Early Life Risk Factors for Incident Atrial Fibrillation in the Helsinki Birth Cohort Study

Background-Early life risk factors are associated with cardiometabolic disease, but have not been fully studied in atrial fibrillation (AF). There are discordant results from existing studies of birth weight and AF, and the impact of maternal body size, gestational age, placental size, and birth length is unknown. Methods and Results-The Helsinki Birth Cohort Study includes 13 345 people born as singletons in Helsinki in the years 1934-1944. Follow-up was through national registries, and ended on December 31, 2013, with 907 incident cases. Cox regression analyses stratified on year of birth were constructed for perinatal variables and incident AF, adjusting for offspring sex, gestational age, and socioeconomic status at birth. There was a significant U-shaped association between birth weight and AF (P for quadratic term = 0.01). The lowest risk of AF was found among those with a birth weight of 3.4 kg (3.8 kg for women [85th percentile] and 3.0 kg for men [17th percentile]). High maternal body mass index (>= 30 kg/m(2)) predicted offspring AF; hazard ratio 1.36 (95% CI 1.07-1.74, P = 0.01) compared with normal body mass index ( Conclusions-High maternal body mass index during pregnancy and maternal height are previously undescribed predictors of offspring AF. Efforts to prevent maternal obesity might reduce later AF in offspring. Birth weight has a U-shaped relation to incident AF independent of other perinatal variables.Peer reviewe

Attenuation of Metals and Inorganics- Insights from Laboratory Testing Approaches

Natural Attenuation of Metals and Inorganics: Insights from Laboratory Testing Approaches Authors Ms. Larissa Smith - Canada - SiREM Mr. Michael Healey - Canada - SiREM Mr. Jeff Roberts - Canada - SiREM Ms. Allison Kreinberg - United States - Geosyntec Consultants, Inc. Ms. Crystal Wilson - United States - Geosyntec Consultants, Inc. Mr. Lane Dorman - United States - Geosyntec Consultants, Inc. Mr. Andrzej Przepiora - Canada - Geosyntec Consultants, Inc. Abstract Laboratory treatability studies can be used to evaluate and optimize groundwater treatment options for contaminants found at coal combustion residual (CCR) sites. An important consideration in groundwater treatment selection is the suitability of monitored natural attenuation (MNA) as a treatment component or as a stand-alone passive treatment. This presentation will focus on the use of treatability testing to evaluate enhanced and natural attenuation treatment options for redox sensitive metals in CCR-impacted groundwater. In one demonstration, a comprehensive laboratory program was performed based upon the USEPA’s tiered approach to identify the natural attenuation processes, rates, attenuation capacities, and longevity of arsenic (As),lithium (Li), sulfate (SO42-), and boron (B) impacted groundwater from CCR impoundment sites. At the Site, the testing was used to develop site-specific sorption coefficients, demonstrate that after sorption, potential desorption back into groundwater would not be affected by redox conditions, and provide insight into the attenuation mechanisms. These findings helped to support MNA as part of the corrective action plan submitted to the regulator. In a second demonstration, zero valent iron (ZVI) was used to reduce and sorb As from groundwater. The results from the treatability study were used to support the feasibility assessment for the Site

Paper_Attenuation of Metals and Inorganics: Insights from Laboratory Testing Approaches

Laboratory treatability studies can be used to evaluate and optimize groundwater treatment options for contaminants of concern (COCs) found at coal combustion residual (CCR) sites. An important consideration in groundwater treatment selection is the suitability of monitored natural attenuation (MNA) as a treatment component or as a stand-alone passive treatment. This presentation will focus on the use of treatability testing to evaluate natural and enhanced attenuation treatment options for redox sensitive metals in CCR-impacted groundwater. In one demonstration, a comprehensive laboratory program was performed based upon the USEPA’s tiered approach to identify the natural attenuation processes, rates, attenuation capacities, and longevity of arsenic (As), lithium (Li), sulfate (SO42-), and boron (B) impacted groundwater from a CCR impoundment site. Laboratory testing was used to develop site-specific sorption coefficients and demonstrate that after sorption, potential desorption back into groundwater would not be affected by changing redox conditions. The data was also used to provide insight into the attenuation mechanisms. These findings helped to support MNA as part of the corrective action plan submitted to the regulator. In a second demonstration, zero valent iron (ZVI) was used to sorb As from groundwater. The results from the treatability study were used to support the feasibility assessment for the Site

Genetic Analyses of Days Open Using a Random Regression Model

The purpose of this study was to investigate the feasibility of using a linear random regression model for the analysis of female fertility as expressed by days open. The analysis provided insight about the kind and amount of variation over the trajectory for age at calving from 24 to 72 mo. Correlations between permanent environmental effects changed from positive to negative values with greater distance between days open in young cows and days open in older cows; r(24,36)=0.88, r(24,72)=-.65. The random regression animal model proved to be a better alternative to a repeatability animal model for prediction of breeding values for days open. Random regression enables breeders to pick the optimum age at calving to select female replacements with enhanced fertility or fewer days open per lactation. Further research is needed to evaluate the advantages of using random regression model on the genetic analysis of days open

Joint Genetic Analysis of Conception and Maintenance of Pregnancy in Dairy Cattle Using a Linear-Threshold Model

A joint analysis of days open and calving success was implemented to further enhance the identification of cows with greater genetic merit for reproductive performance. Calving success is a categorical trait with similar genetic variation as days open and is analyzed jointly with days open to make effective use of the positive genetic correlation between these two traits. The joint analysis can identify cows with greater genetic merit for conception at an earlier stage of lactation and greater success at maintenance of pregnancy. The joint analysis also enhances the reliability of detecting true genetic differences between cows for fertility because it makes more effective use of all data

Direct oral anticoagulants for stroke prevention in patients with device-detected atrial fibrillation: assessing net clinical benefit

Subclinical, device-detected atrial fibrillation (AF) is frequently recorded by pacemakers and other implanted cardiac rhythm devices. Patients with device-detected AF have an elevated risk of stroke, but a lower risk of stroke than similar patients with clinical AF captured with surface electrocardiogram. Two randomized clinical trials (NOAH-AFNET 6 and ARTESiA) have tested a direct oral anticoagulant (DOAC) against aspirin or placebo. A study-level meta-analysis of the two trials found that treatment with a DOAC resulted in a 32\2\ the results of the two trials were consistent. The annualized rate of stroke in the control arms was ∼1\detected AF. Strokes in ARTESiA were frequently fatal or disabling and bleeds were rarely lethal. The higher absolute rates of major bleeding compared with ischaemic stroke while on treatment with a DOAC in the two trials are consistent with the ratio of bleeds to strokes seen in the pivotal DOAC vs. warfarin trials in patients with clinical AF. Prior research has concluded that patients place a higher emphasis on stroke prevention than on bleeding. Further research is needed to identify the characteristics that will help identify patients with device-detected AF who will receive the greatest benefit from DOAC treatment

Do Omega-3 fatty acids prevent atrial fibrillation after open heart surgery? A meta-analysis of randomized controlled trials

OBJECTIVES: N-3 polyunsaturated fatty acids have been proposed as a novel treatment for preventing postoperative atrial fibrillation due to their potential anti-inflammatory and anti-arrhythmic effects. However, randomized studies have yielded conflicting results. The objective of this study is to review randomized trials of N-3 polyunsaturated fatty acid use for postoperative atrial fibrillation. METHODS: Using the CENTRAL, PUBMED, EMBASE, and LILACS databases, a literature search was conducted to identify all of the studies in human subjects that reported the effects of N-3 polyunsaturated fatty acids on the prevention of postoperative atrial fibrillation in cardiac surgery patients. The final search was performed on January 30, 2011. There was no language restriction, and the search strategy only involved terms for N-3 polyunsaturated fatty acids (or fish oil), atrial fibrillation, and cardiac surgery. To be included, the studies had to be randomized (open or blinded), and the enrolled patients had to be >18 years of age. RESULTS: Four randomized studies (three double-blind, one open-label) that enrolled 538 patients were identified. The patients were predominantly male, the mean age was 62.3 years, and most of the patients exhibited a normal left atrial size and ejection fraction. N-3 polyunsaturated fatty acid use was not associated with a reduction in postoperative atrial fibrillation. Similar results were observed when the open-label study was excluded. CONCLUSIONS: There is insufficient evidence to suggest that treatment with N-3 polyunsaturated fatty acids reduces postoperative atrial fibrillation. Therefore, their routine use in patients undergoing cardiac surgery is not recommended