Arrhythmic risk profile and outcomes of patients undergoing cardiac sympathetic denervation for recurrent monomorphic ventricular tachycardia after ablation

Background Cardiac sympathetic denervation (CSD) has been used as a bailout strategy for refractory ventricular tachycardia (VT). Risk of VT recurrence in patients with scar-related monomorphic VT referred for CSD and the extent to which CSD can modify this risk is unknown. We aimed to quantify arrhythmia recurrence risk and impact of CSD in this population. Methods and Results Adjusted competing risk time to event models were developed to adjust for risk of VT recurrence and sustained VT/implantable cardioverter-defibrillator shocks after VT ablation based on patient comorbidities at the time of VT ablation. Adjusted VT and implantable cardioverter-defibrillator shock recurrence rates were estimated for the subgroup who subsequently required CSD after ablation. The expected adjusted recurrence rates were then compared with the observed rates after CSD. Data from 381 patients with scar-mediated monomorphic VT who underwent VT ablation were analyzed, excluding patients with polymorphic VT. Sixty eight patients underwent CSD for recurrent VT. CSD reduced the expected adjusted VT recurrence rate by 36% (expected rate of 5.61 versus observed rate of 3.58 per 100 person-months, P=0.01) and the sustained VT/implantable cardioverter-defibrillator shock rates by 34% (expected rate of 4.34 versus observed 2.85 per 100 person-months, P=0.03). The median number of sustained VT/implantable cardioverter-defibrillator shocks in the year before versus the year after CSD was reduced by 90% (10 versus 1, P<0.0001). Conclusions Patients referred for CSD for refractory scar-mediated monomorphic VT are at a higher risk of VT recurrence after ablation as compared with those not requiring CSD, mostly because of their cardiac comorbidities. CSD significantly reduced both the expected risk of recurrences and VT burden

JUNO Conceptual Design Report

The Jiangmen Underground Neutrino Observatory (JUNO) is proposed to determine the neutrino mass hierarchy using an underground liquid scintillator detector. It is located 53 km away from both Yangjiang and Taishan Nuclear Power Plants in Guangdong, China. The experimental hall, spanning more than 50 meters, is under a granite mountain of over 700 m overburden. Within six years of running, the detection of reactor antineutrinos can resolve the neutrino mass hierarchy at a confidence level of 3-4$\sigma$, and determine neutrino oscillation parameters $\sin^2\theta_{12}$, $\Delta m^2_{21}$, and $|\Delta m^2_{ee}|$ to an accuracy of better than 1%. The JUNO detector can be also used to study terrestrial and extra-terrestrial neutrinos and new physics beyond the Standard Model. The central detector contains 20,000 tons liquid scintillator with an acrylic sphere of 35 m in diameter. $\sim$17,000 508-mm diameter PMTs with high quantum efficiency provide $\sim$75% optical coverage. The current choice of the liquid scintillator is: linear alkyl benzene (LAB) as the solvent, plus PPO as the scintillation fluor and a wavelength-shifter (Bis-MSB). The number of detected photoelectrons per MeV is larger than 1,100 and the energy resolution is expected to be 3% at 1 MeV. The calibration system is designed to deploy multiple sources to cover the entire energy range of reactor antineutrinos, and to achieve a full-volume position coverage inside the detector. The veto system is used for muon detection, muon induced background study and reduction. It consists of a Water Cherenkov detector and a Top Tracker system. The readout system, the detector control system and the offline system insure efficient and stable data acquisition and processing.Comment: 328 pages, 211 figure

Ancient DNA of narrow-headed vole reveal common features of the Late Pleistocene population dynamics in cold-adapted small mammals

The narrow-headed vole, collared lemming and common vole were the most abundant small mammal species across the Eurasian Late Pleistocene steppe-tundra environment. Previous ancient DNA studies of the collared lemming and common vole have revealed dynamic population histories shaped by climatic fluctuations. To investigate the extent to which species with similar adaptations share common evolutionary histories, we generated a dataset comprised the mitochondrial genomes of 139 ancient and 6 modern narrow-headed voles from several sites across Europe and northwestern Asia covering approximately the last 100 thousand years (kyr). We inferred Bayesian time-aware phylogenies using 11 radiocarbon-dated samples to calibrate the molecular clock. Divergence of the main mtDNA lineages across the three species occurred during marine isotope stages (MIS) 7 and MIS 5, suggesting a common response of species adapted to open habitat during interglacials. We identified several time-structured mtDNA lineages in European narrow-headed vole, suggesting lineage turnover. The timing of some of these turnovers was synchronous across the three species, allowing us to identify the main drivers of the Late Pleistocene dynamics of steppe- and cold-adapted species.NWOVI.C.191.070Human Origin

A New Low Background Laboratory in the Pyhäsalmi Mine : Towards 14C free liquid scintillator for low energy neutrino experiments

A new low background laboratory in Pyhäsalmi mine in the Central Finland has been put into operation in the beginning of 2017. The laboratory operates at the depth of 1436 m (~4100 meters of water equivalent). In this paper, we present description of the laboratory’s existing facility and background conditions. In the laboratory, a series of measurements has been started where the 14C concentration is determined from several liquid scintillator samples. A dedicated setup has been designed and constructed with the aim of measuring the 14C/12C ratio smaller than 10-18 .peerReviewe

Recurrent ventricular tachycardia after cardiac sympathetic denervation: Prolonged cycle length with improved hemodynamic tolerance and ablation outcomes

IntroductionCardiac sympathetic denervation (CSD) is utilized for the management of ventricular tachycardia (VT) in structural heart disease when refractory to radiofrequency ablation (RFA) or when patient/VT characteristics are not conducive to RFA.MethodsWe studied consecutive patients who underwent CSD at our institution from 2009 to 2018 with VT requiring repeat RFA post-CSD. Patient demographics, VT/procedural characteristics, and outcomes were assessed.ResultsNinety-six patients had CSD, 16 patients underwent RFA for VT post-CSD. There were 15 male and 1 female patients with mean age of 54.2 ± 13.2 years. Fourteen patients had nonischemic cardiomyopathy. A mean of 2.0 ± 0.8 RFAs for VT was unsuccessful before the patient undergoing CSD. The median time between CSD and RFA was 104 days (interquartile range [IQR] = 15-241). The clinical VT cycle length was significantly increased after CSD both spontaneously on ECG and/or ICD interrogation (355 ± 73 ms pre-CSD vs. 422 ± 94 ms post-CSD, p = .001) and intraprocedurally (406 ± 86 ms pre-CSD vs. 457 ± 88 ms post-CSD, p = .03). Two patients had polymorphic and 14 had monomorphic VT (MMVT) pre-CSD, and all patients had MMVT post-CSD. The proportion of mappable, hemodynamically stable VTs increased from 35% during pre-CSD RFA to 58% during post-CSD RFA (p = .038). At median follow-up of 413 days (IQR = 43-1840) after RFA, eight patients had no further VT.ConclusionRFA for recurrent MMVT post-CSD is a reasonable treatment option with intermediate-term clinical success in 50% of patients. Clinical VT cycle length was significantly increased after CSD with associated improvement in mappable, hemodynamically tolerated VT during RFA

Ancient DNA of narrow-headed vole reveal common features of the Late Pleistocene population dynamics in cold-adapted small mammals

The narrow-headed vole, collared lemming and common vole were the most abundant small mammal species across the Eurasian Late Pleistocene steppe-tundra environment. Previous ancient DNA studies of the collared lemming and common vole have revealed dynamic population histories shaped by climatic fluctuations. To investigate the extent to which species with similar adaptations share common evolutionary histories, we generated a dataset comprised the mitochondrial genomes of 139 ancient and 6 modern narrow-headed voles from several sites across Europe and northwestern Asia covering approximately the last 100 thousand years (kyr). We inferred Bayesian time-aware phylogenies using 11 radiocarbon-dated samples to calibrate the molecular clock. Divergence of the main mtDNA lineages across the three species occurred during marine isotope stages (MIS) 7 and MIS 5, suggesting a common response of species adapted to open habitat during interglacials. We identified several time-structured mtDNA lineages in European narrow-headed vole, suggesting lineage turnover. The timing of some of these turnovers was synchronous across the three species, allowing us to identify the main drivers of the Late Pleistocene dynamics of steppe- and cold-adapted species

Towards 14C-free liquid scintillator

A series of measurements has been started where the 14C concentration is determined from several liquid scintillator samples. A dedicated setup has been designed and constructed with the aim of measuring concentrations smaller than 10−18. Measurements take place in two underground laboratories: in the Baksan Neutrino Observatory, Russia, and in the new Callio Lab in the Pyhäsalmi mine, Finland. Low-energy neutrino detection with a liquid scintillator requires that the intrinsic 14C concentration in the liquid is extremely low. In the Borexino CTF detector the concentration of 2 × 10−18 has been achieved being the lowest value ever measured. In principle, the older the oil or gas source that the liquid scintillator is derived from and the deeper it situates, the smaller the 14C concentration is supposed to be. This, however, is not generally the case and the concentration is probably due to the U and Th content of the local environment.peerReviewe

Measuring the 14C content in liquid scintillators

We are going to perform a series of measurements where the 14C/12C ratio will be measured from several liquid scintillator samples with a dedicated setup. The setup is designed with the aim of measuring ratios smaller than 10−18. Measurements take place in two underground laboratories: in the Baksan Neutrino Observatory, Russia and in the Pyh¨asalmi mine, Finland. In Baksan the measurements started in 2015 and in Pyh¨asalmi they start in the beginning of 2015. In order to fully understand the operation of the setup and its background contributions a development of simulation packages has also been started. Low-energy neutrino detection with a liquid scintillator requires that the intrinsic 14C content in the liquid is extremely low. In the Borexino CTF detector at Gran Sasso, Italy the 14C/12C ratio of 2 × 10−18 has been achieved being the lowest 14C concentration ever measured. In principle, the older the oil or gas source that the liquid scintillator is derived of and the deeper it situates, the smaller the 14C/12C ratio is supposed to be. This, however, is not generally the case, and the ratio is probably determined by the U and Th content of the local environment.peerReviewe

Kysy asiantuntijalta riippuvuuksista : julkinen neuvontapalsta A-klinikkasäätiön Päihdelinkissä

Päihdelinkki on A-klinikkasäätiön ylläpitämä internetpalvelu päihteistä ja riippuvuuksista. Päihdelin-kissä on tarjottu henkilökohtaista verkkoneuvontaa vuodesta 1998 lähtien. Loppuvuodesta 2008 Päihde-linkin keskustelualueelle perustettiin julkinen neuvontapalsta, asiantuntijapalsta, joka oli toiminnassa 7.10-30.11.2008. Palstalle pystyi kirjoittamaan kysymyksen, johon asiantuntijat kävivät vastaamassa noin viikon kuluessa. Kysymysten kirjoittaminen ja lukeminen ei vaatinut rekisteröitymistä, vaan ky-symykset vastauksineen olivat kaikkien palstan kävijöiden nähtävissä. Palstan vastaajina toimi kahdek-san päihdealan ammattilaista. Tämän opinnäytetyön tarkoituksena oli kuvata palstan toimintaa ja sinne tulleita kysymyksiä: mitä aihealuetta palstalle tulleet kysymykset käsittelivät, koskivatko kysymykset kysyjän omaa vai jonkun läheisen tilannetta ja mitä kysyjä kysymyksellään palstalta haki. Tämän lisäksi tarkoituksena oli myös selvittää vastaajien näkemyksiä ja kokemuksia julkisesta neuvontapalvelusta. Opinnäytetyöni on triangulaatiotutkimus. Aineistona käytin palstalle tulleita kysymyksiä sekä materiaalia, jonka keräsin lähettämällä sähköisen kyselylomakkeen palstan vastaajille. Analyysimenetelminä käytin aineistolähtöistä sisällönanalyysiä ja tilastollisia menetelmiä, kuten ristiintaulukointia. Palstalle lähetettiin yhteensä 52 kysymystä. Suurin osa kysymyksistä käsitteli alkoholinkäyttöä, mutta kysymyksiä tuli runsaasti myös huumeista ja lääkkeistä. Kysymyksistä lähes kaksi kolmannesta koski kysyjän omaa tilannetta ja eniten kysymyksillä haettiin tukea omien valintojen tekemiseen. Myös faktatietoa päihteistä ja neuvoja riippuvuusongelman ratkaisemiseksi haettiin. Koska tulokset koskevat vain yksittäistä tapausta, ei niitä voida yleistää koskemaan kaikkia julkisia neuvontapalstoja. Tarpeen olisikin tutkia, haetaanko muiltakin julkisilta neuvontapalstoilta näitä samoja asioita. Sähköiseen kyselyyn vastasi viisi palstan vastaajaa. Palstan tekninen toteutus onnistui hyvin, lukuun ottamatta kysymysten varausjärjestelmää, joka koettiin aluksi hieman sekavaksi. Vastaajien mielestä julkinen neuvontapalsta on hyvä lisäpalvelu, mutta sitä ei ole tarpeen tarjota jatkuvasti. Palstan avulla voidaan auttaa useampia kuin henkilökohtaisella neuvontapalvelulla, sillä kysymyksiä vastauksineen voi lukea myös ne, jotka eivät itse uskalla kysyä. Toisten samankaltaisen tilanteen huomaaminen voi rohkaista ottamaan itsekin yhteyttä tai hakemaan muulla tavalla apua.AddictionLink is an online service maintained by the A-Clinic Foundation, which deals with drugs and addictions. AddictionLink has offered online advice for individuals since 1998. At the end of 2008 an open advice site, an expert advice column, was created on the AddictionLink's discussion site. This expert column was in operation from 7.10.2008 until 30.11.2008. People could write questions to this site which the experts would reply within a week. Creating questions for the experts and reading the column did not require registration; all questions and answers were available for all visitors. The expert board consisted of eight trained specialists working with substance abusers. The goal of this study was to describe the function of the column and the questions it received: what did the questions that were received deal with, did the questions concern the situation of the person posing the question or someone else, and what sort of an end result people were hoping for. In addition to this, one of the main purposes was to discover what kind of ideas and experiences the respondents had on the public advice services. The study was conducted by triangular research. The material consisted of questions sent to the ad-vice column as well as material collected by sending an online questionnaire to those replying to the questions. The methods of analysis were material-based content analysis and statistical methods such as cross tabulation. In total, there were 52 questions sent to the column. Most of the questions dealt with the use of al-cohol, but there were also a great deal of questions on narcotics and prescription medicines. Two thirds of the questions were from people experiencing the problems - they were mostly concerned with getting support for making their own choices. There were also requests for factual information on narcotics and help on how to solve substance abuse problems. Because the results of the questionnaire only dealt with one particular case at a time, they could not be generalised to depict all public advice columns. In order to do generalisations it would be necessary to see if other advice columns receive similar questions. The online questionnaire was answered by five of the experts. The technical implementation was a success, with the exception of the booking system for the questions, which was considered confusing at first. The experts thought that a public advice column was a good extra service but it would not be ne-cessary to have it available all the time. More people can be helped with the column than with an indi-vidual advice service, because its questions and answers can also be read by those who dare not pose any questions of their own. Finding out that others are in a similar situation may encourage people to get in touch with experts or seek help in other ways