bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with successful return to work in young heart failure and ischaemic heart disease patients following index hospital admission
Authors: Thakkar HV , Hollingsworth L , Enright JA , Sanderson S , Macfadyen RJ , Dwyer N 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Factors influencing return to remunerated work following an acute cardiac illness are poorly defined. We wished to compare the factors in our cohorts following first presentation of acute coronary syndrome(ACS) and decompensated heart failure(HF).

Methods
Prospectively identified subjects, aged 18-65years, from a rehabilitation population for ACS and HF during 2018-2019 underwent a survey.

Results
Of 133cases meeting inclusion criteria, 84 completed the survey(41 HF, 80% male, mean age 55years; 43 ACS, 86% male, mean age 57years). Socio-economic indexes for Areas(SIEFA) index were similar for HF(900) & ACS(909) groups, which represents 11th and 14th percentile for Australia respectively. Cardiovascular risk factors were similar except hypercholesterolemia(37% v 60%; p = 0.029) was more common in ACS. Many subjects did not continue beyond Yr12, (54% HF v 30% ACS; p = 0.029). A majority of ACS cases returned to work as compared with HF(70% v 44%; p = 0.017)(Figure). On multivariate analysis, male gender[p = 0.031;OR 13.71 (1.28-147.36)]; access to financial benefits[p &lt; 0.001;OR 22.75 (4.31-119.99)] and a desire to return to work [p = 0.014;OR 12.1 (1.67-87.82)] were associated with successful return to work (Table).

Limitations
Our study has small numbers so will be difficult to generalise to a wider population. We do show a signal towards the complex interplay of the social and individual factors in determining return to work. Further larger studies are required to tease out the differences between the individual factors to help predict return to work in the Australian context.

Conclusion
Successful return to work for patients with first presentation of ACS or HF could not be reliably predicted. Patients with ACS returned to work more often than HF. In HF patients who do n to return to work, recurrent symptoms, individual motivation, social support and access to financial benefits have a complex interplay.
Predictors of return to work Predictor P value OR (95% CI) Diagnosis (heart failure) 0.095 0.29 (0.07, 1.24) Gender (male) 0.031 13.71 (1.28, 147.36) Access to benefit (none) &lt;0.001 22.75 (4.31, 119.99) Desire to RTW (yes) 0.014 12.1 (1.67, 87.82)
Abstract Figure. Rates of return to work in the 2 groups
Coping strategies for stress in medical students with type D personality
Authors: Sumin A , Shcheglova AV , Prokashko IUY 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Aim. To study the choice of coping strategies and coping adequacy in medical students with type D personality.
Material and methods. The study included 98 participants - 68 women and 30 men, studying at the General Medicine Faculty (Kemerovo State Medical University), aged 18 to 23 years (mean age 19.1 ± 2.0 years). All participants completed psychological questionnaires to identify predisposition to psychological distress and choice of coping strategies.
Results. All subjects (n = 98) were divided into two groups: subjects with type D personality (n = 44) and subjects without type D personality (n = 54). Type D personality in men was detected in 20.4%, in women in 79.6% (p = 0.03). In students with type D, the average scores on the negative affectivity (NA) and social inhibition (SI) scales were higher (16.0 and 13.5 points) than in students without type D (6.5 and 9.0 points), (p &lt; 0.001 in both cases). Subjects with type D had higher scores on the "Escape-avoidance" (p &lt; 0.001), "Accepting responsibility" (p = 0.009) and "Distancing" (p = 0.05) scales of the Ways of Coping Questionnaire (WSQ) and "Avoidance" (p = 0.007) scale of the Central Sensitisation Inventory (CSI) questionnaire. The indicator of coping strategies showed a very low level of use of avoidance strategies: with type D - 9.09%, without type D - 31.48% (p = 0.007). Students with type D had a pronounced preference for the "Escape-avoidance" strategy of 75.0% (p = 0.000018). According to univariate logistic regression analysis, an increase of 1 point in the values on the "Escape-avoidance" scale increased the chance of identifying type D by 1.15 times (95% CI 1.07-1.23; p &lt; 0.001). On the contrary, an increase in the score on the "Positive Reappraisal" scale reduced the probability of identifying type D personality (OR 0.98; 95% CI 0.86-0.98; p = 0.005). Receiver operating characteristic (ROC) analysis showed that the identified association between the "Escape-avoidance" strategy and type D personality has high values (AUC = 0.779; 95% CI 0.688-0.870).
Conclusion. Predominance of inadequate of coping strategies, such as "Escape-avoidance" and "Avoidance", was found in healthy medical students with type D personality. According to logistic regression analysis, the independent strategy associated with type D personality is the "Escape-avoidance" and without type D - "Positive Reappraisal".
Feasibility of hybrid telerehabilitation as component of a novel comprehensive care program after acute myocardial infarction in a one-year follow-up preliminary experience of a single center
Authors: Piotrowicz E , Orzechowski P , Kowalik I , Piotrowicz R 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): National Health Fund
Background. A novel comprehensive care program after acute myocardial infarction (AMI) „KOS-zawał" was implemented in Poland. It includes acute intervention, complex revascularization, implantation of cardiovascular electronic devices (in case of indications), rehabilitation or hybrid telerehabilitation (HTR) and scheduled outpatient follow-up. HTR is a unique component of this program.
The purpose of the pilot study was to evaluate a feasibility, safety and patients’ acceptance of HTR as component of a novel care program after AMI and to assess mortality in a one-year follow-up.

Methods
The study included 55 patients (LVEF 55.6 ± 6.8%; aged 57.5 ± 10.5 years). Patients underwent a 5-week HTR based on Nordic walking, consisting of an initial stage (1 week) conducted within an outpatient center and a basic stage (4-week) home-based telerehabilitation five times weekly. HTR was telemonitored with a device adjusted to register electrocardiogram (ECG) recording and to transmit data via mobile phone network to the monitoring center. The moments of automatic ECG registration were pre-set and coordinated with exercise training. The influence on physical capacity was assessed by comparing changes in functional capacity (METs) from the beginning and the end of HTR. Patients filled in a questionnaire in order to assess their acceptance of HTR at the end of telerehabilitation.

Results
HTR resulted in a significant improvement in functional capacity and workload duration in exercise test (Table). Safety: there were neither deaths nor adverse events during HTR. Patients accepted HTR, including the need for interactive everyday collaboration with the monitoring center.

Prognosis
all patients survived in a one-year follow-up.

Conclusions
Hybrid telerehabilitation is a feasible, safe form of rehabilitation, well accepted by patients. There were no deaths in a one-year follow-up.
Outcomes before and after HTR Before telerehabilitation After telerehabilitation P Exercise time [s] 381.5 ± 92.0 513.7 ± 120.2 &lt;0.001 Maximal workload [MET] 7.9 ± 1.8 10.1 ± 2.3 &lt;0.001 Heart rate rest [bpm] 68.6 ± 12.0 66.6 ± 10.9 0.123 Heart rate max effort [bpm] 119.7 ± 15.9 131.0 ± 20.1 &lt;0.001 SBP rest [mmHg] 115.6 ± 14.8 117.7 ± 13.8 0.295 DBP rest [mmHg] 74.3 ± 9.2 76.2 ± 7.3 0.079 SBP max effort [mm Hg] 159.5 ± 25.7 170.7 ± 25.5 0.003 DBP max effort [mm Hg] 84.5 ± 9.2 87.2 ± 9.3 0.043 SBP systolic blood pressure, DBP diastolic blood pressure.
Hybrid cardiac rehabilitation program as a potential enhancer of adherence to cardiac rehabilitation in smoking patients with coronary heart disease - a retrospective single-centre analysis
Authors: Cabral M , Santos R , Januario F , Antunes A , Fonseca-Pinto R 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Cardiac rehabilitation (CR) has well known beneficial effects on physical capacity, health-related quality of life, morbidity and mortality following an acute cardiac event. It is also known that smoking status is a powerful predictor of recurrent cardiovascular disease events. However, it has been noted that smoker patients may be less likely to access or complete CR.
The aim of this study was to determine the levels of anxiety and depression and its improvement, depending on the smoking status of patients with coronary artery disease (CAD) on phase 2 of the Cardiac Rehabilitation Program (CRP). Additionally, we intend to investigate the mental health impact on smoker patients" group in conventional CR versus telemonitored CR.
A retrospective study was conducted and patients in CRP between 2017 and 2020 were included. Patient selection and information collection were obtained through medical records. The outcomes of anxiety and depression were evaluated through the Hospital Anxiety and Depression Scale (HADS). Patients were divided into two groups: group 1 for non-smokers or ex-smokers and group 2 for smokers. For group 2 patients, a sub-analysis was performed for patients following the conventional CR versus the telemonitored CR, with the use of MOVIDA mobile application. Variables were analysed in the beginning (T0) and in the end (T1) of phase 2, around 3 months after. Group comparisons tests and statistical analysis were performed using SPSS software v25.0. A p-value less than 0.05 is statistically significant.
We analysed 107 patients, which 93 of these were assiduous and 69 concluded the phase 2 of CRP: 39 patients in group 1 and 30 patients in group 2. Two groups have similar baseline characteristics, except for the higher presence of diabetes (p = 0.02) in group 1. It was noted an improvement in both anxiety and depression items for group 1 (p &lt; 0.01 for both), but only for anxiety item for group 2 (p = 0.03). In subgroup analysis, we observed no improvement for smoking patients following the conventional CR for both anxiety and depression items (p = 0.60 and p = 0.71, respectably) versus a significant difference in telemonitored CR patients (p = 0.02 and p = 0.04).
We hypothesise that, when compared to conventional CR, cardiac telemonitored exercise using modern communication methods may result in an improved mental health state among smoking patients, which can lead to a better adherence for CRP. Further studies including more patients and phase 3 of CRP are needed to confirm these results.
The impact of different preventive counseling programs on medication adherence in patients with paroxysmal atrial fibrillation after catheter ablation
Authors: Pogosova N , Ovchinnikova AI , Yufereva YM , Sokolova OY , Davtyan KV , Ausheva AK 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Poor medication adherence is a major contributor to suboptimal health outcomes and increased costs in cardiovascular (CV) diseases including atrial fibrillation (AF).

Purpose
To assess the impact of different preventive counseling programs on medication adherence in AF patients (pts) after catheter ablation (CA).

Methods
A prospective randomized controlled study with 3 parallel groups of pts with paroxysmal AF after CA (radiofrequency or cryoablation). Pts were randomized (1:1:1) into 3 groups. Before discharge, pts from all groups received 1 preventive counseling session with focus on their individual risk factors profile. After discharge both intervention groups received 6 sessions of biweekly remote preventive counseling by phone (Group 1) or via email(Group 2) for 3 months after enrollment. Group 3 received usual care. Medication adherence was assessed using the 4-item Morisky-Green scale at baseline and at 12 months.

Results
A total of 135 pts aged 35 to 80 years were enrolled (mean age, 57.3 ± 9.1 years, men, 51.8%). The groups were well balanced according to demographic and clinical features. Baseline levels of non-adherenсe and partial adherence were high in all groups (53.4%, 71.1% and 73.3% respectively). At 1 year of follow-up pts from both intervention groups demonstrated a significant improvement of medication adherence vs control (table).

Conclusions
Preventive counseling programs with remote support via phone or e-mail improve medication adherence in AF pts after CA.
Мedication adherence 1 group (support via phone) 2 group (support via e-mail) Control group P for Group 1 vs. control at 12 months P for Group 2 vs. control at 12 months Baseline After 12 months Baseline After 12 months Baseline After 12 months Adherence,% 46.7 60 28.9 60 26.7 31.1 &lt;0.01 &lt;0.01 Partial adherence ,% 17.8 20 31.1 20 24.4 33.3 n/s n/s Non-adherence,% 35.6 60 40 20 48.9 35.6 n/s n/s
Evaluation of basic life support education for high school students in a city in brazil
Authors: Coutinho Cordeiro J , Oliveira De Deus M , Sousa Pinheiro S , Aparecida De Sousa Pereira L , Souto Lucio De Oliveira MC 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): The researchers themselves.

Background
Cardiorespiratory Arrest (CRP) is a medical emergency that requires urgent aid as well as technical skills to initiate Cardiopulmonary Resuscitation (CPR) maneuvers, primarily among the lay population, seeing as the majority of CRP episodes take place in community environments. Purpose: The purpose of this study is to compare the Basic Life Support (BLS) skills of high school students before and after a theoretical-practical approach. Method: A quasi-experimental study was conducted, consisting of theoretical-practical training on BLS running 60 minutes total (20 minutes of theory and 40 minutes of practice), addressing various steps in layman’s out-of-hospital BLS. Evaluations were conducted before and after training. The instrument was developed by the researchers themselves and underwent a previous validation process. The statistical software employed for the purpose of analyzing the data was SPSS version 21.0 for Windows. At the outset, descriptive statistics were employed to present the data, as well as the Wilcoxon test to compare the results of questionnaires taken before and after the intervention. Results: The sample consisted of 322 students from private institutions in Belo Horizonte, Brazil. The median age was 16.0 years, with an interquartile interval (IQ) of 2 years, with 181 (56.2%) students being female and 141 (43.8%) male. The before and after results revealed statistically significant differences in performance: pre-training – median = 5 points, IQ = 2 points; post training – 9 points, IQ = 2 points; p &lt; 0.0001. Conclusion: The conduction of theoretical-practical classes was followed by an increase in correct answers to the BLS questionnaire. The results suggest that simple educational strategies might aid in the training of lay young people to respond correctly to CRP scenarios.
The acute effects of an ultramarathon on biventricular function and ventricular arrhythmias in master athletes
Authors: Cavigli L , Zorzi A , Spadotto V , Gismondi A , Sisti N , Valentini F , Anselmi F , Mandoli GE , Spera L , Di Florio A , Baccani B , Cameli M , D"ascenzi F 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background. Endurance sports practice has significantly increased over the last decades, with a growing proportion of participants older than 40 years. Although the benefits of moderate regular exercise are well known, concerns exist regarding the potential negative effects induced by extreme endurance sport. The aim of this study was to analyze the acute effects of an ultramarathon race on the ECG, biventricular function and ventricular arrhythmias in a population of master athletes.
Methods. Master athletes participating in an ultramarathon (50 km, 600 meters of elevation gain) with no history of heart disease were recruited. A single-lead ECG was recorded continuously from the day before to the end of the race. Echocardiography and 12-lead resting ECG were performed before and at the end of the race.
Results. The study sample consisted of 68 healthy non-professional master athletes. Compared with baseline, R-wave amplitude in V1 and QTc duration were higher after the race (p &lt; 0.001). Exercise-induced isolated premature ventricular beats were observed in 7% of athletes; none showed non-sustained ventricular tachycardia before or during the race. Left ventricular ejection fraction, global longitudinal strain (GLS) and twisting did not significantly differ before and after the race. After the race, no significant differences were found in right ventricular inflow and outflow tract dimensions, fractional area change, s’ and GLS.
Conclusions. In master endurance athletes running an ultra-marathon, exercise-induced ventricular dysfunction or relevant ventricular arrhythmias were not detected. These results did not confirm the hypothesis of a detrimental acute effect of strenuous exercise on the heart.
Abstract Figure.
High disease activity is associated with higher blood pressure in recent onset rheumatoid arthritis patients, post-hoc analyses of IMPROVED study
Authors: Gegenava M , Bergstra SA , Maassen H , Allaart CF 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Rheumatoid arthritis (RA) is a chronic autoimmune disease with a high prevalence of cardiovascular morbidity and mortality. Purpose: purpose of our project was to investigate the association between disease activity and systolic and diastolic blood pressure (SBP, DBP) in patients with recent-onset rheumatoid arthritis (RA 2010 criteria) or undifferentiated arthritis (UA) who were treated to target disease activity score (DAS)&lt;1.6 in the IMPROVED study. Methods: The associations between disease activity and SBP/DBP were tested for 610 patients (364 RA, 246 UA), cross-sectionally and over time. GEE analyses were performed with both SBP and DBP as outcome measures and disease activity categories (DAS&lt;1.6;&gt;1.6 but ≤2.4; &gt;2.4), CRP level, treatment arms or the number of visits on a certain drug as potential predictors in separate analyses. Separate analyses tested potential contributions of gender, anti-cyclic citrullinated peptide antibodies (ACPA) status, and fulfilling the 2010 ACR/EULAR (American college of rheumatology/ European league against rheumatism) classification criteria. In addition association of BP with various levels of disease activity was tested with T-test. Results: At the baseline mean (SD) SBP was 133 (20) and DBP mean (SD) was 80 (10). SBP &gt; 140mm Hg was observed in 40% of patients and DBP &gt; 90 mm Hg in 21% of patients. SBP and DBP statistically significantly decreased during 5 years follow up (mainly during year 1), but the difference in mm Hg was small. Estimates from GEE analysis showed that patients with high DAS &gt;2.4 (HDAS) had a statistically significantly higher SBP (average 3 mm Hg higher, 95% CI 1.7; 4.2, p &lt; 0.01), than the patients in with DAS ≤2.4. ANOVA analyses showed a statistically significant association between SBP and DAS. In addition, post hoc analyses showed that patients with HDAS had a statistically significantly higher SBP (mean (SD) 132 (19) than the patients with DAS &lt; 1.6 (remission) (mean (SD) 129 (20), p &lt; 0.01), and patients in LDAS but DAS≥1.6 had a statistically significantly higher SBP (mean (SD) 131 (19) than the patients in remission (mean (SD) 129 (20), p = 0.02) (Figure 1), whereas no association was found between DAS category and DBP. Gender, ACPA status or fulfilling the 2010 classification criteria did not influence the relation between DAS and blood pressure. Conclusions: In patients with RA or UA, a higher DAS is associated with higher blood pressure, but the clinical impact is unclear.
Abstract Figure 1
Willingness of non-participants of conventional cardiac rehabilitation to participate in cardiac telerehabilitation: results of semi-structured interviews
Authors: Falter M , Scherrenberg M , Kaihara T , Intan-Goey V , Dendale P 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Introduction
Cardiac rehabilitation (CR) is considered a Class IA recommendation in secondary prevention of ischemic heart disease and heart failure. Participation rates are low however. Telerehabilitation (TR) is widely studied to overcome known barriers. However, the willingness of patients that refuse centre-based CR to participate in TR is scarcely studied. This study aims to assess the willingness to participate in TR in patients that refuse conventional centre-based CR, as well as the main barriers to participation in CR and TR.
Methods
Patients were screened during hospitalisation on the cardiology, cardiac surgery and cardiac intensive care departments. Patients that were eligible for CR but refused to participate were asked to participate in the study. A semi-structured interview consisting of 18 questions was performed during hospitalisation. After signing an informed consent, interviews were conducted, recorded and analysed. Additional data was extracted and analysed from the hospital electronic health records.
Results
A total of 20 patients were included. Mean age was 69.6 years (± 10), 17 patients were male (85%), cardiac pathologies were ischemic heart disease (10), heart failure (5) and arrhythmia (5). Six patients (30%) owned a smartphone. Primary reasons not to participate in conventional CR were transport issues (7), lack of motivation (5), cost (3), already being physically active at home (2), or other reasons (3).
Eight patients (40%) indicated that, if a programme existed, they would participate in a TR programme.
In the group of patients that would not want to participate in TR (n = 12), 10 said lack of digital literacy was a reason, 9 said not having the needed technology (either a computer, a smartphone or both) was a reason. Five said that lack of motivation was a reason and 3 didn’t see the utility of doing rehabilitation at home or rehabilitation at all. The most important reason not to participate was a lack of digital literacy in 6 patients, and a lack of motivation or not seeing the utility of rehabilitation in 6 patients.
In the group of patients that would participate in TR, all 8 said that not needing transport was an advantage, 2 indicated that being able to perform rehabilitation on flexible hours was an advantage. All 8 indicated that not needing transport was the main advantage of TR for them. The most important barrier for this group was not being fluent with computers and/or smartphone (3).
Conclusions
Of a group of patients not willing to participate in conventional CR, 40% would be prepared to participate in TR. Lack of digital literacy and lack of motivation were the main reasons not to participate in TR. Not needing transport was seen as the main advantage of TR. Further research in larger populations will be needed to confirm these results.