Puerarin inhibits macrophage M1 polarization by combining STAT1 to reduce myocardial damage in EAM model mice.

Myocarditis is an inflammatory lesion of the myocardium that is caused by a variety of factors. At present, treatment of symptoms remains the main clinical intervention, but it cannot reduce the myocarditis damage caused by inflammation. M1 macrophages are thought to contribute significantly to the occurrence and development of inflammation by secreting a large number of proinflammatory factors. Puerarin is an isoflavone derivative isolated from pueraria that can be used as a dietary supplement and exerts wide range of anti-inflammatory and antioxidant effects. However, the mechanism underlying its anti-inflammatory effects needs to be further studied. The objective of this study was to investigate whether puerarin inhibited M1 polarization by affecting the JAK-STAT signaling pathway in a mouse model of autoimmune myocarditis, thus inhibiting the occurrence of inflammation in experimental autoimmune myocarditis (EAM) model mice. The results showed that EAM model mice treated with puerarin showed milder clinical symptoms and inflammatory infiltration than EAM model mice. Puerarin suppressed the in vivo and in vitro JAK1/2-STAT1 signal transduction in macrophages, thus inhibiting M1 polarization, reducing the secretion of proinflammatory factors, and ultimately decreasing IFN-γ and TNF-α levels in vivo, which led to myocardial apoptosis. Thus, puerarin could alleviate myocardial damage caused by inflammation. The conclusion of this study was that puerarin reduced myocardial damage in EAM model mice by regulating the polarization of macrophages toward M1, and this inhibitory effect may be achieved by inhibiting JAK1/2-STAT1 signaling.

Procedural efficiency is enhanced combining the pentaspline pulsed field ablation catheter with three-dimensional electroanatomical mapping system for pulmonary vein isolation.

BACKGROUND: Pulsed field ablation (PFA) offers a safe, non-thermal alternative for pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF). Currently, the pentaspline PFA-system relies heavily on fluoroscopy for catheter manipulation, which poses challenges due to the complexity of left atrium anatomy. Incorporating three-dimensional electroanatomical mapping (3D-EAM) could improve procedural efficiency reducing dependency on fluoroscopy guidance. This study aims to evaluate the effects of integration of 3D-EAM with PFA during PVI. METHODS: Between September 2022 and December 2023, we retrospectively enrolled 248 patients with paroxysmal or persistent AF undergoing PVI at our center using the pentaspline PFA catheter. The control group (n = 104) received conventional PFA with fluoroscopic guidance alone, while the intervention group (n = 144) underwent PVI with PFA with 3D-EAM integration. Primary outcomes were procedural time, fluoroscopy time (FT), and dose area product (DAP). Secondary endpoints included acute procedural success and incidence of periprocedural complications. RESULTS: In the 3D-EAM-PFA group, procedural time was 63.3 ± 14.3 min, compared to 65.6 ± 14.9 min in the control group (p = 0.22). The 3D-EAM group experienced significantly reduced FT (9.7 ± 4.4 min vs. 16.7 ± 5.2 min) and DAP (119.2 ± 121.7 cGycm2 vs. 338.7 ± 229.9 cGycm2) compared to the control group, respectively (p < 0.001). Acute procedural success was achieved in all cases. No major complications were observed in either group. CONCLUSION: Integration of 3D-EAM with the pentaspline PFA catheter for PVI in AF treatment offers a promising approach, with significantly reduced fluoroscopy exposure without compromising procedural time and efficacy.

Baicalein alleviates cardiomyocyte death in EAM mice by inhibiting the JAK-STAT1/4 signalling pathway.

BACKGROUND: The experimental autoimmune myocarditis (EAM) model is valuable for investigating myocarditis pathogenesis. M1-type macrophages and CD4+T cells exert key pathogenic effects on EAM initiation and progression. Baicalein (5,6,7-trihydroxyflavone, C15H10O5, BAI), which is derived from the Scutellaria baicalensis root, is a primary bioactive compound with potent anti-inflammatory and antioxidant properties. BAI exerts good therapeutic effects against various autoimmune diseases; however, its effect in EAM has not been thoroughly researched. PURPOSE: This study aimed to explore the possible inhibitory effect of BAI on M1 macrophage polarisation and CD4+T cell differentiation into Th1 cells via modulation of the JAK-STAT1/4 signalling pathway, which reduces the secretion of pro-inflammatory factors, namely, TNF-α and IFN-γ, and consequently inhibits TNF-α- and IFN-γ-triggered apoptosis in cardiomyocytes of the EAM model mice. STUDY DESIGN AND METHODS: Flow cytometry, immunofluorescence, real-time quantitative polymerase chain reaction (q-PCR), and western blotting were performed to determine whether BAI alleviated M1/Th1-secreted TNF-α- and IFN-γ-induced myocyte death in the EAM model mice through the inhibition of the JAK-STAT1/4 signalling pathway. RESULTS: These results indicate that BAI intervention in mice resulted in mild inflammatory infiltrates. BAI inhibited JAK-STAT1 signalling in macrophages both in vivo and in vitro, which attenuated macrophage polarisation to the M1 type and reduced TNF-α secretion. Additionally, BAI significantly inhibited the differentiation of CD4+T cells to Th1 cells and IFN-γ secretion both in vivo and in vitro by modulating the JAK-STAT1/4 signalling pathway. This ultimately led to decreased TNF-α and IFN-γ levels in cardiac tissues and reduced myocardial cell apoptosis. CONCLUSION: This study demonstrates that BAI alleviates M1/Th1-secreted TNF-α- and IFN-γ-induced cardiomyocyte death in EAM mice by inhibiting the JAK-STAT1/4 signalling pathway.

Modelling decision-making biases.

Biases are a fundamental aspect of everyday life decision-making. A variety of modelling approaches have been suggested to capture decision-making biases. Statistical models are a means to describe the data, but the results are usually interpreted according to a verbal theory. This can lead to an ambiguous interpretation of the data. Mathematical cognitive models of decision-making outline the structure of the decision process with formal assumptions, providing advantages in terms of prediction, simulation, and interpretability compared to statistical models. We compare studies that used both signal detection theory and evidence accumulation models as models of decision-making biases, concluding that the latter provides a more comprehensive account of the decision-making phenomena by including response time behavior. We conclude by reviewing recent studies investigating attention and expectation biases with evidence accumulation models. Previous findings, reporting an exclusive influence of attention on the speed of evidence accumulation and prior probability on starting point, are challenged by novel results suggesting an additional effect of attention on non-decision time and prior probability on drift rate.

Effects of Friction Stir Welding on the Mechanical Behaviors of Extrusion-Based Additive Manufactured Polymer Parts.

The friction stir welding (FSW) of thermoplastic polymers is gradually receiving attention because of its advantages including high efficiency and pollution-free manufacturing. The extrusion-based additive manufacturing (EAM) of polymers has also become one of the main processing methods for thermoplastic parts. In this paper, a hybrid manufacturing method for the FSW process and EAM technology is proposed and explored. The effects of the FSW process using two different welding tools on the mechanical behaviors of 3D printing polymer parts were compared and investigated and the corresponding mechanism was analyzed. The results show that the appropriate welding tool is beneficial for eliminating the anisotropy and decreasing the porosity of 3D-printed parts. Therefore, the improving effects of the FSW process on the mechanical behaviors of the EAM parts are verified. The mechanism was attributed to the high-speed rotation of the welding tool with the appropriate shape, which can promote the flow of polymer melt in the welding region, leading to the formation of dense structures caused by the entanglement of the molecular chains. This study may provide some assistance in modern industrial manufacturing for the processing of large custom components.

Minimal Fluoroscopic Catheter Ablation for Adult Patients with Paroxysmal Supraventricular Tachycardia without the Assistance of Intracardiac Echocardiography.

Background: Radiation exposure during fluoroscopic procedures increases the risk of cancer for both patients and operators. Objectives: The aim of this study was to investigate the safety and efficacy of adopting a three-dimensional electroanatomical mapping (3D EAM) system during ablation for paroxysmal supraventricular tachycardia (PSVT), without the assistance of intracardiac echocardiography (ICE), for both right- and left-chamber cardiac procedures. Methods: We retrospectively enrolled all patients with PSVT from September 2018 to December 2020. The patients were grouped according to the use of the 3D EAM system (3D-guided group, n = 102 vs. conventional group, n = 226). Results: The acute success rates were high in both groups (100% vs. 99.1%). The fluoroscopy time was significantly lower in the 3D-guided group than in the conventional group (2.4 ± 4.4 vs. 19.0 ± 10.8 min); the procedure time was significantly increased in the 3D-guided group (104.5 ± 29.9 vs. 94.0 ± 31.9 min), and this was associated with the post-electrophysiology test diagnosis after adjustment for multiple variables [standardized B coefficient (ß) 0.188]. There was no learning curve for each electrophysiologist in terms of fluoroscopy and procedure times. Conclusions: The 3D EAM system, without the assistance of ICE, was safe and effective in guiding PSVT ablation in both left- and right-chamber ablation.

Toxicity of Synthetic Cannabinoids in K2/Spice: A Systematic Review.

(1) Background: Synthetic cannabinoids (SCs) are emerging drugs of abuse sold as 'K2', 'K9' or 'Spice'. Evidence shows that using SCs products leads to greater health risks than cannabis. They have been associated with greater toxicity and higher addiction potential unrelated to the primary psychoactive component of marijuana, Δ9-tetrahydrocannabinol (Δ9-THC). Moreover, early cases of intoxication and death related to SCs highlight the inherent danger that may accompany the use of these substances. However, there is limited knowledge of the toxicology of Spice ingredients. This systematic review intends to analyze the toxicity of SCs compounds in Spice/K2 drugs. (2) Methods: Studies analyzing synthetic cannabinoid toxicity and dependence were included in the present review. We searched the PubMed database of the US National Library of Medicine, Google Scholar, CompTox Chemicals, and Web of Science up to May 2022. (3) Results: Sixty-four articles reporting the effects of synthetic cannabinoids in humans were included in our review. Ten original papers and fifty-four case studies were also included. Fourteen studies reported death associated with synthetic cannabinoid use, with AB-CHMINACA and MDMB-CHMICA being the main reported SCs. Tachycardia and seizures were the most common toxicity symptoms. The prevalence of neuropsychiatric symptoms was higher in third-generation SCs. (4) Conclusion: SCs may exhibit higher toxicity than THC and longer-lasting effects. Their use may be harmful, especially in people with epilepsy and schizophrenia, because of the increased risk of the precipitation of psychiatric and neurologic disorders. Compared to other drugs, SCs have a higher potential to trigger a convulsive crisis, a decline in consciousness, and hemodynamic changes. Therefore, it is crucial to clarify their potential harms and increase the availability of toxicology data in both clinical and research settings.

A importância de uma equipa comunitária de suporte em cuidados paliativos num hospital privado / The importance of a community palliative care support team in a private hospital

A vivência de uma doença grave em estado avançado e sem perspetiva de cura, repercute-se efetivamente, na pessoa em toda a sua integridade, enquanto ser único e irrepetível, com uma história de vida, também ela, ímpar. Contudo, a medicina assumiu o compromisso de lutar contra a morte e procura formas de a combater, o que gera ao profissional de saúde um sentimento de derrota quando enfrenta o fim de vida do doente, em que a morte é a maior certeza. Surgem assim, os cuidados paliativos como uma prioridade da política de saúde, cuidados ativos, rigorosos, que combinam princípios científicos e humanos, que investem na vida. Mas, que precisam de profissionais de saúde com competências específicas nesta área. Partindo destes pressupostos, optamos por realizar em Estágio de Natureza Profissional numa unidade de cuidados paliativos de um hospital privado, de forma a desenvolver competências especializadas e promover as necessárias sinergias interinstitucionais, com consequentes ganhos em saúde. No decurso do estágio de natureza profissional, desenvolvemos competências especializadas no âmbito da prestação de cuidados, como: gestão de sintomas, apoio e acompanhamento familiar; apoio no processo de luto, comunicação e trabalho em equipa e, competências gerais, como: intervenção na formação, gestão de cuidados e investigação no contexto da prática clínica, de forma a contribuir para a humanização do fim de vida e educar os outros para a construção de um fim de vida condigno. No domínio da prestação de cuidados delineamos intervenções com base nas necessidades presentes do doente e família, com os seus próprios valores e prioridades. Gerimos os sintomas presentes, assumindo-se a comunicação como uma estratégia terapêutica de intervenção na minimização do sofrimento, favorecemos o suporte emocional da família, baseamo-nos no trabalho em equipa, avaliamos resultados, a eficácia, a eficiência e a satisfação das intervenções implementadas. Através do diagnóstico de situação, emerge a necessidade de investigar sobre a importância da existência de uma equipa comunitária de suporte em cuidados paliativos num hospital privado, com o objetivo de conhecer as vantagens da integração de uma equipa comunitária de suporte em cuidados paliativos num hospital privado, de forma a contribuir para a continuidade de cuidados e para a acessibilidade das pessoas a cuidados ativos, rigorosos, cientificamente competentes e humanos. Estudo de natureza qualitativo, com recurso à entrevista semiestruturada dirigida a profissionais de saúde de um hospital privado. Os achados foram submetidos à análise de conteúdo segundo Bardin (2015). Respeitados os princípios éticos e legais. Verificamos que prestar cuidados de alta qualidade com base nas necessidades dos doentes e familiares, é indispensável uma colaboração multiprofissional baseada numa visão partilhada da essência dos CP. Foram identificadas vantagens ao nível da existência de uma Equipa Comunitária de Suporte em CP, nomeadamente para o desenvolvimento de habilidades nos familiares, assegurando a continuidade de cuidados no domicílio, bem como a promoção de uma maior confiança entre quem cuida e é cuidado. Contudo, consideram alguns aspetos dificultadores como os custos que acarretam e a falta de recursos com formação em cuidados paliativos. Como aspetos facilitadores dão ênfase à integração do doente no seu meio familiar. Sugerem uma aposta no marketing dos cuidados paliativos. No domínio da formação desenvolvemos um Guia de Cuidados Após Alta Hospitalar para o Doente e sua Família e no domínio da gestão tivemos como foco o desenvolvimento de um Projecto para a criação de Uma Equipa Comunitária de Suporte em Cuidados Paliativos. Considera-se ter desenvolvido competências especializada em cuidados paliativos.

The experience of a severe disease at an advanced stage and with no prospect of cure effectively affects the person in all his/her integrality, as a unique and unrepeatable being, with a unique life history. However, medicine has assumed the commitment to fight against death and seeks ways to combat it, which generates a feeling of defeat for the health professional when facing the end of life of the patient, in which death is the greatest certainty. Thus, palliative care emerges as a priority in health policy, active, rigorous care that combines scientific and human principles, that invests in life. But it needs health professionals with specific skills in this area. Based on these assumptions, we chose to carry out an Internship of Professional Nature in a palliative care unit of a private hospital, in order to develop specialized skills and promote the necessary inter-institutional synergies, with consequent gains in health. During the professional internship, we developed specialized skills in care provision, such as: symptom management, family support and follow-up, support in the bereavement process, communication and teamwork, and general skills, such as: intervention in training, care management and research in the context of clinical practice, in order to contribute to the humanization of the end of life and educate others for the construction of a dignified end of life. In the field of care delivery, we design interventions based on the present needs of the patient and family, with their own values and priorities. We manage the present symptoms, assuming communication as a therapeutic strategy of intervention to minimize suffering, we favor the emotional support of the family, we are based on teamwork, we evaluate results, the effectiveness, efficiency and satisfaction of the interventions implemented. Through the diagnosis of the situation, the need emerges to investigate the importance of the existence of a community palliative care support team in a private hospital, with the purpose of knowing the advantages of integrating a community palliative care support team in a private hospital, so as to contribute to the continuity of care and the accessibility of people to active, rigorous, scientifically competent and humane care. This is a qualitative study, using semi-structured interviews with health professionals from a private hospital. The findings were submitted to content analysis according to Bardin (2015). The ethical and legal principles were respected. We found that providing high quality care based on the needs of patients and families requires a multidisciplinary collaboration based on a shared vision of the essence of PC. The advantages of the existence of a Community PC Support Team were identified, namely for the development of skills in family members, ensuring continuity of care at home, as well as promoting greater trust between those who care and those who are cared for. However, they consider some of the complicating aspects to be the costs involved and the lack of resources with training in palliative care. As facilitating aspects, they emphasize the integration of the patient in his or her family environment. They suggest a focus on the marketing of palliative care. In terms of training, we developed a Post-Discharge Care Guide for the Patient and his Family and in terms of management, we focused on the development of a Project for the creation of a Community Support Team in Palliative Care. It is considered to have developed specialized skills in palliative care

[Recent advances in the development and application of effervescence-assisted microextraction techniques].

Effervescence-assisted microextraction (EAM) is a novel sample pretreatment method based on the reaction of CO2 and H+ donors to generate CO2 bubbles and promote rapid dispersion of the extractant. During this process, the unique dispersion method increases the contact area between the target molecule and the extraction solvent, and the adsorption/extraction efficiency of the adsorbent/extractant toward the target molecule is also enhanced. The EAM technique is of particular interest due its convenient application, low running costs, reduced solvent consumption, high extraction efficiency, and environmental friendliness. Benefiting from the rapid development of extractants, the evolution and application of the EAM technology is becoming more tuned and diversified. Indeed, the synthesis of new extractants, such as nanomaterials with multi-pore structures, large specific surface areas, and rich active sites, has attracted extensive attention, as has the development of ionic liquids with strong extraction abilities and high selectivities. As a result, the EAM technology has been widely applied to the pretreatment of target compounds in various samples, such as food, plant, biological, and environmental samples. However, since these samples often contain polysaccharides, peptides, proteins, inorganic salts, and other interfering substrates, it is necessary to remove some of these substances prior to extraction by EAM. This is commonly achieved using methods such as vortexing, centrifugation, and dilution, among others. The treated samples can then be extracted using the EAM method prior to detection using high performance liquid chromatography (HPLC), gas chromatography (GC), and atomic absorption spectroscopy (AAS) to detect substances such as heavy metal ions, pesticide residues, endocrine-disrupting compounds (EDCs), and antibiotics. Using effervescence as a novel assisted method for the dispersion of solvents or adsorbents, the concentrations of Pb2+, Cd2+, Ni2+, Cu2+, bisphenol, estrogen, and the pyrethyl pesticides have previously been successfully determined. Moreover, many influencing factors have been evaluated during method development, including the composition of the effervescent tablet, the solution pH, the extraction temperature, the type and mass/volume of extractant, the type of eluent, the eluent concentration, the elution time, and the regeneration performance. Generally, the cumbersome single factor optimization and multi-factor optimization methods are also required to determine the optimal experimental conditions. Following determination of the optimal experimental conditions, the EAM method was validated by a series of experimental parameters including the linear range, the correlation coefficient (R2), the enrichment factor (EF), the limit of detection (LOD), and the limit of quantification (LOQ). In addition, the use of this method has been demonstrated in actual sample testing, and the obtained results have compared with those achieved using similar detection systems and methods to ultimately determine the accuracy, feasibility, and superiority of the developed method. In this paper, the construction of an EAM method based on nanomaterials, ionic liquids, and other emerging extractants is reviewed, wherein the preparation method, application range, and comparison of similar extractants were evaluated for the same extraction system. In addition, the current state-of-the-art in relation to EAM research and application when combined with HPLC, cold flame AAS, and other analytical techniques is summarized in terms of the detection of harmful substances in complex matrices. More specifically, the samples evaluated herein include dairy products, honey, beverages, surface water, vegetables, blood, urine, liver, and complex botanicals. Furthermore, issues related to the application of this technology are analyzed, and its future development trend in the field of microextraction is forecasted. Finally, the application prospects of EAM in the analysis of various pollutants and components are proposed to provide reference for monitoring pollutants in food, environmental, and biological samples.

Development of a remote-control system for catheterization capable of high-speed force feedback.

PURPOSE: There is a growing interest in minimally invasive surgery as interventional radiology (IVR), which decreases the burden on a patient. However, occupational exposure is a problem because the treatment is performed using X-ray fluoroscopic images. This problem can be solved by the development of a teleoperation system, but rapid force presentation is important to perform safe surgery. The purpose of this study is to develop a new teleoperation system that can be controlled at a high speed and can provide feedback force sensation within 20 ms delay. METHODS: A master-slave-type remote-control system for catheterization was developed. A compact and high-speed force feedback system is realized using a novel electro-attractive material (EAM) device by which the resistance force is generated by the magnitude of the voltage applied. The linear and rotational movement of master is transferred to the slave device by UDP communication with the LAN cable, and the same movement is performed by two motors. The collision force of catheter or guidewire, detected by the sensor inside the slave device, is also transmitted to the master device. Two voltage-based methods for EAM: the ON/OFF and linear control methods, were implemented. RESULTS: After the collision force is detected by the slave sensor, the voltage is applied to the EAM in the master device for an average of 10.33 ms and 15.64 ms by the ON/OFF and linear control methods, respectively. These delays are less than required 20 ms. The movement of the master was stopped by the resistance force of EAM, and that of the slave was also stopped accordingly. CONCLUSION: A master-slave-type remote-control system for catheterization that is capable of high-speed force feedback was developed. With a low delay, the developed system achieved the requirements of 20 ms that was aimed for this study. Therefore, this system may facilitate the realization of IVR surgery that is safe for both doctors and patients.

Combining 3-Dimensional Electroanatomic Mapping and Cardiac Magnetic Resonance: A New Tool for Arrhythmogenic Cardiomyopathy.

We present the case of a 17-year-old asymptomatic boy with a diagnosis of arrhythmogenic cardiomyopathy. Merging of cardiac magnetic resonance imaging and three-dimensional electroanatomic mapping provided striking visualization of the association between structural and electrical alterations and guided the decision to implant an implantable cardioverter defibrillator. (Level of Difficulty: Intermediate.).

The role of non-coding RNAs in myocarditis: a narrative review.

Background and Objective: Myocarditis is a heterogeneous disease that can lead to acute heart failure, dilated cardiomyopathy (DCM), and sudden death. However, the knowledge of the precise molecular mechanisms of myocarditis is fairly limited. In recent years, non-coding RNAs (ncRNAs) have been demonstrated to be involved in many physiological and pathological processes in myocarditis and to have the potential to be used as novel diagnostic and therapeutic strategies for myocarditis. This review summarizes the role of ncRNAs in myocarditis and discusses their potential as noninvasive biomarkers and therapeutic targets for myocarditis. Methods: Literature on ncRNAs and myocarditis published in PubMed was extensively reviewed for analysis and discussion. Key Content and Findings: This review describes the roles of different ncRNAs in myocarditis and summarizes their potential in diagnosing and treating myocarditis. Multiple functions and mechanisms of ncRNAs in myocarditis have been uncovered. Conclusions: Current studies show that ncRNAs are widely involved in the occurrence and development of myocarditis caused by infection, autoimmunity, and the use of immune checkpoint inhibitors (ICIs) through their regulation of cell apoptosis, immune response, viral replication, and other aspects. Small-sample clinical studies have assessed the diagnostic value of ncRNAs. These results provide a new theoretical basis for diagnosing and treating myocarditis.

MEAM potential-based MD simulations of melting transition on Ni surfaces.

Based on the modified embedded atom method (MEAM) potential suggested by Jin et al. (Appl. Phys. A120: 189, 2015), the molecular dynamics (MD) simulations were adopted to investigate the melting transition of the FCC transition metal Ni, and in the MD simulations, the forces acting on atoms were calculated by using the newly derived formulas. We first studied the melting points of Ni samples with low-index surfaces including Ni(100), Ni(110), and Ni(111). Then, we investigated the structural properties on the surface layers with increasing temperature up to the melting points. The simulation results exhibit that with the temperature increasing, the (110) surface firstly disorders, followed by the (100) surface, while the stability of the (111) surface is maintained until near the melting point. The disorder of surface layer atoms diffuses from the surface to the inside of the crystal lattice. With the density of atoms decreasing on the surface, the premelting effect also increases, being most pronounced on Ni(110) which corresponds to the lowest surface density. This conclusion is linked with the behavior found for the BCC transition metal Fe in our previous simulation study.

A reference-free MEAM potential forα-Fe andγ-Fe.

A reference-free modified embedded atom method (RF-MEAM) potential for iron has been constructed. The new potential is made to predict both bcc and fcc (α-Fe andγ-Fe) lattice properties, with a special interest in modelling in the 800-1300 K temperature range. This is the range in which transformations and key processes in steel occur. RF-MEAM potentials can be used directly in commonly used molecular dynamics simulation software (e.g. LAMMPS). The new potential is compared to several other (M)EAM potentials which are commonly used. It is demonstrated that the new potential combines good characteristics for point defect energies with free surface and stacking fault energies. Also the Nishiyama-Wassermann and Kurdjumov-Sachs orientation relation ratios and interface energies are reproduced, allowing for simulations ofα-Fe andγ-Fe interphases.

Specialized Proresolving Mediators Protect Against Experimental Autoimmune Myocarditis by Modulating Ca2+ Handling and NRF2 Activation.

Specialized proresolving mediators and, in particular, 5(S), (6)R, 7-trihydroxyheptanoic acid methyl ester (BML-111) emerge as new therapeutic tools to prevent cardiac dysfunction and deleterious cardiac damage associated with myocarditis progression. The cardioprotective role of BML-111 is mainly caused by the prevention of increased oxidative stress and nuclear factor erythroid-derived 2-like 2 (NRF2) down-regulation induced by myocarditis. At the molecular level, BML-111 activates NRF2 signaling, which prevents sarcoplasmic reticulum-adenosine triphosphatase 2A down-regulation and Ca2+ mishandling, and attenuates the cardiac dysfunction and tissue damage induced by myocarditis.

Endoscope-assisted microneurosurgery for intracranial aneurysms: A systematic review and meta-analysis.

BACKGROUND: In the surgical approach to treat deep-seated intracranial lesions, endoscopes can be used to assist microsurgical operations and improve outcomes. This technique is often called endoscope-assisted microneurosurgery (EAM). This systematic review and meta-analysis aimed to evaluate the feasibility, safety, and effectiveness of EAM. METHODS: We performed a meta-analysis of relevant articles identified using PubMed, Embase, and the Cochrane Central Register to assess the efficacy of EAM according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Primary outcomes were repositioning of the definitive clip, better surgical field, the overall and endoscope-related complication rates, mortality, and the rate of follow up. RESULTS: A total of 10 studies of 1,432 patients with 1,717 aneurysms treated with EAM were included. EAM led to repositioning of the definitive clip in 13% (95% CI, 9%-17%; I2 = 72.61%; p < 0.001); 77% of aneurysms treated with endoscopically assisted vision and information had a better outcome than that with standard surgery (95% CI, 52%-95%; I2 = 97.63%; p < 0.001). There was an overall complication rate of 6% (95% CI, 1%-13%; I2 = 91.39%; p < 0.001). The incidence of endoscope-related complications was 0% (95% CI, 0%-1%; I2 = 64%; p < 0.001). The mortality was 0% (95% CI, 0-1%; I2 = 0.0%); and 94% of patients had an excellent to good recovery and good outcome (95% CI, 88%-98%; I2 = 88.42%; p < 0.001). CONCLUSIONS: Our comprehensive study showed that EAM for intracranial aneurysms is feasible, the safety of the surgery is good, and the patients have a good prognosis, Therefore, we think EAM can be more widely adopted in the future.

Stereotactic ablative radiotherapy in patients with refractory ventricular tachyarrhythmia.

Stereotactic ablative body radiotherapy (SABR) is an innovative therapeutic approach in patients (pts) with a diagnosis of refractory ventricular tachyarrhythmia (VT) after the use of drugs, radiofrequency catheter ablation, and/or defibrillator (ICD) implant. The current efficacy data of SABR are limited and several prospective clinical studies are ongoing to support the use of ablative radiation dose to control VT. The aim of the current prospective pilot study is to report the efficacy and tolerability of SABR in ICD implanted pts with refractory VT in our centre. Non-invasive electroanatomical mapping (EAM), cardiac computed tomography (CT), and 18F-fluorodeoxyglucose positron emission (FDG-PET)-CT scan were used and combined with a radiation CT scan. A dose prescription of 25 Gy in a single dose was delivered by volumetric modulated arc therapy (VMAT) Linac-based. The primary endpoint was efficacy, defined as a reduction in ICD shocks after SABR treatment, while the secondary endpoint was safety. Six consecutive pts (five males and one female) implanted with an ICD and with three or more VT were enrolled. One pts died after 1 month, due to end-stage heart failure. Two pts experienced ICD shocks in VT 2 and 5 months after treatment. Three pts experienced no more ICD shocks on VT after therapy. Our data suggest the efficacy and safety of SABR treatment in pts with VT. Larger dataset of pts and longer follow-up are otherwise required to validate the impact of SABR as a standardized treatment in these pts.

Inflammatory Cardiomyopathies: A Need to Identify Indolent Inflammation.

We present 3 cases of inflammatory cardiomyopathies illustrating the need for a multimodality imaging and multidisciplinary approach for diagnosis and treatment. (Level of Difficulty: Intermediate.).

Subcutaneous ICD Implantation and Catheter Ablation: A Step-Planned Approach for Ventricular Tachycardia Management in ARVC.

Secondary prevention of sudden cardiac death in the young patient with arrhythmogenic right ventricular cardiomyopathy and hemodynamically tolerated ventricular tachycardia is still a challenging field. We present a combined approach, including subcutaneous implantable cardioverter-defibrillator (ICD) and catheter ablation, as a promising treatment to prevent both ventricular tachycardia recurrences and ICD shocks. (Level of Difficulty: Intermediate.).

Development of the temperature-dependent interatomic potential for molecular dynamics simulation of metal irradiated with an ultrashort pulse laser.

Laser ablation is often explained by a two-temperature model (TTM) with different electron and lattice temperatures. To realize a classical molecular dynamics simulation of the TTM, we propose an extension of the embedded atom method to construct an interatomic potential that is dependent on the electron temperature. This method is applied to copper, and its validity is demonstrated by comparison of several physical properties, such as the energy-volume curve, phonon dispersion, electronic heat capacity, ablation threshold, and mean square displacement of atoms, with those of finite-temperature density functional theory.