Outcomes of Patients With Takotsubo Syndrome Compared With Type 1 and Type 2 Myocardial Infarction

Background Takotsubo syndrome (TS) and myocardial infarction (MI) share similar clinical and laboratory characteristics but have important differences in causes, demographics, management, and outcomes. Methods and Results In this observational study, the National Inpatient Sample and National Readmission Database were used to identify patients admitted with TS, type 1 MI, or type 2 MI in the United States between October 1, 2017, and December 31, 2019. We compared patients hospitalized with TS, type 1 MI, and type 2 MI with respect to key features and outcomes. Over the 27-month study period, 2 035 055 patients with type 1 MI, 639 075 patients with type 2 MI, and 43 335 patients with TS were identified. Cardiac arrest, ventricular fibrillation, and ventricular tachycardia were more prevalent in type 1 MI (4.02%, 3.2%, and 7.2%, respectively) compared with both type 2 MI (2.8%, 0.8%, and 5.4% respectively) and TS (2.7%, 1.8%, and 5.3%, respectively). Risk of mortality was lower in TS compared with both type 1 MI (3.3% versus 7.9%; adjusted odds ratio [OR], 0.3; P<0.001) and type 2 MI (3.3% versus 8.2%; adjusted OR, 0.3; P<0.001). Mortality rate (OR, 1.2; P<0.001) and cardiac-cause 30-day readmission rate (adjusted OR, 1.7; P<0.001) were higher in type 1 MI than in type 2 MI. Conclusions Patients with type 1 MI had the highest rates of in-hospital mortality and cardiac-cause 30-day readmission. Risk of all-cause 30-day readmission was highest in patients with type 2 MI. The risk of ventricular arrhythmias in patients with TS is lower than in patients with type 1 MI but higher than in patients with type 2 MI.

Floquet spin states in OLEDs

Electron and hole spins in organic light-emitting diodes constitute prototypical two-level systems for the exploration of the ultrastrong-drive regime of light-matter interactions. Floquet solutions to the time-dependent Hamiltonian of pairs of electron and hole spins reveal that, under non-perturbative resonant drive, when spin-Rabi frequencies become comparable to the Larmor frequencies, hybrid light-matter states emerge that enable dipole-forbidden multi-quantum transitions at integer and fractional g-factors. To probe these phenomena experimentally, we develop an electrically detected magnetic-resonance experiment supporting oscillating driving fields comparable in amplitude to the static field defining the Zeeman splitting; and an organic semiconductor characterized by minimal local hyperfine fields allowing the non-perturbative light-matter interactions to be resolved. The experimental confirmation of the predicted Floquet states under strong-drive conditions demonstrates the presence of hybrid light-matter spin excitations at room temperature. These dressed states are insensitive to power broadening, display Bloch-Siegert-like shifts, and are suggestive of long spin coherence times, implying potential applicability for quantum sensing.

Medical research productivity in the Arab countries: 2007-2016 bibliometric analysis

Background

The aim of this study was to assess recent trends in medical research productivity in Arab countries.

Methods

We collected bibliometric data for the world countries, Arab countries, and Arab institutions for 2007-2016, using Essential Science Indicators, Journal Citation Reports, and Web of Science database. We collected the number of published papers overall and per year, citations per paper, and number of papers published in top quartile and top 10% journals. For the 10 most productive institutions, we additionally collected the number of papers with correspondence authors affiliated with the institution.

Results

The Arab world produced 189 papers per one million people, about a quarter of the value for other world countries. Four Arab countries (Qatar, Tunisia, Lebanon, and Kuwait) produced more than 695 papers per one million people, exceeding the world average. The average number of citations per paper was 9.2; it rose to more than 15 for papers with international collaboration. At the institutional level, the number of citations showed upward trends, with six institutions having an average citation per paper higher than that of all Arab countries. For the 10 most productive institutions in Arab countries, the percentage of papers involving international collaborations ranged from 42% to 79%; of these, 9% to 29% were led by authors from the same institution. For these 10 most productive institutions, the percentage of papers published in the top quartile journals and with a lead/corresponding author from the institution ranged from 7 to 32%; that percentage drops to 1% to 10% for papers published in top 10% journals.

Conclusions

Although medical research output in Arab countries at both the country and the institution levels has increased over the past 10 years, it is still lagging behind the rest of the world. The percentage of papers involving international collaborations was relatively high, but the majority of these papers were led by authors from outside the local institution, particularly when published in the top 10% journals.

A very low number of national adaptations of the World Health Organization guidelines for HIV and tuberculosis reported their processes

BACKGROUND

Low- and middle-income countries adapt World Health Organization (WHO) guidelines instead of de novo development for financial, epidemiologic, sociopolitical, cultural, organizational, and other reasons.

OBJECTIVE

To systematically evaluate reported processes used in the adaptation of WHO guidelines for human immunodeficiency virus (HIV) and tuberculosis (TB).

METHODS

We searched three online databases/repositories: United States Agency for International Development (USAID) AIDS Support and Technical Resources - Sector One program (AIDSTAR-One) National Treatment Database; the AIDSspace Guideline Repository, and WHO Database of national HIV and TB guidelines. We assessed the rigor and quality of reported adaptation methodology using the ADAPTE process as benchmark.

RESULTS

Of 170 eligible guidelines, only 32 (19%) reported documentation on the adaptation process. The median and interquartile range of the number of ADAPTE steps fulfilled by the eligible guidelines were 11.5 (10, 13.5) (out of 23 steps). The number of guidelines (out of 32 steps) fulfilling each ADAPTE step was 18 (interquartile range, 5-27). Seventeen of 32 guidelines (53%) met all steps relevant to the setup phase, whereas none met all steps relevant to the adaptation phase.

CONCLUSION

The number of well-documented adaptation methodologies in national HIV and/or TB guidelines is very low. There is a need for the use of standardized and systematic framework for guideline adaptation and improved reporting of processes used.