This paper describes the results of process developmental experiments to achieve higher cell densities in the manufacturing of hMSCs using the novel Bach impeller in a stirred-tank bioreactor. Engineering experiments have previously shown that the Bach impeller represents an efficient mixing device that suspends particles in fluids at low power inputs. To assess the impeller during biological experiments, the growth performance of Wharton Jelly (WJ)-hMSCs in a 1 L STR equipped with the Bach impeller was evaluated at a variety of culture conditions. The cells attached to Cytodex 1 microcarriers at a concentration of 5.6 g/L and were cultured for 5-7 days. The growth phase was carried out at varying impeller speeds N  = 75 rpm, N = 115 and 150 rpm. Cell growth was additionally evaluated at a microcarrier concentration of 11.2 g/L Cytodex 1. Here, a maximum cell density of up to 1.7 x 10 6 cells/mL and cell viability >90% was achieved within 5 culture days, which is amongst the highest cell densities ever attained for a hMSC batch culture. Critical cell quality attributes of the WJ-hMSCs were assessed upon completion of the growth phase, i.e. FACS to identify stem cell surface markers, tri-lineage differentiation, and capacity of the cells to form colonies (CFU-assay). In addition, informed by the previously described engineering characterization, the 1 L process at N  = 75 rpm was scaled-up to the 5 L scale, where the hMSCs were again confirmed to have retained the relevant cell quality attributes. The reported findings are important to determine the design space to which scale-ups to even larger tank sizes can adhere.

Subserosal Ectopic Pregnancy: Diagnostic Challenges and ManagementAhmed Sabry 1,2, Gamal Sayed 3,4, Reda Youssef, 1,2,3, Samah Kohla 2,5, Sana Badr 1, Hashem Alakshar 1, Thomas Farrell 4, and Amal Alobaidly 1.1-Department of Clinical Imaging, Hamad Medical Corporation, Doha, Qatar2- Weill Cornell Medical College, Doha, Qatar.3- Clinical Department, Qatar University, College Of Medicine, Doha, Qatar4- Department of Obstetrics & Gynecology, Women’s Wellness and Research Center, Doha, Qatar5- Department of Laboratory Medicine and Pathology, Hematology Division, Hamad Medical Corporation, Doha, Qatar

A document by Hu Li. Click on the document to view its contents.

1IntroductionSolitary fibrous tumors (SFT) are rare mesenchymal tumors that account for approximately 2% of all soft tissue neoplasms[1]. The etiology of SFTs is unknown; however, they are typically slow-growing tumors with a favorable prognosis. These soft tissue tumors can be found in any part of the body, with the thorax identified as the most common site. Renal SFT are relatively rare, with only 105 cases of renal SFTs reported in the literature[1]. The clinical presentation of renal SFT varies widely, ranging from asymptomatic incidental findings to abdominal discomfort, hematuria, renal masses, and large abdominal masses. Furthermore, owing to the nonspecific nature of radiologic features, renal SFT are frequently misdiagnosed and managed as Renal Cell Carcinoma. Surgical resection remains the primary treatment modality for localized renal SFT and, yields favorable outcomes in most cases.

Key Points 1. It is safe and feasible to treat schwannoma by a non-inflation-forced-transaxillary approach. 2. This surgical method has no scar on the neck meets the aesthetic needs of patients. 3. The enlarged surgical field of view under the endoscope reduces the surgical risk and postoperative complications. 4. The function of each branch of vagus nerve can be protected to the greatest extent under the high clear and enlarged field of view of endoscope. 5. This procedure is suitable for the resection of benign vagus nerve tumors within the range of the hyoid bone to the clavicle

Species distribution models (SDMs) are used for understanding where species live or could potentially live and are a key resource for ecological research and conservation decision-making. However, current SDM methods often perform poorly for rare or inadequately sampled species, which includes most species on earth as well as most of those of the greatest conservation concern. Here, we evaluate the performance of three recently developed modeling approaches specifically designed for data-deficient situations: 1) plug-and-play modeling, 2) density-ratio modeling, and 3) environmental-range modeling. We compare the performance of these methods with Maxent, a widely used method. We compare model performance across sample sizes as well as comparisons limited to only data-poor species. We also ask to what extent model cross-validation performance on training data was correlated with model performance on independent, presence-absence data. We show that, across all species, one or more of the plug-and-play, density-ratio, or environmental-range algorithms outperformed Maxent in 72% of cases, with three of the algorithms having AUC distributions not significantly different from Maxent’s. For data-poor species (those with 20 or fewer occurrences), 24 of the algorithms considered had AUC distributions that were not significantly different from Maxent. However, despite these comparable AUC scores, we found that the algorithm outputs (when thresholded to predict presence vs absence) spanned a wide gradient of sensitivity vs. specificity. Specificity and prediction accuracy assessed on training data were strongly correlated with specificity and prediction accuracy assessed on independent presence-absence data, however AUC and sensitivity had weak correlations. We found that only for 16% of species was the model that performed best on the training data the best performing model when evaluated on independent, presence-absence data. Finally, we show how ensembles of models that span the sensitivity-specificity gradient can represent model disagreement in poorly sampled species and improve model predictions.

About 30% of the Amazon Basin is covered by different wetland types that harbor a huge and unique biodiversity and provide essential ecosystem services. This study examines the floristic composition and diversity patterns of tree species in oligotrophic blackwater wetlands of two sub-basins, Abacate River in Central Amazonia and Falsino River in Eastern Amazonia, along a hydroedaphic gradient from the headwaters to the floodplains. Data collection involved nine 0.5 ha plots in each sub-basin, with monitoring of flood levels, water table depths over a year as well as soil properties. The diameter at breast height (DBH) ≥10 cm of all trees was obtained, and the species were identified. Regression models were used to relate floristic patterns to environmental gradients. Results showed distinct responses between sub-basins. Tree Alpha diversity in the Abacate River was influenced by hydroedaphic variation but not floristic composition. Conversely, floristic composition in the Falsino River was significantly explained by the hydroedaphic gradient, while alpha diversity was higher but not statistically significant. Local-scale heterogeneity drives floristic variation, leads to high species turnover, emphasizing the need for conservation strategies tailored to sub-basin-level dynamics.

Evidence suggests that consuming epicatechin-rich green tea can increase metabolism in the body, and this metabolic effect might be linked to weight loss in obese subjects. The precise mechanism by which epicatechin influences weight loss is still unclear. Our goal was to identify a specific signature in the plasma proteins of obese individuals, categorized or not by gender (men and women), and to investigate how epicatechin (EC) supplementation affected them. Additionally, we analyzed anthropometric data to assess the potential anti-obesity effects of EC and to identify any gender-related differences that may have emerged. In our clinical trial, we provided pure EC (90%) at a daily dosage of 200 mg, administered before the main meal, for three months. The participants were obese men and women with a body mass index (BMI) of 30 kg/m² or higher. We conducted measurements of body dimensions and performed biochemical blood tests before and after the supplementation with EC, also analysing the proteome in the plasma samples. EC supplementation did not alter anthropometric parameters in obese subjects, but it did cause significant molecular changes in their plasma proteome, which varied between men and women. Key proteins like RPL30 were consistently regulated, indicating that EC might activate translational remodeling to adapt to metabolic stress in obesity. Proteomic profiling reveals early biomarkers of therapeutic efficacy, and future research should examine EC’s time-dependent effects on ribosomal biogenesis and metabolic regulation.

A novel molecularly imprinted electrochemical sensor for the detection of myricetin is proposed, which integrates deep eutectic solvent (DES) as an electrolyte and a monolayer of MXene as a conductive substrate for the electropolymerization of dual-monomer (p-aminobenzoic acid, p-ABA; pyrrole, py). Characterization by scanning electron microscopy and energy dispersive x-ray spectroscopy revealed the morphology and composition of the imprinted sensor. X-ray diffraction revealed the crystal structure of monolayer MXene. The dual-monomer system is capable of multiple interactions with myricetin: p-ABA forms hydrogen bonds with its hydroxyl group, while py undergoes π-π stacking with the aromatic a-ring. This synergistic binding generates an imprinted cavity with high specificity, achieving a linear response to myricetin in the concentration range of 2.0×10 -6 -1.6×10 -4 mol/L, with a limit of detection of 5.0×10 -7 mol/L (S/N = 3) and an imprinting factor of up to 3.4. Comparative studies have confirmed that the response current of the DES-based sensors is 1.3-fold higher than that of the aqueous system, which is attributed to the role of DES in enhancing the solubility of myricetin and attenuating template oxidation. In addition, it has good stability and reproducibility and has been successfully applied to the detection of real fruit juice samples.

Background: High-fat diets (HFD) generate free radicals causing oxidative stress posing risks of developing various diseases. Objective: The study determined the effects of hexane (HF) and water fractions (WF) of Vigna subterranean (VS) on HFD-induced oxidative stress Wistar rats. Method: VS seeds were processed into powder, extracted in absolute ethanol and fractionated using hexane, chloroform, ethyl acetate, and water. Forty-nine adults male Wistar rats were grouped into seven of seven rats each. Group 1 (Normal control) received normal pelleted diets (NPD) and distilled water; groups 2-7 rats were induced with HFD for 12 weeks. Thereafter, rats were administered; groups; 2 (HFD control+ distilled water), 3 (HFD + 100 mg/kg orlistat), 4 (HFD + 200 mg/kg HF), 5 (HFD + 400 mg/kg HF), 6 (HFD + 200 mg/kg WF), 7 (HFD + 400 mg/kg WF) daily orally for 4 weeks. Biochemical, hematological, oxidative stress markers, histology (liver and kidney) was performed using standard methods. Results: HF and WF significantly reduced (p<0.05) food intake, weight gain, lipid profiles, liver enzymes, renal parameters, MDA and increase SOD, CAT, GSH without inflammation in liver and kidney compared to HFD controls. Conclusion: VS fractions may mitigate hyperlipidemia, oxidative stress, and inflammation without significant adverse effects. The findings suggest further research on pharmacological mechanisms.

• A truncated integration-by-parts expansion allows Laplace transforms to handle nonlinear source terms in groundwater flow equations. • Approximation closely matches exact solutions for exponential, Bessel, and error-function tests common in aquifer analysis. • Smooth, rapidly decaying groundwater signals minimize higher-order terms, ensuring efficiency and broad applicability.

Grasslands, known for their high biodiversity, have significantly declined globally. Semi-natural grasslands, maintained by human activities such as burning, mowing, and grazing, are also decreasing due to the cessation of these practices. Recently, it has been recognized that ”old-growth grasslands,” which have existed for hundreds or thousands of years due to natural and human disturbances, are found worldwide. These grasslands, with longer duration, exhibit higher biodiversity across various taxa. Agricultural reservoirs play a crucial role in maintaining biodiversity and have substantial potential as biodiversity conservation areas in secondary nature involving private land or practices known as OECM (Other Effective area-based Conservation Measures). The reservoir banks, maintained as grasslands through regular mowing by local residents, have been shown to be important habitats for rare grassland plants. While systematic surveys of reservoir bank biota are limited, these reservoir banks have urgent needs for biodiversity conservation in Japan due to the nationwide promotion of disaster-prevention construction. We report on the flora of vascular plants in 71 agricultural reservoir banks and 10 park banks in and around Ueda City, central Japan, with information on the duration of grasslands, reservoir water storage, and the presence of disaster prevention construction for those reservoirs. These data are crucial for understanding the importance of agricultural reservoir banks for local biodiversity, the relationship between grassland duration and plant diversity, the impact of disaster prevention work on plant diversity, and the pre-construction flora in reservoirs slated for future disaster prevention construction.

A Tragic Case of Cefuroxime Allergy During Cardiac Surgery: A Case Report.

IntroductionBony sequestration, also known as sequestrum formation, is a well-documented pathological process characterized by the separation of necrotic bone from viable surrounding tissue, typically observed in the context of osteomyelitis or malignancy. In the maxillofacial region, this condition predominantly affects the mandible due to its relatively limited vascular supply; however, maxillary involvement, though less frequent, presents unique clinical challenges [1].The maxilla’s rich vascularity and porous membranous structure typically confer resistance to osteomyelitis, with a mandible-to-maxilla involvement ratio of approximately 3:1[2]. Predisposing factors for jawbone osteomyelitis include trauma, radiotherapy, and pharmacotherapies such as bisphosphonates and denosumab, which disrupt bone remodeling and increase susceptibility to necrosis [3, 4]. Radiation-induced osteonecrosis, a recognized complication of head and neck cancer treatment, further exacerbates this risk by impairing vascular integrity and promoting hypoxic tissue damage [5].The emergence of mucormycosis as a significant etiological factor in maxillary osteomyelitis has gained attention, particularly in the post-COVID-19 era. Mucormycosis, caused primarily by Mucorales species, is an angioinvasive fungal infection that thrives in immunocompromised states, infiltrating blood vessels and inducing thrombosis and necrosis [6]. Its predilection for the maxilla is attributed to anatomical proximity to the paranasal sinuses, a common entry point for fungal spores [7] .Pre-COVID-19 literature reported maxillary fungal osteomyelitis as a rare entity, with incidence rates favoring the maxilla (52%) over the mandible and a male-to-female ratio of 2.1:1 [8]. However, since 2020, a dramatic rise in mucormycosis cases has been documented among COVID-19 patients, particularly in India, linked to corticosteroid use, hyperglycemia, and immune dysregulation [9]. Pal et al. (2021) reported that Mucorales species accounted for 44% of fungal osteomyelitis cases, with Aspergillus spp. contributing a smaller fraction (2%) [10].Clinically, maxillary bony sequestration presents with pain, swelling, sinus tracts, and occasionally exposed necrotic bone, often mimicking other odontogenic or neoplastic conditions [11]. Radiographic evaluation remains a cornerstone of diagnosis. Plain radiographs and computed tomography (CT) reveal sequestra as calcified fragments within lucent lesions, with multiplanar CT reconstructions enhancing detection sensitivity [12]. However, these modalities struggle to differentiate necrotic bone from residual viable bone or calcified matrix [13]. Magnetic resonance imaging (MRI) offers superior soft-tissue contrast, distinguishing avascular sequestra within necrotic zones from vascularized bone in viable tissue when enhanced with gadolinium [14]. Nevertheless, MRI’s limitations in detecting small calcifications underscore the need for combined CT-MRI approaches [15].The post-COVID-19 surge in mucormycosis-associated osteomyelitis has introduced new diagnostic and therapeutic challenges. Studies indicate that COVID-19 exacerbates susceptibility to opportunistic infections through systemic inflammation and immune suppression, with fungal osteomyelitis emerging as a life-threatening complication (Mehta & Pandey, 2020). Treatment typically involves surgical debridement of necrotic tissue, antifungal therapy (e.g., amphotericin B), and management of underlying predispositions, though outcomes vary widely based on disease extent and patient comorbidities (Skiada et al., 2018).Despite advances in understanding maxillary bony sequestration and its association with mucormycosis in the post-COVID-19 context, several knowledge gaps persist. First, the precise mechanisms linking COVID-19-induced immune dysregulation to enhanced fungal pathogenicity remain poorly elucidated, limiting targeted preventive strategies. Second, the rarity of maxillary involvement prior to the pandemic complicates establishing baseline incidence rates and risk profiles specific to this site, particularly in immunocompetent populations. Third, while imaging modalities like CT and MRI have improved diagnostic precision, their ability to predict sequestrum viability and guide surgical planning remains suboptimal, necessitating novel imaging or biomarker-based approaches. Finally, the long-term outcomes of mucormycosis-associated osteomyelitis in COVID-19 survivors, including recurrence rates and quality of life, are inadequately documented, hindering the development of evidence-based management protocols. Addressing these gaps is critical to improving clinical outcomes in this emerging and complex disease entity.This case report explores the etiology, clinical presentation, and management of post-COVID-19 maxillary bony sequestration, highlighting its association with mucormycosis and the diagnostic challenges posed by this emerging complication.

This short communication develops a variational formulation for modeling a silicon semiconductor design utilizing phosphorus atoms as a dopant substance. The results are based on standard tools of calculus of variations and optimization theory.

Environmental Site Design (ESD) is a stormwater management approach that prioritizes use of infiltration-based non-structural techniques to mimic the natural hydrologic cycle by reducing impervious surfaces, slowing runoff, and increasing infiltration. Traditional storage-based stormwater management is designed for flood control by quickly diverting runoff from developed areas. This study compared the effect of ESD and only storage-based stormwater management practices on the hydrology of an urban watershed in Baltimore County, Maryland, USA. Minebank Run is a 8.47 km 2 flashy urban stream with a catchment largely developed without stormwater management. A calibrated SWMM model was used to simulate changes in catchment hydrology resulting from ESD and detention basins over a 54-year period, from the onset of urbanization in 1948 to urbanization in 2001. The model results were analyzed by quantifying and comparing different hydrologic metrics to evaluate runoff quantity and flow variability. Results indicated that although storage ponds performed similarly to ESD in reducing annual maximum peak flows (43% versus 45% reduction, respectively), ESD reduced mean annual runoff coefficients significantly more than ponds (28% versus 2.7%, p < 0.0001). The Richards-Baker Index was reduced from 0.46 to 0.32 with the implementation of ESD, as compared to 0.36 with detention ponds. This study also tested the hypothesis that the impact of urbanization on the hydrology of the Minebank Run watershed would have been reduced if it had been developed with ESD. The results indicated that implementation of ESD would have reduced annual maximum peak flows by an average of 46%, annual mean runoff coefficients by 51%, and Richard Baker Index by 37%. The study provides quantitative insights into the performance of traditional and innovative stormwater management techniques at the catchment scale, illustrating the benefits of a combination of both infiltration practices and detention storage in reducing the hydrologic impacts of urbanization.

Los estudiantes diseñarán y construirán un prototipo de brazo robótico funcional utilizando K'NEX y servomotores, asignando roles específicos por equipo y aplicando principios de ingeniería para resolver un problema real del entorno.

OBJECTIVE: Total laryngectomy (TL) is one of the techniques most often used for laryngeal cancer. One of the most common complications of TL is pharyngocutaneous fistula (PCF). The employed wound closure technique may affect the incidence rate of PCF after TL. The aim of this meta-analysis is to identify the steps with the least risk of PCF in each intervention. DATA SOURCES: The MEDLINE, Embase, Cochrane, Scopus and Web of Science (WOS) databases, using the following search terms: pharyngocutaneous, Suture, Closure, Shape, Stapler, Connell, Continuous, Layer, Flap, Salivary and Montgomery. REVIEW METHODS: The primary outcome measure was the appearance of PCF depending on the characteristics of the surgery: complete pharyngeal defect, partial pharyngeal defect, salvage or primary TL. Risk of bias was assessed using the relevant Cochrane tools, RoB2. RESULTS: This network meta-analysis included 95 studies with a total of 10,664 patients. For partial defects, the flap with the best results was jejune flap and using salivary bypass tube is recommended. In total defects, tissues with a tubular shape seem to be effective for pharyngeal reconstruction. In primary TL patients, the use of a stapler reduced the risk of developing PCF, and Connell-Mayo suture and tobacco-pouch suture showed the best results. In salvage TL, Vertical Straight continuous suture seems to have the least risk of developing PCF and the use of onlay flaps can be highly beneficial. CONCLUSION: Several factors seem to increase the development of PCF after TL, and so, more research should be carried out in this regard.

Background: The implementation strategies used to facilitate the delivery of youth mental health interventions are rarely reported. Specifying and reporting implementation strategies for impactful innovations that have demonstrated good clinical outcomes has the potential to support replication in other contexts and accelerate adoption of effective youth mental health interventions. Methods: Key project personnel conducted a retrospective review of implementation strategies used in a national programme of enhanced primary care youth mental health services. These strategies were classified and reported using the pragmatic implementation-reporting tool. We used univariate statistics to describe the implementation strategy types, temporality, dosage, and actors. We conducted linear regression techniques to predict time investment. Results: We identified 30 implementation strategies used across the course of one year. Twenty percent of strategies identified were in the domains of evaluative and iterative strategies and developing stakeholder engagement. This was followed by training and educating stakeholders, providing interactive assistance and supporting clinicians. In terms of dosage, interactive assistance accounted for over half of all time invested. Regression analysis showed that interactive assistance was the only category to predict increased person hours. Conclusions: By specifying and reporting the implementation strategies used in a youth mental health primary care programme, the pragmatic implementation-reporting tool can help demonstrate resourcing and skills required to reach programme sustainment.

INTRODUCTION The chain rule in multivariable calculus is often taught in a symbolic and memorization-based manner. However, for early learners and students, this can obscure the intuitive flow of variable dependencies. In this paper, I propose a new visual method, the _Junyeong Ha Diagram_, which structures composite functions from right to left and interprets differentiation as a stepwise movement of fraction-like paths through variable layers. CLASSICAL CHAIN RULE In a standard multivariable case, given: \[ z = f(x, y), \quad x = g(u, v), \quad y = h(u, v) \] the chain rule for partial derivatives is: \[ {\partial u} = {\partial x} \cdot {\partial u} + {\partial y} \cdot {\partial u} \] This formulation, while mathematically correct, provides little structural insight into the dependency paths. THE JUNYEONG HA DIAGRAM Instead of symbolic abstraction, if z=f(x,y), x=(u,v) y=(u,v), the Junyeong Ha Diagram visualizes the functional dependencies as: \[ z \rightarrow (x, y) \rightarrow (u, v) \] Here, the variable on the far right (e.g., u) is the DENOMINATOR, initiating the differentiation. Each path from u to z via intermediate variables (e.g., x or y) represents a product of partial derivatives. The rule is: - Fix the input variable (e.g., u) as the denominator. - Trace all paths leading from u to z. - Multiply each partial derivative along each path. - Sum the products over all valid paths. \[ {\partial u} = \left({\partial x} \cdot {\partial u} \right) + \left( {\partial y} \cdot {\partial u} \right) \] EXAMPLE Given: \[ x = u^2 + v, \quad y = uv, \quad z = x^2 + y^3 \] Compute: \[ {\partial u} = \left(2x \cdot 2u\right) + \left(3y^2 \cdot v\right) \] EDUCATIONAL IMPLICATIONS Stewart’s calculus textbook draws a lot of tree diagrams to explain the chain rule, but I think they’re too complicated. My method is way simpler and more intuitive. You just look at the variables from left to right, fix the one on the far right as the denominator, and trace the paths back. That’s it. It makes partial derivatives much easy to understand and calculate without memorizing formulas. CONCLUSION The Junyeong Ha Diagram presents an intuitive, visual approach to understanding the multivariable calculus chain rule. It encourages flow based reasoning and simplifies the analysis of composite function derivatives. This structure has the potential to assist in both education and algorithmic differentiation systems. REFERENCES - Stewart, J. (2020). _Calculus, 9/E (metric version)_

jabbrv-ltwa-all.ldf jabbrv-ltwa-en.ldf This study presents a high-performance ultralight carbon aerogel (denoted as PFSCA) synthesized via hydrothermal self-assembly, solvent exchange, and carbonization. Compared to passion fruit shell-derived carbon (PFSC) produced by direct pyrolysis, PFSCA exhibits a significantly lower packing density (0.056 g cm⁻³ vs. 0.210 g cm⁻³ for PFSC). Despite its reduced specific surface area (SSA: 455 m² g⁻¹ vs. 1485 m² g⁻¹ for PFSC), PFSCA achieves a comparable specific capacitance (167 F g⁻¹ vs. 170 F g⁻¹ for PFSC) and superior electrochemical performance. These enhancements are attributed to PFSCA’s unique structural and chemical features: (1) helical hollow tubes and surface nanospheres that shorten ion diffusion pathways, (2) a high degree of graphitization with enlarged d₀₀₂ interlayer spacing (0.38 nm vs. 0.35 nm for PFSC), and (3) surface-functional C=O and -COOH groups that improve hydrophilicity and charge transfer. A flexible symmetric supercapacitor (FASSC) fabricated with PFSCA electrodes operates at a 2.0 V voltage window, delivering an energy density of 30.6 Wh kg⁻¹ at 2000 W kg⁻¹. The FASSC retains 100% Coulombic efficiency over 6,000 cycles and demonstrates exceptional mechanical flexibility under bending angles of 0–180°. This work provides a cost-effective and scalable strategy for carbon aerogel synthesis, highlighting their potential for advanced flexible energy storage applications.

jabbrv-ltwa-all.ldf jabbrv-ltwa-en.ldf Background and Aim: The relationship between SGLT-2 (sodium glucose cotransporter-2) inhibitors and atrial fibrillation (AF) recurrence is under investigation. The aim of this study was to investigate the effect of SGLT-2 inhibitors on AF recurrence in patients diagnosed with diabetes mellitus (DM) who underwent Direct Current Cardioversion (DCCV) in our clinic. Method: Consecutive DCCV was performed until to achieve 120 patients in SR (60 DM patients who used SGLT-2 inhibitors and 60 DM patients who did not use SGLT-2 inhibitors). Patients defined as SGLT-2 inhibitor user group and control group. The two groups were monitored for AF recurrence on the first day, then at one, three, and six months after CV. Result: During the six-months follow-up period, AF recurrence developed in 24 (40%) patients in SGLT-2 inhibitor group and in 35 (58.3%) of the control group, p= 0.04. In univariate analysis, AF duration, SGLT-2 inhibitor, left atrium diameter, and TAPSE value were significant parameters in terms of AF recurrence. In multivariate analysis, AF duration OR: 4.98; 95% CI (2.39-10.38), p< 0,001 and non-use of SGLT-2 inhibitors OR: 0.35; 95% CI (0.13-0.90), were found to be independent predictors for AF recurrence. Conclusion: AF recurrence ratio is significantly lower in patients using SGLT-2 inhibitors, in six-month follow-up period. AF duration was positive and SGLT-2 inhibitor using was negative independent predictors, for AF recurrence in DM patients.

Background: Catheter ablation for atrial fibrillation (AF) typically involves transseptal puncture (TSP) to access the left atrium. Traditional TSP requires sheath upsizing and exchanges, increasing procedural complexity, time, and risks. We evaluated the efficiency and safety of zero-exchange technique using the FlexCath Advance™ sheath combined with the VersaCross™ RF wire compared to the traditional method involving initial puncture with Agilis™ NxT sheath and Baylis RF needle, followed by sheath exchange. Methods: This retrospective observational study included 109 patients undergoing their first cryoballoon AF ablation between June 2023 to June 2024 at Marshfield Medical Center. Procedural efficiency (time from venous access to TSP, time to first ablation, total procedural time), safety outcomes (pericardial effusion, bleeding, stroke/TIA, phrenic nerve injury, esophageal injury), and fluoroscopy exposure were compared between zero-exchange (n=50) and traditional (n=59) groups. Linear regression analyses were adjusted for age, sex, BMI, left ventricular ejection fraction (LVEF), and open-heart surgery history. Results: The zero-exchange approach significantly improved procedural efficiency, with shorter time from venous access to TSP (20 ± 9 vs. 28 ± 12 min; p<0.01), time to first ablation (36 ± 9 vs. 48 ± 16 min; p<0.01), and total procedure duration (107 ± 31 vs. 129 ± 51 min; p<0.01). Adjusted regression analyses confirmed these reductions (all p<0.01). Fluoroscopy time was substantially lower with zero-exchange (8.4 ± 4 min vs. 19.9 ± 8.2 min; p<0.01). No significant complications occurred in either group. Conclusion: The zero-exchange transseptal puncture technique using FlexCath Advance™ and VersaCross™ RF wire significantly enhances procedural efficiency and reduces radiation exposure without compromising patient safety, supporting its adoption in AF ablation procedures.

jabbrv-ltwa-all.ldf jabbrv-ltwa-en.ldf Allogeneic inflammatory factor-1 (AIF-1) is a novel adipokine that plays a crucial role in fat metabolism. This study evaluated the effect and mechanism of AIF-1 on adipogenic differentiation of DF-1 fibroblast cell line in Tibetan chickens, aiming to provide insights for solving the problem of excessive abdominal fat accumulation in modern poultry. The results showed that the coding sequence (CDS) of the Tibetan chicken AIF-1 gene was 438 bp, and the predicted protein had a molecular weight of approximately 16.29 kDa, with a high arginine content that may promote adipocyte maturation. AIF-1 was highly expressed in the kidney and abdominal adipose tissue, and its expression increased during adipogenic differentiation of chicken pre-adipocytes, indicating its involvement in adipogenesis. Inhibition of AIF-1 expression resulted in a significant reduction in lipid droplet accumulation and intracellular triglyceride levels. In contrast, overexpression of AIF-1 enhanced lipid droplet formation and triglyceride content. In addition, inhibition of AIF-1 expression significantly down-regulated the expression of known key genes related to adipocyte differentiation: peroxisome proliferation-activated receptor γ (PPARγ) and perilipin 1 (PLIN1) in adipocytes. The expression levels of CCAAT enhancer binding protein β (C/EBP-β) and fatty acid binding protein 4 (FABP4) were also decreased. In adipocytes overexpressing AIF-1, the expression levels of PPARγ, C/EBP-β and FABP4 were significantly increased. Thus, adipogenic differentiation induced by AIF-1 might be related with PPARγ, PLIN1, C/EBP-β and FABP4 activation. In conclusion, Tibetan chicken AIF-1 is a positive regulatory factor in adipogenic differentiation, which promoted adipogenic differentiation and lipid accumulation of preadipocytes.