Longitudinal Study Research Articles

Stereotactic radiosurgery for arteriovenous malformations in pediatric patients: an updated systematic review and meta-analysis.

Intracranial arteriovenous malformations are the most common cause of intracranial hemorrhages in pediatric patients. Stereotactic radiosurgery (SRS) has been used extensively to treat these lesions. The authors conducted a systematic review and meta-analysis to report treatment outcomes and long-term complications. This study follows the PRISMA and MOOSE guidelines, with the search spanning electronic databases up to February 6, 2024. The outcome measures included obliteration rate, hemorrhage in the latency period, symptomatic radiation-induced changes (RICs), cyst formation, and radiation-induced tumorigenesis. A total of 1493 patients across 24 studies were included. The pooled complete obliteration after single-fraction SRS was 64.7% (95% CI 58%-69%). The pooled post-SRS hemorrhage rate at the final follow-up was 6.2% (95% CI 5%-8%). The overall incidence rate of RIC was 31.3% (267/854 patients), and the incidence of symptomatic RIC was 8.8% (114/1289 patients). For permanent symptomatic RIC, the pooled incidence was 4.8% (62/1283 patients). At final follow-up, 17 cases of radiation-induced necrosis were documented among 654 patients (2.6%). Similarly, cyst formation was reported in 1.3% of cases (17/1265 patients) and radiation-induced tumors occurred in 0.15% of cases (2/1342 patients). SRS can be considered an effective intervention for appropriately selected pediatric patients with arteriovenous malformations. Long-term complication rates appear to be low but additional longitudinal studies are required to better define the long-term outcomes.

Behavioral observation and assessment protocol for language and social-emotional development study in children aged 0–6: the Chinese baby connectome project

BackgroundThe global rise in developmental delays underscores the critical need for a thorough understanding and timely interventions during early childhood. Addressing this issue, the Chinese Baby Connectome Project (CBCP)’s behavior branch is dedicated to examining language acquisition, social-emotional development, and environmental factors affecting Chinese children. The research framework is built around three primary objectives: developing a 0–6 Child Development Assessment Toolkit, implementing an Intelligent Coding System, and investigating environmental influence.MethodsUtilizing an accelerated longitudinal design, the CBCP aims to enlist a minimum of 1000 typically developing Chinese children aged 0–6. The data collected in this branch constitutes parental questionnaires, behavioral assessments, and observational experiments to capture their developmental milestones and environmental influences holistically. The parental questionnaires will gauge children’s developmental levels in language and social-emotional domains, alongside parental mental well-being, life events, parenting stress, parenting styles, and family relationships. Behavioral assessments will involve neurofunctional developmental evaluations using tools such as the Griffiths Development Scales and Wechsler Preschool and Primary Scale of Intelligence. Additionally, the assessments will encompass measuring children’s executive functions (e.g., Head-Toe-Knee-Shoulder), social cognitive abilities (e.g., theory of mind), and language development (e.g., Early Chinese Vocabulary Test). A series of behavior observation. experiments will be conducted targeting children of different age groups, focusing primarily on aspects such as behavioral inhibition, compliance, self-control, and social-emotional regulation. To achieve the objectives, established international questionnaires will be adapted to suit local contexts and devise customized metrics for evaluating children’s language and social-emotional development; deep learning algorithms will be developed in the observational experiments to enable automated behavioral analysis; and statistical models will be built to factor in various environmental variables to comprehensively outline developmental trajectories and relationships.DiscussionThis study’s integration of diverse assessments and AI technology will offer a detailed analysis of early childhood development in China, particularly in the realms of language acquisition and social-emotional skills. The development of a comprehensive assessment toolkit and coding system will enhance our ability to understand and support the development of Chinese children, contributing significantly to the field of early childhood development research.Trial registrationThis study was registered with clinicaltrials.gov NCT05040542 on September 10, 2021.

Associations of black and sugar-sweetened coffee consumption with depressive symptoms: A longitudinal study of Chinese adolescents

BackgroundPrevious research revealed an association between coffee consumption and depressive symptoms. However, the results differed between studies in adults and adolescents. Additionally, limited research on coffee and depressive symptoms has distinguished between black and sugar-sweetened coffee. Furthermore, few studies have examined the potential sex differences in the abovementioned association. This longitudinal study aimed to explore the associations of black and sugar-sweetened coffee consumption with subsequent depressive symptoms in adolescents while also investigating sex disparities within these associations. MethodsIn this longitudinal study, 10,770 individuals completing standardized questionnaires at baseline and follow-up were included in the main analysis. The data were analyzed using generalized linear mixed-effects models, and subgroup analyses were grouped according to sex. ResultsAfter adjusting for covariates and baseline depressive symptoms status, adolescents who consumed black coffee daily (OR, 1.45; 95 % CI, 1.14–1.84) had a greater risk of experiencing depressive symptoms compared with those who did not consume it or consumed it monthly. Similarly, in comparison with none or monthly consumers, those who consumed sugar-sweetened coffee weekly (OR, 1.22; 95 % CI, 1.03–1.44) and daily (OR, 1.32; 95 % CI, 1.02–1.73) demonstrated an elevated risk of having depressive symptoms. Subgroup analyses showed that black and sugar-sweetened coffee consumption was associated with depressive symptoms only in males. LimitationsSelf-reported data on coffee consumption and depressive symptoms. ConclusionsAdolescents who consume black or sugar-sweetened coffee weekly or daily are at a higher risk of developing depressive symptoms, with this association appearing to be more pronounced in male adolescents. Future studies are needed to confirm these findings.

Positive effects of lower extremity constraint-induced movement therapy on balance, leg strength and dual-task ability in stroke patients: a longitudinal cohort study.

To investigate whether high-intensity lower extremity constraint-induced movement therapy can improve balance, leg strength, and dual-task ability. A longitudinal cohort study in a real-world outpatient clinic. 147 community-dwelling participants in the subacute and chronic poststroke phases. Participants received lower extremity constraint-induced movement therapy for 6 hours/day during 2 consecutive weeks, including balance, strength, and functional training. The Berg Balance Scale (BBS), Single-Leg-Stance (SLS) bilaterally, one Repetition Maximum (1RM) in a leg press, symmetry of leg strength (Diff-1RM), Timed Up and Go (TUG), and the TUG Manual test were assessed before, after, and 3 months after lower extremity constraint-induced movement therapy. Compared with preintervention data, statistically significant improvements after lower extremity constraint-induced movement therapy (p < 0.001) were demonstrated for balance with an absolute value in BBS at 1.9 points (effect size 0.38) and SLS at 2.4 s (effect size 0.24), and for leg strength at 10.2 kg (effect size 0.54) for the affected leg. Diff 1RM decreased significantly at 5.8 kg (effect size 0.39) and improvements on dual-task ability at 2.7 s were significant (effect size 0.14). The effects persisted at the 3-month follow-up. High-intensity lower extremity constraint-induced movement therapy may be a feasible treatment option for middle-aged stroke patients to affect balance, leg strength, and dual-task ability positively in an out-patient clinical setting.

Sweetened Areca Nut, A Risk in Dental Caries among Adolescents in Pune, Maharashtra? A Case-Control Study

Abstract Introduction: Smokeless tobacco (SLT) causes dental caries and so does chewing of areca nut (sweetened supari) due to the presence of sugar. Since conflicting views exist about whether areca nut causes dental caries or not, and since studies are undertaken in adults and data on adolescents are not available, this study was carried out. Since those were cross-sectional or longitudinal studies, this case-control study was undertaken to understand if flavored/sweetened areca nut is a risk factor for dental caries. Material and Method: This unmatched case-control study was conducted among the male students of 8th to 10th standard in the age group of 12–16 of four Madhyamik Vidyalaya’s (MVs) in Pimpri–Chinchwad (urban area), Pune. A directed acyclic graph (DAG) was drawn to determine the independent variables to be selected for the study and minimal variables to be adjusted during data analysis. Selection of cases was based on diagnostic and eligibility criteria. The data on the use of sweetened areca nuts and the presence of caries were collected through oral examination and a semistructured questionnaire administered by the principal investigator on a one-to-one basis between August 2022 and October 2022. Data were analyzed using epiinfoTM 7.2.5.0. Results: This study of 146 males in the age group of 13 to 16 years had 61 students as cases and 85 as controls. No significant difference was observed between the group with (cases) and without (controls) dental caries for areca nut use (pack years) whether consumed daily or less frequently for 1 year or more. While the exposure rate to areca nut among cases was 44.26%, for the control group it was 36.47%. The odds ratio of sweetened areca nut as being the risk factor for dental caries was 1.38 at 95% CI (0.70–2.71) with P = 0.44. Conclusion: This study revealed that the adolescent users of sweetened areca nuts studying in government schools had a higher exposure odds ratio for dental caries. However, it was not significant statistically. Information bias including recall may have influenced the outcome.

Number of Chronic Conditions and Death Anxiety Among Older Adults in Rural China: A Longitudinal Study in Anhui Province.

Objectives: Death anxiety is feelings of worry and fear regarding death. This study explored the effect of number of chronic conditions on death anxiety in older adults and the moderating effect of age. Methods: This study used the fifth, sixth, seventh, and eighth waves of longitudinal data (2012-2021) collected in Anhui, China (5014 person-year observations). A mixed linear model was used to examine the effect of number of chronic conditions on death anxiety and the moderating effect of age. Results: The number of chronic conditions showed an inverted U-shaped relationship with death anxiety, with death anxiety being lower in older adults with older age. As age increased, the U-shaped curve became flatter, and the extremes shifted to the right. Discussion: Particular attention should be given to younger older adults with chronic conditions to help them recover earlier from the negative impact by providing information and counseling about their chronic conditions.

A 14-year longitudinal study of neurofilament light chain dynamics in premanifest and transitional Huntington's disease.

Growing evidence supports the value of neurofilament light (NfL) as a prognostic biomarker in premanifest Huntington's disease (HD). To date, however, there has been no longitudinal study exceeding 3years examining either its serial dynamics or predictive power in HD. We aimed to conduct the first such study. Serum NfL was sampled using ultrasensitive immunoassay at four timepoints across a 14-year period in a cohort of HD gene carriers (n = 21) and controls (n = 14). Gene carriers were premanifest at baseline. Clinical features of HD were evaluated by Unified Huntington's Disease Rating Scale (UHDRS TMS), Montreal Cognitive Assessment (MoCA), Trail A/B task, Symbol Digit Modalities Task and semantic/phonemic fluency tasks. 14/21 HD gene carriers converted to prodromal or manifest disease by the final timepoint ("converters"). At baseline and each subsequent timepoint, NfL levels were higher in converters than in non-converters and controls (p = < 0.001-0.03, ηp2 = 0.25-0.66). The estimated rate of change in NfL was higher in converters than in non-converters (p = 0.03) and controls (p = 0.001). Baseline NfL was able to discriminate converters from non-converters (area under curve = 1.000, p = 0.003). A higher rate of change in NfL was predictive of more severe motor (UHDRS-TMS p = 0.007, β = 0.711, R2 = 0.468) and cognitive deficits (MoCA p = 0.007, β = -0.798, R2 = 0.604; Trail B, p = 0.007, β = 0.772, R2 = 0.567; phonemic fluency p = 0.035, β = -0.632, R2 = 0.345). Our data suggest that (1) NfL longitudinal dynamics in premanifest/transitional HD are non-constant; rising faster in those closer to disease onset, and (2) NfL can identify individuals at risk of conversion to manifest disease and predict clinical trajectory, > 10years from disease onset.

Psychological distress and trajectories of sleep duration among Australian adolescents: a prospective cohort study

ObjectivesThis study investigated the association between indicators of psychological distress and well-being and trajectories of sleep duration among a cohort of Australian adolescents.DesignA prospective cohort of adolescents was followed over...

СОРЕ-30A: краткая версия методики изучения копинг-стратегий для подростков 12-18 лет

&lt;p&gt;In world practice, many tools for measuring coping strategies have been developed. The COPE questionnaire by C. Carver, M. Scheier and J. Weintraub is the instrument most consistent with the theoretical model and basic psychometric standards. It is concise but gives the possibility to identify the diversity and breadth of the repertoire of coping strategies and coping styles. The article provides a Russian-language adaptation of its short version COPE-30 for adolescents, which allows identifing 15 coping strategies and 4 coping styles. In a sample of adolescents from different regions of the Russian Federation (N=1718; age from 12 to 18 years; mean age 14&amp;plusmn;1 years; 53,8% female), the COPE-30A questionnaire showed good internal consistency: Cronbach&amp;rsquo;s alpha for scales 0,55-0,86; RMSEA=0,04; CFI=0,95; IFI=0,95; SRMR=0,035. Its validity is confirmed by the expected correlations with the scales of the &amp;ldquo;Multidimensional Students&amp;rsquo; Life Satisfaction Scale&amp;rdquo; and &amp;ldquo;Multidimensional School Engagement Scale&amp;rdquo; questionnaires. The new COPE-30A questionnaire can be used to conduct large-scale, longitudinal studies, studies of adolescents of different, including vulnerable, groups, as well as individual studies to build subsequent practice of psychological assistance.&lt;/p&gt;

Kidney tissue loading reduces the critical cooling and warming rates of VS55 and VMP cryoprotective solutions.

Critical cooling and warming rates (CCR and CWR) are two important calorimetric properties of cryoprotective agents (CPA) solutions, and achieving these rates is generally regarded as the critical criterion for successful vitrification and rewarming. In 1996, Peyridieu et al. discovered that the measured critical rates are reduced inside kidney tissue equilibrated with 30% (w/w) 2,3-butanediol compared to its free CPA solution. In general, they found a ∼5-fold reduction for CCR and a >100-fold reduction for CWR. However, to our knowledge, no follow-up studies have been conducted. We revisit this important concept, understanding that tissues never fully equilibrate with full-strength 100% CPAs during perfusion. We therefore performed measurements in a range of dilutions of two commonly employed CPA cocktails, including 75–100% VS55 (41.25–55.00% w/v) and 90–100% VMP (48.60–54.00% w/v) equilibrated with kidney tissues vs. free solution. The measured reduction in the kidney was up to 5-fold for CCR and 9-fold for CWR. After discussing possible mechanisms for this effect, curves that fit the dilution to the observed reduction in critical rate were constructed to allow extrapolation for differentially loaded tissues, which can guide the follow-up studies to find the more concentrated CPA (> 8.4 M VMP) in the M22 family to achieve human-sized kidney vitrification and rewarming.

An analytical approach for identifying trend-seasonal components and detecting unexpected behaviour in psychological time-series.

The recent advances in technological capabilities have led to a massive production of time-series data and remarkable progress in longitudinal designs and analyses within psychological research. However, implementing time-series analysis can be challenging due to the various characteristics and complexities involved, as well as the need for statistical expertise. This paper introduces a statistical pipeline on time-series analysis for studying the changes in a single process over time at either a population or individual level, both retrospectively and prospectively. This is achieved through systemization and extension of existing modelling and inference techniques. This analytical approach enables practitioners not only to track but also to model and evaluate emerging trends and apparent seasonality. It also allows for the detection of unexpected events, quantifying their deviations from baseline and forecasting future values. Given that other discernible population- and individual-level changes in psychological and behavioural processes have not yet emerged, continued surveillance is warranted. A near real-time monitoring tool of time-series data could guide community psychological responses across multiple ecological levels, making it a valuable resource for field practitioners and psychologists. An empirical study is conducted to illustrate the implementation of the introduced analytical pipeline in practice and to demonstrate its capabilities.

Communication and empathy within the patient-physician relationship among patients with and without chronic pain.

Chronic pain may affect the relationship between patients and their treating physicians. This study was designed to compare four aspects of physician communication and physician empathy reported by patients with chronic pain and in chronic pain-free controls. A cross-sectional study was conducted within a national pain research registry from July 2020 through January 2024. Patients with chronic low back pain of greater than 3months duration were matched to chronic pain-free controls utilizing propensity scores derived froma logistic regression model based on 11 variables thatincluded sociodemographic characteristics, cigarette smoking status, history of comorbid medical conditions, and duration of the current patient-physician relationship. Patients reported on the primary outcomes of physician communication utilizing the Communication Behavior Questionnaire (CBQ) and physician empathy utilizing the Consultation and Relational Empathy (CARE) measure. Group means were compared for each aspect of physician communication (patient participation and patient orientation, effective and open communication, emotionally supportive communication, and communication about personal circumstances) and physician empathy, and Cohen's d statistic was utilized to assess the clinical relevance of between-group differences. Secondary exploratory analyses were also performed to compare patients treated by osteopathic physicians vs. allopathic physicians and to determine whether study group X physician type interaction effects were present. The 387 patients in each study group were matched within a caliper width of 0.001 on the propensity score. Overall, patients ranged from 21 to 79 years of age (mean, 50.7 years; standard deviation [SD], 15.1 years), and 617 (79.7 %) of them were female. Patients in the chronic pain group reported poorer scores for all aspects of physician communication and physician empathy than the chronic pain-free controls. All between-group differences were clinically relevant. There were no differences in physician communication or physician empathy according to physician type in the exploratory analyses, and study group X physician type interaction effects were not observed. In this cross-sectional study, patients with chronic pain reported having physicians with poorer communication and less empathy than chronic pain-free controls. Longitudinal research is needed to more clearly determine the temporal relationship between patients' chronic pain and physician communication and physician empathy during medical encounters.

Distribution Personalization and Content Decentralization on Brand Recall

Structural equation modeling examines the impact of distribution personalization and content decentralization on brand recall among Gen-Z consumers to analyze the causal relationship between these factors. The research used Covariance Based–Structural Equation Modeling (CB-SEM) and Partial Least Squares–Structural Equation Modeling (PLS-SEM) based on review of related literature. The 385 samples were Gen Z (age 12 to 27 as of year 2024 randomly from Region III, Philippines, comprising the provinces of Aurora, Bataan, Bulacan, Nueva Ecija, Pampanga, and Tarlac. Questionnaires with rating scales were used as research tools. Confirmatory factor analysis was used to analyze model fit, reliability, and validity. A structural model and path analysis were used to examine the links. Causal relationships were analyzed using PLS-SEM. The findings indicated that the model had a reasonable fit with empirical data and exhibited acceptable reliability and validity. The results demonstrate that distribution personalization has a direct positive effect on Gen Z’s ability to recall a brand. In addition, content decentralization acted as a partial mediator or indirect effect on the relationship between distribution personalization and Gen Z brand recall. Based on these results, sellers of clothing brands reliant on short-form video ads may consider employing advanced data analytics technologies to acquire insights into the preferences, behavior, and demographics of the audience and personalize video content to specific audience segments like Gen Z. Furthermore, it is advisable to optimize distribution channels, incorporate user-generated content into distribution strategies, and emphasize usercentric storytelling to create favorable associations with the brand. Future research should be qualitative or mixed methods to obtain a richer qualitative interpretation, and cohort or longitudinal research should be conducted to study these effects eventually.

Associations of childhood physical activity and screen time with cardiometabolic health in preteens who were born to mothers with previous macrosomic delivery: Findings from the ROLO longitudinal birth cohort study.

Macrosomia (birthweight ≥4 kg) may alter the associations of physical activity (PA) and screen time (ST) throughout childhood with later cardiometabolic risk. To investigate associations of PA and ST over a 4-6-year follow-up period with cardiometabolic outcomes in preteens (9-11-year-olds) who were born to mothers with previous macrosomic delivery. This is an analysis of 402 preteens from the ROLO study, who were born to mothers that previously delivered an infant with macrosomia. Parental-reported measures of PA and ST were obtained in early childhood at 5-years of age. Preteen self-reported PA, parental-reported ST, anthropometry, dual-energy x-ray absorptiometry, blood pressure, heart rate, cardiorespiratory endurance, and blood biomarkers were obtained at 9-11-years. Crude and adjusted linear regression models explored associations and the interaction of birthweight was investigated in all models. Early childhood PA and ST at the 5-year follow-up were not related to preteen cardiometabolic outcomes. In adjusted models, higher preteen PA was associated with lower sum of skinfolds (B = -3.00, 95% CI -5.98, -0.02, p = 0.048) and higher cardiorespiratory endurance (B = 0.50, 95% CI 0.20, 0.80, p = 0.001) at the same time point. No strong evidence for modification by birthweight was found. Higher preteen PA may have potential benefits for cardiometabolic health, irrespective of birthweight.

Correlation between dental symptoms and functional and clinical manifestations of Crohn's disease and ulcerative colitis

Objective. To analyze the correlation between dental symptoms and clinical and functional manifestations of Crohn's disease (CD) and ulcerative colitis (UC). Materials and methods. A prospective, observational, longitudinal clinical study of 70 patients with verified inflammatory bowel diseases, i.e. Crohn's disease and ulcerative colitis, has been performed. For an in-depth assessment of the oral mucosa (OM) and red lip border (RLB) condition in patients with these systemic diseases, a complete dental examination has been carried out. The validated questionnaire "7´7" was used to objectify the symptoms of functional gastric dyspepsia. Results. In patients with the main clinical manifestations of the gastrointestinal tract impairments in CD and UC, extraintestinal dental manifestations in the form of meteorological cheilitis (16 and 9, respectively; p = 0.081), glossitis (15 and 11, respectively; p = 0.323), onset of recurrent aphthous stomatitis (17 and 11; p = 0.144), chronic mechanical trauma of oral mucosa (14 and 11; p = 0.455), and the presence of scalloped tongue (28 and 21, p = 0.068) were diagnosed. At the same time, the incidence of associated pathologies of OM and RLB was significantly higher in patients with CD (p0.05) than in patients with UC. Clinical examination of patients revealed predominance of flatulence symptoms in patients with CD and UC in 74.3 and 77.1 % of cases, respectively (р = 0.771). Patients with CD prevailed in the number of dyspeptic disorders and their variability but statistically significant differences were determined only for the symptom 'abdominal pain decreasing after bowel emptying'. The correlation between the frequency of dyspeptic disorders in patients and characteristic changes in the clinical state of RLB and OM was revealed. For the CD and UC groups Chuprov conjugacy coefficients were statistically significant (ChC=0.36, ChC=0.28 respectively). In patients with CD clinically apparent changes in the RLB and OM associated with various dyspeptic disorders were manifested more often than in patients with UC. Conclusion. The conducted study has shown that in patients with CD and UC there is a correlation between the frequency and severity of the main functional and clinical symptoms/syndromes (in the form of edema, hyperemia, pitting edema of the ОМ (in fact) and the RLB) and dyspeptic disorders, this correlation being stronger in Crohn's disease (p = 0.031 vs p = 0.046).

Conceptualizing reflection-for-action: Empowering teachers as agents of collaborative and collective transformation

This longitudinal case study offers an empirically grounded conceptualization of teachers' reflection-for-action (RFA), that is, proactive or anticipatory reflection which occurs before action. Data were collected from five in-service EFL teachers in Türkiye via teachers' online discussions, critical event narratives, interviews, and researchers’ journals. Findings indicated that RFA is an individual, collaborative and a collective practice, influenced by teacher beliefs and autonomy. RFA appears to be facilitated through a triadic cycle of stimulus, evaluation, and action, allowing teachers to identify their strengths and weaknesses and develop strategies to challenge prescribed institutional practices with more creative, innovative, and out-of-the-box teaching methods.

Why do prospective and retrospective measures of childhood maltreatment differ? Qualitative analyses in a cohort study

BackgroundResearch indicates that prospective and retrospective measures of maltreatment often identify different groups of individuals, yet the reasons for these discrepancies remain understudied. ObjectiveThis study explores potential sources of disagreement between prospective and retrospective measures of maltreatment, utilising qualitative data from interviewers' notes. Participants and settingThe Environmental Risk Longitudinal Twin Study includes 2232 children followed from ages 5–18. Prospective measures relied on caregiver interviews and researcher observations from ages 5–12, while retrospective measures involved self-reports via the Childhood Trauma Questionnaire at age 18. MethodsWe purposively sampled written interviewer notes from 36 participants who reported more types of maltreatment retrospectively than prospectively (‘new reports’ group) and 31 participants who reported fewer types retrospectively than prospectively (‘omitted reports’ group). We conducted a framework analysis of the notes, comparing between the two groups to explore explanations for measurement disagreement. ResultsThree categories of themes emerged related to measurement discrepancies: challenges with prospective measures, highlighting reasons given by the ‘new reports’ group for why maltreatment went undetected or was not adequately responded to prospectively; challenges with retrospective measures that highlight difficulties with openness and accuracy of self-reports; and differences in appraisals of violence or distressing childhood experiences between the two groups that might lead to new or omitted retrospective reports. ConclusionsOur findings underscore potential mechanisms underlying the disagreement between prospective and retrospective measures, contributing to better understanding of these different constructs and more balanced interpretation of related findings.

Lung Structure and Longitudinal Change in Cardiac Structure and Function: The MESA COPD Study.

Lung structure and cardiac structure and function are associated cross-sectionally. The classic literature suggests relationships of airways disease to cor pulmonale and emphysema to reduced cardiac output (CO) but longitudinal data are lacking. The Multi-Ethnic Study of Atherosclerosis Chronic Obstructive Pulmonary Disease (COPD) Study was a multi-center longitudinal COPD case-control study of participants 50-79 years with ≥10 pack-years smoking without clinical cardiovascular disease. Segmental airway wall area (WA) and percent emphysema were measured on computed tomography. Right and left ventricle (RV, LV) parameters were assessed on magnetic resonance imaging (MRI) in exams six years apart. Longitudinal and period cross-sectional associations were evaluated with mixed models adjusted for demographics, body size, and smoking. The 187 participants with repeated MRI were 67±7 years old; 42% had COPD; 22% currently smoked; and the race/ethnicity distribution was 54% white, 30% Black, 14% Hispanic, and 3% Asian. Greater WA at enrollment was associated with longitudinal increase in RV mass (3.5 g per 10mm2 WA, 95% CI: 1.1, 5.9). Greater percent emphysema was associated with stably lower LV end diastolic volume (-7.8 mL per 5% emphysema, 95% CI: -10.3, -3.0) and CO (-0.2 L·min-1 per 5% emphysema, 95% CI: -0.4, -0.1). Cardiac associations varied by lung structure over six years in this multi-ethnic study. Greater WA at enrollment was associated with longitudinal increases in RV mass; whereas greater percent emphysema was associated with stable decrements in LV filling and CO.

Performance of the 4C and SEIMC scoring systems in predicting mortality from onset to current COVID-19 pandemic in emergency departments

The evolution of the COVID-19 pandemic has been associated with variations in clinical presentation and severity. Similarly, prediction scores may suffer changes in their diagnostic accuracy. The aim of this study was to test the 30-day mortality predictive validity of the 4C and SEIMC scores during the sixth wave of the pandemic and to compare them with those of validation studies. This was a longitudinal retrospective observational study. COVID-19 patients who were admitted to the Emergency Department of a Spanish hospital from December 15, 2021, to January 31, 2022, were selected. A side-by-side comparison with the pivotal validation studies was subsequently performed. The main measures were 30-day mortality and the 4C and SEIMC scores. A total of 27,614 patients were considered in the study, including 22,361 from the 4C, 4,627 from the SEIMC and 626 from our hospital. The 30-day mortality rate was significantly lower than that reported in the validation studies. The AUCs were 0.931 (95% CI: 0.90–0.95) for 4C and 0.903 (95% CI: 086–0.93) for SEIMC, which were significantly greater than those obtained in the first wave. Despite the changes that have occurred during the coronavirus disease 2019 (COVID-19) pandemic, with a reduction in lethality, scorecard systems are currently still useful tools for detecting patients with poor disease risk, with better prognostic capacity.

Motivational and emotional correlates of physical activity and sedentary behavior after cardiac rehabilitation: an observational study

BackgroundThe present study assessed physical activity (PA) and sedentary behavior (SB) levels and their motivational and emotional health-related correlates, in outpatients following a cardiovascular rehabilitation (CR) program, and compared these variables with those of a healthy control group.MethodsThe study included 119 participants: 68 CR outpatients (Mage 57.76 ± 10.76; 86.76% males) and 51 control participants matched on age (Mage 57.35 ± 6.33 years; 45.10% males). PA and SB were assessed using accelerometers during the first week post-discharge for outpatients and during a typical week for controls. Motivational (i.e., perceived capabilities, affective and instrumental attitudes, intention, approach-avoidance tendencies) and emotional health-related variables (i.e., anxiety, depressive symptoms, fatigue, pain intensity) were measured using validated scales. PA and SB data from 17 outpatients and 42 controls were valid for analysis, resulting in a final sample of 59 participants.ResultsCR outpatients engaged an average of 60.21 (± 34.79) min of moderate-to-vigorous PA (MVPA), and 548.69 (± 58.64) min of SB per day, with 18 more minutes of MVPA per day than controls (p = .038). Univariate and multivariate regressions indicated that positive affective attitudes were associated with higher MVPA (b = 10.32, R2 = 0.07, p = .029), and that males spent more time in SB than females (b = 40.54, R2 = 0.09, p = .045). Univariate and multivariate logistic regressions showed that meeting the World Health Organization’s weekly guidelines for MVPA was associated with higher perceived capabilities toward PA and more positive affective attitudes (OR = 1.17, p = .030; OR = 1.26, p < .001, respectively). Interaction tests showed no significant differences in these results between outpatients and controls.ConclusionThe study highlights an association between higher perceived capabilities and positive affective attitudes toward PA with higher PA levels after outpatient CR. While these findings suggest that enhancing these motivational variables may be beneficial for increasing PA levels after CR, longitudinal and experimental studies are needed to further establish their role.