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Rojo-Wissar DM, Acosta J, DiMarzio K, Hare M, Dale CF, Sanders W, Parent JM. The role of sleep in prospective associations between parent reported youth screen media activity and behavioral health. Child Adolesc Ment Health 2024; 29:33-42. [PMID: 37431157 DOI: 10.1111/camh.12665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Screen media activity (SMA) can negatively affect youth behavioral health. Sleep may mediate this association but has not been previously explored. We examined whether sleep mediated the association between SMA and youth behavioral health among a community sample. METHOD Parents completed questions about their child (N = 564) ages 3-17 at Wave 1, Wave 2 (4-8 months later), and Wave 3 (12 months later). Path analyses were conducted to examine links between Wave 1 SMA and Wave 3 behavioral health problems (i.e., internalizing, externalizing, attention, peer problems) through Wave 2 sleep disturbance and duration. RESULTS SMA was significantly associated with greater sleep disturbance, β = .11, 95% CI [.01, .21] and shorter sleep duration, β = -.16 [-.25, -.06], and greater sleep disturbance was associated with worse youth behavioral health across internalizing, β = .14 [.04, .24], externalizing, B = .23 [.12, .33], attention, β = .24 [.15, .34], and peer problems, β = .25 [.15, .35]. Longer sleep duration was associated with more externalizing, β = .13 [.04, .21], and attention problems, β = .12 [.02, .22], and fewer peer problems, β = -.09 [-.17, -.01], but not with internalizing problems. Lastly, there was a direct effect of SMA on peer problems, β = -.15 [-.23, -.06] such that higher SMA that does not impact sleep may have a positive impact on reducing peer problems. CONCLUSIONS Sleep (i.e., disturbances and shorter duration) may partially account for the small associations observed between SMA and worse behavioral health in youth. To continue expanding our understanding, future research should utilize more diverse representative samples, use objective measures of SMA and sleep, and examine other relevant aspects of SMA, including content, device type, and timing of use.
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Affiliation(s)
- Darlynn M Rojo-Wissar
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, Providence, RI, USA
- E.P. Bradley Hospital Sleep Research Laboratory, Providence, RI, USA
| | - Juliana Acosta
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Megan Hare
- Florida International University, Miami, FL, USA
| | | | - Wesley Sanders
- Home Base, a Red Sox Foundation and Massachusetts General Hospital Program, Charlestown, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Justin M Parent
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, Providence, RI, USA
- E.P. Bradley Hospital Sleep Research Laboratory, Providence, RI, USA
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2
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Jent JF, Rothenberg WA, Peskin A, Acosta J, Weinstein A, Concepcion R, Dale C, Bonatakis J, Sobalvarro C, Chavez F, Hernandez N, Davis E, Garcia D. An 18-week model of Parent-Child Interaction Therapy: clinical approaches, treatment formats, and predictors of success for predominantly minoritized families. Front Psychol 2023; 14:1233683. [PMID: 37915519 PMCID: PMC10616824 DOI: 10.3389/fpsyg.2023.1233683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/01/2023] [Indexed: 11/03/2023] Open
Abstract
Introduction Disruptive behavior disorders are among the most prevalent pediatric mental health referrals for young children. However, families from historically minoritized social identities have experienced disparities in treatment access, retention, and outcomes. Evidence-based interventions such as Parent-Child Interaction Therapy (PCIT) have been found to be effective in reducing children's disruptive behaviors in minoritized families. However, variable treatment length as a result of skill-based graduation criteria (e.g., observed caregiver verbalizations) may slow and/or hinder treatment progress, particularly for families where expected treatment verbalizations are less linguistically relative (e.g., no exact English to Spanish translations) and/or culturally familiar. Time-limited PCIT has been proposed as a strategy for promoting equity in treatment completion and outcomes amongst minoritized families, because treatment progression and/ or completion is not contingent upon caregiver linguistic skill demonstration. Methods The current study evaluated the overall effectiveness of an 18-week model of PCIT and examined predictors of retention and treatment outcomes. Participants (N = 488 dyads) included predominantly racially, ethnically, linguistically, and socioeconomically diverse children aged two to eight years, and their caregivers. Results Overall findings indicate that the 18-week PCIT model is an effective intervention for reducing children's externalizing and internalizing behaviors and improving caregiver parenting skills for most treatment completers. Despite advances in treatment completion, some caregiver social identities and PCIT treatment characteristics were predictive of lower completion rates and/or less optimal treatment outcomes. Discussion Overall, this study provides strong support for widely disseminating use of the 18-week model of PCIT for most families served. Clinical implications and considerations for continued treatment inequity are discussed.
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Affiliation(s)
- Jason F. Jent
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, United States
| | - William A. Rothenberg
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, United States
- Center for Child and Family Policy, Duke University, Durham, NC, United States
| | - Abigail Peskin
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Juliana Acosta
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Allison Weinstein
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Raquel Concepcion
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Chelsea Dale
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, United States
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Jessica Bonatakis
- Department of Psychiatry and Behavioral Health, The Pennsylvania State University, University Park, PA, United States
| | - Cindy Sobalvarro
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Felipa Chavez
- School of Psychology, Florida Institute of Technology, Melbourne, FL, United States
| | - Noelia Hernandez
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Eileen Davis
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Dainelys Garcia
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, United States
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Rodriguez VJ, Cadet GDJ, Sisitsky M, Cooley C, Acosta J, Coles E, Charity-Parker B, Walters A, Shaffer A, Parent J. Assessing parenting in racially and ethnically diverse families: A lack of measurement equivalence. J Fam Psychol 2023; 37:753-762. [PMID: 37141011 PMCID: PMC10524248 DOI: 10.1037/fam0001095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The present study explored measurement invariance of the Multidimensional Assessment of Parenting Scale (MAPS; Parent & Forehand, 2017) across White, Hispanic, Black, and Asian American parents. Participants included 2,734 parents, 58% of whom were mothers. On average, parents were 36.32 years old (SD = 9.54); the parent sample was 66.9% White non-Hispanic, 10.1% Black, 5.3% Asian, and 17.7% Hispanic regardless of race. Child ages ranged from 3 to 17 years (M = 9.84, SD = 3.71), and 58% were identified as male. Parents completed a demographics questionnaire about themselves and their target child, and the 34-item MAPS. We explored measurement equivalence of the MAPS Broadband Positive and Negative parenting scales using item response theory to identify differential item functioning (DIF). Univariate analyses for Positive and Negative Parenting showed reliability was excellent. Twelve items assessing negative aspects of parenting exhibited bias by race/ethnicity. Specifically, when comparing racial and ethnic groups, three items had nonuniform DIF comparing Black and Asian participants, two items had nonuniform DIF comparing Black and Hispanic participants, and one item showed nonuniform DIF comparing Asian and Hispanic participants. When looking at Positive Parenting, no items showed evidence of DIF. Results from the present study suggest broadband Positive Parenting can be compared across ethnoracial groups, while findings raise concern about assessing Negative Parenting items when examining invariance across race and ethnicity. Findings from the present study imply that racial and ethnic comparisons are potentially invalid. These findings offer guidance for improving parenting assessment for racially/ethnically diverse populations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Violeta J. Rodriguez
- Department of Psychology, University of Georgia, Athens, USA
- Miller School of Medicine, University of Miami, Miami, USA
| | | | - Michaela Sisitsky
- Center for Children and Families, Florida International University, Miami, USA
| | - Cameryn Cooley
- Department of Psychiatry at Icahn School of Medicine, Mount Sinai Hospital, New York, USA
| | - Juliana Acosta
- Miller School of Medicine, University of Miami, Miami, USA
- Center for Children and Families, Florida International University, Miami, USA
| | - Erika Coles
- Center for Children and Families, Florida International University, Miami, USA
- Institute of Rural Health, Idaho State University, Pocatello, USA
| | - Bianka Charity-Parker
- Warren Alpert Medical School, Brown University, Providence, USA
- Bradley/Hasbro Children’s Research Center, E.P. Bradley Hospital, Providence, USA
| | - Anne Walters
- Warren Alpert Medical School, Brown University, Providence, USA
- Bradley/Hasbro Children’s Research Center, E.P. Bradley Hospital, Providence, USA
| | - Anne Shaffer
- Department of Psychology, University of Georgia, Athens, USA
| | - Justin Parent
- Center for Children and Families, Florida International University, Miami, USA
- Warren Alpert Medical School, Brown University, Providence, USA
- Bradley/Hasbro Children’s Research Center, E.P. Bradley Hospital, Providence, USA
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Acosta J, Parent J, Hare M, DiMarzio K, Sisitsky M, McMakin DL. Development of the Nighttime Parenting Scale: Differentiating nighttime versus general parenting practices and their impact on youth sleep health. Sleep Health 2023; 9:489-496. [PMID: 37393144 DOI: 10.1016/j.sleh.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 03/06/2023] [Accepted: 05/08/2023] [Indexed: 07/03/2023]
Abstract
OBJECTIVES The current study provides a novel method of assessing the impact of nighttime parenting practices on youth sleep health during the sensitive transition from childhood to adolescence (ie., peri-puberty). Specifically, we aimed to advance the measurement of nighttime parenting by developing a conceptually driven questionnaire for use in research and clinical settings. METHOD A total of 625 parents (67.9% mothers) of peripubertal youth (age M=11.6, SD=1.31) were recruited online and completed self-report questionnaires. The sample was primarily White (67.4%), followed by 16.5% Black, 13.1% Latinx, and 9.6% Asian. Factor structure was examined through four empirically-driven stages (ie, exploratory factor analyses, confirmatory factor analyses, examining internal and test-retest reliability, and indices of validity). Furthermore, the current study sought to validate nighttime parenting as a unique construct by exploring associations with peripubertal youth sleep health. RESULTS A factor structure consisting of six dimensions of nighttime parenting was established (ie, nighttime supportiveness, hostility, physical control, limit-setting, media monitoring, and co-sleeping behaviors). Furthermore, the current measure demonstrated strong psychometric properties. Finally, the established dimensions were cross-sectionally associated with youth sleep health indices. CONCLUSIONS This study extends previous research by examining the influence of distinct domains of parenting practices that specifically occur at nighttime and how these differentially relate to youth sleep health. Results suggest that intervention and/or prevention programs targeting sleep should place emphasis on fostering positive parenting at nighttime as a strategy for creating an evening environment that is conducive to optimizing youth sleep health.
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Affiliation(s)
- Juliana Acosta
- Center for Children and Families, Florida International University, Miami, Florida, USA; Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, Florida, USA.
| | - Justin Parent
- Center for Children and Families, Florida International University, Miami, Florida, USA; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA; Bradley/Hasbro Children's Research Center, E. P. Bradley Hospital, Providence, Rhode Island, USA.
| | - Megan Hare
- Center for Children and Families, Florida International University, Miami, Florida, USA
| | - Karissa DiMarzio
- Center for Children and Families, Florida International University, Miami, Florida, USA
| | - Michaela Sisitsky
- Center for Children and Families, Florida International University, Miami, Florida, USA
| | - Dana L McMakin
- Center for Children and Families, Florida International University, Miami, Florida, USA; Department of Neurology, Nicklaus Children's Hospital, Miami, Florida, USA
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5
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DiMarzio K, Parent J, Forehand R, Thigpen JC, Acosta J, Dale C, Compas B. Parent-Child Role Confusion: Exploring the Role of Family Processes in the Context of Parental Depression. J Clin Child Adolesc Psychol 2022; 51:982-996. [PMID: 33769163 PMCID: PMC8464626 DOI: 10.1080/15374416.2021.1894943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Parent-child role confusion has been shown to influence developmental outcomes for children whose parents have a history of depression; however, more research is needed to understand the pathways by which parental depression increases risk of role confusion. The current study aimed to extend previous literature by evaluating how different family processes (e.g., interparental conflict, guilt induction, family cohesion, and positive parenting practices) contribute to the development of emotional role confusion in families with a history of parental depression. METHOD The sample was comprised of 90 parent-child dyads (parent Mage = 42, 90% female, 83.3% White; child Mage = 11.51, 51.1% female, 75.6% White) participating in the control group of a randomized controlled trial. All parents had a history of depression. A longitudinal path analysis was conducted to evaluate prospective associations in the multiple mediator model. RESULTS Findings from the current study suggest that parental depressive symptoms are not directly related to the development of parent-child emotional role confusion, but are instead indirectly related through increased interparental conflict observed by youth. Although not identified as significant mediators, guilt induction and positive parenting practices emerged as predictors of emotional role confusion. Lastly, family cohesion did not appear to influence the development of role confusion. CONCLUSION Findings suggest that parenting behaviors and coparenting relationship quality play important roles in the development of parent-child emotional role confusion, with interparental conflict emerging as the strongest predictor in families with a history of parental depression.
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Affiliation(s)
- Karissa DiMarzio
- Center for Children and Families, Department of Psychology,
Florida International University, Miami, FL
| | - Justin Parent
- Center for Children and Families, Department of Psychology,
Florida International University, Miami, FL
| | - Rex Forehand
- Department of Psychological Science, University of Vermont,
Burlington, VT
| | | | - Juliana Acosta
- Center for Children and Families, Department of Psychology,
Florida International University, Miami, FL
| | - Chelsea Dale
- Center for Children and Families, Department of Psychology,
Florida International University, Miami, FL
| | - Bruce Compas
- Department of Psychological Science, Vanderbilt University,
Nashville, TN
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6
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DiMarzio K, Peisch V, Acosta J, Dale C, Gutierrez J, Parent J. Keeping your coparent in mind: A longitudinal investigation of mindfulness in the family system. Fam Process 2022; 61:808-822. [PMID: 34355396 PMCID: PMC9377051 DOI: 10.1111/famp.12702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 05/26/2021] [Accepted: 06/03/2021] [Indexed: 06/03/2023]
Abstract
Recent studies have increasingly focused on mindfulness as it relates to interpersonal processes. In particular, cross-sectional research has shown that parents' dispositional mindfulness is associated with increased mindful parenting and coparenting, as well as improved coparenting relationship quality. The current study replicates and extends such work, representing the first longitudinal investigation of mindful coparenting. A sample of 449 parents (60% mothers) of children between the ages of 3 and 17 years were recruited online through Amazon's Mechanical Turk (MTurk) as part of a larger study on the assessment of parenting. Parents reported on their dispositional mindfulness, mindful coparenting, and coparenting relationship quality at three time points across an 8-month period. Results from a cross-lagged panel model using maximum likelihood estimation suggested that higher levels of parental mindfulness at baseline were related with higher levels of mindful coparenting at 4 months, which, in turn, were related to higher quality coparenting relationship at 8 months. Support for this model was found for both mothers and fathers and across all examined child age groups (i.e., early childhood, middle childhood, and adolescence), highlighting the robust nature of these effects. Overall, findings suggest that increasing mindfulness at an individual level can promote meaningful change within a family system, specifically through improvements in coparenting and parent-child interactions.
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Affiliation(s)
- Karissa DiMarzio
- Center for Children and Families, Florida International University
| | | | - Juliana Acosta
- Center for Children and Families, Florida International University
| | - Chelsea Dale
- Center for Children and Families, Florida International University
| | | | - Justin Parent
- Center for Children and Families, Florida International University
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7
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Falasconi G, Penela D, Carreno JM, Soto-Iglesias D, Jauregui B, Viveros D, Bellido A, Scherer C, Benito B, Marti J, Sabate X, Matiello M, Acosta J, Fernandez-Armenta J, Berruezo A. A novel weighted hybrid clinical and electrocardiographic score to predict the origin of outflow tract ventricular arrhythmias: a multicenter study. Europace 2022. [DOI: 10.1093/europace/euac053.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
To correctly predict the outflow tract ventricular arrhythmia (OTVA) site of origin (SOO) before the ablation is still a procedural major step, having important implications for correct patient counseling, ablation planning, and periprocedural complication evaluation. Although multiple ECG criteria have been proposed for predicting OTVA SOO, their accuracy and usefulness are still limited as recently (1).
Purpose
The present study sought to prospectively evaluate the accuracy of a previously published Hybrid Score (HS) for prediction of OTVAs with LVOT origin. Besides, multiple ECG measurements of patients with V3 precordial transition (V3PT) OTVA were analyzed to identify potential variables useful to improve the accuracy of the HS (2).
Methods
Consecutive patients (n=105) referred for OTVA ablation were prospectively enrolled from three referral centers. Vascular access and first-mapped ventricle were decided based on the previously published HS, which includes ECG (R/S precordial transition) and clinical information (age, hypertension, and gender). Surface ECGs during the OTVA were analyzed by two independent electrophysiologists to compare the discriminative performance of HS and previous published ECG-alone criteria, to assess their inter-observer variability and to identify potential variables useful to improve the proposed model.
Results
Of the 105 VAs, 70.5% had an RVOT origin and 29.5% an LVOT origin. HS achieved a correct prediction in 90% patients. This rate dropped to 75% in the subgroup of patients with V3PT OTVA. The correct prediction rate of the other ECG-alone criteria in the whole population ranged from 74 to 82% and from 41 to 76% in V3PT patients, and their Cohen’s Kappa coefficient for inter-observer variability assessment ranged from 0.63 to 0.81. R-wave amplitude in V3 was the best ECG parameter for discriminating LVOT origin in V3PT patients. When this parameter was incorporated in the novel Weighted Hybrid Score (WHS) (Figure 1), it correctly classified 99 (94.2%) patients (90% sensitivity, 96% specificity, AUC: 0.97). The WHS discriminatory capacity was maintained in V3PT subgroup, (87% sensitivity, 91% specificity AUC: 0.95). WHS showed a Cohen’s kappa coefficient of 0,82. Finally, WHS was validated in an additional population of 97 patients with OTVAs referred for catheter ablation from three additional external centers; in this testing sample the WHS correctly predicted the SOO in 90% patients and proved to have 89% sensitivity and 90% specificity (AUC: 0.94) for a score ≥2 to predict a LVOT origin.
Conclusions
The novel simple-to-use WHS proved to accurately anticipate the PVC’s SOO and can be introduced in clinical practice for choosing the first chamber to map.
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Affiliation(s)
| | - D Penela
- Teknon Medical Centre, Barcelona, Spain
| | | | | | | | - D Viveros
- Teknon Medical Centre, Barcelona, Spain
| | - A Bellido
- Teknon Medical Centre, Barcelona, Spain
| | - C Scherer
- Teknon Medical Centre, Barcelona, Spain
| | - B Benito
- University Hospital Vall d’Hebron, Barcelona, Spain
| | - J Marti
- Teknon Medical Centre, Barcelona, Spain
| | - X Sabate
- Hospital General de Catalunya, Barcelona, Spain
| | - M Matiello
- Hospital General de Catalunya, Barcelona, Spain
| | - J Acosta
- Complex Public Hospital Virgen del Rocio Regional, Sevilla, Spain, Spain
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Jimenez-Perez G, Acosta J, Arana Rueda E, Frutos Lopez M, Sanchez Brotons JA, Llamas Lopez H, Di Massa Pezzutti R, Gonzalez De La Portilla Concha C, Pedrote A. Automated quantification and identification of decremental response after extrastimulus: validation of a novel software. Europace 2022. [DOI: 10.1093/europace/euac053.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Junta de Andalucia
Background
Automatic identification of myocardial electrograms (EGMs) with decremental conduction (DC) is a promising field in catheter ablation procedures, allowing the identification of the critical isthmus of tachycardias with re-entry mechanisms. In this work, a novel artificial intelligence (AI)-based software was developed for the automatic analysis of delays between evoked responses in the coronary sinus (CS), allowing signal quantification.
Methods
Atrioventricular (AV) and ventriculoatrial (VA) conduction was analysed in coronary sinus signals obtained from patients undergoing electrophysiological study. A simple pacing (S=400-600ms) and extra-stimulus protocol (S2=ERP + 20-60ms) were used in all cases. An AI-based algorithm was developed for EGM delineation with the objective of localising the onsets and offsets of each independent local and far field activations. The algorithm consisted in several steps. Firstly, an AI-based QRS detector was employed (Figure 1A). Secondly, the located QRS’ were used alongside another AI model to delineate the EGMs corresponding to all bipolar electrodes in the CS (Figure 1B). Thirdly, majority voting is performed on the delineations to obtain an overall prediction for all CS electrodes (Figure 1C). Fourthly, the predictions are cleaned and a rule-based algorithm is employed to automatically exclude faulty registries (e.g. loss of capture or AV/VA block after S2). Finally, the determination of decremental response is performed by computing the time difference between the last paced beat and the S2 extrastimulus. This was measured using the onsets of morphologically similar activations in the trace, correcting for misalignments. A decremental response was defined as a difference >10 ms between the AV/VA interval during the S1 drive and the same interval immediately after the S2. Four experts validated results of the automated analysis.
Results
321 tracings from 50 patients were analysed. 81 tracings were automatically excluded due to loss of capture or AV/VA block after S2. The AV/VA interval was automatically annotated in 236 EGMs. 192 tracings exhibited decremental conduction properties, whereas 48 tracings showed non-decremental AV or VA conduction due to accessory pathways. Automatic analysis accurately classified 191 tracings as decremental (93.75% sensitivity, 91.47% specificity) and 45 tracings as non-decremental (85.42% sensitivity, 98.53% specificity).
Conclusions
AI-based algorithms are able to produce objective quantifications over real-world data, discriminating between local and far field signals and accurately identifying EGMs with decremental evoked response. Automated data analysis can accelerate research and reduce clinical workload. Moreover, a quantification-based approach can be employed in many other applications. Validation of this software on ventricular signals could facilitate ventricular tachycardia substrate ablation procedures.
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Affiliation(s)
- G Jimenez-Perez
- Institute of Biomedical Research August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - J Acosta
- University Hospital of Virgen del Rocio, Cardiology Department, Arrhythmia Unit, Seville, Spain
| | - E Arana Rueda
- University Hospital of Virgen del Rocio, Cardiology Department, Arrhythmia Unit, Seville, Spain
| | - M Frutos Lopez
- University Hospital of Virgen del Rocio, Cardiology Department, Arrhythmia Unit, Seville, Spain
| | - JA Sanchez Brotons
- University Hospital of Virgen del Rocio, Cardiology Department, Arrhythmia Unit, Seville, Spain
| | - H Llamas Lopez
- University Hospital of Virgen del Rocio, Cardiology Department, Arrhythmia Unit, Seville, Spain
| | - R Di Massa Pezzutti
- University Hospital of Virgen del Rocio, Cardiology Department, Arrhythmia Unit, Seville, Spain
| | | | - A Pedrote
- University Hospital of Virgen del Rocio, Cardiology Department, Arrhythmia Unit, Seville, Spain
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McKee LG, DiMarzio K, Parent J, Dale C, Acosta J, O'Leary J. Profiles of Emotion Socialization Across Development and Longitudinal Associations with Youth Psychopathology. Res Child Adolesc Psychopathol 2022; 50:193-210. [PMID: 34081230 DOI: 10.31234/osf.io/y9pr8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2021] [Indexed: 05/20/2023]
Abstract
Although there is relative consensus in the literature regarding associations between certain emotion socialization (ES) strategies and youth behavioral health, there is very limited research from a person-centered perspective. To address this gap, the current study examined patterns of ES strategies in families and explored predictors and youth outcomes associated with those patterns. An economically-diverse sample of 229 predominately White mothers and fathers of youth aged 3-12 years was recruited online for a longitudinal study. Latent profile analysis was used to determine the optimal number of family clusters with similar ES profiles. Model fit supported a four-class model, which consisted of an Emotion Coaching profile, characterized by the lowest levels of putatively labeled unsupportive ES practices and the highest levels of putatively labeled supportive ES practices, a Moderate profile characterized by moderate levels of both unsupportive and supportive ES practices, a Limited Engagement profile characterized by low levels of both unsupportive and supportive ES practices, and an Emotion Dismissing profile characterized by the highest levels of unsupportive ES practices and the lowest levels of supportive ES practices. Cross-sectional and longitudinal differences were observed across the ES profiles with regard to demographic and parent emotional competence predictors and youth outcomes. The current study extends the literature on ES by providing evidence on how distinct ES profiles differentially predict youth behavioral health outcomes. Findings also underscore the importance of examining parent emotional competence as a catalyst for adaptive change in the family system.
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Affiliation(s)
- Laura G McKee
- Department of Psychology, Georgia State University, Atlanta, GA, USA.
| | - Karissa DiMarzio
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Justin Parent
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Chelsea Dale
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Juliana Acosta
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Jessica O'Leary
- Frances L. Hiatt School of Psychology, Clark University, Worcester, MA, USA
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10
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McKee LG, DiMarzio K, Parent J, Dale C, Acosta J, O'Leary J. Profiles of Emotion Socialization Across Development and Longitudinal Associations with Youth Psychopathology. Res Child Adolesc Psychopathol 2022; 50:193-210. [PMID: 34081230 PMCID: PMC8639825 DOI: 10.1007/s10802-021-00829-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2021] [Indexed: 02/03/2023]
Abstract
Although there is relative consensus in the literature regarding associations between certain emotion socialization (ES) strategies and youth behavioral health, there is very limited research from a person-centered perspective. To address this gap, the current study examined patterns of ES strategies in families and explored predictors and youth outcomes associated with those patterns. An economically-diverse sample of 229 predominately White mothers and fathers of youth aged 3-12 years was recruited online for a longitudinal study. Latent profile analysis was used to determine the optimal number of family clusters with similar ES profiles. Model fit supported a four-class model, which consisted of an Emotion Coaching profile, characterized by the lowest levels of putatively labeled unsupportive ES practices and the highest levels of putatively labeled supportive ES practices, a Moderate profile characterized by moderate levels of both unsupportive and supportive ES practices, a Limited Engagement profile characterized by low levels of both unsupportive and supportive ES practices, and an Emotion Dismissing profile characterized by the highest levels of unsupportive ES practices and the lowest levels of supportive ES practices. Cross-sectional and longitudinal differences were observed across the ES profiles with regard to demographic and parent emotional competence predictors and youth outcomes. The current study extends the literature on ES by providing evidence on how distinct ES profiles differentially predict youth behavioral health outcomes. Findings also underscore the importance of examining parent emotional competence as a catalyst for adaptive change in the family system.
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Affiliation(s)
- Laura G McKee
- Department of Psychology, Georgia State University, Atlanta, GA, USA.
| | - Karissa DiMarzio
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Justin Parent
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Chelsea Dale
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Juliana Acosta
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Jessica O'Leary
- Frances L. Hiatt School of Psychology, Clark University, Worcester, MA, USA
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11
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Acosta J, Flores P, Alarcón M, Grande-Ortiz M, Moreno-Exebio L, Puyen ZM. A randomised controlled trial to evaluate a medication monitoring system for TB treatment. Int J Tuberc Lung Dis 2022; 26:44-49. [PMID: 34969428 PMCID: PMC8734191 DOI: 10.5588/ijtld.21.0373] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: Adherence to TB treatment and therefore treatment success could be improved using digital adherence technology.OBJECTIVE: To evaluate the effectiveness of a medication event reminder monitor system (MERM) on treatment success and treatment adherence in patients with drug-susceptible pulmonary TB in Perú.METHODS: This was an experimental, randomised, open-label, controlled study conducted among patients in the second phase of TB treatment. The intervention group received their medications through MERM with the support of a treatment monitor, whereas the control group used the usual strategy. Participants were followed until they completed the 54 doses of the second phase of treatment.RESULTS: The study included 53 patients in each group; four in the intervention group withdrew from the study. Treatment success was significantly more frequent in the MERM group (RR 1.15, 95% CI 1.02-1.30; P = 0.0322). There was no significant difference in the adherence outcomes; however, the percentage of patients who missed at least one dose and patients with more than 10% of total doses missed were lower in the intervention group.CONCLUSION: The use of MERM in the second phase of treatment showed a significant improvement in the treatment success rate in patients with drug-susceptible pulmonary TB.
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Affiliation(s)
- J Acosta
- Facultad de Medicina Humana, Universidad Nacional del Centro del Perú, Huancayo, Peru
| | - P Flores
- Instituto Nacional de Salud, Lima, Peru
| | - M Alarcón
- Instituto Nacional de Salud, Lima, Peru
| | | | | | - Z M Puyen
- Instituto Nacional de Salud, Lima, Peru, Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
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12
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Acosta J, Parent J, DiMarzio K, McMakin DL, McKee LG, Dale CF. Longitudinal Associations Between Parenting Practices and Youth Sleep Problems. J Dev Behav Pediatr 2021; 42:751-760. [PMID: 33908375 PMCID: PMC8548445 DOI: 10.1097/dbp.0000000000000953] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/15/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Sleep problems among youth are highly prevalent and associated with adjustment difficulties. When considering influences on youth's sleep, bidirectional links between youth's sleep health and family functioning have been suggested. Parenting practices are among the many familial factors that could be transactionally related to poor sleep in youth; however, research is lacking on potential longitudinal associations between parenting practices and sleep problems in youth. In addition, sensitive periods for this link are mostly unknown. The current study examined longitudinal relations between constellations of parenting practices and youth sleep health to identify profiles of parenting practices that are predictive of sleep problems in youth across different developmental stages. METHOD Participants were 292 parents (M = 36.51, SD = 7.3) of children between the ages of 3 and 14 years (M = 8.4, SD = 3.6). A person-centered approach was used to create profiles across traditionally labeled positive and negative parenting practices, as well as supportive and unsupportive parental emotion socialization strategies. Parenting profiles were then examined as longitudinal predictors of youth sleep problems. RESULTS Findings revealed 3 distinct parenting profiles, which were differentially associated with sleep problems in youth, with the first profile predicting the lowest levels of sleep problems and the third profile predicting the highest levels of sleep problems, particularly among peripubertal youth. CONCLUSION This study extends previous findings by elucidating distinct constellations of parenting practices that are differentially predictive of youth sleep problems and highlighting parenting among the various family processes that can longitudinally contribute to youth's sleep health.
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Affiliation(s)
- Juliana Acosta
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL
| | - Justin Parent
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL
| | - Karissa DiMarzio
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL
| | - Dana L. McMakin
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL
| | - Laura G. McKee
- Department of Psychology, Georgia State University, Atlanta, GA
| | - Chelsea F. Dale
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL
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13
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Sullivan ADW, Forehand R, Acosta J, Parent J, Comer JS, Loiselle R, Jones DJ. COVID-19 and the Acceleration of Behavioral Parent Training Telehealth: Current Status and Future Directions. Cogn Behav Pract 2021; 28:618-629. [PMID: 34629838 PMCID: PMC8488182 DOI: 10.1016/j.cbpra.2021.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/12/2021] [Accepted: 06/19/2021] [Indexed: 02/01/2023]
Abstract
The SARS-COV-2 (COVID-19) pandemic and associated social distancing guidelines have accelerated the telehealth transition in mental health. For those providing Behavioral Parent Training (BPT), this transition has called for moving sessions that are traditionally clinic-based, active, and directive to engaging, supporting, and treating families of children with behavior disorders remotely in their homes. Whereas many difficulties accompany this transition, the lessons learned during the current public health crisis have the potential to transform BPT service delivery on a large scale in ways that address many of its long-standing limitations. We describe both challenges and opportunities and consider the possibilities inherent in a large scale BPT service delivery model capable of increasing the reach and impact of evidence-based treatment for all families.
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Affiliation(s)
| | | | - Juliana Acosta
- Center for Children and Families, Florida International University
| | - Justin Parent
- Center for Children and Families, Florida International University
| | - Jonathan S Comer
- Center for Children and Families, Florida International University
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Gomez Ramos J, Arenas M, Castaño F, Gomez E, Aparicio C, Acosta J, Araguas P, Malave B, Pazos M. PO-1978 Chronic and cosmetic toxicity in patients undergoing radiotherapy and breast reconstruction. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08429-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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15
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Rodríguez-Tomàs E, Baiges-Gaya G, Acosta J, Torres L, Castañé H, Gómez J, Árquez M, Castaño F, Camps J, Joven J, Arenas M. PO-1107 Inflammatory markers in breast cancer patients treated with radiotherapy: Machine Learning approach. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07558-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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16
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Arenas M, Algara M, De Febrer G, Rubio C, Sanz X, de la Casa MA, Vasco C, Marín J, Fernández-Letón P, Villar J, Torres-Royo L, Villares P, Membrive I, Acosta J, López-Cano M, Araguas P, Quera J, Rodríguez-Tomás F, Montero A. Could pulmonary low-dose radiation therapy be an alternative treatment for patients with COVID-19 pneumonia? Preliminary results of a multicenter SEOR-GICOR nonrandomized prospective trial (IPACOVID trial). Strahlenther Onkol 2021; 197:1010-1020. [PMID: 34230996 PMCID: PMC8260020 DOI: 10.1007/s00066-021-01803-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/01/2021] [Indexed: 02/08/2023]
Abstract
Purpose To evaluate the efficacy and safety of lung low-dose radiation therapy (LD-RT) for pneumonia in patients with coronavirus disease 2019 (COVID-19). Materials and methods Inclusion criteria comprised patients with COVID-19-related moderate–severe pneumonia warranting hospitalization with supplemental O2 and not candidates for admission to the intensive care unit because of comorbidities or general status. All patients received single lung dose of 0.5 Gy. Respiratory and systemic inflammatory parameters were evaluated before irradiation, at 24 h and 1 week after LD-RT. Primary endpoint was increased in the ratio of arterial oxygen partial pressure (PaO2) or the pulse oximetry saturation (SpO2) to fractional inspired oxygen (FiO2) ratio of at least 20% at 24 h with respect to the preirradiation value. Results Between June and November 2020, 36 patients with COVID-19 pneumonia and a mean age of 84 years were enrolled. Seventeen were women and 19 were men and all of them had comorbidities. All patients had bilateral pulmonary infiltrates on chest X‑ray. All patients received dexamethasone treatment. Mean SpO2 pretreatment value was 94.28% and the SpO2/FiO2 ratio varied from 255 mm Hg to 283 mm Hg at 24 h and to 381 mm Hg at 1 week, respectively. In those who survived (23/36, 64%), a significant improvement was observed in the percentage of lung involvement in the CT scan at 1 week after LD-RT. No adverse effects related to radiation treatment have been reported. Conclusions LD-RT appears to be a feasible and safe option in a population with COVID-19 bilateral interstitial pneumonia in the presence of significant comorbidities. Supplementary Information The online version of this article (10.1007/s00066-021-01803-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M. Arenas
- Universitat Rovira i Virgili, Tarragona, Spain
- Institut d’Investigacions Pere Virgili, Tarragona, Spain
- Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - M. Algara
- Department of Radiation Oncology, Hospital del Mar, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
- Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
| | - G. De Febrer
- Universitat Rovira i Virgili, Tarragona, Spain
- Department of Geriatric and Palliative care, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - C. Rubio
- Department of Radiation Oncology, HM Hospitales., Madrid, Spain
| | - X. Sanz
- Department of Radiation Oncology, Hospital del Mar, Barcelona, Spain
- Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- Pompeu Fabra University Barcelona, Barcelona, Spain
| | | | - C. Vasco
- Universitat Rovira i Virgili, Tarragona, Spain
- Department of Geriatric and Palliative care, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - J. Marín
- Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- Department of Critical Care, Hospital del Mar, Barcelona, Spain
| | | | - J. Villar
- Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- Department of Infection Diseases, Hospital del Mar, Barcelona, Spain
| | - L. Torres-Royo
- Universitat Rovira i Virgili, Tarragona, Spain
- Institut d’Investigacions Pere Virgili, Tarragona, Spain
- Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - P. Villares
- Department of Internal Medicine, HM Hospitales, Madrid, Spain
| | - I. Membrive
- Department of Radiation Oncology, Hospital del Mar, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
| | - J. Acosta
- Universitat Rovira i Virgili, Tarragona, Spain
- Institut d’Investigacions Pere Virgili, Tarragona, Spain
- Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - M. López-Cano
- Department of Internal Medicine, HM Hospitales, Madrid, Spain
| | - P. Araguas
- Universitat Rovira i Virgili, Tarragona, Spain
- Institut d’Investigacions Pere Virgili, Tarragona, Spain
- Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - J. Quera
- Department of Radiation Oncology, Hospital del Mar, Barcelona, Spain
- Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain
- Pompeu Fabra University Barcelona, Barcelona, Spain
| | - F. Rodríguez-Tomás
- Universitat Rovira i Virgili, Tarragona, Spain
- Institut d’Investigacions Pere Virgili, Tarragona, Spain
- Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - A. Montero
- Department of Radiation Oncology, HM Hospitales., Madrid, Spain
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Carreno Lineros JM, Penela D, Jauregui B, Soto-Iglesias D, Fernandez-Armenta J, Acosta J, Bisbal F, Ordonez A, Chauca A, Scherer C, Berruezo A. Prospective evaluation of a hybrid clinical and electrocardiographic algorithm to predict the origin of outflow tract PVCs. A prospective multicenter study. Europace 2021. [DOI: 10.1093/europace/euab116.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Beca de la Asociación del Ritmo Cardiaco para Formación en Investigación Post-Residencia en centros españoles.
Background
To predict the premature ventricular complex (PVC) site of origin (SOO) before the ablation procedure has important implications. 12 lead ECG information as well clinical characteristics are related with the PVC-SOO, but there is no prospective data validation.
Purpose
This prospective multicenter study sought to analyze the applicability and accuracy of a simple hybrid algorithm that includes electrocardiographic and clinical information in a consecutive patient population with outflow tract (OT) PVCs undergoing catheter ablation.
Methods
Consecutive patients with frequent OT-PVCs and indication for catheter ablation were prospectively included in 4 centers. The vascular access (femoral vein vs femoral artery) and the first outflow tract to be mapped were decided based on a two-steps hybrid algorithm (see Figure 1) including ECG information [R/S PVC precordial transition (PT): early PT if it occurs before V3; late PT if beyond V3) and clinical information [the following variables compute 1 point in a clinical score: age (>59 y.o); presence of hypertension; and gender (man)].
Results
115 consecutive patients [42 (37%) man, 52 + 15 y.o] were included. Mean PVC burden at baseline was 20 ± 13% and mean LVEF was 59 ± 8%. Mean procedure time was 55 ± 26 min. Complete acute abolition of the PVC was achieved in 110 (96%) patients. 84 (73%) patients had the PVC’s SOO in the right ventricle OT (RVOT) whereas 31 (27%) in the left ventricular OT (LVOT). Compared with patients with a RVOT-SOO, those with a LVOT-SOO were more frequently man [18 (58%) vs 24 (29%), p = 0.004], more frequently suffered from hypertension [18 (58%) vs 15 (18%), p < 0.001) and had an early R/S PVC transition [17 (55%) early PT, 3 (10%) late PT) in the case of LVOT-SOO vs 4 (5%) early PT, 55 (65%) late PT in the case of RVOT-SOO, p < 0.001]. The hybrid algorithm accurately anticipated the PVC’s SOO in 101 (88%) patients. A reduction of at least 80% of PVC burden was achieved by 90% of patients at 6 months.
Conclusions
The hybrid algorithm, prospectively evaluated in an international multicenter study, has proved to permit to accurately anticipate the PVC’s SOO (right vs left) in a consultive population of patients with OT PVCs. Abstract Figure 1
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Affiliation(s)
| | - D Penela
- Teknon Medical Centre, Barcelona, Spain
| | | | | | | | - J Acosta
- University Hospital Virgen del Rocio, Sevilla, Spain
| | - F Bisbal
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - A Ordonez
- Teknon Medical Centre, Barcelona, Spain
| | - A Chauca
- Teknon Medical Centre, Barcelona, Spain
| | - C Scherer
- Teknon Medical Centre, Barcelona, Spain
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18
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Jauregui B, Soto-Iglesias D, Penela D, Acosta J, Fernandez-Armenta J, Linhart M, Ordonez A, Chauca A, Carreno JM, Scherer C, Mont L, Bosch X, Ortiz-Perez JT, Berruezo A. Cardiovascular magnetic resonance determinants of ventricular arrhythmic events after myocardial infarction. Europace 2021. [DOI: 10.1093/europace/euab116.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) permits to identify the arrhythmogenic substrate in chronic post-myocardial infarction (MI) patients. It is unknown why a minority of chronic post-MI patients develop sustained ventricular tachycardias (VT) over follow-up, regardless of their left ventricular ejection fraction (LVEF).
Objectives
To noninvasively characterize scar differences and potential predictors of VT occurrence in chronic post-MI patients.
Methods
A case-control study was designed through retrospective LGE-CMR data analysis of chronic post-MI patients i) consecutively referred for VT substrate ablation after a first VT episode (n = 66), and ii) from a control group (n = 84) with no arrhythmia evidence. The myocardium was characterized differentiating core, border zone (BZ) and BZ channels (BZC) using the ADAS 3D post-processing imaging platform. Clinical and scar characteristics, including a novel parameter, the BZC mass, were compared between both groups.
Results
150 post-MI patients were included for analysis. Four multivariate Cox proportional hazards regression models were created for total scar mass (model 1), BZ mass (model 2), core mass (model 3), and BZC mass (model 4, see table). All of them were adjusted by age, sex, and LVEF. In the corresponding models, only total scar mass, BZ mass, core mass, and BZC mass were independent variables associated with the development of VT. BZC mass showed the best performance: a cut-off of 5.15 g identified the cases with 92.4% sensitivity and 86.9% specificity [AUC 0.93 (0.89–0.97); p < 0.001], with a significant increase in the AUC compared to the other scar parameters (p < 0.001 for all pairwise comparisons using the De Long’s test). By using BZC mass as a risk stratification parameter together with LVEF, the net reclassification improvement (NRI) was 33.3% for the cases, and 39.3% for the controls. The net proportion of patients reclassified correctly was 36.7%
Conclusions
The mass of BZC, automatically obtained with a commercially available CMR post-processing software, is the strongest independent variable associated with the occurrence of clinical SMVT in post-MI patients after covariate adjustment for age, sex, and LVEF. The measurement of BZC mass could permit a more accurate arrhythmia risk stratification than LVEF in chronic post-MI patients (NRI 36.7%). Scar characteristics analyzed from LGE-CMR imaging should be taken into consideration to better stratify ventricular arrhythmia risk in chronic post-MI patients. Abstract Figure. ROC curves for predicting VT occurrence
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Affiliation(s)
- B Jauregui
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
| | | | - D Penela
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
| | - J Acosta
- University Hospital of Virgen del Rocio, Seville, Spain
| | | | - M Linhart
- University Hospital de Girona Dr. Josep Trueta, Girona, Spain
| | - A Ordonez
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
| | - A Chauca
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
| | - JM Carreno
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
| | - C Scherer
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
| | - L Mont
- Hospital Clinic de Barcelona, Barcelona, Spain
| | - X Bosch
- Hospital Clinic de Barcelona, Barcelona, Spain
| | | | - A Berruezo
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
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19
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Penela D, Fernandez-Armentas J, Acosta J, Bisbal F, Jauregui B, Soto D, Aguinaga L, Acena M, Biagi A, De Sensi F, Ordonez A, Chauca A, Carreno J, Berruezo A. A Left sided site of origin is associated with adverse cardiovascular outcomes in patients with LV dysfunction undergoing PVC ablation. Europace 2021. [DOI: 10.1093/europace/euab116.334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Epidemiological studies suggested that premature ventricular complexes (PVCs) are associated with cardiac mortality. But data are still inconclusive.
Aim
This study sought to analyze predictors of adverse outcomes in a population of patients with left ventricular (LV) systolic dysfunction who underwent PVC ablation.
Methods
135 consecutive patients [100 (74%) men, 59 +12 y.o.] with LV systolic dysfunction [LV ejection fraction (LVEF) <50%] and frequent PVCs who underwent PVC ablation were included in a multicenter prospective international register. Patients were followed-up at 6 and 12 months and annually thereafter. The last evaluation performed was considered the long-term follow-up (LTFUP) evaluation. Cardiac mortality and/or cardiac transplantation and/or admission for heart failure was considered the primary endpoint.
Results
82 (61%) patients had a left-sided PVC’s site of origin (LS-SOO), 51 (38%) had a right-sided SOO (RS-SOO) whereas SOO could not be determined in 2 (1%) patients. LS-SOO patients were older (61 ± 11 vs 52 ± 10, p < 0.001) more frequently men [71 (87%) vs 27 (53%), p < 0.001] with previous history of atrial fibrillation (AF) [14 (15%) vs 0, p = 0.001] and with a previously diagnosed structural heart disease (SHD) [43 (52%) vs 6 (11%), p < 0.001].
After a mean follow-up of 39 ± 21 months (range 24-94 months) there was a significant reduction in the PVC burden from 24 ± 13% at baseline to 4 ± 6% at LTFUP, p < 0.001; LVEF improved from 33 ± 8% at baseline to 41 ± 13% at LTFUP (p < 0.001) and NYHA class from 2.1 ± 0.6% to 1.4 ± 0.6% (p < 0.001); BNP levels decreased from 237 ± 231 pg/mL to 137 ± 185 pg/mL (p = 0.001). The primary end-point was reached in 10% patients (7 cardiac deaths, 1 cardiac transplantation and 5 heart failure admisions), 14,8% in LS-SOO and 1,9% in RS-SOO patients, log rank = 0.05 (Figure 1).
Conclusions
Among patients with LV dysfunction who underwent PVC ablation, those with LS-SOO were older and more frequently had AF and SHD. LS-SOO was associated with adverse cardiovascular outcomes. These findings suggest that PVCs with LS and RS-SOO should be considered as two different clinicals entities, with different prognostic values. Abstract Figure 1
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Affiliation(s)
- D Penela
- MEDICAL CENTRE TEKNON, GRUPO QUIRONSALUD, Barcelona, Spain
| | | | - J Acosta
- Complex Public Hospital Virgen del Rocio Regional, Sevilla, Spain, Spain
| | - F Bisbal
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - B Jauregui
- MEDICAL CENTRE TEKNON, GRUPO QUIRONSALUD, Barcelona, Spain
| | - D Soto
- MEDICAL CENTRE TEKNON, GRUPO QUIRONSALUD, Barcelona, Spain
| | - L Aguinaga
- Private Center of Cardiology, Tucuman, Argentina
| | - M Acena
- University Hospital of Bellvitge, Hospitalet De Llobregat, Spain
| | - A Biagi
- Guglielmo da Saliceto Hospital, Piacenza, Italy
| | | | - A Ordonez
- MEDICAL CENTRE TEKNON, GRUPO QUIRONSALUD, Barcelona, Spain
| | - A Chauca
- MEDICAL CENTRE TEKNON, GRUPO QUIRONSALUD, Barcelona, Spain
| | - J Carreno
- MEDICAL CENTRE TEKNON, GRUPO QUIRONSALUD, Barcelona, Spain
| | - A Berruezo
- MEDICAL CENTRE TEKNON, GRUPO QUIRONSALUD, Barcelona, Spain
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20
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Pajares MA, Margarit JA, García-Camacho C, García-Suarez J, Mateo E, Castaño M, López Forte C, López Menéndez J, Gómez M, Soto MJ, Veiras S, Martín E, Castaño B, López Palanca S, Gabaldón T, Acosta J, Fernández Cruz J, Fernández López AR, García M, Hernández Acuña C, Moreno J, Osseyran F, Vives M, Pradas C, Aguilar EM, Bel Mínguez AM, Bustamante-Munguira J, Gutiérrez E, Llorens R, Galán J, Blanco J, Vicente R. Guidelines for enhanced recovery after cardiac surgery. Consensus document of Spanish Societies of Anesthesia (SEDAR), Cardiovascular Surgery (SECCE) and Perfusionists (AEP). Rev Esp Anestesiol Reanim (Engl Ed) 2021; 68:183-231. [PMID: 33541733 DOI: 10.1016/j.redar.2020.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/03/2020] [Accepted: 11/09/2020] [Indexed: 01/28/2023]
Abstract
The ERAS guidelines are intended to identify, disseminate and promote the implementation of the best, scientific evidence-based actions to decrease variability in clinical practice. The implementation of these practices in the global clinical process will promote better outcomes and the shortening of hospital and critical care unit stays, thereby resulting in a reduction in costs and in greater efficiency. After completing a systematic review at each of the points of the perioperative process in cardiac surgery, recommendations have been developed based on the best scientific evidence currently available with the consensus of the scientific societies involved.
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Affiliation(s)
- M A Pajares
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitari i Politècnic La Fe, Valencia, España.
| | - J A Margarit
- Servicio de Cirugía Cardiaca, Hospital Universitari de La Ribera, Valencia, España
| | - C García-Camacho
- Unidad de Perfusión del Servicio de Cirugía Cardiaca, Hospital Universitario Puerta del Mar,, Cádiz, España
| | - J García-Suarez
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario Puerta de Hierro, Madrid, España
| | - E Mateo
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital General Universitario de Valencia, Valencia, España
| | - M Castaño
- Servicio de Cirugía Cardiaca, Complejo Asistencial Universitario de León, León, España
| | - C López Forte
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitari i Politècnic La Fe, Valencia, España
| | - J López Menéndez
- Servicio de Cirugía Cardiaca, Hospital Ramón y Cajal, Madrid, España
| | - M Gómez
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitari de La Ribera, Valencia, España
| | - M J Soto
- Unidad de Perfusión, Servicio de Cirugía Cardiaca, Hospital Universitari de La Ribera, Valencia, España
| | - S Veiras
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Clínico Universitario de Santiago, Santiago de Compostela, España
| | - E Martín
- Servicio de Cirugía Cardiaca, Complejo Asistencial Universitario de León, León, España
| | - B Castaño
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Complejo Hospitalario de Toledo, Toledo, España
| | - S López Palanca
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital General Universitario de Valencia, Valencia, España
| | - T Gabaldón
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital General Universitario de Valencia, Valencia, España
| | - J Acosta
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - J Fernández Cruz
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitari de La Ribera, Valencia, España
| | - A R Fernández López
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Virgen Macarena, Sevilla, España
| | - M García
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - C Hernández Acuña
- Servicio de Cirugía Cardiaca, Hospital Universitari de La Ribera, Valencia, España
| | - J Moreno
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital General Universitario de Valencia, Valencia, España
| | - F Osseyran
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitari i Politècnic La Fe, Valencia, España
| | - M Vives
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitari Dr. Josep Trueta, Girona, España
| | - C Pradas
- Servicio de Cirugía Cardiaca, Hospital Universitari Dr. Josep Trueta, Girona, España
| | - E M Aguilar
- Servicio de Cirugía Cardiaca, Hospital Universitario 12 de Octubre, Madrid, España
| | - A M Bel Mínguez
- Servicio de Cirugía Cardiaca, Hospital Universitari i Politècnic La Fe, Valencia, España
| | - J Bustamante-Munguira
- Servicio de Cirugía Cardiaca, Hospital Clínico Universitario de Valladolid, Valladolid, España
| | - E Gutiérrez
- Servicio de Cirugía Cardiaca, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - R Llorens
- Servicio de Cirugía Cardiovascular, Hospiten Rambla, Santa Cruz de Tenerife, España
| | - J Galán
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | - J Blanco
- Unidad de Perfusión, Servicio de Cirugía Cardiovascular, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - R Vicente
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitari i Politècnic La Fe, Valencia, España
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Salazar S, Gutiérrez N, Sánchez O, Ramos E, González A, Acosta J, Ramos T, Altamirano C, Toledo J, Montesino R. Establishment of a production process for a novel vaccine candidate against Lawsonia intracellularis. ELECTRON J BIOTECHN 2021. [DOI: 10.1016/j.ejbt.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Jahuira M, Pando A, Acosta J, Sanchez L, Valderrama A, Jacinto C, Maza I, Solis H, Mayta H. Modified chitosan microparticles to molecular diagnostic of Chagas disease. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Rodríguez E, Gomez J, Moreno A, Acosta J, Torres L, Trilla J, López Y, Baiges G, Hernández A, Camps J, Joven J, Arenas M. PO-1104: Effect Of Neoadjuvant Radiochemotherapy On Activity Of Paraoxonase -1 In Rectal Cancer Patients. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01121-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Moreno-Acosta P, Gamboa O, Molano M, Acosta J, Carrillo S, Rojas AR, Magne N. hTERT and IGFIR protein expression as possible biomarkers and molecular targets in cervical cancer. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)31198-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lurie A, Amit G, Divakara Menon S, Acosta J, Healey J, Wong J. OUTCOMES AND SAFETY OF FLUOROLESS RADIOFREQUENCY CATHETER ABLATION FOR ATRIAL FIBRILLATION. Can J Cardiol 2020. [DOI: 10.1016/j.cjca.2020.07.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Jauregui B, Soto-Iglesias D, Zucchelli G, Teres C, Ordonez A, Chauca A, Penela D, Acosta J, Fernandez-Armenta J, Linhart M, Perea RJ, Doltra A, Ortiz-Perez JT, Bosch X, Berruezo A. P1111Arrhythmogenic substrate detection in ischemic patients undergoing ventricular tachycardia ablation using multi-detector computed tomography: compared evaluation with cardiac magnetic resonance. Europace 2020. [DOI: 10.1093/europace/euaa162.232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiac magnetic resonance (CMR) is capable of accurately identifying arrhythmogenic substrate (AS), leading to longer arrhythmia-free survival when used to guide ventricular tachycardia (VT) substrate ablation procedures. However, the use of CMR may be limited in certain centers or patient subsets.
Purpose
To evaluate the performance of multidetector cardiac computed tomography (MDCT) imaging in identifying heterogeneous tissue channels (HTCs) detected by CMR in ischemic patients undergoing VT substrate ablation.
Methods
Thirty ischemic patients undergoing both CMR and MDCT before VT substrate ablation were included. Using a dedicated post-processing software, two blinded operators, assigned either to CMR or MDCT analysis, characterized the presence of CMR- and CT-channels, respectively. CMR-channels were classified as endocardial (layers <50%), epicardial (layers ≥50%) or transmural. CMR- vs. CT-channel concordance was considered when the orientation was the same and they were located in the same AHA segment.
Results
Mean age was 69 ± 10 years; 90% were male. Mean left ventricular ejection fraction (LVEF) was 35 ± 10%. All patients had CMR-channels (n = 76), whereas only 26/30 (86.7%) had CT-channels (n = 91). Global sensitivity (Se) and positive predictive values (PPV) for detecting CMR-channels were 61.8% and 51.6%, respectively. MDCT performance improved in patients with epicardial CMR-channels (Se 80.5%), and transmural scars (Se 72.2%). In 4/11 (36%) patients with subendocardial MI, MDCT was unable to identify the AS.
Conclusion
MDCT fails to detect the presence of AS in 36% of patients with subendocardial MI and shows a modest sensitivity identifying the presence of HTCs, although its performance improves in patients with transmural scar.
Abstract Figure. Multimodality imaging AS detection
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Affiliation(s)
- B Jauregui
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
| | | | - G Zucchelli
- Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - C Teres
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
| | - A Ordonez
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
| | - A Chauca
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
| | - D Penela
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
| | - J Acosta
- University Hospital of Virgen del Rocio, Seville, Spain
| | | | - M Linhart
- University Hospital de Girona Dr. Josep Trueta, Girona, Spain
| | - R J Perea
- Hospital Clinic de Barcelona, Barcelona, Spain
| | - A Doltra
- Hospital Clinic de Barcelona, Barcelona, Spain
| | | | - X Bosch
- Hospital Clinic de Barcelona, Barcelona, Spain
| | - A Berruezo
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
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Jauregui B, Soto-Iglesias D, Teres C, Ordonez A, Chauca A, Penela D, Acosta J, Fernandez-Armenta J, Perea RJ, Prat-Gonzalez S, Ortiz-Perez JT, Berruezo A. P1106Fundamental differences and predictors of scar arrhythmogenicity in ischemic patients using cardiac magnetic resonance: a propensity score-matching study. Europace 2020. [DOI: 10.1093/europace/euaa162.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction
Late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) permits to identify the arrhythmogenic substrate (AS) in ischemic patients. However, it is unknown why the majority of them never develop ventricular tachycardias (VT), irrespectively of their left ventricular ejection fraction (LVEF).
Purpose
To characterize the fundamental differences and potential predictors of scar arrhythmogenicity in post-myocardial infarction (MI) patients with and without VT.
Methods
36 consecutive ischemic patients with no arrhythmia evidence underwent a LGE-CMR study 4 years after the MI (controls). Scar data were compared with those obtained from 49 ischemic patients referred for VT substrate ablation (cases). Propensity score matching (PSM) was performed to adjust for age, LVEF, scar mass, and time from MI. The myocardium was segmented in 10 layers (endo- to epicardium), characterizing the core, border zone (BZ) and BZ channels (BZCs) using a dedicated post-processing software.
Results
Compared to controls, cases were significantly older (67.3 ± 9.1 vs. 56.5 ± 11), had lower LVEF (33.1 ± 10.1 vs. 51 ± 9.4), greater scar mass (33.9 ± 17.2 vs. 14.2 ± 11.6 g), BZ mass (21.1 ± 9.9 vs. 9.6 ± 7.6 g), core mas (12.6 ± 8.8 vs. ± g), number of BZC (2.9 ± 1.4 vs. 1.1 ± 1.1) and BZC mass (10.5 ± 4.2 vs. 2.3 ± 2.4 g) (p < 0.001 in all cases). After PSM (2:1) adjustment[BJG1] , cases had more BZCs (2.9 ± 1.4 vs. 2.2 ± 0.6; p = 0.01) and a greater BZC mass (10.5 ± 4.2 vs. 4.6 ± 2.6 g; p < 0.001). In the multivariable logistic regression analysis, the BZC mass was the only independent predictor of being a case [OR 2.3 (1.5–3.4); p < 0.001]. Receiver operating characteristic curve analysis identified a cut-off point of BZC mass >4.28 g (AUC 0.98; p < 0.001), showing 100% sensitivity and 91% specificity for cases’ discrimination.
Conclusions
Compared with the cases, an otherwise similar control group (PS-matched for age, LVEF, scar mass, and time from MI) showed fewer BZC and a reduced BZC mass. BZC mass was the only independent predictor of being a case. A BZC mass cut-off point of > 4.28 g showed a 100% sensitivity and 91% specificity for the identification of ischemic patients with documented VT.
Abstract Figure. Mean BZC mass and ROC curve analysis
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Affiliation(s)
- B Jauregui
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
| | | | - C Teres
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
| | - A Ordonez
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
| | - A Chauca
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
| | - D Penela
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
| | - J Acosta
- University Hospital of Virgen del Rocio, Seville, Spain
| | | | - R J Perea
- Hospital Clinic de Barcelona, Barcelona, Spain
| | | | | | - A Berruezo
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
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Jauregui B, Fernandez-Armenta J, Acosta J, Penela D, Teres C, Ordonez A, Soto-Iglesias D, Silva E, Chauca A, Bisbal F, Pedrote A, Berruezo A. 125Manual vs. automatic local activation time annotation for guiding premature ventricular complex ablation procedures (MANIaC - PVC study). Europace 2020. [DOI: 10.1093/europace/euaa162.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Financial support was provided in form of a research grant from Biosense Webster
Introduction
The use of an algorithmic method (wavefront, WF) based on automatic annotation of the maximal negative slope of the unipolar electrogram (uni-EGM) within the window demarcated by the bipolar EGM (bi-EGM) may accurately identify the earliest activation site (EAS) during premature ventricular complex (PVC) ablation procedures.
Purpose
To assess the potential benefits of a local activation time (LAT) automatic acquisition protocol using WF plus an automatic algorithm for ECG pattern matching recognition (AUT-arm) instead of a manual LAT annotation plus ECG visual inspection (MAN-arm) during premature ventricular complexes (PVCs) ablation procedures.
Methods
Prospective, randomized, controlled and international multicenter study (NCT03340922). 69 consecutive patients with indication for PVC ablation were enrolled and randomized to AUT (n = 34) or MAN (n = 35) annotation protocols using the CARTO3 navigation system. The primary endpoint was mapping success, defined as complete PVC abolition after a maximum of 2 radiofrequency (RF) applications or up to 90 seconds at the identified EAS, considered the site of origin (SOO). Complete PVC abolition was considered as the procedure success, whereas clinical success was defined as the PVC-burden reduction of >80% in the 24-h Holter at least 1 month after the procedure. Concordance analysis of the maps obtained with both methods was performed.
Results
Mean age was 69 ± 15, 58% men. The mean baseline PVC burden was 26 ± 13%, mean LVEF 55 ± 12%. Baseline characteristics were similar between groups. The most frequent PVC-SOO were RVOT (41%), LV (25%; being the summit the most frequent location), and LVOT (16%), with no MAN-AUT differences. Total mapping time, number of RF applications, RF time, and procedure time were similar for both groups. The AUT-arm had a higher number of mapping points acquired (164 vs. 61; p = 0.002). There was a delayed detection of LAT at the EAS in the AUT-arm (mean 23 ± 13 ms), being more significant in left-sided PVCs (30 ± 12 vs. 15 ± 9 ms, p < 0.001). The 10-ms isochronal area was significantly bigger in the MAN-arm (1.95 ± 2.7 vs. 1.0 ± 1.0; p = 0.05). The median (interquartile range) distance between AUT-EAS and MAN-EAS was 4 (0–6.8) mm. Mapping success was similar for AUT (65%) and MAN (63%) (p = 1.0). Procedure success was significantly better for the AUT-arm (100% AUT vs. 86% MAN; p = 0.04), but without differences in clinical success (87% AUT vs. 82% MAN; p = 0.7). There were no procedure-related complications.
Conclusions
The use of a complete automatic protocol for LAT annotation (WF + ECG pattern matching) during PVC ablation procedures is feasible and safe, allowing to achieve equivalent procedural and clinical endpoints as compared to manual procedures carried out by expert operators.
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Affiliation(s)
- B Jauregui
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
| | | | - J Acosta
- University Hospital of Virgen del Rocio, Seville, Spain
| | - D Penela
- Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - C Teres
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
| | - A Ordonez
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
| | | | - E Silva
- UNIVERSITY HOSPITAL PUERTA DEL MAR, Cadiz, Spain
| | - A Chauca
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
| | - F Bisbal
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - A Pedrote
- University Hospital of Virgen del Rocio, Seville, Spain
| | - A Berruezo
- Teknon Medical Centre, Heart Institute, Barcelona, Spain
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Doltra A, Bertolani Y, Linhart M, Acosta J, Tolosana JM, Mont LL, Berruezo A, Sitges M. P1427 Mechanical dispersion assessed with echocardiography versus scar characterization with cardiac magnetic resonance to predict malignant arrhythmia in cardiac resynchronization therapy patients. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Recent data have shown that scar characterization with late gadolinium enhancement magnetic resonance (LGE-CMR) is useful to predict malignant arrhythmic events in a cardiac resynchronization therapy (CRT) population. On the other hand, echocardiography 2D strain parameters (such as mechanical dispersion – MD) have been recently suggested as a predictor of ventricular arrhythmia (VA).
Purpose
To compare the usefulness of strain echocardiography and MR scar parameters to predict VA and sudden cardiac death (SCD) in CRT patients (pa).
Methods
110 pa undergoing CRT implant were included. A 2D strain echo and a 3D LGE-CMR were performed before the implant. In the echocardiographic exam, left ventricle ejection fraction (LVEF), global longitudinal strain (GLS), mechanical dispersion (MD) and delta contraction time were quantified. Regarding LGE-CMR, scar mass, border zone (BZ) mass and the presence of BZ channels were assessed with specific software. The primary endpoint was the presence of SCD or appropriate implantable cardioverter-defibrillator therapy at long-term follow-up (FU).
Results
The primary outcome occurred in 23 pa (20.9%) during a mean FU of 53.5 ± 10.4 months. In these pa, MD was significantly increased (130.3 ± 55.5ms vs. 102.0 ± 45.1ms, p < 0.05) whereas LVEF, GLS and delta contraction time were not significantly different. All LGE-CMR parameters were significantly increased in PA with events. At multivariate analysis, both MD and LGE-CMR parameters were independent predictors of malignant arrhythmia (table). The MD cut-off value for prediction of VA was 80.88 ms, with 91.3% sensitivity and 36.8% specificity. The figure shows the Kaplan-Meier curves. Regarding LGE-CMR parameters, the cut-off value, sensitivity, and specificity were 13.8g/82.6%/81.6% for scar mass, 5.54g/85.7%/81.8% for BZ mass, and 90.9%/82.1% for presence of BZ channels.
Conclusions
MD and LGE-CMR scar parameters are independent predictors of VA and SCD in CRT. Due to its high sensitivity, MD could be used to identify pa at high arrhythmic risk that could benefit from a more complex and specific LGE-CMR study.
Multivariate analysis Model 1 Model 2 Model 3 HR (95% CI) p HR (95% CI) p HR (95% CI) p Basal LVEF 1.01 (0.94-1.09) 0.731 1 (0.93-1.07) 0.974 1.04 (0.97-1.11) 0.273 MD (ms) 1.01 (1.00-1.02) 0.043 1.01 (1.00-1.02) 0.017 1.01 (1.00-1.02) 0.003 BZ mass (g) 1.08 (1.05-1.11) <0.001 Presence of BZ channels 18.39 (4.26-79.51) <0.001 Scar mass (g) 1.06 (1.04-1.08) <0.001 LVEF: left ventricle ejection fraction; MD:mechanical dispersion; BZ:border zone
Abstract P1427 Figure. Kaplan-Meier curves
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Affiliation(s)
- A Doltra
- Hospital Clinic de Barcelona, Barcelona, Spain
| | | | - M Linhart
- University Hospital de Girona Dr. Josep Trueta, Girona, Spain
| | - J Acosta
- University Hospital of Virgen del Rocio, Seville, Spain
| | | | - L L Mont
- Hospital Clinic de Barcelona, Barcelona, Spain
| | - A Berruezo
- Heart Institute, Teknon Medical Center, Barcelona, Spain
| | - M Sitges
- Hospital Clinic de Barcelona, Barcelona, Spain
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Tong V, Corchuelo S, Cates J, Laiton-Donato K, Dollard S, Rico A, Lanzieri T, Acosta J, Ailes E, Rodríguez H, Ricaldi J, González M, Pelaez D, Valencia D, Mercado M, Honein M, Ospina M. Prevalence of congenital CMV infection in Colombia. Am J Obstet Gynecol 2019. [DOI: 10.1016/j.ajog.2019.10.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lopez IH, Gomez J, Torres L, Acosta J, Arquez M, LaFuerza A, Martinez F, Miranda M, Arenas M. Influence of Statins on Survival Outcome in Patients with Metastatic Castration-Resistant Prostate Cancer Treated with Androgen Receptor Inhibitors. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rodríguez-Tomàs E, Murcia M, Arguís M, Dolz I, De Abreu M, Baiges-Gaya G, Cabré N, Luciano-Mateo F, Torres-Royo L, Árquez M, Gómez J, Acosta J, Gómez D, Jordi C, Jorge J, Sabater S, Arenas Prat M. PO-1079 Metabolic changes with the administration of radiotherapy in lung, head and neck cancer patients. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31499-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Montesino R, Gutiérrez N, Camacho F, Farnós O, Andrades S, González A, Acosta J, Cortez-San Martín M, Sánchez O, Ruiz A, Toledo J. Multi-antigenic recombinant subunit vaccine against Lawsonia intracellularis: The etiological agent of porcine proliferative enteropathy. Vaccine 2019; 37:1340-1349. [DOI: 10.1016/j.vaccine.2019.01.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 01/10/2019] [Accepted: 01/11/2019] [Indexed: 11/30/2022]
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Abstract
Los bioplásticos a partir de almidón, son productos innovadores con un gran potencial de desarrollo y altamente amigables con el medio ambiente; en tal sentido, se evaluó el almidón extraído de cinco variedades de papa categoría richi (Superior (S), ICA Capiro (IC), Betina (B), Parda Pastusa (PP) y Criolla (C)) para la obtención de bioplásticos. Para lo anterior, se extrajo el almidón por el método de decantación natural, se determinó sus propiedades fisicoquímicas como temperatura de gelatinización (Tg), índice de absorbancia (IA), índice de solubilidad (IS), poder de hinchamiento (PDH), proteína, amilosa y amilopectina teniendo en cuenta la norma ISO 6647. Los resultados de cada variedad se evaluaron con una matriz de priorización, posteriormente, se elaboró el bioplástico siguiendo la metodología realizada por (Meza, 2016) y validado con un diseño unifactorial, donde se evalúa la incidencia del porcentaje de almidón (3, 6, 8%) en la mezcla, como variables de respuesta resistencia y calibre con 2 réplicas. Los resultados indican que la variedad (B) tiene las mejores características con 64,125 °C para Tg, para IA 3.130 g gel/g, IS 18,75 g/ml, PDH 4.03, proteína 0.341 %, amilosa 20,751 mg/L y amilopectina 79,249 mg/L. El bioplástico obtenido de esta variedad presentó características de resistencia de 25.35 MPa y calibre 0.17 mm obteniendo las mejores características mecánicas del bioplástico. Se concluye que el almidón de papa de categoría richi tiene alta potencialidad para la generación de bioplástico.
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Affiliation(s)
- J Acosta
- Grupo de Investigación GIIDOP. Universidad Mariana. Ingeniería de Procesos. Docente Investigador. San Juan de Pasto. Nariño. Colombia
| | - H Gomajoa
- Grupo de Investigación GIIDOP. Universidad Mariana. Ingeniería de Procesos. Docente Investigador. San Juan de Pasto. Nariño. Colombia
| | - Y Benavides
- Grupo de investigación GIIDOP. Universidad Mariana. Ingeniería de Procesos. Estudiante Investigador. San Juan de Pasto. Nariño. Colombia
| | - A Charfuelan
- Grupo de investigación GIIDOP. Universidad Mariana. Ingeniería de Procesos. Estudiante Investigador. San Juan de Pasto. Nariño. Colombia
| | - F Valenzuela
- Grupo de investigación GIIDOP. Universidad Mariana. Ingeniería de Procesos. Estudiante Investigador. San Juan de Pasto. Nariño. Colombia
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Muñoz-Flores C, Astuya A, Roa F, Romero A, Acosta J, Sánchez O, Toledo J. Activation of membrane-bound and soluble Toll-like Receptors 5 in Salmo salar depends on the MyD88 signalling pathway. Biochim Biophys Acta Gen Subj 2018; 1862:2215-2225. [DOI: 10.1016/j.bbagen.2018.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 05/29/2018] [Accepted: 07/06/2018] [Indexed: 01/01/2023]
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Beltrán FR, Lorenzo V, Acosta J, de la Orden MU, Martínez Urreaga J. Effect of simulated mechanical recycling processes on the structure and properties of poly(lactic acid). J Environ Manage 2018; 216:25-31. [PMID: 28506670 DOI: 10.1016/j.jenvman.2017.05.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 04/04/2017] [Accepted: 05/07/2017] [Indexed: 06/07/2023]
Abstract
The aim of this work is to study the effects of different simulated mechanical recycling processes on the structure and properties of PLA. A commercial grade of PLA was melt compounded and compression molded, then subjected to two different recycling processes. The first recycling process consisted of an accelerated ageing and a second melt processing step, while the other recycling process included an accelerated ageing, a demanding washing process and a second melt processing step. The intrinsic viscosity measurements indicate that both recycling processes produce a degradation in PLA, which is more pronounced in the sample subjected to the washing process. DSC results suggest an increase in the mobility of the polymer chains in the recycled materials; however the degree of crystallinity of PLA seems unchanged. The optical, mechanical and gas barrier properties of PLA do not seem to be largely affected by the degradation suffered during the different recycling processes. These results suggest that, despite the degradation of PLA, the impact of the different simulated mechanical recycling processes on the final properties is limited. Thus, the potential use of recycled PLA in packaging applications is not jeopardized.
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Affiliation(s)
- F R Beltrán
- Dpto. Ingeniería Química Industrial y Medio Ambiente, Grupo "Polímeros, Caracterización y Aplicaciones", Universidad Politécnica de Madrid, E.T.S.I. Industriales, Madrid, 28006, Spain
| | - V Lorenzo
- Dpto. Ingeniería Química Industrial y Medio Ambiente, Grupo "Polímeros, Caracterización y Aplicaciones", Universidad Politécnica de Madrid, E.T.S.I. Industriales, Madrid, 28006, Spain
| | - J Acosta
- Dpto. Mecánica, Química y Diseño Industrial, Universidad Politécnica de Madrid, E.T.S.I. Diseño Industrial, Madrid, 28012, Spain
| | - M U de la Orden
- Dpto. Ingeniería Química Industrial y Medio Ambiente, Grupo "Polímeros, Caracterización y Aplicaciones", Universidad Politécnica de Madrid, E.T.S.I. Industriales, Madrid, 28006, Spain
| | - J Martínez Urreaga
- Dpto. Ingeniería Química Industrial y Medio Ambiente, Grupo "Polímeros, Caracterización y Aplicaciones", Universidad Politécnica de Madrid, E.T.S.I. Industriales, Madrid, 28006, Spain.
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Ortega C, García I, Irgang R, Fajardo R, Tapia-Cammas D, Acosta J, Avendaño-Herrera R. First identification and characterization of Streptococcus iniae obtained from tilapia (Oreochromis aureus) farmed in Mexico. J Fish Dis 2018; 41:773-782. [PMID: 29315698 DOI: 10.1111/jfd.12775] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 11/20/2017] [Accepted: 11/29/2017] [Indexed: 06/07/2023]
Abstract
This is the first study to isolate, identify and characterize Streptococcus iniae as the causative disease agent in two tilapia (Oreochromis aureus) populations. The populations were geographically isolated, of distinct origins, and did not share water sources. Affected fish showed various external (e.g., exophthalmia and cachexia, among others) and internal (e.g., granulomatous septicaemia and interstitial nephritis, among others) signs. All internal organ samples produced pure cultures, two of which (one from each farm, termed S-1 and S-2) were subjected to biochemical, PCR and 16S rRNA sequencing (99.5% similarity) analyses, confirming S. iniae identification. The two isolates presented genetic homogeneity regardless of technique (i.e., RAPD, REP-PCR and ERIC-PCR analyses). Pathogenic potentials were assessed through intraperitoneal injection challenges in rainbow trout (Oncorhynchus mykiss) and zebrafish (Danio rerio). Rainbow trout mortalities were respectively 40% and 70% at 104 and 106 CFU per fish with the S-1 isolate, while 100% mortality rates were recorded in zebrafish at 102 and 104 CFU per fish with the S-2 isolate. The obtained data clearly indicate a relationship between intensified aquaculture activities in Mexico and new disease appearances. Future studies should establish clinical significances for the tilapia industry.
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Affiliation(s)
- C Ortega
- Centro de Investigación y Estudios Avanzados en Salud Animal (CIESA), Facultad de Medicina Veterinaria y Zootecnia (FMVZ), Universidad Autónoma del Estado de México (UAEM), Toluca, México
| | - I García
- Centro de Investigación y Estudios Avanzados en Salud Animal (CIESA), Facultad de Medicina Veterinaria y Zootecnia (FMVZ), Universidad Autónoma del Estado de México (UAEM), Toluca, México
| | - R Irgang
- Universidad Andrés Bello, Laboratorio de Patología de Organismos Acuáticos y Biotecnología Acuícola, Facultad de Ciencias Biológicas, Viña del Mar, Chile
- Centro FONDAP, Interdisciplinary Center for Aquaculture Research (INCAR), Concepción, Chile
| | - R Fajardo
- Centro de Investigación y Estudios Avanzados en Salud Animal (CIESA), Facultad de Medicina Veterinaria y Zootecnia (FMVZ), Universidad Autónoma del Estado de México (UAEM), Toluca, México
| | - D Tapia-Cammas
- Universidad Andrés Bello, Laboratorio de Patología de Organismos Acuáticos y Biotecnología Acuícola, Facultad de Ciencias Biológicas, Viña del Mar, Chile
- Centro FONDAP, Interdisciplinary Center for Aquaculture Research (INCAR), Concepción, Chile
| | - J Acosta
- Centro de Investigación y Estudios Avanzados en Salud Animal (CIESA), Facultad de Medicina Veterinaria y Zootecnia (FMVZ), Universidad Autónoma del Estado de México (UAEM), Toluca, México
| | - R Avendaño-Herrera
- Universidad Andrés Bello, Laboratorio de Patología de Organismos Acuáticos y Biotecnología Acuícola, Facultad de Ciencias Biológicas, Viña del Mar, Chile
- Centro FONDAP, Interdisciplinary Center for Aquaculture Research (INCAR), Concepción, Chile
- Centro de Investigación Marina Quintay (CIMARQ), Universidad Andrés Bello, Quintay, Chile
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Alcaine A, Soto-Iglesias D, Acosta J, Korshunov V, Penela D, Andreu D, Fernandez-Armenta J, Laguna P, Martinez JP, Camara O, Berruezo A. P780Clinical evaluation of an automatic activation mapping algorithm for identifying the site of origin of idiopathic ventricular arrhythmias. Europace 2018. [DOI: 10.1093/europace/euy015.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Alcaine
- University of Zaragoza, BSICoS Group, Aragon Institute of Engineering Research, IIS Aragón, Zaragoza, Spain
| | - D Soto-Iglesias
- Hospital Clínic, Arrhythmia Section, Cardiology Department, Thorax Institute, Barcelona, Spain
| | - J Acosta
- Hospital Clínic, Arrhythmia Section, Cardiology Department, Thorax Institute, Barcelona, Spain
| | - V Korshunov
- Hospital Clínic, Arrhythmia Section, Cardiology Department, Thorax Institute, Barcelona, Spain
| | - D Penela
- Hospital Clínic, Arrhythmia Section, Cardiology Department, Thorax Institute, Barcelona, Spain
| | - D Andreu
- Hospital Clínic, Arrhythmia Section, Cardiology Department, Thorax Institute, Barcelona, Spain
| | - J Fernandez-Armenta
- Hospital Clínic, Arrhythmia Section, Cardiology Department, Thorax Institute, Barcelona, Spain
| | - P Laguna
- University of Zaragoza, BSICoS Group, Aragon Institute of Engineering Research, IIS Aragón, Zaragoza, Spain
| | - J P Martinez
- University of Zaragoza, BSICoS Group, Aragon Institute of Engineering Research, IIS Aragón, Zaragoza, Spain
| | - O Camara
- University Pompeu Fabra, PhySense Group, Departament of Information and Communication Technologies, Barcelona, Spain
| | - A Berruezo
- Hospital Clínic, Arrhythmia Section, Cardiology Department, Thorax Institute, Barcelona, Spain
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Corona-Guerrero JC, Arana E, Frutos-Lopez M, Acosta J, Jimenez-Baena E, Verseci N, Jauregui B, Pedrote A. P812Should we use cardiac resyncronization theraphy-pacemaker more frequently? Europace 2018. [DOI: 10.1093/europace/euy015.416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - E Arana
- Virgen del Rocio University Hospital, Seville, Spain
| | | | - J Acosta
- Virgen del Rocio University Hospital, Seville, Spain
| | | | - N Verseci
- Virgen del Rocio University Hospital, Seville, Spain
| | - B Jauregui
- Virgen del Rocio University Hospital, Seville, Spain
| | - A Pedrote
- Virgen del Rocio University Hospital, Seville, Spain
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Fernandez-Armenta Pastor J, Andreu D, Acosta J, Penela D, Arbelo E, Tolosana JM, Mont L, Berruezo A. P783Accuracy of a simplified ECG graphical algorithm to identify scar-related ventricular tachycardia exit in a 17-segments AHA model. Europace 2018. [DOI: 10.1093/europace/euy015.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J Fernandez-Armenta Pastor
- University of Barcelona, Hosp. Clinic, Thorax Institute, Department of Cardiology/Arrhythmia Section, Barcelona, Spain
| | - D Andreu
- University of Barcelona, Hosp. Clinic, Thorax Institute, Department of Cardiology/Arrhythmia Section, Barcelona, Spain
| | - J Acosta
- University of Barcelona, Hosp. Clinic, Thorax Institute, Department of Cardiology/Arrhythmia Section, Barcelona, Spain
| | - D Penela
- University of Barcelona, Hosp. Clinic, Thorax Institute, Department of Cardiology/Arrhythmia Section, Barcelona, Spain
| | - E Arbelo
- University of Barcelona, Hosp. Clinic, Thorax Institute, Department of Cardiology/Arrhythmia Section, Barcelona, Spain
| | - J M Tolosana
- University of Barcelona, Hosp. Clinic, Thorax Institute, Department of Cardiology/Arrhythmia Section, Barcelona, Spain
| | - L Mont
- University of Barcelona, Hosp. Clinic, Thorax Institute, Department of Cardiology/Arrhythmia Section, Barcelona, Spain
| | - A Berruezo
- University of Barcelona, Hosp. Clinic, Thorax Institute, Department of Cardiology/Arrhythmia Section, Barcelona, Spain
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Penela D, Aguinaga L, Tercedor L, Fernandez-Armenta J, Acosta J, Ordonez A, Bisbal F, Martinez M, Soto D, Mont L, Berruezo A. P294Long-term benefit of frequent PVC ablation in patients with LV dysfunction. A multicentre prospective study. Europace 2018. [DOI: 10.1093/europace/euy015.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D Penela
- Guglielmo da Saliceto Hospital, Cardiology, Piacenza, Italy
| | - L Aguinaga
- Private Center of Cardiology, Cardiology, Tucuman, Argentina
| | - L Tercedor
- Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | - J Acosta
- Virgen del Rocio, Sevilla, Spain
| | - A Ordonez
- Hospital Universitario Joan XXIII, Tarragona, Spain
| | - F Bisbal
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M Martinez
- Hospital Clinic, Thorax Institute, Cardiology Department, Barcelona, Spain
| | - D Soto
- Hospital Clinic, Thorax Institute, Cardiology Department, Barcelona, Spain
| | - L Mont
- Hospital Clinic, Thorax Institute, Cardiology Department, Barcelona, Spain
| | - A Berruezo
- Hospital Clinic, Thorax Institute, Cardiology Department, Barcelona, Spain
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Jauregui B, Soto-Iglesias D, Efimova E, Penela D, Acosta J, Fernandez-Armenta J, Andreu D, Martinez M, Linkhart M, Borras R, Ortiz-Perez JT, Bosch X, Perea RJ, Berruezo A. 1018Scar size and border zone channel remodelling over a long-term period after an acute myocardial infarction. Europace 2018. [DOI: 10.1093/europace/euy015.567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- B Jauregui
- Hospital Clinic de Barcelona, Arrhythmia Unit, Barcelona, Spain
| | - D Soto-Iglesias
- Hospital Clinic de Barcelona, Arrhythmia Unit, Barcelona, Spain
| | - E Efimova
- Hospital Clinic de Barcelona, Arrhythmia Unit, Barcelona, Spain
| | - D Penela
- Guglielmo da Saliceto Hospital, Arrhyhtmia Unit, Piacenza, Italy
| | - J Acosta
- University Hospital of Virgen del Rocio, Arrhythmia Unit, Seville, Spain
| | | | - D Andreu
- Hospital Clinic de Barcelona, Arrhythmia Unit, Barcelona, Spain
| | - M Martinez
- Hospital Clinic de Barcelona, Arrhythmia Unit, Barcelona, Spain
| | - M Linkhart
- Hospital Clinic de Barcelona, Arrhythmia Unit, Barcelona, Spain
| | - R Borras
- Hospital Clinic de Barcelona, Arrhythmia Unit, Barcelona, Spain
| | - J T Ortiz-Perez
- Hospital Clinic de Barcelona, Arrhythmia Unit, Barcelona, Spain
| | - X Bosch
- Hospital Clinic de Barcelona, Arrhythmia Unit, Barcelona, Spain
| | - R J Perea
- Hospital Clinic de Barcelona, Arrhythmia Unit, Barcelona, Spain
| | - A Berruezo
- Hospital Clinic de Barcelona, Arrhythmia Unit, Barcelona, Spain
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Alcaine A, Soto-Iglesias D, Acosta J, Penela D, Andreu D, Fernandez-Armenta J, Laguna P, Camara O, Martinez JP, Berruezo A. P778Slow conducting channel identification from electroanatomical maps using an automatic algorithm in patients with scar-related ventricular arrhythmias. Europace 2018. [DOI: 10.1093/europace/euy015.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Alcaine
- University Pompeu Fabra, PhySense Group, Departament of Information and Communication Technologies, Barcelona, Spain
| | - D Soto-Iglesias
- Hospital Clínic, Arrhythmia Section, Cardiology Department, Thorax Institute, Barcelona, Spain
| | - J Acosta
- Hospital Clínic, Arrhythmia Section, Cardiology Department, Thorax Institute, Barcelona, Spain
| | - D Penela
- Hospital Clínic, Arrhythmia Section, Cardiology Department, Thorax Institute, Barcelona, Spain
| | - D Andreu
- Hospital Clínic, Arrhythmia Section, Cardiology Department, Thorax Institute, Barcelona, Spain
| | - J Fernandez-Armenta
- Hospital Clínic, Arrhythmia Section, Cardiology Department, Thorax Institute, Barcelona, Spain
| | - P Laguna
- University of Zaragoza, BSICoS Group, Aragon Institute of Engineering Research, IIS Aragón, Zaragoza, Spain
| | - O Camara
- University Pompeu Fabra, PhySense Group, Departament of Information and Communication Technologies, Barcelona, Spain
| | - J P Martinez
- University of Zaragoza, BSICoS Group, Aragon Institute of Engineering Research, IIS Aragón, Zaragoza, Spain
| | - A Berruezo
- Hospital Clínic, Arrhythmia Section, Cardiology Department, Thorax Institute, Barcelona, Spain
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Linhart M, Crespo C, Acosta J, Martinez M, Mira A, Restovic G, Sagarra J, Fahn B, Boltyenkov A, Lasalvia L, Sampietro Colom L, Berruezo A. P913Optimization of cardiac resynchronization therapy device selection guided by cardiac magnetic resonance imaging is cost-effective. Europace 2018. [DOI: 10.1093/europace/euy015.514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Linhart
- Universitat de Barcelona, Institut Clínic Cardiovascular. Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)., Barcelona, Spain
| | - C Crespo
- University of Barcelona, Barcelona, Spain
| | - J Acosta
- Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - M Martinez
- Hospital Clinic de Barcelona, Barcelona, Spain
| | - A Mira
- Institute of Biomedical Research August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - G Restovic
- University of Barcelona, Barcelona, Spain
| | - J Sagarra
- Hospital Clinic de Barcelona, Barcelona, Spain
| | - B Fahn
- Siemens Healthcare, Erlangen, Germany
| | | | - L Lasalvia
- Siemens Healthcare, Tarrytown, United States of America
| | | | - A Berruezo
- Hospital Clinic de Barcelona, Barcelona, Spain
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Penela D, Fernandez-Armenta J, Aguinaga L, Tercedor L, Bisbal F, Ordonez A, Acosta J, Hindricks G, Mont L, Berruezo A. P787Clinical recognition of pure premature ventricular complex-induced cardiomyopathy at presentation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fernandez-Armenta Pastor J, Soto-Iglesias D, Bisbal F, Acosta J, Penela D, Fernandez M, Cabrera M, Vassanelli F, Martinez M, Villuendas R, Cano L, Mont L, Berruezo A. P790Mortality after substrate-guided ablation in patients with structural heart disease. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Soto-Iglesias D, Acosta J, Cabrera M, Martinez M, Linhart M, Penela D, Fernandez-Armenta J, Ortiz J, Mont L, Camara O, Berruezo A. P1116Image-based criteria to identify the presence of epicardial arrhythmic substrate in patients with transmural myocardial infarction. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Moreno-Acosta P, Vallard A, Carrillo S, Gamboa O, Romero-Rojas A, Molano M, Acosta J, Mayorga D, Rancoule C, Garcia MA, Cotes Mestre M, Magné N. Biomarkers of resistance to radiation therapy: a prospective study in cervical carcinoma. Radiat Oncol 2017; 12:120. [PMID: 28716107 PMCID: PMC5514482 DOI: 10.1186/s13014-017-0856-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 07/12/2017] [Indexed: 12/19/2022] Open
Abstract
Background Clinical parameters and proteins have recently been suggested as possible causes of radiotherapy (RT) resistance in cervical carcinoma (CC). The objective of the present study was to validate prognostic biomarkers of radiation resistance. Methods The present prospective study included patients undergoing RT with curative intent for histologically proven locally advanced squamous cell CC. Tissues and blood samples were systematically collected before RT initiation. Immuno-histochemistry was performed (IGF-IR α and β, GAPDH, HIF-1 alpha, Survivin, GLUT1, CAIX, hTERT and HKII). Response to radiation was assessed through tumour response 3 months after RT completion, through overall survival (OS) and through progression-free survival (PFS). Results One hundred forty nine patients with a mean age of 46 years were included, with FIGO IIB (n = 53) and FIGO IIIB (n = 96) CCs. 61 patients were treated with exclusive RT + brachytherapy and 88 underwent chemo-radiotherapy + brachytherapy. Our findings suggest an association between hemoglobin level (Hb) (>11 g/dL) and 3 months complete response (p = 0.02). Hb level < 11 g/dL was associated with decreased PFS (p = 0.05) and OS (p = 0.08). Overexpression of IGF-1R β was correlated with a decreased OS (p = 0.007). Overexpression of GLUT1 was marginally correlated with reduced OS (p = 0.05). PFS and OS were significantly improved in patients undergoing chemoradiation versus exclusive radiotherapy (PFS: p = 0.04; OS: p = 0.01). Conclusions IGF-1R β overexpression and Hb level (≤11 g/dl) were associated with poor prognosis, and thus appear to be possible interesting biomarkers of radiation resistance. Our results corroborate previous pre-clinical studies suggesting IGF-1R and hypoxia to be part of the biological pathways leading to radio-resistance.
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Affiliation(s)
- P Moreno-Acosta
- Research Group in Radiobiology Clinical, Molecular and Cellular, National Cancer Institute, Bogotá, Colombia.,Research Group in Cancer Biology, National Cancer Institute, Bogotá, Colombia
| | - A Vallard
- Department of Radiation Oncology, Institut de cancérologie de la Loire-Lucien Neuwirth, 108 bis, Avenue Albert Raimond, BP 60008, 42271, Saint-Priest en Jarez, France.
| | - S Carrillo
- Research Group in Radiobiology Clinical, Molecular and Cellular, National Cancer Institute, Bogotá, Colombia
| | - O Gamboa
- Research Group in Cancer Biology, National Cancer Institute, Bogotá, Colombia.,Unit of Analysis, National Cancer Institute, Bogotá, Colombia
| | - A Romero-Rojas
- Group of Pathology Oncology, National Cancer Institute, Bogotá, Colombia
| | - M Molano
- Microbiology and Infection Diseases, The Royal Women's Hospital, Melbourne, Australia
| | - J Acosta
- Pathology Group, National University of Colombia, Bogotá, Colombia
| | - D Mayorga
- Research Group in Cancer Biology, National Cancer Institute, Bogotá, Colombia
| | - C Rancoule
- Department of Radiation Oncology, Institut de cancérologie de la Loire-Lucien Neuwirth, 108 bis, Avenue Albert Raimond, BP 60008, 42271, Saint-Priest en Jarez, France
| | - M A Garcia
- Department of Radiation Oncology, Institut de cancérologie de la Loire-Lucien Neuwirth, 108 bis, Avenue Albert Raimond, BP 60008, 42271, Saint-Priest en Jarez, France
| | - M Cotes Mestre
- Research Group in Cancer Biology, National Cancer Institute, Bogotá, Colombia.,Group of Radiotherapy and Medical Physical, National Cancer Institute, Bogotá, Colombia
| | - N Magné
- Department of Radiation Oncology, Institut de cancérologie de la Loire-Lucien Neuwirth, 108 bis, Avenue Albert Raimond, BP 60008, 42271, Saint-Priest en Jarez, France
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Shih R, Acosta J, Chen E, Xenakis L. RECOMMENDATIONS FOR POLICYMAKERS TO IMPROVE OLDER ADULTS’ CLIMATE CHANGE PREPAREDNESS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- R. Shih
- RAND Corporation, Arlington, Virginia
| | - J. Acosta
- RAND Corporation, Arlington, Virginia
| | - E. Chen
- RAND Corporation, Arlington, Virginia
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Fernandez-Armenta Pastor J, Soto-Iglesias D, Bisbal F, Acosta J, Penela D, Fernandez M, Vassanelli F, Martinez M, Cabrera M, Villuendas R, Cano L, Mont L, Berruezo A. P1059Survival and predictors of mortality after substrate-guided ventricular tachycardia ablation. Europace 2017. [DOI: 10.1093/ehjci/eux151.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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