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Introduction: Implantable loop recorders (ILR) are used to screen for atrial fibrillation (AF) in patients with cryptogenic stroke (CS). However, there is limited real‐world data regarding the long‐term rate of AF detection using ILR and management consequences in patients with CS. The objective is to assess the rate of AF detection in patients with CS in a real‐world study over 36 months of follow‐up and its consequences on stroke prevention. Methods: This retrospective study included patients with an ILR placed for CS at Baylor College of Medicine and Baylor St. Luke's Medical Center between January 2014 and July 2021. The primary outcome was AF detection in patients with ILR. The secondary outcome was the rate of subsequent strokes after ILR placement in patients with or without diagnosed AF. The AF detection rate in our cohort was compared to the rate in CRYSTAL‐AF Trial at 36‐month follow‐up. The impact of AF detection on clinical management was examined. Results: We identified 225 patients. 51.1% were women and 38.2% African American. Among 85 patients with ILR labeled AF, 43 patients had true AF, and 42 had incorrectly labeled AF (48.3% false positive). The estimated AF detection rate at 36 months follow‐up was 28.6% (95% CI, 26.6%–30.6%). 58.1% of patients with AF were initiated on oral anticoagulation, 80.0% of whom were started on a direct oral anticoagulant. 13.8% of patients had recurrent strokes after ILR implantation; 4 of whom were diagnosed with AF. Conclusion: Compared to CRYSTAL‐AF, the AF detection rate in our cohort is similar, but this cohort includes a higher proportion of female and African American patients. Most patients with recurrent strokes after ILR implant did not have AF during 36 months of monitoring. [ABSTRACT FROM AUTHOR]

BACKGROUND A combination of magnetic solid‐phase extraction using an efficient and cheap magnetic sorbent obtained from sand and dispersive liquid–liquid microextraction has been developed for the extraction of nine multiclass pesticides (clodinafop‐propargyl, haloxyfop‐R‐methyl, fenoxaprop‐P‐ethyl, oxadiazon, penconazole, diniconazole, chlorpyrifos, fenazaquin, and fenpropathrin) from commercial fruit juices (sour cherry, pomegranate, grape, watermelon, orange, apricot, and peach juices). The enriched pesticides were determined by gas chromatography–flame ionization detector and gas chromatography–mass spectrometry. The sorbent was natural iron oxide entrapped in silica along with some impurities. In this method, to extract the analytes from the samples, an appropriate amount of the magnetic sorbent (at mg level) is added. Then the sorbent particles are isolated from the solution using an external magnetic field and the adsorbed analytes are desorbed from the sorbent by acetone. In the following, a dispersive liquid–liquid microextraction procedure is carried out to concentrate the analytes more and to reach low limits of detection. RESULTS: Under optimized extraction conditions, the method revealed satisfactory repeatability (relative standard deviation ≤8% for intra‐day and inter‐day precision), reasonable extraction recovery (43.3–55.9%), high enrichment factors (433–559), and low limits of detection (0.45–0.89 μg L−1). CONCLUSION: The method was applied in the analysis of pesticides in various fruit juices. Chlorpyrifos was found in peach juice at a concentration of 27 ± 2 μg L−1 (n = 3) using a gas chromatography–flame ionization detector. To verify the results, the peach juice was also injected into gas chromatography–mass spectrometry after applying the proposed extraction method. © 2022 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

A vortex‐assisted dispersive micro‐solid‐phase extraction procedure using a new and green sorbent was developed as a simple, fast, and efficient sample preparation method for the extracting five pesticides in several fruit juice samples. In this study, for the first time, riboflavin was used as an efficient sorbent. A few milligrams of riboflavin was directly added into the aqueous solution containing the analytes to adsorb them. After adsorption the analytes, they were desorbed and more concentrated by a dispersive liquid–liquid microextraction procedure. The influence of several effective parameters such as amount of riboflavin, pH, vortex time, eluent nature and volume, and extraction solvent type and volume on the extraction efficiency was investigated. In optimal conditions, linear ranges of the calibration curves were broad. The limits of detection and quantification were attained in the ranges of 0.56–1.5 and 1.9–0.52 ng mL−1, respectively. The proposed method demonstrated to be suitable for concurrent extraction of the studied pesticides in various fruit juice samples with high enrichment factors (320–360) and precision (relative standard deviation ≤7.8% for intra‐ [n = 6] and interday [n = 4] precisions at a concentration of 25 ng mL−1 of each pesticide). [ABSTRACT FROM AUTHOR]

Background: Catheter ablation is an effective treatment for ventricular arrhythmia (VA) in ischemic cardiomyopathy (ICM). However, results in non‐ICM (NICM) patients are not satisfactory, and studies comparing differences between NICM and ICM are limited. We conducted a meta‐analysis of procedural characteristics and long‐term outcomes of catheter ablation for VA, comparing results between ICM and NICM. Methods: Studies in the PubMed, EMBASE, and Cochrane databases were systematically reviewed. Four studies reporting comparison of catheter ablation of VA between ICM and NICM were examined. The Newcastle‐Ottawa Scale was used to appraise study quality. A random‐effects model with inverse variance method was used for comparisons. Results: Epicardial approach was significantly more undertaken for the NICM group than in the ICM group (odds ratio [OR]: 0.13; 95% confidence interval [CI]: 0.09‐0.18; P <.00001). Mean ablation time (P =.54), fluoroscopy time (P =.55), and procedural time (P =.18) did not differ significantly between the ICM and NICM groups. Procedural failure rates (OR: 0.46; 95% CI: 0.24‐0.89; P =.02) and VA recurrence rates (risk ratio [RR]: 0.68; 95% CI: 0.46‐1.01; P =.06) were significantly higher in the NICM group than in the ICM group. However, all‐cause mortality (RR: 1.37; 95% CI: 0.75‐2.49; P =.31) did not differ significantly between groups. Conclusions: Procedural failure and VA recurrence rates were significantly higher in the NICM group, despite significantly more frequent epicardial access. These highlight the limitations of catheter ablation for VA in NICM, given our current knowledge. [ABSTRACT FROM AUTHOR]

Background: Pericardial access is complicated by two difficulties: confirming when the needle tip is in the pericardial space, and avoiding complications during access, such as inadvertently puncturing other organs. Conventional imaging tools are inadequate for addressing these difficulties, as they lack soft‐tissue markers that could be used as guidance during access. A system that can both confirm access and avoid inadvertent organ injury is needed. Methods: A 21G micropuncture needle was modified to include two small electrodes at the needle tip. With continuous bioimpedance monitoring from the electrodes, the needle was used to access the pericardium in porcine models (n = 4). The needle was also visualized in vivo by using an electroanatomical map (n = 2). Bioimpedance data from different tissues were analyzed retrospectively. Results: Bioimpedance data collected from the subcutaneous space (992.8 ± 13.1 Ω), anterior mediastinum (972.2 ± 14.2 Ω), pericardial space (323.2 ± 17.1 Ω), mid‐myocardium (349.7 ± 87.6 Ω), right ventricular cavity (235.0 ± 9.7 Ω), lung (1142.0 ± 172.0 Ω), liver (575.0 ± 52.6 Ω), and blood (177.5 ± 1.9 Ω) differed significantly by tissue type (P <.01). Phase data in the frequency domain correlated well with the needle being in the pericardial space. A simple threshold analysis effectively separated lung (threshold = 1120.0 Ω) and blood (threshold = 305.9 Ω) tissues from the other tissue types. Conclusions: Continuous bioimpedance monitoring from a modified micropuncture needle during pericardial access can be used to clearly differentiate tissues. Combined with traditional imaging modalities, this system allows for confirming access to the pericardial space while avoiding inadvertent puncture of other organs, creating a safer and more efficient needle‐access procedure. [ABSTRACT FROM AUTHOR]

Background: Atrioventricular nodal reentrant tachycardia (AVNRT) is treatable by catheter ablation. Advances in mapping‐system technology permit fluoroless workflow during ablations. As national practice trends toward fluoroless approaches, easily obtained, reproducible methods of slow‐pathway identification, and ablation become increasingly important. We present a novel method of slow‐pathway identification and initial ablation results from this method. Methods and Results: We examined AVNRT ablations performed at our institution over a 12‐month period. In these cases, the site of the slow pathway was predicted by latest activation in the inferior triangle of Koch during sinus rhythm. Ablation was performed in this region. Proximity of the predicted site to the successful ablation location, complication rates, and patient outcomes were recorded. Junctional rhythm was seen in 40/41 ablations (98%) at the predicted site (mean, 1.3 lesions and median, 1 lesion per case). One lesion was defined as 5 mm of ablation. The initial ablation was successful in 39/41 cases (95%); in two cases, greater or equal to 2 echo beats were detected after the initial ablation, necessitating further lesion expansion. In 8/41 cases (20%), greater than one lesion was placed during initial ablation before attempted reinduction. Complications included one transient heart block and one transient PR prolongation. During follow‐up (median, day 51), one patient had lower‐extremity deep‐vein thrombosis and pulmonary embolus, and one had a lower‐extremity superficial venous thrombosis. There was one tachycardia recurrence, which prompted a redo ablation. Conclusions: Mapping‐system detection of late‐activation, low‐amplitude voltage during sinus rhythm provides an objective, and fluoroless means of identifying the slow pathway in typical AVNRT. [ABSTRACT FROM AUTHOR]

BACKGROUND: A method has been developed based on a three–phase system, followed by dispersive liquid–liquid microextraction for the extraction of seven pesticides from soya milk prior to analysis by gas chromatography‐flame ionization detection. The base of this method is the different extraction capability of the components of soya milk according to each of the phases involved. In this procedure, a homogeneous solution consisting of soya milk and a water–miscible solvent (acetonitrile) is separated into two phases in the presence of Na2SO4 and the analytes are extracted into the produced acetonitrile droplets. The acetonitrile phase is mixed with a pre‐concentration solvent to perform the next microextraction procedure for further enrichment of the analytes. RESULTS: Limits of detection and quantification were reached in the ranges of 0.11–0.35 and 0.35–1.20 µg L−1, respectively. Enrichment factors and extraction recoveries were in the ranges of 562–933 and 56–93%, respectively. Relative standard deviations were ≤7% for intra– (n = 6) and inter–day (n = 5) precisions at two concentrations of 10 and 50 µg L−1 of each analyte. CONCLUSION: The proposed method was applied to the analysis of pesticides in soya milk samples at µg L−1 concentrations. © 2019 Society of Chemical Industry [ABSTRACT FROM AUTHOR]

Introduction Epicardial catheter ablation is increasingly used to treat arrhythmias with an epicardial component. Nevertheless, percutaneous epicardial access remains associated with a significant risk of major complications. Developing a technology capable of confirming proper placement within the pericardial space could decrease complication rates. The purpose of this study was to examine differences in bioimpedance among the pericardial space, anterior mediastinum, and right ventricle. Methods An ovine model (n = 3) was used in this proof-of-concept study. A decapolar catheter was used to collect bipolar impedance readings; data were collected between each of five electrode pairs of varying distances. Data were collected from three test regions: the pericardial space, anterior mediastinum, and right ventricle. A control region in the inferior vena cava was used to normalize the data from the test regions. Analysis of variance was used to test for differences among regions. Results A total of 10 impedance values were collected in each animal between each of the five electrode pairs in the three test regions (n = 340) and the control region (n = 145). The average normalized impedance values were significantly different among the pericardial space (1.760 ± 0.370), anterior mediastinum (3.209 ± 0.227), and right ventricle (1.024 ± 0.207; P < 0.0001). In post hoc testing, the differences between each pair of regions were significant, as well (P < 0.001 for all). Conclusion Impedance values are significantly different among these three anatomical compartments. Therefore, impedance can be potentially used as a means to guide percutaneous epicardial access. [ABSTRACT FROM AUTHOR]

Introduction: Current methods for measuring voltage during radiofrequency (RF) ablation (RFA) necessitate turning off the ablation catheter. If voltage could be accurately read without signal attenuation during RFA, turning off the catheter would be unnecessary, allowing continuous ablation. We evaluated the accuracy of the Thermocool SMARTTOUCH catheter for measuring voltage while RF traverses the catheter. Methods and Results: We studied 26 patients undergoing RFA for arrhythmias. A 7.5F SMARTTOUCH catheter was used for sensing voltage and performing RFA. Data were collected from the Carto-3 3-dimensional mapping system. Voltages were measured during ablation (RF-ON) and immediately before or after ablation (RF-OFF). In evaluating the accuracy of RF-ON measurements, we utilized the RF-OFF measure as the gold standard. We measured 465 voltage signals. The median values were 0.2900 and 0.3100 for RF-ON and RF-OFF, respectively. Wilcoxon signed rank testing showed no significant difference in these values (P = 0.608). The intraclass correlation coefficient (ICC) was 0.96, indicating that voltage measurements were similarly accurate during RF-OFF versus RF-ON. Five patients had baseline atrial fibrillation (AF), for whom 82 ablation points were measured; 383 additional ablation points were measured for the remaining patients. The voltages measured during RF-ON versus RF-OFF were similar in the presence of AF (P = 0.800) versus non-AF rhythm (P = 0.456) (ICC, 0.96 for both). Conclusion: Voltage signal measurement was similarly accurate during RF-ON versus RF-OFF independent of baseline rhythm. Physicians should consider not turning off the SMARTTOUCH ablation catheter when measuring voltage during RFA. [ABSTRACT FROM AUTHOR]

1,2-Benzenedicarboxylic acid esters, commonly referred to as phthalate esters, form a group of compounds that are mainly used as plasticizers in polymers. Because phthalate esters are not chemically bound to the plastics, they can be released easily from products and migrate into the food or water that comes into direct contact. Due to their widespread use, they are considered as ubiquitous environmental pollutants. Phthalate esters are regarded as endocrine disrupting compounds by means of their carcinogenic effect. Phthalate esters can be analyzed by gas chromatography or high-performance liquid chromatography, however, their sensitivity and selectivity limit their direct use for determination of phthalates at very low level of concentrations exist in environmental samples with complex matrices. Therefore a sample pretreatment prior to their analysis is necessary. In this review, the historical development and overview of sample preparation methodologies have briefly been discussed and a comprehensive application of these methods in combination with different analytical techniques for preconcentration and determination of phthalate esters in various matrices have been summarized. Finally, a critical comparison of the different approaches in terms of enrichment factors achieved, extraction efficiency, precision, selectivity and simplicity of operation is provided. [ABSTRACT FROM AUTHOR]

Background Cryoballoon ablation of pulmonary veins (PVs) is widely used to treat atrial fibrillation (AF). Successful ablation requires occluding the PVs by cryoballoon. Angiography is a standard method of assessing PV occlusion. To decrease contrast doses and overcome potential contraindications (e.g., allergy to contrast, renal disease), alternative methods have been tested, including intracardiac echocardiography, transesophageal echocardiography-color flow Doppler, and distal cryoballoon pressure monitoring. Objective We evaluated pressure monitoring's accuracy in detecting PV occlusion during cryoballoon ablation. Methods We studied 72 PVs in 18 nonconsecutive patients (mean age 68 ± 8 years; 13 male) who underwent cryoballoon ablation for paroxysmal AF. In 67 PVs, we documented the point at which the recorded pressure waveform at the distal tip of the inflated cryoballoon transformed from a left atrial into a pulmonary arterial pressure waveform. PV occlusion was confirmed by concurrent PV angiography through the distal balloon channel. Occlusion was rated on a I-IV scale in which I indicated poor occlusion with major leakage and IV indicated complete occlusion without leakage. Results In 43 of 67 PVs (64%), the change in the pressure waveform from left atrial to pulmonary arterial was associated with complete PV occlusion (grade IV), confirmed by angiography. In the other 24 PVs, complete occlusion was achieved by further movement of the cryoballoon under intracardiac echocardiographic guidance and angiographic confirmation. All 67 PVs were electrically isolated with cryoballoon. Conclusions The change in pressure waveforms at the distal tip of inflated cryoballoon is not a reliable predictor of complete PV occlusion during cryoballoon ablation. [ABSTRACT FROM AUTHOR]

ABSTRACT We report on novel diblock copolymers of poly( N-vinylcaprolactam) (PVCL) and poly( N-vinyl-2-pyrrolidone) (PVPON) (PVCL- b-PVPON) with well-defined block lengths synthesized by the MADIX/reversible addition-fragmentation chain transfer (RAFT) process. We show that the lower critical solution temperatures (LCST) of the block copolymers are controllable over the length of PVCL and PVPON segments. All of the diblock copolymers dissolve molecularly in aqueous solutions when the temperature is below the LCST and form spherical micellar or vesicular morphologies when temperature is raised above the LCST. The size of the self-assembled structures is controlled by the molar ratio of PVCL and PVPON segments. The synthesized homopolymers and diblock copolymers are demonstrated to be nontoxic at 0.1-1 mg mL−1 concentrations when incubated with HeLa and HEK293 cancer cells for various incubation times and have potential as nanovehicles for drug delivery. © 2014 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2014, 52, 2725-2737 [ABSTRACT FROM AUTHOR]