Outcome of stand-alone thoracoscopic epicardial left atrial posterior box isolation with bipolar radiofrequency energy for longstanding persistent atrial fibrillation

Introduction

Catheter ablation of longstanding (> 1 year) persistent atrial fibrillation (AF) is associated with poor outcome. This might be due to remodelling and fibrosis formation, mainly located in the posterior left atrial (LA) wall. Therefore, we adopted a thoracoscopic epicardial box isolation of the posterior left atrium using bipolar RF energy with intraoperative testing of conduction block.

Methods and results

Bilateral thoracoscopic box isolation was performed with a bipolar RF clamp. Entrance block was defined as absence of a conducted electrogram within the box, while exit block was confirmed by pacing at 10.0 V/2 ms. Ablation outcome was evaluated after 3, 6, 12 and 24 months with 12-lead ECGs and 24-hour Holter recordings.Twenty-five consecutive patients were included (58 ± 7 years, persistent AF duration 1.8 ± 0.9 years). Entrance block was achieved in all patients and exit block confirmed if sinus rhythm was achieved. After 17 ± 7 months, 76 % of the patients (n = 19) were free of AF recurrence. One patient died within 1 month and was considered an ablation failure. Four patients with AF recurrences regained sinus rhythm with additional catheter ablation or antiarrhythmic drugs.

Conclusions

Treatment of longstanding persistent AF with thoracoscopic epicardial LA posterior box isolation using bipolar RF energy with intraoperative testing of conduction block is feasible and highly effective.     

Ecological total-factor energy efficiency of China’s energy intensive industries

This paper uses a meta-frontier slack-based DEA model to measure the ecological total-factor energy efficiency as well as the energy conservation potential of China’s four energy intensive subsectors. We incorporate both desirable and undesirable output together in the period, 2000–2013. The conclusions are: firstly, under the meta-frontier, the four subsectors of energy intensive industries have low average level of ecological total-factor energy efficiencies. They are 0.137, 0.212, 0.238, and 0.307 in the non-metallic mineral products manufacturing industry, raw chemical materials and chemical products manufacturing industry, smelting and pressing of ferrous metals industry, and smelting and pressing of non-ferrous metals industry, respectively. Secondly, the ecological energy efficiency in East China is the highest among three regions. Central China and West China are behind, but they are extremely close to each other. Thirdly, East China almost has no technology gap pertaining to energy efficiency, while Central China and West China almost have the same gap. Finally, Sichuan is considered to be the best province in West China under group frontier due to its perform in the three energy intensive subsectors. For Central and East China, no province has higher ecological energy efficiency in more than two energy intensive subsectors.     

Attract‐and‐kill systems efficiency against Ceratitis capitata (Diptera: Tephritidae) and effects on non‐target insects in peach orchards

For control of the Mediterranean fruit fly Ceratitis capitata (Diptera: Tephritidae), the attract‐and‐kill or attracticide technique is an alternative to the spraying of traditional organophosphate pesticides. In this study, the effectiveness of Ceranock and AAL&K attract‐and‐kill bait stations was assessed for control of C. capitata in Tunisian peach (Prunus persica) orchards. Our results showed that, in orchards with early‐ripening varieties, the numbers of C. capitata males and fruit damage were significantly lower in plots treated with Ceranock and AAL&K bait stations than in plots treated with conventional organophosphate and pyrethroid insecticides. In addition, the abundances of non‐target insects in the Chrysopidae, Coccinellidae and Miridae were significantly greater in plots treated with the bait stations than in plots treated with the conventional pesticides; that is, the use of attract‐and‐kill bait stations had fewer negative effects than the application of conventional pesticides on the biological diversity in Tunisian peach orchards. Overall, the results indicate that Ceranock and AAL&K attract‐and‐kill bait stations are useful alternatives for the control of C. capitata in Tunisian peach orchards planted with early‐ripening varieties.     

Improvement in the bleaching of kraft pulp with xylanase from Penicillium crustosum FP 11 isolated from the Atlantic forest

Xylanase produced from the newly isolated Penicillium crustosum FP 11 and its potential in the prebleaching of kraft pulp were evaluated using a statistical approach. A Plackett–Burman design (PBD) was carried out to select the significant variables of the medium, these being NaNO₃, KH₂PO₄, MgSO₄, KCl, Fe₂(SO₄)₃, yeast extract, corn stover, and initial pH, in a liquid culture under static conditions for 6 d at 28?°C. Statistical analysis with a central composite design and response surface methodology showed that 0.15% (w/v) KH₂PO₄, 2% (w/v) corn stover, and an initial pH of 6.0 provided the best conditions for xylanase production. Furthermore, xylanase from P. crustosum FP 11 was effective in the bleaching of Eucalyptus kraft pulp, with a significant kappa efficiency of 35.04%. Therefore, the newly isolated P. crustosum FP 11 from the Atlantic Forest biome in Brazil showed two advantages: xylanase production with agricultural residue (corn stover) as a carbon source and an improvement in the bleaching of kraft pulp. Environmental pollution could thus be minimized because of a reduction in the use of chlorine as a bleaching agent.     

Three-dimensional macro-scale assessment of regional and temporal wall shear stress characteristics on aortic valve leaflets

The aortic valve (AV) achieves unidirectional blood flow between the left ventricle and the aorta. Although hemodynamic stresses have been shown to regulate valvular biology, the native wall shear stress (WSS) experienced by AV leaflets remains largely unknown. The objective of this study was to quantify computationally the macro-scale leaflet WSS environment using fluid–structure interaction modeling. An arbitrary Lagrangian–Eulerian approach was implemented to predict valvular flow and leaflet dynamics in a three-dimensional AV geometry subjected to physiologic transvalvular pressure. Local WSS characteristics were quantified in terms of temporal shear magnitude (TSM), oscillatory shear index (OSI) and temporal shear gradient (TSG). The dominant radial WSS predicted on the leaflets exhibited high amplitude and unidirectionality on the ventricularis (TSM>7.50 dyn/cm², OSI < 0.17, TSG>325.54 dyn/cm² s) but low amplitude and bidirectionality on the fibrosa (TSM < 2.73 dyn/cm², OSI>0.38, TSG < 191.17 dyn/cm² s). The radial WSS component computed in the leaflet base, belly and tip demonstrated strong regional variability (ventricularis TSM: 7.50–22.32 dyn/cm², fibrosa TSM: 1.26–2.73 dyn/cm²). While the circumferential WSS exhibited similar spatially dependent magnitude (ventricularis TSM: 1.41–3.40 dyn/cm², fibrosa TSM: 0.42–0.76 dyn/cm²) and side-specific amplitude (ventricularis TSG: 101.73–184.43 dyn/cm² s, fibrosa TSG: 41.92–54.10 dyn/cm² s), its temporal variations were consistently bidirectional (OSI>0.25). This study provides new insights into the role played by leaflet–blood flow interactions in valvular function and critical hemodynamic stress data for the assessment of the hemodynamic theory of AV disease.     

Comparison of three formal methods used to estimate the functional axis of rotation: an extensive in-vivo analysis performed on the knee joint

Estimating the main axis of rotation (AoR) of a human joint represents an important issue in biomechanics. This study compared three formal methods used to estimate functional AoR, namely a cylindrical fitting method, a mean helical axis transformation, and a symmetrical axis approach. These methods were tested on 106 subjects undergoing navigated total knee arthroplasty. AoR orientation in 3D and in the frontal and coronal planes provided by each method was compared to the transepicondylar axis direction. Although all the methods resulted effective, significant differences were identified among them, relatively to the orientation in 3D and in the frontal plane projection. This was probably due to the presence of secondary rotations during the first degrees of knee flexion.     

Identification of Polymorphisms in the Rabbit Growth Hormone Receptor (GHR) Gene and Association with Finishing Weight in a Commercial Meat Rabbit Line

A shortcut to identify DNA markers associated with economic traits is to use a candidate gene approach that is still useful in livestock species in which molecular tools and resources are not advanced or not well developed. Mutations in the growth hormone receptor (GHR) gene associated with production traits have been already described in several livestock species. For this reason GHR could be an interesting candidate gene in the rabbit. In this study we re-sequenced all exons and non-coding regions of the rabbit GHR gene in a panel of 10 different rabbits and identified 10 single nucleotide polymorphisms (SNPs). One of them (g.63453192C>G or c.106C>G), located in exon 3 was a missense mutation (p.L36V) substituting an amino acid in a highly conserved position across all mammals. This mutation was genotyped in 297 performance tested rabbits of a meat male line and association analysis showed that the investigated SNP was associated with weight at 70 days (P < 0.05). The most frequent genotype (GG) was in animals with higher weight at this age, suggesting that the high directional selection pressure toward this trait since the constitution of the genotyped line might have contributed to shape allele frequencies at this polymorphic site.     

跗骨窦入路切开复位内固定与外侧"L"形入路切开复位内固定治疗跟骨骨折的疗效比较研究

目的:比较跗骨窦入路切开复位内固定与外侧"L"形入路切开复位内固定治疗跟骨骨折的疗效。方法:选取2016年10月到2017年6月期间川北医学院附属医院收治的86例跟骨骨折患者,根据随机数字表法分为对照组和观察组,两组均为43例。对照组采用外侧"L"形入路切开复位内固定进行治疗,观察组采用跗骨窦入路切开复位内固定进行治疗。比较两组患者的手术时间、住院时间、骨折愈合时间、踝-后足功能优良率、视觉模拟评分法(VAS)、B?hler角、Gissane角和术后并发症发生率。结果:两组患者的手术时间和骨折愈合时间比较无统计学差异(P0.05),而观察组患者的住院时间短于对照组(P0.05)。观察组患者术后踝-后足功能优良率高于对照组(P0.05)。在术前和术后12个月时,两组患者的VAS评分、Gissane角、B?hler角比较无统计学差异(P0.05),术后12个月时两组患者的VAS评分均明显低于术前,B?hler角及Gissane角明显高于术前(P0.05)。观察组患者术后并发症发生率低于对照组(P0.05)。结论:跗骨窦入路和外侧"L"形入路切开复位内固定均可有效治疗跟骨骨折,但跗骨窦入路可更有效地改善踝-后足功能,且住院时间短、术后并发症发生率更低。     

Review: An integrated graphical tool for analysing impacts and services provided by livestock farming

Livestock farming is criticized for negatively impacting the environment, concerns about animal welfare and the impact of excessive meat consumption on human health. However, livestock farming provides other underappreciated and poorly communicated benefits to society in terms of employment, product quality, cultural landscapes and carbon storage by grasslands. Few attempts have been made so far to simultaneously consider the services and impacts provided by livestock production. Here, we propose an integrated graphical tool, called the ‘barn’ to explicitly summarize the synergies and trade-offs between services and impacts provided by livestock farming. It illustrates livestock farming interacting with its physical, economic and social environment along five interfaces: (i) Markets, (ii) Work and employment, (iii) Inputs, (iv) Environment and climate, (v) Social and cultural factors. This graphical tool was then applied by comparing two contrasting livestock production areas (high livestock density v. grassland-based), and the dominant v. a niche system within a crop-livestock area. We showed the barn could be used for cross-comparisons of services and impacts across livestock production areas, and for multi-level analysis of services and impacts of livestock farming within a given area. The barn graphically summarizes the ecological and socio-economic aspects of livestock farming by explicitly representing multiple services and impacts of different systems in a simple yet informative way. Information for the five interfaces relies on available quantitative assessments from the literature or data sets, and on expert-knowledge for more qualitative factors, such as social and cultural ones. The ‘barn’ can also inform local stakeholders or policy-makers about potential opportunities and threats to the future of livestock farming in specific production areas. It has already been used as a pedagogical tool for teaching the diversity of services and impacts of livestock systems across Europe and is currently developed as a serious game for encouraging knowledge exchange and sharing different viewpoints between stakeholders.     

Scale-dependence in geographic variation in a freshwater gastropod across the Palearctic

ABSTRACT

The reality of spatial clinal variation in morphological traits of freshwater pulmonate snails (Gastropoda: Pulmonata) has repeatedly been questioned or totally discounted. There is a lack of sound statistical evidence in the articles hitherto published on this subject supporting these claims. Here, by means of different analytical methods (analysis of spatial autocorrelation, linear regression analysis, canonical correlation analysis and others), we demonstrate that shell variation in the dwarf pond snail, Galba truncatula, is patterned in space throughout the northern and central Palearctic, with latitudinally-oriented clines in body size and in some shell proportions. Shell size in G. truncatula decreases with latitude and temperature, representing a special case of converse Bergmann cline. However, the temperature itself is hardly the main driver of shell size variation. It is argued that the shorter growing seasons at high latitudes may represent a better explanation for the observed trend. Shell proportions in the dwarf pond snails vary weakly at the macrogeographic scale, being spatially patterned at lower (mesogeographic) scales around 1200–1500?km. In general, spatial variation in G. truncatula shell size is decoupled from variation in shell shape, demonstrating clear scale-dependence similar to that found in different species of terrestrial (non-aquatic) pulmonate snails.