Heart Project Research Articles

The Green Heart Project: Objectives, Design, and Methods.

The Green Heart Project is a controlled, community-based clinical trial to evaluate the effects of increasing greenery on community health. The study was initiated in 2018 in a low-to-middle-income residential area of nearly 30,000 racially diverse residents in Louisville, KY. Community engagement was maintained throughout the project, with feedback integrated into its design and implementation. Based on land use, demographics, and greenness in the area, we designated 8 paired clusters of demographically- and environmentally matched "target" (T) and adjacent "control" (C) areas (total of 16 clusters). Levels of ultrafine particles, ozone, and nitrogen oxides were measured in each cluster. In-person exams were conducted for 735 participants in Wave 1 (2018-2019) and 545 participants in Wave 2 (2021). Blood, urine, nail, and hair samples were collected to evaluate cardiovascular risk, inflammation, stress, and pollutant exposure. Demographic and psychosocial data were collected as well. Cardiovascular function was assessed by measuring arterial stiffness and flow-mediated dilation. After Wave 2, more than 8,000 mature, mostly evergreen, trees and shrubs were planted in the T clusters. Post planting data were collected during Wave 3 (2022) from 561 participants. We plan to follow changes in area characteristics and participant health to evaluate the long-term impact of the greening intervention.

Abstract 4144548: High Morbidity and Mortality in Adults With Turner Syndrome and Aortic Dilation: A Retrospective Cohort Study from the Healthy Heart Project

Introduction: Turner syndrome (TS) is caused by the partial or complete absence of one sex chromosome and affects 1 in 2500 liveborn infants. Hypertension, bicuspid aortic valve (BAV), and thoracic aortic aneurysms (TAAs) are more prevalent in TS compared to the general population and predispose to aortic dissections, which may occur in young adults with TS. We hypothesize that adults with TS who have TAAs experience a high rate of adverse cardiovascular outcomes. Methods: Adults with TS who had Healthy Heart Project (HHP) echocardiograms at national conferences between 2003 and 2023 were contacted for enrollment in descending order of the aortic size index (ASI, cm/m 2 ), defined as the ratio of the maximum ascending aortic diameter to body surface area. After informed consent, clinical characteristics and outcomes (as numbers of participants or median and interquartile range) were abstracted from questionnaires and medical records. Results: Sixty-four of 704 total HHP participants were contacted and 19 (with 10 of the 20 highest ASI values) were enrolled with complete data. The baseline ASI was 2.19 (0.48), compared to 1.51 (0.36) for all other HHP participants. The median age was 59 (13) years. The most prevalent characteristics were 45,X (10) or 45,X/46,XX (6) karyotypes; BAV (9), coarctation (4), or no congenital lesions (6); and hypertension (12). A mean of 10 serial aortic images were available for each participant over a follow up period of 14 (9.8) years. The median increase in aortic diameter was 0.09 (0.29) mm/yr at the sinuses of Valsalva and 0.26 (0.44) mm/yr at the ascending aorta. Seven participants underwent aortic operations due to enlarging TAAs when the median ascending diameter was 3.83 (0.67) cm (ASI 2.58 (0.11) cm/m 2 ). In 3 cases, operations were urgent due to cardiovascular symptoms or rapid aortic dilation, but there were no acute aortic dissections. The median time between the index image and subsequent repair was 3.5 (7.0) years. Three HHP participants with the 8th, 15th, and 42nd largest ASI values died prior to follow up. One death was caused by complications after surgical aortic valve replacement at age 20. Conclusions: In a cohort of adults with TS and TAAs, 40% (7/19) developed progressive aortic enlargement requiring aortic repairs and there were 3 deaths. These observations underscore the importance of lifelong surveillance and timely intervention to prevent deaths due to cardiovascular disease in TS.

A rapid economic assessment of Wildlife Trusts’ nature prescribing programmes

BackgroundThe Wildlife Trusts play an important role in reducing the impact of poor public health on NHS services, improving human health through nature engagement projects. To bring these health benefits to light, the authors conducted a rapid economic assessment of Wildlife Trusts’ projects. MethodsFive green prescribing projects with the most comprehensive data were selected. Benefits to the participants were identified, including improved mental and physical health and reduced loneliness and physical health. To refine the methodologies for valuing the benefits achieved with each service type and its associated costs, a targeted literature review was conducted. The review encompassed studies considering the valuation of green prescribing services, mental health benefits, physical health benefits, and the economic implications related to reduced loneliness. The costs of running each Wildlife Trusts programme were established, and a subsequent cost:benefit figure calculated. FindingsThe authors concluded from the results that green prescribing has the potential to deliver cost saving benefits to the NHS and “take weight out of the system”. For example, through the Wild at Heart project, that involved 82 participants over a year in Rotherham and Sheffield, they estimated a reduction in NHS costs associated with inpatient admissions, A&E attendances and outpatient appointments by £38 646 per year. Or, every £1 spent on this project is estimated to deliver a £1·19 benefit in terms of reduced costs to the NHS. The research then examined the potential impact if this programme was delivered at scale. Reaching a similar demographic of 1·2 million people living with poor mental health would achieve cost savings to the NHS of £635·6 million and a potential running cost of £534 million. InterpretationNature prescribing projects can deliver a greater saving in healthcare costs than the cost of running them. The Wildlife Trusts and other organisations in the environment sector delivering ‘social prescribing’ should be further integrated into health and social care services in the community. We now need policies that sustainably fund the provision. FundingRoyal Society of Wildlife Trusts.

Metabolically “extremely unhealthy” obese and non-obese people with diabetes and the risk of cardiovascular adverse events: the Silesia Diabetes - Heart Project

BackgroundThere is a growing burden of non-obese people with diabetes mellitus (DM). However, their cardiovascular risk (CV), especially in the presence of cardiovascular-kidney-metabolic (CKM) comorbidities is poorly characterised. The aim of this study was to analyse the risk of major CV adverse events in people with DM according to the presence of obesity and comorbidities (hypertension, chronic kidney disease, and dyslipidaemia).MethodsWe analysed persons who were enrolled in the prospective Silesia Diabetes Heart Project (NCT05626413). Individuals were divided into 6 categories according to the presence of different clinical risk factors (obesity and CKM comorbidities): (i) Group 1: non-obese with 0 CKM comorbidities; (ii) Group 2: non-obese with 1–2 CKM comorbidities; (iii) Group 3: non-obese with 3 CKM comorbidities (non-obese “extremely unhealthy”); (iv) Group 4: obese with 0 CKM comorbidities; (v) Group 5: obese with 1–2 CKM comorbidities; and (vi) Group 6: obese with 3 CKM comorbidities (obese “extremely unhealthy”). The primary outcome was a composite of CV death, myocardial infarction (MI), new onset of heart failure (HF), and ischemic stroke.Results2105 people with DM were included [median age 60 (IQR 45–70), 48.8% females]. Both Group 1 and Group 6 were associated with a higher risk of events of the primary composite outcome (aHR 4.50, 95% CI 1.20-16.88; and aHR 3.78, 95% CI 1.06–13.47, respectively). On interaction analysis, in “extremely unhealthy” persons the impact of CKM comorbidities in determining the risk of adverse events was consistent in obese and non-obese ones (Pint=0.824), but more pronounced in individuals aged < 65 years compared to older adults (Pint= 0.028).ConclusionBoth non-obese and obese people with DM and 3 associated CKM comorbidities represent an “extremely unhealthy” phenotype which are at the highest risk of CV adverse events. These results highlight the importance of risk stratification of people with DM for risk factor management utilising an interdisciplinary approach.

The Effects of Neighborhood Greening on Inflammation in The Green Heart Project

The Effects of Neighborhood Greening on Inflammation in The Green Heart Project

Building-Integrated Photovoltaics in Existing Buildings: A Novel PV Roofing System

Among renewable energy generation technologies, photovoltaics has a pivotal role in reaching the EU’s decarbonization goals. In particular, building-integrated photovoltaic (BIPV) systems are attracting increasing interest since they are a fundamental element that allows buildings to abate their CO2 emissions while also performing functions typical of traditional building components, such as sealing against water. In such a context, since one of the main challenges to decarbonizing the building sector lies in the retrofitting of existing buildings, the current paper is focused on the design, development, and testing of a novel roofing BIPV system. The entire research was carried out as part of the Horizon 2020 HEART project. In more detail, the research analyzed the requirements of typical pitched tile roofs, which are currently the most common type in Europe, and developed a universal photovoltaic tile that can be easily and quickly integrated into such a type of roof. The research was also aimed at minimizing the embodied energy of the component and promoting disassembly and recycling at the end of life, fully in line with a circular economy perspective. The adopted design and development processes are described in detail in the present paper, along with the results of several tests performed in the field. In addition, further development prospects of the component, aimed at meeting the integration requirements in historic buildings, are finally presented.

Intra-neighborhood associations between residential greenness and blood pressure

IntroductionPrevious investigations have reported that individuals living in greener neighborhoods have better cardiovascular health. It is unclear whether the effects reported at large geographic scales persist when examined at an intra-neighborhood level. The effects of greenness have not been thoroughly examined using high-resolution metrics of greenness exposure, and how they vary with spatial scales of assessment or participant characteristics. MethodsWe conducted a cross-sectional assessment of associations between blood pressure and multiple high-resolution measures of residential area greenness in spatially concentrated HEAL Study cohort of the Green Heart Project. We employed generalized linear models, accounting for individual-level covariates, to examine associations between different high-resolution measures of greenness and blood pressure among 667 participants in a 4 sq. mile contiguous neighborhood area in Louisville, KY. ResultsIn adjusted models, we observed significant inverse associations between residential greenness, measured by leaf area index (LAI), and systolic blood pressure (SBP) within 150–250 m and 500 m of homes, but not for Normalized Difference Vegetation Index (NDVI) or grass cover. Weaker associations were also found with diastolic blood pressure (DBP). Significant positive associations were observed between LAI and SBP among participants who reported being female, White, without obesity, non-exercisers, non-smokers, younger age, of lower income, and who had high nearby roadway traffic. We found few significant associations between grass cover and SBP, but an inverse association in those with obesity, but positive associations for those without obesity. ConclusionsWe found that leaf surface area of trees around participants home is strongly associated with lower blood pressure, with little association with grass cover. These effects varied with participant characteristics and spatial scales. More research is needed to test causative links between greenspace types and cardiovascular health and to develop population-, typology-, and place-based evidence to inform greening interventions.

Abstract P447: Heart Disease Health Disparities Among Native Hawaiian and Pacific Islander Communities in the United States: A Systematic Review

Background: Heart disease is a leading cause of death among Native Hawaiian and Pacific Islander (NH/PI) communities. However, the nature of disease development and risk factors is not well characterized due to poor availability of disaggregated data, hampering efforts towards the design and implementation of culturally-relevant interventions. The purpose of our review is examine known gaps in heart disease prevention measures and programs for NH/PI populations to identify opportunities to mitigate health disparities through structural- and provider-level factors. Methods: We conducted a systematic search of PubMed, Embase, and CINAHL databases to identify peer-reviewed articles focused on heart disease (coronary artery disease, heart attack, heart failure) in NH/PI populations. Eligible studies were assessed for their relevance to NH/PI populations living in the US, US territories and Freely Associated States and their coverage of topics such as prevalence, risk factors, cultural determinants, prevention, and management. Results: Of the 1,440 articles initially identified (3 duplicates removed), 1,437 article titles and abstracts were screened, 585 full-text articles were screened for eligibility and 68 articles were included for analysis. The main reasons for exclusion were the absence of NH/PI individuals, lack of focus on heart disease, grouping NH/PI people with Asian American and other racial groups, and studies conducted outside the US (e.g., Australia, New Zealand). Many of the included articles examined prevalence, risk factors, health behaviors, knowledge, and healthcare utilization, from sources such as the Multiethnic Cohort Study, Behavioral Risk Factor Surveillance Systems, National and Hawaii Vital Statistics and claims data. Culturally-grounded interventions, community-based programs, and initiatives (e.g., Native Hawaiian Health Research Project, Ohana Heart Project, Pacific Islander Health Care Project, Wahine Heart Wellness Program), which incorporate traditional practices, were identified as showing promise in reducing risk and improving heart health among NH/PI adults. Conclusion: The review unveiled a disproportionate burden of heart disease and high prevalence of obesity, diabetes, and hypertension among NH/PI communities, often attributable to lifestyle behaviors, socioeconomic factors, and limited access to healthcare. These disparities are compounded by the underrepresentation of NH/PI populations in national health surveys and the scarcity of comprehensive epidemiological studies featuring robust NH/PI samples. It is evident that further research and policy initiatives are crucial to increase research investments and promote data equity and disaggregation for this population.

The Healthy Hearts Project: Development and evaluation of a website for cardiovascular risk assessment and visualisation and self-management through healthy lifestyle goal-setting.

Materially deprived communities in the UK have excess morbidity and mortality from cardiovascular disease (CVD) but are less likely to engage with formal care pathways. Community engagement and e-health may be more effective ways to promote risk-reducing lifestyle change. The "Healthy Hearts Project" website was designed for use by community health workers (CHWs) for cardiovascular risk assessment and lifestyle goal setting, or for independent use by community members. This paper describes the website's development and evaluation. The website was developed using interactive wire frame prototypes in a user-led approach. Qualitative evaluation of the completed website's usability and acceptability was conducted using the "Thinking Aloud" method in a purposive sample of 10 participants (one voluntary sector employee, three CHWs, two community members and four healthcare professionals). Thinking Aloud interview transcripts were thematically analysed using an inductive approach. A separate quantitative evaluation of usability and the effect of using the website on CVD knowledge and beliefs was conducted. A random sample of 134 participants, recruited using the online platform Prolific, completed the "Attitudes and Beliefs About Cardiovascular Disease" (ABCD) questionnaire before and after using the website, along with the System Usability Scale (SUS). Qualitative evaluation-Four key themes were identified: 1) Website functionality and design-participants generally found the website easy to use and understood the risk communication graphics and the feedback and goal-setting features,; 2) Inclusivity and representation-most participants considered the website inclusive of a range of users/cultures; 3) Language and comprehension-participants found the language used easy to understand but suggested reducing the amount of text; 4) Motivation and barriers to change-participants liked the personalized feedback and empowerment offered by goal-setting but commented on the need for self-motivation. Quantitative evaluation-The mean score across all domains of the ABCD questionnaire (from 2.99 to 3.11, p<0.001) and in the sub-domains relating to attitudes and beliefs around healthy eating and exercise increased after using the website. The mean(sd) score on the SUS was 77.5 (13.5). The website's usability was generally rated well by both quantitative and qualitative measures, and measures of CVD knowledge improved after use. A number of general recommendations for the design of eHealth behaviour change tools are made based on participants' suggestions to improve the website.

Phase-Change Material Thermal Energy Storage for the Smart Retrofitting of Existing Buildings

This article presents the use of phase-change material (PCM) thermal storage within the Horizon 2020 HEART project (Holistic Energy and Architectural Retrofit Toolkit), aimed at decarbonising the European building sector through the retrofitting of existing structures into energy-efficient smart buildings. These buildings not only reduce energy consumption, but also incorporate advanced technologies for harnessing green energy, thereby promoting environmental sustainability. The HEART project employs state-of-the-art technologies for electricity production/dispatching and heat generation/storage, managed by a cloud-based platform for the real-time monitoring of parameters and optimising energy utilisation, enabling users to control their environmental comfort. The article provides a detailed examination of one of the project’s demonstration sites in Italy, focusing on various components such as heat pumps, photovoltaic systems (PV), controllers, and particularly emphasising the significance of storage tanks. The study involved the measurement and analysis of three heat storage tanks, each with a total volume of 3000 L. These tanks utilised PCM modules for latent heat storage, significantly enhancing overall heat accumulation. Water served as the heat transfer fluid within the tanks. Through meticulous calculations, the article quantifies the accumulated heat and presents a comparative evaluation between PCM-based storage tanks and conventional water tanks, showcasing the advantages of PCM technology in terms of increased heat retention and efficiency.

The European Ape Heart project and cardiovascular changes in the great apes

The European Ape Heart project and cardiovascular changes in the great apes

Socioeconomic and Behavioral Determinants of Cardiovascular Risk in Russia: A Structural Equation Modeling Approach.

Despite much attention within the literature, the multiple risk factors associated with CVD mortality in Russia are still not fully understood. Drawing on the Health Belief Model as a theoretical framework, we aim to elicit socioeconomic and behavioral determinants of cardiovascular risks in Russian men and women. Using the Know Your Heart project data, we utilize regression analysis and then structural equation modeling (latent class analysis and mediation analysis) to study the determinants of CVD risks. OLS and ordered logit regressions show that the key factors defining cardiovascular health behaviors in Russia are health-related actions to reduce the perceived threat of diseases (physical activity and GP visits), perceived barriers to behavioral change (financial constraints), and cues to action (awareness of the federal health check-up program). The latent class analysis further identifies three distinct groups of the population with different CVD risk levels. Over one-third of respondents belong to the "high CVD risk" class characterized by the highest share of smokers and alcohol abusers who evade contact with primary care and face financial constraints. In the mediation analysis, we find that employment mediates the relationship between physical activity and CVD risks: physically active individuals have a greater chance of employment, and employment further mitigates CVD risks. We also find an indication of the selection of the healthy into employment in the causal relationship between GP visits, having a job, and CVD risks. A corresponding set of policy actions stem from these findings. These include reinforcing the change of perceptions of CVD risks and lowering barriers to health care; raising awareness of the free preventive check-up program in the "high CVD risk" group; making sports and exercise accessible to the elderly; and using off-putting labels on alcohol products as behavioral nudges among "physically active but drinking" males.

Surgical placement of implantable cardiac loop recorders in great apes.

Cardiovascular diseaseis the leading cause of morbidity and mortality in zoologically managed adult great apes, accounting for 29%-77% of adult deaths in the North American population depending on the species. In an effort to better understand the underlying causes of heart disease, implantable loop recorders (ILRs) have been used in some cases to monitor great apes with suspected or known cases of arrhythmia. This is a 10-year review of the Great Ape Heart Project's experience of implanting 21 ILRs in 7 gorillas (Gorilla gorilla gorilla; 9 total ILR devices), 5 chimpanzees (Pan troglodytes, 11 total ILR devices), and 1 orangutan (Pongo abelii, 1 ILR device) in an effort to develop effective methods for surgical implantation and remote collection of the data for analysis.

Abstract 307: Kids Save Hearts Project: Hands-only Cardiopulmonary Resuscitation Training For Schoolchildren

Introduction: As part of a global initiative, several countries already provide cardiopulmonary resuscitation (CPR) training to children in school environments. This training is not a part of the Brazilian school curriculum, but it is necessary since cardiorespiratory arrest events are frequently fatal. Objective: This study investigates the effectiveness of hands-only cardiopulmonary resuscitation among different age groups of schoolchildren. Methods: The institution's research ethics committee previously approved the study. Prior to training, both parents and participants signed a consent form. This study was conducted in three (public and private) schools using a quasi-experimental intervention with two age groups: 7 to 11 (group I) and 12 to 17 (group II). The 90-minute training module consisted of short practice videos while watching a song dedicated to "hands-only CPR." Students were then individually evaluated for their skills and knowledge using Skill Reporter Software Laerdal Medical during one minute of chest compressions on a manikin and a dedicated game. Results: The total of 102 schoolchildren (54 females and 48 males) (table1) were trained and evaluated for demographic variables (rate, depth, recoil) and chest compression quality according to international guidelines 2020. There were differences in the physical characteristics of participants (p&lt;0.05) and significant statistical difference related to depth in CPR (median 66 mm; p: 0,01) in group II. Conclusion: It was concluded that schoolchildren performing hands-only cardiopulmonary resuscitation were adequate, and those future efforts are required to implement and expand training in low-income regions of Brazil.

Incidence of Overweight and Its Predictors in Adults after 10 Years of Follow-up: Yazd Healthy Heart Project

Background: Obesity and overweight are important public health problems which are rapidly growing throughout the world. This study aims to provide 10-year incidence estimates of obesity and overweight in adults along with their risk factors in an Iranian adult population.&#x0D; Methods: This cohort study was conducted within the framework of the Yazd Healthy Heart Project (YHHP) throughout phases from 2005-2006 to 2015-2016 among urban adult population. The participants comprised of 1000 males and 1000 females aged 20-74 years from urban areas of Yazd. Cox proportional hazards model was used to examine the potential risk factors for obesity and overweight.&#x0D; Results: A total of 2000 participants aged 47.09 ± 16.97 years and body mass index (BMI) of 21.99 ± 2.21 kg/m2 were entered in this study at baseline. After 10 years of follow-up, the cumulative incidence of overweight for the entire population was 38.6% (41.6% in women and 36.8% in men). Furthermore, the 10-year cumulative incidence of obesity was 14.8% in the population (20.8% for women and 10.5% for men). Female participants showed a significantly higher incidence rate compared to males either for obesity or overweight. Regarding risk factors, there was a significant association between non-smoking (HR= 1.54, 95% CI: 1.06-2.25), socio-economic status (HR= 1.82, 95% CI: 1.13-2.94), and education (HR= 1.56, 95% CI: 1.14-2.13) with overweight (P &lt; 0.05).&#x0D; Conclusion: This study revealed the incidence rate of obesity and overweight is significantly high in adult population of Yazd, Iran especially in women. The most important predictors of overweight seem to be smoking, lower socio-economic status, and education.

1489-PUB: Know Diabetes by Heart Campaign and Project Dulce: A Culturally Tailored Mobile-Based Self-Management Program Supports High-Risk Populations with Diabetes to Manage Cardiovascular Disease Risk

Diabetes, high blood pressure, and obesity are major risk factors for cardiovascular disease (CVD) . Access to and awareness of health education programming is often low in ethnic/racial minorities and individuals of low socioeconomic status experience a higher prevalence of T2D, hypertension, CVD and stroke. Additionally, underserved, at-risk patients face barriers to accessing traditional in-person diabetes self-management education and support (DSME/S) due to transportation, caregiving, and work conflicts. To address this gap, the ADA’s Know Diabetes by Heart (KDBH) initiative partnered with Project Dulce, an evidence-based culturally and linguistically modified DSME/S program to overlay an innovative digital approach to diabetes support programming and resources in the community. In response to COVID-restrictions, Project Dulce sessions integrating KDBH content were delivered via telehealth group sessions and text messaging to encourage heart healthy self-management behaviors. Pre/post surveys assessed knowledge and self-management, and clinical metrics were evaluated via electronic health records. The KDBH/Project Dulce DSME/S program was delivered to 5 health systems in California: 2 Federally Qualified Health Centers, 2 County health clinics and 1 large community-based health system near the US/Mexico border. Of the N=553 who received KDBH/Project Dulce education, 47% were White, 36% Hispanic, 14% African American, Asian, Native American, Pacific Islander, and 3% other. Of all enrollees, 58% were female, and 15% were &amp;lt;/= 45 y/o, 50% were 46-65 y/o and 35% were &amp;gt;/= 66 y/o. Participant feedback indicated acceptance of both the group virtual and texting programs. Findings demonstrate the feasibility of disseminating important heart healthy interventions to diverse ethnic/racial minority groups via a variety of digital and telehealth methods. Disclosure M.Ruiz: n/a. A.L.Fortmann: Consultant; Ascensia Diabetes Care, Employee; Dexcom, Inc. H.Sandoval: None. A.Philis-tsimikas: Advisory Panel; Bayer AG, Novo Nordisk, Research Support; Lilly Diabetes, National Institute of Diabetes and Digestive and Kidney Diseases, Novo Nordisk, Viking Therapeutics. M.Chichmarenko: None. S.R.Bagsic: None. J.Boyer: None. Funding American Diabetes Association/KDBH;

Integrated Approach to Cardio-Vascular Risk in Insulin-Treated People with Diabetes based on the "Heart Project" and on Metabolic Complications Expected from Incorrect Injection Practice-Related Lipohypertrophy

Type 2 diabetes (T2DM) is known to be associated with increased cardiovascular (CV) morbidity and mortality. Over time, the CV Risk of patients with T2DM has been assessed according to various methods, often borrowed from different populations. Nevertheless, never have been evaluated changes in insulin absorption due to improper injection technique and responsible for further, well recognized CV-R factors as high glycemic variability, frequent hypoglycemia, and unsatisfactory glycemic control. Aim of the study was to intensify diabetes and its own comorbidities treatment, and in addition reduce the impact of injection technique of insulin to evaluate possible improvement in the CV-R score and NHYA score in 4499 insulin-treated T2DM subjects with (LH+) and without lipohypertrophy (LH-) due to improper injection habit. The educational training and the treatment intensification significantly reduced glycemic control, hypoglycemia rate and the mean amplitude of glycemic variability, expecially in LH+ subjects, adding new knowledge to a global intervention addressed to reduce the devastating impact to the increased cardiovascular risk of diabetic people, inclusive of the risk due to LHs

Phenomenon of the complete suppression of cardiac activity in the Black Sea scorpionfish Scorpaena porcus (Scorpaenidae) during an alertness reaction

Teleosts serve as experimental models for the physiological and pathophysiological processes investigation, in particular those related to the heart work. Methods allowing to analyze the frequency parameters of the heart functioning over a long period of time require taking into account the peculiarities of fish behavioral reactions, that can affect the results of the experiment. The aim of this study was to examine the effect of the simplest test loading (sound stimulus) on the frequency parameters of the heart activity recorded by the fiber-optic method. The objects of the study were adults of Scorpaena porcus (12–15 cm long, 80–120 g in weight). In the course of experiments, each scorpionfish was kept in a separate aquarium with seawater (400×400×350 mm), with constant temperature (21 ± 0.5) °C and given oxygen content (5.5–6.7 mg·L−1, normoxia). The heart rate (HR) recording was carried out by an invasive fiber-optic method, the essence of which is to transmit the radiation of the infrared semiconductor laser of the photoplethysmograph through a thin fiber-optic cable to the pericardial membrane of the heart and then to fix the signal reflected from the contracting myocardium in the photodetector. During implantation of the photoplethysmograph light guides, the fish were anesthetized by placing them in an anesthetic solution (urethane, 2.4 g·L−1 of seawater). In the fornix of the opercular cavity above the area of the conditional heart projection, a minimal dissection of the lining epithelium was performed, through which the underlying tissues were sequentially separated by a blunt method until the pericardial membrane was reached without breaking it. Through the lumen formed in the tissues, two optical light guide sensors were introduced to the surface of the pericardial membrane. Further, free-swimming scorpionfish participated in the experiment after a day of rehabilitation after the surgery. Additionally, we assessed the functional state of the animals by visual fixation of respiratory activity by the quantity of movements of the opercular covers per minute. During studying the test loading effect on the correct registration of the scorpionfish HR, the phenomenon of temporary complete suppression of cardiac activity was revealed, which manifested itself upon presentation of sound stimuli (alertness, “freezing” reaction). The duration of cardiac arrest was 31 to 50 seconds; it was accompanied by the cessation of movement of the opercular covers (respiratory arrest, apnea). During the restoration of cardiac activity, two types of physiological reactions were noted. The first type of recovery reaction was characterized by a simultaneous 1.5-fold increase in the HR and a 2-fold enhancement in the photoplethysmograph signal amplitude. The second type of reaction was accompanied by a rise in the HR by 22 % (p &lt; 0.05) against the backdrop of a decrement in the signal amplitude of the photoplethysmograph sensors by 28 % (p &lt; 0.05); within 120 seconds, the scorpionfish HR returned to baseline. It is assumed that the short-term delay in the scorpionfish cardiac activity is based on the phenomenon of cardiorespiratory coupling and synchronization. The behavioral reaction in the form of suppression for the cardiac and simultaneously respiratory activity generation ensures the complete absence of acoustic and electrical signals, which unmask an ambush predator location, and contributes to the scorpionfish survival.

Promoting the Mental Health of University Students in China: Protocol for Contextual Assessment to Inform Intervention Design and Adaptation.

BackgroundChinese students are extremely vulnerable to developing mental illness. The stigma associated with mental illness presents a barrier to seeking help for their mental health.ObjectiveThe Linking Hearts—Linking Youth and ‘Xin’ (hearts) project is an implementation science project that seeks to reduce mental illness stigma and promote the mental health of university students in Jinan, China. The Linking Hearts project consists of 3 components. In this paper, we outline the protocol for the first component, that is, the contextual assessment and analysis of the mental health needs of university students as the first step to inform the adaptation of an evidence-based intervention to be implemented in Jinan, China.MethodsSix local universities will participate in the Linking Hearts project. A total of 100 students from each university (n=600) will engage in the contextual assessment through self-report surveys on depression, anxiety, stress, mental health knowledge, and mental health stigma. Quantitative data will be analyzed using several descriptive and inferential analyses via SPSS. A small number of participants (144 students and 144 service providers) will also be engaged in focus groups to assess the socio-environmental contexts of university students’ health and availability of mental health resources. Qualitative data will be transcribed verbatim and NVivo will be used for data management. Social network analysis will also be performed using EgoNet.ResultsLinking Hearts was funded in January 2018 for 5 years. The protocol of Linking Hearts and its 3 components was approved by the research ethics boards of all participating institutions in China in November 2018. Canadian institutions that gave approval were Ryerson University (REB2018-455) in January 2019, University of Alberta (Pro00089364), York University (e2019-162) in May 2019, and University of Toronto (RIS37724) in August 2019. Data collection took place upon ethics approval and was completed in January 2020. A total of 600 students were surveyed. An additional 147 students and 138 service providers took part in focus groups. Data analysis is ongoing. Results will be published in 2021.ConclusionsFindings from this contextual assessment and analysis will generate new knowledge on university students’ mental health status, mental health knowledge, and resources available for them. These findings will be used to adapt and refine the Acceptance and Commitment to Empowerment-Linking Youth N’ Xin intervention model. The results of this contextual assessment will be used to inform the adaptation and refinement of the mental health intervention to promote the mental health of Chinese university students in Jinan.International Registered Report Identifier (IRRID)RR1-10.2196/25009

“We don’t want you to come in and make a decision for us”: Traversing cultural authority and responsive regulation in Australian child protection systems

AbstractThe Ngulluk Koolunga Ngulluk Koort (Our Children Our Heart) project conducted extensive Elder and community consultation to develop principles and practice recommendations for child protection governance in Western Australia. We explore these principles and practice recommendations and highlight the need for culturally safe community consultation and governance with a focus on repairing damage incurred by the Aboriginal and Torres Strait Islander community from past child protection policies. We argue that using principles of responsive regulation and the inclusion of Elder voices in child protection decision making is critical to closing the gap between current practice and what is “best practice” for Aboriginal children and families. We also identify important considerations for preventing further harm through consultation processes, and issues of authority.