bluuebunny/crossref_metadata_2025 huggingface dataset:
Microstructure and mechanical properties of TLP-bonded 9CrMoCoB heat-resistant steel with Ni–Cr–B interlayer
Authors: Jiao Yingjun , Sheng Guangmin , Li Xue , Zhang Yuntao , Yuan Xinjian
Published: May 2022

9CrMoCoB heat-resistant steel was transient liquid phase (TLP) bonded by using a Ni–Cr–B amorphous filler metal. Results indicated that the TLP-bonded joint was composed of three feature regions, and the precipitates in the diffusion affected zone (DAZ) were M23(C,B)6-type carboborides and M3B2-type borides with different morphologies and locations. Fine granular Fe2Mo-type Laves phases and MX-type carbides that existed in the original base metal were found in the grain. The carboborides and borides in the DAZ that grew with the increase in bonding time and temperature were reduced or completely dissolved after post weld heat treatment (PWHT). The joints without PWHT showed high strength and low elongation due to the high hardness and high hardenability of the matrix. The initiation of cracks occurred on borides in the athermal solidification zone and carboborides in the Ni-DAZ and passed through in the bonded seam, resulting in the reduction in the tensile strength of the bonded joints. The hardness of the joints was obviously reduced, and their toughness was obviously improved after PWHT. The highest tensile strength reached to 744 MPa when the TLP joints were bonded at 1150 °C for 30 min, which was comparable with the original base metal.
Design and analysis of brake system for FSAE race car
Authors: Gupta Eshaan , Bora Devashish Khim Singh , A Rammohan
Published: May 2022

The objective of this research paper is to design, simulate and compare components of a race car braking system. The Racecar is an FSAE car that is designed around the rules and regulations of the FSAE rulebook, the main aim of this project is to make components lightweight and improve their performance as compared to their OEM counterparts. The braking system involves the mathematical calculation of pedal ratio, brake torque, heat generated in brake discs, and required clamping force using MATLAB to achieve peak deceleration after which these values would be used to design and simulate the components. The paper presents some innovative new ideas applied in an FSAE car and also involves designing techniques like topology optimization which was done using Altair inspire. Finally, all the components were designed in Solidworks, and simulations like Factor of safety, von mises stress, and strain were performed using ANSYS 18.1. The paper also compares the work of other authors as well and explains the differentiating factors between our and their design.
Irrigating urban green space for cooling benefits: the mechanisms and management considerations
Authors: Cheung Pui Kwan , Nice Kerry A , Livesley Stephen J
Published: May 2022

Evapotranspiration is an important cooling mechanism in urban green space (UGS). Irrigating vegetated surfaces with potable water, collected stormwater or recycled sewage water has the potential to increase the cooling effect of UGS by increasing evapotranspiration. Such cooling effect may not always be strong because evapotranspiration is dependent on local and regional factors such as background climate, seasonality and vegetation type. When using irrigation for cooling, city managers also need to consider management issues such as irrigation water supply and amenity use of the UGS. This study aims to develop a theoretical framework that explains the physical and energetic mechanisms of irrigation cooling effect and a framework to assist city managers to make decision about the use of irrigation for urban cooling. This is achieved by reviewing the impacts of irrigation on local climate reported in the literature and identifying the regional and local factors that influence irrigation cooling effect in warm seasons. The literature suggests that irrigation can potentially reduce daily maximum air temperature and ground surface temperature by approximately 2.5 °C and 4.9 °C, respectively, depending on weather conditions and irrigation amount. Background climate is an important factor that influences the cooling potentials of irrigation. Cities with dry and warm climates have the highest cooling potentials from irrigation. The cooling potentials are also influenced by seasonality and weather, vegetation type, irrigation time of day and irrigation amount. Cities with a dry and warm season can consider using irrigation to mitigate urban heat within UGS because such climatic conditions can increase cooling potentials. To maximise irrigation cooling effect, cities with abundant irrigation water supply can use a soil moisture-controlled irrigation regime while those with limited supply can use a temperature-controlled regime. More studies are required to understand the cooling potentials of irrigating small, individual UGS.
Huber’s theorem for manifolds with 𝐿^{\frac}𝑛2 integrable Ricci curvatures
Authors: Chen Bo , Li Yuxiang
Published: May 2022

In this paper, we generalize Huber’s finite points conformal compactification theorem to higher dimensional manifolds, which are conformally compact with

L

n
2

L^\frac {n}{2}

integrable Ricci curvatures.
Superresolution microscopy reveals actomyosin dynamics in medioapical arrays
Authors: Moore Regan P. , Fogerson Stephanie M. , Tulu U. Serdar , Yu Jason W. , Cox Amanda H. , Sican Melissa A. , Li Dong , Legant Wesley R. , Weigel Aubrey V. , Crawford Janice M. , Betzig Eric , Kiehart Daniel P.
Published: May 2022

Superresolution microscopy produced images of individual actin and myosin filaments and their three-dimensional distribution in medioapical arrays of cells in developing embryos. Arrays are part of a modified cell cortex that condenses and relaxes with isotropic and anisotropic contraction and expansion-they are recruited to ameliorate cell bulging.
Orchestrating nonmuscle myosin II filament assembly at the onset of cytokinesis
Authors: Najafabadi Fereshteh R. , Leaver Mark , Grill Stephan W.
Published: May 2022

We investigate the dynamics of myosin during the assembly of the cytokinetic ring in the first during the first cell division in Caenorhabditis elegans embryos. We show regulated assembly and disassembly of myosin filaments and conclude that a cytoplasmic pool of free motors is required to orchestrate myosin dynamics in different compartments of the cell.
Discovering gene regulatory networks of multiple phenotypic groups using dynamic Bayesian networks
Authors: Suter Polina , Kuipers Jack , Beerenwinkel Niko
Published: May 2022

Dynamic Bayesian networks (DBNs) can be used for the discovery of gene regulatory networks (GRNs) from time series gene expression data. Here, we suggest a strategy for learning DBNs from gene expression data by employing a Bayesian approach that is scalable to large networks and is targeted at learning models with high predictive accuracy. Our framework can be used to learn DBNs for multiple groups of samples and highlight differences and similarities in their GRNs. We learn these DBN models based on different structural and parametric assumptions and select the optimal model based on the cross-validated predictive accuracy. We show in simulation studies that our approach is better equipped to prevent overfitting than techniques used in previous studies. We applied the proposed DBN-based approach to two time series transcriptomic datasets from the Gene Expression Omnibus database, each comprising data from distinct phenotypic groups of the same tissue type. In the first case, we used DBNs to characterize responders and non-responders to anti-cancer therapy. In the second case, we compared normal to tumor cells of colorectal tissue. The classification accuracy reached by the DBN-based classifier for both datasets was higher than reported previously. For the colorectal cancer dataset, our analysis suggested that GRNs for cancer and normal tissues have a lot of differences, which are most pronounced in the neighborhoods of oncogenes and known cancer tissue markers. The identified differences in gene networks of cancer and normal cells may be used for the discovery of targeted therapies.
Art Training and Artistic Efficacy as Predictors of Volunteerism in Elders
Authors: Cheung Chau-Kiu , Chui Wing Hong , Chow Esther Oi-Wah
Published: May 2022

Facilitating elders’ volunteerism, which comprises motivation and practice to help people formally, is beneficial to the elders and their volunteering beneficiaries. According to social–cognitive theory, such facilitation supposedly benefits from art training to raise elders’ artistic efficacy. This study examines such a supposition with a two-wave panel survey of 118 elders in Hong Kong, China. Among them, forty-seven were art trainees in a senior centre and seventy-one were non-trainees. Results show that art training significantly contributed to Waves 1 and 2 artistic efficacy and volunteerism in the elder. Moreover, Wave 1 artistic efficacy significantly contributed to Wave 2 volunteerism. The results imply that art training aiming to raise artistic efficacy in a senior centre is valuable for facilitating elders’ volunteerism. Incorporating such training in social services is thus worthwhile.
Rhythm control in patients with atrial fibrillation admitted to outpatient clinic
Authors: Carvalho D , Carvalho P , Ferraz L , Pacheco A , Carvalho S , Ferreira R , Bastos JM , Neves AB
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. Patients are often symptomatic leading to a reduction in quality of life. Recent studies suggests that early rhythm control therapy have a clinical benefit in patients with recently diagnosed AF.

Purpose

This study aims to evaluate outpatient with AF referred to an outpatient clinic to electrical Cardioversion. Besides that, the study aims to evaluate if outpatient referred from the emergency room had spontaneously reverted to sinus rhythm.

Material and Methods

Retrospective observational study carried out through the analysis of the clinical process. Clinical data were collected from AF patients evaluated in an outpatient clinic during the year of 2020. Statistical analysis was made using R software and RStudio.

Results

This study included 92 patients evaluated in an outpatient clinic and referred because paroxysmal, persistent and long standing AF to electrical cardioversion. Average age was 67.3 ± 10.1 years. 78 patients had atrial fibrillation and 14 patients had atrial flutter. Hypertension was the most prevalent risk factor (n=83; 79,3%), followed by dislipidemia (n=66; 71.7%), overweight (n=43; 46,7%), diabetes mellitus (n=27; 29.3%) and smoke (n=20; 21.7%). 15 patients had paroxysmal AF, 67 patients had persistent AF and 10 patients had long standing AF. CHA2DS2VASC median were 2,78 ± 1.66 and HASBLED median was 1,14 ± 0.94. The heart rate control were most frequently made with betablocker (n=78; 84.7%). 4 patients (4,3%) were medicated with digoxin and 3 patients with calcium channel blockers. 69 patients were forwarded from external consultant and 23 patients from the emergency room (ER). We verified that 12 patients (52,2%) were in sinus rhythm in admission of outpatient clinic and had spontaneously reversion to sinus rhythm. Mostly patients with paroxysmal AF were from the ER (80% of all patients, p<.001) and mostly patients with persistent and long standing AF were from external consultant (respectively 82% p<0.01 and 85% p<0,01). Symptoms improvement were evaluated by EHRA classification. Mostly patients had clinical improvement after electrical or spontaneously cardioversion (63%, p.0.02). The median EHRA score previous to CVE were "2" and after cardioversion were "1".

Conclusions

Risk factor control is the cornerstone of AF prevention. Control rhythm is important to improve clinical symptons related to AF. However, we can delay cardioversion in a recent acute episode in the emergency room. In our sample, it seems that AF with short natural story presents more in emergency room and the more chronic comes to our consultation.
Vascular retinopathy and relationship with long-term development of ischemic heart disease. Results of the RETICARD registry
Authors: Aguila Gordo D , Marina Breysse M , Piqueras Flores J , Mateo Gomez C , Negreira Caamano M , Cubides Novoa AF , Soto Perez M , Munoz Garcia M , Martinez Del Rio J , Moron Alguacil A , Arizon Munoz JM , Salas Bravo D , Blanco Lopez E , Soto Martin P
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Introduction

Despite the undoubted relationship between retinopathy and cardiovascular pathology, its role as a predictor in the development of myocardial ischemia has not been sufficiently studied.

Methodology

Prospective study of a Spanish cohort of 107 patients who underwent diagnostic-therapeutic coronary angiography by medical indication. A fundus examination was also performed, determining the existence of retinopathy of vascular etiology (diabetic, hypertensive or atherosclerotic) and classifying it according to its degree. During follow-up, the appearance of myocardial perfusion defects was recorded by gated-SPECT.

Results

The median age was 67 years. 60.7% were men. The mean follow-up time was 111±19.7 months. Of the patients, 91.6% had some cardiovascular risk factor: 32.7% were diabetic, 78.5% had hypertension and 57% had dyslipidemia. 91.6% of the patients had some cardiovascular risk factor: 32.7% were diabetic, 78.5% had hypertension and 57% had dyslipidemia. 84.1% of the patients, had retinopathy of vascular etiology, 43.6% of whom had high-grade retinopathy. Significant coronary artery disease was present in 44.9%, with a mean SYNTAX score of 3.99±7.5 and 39.3% required percutaneous intervention. During follow-up, 15% presented inducible ischemia assessed by gated-SPECT. Subsequent coronary angiography was performed in 68.8% of these cases. Advanced vascular retinopathy, male sex, SYNTAX score and previous percutaneous coronary intervention were associated with a higher risk of myocardial perfusion defects. In logistic regression adjusted for these variables, vascular retinopathy presented an OR of 5.3 (95%CI 0.9-30.6; p=0.063) for the development of myocardial ischemia.

Conclusion

The presence of high-grade vascular retinopathy is an independent risk marker for the development of myocardial ischemia assessed by SPECT. Performing a funduscopic examination as part of the stratification of the cardiovascular patient could allow us to identify patients at higher risk.
Post-load glucose spike: a better predictor of post-MI prognosis than post-load glucose in patients without known diabetes
Authors: Chattopadhyay S , Soman B , George A , John J , Sathyapalan T
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

In non-diabetic population, number of deaths increase as the post-challenge glucose spike (PGS) i.e. difference between the fasting and 2h-PG increases in the DECODE study.

Purpose

To assess whether PGS is a better predictor of post-ACS prognosis in patients without known diabetes.

Methods

Retrospective cohort analysis of post-MI survivors (n=1056) without known diabetes undergoing pre-discharge oral glucose tolerance test. A standardised dataset was collected for the Myocardial Infarction National Audit Project. MACE (death or non-fatal re-infarction) over 5 (median 3.4) years was collected from notes review. Predictors of MACE were determined from Cox proportional hazard regression (stepwise) models adjusted for several variables (tested for collinearity) including GRACE score (GRS), fasting (FG) and 2-hour post-load glucose (2hG) and PGS as % of the 2hG (%PGS) (VIF=3.12). Incremental predictive value of PGS over 2hG was tested using probabilities of MACE calculated from logistic regression models using the same covariates and FG, 2hG and PGS individually and in combination applying c-statistics, continuous net reclassification improvement (cNRI) and integrated discrimination improvement (IDI).

Results

Of the patients 469 (44.4%) had normal glucose tolerance, 378(35.8%) preDM and 209 (19.8%) had new DM. In the whole cohort, MACE was predicted by %PGS (HR 1.02 (1.01-1.03), p<0.0001), GRS (HR 1.01, (1.01-1.02), p<0.0001), discharge with betablockers (HR 1.50 (1.14-1.98), p=0.0037), previous history of MI (HR 1.44 (1.02-2.03), p=0.039) but neither FG nor 2hG were included in the final model. MACE was predicted by %PGS (HR 1.04 (1.02-1.06), p<0.0001) in the non-diabetic group but not in the new DM patients (HR 1.02 (0.99-1.05), p=0.296). Addition of PGS to models containing FG and 2hG improved reclassification by 22.6% for events and 5.0% for non-events (NRI>0 0.275, p<0.001) and discrimination (IDI 0.0076, p=0.033). However the c-statistics did not change significantly (ΔAUC 0.0094, p=0.099).

Conclusion

PGS is a better predictor of post-MI prognosis than FG or 2hG in patients without known diabetes.
Features of nutrition in women with arterial hypertension and abdominal obesity
Authors: Koval SERGEY , Rieznik LARYSA , Starchenko TG , Penkova MYU
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Aim

The study was aimed to investigate the nutritional characteristics of female patients (residents of Ukraine) with arterial hypertension and abdominal obesity.

Materials and methods

We examined 75 female patients (residents of Ukraine) with AH stage II, 2–3 degrees, aged from 40 to 59 years (40 women with AO (I–II degrees) and 35 women with normal body weight (NBW). All patients underwent a routine examination. The peculiarities of the nutrition of the patients were analyzed using the questionnaire "Diary of daily nutrition".

Results

The energy value of the daily ration was higher in the group of women with AH and AO (2782.4 [2214.6; 3118.4] kcal), than in women with AH and NBW (1823.2 [1516.5; 2368.5] kcal, р < 0,05. In the group of women with AH and AO, the maximum energy value of the daily ration was for dinner in the most of the examined (73%), in women with AH and NBW - only in 43% (p <0.05). The study of the macronutrient composition of the daily diet of patients showed a significant increase in fat intake (106.8 [87.9; 182.0] g / day) in the main group, in contrast to the comparison group (50.5 [38.5; 118.7] g/ day), p <0.01. Intake of saturated fatty acids (p <0.01) and trans-unsaturated fatty acids (p <0.01) was also likely to be higher in the group of women with АН and AO than in the group of women with AH and NBW. Women with AH and AO probably consumed more carbohydrates than women with AH and NBW (375.1 [302.4; 447.3] g / day and 269.2 [211.7; 374.8] g / day respectively, p <0.05. Daily protein intake in the group of women with AH in combination with AO and in the group of women with AH and NBW probably did not differ and amounted to 81.2 [57.4; 127.6] g / day and 74.5 [56.6; 132.7] g / day (p <0.05). Women with AH and AO consumed an insufficient amount of dietary fiber - 28.8 [6.3; 38.4] g/day. At the same time, the consumption of dietary fiber in the group of women with AH and NBW was probably high - 39.2 [15.9; 52.5] g / day (p <0.05) and corresponded to the European norms of healthy nutrition. The groups of women probably did not differ in the level of consumption of table salt (p = 0.082) and in the number of persons who "add salt to their food".

Conclusions

Significant violations of the healthy eating norms were found in women with AH, which were much more pronounced in women with AO that must be taken into account when developing optimal schemes for correcting the diet in these patients.
Alternations in markers of insulin resistance: HOMA-IR, HOMA-B, QUICKI, after dual therapy combination with delapril/manidipine in prediabetic hypertensive patients
Authors: Liontos A , Papathanasiou A , Biros D , Papagiannopoulos C , Tsourlos S , Athanasiou L , Kolios NG , Pappa C , Veliani C , Zarachi A , Christaki E , Liberopoulos E , Elisaf M , Milionis H , Liamis G
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Purpose

The administration of the 30mg hydrochloric delapril and 10mg hydrochloric manidipine formulation is indicated for patients with idiopathic hypertension whose arterial pressure cannot be sufficiently managed with monotherapy. The purpose of this study is to investigate the effect of the premade combination delapril/manidipine 30/10mg per day on the variation of HOMA-IR, HOMA-B and QUICKI values, in patients with stage 2 hypertension (systolic blood pressure (SBP) 160-180 mmHg and/or diastolic blood pressure (DBP) 100-110 mmHg) and with prediabetes (IFG/IGT) before and after the 3-month treatment with the fixed combination dual-therapy.

Methods

53 patients (30 male/23 female, from whom 12 smokers and 7 alcohol users) who visited our outpatient clinic for lipid metabolism disorders and fulfilled the study’s criteria joined the study’s sample. They were randomized in the delapril/manidipine group. The patients’ BMI was 28.73 [27.73-30.3] and the SBP and DBP values were: 156 [151-161] and 100 [88-101] mmHg respectively.

Results

The resulting variations of SBP and DBP levels, as well as the variations of glucose and insulin levels and HOMA-IR, HOMA-B and QUICKI are presented on Table 1.

Results

From the sampled patients it seems that the 3-month treatment with delapril/manidipine improved statistically significantly the levels of both SBP and DBP (reduction by -11.54% and -12% respectively, p<0.001 for both values). Glucose levels witnessed a 1.55% decrease with statistical significance while a notable increase in insulin by 4.65% was also observed after the 3-month treatment, albeit without any statistical significance. Concerning HOMA-IR and QUICKI, there were no significant variance, while HOMA-B values showed a statistically significant increase (7%, p=0.006)
Physical activity is extremely low and should be encouraged in patients with severe aortic stenosis waiting for transcatheter aortic valve implantation
Authors: Van Erck D , Dolman CD , Scholte Op Reimer WJM , Henriques JP , Delewi R , Schoufour JD
Published: May 2022

Funding Acknowledgements

Type of funding sources: Public Institution(s). Main funding source(s): Amsterdam UMC - location AMC

Background

Physical activity is crucial to preserve muscle mass and muscle function, which is hard to regain at older age. Therefore, even short periods of physical inactivity can be harmful for older adults. Due to symptoms of aortic stenosis patients planned for an elective Transcatheter Aortic Valve Implantation (TAVI) treatment could be at risk of physical inactivity. Specifically, because many of these patients are already older and frail, this could be harmful for physical functioning and even mortality at the long-term.

Purpose

To determine physical activity in patients planned for TAVI, using a wearable.

Methods

Consecutive patients undergoing TAVI from January 2020 to September 2021 were included. All patients were asked to wear a Stepwatch activity monitor to objectively measure physical activity in the period before the TAVI. The Stepwatch is a valid tool to determine physical activity in frail and older adults, because it is able to detect slow or irregular movement. Patients were asked to wear the Stepwatch for seven consecutive days during every awake hour. By three complete days of at least 10 hours of wear time the data were included in the analysis. Two parameters were collected: the number of steps per day and activity time at moderate intensity. For number of steps per day patients were classified as extremely inactive (<2500), inactive (<7500) or active (>7500). For time at moderate intensity, it was determined how many patients did meet the activity guidelines (>150 min of moderate activity per week).

Results

In total 89 patients were included; mean age was 81 ± 5 years and 54% was male. Average number of steps per day were 6249 ± 2999. In total 19% (n=17) of the patients were extreme inactive, 67% (n=59) were inactive, and 15% (n=13) were active. Patients were moderate active for a median of 8 [IQR: 0 – 43] minutes per week. In total 6% (n=5) of the patients met the recommended guidelines of at least 150 minutes of moderate physical activity per week.

Conclusion

Older and frail patients with severe aortic stenosis planned for TAVI are mainly inactive. Most patients only moved at low intensity and a very small number of patients (6%) met the activity guidelines. The extremely low physical activity in patients waiting for TAVI, make them at high risk for muscle breakdown and adverse health outcomes at the longer term. (P)rehabilitation interventions should be developed to encourage patients with severe aortic stenosis to become more active during waiting time before TAVI.
Effects of concurrent training on cardiorespiratory fitness and body composition in adults with schizophrenia: CORTEX-SP study
Authors: Tous-Espelosin M , Iriarte-Yoller N , Sanchez P , Maldonado-Martin S
Published: May 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Spanish Ministry of Economy and Competitiveness “Fondo de Investigación Sanitaria del Insti-tuto de Salud Carlos III”

Background

Concurrent training (i.e. a combination of aerobic and resistance exercise in the same session) is emerging as a time-efficient exercise strategy for improving cardiorespiratory fitness and controlling body composition parameters.

Purpose

The purpose of this study was to determine the effectiveness of a concurrent exercise program on cardiorespiratory fitness and body composition in adults with schizophrenia (SP).

Methods

Participants (n=98, 20.4% women, 41.4±10.1 yr old) with SP were randomly assigned into an attention control group (usual care) or a supervised exercise group (concurrent training, 3 days/week). All variables were assessed pre- and post-intervention (20 weeks). For the assessment of cardiorespiratory fitness, a peak cardiopulmonary exercise test on a cycle ergometer and the Modified Shuttle Walk Test (MSWT) were used.

Results

Following the intervention, in the control group, there was a significant (P <0.05) increased in body mass (Δ = 2.54%), body mass index, BMI (Δ = 2.82%), waist circumference (Δ = 2.70%) and a decreased in MSWT (Δ = - 7.54%). However, in the exercise group, there was a significant (P<0.001) increased in first ventilatory threshold, VT1 (Δ = 28.69%), peak oxygen uptake, V̇O2peak (L∙min-1) (Δ = 19.58%), V̇O2peak (mL∙kg.1∙min-1) (Δ = 21.52%) and MSWT-distance (Δ = 11.43%), with no significant changes in body composition (P>0.05). When both groups were compared, body mass, and BMI was significantly (P<0.05) more reduced, and VT1, V̇O2peak, and MSWT more increased in the exercise group.

Conclusion

A supervised concurrent exercise program in people with SP helps to maintain body composition values and leads to improvements in cardiorespiratory fitness levels. Exercise should be considered as a co-adjuvant program in the treatment of population with SP.
Awareness and knowledge of pneumococcal vaccination in cardiology outpatient clinics and impact of physicians' recommendation on vaccination rates
Authors: Ekin T , Kis M , Gungoren F , Atici A , Kunak AÜ , Mutlu D , Katkat F , Demir M , Sarac İ , Soydan E , Karaduman M , Bekar L , Boyuk F , Adiyaman MS , Zoghi M
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Although there is not enough data on pneumococcal vaccination status in patients with cardiovascular disease and or risk factors in our country, it is known that vaccination rates are quite low in the current data.

Purpose

We aimed to evaluate the awareness of pneumococcal vaccination (PCV13, PPSV23) in general cardiology outpatient clinics and impact of physician’s recommendation (with educational brochures) on vaccination rate.

Methods

Awareness of vaccination, before COVID-19 pandemic, was measured in patients admitting to cardiology outpatient clinics from 40 center of our country by a questionnaire contained 19 questions. The demographics (including gender, age, educational level, awareness vaccination level) and comorbidities were obtained. The vaccination rates were calculated within 3-months follow-up from the admitting of patient to cardiology clinics.

Results

The 403 (18.2%) of patients with previous pneumococcal vaccination were excluded from the study. The mean age of study population (n=1808) was 61.9±12.1 years and 55.4% were male. The 58.7% had coronary artery disease, hypertension (74.1%) was the most common risk factor and 32.7% of the patients had never been vaccinated although they had information about vaccination before. The 98.5% were referred to family medicine (n=1412, 78.1%) or vaccination outpatient clinics (n=370, 20.5%) and the vaccination rate was 62.1% during the follow-up period. The differences between vaccinated and not-vaccinated patients are presented in Table 1.

The physician’s recommendation was positively correlated with vaccination intention and behavior in our participants. Multivariate logistic regression analysis showed a significant between vaccination and female sex [OR=1.55 (95% CI=1.25–1.92), p<0.001], higher education level [OR=1.49 (95% CI=1.15-1.92), p=0.002] patients’ knowledge [OR=1.93 (95% CI=1.56-2.40), p<0.001], and their physician’s recommendation [OR=5.12 (95% CI=1.92-13.68), p=0.001].

Conclusion

To our knowledge this is the first report about the awareness pneumococcal vaccination rates and impact of physician’s recommendation in patients with cardiovascular disease by high study population. These findings suggest providing information on the benefits of vaccination by physician’s and educational advice was significantly associated with an increase vaccination rate and have a key role.
Implementing the ask-advice-connect method in a university hospital
Authors: De Frel DL , Janssen VR , Meijer E , Atsma DE
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Smoking cessation reduces the relative risk of morbidity and mortality.(1, 2) Healthcare professionals (HPs) can play a substantial role in smoking cessation counselling (SCC) but in practice often skip this task.(3, 4) A quick and effective method for HPs to assist is the Ask-Advise-Connect method in which the physician asks about smoking, advises to quit and offers to connect the patient to an external SCC program.(5)

Purpose

To evaluate an intervention aimed to implement the Ask-Advise-Connect (AAC) method in a University hospital.

Methods

This mixed methods pre-post interventional study was performed at the Cardiology department of a University hospital and consisted of 1) semi-structured interviews with 10 HPs to assess their attitudes towards AAC, 2) a blended intervention aimed to implement AAC, and 3) quantitative assessment of patient smoking registration and HP connection rates to external SCC which were collected from the Electronic Medical Record. In total, 48,321 patient consultations and 67 HPs were included. The blended intervention consisted of face-to-face and online AAC psychoeducation for HPs followed-up with motivational messages over a period of 6 weeks.

Results

Before the intervention, HPs assessed smoking status in 74.0% of patients and connected 9.3% of identified smokers with external SCC. The blended intervention did not increase these percentages at post-test (respectively 73.2%, p=0.20; and 10.9%, p>0,05). Nonetheless, the vast majority of HPs feel it is important to discuss patient smoking, and view it as their duty to do so. Main barriers to AAC reported by HPs were forgetfulness and time pressure.

Conclusion

This study shows that this AAC intervention does not increase Asking after smoking status or Connection of patients to SCC. However, HPs hold positive attitudes towards AAC. A better understanding of the mechanisms required for changing HPs practice behavior is needed.
The impact of temperature changes on patients with acute coronary syndrome
Authors: Shuka N , Cabeli A , Dado E , Hasimi E , Kondi L , Qordja M , Simaku A , Begaj B , Goda A
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

There are few studies about changes in temperature as a risk factor instability of atheromatous plaque and Acute Coronary Syndrome (ACS). It is the first study in our country.

Purpose

To evaluate the impact of temperature on patients with Acute Coronary Syndrome.

Methods

This is a retrospective, observational, analytical study conducted in a single-center, in the period January-December 2018. We included patients with the diagnosis of ACS, hospitalized in CCU, who performed emergency coronary angiography. Data were collected retrospectively using patient records from archived files at the Statistics Center. Data on atmospheric parameters, measured at the weather monitoring station, were obtained from the National Meteorological Service database (average daily temperature in each district of the country). The number of inhabitants for the respective districts is taken from the National Institute of Statistics.

Results

The study included 1165 patients. A significant association was found between the number of ACS per day with temperature changes (r=-0.13, p<0.01). The highest number of ACS was in October 10.4%, whereas the lowest number was in January 10.6%, with a significant decreasing trend during May-June and the peak in October (p=0.04). Significant changes in the average monthly values of temperature were accompanied by a statistically significant increase in the number of cases as occurred in March-April and October-November. (p≤0.05) A statistically significant relationship was observed between seasonal changes in temperature with the number of cases with ACS. The autumn season prevails with 27.9% of the total cases, followed by the spring season with 25.6%, the summer season with 24.2%, and the winter season with 22.3%, (p = 0.04). Most cases in the cold period (November-March) occurred on days with statistically significant changes in Temperature.

Conclusion

The study notes an important relationship between seasonal, monthly, and daily changes of temperatures, in relation to the frequency of cases with Acute Coronary Syndrome.
Optimising screening of intermediate to high-risk asymptomatic sportsmen with exercise electrocardiogram. The SEEPRED study
Authors: Hupin D , Oriol M , Roche F
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

The importance of exercise electrocardiogram (ECG) is still controversial in the prevention of cardiovascular events among sportsmen. The aim of this study was to assess the relevance of exercise ECG as a significant prognostic marker for cardiovascular events when any CVD risk factors are present.

Methods

The SEEPRED cohort study included leisure time asymptomatic sportsmen over 35 years old, referred from 2011 to 2016 in the Sports Medicine Unit of our university hospital. Major adverse cardiovascular events (MACE) and atrial fibrillation were collected 5 years after exercise ECG using a phone questionnaire.

Multivariate logistic regression models were performed to predict positive exercise ECG, suspected and confirmed silent myocardial ischemia (SMI) and cardiovascular events.

Results

Of the cohort of 2457 sportsmen (1898 men; mean age 50.2 ± 9.4 years; physical activity level 29.4 ± 25.1 MET-h/week), 1482 (60%) had at least one cardiovascular disease (CVD) risk factor and 52 (2%) had a SCORE>5%. A total of 256 exercise ECGs (10%) were defined as positive, most of them due to SMI (n = 196; 8%). SMI was an indication for coronary angiography in 43 cases, leading to 33 documented SMIs (1%), including 23 significant stenoses requiring revascularization. In multivariate logistic regression analysis, having at least 2 CVD risk factors was independently associated with (1) positive exercise ECG [OR=1.80 (CI 95%: 1.29-2.52), p=0.0006], with (2) suspected SMI [OR=2.57 (CI 95%: 1.10-6.02), p=0.0304], with (3) confirmed SMI [OR=8.20 (CI 95%: 3.46-19.46), p<0.0001] and with (4) cardiovascular events (MACE or atrial fibrillation) [OR=6.95 (CI 95%: 3.49-13.81), p<0.0001].

Conclusions

The study supports the European recommendations for the use of exercise ECG in evaluation of asymptomatic leisure time sportsmen over 35 years. Having at least 2 CVD risk factors was the best predictors for presence of coronary lesions at risk for events.
Facilitators and barriers to centre- and home-based exercise training in breast cancer patients - a swiss tertiary centre experience
Authors: Schneider C , Reimann S , Schmid J , Bernhard J , Campbell KL , Wilhelm M , Eser P
Published: May 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Swiss Cancer Research

Background

Exercise is an effective therapy for cancer patients to reduce fatigue and to improve health-related quality of life and physical function. Yet, cancer patients often do not meet physical activity guidelines.

Purpose

To understand why recommendations are not met, we aimed at identifying facilitators and barriers to supervised, centre-based exercise within a cardio-oncologic rehabilitation (CORE) programme and to unsupervised, home-based exercise as well as strategies used to manage these barriers.

Methods

Breast cancer patients who had completed a CORE programme at a Swiss tertiary centre were recruited. Semi-structured interviews were conducted with subsequent thematic analysis.

Results

Of 37 eligible breast cancer patients, 19 patients (mean age 48.9±9.7 years) participated to our invitation. Facilitators for centre-based exercise were social support, committedness and provision of structured exercise. Barriers towards centre-based exercise included physical and environmental barriers, while psychological barriers were reported predominantly for home-based exercise. Strategies to manage barriers included the adaptation of training circumstances, behaviour change strategies and strategies to deal with side effects.

Conclusions

Our results support the importance of providing CORE programmes and suggest that a special focus should be directed at the transition from supervised to self-organized exercise in order to enhance long-term exercise participation.
Information needs and information seeking behavior in patients receiving cardiac rehabilitation
Authors: Tenbult - Van Limpt N , Van Asten I , Brouwers R , Spee RF , Brini A , Kemps HMC
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

In Cardiac Rehabilitation (CR), education is an important element of interventions that aims to reduce the risk of new cardiovascular diseases. Previous research showed that in order to be effective, information provided by medical professionals should be tailored to the information needs of the individual patient. However, knowledge on determinants of specific information needs is scarce. Therefore, the aim of this study was to investigate the variability in information needs among participants and the determinants of information needs on lifestyle behaviour, psychological wellbeing and medication after an acute coronary event or revascularization procedure.

Methods

Patients entering the CR program for the first time following myocardial infarction (MI) and / or percutaneous coronary intervention (PCI) or coronary bypass (CABG) were instructed to complete questionnaires on (1) the level and type of information needs about nutrition, physical activity, smoking, psychological well-being and medication, (2) information seeking behaviour and (3) potential determinants of information needs (i.e., socio-demographic characteristics, level of health literacy, illness perceptions, anxiety, depression, type D personality and quality of life).

Results

259 patients were included. The mean age was 65 years, 76% of the study population was male, 58% was diagnosed with MI and 63% undergone a PCI (63%). The majority of patients (63%) indicated the need for information on at least one of the 4 topics (i.e., nutrition, physical activity, medication, psychological well-being), with considerable inter-individual variation. Gender, employment and socio-economic status, level of anxiety and illness perception were found to be significant predictors for the information needs, based on multivariable logistic regression analysis.

Conclusion

This study showed that there was a need for information in the majority of the patients with considerable inter-individual variability with respect to the topics. Whereas diagnosis was not related to the preference for specific information topics, characteristics as gender, employment, socio-economic status, anxiety and illness perception were selected as independent predictors of information needs. These results underline the need for personalized information strategies.
Endothelin-1 negatively correlates with functional capacity in patients with breast cancer receiving first line anthracycline-based chemotherapy
Authors: Anggraeni VY , Ambari AM , Dwiputra B , Radi B , Hutajulu SH , Hardianti MS , Mumpuni H , Kusumastuti DA , Hartopo AB
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Endothelial dysfunction caused by anthracycline is one of the key mechanism of chemotherapy induced cardiomyopathy that ultimately resulted in heart remodeling and exercise limitations. An endothelial molecular factor Endothelin-1 (ET-1) is known to be extremely important in vasoconstriction and angiogenesis. Interestingly, ET-1 concentration is also altered in vascular injury following anthracycline administration suggesting a distinct association. Nonetheless, the correlation between ET-1 and functional capacity in chemotherapy induced cardiomyopathy remained largely unknown.

Purpose

To elucidate correlation between ET-1 serum concentration with left ventricular (LV) function and functional capacity using echocardiography and 6 minute walk test (6MWT) following anthracycline-based chemotherapy in patient with breast cancer.

Methods

This is a prospective study that involves 19 female participants diagnosed with breast cancer (stage IIA-IV) receiving first line chemotherapy with 4-8 cycles of anthracycline-based regiments. Baseline pre-chemotherapy characteristics, ET-1 serum concentration, echocardiography and 6MWT, followed by post-chemotherapy evaluation were measured. Additionally, 6MWT were also performed at 6 months and 12 months after completion of chemotherapy.

Results

ET-1 serum significantly increased post-chemotherapy (1.521±0.57 vs 1.817±0.52 pg/mL, p=0.0169) in comparison with baseline. 6MWT distance was decreased after initial pre-chemotherapy measurement (372.5±84.23), 366.8±51.96 and 358.5±51.97 post-chemotherapy and 6 months after chemotherapy completion respectively. Moreover, post-chemotherapy LV ejection fraction (LVEF) was significantly lower in high ET-1 group (≥ 1.817 pg/mL) as compared to patients with low ET-1 (70.39±3.75 vs 65.80±2.49, p=0.0465) regardless comparable baseline LVEF. In addition, Pearson’s correlation test displayed a tendency of negative correlation between post chemotherapy ET-1 with 6MWT distance post-chemotherapy and 6 months after chemotherapy completion (r = -0.264, p=0.2745, 95% CI = -0.64-0.22 and r = -0.172, p=0.4803, 95% CI = -0.58-0.3).

Conclusion

Collectively, these findings strongly suggest that ET-1 may serve as a novel biomarker to predict compromised functional capacity in cancer patients underwent chemotherapy, arguably requires further investigations.
Self-care among men with chronic heart failure - need for educational interventions?
Authors: Wisnicka A , Wisnicki K , Lomper K , Uchmanowicz I
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Introduction

Heart failure (HF) is one of the biggest problems in cardiology and public health. The long-term risk of developing HF symptoms in a person aged 55 years is 33% for men. Self-care is a key element of therapeutic process of patients with HF.

Purpose

To assess the level of self-care among men with chronic heart failure.

Methods

The study was conducted among 80 men diagnosed with chronic heart failure (mean age 58 years). A self-administered questionnaire and analysis of medical records were used to collect baseline sociodemographic and clinical data. Self-care was assessed using the standardized European Heart Failure Self-care Behavior Scale- EHFScBS-9.

Results

Patients in NYHA class II constituted the vast majority (71.25%), mean LVEF in the study group was 43.5%, and mean disease duration was 3 years. The most common comorbidities were ischemic heart disease (72.5%), hypertension (70%) and diabetes mellitus (60%). The most commonly reported non-pharmacological treatments for NS were fluid restriction (45%), moderate physical activity (42.50%) and daily weight control (41.25%). The EHFSc-9 questionnaire score averaged 50.31 points out of 100 possible (SD = 26.52).

Conclusions

Patients with HF have unsatisfactory self-care outcomes. There is a need to implement interventions based on patient-tailored health education.
Hemodynamic forces in olympic athletes assessed by cardiac magnetic resonance: a new non-invasive screening tool?
Authors: Filomena D , Monosilio S , Birtolo L I , Penza M , Lemme E , Squeo M R , Di Gioia G , Tonti G , Pedrizzetti G , Fedele F , Gualdi G , Spataro A , Pelliccia A , Di Giacinto B , Maestrini V
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Non-invasive evaluation of left ventricular hemodynamic forces (HDFs) by Cardiac Magnetic Resonance (CMR) is a promising tool to improve systolic and diastolic evaluation. No data are available on athletic population.

Purpose

To provide the range of normal values of HDFs in Olympic athletes and to evaluate the possible influence of different sport categories.

Methods

A group of Olympic athletes evaluated prior the Olympic games with unremarkable cardiovascular pre-participation screening tests underwent CMR without contrast administration. A group of sedentary subjects was enrolled as a control group. Cine-images were post-processed by a feature-tracking based software to estimate HDFs. HDFs were measured in apex-base (AB) and latero-septal (LS) directions, over the entire heartbeat, in systole and diastole. Athletes were divided in subgroups according to ESC sport classification for comparison. They were also divided according to the ejection fraction (EF ≤ or >53%).

Results

93 elite athletes (33% power, 33% mixed, 33% endurance) were enrolled. HDFs in AB and LS direction were 20.5%± 4.3 and 2.9%± 0.7 in the entire heartbeat, 32.6% ± 7 and 3.6%± 1 in systole, 11%± 4.1 and 2.3%± 0.8 in diastole. Comparing athletes of different sport category and sedentary controls no significant differences were found between groups (Table). Comparing athletes with ejection fraction (EF) £ 53% and > 53%, the former showed lower values of AB-HDFs assessed in the entire heartbeat and in systole (18.9 ± 4.6 % vs 20.9 ± 4.1; p= 0.024 and 29.6 ± 6.3 vs 33.3 ± 7; p= 0.024, respectively), but within the normal range.

Conclusion

We provide normal range for HDFs assessed by CMR in elite athletes and no differences were observed between sedentary controls and athletes involved in different sport categories. Comparing athletes with low-normal and normal ejection fraction, the former showed lower values of AB-HDFs but within the normal range.