Pharmacological Considerations during Percutaneous Treatment of Heart Failure.

Heart Failure (HF) remains a global health challenge, marked by its widespread prevalence and substantial resource utilization. Although the prognosis has improved in recent decades due to the treatments implemented, it continues to generate high morbidity and mortality in the medium to long term. Interventional cardiology has emerged as a crucial player in HF management, offering a diverse array of percutaneous treatments for both acute and chronic HF. This article aimed to provide a comprehensive review of the role of percutaneous interventions in HF patients, with a primary focus on key features, clinical effectiveness, and safety outcomes. Despite the growing utilization of these interventions, there remain critical gaps in the existing body of evidence. Consequently, the need for high-quality randomized clinical trials and extensive international registries is emphasized to shed light on the specific patient populations and clinical scenarios that stand to benefit most from these innovative devices.

An eight-season analysis of the teams' performance in the Spanish LaLiga according to the final league ranking.

This study aimed to analyse the performance of 5,518 collective observations of the Spanish LaLiga teams for eight consecutive seasons (from 2011-12 to 2018-19), considering the final league ranking. The teams were divided into four groups: Europe (from 1st to 6th), Upper-Middle (from 7th to 11th), Lower-Middle (from 12th to 17th) and Relegation (from 18th to 20th). The variables recorded were: Passes, Successful Passes, Crosses, Shots, Goals, Corners, Fouls, Width, Length, Height, distance from the goalkeeper to the nearest defender (GkDef), total distance covered (TD) and number of points accumulated. The main results were that: 1) Europe, being superior to the rest of the groups, showed lower values of Length from 2015-16, and lower values of GkDef from 2014-15; 2) Upper-Middle showed lower values of Length from 2015-16; 3) Lower-Middle showed fewer Shots from 2013-14, and lower values of Length, GkDef and TD from 2014-15; and, 4) Relegation barely showed significant differences between seasons in any variable. The study concludes that the teams of the Europe, Upper-Middle and Relegation groups showed quite stable performance, while the teams of the Lower-Middle group presented a worsening in different dimensions as the seasons progressed. The information provided in this study makes it possible to have reference values that have characterized the performance of the teams for each group.

Clinical practice guideline of the Spanish society of oral surgery for dental care in patients with oral cancer / Guía de práctica clínica de la sociedad española de cirugía bucal para el cuidado dental en pacientes con cáncer oral

Background: Oral cancer is the sixteenth most common malignant neoplasm worldwide, with a high mortalityrate, greater than 50% at five years, and high morbidity. The effect of oncological treatment in the oral cavity isbroad and has multiple levels, therefore knowing these effects and preventing them is essential for avoiding anincrease in the oral pathology related with oncological therapy, maintaining the quality of life of the patient, andimproving the efficacy of the treatment itself.Material and Methods: A group of experts belonging to the fields of Dentistry, Maxillofacial Surgery and Oncol-ogy of the University of Seville and the Virgen del Rocío University Hospital of Seville in collaboration with theUniversity of Valencia, University of Barcelona, and University of the Basque Country, developed this ClinicalPractice Guideline for the proper clinical management of patients diagnosed with oral cancer. The clinical ques-tions were formulated in PICO format. The databases consulted were Medline/PubMed and Embase/Elsevier. Thesystematic reviews published on the topic were identified on Tripdatabase, Cochrane Library and CRD (Centre forReviews and Dissemination). The recommendations were prepared based on the GRADE methodology.Results: Various recommendations were defined, derived from the 21 PICO questions, referring to prevention,treatment and care for alterations arising from the pathology of oral cancer itself and its treatment.Conclusions: The preparation of this clinical practice guideline allows recommendations to be generated basedon the scientific evidence available, on dentistry actions in patients with oral cancer and undergoing oncologicaltreatment, which may be of use to the multidisciplinary team treating this type of patient.(AU)

Left bundle branch pacing versus left ventricular septal pacing as a primary procedural endpoint during left bundle branch area pacing: Evaluation of two different implant strategies.

INTRODUCTION: Implant procedure features and clinical implications of left bundle branch pacing (LBBP) and left ventricular septal pacing (LVSP) have not been yet fully described. We sought to compare two different left bundle branch area pacing (LBBAP) implant strategies: the first one accepting LVSP as a procedural endpoint and the second one aiming at achieving LBBP in every patient in spite of evidence of previous LVSP criteria. METHODS: LVSP was accepted as a procedural endpoint in 162 consecutive patients (LVSP strategy group). In a second phase, LBBP was attempted in every patient in spite of achieving previous LVSP criteria (n = 161, LBBP strategy group). Baseline patient characteristics, implant procedure, and follow-up data were compared. RESULTS: The final capture pattern was LBBP in 71.4% and LVSP in 24.2% in the LBBP strategy group compared to 42.7% and 50%, respectively, in the LVSP strategy group. One hundred and eighty-four patients (57%) had proven LBB capture criteria with a significantly shorter paced QRS duration than the 120 patients (37%) with LVSP criteria (115 ± 9 vs. 121 ± 13 ms, p < .001). Implant parameters were comparable between the two strategies but the LBBP strategy resulted in a higher rate of acute septal perforation (11.8% vs. 4.9%, p = .026) without any clinical sequelae. Patients with CRT indications significantly improved left ventricular ejection fraction (LVEF) during follow-up irrespective of the capture pattern (from 35 ± 11% to 45 ± 14% in proven LBBP, p = .024; and from 39 ± 13% to 47 ± 12% for LVSP, p = .003). The presence of structural heart disease and baseline LBBB independently predicted unsuccessful LBB capture. CONCLUSION: The LBBP strategy was associated with comparable implant parameters than the LVSP strategy but resulted in higher rates of septal perforation. Proven LBB capture and LVSP showed comparable effects on LVEF during follow-up.

Conduction System Pacing for Cardiac Resynchronization Therapy.

Cardiac resynchronization therapy (CRT) via biventricular pacing (BiVP-CRT) is considered a mainstay treatment for symptomatic heart failure patients with reduced ejection fraction and wide QRS. However, up to one-third of patients receiving BiVP-CRT are considered non-responders to the therapy. Multiple strategies have been proposed to maximize the percentage of CRT responders including two new physiological pacing modalities that have emerged in recent years: His bundle pacing (HBP) and left bundle branch area pacing (LBBAP). Both pacing techniques aim at restoring the normal electrical activation of the ventricles through the native conduction system in opposition to the cell-to-cell activation of conventional right ventricular myocardial pacing. Conduction system pacing (CSP), including both HBP and LBBAP, appears to be a promising pacing modality for delivering CRT and has proven to be safe and feasible in this particular setting. This article will review the current state of the art of CSP-based CRT, its limitations, and future directions.

Heat rectification, heat fluxes, and spectral matching.

Heat rectifiers would facilitate energy management operations such as cooling or energy harvesting, but devices of practical interest are still missing. Understanding heat rectification at a fundamental level is key to helping us find or design such devices. The match or mismatch of the phonon band spectrum of device segments for forward or reverse temperature bias of the thermal baths at device boundaries was proposed as the mechanism behind rectification. However, no explicit theoretical relation derived from first principles had been found so far between heat fluxes and spectral matching. We study heat rectification in a minimalistic chain of two coupled ions. The fluxes and rectification can be calculated analytically. We propose a definition of the matching that sets an upper bound for the heat flux. In a regime where the device rectifies optimally, matching and flux ratios for forward and reverse configurations are found to be proportional. The results can be extended to a system of N particles in arbitrary traps with nearest-neighbor linear interactions.

Spin-to-Charge Conversion in All-Oxide La2/3Sr1/3MnO3/SrIrO3 Heterostructures.

Spin injection and spin-charge conversion processes in all-oxide La2/3Sr1/3MnO3/SrIrO3 (LSMO/SIO) heterostructures with different SIO layer thickness and interfacial features have been studied. Ferromagnetic resonance (FMR) technique has been used to generate pure spin currents by spin pumping (SP) in ferromagnetic (FM) half-metallic LSMO. The change of the resonance linewidth in bare LSMO layers and LSMO/SIO heterostructures suggests a successful spin injection into the SIO layers. However, low values of the spin mixing conductance, compared to more traditional permalloy (Py)/Pt or yttrium iron garnet (YIG)/Pt systems, are found. A thorough analysis of the interfaces by high-resolution scanning transmission electron microscopy (HR-STEM) imaging suggests that they are structurally clean and atomic sharp, but a compositional analysis by energy-dispersive X-ray spectroscopy (EDS) reveals the interdiffusion of La, Ir, and Mn atomic species in the first atomic layers close to the interface. Inverse spin Hall effect (ISHE) measurements evidence that interfacial features play a very relevant role in controlling the effectiveness of the spin injection process and low transversal ISHE voltage signals are detected. In addition, it is found that larger voltage signals are detected for the lowest SIO layer thickness highlighting the role of the spin diffusion length (λsd)/SIO layer thickness ratio. The values of ISHE voltage are rather low but allow us to determine the spin Hall angle of SIO (θSH ≈ 1.12% at T = 250 K), which is remarkably similar to that obtained for the well-known Py/Pt system, therefore suggesting that SIO could be a promising spin-Hall material.

Gingival lymphatic malformation. An atypical case report.

Lymphatic malformations are a rare pathology that presents a highly variable clinical expression. Intraorally, it mainly affects the dorsum of the tongue. The objective of this work is to present a case of lymphatic malformation in an atypical location. A 20-year-old male who attended the clinic for multiple vesicular lesion in attached gingiva, asymptomatic and of unknown evolution. Removal of the lesion and subsequent histological analysis were performed, which showed a microcystic lymphatic vascular lesion. Immunohistochemistry for D2-40 was performed, which corroborated the lymphatic origin of the lesion. At 6 months, no recurrence of the lesion was recognized. Clinicians should include lymphatic malformations in the differential diagnosis of multiple vesicular lesions. Knowing the oral manifestations of this entity is essential for its proper diagnosis and clinical management. Key words:Gingiva, oral lymphatic malformation, diagnosis.

Cambios morfométricos en pacientes con enfermedad renal crónica fallecidos relacionados con diabetes mellitus, hipertensión arterial y obesidad

Fundamento: la enfermedad renal crónica ha incrementado su incidencia, no existen estudios en Cuba ni en la provincia sobre morfometría renal en pacientes con enfermedad renal crónica a los que se les ha practicado autopsia. Objetivo: determinar variaciones morfométricas renales en pacientes fallecidos a los que se les ha practicado autopsia en el Hospital General Universitario Dr. Gustavo Aldereguía Lima de Cienfuegos. Método se realizó un estudio descriptivo, longitudinal y retrospectivo. El universo lo conformaron 85 pacientes fallecidos a los que se les practicó autopsia y que tenían diagnóstico clínico de enfermedad renal crónica en cualquier estadio. Se trabajó con el total del universo. Las variables estudiadas fueron: edad, sexo, peso y talla para el cálculo del índice de masa corporal, antecedentes patológicos personales, el estadio clínico de la enfermedad renal crónica y la morfometría renal a cada órgano por separado, las mensuraciones realizadas fueron: peso, diámetro longitudinal, diámetro transversal, espesor o grosor de la corteza renal. Los datos se procesaron en el paquete estadístico de SSPS v. 11.5 presentándose tablas en números absolutos y porcientos. Resultados predominó el sexo femenino, en edades entre 70-79 años, con estadio clínico I y IV de la enfermedad renal crónica, los obesos representaron el 57,6 %, los hipertensos el 67,1 % y los diabéticos el 25,8 %. Hubo disminución de todas las variables morfométricas en ambos riñones, destacándose el espesor de la corteza renal. Conclusiones: existió relación entre la hipertensión, la diabetes mellitus y la obesidad con las variables morfométricas renales.

Background: chronic kidney disease has increased its incidence, there are no studies in Cuba or in the province on renal morphometry in patients with chronic kidney disease who have undergone autopsy. Objective: to determine renal morphometric variations in deceased patients who have undergone autopsy at the Dr. Gustavo Aldereguía Lima University General Hospital of Cienfuegos. Method: a descriptive, longitudinal and retrospective study was carried out. The universe was made up of 85 deceased patients who underwent autopsy with a clinical diagnosis of chronic kidney disease at any stage. We worked with the whole universe. The variables studied were: age, sex, weight and height for the calculation of the body mass index, personal pathological history, the clinical stage of chronic kidney disease and renal morphometry to each organ separately, the measurements made were: weight, longitudinal diameter, transverse diameter, thickness or thickness of the renal cortex. The data was processed in the statistical package of SSPS v. 11.5 presenting tables in absolute numbers and percentages. Results: the female sex predominated, aged between 70-79 years, with clinical stage I and IV of chronic kidney disease, the obese represented 57.6 %, the hypertensive 67.1 % and the diabetic 25.8 %. There was a decrease in all morphometric variables in both kidneys, highlighting the thickness of the renal cortex. Conclusions: there was a relationship between hypertension, diabetes mellitus and obesity with renal morphometric variables.

Tailoring crosstalk between localized 1D spin-wave nanochannels using focused ion beams.

1D spin-wave conduits are envisioned as nanoscale components of magnonics-based logic and computing schemes for future generation electronics. À-la-carte methods of versatile control of the local magnetization dynamics in such nanochannels are highly desired for efficient steering of the spin waves in magnonic devices. Here, we present a study of localized dynamical modes in 1-[Formula: see text]m-wide permalloy conduits probed by microresonator ferromagnetic resonance technique. We clearly observe the lowest-energy edge mode in the microstrip after its edges were finely trimmed by means of focused Ne[Formula: see text] ion irradiation. Furthermore, after milling the microstrip along its long axis by focused ion beams, creating consecutively [Formula: see text]50 and [Formula: see text]100 nm gaps, additional resonances emerge and are attributed to modes localized at the inner edges of the separated strips. To visualize the mode distribution, spatially resolved Brillouin light scattering microscopy was used showing an excellent agreement with the ferromagnetic resonance data and confirming the mode localization at the outer/inner edges of the strips depending on the magnitude of the applied magnetic field. Micromagnetic simulations confirm that the lowest-energy modes are localized within [Formula: see text]15-nm-wide regions at the edges of the strips and their frequencies can be tuned in a wide range (up to 5 GHz) by changing the magnetostatic coupling (i.e., spatial separation) between the microstrips.

Facial expression analysis in a wild sporting environment.

The scientific community and mass media have already reported the use of nonverbal behavior analysis in sports for athletes' performance. Their conclusions stated that certain emotional expressions are linked to athlete's performance, or even that psychological strategies serve to improve endurance performance. This paper examines the portrayal of well-known emotions and their relationship to the participants of an ultra-distance race in a high-stake environment. For this purpose, we analyzed almost 600 runners captured when they passed through a set of locations placed along the race track. We have observed a correlation between the runners' facial expressions and their performance along the track. Moreover, we have analyzed Action Unit activations and aligned our findings with the state-of-the-art psychological baseline.

The impact of COVID-19 lockdown on soccer positional and physical demands in the Spanish La Liga.

The present study aimed to analyse the playing surface area, dispersion and distance covered of professional football teams comparing the pre-lockdown and post-lockdown periods. Positional and match physical demands data were collected from all matches played in the First Spanish Division (n = 760) during season 2019/2020. Pre-lockdown (1st-27th matchday) and post-lockdown periods (28th-38th matchday) were compared. Variables related to team-level spatial (i.e., convex hull, team width and team length) and physical performance (i.e., total distance and high-speed running distance) were analysed using an optical tracking system (i.e., ChyronHego). In addition, these variables were concerned with respect to the match location contextual variable. Linear mixed models were used to examine the difference between the pre-lockdown and post-lockdown periods following a hierarchical structure considering players, matches and teams. The results revealed that the pandemic lockdown affected the teams' performance when comparing the periods before and after lockdown, showing a general decrease in the average values of the spatial and physical variables measured. The current data could assist practitioners in making informed decisions in order to design and improve training plans for similar situations in which teams return to competition after an unusual period with no training.

Topical prebiotics/postbiotics and PRURISCORE validation in atopic dermatitis. International study of 396 patients.

Aim: To investigate the efficacy and tolerability of a cream (Rilastil Xerolact PB) containing a mixture of prebiotics and postbiotics, and to validate the PRURISCORE itch scale in the management of atopic dermatitis.Methods: The study is based on 396 subjects of both sexes in three age groups (i.e., infants, children, adults) suffering from mild/moderate Atopic Dermatitis, recruited from 8 European countries and followed for 3 months.Results: The product demonstrated good efficacy combined with good/very good tolerability in all age groups. In particular, SCORAD, PRURISCORE and IGA scores decreased significantly over the course of the study. The PRURISCORE was preferred to VAS by the vast majority of patients.Conclusion: Even though the role of prebiotics and postbiotics was not formally demonstrated since these substances were part of a complex formulation, it can be reasonably stated that prebiotics and postbiotics have safety and standardization features that probiotics do not have. In addition they are authorized by regulatory authorities, whereas topical probiotics are not.

Extracellular vesicles and microvilli in the immune synapse.

T cell receptor (TCR) binding to cognate antigen on the plasma membrane of an antigen-presenting cell (APC) triggers the immune synapse (IS) formation. The IS constitutes a dedicated contact region between different cells that comprises a signaling platform where several cues evoked by TCR and accessory molecules are integrated, ultimately leading to an effective TCR signal transmission that guarantees intercellular message communication. This eventually leads to T lymphocyte activation and the efficient execution of different T lymphocyte effector tasks, including cytotoxicity and subsequent target cell death. Recent evidence demonstrates that the transmission of information between immune cells forming synapses is produced, to a significant extent, by the generation and secretion of distinct extracellular vesicles (EV) from both the effector T lymphocyte and the APC. These EV carry biologically active molecules that transfer cues among immune cells leading to a broad range of biological responses in the recipient cells. Included among these bioactive molecules are regulatory miRNAs, pro-apoptotic molecules implicated in target cell apoptosis, or molecules triggering cell activation. In this study we deal with the different EV classes detected at the IS, placing emphasis on the most recent findings on microvilli/lamellipodium-produced EV. The signals leading to polarized secretion of EV at the synaptic cleft will be discussed, showing that the IS architecture fulfills a fundamental task during this route.

Acute performance of stylet driven leads for left bundle branch area pacing: A comparison with lumenless leads.

Background: Lumenless leads (LLLs) are widely used for left bundle branch area pacing (LBBAP). Recently, stylet-driven leads (SDLs) have also been used for LBBAP. Objective: The purpose of this study was to evaluate the acute performance of SDLs during LBBAP in comparison with LLLs. Methods: Consecutive patients undergoing LBBAP for bradycardia or cardiac resynchronization therapy indications at 2 high-volume, early conduction system pacing adopters, tertiary centers were included from January 2019 to July 2023. Patients received either SDLs or LLLs at the discretion of the implanting physician. Acute performance and follow-up data of both lead types were evaluated. Results: A total of 925 LBBAP implants were included, 655 using LLLs and 270 using SDLs. Overall, LBBAP acute success was significantly higher with LLLs than SDLs (95.3% vs 85.1%, respectively; P <.001) even after the learning curve (97% vs 86%; P = .013). LLLs were implanted in more mid-basal septal positions in comparison with SDLs, which tended to be implanted in more inferior and mid-apical septal positions. Acute lead-related complications were higher with SDLs than LLLs (15.9% vs 6.1%, respectively; P <.001) with 15 cases of lead damage during implant (4.4% vs 0.5%; P <.001) but decreased with acquired experience and were comparable in the last 100 patients included in each group. Lead implant and fluoroscopy times were shorter for SDLs, with lead dislodgment occurring in 0.9% with LLLs and 1.5% with SDLs (P = .489). Conclusion: Acute lead performance proved to be different between LLLs and SDLs. A specific learning curve should be considered for SDLs even for implanters with extensive previous experience with LLLs.

Low-abundance populations distinguish microbiome performance in plant cell wall deconstruction.

BACKGROUND: Plant cell walls are interwoven structures recalcitrant to degradation. Native and adapted microbiomes can be particularly effective at plant cell wall deconstruction. Although most understanding of biological cell wall deconstruction has been obtained from isolates, cultivated microbiomes that break down cell walls have emerged as new sources for biotechnologically relevant microbes and enzymes. These microbiomes provide a unique resource to identify key interacting functional microbial groups and to guide the design of specialized synthetic microbial communities. RESULTS: To establish a system assessing comparative microbiome performance, parallel microbiomes were cultivated on sorghum (Sorghum bicolor L. Moench) from compost inocula. Biomass loss and biochemical assays indicated that these microbiomes diverged in their ability to deconstruct biomass. Network reconstructions from gene expression dynamics identified key groups and potential interactions within the adapted sorghum-degrading communities, including Actinotalea, Filomicrobium, and Gemmatimonadetes populations. Functional analysis demonstrated that the microbiomes proceeded through successive stages that are linked to enzymes that deconstruct plant cell wall polymers. The combination of network and functional analysis highlighted the importance of cellulose-degrading Actinobacteria in differentiating the performance of these microbiomes. CONCLUSIONS: The two-tier cultivation of compost-derived microbiomes on sorghum led to the establishment of microbiomes for which community structure and performance could be assessed. The work reinforces the observation that subtle differences in community composition and the genomic content of strains may lead to significant differences in community performance. Video Abstract.