Peak frequency mapping of atypical atrial flutter.

INTRODUCTION: Peak frequency (PF) mapping is a novel method that may identify critical portions of myocardial substrate supporting reentry. The aim of this study was to describe and evaluate PF mapping combined with omnipolar voltage mapping in the identification of critical isthmuses of left atrial (LA) atypical flutters. METHODS AND RESULTS: LA omnipolar voltage and PF maps were generated in flutter using the Advisor HD-Grid catheter (Abbott) and EnSite Precision Mapping System (Abbott) in 12 patients. Normal voltage was defined as ≥0.5 mV, low-voltage as 0.1-0.5 mV, and scar as <0.1 mV. PF distributions were compared with ANOVA and post hoc Tukey analyses. The 1 cm radius from arrhythmia termination was compared to global myocardium with unpaired t-testing. The mean age was 65.8 ± 9.7 years and 50% of patients were female. Overall, 34 312 points were analyzed. Atypical flutters most frequently involved the mitral isthmus (58%) or anterior wall (25%). Mean PF varied significantly by myocardial voltage: normal (335.5 ± 115.0 Hz), low (274.6 ± 144.0 Hz), and scar (71.6 ± 140.5 Hz) (p < .0001 for all pairwise comparisons). All termination sites resided in low-voltage regions containing intermediate or high PF. Overall, mean voltage in the 1 cm radius from termination was significantly lower than the remaining myocardium (0.58 vs. 0.95 mV, p < .0001) and PF was significantly higher (326.4 vs. 245.1 Hz, p < .0001). CONCLUSION: Low-voltage, high-PF areas may be critical targets during catheter ablation of atypical atrial flutter.

2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation.

In the last three decades, ablation of atrial fibrillation (AF) has become an evidence-based safe and efficacious treatment for managing the most common cardiac arrhythmia. In 2007, the first joint expert consensus document was issued, guiding healthcare professionals involved in catheter or surgical AF ablation. Mounting research evidence and technological advances have resulted in a rapidly changing landscape in the field of catheter and surgical AF ablation, thus stressing the need for regularly updated versions of this partnership which were issued in 2012 and 2017. Seven years after the last consensus, an updated document was considered necessary to define a contemporary framework for selection and management of patients considered for or undergoing catheter or surgical AF ablation. This consensus is a joint effort from collaborating cardiac electrophysiology societies, namely the European Heart Rhythm Association, the Heart Rhythm Society, the Asia Pacific Heart Rhythm Society, and the Latin American Heart Rhythm Society .

New PFASs Identified in AFFF Impacted Groundwater by Passive Sampling and Nontarget Analysis.

Monitoring contamination from per- and polyfluoroalkyl substances (PFASs) in water systems impacted by aqueous film-forming foams (AFFFs) typically addresses a few known PFAS groups. Given the diversity of PFASs present in AFFFs, current analytical approaches do not comprehensively address the range of PFASs present in these systems. A suspect-screening and nontarget analysis (NTA) approach was developed and applied to identify novel PFASs in groundwater samples contaminated from historic AFFF use. A total of 88 PFASs were identified in both passive samplers and grab samples, and these were dominated by sulfonate derivatives and sulfonamide-derived precursors. Several ultrashort-chain (USC) PFASs (≤C3) were detected, 11 reported for the first time in Australian groundwater. Several transformation products were identified, including perfluoroalkane sulfonamides (FASAs) and perfluoroalkane sulfinates (PFASis). Two new PFASs were reported (((perfluorohexyl)sulfonyl)sulfamic acid; m/z 477.9068 and (E)-1,1,2,2,3,3,4,5,6,7,8,8,8-tridecafluorooct-6-ene-1-sulfonic acid; m/z 424.9482). This study highlights that several PFASs are overlooked using standard target analysis, and therefore, the potential risk from all PFASs present is likely to be underestimated.

Attention Training after Moderate-to-Severe Traumatic Brain Injury in Adults: A Systematic Review.

OBJECTIVE: To determine the extent and efficacy of attentional training as a form of neuropsychological rehabilitation to ameliorate attention deficits in adults with moderate-to-severe traumatic brain injury. DATA SOURCES: Articles published in Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, PubMed, PsycINFO, Scopus, and Web of Science were searched between January 17, and February 27, 2021. STUDY SELECTION: Two reviewers blindly assessed studies for eligibility according to the following criteria: any article evaluating the efficacy of any type of behavioral intervention that targeted attention (by means of cognitive rehabilitative, psychoeducational, or neuropsychological strategies, at either an individual or group level) in adults who had sustained a formally documented moderate-to-severe traumatic brain injury. DATA EXTRACTION: Methodological quality of each article was blindly assessed by 2 reviewers. Data were extracted from each study, including study type, sample size, sample characteristics, summary of intervention, measures used to assess attention, statistical outcomes and results, effect size, conclusion, and limitations. DATA SYNTHESIS: 7314 articles were retrieved from databases, 4325 articles remained after duplicate removal, and finally 21 articles met eligibility criteria and were included in this review. Articles represented varied methodological quality in group or single subject design. Irrespective of the heterogeneity regarding intervention types and attentional outcome measures used across the studies, overall findings suggest that attentional gains can be made in this sample, irrespective of time since injury, age, and injury severity. Further, a growing interest in technology-based interventions is frequently used and holds promise to bettering rehabilitation efforts. However, there is still limited evidence supporting the ecological validity of attentional training interventions (eg, the transfer of treatment effects to daily activities). CONCLUSIONS: This article plays a crucial role in informing ongoing rehabilitation practices, guiding clinicians with evidence-based strategies and shaping future research directions for more effective attentional training guidelines.

Subcutaneous cardioverter-defibrillator implantation in an adult with congenital heart disease and left infra-mammary pacemaker.

The approach/type of an implantable cardioverter defibrillator (ICD) is determined by the underlying cardiac anatomy, venous access, and pre-existing cardiac implantable electronic devices. We describe a case of subcutaneous ICD implantation in an adult with congenital heart disease (CHD) with a pre-existing inframammary transvenous pacemaker. This was preferred over adding a defibrillator coil to existing pacing leads, extraction/replacement of pacing system, or a sternotomy/epicardial ICD placement. The procedure was accomplished uneventfully with successful defibrillation threshold testing. Innovative approaches are required to manage arrhythmias in adults with CHD, with shared decision making playing a critical role.

Racial Family Configurations and Inequalities in Private School Enrollment Among Adopted Children.

This study uses data from the American Community Survey to examine the relationship between race, family configurations, and inequalities in private school enrollment among adoptees. We find that private school enrollment is higher in transracial than in same-race families. This disparity is driven by the outcomes of adoptees in transracial families with zero rather than one same-race parent. Among adoptees themselves, there are diverging patterns of racial stratification in same-race and transracial families. White adoptees in same-race families are more likely to be enrolled in private school than Black, Asian, or Hispanic adoptees in such families. However, among adoptees in transracial families, the highest odds of private school enrollment are found among Asians. Finally, we argue that our findings have important implications for understanding how kinship cues, compensation, and social disadvantage shape parental investment in adopted children.

Mass quantification of nanoplastics at wastewater treatment plants by pyrolysis-gas chromatography-mass spectrometry.

Municipal wastewater treatment plants (WWTPs) play a crucial role in the collection and redistribution of plastic particles from both households and industries, contributing to their presence in the environment. Previous studies investigating the levels of plastics in WWTPs, and their removal rates have primarily focused on polymer type, size, shape, colour, and particle count, while comprehensive understanding of the mass concentration of plastic particles, particularly those <1 µm (nanoplastics), remains unclear and lacking. In this study, pyrolysis gas chromatography-mass spectrometry was used to simultaneously determine the mass concentration of nine selected polymers (i.e., polyethylene (PE), polypropylene (PP), polystyrene (PS), poly(ethylene terephthalate) (PET), nylon 6, nylon 66, polyvinylchloride (PVC), poly(methyl methacrylate) (PMMA) and polycarbonate (PC)) below 1 µm in size across the treatment processes or stages of three WWTPs in Australia. All the targeted nanoplastics were detected at concentrations between 0.04 and 7.3 µg/L. Nylon 66 (0.2-7.3 µg/L), PE (0.1-6.6 µg/L), PP (0.1-4.5 µg/L), Nylon 6 (0.1-3.6 µg/L) and PET (0.1-2.2 µg/L), were the predominant polymers in the samples. The mass concentration of the total nanoplastics decreased from 27.7, 18 and 9.1 µg/L in the influent to 1, 1.4 and 0.8 µg/L in the effluent, with approximate removal rates of 96 %, 92 % and 91 % in plants A, B and C, respectively. Based on annual wastewater effluent discharge, it is estimated that approximately 24, 2 and 0.7 kg of nanoplastics are released into the environment per year for WWTPs A, B and C, respectively. This study investigated the mass concentrations and removal rates of nanoplastics with a size range of 0.01-1 µm in wastewater, providing important insight into the pollution levels and distribution patterns of nanoplastics in Australian WWTPs.

Limited exposure of captive Australian marsupials to plastics.

The global concern regarding the ubiquitous presence of plastics in the environment has led to intensified research on the impact of these materials on wildlife. In the Australian context, marsupials represent a unique and diverse group of mammals, yet little is known about their exposures to plastics. This study aimed to assess the contamination levels of seven common plastics (i.e., polystyrene (PS), polycarbonate (PC), poly-(methyl methacrylate) (PMMA), polypropylene (PP), polyethylene terephthalate (PET), polyethylene (PE), and polyvinyl chloride (PVC)) in both the diet and faeces of kangaroos, wallabies and koalas sampled from a sanctuary in Northeastern Australia. Quantitative analysis was performed by pressurized liquid extraction followed by double-shot microfurnace pyrolysis coupled to gas chromatography mass spectrometry. Interestingly, the analysis of the food and faeces samples revealed the absence of detectable plastic particles; with this preliminary finding suggesting a relatively limited exposure of captive Australian marsupials to plastics. This study contributes valuable insights into the current state of plastic contamination in Australian marsupials, shedding light on the limited exposures and potential risks, and highlighting the need for continued monitoring and conservation efforts. The results underscore the importance of proactive measures to mitigate plastic pollution and protect vulnerable wildlife populations in Australia's unique ecosystems.

Tracing the origins of plastics in biosolids: The role of sewerage pipe materials and trade waste.

Plastics are ubiquitous in virtually every environment on earth. While the specific sources of plastics entering wastewater are not well known, growing evidence suggests sewage sludge (biosolids) can be a sink for plastics. One potential source could be the sewerage pipe materials used to transport sewage between premises and wastewater treatment plants (WWTPs). To evaluate the significance of sewerage piping as a source of biosolids plastics concentrations, we compared the proportion of the total network (by length and surface area) of polyethylene (PE), polyvinylchloride (PVC), and polypropylene (PP) pipes from 10 WWTPs against their biosolids mass concentrations (mg plastic/g biosolid). Among the 10 catchments, the percentage of the network consisting of PP piping ranged from 0 to 1 %, with 0.8-21 % for PE, and 8-73 % for PVC. Biosolids plastics concentrations ranged from 0.09 to 8.62 mg/g (mg plastic/g biosolid) for PP and PE, respectively. For all three plastics, there was no significant Pearson correlation (r < 0.4) between the biosolids concentration (dry weight mg/g) and the proportion of the network material of the sewerage piping as plastic (either length or surface area). A comparison of trade waste entering a subset of 6 WWTP showed the highest biosolid principal components analysis (PCA) associations between loads of plastics (g/day) and automotive wash bays, general manufacturing, hospitals, laboratories, food manufacturing, laundry and dry cleaning, and cooling towers. A stepwise regression analysis indicated pipe length and surface area, as well as automotive wash bays and food manufacturing may be significant. While our data gave mixed results on the attribution of the sources of plastics entering WWTPs, it suggests that sewerage infrastructure and trade waste may play some role. Future studies should investigate the leachability of sewerage infrastructure and contributions from specific trade waste categories to determine their significance in plastics entering WWTPs.

Enhanced efficiency of bifacial perovskite solar cells using computational study.

The most rapidly expanding type of solar cells are the Perovskite Solar Cells (PSCs), because of its high device performance, ease of synthesis, high open-circuit voltage, and affordability. Despite these advantages, the development of perovskite-based solar cells continues to be impeded by the issues with perovskite stability and the utilization of the hazardous heavy element lead (Pb). The study emphasizes on the bifacial structure that maintains the conventional absorber layer and electron transport layer (ETL) in the optimized PSC structure. This study employs SCAPS software for device simulation to comprehensively analyze how various parameters affect the performance of solar cells. Additionally, doping concentration variation in both ETL and HTL are explored. The simulation reveals that changing device structure from monofacial to bifacial significantly influences PSC performance, demonstrating that optimizing individual layers effectively enhances overall solar cell performance. The optimized structure achieves impressive PSC performance metrics through parametric analysis, such as voltage (VOC) of 1.18 V, fill factor (FF) of 82.24%, current density (JSC) of 27.12 mA/cm2, power conversion efficiency (PCE) of 27.90% for an incident solar spectrum from the ETL side, and power conversion efficiency (PCE) of 19.86% for an incident solar spectrum from the HTL side, the calculated bifaciality factor (BF) for this structure is 71.18%.

Exercise Is a Vital Sign.

Description In this review, we argue that exercise (physical activity) be monitored as a vital sign since no other basic sign or symptom provides as much information about a patient's health status. The influence of regular exercise on patient health is indisputable, with strong evidence to show the power of exercise to mitigate chronic disease and improve overall health. Several simple tools, such as Physical Activity as a Vital Sign and Exercise as a Vital Sign are available to assess patient physical activity. When properly applied, there is evidence to support the efficacy of these tools, but there are barriers that prevent broad inclusion in primary care, among which are time and provider knowledge. In our review, we also discussed the value of physician-led lifestyle discussions with patients and found they view these discussions favorably. There is also evidence that physicians who exercise are more likely to have these lifestyle discussions with their patients, but the proportion of physicians who exercise regularly is fairly low. We believe physicians' awareness of their patients' sedentary lifestyles should prompt a prescription to increase physical activity, but additional in-clinic support and community resources need to be in place for patients to get a regular dose.

Supraspinal, spinal, and motor unit adjustments to fatiguing isometric contractions of the knee extensors at low and high submaximal intensities in males.

Contraction intensity is a key factor determining the development of muscle fatigue, and it has been shown to induce distinct changes along the motor pathway. The role of cortical and spinal inputs that regulate motor unit (MU) behavior during fatiguing contractions is poorly understood. We studied the cortical, spinal, and neuromuscular response to sustained fatiguing isometric tasks performed at 20% and 70% of the maximum isometric voluntary contraction (MVC), together with MU behavior of knee extensors in healthy active males. Neuromuscular function was assessed before and after performance of both tasks. Cortical and spinal responses during exercise were measured via stimulation of the motor cortex and spinal cord. High-density electromyography was used to record individual MUs from the vastus lateralis (VL). Exercise at 70%MVC induced greater decline in MVC (P = 0.023) and potentiated twitch force compared with 20%MVC (P < 0.001), with no difference in voluntary activation (P = 0.514). Throughout exercise, corticospinal responses were greater during the 20%MVC task (P < 0.001), and spinal responses increased over time in both tasks (P ≤ 0.042). MU discharge rate increased similarly after both tasks (P ≤ 0.043), whereas recruitment and derecruitment thresholds were unaffected (P ≥ 0.295). These results suggest that increased excitability of cortical and spinal inputs might be responsible for the increase in MU discharge rate. The increase in evoked responses together with the higher MU discharge rate might be required to compensate for peripheral adjustments to sustain fatiguing contractions at different intensities.NEW & NOTEWORTHY Changes in central nervous system and muscle function occur in response to fatiguing exercise and are specific to exercise intensity. This study measured corticospinal, neuromuscular, and motor unit behavior to fatiguing isometric tasks performed at different intensities. Both tasks increased corticospinal excitability and motor unit discharge rate. Our findings suggest that these acute adjustments are required to compensate for the exercise-induced decrements in neuromuscular function caused by fatiguing tasks.

Assisting Black Patients With Decision-Making for Implantable Cardioverter Defibrillator Therapy: Qualitative Findings From the Videos to Reduce Racial Disparities in ICD Therapy via Innovative Designs (VIVID) Trial.

BACKGROUND: The VIVID (Videos for Addressing Racial Disparities in Implantable Cardioverter Defibrillator Therapy via Innovative Designs) study was a multicenter, randomized controlled trial aimed at evaluating the effectiveness of a video-based decision support tool in enhancing informed consent for implantable cardioverter defibrillator (ICD) implantation among Black patients who met guideline criteria for primary prevention ICDs. Within the broader VIVID randomized trial, a qualitative investigation was conducted to elucidate the decisional factors among Black individuals considering ICD implantation for the primary prevention of sudden cardiac arrest. METHODS: Between October 2016 and July 2019, in-depth interviews were conducted at 2 time points from randomization, ≈7 days (time interval for the decision) and at 90 days; the time interval for determining ICD implantation. Interview findings were categorized by randomized groups, those assigned to 1 of the 2 encounter-based video decision support tools or standard care (without video). Interview participants were purposefully selected to ensure diversity across gender, age, educational background, research site, and randomization group; participants were sampled from 14 academic and community-based electrophysiology clinics in the United States. Data analysis employed applied thematic analysis techniques. RESULTS: A diverse sample of Black individuals were interviewed at 1 week (n=59; female, 37.3%) and 90 days (n=48; female, 39.6%). The primary factors influencing the decisions of Black individuals considering a primary prevention ICD implantation were (1) their clinicians' recommendations for ICD implantation; (2) their perception of their cardiac health status; and (3) a desire to prolong their lives for the sake of their families. CONCLUSIONS: These findings offer valuable insights that may guide clinicians in their communication with Black patients during shared decision-making encounters related to ICD implantation.

Exploring the Chemical Space of the Exposome: How Far Have We Gone?

Around two-thirds of chronic human disease can not be explained by genetics alone. The Lancet Commission on Pollution and Health estimates that 16% of global premature deaths are linked to pollution. Additionally, it is now thought that humankind has surpassed the safe planetary operating space for introducing human-made chemicals into the Earth System. Direct and indirect exposure to a myriad of chemicals, known and unknown, poses a significant threat to biodiversity and human health, from vaccine efficacy to the rise of antimicrobial resistance as well as autoimmune diseases and mental health disorders. The exposome chemical space remains largely uncharted due to the sheer number of possible chemical structures, estimated at over 1060 unique forms. Conventional methods have cataloged only a fraction of the exposome, overlooking transformation products and often yielding uncertain results. In this Perspective, we have reviewed the latest efforts in mapping the exposome chemical space and its subspaces. We also provide our view on how the integration of data-driven approaches might be able to bridge the identified gaps.

Plastic pollution in Moreton Bay sediments, Southeast Queensland, Australia.

The mounting issue of plastic waste in the aquatic ecosystem is a growing source of concern. Most plastic waste originates on land and a significant proportion of this eventually finds its way into the marine environment, which is widely regarded as a major repository for plastic debris. Currently, there exists a substantial gap in our understanding of how much plastic, the main polymer types, and the distribution of plastic in the marine environment. This study aimed to provide information on mass concentrations of a range of plastics in the surface sediments in the semi-enclosed Moreton Bay, just offshore the large city of Brisbane, Southeast Queensland, Australia. Surface sediment samples were quantitatively analysed for a suite of 7 common plastic polymer types (i.e., polystyrene (PS), polycarbonate (PC), poly-(methyl methacrylate) (PMMA), polypropylene (PP), polyethylene terephthalate (PET), polyethylene (PE) and polyvinyl chloride (PVC)) using a pressurized liquid extraction (PLE) followed by double-shot microfurnace pyrolysis coupled to gas chromatography mass spectrometry (Pyr-GC/MS). The advantage of this approach is that it can measure plastics below the limit of visual detection. The study revealed that Σ7plastics were consistently present in the samples, although the concentrations displayed a wide range of concentrations from 3.3 to 2194.2 µg/g across different sites. Among the polymers analysed, PE and PVC were found at the highest concentrations, ranging from 2.3 to 1885.9 µg/g and 3.0-979.5 µg/g, respectively. Based on the average concentrations of plastics measured, the dry bulk density and volume of sediments within the top 10 cm of the bay, it was estimated that there is a minimum of 7000 t of plastics stored in the surface sediments of the bay. This study is the first to report the mass concentrations of identified plastics and identify the main polymer types in Moreton Bay. This is important information to develop management plans to reduce the plastic waste entering the coastal marine environment.

Exploring the chemical subspace of RPLC: A data driven approach.

BACKGROUND: The chemical space is comprised of a vast number of possible structures, of which an unknown portion comprises the human and environmental exposome. Such samples are frequently analyzed using non-targeted analysis via liquid chromatography (LC) coupled to high-resolution mass spectrometry often employing a reversed phase (RP) column. However, prior to analysis, the contents of these samples are unknown and could be comprised of thousands of known and unknown chemical constituents. Moreover, it is unknown which part of the chemical space is sufficiently retained and eluted using RPLC. RESULTS: We present a generic framework that uses a data driven approach to predict whether molecules fall 'inside', 'maybe' inside, or 'outside' of the RPLC subspace. Firstly, three retention index random forest (RF) regression models were constructed that showed that molecular fingerprints are able to predict RPLC retention behavior. Secondly, these models were used to set up the dataset for building an RPLC RF classification model. The RPLC classification model was able to correctly predict whether a chemical belonged to the RPLC subspace with an accuracy of 92% for the testing set. Finally, applying this model to the 91 737 small molecules (i.e., ≤1 000 Da) in NORMAN SusDat showed that 19.1% fall 'outside' of the RPLC subspace. SIGNIFICANCE AND NOVELTY: The RPLC chemical space model provides a major step towards mapping the chemical space and is able to assess whether chemicals can potentially be measured with an RPLC method (i.e., not every RPLC method) or if a different selectivity should be considered. Moreover, knowing which chemicals are outside of the RPLC subspace can assist in reducing potential candidates for library searching and avoid screening for chemicals that will not be present in RPLC data.

Depression and Implantable Cardioverter-Defibrillator Implantation in Black Patients at Risk for Sudden Cardiac Death.

BACKGROUND: Black patients meeting indications for implantable cardioverter-defibrillators (ICDs) have lower rates of implantation compared with White patients. There is little understanding of how mental health impacts the decision-making process among Black patients considering ICDs. Our objective was to assess the association between depressive symptoms and ICD implantation among Black patients with heart failure. METHODS AND RESULTS: This is a secondary analysis of the VIVID (Videos to Address Racial Disparities in ICD Therapy via Innovative Designs) randomized trial, which enrolled self-identified Black individuals with chronic systolic heart failure. Depressive symptoms were assessed by the Patient Health Questionnaire-2 and the Mental Component Summary of the 12-Item Short-Form Health Survey. Decisional conflict was measured by an adapted Decisional Conflict Scale (DCS). ANCOVA was used to assess differences in Decisional Conflict Scale scores. Multivariable logistic regression was used to examine the association between depressive symptoms and ICD implantation. Among 306 participants, 60 (19.6%) reported depressed mood, and 142 (46.4%) reported anhedonia. Participants with the lowest Mental Component Summary of the 12-Item Short-Form Health Survey scores (poorer mental health and higher likelihood of depression) had greater decisional conflict regarding ICD implantation compared with those with the highest Mental Component Summary of the 12-Item Short-Form Health Survey scores (adjusted mean difference in Decisional Conflict Scale score, 3.2 [95% CI, 0.5-5.9]). By 90-day follow-up, 202 (66.0%) participants underwent ICD implantation. There was no association between either the Patient Health Questionnaire-2 score or the Mental Component Summary of the 12-Item Short-Form Health Survey score and ICD implantation. CONCLUSIONS: Depressed mood and anhedonia were prevalent among ambulatory Black patients with chronic systolic heart failure considering ICD implantation. The presence of depressive symptoms did not impact the likelihood of ICD implantation in this population.

Deep dive into the chronic toxicity of tyre particle mixtures and their leachates.

Particles from the tread of vehicle tyres are a global pollutant, which are emitted into the environment at an approximate rate of 1.4 kg.year-1 for an average passenger-car. In this study, popular tyre brands were used to generate a tyre tread microparticle mixture. The chronic toxicity of both particles and chemical leachates were compared on a planktonic test species (Daphnia magna). Over 21 days of exposure, pristine tyre tread microparticles were more toxic (LC50 60 mg.L-1) than chemical lechates alone (LC50 542 mg.L-1). Microparticles and leachates showed distinct effects on reproduction and morphological development at environmentally relevant concentrations, with dose-dependent uptake of particles visible in the digestive tract. Chemical characterization of leachates revealed a metal predominance of zinc, titanium, and strontium. Of the numerous organic chemicals present, at least 54 were shared across all 5 tyre brands, with many classified to be very toxic. Our results provide a critically needed information on the toxicity of tyre tread particles and the associated chemicals that leach from them to inform future mitigation measures. We conclude that tyre particles are hazardous pollutants of particular concern that are close to or possibly above chronic environmental safety limits in some locations.

Analysis of wastewater from 2013 to 2021 detected a recent increase in nicotine use in Queensland, Australia.

Previous wastewater-based epidemiology (WBE) studies have reported decreasing trends of nicotine and tobacco use in Australia before 2017, but there is concern that increasing illicit use of nicotine in vaping products and illicit tobacco could reverse this progress. This study aimed to assess temporal trends of nicotine consumption and specifically tobacco consumption via wastewater analysis in a population in Australia between 2013 and 2021. One week of daily wastewater samples were analyzed every two months from February 2013 to December 2021 in a regional city serving ∼100,000 people. A total of 340 daily samples were analyzed for anabasine (tobacco specific biomarker) and nicotine metabolites, cotinine and hydroxycotinine, using direct injection method by liquid chromatography with tandem mass spectrometry. Daily consumption estimates were calculated from daily flow data, population estimates and previously reported excretion factors. Linear spline regression was performed to identify periods when significant change of slopes occurred and to evaluate the temporal trends. Tobacco use monitored using anabasine as a biomarker, showed a decreasing trend over the whole period with a higher rate of decrease during the first two years (2013-2014, 21 % decrease) compared to the later 7 years (2015-2021, 10 % decrease). Nicotine use, monitored using cotinine and hydroxycotinine, showed a downward trend between 2013 and 2018 (2013-2014: 18 % decrease, p < 0.05; 2015-2016: 6 % increase, p = 0.48; Feb-Dec 2017: 15 % decrease, p = 0.39) followed by a significant increase from 2018 to 2021 (40 % increase, p < 0.001). This finding suggests the increasing use of non-tobacco nicotine-based products. Additionally, the tobacco use estimate by wastewater analysis was higher than the tobacco sales data, which suggests the use of illicit tobacco in the catchment.

Sleep and cognition in South African patients with non-functioning pituitary adenomas.

Strong lines of evidence in the neuroscience literature indicate that (a) healthy sleep facilitates cognitive processing, and (b) sleep disruption is associated with cognitive dysfunction. Despite the fact that patients with pituitary disease often display both disrupted sleep and cognitive dysfunction, few previous studies investigate whether these clinical characteristics in these patients might be related. Hence, we explored whether sleep disruption in patients with pituitary disease mediates their cognitive dysfunction. We recruited 18 patients with non-functioning pituitary adenomas (NFPA) and 19 sociodemographically matched healthy controls. They completed the Global Sleep Assessment Questionnaire (thus providing self-report data regarding sleep disruption) and were administered the Brief Test of Adult Cognition by Telephone, which assesses cognitive functioning in the domains of processing speed, working memory, episodic memory, inhibition, and reasoning. We found no significant differences in cognition between patients and controls. Furthermore, spectra of sleep disturbance did not differ significantly between patients and controls. Our data suggest that NFPA patients' cognition and sleep quality is relatively intact, and that sleep disruption does not mediate cognitive dysfunction. Larger studies should characterize sleep and cognition in patients with NFPA (and other pituitary diseases) to confirm whether disruption of the former mediates impairment in the latter.