bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of COVID-19 on health-related quality of life in patients with cardiovascular disease: a multi-ethnic Asian study
Authors: Lim Shir Lynn , Woo Kai Lee , Lim Eleanor , Ng Faclin , Chan Mark Y. , Gandhi Mihir 
Published: December 2020

AbstractBackgroundLittle is known about the impact of the global coronavirus disease-2019 (COVID-19) pandemic on patients with cardiovascular disease (CVD), the biggest global killer and major risk factor for severe COVID-19 infections. We aim to explore the indirect consequences of COVID-19 on health-related quality of life (HRQoL) of patients with CVD.MethodsEighty-one adult outpatients with CVD were assessed using the EQ-5D, a generic health status instrument with five dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression), before and during the pandemic. Changes in the EQ-5D dimensional responses were compared categorically as well as using the dimension-specific sum-score (range 1–3, with a higher score indicating worse health). The responses and sum-score were compared using the exact test of symmetry and the pairedt-test, respectively.ResultsThese patients [mean age (SD) 59.8 (10.5); 92.6% males; 56% New York Heart Association (NYHA) functional class I] had coronary artery disease (69%), heart failure (28%), or arrhythmias (15%). None experienced change in NYHA class between assessments. About 30% and 38% of patients reported problems with at least one of the EQ-5D dimensions pre-pandemic and during the pandemic, respectively. The highest increase in health problems was reported for anxiety/depression (12.5% pre-pandemic vs 23.5% during pandemic;p = 0.035) with mean domain-specific score from 1.12 (SD 0.33) to 1.25 (SD 0.46) (standardized effect size = 0.373,p = 0.012). There was no meaningful change in other dimensions as well as overall HRQoL.ConclusionThe COVID-19 pandemic is associated with a significant worsening of the mental health of patients with CVD.
Post-resuscitation shock: recent advances in pathophysiology and treatment
Authors: Jozwiak Mathieu , Bougouin Wulfran , Geri Guillaume , Grimaldi David , Cariou Alain 
Published: December 2020

AbstractA post-resuscitation shock occurs in 50–70% of patients who had a cardiac arrest. It is an early and transient complication of the post-resuscitation phase, which frequently leads to multiple-organ failure and high mortality. The pathophysiology of post-resuscitation shock is complex and results from the whole-body ischemia–reperfusion process provoked by the sequence of circulatory arrest, resuscitation manoeuvers and return of spontaneous circulation, combining a myocardial dysfunction and sepsis features, such as vasoplegia, hypovolemia and endothelial dysfunction. Similarly to septic shock, the hemodynamic management of post-resuscitation shock is based on an early and aggressive hemodynamic management, including fluid administration, vasopressors and/or inotropes. Norepinephrine should be considered as the first-line vasopressor in order to avoid arrhythmogenic effects of other catecholamines and dobutamine is the most established inotrope in this situation. Importantly, the optimal mean arterial pressure target during the post-resuscitation shock still remains unknown and may probably vary according to patients. Mechanical circulatory support by extracorporeal membrane oxygenation can be necessary in the most severe patients, when the neurological prognosis is assumed to be favourable. Other symptomatic treatments include protective lung ventilation with a target of normoxia and normocapnia and targeted temperature management by avoiding the lowest temperature targets. Early coronary angiogram and coronary reperfusion must be considered in ST-elevation myocardial infarction (STEMI) patients with preserved neurological prognosis although the timing of coronary angiogram in non-STEMI patients is still a matter of debate. Further clinical research is needed in order to explore new therapeutic opportunities regarding inflammatory, hormonal and vascular dysfunction.
Association of information, education, and communication with enrolment in health insurance: a case of Nepal
Authors: Acharya Devaraj , Devkota Bhimsen , Gautam Kamal , Bhattarai Radha 
Published: December 2020

Abstract
Background
Many studies indicate that various health programmes have been failed because of the lack of appropriate information, education, and communication [IEC] for the target audiences. It is still unanswered which methods/means of communication could be the most powerful for changing behaviour or decision-making capacity. The paper aims to assess the effects of IEC on family enrolment in health insurance programme [HIP] in Nepal.

Methods
We employed a household-based observational study with a control group. Altogether 810 household interviews were conducted in Baglung and Kailali districts of Nepal in 2018. The study used a validated structured interview schedule. Background characteristics of the family and respondents and their exposure to the means of communication were the independent variables while enrolment in health insurance [HI] was the dependent variable.

Results
Data showed that 72% of the respondents heard about the HI and 66% knew the contribution amount for enrolment in HI. In the total enrolled households, 53% were household heads, 59% belonged to the age group 41–60 and 68% were above 60 years. More than half (56%) of rich compared to 46 and 49% of middle and poor (p < 0.05); 60% of the family member suffering from the chronic disease were enrolled in the HI. Similarly, 68% of those who heard about HI compared to 4 % who did not hear were enrolled (p < 0.001). A vast majority (69%) of those knowing contribution amount, 73% who interact with peer neighbour compared to 39% who did not, and 62% of those who listened to the radio and 63% of those who watched TV were enrolled in HI (p < 0.001). However, heard about HI (aOR = 21.18, 95%CI: 10.17–44.13, p < 0.001), knowledge about contribution amount (aOR = 5.13, 95%CI: 3.09–8.52, p < 0.001), having HI related books or guidelines (aOR = 4.84, 95%CI: 2.61–8.98, p < 0.001), and interact with peer or neighbours (aOR = 1.74, 95%CI: 1.34–2.65, p < 0.01) were appeared to be positive and significant predictors for enrolment in HI.

Conclusion
Knowledge about HI and interaction with peers and neighbours about the HI scheme of the government could lead to higher participation in the HIP. It would be better to incorporate this strategy while planning interventions for increasing enrolment in the HIP.
Socio-demographic and clinical predictors of outcome to long-term treatment with lithium in bipolar disorders: a systematic review of the contemporary literature and recommendations from the ISBD/IGSLI Task Force on treatment with lithium
Authors:   On behalf of the ISBD-IGSLI Joint Task Force on Lithium Treatment, Grillault Laroche Diane , Etain Bruno , Severus Emanuel , Scott Jan , Bellivier Frank 
Published: December 2020

Abstract
Objective
To identify possible socio-demographic and clinical factors associated with Good Outcome (GO) as compared with Poor Outcome (PO) in adult patients diagnosed with Bipolar Disorder (BD) who received long-term treatment with lithium.

Methods
A comprehensive search of major electronic databases was performed to identify relevant studies that included adults patients (18 years or older) with a diagnosis of BD and reported sociodemographic and/or clinical variables associated with treatment response and/or with illness outcome during long-term treatment to lithium (> = 6 months). The quality of the studies was scored using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies from the National Institute of Health.

Results
Following review, 34 publications (from 31 independent datasets) were eligible for inclusion in this review. Most of them (n = 25) used a retrospective design. Only 11 studies were graded as good or borderline good quality. Forty-three potential predictors of outcome to lithium were identified. Four factors were associated with PO to lithium: alcohol use disorder; personality disorders; higher lifetime number of hospital admissions and rapid cycling pattern. Two factors were associated with GO in patients treated with lithium: good social support and episodic evolution of BD. However, when the synthesis of findings was limited to the highest (good or borderline good) quality studies (11 studies), only higher lifetime number of hospitalization admissions remained associated with PO to lithium and no associations remained for GO to lithium.

Conclusion
Despite decades of research on lithium and its clinical use, besides lifetime number of hospital admissions, no factor being consistently associated with GO or PO to lithium was identified. Hence, there remains a substantial gap in our understanding of predictors of outcome of lithium treatment indicating there is a need of high quality research on large representative samples.
Ultradeep targeted sequencing reveals low allele frequencies of somatic JAK2 and MPL variants in patients with abdominal vein thromboses: results of an ongoing prospective prevalence study in Mecklenburg-West Pomerania
Authors: Grunwald Luise , Grosse-Thie Christina , Sender Sina , Knuebel Gudrun , Krohn Saskia , Roolf Catrin , Junghanss Christian , Henze Larissa , Murua Escobar Hugo 
Published: December 2020

AbstractMyeloproliferative neoplasms are characterized by mutations in JAK2, MPL and CALR genes. Commonly in diagnostics and previous studies mainly sequencing and common PCR techniques under conventional detection limits are used.Splanchnic vein thromboses are rare, but often appear associated with myeloproliferative neoplasms and represent serious complications.Herein, blood from patients with abdominal vein thromboses in Mecklenburg-West Pomerania (federal district of northern Germany), included in an ongoing prospective prevalence study, was analyzed by next generation sequencing representing the complete protein coding regions of JAK2, MPL and CALR genes with a coverage of > 2000 reads, therefore an ultradeep targeting approach.JAK2 V617F mutations were detected in 11/44 patients. In four of these cases allele frequencies ranged below the conventional cut off of 2%. MPL W515R was detected in 3/44 cases in low frequencies.Very low allele frequencies of JAK2 and MPL variants in patients with abdominal vein thromboses may indicate early manifestations of myeloproliferative neoplasms.
Sex-biased topography effects on butterfly dispersal
Authors: Plazio Elisa , Bubová Terezie , Vrabec Vladimír , Nowicki Piotr 
Published: December 2020

AbstractBackgroundMetapopulation persistence in fragmented landscapes is assured by dispersal of individuals between local populations. In this scenario the landscape topography, although usually neglected, may have an important role in shaping dispersal throughout the matrix separating habitat patches. Due to inter-sexual differences in optimal reproductive strategies, i.e., males maximizing the number of mating opportunities and females maximizing the offspring survival chances, topography-related constraints are expected to exert a different effect on male and female dispersal behaviour. We tested sex-biased topography effects on butterfly dispersal, with the following hypotheses: (1) females are constrained by topography in their movements and avoid hill crossing; (2) male dispersal is primarily driven by two-dimensional spatial structure of the habitat patches (i.e. their geometric locations and sizes) and little influenced by topography.MethodsFollowing intensive mark-recapture surveys ofMaculinea(=Phengaris)nausithousandM. teleiuswithin a landscape characterised by an alternation of hills and valleys, we investigated sex-specific patterns in their inter-patch movement probabilities derived with a multi-state recapture model. In particular, we (1) analysed the fit of dispersal kernels based on Euclidean (= straight line) vs. topography-based (= through valley) distances; (2) compared movement probabilities for the pairs of patches separated or not by topographic barriers; and (3) tested the differences in the downward and upward movement probabilities within the pairs of patches.ResultsEuclidean distances between patches proved to be a substantially stronger predictor of inter-patch movement probabilities in males, while inter-patch distances measured along valleys performed much better for females, indicating that the latter tend to predominantly follow valleys when dispersing. In addition, there were significantly lower probabilities of movements across hills in females, but not in males.ConclusionsBoth above results provide support for the hypothesis that topography restricts dispersal in females, but not in males. Since the two sexes contribute differently to metapopulation functioning, i.e., only female dispersal can result in successful (re)colonisations of vacant patches, the topography effects exerted on females should be considered with particular attention when landscape management and conservation actions are designed in order to maintain the functional connectivity of metapopulation systems.
Non-cardiac surgery in congenital heart disease-associated pulmonary arterial hypertension: risk recognition and management
Authors: Constantine Andrew , Clift Paul 
Published: December 2020

Abstract
Background
Current guidelines for the peri-operative assessment and management are not sufficient to allow effective risk assessment and management of the patient with pulmonary arterial hypertension associated with congenital heart disease. Well-established risk stratification tools are not validated in this group. Additional, disease-specific risks require individualised, specialist, multidisciplinary management.

Case presentation
We present an illustrative clinical case of patients with pulmonary arterial hypertension associated with congenital heart disease undergoing non-cardiac surgery. The case follows a 66-year-old male with pulmonary hypertension associated with an atrial septal defect underwent an elective hernia repair.

Conclusions
We discuss useful management strategies for minimising risk during the peri- and post-operative periods in this population.
General management of pulmonary arterial hypertension associated with adult congenital heart disease
Authors: Gin-Sing Wendy 
Published: December 2020

AbstractOver the past 15 years there have been significant improvements in the treatment of pulmonary arterial hypertension due to congenital heart disease. Patients now live for several decades, but morbidity and mortality remain high. This article describes the holistic management of this patient group with an emphasis on both the physical and psychosocial aspects of care, taking into account the consequences of chronic cyanosis, avoiding complications and improving quality of life.
Clinical outcomes of submassive pulmonary embolism thrombolysis—an Indian experience
Authors: Rehman Nadeem U. , Dar Mohd Iqbal , Bansal Manish , Kasliwal R. R. 
Published: December 2020

AbstractBackgroundAcute pulmonary thromboembolism is the most dangerous presentation of venous thromboembolic disease. The role of thrombolysis in massive pulmonary embolism has been studied extensively, but the same is not there for submassive pulmonary embolism. This study is aimed at evaluating the effects of thrombolysis in acute submassive pulmonary embolism. This was a prospective, case-control, observational study. Patients presenting with acute submassive pulmonary embolism were divided into thrombolysis group and control group depending on whether they received thrombolysis plus anticoagulation or anticoagulation only, respectively.ResultsA total of 86 patients were included in the study. Forty-two patients were in the thrombolysis group, and 44 patients were in the control group. The mean ± SD age in the control and thrombolysis groups was 63.3 ± 14.7 and 56.4 ± 13.8 years, respectively. The two groups were well matched in sex distribution and associated comorbidities like COPD, active surgery, major trauma, and immobilization. On echocardiography, dilated RA/RV in pre-treatment vs. post-treatment was seen in 20 (45.5%) vs. 20 (45.5%) in the control group and 26 (61.9%) vs. 11 (26.2%) in the thrombolysis group. Similarly, RV systolic dysfunction in pre-treatment vs. post-treatment was seen in 24 (54.5%) vs. 21 (47.7%) in the control group and 22 (52.4%) vs. 8 (19.0%) in the thrombolysis group. Pulmonary artery pressure in pre-treatment vs. post-treatment was 64.4 ± 15.0 vs. 45.9 ± 9.9 mmHg in the control group and 68.3 ± 17.4 vs. 31.4 ± 6.9 mmHg in the thrombolysis group. In control vs. thrombolysis group, there were 5 vs. 1 death, 6 vs. 1 hemodynamic decompensation, and 6 vs. 1 patient needing mechanical ventilation.ConclusionThrombolysis in submassive pulmonary embolism is associated with better right ventricular functions, lower pulmonary artery pressures, and comparable mortality rates.
Muscle-Specific Deletion of Toll-like Receptor 4 Impairs Metabolic Adaptation to Wheel Running in Mice
Authors: ALI MOSTAFA M. , MCMILLAN RYAN P. , FAUSNACHT DANE W. , KAVANAUGH JOHN W. , HARVEY MORDECAI M. , STEVENS JOSEPH R. , WU YARU , MYNATT RANDALL L. , HULVER MATTHEW W. 
Published: December 2020

ABSTRACT

Purpose
Toll-like receptor 4 (TLR4) is an inflammatory receptor expressed ubiquitously in immune cells as well as skeletal muscle and other metabolic tissues. Skeletal muscle develops favorable inflammation-mediated metabolic adaptations from exercise training. Multiple inflammatory myokines, downstream from TLR4, are proposed links to the metabolic benefits of exercise. In addition, activation of TLR4 alters skeletal muscle substrate preference. The role of skeletal muscle TLR4 (mTLR4) in exercise metabolism has not previously been investigated. Herein, we aimed to specifically test the significance of mTLR4 to exercise-induced metabolic adaptations.

Methods
We developed a novel muscle-specific TLR4 knockout (mTLR4−/−) mouse model on C57BL/6J background. Male mTLR4−/− mice and wild-type (WT) littermates were compared under sedentary (SED) and voluntary wheel running (WR) conditions for 4 wk.

Results
mTLR4 deletion revealed marked reductions in downstream interleukin-1 receptor-associated kinase-4 (IRAK4) phosphorylation. In addition, the disruption of mTLR4 signaling prominently blunted the metabolic adaptations in WR-mTLR4−/− mice as opposed to substantial improvements exhibited by the WT counterparts. Voluntary WR in WT mice, relative to SED, resulted in significant increases in skeletal muscle fatty acid oxidation, glucose oxidation, and associated mitochondrial enzyme activities, all of which were not significantly changed in mTLR4−/− mice.

Conclusions
This study introduces a novel mTLR4−/− mouse model and identifies mTLR4 as an immunomodulatory effector of exercise-induced metabolic adaptations in skeletal muscle.
Endurance and Sprint Training Improve Glycemia and V˙O2peak but only Frequent Endurance Benefits Blood Pressure and Lipidemia
Authors: PETRICK HEATHER L. , KING TREVOR J. , PIGNANELLI CHRISTOPHER , VANDERLINDE TARA E. , COHEN JEREMY N. , HOLLOWAY GRAHAM P. , BURR JAMIE F. 
Published: December 2020

ABSTRACT

Purpose
Sprint interval training (SIT) has gained popularity as a time-effective alternative to moderate-intensity endurance training (END). However, whether SIT is equally effective for decreasing cardiometabolic risk factors remains debatable, as many beneficial effects of exercise are thought to be transient, and unlike END, SIT is not recommended daily. Therefore, in line with current exercise recommendations, we examined the ability of SIT and END to improve cardiometabolic health in overweight/obese males.

Methods
Twenty-three participants were randomized to perform 6 wk of constant workload SIT (3 d·wk−1, 4–6 × 30 s ~170% W
peak, 2 min recovery, n = 12) or END (5 d·wk−1, 30–40 min, ~60% W
peak, n = 11) on cycle ergometers. Aerobic capacity (V˙O2peak), body composition, blood pressure (BP), arterial stiffness, endothelial function, glucose and lipid tolerance, and free-living glycemic regulation were assessed pre- and posttraining.

Results
Both END and SIT increased V˙O2peak (END ~15%, SIT ~5%) and glucose tolerance (~20%). However, only END decreased diastolic BP, abdominal fat, and improved postprandial lipid tolerance, representing improvements in cardiovascular risk factors that did not occur after SIT. Although SIT, but not END, increased endothelial function, arterial stiffness was not altered in either group. Indices of free-living glycemic regulation were improved after END and trended toward an improvement after SIT (P = 0.06–0.09). However, glycemic control was better on exercise compared with rest days, highlighting the importance of exercise frequency. Furthermore, in an exploratory nature, favorable individual responses (V˙O2peak, BP, glucose tolerance, lipidemia, and body fat) were more prevalent after END than low-frequency SIT.

Conclusion
As only high-frequency END improved BP and lipid tolerance, free-living glycemic regulation was better on days that participants exercised, and favorable individual responses were consistent after END, high-frequency END may favorably improve cardiometabolic health.
Sex differences in disease presentation, surgical and oncological outcome of liver resection for primary and metastatic liver tumors—A retrospective multicenter study
Authors: Braunwarth Eva , Rumpf Benedikt , Primavesi Florian , Pereyra David , Hochleitner Margarethe , Göbel Georg , Gasteiger Silvia , Gehwolf Philipp , Öfner Dietmar , Starlinger Patrick , Stättner Stefan 
Published: December 2020

Background
Sex differences are becoming of rising interest in many fields of medicine. It remains unknown whether sex has a role in postoperative and long-term outcome after hepatic resection (HR). The aim of this study was to investigate sex differences in disease presentation, surgical and oncological outcome after curative HR.

Methods
Retrospective analysis of 1010 patients who underwent HR between 2005 and 2018 at two tertiary hospitals in Austria. Demographics and survival data were obtained from a prospectively maintained database. Univariate analysis was used to identify sex differences for the entire cohort and for sub-cohorts. Disease-free- and overall survival was assessed by the Kaplan-Meier estimate and results were compared by log-rank tests.

Results
436 females and 574 males were analyzed. Women were younger (p<0.001), had less liver cirrhosis (p<0.001), cardiac comorbidities (p<0.001), diabetes (28 (p<0.001) and obesity (p<0.001). Type of HR and surgical management did not vary by sex. Ninety-day morbidity (p = 0.179) and -mortality (p = 0.888) were comparable. In patients with malignant disease, no differences in disease-free- and overall survival was observed, neither for the entire cohort nor for the subgroups according to tumor entity or type of resection. Only in HCC patients, females showed an inferior OS (p = 0.029).

Conclusion
This study delivers new insights on the impact of sex differences in liver surgery. Despite the fact that male patients have a higher incidence of preoperative morbidities, we did not observe specific disparities in terms of immediate postoperative as well as long term oncological outcome between sexes.