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Effective nutrition policies require timely, accurate individual dietary consumption data; collection of such information has been hampered by cost and complexity of dietary surveys and lag in producing results. The objective of this work was to assess accuracy and cost-effectiveness of a streamlined, tablet-based dietary data collection platform for 24-hour individual dietary recalls (24HR) administered using INDDEX24 platform v. a pen-and-paper interview(PAPI) questionnaire, with weighed food record (WFR) as a benchmark. This cross-sectional comparative study included women 18-49 years old from rural Burkina Faso (n 116 INDDEX24; n 115 PAPI). A WFR was conducted; the following day, a 24HR was administered by different interviewers. Food consumption data were converted into nutrient intakes. Validity of 24HR estimates of nutrient and food group consumption was based on comparison with WFR using equivalence tests (group level) and percentages of participants within ranges of percentage error (individual level). Both modalities performed comparably estimating consumption of macro- and micronutrients, food groups and quantities (modalities' divergence from WFR not significantly different). Accuracy of both modalities was acceptable (equivalence to WFR significant at P < 0·05) at group level for macronutrients, less so for micronutrients and individual-level consumption (percentage within ±20 % for WFR, 17-45 % for macronutrients, 5-17 % for micronutrients). INDDEX24 was more cost-effective than PAPI based on superior accuracy of a composite nutrient intake measure (but not gram amount or item count) due to lower time and personnel costs. INDDEX24 for 24HR dietary surveys linked to dietary reference data shows comparable accuracy to PAPI at lower cost.

Coronavirus Disease 2019 (COVID-19) has infected more than 3.0 million people worldwide and killed more than 200,000 as of April 27, 2020. In this White Paper, we address the cardiovascular co-morbidities of COVID-19 infection; the diagnosis and treatment of standard cardiovascular conditions during the pandemic; and the diagnosis and treatment of the cardiovascular consequences of COVID-19 infection. In addition, we will also address various issues related to the safety of healthcare workers and the ethical issues related to patient care in this pandemic.

The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has important implications for the safety of participants in clinical trials and the research staff caring for them and, consequently, for the trials themselves. Patients with heart failure may be at greater risk of infection with COVID-19 and the consequences might also be more serious, but they are also at risk of adverse outcomes if their clinical care is compromised. As physicians and clinical trialists, it is our responsibility to ensure safe and effective care is delivered to trial participants without affecting the integrity of the trial. The social contract with our patients demands no less. Many regulatory authorities from different world regions have issued guidance statements regarding the conduct of clinical trials during this COVID-19 crisis. However, international trials may benefit from expert guidance from a global panel of experts to supplement local advice and regulations, thereby enhancing the safety of participants and the integrity of the trial. Accordingly, the Heart Failure Association of the European Society of Cardiology on 21 and 22 March 2020 conducted web-based meetings with expert clinical trialists in Europe, North America, South America, Australia, and Asia. The main objectives of this Expert Position Paper are to highlight the challenges that this pandemic poses for the conduct of clinical trials in heart failure and to offer advice on how they might be overcome, with some practical examples. While this panel of experts are focused on heart failure clinical trials, these discussions and recommendations may apply to clinical trials in other therapeutic areas.

BackgroundChronic kidney disease (CKD) is characterized by dysbiosis, elevated levels of uremic toxins, systemic inflammation, and increased markers of oxidative stress. These factors lead to an increased risk of cardiovascular disease (CVD) which is common among CKD patients. Supplementation with high amylose maize resistant starch type 2 (RS-2) can change the composition of the gut microbiota, and reduce markers of inflammation and oxidative stress in patients with end-stage renal disease. However, the impact of RS-2 supplementation has not been extensively studied in CKD patients not on dialysis. Aerobic exercise training lowers certain markers of inflammation in CKD patients. Whether combining aerobic training along with RS-2 supplementation has an additive effect on the aforementioned biomarkers in predialysis CKD patients has not been previously investigated.MethodsThe study is being conducted as a 16-week, double-blind, placebo controlled, parallel arm, randomized controlled trial. Sixty stage 3-4 CKD patients (ages of 30-75 years) are being randomized to one of four groups: RS-2 & usual care, RS-2 & aerobic exercise, placebo (cornstarch) & usual care and placebo & exercise. Patients attend four testing sessions: Two baseline (BL) sessions with follow up visits 8 (wk8) and 16 weeks (wk16) later. Fasting blood samples, resting brachial and central blood pressures, and arterial stiffness are collected at BL, wk8 and wk16. A stool sample is collected for analysis of microbial composition and peak oxygen uptake is assessed at BL and wk16. Blood samples will be assayed for p-cresyl sulphate and indoxyl sulphate, c-reactive protein, tumor necrosis factor α, interleukin 6, interleukin 10, monocyte chemoattractant protein 1, malondialdehyde, 8-isoprostanes F2a, endothelin-1 and nitrate/nitrite. Following BL, subjects are randomized to their group. Individuals randomized to conditions involving exercise will attend three supervised moderate intensity (55-65% peak oxygen uptake) aerobic training sessions (treadmills, bikes or elliptical machine) per week for 16 weeks.DiscussionThis study has the potential to yield information about the effect of RS-2 supplementation on key biomarkers believed to impact upon the development of CVD in patients with CKD. We are examining whether there is an additive effect of exercise training and RS-2 supplementation on these key variables.Trial registrationClinicaltrials.gov Trial registration# NCT03689569 . 9/28/2018, retrospectively registered.

Heart attack is mainly caused by the rupture of a vulnerable plaque. IVUS-OCT is a novel medical imaging modality that provides opportunities for accurate assessment of vulnerable plaques in vivo in patients. IVUS provides deep penetration to image the whole necrotic core while OCT enables accurate measurement of the fibrous cap of a plaque owing to its high resolution. In this paper, the authors describe the fundamentals, the technical designs and the applications of IVUS-OCT technology. Results from cadaver specimens are summarized, which indicated the complementary nature of OCT and IVUS for assessment of vulnerable plaques, plaque composition, and stent-tissue interactions. Furthermore, previously reported in vivo animal experiments are reviewed to assess the clinical adaptability of IVUS-OCT. Future directions for this technology are also discussed in this review.

The ACR Incidental Findings Committee presents recommendations for managing incidentally detected mediastinal and cardiovascular findings found on CT. The Chest Subcommittee was composed of thoracic radiologists who developed the provided guidance. These recommendations represent a combination of current published evidence and expert opinion and were finalized by informal iterative consensus. The recommendations address the most commonly encountered mediastinal and cardiovascular incidental findings and are not intended to be a comprehensive review of all incidental findings associated with these compartments. Our goal is to improve the quality of care by providing guidance on how to manage incidentally detected thoracic findings. [ABSTRACT FROM AUTHOR]

Psoriasis is a common, immune-mediated chronic inflammatory disease with a primary involvement of skin and joints, affecting approximately 2% of the population worldwide. Up to one third of patients with psoriasis are diagnosed with psoriatic arthritis (PsA). Psoriasis and PsA are heterogeneous diseases whose severity depends on a number of clinical factors, such as areas affected and pattern of involvement, and are associated with a range of comorbid diseases and risk factors, including obesity, metabolic syndrome, cardiovascular disease and liver disease. Thus measuring the severity of psoriatic disease needs to take into account the multidimensional aspects of the disease. Subjective measures including the impairment in quality of life or in daily living activities as well as the presence of cardio-metabolic comorbidities, are important for the outcome and add further levels of complexity that, to a certain extent, need to be assessed. Because of the wide range of comorbid conditions associated with psoriasis, comprehensive screening and treatment must be implemented for a most effective managing of psoriasis patients. A joint dermatologist–rheumatologist roundtable discussion was convened to share evidence on the real-life use of methods for measuring psoriasis severity comprehensively. Our objective was to provide an expert position on which clinical variables are to be taken into account when considering patients affected by psoriasis and/or PsA globally and on the assessment tools more suitable for measuring disease activity and/or severity in clinical practice. [ABSTRACT FROM AUTHOR]

The article examines mortality among pulp and paper mill workers according to the mail mill pulping process, department, and gender. It states that death from acute myocardial infarction was increased, which was probably related to a combination of different occupational exposures such as dust, sulfur compounds, shift work and noise. It is concluded that the study supports earlier indications of fatal cardiovascular effects among pulp and paper mill workers.

Ensemble methods overcome the limitations of single machine learning techniques by combining different techniques, and are employed in the quest to achieve a high level of accuracy. This approach has been investigated in various fields, one of them being that of bioinformatics. One of the most frequent applications of ensemble techniques involves research into cardiovascular diseases, which are considered the leading cause of death worldwide. The purpose of this research work is to identify the papers that investigate ensemble classification techniques applied to cardiology diseases, and to analyse them according to nine aspects: their publication venues, the medical tasks tackled, the empirical and research types adopted, the types of ensembles proposed, the single techniques used to construct the ensembles, the validation frameworks adopted to evaluate the proposed ensembles, the tools used to build the ensembles, and the optimization methods employed for the single techniques. This paper reports the carrying out of a systematic mapping study. An extensive automatic search in four digital libraries: IEEE Xplore, ACM Digital Library, PubMed, and Scopus, followed by a study selection process, resulted in the identification of 351 papers that were used to address our mapping questions. This study found that the papers selected had been published in a large number of different resources. The medical task addressed most frequently by the selected studies was diagnosis. In addition, the experiment-based empirical type and evaluation-based research type were the most dominant approaches adopted by the selected studies. Homogeneous ensembles were the ensemble type that was developed most often in literature, while decision trees, artificial neural networks and Bayesian classifiers were the single techniques used most frequently to develop ensemble classification methods. The weighted majority and majority voting rules were adopted to obtain the final decision of the ensembles developed. With regard to evaluation frameworks, the datasets obtained from the UCI and PhysioBank repositories were those used most often to evaluate the ensemble methods, while the k-fold cross-validation method was the most frequently-employed validation technique. Several tools with which to build ensemble classifiers were identified, and the type of software adopted with the greatest frequency was open source. Finally, only a few researchers took into account the optimization of the parameter settings of either single or meta ensemble classifiers. This mapping study attempts to provide a greater insight into the application of ensemble classification methods in cardiovascular diseases. The majority of the selected papers reported positive feedback as regards the ability of ensemble methods to perform better than single methods. Further analysis is required to aggregate the evidence reported in literature. [ABSTRACT FROM AUTHOR]

Introduction and purpose: The purpose of this scientific paper is to review the current knowledge of the effects of red wine on human health, particularly with regard to cardiovascular disease. State of Knowledge: Since the 1990s, red wine has gained its status as a health-promoting alcohol through the French Paradox - when drunk in moderate amounts, it protects against cardiovascular disease. The authors have collected scientific papers on the health effects of alcohol, red wine and resveratrol-a polyphenol that is the main component with healthpromoting effects of wine. On their basis, they analyzed the assumptions of the positive effects of wine reaching inconclusive conclusions. Summary: Despite the fact that both ethanol and resveratrol have a positive effect in in vitro studies, in population studies their effect is much less significant, either because the negative behavioral-health effects in the case of ethanol are omitted or the actual effective doses of resveratrol are omitted. [ABSTRACT FROM AUTHOR]

Flavonoids exert vasculoprotective effects in humans, but interindividual variability in their action has also been reported. This study aims to identify genes that are associated with vascular health effects of flavonoids and whose polymorphisms could explain interindividual variability in response to their intake. Applying the predetermined literature search criteria, we identified five human intervention studies reporting positive effects of flavonoids on vascular function together with global genomic changes analyzed using microarray methods. Genes involved in vascular dysfunction were identified from genome-wide association studies (GWAS). By extracting data from the eligible human intervention studies, we obtained 5807 differentially expressed genes (DEGs). The number of identified upstream regulators (URs) varied across the studies, from 227 to 1407. The search of the GWAS Catalog revealed 493 genes associated with vascular dysfunction. An integrative analysis of transcriptomic data with GWAS genes identified 106 candidate DEGs and 42 candidate URs, while subsequent functional analyses and a search of the literature identified 20 top priority candidate genes: ALDH2, APOE, CAPZA1, CYP11B2, GNA13, IL6, IRF5, LDLR, LPL, LSP1, MKNK1, MMP3, MTHFR, MYO6, NCR3, PPARG, SARM1, TCF20, TCF7L2, and TNF. In conclusion, this integrated analysis identifies important genes to design future nutrigenetic studies for development of precision nutrition for polyphenols. [ABSTRACT FROM AUTHOR]

Heart sound classification plays a critical role in the early diagnosis of cardiovascular diseases. Although there have been many advances in heart sound classification in the last few years, most of them are still based on conventional segmented features and shallow structure-based classifiers. Therefore, we propose a new heart sound classification method based on improved mel-frequency cepstrum coefficient features and deep residual learning. Firstly, the heart sound signal is preprocessed, and its improved features are computed. Then, these features are used as input features of the neural network. The pathological information in the heart sound signal is further extracted by the deep residual network. Finally, the heart sound signal is classified into different categories according to the features learned by the neural network. This paper presents comprehensive analyses of different network parameters and network connection strategies. The proposed method achieves an accuracy of 94.43% on the dataset in this paper. [ABSTRACT FROM AUTHOR]

Aims Cardiovascular disease is the most common cause of mortality and morbidity in the world, but the pharmaceutical industry's willingness to invest in this field has declined because of the many challenges involved with bringing new cardiovascular drugs to market, including late-stage failures, escalating regulatory requirements, bureaucracy of the clinical trial business enterprise, and limited patient access after approval. This contrasts with the remaining burden of cardiovascular disease in Europe and in the world. Thus, clinical cardiovascular research needs to adapt to address the impact of these challenges in order to ensure development of new cardiovascular medicines. Methods and results The present paper is the outcome of a two-day workshop held by the Cardiovascular Round Table of the European Society of Cardiology. We propose strategies to improve development of effective new cardiovascular therapies. These can include (i) the use of biomarkersto describe patients who will benefit from new therapies more precisely, achieving better human target validation; (ii) targeted, mechanism-based approaches to drug development for defined populations; (iii) the use of information technology to simplify data collection and follow-up in clinical trials; (iv) streamlining adverse event collection and reducing monitoring; (v) extended patent protection or limited rapid approval of new agents to motivate investment in early phase development; and (vi) collecting data needed for health technology assessment continuously throughout the drug development process (before and after approval) to minimize delays in patient access. Collaboration across industry, academia, regulators, and payers will be necessary to enact change and to unlock the existing potential for cardiovascular clinical drug development. Conclusions A coordinated effort involving academia, regulators, industry, and payors will help to foster better and more effective conduct of clinical cardiovascular trials, supporting earlier availability of innovative therapies and better management of cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Aim: The aim of this structured review was to discuss knowledge of nicotine use during pregnancy and long‐term effects on children's cardiovascular function. Methods: PubMed and MEDLINE were searched for original papers that covered various forms of nicotine exposure during pregnancy and this identified 314 papers published in English from inception of the databases to 1 March 2021. The research focus was prenatal exposure that had long‐term effects on the cardiovascular system. The search was expanded from the reference list of the selected papers, which identified another 17 papers. Results: The 34 original papers that were included covered 172,696 subjects from foetuses to 19 years of age. Cardiovascular autonomic dysfunction was discussed in 12 of the papers and 16 studies reported on blood pressure. The remaining studies covered structural or functional changes in arterial wall or heart. There were convincing data on autonomic dysfunction and increased blood pressure. Some data were conflicting and problems with misclassification of exposure were evident. Conclusion: Prenatal nicotine exposure was associated with long‐term developmental changes in the cardiovascular system and regulation. There were no safe periods, doses or nicotine products during pregnancy and women should abstain when planning a pregnancy. [ABSTRACT FROM AUTHOR]

Background: Disturbed heart dynamics in depression seriously increases mortality risk. Heart rate variability (HRV) is a rich source of information for studying this dynamics. This paper is a meta-analytic review with methodological commentary of the application of nonlinear analysis of HRV and its possibility to address cardiovascular diseases in depression. Objective: This paper aimed to appeal for the introduction of cardiological screening to patients with depression, because it is still far from established practice. The other (main) objective of the paper was to show that nonlinear methods in HRV analysis give better results than standard ones. Methods: We systematically searched on the web for papers on nonlinear analyses of HRV in depression, in line with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 framework recommendations. We scrutinized the chosen publications and performed random-effects meta-analysis, using the esci module in jamovi software where standardized effect sizes (ESs) are corrected to yield the proof of the practical utility of their results. Results: In all, 26 publications on the connection of nonlinear HRV measures and depression meeting our inclusion criteria were selected, examining a total of 1537 patients diagnosed with depression and 1041 healthy controls (N=2578). The overall ES (unbiased) was 1.03 (95% CI 0.703-1.35; diamond ratio 3.60). We performed 3 more meta-analytic comparisons, demonstrating the overall effectiveness of 3 groups of nonlinear analysis: detrended fluctuation analysis (overall ES 0.364, 95% CI 0.237-0.491), entropy-based measures (overall ES 1.05, 95% CI 0.572-1.52), and all other nonlinear measures (overall ES 0.702, 95% CI 0.422-0.982). The effectiveness of the applied methods of electrocardiogram analysis was compared and discussed in the light of detection and prevention of depression-related cardiovascular risk. Conclusions: We compared the ESs of nonlinear and conventional time and spectral methods (found in the literature) and demonstrated that those of the former are larger, which recommends their use for the early screening of cardiovascular abnormalities in patients with depression to prevent possible deleterious events. [ABSTRACT FROM AUTHOR]

This scoping review aimed to gain an insight into the oral health status, behaviour, knowledge, and risk among cardiovascular patients, as well as to explore challenges and to make a recommendation concerning oral health and cardiovascular patients. It focused on four key areas, namely oral health status, behaviour, knowledge, and associated risk factors. Relevant studies were searched using a combination of keywords and related search terms. Four available databases were used; EBSCOhost, Scopus, Proquest, and Pubmed to identify the relevant studies. A total of 789 papers were screened and duplicated papers were removed, 28 papers were retrieved for full-text review. It was found that most cardiovascular patients have poor oral health, while their oral health behaviour and knowledge were at a fair level. There are a limited number of studies assessing oral health conditions during cardiac rehabilitation. In general, protocol and guidelines about the importance of oral health care for cardiovascular patients are still lacking. Having good oral health has potential impacts in reducing the risk of CVD. Future research is warranted with potential intervention approaches to improve oral health conditions among cardiovascular patients, thus reducing the risk of CVD. [ABSTRACT FROM AUTHOR]

Cardiovascular prosthetic devices, stents, prosthetic valves, heart-assist pumps, etc., operate in a wide regime of flows characterized by fluid dynamic flow structures, laminar and turbulent flows, unsteady flow patterns, vortices, and other flow disturbances. These flow disturbances cause shear stress, hemolysis, platelet activation, thrombosis, and other types of blood trauma, leading to neointimal hyperplasia, neoatherosclerosis, pannus overgrowth, etc. Couette-type blood-shearing devices are used to simulate and then clinically measure blood trauma, after which the results can be used to assist in the design of the cardiovascular prosthetic devices. However, previous designs for such blood-shearing devices do not cover the whole range of flow shear, Reynolds numbers, and Taylor numbers characteristic of all types of implanted cardiovascular prosthetic devices, limiting the general applicability of clinical data obtained by tests using different blood-shearing devices. This paper presents the key fluid dynamic parameters that must be met. Based on this, Couette device geometric parameters such as diameter, gap, flow rate, shear stress, and temperature are carefully selected to ensure that the device's Reynolds numbers, Taylor number, operating temperature, and shear stress in the gap fully represent the flow characteristics across the operating range of all types of cardiovascular prosthetic devices. The outcome is that the numerical data obtained from the presented device can be related to all such prosthetic devices and all flow conditions, making the results obtained with such shearing devices widely applicable across the field. Numerical simulations illustrate that the types of flow patterns generated in the blood-shearing device meet the above criteria. [ABSTRACT FROM AUTHOR]