A novel interpretable deep learning model for diagnosis in emergency department dyspnoea patients based on complete data from an entire health care system.

Background: Dyspnoea is one of the emergency department's (ED) most common and deadly chief complaints, but frequently misdiagnosed and mistreated. We aimed to design a diagnostic decision support which classifies dyspnoeic ED visits into acute heart failure (AHF), exacerbation of chronic obstructive pulmonary disease (eCOPD), pneumonia and "other diagnoses" by using deep learning and complete, unselected data from an entire regional health care system.

Methods: In this cross-sectional study, we included all dyspnoeic ED visits of patients ≥ 18 years of age at the two EDs in the region of Halland, Sweden, 07/01/2017-12/31/2019.

Associations of adiposity and device-measured physical activity with cancer incidence: UK Biobank prospective cohort study.

Background: High adiposity and low physical activity are associated with cancer risk. Whether different amounts and intensities of physical activity can mitigate this association is unclear. We aimed to examine the independent and combined associations of adiposity and device-measured physical activity levels of different intensities with cancer incidence and mortality.

Physical activity, sedentary time and health - a narrative review with new insights.

Physical activity and sedentary time are associated with multiple health outcomes, and benefits also extend to those living with chronic conditions. These observations are primarily based on data from studies in which self-reported data assessed physical activity. Recent data where physical activity and sedentary time are measured with devices suggest that the dose-response association between device-measured physical activity and risk of incident diseases and mortality is greater and observed at lower levels of physical activity than indicated by self-reported data.

Physical Activity and All-Cause Mortality by Age in 4 Multinational Megacohorts.

Importance: Physical activity (PA) guidelines recommend the same amount of PA through adulthood to live longer.

Objective: To explore whether there is an age-dependent association between PA and all-cause mortality and to investigate the age-dependent associations between other modifiable health factors (high educational level, not smoking, not regularly consuming alcohol, healthy body weight, and living without hypertension and diabetes) and mortality.

Design, Setting, And Participants: This cohort study used a pooled analysis of 4 population-based prospective cohorts (National Health Interview Survey, 1997-2018; UK Biobank, 2006-2010; China Kadoorie Biobank, 2004-2008; and Mei Jau, 1997-2016).

Device-Measured 24-Hour Movement Behaviors and Blood Pressure: A 6-Part Compositional Individual Participant Data Analysis in the ProPASS Consortium.

Background: Blood pressure (BP)-lowering effects of structured exercise are well-established. Effects of 24-hour movement behaviors captured in free-living settings have received less attention. This cross-sectional study investigated associations between a 24-hour behavior composition comprising 6 parts (sleeping, sedentary behavior, standing, slow walking, fast walking, and combined exercise-like activity [eg, running and cycling]) and systolic BP (SBP) and diastolic BP (DBP).

PROSPECTIVE ASSOCIATIONS OF PHYSICAL ACTIVITY AND SEDENTARY TIME IN ADOLESCENCE WITH CARDIOMETABOLIC RISK IN YOUNG ADULTHOOD.

Purpose: The relationship between sedentary time, physical activity, and cardiometabolic risk factors during the transition from adolescence to adulthood remain uncertain. We examined the prospective associations of sedentary time and physical activity at age 15 with cardiometabolic risk markers at age 24.Methods: We used data from the Physical Activity among Norwegian Children Studies (PANCS).

Effectiveness and Safety of the ESC-TROP (European Society of Cardiology 0h/1h Troponin Rule-Out Protocol) Trial.

Background: European guidelines recommend the use of a 0h/1h hs-cTn (high-sensitivity cardiac troponin) protocol in patients with acute chest pain. We aimed to determine the performance of this protocol in routine care when supplemented with patient history and ECG and a recommendation to refrain from noninvasive testing in low-risk patients.

Methods And Results: This was a pre- and postimplementation study with concurrent controls.

Family Car Ownership: Driving Inactivity in Young People? Cross-Sectional and Longitudinal Analyses in the International Children's Accelerometry Database.

Background: Ubiquitous car ownership may affect children's activity and health. We assessed the cross-sectional and longitudinal associations between household car ownership and children's daily time spent sedentary (SED) and in moderate to vigorous physical activity (MVPA).

Methods: Pooled cohort data were from the International Children's Accelerometry Database.

Decline in Isotope Dilution Space Ratio Above Age 60 Could Affect Energy Estimates Using the Doubly Labeled Water Method.

Background: Doubly labeled water is gold standard for measuring total energy expenditure (TEE). Measurements using the method are sensitive to the isotope dilution space ratio (DSR). Accuracy and precision of the method might be improved if we could identify factors influencing DSR.

Gender Gap for Accelerometry-Based Physical Activity Across Different Age Groups in 5 Brazilian Cohort Studies.

Objectives: This study aims to evaluate the gender inequalities in accelerometer-based physical activity (PA) across different age groups using data from 5 Pelotas (Brazil) cohorts.

Methods: The data come from 4 birth cohort studies, covering all live births in the urban area of Pelotas for each respective year (1982, 1993, 2004, and 2015), and the Como vai? cohort study focusing on 60 years and above. Raw accelerometry data were collected on the nondominant wrist using GENEActive/ActiGraph devices and processed with the GGIR package.

Should workers be physically active after work? Associations of leisure-time physical activity with cardiovascular and all-cause mortality across occupational physical activity levels-An individual participant data meta-analysis.

Background: There is insufficient evidence to provide recommendations for leisure-time physical activity among workers across various occupational physical activity levels. This study aimed to assess the association of leisure-time physical activity with cardiovascular and all-cause mortality across occupational physical activity levels.

Methods: This study utilized individual participant data from 21 cohort studies, comprising both published and unpublished data.

Associations of occupational and leisure-time physical activity with all-cause mortality: an individual participant data meta-analysis.

Objective: Health effects of different physical activity domains (ie, during leisure time, work and transport) are generally considered positive. Using data, we assessed independent associations of occupational and leisure-time physical activity (OPA and LTPA) with all-cause mortality.

Design: Two-stage individual participant data meta-analysis.

Elevated carbohydrate antigen 125 (CA125) is associated with incident heart failure and mortality in acute coronary syndrome.

Aims: Carbohydrate antigen 125 (CA125), a mucin produced by serosal cells in response to mechanical and inflammatory stimuli, has emerged as an important biomarker to guide risk stratification in heart failure (HF). The prognostic value of CA125 in acute coronary syndrome (ACS) patients is less explored.

Methods: In a cohort of 524 ACS patients (73% males, mean age 67 ± 12 years), we assessed the associations between CA125 and the risk for HF and death during a median follow-up period of 27.

Interplay between physical activity volume and intensity with modeled life expectancy in women and men: A prospective cohort analysis.

Background: There is a lack of research examining the interplay between objectively measured physical activity volume and intensity with life expectancy.

Methods: Individuals from UK Biobank with wrist-worn accelerometer data were included. The average acceleration and intensity gradient were extracted to describe the physical activity volume and intensity profile.

Independent, Stratified, and Joint Associations of Sedentary Time and Physical Activity With Cardiovascular Disease: A Systematic Review.

Background: Recent statistics highlight cardiovascular diseases (CVD) as a major global cause of death. This review examines the methodological approaches and the main results of independent, stratified, and joint association of sedentary time (ST) and physical activity (PA) on CVD outcomes.

Methods: We searched PubMed, Embase, Web of Science, and Scopus for prospective cohorts that examined the independent, stratified, or joint associations of ST and PA with CVD outcomes.

Physical Activity Volume, Intensity, and Mortality: Harmonized Meta-Analysis of Prospective Cohort Studies.

Introduction: It is unclear whether moderate-to-vigorous physical activity (MVPA) is associated with a lower mortality risk, over and above its contribution to total physical activity volume.

Methods: 46,682 adults (mean age: 64 years) were included in a meta-analysis of nine prospective cohort studies. Each cohort generated tertiles of accelerometry-measured physical activity volume and volume-adjusted MVPA.

Device-measured sedentary time and intensity-specific physical activity in relation to all-cause and cardiovascular disease mortality: the UK Biobank cohort study.

Background And Aims: Understanding the amounts of intensity-specific movement needed to attenuate the association between sedentary time and mortality may help to inform personalized prescription and behavioral counselling. Herein, we examined the joint associations of sedentary time and intensity-specific physical activity with all-cause and cardiovascular disease (CVD) mortality.

Methods: Prospective cohort study including 73,729 adults from the UK Biobank who wore an Axivity AX3 accelerometer on their dominant wrist for at least 3 days, being one a weekend day, between June 2013 and December 2015.

Cohort study of prediction of venous thromboembolism in emergency department patients with extremity symptoms.

Despite diagnostic algorithms, identification of venous thromboembolism (VTE) in emergency departments (ED) remains a challenge. We evaluated symptoms, background, and laboratory data in 27,647 ED patients presenting with pain, swelling, or other symptoms from the extremities, and identified predictors of VTE diagnosis within one year. Predictors of a clinical decision to perform phlebography, ultrasound, or computer tomography (CT) angiography of pelvic, lower, or upper extremity veins, CT of pulmonary arteries, or pulmonary scintigraphy at the ED or within 30 days, and the results of such investigations were also evaluated.

Direct Comparison of the European Society of Cardiology 0/1-Hour Vs. 0/2-Hour Algorithms in Patients with Acute Chest Pain.

Background: The recent guidelines from the European Society of Cardiology recommends using high-sensitivity cardiac troponin (hs-cTn) in either 0/1-h or 0/2-h algorithms to identify or rule out acute myocardial infarction (AMI). Several studies have reported good diagnostic accuracy with both algorithms, but few have compared the algorithms directly.

Objective: We aimed to compare the diagnostic accuracy of the algorithms head-to-head, in the same patients.

The prevalence of clinically relevant delayed intracranial hemorrhage in head trauma patients treated with oral anticoagulants is very low: a retrospective cohort register study.

Background: Current guidelines from Scandinavian Neuro Committee mandate a 24-hour observation for head trauma patients on anticoagulants, even with normal initial head CT scans, as a means not to miss delayed intracranial hemorrhages. This study aimed to assess the prevalence, and time to diagnosis, of clinically relevant delayed intracranial hemorrhage in head trauma patients treated with oral anticoagulants.

Method: Utilizing comprehensive two-year data from Region Skåne's emergency departments, which serve a population of 1.

Association between arterial health and cognition in adolescents: The PANIC study.

We investigated the associations of the measures of arterial health with cognition in adolescents and whether physical activity (PA) or sedentary time (ST) confounds these associations. One hundred sixteen adolescents (71 boys) aged 15.9 ± 0.

The skåne emergency medicine (SEM) cohort.

Background: In the European Union alone, more than 100 million people present to the emergency department (ED) each year, and this has increased steadily year-on-year by 2-3%. Better patient management decisions have the potential to reduce ED crowding, the number of diagnostic tests, the use of inpatient beds, and healthcare costs.

Methods: We have established the Skåne Emergency Medicine (SEM) cohort for developing clinical decision support systems (CDSS) based on artificial intelligence or machine learning as well as traditional statistical methods.

Complications in Emergency Department Patients with Acute Coronary Syndrome with Contemporary Care.

Introduction: With the implementation of early reperfusion therapy, the number of complications in patients with acute coronary syndrome (ACS) has diminished significantly. However, ACS patients are still routinely admitted to units with high-level monitoring such as the coronary or intensive care unit (CCU/ICU). The cost of these admissions is high and there is often a shortage of beds.