Objective: To identify pathophysiological mechanisms of nocturia and the correlation of these mechanisms with nocturia severity. Methodology: After approval by the local ethics committee, all patients with nocturia (≥1 nocturnal void/night) were included and filled the overactive bladder questionnaire (OABq), nocturia quality of life (N-QoL), ICIQ-MLUTS (male), ICIQ-FLUTS (female) and 3-day frequency-volume chart. Patients were divided into three groups according the severity of nocturia: group 1 consisted of patients with mild (1-2 voids/night), group 2 with moderate (3-4 voids/night) and group 3 with severe nocturia (>4 voids/night). Comparative analysis were performed between groups, p<0.05 was deemed as statistically significant. Results: 68.1%, 64.1% and 8.7% of the patients had nocturnal polyuria, reduced bladder capacity and global polyuria; respectively. 42.7% of the patients had mixed nocturia. 6.1% of the patients did not comply with the afore-mentioned subtypes and defined as isolated nocturia. Regarding the severity of nocturia; 155 (41%) patients had mild, 167 (45%) patients had moderate and 57 (15%) patients had severe nocturia. Increased nocturia severity was related with decreased quality of life; higher age, urinary tract symptom scores, nocturnal urine volume, evening fluid consumption and beta-blocker medication rates. Increased nocturia severity was also associated with higher nocturnal polyuria, global polyuria and reduced bladder capacity rates. Conclusions: Nocturia mechanisms may vary between mild and moderate to severe nocturia groups according to the present study. Nocturia grading with identification of subtypes may help for better standardization of the diagnostic and treatment approaches as well as for the design of future clinical trials.

In gas turbines, superalloys are exposed to thermal as well as mechanical cyclic loadings during start-up and shut down processes, which can accelerate the formation of fatigue failure mechanisms. In the present study, low cycle fatigue behavior and fracture mechanism of a directionally-solidified CM247 LC superalloy at two temperatures of 600 °C and 800 °C were investigated. For this purpose, strain-controlled low cycle fatigue tests were carried out at 600 °C and 800 °C, and constant total strain amplitudes of 0.4, 0.6, 0.8, and 1% were applied during the totally reversed loading ratio (R = -1). The Coffin-Manson model, based on plastic deformation and a model based on the hysteresis energy criterion is used to predict fatigue life and evaluate the low cycle fatigue behavior. SEM observations of the surface of the failed specimen showed similar LCF failure mechanisms in all the strain amplitudes and temperatures.

Hepatocellular carcinoma is a primary liver malignancy caused by chronic inflammation and persistent cytokine release. Although rare, they may present as large, pedunculated hepatocellular neoplasms. We present a case report on a 66-year-old male with such a mass requiring thorough pre-operative planning to complete a challenging surgical resection.

Kidney diseases have recently become one of the major global health problems with high incidence and death risk. Extracellular vesicles (EVs), which are released from most cell types and human body fluids, have recently attracted extensive attention as the important carriers of protective cargos such as microRNAs and proteins that may contribute to promoted renal function. Therefore, we conducted this systematic review to investigate the renoprotective potential of EVs. We performed a comprehensive search of Medline (via PubMed), Embase, Cochrane and Proquest on August, 2019 for English papers. Of 2887 articles met the search criteria, 80 included in this systematic review and classified into several groups based on source of EVs. We then evaluated the EV research through screening their isolation method, size, marker, main effector, and potential mechanisms to induce renal protection. Taken together, EVs from various sources including mesenchymal stem cells, human liver stem cells, endothelial progenitor cells, endothelial colony-forming cells, serum and some other sources might have positive impacts on treatment of human kidney diseases in the future.

Introduction: Patient adherence is a cornerstone in successful management of psychiatric disorders and is affected by patient perspectives and barriers, differing from rural to urban areas. In this perspective, pharmacists have a vital role in identifying patients in need of help and in dealing with barriers to adherence. This paper investigates perspectives of patients diagnosed with psychiatric disorders, living in rural areas in Jerash, Jordan, regarding their awareness about their psychiatric conditions, including religious and cultural factors, adherence to their treatment and related barriers, with special focus on pharmacist’s role. Methods: This cross-sectional survey study was conducted in Jordan from August to November 2019. A validated questionnaire was administered by two pharmacists, asking patients as they were waiting in the psychiatric clinic (following the specialists’ approval). Data were analyzed using the Statistical Package for the Social Science (SPSS). Results: Most patients (n= 120, age 39.4±9.5, 66.7% males) reported that they always/usually adhere to their medications (71.0%), and 47.5% of them reported complete control of their symptoms after treatment. Most patients (69.2%) reported that they perceive their psychological illness in terms of religious faith as being counted for their favor in the Hereafter, and 52.5% of them always/usually looked at themselves positively and unaffected by the existence of their illness; with both factors correlating significantly with better treatment adherence (p < 0.045 and p < 0.001; respectively). Barriers affecting adherence included mainly suffering from adverse effects (31.9%) and being unconvinced that they needed a medication (23.3%). Only 14.2% of patients reported that they refer to the pharmacist to get information about their medications. Conclusion: Most psychiatric patients reported suboptimal control of their symptoms. Nonadherence is one reason, with barriers identified. Positive religious and cultural perspectives are associated with better adherence, and most patients do not refer to pharmacists for medication informatio

The article "Exemplifying Computational Thinking Scenarios in the Age of COVID-19: Examining the Pandemic’s Effects in a Project-Based MOOC" describes a project-based MOOC designed to teach a wide variety of STEM students "computational thinking."  This course was being conducted during the initial outbreak of COVID-19 and thus has some really interesting data relating to the uptake in student enrollment as well as a focus on students choosing projects based on COVID-19.  In addition to the COVID-19 data, I found two aspects of the article to be particularly interesting.  First, the article describes teaching a "computational thinking" course without teaching programming.  This is the first time I have seen this type of idea implemented in an entire course.  I am very interested in learning the pros and cons to teaching "Computational Thinking" in this way.   The second thing I noticed about this article is that the course is being taught as a project-based MOOC to around 1000 students.  This seems like a lot of work and I would be curious to learn more about how the course was scaled.  In particular, how were that many projects organized and graded (peer grading, team grading something else)?  What other things did the instructors do to help scaling?Overall, I thought this article was well written and is a great addition to the COVID-19 special issue.  Although I would like to see more details about no-programming "Computational Thinking" and scaling project based MOOCs, I think the authors made a reasonable discussion leaving these topics out given the length limitation.Unfortunately, it looks to me like even more needs to be cut.  There is a 3000-word limit for CiSE department articles, with each figure/table counting as 250 words.  Given that, we need to work with the authors to try and cut another 1300 words form the current draft.  

Porcine epidemic diarrhea virus (PEDV), a coronavirus pathogen of the pig intestinal tract, can cause fatal watery diarrhea in piglets, thereby leading huge economic losses to swine industry around the world. The pathogenesis of PEDV has been intensively studied, however, the viral proteins of PEDV and the host factors in target cells, as well as their interactions, which underly the molecular mechanisms of viral infection, remains to be illustrated and summarized. PEDV has multiple important structural and functional proteins which play various roles in the process of virus infection. Among them, the S and N proteins play vital roles in biological processes related to PEDV survival via interacting with the host cell proteins. Vice versa, a number of host factors including receptors are required for the infection of PEDV per the interactions with the viral proteins, thereby affecting the reproduction and contributing to the life cycle of PEDV. In this review, we intend to provide an update understanding of the PEDV viral proteins and host factors and illustrate the interactions between them. Additionally, the effects of cellular factors or events or signaling pathways on PEDV infection are also discussed. Thus, these comprehensive and creative insights should facilitate to guide the future research, control and prevention of PEDV infection.

Aim To provide a comprehensive/updated evaluation of the effect of ACEIs/ARBs on COVID-19 related-clinical outcomes, including exploration of inter-class differences between ACEIs and ARBs. Methods This was a systematic review/meta-analysis conducted in Medline (OVID), Embase, Scopus, Cochrane library and medRxiv from inception to 22nd May-2020. English studies that evaluated the effect of ACEIs/ARBs among patients with COVID-19 were included. The study outcomes included any COVID-19 related-clinical outcomes. Studies’ quality was appraised using the Newcastle-Ottawa Scale. Data were analysed using the random-effects modelling stratified by ACEIs/ARBs, ACEIs, and ARBs. Heterogenicity was assessed using I2 statistic. Several sub-group analyses were conducted to explore the impact of potential confounders. Results Out of the identified 452 studies, 27 studies were eligible for inclusion. The pooled analyses showed non-significant associations between ACEIs/ARBs and death (OR:0.97, 95%CI:0.75,1.27), ICU admission (OR:1.09;95%CI:0.65,1.81), death/ICU admission (OR:0.67; 95%CI:0.52,0.86), risk of COVID-19 infection (OR:1.01; 95%CI:0.93,1.10), severe infection (OR:0.78; 95%CI:0.53,1.15) and hospitalisation (OR:1.15; 95%CI:0.81,1.65). However, the sub-group analyses indicated different results such as significant association between ACEIs/ARBs and hospitalisation among USA studies (OR:1.59; 95%CI:1.03,2.44), peer-reviewed (OR:1.93, 95%CI:1.38,2.71), good quality and studies which reported adjusted measure of effect (OR:1.30, 95%CI:1.10,1.50). Significant differences were found between ACEIs and ARBs with the latter being significantly associated with lower risk of acquiring COVID-19 infection (OR:0.24; 95%CI: 0.17,0.34). Conclusions High-quality evidence exist for the effect of ACEIs/ARBs on some COVID-19 clinical outcomes. For the first time, we provided evidence, albeit of low quality, on inter-class differences between ACEIs and ARBs for some of the reported clinical outcome.

Background:COVID-19 has become a global epidemic, close contacts and asymptomatic patients are worthy of attention. Methods:A total of 1844 people in close contact with 76 COVID-19 patients were investigated, and nasopharyngeal swabs and venous blood were collected for centralized medical quarantine observation. Real-time fluorescence used to detect 2019-nCoV nucleic acid in nasopharyngeal swabs of all close contacts, and colloidal gold method used to detect serum specific antibodies. Levels of IgM and IgG specific antibodies were detected quantitatively through chemiluminescence from the first nucleic acid negative date (0 wk) within weekly periods of:1, 1-2, 2-3, and 6-7 weeks. Results:The total positive rate of the colloidal gold method (88.5%,23/26) was significantly higher (χ2=59.182,P< 0.001) than that of the healthy control group (2.0%, 1/50). There was significant difference in IgG concentration at different time points (0-7week) after nucleic acid turned negative (χ2=14.034,P=0.029). Serum IgG levels were significantly higher within weekly timepoints 4-5 wk(Z=-2.399, P=0.016), 5-6 wk(Z=-2.049,P=0.040), and 6-7 wk(Z=-2.197,P=0.028), compared to 1-2 wk after nucleic acid negative conversion. However, there was no significant difference (χ2=4.936,P=0.552) in IgM concentration between timepoints tested (0-7 weeks) after nucleic acid conversion. The positive rates of IgM and IgG in asymptomatic patients (χ2=84.660,P<0.001) were significantly higher than the controls (χ2=9.201,P=0.002) within 7 weeks of nucleic acid negative conversion. Conclusions: The IgG concentration in asymptomatic cases remained at a high level after nucleic acid turned negative. Nucleic acid combined with IgM and IgG antibody detection is a more effective way to screen asymptomatic infections.

Background: HHe-3 MR is a non-invasive imaging method which maps and quantifies regions of ventilation heterogeneity (VH) in the lung. VH is an important feature of asthma, but little is known as to how VH informs patient phenotypes. Purpose: To determine if VH indicators quantified by HHe-3 MRI predict phenotypic characteristics and map to regions of inflammation in children with problematic wheeze/asthma. Methods. Sixty children with poorly-controlled asthma underwent HHe-3 MRI, including 22 with bronchoalveolar lavage (BAL). The HHe-3 signal intensity defined four ventilation compartments. The non-ventilated and hypoventilated compartments divided by the total lung volume defined a VH index (VHI %). Results: Children with VHI % in the upper quartile had significantly greater airflow limitation, bronchodilator responsiveness, blood eosinophils, expired nitric oxide (FeNO), and BAL eosinophilic/ neutrophilic granulocyte patterns compared to children with VHI % in the lower quartile. Lavage return from hypoventilated bronchial segments had greater eosinophil % than from ventilated segments. Conclusion: In children with asthma, greater VHI % as measured by HHe-3 MRI identifies a severe phenotype with higher type 2 inflammatory markers, and maps to regions of lung eosinophilia. Listed on ClinicalTrials.gov (NCT02577497).

Changing environments and habitat structure likely affect eco-evolutionary processes involved in the spatial spread of disease. Exploitative parasites are predicted to evolve in highly connected populations or in expanding epidemics. However, many parasites rely on host dispersal to reach new populations, potentially causing conflict between local transmission and global spread. We performed experimental range expansions in interconnected microcosms of the protozoan Paramecium caudatum, allowing natural dispersal of hosts infected with the bacterial parasite Holospora undulata. Parasites from range front treatments were less virulent and interfered less with host dispersal, but also invested less in horizontal transmission than parasites from range cores. An epidemiological model fitted on experimental time-series data confirmed this trade-off between dispersal adaptation and transmission, so far rarely considered in theoretical models. Our study illustrates the importance of the ecology and evolution of dispersal-related traits in spatial non-equilibrium scenarios, including emerging diseases, metapopulations or biological invasions.

By influencing soil biota and nutrient cycling, plants can alter their fitness and that of their neighbours through plant-soil feedbacks. However, we need more detailed understanding of the biological causes of such feedbacks. This includes identifying the soil microbial guilds causing them. As most plant-soil feedbacks have been reported to be negative, the dominant paradigm is focused on the accumulation of soil pathogens. This neglects the full range of soil microorganisms likely to influence plant performance. Here, we studied plant growth responses to field-collected soil inocula in a large-scale greenhouse study coupled with next-generation sequencing. Although we found a high prevalence of negative plant-soil feedbacks, the microorganisms driving the responses were largely saprotrophs and N-cycling prokaryotes, not pathogens. These results show that negative plant-soil feedbacks need not be caused by trophic interactions, highlighting the need to bring back nutrient cycling as a central component of plant-soil feedbacks.

In this paper, for the first time, the distributed order time-fractional forced Korteweg-de Vries equation is studied. We use a numerical method based on the shifted Legendre operational matrix of distributed order fractional derivative with Tau method to find approximate solution of distributed order forced Korteweg-de Vries equation. This shifted Legendre operational matrix of distributed order fractional derivative with Tau method are used to reduce the solution of the distributed order time-fractional forced Korteweg-de Vries equations to a system of algebraic equations. An error analysis and convergence are obtained. Finally, to display the applicability and validity of the numerical method some examples are implemented.

The velocity correction coefficient is the key to calculate the mean velocity of overland flow, which is a parameter of slope soil erosion process model. Therefore, this paper systematically studied the variation mechanism of the correction coefficient under 5 kinds of slope, 5 kinds of flow rate, 5 kinds of roughness, 9 kinds of gravel coverage and 3 kinds of rainfall intensity conditions based on fixed-bed resistance and simulated rainfall test. The results showed that the relationship between the coefficient and the slope was the inverse function, and its influence on the correction coefficient was weak when the slope was steeper than 10°; both Reynolds number and rainfall intensity could promote the increase of correction coefficient; the relationship between correction coefficient and the submergence degree was in the form of logarithm function, which was alos the same as Reynolds number, but the response of the correction coefficient to both was just opposite. The research results provide the theoretical basis for the accurate selection of velocity correction coefficient, which has important theoretical and practical significance for the investigation of soil erosion power and sediment carrying mechanism of overland flow related to the mean velocity.

Evapotranspiration (ET) plays an important role in integrated water resource planning, development and management. This process is particularly relevant in semiarid regions. The aim of the present study is to compare the actual spatial and temporal evapotranspiration (ETa) patterns and temporal trends in two semiarid forests, one in Brazil (Aiuaba) and the other in Spain (Valladolid). We used the Surface Energy Balance Algorithm for Land (SEBAL) to assess the effect of climatic variation in both areas. In the Brazilian semiarid forest, Caatinga is the main vegetation, while it is stone pine in Spain. For this purpose, 69 Landsat-5 and 42 Landsat-8 images (1995 – 2019) were used. The Mann-Kendall test was applied to assess the occurrence of trends in precipitation, temperature and potential evapotranspiration data; and the Temporal Stability Index (TSI) to know which areas have greater seasonal ETa. The annual amplitude of the potential evapotranspiration (ET0) is the same in both areas, however, the Caatinga values are higher. In the Caatinga forest, when ET0 presents its highest values throughout the year, ETa presents the lowest, and vice versa. In the Pinares forest, ETa follows the ET0 dynamics during the year, and the difference between ET0 and ETa is maximum during the summer. The Caatinga forest showed a greater spatial variation of ETa than the Pinares forest as well as a greater extension with lower temporal stability of ETa than the Pinares forest. Both the Caatinga forest and the Pinares forest showed significant annual trends of increase for ET0 and ETa: 3.5 mm and 2.2 mm, and 7.0 mm and 3.9 mm, respectively.

Field measurements were conducted in floodplains of Poyang Lake (China) to study the influence of aquatic vegetation on flow structures under combined current and wave conditions. Wave and turbulent velocity components were decomposed from the time series of instantaneous velocity and analyzed separately. With weak wave-plant interaction, indicated as the ratio of wave excursion to stem spacing Ew/S < 0.5 in present study, the vertical distributions of time-averaged velocity (Uhoriz) and turbulent kinetic energy (TKE) with the presence of vegetation were similar to that under pure current conditions. For emergent conditions, Uhoriz and TKE distributed uniformly through the entire water column or increased slightly toward the water surface. Similar distributions were present in the lower part of submerged vegetation, above which the Uhoriz and TKE increased with increasing distance to bed bottom and TKE reached its maximum near the top of vegetation. With small Ew/S the wave orbital velocity (Uw) was not attenuated within vegetation compared with that above the vegetation or near the water surface, and Uw through the entire water column can be predicted by the linear wave theory. However, the turbulence generated near the top of canopy can penetrate a deeper depth into vegetation with the presence of wind-driven waves than without.

Background: How to shorten the anesthesia time is an important problem to ERAS. The authors formulated a series of optimization measures and verified that these measures could shorten the anesthesia time and improve the operating room utilization efficiency by multidisciplinary diagnosis and treatment pattern. Methods: 90 patients were random selected to analyses the time of every preparing procedure and between 2 adjacent procedures, the multidisciplinary team established the optimization measures accordingly. Then 95 patients for gastrointestinal surgery received collaborative optimization measures that were established after discussion among anesthesiologists, surgeons and operating room nurses (optimization group), while 226 cases received the conventional approaches (control group). The data obtained from operating room monitoring recording of the two groups of patients were analyzed. Results: The preparation times from the initial of induction of anesthesia to start of surgery in optimization group were all significantly shorter than those in control group (all P<0.0001). In supine position surgery, the times from initial of induction of anesthesia to start of urinary catheterization, from urinary catheterization finish to start of disinfection, and from completion of draping to start of surgery in patients receiving optimization measures were all significantly superior to those receiving conventional approaches (all P<0.0001); in lithotomy position surgery, the times from the initial of induction of anesthesia to positioning, from positioning finish to start of disinfection, and from completion of draping to start of surgery in patients receiving optimization measures were all significantly superior to those receiving conventional approaches (all P<0.0001). Conclusions: The established optimization measures based on multidisciplinary team collaboration could significantly shorten the anesthesia time. The optimized measures in this study are feasible and effective to shorten the anesthesia time.

Extreme drought conditions across the globe are impacting biodiversity with serious implications for the persistence of native species. However, quantitative data on drought tolerance is not available for diverse flora to inform conservation management. We quantified physiological drought tolerance in the diverse Hakea genus (Proteaceae) to test predictions based on climatic-origin, life history and functional traits. We sampled terminal branches of replicate plants of 16 species in a common garden. Xylem cavitation was induced in branches under varying water potential (tension) in a centrifuge and the tension generating 50% loss of conductivity (stem P50) was characterized as a metric for drought tolerance. The same branches were used to estimate plant functional traits, including wood density, specific leaf area, and Huber value (sap flow area to leaf area ratio). There was significant variation in stem P50 among species, which was negatively associated with the species climate-origin (rainfall and aridity). Drought tolerance did not differ among life histories; however, a drought avoidance strategy with terete leaf form and greater Huber value may be important for species to colonize and persist in the arid biome. Our findings will contribute to future prediction of species vulnerability to drought and adaptive management under climate change.

In the present work, we evaluate the Laplace transforms and inverse Laplace transforms of functions involving the generalized and reverse generalized Bessel matrix polynomials, which yield a number of potentially useful (known or new) integral transforms as special cases. Furthermore, pertinent relations of the different results given here with those involving simpler and earlier ones are also considered.

Introduction: Hemodynamics of left atrial appendage (LAA) is an important factor for future risk of ischemic stroke in atrial fibrillation (AF) patients and velocity encoded cardiac magnetic resonance imaging (VENC-MRI) can evaluate blood flow volume of LAA without any invasive procedures. We aimed to evaluate the impact of radiofrequency catheter ablation (RFCA) on LAA hemodynamics via MRI evaluation. Methods and Results: Consecutive RFCA cases in a single arrhythmia center were retrospectively analyzed. A total of 3,120 AF patients who underwent first RFCA were analyzed. Among these patients 360 patients had both pre- and post-RFCA VENC-MRI evaluation. Atrial fibrillation was non-paroxysmal in 174 (48.3%) patients. Mean VENC-MRI (ml/sec) was significantly improved after RFCA with 49.75±32.97 and 71.92±34.94 for pre- and post-RFCA, respectively. Patients with non-paroxysmal AF (∆VENC-MRI = 29.71±35.30 vs. 14.42±40.94; p < 0.001) and low pre-RFCA VENC-MRI (∆VENC-MRI = 50.64±28.92 vs. 16.72±38.39; p < 0.001) had significantly higher improvement in VENC-MRI. Those who experienced late recurrence before post-RFCA MRI had significantly less improvement in LAA flow volume (∆VENC-MRI = 15.55±41.41 vs. 25.75±37.00; p = 0.016). Similar results were obtained after adjusting covariates. Conclusions: Radiofrequency catheter ablation can significantly improve hemodynamics of LAA in AF patients. The beneficial effects were most prominent in non-paroxysmal AF, those who had low pre-RFCA VENC-MRI, and those without late recurrence. Whether the improved hemodynamics of LAA after RFCA actually leads to reduced risk of ischemic stroke should be evaluated in future trials.

Introduction – We aimed to assess changes in QTc over time following cardioversion (CV) for persistent atrial fibrillation (AF), and to compare the benefit of using continuous Holter monitoring vs. conventional follow-up. Methods – The study population comprised 90 patients admitted to our center for elective CV due to persistent AF who were prospectively enrolled from July 2017 through August 2018. All patients underwent 7-day Holter started prior to CV. Baseline QTc was defined as median QTc during first hour post CV. The primary endpoint was QTc prolongation defined as QTc ≥500ms, or ≥10% increase (if baseline QTc was >480ms). Conventional monitoring was defined as an ECG recording 2-hours post CV. McNemar test was used for comparison. Results - Mean age was 67 ± 11 years and 61% were male. Median baseline QTc was 452msec (IQ range: 431-479 msec) as compared with a maximal median QTc of 474msec (IQ range: 433–527 msec; p<0.001 for the change in QTc from baseline). Peak median QTc occurred 44-hours post CV. The primary endpoint was met in 3 patients (3%) using conventional monitoring, compared with 39 new patients (43%) using Holter (p<0.001 for comparison). The Holter monitoring was superior to conventional monitoring in detecting clinically significant QTc prolongation (OR=13; p<0.001). Conclusion – CV of patients with persistent AF may be associated with increased transient risk of QTc prolongation. Peak median QTc occurs during end of second day following CV and prolonged ECG monitoring provides superior detection of significant QTc prolongation compared with conventional monitoring

Introduction Left bundle branch area pacing (LBBAP) aims to achieve physiological pacing by capturing the conduction system in the area of the left bundle branch. LBBAP has exclusively been performed using lumen-less pacing leads (LLL) with fixed helix design. This study explores the feasibility, safety and pacing characteristics of LBBAP using stylet-driven leads (SDL) with an extendable helix design. Methods Patients, in which LBBAP was attempted for bradycardia or heart failure pacing indications, were prospectively enrolled at the Ghent University Hospital. LBBAP was attempted with two different systems: 1/ LLL with fixed helix (SelectSecure 3830, Medtronic, Inc) delivered through a preshaped sheath (C315His Medtronic) and 2/ SDL with extendable helix (SoliaS60, Biotronik, SE & CO) delivered through a new delivery sheath (Selectra 3D, Biotronik). Results The study enrolled 50 patients (mean age 7014 years, 44% female). LBBAP with SDL was successful in 20/23 (87%) patients compared to 24/27 (89%) of patients in the LLL group (p=0.834). Screw attempts, screw implant depth, procedural and fluoroscopy times were comparable among both groups. Acute LBBAP thresholds were low and comparable between SDL and LLL (0.50.15V versus 0.40.17V, p=0.251). Pacing thresholds remained low at 32.1 months of follow up in both groups and no lead revisions were necessary. Post procedural echocardiography revealed a septal coronary artery fistula in one patient with SDL LBBAP. Conclusion LBBAP using stylet-driven pacing leads is feasible and yields comparable implant success to LBBAP with lumen-less pacing leads. LBBAP thresholds are low and comparable with both types of leads.

Introduction: Non-white patients are underrepresented in left atrial appendage occlusion (LAAO) trials, and racial disparities in LAAO periprocedural management are unknown. Methods: We assessed sociodemographics and comorbidities of consecutive patients at our institution undergoing LAAO between 2015 – 2020, then in adjusted analyses, compared procedural wait time, procedural complications, and post-procedure oral anticoagulation (OAC) use in whites versus non-whites. Results: Among 109 patients undergoing LAAO (45% white), whites were less likely to have heart failure than non-whites (18% vs. 48%, p=0.001), prior stroke (14% vs. 43%, p=0.001), or end stage renal disease (0 vs. 20%, p<0.001). Whites had lower CHA2DS2VASc scores, on average (4.0 vs. 4.8, p=0.006). There was no difference in median time from index event or initial outpatient cardiology encounter to LAAO procedure (whites 10.5 vs. non-whites 13.7 months, p=0.9; 1.9 vs 1.8 months, p=0.6, respectively), and there was no difference in procedural complications (whites 4% vs. non-whites 5%, p=0.33). After adjusting for CHA2DS2VASc score, OAC use at discharge tended to be higher in whites (OR 2.4, 95%CI [0.9-6.0], p=0.07). When restricting the analysis to those with prior gastrointestinal (GI) bleed, adjusting for CHA2DS2VASc score and GI bleed severity, whites had a nearly five-fold odds of being discharged on OAC (OR 4.6, 95% CI [1-21.8], p=0.05). Conclusion: Despite an increased prevalence of comorbidities amongst non-whites, wait time for LAAO and procedural complications were similar in whites versus non-whites. Among those with prior GI bleed, whites were nearly five-fold more likely to be discharged on OAC than non-whites.

Objective: This study aimed to investigate the outcome of adults with benign paroxysmal positional vertigo(BPPV)secondary to sudden sensorineural hearing loss(SSNHL). Methods: A retrospective study was conducted in patients with evidence of idiopathic BPPV or SSNHL with BPPV . All participants were identified and categorized by using the Dix-Hallpike test and roll test, followed by canalith repositioning procedures (CRPs) that were repeated 2 to 3 times. Assessment of the outcome was conducted one-hour and one-week post-CRPs, respectively. Results Six-four adults with BPPV secondary to SSNHL and 328 adults with idiopathic BPPV were included. The posterior canal was the most affected in both groups. At one-hour posttreatment, the cured rate of the BPPV with SSNHL group was 45.31%, which was significantly lower than that of the i-BPPV group (94.82%, P<0.01). At one-week posttreatment, the cured rate of the BPPV with SSNHL group was 66.67%,which was significantly lower than that of the i-BPPV group (98.78%, P<0.01). Conclusions BPPV with SSNHL was associated with poorer outcomes than i-BPPV in the short term.