Search

Communication has played a critical role during the initial response to the COVID-19 pandemic, and communicators have had a particularly difficult task in persuading different types of audience to comply with ever-changing regulations. Local government organisations play a crucial role in recontextualising the national messaging for a local audience and encouraging the public to comply with regulations. This paper investigates local government organisations' (henceforth LGOs) engagement strategies in COVID-related posts on social media. In collaboration with LGOs in England, we examined their communication strategies on Twitter and Facebook during the second UK national lockdown of the COVID-19 pandemic in November-December 2020. Using methods from corpus-assisted discourse studies, the paper analyses the occurrence and functions of selected interactive engagement markers, in this case personal pronouns, questions and hashtags. We find that such linguistic features function to encourage engagement by (a) helping to foster relatedness through ambiguity; (b) creating autonomy-supporting communication; and (c) making messages 'stand out'. Based on our corpus analysis, we discuss the initial response of the participating councils to our findings and outline future directions including the integration of multimodal approaches to studying the role of localised social media in national crisis management. We argue for more attention to be paid to the many local communicators who play an invaluable role in encouraging the public to comply with national measures in times of crisis., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Author(s).)

Background: Microalbuminuria is associated with adverse outcomes in acute coronary syndrome (ACS) patients., Methods: To evaluate the very long-term association between Microalbuminuria and the overall mortality and causes of death in this clinical setting, we prospectively studied 579 unselected ACS patients admitted to three hospitals. The baseline albumin-to-creatinine ratio (ACR) was measured on days 1, 3, and 7 in 24-h urine samples. Patients were followed for 22 years or until death., Results: Virtually all patients completed follow-up; 449(78%) had died: 41% due to non-sudden cardiac death (non-SCD), 19% sudden cardiac death (SCD), 40% due to non-cardiac (non-CD) death. Using unadjusted Cox regression analysis, ACR was a significant predictor of all-cause mortality (hazard ratio [HR] 1.26;95%confidence interval [CI] 1.22-1.31; p˂0.0001) and the three causes of death (HR 1.40;95%CI 1.32-1.48; p˂0.0001), (HR 1.22;95%CI 1.12-1.32; p˂0.0001) and (HR 1.16;95%CI 1.09-1.23; p˂0.0001) for non-SCD, SCD and non-CD respectively. Using a fully adjusted model, ACR was a significant independent predictor of all-cause mortality (HR 1.12; 95%CI 1.08-1.16; p˂0.0001) and only non-SCD (HR 1.21; 95%CI 1.14-1.29; p˂0.0001). There was a positive interaction between ACR level and history of AMI (HR 1.15; 95%CI 1.03-1.29; p = 0.01) and the presence of heart failure at admission (HR 1.11; 95%CI 1.01-1.24; p = 0.04), and negative interaction with higher than median LVEF (HR 0.89; 95%CI 0.80-0.99; p = 0.03) for all-cause mortality at the multivariable level., Conclusion: Based on the present analysis, baseline urinary albumin excretion during ACS is a strong independent predictor of the very long-term mortality risk, chiefly due to non-sudden cardiac death., Competing Interests: Declaration of Competing Interest None., (Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.)

In acute myeloid leukemia (AML), measurable residual disease (MRD) before or after allogeneic hematopoietic cell transplantation (HCT) is an established independent indicator of poor outcome. To address how peri-HCT MRD dynamics could refine risk assessment across different conditioning intensities, we analyzed 810 adults transplanted in first or second remission after myeloablative conditioning (MAC; n = 515) or non-MAC (n = 295) who underwent multiparameter flow cytometry-based MRD testing before as well as 20 to 40 days after allografting. Patients without pre- and post-HCT MRD (MRDneg/MRDneg) had the lowest risks of relapse and highest relapse-free survival (RFS) and overall survival (OS). Relative to those patients, outcomes for MRDpos/MRDpos and MRDneg/MRDpos patients were poor regardless of conditioning intensity. Outcomes for MRDpos/MRDneg patients were intermediate. Among 161 patients with MRD before HCT, MRD was cleared more commonly with a MAC (85 of 104; 81.7%) than non-MAC (33 of 57; 57.9%) regimen (P = .002). Although non-MAC regimens were less likely to clear MRD, if they did, the impact on outcome was greater. Thus, there was a significant interaction between conditioning intensity and "MRD conversion" for relapse (P = .020), RFS (P = .002), and OS (P = .001). Similar findings were obtained in the subset of 590 patients receiving HLA-matched allografts. C-statistic values were higher (indicating higher predictive accuracy) for peri-HCT MRD dynamics compared with the isolated use of pre-HCT MRD status or post-HCT MRD status for prediction of relapse, RFS, and OS. Across conditioning intensities, peri-HCT MRD dynamics improve risk assessment over isolated pre- or post-HCT MRD assessments in patients with AML., (© 2022 by The American Society of Hematology.)

Background: Fully automated urine analyzers integrated with expert software can help to select samples that need review in routine clinical laboratory. This study aimed to define review rules to be set in the expert software Director for routine urinalysis on the AutionMAX-SediMAX platform., Methods: A set of 1002 urinalysis data randomly extracted from the daily routine was used. The blind on-screen assessment was used as a reference. The data set was used to optimize the standard rules preset in the software to establish review criteria useful to intercept automated microscopy misidentification and particles suggestive of clinically significant profile. The review rate was calculated. The rules-set was also evaluated for the selection of clinically significant samples., Results: The review rules established were cross-checked between AutionMAX and SediMAX parameters, element reporting by SediMAX and strip results. For the complete rules-set the review rate was 47.6% and the efficiency for clinically significant sample selection was 58%. Finally, on the basis of the review rules an algorithm for routine practice was created., Conclusions: Review rules applied to the algorithm for routine practice enhance workflow efficiency and optimize sample screening. Revision is not necessary for samples not flagged by the rules., (Copyright © 2018. Published by Elsevier B.V.)

Background: The post-surgical history of repaired congenital heart disease (rCHD), in particular tetralogy of Fallot (TOF), is often complicated by sudden death. Electrical myocardial abnormalities could be a substrate for malignant ventricular arrhythmias., Methods and Results: 146 patients with TOF or other rCHD involving a subpulmonary right ventricle, considered to be at high arrhythmic risk, underwent right ventricular (RV) electroanatomic voltage mapping (EVM). Maps showed endocardial scars (<0.5mV) in all cases, mainly involving the RV outflow tract (n=141, 96.6%). In 28 cases (19.2%), other areas were involved. Total scar extension, expressed as % of total endocardial area, was significantly higher in patients with QRS ≥180ms [4.5% (±2.5) vs 2.8% (±2.4), p=0.014], left and right ventricular systolic dysfunction [4.5% (±3.2) vs 2.8% (±2.3), p=0.016 and 3.5% (±3.0) vs 2.6% (±1.9), p=0.03, respectively], premature ventricular contractions (PVCs) [3.2% (±2.6) vs 2.2% (±1.8), p<0.05], exercise-induced PVCs [3.8% (±2.4) vs 2.6% (±2.2), p=0.01], previous shunt [4.0% (±2.7) vs 2.6% (±2.2), p=0.01] and reintervention [4.2% (±3.2) vs 2.6% (±2.0), p=0.008]. Scar size also showed a positive correlation with duration of post-surgical follow-up (ρ=0.01), age at correction (ρ=0.01) and absolute QRS duration (ρ=0.05)., Conclusions: Patients with rCHD involving the right ventricle show electrical scars with variable distribution, not necessarily matching with sites of surgical lesions. Scar extension correlates with some of the risk factors for life-threatening arrhythmias in CHD, such as prolonged QRS. Thus EVM could be considered an additional tool in the assessment of risk stratification in this particular population., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

The Orbetello lagoon (Tyrrhenian coast, Italy) receives treated urban and land based fishfarms wastewater. The development of severe eutrophication imposed the three main activity adoption focuses on (1) macroalgae harvesting; (2) pumping of water from the sea; (3) confining wastewater to phytotreatment ponds. The responses to these interventions were rapid and macroalgal reduction growth and seagrass return were recorded. Since 1999, a new macroalgal development was recorded. The aim of this research was to discover whether the recent macroalgal growth can be attributed to the continuing wastewater influx from the remaining persistent anthropic sources (PAS) or from the sediment nutrient release. A monitoring programme was carried out between August 1999 and July 2000 in order to measure dissolved inorganic nitrogen and phosphorus in the wastewaters entering into the lagoon and in central lagoon areas, seaweed and seagrass distribution and lagoon N, P annual budgets. The results showed higher N and P values close to PAS. The distribution of the macroalgal species confirms that the available P comes almost entirely from these remaining PAS. In conclusion, the environmental measures adopted produced a significant reduction in algal biomass development in the lagoon; the macroalgal harvesting activities produced a sediment disturbance with following oxidize conditions, which make P unavailable in the lagoon water, excepting close the PAS.

Background: Elevated heart rate (HR) has been found to be related to an increased death rate in patients with acute myocardial infarction (AMI), but sex differences and optimal timing for HR measurement have not been sufficiently investigated., Objectives: To verify the predictive value of HR for one-year mortality in a cohort of subjects hospitalized for AMI, with men and women considered separately., Patients and Methods: HR was measured in 424 patients (303 men and 121 women) with constant sinus HR, on the first, third and seventh days after hospital admission for AMI. Clinical and laboratory data were obtained on the same days. All patients were followed up for one year., Results: Among the men, the one-year mortality rate was 5% for the subjects with a seven-day HR of less than 80 beats/min, and the one-year mortality rate was 39% for patients with a seven- day HR of 80 beats/min or more (P<0.0001). Among the women, the differences in mortality related to HR were not significant. In a multivariate Cox regression analysis, the relative risks of mortality in men who had an HR of 80 beats/min or more were 3.1 (CI=1.4 to 7.0, P=0.003) on the first day, 4.1 (CI=1.8 to 9.8, P=0.001) on the third day and 8.6 (CI=2.9 to 27.0, P<0.0001) on the seventh day. In the 203 men in whom echocardiographic left ventricular ejection fraction was measured, an interactive effect of high HR with depressed ejection fraction on mortality was found. Beta-blocking therapy influenced HR during AMI but did not influence the HR-mortality association., Conclusions: The results of the present prospective study show that HR measured during the first week after admission for AMI is an important predictor of mortality in men. The predictive power of HR increased from the first to the seventh day after AMI.