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Background: Atrial fibrillation/flutter (AF/AFl) is commonly diagnosed arrhythmia, associated with increased morbidity and mortality. Therefore, we have to improve our early AF/AFl diagnostics. Several studies indicated association between conduction delay, excessive atrial ectopic beats (AEBs) and AF/AFl onset. Association with some other AEB features is less clear. Objective: To validate the role of early AEBs from Holter-ECG in relation to documented AF/AFl events. Methods and Results: We enrolled 14 consecutive patients (6 female, median 60.5 years) with documented AF/AFl during or within 6 months after Holter-ECG (AF-group). Control group consisted of 10 clinically similar consecutive patients (5 female, median 64.5 years), without any evidence of AF/AFl, but with comparable burden of AEBs. Holter-ECGs were examined with 3-channel Holter system (Schiller, Darwin2 software). 24-hour data were analyzed for number and/or burden (%) of: a) AF/AFl, b) AEBs, c) early-AEBs (coupling interval cut-off

The InsectAI COST action will support insect monitoring and conservation at the national and continental scale in order to understand and counteract widespread insect declines. The Action will bring together a critical mass of researchers and stakeholders in image-based insect AI technologies to direct and drive the research agenda, build research capacity across Europe and support innovation and application.There is mounting evidence that populations of insects around the world are in sharp decline. Understanding trends in species and their drivers is key to knowing the size of the challenge, its causes and how to address it. To identify solutions that lead to sustainable biodiversity alongside economic prosperity, insect monitoring should be efficient and provide standardised and frequently updated status indicators to guide conservation actions.The EU Biodiversity Strategy 2030 identifies the critical challenge of delivering standardised information about the state of nature and image-based insect AI can contribute to this. Specifically, the EU Nature Restoration Law will likely set binding targets for the high resolution data that cameras can provide. Thus, outputs of the Action will contribute directly to EU policies implementation, where biodiversity monitoring is considered a key component.The InsectAI COST Action will organise workshops, conferences, short-term scientific missions, hackathons, design-sprints and much more, across four Working Groups. These groups will address how image-based insect AI technologies can best address Societal Needs, support innovation in Image Collection hardware, create standardised approaches for Image Processing and develop novel Data Analysis and Integration methods for turning data into actionable insights.

Citizen participation in tracking the spread of newly introduced or invasive species is an effective tool in nature conservation. Recently arrived species that pose threats to humans, animals, or plants—especially those widely covered in the media—are particularly suitable for citizen-led monitoring.In this study, we selected the Nosferatu spider (Zoropsis spinimana), a species spreading from the Mediterranean to northern Europe, to investigate whether its media coverage motivates citizens to report observations. Additionally, we aimed to gather insights into the spider's dispersal ecology through citizen science data. We utilized Google News and Google Videos as indicators of media presence, Google Trends as a proxy for public awareness, and citizen science observation data to assess the spider's distribution and ecology. Our analysis of 3,017 citizen science observations from different sources revealed a north-eastern spread of Z. spinimana. We found a temporal correlation between media presence, Google search activity, and the number of citizen-reported observations. Additionally, there was a strong spatial correlation between federal states with the highest media presence and the highest number of citizen reports. Most observations were recorded between August and October, with the majority occurring inside human dwellings. Hence, the current dispersion dynamics and extensive media coverage of Z. spinimana appear to be significant factors driving increased public awareness, as evidenced by higher search interest and a greater number of citizen observations.

Background Clinical studies suggest that vestibular migraine patients have psychiatric comorbidities and low life quality. However, the absence of a multidisciplinary approach to vestibular migraine patients, including otorhinolaryngologists and psychiatrists, is concerning. We aimed to investigate these patients comprehensively and to compare the results of three questionnaires—the Hospital Anxiety and Depression Scale (HADS), Dizziness Handicap Inventory (DHI), and Short Form Health Survey (SF-36)—between patients with definite vestibular migraine (dVM), migraine without vertigo (MO), and healthy controls (HCs). Methods: A total of 104 participants were divided into 3 groups: dVM patients (19 participants), MO patients (22 participants), and HCs (63 participants). The scores of the three questionnaires across the three groups were compared using analysis of variance, and linear regression was used to examine the associations between the questionnaire scores within each group. Results: Compared to MO patients and HCs, dVM patients had significantly higher total scores on the HADS (p < 0.0001) and DHI (p < 0.0001) scales, and lower scores for all nine components of the SF-36, indicating poorer health. In the vestibular migraine group, the DHI score was strongly negatively correlated with the Physical Functioning subscale of the SF-36. Conclusions: Anxiety and depression are more prevalent in patients with definite vestibular migraine compared to patients with migraine without vertigo and healthy controls. The physical functioning of patients with definite vestibular migraine is highly affected by their dizziness, resulting in a lower quality of life. Timely screening for psychiatric comorbidity in vestibular migraine patients is essential to prevent psychiatric consequences.

Introduction The allostatic load (AL) is a framework for conceptualising the physiological multisystemic impact of prolonged exposure to stress and its related side effects on mental health.Stress due to AL can influence the development and outcomes of cardiovascular diseases. AL increases the risk of coronary and peripherical artery diseases. AL emerges from the detection of emotional dimensions related to the disease, low psychosocial functioning and high rates of psychopathological signs in patients with hypertension or coronary heart disease.Method and analysis The primary endpoint of the PLAY-UP protocol is the implementation of a multidimensional model underlying the clinical treatment of patients with cardiovascular disease through the integration of medical and psychological clinical variables.PLAY-UP is a cohort study that will last for 24 months. 200 participants will be recruited and divided into three groups: early disease, midterm disease and long disease. All patients will undergo a clinical evaluation based on the detection of biological, medical and psychological indicators and variables. The evaluation battery will comprise three types of measurements: medical, psychological and pharmacological treatments. Clinical and psychological measurements will be processed in an integrated manner through the combination of all variables examined, elaborating the Allostatic Load Index from a longitudinal time perspective. The Allostatic Load Index will be calculated by measuring the z-score.Ethics and dissemination Ethical Committee Approval was obtained from CEtRA Abruzzo Region (IT) (ID 0461499/23). The results of the present project will be published in peer-reviewed journals, disseminated electronically and in print, and presented as abstracts and/or personal communications during national and international conferences.

Introduction: Inappropriate sinus tachycardia (IST) is a syndrome characterized by unexpectedly fast and prolonged sinus rates at rest or with minimal physical activity. Epidemiologic characteristics are uncertain, but most patients are young and female. When IST occurs in athletes, its management (controlling symptoms and reducing heart rate) can present additional challenges. We designed an observational pilot study to investigate whether a food supplement can be useful in the treatment of IST when standard therapy is refused. Methods: We enrolled 50 consecutive recreational athletes affected by frequent recurrences of IST. Twelve-lead ECG and Holter ECG parameters were recorded at enrollment (T0) and after a 6-month treatment (T1) with the food supplement. Symptoms and quality of life were also evaluated through specific questionnaires. The study population was compared to a historical control group of 25 patients receiving ivabradine as treatment for the same clinical condition. Results: The resting ECG heart rate was 88.7 ± 12.4 bpm (T0) and 73.6 ± 6.6 bpm (T1) (p < 0.00001); Holter average heart rate was 88.4 ± 3.3 bpm and 74.9 ± 4.8 bpm (p < 0.0001). Holter ECG maximum heart rate was 147.1 ± 16.7 bpm and 139.2 ± 16.8 bpm (p = 0.06); Holter minimum heart rate was 49.9 ± 6.5 bpm and 50.5 ± 6.9 bpm (p = 0.33). Finally, the number of sustained episodes decreased from 3.3 ± 1.7 to 0.8 ± 0.8 (p < 0.00001). The following variations in ASTA scores were observed: ASTA symptom scale (range: 0–27) decreased from 14.9 ± 2.1 to 5.8 ± 1.4 (p < 0.00001), while ASTA HR QoL (range: 0–39) decreased from 24.1 ± 2.1 to 10.8 ± 2.3 (p < 0.00001). Conclusions: The findings of our pilot study suggest that this food supplement could play a beneficial role in managing symptoms and improving quality of life in recreational athletes affected by IST who refuse standard medical therapy. These clinical effects appear to correlate with significant improvements in resting ECG parameters and some Holter ECG parameters.

Abstract Movement performance of insects is an important measure of physiological fitness and is likely affected by novel stressors associated with global change. Reduced fitness can lead to smaller foraging areas and thus to decreasing abundance, diversity and nutritional quality, which could weaken insect populations and contribute to global insect decline. Here, we combined two different methods: An experimental semi‐field design applying treatments in outdoor flight cages and a follow‐up experiment conducted in the laboratory, in which different parameters of movement performance, such as (a) velocity, (b) duration and (c) distance of an insect's flight can be quantified. We kept colonies of the bumblebee Bombus terrestris under contrasting nutritional conditions and measured treatment effects on the movement performance of individuals. Monophagously fed bumblebees showed reduced movement performance than polyphagously fed bumblebees. In particular, they stopped more frequently during flight, flew shorter distances and showed less often flight duration of 20 min. Our results suggest that nutritional deficiency due to a monophagic diet leads to reduced flight performance, which can have dramatic negative consequences for bees. Reduced flight performance may result in decreased availability of host plants, which may negatively affect stress resistance of bees and brood provisioning, facilitating extinction of insects. Although food of great nutritional value is an important compensator for the negative effects of different novel stressor, such as pesticides, it is not much known how to compensate for the effects of nutritional stress, especially in landscapes dominated by monocultures. However, our experimental approach with semi‐field and laboratory components has high potential for further studies investigating the impact of different stressors on the physiological fitness of insects but also body mass, or reproductive success and to find factors that may mitigate or even overcome the negative effect of stressors on insects.

Celiakija je kronična avtoimunska bolezen, ki prizadene tanko črevo pri bolnikih z genetsko predispozicijo ob uživanju glutena. Lahko se pojavi v katerem koli starostnem obdobju pri ženskah in moških. Predstavljamo starostnika s kronično drisko in hujšanjem, pri katerem smo s histološkim izvidom vzorcev sluznice terminalnega ileuma odkrili celiakijo. Le-ta se je odkrila po kirurškem zdravljenju zapletenega zloma in med dolgotrajnim zdravljenjem z antibiotiki. Pojavili so se huda dehidracija z ortostatsko hipotenzijo, metabolna acidoza, ledvična insuficienca, motnje elektrolitov in pomanjkanje vitamina K. Ob potrjeni diagnozi celiakije govorimo o celiakalni krizi. Po brezglutenski dieti se je hitro izboljšala bolnikova telesna zmogljivost, telesna teža je pričela naraščati, laboratorijski izvidi so se usmerili k normalizaciji. S primerom želimo opozoriti, da se lahko celiakija pojavi tudi v 8. desetletju življenja in da je pri klinični sliki kronične driske nanjo potrebno tudi pomisliti.

Abstract We investigated the plant‐pollinator interactions of the Mexican grass‐carrying wasp Isodontia mexicana—native to North America and introduced in Europe in the 1960s—through the use of secondary data from citizen science observations. We applied a novel data exchange workflow from two global citizen science platforms, iNaturalist and Pl@ntNet. Images from iNaturalist of the wasp were used to query the Pl@ntNet application to identify possible plant species present in the pictures. Simultaneously, botanists manually identified the plants at family, genus and species levels and additionally documented flower color and biotic interactions. The goals were to calibrate Pl@ntNet's accuracy in relation to this workflow, update the list of plant species that I. mexicana visits as well as its flower color preferences in its native and introduced ranges. In addition, we investigated the types and corresponding frequencies of other biotic interactions incidentally captured on the citizen scientists' images. Although the list of known host plants could be expanded, identifying the flora from images that predominantly show an insect proved difficult for both experts and the Pl@ntNet app. The workflow performs with a 75% probability of correct identification of the plant at the species level from a score of 0.8, and with over 90% chance of correct family and genus identification from a score of 0.5. Although the number of images above these scores may be limited due to the flower parts present on the pictures, our approach can help to get an overview into species interactions and generate more specific research questions. It could be used as a triaging method to select images for further investigation. Additionally, the manual analysis of the images has shown that the information they contain offers great potential for learning more about the ecology of an introduced species in its new range.

Abstract Urbanization has far‐reaching consequences on birds, and knowledge of the impacts on taxonomic and functional diversity is necessary to make cities as compatible as possible for species. Avian diversity in parks in urban centers has been investigated multiple times, but rarely so in long‐term studies due to lacking data. The Tiergarten in Berlin is a large‐scale park in the city center of great value for people and many species including birds. We compiled bird species lists since 1850 and from monitoring in 2022 in one dataset to investigate how bird communities and guilds have changed over time and how these alterations were influenced by the eventful history of the park's vegetation conditions. Long‐term changes in species assemblages were analyzed with an ordination analysis, and changes in guild presence and functional richness were discussed with regard to landscape transitions. A gradual development of species assemblages yet only small changes in guild composition since 1850 was detected, whereas the 1950 community stands out with a drop in species richness and replacement of forest species with an open land community, which reflects the deforestation of the park during World War II. Consideration of habitat, lifestyle, trophic, and migration guilds revealed no sign of functional homogenization over the last 172 years (1850–2022). Despite the high frequentation of the park by humans it still allows for a high bird diversity due to the Tiergarten's sheer size and heterogeneity of vegetation and habitats. We recommend that the park is maintained and managed accordingly to preserve this condition and advise other urban parks to strive for these beneficial features.

Introduction The COVID-19 pandemic has significantly affected everyday life in most countries of the world. Researches conducted in 2020 showed that COVID-19 was a traumatic experience for 18-60% of respondents in the general population, depending on the country where the research is conducted. Researches for later periods are rare, although we can expect significant changes. We found only one study from 2023 on this topic, although not on the general population. Objectives That is why we were interested in what the situation is like after 3 years of the pandemic, when we have been living without non-pharmacological anti-pandemic measures for almost a year. Methods The research was conducted at the beginning of 2023. 48 respondents who were not treated psychiatrically or are medical workers were surveyed, because it was shown that these groups were exposed to a greater risk of impaired mental health during the COVID-19 pandemic. To assess the level of traumatic experience, i.e. the risk of developing PTSD as a consequence of the COVID-19 pandemic, we used the Impact of Event Scale With Modifications for COVID-19 (IES-COVID19). A score on that scale of 27 to 34 indicates a clinically significant level of trauma, i.e. there is a 75% chance of developing PTSD. A result of 35 and above suggests that it is necessary to seek professional help. Results Our research included 19 (39.6%) men and 29 (60.4%) women. The average age of the respondents is 60.4 years. 29 (60.4%) respondents know that they have recovered from COVID-19. 2 (4.2%) subjects were treated in the hospital due to COVID-19. 8 (16.7%) respondents have a traumatic experience of the COVID-19 pandemic. 5 (10.4%) respondents are in the category of clinically significant level of trauma, while 3 (6.3%) respondents are in the category that should seek professional help. The group traumatized by COVID-19 does not have significantly more respondents who recovered from COVID-19 (p=0.510) nor does it differ in terms of gender representation (p=0.984). Conclusions At the beginning of the COVID-19 pandemic, there were discussions about whether it can even be classified as a traumatic experience and whether we can talk about PTSD as a consequence of the pandemic. With this time lag, it seems that in part of the population we are finding PTSD symptoms that are a consequence of the pandemic, but to a lesser extent than research at the beginning of the pandemic suggested. Certainly, additional research is needed on this topic. Also, it is necessary to examine risk factors for possible prevention, as well as therapeutic possibilities. Disclosure of Interest None Declared

Introduction: Acute pulmonary vein (PV) reconnection is frequently encountered in patients undergoing PV isolation (PVI) procedure for the treatment of atrial fibrillation. In this study, we investigated whether the identification and ablation of residual potentials (RPs), after the initial achievement of PVI, reduces acute PV reconnection rate. Methods: Following PVI in 160 patients, mapping along the ablation line was performed to identify RPs, defined as bipolar amplitude ≥0.2 mV or 0.1-0.19 mV combined with a negative component of the unipolar electrogram. Ipsilateral PV sets with RPs were randomized to either no further ablation (Group B) or to additional ablation of the identified RPs (Group C). The primary study endpoint was spontaneous or adenosine-mediated acute PV reconnection after a 30-min waiting period and was also evaluated in ipsilateral PV sets without RPs (Group A). Results: After isolation of 287 PV pairs, 135 had no RPs (Group A), whereas the remaining PV pairs were randomized to either Group B (n = 75) or Group C (n = 77). Ablation of RPs resulted in a reduction of spontaneous or adenosine-mediated PV reconnection rate (16.9% in Group C vs 48.0% in Group B; p

Abstract Worldwide, citizen scientists help to map the distribution of native and introduced mosquito species in a variety of programs, contributing to environmental research and management decisions. Participant background, behavior, and engagement may vary depending on the project design, especially between those using digital apps and those using physical samples, which in turn may impact the quality and representativeness of the data collected. During the analysis of the responses to a survey directed at citizen scientists participating in a digital and an analog program, we found significant differences in the respondents’ demographic backgrounds. Diverse participant motivations and varying sentiments towards mosquitoes were observed, indicating differing susceptibility in response to the program messages. The results can be translated into recommendations to further strengthen the appeal of citizen science projects and to promote and sustain public engagement in environmental research.

Abstract In the face of the global biodiversity crisis, collecting comprehensive data and making the best use of existing data are becoming increasingly important to understand patterns and drivers of environmental and biological phenomena at different scales. Here we address the concept of secondary data, which refers to additional information unintentionally captured in species records, especially in multimedia‐based citizen science reports. We argue that secondary data can provide a wealth of ecologically relevant information, the utilisation of which can enhance our understanding of traits and interactions among individual organisms, populations and biodiversity dynamics in general. We explore the possibilities offered by secondary data and describe their main types and sources. An overview of research in this field provides a synthesis of the results already achieved using secondary data and different approaches to information extraction. Finally, we discuss challenges to the widespread use of secondary data, such as biases, licensing issues, use of metadata and lack of awareness of this trove of data due to a missing common terminology, as well as possible solutions to overcome these barriers. Although the exploration and use of secondary data is only emerging, the many opportunities identified show how these data can enrich biodiversity research and monitoring.

Background: The lack of reliable biomarkers in response to anti-TNFα biologicals hinders personalized therapy for Crohn’s disease (CD) patients. The motivation behind our study is to shift the paradigm of anti-TNFα biomarker discovery toward specific immune cell sub-populations using single-cell RNA sequencing and an innovative approach designed to uncover PBMCs gene expression signals, which may be masked due to the treatment or ongoing inflammation; Methods: The single-cell RNA sequencing was performed on PBMC samples from CD patients either naïve to biological therapy, in remission while on adalimumab, or while on ustekinumab but previously non-responsive to adalimumab. Sieves for stringent downstream gene selection consisted of gene ontology and independent cohort genomic profiling. Replication and meta-analyses were performed using publicly available raw RNA sequencing files of sorted immune cells and an association analysis summary. Machine learning, Mendelian randomization, and oligogenic risk score methods were deployed to validate DEGs highly relevant to anti-TNFα therapy response; Results: This study found PLCB1 in CD4+ T cells and CRTAM in double-negative T cells, which met the stringent statistical thresholds throughout the analyses. An additional assessment proved causal inference of both genes in response to anti-TNFα therapy; Conclusions: This study, jointly with an innovative design, uncovered novel candidate genes in the anti-TNFα response landscape of CD, potentially obscured by therapy or inflammation.

Abstract Successful conservation efforts have led to recent increases of large mammals such as European bison Bison bonasus, moose Alces alces and grey wolf Canis lupus and their return to former habitats in central Europe. While embraced by some, the recovery of these species is a controversial topic and holds potential for human‐wildlife conflicts. Involving the public has been suggested to be an effective method for monitoring wildlife and mitigating associated conflicts. To assess two interrelated prerequisites for engaging people in Citizen Science (CS)—knowledge of returning species and respondents' readiness to participate in CS activities for monitoring and managing these species—we conducted a survey (questionnaire) in two wildlife parks located in different states of Germany. Based on 472 complete questionnaires, we developed generalized linear models to understand how sociodemographic variables and exposure to the species affected visitors' knowledge of each species, and to investigate if sociodemographic variables and knowledge influenced the likelihood of visitors to participate in CS activities. Almost all visitors were aware of the returning wolf population, while knowledge and awareness about bison and moose were significantly lower. Knowledge of the two herbivores differed geographically (higher knowledge of moose in the north‐eastern state), possibly indicating a positive association between exposure to the species and knowledge. However, models generally performed poorly in predicting knowledge about wildlife, suggesting that such specific knowledge is insufficiently explained by sociodemographic variables. Our model, which explained stated willingness in CS indicated that younger participants and those with higher knowledge scores in the survey were more willing to engage in CS activities. Overall, our analyses highlight how exposure to large mammals, knowledge about wildlife and human demographics are interrelated—insights that are helpful for effectively recruiting citizen scientists for wildlife conservation. Read the free Plain Language Summary for this article on the Journal blog.

This study characterizes the effects of three commonly detected pharmaceuticals—diclofenac, erythromycin, and gemfibrozil—on aerobic granular sludge. Approximately 150 µg/L of each pharmaceutical was fed in the influent to a sequencing batch reactor for 80 days, and the performance of the test reactor was compared with that of a control reactor. Wastewater treatment efficacy in the test reactor dropped by approximately 30-40%, and ammonia oxidation was particularly inhibited. The relative abundance of active Rhodocyclaceae, Nitrosomonadaceae, and Nitrospiraceae families declined throughout exposure, likely explaining reductions in wastewater treatment performance. Pharmaceuticals were temporarily removed in the first 12 days of the test via both sorption and degradation; both removal processes declined sharply thereafter. This study demonstrates that aerobic granular sludge may successfully remove pharmaceuticals in the short term, but long-term tests are necessary to confirm if pharmaceutical removal is sustainable.

Purpose: Atrioesophageal fistula is one of the most feared complications of radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) as it is associated with high mortality. Determining the esophagus location during RFCA might reduce the risk of esophageal injury. The present study aims to evaluate the feasibility of using intracardiac echocardiography integrated into a 3-dimensional electroanatomical mapping system (ICE/3D EAM) for the assessment of esophageal position and shifts in response to ablation. Methods: We prospectively enrolled 20 patients that underwent RFCA of AF under conscious analgosedation. The virtual anatomy of the left atrium, the pulmonary vein (PV) ostia, and the esophagus was created with ICE/3D EAM. The esophageal positions were obtained at the beginning of the procedure and then after left and right PV isolation (PVI). Esophageal shifts were measured offline after the procedure using the tools available in the 3D EAM system. Results: Most esophagi moved away from the ablated PV ostia. After the left PVI, the median of the shifts was 2.8 mm (IQR 1.0–6.3). In 25% of patients, the esophagus shifted by >5.0 mm (max. 13.4 mm). After right PVI, the median of shifts was 2.0 mm (IQR 0.7–4.9). In 10% of patients, the esophageal shift was >5.0 mm (max. 7.8 mm). Conclusions: ICE/3D EAM enables the intraprocedural visualization of baseline esophageal position and its shifts after PVI. The shifts are variable, but they tend to be small and directed away from the ablation site. Repeated intraprocedural visualization of the esophagus may be needed to reduce the risk of esophageal injury.

Abstract Purpose The aim of this study was to evaluate the safety and efficacy of zero-fluoroscopy (ZF) catheter ablation (CA) for supraventricular tachycardias (SVT). Methods 584 consecutive patients referred to our institution for CA of SVT were analysed. Patients were categorised into two groups; zero-fluoroscopy (ZF) group and conventional fluoroscopy (CF) group. The ZF group was further divided into two subgroups (adults and paediatric). Patient characteristics, procedural information, and follow-up data were compared. Results The ZF group had a higher proportion of paediatric patients (42.2% vs 0.0%; p

Background: Therapeutic plasma exchange (TPE) removes coagulation factors and leads to depletion coagulopathy. The aim of the study was to compare hemostasis between TPE procedures without coagulation factor replacement (electrolyte group), the partial replacement of fibrinogen with fibrinogen concentrates (fibrinogen group) and partial coagulation factors replacement with fresh frozen plasma (partial FFP group). Methods: A total of 73 TPE procedures in patients with fibrinogen levels 1–2 g/L were divided into three study groups depending on clinically estimated bleeding risk. Standard coagulation and ROTEM® tests were performed before and after TPE. Results: Fibrinogen levels before TPE (p = 0.88) and after TPE (p = 0.33) were comparable between the fibrinogen and partial FFP groups. INR and ROTEM® parameters reflected moderately worse hemostasis after TPE with fibrinogen-only replacement compared to partial FFP replacement, which could result in increased bleeding risk. In the electrolyte group, most laboratory tests confirmed the most deranged hemostasis after TPE, as compared to fibrinogen or partial FFP replacement. A mild allergic reaction to FFP infusion was noted during one TPE. No clinically significant bleeding occurred in any of the study groups. Conclusions: Fibrinogen concentrate supplementation and partial FFP replacement can both maintain fibrinogen levels > 1 g/L after TPE, but modest differences in classical coagulation tests and bedside ROTEM® tests favor FFP replacement (NCT03801135). [ABSTRACT FROM AUTHOR]

Background Clinical studies suggest that vestibular migraine patients have psychiatric comorbidities and low life quality. However, the absence of a multidisciplinary approach to vestibular migraine patients, including otorhinolaryngologists and psychiatrists, is concerning. We aimed to investigate these patients comprehensively and to compare the results of three questionnaires—the Hospital Anxiety and Depression Scale (HADS), Dizziness Handicap Inventory (DHI), and Short Form Health Survey (SF-36)—between patients with definite vestibular migraine (dVM), migraine without vertigo (MO), and healthy controls (HCs). Methods: A total of 104 participants were divided into 3 groups: dVM patients (19 participants), MO patients (22 participants), and HCs (63 participants). The scores of the three questionnaires across the three groups were compared using analysis of variance, and linear regression was used to examine the associations between the questionnaire scores within each group. Results: Compared to MO patients and HCs, dVM patients had significantly higher total scores on the HADS (p < 0.0001) and DHI (p < 0.0001) scales, and lower scores for all nine components of the SF-36, indicating poorer health. In the vestibular migraine group, the DHI score was strongly negatively correlated with the Physical Functioning subscale of the SF-36. Conclusions: Anxiety and depression are more prevalent in patients with definite vestibular migraine compared to patients with migraine without vertigo and healthy controls. The physical functioning of patients with definite vestibular migraine is highly affected by their dizziness, resulting in a lower quality of life. Timely screening for psychiatric comorbidity in vestibular migraine patients is essential to prevent psychiatric consequences. [ABSTRACT FROM AUTHOR]

Izhodišče: Katetrska ablacija je danes uveljavljena metoda zdravljenja preddvorne fibrilacije (AF). O zgodnjih in srednjeročnih izidih smo že poročali. Tokrat želimo predstaviti še dolgoročne klinične izide. Metode: Spremljali smo vse bolnike, pri katerih smo v obdobju 2003‒2009 prvič opravili katetrsko ablacijo paroksizmalne ali vztrajajoče AF zaradi neučinkovitosti antiaritmičnega zdravljenja. Upoštevali smo tudi ablacijske posege zaradi tipične atrijske undulacije (AU) po letu 1999. Glavni cilj ablacijskega posega je bil popolna električna osamitev pljučnih ven (PV). Uporabili smo metodo segmentne radiofrekvenčne ablacije s fluoroskopskim nadzorom in beleženjem elektrogramov na krožnem katetru »laso«. Pri bolnikih s tipično AU smo opravili linijsko ablacijo kavotrikuspidalne ožine. Bolnike smo spremljali vsaj 5 let po doseženi popolni osamitvi PV oz. do telefonskega razgovora v aprilu 2020 oz. do morebitne smrti. Razvrstili smo jih v tri skupine: a) uspešne, tj. v stabilnem sinusnem ritmu z nemotečimi palpitacijami do 5 min, brez rednega antiaritmičnega zdravljenja, b) delno uspešne, ko so bili pretežno v sinusnem ritmu, z epizodami dokumentirane AF/AU do enkrat letno in tudi občasno uporabo antiaritmičnih zdravil v ustreznih odmerkih in c) neuspešne, tj. s pogostimi epizodami AF/AU, neučinkovitim antiaritmičnim zdravljenjem v ustreznih odmerkih ali z dolgotrajno vztrajajočo AF/AU. Ablacijski poseg smo ponovili zaradi recidiva AF/AU, vendar ne prej kot po 3 mesecih. Ob sumu na ponovitev aritmije smo naročili serijske posnetke EKG in Holterjevega monitoriranja. Podatke smo vrednotili s Kaplan-Meierjevo analizo, testom-t in Fisherjevim testom. Vrednost p < 0,05 je bila značilna. Rezultati: V raziskavo smo uvrstili 128 bolnikov (95 moških, 33 žensk; mediana starost pri prvem posegu zaradi AF je bila 54,5 let, rang 19–75), pri katerih smo opravili povprečno 1,7 ablacijskega posega zaradi AF oziroma 2 posega, če smo upoštevali še ablacije AU. Spremljanje je zaključilo 117 bolnikov (85 moških in 32 ženskah) po povprečno 11,7 letih (mediana 140 mesecev, rang 21–230 mesecev). Umrlo je 10 bolnikov (6 moških, 4 ženske), nihče pa zaradi ablacijskega posega. Od soobolevnosti sta bili v ospredju maligna bolezen in ščitnična disfunkcija. Verjetnost za ohranitev stabilnega sinusnega ritma je bila po 10 letih približno 50-odstotna. Po 15-odstotnem padcu verjetnosti za sinusni ritem v prvem letu je bil padec nato linearen, in sicer 4 % letno. Ablacijsko zdravljenje je bilo uspešno pri 54 bolnikih (46 %), delno uspešno pri 25 (21 %) in neuspešno pri 38 bolnikih (33 %, manj uspešno pri ženskah, p < 0,05). V zadnjih 10 letih spremljanja smo opravili manjši del ablacijskih posegov ‒ 46 (16 %). Antiaritmična zdravila je prejemalo 38 bolnikov (32 %), pretežno amiodaron in propafenon. Med ablacijskim posegom smo povzročili tamponado pri 5 bolnikih (4 %). Nihče od njih ni potreboval kirurškega posega. Drugih večjih zapletov ni bilo. Zaključek: Ablacijsko zdravljenje AF je dolgoročno dovolj uspešno, varno in po podatkih drugih avtorjev tudi cenovno učinkovito. Zato ga lahko priporočimo večini bolnikov z AF. Za celostno obravnavo bolnikov z AF pa so pomembni tudi: ureditev odpravljivih dejavnikov tveganja, antiaritmično zdravljenje in kakovostno antikoagulacijsko zdravljenje.

Abstract Intensified travel activities of humans and the ever growing global trade create opportunities of arthropod-borne disease agents and their vectors, such as mosquitoes, to establish in new regions. To update the knowledge of mosquito occurrence and distribution, a national mosquito monitoring programme was initiated in Germany in 2011, which has been complemented by a citizen science project, the ‘Mückenatlas’ since 2012. We analysed the ‘Mückenatlas’ dataset to (1) investigate causes of variation in submission numbers from the start of the project until 2017 and to (2) reveal biases induced by opportunistic data collection. Our results show that the temporal variation of submissions over the years is driven by fluctuating topicality of mosquito-borne diseases in the media and large-scale climate conditions. Hurdle models suggest a positive association of submission numbers with human population, catch location in the former political East Germany and the presence of water bodies, whereas precipitation and wind speed are negative predictors. We conclude that most anthropogenic and environmental effects on submission patterns are associated with the participants’ (recording) behaviour. Understanding how the citizen scientists’ behaviour shape opportunistic datasets help to take full advantage of the available information.

Abstract Background Aedes japonicus japonicus, first detected in Europe in 2000 and considered established in Germany 10 years later, is of medical importance due to its opportunistic biting behaviour and its potential to transmit pathogenic viruses. Its seasonal phenology, temperature and land use preference related to oviposition in newly colonised regions remain unclear, especially in the context of co-occurring native mosquito species. Methods Focussing on regions in Germany known to be infested by Ae. japonicus japonicus, we installed ovitraps in different landscapes and their transition zones and recorded the oviposition activity of mosquitoes in relation to season, temperature and land use (arable land, forest, settlement) in two field seasons (May–August 2017, April–November 2018). Results Ae. japonicus japonicus eggs and larvae were encountered in 2017 from June to August and in 2018 from May to November, with a markedly high abundance from June to September in rural transition zones between forest and settlement, limited to water temperatures below 30 °C. Of the three native mosquito taxa using the ovitraps, the most frequent was Culex pipiens s.l., whose offspring was found in high numbers from June to August at water temperatures of up to 35 °C. The third recorded species, Anopheles plumbeus, rarely occurred in ovitraps positioned in settlements and on arable land, but was often associated with Ae. japonicus japonicus. The least frequent species, Aedes geniculatus, was mostly found in ovitraps located in the forest. Conclusions The transition zone between forest and settlement was demonstrated to be the preferred oviposition habitat of Ae. japonicus japonicus, where it was also the most frequent container-inhabiting mosquito species in this study. Compared to native taxa, Ae. japonicus japonicus showed an extended seasonal activity period, presumably due to tolerance of colder water temperatures. Higher water temperatures and arable land represent distribution barriers to this species. The frequently co-occurring native species An. plumbeus might be useful as an indicator for potentially suitable oviposition habitats of Ae. japonicus japonicus in hitherto uncolonised regions. The results contribute to a better understanding of mosquito ecology and provide a basis for more targeted monitoring, distribution modelling and risk management of mosquitoes.

Abstract Background Right free wall accessory pathways (AP) are difficult to treat with catheter ablation as ablation catheter (AC) instability at the tricuspid annulus often precludes successful procedure. The aim of our study was to test a novel intra-cardiac echocardiography (ICE) guided technique for AC placement. Feasibility and success rates were observed. Methods Eight consecutive patients (aged 29 ± 21 years, 4 female) with Wolff-Parkinson-White syndrome and a right free wall AP were included in the study. ICE, three-dimensional (3D) electro-anatomic mapping (EAM) system, and a steerable long sheath were used together with either an irrigated or a non-irrigated tip radio-frequency AC to achieve a “loop” manoeuvre which provided AC tip stability at the ventricular aspect of the tricuspid annulus. X-ray fluoroscopy was not used. Results Three patients had an anterior and five had a lateral location of the right free wall AP. Procedures were successful in all patients, without recurrences during the mean follow-up of 397 ± 363 days. Average procedural duration was 90 ± 31 min. On average, 6.6 ± 5.7 ablations were needed. Average time to terminate AP conduction after the start of ablation was 4.8 ± 4.2 s. In five patients (62%) AP conduction was successfully terminated with the first ablation. There were no procedural complications. Conclusions The novel ICE-guided approach with concomitant use of the steerable sheath and the 3D EAM system for zero-fluoroscopy mapping and ablation of the right free wall APs proved feasible and resulted in excellent acute and long-term outcomes.

The urban heat island (UHI) effect remains a major threat to society as cities densify and sprawl. Urban greening through local to landscape management is a proposed strategy to combat UHI and improve environmental justice in city neighborhoods. For example, urban community gardens are multifunctional green spaces that play an important role for biodiversity and for civic engagement. But the role of urban gardens in urban cooling and relieving UHI remain unclear, specifically how temperatures fluctuate within gardens in relation to garden management factors and city landscape context, and how this relates to urban heat in city neighborhoods. We investigated diurnal and nocturnal temperature ranges, and daily maximum and minimum temperatures in 18 urban gardens over the peak of the summer agricultural growing season. We then analyzed how temperatures were correlated to local land cover factors within the garden, to surrounding landscape imperviousness at various spatial scales, and to environmental justice indicators (stressors) of garden neighborhoods. We found that nocturnal temperature range is negatively correlated to landscape imperviousness, and that the relationship decreases in strength with increasing spatial scale. This result supports the importance of evapotranspiration processes of surrounding green areas for nocturnal cooling. Some local land cover factors were important for temperatures, indicating heating or cooling management mechanisms from within urban gardens. Finally, the mean number of environmental stressors in neighborhoods negatively related to temperature variation. The results of this work can inform resource use and crop selection in urban agriculture, as well as how temperature-related ecosystem services of gardens relate to environmental justice of city neighborhoods.

Since 2012, the citizen science project ‘Mückenatlas’ has been supplementing the German mosquito monitoring programme with over 28,000 submissions of physical insect samples. As the factors triggering people to catch mosquitoes for science are still unknown, we analysed the influence of mass media reports on mosquito submission numbers. Based on a theoretical framework of how mass media affect citizen responsiveness, we identified five possible influencing factors related to citizen science: (i) project awareness and knowledge, (ii) attention (economy), (iii) individual characteristics of citizen scientists and targeted communication, (iv) spatial differences and varying affectedness, and (v) media landscape. Hypotheses based on these influencing factors were quantitatively and qualitatively tested with two datasets: clipping data of mass media reports (online, television, radio and print) referring to or focussing on the ‘Mückenatlas’, and corresponding data of ‘Mückenatlas’ submissions between 2014 and 2017. In general, the number of media reports positively affected the number of mosquito submissions on a temporal and spatial scale, i.e. many media reports provoke many mosquito submissions. We found that an already heightened public and media awareness of mosquito-relevant topics combined with a direct call-to-action in a media report title led to a maximum participation. Differences on federal state level, however, suggest that factors additional to quantitative media coverage trigger participation in the ‘Mückenatlas’, in particular the mosquito affectedness of the resident population. Lastly, media types appear to differ in their effects on the number of submissions. Our results show under which circumstances the media presence of the ’Mückenatlas’ is most effective in activating people to submit mosquito samples, and thus provide advice for designing communication strategies for citizen science projects.

Movement performance of insects is an important measure of physiological fitness and is likely affected by novel stressors associated with global change. Reduced fitness can lead to smaller foraging areas and thus to decreasing abundance, diversity and nutritional quality, which could weaken insect populations and contribute to global insect decline. Here, we combined two different methods: An experimental semi‐field design applying treatments in outdoor flight cages and a follow‐up experiment conducted in the laboratory, in which different parameters of movement performance, such as (a) velocity, (b) duration and (c) distance of an insect's flight can be quantified. We kept colonies of the bumblebee Bombus terrestris under contrasting nutritional conditions and measured treatment effects on the movement performance of individuals. Monophagously fed bumblebees showed reduced movement performance than polyphagously fed bumblebees. In particular, they stopped more frequently during flight, flew shorter distances and showed less often flight duration of 20 min. Our results suggest that nutritional deficiency due to a monophagic diet leads to reduced flight performance, which can have dramatic negative consequences for bees. Reduced flight performance may result in decreased availability of host plants, which may negatively affect stress resistance of bees and brood provisioning, facilitating extinction of insects. Although food of great nutritional value is an important compensator for the negative effects of different novel stressor, such as pesticides, it is not much known how to compensate for the effects of nutritional stress, especially in landscapes dominated by monocultures. However, our experimental approach with semi‐field and laboratory components has high potential for further studies investigating the impact of different stressors on the physiological fitness of insects but also body mass, or reproductive success and to find factors that may mitigate or even overcome the negative effect of stressors on insects. [ABSTRACT FROM AUTHOR]

Abstract Background Up to 80% of the adult homeless population use tobacco, and smoking cessation programs could offer an important opportunity to address preventable mortality and morbidity for this population. This population faces serious challenges to smoking cessation, including the impact of the social environment. Methods Forty participants (11 female; 29 male) from an ongoing smoking cessation randomized clinical trial conducted at 2 urban homeless shelters in the Upper Midwest were invited to take part in semi-structured interviews in 2016–2017. An interviewer used a semi-structured interview guide asking participants to describe their experience of how the social environment impacted their attempt to quit smoking. Results Participants described feeling pressure to smoke and drink in and around shelters, and that this pressure had led some to start smoking or resume smoking, along with making it very challenging to quit. Participants described being motivated to quit, and seeing smoking cessation as positively impacting the time and focus they felt they had for finding housing. However many felt more interested in reducing their smoking, rather than quitting. Conclusions Addressing smoking cessation for people experiencing homelessness is both an important public health opportunity, and a challenge. There is a need to consider cessation in the context of the social and environmental factors impacting smokers who are experiencing homelessness. In particular, there is a need to address the collective value placed on smoking in social interactions. Despite these challenges, there are high levels of motivation and interest in addressing smoking. Trial registration NCT01932996. Date of registration 30th August 2013. Prospectively registered.

Abstract Although biodiversity conservation is a prioritized topic globally, agreements and regulations at multiple levels often fail to meet the desired effects due to insufficient knowledge transmission about and tolerance toward environmental protection measures among the public. To find effective measures to solve human–wildlife conflicts (HWCs) and promote a sustainable coexistence, it is essential to gain the public's understanding of the importance of preserving biodiversity. To spur progress in solution‐oriented conservation science, we examine how citizen science (CS) can complement research in the HWC field and coexistence/mitigation strategies. We find that CS (1) is an effective tool for gathering wildlife data and (2) empowers citizens to participate in or drive (in a bottom‐up manner) wildlife research and management. Each HWC has a unique social, economic, and geographical context, which makes it challenging to find appropriate mitigation measures. We developed a Global and Local Geographic (GLG) model that provides practical guidelines for implementing CS in HWC research. We argue that the inclusion of youth is fundamental to achieving coexistence between people and wildlife; thus integrating CS into formal education or including an educational component in CS projects can support the sustainable conservation of wildlife species and foster environmentally aware future generations.