bluuebunny/crossref_metadata_2025 huggingface dataset:
Circulating microRNA as predictors for exercise response in heart failure with reduced ejection fraction
Authors: Witvrouwen Isabel , Gevaert Andreas B , Possemiers Nadine , Beckers Paul J , Vorlat Anne , Heidbuchel Hein , Van Laere Steven J , Van Craenenbroeck Amaryllis H , Van Craenenbroeck Emeline M
Published: January 2021

Aims

Exercise training is a powerful adjunctive therapy in patients with heart failure with reduced ejection fraction (HFrEF), but ca. 55% of patients fail to improve VO2peak. We hypothesize that circulating microRNAs (miRNAs), as epigenetic determinants of VO2peak, can distinguish exercise responders (ER) from exercise non-responders (ENR).

Methods and results

We analysed 377 miRNAs in 18 male HFrEF patients (9 ER and 9 ENR) prior to 15 weeks of exercise training using a miRNA array. ER and ENR were defined as change in VO2peak of >20% or <6%, respectively. First, unsupervised clustering analysis of the miRNA pattern was performed. Second, differential expression of miRNA in ER and ENR was analysed and related to percent change in VO2peak. Third, a gene set enrichment analysis was conducted to detect targeted genes and pathways. Baseline characteristics and training volume were similar between ER and ENR. Unsupervised clustering analysis of miRNAs distinguished ER from ENR with 83% accuracy. A total of 57 miRNAs were differentially expressed in ENR vs. ER. A panel of seven miRNAs up-regulated in ENR (Let-7b, miR-23a, miR-140, miR-146a, miR-191, miR-210, and miR-339-5p) correlated with %changeVO2peak (all P < 0.05) and predicted ENR with area under the receiver operating characteristic curves ≥0.77. Multiple pathways involved in exercise adaptation processes were identified.

Conclusion

A fingerprint of seven miRNAs involved in exercise adaptation processes is highly correlated with VO2peak trainability in HFrEF, which holds promise for the prediction of training response and patient-targeted exercise prescription.
Plasma ceramide and phospholipid-based risk score and the risk of cardiovascular death in patients after acute coronary syndrome
Authors: Gencer Baris , Morrow David A , Braunwald Eugene , Goodrich Erica L , Hilvo Mika , Kauhanen Dimple , Sabatine Marc S , Laaksonen Reijo , O’Donoghue Michelle L
Published: January 2021

Aims

Ceramide (Cer) and phosphatidylcholine (PC) lipids are associated with pathophysiological processes in cardiovascular (CV) diseases. A previously derived and validated plasma Cer-PC risk score (CERT2) was associated with CV death risk in patients with stable disease, but its prognostic value has not been evaluated in patients early post-acute coronary syndrome (ACS).

Methods and results

Prespecified plasma Cer and PC species in the CERT2 risk score were measured in 4871 subjects from SOLID-TIMI 52, which enrolled patients ≤30 days after ACS (median follow-up 2.5 years). The CERT2 score (scale 0–12 points) was calculated as previously defined. The primary outcome was CV death; Coronary heart disease death, all-cause death, hospitalization for heart failure (HF), myocardial infarction (MI) and stroke were also analyzed. Poisson models included baseline characteristics and established biomarkers. Patients with higher CERT2 risk scores were more likely to be older, female, current smokers, presenting with STEMI, and to have impaired renal function and higher LDL-C. After multivariable adjustment, patients in the highest risk score category remained at a nearly two-fold higher risk of CV death (adj relative risk [RR] 1.92, 95% CI 1.01–3.66, P = 0.047). Patients in the highest risk score category were also at higher risk of all-cause death (adj RR 2.01, 95% CI 1.21–3.35, P = 0.007), whereas the relationships with HF, MI, and stroke were attenuated with multivariable adjustment.

Conclusions

A plasma ceramide and phospholipid-based risk score is associated with the risk of CV death independent of established clinical risk factors and biomarkers in patients after ACS.
Gender gap in risk factor control of coronary patients far from closing: results from the European Society of Cardiology EUROASPIRE V registry
Authors: Vynckier Pieter , Ferrannini Giulia , Rydén Lars , Jankowski Piotr , De Backer Tine , Gevaert Sofie , De Bacquer Dirk , De Smedt Delphine ,   the EUROASPIRE V Investigators group
Published: January 2021

Aims

This study aims to provide an overview on contemporary gender differences in the risk factor control of coronary heart disease (CHD) patients.

Methods and results

Analyses were based on the cross-sectional ESC (European Society of Cardiology) EORP (EurObservational Research Programme) EUROASPIRE V (European Survey of Cardiovascular Disease Prevention and Diabetes) survey including data on CHD patients across 27 European countries. Men and women between 18 and 80 years old, hospitalized for a first or recurrent coronary event were included in the study. Data were available for 8261 patients of which 25.8% women. Overall, women had a worse risk factor control compared with men. Whereas women were more likely to be non-smokers (79.3% vs. 87.2%; P < 0.001), they were less likely to reach recommended levels of physical activity (36.8% vs. 27.5%; P < 0.001), and they were less likely to be non-obese (65.1% vs. 54.3%; P < 0.001). There is indication that risk factors such as smoking behaviour and obesity differed depending on country income level. No gender differences could be observed in blood pressure on target (P > 0.05). Moreover, a lower proportion of women reached low-density lipoprotein cholesterol (LDL-C) target levels (31.4% vs. 22.1%; P < 0.001), and they were less likely to reach glycated haemoglobin (HbA1c) targets if having self-reported diabetes (56.7% vs. 48.6%; P < 0.001).

Conclusion

The risk factor control of CHD women is substantial worse compared with men despite little gender differences in cardiovascular medication intake. Further actions are needed to increase the awareness of the worse risk factor control in female CHD patients.
Association of fatal myocardial infarction with past level of physical activity: a pooled analysis of cohort studies
Authors: Hansen Kim Wadt , Peytz Nina , Blokstra Anneke , Bojesen Stig E , Celis-Morales Carlos , Chrysohoou Christina , Clays Els , De Bacquer Dirk , Galatius Søren , Gray Stuart R , Ho Frederick , Kavousi Maryam , Koolhaas Chantal M , Kouvari Matina , Løchen Maja-Lisa , Marques-Vidal Pedro , Osler Merete , Panagiotakos Demosthenes , Pell Jill P , Sulo Gerhard , Tell Grethe S , Vassiliou Vassilios , Verschuren W M Monique , Prescott Eva
Published: January 2021

Aims

To assess the association between past level of physical activity (PA) and risk for death during the acute phase of myocardial infarction (MI) in a pooled analysis of cohort studies.

Methods and results

European cohorts including participants with a baseline assessment of PA, conventional cardiovascular (CV) risk factors, and available follow-up on MI and death were eligible. Patients with an incident MI were included. Leisure-time PA was grouped as sedentary (<7 MET-hours), low (7–16 MET-hours), moderate (16.1–32 MET-hours), or high (>32 MET-hours) based on calculated net weekly energy expenditure. The main outcome measures were instant and 28-day case fatality of MI. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using multivariate random-effects models. Adjustments for age, sex, CV risk factors, alcohol consumption, and socioeconomic status were made. From 10 cohorts including a total of 1 495 254 participants, 28 140 patients with an incident MI comprised the study population. A total of 4976 (17.7%) died within 28 days—of these 3101 (62.3%) were classified as instant fatal MI. Compared with sedentary individuals, those with a higher level of PA had lower adjusted odds of instant fatal MI: low PA [OR, 0.79 (95% CI, 0.60–1.04)], moderate PA [0.67 (0.51–0.89)], and high PA [0.55 (0.40–0.76)]. Similar results were found for 28-day fatal MI: low PA [0.85 (0.71–1.03)], moderate PA [0.64 (0.51–0.80)], and high PA [0.72 (0.51–1.00)]. A low-to-moderate degree of heterogeneity was detected in the analysis of instant fatal MI (I2 = 47.3%), but not in that of 28-day fatal MI (I2 = 0.0%).

Conclusion

A moderate-to-high level of PA was associated with a lower risk of instant and 28-day death in relation to a MI.
Burden of heart failure and underlying causes in 195 countries and territories from 1990 to 2017
Authors: Bragazzi Nicola Luigi , Zhong Wen , Shu Jingxian , Abu Much Arsalan , Lotan Dor , Grupper Avishay , Younis Arwa , Dai Haijiang
Published: January 2021

Aims

To provide the first systematic analysis of the burden and underlying causes of heart failure (HF) in 195 countries and territories from 1990 to 2017.

Methods and results

We collected detailed information on prevalence, years lived with disability (YLDs), and underlying causes of HF from the Global Burden of Disease study 2017. Numbers and age-standardized rates of HF prevalence and YLDs were compared by age, sex, socio-demographic index (SDI), and location. The proportions of HF age-standardized prevalence rates due to 23 underlying causes were also presented. Globally, the age-standardized prevalence and YLD rates of HF in 2017 were 831.0 and 128.2 per 100 000 people, a decrease of −7.2% and −0.9% from 1990, respectively. Nevertheless, the absolute numbers of HF prevalent cases and YLDs have increased by 91.9% and 106.0% from 1990, respectively. There is significant geographic and socio-demographic variation in the levels and trends of HF burden from 1990 to 2017. Among all causes of HF, ischaemic heart disease accounted for the highest proportion (26.5%) of age-standardized prevalence rate of HF in 2017, followed by hypertensive heart disease (26.2%), chronic obstructive pulmonary disease (23.4%).

Conclusion

HF remains a serious public health problem worldwide, with increasing age-standardized prevalence and YLD rates in countries with relatively low SDI. More geo-specific strategies aimed at preventing underlying causes and improving medical care for HF are warranted to reduce the future burden of this condition.
Triglyceride-rich lipoproteins, apolipoprotein C-III, angiopoietin-like protein 3, and cardiovascular events in older adults: Atherosclerosis Risk in Communities (ARIC) study
Authors: Hussain Aliza , Sun Caroline , Selvin Elizabeth , Nambi Vijay , Coresh Josef , Jia Xiaoming , Ballantyne Christie M , Hoogeveen Ron C
Published: January 2021

Aims

Despite statin and antihypertensive therapies, older Americans have high atherosclerotic cardiovascular disease (ASCVD) risk. Novel measures of triglyceride-rich lipoproteins, low-density lipoprotein triglycerides (LDL-TG), and remnant-like particle cholesterol (RLP-C), are associated with ASCVD in middle-aged adults. Polymorphisms in genes encoding angiopoietin-related protein 3 (ANGPTL3) and apolipoprotein C-III (apoC-III), two proteins involved in triglyceride catabolism, are associated with increased risk for hypertriglyceridaemia and ASCVD and are potential therapeutic targets. We examined associations of LDL-TG, RLP-C, apoC-III, and ANGPTL3 levels with ASCVD events in older adults in the Atherosclerosis Risk in Communities (ARIC) study.

Methods and results

In 6359 participants (mean age 75.8 ± 5.3 years) followed for ASCVD events [coronary heart disease (CHD) or ischaemic stroke] up to 6 years, associations between LDL-TG, RLP-C, apoC-III, and ANGPTL3 and ASCVD events were assessed using Cox regression. With adjustment for age, sex, and race, RLP-C, LDL-TG, apoC-III, and ANGPTL3 (as continuous variables) were significantly associated with CHD. However, after adjustment for traditional risk factors and lipid-lowering medications, only LDL-TG and ANGPTL3 were significantly associated with ASCVD events [hazard ratio (HR) 1.72, 95% confidence interval (CI) 1.25–2.37 per log unit increase in LDL-TG; HR 1.63, 95% CI 1.17–2.28 per log unit increase in ANGPTL3].

Conclusions

In older adults, LDL-TG, RLP-C, apoC-III, and ANGPTL3 were associated with CHD events in minimally adjusted models; LDL-TG and ANGPTL3 remained independent predictors of ASCVD events with further adjustment. Future studies should assess potential benefit of lowering hepatic apoC-III or ANGPTL3 expression in patients with elevated triglyceride-rich lipoproteins.
Excess deaths in people with cardiovascular diseases during the COVID-19 pandemic
Authors: Banerjee Amitava , Chen Suliang , Pasea Laura , Lai Alvina G , Katsoulis Michail , Denaxas Spiros , Nafilyan Vahe , Williams Bryan , Wong Wai Keong , Bakhai Ameet , Khunti Kamlesh , Pillay Deenan , Noursadeghi Mahdad , Wu Honghan , Pareek Nilesh , Bromage Daniel , McDonagh Theresa A , Byrne Jonathan , Teo James T H , Shah Ajay M , Humberstone Ben , Tang Liang V , Shah Anoop S V , Rubboli Andrea , Guo Yutao , Hu Yu , Sudlow Cathie L M , Lip Gregory Y H , Hemingway Harry
Published: January 2021

Aims

Cardiovascular diseases (CVDs) increase mortality risk from coronavirus infection (COVID-19). There are also concerns that the pandemic has affected supply and demand of acute cardiovascular care. We estimated excess mortality in specific CVDs, both ‘direct’, through infection, and ‘indirect’, through changes in healthcare.

Methods and results

We used (i) national mortality data for England and Wales to investigate trends in non-COVID-19 and CVD excess deaths; (ii) routine data from hospitals in England (n = 2), Italy (n = 1), and China (n = 5) to assess indirect pandemic effects on referral, diagnosis, and treatment services for CVD; and (iii) population-based electronic health records from 3 862 012 individuals in England to investigate pre- and post-COVID-19 mortality for people with incident and prevalent CVD. We incorporated pre-COVID-19 risk (by age, sex, and comorbidities), estimated population COVID-19 prevalence, and estimated relative risk (RR) of mortality in those with CVD and COVID-19 compared with CVD and non-infected (RR: 1.2, 1.5, 2.0, and 3.0).

Mortality data suggest indirect effects on CVD will be delayed rather than contemporaneous (peak RR 1.14). CVD service activity decreased by 60–100% compared with pre-pandemic levels in eight hospitals across China, Italy, and England. In China, activity remained below pre-COVID-19 levels for 2–3 months even after easing lockdown and is still reduced in Italy and England. For total CVD (incident and prevalent), at 10% COVID-19 prevalence, we estimated direct impact of 31 205 and 62 410 excess deaths in England (RR 1.5 and 2.0, respectively), and indirect effect of 49 932 to 99 865 deaths.

Conclusion

Supply and demand for CVD services have dramatically reduced across countries with potential for substantial, but avoidable, excess mortality during and after the pandemic.
Current perceptions and practices in lipid management: results of a European Society of Cardiology/European Atherosclerosis Society Survey
Authors: Koskinas Konstantinos C , Catapano Alberico L , Baigent Colin , Tokgozoglu Lale , Mach Francois
Published: January 2021

Aims

We sought to evaluate physicians’ opinions and practices in lipid management.

Methods and results

A web-based survey by the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) was distributed to 70 696 individuals at two time points, before and after publication of the 2019 ESC/EAS dyslipidaemia guidelines. Respondents (1271 in the first and 1056 in the second part) were most commonly cardiologists in Europe. More than 90% of participants reported that they regularly measure lipid levels and discuss lipid-lowering treatment with patients. More than 87% found the use of LDL-C goals useful or potentially useful, although it was acknowledged that recommended goals are frequently not achieved. Regarding the LDL-C goal according to the 2019 guidelines (<1.4 mmol/L for very high-risk patients), more than 70% of respondents felt that it is based on solid scientific evidence, but 31% noted that implementation should also consider available local resources and patient preferences. Statin intolerance was perceived as infrequent, affecting 1–5% of patients according to most respondents but was the main reason for not prescribing a statin to secondary-prevention patients, followed by patient non-adherence. Although most respondents reported that 11–20% of secondary-prevention patients have an indication to add a non-statin medication, fewer patients (<10% according to most respondents) receive these medications.

Conclusions

This survey shows a high level of acceptance of the LDL-C treatment goals recommended by current ESC/EAS guidelines. Although patient-related factors were the main reported reasons for suboptimal lipid-lowering therapy, physician inertia to intensify treatment cannot be excluded as an additional contributing factor.
β-blocker use and risk of all-cause mortality in patients with coronary heart disease: effect modification by serum vitamin A
Authors: Dhar Indu , Svingen Gard F T , Olsen Thomas , Lysne Vegard , Bjørnestad Espen Ø , Ueland Per M , Nygård Ottar K
Published: January 2021

Aims 

Blockade of β-adrenoceptors reduces sympathetic nervous system activity and improves survival in patients with heart failure with reduced left ventricular ejection fraction (HFrEF); however, any improvement in longevity among patients with coronary heart disease (CHD) but without HFrEF remains uncertain. Vitamin A has been linked to the activation of tyrosine hydroxylase, the rate-limiting enzyme in the catecholamine synthesis pathway. We investigated if vitamin A status modified the association of β-blocker use with the risk of all-cause mortality.

Methods and results 

A total of 4118 patients undergoing elective coronary angiography for suspected stable angina pectoris, of whom the majority had normal left ventricular ejection fraction (LVEF) were studied. Hazard ratios (HRs) of all-cause mortality comparing treatment vs. non-treatment of β-blockers according to the tertiles of serum vitamin A were explored in Cox proportional hazards regression models. During a median follow-up of 10.3 years, 897 patients (21.8%) died. The overall LVEF was 65% and 283 (6.9%) had anamnestic HF. After multivariable adjustments for traditional risk factors, medical history, and drug therapies of cardiovascular disease, β-blocker treatment was inversely associated with the risk of all-cause mortality [HR : 0.84; 95% CI (confidence interval), 0.72–0.97]. However, the inverse association was generally stronger among patients in the upper serum vitamin A tertile (HR :0.66; 95% CI, 0.50–0.86; Pinteraction = 0.012), which remained present after excluding patients with LVEF < 40%.

Conclusion 

In patients with suspected CHD, β-blocker treatment was associated with improved survival primarily among patients with high serum vitamin A levels.
Associations between acute and long-term exposure to PM2.5 components and temperature with QT interval length in the VA Normative Aging Study
Authors: Peralta Adjani A , Schwartz Joel , Gold Diane R , Coull Brent , Koutrakis Petros
Published: January 2021

Aims

Our study adds to the sparse literature on the effect of multiple fine particulate matter (PM2.5) components on QT interval length, an outcome with high clinical relevance in vulnerable populations. To our knowledge, this is the first study to examine the association between spatiotemporally resolved exposures to PM2.5 components and QT interval length.

Methods and results

Among 578 men living in Eastern Massachusetts between 2000 and 2011, we utilized time-varying linear mixed-effects regressions with a random intercept to examine associations between acute (0–3 days), intermediate (4–28 days), and long-term (1 year) exposure to PM2.5 components, temperature, and heart-rate corrected QT interval (QTc). Each of the PM2.5 components and temperature was geocoded to the participant’s residential address using validated ensemble and hybrid exposure models and gridMET predictions. We also evaluated whether diabetic status modified the association between PM2.5 components and QTc interval. We found consistent results that higher sulfate levels and colder temperatures were associated with significant longer QTc across all moving averages except the day of exposure. The greatest effect of sulfate and temperature was detected for the 28-day moving average. In the multi-pollutant model, each 1.5 µg/m3 IQR increase in daily sulfate was associated with a 15.1 ms [95% confidence interval (CI): 10.2–20.0] increase in QTc interval and in the single-pollutant models a 15.3 ms (95% CI: 11.6–19.1) increase in QTc interval. Other secondary particles, such as nitrate and organic carbon, also prolonged QT interval, while elemental carbon decreased QT interval. We found that diabetic status did not modify the association between PM2.5 components and QTc interval.

Conclusion

Acute and long-term exposure to PM2.5 components and temperature are associated with changes in ventricular repolarization as measured by QT interval.
Dose–response effects of physical activity on all-cause mortality and major cardiorenal outcomes in chronic kidney disease
Authors: Kuo Chou-Pin , Tsai Ming-Tsun , Lee Kuo-Hua , Lin Yao-Ping , Huang Shao-Sung , Huang Chin-Chou , Tseng Wei-Cheng , Tarng Der-Cherng
Published: January 2021

Aims

Physical activity has a protective effect against mortality and cardiovascular events in chronic kidney disease (CKD) patients. Nonetheless, how different levels of physical activity affect the health benefits in CKD remains unclear. This study aimed to investigate the dose–response effects of physical activity on mortality and major cardiorenal events in CKD.

Methods and results

We evaluated a longitudinal cohort of 4508 Taiwanese CKD patients between 2004 and 2017. Physical activity was assessed by the NHANES questionnaire and quantified in metabolic equivalent-hours per week (MET-hour/week). Patients were categorized into highly active (≥7.5 MET-h/week), low-active (0.1 to <7.5 MET-h/week), or inactive (0 MET-h/week) groups. Cox regression and restricted cubic spline models were utilized to explore the association between physical activity and the risks of study outcomes, including all-cause mortality, end-stage renal disease (ESRD), and major adverse cardiovascular events (MACE, a composite of cardiovascular death, myocardial infarction, ischaemic stroke, and hospitalized heart failure). During a median follow-up of 686 days, 739 death, 1059 ESRD, and 521 MACE events occurred. Highly active group had the lowest chance of all study outcomes, followed by low-active and inactive groups (P < 0.001). Multivariable Cox regression showed that only highly active group was independently associated with lower risks for all-cause mortality [hazard ratio (HR) 0.62; 95% confidence interval (CI) 0.53–0.74], ESRD (HR 0.83, 95% CI 0.72–0.96), and MACE (HR 0.63, 95% CI 0.51–0.76) compared to the inactive group. The risks of MACE did not further decrease once physical activity surpassed 15 MET-h/week, indicating a U-shaped association. The results were consistent in the subgroup and sensitivity analyses.

Conclusion

Physical activity of 7.5 to <15 MET-h/week is associated with lower risks of adverse cardiorenal outcomes and should be integrated into the care of CKD.
SCORE underestimates cardiovascular mortality in hypertension: insight from the OLD-HTA and NEW-HTA Lyon cohorts
Authors: Courand Pierre-Yves , Lenoir Jerôme , Grandjean Adrien , Garcia Damien , Harbaoui Brahim , Lantelme Pierre
Published: January 2021

Aims

Current European guidelines recommend the SCORE to estimate 10-year cardiovascular mortality in patients with moderate/low cardiovascular risk. SCORE was derived from the general population. The objective of this study was to investigate the estimated 10-year cardiovascular mortality according to the SCORE in a historic and a contemporary cohort of hypertensive patients.

Methods and results

After exclusion of secondary prevention and diabetes, 3086 patients were analysed in the OLD-HTA (1969–90) and 1081 in the NEW-HTA (1997–2014) Lyon cohorts. SCORE was calculated using the low and high cardiovascular risk equations and charts, and patients classified as being at low (0%), moderate (1–4%), high (5–9%), and very high (≥10%) risk. In the OLD-HTA cohort, 10-year cardiovascular mortality was higher (1.2%, 5.5%, 17.7%, and 27.0%) than that predicted by the low-risk equation (0%, 1.7%, 6.4%, and 14.8%). In the NEW-HTA cohort, similar results were observed (1.1%, 4.7%, 15.1%, and 15.2% vs. 0%, 1.9%, 6.2%, and 11.7%, respectively). Using the high-risk equation, mortality was underestimated in both cohorts, but the difference was smaller. The diagnostic performance of the high-risk equation was lower than the low-risk equation in both cohorts, considering the SCORE as a continuous or a categorical variable (Likelihood ratio test P < 0.05 for all comparisons in OLD-HTA). Similar results were obtained using SCORE charts.

Conclusion

SCORE underestimates the 10-year cardiovascular mortality risk in hypertensive patients in a historic cohort and in a contemporary one. The algorithm to predict cardiovascular mortality in hypertensive patients needs an update given new information since its creation.
Limited carbon sources prevent sulfate remediation in circumneutral abandoned mine drainage
Authors: Valkanas Michelle M , Rosso Taylor , Packard Jessica E , Trun Nancy J
Published: January 2021

Passive remediation systems (PRS) use both biotic and abiotic processes to precipitate contaminants from abandoned mine drainage (AMD) so that the contaminants do not spread into local watersheds. PRS are efficient at removing heavy metals but sulfate remediation frequently does not occur. To understand the reasons for the lack of sulfate remediation, we studied four PRS that treat circumneutral AMD and one raw mine drainage discharge. Using 16S sequencing analysis, microbial community composition revealed a high relative abundance of bacterial families with sulfur cycling genera. Anaerobic abiotic studies showed that sulfide was quickly geochemically oxidized in the presence of iron hydroxides, leading to a buildup of sulfur intermediates. Supplementation of laboratory grown microbes from the PRS with lactate demonstrated the ability of actively growing microbes to overcome this abiotic sulfide oxidation by increasing the rate of sulfate reduction. Thus, the lack of carbon sources in the PRS contributes to the lack of sulfate remediation. Bacterial community analysis of 16S rRNA gene revealed that while the microbial communities in different parts of the PRS were phylogenetically distinct, the contaminated environments selected for communities that shared similar metabolic capabilities.
A Dictionary of Slovak Neologisms (A Project Description)
Authors: Ološtiak Martin , Rešovská Soňa
Published: January 2021

The paper presents the project focusing on neologisms in the Slovak language, the main outcome of which is A Dictionary of Slovak Neologisms (DSN), a specialized restricted dictionary of a certain lemma type. The first part introduces general remarks including relations of extralinguistic reality with the lexicon of a natural language. In the second section, elementary terminology (language change, lexical change, innovation, neologism, neology, newness) is outlined. In the third section, the project of the DSN is introduced. The dictionary aims to provide linguistic (lexicographic) information on approximately 13,000-15,000 new words, meanings and expressions. When compiling the dictionary, the synchronic-diachronic perspective is taken into account. This indicates that lexical units that came into existence in the Slovak language after 1989 are included. The publication of the dictionary is planned for 2023, both in printed and electronic form, with the latter intended to be available online.
The Wessex Dementia Friendly Pharmacy Framework
Authors: Moores Amanda , Rutter Paul
Published: January 2021

Objectives

To develop and launch a dementia friendly framework for community pharmacies in the Wessex region of England.

Methods

A framework consisting of essential (mandatory) and additional (non-mandatory) criteria were devised by local stakeholders and external scrutiny from the Alzheimer’s Society. The framework was designed to allow pharmacy teams to achieve essential criteria without the need for approval by others (e.g. authorisation from internal company management structures). In total, 38 essential criteria across seven domains were devised. All essential criteria had to be met for pharmacies to be awarded dementia friendly status. Engagement events were organised to launch the framework detailing what it was and how pharmacies could meet each criterion. Pharmacies self-certified compliance with the framework criteria via an online platform, and validation activity was subsequently undertaken to see if pharmacies had appropriately self-certified against all essential criteria.

Key findings

Three hundred and fifty-five pharmacies (n = 504, 70%) engaged with the initiative, of which 330 uploaded self-certifications met all essential criteria of the framework. Validation visits showed self-certification to be appropriate in all but one visit (n = 11/12). Staff comments revealed that engaging with the framework had allowed them to be more aware of how better to support people with dementia.

Conclusions

A dementia friendly framework was devised and implemented with a subsequent high level of uptake by community pharmacy.
The evolving role of community pharmacists during COVID-19 in the UAE; assessing preparedness and knowledge
Authors: Al Mazrouei Nadia , Ibrahim Rana M , Al Meslamani Ahmad Z , Abdel-Qader Derar H , Sadeq Adel Shaban , Mohamed Ibrahim Osama
Published: January 2021

Objectives

To investigate community pharmacists’ knowledge about COVID-19 and their preparedness for the pandemic.

Methods

This cross-sectional online survey was conducted (in community pharmacies in the United Arab Emirates) over 3 weeks (24 May 2020 to 14 June 2020). A proportionate random sample of 491 participants was invited to take part. The SPSS version 26 was used for data management and analysis.

Key Findings

The majority of participants (n = 400) had good knowledge about COVID-19 and high level of preparedness for the pandemic control. Most pharmacists agreed (212, 53.0%) or strongly agreed (91, 22.8%) that they have a major role in the management of the ongoing crisis. Most participants had good awareness about the most common methods of COVID-19 transmission (359, 89.7%) and symptoms encountered (368, 92.0%). However, approximately a quarter of participants (103, 25.7%) incorrectly thought COVID-19 was caused by a DNA virus. Participants who had 5–10 and >10 years of experience were 3.95 (P = 0.03) and 1.59 (P = 0.01) times, respectively, were more likely to have good knowledge compared to participants with less than 2 years of experience. Those with good knowledge were more likely to have a specific area for customers with suspected COVID-19 symptoms compared to those with poor knowledge (P = 0.031).

Conclusion

This study indicates that years of experience and good knowledge on COVID-19 were significant determinants of pharmacists’ preparedness for the pandemic control.
A rapid review and narrative synthesis of hospital to community pharmacy transfer of care services in England
Authors: Nazar Hamde , Howard Clare , Nazar Zachariah , Watson Neil W
Published: January 2021

Objectives

A new discharge medicines service in England has been proposed for rollout in July 2020. This study aims to appraise the evidence for hospital to community pharmacy referral services in England. A rapid review methodology was adopted, findings were synthesised and reported narratively. The PubMed search engine was used and specific pharmacy journals were searched in March 2020. Studies published since 2012, reporting on transfer of care (ToC) services provided from hospitals and community pharmacies in England were included. Study data analysed included clinical outcomes; findings relating to implementation, staff and patient perceptions and experiences. Studies were assessed for risk of bias using a critical appraisal checklist.

Key findings

Ten studies met the inclusion criteria. The ToC services varied in relation to patients targeted, mode of referral, and post-discharge service provided. There were some conservative observations that ToC services were associated with reduced hospital readmission rates, however other outcomes were less well substantiated. Pharmacy staff were generally supportive of these services for patient benefit, however, patient engagement and accessibility issues have been reported.

There is some emerging evidence that hospital to community pharmacy referral services are associated with reduced hospital readmission. Service delivery reported in these studies highlights barriers and facilitators to patient recruitment, engagement and follow-up and limitations on recording and measuring meaningful outcomes. Future work is recommended to take advantage of the implementation and delivery of the national service that includes the analysis of patient data at scale to substantiate evidence in this area.
Comparative assessment of competency frameworks for pharmacists in the Western Pacific region including the potential for a regional framework
Authors: Jackson John , Caliph Suzanne , Lee Jun Kyung , Chui Wai Keung
Published: January 2021

Objectives

To assess the potential for a regional competency framework for pharmacists in the Western Pacific using the Global Competency Framework (GbCF) as a reference.

Methods

Mixed-methods approach used a self-administered survey and semi-structured interviews of 13 countries to evaluate the perceived benefits, existence and content of competency frameworks.

Key findings

Variations in structure, components and emphasis of the four frameworks that do exist indicate significant tailoring to local requirements. Based on these four and the GbCF, 32 competencies allocated into four themes has been proposed.

Conclusion

Varying national requirements mitigate against a single regional competency framework.
Assessing the need for native language in pharmacy education and practice: a survey in the UAE
Authors: Hasan Sanah , Faragallah Alaa , Shanableh Sawsan Deeb , Alebrahem Sundos Qassim
Published: January 2021

Objectives

To evaluate pharmacists’ opinions on the need for Arabic in pharmacy education and practice in the United Arab Emirates (UAE).

Methods

A questionnaire was developed to address the study objectives and hand delivered to a stratified sample of community pharmacists and a convenience sample of pharmacists in other areas of practice in the UAE. Pharmacists’ responses were measured on a 5-point Likert-type scale (strongly disagree to strongly agree) towards teaching of the following topics in Arabic: management of chronic diseases and minor ailments, screening for diseases and counselling on smoking cessation, exercise, weight management, diet and nutrition and complementary/alternative medicine. Topics related to communication skills were also assessed. Descriptive statistics on participant responses were calculated and chi-square test of independence examined inter-relationships among pharmacist and pharmacy variables.

Key findings

A total of 351 pharmacists completed the questionnaire. Almost 50% of pharmacists considered Arabic in health sciences education a cultural and/or practice necessity. In pharmacy undergraduate curricula, preferred topics to be taught in Arabic included counselling on complementary/alternative medicine (67.4%), management of cold/flu (65.5%), counselling on weight management (64.2%), communication in special situations (63.2%), vocabulary (63.2%) and listening and empathic responding (62.6%). For continuing education, topics included management of cold/flu (69.8%) and skin conditions (69.2%), counselling on smoking cessation (68.9%), communicating with physicians and other professionals (54.8%), communication in special situations (54.7%) and vocabulary (50.9%).

Conclusions

For all assessed topics and communication skills, more than half of the pharmacists agreed that they needed to be included in pharmacy education. A blended learning approach that combines integrated content for native language within an English curriculum could be explored.
Pharmaceutical care issues in lung cancer: can community pharmacists support patients receiving systemic anticancer therapy?
Authors: MacLean Fiona M , Boyter Anne C , Mullen Alexander B , Lowrie Richard
Published: January 2021

Objectives

Most patients receive systemic anticancer therapy (SACT) as day cases and toxicities, if they occur, are likely to appear first in primary care. Pharmaceutical care can be delivered by community pharmacists, but little is known about the epidemiology of SACT toxicities in the community and potential interventions to address these which raise the following questions: what are the typologies of SACT-associated toxicities experienced by community-based patients and what are the associated pharmaceutical care issues (PCIs)? The aim of this study was to identify toxicities and pharmaceutical care issues of patients prescribed SACT for lung cancer and understand the potential for community pharmacists to deliver aspects of cancer care including toxicity management.

Methods

Retrospective analysis of clinical records of patients prescribed oral and parenteral SACT in 2013–14, to describe patient characteristics; SACT toxicity; PCIs and episodes of unscheduled care.

Key findings

Twelve categories of toxicity and 13 categories of PCIs were identified from 50 patients. More PCIs were observed with oral SACT/oral-parenteral combinations than with parenteral regimens. The PCIs which could be managed by community pharmacists were mucositis; skin toxicity; gastrointestinal toxicity; reinforcing patient education and identification/prevention of drug interactions.

Conclusions

Community pharmacists are ideally placed to provide pharmaceutical care to patients with lung cancer prescribed SACT. Cancer specialists in secondary care can signpost patients to community pharmacists for early management of low-grade SACT toxicity.
The transition from hospital to home following acute coronary syndrome: an exploratory qualitative study of patient perceptions and early experiences in two countries
Authors: Crawshaw Jacob , Bartoli-Abdou John K , Weinman John , McRobbie Duncan , Stebbins Marilyn , Brock Tina , Auyeung Vivian
Published: January 2021

Objectives

Following acute coronary syndrome (ACS), it is standard practice for stable patients to be discharged as quickly as possible from hospital. If patients are not adequately supported at this time, issues such as readmission can occur. We report findings from an exploratory qualitative study investigating the perceptions and early experiences of patients transitioning from hospitals in the UK and USA to home following ACS.

Methods

Within 1 month of discharge, we conducted semi-structured telephone interviews with patients hospitalised for ACS (UK: n = 8; USA: n = 9). Data were analysed using the Framework Method.

Key findings

We identified four superordinate themes. Coping, adjustment and management: Patients were still adjusting to the physical limitations caused by their event but most had begun to implement positive lifestyle changes. Gaps in care transition: Poor communication and organisation postdischarge resulted in delayed follow-up for some patients causing considerable frustration. Quality of care from hospital to home: Patients experienced varied inpatient care quality but had largely positive interactions in primary/community care. Pharmacy input during care transition was viewed favourably in both countries. Medication-taking beliefs and behaviour: Patients reported good initial adherence to treatment but side effects were a concern.

Conclusions

ACS patients experienced gaps in care early in the transition from hospital to home. Poor communication and uncoordinated support postdischarge negatively impacted patient experience. Further research is needed to determine how patients’ early experiences following ACS can affect longer-term outcomes including healthcare engagement and treatment maintenance.
Australian community pharmacists’ perceptions of public health before the COVID-19 pandemic
Authors: Hope Denise L , Day Georgie , Clements Joshua , Hattingh H Laetitia
Published: January 2021

Background

Consensus is lacking regarding delivery of public health services in community pharmacy.

Objective

The objective of this study was to explore pharmacists’ perspectives on public health initiatives in community practice.

Method

Australian community pharmacists were randomly sampled to participate in face-to-face, semi-structured interviews to explore public health definitions and perceptions.

Key findings

Nine pharmacists participated early 2020, pre-COVID-19. Mean interview duration was 23 min. Results revealed little distinction between individual and public health services. Barriers to service provision were lack of time, remuneration, training, standards and privacy. Enablers opposed barriers, namely accessibility, improved funding, education, standardised services and consulting rooms.

Conclusion

Improved clarity is required regarding the role that community pharmacists can assume in provision of public health.
Assessment of antimicrobial stewardship programs within governmental hospitals in Qatar: a SWOC analysis
Authors: Nasr Ziad G , Jibril Farah , Elmekaty Eman , Sonallah Hala , Chahine Elias B , AlNajjar Afnan
Published: January 2021

Objectives

Antimicrobial resistance is a worldwide public health issue that requires emergent action. Antimicrobial stewardship programs (ASPs) have been proposed as a strategy to minimise resistance. Although ASPs were implemented in governmental hospitals in Qatar since 2015, a formal evaluation of these programs has not been conducted. We aimed to assess the status of ASPs in Qatar and to identify strengths, weaknesses, opportunities and challenges (SWOC) to further enhance ASPs within Hamad Medical Corporation (HMC).

Methods

Lead stakeholders of ASPs in HMC filled a questionnaire adapted from the 2019 Centers for Disease Control Prevention checklist for ASPs. Notes were taken by research team to assist in formulating a SWOC analysis.

Key findings

All hospitals (12/12) had an infectious diseases physician and pharmacist designated as an ASP leader (major strength identified). Almost all hospitals lack a financial statement and information technology resources to support ASPs (major weaknesses identified). Nine hospitals had an antibiotic pre-authorisation policy and adopted a prospective audit with feedback strategy. Among hospitals surveyed, 11 hospitals tracked antibiotic use by measuring the defined daily dose, and only four hospitals tracked rates of Clostridioides difficile infection. Qatar’s rich economy supports the allocation of financial resources and budgeting to improve ASPs despite the increased emergence of resistant organisms and the limited resources currently available to expand ASPs across the country’s healthcare settings.

Conclusions

Although ASPs were implemented in all governmental hospitals in Qatar, national efforts and more resources are needed to further develop and improve these programs.
Pharmacists’ views and desires regarding pharmacist administration of vaccines in New Zealand
Authors: Gauld Natalie , Johnstone Elizabeth , McMichael Ian , Braund Rhiannon
Published: January 2021

Objectives

To explore pharmacists’ views and experiences of pharmacist-administered vaccinations, motivators and barriers to pharmacists administering vaccinations and their preferences for expansions to such services.

Methods

All practising pharmacist members (n = 3400) of the Pharmaceutical Society of New Zealand were invited to participate in an online survey in 2017.

Key findings

A total of 468 pharmacists completed the survey (14%). Most (86%) strongly agreed/agreed that pharmacists should provide vaccinations, primarily citing patient benefit, for example, convenience, potential for increased vaccination uptake, easing general practice burden and better utilisation of the pharmacist. Half had completed vaccinator training, mainly for professional satisfaction, to help public or community health and/or to provide a new service for their community. Trained pharmacists had administered influenza (95%), pertussis (47%), zoster (45%) and/or meningococcal vaccines (13%), with patient cost limiting some vaccination uptake. Cost or workplace constraints were leading reasons for the 17% not planning to undertake vaccinator training. Key barriers for pharmacy owners not offering vaccinations were set-up or other costs, insufficient funding (62%) or staffing/time concerns (27%). Some trained vaccinators (39%) wanted the recipient age lowered below 13 years, and 44% wanted intern pharmacists to be able to administer vaccinations.

Conclusion

This study found strong support for this service, including benefits for patients, and for customer relationships. Identified barriers including service setup and patient costs could be reduced by expanding the categories (e.g. pharmacy students and technicians) of staff able to vaccinate and having more government funded vaccines available through pharmacies, therefore, improving access for patients.
Role of pharmacists in the provision of palliative care services and support in South Africa
Authors: Inderlall R , Naidoo P
Published: January 2021

Objectives

South Africa (SA) has high demand but inequitable access to palliative care (PC). Realising this need and the growing recognition of pharmacists’ in PC globally, a study was undertaken regarding the role of pharmacists in the provision of PC services and support in SA.

Method

A descriptive cross-sectional quantitative study was conducted among 540 community and hospital pharmacists. A self-administered, closed-ended questionnaire covering knowledge, attitude, current role, future role and barriers to PC was used. Data was coded and analysed using SPSS® Version 24.0. P-values < 0.05 were considered statistically significant.

Key Findings

Response rate was 48.7% (n = 263). Pharmacists (72.2%) were already playing a role in PC, however, only 20.5% reported frequent involvement in PC. Services provided included medicine supply (88.2%), side-effect/symptom management (82.1%), information sharing (60.8%), bereavement counselling (60.8%), treatment/care needs (57.4%) and spiritual support (52.1%). More pharmacists (96.6%) wanted to play a role in PC, beyond medicine supply to include PC team member (91.6%), medicine reviews (91.3%), referrals (80.2%) and patient visits (50.6%). Pharmacists had a good knowledge (71.4%) and a positive attitude (61.5%) towards PC despite many health system barriers such as lack of training (91.3%), inadequate clinical experience (90.5%) and insufficient resources (77.2%).

Conclusions

Pharmacists with their high level of knowledge, positive attitude and broad scope of practice are well-placed to play a role in PC. Further strengthening and integration of their roles into the continuum of care, will encourage the involvement of more pharmacists, enhancing availability, access and resources for PC.