Risk Of Arrest Research Articles

O-030 The impact of aneuploidy on human peri-implantation development: findings from the extended in vitro culture of 191 human embryos

Abstract Study question How does aneuploidy affect lineage specification and the developmental potential of human embryos cultured up to 12 days post fertilization (D12)? Summary answer While distinct types of aberrations carry their own risk of embryonic arrest, prevailing aneuploidies appear to compromise lineage specification beyond the blastocyst stage of development. What is known already Chromosomal instability is a hallmark of human preimplantation development, with up to 50% of embryos diagnosed as aneuploid following preimplantation genetic testing (PGT). Aneuploidies are a major cause of implantation failure, pregnancy loss and human congenital defects. Yet despite their clinical relevance, the impact of distinct aberrations on early human development remains poorly understood. Innovative platforms for culturing human embryos up to D12 provide an important opportunity for investigating chromosomal instability. Understanding the effects of specific aneuploidies on human peri-implantation development will be key for advancing human embryo research and improving the interpretation of findings from in vitro embryo models. Study design, size, duration A total of 191 PGT blastocysts obtained from 103 patients were included in the study. Blastocysts were selected based on their original diagnosis, including embryos with single whole-chromosome aneuploidies (single trisomies, n = 37 and single monosomies, n = 71), single segmental aberrations (n = 22), embryos with complex chromosomal constitutions (two or more abnormalities, n = 44), as well as control euploid embryos (n = 17). Participants/materials, setting, methods Vitrified blastocysts were warmed and cultured up to D12 using an optimized protocol to generate embryo outgrowths. We correlated the original PGT diagnoses to developmental outcomes, including outgrowth viability, morphology and outgrowth size. We evaluated blastocyst quality using the Gardner grading system. Following culture, we immunostained 38 viable outgrowths for lineage-specific markers, including OCT4 (epiblast), GATA6 (hypoblast) and CK-7 (trophoblast). Fisher’s exact test was used for statistical analysis (p < 0.05 was considered significant). Main results and the role of chance Following extended culture, 43.5% of embryos remained viable and attached, while 56.5% degenerated and detached. No significant correlation was found between embryo grade and attachment rate. Euploid embryos exhibited the highest attachment rate, with 88.2% (15/17) forming viable outgrowths. Euploid embryos also generated significantly larger outgrowths than trisomic and monosomic embryos (p = 0.01). Embryos diagnosed with trisomies and segmental aberrations exhibited attachment rates comparable to euploid embryos, at 70.3% (p = 0.18) and 68.2% (p = 0.25), respectively. However, embryos with monosomies and complex chromosomal constitutions arrested more readily (28.2% and 15.9% viable, <0.00001, respectively). All euploid embryos (6/6) retained a discernible OCT4+ epiblast-like structure. This was similar to embryos with segmental aberrations and trisomies, with 75% (3/4) and 53.8% (7/13) of outgrowths containing OCT4+ cells, respectively. Nonetheless, distinct trisomies exerted varying effects on peri-implantation development in vitro. For instance, viable trisomies (13, 18, 21) developed similarly to euploid embryos, while outgrowths carrying a trisomy 22 had fewer OCT4+ cells (p = 0.02) and a higher number of GATA6+ cells (p < 0.01), suggesting a potential lineage proliferation defect. Monosomies had the most profound effects on development. Compared to euploid embryos, monosomic embryos formed significantly fewer OCT4+ outgrowths (28.6%, p = 0.02) and contained fewer epiblast (p < 0.0001) and hypoblast-like (p = 0.003) cells. Limitations, reasons for caution The limited number of embryos in certain groups warrants careful interpretation. The central drawback of the models is that embryo outgrowths are predominately flattened, which confounds identification of three-dimensional structures formed during normal embryogenesis. Future studies should encompass additional lineage specification markers and potential culture refinements to enhance our interpretation. Wider implications of the findings Our findings underscore the critical importance of reporting the chromosomal composition of human embryos utilized for research. This practice will enable a more nuanced interpretation of results from in vitro embryo models and ultimately advance our capabilities in human embryo research. Trial registration number not applicable

Atrial fibrillation and risk of sudden cardiac arrest in young adults.

Evidence of an association between atrial fibrillation (AF) and sudden cardiac arrest (SCA) in young adults is limited. In this study, we aim to evaluate this association in a general population aged between 20 and 39 years. Young adults who underwent health check-ups between 2009 and 2012 were screened from a nationwide healthcare database in South Korea. A history of AF diagnosis before the health check-ups was identified based on the relevant International Classification of Diseases, 10th edition codes reported in the database. Associations between an established diagnosis of AF and the risk of SCA during follow-up were examined. A total of 6 345 162 young people were analysed with a mean follow-up duration of 9.4 years. The mean age was 30.9 ± 5.0 years, and 5875 (0.09%) individuals were diagnosed with AF. During follow-up, SCA occurred in 5352 (0.08%) individuals, and the crude incidence was 0.56 and 0.09 events per 1000 person-years for participants with and without AF, respectively. Individuals with AF had a 3.0-fold higher risk in a multivariate model adjusted for age, sex, lifestyle, anthropometric data, and medical comorbidities (adjusted hazard ratio 2.96, 95% confidence interval 1.99-4.41, P < 0.001). Both incident and prevalent AFs were associated with an increased risk of SCA, with no significant differences between the two groups. Atrial fibrillation was associated with a significantly higher risk of SCA developing in healthy young adults. Whether the rate or rhythm control influences the risk of SCA in young patients with AF remains to be examined.

Exploring and Estimating the Revenues of Cybercrime-As-Service Providers: Analyzing Booter and Stresser Services

ABSTRACT Research on cybercrime-as-service markets has increased substantially over the last decade, particularly the use of so-called booter and stresser services that enable individuals to engage in high volume denial of service attacks against websites and servers. There is far less research considering the revenues vendors may generate from running these services, calling to question whether the economic gains from this form of crime are greater than the potential risk of arrest or legal sanctions. This analysis attempted to estimate the revenues of 42 booter and stresser services in operation after a series of arrests and takedowns by law enforcement. The models presented were based on the visible characteristics of vendor services, attack volume and customer detail. Three pricing tiers were developed using different potential distributions for booter/stressor markets and find that their potential revenues are of such a magnitude that they may be viewed as an incentive for individuals to enter the market and persist despite the risk of formal sanctions.

The Clinical Relevance of ECG Parameters in the Prediction of Cardiac Mortality: A Comprehensive Review

About half of all heart disease deaths are caused by cardiac arrest, making it one of the major causes of mortality in prosperous countries. When confronted with potentially fatal arrhythmias, implanted preventive cardioverter defibrillators significantly improve survival chances. However, this is only possible if high-risk patients who are prone to spontaneous cardiac arrest are identified beforehand. The current analysis examines the most recent findings regarding the use of surface electrocardiogram (ECG) data to predict sudden cardiac arrest. Here, we provide a comprehensive overview of the literature on non-invasive ECG techniques for predicting these kinds of cardiovascular crises. Several electrocardiographic risk stratification methods, including T-wave alternans, signal-averaged ECG, T-peak-to-end variation, early repolarization, an extension of the QT interval, QRS duration, QRS cluster patterns, and Holter monitoring, have been reviewed and analysed. These ECG results have shown to be useful as first screening instruments. Nonetheless, no single ECG measure has shown to be an effective technique for classifying individuals based on their risk of sudden cardiac arrest to date. Nevertheless, one or more of these prospective SEM metrics might potentially be important in intricate risk categorization schemes.

AI-based 3D-QSAR model of FDA-approved repurposed drugs for inhibiting sclerostin

BACKGROUND: Wnt activation promotes bone formation and prevents bone loss. The Wnt pathway antagonist sclerostin and additional anti-sclerostin antibodies were discovered as a result of the development of the monoclonal antibody romosozumab. These monoclonal antibodies greatly increase the risk of cardiac arrest. Three-dimensional quantitative structure-activity relationships (3D-QSAR) predicts biological activities of ligands based on their three-dimensional features by employing powerful chemometric investigations such as artificial neural networks (ANNs) and partial least squares (PLS). OBJECTIVE: In this study, ligand-receptor interactions were investigated using 3D-QSAR Comparative molecular field analysis (CoMFA). Estimates of steric and electrostatic characteristics in CoMFA are made using Lennard-Jones and Coulomb potentials. METHODS: To identify the conditions necessary for the activity of these molecules, fifty Food and Drug Administration (FDA)-approved medications were chosen for 3D-QSAR investigations and done by CoMFA. For QSAR analysis, there are numerous tools available. This study employed Open 3D-QSAR for analysis due to its simplicity of use and capacity to produce trustworthy results. Four tools were used for the analysis on this platform: Py-MolEdit, Py-ConfSearch, and Py-CoMFA. RESULTS: Maps that were generated were used to determine the screen’s r2 (Coefficient of Multiple Determinations) value and q2 (correlation coefficient). These numbers must be fewer than 1, suggesting a good, trustworthy model. Cross-validated (q2) 0.532 and conventional (r2) correlation values of 0.969 made the CoMFA model statistically significant. The model showed that hydroxamic acid inhibitors are significantly more sensitive to the steric field than the electrostatic field (70%) (30%). This hypothesis states that steric (43.1%), electrostatic (26.4%), and hydrophobic (20.3%) qualities were important in the design of sclerostin inhibitors. CONCLUSION: With 3D-QSAR and CoMFA, statistically meaningful models were constructed to predict ligand inhibitory effects. The test set demonstrated the model’s robustness. This research may aid in the development of more effective sclerostin inhibitors that are synthesised using FDA-approved medications.

Noninvasive Ventilation for Preoxygenation during Emergency Intubation

BackgroundAmong critically ill adults undergoing tracheal intubation, hypoxemia increases the risk of cardiac arrest and death. The effect of preoxygenation with noninvasive ventilation, as compared with preoxygenation with an oxygen mask, on the incidence of hypoxemia during tracheal intubation is uncertain.MethodsIn a multicenter, randomized trial conducted at 24 emergency departments and intensive care units in the United States, we randomly assigned critically ill adults (age, ≥18 years) undergoing tracheal intubation to receive preoxygenation with either noninvasive ventilation or an oxygen mask. The primary outcome was hypoxemia during intubation, defined by an oxygen saturation of less than 85% during the interval between induction of anesthesia and 2 minutes after tracheal intubation.ResultsAmong the 1301 patients enrolled, hypoxemia occurred in 57 of 624 patients (9.1%) in the noninvasive-ventilation group and in 118 of 637 patients (18.5%) in the oxygen-mask group (difference, −9.4 percentage points; 95% confidence interval [CI], −13.2 to −5.6; P<0.001). Cardiac arrest occurred in 1 patient (0.2%) in the noninvasive-ventilation group and in 7 patients (1.1%) in the oxygen-mask group (difference, −0.9 percentage points; 95% CI, −1.8 to −0.1). Aspiration occurred in 6 patients (0.9%) in the noninvasive-ventilation group and in 9 patients (1.4%) in the oxygen-mask group (difference, −0.4 percentage points; 95% CI, −1.6 to 0.7).ConclusionsAmong critically ill adults undergoing tracheal intubation, preoxygenation with noninvasive ventilation resulted in a lower incidence of hypoxemia during intubation than preoxygenation with an oxygen mask. (Funded by the U.S. Department of Defense; PREOXI ClinicalTrials.gov number, NCT05267652.)

Comparison of the impact of longitudinal body mass index changes on cardiac arrest risk between normal and overweight populations.

Being overweight is a key modifiable risk factor for cardiovascular disease. However, the impact of longitudinal changes in body mass index (BMI) on the risk of out-of-hospital cardiac arrests (OHCA) remains unclear, especially among overweight populations. This nested case-control study utilized data from the Korean National Health Information Database between 2009 and 2018. A total of 23453 OHCA patients, who underwent national health check-ups within 1 and 2-4years before OHCA occurrence, and 31686 controls, who underwent similar national health check-ups, were included. The study population was matched for sex, age and survival status. Conditional logistic regression was employed to analyse the odds ratios (ORs) and 95% confidence intervals (CIs) of each BMI per cent change in assessing the risk of OHCA occurrence within 1year. A reverse J-shaped association between BMI per cent change and OHCA risk was observed, even among overweight populations. Among the overweight populations, weight loss significantly increased OHCA risk, with ORs (95% CI) of 4.10 (3.23-5.20) for severe weight loss (BMI decrease>15%), 2.72 (2.33-3.17) for moderate weight loss (BMI decrease 10-15%) and 1.46 (1.35-1.59) for mild weight loss (BMI decrease 5-10%). Conversely, mild weight gain (BMI increase 5-10%) did not significantly increase OHCA risk. The impact of weight changes on the occurrence of OHCA differed by sex, being more prominent in males. Significant weight changes within a 4-year period increase the risk of OHCA with a reverse J-shaped association, even among overweight and obese individuals. Maintaining a stable weight could be a reliable public health strategy irrespective of the weight status, particularly for males.

Concomitant use of lansoprazole and ceftriaxone is associated with an increased risk of ventricular arrhythmias and cardiac arrest in a large Japanese hospital database

To determine whether concomitant use of ceftriaxone and oral or intravenous lansoprazole increases the risk of ventricular arrhythmia and cardiac arrest in the real-world setting in Japan. The data analyzed were obtained from the JMDC hospital-based administrative claims database for the period April 2014 to August 2022. Patients who received a proton pump inhibitor (PPI) while receiving ceftriaxone or sulbactam/ampicillin were identified. The frequency of ventricular arrhythmia and cardiac arrest was analyzed according to whether oral or intravenous PPI was concomitant with ceftriaxone or sulbactam/ampicillin. Estimates of the incidence of ventricular arrhythmia and cardiac arrest were then compared among the groups, using the Fine-Gray competing risk regression model. The results showed that the risk of ventricular arrhythmia and cardiac arrest was significantly higher with concomitant ceftriaxone and oral lansoprazole (hazard ratio 2.92, 95% confidence interval 1.99-4.29, P<0.01) or intravenous lansoprazole (hazard ratio 4.57, 95% confidence interval 1.24-16.80, P=0.02) than with concomitant sulbactam/ampicillin and oral or intravenous lansoprazole. Oral and intravenous lansoprazole may increase the risk of ventricular arrhythmia and cardiac arrest in patients who are receiving ceftriaxone.

Oral phosphate binders and incident osteoporotic fracture in patients on dialysis.

End-stage kidney disease (ESKD) has an elevated risk of osteoporotic fractures in relation to mineral and bone disorder (MBD) as well as conventional risks of osteoporosis. We investigated the association between oral phosphate binders, the mainstay of MBD treatment, and osteoporotic fracture in dialysis patients. We obtained data from the National Health Insurance database for incident dialysis patients without a history of osteoporotic fractures. Participants were categorized into four groups based on their initial 1-year prescription profiles: calcium-based phosphate binder (CBPB), non-calcium-based phosphate binder (NCBPB), both calcium and non-calcium-based binders (Mixed), and non-phosphate binder (non-user) groups. The primary outcome was the occurrence of new-onset osteoporotic fractures after 1 year of dialysis. Secondary outcomes included cardiovascular events and mortality. Out of 69368 incident dialysis patients, 22326, 5020, 2853, and 39169 were included in the CBPB, NCBPB, mixed, and non-user groups, respectively. The overall risk of osteoporotic fractures was lower in patients taking any phosphate binders compared to non-users. Specifically, only the CBPB group showed a reduced risk of vertebral (adjusted hazard ratio (aHR) 0.83 [0.76-0.92]), hip (aHR 0.81 [0.74-0.89]), and distal radius (aHR 0.88 [0.78-0.99]) fractures compared to non-users. This relationship was represented by a time-dependent manner with fracture risk reduction in patients taking CBPB for 3-6 months (aHR 0.9 [0.83-0.99]) and≥6 months (aHR 0.83 [0.78-0.89]), compared to those using CBPB for less than 3 months. Additionally, only the CBPB group had a lower risk of MACE, cardiac arrest, and ventricular arrhythmia than non-users. All phosphorus binder groups showed a reduced mortality risk compared to non-users. Our findings indicate that the using phosphate binders in ESKD patients is lowers the risk of osteoporotic fractures. Notably, those taking CBPB had a reduced risk without increasing cardiovascular events or mortality compared to non-users.

The effectiveness of phosphocreatine cardioprotection during vascular surgery in high cardiac risk patients

The objective was to study the occurrence of perioperative cardiovascular complications (CVС) and clinical and laboratory cardioprotection signs in patients treated with phosphocreatine infusion in intraoperative period of vascular surgery.Materials and methods. The study involved 204 patients with high cardiac risk (revised cardiac risk index &gt; 2, risk of perioperative myocardial infarction or cardiac arrest &gt; 1%) who underwent elective vascular surgery. The patients were randomly divided into two groups. Group I patients received intraoperative infusion of phosphocreatine at a dose of 75.9 [69.8–85.7] mg/kg during 120.0 [107.1–132.0] min. Group II was a control group. The occurrence of CVC, the blood level of the cardiospecific troponin I (cTnI) and N-terminal segment of natriuretic B-type prohormone (NT-proBNP) were analyzed. The data were statistically processed, using the Fisher’s exact test, Mann–Whitney test and logistic regression.Results. Perioperative CVС were recorded in 5 (4.9%) patients in group I and in 18 (17.6%) patients in group II (p = 0.007). Intraoperative administration of phosphocreatine was associated with a reduced risk of CVС: OR 0.2405, 95% CI 0.0856–0.6758, p = 0.007. The cTnI level in patients of groups I and II was 0.021 [0.016–0.030] and 0.019 [0.011–0.028] ng/ml (p = 0.102) before surgery, 0.025 [0.020–0.036] and 0.022 [0.015–0.039] ng/ml (p = 0.357) after surgery, 0.025 [0.020–0.031] and 0.028 [0.018–0.033] ng/ml (p = 0.531) before discharge from the hospital. At the same stages, the level of NT-proBNP was 233.5 [195.0–297.5] and 237.8 [171.3–310.1] pg/ml (p = 0.404), 295.5 [257.3–388.0] and 289.0 [217.5–409.5] pg/ml (p = 0.226), 265.5 [204.8–348.5] and 259.6 [171.0–421.6] pg/ml (p = 0.369).Conclusion. In patients with high cardiac risk undergoing vascular surgery, intraoperative phosphocreatine infusion at a total dose of 75.9 [69.8–85.7] mg/kg reduces the risk of perioperative CVC per 24%. Administration of phosphocreatine to patients with high cardiac risk during vascular surgery does not affect perioperative cTnI and NT-proBNP blood levels.

A bidirectional Mendelian randomization analysis between COVID-19 and cardiac arrest

ABSTRACT Epidemiological studies link COVID-19 to increased cardiac arrest (CA) risk, but causality remains unclear due to potential confounding factors in observational studies . We conducted a Mendelian randomization (MR) analysis using genome-wide association study (GWAS) data, employing COVID-19-associated single nucleotide polymorphisms (SNPs) with significance values smaller than 5 × 10⁻⁸. We calculated inverse-variance weighted (IVW) MR estimates and performed sensitivity analyses using MR methods robust to horizontal pleiotropy. Additionally, a reverse MR analysis was conducted using CA-associated SNPs with significance values smaller than 1 × 10⁻⁵. Results indicated that infected COVID-19 (OR = 1.12, 95% CI = 0.47–2.67, p = 0.79), hospitalized COVID-19 (OR = 1.02, 95% CI = 0.70–1.49, p = 0.920), and severe respiratory COVID-19 (OR = 0.99, 95% CI = 0.81–1.21, p = 0.945) did not causally influence CA risk. Reverse MR analysis also did not support a causal effect of CA on COVID-19. Thus, associations in observational studies may stem from shared biological factors or environmental confounding.

Predictors of Criminal Sentiments Scale-Modified Scores in Outpatients with Legal System Involvement.

The Criminal Sentiments Scale-Modified (CSS-M) has been widely used as a measure of criminal attitudes. This analysis examined CSS-M scores in a large sample of outpatients with serious mental illnesses and a criminal legal system history. We compared total and subscale scores in our sample to scores from two other previously published U.S. studies in which the CSS-M was used, and evaluated associations between total CSS-M score and nine variables (age, educational attainment, gender, race, marital status, employment status, diagnostic category, substance use disorder comorbidity, and adverse childhood experiences (ACE) score). Scores were higher than in two prior U.S. studies involving other types of samples. Independently significant predictors of higher CSS-M scores included being younger (P < .001), having a higher ACE score (P < .001), being male (P = 03), not identifying as White (P < 001), not having a psychotic disorder (P < 001), and having a comorbid substance use disorder (P = 002). Future research should test the hypothesis that these factors increase risk for arrest and that arrest events, and subsequent criminal legal system involvement, are characterized by negative experiences and perceptions of poor procedural justice, which in turn underpin the negative opinions referred to as "criminal sentiments" or criminal attitudes.

In-hospital outcomes of autologous stem cell transplantation in patients with multiple myeloma with versus without heart failure.

e19511 Background: Autologous stem cell transplantation (ASCT) in patients with multiple myeloma (MM) is known to improve progression-free survival. However, the outcomes in patients with heart failure (HF) are uncertain. This study aims to compare hospital outcomes in patients with MM undergoing ASCT with and without HF. Methods: The National Inpatient Sample database was used to identify patients with MM undergoing ASCT during hospitalizations between 2016 and 2020. Under IRB exemption, data was extracted using ICD-10 codes. Data were stratified between patient with and without HF. A multivariate regression model was used to estimate the association of HF with ASCT in hospital outcomes, adjusting for statistically significant comorbidities. Results: A total of 30,375 hospitalizations with a diagnosis of MM undergoing ASCT were included, of which 1,535 had HF. On multivariant analysis compared to hospitalization without HF, those with HF had significantly higher risk of in-hospital mortality (adjusted odds ratio [aOR]: 2.20, 95% confidence interval [CI]: 1.49-3.24), graft-versus-host disease (GvHD) (aOR: 4.02, 95% [CI]: 2.48-6.52), transplant complications (aOR: 2.03, 95% [CI]: 1.62-2.56), sepsis (aOR: 2.279, 95% [CI]: 1.95- 2.65), septic shock (aOR: 3.49, 95% [CI]: 2.71-4.48), cardiogenic shock (aOR: 5.33, 95% [CI]: 2.61- 10.9), cardiac arrest (aOR: 3.78, 95% [CI]: 2.24- 6.35) and ventricular arrhythmia (aOR: 2.81, 95% [CI]: 2.08- 3.78). All p-values were &lt;0.001. Additionally, patients with HF had a longer average length of stay (20.48 vs 16.38 days, p&lt; 0.001) and a higher total cost of hospital stay ($245,831 vs $198,732, p&lt;0.001) compared to those without HF. Conclusions: Our findings demonstrated that patients with multiple myeloma undergoing autologous stem cell transplantation, while also having coexisting heart failure (HF), experienced worse outcomes compared to patients without HF. These patients had a higher risk of transplant complications, GvHD, sepsis, septic shock, cardiogenic shock, cardiac arrest, ventricular arrhythmias and mortality. Additionally, these patients experienced a longer hospital stay with higher healthcare costs. Further interventions and research are warranted to improve outcomes in this group of patients.

Understanding the relationship between obesity and in-hospital outcomes in gastric cancer patients : A nationwide analysis.

e16050 Background: Gastric cancer is the fifth most common form of cancer and the third leading cause of cancer-related deaths worldwide. Obesity has been identified as a significant risk factor for gastric cancer, associated with increased incidence and heightened complications in hospitalized patients. Our analysis comprehensively evaluates obesity's impact on hospital-admitted gastric cancer patients. Methods: Using the National Inpatient Sample (NIS) 2020, we identified gastric cancer patients with regional and advanced metastatic disease, and they were stratified into patients with and without obesity. The primary outcome was mortality, and secondary outcomes included length of stay, the total cost of hospitalization, and other in-hospital adverse outcomes. Multivariate logistic regression analysis was used to calculate the outcomes after adjusting for confounding variables. Results: A total of 17560 patients were hospitalized with gastric cancer, among which 1720(9.8%) had the concurrent diagnosis of Obesity. The mean age of patients with and without Obesity was 63 (+/- 13.88) and 66 (+/- 12.93),p&lt;0.001 respectively. The obese category had the greater percentage of male patients as compared to females (58.14% vs 44.85% respectively, p&lt;0.001). After adjusting for confounding variables, Obesity was not considered as an independent predictor of mortality in patients with gastric cancer (OR=1.06(0.59-1.92); p=0.90). However, patients with Obesity had prolonged length of stay (+ 1.52 days(1.49-2.26); p=0.004) and total cost of hospitalization (+ $30977(12320-49633); p=0.001). Similarly, obese patients had an increased likelihood of Acute kidney injury (OR=1.47(1.09-1.96); p=0.01), ICU admission (OR=2.01(1.30-3.09); p=0.002), invasive (OR=2.14(1.29-3.54); p=0.003) Noninvasive mechanical ventilation (OR=5.36(2.17-13.14); p&lt;0.001) and Heart failure (OR=1.68(1.09-2.57); p=0.02). No difference was noted in the risk of cardiac arrest (OR=1.26(0.28-5.68); p=0.76), and sepsis(OR=1.76(0.99-3.13); p=0.05). Conclusions: Obesity in patients with gastric cancer is not an independent predictor of mortality but is associated with increased length of stay, the total cost of hospitalization, increased risk of mechanical ventilation, and ICU admissions. Management of obesity can prove crucial in averting a wide range of potential health complications and significantly enhancing the overall quality of life in gastric cancer patients. [Table: see text]

Gupta Perioperative Risk for Myocardial Infarction or Cardiac Arrest Score is a Long-Term Cardiovascular Risk Predictor After Aortoiliac Revascularization

Gupta Perioperative Risk for Myocardial Infarction or Cardiac Arrest (MICA) is a validated self-explanatory score applied in cardiac or noncardiac surgeries. This study aims to assess the predictive value of the MICA score for cardiovascular events after aortoiliac revascularization. This prospective cohort underwent elective aortoiliac revascularization between 2013 and 2021. Patients' demographic, clinical characteristics, and outcomes were registered. The patients were divided into 2 groups according to the MICA score using optimal binning. Survival analysis to test for time-dependent variables and multivariate Cox regression analysis for independent predictors were performed. This study included 130 patients with a median follow-up of 55months. Preoperative MICA score was ≥6.5 in 41 patients. MICA ≥6.5 presented a statistically significant association, with long-term occurrence of acute heart failure (HR=1.695, 95% CI 1.208-2.379, P=0.002), major adverse cardiovascular events (HR=1.222, 95% CI 1.086-1.376, P<0.001), and all-cause mortality (HR=1.256, 95% CI 1.107-1.425, P<0.001). Multivariable Cox regression confirmed MICA as a significant independent predictor of long-term major adverse cardiovascular events (aHR=1.145 95% CI 1.010-1.298, P=0.034) and all-cause mortality (aHR=1.172 95% CI 1.026-1.339, P=0.020). The MICA score is a quick, easy-to-obtain, predictive tool in identifying patients with a higher risk of postaortoiliac revascularization cardiovascular events, such as acute heart failure, major adverse cardiovascular events, and all-cause mortality. Additional research for the validation of the MICA score in the context of aortoiliac revascularization and specific interventions is necessary.

Clearance rates, arrest rates, and racial stratification: A time series analysis, 1965–2020

ABSTRACT Guided by the etiology of crime and policing literatures, this report presents the exploratory hypothesis that the overemphasis placed upon crime clearance rates as a measure of law enforcement efficiency/effectiveness may help account for longstanding racial disparities in the risk of arrest in the US. In the context of an increasingly quantitative fixation on measurable outputs within policing administration, it is argued that the oversurveillance, contact, and ultimate arrest of racial minorities, through discretionary proactive policing activities, has become embedded in the (sub)culture of policing to illustrate that something is being done about unsolved crime. In assessing this hypothesis, national-level, advanced time series models were estimated from 1965 to 2020 (N = 54), with results indicating that year-to-year increases in the lagged percentages of unsolved criminal offenses were significantly associated with year-to-year increases (decreases) in arrest rates for Black (White) people in the US – net of prior theoretically relevant macro-structural correlates of crime. The reported analyses represent a meaningful first attempt in assessing the validity of the hypothesized relationship between crime clearance percentages and trends in Black and White arrest rates – opening the door for a new line of inquiry within an already important field of stratification and crime.

Long-term QT interval analysis for real world patients with Insertable cardiac monitors taking antiarrhythmic drugs

Abstract Background The QT interval serves as a surrogate biomarker for ventricular repolarization. Variance in QT intervals can clinically lead to pro-arrhythmia and sudden cardiac death. An insertable cardiac monitor (ICM) device capable of continuously monitoring the QT interval over a long period can provide diagnostic value for evaluating physiologic or drug induced variations in QT interval. Objective To analyze feasibility of continuous QTc interval monitoring in patients with ICM and evaluate the QTc interval changes in patients taking antiarrhythmic drugs. Methods Patients QT intervals detected from daily ICM ECG data from real-world patients taking antiarrhythmic drugs such as sotalol, amiodarone and dofetilide during hospitalization while implanted with ICM were analyzed from the de-identified Electronic Health Record (EHR) database linked with ICM device data warehouse. The ICM ECG was processed through the previously defined QT detection algorithm which calculates the QTc interval for every beat to generate continuous long term QTc trends. A patient contributed to the prescription group if they were prescribed antiarrhythmics drugs prior to hospitalization in the EHR database otherwise they contributed to the non-prescription group. Patients from the prescription group who were administered antiarrhythmic drugs via injection or IV during hospitalization were removed from the analysis. A 30-day median QTc interval from 30-60 days prior to hospitalization was used as baseline. Wilcoxon signed-rank test was used to compare the paired difference from days 1-5, 1-10, 30-60, and 60-90 after hospitalization to their respective baseline. Results 441 patients (avg. age: 70±11, 50.5% female) were included with 220 prescription and 221 non-prescription. The baseline QTc intervals were 414 and 417.3 msec for non-prescription and prescription groups, respectively. There was a significant increase in QTc on days 1-5, 1-10, 30-60, and 60-90 after hospital admission compared to the baseline (all p &amp;lt; 0.001) for the non-prescription group. The prescription group showed increase in QTc only on days 30-60 after hospitalization when compared to baseline (p&amp;lt;0.05). A larger QTc increase was observed in non-prescription receiving anti-arrhythmic loading on days 1-5 after hospitalization compared to patients on prescription prior to hospitalization (P&amp;lt;0.05). Conclusion Utilizing a QT interval detection algorithm from an ICM can provide long term QT trends for patients with an ICM. Continuous monitoring of QT can help to detect sudden changes in QT due to antiarrhythmic drugs which may lead to increased risk of arrhythmias or cardiac arrest.

Long-time exposure to sunlight is associated with the risk of sudden cardiac arrest and coronary heart disease

Abstract Background With ongoing climate change, the duration of sunshine hours will likely increase over the coming decades that escalating air temperature. Little is known about the potential cardiovascular risk from this climate factor. Purpose The aim of this study was to test whether duration of sunlight exposure is associated with incident sudden cardiac arrest (SCA), coronary heart disease (CHD), and hospitalization for heart failure (HF) and whether this association depends on seasonal variation. Methods A total of 308,851 participants from UK Biobank were included and were followed for a median time of 11.8 years. Participants reported how many hours they respectively spent the daylight outdoors on summer and winter typical days. Extreme outliers (&amp;gt;12 hours/day in summer and &amp;gt;8 hours/day in winter) were excluded. Average exposure time was calculated to unify the daylight outdoors time standard. Duration of sunlight exposure (average, summer, and winter) were categorized using quantiles and a restricted cubic spline for outcomes. Multivariate cox proportional hazard regression adjusted by age, sex, demographics, lifestyle, clinical and environmental factors was used for the analysis. Results During a follow-up, 1,572 (0.51%), 11,557 (3.74%) and 2,145 (0.68%) participants were diagnosed with SCA, CHD and hospitalization for HF. Compared with the participants exposed to short-time sunlight (average ≤ 1.5 hours/day), those who exposed to long-term sunlight (average ≥ 3.5 hours/day) had increased risk of SCA (HR 1.22, 95% CI 1.06 to 1.40) and CHD (HR 1.22, 95% CI 1.06 ~1.40). The associations between long-time exposure to sunlight and SCA were largely attributable to summer (HR 1.22, 95% CI 1.06 to 1.39) and not winter (HR 1.02, 95% CI 0.86 to 1.20), respectively. An hour increase of sunlight exposure was associated with increased risk of SCA in summer (HR, 1.03; 95% CI, 1.01 to 1.05), but not in winter (HR, 1.03, 95% CI, 0.99 to 1.06). Subgroup analysis identified that exposure to long-term sunlight was consistently increased risk of SCA, regardless of age, sex, body mass index, previous cardiovascular diseases, total physical activity, types of physical activity in last 4 weeks, use of sun/UV protection, sedentary time, natural environment percentage (buffer 1000m), and PM2.5. Finally, long-time exposure to sunlight was also associated with increased risk of CHD, but not associated with increased risk of HF hospitalization. Conclusions Findings from the present study indicate that daily long-time exposure to sunlight that increase in air temperature is a risk factor for SCA and CHD. These associations revealed graded relationship according to the duration of exposure to sunlight and more pronounced in summer. Our results suggest that public health efforts to reduce cardiovascular risk should take a wide range of exposure time to sunlight into account.

External Validation of Deep Learning-Based Cardiac Arrest Risk Management System for Predicting In-Hospital Cardiac Arrest in Patients Admitted to General Wards Based on Rapid Response System Operating and Nonoperating Periods: A Single-Center Study: Erratum.

External Validation of Deep Learning-Based Cardiac Arrest Risk Management System for Predicting In-Hospital Cardiac Arrest in Patients Admitted to General Wards Based on Rapid Response System Operating and Nonoperating Periods: A Single-Center Study: Erratum.

The role of magnesium in cardiac arrest.

Cardiac arrest is a leading cause of death globally. Only 25.8% of in-hospital and 33.5% of out-of-hospital individuals who achieve spontaneous circulation following cardiac arrest survive to leave the hospital. Respiratory failure and acute coronary syndrome are the two most common etiologies of cardiac arrest. Effort has been made to improve the outcomes of individuals resuscitated from cardiac arrest. Magnesium is an ion that is critical to the function of all cells and organs. It is often overlooked in everyday clinical practice. At present, there have only been a small number of reviews discussing the role of magnesium in cardiac arrest. In this review, for the first time, we provide a comprehensive overview of magnesium research in cardiac arrest focusing on the effects of magnesium on the occurrence and prognosis of cardiac arrest, as well as in the two main diseases causing cardiac arrest, respiratory failure and acute coronary syndrome. The current findings support the view that magnesium disorder is associated with increased risk of cardiac arrest as well as respiratory failure and acute coronary syndrome.