Search Results (211)

Background: This study aimed to evaluate the effectiveness of right and left atrial strain reservoir (RASr and LASr) in predicting the recurrence of atrial arrhythmias (AAs) following cavotricuspid isthmus ablation (CTIA) for typical atrial flutter (AFL). Methods: We retrospectively enrolled consecutive patients with AFL who had undergone CTIA. Transthoracic echocardiography was conducted within one month before the procedure, and atrial two-dimensional speckle tracking analysis was performed offline. Results: Sixty-two subjects were evaluated (mean age 64.8 ± 13.2 years, 29% females). At a median follow-up of 12.1 months, AA recurrence occurred in 21 subjects (33.8%). The study endpoint occurred mainly among females (p = 0.021) and patients with lower RASr and LASr values (both p < 0.001). In Cox regression analysis, RASr and LASr remained independent predictors of AA recurrence (p = 0.02 and p = 0.03, respectively). In ROC curve analysis, RASr and LASr showed a similar and satisfactory ability to predict AA recurrence with optimal cut-off values of 16.8% and 17.7%, respectively. In survival analysis, RASr > 16.8% and LASr > 17.7% were associated with significantly higher freedom from AAs during follow-up (log rank p = 0.001 and p = 0.002, respectively). Conclusions: The results of this study suggest that pre-CTIA atrial speckle tracking analysis may aid in identifying AFL patients at an increased risk of AA recurrence, allowing for more frequent follow-up visits and extended antiarrhythmic therapy. Full article

Addressing the challenges of Industry 4.0 in Thailand’s agri-food logistics (AFL), this study develops a structural logistics management model grounded in the Technology–Organization–Environment (TOE) framework, Resource-Based View (RBV), and Dynamic Capabilities (DC) theory. The model integrates four key constructs: standardization, operations management, smart technology, and wastage management targeting cold chain logistics (CCL) systems. Using a mixed-methods design, the study combines in-depth expert interviews with a quantitative survey of 300 logistics firms certified under the Q Cold Chain standard. Structural equation modeling (SEM) analysis confirms the robustness of the model (CMIN/DF = 1.151; GFI = 0.928; RMSEA = 0.022), supporting all five hypotheses. The findings show that standardization significantly enhances both operational performance and the adoption of digital technology, while waste reduction acts as a key mediator linking organizational processes to technological transformation. By highlighting institutional certification as a policy instrument, this research addresses existing gaps in logistics innovation literature. The results inform both theory and practice, supporting Thailand’s strategic transition toward sustainable, digitally enabled agri-logistics ecosystems. Full article

We introduce a lightweight 1D ConvNeXtV2–based neural network for the robust detection of atrial fibrillation (AFib) and atrial flutter (AFL) from single-lead ECG signals. Trained on multiple public datasets (Icentia11k, CPSC-2018/2021, LTAF, PTB-XL, PCC-2017) and evaluated on MIT-AFDB, MIT-ADB, and NST, our model attained a state-of-the-art F1-score of 0.986 on MIT-AFDB. With only 770 k parameters and 46 MFLOPs per 10 s window, the network remained computationally efficient. Guided Grad-CAM visualizations confirmed attention to clinically relevant P-wave morphology and R–R interval irregularities. This interpretable architecture is, therefore, well-suited for deployment in resource-constrained wearable or bedside monitors. Future work will extend this framework to multi-lead ECGs and a broader spectrum of arrhythmias. Full article

Background: Atypical atrial flutter (AFL) is a complex clinical challenge, particularly in patients with prior atrial fibrillation (AF) treated with pulmonary vein isolation (PVI). Arrhythmias involving the vein of Marshall (VOM) often require extensive lesion sets, including ethanol infusion, to effectively target the epicardial substrate. To minimize tissue damage, an alternative strategy has been proposed, emphasizing advanced electroanatomical mapping, entrainment maneuvers, and highly targeted ablation techniques. Case Presentation: We describe a 72-year-old woman with recurrent atrial arrhythmias following pulmonary vein isolation (PVI), who presented with palpitations as her primary symptom. After ineffective pharmacological therapy, she underwent a catheter ablation procedure. Electroanatomical mapping revealed significant left atrial scarring and suggested a macroreentrant circuit involving the VOM. Entrainment maneuvers confirmed the VOM’s involvement. A single targeted endocardial ablation guided by the ablation index terminated the arrhythmia within 12 s, without the need for ethanol infusion or extensive lesion sets. Discussion: This case underscores the VOM’s role in sustaining atypical AFL post-PVI and highlights the effectiveness of precise electroanatomical mapping combined with targeted endocardial ablation. Unlike broader ablation or ethanol infusion strategies, a focused lesion at the critical isthmus achieved arrhythmia termination with minimal tissue damage. Conclusions: Endocardial ablation at the site of entrainment can safely and effectively treat VOM-related AFL, offering symptom relief and restoration of sinus rhythm. This approach may reduce procedural risks and expand the feasibility of VOM-related arrhythmia management in centers without access to ethanol infusion. Full article

Internet of Things (IoT) devices are frequent targets of cyber attacks, and firmware emulation is essential for enabling automated techniques like fuzzing to uncover vulnerabilities. However, the growing use of encryption in firmware poses significant challenges for building accurate emulated environments. To overcome this, we present EncryptAFL, the first IoT fuzzer specifically tailored for devices with encrypted firmware. In contrast to existing methods that primarily focus on peripheral emulation, EncryptAFL places greater emphasis on automating the decryption process. We evaluate EncryptAFL using real-world firmware and known vulnerabilities, demonstrating its effectiveness in both emulation and vulnerability detection. Full article

Due to the independent, identically distributed (non-IID) nature of IoT device data, the traditional federated learning (FL) procedure, where IoT devices train the deep model in parallel, suffers from a degradation in learning accuracy. To mitigate this problem, a sequential FL procedure has been proposed, in which IoT devices train the deep model in a serialized manner via a parameter server. However, this approach experiences a longer convergence time due to the lack of parallelism. In this paper, we propose an adaptive FL procedure selection (AFLS) scheme that selects an appropriate FL scheme, either the traditional or the sequential FL procedures, based on the degree of non-IID among IoT devices to achieve both the required learning accuracy and low convergence time. To further reduce the convergence time of the sequential FL procedure, we also introduce a device-to-device (D2D)-based sequential FL procedure. The evaluation results demonstrate that AFLS can reduce convergence time by up to $16\%$ compared to the sequential FL procedure and improve learning accuracy by up to 6∼26% compared to the traditional FL procedure. Full article

Background/Objectives: Systemic lupus erythematosus (SLE) is an autoimmune disease associated with an increased prevalence of cardiac and cerebrovascular events. Despite advancements in management, no validated tools exist that can predict the risk of ischemic stroke in SLE patients. However, several studies have demonstrated an association between a higher CHA₂DS₂-VASc score and an enhanced risk of ischemic stroke in autoimmune diseases without atrial fibrillation (AF) or atrial flutter (AFL). Recently, the European Society of Cardiology suggested the use of a revised score of CHA₂DS₂-VASc without taking sex into account (CHA₂DS₂-VA). Therefore, we sought to check if the new CHA₂DS₂-VA score might predict stroke or other cardiovascular events in SLE patients without AF/AFL. Patients and Methods: We retrospectively analyzed the records of patients with SLE treated at the University Hospital in Kraków, Poland, from 2012 to 2022. Patients with a history of AF/AFL were excluded. Results: This study enrolled 787 SLE patients without AF/AFL (aged 49 (38–60) years) with a predominance of women (n = 705, 89.58%). Common comorbidities included arterial hypertension (n = 376, 47.78%) and hypercholesterolemia (n = 345, 43.84%). Most non-AF/AFL SLE patients had 0–1 points in the CHA₂DS₂-VA score (n = 514, 65.31%). Overall, ischemic stroke occurred in 47 cases during a median follow-up of 8 (4–17) years regarding time from the SLE diagnosis to the stroke, with the incidence rising from 0% (n = 0/297) to 28% (n = 14/50) as the CHA₂DS₂-VA score increased from 0 to ≥5 points. No ischemic strokes or other thromboembolic events occurred among the 575 (73.06%) patients with a CHA₂DS₂-VA score of 0–2 points. In the whole cohort, patients with ≥3 points in the CHA₂DS₂-VA score (n = 212, 26.94%) were older at the last visit, had longer disease duration, were more commonly of the male sex, and were diagnosed more frequently with ischemic stroke or other thromboembolic events in their medical history (p < 0.05, for all) compared to those with 0–2 points (n = 575, 73.06%). However, in multivariable logistic regression, among the CHA₂DS₂-VA components, only older age (≥50 years) was related to the increased risk of thromboembolic complications (OR = 2.09, 95% CI: 1.36–3.22). Other determining factors included the presence of lupus anticoagulant (OR = 3.39, 95% CI: 2.20–5.27) and neurological SLE symptoms (OR = 2.19, 95% CI: 1.19–4.02). Interestingly, male sex (OR = 0.34, 95% CI: 0.22–0.52) and general SLE symptoms (OR = 0.43, 95% CI: 0.28–0.67) were associated with a decreased risk of thromboembolic events in this model (p = 0.034, for the model). Conclusions: SLE-related factors seem important for the onset of thromboembolic episodes. However, a higher CHA₂DS₂-VA score may also help to identify SLE patients with an increased risk of cardiovascular events, including stroke. Prospective studies with a long-term analysis need to be validated using the CHA₂DS₂-VA score to predict stroke risk in SLE patients. Full article

Hamstring strain injuries (HSIs) are the most common time loss injury sustained in male Australian Football League (AFL) athletes, causing significant financial cost, time cost, and impaired team and individual performance. In a squad of 42 players, HSIs accounted for 4.86 new injuries sustained by players per club per AFL season in 2020. This is consistent with injury reporting over the last decade in AFL, despite best efforts to reduce the rate. This scoping review sought to firstly identify the reported hamstring injury prevention risk factors in elite AFL, discern the impact of these factors, and map the gaps in the current literature using a biopsychosocial understanding of injury prevention. The scoping review process was based on the Askey and O’Malley framework. Five relevant online databases (MEDLINE, Proquest, CINAHL, SPORTdiscuss, and EMBASE) were systematically searched using a series of Boolean and operator terms following the PRISMA-ScR protocol using the criteria: (1) assessing male professional/elite athletes in AFL; (2) written in English and peer-reviewed; (3) full text available; and (4) published after 2006. Only manuscripts that fit the search terms and inclusion criteria were retained in the scoping review. Following an initial search, 246 potential studies were identified, with 12 studies meeting the inclusion criteria after full-text screening. The risk factors examined were subclassified into modifiable and non-modifiable categories. Modifiable factors include high-speed running exposure, gluteus medius activation, eccentric hamstring strength, shorter bicep femoris fascicle length, use of interchange, and hamstring stiffness. Non-modifiable factors include previous history of HSI and limb injury, age, and size of injury on MRI. This scoping review highlights the need for continued monitoring of high-speed running volumes as rapid increases in completed distances present as a substantial risk factor. The modifiable mechanistic risk factors of eccentric hamstring strength and hamstring stiffness were identified as important components of player screening to reduce the risk of future HSI. Risk factors identified throughout will help develop comprehensive injury profiling for athletes. Further research is warranted to develop a holistic approach to injury profiling. Full article

The compiler serves as a bridge connecting hardware architecture and application software, converting source code into executable files and optimizing code. Fuzz testing is an automated testing technology that evaluates software reliability by providing a large amount of random or mutated input data to the target system to trigger abnormal program behavior. When existing fuzz testing methods are applied to compiler testing, although they can detect common errors like lexical and syntax errors, there are issues such as insufficient pertinence in constructing the input corpus, limited support for structured Intermediate Representation (IR) node manipulation, and limited perfection of the mutation strategy. This study proposes a deep fuzz testing framework named BoostPolyGlot for GCC compiler frontend IR generation, which effectively covers the code-execution paths and improves the code-coverage rate through constructing an input corpus, employing translation by a master–slave IR translator, conducting operations on structured program characteristic IR nodes, and implementing an IR mutation strategy with dynamic weight adjustment. This study evaluates the fuzz testing capabilities of BoostPolyGlot based on dependency relationships, loop structures, and their synergistic effect. The experimental outcomes confirm that, when measured against five crucial performance indicators including total paths, count coverage, favored paths rate, new edges on rate, and level, BoostPolyGlot demonstrated statistically significant improvements compared with American Fuzzy Lop (AFL) and PolyGlot. These findings validate the effectiveness and practicality of the proposed framework. Full article

The author reviewed and classified maintenance reports that cited smoke, odor, or fumes (SOFs) that US airlines sent to the FAA over four years between 2018 and 2023. The US fleet composition was also calculated to put the number of SOF reports on each aircraft type in perspective. “Fume events” (engine oil or hydraulic fluid) were the most common type of onboard SOFs reported by US airlines (43%), followed by electrical (20%), and fans (6.1%). During these years, A320fam aircraft made up 20% of the US fleet but 80% of the reported fume events. Conversely, B737fam aircraft made up 27% of the US fleet but only 3.0% of the reported fume events. Aircraft design features, airline reporting practices, and maintenance procedures that may contribute to these differences were reviewed. Pilots were most likely to document a fume event during descent (47%) and takeoff/climb (19%). The A320fam, MD80fam, A330, and ERJ140-145 aircraft were over-represented in other types of SOFs reports. Airline narratives show that the APU can be the primary source of oil/hydraulic fumes, even when it is not operating. Additionally, failure to find the source of fumes, rectify it, and clean any secondary sources of fumes can cause repeat events. Full article

Background: Atrial flutter (AFL) is a macro-reentrant tachycardia classified as cavotricuspid isthmus (CTI)-dependent or non-CTI-dependent based on its reliance on the CTI for conduction. CTI dependence can present as type I ECG (sawtooth flutter waves in inferior leads and positive P-waves in V1) or type II ECG (absence of these characteristics). This study aimed to identify clinical and electrophysiological parameters to improve CTI dependence prediction in AFL. Methods: Patients at the Ulm University Heart Center between 2010 and 2019 with AFL undergoing electrophysiological studies and ablation were enrolled. Clinical and electrophysiological parameters such as age, gender, prior comorbidities, interventions, and medication use were analyzed. Results: The study included 383 patients, with 70% presenting with type I ECG AFL. CTI dependence was observed in 242 (90.3%) type I ECG patients and 52 (45.2%) type II ECG patients. CTI-dependent AFL patients were younger and had fewer comorbidities. Predictors for CTI dependence in type I ECG included male gender (p = 0.006), absence of beta-blocker use (p = 0.031), no prior atrial fibrillation (p = 0.035), and no prior pulmonary vein isolation (p < 0.001). In type II ECG, predictors for CTI dependence included younger age (p = 0.016), male gender (p = 0.007), absence of arterial hypertension (p = 0.036), and longer atrial cycle length (p < 0.001). Conclusions: Identifying clinical and electrophysiological parameters enhances the ability to predict CTI dependence in AFL, offering valuable insights for tailored diagnostic and therapeutic approaches. Coupling these parameters with ECG findings holds promise for refining prediction accuracy and optimizing patient care. Full article

The presence of mycotoxins in cheese is a significant concern due to their potential health risks. Mycotoxins can contaminate cheese through two main routes: indirectly via contaminated animal feed, and/or directly, because of mold growth on dairy products. It has been reported that cheese may contain metabolites of aflatoxin B1 such as aflatoxin M1 (AFM1), aflatoxicol (AFL), and, its precursor, sterigmatocystin (STC). This study presents a reliable method for the simultaneous determination of AFM1, AFL, and STC in cheeses made from ovine, goat, or buffalo milk. The method was developed using single liquid extraction, clean-up by an immunoaffinity column (IAC), and liquid chromatography-tandem mass spectrometry (LC-MS/MS) determination. The method was subjected to initial validation according to EU regulations, which outline the required performance parameters and criteria of analytical methods for official food control. The limits of quantification (LOQs) of the method for AFM1, AFL, and STC are 2.0 ng/kg, 5.0 ng/kg, and 1.0 ng/kg, respectively. The method was applied in a study for the assessment of mycotoxin transfer from milk to cheeses and also their growth. Full article

Background/Objectives: XTEND is the largest global, prospective, observational study of treatment-naïve patients with neovascular age-related macular degeneration (nAMD) receiving 2 mg of intravitreal aflibercept (IVT-AFL) in routine clinical practice designed to examine the real-world effectiveness of IVT-AFL proactive treatment regimens. The outcomes from the Switzerland cohort are reported here. Methods: Patients aged ≥50 years were eligible if they planned to receive IVT-AFL 2 mg. After three initial monthly IVT-AFL injections, treatment intervals could be extended (4-week minimum treatment interval). Visual and anatomic outcomes, treatment exposure, and safety were assessed. Statistics were descriptive. Results: Fifty-one patients were treated. At baseline, the mean ± standard deviation (SD) best-corrected visual acuity (BCVA) was 64.9 ± 17.9 letters, and central subfield thickness (CST) was 402 ± 106 µm. At month (M) 12 and M24, the mean (95% confidence interval [CI]) change from baseline in BCVA was +5.7 (1.9, 9.4) and +5.6 (1.3, 9.8) letters, respectively. In patients with a high baseline BCVA (≥70 letters [n = 28; mean ± SD: 77.5 ± 4.8 letters]), BCVA was maintained at ≥70 letters at M12 and M24 (mean change from baseline [range] +1.0 [−15.0, 11.0] and +1.1 [–10.0, 14.0], respectively). At M12 and M24, the mean (95% CI) change in CST was −125 (−161, −90) µm and −127 (−162, −93) µm, respectively. Patients received a mean ± SD of 9.5 ± 3.2 and 13.7 ± 6.0 injections by M12 and M24, respectively. No safety concerns were identified. Conclusions: In Swiss routine clinical practice, functional and anatomic improvements were achieved with IVT-AFL 2 mg proactive treatment in patients with nAMD over 24 months despite a relatively high baseline BCVA. Full article

Background/Objectives: To determine the relationship between plasma leptin levels and airflow limitation (AFL) in the small and medium airways of young adults according to their body composition (BC). Methods: To determine AFL, the following measurements were taken: forced expiratory volume in the first second (FEV₁), forced expiratory flow between 25–75% (FEF_25–75%), airway resistance (Raw), and specific airway resistance (sRaw). The measured BC variables were body mass index (BMI), body fat percentage (%BF), trunk fat percentage (TF%), and fat-free mass (FFM). Plasma leptin was measured using the ELISA technique. Results: In total, 83 participants (40 male and 43 female) aged 21.55 ± 2.08 years were evaluated. Leptin was significantly higher in women than men (p < 0.01). When relating leptin to lung function variables, FEV₁ and FEF25–75% showed a significant inverse relationship (p < 0.01), and Raw and sRaw showed a direct and significant relationship (p < 0.01). Female participants with a BF% and leptin higher than their p75 were observed to have a higher risk of increased sRaw (OR = 1.0; OR = 1.15, respectively), regardless of age, and participants with an FFM% higher than their p75 had a lower risk of increased sRaw (OR = 0.71), regardless of gender and age. Conclusions: There is an inverse relationship between FEV₁, FEF_25–75%, and a direct relationship between Raw and sRaw with leptin. For female participants with a higher BF%, higher FFM%, and leptin, the risk of developing Raw and sRaw was found to be modified. Full article

In the context of pollution-free waste treatment, anaerobic fermentation liquid (AFL), a prominent by-product of biogas engineering, has emerged as a focal point in contemporary research. Concurrently, vitamin C, an active compound abundant in fruits and vegetables, possesses extensive application potential. The development of efficient extraction processes and the utilization of its biological activities have garnered significant attention from researchers. This study investigated the impact of AFL on the growth and vitamin C content of Bok choy through field trials of varying concentrations of AFL. The results indicated that the growth characteristics of Bok choy exhibited a concentration-dependent trend with increasing AFL dosage, with the highest yield observed in the AFL-2 group (8.43 kg/m²). Additionally, with the increase in the concentration of the AFL application, the vitamin C content in Bok choy exhibited a trend of initially increasing and then decreasing, reaching its highest value (70.83 mg/100 g) in the AFL-1 group. Furthermore, response surface methodology was employed to optimize the microwave-assisted organic solvent extraction process of vitamin C, revealing that the optimal conditions for microwave-assisted extraction using a 2% citric acid solution were as follows: a microwave power of 313 W, a microwave time of 1.3 min, and a liquid-to-solid ratio of 16.4:1 v/w, achieving a vitamin C extraction rate of 90.77%. Subsequent mechanistic studies on colitis repair demonstrated that the combination of vitamin C and allicin significantly enhanced the ability of intestinal microorganisms to ferment and degrade complex carbohydrates in colitis-afflicted mice, thereby alleviating intestinal inflammation, markedly reducing bacterial invasion signals on intestinal epithelial cells, and decreasing the risk of intestinal infection. This study provides a valuable perspective for the harmless utilization of agricultural waste, and provides a theoretical basis and technical support for the high-value utilization of natural active ingredients. Full article