bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing the Urban Environmental Quality: A Case Study of Kolkata Metropolitan Area, India
Authors: Paul D , Mukherjee K , Pandey J K , Dutta Roy A
Published: May 2023

Rapid unplanned urbanization is always associated with environmental degradation which plays a direct role in the quality of life. Poor environmental quality is linked to premature death, cancer, long-term damage to respiratory and cardiovascular systems, etc. Using a case study of the Kolkata Metropolitan Area (KMA), the Urban Environmental Quality (UEQ) index has been constructed using a geoinformatics platform in the dimensions of the physical environment and built environment encompassing urban greenery, NO2, SO2, PM 2.5, PM 10, road induced pollution, land surface temperature, built-up area and noise followed by an exploration of its spatial pattern. KMA is the largest urban agglomeration in eastern India and the second-largest in India with a population of 13.2 million as per the 2001 census. Using the Urban Environmental Quality (UEQ) index, this study tried to find out the poor Environmental Quality area through multi-criteria analysis in KMA. Based on the relative importance of controlling the outdoor environment, criteria weights for nine parameters have been derived through the analytical hierarchy process (AHP). The UEQ index was prepared by combining parameters rating and corresponding weight. Polycentric growth of urban centers leads to appropriate spatial matches to low environmental quality. Although the UEQ in the peripheries is being affected by suburbanization in a few instances, the majority of the areas have better environmental quality.
Assessing the Tidal Influences on the Coastal Erosion-Accretion Processes in the Indian Sundarban Delta using Hydrodynamic Models and Geoinformatics
Authors: Bhui K , Bhadra T , Samanta S , Hazra S
Published: May 2023

The Sundarbans is currently a subject of serious concern due to the massive coastline erosion that is responsible for reshaping the geomorphological content of the islands. The coastal islands of the Sundarbans have become more susceptible to sea-level rise, cyclonic storms, and coastal flooding, which further accelerate the process of coastal erosion. Identification of erosion-prone regions is highly essential for integrated coastal zone management. Till date, no scientific study has been done to relate the coastal erosion accretion process with tidal velocity and current direction in the Indian Sundarbans. In this perspective, the present study identifies the erosion-accretion zones in the Indian Sundarbans using Landsat imageries of 2000 and 2020 using geoinformatics. It investigates the impact of tidal velocity and direction on the erosion accretion processes. MIKE 21 two-dimensional hydrodynamic model was simulated to predict tidal velocities and directions. The study finds that the sea-facing islands of the Indian Sundarbans experience the maximum amount of erosion. A significant shrinking of the land area takes place in the Bulchery, Bhangaduiani, and Dalhousie islands. The rates of erosion of these islands are 485.99 m/year, 487 m/year, and 480.65 m/year, respectively. Places with high velocity are found to be erosion-prone, while the rate of erosion significantly varied with the flow directions. Two islands, Bulchery and Dalhousie, on the south-eastern margin of the delta, suffered maximum erosion over the past decades due to the impact of high-velocity currents from the southeast and southwest, respectively. Alternatively, minor accretions were observed along with the sheltered island precincts where velocities were comparatively low. Such studies on the current drive erosion–accretion processes along the delta margin during sea-level rise appear to be of utmost importance for sustainable coastal protection and management.
Forest Fire Risk Zone Mapping in Mizoram Using RS and GIS
Authors: Pramanick N , Kundu B , Acharyya R , Mukhopadhyay A
Published: May 2023

In recent years, India’s Northeastern territory has been plagued by wildfires. Mizoram, as per FSI, has been among the most affected regions, with approximately 20,744-recorded wildfires. Forest fire directly or indirectly affects human health, climate change, and the environment. The forest fire risk zonation is generated utilizing remote sensing data, and Geographic Information System based on specified physical and socioeconomic factors. As part of the current study, a Geographical Information System is employed to determine forest fire risk based on predetermined physical and socioeconomic parameters. This study used three distinct models of fire risk zonation index namely FRI (Fire Risk Index), HFI (Hybrid Fire Index), and SFI (Structural Fire Index) to identify the zones in the study area under the risk of forest fires. The Indian state of Mizoram is categorized into five distinct hazard zones based on the probability of wildfire incidents. Fire alerts generated using risk models, and real-time hotspot datasets (forest fire spots) received from MODIS and USGS have been validated. According to the study’s findings, 18.84 km2 of the study area is at low risk of forest fire, 11.072 km2 is at moderate risk, and 5.38 km2 is at high risk. The probability from each metric varies since the input and weightage of the different parameters vary from one another. SFI, therefore, therefore predicts a lower frequency of high-risk wildfire-prone zones than HFI and FRI. In this research, the coefficient of discrimination (R2) is employed to assess the reliability of the projected fire indices being compared with real-time hot spots. Here, FRI possesses the highest accuracy (R2=0.892), HFI has moderate accuracy (R2=0.676), and FRI has the lowest accuracy (R2=0.629).
Beach Erosion Assessment and Tourism Viability Analysis at Mandarmani Coast, West Bengal, India
Authors: Bose A , Bardhan S
Published: May 2023

Mandarmani is a popular seaside tourist destination in Coastal West Bengal, India. The geomorphologically dynamic and ecologically diverse terrain falls within an active coastal belt with strong erosion but limited accretion. It is important to monitor and predict changes in beach morphology and shoreline over a short and long timescale to identify the specific drivers of such changes and their related impacts. While manual ground surveying techniques are relatively more accurate for this purpose, Remote Sensing and GIS techniques are proven to be more applicable as they are relatively accurate, cost-effective, less time-consuming and can cover a large coastal belt. The present paper analysed the beach morphology and shoreline changes along the Digha-Mandarmani coast of West Bengal using RS & GIS as a tool and fish net model to demarcate the erosion and accretion zones, to project the future shoreline position and understand the risk of climatic hazard on the tourism establishments and their sustainability in this region in future. Such a study would help in taking informed policy choices by the planners on such growing tourism destinations developed over time, often violating the existing coastal zone regulations and thus without required environmental clearances. Should be protected with public investment to safeguard the business hub, or will be allowed to face its natural consequences?
Implication of Applying IPCC AR4 and AR5 Framework for Drought-based Vulnerability and Risk Assessment in Bankura and Purulia Districts, West Bengal
Authors: Singha A , Pramanick N , Acharyya R
Published: May 2023

In the districts of Purulia and Bankura, this study offers a methodology for spatial assessment of vulnerable and risk-prone areas. These districts are adjacent in space and have identical geographic characteristics (other than the eastern portion of Bankura district). Vulnerability and risk assessment could be used to measure the interactions between individuals and their surroundings. This research aims to pinpoint the areas in these two districts that are particularly susceptible to natural, social, and meteorological disasters. The natural and climate-induced factors considered are rainfall distribution and vegetation conditions. The social factors are agricultural dependence, percentage of farmers, female population, labor dependence on agriculture, and literacy rate. The potential impacts of developmental and environmental degradation processes can be examined and assessed by classifying regions according to their vulnerability and risk levels. The fundamental factors impacting susceptibility and risk, which are recognized, and the associated thematic-based outputs are produced in this study based on the persistent phenomenon of drought within these two districts. The elements of vulnerability selected for this study are exposure, sensitivity, and adaptive capacity (IPCC AR4) and risk, which is the combined outcome of hazard, exposure, and vulnerability (IPCC AR5). The aim of this research is to create a simplified, scalable assessment model for evaluating both vulnerabilities and threats, which can help with drought mitigation. It has been observed from the results that the western portion of the study area (Arsha, Purulia-I, Baghmundi blocks of Purulia district) with relatively higher risk and vulnerability needs more attention for reducing the vulnerability and risk than the eastern part. As a result, this research can serve as a platform for district-level prioritizing efforts, emergency response protocols, and policy interventions aimed at reducing disaster susceptibility (mostly drought) in Bankura and Purulia districts.
Monitoring Land Use & Land Cover Change in an Urban Landscape: A Case Study of Siliguri, India
Authors: Sarkar R , Baral M
Published: May 2023

Information related to Land use and Land Cover (LULC) change is important for conservation of natural resources and sustainable development of an area. Siliguri is one of the populated metropolitan of West Bengal, India that has witnessed rapid urbanization. The major challenge is to identify the reason and pattern of urbanization due to inadequate and insufficient data in small cities like Siliguri. This paper has mainly assessed the LU & LC change of Siliguri municipality for the period of 1991-2001, 2001-2011 and 2011-2021. The main aim of the study is to determine the pattern and direction of future expansion. Satellite images from Landsat 4-5(1991-2011) and Landsat 8(2021) were used to extract LU & LC map of the municipality. Supervised classification using maximum likelihood classification was used to developed LULC maps. The supervised classification produced good results with overall accuracy of more than 80%. The change of the LULC pattern was obtained using change detection method. Four major classes viz. Vegetation, water body, sand and built-up have been identified. The analysis shows that maximum transformation has happened in the buildup environment from other land surface features.
Monitoring Change in Urbanization and Green Space for Eastern Indian Cities in 30 Years-A Comparison between Kolkata and Bhubaneswar
Authors: Bose S , Mazumdar A , Basu S
Published: May 2023

Advancement in technology has made a new sphere of geospatial exploration. Application of geoinformatics in Landuse and Landcover study has made quantitative analysis most clear. Urbanization process is an inevitable factor in developing countries like India. Last 30 years eastern India has also been changed itself in terms of urban development. Kolkata and Bhubaneswar are two most important cities in eastern India where urban growth has taken place rapidly. Landuse and landcover pattern has also changed here with time. Urbanization process of both cities has been identified using satellite images taken from USGS. Applying satellite images, this paper has investigated about the urban green spaces that has been changed with time also depth of urbanization has been studied to find out an overall ecological balance in these cities. Different LULC classes has been chosen to define the ecology. Details about landscape matrices has been applied which are necessary to get the result. Urban Index (UI), Urban expansion index (UX) and Urban green index (UGI) has been used to calculate and compare results with both the cities. Geospatial analysis has been processed maintain time interval of 15 years to better understand the change that affected on land with time. Kolkata is one of the most urbanized cities as it has large history of urbanization whereas Bhubaneswar is also has developed with time, it has been selected as smart city for maintaining a holistic growth approach. Quantitative analysis and application of LecoS made the results more specific and appropriate to understand the actual relationship between growth of cities and greenspace towards sustainability.
Nonlinear response of Equatorial Western Pacific phytoplankton blooms to ‘double-dip’ La Niña events
Authors: Chen Ruyan , Du Yan , Zhang Ying , Chi Jianwei
Published: May 2023

Phytoplankton in the equatorial western Pacific tends to bloom during consecutive (‘double-dip’) La Niña events with nonlinear characteristics: extremely high chlorophyll-a (Chl-a) concentrations typically occur during the second-year La Niña events even when the associated SST anomalies are significantly weakened. Photosynthetically available radiation is found to have the strongest correlation with the equatorial western Pacific Chl-a fluctuations. However, barrier layer variation is critical in driving the strong bloom events seen in the second-year La Niña, which can be further explained by the nonlinear heat advection within the isothermal layer. To improve the current climate models’ performance in simulating the western Pacific phytoplankton bloom events, it is recommended that the influence of barrier layer should be better considered.
Determining the collision kernel in the Boltzmann equation near the equilibrium
Authors: Li Li , Ouyang Zhimeng
Published: May 2023

We consider an inverse problem for the nonlinear Boltzmann equation near the equilibrium. Our goal is to determine the collision kernel in the Boltzmann equation from the knowledge of the Albedo operator. Our approach relies on a linearization technique as well as the injectivity of the Gauss-Weierstrass transform.
Sampling measure on Bergman spaces
Authors: Zhuo Zhengyuan , Ye Shanli
Published: May 2023

In this paper, we investigate the relationship between sampling measure

μ
\mu

, Berezin transform

μ
~

\tilde {\mu }

and

r
r

-averaging transform

μ
^

r

\widehat {\mu }_r

on Bergman spaces. Compared with some results of Luecking [Amer. J. Math. 107 (1985), pp. 85–111], our results provide an equivalent description of sampling measures, which reveals the reason why

1

/

μ
^

r

∈

L
∞

1/\hat {\mu }_r\in L^\infty

or

1

/

μ
~

∈

L
∞

1/\tilde {\mu }\in L^\infty

does not make sure that

μ
\mu

is a sampling measure on Bergman spaces.
mythography
Authors: Smith R. Scott
Published: May 2023

Mythography is a modern scholarly term used to describe a wide variety of ancient writing practices, all in prose, that treat the stories that we designate as myth. It is an index term that encompasses both systematic mythography, which seeks to narrate, organize, and systematize mythical stories (as exemplified in its best surviving representative, the Library of Apollodorus (9)), and interpretative mythography, which aims at uncovering the origins or hidden meanings of the surface myths through rationalizing and allegorizing approaches. Even within these categories the products may differ widely, illustrating the basic point that mythography is as protean as myth itself and depends on the time, place, and purposes of production. Mythography was a continuous activity from the archaic period into late antiquity and beyond, although the vast majority of extant mythographical texts belong to the imperial period. From the Hellenistic period, which must have been instrumental in defining the forms and variety of mythography, we have, apart from Palaephatus’s On Unbelievable Stories, only fragmentary authors or later abridgements. The earliest prose writers, although never termed “mythographers” in antiquity, nevertheless established the methodological principles that would become the hallmarks of mythographical writing.
pyGOMoDo: GPCRs modeling and docking with python
Authors: Ribeiro Rui P , Giorgetti A
Published: May 2023

Motivation

We present pyGOMoDo, a Python library to perform homology modeling and docking, specifically designed for human GPCRs. pyGOMoDo is a python wrap-up of the updated functionalities of GOMoDo web server (https://molsim.sci.univr.it/gomodo). It was developed having in mind its usage through Jupyter notebooks, where users can create their own protocols of modeling and docking of GPCRs. In this article, we focus on the internal structure and general capabilities of pyGOMoDO and on how it can be useful for carrying out structural biology studies of GPCRs.

Results

The source code is freely available at https://github.com/rribeiro-sci/pygomodo under the Apache 2.0 license. Tutorial notebooks containing minimal working examples can be found at https://github.com/rribeiro-sci/pygomodo/tree/main/examples.
Power and sample size calculations for rerandomization
Authors: Branson Zach , Li Xinran , Ding Peng
Published: May 2023

Power analyses are an important aspect of experimental design, because they help determine how experiments are implemented in practice. It is common to specify a desired level of power and compute the sample size necessary to obtain that power. Such calculations are well known for completely randomized experiments, but there can be many benefits to using other experimental designs. For example, it has recently been established that rerandomization, where subjects are randomized until covariate balance is obtained, increases the precision of causal effect estimators. This work establishes the power of rerandomized treatment-control experiments, thereby allowing for sample size calculators. We find the surprising result that, while power is often greater under rerandomization than complete randomization, the opposite can occur for very small treatment effects. The reason is that inference under rerandomization can be relatively more conservative, in the sense that it can have a lower Type-I error at the same nominal significance level, and this additional conservativeness adversely affects power. This surprising result is due to treatment effect heterogeneity, a quantity often ignored in power analyses. We find that heterogeneity increases power for large effect sizes, but decreases power for small effect sizes.
Altered structural covariance of locus coeruleus in individuals with significant memory concern and patients with mild cognitive impairment
Authors: Tang Yingmei , Cao Minghui , Li Yunhua , Lin Yuting , Wu Xiaoyan , Chen Meiwei ,   for the Alzheimer’s Disease Neuroimaging Initiative, Shen Jun
Published: May 2023

The locus coeruleus (LC) is the site where tau accumulation is preferentially observed pathologically in Alzheimer’s disease (AD) patients, but the changes in gray matter co-alteration patterns between the LC and the whole brain in the predementia phase of AD remain unclear. In this study, we estimated and compared the gray matter volume of the LC and its structural covariance (SC) with the whole brain among 161 normal healthy controls (HCs), 99 individuals with significant memory concern (SMC) and 131 patients with mild cognitive impairment (MCI). We found that SC decreased in MCI groups, which mainly involved the salience network and default mode network. These results imply that seeding from LC, the gray matter network disruption and disconnection appears early in the MCI group. The altered SC network seeding from the LC can serve as an imaging biomarker for discriminating the patients in the potential predementia phase of AD from the normal subjects.
Local habitat type influences bumble bee pathogen loads and bee species distributions
Authors: Gratton Elena M , McNeil Darin J , Grozinger Christina M , Hines Heather M
Published: May 2023

Bumble bees (Hymenoptera: Apidae, Bombus Latreille) perform important ecological services in both managed and natural ecosystems. Anthropogenically induced change has altered floral resources, climate, and insecticide exposure, factors that impact health and disease levels in these bees. Habitat management presents a solution for improving bee health and biodiversity, but this requires better understanding of how different pathogens and bee species respond to habitat conditions. We take advantage of the washboard of repeated ridges (forested) and valleys (mostly developed) in central Pennsylvania to examine whether local variation in habitat type and other landscape factors influence bumble bee community composition and levels of 4 leading pathogens in the common eastern bumble bee, Bombus impatiens Cresson. Loads of viruses (DWV and BQCV) were found to be lowest in forest habitats, whereas loads of a gut parasite, Crithidia bombi, were highest in forests. Ridgetop forests hosted the most diverse bumble bee communities, including several habitat specialists. B. impatiens was most abundant in valleys, and showed higher incidence in areas of greater disturbance, including more developed, unforested, and lower floral resource sites, a pattern which mirrors its success in the face of anthropogenic change. Additionally, DNA barcoding revealed that B. sandersoni is much more common than is apparent from databases. Our results provide evidence that habitat type can play a large role in pathogen load dynamics, but in ways that differ by pathogen type, and point to a need for consideration of habitat at both macro-ecological and local spatial scales.
Troponin-T and age as predictors for mortality in patients with atrial fibrillation at the emergency department
Authors: Celik S , Bodestrom Eriksson L , Waldemar A , Mallios P , Andersson J , Lunden M , Digerfeldt C , Hubbert L
Published: May 2023

Funding Acknowledgements

Type of funding sources: Public hospital(s). Main funding source(s): Grants from Region Östergötland County

Medical Research Council of Southeast Sweden

Background

Atrial fibrillation/flutter (AF) is a common heart arrhythmia and medical condition at the emergency room, making up approximately 1-2% of the visits and hospital admissions. Previous studies have shown an association between elevated Troponin-T levels and mortality (1). However, there is limited data in whether mildly elevated Troponin-T levels together with age correlates with an increased mortality.

Purpose

The purpose of this study was to analyse the usage of Troponin-T and its prognostic value for mortality together with age in patients with AF at the emergency department.

Methods

A comparison of when Troponin-T was used and when multiple sampling occurred was made. A comparison of Troponin-T together with age was also made to analyse potential associations with mortality. Patients were identified through the ICD-10 code for AF (I48) and the data was collected through medical records and diagnostic registers. Patients were divided in three groups based on Troponin-T (< 15 ng/L, 15-50 ng/L and > 50 ng/L) and four subgroups based on age (< 60, 60-69, 70-79 and > 80 years). Primary outcomes were all-cause mortality at 30 days and 1 year. The association between Troponin-T, age and mortality were analysed through hazard ratio (HR) with 95% confidence interval (CI).

Results

771 patients with AF at the emergency room were included in this cohort study (median age 72, 44,6% female and median AF duration 1,3 years). There was a significant difference in Troponin-T levels between patients admitted to hospital compared to discharge (p < 0,001). All-cause mortality was 1,9% (n = 15) at 1 month and 7,7% (n = 59) at 1 year. The hazard ratio (HR) was 9,86 (95% CI 1,23-78,82, p = 0,031) for Troponin-T 15-50 ng/L and 32,98 (95% CI 3,85-282,29, p < 0,001) for Troponin-T > 50 ng/L at 30 days compared to Troponin-T < 15 ng/L. The HR at 1 year was 7,98 (95% CI 3,10-20,51, p < 0,001) for Troponin-T 15-50 ng/L and 20,88 (95% CI 7,52-57,98, p < 0,001) for Troponin-T > 50 ng/L compared to Troponin-T < 15 ng/L. For age, the HR at 1 year was 2,67 (95% CI 0,54-13,23, p = 0,229) for age 60-69 years, 3,59 (95% CI 0,82-15,80, p = 0,091) for age 70-79 years and 12,79 (95% CI 3,05-53,68, p < 0,001) for age > 80 years compared to age < 60 years.

Conclusions

Troponin-T appears to influence several decisions taken at the emergency room for patients with AF, such as whether admission or multiple sampling is required. Troponin-T and age appears to independently indicate the risk for all-cause mortality. Higher Troponin-T were also associated with increased mortality in most age groups.
Sex differences in symptoms of anxiety, depression, and post-traumatic stress disorder among cardiac arrest survivors
Authors: Kragh A , Fuglsbjerg C , Wagner M K , Berg S K , Borregaard B , Hansen C M , Hassager C , Moeller J E , Grand J , Kjaergaard J
Published: May 2023

Funding Acknowledgements

Type of funding sources: None.

Introduction

Anxiety, depression, and post-traumatic stress disorder (PTSD) among out-of-hospital cardiac arrest (OHCA) survivors may impact their long-term recovery and quality of life. Gaining knowledge on sex differences in psychological consequences following cardiac arrest is important to explore strategies aiming to reduce these symptoms.

Purpose

To explore sex differences in anxiety, depression and PTSD levels after discharge among OHCA survivors hospitalized at a cardiovascular intensive care unit.

Methods

This was a prospective observational study in OHCA survivors that attended a follow-up after 4 months, (median, IQR 3-8). Presence of symptoms of anxiety and depression was measured using Hospital Anxiety and Depression Scale (HADS), range 0-21. Scores between 8 to 10 suggest the possible presence of a mood disorder whereas scores of 11 and above indicate the probable presence of a mood disorder. Symptoms of PTSD were measured with PTSD Checklist for DSM-5 (PCL-5), a 20-item self-report measure that assesses symptoms of PTSD, range 0-80.

Results

Between 2016 and 2021, 245 consecutive OHCA survivors admitted in coma (44 women, 18% and 201 men, 82%) completed the survey. Mean values measured on HADS were 2.7 ±3.2 for depression and 4.8±3.9 for anxiety. Depression and anxiety levels were significantly higher in women (3.3±3.4 and 6.1±3.8), respectively, compared to men (2.6±3.2 and 4.5± 3.9), respectively (p<0.0001 for both). Anxiety scores of 8 or more were observed in 43% of women, and 23% of men (p=0.007). Scores of 8 to 10 suggesting the possible presence of anxiety were found in 23% of women and 11% of men (p=0.007), whereas one out of five women scored ≥ 11 (20%) indicating probable anxiety disorder, while one in ten of men(12%), (p=0.02). Further, female sex was significantly associated with higher levels of PTSD (median for women: 33, IQR 24-54, and for men 26, IQR 22-35), (p=<0.0001). Finally, anxiety was significantly correlated to post-traumatic stress symptoms (correlation coefficient 0.81, p=<0.0001).

Conclusion

Symptoms of anxiety and PTSD are frequent in OHCA survivors and female cardiac arrest survivors report significantly higher symptom levels of anxiety, depression, and PTSD compared to men. These results underline the presence of long-term symptoms in these patients and support further research in sex-specific approaches to alleviating these symptoms in patients surviving OHCA.
Measured vs estimated renal function on cardiovascular outcomes in an acute heart failure population
Authors: Jorge Perez P , Garcia-Gonzalez M J , Martin-Cabeza M M , Luis-Lima S , Negrin-Mena N , Gonzalez-Rinne F , Ferrer-Hita J J , Poveda-Pineda I D , Porrini E
Published: May 2023

Funding Acknowledgements

Type of funding sources: Public hospital(s). Main funding source(s): Complejo Hospitalario Universitario de Canarias, Tenerife -Spain.

Background/Introduction

HF syndrome is a highly prevalent disease which courses with frequent readmissions, mainly by Acute Heart Failure (AHF). Worsening renal function is associated with increased mortality in patients with HF. Therefore, an accurate and precise evaluation of renal function in patients with HF is crucial. The error of estimated GFR (eGFR) is wide and common, showing ±30% of variability compared to measured GFR (mGFR). However, there is no evidence on the error of the available formulas in reflecting real renal function and particularly the consequences of this error in patients with AHF.

Methods

This is a prospective pilot study comparing measured versus estimated renal function and its relationship with long-term cardiovascular (CV) outcomes in patients with AHF. A group of patients with AHF who required admission in the CICU were included. Plasma clearance of iohexol, a gold-standard method to mGFR was assessed at the same time as eGFR by five different creatinine- and cystatin c–based equations. The association between estimated or measured GFR and major CV outcomes was evaluated with univariate and multivariate logistic analysis and cox-survival analysis. The main outcome was the first onset of fatal and nonfatal major cardiovascular events during follow-up.

Results

A total of 90 patients were included. Average age was 66 (± 12 years) and 52 (57,8%) were male. A total of 53 patients (59%) had a cardiovascular event during follow-up, being fatal in 22 cases (41,5%). Other variables are shown in Table 1. None of eGFR was significantly associated with the primary outcome in the unadjusted analyses. In the adjusted regression models, mGFR was significantly associated (p 0,037) with major cardiovascular events when it was correlated with NTproBNP, BMI, LVEF and previous coronary artery disease. mGFR on admission predicts future CV events compared with eGFR based on creatinine or cystatin equations. eGFR overestimates renal function showing around ±20% variability of mGFR in our AHF population (Figure 1).

Conclusions

Frequently used eGFR formulas in our daily practice in AHF patients do not predict well long-term cardiovascular outcomes. Measured GFR in AHF admission predicts CV events, while eGFR reflects an important variability of the real renal function. Specific subpopulations of AHF may require better evaluation of renal function because it may have prognosis consequences.
Telemonitoring heart failure in a remote region: data from cardiac implantable electronic devices
Authors: Duarte F , Santos I , Barradas M , Dourado R , Martins D
Published: May 2023

Funding Acknowledgements

Type of funding sources: None.

Introduction

Heart failure (HF) represents an important burden to the medical system attending to its high prevalence and high risk of hospital admissions by decompensations.

Remote monitoring (RM) systems using invasive and non-invasive parameters were developed to anticipate clinical deterioration in patients with cardiac implantable electronic devices (CIEDs).

Objective

To characterize a cohort of patients with HF and CIEDs in an outermost region. We aimed to accessed data from monitoring device algorithms and to analyze the real impact in clinical decompensations, hospital admissions and all-cause mortality.

Methods

Retrospectively multicenter cohort study included 211 patients with HFrEF and CIEDs, between 2010 and 2020. This study population was divided into two specific groups: Group A including patients with RM data and Group B including patients who receive usual care at regular hospital consultations. RM technology applied used different parameters to access the risk of worsening HF and stablishing an alert threshold.

Results

Out of 211 patients enrolled, 75% were male and 44.8% were in NYHA functional class II at the time of device implantation. One-hundred and twenty (56.9%) received in-home monitoring system (89% Latitude® and 10.8% Carelink®), corresponding to the Group A. The remaining 91 patients (43.1%) were included in Group B. Forty-nine patients (40.8%) had transvenous implantable cardioverter defibrillator (ICD), 13 (10.8%) had a subcutaneous ICD, 54 (45%) a cardiac resynchronization therapy (CRT) defibrillator and 4 (3.3%) a CRT pacemaker. Group A patients did not have coronary artery disease (p 0.047) and were younger than patients in Group B (median age 66 years, IQR 55 – 73; median age 70 years, IQR 63 – 77). No other statistically differences in main comorbidities were detected between groups. The number of atrial fibrillation (AF) episodes and AF burden was higher in Group A during the follow-up (p 0.006) as well as non-sustained ventricular tachycardia episodes (p 0.016). However, no differences were accessed in emergency department (ED) admissions or heart failure hospitalizations (HFH) by decompensation for patients in group A who received alerts versus patients who not received (p 0.178 and p 0.748, respectively) nor between group A and B (p 0.921 and p 0.213, respectively). Patients in group A had a lower all-cause mortality rate (p < 0.001) and cardiovascular mortality (p 0.002), but no difference in life-threatening ventricular events occurred.

Conclusion

In our cohort of HF patients, remote monitoring allowed the premature detection and the correct quantification of arrhythmic events but did not reflect any difference in ED nor HFH by decompensation. Instead, RM system demonstrates ability to reduce global mortality when compared to conventional care. More data about the application of this system and the ideal tracking algorithms are necessary.
Clinical characteristics, treatment and outcomes of acute heart failure patients over 65 years of age (analysis from the OP-AHF registry)
Authors: Sitkiewicz J , Rajski R , Dabrowska K , Wojcicki K , Chruscicki D , Borys D , Krzypkowska M , Pelc M , Klimek M , Malaka E , Kucharska J , Rzepiela L , Wezyk-Wylegala N , Plonka J , Gierlotka M
Published: May 2023

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work was supported by a grant from the Institute of Medical Sciences, University of Opole, Poland.

Introduction

Acute heart failure (AHF) is one of the most common causes of hospitalizations and deaths in the developed countries. Advances in the diagnosis and treatment of heart diseases and the increase of life expectancy have resulted in the fact that we are increasingly hospitalizing elderly patients, often with multi-diseases, which is a significant challenge for health care.

Purpose

The aim of the study was to analyze the clinical characteristics, treatment and outcomes of patients with AHF over 65 years of age compared to the younger ones.

Methods

As part of the prospective Acute Heart Failure Registry (OP-AHF), data from 122 patients hospitalized in ICCU were collected from June 2019. Inclusion criteria were hospitalization for AHF and the use of at least one of: intravenous diuretics, catecholamines or mechanical circulatory support. All patients were then followed for 12 months.

Results

Patients older than 65 years constituted 64% of patients with AHF (78 out of 122 people). Compared to younger ones, they were more often males (36% vs 14%, p = 0.01), smokers (85% vs 55%, p <0.01) and had a significantly lower BMI (29 vs 32 kg / m2, p = 0.02). Older patients had more often history of renal failure (54% vs 44%, p <0.01), diabetes (58% vs 42%, p = 0.07) and arterial hypertension (47% vs 53%), p = 0, 02). Dyspnea was the dominant symptom in both groups (79% vs 94%, p = 0.04). Left ventricular ejection fraction LVEF was insignificantly lower in the elderly (40% vs 44%, p = 0.18). In both groups, NTpro-BNP was increased on admission (9722 vs 8221 pg / ml, p = 0.08) and then decreased on discharge (8057 vs 5377 pg / ml, p = 0.11). Significantly lower hemoglobin values were noted on admission in the group of patients over 65 years of age (12.5 vs 13.8 g%, p <0.01). Elderly patients had higher 12-month mortality (29% vs 14% in younger patients, p = 0.06; HR = 2.34 [95% CI = 0.95-5.76]; adjusted for age, sex, LVEF and NTpro-BNP HR = 2.64 [0.99-7.01], p = 0.05. There was no statistically significant difference in the rates of rehospitalizations within 12 months after hospital discharge (27% in both groups, corrected HR = 0.95 [0.45-1.99]).

Conclusions

Elderly patients >65 years of age have higher risk of death within 12 months after an episode of acute heart failure than younger ones. However, despite greater burden of comorbidities, they are not more often rehospitalized due to cardiovascular reasons.

Fig. Actual and adjusted for age, sex, LVEF and NT-pro BNP 12- month survival of patient over 65 years of age
Using urine output tending to manage fluid balance among patients with acute decompensated heart failure
Authors: Shacham Y , Rozenfeld A , Banai S , Goldman A , Stern T
Published: May 2023

Funding Acknowledgements

Type of funding sources: None.

Background

Positive fluid balance has been associated with adverse outcomes in patients admitted to intensive care units (ICU). Urine output (UO) is used both to assess deterioration of renal function as well as for management of fluid balance in patients admitted to the general ICU. In the cardiac ICU, patients admitted for acute decompensated heart failure (ADHF) are at high risk for type I cardio-renal syndrome and increased morbidity and mortality. Studies have shown that poor fluid management in these patients contributes to worse outcomes in this patient population (1).

Aim

To investigate the possible effect of real-time monitoring of UO trends on the individualized pharmacologic management, fluid balance, and clinical outcomes of patients admitted to the cardiac ICU with ADHF.

Methods

We performed a case series of 35 patients admitted to the cardiac ICU from July 2021 and January 2022 with ADHF. Their standard Foley catheter was connected to an electronic monitoring system (Clarity-RMS sensor kit) that continuously monitors UO in real-time. Its technology is described elsewhere (2). The UO monitoring system displays UO trends on the consoles that are updated in real-time. UO trends were utilized to detect dynamic changes in urine output and guide an individualized approach for the pharmacologic management of each patient, based on blood pressure, hourly UO and total fluid balance. Daily and accumulated fluid balance was registered at up to 72 hours following admission. Patient outcomes included incidence of acute kidney injury (AKI), as defined by the KDIGO criteria for changes in serum creatinine (SCr), and 30-day mortality. The case series group was than compared to a historical group of 35 matched controlled patients admitted between 2018-2019. Patients were matched according to cause of admission, age and glomerular filtration rate.

Results

Mean age was 71 ± 11 years and 49 (70%) were men. Patients in the electronic urinary monitoring cohort demonstrated significantly more negative daily and cumulative fluid balance as compared to the historical cohort, (P<0.001 for all, Figure 1). Incidence of AKI and AKI combined with 30-day mortality was significantly lower in the electronic UO monitoring cohort (23% vs. 57%, p<0.001, and 34% vs. 63%, p<0.001, respectively). These changes were more prominent in the subgroup of patients with chronic kidney disease (CKD) (Figure 2).

Conclusion

We demonstrated that real time monitoring of UO trends may be used for goal-directed care for the prevention of fluid overload and adverse outcomes in patients with ADHF. Further studies on larger populations are required to validate the potential utility of UO trending in the management of critically ill patients with ADHF.
Correlation of serial high-sensitivity cardiac troponin t values to infarct mass determined by cardiac magnetic resonance imaging
Authors: Biener M , Giannitsis E , Hegenbarth A , Mueller-Hennessen M , Andre F , Katus H A , Frey N , Salatzki J
Published: May 2023

Funding Acknowledgements

Type of funding sources: None.

Background/Introduction

The extent of myocardial injury is strongly associated with adverse outcome after acute myocardial infarction (AMI). Contrast-enhanced magnetic resonance imaging (CE-MRI) is the preferred technique for myocardial imaging. Its use in daily clinical practise, however, is restricted due to limited availability and high costs. High-sensitivity cardiac troponin T (hs-cTnT) correlates well with the extent of myocardial injury and may therefore be a cost effective and widely available surrogate for the estimation of infarct size.

Purpose

To validate correlations between CE-MRI infarct mass and hs-cTnT values at different time points in patients with confirmed AMI.

Methods

Patients presenting with AMI and with available CE-MRI between January 1, 2018 and December 31, 2020 were included. Correlation coefficients between hs-cTnT on admission, after 24h, 48h, 72h, 96h and peak hs-cTnT values and CE-MRI infarct mass were calculated. Correlations between hs-cTnT and CE-MRI infarct mass were compared to those of a 3rd generation cTnT assay from a previously published study of our group.

Results

137 patients were included for the present analysis. Median CE-MRI infarct mass was 12,5 g (95%CI: 9.8-16.2 g). Hs-cTnT values and infarct mass correlated well at all time points including admission (r=0.474, [95%CI: 0.331-0.560], p<0.0001), 24h (r=0.508, [95%CI: 0.370-0.625], p<0.0001), 48h (r=0.547, [95%CI: 0.404-0.664], p<0.0001), 72h (r=0.489, [95%CI: 0.320-0.628], p<0.0001), 96h (r=0.509, [95%CI: 0.330-0.653], p<0.001) including peak hs-cTnT values (r=0.547, [95%CI: 0.416-0.656], p<0.0001) and maximum absolute delta changes within 96h (r=0.507, [95%CI: 0.369-0.622], p<0.001). Correlations of the 3rd generation assay could be confirmed for hs-cTnT at all time points. A superior correlation with CE-MRI infarct mass was observed for hs-cTnT values on admission.

Conclusions

Hs-cTnT values at different time points correlate well with CE-MRI infarct mass. Correlations of admission hs-cTnT values are superior to those of a 3rd generation assay.
Less risk factor at AMI onset, higher risk in prognosis---the paradoxical phenomenon from MIMIC-III database
Authors: Yang Y , Yu Z H I X I , Chen W E I W E I , Wang X I A O Y U , Peng K E X I N , Yin W E I S I , Pan Y I L I N , Du B E I B E I , Yang P I N G
Published: May 2023

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Natural Science Foundation of China (NSFC).

Introduction

Numerous epidemiologic studies have confirmed that Standard Modifiable Cardiovascular Risk Factors (SMuRFs) are independent risk factors for coronary heart disease (CHD) and are recommended by guidelines for the primary and secondary prevention of CHD. However, it is interesting to find that the increasing proportion of individuals without SMuRFs in CHD and acute myocardial infarction (AMI). Moreover, accumulating clinical trials have reported the inverse association between the number of risk factors and crude mortality in AMI. It is unknown whether this paradoxical phenomenon can be seen in critical ill patients.

Purpose

To analyze and validate whether the number of risk factors contradicts the mortality outcome in patients with AMI in the MIMIC-III (Medical Information Mart for Intensive Care III) database.

Methods

A total of 2484 AMI patients (62.8% male, mean age 71.2 [59.3;80.8] years) admitting to cardiac care unit for the first time from the MIMIC-III database were enrolled. Risk factors were defined as hypertension, diabetes,dyslipidemia, and smoking history. They were grouped according to the number of risk factors. Main outcome was mortality at 2-year following hospitalization. Kaplan-Meier curve and Cox proportional hazards models adjusting for baseline clinical characteristics and in-hospital treatment were constructed to evaluate the impact of numbers of risk factors on mortality in critical AMI patients.

Results

At 2-year follow-up, death was observed in 714 patients (28.7%). A total of 474(19.1%),1541(62%),469(18.9%) patients had 0,1-2,3-4 SMuRFs respectively. No risk group has a significantly higher 2-year mortality (Picture 1). Compared with no risk group, patients with 1-2 and 3-4 SMuRFs were correlated to an HR of 0.72(95%CI, 0.61-0.86) and 0.66(95%CI, 0.52-0.83) for all-cause mortality in the unadjusted model. Interestingly, after multivariate adjustment, less risk factor at AMI onset was still associated with poor prognosis.

Conclusions

Taking into confounders, critical AMI patients with less risk factors have higher risk in poor prognosis. Further studies on this paradoxical phenomenon are needed.
Is gender an independent risk factor for AKI in STEMI patients?
Authors: Frydman S , Freund O , Banai A , Zornizki L , Banai S , Shacham Y
Published: May 2023

Funding Acknowledgements

Type of funding sources: None.

Introduction

Patients undergoing percutaneous coronary interventions (PCI) are prone to a wide range of complications, one complication that is constantly correlated with worse prognosis is acute kidney injury (AKI). Gender as an independent risk factor for said complications raised some interest yet studies showed conflicting results so far.

Purpose

We aimed to investigate the possible relation of gender on the occurrence of AKI among ST elevation myocardial infarction (STEMI) patients undergoing PCI.

Methods

This retrospective observational study cohort included 2967 consecutive patients admitted with STEMI between the years 2008-2019. Their renal outcomes ware assessed according to KDIGO criteria (AKI- serum creatinine ≥ 0.3 mg/dl from baseline within 48 hours from admission) and in-hospital complications and mortality were reviewed.

Results

Study population included 544 females and 2400 males. Female patients were older and with more co-morbidities. The occurrence of AKI was significantly higher among females (12.7% vs. 7.8%, p<0.001). Furthermore, among patients with AKI, severe AKI (defined as more than doubling on serum creatinine) was also more prevalent in females (26.1% vs. 14.5%, p=0.03). In general, AKI was associated with higher rates of in hospital complications and mortality in the entire cohort, while females demonstrated significantly higher rates of bleeding (8.9% vs. 3.7%, p<0.001), need for hemodynamic support (4.4% vs. 2.3%, p<0.001) and mortality (4.3% vs. 1.3 %, p<0.001) only in the "no AKI" group (figure 1). However, in multivariate analysis, after adjusting for the baseline characteristics, female gender was a nonsignificant predictor for AKI (adjusted OR 1.01, 95% CI 0.73-1.4, p=0.94) and for severe AKI (adjusted OR 1.65, 95% CI 0.80-1.65, p=0.18).

Conclusions

While females had higher rates of AKI and severe AKI, gender was non-significant as an independent risk factor after adjusting for other confounding variables. Other comorbidities that were more prevalent in females can account for the difference of AKI between the genders.
Acute coronary syndromes in the Covid era : is there any difference? The experience of a general hospital
Authors: Stratinaki M , Stavrakis S , Stavrakis S , Detoraki M , Detoraki M , Korela D , Korela D , Honda E , Honda E , Aletras G , Aletras G , Eleftheriadou E , Eleftheriadou E , Georgopoulou T , Georgopoulou T , Pitarokoilis M , Bachlitzanaki I , Foukarakis E , Pitarokoilis M , Foukarakis E
Published: May 2023

Funding Acknowledgements

Type of funding sources: None.

Background

SARS-Cov2 has been linked to increased rates of thrombosis and it has been shown that post covid patients are more susceptible to acute coronary syndromes (ACS).

Purpose

To identify whether there is any difference in the frequency of stress induced cardiomyopathy during the Covid 19 pandemic.

Methods

We retrospectively analyzed the data from the cardiology department, regarding the patients who were admitted with ACS during the covid-19 pandemic (2020-2021) and compared it with the data prior the pandemic (2018-2019).

Results

We recorded a higher frequency of Takotsubo cardiomyopathy in the post Covid era (post Covid vs non Covid) (18.18% vs 4.91%, p<0.01), as well as SCAD (6% vs 0%, p<0.05). No statistically significant was noticed in STEMI (18.18% vs 13.11%), NSTEMI (21.21% vs 26.22%) and MINOCA (36.36% vs 55.73%).

Conclusions

We noticed in the post Covid patients an increase in Takotsubo cardiomyopathy as well as SCAD when compared to the non-infectes patients. This could be partly explained by the psychological burden of the pandemic that seems to have affected the society.