Cardiac Monitoring Research Articles

Late gadolinium enhancement in mid infero-septal area after left bundle branch area pacing in the setting of bifascicular block and syncope: a case report

Abstract Background Conduction system pacing (CSP), which includes His bundle pacing (HBP) and left bundle branch area pacing (LBBAP), is becoming increasingly common in clinical practice. HBP, introduced over two decades ago, continues to see growing use, while LBBAP is gaining traction due to its broader target area and shorter procedure times. However, complications such as septal perforation and lead-related issues may still arise. This case report explores the evaluation and management of recurrent syncope in the context of bifascicular block (BFB), highlighting the importance of thorough assessment, continuous ECG monitoring, and the potential need for permanent pacemaker implantation. Case summary A 60-year-old woman with a history of myocardial infarction, type II diabetes, and dyslipidemia presented with recurrent syncope and BFB, for which a LBBAP device was implanted in August 2023. In February 2024, she was admitted again due to recurrent syncope and frequent premature ventricular contractions. Cardiac MRI revealed two localized myocardial scars: one at the basal anterior wall from the 2018 ischemic event, and another in the mid infero-septal wall at the site of the LBBAP lead. During her hospital stay, she experienced multiple episodes of near-fainting due to orthostatic hypotension, indicative of underlying autonomic neuropathy. Discussion This narrative explores the evolving landscape of cardiac pacing techniques, with a focus on LBBAP, highlighting its advantages over traditional methods while also acknowledging potential complications. Additionally, it emphasizes the importance of a comprehensive workup for syncope and the need for tailored interventions that extend beyond pacemaker implantation.

An anonymized, de-identified registry study protocol to determine the effectiveness and safety of weight loss with enavogliflozin in patients with type 2 diabetes mellitus.

Sodium-glucose co-transporter 2 inhibitors, such as enavogliflozin, offer promising metabolic benefits for patients with type 2 diabetes (T2D), including glycemic control and improved cardiac function. Despite the clinical evidence, real-world evidence is needed to validate their safety and effectiveness. This study aims to evaluate the effects of weight loss and safety of enavogliflozin administration in patients with T2D in a real-world clinical setting over 24 weeks. This is a large-scale, prospective, multicenter, non-interventional observational study and will be conducted in 12 primary care centers nationwide between 2024 and 2026. Data will be collected at baseline, 12 weeks, and 24 weeks in a real-world clinical setting, including demographic details, clinical history, lifestyle habits, medication use, and various health indicators. Eligible participants are adults aged 19 to 80 with T2D and a body mass index (BMI) of ≥23 kg/m2 who are currently receiving treatment with Envlo (enavogliflozin) or Envlomet (enavogliflozin/metformin) tablets or planning to start treatment. The primary outcome is the change in BMI and body weight at 24 weeks from baseline. Secondary outcomes evaluated are changes in BMI and weight at 12 weeks, the proportion of participants achieving significant reductions in BMI and weight at 12 and 24 weeks, and body composition and glycemic improvements at 12 and 24 weeks. The study will analyze shifts in lipid profiles, liver and kidney functions, and body composition at 12 and 24 weeks as exploratory outcomes. For safety outcomes, the trial will prioritize the monitoring of adverse drug reactions and specific events of interest such as hypoglycemia, urinary tract infections, genital infections, polyuria, and polydipsia. This study design enables us to evaluate the effectiveness and safety of enavogliflozin for weight loss in a real-world setting while exploring its potential positive effects on cardiac function and metabolic risk factors in overweight or obese patients with T2D.

P0648 The Safety and Effects of a Dual-Strain Probiotic Versus Placebo on Fatigue in Patients with Ulcerative Colitis

Abstract Background Ulcerative colitis (UC) is a form of inflammatory bowel disease (IBD) characterised by chronic mucosal inflammation of the colon. Patients with IBD may have higher fatigue scores compared to non-IBD controls [1] with up to 41% reporting fatigue as a debilitating symptom [2]. Previous clinical trials have demonstrated anti-inflammatory properties of Bifidobacterium longum 35624® in people with UC [3], and increased energy/vitality with Bifidobacterium longum 1714® in a healthy population [4]. However, studies of this dual combination of strains have not been conducted in people with IBD. Methods This single-centre, randomised, double-blind, placebo-controlled trial investigated the safety, tolerance and effect on fatigue of 12-weeks’ intervention with a dual-strain probiotic containing B. longum strains 35624 and 1714 (probiotic) versus an identical placebo. Fatigue (IBD Fatigue Self-Assessment Scale Section II; IBD-F-II), fecal calprotectin and plasma C-reactive protein (CRP) values were measured at baseline and 12 weeks. Safety and tolerance were measured with by monitoring of adverse events throughout the study period. Results 59 participants completed the study (probiotic n=30; placebo n=29)(Table 1). There was a statistically significant reduction in IBD-F-II scores at 12 weeks compared to baseline in both the probiotic (p=0.0003) and placebo (p<0.0001) groups, with no significant difference between groups (p=0.398)(Table 2). There were no significant changes in calprotectin or CRP from baseline to week 12 in the probiotic (p=0.80 and p=0.27) or placebo (p=0.76 and p=0.47) groups. No adverse events were thought to be related to the intervention. Conclusion The findings of this study showed statistically significant improvements in fatigue scores in individuals with UC following 12 weeks of probiotic and placebo intervention respectively, which may be suggestive of a high placebo response in the UC population. Contrary to previous clinical findings showing improvements to plasma CRP with B. longum 35624 in people with UC [3], significant changes in inflammatory markers were not observed in the present study. This study also provides evidence to show that a combination of B. longum 35624 and 1714 was safe and well-tolerated by UC patients. Additional analysis investigating the effect of the probiotic intervention on the gut microbiome is warranted. Further studies conducted in a larger sample are required to better understand the placebo response in the UC population.

Evaluation of the safety profile of amivantamab based on real-world evidence: a call to vigilance

ABSTRACT Background Amivantamab has been approved for EGFR exon 20 insertion-mutated non-small-cell lung cancer. The aim of this study was to perform an in-depth analysis of its safety profile. Research design and methods Safety reports were collected from the database of the Food and Drug Administration Adverse Event Reporting System from April 2021 to September 2023, and the reporting odds ratio (ROR) method was used to detect potential safety signals. Mobocertinib, an agent with similar properties to amivantamab, served as a control for comparison. Results A total of 88 safety signals were detected, most of which were novel. In comparison with mobocertinib, amivantamab appeared to cause more injury, poisoning, and procedural complications (ROR = 15.54, 95% CI 10.25–23.58); respiratory, thoracic, and mediastinal disorders (ROR = 1.92, 95% CI 1.57–2.34); infections and infestations (ROR = 1.39, 95% CI 1.09–1.76); blood and lymphatic system disorders (ROR = 9.57, 95% CI 6.17–14.84); and immune system disorders (ROR = 6.41, 95% CI 3.14–13.12). Moreover, amivantamab was associated with higher risks of thrombosis events, bone marrow suppression, skin and soft tissue infection, deterioration of respiratory symptoms, and noninfectious pneumonitis. Conclusion The safety profile of amivantamab requires attention; particularly, monitoring of the adverse drug events described above is necessary during its administration.

Excessive Supraventricular Ectopic Activity in Patients With Acute Ischemic Stroke Is Associated With Atrial Fibrillation Detection Within 24 Months After Stroke: A Predefined Analysis of the MonDAFIS Study.

Excessive supraventricular ectopic activity (ESVEA) is regarded as a risk marker for later atrial fibrillation (AF) detection. The investigator-initiated, prospective, open, multicenter MonDAFIS (Impact of Standardized Monitoring for Detection of Atrial Fibrillation in Ischemic Stroke) study randomized 3465 patients with acute ischemic stroke without known AF 1:1 to usual diagnostic procedures for AF detection or additive Holter monitoring in hospital for up to 7 days, analyzed in a core laboratory. Secondary study objectives include the comparison of recurrent stroke, myocardial infarction, major bleeding, and all-cause death within 24 months in patients with ESVEA (defined as ectopic supraventricular beats ≥480/day or atrial runs of 10-29 seconds or both) versus patients with newly diagnosed AF versus patients without ESVEA or AF (non-ESVEA/AF), randomized to the intervention group. Overall, 1435 (84.8%) of 1714 patients randomized to the intervention group had analyzable study ECG monitoring of at least 48 hours' duration within the first 72 hours of monitoring. ESVEA was detected in 363 (25.3%) patients, while AF was first detected in 48 (3.3%) patients. Within 24 months, AF was newly detected in 67 (18.5%) patients with ESVEA versus 60 (5.9%) patients without ESVEA/AF- (P<0.001). The composite outcome at 24 months was not different between patients with ESVEA and patients without ESVEA/AF (15.2% versus 12.6%; P=0.242). All-cause death was numerically higher in patients with ESVEA (6.6% versus 3.2%), but failed statistical significance (P=0.433) in multivariate analysis (including age, heart failure, stroke severity, and creatinine at baseline). ESVEA in the acute phase of ischemic stroke or transient ischemic attack is associated with AF detection during follow-up and therefore may be used to select patients for prolonged ECG monitoring. URL: https://www.clinicaltrials.gov; Unique identifier: NCT02204267.

Mobile/wearable digital devices for care of active cancer patients: a survey from the ESC Council of Cardio-Oncology

Abstract Aims The Council of Cardio-Oncology of the European Society of Cardiology developed an on-line anonymous survey to provide an overall picture of the current practice on the use of mobile and wearable digital devices in cardio-oncology and the potential barriers to their large-scale applicability. Methods and results Between June 2023 and January 2024, an online anonymous questionnaire was completed by 220 healthcare professionals from 55 countries. The greatest number of respondents reported that mobile/wearable digital devices have a role in all active cancer patients for measuring heart rate (33.9%), blood pressure (34.4%), body temperature (32.0%), physical activity (42.4%), and sleep (31.2%). In the setting of atrial fibrillation detection, respondents were evenly split between applying these technologies in all patients (33.0%) or only in selected patients (33.0%). Regarding QTc interval monitoring, 30.6% reported that mobile/wearable digital devices play a role only in selected patients. The decision to use the device was taken by the patient in 56.6% of cases and the physician in 43.4%. The most important barrier reported to mobile/wearable device implementation in the setting of cardiac rhythm monitoring and QTc measurement was their cost (weighted average: 3.38 and 3.39, respectively). Conclusion Mobile/wearable digital devices are considered to play an important role in different settings of cardio-oncology, including monitoring of patients’ parameters and arrhythmia detection. Their role in monitoring physical activity and QTc interval appears more nuanced. The most important perceived barrier to mobile/wearable digital device implementation is considered their high cost.

An exploratory study on the effect of rescuer team size on basic and advanced life support technical skills in a high-fidelity simulation of canine cardiopulmonary arrest.

To evaluate the effect of rescuer team size on objective skill measures of basic life support (BLS) and advanced life support (ALS) using high-fidelity canine CPR simulation. Prospective, experimental study. Veterinary clinical simulation center. Forty-eight Reassessment Campaign on Veterinary Resuscitation CPR-certified veterinary students. Five groups of participants each conducted 3 CPR simulations in configurations of 4, 6, and 8 rescuers. Simulations represented a shock patient declining into asystole, followed by ventricular fibrillation and return of spontaneous circulation. Resuscitation efforts were video-recorded to evaluate BLS and ALS tasks. Mean (±SD) was derived and data were compared among team sizes using ANOVA and Tukey's post hoc analysis. Significance was set at P<0.05. Among teams of 4, 6, and 8 rescuers, time to first chest compression (13s [±6], 9s [±2], 8s [±4]; P=0.24) and positive-pressure breath (101s [±37], 56s [±15], 67s [±24]; P=0.05) were not significantly different. Chest compression (100/min [±5], 108/min [±6], 107/min [±6]; P=0.12) and ventilatory rates (9/min [±1], respectively, P=0.52) were not significantly different. Time without chest compressions/total length of CPR was not significantly different (72s [±16], 61s [±16], 54s [±8]; P=0.15). Capnography and ECG monitoring were used by all teams. Time to first vasopressor administration was significantly different among team sizes (268s [±70], 164s [±65], 174s [±34]; P=0.04), with vasopressors being most quickly administered by teams of 6 rescuers. Time to electrical defibrillation was not significantly different (486s [±45], 424s [±22], 488s [±181]; P=0.57). Incorrect ALS interventions occurred in 60%, 0%, and 40% of CPR events in 4, 6, and 8 rescuer teams, respectively. Although the achievement of BLS tasks was comparable in teams of 4 rescuers, teams of 6 rescuers may be preferable based on differences in the rate of guideline-incompliant treatments and ALS task efficiency. Teams of 8 rescuers were neither more efficient nor more accurate at conducting BLS and ALS tasks.

The Safety Profile of Amiodarone Among Older Adults (age ≥ 75 years): A Pharmacovigilance Study from the FDA Data.

Amiodarone is a widely used antiarrhythmic agent with significant toxicities and drug interactions more likely to affect older adults. Nevertheless, data regarding amiodarone safety in this population are limited. We conducted a retrospective analysis of FDA Adverse Event Reporting System (FAERS) data from 2003 to 2024 . Reports with amiodarone as the primary suspect were compared to other antiarrhythmics (sotalol, dronedarone, flecainide, propafenone, dofetilide). Disproportionality analysis assessed reporting odds ratios (RORs) for predefined adverse events in adults (<75 years) and older adults (≥75 years). Interaction analysis evaluated differences between age groups. Among 9,196 amiodarone FAERS reports, 4,129 (44.9%) involved older adults. Hyperthyroidism (ROR 39.1, 95% CI [25-61] and ROR of 23.4 [11-49.8]) and hypothyroidism (ROR 36.9 [15.2-89.8] and ROR 24.5 [11.5-52.1]) were substantially over-reported in amiodarone users among both adults and older adults, respectively. Drug-induced liver injury and peripheral neuropathy were also over-reported without a significant age interaction. Interstitial lung disease was reported more frequently in amiodarone users overall, with significantly higher reporting in older adults (ROR 11.4 [6.9-18.6] vs. 4.9 [3.4-7.0], Pinteraction=0.007). Bradycardia was also over-reported in older adults compared to adults (ROR 1.6 [1.3-2] vs. 1.0 [0.8-1.3], Pinteraction=0.003). Torsades de Pointes/QT prolongation were less frequently reported in both age groups. In this global postmarketing study, interstitial lung disease and bradycardia were more frequently reported in older adults treated with amiodarone. These findings support vigilant monitoring for these adverse events, particularly in older patients.

Relationship of maternal ophthalmic artery Doppler with uterine artery Doppler, hemodynamic indices and gestational age: prospective MATERA study.

To examine the relationship of ophthalmic artery (OA) Doppler indices with uterine artery (UtA) Doppler indices, selected maternal hemodynamic parameters and gestational age, and to evaluate the intraobserver reproducibility of OA Doppler indices. This was a prospective cohort study of women recruited between 11 + 0 and 23 + 6 weeks' gestation using a stratified and random sampling approach to ensure adequate distribution across the gestational-age range. OA pulsatility index (PI), first peak systolic velocity (PSV1), second peak systolic velocity (PSV2) and peak systolic velocity ratio (PSV ratio), calculated as PSV2/PSV1, were measured twice in each eye by the same observer. UtA-PI was also measured twice on each side by the same observer. Maternal hemodynamic assessment was undertaken using an ultrasonic cardiac output monitor (USCOM 1A). Pearson's and Spearman's rank correlation coefficients were used to assess the correlations between variables, and Bland-Altman plots were used to evaluate the intraobserver reproducibility of OA Doppler indices. Of 194 women invited to participate in the study, 169 were eligible for inclusion, of whom 16 were excluded following an obstetric ultrasound scan and a further three owing to inadequate or incomplete OA or UtA Doppler assessment, leaving 150 women in the final analysis. Log UtA-PI had a weak correlation with both OA-PI (r = -0.19 (95% CI, -0.34 to -0.03), P = 0.021) and OA-PSV ratio (r = 0.31 (95% CI, 0.15-0.45), P < 0.001). The correlation between gestational age and OA-PI was non-significant (r = 0.14 (95% CI, -0.03 to 0.29), P = 0.097), and that between gestational age and OA-PSV ratio was weak (r = -0.23 (95% CI, -0.38 to -0.07), P = 0.004), as opposed to the strong correlation between gestational age and UtA-PI (r = -0.68 (95% CI, -0.76 to -0.58), P < 0.001). No strong correlations were observed between OA-PI or OA-PSV ratio and maternal hemodynamic indices. The correlations were unaltered by adjustment for maternal age and body mass index. The intraobserver reproducibility of OA-PI and OA-PSV ratio in the same eye was high. The correlation between the right and left eyes was moderate for OA-PI (r = 0.63 (95% CI, 0.53-0.72), P < 0.001) and strong for OA-PSV ratio (r = 0.81 (95% CI, 0.75-0.86), P < 0.001). OA-PI and OA-PSV ratio had a weak or no correlation with UtA-PI and maternal hemodynamic parameters, meaning that they can be used as independent predictors for pre-eclampsia. Gestational age had no clinically relevant effect on OA-PI and OA-PSV ratio, suggesting that these indices could be measured without adjustment at any time between 11 and 23 weeks' gestation. OA Doppler indices had high intraobserver reproducibility and were strongly correlated between the right and left eyes. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

A real-world Pharmacovigilance study of brodalumab based on the FDA adverse event reporting system

Brodalumab, a humanized monoclonal antibody that targets the interleukin-17 receptor A, is primarily used to manage moderate-to-severe plaque psoriasis. Although it has demonstrated favorable efficacy and safety in clinical trials, the strict inclusion and exclusion criteria may not fully reflect its safety profile in real-world settings. As its use becomes more widespread in clinical practice, understanding its safety in real-world applications is crucial.This study employed disproportionality analysis to assess the safety of brodalumab by examining all adverse event reports that identified brodalumab as the primary suspected drug in the FDA Adverse Event Reporting System database since 2017. Techniques such as the Reporting Odds Ratio, Proportional Reporting Ratio, Multi-item Gamma Poisson Shrinker, and Bayesian Confidence Propagation Neural Network were utilized to analyze the adverse events associated with brodalumab. Additionally, the Weibull distribution was used to model the temporal risk of adverse events.The study identified several adverse reactions already listed on the drug’s label that showed positive signals, including arthralgia, headache, myalgia, suicidal ideation, oropharyngeal pain, injection site mass, and infections. Additionally, we found potential adverse reactions not noted on the drug’s label that exhibited positive signals, including depression, increased blood pressure, peripheral swelling, gait disturbance, inability to walk, stress, myocardial infarction, sepsis, uveitis, nephrolithiasis, and interstitial lung disease. Moreover, this analysis highlighted the critical need for vigilant monitoring of adverse events, especially during the first month following the initiation of treatment.This study provides initial insights into the real-world safety of brodalumab, confirming known adverse reactions and uncovering additional potential risks. The results deliver vital information that can assist clinicians in making informed decisions when prescribing brodalumab for psoriasis treatment.

Association of glucagon-like peptide-1 receptor agonists with acute pancreatitis and biliary disease in individuals with diabetes and obesity: a propensity-weighted, population-based cohort study.

To evaluate the risk of acute pancreatitis and biliary disease in patients treated with glucagon-like peptide-1 receptor agonists (GLP-1 RA). Population-based, propensity-weighted, new user, active comparator design study including patients with diabetes and obesity initiating treatment with GLP-1 RA or the comparator group sodium-glucose cotransporter 2 inhibitors (SGLT-2i) in the region of Valencia from 2015 to 2021. In adjusted, per protocol main analysis, no risk differences were found for acute pancreatitis (HR: 0.56; 95%CI: 0.17-1.91) nor for biliary disease (HR: 1.12; IC95%: 0.79, 1.58). Secondary analyses yielded similar results. Despite we did not observe increased risk of gastrointestinal events in GLP-1 RA vs SGLT-2i patients, adherence to approved indications and close monitoring of potential adverse events are warranted to ensure patient safety.

A novel wearable device integrating ECG and PCG for cardiac health monitoring

The alarming prevalence and mortality rates associated with cardiovascular diseases have emphasized the urgency for innovative detection solutions. Traditional methods, often costly, bulky, and prone to subjectivity, fall short of meeting the need for daily monitoring. Digital and portable wearable monitoring devices have emerged as a promising research frontier. This study introduces a wearable system that integrates electrocardiogram (ECG) and phonocardiogram (PCG) detection. By ingeniously pairing a contact-type PZT heart sound sensing structure with ECG electrodes, the system achieves the acquisition of high-quality ECG and PCG signals. Notably, the signal-to-noise ratios (SNR) for ECG and PCG signals were measured at 44.13 dB and 30.04 dB, respectively, demonstrating the system’s remarkable stability across varying conditions. These collected signals were subsequently utilized to derive crucial feature values, including electromechanical delay (EMD), left ventricular ejection time (LVET), and pre-ejection period (PEP). Furthermore, we collected a dataset comprising 40 cases of ECG and PCG signals, enabling a comparative analysis of these three feature parameters between healthy individuals and coronary heart disease patients. This research endeavor presents a significant step forward in the realm of early, non-invasive, and intelligent monitoring of cardiovascular diseases, offering hope for earlier detection and more effective management of these life-threatening conditions.

Vialess heterogeneous skin patch for multimodal monitoring and stimulation

System-level wearable electronics require to be flexible to ensure conformal contact with the skin, but they also need to integrate rigid and bulky functional components to achieve system-level functionality. As one of integration methods, folding integration offers simplified processing and enhanced functionality through rigid-soft region separation, but so far, it has mainly been applied to modality of electrical sensing and stimulation. This paper introduces a vialess heterogeneous skin patch with multi modalities that separates the soft region and strain-robust region through folded structure. Our system includes electrical and optical modalities for hemodynamic and cardiovascular monitoring, and a force-electrically driven micropump for drug delivery. Each modality is demonstrated through on-demand drug delivery, flexible waveguide-based PPG monitoring, and ECG and body movement monitoring. Wireless data transmission and real-time measurement validate the feedback operation for multi-modalities. This engineered closed-loop platform offers the possibility for broad applications, including cardiovascular monitoring and chronic disease management.

&lt;b&gt;Machine Learning Enabled In-Home ECG: A Review&lt;/b&gt;

Machine learning (ML)-based in-home electrocardiogram (ECG) systems have emerged as transformative tools, advancing beyond traditional cardiology methods by offering innovative techniques for cardiac care. These systems enable sustained data collection, real-time monitoring of cardiac status, and individualized treatment plans, all while minimizing the need for frequent clinic visits. By leveraging advanced analytics and ML algorithms, in-home ECG systems analyze large-scale datasets to detect patterns and anomalies that might otherwise go unnoticed, providing early alerts and improving patient outcomes. This review examines the latest trends in ML-enhanced in-home ECG technology, emphasizing its functionality in anomaly detection, continuous monitoring, and decision-making processes. The integration of ML not only enhances diagnostic precision but also opens avenues for scalable, personalized, and remote healthcare solutions. Despite these advancements, significant challenges remain, including issues related to data privacy, algorithmic biases, and the reliability of real-world implementations. Addressing these challenges is essential for optimizing the performance and ethical use of these systems. This review also explores opportunities for future research, particularly in improving algorithm robustness and addressing biases to ensure equitable and accurate cardiac care for diverse populations. By integrating state-of-the-art ML techniques, in-home ECG systems are poised to revolutionize contemporary cardiology, reducing healthcare costs and enabling a progressive shift toward accessible, patient-centered care. This comprehensive exploration highlights the potential of ML-based in-home ECG systems to redefine cardiac monitoring and treatment, contributing to the broader transformation of modern healthcare. Received: 13 September 2024 | Revised: 11 December 2024 | Accepted: 31 December 2024 Conflicts of Interest The authors declare that they have no conflicts of interest to this work. Data Availability Statement Data sharing is not applicable to this article as no new data were created or analyzed in this study. Author Contribution Statement Aqsa Bibi: Conceptualization, Methodology, Validation, Formal analysis, Investigation, Resources, Data curation, Writing - original draft, Writing - review &amp; editing, Visualization, Project administration. Jawwad Sami Ur Rahman: Methodology, Validation, Investigation, Resources, Writing - review &amp; editing, Supervision, Project administration.

The Analysis and Discussion of Risks Related to FDA Adverse Event of Continuous Glucose Monitoring System

Adverse events are one of the important bases for the re-evaluation of the safety and efficacy of medical devices. According to MAUDE, the U.S. Food and Drug Administration's (FDA) adverse event monitoring database, the factory-calibrated, integrated continuous glucose monitoring system (iCGM) received 130088 adverse events reports during the first half of 2023, ranking the second highest among all devices. In this paper, we conduct a multi-dimensional analysis of 130088 adverse events, summarize the main risk points of CGM products, and discuss these risk points accordingly. The analysis in this article can provide a reference for manufacturers, users, and regulators to provide risk management and control of CGM products

Twitter User Geolocation Based on Location Feature Enhancement

User location discovery from social media is crucial for location-based services like emergency awareness and event monitoring. Existing approaches generally integrate user-generated text features and social relationships, but insufficiently explore location-specific features and geographically proximate relationships, leading to suboptimal accuracy. In this paper, we propose a Twitter user geolocation method based on location feature enhancement, to better capture the location characteristics in users’ tweets and social relationships. Specifically, a user tweet representation algorithm based on location feature separation (TwLS) is designed. By leveraging words’ location-aware weight matrix and pre-trained embeddings, TwLS calculates a tweet representation for each user in every location, explicitly indicating the relevance between users and various locations. Additionally, we develop the local celebrity discovery method (LocCel) to construct social networks by identifying and preserving geographically concentrated high-degree nodes while filtering noise. Thereby LocCel enhances local relationships and strengthens location-proximate connections within the user social network. Experiments on two real-world datasets show that our method outperforms seven baselines, improving user geolocation accuracy by 3.1% ∼ 8.1% and 1.8% ∼ 8.8%, while reducing median error by 22.2% ∼ 52.8% and 19.4% ∼ 50.7%, respectively.

Osimertinib induced cardiac failure and atrial flutter in a patient with advanced pulmonary adenocarcinoma: A case report and review of the literature

&lt;b&gt;Background: &lt;/b&gt;Osimertinib-induced cardiotoxicity is a significant but rare condition. This article reports a case of an elderly patient who developed cardiac failure and atrial flutter due to Osimertinib treatment, potentially related to both the drug and the patient’s underlying factors.&lt;br /&gt; &lt;b&gt;Case presentation:&lt;/b&gt; A 63-year-old man diagnosed with advanced non-small cell lung cancer (NSCLC) with bone metastasis was found to have an epidermal growth factor receptor mutation (exon 19 deletion). He had undergone four prior treatment regimens, including afatinib and bevacizumab. After two years, he developed resistance and experienced brain and bone metastases, prompting a switch to Osimertinib (80 mg/day). Before starting Osimertinib, he had a history of coronary artery disease and hypertension, with a normal electrocardiogram (ECG) and a left ventricular ejection fraction (LVEF) of 53%. However, nearly two months after initiating Osimertinib, he was presented with cardiac failure symptoms, with LVEF decreasing to &amp;lt;53% and atrial flutter observed on ECG. Suspecting drug-induced cardiotoxicity, Osimertinib was discontinued. Following cessation of the drug, his cardiac function improved, and the ECG abnormalities resolved. This case represents the first reported instance of concurrent cardiac failure and atrial flutter associated with Osimertinib treatment.&lt;br /&gt; &lt;b&gt;Conclusions: &lt;/b&gt;As Osimertinib continues to significantly enhance survival in NSCLC, there remains a need for active monitoring of cardiac adverse events in patients undergoing Osimertinib treatment. These events can be life-threatening but are usually reversible after discontinuation of the drug.

Safety and Efficacy of CT-Guided Percutaneous Cryoablation of Large Angiomyolipomas: Case Series and Review of Literature

AbstractTo evaluate the safety and clinical outcomes of percutaneous cryoablation of large renal angiomyolipomas (AMLs), three patients with large predominantly fat-containing AMLs measuring over 4 cm were treated with cryoablation. Two patients underwent cryoablation alone and one patient underwent selective arterial embolization followed by cryoablation. All patients were followed up with cross-sectional imaging. All procedures were performed safely and successfully. The first two patients had no side effects or complications. The third patient developed tachycardia following the procedure that required additional cardiac monitoring and resolved without difficulty. The follow-up imaging demonstrated reduction in size of the AMLs in all three patients. CT-guided percutaneous cryoablation is a minimally invasive, viable, and safe treatment option for large AMLs without a significant vascular component while improving the patient's clinical outcomes.

Thunderstorm asthma: current status and perspectives

Thunderstorm asthma refers to the acute exacerbation of asthma triggered by extreme weather events, which poses life-threatening risks due to severe asthma attacks and strained medical resources. Recent climate changes, including global warming, the greenhouse effect, and increased carbon emissions, have increased the levels of environmental allergens, contributing to a higher incidence of asthma and other allergic diseases. In addition, the increasing frequency of thunderstorms has exacerbated the impact of thunderstorm asthma. There is an urgent need to establish prevention and control mechanisms, promote interdepartmental collaboration, and implement real-time monitoring of extreme weather events and allergen concentrations. Developing early warning systems and integrating medical services with public health departments for timely information sharing and coordinated responses can help reduce the incidence of thunderstorm asthma and reduce mortality.

Bioinspired Tunable Helical Fiber-Shaped Strain Sensor with Sensing Controllability for the Rehabilitation of Hemiplegic Patients.

Fiber-based strain sensors, as wearable integrated devices, have shown substantial promise in health monitoring. However, current sensors suffer from limited tunability in sensing performance, constraining their adaptability to diverse human motions. Drawing inspiration from the structure of the spiranthes sinensis, this study introduces a unique textile wrapping technique to coil flexible silver (Ag) yarn around the surface of multifilament elastic polyurethane (PU), thereby constructing a helical structure fiber-based strain sensor. The synergistic interaction between the elastic PU core and the outer helical Ag yarn enhances the mechanical strength and stretchability of the sensor, while the external helical Ag yarn offers high conductivity. By adjusting the spacing of Ag yarn coils on the surface of the fiber-based sensor, we achieve precise control over both sensing sensitivity and strain range. Specifically, experimental results show that with a pitch of 1.25 mm, the strain range reaches up to 150%, and the gauge factor (GF) is 2.6; when the pitch is adjusted to 5 mm, within a 60% strain range, the GF value significantly increases to 9.3. Based on these excellent performance metrics, we further apply the sensor as a conductor in ECG monitoring garments, successfully verifying its practicality in cardiac monitoring. Additionally, we developed a smart glove for hand function rehabilitation training, utilizing wireless signal transmission to promote hand function recovery in hemiplegic patients. The sensor is also capable of effectively monitoring respiratory rate and pulse, showing broad prospects in the fields of rehabilitation medicine and smart healthcare.