A Concept for Mining Transitive Sequential Patterns from Pancreatic Cancer Patient Journeys.

Pancreatic cancer, renowned for its aggressive nature and poor prognosis, necessitates the optimization of treatment strategies. The sequence of procedures in clinical trials is critical, such as evaluating the potential benefits of preoperative chemo-radio-therapy for pancreatic cancer. Nevertheless, we might not be aware of other temporal sequences which have an effect on therapy response or the general outcome. Extracting transitive sequential patterns from patients' medical trajectories allows researchers to identify temporal characteristics for complex diseases. We illustrate how such sequential patterns can be discovered and might be utilized in pancreatic cancer research as well as patient care.

Strong Cavity-Optomechanical Transduction of Nanopillar Motion.

Nanomechanical resonators can serve as ultrasensitive, miniaturized force probes. While vertical structures such as nanopillars are ideal for this purpose, transducing their motion is challenging. Pillar-based photonic crystals (PhCs) offer a potential solution by integrating optical transduction within the pillars. However, achieving high-quality PhCs is hindered by inefficient vertical light confinement. Here, we present a full-silicon photonic crystal cavity based on nanopillars as a platform for applications in force sensing and biosensing areas. Its unit cell consists of a silicon pillar with a larger diameter at its top portion than at the bottom, which allows vertical light confinement and an energy band gap in the near-infrared range for transverse-magnetic polarization. We experimentally demonstrate optical cavities with Q factors exceeding 103, constructed by inserting a defect within a periodic arrangement of this type of pillars. Each nanopillar naturally behaves as a nanomechanical cantilever, making the fabricated geometries excellent optomechanical (OM) photonic crystal cavities in which the mechanical motion of each nanopillar composing the cavity can be optically transduced. These geometries display enhanced mechanical properties, cost-effectiveness, integration possibilities, and scalability. They also present an alternative in front of the widely used suspended Si beam OM cavities made on silicon-on-insulator substrates.

Correlación del Ángulo de Fase con las Masas Muscular y Grasa en una Población Caucásica Sana de Amplio Rango de Edad / Correlation of Phase Angle with Muscle and Fat Mass in a Healthy Caucasian Population of a Wide Age Range

El análisis de impedancia bioeléctrica (BIA) es un método relativamente económico, rápido y no invasivo para la determinación de la composición corporal. El ángulo de fase (PhA) es un indicador de la salud celular y de la integridad de la membrana y parece estar relacionado con la capacidad física y el rendimiento deportivo. El objetivo de este estudio fue el de analizar las posibles relaciones entre PhA y el porcentaje de masa muscular esquelética (SMM%) y entre PhA y el porcentaje de masa grasa (FM%) en una población caucásica sana, con un amplio rango de edad. Se analizaron 210 sujetos caucásicos sanos (99 mujeres y 111 hombres), de edades comprendidas entre 20 y 70 años. Se utilizó un dispositivo BIA mano-pie (BIA-101, AKERN-Srl, Firenze, Italy) para la determinación de los parámetros bioeléctricos y un escáner DXA de cuerpo entero QDR, serie Horizon (Hologic Inc., Bedford, MA, USA) para la determinación de SMM% y FM%. Se observaron correlaciones significativas positivas fuertes entre PhA y SMM%, independientemente de la franja de edad, (0,520-0,687; p < 0,01) y correlaciones significativas negativas fuertes (o moderadas/fuertes) entre PhA y FM% (0,492-0,657; p < 0,01), también independientemente de la franja de edad. Estas correlaciones indican que PhA podría utilizarse como marcador para ver la evolución de un sujeto activo, sea deportista o no. Se recomienda, por tanto, el desarrollo y la validación de nuevas ecuaciones para determinar la masa muscular y la masa grasa, que incluyan PhA como parámetro bioeléctrico.

SUMMARY: Bioelectrical impedance analysis (BIA) is a non-invasive, economic and fast method for body composition assessment. Phase angle (PhA) is considered an indicator of cellular health and cell membrane integrity, and it seems to be related to physical capacity and performance. The aim of this study was to analyze the possible relationships between PhA and skeletal muscle mass percentage (SMM%) and between PhA and fat mass percentage (FM%) in a healthy Caucasian population with a wide age range. 210 healthy Caucasian participants (99 women and 111 men), aged 20-70 years were analyzed. A BIA foot-to-hand body composition analyzer (BIA-101, AKERN-Srl, Firenze, Italy) was used to determine bioelectrical parameters, and a whole body DXA scanner QDR, serie Horizon (Hologic Inc., Bedford, MA, USA) was used for SMM% and FM% assessment. Irrespective of age range, strong positive significant correlations were observed between PhA and SMM% (0.520-0.687; p < 0.01) and strong (or moderate/strong) negative significant correlations were observed between PhA and FM% (0.492-0.657; p < 0.01). These correlations indicate that PhA could be used as a marker to monitor the evolution of an active subject, whether an athlete or not. It would be useful to develop and validate new equations for skeletal muscle mass and fat mass assessment, which include PhA as a bioelectrical parameter.

Effects of a guided neck-specific exercise therapy on recovery after a whiplash: A systematic review and meta-analysis.

OBJECTIVE: To analyze the effects on pain and disability recovery after a whiplash of a guided neck-specific exercise (NSE) therapy, compared to a different or an unguided NSE therapy. DESIGN: A literature search was conducted from inception to May 31, 2023, in three electronic databases: PubMed, ScienceDirect, and Web of Science. Eleven randomized controlled trials were included. Meta-analyses were performed with Review Manager software. The standardized mean difference (SMD) with a 95% confidence interval (CI) was used to measure the effect sizes and only short-term time points were considered. RESULTS: Not all studies reported a significant decrease of pain and disability in the NSE group compared to controls. However, meta-analyses demonstrated a significantly greater decrease in neck pain (SMD: -0.25; 95% CI: [-0.38, -0.12]; p = 0.0002) and neck-disability index (SMD: -0.35; 95% CI: [-0.54, -0.15]; p = 0.0005) in the NSE group. CONCLUSION: In addition to the benefits that a guided NSE therapy has on motivation and program adherence, it provides greater benefits in pain and disability than a different or unguided NSE therapy. Positive results are observed primarily with intervention periods of more than six weeks and at least two sessions per week.

A Late Antiquity case of a chronic osteomyelitis from the population of Cortijo Coracho, Córdoba, Spain (IV-VIII centuries AD).

The Cortijo Coracho archaeological site dates from the Late Antiquity period, from the 5th to the 8th century AD. During this period, a number of populations settled in the area (Germanic peoples until Visigothic rule, Byzantine until the arrival of the Arabs, etc.), each of them concentrating the historical characteristics in the Sub-Baetic that are currently known. The Cortijo Coracho archaeological site is currently located in the city of Lucena (Cordoba, Spain), found after the works on the A-45 motorway. The necropolis consists of 294 inhumations and the remains of a basilica, although after a series of surveys it is estimated that there are around 700 additional burials, which would make it the largest necropolis with ad sancti burials surrounding a martyrial basilica dating back to the 4th century AD. Among the burials, 397 subjects were recovered, which implies a large presence of shared and/or reused burials. These subjects were transferred to the city's museum, where they were examined, reorganised and classified. At this point, subjects of scientific interest were found, as is the case of subject 204, the topic of this article. This individual, described as an adult male, is an example of the living conditions of this period, since despite his injury on the left lower extremity, a double fracture aggravated by a chronic osteomyelitis infection, he continued to use that limb. This paper will give the details of that distinctive lesion and the possible hypotheses underlying it.

Development and validation of new bioelectrical impedance equations to accurately estimate fat mass percentage in a heterogeneous Caucasian population.

Fat mass percentage (%FM) is frequently determined by nutritionists and personal trainers with bioelectrical impedance analysis (BIA) devices. The aims of the present study were: (1) to develop new regression equations using dual-energy X-ray absorptiometry (DXA) as the reference method for estimating %FM in a heterogeneous Caucasian population with a foot-to-hand device (BIA-101) and a hand-to-hand device (BIA-TELELAB) and (2) to compare the new equations with the manufacturers' equations. We hypothesized that the new equations would lead to more accurate estimations compared with DXA. A total of 218 healthy Caucasian participants aged 18 to 65 years were divided into a development group and a validation group. The accuracy of the different equations was assessed by mean differences, coefficient of determination, standard error of the estimate (SEE), intraclass correlation coefficients (ICC), and Bland-Altman plots. The proposed equation for BIA-101 explained 90.0% of the variance in the DXA-derived %FM, with a low random error (SEE = 2.98%), excellent agreement (ICC = 0.94), no fixed bias, and relatively low individual variability (5.86%). For BIA-TELELAB, the proposed equation explained 88.0% of the variance in the DXA-derived %FM, with a low random error (SEE = 3.27%), excellent agreement (ICC = 0.93), no fixed bias, and relatively low individual variability (6.37%). The results obtained for the manufacturers' equations confirm that these equations are not a good option for %FM assessment. As hypothesized, the new regression equations for BIA-101 and BIA-TELELAB devices can accurately estimate %FM in a heterogeneous Caucasian population with a broad age range.

Magnetic coagulometry: towards a new nanotechnological tool for ex vivo monitoring coagulation in human whole blood.

Blood clotting disorders consisting of unwanted blood clot formation or excessive bleeding are some of the main causes of death worldwide. However, there are significant limitations in the current methods used to clinically monitor the dynamics of clot formation in human whole blood ex vivo. Here a new magnetic coagulometry platform for testing ex vivo coagulation is described. This platform exploits the sensitivity of the out-of-phase component of alternating current (AC) magnetic susceptibility (χ'') to variations in mobility and agglomeration of magnetic nanoparticles when trapped during blood clot formation. By labelling human whole blood with magnetic nanoparticles, the out-of-phase component of AC magnetic susceptibility shows that the dynamics of blood clot formation correlates with a decrease in the out-of-phase component χ'' over time activation of coagulation. This is caused by a rapid immobilisation of nanoparticles upon blood coagulation and compaction. In contrast, this rapid fall in the out-of-phase component χ'' is significantly slowed down when blood is pre-treated with three different anticoagulant drugs. Remarkably, the system showed sensitivity towards the effect of clinically used direct oral anticoagulation (DOAC) drugs in whole blood coagulation, in contrast to the inability of clinical routine tests prothrombin time (PT) and partial thromboplastin time (PTT) to efficiently monitor this effect. Translation of this nanomagnetic approach into clinic can provide a superior method for monitoring blood coagulation and improve the efficiency of the current diagnostic techniques.

Cultural Adaptation, Validation and Evaluation of the Psychometric Properties of an Obstetric Violence Scale in the Spanish Context.

Obstetric violence refers to dehumanized or derogative treatment of women in their pregnancy, childbirth or postpartum periods and may be manifested in different ways. Currently, there is no tool validated in Spain to measure women's perception of obstetric violence. The objective of this study was to carry out the cultural adaptation and validation of an existing 14-item obstetric violence scale in the Spanish context and to evaluate its psychometric properties. The research was conducted in two phases: first, a methodological study designed to evaluate content validity, through assessments by eight experts (calculating the Aiken V coefficient) and face validity in a sample of 20 women; second, a cross-sectional study to evaluate construct validity (through confirmatory factor analysis and Rasch analysis), divergent validity against a scale of birth satisfaction, known-groups validity and, finally, reliability. In Phase 1, Aiken V values higher than 0.71 were obtained for all items. Phase 2 was conducted on a sample of 256 women and the fit values for the unidimensional model were RMSEA: 0.070 (95% CI: 0.059-0.105) and GFI: 0.982 (95% CI: 0.823-0.990). The Rasch analysis indicated poor performance of item 2, which was removed. The Omega and Cronbach's Alpha coefficients were 0.863 and 0.860, respectively. A final 13-item version of the Obstetric Violence Scale was produced, with a total score ranging from 0 (no obstetric violence perception) to 52 (maximum obstetric violence perception). The Obstetric Violence Scale is a reliable and useful tool to measure women's perception of obstetric violence. This study was not registered.

Quercetin supplementation promotes recovery after exercise-induced muscle damage: a systematic review and meta-analysis of randomized controlled trials.

Quercetin (Q) is one of the most frequently consumed flavonoids in the human diet. The purpose of this systematic review and meta-analysis was to determine the effects of Q supplementation on muscle damage, muscle soreness and biochemical markers of inflammation, antioxidant capacity and oxidative stress after intense exercise. A literature search of SPORTDiscus, PubMed, Web of Science and Scopus was performed from inception to May 31, 2022. Forest plots were generated with fixed or random-effect models and standardized mean differences (SMD). Data extraction and quality assessment were performed independently by two authors. After application of the inclusion and exclusion criteria, 13 studies with a total of 249 sedentary to well-trained participants were included. For all studies there were some concerns about the risk of bias. All but one study used a supplementation dosage of 1000 mg/day. Q supplementation accelerated recovery of muscle function and significantly decreased muscle soreness 0/24 h after exercise (SMD: -1.33; p = 0.03), creatine kinase levels 24/48 h after exercise (SMD: -1.15; p = 0.02), and post-exercise oxidative stress (SMD: -0.92; p = 0.03). However, Q supplementation had no effect on IL-6 concentration. Q supplementation with a dose of 1000 mg/day for periods of more than seven days and a maximum of 12 weeks appears to be a safe and efficacious strategy to reduce muscle damage and muscle soreness, as well as to enhance recovery after intense exercise in sedentary to well-trained young men. Systematic review registration: PROSPERO CRD42021266801.

Estimating the heating of complex nanoparticle aggregates for magnetic hyperthermia.

Understanding and predicting the heat released by magnetic nanoparticles is central to magnetic hyperthermia treatment planning. In most cases, nanoparticles form aggregates when injected in living tissues, thereby altering their response to the applied alternating magnetic field and preventing the accurate prediction of the released heat. We performed a computational analysis to investigate the heat released by nanoparticle aggregates featuring different sizes and fractal geometry factors. By digitally mirroring aggregates seen in biological tissues, we found that the average heat released per particle stabilizes starting from moderately small aggregates, thereby facilitating making estimates for their larger counterparts. Additionally, we studied the heating performance of particle aggregates over a wide range of fractal parameters. We compared this result with the heat released by non-interacting nanoparticles to quantify the reduction of heating power after being instilled into tissues. This set of results can be used to estimate the expected heating in vivo based on the experimentally determined nanoparticle properties.

Effects of vitamin D supplementation on muscle function and recovery after exercise-induced muscle damage: A systematic review.

BACKGROUND: Vitamin D is essential for the optimal health of the skeletal system. However, this vitamin is also involved in other functions of the human body, such as muscle, immune and inflammatory ones. Some studies suggest that adequate levels of vitamin D support muscular function during exercise and accelerate recovery because they reduce specific pro-inflammatory cytokine levels, but those results have not always been observed. Therefore, this review aims to evaluate the effects of vitamin D supplementation on inflammation, oxidative stress and recovery after exercise. METHODS: This systematic review was conducted using the Preferred Reporting of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search of SPORTDiscuss, PubMed, Web of Science and Scopus was performed from inception through February 2022. The articles' methodological quality was assessed with the PEDro scale. RESULTS: After the application of the inclusion and exclusion criteria, 11 eligible articles were included. All the studies were considered of moderate methodological quality. Ten studies involved regular vitamin D supplementation for more than 7 days, and one study performed acute vitamin D supplementation 24 h before exercise. CONCLUSIONS: The existing evidence suggests that vitamin D supplementation for periods of more than 1 week with a minimum dose of 2000 IU/day appears to be an efficacious strategy for attenuating muscle damage and inflammation after exercise. The potential positive effects on muscle function, muscle pain and oxidative stress need to be confirmed with new investigations. Further research is also required to determine the adequate vitamin D dosage to obtain positive effects without adverse effects.

Body Composition, Somatotype and Raw Bioelectrical Impedance Parameters of Adolescent Elite Tennis Players: Age and Sex Differences.

Studies analyzing tennis players' body composition and morphological and bioelectrical characteristics are scarce, especially among adolescents. This study aimed to explore sex- and age-based differences in body composition, somatotype, and bioelectrical properties among elite young male and female tennis players aged 13-16 years. Twenty-two male (14.45 ± 1.10 years) and 20 female (14.30 ± 1.03 years) elite tennis players participated in this study and were compared according to sex (males vs. females) and, within each sex, according to age (13-14 years vs. 15-16 years). Female adolescent elite tennis players had higher body fat (BF) percentage and higher endomorphy than males. They also had lower skeletal muscle mass and total body water (TBW) percentages. Older boys had lower resistance and a higher TBW and phase angle (PhA) than younger boys, likely due to maturation and performance. No significant differences were found between younger and older girls, except for the PhA, potentially associated with better cell function and performance. This study provides valuable reference data for coaches of elite youth tennis players. Due to the few differences found in body composition and somatotype in the different age groups, the PhA may be used by practitioners as a reference for cell function and performance.

Microwave-assisted NixFe1-x nanoclusters ultra-stable to oxidation in aqueous media.

Metal alloy nanoparticles, and, in particular, permalloy, still hold an untapped potential in nanotechnology, although their poor stability against oxidation due to environmental exposure limits their use in many technological applications, and even more in life sciences. We propose a scalable single-step microwave-assisted method to produce water suspensions of Ni1-xFex nanoparticles without the need for an inert atmosphere, either organic solvents or any type of post-processing. We use hydrazine as a reducer, iron(II), iron(III) and nickel(II) chloride as precursors, 1,12-dodecanediol as a surfactant and water as a reaction medium. The mixture is heated at 160 °C for 10 minutes to obtain uniform alloy nanoparticles with sizes of around 24.5 nm for Ni (0% Fe) and 5.5 nm for 35% Fe that are forming uniform aggregates with sizes between 200 nm for Ni and 65 nm for iron oxide NPs. A linear increase of saturation magnetization is observed with an Fe content of up to 25%, whereas for larger percentages a sudden drop takes place due to the formation of iron oxides. X-ray diffraction measurements rule out the formation of any oxides after more than one year of storage at 4 °C, surely due to the presence of 1,12-dodecanediol at the surface, as evidenced by infrared spectroscopy.

The lure of novel biological and chemical entities in food-system transformations.

Synthetic chemicals and biologically engineered materials are major forces in today's food systems, but they are also major drivers of the global environmental changes and health challenges that characterize the Anthropocene. To address these challenges, we will need to increase assessment activity, promote alternative production practices with less reliance on such technologies, and regulate social campaigns and experiments.

Insights into Environmental Drivers on the Reproductive Cycle of Diopatra neapolitana (Polychaeta: Onuphidae).

The reproductive cycle of Diopatra neapolitana was studied over two years in Redondela (NW Spain), considering both the monthly evolution of the percentage of individuals with oocytes and the variation of the mean oocyte size. Moreover, since three other species of Diopatra have recently been documented in regions geographically close to NW Spain, we first confirmed the identity of this species by carrying out a morphological identification of a representative number of the specimens collected. Our data showed a discontinuous reproductive season, with a period of proliferation and maturation of oocytes from January to September and asynchronous spawning events between July and October. Then, a resting period in the months of November and December was observed. We also explored the influence of some relevant environmental factors (namely, water temperature, photoperiod, salinity, primary production and upwelling index) on the observed reproductive cycle. The results suggest that water temperature is one of the most important drivers of the reproductive cycle for this species. Particularly, in Ría de Vigo, the reproductive cycle seems to be influenced by upwelling events of deep cold water that occur frequently between March and September, and that could act as a spawning-inducing switch.

Heating of metallic biliary stents during magnetic hyperthermia of patients with pancreatic ductal adenocarcinoma: an in silico study.

OBJECTIVE: To investigate the eddy current heating that occurs in metallic biliary stents during magnetic hyperthermia treatments and to assess whether these implants should continue to be an exclusion criterion for potential patients. METHODS: Computer simulations were run on stent heating during the hyperthermia treatment of local pancreatic tumors (5-15 mT fields at 300 kHz for 30 min), considering factors such as wire diameter, type of stent alloy, and field orientation. Maxwell's equations were solved numerically in a bile duct model, including the secondary field produced by the stents. The heat exchange problem was solved through a modified version of the Pennes' bioheat equation assuming a temperature dependency of blood perfusion and metabolic heat. RESULTS: The choice of alloy has a large impact on the stent heating, preferring those having a lower electrical conductivity. Only for low field intensities (5 mT) and for some of the bile duct tissue layers the produced heating can be considered safe. The orientation of the applied field with respect to the stent wires can give rise to the onset of regions with different heating levels depending on the shape that the stent has finally adopted according to the body's posture. Bile helps to partially dissipate the heat that is generated in the lumen of the bile duct, but not at a sufficient rate. CONCLUSION: The safety of patients with pancreatic cancer wearing metallic biliary stents during magnetic hyperthermia treatments cannot be fully assured under the most common treatment parameters.

Two Methods of AuNPs Synthesis Induce Differential Vascular Effects. The Role of the Endothelial Glycocalyx.

AuNPs are synthesized through several methods to tune their physicochemical properties. Although AuNPs are considered biocompatible, a change in morphology or properties can modify their biological impact. In this work, AuNPs (~12 to 16 nm) capping with either sodium citrate (CA) or gallic acid (GA) were evaluated in a rat aorta ex vivo model, which endothelial inner layer surface is formed by glycocalyx (hyaluronic acid, HA, as the main component), promoting vascular processes, most of them dependent on nitric oxide (NO) production. Results showed that contractile effects were more evident with AuNPsCA, while dilator effects predominated with AuNPsGA. Furthermore, treatments with AuNPsCA and AuNPsGA in the presence or absence of glycocalyx changed the NO levels, differently. This work contributes to understanding the biological effects of AuNPs with different capping agents, as well as the key role that of HA in the vascular effects induced by AuNPs in potential biomedical applications.

A novel family of non-secreted tridecaptin lipopeptide produced by Paenibacillus elgii.

Bacteria from the genus Paenibacillus make a variety of antimicrobial compounds, including lipopeptides produced by a non-ribosomal synthesis mechanism (NRPS). In the present study, we show the genomic and phenotypical characterization of Paenibacillus elgii AC13 which makes three groups of small molecules: the antimicrobial pelgipeptins and two other families of peptides that have not been described in P. elgii. A family of lipopeptides with [M + H]+ 1664, 1678, 1702, and 1717 m/z was purified from the culture cell fraction. Partial characterization revealed that they are similar to tridecaptin from P. terrae. However, they present amino acid chain modifications in positions 3, 7, and 10. These new variants were named tridecaptin G1, G2, G3, and G4. Furthermore, a gene cluster was identified in P. elgii AC13 genome, revealing high similarity to the tridecaptin-NRPS gene cluster from P. terrae. Tridecaptin G1 and G2 showed in vitro antimicrobial activity against Escherichia coli, Klebsiella pneumonia (including a multidrug-resistant strain), Staphylococcus aureus, and Candida albicans. Tri G3 did not show antimicrobial activity against S. aureus and C. albicans at all tested concentrations. An intriguing feature of this family of lipopeptides is that it was only observed in the cell fraction of the P. elgii AC13 culture, which could be a result of the amino acid sequence modifications presented in these variants.

A comparative analysis of four dental pathologies of the historical population of Cortijo Coracho, Roman southern Spain (4th-8th centuries AD).

Here we present the dental pathologies found in the population of Cortijo Coracho, which dates from Late Antiquity (4th-8th centuries AD) and is located in the region of Lucena (Córdoba). Using a sample of 160 individuals over the age of twenty years at death, with a total of 1681 dental crowns, the frequency of various oral diseases (dental calculus, alveolar reabsorptions, periodontal diseases, and dental abscesses) were analysed. The frequency of oral disease was compared between the mandible and the maxilla, the anterior and posterior teeth as well as the right and left sides. Consideration was given to ante-mortem tooth loss, which may be caused by dental disease. Statistical analysis showed a significantly greater frequency of oral disease in the posterior teeth of the mandible.

Usefulness of ventricular sense response in last-generation cardiac resynchronization therapy devices.

OBJECTIVES: High percentages of pacing were associated to maximal symptomatic and mortality benefit from cardiac resynchronization therapy (CRT). Loss of CRT pacing is linked to intrinsic ventricular activation preceding biventricular pacing (BiV), as it occurs in patients with atrial fibrillation (AF). Last generation CRT devices incorporate the ventricular sense response (VSR) mechanism to maintain biventricular pacing in patients with atrial arrhythmias. This work aimed to characterize electrical dyssynchrony differences among baseline, BiV and VSR pacing, and determine whether the VSR mode is as beneficial as the BiV mode in terms of electrical dyssynchrony. METHODS: Thirty-two patients implanted with CRT devices were retrospectively studied. All patients presented non-ischemic dilated myocardiopathy and complete left bundle branch block (LBBB). Every patient went through baseline, BiV and VSR pacing while recording the 12­lead ECG. Electrical dyssynchrony was assessed by a dyssynchrony index (DIn) obtained from correlation analysis on the 12­lead ECG. RESULTS: When comparing with baseline, VSR pacing improved QRS duration (178 ± 22 ms vs 158 ± 43 ms, baseline vs VSR, p < 0.05) and so did BiV pacing (178 ± 22 ms vs 142 ± 20 ms, baseline vs BiV, p < 0.05). However, electrical dyssynchrony only improved at BiV pacing (2.86±0.6 vs 0.54±0.8, baseline vs BiV, p < 0.05) while VSR showed average DIn values similar to those at baseline. CONCLUSIONS: VSR pacing did not improve the electrical synchrony while did shorten QRS duration in this sample population. Therefore, VSR paced beats would fall in the category of inefficient BiV and may not be the preferred alternative in patients with CRT and AF.