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Copyright of Verba: Anuario Galego de Filoloxia is the property of Universidad de Santiago de Compostela, Servicio de Publicaciones and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Acute myocardial infarction (AMI) resulting in cardiogenic shock (CS) is associated with significant mortality. There is a paucity of data on the effect of patient socioeconomic status on AMI-CS outcomes, use of mechanical circulatory support (MCS), and cardiac revascularization rates. The National Inpatient Sample Database was queried from 2016-2019 for relevant ICD-10 procedural and diagnostic codes. Patients were stratified into quartiles based on median household income and baseline characteristics and AMI-CS outcomes were compared. A p-value <0.001 was considered significant. A total of 104,885 hospitalizations for AMI-CS were identified, of which 31,355 (29.9%) are in the first; 28, 655(27.3%) are in the second; 24,670 (23.5%) are in the third; and 20,205(19.3%) are in the fourth quartile for median household income. See Table 1 for baseline characteristics. Hospitalizations from higher SES regions saw higher rates of MCS utilization (frequency from the lowest SES quartile to the highest SES quartile: 43.19%, 42.91%, 43.45%, 45.79%, p < 0.001) and higher rates of revascularization (56.26%, 57.25%, 57.28%, 58.16%, p < 0.001). However, there was no significant difference in rates of mortality between groups (frequency from the lowest SES quartile to the highest SES quartile: 48.05%, 46.58%, 47.02%, 47.28%, p =0.004). Despite a lower burden of comorbidities, higher SES hospitalizations have higher rates of MCS utilization and cardiac revascularization for AMI-CS. SES disparities in clinical outcomes continue to pose a significant challenge to our healthcare system, a topic that warrants further studies and novel solutions. [ABSTRACT FROM AUTHOR]

Cardiogenic shock (CS) complicates approximately 5% to 10% of acute myocardial infarction (AMI) with over 50 percent in-hospital mortality. There is a paucity of data on recent trends in incidence, management, and outcomes of cardiogenic shock complicating both ST‐elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI). The National Inpatient Sample Database was queried from 2011-2019 for relevant ICD-9 and -10 procedural and diagnostic codes. Baseline characteristics and in-hospital outcomes for patients who developed CS after presenting with STEMI or NSTEMI were compared by calendar year. Linear regression was performed to evaluate for chronological trends in baseline patient characteristics, mortality, use of mechanical circulatory support (MCS), and other in-hospital outcomes. Total hospital charges were normalized using gross domestic product indices. A p-value <0.001 was considered significant. Among a total of 317,002 patients aged ≥18 years with CS from 2011 to 2019, 178,580 (56.33%) had STEMI, and 138,422 (43.67%) had NSTEMI. The presence of the latter ultimately increased within these 8 years (41.3% to 46.2%) while STEMI incidence rate decreased (58.7% to 53.8%), p<0.001 for all. The burden of comorbidities was also significantly increased over this interval (Table 1). All-cause in-hospital mortality remains high, with an increasing frequency of 0.8% per year (30.8% in 2011 to 43.0% in 2019) with patients with cardiogenic shock dying despite increased contemporary treatment with revascularization therapy (67.3% in 2011 to 69.3% in 2019), p<0.001. The proportion of patients with STEMI/NSTEMI and CS undergoing temporary mechanical circulatory support (MCS) increased by 2% per year from 2.7% in 2011 to 19.5% in 2019 while the use of intra-aortic balloon pumps (IABP) decreased by the same proportion (45.4% to 29.9%), p<0.001 for all. Extracorporeal membrane oxygenation (ECMO) use significantly increased as well (0.7% in 2011 to 3.6% in 2019), p<0.001. Length of stay was similar whereas adjusted total charges increased from $169,268.00 in 2011 to $249,773.37 in 2019, p<0.001. No statistical differences were found for any MCS. The mortality rate of patients with CS due to AMI from 2011 to 2019 remains high despite important advancements in therapies. With the surge of new mechanical circulatory supports, the use of temporary MSC and ECMO has significantly increased over time. Conversely, there has been a parallel decrease in the use of intra‐aortic balloon pumps in the same period. Comorbidities seem to have increased overall along with higher hospital costs. [ABSTRACT FROM AUTHOR]

Delirium is a common complication after undergoing cardiac surgery and is associated with poor outcomes. Limited data is available regarding the incidence and consequences of delirium in patients undergoing heart transplant (HTX). The National Inpatient Sample was queried from 2011-2019 for relevant ICD-9 and ICD-10 codes to identify patients who underwent HTX. Baseline characteristics and in-hospital outcomes between patients with and without delirium were compared. Logistic regression was performed to adjust for pre-specified co-variates for mortality and other in-hospital outcomes. p-value was considered significant when <0.001. We identified a weighted sample of 25,371 admissions for HTX, of which 5.8% (n=1,482) had a diagnosis of delirium. Baseline characteristics are shown in Table 1. When controlling for significantly different variables, we found a significantly decreased difference in inpatient mortality in the delirium group (3.7% vs. 5.7%, adjusted OR 0.622 [CI 0.471-0.822], p<0.001). Despite decreased mortality, patients who underwent HTX with concomitant delirium had significantly increased length of stay (aOR 1.004 [CI 1.002-1.006]), post-procedural thromboembolic events (aOR 1.871 [CI 1.648-2.125]), renal replacement therapy use (aOR 2.668 [CI 2.276-3.128]), infections (aOR 1.592 [CI 1.393-1.820]) and HTX rejection (aOR 1.528 [CI 1.289-1.811]), p<0.001 for all. While patients undergoing HTX who have a concurrent diagnosis of delirium have lower in-hospital mortality as compared to the non-delirium group, morbidity was significantly higher across multiple indices. Further studies are needed to elucidate the paradoxical effect of delirium on mortality and characterize the risks of delirium in this patient population. [ABSTRACT FROM AUTHOR]

Acute myocardial infarction (AMI) is the most common etiology of cardiogenic shock (CS) and can result in left ventricular (LV), right ventricular (RV), or biventricular (BiV) failure. Currently there is limited data on in-hospital outcomes, rates of cardiac revascularization, and use of mechanical circulatory support (MCS) for different types of ventricular failure. The National Inpatient Sample Database was queried from 2017-2019 for relevant ICD-10 procedural and diagnostic codes. Hospitalizations where patients were transferred out were excluded. Baseline characteristics and in-hospital outcomes were compared between hospitalizations for AMI-CS with LV, RV, and BiV failure. Cases with ICD codes for both RV and LV failure were evaluated as BiV failure. A p-value <0.001 was considered significant. A weighted sample of 81,605 hospitalizations with a primary diagnosis of AMI with CS were identified. 46,465 (56.9%) cases did not specify type of ventricular failure. Of the remaining 35,140 cases, 34,095 (97.0%) had LV failure, 565 (1.6%) had RV failure, and 480 (1.4%) had BiV failure. Baseline characteristics are shown in Table 1. Compared to LV failure (43.1%), AMI-CS with RV failure (63.7%) or BiV failure (70.8%) had significantly higher mortality, p<0.001. Rates of cardiac catheterization and cardiac revascularization were significantly different between LV failure (67.5% and 53.6%), RV failure (72.6% and 60.2%), and BiV failure (53.1% and 44.8%) groups, p<0.001. Use of any mechanical circulatory support was significantly higher in the RV (56.6%) and BiV (62.5%) failure groups compared to LV failure (47.1%), p<0.001. Right and biventricular failure from AMI-CS have higher rates of mortality and higher utilization of mechanical circulatory support compared to AMI-CS with LV failure. Additional research into treatment strategies for RV and BiV failure is required to improve mortality outcomes. [ABSTRACT FROM AUTHOR]

Growing urbanization and the expansion of the agricultural frontier in tropical ecosystems have generated patchy landscapes composed of remnants of natural habitats and abandoned fields. This scenario offers an opportunity to develop urban reserves in order to preserve local fauna in expanding cities. We propose that if native animals are able to use these two habitat types, reserves composed of a mixture of natural habitats and abandoned fields would contain more diversity than reserves composed only of natural habitats. However, to be useful for conservation, these reserves must harbor specialized organisms that depend on natural habitats. To test this proposal, we focused on diurnal butterflies inhabiting an urban reserve located within the city of Puebla (Mexico), which contains relics of oak forests and abandoned fields. Butterfly assemblages were sampled and compared in the different habitat types of the reserve. The data were then pooled and analyzed for the reserve as a whole. These analyses discriminated between habitat generalist and forest specialist butterflies. Our results indicated that the different habitat types of the reserve harbor different forest specialist butterflies, which in turn enhanced the diversity of forest-dwelling butterflies at the landscape scale. This suggests that the inclusion of abandoned fields together with natural habitats in the design of urban protected areas could help to preserve at least part of the regional biodiversity. [ABSTRACT FROM AUTHOR]

The following paper is based on the observation of two related phenomena in Spanish. First, when two personal pronouns acting as prepositional objects are coordinated, they are usually constructed by repeating the preposition before each member of the coordination. Secondly. when this does not happen. the second member of the coordination doesnot appear in oblique case (which would be expected to happen through government), but it appears in nominative case. This can be clearly appreciated in the coordination of pronouns that display morphological case. The purpose of this paper is to explain these phenomena within the Minimalist Program. The conclusions suggest that the irregular case of the second member of the coordination can be explained by Johannessenn's structure for coordination (1996) hnd default case valuation principle (2008), while the duplication of the preposition can be accounted for through reasons of economy. [ABSTRACT FROM AUTHOR]

Copyright of Estudios Publicos is the property of Centro de Estudios Publicos and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)