Association Class Research Articles

Associative Classification with Classification Based Association (CBA) Algorithm on Transaction Data with Rshiny

Data mining can be used for businesses with large amounts of data. One of the data mining techniques is Associative Classification. It is a new strategy in data processing that combines association and classification techniques to build a classification model. This research used an associative classification technique on sales transaction data of Frozen Food Stores, which had sales transaction data on their business activities. It would be used in sales strategies to find items often purchased by class customers, namely, members and general. This research aimed to classify based on association rules using the CBA (Classification based Association) algorithm on sales transaction data. The application used the R programming language that business owners could use. The results of the rules obtained from the trial had the value of support, confidence, coverage, and lift ratio, which were the best value levels of a rule. The results of the rules that had the highest lift ratio value from all the data that have been inputted can be used as a reference to be implemented in sales strategies in knowing consumer needs.

Intravenous Iron Technique Evaluation in Chronic Heart Failure With Iron Deficiency Anemia.

This study aimed to investigate and assess whether IV iron improves symptoms of chronic heart failure (CHF) in patients with iron deficiency anemia (IDA). A total of 66 subjects with heart failure (HF) seeking therapy in the Department of Medicine's Inpatient Department (IPD) and Outpatient Department (OPD) were included. The data were collected during an outpatient or inpatient visit, documented in a predesigned and pretested proformaand then evaluated. All subjects received history-taking, examinationsand regular laboratory tests after being informed and signing an agreement. On admission, the following data was collected: name, age, genderand comorbidities. The examination of subjects included a general examination and a systematic examination. Hematological parameters includinghemoglobin (Haemometer, Top Tech Bio Medicals Mumbai), serum iron (Roche Cobas c501, USA), total iron binding capacity (TIBC, Beckman Coulter AU480, India), transferrin saturation percentage (TSAT% = (serum iron/TIBC) × 100), left ventricular ejection fraction (LVEF, 2D echocardiography, Nivan Healthcare Solutions, India) and ferritin (Abbott Architect Ferritin Assay, Delhi) are also important. Other blood tests like liver and renal function tests include an electrocardiogram (12-lead ECG) and two-dimensional echocardiography on admission and follow-up. In our study, 66 patients in total received IV iron as a treatment option to improve the symptoms of CHF with IDA; the New York Heart Association (NYHA) classification showed significant improvement (p-value <0.001). Before the intervention, 57.58% of patients had NYHA class II and 42.4% of patients had NYHA class III. After treatment, 33.33% of patients showed NYHA class II and 19.70% of patients showed NYHA class III. After iron therapy treatment, out of 29 cases of NYHA class III, nine (31.03%) cases converted to NYHA class I, seven (24.14%) cases converted to NYHA class II, and 13 (44.83%) cases belonged to the same NYHA class. Out of 37 cases of NYHA class II, 22 (59.45%) cases converted to NYHA class I, and 15 (40.54%) cases belong to the same NYHA class. Thus, we come to the conclusion that the NYHA classification has exhibited notable enhancement subsequent to the administration of parenteral iron therapy. Sufficient evidence exists to substantiate the advantageous effects of intravenous iron therapy in the treatment of iron deficiency anemia.The administration of iron therapy has been observed to yield favorable outcomes in the mitigation of symptoms among individuals afflicted with cardiac insufficiency.

Cryoballoon ablation for atrial fibrillation in patients with heart failure and reduced left ventricular ejection fraction: A systematic review and meta-analysis.

The coexistence of atrial fibrillation (AF) with heart failure (HF) is prevalent, leading to severe complications. This review aimed to investigate the success rate and efficacy of cryoballoon ablation (CBA) by measuring the improvement in the New York Heart Association (NYHA) classification and the effect on the left ventricular systolic function in patients with AF accompanied by heart failure with reduced ejection fraction (HFrEF). Electronic databases search included PubMed, Web of Science, and Scopus in January 2023. Outcomes addressed the following: left ventricular ejection fraction (LVEF) improvement, AF recurrence, NYHA classification improvement, and mortality. STATA 17.0 software was used for data analysis. The effect size for the studies was a standard mean difference (SMD) with a 95% confidence interval (CI) for outcomes. Proportion analysis with 95% CI was used for freedom from early AF and AF after 2 years and all-cause death. We included six studies, including 1699 HF patients with 365 HFrEF patients. The SMD of postoperative LVEF compared to preoperative LVEF in HFrEF was 0.99 ([95% CI: 0.60, 1.39], p = .00), and for NYHA was -1.12 ([95% CI: -1.36, -0.87], p = .00). The analysis results in HFrEF patients for freedom from AF after 1 year was 65% ([95% CI: 0.55, 0.75], and after 2 years was 39% ([95% CI: 0.10, 0.67]). Proportional analysis was conducted for all-cause death, resulting in 3% mortality ([95% CI: -0.01, 0.07]). Cryoablation of AF accompanied by HFrEF appeared safe as it reduced AF recurrence and enhanced clinical outcomes.

Postoperative acute kidney injury increases short- and long-term death risks in elderly patients (≥ 75 years old) undergoing coronary artery bypass graft surgery

PurposeTo explore the incidence of postoperative acute kidney injury (AKI) after coronary artery bypass grafting (CABG) in elderly Chinese patients (≥ 75 years old) and its impacts on the short- and long-term prognosis.MethodsA total of 493 patients aged 75–88 years old who underwent CABG from two medical centers between January 2006 and October 2021 were involved. Perioperative (preoperative and 7 days after operation) serum creatinine (Scr) levels were measured in all the enrolled patients. Univariate and multivariate logistic regression analyses were conducted to explore the independent risk factors of postoperative in-hospital mortality. Kaplan–Meier curves and COX model were used to test the risk factors of all-cause death during follow-up. Propensity score matching was used to balance differences between AKI and control groups. The primary outcome event was in-hospital death, and the secondary outcome was all-cause death during follow-up.ResultsThe 198 patients were diagnosed with postoperative AKI. Intra-aortic balloon pump (IABP), cardiopulmonary bypass, and postoperative AKI were independent risk factors of in-hospital death. Gender, New York Heart Association Classification, preoperative eGFR, last eGFR within 7 days after operation, postoperative AKI, and postoperative renal function all impacted long-term prognosis. After 1:1 matching, 190 patients were included in the AKI and control groups. Use of IABP, use of cardiopulmonary bypass, and occurrence of postoperative AKI were still independent risk factors of in-hospital death. Preoperative eGFR, last eGFR within 7 days after operation, postoperative AKI and postoperative renal function all impacted long-term prognosis.ConclusionThe incidence of postoperative AKI in elderly patients undergoing CABG is high, and postoperative AKI is an independent risk factor of both short- and long-term postoperative prognosis.

On z-cycle factorizations with two associate classes where z is 2a and a is even

On z-cycle factorizations with two associate classes where z is 2a and a is even

Benefit of Catheter Ablation for Atrial Fibrillation in Heart Failure Patients with Different Etiologies.

(1) Background: A plethora of studies have elucidated the safety and efficacy of catheter ablation (CA) for patients afflicted with atrial fibrillation (AF) and concomitant reduction in left ventricular ejection fraction (LVEF). Nevertheless, the literature on the benefits of CA in the specific etiological context of heart failure (HF) remains limited. This study delineates a comparative assessment of outcomes for patients with AF and reduced LVEF across the primary etiologies. (2) Methods: Our inquiry encompassed 216 patients diagnosed with congestive heart failure and an LVEF of less than 50 percent who were referred to our institution for circumferential pulmonary vein isolation (CPVI) between the years 2016 and 2020. The selection criteria included a detailed medical history while excluding those suffering from valvular disease, congenital heart disease, and hypertrophic cardiomyopathy. In an effort to scrutinize varying etiologies, patients were stratified into three categories: dilated cardiomyopathy (DCM, n = 56, 30.6%), ischemic cardiomyopathy (ICM, n = 68, 37.2%), and tachycardia-induced cardiomyopathy (TIC, n = 59, 32.2%). (3) Results: Following an average (±SD) duration of 36 ± 3 months, the prevalence of sinus rhythm was 52.1% in the DCM group, 50.0% in the ICM group, and 68.14% in the TIC group (p = 0.014). This study revealed a significant disparity between the DCM and TIC groups (p = 0.021) and the ICM and TIC groups (p = 0.007), yet no significant distinction was discerned between the TIC and ICM groups (p = 0.769). Importantly, there were no significant variations in the application of antiarrhythmic drugs or recurrence of procedures among the three groups. The mortality rates were 14.29% for the DCM group and 14.71% for the ICM group, which were higher than the 3.39% observed in the TIC group (DCM vs. TIC p = 0.035 (HR = 4.50 (95%CI 1.38-14.67)), ICM vs. TIC p = 0.021 (HR = 5.00 (95%CI 1.61-15.50))). A noteworthy enhancement in heart function was evidenced in the TIC group in comparison to the DCM and ICM groups, including a higher LVEF (p < 0.001), diminution of LV end-diastolic diameter (p < 0.001), and an enhanced New York Heart Association classification (p = 0.005). Hospitalization rates for heart failure were discernibly lower in TIC patients (0.98 (0,2) times) relative to those with DCM (1.74 (0,3) times, p < 0.01) and TIC (1.78 (0,4) times, p < 0.001). Patients with paroxysmal atrial fibrillation and brief episodes were found to achieve superior clinical outcomes through a catheter ablation strategy. (4) Conclusion: Patients diagnosed with TIC demonstrated a more pronounced benefit from catheter ablation compared to those with DCM and ICM. This encompassed an augmented improvement in cardiac function, an enhanced maintenance of sinus rhythm, and a reduced mortality rate.

Intraoperative Measurement of Tibial Rotation With Lateral Axis Views Using C-arm for Tibial Fractures.

Malrotation of tibial fractures after intramedullary nailing remains an unsolved problem. The incidence of malrotation >10° on computer tomography (CT) measurements has been highin cases of tibial shaft fractures. We aimed to assess the accuracy of a novel method for the measurement of tibial rotation using lateral axis views of the C-arm, to prevent postoperative malrotation. Consecutive patients with fresh tibial fractures treated by intramedullary nailing between January 2021 and December 2022 were included prospectively. Baselinetibial external rotation (TER) was measured preoperatively on the non-injured normal sidewith CT. After proximal or distal screw fixation, the C-arm TER was measured based on lateral axis views (tibial posterior condylar axisand bimalleolar axisviews). The C-arm TER was compared with the normal-side CT TER; when the difference was ≤5°, the procedure progressed, and screw fixation was carried out. The fractured-side CT TER was measured one week post-operatively. Twenty patients (13 males and seven females) were included. The mean age was 52.4 years. The Orthopaedic Trauma Association (OTA) classification was 42A in five patients, 42B in twelve patients, and 42C in three patients. The mean difference between C-arm TER and fractured-side CT TER was 2.3°±1.7°, with Pearson correlation coefficientr=0.968. The mean difference between normal-side CT TER and fractured-side CT TER was 4.8°±2.8°, and there was no incidence of malrotation >10°. The C-arm method was highly accurate in estimating CT measurements and preventing tibial malrotation.

Beneficial effects of upgrading to His-Purkinje system pacing in patients with pacing-induced cardiomyopathy: a systematic review and meta-analysis.

The purpose of this study was to evaluate the effectiveness of His-Purkinje system pacing (HPSP) in the management of patients with pace-induced cardiomyopathy (PICM). PubMed, Embase, Web of Science, and the Cochrane Library were searched comprehensively to collect related studies published from the inception of databases to June 1, 2022. R 4.04 software, including the Metafor package, matrix package, and the Meta package, was utilized to conduct the singe-arm meta-analysis. The methodology index for non-randomized studies (MINORS) was used to assess the methodological quality of the included studies. A total of seven studies were included, involving 164 PICM patients. The meta-analysis showed that HPSP ameliorated the left ventricular ejection fraction (LVEF) by 13.41% (95% CI [11.21-15.61]), improved the New York Heart Association (NYHA) classification by 1.02 (95% CI [-1.41 to -0.63]), and shortened the QRS duration (QRSd) by 60.85 ms (95% CI [-63.94 to -57.75]), resulting in improved cardiac functions in PICM patients. Besides, HPSP reversed the ventricular remodeling, with a 32.46 ml (95% CI [-53.18 to -11.75]) decrease in left ventricular end systolic volume (LVESV) and a 5.93 mm (95% CI [-7.68 to -4.19]) decrease in left ventricular end-diastolic dimension (LVEDD). HPSP also showed stable electrical parameters of pacemakers, with a 0.07 V (95% CI [0.01-0.13]) increase in pacing threshold, a 0.02 mV (95% CI [-0.85 to 0.90]) increase in sensed R-wave amplitude, and a 31.12 Ω reduction in impedance (95% CI [-69.62 to 7.39]). Compared with LBBP, HBP improved LVEF by 13.28% (95% CI [-11.64 to 14.92]) vs 14.43% (95% CI [-13.01 to 15.85]), ameliorated NHYA classification by 1.18 (95% CI [-1.97 to -0.39]) vs 0.95 (95% CI [-1.33 to -0.58]), shortened QRSd by 63.16 ms (95% CI [-67.00 to -59.32]) vs 57.98 ms (95% CI [-62.52 to -53.25]), and decreased LVEDD by 4.12 mm (95% CI [-5.79 to -2.45]) vs 6.26 mm (95% CI [-62.52 to -53.25]). The electrical parameters of the pacemaker were stable in both groups. This meta-analysis showed that HPSP could significantly improve cardiac function, promote reverse remodeling, and provide stable electrical parameters of pacemakers for PICM patients.

Pedogenesis of soils formed on jurassic calcareous sedimentary rock formations: A transect study in northern semi-arid highlands of Ethiopia

With the objective of examining soil characteristics, pedogenic processes and classification in association to local environmental and landscape attributes, a transect study was carried out in Hnitalo Wajerat district of Northern Ethiopia. Six pedons beded on shale and dolerite parent rocks were investigated. The soils were sandy loam to clay in texture, moderately porous, neutral to strongly alkaline, nonsaline, base-rich and calcareous. The dominant pedogenic processes prominent in soils of the area were calcification, vertization, argilluviation, melanization and colloidal eluviations. Mollic and ochric horizons were noticed on surface horizons, while cambic, calcic and vertic horizons were found to be the dominant subsurface horizons. Steep upslope areas were characterized by shallow gravelly soils with continuous hard rock. Shrink-swell cracks, colluvic materials and deep soils were prominent on flat areas. The soils of the area were classified as Leptosols/Entisols, Cambisols/Inceptisols, Calcisols/Aridisols and Vertisols. The study evidenced that the pedogenic processes and soil development were largely patterned by terrain positions, lithology and land use type.

THU674 Papillary Thyroid Carcinoma Presenting As A Benign Ectopic Thyroid Mass In The Anterior Mediastinum. A Case Report

Abstract Disclosure: M.V. David-santos: None. C. Narvacan-montano: None. Background: Ectopic Thyroid Tissue (ETT) is a rare developmental anomaly that is due to the failure of the thyroid gland to assume its position in front of the trachea. Ectopic Thyroid tissue in the mediastinum is very rare, with only a few cases reported in the literature. An incidental Papillary Thyroid Carcinoma presenting as a mediastinal mass that turns out to be benign ectopic thyroid cells is even rarer. Case: This is the case of a 33-year-old female who presented with sudden onset difficulty of breathing and chest heaviness. On workup, she was found to have an anterior mediastinal mass, which showed ectopic thyroid cells on biopsy. Further evaluation of the neck area revealed a 1.25 cm x 1 x 1.13 cm nodule on the thyroid gland which showed suspicious for Papillary Thyroid Carcinoma on Fine needle aspiration biopsy. The patient underwent Total Thyroidectomy and Excision of the Anterior Mediastinal Mass. The histopathologic report of the thyroid mass revealed a Conventional Unifocal Papillary Thyroid Carcinoma, while the excised tissues comprising the mediastinal mass were consistent with benign ectopic thyroid tissues with colloid goiter. Conclusion: The presence of the ectopic thyroid mass in the anterior mediastinum may be a potential area for metastasis. The final pathologic report nevertheless, categorizes this Papillary thyroid carcinoma as having a low risk of metastasis as per the American Thyroid Association Classification of 2015. Hence the conservative approach of Suppression therapy and active surveillance is the choice of management for this unusual case. Presentation: Thursday, June 15, 2023

Safety outcomes of bariatric surgery in patients with advanced organ disease: the ONWARD study: a prospective cohort study.

Increasing numbers of patients with advanced organ disease are being considered for bariatric and metabolic surgery (BMS). There is no prospective study on the safety of BMS in these patients. This study aimed to capture outcomes for patients with advanced cardiac, renal, or liver disease undergoing BMS. This was a multinational, prospective cohort study on the safety of elective BMS in adults (≥18years) with advanced disease of the heart, liver, or kidney. Data on 177 patients with advanced diseases of heart, liver, or kidney were submitted by 75 centres in 33 countries. Mean age and BMI was 48.56±11.23 years and 45.55±7.35kg/m 2 , respectively. Laparoscopic sleeve gastrectomy was performed in 124 patients (70%). The 30-day morbidity and mortality were 15.9% ( n =28) and 1.1% ( n =2), respectively. Thirty-day morbidity was 16.4%, 11.7%, 20.5%, and 50.0% in patients with advanced heart ( n =11/61), liver ( n =8/68), kidney ( n =9/44), and multi-organ disease ( n =2/4), respectively. Cardiac patients with left ventricular ejection fraction less than or equal to 35% and New York Heart Association classification 3 or 4, liver patients with model for end-stage liver disease score greater than or equal to 12, and patients with advanced renal disease not on dialysis were at increased risk of complications. Comparison with a propensity score-matched cohort found advanced disease of the heart, liver, or kidney to be significantly associated with higher 30-day morbidity. Patients with advanced organ disease are at increased risk of 30-day morbidity following BMS. This prospective study quantifies that risk and identifies patients at the highest risk.

Identification of aggressive driving behavior of online car‐hailing drivers based on association classification

AbstractWith the rapid development of online car‐hailing, the related crashes have become a key issue with public concern. Identifying and predicting aggressive driving behaviors is critical to reduce traffic crashes. In this study, we propose a method to recognize aggressive driving behavior based on association classification, with multisource features being employed, including driver emotion, vehicle kinematic characteristics, and road environment. The model performs best in a 10‐fold cross‐test when the minimum support and minimum confidence are set as 0.01 and 0.8, respectively. Besides, we also compare the performance of aggressive driving behavior recognition classifiers constructed using association classification with other rule‐based classification methods, including ID3, C4.5, CART, and Random Forest. The results show that association classification performs better than other classification competitors. Thirty‐six if–then rules generated by the association classification are used to analyze the influencing factors and associated mechanisms of aggressive driving behavior. It is found that aggressive driving behavior is highly correlated with driver anger and disgust emotions. Aggressive driving behavior is more likely to occur when no passengers are in the car than the case with passengers. Driver entertainment behavior and passenger interference also affect driving behavior. Moreover, drivers are prone to aggressive driving when making a U‐turn. This research not only proposed a new identification method for aggressive driving behavior but also provided a comprehensive understanding of the associated influencing factors which thus benefit the further research and development of safety assistance driving devices.

Reduction quality in lateral view of X-ray and hypoalbuminemia are associated with postoperative mortality in elderly pertrochanteric fracture patients.

Pertrochanteric fracture is one of the most prevalent public health issues across the world for the elderly population. The purpose of this study was to investigate the association between surgical factors and postoperative mortality in patients with intramedullary nail-treated pertrochanteric fractures. A retrospective cohort study was designed to evaluate the pertrochanteric fracture patients treated with intramedullary nail between January 2016 to February 2021. The surgical factors included the Dorr morphology, Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association (AO/OTA) classification of fractures, the tip-apex distance (TAD), location of the cephalic screw, reduction quality in anterior-posterior (AP) and lateral views, the integrity of the lateral wall, and the design of cephalic screws. Using univariate and multivariate Cox proportional hazard models, the association between these risk factors and postoperative mortality in patients with this type of fractures was evaluated. A total of 169 pertrochanteric fracture patients treated with intramedullary nails were included in our study, with the average age of 82.68±5.93 years. The mortality rates at 3 months, 1 year, and the end of follow-up were 4.14%, 11.24%, and 26.04%, respectively. According to the univariate Cox analysis, age, gender, preoperative levels of hemoglobin (Hb) and albumin (Alb) were associated with a poor overall survival (OS) (P<0.05). After multivariate adjustment, the pre-operative level of Alb (P<0.001) and the reduction in lateral view (P<0.001) were shown to be independent risk factors for poor OS. The preoperative hypoalbuminemia and reduction quality in lateral view were associated with postoperative mortality in our study. Therefore, optimizing both parameters could improve the prognosis in elderly pertrochanteric fracture patients.

Assessment of three different radioiodine doses for ablation therapy of thyroid remnants: Efficiency, complications and patient comfort.

I-131 radioiodine (RAI) ablation removes postoperative residual tissue and facilitates follow-up in low- and intermediate-risk differentiated thyroid cancer (DTC). Although low doses have been reported to be as effective as higher doses for ablation, the doses administered still vary depending on the patient and the practitioner. We aimed to evaluate the ablation efficiency, complications, and length of stay (LOS) of patients with DTC treated with 3 different doses for ablation. Patients with DTC who received RAI therapy were retrospectively reviewed. One hundred thirty patients with low-intermediate-risk, according to American Thyroid Association classification, without known lymph nodes or distant metastases were included. Patients were divided into 3 groups as 30 to 50 mCi, 75 mCi, and 100 mCi. Residue thyroid and salivary glands were evaluated from 9 to 12 months post-RAI I-131 scans. No significant difference was found between groups regarding ablation success (P = .795). In multivariable analyses, pretreatment thyroglobulin (hazard ratio = 0.8, 95% confidence interval 0.601-0.952, P = .017) and anti- thyroglobulin antibody (hazard ratio = 1.0, 95% confidence interval 0.967-0.998, P = .024) were 2 independent predictors of ablation success. The mean LOS was 2.1 ± 0.3, 2.6 ± 0.6, and 2.9 ± 0.4 days, respectively, (P = .001). LOS rates of ≥ 3 days were 13.2%, 54.3%, and 84.8%, respectively. Mild decreases in hemoglobin, white blood cell (WBC), and platelet counts were observed in all groups after 6 weeks without any clinically significant findings. A lower rate of change in WBC counts was observed in the 30 to 50 mCi group compared to others. There was no dose-dependent difference regarding the early complaints questioned. Ablation with 30 to 50 mCi provides benefits such as shorter LOS, better patient comfort, less salivary gland dysfunction, and less WBC suppression, thus reducing costs without decreasing efficacy.

On predicting outcomes in patients with chronic heart failure with frailty syndrome

Background. The presence of frailty negatively affects the prognosis of patients with chronic heart failure, increasing the frequency of hospitalizations, limiting treatment options, and also increasing the mortality of patients.&#x0D; Aim. To develop a model for predicting mortality in patients with decompensated chronic heart failure, including frailty syndrome.&#x0D; Material and methods. 107 patients aged 4595 years with decompensated chronic heart failure were studied. Four age groups were formed: the first 29 patients aged 4559 years old (average age 53.94.5 years), the second 31 elderly patients (6074 years old, average 68.35.0 years), the third 40 senile people (7590 years, average age 81.54.1 years), the fourth 7 long-lived patients (90 years, average 921.4 years). A comprehensive geriatric assessment was performed using the program Optimization of care in geriatrics depending on the degree of frailty. A multivariate logistic regression analysis was performed to select mortality predictors.&#x0D; Results. The prognostic model included 6 independent variables: age 1.05 [0.96; 1.17] (p=0.28), male gender 0.25 [0.03; 1.65] (p=0.17), frailty of severe or terminal degree 5.56 [1.08; 37.14] (p=0.05), IV functional class according to the classification of New York Heart Association 3.41 [0.60; 27.35] (p=0.19), ejection fraction 50% or more 0.29 [0.03; 2.28] (p=0.26), ejection fraction 4049% 0.40 [0.05; 2.60] (p=0.36). The sensitivity of the model was 62%, specificity 82%, prognostic effectiveness 88%.&#x0D; Conclusion. Severe or terminal asthenia is the strongest predictor of mortality, increasing the risk of an unfavorable outcome by 5.56 times.

Effectiveness of conduction system pacing for cardiac resynchronization therapy: A systematic review and network meta-analysis.

Cardiac resynchronization therapy (CRT) with biventricular pacing (BiV-CRT) is ineffective in approximately one-third of patients. CRT with Conduction system pacing (CSP-CRT) may achieve greater synchronization. We aimed to assess the effectiveness of CRT with His pacing (His-CRT) or left bundle branch pacing (LBB-CRT) in lieu of biventricular CRT. The PubMed, Embase, Web of Science, Scopus, and the Cochrane Library were systematically searched until August 19, 2023, for original studies including patients with reduced left ventricular ejection fraction (LVEF) who received His- or LBB-CRT, that reported either CSP-CRT success, LVEF, QRS duration (QRSd), or New York Heart Association (NYHA) classification. Effect measures were compared with frequentist network meta-analysis. Thirty-seven publications, including 20 comparative studies, were included. Success rates were 73.5% (95% CI: 61.2-83.0) for His-CRT and 91.5% (95% CI: 88.0-94.1) for LBB-CRT. Compared to BiV-CRT, greater improvements were observed for LVEF (mean difference [MD] for His-CRT +3.4%; 95% CI [1.0; 5.7], and LBB-CRT: +4.4%; [2.5; 6.2]), LV end-systolic volume (His-CRT:17.2mL [29.7; 4.8]; LBB-CRT:15.3mL [28.3; 2.2]), QRSd (His-CRT: -17.1ms [-25.0; -9.2]; LBB-CRT: -17.4ms [-23.2; -11.6]), and NYHA (Standardized MD [SMD]: His-CRT:0.4 [0.8; 0.1]; LBB-CRT:0.4 [-0.7; -0.2]). Pacing thresholds at baseline and follow-up were significantly lower with LBB-CRT versus both His-CRT and BiV-CRT. CSP-CRT was associated with reduced mortality (R = 0.75 [0.61-0.91]) and hospitalizations risk (RR = 0.63 [0.42-0.96]). This study found that CSP-CRT is associated with greater improvements in QRSd, echocardiographic, and clinical response. LBB-CRT was associated with lower pacing thresholds. Future randomized trials are needed to determine CSP-CRT efficacy.

Evidence of Bariatric Surgery Benefits Cardiac Function in Non-HFpEF Patients with Obesity: a Meta-Analysis.

Nowadays, increasing clinical evidence on metabolic and weight-loss effects of bariatric surgery on improving cardiac structure in obese patients, but its application in improving the cardiac function of HF (heart failure) patients remains controversial. The objective of this meta-analysis was to assess the effects of BS on cardiac function by quantifying the changes of LVEF (left ventricular ejection fraction) and NYHA (New York Heart Association classification) after operations in non-HFpEF (heart failure and preserved ejection fraction) patients. Articles were searched using PubMed and Embase from inception to December 9, 2022, and the Minors scale was used for quality assessments. The included patients should be non-HFpEF and clinically severely obese, and their pre-operative and post-operative values of LVEF or NYHA should be reported. Nine studies involving 146 patients were eventually included with a final result showing that the cardiac functional parameters were improved in non-HFpEF patients. After a weighted mean follow-up time of 15.8months, the mean NYHA decreased by 0.59 (I2 = 0; 95% CI 0.27 ~ 0.92; p = 0.003), and the mean LVEF increased by 7.49% (I2 = 0; 95% CI - 9.99 ~ - 4.99; p < 0.00001). Bariatric surgery offers beneficial cardiac effects on non-HFpEF patients with obesity but failed to show a significant improvement in the pooled analysis for the changes of cardiac parameters. The improving degree may be related to the baseline BMI, the extent of BMI loss, and the baseline age. Future studies should focus on finding out the influencing factors of effectivenesses and defining the suitable crowd.

The status of patient-reported outcomes and their correlation with the number of hospitalizations within 1 year in patients with atrial fibrillation

Objective: To observe the status of patient-reported outcomes (PROs) and their correlation with the number of hospitalizations within 1 year in patients with atrial fibrillation(AF). Methods: This study is a prospective investigation. Patients with non-valvular atrial fibrillation treated in the Department of Cardiology of the Third People's Hospital of Yancheng from May 2020 to April 2021 were selected. General information and AF6 questionnaire were used to define PROs. The number of hospitalizations within 1 year after discharge was obtained. Spearman correlation analysis was used to analyze the correlation between PROs and the New York Heart Association (NYHA) classification. The logistic regression model was used to analyze the number of hospitalizations in AF patients within 1 year. Results: A total of 197 patients were enrolled, the mean age was (74.1±9.0) years, 106 (53.8%) patients were female. The mean AF6 score was (24.3±8.3). The proportion of patients with 6 entries≥1 point exceeded 50%. There was a positive correlation between NYHA classification and PROs (r=0.360, P<0.001). Logistic regression analysis showed that the older age (OR=1.058, P=0.004) and the AF6 scores≥24(OR=4.082, P<0.001) were the risk factors of rehospitalization within 1 year for AF patients. Conclusions: The PROs of AF patients are at the medium level and poor levels of PROs are associated with increased risk of rehospitalization within 1 year.

ASSESSMENT OF THE LEVEL OF STRESS AMONG PATIENTS WITH HEART FAILURE IN SULAIMANI CARDIAC HOSPITAL

BackgroundLife events and experiences eventually lead to stress. Stress also activates one’s process of thinking and autonomic arousal level. One of the complications of heart failure is coronary artery disease, which can also be caused by stress and behaviours like being extremely hardworking toward achieving one’s goals.&#x0D; ObjectivesTo detect the stress levels of heart failure patients, and to find out the association between socio-demographic characteristics and level of stress.&#x0D; Materials and MethodsQuantitative descriptive design (non-probability purposive sample). The sample was the heart failure admitted to Sulaimani Cardiac Hospital. A total of 200 heart failure patients were selected by non‑probability sampling methods. The standardized Perceived Stress Scale tool was used for the study.&#x0D; ResultsAlmost half (50.5%) of the sample was between 62 to 77 years. More than half were males, widows, illiterate with low economic status, and lived with their family members (65.5, 53%, 61%, 65.5%, and 68%) respectively. Less than half (48%) of them were in class III of heart failure according to the New York Heart Association classification. Most of the sample were from urban areas (91%), Nearly half of the sample (47.5%) had a high level, (51%) had moderate stress, and only (1.5%) of them had low stress. Also, the present study revealed a significant association among all items of sociodemographic and clinical characteristics and levels of stress except the economic state, marital state, and resident at the p-value of 0.05.&#x0D; ConclusionThis research demonstrated an approach to developing more coping strategies to reduce stress among heart failure patients. So, this study recommended that the medical staff who work in the coronary care unit should involve themselves in dealing with the psychosocial needs of those patients and take measures to plan to solve their problems, especially stress, through teamwork.

ACMKC: A Compact Associative Classification Model Using K-Modes Clustering with Rule Representations by Coverage

The generation and analysis of vast amounts of data have become increasingly prevalent in diverse applications. In this study, we propose a novel approach to address the challenge of rule explosion in association rule mining by utilizing the coverage-based representations of clusters determined by K-modes. We utilize the FP-Growth algorithm to generate class association rules (CARs). To further enhance the interpretability and compactness of the rule set, we employ the K-modes clustering algorithm with a distance metric that binarizes the rules. The optimal number of clusters is determined using the silhouette score. Representative rules are then selected based on their coverage within each cluster. To evaluate the effectiveness of our approach, we conducted experimental evaluations on both UCI and Kaggle datasets. The results demonstrate a significant reduction in the rule space (71 rules on average, which is the best result among all state-of-the-art rule-learning algorithms), aligning with our goal of producing compact classifiers. Our approach offers a promising solution for managing rule complexity in association rule mining, thereby facilitating improved rule interpretation and analysis, while maintaining a significantly similar classification accuracy (ACMKC: 80.0% on average) to other rule learners on most of the datasets.