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Evaluation of vascular aging on measures of cardiac function and mechanical efficiency: insights from
Get PDFINTRODUCTION: This study evaluated the hypothesis that vascular aging (VA) reduces ventricular contractile function and mechanical efficiency (ME) using the left ventricular pressure-volume (PV) construct.
METHODS: A previously published in-silico computational model (CM) was modified to evaluate the hypothesis in two phases. In phase I, the CM included five settings of aortic compliance (CA) from normal to stiff, studied at a heart rate of 80 bpm, and phase II included the normal to stiff CA settings evaluated at 60, 100, and 140 bpm. The PV construct provided steady-state and transient data through a simulated vena caval occlusion (VCO). The steady-state data included left ventricular volumes (EDV and ESV), stroke work (SW), and VCO provided the PV area (PVA) data in addition to the three measures of contractile state (CS): end-systolic pressure-volume relationship (ESPVR), dP/dtmax-EDV and preload recruitable stroke work (PRSW). Finally, ME was calculated with the SW/PVA parameter.
RESULTS: In phase I, EDV and ESV increased, as did SW and PVA. The impact on the CS parameters demonstrated a small decrease in ESPVR, no change in dP/dtmax-EDV, and a large increase in PRSW. ME decreased from 71.5 to 60.8%, respectively. In phase II, at the normal and stiff CA settings, across the heart rates studied, EDV and ESV decreased, ESPVR and dP/dtmax-EDV increased and PRSW decreased. ME decreased from 76.4 to 62.6% at the normal CA and 65.8 to 53.2% at the stiff CA.
DISCUSSION: The CM generated new insights regarding how the VA process impacts the contractile state of the myocardium and ME
ursaPGx: a new R package to annotate pharmacogenetic star alleles using phased whole-genome sequencing data.
Get PDFLong-read sequencing technologies offer new opportunities to generate high-confidence phased whole-genome sequencing data for robust pharmacogenetic annotation. Here, we describe a new user-friendly R package, ursaPGx, designed to accept multi-sample phased whole-genome sequencing data VCF input files and output star allele annotations for pharmacogenes annotated in PharmVar
The Correlation of Consistent Exercise with Depressive Symptoms
Get PDFBackground: Depression is a major health issue that affects an estimated 350 million people worldwide. Typically, depression is associated with individuals who follow a poor diet and are physically inactive. Exercise is one form of treatment for depression and has been shown to reduce the risk of depression and protect against the onset of depression. The PHQ-9 Depression Score is a tool used to screen individuals for depression on a scale from 0-27. The goal of this study is to identify a relationship between consistent exercise and depression symptoms.
Methods: An original Qualtrics survey was created to be distributed with an informational flier to gyms and family medicine offices in the South Jersey area, as well as various social media sites. Data collection began on June 1st, 2023, and ended on July 3rd, 2023. The data was analyzed using SPSS, where statistical tests were performed to evaluate correlations.
Results: Results from the survey were reported using Spearman Rank Correlations and distribution charts. Gender, race, years of exercise, days per week of exercise, length of exercise sessions, and total types of exercise were correlated with total PHQ-9 scores.
Discussion: Results showed that female participants and those who are not Caucasian had higher PHQ-9 scores. Total years of exercise, days per week of exercise, length of exercise sessions, and total types of exercise were associated with lower PHQ-9 scores.
Conclusion: Exercising consistently with longer sessions and a wide variety of types of exercise can help reduce symptoms of depression
Atypical Case of Recurrent Saddle Pulmonary Embolism with Associated Chronic Hypoxia
Get PDFA saddle pulmonary Embolism (PE) represents a blood clot within the pulmonary artery vasculature that lodges itself between both the left and right pulmonary artery. They can be described as being massive or sub-massive. Massive PE’s cause large clot burden that puts the patient risk for sudden hemodynamic collapse, while sub-massive saddle PE’s typically do not cause hemodynamic collapse nor significant cardiac effects, such as right heart dysfunction. As clinicians, we need to be vigilant about whether a patient is placed into that criteria of sub-massive or massive and act quickly to start management that could be lifesaving
Sex Differences in Outcomes Among Patients Who Underwent Cardiac Ablation: A Retrospective Cohort Study
Get PDFBackground Cardiac ablation, encompassing radiofrequency and cryoablation modalities, is a therapeutic intervention targeting abnormal heart rhythms by disrupting electrical pathways within the heart. Despite its widespread use, research focusing on sex-specific outcomes among patients undergoing cardiac ablation remains limited. Understanding potential sex differences in treatment response and outcomes is crucial for optimizing patient care and outcomes.1,2 Therefore, this retrospective cohort study aimed to analyze the national inpatient sample database to assess in-hospital outcomes among patients undergoing cardiac ablation, specifically focusing on sex disparities.
Methods Data from the National Inpatient Sample (NIS) Database for the years 2019 and 2020 were utilized to identify hospitalizations of female patients who underwent cardiac ablation based on international classification of diseases 10th revision codes. Multivariate logistic regression was employed to adjust for confounding variables, with inpatient mortality as the primary outcome measure. Statistical analyses were conducted using SPSS software.
Results The study cohort comprised 25,754 patients who underwent cardiac ablation, including 9,616 (37.3%) females. Female patients undergoing cardiac ablation exhibited a higher prevalence of hypertension (66.8% vs. 51%, P\u3c0.001) and chronic kidney disease (35.2% vs. 23.6%, P\u3c0.001) compared to their male counterparts. In-hospital mortality was significantly elevated among female patients (1.3% vs. 1.2%, P\u3c0.001). Multivariate regression analysis revealed that female patients had a higher risk of inpatient mortality (OR 1.446, 95% CI 1.355-1.542, P\u3c0.001) and increased odds of adverse events including ventricular arrhythmia, acute kidney failure, stroke, and deep vein thrombosis.
Conclusions This nationally representative retrospective cohort study highlights the association between female sex and heightened mortality, as well as worse outcomes, among patients undergoing cardiac ablation. These findings emphasize the importance of considering sex-specific factors in treatment strategies to optimize outcomes and minimize disparities in cardiac care.
References 1.Redfearn DP, et al. Sex Differences in Outcomes After Ablation for Atrial Fibrillation: A Systematic Review and Meta-analysis. JACC Clin Electrophysiol. 2019;5(3):296-305. 2.Blomström-Lundqvist C, et al. 2020 ESC Guidelines for the Diagnosis and Management of Atrial Fibrillation Developed in Collaboration with the European Association for Cardio- Thoracic Surgery (EACTS). Eur Heart J. 2021;42(5):373-498
Social Media Addiction Affecting Mental Health of College Women
Get PDFIn our digital society, many teenagers and young adults use the many forms of social media, which are applications that enable users to create, share, and view content. Addiction to sites such as Instagram, TikTok, and Snapchat is a rising concern due to the impact it has on the mental health of young women, particularly those aged 18-25. Addiction can result in spending an unreasonable amount of time on social media, being overly preoccupied with social media content, or having day-to-day activities that revolve around social media usage. Different sources of data were reviewed to understand why mental health concerns such as anxiety, depression, and low self-esteem are common among those who are heavy social media users. Gaining a better understanding of why addiction to social media creates issues for college women allows for the opportunity to develop possible solutions that could improve the well-being of those affected
Ultrasound versus Radiography for Evaluating Surgical Necrotizing Enterocolitis
Get PDFPurpose:
Necrotizing enterocolitis (NEC) is an abdominal inflammatory condition that is common in premature neonates. Although abdominal radiograph (AR) remains the imaging standard for NEC, it may miss up to 50% of early signs of NEC and has been described to have a sensitivity as low as 15.4% for detecting pneumoperitoneum. Abdominal ultrasound (US) is portable, non-invasive, and allows real-time bowel integrity, movement, and perfusion assessment. We aim to evaluate the concordance between US and AR in detecting NEC features and the diagnostic performance of both modalities in detecting pneumoperitoneum.
Methods and materials:
We conducted an IRB-approved retrospective, cross-sectional, single-center study. We identified infants with a diagnosis of NEC confirmed by pathology reports that had a bowel US and AR studies obtained before surgery from January 2012 to August 2022. We extracted clinical and demographic data from our electronic chart system. Two pediatric radiologists, blinded to reports, evaluated the images to determine the presence of pneumatosis (PI), portal vein gas (PVG), bowel distension (BD), and pneumoperitoneum on both modalities. A third pediatric radiologist resolved discrepant responses. We calculated the diagnostic performance of both modalities to detect perforation based on the presence of pneumoperitoneum, and the concordance between them utilizing the kappa statistic (κ). We excluded studies with insufficient diagnostic quality.
Results
Our cohort included 9 girls and 22 boys, median age 23 days (IQR 14.5-55 days). Of those, 23 (76%) were born prematurely, and 20 had confirmed intestinal perforation. US demonstrated 35% sensitivity and 90% specificity, while AR demonstrated 15% sensitivity and 100% specificity. Agreement between US and AR was 10/30 (33.3%) for PI (κ=0.01), 22/28 (79%) for PVG (κ=0.2), 19/31 (61%) for BD (κ=0.21), and 24/31 (77%) for pneumoperitoneum (κ=0.34). Each feature was present more frequently on US than AR.
Conclusion:
Our study demonstrated that abdominal US was a valuable complementary tool for detecting NEC features and intestinal perforation. Despite a low to moderate agreement between both modalities, US consistently outperformed AR in identifying NEC features, including pneumoperitoneum. These findings highlight the significance of integrating US into the NEC diagnostic process and the need for revising the current NEC diagnostic algorithm. Future efforts include larger cohorts and a collaborative approach to improve the NEC diagnostic algorithm
Barriers Experienced by First Nations Deaf People in the Justice System
Get PDFAnecdotal evidence strongly suggests that members of the First Nations Deaf community experience more barriers when engaging with the criminal justice system than those who are not deaf. Therefore, our purpose for writing this article is to highlight legal and policy issues related to First Nations Deaf people, including perspectives of professionals working with these communities, living in Australia who have difficulty in accessing supports within the criminal justice system. In this article, we present data from semi-structured qualitative interviews focused on four key themes: (a) indefinite detention and unfit to plead, (b) a need for an intersectional approach to justice, (c) applying the maximum extent of the law while minimizing social services–related resources, and (d) the need for language access and qualified sign language interpreters. Through this article and the related larger sustaining project, we seek to center the experiences and needs of First Nations Deaf communities to render supports for fair, just, and equitable access in the Australian criminal justice system to this historically marginalized group
Mid-Term Outcome after Extracorporeal Life Support in Postcardiotomy Cardiogenic Shock: Recovery and Quality of Life
Get PDFBackground: Extracorporeal life support (ECLS) therapy for refractory postcardiotomy cardiogenic shock (rPCS) is associated with high early mortality rates. This study aimed to identify negative predictors of mid-term survival and to assess health-related quality of life (HRQoL) and recovery of the survivors. Methods: Between 2017 and 2020, 142 consecutive patients received ECLS therapy following cardiac surgery. The median age was 66.0 [57.0–73.0] years, 67.6% were male and the median EuroSCORE II was 10.5% [4.2–21.3]. In 48 patients, HRQoL was examined using the 36-Item Short Form Survey (SF-36) and the modified Rankin-Scale (mRS) at a median follow-up time of 2.2 [1.9–3.2] years. Results: Estimated survival rates at 3, 12, 24 and 36 months were 47%, 46%, 43% and 43% (SE: 4%). Multivariable Cox Proportional Hazard regression analysis revealed preoperative EuroSCORE II (p = 0.013), impaired renal function (p = 0.010), cardiopulmonary bypass duration (p = 0.015) and pre-ECLS lactate levels (p = 0.004) as independent predictors of mid-term mortality. At the time of follow-up, 83.3% of the survivors were free of moderate to severe disability (mRS \u3c 3). SF-36 analysis showed a physical component summary of 45.5 ± 10.2 and a mental component summary of 50.6 ± 12.5. Conclusions: Considering the disease to be treated, ECLS for rPCS is associated with acceptable mid-term survival, health-related quality of life and functional status. Preoperative EuroSCORE II, impaired renal function, cardiopulmonary bypass duration and lactate levels prior to ECLS implantation were identified as negative predictors and should be included in the decision-making process
Engineering Education in the Age of AI: Analysis of the Impact of Chatbots on Learning in Engineering
Get PDFThe purpose of this paper is to explore the influence of using AI chatbots on learning within the context of engineering education. We framed this study on the principles of how learning works in order to describe the contributions and challenges of AI chatbots in five categories: (1) facilitating the acquisition, completion, or activation of prior knowledge and helping organize knowledge and making connections; (2) enhancing student motivation to learn; (3) fostering self-directed learning and the acquisition, practice, and application of the skills and knowledge they acquire; (4) supporting goal-directed practice and feedback; and (5) addressing student diversity and creating a positive classroom environment. To elicit the uses, benefits, and drawbacks of using AI chatbots in students’ learning, we conducted a thematic analysis of qualitative data gathered from surveying 38 student volunteers from 5 different electronic and mechatronic engineering courses at a South American university. Based on a literature review and an evidence-based discussion, we offer practical suggestions for instructors who want to promote the use of AI to enhance their students’ learning. © 2024 by the authors