Clinical features, future cardiac events, and prognostic factors following percutaneous coronary intervention in young female patients.

BACKGROUND: The proportion of young females among the patients who undergo percutaneous coronary intervention (PCI) is relatively small, and information on their clinical characteristics is limited. This study investigated the clinical characteristics and prognostic factors for future cardiac events in young females who underwent PCI. METHODS: This multicenter observational study included 187 consecutive female patients aged < 60 years who underwent PCI in seven hospitals. The primary composite endpoint was the incidence of cardiac death, nonfatal myocardial infarction, and target vessel revascularization. RESULTS: The mean patient age was 52.1 ± 6.1 years and 89 (47.6%) had diabetes, and renal dysfunction (an estimated glomerular filtration rate < 60 mL/min/1.73 m2) was observed in 38 (20.3%). During a median follow-up of 3.3 years, the primary endpoint occurred in 28 patients. The Cox proportional hazards models showed that renal dysfunction was an independent predictor for the primary endpoint (hazard ratio 3.04, 95% confidence interval 1.25-7.40, p = 0.01), as well as multivessel disease (hazard ratio 2.79, 95% confidence interval 1.12-6.93, p = 0.03). Patients with renal dysfunction had a significantly higher risk for the primary endpoint than those without renal dysfunction. CONCLUSIONS: Renal dysfunction was strongly associated with future cardiac events in young females who underwent PCI.

Electrophysiological and Histopathological Characteristics of Ventricular Tachycardia Associated With Primary Cardiac Tumors.

BACKGROUND: Ventricular tachycardia (VT) associated with primary cardiac tumors (PCTs) originating from the ventricles is rare, but lethal, in young patients. OBJECTIVES: This study aimed to clarify the mechanisms underlying primary cardiac tumor-related ventricular tachycardia (PCT-VT) and establish a therapeutic strategy for this form of VT. METHODS: Among 67 patients who underwent surgery for VT at our institute between 1981 and 2020, 4 patients aged 1 to 34 years, including 3 males, showed PCT-VT (fibroma, 2; lipoma, 1; and hamartoma, 1), which was investigated using a combination of intraoperative electroanatomical mapping and histopathological studies. RESULTS: All 4 patients developed electrical storms of sustained VTs refractory to multiple drugs and repetitive endocardial ablations. The VT mechanism was re-entry, and intraoperative electroanatomical mapping showed a centrifugal activation pattern originating from the border between the tumor and healthy myocardium, where fractionated potentials were detected during sinus rhythm. Histopathological studies of serial sections of specimens acquired from these areas revealed tumor infiltration into the surrounding myocardium with cell disorganization, exhibiting myocardial disarray. Several myocardia entrapped in the tumor edges contributed to the development and sustainment of re-entrant VT activation. In the 2 patients in whom complete resection was unfeasible, encircling cryoablation to entirely isolate the unresectable tumor was effective in suppressing VT occurrence. CONCLUSIONS: The mechanism underlying PCT-VT involves re-entry localized at the tumor edges. Myocardial disarray associated with tumor infiltration is a substrate for this form of VT. Cryoablation along the border between the tumor and myocardium is a promising therapeutic option for unresectable PCT-VT.

Blessing of the moon: cultural beliefs, birth timing and child health in Nepal.

In many South Asian contexts, specific dates are auspicious and inauspicious for health-related behaviours and outcomes. This study analysed the effect of lunar date-related auspicious beliefs in Nepal on childbirths and neonatal health outcomes. Using the daily birth records from a tertiary maternity hospital, we empirically examined whether births occurred disproportionally around full moon days. We found an average of 10.7 extra births on and before full moon days, with an average of 7.5 extra Caesarean deliveries on full moon days. We demonstrated that births occurring on or before the full moon day have poor neonatal health outcomes. However, a subsample analysis suggested better health outcomes for low-risk mothers and worse health outcomes for high-risk mothers. These findings suggest that low-risk mothers may move their deliveries to auspicious dates with fewer complications than high-risk mothers. The results emphasise the need for additional research to distinguish health service demand from supply influences on birth timing in Nepal.

The ridge line of left pulmonary vein isolation from left atrial appendage can subsequently increase the completion rate of the mitral isthmus block line.

BACKGROUND AND OBJECTIVES: Mitral isthmus (MI) ablation for mitral flutter is technically difficult, and incomplete block line is not uncommon. The objective of this study is to investigate the effect of the ridge line of left pulmonary vein isolation (LPVI) from left atrial appendage (LAA) on completion rate of mitral isthmus (MI) block line and recurrence rate of atrial tachycardia (AT) or atrial flutter (AFL) after the first MI ablation. METHODS: We identified 611 patients who underwent first MI ablation for mitral flutter during the study period. Finally, 559 patients were enrolled and divided into two groups according to the method of ridge line ablation of LPVI (LAA group, n = 467, conventional group, n = 92). Outcome measures were the completion of MI block line by first MI ablation, the recurrence of AT/AFL, and repeat MI ablation after the first MI ablation. RESULTS: The first MI block line completion rate was significantly higher in the LAA group than the conventional group (95% vs. 85%, p < 0.001). The recurrence rate of AT/AFL after 3 months from first MI ablation was significantly lower in the LAA group. The requirement of additional MI ablation tended to be lower in the LAA group. CONCLUSIONS: Our novel approach of ablating LPV-LAA ridge from the LAA side during PVI can increase the success rate of MI block line completion, and reduce the recurrence rate of AT/AFL and the need for additional MI block line ablation. Graphical abstract Ablation of the left pulmonary vein-left atrial appendage ridge from the left atrial appendage side during PVI increased the success rate of mitral isthmus block line completion.

Ten-year trends in vertical distribution of radiocesium in Fukushima forest soils, Japan.

To elucidate interannual changes in the vertical distribution of 137Cs in forest ecosystems contaminated by the Fukushima Dai-ichi Nuclear Power Plant accident, we investigated 137Cs inventories in forest soils (both organic and mineral soil horizons) at 10 sampling plots with different 137Cs deposition levels and dominant species for up to 10 years after the accident. We examined the temporal variation of the 137Cs inventories by depth with exponential regression models (assuming that the transition and partitioning of 137Cs are still active) and exponential offset regression models (assuming a shift to a stable 137Cs distribution, defined as the "quasi-equilibrium steady-state" in the Chernobyl accident). In the organic horizon, the 137Cs inventories were exponentially decreasing, and it might take more time to converge in the quasi-equilibrium steady-state at most plots. In the mineral soil horizon, most of 137Cs was found in the surface layer of the mineral soil horizon (0-5 cm). In this layer, the inventories first increased and then become relatively constant, and the exponential offset model was selected at most plots, suggesting entry into the quasi-equilibrium steady-state over the observation period. Although we also observed exponentially increasing trends in a lower layer (5-10 cm) of the mineral soil horizon, there was no clear increasing or decreasing trend of 137Cs inventory in the deeper mineral soil layers (10-15 and 15-20 cm). Our calculation of the relaxation depth and migration center revealed that downward migration of 137Cs is not significant in terms of the overall 137Cs distribution in the mineral soil horizon over 10 years.

Is Self-Transcendence Philanthropic? Graded Response Model Approach.

This study reveals that strong feelings of altruism were found to be statistically significant in explaining prosocial and pro-environmental behaviors. However, this was not the case for the latent trait biosphere in explaining pro-environmental behavior (e.g., past volunteering in clean-up activities). Regardless of whether they are overseas graduates or not, subjects in this study are more altruistic than biospheric by nature. Using the Graded Response Model (GRM) approach, the study found that the biosphere and altruism are obviously independent of each other and merging them into one dimension, in this instance referred to as "self-transcendence," makes the construct less reliable. That is why this study in consistence with previous studies could not detect the effect of self-transcendence statistically, as it affects both the past volunteering in environmental affairs and the past volunteering in social welfare.

Dataset: Japan household panel survey on Sustainable Development Goals 2019-2020.

The dataset concerning the Japan Household Panel Survey on Sustainable Development Goals (JHPSDGs) was collected through online surveys conducted in March 2019 and March 2020. The dataset consists of 12,098 observations, including two-period panel datasets of 3,227 individuals. The JHPSDGs include a wide range of individual survey responses, which allows researchers and policymakers to investigate a variety of social science research topics, including but not limited to Sustainable Development Goal (SDG) awareness, pro-sustainable behavior, and labor market decision-making. The variables include detailed demographic information, labor market information, SDG awareness, sustainable and financial decision-making, and personality traits. The dataset can be used to conduct quantitative analyses, especially in the areas of business, economics, and psychology. The dataset is available to the public via the Harvard Dataverse and provides access to questionnaires, codebooks, data, and descriptive statistics.

Comparison of the empirical linear ablation and low voltage area-guided ablation in addition to pulmonary vein isolation in patients with persistent atrial fibrillation: a propensity score-matched analysis.

BACKGROUND: The efficacy of pulmonary vein isolation (PVI) alone is not guaranteed for persistent atrial fibrillation (PeAF), and it is unclear which type of ablation approach should be applied in addition to PVI. This study aimed to compare outcomes and prognosis between empirical linear ablation and low-voltage area (LVA) ablation after PVI for PeAF. METHODS: We enrolled 128 patients with PeAF who were assigned to the linear ablation group (n = 64) and the LVA ablation group (n = 64) using a propensity score-matched model. After PVI and cardioversion, the patients underwent either empirical linear ablation or LVA ablation during sinus rhythm. All patients in the linear ablation group underwent both roof line and mitral valve isthmus (MVI) ablations. An electrical-guided ablation targeting LVA (< 0.5 mV) was performed in the LVA group. When there was no LVA in the LVA group, only PVI was applied. We compared the procedural outcomes and recurrence after ablation between the two groups. RESULTS: The baseline characteristics were well-balanced between the two groups. Fifty patients had LVA (22 and 28 patients in the linear and LVA groups). The roof and MVI lines were completed in 100% and 96.9% of the patients. During the mean follow-up of 279.5 ± 161.3 days, the LVA group had significantly lower recurrence than the linear group (15 patients [23%] vs. 29 patients [45%], p = 0.014). Thirty-five patients were prescribed antiarrhythmic drugs during the follow-up period (linear group, n = 17; LVA group, n = 18); amiodarone and bepridil were administered to most of the patients (15 and 17 patients, respectively). The difference in the prognosis was relevant among the patients with LVA, while this trend was not observed in those without LVA. The LVA ablation group demonstrated significantly lower radiofrequency energy and shorter procedural time compared to the linear ablation group. The recurrence of atrial flutter was more likely to occur in the linear group than in the LVA group (14 [22%] vs. 6 [9.4%], p = 0.052). CONCLUSION: The electrophysiological-guided LVA ablation is more effective than empirical linear ablation in PeAF patients with LVA. Unnecessary empirical linear ablation might have a risk of iatrogenic gap and atrial flutter recurrence.

Stellate Ganglion Phototherapy Using Low-Level Laser: A Novel Rescue Therapy for Patients With Refractory Ventricular Arrhythmias.

OBJECTIVES: This study investigates the effect of stellate ganglion (SG) phototherapy in healthy participants and assesses its efficacy in suppressing electrical storm (ES) refractory to antiarrhythmic drugs and catheter ablation. BACKGROUND: Modulation of the autonomic nervous system has been shown to be an effective adjunctive therapy for ES. METHODS: Ten-minute SG phototherapy was performed twice weekly for 4 weeks in 20 healthy volunteers. To evaluate the acute and chronic effects of SG phototherapy, heart rate variability and serum concentrations of adrenaline, noradrenaline, and dopamine were obtained before phototherapy, immediately after the first phototherapy session, after 8 sessions of phototherapy, and 3 months after the first phototherapy session. In addition, the efficacy of SG phototherapy was evaluated in 11 patients with ES refractory to medication, sedation, and catheter ablation. RESULTS: In healthy participants, serum adrenaline concentration significantly decreased after phototherapy, whereas low-frequency power/high-frequency power significantly decreased during phototherapy. Moreover, the effect on heart rate variability did not last beyond 3 months. In the clinical pilot study, 7 patients had a suppression of ES after SG phototherapy; however, without maintenance therapy, 2 patients had a recurrence of ventricular arrhythmias. Furthermore, it did not control ES in 4 patients. CONCLUSIONS: SG phototherapy reduced sympathetic activity and may be a safe and effective adjunctive therapy to control ES in some patients, but its long-term efficacy remains unknown. Chronic phototherapy might help reduce ES recurrence.

The sustainability-peace nexus: why is it important?

Sustainability and peace have long been recognized within academic and policy circles as intrinsically interrelated. Although there are some studies that examine impacts of sustainability on peace and vice versa, a specific focus on the sustainability-peace nexus remains marginal in academic and policy discourses, and pathways where sustainability and peace interact remain ambiguous. As a result, global initiatives on peace and sustainability remain fragmented. It is, therefore, crucial to identify the different components that mutually reinforce the desirable outcomes from sustainability and peace initiatives. This special feature of Sustainability Science aims to contribute to a better understanding of these components by highlighting the emerging discourses on the peace-sustainability nexus and the issues surrounding it. It includes articles that provide insights to better address issues at the nexus of peace and sustainability. Key takeaways for scientists and policy makers are that systemic approaches are needed to capture the multiple dynamic interactions between peace and sustainability; addressing issues at the intersection of peace and sustainability requires interactions between a wide range of stakeholders within and across various local, regional, national, and global scales; and international scientific collaboration is essential for comprehensive understanding of the interactions between peace and sustainability. We hope that this special feature will contribute to a better understanding of the complexities of the peace-sustainability nexus and provide insights into developing more effective solutions and strategies for making progress towards creating more peaceful and sustainable communities in the future.

A co-designed heuristic guide for investigating the peace-sustainability nexus in the context of global change.

The interlinkages between peace and sustainability are embedded in several international agreements and declarations and recognized by various research studies. However, the characteristics of their bidirectional relationship remain underexamined. Here we scope the complex and multifaceted relationship between peace and sustainability based on an experts workshop held at Hiroshima University in August 2019. The workshop focused on how peace, as a process or a condition, can help or hinder sustainability and vice versa. Relevant environmental, socio-political, and economic and technological considerations highlighted at the workshop were integrated into a co-designed heuristic guide for investigating the peace-sustainability nexus in the context of global change. The proposed guide aims to assist academic and policy researchers in identifying the specific pathways through which peace and sustainability interact when addressing complex challenges. The reinforcing potential of the two will ultimately depend on the governance and management of global transformations.

Real-World Safety Profile of Atrial Fibrillation Ablation Using a Second-Generation Cryoballoon in Japan: Insight From a Large Multicenter Observational Study.

OBJECTIVES: This study sought to investigate the incidence and characteristics of the real-world safety profile of second-generation cryoballoon ablation (2nd-CBA) in Japan. BACKGROUND: Pulmonary vein isolation using second-generation cryoballoons is an accepted atrial fibrillation ablation strategy. METHODS: This multicenter observational study included 4,173 patients with atrial fibrillation (3,807 paroxysmal) who underwent a 2nd-CBA in 18 participating centers. The baseline data and details of all procedure-related complications within 3 months post-procedure in consecutive patients from the first case at each center were retrospectively collected. RESULTS: Adjunctive ablation after the pulmonary vein isolation was performed in 2,745 (65.8%) patients. Complications associated with the entire procedure were observed in 206 (4.9%) total patients, and in the multivariate analysis, the age (odds ratio: 1.015; 95% confidence interval: 1.001 to 1.030; p = 0.035) and study period were predictors. Air embolisms manifesting as ST-segment elevation and cardiac tamponade requiring drainage occurred in 63 (1.5%) and 15 (0.36%) patients, respectively. Six (0.14%) patients had strokes/transient ischemic attacks, among whom 5 underwent ablation under an interrupted anticoagulation regimen. No atrioesophageal fistulae occurred; however, 10 (0.24%) patients had symptomatic gastric hypomotility. Esophageal temperature monitoring did not reduce the incidence, and the incidence was significantly higher in patients with adjunctive posterior wall isolations or mitral isthmus ablation than those without (p = 0.004). Phrenic nerve injury occurred during the 2nd-CBA in 58 (1.4%) patients; however, all were asymptomatic and recovered within 13 months. One patient died of aspiration pneumonia. CONCLUSIONS: This study had a high safety profile of 2nd-CBA despite including the early experience and high rate of adjunctive ablation. Care should be taken for air embolisms during 2nd-CBA.

The literature landscape on peace-sustainability nexus: A scientometric analysis.

Academics, policymakers, and practitioners have long considered peace and sustainability to be fundamentally linked. However, despite the increased attention paid toward the intersection of peace and sustainability, there is still limited knowledge on the nature of their linkages. To advance the current understanding on the peace-sustainability nexus and inform an integrated research agenda, this paper employs a scientometric analysis of literature to identify publication trends, thematic clusters, and knowledge gaps. Analyzing the publications according to the types of peace, the pillars of positive peace, the dimensions of sustainability, and the SDGs further reveals weak engagement among academic disciplines and across the SDGs. The results of this analysis emphasize the need for future research to focus on underexamined subjects, geographic regions, and sectors to bolster the linkages between peace and sustainability.

A dataset of 137Cs activity concentration and inventory in forests contaminated by the Fukushima accident.

The majority of the area contaminated by the Fukushima Daiichi Nuclear Power Plant accident is covered with forests. We developed a dataset for radiocaesium (137Cs) in trees, soil, and mushrooms measured at numerous forest sites. The 137Cs activity concentration and inventory data reported in scientific journal papers written in English and Japanese, governmental reports, and governmental monitoring data on the web were collated. The ancillary information describing the forest stands were also collated, and further environmental information (e.g. climate) was derived from the other databases using longitude and latitude coordinates of the sampling locations. The database contains 8593, 4105, and 3189 entries of activity concentration data for trees, soil, and mushrooms, and 471 and 3521 entries of inventory data for trees and soil, respectively, which were collected from 2011 to 2017, and covers the entire Fukushima prefecture. The data can be used to document and understand the spatio-temporal dynamics of radiocaesium in the affected region and to aid the development and validation of models of radiocaesium dynamics in contaminated forests.

Temporal changes in the spatial patterns of air dose rate from 2012 to 2016 at forest floors in Fukushima, Japan.

This study investigates temporal changes in the distribution of air dose rates at forest floors from 2012 to 2016 by measuring air dose rates at a height of 10 cm. The study was conducted at four different topography forest sites in Fukushima Prefecture, Japan. At each forest site, the air dose rate was found to have decreased by 7%-22% over time from 2012 to 2016 owing to the movement of radiocesium from organic layers to mineral soil layers in the forest site. However, the spatial distribution patterns of air dose rates did not change at these forest sites over five years. Besides, high correlations between air dose rates and organic plus surface mineral soil inventories were found at these forest sites during most of study years. Therefore, little changes in the spatial distribution of air dose rates could be caused by radiocesium retention at the same location in these forest sites. No statistical correlation between air dose rates and slope gradients was found in the two hilly forest sites with steep slopes above 35°. Accordingly, this study shows that the distribution patterns of air dose rates in the forest floors remained stable depending on the spatial distribution of radiocesium, which formed in the early phase after the Fukushima Daiichi Nuclear Power Plant accident.

Assessment of vertical radiocesium transfer in soil via roots.

Several years after the Fukushima Daiichi Nuclear Power Plant accident, the surface mineral soil layer is believed to be the main reservoir of radiocesium (137Cs) in forest ecosystems in Japan. Dissolved 137Cs combines with clay minerals in the soil, and hence, it is not expected to easily infiltrate over time. However, previous studies have indicated that 137Cs derived from the older global fallout migrated deeper than that of the Chernobyl accident, and this cannot be explained by only the dissolved 137Cs vertical migration in the soil. Considering the carbon and nutrient dynamics in the forest floor, the 137Cs transfer process in soil via roots may alter its vertical distribution on a decadal scale. Therefore, in this study, we investigated the 137Cs activity concentrations in both roots and soil matrix, by considering four (0-20 cm) or six (0-30 cm) mineral soil layers taken at every 5 cm at seven study sites dominated by one of the six plant species (three coniferous forests, one deciduous forest, two deciduous forests covered by Sasa, and one bamboo forest) in eastern Japan in 2013. Comparing the results of 137Cs activity concentrations between roots and soil matrix taken at the same soil layer, roots at the surface (0-5 cm) layer often showed lower values than the soil matrix. However, roots deeper than 5 cm had higher activity concentrations than the soil matrix, conversely. The 137Cs inventories ratio of roots to soil matrix are about 1% at the 0-5 and 5-10 cm soil layer, and about 2% at the soil layers deeper than 10 cm. These results suggest that decomposition of root litter little affect the short-term vertical migration of 137Cs in the forest soil. However, it indicates that continuous production and mortality of roots with relatively high 137Cs activity concentrations have an important role for changing the vertical distribution of 137Cs on time scale of decades, particularly at deeper soil layers.

New predictions of 137Cs dynamics in forests after the Fukushima nuclear accident.

Most of the area contaminated by the Fukushima Daiichi Nuclear Power Plant accident is covered by forest. In this paper, we updated model predictions of temporal changes in the 137Cs dynamics using the latest observation data and newly provided maps of the predicted 137Cs activity concentration for wood, which is the most commercially important part of the tree body. Overall, the previous prediction and latest observation data were in very good agreement. However, further validation revealed that the migration from the soil surface organic layer to the mineral soil was overestimated for evergreen needleleaf forests. The new prediction of the 137Cs inventory showed that although the 137Cs distribution within forests differed among forest types in the first 5 years, the difference diminished in the later phase. Besides, the prediction of the wood 137Cs activity concentrations reproduced the different trends of the 137Cs activity concentrations for cedar, oak, and pine trees. Our simulation suggests that the changes of the wood 137Cs activity concentration over time will slow down after 5-10 years. Although the model uncertainty should be considered and monitoring and model updating must continue, the study provides helpful information on the 137Cs dynamics within forest ecosystems and the changes in wood contamination.

Impacts of pecuniary and non-pecuniary information on pro-environmental behavior: A household waste collection and disposal program in Surabaya city.

Information strategies are increasingly used to promote pro-environmental behavior through changing perceptions, knowledge, awareness and norms. While some studies have argued that information strategies are ineffective, others have reported, that information strategies can have immediate impacts. Information strategies are particularly relevant in developing countries such as Indonesia because of their low-cost and immediate impact. The objective of this paper is to compare the impacts of pecuniary and non-pecuniary information on stated preferences and willingness to pay (WTP) for an improved waste collection and disposal program. Stated preferences were elicited by using a randomized conjoint field experiment. The information treatments were in the form of posters and were randomly assigned to the respondents. Among the seven attributes used in the conjoint analysis, the separation of non-organic waste and recycling as an intermediate processing technology had significant positive effects on the rate of support. Moreover, pecuniary information was found to directly influence household preference for payment for an improved waste collection and disposal program while affecting none of the other design elements of waste management services. In the reference case in which the no information treatment was applied, the lower bound of the mean WTP for marginalized improvements in a waste collection and disposal program was estimated to be USD 14.65. The study also found that pecuniary information increased WTP by 20.5%, whereas non-pecuniary information had a negative but statistically insignificant effect on WTP.

Six-year trends in exchangeable radiocesium in Fukushima forest soils.

We investigated the changes in 137Cs exchangeable fraction in the soils of contaminated forest ecosystems until 6 years after the Fukushima radioactive atmospheric deposits. For this investigation, we performed chemical extractions of 137Cs from both organic and mineral soil layer sampled from two forest stands, Japanese cedar (Cryptomeria japonica) and broadleaf deciduous, mainly konara oak (Quercus serrata), which are located 26-27 km inland from the Fukushima Dai-ichi Nuclear Power Plant. The exchangeable 137Cs as a proportion of the total 137Cs inventory was only 10% in the organic layer and 6.1% in the mineral soil layer about 5 months after the accident at the Japanese cedar site. We observed an exponential decrease in the proportion of exchangeable 137Cs in both organic and mineral soil layer samples over the 6-years observation period at both sites. The proportion significantly decreased within 2-4 years after the accident, becoming almost constant (2-4%). These results support the interpretation that contaminated forests have entered a steady-state phase of 137Cs cycling, although we need more integration for an improved vision of the future of Fukushima forests.