bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers to cardiac rehabilitation: a first national survey
Authors: Farah R , Groot W G , Pavlova M P 
Published: October 2021

Abstract

Introduction
Cardiovascular diseases (CVD) are among the leading causes of morbidity and mortality worldwide. Over three quarters of the cardiovascular deaths take place in low-and middle-income countries. CVD represent half of all death in the country. Despite the benefits and clinical recommendations from ESC/AHA and WHO, Cardiac Rehabilitation (CR) is still not routinely and not universally available. Numerous studies have found that barriers to access to CR are correlated with providers, patients and environment characteristics.

Purpose
This first national survey on CR assesses and identifies what the main barriers to access to CR are. In addition, this study provides suggestions for the implementation of CR in the country. This study takes into consideration the recommendations of cardiologists and cardiac surgeons for further expansion of CR practice. Until 2018, no local comprehensive CR program had been realised. Nevertheless, secondary cardiovascular preventive programs such as CR are not a priority.

Methods
A quantitative cross-sectional study design was adopted using a structured, self-administrated questionnaire. The survey was conducted in December 2018 among cardiologists and cardiac surgeons. A 25item questionnaire was used to collect information on CR. Responses were analysed using descriptive statistics SPSS software (version 24).

Results
The respondents' rate was 41.5% (n=83). 77.7% of Physicians will face barriers to refer patients to a CR program. The top 3 barriers are: first “the lack of specialist”, second barrier to overcome is “the lack of patient motivation” and third “financial covering of CR”. Supplementary learning about the benefits of CR is highly recommended to enrol more patients with CVD. CR need to be covered by a insurances and government policies above all during this time of pandemic.

Conclusions
The role of physicians in promoting patient enrolment should be optimised and exploited in the country. The access barriers identified can help to develop CR programs and to improve CR referral and enrolment rates. Funds from private parties and a budget from the government are needed to launch new CR programs in the country. Further research is needed.

Funding Acknowledgement
Type of funding sources: None.
Associations of the ITGB3 gene rs5918T&gt;C and the APOA1 gene rs1799837C&gt;T markers with serum lipid metabolism in coronary artery disease patients
Authors: Conkbayir C , Ergoren M , Cobanogullari H , Balcioglu O , Abras I , Eminsel T , Oztas D , Ugurlucan M , Temel S 
Published: October 2021

Abstract

Aim
The relationship between hypercholesterolemia, particularly elevated low density lipoprotein-cholesterol (LDL-C) levels and coronary artery disease is recognized by the evidence from previous epidemiologic studies. Importantly, genetic polymorphisms on different genes have been reported to be associated with plasma lipid levels. In this particular study, we aimed to investigate the relationship between the ITGB3 gene rs5918 T&gt;C and APO-A1 gene rs1799837 C&gt;T markers and serum lipid metabolism.

Patients and methods
A total of 100 subjects with CAD and 250 healthy subjects were involved in the current study. A basic biochemical analysis, including serum glucose, total serum cholesterol, HDL-C, LDL-C and triglycerides, was performed for each participant. Genotyping for the ITGB3 gene and APO-A1 gene polymorphisms was performed by polymerase chain reaction followed by restriction fragment length polymorphism (RFLP) analysis.

Results
With respect to the genotype and allele distributions of ITGB3 rs5918 T&gt;C polymorphism, the frequency of the C allele was higher in the coronary artery disease (CAD) group compare to control group (p=0.001). Moreover, there was a statistically significant association detected between ITGB3 rs5918 CC genotype and serum total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) (p=0.0006, p=0.016 respectively) in CAD group. However there was no statistically significant association was identified between the APOA1 rs1799837 C&gt;T polymorphism and biochemical parameters in control and CAD group.

Conclusion
The results demonstrated that rs5918 T&gt;C variant within the ITGB3 gene might have a clinical importance as a genetic marker which increases the susceptibility to CAD. Therefore, the ITGB3 gene rs5918 C allele may be offered as a screening option for CAD in Turkish Cypriot population who come in for medical check-up.

Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Near East University
Transcriptional profiles of genes related to electrophysiological function in scn5a+/− murine hearts
Authors: Takla M , Edling C E , Zhang K , Saadeh K , Tse G , Salvage S C , Huang C L H , Jeevaratnam K 
Published: October 2021

Abstract

Background
The Scn5a gene encodes the major pore-forming Nav1.5 (α) subunit, of the voltage-gated Na+ channel in cardiomyocytes. The key role of Nav1.5 in action potential initiation and propagation in both atria and ventricles predisposes organisms lacking Scn5a or carrying Scn5a mutations to cardiac arrhythmogenesis. Loss-of-function Nav1.5 genetic abnormalities account for many cases of the human arrhythmic disorder Brugada Syndrome (BrS) and related conduction disorders. A murine model with a heterozygous Scn5a deletion recapitulates many electrophysiological phenotypes of BrS.

Purpose
This study examines relationships between its Scn5a+/− genotype, resulting transcriptional changes and the consequent phenotypic presentations of BrS.

Methods
Atrial and ventricular tissue samples were obtained from aged (11±3 months) wild-type (WT) and homozygous Scn5a+/− mice. Quantitative PCR was used to examine transcription of 60 genes underlying cardiac tissue excitability.

Results
Of selected protein-coding genes related to cardiomyocyte electrophysiological or homeostatic function, concentrations of mRNA transcribed from 15 differed significantly from WT. Despite halved apparent ventricular Scn5a transcription heterozygous deletion did not significantly downregulate its atrial expression, raising possibilities of atria-specific feedback mechanisms. Most of the remaining 14 genes whose expression differed significantly between WT and Scn5a+/− animals involved Ca2+homeostasis specifically in atrial tissue, with no overlap with any ventricular changes. All significant differences shown by the atria and ventricles were up- and downregulations, respectively.

Conclusion
This investigation demonstrates the value of future experiments exploring for and clarifying links between transcriptional control of Scn5a and of genes whose protein products coordinate Ca2+ regulation and examining their possible roles in BrS.

Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): University of Surrey; Medical Research Council
Time and frequency domain analysis of long-term heart rate variability in an experimental model of diet-induced metabolic syndrome
Authors: Lozano W M , Arias-Mutis O J , Calvo C J , Bizy A , Such-Miquel L , Chorro F J , Zhao J , Alberola A , Zarzoso M 
Published: October 2021

Abstract

Background
Metabolic syndrome (MetS) is defined as the set of at least three of the following conditions: central obesity, elevation of triglycerides, decreased in high-density lipoproteins, systemic hypertension and glucose intolerance. MetS is linked with a high prevalence of cardiovascular disease, including sudden cardiac death and atrial arrhythmias, which may be a consequence of changes related to the structure, function and autonomic control of the heart. One of the underlying mechanisms responsible could be the alteration of sinus node automaticity. Heart rate variability (HRV) analysis is a useful non-invasive tool for evaluating alterations in neural control of cardiac automaticity.

Purpose
To examine the changes in long-term HRV using time- and frequency- domain analyses in an experimental model of diet-induced MetS which develops all its components.

Methods
Male NZW rabbits were randomly assigned to control (n=10) or MetS group (n=10), fed with high-fat (10% coconut oil and 5% lard) and high sucrose (15% dissolved in water) diet during 28 weeks. At week 28, 24 hour ECG recording was performed (eMotion Faros 180, Mega Electronics®, 1 kHz). We analyzed 60 minutes of RR time series, comparing day (from 8:00 to 19:59 h) and night (from 20:00 to 7:59 h), and quantified the standard parameters of time and frequency domains: 1) Time domain: RR, SDNN, triangular index (Ti), RMSSD and TINN; 2) Frequency domain: very low (VLF), low (LF), high frequency (HF), and LF/HF index. Multivariate analysis of variance (MANOVA, factorial model) was used for statistical analysis (p&lt;0.05).

Results
Time domain analysis showed a decrease in RR interval (p&lt;0.001) and geometrical Ti (p=0.036) in MetS animals (Figure, A-B), indicative of an increased heart rate. The rest of parameters in the time domain (SDNN, RMSSD, TINN) were not modified. Further, in the frequency domain at FFT spectrum, we did find a significant decrease in the LF band (p=0.032) in MetS animals (Figure, C). The rest of the frequency domain parameters (VLF, HF and LF/HF index) remained unchanged.

Conclusion
MetS decreased RR interval duration and triangular index, suggesting an increased sympathetic activity during day and night. Those changes were reflected in LF modifications, and might be attributable to a deficiency in sympathetic-parasympathetic control, which requires adjustments to maintain normal autonomic balance. Collectively, these results could give insight into the autonomic mechanisms that underlie increased atrial arrhythmia susceptibility in MetS.

Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Generalitat Valenciana, University of Valencia
Light-controllable recellularized ventricular and atrial tissues
Authors: Ghiringhelli M , Gruber A , Abboud Y , Shiti A , Ballan N , Huber I , Arbel G , Gepstein L 
Published: October 2021

Abstract

Introduction
Construction of three-dimensional ventricular and atrial patches using decellularized extracellular matrix could allow the creation of “organ-like” structures for disease modeling, drug testing and regenerative medicine applications. To engineer functional artificial anatomical hearts several obstacles need to be overcome including generation of chamber-specific cells, prevention of immune reaction and donor/host tissue electrical coupling.

Purpose
In order to tackle these challenges we aimed to combine human induced pluripotent stem cell (hiPSC) technology, developmental biology inspired differentiation system to generate chamber-specific cardiomyocytes, decellularization/recellularization processes, and optogenetics utilizing light-sensitive ion channels to generate light-controllable atrial/ventricular tissue engineered patches.

Material and method
Atrial and ventricular patches of adult rats were decellularized using 1% SDS, 3% triton-X. The decellularized scaffolds were then recellularized with hiPSC- derived cardiomyocytes (2x107 atrial or ventricular cells). Adenoviral transduction was used to express the light-sensitive cationic channel ChR2 in the tissue engineered constructs.

Results and discussion
Eight days after cell seeding, we observed the development of spontaneous contraction of the atrial/ventricular tissues. Immunostaining for atrial (Cx40) or ventricular (MLC-2V) markers, gene expression, action-potential morphology, and the response to chamber-specific pharmacology confirmed the atrial/ventricular specific identity of the patches. Histological examination confirmed the preservation of the macro/micro- atrial/ventricular anatomical features in the generated chamber-specific recellularized patches. Optical mapping, using an EM-CCD camera, was used to characterize the conduction and repolarization properties of the generated tissues. The engineered patches could be paced and their electrical activity controlled by either electrical or optogenetic stimulation. Finally, arrhythmogenic reentrant arrhythmias could be induced in the tissue models and terminated by using optogenetic stimulation (“optogenetic-defibrillation”).

Conclusions
Three-dimensional light-sensitive chamber-specific engineered heart patches could be generated that could be controlled and manipulated through electrical and light pacing. These tissue could be used for several pathophysiological, drug testing, disease modeling and regenerative medicine applications.

Funding Acknowledgement
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): H2020-ERC-COG
Quercetin enhances the efficacy of telmisartan in myocardial ischaemia/reperfusion injury in rats
Authors: Ahmed L , El-Mokadem B , Khattab M , El-Abhar H 
Published: October 2021

Abstract

Background
The clinical outcome of myocardial ischaemia/reperfusion (I/R) injury is still unpredictable and detrimental despite the use of several agents including renin-angiotensin system inhibitors. Quercetin (QN), one of the most prevalent flavonoids, has attracted great attention in the recent years due to its protective role against I/R injury. Interestingly, a recent experimental study showed an important role for β-catenin in the regulation of myocardial I/R injury following heterotopic heart transplantation.

Purpose
The present investigation was directed to estimate the role GSK-3β/β-catenin signaling as a possible mechanistic pathway, through which QN could modulate the therapeutic effect of telmisartan (Tel) in myocardial I/R injury in rats.

Methods
Myocardial I/R was induced by ligation of the left descending coronary artery for 30 min followed by reperfusion for 2 h. Rats were pretreated with Tel (12 mg/kg/day, po), QN (25 mg/kg/day) or a combination of both agents for 3 days before the experiment. Electrocardiographic abnormalities were assessed at the end of ischemic and reperfusion periods. Animals were then sacrificed to assess the cardiac injury surrogate markers; viz., serum CK-MB and cTn-I levels and cardiac energy content (ATP) as well as oxidative stress (ROS, MDA, SOD and TAC), inflammation-related (TNF-α, NF-κB, ICAM-1 and MPO) and apoptotic markers (caspase 3 and Bcl-2). Moreover, the hallmark of fibrosis (TGF-β1) was estimated in addition to GSK-3β/β-catenin signaling. Finally, histological examinations were performed to assess the severity of myocardial damage.

Results
Combined Tel/QN therapy showed an additional improvement compared to each therapy alone (p&lt;0.05) toward reducing myocardial I/R-induced oxidative stress, inflammatory, fibrogenic, and apoptotic markers which subsequently restored Wnt/β-catenin signaling through inhibition of GSK-3β upregulation together with spiking up of β-catenin content. All these changes were associated with restoration of myocardial energy content and prevention of I/R-induced damage in histological examination.

Funding Acknowledgement
Type of funding sources: None.
Analysing drivers of routine and COVID-19 vaccination in migrants to develop tailored interventions
Authors: Crawshaw AF , Farah Y , Deal A , Goldsmith LP , Carter J , Rustage K , Campos-Matos I , Vandrevala T , Forster AS , Hargreaves S 
Published: October 2021

Abstract

Background
Migrants in Europe are at risk of under-immunisation and may also have lower COVID-19 vaccination intent and uptake. There is an urgent need to better understand the drivers of uptake in these groups to inform the development of migrant-sensitive interventions for COVID-19 vaccination and routine vaccination beyond the pandemic.

Methods
We did a systematic review (PROSPERO: CRD42020219214) following PRISMA guidelines to explore factors influencing vaccine uptake in migrants in the EU/EEA and identify determinants of under-immunisation. We also held 3 participatory workshops with multinational migrant community leaders (n = 23) in London, to explore solutions and approaches to strengthen COVID-19 vaccine roll-out.

Results
We included 66 papers reporting data on 262,761 migrants in the review. Numerous access-related factors (e.g. government policy, communication barriers) influenced uptake. Vaccine hesitancy was attributed to lack of information, concerns about side-effects, and cultural beliefs/stigma around specific vaccinations. Migrants who had recently arrived, were older, female or of African and Eastern Mediterranean origin were at risk for under-immunisation for key vaccine-preventable diseases. Migrant community leaders reported considerable hesitancy towards COVID-19 vaccination in their communities and misinformation circulating via social media. Leaders requested support in producing simple COVID-19 guidance that could be translated and adapted locally, alongside more meaningful engagement and partnership-working.

Conclusions
Access barriers and vaccine hesitancy may affect vaccine uptake in some migrant populations in Europe, which needs to be urgently addressed for COVID-19 vaccine roll-out but also beyond the pandemic to strengthen uptake of routine vaccinations. Actively involving migrant communities in the planning, co-production and implementation of tailored and targeted approaches will be essential.
On behalf of ESGITM.

Key messages
Access barriers and vaccine hesitancy (from information gaps, cultural factors) contribute to low vaccine uptake in some migrant populations in the EU/EEA, with implications for COVID-19 vaccination. Meaningful engagement and co-production of tailored approaches with under-immunised migrants are urgently needed to ensure their inclusion in COVID-19 and routine vaccination programmes.
A COVID-19 screening method based on eyes photographs and artificial intelligence
Authors: Li F , Xue XY , Boned Fustel P , Rong SS , Sun Q , Tang HC , Wang WX , Fu Y , Boned-Ombuena A , Gu MW 
Published: October 2021

Abstract

Background
SARS-CoV-2 can spread both from symptomatic and asymptomatic individuals. Ocular manifestations due to SARS-CoV-2 have been described, being conjunctival inflammation the most common affectation. Evidence shows that conjunctivitis could be the first and/or only manifestation of COVID-19. This study aimed to develop and validate a COVID-19 screening method based on eyes photographs and artificial intelligence.

Methods
In this multicentre study, 1,200 participants were enrolled from Shanghai Public Health Clinical Center (SPHCC) Fudan University, AIMOMICS LAB and La Fe University and Polytechnic Hospital (LFUPH) of Valencia (Spain). Pictures of participants' ocular surface were taken in four different positions with mobile phone cameras, and a Deep Learning System (DLS) was developed through machine learning to identify characteristic conjunctival inflammation patterns. The study was conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Committees of SPHCC and LFUPH.

Results
The area under the receiver-operating-characteristic curve (AUC), sensitivity, specificity, and accuracy were calculated according to the results of our binary classification network. Bootstrapping with 1,000 replicates was used to estimate 95% confidence intervals of the performance metrics, with photography as the resampling unit. On the subject-level classification, the network achieved the AUC of 0.976 (95% CI 0.965-0.988) among Asian population and 0.892 (95% CI 0-763-1.000) among Caucasian population.

Conclusions
Preliminary results show that this DLS performed well in identifying probable asymptomatic COVID-19 cases through the analysis of participants' eyes pictures. This method could be an innocuous, accessible, low cost and quick COVID-19 screening method. Eventually, it could potentially contribute to pandemic control.

Key messages
In the context of the COVID-19 pandemic it would be useful to have a screening method to easily and quickly detect asymptomatic individuals, in addition to using temperature control. Preliminary results show that this Deep Learning System (DLS) based on eyes pictures taken with mobile phone cameras could be an innocuous, accessible, low cost and quick COVID-19 screening method.
Implementation of student experiential learning in health & wellbeing in a large university setting
Authors: Heffernan M , Mullins B , Bermingham AK , Neville R , Dervan N , Corish CA , Murrin CM , Fitzpatrick P 
Published: October 2021

Abstract

Background
Healthy UCD is a health promotion initiative in University College Dublin (UCD). Working together with university academic staff, we have provided opportunities for graded experiential learning for students in health and wellbeing-related courses. This abstract presents how experiential learning was implemented in the 2020/21 academic year.

Objectives
The first objective was to provide a public health nutrition learning opportunity to MSc in Clinical Nutrition & Dietetics students through the design, implementation and evaluation of UCD Healthy Eating Week in Autumn 2020. Secondly, we aimed to facilitate the running of a wellbeing event by BSc Sport & Exercise Management students with Healthy UCD as their client in Spring 2021. The students had the additional challenge this year of delivering the content online.

Results
MSc Clinical Nutrition & Dietetics students utilised Healthy UCD's website and social media channels to deliver a virtual Healthy Eating Week. Infographics, videos, articles and podcasts were produced which generated 1,000 website visits and reached over 3,000 on social media. Most students involved agreed that the event was successful (95%) and that they were sufficiently supported by Healthy UCD and their tutors (65%). BSc Sport & Exercise Management students devised and delivered a week-long event titled “Wellbeing Your Way”, creating wellbeing seminars and live exercise classes with each receiving an average of 460 views. The students reported gaining valuable experience of the responsibilities of running a professional event and operating as a team.

Conclusions
These examples of experiential learning for credit demonstrate how university campus health promotion teams can facilitate student learning and simultaneously reap the benefit for university faculty and students. The key requirements are committed academic engagement and supported students.

Key messages
University campus health promotion provides excellent opportunities for experiential learning. Health promotion practical experience can have benefits both for students and for the university.