Aims: To evaluate whether mobility-derived greenspace visitation, as a behavioural measure of environmental exposure, is associated with major adverse cardiovascular events (MACE) independent of individual and neighbourhood factors. Methods and results: We conducted a retrospective cohort study of adults in the Houston Methodist Cardiovascular Disease Learning Health System Registry (2016–2023). Greenspace visitation was defined at the census-tract level using mobility-derived foot-traffic data and modelled as annual visits per resident device. The primary outcome was incident MACE (myocardial infarction, stroke, coronary revascularization, and all-cause mortality). The Cox models, restricted cubic splines, and Kaplan–Meier curves assessed associations with sequential adjustment for demographics, comorbidities, smoking, and neighbourhood social vulnerability. Among 1 088 866 adults without baseline atherosclerotic cardiovascular disease, median (SD) age was 49 (17.6) years, and 59.9% were female. Greenspace visitation varied across neighbourhoods and by demographic and socioeconomic characteristics. Each additional 10 annual visits was associated with lower MACE risk in unadjusted models [hazard ratio (HR) 0.82; 95% confidence interval (CI): 0.81–0.83] and after adjustment for demographics, comorbidities, and smoking (HR 0.89; 95% CI: 0.88–0.91). A non-linear relationship showed risk reductions at low-to-moderate visitation, plateauing at 10–15 visits annually. After adjusting for social vulnerability, associations were attenuated and no longer significant. The Kaplan–Meier curves showed higher event-free survival in high-visitation areas, consistent across MACE components. Conclusion: Mobility-derived greenspace visitation is associated with lower cardiovascular risk. These findings highlight greenspace engagement as a potentially modifiable behavioural exposure and support strategies to enhance access and utilization of greenspaces for cardiovascular prevention.

Pseudomonas aeruginosa bacteremia has become increasingly recognized as a major cause of morbidity and mortality and represents a challenge to the treating physician with the rise of multi-drug resistant (MDR) Pseudomonas. The purpose of this study is to evaluate the risk factors associated with Pseudomonas aeruginosa bacteremia and its clinical out-comes. A retrospective cohort study at the American University of Beirut Medical Center (AUBMC) was performed. It included 85 patients > 18 years of age who had confirmed Pseudomonas aeruginosa bacteremia during their hospital stay from 2017 to 2022. With regard to resistance patterns, 8 (9.4%) were considered multidrug-resistant (MDR) and 19 (22.4%) were considered difficult to treat (DTR). Antibiotic use in the month preceding the infection was associated with the risk of DTR Pseudomonas infections (odds ratio 4.97; p-value 0.026). The in-hospital mortality rate was 51.8%. Male sex was associated with decreased mortality (odds ratio 0.13; p-value 0.036). Recent central line placement and Pitt bacteremia score were associated with increased mortality (odds ratios 2.63; p-value 0.028 and 51.71; p-value < 0.001, respectively). Patients with high-risk primary sources of in-fection such as central line, gastrointestinal, and respiratory sources had increased mortality when compared to those with low-risk sources such as skin, abscess, and urinary sources (odds ratio of 25.96; p-value 0.001). In Pseudomonas aeruginosa bacteremia, in addition to prompt empirical treatment, identifying the primary source of infection is imperative as it can estimate the severity of the curent infection. Pitt bacteremia score can be an effective tool to evaluate patient outcome. Increasing antibiotic use has led to in-creasing rates of DTR Pseudomonas infections, which highlights the importance of an-timicrobial stewardship.