Anti- and pro-fibrillatory effects of pulmonary vein isolation gaps in human atrial fibrillation digital twins.

Although pulmonary vein isolation (PVI) gaps and extrapulmonary vein triggers contribute to recurrence after atrial fibrillation (AF) ablation, their precise mechanisms remain unproven. Our study assessed the impact of PVI gaps on rhythm outcomes using a human AF digital twin. We included 50 patients (76.0% with persistent AF) who underwent catheter ablation with a realistic AF digital twin by integrating computed tomography and electroanatomical mapping. We evaluated the final rhythm status, including AF and atrial tachycardia (AT), across 600 AF episodes, considering factors including PVI level, PVI gap number, and pacing locations. Our findings revealed that antral PVI had a significantly lower ratio of AF at the final rhythm (28% vs. 56%, p = 0.002) than ostial PVI. Increasing PVI gap numbers correlated with an increased ratio of AF at the final rhythm (p < 0.001). Extra-PV induction yielded a higher ratio of AF at the final rhythm than internal PV induction (77.5% vs. 59.0%, p < 0.001). In conclusion, our human AF digital twin model helped assess AF maintenance mechanisms. Clinical trial registration: https://www.clinicaltrials.gov ; Unique identifier: NCT02138695.

Analysis of Characteristics and Risk Factors of Patients with Single Gastric Cancer and Synchronous Multiple Gastric Cancer among 14,603 Patients.

Background/Aims: Synchronous multiple gastric cancer (SMGC) accounts for approximately 6% to 14% of gastric cancer (GC) cases. This study aimed to identify risk factors for SMGC. Methods: A total of 14,603 patients diagnosed with GC were prospectively enrolled. Data including age, sex, body mass index, smoking, alcohol consumption, family history, p53 expression, microsatellite instability, cancer classification, lymph node metastasis, and treatment were collected. Risk factors were analyzed using logistic regression analysis between a single GC and SMGC. Results: The incidence of SMGC was 4.04%, and that of early GC (EGC) and advanced GC (AGC) was 5.43% and 3.11%, respectively. Patients with SMGC were older (65.33 years vs 61.75 years, p<0.001) and more likely to be male. Lymph node metastasis was found in 27% of patients with SMGC and 32% of patients with single GC. Multivariate analysis showed that SMGC was associated with sex (male odds ratio [OR], 1.669; 95% confidence interval [CI], 1.223 to 2.278; p=0.001), age (≥65 years OR, 1.532; 95% CI, 1.169 to 2.008; p=0.002), and EGC (OR, 1.929; 95% CI, 1.432 to 2.600; p<0.001). Survival rates were affected by Lauren classification, sex, tumor size, cancer type, distant metastasis, and venous invasion but were not related to the number of GCs. However, the survival rate of AGC with SMGC was very high. Conclusions: SMGC had unique characteristics such as male sex, older age, and EGC, and the survival rate of AGC, in which the intestinal type was much more frequent, was very good (Trial registration number: NCT04973631).

Comparison of chitosan and gelatin-based films and application to antimicrobial coatings enriched with grapefruit seed extract for cherry tomato preservation.

Bio-based single, composite, and bilayer edible films were developed based on chitosan and gelatin, including grapefruit seed extract (GSE) as an antimicrobial agent. The physicochemical and antimicrobial properties of films were analyzed, and it was found that compounding and laminating two polymers could enhance their physicochemical properties. The composite film was strong, endurable, and flexible compared with the single ones. In addition, the composite and bilayer films had lower water vapor permeability than the single ones. Edible films and coatings with GSE presented a greater bactericidal effect than the inactive ones. In addition, the hardness, weight, and color changes of the coated cherry tomatoes during 7-day storage did not differ, whereas a bacterial reduction against Salmonella Typhimurium was revealed. Taken together, composite and bilayer films with CH and GL and enriched with GSE were developed for food packaging applications, and it showed improved mechanical, water barrier, and antimicrobial properties. Supplementary Information: The online version contains supplementary material available at 10.1007/s10068-023-01254-9.

Synergistic antimicrobial effect and mode of action of palmarosa oil-loaded nanoemulsion and citric acid against Pectobacterium carotovorum.

The synergistic antimicrobial activity of palmarosa oil (Cymbopogon martini, PO)-loaded nanoemulsion (PO-NE) and citric acid (CA) against Pectobacterium, the major pathogen for soft-rot disease, was evaluated. The combination of PO-NE and CA (PO-NE + CA) significantly improved the storage stability of PO-NE at 30 °C. Compared to the anti-Pectobacterium activity of alone, PO-NE + CA reduced the minimum inhibitory concentration (MIC) by 1/4 and 1/2, respectively. Bactericidal efficacy of PO-NE + CA against P. carotovorum PCC3 was similar of PO-NE alone in the MIC in time-kill kinetic assay. PO-NE treatment mainly influenced membrane integrity, while CA treatment strongly stimulated intracellular ATP depletion. This synergistic combination effectively reduced the use of PO-NE, imparting a strong flavor note without sacrificing the antimicrobial efficacy against Pectobacterium. Supplementary Information: The online version contains supplementary material available at 10.1007/s10068-022-01217-6.

Anti-Salmonella polyvinyl alcohol coating containing a virulent phage PBSE191 and its application on chicken eggshell.

The use of antibiotics in the food industry is avoided due to the increase of antibiotic-resistant bacteria. Therefore, the bacteriophage is emerging as an alternative agent. Here, we characterized the Salmonella Enteritidis phage PBSE191 and applied it to a polyvinyl alcohol (PVA) film. Transmission electron microscopic analysis revealed that it belonged to the Caudoviricetes class, with an icosahedral head and flexible tails. The phage showed rapid and strong lytic activity within 1 h. It was active against a broad range of Salmonella isolates, including six serotypes. In 25 min, 99 % of the initial population was adsorbed to the bacterial cell surface. The phage was also applied to 10 % (w/v) PVA films and coatings, which were then characterized in terms of phage stability and antibacterial performance, both in vitro and in foods. The phage remained stable in the 10 % (w/v) PVA solution containing 20 % (w/w, based on PVA weight) sorbitol (PVAS20), indicating that the phage was stable under dry conditions and strongly released in the polymer. Furthermore, significant bacterial cell reduction (2.0 × 105 CFU/film within 2 h) was observed in the phage-containing PVAS20 films. In addition, the PBSE191-containing PVAS20 coating on the chicken eggshell surface showed significant anti-Salmonella efficiency (about 2 log CFU reduction) within 24 h. Overall, the PBSE191 phage possesses a high potential as a biocontrol agent for use as an additive, or as an active antibacterial packaging to improve food safety against Salmonella contamination.

Outcomes of acute kidney injury patients with and without cancer.

Incidence of AKI in hospitalized patients with cancer is increasing, but there have been few studies on AKI in patients with cancer. We conducted a retrospective cohort study in a South Korean tertiary care hospital. A total of 2211 consecutive patients (without cancer 61.5%; with cancer 38.5%) were included over a 140-month period. Predictors of all-cause death were examined using the Kaplan-Meier method and the Cox proportional hazards model. The main contributing factors of AKI were sepsis (31.1%) and ischemia (52.7%). AKI was multifactorial in 78% of patients with cancer and in 71% of patients without cancer. Hospital mortality rates were higher in patients with cancer (42.8%) than in patients without cancer (22.5%) (p = 0.014). In multivariate analyses, diabetes mellitus (DM) and cancer diagnosis were associated with hospital mortality. Cancer diagnosis was independently associated with mortality [odds ratio = 3.010 (95% confidence interval, 2.340-3.873), p = 0.001]. Kaplan-Meier analysis revealed that subjects with DM and cancer (n = 146) had lower survival rates than subjects with DM and without cancer (n = 687) (log rank test, p = 0.001). The presence of DM and cancer was independently associated with mortality in AKI patients both with and without cancer. Studies are warranted to determine whether proactive measures may limit AKI and improve outcomes.