation between MHR and the risk of AF confirmed by restricted cubic splines (RCS). The receiver operating characteristic (ROC) curve analysis was used to determine the optimum MHR cutoff value to predict AF. Results: Univariate analysis showed that AF patients had higher MHR than non-AF patients (P < 0.001). Meanwhile, compared with pure NAFLD patients, multivariate logistic regression analysis showed that MHR remained to be an independent risk factor for AF after adjusting for confounding risk factors (OR = 10.67, 95% CI 2.17-52.37, P = 0.004). TC、HDL-C were also independent risk factors for AF. Among them, TC and HDL-C are protective factors for AF. The trend chi-square test showed that the risk of AF increased with an increase in MHR (P < 0.05). However, the RCS showed a nonlinear and J-shaped relationship between MHR and the risk of AF (P for non-linearity = 0.023). The occurrence of AF increased with increasing MHR only when MHR > 0.44. The ROC curve showed that MHR combined with traditional risk factors can improve the ability to predict AF. Conclusion: MHR is an independently associated with incident AF in patients with NAFLD and show a certain predictive value.

Total Bilirubin Level is Associated with the Risk of Left Atrial Appendage Thrombosis in Patients with Non-Valvular Atrial Fibrillation.

Objectives: There are some evidence suggesting that total bilirubin (TBIL) appears to be associated with stroke in patients with nonvalvular atrial fibrillation (NVAF). The left atrial appendage (LAA) is the most common orgin of thrombus in patients with NVAF. The purpose of this study was to assess a possible relationship between plasma TBIL levels and LAA thrombus in NVAF patients. Methods: We retrospectively screened 459 consecutive hospitalized patients with NVAF at three AF centers, who underwent transesophageal echocardiography or cardiac CT. According to the examination results, the patients were divided into either the LAA thrombosis group (41 cases) or the no LAA thrombosis group (418 cases). Independent sample t test, Mann-Whitney U-test and chi-square test were used to compare and analyze the general clinical data of the two groups. Multivariate Logistic regression was used to analyze whether TBIL was a risk factor for LAA thrombosis in patients with NVAF. Pearson correlation analysis was used to explore the correlation between TBIL and other influencing factors. The predictive value of TBIL for LAA thrombosis in patients with NVAF was evaluated by ROC curve. Results: A total of 459 patients were enrolled in this study. Compared with the group without LAA thrombosis, the level of TBIL in LAA thrombosis group was significantly increased (21.34 ± 9.34 umol/L vs. 13.98 ± 4.25 umol/L, P < 0.001). Multivariate logistic regression showed that TBIL level was a risk factor for LAA thrombosis (OR, 1.229; 95% CI, 1.122~1.345; P < 0.001). The AUC of the ROC curve is 0.801 (95% CI, 0.725~0.877; P < 0.001). At 17.4 umol/L of TBIL, the patient may have LAA thrombosis (sensitivity 73.2%; specificity 82.1%). Conclusions: In patients with NVAF, TBIL level is positively associated with LAA thrombosis, and TBIL level may be an index reflecting LAA thrombosis.

A systematic review and meta-analysis of the safety and efficacy of left atrial substrate modification in atrial fibrillation patients with low voltage areas.

Background: The left atrial low-voltage areas (LVAs) are associated with atrial fibrosis; however, it is not clear how the left atrial LVAs affect the recurrence of arrhythmias after catheter ablation, and the efficacy and safety of the left atrial substrate modification based on LVAs as a strategy for catheter ablation of atrial fibrillation (AF) are not evident for AF patients with LVAs. Methods: We performed a systematic search to compare the arrhythmia recurrence in AF patients with and without LVAs after conventional ablation and arrhythmia recurrence in LVAs patients after conventional ablation with and without substrate modification based on LVAs. Result: A total of 6 studies were included, involving 1,175 patients. The arrhythmia recurrence was higher in LVA patients after conventional ablation (OR: 5.14, 95% CI: [3.11, 8.49]; P < 0.00001). Additional LVAs substrate modification could improve the freedom of arrhythmia in LVAs patients after the first procedure (OR: 0.30, 95% CI: [0.15, 0.62]; P = 0.0009). However, there was no significant difference after multiple procedures (P = 0.19). The procedure time (MD: 26.61, 95% CI [15.79, 37.42]; P < 0.00001) and fluoroscopy time (MD: 6.90, 95% CI [4.34, 9.47]; P < 0.00001) in LVAs patients with additional LVAs substrate modification were significantly increased compared to LVAs patients' without substrate modification. Nevertheless, there were no higher LVAs substrate modification-related complications (P = 0.93) between LVAs patients with and without additional LVAs substrate modification. In the subgroup analysis, the additional LVAs substrate modification reduced the risk of arrhythmia recurrence in LVAs patients during the follow-up time, which was 12 months (OR: 0.32, 95% CI (0.17, 0.58); P = 0.002), and box isolation (OR: 0.37, 95% CI (0.20, 0.69); P = 0.002) subgroups, but the type of AF, follow up >12 months and homogenization subgroups were not statistically significant. Trial sequential analysis shows conclusive evidence for the LVAs ablation. Conclusion: This study has shown that LVAs could improve the risk of arrhythmia recurrence in AF patients after conventional ablation. And additional LVAs substrate modification after conventional ablation could increase the freedom of arrhythmia recurrence in LVAs patients. Interestingly, the box isolation approach appeared more promising. Systematic review registration: [http://www.crd.york.ac.uk/prospero], identifier [CRD42021239277].

TyG index is positively associated with risk of CHD and coronary atherosclerosis severity among NAFLD patients.

BACKGROUND: Insulin resistance (IR), endothelial dysfunction, inflammation, glucose and lipid metabolism disorders, and thrombosis are believed involved in coronary heart disease (CHD) and non-alcoholic fatty liver disease (NAFLD). Triglyceride-glucose (TyG) index, a new IR indicator, is correlated with NAFLD occurrence and severity, but its relationship with CHD risk remains unclear. This study investigated the correlation between TyG index and CHD risk among NAFLD patients. METHODS: This cross-sectional study included 424 patients with NAFLD and chest pain in the Department of Cardiology, The Second Hospital of Shanxi Medical University, from January 2021 to December 2021. The TyG index was calculated and coronary angiography performed. All individuals were divided into NAFLD + CHD and NAFLD groups and then by TyG index level. The t-test, Mann-Whitney U-test, or one-way analysis of variance compared differences in continuous variables, while the chi-square test or Fisher's exact test compared differences in categorical variables. Logistic regression analysis determined the independent protective or hazardous factors of NAFLD with CHD. The receiver operating characteristic curve evaluated the ability of different TyG index rule-in thresholds to predict CHD. The relationship between Gensini score and TyG index was evaluated using linear correlation and multiple linear regression. RESULTS: CHD was detected in 255 of 424 patients. Compared to NAFLD group, multivariate logistic regression showed that TyG index was a risk factor for CHD among NAFLD patients after adjustment for age, sex, hypertension, and diabetes mellitus with the highest odds ratio (OR, 2.519; 95% CI, 1.559-4.069; P < 0.001). TG, low-density lipoprotein cholesterol, FBG and TYG-body mass index were also risk factors for CHD among NAFLD patients. High-density lipoprotein cholesterol level was a protective factor for CHD events in patients with NAFLD. In an in-depth analysis, multivariate logistic regression analysis showed that each 1-unit increase in TyG index was associated with a 2.06-fold increased risk of CHD (OR, 2.06; 95% CI, 1.16-3.65; P = 0.013). The multifactor linear regression analysis showed each 0.1-unit increase in TyG in the NAFLD-CHD group was associated with a 2.44 increase in Gensini score (ß = 2.44; 95% CI, 0.97-3.91; P = 0.002). CONCLUSIONS: The TyG index was positively correlated with CHD risk in NAFLD patients and reflected coronary atherosclerosis severity.

Adsorption desulfurization performance of PdO/SiO2@graphene oxide hybrid aerogel: Influence of graphene oxide.

Preparation of PdO/SiO2@graphene oxide (GO) hybrid aerogels were carried out sol-gel method combined with atmospheric drying technology to study their adsorption performance for thiophenics and compared with PdO/SiO2. Scanning electron microscope (SEM), N2 adsorption-desorption isotherms, X-ray diffraction (XRD) analysis, X-ray photoelectron spectroscopy (XPS), and fourier transformation infrared spectroscopy (FT-IR) for samples were performed. The adsorption performance of PdO/SiO2@GO for thiophene were better than that of PdO/SiO2, attributed to that incorporation of GO increased the specific surface area and the Pd incorporation rate, where Pd2+ ions acted as the π-complexation and sulfur-metal (SM) bond adsorption active centers, as well as GO adsorbed thiophene by the π-π stacking effect. The adsorption capacities of PdO/SiO2@GO-1.0 for thiophene (TH), benzothiophene (BT) and dibenzothiophene (DBT) were 8.89, 9.3 and 12.6 mg-S/gads, respectively. The addition of GO in aerogels could improve the inhibition effect of toluene, cyclohexene and pyridine while decreased the inhibition effect of MTBE and H2O for the adsorption of thiophene, due to the π-π stacking effect and the hydrophobicity of GO, respectively. The adsorption process was spontaneous and exothermic, be well fitted by the apparent second-order kinetic model and dominated by chemical interaction. Pd/SiO2@GO-1.0 had a good solvent elution regeneration performance.

Genome-Wide Analysis of the Biosynthesis and Deactivation of Gibberellin-Dioxygenases Gene Family in Camellia sinensis (L.) O. Kuntze.

Gibberellins (GAs), a class of diterpenoid phytohormones, play a key role in regulating diverse processes throughout the life cycle of plants. Bioactive GA levels are rapidly regulated by Gibberellin-dioxygenases (GAox), which are involved in the biosynthesis and deactivation of gibberellin. In this manuscript, a comprehensive genome-wide analysis was carried out to find all GAox in Camellia sinensis. For the first time in a tea plant, 14 CsGAox genes, containing two domains, DIOX_N (PF14226) and 2OG-FeII_Oxy, were identified (PF03171). These genes all belong to 2-oxoglutarate-dependent dioxygenases (2-ODD), including four CsGA20ox (EC: 1.14.11.12), three CsGA3ox (EC: 1.14.11.15), and seven CsGA2ox (EC: 1.14.11.13). According to the phylogenetic classification as in Arabidopsis, the CsGAox genes spanned five subgroups. Each CsGAox shows tissue-specific expression patterns, although these vary greatly. Some candidate genes, which may play an important role in response to external abiotic stresses, have been identified with regards to patterns, such as CsGA20ox2, CsGA3ox2, CsGA3ox3, CsGA2ox1, CsGA2ox2, and CsGA2ox4. The bioactive GA levels may be closely related to the GA20ox, GA3ox and GA2ox genes. In addition, the candidate genes could be used as marker genes for abiotic stress resistance breeding in tea plants.

α-Fe2O3 cubes with high visible-light-activated photoelectrochemical activity towards glucose: hydrothermal synthesis assisted by a hydrophobic ionic liquid.

A liquid/liquid interfacial reaction system was designed to fabricate α-Fe2O3 cubes. The reaction system uses a hydrophobic ionic liquid containing iron ions ([(C8H17)2(CH3)2N]FeCl4) for manufacturing α-Fe2O3 cubes by a novel and environmentally friendly hydrothermal method under low-temperature conditions (140 °C). The iron-containing ionic liquid is hydrophobic and can form a liquid/liquid interface with water, which is vital for fabrication of the α-Fe2O3 cubes. Nanomaterials synthesized from hydrophobic iron-containing ionic liquids show good crystallinity, well-developed morphology, and uniform size. The effect of different ionic liquids on the morphology of α-Fe2 O3 was investigated in detail. [(C8H17)2(CH3)2N]FeCl4 is assumed to perform the triple role of forming a liquid/liquid interface with water and acting as reactant and template at the same time. The effect of the reaction temperature on the formation of the α-Fe2O3 cubes was also studied. Temperatures lower or higher than 140 °C are not conducive to formation of the α-Fe2O3 cubes. Their photoelectrochemical properties were tested by means of the transient photocurrent response of electrodes modified with as-prepared α-Fe2O3 cubes. The photocurrent response of an α-Fe2O3 cubes/indium tin oxide electrode is high and stable, and it shows great promise as a photoelectrochemical glucose sensor with high sensitivity and fast response, which are beneficial to practical applications of nanosensors.

AgX/graphite-like C(3)N(4) (X = Br, I) hybrid materials for photoelectrochemical determination of copper(II) ion.

A novel photoelectrochemical strategy has been designed for the detection of Cu(2+) with AgX/g-C3N4 (X = Br, I) hybrid materials. The present study can serve as a foundation for the application of AgX/g-C3N4 hybrid materials in photoelectron-chemical ion sensing. It can be successfully applied to the detection of copper in human hair samples.

Ionic liquid assisted synthesis and photocatalytic properties of α-Fe2O3 hollow microspheres.

α-Fe2O3 hollow microspheres have been successfully prepared in the presence of metal ion-containing reactable ionic liquid 1-octyl-3-methylimidazolium tetrachlorideferrate(III) ([Omim]FeCl4) under the solvothermal condition. The as-prepared samples were characterized by X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), transmission electron microscopy (TEM), energy-dispersive X-ray spectroscopy (EDS), FT-IR spectrum, and diffuse reflectance spectroscopy (DRS). The effect of concentration of ionic liquids on the morphology of α-Fe2O3 had been investigated in detail. It was found that [Omim]FeCl4 acted not only as Fe source but also as solvent and template for the fabrication of α-Fe2O3 hollow microspheres. In addition, the electrochemical and photocatalytic properties of α-Fe2O3 were investigated. The α-Fe2O3 hollow microspheres exhibited high conductivity, high photocurrent, and high photocatalytic activity. The designed hollow microsphere showed potential applications in photocatalysis.