Background: In the wake of the coronavirus disease 2019 (COVID-19) pandemic, people need to practice social distancing in order to protect themselves from SARS-CoV-2 infection. In such stressful situations, remote cardiac rehabilitation (CR) might be a viable alternative to the outpatient CR program. Methods: We prospectively investigated patients hospitalized for heart failure (HF) with a left ventricular ejection fraction of < 50%. As for patients who participated in the remote CR program, telephone support was provided by cardiologists and nurses who specialized in HF every 2 weeks after discharge. The emergency readmission rate within 30 days of discharge was compared among the outpatient CR, remote CR, and non-CR groups, and the EQ-5D score was compared between the outpatient CR and remote CR groups. Results: The participation rate of HF patients in our remote CR program elevated during the COVID-19 pandemic. As observed in the outpatient CR group (n = 69), the emergency readmission rate within 30 days of discharge was lower in the remote CR group (n = 30) than in the non-CR group (n = 137) (P = 0.02). The EQ-5D score was higher in the remote CR group than in the outpatient CR group (P = 0.03) 30 days after discharge. Conclusions: Remote CR is as effective as outpatient CR for improving the short-term prognosis of patients hospitalized for heart failure post-discharge. This suggests that the remote CR program can be provided as a good alternative to the outpatient CR program.

Background: Virtually no reports on the effects of exercise in patients with a small abdominal aortic aneurysm ( AAA ) exist. Methods and Results: We conducted a retrospective cohort study on 1515 patients with a small AAA before surgery at 2 high‐volume hospitals in Tokyo, Japan, from April 2004 to September 2015. A carefully modified cardiac rehabilitation program without excessive blood pressure elevation during exercise was prescribed to 50 patients with an AAA . Using propensity score matching, mortality and clinical outcomes, including AAA expansion rate, were compared between 2 groups: rehabilitation group and nonrehabilitation group. The background characteristics of the rehabilitation group (n=49) and the nonrehabilitation group (n=163) were almost identical. The risk for AAA repair was much lower in the rehabilitation group after matching (before matching: hazard ratio, 0.43; 95% confidence interval, 0.25–0.72; P =0.001; and after matching: hazard ratio, 0.19; 95% confidence interval, 0.07–0.50; P <0.001). AAA expansion rate was slower in the rehabilitation group (before matching: rehabilitation versus nonrehabilitation group, 2.3±3.7 versus 3.8±3.4 mm/y [ P =0.008]; after matching: rehabilitation versus nonrehabilitation group, 2.1±3.0 versus 4.5±4.0 mm/y [ P <0.001]). Elevation of blood pressure during exercise was positively correlated with AAA expansion rate after the rehabilitation program ( r =0.569, P <0.001). Conclusions: Cardiac rehabilitation protects against the expansion of small AAA s and mitigates the risk associated with AAA repair, possibly because of the decreased elevation of blood pressure during exercise. Clinical Trial Registration: URL: upload.umin.ac.jp . Unique identifier: UMIN 000028237.

Purpose: Geographical analysis is becoming a powerful tool for evaluating the quality of medical services and acquiring fundamental data for medical decision-making. Using geographical analysis, we evaluated the impact of the distance from patients’ homes to the hospital on their participation in outpatient cardiac rehabilitation (OCR). Methods: All patients hospitalized for percutaneous coronary intervention, coronary artery bypass grafting, valvular surgery, congestive heart failure, and aortic diseases were advised to participate in an OCR program after discharge. Using the dataset of our cohort study of OCR from 2004 to 2015 (n = 9,019), we used geographical analysis to investigate the impact of the distance from patients’ homes to hospital on their participation in our OCR program. Results: Patients whose road distance from home to hospital was 0–10 km, 10–20 km, and 20–30 km participated more in OCR than those whose road distance was ≧ 30 km (OR 4.34, 95% CI 3.80–4.96; OR 2.98, 95% CI 2.61–3.40; and OR 1.90, 95% CI 1.61–2.23, respectively). Especially in patients with heart failure, the longer the distance, the lesser the participation rate (P < .001). Conclusions: Using geographical analysis, we successfully evaluated the factors influencing patients’ participation in OCR. This illustrates the importance of using geographical analysis in future epidemiological and clinical studies. Trial registration: UMIN000028435.

Social media have opened up new opportunities for the creation of innovative public relations strategies focused on establishing and cultivating relationships with stakeholders on the basis of meaningful dialogue. Consideration of the interrelation between corporate social responsibility (CSR) and public relations highlights new areas for exploration and engagement. Both the dialogical and semantic perspectives reveal the performative and conversational aspects of social media. In general, both the linguistic panorama of CSR and digital media as part of a PR strategy open new possibilities for a dialogical, interactive, meaningful relationship strategy for corporate image management. Based on the linguistic approach to CSR and the Communication Management Approach, this paper explores the linguistic use of Twitter as a primary dialogical strategy to effectively enhance interactive dialogue-based relationships with the stakeholders of the top 50 companies in the energy sector based on tweet data from 2016. Semantic analysis was conducted by advanced text mining and clustering techniques on 3042 tweets monitored in 2017 that contained the leading CSR-related hashtags and keywords. The results demonstrated that the top energy companies apply a defensive and symbolic perspective, mainly for branding purposes. The corporate discourse dominates over a meaningful conversational strategy to foster interaction with stakeholders around sustainability issues on Twitter. The study reveals a homogenized interrelation between CSR, social media, and public relations. The results reveal a tendency for isomorphy in the communication models applied by the companies in the energy sector. Furthermore, similarities in semantics and thus strong tendencies to mutually mimic dialogical strategies are also observed. The semantic narrative built around the brand indicates a limited orientation towards CSR and sustainability. As such, it does not contribute to the creation of a dialogical interaction and meaningful relationships with multiple stakeholders on Twitter, in the high-risk sector represented by the energy industry.

Nakayama A, et al. Korean Circ J. 2023 Oct;53:e82. https://doi.org/10.4070/kcj.2023.0242