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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 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 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.

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 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

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 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.

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 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.

Obesity is one of the main risk factors for progression of chronic kidney disease (CKD). Weight loss interventions have limited efficacy in patients with pre-dialysis CKD. Our objective is to test the efficacy of a cognitive behavioral therapy program for obesity management in patients with CKD. We will conduct a randomized controlled intervention trial to evaluate the effects of cognitive behavioral therapy for obesity on weight loss, change in proteinuria, weight maintenance, quality of life, depression symptoms, and anxiety symptoms in patients with CKD. The duration of the intervention will be 16 weeks. The primary study outcomes will be body mass index (BMI) and proteinuria. CKD patients will be randomized into two groups: an intervention group with cognitive behavioral therapy, sessions with a dietitian and a kinesiologist, and a control group with sessions with a dietitian and a kinesiologist, without cognitive behavioral therapy. Study outcomes will be assessed at baseline, immediately after the 16-week intervention, 3 months after the end of the intervention, and 12 months after the end of the intervention. This study will be the first to evaluate the efficacy of cognitive behavioral therapy for obesity in patients with CKD. We expect that our results will contribute to new ways of non-pharmacological treatment of CKD. Clinical trial registration: ClinicalTrials.Gov, NCT05927337.

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.

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.

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.

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 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]

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]

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 FROM AUTHOR]

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.

Aims Primary prevention patients with ischaemic cardiomyopathy and chronic total occlusion of an infarct-related coronary artery (CTO) are at a particularly high risk of implantable cardioverter-defibrillator (ICD) therapy occurrence. The trial was designed to evaluate the efficacy of preventive CTO-related substrate ablation strategy in ischaemic cardiomyopathy patients undergoing primary prevention ICD implantation. Methods and results The PREVENTIVE VT study was a prospective, multicentre, randomized trial including ischaemic patients with ejection fraction ≤40%, no documented ventricular arrhythmias (VAs), and evidence of scar related to the coronary CTO. Patients were randomly assigned 1:1 to a preventive substrate ablation before ICD implantation or standard therapy with ICD implantation only. The primary outcome was a composite of appropriate ICD therapy or unplanned hospitalization for VAs. Secondary outcomes included the primary outcome's components, the incidence of appropriate ICD therapies, cardiac hospitalization, electrical storm, and cardiovascular (CV) mortality. Sixty patients were included in the study. During the mean follow-up of 44.7 ± 20.7 months, the primary outcome occurred in 5 (16.7%) patients undergoing preventive substrate ablation and in 13 (43.3%) patients receiving only ICD [hazard ratio (HR): 0.33; 95% confidence interval (CI): 0.12–0.94; P = 0.037]. Patients in the preventive ablation group also had fewer appropriate ICD therapies (P = 0.039) and the electrical storms (Log-rank: P = 0.01). While preventive ablation also reduced cardiac hospitalizations (P = 0.006), it had no significant impact on CV mortality (P = 0.151). Conclusion Preventive ablation of the coronary CTO-related substrate in patients undergoing primary ICD implantation is associated with the reduced risk of appropriate ICD therapy or unplanned hospitalization due to VAs. [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.