Search Results (10)

This paper introduces a new class of periodic volatility models, namely, the Stochastic Volatility Periodic Logarithmic Asymmetric GARCH (PlogAG-SV) model. The proposed framework extends periodic logGARCH models by incorporating a stochastic volatility component combined with a distinctive threshold mechanism, thereby significantly enhancing their ability to capture asymmetric and time-varying volatility dynamics. Sufficient conditions for strict stationarity, second-order stationarity, and the existence of higher-order moments are rigorously established, providing a comprehensive characterization of the model’s probabilistic properties. Parameter estimation is conducted via extensive Monte Carlo simulations, demonstrating the robustness and reliability of the proposed estimation procedure across a wide range of scenarios. Furthermore, the empirical relevance of the PlogAG-SV model is illustrated through an application to the Algerian dinar–euro exchange rate, highlighting its effectiveness in modeling real-world financial volatility. Full article

Background/Objectives: Left ventricular diastolic dysfunction (LVDD) is associated with unfavorable outcomes, and though it is recognized as an important clinical diagnosis, specific quantification and effective management continue to challenge clinicians, representing an unmet need in modern cardiology. Advanced LVDD diagnosis is likely to have a prognostic role among hospitalized patients. The aim of this study was to describe the prevalence and predictors of advanced LVDD among hospitalized patients and its long-term (5-year) prognostic significance on all-cause mortality. Methods: This was a retrospective observational study of consecutive, non-selected hospitalized patients referred for echocardiography at a tertiary care medical center from October 2013 to February 2024. Diastolic function was classified into normal/LVDD grade I vs. advanced LVDD (grades II and III). Results: A total of 5926 participants were included in the analysis, of whom 3229 (54%) were men, with a mean age of 66 ± 2 years. These included 4779 (81%) patients with normal/LVDD grade I and 1147 (19%) with advanced LVDD. Compared to patients with normal/LVDD grade I, those with advanced LVDD were older, were more likely to be men, and had a higher burden of hypertension, diabetes mellitus, congestive heart failure, atrial fibrillation/flutter and renal failure, abnormal laboratory findings, worse echocardiogram parameters, and longer hospital stay. Multivariate analysis revealed that advanced LVDD was independently associated with increasing age, the male sex, significant aortic stenosis, hypertension, and atrial fibrillation. Patients with advanced LVDD vs. normal/LVDD grade I had higher 5-year all-cause mortality rates (p_log-rank < 0.001). Multivariate Cox proportional hazards regression model revealed that advanced LVDD was associated with a 24% increase in the 5-year mortality rate (HR = 1.236, 95% CI of 1.008–1.517, p = 0.042). Conclusions: Among hospitalized patients referred for echocardiography, the prevalence of advanced LVDD was 19%, and it was independently associated with age, the male sex and the presence of multiple comorbidities. Moreover, advanced LVDD was identified as an independent predictor of long-term all-cause mortality. Advanced LVDD should be proactively diagnosed among admitted patients at risk for early therapy tailoring. Full article

Background/Objectives: To date, data regarding the characteristics and management of obstructive, stable coronary artery disease (CAD) encountered in patients undergoing transcatheter aortic valve implantation (TAVI) are sparse. The aim of the study was to analyze granular details, treatment, and outcomes of patients undergoing TAVI with obstructive, stable CAD from real-world practice. Methods: REVASC-TAVI (Management of myocardial REVASCularization in patients undergoing Transcatheter Aortic Valve Implantation with coronary artery disease) is an investigator-initiated, multicenter registry, which collected data from patients undergoing TAVI with obstructive stable CAD found during the pre-TAVI work-up. Results: A total of 2025 patients from 30 centers worldwide with complete follow-up were included in the registry. Most patients had single-vessel CAD (56.1%). An involvement of proximal coronary tracts was detected in 62.5% of cases, with 12.0% of patients having CAD in left main (LM). Most patients received percutaneous coronary intervention (PCI) (n = 1617, 79.9%), especially those with proximal CAD (90.4%). At 2 years, the rates of all-cause death [Kaplan–Meier (KM) estimates 20.1% vs. 18.8%, p_log-rank = 0.86] and of the composite of all-cause death, stroke, myocardial infarction, and rehospitalization for heart failure (KM estimates 29.7% vs. 27.5%, p_log-rank = 0.82) did not differ between patients undergoing PCI and those who were not. Conclusions: Patients undergoing TAVI with obstructive CAD more commonly had a single-vessel disease and an involvement of proximal coronary tracts. They were commonly treated with PCI, with similar outcomes compared to those treated conservatively. Full article

The climate crisis remains a paramount challenge that contemporary society and forthcoming generations will grapple with. The significance of instilling sustainability awareness during formative years, particularly during adolescence, is underscored due to the potential for personality consolidation during this phase. In the educational context, physical education emerges as a valuable avenue to further the cause of a sustainable world by fostering student competencies across the three dimensions of sustainable development. Within this domain, activities such as plogging—an outdoor exercise that intertwines physical activity with litter collection—directly enhance environmental quality. However, a discernible gap exists in previous literature regarding high school students’ perspectives on this practice. Thus, this research aimed to integrate a plogging intervention within physical education lessons to assess student perceptions of this innovative activity. A cohort of 28 secondary school students (16 females and 12 males aged 15 ± 1.2 years) participated in this qualitative study. Semi-structured interviews consisting of nine questions were deployed to elicit narratives pertaining to their plogging experiences within an educational setting. Over four sessions, an active methodology rooted in plogging was employed, culminating in a hands-on excursion in a natural environment. The findings were bifurcated into two categories. The first pertained to reflections on the didactic experience, encapsulating its immediate impact and prospective implications. The second category offered a critical evaluation of plogging, underscoring predominantly affirmative views, especially those highlighting environmental benefits. Responses revealed high acceptance levels for plogging, a heightened awareness of littering, and a recognition of the tangible environmental benefits of such activities. For a sustainable future, it is imperative for adults to possess and impart profound environmental consciousness to younger generations. These insights can potentially catalyze further research on the integration of sustainability in physical education and the role of plogging as an instrumental classroom tool. Full article

In response to rising environmental concerns and the increase in eco-friendly sports activities, this study investigated the determinants of sustained intention to participate in plogging, a combination of jogging and litter collection. A total of 288 randomly assigned plogging participants were surveyed to discern the effects of autonomy, competence, and relatedness experiences on sustained plogging intentions as suggested by self-determination theory. The study also examined the moderating role of eco-friendly attitudes. The analysis, executed using multi-group structural equation modeling, revealed that while autonomy and competence did not significantly influence extrinsic motivation, relatedness emerged as the most influential factor. This suggests that plogging primarily serves as a prosocial behavior, enhancing relationships, rather than a means to increase physical competence. The values derived from plogging and the intention to continue varied based on the participants’ eco-friendly attitudes. The authors conclude that voluntary participation and socialization are the core values of plogging and understanding these can promote healthier and more sustainable behaviors. Full article

Background: Concomitant mitral transcatheter edge-to-edge repair (M-TEER) and left atrial appendage closure (LAAC) showed to be a feasible approach to optimize the treatment of patients eligible for both procedures, but mid-term outcomes are unclear. Methods: We retrospectively analyzed consecutive patients undergoing M-TEER and enrolled in the local prospective Getting Reduction of Mitral Insufficiency by Percutaneous Clip Implantation (GRASP) registry. We compared patients undergoing isolated M-TEER (n = 58, 58.5%) with those undergoing concomitant M-TEER and LAAC (n = 41, 41.5%) from January 2018 to December 2022. The primary endpoint was a composite of all-cause death, stroke or systemic embolism, hospitalization for heart failure, and bleeding at 1 year. The co-primary endpoint was procedural success. Results: The primary endpoint was similar between patients undergoing concomitant M-TEER+LAAC or isolated M-TEER (Kaplan Meier (KM) estimates 36.6% vs. 44.8%; p_log-rank = 0.75). Procedural success was also similar (92.7% vs. 94.8%; p = 0.69). At 1- year, minor bleeds were lower in patients undergoing concomitant M-TEER and LAAC (KM estimates 0.0% vs. 18.9%; p_log-rank < 0.01). Conclusion: In patients with concomitant MR and AF and eligible for M-TEER and LAAC treatment, a combined approach of M-TEER and LAAC was as safe as an M-TEER-alone strategy and associated with lower minor bleeding at 1 year. Full article

Background: Despite colchicine’s proven efficacy in the non-gout population, the effects of colchicine on the risk of major adverse cardiovascular events (MACE) among high-risk patients with gout remain to be determined. The purpose of this study is to evaluate the association between colchicine use and MACE in gout patients with preexisting coronary artery disease (CAD). Methods: This retrospective cohort study followed patients with gout and established CAD within the VA New York Harbor Healthcare System who did or did not use colchicine regularly (>30 continuous days prescription with at least 1 refill). The primary outcome was first MACE, defined as a composite of non-fatal myocardial infarction, coronary artery bypass graft, non-fatal stroke, and all-cause mortality. Part I of the primary analysis compared MACE between colchicine users and nonusers. Part II of the study compared MACE within the colchicine-use group, divided into quartiles based on consistency of colchicine use (i.e., percentage of time on colchicine). Results: Among 1638 patients with gout, 355 had established CAD (239 colchicine users and 116 nonusers). In this cohort, the odds of MACE were similar between any colchicine use compared to nonuse (OR 1.14; 95% CI (0.59–2.20)); however, colchicine users overall had a higher baseline cardiovascular risk profile than nonusers, suggesting that colchicine may have served to equilibrate risk between the two groups. Moreover, patients in the highest continuous colchicine-use quartile (>70% of observation period on colchicine) demonstrated lower odds of MACE compared to those in the lowest three quartiles (OR 0.35; 95% CI (0.13–0.93)), with no difference in baseline risk. Additionally, colchicine users had a numerically lower rate of MACE during periods of active use compared with periods of lapse. Kaplan–Meier analysis revealed a difference in cumulative MACE over time, favoring the subgroup with the most consistent colchicine use (p_log-rank = 0.01). Conclusions: Despite higher CV risk, gout patients with CAD receiving colchicine had no higher rates of MACE than those not receiving colchicine. Among all patients with gout and CAD treated with colchicine, those with the most consistent colchicine use had lower odds of MACE, and event rates were lower during active use. Colchicine protection against cardiovascular events may require maintenance of colchicine bloodstream levels. Full article

This study examines plogging as an environmental movement, using Claus Offe’s new social movement theory to critically analyze why its value as an environmental movement has not been recognized in Korean society. Four rounds of in-depth interviews and narrative analysis were conducted between 2 October and 28 December 2022, which involved eight individuals who participated in and organized the plogging movement. The results revealed three reasons for plogging’s failure to be appreciated by Korean society as an environmental movement: (1) the plogging movement overlaps with existing social movements; (2) the generational gap related to plogging movement participants stemming from the “new middle class”; and (3) conglomerates using the plogging movement as a marketing tool. The plogging movement has value as a new proactive, social movement for environmental protection that centers on people’s participation. However, long-standing ideological and structural issues embedded in Korean society hinder the recognition of plogging’s value. Full article

Dietary glycemic index (GI), carbohydrate to fiber ratio (CF) and carbohydrate quality index (CQI) are conventional and emerging indicators for carbohydrate quality. We aimed to investigate the associations between these indicators and new-onset type 2 diabetes mellitus (T2DM) risk among Chinese adults. This prospective cohort study included 14,590 adults from the China Health and Nutrition Survey without cardiometabolic diseases at baseline. The associations between dietary GI, CF and CQI and T2DM risk were assessed using Cox proportional hazard regression analysis and dose–response relationships were explored using restricted cubic spline and threshold analysis. After a mean follow-up duration of 10 years, a total of 1053 new-onset T2DM cases occurred. There were U-shaped associations between dietary GI and CF and T2DM risk (both P-nonlinear < 0.0001), and T2DM risk was lowest when dietary GI was 72.85 (71.40, 74.05) and CF was 20.55 (17.92, 21.91), respectively (both P-log likelihood ratio < 0.0001). Inverse associations between CQI and T2DM risk specifically existed in participants < 60 y or attended middle school or above (both P-trend < 0.05). These findings indicated that moderate dietary GI and CF range and a higher dietary CQI score may be suggested for T2DM prevention in Chinese adults. Full article

The optimal body mass index (BMI) range for predicting survival in Asian colorectal cancer patients is unknown. We established the most appropriate cut-off point of BMI to predict better survival in Asian colorectal cancer patients using a two-stage approach. Two cohorts of colorectal cancer patients were included in this study: 5815 hospital-based development cohort and 54,043 nationwide validation cohort. To determine the optimal BMI cut-off point at diagnosis, the method of Contal and O’Quigley was used. We evaluated the association between BMI and overall survival (OS) using the Cox proportional hazard model. During a median follow-up of 5.7 and 5.1 years for the development and the validation cohort, 1180 (20.3%) and 10,244 (19.0%) deaths occurred, respectively. The optimal cut-off of BMI identified as 20.2 kg/m² (p_log-rank < 8.0 × 10⁻¹⁶) for differentiating between poorer and better OS in the development cohort. When compared to the patients with a BMI < 20.2 kg/m², the patients with a BMI ≥ 20.2 kg/m² had a significantly better OS (HR = 0.62, 95% CI = 0.54–0.72, p = 1.1 × 10⁻¹⁰). The association was validated in the nationwide cohort, showing better OS in patients with a BMI ≥ 20.2 kg/m² (HR = 0.64, 95% CI = 0.60–0.67, p < 0.01). We suggest the use of a BMI value of 20.2 kg/m² to predict survival in Asian colorectal cancer patients. Full article