Cardiorespiratory fitness in COPD and HF from the Fitness Registry and the Importance of Exercise: a National Database.

Aims: To better characterize functional consequences of the presence of COPD on cardiorespiratory fitness in patients with HF.

Methods And Results: Patients with any clinical indication for cardiopulmonary exercise testing (CPET) were included in the international FRIEND registry. Diagnosis of COPD was confirmed by a ratio of forced expiratory volume in 1 s and forced vital capacity (FEV/FVC) < 0.

Cocoa bean metabolomics reveals polyphenols as potential markers relating to fine dark chocolate color shades.

Introduction: This study aimed to evaluate the color and the discriminating compounds for two types of cocoa beans (black and brown beans) related to 70% dark chocolates of black and brown colors from a previous work of our group.

Methods: Color analysis and untargeted high-resolution mass spectrometry-based metabolomic analysis were performed on eight beans of each type. Mass spectral data processing, univariate and multivariate statistical methods were conducted for classification of beans and selection of discriminant features.

Palliative care is a viable option for frail elderly patients with neurocognitive disorders admitted for hip fractures.

Importance: Most patients presenting with a hip fracture regardless of their comorbidities are surgically treated. A growing body of research states that a certain type of elderly patient could benefit more from a palliative approach.

Objective: Identify the patient who would benefit most from a palliative care approach instead of a surgery.

Conducting an objective structured clinical examination under COVID-restricted conditions.

Background: The administration of performance assessments during the coronavirus disease of 2019 (COVID-19) pandemic posed many challenges, especially for examinations employed as part of certification and licensure. The National Assessment Collaboration (NAC) Examination, an Objective Structured Clinical Examination (OSCE), was modified during the pandemic. The purpose of this study was to gather evidence to support the reliability and validity of the modified NAC Examination.

Arthroscopic Subdeltoid Humeroplasty in the Beach-Chair Position for Reverse Hill-Sachs Lesions.

Reverse Hill-Sachs lesions (HSLs) often involve a greater percentage of the humeral head articular surface than posterior HSLs and frequently require surgical treatment in the setting of posterior shoulder instability. Multiple techniques have been described to treat these lesions depending on their size, acuity, and location. The (modified) McLaughlin procedure is widely used to treat smaller engaging lesions, whereas larger lesions involving a greater percentage of the humeral head articular surface require anatomic disimpaction, termed "humeroplasty.

Strategies to improve end-of-life decision-making and palliative care following hip fracture in frail older adults: a scoping review.

Background: Although surgery is the gold standard following a hip fracture, the potential for rehabilitation and survival rates are low in frail older patients. Some patients may derive more benefit from palliative care. The objectives of this review were to identify the available strategies to improve end-of-life decision-making and palliative care for frail patients with hip fractures and to synthetise their level of support.

Clonal Hematopoiesis of Indeterminate Potential and Long-term Outcomes in Heart Transplantation.

Background: Clonal hematopoiesis of indeterminate potential (CHIP) mutations, a trait of aging, has been associated with the progression of cardiovascular disease and the development of malignancy. Uncertainty prevails regarding a robust association between CHIP and heart-transplantation (HT) outcomes.

Objectives: To determine the prevalence of CHIP mutations in HT and their association with long-term outcomes, including cardiac allograft vasculopathy (CAV), graft failure, malignancy, and all-cause mortality.

Cardiomyopathy in First-Degree Relatives of Patients Presenting With Acute Myocarditis: Prevalence and Prognostic Significance.

Background: Acute myocarditis has been genetically linked to dilated cardiomyopathy (DCM), but the clinical significance remains uncertain. We investigated the prevalence and long-term prognosis of DCM and heart failure (HF) among unselected patients hospitalized with acute myocarditis and their first-degree relatives compared with an age- and sex-matched cohort.

Methods: This was an observational study utilizing the Danish nationwide registries, where all patients with a first-time myocarditis diagnosis from 1995 to 2018 were identified and matched (on birth year and sex) with 10 controls from the general population.

Inflammation in heart failure: pathophysiology and therapeutic strategies.

A role for inflammation in the development and progression of heart failure (HF) has been proposed for decades. Multiple studies have demonstrated the potential involvement of several groups of cytokines and chemokines in acute and chronic HF, though targeting these pathways in early therapeutic trials have produced mixed results. These studies served to highlight the complexity and nuances of how pro-inflammatory pathways contribute to the pathogenesis of HF.

A validity study of COMLEX-USA Level 3 with the new test design.

Context: The National Board of Osteopathic Medical Examiners (NBOME) administers the Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA), a three-level examination designed for licensure for the practice of osteopathic medicine. The examination design for COMLEX-USA Level 3 (L3) was changed in September 2018 to a two-day computer-based examination with two components: a multiple-choice question (MCQ) component with single best answer and a clinical decision-making (CDM) case component with extended multiple-choice (EMC) and short answer (SA) questions. Continued validation of the L3 examination, especially with the new design, is essential for the appropriate interpretation and use of the test scores.

Optical coherence tomography angiography macular biomarkers of peripheral retinal ischemia in diabetic macular edema: secondary endpoints from the clinical study "FOVEA".

Purpose: To investigate the relationship between the macular values of fractal dimension (FD) and lacunarity (LAC) on optical coherence tomography angiography (OCTA) images and the presence of peripheral retina non-perfusion areas (NPAs) on fluorescein angiography (FA) in patients with treatment-naïve diabetic macular edema (DME).

Methods: Fifty patients with treatment-naïve DME underwent a full ophthalmic examination, including best-corrected visual acuity measurement, FA, spectral-domain optical coherence tomography, and OCTA. Specifically, FA was performed to detect the presence of retinal NPAs, whereas fractal OCTA analysis was used to determine macular FD and LAC values at the level of the superficial and deep capillary plexus (SCP and DCP).

Clinical competence, communication ability and adherence to choosing wisely recommendations for lipid reducing drug use in older adults.

Background: Although lipid-lowering drugs are not recommended for primary prevention in patients 75+, prevalence of use is high and there is unexplained variation in prescribing between physicians. The objective of this study was to determine if physician communication ability and clinical competence are associated with prescribing lipid-lowering drugs for primary and secondary prevention.

Methods: We used a cohort of 4,501 international medical graduates, 161,214 U.

Do clinical and communication skills scores on credentialing exams predict potentially inappropriate antibiotic prescribing?

Background: There is considerable variation among physicians in inappropriate antibiotic prescribing, which is hypothesized to be attributable to diagnostic uncertainty and ineffective communication. The objective of this study was to evaluate whether clinical and communication skills are associated with antibiotic prescribing for upper respiratory infections and sinusitis.

Methods: A cohort study of 2,526 international medical graduates and 48,394 U.

Contemporary Left Ventricular Assist Device Therapy as a Bridge or Alternative to Transplantation.

Left ventricular assist devices (LVADs), which were introduced as a bridge to heart transplantation, are now an established alternative to heart transplantation (HT) for patients with advanced heart failure. These devices have undergone significant technological advancements over the years, and contemporary LVADs prolong life substantially in patients dependent on inotropic therapy or in those with severe ambulatory advanced heart failure with a median survival that exceeds 5 y, and most patients benefit from a doubling in functional capacity, even among those intended as destination therapy because of ineligibility for transplantation. Other intended goals for LVAD implantation consist of (1) bridge to remission or recovery and (2) bridge to transplant or candidacy for transplant.

The Impact of COVID-19 on the Response to Hypoxia.

Louis, Alexandre, Charlotte Pröpper, Yann Savina, Corentin Tanne, Guy Duperrex, Paul Robach, Pascal Zellner, Stéphane Doutreleau, Jean-Michel Boulet, Alain Frey, Fabien Pillard, Cristina Pistea, Mathias Poussel, Thomas Thuet, Jean-Paul Richalet, and François Lecoq-Jammes. The impact of COVID-19 on the response to hypoxia. .

Statins for primary prevention in multimorbid patients: to prescribe or not to prescribe? A qualitative analysis of general practitioners' decision-making processes.

Introduction: A better understanding of the determinants involved in general practitioners' (GPs) decision-making processes when it comes to prescribing statins as primary prevention in patients with multimorbidity could provide insights for improving implementation of primary prevention guidelines.

Methods: We conducted a qualitative study using a deductive framework-based and inductive analysis of GPs' semi-structured interviews verbatim, from which expertise profiles of prescribers were also drawn. The analytical framework was built from a pragmatic synthesis of the evidence-based medicine, Modelling using Typified Objects (MOT) model of clinical reasoning processes, Theoretical Domains Framework, and shared decision-making frameworks.

Predictive Factors of Visual Outcome in Treatment-Naïve Diabetic Macular Edema: Preliminary Results from the Clinical Study "FOVEA".

Unlabelled: Diabetic macular edema (DME) is a common cause of vision impairment in diabetic retinopathy. The aim of this study was to analyze the relationship between visual outcome and anatomic changes detected by traditional multimodal retinal imaging and optical coherence tomography angiography (OCTA) in DME eyes under treatment with Aflibercept.

Methods: Sixty-six DME eyes of 62 patients under treatment with intravitreal Aflibercept and with one-year follow-up were enrolled.

Shades of Fine Dark Chocolate Colors: Polyphenol Metabolomics and Molecular Networking to Enlighten the Brown from the Black.

High-quality dark chocolates (70% cocoa content) can have shades from light to dark brown color. This work aimed at revealing compounds that discriminate black and brown chocolates. From 37 fine chocolate samples from years 2019 and 2020 provided by Valrhona,8 dark black samples and 8 light brown samples were selected.

Focus on the relationships between the cell wall composition in the extraction of anthocyanins and tannins from grape berries.

Concentrations of anthocyanins and tannins after extraction from berries in wines and from skin macerations in model solutions have been studied for two grape varieties, two maturation levels and two vintages berries. Characterization of the cell wall polysaccharides has also been performed, the classical method based on the analysis of the neutral sugars after depolymerization being completed by a comprehensive microarray polymer profiling (CoMPP). Extraction was lower in model solutions than in wines, with the same ranking: non acylated anthocyanins> tannins > p-coumaroylated anthocyanins.