bluuebunny/crossref_metadata_2025_split huggingface dataset:
A cluster‐randomized study on the Risk Assessment and Management Program for home blood pressure monitoring in an older population with inadequate health literacy
Authors: Fu Sau Nga , Dao Man Chi , Luk Wan , Lam Margaret Choi Hing , Ho Irene Sau Fan , Cheung Siu Keung , Wong Carlos King Ho , Cheung Bernard Man Yung 
Published: August 2020

AbstractThe Risk Assessment and Management Program (RAMP) has successfully demonstrated a reduction of blood pressure (BP) and cardiovascular (CVD) risk of patients with hypertension. This study aimed to compare the blood pressure control rate of participants after attended RAMP group, with those attended RAMP individual from usual care. A prospective open cluster‐randomized controlled trial was performed in five public primary care clinics. Patients with uncontrolled hypertension were recruited. RAMP group consisted of multi‐disciplinary group education on knowledge of hypertension, lifestyle modification, and hands‐on home blood pressure monitoring (HBPM) training. Each participant was given a branchial HBPM device. An individual face‐to‐face nurse follow‐up was arranged 6 weeks later. Participants' office BP and clinical parameters were assessed at 6, 12, and 18 months. Three RAMP group and two RAMP‐individual clusters recruited 152 and 139 participants, respectively. The mean age was 67.0 (SD 9.9) year. After 18 months of treatment, there was a significantly higher BP control rate in the RAMP‐group participants than the RAMP‐individual participants (78.9% vs 36.5%, P < .001). The systolic BP was reduced by 19.7 mm Hg (95% CI −22.03, −17.40, P < .001) and diastolic BP by 8.1 mm Hg (95% CI −9.66, −6.61, P < .001) in RAMP group while the RAMP individual demonstrated 9.3 mm Hg (95% CI −12.1, −6.4, P < .001) reduction in systolic BP without any significant difference in diastolic BP. The RAMP‐group participants' body weight (BW) and body mass index(BMI) had no significant changes, while the RAMP‐individual participants had a significant increase in BW and BMI. No adverse effect was reported.
Effects of luseogliflozin on arterial properties in patients with type 2 diabetes mellitus: The multicenter, exploratory LUSCAR study
Authors: Kario Kazuomi , Okada Kenta , Murata Mitsunobu , Suzuki Daisuke , Yamagiwa Kayo , Abe Yasuhisa , Usui Isao , Tsuchiya Norihiro , Iwashita Chie , Harada Noriko , Okawara Yukie , Ishibashi Shun , Hoshide Satoshi 
Published: August 2020

AbstractSodium‐glucose cotransporter 2 (SGLT2) inhibitors reduce the occurrence of cardiovascular and renal complications in patients with type 2 diabetes mellitus (T2DM) and represent guideline‐recommended therapy in this indication. However, precise mechanisms underlying the beneficial cardiovascular effects of SGLT2 inhibitors are not fully understood. This study investigated the effects of the SGLT2 inhibitor, luseogliflozin, on arterial properties and home blood pressure (BP) in patients with T2DM. This multicenter, single‐arm study enrolled adults with T2DM, glycosylated hemoglobin (HbA1c) 6.5%‐8.9% in the previous 4 weeks, and an indication for new/additional antidiabetic therapy. Luseogliflozin 2.5 mg/d was given for 12 weeks. Primary outcome was change in cardio‐ankle vascular index (CAVI) from baseline to Week 4 and Week 12. Home and office BP, BP variability, and metabolic parameters were secondary endpoints. Forty‐seven patients (mean age 63.5 ± 10.7 years) treated with luseogliflozin were included in the full analysis set. CAVI did not change significantly from baseline (mean [95% confidence interval] 8.67 [8.37‐8.97]) to Week 12 (8.64 [8.38‐8.91]; P = .750), but there were significant reductions from baseline in morning home BP, HbA1c, body weight, body mass index, and serum uric acid levels during luseogliflozin therapy. The reduction in morning home systolic BP was ≥ 5 mm Hg and was independent of baseline BP and BP control status. In conclusion, there was no change in arterial stiffness (based on CAVI) during treatment with luseogliflozin, but changes in BP and metabolic parameters were consistent with the known beneficial effects of SGLT2 inhibitors in T2DM.
Pharmacological treatment of high‐normal blood pressure (prehypertension) in high‐risk patients for primary prevention of cardiovascular events
Authors: Borazjani Roham , Kojuri Javad , Abdi‐Ardekani Alireza , Izadpanah Peyman , Dehghani Pooyan , Sayadi Mehrab , Attar Armin 
Published: August 2020

AbstractCurrently, the best treatment strategy for patients with a high‐normal blood pressure (prehypertension) is not known. The authors aimed to determine whether pharmacological reduction of systolic blood pressure (SBP) to a normal level (<120 mm Hg) would prevent cardiac morbidity and mortality in prehypertensive patients. In this secondary analysis, the authors obtained the data from SPRINT from the National Heart, Lung, and Blood Institute data repository center. Among 9361 patients enrolled in SPRINT, 289 high‐risk (ASCVD risk = 24.8% ± 13.0 [10‐65]) prehypertensive patients without previous cardiovascular disease and not receiving any antihypertensive medications were enrolled. One hundred and forty‐eight of them were assigned to standard treatment which consisted of clinical follow‐up till SBP goes above 140 mm Hg and then staring medications to keep SBP <140 mm Hg. One hundred and forty‐one were assigned to the intensive treatment receiving pharmacological SBP reduction to <120 mm Hg upon enrollment. The primary composite outcome was myocardial infarction, and other acute coronary syndromes, stroke, heart failure, or death from cardiovascular causes. Throughout the 3.06 years of follow‐up, a primary outcome event was confirmed in three participants (0.74% per year) in the intensive‐treatment group and 8 (1.61% per year) in the standard‐treatment group (hazard ratio [HR], 0.19; P = .045). Rates of serious adverse events were not increased by intensive‐treatment (HR, 0.83; P = .506). Based on this secondary post hoc analysis, intensive SBP reduction may probably be beneficial for primary prevention of cardiovascular morbidity and mortality in high‐risk prehypertensive patients. This finding needs to be evaluated in a larger trial designed specifically to answer this question.
The role of sphingosine 1‐phosphate and its receptors in cardiovascular diseases
Authors: Ouyang Jie , Shu Zhihao , Chen Shuhua , Xiang Hong , Lu Hongwei 
Published: August 2020

AbstractThere are many different types of cardiovascular diseases, which impose a huge economic burden due to their extremely high mortality rates, so it is necessary to explore the underlying mechanisms to achieve better supportive and curative care outcomes. Sphingosine 1‐phosphate (S1P) is a bioactive lipid mediator with paracrine and autocrine activities that acts through its cell surface S1P receptors (S1PRs) and intracellular signals. In the circulatory system, S1P is indispensable for both normal and disease conditions; however, there are very different views on its diverse roles, and its specific relevance to cardiovascular pathogenesis remains elusive. Here, we review the synthesis, release and functions of S1P, specifically detail the roles of S1P and S1PRs in some common cardiovascular diseases, and then address several controversial points, finally, we focus on the development of S1P‐based therapeutic approaches in cardiovascular diseases, such as the selective S1PR1 modulator amiselimod (MT‐1303) and the non‐selective S1PR1 and S1PR3 agonist fingolimod, which may provide valuable insights into potential therapeutic strategies for cardiovascular diseases.
Potentially preventable hospitalizations—The ‘pre‐hospital syndrome’: Retrospective observations from the MonashWatch self‐reported health journey study in Victoria, Australia
Authors: Martin Carmel , Hinkley Narelle , Stockman Keith , Campbell Donald 
Published: August 2020

AbstractRationale, Aims, and ObjectivesHealthLinks: Chronic Care is a state‐wide public hospital initiative designed to improve care for cohorts at‐risk of potentially preventable hospitalizations at no extra cost. MonashWatch (MW) is an hospital outreach service designed to optimize admissions in an at‐risk cohort. Telehealth operators make regular phone calls (≥weekly) using the Patient Journey Record System (PaJR). PaJR generates flags based on patient self‐report, alerting to a risk of admission or emergency department attendance. ‘Total flags’ of global health represent concerns about self‐reported general health, medication, and wellness. ‘Red flags’ represent significant disease/symptoms concerns, likely to lead to hospitalization.MethodsA time series analysis of PaJR phone calls to MW patients with ≥1 acute non‐surgical admissions in a 20‐day time window (10 days pre‐admission and 10 days post‐discharge) between 23 December 2016 and 11 October 2017. Pettitt's hypothesis‐testing homogeneity measure was deployed to analyse Victorian Admitted Episode/Emergency Minimum Datasets and PaJR data.FindingsA MW cohort of 103 patients (mean age 74 ± 15 years; with 59% males) had 263 admissions was identified. Bed days ranged from <1 to 37.3 (mean 5.8 ± 5.8; median 4.1). The MW cohort had 7.6 calls on average in the 20‐day pre‐ and post‐hospital period. Most patients reported significantly increased flags ‘pre‐hospital’ admission: medication issues increased on day 7.0 to 8.5; total flags day 3, worse general health days 2.5 to 1.8; and red flags of disease symptoms increased on day 1. These flags persisted following discharge.Discussion/ConclusionThis study identified a ‘pre‐hospital syndrome’ similar to a post‐hospital phase aka the well‐documented ‘post‐hospital syndrome’. There is evidence of a 10‐day ‘pre‐hospital’ window for interventions to possibly prevent or shorten an acute admission in this MW cohort. Further validation in a larger diverse sample is needed.
Cognitive Function and Cardiometabolic‐Inflammatory Risk Factors Among Older Indians and Americans
Authors: Hu Peifeng , Lee Jinkook , Beaumaster Sidney , Kim Jung Ki , Dey Sharmistha , Weir David , Crimmins Eileen M. 
Published: August 2020

OBJECTIVESTo investigate how cardiometabolic‐inflammatory risk factors are related to cognition among older adults in India and the United States.DESIGNThe Longitudinal Aging Study in India–Diagnostic Assessment of Dementia (LASI‐DAD) and the Harmonized Cognitive Assessment Protocol of the Health and Retirement Study (HRS‐HCAP) in the United States conducted an in‐depth assessment of cognition, using protocols designed for international comparison.SETTINGCognitive tests were conducted in hospital or household settings in India and in household settings in the United States.PARTICIPANTSRespondents aged 60 years and older from LASI‐DAD (N = 1,865) and respondents aged 65 years and older from HRS‐HCAP (N = 2,111) who provided venous blood specimen.MEASUREMENTSWe used total composite scores from the common cognitive tests administered. Cardiovascular risk was indicated by systolic and diastolic blood pressure, pulse rate, pro‐B‐type natriuretic peptide (proBNP), and homocysteine. Metabolic risk was measured by body mass index, glycosylated hemoglobin (HbA1c), high‐density lipoprotein cholesterol, and lipoprotein (a) (only in India). Inflammatory risk was indicted by white blood cell count, C‐reactive protein, albumin, and uric acid (only in India).RESULTSThe distribution of both total cognition scores and of cardiometabolic risk factors differed significantly between India and the United States. In both countries, lower cognition was associated with older age, lower education, elevated homocysteine, elevated proBNP, and lower albumin levels. The associations between HbA1c levels and cognitive measures were statistically significant in both countries, but in the opposite direction, with a coefficient of 1.5 (P < .001) in India and −2.4 (P < .001) in the United States for one percentage increase in absolute HbA1c value.CONCLUSIONCardiometabolic‐inflammatory biomarkers are associated with cognitive functional levels in each country, but the relationships may vary across countries. J Am Geriatr Soc 68:S36‐S44, 2020.
Online Clinical Consensus Diagnosis of Dementia: Development and Validation
Authors: Lee Jinkook , Ganguli Mary , Weerman Albert , Chien Sandy , Lee Dong Young , Varghese Mathew , Dey Aparajit B. 
Published: August 2020

OBJECTIVESTo introduce cost‐effective expert clinical diagnoses of dementia into population‐based research using an online platform and to demonstrate their validity against in‐person clinical assessment and diagnosis.DESIGNThe online platform provides standardized data necessary for clinicians to rate participants on the Clinical Dementia Rating (CDR®). Using this platform, clinicians diagnosed 60 patients at a range of CDR levels at two clinical sites. The online consensus diagnosis was compared with in‐person clinical consensus diagnosis.SETTINGAll India Institute of Medical Sciences (AIIMS), Delhi, and National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.PARTICIPANTSThirty patients each at AIIMS and NIMHANS with equal numbers of patients previously independently rated in person by experts as CDR is 0 (cognitively normal), CDR is 0.5 (mild cognitive impairment), and CDR is 1 or greater (dementia).MEASUREMENTSMultiple clinicians independently rate each participant on each CDR domain using standardized data and expert clinical judgment. The overall summary CDR is calculated by algorithm. When there are discrepancies among clinician ratings, clinicians discuss the case through a virtual consensus conference and arrive at a consensus overall rating.RESULTSOnline clinical consensus diagnosis based on standardized interview data provides consistent clinical diagnosis with in‐person clinical assessment and consensus diagnosis (κ coefficient = 0.76).CONCLUSIONA web‐based clinical consensus platform built on the Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India interview data is a cost‐effective way to obtain reliable expert clinical judgments. A similar approach can be used for other epidemiological studies of dementia. J Am Geriatr Soc 68:S54‐S59, 2020.
Hypertension and Cognitive Health Among Older Adults in India
Authors: Farron Madeline R. , Kabeto Mohammed U. , Dey Aparajit Ballav , Banerjee Joyita , Levine Deborah A. , Langa Kenneth M. 
Published: August 2020

OBJECTIVESTo assess the prevalence of diagnosed and undiagnosed hypertension and their relationship to cognitive function in older adults in India.DESIGNLongitudinal Aging Study in India–Diagnostic Assessment of Dementia (LASI‐DAD), an in‐depth national study of late‐life cognition and dementia.SETTINGGeriatric hospitals and respondentsʼ homes across 14 states in India.PARTICIPANTSN = 2,874 individuals aged 60 years and older from LASI‐DAD.MEASUREMENTSHypertension was identified by self‐report of physician diagnosis or measured blood pressure (BP) of 140/90 mmHg or higher. Undiagnosed hypertension was defined as hypertensive BP measurements, but no physician diagnosis. Controlled hypertension was defined as BP lower than 140/90 mmHg among those with a physician diagnosis. Total hypertension included both diagnosed and undiagnosed hypertension. A summary cognition score, derived from the sum of 18 cognitive tests administered in the LASI‐DAD (range = 0–360) was used to assess cognitive function.RESULTSTotal hypertension prevalence was 63.2% (41.5% diagnosed and 21.6% undiagnosed). Among those with hypertension, 34.5% were undiagnosed, 34.2% were diagnosed but uncontrolled, and 31.3% were diagnosed and controlled. Neither diagnosed nor undiagnosed hypertension was related to cognitive function in fully adjusted models. Older age, female sex, less education, being widowed, rural residence, residing in the north or central regions, being in a scheduled caste or tribe, low consumption, being underweight, and history of stroke were all independently associated with worse cognitive test performance.CONCLUSIONTwo‐thirds of older Indian adults had hypertension, with the majority being undiagnosed or diagnosed but not adequately controlled. Hypertension was not independently associated with cognitive function, whereas sociodemographic factors were independently related to cognitive function. J Am Geriatr Soc 68:S29‐S35, 2020.
Pneumonia Lung Ultrasound Score (PLUS): A New Tool for Detecting Pneumonia in the Oldest Patients
Authors: Linsalata Giuseppe , Okoye Chukwuma , Antognoli Rachele , Guarino Daniela , Ravenna Virginia , Orsitto Eugenio , Calsolaro Valeria , Monzani Fabio 
Published: August 2020

OBJECTIVESTo compare the diagnostic accuracy of lung ultrasound (LUS) and standard chest X‐ray (CXR) in older patients admitted to an acute‐care geriatric ward for suspected acute pneumonia, and to develop an easy‐to‐use diagnostic tool, now called Pneumonia Lung Ultrasound Score (PLUS), for early risk stratification.DESIGNProspective, single‐center, cohort study.SETTINGAcute‐care geriatric ward of tertiary care center.PARTICIPANTSIndividuals, aged 65 years and older, with suspected acute pneumonia.MEASUREMENTSParticipants were stratified according to the Multidimensional Prognostic Index. All the patients underwent CXR and LUS, whereas chest computed tomography was performed in case of mismatch between LUS and CXR. Using logistic multivariate regression, we assessed the influence of age, sex, multimorbidity, cognitive impairment, and clinical biomarkers in the misdiagnosis of acute pneumonia. Finally, an easy‐to‐perform diagnostic tool based on the combination of biomarkers (brain natriuretic peptide, high‐sensitivity C‐reactive protein, and partial pressure arterial oxygen/fraction of inspired oxygen ratio) and LUS was realized. A receiver operating characteristic curve was used to verify the predictive accuracy of PLUS, CXR, and LUS in pneumonia diagnosis.RESULTSA total of 132 subjects (69% women; mean age = 85.3 ± 6.9 years) were enrolled in the study. Acute pneumonia was diagnosed in 94 of 132 cases. LUS showed higher diagnostic accuracy compared with CXR (0.91 (95% confidence interval (CI) = 0.85–0.93) vs 0.67 (95% CI = 0.58–0.75)) in detecting pneumonic consolidations. A higher degree of cognitive impairment was associated with both LUS and CXR pneumonia misdiagnosis (odds ratio = 1.30 (95% CI = 1.04–1.65)). PLUS showed higher predictive accuracy in the diagnosis of acute pneumonia compared with LUS (AUC = 0.92 (95% CI = 0.87–0.98) vs 0.86 (95% CI = 0.80–0.96); P = .029).CONCLUSIONSThis study confirms the higher diagnostic accuracy of LUS compared with CXR for acute pneumonia in older adults. Nonetheless, the accuracy of PLUS, an easy‐to‐use, biomarker‐derived diagnostic tool, was superior to LUS regardless of patientsʼ degree of frailty.
Sharing the safe operating space: Exploring ethical allocation principles to operationalize the planetary boundaries and assess absolute sustainability at individual and industrial sector levels
Authors: Hjalsted Anjila Wegge , Laurent Alexis , Andersen Martin Marchman , Olsen Karen Holm , Ryberg Morten , Hauschild Michael 
Published: August 2020

AbstractIn the light of increasing human pressures on the Earth system, the issue of sharing in the face of scarcity is more pressing than ever. The planetary boundary framework identifies and quantifies nine environmental boundaries and corresponding human pressures. However, when aiming to make the concept operational for decision support it is unclear how this safe operating space (SOS) within each of the planetary boundaries should be shared. This study proposes a two‐step approach, where the operating space is first downscaled to the individual level using ethical allocation principles and next scaled up to a higher organizational level using different upscaling methods. For the downscaling, three allocation principles are demonstrated: egalitarian (equal per capita); grandfathering (proportional to current share of the total impacts); and ability to pay (proportional to economic activity). For upscaling from the individual level final consumption expenditure is used as a proxy for the priority that the individual gives to the product or sector. In an alternative upscaling approach, an additional upscaling factor is based on the eco‐efficiency (ratio between turnover and environmental impact) of the product or sector. A demonstration of the method's application is given by applying the framework to two of the planetary boundaries, climate change and biogeochemical flows, with the Danish, Indian and global dairy sectors as cases. It is demonstrated how the choices of allocation and upscaling approaches influence the results differently in the three cases. The developed framework is shown to support an informed and transparent selection of allocation principles and upscaling methods and it provides a step toward standardization of distributing the SOS in absolute environmental sustainability assessments.
Cosmetovigilance in a tertiary care hospital: A prospective observational study
Authors: Jyrwa Serika , Sebastian Juny , Shastry Veeranna 
Published: August 2020

AbstractBackgroundCosmetovigilance is a term used for the activities related to the collection, evaluation, and monitoring of reporting of undesirable events observed during or after normal or reasonably foreseeable use of a cosmetic product.AimThe study was conducted to assess the adverse cosmetic events from a tertiary care hospital.Patients/MethodsThe patients visiting the study site was reviewed and those who met the study criteria are enrolled in the study after administration of the informed consent. Study participants were followed on regular intervals either telephonically or hospital visits in order to determine the outcome. The causality assessment of the reported event was performed using Colipa and PLM method.ResultsDuring the study period 22,893 patients visited the dermatology department, in which 87 subjects were enrolled in the study. The incidence of adverse cosmetic event was 0.38%. Hair care products caused more events than body care products. In 73.56% of cases, the suspected cosmetic was withdrawn and all the study population received symptomatic treatment for the adverse events. Causality assessment of Using Colipa method, categorized 49.43% events as likely and using PLM method, 64.37% events were probable. Study couldn't identify any predictors of adverse cosmetic events. Median cost associated with the management of ACRs for hair care products and body care products were 716.62 (IQR: 1011.36–470) and 557.4 (IQR: 711.63–373.8).ConclusionThe study suggest need for approaches such as awareness programs among the cosmetic sellers, consumers and other stakeholders on cosmetovigilance needs to be developed and implemented.