bluuebunny/crossref_metadata_2025_split huggingface dataset:
Altered Somatosensory Cortical Activity Is Associated with Cortical Thickness in Adults with Cerebral Palsy: Multimodal Evidence from MEG/sMRI
Authors: Trevarrow Michael P , Lew Brandon J , Hoffman Rashelle M , Taylor Brittany K , Wilson Tony W , Kurz Max J 
Published: July 2021

Abstract
Somatosensory cortical activity is altered in individuals with cerebral palsy (CP). However, previous studies have focused on the lower extremities in children with CP and have given less attention to structural changes that may contribute to these alterations. We used a multimodal neuroimaging approach to investigate the relationship between somatosensory cortical activity and cortical thickness in 17 adults with CP (age = 32.8 ± 9.3 years) and 18 healthy adult controls (age = 30.7 ± 9.8 years). Participants performed a median nerve paired-pulse stimulation paradigm while undergoing magnetoencephalography (MEG) to investigate somatosensory cortical activity and sensory gating. Participants also underwent magnetic resonance imaging to evaluate cortical thickness within the area of the somatosensory cortex that generated the MEG response. We found that the somatosensory responses were attenuated in the adults with CP (P = 0.004). The adults with CP also hypergated the second stimulation (P = 0.030) and had decreased cortical thickness in the somatosensory cortex (P = 0.015). Finally, the strength of the somatosensory response was significantly correlated with the cortical thickness (P = 0.023). These findings demonstrate that the aberrant somatosensory cortical activity in adults with CP extends to the upper extremities and appears to be related to cortical thickness.
Cardiac natriuretic peptide deficiency sensitizes the heart to stress-induced ventricular arrhythmias via impaired CREB signalling
Authors: Hall Eric J , Pal Soumojit , Glennon Michael S , Shridhar Puneeth , Satterfield Sidney L , Weber Beth , Zhang Qinkun , Salama Guy , Lal Hind , Becker Jason R 
Published: July 2021

Abstract

Aims
The cardiac natriuretic peptides [atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP)] are important regulators of cardiovascular physiology, with reduced natriuretic peptide (NP) activity linked to multiple human cardiovascular diseases. We hypothesized that deficiency of either ANP or BNP would lead to similar changes in left ventricular structure and function given their shared receptor affinities.

Methods and results
We directly compared murine models deficient of ANP or BNP in the same genetic backgrounds (C57BL6/J) and environments. We evaluated control, ANP-deficient (Nppa−/−) or BNP-deficient (Nppb−/−) mice under unstressed conditions and multiple forms of pathological myocardial stress. Survival, myocardial structure, function and electrophysiology, tissue histology, and biochemical analyses were evaluated in the groups. In vitro validation of our findings was performed using human-derived induced pluripotent stem cell cardiomyocytes (iPS-CMs). In the unstressed state, both ANP- and BNP-deficient mice displayed mild ventricular hypertrophy which did not increase up to 1 year of life. NP-deficient mice exposed to acute myocardial stress secondary to thoracic aortic constriction (TAC) had similar pathological myocardial remodelling but a significant increase in sudden death. We discovered that the NP-deficient mice are more susceptible to stress-induced ventricular arrhythmias using both in vivo and ex vivo models. Mechanistically, deficiency of either ANP or BNP led to reduced myocardial cGMP levels and reduced phosphorylation of the cAMP response element-binding protein (CREBS133) transcriptional regulator. Selective CREB inhibition sensitized wild-type hearts to stress-induced ventricular arrhythmias. ANP and BNP regulate cardiomyocyte CREBS133 phosphorylation through a cGMP-dependent protein kinase 1 (PKG1) and p38 mitogen-activated protein kinase (p38 MAPK) signalling cascade.

Conclusions
Our data show that ANP and BNP act in a non-redundant fashion to maintain myocardial cGMP levels to regulate cardiomyocyte p38 MAPK and CREB activity. Cardiac natriuretic peptide deficiency leads to a reduction in CREB signalling which sensitizes the heart to stress-induced ventricular arrhythmias.
Empirical studies of escape behavior find mixed support for the race for life model
Authors: Wrensford Kwasi , Gutierrez Jahaziel , Cooper William E , Blumstein Daniel T 
Published: July 2021

Abstract
Escape theory has been exceptionally successful in conceptualizing and accurately predicting effects of numerous factors that affect predation risk and explaining variation in flight initiation distance (FID; predator–prey distance when escape begins). Less explored is the relative orientation of an approaching predator, prey, and its eventual refuge. The relationship between an approaching threat and its refuge can be expressed as an angle we call the “interpath angle” or “Φ,” which describes the angle between the paths of predator and prey to the prey’s refuge and thus expresses the degree to which prey must run toward an approaching predator. In general, we might expect that prey would escape at greater distances if they must flee toward a predator to reach its burrow. The “race for life” model makes formal predictions about how Φ should affect FID. We evaluated the model by studying escape decisions in yellow-bellied marmots Marmota flaviventer, a species which flees to burrows. We found support for some of the model’s predictions, yet the relationship between Φ and FID was less clear. Marmots may not assess Φ in a continuous fashion; but we found that binning angle into 4 45° bins explained a similar amount of variation as models that analyzed angle continuously. Future studies of Φ, especially those that focus on how different species perceive relative orientation, will likely enhance our understanding of its importance in flight decisions.
What affects the acceptance of illness in patients with atrial fibrillation?
Authors: Swiatoniowska-Lonc N , Kasperczak D , Jankowska-Polanska B 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background. Patients with atrial fibrillation (AF) have symptoms that require advanced treatment. The most common include palpitations, dyspnea, dizziness, tiredness, chest pain and anxiety. Both the symptoms and treatment and its complications adversely affect the perception of the disease among patients with AF. The research proves that acceptance of illness (AIS) is a factor positively influencing the quality of life, but also the adaptation to the therapeutic recommendations of patients with chronic diseases. There is little research on factors increasing the level of AIS among patients with AF.
The aim of the study is to determine the level of acceptance of illness in patients with AF and factors influencing the level of acceptance of illness.
Material and methods. 84 patients (including 51 men) aged 57.86 ± 17.72 years hospitalized in the cardiology department due to heart rhythm disorders. Standardized tools were used in the study: Acceptance of Illness Scale (AIS) to assess disease acceptance and International Physical Activity Questionnaire (IPAQ) to assess physical activity. Sociodemographic and clinical data were taken from the hospital register.
Results. In the study group the average result of acceptance of illness (AIS) was 27.67 ± 7.70. 48.8% of patients had a high degree of disease acceptance, 38.09% average, and 13.11% had no acceptance. The examined patients showed a lack of physical activity (IPAQ = 0.92 ± 0.40). In comparative analyses women had lower level of AIS than men (27.36 ± 7.37 vs. 27.86 ± 7.97; p = 0.01), patients more often hospitalized due to AF lower than patients less frequently hospitalized (26.30 ± 6.11 vs. 30.55 ± 8.55; p = 0.02). Lower level of AIS was observed in patients with comorbidities (34 ± 6.25 vs. 22 ± 6.66; p &lt; 0.001). Smokers had higher level of AIS than non-smokers (28.66 ± 6.65 vs. 27.00 ± 7.56; p = 0.02), similarly, physically active persons than inactive ones (26.48 ± 8.27 vs. 23.07 ± 10.58; p = 0.01). In correlation analysis, physical activity turned out to be an important determinant having a positive effect on the level of AIS (r = 0.220; p = 0.03).
Conclusions. Patients with AF have moderate level of acceptance of illness and low level of physical activity. A higher level of AIS is observed in men, without comorbidities, less frequently hospitalized and smokers. The important determinant having positive influence on AIS is physical activity.
The impact of the acceptance of illness on the quality of life of patients with atrial fibrillation
Authors: Jankowska-Polanska B , Kasperczak D , Swiatoniowska-Lonc N , Polanski J 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background. Atrial fibrillation (AF) is the most common supraventricular arrhythmia. AF and the complications associated with it interfere with the physical, mental and social well-being of a person, thus affecting the quality of life. An important factor affecting the quality of life of patients with AF is the acceptance of illness (AI). In spite of the large problem related to this subject, the analysis of the relation between the acceptance of illness and the quality of life of patients with AF is insufficient.
The aim of the study was to assess the impact of the acceptance of illness on the quality of life of patients with AF.
Material and methods. 84 patients (including 51 men) aged 57.86 ± 17.72 years hospitalized in the cardiology department due to heart rhythm disorders. Standardized tools were used in the study: Acceptance of Illness Scale (AIS) to assess the acceptance of illness and Arrhythmia-Specific questionnaire In Tachycardia and Arrhythmia (ASTA) to assess quality of life.
Results. The majority of patients were secondary educated (64.27%), lived in a city (78.58%), were inactive (57.15%), were hospitalized 3-5 times (42.85%), had a cardiostimulator (23.80%) or underwent ablation (22.62%) during the last year. The average result of the acceptance of illness was 27.67 ± 7.70. 48.8% of patients had a high level of the acceptance of illness, 38.09% average, and 13.11% did not accept their illness. The mean result of quality of life for the whole studied group was (ASTA III) 25.64 ± 8.64. As regards the severity of symptoms (ASTA II) the mean result was 17.15 ± 5.89. Correlation analysis showed that the higher the level of the acceptance of illness the higher the quality of life (r = 0.640; p = 0.002) and lower the severity of AF symptoms (r=-0.51, p &lt; 0.001).
Conclusions. Patients with AF present a moderate level of disease acceptance and quality of life. The acceptance of illnessis the independent predictor and significantly increases quality of life of patients with AF.
Quality evaluation of patient educational resources for catheter ablation of atrial fibrillation
Authors: Cano Valls A , Gallagher C , Mont LL , Carro E , Sanders P , Hendriks JM 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
The prevalence of atrial fibrillation (AF) is increasing rapidly with growing utilisation of catheter ablation (CA) as a treatment strategy. Education of individuals undertaking this procedure is diverse, with varying degrees of information provided and little standardisation. Many individuals utilise the internet as an educational resource. However, there is limited regulation of online patient information.

Aims
The purpose of this study was to evaluate the quality of web based patient education resources for patients undergoing CA in the management of AF.

Methods
A cross-sectional observational study was performed to obtain all freely accessible online educational resources designed to inform AF patients about CA. from inception until 1st October 2019. Three search engines were used: Google, Yahoo! and Bing, using the search terms "atrial fibrillation" and "catheter ablation" combined with "patient information and patient education" in English and Spanish. The Patient Education Materials Assessment Tool (PEMAT) is a validated tool used to evaluate web-based patient education materials as well as printable tools. The PEMAT score objectively measures the understandability and actionability of printable tools for audio-visual material.

Results
A total of 17 websites and 15 printable tools were included in the analysis. Non-government organizations developed 19% of materials and 75% were created by private or university hospitals. Nineteen materials (59.3%) were rated as highly understandable and 25 materials (21%) were rated as highly actionable, whilst ten materials had an actionability of 0% (6 websites and 4 printable tools). Less than a half of the materials evaluated were highly rated by the PEMAT score, with a total of 7 websites (41%) and 7 printable tools (46,6%) scoring &gt;70%.

Conclusion
The overall understandability of educational CA material was high, whilst improvement of actionability is warranted. The addition of summaries, visual aids and tools such as checklists may improve quality. These findings have significant implications for developing new patient educational material for CA in AF.
Pharmacist-led medicines optimisation clinic for implantable cardiac device patients
Authors: Patel M , Fhadil S , Zemrak F , Wright P , Rochford C , Jones S , Earley M , Antoniou S 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background/Introduction: Cardiac implantable electronic devices (CIED) enhance detection of atrial fibrillation (AF), providing a comprehensive measure of AF burden. Patients with device-detected AF are usually referred for anticoagulation to their local anticoagulation clinic or General Practitioner (GP), which often delays time to initiation, potentially increasing the risk of stroke. In addition, AF is associated with increased risk of cardiovascular disease and mortality. Optimising blood pressure, cholesterol and lifestyle choices can significantly reduce the risk of cardiovascular disease and associated mortality in these patients.

Purpose
To develop and evaluate an innovative pathway to allow Specialist Cardiac Pharmacists to promptly assess and initiate anticoagulation in patients with device-detected AF, and additionally address risk factors for prevention of cardiovascular disease.

Methods
As part of a quality improvement initiative, a pathway was developed where patients with AF identified on CIED who require anticoagulation are referred for assessment and management to a pharmacist-led optimisation clinic. Specialist Cardiac Pharmacists contact patients within 5 days of referral to discuss and initiate or optimise treatment for AF, blood pressure, cholesterol and lifestyle choices. Patients deemed inappropriate for anticoagulation were referred back to the medical team for further assessment. All patients received a follow-up telephone consultation at 4-6 weeks to assess tolerability, adherence and response to treatment.

Results
Between September 2020 and February 2021, 22 patients were referred to the optimisation clinic. Mean age was 74.32 +/- 12.34 years and 77% were men. Mean CHA2DS2VASc was 3.4 +/- 0.8 and mean HASBLED was 1.2 +/- 0.6. The average time from referral to anticoagulation was 3 days compared to 4 weeks prior to implementation of the pathway. All patients were assessed and appropriately anticoagulated, whereas approximately 15% of patients were still not anticoagulated at 3 months prior to implementation of the pathway despite referral to their local clinic. All patients had their blood pressure and cholesterol reviewed, which were optimised in 23% and 41% of patients respectively. All patients confirmed adherence and suffered no adverse effects on follow-up.
Conclusion(s): We report the safe and successful implementation of a pharmacist-led medicines optimisation clinic. This has significantly reduced time to anticoagulation without compromising safety, as well as assuring all patients are appropriately anticoagulated. In addition, over half of patients required blood pressure and/or cholesterol optimisation to reduce the risk of cardiovascular disease, a service not previously provided for this cohort of patients.
Kidney function decline in heart failure patients: an audit of out-patient heart failure services
Authors: Lehane M , Connolly S , Crowley M , Hart C , O"flynn AM 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
A bidirectional relationship exists between the kidney and the heart; the lower the eGFR the more challenging it is to manage the heart failure (HF) patient. Worsening renal function is common in HF patients and associated with a two-fold increase in mortality and a lower likelihood of being prescribed efficacious HF therapy. The role of cardio-renal interactions in HF is essential to identify risk and subsequent treatment strategies.

Purpose
The purpose of this audit is to provide insights into the assessment of renal function in a real world heart failure population by identifying the degree of renal dysfunction and changes in renal function over a five year time frame.

Methods
A retrospective audit included patients with HFrEF attending a heart failure service. These patients were classified using KIDGO criteria CKD 1-5. A current eGFR sample was compared with a sample taken five years earlier, identified using the electronic laboratory record. Ethical approval was granted from the Research Ethics Committee.

Resultss
100 patients with HFrEF attending a heart failure service fulfilled the selection criteria of which sixty three patients with an eGFR &gt;60ml/min/1.73 m2 were audited. Of this group 43 were CKD class 2 and 20 were CKD class 1. Thirty seven patients had an eGFR &lt;60ml/min/1.73 m2 of which 9 were class 3b, 9 were CKD class 4 and 1 was CKD Class 5.
Of the 100 patients enrolled, 6 were excluded from the analysis of kidney function decline as an eGFR from five years earlier was unavailable. Within a five year time span, 44 patients did not change their CKD class, 31 patients declined by one class, 9 patients declined by two classes, 3 patients declined by three classes and 7 patients improved their kidney function.
GFR &lt; 60mL/min/1.73m2,
n = 37
GFR &gt; 60mL/min/1.73m2, n = 63
Age – mean (range)
77.8 (49-94)
66.5 (45-89)
Gender – female (%)
12 (32%)
16 (25%)
Average renal function measurements (mean, range)
6.4
6.7

Total albumin
creatinine ratio measurements
8
6
Actively attending renal service
6
0

Conclusion
Nurses should be aware of the increasing risk conferred by the dual diagnosis of heart failure and chronic kidney disease. Patients with heart failure who have decreasing eGFR levels (especially less than 30 mL/min), should have collaborative management with nephrology services to optimise outcomes. Recognition of CKD in our institution and referral to nephrology services was suboptimal and further work is necessary to optimise the management of these patients.
Somatic changes experienced by patients with heart failure during acute exacerbation: A qualitative text mining analysis
Authors: Okada AKIKO , Tsuchihashi-Makaya MIYUKI , Ochiai RYOTA 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Ministry of education

Background
In patients with heart failure (HF), symptom perception’ is a self-care requirement for effective disease management. However, previous studies have reported that these patients have inadequate symptom perception. When patients experience somatic changes, they generally interpret these as symptoms, which can cause them to adopt coping behaviours. To improve symptom perception, it is important that health care providers understand the somatic changes experienced during an acute HF exacerbation based on patients’ representation of symptoms, rather than clinical symptom names.

Purpose
This study aimed to clarify the comprehensive picture of somatic changes experienced by patients with HF during acute exacerbations by analysing the expressions they use to describe these changes.

Methods
In semi-structured interviews, 21 patients with HF hospitalised due to acute exacerbation were asked to use their own words to describe any somatic change they perceived before hospitalisation. A three-step text mining process was used to analyse the expressions patients used to describe these changes. First, the frequency of use was calculated for the terms used to describe somatic changes. Next, the extracted words were classified into clusters based on concatenation between words. Finally, cluster names were assigned using patient expressions.

Results
The sample was 76.2% male, and the mean patient age was 71.3 ± 13.7 years. Of the 21 patients, 52.4% had a history of hospitalisation. The interviews generated 59 pages of data. Analysis indicated that 472 terms were related to somatic changes. The most frequently used terms were ‘breath’ (46 times), ‘painful’ (40 times), ‘foot’ (29 times), ‘ha-ha’ (the sound of gasping; 28 times) and ‘walking’ (25 times).
The somatic changes experienced by patients were classified into 10 clusters based on concatenation between words. The cluster names were ‘shortness of breath when moving’, ‘not being able to walk the distances one normally walks without a rest’, ‘not being able to sleep at night because of difficulty breathing’, ‘increased frequency of urination at night’, ‘swollen and tense legs’, ‘socks leave marks in legs’, ‘projecting abdomen and tighter pants’, ‘fatigue while moving’, ‘increased phlegm and a feeling of discomfort in the throat’, and ‘a vague feeling of being unwell’.

Conclusions
Instead of employing symptom names used by medical professionals, patients described their perceived somatic changes in diverse ways using various expressions, such as mimetic words and metaphorical expressions. Moreover, some patients described vague physical changes that could not be classified with corresponding symptom names. These findings indicate that the symptoms patients experience during an acute exacerbation cannot always be categorised using clinical symptom names.
Incidence and impact of acute cardiorenal syndrome
Authors: Mantis C , Vasiliadis I , Anadiotis A , Papadakis E , Patsilinakos S 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Acute (or type 1) cardio-renal syndrome (ACRS) is defined as the acute kidney injury in patients hospitalized for acute heart failure (HF), which often is associated to a complex and complicated clinical course. In addition, renal failure is a strong predictor of long-term adverse events in patients with acute heart failure (HF).

Purpose
To investigate the impact of ACRS, what factors are related to its occurrence, and how it affects the outcome of patients hospitalized with acute HF.

Methods
We studied consecutive patients hospitalized with acute HF from January 2019 to December 2020. Renal function as well as other biomarkers were recorded and monitored during hospitalization, and correlated with various clinical characteristics, risk factors and patient outcome.

Results
The sample consists of 612 patients, mean age 77 ± 12 years, 63% men with average duration of hospitalization 6 ± 4 days. A total of 37 deaths (6%) were observed. ACRS was found in 141 patients (23%) and independent prognostic factors for its occurrence were ischemic cardiomyopathy, age, prolonged hospitalization, use of aldosterone antagonists and high CRP upon admission. The incidence of ACRS during hospitalization was an independent prognostic factor of death (r = 0.15, p = 0.02) and anemia (r = 0.24, p = 0.04), while the outcome of death was more common in patients with ACRS - but without statistical significance - compared to patients without ACRS.

Conclusion
Deterioration of renal function in acute HF is associated with anemia and death. Factors such as ischemic cardiomyopathy, age, length of hospital stay seem to play a role in the onset of ACRS and should be taken into account in these patients, to prevent negative outcomes.