US hospital webpages on atrial fibrillation ablation: A potential source for misinformation.

INTRODUCTION: Atrial fibrillation (AF) ablation is performed worldwide. To attract patients, hospitals frequently have webpages that tout the success of the procedure. The information disseminated to the public via these webpages has not been systematically reviewed. Our objective was to assess accuracy of information delivered to the public on hospital websites in regard to atrial AF ablation. METHODS: From July 2019 to January 2020, we performed a Google search for all US hospitals registered with Medicare to see if they had a webpage describing AF ablation. Resulting hospital webpages were abstracted for data on AF ablation success rates and risks. Success rates over 86%, the highest success rate in the medical literature, were deemed exaggerated. RESULTS: Among 4805 hospitals, 487 had webpages describing AF ablation and 33 discussed success rates of AF ablation. Twelve percentage reported exaggerated success rates, 3% referred to ablation as a cure, and 2.8% referred to ablation as a tool to eliminate AF. Less than 10% of webpages describing AF ablation noted the potential need for a second ablation to achieve the stated success rate and merely 16% mentioned risks of the procedure. One percentage of webpages directly suggested AF ablation could reduce risk of stroke while others indirectly suggested it by discussing cessation of anticoagulation. Two webpages mentioned reduced mortality. CONCLUSION: US hospital webpages rarely discuss AF ablation. When discussed, there were concerning unsubstantiated claims regarding mortality, stroke prevention, and need for medical therapy. This could lead to some patients undergoing AF ablation based on faulty understanding.

Imaging update in arthroplasty.

Imaging of metal implants has historically been difficult, regardless of the applied modality. The number of primary arthroplasties is increasing over the years. With it, we expect the number of symptomatic complications to increase as well. Acquiring accurate imaging for diagnosis and treatment planning for these cases is of paramount importance. Significant advancements have been made to reduce artifacts, leading to better imaging representation of arthroplasty. This review article would give a background on the current ways of imaging arthroplasty and metal implants, covering recent advances in imaging techniques.

Callosal angle in idiopathic normal pressure hydrocephalus: small angular mal-rotations of the coronal plane affect measurement reliability.

PURPOSE: The callosal angle (CA) is a useful biomarker in the diagnosis and management of idiopathic normal pressure hydrocephalus (NPH). Used incorrectly, CA measurements are variable, affecting its reliability as a clinical tool. Our objectives are to evaluate (i) reproducibility of established CA measurements between trained raters and (ii) impact of minor angular mal-rotations of the true coronal plane on CA measurements. METHODS: CAs were measured by two independent raters on three-dimensional isovolumetric T1-weighted brain MRI of NPH patients and healthy controls using the established true coronal plane reformatted orthogonal to the plane containing the anterior-posterior commissural (AC-PC) line at the level of the posterior commissure. CA changes were subsequently evaluated when the coronal plane was mal-rotated by ± 5° and ± 10° in anterior-posterior and clockwise-anticlockwise directions. Inter-rater reliability of CA measurements was assessed using the intraclass correlation coefficient (ICC). RESULTS: On the true coronal plane, inter-rater ICC was excellent (0.973) for NPH patients and good (0.875) for controls. On mal-rotated coronal plane setups, ICC for CA was worse in controls (0.484-0.886) than NPH (0.879-0.981) groups and in clockwise-anticlockwise (0.484-0.956) than anterior-posterior (0.503-0.981) mal-rotations. CA changes secondary to mal-rotations from the true coronal plane were significant in NPH patients (P < 0.0001 to 0.0378) but not in controls (P > 0.1). CONCLUSION: This is the first demonstration of how small angular mal-rotations of the coronal plane used for CA measurement affect its value and inter-rater reliability, highlighting the importance of a standardized protocol when measuring the CA in NPH workup.

Shear-unlimited common-path speckle interferometer.

A single-aperture common-path speckle interferometer with an unlimited shear amount is developed. This unlimited shear amount is introduced when a Wollaston prism is placed near the Fourier plane of a common-path interferometer, which is built by using a quasi-${4f}$4f imaging system. The fundamentals of the shear amount and the spatial carrier frequency generation are analyzed mathematically, and the theoretical predictions are validated by a static experiment. Mode-I fracture experiments through the three-point bending are conducted to prove the feasibility and the capability of this method in full-field strain measurement with various shear amounts. A remarkable feature of this setup is that no tilt is required between the optical components to produce the unlimited shear amount in off-axis holography.

A Miniaturized Escherichia coli Green Light Sensor with High Dynamic Range.

Genetically engineered photoreceptors enable unrivaled control over gene expression. Previously, we ported the Synechocystis PCC 6803 CcaSR two-component system, which is activated by green light and deactivated by red, into Escherichia coli, resulting in a sensor with a sixfold dynamic range. Later, we optimized pathway protein expression levels and the output promoter sequence to decrease transcriptional leakiness and to increase the dynamic range to approximately 120-fold. These CcaSR v 1.0 and v 2.0 systems have been used for precise quantitative, temporal, and spatial control of gene expression for a variety of applications. Recently, other workers deleted two PAS domains of unknown function from the CcaS sensor histidine kinase in a system similar to CcaSR v 1.0. Here we apply these deletions to CcaSR v 2.0, resulting in a v 3.0 light sensor with an output four times less leaky and a dynamic range of nearly 600-fold. We demonstrate that the PAS domain deletions have no deleterious effect on CcaSR green light sensitivity or response dynamics. CcaSR v 3.0 is the best-performing engineered bacterial green light sensor available, and should have broad applications in fundamental and synthetic biology studies.

Engineering an E. coli Near-Infrared Light Sensor.

Optogenetics is a technology wherein researchers combine light and genetically engineered photoreceptors to control biological processes with unrivaled precision. Near-infrared (NIR) wavelengths (>700 nm) are desirable optogenetic inputs due to their low phototoxicity and spectral isolation from most photoproteins. The bacteriophytochrome photoreceptor 1 (BphP1), found in several purple photosynthetic bacteria, senses NIR light and activates transcription of photosystem promoters by binding to and inhibiting the transcriptional repressor PpsR2. Here, we examine the response of a library of output promoters to increasing levels of Rhodopseudomonas palustris PpsR2 expression, and we identify that of Bradyrhizobium sp. BTAi1 crtE as the most strongly repressed in Escherichia coli. Next, we optimize Rps. palustris bphP1 and ppsR2 expression in a strain engineered to produce the required chromophore biliverdin IXα in order to demonstrate NIR-activated transcription. Unlike a previously engineered bacterial NIR photoreceptor, our system does not require production of a second messenger, and it exhibits rapid response dynamics. It is also the most red-shifted bacterial optogenetic tool yet reported by approximately 50 nm. Accordingly, our BphP1-PpsR2 system has numerous applications in bacterial optogenetics.

Utility of a Medical Alert Protection System compared to telephone follow-up only for home-alone elderly presenting to the ED - A randomized controlled trial.

OBJECTIVE: Medical Alert Protection Systems (MAPS) are a form of assistive technology designed to support independent living in the care of elderly patients in the community. We aimed to investigate the utility of using such a device (eAlert! System) in elderly patients presenting to an Emergency Department (ED). METHODS: Elderly patients presenting to an ED were randomized to receive MAPS or telephone follow-up only (control arm). All patients were followed up at one-week, one-month and six-month post-intervention. A confidence scale (at 1week, 1month and 6months) and EQ-5D score (at 6months) were also administered. RESULTS: 106 and 91 participants enrolled in the MAPS and control arms respectively. Within both individual arms, there were significant reductions in the median number of ED visits and median number of admissions in the six month periods before, compared to after intervention (p<0.01 for both). However, the reductions were not significantly different between the two arms. Among participants who have had one or more admissions during the six months period post intervention, the MAPS arm had significantly lower median total length of stay (8days, Interquartile Range [IQR]=(4, 14)) compared to the control arm (15days, IQR=(3, 25), p=0.045). The median health state score for health state was significantly higher in the MAPS arm (70 IQR=(60,80) versus 60 IQR=(50,70), p=0.008). CONCLUSION: In this population of elderly ED patients, the use of a MAPS decreased length of stay for admissions and improved quality of life measures.

Growth inhibition of pathogenic bacteria by sulfonylurea herbicides.

Emerging resistance to current antibiotics raises the need for new microbial drug targets. We show that targeting branched-chain amino acid (BCAA) biosynthesis using sulfonylurea herbicides, which inhibit the BCAA biosynthetic enzyme acetohydroxyacid synthase (AHAS), can exert bacteriostatic effects on several pathogenic bacteria, including Burkholderia pseudomallei, Pseudomonas aeruginosa, and Acinetobacter baumannii. Our results suggest that targeting biosynthetic enzymes like AHAS, which are lacking in humans, could represent a promising antimicrobial drug strategy.