Low rate of asymptomatic cerebral embolism and improved procedural efficiency with the novel pulmonary vein ablation catheter GOLD: results of the PRECISION GOLD trial

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App-based maintenance treatment for alcohol use disorder after acute inpatient treatment : Study protocol for a multicentre randomized controlled trial

Background: Alcohol use disorder, a prevalent and disabling mental health problem, is often characterized by a chronic disease course. While effective inpatient and aftercare treatment options exist, the transferal of treatment success into everyday life is challenging and many patients remain without further assistance. App-based in terventions with human guidance have great potential to support individuals after inpatient treatment, yet ev idence on their efficacy remains scarce. Objectives: To develop an app-based intervention with human guidance and evaluate its usability, efficacy, and cost-effectiveness. Methods: Individuals with alcohol use disorder (DSM-5), aged 18 or higher, without history of schizophrenia, undergoing inpatient alcohol use disorder treatment (N = 356) were recruited in eight medical centres in Bavaria, Germany, between December 2019 and August 2021. Participants were randomized in a 1:1 ratio to either receive access to treatment as usual plus an app-based intervention with human guidance (intervention group) or access to treatment as usual plus app-based intervention after the active study phase (waitlist control/TAU group). Telephone-based assessments are conducted by diagnostic interviewers three and six weeks as well as three and six months after randomization. The primary outcome is the relapse risk during the six months after randomization assessed via the Timeline Follow-Back Interview. Secondary outcomes include intervention usage, uptake of aftercare treatments, AUD-related psychopathology, general psychopathology, and quality of life. Discussion: This study will provide further insights into the use of app-based interventions with human guidance as maintenance treatment in individuals with AUD. If shown to be efficacious, the intervention may improve AUD treatment by assisting individuals in maintaining inpatient treatment success after returning into their home setting. Due to the ubiquitous use of smartphones, the intervention has the potential to become part of routine AUD care in Germany and countries with similar healthcare systems

Safety of pulsed field ablation in more than 17,000 patients with atrial fibrillation in the MANIFEST-17K study

Pulsed field ablation (PFA) is an emerging technology for the treatment of atrial fibrillation (AF), for which pre-clinical and early-stage clinical data are suggestive of some degree of preferentiality to myocardial tissue ablation without damage to adjacent structures. Here in the MANIFEST-17K study we assessed the safety of PFA by studying the post-approval use of this treatment modality. Of the 116 centers performing post-approval PFA with a pentaspline catheter, data were received from 106 centers (91.4% participation) regarding 17,642 patients undergoing PFA (mean age 64, 34.7% female, 57.8% paroxysmal AF and 35.2% persistent AF). No esophageal complications, pulmonary vein stenosis or persistent phrenic palsy was reported (transient palsy was reported in 0.06% of patients; 11 of 17,642). Major complications, reported for ~1% of patients (173 of 17,642), were pericardial tamponade (0.36%; 63 of 17,642) and vascular events (0.30%; 53 of 17,642). Stroke was rare (0.12%; 22 of 17,642) and death was even rarer (0.03%; 5 of 17,642). Unexpected complications of PFA were coronary arterial spasm in 0.14% of patients (25 of 17,642) and hemolysis-related acute renal failure necessitating hemodialysis in 0.03% of patients (5 of 17,642). Taken together, these data indicate that PFA demonstrates a favorable safety profile by avoiding much of the collateral damage seen with conventional thermal ablation. PFA has the potential to be transformative for the management of patients with AF.Peer reviewe

Praxistool zur Reflexion und Diagnose aus der zweiten Ausbildungsphase

Die Fachausbildung des Vorbereitungsdiensts im Land Brandenburg bietet Lehramtskandidat:innen (LAK) gemeinsame Fachgruppenarbeit, individuelle Fachkonsultationen sowie Hospitationen als unterstützende Angebote im Entwicklungsprozess. Um diesen Professionalisierungsprozess sichtbar zu machen und Zielperspektiven entwickeln und verfolgen zu können, wurden aus einem Spinnennetzdiagramm zwei Praxistools zur Reflexion und Diagnose entwickelt. (1) Reflexionstool: Die Übertragung eines tabellarischen Kompetenzprofils (Arnold & Iffert nach MBJS [Ministerium für Bildung, Jugend und Sport des Landes Brandenburg], 2014) in das Spinnennetzdiagramm bietet den LAK niederschwellige Gelegenheit der kontinuierlichen, prozessbegleitenden Selbstreflexion. Die Selbstwahrnehmung von positiven Entwicklungen kann zur Stärkung der Selbstwirksamkeit führen, schafft gleichzeitig jedoch eine Bewusstmachung für einzelne Herausforderungen. Die Abbildung individueller Entwicklungsaufgaben und Professionalisierungsbedarfe ermöglicht eine bedarfsorientierte Gestaltung der Fachgruppenarbeit. (2) Diagnosetool: Analog wird Fachausbilder:innen durch die Übertragung der Beobachtungskriterien des MBJS (2014) in das Diagramm eine übersichtliche Bestandsaufnahme einzelner Unterrichtssituationen zur Diagnose von Grundkoordinaten des Unterrichts transparent. Auf diese Weise können Fachausbilder:innen mögliche blinde Flecken identifizieren und Feedback zur Auswahl von Beobachtungskriterien geben. Darüber hinaus ergeben sich Aspekte zur Gestaltung von Fachkonsultationen sowie Diskussionsgrundlagen für Gruppenhospitationen

Figure 1 in Co-occurrence of three Aristolochia-feeding Papilionids (Archon apollinus, Zerynthia polyxena and Zerynthia cerisy) in Greek Thrace

Figure 1. Position of the study area in northeastern Greece (dark dot on the map) and mutual positions of the three study subsites, with the mosaics of individual biotopes. The longest single moves of three study species: Aa, Archon apollinus; Zc, Zerynthia cerisy; Zp, Zerynthia polyxena.Published as part of <i>Slancarova, Jana, Vrba, Pavel, Platek, Michal, Zapletal, Michal, Spitzer, Lukas & Konvicka, Martin, 2015, Co-occurrence of three Aristolochia-feeding Papilionids (Archon apollinus, Zerynthia polyxena and Zerynthia cerisy) in Greek Thrace, pp. 1825-1848 in Journal of Natural History 49 (29)</i> on page 1828, DOI: 10.1080/00222933.2015.1006281, <a href="http://zenodo.org/record/3999678">http://zenodo.org/record/3999678</a&gt

Figure 4 in Co-occurrence of three Aristolochia-feeding Papilionids (Archon apollinus, Zerynthia polyxena and Zerynthia cerisy) in Greek Thrace

Figure 4. Results of model for eggs and larval records. (A) Interaction plot showing average egg batch sizes for individual butterfly species on individual species of Aristolochia plants; (B) box-plots (medians and quartiles) showing the amount of canopy closure (variable Trees10: see Material and methods) above Aristolochia plants bearing eggs of the respective butterflies; (C) numbers of larvae of the three studied butterfly species recorded during searches for larvae, note the unbalanced scale on the x-axis; (D) interaction plot showing average number of larvae of the three studied butterfly species in individual instars. For panels (A, C, D) dotted line, Archon apollinus; dashed line, Zerynthia cerisy; full line, Zerynthia polyxena.Published as part of Slancarova, Jana, Vrba, Pavel, Platek, Michal, Zapletal, Michal, Spitzer, Lukas & Konvicka, Martin, 2015, Co-occurrence of three Aristolochia-feeding Papilionids (Archon apollinus, Zerynthia polyxena and Zerynthia cerisy) in Greek Thrace, pp. 1825-1848 in Journal of Natural History 49 (29) on page 1840, DOI: 10.1080/00222933.2015.1006281, http://zenodo.org/record/399967

Co-occurrence of three Aristolochia-feeding Papilionids (Archon apollinus, Zerynthia polyxena and Zerynthia cerisy) in Greek Thrace

Slancarova, Jana, Vrba, Pavel, Platek, Michal, Zapletal, Michal, Spitzer, Lukas, Konvicka, Martin (2015): Co-occurrence of three Aristolochia-feeding Papilionids (Archon apollinus, Zerynthia polyxena and Zerynthia cerisy) in Greek Thrace. Journal of Natural History 49 (29): 1825-1848, DOI: 10.1080/00222933.2015.100628

Figure 3 in Co-occurrence of three Aristolochia-feeding Papilionids (Archon apollinus, Zerynthia polyxena and Zerynthia cerisy) in Greek Thrace

Figure 3. Estimates of the adult daily population sizes based on mark–recapture data: year 2010, when only data for Archon apollinus (most of flight period) and Zerynthia cerisy (late tail of flight period) allowed the estimation; year 2011, A. apollinus, Z. cerisy, Zerynthia polyxena. The error lines present standard errors of estimates, see Table 3 for model parameters.Published as part of <i>Slancarova, Jana, Vrba, Pavel, Platek, Michal, Zapletal, Michal, Spitzer, Lukas & Konvicka, Martin, 2015, Co-occurrence of three Aristolochia-feeding Papilionids (Archon apollinus, Zerynthia polyxena and Zerynthia cerisy) in Greek Thrace, pp. 1825-1848 in Journal of Natural History 49 (29)</i> on page 1835, DOI: 10.1080/00222933.2015.1006281, <a href="http://zenodo.org/record/3999678">http://zenodo.org/record/3999678</a&gt

Low rate of asymptomatic cerebral embolism and improved procedural efficiency with the novel pulmonary vein ablation catheter GOLD: results of the PRECISION GOLD trial

This prospective, multicentre study (PRECISION GOLD) evaluated the incidence of asymptomatic cerebral embolism (ACE) after pulmonary vein isolation (PVI) using a new gold multi-electrode radiofrequency (RF) ablation catheter, pulmonary vein ablation catheter (PVAC) GOLD. Also, procedural efficiency of PVAC GOLD was compared with ERACE. The ERACE study demonstrated that a low incidence of ACE can be achieved with a platinum multi-electrode RF catheter (PVAC) combined with procedural manoeuvres to reduce emboli. A total of 51 patients with paroxysmal atrial fibrillation (AF) (age 57 +/- 9 years, CHA(2)DS(2)-VASc score 1.4 +/- 1.4) underwent AF ablation with PVAC GOLD. Continuous oral anticoagulation using vitamin K antagonists, submerged catheter introduction, and heparinization (ACT a parts per thousand yen 350 s prior to ablation) were applied. Cerebral magnetic resonance imaging (MRI) scans were performed within 48 h before and 16-72 h post-ablation. Cognitive function assessed by the Mini-Mental State Exam at baseline and 30 days post-ablation. New post-procedural ACE occurred in only 1 of 48 patients (2.1%) and was not detectable on MRI after 30 days. The average number of RF applications per patient to achieve PVI was lower in PRECISION GOLD (20.3 +/- 10.0) than in ERACE (28.8 +/- 16.1; P = 0.001). Further, PVAC GOLD ablations resulted in significantly fewer low-power ( <3 W) ablations (15 vs. 23%, 5 vs. 10% and 2 vs. 7% in 4:1, 2:1, and 1:1 bipolar:unipolar energy modes, respectively). Mini-Mental State Exam was unchanged in all patients. Atrial fibrillation ablation with PVAC GOLD in combination with established embolic lowering manoeuvres results in a low incidence of ACE. Pulmonary vein ablation catheter GOLD demonstrates improved biophysical efficiency compared with platinum PVAC. ClinicalTrials.gov NCT0176755

Low rate of asymptomatic cerebral embolism and improved procedural efficiency with the novel pulmonary vein ablation catheter GOLD: results of the PRECISION GOLD trial

This prospective, multicentre study (PRECISION GOLD) evaluated the incidence of asymptomatic cerebral embolism (ACE) after pulmonary vein isolation (PVI) using a new gold multi-electrode radiofrequency (RF) ablation catheter, pulmonary vein ablation catheter (PVAC) GOLD. Also, procedural efficiency of PVAC GOLD was compared with ERACE. The ERACE study demonstrated that a low incidence of ACE can be achieved with a platinum multi-electrode RF catheter (PVAC) combined with procedural manoeuvres to reduce emboli. A total of 51 patients with paroxysmal atrial fibrillation (AF) (age 57 +/- 9 years, CHA(2)DS(2)-VASc score 1.4 +/- 1.4) underwent AF ablation with PVAC GOLD. Continuous oral anticoagulation using vitamin K antagonists, submerged catheter introduction, and heparinization (ACT a parts per thousand yen 350 s prior to ablation) were applied. Cerebral magnetic resonance imaging (MRI) scans were performed within 48 h before and 16-72 h post-ablation. Cognitive function assessed by the Mini-Mental State Exam at baseline and 30 days post-ablation. New post-procedural ACE occurred in only 1 of 48 patients (2.1%) and was not detectable on MRI after 30 days. The average number of RF applications per patient to achieve PVI was lower in PRECISION GOLD (20.3 +/- 10.0) than in ERACE (28.8 +/- 16.1; P = 0.001). Further, PVAC GOLD ablations resulted in significantly fewer low-power ( <3 W) ablations (15 vs. 23%, 5 vs. 10% and 2 vs. 7% in 4:1, 2:1, and 1:1 bipolar:unipolar energy modes, respectively). Mini-Mental State Exam was unchanged in all patients. Atrial fibrillation ablation with PVAC GOLD in combination with established embolic lowering manoeuvres results in a low incidence of ACE. Pulmonary vein ablation catheter GOLD demonstrates improved biophysical efficiency compared with platinum PVAC. ClinicalTrials.gov NCT0176755