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Background: Patients undergoing transcatheter aortic valve replacement surgery (TAVR) are typically older adults with multiple chronic diseases and therefore have a high surgical risk. The N-terminal of brain natriuretic peptide (BNP) and pro-BNP, referred to as NT-pro-BNP, is an easily measurable biomarker of heart failure. Studies on correlation between higher NT-pro-BNP levels and adverse prognoses after TAVR have yielded inconsistent results. Here, we investigated whether preoperative NT-pro-BNP levels are correlated with outcomes among older adults undergoing TAVR. Methods: This retrospective study included older adults with severe aortic stenosis (AS) who received TAVR from a medical center between January 2013 and June 2017. The patients' demographics, preoperative laboratory data, postoperative complications, and 1-year mortality were recorded. They were divided into two groups based on their preoperative NT-pro-BNP levels. The post-TAVR outcomes in the two groups were analyzed using a multivariate logistic regression analysis of the binary results. Results: Of the 132 patients included (mean age: 81.5 ± 8.1 years; 47% men), 96 (72.7%) had preoperative NT-pro-BNP levels = 4853 ng/L, and 36 (27.3%) had preoperative NT-pro-BNP levels > 4853 ng/L. The postoperative outcomes were significantly better in the NT-pro-BNP=4853 group than in the NT-pro-BNP>4853 group: postoperative extracorporeal membrane oxygenation fittings (4.2% vs 16.7%, p = 0.025), number of days in hospital (17.5 ± 21.0 vs 27 ± 17.0, p = 0.009), in-hospital mortality (4.2% vs 16.7%, p = 0.025), and 1-year mortality (11.5% vs 38.9%, p = 0.001); the significant differences persisted after controlling for other variables. Conclusion: For older patients undergoing TAVR with NT-pro-BNP levels > 4853 ng/L, their postoperative outcomes and 1-year mortality were correlated. Thus, NT-pro-BNP is useful for the risk assessment of patients undergoing TAVR and should be regarded as a biomarker in future risk assessments. [ABSTRACT FROM AUTHOR]

Background: A subgroup of patients with acute minor stroke (AMS) or transient ischemic attack (TIA) become disabled due to disease progression (DP) or recurrent stroke within 3 months. The aim of this article is to identify the risk factors for DP in AMS/TIA patients. In the literature, no studies focused on computed tomography perfusion (CTP) in AMS/TIA patients at the acute stage. Methods: This retrospective study included patients with AMS or TIA (onset of symptoms ≤4.5 hours, baseline National Institutes of Health Stroke Scale [NIHSS] score of 0-4). DP was defined as a deterioration of NIHSS score of ≥2 points during hospitalization or modified Ranking Scale ≥2 at 3-month follow-up. Clinical data and imaging results were retrieved and measured for statistical analysis. Results: From 2011 to 2017, total 135 patients were eligible for further analysis: 28 patients (20.7%, DP group) and 107 patients (79.3%, non-DP group). The DP group had significantly higher larger penumbra volumes (p = 0.028). In univariate model of the logistic regression, patients with the following risk factors tended to have unfavorable outcome: female gender, higher HbA1c, chronic kidney disease stage ≥3b, intracranial atherosclerosis, and penumbra volume were associated unfavorable outcome, but larger deadcore volume was not. In further multivariate analysis, only penumbra volume >5 cm³ (p = 0.049, odds ratio [OR] = 3.21, 95% CI: 1.00-10.27) had the statistical significance. The cut-point value of the penumbra volume for unfavorable outcome in AMS/ TIA patients was 4.73 cm³. Conclusion: One fifth of the AMS/TIA patients had unfavorable outcome at 90 days. In CTP performed within 4.5 hours after the onset of AMS/TIA, the penumbra volume (>5 cm³) was a significant risk factor for DP, and the cut-point value was 4.73 cm³. Further studies could be designed to involve this subgroup of patients for more aggressive treatment. [ABSTRACT FROM AUTHOR]

Background: To compare the efficacy, safety, and results of Viabahn versus bare-metal stents (BMS) in chronic total occluded (CTO) long femoropopliteal lesions. Methods: From April 2009 to August 2014, a total 97 patients (71.2 ± 9.7, 45-90 years old, 70 males) with occluded femoropopliteal lesions underwent Viabahn (55 patients) or BMS (42 patients) implantation. The clinical findings, procedural factors, and overall outcomes were collected and analyzed. Results: The average lesion length was 22.1 ± 4.8 cm in the Viabahn group and 17.8 ± 3.3 cm in the BMS group. Both groups had a 100% technical success rate. Although there was no difference between the groups in complication, mortality, and major amputation rates, the Viabahn group had a significantly better average post-operative ankle brachial index (ABI) at 1-year and 2-year follow-ups. The Viabahn group also had significantly less in-stent restenosis (ISR) and target lesion revascularization (TLR) compared with the BMS group. Nevertheless, the two groups shared similar 2-year primary patency rates (63.6% vs. 50.0%, p = .178) and 2-year secondary patency rates (85.5% vs. 81.0%, p = .554). Conclusion: Both Viabahn and BMS were efficient treatments for long femoropopliteal CTO lesions. However, the Viabahn group had significantly improved results compared with the BMS group in TLR and ISR, but the difference was not sufficient enough to result in different primary and secondary patency rates. [ABSTRACT FROM AUTHOR]

This study explored the influences of well-being instruction on college students' positive thinking. The participants of this study were 63 college students who took the course of "Psychology of Well-Being" in the case university. Results showed that after the intervention, the posttest scores of the participants were significantly higher than their pretest scores in such variables as "subjective well-being," "mindfulness," and "emotional state. "Also, students' mental health status has changed from "sentimental type, languishing type, and contented type" to "languishing type, popular type, and contented type." Based on the results, directions of higher education and future research were suggested. [ABSTRACT FROM AUTHOR]