Cardiovascular Care in an Increasingly Diverse Community

The invasive Drosophila suzukii feeds and reproduces on various cultivated and wild fruits and moves between agricultural and semi-natural habitats. Hedges in agricultural landscapes play a vital role in the population development of D. suzukii, but also harbor a diverse community of natural enemies. We investigated predation by repeatedly exposing cohorts of D. suzukii pupae between June and October in dry and humid hedges at five different locations in Switzerland. We sampled predator communities and analyzed their gut content for the presence of D. suzukii DNA based on the COI marker. On average, 44% of the exposed pupae were predated. Predation was higher in dry than humid hedges, but did not differ significantly between pupae exposed on the ground or on branches and among sampling periods. Earwigs, spiders, and ants were the dominant predators. Predator communities did not vary significantly between hedge types or sampling periods. DNA of D. suzukii was detected in 3.4% of the earwigs, 1.8% of the spiders, and in one predatory bug (1.6%). While the molecular gut content analysis detected only a small proportion of predators that had fed on D. suzukii, overall predation seemed sufficient to reduce D. suzukii populations, in particular in hedges that provide few host fruit resources.

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Kardia Mobile and ISTEL HR applicability in clinical practice: A comparison of Kardia Mobile, ISTEL HR and standard 12-lead electrocardiogram records in 98 consecutive patients of a tertiary cardiovascular care centre

European Heart Journal - Digital Health ◽

10.1093/ehjdh/ztab040 ◽

2021 ◽

Author(s):

Bartosz Krzowski ◽

Kamila Skoczylas ◽

Gabriela Osak ◽

Natalia Żurawska ◽

Michał Peller ◽

...

Keyword(s):

Atrial Fibrillation ◽

Clinical Practice ◽

Cardiovascular Diseases ◽

Sinus Rhythm ◽

Sensitivity And Specificity ◽

Heart Rhythm ◽

Everyday Practice ◽

Portable Devices ◽

Care Centre ◽

Cardiovascular Care

Abstract Aims Mobile, portable ECG-recorders allow the assessment of heart rhythm in out-of-hospital conditions and may prove useful for monitoring patients with cardiovascular diseases. However, the effectiveness of these portable devices has not been tested in everyday practice. Methods and results A group of 98 consecutive cardiology patients (62 males [63%], mean age 69 ± 12.9 years) were included in an academic care centre. For each patient, a standard 12-lead electrocardiogram (SE), as well as a Kardia Mobile 6L (KM) and Istel (IS) HR-2000 ECG were performed. Two groups of experienced physycians analyzed obtained recordings. After analyzing ECG tracings from SE, KM, and IS, quality was marked as good in 82%, 80%, and 72% of patients, respectively (p < 0.001). There were no significant differences between devices in terms of detecting sinus rhythm (SE [60%, n = 59], KM [58%, n = 56], and IS [61%, n = 60]; SE vs KM p = 0.53; SE vs IS p = 0.76) and atrial fibrillation (SE [22%, n = 22], KM [22%, n = 21], and IS [18%, n = 18]; (SE vs KM p = 0.65; SE vs IS = 0.1). KM had a sensitivity of 88.1% and a specificity of 89.7% for diagnosing sinus rhythm. IS showed 91.5% and 84.6% sensitivity and specificity, respectively. The sensitivity of KM in detecting atrial fibrillation was higher than IS (86.4% vs. 77.3%), but their specificity was comparable (97.4% vs. 98.7%). Conclusion Novel, portable devices are useful in showing sinus rhythm and detecting atrial fibrillation in clinical practice. However, ECG measurements concerning conduction and repolarisation should be clarified with a standard 12-lead electrocardiogram.

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Social determinants of telemedicine utilization in ambulatory cardiovascular patients during the COVID-19 pandemic

European Heart Journal - Digital Health ◽

10.1093/ehjdh/ztab039 ◽

2021 ◽

Author(s):

Kemar J Brown ◽

Njambi Mathenge ◽

Daniela Crousillat ◽

Jaclyn Pagliaro ◽

Connor Grady ◽

...

Keyword(s):

Statistical Significance ◽

The Elderly ◽

P Value ◽

Chi Square ◽

Cardiovascular Patients ◽

Baseline Characteristics ◽

Racial Ethnic ◽

Cardiovascular Care ◽

Zip Code ◽

Hispanic White

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has resulted in the rapid uptake of telemedicine (TM) for routine cardiovascular care. Objectives To examine the predictors of TM utilization among ambulatory cardiology patients during the COVID-19 pandemic. Methods In this single centre retrospective study, all ambulatory cardiovascular encounters occurring between March 16th - June 19th, 2020 were assessed. Baseline characteristics by visit type (in-person, TM-phone, TM-video) were compared using Chi-square and student t-tests, with statistical significance defined by p value < 0.05. Multivariate logistic regression was used to explore the predictors of TM versus in-person care. Results 8446 patients (86% Non-Hispanic White, 42% female, median age 66.8 +/- 15.2 years) completed an ambulatory cardiovascular visit during the study period. TM-phone (n = 4,981, 61.5%) was the primary mode of ambulatory care followed by TM-video (n = 2693, 33.2%). Non-Hispanic Black race (OR 0.56; 95% CI: 0.35 - 0.94, p-value=0.02), Hispanic ethnicity (OR 0.53; 95% CI: 0.29 - 0.98, p = 0.04), public insurance (Medicaid OR 0.50; 95% CI:0.32 – 0.79, p = 0.003, Medicare OR 0.65; 95% CI: 0.47– 0.89, p = 0.009), zip-code linked median household income (MHI) of <$75,000, age >85 years, and patients with a diagnosis of heart failure were associated with reduced access to TM-video encounters and a higher likelihood of in-person care. Conclusions Significant disparities in TM-video access for ambulatory cardiovascular care exist among the elderly, lower income, as well as Black and Hispanic racial/ethnic groups.

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Education, Implementation, and Teams: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Circulation ◽

10.1161/cir.0000000000000896 ◽

2020 ◽

Vol 142 (16_suppl_1) ◽

Cited By ~ 4

Author(s):

Robert Greif ◽

Farhan Bhanji ◽

Blair L. Bigham ◽

Janet Bray ◽

Jan Breckwoldt ◽

...

Keyword(s):

Cardiopulmonary Resuscitation ◽

Performance Feedback ◽

Life Support ◽

Task Force ◽

Treatment Recommendations ◽

Treatment Recommendation ◽

Opioid Overdose ◽

International Consensus ◽

Scoping Reviews ◽

Cardiovascular Care

For this 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations , the Education, Implementation, and Teams Task Force applied the population, intervention, comparator, outcome, study design, time frame format and performed 15 systematic reviews, applying the Grading of Recommendations, Assessment, Development, and Evaluation guidance. Furthermore, 4 scoping reviews and 7 evidence updates assessed any new evidence to determine if a change in any existing treatment recommendation was required. The topics covered included training for the treatment of opioid overdose; basic life support, including automated external defibrillator training; measuring implementation and performance in communities, and cardiac arrest centers; advanced life support training, including team and leadership training and rapid response teams; measuring cardiopulmonary resuscitation performance, feedback devices, and debriefing; and the use of social media to improve cardiopulmonary resuscitation application.

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