Association of catheter ablation for atrial fibrillation with mortality and stroke: A systematic review and meta-analysis

BACKGROUND: Maintenance of sinus rhythm has been associated with lower mortality, but whether atrial fibrillation (AF) ablation per se benefits hard outcomes such as mortality and stroke is still debated. OBJECTIVE: To determine whether AF ablation is associated with a reduction in all-cause mortality and stroke compared with medical therapy alone. METHODS: Literature search looking for both randomized and observational studies comparing AF catheter ablation vs. medical management. Data pooled using random-effects. Risk ratios (RR) with 95% confidence intervals (CI) used as a measure of treatment effect. The primary and secondary outcomes were all-cause mortality and occurrence of cerebrovascular events during follow-up, respectively. RESULTS: Thirty studies were eligible for inclusion, comprising 78,966 patients (25,129 receiving AF ablation and 53,837 on medical treatment) and 233,990 patient-years of follow-up. The pooled data of studies revealed that ablation was associated with lower risk of all-cause mortality: 5.7% vs. 17.9%; RR = 0.44, 95% CI 0.32–0.62, p < 0.001. In a sensitivity analysis by study design, a survival benefit of AF ablation was seen in randomized studies, with no heterogeneity (mortality risk 4.2% vs. 8.9%; RR = 0.55, 95% CI 0.39–0.79, p = 0.001, I2= 0%), and also in observational studies, but with marked heterogeneity (6.1% vs. 18.3%; RR = 0.39, 95% CI 0.26–0.59, p < 0.001, I2= 95%). The mortality benefit in randomized studies was mainly driven by trials performed in patients with left ventricular (LV) dysfunction and heart failure. The pooled risk of a cerebrovascular event was lower in patients receiving AF ablation (2.3% vs. 5.5%; RR = 0.57, 95% CI 0.46–0.70, p < 0.001, I2= 62%), but no difference was seen in randomized trials (2.2% vs. 2.1%; RR = 0.94, 95% CI 0.46–1.94, p = 0.87, I2= 0%). CONCLUSIONS: Ablation of atrial fibrillation associates with a survival benefit compared with medical treatment alone, although evidence is restricted to the setting of heart failure and LV systolic dysfunction

The two-loop four-fermion scattering amplitude in QED

We present the analytic evaluation of the two-loop corrections to the amplitude for the scattering of four fermions in Quantum Electrodynamics, $f^- + f^+ + F^- + F^+ \to 0$, with $f$ and $F$ representing a massless and a massive lepton, respectively. Dimensional regularization is employed to evaluate the loop integrals. Ultraviolet divergences are removed by renormalizing the coupling constant in the ${\overline{\text{MS}}}$-scheme, and the lepton mass as well as the external fields in the on-shell scheme. The analytic result for the renormalized amplitude is expressed as Laurent series around $d=4$ space-time dimensions, and contains Generalized Polylogarithms with up to weight four. The structure of the residual infrared divergences of the virtual amplitude is in agreement with the prediction of the Soft Collinear Effective Theory. Our analytic results are an essential ingredient for the computation of the scattering cross section for massive fermion-pair production in massless fermion-pair annihilation, i.e. $f^- f^+ \to F^- F^+$, and crossing related processes such as the elastic scattering $f F \to f F$, with up to Next-to-Next to Leading Order accuracy.Comment: 5 pages, 2 figures, 1 table + supplemental materia

Two-Loop Four-Fermion Scattering Amplitude in QED

We present the first fully analytic evaluation of the transition amplitude for the scattering of a massless into a massive pair of fermions at the two-loop level in quantum electrodynamics. Our result is an essential ingredient for the determination of the electromagnetic coupling within scattering reactions, beyond the currently known accuracy, which has a crucial impact on the evaluation of the anomalous magnetic moment of the muon. It will allow, in particular, for a precise determination of the leading hadronic contribution to the (g−2)μ in the MUonE experiment at CERN, and therefore can be used to shed light on the current discrepancy between the standard model prediction and the experimental measurement for this important physical observable

Consumo de carboidratos totais e de carboidratos não fibrosos em ovinos alimentados com dietas contendo soro de leite bovino.

Objetivou-se com o presente estudo, determinar o consumo de carboidratos totais e de carboidratos não fibrosos em ovinos alimentados com dietas contendo SLB em níveis crescentes

On μe-scattering at NNLO in QED

We report on the current status of the analytic evaluation of the two-loop corrections to the μescattering in Quantum Electrodynamics, presenting state-of-the art techniques which have been developed to address this challenging task

Soil water dynamics and evapotranspiration of forage cactus clones under rainfed conditions.

The objective of this work was to evaluate soil water dynamics in areas cultivated with forage cactus clones and to determine how environmental conditions and crop growth affect evapotranspiration. The study was conducted in the municipality of Serra Talhada, in the state of Pernambuco, Brazil. Crop growth was monitored through changes in the cladode area index (CAI) and through the soil cover fraction, calculated at the end of the cycle. Real evapotranspiration (ET) of the three evaluated clones was obtained as the residual term in the soil water balance method. No difference was observed between soil water balance components, even though the evaluated clones were of different genus and had different CAI increments. Accumulated ET was of 1,173 mm during the 499 days of the experiment, resulting in daily average of 2.35 mm. The CAI increases the water consumption of the Orelha de Elefante Mexicana clone. In dry conditions, the water consumption of the Miúda clone responds more slowly to variation in soil water availability. The lower evolution of the CAI of the IPA Sertânia clone, during the rainy season, leads to a higher contribution of the evaporation component in ET. The atmospheric demand controls the ET of clones only when there is higher soil water availability; in this condition, the water consumption of the Miúda clone decreases more rapidly with the increase of atmospheric demand

Protein-Protein Interactions in Crystals of the Human Receptor-Type Protein Tyrosine Phosphatase ICA512 Ectodomain

ICA512 (or IA-2) is a transmembrane protein-tyrosine phosphatase located in secretory granules of neuroendocrine cells. Initially, it was identified as one of the main antigens of autoimmune diabetes. Later, it was found that during insulin secretion, the cytoplasmic domain of ICA512 is cleaved and relocated to the nucleus, where it stimulates the transcription of the insulin gene. The role of the other parts of the receptor in insulin secretion is yet to be unveiled. The structures of the intracellular pseudocatalytic and mature extracellular domains are known, but the transmembrane domain and several intracellular and extracellular parts of the receptor are poorly characterized. Moreover the overall structure of the receptor remains to be established. We started to address this issue studying by X-ray crystallography the structure of the mature ectodomain of ICA512 (ME ICA512) and variants thereof. The variants and crystallization conditions were chosen with the purpose of exploring putative association interfaces, metal binding sites and all other structural details that might help, in subsequent works, to build a model of the entire receptor. Several structural features were clarified and three main different association modes of ME ICA512 were identified. The results provide essential pieces of information for the design of new experiments aimed to assess the structure in vivo

A portal of educational resources: providing evidence for matching pedagogy with technology

The TPACK (Technology, Pedagogy and Content Knowledge) model presents the three types of knowledge that are necessary to implement a successful technology-based educational activity. It highlights how the intersections between TPK (Technological Pedagogical Knowledge), PCK (Pedagogical Content Knowledge) and TCK (Technological Content Knowledge) are not a sheer sum up of their components but new types of knowledge. This paper focuses on TPK, the intersection between technology knowledge and pedagogy knowledge – a crucial field of investigation. Actually, technology in education is not just an add-on but is literally reshaping teaching/learning paradigms. Technology modifies pedagogy and pedagogy dictates requirements to technology. In order to pursue this research, an empirical approach was taken, building a repository (back-end) and a portal (front-end) of about 300 real-life educational experiences run at school. Educational portals are not new, but they generally emphasise content. Instead, in our portal, technology and pedagogy take centre stage. Experiences are classified according to more than 30 categories (‘facets’) and more than 200 facet values, all revolving around the pedagogical implementation and the technology used. The portal (an innovative piece of technology) supports sophisticated ‘exploratory’ sessions of use, targeted at researchers (investigating the TPK intersection), teachers (looking for inspiration in their daily jobs) and decision makers (making decisions about the introduction of technology into schools)