bluuebunny/crossref_metadata_2025 huggingface dataset:
High prevalence of complex coronary artery lesions in sport-related myocardial infarction. Contemporary data from the RICO survey
Authors: Chague F , Kouame I , Porot G , Lhuilier I , Maza M , Saint Jalmes M , Bichat F , Laurent G , Zeller M , Cottin Y
Published: May 2022

Funding Acknowledgements

Type of funding sources: Public Institution(s). Main funding source(s): Agence régionale de santé de Bourgogne Franche-Comté

Background

Underlying mechanisms for sport-related acute myocardial infarction (SR-AMI) are only poorly understood. Moreover, their coronary artery disease (CAD) characteristics and lesion complexity are poorly described.

Purpose

To characterize coronary angiographic feature of patients with SR-AMI

Methods

From the RICO database, a large regional acute MI survey, all consecutive patients hospitalized in our University Hospital from 2010 to 2021 who underwent coronary angiography for SR-MI were retrospectively analysed. SR-MI was defined as MI occurring during sport activity or within the first hour of recovery.

Results

Among the 174 patients included, most were male (n=157(91%)). Median (IQR) age was 59 y (48-66), and had ST segment elevation MI (STEMI) (n= 112 (64%)). The SR-MI often occurred while cycling (41%), jogging (23%), hiking (9%) or playing soccer (9%). Patients commonly experienced pre-hospital (PH) sudden cardiac arrest (SCA) (17%). Atherothrombotic risk factors were dyslipidaemia (32%), current smoking (31%) or hypertension (28%). A history of CAD was documented in 31 (18%) patients. Most (n=156(91%)) had significant lesions, of whom 140 (81%) were considered as culprit. Culprit lesions were located on left anterior descending (39%), circumflex (14%) and right coronary artery (33%). Median (IQR) Syntax score was 10.5 (6-15). The vast majority of patients (n=152 (87%)) had at least one complex lesion; 114 of them had several characteristics of complex lesion. Lesions were eccentric in 68 (39%) patients; an intraluminal thrombus was documented in 85 patients (49%), in 55% of STEMI and 37% of non-STEMI (p =0.027). However, 18 subjects (10%) had optically normal coronary angiogram or non-significant lesions, suggesting alternative mechanism such as type 2 MI. Treatment of the lesions was mainly achieved by PCI and/or stenting (n=132(77%)) or coronary artery bypass grafting (n=11(6%)). In-hospital death occurred in 11 patients (6%), of whom 10 experienced a PH-SCA and one was admitted with a cardiogenic shock during the Covid-19 pandemics lockdown. Among the 5 patients treated with extracorporeal membrane oxygenator, only one survived.

Conclusion

In our large retrospective study, SR-MI was commonly associated with complex coronary lesions, often characterized by intraluminal thrombus. Our findings suggest that the mechanisms of these events could be mainly related to type 1 MI patterns Moreover, PH-SCA was frequent, thus justifying mass-education to basic life support and deployment of automated external defibrillators, especially in the sport settings.
SARS-CoV-2 infection and return-to-play in junior competitive athletes: is systematic cardiac screening needed?
Authors: Cavigli L , Cillis M , Mochi V , Frascaro F , Mochi N , Hajdarevic A , Roselli A , Capitani M , Alvino F , Lisi C , Mandoli GE , Valente S , Focardi M , Cameli M , D'ascenzi F
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

SARS-CoV-2 infection might be associated with cardiac complications in low-risk populations, such as in competitive athletes. However, data obtained in adults cannot be directly transferred to preadolescents and adolescents that are less susceptible to adverse clinical outcomes and are often asymptomatic.

Purpose

We conducted this prospective multi-centre study to describe the incidence of cardiovascular complications following SARS-CoV-2 infection in a large cohort of junior athletes and to examine the effectiveness of a screening protocol for a safe return-to-play.

Methods

Junior competitive athletes suffering from asymptomatic or mildly symptomatic SARS-CoV-2 infection underwent cardiac screening, including physical examination, 12-lead resting electrocardiogram (ECG), echocardiogram, and exercise ECG testing. Further investigations were performed in cases of abnormal findings.

Results

A total of 571 competitive junior athletes (14.3±2.5 years) were evaluated. About half of the population (50.3%) was mildly symptomatic during SARS-CoV-2 infection, and the average duration of symptoms was 4±1 days. Pericardial involvement was found in 3.2% of junior athletes: small pericardial effusion (2.6%), moderate pericardial effusion (0.2%), and pericarditis (0.4%). No relevant arrhythmias or myocardial inflammation were found in subjects with pericardial involvement. Athletes with pericarditis or moderate pericardial effusion were temporarily disqualified, and a gradual return-to-play was achieved after complete clinical resolution.

Conclusions

The prevalence of cardiac involvement was low in junior athletes after asymptomatic or mild SARS-CoV-2 infection. A screening strategy primarily driven by cardiac symptoms, ECG abnormalities and arrhythmias at rest and/or during exercise should detect cardiac involvement from SARS-CoV-2 infection in most junior athletes. Systematic echocardiographic screening is not recommended in junior athletes.
Cardiovascular screening in olympic athletes before and after SARS-CoV-2 infection
Authors: Maestrini V , Filomena D , Birtolo L I , Monosilio S , Tatangelo M , Penza M , Serdoz A , Fiore R , Lemme E , Squeo M R , Fedele F , Gualdi G , Spataro A , Pelliccia A , Di Giacinto B
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Conflicting results on the cardiovascular involvement after SARS-CoV-2 infection generated concerns on the safety of return-to-play (RTP) in the athletic population. However, these data are mainly based on Troponin and imaging findings.

Purpose

Aim of the study was to evaluate the prevalence of cardiac involvement after COVID-19 in Olympic athletes, who had previously been screened in our pre-participation program.

Methods

Since November 2020, all consecutive Olympic athletes presented to our Institute after COVID-19 prior RTP were enrolled. The protocol was dictated by the Italian governing bodies and comprised: 12-lead ECG, blood test, cardiopulmonary exercise test (CPET), 24-hours ECG monitoring, spirometry. Cardiovascular Magnetic Resonance (CMR) was also performed. All Athletes were previously screened in our Institute as part of their periodical pre-participation evaluation.

Results

Forty-seven Italian Olympic athletes were enrolled: 83% asymptomatic, 13% mildly asymptomatic, 4% had pneumonia. The evaluation was performed after a median of 9 days from negative SARS-CoV-2 swab. Uncommon premature ventricular contractions (PVCs) were found in 13% athletes, however, only 6% (n=3) were newly detected. All newly diagnosed uncommon PVCs were detected by CPET. One of these three athletes had evidence for acute myocarditis by CMR, along with Troponin raise; another had mild pericardial effusion. No one of the remaining athletes had abnormalities detected by CMR (Figure).

Conclusions

Cardiac abnormalities in Olympic athletes screened after COVID-19 resolution were detected in a minority and were associated with new ventricular arrhythmias. Only one had evidence for acute myocarditis (in presence of symptoms and elevated biomarkers). No one of the remaining athletes had abnormalities by imaging or laboratory test. Our data support the efficacy of the clinical assessment including exercise-ECG to raise suspicion for cardiovascular abnormalities after COVID-19. Instead, the routine use of CMR as a screening tool appears not justified.
Low prevalence of cardiac abnormalities in competitive athletes before the return-to-play after COVID-19 based on the italian strategy
Authors: Penza M , Filomena D , Birtolo L , Monosilio S , Serdoz A , Fiore R , Mango R , Lemme E , Squeo M , Fedele F , Gualdi G , Spataro A , Pelliccia A , Di Giacinto B , Maestrini V
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Conflicting results on the cardiovascular involvement after SARS-CoV-2 infection generated concerns on the safety of return-to-play (RTP) in the athletic population. However, data are limited to the approached based on Troponine, ECG and echocardiogram while the data on exercise test are scarce.

Purpose

Aim of the study was to evaluate the prevalence of cardiac involvement after COVID-19 in competitive athletes for the RTP applying a comprehensive cardiovascular evaluation.

Methods

Since October 2020, all consecutive competitive athletes (age≥14 years) presented to our Institute after COVID-19 prior RTP were enrolled. The protocol was dictated by the Italian governing bodies and comprised: 12-lead ECG, blood test, cardiopulmonary exercise test (CPET), 24-hours ECG monitoring, spirometry. Cardiovascular Magnetic Resonance (CMR) was performed based on clinical indication.

Results

219 competitive athletes were enrolled (59% male), age 23 years (19,27): 20% asymptomatic, 77% mildly asymptomatic, 2% had pneumonia. The evaluation was performed after a median of 10 days (6-17 days) from negative SARS-CoV-2 swab. All athletes had a good performance at CPET. Uncommon premature ventricular contractions (PVCs) were found in 10% (n=21) and were detected by CPET. Two athletes (1%) were finally diagnosed with acute myocarditis (confirmed by CMR) and another had newly diagnosed mild pericardial effusion (Figure). All the three athletes were temporally refrain from sport participation.

Conclusions

Cardiac abnormalities in competitive athletes screened after COVID-19 resolution were detected in a minority of the cases (1.4%). No one of the remaining athletes had abnormalities by imaging or laboratory test neither reduction in cardiopulmonary fitness. Our data are in line with those reporting low prevalence of cardiovascular complication in mildly symptomatic or symptomatic athletes.
Does perceived stress mediate the relationship between financial status, depression, and anxiety in caregivers at risk for cardiovascular disease (CVD)?
Authors: Smith J , Mcneely C , Chung ML , Miller JL , Biddle M , Schuman DL , Rayens MK , Lennie TA , Hammash M , Mudd-Martin G , Moser DK
Published: May 2022

Funding Acknowledgements

Type of funding sources: Public Institution(s). Main funding source(s): National Institutes of Health National Institute of Nursing Research

Background/Introduction

Caregivers are at high risk of anxiety and depression, and caregiver mental health is linked to higher CVD risk in caregivers over their non-caregiving peers. Most research focuses on caregiver burden as a primary cause for caregiver’s emotional distress, such as anxiety and depression. Other stressors like financial burden are less emphasized, despite widespread documentation of financial burden as a key social determinant of health. We hypothesize financial status predicts anxiety and depression through perceived stress.

Purpose

To identify the relationship between financial status and caregiver anxiety and depression and determine if it is mediated by perceived stress.

Methods

We analyzed cross-sectional data from the Rural Intervention for Caregiver’s Heart Health study. Anxiety was assessed using the Brief Symptom Inventory – Anxiety subscale (range 0 -3.5) and depression was assessed by the Patient Health Questionnaire –9 (range 0 - 27). Financial status was measured with one item that asked participants to rank their financial situation by level of comfort (not enough to make ends meet, enough to make ends meet, and comfortable), and perceived stress measured with Cohen’s Perceived Stress Scale – 4. Analysis was performed separately for the two mental health outcomes using OLS regression and, to test mediation, the PROCESS macro for SPSS and the bootstrapping procedure with 5,000 samples. We included age, gender, marital status, number of people in the household, body mass index, smoking status, and caregiver burden as covariates.

Results

Of the 287 participants, average age was 54 ± 13; 76% were female, 95.8% were Caucasian, and 70.4% were married. Controlling for covariates, caregivers with not enough to make ends meet reported substantially greater depressive symptoms (b=2.22, 95% CI = 0.48 – 3.96) and marginally greater anxiety (b=0.23, 95% CI = -0.02 – 0.47) compared to caregivers who were financially comfortable. These associations were not mediated by perceived stress as hypothesized.

Conclusions

Among caregivers who are at risk for CVD, financial status was important in reporting both depression and to a lesser extent, anxiety however perceived stress does not mediate this relationship. This is interesting as perceived stress is often a target for interventions that focus on reducing depression and anxiety in this population however our analysis emphasizes the importance of financial status alone. When designing interventions to reduce the CVD risk factors of anxiety and depression, more attention should be paid to relieving financial burden.
Effect of aerobic exercise on functional capacity in post operative breast cancer patients receiving adjuvant therapy
Authors: Bhise A , Amarsheda S
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Adjuvant therapy in patients with early stage breast cancer can increases patients’ overall health and survival rate but it also has some unwanted changes in patients’ life. Of all the symptoms experienced by patients due to adjuvant therapy, decreased physical activity is common which is having impact on their overall well-being and quality of life. Aerobic exercise training mostly involves activities with intensity that is light to moderate which sufficiently stimulate the aerobic metabolism so activities can be performed for prolonged period of time.

Purpose

The purpose of the present study was to identify the effect of aerobic exercise training with conventional exercise on functional capacity in postoperative breast cancer patients who are receiving adjuvant therapy.

Method

A randomized controlled trial was conducted on stage I-III post operative breast cancer patients receiving adjuvant therapy. Outcome measurement was 6 Minute Walk Test (6MWT) for functional capacity. Group A participants received aerobic exercise with conventional exercise for 8 weeks and Group B participants received conventional exercise alone daily for 8 weeks. Group A received training 3 times in a week with two supervised sessions and one unsupervised session for 8 weeks.

Result

Total of 55 participants were analyzed using appropriate test after testing for normal distribution. Changes in outcome measure was analysed within the group as well as between the groups. Group A participants (n=27) have shown significant improvement in functional capacity after the intervention. Group B participants (n=28) have shown no improvement in functional capacity. There was significant improvement in functional capacity in aerobic exercise group compared to conventional exercise group.

Conclusion

Aerobic exercise is effective for the management of functional capacity in post-operative breast cancer women receiving adjuvant therapy.
The first national program of remote cardiac rehabilitation - goal achievements, adherence, and responsiveness in elderly patients
Authors: Nabutovsky I , Breitner D , Heller A , Klempfner Y , Nachshon A , Yeshayahu S , Gang N , Klempfner R
Published: May 2022

Funding Acknowledgements

Type of funding sources: Public hospital(s). Main funding source(s): Sheba medical center

Background

Remote cardiac rehabilitation (RCR) after myocardial infarction is an innovative program in the field of telemedicine. RCR is included in the health basket. Many believe that telemedicine programs better fit younger patients, whose technological literacy is higher than older patients. Older patients are also thought to have difficulty consuming technology-based programs and meeting program goals. The objectives of this study were as follows: 1) To study patterns of physical activity, goal achievement, and improvement in functional level among RCR participants over 65 compared with younger patients. 2) To study the variables that can predict better patient adherence and compliance with the rehabilitation program.

Methods

A retrospective study of post-myocardial infarction patients enrolled in six-month RCR program. The activity of the patients was monitored using a smart watch. The data were collected and analyzed by a special telemedicine system. RCR program goals were: (i)150 minutes of aerobic activity per week; (ii) 120 minutes of the activity within the target heart rate; (iii) 8000 steps per day. Predictive models were created to evaluate variables predicting adherence and compliance with the program.

Results

306 participants, 80 of them were elderly (average age 70 ± 3.38). At the end of the program, there was a significant improvement (p <0.001) in the functional capacity of all participants. The elderly improved from 8.11 ± 2.8 to 11.25 ± 12.6 METs, while the final METs results in the elderly group were similar to other participants. During all program months, the elderly showed better achievement of program goals compared to younger ones (p <0.01). We found that age of patients is a clear predictor (p <0.01) of early dropout from the program and goals achievements – the higher the age, the fewer dropouts and better achievement.

Conclusions

Elderly can successfully participate in telemedicine rehabilitation programs, and such programs are beneficial for them. Age is not a limitation, but a predictor for better achievement of goals and compliance with the RCR program.
The digital profile of cardiac patients anno 2021
Authors: Bonneux C , Dendale P , Coninx K
Published: May 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – EU funding. Main funding source(s): EU funded project H2020 IA CoroPrevention,Special Research Fund (BOF) of Hasselt University

Background

The usage of technology and digital applications for the prevention of cardiovascular diseases is increasing rapidly. When designing health applications, it is important to take into account the digital literacy and profile of the target users. However, few studies assess cardiac patients’ digital profile and willingness to use health applications, though often concerns are raised regarding usability in this target population.

Purpose

We investigated the digital profile of cardiac patients, including their technology usage and interest in using health applications.

Methods

In the context of a European project, we launched a call in the local media (radio and newspaper) to recruit participants for a usability study for applications supporting secondary prevention of cardiovascular diseases. As part of the formative usability study, all patients filled in a custom-made background questionnaire that assessed their socio-demographical information and technology usage.

Results

Of all respondents to the call in the local media, 56 cardiac patients (47 male, 9 female) participated in the usability study in the local rehabilitation centre. The age distribution was quite diverse, ranging from people below 30 years until people older than 70 years, with 75% of the participants being 60 years or older. Most participants liked (53,57%) or strongly liked (28,57%) to use technology and applications. 58,93% of the participants had already prior experience with health applications and none of them disliked using health applications. The most frequently used device was a smartphone (Figure 1), being used by almost all participants (96,43%) on a daily basis, followed by a computer or laptop (80,36%). When looking at the newest technology, such as smartwatches and activity trackers, half of the participants use a smartwatch or activity tracker. In general, most technology usage was for personal purposes. The participants used technology for varying purposes, predominantly communication and information seeking, but also for games, music, social networking sites, and videos and pictures (as depicted in Figure 2).

Conclusion

The technology usage of cardiac patients and their familiarity with health applications is increasing rapidly, indicated by high possession of different types of technology and using these devices for varying purposes. This provides opportunities for telehealth applications supporting cardiovascular disease prevention. As a minor limitation, we should note that there is a possibility for bias in favour of the participants being tech-savvy, due to the way in which we recruited our participants. Nevertheless, a substantial number of participants still had no prior experience with health applications.
Role of telecardiology in prevent mortality and improve quality of life in patients with chronic heart failure : a meta-analysis of randomized controlled trials
Authors: Prana Jagannatha G , Dwi Adelia Yasmin AAA , Gita Raditya Sanjiwani NP , Surya Pradnyana IWA , Kamardi S
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background/Introduction

Patients with heart failure (HF) usually have limited functional capacity which ultimately reduces the quality of life and increases mortality rates that burden the health care system, HF currently has the highest readmission rate among all medical conditions. Telecardiology is a modern method based on long-distance telecommunications that are practical to implement and has the potential to improve the outcome of HF patients.

Purpose

The purpose of this study was to determine the impact of telecardiology on mortality and quality of life of patients with HF

Methods

A systematic literature search was conducted on PubMed and Cochrane Library with the journal publication period was 2010-2021. The primary outcomes of this study were mortality and quality of life (QoL). Secondary outcomes were major adverse cardiac events (MACE), rehospitalization, and changes in left ventricular ejection fraction (LVEF). Telecardiology in this study covers telephone-based, software-based, and monitoring with devices. Risk Ratio (RR) with 95% CI was calculated using a random-effect model, and the Mantel-Haenszel method was used to combine RR.

Results

A total of 29 RCTs with 13,837 adult NYHA I-IV HF patients were included. The follow-up range was 1-26 months. Telecardiology resulted in statistically significant risk reduction of all-cause mortality (RR: 0.90 ; 95% CI:0.83,0.99; p=0.02), and significant improvement in quality of life based on the Minnesota Living with Heart Failure Questionnaire (MLHFQ) (p<0.00001 ). We were also found the incidence of rehospitalization (RR: 0.94; 95% CI:0.90,0.98; p=0.004) and MACE (RR: 0.58; 95% CI:0.55,0.62; p<0.00001) were significantly lower in the telecardiology population. when compared with the control population, but not significantly associated with changes in LVEF (p = 0.79).

Conclusion(s)

Telecardiology is proven to improve patient outcomes in terms of mortality and quality of life. A significant reduction in rehospitalization has the potential to reduce the national health burden.
Impact of Secondhand smoking on Dyslipidaemia among non-smokers: findings from the 2015-2016 NHANES dataset in the United States
Authors: Okekunle A , Asowata OJ , Adedokun B , Akpa OM
Published: May 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This research was supported by the Brain Pool Program supported through the National Research Foundation of Korea, funded by the Ministry of Science and ICT (2020H1D3A1A04081265).

Background

Dyslipidemia is a prominent risk factor of mortality globally. While active smoking has been implicated in the burden of cardiovascular disease (CVD) worldwide, there is little understanding on the impact of subtle secondhand smoke exposure (SHSE) on dyslipidaemia among non-smokers.

Purpose

This study assessed the association of SHSE with dyslipidaemia among non-smoking adults from the 2015-2016 National Health and Nutrition Examination Survey (NHANES) in the United States.

Method

Participants for this study were 3,064 non-smoking adults (≥18years) identified through a multistage sampling method in the United States. Data on sociodemographic, lifestyle and history of CVD were collected using standard operating principles. Also, fasting blood samples were collected by trained personnel to determine blood lipid profiles. SHSE was defined as exposure to smoke from a burning cigarette (exhaled by a smoker) in an indoor environment or a blood cotinine concentration ≥ 0.05 ng/ml. Dyslipidemia was defined according to the National Cholesterol Education Program guidelines. Logistic regression was adopted to estimate the multivariable-adjusted odds ratio (aOR) and 95% confidence interval (CI) for the association between SHSE and dyslipidaemia at a two-sided P < 0.05.

Results

The mean age of respondents was 46.4 ± 18.0years, 63.2% were females, 36.2% reported SHSE, and 59.6% had dyslipidemia. The aOR and 95% CI among respondents with SHSE was 1.148 (1.147-1.149) in the entire sample. Similarly, odds of dyslipidaemia in the light of SHSE was 1.130 (1.129-1.131) among those < 60 years, 1.304 (1.300-1.308)] among those ≥ 60 years, 1.165 (1.163-1.167) among males and 1.214 (1.212-1.215) among females.

Conclusion(s)

SHSE was associated with higher odds of dyslipidaemia and might be an often missed risk factor in the risk of dyslipidaemia. Primary prevention strategies(s) might be necessary to reduce the impact of SHSE on the burden of dyslipidaemia and CVD worldwide.
Subcutaneous and visceral fat density is associated with long-term mortality after transcatheter aortic valve implantation
Authors: Van Erck D , Moeskops P , Schoufour JD , Scholte Op Reimer WJM , Weijs PJM , Henriques JP , De Vos B , Delewi R
Published: May 2022

Funding Acknowledgements

Type of funding sources: Public Institution(s). Main funding source(s): Amsterdam UMC

Background

Despite a technically successful procedure, not all patients with severe aortic valve stenosis benefit from Transcatheter Aortic Valve Implantation (TAVI). Screening of patients at increased risk of adverse outcomes can improve treatment decisions. Studies in healthy older adults show that fat density on a Computed Tomography scan (CT) scan is a possible risk factor associated with weight loss and mortality. The association of fat density with mortality after TAVI is unknown.

Objectives

The aim of this study is to investigate the association of subcutaneous and visceral fat density with long-term mortality after TAVI, in addition to known risk factors.

Methods

Patients undergoing TAVI from January 2010 to January 2020 were included. Computed-tomography (CT) scans were made in all patients as work-up for the procedure. Deep-learning-based software was used to automatically determine subcutaneous and visceral fat density on available fat tissue at the transversal slice at the height of lumbar vertebra 3 (L3), see figure 1. Association with all-cause long-term mortality was determined with Kaplan-Meier curves, log-rank tests, and adjusted Cox regression models. In all analyses, patients in the highest tertile of fat density were compared to patients in the middle and lowest tertile. Two Cox regression models were made, model one adjusted for relevant confounders: age, sex, EuroSCORE-II, New York Heart Association score, chronic obstructive pulmonary disease, left ventricular ejection fraction, transfemoral access route, body mass index, and chronic kidney disease; and model two additionally including muscle mass and muscle density.

Results

In total, 1,404 patients were included, mean age was 80 ± 7 years and 53% were female. Median long-term follow up was 1,093 [IQR: 639 – 1,602] days. Unadjusted Kaplan-Meier curves showed that both subcutaneous fat density (Figure 2, log rank p<0.01) and visceral fat density (Figure 2, log rank p<0.01) were strongly associated with mortality. In the multivariate Cox regression model one, the association remained significant with a hazard ratio of 1.46 [95%CI: 1.23 – 1.73] for high subcutaneous fat density and 1.31 [95%CI: 1.09 – 1.58] for high visceral fat density. Also, in model two fat density remained significantly associated with mortality for subcutaneous fat density HR 1.52 [95%CI: 1.28 – 1.81] and visceral fat density HR 1.41 [95%CI: 1.16 – 1.71].

Conclusion

High subcutaneous and visceral fat density determined on the procedural CT-scan before the TAVI are independently associated with long-term mortality. These results show that future risk models in TAVI patients should take fat density into account.
Maternal type 1 diabetes, pre-term birth and risk of autism spectrum disorder–a prospective cohort study
Authors: Persson Martina , Reichenberg Abraham , Andersson Franko Mikael , Sandin Sven
Published: May 2022

Background

It has been suggested that maternal type 1 diabetes (T1D) increases the risk of autism spectrum disorder (ASD) in the offspring. However, it is unclear whether this risk is mediated by pre-term birth, affecting around one-third of pregnancies with T1D, and whether maternal levels of glycated haemoglobin (HbA1c) impact the risk.

Methods

A cohort of 1.4 million Swedish children born between 1998 and 2015, and their parents. Maternal T1D and HbA1c before or in early pregnancy, gestational and ASD diagnoses were obtained from Swedish national registers. Relative risk (RR) and 95% CIs of ASD were estimated by hazard ratios (HRs) from Cox regression or RR from log-binomial regression.

Results

Of 1 406 650 children, 8003 (0.6%) were born to mothers with T1D, 24 941 (1.8%) were diagnosed with ASD and 81 915 (5.8%) were born pre-term. The risk of ASD was increased in offspring of mothers with T1D was HR = 1.40 (1.21–1.61). The RR for each +5-mmol/mol excess HbA1c was estimated at HR = 1.03 (0.97–1.10). The T1D effect on ASD mediated through pre-term birth was estimated at RR = 1.06 (1.05 to 1.08), corresponding to 22% (16% to 41%) of the total effect. T1D in pregnancy was associated with increased ASD risk in the offspring. Twenty percent of the total effect was accounted for by pre-term birth. HbA1c was not associated with ASD risk, beyond the risk associated by the T1D diagnosis itself.

Conclusion

Awareness of ASD in the offspring of mothers with T1D may be warranted, especially considering the additional effect of pre-term birth.
Mass Media Influence on the Rapid Rise of Climate Change
Authors: Damsbo-Svendsen Søren
Published: May 2022

When a political issue rises to the top of the public agenda, it puts pressure on decision-makers, shifts power to actors engaging with the issue, and opens a window of opportunity. This article shows that online mass media contributed to the rapid rise of climate change on European public agendas in and around 2019. It also suggests that climate issue publics, that is particularly concerned and interested citizens, were influenced most. Conversely, citizens without strong climate opinions are not subject to influence from intensive media coverage. The results come from vector autoregression (VAR) models that take advantage of unique daily salience time series. The time series are constructed from weekly repeated nationally representative surveys of the public (N = 25,445) and online news articles (N = 6,905) by a dominant mass media news outlet that boasts a particularly large, trustful, and diverse audience. Traditional mass media can retain a powerful agenda-setting role even in increasingly fragmented media environments. But the target of their influence depends on the issue and the composition of corresponding issue publics, plausibly due in part to individual differences in use and processing of information about the issue.
Learning-based essential matrix estimation for visual localization
Authors: Son Moongu , Ko Kwanghee
Published: May 2022

Visual localization is defined as finding the camera pose from two-dimensional images, which is a core technique in many computer vision tasks, including robot navigation, autonomous driving, augmented/mixed/virtual reality, mapping, etc. In this study, we address the pose estimation problem from a single-color image using a neural network. We propose a coarse-to-fine approach based on a deep learning framework, which consists of two steps: direct regression-based coarse pose estimation that obtains a pose by finding a pose-based similar image retrieval and Siamese network-based essential matrix estimation to obtain a refined pose. Experimental results using the 7-scenes, Cambridge, and RobotCar datasets demonstrate that the proposed method performs better than the existing methods in terms of accuracy and stability.
From dawn till disc: Milky Way’s turbulent youth revealed by the APOGEE+Gaia data
Authors: Belokurov Vasily , Kravtsov Andrey
Published: May 2022

We use accurate estimates of aluminium abundance from the APOGEE Data Release 17 and Gaia Early Data Release 3 astrometry to select a highly pure sample of stars with metallicity −1.5 ≲ [Fe/H] ≲ 0.5 born in-situ in the Milky Way proper. The low-metallicity ([Fe/H]  ≲ −1.3) in-situ component we dub Aurora is kinematically hot with an approximately isotropic velocity ellipsoid and a modest net rotation. Aurora stars exhibit large scatter in metallicity and in many element abundance ratios. The median tangential velocity of the in-situ stars increases sharply with metallicity between [Fe/H] = −1.3 and −0.9, the transition that we call the spin-up. The observed and theoretically expected age–metallicity correlations imply that this increase reflects a rapid formation of the MW disc over ≈1–2 Gyr. The transformation of the stellar kinematics as a function of [Fe/H] is accompanied by a qualitative change in chemical abundances: the scatter drops sharply once the Galaxy builds up a disc during later epochs corresponding to [Fe/H] > −0.9. Results of galaxy formation models presented in this and other recent studies strongly indicate that the trends observed in the MW reflect generic processes during the early evolution of progenitors of MW-sized galaxies: a period of chaotic pre-disc evolution, when gas is accreted along cold narrow filaments and when stars are born in irregular configurations, and subsequent rapid disc formation. The latter signals formation of a stable hot gaseous halo around the MW progenitor, which changes the mode of gas accretion and allows development of coherently rotating disc.
100 Years of Social Forces as seen through Bibliometric Publication Patterns
Authors: Moody James , Edelmann Achim , Light Ryan
Published: May 2022

The 100th anniversary of Social Forces provides a rich opportunity to reflect on the history of the journal and changes to sociology as a whole. Using a series of formal text-analytic methods, we describe the shifting intellectual landscape of Social Forces publications. We uncover a wide diversity of topics that shift over time reflecting the breadth of interests engaging sociologists as Social Forces grew into one of the discipline’s premier journals. In addition to shifts in content, we examine changes in sociological work during this century. We find that articles have generally become more interdisciplinary, while being produced by larger, more gender inclusive and globalized teams. We examine both the most cited papers in Social Forces as well as factors associated with greater recognition. The overall story implied by these explorations suggests a vibrant journal that has shaped the way that sociology has worked over the last 100 years.
Time to Say ‘Goodbye’: winding up Manx foundations
Authors: Rimmer John
Published: May 2022

New beginnings can be exciting. But how do you get rid of foundations when it is time for them to go? There are several means by which a foundation may cease to exist under Manx law: planned, ie, under the rules, or on discontinuance in the Isle of Man, or forced, to remedy problems that have arisen. For any means of termination of a Manx foundation, it must culminate in removal from the register. This article examines the key features of Manx law that determine how a Manx foundation can meet its end.
Effects of Food Matrix and Western Diet on Colorectal Cancer and Metabolism in C57BL/6 Mice
Authors: Hintze Korry , Hisatome Takumaru , Kellen Sara , Ward Robert , Benninghoff Abby , Lefevre Michael
Published: May 2022

Rodent studies that test the effects of bioactive dietary components on chronic disease generally use purified basal diets that were established using nutrient profiles optimized for growth and fertility such as the AIN93‐G diet which is not reflective of typical American macro and micronutrient intake. Previously, we used NHANES data to formulate the Total Western Diet (TWD), a rodent diet that emulates average American intake levels for macro and micronutrients using nutrient density. We have demonstrated that the TWD increases basal colorectal cancer (CRC) by ~2‐fold compared to the standard AIN93‐G diet in three different models. However, the TWD is comprised of purified ingredients and does not recapitulate the complex food matrix consumed by Americans. Using the latest version of the USDA Food Intakes Converted to Retail Commodities Database, we modified the TWD by using the most commonly consumed whole foods as dietary ingredients. The TWD2 has the same micro and macronutrient content as the previous TWD but contains 25 food ingredients including: sweeteners (sucrose and high fructose corn syrup); flours (wheat, potato, corn, rice and oat); meats (beef, poultry, pork, eggs and fish); dairy (lactose, whey and casein); fruits/vegetables (oranges, apples, bananas, grapes, strawberries, soy, snap beans, peanuts and cashews). To test whether food matrix affected CRC outcome, mice were fed either: AIN93‐G, TWD, TWD2 or TWD‐F (TWD matched for total fiber to TWD2). Mice were initiated with 10 mg/kg azoxymethane (AOM) and provided 1% dextran sodium sulfate (DSS) in their drinking water for 4 weeks to promote colonic inflammation and tumorigenesis. Necropsy and tumor assessment was performed after 15 weeks of treatment. A cohort of sham mice were fed the same diets but not injected with AOM or given DSS to determine effect of diets on metabolism and the gut microbiome. Mice fed the TWD, TWD‐F, and TWD2 did not differ in colon tumor multiplicity but all had significantly more tumors than mice fed the AIN93‐G diet (P < 0.01). Interestingly, mice fed the TWD2 diet consumed significantly more energy and gained more weight than all other treatments (P < 0.05). TWD2 fed mice also had significantly higher total fat mass, body fat percentage, and total visceral fat mass than AIN93‐G fed mice (P < 0.05) but not the purified TWD treatments. Lastly, TWD2 fed mice had significantly higher blood glucose concentrations than AIN93‐G fed mice, but not mice fed the purified TWD diets, at 90 and 120 minutes after oral glucose challenge (P < 0.05). Our data suggests that a diet with a complex food matrix, compared to purified diets with the same macro and micronutrient content, does not influence CRC but does increase energy consumption, adiposity, and glucose intolerance.

Support or Funding Information

Utah Agricultural Experiment Station
Outcomes After Operative Treatment of Pediatric Monteggia Fracture-Dislocations: Comparison Between Open and Closed Injuries
Authors: Roper Brennan , Parikh Shrina , Haidar Layla , Warth Ryan , Ambrose Catherine , Younas Shiraz , Crawford Lindsay , Mansour Alfred
Published: May 2022

Background:

Open pediatric Monteggia fracture-dislocations are a relatively uncommon injury pattern, with limited numbers reported in previous series. Open fracture-dislocations frequently represent more severe injury patterns with potential for contamination. We aim to determine differences in long-term clinical and functional outcomes in the operative management of closed versus open pediatric Monteggia fracture-dislocations.

Methods:

A retrospective review of operatively treated pediatric Monteggia fracture-dislocations was performed. Closed versus open injuries were compared in both clinical outcomes, as well as patient-reported outcomes through Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire.

Results:

Of 30 operatively treated injuries, 12/30 (40%) were open fracture-dislocations. Patients were followed clinically for an average of 15.65 months in open injuries and an average of 4.61 months in closed injuries. A trend toward increased time to union was observed, however, significance was not achieved; open injuries averaged 8.0 versus 5.8 weeks for closed injuries (P=0.07). Two patients (11%) in the closed fracture group experienced postoperative complications; both were minor. Five patients (42%) in the open fracture-dislocation group experienced a total of 6 postoperative complications; 5 of the 6 complications were major. QuickDASH scores were obtained at an average of 5 years postoperatively; mean QuickDASH scores were higher in the open fracture group, 13.1, compared with the closed fracture group, 5.9 (P=0.038). Increased QuickDASH scores were independently associated with presence of postoperative complications. QuickDASH score could be expected to increase by 12.5 points in those with major complications (P=0.044).

Conclusion:

We present the largest single cohort of pediatric open Monteggia fracture-dislocation injuries to date. These injuries are predictive of poorer outcomes including trend toward increased time to union, increased risk of major complication, and can independently predict worse long-term patient-reported functional outcomes.

Level of Evidence:

Level III—these data represent a retrospective comparative study of clinical and functional outcomes.
The Costs of Interfacility Transfers for Nonurgent Pediatric Supracondylar Fractures
Authors: Mechas Charles , Mayer Ryan , Iwinski Henry , Riley Scott A. , Talwalkar Vishwas , Prusick Vincent , Walker Janet L. , Muchow Ryan D. , Hubbard Elizabeth , Zuelzer David
Published: May 2022

Background:

Unnecessary transfers of nonemergent pediatric musculoskeletal injuries to regional trauma centers can be costly. The severity of fracture displacement in supracondylar humerus fractures dictates the risk of complications, the urgency of transfer and the need for surgical treatment. The purpose of this study is to examine the transfer patterns of Gartland type II pediatric supracondylar humerus fractures to identify strategies for improving patient care, improving health care system efficiency, and reducing costs. We hypothesize that there will be a high rate of unnecessary, emergent transfers resulting in increased cost.

Methods:

We retrospectively identified all pediatric patients that underwent treatment for a supracondylar humerus fracture between 2013 and 2018. Patient demographics, injury characteristics, chronological data, and surgical data were collected and analyzed from ambulance run sheets, transferring hospital records, and electronic medical records. Transfer distances were estimated using Google-Maps, while transfer costs were estimated using Internal Revenue Service (IRS) standard mileage rates and the American Ambulance Association Medicare Rate Calculator. A student t test was used to evaluate different treatment groups.

Results:

Sixty-two patients had available and complete transfer data, of which 44 (71%) patients were safely transferred via private vehicle an average distance of 51.8 miles, and 18 (29%) patients were transferred via ambulance on an average distance of 55.6 miles (P=0.76). The average transfer time was 4.1 hours by private vehicle, compared with 3.9 hours by ambulance (P=0.56). The average estimated cost of transportation was $28.23 by private vehicle, compared with $647.83 by ambulance (P=0.0001). On average, it took 16.1 hours after injury to undergo surgery and 25.7 hours to be discharged from the hospital, without a significant difference in either of these times between groups. There were no preoperative or postoperative neurovascular deficits.

Conclusion:

Patients with isolated Gartland type II supracondylar humerus fractures that are transferred emergently via ambulance are subjected to a significantly greater financial burden with no demonstrable improvement in the quality of their care, since prior research has shown these injuries can safely be treated on an outpatient basis. Potential options to help limit costs could include greater provider education, telemedicine and improved coordination of care.

Level of Evidence:

Level III (retrospective comparative study).
Tocilizumab Versus Baricitinib in Patients Hospitalized With COVID-19 Pneumonia and Hypoxemia: A Multicenter Retrospective Cohort Study
Authors: Roddy John , Wells Daniel , Schenck Katharine , Santosh Shrihari , Santosh Sadashiv
Published: May 2022

OBJECTIVES:

In patients hospitalized with COVID-19 pneumonia, both tocilizumab and baricitinib have been shown to have clinical benefit compared with placebo. To date, there are few data comparing the two treatments, and their relative benefits and harms are unknown. This study aims to evaluate the effectiveness of tocilizumab versus baricitinib in patients hospitalized with COVID-19 pneumonia and hypoxemia.

DESIGN:

Retrospective cohort study.

SETTING:

Seven inpatient acute-care hospitals in Wisconsin.

PARTICIPANTS:

Patients hospitalized with COVID-19, hypoxemia, and Pao
2-to-Fio
2 ratio less than or equal to 300 mm Hg, who received either tocilizumab or baricitinib.

INTERVENTIONS:

Electronic chart review.

MEASUREMENTS AND MAIN RESULTS:

Patients were divided into tocilizumab and baricitinib cohorts based on actual medication received. The primary outcome was hospital discharge alive and free from mechanical ventilation within 60 days, assessed by logistic regression. Three hundred eighty-two patients were included: 194 in the tocilizumab cohort and 188 in the baricitinib cohort. Most baseline characteristics in the two cohorts were similar. All patients received dexamethasone. Two patients were lost to follow-up. In the remaining 380 patients, probability of successful discharge in the two cohorts was quantitatively similar in unadjusted, multivariate-adjusted, and propensity score-matched analyses. Hospital length of stay, rates of thromboembolic events, and rates of hospital-acquired infections were all similar in the two cohorts.

CONCLUSIONS:

In patients hospitalized with COVID-19 pneumonia and hypoxemia who receive dexamethasone, treatment with tocilizumab or baricitinib appears to result in similar outcomes.
The history and evolution of vestibular schwannoma surgery: a comprehensive review
Authors: Gajic Nikolai , Mohd Slim Mohd Afiq , Kontorinis Georgios
Published: May 2022

Vestibular schwannoma (VS) surgery has had a compelling historical evolution. This article aimed to provide a detailed narrative historical review of the chronological progression and conception of surgical VS management. Acknowledgment of the development, revision, and transformation of VS surgery over the decades facilitate a comprehensive understanding of current clinical practice and the scope for further procedural evolution. Following the commencement of VS surgery in the late 18th century, procedures and management have been perpetually revised and augmented, culminating in drastically improved surgical outcomes. This article draws upon the primary source material to provide augmented acuity into the principal pioneers and landmark cases that define the surgery’s trajectory. Moreover, the article includes original interpretive artwork by the first author along with a detailed timeline to facilitate enhanced perspicacity of this unique and salient constituent in surgical history.