Energy Delivery Research Articles

Endoscopic-Ultrasound-Guided Radiofrequency Ablation for Pancreatic Tumors

Endoscopic ultrasound (EUS)-guided radiofrequency ablation (RFA) is a promising minimally invasive technique for the treatment of pancreatic lesions. This review first focuses on the technical aspects in EUS-RFA: the procedure typically employs EUS probes with integrated radiofrequency electrodes, enabling accurate targeting and ablation of pancreatic lesions. Different types of RFA devices, monopolar and bipolar energy delivery systems, are discussed, along with considerations for optimal ablation, including energy settings, procedure time, and pre- and post-procedural management. This paper presents a comprehensive literature review of EUS-RFA applied to both solid and cystic pancreatic lesions, including functioning and non-functioning pancreatic neuroendocrine tumors (pNETs), pancreatic cystic lesions (PCLs), pancreatic ductal adenocarcinoma (PDAC), and pancreatic metastases (PMs), discussing current evidence on safety, efficacy, clinical outcomes, and adverse events (AEs). EUS-RFA is an emerging technique with expanding potential for the treatment of both benign and malignant conditions; however, further studies are needed to better define patient selection criteria, assess long-term benefits, and establish definitive indications for its use.

ENHANCING VOLTAGE STABILITY AND ENERGY OUTPUT OF PLTM SALIDO IN THE PLN DISTRIBUTION NETWORK

Distributed generation (DG) integration in PLN’s extended distribution network often encounters voltage instability issues due to high voltage drops. These challenges restrict power delivery and can lead to disconnection, particularly during peak load conditions. This study investigates methods to enhance voltage stability and optimize the energy output of PLTM Salido. Using ETAP Power Station software, various operational schemes were simulated to address the problem of low terminal voltage. The study focused on the impact of reactive power injection and governor settings optimization to maintain generator performance under high demand. Results indicate that reactive power injection significantly improves terminal voltage, ensuring continuous power delivery. Adding a third generator unit further increased energy supply capacity, leveraging the full potential of available hydropower. The optimized operation of PLTM Salido with two generators increased daily energy output by 32.2%, while introducing a third generator boosted energy delivery by 107%. This research highlights the critical role of reactive power management and system configuration in enhancing the performance of small-scale hydropower plants in rural distribution networks.

The impact of a tailored nutrition intervention delivered for the duration of hospitalisation on daily energy delivery for patients with critical illness (INTENT): a phase II randomised controlled trial

BackgroundNutrition interventions commenced in ICU and continued through to hospital discharge have not been definitively tested in critical care to date. To commence a program of research, we aimed to determine if a tailored nutrition intervention delivered for the duration of hospitalisation delivers more energy than usual care to patients initially admitted to the Intensive Care Unit (ICU).MethodsA multicentre, unblinded, parallel-group, phase II trial was conducted in twenty-two hospitals in Australia and New Zealand. Adult patients, requiring invasive mechanical ventilation (MV) for 72–120 h within ICU, and receiving < 80% estimated energy requirements from enteral nutrition (EN) were included. The intervention (tailored nutrition) commenced in ICU and included EN and supplemental parenteral nutrition (PN), and EN, PN, and/or oral nutrition after liberation from MV, and was continued until hospital discharge or study day 28. The primary outcome was daily energy delivery from nutrition (kcal). Secondary outcomes included duration of hospital stay, ventilator free days at day 28 and total blood stream infection rate.Main resultsThe modified intention to treat analysis included 237 patients (n = 119 intervention and n = 118 usual care). Baseline characteristics were balanced; the median [interquartile range] intervention period was 19 [14–35] and 19 [13–32] days in the tailored nutrition and usual care groups respectively. Energy delivery was 1796 ± 31 kcal/day (tailored nutrition) versus 1482 ± 32 kcal/day (usual care)—adjusted mean difference 271 kcal/day, 95% CI 189–354 kcal. No differences were observed in any secondary outcomes.ConclusionsA tailored nutrition intervention commenced in the ICU and continued until hospital discharge achieved a significant increase in energy delivery over the duration of hospitalisation for patients initially admitted to the ICU.Trial registration ClinicalTrials.gov Identifier NCT03292237. First registered 25th September 2017. Last updated 10th Feb 2023.

Multiobjective energy management of multi-source offshore parks assisted with hybrid battery and hydrogen/fuel-cell energy storage systems

With the recent advancements in the development of hybrid offshore parks and the expected large-scale implementation of them in the near future, it becomes paramount to investigate proper energy management strategies to improve the integrability of these parks into the power systems. This paper addresses a multiobjective energy management approach using a hybrid energy storage system comprising batteries and hydrogen/fuel-cell systems applied to multi-source wind-wave and wind-solar offshore parks to maximize the delivered energy while minimizing the variations of the power output. To find the solution of the optimization problem defined for energy management, a strategy is proposed based on the examination of a set of weighting factors to form the Pareto front while the problem associated with each of them is assessed in a mixed-integer linear programming framework. Subsequently, fuzzy decision making is applied to select the final solution among the ones existing in the Pareto front. The studies are implemented in different locations considering scenarios for electrical system limitation and the place of the storage units. According to the results, applying the proposed multiobjective framework successfully addresses the enhancement of energy delivery and the decrease in power output fluctuations in the hybrid offshore parks across all scenarios of electrical system limitation and combinational storage locations. Based on the results, in addition to the increase in delivered energy, a decrease in power variations by around 40 % up to over 80 % is observed in the studied cases.

Creation of a distributed energy system for the production of thermal and electric energy

The object of the study is the distributed generation (DG) system for remote areas where extending power lines is challenging or impossible. The study demonstrates how integrating electrical and thermal energy modules based on renewable energy sources (RES) into a common DG bus can ensure continuous energy supply. This approach provides both heat and electricity to consumers, independent of weather conditions an advantage over traditional systems reliant on variable sources like wind and solar energy. Numerical assessments suggest that the proposed system can improve local renewable resource utilization by approximately 20–30 % compared to single-source renewable setups. This enhanced efficiency results in a more stable power output, with fewer interruptions caused by low wind speeds or reduced solar irradiance. Economically, reducing dependence on diesel generators by about 15–25 % can translate into substantial fuel cost savings. In addition, shifting energy production away from non-renewable sources may cut greenhouse gas emissions by an estimated 10–20 %, contributing to environmental protection targets. In this research received lies in its solution for off-grid energy delivery in rural areas, which generally rely on expensive and frequently unreliable centralized energy infrastructure. By leveraging renewable energy sources and implementing a cogenerative DG system, the study significantly reduces reliance on traditional energy grids and enhances energy independence for remote facilities. The research highlights the practical value of the proposed solution, particularly for rural areas far from power lines and with limited access to traditional electricity systems. The suggested system not only provides continuous energy, but it also coincides with worldwide trends toward sustainable and decentralized energy solutions

Advances in Metal Chalcogenides and Metal Oxides Supercapacitors: A Comprehensive Review of Fundamental Mechanisms and Recent Progress

The rising worldwide demand for energy storage devices has driven significant advancements in studies regarding supercapacitor (SC), particularly in the context of renewable green energy systems and electronics. SCs have come up as a critical technology, providing ultra-fast charging, long lifespan and high-power density when compared to conventional batteries. These attributes make SCs ideal for applications that needs surging energy delivery, such as electric vehicles and grid energy storage systems. Lately wide range of research has been focused on enhancing the energy density through the development of advanced evolved materials and device architectures. This review article discusses recent advancements in SC, particularly in electrode materials, such as transition metal oxides (e.g., RuO2, MnO2, V2O5) and metal chalcogenides (e.g., MoS2), which exhibit high surface area, great electrical conductivity, and mechanical stability. These materials, alongside carbon-based materials like graphene and conducting polymers, have demonstrated significant improvements in charge storage capacity and energy transfer efficiency. Hybrid materials containing metal oxides with carbon-based contents have shown great promise in enhancing both energy and power densities. The review also discusses recent trends in electrolytes, including ionic liquids, aqueous solutions, and solid-state electrolytes, which have played significant role in improving SC performance by widening the voltage window and enhancing stability. Despite these technological advancements, challenges such as cost-effective material production and scalability remain barriers to widespread commercialization. The customization of SCs into hybrid energy storage systems alongside batteries and fuel cells presents a promising avenue for future development. This review article pins down the importance of ongoing research to overcome these challenges while fully realizing the potential of SCs in the evolving energy landscape.

Higher Versus Lower Protein Delivery in Critically Ill Patients: A Systematic Review and Bayesian Meta-Analysis.

Recent multicenter trials suggest that higher protein delivery may result in worse outcomes in critically ill patients, but uncertainty remains. An updated Bayesian meta-analysis of recent evidence was conducted to estimate the probabilities of beneficial and harmful treatment effects. An updated systematic search was performed in three databases until September 4, 2024. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and the protocol was preregistered in PROSPERO (CRD42024546387). Randomized controlled trials that studied adult critically ill patients comparing protein doses delivered enterally and/or parenterally with similar energy delivery between groups were included. Data extraction was performed by two authors independently, using a predefined worksheet. The primary outcome was mortality. Posterior probabilities of any benefit (relative risk [RR] < 1.00) or harm (RR > 1.00) and other important beneficial and harmful effect size thresholds were estimated. Risk of bias assessment was performed using the risk of bias 2.0 tool. All analyses were performed using a Bayesian hierarchical random-effects models, under vague priors. Twenty-two randomized trials (n = 4164 patients) were included. The mean protein delivery in the higher and lower protein groups was 1.5 ± 0.6 vs. 0.9 ± 0.4 g/kg/d. The median RR for mortality was 1.01 (95% credible interval, 0.84-1.16). The posterior probability of any mortality benefit from higher protein delivery was 43.6%, while the probability of any harm was 56.4%. The probabilities of a 1% (RR < 0.99) and 5% (RR < 0.95) mortality reduction by higher protein delivery were 38.7% and 22.9%, respectively. Conversely, the probabilities of a 1% (RR > 1.01) and 5% (RR > 1.05) mortality increase were 51.5% and 32.4%, respectively. There is a considerable probability of an increased mortality risk with higher protein delivery in critically ill patients, although a clinically beneficial effect cannot be completely eliminated based on the current data.

Design, Analysis, and Testing of a Type V Composite Pressure Vessel for Hydrogen Storage.

Hydrogen, as a zero-emission fuel, produces only water when used in fuel cells, making it a vital contributor to reducing greenhouse gas emissions across industries like transportation, energy, and manufacturing. Efficient hydrogen storage requires lightweight, high-strength vessels capable of withstanding high pressures to ensure the safe and reliable delivery of clean energy for various applications. Type V composite pressure vessels (CPVs) have emerged as a preferred solution due to their superior properties, thus this study aims to predict the performance of a Type V CPV by developing its numerical model and calculating numerical burst pressure (NBP). For the validation of the numerical model, a Hydraulic Burst Pressure test is conducted to determine the experimental burst pressure (EBP). The comparative study between NBP and EBP shows that the numerical model provides an accurate prediction of the vessel's performance under pressure, including the identification of failure locations. These findings highlight the potential of the numerical model to streamline the development process, reduce costs, and accelerate the production of CPVs that are manufactured by prepreg hand layup process (PHLP), using carbon fiber/epoxy resin prepreg material.

Nutrition provision over time in longer stay critically ill patients: A post hoc analysis of The Augmented vs Routine Approach to Giving Energy Trial.

Limited literature exists on nutrition practices for long-stay patients in the intensive care unit (ICU). We aimed to compare nutrition practices in the first and second weeks of an ICU admission. A post hoc exploratory analysis of The Augmented vs Routine Approach to Giving Energy Trial (TARGET) randomized controlled trial (RCT) was undertaken. Inclusion criteria were: enrolled in TARGET on day 1 or 2 of ICU admission and ICU length of stay (LOS) >14 days. Clinical characteristics are described, and nutrition delivery and management compared between days 1-7 and 8-14. Data are n (%), mean ± SD, median (interquartile range [IQR]), or mean difference (MD) and 95% confidence interval (95% CI), with P < 0.05 considered significant. Data from 664 patients were analyzed (56.2 ± 16.3 years; 61% male; body mass index 29.2 ± 7.5 kg/m2 and APACHE II 21.9 ± 8.1). When comparing days 1-7 to 8-14: (1) energy delivery was greater (all sources: 1826 ± 603 vs 1729 ± 689 (MD: 97 [95% CI: 52-140] kcal/day, P < 0.001) and nonnutrition sources: 317 ± 230 vs 192 ± 197 (MD 125 [95% CI: 111-139] kcal/day; P < 0.001); (2) protein delivery was similar (66 ± 20 vs 68 ± 24 (MD: -1.4 [95% CI: -3.2 to 0.4] g/day; P = 0.125]); and (3) fewer patients received parenteral nutrition (PN) (5% vs 9%, P < 0.001) or small intestine feeding (3% vs 8%; P < 0.001). In this post hoc analysis, patients with an ICU LOS >14 days had greater energy delivery and fewer patients received PN or small intestine feeding during days 1-7 than days 8-14. Uncertainty remains regarding whether these data reflect usual practice and the clinical implications of this.

Adaptive Clustering and Trust Aware Routing (ACTAR) for Wireless Sensor Networks in IoT Environments

ABSTRACTThe Internet of Things (IoT) has emerged as a revolutionary technology, connecting a vast number of people to the internet through various devices such as smartphones, laptops, sensors, and more. An essential component of IoT, the wireless sensor network (WSN), enables automation in processes like sensing, node monitoring, and data transmission. However, the full potential of IoT is hindered by cyber threats and unreliable communication. Although several security algorithms exist, they are not suitable for energy‐constrained sensor nodes. To address this issue, this paper proposes an energy‐efficient security mechanism called adaptive clustering and trust aware routing (ACTAR) for IoT‐WSNs. ACTAR operates in three phases: adaptive and hybrid clustering (AHC), multiobjective function‐based cluster head selection (MOCH), and trust aware routing (TAR). First, AHC utilizes a nonuniform clustering mechanism to categorize the network into nearby and distant clusters. Next, the selection of cluster heads is based on four metrics: coverage, communication cost, residual energy, and node proximity. Finally, TAR calculates the trust degree of sensor nodes by evaluating their direct and indirect behavior in terms of communication interactions and energy consumption. The node with the highest trust degree is selected as the next‐hop forwarding node, followed by the route with the highest trust degree. Extensive simulations of ACTAR demonstrate its performance in terms of malicious detection rate, false‐positive rate, residual energy, and packet delivery ratio. Comparative analysis shows that ACTAR outperforms existing methods, proving its superiority.

Повышающий Zeta-преобразователь для фотоэлектрической сетевой системы

A power electronic converter known as a Zeta-converter is widely utilized in various applications, including renewable energy systems, power supply, and electric vehicles. Despite its advantages in photovoltaic source conversion, such as single-stage power conversion and power factor adjustment, conventional Zeta- converters face limitations in efficiency and adaptability due to their narrow working range and additional circuitry. To address these challenges, this research proposes an enhanced high step-up Zeta-converter architecture tailored for grid-connected PV systems. The suggested converter offers exceptional power factor adjustment and can handle a broad range of input voltages, ensuring optimal performance even under varying environmental conditions. By actively aligning the input current with the input voltage, the converter achieves a power factor close to unity, minimizing harmonic content and enhancing system efficiency. Additionally, interleaved operation reduces switching noise and voltage spikes, leading to decreased electromagnetic interference emissions. This makes the proposed converter highly suitable for grid-connected PV systems, where reliable power conversion and high-quality energy delivery are paramount. The versatility of the converter makes it applicable not only to PV systems but also to other scenarios requiring a greater output voltage than input voltage, such as LED drivers or certain DC-DC conversion applications.

New York State Climate Impacts Assessment Chapter 06: Energy.

Energy plays an integral role in New Yorkers' lives. It powers the economy, moves people and goods, keeps homes and workplaces at a livable temperature, and runs critical infrastructure that keeps people healthy and safe. Reliable energy systems are easy to take for granted, but many aspects of these systems are vulnerable to weather and climate hazards. This chapter discusses how climate change is affecting and will increasingly affect New York State's energy supply, delivery, and end uses. It provides insights into current and future climate vulnerabilities as New York's energy system transitions to clean energy sources. This assessment also highlights opportunities to adapt current and future energy systems and to build resilience to climate impacts.

Dietetic-led interventions in critically ill adults that influence outcome: A scoping review.

Critically ill patients face malnutrition risks, making nutrition management challenging. Dietitians play a crucial role in the intensive care unit (ICU) by applying their expertise to address these challenges. This review examines dietitian-led interventions and their impact on patient outcomes. A scoping review of MEDLINE, Embase, CINAHL, EBSCO, Web of Science, and ProQuest databases from January 1995 to July 2023 was conducted. Studies involving dietitian-led interventions in adult critical care were included. Data extraction followed Joanna Briggs Institute methodology, focusing on study design, population, and interventions. Of 751 studies, 39 met the inclusion criteria. Most studies were observational, with only three interventional trials. Dietitian-led interventions included (1) guideline development and implementation, (2) individualized nutrition treatment, and (3) enteral nutrition tube insertion. Outcomes were classified into (1) patient clinical outcomes (ICU stay duration, mechanical ventilation, infections, cost savings, readmissions, mortality, adverse effects, and glycemic control) and (2) nutrition-related outcomes (nutrition initiation, energy and protein delivery, gastrointestinal tolerance, parenteral nutrition use, and appropriate dietetic referral). Dietitian-led interventions improved nutrition outcomes and may have contributed to better clinical outcomes. Future research should prioritize reporting core outcomes, including nutrition status and physical function, to further quantify the effectiveness of dietitians in ICU care and enhance their recognition within the multiprofessional team.

Impact of Power and Time in Hepatic Microwave Ablation: Effect of Different Energy Delivery Schemes.

Microwave ablation often involves the use of continuous energy-delivery protocols with a fixed power and time. To achieve larger ablation zones, a range of protocols and power levels have been studied in experimental studies. The objective of the present study was to develop and experimentally evaluate the performance of a coupled computational electromagnetic-bioheat transfer model of 2.45 GHz microwave ablation under a variety of continuous and pulsed power delivery schemes. The main aim was to obtain an in-depth knowledge of the influence of energy delivery settings on ablation zone profiles and thermal damage in the peri-ablation zone. In addition to the theoretical model, we evaluated the power delivery schemes using ex vivo experiments and compared them to previously published data from in vivo experiments. The results showed slight differences in terms of the ablation zone size for different power delivery schemes under ex vivo conditions, with the applied energy level being the most important factor that determines ablation zone size; however, under in vivo conditions, applying a high-power pulse prior to and following a longer constant power application (BOOKEND 95 W protocol) presented the most favorable ablation zones. Moreover, the modeling and experimental studies identified threshold applied power and ablation times beyond which increases did not yield substantive increases in ablation zone extents.

Nutritional therapy among adult patients with severe burns: A retrospective observational study.

The objective of this study was to examine the effects of nutritional therapy in adult patients with severe burns. Sixty adult patients with severe burns were enrolled. Data on nutritional intake through enteral nutrition (EN) or parenteral nutrition (PN) on days 7, 14, 21, and 28 post-injury were collected. Patients were divided into target and non-target groups according to whether their energy or protein intake reached the target. Age, length of ventilation, and total bilirubin (TBIL), albumin (ALB), prealbumin (pALB), and C-reactive protein (CRP) concentrations of patients were recorded. The percentage of protein targets with protein delivery was lower than that of energy target with energy delivery. The ratio of PN protein to total protein was lower than that of PN energy to total energy on days 7, 14, 21, and 28 (p<0.001, p<0.001, p=0.001, and p=0.003, respectively). Compared to the non-target group on day 21, the target group was younger, had lower TBIL on day 7, higher ALB and pALB on day 21, and lower CRP on day 14 (p=0.025, p=0.021, p=0.028, p=0.029, and p=0.049, respectively). Multivariate logistic regression analysis showed that older age and longer ventilation were independent risk factors in patients who did not meet the nutritional target on day 21 (p=0.026 and p=0.043, respectively). The protein intake of adult patients with severe burns was low. Compared to the non-target group, the target group had better laboratory test results. Older age and longer ventilation were independent risk factors for patients not meeting the nutritional target.

Effects of sex differences on energy providing capacities during short duration high-intensity exercise: focusing on changes in exercise duration.

This study aimed to examine the effects of sex differences on each energy supply (phosphagen, glycolytic, and oxidative systems) when athletes performing short-duration high-intensity exercises for different durations. Eight male and seven female college students specializing in tracks and fields participated in this experiment. They performed full-strength pedaling for the experimental exercise. The participants were asked to pedal at a load of 6.5% of their body weight (kp) for three conditions: 10, 30, and 50 s. The phosphagen system was calculated by considering the fast component of the excess post-exercise oxygen consumption after all tests. The glycolytic system was expressed as the delta value of the difference between the peak and baseline blood lactate concentrations measured during the test. The oxidative system was estimated by subtracting the baseline oxygen uptake from the area of sprint oxygen uptake. At 10 s, a significant correlation was found between the relative mean power and the phosphagen and glycolytic systems in males. At 30 s, a significant correlation was found between relative mean power and phosphagen and oxidative systems in males, and between glycolytic and oxidative systems in females. At 50 s, a significant correlation was found between relative mean power and oxidative systems in males. The results of this study indicate that the energy delivery systems supporting high performance in short-duration high-intensity exercise differ between males and females, a finding that is valuable for developing training plans.

Nutrition delivery during hospitalisation after critical illness in Australia and New Zealand: a multicentre, prospective observational study.

Energy and protein provision for critically ill patients who receive oral nutrition often falls below recommended targets. We compared characteristics and nutrition processes during hospital stay (within and post-intensive care unit [ICU] stay) of those who received oral nutrition as the sole nutrition source to those who first commenced enteral (EN) or parenteral nutrition (PN) within an Australian or New Zealand (ANZ) ICU. Multicentre, observational study of routine nutrition care in 44 hospitals across ANZ, including adult patients within ICU admitted for at least 48 h. Those receiving oral nutrition as the sole source of nutrition (with or without oral nutrition supplements) were included in the 'oral nutrition' group and those who first received EN and/or PN in the ICU as the 'EN/PN group'. The primary outcome was median daily energy delivery in ICU. Data are presented as number (%) or median [interquartile range]. Of the 409 patients enroled, median [IQR] age was 64 [51-74] years and 257 patients (62%) were male. APACHE II score, use of invasive ventilation and hospital length of stay (LOS) were all lower in those receiving oral nutrition (n = 200) compared to those receiving EN/PN (n = 209). In ICU, 63 (31.5%) and 169 (81%) (p < 0.001), patients who were receiving oral nutrition and in the EN/PN group received a nutrition assessment, respectively. Oral nutrition supplements were provided for 40 (20%) patients in the oral nutrition group and 31 of 94 (33%) of those receiving oral nutrition in the EN/PN group (p = 0.019). Energy and protein intake in ICU for the oral nutrition group was 716 [597-1069] kcal/day and 37 [19-46] g/day versus 1158 [664-1583] kcal/day and 57 [31-77] g/day for those receiving EN/PN (p = 0.020 energy, p = 0.016 protein). Quantification of oral nutrition was attempted in 78/294 (27%) patients in ICU and completed on 27/78 (36%) occasions. On the ward, attempts were made for 120/273 (44%) patients, with 60/120 (50%) complete. Patients who received oral nutrition as the sole nutrition source in ICU had lower illness severity, rates of nutrition assessment and provision of oral supplements compared to those who first received EN/PN. Quantification of oral nutrition was often incomplete for all patients in ICU and on the ward.

Comparative Analysis of Real-World Clinical Outcomes of a Novel Pulsed Field Ablation System for Pulmonary Vein Isolation: The Prospective CIRCLE-PVI Study.

Background: Pulsed field ablation (PFA) represents a novel non-thermal approach for treating atrial fibrillation (AF) through pulmonary vein isolation (PVI). By utilizing irreversible electroporation, PFA creates lesions with minimal impact on adjacent tissues. This study investigates the procedural outcomes and safety of a novel circular PFA catheter in comparison to an established PFA system in a real-world clinical setting. Methods: This prospective, single-center study enrolled 125 consecutive patients with symptomatic paroxysmal or persistent AF undergoing first-time PVI with PFA at Ulm University Heart Center. Twenty-five patients underwent PFA PVI using a novel PFA system (PulseSelectTM, Medtronic, Dublin, Ireland) which incorporates a new circular catheter design and additional features such as ECG-triggered energy application and phrenic nerve capture testing. In comparison, 100 patients were treated using the established PFA system (FarapulseTM, Boston Scientific, Marlborough, MA, USA). Results: Acute PVI was achieved in 100% of the patients. Procedure duration, total left atrial (LA) time and fluoroscopy time remained comparable between both groups. The total number of energy deliveries was higher with the novel circular PFA catheter (34.0 vs. 32.0; p < 0.001). No procedure-related complications, including pericardial tamponade, phrenic nerve injury, atrial-esophageal fistula, vascular complications, embolisms, malignant cardiac arrhythmias, or coronary spasms were observed. Conclusions: The novel and the established PFA systems demonstrated comparable results in terms of procedure duration, fluoroscopy time, and LA time. In the hands of experienced operators, the novel circular PFA system enables an effective, consistent, and safe approach to successful PFA PVI.

Submyocardial Pacing Threshold Distribution During Cold Saline Application; Exploring Reversible Arrhythmia Inhibition.

Cold saline application through an irrigation catheter may induce reversible inhibition of submyocardial excitation, which may be used to identify in advance an ideal site for radiofrequency (RF) energy delivery around delicate areas. An open irrigation catheter was positioned vertically or parallel with 10-g contact on coronary perfusing porcine hearts and the contacted myocardium was cooled by cold saline at 4°C (20mL/min). A temperature electrode was inserted 2mm below the myocardial surface (intra-myocardial temperature at approximately 2 mm below the surface [Temp-BS]). Pacing threshold inside the ventricular wall was measured using aneight-pole electrode plunge needle inserted 5-8mm close to the ablation catheter, and percent increase of the pacing threshold by the cold saline application (%increase-PT) was calculated. During cooling, pacing at 10V from the myocardial surface interrupted constant capture in 7/10 experiments in vertical and in 9/10 experiments in parallel ablation catheter contact. Minimum Temp-BS was not different in both catheter contact positions (25.9±4.0°C in vertical vs. 25.4±2.6°C in parallel). Large % increase-PT on the surface myocardium decreased as the myocardial depth became deeper, and > 150% increase was at a depth approximately 2-3mm from the surface and > 120% increase around 6-7mm from the surface. After cessation of cold saline application, the increased %increase-PT recovered to the pre-cooling values. Cold saline application through an irrigation catheter reversibly inhibited submyocardial excitation. This simple method may have the potential to pre-determine the ideal ablation site in sensitive areas of the heart, although further studies and technological adjustments are required before clinical use.

Innovations in intraoperative therapies in neurosurgical oncology: a narrative review.

High-grade gliomas (HGG) represent the most aggressive primary brain tumors in adults, characterized by high recurrence rates due to incomplete resection. This review explores the effectiveness of emerging intraoperative therapies that may extend survival by targeting residual tumor cells. The main research question addressed is: What recent intraoperative techniques show promise for complementing surgical resection in HGG treatment? A comprehensive literature review was conducted, examining recent studies on intraoperative therapeutic modalities that support surgical resection of HGG. Techniques reviewed include laser interstitial thermal therapy (LITT), intraoperative brachytherapy, photodynamic therapy (PDT), sonodynamic therapy (SDT), and focused ultrasound (FUS). Each modality was evaluated based on clinical application, evidence of effectiveness, and potential for integration into standard HGG treatment protocols. Findings indicate that these therapies offer distinct mechanisms to target residual tumor cells: LITT provides localized thermal ablation; intraoperative brachytherapy delivers sustained radiation; PDT and SDT activate cytotoxic agents in tumor cells; and FUS enables precise energy delivery. Each method has shown varying levels of clinical success, with PDT and LITT currently more widely implemented, while SDT and FUS are promising but under investigation. Intraoperative therapies hold potential to improve surgical outcomes for HGG by reducing residual tumor burden. While further clinical studies are needed to optimize these techniques, early evidence supports their potential to enhance the effectiveness of surgical resection and improve patient survival in HGG management.