bluuebunny/crossref_metadata_2025 huggingface dataset:
Highly sensitive and flexible three-dimensional force tactile sensor based on inverted pyramidal structure
Authors: Wang Yifan , Ruan Xiaoyun , Xing Changwen , Zhao Houqi , Luo Mengmeng , Chen Yexin , Hong Weiqiang , Guo Xiaohui
Published: July 2022

To improve the haptic sensing performance of electronic skin (e-skin), this study designed a capacitance-based highly sensitive three-dimensional (3D) force tactile sensor with an inverted pyramidal structure with high electrical stability and mechanical repeatability. The working mechanism of the sensor was verified by finite element simulation, and it was fabricated by low-cost 3D printing technology and layer-by-layer self-assembly process. A capacitive signal acquisition system and an application test platform were constructed. The results revealed that the proposed 3D-force tactile sensor had a normal force sensitivity of 0.551 N−1 at 0–7 N and 0.107 N−1 at 7–35 N. The results for tangential force were 0.404 N−1 at 0–4 N and 0.227 N−1 at 4–14 N, with a low hysteresis of 4.17% and a fast response/recovery time of 56/30 ms. High sensitivity and reliability of the device were demonstrated experimentally. The proposed capacitive flexible 3D-force haptic sensor can be used in applications such as robotic gripping, gamepad control and human motion detection, and its feasibility for application as e-skin was confirmed.
Rolling velocity and relative motion of particle detector in local granular flow
Authors: Li Ran , Liu Bao-Lin , Zheng Gang , Yang Hui
Published: July 2022

The velocity of a particle detector in granular flow can be regarded as the combination of rolling and sliding velocities. The study of the contribution of rolling velocity and sliding velocity provides a new explanation to the relative motion between the detector and the local granular flow. In this study, a spherical detector using embedded inertial navigation technology is placed in the chute granular flow to study the movement of the detector relative to the granular flow. It is shown by particle image velocimetry (PIV) that the velocity of chute granular flow conforms to Silbert’s formula. And the velocity of the detector is greater than that of the granular flow around it. By decomposing the velocity into sliding and rolling velocity, it is indicated that the movement of the detector relative to the granular flow is mainly caused by rolling. The rolling detail shown by DEM simulation leads to two potential mechanisms based on the position and drive of the detector.
Monitoring of hand function enabled by low complexity sensors printed on textile
Authors: Paterson T E , Hagis N , Boufidis D , Wang Q , Moore S R , da Silva A C , Mitchell R L , Alix J J P , Minev I R
Published: July 2022

Development of inexpensive, disposable, use-at-home, personalised health wearables can revolutionise clinical trial design and clinical care. Recent approaches have focused on electronic skins, which are complex systems of sensors and wiring produced by integration of multiple materials and layers. The requirement for high-end clean room microfabrication techniques create challenges for the development of such devices. Drawing inspiration from the ancient art of henna tattoos, where an artist draws designs directly on the hand by extruding a decorative ink, we developed a simple strategy for direct writing (3D printing) of bioelectronic sensors on textile. The sensors are realised using a very limited set of low-cost inks composed only of graphite flakes and silicone. By adapting sensor architectures in two dimensions, we produced electromyography (EMG), strain and pressure sensors. The sensors are printed directly onto stretchable textile (cotton) gloves and function as an integrated multimodal monitoring system for hand function. Gloves demonstrated functionality and stability by recording simultaneous readings of pinch strength, thumb movement (flexion) and EMG of the abductor pollicis brevis muscle over 5 days of daily recordings. Our approach is targeted towards a home based monitoring of hand function, with potential applications across a range of neurological and musculoskeletal conditions.
Effects of trehalose and polyacrylate-based hydrogels on tomato growth under drought
Authors: Panescu Priera H , Browne Marvin , Chen Kathleen K , Sack Lawren , Maynard Heather D
Published: July 2022

Hydrophilic amendments can enhance soil moisture content, which, in turn, can improve crop health under drought conditions. Understanding how different hydrogels interact with specific crops is necessary for optimal application. The soil conditioning abilities of a trehalose hydrogel and polyacrylate-based hydrogel were evaluated for tomatoes (Solanum lycopersicum) subjected to drought. Tomato plants were transplanted into individual pots with soil that contained trehalose hydrogel (0.4 wt%), polyacrylate-based hydrogel (0.4 wt%), or no hydrogel and subjected to a well-watered treatment or to pronounced soil drought, with or without rewatering. The health of tomato plants was monitored by measuring leaf total chlorophyll (a + b) concentration, leaf water potential (Ψleaf), stomatal conductance (gs) and relative growth rate (RGR). The polyacrylate-based hydrogel, but not the trehalose hydrogel, improved tomato plant function under drought conditions, as indicated by improved gs and RGR relative to the well-watered control. However, when subjected to a second drought, neither hydrogel was effective, and neither prolonged survival. The more hydrophilic polyacrylate-based hydrogel demonstrated promise in improving the growth of tomato plants under drought when included as a soil amendment at 0.4 wt%. This research is important for understanding the effects of these hydrogels as soil conditioners in drought prone systems.
Progressive multifocal leukoencephalopathy: epidemiology and spectrum of predisposing conditions
Authors: Joly Marine , Conte Cécile , Cazanave Charles , Le Moing Vincent , Tattevin Pierre , Delobel Pierre , Sommet Agnès , Martin-Blondel Guillaume
Published: July 2022

Population-based data on the epidemiology of progressive multifocal leukoencephalopathy, its predisposing conditions and mortality rate are lacking, although such data are crucial to raise awareness among clinicians and to lay foundations for future therapeutic trials in immunomodulating therapies.

In our study, patients were identified by interrogating the French national healthcare reimbursement database from 1 January 2008 to 31 December 2017, using progressive multifocal leukoencephalopathy International Classification of Diseases code and a patient’s selection algorithm. Overall incidence rate, 1-year all-cause mortality rate and survival patterns were calculated, and factors associated with death were identified using a multivariate Cox proportional hazards regression model.

Our cohort is the largest to date, comprising 584 patients with incident progressive multifocal leukoencephalopathy. The overall incidence in France from 2010 to 2017 was stable during the study period at 0.11 per 100 000 person-years, 95% confidence interval [0.10–0.12]. Predisposing diseases were HIV infection (43.7%), followed by haematological malignancies (21.9%), chronic inflammatory diseases (20.2%), solid organ transplantation (4.3%), solid neoplasm (4.1%) and primary immune deficiency (1.5%). The 1-year mortality rate was 38.2%, with a 95% confidence interval (34.2–42.2). In multivariate analysis, factors independently associated with death were older age [adjusted hazard ratio 0.33 (0.20–0.53) for patients aged 20 to 40 compared with patients aged over 60], male gender [adjusted hazard ratio 0.73 (0.54–0.99) for females compared with males] and predisposing immunosuppressive disease, with the highest risk for solid neoplasms [adjusted hazard ratio 4.34 (2.25–8.37)], followed by haematological malignancies [adjusted hazard ratio 3.13 (1.85–5.30)] and HIV infection [adjusted hazard ratio 1.83 (1.12–3.00)], compared with chronic inflammatory diseases. Immune reconstitution inflammatory syndrome was notified in 7.0% of patients.

In conclusion, incidence of progressive multifocal leukoencephalopathy is stable in France, and HIV infection remains the main predisposing disease. This large-size cohort uncovers a higher risk of mortality for male patients compared to females, and the worst prognosis for patients with solid neoplasm, while prognosis in patients with haematological malignancies appeared less dismal than in previous studies.
Antibiotic-Resistant Infections Among Inpatients with Coronavirus Disease 2019 (COVID-19) in US Hospitals
Authors: Baggs James , Rose Ashley N , McCarthy Natalie L , Wolford Hannah , Srinivasan Arjun , Jernigan John A , Reddy Sujan C
Published: July 2022

We described bacterial/fungal coinfections and antibiotic-resistant infections among inpatients with a diagnosis of coronavirus disease 2019 (COVID-19) and compared findings in those with a diagnosis of influenza like illness. Less than 10% of inpatients with COVID-19 had bacterial/fungal coinfection. Longer lengths of stay, critical care stay, and mechanical ventilation contribute to increased incidence of hospital-onset infections among inpatients with COVID-19.
Detecting Affine Equivalence Of Boolean Functions And Circuit Transformation
Authors: Zeng Xiao , Yang Guowu , Song Xiaoyu , Perkowski Marek A , Chen Gang
Published: July 2022

Affine equivalence of Boolean functions has various applications in computer science and modern cryptography, such as circuit design and S-boxes. Existing methods for detecting affine equivalence of Boolean functions work in some cases but not when the truth table of a Boolean function is sparse. To improve previous methods and overcome this limitation, we propose a method by transforming the Boolean function to a function with the property that its function values at the orthonormal basis are all equal to 1 or 0, which narrows down the search space of affine transformations. Our first algorithm has the advantage of getting a smaller search space than previous methods and is especially useful for sparse functions. Specifically, when the Boolean functions are sparse, the search space can be reduced exponentially in average and experiments show the efficiency of our first algorithm. We then present another algorithm to transform one circuit into its equivalent affine circuit by synthesizing a reversible circuit and inserting it in front of the original circuit. To our knowledge, this is the first work to automatically synthesize an affine equivalent circuit for any given circuit and the first to do this by combining reversible circuit and non-reversible circuit.
dbBIP: a comprehensive bipolar disorder database for genetic research
Authors: Li Xiaoyan , Ma Shunshuai , Yan Wenhui , Wu Yong , Kong Hui , Zhang Mingshan , Luo Xiongjian , Xia Junfeng
Published: July 2022

Bipolar disorder (BIP) is one of the most common hereditary psychiatric disorders worldwide. Elucidating the genetic basis of BIP will play a pivotal role in mechanistic delineation. Genome-wide association studies (GWAS) have successfully reported multiple susceptibility loci conferring BIP risk, thus providing insight into the effects of its underlying pathobiology. However, difficulties remain in the extrication of important and biologically relevant data from genetic discoveries related to psychiatric disorders such as BIP. There is an urgent need for an integrated and comprehensive online database with unified access to genetic and multi-omics data for in-depth data mining. Here, we developed the dbBIP, a database for BIP genetic research based on published data. The dbBIP consists of several modules, i.e.: (i) single nucleotide polymorphism (SNP) module, containing large-scale GWAS genetic summary statistics and functional annotation information relevant to risk variants; (ii) gene module, containing BIP-related candidate risk genes from various sources and (iii) analysis module, providing a simple and user-friendly interface to analyze one’s own data. We also conducted extensive analyses, including functional SNP annotation, integration (including summary-data-based Mendelian randomization and transcriptome-wide association studies), co-expression, gene expression, tissue expression, protein–protein interaction and brain expression quantitative trait loci analyses, thus shedding light on the genetic causes of BIP. Finally, we developed a graphical browser with powerful search tools to facilitate data navigation and access. The dbBIP provides a comprehensive resource for BIP genetic research as well as an integrated analysis platform for researchers and can be accessed online at http://dbbip.xialab.info.

Database URL:  http://dbbip.xialab.info
Anabolic steroid misuse is an important reversible cause of cardiomyopathy: a case report
Authors: Milevski Stefan V , Sawyer Matthew , La Gerche Andre , Paratz Elizabeth
Published: July 2022

Background

Anabolic steroid misuse is very common and has been linked to the development of a severe cardiomyopathy, arrhythmias, and sudden death.

Case summary

A 46-year-old miner presented to hospital with subacute dyspnoea and palpitations. Investigations revealed atrial fibrillation and a severe dilated cardiomyopathy with left ventricular ejection fraction of 12%. The patient had a history of longstanding exogenous testosterone administration. Haematological investigations demonstrated a marked polycythaemia, with haematocrit of 0.60 L/L (normal 0.40–0.54 L/L). Hormonal investigations revealed an elevated testosterone level of 46.4 nmol/L (normal 8.0–30.0 nmol/L) and suppressed luteinizing and follicle-stimulating hormones, consistent with excess testosterone use. The patient was referred to the endocrinology specialty team for support with ceasing excess testosterone use, while commencing guideline-directed heart failure therapy. At 6 months of follow-up, the patient’s left ventricular ejection fraction had normalized and he was asymptomatic. Biochemical indicators of testosterone excess had also normalized.

Discussion

Anabolic steroids are widely misused, particularly among young and middle-aged males. Cardiovascular complications include a potentially reversible severe cardiomyopathy, accelerated coronary disease, dyslipidaemia, arrhythmias, and sudden death. It is important to identify a history of anabolic steroid misuse when investigating cardiomyopathy and be alert for indicators such as polycythaemia. Cessation of anabolic steroid misuse may lead to complete reversal of cardiomyopathy but should be undertaken in close partnership with the patient and endocrinologists.
A case report of pericardial constriction with coexisting severe left main coronary artery disease
Authors: Ostad Karampour Saman , Sedlak Tara L , Luong Christina L , Price Joel E , Brunner Nathan W
Published: July 2022

Background

Constrictive pericarditis (CP) is a rare condition in which the pericardium becomes progressively fibrotic and non-compliant leading to impaired ventricular filling and overt heart failure. While CP shares many clinical and haemodynamic similarities with restrictive cardiomyopathy, differentiation of these diseases is crucial as CP is potentially curative through pericardiectomy. Here, we present a case of proven pericardial constriction with atypical haemodynamics in a patient presenting with heart failure and severe left main coronary artery disease (CAD).

Case summary

A 69-year-old female with a history of hypertension and paroxysmal atrial fibrillation presented with persistent heart failure refractory to diuretics. Ischaemic and infiltrative work-up were found to be negative with magnetic resonance imaging demonstrating trace pericardial fluid and thickening of the pericardium. Echocardiogram and right-heart catheterization demonstrated atypical haemodynamics suggestive of but not conclusive for CP, with coronary angiogram demonstrating severe left main CAD. Ultimately, the patient underwent coronary artery bypass grafting along with pericardiectomy and pericardial biopsy demonstrating constrictive physiology.

Discussion

We suspect the inconclusive nature of the echocardiogram and cardiac catheterization was likely secondary to severe CAD impairing left ventricular relaxation and dampening ventricular interdependence. As such, clinicians should consider the possibility of coexistent severe CAD in patients with a clinical suspicion of CP, but inconclusive haemodynamics.
Sex-related differences in the management and outcomes of patients hospitalized with ST-elevation myocardial infarction: a comparison within four European myocardial infarction registries
Authors: Hellgren Tora , Blöndal Mai , Jortveit Jarle , Ferenci Tamas , Faxén Jonas , Lewinter Christian , Eha Jaan , Lõiveke Piret , Marandi Toomas , Ainla Tiia , Saar Aet , Veldre Gudrun , Andréka Péter , Halvorsen Sigrun , Jánosi András , Edfors Robert
Published: July 2022

Aims

Data on how differences in risk factors, treatments, and outcomes differ between sexes in European countries are scarce. We aimed to study sex-related differences regarding baseline characteristics, in-hospital managements, and mortality of ST-elevation myocardial infarction (STEMI) patients in different European countries.

Methods and results

Patients over the age of 18 with STEMI who were treated in hospitals in 2014–17 and registered in one of the national myocardial infarction registers in Estonia (n = 5817), Hungary (n = 30 787), Norway (n = 33 054), and Sweden (n = 49 533) were included. Cardiovascular risk factors, hospital treatment, and recommendation of discharge medications were obtained from the infarction registries. The primary outcome was mortality, in-hospital, after 30 days and after 1 year. Logistic and cox regression models were used to study the associations of sex and outcomes in the respective countries. Women were older than men (70–78 and 62–68 years, respectively) and received coronary angiography, percutaneous coronary intervention, left ventricular ejection fraction assessment, and evidence-based drugs to a lesser extent than men, in all countries. The crude mortality in-hospital rates (10.9–15.9 and 6.5–8.9%, respectively) at 30 days (13.0–19.9 and 8.2–10.9%, respectively) and at 1 year (20.3–28.1 and 12.4–17.2%, respectively) after hospitalization were higher in women than in men. In all countries, the sex-specific differences in mortality were attenuated in the adjusted analysis for 1-year mortality.

Conclusion

Despite improved awareness of the sex-specific inequalities on managing patients with acute myocardial infarction in Europe, country-level data from this study show that women still receive less guideline-recommended management.
Nurse follow-up visit after the atrial complex ablation: a cross-sectional descriptive study
Authors: Cano Valls A , Carro E , Niebla M , Hevia S , Domingo R , Carrasco M , Massanet L , Poza M , Marginet J , Duenas I , Lajara M A , Venturas M
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Atrial fibrillation (AF) and flutter are complex arrhythmias to ablation because their anatomical location. A navigation system is required to map the ablationable area and in addition, the patient are under general anesthesia. In our hospital, the expert nurse control these patients 10 days afters discharge.

Purpose

To identify the complications and recurrences of arrhythmia that the nurse has detected early and how it has been managed.

Methods

Cross-sectional descriptive study, from September 2020 to January 2022, all patients who underwent complex atrial ablation under total anaesthesia and who were assessed by a nurse 10 days later were included. In the event that any problem arises, the nurse is in charge of managing the network of referrals to specialist doctors.

Results

A total of 159 patients were included with a mean age of 62 years (SD 10.4) and 34% were women. Arrhythmias were 73.5% AF, 11.3% flutter, 14.5% re-do ablations mixed AF/Flutter. CHA2DS2-VASc scale mean 2 points (SD 1.2). Nine cardioversions were scheduled due to early AF recurrence documented. 35% (n=55) of the patients underwent a blood test to control risk factors such as cholesterol, diabetes, kidney failure or thyroid problems. 17.6% (n=28) were programmed for a polysomnography. Cardiologist was consulted in 6.3% (n=10) due to edema of the lower legs, ventricular extrasystoles, asthenia and bradycardia. Interconsultations were also made with endocrinology 1.2%, urology 0.6%, vascular surgery 6.2% and neurology 2.5%. Finally, 12% of patients were referred to their GP for minor controls.

Conclusion

There is little evidence to suggest that nursing consultation could be useful for the early detection of complications and the management of arrhythmia recurrences. More experimental studies are necessary to know the impact of nurse follow-up in the management of patients undergoing complex atrial ablation.
Development of videoconferencing group educational program for patients with heart failure: A Delphi study.
Authors: Alkouri O , Al Marzouqi A , Al-Bashaireh A , Khader Y , Jarrah M , Schultz T
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Background

During the COVID-19 outbreak, videoconference technology can help people avoid physical contact and minimise the exposure of healthcare providers to sick people as well as respiratory secretions. Videoconferencing can be beneficial for people with chronic conditions (such as heart failure) who have restricted mobility, live in remote and rural areas, or experience social loneliness. However, evidence for the effectiveness of using internet videoconferencing and its components accounted for the positive outcomes (such as knowledge, quality of life, self-care, healthcare utilization) is still lacking.

Purpose

To develop a feasible videoconferencing program for patients with heart failure that meets patients’ needs and preferences in Jordan.

Methods

The study involved two Delphi survey studies of three rounds each. The first Delphi survey involved 32 healthcare staff, with heart failure clinical experience, to obtain a consensus of opinion on a proposed group videoconferencing program for patients with heart failure. The second Delphi study involved seven staff of the information technology center, with experience in videoconferencing and using supporting applications, to obtain their consensus on the current capabilities, needs, barriers and facilitators of the healthcare system (providers) and patients (users) about information technology. For both Delphi studies, content analysis was used to analyze responses of participants in the first-Delphi round. Items resulting from the first-round analysis were summarized, listed, and rated (5-point Likert scale) in order to provide input and develop the second-round questionnaire. The percent agreement of participants was defined to be 80% or above to indicate their consensus.

Results

Healthcare providers prefer sessions to be led by the cardiologists and cardiac nurses, moving from simple to a complex topic, and the dose of information and frequency should be varied according to the needs and severity of heart failure. Videoconferencing strategy could improve patients’ satisfaction, knowledge and self-care, and adherence with their therapy plans. Jordan healthcare system has a capability to use videoconferencing strategy in Jordan.

Conclusion

This study addresses the equivocal evidence for the effectiveness of using internet videoconferencing between healthcare provider and patients. Establishing an effective videoconferencing program assists with meeting patients’ needs and preferences, accessing healthcare during COVID-19, reducing travel burden/costs as well as the risk of exposure to the virus, and ultimately improving clinical outcomes. This study will capture attention of healthcare providers to perform further studies targeting videoconferencing heart failure management programs
Influence of sacubitril/valsartan on hibernating myocardium in patients with chronic heart failure with reduced ejection fraction
Authors: Mukhamedova M , Narzullaeva D S , Uzokov J K
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Myocardial viability particularly hibernating myocardium is one of the critical parameters for the assessment of the long-term prognosis of patients with ischemic etiology heart disease. Purpose of the study was to evaluate the influence of angiotensin receptor neprilysin inhibitor - sacubitril/valsartan on hibernating myocardium in patients with ischemic etiology chronic heart failure with reduced ejection fraction.

Material and Methods

One hundred and twenty patients with chronic heart failure with reduced ejection fraction (EF<40%) were enrolled in the study (mean age 58.2±14.6 years, male=53%). Patients were divided into two groups by sixty. Group I patients were assigned sacubitril/valsartan while Group II were assigned valsartan in addition to the standard treatment. Hibernating myocardium were assessed with echocardiography with dopamine test. All statistical analysis were assessed using STATA software.

Results

Ejection fraction and the wall motion score has been improved in both groups from baseline (P<0.05), however when we compared two groups, sacubitril/valsartan group tended to have more positive effect on ejection fraction (from 32.2±8.2% to 43.6±12.4% vs. from 31.7±8.0% to 37.2±10.3%, P<0.05) and the wall motion score (from 2.34±0.5 to 1.92±0.4 vs. 2.36±0.6 to 2.15±0.45, P<0.05) compared to valsartan group. Diastolic and systolic wall thickness has been improved in both groups from baseline (P<0.05), however there were not statistically significant changes between groups (P>0.05). When we analyzed by gender there were not significant changes between male and female (P<0.05).

Conclusion

Sacubitril/valsartan improves myocardial viability in patients with ischemic etiology chronic heart failure with reduced ejection fraction. Further studies with large amount of patients are required to clarify exact mechanisms.
Identifying if patient's living with heart failure retain knowledge better by gaining it through lived experience rather than through education.
Authors: Caples N , Regan A , Vijayamma Sadanandan D , Huish K
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Self-care is when a patient possesses a set of knowledge and skills that are used to process information to make correct health decisions. Self-care in heart failure (HF) includes monitoring symptoms for deterioration in HF and having an appropriate response time in contacting their health care provider. One of the main principles of a heart failure clinic is to provide a structured education programme for the patient regarding self-care. Patient education is the leading intervention to equip patients with the skills for symptom recognition. The education aims to ensure the patient can recall the knowledge from memory if required.

Purpose

The aim of this study was to evaluate patient knowledge, through testing memory, regarding symptom recognition in a single center HF clinic. To identify if there was a difference between attaining knowledge on symptom recognition gained through lived experience versus knowledge on symptom recognition gained through education.

Methods

50 patients were recruited for this study.

Average age was 72 years old.

38 male and 12 female.

All participants had previously experienced at least one symptom of HF.

All participants had a minimum of 2 education sessions in the HF clinic.

All patients had evidence from their weight logbook of daily weight monitoring. Question "a" tests knowledge acquired from education and question "b" tests knowledge acquired from lived experience.

All participants were asked two questions:

a) what is the amount of weight increase you are monitoring for?

b) name one symptom you are monitoring that would indicate possible deterioration in HF.

Results

single center prospective analysis

Question a: 35% answered correctly

Question b: 82% answered correctly

Conclusions

Processes of learning and the transfer of learning are central to understanding how people can achieve competency in self-care. In this study patients seem to remember information better from a lived experience rather than trying to recall taught information. It important to identify the patients’ individual factors and needs to successfully support their self-care management. Further evaluation of assessing the implementation of other supports available such as, mobile Apps and multimedia-based education, to address knowledge recall deficits is needed to determine if they aid the patient to achieve competency in self-care.
An intervention to improve caregiver self-efficacy and contribution to self-care does not affect caregiver anxiety, depression, quality of life and sleep. Secondary outcome analysis of MOTIVATE-HF RCT
Authors: Locatelli G , Rebora P , Occhino G , Ausili D , Riegel B , Vellone E , Alvaro R
Published: July 2022

Funding Acknowledgements

Type of funding sources: Private company. Main funding source(s): Center of Excellence for Nursing Scholarship (CECRI), Rome, Italy.

Background

Caregiver contribution (CC) to self-care can improve patient outcomes in heart failure (HF). However, caring for a person with HF can be a burdensome experience for caregivers. Experimental studies aimed at improving caregiver self-efficacy and CC to HF self-care are scarce. Moreover, it is underexplored if interventions aiming to improve caregiver self-efficacy and CC to HF self-care consequently affect caregiver anxiety, depression, quality of life and sleep.

Purpose

To evaluate if the delivery of a Motivational Interviewing intervention aimed at improving caregiver self-efficacy and CC to HF self-care affects caregiver anxiety, depression, quality of life, and sleep.

Methods

Secondary outcome analysis of the MOTIVATE-HF randomized controlled trial. Participants were recruited from three centers in Italy, and they were randomized into three arms: Arm 1 (Motivational Interview for patients), Arm 2 (Motivational Interview for patients and caregivers), Arm 3 (standard care). The intervention consisted in one face-to-face MI session, plus three telephone contacts within two months from enrollment with patients (Arm 1) or with patients and caregivers (Arm 2). Data were collected at baseline and after 3, 6, 9, 12 months. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale, quality of life was measured with the 12-Item Short-Form Health Survey, and sleep was evaluated with the Pittsburgh Sleep Quality Index.

Results

A total of 510 patient and caregiver dyads were enrolled. Caregiver median age ranged between 53 and 57, they were mainly female (76%), married (72%), spouses (37%), educated at high school or university level (55%), employed (73.5%), and living with the patient (60%). At baseline, anxiety, depression, quality of life and sleep scores were comparable among the three Arms. Over the year of follow-up, anxiety, depression, and sleep disturbances decreased, while quality of life slightly increased in all the three Arms. However, these changes were not significant in any of the study arms. When comparing these changes between Arm 2 and Arm 1 and 3, we did not observe any significant difference.

Conclusion

Delivering Motivational Interview to caregivers to improve their self-efficacy and contribution towards patient self-care did not increase caregivers’ own levels of anxiety and depression and did not decrease their quality of life and sleep. This may help tailoring future interventions for caregivers knowing that such an intervention does not worsen caregivers’ conditions and wellbeing.
Influence of sacubitril/valsartan on diastolic parameters in patients with chronic heart failure with reduced ejection fraction
Authors: Uzokov J , Mukhamedova M G , Narzullaeva D S , Nosirova G A , Orziev D Z , Majidov I
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Chronic heart failure (CHF) is one of the pressing issues of modern cardiology and is widely discussed lately. Chronic heart failure with reduced ejection fraction (HFrEF) is common and is concerned with poor outcomes. Not only systolic function, but also diastolic function is deteriorated in HFrEF. Thus, we hypothesized the efficacy of angiotensin converting enzyme-neprilysin inhibitors on the diastolic function of patients with HFrEF.

Objective

Aim of the study was to evaluate the efficacy of angiotensin converting enzyme-neprilysin inhibitor - sacubitril/valsartan on diastolic parameters in patients with CHFrEF.

Material and Methods

114 patients with diagnosed HFrEF with NYHA II-III functional class patients had been enrolled in the study. Mean age of the patients was 61.12±14.4 years, male was 53%. Patients randomly were divided into two groups by 57. Group I was provided with sacubitril/valsartan whereas Group II was provided with valsartan. All anthropometric, laboratory and instrumental methods including echocardiography with Doppler were performed at baseline and after the six months of the treatment. All statistical analysis were performed with STATA software.

Results

Diastolic function was significantly improved after the treatment of sacubitril/valsartan in six months compared to valsartan group (P<0.05). E/e ratio was significantly improved in patients with sacubitril/valsartan compared to valsartan group (P<0.01). Left atrial longitudinal strain was significantly lower in the first group patients than second one was (P<0.001). Even though, isovolumic relaxation time and velocity time integral of the E-A complex have been improved in both groups during the treatment in six months, there have not been observed significant changes between groups (P>0.05). During the follow-up period group I patients have been experienced less hospitalization than group II patients were (P<0.05).

Conclusion

Sacubitril/valsartan significantly improved diastolic function compared to valsartan in patients with HFrEF. Further studies are required with large amount of patients.
The role of NT-proBNP in patients discharged after COVID-19 pneumonia
Authors: Shchudro O , Konopkina L , Pertseva T , Botvinikova L , Bielosludtseva K
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Aims

The long-term health effects after SARS-CoV-2 infection remain poorly understood. The aim of our study was to define the cardiac disorders in the early postCOVID period.

Methods and resuts

Was observed 85 patients (40 (47,1%) men, 45 (52,9%) women, average age – 44,2 (39,3; 47,1)) on 48,3 (45,0; 56,2) days after the onset of the first symptoms of COVID-19. The main group were divided into 3 subgroups: 1 – 39 patients after moderate COVID-19 pneumonia, 2 – 36 patients after severe COVID-19 pneumonia, 3 – 10 patients after critical COVID-19 pneumonia. The subgroups were comparable in gender and age. All patients before COVID-19 were virtually healthy and had no history of cardiovascular disease, including arrhythmias. All patients underwent general clinical methods of examination, determination of SpO2, echocardiography and measured NT-proBNP concentration in serum. In 100% patients was the level of SpO2 more than 95% (average 97,5 (96,3; 98,8)%) and preserved left ventricular ejection fraction (LVEF) (average 62,3 (60,2; 74,3)%). In patients after moderate COVID-19 pneumonia, the level of NT-proBNP was significantly lower (79,4 (59,9; 75,3) pg/ml) than in patients after severe (145,0 (66,9; 170,9) pg/ml) and critical (149,7 (79,3; 138,5) pg/ml) COVID-19 pneumonia (p < 0,01). But concentration NT-proBNP in patients after severe and critical COVID-19 pneumonia didn’t differ significantly (p > 0,05).

Conclusions

Patients after severe and critical COVID-19 pneumonia are at risk for developing cardiac disorders in the early postCOVID period. Determining the level of NT-proBNP, and not just performing echocardiography, after discharged in such patients will help to customize the most appropriate therapeutic strategies.
Association of gender on the time of first medical contact primary pci activation for stemi patients at emergency department
Authors: Berga Congost G , Martinez Momblan M A M M , Valverde Bernal J V B , Marquez Lopez A M L , Ruiz Gabalda J R G , Garcia Picart J G P , Puig Campmany M P C , Marques Sule E M S , Brugaletta S B
Published: July 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Strategic Health Research and Innovation Plan (PERIS) 2016-2020

Background

Time between first medical contact (FMC) and STEMI activation is a good indicator of the Code STEMI quality. Times of attention are of particular importance in some STEMI subgroups, such as women. Women receive later, inadequate treatment and their mortality rate is higher.

Aim

To determine association of gender with the FMC- activation time in STEMI patients admitted to ED.

Methods

An observational retrospective study was conducted including all patients admitted to the ED activated as a STEMI between 2013 and 2016. Patients identified as STEMI on a pre-hospital basis, in other hospitals or in primary care centres and activated as code STEMI before being admitted to the hospital were excluded. The main variable was the FMC- activation time, defined as the time between FMC and primary PCI activation. Main clinical variables and comorbidities, in-hospital mortality, hospital stay (in days), and false STEMI positives were also recorded.

Results

A total of 330 patients were included. They were classified by gender: 23.9% (78) women and 76.1% (249) men. Women exhibited more atypical symptoms and ECG changes as compared to men, with abdominal pain (p=0.029), scapular pain (p=0.003), rib pain (p=0.035), back pain (p=0.013) and general poor condition (p=0.008). Delays in the STEMI response time are longer in the case of women, particularly in the following intervals: FMC-activation (p=0.049) and arrival at the Haemodynamic-balloon (p= 0.021).

Conclusion

FMC- activation time are longer in women with atypical presentation. The longest time was detected in women older than 65 years old. This highlights the need to develop strategies to improve STEMI activation time in women.
Implementation of nurse-led early mobilisation after transcatheter aortic valve implantation: Identification of barriers to standardised practice
Authors: Lauck S , Bancroft C , Yu M , Polderman J , Andrews H , Stephenson A
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Background

We examined the barriers of early nurse-led mobilisation after transcatheter aortic valve implantation (TAVI) to support safe next-day discharge home.

Methods

We conducted a prospective observational cohort study of patients treated in 2019-2021 using a standardised post-procedure nursing care standard to promote mobilisation in 4 to 6 hours after TAVI. Results are presented as mean (standard deviation) for continuous variables and as number (percentage) for categorical data; student t test was used to compare continuous variables and χ2 and Fisher exact tests were used to compare categorical variables. All analyses were performed in SAS version 9.4 (SAS Institute).

Results

The cohort included a convenience sample of 139 patients (64 women, 46%) mean age 82.5±6.7 years, NYHA III/IV 72 (51.8%), prior pacemaker 18 (13%), and prior SAVR 11 (7.9%). Patients were treated under local anaesthesia only (n=29, 20.9%) or conscious sedation (n=106, 76.3%) with a balloon expandable device (n=134, 96.4%) in a cardiac catheterisation laboratory (n=111, 79.9%) or hybrid operating room (n=28, 25.2%), and early recovery in cardiac telemetry (n=101, 72.7%) or critical care unit (n=38, 27.3%). Early mobilisation was achieved in 113 patients (81.3%: 4 hours: n=100, 71.9%, 4-6 hours: n=13, 9.4%); there were no significant (p≤0.05) differences in baseline characteristics between patients with early vs. late mobilisation; the primary reasons for delayed mobilisation included monitoring and/or managing cardiac conduction issues (n=6), vascular access hemostasis (n=6) and neurological status (n=4), patient preference or other self-reported issue (n=5) and nursing workload (n=5). In patients who achieved early mobilisation, 81.4% were discharge on post-operative day 1 and 86.3% by day 2, with 99.1% returning directly home. There was no significant difference in 30-day readmission between the two groups.

Conclusions

Early nurse-led protocol-driven mobilisation is safe and effective to facilitate rapid reconditioning and safe transition home after uncomplicated TAVI. Research is needed to better understand patient and systems-level enablers to improve standardisation of practice.
For hypertensive patients with comorbidity, the number of comorbidity is associated with the pattern of their medication adherence
Authors: Oh O , Lee K S
Published: July 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Although medication adherence is an important self-care activity for hypertensive patients, their medication adherence is not often optimal. When patients with hypertension have comorbidities, they are asked to adhere to medications prescribed for all of their conditions, resulting in a greater burden. Some may decide to take medications for conditions they prioritize, while others may take all medications as prescribed. It is possible that the number of comorbidity affect the pattern of the patients’ medication adherence.

Purpose

To examine if the number of comorbidity is associated with the medication adherence pattern in patients with hypertension and at least one of the following comorbidity related to poor outcomes in hypertensive patients: diabetes, hyperlipidemia, ischemic heart disease and stroke.

Methods

A secondary data analysis was conducted using the 2018 Korea Health Panel Survey, including 2218 hypertensive patients with at least one of the following comorbidity: diabetes, hyperlipidemia, ischemic heart disease and stroke. Two types of medication adherence was assessed: primary (i.e., filling prescriptions of medications prescribed by clinicians) and secondary medication adherence (i.e., taking medications as directed). Patients were divided into three groups based on the patterns of primary and secondary medication adherence in each comorbidity (Figure 1). Multinomial logistic regression was used to determine whether the number of comorbidity was associated with the medication adherence pattern after controlling for relevant covariates (i.e. age, gender, marital status, income level, education level, unmet medical needs and presence of primary care providers).

Results

A total of 2218 patients (mean age 70.1, female 58.7%) had an average of 1.5 comorbidities (SD: 0.7); 10% had three or more comorbidities. About four-fifths of the patients (84.9%) were adherent to medications for all their chronic conditions (i.e., adherent group), 11% partially adhered to their medications (i.e., suboptimal group) and 4.1% did not adhere to any medications (i.e., non-adherent group). Compared with the adherent group, the suboptimal group were more likely to have a greater number of comorbidities after adjusting for covariates (adjusted odds ratio [aOR]=1.46). On the other hand, compared with the adherent group, the non-adherent group were more likely to have a smaller number of comorbidities (aOR=0.54).

Conclusion

Our study showed that an increased number of comorbidity is a risk factor for inconsistent medication adherence. However, since we also found that patients with a smaller number of chronic conditions were likely to be non-adherent to all medications, hypothesizing that increased number of comorbidity is associated with medication non-adherence may have been simplistic regarding these patients. The unexpected findings of non-adherent group needs to be further explored.
Soluble ST2 and nutritional status in patients hospitalized with heart failure with reduced ejection fraction - pilot study
Authors: Wasniewski F , Sawczak F , Kukfisz A , Szczechla M , Krysztofiak H , Przytarska K , Kaluzna-Oleksy M , Dudek M , Migaj J , Straburzynska-Migaj E
Published: July 2022

Funding Acknowledgements

Type of funding sources: Public Institution(s). Main funding source(s): Student Scientific Society

Background

Chronic heart failure with reduced ejection fraction (HFrEF) is very often accompanied by malnutrition, which seems to be a marker for poor prognosis. With still high prevalence of HFrEF new aspects of malnourishment should be assessed in order to plan a more individualized management and to achieve better prognosis. In addition to that the multimarker approach to evaluating HFrEF is gaining importance. One of the most promising new markers seems to be the soluble receptor for interleukin-33 (IL-33) - sST2 peptide.

Purpose

The aim of the study was to find relationship between serum sST2 level and malnourishment indicators in patients with HFrEF.

Methods

33 consecutive patients hospitalized in the Department of Cardiology. The sST2 level was assessed using the rapid ST2 test. We assessed nutritional status with the Mini Nutritional Assessment (MNA) questionnaire and collected the chosen clinical and biochemical parameters related to nutrition. It was tested if sST2 level could predict risk of malnutrition defined as MNA score below or equal to 23.5 using ROC curve analysis. Then to further evaluate the relation between nutritional status and sST2 level appropriate correlations were tested.

Results

The studied group consisted of 9.1% women, mean age was 55.3 ± 10.0 years, left ventricular ejection fraction - 24.8 ± 8.7%, sST2 level - 49.84 ± 37.02 ng/ml. Using ROC curve analysis we found that sST2 levels can predict the risk of malnutrition with both considerable sensitivity – 0.786, specificity – 0.737 and an area under the curve (AUC) 0.726 (95%CI 0.548-0.903; p=0.013). The optimal cutoff point - 35 ng/ml was derived and according to this value patients were divided into two groups. MNA score was 22.4 ± 2.3 in group with high ST2 (>35 ng/ml) and 24.4 ± 2.4 in group with low ST2 (<35 ng/ml); the difference was statistically significant (p=0.026). Using Spearman’s Rank-Order Correlation we found that sST2 level correlated significantly with total protein level (p=0.0349, R=-0.46), albumin level (p<0.001, R=-0.80) and total cholesterol level (p=0.002, R=-0.52), while no relevant relation to BMI nor triglycerides was found.

Conclusions

The study revealed a potential value of sST2 level in predicting impaired nutritional status defined with MNA and its correlation with serum protein, albumin and total cholesterol. More research needs to be conducted in order to verify these relations and to study its usefulness.