Healthcare Utilization and Quality of Life Improvement after Ablation for Paroxysmal AF in Younger and Older Patients

Background Atrial fibrillation (AF) prevalence increases significantly with age. Little is known about the effect of AF ablation on quality of life and healthcare utilization in the elderly. The objective of this study was to quantify the healthcare utilization and quality of life benefits of catheter ablation for AF, for patients ≥65 years compared to patients <65 years. Methods Two multicenter U.S. registry studies enrolled patients with paroxysmal AF. Baseline characteristics and acute outcomes were collected for 736 patients receiving catheter ablation with the Navistar® ThermoCool® SF Catheter (Biosense Webster, Inc., Diamond Bar, CA, USA). Healthcare utilization and quality of life outcomes were collected through 1 year postablation for 508 patients. Results The rates of acute pulmonary vein isolation were high and similar between patients ≥65 years and <65 years (97.5% vs 95.8%, P = 0.2130). Length of stay for the index procedure was similar between age groups with 82.2% of the older group and 83.2% of the younger group having one-day hospitalization. Disease-specific quality of life instrument scores improved significantly and similarly for older and younger patients at 1 year postablation, compared to baseline. AF-related hospitalizations and emergency department visits were similar or lower in older patients compared to younger patients, as reported at 1 year postablation. Conclusion For older patients undergoing catheter ablation for paroxysmal AF, healthcare utilization parameters were lower or not significantly different than for younger patients, and quality of life outcomes were similarly improved. These findings support the use of catheter ablation as a treatment option in older patients with paroxysmal AF

MontanAqua : Wasserbewirtschaftung in Zeiten von Knappheit und globalem Wandel. Wasserbewirtschaftungsoptionen für die Region Crans-Montana-Sierre im Wallis

Das nationale Forschungsprogramm NFP 61 «Nachhaltige Wassernutzung » des Schweizerischen Nationalfonds hat sich zum Ziel gesetzt, wissenschaftliche Grundlagen zur nachhaltigen Wasserbewirtschaftung in der Schweiz zu liefern. Als Teil dieses Forschungsvorhabens wurde im Rahmen des Projektes MontanAqua die Wasserbewirtschaftung der Region Crans-Montana-Sierre (Wallis) untersucht. Es ging dabei darum, in enger Zusammenarbeit mit den in der Region betroffenen Akteuren nachhaltige Wassernutzungsstrategien für die Zukunft zu entwickeln. MontanAqua hat sich vertieft mit den bestehenden Systemen der Wasserbewirtschaftung auf der regionalen Skala (11 Gemeinden) auseinandergesetzt. Dazu wurden die zukünftigen Auswirkungen der klimatischen und sozioökonomischen Veränderungen einbezogen. Das Forschungsteam analysierte die aktuelle Situation anhand von quantitativen, qualitativen sowie kartografischen Methoden und kombinierte diese mit Modellberechnungen. Für die Modellierung der Zukunft wurden regionale Klimaszenarien und vier mit lokalen Akteuren entwickelte sozioökonomische Szenarien verwendet. Dieser Überblick fasst die Resultate des Projektes MontanAqua zusammen. Fünf wesentliche Fragen werden beantwortet und fünf Kernbotschaften erläutert. Zudem sind Empfehlungen für die Verantwortlichen der regionalen und kantonalen Wasserbewirtschaftung formuliert

Education for Sustainable Development: Towards the Sustainable University

We  planned  this  conference  in  anticipation  of  the  end  of  the  UN  Decade  of  Education  for  Sustainable   Development  (DESD),  and  the  start  of  the  next  phase  for  those  involved  in  ESD  here  and   internationally.    At  Plymouth  University,  2015  marks  ten  year  anniversary  since  cross-­‐institutional   work  on  sustainability  and  sustainability  education  was  spearheaded  by  the  founding  of  the  Centre  for   Sustainable  Futures  (CSF).    Coincidentally,  2015  also  marks  a  ten  years  since  the  influential  HEFCE   policy  document  ‘Sustainable  Development  in  Higher  Education’  was  released.   Holding  the  conference  in  January  –  named  after  the  Roman  god  of  doorways,  of  endings  and   beginnings  –  we  sought  to  look  at  some  of  what  has  been  achieved  in  sustainability  education  to  date   and  explore  its  prospects  as  we  move  forward.   Following  an  enthusiastic  response  to  the  call  for  abstracts,  the  conference  featured  a  diverse  range   of  research  papers,  posters,  and  roundtable  presentations  from  academics  and  practitioners  across   the  UK  and  beyond.  The  conference  was  arranged  around  three  overarching  themes:     ESD  Pedagogy:  Criticality,  Creativity,  and  Collaboration   What  are  the  teaching  and  learning  processes  that  enable  students  to  develop  their  own  capacity  to   think  critically  and  creatively  in  the  face  of  global  sustainability  challenges  and,  secondly,  to  act   collaboratively  in  ways  that  pursue  more  hopeful  and  sustainable  futures?   Innovative  Learning  Spaces  for  ESD   What  are  the  physical  environments  that  provide  opportunities  for  new  forms  of  sustainability   education  to  flourish?  What  lies  beyond  the  lecture  hall  that  is  conducive  to  student  learning  through   inquiry-­‐based,  active,  participatory,  interdisciplinary  and  experiential  methods?   Towards  the  Sustainable  University   What  are  effective  approaches  for  leading  institutional  change,  organisational  learning,  and  staff  CPD   towards  sustainability?  This  publication  focuses  on  the  last  theme  –  Towards  the  Sustainable  University.    The  previous   PedRIO  Occasional  Paper  8  looks  at  the  first  theme  ESD  Pedagogy:  Criticality,  Creativity,  and   Collaboration

Pin1-dependent signaling negatively affects GABAergic transmission by modulating neuroligin2/gephyrin interaction

The cell adhesion molecule Neuroligin2 (NL2) is localized selectively at GABAergic synapses, where it interacts with the scaffolding protein gephyrin in the post-synaptic density. However, the role of this interaction for formation and plasticity of GABAergic synapses is unclear. Here, we demonstrate that endogenous NL2 undergoes proline-directed phosphorylation at its unique S714-P consensus site, leading to the recruitment of the peptidyl-prolyl cis-trans isomerase Pin1. This signalling cascade negatively regulates NL2' s ability to interact with gephyrin at GABAergic post-synaptic sites. As a consequence, enhanced accumulation of NL2, gephyrin and GABA A receptors was detected at GABAergic synapses in the hippocampus of Pin1-knockout mice (Pin1\ufffd/\ufffd) associated with an increase in amplitude of spontaneous GABA A -mediated post-synaptic currents. Our results suggest that Pin1-dependent signalling represents a mechanism to modulate GABAergic transmission by regulating NL2/gephyrin interaction. \ufffd 2014 Macmillan Publishers Limited. All rights reserved

A comparison of conventional and 137 Cs-based estimates of soil erosion rates on arable and grassland across lowland England and Wales

Soils deliver a range of ecosystem services and underpin conventional global food production which must increase to feed the projected growth in human population. Although soil erosion by water and subsequent sediment delivery to rivers are natural processes, anthropogenic pressures, including modern farming practices and management, have accelerated soil erosion rates on both arable and grassland. A range of approaches can be used to assess and document soil erosion rates and, in the case of the UK, these mainly comprise the 137Cs-based approach, conventional surveys using volumetric measurements, integration of information on suspended sediment flux, fine sediment source apportionment and landscape sediment retention and traditional bounded hydrological monitoring at edge-of-field using experimental platforms. We compare the erosion rates for arable and grassland in lowland England assessed by these different techniques. Rates assessed by volumetric measurements are similar to those generated by integrating information on suspended sediment flux, sources and landscape retention, but are much less than those estimated by the 137Cs-based approach; of the order of one magnitude less for arable land. The 137Cs approach assumes an initial distribution of 137Cs uniformly spread across the landscape and relates the sampled distribution to erosion, but other (transport) processes are also involved and their representation in the calibration procedures remains problematic. We suggest that the 137Cs technique needs to be validated more rigorously and conversion models re-calibrated. As things stand, rates of erosion based on the distribution of 137Cs may well overstate the severity of the problem in lowland Britain and, therefore, are not a reliable indicator of water erosion rates