Prevalence of cardiac arrhythmias among patients undergoing chronic hemodialysis

Aim. To evaluate the prevalence of arrhythmias in patients undergoing chronic hemodialysis, to characterize the arrhythmia types in relation to the dialysis procedure and to determine their relationship with clinical findings and echocardiographic characteristics.Material and methods. The study involved 152 patients with kidney failure undergoing chronic hemodialysis. All patients underwent an assessment of dialysis parameters, collection of clinical data, and 48-hour Holter monitoring. In addition, 93 patients underwent an echocardiography with an assessment of left ventricular (LV) mass index, LV ejection fraction, left atrial (LA) volume index, E/e’, cardiac output and preload, which was defined as increased LV filling pressure (E/e’ >12) and LA enlargement (LA volume index >30 ml/m2).Results. Among the 152 examined patients, premature supraventricular and ventricular contractions (PVCs) were observed in almost all patients, while 41% had paroxysmal supraventricular tachycardia. Clinically significant arrhythmias included persistent atrial fibrillation (AF) in 8,6% of patients, paroxysmal AF in 3,9%, nonsustained ventricular tachycardia in 19,7%, bradycardia in 4,6%, second-degree atrioventricular block in 1,3% and third-degree atrioventricular block among 2,6%. PVCs were more common on dialysis days, while tachyarrhythmias were more common during dialysis and in the immediate post- dialysis period. Older age (odds ratio (OR) 10 years older, 1,53; 95% confidence interval (CI): 1,15-2,03; P=0,003), lower cardiac output (OR 1 L/min more, 0,66; 95% CI: 0,44-1,00; P=0,05) were independently associated with clinically relevant arrhythmias.Conclusion. In patients on chronic hemodialysis, older age, increased preload and lower cardiac output are independently associated with clinically relevant arrhythmias. In addition, a positive association between increased LV mass index and AF episodes has been demonstrated. Lower cardiac output had positive correlation with AF and ventricular arrhythmias

Rapid synthesis and enhancement in down conversion emission properties of BaAl2O4:Eu2+,RE3+ (RE3+=Y, Pr) nanophosphors

[EN] BaAl2O4:Eu2+,RE3+ (RE3+=Y, Pr) down conversion nanophosphors were prepared at 600 °C by a rapid gel combustion technique in presence of air using boron as flux and urea as a fuel. A comparative study of the prepared materials was carried out with and without the addition of boric acid. The boric acid was playing the important role of flux and reducer simultaneously. The peaks available in the XPS spectra of BaAl2O4:Eu2+ at 1126.5 and 1154.8 eV was ascribed to Eu2+(3d5/2) and Eu2+(3d3/2) respectively which confirmed the presence of Eu2+ ion in the prepared lattice. Morphology of phosphors was characterized by tunneling electron microscopy. XRD patterns revealed a dominant phase characteristics of hexagonal BaAl2O4 compound and the presence of dopants having unrecognizable effects on basic crystal structure of BaAl2O4. The addition of boric acid showed a remarkable change in luminescence properties and crystal size of nanophosphors. The emission spectra of phosphors had a broad band with maximum at 490–495 nm due to electron transition from 4f65d1 → 4f7 of Eu2+ ion. The codoping of the rare earth (RE3+=Y, Pr) ions help in the enhancement of their luminescent properties. The prepared phosphors had brilliant optoelectronic properties that can be properly used for solid state display device applications.The authors gratefully recognize the financial support from the University Grant Commission (UGC), New Delhi [MRP-40-73/2011(SR)] and the European Commission through Nano CIS project (FP7-PEOPLE-2010-IRSES ref. 269279).Singh, D.; Tanwar, V.; Simantilke, AP.; Marí, B.; Kadyan, PS.; Singh, I. (2016). Rapid synthesis and enhancement in down conversion emission properties of BaAl2O4:Eu2+,RE3+ (RE3+=Y, Pr) nanophosphors. Journal of Materials Science: Materials in Electronics. 27(3):2260-2266. https://doi.org/10.1007/s10854-015-4020-1S22602266273J.S. Kim, P.E. Jeon, J.C. Choi, H.L. Park, S.I. Mho, G.C. Kim, Appl Phys Lett 84, 2931 (2004)D. Jia, D.N. Hunter, J Appl Phys 100, 1131251 (2006)H. Aizawa, T. Katsumata, J. Takahashi, K. Matsunaga, S. Komuro, T. Morikawa, E. Toba, Rev Sci Instrum 74, 1344 (2003)C.N. Xu, X.G. Zheng, M. Akiyama, K. Nonaka, T. Watanabe, Appl Phys Lett 76, 179 (2000)C. Feldmann, T. Justel, C.R. Ronda, P.J. Schmidt, Adv Funct Mater 13, 511 (2004)P.J. Saines, M.M. Elcombe, B.J. Kennedy, J Solid State Chem 179, 613 (2006)R. Sakai, T. Katsumata, S. Komuro, T. Morikawa, J Lumin 85, 149 (1999)T. Aitasalo, P. Deren, J Solid State Chem 171, 114 (2003)S. Nakamura, T. Mukai, M. Senoh, J Appl Phys 76, 8189 (1994)S.H.M. Poort, G. Blasse, J Lumin 72, 247 (1997)P. Mingying, H. Guangyan, J Lumin 127, 735 (2007)X. Linjiu, H. Mingrui, T. Yanwen, C. Yongjie, K. Tomoaki, Z. Liqing, W. Ning, Jap J Applied Physics 46, 5871 (2007)T. Aitasalo, J. Hölsä, H. Jungner, M. Lastusaari, J. Niittykoski, J Phys Chem B 110, 4589 (2006)R. Stefani, L.C.V. Rodrigues, C.A.A. Carvalho, M.C.F.C. Felinto, H.F. Brito, M. Lastusaari, J. Hölsä, Opt Mater 31, 1815 (2009)M. Peng, G. Hong, J Lumin 127, 735 (2007)V. Singh, V. Natarajan, J.J. Zhu, Opt Mater 29, 1447 (2007)X.Y. Chen, C. Ma, X.X. Li, C.W. Shi, X.L. Li, D.R. Lu, J Phys Chem C 113, 2685 (2009)A.J. Zarur, J.Y. Ying, Nature 403, 65 (2000)J. Chen, F. Gu, C. Li, Cry Growth Des 8, 3175 (2008)J. Zhang, M. Yang, H. Jin, X. Wang, X. Zhao, X. Liu, L. Peng, Mater Res Bull 47, 247 (2012)P. Maślankiewicz, J. Szade, A. Winiarski, Ph Daniel, Cryst Res Technol 40, 410 (2005)Y.J. Chen, G.M. Qiu, Y.B. Sun et al., J Rare Earths 20, 50 (2002)F.C. Palilla, A.K. Levine, M.R. Tomkus, J Electrochem Soc 115, 642 (1968)J. Niittykoski, T. Aitasalo, J. Holsa, H. Jungner, M. Lastusaari, M. Parkkinen, M. Tukia, J Alloys Compd 374, 108 (2004)A. Nag, T.R.N. Kutty, J Alloys Compd 354, 221 (2003)D. Haranath, P. Sharma, H. Chander, J Phys D Appl Phys 38, 371 (2005

Predictors of the experience of a Cytosponge test: analysis of patient survey data from the BEST3 trial

Availability of data and materials: The trial protocol, statistical analysis plan, and statistical report are available via the University of Cambridge data repository (https://www.data.cam.ac.uk/repository). Datasets will be available from R Fitzgerald ([email protected]) on request.Copyright © The Author(s) 2023. Background: The Cytosponge is a cell-collection device, which, coupled with a test for trefoil factor 3 (TFF3), can be used to diagnose Barrett’s oesophagus, a precursor condition to oesophageal adenocarcinoma. BEST3, a large pragmatic, randomised, controlled trial, investigated whether offering the Cytosponge-TFF3 test would increase detection of Barrett’s. Overall, participants reported mostly positive experiences. This study reports the factors associated with the least positive experience. Methods: Patient experience was assessed using the Inventory to Assess Patient Satisfaction (IAPS), a 22-item questionnaire, completed 7–14 days after the Cytosponge test. Study cohort: All BEST3 participants who answered ≥ 15 items of the IAPS (N = 1458). Statistical analysis: A mean IAPS score between 1 and 5 (5 indicates most negative experience) was calculated for each individual. ‘Least positive’ experience was defined according to the 90th percentile. 167 (11.4%) individuals with a mean IAPS score of ≥ 2.32 were included in the ‘least positive’ category and compared with the rest of the cohort. Eleven patient characteristics and one procedure-specific factor were assessed as potential predictors of the least positive experience. Multivariable logistic regression analysis using backwards selection was conducted to identify factors independently associated with the least positive experience and with failed swallow at first attempt, one of the strongest predictors of least positive experience. Results: The majority of responders had a positive experience, with an overall median IAPS score of 1.7 (IQR 1.5–2.1). High (OR = 3.01, 95% CI 2.03–4.46, p < 0.001) or very high (OR = 4.56, 95% CI 2.71–7.66, p < 0.001) anxiety (relative to low/normal anxiety) and a failed swallow at the first attempt (OR = 3.37, 95% CI 2.14–5.30, p < 0.001) were highly significant predictors of the least positive patient experience in multivariable analyses. Additionally, sex (p = 0.036), height (p = 0.032), alcohol intake (p = 0.011) and education level (p = 0.036) were identified as statistically significant predictors. Conclusion: We have identified factors which predict patient experience. Identifying anxiety ahead of the procedure and discussing particular concerns with patients or giving them tips to help with swallowing the capsule might help improve their experience. Trial registration ISRCTN68382401.The BEST3 trial was funded by Cancer Research UK (C14478/A21047), National Institute for Health Research covering service support costs, the UK National Health Service funding excess treatment costs and Medtronic providing funding for Cytosponge devices and TFF3 antibodies. RCF is funded by a Programme Grant from the Medical Research Council (RG84369) and is CI for the BEST3 trial and the Innovate UK funded DELTA study. JO was supported by PDS’s Cancer Research UK programme Grant (C8162/A16892) and is currently supported by the Barts Charity (EMSG1K1R). RM was supported by PDS’ Cancer Research UK Cancer Prevention Clinical Trials Unit funding (Grant No.: C8162/A25356). SGS is supported by a Yorkshire Cancer Research Fellowship. JW is funded by a Cancer Research UK career development fellowship (C7492/A17219). BG was funded as part of the DELTA study by Innovate UK (Grant No. 41162). FW is supported by the Cancer Research UK CanTest Grant [C8640/A23385]. RL is supported by the Intramural Research Program of the US National Institutes of Health/National Cancer Institute

Are Emerging Technologies Unlocking the Potential of Sustainable Practices in the Context of a Net Zero Economy? An Analysis of Driving Forces

Increasing globalization and climate change have significantly affected business activities. Government and other stakeholders are creating pressure to have a sustainable business model for efficient resource utilization and minimizing negative environmental impact. Many organizations have started focusing on sustainable and cleaner production through the adoption of net zero economy (NZE) practices. Certain technological advancements are required to put these concepts into practice. Firms have begun to adopt digital technologies (such as Big Data Analytics, Artificial Intelligence, and Internet of Things, among others), and have been widely used in practice to achieve NZE. Is digitalization unlocking the potential of sustainable practices in the context of a net zero economy? This question is still unanswered, therefore this study aims to identify and analyse the drivers of digitalization that ensure sustainable practices to achieve net zero economy. Through an extensive literature review and experts’ opinions, a list of drivers was identified. An empirical investigation was conducted to validate the identified drivers and further understand the influencing relationship among the drivers, Pythagorean Fuzzy-Decision Making Trial and Evaluation Laboratory (PF-DEMATEL) was employed. The findings of the study show that ‘high degree of automation’, ‘enhancing the flexibility in the manufacturing process’, and ‘real-time sensing capability’ are the main influencer drivers among all cause group forces. The present study can be a source for industrial practitioners and academia that can provide significant guidance on how the adoption of digitalization can unlock the potential to achieve CE, which can lead us towards net-zero

Large proximal ureteral stones: Ideal treatment modality?

Background and Purpose: Ideal treatment modality for patients with large impacted proximal ureteral stone remains controversial. We compared laparoscopic transperitoneal ureterolithotomy (Lap-TPUL) and semirigid ureteroscopy for large proximal ureteric stones to evaluate their efficacy and safety. Patients and Methods: From November 2012 to December 2014, we enrolled 122 patients with large (≥1.5 cm) proximal ureteral stone in the study. Patients were randomly divided into two groups: Group A (60 patients), retrograde ureteroscopic lithotripsy using a semirigid ureteroscope; Group B (62 patients), transperitoneal LU (Lap-TPUL). Results: The overall stone-free rate was 71.6% and 93.5% for Group A and Group B respectively (P = 0.008). Auxiliary procedure rate was higher in Group A than in Group B (27.3% vs. 5.6%). The complication rate was 11.2% in Group B versus 25% in Group A. Mean procedure time was higher in laparoscopy group as compared to ureterorenoscopy (URS) groups (84.07 ± 16.80 vs. 62.82 ± 12.71 min). Hospital stay was 4.16 ± 0.67 days in laparoscopy group and 1.18 ± 0.38 days in URS group (P < 0.0001). Conclusion: Laparoscopic transperitoneal ureterolithotomy is a minimally invasive, safe and effective treatment modality and should be recommended to all patients of impacted large proximal stones, which are not amenable to URS or extracorporeal shock-wave lithotripsy or as a primary modality of choice especially if patient is otherwise candidate for open surgery