Physical activity for coronary heart disease: cardioprotective mechanisms and effects on prognosis

A sedentary lifestyle is one of the five major risk factors for coronary heart disease (CHD) along with hypertension, abnormal values of blood lipids, smoking and obesity. After an acute myocardial infarction, risk factors continue to contribute synergically to the clinical progression and prognosis of CHD. Regular physical exercise has been shown to improve exercise capacity and quality of life, to reduce symptoms and to decrease the risk of new coronary events in patients with CHD. Regular physical activity with its favourable effects on coronary risk factors, endothelial dysfunction, inflammation, tendency to thrombosis, on autonomic tone and myocardial ischemia, may play a role in reducing the risk of new coronary events and death. In view of the clinical benefits yielded and its well-documented cardioprotective mechanisms, regular physical activity should be regarded, by general practitioners and cardiologists, as a true and effective form of therapy for patients with CHD

Pedestrian Models for Autonomous Driving Part II: High-Level Models of Human Behavior

Abstract—Autonomous vehicles (AVs) must share space with pedestrians, both in carriageway cases such as cars at pedestrian crossings and off-carriageway cases such as delivery vehicles navigating through crowds on pedestrianized high-streets. Unlike static obstacles, pedestrians are active agents with complex, inter- active motions. Planning AV actions in the presence of pedestrians thus requires modelling of their probable future behaviour as well as detecting and tracking them. This narrative review article is Part II of a pair, together surveying the current technology stack involved in this process, organising recent research into a hierarchical taxonomy ranging from low-level image detection to high-level psychological models, from the perspective of an AV designer. This self-contained Part II covers the higher levels of this stack, consisting of models of pedestrian behaviour, from prediction of individual pedestrians’ likely destinations and paths, to game-theoretic models of interactions between pedestrians and autonomous vehicles. This survey clearly shows that, although there are good models for optimal walking behaviour, high-level psychological and social modelling of pedestrian behaviour still remains an open research question that requires many conceptual issues to be clarified. Early work has been done on descriptive and qualitative models of behaviour, but much work is still needed to translate them into quantitative algorithms for practical AV control

Children perceptions of emotional and rational appeals in social advertisements

Purpose This study aims to understand the impact of rational and emotional appeals on children\u2019s attitude towards two public service announcements (PSAs) that promoted eating fruits and vegetables. Design/methodology/approach A mixed-methods study was conducted with children aged 8 to 11. A convergent parallel design was selected that comprised a questionnaire for the quantitative approach and a semi-structured focus group for the qualitative approach. Findings The results from the quantitative and qualitative phases converged, showing that both components (i.e. emotional and rational) play a significant role in children\u2019s preference towards an advertisement, but the emotional component appeared to be the preeminent. Research limitations/implications Future studies should use other social subjects and children of different age brackets from various countries to test whether they continue to prefer emotional appeals in advertising. Practical implications An understanding of which elements children prefer in PSAs will enable advertising campaigns and social marketing strategies with targeted approaches that respect children\u2019s tastes to be planned. Social implications A properly designed social advertisement could have important effects on disseminating useful information, changing or preventing unhealthy habits and adopting good practices in children. Originality/value Few studies have examined the effectiveness of PSAs, especially those targeted at children. This paper contributes to extend concepts from the commercial field of advertising directed to children to the field of social advertising. To date, this field has received little attention

Association of primary pulmonary hypertension and portal hypertension. Review of the literature and description of 2 further cases]

Abstract Previous studies have shown that the association between primary pulmonary hypertension and portal hypertension is not merely coincidental. Pathogenesis of this rare combination is unclear, and several hypotheses have been advanced. In the present article, we reviewed the literature on this topic. Two new cases of this syndrome, recently admitted to our hospital, are described. Clinical and laboratory findings of our patients agree with data of the previous case reports

CARDIOVASCULAR REHABILITATION IN PATIENTS WITH DIABETES

PURPOSE: The cardiovascular disease risk profile and exercise capacity of coronary heart disease patients with type 2 diabetes mellitus (DM) were measured and compared with those of nondiabetic (NDM) patients before and after a 6-week multidisciplinary cardiac rehabilitation program. METHODS: Subjects included 413 patients with DM (56.9 +/- 7.9 years) and 614 patients with NDM (56.8 +/- 10.3 years). RESULTS: At program entry, DM patients had a higher prevalence of risk factors (hypertension, hypercholesterolemia, hypertriglyceridemia, obesity, excess abdominal fat, and depression), had a lower peak oxygen uptake (14.3 +/- 4.4 vs 16.6 +/- 5.4 mL . kg . min; P < .001), and covered a shorter distance in the 6-minute walk test (404 +/- 117 m vs 445 +/- 116 m; P < .001) than NDM patients. At the end of the exercise program, all patients achieved significant improvements in physical capacity, which were similar in DM and NDM patients (+27.6 +/- 28.2% vs +30.5 +/- 27.7% for peak oxygen uptake and +21.0 +/- 31.5% vs +21.3 +/- 53.2% for the 6-minute distance test). CONCLUSION: DM patients with coronary heart disease had a higher prevalence of cardiovascular disease risk factors as well as lower physical capacity than NDM patients at the beginning of rehabilitation. All patients demonstrated improvement in exercise capacity after rehabilitation. More importantly, the extent of the improvement was similar in DM and NDM patients. This study, which involved a large population, emphasizes the capacity of DM patients to fully benefit from a multidisciplinary risk factor management program, including exercise training and educational programs

Physical activity for coronary heart disease: cardioprotective mechanisms and effects on prognosis

Abstract: A sedentary lifestyle is one of the five major risk factors for coronary heart disease (CHD) along with hypertension, abnormal values of blood lipids, smoking and obesity. After an acute myocardial infarction, risk factors continue to contribute synergically to the clinical progression and prognosis of CHD. Regular physical exercise has been shown to improve exercise capacity and quality of life, to reduce symptoms and to decrease the risk of new coronary events in patients with CHD. Regular physical activity with its favourable effects on coronary risk factors, endothelial dysfunction, inflammation, tendency to thrombosis, on autonomic tone and myocardial ischemia, may play a role in reducing the risk of new coronary events and death. In view of the clinical benefits yielded and its well-documented cardioprotective mechanisms, regular physical activity should be regarded, by general practitioners and cardiologists, as a true and effective form of therapy for patients with CHD

Autonomic dysfunction predicts poor physical improvement after cardiac rehabilitation in patients with heart failure

Background: Cardiac autonomic dysfunction, clinically expressed by reduced heart rate variability (HRV), is present in patients with congestive heart failure (CHF) and is related to the degree of left ventricular dysfunction. In athletes, HRV is an indicator of ability to improve performance. No similar data are available for CHF. Objectives: The aim of this study was to assess whether HRV could predict the capability of CHF patients to improve physical fitness after a short period of exercise-based cardiac rehabilitation (CR). Patients and Methods: This was an observational, non-randomized study, conducted on 57 patients with advanced CHF, admitted to a residential cardiac rehabilitation unit 32 ± 22 days after an episode of acute heart failure. Inclusion criteria were sinus rhythm, stable clinical conditions, no diabetes and ejection fraction = 35%. HRV (time-domain) and mean and minimum heart rate (HR) were evaluated using 24-h Holter at admission. Patients' physical fitness was evaluated at admission by 6-minute walking test (6MWT) and reassessed after two weeks of intensive exercise-based CR. Exercise capacity was evaluated by a symptom-limited cardiopulmonary exercise test (CPET). Results: Patients with very depressed HRV (SDNN 55.8 ± 10.0 ms) had no improvement in their walking capacity after short CR, walked shorter absolute distances at final 6MWT (348 ± 118 vs. 470 ± 109 m; P = 0.027) and developed a peak-VO2 at CPET significantly lower than patients with greater HRV parameters (11.4 ± 3.7 vs. an average > 16 ± 4 mL/kg/min). Minimum HR, but not mean HR, showed a negative correlation (ρ = -0.319) with CPET performance. Conclusions: In patients with advanced CHF, depressed HRV and higher minimum HR were predictors of poor working capacity after a short period of exercise-based CR. An individualized and intensive rehabilitative intervention should be considered for these patients