New York Risk Model and Simplified Risk Score for In-Hospital/30-Day Mortality for Percutaneous Coronary Intervention.

Risk models and risk scores derived from those models require periodic updating to account for changes in procedural performance, patient mix, and new risk factors added to existing systems. No risk model or risk score exists for predicting in-hospital/30-day mortality for percutaneous coronary interventions (PCIs) using contemporary data. This study develops an updated risk model and simplified risk score for in-hospital/30-day mortality following PCI.

Ad Hoc Percutaneous Coronary Intervention in Stable Patients With Multivessel or Unprotected Left Main Disease.

Background: There is very little information about the use of ad hoc percutaneous coronary intervention (PCI) in stable patients with multivessel (MV) disease or unprotected left main (LM) disease patients for whom a heart team approach is recommended.

Objective: To identify the extent of ad hoc PCI utilization for patients with multivessel disease or left main disease, and to explore the inter-hospital variation in ad hoc PCI utilization for those patients.

Methods: New York State's cardiac registries were used to examine the use and variation in use of ad hoc PCI for MV/LM disease as a percentage of all MV/LM PCIs and revascularizations (PCIs plus coronary artery bypass graft procedures) during 2018 to 2019 in New York.

Impact of COVID-19 on percutaneous coronary intervention utilization and mortality in New York.

Background: COVID-19 has disrupted the care of all patients, and little is known about its impact on the utilization and short-term mortality of percutaneous coronary intervention (PCI) patients, particularly nonemergency patients.

Methods: New York State's PCI registry was used to study the utilization of PCI and the presence of COVID-19 in four patient subgroups ranging in severity from ST-elevation myocardial infarction (STEMI) to elective patients before (December 01, 2018-February 29, 2020) and during the COVID-19 era (March 01, 2020-May 31, 2021), as well as to examine the impact of different COVID severity levels on the mortality of different types of PCI patients.

Results: Decreases in the mean quarterly PCI volume from the prepandemic period to the first quarter of the pandemic ranged from 20% for STEMI patients to 61% for elective patients, with the other two subgroups having decreases in between these values.

Short-term Deaths After Percutaneous Coronary Intervention Discharge: Prevalence, Risk Factors, and Hospital Risk-Adjusted Mortality.

Background: Little is known about patients who die shortly after discharge following any procedures, including percutaneous coronary intervention (PCI). Our aim was to explore the implications of using 30-day deaths after discharge as part of a quality measure for PCI.

Methods: New York State's PCI registry was used to find PCI deaths that occurred after discharge within 30 days of the procedure from January 1, 2015, to November 30, 2017.

Using microartifacts to infer Middle Pleistocene lifeways at Schöningen, Germany.

While archeologists usually favor the study of large and diagnostic lithic artifacts, this study illustrates the invaluable contribution of lithic microartifacts for interpreting hominin lifeways. Across a 64 m area of the Middle Pleistocene lakeshore site of Schöningen 13 II-3 in Northern Germany, we recovered a total of 57 small and micro flint artifacts, four small debris pieces, three natural fragments and three bone retouchers in close association with the skeleton of an extinct Eurasian straight-tusked elephant (Palaeoloxodon antiquus). This area lacks the type of formal knapped stone tools that would normally constitute the focus of archeological interpretations.

Relation of Operator Volume and Access Site to Short-Term Mortality in Radial Versus Femoral Access for Primary Percutaneous Coronary Intervention.

The relation between operator volume and mortality of primary percutaneous coronary intervention (PPCI) procedures for ST-elevation myocardial infarction has not been studied comprehensively. This study included patients who underwent PPCI between 2010 and 2017 in all nonfederal hospitals approved to perform PCI in New York State. We compared risk-adjusted in-hospital/30-day mortality for radial access (RA) and femoral access (FA) and the relation between risk-adjusted mortality and procedure volume for each access site.

Percutaneous Coronary Intervention With and Without Intravascular Ultrasound for Patients With Complex Lesions: Utilization, Mortality, and Target Vessel Revascularization.

Background: Intravascular ultrasound (IVUS) has several benefits during percutaneous coronary interventions (PCIs), including more accurate vessel sizing, improved stent expansion, and better strut apposition. Prior clinical trials have demonstrated a reduction in cardiac events when IVUS is used. However, there is limited information about the utilization of IVUS and the outcomes of IVUS-guided versus angiography-guided PCI in patients with complex lesions in a contemporary population-based setting.

Function, life histories, and biographies of Lower Paleolithic patinated flint tools from Late Acheulian Revadim, Israel.

Flint tools exhibiting modified patinated surfaces ("double patina", or post-patination flaked items) provide a glimpse into Paleolithic lithic recycling, stone economy, and human choices. Different life cycles of such items are visually evident by the presence of fresh new modified surfaces alongside old patinated ones (according to color and texture differences). New modifications testify to a gap in time between the previous life cycle of the patinated flaked item and its new one.

A Clinical Perspective on Arsenic Exposure and Development of Atherosclerotic Cardiovascular Disease.

Cardiovascular risk has traditionally been defined by modifiable and non-modifiable risk factors, such as tobacco use, hyperlipidemia, and family history. However, chemicals and pollutants may also play a role in cardiovascular disease (CVD) risk. Arsenic is a naturally occurring element that is widely distributed in the Earth's crust.

The Association of Socioeconomic Factors With Percutaneous Coronary Intervention Outcomes.

Background: Numerous studies have identified the association of socioeconomic factors with outcomes of cardiac surgical procedures. Most have focused on easily measured demographic factors or on socioeconomic characteristics of patients' 5-digit zip codes. The impact of socioeconomic information that is derived from smaller geographic regions has rarely been studied.

Hybrid coronary revascularization . percutaneous coronary interventions for multivessel coronary artery disease.

Objective: Hybrid coronary revascularization (HCR) combines a minimally invasive surgical approach to the left anterior descending (LAD) artery with percutaneous coronary intervention (PCI) for non-LAD diseased coronary arteries. It is associated with shorter hospital lengths of stay and recovery times than conventional coronary artery bypass surgery, but there is little information comparing it to isolated PCI for multivessel disease. Our objective is to compare long-term outcomes of HCR and PCI for patients with multivessel disease.

An integrated study discloses chopping tools use from Late Acheulean Revadim (Israel).

Chopping tools/choppers provide one of the earliest and most persistent examples of stone tools produced and used by early humans. These artifacts appeared for the first time ~2.5 million years ago in Africa and are characteristic of the Oldowan and Acheulean cultural complexes throughout the Old World.

Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction Before and During COVID in New York.

Little is known about regional differences in volume, treatment, and outcomes of STEMI patients undergoing PCI during the pandemic. The objectives of this study were to compare COVID-19 pandemic and prepandemic periods with respect to regional volumes, outcomes, and treatment of patients undergoing percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) between January 1, 2019 and March 14, 2020 (pre-COVID period) and between March 15, 2020 and April 4, 2020 (COVID period) in 51 New York State hospitals certified to perform PCI. The hospitals were classified as being in either high-density or low-density COVID-19 counties on the basis of deaths/10,000 population.

The use of ash at Late Lower Paleolithic Qesem Cave, Israel-An integrated study of use-wear and residue analysis.

Employing an integrated approach to investigate the use of Late Lower Paleolithic flint tools found at the site of Qesem Cave (Israel), we revealed a particular trace pattern related to the employment of ashes at the site. Using a designated collection of replica items and combining use-wear and residue (morphological analysis, FTIR, SEM-EDX) analyses, we revealed the intentional use of ashes in preserving foods for delayed consumption as well as hide for delayed processing. Our interpretation, we believe is the most plausible one since we were able to delineate the specific use-wear fingerprints of the intentional use of ashes for such purposes, suggesting that our approach might be useful for the recognition of other similar functional-behavioral patterns.

Assessment of repeat target lesion percutaneous coronary intervention as a quality measure for public reporting and general quality assessment for PCIs.

Background: Target lesion percutaneous coronary intervention (TLPCI) within 1 year of PCI has been proposed by critics of public reporting of short-term mortality as an alternative measure for PCI reporting.

Methods: New York's PCI registry was used to identify 1-year repeat TLPCI and 1-year repeat TLPCI/mortality for patients discharged between December 1, 2013 and November 30, 2014. Significant independent predictors of the outcomes were identified.

Animal residues found on tiny Lower Paleolithic tools reveal their use in butchery.

Stone tools provide a unique window into the mode of adaptation and cognitive abilities of Lower Paleolithic early humans. The persistently produced large cutting tools (bifaces/handaxes) have long been an appealing focus of research in the reconstruction of Lower Paleolithic survival strategies, at the expenses of the small flake tools considered by-products of the stone production process rather than desired end products. Here, we use use-wear, residues and technological analyses to show direct and very early evidence of the deliberate production and use of small flakes for targeted stages of the prey butchery process at the late Lower Paleolithic Acheulian site of Revadim, Israel.

Recycling for a purpose in the late Lower Paleolithic Levant: Use-wear and residue analyses of small sharp flint items indicate a planned and integrated subsistence behavior at Qesem Cave (Israel).

The purposeful production of small flakes is integral to the lithic variability of many Middle Pleistocene sites. Inhabitants of the Acheulo-Yabrudian site of Qesem Cave, Israel, systematically recycled 'old' discarded blanks and tools, using them as cores for the production of small sharp tools with distinct technological features. These recycling end-products were produced in significant quantities throughout the human occupation of Qesem Cave, and their outstanding state of preservation made possible a functional analysis with residue detection using Fourier transform infrared spectroscopy (FTIR) and energy-dispersive X-ray spectroscopy (SEM-EDX).

Sex differences in the treatment and outcomes of patients hospitalized with ST-elevation myocardial infarction.

Objectives: To compare mortality for women and men hospitalized with ST-elevation myocardial infarction (STEMI) by age and revascularization status.

Background: There is little information on the mortality of men and women not undergoing revascularization, and the impact of age on relative male-female mortality needs to be revisited.

Methods And Results: An observational database of 23,809 patients with STEMI presenting at nonfederal New York State hospitals between 2013 and 2015 was used to compare risk-adjusted inhospital/30-day mortality for women and men and to explore the impact of age on those differences.

Determination of bisphenol A in red wine using a double vortex-ultrasound-assisted microextraction assay: Role of the interfacial properties.

Bisphenol A (BPA) is a synthetic compound broadly used in medical devices as well as in packaging of food and drinks. Recently, BPA toxicity has become of concern to environmental public health. Red wine that is susceptible to BPA contamination is an alcoholic beverage made from yeast fermentation of grapes in the presence of grape skins so as to extract phenolic compounds.

Treatment of Coronary Artery Disease and Acute Myocardial Infarction in Hospitals With and Without On-Site Coronary Artery Bypass Graft Surgery.

Background: Many studies have revealed no outcome differences among patients undergoing percutaneous coronary intervention (PCI) in hospitals with and without surgery on-site (SOS), but one earlier study found differences in target vessel PCI rates and in mortality for patients with acute myocardial infarction who did not undergo PCI. It is important to examine outcome differences between SOS and non-SOS hospitals with more contemporary data.

Methods And Results: A total of 21 924 propensity-matched patients who were discharged between January 1, 2013, and November 30, 2015, who were in the New York PCI registry and other hospital databases were used to compare outcomes in hospitals with and without SOS for all patients and for patients with and without ST-segment-elevation myocardial infarction (STEMI) undergoing PCI.

Left ventricular mass regression after aortic valve replacement: Sex differences or effect of different methods of indexation?

Background: The influence of sex on regression of left ventricular (LV) hypertrophy (LVH) after aortic valve replacement (AVR) for aortic stenosis (AS) remains elusive. The lack of consensus on how to correct LV mass (LVM) for body size, and different normalcy values, contribute to inconclusive results.

Methods: In 164 consecutive patients (mean age 80 ± 4 years, 59% females) with AS, we analyzed LVM (Devereux formula) before and 1 year after AVR (St.