Leadless pacemaker implantation with hybrid image mapping technique in a congenital heart disease case

Sinus venosus atrial septal defect (SVASD) is an interatrial communication caused by a deficiency of the common wall between the superior vena cava and the right-sided pulmonary veins. Implantation of a conventional pacemaker in this setting can be challenging. We report the feasibility of leadless pacemaker (LPM) implantation assisted by imaging integration and electroanatomical mappingS

Long-term cardiac reverse remodeling after cardiac resynchronization therapy

Introduction: The benefit of cardiac resynchronization therapy (CRT) in heart failure (HF) patients with reduced left ventricular ejection fraction (LVEF) have been observed in the first year. However, there are few data on long-term follow-up and the effect of changes of LVEF on mortality. This study aimed to assess the LV remodeling after CRT implantation and the probable effect of changes in LVEF with repeated measures on mortality over time in a real-world registry. Methods: Among our cohort of 328 consecutive CRT patients, mixed model effect analysis have been made to describe the temporal evolution of LVEF and LVESV changes over time up with several explanatory variables. Besides, the effect of LVEF along time on the probability of mortality was evaluated using joint modeling for longitudinal and survival data. Results: The study population included 328 patients (253 men; 70.2 ± 9.5 years) in 4.2 (2.9) years follow-up. There was an increase in LVEF of 11% and a reduction in LVESV of 42 mL during the first year. These changes are more important during the first year, but slight changes remain during the follow-up. The largest reduction in LVESV occurred in patients with left bundle branch block (LBBB) and the smallest reduction in patients with NYHA IV. The smallest increase in LVEF was an ischemic etiology, longer QRS, and LV electrode in a nonlateral vein. Besides, the results showed that the LVEF profiles taken during follow-up after CRT were associated with changes in the risk of death. Conclusion: Reverse remodeling of the left ventricle is observed especially during the first year, but it seems to be maintained later after CRT implantation in a contemporary cohort of patients. Longitudinal measurements could give us additional information at predicting the individual mortality risk after adjusting by age and sex compared to a single LVEF measurement after CRTS

Neuromodulatory Approaches for Atrial Fibrillation Ablation

In this review, the authors describe evolving alternative strategies for the management of AF, focusing on non-invasive and percutaneous autonomic modulation. This modulation can be achieved – among other approaches – via tragus stimulation, renal denervation, cardiac afferent denervation, alcohol injection in the vein of Marshall, baroreceptor activation therapy and endocardial ganglionated plexi ablation. Although promising, these therapies are currently under investigation but could play a role in the treatment of AF in combination with conventional pulmonary vein isolation in the near future

Novedades corológicas para la flora vascular de la sierra de Gredos (Sistema Central, España)

In the present paper, 58 chorological novelties for Gredos range (Central System, Spain) are showed. Some of them represent important disjunctions with respect to known Iberian distribution, as the cases of Cytinus ruber (Fourr.) Fritsh, Isolepis fluitans (L.) R.Br., Alyssum montanum L. and Lysimachia ephemerum L. Some species, such as Carex lainzii Luceño, E. Rico & T. Romero, Iberodes brassicifolia (Lag.) Serrano, R. Carbajal & S. Ortiz, Lycopodiella inundata (L.) J. Holub and Tephroseris coincyi (Rouy) Holub are of great interest from a conservational point of view. Finally, we present a number of provincial novelties, mainly for Ávil

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

TRY plant trait database – enhanced coverage and open access

Plant traits - the morphological, anatomical, physiological, biochemical and phenological characteristics of plants - determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait‐based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits - almost complete coverage for ‘plant growth form’. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait–environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives

Evaluation of tubal patency in repeat breeder Holstein cows

Aim of study: To evaluate tubal patency in repeat breeder Holstein cows with the purpose of estimating the frequency of oviduct obstruction as a cause of the repeat breeding syndrome. Area of study: Lugo (NW Spain) Material and methods: In 50 repeat breeding cows, a solution of the dye phenol-sulphon-phthalein (PSP) was instilled into one uterine horn with the aid of a balloon catheter. Urine was collected 15, 25 and 45 min post-PSP infusion. Urine of a reddish color was used as indicator of tubal patency, as the PSP had passed across the oviduct into the abdominal cavity and was eliminated in urine. The other oviduct was evaluated on a different day. Main results: Of the 50 cows tested, 44% had some degree of oviduct obstruction: 4% had bilateral oviduct occlusion, 20% unilateral oviduct occlusion, 16% bilateral oviduct stenosis and 4% unilateral oviduct stenosis. No significant relationship could be established between tubal impermeability and postpartum reproductive or metabolic diseases. Research highlights: Tubal stenosis or occlusions were frequent and they are likely to contribute to the repeat breeding syndrome in dairy cows; thus, tubal patency should be routinely evaluated in repeat breeders. The PSP test is easy to perform, well tolerated by animals, and allows evaluating both oviducts separately.Xunta de Galicia, Spain: Programme for consolidating and structuring competitive research groups: GRC2015/003. Xunta de Galicia, Spain: Project ‘RUMIGAL: Rede de estudo multidisciplinar dos ruminantes en Galicia R2014/005S