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This study examined changes food and drink purchasing during the first 3 months of the COVID-19 pandemic in England, and if changes varied by population subgroups. We investigated changes in take-home food and drink purchasing and frequency of out-of-home (OOH) purchasing using an interrupted time series analysis design. The start of pandemic restrictions (the intervention) was defined as 16 March 2020, when first announced in the UK. London and the North of England. 1245 households reporting take-home and 226 individuals reporting OOH purchases between January 2019 and mid-June 2020 from the GB Kantar Fast Moving Consumer Goods Panel. The marginal mean estimate of total take-home energy purchased was 17·4 % (95 % CI 14·9, 19·9) higher during the pandemic restriction period compared with the counterfactual. Increases of 35·2 % (95 % CI 23·4, 47·0) in take-home volume of alcoholic beverages and 1·2 % (95 % CI 0·1, 2·4) in foods and drinks high in fat, salt and sugar were observed. Reductions in purchased energy from fruit and vegetables (-7·3 %, 95 % CI -10·9, -3·6), ultra-processed foods (-4·0 %, 95 % CI -5·2, -2·8) and in OOH purchasing frequency (-44·0 %, 95 % CI -58·3, -29·6) were observed. Changes in chocolate and confectionery, soft drink and savoury snack purchases levelled off over time. Changes in all studied outcomes varied by sociodemographic characteristics and usual purchasing. Pandemic restrictions were associated with positive and negative changes in food and drink purchasing, which differed by individual characteristics. Future research should ascertain if changes persist and translate into changes in health.

Background Evidence for an association between the local food environment, diet and diet-related disease is mixed, particularly in the UK. One reason may be the use of more distal outcomes such as weight status and cardiovascular disease, rather than more proximal outcomes such as food purchasing. This study explores associations between food environment exposures and food and drink purchasing for at-home and out-of-home (OOH) consumption. Methods We used item-level food and drink purchase data for London and the North of England, UK, drawn from the 2019 Kantar Fast Moving Consumer Goods panel to assess associations between food environment exposures and household-level take-home grocery ( n =2,118) and individual-level out-of-home ( n =447) food and drink purchasing. Density, proximity and relative composition measures were created for both supermarkets and OOH outlets (restaurants and takeaways) using a 1 km network buffer around the population-weighted centroid of households’ home postcode districts. Associations between food environment exposure measures and frequency of take-home food and drink purchasing, total take-home calories, calories from fruits and vegetables, high fat, salt and sugar products, and ultra-processed foods (UPF), volume of take-home alcoholic beverages, and frequency of OOH purchasing were modelled using negative binomial regression adjusted for area deprivation, population density, and individual and household socio-economic characteristics. Results There was some evidence for an inverse association between distance to OOH food outlets and calories purchased from ultra-processed foods (UPF), with a 500 m increase in distance to the nearest OOH outlet associated with a 1.1% reduction in calories from UPF (IR=0.989, 95%CI 0.982–0.997, p =0.040). There was some evidence for region-specific effects relating to purchased volumes of alcohol. However, there was no evidence for an overall association between food environment exposures and take-home and OOH food and drink purchasing. Conclusions Despite some evidence for exposure to OOH outlets and UPF purchases, this study finds limited evidence for the impact of the food environment on household food and drink purchasing. Nonetheless, region-specific effects regarding alcohol purchasing indicate the importance of geographical context for research and policy.

Evidence for the effect of neighbourhood food environment (NFE) exposures on diet in the UK is mixed, potentially due to exposure misclassification. This study used the first national COVID-19 lockdown in England as an opportunity to isolate the independent effects of the NFE exposure on food and drink purchasing, and assessed whether these varied by region. Transaction-level purchasing data for food and drink items for at-home (1,221 households) and out-of-home consumption (171 individuals) were available from the GB Kantar Fast Moving Consumer Goods Panel for London and the North of England. The study period included 23rd March to 10th May 2020 ('lockdown'), and the same period in 2019 for comparison. NFE exposures included food outlet density and proximity, and NFE composition within a 1 km network buffer around the home. Associations were estimated for both years separately, adjusted for individual and household characteristics, population density and area deprivation. Interaction terms between region and exposures were explored. There were no consistent patterns of association between NFE exposures and food and drink purchasing in either time period. In 2019, there was some evidence for a 1.4% decrease in energy purchased from ultra-processed foods for each additional 500 m in the distance to the nearest OOH outlet (IR 0.986, 95% CI 0.977 to 0.995, p = 0.020). In 2020, there was some evidence for a 1.8% reduction in total take-home energy for each additional chain supermarket per km2 in the neighbourhood (IR 0.982, 95% CI 0.969, 0.995, p = 0.045). Region-specific effects were observed in 2019 only. Findings suggest that the differences in exposure to the NFE may not explain differences in the patterns or healthiness of grocery purchasing. Observed pre-pandemic region-specific effects allude to the importance of geographical context when designing research and policy. Future research may assess associations for those who relied on their NFE during lockdown.

Electrocardiographic imaging (ECGi) is an innovative noninvasive mapping technique. Indeed, ECGi enables the identification of the earliest points of cardiac activation in both atrial and ventricular focal arrhythmias, as well as rotors and high-frequency domains that could act as potential drivers of atrial fibrillation. Currently, ECGi is most widely used in the management of ventricular tachycardia (VT). Meanwhile, in cases of macro-reentrant arrhythmias, ECGi assists in outlining the re-entry circuit and identifying the myocardial exit site. Additionally, current research is focusing on detecting myocardial scars and critical isthmuses. This information is particularly valuable for planning stereotactic arrhythmia radioablation procedures for VT in patients where invasive electroanatomic maps are unavailable, and a fully noninvasive approach is preferred. The present review aims to examine commercially available options for noninvasive ECG mapping (Amycard, CardioInsight, VIVO, Acorys, and vMAP), highlighting key features and limitations.

Digital place has been variously characterised as a set of online augmentations and representations that influence how physical places are imagined, cognised, and interacted with. In an evolving media ecosystem, star ratings enjoy a pervasive presence on platforms. Ratings provide information and alter people’s decision-making not only when choosing consumer products but also places. Focusing on numeric ratings, through a scoping review, this article (1) traces the origins and rapid proliferation of place ratings , categorising them into primary, secondary, volunteered, transactional, expert, and user-generated types, and examines how they are applied geographically, from countries to points of interest. Then, it reports on (2) a global survey of rating platforms, accounting for their variety and similarities across sectors and countries. (3) It engages with significant issues are entangled with place ratings: the challenges in their interpretation and aggregation; their potential cognitive, spatial, and demographic biases; their impact on power dynamics between businesses and consumers; and their contribution to the socio-spatial inequalities that exist between digital and physical realms. These insights converge into a geographical research agenda to study place ratings’ deep and ubiquitous effects.

Aim of the present study is to analyze thermal events occurring during cryoablation. Different bovine liver samples underwent freezing cycles at different cooling rate (from 0.0075 to 25 K/min). Ice onset temperature and specific latent heat capacity of the ice formation process were measured according to differential scanning calorimetry signals. A computational model of the thermal events occurring during cryoablation was compiled using Neumann’s analytical solution. Latent heat (#1 = 139.8 ± 7.4 J/g, #2 = 147.8 ± 7.9 J/g, #3 = 159.0 ± 4.1 J/g) of all liver samples was independent of the ice onset temperature, but linearly dependent on the water content. Ice onset temperature was proportional to the logarithm of the cooling rate in the range 5 ÷ 25 K/min (#3a = − 12.2 °C, #3b = − 16.2 °C, #3c = − 6.6 °C at 5K/min; #3a = − 16.5 °C, #3b = − 19.3 °C, #3c = − 11.6 °C at 25 K/min). Ice onset temperature was associated with both the way in which the heat involved into the phase transition was delivered and with the thermal gradient inside the tissue. Ice onset temperature should be evaluated in the early phase of the ablation to tailor cryoenergy delivery. In order to obtain low ice trigger temperatures and consequent low ablation temperatures a high cooling rate is necessary.

Background and objectives: Atrial fibrillation (AF) and dementia are growing causes of morbidity and mortality, representing relevant medical and socioeconomic burdens. In this study, based on data from the Global Burden of Disease Injuries and Risk Factors Study (GBD) 2019, we focused on AF and dementia distribution and investigated the potential correlation between the two epidemiological trends. Materials and Methods: Crude and age-standardized incidence, prevalence, mortality rate, and disability-adjusted life years (DALYs) lost, derived from GBD 2019, were reported for AF and dementia. Global features were also stratified by high and low sociodemographic-index (SDI) countries. Granger test analysis was performed to investigate the correlation between AF and dementia incidence time trends. Results: From 1990 to 2019 crude worldwide incidence and prevalence showed a dramatic increase for both conditions (from 43.24 to 61.01 and from 528.72 to 771.51 per 100,000 individuals for AF, respectively; from 54.60 to 93.52 and from 369.88 to 667.2 per 100,000 individuals for dementia, respectively). In the same timeframe, crude mortality rate doubled for AF and dementia (from 2.19 to 4.08, and from 10.49 to 20.98 per 100,000 individuals, respectively). Age-standardized estimate showed a substantial stability over the years, highlighting the key role of the progressively aging population. Crude estimates of all of the investigated metrics are greater in high SDI countries for both conditions. This association was still valid for age-standardized metrics, albeit by a reduced magnitude, suggesting the presence of higher risk factor burden in these countries. Finally, according to Granger test, we found a significant association between the historical trends of AF and dementia incidence (p = 0.004). Conclusions: AF and dementia burden progressively increased in the last three decades. Given the potential association between these two conditions, further clinical data assessing this relationship is needed.

Background: Atrial fibrillation (AF) is independently associated with the onset of cognitive decline/dementia. AF catheter ablation (AFCA) is the most effective treatment strategy in terms of sinus rhythm maintenance, but its effects on dementia prevention remain under investigation. The aim of the present study was to perform a systematic review and meta-analysis of the presently available studies exploring the effect of AFCA on dementia occurrence. Methods: PubMed/MEDLINE databases were screened for articles through 14 March 2022 reporting adjusted time-to-event outcome data comparing AFCA and non-AFCA cohorts in terms of de novo dementia occurrence. A random effect meta-analysis was performed to estimate the meta-analytic hazard ratio (HR) of dementia occurrence in AFCA vs. non-AFCA cohorts, as well as the meta-analytic incidence rate of dementia in the non-AFCA cohort. Based on the aforementioned estimates, the number needed to treat (NNT), projected at median follow-up, was derived. Results: Four observational studies were included in the analysis, encompassing 40,146 patients (11,312 in the AFCA cohort; 28,834 in the non-AFCA cohort). AFCA conferred a significant protection to the development of dementia with an overall HR of 0.52 (95% CI 0.35–0.76). The incidence rate of dementia in the non-AFCA group was 1.12 events per 100 person-year (95% CI 0.47–2.67). The derived NNT projected to the median follow-up (4.5 years) was 41. Conclusion: AFCA is associated with a nearly 50% reduction in dementia occurrence during a median 4.5-year follow-up. Future randomized clinical trials are needed to reinforce these findings.

Atrial fibrillation (AF) is the most common cardiac arrhythmia encountered in clinical practice. Despite the frequent coexistence with coronary artery disease (CAD), the prognostic independent implication of AF in patients with stable CAD remains controversial. Our aim was to perform a pairwise meta-analysis of adjusted observational studies comparing cardiovascular outcomes in patients with stable CAD with and without concomitant AF, in search of AF-specific prognostic implications. We performed random effect meta-analysis of binary outcome events in studies comparing stable CAD patients with versus without AF providing risk estimates adjusted for confounding variables. Literature search was performed in PubMed/MEDLINE and Google Scholar. Death was the primary endpoint of the analysis, while myocardial infarction, coronary revascularization and stroke secondary endpoints. 5 studies were included in the meta-analysis, encompassing a total of 30230 stable CAD patients (2844 with AF, 27386 without AF). Stable CAD patients with AF presented an independent increased risk of death (HR 1.39, 95% CI: 1.17–1.66) and stroke (HR 1.88, 95% CI: 1.45–2.45) compared to those without AF. Instead, risk of myocardial infarction (HR 0.90, 95% CI: 0.66–1.22) and coronary revascularization (HR 0.96, 95% CI: 0.79–1.16) did not differ in stable CAD patients with and without the arrhythmia. In patients with stable CAD, AF exerts an independent negative prognostic effect, increasing the risk of death and stroke. However, the small number of eligible studies included in this analysis highlights the astonishing lack of data regarding prognostic implications of concomitant AF in patients with stable CAD.