Engineering for restricted root Na+ uptake could potentially enhance salt tolerance in Eucalyptus. High-affinity K+ transporters (HKTs) have been implicated in Na+ uptake from the external medium as in the case of TaHKT2;1 or in the unloading of Na+ from xylem like in AtHKT1;1. To rapidly determine the in planta role of EcHKT1:1, composite transgenics in which EcHKT1:1 was specifically downregulated via RNAi in the roots were generated. Compared to the controls that failed to survive at 350 mM NaCl, 33 % of the composite transgenic plantlets generated using the EcHKT1;1 silencing construct were able to tolerate up to 400 mM NaCl. In these composite transgenics, EcHKT1;1 downregulation ranged from 37 % to 74 %. The average shoot to root ratio of sodium was 4.9 folds lower than the controls indicating restricted translocation of Na+ to the shoots. Relative expression analysis in the leaves of two non-transgenic genotypes contrasting for their salt tolerance also showed downregulated EcHKT1;1 expression in the tolerant clone. The study thus determined that EcHKT1;1 is a major gene determining Na+ transport from the roots to shoots. This study also demonstrated the utility of the composite transgenic approach for screening genes conferring salt tolerance in tree species.

Background: The efficacy of ablation targeting low-voltage areas (LVAs) is controversial, although LVA presence is well known to be associated with AF recurrence after ablation. Atrial fibrillation (AF) substrate may not localize within LVAs. Methods and results: This observational study enrolled 405 consecutive patients who underwent an initial AF ablation procedure. The left atrial voltage map was obtained after pulmonary vein isolation. LVAs were defined as areas with voltage < 0.5 mV. To estimate whole atrial electrophysiological degeneration, mean regional voltage at each of 6 regions and left atrial total conduction velocity were measured. LVAs existed in 143 of 405 (35.3%) patients. Patients with LVAs demonstrated lower mean regional voltages throughout all 6 regions than those without LVAs (1.3 [1.8, 0.8] vs. 0.6 [1.0, 0.2] for anterior wall, p<0.001). On the other hand, left atrial conduction velocity was lower in patients with LVAs than in those without (0.89 [1.01, 0.74] vs. 0.93 [1.03, 0.87] m/s, p<0.001). Multivariate analysis revealed that low left atrial total conduction velocity and a higher number of regions with mean voltage reduction were independently associated with AF recurrence, although LVA presence was not. Conclusion: Patients with localized left atrial LVAs were characterized by whole left atrial electrophysiological degeneration as assessed by mean regional voltage and conduction velocity. In addition, whole left atrial electrophysiological degeneration parameters were well associated with AF recurrence.

OBJECTIVES: To explore the value of detecting the peri-device leak (PDL) and device endothelialization after left atrial appendage closure (LAAC) by cardiac CT in patients with atrial fibrillation (AF), who underwent Watchman LAAC combined with radiofrequency ablation of atrial fibrillation (AFCA) METHODS: Patients with symptomatic drug-refractory atrial fibrillation at high risk of stroke (CHA2DS2-VASc Score ≥ 2), who underwent Watchman LAAC combined with AFCA in our center from March 2017 to December 2018 were enrolled Maximum diameter of LAA orifice was determined by preoperative CCTA A standardized view of Watchman device was obtained by postoperative CCTA multi-plannar reconstruction to evaluate the PDL and device endothelialization RESULTS: 84 patients post successful LAAC and AFCA were enrolled in this study Satisfactory LAA occlusion rate was 100% There were no death, bleeding, stroke, and device related thrombus (DRT) events At 6-month post procedure, CCTA images evidenced complete endothelialization in 44 patients (no contrast enhancement in LAA); contrast enhancement in LAA and visible PDL in 33 patients; contrast enhancement in LAA but without PDL in 7 patients (incomplete device endothelialization) Maximum diameter of LAA orifice could independently predict the occurrence of PDL (OR, 1.31; 95% CI, 1.11-1.55; P = 0.002), sensitivity was 69.7% and specificity was 80.4% with the cutoff value of maximum diameter of LAA orifice >28.2 mm on predicting PDL CONCLUSIONS: CCTA is feasible to evaluate PDL and device endothelialization after LAAC The maximum diameter of LAA orifice derived from CT can independently predict the occurrence of post-LAAC PDL

Introduction: In patients with left ventricular (LV) nonischemic cardiomyopathy and monomorphic ventricular tachycardia (VT), midmyocardial and epicardial substrates are often involved but endocardial structures may also be affected. Delayed enhancement – magnetic resonance imaging (DE–MRI) was used to characterize the substrates of predominantly epicardial VT to improve identification of target sites for ablation. Methods and Results: 12 patients with LV nonischemic cardiomyopathy and monomorphic VT (prior myocarditis in 9) had a predominantly epicardial (n = 8) or epicardial-only DE-MRI substrate (n = 4). Modest-sized endocardial involvement in predominantly epicardial substrates was identified by DE-MRI in 8 patients. Mapping of 22 VTs was performed in 12 patients using an endo-epicardial approach in 6 patients and an endocardial-only approach in 6 patients. Endocardial VT reentry circuit exit sites as defined by entrainment and pace mapping criteria corresponded to endocardial breakthroughs from predominantly epicardial DE-MRI substrates in 7 patients. The endocardial VT exits were located at the ventricular base near the mitral annulus in 6 patients. Successful endocardial ablation of at least one VT was accomplished in 5 patients. Epicardial ablation as a part of an endo-epicardial approach or as epicardial-only ablation was performed in 6 patients and was successful in 4 patients. Conclusion: Endocardial breakthroughs from predominantly epicardial DE-MRI substrates are often located near the ventricular base in the perivalvular region and correlate with endocardial VT reentry circuit exit sites amenable to ablation.

Objectives: We aimed to investigate the diagnostic accuracy of Caloric Testing and video Head Impulse Testing (vHIT) in differentiating between vestibular neuritis and strokes in acute dizziness. Design: Prospective cross-sectional study. Setting: Emergency department of a tertiary referral center. Participants: 1677 adult patients were screened between 2015 and 2020 for AVS, of which 152 met the inclusion criteria. Inclusion criteria consisted of a state of continuous dizziness, associated with nausea or vomiting, head-motion intolerance, new gait or balance disturbance and nystagmus. Patients were excluded if symptoms lasted <24 hours or if the index ED visit was >72 hours after symptom onset. Eighty-five patients completed testing of which 58 were vestibular neuritis and 27 strokes. Main outcome measures: All patients underwent calorics and vHIT followed by a delayed MRI (gold standard for vestibular stroke confirmation). Results: The sensitivity/specificity for detecting stroke (caloric asymmetry cut-off of 30.9%) was 75% and 86.8% respectively (Negative likelihood ratio (NLR) 0.29) compared to 91.7% and 88.7% for vHIT (NLR 0.094). Best VOR gain cut-off was 0.685. Twenty-five percent of vestibular strokes were misclassified by calorics, 8% by vHIT. Conclusions: Caloric testing demonstrated lower accuracy than vHIT in discriminating stroke from vestibular neuritis in acute dizziness. Asymmetric caloric responses can also occur with vestibular strokes and might put the patient at risk for misdiagnosis. We therefore recommend replacing calorics with vHIT in the acute setting. Caloric testing has still its place as a diagnostic tool in an outpatient setting.

Repair rate is very important parameter in a system maintainability and it can be defined as frequency of the successfully performed repair actions on failed component per unit of time. This paper analyses the integral characteristics of a stochastic repair rate for corresponding values of availability in the system operating under maintenance contracts. The equation for the envelope line of the probability density function (PDF) maximums of the repair rate has been provided. This new expression can be used for planning of base stock levels and capacities of repair facilities. Namely, in that way instead of repair rate PDF equation, for some calculations we can use envelope line parameters, which are expressed in simpler mathematical form, to reduce the time required for calculations and prediction and enhance reactions in failure events. For analytical and numerical evaluation of system performance, the annual repair rate PDFs are analyzed like particular solutions of corresponding differential equation, while the existence of singular solution is considered and analyzed under different conditions. Moreover, we have derived optimal values of availability for which the PDF maximums have been obtained. Finally, in order to generalize behavior of the repair process, a partial differential equation, as a function of the repair rate process and availability parameter, has been formed.

The aim of this research is to investigate the relationship between the counts of cases with Covid-19 and the deaths due to it in seven countries that are severely affected by the pandemic. First, the Pearson's correlation is used to determine the relationships among these countries. Then, the factor analysis is applied to categorize these countries based on their relationships.

Age, presenting total leukocyte counts, steroid response and cytogenetics are known prognostic markers for acute lymphoblastic leukemia (ALL). Measurable Residual Disease (MRD) (or minimal residual disease) after induction chemotherapy is well accepted prognostic markers in childhood leukemia. In resource constrained countries evaluation of MRD either not widely available or increases the cost of treatment. We retrospectively analyzed data of patients, treated with non-MRD based protocol, to see correlation of known risk factors and risk groups with end of induction MRD. Children with acute lymphoblastic leukemia treated with IC-BFM 2002 (Non-MRD based protocol) and end of the induction MRD was done. Day15 bone marrow morphology and risk groups were significantly associated with MRD level. All standard risk patients except one had MRD negative. Significant number of intermediate risk group and high risk group had positive MRD. In resource constrained settings, MRD can be avoided in standard risk, but cannot be avoided in higher risk group for optimization of therapy.

Commercial production of therapeutic proteins using mammalian cells requires complex process solutions, and consistency of these process solutions is critical to maintaining product titer and quality between batches. Inconsistencies between process solutions prepared at bench and commercial scale may be due to differences in mixing time, temperature, and pH which can lead to precipitation and subsequent removal via filtration of critical solution components such as trace metals. Pourbaix diagrams provide a useful tool to model the solubility of trace metals and were applied to troubleshoot the scale-up of nutrient feed preparation after inconsistencies in product titer were observed between bench- and manufacturing-scale batches. Pourbaix diagrams modeled the solubility of key metals in solution at various stages of the nutrient feed preparation and identified copper precipitation as the likely root cause of inconsistent media stability at commercial scale. Copper precipitation increased proportionally with temperature in bench-scale preparations of nutrient feed and temperature was identified as the root cause of copper precipitation at the commercial scale. Additionally, cell culture copper titration studies performed in bench-scale bioreactors linked copper-deficient mammalian cell culture to inconsistent titers at the commercial scale. Pourbaix diagrams can predict when trace metals are at risk of precipitating and can be used to mitigate risk during the scale-up of complex media preparations.

Background and Aim: The P2Y12 platelet receptor inhibitor ticagrelor is widely used in patients following acute coronary syndromes or in those who have received coronary stents. Bentracimab is a monoclonal antibody-based reversal agent that is being formally evaluated in a Phase 3 clinical trial. Here, we probe the knowledge, attitudes, and practice patterns of cardiac surgeons regarding their perioperative management of ticagrelor and potential application of a ticagrelor reversal agent. Methods: A questionnaire was developed by a working group of cardiac surgeons to inquire into participants’ practices and beliefs regarding ticagrelor and disseminated to practicing Canadian cardiac surgeons. Results: A total of 70 Canadian cardiac surgeons participated. Bleeding risk was identified as the most significant consideration when surgically revascularizing ticagrelor-treated patients (90%). There is variability in the duration of withholding ticagrelor prior to coronary artery bypass graft procedure in a stable patient; 44.3% wait 3 days and 32.9% wait 4 days or longer. Currently, 14.3% of cardiac surgeons prophylactically give platelet transfusions and/or fresh frozen plasma intraoperatively following protamine infusion in patients who have recently received ticagrelor. Interestingly, 47.1% of surveyed surgeons were aware of a reversal agent for ticagrelor, 91.4% of cardiac surgeons would consider utilizing a ticagrelor reversal agent if available, and 51.4% acknowledged that the introduction of such an agent would be a major advance in clinical practice. Conclusions: The present survey identified ticagrelor-related bleeding as a major concern for cardiac surgeons. Surgeons recognized the significant unmet need that a ticagrelor reversal agent would address.

Unilateral vocal cord paralysis (UVCP) is a known complication of thyroid surgery, due to iatrogenic recurrent laryngeal nerve injury, with reported rates of 2-5% in children. The gold standard for assessing vocal cord function in flexible nasendoscopy (FNE) examination, which is considered high-risk for contraction of the COVID-19 virus. Intraoperative ultrasonographic assessment (IUA) of vocal cord function is a non-invasive and relatively simple procedure, performed in a supine position under general anesthesia. Objectives: To evaluate the validity of IUA modality in children undergoing thyroidectomy, and to compare it to the standard FNE. Design: A prospective double-blind study covering 24 months (March 2019-March 2021). Twenty thyroid lobectomies were performed, during 15 surgeries. Vocal cord function was assessed three times: Preoperatively by FNE, intraoperative (IUA) following extubation, and a second FNE on the first post-operative day. Settings: A tertiary pediatric hospital. Results: The overall accuracy of IUA results in our study was 92%. IUA sensitivity, specificity, positive and negative predictive values were 100%, 89%, 33%, and 100% respectively. Patient’s age demonstrated borderline significance (p= 0.08). The resident’s experience was associated with a better correlation between IUA and FNE results (p<0.05). Conclusions: IUA of vocal cord motion has a high accuracy rate for detection of iatrogenic vocal cord paralysis, similar to FNE. It is easily learned by residents, well tolerated by children, and it provides a safe and valid alternative modality while ensuring the safety of the medical staff in treating patients, especially in times of COVID-19 pandemic.

Vascular anomalies are a group of disorders divided into two distinct subtypes: vascular tumors and vascular malformations. Vascular tumors are proliferative in nature, while malformations are non-proliferative. Simple, localized vascular malformations refer to a group of malformations that are localized to a single area of involvement. These simple malformations include capillary, lymphatic, venous, and arteriovenous malformations. The pediatric hematologist and oncologist is becoming increasingly involved in the diagnosis and management of these disorders. This review presents four cases as a means to discuss the diagnosis, clinical and imaging features, and management strategies of simple, localized vascular malformations.

Migraine is one of the most common of neurological disorders with a global prevalence of up to 15%. One in five migraineurs have frequent episodic or chronic migraine requiring prophylactic treatment. In recent years, specific pharmaceutical treatments targeting calcitonin gene-related peptide (CGRP) signalling molecules have provided safe and effective treatments; monoclonal antibodies for prophylaxis and gepants for acute therapy. Albeit the beneficious impact of these new drugs, it is important to understand the molecular mechanisms involved to better understand migraine pathophysiology and improve the therapy. Here we describe current views on the role of the CGRP family of peptides CGRP, calcitonin (CT), adrenomedullin (AM), amylin (AMY) and their receptors in the trigeminovascular system (TGV). All these molecules are present within the TGV system but differ in expression and localization. It is likely that they have different roles, which can be utilized in providing additional drug targets.

Guava (Psidium guajava) is one of the most aggressive invasive plants in the Galapagos Islands. Determining its provenance and genetic diversity could provide valuable information for its control. With this purpose, we analyzed 11 SSR markers in guava individuals collected from Isabela, Santa Cruz, San Cristobal and Floreana islands in the Galapagos, as well as from mainland Ecuador. The mainland guava population appeared genetically differentiated from the Galapagos populations, with higher genetic diversity levels found in the former. By using different approaches for data analysis, we consistently found that the Central Highlands region of mainland Ecuador is one of the most likely origins of the Galapagos populations. Moreover, the guavas from Isabela and Floreana show a potential genetic input from southern mainland Ecuador, while the population from San Cristobal would be linked to the coastal mainland regions. Interestingly, the proposed origins for the Galapagos guava coincide with the first human settlings of the archipelago. By employing Approximate Bayesian Computation, we propose a model where San Cristobal was the first island to be colonized by guava from the mainland, from which it would have spread to Floreana and finally to Santa Cruz; Isabela would have been seeded from Floreana. An independent trajectory could also have contributed in the invasion of Floreana and Isabela. The pathway shown in our model agrees with the human colonization history of the different islands in the Galapagos. Our model, in conjunction with the clustering patterns of the guava individuals (based on genetic distances), suggests that guava introduction history in the Galapagos archipelago was driven predominantly by a single event (or events in rapid succession) instead of several independent introductions. We thus show that genetic analyses supported by historical sources can be used to answer questions on the variability and history of guava in the Galapagos Islands.

Acute viral bronchiolitis (AVB) is the most common infection of the lower airways in children under 2 years of age. Attempts to determine the severity of the disease based on clinical and radiological manifestations are a major challenge. Measurements of the anatomy of the trachea, main bronchi and bronchioles are not limited to pure anthropometry, but are also useful for better knowledge and applicability in pulmonary physiology, thoracic surgery, anesthesiology and in the care of critically ill patients. This is a cross-sectional, retrospective study, which included all patients admitted to a tertiary hospital in the city of Porto Alegre, over a period of one year, with a diagnosis of AVB. The interbronchial angle (ITB) of these patients was measured and clinical and epidemiological characteristics were analyzed. A total of 425 patients were included, diagnosed with BVA by respiratory syncytial virus (RSV) confirmed by immunofluorescence. Most of these patients were male (59.5%) and the median age was 130 days, 91.11% of them required oxygen therapy through a nasal catheter, 3.3% used non-invasive ventilation (NIV) and 4% mechanical ventilation (MV) . Among the studied patients, we obtained only one death (0.2%). Those who required MV or NIV and support in an intensive care unit were considered serious. The mean ITB was lower for these patients than for less severe ones. It is concluded that the ABI has a correlation with the prognosis of patients with AVB and, after further studies, can be used as a severity score.

From point of view of two different schemas several new impressive lump solutions to (1+1)-dimensional Ito equation have been established. The first schema is the Paul-Painleve approach method (PPAM) which will be applied perfectly to extract multiple lump solutions of this model, while the second schema is the famous one of the ansatze method and has personal profile named the Ricatti-Bernolli Sub-ODE method. In related subject the numerical solutions corresponding to all lump solutions achieved via each method have been demonstrated individually in the framework of the variational iteration method (VIM).

Advances in molecular biology alongside the accelerated development of gene and cell engineering have contributed to the development of several endotype-targeted biological therapies against chronic immune-mediated allergic diseases. Conventional therapies for asthma, chronic rhinosinusitis with polyposis (CRSwNP), chronic spontaneous urticaria and atopic dermatitis (AD) are not without limitations, and as such the advent of biological therapies have provided a promising alternative treatment option. Biologicals have proven efficacious in the treatment of refractory chronic spontaneous urticaria, asthma, AD, CRSwNP and there is increasing evidence for their utility in treating food allergy. Biologicals are applied and investigated for the most urgent need: acute treatment, symptom control and reduction of steroid usage. Currently there are five approved biologicals for allergic disease management, targeted against IgE (omalizumab), type 2 (T2) cytokines and cytokine receptors (IL-4Ra; dupilumab, IL-5; mepolizumab/reslizumab, IL-5Ra; benralizumab).

Background: The present study aimed to determine the duration of hospital admission of the panic diagnosed patients, examine the factors that may influence hospital admission time, and identify the impact of the COVID-19 pandemic on hospital admission time. Materials and methods: In this study, the panic diagnosed patients between January 2018 and January 2021 were determined. These patients’ demographic, clinical, and panic diagnosis form data were documented. The duration of hospital admission of patients during and pre-COVID-19 pandemic period was determined. Results: There were 65 panic diagnosed cases, of which one One patient had leukocytoclastic vasculitis, 10 patients had uterine contents without villi or trophoblasts, and 54 patients had unexpected malignancy. The mean time of admission to the hospital of verbally informed and not verbally informed cases were five days and 156 days, respectively in the pre-COVID group. All cases in the COVID pandemic group were verbally informed about panic diagnosis by phone call. The mean time (day) of admission to the hospital was 18.3 days (1-40). Admission times were on mean about 13.3 days longer in verbally informed cases in the COVID pandemic group compared to verbally informed cases in the pre-COVID group. Conclusion: We determined a dramatic decrease in the number of panic diagnosed cases during the COVID pandemic and patients who are verbally informed admitted to the hospital in a shorter time. Integrations of hospital panic diagnosis notification systems to health application programs and primary responsible family physician’s systems may be useful for preventing unwanted delays.

In this paper, we prove some existence and Ulam-Hyers-Rassias stability results for a class of initial value problem for implicit nonlinear fractional differential equations and generalized Ψ-Hilfer fractional derivative in Banach spaces. The results are based on fixed point theorems of Darbo and Monch associated with the technique of measure of noncompactness. Illustrative examples are the subject of the last section.

The stability and boundedness for delayed impulsive SDEs driven by fBm are studied in this paper. Two kinds of noises, i.e, additive fBm noise and mul-tiplicative fBm noise are both taken into consideration. By using stochastic Lyapunov technique and impulsive control theory, sufficient criteria for pth moment exponential stability and mean square ultimate boundedness are derived, for two kinds of fBm driven delayed impulsive SDEs, respectively. As application, the obtained results are used to do practical synchronization w.r.t. a class of chaotic systems, in which the response system is perturbed by additive fBm noises. Finally, A Chua chaotic oscillator is given to verify the validity and applicability of the derived results.

Mixed fibrolamellar hepatocellular carcinoma is a rare liver tumor defined by the presence of both pure fibrolamellar hepatocellular carcinoma and conventional hepatocellular components. It represents up to 25% of cases of fibrolamellar hepatocellular carcinoma, and has been associated with a worse prognosis.

In December 2019, the novel coronavirus disease 2019 (COVID-19) emerged in China and spread rapidly around the world, resulting in a pandemic declared by the World Health Organization in March 2020. The disease has affected more than 11 million people in Brazil, with more than 265.000 deaths to date, as we are now facing a second wave of infections. Regarding medical assistance and training, it turned out to be a great challenge, since - among other things - many residents were relocated to respiratory units to treat patients with COVID-19. Even though the residency programs situation has become chaotic all around the world and the activities in almost all specialties nearly stopped (especially in surgical specialties), the need to reinvent the way of teaching was the best concern. Worldwide the “webinars fever” was an impulse to try new strategies to fulfill the gaps of knowledge of these future specialists. It is crucial to call to the responsibility put on medical training institutions to prepare these new professionals according the principles of evidence-based medicine, surgical proficiency and patient safety.

This is a preprint of an article accepted for publication in Oxford Handbook of the Music of China (Oxford University Press) The articulation of humanism is a recurrent theme in various Chinese literature and arts over the history. One of such well-known cases is the classic novel Journey to the West (Xi you ji) dates from the 16 th Century which stresses the issues of freedom, fighting with the authorities, the loss of belief, and the importance of self-direction. Various adapted versions from this novel popular over since then which hinted strong desire to humanism expression under China's tight central governance. The recent interpretation of nationwide impacted products is an online novel The Wu Kong's Biography (Wukong zhuan, written by Zeng Yu, pseudonym Jin Hezai, 2000) which adding the ambitions to challenge the authorities, an imaginary compensation of the young people in China (Liao, 2017). The great popularity of the novel leads to the release of its film version Wu Kong in 2017. Even the theme song of this movie "Equaling Heaven" (music and sung by Hua Chenyu, lyrics by Jin Hezai) brings a real hit in Chinese popular music scene. It was performed by Tibetan singer Zahi Bingzuo, the 2017 winner of The Voice of China in his final song-battle in that show (Qian, 2017: 57-8) and then Hua Chenyu in the TV talent show Singer (Geshou) in 2018. The humanism articulation of the song, same as in the novels and movie, shown well in the song: When I were young and wild, were worthy of it, who would give me a belief? …I could still smile before dawn… ignore the fate decided by the god and I would say the fate follows my heart. 1 Humanist articulations are part of a trend in Chinese pop song that dates back to the 1980s, when that genre first reappeared as an indigenous entertainment genre within China itself. As a transitional phrase during which multiple pre-existing and newly emerging social

Introduction: Limited data exist on pulmonary vein isolation (PVI) using cryoballoon (CB) or radiofrequency (RF) ablation and additional non-pulmonary vein triggers ablation for non-paroxysmal atrial fibrillation (non-PAF). The objective of this study was to assess the outcomes of first-stage catheter ablation for non-PAF patients. Methods and Results: Initial PVI was performed on 734 non-PAF patients (age: 64±10 years; male: 584) between September 2014 and June 2018 [315 (43%), CB ablation; 419 (57%), RF catheter]. A logistic regression model was used to match 257 pairs (514 patients) according to propensity scores (CB group or RF group). After PVI, additional non-PV triggers ablation was performed if induced by isoproterenol. We analyzed the clinical outcomes of both groups. The mean procedural time was significantly shorter in the CB group (125 [range, 89–165] min) than in the RF group (190 [160–224] min; P < 0.001). The 1-year Kaplan-Meier event rate revealed similar atrial fibrillation-free survival rate between the groups (CB: 77.9%, RF: 82.3%; log-rank P = 0.111). The additional ablation percentage for non-PV foci (CB: 39%, RF: 41%; P = 0.653) and the complications incidence (CB: 5%, RF: 4%; P = 0.670) were also similar. Conclusion: In non-PAF patients, PVI using CB or RF ablation and non-PV triggers ablation achieved comparable outcomes. The safety and efficacy of the combination strategy of PVI and non-PV triggers ablation was demonstrated.