Long-term association of ultra-short heart rate variability with cardiovascular events

Heart rate variability (HRV) is a cardiac autonomic marker with predictive value in cardiac patients. Ultra-short HRV (usHRV) can be measured at scale using standard and wearable ECGs, but its association with cardiovascular events in the general population is undetermined. We aimed to validate usHRV measured using ≤ 15-s ECGs (using RMSSD, SDSD and PHF indices) and investigate its association with atrial fibrillation, major adverse cardiac events, stroke and mortality in individuals without cardiovascular disease. In the National Survey for Health and Development (n = 1337 participants), agreement between 15-s and 6-min HRV, assessed with correlation analysis and Bland-Altman plots, was very good for RMSSD and SDSD and good for PHF. In the UK Biobank (n = 51,628 participants, 64% male, median age 58), after a median follow-up of 11.5 (11.4-11.7) years, incidence of outcomes ranged between 1.7% and 4.3%. Non-linear Cox regression analysis showed that reduced usHRV from 15-, 10- and 5-s ECGs was associated with all outcomes. Individuals with low usHRV (< 20th percentile) had hazard ratios for outcomes between 1.16 and 1.29, p < 0.05, with respect to the reference group. In conclusion, usHRV from ≤ 15-s ECGs correlates with standard short-term HRV and predicts increased risk of cardiovascular events in a large population-representative cohort

Premature atrial and ventricular contractions detected on wearable-format electrocardiograms and prediction of cardiovascular events

AIMS: Wearable devices are transforming the electrocardiogram (ECG) into a ubiquitous medical test. This study assesses the association between premature ventricular and atrial contractions (PVCs and PACs) detected on wearable-format ECGs (15 s single lead) and cardiovascular outcomes in individuals without cardiovascular disease (CVD). METHODS AND RESULTS: Premature atrial contractions and PVCs were identified in 15 s single-lead ECGs from N = 54 016 UK Biobank participants (median age, interquartile range, age 58, 50-63 years, 54% female). Cox regression models adjusted for traditional risk factors were used to determine associations with atrial fibrillation (AF), heart failure (HF), myocardial infarction (MI), stroke, life-threatening ventricular arrhythmias (LTVAs), and mortality over a period of 11.5 (11.4-11.7) years. The strongest associations were found between PVCs (prevalence 2.2%) and HF (hazard ratio, HR, 95% confidence interval = 2.09, 1.58-2.78) and between PACs (prevalence 1.9%) and AF (HR = 2.52, 2.11-3.01), with shorter prematurity further increasing risk. Premature ventricular contractions and PACs were also associated with LTVA (P < 0.05). Associations with MI, stroke, and mortality were significant only in unadjusted models. In a separate UK Biobank sub-study sample [UKB-2, N = 29,324, age 64, 58-60 years, 54% female, follow-up 3.5 (2.6-4.8) years] used for independent validation, after adjusting for risk factors, PACs were associated with AF (HR = 1.80, 1.12-2.89) and PVCs with HF (HR = 2.32, 1.28-4.22). CONCLUSION: In middle-aged individuals without CVD, premature contractions identified in 15 s single-lead ECGs are strongly associated with an increased risk of AF and HF. These data warrant further investigation to assess the role of wearable ECGs for early cardiovascular risk stratification

Project-based learning, an experience in the industrial practices of the Industrial Engineering Programme of the UFPS

Las prácticas Industriales se convierten en la primera experiencia de desarrollo de proyectos en el ámbito laboral. El desarrollo de un proyecto que brinde soluciones empresariales, permite desenvolver las competencias genéricas necesarias para el desarrollo profesional, afianzando un aprendizaje constructivo a través de la solución de una problemática propia de un entorno laboral, donde a través de una colaboración multidisciplinar entre la universidad y la empresa, el estudiante realiza actividades orientadas a la planeación, búsqueda de soluciones, investigación y trabajo colaborativo, que permite aplicar los conocimientos adquiridos dentro de su formación profesional, trabajo en equipo, actitud crítica, entro otros elementos que benefician la formación integral del futuro profesional. La presente investigación abarca la experiencia desarrollada en el Programa de Ingeniería Industrial en la orientación de la asignatura de Prácticas Industriales, aplicando el Aprendizaje Basado en Proyectos como estrategia para desarrollar competencias cognitivas, colaborativas e investigativas. Palabras clave: Aprendizaje Basado en Proyectos, prácticas profesionales de ingeniería industrial, relación universidad – empresa

Premature atrial and ventricular contractions detected on wearable-format electrocardiograms and prediction of cardiovascular events

Aims: Wearable devices are transforming the electrocardiogram (ECG) into a ubiquitous medical test. This study assesses the association between premature ventricular and atrial contractions (PVCs and PACs) detected on wearable-format ECGs (15 s single lead) and cardiovascular outcomes in individuals without cardiovascular disease (CVD). Methods and results: Premature atrial contractions and PVCs were identified in 15 s single-lead ECGs from N = 54 016 UK Biobank participants (median age, interquartile range, age 58, 50–63 years, 54% female). Cox regression models adjusted for traditional risk factors were used to determine associations with atrial fibrillation (AF), heart failure (HF), myocardial infarction (MI), stroke, life-threatening ventricular arrhythmias (LTVAs), and mortality over a period of 11.5 (11.4–11.7) years. The strongest associations were found between PVCs (prevalence 2.2%) and HF (hazard ratio, HR, 95% confidence interval = 2.09, 1.58–2.78) and between PACs (prevalence 1.9%) and AF (HR = 2.52, 2.11–3.01), with shorter prematurity further increasing risk. Premature ventricular contractions and PACs were also associated with LTVA (P < 0.05). Associations with MI, stroke, and mortality were significant only in unadjusted models. In a separate UK Biobank sub-study sample [UKB-2, N = 29,324, age 64, 58–60 years, 54% female, follow-up 3.5 (2.6–4.8) years] used for independent validation, after adjusting for risk factors, PACs were associated with AF (HR = 1.80, 1.12–2.89) and PVCs with HF (HR = 2.32, 1.28–4.22). Conclusion: In middle-aged individuals without CVD, premature contractions identified in 15 s single-lead ECGs are strongly associated with an increased risk of AF and HF. These data warrant further investigation to assess the role of wearable ECGs for early cardiovascular risk stratification

Prognostic Significance of Different Ventricular Ectopic Burdens During Submaximal Exercise in Asymptomatic UK Biobank Subjects

BACKGROUND: The consequences of exercise-induced premature ventricular contractions (PVCs) in asymptomatic individuals remain unclear. This study aimed to assess the association between PVC burdens during submaximal exercise and major adverse cardiovascular events (MI/HF/LTVA: myocardial infarction [MI], heart failure [HF], and life-threatening ventricular arrhythmia [LTVA]), and all-cause mortality. Additional end points were MI, LTVA, HF, and cardiovascular mortality. METHODS: A neural network was developed to count PVCs from ECGs recorded during exercise (6 minutes) and recovery (1 minute) in 48 315 asymptomatic participants from UK Biobank. Associations were estimated using multivariable Cox proportional hazard models. Explorative studies were conducted in subgroups with cardiovascular magnetic resonance imaging data (n=6290) and NT-proBNP (N-terminal Pro-B-type natriuretic peptide) levels (n=4607) to examine whether PVC burden was associated with subclinical cardiomyopathy. RESULTS: Mean age was 56.8±8.2 years; 51.1% of the participants were female; and median follow-up was 12.6 years. Low PVC counts during exercise and recovery were both associated with MI/HF/LTVA risk, independently of clinical factors: adjusted hazard ratio (HR), 1.2 (1-5 exercise PVCs, P20 exercise PVCs, P5 recovery PVCs, P20 exercise PVCs, P5 recovery PVCs, P<0.001). Complex PVC rhythms were associated with higher risk compared with PVC count alone. PVCs were also associated with incident HF, LTVA, and cardiovascular mortality, but not MI. In the explorative studies, high PVC burden was associated with larger left ventricular volumes, lower ejection fraction, and higher levels of NT-proBNP compared with participants without PVCs. CONCLUSION: In this cohort of middle-aged and older adults, PVC count during submaximal exercise and recovery were both associated with MI/HF/LTVA, all-cause mortality, HF, LTVAs, and cardiovascular mortality, independent of clinical and exercise test factors, indicating an incremental increase in risk as PVC count rises. Complex PVC rhythms were associated with higher risk compared with PVC count alone. Underlying mechanisms may include the presence of subclinical cardiomyopathy

Mapping of the atmospheric deposition of sulfur and nitrogen during the dry season 2016 in the Metropolitan zone of Merida, Yucatan, Mexico

Abstract. Atmospheric deposition of sulfur and nitrogen was measured in the Metropolitan Area of Merida, Yucatan in Mexico during the dry season of 2016. Passive samplers type "throughfall" based on ion exchange resins were used to measure the hydrological flows in a total of 9 sampling sites distributed throughout the city. The ions retained in the resin were analyzed by turbidimetry and colorimetry to determine Ammonium, Nitrate and Sulfate. Deposition fluxes of S and N obtained were 6.25 and 5.19 Kg ha-1 yr-1. Both, sulfur and nitrogen atmospheric deposition fluxes were higher in urban sites, exceeding almost 2 times, the reference values proposed internationally for sensitive ecosystems. From the analysis of wind roses and air masses trajectories, it was possible to establish that during this climatic season, in addition to the local vehicular emissions, regional emissions generated upwind (from E-SE) contributed to atmospheric deposition of these ions. Finally, N and S deposition fluxes and their relationship with criteria pollutants were assessed, and maps for atmospheric deposition fluxes of Ammonium, Sulfate and Nitrate were generated using geo-statistical tools in order to identify critical deposition zones in this Metropolitan zone

Frequency of infection by Leptospira sp. in white neck squirrel (Sciurus stramineus) in a zoo of Lima city

El objetivo del estudio fue detectar la frecuencia de anticuerpos contra Leptospira sp en la población de ardillas nuca blanca (Sciurus stramineus) silvestres capturadas en el zoológico Parque de Las Leyendas, Lima. Se colectó 35 muestras de suero de ardillas nuca blanca de ambos sexos, de diferentes edades y zonas del zoológico, para la detección de anticuerpos contra Leptospira sp mediante la prueba de microaglutinación. El 82.3% (29/35) de animales presentó anticuerpos contra Leptospira sp, donde el 60% correspondió al serovar icterohemorraghiae, seguidos por georgia (31.4%), canicola (5.7%), y australis (2.8%). No hubo diferencia estadística entre la presencia de anticuerpos contra Leptospira sp y las variables sexo, edad y área de captura de las ardillas. Los resultados indican que la infección leptospiral está presente en las ardillas nuca blanca pudiendo constituir un riesgo para los animales de la colección faunística y las personas que laboran en el zoológico.The purpose of the study was to detect the frequency of antibodies against Leptospira sp in the wild neck white squirrel population (Sciurus stramineus) caught in the Parque de las Leyendas Zoo, Lima. Thirty five blood samples were collected from neck white squirrels, males and females of various ages that were trapped in various areas in the zoo. Samples were analyzed for antibodies against Leptospira sp by micro agglutination test. The 82.3% (29/35) of animals had antibodies against Leptospira sp of which 60% corresponded to the icterohemorraghiae serovar, followed by georgia (31.4%), canicola (5.7%), and australis (2.8%). None statistical difference between the presence of antibodies against Leptospira sp and the variables sex, age and area of trapping was found. The results indicated that leptospiral infection is present in the neck white squirrels, and the disease poses a health risk to animals and people working at the zoo

Estudio de la respuesta espectral en el visible de películas delgadas de ZnSe

In this work are presented results in the study of photoconductivity of ZnSe thin films deposited on glass substrates at different temperatures, under high vacuum using thermal evaporation technique. The effect of substrate temperature on the spectral phoEn este trabajo se presentan resultados en el estudio de la fotoconductividad de películas delgadas de ZnSe depositadas sobre sustratos de vidrio a diferentes temperaturas, bajo alto vacío utilizando la técnica de evaporación térmica. Se estudió el efect

Epidemiological Algorithm and Early Molecular Testing to Prevent COVID-19 Outbreaks in a Mexican Oncologic Center

Introduction: Prevention strategies and detection of latent COVID-19 infections in oncology staff and oncologic patients are essential to prevent outbreaks in a cancer center. In this study, we used two statistical predictive models in oncology staff and patients from the radiotherapy area to prevent outbreaks and detect COVID-19 cases. Methods: Staff and patients answered a questionnaire (electronic and paper surveys, respectively) with clinical and epidemiological information. The data was collected through two online survey tools: Real-Time Tracking (R-Track) and Summary of Factors (S-Facts). According to the algorithm\u27s models, cut-off values were established. SARS-CoV-2 qRT-PCR tests confirmed the algorithm\u27s positive individuals. Results: Oncology staff members (n=142) were tested, and 14% (n=20) were positives for the R-Track algorithm; 75% (n=15) were qRT-PCR positive. The S-Facts algorithm identified 7.75% (n=11) positive oncology staff members, and 81.82% (n=9) were qRT-PCR positive. Oncology patients (n=369) were evaluated, and 1.36% (n=5) were positive for the algorithms. The 5 patients (100%) were confirmed by qRT-PCR at a very early stage. Conclusions: The proposed algorithms could prove to become an essential prevention tool in countries where qRT-PCR tests and vaccines are insufficient for the population

Generation of periventricular reactive astrocytes overexpressing aquaporin 4 Is stimulated by mesenchymal stem cell therapy

Aquaporin-4 (AQP4) plays a crucial role in brain water circulation and is considered a therapeutic target in hydrocephalus. Congenital hydrocephalus is associated with a reaction of astrocytes in the periventricular white matter both in experimental models and human cases. A previous report showed that bone marrow-derived mesenchymal stem cells (BM-MSCs) transplanted into the lateral ventricles of hyh mice exhibiting severe congenital hydrocephalus are attracted by the periventricular astrocyte reaction, and the cerebral tissue displays recovery. The present investigation aimed to test the effect of BM-MSC treatment on astrocyte reaction formation. BM-MSCs were injected into the lateral ventricles of four-day-old hyh mice, and the periventricular reaction was detected two weeks later. A protein expression analysis of the cerebral tissue differentiated the BM-MSC-treated mice from the controls and revealed effects on neural development. In in vivo and in vitro experiments, BM-MSCs stimulated the generation of periventricular reactive astrocytes overexpressing AQP4 and its regulatory protein kinase D-interacting substrate of 220 kDa (Kidins220). In the cerebral tissue, mRNA overexpression of nerve growth factor (NGF), vascular endothelial growth factor (VEGF), hypoxia-inducible factor-1 (HIF1α), and transforming growth factor beta 1 (TGFβ1) could be related to the regulation of the astrocyte reaction and AQP4 expression. In conclusion, BM-MSC treatment in hydrocephalus can stimulate a key developmental process such as the periventricular astrocyte reaction, where AQP4 overexpression could be implicated in tissue recovery.The present work was supported by grants PI15/00619 and PI19/00778 (to A.J.J. and P.P.-G.), PI21/000914 (to J.V.) and PI21/000915 (to A.G.) from the Instituto de Salud Carlos III, Spain, co-financed by FEDER funds from the European Union; PI18-RT-2233 from Junta de Andalucía (to A.G.) co-financed by Programa Operativo FEDER 2014–2020; PID2020-115218RB-I00 to T.I., funded by MCIN/AEI/10.13039/501100011033; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED, Instituto de Salud Carlos III, Spain) to J.V., T.I. and A.G.; FPU13/02906 to MG-B from the Ministerio de Educación, Cultura y Deporte, Spain; RYC-2014-16980 to P.P.-G. from the Ministerio de Economía y Competitividad, Spain; UMA18-FEDERJA-277 from Plan Operativo FEDER Andalucía 2014–2020 and Universidad de Málaga to P.P.-G.; Proyectos dirigidos por jóvenes investigadores from Universidad de Málaga to P.P.-G. The cost of this publication has been paid in art by “ERDF A way of making Europe” funds. Partial funding for open access charge: Universidad de Málaga