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Ahlam J Alhemedi,1 Motaz Ghazi Qasaimeh,2 Nour Abdo,1 Lina Elsalem,3 Dina Qaadan,4 Esraa Alomari,5 Qudama lssa,1 Mohammed Alhadeethi,1 Hamza Mazin Abdul Kareem,1 Ayham Almasri,1 Osama Elkhateeb,1 Abdallah Y Naser5 1Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan; 2Department of General Surgery and Anesthesia, Faculty of Medicine, The Hashemite University, Zarqa, Jordan; 3Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan; 4Department of Clinical Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan; 5Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, JordanCorrespondence: Ahlam J Alhemedi, Assistant Professor in Family Medicine, Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, P.O. Box 3030, Irbid, 22110, Jordan, Tel +00962796555971, Email ajalhmedy@just.edu.joBackground: University students encounter stressors that make them more susceptible to depression than the general population. Depression negatively impacts mental and physical health. Our study assessed the prevalence of depression among university students in Jordan and its associated predictors after the COVID-19 pandemic.Methods: We conducted this cross-sectional online survey study in the first quarter of 2022 by sending an online questionnaire to university students aged 18 years and older. This study assessed the symptoms of depression using the Patient Health Questionnaire-9 (PHQ-9). Binary logistic regression analysis was used to identify associated predictors of depression.Results: A total of 535 university students participated in this study. The mean depression score for the study participants was 13.9 (SD: 7.1) out of 27, representing a moderate level of depression. Among the participants, 26.2% had moderate, 19.3% had moderately severe, and 25.8% had severe depression. Students who drink three or more cups of coffee per day, have had an evaluation of their psychological state by specialists before, and have been diagnosed with any mental illness were more likely to have a higher depression score compared to others (p< 0.05). On the other hand, students who were aged 24 years and older and those who practiced regular exercise were less likely to have a higher depression score compared to others (p< 0.05).Conclusion: We found a high prevalence of depression among university students in Jordan. This result is vital for decision-makers to implement a plan to prevent and manage this mental health issue.Keywords: depression, Jordan, prevalence, students, university

Neda Bogari,1 Anas Dannoun,1 Mohammad Athar,1,2 Osama Elkhateeb,3,4 Massimo Porqueddu,5,6 Reem Allam,7 Francesco Alamanni6 1Department of Medical Genetics, Faculty of Medicine, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia; 2Science and Technology Unit, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia; 3Department of Cardiology, King Abdullah Medical City Makkah, Makkah, Kingdom of Saudi Arabia; 4Department of Cardiology, Dalhousie University Halifax, Nova Scotia, Canada; 5Department of Cardiac Surgery, King Fahd Armed Forces Hospital, Jeddah, Kingdom of Saudi Arabia; 6Department of Cardiac Surgery, Monzino Heart Center, University of Milan, Milano, Italy; 7Clinical Pathology Department, Faculty of Medicine, Zagazig University, Sharkia, EgyptCorrespondence: Neda BogariDepartment of Medical Genetics, Faculty of Medicine, Umm Al-Qura University, Makkah, Kingdom of Saudi ArabiaTel + 966 25270000 Ext:5057-4168Fax +966 25272155Email nmbogari@uqu.edu.saReem AllamClinical Pathology Department, Faculty of Medicine, Zagazig University, Sharkia, EgyptEmail rmallam@medicine.zu.edu.egPurpose: Coronary artery disease (CAD) is one of the most important leading causes of morbidity and mortality worldwide. Few studies have been carried out in the Saudi population regarding the association of rs10757278 polymorphism with CAD. This study aimed to investigate the association of the rs10757278 polymorphism with CAD in Saudi population.Materials and Methods: In this case-control study, we recruited 437 patients with CAD and 251 cross-matched healthy controls and performed polymorphism genotyping for rs10757278 using a polymerase chain reaction followed by a restriction fragment length polymorphism analysis.Results: The G allele (OR-1.44; 95% CI: 1.15– 1.80; p=0.001), as GG (OR-2.13; 95% CI: 1.35– 3.36; p=0.0009), in the dominant (OR-1.47; 95% CI: 1.03– 2.10; p=0.03) and recessive mode (OR-1.84; 95% CI: 1.26– 2.70; p=0.001) of inheritance showed a high-risk association. A disease stratified risk analysis was conducted and comparisons were made using an ANOVA analysis. Diabetes showed a risk association (p=0.001). However, a regression analysis confirmed that for the CAD cases, there was an association between the GG genotype and diabetes (p=0.005).Conclusion: The results of this study suggest that the polymorphism rs10757278 is related to a high risk of CAD in a Saudi population.Keywords: coronary artery disease, 9p21, rs10757278, gene polymorphism and Saudi population

OBJECTIVE: We aim to investigate the relationship between genetic variation and biological function on a genomic scale, focusing on identifying genes responsible for complex diseases using single nucleotide polymorphisms. Specifically, the study explores the association between the rs2383206 gene located on chromosome 9p21.3 and the development of coronary artery disease (CAD) in a specific Saudi population. PATIENTS AND METHODS: This case-control study was conducted between September 2013 and May 2015 at King Abdullah Medical City (KAMC) and Al-Noor Specialist Hospital targeting the Saudi Population residing in the western region of Saudi Arabia. The study enrolled 315 cases with documented CAD and 205 controls with normal coronary arteries on coronary angiography. Genomic DNA was extracted from peripheral blood samples of both groups, and genotyping of rs2383206 was performed using the tetra-primer amplification-refractory mutation system-polymerase chain reaction (ARMS-PCR) method. RESULTS: In this study, the prevalence of the GG genotype in rs2383206 was found to be higher in patients with CAD than in controls, with an odds ratio of 1.997 [95% confidence interval (CI): 1.176-3.394, p = 0.007]. Additionally, individuals with the GG genotype who had sedentary lifestyles, hyperlipidemia, and smoked were found to be at a higher risk for developing CAD (p = 0.003, 0.009, and 0.003, respectively). The G allele also increased the risk of CAD with an odds ratio of 1.413 (95% CI: 1.099-1.817; p = 0.004). CONCLUSIONS: In conclusion, this study demonstrated a significant association between the rs2383206 variant located on chromosome 9p21 and the development of CAD. The findings of this study provide valuable insights into the genetic susceptibility to CAD and highlight the potential of this variant as a target for future functional studies. [ABSTRACT FROM AUTHOR]

This research evaluated permeability and hydraulic conductivity of Open Graded Friction Course (OGFC) in multiple directions. Using Computational Fluid Dynamics (CFD), Ansys Fluent was utilized to simulate the laminar flow model for twelve cubic specimens of OGFC with different geometry and various porosities. Reynolds number (Re), permeability (K), and hydraulic conductivity (k) were computed for each simulation horizontally and vertically. According to the study, the horizontal permeability measurements were greater than the vertical measurements. Moreover, the permeability of OGFC is governed by the percentage of the air voids, aggregate particle size, and the thickness of the specimens. As the diameter and percentage of air voids increased, the permeability increased. Specimens with large size of aggregates and larger thicknesses have the highest values of permeability, while specimens with the small size of aggregates have the lowest values of permeability. In addition, the velocity of the flow inside the voids decreased as the diameter and percentage of air voids increased, while the pressure increased, according to the study.

Intravascular imaging has become an integral part of the diagnostic and management strategies for intracoronary pathologies. In this White Paper we summarize current evidence and its implications on the use of intravascular imaging in interventional cardiology practice. The areas addressed are planning and optimization of percutaneous coronary intervention, management of stent failure, and evaluation of ambiguous coronary lesions and myocardial infarction with nonobstructive coronary disease. The findings presented followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system in an expert consensus process that involved a diverse writing group vetted by a review group. Expert consensus was achieved around 9 statements. Use of intravascular imaging in guiding percutaneous revascularization is supported by high-quality evidence, particularly for lesions with increased risk of recurrent events or stent failure. Specific considerations for intravascular imaging guidance of intervention in left main lesions, chronic occlusion lesions, and in patients at high risk of contrast nephropathy are explored. Use of intravascular imaging to identify pathologies associated with stent failure and guide repeat intervention, resolve ambiguities in lesion assessment, and establish diagnoses in patients who present with myocardial infarction with nonobstructive coronary disease is supported by moderate- to low-quality evidence. Each topic is accompanied by clinical pointers to aid the practicing interventional cardiologist in implementation of the White Paper findings. The findings presented in this White Paper will help to guide the use of intravascular imaging toward situations in which the balance of efficacy, safety, and cost are most optimal., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The biosynthesis of iron oxide nanoparticles has received increasing attention in the field of food nanotechnology because of their non-toxicity, high efficiency, high antibacterial power, and decontamination features. Therefore, biosynthesis of iron oxide nanoparticles (nFe) was prepared from the leaves of some vegetables, such as cabbage (C) and turnips (T), as well as moringa leaves (M). Alcoholic extracts of these nanoparticles were also tested on Staphylococcus aureus and Escherichia coli to evaluate their antibacterial activity. The results revealed that the particle sizes of the biosynthesis nanomaterials studied ranged from 12.99 to 22.72 nm, and the particles were spherical, irregular, and surrounded by black color. It also contains many functional groups and minerals. Iron nanoparticles modified with Moringa oleifera extract at a concentration of 200 ppm had the highest phenol content compared to other biosynthesis nanoparticles studied. TnFe and MnFe at 200 ppm had a maximum zone of inhibition of 25 mm and 24 mm against Staphylococcus aureus and Escherichia coli, respectively. While the minimum inhibition zone of 8.0 mm was observed at 25 ppm for nFe against Escherichia coli. Therefore, it is recommended to use these extracts of biosynthesis iron oxide nanoparticles as antibacterial agents for stored foods., (© 2024. The Author(s).)

Background: The study assessed the outcomes of patients undergoing percutaneous coronary intervention (PCI) to bypass grafts, focusing on all-cause mortality and target vessel failure (TVF) rates., Methods: A single-centre registry analysis included 364 patients who underwent PCI on coronary bypass grafts between 2008 and 2019. The study analyzed all-cause mortality and TVF, which encompassed target lesion revascularization, target vessel revascularization, and medically treated occluded target graft post-PCI., Results: The median age of the patients was 71 years (interquartile range: [IQR] 65-78), with 82.1% being male. Most patients (94.8%) received PCI on saphenous vein grafts, and the median graft age was 13.0 years (IQR: 8.4-17.6). Drug-eluting stents were used more frequently (54.4%) than bare-metal stents (45.6%), with a median stent diameter of 3.5 mm (IQR: 3-4) and length of 19 mm (IQR: 18-28). Outcome differences were not significant for PCI sites (aorto-ostial, graft body, anastomosis), use of drug-eluting stents, or use of protection devices. The 1-year mortality rate was 3.3%, whereas the combined rate of TVF or death was 20.3%. After 5 years, the mortality rate increased to 14.9%, and the combined TVF or death rate rose to 40.3%. Multivariable analyses revealed that chronic kidney disease was independently associated with mortality (hazard ratio [HR] 1.74, 95% confidence interval [CI] 1.16-2.61, P  = 0.007), whereas hypertension (HR 2.42, 95% CI 1.32-4.42, P  = 0.004) and increased stent length (HR 1.01, 95% CI 1.00-1.02, P  = 0.007) were independently associated with the TVF-or-mortality outcome., Conclusions: Patients undergoing PCI to bypass grafts experience considerable adverse outcomes over a 5-year period, highlighting the need for further strategies in managing this high-risk population., (© 2023 The Authors.)

Background: Curcumin is a biomolecule that can be extracted from the Curcuma longa that has been shown to have the potential to aid skin wound healing. It has been studied for its anti-inflammatory and antioxidant properties, which may help to reduce swelling and promote tissue repair. However, curcumin has low solubility in water, which can limit its absorption and bioavailability. Encapsulating it in lipid nanoparticles may help to increase its absorption, leading to improved bioavailability., Methods: Curcumin-loaded nanostructure lipid nanocarriers (CURC-NLCs) were prepared and characterized. Also, the phenolic, flavonoid contents, antioxidant and antimicrobial efficacy against gram-positive and gram-negative bacteria were investigated. Furthermore, in vivo rabbit animal model was used to test its regenerative capacity and wound-healing efficiency., Results: The CURC-NLCs significantly increased the content of phenolic and flavonoid compounds compared to curcumin, resulting in a dramatic increase in antioxidant activity. CURC-NLCs also showed a potent inhibitory effect on Gram-positive, Gram-negative, and fungi, two times higher than curcumin. CURC-NLCs showed a higher potential to fasten the wound healing of full-thickness skin injuries as it resulted in 1.15- and 1.9-fold higher wound closure at the first week of injury compared to curcumin and control, respectively (p < 0.0001)., Conclusion: These results suggest that CURC-NLCs have an excellent potential to promote skin regeneration, which could be attributed to its antioxidant and broad-spectrum antimicrobial effect., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Competing Interests: The authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest.

Leadless pacemakers have been developed with key advantages over traditional transvenous pacemakers by substantially mitigating the risks of device infection and lead related complications, and providing an alternative pacing strategy in patients with barriers to superior venous access. The Medtronic Micra leadless pacing system is designed for implantation through a femoral venous approach across the tricuspid valve, via Nitinol tine fixation into the trabeculated subpulmonic right ventricle. Patients with surgically corrected dextro-transposition of the great arteries (d-TGA) have an increased risk of pacing requirement. There is limited published experience of implantation of leadless Micra pacemakers in this population, with key challenges relating to trans-baffle access, and deployment of the device into the less trabeculated subpulmonic left ventricle. Here we describe a case report of leadless Micra implantation in a 49 year old male with d-TGA and Senning procedure in childhood, who required pacing for symptomatic sinus node disease, with anatomic barriers to transvenous pacing. Micra implantation was successfully performed following careful consideration of patient anatomy, including the utilisation of 3D modelling to guide the implantation procedure.

Background and Objective: To systematically review, critically appraise the quality of recent clinical practice guidelines (CPGs) for neonatal hypoxic ischemic encephalopathy (HIE), and map their recommendations., Data Sources: CPG databases (GIN, ECRI, NICE, SIGN, DynaMed), Bibliographic databases (PubMed, Embase, CINAHL), and related specialized professional societies (e.g., AAP, CPS, BAPM, RCPCH, and SNS)., Study Selection: Original de-novo developed evidence-based CPGs for HIE, group authorship, Arabic or English languages, and international or national scope. The systematic review was drafted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement and Johnston et al methodological guide., Data Extraction: Quality assessment of the included HIE CPGs by the Appraisal of Guidelines for REsearch & Evaluation II (AGREE II) Instrument and report their characteristics, AGREE II ratings, and recommendations., Data Synthesis: Our search retrieved 2,489 citations, of which two recent HIE CPGs were eligible and appraised: Canadian Paediatric Society (CPS) and Queensland Maternity and Neonatal Services (QMN). The overall assessment of the QMN CPG was superior (83%). Domain 1 (Scope & Purpose) scored (47%, 63%), Domain 2 (Stakeholder Involvement) (72%, 39%), Domain 3 (Rigour of Development) (48%, 43%), Domain 4 (Clarity & Presentation) (100%, 96%), Domain 5 (Applicability) (59%, 9%), and Domain 6 (Editorial Independence) (67%, 17%) for the QMN and CPS CPGs respectively. All appraisers recommended the QMN CPG for use in practice., Conclusion: The methodological quality of the QMN CPG was superior with the relevant recommendations for its use in neonatal practice., Limitations: limited to Arabic and English languages., Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display&#95;record.php?RecordID=258291, identifier: CRD42021258291., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Amer, Anabrees, Abdelmawla, Abdalgader, Almazroei, Alhifzi, AlOnazi, Sabr, Hneiny, El-Malky, Alshalawi, Alayoubi, Chaudhry and Elkhateeb.)

Background: Aortic valve replacement (AVR) is one of the most common open-heart surgical procedures. The durability of the tissue valve in the aortic position is crucial in AVR and transcatheter AVR. We reviewed structural valve deterioration using echocardiographic follow-up in three types of surgical aortic tissue valves., Methods: A retrospective analysis was conducted where hemodynamic deterioration was evaluated and compared using transthoracic echocardiography, including pressure gradients and effective orifice area. Kaplan-Meier analyses were used to summarize the time to failure., Results: The study included 133 Trifecta, 156 Epic, and 321 Magna Ease valves. Seventy-six percent (1941/2551) of patients had to be excluded due to insufficient echo data. Through univariate analysis, 34% (216/610) of valves met deterioration criteria after 24 months. Unadjusted survival curves showed a significant difference between valves (p ≤ .001), with a longer mean time to deterioration for the Magna Ease versus Trifecta and Epic of 68.9 versus 50.1 and 38.2 months, respectively. A Cox proportional hazard analysis found worse hazard ratios of 1.69 (p ≤ .04) and 2.4 (p ≤ .01) for Trifecta versus Magna and Epic versus Trifecta, respectively., Conclusion: All three valve types demonstrated structural valve deterioration on echocardiographic follow-up with significant differences in rate. The Magna Ease appeared to have the highest durability, and the Epic the lowest. Further investigation is warranted to confirm the results in a larger multicenter study., (© 2022 Wiley Periodicals LLC.)

Objectives: To determine the one-year and five-year occurrence and prognosticators of major adverse cardiac events (MACE: composition of all-cause death, myocardial infarction, target vessel revascularization, and vessel thrombosis), mortality, and target lesion revascularization (TLR) in patients with in-stent restenosis (ISR) treated with drug-eluting balloons (DEBs)., Background: DEBs have become an emerging therapeutic option for ISR. We report the results of a single-center retrospective study on the treatment of ISR with DEB., Methods: 94 consecutive patients with ISR treated with the paclitaxel-eluting balloon were retrospectively studied between August 2011 and December 2019., Results: The one-year MACE rate was 11.8%, and the five-year MACE rate was 39.8%. The one-year mortality was 5.3%, and the five-year mortality rate was 21.5%. The one-year TLR rate was 4.3%, and the five-year rate was 18.7%. The univariable-Cox proportional hazard models for TLR showed lesion length, and the number of DEBs per vessel is associated with adverse outcomes with H.R. of 1.038 (1.007-1.069) and 4.7 (1.6-13.8), respectively., Conclusion: Our data indicate that at one year, DEBs provide an effective alternative to stenting for in-stent restenosis. Our five-year data, representing one of the longest-term follow-ups of DEB use, demonstrate high rates of MACE. The high five-year MACE reflects all-cause mortality in a high-risk population. This is offset by a reasonable five-year rate of TLR, indicating that DEB provides both short-term and long-term benefits in ISR., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Kyle Murnaghan et al.)

Competing Interests: Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Background: Ostial left anterior descending (LAD) artery lesions are a critical area for coronary stenting, given that the location subtends a large area of the myocardium and can also be more technically challenging. It remains controversial whether crossover stenting of ostial LAD back into the left-main (LM) is advantageous over stenting the ostium alone., Methods: To evaluate the long-term clinical outcomes of stenting ostial LAD lesions, we retrospectively reviewed all ostial LAD lesions cases at QEII Health Science Centre between 2008 and 2018. Specifically, we compared the outcomes in those patients that had left main stent crossover vs. ostial stenting (OS) alone., Results: The total number of patients included in the study was 175, with 25 patients (14%) having a crossover to the LM and 150 (86%) having OS. There were more patients with previous CABG (24%) in the crossover group compared to the OS group (9.2%) (P = 0.042). The one-year MACE was not significantly different between CO vs. OS (13.3% (10.5-16.1) vs. 12% (5.5-18.5)). The five-year MACE was numerically higher, although statistically not significant, in CO vs. OS (19.3 (15.9-22.7) vs. 25.9 (16.6-35.2))., Conclusion: This study shows that percutaneous intervention provides reasonable long-term outcomes and low rates of repeat revascularization for isolated ostial LAD lesions, with no noticeable difference in outcomes with crossover stenting into the LM vs. OS alone. A larger, prospective study may be required to determine the optimal strategy for treating ostial LAD lesions., Competing Interests: None., (AJCD Copyright © 2022.)

Background: Coronary artery disease (CAD) is one of the common genetic and clinical risk factors associated with cardiovascular and multifactorial disorder. ATP-binding cassette transporter A1 (ABCA1) gene plays an important role in lipid metabolism and in multiple studies associated with CAD. However, more studies are needed to identify the exact role of single nucleotide polymorphisms which may cause CAD., Objectives: The aim of this study is to investigate the genetic association of polymorphism g.1051G > A in the ABCA1 gene with CAD patients in the Saudi population., Methods: We included 315 confirmed CAD cases, and 205 non-CAD or control subjects in this case-control study. DNA isolation was carried out for all registered participants and the polymorphism g.1051G > A was genotyped with Polymerase Chain Reaction followed by Restriction Fragment Length Polymorphism analysis with EcoNI restriction enzyme., Results: Modifiable risk factors such as Body Mass Index, smoking and diabetes were strongly associated and non-modifiable risk factors such as hypertension (Systolic Blood Pressure and Diastolic Blood Pressure) and serum analysis such as Fasting Blood Glucose, Total cholesterol (TC), Triglyceride (TG) and LDL-c were significantly associated in CAD cases (p < 0.05). Allele (OR-1.73;95% CI:1.33-2.26; p = 0.0004), GA vs GG (OR-2.26; 95% CI: 1.53-3.35; p = 0.0003 and dominant inheritance pattern (OR-2.23; 95% CI:1.56-3.20; p = 0.00009 was strongly associated with CAD cases and control subjects. The frequency level of use of atorvastatin was significantly different among GG, GA and AA subjects. Additionally, TC and TG levels were influenced by the presence of g.1051G > A polymorphism., Conclusion: The polymorphism g.1051G > A in the gene ABCA1 is closely associated with the existence of the CAD subjects. This polymorphism could also affect the serum levels of the lipid profile, suggesting a possible occurrence of CAD in the Saudi population., 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., (© 2021 The Author(s).)

Background: Different common gene variants were related to coronary artery disease (CAD) in many studies. Yet, the relation of these loci to the severity of CAD is not completely elucidated., Methods: We enrolled 520 subjects (315 CAD cases and 205 controls). CAD presence and extension were assessed by coronary angiography (CAG). Genotyping of five SNPs (namely, rs2230806 (1051G > A) in ABCA1 on chromosome 9, rs2075291 (553G > T) in ApoA5 on chromosome 11, rs320 in LPL on chromosome 8 intron (T → G at position 481), rs10757278 (c.22114477A > G), and rs2383206 (c.22115026 A > G) on chromosome 9p21 locus) was performed by allele-specific PCR. The degree and site of arterial lesions were used to classify patients, tested for association with CAD severity, and related to allele dosage., Results: The polymorphisms rs2383206 and rs10757278 showed significant associations with 2- and 3-vessel coronary disease (p =0.003 and 0.006, respectively). The homozygous GG genotypes of rs10757278 was associated with higher frequency of left anterior descending (LAD), right coronary artery (RCA) and left circumflex (LCX) diseases (p =0.002, 0.016 and 0.002, respectively). The GG genotypes of rs2383206 were found in higher percentage in patients with left main (LM) trunk and left circumflex (LCX) diseases ( p = 0.013 and 0.002, respectively)., Conclusion: SNPs rs10757278 and rs2383206 allele dosage could predict CAD severity in the Saudi Arab population., Competing Interests: There is no conflict of interest concerning this article., (Copyright © 2021 Neda M. Bogari et al.)

Objectives: Social media use is associated with developing communities of practice that promote the rapid exchange of information across traditional institutional and geographical boundaries faster than previously possible. We aimed to describe and share our experience using #neoEBM (Neonatal Evidence Based Medicine) hashtag to organise and build a digital community of neonatal care practice., Materials and Methods: Analysis of #neoEBM Twitter data in the Symplur Signals database between 1 May 2018 to 9 January 2021. Data on tweets containing the #neoEBM hashtag were analysed using online analytical tools, including the total number of tweets and user engagement., Results: Since its registration, a total of 3 228 distinct individual Twitter users used the hashtag with 23 939 tweets and 37 259 710 impressions generated. The two days with the greatest number of tweets containing #neoEBM were 8 May 2018 (n = 218) and 28 April 2019 (n = 340), coinciding with the annual Pediatric Academic Societies meeting. The majority of Twitter users made one tweet using #neoEBM (n = 1078), followed by two tweets (n = 411) and more than 10 tweets (n = 347). The number of individual impressions (views) of tweets containing #neoEBM was 37 259 710. Of the 23 939 tweets using #neoEBM, 17 817 (74%) were retweeted (shared), 15 643 (65%) included at least one link and 1 196 (5%) had at least one reply. As #neoEBM users increased over time, so did tweets containing #neoEBM, with each additional user of the hashtag associated with a mean increase in 7.8 (95% CI 7.7-8.0) tweets containing #neoEBM., Conclusion: Our findings support the observation that the #neoEBM community possesses many of the characteristics of a community of practice, and it may be an effective tool to disseminate research findings. By sharing our experiences, we hope to encourage others to engage with or build online digital communities of practice to share knowledge and build collaborative networks across disciplines, institutions and countries., Competing Interests: AK, RP, CW, SM, AS, OE and BK are current or previous social media editors and NB is immediate past lead social media editor for the International Society for Evidence-Based Neonatology (ebneo.org) and all tweet as part of these roles as @EBNEO. None are compensated for their role as social media editors. The authors have no financial relationships with the online analytical platform Symplur. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted many aspects of ST-segment elevation myocardial infarction (STEMI) care, including timely access to primary percutaneous coronary intervention (PPCI)., Objectives: The goal of the NACMI (North American COVID-19 and STEMI) registry is to describe demographic characteristics, management strategies, and outcomes of COVID-19 patients with STEMI., Methods: A prospective, ongoing observational registry was created under the guidance of 3 cardiology societies. STEMI patients with confirmed COVID+ (group 1) or suspected (person under investigation [PUI]) (group 2) COVID-19 infection were included. A group of age- and sex-matched STEMI patients (matched to COVID+ patients in a 2:1 ratio) treated in the pre-COVID era (2015 to 2019) serves as the control group for comparison of treatment strategies and outcomes (group 3). The primary outcome was a composite of in-hospital death, stroke, recurrent myocardial infarction, or repeat unplanned revascularization., Results: As of December 6, 2020, 1,185 patients were included in the NACMI registry (230 COVID+ patients, 495 PUIs, and 460 control patients). COVID+ patients were more likely to have minority ethnicity (Hispanic 23%, Black 24%) and had a higher prevalence of diabetes mellitus (46%) (all p < 0.001 relative to PUIs). COVID+ patients were more likely to present with cardiogenic shock (18%) but were less likely to receive invasive angiography (78%) (all p < 0.001 relative to control patients). Among COVID+ patients who received angiography, 71% received PPCI and 20% received medical therapy (both p < 0.001 relative to control patients). The primary outcome occurred in 36% of COVID+ patients, 13% of PUIs, and 5% of control patients (p < 0.001 relative to control patients)., Conclusions: COVID+ patients with STEMI represent a high-risk group of patients with unique demographic and clinical characteristics. PPCI is feasible and remains the predominant reperfusion strategy, supporting current recommendations., Competing Interests: Funding Support and Author Disclosures This work was supported by an American College of Cardiology Accreditation Grant, Saskatchewan Health Research Foundation (SHRF), and grants from Medtronic and Abbott Vascular to SCAI. Dr. Garcia has received institutional research grants from Edwards Lifesciences, BSCI, Medtronic, and Abbott Vascular; has served as a consultant for Medtronic and BSCI; and has served as a proctor for Edwards Lifesciences. Dr. Saw has received unrestricted research grant support from the Canadian Institutes of Health Research, Heart and Stroke Foundation of Canada, National Institutes of Health, AstraZeneca, Abbott Vascular, St. Jude Medical, Boston Scientific, and Servier; has received salary support from the Michael Smith Foundation for Health Research; has received speaker honoraria from AstraZeneca, Abbott Vascular, Boston Scientific, and Bayer; has received consultancy and advisory board honoraria from AstraZeneca, Boston Scientific, Abbott Vascular, Gore, Abiomed, and Baylis; and has received proctorship honoraria from Abbott Vascular and Boston Scientific. Dr. Jaffer has received research grants from Siemens, Canon, Shockwave, and Teleflex; has served as a consultant for Boston Scientific, Siemens, Biotronik, and Magenta Medical; owns equity interest in Intravascular Imaging; and Massachusetts General Hospital has patent licensing arrangements with Canon, Terumo, and Spectrawave, and Dr. Jaffer has a right to receive licensing royalties. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2021 American College of Cardiology Foundation. All rights reserved.)

Lipoprotein Lipase (LPL) is known to be a key enzyme for lipid metabolism specifically in an enzymatic glycoprotein which provide tissues without fatty-acids and eliminates triglycerides (TG) by the circulation. Mutations in LPL were proven to cause alteration in fractions within lipoprotein, causing the development of atherosclerosis which predispose to weakening coronary artery disease (CAD) and stroke. We examined the linkage between genetic variant Hind III in LPL on lipoprotein fractions, stroke occurrences and CAD. In this case-control study, we have recruited 315 CAD cases and 205 age-matched controls. A total of 520 genomic DNA was digested with the purified PCR products for restriction fragment length polymorphism with Hind III restriction enzyme. The distribution of genotypes in a decreasing order were TT, 148 (47%), GT 135 (42.9%) and GG 32 (10.2%) in CAD groups of the study while the pattern in controls were GT 91 (44.4%), TT 86 (42%) and GG 28 (13.7%). None of all the allele or genotype frequencies were found to be significant in our study (p greater than 0.05), while the biochemical levels for both TG and LDL-c were shown to be prone in CAD patients when compare with the controls. Furthermore, the occurence of strokes were more in CAD groups vs. controls: 72 (22.9%) vs. 7 (3.4%) [p 0.000]. This could indicate the influence of Hind III variant on plasma lipid levels, and the possibility of considering it a risk factor for atherosclerosis leading to CAD and stroke occurrence., 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., (© 2020 The Author(s).)

Objective: To evaluate outcomes of preterm infants <26 weeks gestational age (GA) following postdelivery extensive cardiopulmonary resuscitation (ECPR) compared with airway and breathing support (ABS)., Study Design: Retrospective review of Canadian Neonatal Network data during January 2010 to December 2016. The primary outcome was death or severe morbidity (intraventricular hemorrhage ≥grade 3 or periventricular leucomalacia, retinopathy of prematurity ≥stage 3, bronchopulmonary dysplasia, or necrotizing enterocolitis)., Result: Among 3633 infants analyzed, 433 (11.9%) received ECPR. In multivariable analysis, death or severe morbidity was higher in the ECPR versus ABS group [adjusted odds ratio 2.26 (95% confidence interval 1.49, 3.43)]. The majority of the difference was due to increased mortality, which occurred mostly during the first week of life., Conclusion: These data from a recent cohort of infants near the limits of viability may be useful for prognostication for health care providers and counseling of parents.

Background: Left ventricular thrombus (LVT) is a well-recognized complication of myocardial infarction that affects patient outcomes and warrants screening., Methods: This retrospective study included 308 consecutive patients who presented with acute ST-elevation myocardial infarction and were treated with primary percutaneous coronary intervention., Results: Early screening for LVT by echocardiography and cardiac magnetic resonance revealed the following: LVT (+) group (36 patients [11.7%]) and LVT (-) group (272 patients [88.3%]). The 2 powerful independent variables associated with LVT formation were left anterior descending-related infarct (odds ratio, 10.17; P < 0.0001) and severe left ventricular systolic dysfunction (odds ratio, 8.3; P  = 0.0001). The lower the left ventricular ejection fraction, the higher the risk of LVT was. Multivessel coronary artery disease and the type of early invasive strategy (culprit lesion only vs complete revascularization) were not predictive of LVT. The impact of environment (i.e., hot climate, exercise) and dehydration on the risk of LVT formation is uncertain., Conclusion: Early LVT formation is a frequent complication in acute ST-elevation myocardial infarction despite timely intervention. Its independent predictors are left anterior descending-related infarct and severe left ventricular systolic dysfunction. In patients with multivessel coronary artery disease, there was no significant difference between lesion-only culprits and complete revascularization in reducing the risk of LVT development. Further studies in larger numbers of patients are needed because of the uncertainties regarding the links between the biological effects of the environment and the risk of LVT formation., (© 2020 Canadian Cardiovascular Society. Published by Elsevier Inc.)

Competing Interests: Competing interests: None declared.

Background: Despite evidence that effective family support improves health behaviour and outcomes, the nature of the correlation between congestive heart failure (CHF) outcome and caregiver contribution has not been well studied., Aim: This single centre pilot study aimed to determine epidemiological correlations between education level and hospital readmission and mortality rates of CHF patients in a nonwestern country population., Methods: The study was performed in King Abdullah Medical City, Makkah, Saudi Arabia from February 2015 to February 2016, and included 167 consecutive patients enrolled in a CHF management registry. Data on the education levels of patients and their caregivers were collected, and patient outcomes in high education level (HEL) and low education level (LEL) groups were compared., Results: Of 167 patients, 101 completed 12 months of follow-up. The mean age was 58 (13.4) years and 80% were men; 87% were Saudi nationals. The HEL group comprised 42 (42%) patients. There were no significant differences in the mortality (3 vs 2%) or readmission rate (18 vs 19%) between the LEL and HEL patients, and 29.6% of LEL patients had caregivers with an LEL., Conclusion: The education levels of CHF patients and caregivers were not correlated with readmission or mortality rates., (Copyright © World Health Organization (WHO) 2018. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).)

Underexpansion of an aortic bioprosthetic valve is common after transcatheter aortic valve replacement (TAVR). Significant discrepancy between invasive hemodynamic gradients and echocardiographic Doppler gradients in an underexpanded bioprosthesis can be attributed to pressure recovery phenomenon. This case emphasizes the importance of echocardiographic guidance in implantation and assessment of bioprosthetic valve during TAVR.

Aims: The two components of disability-adjusted life year (DALY), years of life lost (YLL) and years lived with disability (YLD), are underutilized in evaluating heart failure with reduced ejection fraction (HFrEF) and in assessing the global burden of disease. We aim to describe both the direct (medical) and the indirect (morbidity and mortality) inpatient cost of congestive heart failure in a high-income non-Organization for Economic Cooperation and Development Middle Eastern country in relation to YLL and YLD., Methods and Results: We used the World Health Organization's global burden of disease methodology to calculate DALY, YLL, and YLD in 174 consecutive prospectively enrolled New York Heart Association Classes II-IV patients in a single-centre heart failure registry using a 0.4 disability weight and a 3% future age discount. We reported the cost of hospitalization, re-hospitalization, and non-invasive and invasive procedures per 1000 HFrEF patients in US dollars (USD). Expressing results as per 1000 HFrEF capita revealed a DALY of 1480 ± 1909 vs. 2177 ± 2547 in women and men, respectively. The costs per HFrEF capita in USD were $909.00 ± 676.1 for a single-day hospital stay, $7999 per single hospitalization, $12 311 ± 13 840 for annual hospitalizations, $20 486 ± 22 068 for all-cause hospitalizations, and $37 355 ± 49 336 from the time of diagnosis until death or recovery., Conclusions: In this study, HFrEF imposed a substantial economic and disability burden on one non-Organization for Economic Cooperation and Development Middle Eastern country. However, men represented a higher economic burden than women., (© 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.)

Aims: We aimed to evaluate congestive heart failure (CHF) multidisciplinary disease management program (DMProg) impact on mortality, readmission rates, length of stay (LOS), and gender health characteristics., Methods and Results: This was a quasi-observational, pre- and post-trial with a parallel nonequivalent group. We enrolled 174 inpatients having CHF with reduced ejection fraction and New York Heart Association (NYHA) Class II-IV, and a total of 197 hospital admissions. A comparative follow-up was performed from 15 December 2014 to 15 December 2015. Among 197 consecutive hospital admissions, 76 (39%) were included in the preintervention or usual care group and 121 (61%) were assigned to the postintervention group. After 1 year, in comparison with the preintervention group, the postintervention group had shorter average LOS in days (7.6 days vs. 11.1 days, p  < 0.002), lower 1-year readmission rate (36% vs. 57%, p  < 0.003), and lower in-house mortality (1.6% vs. 7.8%, p  = 0.03), but similar baseline mortality scores (38.2 vs. 38.6, p  = 0.7), 30-day and 90-day readmission rates (15% vs. 18.3%, p  = 0.62 and 27.6% vs. 30%, p  = 0.65), and 30-day readmission risk score (24.9% vs. 26.2%, p  = 0.09). By regression analysis, the DMProg intervention was an independent factor for 1-year readmission reduction ( p  = 0.001). Kaplan-Meier survival analysis favored the postintervention group (log-rank, p  < 0.001)., Conclusion: DMProg significantly decreased 1-year readmission rates, LOS, and in-house mortality.

We describe a case of cytomegalovirus-induced pancytopenia in a heart transplant patient. The interesting finding of a hypercellular bone marrow indicates the possibility of a different mechanism for the pancytopenia other than bone marrow suppression. The patient was treated with ganciclovir, which resulted in the complete resolution of the viremia and pancytopenia. Cytomegalovirus infection should be suspected in heart transplant patients with pancytopenia, regardless of bone marrow results. The pathogenesis of cytomegalovirus-induced pancytopenia is likely multifactorial, with both a central and peripheral effect.