Hemolysis, myocardial and neural injury after monopolar pulsed field ablation using a novel lattice-tip catheter to treat atrial fibrillation.

Background And Aims: Aim of this study was to assess the risk of hemolysis, the extent of myocardial and neural injury after monopolar, monophasic pulsed field ablation (PFA) using a lattice-tip catheter in comparison to single-shot PF ablation platforms employing bipolar, biphasic waveforms.

Methods: This prospective study included consecutive patients undergoing PFA for atrial fibrillation (AF) using the Affera™ mapping and ablation system (n=40). Biomarkers for hemolysis (haptoglobin, LDH, bilirubin), myocardial injury (high-sensitive troponin T, CK, CK-MB), neurocardiac injury (S100), and renal function (creatinine) were assessed pre- and within 24 hours post-ablation.

Shrinking to bird size with dinosaur-level cancer defences: Evolution of cancer suppression over macroevolutionary time.

Ubiquity of cancer across the tree of life yields opportunities to understand variation in cancer defences across species. Peto's paradox, the finding that large-bodied species do not suffer from more cancer despite having more cells at risk of oncogenic mutations compared to small species, can be explained if large size selects for better cancer defences. Since birds live longer than non-flying mammals of equivalent size, and are descendants of moderate-sized dinosaurs, we ask whether ancestral cancer defences are retained if body size shrinks in a lineage.

Sensory processing patterns in pediatric mild traumatic brain injury: A longitudinal study.

Sensory processing (SP) difficulties, such as heightened sensitivity to sensory input, have been linked to prolonged recovery and persistent post-concussive symptoms in adults following mild traumatic brain injury (mTBI). However, research on SP across different sensory inputs after pediatric mTBI is limited. This study examined SP patterns in children and adolescents aged 6-17 years with mTBI at 2 weeks and 6 months post-injury.

Protocol for a core outcome set for pharmacological treatments in hospitalised patients with acute viral respiratory infections (COSAVRI).

Background: Acute viral respiratory infections (AVRIs) rank among the most common causes of hospitalisation worldwide, imposing significant healthcare burdens and driving the development of pharmacological treatments. However, inconsistent outcome reporting across clinical trials limits evidence synthesis and its translation into clinical practice. A core outcome set (COS) for pharmacological treatments in hospitalised adults with AVRIs is essential to standardise trial outcomes and improve research comparability.

Towards a definition of an existential approach in cancer patients: a co-produced scoping review.

Background: Attention to existential needs has become part of daily treatment. Studies have described the concepts of existential experiences and existential interventions. However, a consensus or conceptual clarity regarding an existential approach in cancer patients is currently missing.

Evaluation of diagnostic measurements in patients with non-specific complaints: A secondary analysis after implementation of a care-pathway in the emergency department.

Background: Older patients presenting with nonspecific complaints (NSC) in the Emergency Department (ED) pose diagnostic challenges. The lack of clear symptoms leads to high misdiagnosis rates, extended hospital stays, and functional impairment. However, limited research exists on diagnostic test utilization for this population.

Study Protocol of the 10-year longitudinal Amersfoort Cohort Study on Functional decline, Healthy aging, and Frailty (AMCOHF) in a community-dwelling older population.

Introduction: Frailty, characterized by a reduction in intrinsic capacity across multiple physiological systems, is a key concern in healthy aging. Insight in the trajectory of an individual's functional ability and intrinsic reserve capacity in a relatively younger population of older adults is lacking. This study aims to investigate the early stages of frailty by tracking trajectories of physical indicators of intrinsic capacity before frailty becomes clinically evident.

Sex differences in allostatic load profiles and incident dementia: The AGES-Reykjavik Study.

BackgroundAllostatic load (AL), an umbrella term for the physiological response to chronic stress, is different in women and men. AL has also been associated with all-cause dementia.ObjectiveThe current study investigates if AL clusters differently in men and women, and if these sex-based clusters are associated with all-cause dementia.

Impact of hand function impairment on daily life of patients with systemic sclerosis: a qualitative study.

Objectives: Many patients with systemic sclerosis (SSc) experience impaired hand function, yet the precise nature and impact of this impairment remains unclear. In this study, we explored the determinants of hand function impairment in SSc from a patient perspective and its impact on daily life. Additionally, we identified unmet care needs related to hand function impairment.

Prenatal SMN-dependent defects in translation uncover reversible primary cilia phenotypes in spinal muscular atrophy.

Spinal muscular atrophy (SMA) is a neuromuscular disease caused by low levels of SMN protein. Several therapeutic approaches boosting SMN are approved for human patients, delivering remarkable improvements in lifespan and symptoms. However, emerging phenotypes, including neurodevelopmental comorbidities, are being reported in some treated SMA patients, indicative of alterations in brain development.

Effect of knee joint position on soleus muscle function during isokinetic plantarflexion.

Purpose: Contribution of the gastrocnemii muscles to ankle moment is influenced by the knee joint position because they span the knee and the ankle joint as well. However, limited information is available on the effect of knee joint position on soleus activation under dynamic plantarflexion, hence the aim of this study was to investigate if soleus have a compensatory strategy in fascicle behavior or EMG activity during knee flexed plantarflexion in order to reduce the magnitude of the decrement in ankle moment.

Equipment And Methods: Isokinetic dynamometry with EMG and ultrasound measurements was used to estimate medial gastrocnemius and soleus behavior during knee flexed and extended plantarflexions using three angular velocities.

Neural correlates of Bayesian social belief updating in the medial prefrontal cortex.

Social learning, a hallmark of human behavior, entails integrating other's actions or ideas with one's own. While it can accelerate the learning process by circumventing slow and costly individual trial-and-error learning, its effectiveness depends on knowing when and whose information to use. In this study, we explored how individuals use social information based on their own and others' levels of uncertainty.

Cortical response to transient and long-term visual field loss.

In the visual cortices, receptive fields (RFs) are arranged in a gradient from small sizes in the center of the visual field to the largest sizes at the periphery. Using functional magnetic resonance imaging (fMRI) mapping of population RFs, we investigated RF adaptation in V1, V2, and V3 in patients after long-term photoreceptor degeneration affecting the central (Stargardt disease [STGD]) and peripheral (Retinitis Pigmentosa [RP]) regions of the retina. In controls, we temporarily limited the visual field to the central 10° to model peripheral loss.

Lymphotoxin beta receptor mice display altered B- and T-cell subpopulations in the bone marrow and peritoneal cavity after infection.

Lymphotoxin β receptor (LTβR/TNFRSF3) signaling plays a crucial role in immune defense. Notably, LTβR-deficient (LTβR) mice exhibit severe defects in innate and adaptive immunity against various pathogens and succumb to infection. Here, we investigated the bone marrow (BM) and peritoneal cavity (PerC) compartments of LTβR mice during infection, demonstrating perturbed B-cell and T-cell subpopulations in the absence of LTβR signaling.

Targeting the Epigenetic Remodeler GCN5 Prevents Vascular Oxidative Stress and Endothelial Dysfunction in Obesity: Insights in Patients with Cardiometabolic Disease.

Introduction: Epigenetic changes are important modulators of gene expression. The histone acetyltransferase gene non-derepressible 5 (Gcn5) is emerging as a pivotal epigenetic player in metabolism and cancer, yet its role in obesity and cardiovascular disease remains elusive.

Aims: To investigate Gcn5 role in obesity-related endothelial dysfunction.

Machine learning for myocarditis diagnosis using cardiovascular magnetic resonance: a systematic review, diagnostic test accuracy meta-analysis, and comparison with human physicians.

Myocarditis is an inflammation of heart tissue. Cardiovascular magnetic resonance imaging (CMR) has emerged as an important non-invasive imaging tool for diagnosing myocarditis, however, interpretation remains a challenge for novice physicians. Advancements in machine learning (ML) models have further improved diagnostic accuracy, demonstrating good performance.

Experiences and challenges of implementing clinical medication reviews in daily practice: a mixed-methods study.

Introduction: Organisational problems still prevent widespread implementation of clinical medication reviews. The Opti-Med2 method was developed to facilitate the process of performing clinical medication reviews. The method includes patient involvement by means of a questionnaire and expert teams of community pharmacists and general practitioners (GPs) to perform pharmacotherapeutic analyses, providing the patients' own GP with pharmacotherapeutic advice.

Target controlled infusion in the intensive care unit: a scoping review.

Target-controlled infusion (TCI) systems, originally developed for intravenous drug administration of anesthetic drugs, enable precise drug delivery based on pharmacokinetic-pharmacodynamic (PKPD) models. While widely used in the operating room, their application in the intensive care unit (ICU) remains limited despite the complexity of drug dosing in critically ill patients. This scoping review evaluates existing evidence on the use of TCI systems in ICU settings, focusing on sedation, analgesia, and antibiotic administration.

Hair analysis for monitoring adherence to inhaled respiratory medications: possibilities and limitations.

Purpose: Non-adherence to inhaled medication poses a significant clinical and economic burden on patients with respiratory diseases. This narrative review provides an overview of key aspects of hair analysis, in general and specific for inhaled medications, and explores the potential of hair analysis as a novel tool to monitor adherence to inhaled medications.

Methods: PubMed searches were conducted to explore four aspects: (1) mechanisms of (inhaled) drug's systemic absorption and deposition in hair; (2) quantification of drugs in hair; (3) factors impacting (inhaled) drug hair concentrations; and (4) clinical studies assessing inhaled medication adherence through hair analysis.

Influence of ultrafiltration conditions on the unbound fraction of phenytoin and valproic acid.

Purpose: This study was designed to analyse the influence of temperature, pH and storage time on unbound fractions of PHT and VPA.

Methods: The influence of ultrafiltration (UF) temperature on measured unbound fractions of PHT and VPA in spiked samples was evaluated in a single laboratory experiment and in data from a national external quality control (EQC) database. The influence of pH adjustment with phosphate buffered saline (PBS) on measured unbound fractions of PHT and VPA was investigated in patient samples.

Validation of angiography-based FFR in non-culprit vessels of patients presenting with STEMI.

Background: Fractional flow reserve (FFR) for non-culprit lesions (NCLs) in patients with ST-elevation myocardial infarction (STEMI) can be influenced by temporary changes in microvascular resistance. Angiography-derived vessel fractional flow reserve (vFFR) has been tested as a less-invasive alternative.

Aims: The FAST STEMI II study aimed to assess the diagnostic performance of acute-setting vFFR vs.

Time below range alone is insufficient to identify severe hypoglycaemia risk in type 1 diabetes-the critical role of hypoglycaemia awareness: results from the SFDT1 study.

Aims/hypothesis: Severe hypoglycaemia events (SHE) remain frequent in people with type 1 diabetes despite advanced diabetes technologies. We examined whether time below range (TBR) 3.9 mmol/l (70 mg/dl; TBR70) or 3.

Identifying rehabilitation needs as part of secondary prevention in individuals with Atrial Fibrillation - a Delphi consensus study.

Aim: This study aimed to establish general consensus on a systematic needs assessment model to determine eligibility for cardiac rehabilitation (CR) as part of secondary prevention in individuals with atrial fibrillation (AF). Specific objectives included identifying relevant needs assessment criteria and establishing consensus on referral criteria.

Methods: A Delphi study was conducted following the ACCORD guidelines (ACcurate COnsensus Reporting Document) with participation of an international, multi-disciplinary expert panel including physicians, nurses and other healthcare professionals, across primary and secondary care as well as academic research.

Lacrimal gland ultrasonography shows superior reliability of OMERACT colour Doppler scoring compared to B-mode, in patients with clinically suspected Sjögren's disease.

Objective: To investigate the reliability of lacrimal gland ultrasound (LGUS) in patients with clinically suspected Sjögren's disease (SjD).

Method: Of 41 consecutive patients with clinically suspected SjD, 28 were diagnosed with SjD and 13 were classified as non-SjD. Forty patients were scored for bilateral lacrimal gland (LG) B-mode evaluation; LGs were 'not visible' in one case.