Bridging Requirements, Planning, and Evaluation: A Review of Social Robot Navigation.

Navigation lies at the core of social robotics, enabling robots to navigate and interact seamlessly in human environments. The primary focus of human-aware robot navigation is minimizing discomfort among surrounding humans. Our review explores user studies, examining factors that cause human discomfort, to perform the grounding of social robot navigation requirements and to form a taxonomy of elementary necessities that should be implemented by comprehensive algorithms. This survey also discusses human-aware navigation from an algorithmic perspective, reviewing the perception and motion planning methods integral to social navigation. Additionally, the review investigates different types of studies and tools facilitating the evaluation of social robot navigation approaches, namely datasets, simulators, and benchmarks. Our survey also identifies the main challenges of human-aware navigation, highlighting the essential future work perspectives. This work stands out from other review papers, as it not only investigates the variety of methods for implementing human awareness in robot control systems but also classifies the approaches according to the grounded requirements regarded in their objectives.

Electric Cardioversion in Older Adults. Is Sedation Using Propofol Safe in the Absence of the Direct Anesthetist's Assistance?

Aims: This study aimed to assess the safety of electric cardioversion in the absence of anesthetists assistance. We also evaluated the efficacy and safety of this procedure in older adults (≥80 years) compared to younger populations. Methods: We retrospectively analyzed the data of patients who underwent electric cardioversion at our cardiology department. Patients were divided into 2 groups according to age: ≥ 80 years and <80 years old. Results: The study included 218 participants, 73 were aged 80 years or more (mean age: 84.8 years), and 145 were younger than 80 years (mean age: 66.7 years). Electric cardioversion was effective in 97.3% of older patients and 96.5% of younger patients (P = 1.00). No thromboembolic complications were observed in either of the groups. Asystole >5 s occurred immediately after shock in 4.1% of older and 2.1% of younger patients (P = .405). Propofol was used as a sedative, with a mean dose of 0.83 mg/kg versus 0.93 mg/kg, in older and younger patients, respectively. Intubation, medical intervention, or other advanced resuscitation techniques were not required. During hospitalization, arrhythmia recurred in 9.6% and 12.4% of the older and younger patients, respectively (P = .537). Conclusions: Electrical cardioversion is an effective and safe procedure regardless of patient age. Sedation with propofol administered by cardiologists was safe. Adverse events were not considered serious or reversible.

Risk factors for thrombosis and spontaneous echocardiographic contrast with sludge in atrial fibrillation patients treated with oral anticoagulants before electrical cardioversion.

BACKGROUND: Knowledge of thrombosis (T) risk predictors and transesophageal echocardiography (TEE) are important tools in appropriate qualification of patients for safe electrical cardioversion. AIMS: We aimed to investigate predictors of T and spontaneous echocardiographic contrast (SEC) with sludge in the left atrium (LA) and appendage (LAA) in atrial fibrillation (AF) patients on oral anticoagulation. METHODS: The study included 300 patients with AF lasting >48 hours. Two hundred and nineteen patients were treated with oral anticoagulants (OACs) (study group, rivaroxaban: 104 [47.5%], apixaban: 52 [23.7%], dabigatran: 23 [11.5%], VKAs: 40 [18.3%]). Eighty-one consecutive patients with AF lasting >48 hours and not treated with OACs constituted the control group. Before electrical cardioversion, all patients underwent transthoracic echocardiography and TEE. RESULTS: TEE revealed T in the LAA in 4.7% of cases. The number of patients with T or SEC4+ with sludge in the OAC and control groups was similar, 5.9% vs. 1.2% and 16.4% vs. 16.0%, respectively. The risk of SEC4+/T in patients treated with OACs was lowest in those taking rivaroxaban (odds ratio [OR], 0.42; 95% confidence interval [CI], 0.21-0.87; P = 0.027) and highest in those receiving VKAs (OR, 2.49; 95% CI, 1.15-5.39; P = 0.018). Multivariable analysis showed independent prognostic factors for SEC 4+/T: female sex (OR, 3.800; 95% CI, 1.592-9.072; P = 0.003), left ventricular ejection fraction (OR, 0.932; 95% CI, 0.890-0.957; P <0.001), and minimum LAA flow velocity (LAAfly min) (OR, 0.895; 95% CI, 0.841-0.954; P <0.001). CONCLUSIONS: Female sex, transthoracic echocardiography, and TEE results should be taken into account in assessing the risk of T/SEC with sludge in LA/LAA patients with AF.

Efficacy and safety of antazoline vs propafenone for conversion of paroxysmal atrial fibrillation to sinus rhythm: a randomized, double-blind study (AnProAF).

INTRODUCTION: Antazoline is a frequently used antiarrhythmic drug (AAD); however, to date, no randomized controlled trial has evaluated its efficacy and safety for cardioversion of recent­onset atrial fibrillation (AF) in comparison with other approved AADs. OBJECTIVES: This study aimed to compare clinical efficacy and safety of antazoline and propafenone for a rapid conversion of nonvalvular paroxysmal AF to sinus rhythm in patients without heart failure. PATIENTS AND METHODS: This was a single­center, randomized, double­blind study. It included patients with AF (lasting <48 hours) who were in a stable cardiopulmonary condition and eligible for cardioversion. The individuals who fulfilled the inclusion criteria were randomly assigned to receive either antazoline (up to 300 mg) or propafenone (up to 140 mg) intravenously. The primary end point was conversion of AF to sinus rhythm confirmed on electrocardiography. RESULTS: Overall, 94 participants (46 [48.9%] in the antazoline group and 48 [51.1%] in the propafenone group) were included. The mean (SD) age was 67.5 (14) years, and 40 participants (42.5%) were men. Successful AF conversion was observed in 29 patients (63%) from the antazoline group and 25 individuals (52.1%) from the propafenone group (P = 0.39). The median time to conversion was 10 minutes in the antazoline group and 30 minutes in the propafenone group (P = 0.03). Severe adverse events were observed in 5 patients (10.8%) treated with antazoline and 5 individuals (10.4%) who received propafenone. CONCLUSIONS: Intravenous antazoline demonstrated efficacy and safety comparable to those of intravenous propafenone for acute conversion of nonvalvular paroxysmal AF to sinus rhythm in patients without heart failure.

Electric cardioversion in patients treated with oral anticoagulants: embolic material in the left atrial appendage.

Atrial fibrillation (AF) remains the most common arrhythmia. The sinus rhythm restoration procedure without adequate anticoagulant preparation may lead to a thromboembolic event in approximately 5-7% of patients. The initiation of oral anticoagulation significantly reduces this risk by inhibiting formation of embolic material in the heart cavities, especially in the left atrial appendage (LAA). However, there is a group of patients who develop embolic material in the LAA despite oral anticoagulation treatment. The best treatment method to dissolve thrombus in the LAA is not clear, due to the lack of studies with adequate power and endpoints that can determine the best management strategy. We present clinical trials comparing the efficacy and safety of oral anticoagulants in patients undergoing AF cardioversion. We evaluate the frequency of LAA thrombus formation in patients with AF on treatment with oral anticoagulants. Furthermore, we discuss the effectiveness of various treatment strategies on LAA thrombus resolution.

Electric cardioversion in patients treated with oral anticoagulants: embolic material in the left atrial appendage.

Atrial fibrillation (AF) remains the most common arrhythmia. The sinus rhythm restoration procedure without adequate anticoagulant preparation may lead to a thromboembolic event in approximately 5-7% of patients. The initiation of oral anticoagulation significantly reduces this risk by inhibiting formation of embolic material in the heart cavities, especially in the left atrial appendage (LAA). However, there is a group of patients who develop embolic material in the LAA despite oral anticoagulation treatment. The best treatment method to dissolve thrombus in the LAA is not clear, due to the lack of studies with adequate power and endpoints that can determine the best management strategy. We present clinical trials comparing the efficacy and safety of oral anticoagulants in patients undergoing AF cardioversion. We evaluate the frequency of LAA thrombus formation in patients with AF on treatment with oral anticoagulants. Furthermore, we discuss the effectiveness of various treatment strategies on LAA thrombus resolution.

Left atrial appendage thrombus in patients with atrial fibrillation who underwent oral anticoagulation.

BACKGROUND: Electric cardioversion of atrial fibrillation (AF) is associated with an increased risk of embolism, with embolic material existing in the heart cavities. The initiation of oral anticoagulation therapy reduces the risk of thromboembolic events. The aims of this study were to evaluate the prevalence of left atrial appendage (LAA) thrombi in non-valvular AF, to compare vitamin K antagonists (VKAs) and non-vitamin K oral anticoagulants (NOACs) with respect to thrombus prevalence, and to evaluate the rate of LAA thrombus persistence on repeat transesophageal echocardiography (TEE) after treatment change. METHODS: We enrolled 160 consecutive AF patients who presented with an AF duration > 48 h and had undergone TEE before cardioversion. RESULTS: Left atrial appendage thrombus was observed in 12 (7.5%) patients, and spontaneous echo contrast 4 was observed in 19 (11.8%) patients; the incidence was similar between the NOAC and VKA groups (8.9% vs. 3.6% and 12.4% vs. 18.5 %, respectively). Among patients on NOAC, thrombus prevalence was detected in 8.4% of users of rivaroxaban, 8% of users of dabigatran, and 12.5% of users of apixaban. CONCLUSIONS: The LAA thrombus developed in 7.5% of patients despite anticoagulation therapy, demonstrating similar prevalence rates among patients either on NOAC or VKA. Lower mean LAA flow velocity and a history of vascular disease were independent predictors of embolic material in the LAA. It seems that in the case of embolic materials in LAA under NOAC treatment, switching to VKA provides additional clinical benefit to the patients.

Differences in Symptomatology and Clinical Course of Acute Coronary Syndromes in Women ≤45 Years of Age Compared to Older Women.

Acute coronary syndromes (ACS) in young people are rare. The data regarding differences in symptoms in relation to age are scarce, which may have an influence on outcomes. The aim of this study was to evaluate the differences in the clinical course of ACS between younger women (≤45 years old) and older women (63-64 years old). We compared 7481 women with ACS from the Polish Registry of ACS between 2007 and 2014 (1834 women aged ≤45 years and 5647 women aged 63-64 years). The predominant symptom of ACS in both groups was chest pain, with a higher incidence occurring in younger women (90.4% vs 88.5%, P = 0.025). Prehospital cardiac arrest occurred more often in younger women (2.1% vs 0.8%, P < 0.001), and onset-to-balloon time was shorter (8.9 vs 15.2 hours, P < 0.0001) in this group. Younger women presented with a lower Killip class at admission (class I at admission: 92.7% vs 86.2%, P < 0.001). The dominant type of ACS in the younger cohort was ST-segment elevation myocardial infarction (STEMI) (42% vs 26.1%), localized mainly in the anterior wall (47.7% vs 36.1%, P < 0.001), with a higher percentage of total occlusion of infarct-related artery (TIMI 0, 45.2% vs 36.1%) and left anterior descending artery engagement for all (33.5% vs 26.5%, P < 0.001). Drug-eluting stents were often used in the younger patients (43.3% vs 38.2%, P = 0.003) without significant differences in percutaneous coronary intervention numbers. Pharmacotherapy was used less in younger women. The 30-day and 2-year mortality in young women was lower than in the older cohort. The clinical course of ACS in younger women differed in comparison to older women. Younger women had a higher occurrence of typical chest pain, STEMI, and left anterior descending artery engagement. Except STEMI patients young women received faster revascularization, however with no significant differences in invasive treatment. Pharmacotherapy was inadequate in younger women and that resulted in a lower usage of the beta-blockers, angiotensin-converting enzyme inhibitors, and statins in that group. Short- and long-term mortality was low, regardless of the type of ACS.

Factors Affecting Early Mortality and 1-Year Outcomes in Young Women With ST-Segment-Elevation Myocardial Infarction Aged Less Than or Equal to 45 Years.

Given that up to 2% of patients with myocardial infarction (MI) are young women, the purpose of this study was to evaluate factors affecting outcomes in young women with ST-segment-elevation myocardial infarction (STEMI) aged less than or equal to 45 years. We evaluated 796 women with STEMI aged less than or equal to 45 years between 2007 and 2014, and mortality was 4.0%. Death occurred more often in women with prehospital sudden cardiac arrest, and severe symptoms of heart failure; less commonly, the women were subjected to percutaneous coronary intervention (PCI), with a higher rate of incomplete revascularization. Beta blockers (BB) and angiotensin converting enzyme inhibitors were frequently used in the survivor group. The independent predictor of 30-day mortality was as follows: inability to undergo PCI (odds ratio [OR] 4.6, 95% confidence interval [CI] 1.45-14.76, P = 0.009), sudden cardiac arrest (OR 4.5, 95% CI 1.5-18.3, P = 0.04). An increase in systolic blood pressure for every 5 mm Hg was associated with lower mortality, OR 0.90, 95% CI 0.76-0.97 in patients without cardiogenic shock (CS) and OR 0.69, 95% CI 0.61-0.78, P < 0.0001 in the group with CS. Predictors for 1-year mortality were the inability to undergo PCI (hazard ratio [HR] 84, 95% CI 1.6-43.1, P = 0.01) and CS (HR 6.97, 95% CI 1.39-34.7, P = 0.01). An increase of 5% in left ventricular ejection fraction reduced the mortality rate for 60% (HR 0.40, 95% CI 0.26-0.63, P < 0.0001) and an increase in systolic blood pressure for every 5 mm Hg reduced mortality for 34% (HR 0.66, 95% CI 0.52-0.84, P = 0.02). Both short- and long-term outcomes in young women aged less than or equal to 45 years with STEMI are good. The strongest predictor for both 30-day and 1-year mortality was the inability to undergo PCI. Suboptimal use of beta blockers and angiotensin converting enzyme inhibitors affect the outcomes in young women. Hypotension in the acute phase of MI increased mortality in young women, independent of coexisting CS.

Risk factors predisposing to acute coronary syndromes in young women ≤45 years of age.

BACKGROUND: Acute coronary syndromes (ACS) are rare in young women. The purpose of this study was to characterize risk factors (RF) predisposing to ACS in young women and evaluate possible age-related differences. METHODS AND RESULTS: We studied 1941 young women with ACS aged ≤45 years (≤45ACS) from the PL-ACS registry and compared them with two control groups: 4275 women aged 63-64 years with ACS (63-64ACS) from the PL-ACS registry and 1170 young healthy women aged ≤45 years (≤45H) without confirmed coronary artery disease (CAD), from two national, representative, cross-sectional population health surveys, NATPOL 2011 and WOBASZ. The prevalence of major RF in these three groups was as follows, respectively: (≤45 ACS vs. 63-64ACS vs. ≤45H, for all P < 0.0001): hypertension 49.8% vs. 78.1% vs. 16.8%; hypercholesterolemia 36.1% vs. 44.3% vs. 12.9%; obesity 22.3% vs. 28.1% vs. 15.6%; diabetes 10.6% vs. 29.9% vs. 1.8% and smoking 48.7% vs. 22.2% vs. 39%. Healthy women had the lowest number of major RF (1.7 ±â€¯1.2 vs. 2.0 ±â€¯1.1 vs. 1.1 ±â€¯1.0). No RF was found in 16.7% vs. 8.2% vs. 34.4% women, respectively. Independent predictors of ACS in the ≤45ACS group included diabetes [odds ratio (OR) 6.66, 95% confidence interval (CI) 3.47-12.74]*, hypertension (OR 4.30, 95% CI 3.42-5.38)*, hypercholesterolemia (OR 3.45; 95% CI 2.60-4.29)*, and smoking (OR 1.63, 95% CI 1.34-1.98)*, *(P < 0.0001 for all). CONCLUSIONS: The prevalence of risk factors for acute coronary syndromes in young women with ACS is different to those in healthy women and to those in older women. The prevalence of smoking was higher. The strongest predictor of ACS in women ≤45 years of age was diabetes, with a 6-fold increase in risk. There is still need to improve the cardio-vascular primary prevention and health promotion in the population of young women.

Total coronary occlusion of infarct-related arteries in patients with non-ST-elevation myocardial infarction undergoing percutaneous coronary revascularisation.

BACKGROUND: The prevalence and impact of total coronary occlusion of an infarct-related artery (IRA) on outcomes in patients with non-ST-elevation myocardial infarction (NSTEMI) remain unclear. AIM: We evaluated the clinical significance of total coronary occlusion in NSTEMI patients. METHODS: A total of 2767 patients with NSTEMI enrolled in the Polish Registry of Acute Coronary Syndromes, who underwent percutaneous coronary interventions, were analysed. The patients were divided into two groups according to preprocedural culprit vessel thrombolysis in myocardial infarction (TIMI) flows (TIMI flow 0 - total coronary occlusion [TO]: 728, 26.3% of the patients, and TIMI flow 1-3 - non-total occlusion [non-TO]: 2039, 73.7% of the patients). RESULTS: Patients with total occlusion were younger, were more often current smokers, and had lower incidence of hypertension and diabetes mellitus. The left circumflex artery (LCx) was the major IRA in the TO group (48.1%), whereas the left anterior descending artery (LAD) was more commonly the IRA in the non-TO group (38.8%). Multivariate analysis revealed that LCx as the culprit lesion (OR ± 95 CI 1.54 [1.26-1.89], p < 0.0001) was an independent predictor of TIMI flow 0 in IRA. In-hospital and one-month mortality occurred more frequently in the TO group (4.0% vs. 1.7%, p = 0.0005 and 5.5% vs. 3.5%, p = 0.0175, respectively), no differences in the 12-, 24-, or 36-month mortalities were observed between these groups. CONCLUSIONS: Only LCx as a culprit lesion was an independent predictor of total occlusion in IRAs. The NSTEMI patients with TO had higher in-hospital and one-month mortalities, but their long-term outcomes were similar to those of non-TO patients.

Relationship between infarct artery location, acute total coronary occlusion, and mortality in STEMI and NSTEMI patients.

INTRODUCTION: The prevalence of total coronary occlusion of an infarct­related artery (IRA) and its impact on the outcome can differ between patients with non­ST­elevation myocardial infarction (NSTEMI) and those with ST­segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). OBJECTIVES: We evaluated the impact of IRA occlusion on the outcome of myocardial infarction according to the presence or absence of ST­segment elevation and the location of the culprit lesion. PATIENTS AND METHODS: We analyzed 4581 patients with STEMI and 2717 patients with NSTEMI who underwent PCI and were enrolled in the Polish Registry of Acute Coronary Syndromes. Patients were divided into 3 cohorts depending on the IRA: left anterior descending artery (LAD), left circumflex artery (LCx), or right coronary artery (RCA). Patients were further divided according to preprocedural Thrombolysis in Myocardial Infarction (TIMI) flow to either a subgroup with total occlusion (TO; TIMI flow grade, 0) or a subgroup with incomplete occlusion (nTO; TIMI flow grade ≥1). RESULTS: TO was observed in 2949 patients (64.4%) with STEMI and 723 patients (26.6%) with NSTEMI. The most common IRAs were the RCA (49.4%) and LCx (48.4%) in the STEMI and NSTEMI groups, respectively. STEMI patients with TO of the LAD showed higher mortality during the 36­month follow­up; mortality in the NSTEMI group was comparable between patients with TO and nTO. STEMI and NSTEMI groups with TO of the LCx showed higher in­hospital mortality. No differences were observed between patients with TO and nTO of the RCA. CONCLUSIONS: Totally occluded IRA (TIMI flow grade 0) on baseline angiogram was not associated with higher 36­month mortality rates after both NSTEMI and STEMI treated with PCI in comparison with patients with patent IRA except for totally occluded LAD in STEMI.

Post-procedural TIMI flow grade 2 is not associated with improved prognosis in patients with non-ST-segment elevation myocardial infarction undergoing percutaneous coronary revascularization (PL-ACS registry).

BACKGROUND: The impact of final Thrombolysis in Myocardial Infarction (TIMI) flow in the infarct-related artery (IRA) on outcomes in non-ST-segment elevation myocardial infarc-tion (NSTEMI) patients treated with percutaneous coronary intervention (PCI) is unknown. This study aimed to evaluate the impact of post-procedural TIMI flow in IRA on outcomes in NSTEMI patients undergoing percutaneous coronary revascularization. METHODS: We analyzed 2,767 patients with first NSTEMI from the Polish Registry of Acute Coronary Syndromes (PL-ACS) who underwent PCI. The patients were divided according to post-procedural culprit vessel TIMI (0-1: 90, 3.26%; 2: 61, 2.20%; 3: 2,616, 94.54%). RESULTS: The following mortality values were obtained in TIMI 0-1, 2, and 3 groups, respec-tively: in-hospital, 12.22%, 13.11%, 1.72% (p < 0.0001); 1-month, 13.33%, 13.11%, 3.44% (p < 0.0001); 12-month, 15.56%, 16.39%, 6.50% (p < 0.0001); 36-month, 25.56%, 21.31%, 13.91% (p = 0.0007). Mortality rates in patients with final TIMI 0-1 and 2 were not signifi-cantly different. Optimal TIMI 3 was independently associated with baseline TIMI 2-3 (OR ± ± 95% CI: 7.070 [4.35-11.82]), p < 0.0001; higher ejection fraction (1.30 [1.03-1.63]), p = 0.0038; and family history of coronary artery disease (2.83 [1.17-8.11]), p = 0.0294. Type C lesion, previous heart failure, and PCI without stenting independently predicted suboptimal TIMI 0-2. CONCLUSIONS: Only achieving final TIMI 3 in IRA improves outcomes in NSTEMI patients treated with percutaneous coronary revascularization. The mortality rate of near-normal TIMI 2 is comparable to that of TIMI 0-1 after PCI. (.

Acute coronary syndrome in a 100-year-old woman treated successfully with primary percutaneous coronary angioplasty.

We present a case of a 100-year-old woman living alone with ST-elevation myocardial infarction acute coronary syndrome of the infero-lateral wall treated with percutaneous coronary intervention. Coronary angiography revealed critical 99% stenosis in the marginal branch of the circumflex artery and insignificant lesions in other arteries. Two bare metal stents were implanted successfully in the same session. The patient was discharged home in good general condition, able to live and function independently.