A structured review of the associations between breast cancer and exposures to selected organic solvents.

Introduction: Our objective was to identify published, peer-reviewed, epidemiological studies that estimated associations between the risk of developing or dying from malignant breast cancer and past exposure to selected organic solvents with reactive metabolites, to delineate the methods used and to synthesize the results.

Content: We undertook a structured review of case-control and cohort studies used to investigate breast cancer risk and exposure to selected organic solvents that produce reactive metabolites in the body. We used SCOPUS, MEDLINE (Ovid) and Web of Science databases from 1966 to December 31, 2023 to identify epidemiological studies that estimated associations between the risk of developing or dying from malignant breast cancer and past exposure to selected organic solvents with reactive metabolites and organic solvents combined as a group.

Assessment of ventricular electrical heterogeneity in left bundle branch pacing and left ventricular septal pacing by using various electrophysiological methods.

Introduction: Left bundle branch area pacing (LBBAP) comprises pacing at the left ventricular septum (LVSP) or left bundle branch (LBBP). The aim of the present study was to investigate the differences in ventricular electrical heterogeneity between LVSP, LBBP, right ventricular pacing (RVP) and intrinsic conduction with different dyssynchrony measures using the ECG, vectorcardiograpy, ECG belt, and Ultrahigh frequency (UHF-)ECG.

Methods: Thirty-seven patients with a pacemaker indication for bradycardia or cardiac resynchronization therapy underwent LBBAP implantation.

The pharmacokinetics and pharmacodynamics of ibogaine in opioid use disorder patients.

Objective: Ibogaine is a hallucinogenic drug that may be used to treat opioid use disorder (OUD). The relationships between pharmacokinetics (PKs) of ibogaine and its metabolites and their clinical effects on side effects and opioid withdrawal severity are unknown. We aimed to study these relationships in patients with OUD undergoing detoxification supported by ibogaine.

Heat stress from current and predicted increases in temperature impairs lambing rates and birth weights in the Australian sheep flock.

Livestock heat stress threatens production, particularly in semi-arid, arid and tropical regions. Using established temperature thresholds for sheep, we modelled +1 °C and +3 °C temperature increases over the historical baseline, estimating that 2.1 million potential lambs are lost annually due to heat stress alone, increasing to 2.

The association between the incidence of postmenopausal breast cancer and occupational exposure to selected organic solvents, Montreal, Canada, 2008-2011.

Background: Breast cancer is the most diagnosed cancer among women and recognized risk factors explain 25%-47% of cases. Organic solvents are used widely in the workplace and exposure may increase the risk of developing breast cancer, yet there are insufficient data to confirm this hypothesis. We sought to determine whether past occupational exposures to selected organic solvents were associated with the incidence of invasive breast cancer in postmenopausal women in Montréal, Canada.

The association between the incidence of Lyme disease in the USA and indicators of greenness and land cover.

Lyme disease (LD) is the most common vector-borne illness in the USA. Incidence is related to specific environmental conditions such as temperature, metrics of land cover, and vertebrate species diversity. To determine whether greenness, as measured by the Normalized Difference Vegetation Index (NDVI), and other selected indices of land cover were associated with the incidence of LD in the northeastern USA for the years 2000-2018, we conducted an ecological analysis of incidence rates of LD in counties of 15 "high" incidence states and the District of Columbia for 2000-2018.

Comparison and predictors of implantable cardioverter-defibrillator therapy for primary and secondary prevention.

Background: Implantable cardioverter-defibrillators (ICDs) are effective in detecting and treating ventricular arrhythmias. Studies on ICD therapy for different indications (primary and secondary prevention) and possible predictors of ICD therapy are limited. In this study, the incidence and type of ICD therapy were related to the indication and the underlying cardiac pathology.

Atrial fibrillation-specific refinement of the STOP-Bang sleep apnoea screening questionnaire: insights from the Virtual-SAFARI study.

Background: Sleep-disordered breathing (SDB) is prevalent in up to 50% of patients referred for atrial fibrillation (AF) catheter ablation (CA). Currently, it remains unclear how to improve pre-selection for SDB screening in patients with AF.

Aim: We aimed to (1) assess the accuracy of the STOP-Bang screening questionnaire for detection of SDB within an AF population referred for CA; (2) derive a refined, AF-specific SDB score to improve pre-selection.

A new efficient and integrated pathway for patient evaluation prior to atrial fibrillation ablation.

Aims: In this quality improvement project, a care pathway for patients considered for atrial fibrillation (AF) ablation was optimized with the goals to improve the patient journey and simultaneously integrate prospective data collection into the clinical process.

Methods And Results: The Lean Six Sigma approach was used to map the pre-existing process, identify constraints, and formulate countermeasures. The percentage of patients going through the full pre-ablation preparation that eventually underwent AF ablation, number of hospital visits and consultations, pathway compliance, and completeness of scientific data were measured before and after pathway optimization.

Rationale and Design of the ISOLATION Study: A Multicenter Prospective Cohort Study Identifying Predictors for Successful Atrial Fibrillation Ablation in an Integrated Clinical Care and Research Pathway.

Introduction: Continuous progress in atrial fibrillation (AF) ablation techniques has led to an increasing number of procedures with improved outcome. However, about 30-50% of patients still experience recurrences within 1 year after their ablation. Comprehensive translational research approaches integrated in clinical care pathways may improve our understanding of the complex pathophysiology of AF and improve patient selection for AF ablation.

COMPARE LAAO: Rationale and design of the randomized controlled trial "COMPARing Effectiveness and safety of Left Atrial Appendage Occlusion to standard of care for atrial fibrillation patients at high stroke risk and ineligible to use oral anticoagulation therapy".

Background: Left atrial appendage occlusion (LAAO) provides an alternative to oral anticoagulation (OAC) for stroke prevention in patients with atrial fibrillation (AF). In patients with a long-term or permanent contraindication for OAC randomized controlled trial (RCT) data is lacking.

Study Objectives: To assess the efficacy and safety of LAAO in AF patients who are ineligible to use OAC.

A single-centre prospective evaluation of left bundle branch area pacemaker implantation characteristics.

Background: Left bundle branch area pacing (LBBAP) has recently been introduced as a physiological pacing technique with synchronous left ventricular activation. It was our aim to evaluate the feasibility and learning curve of the technique, as well as the electrical characteristics of LBBAP.

Methods And Results: LBBAP was attempted in 80 consecutive patients and electrocardiographic characteristics were evaluated during intrinsic rhythm, right ventricular septum pacing (RVSP) and LBBAP.

Persistent phrenic nerve palsy after atrial fibrillation ablation: Follow-up data from The Netherlands Heart Registration.

Background: Persistent phrenic nerve palsy (PNP) is an established complication of atrial fibrillation (AF) ablation, especially during cryoballoon and thoracoscopic ablation. Data on persistent PNP reversibility is limited because most patients recover <24 h. This study aims to investigate persistent PNP recovery, freedom of PNP-related symptoms after AF ablation and identify baseline variables associated with the occurrence and early PNP recovery in a large nationwide registry study.

Left Ventricular Lead Placement Guided by Reduction in QRS Area.

: Reduction in QRS area after cardiac resynchronization therapy (CRT) is associated with improved long-term clinical outcome. The aim of this study was to investigate whether the reduction in QRS area is associated with hemodynamic improvement by pacing different LV sites and can be used to guide LV lead placement. : Patients with a class Ia/IIa CRT indication were prospectively included from three hospitals.

A VIRTUAL Sleep Apnoea management pathway For the work-up of Atrial fibrillation patients in a digital Remote Infrastructure: VIRTUAL-SAFARI.

Aims: In atrial fibrillation (AF) patients, untreated sleep-disordered breathing (SDB) is associated with lower success rates of rhythm control strategies and as such structured SDB testing is recommended. Herein, we describe the implementation of a virtual SDB management pathway in an AF outpatient clinic and examine the utility and feasibility of this new approach.

Methods And Results: Prospectively, consecutive AF patients accepted for AF catheter ablation procedures without previous diagnosis of SDB were digitally referred to a virtual SDB management pathway and instructed to use WatchPAT-ONE (ITAMAR) for one night.

Patient-level dose monitoring in computed tomography: tracking cumulative dose from multiple multi-sequence exams with tube current modulation in children.

Background: In children exposed to multiple computed tomography (CT) exams, performed with varying z-axis coverage and often with tube current modulation, it is inaccurate to add volume CT dose index (CTDI) and size-specific dose estimate (SSDE) to obtain cumulative dose values.

Objective: To introduce the patient-size-specific z-axis dose profile and its dose line integral (DLI) as new dose metrics, and to use them to compare cumulative dose calculations against conventional measures.

Materials And Methods: In all children with 2 or more abdominal-pelvic CT scans performed from 2013 through 2019, we retrospectively recorded all series kV, z-axis tube current profile, CTDI, dose-length product (DLP) and calculated SSDE.

Meta-analysis of controlled studies on minimally interrupted vs. continuous use of non-vitamin K antagonist oral anticoagulants in catheter ablation for atrial fibrillation.

Aims: At present, there are no guideline recommendations for minimally interrupted use of non-vitamin K antagonist oral anticoagulants (mi-NOAC) during catheter ablation (CA) for atrial fibrillation (AF). Current evidence is predominantly based on observational studies, with continuous use of vitamin K antagonist in the control arm. This quantitative summary reflects the first high-level evidence on contemporary regimens, with continuous NOAC use (c-NOAC) as the current gold standard.

Fetal dose evaluation for body CT examinations of pregnant patients during all stages of pregnancy.

Purpose: CTDI-to-fetal-dose coefficients from Monte Carlo simulations are useful for fetal dose evaluations, but the available data is limited to the fetus being completely inside the abdominopelvic scan range. Whereas in a chest examination, the fetus is completely outside the scan range. In an abdominal examination, the fetus after 16 gestational weeks is partly in the scan region, and an earlier fetus is completely outside of it.

Globally observed trends in mean and extreme river flow attributed to climate change.

Anthropogenic climate change is expected to affect global river flow. Here, we analyze time series of low, mean, and high river flows from 7250 observatories around the world covering the years 1971 to 2010. We identify spatially complex trend patterns, where some regions are drying and others are wetting consistently across low, mean, and high flows.

Comparing Ventricular Synchrony in Left Bundle Branch and Left Ventricular Septal Pacing in Pacemaker Patients.

Background: Left bundle branch area pacing (LBBAP) has recently been introduced as a novel physiological pacing strategy. Within LBBAP, distinction is made between left bundle branch pacing (LBBP) and left ventricular septal pacing (LVSP, no left bundle capture).

Objective: To investigate acute electrophysiological effects of LBBP and LVSP as compared to intrinsic ventricular conduction.