bluuebunny/crossref_metadata_2025 huggingface dataset:
Atrioventricular block in patients with acute myocardial infarction in a state of cardiogenic shock
Authors: Pelaz Sanchez M , Cortes Cortes F J , Ferrer Lujan I , Montero Parrilla M , Hidalgo Urbano R
Published: May 2024

Funding Acknowledgements

Type of funding sources: Public hospital(s). Main funding source(s): University Hospital of Virgen Macarena.

Introduction

Atrioventricular block (AVB) is a complication to consider in patients with acute myocardial infarction (AMI), constituting a factor in decompensation that can contribute to the shock state in some patients.

Purpose

The study analyzed the incidence of AVB and its relationship with the culprit artery, mortality, and the final need for device implantation.

Methods

A single-center, observational, retrospective study included patients admitted to the Coronary Care Unit in a state of cardiogenic shock in the context of AMI between July 2011 and September 2022.

Results

A total of 298 patients with AMI in a state of shock were included. The average age of the sample was 69 years, with 66.7% being male, 66.8% having hypertension, 55% having dyslipidemia, 50% having diabetes, and 33% being smokers. Nearly half of the patients (47.86%) already presented with a Killip Kimball class IV at the time of admission. The left anterior descending artery (LAD) was responsible for the infarction in 57.4% of cases, and the right coronary artery (RCA) in 24.8%. The incidence of AVB was significantly higher in patients with RCA infarctions compared to LAD (39.1% vs. 3.1%) and compared to other vessels (39.1% vs. 6.69%), with this significance remaining in any type of acute coronary syndrome. The need for device implantation was infrequent. Patients with LAD infarctions required more implantation of implantable cardioverter-defibrillators (ICDs) compared to RCA infarctions (4.43% vs. 0.49%), and RCA infarctions required more conventional pacemaker implantation (2.7% vs. 0%). A better prognosis was observed in RCA involvement with lower mortality compared to other vessels (OR 0.35, 95% CI 0.19-1.6; p=0.01) and compared to LAD involvement (OR 0.44, 95% CI 0.23-0.84; p=0.013).

Conclusions

The incidence of AVB was a particularly common complication in patients in a state of shock with RCA infarctions. However, the mortality was significantly lower in this subgroup of patients. Regardless of the responsible artery, the need for device implantation was infrequent, with a notable need for ICDs in LAD involvement and pacemakers in RCA involvement.
Early outcome in patients with STEMI undergoing primary PCI and high Zwolle risk score discharged within 72 hours
Authors: Dibra L , Voci A , Gjana A , Kristo A , Pavli E , Tafaj E , Katana E , Simoni L , Duka A , Kastrati A , Dibra A
Published: May 2024

Funding Acknowledgements

None.

Introduction

Zwolle risk score has been used to guide decision for early discharge in patients with ST- elevation acute myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). There is limited evidence on the outcome of patients with high score discharged within 72 hours from primary PCI. Our study aim is to evaluate the outcomes via 1 - month follow up in patients with STEMI undergoing primary PCI, with different Zwolle risk who were discharged within 72 hours from the hospital.

Purpose

To evaluate 1-month outcome of STEMI patients treated with primary PCI discharged within 72 hours according to Zwolle risk score.

Methods

We studied 187 consecutive STEMI patients from April 2022 to December 2022, presented in hospital within 12 hours of initial of chest pain, treated with primary PCI and discharged within 72 hours from hospital admission based on physician’s clinical judgement and patient’s preference. Patients were divided in two groups according to Zwolle risk score – low risk (≤3) and high risk (>3). The composite of major adverse events (MACE) consisting of: death, non-fatal re-infarction, stroke and repeat intervention at 1-month follow up was the primary endpoint. Follow up rate was 100%.

Results

There were 131 patients in the low risk and 56 in high risk groups. Males were 90% versus 80.3% in the low vs high risk group; in addition, mean age was 58.64 ± 10.6 vs 67.8± 6.24 years, respectively; mean ischemic time was 4.78± 3.03 vs 6.9 ± 3.6 hours, respectively; anterior localization was present in 32.8% vs 46.4% of the patients, respectively; 3-vessel coronary artery disease was present in 29.0% vs 46.4% of the patients, respectively; final TIMI 3 flow was present in all vs 96.4% of the patients, respectively. MACE occurred in 7 patients (3.8%) in the low risk group versus 3 patients (5.3%) in the high risk group (P = 0.63).

Conclusions

In our study population at higher Zwolle risk score was not associated with a worse early outcome among STEMI patients discharged within 72 hours.
Acute heart failure in patients with valvular infective endocarditis: a one-year consecutive cohort from a Spanish tertiary centre
Authors: Tomasino M , Fernandez Hidalgo N , Vila-Sanjuan Zamora S , Oristrell Santamaria G , Sambola Ayala A , Rodenas Alesina E , Otero Escudero M , Soriano Colome T , Pizzi M N , Rios Barrera R , Vigil Escalera Lopez C , Villamarin Melio M , Fernandez Galera R , Ferreira Gonzalez I , Rello Sabate P
Published: May 2024

Funding Acknowledgements

None.

Background

Infective endocarditis (IE) is associated with substantial morbidity and mortality. Acute decompensated heart failure (AHF) is a frequent complication of IE and it is often an indication for urgent cardiac surgery.

Purpose

The aim of this study was to describe clinical data and short term outcomes of patients admitted for valvular IE complicated with AHF.

Methods

We collected data from all the patients with IE admitted or referred to our Spanish tertiary centre from September 1st, 2022 to August 31st, 2023. Patients with non-valvular IE were not included.

Results

Two patients did not consent to participate in the study. 87 consenting patients were included. Of them, 38 (44%) presented with AHF, of whom 14 (16.1%) had acute pulmonary oedema, and 6 (6.9%) suffered cardiogenic shock. Mean age was 67.4 years old in the AHF group vs 64.0 in patients without AHF (non significant), 74% of male sex in both groups, Charlson Comorbidity Index of 4.9 vs 5.6 points (n.s.); prosthetic-valve endocarditis was more frequent in the AHF group compared to patients without AHF (42% vs 28%, p < 0.05). Urgent cardiac surgery was indicated in 91% of patients with AHF vs 44% of patients without heart failure (p < 0.01); when indicated, surgery was eventually performed in 65% vs 57% of the patients (n.s.). In AHF patients with surgical indication, in-hospital mortality rate was significantly higher in those that did not undergo surgery (64% vs 16%, p < 0.01). Compared to native-valve IE, prosthetic-valve IE was associated with higher rates of AHF (42% vs 28%, p < 0.05). In-hospital mortality rate was significantly higher in AHF patients (33.3% vs 3.0%, p < 0.01). Acute pulmonary oedema and cardiogenic shock patients had the highest in-hospital mortality (respectively, 43% and 67%). Similarly, mortality rate 30 days after hospital discharge was higher in the AHF group (16.0% vs 6.3%, p < 0.05).

Conclusions

In this population, presentation with AHF was associated with worse short-term outcomes. Surgery was indicated in the majority of AHF patients, and not performing it was associated with worse outcome.
Global longitudinal strain as a predictor of mortality in patients with cardiogenic shock
Authors: Hansen K B , Ito S , Wiggers H , Oh J K , Jentzer J C
Published: May 2024

Funding Acknowledgements

Type of funding sources: Foundation. Main funding source(s): Aarhus University Dagmar Marshalls Fond.

Background

The assessment of left ventricular (LV) function through transthoracic echocardiography (TTE) is essential for guiding diagnosis and treatment in cases of cardiogenic shock (CS). Myocardial global longitudinal strain (GLS) provides an objective and reproducible measure of systolic function, independently predicting outcomes in acute heart failure, regardless of left ventricular ejection fraction (LVEF). However, whether assessment of GLS can predict mortality in patients with CS remains unknown.

Purpose

In this study, we aimed to evaluate the prognostic significance of GLS in patients with CS.

Methods

Data from cardiac intensive care unit (CICU) patients admitted between 2007 and 2018 with CS who received vasoactive agents and/or mechanical circulatory support were analysed. GLS (as absolute values) and biplane LVEF were measured via TTE performed within 24 hours of CICU admission. Patients with CS were categorised based on the GLS quartile: mild (GLS >9.7%), moderate (7.0% < GLS <9.6%), severe (5.0% < GLS < 6.9%), and very severe (GLS ≤ 4.9%). CICU and in-hospital mortality were compared across GLS categories, and the relationship between GLS and mortality was assessed using multivariable logistic regression.

Results

The study included 626 patients with a median age of 68.6 years, a median LVEF of 31% (IQR 24 to 40%), and a median GLS of 7.0% (IQR 5.0 to 9.7%). In-hospital mortality was 29.1%. As GLS deteriorated, there was an increasing need for vasopressors (P<0.001). Patients with progressively lower GLS exhibited significantly higher CICU and in-hospital mortality across the GLS quartiles (Figure A; P<0.001). Patients in the severe (adjusted OR 2.67; p<0.001) and very severe category (adjusted OR 3.54; P<0.001) had significantly increased risk of in-hospital death compared with mild category. In multivariable analysis, every 1% decrease in GLS corresponded to a 14% higher risk of in-hospital mortality (P<0.001). Finally, GLS outperformed LVEF for discrimination of in-hospital mortality (P=0.002), and when both measurements were included in the same multivariable model, only GLS remained significant. When patients were divided according to whether they had GLS and/or LVEF below the median value, patients with low GLS had higher mortality irrespective of the LVEF (Figure B).

Conclusion

In patients with CS, GLS assessment surpasses LVEF in its prognostic value and improves risk stratification. Routine evaluation of GLS should be considered for patients with CS.Figure AFigure B
Urgent transcatheter aortic valve implantation (TAVI) is associated with increased in-hospital mortality: a systematic review and meta-analysis
Authors: Apostolos A , Ktenopoulos N , Chlorogiannis D , Katsaros O , Korovesis T , Koliastasis L , Oikonomou G , Karmpalioti M , Sakalidis A , Drakopoulou M , Tsalamandris S , Trantalis G , Aggeli C , Tsioufis C , Toutouzas K
Published: May 2024

Funding Acknowledgements

None.

Introduction

Transcatheter Aortic Valve Implantation (TAVI) is recommended for patients suffering from severe aortic stenosis (AoS) as an elective procedure. Taking into consideration that AoS is associated with acute heart failure and cardiogenic stroke resistant to pharmacotherapy, urgent TAVI might be a therapeutic option. However, a few data exist regarding its safety and efficacy against this background.

Purpose

Aim of our systematic review and meta-analysis is to compare in-hospital mortality among patients undergoing urgent and elective TAVI.

Methods

We systematically screened three major databases (Medline, Cochrane Central Register of Controlled Trials and Scopus) searching for studies comparing urgent versus elective TAVI. Primary endpoint of our systematic review and meta-analysis is the in-hospital mortality. Only studies provided data about in-hospital mortality were considered for our analysis. Secondary endpoints included acute kidney injury (AKI), permanent pacemaker implantation (PPM) and ischemic stroke. All the secondary endpoints were evaluated during the first 30-days after TAVI. Risk ratio (RR) was calculated with 95% confidence intervals (CIs) and a random-effects model (Mantel-Haenzel) was used to estimate the pooled RR.

Results

Twelve studies, all retrospective except one, published between 2014 and 2023 were included in our analysis. A total of 133,348 patients undergoing TAVI were included in our analysis; 110,606 had elective procedure and the 22,742 urgent intervention. Mortality rate was 5.1% in urgent and 2.2% in elective group. The risk of mortality is 2.38 times higher in the urgent TAVI group compared to the elective TAVI group (RR: 2.38, 95% CI: 1.80, 3.15). Data about AKI, PPM and stroke during the first 30-days were available for 12, 11 and 11 studies, respectively. The risk for AKI is significantly higher in patients having undergone urgent TAVI (RR: 2.10, 95% CI:1.62, 2.73). No significant differences were observed in stroke incidence (RR: 1.07, 95% CI: 0.97, 1.18) and PPM (RR: 1.05, 95%CI: 0.99, 1.11) during 30-days follow-up.

Conclusion

To the best of our knowledge, this is the first systematic review and meta-analysis showing that urgent TAVI is associated with significantly higher in-hospital mortality rates, compared to elective TAVI. Given these results, it is advisable to prefer an elective procedure, prior disease's worsening, in order to prevent the increased risk of in-hospital mortality associated with urgent TAVI.In-hospital mortality
Obstructive sleep apnea and acute decompensated heart failure
Authors: Kalaydzhiev P , Kinova E , Voinova G , Qkov S , Goudev A
Published: May 2024

Funding Acknowledgements

None.

Background

Acute decompensated heart failure is a condition with a high frequency of hospitalizations and mortality. Screening and treatment for obstructive sleep apnea can be helpful in these patients.

Purpose

To determine the frequency of obstructive sleep apnea in patients with acute decompensated heart failure. To add CPAP home therapy to standard medical treatment for heart failure. To follow patients for 1 year.

Methods

We conducted a single-centre, prospective cohort study form 150 consecutive patients hospitalized for exacerbation heart failure in the cardiology department. 81 patients meet inclusion criteria – Apnea-Hypopnea index (AHI) > 5, Epworth Sleepiness Scale (ESS) > 8, NYHA class II/III and NTproBNP>900 pg/ml. Patients with OSA were offered to purchase a CPAP device for the home. They were divided into two groups with CPAP and no-CPAP. All patients receiving optimal medical treatment. The follow-up period was 1 year. At the end of the period, patients underwent a physical examination, an echocardiography, and ESS. In the non-CPAP group, 29 patients were followed up and 13 patients dropped out due to mortality. In the CPAP group, 16 patients were followed up, with 1 dropped out. Sleep apnea screening was performed with ApneaLinkTM. Echocardiographic assessment of left ventricular ejection fraction (LVEF) and the E/e‘m ratio.

Results

From 81 with sleep apnea 72.8% (n=59) has obstructive sleep apnea (OSA) and 27.2% (n=22) has central sleep apnea (CSA). Of the 59 patients with OSA, 17 patients (28.8%) purchased a device and continued therapy at home, while 42 patients (71.2%)on optimal drug therapy without CPAP. There is a statistically significant difference in BMI in the group with CPAP compared to the no-CPAP group at the beginning and at the end of the follow-up (CPAP group at the start 36.47±7.3 vs. the end 33.3±5.7, p=0.001 and no-CPAP group at the start 36.35±7.34 vs. the end 35.74±7.46 , p=0.356). A similar relationship is found in systolic blood pressure(SBP) and diastolic blood pressure(DBP). SBP in CPAP group at start 136.2±6.2 mmHg vs. end 123.1±5.9 mmHg; р<0.001. relative to no-CPAP group – start 131.2±9.8 mmHg vs. end 131.3±7.7 mmHg; р=0.965. DBP in CPAP group at start 85.9±6.7 mmHg vs. end 77.3±5.3 mmHg; р<0.001 and no-CPAP group start 82.1±7.4 mmHg vs. end 81.7±5.7 mmHg, р=0.644. There is a significant change in LVEF between the two groups at the beginning and at the end of the follow-up (in CPAP group at start 47.5±8.7, vs. at end 50.07±7.5; р=0.005, between no-CPAP at start 52.5±6.9 vs. at end 52.2±7.1; р=0.389). The CPAP group had a median survival of 11.7 months vs. 10.1 months in no CPAP group(Log Rank (Mental-Cox) p=0.044 ).

Conclusion

Obstructive sleep apnea is a common comorbidity in patients with acute decompensated heart failure. The addition of CPAP therapy in these patients improved BMI, SBP, DBP and increases LVEF. All this improves the prognosis for these patients.
C-reactive protein level at admission is associated with increased mortality in critically ill cardiac patients with heparin-induced thrombocytopenia
Authors: Szyda L , Kasprzak J D
Published: May 2024

Funding Acknowledgements

None.

Introduction

Heparin-induced thrombocytopenia (HIT) is a rare immune-mediated disorder related to the use of unfractionated heparin or low-molecular weight heparin. As heparin is commonly used in critically ill cardiac patients, HIT consititute a relevant clinical issue in the intensive cardiac care unit. Despite this, there isn't any known factor that could predict mortality in acute cardiac patients with heparin-induced thrombocytopenia.

Purpose

The purpose of our study was to verify if any clinical or laboratory factor could predict mortality in critically ill cardiac patients with heparin-induced thrombocytopenia.

Methods

We retrospectively collected data of all patients with HIT who were hospitalized in our intensive cardiac care unit in 2016-2023. We had used functionalized latex immunoassay to confirm the diagnosis of HIT. We performed statistical analysis including clinical and laboratory variables to find any predictor of mortality in critically ill cardiac patients with HIT.

Results

Among 22 483 patients hospitalized in 2016-2023 in our department of cardiology 12 were diagnosed with HIT. 4 of them died during index hospitalization and 8 survived. Among clinical and laboratory characteristics only C-reactive protein level at admission was associated with increased mortality in acute caridac patients with HIT. Non-survivors had higher CRP levels at admission as compared to survivors, 190 [125-247] mg/l vs. 22 [9-71] mg/l respectively (p = 0,03).

Conclusions

C-reactive protein level at admission is associated with increased mortality in critically ill cardiac patients with HIT. Initial underlying systemic inflammatory response may constitute the precipitating factor of unfavorouble outcome in acute cardiac patients with heparin-induced thrombocytopenia. Further studies are necessary to confirm these findings.
MINOCA, experience of a single tertiary center with a high volume of ACS
Authors: Dibra L , Zaimi G , Pavli E , Gjergo H , Gjana A , Kristo A , Katana E , Tafaj E , Kastrati A , Dibra A
Published: May 2024

Funding Acknowledgements

None.

Introduction

Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a clinical entity for which there is limited evidence regarding the clinical data and prognosis.

Purpose

To evaluate epidemiological and clinical characteristics as well as short-term outcomes of patients with MINOCA presented at a university hospital center with high volume percutaneous coronary intervention (PCI).

Methods

We evaluated 1035 consecutive patients admitted to our hospital with acute myocardial infarction from June 2022 to January 2023 who underwent invasive evaluation. In-hospital and follow-up data after 30 and 90 days were collected. Primary endpoint was occurrence of a major adverse cardiovascular and cerebrovascular event (composite of cardiovascular death, cerebrovascular accident, re-hospitalization for non-fatal myocardial infarction, re-hospitalization for heart failure, malignant ventricular arrhythmia). Secondary endpoints were improvement in left ventricular ejection fraction and angina status at 30 and 90 days follow-up.

Results

Among patients presented with acute myocardial infarction, 8.5% (88 patients) were diagnosed with MINOCA. Mean age was 60.9 years and 61.4% were females. Arterial hypertension was present in 86.4%, hypercholesterolemia in 38.6%, diabetes in 12.5% of the patients. Smokers were 29.5% of them. During hospitalization 14.7% had a major adverse cardiovascular event, cardiovascular death occurred in 1.1%, cerebrovascular accident in 1.1%, acute heart failure in 12.5% and malignant ventricular arrhythmia in 1.1%. Primary endpoint at 30 and 90 days follow-up occurred in 10.3% and 13.7% respectively. At 30 days follow-up there was no cardiovascular death, cerebrovascular accident or malignant ventricular arrhythmia; re-hospitalization for MI was 5.7% and re-hospitalization for heart failure was 4.6%. At 90 days follow-up there was no cardiovascular death, cerebrovascular accident or malignant ventricular arrhythmia; re-hospitalization for MI occurred in 8%, re-hospitalization for heart failure in 5.7%. In regard to secondary endpoints, 24.1% experienced angina, while at 30 days and 90 days follow, 66.7% and 72.2% respectively had improvement of left ventricle EF.

Conclusions

In our study we found a high incidence of MINOCA affecting more frequently female patients. Angina at short term follow up was frequently recorded among out study population.
Acute kidney injury in patients with acute coronary syndrome - risk profile
Authors: Bogevska-Naumovska I , Vraynko E , Dobjani A , Shehu E , Taravari H , Andova V , Pejkov H , Vavlukis M , Pocesta B
Published: May 2024

Funding Acknowledgements

None.

Introduction

Acute kidney injury (AKI) is a strong predictor of in-hospital adverse outcomes, which is a common complication of acute coronary syndrome (ACS).

Aim

To analyse the risk profile of patients treated for acute coronary syndrome who develop acute kidney injury.

Material and methods

This is a single-centre cross-sectional cohort study on 3507 patients with ACS. The main exclusion criteria was left ventricular dysfunction. Demographical and clinical characteristics, biochemical parameters, the anatomical distribution of coronary artery disease (CAD) and the final outcomes were analysed according to RF at the moment of the indexed event. The estimated glomerular filtration rate (eGFR) was calculated by the Modification of Diet in Renal Disease Study Group Equation (MDRD), where patients with eGFR<60ml/min 1.73 m2 had moderate to severe renal dysfunction.

Results

74 (2.1%) out of 3507 patients developed acute kidney injury (AKI). Those were predominantly males [62.2% (46), OR 1.55 (95% CI 0.98-2.47), p=0.044], significantly older (68.95±9.9. vs 62.5±11.2; p <0.000001), more often with preexisting HBI (OR 4.72 (95% CI 2.20-10.30, p=0.000070), HTA(OR 1.89 95%CI 1.11-3.23, p=0.020), diabetes(OR 1.88 95%CI 1.18-3.00, p=0.008), cancer(OR 2.92 95%CI 1.15-7.44, p=0.024), anaemia (beta -.104, p=0.000032), while less often were smokers (OR 0.51, 95% CI 0.31-0.83, p=0.006). They had statistically significantly higher values of cardiac troponin (beta .075, p=0.000011), stress glycemia (beta .104, p=0. 0.000019), and WBC (beta .074, p=0.000013), higher BUN (beta .325, p=0.000011), creatinine (beta .268, p=0.000016), and lower eGFR at admission (beta -.211, p=0.000032), lower sodium (beta -.101, p=0.000012), and higher potassium levels (beta .087, p=0.0008). Vice versa, total cholesterol, LDL-C and non-HDL-C (beta -.051, p=0.002, -.049, p=0.003, and -.047, p=0.005 respectively), were lower, the same for Hgb (beta -.107, p=0.000021). It is worth mentioning that 18(11.5%), of AKI patients were not PCI treated. Independent variables associated with AKI were: preexisting renal failure, cancer, and WBC. Outcomes: AKI carried a significantly higher in-hospital mortality rate (4.2% in general population, and 21.1% of all deaths were AKI patients, OR 23.01 (95% CI 14.04-47.03, p=0.00002)]. It was significantly associated with the development of pulmonary oedema (OR 17.94, 95% CI 9.67-33.26, p=0.000012), cardiogenic shock (OR 21.59, 95% CI 12.79-36.47, p=0.00006), any type of dysrhythmia (OR 1.83, 95%CI 1.53-2.18, p=0.0001), and any type of bleeding complications (OR 1.61, 95%CI 1.14-2.27, p=0.007).

Conclusion

AKI is a relatively rare complication in ACS patients, however is associated with significant in-hospital morbidity and mortality. Patients with pre-existing renal failure, and cancer, as well as patients who developed more pronounced inflammatory reaction were more prone to AKI.
Fair Pension Policies with Occupation-Specific Ageing
Authors: Grossmann Volker , Schünemann Johannes , Strulik Holger
Published: May 2024

We study the optimal design of a fair public pension system in a multi-period overlapping generations model with occupation-specific morbidity and mortality that depends on the retirement age. The fairness constraint acts as institutional device ensuring that lifetime returns to contributions are equal across occupational groups. We consider group-specific replacement rates and a calculatory interest rate for early contributions as policy instruments. Calibrating the model to Germany, we find that the transition to optimal fair pension policies may induce early retirement of blue-collar workers and significantly raises their lifetime pension benefits and welfare. Aggregate welfare increases in all fair pension scenarios.
The Uncontrollable Mortality Risk Hypothesis
Authors: Brown Richard D , Pepper Gillian V
Published: May 2024

The ‘Uncontrollable Mortality Risk Hypothesis’ employs a behavioural ecological model of human health behaviours to explain the presence of social gradients in health. It states that those who are more likely to die due to factors beyond their control should be less motivated to invest in preventative health behaviours. We outline the theoretical assumptions of the hypothesis and stress the importance of incorporating evolutionary perspectives into public health. We explain how measuring perceived uncontrollable mortality risk can contribute towards understanding socioeconomic disparities in preventative health behaviours. We emphasize the importance of addressing structural inequalities in risk exposure, and argue that public health interventions should consider the relationship between overall levels of mortality risk and health behaviours across domains. We suggest that measuring perceptions of uncontrollable mortality risk can capture the unanticipated health benefits of structural risk interventions, as well as help to assess the appropriateness of different intervention approaches.
How researchers can translate health evidence into books for children
Authors: Walsh Erin I , Sargent Ginny M , Gooyers Laura , Masters Jessica , Laachir Karima , Vardoulakis Sotiris
Published: May 2024

The health promotion literature that considers how scientific evidence can be effectively communicated tends to focus on evaluating the effectiveness of communication materials. This has resulted in a knowledge gap regarding effective knowledge translation processes. This study explores the process, reasoning and practices for developing books for children that incorporate evidence-based information to aid understanding of scientific evidence about health and environmental or natural disasters. This study is informed by a systematic review of the literature combined with responses to an email interview with authors of books for children. Nine published studies were included in the systematic review. Twenty-two authors responded to the email survey (25% response rate, following 86 invitations). We report seven key findings to guide the development of health-promoting books for children: (i) understand the needs and expectations of the audience, (ii) articulate the topic and research evidence, (iii) assemble a team with a mix of content knowledge and creative expertise, (iv) format should be chosen to suit the user group and guided by the creative team, (v) early testing with children and their support system is crucial, (vi) develop a dissemination strategy to reach the user group and (vii) engage in reflexivity through evaluation of effectiveness of messaging. The current investigation can guide the process, reasoning and practice of developing books for children that incorporate evidence about health and environmental disasters.
Atlas asunder? Neo-liberal think tanks and the radical right
Authors: Vucetic Srdjan
Published: May 2024

How are neoliberal thought leaders reacting to the rise of radical conservatism? Looking at Atlas, a worldwide network comprising approximately 500 free market think tanks and campaign groups, this study examines how its affiliates prioritize threats. This is accomplished through a qualitative analysis of a sample of documents that Atlas partners published on their websites from 2017 to 2022. The findings range from expected to puzzling. First, there is a reliable adherence to core neo-liberal ideas such as globalization and marketization. Second, explicit evidence of ideological tension is scarce, as only a few think tanks openly signal alignment with illiberal and authoritarian positions. However, as a whole, the network appears consistently—and wilfully—apathetic towards the radical right. This indifference contrasts with the vigour and regularity with which the network confronts left-of-center ideas, parties and governments. Delving into this contrast and its political implications, the study highlights the twin concepts of strategic and selective ignorance and considers their analytical potential.
Manipulating Public Beliefs about Alliance Compliance: A Survey Experiment
Authors: Reiter Dan , Greenhill Brian
Published: May 2024

Conventional wisdom on alliances proposes that leaders comply with alliances because the public opposes violating alliance commitments. However, this assumes that the public can easily judge whether or not a particular policy violates an alliance treaty. This article challenges this assumption and develops a theory that elites have the opportunity to shape public understanding as to whether an action violates an alliance treaty. It shows that while alliance commitments continue to have an important impact on public opinion, signals from unified elites can significantly reduce public pressure to support an ally by arguing that the alliance treaty does not create a legal obligation to intervene. In a pair of experiments on large samples of American adults, we found that a unified signal from the president and the Senate opposition leader can significantly reduce support for sending troops to the embattled ally. Consistent with elite cueing theory, the president’s ability to move public opinion in this manner is eliminated if the Senate opposition leader disagrees with his argument.
Death, Grief, and Mourning in an ICTY Film: Exploring Relational and Non/Living Worlds
Authors: Biddolph Caitlin
Published: May 2024

International criminal justice is filled with living, dead, and dying bodies. While witnesses detail atrocities in the courtroom, such testimonies are largely considered for their evidentiary value to establish innocence or guilt. In this article, I explore how death, grief, and mourning are represented at the International Criminal Tribunal for the former Yugoslavia (ICTY). I focus on the ICTY documentary, Crimes Before the ICTY: Višegrad, to analyse how filmic representations of international criminal justice register dead, dying, and grieving bodies. Drawing on Queer Death Studies and relational ontologies, I explore the more-than-human and non/living worlds through which death, grief, and mourning are represented in the film. A queer relational approach reveals and challenges the construction of the dead as evidence and death worlds as crime scenes. This approach illuminates how the natural world and buildings, bridges, and artifacts are vestiges, witnesses, and sites of death and grief in Višegrad. My analysis explores how these representations in the ICTY documentary reinforce civilizational logics and reductive representations of violence at the same time as they illuminate relational encounters of death and dying in international criminal justice, thus enriching attempts to see, know, and feel loss in the wake of violence.
Carbon capture and utilization under EU law: impermanent storage of CO2 in products and pre-combustion carbon capture
Authors: Talus Kim , Maddahi Reza
Published: May 2024

The evolving regulatory landscape within the European Union demonstrates a transition from prioritizing carbon capture and storage over carbon capture and utilization towards a more equitable treatment of both approaches in relevant legislation and policy frameworks. Nevertheless, the ‘permanence’ criterion of carbon dioxide in the products remains an ongoing challenge. Within the current European legal framework, harnessing the regulatory incentives depends on how long carbon dioxide remains in carbon capture and utilization products. The study elucidates the evolving regulatory landscape surrounding carbon capture and utilization by examining recent legislative initiatives and amendments to key directives such as the Emissions Trading System Directive and the Renewable Energy Directive. Furthermore, it explores the implications of the European Union Net-zero Industry Act and the Carbon Removal Certification Framework. In addition, this article examines and explains the need for expanding the scope of carbon capture and utilization and storage by incorporating pre-combustion carbon capture through methane splitting into the definition.
Histone modifications affecting plant dormancy and dormancy release: common regulatory effects on hormone metabolism
Authors: Sato Hikaru , Yamane Hisayo
Published: May 2024

As sessile organisms, plants enter periods of dormancy in response to environmental stresses to ensure continued growth and reproduction in the future. During dormancy, plant growth is suppressed, adaptive/survival mechanisms are exerted, and stress tolerance increases over a prolonged period until the plants resume their development or reproduction under favorable conditions. In this review, we focus on seed dormancy and bud dormancy, which are critical for adaptation to fluctuating environmental conditions. We provide an overview of the physiological characteristics of both types of dormancy as well as the importance of the phytohormones abscisic acid and gibberellin for establishing and releasing dormancy, respectively. Additionally, recent epigenetic analyses have revealed that dormancy establishment and release are associated with the removal and deposition of histone modifications at the loci of key regulatory genes influencing phytohormone metabolism and signaling, including DELAY OF GERMINATION 1 and DORMANCY-ASSOCIATED MADS-box genes. We discuss our current understanding of the physiological and molecular mechanisms required to establish and release seed dormancy and bud dormancy, while also describing how environmental conditions control dormancy depth, with a focus on the effects of histone modifications.
Massive compact quiescent galaxies in the M⋆ versus σe plane: insights from stellar population properties
Authors: Clerici K Slodkowski , Schnorr-Müller A , Trevisan M , Ricci T V
Published: May 2024

We investigated the stellar population properties of a sample of 1858 massive compact galaxies (MCGs) extracted from the Sloan Digital Sky Survey (SDSS). Motivated by previous results showing that older compact galaxies tend to have larger velocity dispersion at fixed stellar mass, we used the distance to the σe versus Re and M⋆ versus σe relations as selection criteria. We found that MCGs are old (≳10 Gyr), α-enhanced ([α/Fe] ∼ 0.2), and have solar to supersolar stellar metallicities. Metallicity increases with σe, while age and [α/Fe] do not vary significantly. Moreover, at fixed σe, metallicity and stellar mass are correlated. Compared with a control sample of typical quiescent galaxies, MCGs have, on average, lower metallicities than control sample galaxies (CSGs) of similar σe. For σe ≲ 225 km s−1, MCGs are older and more α-enhanced than CSGs, while for higher σe ages and α-enhancement are similar. The differences in age and α-enhancement can be explained by lower σe CSGs being an amalgam of quiescent galaxies with a variety of ages. The origin of the differences in metallicity, however, is not clear. Lastly, we compared the stellar mass within the region probed by the SDSS fibre finding that, at fixed fibre velocity dispersion, MCGs have lower stellar masses on average. Since the velocity dispersion is a tracer of the dynamical mass, this raises the possibility that MCGs have, on average, a bottom-heavier initial mass function or a larger dark matter fraction within the inner ∼1−2 kpc.
Noncoding RNA Terc-53 and hyaluronan receptor Hmmr regulate aging in mice
Authors: Wu Sipeng , Cai Yiqi , Zhang Lixiao , Li Xiang , Liu Xu , Zhou Guangkeng , Luo Hongdi , Li Renjian , Huo Yujia , Zhang Zhirong , Chen Siyi , Huang Jinliang , Shi Jiahao , Ding Shanwei , Sun Zhe , Zhou Zizhuo , Wang Pengcheng , Wang Geng
Published: May 2024

One of the basic questions in the aging field is whether there is a fundamental difference between the aging of lower invertebrates and mammals. A major difference between the lower invertebrates and mammals is the abundancy of noncoding RNAs, most of which are not conserved. We have previously identified a noncoding RNA Terc-53 that is derived from the RNA component of telomerase Terc. To study its physiological functions, we generated two transgenic mouse models overexpressing the RNA in wild-type and early-aging Terc−/− backgrounds. Terc-53 mice showed age-related cognition decline and shortened life span, even though no developmental defects or physiological abnormality at an early age was observed, indicating its involvement in normal aging of mammals. Subsequent mechanistic study identified hyaluronan-mediated motility receptor (Hmmr) as the main effector of Terc-53. Terc-53 mediates the degradation of Hmmr, leading to an increase of inflammation in the affected tissues, accelerating organismal aging. adeno-associated virus delivered supplementation of Hmmr in the hippocampus reversed the cognition decline in Terc-53 transgenic mice. Neither Terc-53 nor Hmmr has homologs in C. elegans. Neither do arthropods express hyaluronan. These findings demonstrate the complexity of aging in mammals and open new paths for exploring noncoding RNA and Hmmr as means of treating age-related physical debilities and improving healthspan.
The Impact of Climate Change on Work: Lessons for Developing Countries
Authors: Feriga Moustafa , Gracia Nancy Lozano , Serneels Pieter
Published: May 2024

We identify five areas where climate change may impact work and draw lessons for developing countries by reviewing the evidence. Firstly, demand for labor is unevenly affected, with agriculture, heat-exposed manufacturing, and the brown energy sector experiencing downturns, while other sectors may see a rise, resulting in an uncertain overall impact. Secondly, climate change impacts labor supply through absenteeism, shirking, and altering work-time patterns, depending on the activity and sector. Thirdly, productivity may decline, especially in heat-exposed industries, primarily due to health reasons. Fourthly, heightened earnings variability likely increases vulnerability among the self-employed. Fifthly, climate change can influence labor allocation and catalyze sectoral reallocation. Higher temperatures are also linked to increased migration. But caution is needed in interpreting these findings, as studies across these topics predominantly use fixed effect estimation and concentrate on short-term impacts, neglecting adaptation. Emerging research on adaptation indicates that workplace cooling is unappealing for firms with narrow profit margins, while coping strategies of farms and households have unclear optimality due to adoption barriers. Government responses remain understudied, with six potential areas identified: green jobs, green skills, labor-oriented adaptation, flexible work regulation, labor market integration, and social protection. We conclude by outlining future research directions.
A Loop-Mediated Isothermal Amplification (LAMP) Assay for the Detection of Bremia lactucae in the Field
Authors: Farmer Alicia A. , Brierley Jennie L. , Lynott James S. , Lees Alison K.
Published: May 2024

A real-time loop-mediated isothermal amplification (LAMP) assay for the detection of Bremia lactucae, the causal pathogen of lettuce downy mildew, was developed and validated to aid in-field detection of airborne inoculum. Assay specificity was confirmed against a range of other pathogenic oomycete and fungal spp., and sensitivity of the assay for the detection of DNA extracted from sporangia was evaluated. The B. lactucae LAMP assay reliably detected DNA equivalent to 1 spore/reaction (16.7 pg DNA/reaction). Following extraction of DNA from Rotorod air samplers, to which sporangial suspensions were added, the assay reliably detected 25 sporangia/Rotorod. Detection of airborne inoculum of B. lactucae collected through the season from air samplers deployed in-field in plots infected with B. lactucae and in commercial lettuce fields in Scotland over two growing seasons was assessed. The method can be deployed on samples collected from commercial lettuce production to inform disease management strategies and limit the use of unnecessary prophylactic pesticide applications.
A Synoptic Review of Plant Disease Epidemics and Outbreaks Published in 2022
Authors: Fielder Hannah , Beale Tim , Jeger Michael J. , Oliver Gabriella , Parnell Stephen , Szyniszewska Anna M. , Taylor Philip , Cunniffe Nik J.
Published: May 2024

This scientometric study reviews the scientific literature and CABI distribution records published in 2022 to find evidence of major disease outbreaks and first reports of pathogens in new locations or on new hosts. This is the second time we have done this, and this study builds on our work documenting and analyzing reports from 2021. Pathogens with three or more articles identified in 2022 literature were Xylella fastidiosa, Bursaphelenchus xylophilus, Meloidogyne species complexes, ‘ Candidatus Liberibacter asiaticus’, Raffaelea lauricola, Fusarium oxysporum formae specialis, and Puccinia graminis f. sp. tritici. Our review of CABI distribution records found 29 pathogens with confirmed first reports in 2022. Pathogens with four or more first reports were Meloidogyne species complexes, Pantoea ananatis, grapevine red globe virus, and Thekopsora minima. Analysis of the proportion of new distribution records from 2022 indicated that grapevine red globe virus, sweet potato chlorotic stunt virus, and ‘ Ca. Phytoplasma vitis’ may have been actively spreading. As we saw last year, there was little overlap between the pathogens identified by reviewing scientific literature versus distribution records. We hypothesize that this lack of concordance is because of the unavoidable lag between first reports of the type reported in the CABI database of a pathogen in a new location and any subsequent major disease outbreaks being reported in the scientific literature, particularly because the latter depends on the journal policy on types of papers to be considered, whether the affected crop is major or minor, and whether the pathogen is of current scientific interest. Strikingly, too, there was also no overlap between species assessed to be actively spreading in this year's study and those identified last year. We hypothesize that this is because of inconsistencies in sampling coverage and effort over time and delays between the first arrival of a pathogen in a new location and its first report, particularly for certain classes of pathogens causing only minor or non-economically damaging symptoms, which may have been endemic for some time before being reported. In general, introduction of new pathogens and outbreaks of extant pathogens threaten food security and ecosystem services. Continued monitoring of these threats is essential to support phytosanitary measures intended to prevent pathogen introductions and management of threats within a country.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
Development and Validation of an Automated, Real-Time Predictive Model for Postpartum Hemorrhage
Authors: Ende Holly B. , Domenico Henry J. , Polic Aleksandra , Wesoloski Amber , Zuckerwise Lisa C. , Mccoy Allison B. , Woytash Annastacia R. , Moore Ryan P. , Byrne Daniel W.
Published: May 2024

OBJECTIVE:

To develop and validate a predictive model for postpartum hemorrhage that can be deployed in clinical care using automated, real-time electronic health record (EHR) data and to compare performance of the model with a nationally published risk prediction tool.

METHODS:

A multivariable logistic regression model was developed from retrospective EHR data from 21,108 patients delivering at a quaternary medical center between January 1, 2018, and April 30, 2022. Deliveries were divided into derivation and validation sets based on an 80/20 split by date of delivery. Postpartum hemorrhage was defined as blood loss of 1,000 mL or more in addition to postpartum transfusion of 1 or more units of packed red blood cells. Model performance was evaluated by the area under the receiver operating characteristic curve (AUC) and was compared with a postpartum hemorrhage risk assessment tool published by the CMQCC (California Maternal Quality Care Collaborative). The model was then programmed into the EHR and again validated with prospectively collected data from 928 patients between November 7, 2023, and January 31, 2024.

RESULTS:

Postpartum hemorrhage occurred in 235 of 16,862 patients (1.4%) in the derivation cohort. The predictive model included 21 risk factors and demonstrated an AUC of 0.81 (95% CI, 0.79–0.84) and calibration slope of 1.0 (Brier score 0.013). During external temporal validation, the model maintained discrimination (AUC 0.80, 95% CI, 0.72–0.84) and calibration (calibration slope 0.95, Brier score 0.014). This was superior to the CMQCC tool (AUC 0.69 [95% CI, 0.67–0.70], P<.001). The model maintained performance in prospective, automated data collected with the predictive model in real time (AUC 0.82 [95% CI, 0.73–0.91]).

CONCLUSION:

We created and temporally validated a postpartum hemorrhage prediction model, demonstrated its superior performance over a commonly used risk prediction tool, successfully coded the model into the EHR, and prospectively validated the model using risk factor data collected in real time. Future work should evaluate external generalizability and effects on patient outcomes; to facilitate this work, we have included the model coefficients and examples of EHR integration in the article.