bluuebunny/crossref_metadata_2025 huggingface dataset:
The value of microRNA-122 in the diagnosis of coronary heart disease
Authors: Marchenko O , Rudenko N , Kyriachenko Y , Dzobak A , Krasnienkov D
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background. Patients with ischemic heart diseases form the majority group of cardiac diseases. Studies on the roles and mechanisms of microRNAs taking part in cardiac pathophysiology have become the focus of research worldwide.

Purpose. To elucidate whether microRNAs could be markers of atherosclerotic lesions, and further explore the mechanism of microRNAs in ischemic heart diseases. 

Methods. In general, 40 patients were investigated in our Clinic. Blood tests, echocardiography (with two-dimensional speckle tracking echocardiography), ECG, coronary angiograms, microRNA detection were conducted. The patients were divided into two groups, i.e., a control group (Group A) without atherosclerotic lesion and a group with proven coronary artery disease (Group В). The data were analyzed using SPSS Statistics 20.0

Results. According to the level of circulating microRNA, a significant association between miR-122 and coronary artery lesion was identified (р=0.033). The results are shown in Figure 1. Besides, the positive moderate correlation was also revealed (r= 0.337, р=0.036). These data show miR-122 as a robust biomarker for predicting atherosclerosis lesions, and it plays certain role in pathogenesis of atherosclerosis.

Conclusion. Particularly, microRNA-122 fulfils the criteria of good biomarkers due to their key-role in severity assessment. The correlation between obtained coronary artery lesion results and epigenetic markers was found. The circulating microRNA has also improved the predictive power for diagnostics of ischemic heart disease, which is crucially important for patients and possible biochemical markers for control of treatment. Abstract Figure.
Analysis of clinical features and coronary angiography in 10 patients with de winter syndrome
Authors: Ni N I
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

OnBehalf

Guohua Ni

Objective

To investigate the clinical characteristics and electrocardiogram (ECG) changes of patients with de winter syndrome, so as to enhancing the awareness of de Winter ECG pattern and conducting early emergency interventional therapy for the patients.

Methods

The clinical data of 10 cases of patients with de winter syndrome admitted to a Medical University Hospital from January 2015 to May 2019 were retrospectively analyzed, to summarize the clinical characteristics, de Winter ECG pattern, timing of emergency interventional therapy, prognosis and other factors.

Results

Among the 10 patients with de winter syndrome, 9 males and 1 female, 3 cases of acute extensive anterior wall myocardial infarction (MI), 3 cases of non-ST -segment elevation MI (NSTEMI), 2 cases of acute anterior wall MI, and 2 cases of acute anterior septal MI. All the cases were in line with de winter ECG pattern, and they all had dynamic evolution characteristics. Of these, 7 patients developed ST-segment elevation MI (STEMI) and 3 patients developed NSTEMI. All cases were performed coronary angiography (CAG) and 9 patients were performed percutaneous coronary intervention(PCI). CAG showed that there were 6 cases of multi-vessel coronary disease, 4 cases of proximal occlusion of left anterior descending artery, 2 cases of subtotal occlusion, 1 case of 95% stenosis in proximal middle segment of stent. There was 1 case of middle occlusion of anterior descending branch and 1 case of subtotal occlusion, all the above 9 cases were performed PCI. One case had 95% stenosis in the middle segment of anterior descending branch, and no interventional therapy was performed due to hematuria.

Conclusion

de winter ECG pattern should be regarded as an STEMI equivalent, prompt recognition of the de winter ECG pattern and a timely diagnosis is of the utmost importance, in order to perform early emergency medical and interventional therapy.

Clinical Implications *

My study will enable cardiovascular clinicians to enhancing the awareness of de Winter ECG pattern and conducting early emergency interventional therapy for the patients, so as to improve the outcome and prognosis of the de winter syndrome. Abstract Figure.
Clinical implications of troponin-T elevations following TAVR
Authors: Imamura T , Oshima A , Onoda H , Tanaka S , Ushijima R , Sobajima M , Fukuda N , Ueno H , Kinugawa K
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Baseline and post-procedural elevations in serum troponin-T levels are associated with increased morbidity and mortality following transcatheter aortic valve replacement (TAVR). However, the prognostic impact of change in serum troponin-T level following TAVR remains unknown.

Methods

Among the patients with severe aortic stenosis who underwent TAVR, those with baseline serum troponin-T level ≥51.5 ng/L were excluded. The impact of increases in serum troponin-T level to an abnormally high range (≥51.5 ng/L) following TAVR on 2-year cardiovascular death or heart failure readmissions was investigated.

Results

Among 189 included patients (median 86 years old, 28% men), serum troponin-T level increased in 79 patients following TAVR. An increase in serum troponin-T was associated with a higher rate of 30-day adverse events, predominantly due to pacemaker implantation for complete atrio-ventricular block, and a higher 2-year cumulative incidence of the primary endpoint (hazard ratio 3.97, 95% confidence interval 1.51-10.4, p = 0.005) adjusted for the use of balloon-expandable valve and post-TAVR pacemaker implantation (Figure 1).

Conclusion

Post-procedural increase in serum troponin-T level was associated with adverse clinical outcomes following TAVR. Abstract Figure. Cumulative incidence of endpoint
Single center experience of transcatheter aortic valve implantation in severe aortic stenosis: study of mid-term clinical outcome
Authors: Tey Y S , Aris F A , Jalaluddin M S , Wan Rahimi Shah W F , Ashari A , Kolanthai Velu J , Ganesan K G , Dillon J J , Kadiman S , Sulong M A , Yahaya S A
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

BACKGROUND

Transcatheter Aortic Valve Implantation (TAVI) had revolutionized the treatment and outcome of symptomatic severe aortic stenosis (AS) since its introduction. In 2009, our center performed the first TAVI in Malaysia and since then it has provided an alternative treatment for severe AS patients. The objective of the study is to evaluate the clinical outcome of severe AS patients who had undergone TAVI in our center.

METHODS 

A retrospective observational study was conducted. All TAVIs performed in our center between 01 Jan 2009 and 31 December 2020 were included. Patients’ baseline characteristic, clinical outcomes post procedure at 1-year and 3-year mortality were studied. Data were collected by using case report form and reviewing patient’s case note. 

RESULTS 

A total of 107 patients had TAVI performed during this period of time. The mean age (±SD) was 77.4 ± 5 (range 61-90 years). 50.5% of the patients were male (n = 54) and 45.8% were Malay ethnicity (n = 49). Majority of the patients had hypertension (86.9%, n = 93), dyslipidaemia (84.1%, n = 90) and ischemic heart disease (60.7%, n = 65). 26.2% of patients (n = 28) had previous coronary artery bypass surgery and 2.8% of patients (n = 3) had previous valvular operation. 85.9% of patient was in NYHA II – IV (n = 92). Mean EuroScore II and STS score were 4.82 and 4.564 respectively. Average hospitalization stay was 5 days. Total of 60 (56.1%) CoreValve were deployed followed by 46 Edwards Sapien (43%) and 1 MyVal (0.9%). 89.7% of procedure was performed via transfemoral access (n = 96) followed by transapical (6.5%, n = 7), transaortic (2.8%, n = 3) and subclavian (0.9%, n = 1). 98.1% (n = 105) procedure was successfully performed. There were 6 in-hospital mortality (5.6%) during indexed TAVI admission, of which 5 out of 6 were TAVI related. Kaplan Meier analysis of predicted survival rate with freedom from all-causes mortality at 1 year was 86.9% and 73.7% at 3 years. 

CONCLUSIONS 

Untreated severe AS was associated with poor outcome. High success rate of TAVI had provided another option of treatment to severe AS patient who are not the suitable candidate for surgical intervention.
Symptomatology, prognosis and clinical findings of myocarditis as an adverse event of COVID-19 mRNA vaccine: a systematic review
Authors: Jaiswal VIKASH , Jaiswal AKASH , Batra NITYA , Mukherjee D , Ruchika R , Ishak ANGELA , Maskey U , Hitawala GAZALA , Song DAVID , Sattar YASAR
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Myocarditis, an inflammation of the myocardium in the absence of ischemic injury, may be caused by viruses, drugs, and vaccines. The Myocarditis following COVID-19 vaccinations is most commonly seen in young adult males and commonly after the second dose of the mRNA vaccine. It usually presents with chest pain, dyspnoea, palpitations but has a diverse clinical presentation and varied therapeutic response. We aim to systematically collate the symptomatology, prognosis, and clinical findings of COVID-19 vaccine adverse events causing Myocarditis.

Method

Following the PRISMA statement 2020, a systematic search was conducted to isolate confirmed cases of COVID-19 vaccine-induced Myocarditis. By applying the BOOLEAN logic, the following keywords were used: COVID-19, SARS-CoV-2, Myocarditis, Mortality. Four databases were searched from January 2021 through August 2021: PubMed, Science Direct, Google Scholar, and Cochrane Library; the reference lists of screened studies were searched as well (umbrella methodology).

Results

In total, 12 case reports, 10 case series and 1 cohort study with a total of 107 patients were included in the final analysis. A total of 101 male patients were recorded, and 6 were female showing male dominance. The mean age of all participants was 24.73 years(SD = 13.18), ranging from 14 to 70. The most common presenting symptoms were chest pain (47.66%), fever (35.51%), and myalgia (25.23%). Lab findings showed elevated Troponin I, CRP, and ESR levels in the majority of patients.

ECG was abnormal in most of the patients, which include sinus rhythm (24%), ST-elevation (42.05%) and T wave inversion (13.08%). Echo findings include decreased Ejection fraction in 19.62% of patients while 13.08% of patients having a hypokinetic left ventricular wall. Further, CMR finding suggestive of confirmed myocarditis cases in 36% patients while rest are suspected one. Overall mortality(1.86%) was low among patients.

Conclusion

There is increasing evidence for Myocarditis as a rare adverse event of COVID-19 mRNA vaccination in young adults. This evidence is strongest amongst young male patients. The majority of the patients complain of chest pain and fever. In lab findings Troponin I, CRP and ESR are usually increased and ST elevation is common in the ECG. This entity is mainly treated with nonsteroidal anti-inflammatory drugs, Colchicine, Beta-blockers, ACE inhibitors, Steroids. However, prognosis and outcomes are favourable with a very low mortality rate.
The association of preoperative dialysis with troponin trends and short term outcomes among advanced kidney disease patients undergoing coronary artery bypass grafting
Authors: Manla Y , Hogan M , Bhatnagar G , Khan N , Alsindi F , Aljabery Y , Sanger S , Gobolos L
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Introduction

Coronary artery disease continues to be the leading cause of death in patients with stage IV-V chronic kidney disease (CKD IV-V). However, the prognosis and early outcomes for advanced CKD patients undergoing coronary artery bypass grafting (CAB) worsen as the estimated glomerular filtration rate (eGFR) deteriorates. Therefore, we compared postoperative clinical outcomes and troponin trends in patients having advanced CKD according to preoperative dialysis status in a single centre experience.

Methods

A total of 51 patients with CKD IV and V who underwent CAB between 2016-2021 were included in the study. Data on patient characteristics and postoperative outcomes were collected retrospectively, and independently for our Society of Thoracic Surgeons database. Characteristics were compared between patients having CKD IV vs. CKD V. The differences in postoperative cardiac troponin trends and outcomes were evaluated between patients who did vs. did not undergo preoperative dialysis. The statistical analysis was conducted applying appropriate parametric or non-parametric (for skewed variables) testing methods, and a p value < 0.05 was considered to be statistically significant.

Results

47% (24) of subjects had CKD IV, while the rest featured CKD V. Patients with CKD IV tended to be older (61.8 ± 9.2 vs. 56.3 ± 11.5 years, p = 0.07), more obese (BMI: 31.4 ± 6.8, 27.4 ± 4.9 kg/m2, p = 0.02) and had significantly higher preoperative GFR (23 ± 4.9 vs. 9 ± 3.3 mL/min, p < 0.001) (Table.1). When comparing patients who underwent preoperative dialysis vs. those who did not, troponin levels were the highest at 18h postoperative in both groups, however, troponin levels were comparable between both groups at all time points (Table.2). Although, there was no difference in hospital length of stay and mortality between these groups, patients who did not undergo preoperative dialysis had longer intensive care unit length of stay (ICU LOS).

Conclusion

In this single centre experience preoperative dialysis was not associated with a significant difference in trends of postoperative cardiac enzymes. Although preoperative dialysis was associated with shorter ICU LOS, complex pre-procedural surgical risk assessment remains paramount in reducing complications and mortality in this high-risk population. Abstract Figure.  Abstract Figure.
Sex-specific differences in mortality after first time, isolated coronary artery bypass graft surgery: a systematic review and meta-analysis of randomized controlled trials
Authors: Matthews S , O"neil A , Sanders J , Buttery A , Maraosco S , Fredericks S , Martorella G , Keenan N , Ganes A , Wynne R
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

BACKGROUND

Evidence quantifying sex-specific differences in cardiac surgical outcomes is scant.

PURPOSE

The purpose of this review was to determine whether contemporary evidence indicates Coronary Artery Bypass Graft Surgery (CABGS) is differentially efficacious than alternative procedures by sex on mortality outcomes.

METHODS

EMBASE, CINAHL, Medline and Cochrane Library databases were searched (January 2010-April 2020). English language, randomized controlled trials, comparing isolated CABGS to an alternative revascularization strategy in adults, with analyses comparing sex-specific differences in mortality were included. Analyses of incidence data was performed using Mantel-Haenszel fixed-effects modelling, Cochrane RoB2 tool and CONSORT checklist. PROSPERO Registration ID: CRD42020181673.

RESULTS

The search yielded 4459 citations, with 29 articles for full-text review revealing 9 eligible studies with variability in time to follow-up. In contrast to men, mortality risk for women was lower in pooled analyses (RR 0.95, 95% CI 0.85-1.05, p = 0.33) but higher in sensitivity analyses excluding ‘high-risk’ patients (RR 1.18, 95% CI 0.99-1.40, p = 0.07). At 30-days and 10 years, women had an 18% (RR 0.82, 95% CI 0.66-1.02, p = 0.08) and 19% (RR 0.81, 95% CI 0.69-0.95, p = 0.01) mortality risk reduction. At 1-2 years women had a 7% (RR 1.07, 95% CI 0.69-1.64, p = 0.77), and at 2-5 years a 25% increase in risk of mortality compared to men (RR 1.25, 95% CI 1.03-1.53, p = 0.03). Women were increasingly under represented (23.2%) over time, comprising 29% (30-days) to 16% (10 years) of the pooled population.

CONCLUSION

Trials with sex-specific stratification are required to ensure appropriate treatment options for coronary revascularization.
Impact of the anti-hypertensive diets virtual education towards knowledge, attitude, practice, and reduction of blood pressure during covid-19 pandemic
Authors: Andrianto A , Ardiana M , Yutha A , Khrisna B P D , Nugraha R A , Putra T S , Shahab A R , Andrianto H , Kikuko I H , Puspitasari A N , Hajjrin M R
Published: February 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Universitas Airlangga Project Grants for Community Empowerment

OnBehalf

Universitas Airlangga

Background. One of the efforts to reduce hypertension rates in the community is through dietary changes that refer to the Dietary Approach to Stop Hypertension guidelines or abbreviated as DASH. However, in the COVID-19 pandemic, there is a significant obstacle regarding the most effective way to transfer knowledge, skill, and attitude towards society. 

Aims. Department of Cardiology and Vascular Medicine created a virtual education series about dietary guideline that refers to DASH by adapting the local wisdom of the Surabaya community. We aimed to evaluate the impact of Airlangga Comprehensive Anti-Hypertensive Diets Virtual Education Series towards knowledge, attitude, practice, and reduction of blood pressure in the primary care setting during COVID-19 pandemic. 

Methods. This type of online action research is quantitative with a quasi-experimental design that designs using one group pretest-posttest, when this study was conducted in October-December 2020. The population in this study were all patients with hypertension who were treated in Mojo primary health care setting. A purposive sampling technique were done to receive 110 participants using online questionnaire.

Results. A total of 110 participants were included in the analysis, 55 in the intervention group and 55 in the control group. Following the Airlangga Comprehensive Anti-Hypertensive Diets Virtual Education Series implementation, the only parameter that showed significant improvement were knowledge and attitude (p < 0 .001). There is no significant change in the skill parameters (p = 0.131) and blood pressure parameters (p = 0.433) .

Conclusion. Airlangga Comprehensive Anti-Hypertensive Diets Virtual Education Series implementation in our study population seems to be effective to improve knowledge and attitude of participants, however, this program seems to be ineffective to improve skill and blood pressure reduction in participants. Future study with longer durations and more comprehensive programme needs to be done to scrutinize the clinical impact of this program nationwide.
Homocysteine predicts vascular target organ damage in hypertension and may serve as guidance for first-line antihypertensive therapy
Authors: Carnagarin R , Schlaich MARKUS
Published: February 2022

Funding Acknowledgements

Type of funding sources: Foundation. Main funding source(s): the primary author is supported by the Australian National Heart Foundation post docctoral fellowship

OnBehalf

Dobney Hypertension Centre

Background

Homocysteine is an independent risk factor for cardiovascular and cerebrovascular disease and has been proposed to contribute to vascular dysfunction. We sought to determine in a real-world clinical setting whether homocysteine levels were associated with hypertension mediated organ damage (HMOD) and could guide treatment choices in hypertension.

Methods

We performed a cross-sectional analysis of prospectively collected data in 145 hypertensive patients referred to our tertiary hypertension clinic at our Hospital and analysed the association of homocysteine with HMOD, renin-angiotensin-aldosterone signaling (RAAS) and blockade.

Results

 The average age of participants was 56 ± 17 years and there was a greater proportion of males than females (89vs56). Regression analysis showed that homocysteine was significantly associated with PWV (β=1.99; 95% CI 0.99-3.0; p < 0.001), albumin creatinine ratio (β=1.14; 95% CI 0.47,1.8;  p < 0.001), 24 hr urinary protein excretion (β=0.7; 95% CI 0.48, 0.92; p < 0.001) and estimated glomerular filtration rate (β=-29.4;  95% CI -36.35, -22.4; p < 0.001), which persisted after adjusting for potential confounders such as age, sex, 24 hr BP, inflammation, smoking, diabetes mellitus, renal insufficiency and dyslipidaemia. A positive predictive relationship was observed between plasma homocysteine levels and PWV, with every 1.0 µmol/L increase in homocysteine associated with a 0.1 m/s increase in PWV. Homocysteine was significantly associated with elevated aldosterone concentration (β=0.26; p < 0.001), thereby possible RAAS activation, an effect better resisted by angiotensin receptor blockers than ACE-inhibitors in higher physiological ranges of homocysteine.

Conclusions

Our results indicate that homocysteine is associated with hypertension mediated vascular damage and could potentially serve to guide first-line antihypertensive therapy.
Impact of perioperative interruption of antithrombotic therapy on thrombotic and bleeding events in non-cardiac surgery
Authors: Saito K , Saito Y , Muramatsu T , Kitahara H , Fujimoto Y , Isono S , Kobayashi Y
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Introduction

Antithrombotic therapy including antiplatelet agents and anticoagulants are prescribed for secondary prevention in patients with established cardiovascular disease. Although antithrombotic therapy is often interrupted before non-cardiac surgery with or without perioperative bridging anticoagulation, the impact on thrombotic and bleeding events remains uncertain. 

Purpose

The aim of this study was to clarify the impact of perioperative interruption of anticoagulants on thrombotic and bleeding events in patients with established CVD undergoing elective non-cardiac surgery. 

Methods

A total of 330 patients chronically treated with antithrombotic therapy for secondary prevention underwent elective non-cardiac surgery under general anesthesia, with the complete interruption of antithrombotic agents. The study endpoints included all-cause death, thrombotic events, and major bleeding complications after surgical procedures. 

Results

Of 330 patients, 171 (51.8%) and 159 (48.2%) received antiplatelet agents and anticoagulants perioperatively. Atrial fibrillation (31.8%) and coronary artery disease (20.3%) were the major indications for antithrombotic regimens. Antithrombotic therapy was interrupted from 5 [2, 7] days before the surgery to 4 [2, 7] days postoperatively. Perioperative bridging therapy with unfractionated heparin was employed in 99 (30.0%) patients. During the hospitalization, 3 (0.9%) patients died due to non-cardiovascular causes. Thrombotic events and major bleeding occurred in 2 (0.6%) and 9 (2.7%) patients. Bridging therapy with heparin was non-significantly associated with an increased risk of bleeding events (5.1% vs. 1.7%, p = 0.09). In univariable and multivariable analyses, pre-operative hemoglobin level and operative duration were significantly associated with bleeding complications.

Conclusions

In the present study, complete interruption of antithrombotic therapy resulted in a few thrombotic events with a numerically higher rate of bleeding events in patients undergoing elective non-cardiac surgery. Pre-operative hemoglobin level and operative duration were significantly associated with post-operative bleeding complications.
A four year experience of peripartum cardiomyopathy in a rural public hospital in south india
Authors: Kanakasabapathy R A , Annamalai N
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Introduction

Peripartum cardiomyopathy (PPCM), as defined by the study group on PPCM of Heart Failure Association of the European Society of Cardiology (ESC), is an idiopathic Cardiomyopathy with systolic heart failure occurring towards the end of pregnancy or in the months following delivery, in previously healthy women. The current diagnostic criteria are:

- heart failure in the last month of pregnancy or in the first 5 postpartum months

- absence of other causes of heart failure

- absence of known heart disease predating the development of heart failure.

- reduced Left Ventricular Ejection Faction (LVEF) of < 45% or Fractional Shortening < 30%

The global incidence of PPCM is variable, the least reported in Japan and the most in Nigeria. The estimates of the incidence in India need more scrutiny because of the difficulties in diagnosing the condition. The current incidence in literature is 1 in 1374 live births. We conducted the study to characterize PPCM among women delivered at a resource-limited setting in South India.

Aim

To estimate the incidence of PPCM

To describe the risk factors and Feto-maternal outcomes and associated mortality

To estimate the recovery of cardiac function at the end of one year.

Materials and Methods

This was a prospective longitudinal study conducted in a rural public hospital in South India, from 2017 to 2020.

PPCM was diagnosed in pregnant and puerperal women, in concurrence with global standards.

Data included were Age, Parity, Gestational age, Risk factors, Medical Management, Pregnancy outcome and Echocardiography data on diagnosis and at 1-year follow-up.

Results

- 32 out of 14505 women in the 4-year study period were diagnosed with PPCM.

- The incidence of PPCM was 1 in 453 live births.

- The mean age was 23.2 years.

- 46.8% were primigravidae.

- 21.8% had pre-eclampsia.

- 100% had breathlessness at presentation (62.5% were in New York Heart Association – Class III).

- The mean LVEF on diagnosis was 24.5%.

- The Fractional Shortening was 16%.

- The Left Ventricular End Diastolic Dimension was 5.8cm.

- 18.75% of women were diagnosed antenatally, 75% in the early puerperium and 6.25% in the late puerperium.

- 81.3% were delivered by caesarean section.

- At 1-year follow up, complete recovery of cardiac function was observed in 65.6% of the women.

- There was no maternal mortality or adverse perinatal outcomes.

Conclusion

Although rare, PPCM is an important cause for Maternal Mortality. Being a diagnosis of exclusion, a high index of suspicion and involvement of a multi-disciplinary team will aid to optimize the Feto-maternal outcomes. Setting up a National PPCM registry will help in establishing the clinical epidemiology, risk factor assessment, screening strategies, diagnostic criteria and management options for mothers suffering from the condition.
Prognostic indicators for the onset of ischaemic versus haemorrhagic stroke in stable coronary artery disease
Authors: Wang W T
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background 

The incidence of stroke may be increased in patients with coronary artery disease (CAD). We aimed to investigate the specific risk factors for the development of ischaemic and haemorrhagic stroke in stable CAD patients.

Methods

Patients with stable CAD were prospectively enrolled for future cardiovascular events in Taiwan. All the patients had received coronary interventions and were stable for least 1 month before enrolment. The incidence of ischaemic stroke was identified and confirmed by telephone and hospital records. Baseline characteristics, including demographic data, lipid profiles, medications, and biomarkers for potential inflammatory and atherosclerosis, were analysed. 

Results

In total, 1428 patients (age, 63.07 ± 11.4 years; 1207 males) were under standard medical treatment and regularly followed-up for at least 4 years. Multivariate logistic regression analysis showed that baseline serum myeloperoxidase (MPO) level (HR: 1.89, 95% CI: 1.16-3.10, p = 0.01) and statin use (HR: 0.37; 95% CI: 0.17-0.79, p = 0.01) were independently associated with the onset of ischaemic stroke. Age (HR: 1.07, 95% CI: 1.00-1.14, p = 0.04) and angiotensin receptor blocker (ARB) use (HR: 0.37, 95% CI: 0.17-0.79, p = 0.01) were independently associated with future onset of intracranial haemorrhage (ICH), implying the different mechanisms of ischaemic stroke and ICH.

Conclusion Age and ARB use were related to ICH onset. Baseline MPO level and statin use were independently associated with longer and shorter future ischaemic stroke onset in stable CAD patients, respectively. Further studies are indicated to confirm the potential mechanisms and advance individual risk stratification for the onset of different types of stroke in clinical CAD.
The effect of high intensity interval training on patients with heart transplantation: a systematic review
Authors: Rajandekar T , John G
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

BACKGROUND

Exercise rehabilitation after heart transplant is of major importance in order to improve physical capacity and prognosis.High-intensity interval training (HIIT) has repeatedly proven to be a highly efficient form of exercise for improving the physical capacity of both normal subjects and patients with coronary artery diseases (CAD) and heart failure. In contrast to the chronotropic response of a normal heart to exercise, a newly transplanted heart is denervated, which causes higher resting heart rate (HR) and reduced heart response (chronotropic incompetence). The HR response during exercise is mainly controlled by catecholamine’s from the adrenal glands, resulting in a significantly slower increase of the HR at onset of exercise, a reduced peak HR, and a delayed return towards resting values after cessation of exercise.  A study conducted in 2013 concluded  that high-intensity, aerobic training, especially interval-based training, is a favourable type of exercise that yields improvements in both peripheral and central factors.The review was conducted to determine the effect of HIIT on heart transplant patients.I

PURPOSE

Heart transplant patients have benefitted from aerobic exercises, but the protocol is mostly focussed on moderate intensity exercises. Chronotropic incompetence and safety have been two issues while considering high intensity exercises in heart transplant patients.HIIT has been proved to be effective in coronary artery disease and heart failure patients.

METHODOLOGY

Criteria for considering these studies for the review

PRISMA guidelines of systematic review used. Physiotherapy Evidence Database scale used for assessing risk of bias. GRADE System of evaluation used for data extraction and quality assessment. "Mesh" terms used to search the article. Various databases like PubMed, Scopus, Google scholar, Cochrane screened. Inclusion and exclusion criteria stated. Studies done between 2010-2020 taken.Out of all the studies screened, which 3 studies fulfilled the full text eligibility and were included in the systematic review.

RESULTS

The heart transplant patients  demonstrated a  great improvement in VO2 peak, anaerobic threshold, peak expiratory flow, extensor muscle capacity, general health, systolic blood pressure and endothelial function post HIIT. One of the screened studies compared HIIT with moderate intensity exercises in heart transplant patients and found out that patients receiving HIIT demonstrated better improvement that moderate intensity exercises.The studies also emphasised that long term and community based HIIT is effective in improving the overall quality of life of the patients.

CONCLUSION

According to the three studies reviewed in this article, HIIT proved to be effective as exercise intervention on heart transplant patients. Abstract Figure. Forms of HIIT  Abstract Figure. Heart transplant
Blackout Brownie: A Final Dessert Case Study
Authors: Kedzierski Nancy , Hernandez Melanie
Published: February 2022

Cannabis products have been becoming more widely accepted as a recreational drug and for medicinal purposes to aid in various ailments. This paper reports a death after acute ingestion of an edible cannabis brownie. The 65-year-old female decedent with a history of chronic pain ingested an edible cannabis brownie after other alternative edibles and prescribed medication produced no desired effects. After consuming the cannabis product with her husband, both began feeling high and nauseated. The decedent was last seen alive stopped part way up the stairs by her husband prior to him going to sleep. She was found expired at the base of the stairs the following morning with no apparent trauma. The autopsy concluded the decedent was obese with severe ischemic cardiovascular disease. The toxicology report detected delta-9-tetrahydrocannabinol present at >5,000 ng/mL in the decedent’s central blood at the time of sample collection. The final cause of death was ruled as natural due to cardiovascular disease with cannabis present in her system.
Twisted extreme trans-Neptunian orbital parameter space: statistically significant asymmetries confirmed
Authors: de la Fuente Marcos C , de la Fuente Marcos R
Published: February 2022

Asymmetric debris discs have been found around stars other than the Sun; asymmetries are sometimes attributed to perturbations induced by unseen planets. The presence or absence of asymmetries in our own trans-Neptunian belt remains controversial. The study of sensitive tracers in a sample of objects relatively free from the perturbations exerted by the four known giant planets and most stellar flybys may put an end to this debate. The analysis of the distribution of the mutual nodal distances of the known extreme trans-Neptunian objects (ETNOs) that measure how close two orbits may get to each other could be such a game changer. Here, we use a sample of 51 ETNOs together with random shufflings of this sample and two unbiased scattered-disc orbital models to confirm a statistically significant (62σ) asymmetry between the shortest mutual ascending and descending nodal distances as well as the existence of multiple highly improbably (p < 0.0002) correlated pairs of orbits with mutual nodal distances as low as 0.2 au at 152 au from the Solar system’s barycentre or 1.3 au at 339 au. We conclude that these findings fit best with the notion that trans-Plutonian planets exist.
What happens when a settlor or powerholder loses capacity?
Authors: Piskorz Emilia , Steen Peter
Published: February 2022

Capacity issues are a common feature of the landscape of wills and estates. However, such issues tend to arise much less frequently in the context of discretionary trusts. This relative absence is perhaps attributable to (often) the lack of direct benefit to anyone alleging the existence of mental incapacity issues in relation to a discretionary trust. There are significant consequences that can arise from successfully challenging capacity in the context of, say, a specific legacy under a will, whereas a discretionary beneficiary who raises mental incapacity issues usually remains merely a discretionary beneficiary. However, in the climate of ever increasing life expectancy and rising rates of dementia diagnoses, mental capacity issues in the trusts context are on the rise, and it is essential to understand what happens when settlors and power holders remain in place despite questions over their mental capacity. After all, “having capacity to exercise a power is ‘of the essence of a power’”.1 In this article, we look at the sorts of mental capacity issues that can arise in the trusts context and what can be done about them.
The Consequences of Depression
Authors: Rottenberg Jonathan
Published: February 2022

This chapter details how depression affects
relationships, careers, and health. It is important to consider the evidence that
depression harms relationships, careers, and health and to explore the reasons why
depression may create such harms. Depression is also often quite commonly accompanied by
other mental health problems, such as substance problems or difficulties with anxiety,
which can compound depression’s harms. Patterns of mental health comorbidity and
possible explanations for why depression co-occurs with other mental health problems are
also outlined. Although the harmful consequences of depression are well established,
little research considers whether depression ever has positive consequences. Preliminary
evidence that depression could have positive consequences for some individuals is
considered.
Biological Contributions to Depression
Authors: Rottenberg Jonathan
Published: February 2022

This chapter considers biological aspects of
depression, including what it means to state that depression is a chemical imbalance or
a genetic problem. The evidence for neurotransmitter theories of depression is reviewed,
with a focus on both what is known and what is not known about the role of
neurotransmitters in depression. Similarly, depression has been shown to be broadly
related to genetic variations, yet scientists still do not know which specific genes
play a role and how those genes operate to make depression more likely. Finally,
research using advanced technologies to image the structure and the function of the
brain has revealed numerous differences in the brain between depressed persons and
nondepressed persons. Although exciting, for reasons that are explained, these findings
on the biology of depression have yet to transform the understanding of this
condition.
Environmental and Psychological Contributions to Depression
Authors: Rottenberg Jonathan
Published: February 2022

This chapter considers the role of several
psychological and environmental factors in depression. One key factor is stressful life
events, which often but not always precede episodes of depression. Life stress may
precipitate depression. In turn, there is evidence that depression can generate stress
in a person’s life. Similarly, negative thinking patterns are elevated in depressed
persons, and negative thinking may also be a cause of depression. Research and treatment
studies are unlocking the varied connections between cognition and depression. Finally,
depression and mood problems are often closely tied to relationship problems, such as
marital and family difficulties. The importance of social connections is often revealed
in interpersonal therapies for depression. In many cases, depression can result from the
interplay between stressful life events, negative thinking, and relationship problems.
The chapter closes with special consideration of adversity during childhood and the ways
that childhood adversity might increase psychological and environmental risk for
depression during adulthood.
Depression Throughout the Life Course
Authors: Rottenberg Jonathan
Published: February 2022

Over the life course depression affects
different groups of people in different ways. This chapter considers the ways that
depression manifests in children, the prevalence of child depression, the challenges of
assessing child populations, and the ways that depression can adversely affect
development. As children move into adolescence, they are particularly susceptible to
depression. The reasons for the spike in adolescent depression are explored, along with
consideration of measures that might reduce the toll of adolescent depression. Beginning
in adolescence and continuing throughout adulthood, depression is much more common among
females than males. Biological, cognitive, and social explanations for this sex
difference in depression are considered. Finally, late-life depression is considered,
including ways that depression in older persons is distinct from, and similar to,
depression at earlier life stages.
What Can the Depressed Person do for Themself?
Authors: Rottenberg Jonathan
Published: February 2022

This chapter reviews what a person can do to
expand his or her zone of control over their mood. Degree of control over mood likely
depends on the severity of depression, yet even people who are severely depressed can
take some important first steps. The chapter invites the reader to experiment with
several potential mood control techniques or programs. The efficacy of self-help books,
or bibliotherapy, is reviewed, and specific book resources are recommended. Evidence of
benefits from exercise, pet ownership, and changes to sleep regimen are reviewed.
Thoughts are offered on how an individual can go about selecting and discovering those
mood control techniques that work best. The value of meditation and self-compassion is
also considered as means to gain greater control over mood.
How to Talk About Depression and Help a Depressed Person
Authors: Rottenberg Jonathan
Published: February 2022

Several reasons explain why depression remains
a difficult topic for everyday conversation. Depressed people themselves can be
resistant to talking, and it is difficult to help a depressed person without first
opening a channel of communication. This chapter considers the value of opening up and
breaking conversational barriers as well as the practical steps that friends or family
members may take to accomplish these goals. Attention to how conversations are started,
the setting, and specific attitudes and behaviors can improve the trajectory of
conversations and allow one to be a stronger support or advocate for a person with
depression. It is important to consider all the ways to be an ally to a friend or family
member who is struggling with depression, as well as to recognize when professional help
may be needed, as in a crisis situation. Practical advice for negotiating both everyday
interactions and crisis moments is emphasized.
What is the Long-Term Prognosis for Depression?
Authors: Rottenberg Jonathan
Published: February 2022

This chapter considers the long-term course of
depression. Epidemiology has shown that a large segment of depressed persons have a
difficult future course, marked by recurrence of disorder and intermittent impairment of
function. More benign courses of depression have been overlooked, in part because
research has not used samples of depressed persons that are fully representative of the
population. A first step towards clarifying who has a poor course and who has a benign
course is defining key depression course markers such as recovery, response, and
remission. In this chapter, research on depression recovery, response, and remission is
reviewed with an eye toward achieving a balanced view of prognosis that considers the
possibility both of poor outcomes and of relatively benign outcomes over the long term.
The chapter concludes with a consideration of what is known about the best depression
outcomes and what it might mean to flourish after depression.
Sustainability and Business
Authors: Thompson Paul B. , Norris Patricia E.
Published: February 2022

The profitability of a business is used to model sustainability as a function of the relationship
between revenue (or inflows) and expenses (or outflows). Profitability is a simple model for
sustainability, but for individual businesses to remain profitable, they must be mindful of the
socio-economic context in which they operate. This leads business managers to understand that
profitability depends partly on a larger hierarchy (the economy) in which a firm is embedded. In
addition, trusted firms can reduce operating costs, leading managers to include factors such as
fairness and civic responsibility in their plans. In contrast, conduct such as greenwashing
undermines a firm's social permission to operate. These factors were associated with corporate
social responsibility and the triple bottom line in business schools and have been incorporated
into business-oriented thinking on sustainability.
Sustainable Development
Authors: Thompson Paul B. , Norris Patricia E.
Published: February 2022

The 1987 report of the World Commission on Environment and Development defined sustainable
development as development that meets the needs of the current generation while allowing future
generations to meet their needs. Subsequent discussions of sustainability were deeply influenced
by the theory of economic development and by the tools used to measure it. Having a basic
understanding of economic development is therefore crucial for understanding sustainability. The
chapter discusses how debates over the substitutability of different forms of capital and
measures of development, such as GDP, have shaped the discourse on sustainability. Alternatives
to GDP include the Genuine Progress Indicator.
Robots
Authors: Husbands Phil
Published: February 2022

This book presents a balanced and broad introduction to robotics and the
current state of the field, analyzing where it has come from and where it might go in the future.
Beginning with the history of robotics and its complex relationship with popular culture, it then moves
on to discuss the technology underlying robots, exploring the limits of what robots can actually do now
and what they might be able to do in the future. Naturally, these machines, which often seem to display
life-like properties, are attracting great attention. Do they pose a threat or an unprecedented
opportunity? Will they replace traditionally human workforces—as indeed they have in some sectors
already? And although the “singularity” may not be something to worry about, there are certainly ethical
issues needing consideration as robots with some intelligence are increasingly used. The book considers
both these ethical problems and also the wider socio-political challenges that robots are already
creating, and the larger ones they might bring in the future.
Inside the Machine
Authors: Husbands Phil
Published: February 2022

This chapter examines how robots work. All robots can be
described in terms of sensors, actuators, overall body parts, and a control system. Control
involves generation and coordination of behavior by somehow using incoming sensory information
to produce appropriate actuator outputs. Autonomous vehicles are a very good exemplar of current
mobile robotics as they employ many of today's cutting-edge techniques. Attempts to develop
driverless vehicles go right back to the 1920s. A very significant step in this quest occurred
in 1989 when Dean Pomerleau and a team at Carnegie Mellon University (CMU) demonstrated how an
artificial neural network could be used to successfully steer a test vehicle around the CMU
campus roads. The chapter then considers Pomerleau's system, ALVINN (autonomous land vehicle in
a neural network), and studies how the artificial neural networks used in cars and robots work.
Current leading-edge autonomous vehicles use a variety of sensors, including vision (cameras),
LIDAR, radar, ultrasonics, and GPS information. Finally, the chapter outlines the main
approaches to achieving the goal of widespread fully autonomous vehicles, looks at biomechanics,
and assesses how reliable and intelligent current robots really are.
Robot Futures
Authors: Husbands Phil
Published: February 2022

This chapter sketches plausible robot futures, using
short descriptive scenarios, rather than fact-based argument. Some scenarios highlight the
positive contributions robots might make, while others illustrate some potential problems. They
give an indication of the type of timescale the author would bet on for major progress toward
powerful general intelligent robotics—not decades but centuries. Ultimately, forecasting
technological futures is a mug's game. Technology often advances at a steady pace, so it is
possible to cautiously extrapolate. But there are also sudden bursts of rapid development. These
bursts rarely last as long as people imagine they will and many problems turn out to be much
harder than first thought. Conversely, there are unexpected game-changing discoveries that fly
in from left-field and throw everything into the air. Hence, all speculations in the chapter
should be taken with a large pinch of salt. A number of everyday robot scenarios are imagined,
some positive, some negative. Half of these are projected forward to the relatively near future
– in about fifty or sixty years’ time, the rest to the far future – in about five or six hundred
years.