Preoperative Prediction of Catheter Ablation Outcome in Persistent Atrial Fibrillation Patients through Spectral Organization Analysis of the Surface Fibrillatory Waves

Catheter ablation (CA) is a commonly used treatment for persistent atrial fibrillation (AF). Since its medium/long-term success rate remains limited, preoperative prediction of its outcome is gaining clinical interest to optimally select candidates for the procedure. Among predictors based on the surface electrocardiogram, the dominant frequency (DF) and harmonic exponential decay (g) of the fibrillatory waves ( f -waves) have reported promising but clinically insufficient results. Hence, the main goal of this work was to conduct a broader analysis of the f -wave harmonic spectral structure to improve CA outcome prediction through several entropy-based measures computed on different frequency bands. On a database of 151 persistent AF patients under radio-frequency CA and a follow-up of 9 months, the newly introduced parameters discriminated between patients who relapsed to AF and those who maintained SR at about 70%, which was statistically superior to the DF and approximately similar to g. They also provided complementary information to g through different combinations in multivariate models based on lineal discriminant analysis and report classification performance improvement of about 5%. These results suggest that the presence of larger harmonics and a proportionally smaller DF peak is associated with a decreased probability of AF recurrence after CA

Respuesta reproductiva de conejas alimentadas con dietas enriquecidas con aceite de salmón

Un total de 136 conejas luníparasse alimentaron ad libitum desde las 10 semanas de edad con dos piensos isofibrosos, isoenergéticos e isoproteicos formulados con dos fuentes de grasa diferentes: manteca (grupo C; n=68) y un suplemento a base de aceite de salmón rico en ácidos grasos poliinsaturados (PUFA) n=3 (grupo P, n=68) con un nivel de inclusión de 1,5% (7,5g/kg) hasta el primer parto y de 3% (15g/kg) hasta el 2º destete. El peso y la composición corporal de las conejas a lo largo del estudio fueron similares entre grupos a pesar de que las conejas del grupo P redujeron el consumo al incrementar el nivel de inclusión de PUFA n-3. La prolificidad, el peso de los gazapos al nacimiento y el número de destetados fue similar en los dos grupos pero en los gazapos del grupo C la ganancia media diaria tendió a ser mayo, así como su peso al destete. No obstante, la fertilidad media fue más de un 12% superior en las conejas del grupo P, por lo que, el número estimado de gazapos destetados por coneja y año resultó mayor en ellas. En conclusión, el incremento en los niveles de inclusión de ácidos grasos poliisaturados n-3 de 7,5 a 15 g/kg después del primer parto disminuyó el consumo de las madres reduciendo el crecimiento de sus camadas pero incidiendo positivamente sobre su fertilidad

Levels and patterns of objectively assessed physical activity and compliance with different public health guidelines in university students

ArticleBackground Physical activity (PA) is associated with health enhancement. The aim of this study was to assess: 1) levels and patterns of PA in university students by using accelerometers; and 2) the percentage of fulfilment of PA recommendations for adults, according to different public health guidelines. Methods Observational cross-sectional study (Cuenca’s Adults Study) involving 296 (206 women) healthy Spanish university students aged 18–25 years old. Participants wore the ActiGraph GT1M accelerometer for seven consecutive days. Total PA, steps and time spent in sedentary time, light, moderate, vigorous, and moderate to vigorous PA (MVPA) was assessed, and the prevalence of sufficient PA was calculated according to various public health guidelines. Results No sex differences in total PA were found. University students were more sedentary during weekend days than weekdays (p<0.05). Only 30.3% of participants accumulated 30 min/day at least five days a week of MVPA. A total of 5.4% of students met the recommendation of 150 min/week of MVPA or 75 min/week of vigorous PA, in PA bouts of at least 10 min. using the same definition, but on five or more days a week, only 0.5% students were found to meet the recommendation. In addition, only 0.5% of students met the recommendation of 30 min/day of MVPA, at least five days a week and in bouts of at least 10 min. Finally, 28.1% of the students met the recommendation of 10,000 steps/day. Conclusions Our study shows a high incidence of sedentary time in university students. The number of students meeting PA recommendations significantly differed depending on the recommendation proposed. Specific strategies to promote PA in this population are necessary as well as an agreement as to which PA guidelines should be used.Fundación para la Investigación SanitariaMinistry of Health and Consumer AffairsInstituto de Salud Carlos IIIRed de Investigación en Actividades Preventivas y de Promoción de Salu

Spin diffusion versus proximity effect at ferromagnet/superconductor La_(0.7)Ca_(0.3)MnO_(3)/YBa_(2)Cu_(3)O_(7-δ) interfaces

We report on the interplay between magnetism and superconductivity in La_(0.7)Ca_(0.3)MnO_(3)/YBa_(2)Cu_(3)O_(7) structures. We have grown heterostructures (bilayers and trilayers) with a constant thickness of the ferromagnetic layer of 40 unit cells (15 nm) and changing the thickness of the superconductor between 1 (1.2 nm) and 40 unit cells (48 nm). The critical temperature of the bilayers decreases when the thickness of the superconductor is reduced below 10 unit cells, thus providing an estimate of the length scale of superconductivity suppression by spin-polarized quasiparticles in YBa_(2)Cu_(3)O_(7-δ) (YBCO) of 10 nm, much larger than the coherence length. For thickness of the YBCO layer smaller than 4 unit cells; a second mechanism of superconductivity depression comes into play, probably related to the ferromagnetic/superconducting proximity effect. The relative importance in depressing the critical temperature of intrinsic mechanisms (quasiparticle diffusion and proximity effect) and extrinsic ones (intralayer disorder, interface roughness, or reduced dimensionality of ultrathin layers) is discussed

Impact of antibiotic timing on mortality from Gram-negative bacteraemia in an English district general hospital: the importance of getting it right every time

Objectives: There is limited evidence that empirical antimicrobials affect patient-oriented outcomes in Gram-negative bacteraemia. We aimed to establish the impact of effective antibiotics at four consecutive timepoints on 30 day all-cause mortality and length of stay in hospital. / Methods: We performed a multivariable survival analysis on 789 patients with Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa bacteraemias. Antibiotic choices at the time of the blood culture (BC), the time of medical clerking and 24 and 48 h post-BC were reviewed. / Results: Patients that received ineffective empirical antibiotics at the time of the BC had higher risk of mortality before 30 days (HR = 1.68, 95% CI = 1.19–2.38, P = 0.004). Mortality was higher if an ineffective antimicrobial was continued by the clerking doctor (HR = 2.73, 95% CI = 1.58–4.73, P < 0.001) or at 24 h from the BC (HR = 1.83, 95% CI = 1.05–3.20, P = 0.033) when compared with patients who received effective therapy throughout. Hospital-onset infections, ‘high inoculum’ infections and elevated C-reactive protein, lactate and Charlson comorbidity index were independent predictors of mortality. Effective initial antibiotics did not statistically significantly reduce length of stay in hospital (−2.98 days, 95% CI = −6.08–0.11, P = 0.058). The primary reasons for incorrect treatment were in vitro antimicrobial resistance (48.6%), initial misdiagnosis of infection source (22.7%) and non-adherence to hospital guidelines (15.7%). / Conclusions: Consecutive prescribing decisions affect mortality from Gram-negative bacteraemia

Long-term outcome and risk factors for late mortality in Gram-negative bacteraemia: a retrospective cohort study

OBJECTIVES: The long-term outcomes of patients following Gram-negative bacteraemia (GNB) are poorly understood. We describe a cohort of patients with GNB over a two-year period and determine factors associated with late mortality (death between days 31 and 365 after detection of bacteraemia). METHODS: This is a single center retrospective observational cohort study of 789 patients with confirmed Escherichia coli, Klebsiella spp and Pseudomonas aeruginosa bacteraemias with a follow-up of one year. Multivariable survival analysis was used to determine the risk factors for late mortality in patients who survived the initial 30-day period of infection. RESULTS: Overall, one-year all-cause mortality was 36.2%, with 18.1% of patients dying within 30 days and 18.1% of patients suffering late mortality. An adverse antimicrobial resistance profile (HR 1.095 per any additional antimicrobial category, 95% CI 1.018 - 1.178, p = 0.014) and infection with Pseudomonas aeruginosa (HR 2.08, 95% CI 1.11 - 3.88, p = 0.022) were independent predictors of late mortality. Other significant factors included the Charlson Comorbidity Index and hospitalization length after the index blood culture. CONCLUSION: Patients with GNB have a poor long-term prognosis. Risk factors for greater mortality at one year include comorbidity, hospitalization length, the infecting organism, and its resistance profile

Integrin activation - the importance of a positive feedback

Integrins mediate cell adhesion and are essential receptors for the development and functioning of multicellular organisms. Integrin activation is known to require both ligand and talin binding and to correlate with cluster formation but the activation mechanism and precise roles of these processes are not yet resolved. Here mathematical modeling, with known experimental parameters, is used to show that the binding of a stabilizing factor, such as talin, is alone insufficient to enable ligand-dependent integrin activation for all observed conditions; an additional positive feedback is required.Comment: in press in Bulletin of Mathematical Biolog

Circulating concentrations of free triiodothyronine are associated with central adiposity and cardiometabolic risk factors in young euthyroid adults

Funding for open access charge: Universidad de Granada/CBUA. This study was funded by the Spanish Ministry of Economy and Competitiveness via the Fondo de Investigacion Sanitaria del Instituto de Salud Carlos III (PI13/01393), by the Retos de la Sociedad program (DEP2016-79512-R), European Regional Development Funds (ERDF), the Spanish Ministry of Education (FPU13/04365), the Fundacion Iberoamericana de Nutricion (FINUT), the Redes Tematicas de Investigacion Cooperativa RETIC (Red SAMID RD16/0022), the AstraZeneca HealthCare Foundation, the University of Granada Plan Propio de Investigacion 2016-Excellence actions: Unit of Excellence on Exercise and Health (UCEES)-and Plan Propio de Investigacion 2018-the Programa Contratos-Puente and Contratos Perfeccionamiento de Doctores, the Junta de Andalucia, Consejeria de Conocimiento, Investigacion y Universidades (ERDF; ref. SOMM17/6107/UGR), and the Fundacion Alfonso Martin Escudero (grant awarded to GSD).Thyroid dysfunction is associated with classic cardiometabolic risk factors in humans. However, this relationship remains unclear in young euthyroid adults. The present work examines the associations of circulating thyroid hormones (THs) and thyroid-stimulating hormone (TSH) concentrations with body composition and cardiometabolic risk factors in young euthyroid adults. A total of 106 sedentary, euthyroid adults (72 women; 22 ± 2 years old) participated in this cross-sectional study. THs and TSH serum concentrations were determined in fasting conditions (6 h). Body composition (fat mass (FM), lean mass (LM), and visceral adipose tissue (VAT)) was determined by dual-energy X-ray absorptiometry, anthropometric parameters (weight, height, and waist circumference) were measured, and neck adipose tissue mass was quantified through computed tomography (CT) scanning. Cardiometabolic risk factors including fasting glucose and lipid metabolism markers, hepatic phosphatase and transaminases, and blood pressure were also assessed. Free triiodothyronine (FT3) concentration was positively associated with body mass index, LM, VAT, and waist circumference (all P ≤ 0.038). FT3 was also associated with glucose, insulin, HOMA-IR, fatty liver index, and blood pressure (all P < 0.024). All the associations were attenuated when adjusting for sex. In contrast, we found no associations of TSH or free thyroxine with any body composition parameter or cardiometabolic risk factors. In conclusion, FT3 is associated with central adiposity and cardiometabolic risk factors including insulin resistance, fatty liver index, and mean, systolic and diastolic blood pressure in young euthyroid adults. ClinicalTrials.gov identifier: NCT02365129.Universidad de Granada/CBUASpanish Government PI13/01393Retos de la Sociedad program DEP2016-79512-REuropean CommissionSpanish Government FPU13/04365Fundacion Iberoamericana de Nutricion (FINUT)Redes Tematicas de Investigacion Cooperativa RETIC Red SAMID RD16/0022AstraZenecaUniversity of Granada Plan Propio de Investigacion 2016-Excellence actions: Unit of Excellence on Exercise and Health (UCEES)Plan Propio de Investigacion 2018-the Programa Contratos-PuenteContratos Perfeccionamiento de DoctoresJunta de AndaluciaConsejeria de Conocimiento, Investigacion y Universidades (ERDF) SOMM17/6107/UGRFundacion Alfonso Martin Escuder