A Review of Transcatheter Ablation for the Treatment of AVNRT in Children

Background: Atrioventricular nodal reentrant tachycardia (AVNRT) is an arrhythmia due to re-entrant rhythm within the region of the atrioventricular (AV) node, which accounts for most supraventricular tachycardia (SVT) cases in children. There are two main pathways involved for the re-entrant rhythm, slow and fast pathways, with different anatomic locations and involvement in the circuit associated with AVNRT. AVNRT is rare in newborns, but an increase of prevalence throughout childhood was previously reported.Study Objective/Purpose: Currently, Radiofrequency (RF) ablation is the primary method for the treatment of AVNRT in pediatrics. However, multiple modalities with varying efficacies can also be utilized. In this study, we attempt to review indications and complications of the gold-standard use of RF compared to newer modalities for the ablation treatment of AVNRT in the pediatric population. Results/Discussion: Currently there are two transcatheter ablations methods widely applied as AVNRT treatment: RF ablation and Cryoablation (Cryo). Indications for these methods vary with blood flow in the target area, duration of procedure, and risk of recurrence of AVNRT. Both methods have success rates \u3e90% in AVNRT children, with a 3% complication rate. AV block is the most common complication of RF ablation cases, while Cryo, being a newer technology, requires further investigation. Factors that complicate ablation in AVNRT include anatomical and electrophysiological variations between individuals. Fluoroscopic visualization and 3D-voltage mapping of pathways can provide markers for catheter ablation in AVNRT cases to expedite ablation success and enhance safety. Other predictors of success include: reduced fluoroscopy time, lower patient weight, the ability to induce junctional rhythm in the patient during the procedure, and the utilization of image-based guidance and ice-mapping during the ablation. Conclusion: Radiofrequency catheter ablation remains the highly successful gold standard for the treatment of AVNRT in children, with low complication rates. Cryoablation and other advanced techniques are emerging as new methods tailored to the accessory pathways and more sophisticated structural variations underlying AVNRT in children

Mutations in DYNC2LI1 disrupt cilia function and cause short rib polydactyly syndrome.

The short rib polydactyly syndromes (SRPSs) are a heterogeneous group of autosomal recessive, perinatal lethal skeletal disorders characterized primarily by short, horizontal ribs, short limbs and polydactyly. Mutations in several genes affecting intraflagellar transport (IFT) cause SRPS but they do not account for all cases. Here we identify an additional SRPS gene and further unravel the functional basis for IFT. We perform whole-exome sequencing and identify mutations in a new disease-producing gene, cytoplasmic dynein-2 light intermediate chain 1, DYNC2LI1, segregating with disease in three families. Using primary fibroblasts, we show that DYNC2LI1 is essential for dynein-2 complex stability and that mutations in DYNC2LI1 result in variable length, including hyperelongated, cilia, Hedgehog pathway impairment and ciliary IFT accumulations. The findings in this study expand our understanding of SRPS locus heterogeneity and demonstrate the importance of DYNC2LI1 in dynein-2 complex stability, cilium function, Hedgehog regulation and skeletogenesis

Delivery of Health Education in Adolescents with Behavioral Health Challenges

BACKGROUND Adolescents with behavioral health issues tend to have inadequate access to health education, and are thus less aware of the importance of personal and dental hygiene, exercise, and healthy diet and lifestyle habits. Due to this disparity, this population has been known to harbor a higher prevalence of STI’s, drug and alcohol abuse, physical altercations, juvenile detention, and suicide attempts. PURPOSE The overall objective of this study was to examine the effect of integrating a health science curriculum in this population. METHODS Participants aged 5-17 years old were recruited and assigned to either control or science groups by Family and Children’s Services (FCS). We created an 8-week health science curriculum to teach everyday life skills. A questionnaire was utilized to assess participants’ comprehension of health information. The effect of the curriculum on participants’ behaviors was examined using a pre/post “Behavioral Insight” questionnaire. Non-parametric Mann-Whitney U test was utilized to determine whether there was a significant difference in behavioral goals and science based knowledge between the control and science groups. RESULTS We examined two measurements to evaluate the efficacy of delivering health science information to 23 participants in two science groups, compared to 20 participants in two control groups who did not receive the curriculum. The health knowledge assessment results demonstrated a marginally significant improvement of understanding and retaining health science, which was delivered to the science group in 8 independent sessions on a weekly basis (p=0.0669). We observed a statistically significant difference in participants’ understanding of their behavioral deficits and how to improve primary behavior (p=0.01). There was no significant difference in either group regarding the extent to which participants understand the particular behavior to improve (p\u3e0.05). CONCLUSION Findings from our study demonstrate that integration of an 8-week science curriculum into life skill training did not negatively affect participants’ understanding of their own behaviors. Compared to the control group, we observed a marginally significant improvement in health knowledge assessment scores among students in the science group. Finally, the 8-week science curriculum, both active and passive learning components, was determined to be an effective delivery method for the content involved. Further study in a larger sample may be necessary to detect significant effects of the curriculum

PO-185 Lifestyle intervention modify DNA methylation of adipose tissue in overweight and obese men with insomnia symptoms

Objective To study whether diet and exercise intervention affect sleep and obesity-related genes’ DNA methylation in overweight and obese men with insomnia symptoms Methods The study participants were a subgroup of a large intervention and consisted of 10 overweight or obesity men aged 34-65 years with insomnia symptoms. They participated in a 6-month progressive aerobic exercise training and individualized dietary consoling program and were randomly selected from diet (n=4), exercise (n=3) and control (n=3) groups. Body composition included fat mass and lean mass in the whole body and abdominal android region were assessed by dual-energy X-ray densitometry. The fitness level (VO2max) was determined by 2-km walk test using a standard protocol. Blood samples from venous were taken at fasted state in the morning. Total cholesterol, high density lipid cholesterol, low density lipid cholesterol, triglycerides, glucose, insulin, non-esterified fatty acid, alanine aminotransferase, aspartate aminotransferase and γ-glutamyltransferase were assessed by conventional methods. Subcutaneous adipose tissue was taken from abdominal region before and after the intervention. DNA was extracted from subcutaneous adipose tissue using a QIAamp DNeasy Tissue Kit. Whole genome-wide DNA methylation was obtained using MethylRAD-Seq. MethylRAD library preparation started from DNA digestion by FspEI, then digested products were run on agarose gel to verify digestion and DNA ligase was added to the digestion solution. After ligation products amplication, PCR was conducted by MyCycler thermal cycler (Bio-Rad). The target fragment was excised from polyacrylamide gel and DNA was diffused from the gel in nuclease-free water. For relative quantification of MethylRAD data, DNA methylation levels were determined using the normalized read depth (reads per million, RPM) for each site. For each restriction site, its methylation level was estimated by dividing the log-transformed depth of each site by the log-transformed maximum depth (representing 100% methylation; i.e. M-index ¼ log(depth site)/ log(depth max)), where depth max was summarized from the top 2% of sites (approx. 500 for the standard library) with the highest sequencing coverage. Heat map images are generated with Matlab 7.0 software and pathways are analysed by WEB-based Gene SeT AnaLysis Toolket. A statistical significance for methylated CpGs and pathways were set to p=0.001 and p=0.05, respectively. Results No significant group differences by time were found in sleep-related variables, body composition, lifestyle factors nor with measured lipid and glucose biomarkers. However, whole genome-wide DNA methylation was decreased after dietary intervention, but was increased after exercise intervention, respectively. Correspondingly, 1253 and 708 differentially methylated loci were found in diet and exercise groups by contrast to the control group. Among them, the overlap genes between diet and exercise had multiple differentially methylated CpGs, including e.g. MYT1L (4 CpGs), CAMTA1 (3 CpGs), NRXN1 (3 CpGs), RPS6KA2 (3 CpGs), SEMA4D (3 CpGs). DNA methylation in PCDH8 was negatively correlated with wake after sleep onset after exercise intervention and MYRIP associated with sleep duration showed lower methylation after the dietary intervention. Further, 13 (DIO1, GCK, GYS1, LMNA, LY86, PNMT, PPARA, PPARD, SERPINE1, TH, TMEM18, TNFRSF1B and UBL5) and 2 (SDCCAG8 and TNF) obesity-related genes’ DNA methylation profile changed in response to diet and exercise, respectively. Percentage changes of CpGs within KLHDC8A, ANKS1A, FGFRL1 and KDM3B were correlated with energy yield fat and carbohydrate, HOMA-IR and VO2max, respectively. Conclusions We found that both exercise and dietary interventions have impacts on these genes related to sleep indicating by DNA methylation in PCDH8 and MYRIP, respectively. Further diet may be more effective than aerobic exercise intervention since greater number of modified obesity-related genes observed after dietary intervention. Our results indicate that reduce insomnia symptoms may need to more focus on control obesity

Evidence for the h_b(1P) meson in the decay Upsilon(3S) --> pi0 h_b(1P)

Using a sample of 122 million Upsilon(3S) events recorded with the BaBar detector at the PEP-II asymmetric-energy e+e- collider at SLAC, we search for the $h_b(1P)$ spin-singlet partner of the P-wave chi_{bJ}(1P) states in the sequential decay Upsilon(3S) --> pi0 h_b(1P), h_b(1P) --> gamma eta_b(1S). We observe an excess of events above background in the distribution of the recoil mass against the pi0 at mass 9902 +/- 4(stat.) +/- 2(syst.) MeV/c^2. The width of the observed signal is consistent with experimental resolution, and its significance is 3.1sigma, including systematic uncertainties. We obtain the value (4.3 +/- 1.1(stat.) +/- 0.9(syst.)) x 10^{-4} for the product branching fraction BF(Upsilon(3S)-->pi0 h_b) x BF(h_b-->gamma eta_b).Comment: 8 pages, 4 postscript figures, submitted to Phys. Rev. D (Rapid Communications

Jet energy measurement with the ATLAS detector in proton-proton collisions at root s=7 TeV

The jet energy scale and its systematic uncertainty are determined for jets measured with the ATLAS detector at the LHC in proton-proton collision data at a centre-of-mass energy of √s = 7TeV corresponding to an integrated luminosity of 38 pb-1. Jets are reconstructed with the anti-kt algorithm with distance parameters R=0. 4 or R=0. 6. Jet energy and angle corrections are determined from Monte Carlo simulations to calibrate jets with transverse momenta pT≥20 GeV and pseudorapidities {pipe}η{pipe}<4. 5. The jet energy systematic uncertainty is estimated using the single isolated hadron response measured in situ and in test-beams, exploiting the transverse momentum balance between central and forward jets in events with dijet topologies and studying systematic variations in Monte Carlo simulations. The jet energy uncertainty is less than 2. 5 % in the central calorimeter region ({pipe}η{pipe}<0. 8) for jets with 60≤pT<800 GeV, and is maximally 14 % for pT<30 GeV in the most forward region 3. 2≤{pipe}η{pipe}<4. 5. The jet energy is validated for jet transverse momenta up to 1 TeV to the level of a few percent using several in situ techniques by comparing a well-known reference such as the recoiling photon pT, the sum of the transverse momenta of tracks associated to the jet, or a system of low-pT jets recoiling against a high-pT jet. More sophisticated jet calibration schemes are presented based on calorimeter cell energy density weighting or hadronic properties of jets, aiming for an improved jet energy resolution and a reduced flavour dependence of the jet response. The systematic uncertainty of the jet energy determined from a combination of in situ techniques is consistent with the one derived from single hadron response measurements over a wide kinematic range. The nominal corrections and uncertainties are derived for isolated jets in an inclusive sample of high-pT jets. Special cases such as event topologies with close-by jets, or selections of samples with an enhanced content of jets originating from light quarks, heavy quarks or gluons are also discussed and the corresponding uncertainties are determined. © 2013 CERN for the benefit of the ATLAS collaboration

Measurement of the inclusive and dijet cross-sections of b-jets in pp collisions at sqrt(s) = 7 TeV with the ATLAS detector

The inclusive and dijet production cross-sections have been measured for jets containing b-hadrons (b-jets) in proton-proton collisions at a centre-of-mass energy of sqrt(s) = 7 TeV, using the ATLAS detector at the LHC. The measurements use data corresponding to an integrated luminosity of 34 pb^-1. The b-jets are identified using either a lifetime-based method, where secondary decay vertices of b-hadrons in jets are reconstructed using information from the tracking detectors, or a muon-based method where the presence of a muon is used to identify semileptonic decays of b-hadrons inside jets. The inclusive b-jet cross-section is measured as a function of transverse momentum in the range 20 < pT < 400 GeV and rapidity in the range |y| < 2.1. The bbbar-dijet cross-section is measured as a function of the dijet invariant mass in the range 110 < m_jj < 760 GeV, the azimuthal angle difference between the two jets and the angular variable chi in two dijet mass regions. The results are compared with next-to-leading-order QCD predictions. Good agreement is observed between the measured cross-sections and the predictions obtained using POWHEG + Pythia. MC@NLO + Herwig shows good agreement with the measured bbbar-dijet cross-section. However, it does not reproduce the measured inclusive cross-section well, particularly for central b-jets with large transverse momenta.Comment: 10 pages plus author list (21 pages total), 8 figures, 1 table, final version published in European Physical Journal

Measurement of the cross-section and charge asymmetry of WW bosons produced in proton-proton collisions at s=8\sqrt{s}=8 TeV with the ATLAS detector

This paper presents measurements of the $W^+ \rightarrow \mu^+\nu$ and $W^- \rightarrow \mu^-\nu$ cross-sections and the associated charge asymmetry as a function of the absolute pseudorapidity of the decay muon. The data were collected in proton--proton collisions at a centre-of-mass energy of 8 TeV with the ATLAS experiment at the LHC and correspond to a total integrated luminosity of 20.2~\mbox{fb^{-1}}. The precision of the cross-section measurements varies between 0.8% to 1.5% as a function of the pseudorapidity, excluding the 1.9% uncertainty on the integrated luminosity. The charge asymmetry is measured with an uncertainty between 0.002 and 0.003. The results are compared with predictions based on next-to-next-to-leading-order calculations with various parton distribution functions and have the sensitivity to discriminate between them.Comment: 38 pages in total, author list starting page 22, 5 figures, 4 tables, submitted to EPJC. All figures including auxiliary figures are available at https://atlas.web.cern.ch/Atlas/GROUPS/PHYSICS/PAPERS/STDM-2017-13

Evidence for the Higgs-boson Yukawa coupling to tau leptons with the ATLAS detector

Results of a search for H → τ τ decays are presented, based on the full set of proton-proton collision data recorded by the ATLAS experiment at the LHC during 2011 and 2012. The data correspond to integrated luminosities of 4.5 fb−1 and 20.3 fb−1 at centre-of-mass energies of √s = 7 TeV and √s = 8 TeV respectively. All combinations of leptonic (τ → `νν¯ with ` = e, µ) and hadronic (τ → hadrons ν) tau decays are considered. An excess of events over the expected background from other Standard Model processes is found with an observed (expected) significance of 4.5 (3.4) standard deviations. This excess provides evidence for the direct coupling of the recently discovered Higgs boson to fermions. The measured signal strength, normalised to the Standard Model expectation, of µ = 1.43 +0.43 −0.37 is consistent with the predicted Yukawa coupling strength in the Standard Model

Search for direct production of charginos and neutralinos in events with three leptons and missing transverse momentum in √s = 7 TeV pp collisions with the ATLAS detector

A search for the direct production of charginos and neutralinos in final states with three electrons or muons and missing transverse momentum is presented. The analysis is based on 4.7 fb−1 of proton–proton collision data delivered by the Large Hadron Collider and recorded with the ATLAS detector. Observations are consistent with Standard Model expectations in three signal regions that are either depleted or enriched in Z-boson decays. Upper limits at 95% confidence level are set in R-parity conserving phenomenological minimal supersymmetric models and in simplified models, significantly extending previous results