A novel image integration technology mapping system significantly reduces radiation exposure during ablation for a wide spectrum of tachyarrhythmias in children

ObjectiveRadiofrequency catheter ablation (RFCA) has evolved into an effective and safe technique for the treatment of tachyarrhythmia in children. Concerns about children and involved medical staff being exposed to radiation during the procedure should not be ignored. “Fluoroscopy integrated 3D mapping”, a new 3D non-fluoroscopic navigation system software (CARTO Univu Module) could reduce fluoroscopy during the procedure. However, there are few studies about the use of this new technology on children. In the present study, we analyzed the impact of the CARTO Univu on procedural safety and fluoroscopy in a wide spectrum of tachyarrhythmias as compared with CARTO3 alone.MethodsThe data of children with tachyarrhythmias who underwent RFCA from June 2018 to December 2021 were collected. The CARTO Univu was used for mapping and ablation in 200 cases (C3U group) [boys/girls (105/95), mean age (6.8 ± 3.7 years), mean body weight (29.4 ± 7.9 kg)], and the CARTO3 was used in 200 cases as the control group (C3 group) [male/female (103/97), mean age (7.2 ± 3.9 years), mean body weight (32.3 ± 19.0 kg)]. The arrhythmias were atrioventricular reentrant tachycardia (AVRT, n = 78), atrioventricular node reentrant tachycardia (AVNRT, n = 35), typical atrial flutter (AFL, n = 12), atrial tachycardia (AT, n = 20) and ventricular arrhythmias [VAs, premature ventricular complexes or ventricular tachycardia, n = 55].Results① There was no significant difference in the acute success rate, recurrence rate, and complication rate between the C3 and C3U groups [(94.5% vs. 95.0%); (6.3% vs. 5.3%); and (2.0% vs. 1.5%); P > 0.05]. ② The CARTO Univu reduced radiation exposure: fluoroscopy time: AVRT C3: 8.5 ± 7.2 min vs. C3U: 4.5 ± 2.9 min, P < 0.05; AVNRT C3: 10.7 ± 3.2 min vs. C3U: 4.3 ± 2.6 min, P < 0.05; AT C3: 15.7 ± 8.2 min vs. C3U: 4.5 ± 1.7 min, P < 0.05; AFL C3: 8.7 ± 3.2 min vs. C3U: 3.7 ± 2.7 min, P < 0.05; VAs C3: 7.7 ± 4.2 min vs. C3U: 3.9 ± 2.3 min, P < 0.05. Corresponding to the fluoroscopy time, the fluoroscopy dose was also reduced significantly. ③ In the C3U group, the fluoroscopy during VAs ablation was lower than that of other arrhythmias (P < 0.05).ConclusionThe usage of the “novel image integration technology” CARTO Univu might be safe and effective in RFCA for a wide spectrum of tachyarrhythmias in children, which could significantly reduce fluoroscopy and has a more prominent advantage for VAs ablation

Logarithmic Mean Divisia Index Decomposition of CO2 Emissions from Urban Passenger Transport: An Empirical Study of Global Cities from 1960–2001

The urban transport sector has become one of the major contributors to global CO2 emissions. This paper investigates the driving forces of changes in CO2 emissions from the passenger transport sectors in different cities, which is helpful for formulating effective carbon-reduction policies and strategies. The logarithmic mean Divisia index (LMDI) method is used to decompose the CO2 emissions changes into five driving determinants: Urbanization level, motorization level, mode structure, energy intensity, and energy mix. First, the urban transport CO2 emissions between 1960 and 2001 from 46 global cities are calculated. Then, the multiplicative decomposition results for megacities (London, New York, Paris, and Tokyo) are compared with those of other cities. Moreover, additive decomposition analyses of the 4 megacities are conducted to explore the driving forces of changes in CO2 emissions from the passenger transport sectors in these megacities between 1960 and 2001. Based on the decomposition results, some effective carbon-reduction strategies can be formulated for developing cities experiencing rapid urbanization and motorization. The main suggestions are as follows: (i) Rational land use, such as transit-oriented development, is a feasible way to control the trip distance per capita (ii) fuel economy policies and standards formulated when there are oil crisis are effective ways to suppress the increase of CO2 emissions, and these changes should not be abandoned when oil prices fall and (iii) cities with high population densities should focus on the development of public and non-motorized transport. Document type: Articl

Does the Use of Antidepressants Accelerate the Disease Progress in Creutzfeldt–Jakob Disease Patients With Depression? A Case Report and A Systematic Review

Background: Creutzfeldt–Jakob disease (CJD) is a fatal neurodegenerative disorder characterized by rapidly progressive dementia. Growing evidence suggests that antidepressant usage was associated with dementia. Given the commonality of depression in CJD, it is necessary to investigate the effect of antidepressants on CJD.Methods: First, we report a case of sporadic CJD (sCJD) with depression where the condition worsened rapidly after using a serotonin and noradrenaline reuptake inhibitor (SNRI) antidepressant. Second, a systematic literature survey was conducted to investigate the effect of antidepressants on the survival time of sCJD patients with depression. Thirteen cases plus our case were included for qualitative analysis. Twelve subjects were included in the Kaplan–Meier survival and Cox regression analysis. Finally, we provide a postulation of pathophysiological mechanism in CJD.Results: The median survival time of all patients was 6.0 months, of which patients with SNRIs were significantly shorter than those with first-generation antidepressants (2.0 vs. 6.0 months; log rank, P = .008) and relatively shorter than those with nonselective serotonin reuptake inhibitors (SSRIs; 4.0 vs. 6.0 months; log rank, P = .090). In comparison with first-generation antidepressants, the use of SNRIs [hazard ratio (HR), 23.028; 95% confidence interval (CI), 1.401 to 378.461; P = .028] remained independently associated with shorter survival time.Conclusions: The use of antidepressants, especially SNRIs, was associated with a shorter survival time of sCJD patients. The possible changes in neurotransmitters should be emphasized. Scientifically, this study may provide insights into the mechanism of CJD. Clinically, it may contribute to the early diagnosis of CJD

Dynamic Changes in the Global MicroRNAome and Transcriptome Identify Key Nodes Associated With Ovarian Development in Chickens

The analysis of gene expression patterns during ovarian follicle development will advance our understanding of avian reproductive physiology and make it possible to improve laying performance. To gain insight into the molecular regulation of ovarian development, a systematic profiling of miRNAs and mRNAs at four key stages was conducted, using ovarian tissues from hens at 60 days of age (A), 100 days (B), 140 days-not yet laying (C), and 140 days-laying (D). Comparisons of consecutive stages yielded 73 differentially expressed miRNAs (DEMs) (14 for B vs. A, 8 for C vs. B, and 51 for D vs. C) and 2596 differentially expressed genes (DEGs) (51 for B vs. A, 20 for C vs. B, and 2579 for D vs. C). In addition, 174 DEMs (22 for C vs. A, 74 for D vs. A, and 78 for D vs. B) and 3205 DEGs (118 for C vs. A, 2284 for D vs. A, and 2882 for D vs. B) were identified between nonconsecutive stages. Some DEGs are involved in the Wnt and TGF-beta signaling pathways, which are known to affect ovarian development and ovulation. An integrative analysis of the miRNA and mRNA profiles identified 3166 putative miRNA-mRNA regulatory pairs containing 84 DEMs and 1047 DEGs. Functional annotation of the networks provides strong evidence that the miRNA regulatory networks may play vital roles in ovarian development and ovulation. Ten DEMs and 10 genes were validated by real-time quantitative PCR. The candidate miRNA-mRNA pairs gga-miR-200a-3p-SFRP4, gga-miR-101-3p-BMP5, gga-miR-32-5p-FZD4, and gga-miR-458b-5p-CTNNB1 potentially associated with ovarian development

Research progress of drug eluting balloon in arterial circulatory system

The arterial circulatory system diseases are common in clinical practice, and their treatment options have been of great interest due to their high morbidity and mortality. Drug-eluting balloons, as a new type of endovascular interventional treatment option, can avoid the long-term implantation of metal stents and is a new type of angioplasty without stents, so drug-eluting balloons have better therapeutic effects in some arterial circulatory diseases and have been initially used in clinical practice. In this review, we first describe the development, process, and mechanism of drug-eluting balloons. Then we summarize the current studies on the application of drug-eluting balloons in coronary artery lesions, in-stent restenosis, and peripheral vascular disease. As well as the technical difficulties and complications in the application of drug-eluting balloons and possible management options, in order to provide ideas and help for future in-depth studies and provide new strategies for the treatment of more arterial system diseases

China, Pariah Status and International Society

Pariah status in international society denotes an international social hierarchy and differentiation of states caused by power differentials between state groups along the material and normative spectrums. From the late Qing era to the present day, China’s engagement with international society has largely been marked by a sharp fall from the ‘Middle Kingdom’ to a pariah, followed by a recent rise to great power status. This thesis traces and analyses China’s experience as a pariah in international society since 1839, and explains China’s responses to the normative boundaries and behavioural standards set by members of international society. To this end, this thesis addresses two themes. Theme One (Chapter 1, 2, 3, 4) provides an account of the sociological history of pariah state, on which basis it conducts an empirical study on China’s pariah past. Theme Two (Chapter 5) brings in a sociological account of status to understand the fall and rise of states (particularly that of China), and to explain state responses to the normative boundaries alongside their status change in international society. Moreover, it challenges the material-power based power transition theory on China’s rise and destiny, and argues for an alternative status-led account. In general, this thesis resonates greatly with English School theorists and social constructivists in terms of the understanding of and approach towards international relations. In a broad sense, it adopts a combined sociological and historical approach towards the study of the international, specifically that of pariah and status. The main contentions of this thesis are: first, pariah is a social, relational and historically contingent term. Pariah states are socially made through a process of rule making, rule-application, and behaviour-judging, with the rule-makers being those who are positioned at the higher ends of both material and normative power spectrums. The criteria for pariah are not fixed, but subject to change as they are conditioned by the changing international normative/material structures and dynamics among actors. Second, state status has both material and social implications in international society. It derives from the internal/domestic attributes of the state as well as the external/international. The attainment of status hinges upon material power capacity, state identity, behavioural legitimacy, and international perception thereof. Third, empirically, the fall and rise of China in international society is not merely a process of China’s material power decline and elevation relative to others, but was also accompanied by its social mobility downward and upward. China’s responses to the international normative boundaries are not purely determined by material power incentives. Instead, it is the complex interplay between the material and the social that accounts for China’s constant struggle between compliance with the standardised behavioural codes prescribed in the standard of civilisation, and attempts to contest them by inserting its own civilisational values

Form Follows Environmental Energy: Ecological Heat In Contemporary Vernacular Architecture

The aesthetic of architecture changes with the history, and its evolution is a dynamic, humane and regional process. The contemporary China is in the double transition periods of traditional and modern, modern and postmodern, therefore the value of architecture lost its order caused by the overlapping and conflicting of different values in different periods, either external “image” or intrinsic “meaning”, are in a state of disorder. With the advent of modernization, traditional architecture seems to be gradually forgotten and abandoned. However, many traditional villages still circulate the environmental wisdom that contemporary architects still use in their designs. Most of the traditional houses all over the world use local building material, make full use of renewable energy, using the natural energy of natural climate actively such as light, heat, wind to adapt to the climate environment, with good adaptability to the local climate, topography and, is a model of passive building technology. This article attempts from Three angles to explore, which are the diagram and theory, simulation software, and environment measurement of Chinese traditional village. Through the above research, we try to find the coupling between traditional local-style dwelling houses and modern residence in the design

China, pariah status and international society

Pariah status in international society denotes an international social hierarchy and differentiation of states caused by power differentials between state groups along the material and normative spectrums. From the late Qing era to the present day, China’s engagement with international society has largely been marked by a sharp fall from the ‘Middle Kingdom’ to a pariah, followed by a recent rise to great power status. This thesis traces and analyses China’s experience as a pariah in international society since 1839, and explains China’s responses to the normative boundaries and behavioural standards set by members of international society. To this end, this thesis addresses two themes. Theme One (Chapter 1, 2, 3, 4) provides an account of the sociological history of pariah state, on which basis it conducts an empirical study on China’s pariah past. Theme Two (Chapter 5) brings in a sociological account of status to understand the fall and rise of states (particularly that of China), and to explain state responses to the normative boundaries alongside their status change in international society. Moreover, it challenges the material-power based power transition theory on China’s rise and destiny, and argues for an alternative status-led account. In general, this thesis resonates greatly with English School theorists and social constructivists in terms of the understanding of and approach towards international relations. In a broad sense, it adopts a combined sociological and historical approach towards the study of the international, specifically that of pariah and status. The main contentions of this thesis are: first, pariah is a social, relational and historically contingent term. Pariah states are socially made through a process of rule making, rule-application, and behaviour-judging, with the rule-makers being those who are positioned at the higher ends of both material and normative power spectrums. The criteria for pariah are not fixed, but subject to change as they are conditioned by the changing international normative/material structures and dynamics among actors. Second, state status has both material and social implications in international society. It derives from the internal/domestic attributes of the state as well as the external/international. The attainment of status hinges upon material power capacity, state identity, behavioural legitimacy, and international perception thereof. Third, empirically, the fall and rise of China in international society is not merely a process of China’s material power decline and elevation relative to others, but was also accompanied by its social mobility downward and upward. China’s responses to the international normative boundaries are not purely determined by material power incentives. Instead, it is the complex interplay between the material and the social that accounts for China’s constant struggle between compliance with the standardised behavioural codes prescribed in the standard of civilisation, and attempts to contest them by inserting its own civilisational values.EThOS - Electronic Theses Online ServiceGBUnited Kingdo