New-onset atrial high-rate episodes in left bundle branch area pacing versus right ventricular pacing for patients with atrioventricular block

Background: Left bundle branch area pacing (LBBAP) demonstrated beneficial effects on clinical outcomes. Comparative data on the risk of atrial high-rate episodes (AHREs) between LBBAP and right ventricular pacing (RVP) are lacking.Aims: This study aimed to investigate whether LBBAP can reduce the risk of new-onset AHREs compared with RVP in patients with atrioventricular block (AVB).Methods: We enrolled 175 consecutive AVB patients with no history of atrial fibrillation undergoing dual-chamber pacemaker implantation (LBBAP or RVP). Propensity score matching for baseline characteristics yielded 43 matched pairs. The primary outcome was new-onset AHREs detected on a scheduled device follow-up. Changes in echocardiographic measurements were also compared between the groups.Results: New-onset AHREs occurred in 42 (24.0%) of all enrolled patients (follow-up 14.1 [7.5] months) and the incidence of new-onset AHREs in the LBBAP group was lower than in the RVP group (19.8% vs. 34.7%; P = 0.04). After propensity score matching, LBBAP still resulted in a lower incidence of new-onset AHREs (11.6% vs. 32.6%; P = 0.02), and a lower hazard ratio for new-onset AHREs compared with RVP (HR, 0.274; 95% CI, 0.113–0.692). At 1 year, LBBAP achieved preserved left ventricular ejection fraction (LVEF) (63.0 [3.2]% to 63.1 [3.1]%; P = 0.56), while RVP resulted in reduced LVEF (63.4 [4.9]% to 60.5 [7.3]%; P = 0.01]). Changes in LVEF were significantly different between the 2 groups (by 2.6% [0.2 to 5.0]%; P = 0.03).Conclusion: LBBAP demonstrated a reduced risk of new-onset AHREs compared with RVP in patients with AVB

Integrated machine learning and single-cell RNA sequencing reveal COL4A2 and CXCL6 as oxidative stress-associated biomarkers in periodontitis

BackgroundPeriodontitis, recognized as the second most prevalent oral disease globally, is strongly linked to systemic disorders like diabetes and cardiovascular diseases, highlighting the critical need for effective prevention and treatment strategies. Oxidative stress plays an important role in periodontitis pathogenesis and progression, yet their specific association remains unclear. This study aims to explore the association between oxidative stress and periodontitis pathogenesis while identifying potential diagnostic biomarkers and therapeutic targets for this condition.MethodsTranscriptomic data from gingival tissues of periodontitis patients and controls were obtained from the Gene Expression Omnibus (GEO) database. Key genes linked to oxidative stress in periodontitis were identified through a comprehensive analytical approach, including differential expression analysis, weighted gene co-expression network analysis (WGCNA), gene set enrichment analysis (GSEA), and functional enrichment analyses (GO and KEGG). Machine learning algorithms were subsequently employed to refine the selection of key genes. The relationship between oxidative stress and the expression of these key genes was validated using external datasets and a periodontitis rat model. Additionally, single-cell RNA sequencing (scRNA-seq) data were interrogated to delineate the cellular subpopulations expressing the key genes, leveraging clustering and annotation approaches.ResultsComprehensive bioinformatics analysis identified COL4A2, CYR61, and CXCL6 as key genes associated with oxidative stress in periodontitis. Among these genes, COL4A2 and CXCL6 showed elevated expression levels in the gingival tissues of periodontitis rats. Single-cell RNA-seq analysis further demonstrated that COL4A2 exhibited predominant expression within endothelial and stromal cell clusters, whereas CXCL6 was predominantly localized to epithelial cell clusters.ConclusionsThis study demonstrates a correlation between oxidative stress and the progression of periodontitis. COL4A2 and CXCL6 were identified as potential therapeutic targets for the treatment of periodontitis

Out of sight, but not out of mind: Key issues regarding seafloor macrolitter monitoring Issued by the expert community “International Seafloor Macrolitter Imaging and Quantification”

Following a number of meetings devoted to knowledge sharing, identification of key issues, and discussing the best ways to move forward, a wide international expert community is now able to provide recommendations regarding the monitoring of seafloor macrolitter through observation and imaging. As the seafloor constitutes a major sink for marine litter including plastics, it is important to acquire robust and extensive data on litter distribution, abundance, types and size ranges across marine habitats. This should be done through widely agreed, harmonised, and non-destructive methods encompassing advanced technologies. Training and capacity building are essential elements in this endeavour. Both new and legacy imagery are needed to establish baseline assessments and trends. Informing policy-making is indispensable for effective action through upstream and targeted measures, with seafloor macrolitter (and megalitter) being a vital part of the evidence base for global mitigation measures