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Background: The impact of delaying atrial fibrillation catheter ablation (AFCA) for antiarrhythmic drug (AAD) management on the disease course remains unclear. This study investigated AFCA rhythm outcomes based on the diagnosis‐to‐ablation time (DAT) and AAD responsiveness in participants with persistent AF (PeAF). Methods: We included data from 1038 AAD‐resistant PeAF participants, all of whom had a clear time point for AF diagnosis, especially PeAF at diagnosis time, and had undergone an AFCA for the first time. Participants who experienced recurrences of paroxysmal type on AAD therapy were analyzed as a cohort of AAD‐partial responders; those maintaining PeAF on AAD were AAD‐non‐responders. We determined the DAT cutoff for best discriminating long‐term rhythm outcomes using a maximum log‐likelihood estimation method based on the Cox proportional hazard regression model. Results: Of the participants (79.8% male; median age 61), 806 (77.6%) were AAD‐non‐responders. AAD‐non‐responders had a higher body mass index and a larger left atrial diameter than AAD‐partial‐responders. They also had a higher incidence of AF recurrence after AFCA (adjusted hazard ratio 1.75, 95% confidence interval 1.33–2.30; log‐rank p <.001) compared to AAD‐partial‐responders. The maximum log‐likelihood estimation showed bimodal cutoffs at 22 and 40 months. The optimal DAT cutoff rhythm outcome was 22 months, which discriminated better in the AAD‐partial‐responders than in the AAD‐non‐responders. Conclusions: Both DAT and AAD responsiveness influenced AFCA rhythm outcomes. Delaying AFCA to a DAT of longer than 22 months was inadvisable, particularly in the participants in whom PeAF was changed to paroxysmal AF during AAD therapy. [ABSTRACT FROM AUTHOR]

The learning accuracy of neuromorphic computing that mimics the biological brain, is affected by the conductance‐modulation characteristics of an artificial synapse. In ferroelectric‐based devices, these characteristics are implemented using a distribution of polarization values. Therefore, the distribution in a ferroelectric thin film with various external voltage signals is investigate. As polarization switching proceeds with voltage pulse, the domains of the switched polarization become larger. In ferroelectric‐gate field effect transistors, the channel layer assumed to lie beneath the ferroelectrics experiences a local conductance change, according to the polarization distribution of the ferroelectric layer. It is found that small clusters with high conductivity become large clusters in the channel layer as the polarization switching proceeds. When the additional pulses are applied, the high conductive regions eventually connect (i.e., percolate) in the channel layer and the conductance of the layer is greatly increased. Adjusting the height of the applied voltage can slow down or speed up this phenomenon. Also, the nanosecond voltage pulses are employed and the width of the conductive pathway is adjusted. It enables to fine‐tune the conductance of the channel layer. It demonstrates that conductance modulation is optimized with an appropriate voltage pulse train pattern. [ABSTRACT FROM AUTHOR]

Hybridizing single‐walled carbon nanotubes (SWCNTs) with π‐conjugated organic small molecules (π‐OSMs) offers a promising approach for producing high‐performance thermoelectric (TE) materials through the facile optimization of the molecular geometry and energy levels of π‐OSMs. Designing a twisted molecular structure for the π‐OSM with the highest occupied molecular orbital energy level comparable to the valence band of SWCNTs enables effective energy filtering between the two materials. The SWCNTs/twisted π‐OSM hybrid exhibits a high Seebeck coefficient of 110.4 ± 2.6 µV K−1, leading to a significantly improved power factor of 2,136 µW m−1 K−2, which is 2.6 times higher than that of SWCNTs. Moreover, a maximum figure of merit over 0.13 at room temperature is achieved via the efficient TE transport of the SWCNTs/twisted π‐OSM hybrid. The study highlights the promising potential of optimizing molecular engineering of π‐OSMs for hybridization with SWCNTs to create next‐generation, efficient TE materials. [ABSTRACT FROM AUTHOR]

Exploration of significantly active functional materials is highly valued for designing efficient electrochemical energy devices. 2D‐covalent organic frameworks (2D‐COF) have attracted significant interest in the context of important electrochemical applications due to their tunable structural and electronic properties, high thermal/chemical stability, and their carbon‐based motifs. The present review highlights the strategies and properties of modifying 2D‐COF electronically in detail and their prospects in electrochemical devices. The review clearly explains the electronic actuation methods of the COF skeletons by various synthetic and post‐synthetic strategies. The review crucially elucidates the importance of electroactive 2D‐COF as emerging functional materials in practical applications of electrochemical energy conversion devices. The review concludes by summarizing the effective strategies of 2D‐COF in improving electrocatalytic applications and suggests future research scope. The review orients the electroactive 2D‐COFs for critical analysis as advanced functional materials for a sustainable and reliable future. [ABSTRACT FROM AUTHOR]

The synergistic effect in multi‐metal electrocatalysts has gained attention as an efficient strategy for enhancing intrinsic electrocatalytic activities. In this study, a facile electrodeposition technique is used to synthesize a multi‐metal high entropy catalyst (HEC) for efficient electrocatalytic hydrogen production. To boost the synergistic effect between noble metals and transition metals, the Pt ratio is controlled in a multi‐metal electrocatalyst system. The prepared Pt‐involved HEC (Pt‐HEC) exhibits a bamboo‐like morphology with uniformly distributed elements. The 2.5 mM Pt‐HEC has outstanding electrocatalytic activity toward hydrogen evolution reaction (HER) among other Pt‐HECs, with a low overpotential of 70 mV and a Tafel slope value of 47 mV dec−1. Additionally, the Pt mass activity of the 2.5 mM Pt‐HEC is 5.6 times higher than commercial Pt/C electrocatalyst owing to the improved synergistic effect with an optimized Pt ratio. According to the electrochemical impedance spectroscopy (EIS) analysis, the proton‐coupled electron transfer (PCET) process occurs more quickly in the 2.5 mM Pt‐HEC electrocatalyst, confirming its smaller charge transfer resistance properties compared to those of the 5 and 1 mM Pt‐HEC. Therefore, HEC systems can be extensively encouraged as a platform for improving synergistic effects and enhancing electrocatalytic activities for a highly efficient HER electrocatalyst. [ABSTRACT FROM AUTHOR]

Cardiac resynchronization therapy (CRT) strategy for heart failure with mildly reduced ejection fraction (HFmrEF) is controversial. Left bundle branch area pacing (LBBAP) is an emerging pacing modality and an alternative option to CRT. This analysis aimed to perform a systematic review of the literature and meta‐analysis on the impact of the LBBAP strategy in HFmrEF, with left ventricular ejection fraction (LVEF) between 35% and 50%. PubMed, Embase, and Cochrane Library were searched for full‐text articles on LBBAP from inception to July 17, 2022. The outcomes of interest were QRS duration and LVEF at baseline and follow‐up in mid‐range heart failure. Data were extracted and summarized. A random‐effect model incorporating the potential heterogeneity was used to synthesize the results. Out of 1065 articles, 8 met the inclusion criteria for 211 mid‐range heart failure patients with an implant LBBAP across the 16 centers. The average implant success rate with lumenless pacing lead use was 91.3%, and 19 complications were reported among all 211 enrolled patients. During the average follow‐up of 9.1 months, the average LVEF was 39.8% at baseline and 50.5% at follow‐up (MD: 10.90%, 95% CI: 6.56−15.23, p <.01). Average QRS duration was 152.6 ms at baseline and 119.3 ms at follow‐up (MD: −34.51 ms, 95% CI: −60.00 to −9.02, p <.01). LBBAP could significantly reduce QRS duration and improve systolic function in a patient with LVEF between 35% and 50%. Application of LBBAP as a CRT strategy for HFmrEF may be a viable option. [ABSTRACT FROM AUTHOR]

Background: The machine‐specific reference (msr) correction factors (kQmsr,Q0fmsr,fref$k_{{Q_{{\rm{msr}}}},\;{Q_0}}^{{f_{{\rm{msr}}}},{f_{{\rm{ref}}}}}$) were introduced in International Atomic Energy Agency (IAEA) Technical Report Series 483 (TRS‐483) for reference dosimetry of small fields. Several correction factor sets exist for a Leksell Gamma Knife (GK) Perfexion or Icon. Nevertheless, experiments have not rigorously validated the correction factors from different studies. Purpose: This study aimed to assess the role and accuracy of kQmsr,Q0fmsr,fref$k_{{Q_{{\rm{msr}}}},\;{Q_0}}^{{f_{{\rm{msr}}}},{f_{{\rm{ref}}}}}$ values in determining the absorbed dose rates to water in the reference dosimetry of Gamma Knife. Methods: The dose rates in the 16 mm collimator field of a GK were determined following the international code of practices with three ionization chambers: PTW T31010, PTW T31016 (PTW Freiberg GmbH, New York, NY), and Exradin A16 (Standard Imaging, Inc., Middleton, WI). A chamber was placed at the center of a solid water phantom (Elekta AB, Stockholm, Sweden) using a detector‐specific insert. The reference point of the ionization chamber was confirmed using cone‐beam CT images. Consistency checks were repeated five times at a GK site and performed once at seven GK sites. Correction factors from six simulations reported in previous studies were employed. Variations in the dose rates and relative dose rates before and after applying the kQmsr,Q0fmsr,fref$k_{{Q_{msr}},\;{Q_0}}^{{f_{msr}},{f_{ref}}}$ were statistically compared. Results: The standard deviation of the dose rates measured by the three chambers decreased significantly after any correction method was applied (p = 0.000). When the correction factors of all studies were averaged, the standard deviation was reduced significantly more than when any single correction method was applied (p ≤ 0.030), except for the IAEA TRS‐483 correction factors (p = 0.148). Before any correction was applied, there were statistically significant differences among the relative dose rates measured by the three chambers (p = 0.000). None of the single correction methods could remove the differences among the ionization chambers (p ≤ 0.038). After TRS‐483 correction, the dose rate of Exradin A16 differed from those of the other two chambers (p ≤ 0.025). After the averaged factors were applied, there were no statistically significant differences between any pairs of chambers according to Scheffe's post hoc analyses (p ≥ 0.051); however, PTW T31010 differed from PTW 31016 according to Tukey's HSD analyses (p = 0.040). Conclusion: The kQmsr,Q0fmsr,fref$k_{{Q_{{\rm{msr}}}},\;{Q_0}}^{{f_{{\rm{msr}}}},{f_{{\rm{ref}}}}}$ significantly reduced variations in the dose rates measured by the three ionization chambers. The mean correction factors of the six simulations produced the most consistent results, but this finding was not explicitly proven in the statistical analyses. [ABSTRACT FROM AUTHOR]

Background/Purpose: The pathogenesis of chronic actinic dermatitis (CAD) is more complicated than other photodermatoses. However, the relationship between the clinical severity of CAD and the offending photocontact or contact allergens or both, and the correlations of CAD immunopathogenesis with the immunoregulatory molecules involved in adaptive immunity are yet to be investigated. Methods: We performed phototesting with broad‐spectrum ultraviolet (UV) B, UVA, and visible light to establish the presence of photosensitivity in 121 patients with CAD, together with photopatch and contact patch testing. Nine patients with CAD were selected according to their clinical severity score for CAD (CSS‐CAD), and triple direct immunofluorescence analysis was performed with paraffin‐embedded skin biopsy samples. Results: As CSS‐CAD was closely correlated with the multiplicity of photo(contact) allergens, particularly photoallergens, three or more photoallergens were detected in the severe CAD group (52.5%); less in the moderate group (32.8%); and only one in the mild group (14.8%; P =.025). In the groups showing greater severity of disease, the absolute numbers of IFN‐γ+, IL‐17+, CD4+, CD8+, common‐γ chain receptor (common‐γCR)+, and CD69+ tissue‐resident memory cells increased on average; there was also an increase in the CD4+/CD8+ cell ratio, with the more severely affected groups. However, the levels of TNF‐α+ and FoxP3+ regulatory T (Treg) cells and the mean IL‐17/IFN‐γ cell ratio decreased in the more severely affected CSS‐CAD subgroups. Conclusions: Based on the clinical analysis and immunopathogenic results, avoidance of excessive sun exposure, and topical and systemic blocking agents for photo(contact) allergens are recommended. Additionally, conventional immunomodulators and emerging agents including JAK–STAT inhibitors may be administered for CAD treatment in the future. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to elucidate the relationship between premature ventricular complexes (PVCs) and right ventricular (RV) dysfunction, and the effects of radiofrequency catheter ablation (RFCA) on RV function. Methods: A total of 110 patients (age, 50.8 ± 14.4 years; 30 men) without structural heart disease who had undergone RFCA for RV outflow tract (RVOT) PVCs were retrospectively included. RV function was assessed using fractional area change (FAC) and global longitudinal strain (GLS) before and after RFCA. Clinical data were compared between the RV dysfunction (n = 63) and preserved RV function (n = 47) groups. The relationship between PVC burden and RV function was analyzed. Change in RV function before and after RFCA was compared between patients with successful and failed RFCA. Results: PVC burden was significantly higher in the RV dysfunction group than in the preserved RV function group (p <.001). FAC and GLS were significantly worse in proportion to PVC burden (p <.001 and p <.001, respectively). The risk factor associated with RV dysfunction was PVC burden [odds ratio (95% confidence interval), 1.092 (1.052–1.134); p <.001]. Improvement in FAC (13.0 ± 8.7% and –2.5 ± 5.6%, respectively; p <.001) and GLS (–6.8 ± 5.7% and 2.1 ± 4.2%, respectively; p <.001) was significant in the patients with successful RFCA, compared to the patients in whom RFCA failed. Conclusions: Frequent RVOT PVCs are associated with RV dysfunction. RV dysfunction is reversible by successful RFCA. [ABSTRACT FROM AUTHOR]

Background: The assessment of liver surface nodularity (LSN) for staging hepatic fibrosis is restricted in clinical practice because it requires customized software and time‐consuming procedures. A simplified method to estimate LSN score may be useful in the clinic. Purpose: To evaluate the regional analysis of LSN and processing time in a single axial liver MR image for staging liver fibrosis. Study Type: Retrospective. Population: A total of 210 subjects, a multicenter study. Field Strength/Sequence: A 3 T/noncontrast gradient echo T1WI. Assessment: Subjects were divided into five fibrosis groups (F0 = 29; F1 = 20; F2 = 32; F3 = 50; F4 = 79) based on the METAVIR fibrosis scoring system. The mean LSN (on three slices) and regional LSN (on one slice) measurements, and the processing times, are compared. The regional LSN scores in five regions‐of‐interests (ROI1‐5) were analyzed in a single axial MRI at the level of the hilum by two independent observers. Statistical Tests: Regional variations in LSN scores were compared using ANOVA with Tukey test. Agreement between the mean and regional LSN measurements was evaluated using Pearson correlation coefficients (r) and Bland–Altman plots. The diagnostic performance of mean and regional LSN scores according to fibrosis stage was evaluated with the AUROC. A P value < 0.05 was considered statistically significant. Results: Total processing time for a regional LSN measurement (3.6 min) was 75.5% less than that for mean LSN measurement (14.7 min). Mean LSN scores and all five regional LSN scores showed significant differences between fibrosis groups. Among regional LSN scores, ROI5 showed the highest AUROC (0.871 at cut‐off 1.12) for discriminating F0‐2 vs. F3‐4 and the best correlation with mean LSN score (r = 0.800, −0.07 limit of agreement). Conclusion: Quantitative regional LSN measurement in a single axial MR image reduces processing time. Regional ROI5 LSN score might be useful for clinical decision‐making and for distinguishing the difference between early fibrosis (F0‐2) and advanced fibrosis (F3−4) in the liver. Evidence Level: 3 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]

Purpose: Scintillation detectors were 3D printed based on a gamma knife (GK) dose distribution to calculate the volume averaging effect. The collimator output factors were measured using isodose‐shaped scintillators (ISSs) and compared with those of a micro‐diamond detector and previous reports. Methods: An absorbed dose distribution in a spherical dosimetry phantom with a radius of 8 cm was obtained from GK treatment planning software (Leksell GammaPlan [LGP], Elekta AB, Stockholm, Sweden). Two types of ISSs were fabricated to fit the 97.2% (ISS‐1) and 95.6% (ISS‐2) isodose surfaces. The volume averaging correction factors were obtained by dividing the absorbed dose to water in the central voxel (CV) by that in the ISS. The correction effect due to the difference between the ISS and water was calculated by Monte Carlo simulations. Ten ISS detectors, five of each type, were used to measure the output factors of the 4‐ and 8‐mm collimators of a GK Icon to assess system consistency. The output factors of seven GKs were measured using two ISS detectors, one of each type, and a PTW T60019 (PTW, Freiburg, Germany) micro‐diamond detector. Results: The detector output ratios (DORs) measured using the five ISSs of each type were consistent, with standard uncertainties less than 0.2%. In the 4‐mm field, the volume averaging correction factor ratios were 1.018 and 1.026, and the output factors after all corrections were 0.827 (0.006) and 0.825 (0.006) for ISS‐1 and ISS‐2, respectively. In the 8‐mm field, the volume averaging correction factor ratios were 1.000 for both ISS types, and the output factors were 0.898 (0.003) and 0.900 (0.003) for ISS‐1 and ISS‐2, respectively. The ISS detectors could measure the output factors of a GK with uncertainties comparable to that of the PTW 60019 detector. The output factors of all detectors decreased with the dose rate. Conclusion: The volume averaging effect of an ISS developed in‐house could be calculated using known dose distributions. The collimator output factors of the GK Perfexion/Icon models measured using ISS detectors were consistent with those of a commercial synthetic micro‐diamond detector and recent studies. [ABSTRACT FROM AUTHOR]

In order to evaluate the spatiotemporal distribution of the carbonate system in the northern East China Sea (ECS), we first measured the seasonal dissolved inorganic carbon (DIC) and total alkalinity (TA), from which the aragonite saturation state (Ωarag) was calculated for the years 2015–2017. The DIC, TA, and Ωarag were 1,680.9–2,211.4 μmol kg−1, 2,145.1–2,312.8 μmol kg−1, and 1.2–6.0, respectively. The spatiotemporal variability of Ωarag in the northern ECS was mainly controlled by seasonal water mass, such as Yellow Sea Surface Water, Changjiang Dilute Water, and Yellow Sea Bottom Water (YSBW). The lowest Ωarag (∼1.4) in bottom layer was observed in high primary production areas caused by the extension of the Changjiang River plume with the higher Ωarag (up to 6) and was closely linked to the YSBW with low Ωarag expanded southward from Yellow Sea near bottom. Although this area was not a hypoxia zone unlike western shelf region (Chinese region) of the northern ECS, YSBW near bottom could enhance the suppression of bottom aragonite without hypoxia. In eastern region of northern ECS, higher production at surface, YSBW with lower Ωarag extension, and longer respiration product accumulations near bottom tend to lower Ωarag, as compared with western region where the summer hypoxia led to lower Ωarag. Therefore, this result indicates that the eastern region of the northern ECS is also susceptible to ocean acidification, along with the summer hypoxic zone of the western region. Plain Language Summary: Excess carbon dioxide from fossil fuel burning enters the ocean and reacts with seawater decreasing ocean pH, and lowering carbonate ion concentrations. These chemical reactions are known as ocean acidification (OA). Aragonite saturation state (Ωarag) is generally used to trace OA because it measures carbonate ion concentration. A decrease in Ωarag affects marine calcifying organisms and marine ecosystem. In previous studies on OA in East China Sea (ECS), most data were confined to the western shelf region (Chinese region), and this has limited our knowledge about the state of OA for the entire ECS. This study is the first to explore spatiotemporal variability of Ωarag in the northern ECS (Korean region). We found that the spatiotemporal variability of Ωarag in the northern ECS was mainly controlled by seasonal water mass, such as Yellow Sea Surface Water, Changjiang Dilution Water, and Yellow Sea Bottom Water (YSBW). The lowest Ωarag (∼1.4) at the bottom layer was found in areas of surficial high primary production (Ωarag = 6.0), where the Changjiang River plume with nutrient‐rich water discharged and the YSBW with lower Ωarag expanded southward from Yellow Sea near bottom. This value was almost the same as that in areas of hypoxia in Chinese region. Compared with Chinese region, higher production at surface, YSBW with lower Ωarag extension, and long‐term respiration product accumulations near bottom tend to lower Ωarag. This result shows that the Korean region of ECS also could be also vulnerable to OA. Key Points: Dissolved inorganic carbon concentration was main driver of the seasonal variability of aragonite saturation state (Ωarag) in the northern East China Sea (ECS)Spatial variability of Ωarag was mainly controlled by seasonal water massThe northern ECS could be vulnerable to acidification due to high production, Yellow Sea Bottom Water expansion with low Ωarag, and long‐term remineralization [ABSTRACT FROM AUTHOR]

Background: Sinoatrial node dysfunction and atrial fibrillation (AF) frequently coexist and interact with each other, often to initiate and perpetuate each other. Objective: To determine the effect of AF on the incidence and risk of sick sinus syndrome (SSS). Methods: The association of incident AF with the development of incident SSS was assessed from 2004 to 2014 in 302 229 SSS‐ and pacemaker‐free subjects aged ≥60 years in the Korea National Health Insurance Service‐Senior cohort. Results: During an observation period of 1 854 800 person‐years, incident AF was observed in a total of 12 797 subjects (0.69%/year). The incidence of SSS was 3.4 and 0.2 per 1000 person‐years in the propensity score‐matched incident AF and no‐AF groups, respectively. After adjustment, the significantly increased risk of SSS was observed in the incident AF group, with a hazard ratio (HR) of 13.4 (95% confidence interval [CI]: 8.4–21.4). This finding was consistently observed after censoring for heart failure (HR: 16.0; 95% CI: 9.2–28.0) or heart failure/myocardial infarction (HR: 16.6; 95% CI: 9.3–29.7). Incident AF also was associated with an increased risk of pacemaker implantation related with both SSS (HR: 21.8; 95% CI: 8.7–18.4) and atrioventricular (AV) block (HR: 9.5; 95% CI: 4.9–18.4). These results were consistent regardless of sex and comorbidities. Conclusion: Incident AF was associated with more than 10 times increased risk of SSS in an elderly population regardless of comorbidities. The risk of pacemaker implantations related with both sinus node dysfunction and AV block was increased in the elderly population with incident AF. [ABSTRACT FROM AUTHOR]

Background: Preserved ratio impaired spirometry (PRISm) is a common spirometric pattern that is associated with respiratory symptoms and higher mortality rates. However, the relationship between lung cancer and PRISm remains unclear. This study investigated the clinical characteristics of lung cancer patients with PRISm and the potential role of PRISm as a prognostic factor. Methods: We retrospectively reviewed data collected from 2014 to 2015 in the Korean Association for Lung Cancer Registry. We classified all patients into three subgroups according to lung function as follows: normal lung function; PRISm (forced expiratory volume in 1 s [FEV1] < 80% predicted and FEV1/forced vital capacity [FVC] ≥ 0.7); and chronic obstructive pulmonary disease (COPD; FEV1/FVC < 0.7). In non–small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), the overall survival period was compared among the three subgroups. The prognostic factors were investigated using Cox regression analysis. Results: Of the 3763 patients, 38.6%, 40.1%, and 21.3% had normal lung function, COPD, and PRISm, respectively. Patients with PRISm had poorer overall survival than those with COPD or normal lung function in NSCLC and SCLC (Mantel–Cox log‐rank test, p < 0.05). In the risk‐adjusted analysis, overall survival was independently associated with COPD (hazard ratio [HR] 1.209, p = 0.027) and PRISm (HR 1.628, p < 0.001) in NSCLC, but was only associated with PRISm (HR 1.629, p = 0.004) in SCLC. Conclusions: PRISm is a significant pattern of lung function in patients with lung cancer. At the time of lung cancer diagnosis, pre‐existing PRISm should be considered a predictive factor of poor prognosis. [ABSTRACT FROM AUTHOR]

Background: In European ancestry, 111 genetic loci were identified as associated with atrial fibrillation (AF). We explored the reproducibility of those single nucleotide polymorphisms (SNPs) in a genome‐wide association study (GWAS) meta‐analysis of Far East Asian populations. Methods: We performed a meta‐analysis of the Korean AF network and Japanese AF data sets (9118 cases and 33 467 controls) by an inverse‐variance fixed‐effects model. We compared the results with 111 previously reported SNPs proven in Europeans after excluding 36 missing loci and a locus with a minor allelic frequency (MAF) < 0.01 in the European population. Results: Among remaining 74 loci, 29 loci were replicated at a P <.05, and 17 of those loci were newly found in the Far East Asian population: 3 loci with a P < 5×10−8 (METTL11B at 1q24, KCNN2 at 5q22 and LRMDA at 10q22), 4 loci at the threshold of the Bonferroni correction of P = 4.5 × 10−4 ~ 5×10−8 (KIF3C at 2p23, REEP3, NRBF2 at 10q21, SIRT1, MYPN at 10q21 and CFL2 at 14q13) and 10 SNPs with a P =.05 ~ 4.5 × 10−4. Among 18 AF loci with a MAF< 0.01 in the Far East Asian populations, 2 loci (GATA4 at 8q23 and SGCG at 13q12) were replicated after a fine mapping. Twenty‐seven AF loci, including a locus, which had a sufficient sample size to get a power of over 80% (with a type 1 error α = 4.5 × 10−4), were not replicated in the Far East Asian populations. Conclusions: We newly replicated 19 AF‐associated genetic loci in the European descent among the Far East Asian populations. It highlights the extensive sharing of AF genetic risks across Far East Asian populations. [ABSTRACT FROM AUTHOR]

Background: Chronic cough is a common respiratory symptom, and, if persistent, the patient's quality of life can worsen and result in a depressive mood, or vice versa. Although previous reports suggest a relationship between chronic cough and depression, we further investigated this relationship according to smoking status and lung function. Methods: This observational study used cross‐sectional data from the 6th Korean National Health and Nutrition Examination Survey (2014 and 2016). Propensity score matching using age, sex, smoking status, and lung function was performed for participants with and without chronic cough to reduce the confounding effects associated with depressive mood. Questionnaires recorded coughs persisting for >3 months and the Patient Health Questionnaire‐9 (PHQ‐9) assessed the severity of depressive mood. Results: Among 12 494 participants who were >18 years old, 226 with chronic cough were matched with 226 with non‐chronic cough. Overall, chronic cough participants showed higher PHQ‐9 scores than the non‐chronic cough participants (4.29 ± 5.23 vs. 2.63 ± 3.38, P <.001). When stratified by sex, the difference remained significant in women (5.69 ± 5.96 vs. 3.05 ± 3.97, P <.001) but not in men (3.18 ± 4.27 vs. 2.31 ± 3.65, P =.092). When stratified by lung function status, the difference remained significant for those with normal lung function (4.32 ± 5.32 vs. 2.78 ± 3.86, P =.003) and reduced lung function (4.19 ± 4.93 vs. 2.11 ± 3.55, P ≤ 0.001). Multivariate logistic regression analysis revealed that chronic cough was associated with PHQ‐9 score (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.014–1.27, P =.014), chronic obstructive pulmonary disease (OR, 4.87; 95% CI, 1.041–22.86, P =.044) and physician‐diagnosed bronchial asthma (OR, 2.93; 95% CI, 1.162–7.435, P =.023). Conclusions: Depressive mood is significantly correlated with chronic cough in females. [ABSTRACT FROM AUTHOR]

The objective of this study is to verify the anatomic correlate of the second (2nd) outer retina band in optical coherence tomography (OCT), and to demonstrate the potential of using intrinsic optical signal (IOS) imaging for concurrent optoretinography (ORG) of phototransduction activation and energy metabolism in stimulus activated retinal photoreceptors. A custom‐designed OCT was employed for depth‐resolved IOS imaging in mouse retina activated by a visible light flicker stimulation. The spatiotemporal properties of the IOS changes at the photoreceptor outer segment (OS) and inner segment (IS) were quantitatively evaluated. Rapid IOS change was observed at the OS almost right away, and the IOS at the IS was relatively slow. Comparative analysis indicates that the OS‐IOS reflects transient OS deformation caused by the phototransduction activation, and IS‐IOS might reflect the energy metabolism caused by mitochondria activation in retinal photoreceptors. The consistency of the distribution of the IS‐IOS and the 2nd OCT band supports the IS ellipsoid (ISe), which has abundant mitochondria, as the signal source of the 2nd OCT band of the outer retina. [ABSTRACT FROM AUTHOR]

Background: We have previously reported that unilateral groin‐single transseptal (ST) ablation in patients with paroxysmal atrial fibrillation (AF) was safe and significantly reduced patient discomfort compared with bilateral groin‐double transseptal (DT) ablation. Hypothesis: In the present study, we hypothesized that ST ablation would be as effective and safe as DT ablation in real‐world practice like previous study. Among the 1765 consecutive patients in the Yonsei AF ablation cohort from October 2015 to January 2020, 1144 patients who underwent radiofrequency ablation were included for the analysis. Among them, 450 underwent ST ablation and 694 underwent DT ablation. Results: The total procedure time, ablation time, and fluoroscopy time were longer in the ST group than in the DT group (p <.05 for all). The hospital stay after catheter ablation was 1.3 ± 1.1 days which was longer in DT group than ST group (p =.001). No significant difference was observed in the complication rate (p =.263) and AF‐free survival rate (log‐rank p =.19) between the groups. However, after excluding patients who used antiarrhythmic drugs when AF recurred, the AF‐free survival rates were lower in the DT group than in the ST group before and after propensity score matching (log‐rank p =.026 and.047, respectively). Conclusion: Although the ST approach increases the procedure time compared with the DT approach owing to the need for more frequent catheter exchanges, the ST approach is a feasible and safe strategy for AF ablation in terms of rhythm outcomes and risk of complications. [ABSTRACT FROM AUTHOR]

Improper functional orientation of the acetabular cup can result in improper positions when dynamic pelvic positions are not considered. The purpose of this study was to evaluate changes on acetabular anteversion according to pelvic tilt under various acetabular inclinations. Two artificial pelvic models were selected for this study. Acetabular inclinations on the coronal plane were 25°, 32°, 50°, and 60°. Acetabular anteversion of all components were 15°. Changes of anteversion according to pelvic tilt were measured at angles of 0°, 10°, 20°, 30°, and 40°. Computer Navigation, PolyWare 3D pro, CT, and plain radiography were used to measure each angle. The anatomical anteversions against pelvic tilt were calculated using the following formulae: anatomical anteversion (°) = −14.48Χ + 90.18 (inclination angle 25°); anatomical anteversion (°) = −12.26Χ + 80.10 (inclination angle 32°); anatomical anteversion (°) = −7.468Χ + 61.13 (inclination angle 50°); and anatomical anteversion (°) = −5.328Χ + 44.84 (inclination angle 60°) (Χ: pelvic tilt angle). Radiographic anteversion against pelvic tilt were calculated using the following formulae: radiographic anteversion (°) = −9.50Χ + 57.09 (inclination angle 25°); radiographic anteversion (°) = −8.577Χ + 50.89 (inclination angle 32°); radiographic anteversion (°) = −6.794Χ + 45.73 (inclination angle 50°); radiographic anteversion (°) = −5.226Χ + 33.08 (inclination angle 60°). In conclusion, changes in anteversion according to pelvic tilt were lesser at higher degrees of acetabular inclination. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to elucidate the risk for stroke and systemic embolism (SE) in patients with atrial fibrillation and heart failure (HF) according to HF type. Methods and results: A total of 10 780 patients with atrial fibrillation were enrolled in a multicentre prospective registry and divided according to HF type: no‐HF, HF with preserved ejection fraction (EF) (HFpEF), HF with mid‐range EF (HFmrEF), and HF with reduced EF (HFrEF). Each group included 237 age‐matched and sex‐matched patients (age, 69.0 ± 10.3 years; men, 69.6%). The baseline characteristics, cumulative incidence, and hazard ratios for stroke/SE and major bleeding were compared across the groups. Patients with HF accounted for 10.3% of the total population; HFpEF, HFmrEF, and HFrEF represented 43.7%, 23.6%, and 32.7% of the patients with HF, respectively. The CHA2DS2‐VASc score was significantly higher in the HFpEF, HFmrEF, and HFrEF groups than in the no‐HF group. The annual stroke/SE incidence rates were 2.8%, 0.7%, 1.1%, and 0.9% in the HFpEF, HFmrEF, HFrEF, and no‐HF groups, respectively. The cumulative incidence of stroke/SE was significantly highest in the HFpEF group at 22.8 ± 10.0 months (P = 0.020). The stroke/SE risk was higher in the HFpEF group than in the HFmrEF and HFrEF groups (hazard ratio, 3.192; 95% confidence interval, 1.039–9.810; P = 0.043). E/e' value was an independent risk factor for stroke/SE. There were no significant differences in the incidence of major bleeding across the groups. Conclusions: The stroke/SE risk was the highest in the HFpEF group and comparable between the HFmrEF and HFrEF groups. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: To evaluate the efficacy and safety of a slow-release form of bepotastine salicylate (HL151, Belion CR) in patients with perennial allergic rhinitis (PAR).Study Design: Double-blind, placebo-controlled multicenter comparative study.Methods: Two hundred seventy-two PAR patients (aged 19-65 years) were studied to determine the efficacy and safety of HL151 (20 mg once daily administration) relative to those of a placebo in terms of improvements in total and nasal symptom scores. The subjects were randomized to the placebo (n = 138) or HL151 group (n = 134, 20 mg orally once daily for 4 weeks), and reflective and instantaneous total nasal symptom scores (TNSS) were measured daily in comparison with baseline. Among 272 subjects, 229 subjects (119 in the placebo group, 110 in the HL151 group) who completed the study were included for efficacy analysis.Results: Instantaneous and reflective TNSS and nasal symptoms such as rhinorrhea, nasal itching, and sneezing at 2 and 4 weeks showed that HL151 was superior to the placebo (all P < .05). There were no significant differences in terms of adverse events and adverse drug reactions between the two groups. Regarding serious adverse events, there was only one case of acute hepatitis B, which was reported not to be associated with HL151.Conclusions: This multicenter trial showed that once-daily use of HL151 is efficacious and safe in adult patients with PAR and could improve compliance due to its convenience.Level Of Evidence: 1b Laryngoscope, 131:E702-E709, 2021. [ABSTRACT FROM AUTHOR]

Though endometriosis and infertility are clearly associated, the pathophysiological mechanism remains unclear. Previous work has linked endometrial ARID1A loss to endometriosis‐related endometrial non‐receptivity. Here, we show in mice that ARID1A binds and regulates transcription of the Foxa2 gene required for endometrial gland function. Uterine‐specific deletion of Arid1a compromises gland development and diminishes Foxa2 and Lif expression. Deletion of Arid1a with Ltf‐iCre in the adult mouse endometrial epithelium preserves the gland development while still compromising the gland function. Mice lacking endometrial epithelial Arid1a are severely sub‐fertile due to defects in implantation, decidualization, and endometrial receptivity from disruption of the LIF‐STAT3‐EGR1 pathway. FOXA2 is also reduced in the endometrium of women with endometriosis in correlation with diminished ARID1A, and both ARID1A and FOXA2 are reduced in nonhuman primates induced with endometriosis. Our findings describe a role for ARID1A in the endometrial epithelium supporting early pregnancy establishment through the maintenance of gland function. [ABSTRACT FROM AUTHOR]

Aims: Optimal medical therapy after cardiac resynchronization therapy (CRT) implantation is important in heart failure (HF) with reduced ejection fraction (HFrEF) patients. Although sacubitril/valsartan (SV) is a mainstay in the treatment of HFrEF, its efficacy in the management of CRT non‐responders has not been emphasized. We aimed to investigate the efficacy of SV in CRT non‐responders. Methods and results: We analysed 175 HFrEF patients who received CRT implantation between January 2010 and January 2019. CRT responder was defined as a decrease in left ventricular (LV) end‐systolic volume > 15% on echocardiography 6 months after implantation. Medical records were retrospectively reviewed. Patients underwent follow‐up for HF rehospitalization, heart transplantation (HT), implantation of a LV assistant device (LVAD), cardiac death, and all‐cause death. Among the study population, 164 patients were evaluated for CRT response; 54 (33%) were CRT non‐responders. Four patients (6%) who received SV before CRT implantation were excluded, leaving 50 patients for analysis. Twenty‐two non‐responders (44%) received SV. There was no significant difference in baseline characteristics between SV users and non‐users (n = 28). During follow‐up, SV users had significantly lower incidence of all‐cause death [1 (5%) vs. 10 (36%), P = 0.022] and tended to have lower HF rehospitalization [6 (27%) vs. 16 (57%), P = 0.068] and cardiac death (including HT and LVAD implant) [2 (9%) vs. 10 (36%), P = 0.064]. Kaplan–Meier survival analysis revealed that SV use was associated with a lower risk of cardiac death (including HT and LVAD implant) (log‐rank P = 0.029). Conclusions: SV treatment was related to a lower incidence of cardiac death including HT and LVAD implant in CRT non‐responders. The optimization of HF management, including SV, should be considered in CRT non‐responders. [ABSTRACT FROM AUTHOR]

Background: Observational studies have shown that high levels of serum uric acid (UA) were associated with atrial fibrillation (AF). However, the causal effect of urate on the risk of AF is still unknown. To clarify the potential causal association between UA and AF, we performed a Mendelian randomization (MR) analysis using genetic instrumental variables (IVs). Materials and methods: From the Korean GWAS dataset of 633 patients with AF (mean age 50.6 ± 7.8 years, 80.9% male, Yonsei AF Ablation cohort) who underwent radiofrequency catheter ablation and the data from 3533 controls (from the Korea Genome Epidemiology Study), we selected 9 SNPs, with a P value less than.05, associated with an increased UA serum level. Additionally, we calculated the weighted genetic risk score (wGRS) using the selected 9 SNPs, to use it as an instrumental variable. A Mendelian randomization analysis was calculated by a 2‐stage estimator method. Results: The conventional association between the serum UA and AF was significant (P =.001) after adjusting for potential confounding factors. The SNP rs1165196 on SLC17A1 (F‐statistics = 208.34, 0.18 mg/mL per allele change, P <.001) and wGRS (F‐statistics = 222.26, 0.20 mg/mL per 1SD change, P <.001) were significantly associated with an increase in the UA level. The MR analysis was causally associated with rs1165196 (estimated odds ratio (OR), 0.21, 95% confidence interval (CI), 0.06‐0.75, P =.017), but not wGRS (estimated OR, 1.07, 95% CI, 0.57‐2.01, P =.832). Conclusion: The serum UA level was independently associated with the AF risk. [ABSTRACT FROM AUTHOR]

Background: The benefit of integrated care management was unknown in frail atrial fibrillation (AF) patients. This study evaluated whether compliance with the atrial fibrillation Better Care (ABC) pathway for integrated care management would improve clinical outcomes in frail AF patients. Methods: From the Korea National Health Insurance Service database, 262,987 nonvalvular AF patients were enrolled between 1 January 2005 and 31 December 2015. For each patient, the Hospital Frailty Risk Score and category were calculated retrospectively using all available ICD‐10 diagnostic codes. Patients were divided into three frailty‐based risk categories: low (<5 points, n = 221,542), intermediate (5‐15 points, n = 37,341), and high risk (>15 points, n = 4,104). Results: Over a mean follow‐up of 5.9 (interquartile range 3.2, 9.4) years, in high frailty risk patients, the ABC group had lower rates of all‐cause death (6.5 vs 17.5 per 100 person‐years, P <.001; hazard ratio [HR] 0.74; 95% confidence interval [CI] 0.56‐0.97) but was nonsignificant for the composite outcome (10.5 vs 26.0 per 100 person‐years, P =.101; HR 0.79; 95% CI 0.59‐1.05) compared with the Non‐ABC group. When the three frailty categories were compared, the greatest benefit on mortality was seen in the high frailty group (pint < 0.001), but for the composite outcome, there was no statistical interaction for the three frailty categories (pint = 0.063). Conclusions: Compliance with the simple ABC pathway is associated with improved outcomes in AF patients with high frailty risk. Given the high healthcare burden associated with frail AF patients, integrated AF management should be implemented to improve outcomes in these patients. [ABSTRACT FROM AUTHOR]

CCL2 mitigates cyclic AMP-suppressed Th2 immune response in human dendritic cells Keywords: allergic rhinitis; cAMP; CCL2; dendritic cells; Gnas CD11c mice EN allergic rhinitis cAMP CCL2 dendritic cells Gnas CD11c mice 1 4 4 07/29/20 20200801 NES 200801 Allergic rhinitis (AR) is a Th2-type chronic inflammatory disease of the nasal mucosa, characterized by symptoms including rhinorrhea, obstruction, and sneezing. However, CCL7 mRNA in AR MDDCs was not different from that in control MDDCs (Figure S4), suggesting that decreased cAMP levels in AR DCs induce the Th2 immune response through upregulation of CCL2. [Extracted from the article]

Introduction: Mesh‐type flexible tip (MFT) catheters allow clinicians to safely generate large radiofrequency lesions during catheter ablation of atrial fibrillation (AF), while contact force (CF) catheters provide better catheter‐tissue contact. We compared the clinical outcomes of catheter ablation of AF using MFT and CF catheters in a prospective, nonrandomized manner. Methods: We prospectively assigned 217 patients with AF (paroxysmal AF 73.5%; male 69.1%; 59.9 ± 10.7 years old) at a 1:1 ratio to ablation with MFT catheters (FlexAbility) or CF catheters (TactiCath). The primary endpoint was AF recurrence after a single procedure; the secondary endpoint was a response to antiarrhythmic drugs. Results: After a mean follow‐up of 22.3 ± 4.4 months, the clinical recurrence rate did not significantly differ between the two study groups (29.7% vs 30.2%; P =.941) (log‐rank P =.838). The recurrence rate for atrial tachycardias (30.3% vs 9.7%; P =.035) and cardioversion rates (8.1% vs 1.9%; P =.024) were higher in the MFT group than CF group. At the final follow‐up, sinus rhythm was maintained without antiarrhythmic drugs in 57.7% of the MFT group and 40.6% of the CF group (P =.010). No significant difference was found in the major complication rates between the two groups (0.9% vs 5.7%), although the ablation time was significantly longer in the MFT group (4192.1 ± 1080.2 vs 3583.8 ± 977.2 seconds; P <.001). Conclusion: MFT and CF catheters had similar effectiveness in achieving AF rhythm control during catheter ablation, and there was no significant difference between the two catheters with regard to overall safety. [ABSTRACT FROM AUTHOR]

Instruction: Longer atrial fibrillation (AF) durations have higher recurrence rates after rhythm control. However, there is limited data on the effect of the AF duration on recurrence after atrial fibrillation catheter ablation (AFCA). In the present study, we investigated the rhythm outcome of AFCA according to the AF duration based on the first electrocardiogram (ECG) diagnosis. Methods and Results: We included 1005 patients with AF (75% male, 59 ± 11 years old) who underwent AFCA and whose first ECG diagnosis time point was evident. The clinical characteristics and rhythm outcomes were compared based on the AF duration (≤3 years, n = 537; >3 years, n = 468) and AF burden (paroxysmal atrial fibrillation [PAF], n = 387; persistent atrial fibrillation [PeAF], n = 618). Longer AF durations were associated with older age (P =.020), larger left atrial size (P =.009) and a higher number of patients with hypertension (P <.001) or PeAF (P <.001). During 24 ± 22 months of follow‐up, the postablation clinical recurrence rate was higher in patients with a longer AF duration (logrank P =.002). The AF recurrence rate was significantly higher in PeAF patients with an AF duration >3 years (logrank P = 0.009), but not in subjects with PAF (logrank P =.939). In a multivariate Cox regression analysis, a longer AF duration was significantly associated with a higher clinical recurrence rate after AFCA in PeAF patients (adjusted hazard ratio, 1.06; range, 1.03‐0.10; P = 0.001), but not PAF. Conclusion: Although longer AF duration was associated with higher clinical recurrence rates after AFCA, the rate was significant in patients with PeAF lasting >3 years, but not in PAF patients. [ABSTRACT FROM AUTHOR]

Background: Neutrophil extracellular traps (NETs) participate in innate immunity by trapping microorganisms. Their pathophysiological implications have not been defined in chronic rhinosinusitis (CRS). Objective: We investigated the presence of NETs in nasal secretion of patients with stable or exacerbated CRS and evaluated whether NETs participate in the secretion of chemokines in sinonasal epithelial cells, the epithelial permeability, and transendothelial leucocyte migration, and elucidate whether NETs are released by macrolides and dexamethasone. Methods: The presence of NETs in nasal secretion and the release of NETs from neutrophils stimulated with macrolides or dexamethasone were evaluated by dsDNA Assay kit and fluorescence microscope. The chemokine secretion, epithelial permeability, and transendothelial leucocyte migration were measured in cultured cells incubated with NETs, the supernatant of unstimulated neutrophils (unstim), NETs inhibitor (DPI), or H3Cit, where the expression of junctional complex proteins and ICAM‐1 was evaluated by real‐time PCR, Western blots, and confocal microscope. Results: The amount of NETs and NETs‐forming neutrophils in nasal secretion increased in exacerbated CRS. Epithelial cells treated with NETs or H3Cit secreted chemokines and showed decreased permeability associated with up‐regulated junctional complex proteins. Increased transendothelial leucocyte migration associated with up‐regulated ICAM‐1 was noted in endothelial cells treated with NETs or H3Cit. These findings were not found in cells treated with unstim, or DPI. NETs were released by macrolides, but not by dexamethasone. Conclusions and Clinical Relevance: NETs formation increased in exacerbated CRS, inducing chemokine secretion, strengthening the epithelial barrier, and promoting the neutrophils infiltration. Therefore, the release of NETs in CRS might be beneficial or detrimental to CRS patients. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the hepatic metabolic alterations in nonalcoholic fatty liver disease (NAFLD) by using 1 H-MRS (proton magnetic resonance spectroscopy) with long echo time and to test the reproducibility of human study in an animal model. Liver biopsy is the gold standard for diagnosing NAFLD but with practical constraints. 1 H-MRS allows in vivo assessment of hepatocellular metabolism and has shown potential for biochemical differentiation in diffuse liver disease.Materials and Methods: In all, 32 subjects (11 patients with nonalcoholic steatohepatitis [NASH], 15 with simple steatosis [SS], and six healthy controls) were studied. For test reproducibility, 36 C57BL/6 mice, including 10 mice with streptozotocin-induced NASH, 15 with SS, and 11 high-fat diet controls, were studied. 1 H-MRS measurements at 3T and 4.7T MRI were performed on a localized voxel of the liver using PRESS sequence. Hepatic alanine (Ala), lactate+triglyceride (Lac+TG), and TG levels were compared between NASH, SS, and control groups using analysis of variance (ANOVA) tests. Diagnostic accuracy was determined by calculating the area under the receiver operating characteristics (ROC) curve. The associations between metabolite levels and pathologic grades or NAFLD activity scores (NAS) were assessed using Pearson's correlation.Results: NASH patients had higher levels of Ala (P < 0.001), Lac+TG (P < 0.001), and TG (P < 0.05) than SS patients or controls. The AUROC curve to distinguish NASH from SS was 1.00 (95% confidence interval [CI] 1.00-1.00) for Ala and 0.782 (95% CI 0.61-0.96) for Lac+TG. Ala and Lac+TG concentrations were positively correlated with steatosis grade (Ala Pearson's r = 0.723; Lac+TG r = 0.446), lobular inflammation (Ala r = 0.513), and NAS (Ala r = 0.743; Lac+TG r = 0.474).Conclusion: 1 H-MRS is potentially useful for noninvasive diagnosis of NASH and simple steatosis by hepatic metabolite quantification.Level Of Evidence: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1298-1310. [ABSTRACT FROM AUTHOR]

Poly(lactic‐co‐glycolic acid) (PLGA) particles are one of the most widely used biocompatible and biodegradable materials, and have been extensively investigated as drug delivery vehicles. While a number of different types of additives have been used during and after the synthesis of the PLGA particles for the enhancement of their functions, the shape control of the particles and observations of their shape‐dependent properties have been rarely reported to date. To overcome the limitations of conventional PLGA particles, including the slow degradation of PLGA and the resultant slow drug release, we synthesized porous PLGA particles with much higher surface area than in previous works. Unlike in previous studies, the porous PLGA particles in this work exhibit distinctive advantages such as a simpler synthetic scheme, improved size monodispersity, and controllable pore size distribution (approximately 1 μm in diameter). Polyethylenimine (PEI) was chosen as a pore‐generating material, which simplified the synthesis process significantly. The performance of the porous PLGA particles was evaluated using doxorubicin (DOX) and the A549 cell line as a drug and target cells of a model system, respectively. Based on the observation of the cell viability, the DOX‐loaded porous PLGA particles were determined to be five times more efficient than molecular DOX. [ABSTRACT FROM AUTHOR]

Background: Radiofrequency catheter ablation (RFCA) for accessory pathways (APs) at the site of prior valve surgery (VS) remains challenging. We aimed to clarify the factors associated with successful RFCA for such APs. Methods: Upon reviewing a RFCA registry and previous case reports, we included nine patients who underwent RFCA of APs at the site of prior VS (total‐VS group; age, 34.0 [24.5‐45.0] years; men, 4/9) and 196 patients who underwent RFCA of APs with no history of VS (no‐VS group; age, 40.5 [23.0‐54.0] years; men, 114/196). Electrophysiological features, procedural details, and outcomes were examined. Results: Accessory pathway exhibited decremental conduction in four of nine patients in the total‐VS group. The number of RFCA attempts was significantly higher in the total‐VS group than in the no‐VS group (10.0 [4.5‐14.5] vs 2.0 [1.0‐3.0]; P < 0.001). In four patients who underwent mitral VS, successful RFCA was achieved using the transaortic approach, coronary sinus (CS) approach, or bipolar ablation. In three patients who underwent tricuspid VS, successful RFCA was achieved using the above‐prosthetics or trans‐prosthetics approach. In two patients, RFCA failed. The trans‐prosthetics approach and bipolar ablation technique were effective. The transaortic and CS approaches were occasionally effective. The transseptal approach was ineffective. Conclusions: Successful RFCA of APs at the site of prior VS can be achieved by detailed mapping of the areas both above and below the prosthetic valve, as well as by ensuring effective radiofrequency energy delivery using various catheter approaches and RFCA techniques. [ABSTRACT FROM AUTHOR]

Ternary lithium nickel borides LiNi3B1.8 and Li2.8Ni16B8 have been synthesized by using reactive LiH as a precursor. This synthetic route allows better mixing of the precursor powders, thus facilitating rapid preparation of the alkali‐metal‐containing ternary borides. This method is suitable for "fast screening" of multicomponent systems comprised of elements with drastically different reactivities. The crystal structures of the compounds LiNi3B1.8 and Li2.8Ni16B8 have been re‐investigated by a combination of single‐crystal X‐ray/synchrotron powder diffraction, solid‐state 7Li and 11B NMR spectroscopies, and scanning transmission electron microscopy. This has allowed the determination of fine structural details, including the split position of Ni sites and the ordering of B vacancies. Field‐dependent and temperature‐dependent magnetization measurements are consistent with spin‐glass behavior for both samples. Faster phase space screening: A reactive lithium hydride precursor has been utilized for rapid compound screening in the Li‐Ni‐B ternary system through intimate mixing of the salt‐like powders (see graphic). Characterization of the synthesized lithium nickel borides LiNi3B1.8 and Li2.8Ni16B8 has allowed delineation of the ordering of B vacancies and split Ni sites. Magnetic property measurements indicate low‐temperature spin‐glass behavior for both compounds, and band structure calculations imply metallic behavior with a nearly filled Ni 3d band. [ABSTRACT FROM AUTHOR]

Incidence of atrial fibrillation (AF) is high in patients with congenial heart disease. However, management of AF is challenging in these patients. Although radiofrequency catheter ablation (RFCA) is effective therapeutic option for AF, RFCA for AF is not common in patients who underwent Fontan operation. We present a 24‐year‐old woman with paroxysmal AF, who underwent lateral tunnel Fontan operation for functional single ventricle. Circumferential pulmonary vein isolation was successfully performed. However, significant pulmonary vein stenosis developed after RFCA. Pulmonary vein stenosis was successfully treated by transcatheter intervention. [ABSTRACT FROM AUTHOR]