2021 Asia Pacific Heart Rhythm Society (APHRS) practice guidance on atrial fibrillation screening

In this paper, the Asia Pacific Heart Rhythm Society (APHRS) sought to provide practice guidance on AF screening based on recent evidence, with specific considerations relevant to the Asia-Pacific region. A key recommendation is opportunistic screening for people aged >= 65 years (all countries), with systematic screening to be considered for people aged >= 75 years or who have additional risk factors (all countries)

Keratin Expression in Mammary Paget’s Disease in situ with Intraductal Invasion

We performed immunohistochemical studies of epithelial keratins in intraductal carcinoma in situ (IDCIS) in mammary Paget’s disease (MPD). K7, K8 and K18 were expressed in IDCIS in MPD. However, K19 was not expressed in IDCIS in MPD. Interestingly, K17 was expressed in some tumor cells in IDCIS. K17, a hyperproliferative keratin, may suggest ductal invasion and poor prognosis in MPD

Minor taxa in human skin microbiome contribute to the personal identification

<div><p>The human skin microbiome can vary over time, and inter-individual variability of the microbiome is greater than the temporal variability within an individual. The skin microbiome has become a useful tool to identify individuals, and one type of personal identification using the skin microbiome has been reported in a community of less than 20 individuals. However, identification of individuals based on the skin microbiome has shown low accuracy in communities larger than 80 individuals. Here, we developed a new approach for personal identification, which considers that minor taxa are one of the important factors for distinguishing between individuals. We originally established a human skin microbiome for 66 samples from 11 individuals over two years (33 samples each year). Our method could classify individuals with 85% accuracy beyond a one-year sampling period. Moreover, we applied our method to 837 publicly available skin microbiome samples from 89 individuals and succeeded in identifying individuals with 78% accuracy. In short, our results investigate that (i) our new personal identification method worked well with two different communities (our data: 11 individuals; public data: 89 individuals) using the skin microbiome, (ii) defining the personal skin microbiome requires samples from several time points, (iii) inclusion of minor skin taxa strongly contributes to the effectiveness of personal identification.</p></div

Results obtained using the personal identification method.

<p>Results obtained using the personal identification method.</p

Boxplot for the accuracy of assessing the effects of each factor.

<p>A) Accuracies derived from reference samples from within the same year as the query and from different years. B) Accuracy of identifying individuals with consideration of different numbers of reference samples. *<i>P</i> ≤ 0.05 (Wilcoxon rank-sum test). C) Effect of the cut-off value for bacterial relative abundance on personal identification accuracy. D) Effect of the number of reads for bacterial relative abundance on personal identification accuracy.</p

Microbial communities of 11 individuals.

<p>A) Shannon diversity index values for the six time-point samples of individuals A to K. B) Relative abundance of OTUs in samples from the six time points for individuals A to K. For each individual, the first three columns represent first-year samples, and the remaining three columns represent the second-year samples. C) Each point represents the Canberra distance between a pair of samples grouped by three comparison schemes. *<i>P</i> ≤ 0.05 (Wilcoxon rank-sum test). N.S., not significant.</p

What Are the Expectations for Cardiac Resynchronization Therapy? A Validation of Two Response Definitions

Background: The definition of response to cardiac resynchronization therapy (CRT) varies across clinical trials. There are two main definitions, i.e., echocardiographic response and functional response. We assessed which definition was more reasonable. Methods: In this study of 260 patients who had undergone CRT, an echocardiographic response was defined as a reduction in a left ventricular end-systolic volume of greater than or equal to 15% or an improvement in left ventricular ejection fraction of greater than or equal to 5%. A functional response was defined as an improvement of at least one class category in the New York Heart Association functional classification. We assessed the response to CRT at 6 months after device implantation, based on each definition, and investigated the relationship between response and clinical outcomes. Results: The echocardiographic response rate was 74.2%. The functional response rate was 86.9%. Non-responder status, based on both definitions, was associated with higher all-cause mortality. Cardiac death was only associated with functional non-responder status (hazard ratio (HR) 2.65, 95% confidence interval (CI) 1.19–5.46, p = 0.0186) and heart failure hospitalization (HR 2.78, 95% CI, 1.29–5.26, p = 0.0111). Conclusion: After CRT implantation, the functional response definition of CRT response is associated with a higher response rate and better clinical outcomes than that of the echocardiographic response definition, and therefore it is reasonable to use the functional definition to assess CRT response