bluuebunny/crossref_metadata_2025_split huggingface dataset:
Survival in patients with chronic congestive heart failure and correlation of presence of risk factors and all-cause mortality
Authors: Hartmann C , Albrecht R , Westphal J G , Schulze P C 
Published: October 2024

Abstract

Background
Right heart function is known to be an independent risk factor for early mortality in patients with acute and chronic heart failure (HF). The prognostic value of cardiopulmonary exercise testing (CPET) is established for risk stratification in patients with Heart Failure. Further, markers of inflammation may predict clinical outcomes.

Purpose
We performed a single-center retrospective analysis of a large single center cohort and assessed all-cause mortality. A simple score including presence of RVD, systemic inflammation and reduced O2 uptake was applied to all patients and a subgroup survival analysis was performed.

Methods
A total of 612 patients with HF across the whole spectrum of left ventricular ejection fraction (LVEF) were analyzed. We stratified patients according to RV function, peak relative oxygen consumption in ml/min/kg (VO2max) and CRP levels. Patients were classified as RV Dysfunction when a right ventricular dilation (RVEDD &gt; 40 mm or RVOT &gt; 30 MM) or decreased tricuspid annular systolic excursion (TAPSE &lt; 17 mm) was seen in the echocardiography. All patients were followed up by phone or by hospital records if available. The primary end-point of all-cause mortality was assessed.

Results
For the primary analysis, 612 patients (mean age 59.8 ± 13.8 years, 71.41% male) were included. According to LVEF 248 (40.5%) patients had preserved LVEF (HFpEF), 82 (13.0%) had mid-range LVEF (HFmrEF) and 282 (46.0%) had reduced LVEF (HFrEF). HF etiology was in 27% ischemic. Mean BNP values were 514.1 ± 827.1 pg/l. Mean VO2max 15,9 ± 5,9 ml/min per kg. Patients were followed up for a median of 4.0 years (IQR: 3.4 - 4.9 years). Over this period, the primary end-point occurred in 17.6% of patients. 135 (22%) of patients had evidence of RV dysfunction, 26% had increased CRP-levels and 256 (41.8%) had a VO2max &lt; 14 ml/min per kg. Patients with elevated CRP, VO2max &lt; 14 ml/min/kg and RV-dysfunction showed worse survival according to the Kaplan-Meier-Estimate with a significant difference (Log Rank: Chi²: 1480, p = 0.013) compared to patients with only RV dysfunction low VO2 max or only increased CRP values.

Conclusion
A combined evaluation of systemic inflammation, cardiopulmonal exercise testing and right ventricular dysfunction is useful in predicting long-term outcomes of patients with HF. Patients with both risk factors show worse survival than patients with signs of inflammation or RV dysfunction only.Kaplan-Meier-Estimates
Association of osteopontin and shrunken pore syndrome with hospitalization for renal failure in acute heart failure patients
Authors: Ohlsson M A , Holm H , Molvin J , Zaghi A , Dieden A , Nezami Z , Jujic A , Magnusson M 
Published: October 2024

Abstract

Background
Shrunken pore syndrome (SPS) emerges as a distinctive manifestation of glomerular filtration dysfunction mainly manifested by the impairment of moderate-sized molecular filtration, distinguished by a variance in renal filtration between cystatin C and creatinine. SPS exhibits correlations with adverse prognosis of various cardiovascular diseases. A decline in renal function correlates with a poor prognosis among individuals with heart failure (HF). Osteopontin (OPN), a protein involved to bone mineralization, has been linked to deteriorating renal function and heightened risk for adverse outcomes in patients with chronic kidney disease.

Purpose
To explore if OPN and SPS are associated with hospitalization for renal failure in patients with acute HF.

Methods
Cystatin C and creatinine were analyzed in 395 hospitalized HF patients, of which 324 also had osteopontin (OPN) analyzed using a proximity extension assay. SPS was calculated using the CKD-EPI Equations for Glomerular Filtration Rate and defined as a cystatin C-based estimated glomerular filtration rate (eGFR) &lt;60% of the creatinine based eGFR. Hospitalization for renal failure was extracted from regional registries using ICD10 codes N17-N19. Logistic and Cox regression models were deployed to explore a) OPN’s association with SPS; b) OPN’s association with hospitalization for renal failure; and c) SPS’s association with hospitalization for renal failure, adjusting for age, sex, systolic blood pressure and use of renin-angiotensin-aldosterone system (RAAS) inhibitors.

Results
The study population had a mean age of 74.8 (±12.0) years, 32.4% were women and 104 (26.5%) patients presented with SPS (Table 1). During the median follow-up period of 71 (interquartile range 56-88) months, 35 (8.9%) patients were hospitalized for renal failure. OPN was associated with the prevalence of SPS (OR 1.66; 95%CI 1.08-2.27; p=0.002), as well as with higher risk of hospitalization due to renal failure (HR 2.71; 95%CI 1.61-4.56; p&lt;0.001). Further, also prevalent SPS was associated with higher risk of hospitalization due to renal failure (HR 2.44; 95%CI 1.14-5.24; p=0.022).

Conclusions
Here, we demonstrate that higher OPN levels are associated with a higher prevalence of SPS and an elevated risk of hospitalization due to renal failure among patients with HF. Additionally, the presence of SPS was associated with a higher risk of renal failure-related hospitalizations. These findings highlight the potential utility of OPN and SPS as biomarkers for identifying heart failure patients at risk of renal function decline, underscoring the importance of early risk stratification and targeted interventions in this population.
Circulating secretoneurin concentrations predict 90-day mortality in patients with cardiogenic shock
Authors: Rosjo H , Azibani F , Kimmoun A , Harjola V P , Lassus J , Mebazaa A , Omland T 
Published: October 2024

Abstract

Background
Secretoneurin (SN) concentrations have been found to provide strong prognostic information in critically ill patients. Accordingly, in this study we hypothesized that SN would provide prognostic information in patients with cardiogenic shock.

Objectives
To evaluate the utility of SN concentrations to predict 90-day mortality in two multicenter, prospective clinical trials including patients with cardiogenic shock.

Methods
We measured SN concentrations with a CE-marked ELISA in patients with cardiogenic shock of all etiologies (Cohort #1, n=168) and in patients with post-myocardial infarction cardiogenic shock (Cohort #2, n=45). Inclusion criteria in both cohorts focused on systolic blood pressure &lt;90 mmHg and evidence of tissue hypoperfusion, including increased lactate concentrations. We used Cohort #1 for primary analysis and Cohort #2 for validation. We assessed association between SN concentrations and mortality by Kaplan-Meier curves and by univariate and multivariable Cox proportional hazard regression analysis.

Results
Median age was 67 and 69 years (Cohort #1 and #2) and the patients were predominantly male (74% and 67%, respectively). Median SN concentration on study inclusion was 53 pmol/L in Cohort #1 and 50 pmol/L in Cohort #2, and SN concentrations decreased from study inclusion to 72 hours (p=0.03 for trend). 90-day mortality was 42% in Cohort #1 and patients with high SN concentrations had worse outcome (Figure A). Adjusting for variables that were associated with 90-day mortality in univariate analysis and not part of the inclusion selection, i.e., age, sex, comorbidities, blood pressure, estimated glomerular filtration rate, treatment, and N-terminal pro-B-type natriuretic peptide concentrations, SN concentrations on study inclusion were still associated with 90-day mortality: hazard ratio per 100 pmol/L increment 1.97 (1.29-3.01), p=0.002. 90-day mortality was 45% in Cohort #2 and SN concentrations were predictive of 90-day mortality also in Cohort #2 (Figure B).

Conclusion
SN concentrations provide incremental prognostic information to established risk indices in the early phase of cardiogenic shock.A. Cohort #1 with SN tertilesB. Cohort #2 divided by SN median
First insights in children’s health literacy in the Netherlands–results in a sample of 8-11 year olds
Authors: Rademakers J , Hahnraths M , Bollweg T , Okan O , Willeboordse M , Heijmans M 
Published: October 2024

Abstract

Background
There are few valid, age-appropriate tools to assess children’s HL. The German-language European Health Literacy Survey Questionnaire Adapted for Children (HLS-Child-Q15-DE) is a self-report questionnaire adapted from the adult European Health Literacy Survey Questionnaire. In 2021, this instrument was translated and validated in the Netherlands. In this presentation, we will describe the distribution of Health literacy in a sample of Dutch children, and relate their Health literacy level to certain aspects of their health behaviour such as food intake and physical activity.

Methods
The HLS-Child-Q15-DE was translated following WHO guidelines and administered digitally to 209 Dutch schoolchildren (eight-to-eleven-year-olds). Its psychometric properties were assessed and the sample’s HL distribution was explored by demographic characteristics. Associations with food intake and physical activity were computed.

Results
Of the sample, 17.2% had a low health literacy score (first quintile), 61.1% medium (second to fourth quintile) and 21.7% high (fifth quintile). Higher HL scores were observed for ten-to-eleven-year-olds (compared with eight-to-nine-year-olds; p = 0.021) and fourth-grade students (compared with third-grade; p = 0.019). A positive association between children’s HL and their vegetable consumption and PA behaviour was observed.

Conclusions
Children’s health literacy can have an impact on some aspects of their lifestyle. This supports the idea that health literacy evolves throughout life and stresses the importance of both parents and schools in this process.
Administrative data for public health: a regional data warehouse applied to dementia epidemiology
Authors: Clemens T , Blandi L , Bertuccio P , Brand H , Odone A 
Published: October 2024

Abstract
Administrative data can represent valuable sources of information for researchers seeking to advise policymakers. Several countries have established population-based data warehouses (DWH), integrating multiple data sources in single repositories through data linkage techniques. In Lombardy (Italy), a regional population-based DWH was established in the 1980s. It collects data about citizens from multiple sources in the social and health sectors, anonymising them immediately after their acquisition. Lombardy Region signed a specific agreement with the University of Pavia to investigate the epidemiology and access to care among people living with dementia (PLWD), using the DWH. A retrospective cohort study was conducted on hospitalised PLWD, including people aged ≥ 65 years with diagnoses of dementia at discharge from 2002 to 2020. The aim was to study the trends of hospitalisations among PLWD, computing these by calendar year, age, sex and cause of hospitalisation. A total of 340,144 hospital discharges were registered, of which 211,709 (63.0%) were women and 124,195 (37.0%) were men. The rate of hospitalisation decreased over the study period, ranging from 100.6/10,000 in 2002 to 65.1/10,000 in 2020. The average age at hospitalisation increased for men and women from 78.9 and 81.8 years in 2002 to 82.0 years and 84.2 years, respectively, in 2020. Respiratory diseases caused 10.4% of all hospitalisations in 2002 and grew steadily to 26.8% in 2020, becoming the leading cause of hospital admissions since 2017. Results allowed us to elaborate epidemiological measures and to characterise our population in a wide temporal trend, quantifying access to acute care by leading causes of hospitalisation. However, the analysis of administrative data comes along with several challenges, such as data incompleteness and biases. Researchers should take advantage of these data sources while keeping in mind the limitations and constraints related to data quality.
Sodium and potassium intake in adults: the Italian Health Examination Survey 2023 – CUORE Project
Authors: Donfrancesco C , Lo Noce C , Marcozzi B , Di Lonardo A , Vannucchi S , Morello M , Di Carlo S , Galeone D , Bellisario P , Palmieri L 
Published: October 2024

Abstract

Background
The WHO recommends a 30% relative reduction in mean population intake of salt/sodium within 2025 (baseline 2010) and an adequate potassium intake. To these ends, the Italian Ministry of Health (MoH) has strengthened prevention/health promotion. To update the assessment of the habitual salt and potassium intake in the Italian general adult population, national health examination surveys (HESs), funded by the MoH-CCM, are conducted within the CUORE Project.

Methods
In 2023 a new HES started including salt and potassium intake assessment by the use of 24h urine collection. Up to now, data from random samples of residents in 7 Regions (of 20 regions) distributed in North, Centre and South of Italy and aged 35-74 years are available (686 men, 702 women). Urinary excretion is assayed by a central lab. Persons with urinary volume &lt; 500 ml and/or a urinary creatinine content referred to body weight outside the range of population mean ± 2 standard deviations are excluded.

Results
Out of 657 men and 671 women, mean level of salt per day was 9,2 g (95% CI: 9,0-9.5 g) and 7,1 g (6,9-7,3 g) respectively, and mean level of potassium per day was 2,9 g (2,8-3,0 g) and 2,4 g (2,3-2,5 g) respectively. A salt intake level lower than the WHO recommended target of 5g/day was detected in 9,5 % (5,2 -13,9 %) of men and 23,7 % (17,5 -29,9 %) of women and a potassium intake level higher than the WHO recommended target of 3510 mg/day was detected in 22,4 % (16,3 -28,6 %) of men and 9,7 % (5,4 -14,0 %) of women.

Conclusions
These preliminary data showed that in Italian adults the average salt intake is still higher and the average potassium intake is still lower than recommended. Compared to 2008, the habitual salt intake decreased of about 12% in 2018 and remained stable in 2023; the habitual potassium intake remained stable in 2008, 2018 and 2023.These results justify and encourage the ongoing preventive initiatives of MoH, facilitating the meeting of WHO targets.

Key messages
• In Italian adults the average salt intake is still higher than recommended and the habitual salt intake decreased compared to 15 years ago.
• In Italian adults the average potassium intake is still lower than recommended and remained stable compared to 15 years ago.
Data governance challenges on smart home involving multiple research sites
Authors: Wang K , Cao S , Morita P 
Published: October 2024

Abstract

Background
The development of Ambient Assisted Living (AAL) technology has great potential for ubiquitous health monitoring through collaboration between multiple research sites, but its use poses significant challenges to data governance. This study aims to investigate data governance challenges arising when smart home data flows across different research sites.

Methods
A four-analytic-dimension method was used to identify potential data-related issues that may occur when heterogeneous smart home data moves around multiple research sites. These dimensions include data domain, stakeholders, value, and governance goal.

Results
Data domain has difficulty in categorizing new data types generated by analytical models without a specified agreement, and determining the regulations for varying levels of anonymization and privacy protection is unclear in the AAL research field. Stakeholders in the AAL project may hold have different norms and practices for data use. Although some common values may be shared, such as improving the quality of homecare, conflicts may still arise and need to be regulated by data governance. Shifting AAL data between stakeholders may reduce its value, as different stakeholders may have varying interests. For instance, removing identifiable information from data to preserve privacy may reduce its value for researchers exploring individuals’ activity patterns. Governance goals are objectives for maintaining and facilitating data. While some governance goals can be widely acknowledged and shared, such as ensuring data security and privacy, conflicts may still exist over others, such as data access.

Conclusions
The big data generated by smart home technology highlights the need to develop proper data governance models to regulate data. This study’s implications include a better understanding of potential data-related challenges when data flows around multiple research sites, helping policymakers set up suitable data governance models.

Key messages
• AAL tech for health monitoring poses data governance challenges due to varying stakeholder norms and values.
• Proper data governance models need to be developed for AAL data as it remains challenges in data domain, stakeholders, value, and governance goal.
Human-swine interface: is the hepatitis E virus a real risk for humans?
Authors: Arnaboldi S , Righi F , Scarazzato A , Pavoni E , Filipello V , Lelli D , Trogu T , Lavazza A , Romanò L , Bertasi B 
Published: October 2024

Abstract

Background
Hepatitis E virus (HEV) is the agent of hepatitis E, an emerging public-health infection with an increasing incidence in Europe. Due to the apparent lack of species barriers, HEV is considered a zoonotic agent, with swine as the main reservoir. This study investigated HEV prevalence in humans and domestic pigs in Northern Italy, a highly anthropic area with the highest pig farm density, to gain insights into the risk of HEV transmission from swine to humans.

Methods
A total of 508 blood samples were collected from blood donors (341 males and 167 females; from 18 to 66 years old) and from 1619 pigs in 40 different farms. Serological analyses were performed with ELISA to detect anti-HEV antibodies. In addition, 120 faecal pool samples collected from the pig farms with the highest seroprevalence and 69 salami produced in the same area were analysed to detect viral genome by Real-time PCR.

Results
In humans, HEV seroprevalence was 4.9% (CI95% 0.03-0.07); positive donors were mainly males, with seroprevalence increasing up to 12% (CI95% 0.09-0.15) in the 46-55 age group. Seroprevalence in swine was 53.00% (CI95% 0.50-0.55), with HEV detected in only 1% (CI95% 0.001-0.045) faeces. All food samples tested negative.

Conclusions
Even if the seroprevalence in pigs highlighted that HEV was actively circulating in the farms, the low seroprevalence in humans, the scarce HEV detection in swine faeces, and the absence in food products suggested that HEV transmission via faecal-oral or foodborne routes is unlikely, probably due to the implementation of severe biosecurity measures and high standards of hygiene in swine farms, and the continuous assessment of the critical points in the pig supply chain (from farm to fork). The serological surveillance of humans and the monitoring of farmed animals are needed to support the competent authorities in timely managing public health issues, improving human health and veterinary safety from a One Health perspective.

Key messages
• In the human-swine interface is important to monitor HEV presence.
• The One Health approach is essential to control zoonotic diseases.
Next-generation public health surveillance: extreme heat event prediction and monitoring system
Authors: Zakir Hussain I , Oetomo A , Kaur J , Morita P P 
Published: October 2024

Abstract

Background
Extreme Heat Events (EHEs) are a growing threat to public health. The increase in the frequency of occurrence of once rarer EHEs and the rise in their average temperatures are dangerously drastic for public health outcomes. Despite this, existing public health surveillance (PHS) systems fail to leverage IoT and AI technologies to facilitate real-time, continuous monitoring of EHE indicators and its associated health risks. This study closes this gap by proposing a comprehensive PHS system that can, in real-time monitor and predict EHE indicators to provide timely alerts to public health authorities.

Methods
The EHE PHS system collects EHE detection metrics, including indoor temperature and humidity levels, from IoT sensors and thermostats to map them across Canada, primarily focusing on low-income communities. The system also integrates historical climate data (surface temperature, humidity, wind speed and direction, and air quality indicators) from Environment Canada. The system uses the data to train initial prediction models including CNN, LSTM and GNN. The validated model will be integrated into the system, enabling real-time EHE prediction. The output will be displayed in user-friendly visualizations on the EHE PHS system’s dashboard capabilities.

Results
The system allows for the analysis of real-time data through dashboards and provides alerts when certain indicators (e.g. excessive or prolonged heat) detrimental to public health outcomes are detected. The alerts enable valuable lead time for public health authorities to implement proactive measures, such as issuing heat advisories and deploying resources to vulnerable areas.

Conclusions
The EHE PHS system will serve as a blueprint for global public health researchers, utilizing IoT and AI technologies for proactive crisis prevention. This knowledge will inform the development of heat-resilient policies and set a precedent for global public health crisis prevention.

Key messages
• The proposed EHE PHS system uses AI and IoT technologies, to enhance EHE prediction, risk identification, and real-time monitoring for effective public health interventions.
• By integrating advanced predictive models and environmental data, the system facilitates early detection of EHE risk, which can significantly mitigate the health impact on vulnerable populations.