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Ventricular tachycardia (VT) is a life-threatening arrhythmia common in patients with structural heart disease or nonischemic cardiomyopathy. Many VTs originate from regions of fibrotic scar tissue, where delayed electrical signals exit scar and re-enter viable myocardium. Cardiac stereotactic body radiotherapy (SBRT) has emerged as a completely noninvasive alternative to catheter ablation for the treatment of recurrent or refractory ventricular tachycardia. While there is no common consensus on the ideal imaging workflow, therapy planning for cardiac SBRT often combines information from a plurality of imaging modalities including MRI, CT, electroanatomic mapping and nuclear imaging. MRI and CT provide detailed anatomic information, and late enhancement contrast imaging can indicate regions of fibrosis. Electroanatomic maps indicate regions of heterogenous conduction voltage or early activation which are indicative of arrhythmogenic tissue. Some early clinical adopters performing cardiac SBRT report the use of myocardial perfusion and viability nuclear imaging to identify regions of scar. Nuclear imaging of hibernating myocardium, inflammation and sympathetic innervation have been studied for ventricular arrhythmia prognosis and in research relating to catheter ablation of VT but have yet to be studied in their potential applications for cardiac SBRT. The integration of information from these many imaging modalities to identify a target for ablation can be challenging. Multimodality image registration and dedicated therapy planning tools may enable higher target accuracy, accelerate therapy planning workflows and improve patient outcomes. Understanding the pathophysiology of ventricular arrhythmias, and localizing the arrhythmogenic tissues, is vital for successful ablation with cardiac SBRT. Nuclear imaging provides an arsenal of imaging strategies to identify regional scar, hibernation, inflammation, and sympathetic denervation with some advantages over alternative imaging strategies. [ABSTRACT FROM AUTHOR]

Incidence of anal carcinoma (AC) in people living with HIV (PLWH) is increased compared to the general population. Adverse effects of chemoradiotherapy (CRT) on the immune system are associated with a significant detrimental prognosis on overall survival in patients receiving CRT for solid tumors. The aim of this study was to evaluate immunological factors, in particular the differences in recovery of CD4+ and CD8+ cell counts before and after CRT for AC in PLWH. Retrospective single-center chart review extraction to analyze immunological data collected from PLWH with AC; descriptive statistics were used. Thirty-six PLWH with histologically proven AC were included in the analysis. Absolute CD4 cell count 60 months after CRT was 67.2% of the value at the beginning of CRT, whereas the CD8 cell count reached 82.3%. These differences were statistically significant (p = .048), whereas CD4/CD8-ratio remained stable. The findings of the presented study regarding CD4+ and CD8+ cell recovery after CRT are congruent with results from prior studies in non-HIV infected patients. Although not reaching the level of prior CRT T cell numbers, the ability to generate CD8+ cells seems to be better recovered, while CD4+ regeneration is more impaired. These observations are best explained by faster recovery of CD8+ cells via thymic-independent pathways, which are not available for regeneration of CD4+ cells. Further studies with larger numbers of patients are required to analyze the specific CD4+ and CD8+ cell subsets. [ABSTRACT FROM AUTHOR]

A conceptual new window/glazing technology called POLarizer-FENestration (POLFEN) is presented. In 1935, Edwin Land's pioneering work on polarizers successfully developed a sheet polarizer that was used in various applications. Subsequently, polarizers were employed in windows to modulate daylight and reduce associated glare. Early prototype windows were circular in shape so that the polarizing filter could be rotated to modulate the daylight. However, compared to rectangular-shaped windows that are ubiquitous, circular windows are rare in buildings. Therefore, a new window/glazing technology, discussed in this paper, was developed that utilizes a polarizing film in a conventional rectangular or square window, arranged in the form of strips or a checker-grid over the window panes to modulate daylighting levels and control glare. In this new research, a working prototype of the glazing technology is developed and demonstrated including simulations using the Radiance daylighting simulation software. In the current work, two types of measurements were taken: photographs of the indoor luminous environment and illumination levels (Lux) at selective points on the work-plane both in a physical prototype as well as in the simulation model under two sky conditions: CIE clear sky with sun, and overcast sky. The results indicate that the new glazing technology resulting from this concept can effectively modulate daylighting levels, minimized associated glare to an acceptable level while maintaining a view to the outdoor environment. The technology can be classified as Variable Transmission Glazing (VTG), similar to Electrochromic (EC) glazing since it also offers a dynamic modulation of solar optical properties (T vis). • POLFEN, a concept of a new glazing technology utilizing linear polarizers, can be successfully employed in conventional window shapes (i.e., square or rectangular) to quickly and effectively modulate daylight and its associated glare. • POLFEN glazing technology can be classified as Variable Transmission Glazing (VTG), similar to Electrochromic (EC), as it offers variable transmission properties. • POLFEN glazing technology offers quick modulation of daylight and associated glare through mechanical actuation. • POLFEN modulates daylight and preserves the view of the outdoors. [ABSTRACT FROM AUTHOR]

• Mapping material stocks at 10 m resolution for the entire UK and IRL. • 9 building types, 32 mobility infrastructure types, 12 materials. • Building stocks per capita are surprisingly similar for most population densities. • Infrastructure stocks per capita decrease with higher population densities. • High-resolution maps can inform circular economy strategies and actions. Understanding the size and spatial distribution of material stocks is crucial for sustainable resource management and climate change mitigation. This study presents high-resolution maps of buildings and mobility infrastructure stocks for the United Kingdom (UK) and the Republic of Ireland (IRL) at 10 m, combining satellite-based Earth observations, OpenStreetMaps, and material intensities research. Stocks in the UK and IRL amount to 19.8 Gigatons or 279 tons/cap, predominantly aggregate, concrete and bricks, as well as various metals and timber. Building stocks per capita are surprisingly similar across medium to high population density, with only the lowest population densities having substantially larger per capita stocks. Infrastructure stocks per capita decrease with higher population density. Interestingly, for a given building stock within an area, infrastructure stocks are substantially larger in IRL than in the UK. These maps can provide useful insights for sustainable urban planning and advancing a circular economy. [ABSTRACT FROM AUTHOR]

• Developed a volume-driven framework to estimate material stocks using multi-source geographical data. • Generated spatially explicit material stocks maps of buildings and infrastructures at a 10 m resolution. • Estimated total material stocks within BTH-UA at 195,000 Mt in 2020, amounting to 182 t/capita and 2.43 Mt/km². • Identified significant correlations between material stocks, population size, and economic activity at the administrative level. Spatial patterns of material stocks in buildings and infrastructures are crucial for understanding resource use, spatial planning and environmental management. So far, spatially explicit stock-driven approaches face substantial data limitations, requiring costly and time-intensive efforts to map stocks at urban micro-scales. Herein, we developed a volume-based framework for material stocks mapping in buildings and infrastructures at a 10 m resolution, applied across the entire Beijing–Tianjin–Hebei urban agglomeration (BTH-UA) in China, a key growth pole for regional economic development. We integrated multi-source remote sensing data, GIS products, crowdsourced data, and material intensity databases, covering ten bulk materials. The findings reveal that the total mass of buildings and infrastructures in BTH-UA amounts to 195,000 Mt, equivalent to 182 t/cap, 2.43 Mt/km2. Material stocks are spatially clustered and correlate with the population size and economic activity of the secondary industry. This research contributes to the quantitative description and detailed mapping of material stocks in built environment. [ABSTRACT FROM AUTHOR]

• Crucial role of the ERP for the energy transition in France. • ERP enabled fast and large-scale expansion of oil and petroleum product supply. • Refinery expansion allowed to reposition France within global crude oil and petroleum product trade. • OEEC technical committees engaged in creating technological interlinkages of different sociotechnical systems relying on petroleum products. • Transition studies can benefit from the integration of a historical and biophysical perspective. The article investigates the roles of the European Recovery Program (ERP) and the Organization for European Economic Co-Operation (OEEC) in pushing France towards a pathway of petroleum dependency. The study is based on the energy transition and the Deep Transition frameworks, notably the analysis of specific collective actors. The analysis elaborates on the impact the OEEC Refinery Expansion Program had on (a) quality and quantity of petroleum product supply in France; (b) the French position within global crude oil and petroleum product trade; (c) the technological interrelatedness of the petroleum sector with agriculture, transport, and mobility. We show how different measures were designed to integrate sociotechnical systems, accelerate the transformation of energy systems and put the objective of Western Europe's "hidden integration" to work. The article concludes that complementing transition studies with historical and socio-metabolic perspectives can shed light on the origins of unsustainable pathways during the 20th century. [ABSTRACT FROM AUTHOR]

The planetary boundaries concept has profoundly changed the vocabulary and representation of global environmental issues. We bring a critical social science perspective to this framework through the notion of societal boundaries and aim to provide a more nuanced understanding of the social nature of thresholds. We start by highlighting the strengths and weaknesses of planetary boundaries from a social science perspective. We then focus on capitalist societies as a heuristic for discussing the expansionary dynamics, power relations, and lock-ins of modern societies that impel highly unsustainable societal relations with nature. While formulating societal boundaries implies a controversial process ‒ based on normative judgments, ethical concerns, and socio-political struggles ‒ it has the potential to offer guidelines for a just, social-ecological transformation. Collective autonomy and the politics of self-limitation are key elements of societal boundaries and are linked to important proposals and pluriverse experiences to integrate well-being and boundaries. The role of the state and propositions for radical alternative approaches to well-being have particular importance. We conclude with reflections on social freedom, defined as the right not to live at others' expense. Toward the aim of defining boundaries through transdisciplinary and democratic processes, we seek to open a dialogue on these issues. [ABSTRACT FROM AUTHOR]

To determine if the incidence of pressure injuries (PIs) on admission to an inpatient rehabilitation hospital (IRH) system of care was increased during the early coronavirus disease 2019 (COVID-19) pandemic period. Retrospective survey chart review of consecutive cohorts. Admissions to 4 acute IRHs within 1 system of care over the first consecutive 6-week period of admitting patients positive for COVID-19 during the initial peak of the COVID-19 pandemic, April 1-May 9, 2020. A comparison was made with the pre–COVID-19 period, January 1-February 19, 2020. Four acute IRHs with admissions on a referral basis from acute care hospitals. A consecutive sample (N=1125) of pre–COVID-19 admissions (n=768) and COVID-19 period admissions (n=357), including persons who were COVID-19–positive (n=161) and COVID-19–negative (n=196). Incidence of PIs on admission to IRH. Prevalence of PIs on admission during the COVID-19 pandemic was increased when compared with the pre–COVID-19 period by 14.9% (P <.001). There was no difference in the prevalence of PIs in the COVID-19 period between patients who were COVID-19–positive and COVID-19–negative (35.4% vs 35.7%). The severity of PIs, measured by the wound stage of the most severe PI the patient presented with, worsened during the COVID-19 period compared with pre–COVID-19 (χ2 32.04%, P <.001). The length of stay in the acute care hospital before transfer to the IRH during COVID-19 was greater than pre–COVID-19 by 10.9% (P <.001). During the early part of the COVID-19 pandemic time frame, there was an increase in the prevalence and severity of PIs noted on admission to our IRHs. This may represent the significant burden placed on the health care system by the pandemic, affecting all patients regardless of COVID-19 status. This information is important to help all facilities remain vigilant to prevent PIs as the pandemic continues and potential future pandemics that place strain on medical resources. [ABSTRACT FROM AUTHOR]

The implantation of rapid-deployment aortic valves may interfere with the conduction system of the heart. This study evaluates the occurrence and predictive factors of conduction anomalies in patients undergoing surgical aortic valve replacement (SAVR) with a rapid-deployment balloon-expandable bioprosthesis in a single-center, real-world experience. Between May 2010 and April 2019, 700 consecutive patients were included in a prospective, ongoing database with a longitudinal follow-up preoperatively, at discharge, and at 3 months, 1 year, 3 years, and 5 years postoperatively. Thirty-seven patients (5.3%) had a permanent pacemaker at baseline and were excluded from further analysis, leaving 663 patients for analysis. Assessment of conduction anomalies was performed by electrocardiography (ECG) monitoring and repeated 12-lead ECG during the hospital stay and at postoperative follow-ups. Preoperatively, 126 patients (19.0%) presented with different conduction disturbances. New permanent pacemaker implantation (PPI) occurred in 61 patients during the first 14 days (cumulative incidence, 9.4%). The indication for PPI was complete atrioventricular block in 47 cases (77%). Preoperative conduction anomalies, such as right bundle branch block, as well as operative characteristics (concomitant procedures) were found to be independent predictors for new PPI. One-year survival was 98% in patients with new early PPI and 96% in those without new early PPI (P =.60). The PPI rate was in the range of previous reports for rapid-deployment prostheses. PPI did not have a significant influence on short- to intermediate-term survival. Case selection with exclusion of patients presenting with baseline conduction disturbances may decrease the rate of new PPIs after SAVR with rapid-deployment balloon-expandable bioprostheses. Conduction disturbances after rapid-deployment aortic valve replacement: incidence and anatomic considerations. The expansion of the subannular stent within the left ventricular outflow tract in the proximity of the left bundle branch (black arrows) may exert compression to the conduction system and influence the occurrence of postoperative conduction disturbances. SA, sinoatrial; AV, atrioventricular; PPI, permanent pacemaker implantation; LBBB, left bundle branch block; RBBB, right bundle branch block, AVB, I, first-degree atrioventricular block; AVB II, second-degree atrioventricular block. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: HIV-infected patients with Pneumocystis-pneumonia (PCP) may develop paradoxical immune reconstitution inflammatory syndrome (IRIS), when combination antiretroviral therapy (cART) is started early during the course of PCP-treatment (PCPT). The aim of this study was to identify risk factors and predictors for PCP-IRIS and to improve individualized patient care.Methods: An ICD-10 code hospital database query identified all Frankfurt HIV Cohort patients being diagnosed with PCP from January 2010 - June 2016. Patient charts were evaluated retrospectively for demographic, clinical and therapeutic (cART/PCPT) characteristics and incidence of paradoxical IRIS according to French's case definitions.Results: IRIS occurred in 12/97 patients that started cART while on PCPT (12.4%). They had a higher rate of re-hospitalization (41.7vs. 4.7%; odds ratio (OR) 14.46; p = 0.009), intensive care treatment (66.7vs. 30.6%; OR = 4.54; p = 0.018), and longer median hospitalization (48 days vs. 23; p < 0.001). A high HIV-RNA level (> 6Log10/ml) before cART initiation was associated with IRIS development (41.6vs. 15.0%; OR 4.05; p = 0.042). Serum immunoglobulin G-levels (IgG) [mg/dl] were lower (894.0 vs. 1446.5; p = 0.023).Conclusion: Higher hospitalization rate and morbidity parameters underscore the clinical importance of PCP-related paradoxical IRIS. A baseline viral load of > 6Log10/ml and serum IgG may help to assess individual risks for PCP-IRIS. [ABSTRACT FROM AUTHOR]