The importance of energy transition was underlined at COP28 in Dubai, where governments committed to tripling renewables capacities and doubling the rate of energy efficiency by 2030. However, the ...power generated by climate-dependent energy sources exhibits greater vulnerability to potential climate changes in the long term. Therefore, climate models play a pivotal role in estimating the effects of climate change on renewables in the context of strategic planning for the development and operation of new renewable power plants. In this context, the World Meteorological Organization (WMO) developed a Global Energy Resilience Atlas aimed at providing insights into the climate change risks for the hydropower sector, the largest renewable electricity source for most countries, generating over 4300 TWh globally. This study focuses on defining four Hydro Climate Risk indices (HCRIs) using historical and climate projection precipitation data for three climate scenarios. The final product is a freely available and interactive tool. The developed methodology and tool address how climate changes have historically affected hydropower generation and how they will impact the future at national scales. The final product also addresses the needs of policymakers at national, regional, and global levels in crafting long-term planning for a more secure energy sector, accelerating the energy transition to more sustainable and reliable energies.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Purpose
Cather ablation is known to influence the autonomic nervous system. This study sought to investigate the association of sinus heart rate pre-/post-ablation and recurrences in patients with ...atrial fibrillation undergoing pulmonary vein isolation (PVI).
Methods
Between January 2012 and December 2017, data of 482 patients undergoing their first PVI were included. Sinus heart rate was recorded before (PRE), directly post-ablation (POST) and 3 months post-ablation (3 M). All patients were screened for atrial tachyarrhythmia recurrences during the one-year follow-up.
Results
In the total study cohort, the mean resting sinus heart rate at PRE mean 57.9 bpm (95% CI 57.1–58.7 bpm) increased by over 10 bpm to POST mean 69.4 bpm (95% CI 68.5–70.3 bpm);
p
< 0.001 followed by a slight decrease at 3 M mean 67.3 bpm (95% CI 66.4–68.2 bpm) but still remaining higher compared to PRE (
p
< 0.001). This pattern was observed in patients with and without recurrences at POST and 3 M (both
p
< 0.001 compared to PRE). However, at 3 M the mean sinus heart rate was significantly lower in patients with compared to patients without recurrences (
p
= 0.031). In this regard, patients with a heart rate change < 11 bpm (PRE to 3 M) or, as an alternative parameter, patients with a heart rate < 60 bpm at 3 M had a significantly higher risk of recurrences compared to the remaining patients (Hazard ratio (HR) 1.82 (95% CI 1.32–2.49),
p
< 0.001 and HR 1.64 (95% CI 1.20–2.25),
p
= 0.002, respectively).
Conclusion
Our study confirms the impact of PVI on cardiac autonomic function with a significant sinus heart rate increase post-ablation. Patients with a sinus heart rate change < 11 bpm (PRE to 3 M) are at higher risk for recurrences during one-year post-PVI.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Atrial Tachycardia Incidence After RF versus Cryoballoon PVI
Background
Postablation atrial tachycardia (AT) is a significant complication following radiofrequency (RF) pulmonary vein isolation ...(PVI). Cryoballoon (CB) ablation is an alternative technique for PVI that appears to have a low incidence of AT. No direct comparison between AT risk in RF and CB ablation has been made.
Objective
To compare the incidence and characteristics of ATs after PVI with RF and with CB ablation in patients with paroxysmal atrial fibrillation (AF).
Methods
All patients who underwent their first PVI between January 2006 and September 2012 using either RF or CB ablation were included. When a repeat ablation procedure for AT was performed, the arrhythmia was classified as typical cavotricuspid isthmus (CTI) flutter or left atrial tachycardia (LA‐AT) based on invasive mapping procedure findings and ECG P‐wave morphology.
Results
The study population consisted of 415 and 215 consecutive patients in the RF and CB groups, respectively. After a mean follow‐up of 38 ± 21 months, 52 (8.3%) patients presented ATs (9.4% and 6% in the RF and CB groups, respectively; P = 0.15). Of those, 26 (4.1%) were classified as LA‐AT with 20 (4.8%) in the RF group and 6 (2.8%) in the CB group (P = 0.23). In patients without a history of typical CTI flutter or CTI line (n = 458), the incidence for this type of arrhythmia during follow‐up was 3.5%.
Conclusion
In patients with paroxysmal AF undergoing either RF or CB PVI as the sole ablation strategy, the incidence of postprocedural AT was low and there was no significant difference between the 2 techniques.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
The preferential sites for focal atrial tachycardia (FAT) are mainly in the right atrium in both sexes. However, a limited number of studies have indicated that sex differences in the localization of ...FAT. This study investigated possible sex differences in the distribution of FAT in a large cohort of patients referred for ablation.
From 2004 to 2019, 487 patients (298 women) were referred to our institution for ablation of FAT. A standard electrophysiological study was conducted, and isoproterenol or atropine was given when needed. Conventional catheter mapping, electroanatomic contact mapping, and noncontact mapping were used to assess the origin of ectopic atrial tachycardia.
Overall, 451 foci were successfully ablated in 436 patients (90%). Although the foci located along the crista terminalis were more common in women than in men (42% vs. 29%; p=0.023), the opposite were found in the foci located along the tricuspid annulus (5% vs. 11%; p=0.032) and the right atrial appendage (RAA) (1% vs. 3%; p=0.032). Other locations were similarly distributed in men and women. In addition, the presence of persistent FAT was more frequent in men than in women (22% vs. 5%; p<0.001). Finally, the difference in the induction pattern of FAT was also remarkable between sexes.
The distribution of FAT in women and men is different. In addition, persistent FAT seems more often in men than in women. The different distribution, persistency, and induction pattern of FAT should be considered in the successful management of this type of tachycardia.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Radiofrequency (RF) ablation of the cavotricuspid isthmus (CTI) is an effective treatment for atrial flutter (AFL). However, RF may injure cardiac structures such as the atrio-ventricular node or the ...right coronary artery and is usually painful. This prospective, randomized study compares cryoablation (Cryo) with RF ablation regarding efficacy, safety, and perceived pain.
One-hundred and fifty-three patients (78 Cryo; 75 RF) with CTI-dependent AFL--median age 65 years (range 34-82), 140 men (91%)--were randomized to Cryo or RF. Primary endpoint was demonstration of long-term efficacy defined as no symptomatic recurrence of AFL at the 6-month follow-up. Radiofrequency ablation was performed with a 3.5 mm open-irrigated-tip catheter and Cryo with a 9 F, 8 mm tip catheter. Ablation endpoint was bidirectional CTI block. Pain was evaluated with a visual analogue scale (VAS; 0-10). The acute success rate was 92% for Cryo and 95% for RF (P = 0.58). Procedural time was longer in the Cryo group (152 ± 54 min) than the RF group (116 ± 41 min) (P < 0.001). Cryoablation was considerably less painful compared with RF (mean VAS-Cryo 0.7 ± 1.2 vs. VAS-RF 4.6 ± 2.0; P < 0.001). Success rate at 6-month follow-up was 93% (73 of 78) for Cryo and 97% (73 of 75) for RF (P = 0.86). No major adverse events occurred in any group.
Cryoablation of isthmus-dependent AFL is not inferior to RF but with significantly less procedure-related pain.
Abstract Weather and Climate Services (W&CS) are key to supporting the transition to net-zero emissions in the energy sector. These services are utilised to increase energy system resilience, enhance ...renewable energy deployment, and enable uptake of energy-efficiency measures and innovations. As energy systems become increasingly dependent on and affected by weather and climatic conditions, integrating weather and climate data into energy management systems is essential. This paper addresses the gap in comprehensive guidance for developing integrated W&CS to support net-zero energy transitions, drawing upon a report by the World Meteorological Organization’s Services Commission Study Group on Integrated Energy Services (WMO 2023). We present a framework for co-production of W&CS, exploring how the uptake of W&CS for energy transitions can be enabled through evaluation of socio-economic benefits, harnessing business models, identification of key policies, and capacity development measures. To support the uptake of W&CS for net-zero energy transitions we recommend: a deeper understanding of user needs and requirements; continuous advancements in the science and technology of W effective integration of weather and climate data within energy conversion models; improved accessibility and sharing of meteorological and, especially, energy data; promotion of co-production approaches; exploration of novel applications of W&CS in the energy sector; refinement of business models for sustainable W&CS delivery; execution of capacity-building activities; enhanced communication among stakeholders and strengthened collaborative efforts. These steps are crucial for realizing the full potential of W&CS in driving the energy sector towards a sustainable, net-zero future.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The long-term stagnation in metal water supply pipes, usually caused by intermittent consumption patterns, will cause significant iron release and water quality deterioration, especially at the ...terminus of pipelines. Another common phenomenon at the terminus of pipelines is leakage, which is considered helpful by allowing seepage of low-quality drinking water resulting from long-term stagnation. In this study, the effect of laminar flow on alleviating water quality deterioration under different leakage conditions was investigated, and the potential thresholds of the flow rate, which can affect the iron release process, were discussed. Based on a galvanized pipe and ductile cast iron pipe pilot platform, which was established at the terminus of pipelines, this research was carried out by setting a series of leakage rate gradients to analyze the influence of different leakage flow rates on iron release, as well as the relationship with chemical and biological parameters. The results showed that the water quality parameters were obviously influenced by the change in flow velocity. Water quality was gradually improved with an increase in flow velocity, but its change regularity reflected a diversity under different flow rates (p < 0.05). The iron release was remarkably correlated to the redox potential, dissolved oxygen, pH, iron-oxidized bacteria and sulfate-reducing bacteria. The cumulative total iron release (r = 0.587, p < 0.05) and total iron release rate (r = 0.71, p < 0.022) were significantly influenced by the changes in flow velocity. In short, they tended first to increase and then to decrease with an increasing flow velocity with the threshold as approximately 40% of the critical laminar flow velocity (1.16 × 10−3 m/s). For the pipes at the terminus of the drinking water distribution system, when the bulk water was at the critical laminar flow velocity, the concentration of total iron, the quantity and rate of total iron release remain relatively in an ideal and safe situation.
Display omitted
•Pilot experimental platform was located in a real drinking water distribution system.•Flow velocity threshold effecting iron release under laminar flow was investigated.•Total iron release and chemical-microbial indicators was investigated.•The impact of different leakage flow rates on iron release in metal pipes.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Objective. Construction is a hazardous occupation due to the unique nature of activities involved and the repetitiveness of several field behaviors. The aim of this methodological and theoretical ...review is to explore the empirical factors influencing unsafe behaviors and accidents on construction sites. Methods. In this work, results and findings from 56 related previous studies were investigated. These studies were categorized based on their design, type, methods of data collection, analytical methods, variables, and key findings. A qualitative content analysis procedure was used to extract variables, themes, and factors. In addition, all studies were reviewed to determine the quality rating and to evaluate the strength of provided evidence. Results. The content analysis identified 8 main categories: (a) society, (b) organization, (c) project management, (d) supervision, (e) contractor, (f) site condition, (g) work group, and (h) individual characteristics. The review highlighted the importance of more distal factors, e.g., society and organization, and project management, that may contribute to reducing the likelihood of unsafe behaviors and accidents through the promotion of site condition and individual features (as proximal factors). Conclusion. Further research is necessary to provide a better understanding of the links between unsafe behavior theories and empirical findings, challenge theoretical assumptions, develop new applied theories, and make stronger recommendations.
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BFBNIB, GIS, IJS, KISLJ, NUK, PNG, UL, UM, UPUK
Aims
This study evaluates the incidence of procedural complications related to catheter ablation of atrial fibrillation (AF) to assess the potential feasibility and safety of same‐day discharge in a ...large cohort.
Methods
We performed an analysis of prospectively collected data of complications of all patients staying overnight after undergoing AF ablation between 2001 and 2020 at a tertiary center. Using medical records, we analyzed complications occurring intraprocedurally until 6 h postablation and between 6 h postablation and discharge the day after the ablation procedure.
Results
In 5414 AF ablations, we identified a total of 108 (2.0%) major complications occurring intraprocedural or before discharge. Most major complications occurred intraprocedurally or within 6 h after the procedure (n = 96, 1.8%). Twelve (0.2%) major complications occurred between 6 h Postablation and discharge. The most common of these major complications were congestive heart failure (n = 6) and transient ischemic attack (TIA, n = 4). During this time span, 61 (1.1%) minor complications occurred. Factors independently associated with major complications intraprocedurally and until discharge were body mass index (BMI) ≥ 30 kg/m2 (p = .009), significant valvular disease (p = .001), cardiomyopathy (p < .001), prior stroke or TIA (p = .014), first‐time procedure versus repeat procedure (p = .013), cryoablation versus radiofrequency (p < .001), and procedure duration (p < .001).
Conclusion
After AF ablation, very few complications occurred between 6 h postprocedure and discharge the next day. Therefore, same‐day discharge is a safe option for a majority of patients.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
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