A Novel apaQTL-SNP for the Modification of Non-Small-Cell Lung Cancer Susceptibility across Histological Subtypes.

Background: Alternative polyadenylation (APA) events may be modulated by single nucleotide polymorphisms (SNPs). Therefore, this study aims to evaluate the association between APA quantitative trait loci (apaQTLs)-related SNPs (apaQTL-SNPs) and non-small-cell lung cancer (NSCLC) risk. Methods: APA-related genes associated with NSCLC (LUAD and LUSC) were first identified, and the respective apaQTL-SNPs of those genes were selected. Then, a two-phase case-control study was performed to evaluate the association between candidate apaQTL-SNPs and NSCLC risk. Results: A total of 7 LUAD- and 21 LUSC-associated apaQTL-SNPs were selected. In the first phase, the apaQTL-SNP rs10138506 was significantly associated with LUAD risk (p < 0.05), whereas the other two apaQTL-SNPs (rs1130698 and rs1130719) were significantly associated with LUSC risk (p < 0.05). In the second phase, the variant G allele of rs10138506 was still significantly associated with an increased risk of LUAD (OR = 1.42, 95%CI = 1.02−1.98, p = 0.038). Functional annotation indicated that the variant G allele of rs10138506 was significantly associated with a higher PDUI value of CHURC1. Meanwhile, 3'RACE experiments verified the presence of two poly(A) sites (proximal and distal) in CHURC1, while qRT-PCR results indicated that different genotypes of rs1127968 which, in perfect LD with rs10138506, can mediate changes in the lengths of the 3'UTR of CHURC1 isoforms. Conclusion: The variant G allele of rs10138506 in CHURC1 was correlated with a longer 3'UTR of CHURC1 mRNA and an increased LUAD risk. Further studies should evaluate the interaction between rs10138506 and different 3'UTR lengths of CHURC1 that regulate LUAD development.

Minimalistic fully convolution networks (MFCN): pixel-level classification for hyperspectral image with few labeled samples.

Most of the existing deep learning methods for hyperspectral image (HSI) classification use pixel-wise or patch-wise classification. In this paper, we propose an image-wise classification method, where the network input is the original hyperspectral cube rather than the spectral curve of each pixel (i.e., pixel-wise) or neighbor region of each pixel (i.e., patch-wise). Specifically, we propose a minimalistic fully convolution network (MFCN) and a semi-supervised loss function, which can perform pixel-level classification for HSI with few labeled samples. The comparison experiments demonstrated the progress of our methods, using three new benchmark HSI datasets (WHU-Hi-LongKou, WHU-Hi-HanChuan and WHU-Hi-HongHu) with wavelength range from 400 to 1000nm. In the comparison experiments, we randomly selected 25 labeled pixels from each class for training, equivalent to only 0.11%, 0.16%, and 0.14% of all labeled pixels for the three datasets, respectively. In addition, through ablation studies and theoretical analysis, we verified and analyzed the effectiveness and superiority of our design choices.

Catheter Ablation Versus Medical Therapy for Atrial Fibrillation in Patients with Heart failure: A Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: The optimal treatments for atrial fibrillation in heart failure patients are controversial. The present study compared the efficacy of catheter ablation and medical therapy in patients with atrial fibrillation and heart failure. METHODS: Pubmed, Embase, Cochrane Library, and Web of Science were searched until January 15, 2022. Randomized controlled trials comparing catheter ablation for atrial fibrillation with medical therapy in patients with atrial fibrillation and heart failure were enrolled. Primary outcome was all-cause mortality. Secondary outcomes included the heart failure hospitalization and the change in left ventricular ejection fraction, 6-minute walk test distance, peak oxygen consumption, and Minnesota Living with Heart Failure questionnaire score. RESULTS: Totally 8 randomized controlled trials involving 1693 patients were included. Compared with medical therapy, catheter ablation significantly reduced all-cause mortality (risk ratios=0.60, 95% Cl: 0.45 to 0.80, P < .001) and hospitalization due to heart failure (risk ratios=0.58, 95% Cl: 0.46 to 0.73, P < .001), improved left ventricular ejection fraction (mean difference=5.25%, 95% CI: 2.78% to 7.71%, P < .001), improved the performance of 6-minute walk test (mean difference=28.83 m, 95% CI: 8.61 to 49.05 m, P=.005), increased peak oxygen consumption (mean difference=3.11 mL/kg/min, 95% CI: 1.04 to 5.18 mL/kg/min, P=.003), and reduced Minnesota Living with Heart Failure score (mean difference=-8.45, 95% CI: -16.28 to -0.62, P=.03). CONCLUSION: In heart failure patients with atrial fibrillation, catheter ablation provides more benefits over medical therapy in the important clinical outcomes, exercise capacity, and quality of life.

P2Y12 inhibitor pretreatment in patients with nonST-segment elevation acute coronary syndrome: A meta-analysis.

BACKGROUND: The 2020 European Society of Cardiology guidelines do not recommend pretreatment for nonST-segment elevation myocardial infarction (NSTEMI) patients with unclear coronary anatomy, which is inconsistent with our routine preoperative approach to loading P2Y12 receptor inhibitors (e.g., preoperative loading of 300 mg of clopidogrel). OBJECTIVES: The purpose of our study was to compare the safety and effectiveness of P2Y12 inhibitors administered before coronary angiography or at least before percutaneous coronary intervention (PCI) with during or after PCI. METHODS: Cochrane, PubMed, and Embase databases were searched. The primary effect endpoint and safety endpoint were any-cause death and major bleeding, respectively. Major adverse cardiovascular events, myocardial infarction and revascularization were also analyzed. RESULTS: Our search identified 9 trials. P2Y12 inhibitor pretreatment was associated with lower death from any cause (OR 0.62, 95% CI 0.53-0.72, P < 0.00001) without increasing the risk of bleeding (OR 1.02, 95% CI 0.80-1.30, P = 0.89). However, prasugrel or ticagrelor pretreatment was not associated with a lower risk of mortality (OR 0.70, 95% CI 0.31-1.59, P = 0.40) and increased the risk of bleeding (OR 1.67, 95% CI 1.10-2.54, P = 0.02). CONCLUSIONS: In summary, clopidogrel pretreatment was associated with significantly lower mortality, major adverse cardiovascular events, myocardial infarction and revascularization with no increase in major bleeding. However, these advantages were not observed with prasugrel or ticagrelor pretreatment.

Fixed complex electrograms during sinus rhythm and local pacing: potential ablation targets for persistent atrial fibrillation.

In atrial fibrillation (AF) patients, complex electrograms during sinus rhythm (C-EGMs) could be pathological or not. We aimed to demonstrate whether local pacing was helpful to discern pathological C-EGMs. 126 persistent AF patients and 27 patients with left-side accessory pathway (LAP) underwent left atrial mapping during sinus rhythm. If C-EGMs were detected, local pacing was performed. If the electrograms turned normal, we defined them as non-fixed C-EGMs, otherwise as fixed C-EGMs. No difference was detected in the incidence and proportion of non-fixed C-EGMs between AF patients and LAP patients (101/126 vs. 19/27, P = 0.26; 9.1 ± 6.0% vs. 7.7 ± 5.7%, P = 0.28). However, the incidence and proportion of fixed C-EGMs were higher in persistent AF patients (87/126 vs. 1/27, P < 0.01; 4.3 ± 3.4% vs. 0.1 ± 0.5%, P < 0.01). Compared with non-fixed C-EGMs, fixed C-EGMs had lower amplitudes, longer electrogram durations and longer Stimuli-P wave internals. All AF patients received circumferential pulmonary vein isolation. Among AF patients with fixed C-EGMs, 45 patients received fixed C-EGMs ablation and 42 patients underwent linear ablation. Compared with linear ablation, fixed C-EGMs ablation reduced recurrence (HR: 0.43; 95% CI 0.21-0.81; P = 0.011). Among patients without fixed C-EGMs ablation, the proportion of fixed C-EGMs was an independent predictor of ablation outcomes (HR for per percent: 1.13, 95% CI 1.01-1.28, P = 0.038). C-EGMs could be classified into fixed and non-fixed C-EGMs through local pacing. Fixed rather than non-fixed C-EGMs might indicate abnormal atrial substrates and fixed C-EGMs ablation improve outcomes of persistent AF ablation.

Pretreatment with Shenmai Injection Protects against Coronary Microvascular Dysfunction.

Background: The clinical treatment of coronary microvascular dysfunction (CMD) is mainly based on conventional medicine, but the mechanism of the medicine is single and the efficacy is different. Shenmai injection (SMI) has a variety of ingredients, but the effect of SMI on CMD has not been studied. This study investigated the effect of SMI on CMD and its possible mechanism. Methods: The protective effect of SMI on CMD was evaluated in Sprague-Dawley (SD) rats and human umbilical vein endothelial cells (HUVECs). In vivo, forty-five male SD rats were randomly divided into control group (sham group), CMD group (model group), and SMI group (treatment group). Two weeks after SMI intervention, laurate was injected into the left ventricle of rats to construct a CMD model. Blood samples were collected to detect myocardial enzymes, oxidative stress, and inflammatory factors, and the hearts of rats were extracted for histopathological staining and western blot detection. In vitro, a hydrogen peroxide-induced endothelial injury model was established in HUVECs. After pretreatment with SMI, cell viability, oxidative stress, vasodilative factors, and apoptosis were detected. Results: In vivo, pretreatment with SMI could effectively reduce the concentrations of lactate dehydrogenase (LDH), creatine kinase-MB (CK-MB), cardiac troponin I (cTnI), endothelin-1 (ET-1), tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), and malondialdehyde (MDA) in the serum of rats. Meanwhile, the expression of bcl-2-associated X (Bax) and caspase-3 protein in the myocardium of rats was decreased in the SMI group. The levels of nitric oxide (NO) and superoxide dismutase (SOD) and the expression of B-cell lymphoma-2 (Bcl-2) were higher in the SMI group than in the CMD group. Pathological staining results showed that SMI could effectively reduce inflammatory infiltration and the formation of collagen fibers and microthrombus in the rat myocardium. In vitro, intervention with SMI could improve endothelial function in a dose-dependent manner as evidenced by increasing the activity of endothelial cells and the expression of NO, SOD, endothelial nitric oxide synthase (eNOS), and Bcl-2, while decreasing cell apoptosis and the levels of ET-1, MDA, Bax, and caspase-3. Conclusions: Pretreatment with SMI could improve CMD by alleviating oxidative stress, inflammatory response, and apoptosis and then improving vascular endothelial function and microvascular structure.

Relationship between the time point of left atrial size change and the outcomes of radiofrequency catheter ablation.

PURPOSE: The change in the left atrial anteroposterior diameter (LAD) after radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) has become an independent factor in predicting the postoperative curative effect; however, whether the specific time point of this change is related to the postoperative curative effect is unclear. The purpose of this study was to explore the correlation between the specific time point of LAD change and the recurrence of AF 1 year after RFCA. METHODS: Patients with AF who underwent RFCA in our hospital from July 2016 to May 2020 were enrolled in the study. The patients were divided into four groups according to the time point when the LAD decreased by 10% after RFCA: group A, first month after RFCA; group B, second month after RFCA; group C, third month after RFCA; group D, unchanged or changed > 3 months after RFCA. RESULTS: In the multivariable Cox analyses, the duration of AF, LAD, and persistent AF were independent risk factors for the recurrence of AF. The recurrence rate of AF 1 year after RFCA were significantly lower in groups A (odds ratio [OR], 0.160; 95% confidence interval [CI]: 0.073-0.352; P < 0.001) and C (OR, 0.388; 95% CI: 0.156-0.963; P = 0.041) than in the control group. CONCLUSIONS: Reduction of LAD within 3 months after operation predicts the success rate of RFCA, with reduction within 1 month after operation having a higher success rate. This indicates the necessity of treatment in patients with AF who do not experience an early reduction in the LAD after RFCA.

Left Atrial Appendage Morphology and Local Thrombogenesis-Related Blood Parameters in Patients With Atrial Fibrillation.

Background Left atrial appendage (LAA) morphology predicts stroke risk in patients with atrial fibrillation. However, it is not precisely understood how LAA morphology influences stroke risk. The present study aimed to investigate the relationship between LAA morphology and local thrombogenesis-related blood parameters in LAA. Methods and Results We enrolled 205 patients undergoing catheter ablation of atrial fibrillation. The prevalence of chicken wing-, cactus-, windsock-, and cauliflower-type LAAs were 23.9%, 32.7%, 29.3%, and 14.1%, respectively. Blood samples were collected from the femoral vein, left atrium, and LAA in each patient. The levels of blood parameters were tested for each blood sample. The cauliflower-type LAA was associated with elevated platelet P-selectin expression, and interleukin-6 levels and with lower NO levels in LAA blood samples (P<0.05) independent of LAA flow velocity and LAA volume. LAA flow velocity, which was lowest in the cauliflower-type LAA, was the only independent predictor of von Willebrand factor antigen and plasminogen activator inhibitor-1 levels in LAA blood samples. In femoral vein blood samples, no significant difference was detected in the above blood parameters among the four LAA morphological types. In all blood samples, the levels of thrombin-antithrombin complex, D-dimer, fibrinogen, and tissue plasminogen activator were comparable among the four LAA morphological types. Conclusions In patients with atrial fibrillation, LAA morphological types might be associated with local platelet activity, fibrinolysis function, endothelial dysfunction, and inflammation.

Chest CT for detecting COVID-19: a systematic review and meta-analysis of diagnostic accuracy.

OBJECTIVE: The purpose of this article was to perform a systematic review and meta-analysis regarding the diagnostic test accuracy of chest CT for detecting coronavirus disease 2019 (COVID-19). METHODS: PubMed, Embase, Web of Science, and CNKI were searched up to March 12, 2020. We included studies providing information regarding diagnostic test accuracy of chest CT for COVID-19 detection. The methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity and specificity were pooled. RESULTS: Sixteen studies (n = 3186 patients) were included. The risks of bias in all studies were moderate in general. Pooled sensitivity was 92% (95% CI = 86-96%), and two studies reported specificity (25% [95% CI = 22-30%] and 33% [95% CI = 23-44%], respectively). There was substantial heterogeneity according to Cochran's Q test (p < 0.01) and Higgins I2 heterogeneity index (96% for sensitivity). After dividing the studies into two groups based on the study site, we found that the sensitivity of chest CT was great in Wuhan (the most affected city by the epidemic) and the sensitivity values were very close to each other (97%, 96%, and 99%, respectively). In the regions other than Wuhan, the sensitivity varied from 61 to 98%. CONCLUSION: Chest CT offers the great sensitivity for detecting COVID-19, especially in a region with severe epidemic situation. However, the specificity is low. In the context of emergency disease control, chest CT provides a fast, convenient, and effective method to early recognize suspicious cases and might contribute to confine epidemic. KEY POINTS: • Chest CT has a high sensitivity for detecting COVID-19, especially in a region with severe epidemic, which is helpful to early recognize suspicious cases and might contribute to confine epidemic.

The Role of Xuefu Zhuyu Decoction in Prevention of Contrast-Induced Nephropathy after Percutaneous Coronary Intervention.

OBJECTIVE: This study aimed to investigate the effect of Xuefu Zhuyu decoction on preventing contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI). METHODS: A total of 256 patients undergoing selective PCI for coronary artery disease were consecutively enrolled and randomly divided into two groups: Group A (n = 126) and Group B (n = 130). Before and after PCI, all patients routinely received antiplatelet aggregation therapy, antilipidemic therapy, and hydration therapy. Besides routine therapy, patients in Group B received Xuefu Zhuyu decoction from 3 days before PCI to 3 days after PCI. Serum creatinine (Scr), estimated glomerular filtration rate (eGFR), superoxide dismutase (SOD), and malondialdehyde (MDA) were measured, respectively, at baseline (72 h before PCI) and at 24, 48, and 72 h after PCI. RESULTS: Compared with Group A, Group B presented a lower fluctuation of SCr and eGFR (P < 0.01). The incidence of CIN was less in Group B. According to the definition, CIN occurred in 5 patients (2.0%) in the intervention group and 5 (4.0%) in the control group (P=0.167). In terms of oxidative stress, Group B had a lower MDA (P < 0.05), but a higher SOD (P < 0.05). CONCLUSIONS: Compared with the control group, Xuefu Zhuyu decoction intervention therapy increased the level of SOD and reduced MDA. The Xuefu Zhuyu decoction intervention group presented a higher level of eGFR at 24, 48, and 72 h after PCI in patients with coronary heart disease and a lower level of Scr. The results are propitious to prove that Xuefu Zhuyu decoction might play an antioxidative stress role in the prevention of CIN after PCI.

Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis.

BACKGROUND: An epidemic of Coronavirus Disease 2019 (COVID-19) began in December 2019 and triggered a Public Health Emergency of International Concern (PHEIC). We aimed to find risk factors for the progression of COVID-19 to help reducing the risk of critical illness and death for clinical help. METHODS: The data of COVID-19 patients until March 20, 2020 were retrieved from four databases. We statistically analyzed the risk factors of critical/mortal and non-critical COVID-19 patients with meta-analysis. RESULTS: Thirteen studies were included in Meta-analysis, including a total number of 3027 patients with SARS-CoV-2 infection. Male, older than 65, and smoking were risk factors for disease progression in patients with COVID-19 (male: OR = 1.76, 95% CI (1.41, 2.18), P < 0.00001; age over 65 years old: OR =6.06, 95% CI(3.98, 9.22), P < 0.00001; current smoking: OR =2.51, 95% CI(1.39, 3.32), P = 0.0006). The proportion of underlying diseases such as hypertension, diabetes, cardiovascular disease, and respiratory disease were statistically significant higher in critical/mortal patients compared to the non-critical patients (diabetes: OR=3.68, 95% CI (2.68, 5.03), P < 0.00001; hypertension: OR = 2.72, 95% CI (1.60,4.64), P = 0.0002; cardiovascular disease: OR = 5.19, 95% CI(3.25, 8.29), P < 0.00001; respiratory disease: OR = 5.15, 95% CI(2.51, 10.57), P < 0.00001). Clinical manifestations such as fever, shortness of breath or dyspnea were associated with the progression of disease [fever: 0R = 0.56, 95% CI (0.38, 0.82), P = 0.003;shortness of breath or dyspnea: 0R=4.16, 95% CI (3.13, 5.53), P < 0.00001]. Laboratory examination such as aspartate amino transferase(AST) > 40U/L, creatinine(Cr) ≥ 133mol/L, hypersensitive cardiac troponin I(hs-cTnI) > 28pg/mL, procalcitonin(PCT) > 0.5ng/mL, lactatede hydrogenase(LDH) > 245U/L, and D-dimer > 0.5mg/L predicted the deterioration of disease while white blood cells(WBC)<4 × 109/L meant a better clinical status[AST > 40U/L:OR=4.00, 95% CI (2.46, 6.52), P < 0.00001; Cr ≥ 133µmol/L: OR = 5.30, 95% CI (2.19, 12.83), P = 0.0002; hs-cTnI > 28 pg/mL: OR = 43.24, 95% CI (9.92, 188.49), P < 0.00001; PCT > 0.5 ng/mL: OR = 43.24, 95% CI (9.92, 188.49), P < 0.00001;LDH > 245U/L: OR = 43.24, 95% CI (9.92, 188.49), P < 0.00001; D-dimer > 0.5mg/L: OR = 43.24, 95% CI (9.92, 188.49), P < 0.00001; WBC < 4 × 109/L: OR = 0.30, 95% CI (0.17, 0.51), P < 0.00001]. CONCLUSION: Male, aged over 65, smoking patients might face a greater risk of developing into the critical or mortal condition and the comorbidities such as hypertension, diabetes, cardiovascular disease, and respiratory diseases could also greatly affect the prognosis of the COVID-19. Clinical manifestation such as fever, shortness of breath or dyspnea and laboratory examination such as WBC, AST, Cr, PCT, LDH, hs-cTnI and D-dimer could imply the progression of COVID-19.

A left common pulmonary vein: Anatomical variant predicting good outcomes of repeat catheter ablation for atrial fibrillation.

INTRODUCTION: A left common pulmonary vein (LCPV) is a common anatomical variant in atrial fibrillation (AF) patients. Whether an LCPV influences outcomes of repeated radiofrequency catheter ablation (RFCA) for AF has not been elucidated. METHODS: From a prospectively collected database, we enrolled 154 patients who received repeated RFCA for recurrent AF after the initial RFCA (56 ± 9 years, 72% paroxysmal AF, 32 patients with an LCPV, and 122 patients with typical left-sided pulmonary veins [PVs]). Median postprocedural follow-up was 26 months. The primary outcome was an episode of AF, atrial tachyarrhythmia, or atrial flutter lasting for more than 30 seconds, after the 3 months blanking period following the repeated procedure. RESULTS: After the follow-up period, 75 patients suffered recurrence after repeated ablation. In the Kaplan-Meier analysis, an LCPV was significantly associated with less recurrence (hazard ratio [HR]: 0.39; 95% confidence interval [CI]: 0.28-0.79; P = 0.005). In subgroup analysis, the significant association persisted in paroxysmal AF patients. Regarding persistent AF patients, an LCPV tended to be associated with less recurrence with no statistical significance (HR: 0.40; 95% CI: 0.20-1.03; P = 0.067). In multivariate analyses, an LCPV still independently predicted freedom from recurrence (HR: 0.44; 95% CI: 0.22-0.88; P = 0.02). CONCLUSION: Compared with typical left-sided PVs, an LCPV was independently associated with better outcomes after repeated RFCA of AF, particularly in patients with paroxysmal AF.

Investigating the perception of face identity in adults on the autism spectrum using behavioural and electrophysiological measures.

In the present study, we investigated face processing in individuals with self-reported Autism Spectrum Disorder (ASD, n = 16) and typically developing control participants (n = 16) using behavioural and electrophysiological measures. As a measure of their face memory, we administered the Cambridge Face Memory Test to participants in the ASD group. The results showed that the scores of the ASD participants were reliably below the age- and gender-matched norms of neurotypical individuals. To measure brain responses to faces, we used the fast periodic visual stimulation method, presenting photographs of a same-identity face (i.e., base face) at a constant frequency of 6 Hz (F) interleaved with different-identity faces (i.e., the oddball faces) presented at 1.2 Hz. The 6 Hz presentation of the base face and 1.2 Hz presentation of the oddball face elicited periodic brain responses corresponding to face detection and face individuation processes, respectively. Participants viewed four blocks of upright faces and four blocks of inverted faces. The results showed an enhanced EEG response to upright base faces at 6 Hz frequency and its harmonics compared to inverted faces, and the response was most focal over medial occipital channels. An enhanced response was found to upright oddball faces at 1.2 Hz and its harmonics compared to the inverted faces, and the response was centred over occipito-temporal channels in the right hemisphere. Critically, no differences or interactions were found between the ASD and typically developing groups in the responses to either the 6 Hz base faces or the 1.2 oddball faces. These results suggest that in individuals with ASD, the earlier stage of face perception, as measured by the fast periodic visual stimulation paradigm, can be dissociated from the later memory stage of face processing, as assessed by the Cambridge Face Memory Test.

The easy-to-hard training advantage with real-world medical images.

Many medical professions require practitioners to perform visual categorizations in domains such as radiology, dermatology, and neurology. However, acquiring visual expertise is tedious and time-consuming and the perceptual strategies mediating visual categorization skills are poorly understood. In this paper, the Ease algorithm was developed to predict an item's categorization difficulty (Ease value) based on the item's perceptual similarity to all within-category items versus between-category items in the dataset. In this study, Ease values were used to construct an easy-to-hard and hard-to-easy training schedule for teaching melanoma diagnosis. Whereas previous visual training studies suggest that an easy-to-hard schedule benefits learning outcomes, no studies to date have demonstrated the easy-to-hard advantage with complex, real-world images. In our study, 237 melanoma and benign images were collected for training and testing purposes. The diagnostic accuracy of images was verified by an expert dermatologist. Based on their Ease values, the items were grouped into easy, medium, and hard categories, each containing an equal number of melanoma and benign lesions. During training, participants categorized images of skin lesions as either benign or melanoma and were given corrective feedback after each trial. In the easy-to-hard training condition, participants learned to categorize all the easy items first, followed by the medium items, and finally the hard items. Participants in the hard-to-easy training condition learned items in the reverse order. Post-training results showed that training in both conditions transferred to the classification of new melanoma and benign images. Participants in the easy-to-hard condition showed modest advantages both in the acquisition and retention of the melanoma diagnosis skills, but neither scheduling condition exhibited a gross advantage. The Ease values of the items predicted categorization accuracy after, but not before training, suggesting that the Ease algorithm is a promising tool for optimizing medical training in visual categorization.

Transformation from persistent atrial fibrillation to paroxysmal type after initial ablation predicts success of repeated ablation.

BACKGROUND: If transformation from persistent atrial fibrillation (AF) to paroxysmal AF after catheter ablation had impacts on the outcome of repeated ablation was unclear. This study aimed to explore whether the type of recurrent AF after ablation for persistent AF was associated with recurrence after repeated ablation. METHODS AND RESULTS: This was a retrospective cohort study. 116 persistent AF patients undergoing the second ablation due to a failed initial ablation were enrolled in our study. Patients with recurrent paroxysmal AF after initial ablation were categorized as Group A (47 patients) while those with recurrent persistent AF were categorized as Group B (69 patients). The study endpoint was defined as any episode of AF, atrial tachyarrhythmia or atrial flutter lasting for >30 s, after the 3 month blanking period following repeated procedure. After 3-72 months (median: 24 months) of follow-up from repeated ablation, 54 (47%) patients suffered from recurrence after repeated ablation. In univariate analyses, Group B suffered a higher risk for recurrence than those in Group A (hazard ratio: 2.05, 95% confidence interval: 1.14-3.70, P = 0.01). Besides recurrent AF type, larger left atrial dimension at repeated procedure and pulmonary vein reconnection also predicted success of repeated ablation. In multivariate analysis, patients in Group B still had a 1.91-fold higher risk for recurrence than those in Group A (HR: 1.91, 95% CI: 1.06-3.44, P = 0.03). CONCLUSIONS: After persistent AF ablation, transformation from persistent AF to paroxysmal AF is independently associated with success of repeat ablation.

Efficacy and Safety of Uninterrupted Low-Intensity Warfarin for Radiofrequency Catheter Ablation of Atrial Fibrillation in the Elderly.

BACKGROUND: No previous studies exist investigating the optimal intensity of uninterrupted anticoagulation with warfarin during radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) in the elderly. OBJECTIVE: Evaluate the efficacy and safety of continuous low-intensity warfarin therapy throughout the periprocedural period of RFCA for AF in the elderly. METHODS: This is a prospective randomized study. We enrolled AF patients (age ≥ 70 years) who underwent first-time RFCA for AF. Enrolled patients were randomized to group A and group B. The international normalized ratios before ablation were maintained at 1.5 to 2.0 and 2.0 to 2.5 in group A and B, respectively. Primary end points were periprocedural thromboembolic complications and major bleeding. Secondary end points included periprocedural asymptomatic cerebral emboli (ACE) and minor bleeding. RESULTS: A total of 101 patients were enrolled in our study (group A: 52; group B: 49). Baseline characteristics were well balanced between the 2 groups. Only 1 patient suffered from stroke in group B. No major bleeding events occurred in either group. The incidence of new ACE lesions was comparable between the 2 groups (11.5% vs 8.2%, P = 0.82). Minor bleeding occurred in 1 of 52 (1.9%) patients in group A and in 5 of 49 (10.2%) patients in group B ( P = 0.10). CONCLUSIONS: Uninterrupted low-intensity warfarin for RFCA of AF might be as effective as standard-intensity warfarin in preventing periprocedural thromboembolic complications and might be associated with fewer bleeding events in the elderly.

Individual Differences in Face Identity Processing with Fast Periodic Visual Stimulation.

A growing body of literature suggests that human individuals differ in their ability to process face identity. These findings mainly stem from explicit behavioral tasks, such as the Cambridge Face Memory Test (CFMT). However, it remains an open question whether such individual differences can be found in the absence of an explicit face identity task and when faces have to be individualized at a single glance. In the current study, we tested 49 participants with a recently developed fast periodic visual stimulation (FPVS) paradigm [Liu-Shuang, J., Norcia, A. M., & Rossion, B. An objective index of individual face discrimination in the right occipitotemporal cortex by means of fast periodic oddball stimulation. Neuropsychologia, 52, 57-72, 2014] in EEG to rapidly, objectively, and implicitly quantify face identity processing. In the FPVS paradigm, one face identity (A) was presented at the frequency of 6 Hz, allowing only one gaze fixation, with different face identities (B, C, D) presented every fifth face (1.2 Hz; i.e., AAAABAAAACAAAAD…). Results showed a face individuation response at 1.2 Hz and its harmonics, peaking over occipitotemporal locations. The magnitude of this response showed high reliability across different recording sequences and was significant in all but two participants, with the magnitude and lateralization differing widely across participants. There was a modest but significant correlation between the individuation response amplitude and the performance of the behavioral CFMT task, despite the fact that CFMT and FPVS measured different aspects of face identity processing. Taken together, the current study highlights the FPVS approach as a promising means for studying individual differences in face identity processing.

Short-term Antiarrhythmic Drugs After Catheter Ablation for Atrial Fibrillation: A Meta-analysis of Randomized Controlled Trials.

BACKGROUND: The incidence of recurrent arrhythmia after catheter ablation (CA) for atrial fibrillation (AF) is unacceptable. Short-term antiarrhythmic drug (AAD) treatment following CA was presumed to be effective in reducing recurrent arrhythmia. OBJECTIVE: To fully evaluate the efficacy of short-term use of AADs following CA for AF in preventing recurrence of atrial tachyarrhythmias. METHODS: PubMed, Embase, Cochrane Library, and ClinicalTrials.gov were searched up until May 1, 2016. We enrolled randomized controlled trials (RCTs) that evaluated the efficacy of short-term use of AADs following CA for AF in preventing early and/or late recurrence of atrial tachyarrhythmias. The statistical analyses were performed using Review Manager Version 5.3. RESULTS: Six RCTs were included in this analysis, involving a total of 2764 patients. The frequency of early recurrence of atrial tachyarrhythmias was 39.5% in the AAD group (556 of 1407) and 47.2% (640 of 1357) in the control group. The pooled risk ratio of the AAD group to the control group was 0.78 (95% CI = 0.62-0.98). Regarding late recurrence of AF (LRAF), the incidence in the AAD group and the control group was 32.5% (420 of 1293) and 34.6% (450 of 1300), respectively. No significant difference was identified between the 2 groups (relative risk = 0.94, 95% CI = 0.85-1.05). CONCLUSIONS: Short-term use of AADs following CA for AF reduced the incidence of early recurrent atrial tachyarrhythmias but did not prevent LRAF.

Endothelial Progenitor Cells and In-stent Restenosis.

Coronary artery disease (CAD) is a significant global health problem, contributing to significant morbidity and mortality. Percutaneous coronary intervention (PCI) is an efficient therapy for treating CAD, but it carries the risk of iatrogenic endothelial injury, which contributes to vessel inflammation and induction of in-stent restenosis. Therefore, developing novel methods for enhancing re-endothelialization after PCI is highly needed. Endothelial progenitor cells (EPCs) can differentiate into mature endothelial cells, and cell therapy with EPC may offer a novel way for accelerating reendothelialization. In this review paper, we aimed to briefly describe EPCs and highlight their potential therapeutic roles in in-stent re-stenosis and endothelial injury.

The cued recognition task: dissociating the abrupt onset effect from the social and arrow cueing effect.

In a standard center cueing paradigm, participants are asked to identify a target object presented either to the left or the right of a center cue (e.g., eye gaze, head-turn, arrow, etc.). When the center cue is non-predictive (e.g., the arrow points to the correct location of the target only 50 % of the time), the target can still be identified faster at the validly cued location than at the invalidly cued location. However, the abrupt onset of an object can elicit reflexive attention orientation. It is important to investigate whether this abrupt onset effect interferes with the cueing effect elicited by center cues because this interference effect, if it exists, should be controlled for in order to improve the test validity of the center cueing task. In an attentional cueing paradigm, we examined how the abrupt appearance of an exogenous target object mitigates the influence of center cues involving either a head turn (Experiment 1) or an arrow (Experiment 2). In Experiment 1, a non-predictive head-turn cue was followed by a target object (circle or square) presented in the left or right visual field. In the non-distractor condition, the target object was presented by itself. In this case, it is assumed that the sudden appearance of the target provides an orienting cue to the observer. To equalize the cueing effect of the target object, we presented a competing distractor object (triangle) in the opposite visual field to the target object. The participant's task was to categorize the target object as either a circle or square while ignoring the non-target triangle object in the opposite visual field. In Experiment 2, the arrow version of the cued recognition task was used, in which a single-headed arrow pointed to the object. The results from both experiments showed that both the non-predictive head-turn and arrow cues produced a reliable cueing effect in the distractor and non-distractor conditions. However, the magnitude of the cueing effect was greater in the distractor condition than in the non-distractor condition, suggesting that the abrupt onset of the target object acts like an exogenous signal, thereby reducing the impact of the internal head turn and arrow cues.