Catheter ablation of atrial fibrillation in the elderly: Where do we stand?

Catheter ablation has emerged as an important therapy for the management of drug refractory symptomatic paroxysmal and persistent atrial fibrillation (AF). Although the elderly account for the majority of patients with AF, limited data exists regarding the use of catheter ablation for elderly patients with AF. As AF ablation has become more widespread, ablation techniques have improved and the complication rate has decreased. As a result, referrals of elderly patients for catheter ablation of AF are on the rise. Two retrospective analyses have recently demonstrated that catheter ablation of AF in the elderly can safely be performed and results are comparable to a younger population with up to 80% or more of patients maintaining sinus rhythm at 12 months follow-up. We compared the results of 15 consecutive patients ≥ 70 years old with symptomatic paroxysmal atrial fibrillation who underwent catheter ablation of AF at our institution to 45 randomly sampled younger patients. The primary endpoint of our study, presence of sinus rhythm in the absence of symptoms at 12 months follow-up, was present in 60% of elderly patients and 80% of younger patients (p = 0.17). There was no statistically significant difference in complication rate between the younger and elderly patients. In this article we present the results of our study and review the published literature to date regarding the clinical efficacy and safety of catheter ablation for AF in elderly patients with paroxysmal and persistent atrial fibrillation

Science yield estimate with the Wide-Field Infrared Survey Telescope coronagraph

The coronagraph instrument (CGI) on the Wide-Field Infrared Survey Telescope will directly image and spectrally characterize planets and circumstellar disks around nearby stars. Here we estimate the expected science yield of the CGI for known radial-velocity (RV) planets and potential circumstellar disks. The science return is estimated for three types of coronagraphs: the hybrid Lyot and shaped pupil are the currently planned designs, and the phase-induced amplitude apodizing complex mask coronagraph is the backup design. We compare the potential performance of each type for imaging as well as spectroscopy. We find that the RV targets can be imaged in sufficient numbers to produce substantial advances in the science of nearby exoplanets. To illustrate the potential for circumstellar disk detections, we estimate the brightness of zodiacal-type disks, which could be detected simultaneously during RV planet observations

Stemming the Tide of Disinformation in Public Health

Context: Disinformation, or incorrect information that is intended to mislead, was pronounced during the COVID pandemic. Disinformation that steers away from life-saving practices or toward life-threatening practices can be fatal. The European Union has in place policies and offices to combat disinformation. However, they lack the full mandate and clarity of systems to meet the needs for quick and effective responses.Policy Options:Means to enhance the effectiveness of existing policies include [1] clarifying a rapid response framework, [2] enhancing media literacy in the public, [3] inoculating the public against anticipated disinformation, and [4] engendering public trust through coordinated and consistent communication. Recommendations:Among these four, options 2 and 3 were deemed the best opportunities for quick action, early successes, and the fewest institutional or political hurdles. We recommend [a] that the EU Commission establishes an EU Media Agency with a solid governance structure to support innovative media literacy undertakings and successful implementation; [b] that the existing Media Literacy Expert Group create a media literacy program implementation framework; and [c] that existing EU initiatives on disinformation debunking, media literacy, and inoculation strategies be merged into a single Misinformation Community within the European Institute of Innovation and Technology [EIT]

Extrasolar planet science with the Antarctic planet interferometer

The primary limitation to ground based astronomy is the Earth's atmosphere. The atmosphere above the Antarctic plateau is different in many regards compared to the atmosphere at temperate sites. The extreme altitude, cold and low humidity offer a uniquely transparent atmosphere at many wavelengths. Studies at the South Pole have shown additionally that the turbulence properties of the night time polar atmosphere are fundamentally different to mid latitudes. Despite relatively strong ground layer turbulence, the lack of high altitude turbulence combined with low wind speeds presents favorable conditions for interferometry. The unique properties of the polar atmosphere can be exploited for Extrasolar Planet studies with differential astrometry, differential phase and nulling intereferometers. This paper combines the available data on the properties of the atmosphere at the South Pole and other Antarctic plateau sites for Extrasolar Planet science with interferometry

The AP-2 adaptor β2 appendage scaffolds alternate cargo endocytosis

The independently folded appendages of the large α and β2 subunits of the endocytic adaptor protein (AP)-2 complex coordinate proper assembly and operation of endocytic components during clathrin-mediated endocytosis. The β2 subunit appendage contains a common binding site for β-arrestin or the autosomal recessive hypercholesterolemia (ARH) protein. To determine the importance of this interaction surface in living cells, we used small interfering RNA-based gene silencing. The effect of extinguishing β2 subunit expression on the internalization of transferrin is considerably weaker than an AP-2 α subunit knockdown. We show the mild sorting defect is due to fortuitous substitution of the β2 chain with the closely related endogenous β1 subunit of the AP-1 adaptor complex. Simultaneous silencing of both β1 and β2 subunit transcripts recapitulates the strong α subunit RNA interference (RNAi) phenotype and results in loss of ARH from endocytic clathrin coats. An RNAi-insensitive β2-yellow fluorescent protein (YFP) expressed in the β1 + β2-silenced background restores cellular AP-2 levels, robust transferrin internalization, and ARH colocalization with cell surface clathrin. The importance of the β appendage platform subdomain over clathrin for precise deposition of ARH at clathrin assembly zones is revealed by a β2-YFP with a disrupted ARH binding interface, which does not restore ARH colocalization with clathrin. We also show a β-arrestin 1 mutant, which engages coated structures in the absence of any G protein-coupled receptor stimulation, colocalizes with β2-YFP and clathrin even in the absence of an operational clathrin binding sequence. These findings argue against ARH and β-arrestin binding to a site upon the β2 appendage platform that is later obstructed by polymerized clathrin. We conclude that ARH and β-arrestin depend on a privileged β2 appendage site for proper cargo recruitment to clathrin bud sites

A Novel, Species-Specific, Real-Time PCR Assay for the Detection of the Emerging Zoonotic Parasite Ancylostoma Ceylanicum in Human Stool

Historically, Ancylostoma ceylanicum has been viewed as an uncommon cause of human hookworm infection, with minimal public health importance. However, recent reports have indicated that this zoonotic hookworm causes a much greater incidence of infection within certain human populations than was previously believed. Current methods for the species-level detection of A. ceylanicum rely on techniques that involve conventional PCR accompanied by restriction enzyme digestions. These PCR-based assays are not only labo- rious but they lack sensitivity as they target suboptimal regions on the DNA. As efforts aimed at the eradication of hookworm disease have grown substantially over the last decade, the need for sensitive and specific tools to monitor and evaluate programmatic successes has correspondingly escalated. Since a growing body of evidence suggests that patient responses to drug treatment can vary based upon the species of hookworm that is causing infection, accurate species-level diagnostics are advantageous. Accordingly, the novel real-time PCR-based assay described here provides a sensitive, species-specific diag- nostic tool that will facilitate the accurate mapping of disease endemicity and will aid in the evaluation of progress of programmatic deworming efforts

Review of small-angle coronagraphic techniques in the wake of ground-based second-generation adaptive optics systems

Small-angle coronagraphy is technically and scientifically appealing because it enables the use of smaller telescopes, allows covering wider wavelength ranges, and potentially increases the yield and completeness of circumstellar environment - exoplanets and disks - detection and characterization campaigns. However, opening up this new parameter space is challenging. Here we will review the four posts of high contrast imaging and their intricate interactions at very small angles (within the first 4 resolution elements from the star). The four posts are: choice of coronagraph, optimized wavefront control, observing strategy, and post-processing methods. After detailing each of the four foundations, we will present the lessons learned from the 10+ years of operations of zeroth and first-generation adaptive optics systems. We will then tentatively show how informative the current integration of second-generation adaptive optics system is, and which lessons can already be drawn from this fresh experience. Then, we will review the current state of the art, by presenting world record contrasts obtained in the framework of technological demonstrations for space-based exoplanet imaging and characterization mission concepts. Finally, we will conclude by emphasizing the importance of the cross-breeding between techniques developed for both ground-based and space-based projects, which is relevant for future high contrast imaging instruments and facilities in space or on the ground.Comment: 21 pages, 7 figure