bluuebunny/crossref_metadata_2025_split huggingface dataset:
SARS-CoV-2 Plasma Antibody and Nucleocapsid Antigen Status Predict Outcomes in Outpatients With COVID-19
Authors: Jilg Nikolaus , Giganti Mark J , Chew Kara W , Shaw-Saliba Katy , Ritz Justin , Moser Carlee , Evering Teresa H , Daar Eric S , Eron Joseph J , Currier Judith S , Hughes Michael D , Lane H Cliff , Dewar Robin , Smith Davey M , Li Jonathan Z 
Published: July 2024

Abstract

Background
Reliable biomarkers of coronavirus disease 2019 (COVID-19) outcomes are critically needed. We evaluated associations of spike antibody (Ab) and plasma nucleocapsid antigen (N Ag) with clinical outcomes in nonhospitalized persons with mild-to-moderate COVID-19.

Methods
Participants were nonhospitalized adults with mild-to-moderate COVID-19 enrolled in ACTIV-2 between January and July 2021 and randomized to placebo. We used quantitative assays for severe acute respiratory syndrome coronavirus 2 spike Ab and N Ag in blood and determined numbers of hospitalization/death events within 28 days and time to symptom improvement.

Results
Of 209 participants, 77 (37%) had quantifiable spike Ab and 139 (67%) quantifiable N Ag. Median age was 50 years; 111 (53%) were female, 182 (87%) White, and 105 (50%) Hispanic/Latino. Higher risk of hospitalization/death was seen with unquantifiable (22/132 [16.7%]) versus quantifiable (1/77 [1.3%]) spike Ab (risk ratio [RR], 12.83 [95% confidence interval {CI}, 1.76–93.34]) and quantifiable (22/139 [15.8%]) vs unquantifiable (1/70 [1.4%]) N Ag (RR, 11.08 [95% CI, 1.52–80.51]). Increasing risk of hospitalizations/deaths was seen with increasing N Ag levels. Time to symptom improvement was longer with unquantifiable versus quantifiable spike Ab (median, 14 [interquartile range {IQR}, 8 to &gt;27] vs 8 [IQR, 4–22] days; adjusted hazard ratio [aHR], 0.66 [95% CI, .45–.96]) and with quantifiable versus unquantifiable N Ag (median, 12 [7 to &gt;27] vs 10 [5–22] days; aHR, 0.79 [95% CI, .52–1.21]).

Conclusions
Absence of spike Ab and presence of plasma N Ag predicted hospitalization/death and delayed symptom improvement in COVID-19 outpatients.

Clinical Trials Registration
NCT04518410
Urine metabolite changes after cardiac surgery predict acute kidney injury
Authors: Zeng Qi , Feng Jinghan , Zhang Xinni , Peng Fangyuan , Ren Ting , Zou Zhouping , Tang Chao , Sun Qian , Ding Xiaoqiang , Jia Ping 
Published: July 2024

ABSTRACT

Background
Acute kidney injury (AKI) is a serious complication in patients undergoing cardiac surgery, with the underlying mechanism remaining elusive and a lack of specific biomarkers for cardiac surgery-associated AKI (CS-AKI).

Methods
We performed an untargeted metabolomics analysis of urine samples procured from a cohort of patients with or without AKI at 6 and 24 h following cardiac surgery. Based on the differential urinary metabolites discovered, we further examined the expressions of the key metabolic enzymes that regulate these metabolites in kidney during AKI using a mouse model of ischemia–reperfusion injury (IRI) and in hypoxia-treated tubular epithelial cells (TECs).

Results
The urine metabolomic profiles in AKI patients were significantly different from those in non-AKI patients, including upregulation of tryptophan metabolism– and aerobic glycolysis–related metabolites, such as l-tryptophan and d-glucose-1-phosphate, and downregulation of fatty acid oxidation (FAO) and tricarboxylic acid (TCA) cycle–related metabolites. Spearman correlation analysis showed that serum creatinine was positively correlated with urinary l-tryptophan and indole, which had high accuracy for predicting AKI. In animal experiments, we demonstrated that the expression of rate-limiting enzymes in glycolysis, such as hexokinase II (HK2), was significantly upregulated during renal IRI. However, the TCA cycle–related key enzyme citrate synthase was significantly downregulated after IRI. In vitro, hypoxia induced downregulation of citrate synthase in TECs. In addition, FAO-related gene peroxisome proliferator-activated receptor alpha (PPARα) was remarkably downregulated in kidney during renal IRI.

Conclusion
This study presents urinary metabolites related to CS-AKI, indicating the rewiring of the metabolism in kidney during AKI, identifying potential AKI biomarkers.
CardioTwins: case report of a transcatheter mitral and tricuspid valve implantation in one patient
Authors: Schmidt Tobias , Kuck Karl-Heinz , Marquetand Christoph , Eitel Ingo , Frerker Christian 
Published: July 2024

Abstract

Background
Besides transcatheter edge-to-edge repair (TEER), there are new interventional treatment options for mitral and tricuspid regurgitation in evaluation, such as a complete replacement of the valve through a prosthesis.

Case summary
A 78-year-old previous coronary artery bypass graft-operated patient with symptomatic severe mitral regurgitation and tricuspid regurgitation was sequentially treated by a transfemoral transcatheter mitral and tricuspid valve prosthesis (Cardiovalve; Cardiovalve Ltd, Israel) due to unfavourable mitral valve anatomy. The transcatheter mitral valve implantation (TMVI) was performed first and after progression of the tricuspid regurgitation, a second transcatheter valve prosthesis was implanted in tricuspid position (TTVI) 1.5 years later. Imaging showed a twin look-alike picture of a mitral and tricuspid prosthesis and showing the possibility of a complete transcatheter based replacement of the mitral and tricuspid valve.

Discussion
This case shows the possibility of a Cardiovalve prosthesis being used for TMVI and TTVI in a single patient. Especially in TEER ineligible patients, it might be a good treatment option after device approval.
Agricultural Technological Change, Female Earnings and Fertility: Evidence from Brazil
Authors: Moorthy Vivek S 
Published: July 2024

Abstract
I study how agricultural technological change affects labour market opportunities and fertility in a developing country context. Exploiting plausibly exogenous variation in the adoption of genetically engineered soy across municipalities in Brazil, I show that this labour-saving technology reduced female agricultural earnings and employment without inducing any female sectoral reallocation. Furthermore, this technology adoption increased fertility due to increases in overall household earnings and substitution effects driven by the reduction in female labour demand. These results suggest that technological progress in developing countries may not improve female economic opportunities or lower fertility unless substitution effects are negative and sufficiently large.
Oral anticoagulants and cognitive disease progression in atrial fibrillation
Authors: Wood K A , Ko Y A , Han F , Wharton W 
Published: July 2024

Abstract

Background
Atrial fibrillation (AF) is associated with cognitive decline and dementia. Use of oral anticoagulant (OAC) medications has been reported to offer a lower risk of dementia, but whether differences exist in risk of cognitive decline between types of OAC agents is unclear.

Purpose
We explored whether the progression from normal cognition to mild cognitive impairment (MCI) or MCI to dementia differs between adults with AF on warfarin versus non-Vitamin K inhibitors (NOACs) in the National Alzheimer’s Coordinating Center (NACC) clinical case series.

Methods
Data freeze/extraction of NACC data (N= 48,605) took place June 2023. The presence of AF was derived using both clinician-reported health information and self-reported medical history. Subjects with AF who reported use of OACs, had normal cognition and no history of stroke at baseline, and had at least one follow-up visit were included. OAC usage was calculated based on follow-up time and reported OAC use in previous visits. Continuation ratio models (with subject-specific random intercepts) were used to examine the association between OAC type and cognitive diagnosis controlling for cognitive diagnosis from previous visit. Interactions with sex were examined in all models.

Results
Among 1,475 eligible participants, 478 reported taking OACs including either warfarin (N=396) or NOACs (N=82) at baseline (mean age 79 years, 51% females, 84% White). Individuals on NOACs were either on dabigatran (N=24, 29%) or rivaroxaban (N=58, 71%). The median follow-up time was 4 (interquartile range 2-7) years. About 63% continued using either warfarin or NOACs, 44% switched from warfarin to NOACs, and 2% switched from NOACs to warfarin. After adjusting for age, sex, education, race, hypertension, diabetes, hyperlipidemia, smoking history, and depression in the past two years, no significant association was found between OAC type and cognitive decline (p=0.14).

Conclusions
In this study of older patients with AF on OACs, we found similar risks of cognitive decline between those on NOACs or warfarin. Future studies should consider effects of patient age, provider prescribing practices, and OAC adherence on this risk.
Experiences of patients and nurses with thirst in advanced chronic heart failure: a mixed methods study
Authors: Wefer F , Moehler R , Calo S , Koepke S 
Published: July 2024

Abstract

Background
Many patients with chronic heart failure (CHF) express thirst. Perceptions of thirst and strategies for reducing this symptom can differ between patients and nurses.

Purpose
As part of a study to develop and evaluate a nurse-based counselling intervention on thirst in patients with advanced CHF waiting for heart transplantation, we aimed to assess patients' and nurses' perceptions on thirst, possible strategies, as well as information needs and information transfer.

Methods
Mixed methods study consisting of semi-structured interviews with hospitalized patients waiting for a heart transplantation in Germany. Interviews focussed on experiences with thirst, needs and requirements, and experiences with the information provided by healthcare professionals. We also conducted focus groups and an online survey with German nurses with experiences in the care of cardiac patients. Topics of the focus groups were the perceptions and handling of the symptom in nursing practice as well as the provision of information and counselling. The survey was based on the results of the focus groups and current research findings. In addition to work-related data, we asked questions about the relevance of thirst, the causes of this symptom, recommended interventions and the need for counselling. We analysed quantitative data descriptively and qualitative data using content analysis.

Results
We conducted 10 interviews with patients (mean age: 43.5 years; 30% female; duration of CHF: 25 days to 21 years; length of stay: 7 to 116 days). All participants had a prescribed fluid restriction. Perceived thirst markedly differed between patients, with some reporting thirst to be very distressing. Most patients described that the feeling of thirst increased especially at mealtimes. Individual strategies for reducing thirst also differed between patients depended on disease durations and their therapeutic regiment. Some patients rated the information provision by healthcare professionals concerning thirst as insufficient. In addition, we conducted two focus groups with respectively 5 nurses from two university hospitals in Germany. 59 nurses participated in the survey. Nurses (81.4% working in a hospital; 54.2% already have at least 5 years of experience in care of cardiac patients) stated that the feeling of thirst in patients with CHF is of great importance in nursing practice, but only 44.1% specified to regularly assess thirst. The perceived most common cause of thirst was a prescribed fluid restriction (93.2%) and diuretics (79.7%). Among others, most nurses recommended ice cubes as intervention to reduce thirst and considered counselling interventions as important.

Conclusion(s)
The occurrence of thirst is an important issue for patients with advanced CHF. The perception of the symptom varies greatly. Individualised, evidence-based strategies for symptom management are required.
Pre - and post- COVID era: how did the pandemic impact the number of cardiovascular examinations?
Authors: Dimishkovska S D , Lazeska M L , Alii N A , Tasevska V T , Josevska I J , Zafirovska D Z , Klincheva M K , Mitrev Z M 
Published: July 2024

Abstract

Introduction
A lot of evidence suggests a close link between COVID-19 and cardiovascular diseases. Recent data indicate that COVID-19 may increase the risk of cardiovascular diseases in the future, to an extent similarly observed in reference to the more traditional cardiovascular risk factors.
Health practitioners, nurses, and doctors have a hypothesis that, since COVID began, more and more younger patients seek cardiovascular examinations.
The Purpose of this study is to compare the number of cardiovascular examinations before and after the beginning of the COVID pandemic, by gender and age.

Materials and Methods
We examined the total number of cardiovascular examinations performed at the diagnostic center, Zan Mitrev clinic, Skopje, R. Macedonia, for a period of three years before COVID-19, i.e., from January 2017 to March 2020, and three years after the start of the pandemic, i.e. from March 2020 to March 2023. We structured the comparison by gender and age of the patients before and after COVID. Cardiovascular examination in our hospital comprises electrocardiography, echocardiography and cardiologic consultation. All of the collected data came from the Hospital Information System.

Results
A total of 24,496 cardiovascular examinations were performed between January 2017 and March 2020. The cohort of patients comprised 13,374 men (55%) and 11,121 (45%) women. The average age was 53±30 years. During the period from March 2020 to March 2023 a total of 33,825 cardiovascular examinations were performed, and the patients comprised 18,137 (54%) men and 15,687 (46%) women. The average age was 55±43 years.

Conclusions
Although there seems to be an upward trend of the number of cardiovascular examinations after the COVID pandemic started, there is no statistically significant difference between the data categorized by age and gender before and after the COVID era.
A generic logic model for physical activity interventions for the cardiac population using intervention mapping
Authors: Marcos T A , Kulnik S , Crutzen R 
Published: July 2024

Abstract

Introduction
Regular physical activity is important in the secondary prevention of cardiovascular disease. But many cardiac patients have difficulty establishing lifelong physical activity habits, even after completion of an exercise-based cardiac rehabilitation programme. There is a need for effective interventions to support cardiac patients' physical activity. Such interventions are often complex behaviour change interventions whose design should be grounded in programme theory, i.e., a description of how the intervention is expected to lead to its effects and under what conditions. A logic model is often used to communicate programme theory [1].

Purpose
The purpose of this work was to describe a generic logic model for behaviour change interventions to increase and maintain physical activity among patients who have had an acute cardiac event.

Methods
We applied the Intervention Mapping approach [2] to develop a generic logic model that is both data- and theory-driven, i.e. informed by research evidence and behaviour change theory. The at-risk behaviour for the individual cardiac patient was defined as "insufficient independent long-term maintenance of heart-healthy physical activity", compounded by the environmental factor "lack of support provision for long-term independent physical activity" from the healthcare providers and people in the patient’s interpersonal environment. We defined performance objectives by asking the questions: "What do people who had an acute cardiac event need to do to increase and maintain their heart-healthy physical activity?" and "What do the healthcare providers and people in the patient’s interpersonal environment need to do to encourage and support the patient in being physically active?" The performance objectives specify what actions are required of the individuals targeted in the intervention. We selected determinants corresponding to performance objectives based on empirical evidence from systematic reviews and based on behaviour change theory such as the Reasoned Action Approach (RAA) and the Health Action Process Approach (HAPA).

Results
Central elements of the logic model are presented in table 1. The logic model includes 18 performance objectives and 13 determinants, supported by empirical evidence from 40 scientific publications.

Conclusion
The generic logic model serves as a collection of current knowledge regarding increasing and maintaining physical activity among the cardiac population and can be used for a number of purposes: as a foundation for developing new interventions; as a blueprint against which to compare and/or solidify the programme theory of existing interventions; as a conceptual framework for designing evaluations of interventions; as a current evidence map from which to identify research gaps; and as a point of reference for reflecting on one’s own health behaviour.Table 1.Elements of the logic model.
The influence of the health status and functional capacity assessment of older people with heart failure on the participation in a cardiac rehabilitation program after myocardial infarction
Authors: Pietrzykowski L , Ratajczak J , Kasprzak M , Kubielas G , Kosobucka-Ozdoba A , Michalski P , Krys J , Kubica A 
Published: July 2024

Abstract

Background
Cardiac rehabilitation (CR) after myocardial infarction (MI), conducted by a multidisciplinary team, is considered to be the most effective secondary prevention strategy. CR might be particularly beneficial in older patients, who often suffer from heart failure (HF) and other comorbidities. Low enrolment in CR programs is observed in various age groups despite the proven effectiveness of CR in the reduction of subsequent ischemic episodes, hospitalization, and mortality risk.

Purpose
The study aimed to analyze the impact of the health status and functional capacity assessment of elderly patients with HF using the Vulnerable Elders Survey (VES-13) scale on the willingness to participate in the CR program as part of the national Comprehensive Care Program after Myocardial Infarction.

Methods
The analysis of the medical records of MI patients, who were hospitalized between 2017 and 2023 and met the inclusion criteria for CR was performed. People included in the study were ≥60 years of age and had previously been diagnosed with HF. The study included 350 people who underwent VES-13 assessment during hospitalization. The median age of the studied group was 74 (IQR 68-81), with the majority of males (59.1%).

Results
The willingness to participate in CR was declared by 26.3% of respondents. The median VES-13 score was 3 (IQR 2-7) points and was higher in patients who did not want to participate in CR [3 (IQR 2-7) vs 2 (IQR 1-3), p &lt;0.0001]. In the group of patients who scored &lt;3 points in the VES-13 scale, there was a significantly higher percentage of patients declaring their willingness to participate in CR compared to the group with ≥3 points (38.8% vs 18.5%, p=0.0001). Univariate analysis showed that all parameters assessed by the VES-13 scale had a significant impact on patients' willingness to participate in CR (Figure 1). Independent factors determining patients' declaration were age, difficulties in reaching or extending arms above the shoulder level, and limitations in shopping for personal items (like toilet items or medicines) (Figure 2).

Conclusion
The VES-13 scale can help to identify patients with HF after MI who require additional support and motivation in the decision process to participate in coordinated care and early CR.
Limitations in the everyday functioning of elderly patients with HF determine the lack of willingness to participate in CR after MI. It is necessary to carry out intensive educational and motivational activities to improve the recruitment to the CR program.
From the waiting list to the transplanted heart: a qualitative approach to emotions, feelings, and coping strategies
Authors: Medeiros Bussi Teixeira R , Malaman Galhardi N , Batista Dos Santos Pedrosa R 
Published: July 2024

Abstract

Introduction
Living with a complex disease such as heart failure (HF) can influence the functional and emotional capacity of individuals, compromising their quality of life. Furthermore, it is a progressive disease that can result in the final route of treatment, which is heart transplantation (HT), and the patient suffers an impactful change in health and disease status that can generate different emotions and feelings. A stressful factor can interfere with the way an individual deals with situations and this can result in negative behavior that harms themselves, their quality and meaning in life. Understanding emotions, and feelings and being able to deal with emotions are fundamental practices for coping with the disease and maintaining quality of life.

Objective
To identify the emotions, feelings, and coping strategies of patients who are on the waiting list for an HT and those who have already received the graft.

Method
Qualitative and exploratory research was conducted with 3 patients on the waiting list and 3 HT patients undergoing outpatient follow-up in a Brazilian public hospital. The Symbolic Interactionism was used as a theoretical framework. Data collection was carried out through a semi-structured interview with the following triggering questions: "How do you feel when you think about Heart Transplantation?", and "What do you usually do to deal with these emotions and feelings?", "Is the way you deal with these emotions ideal for you?" The interview was recorded in audio, and transcribed in full and the data was subjected to content analysis consisting of 03 phases: I) Pre-exploration; II) Selection of analysis units; III) Categorization and subcategorization.

Results
The emotions mentioned by patients on the HT waiting list were fear, anger, and surprise and the feelings were hope, melancholy, and disappointment. The coping strategies of this group were religious belief, support from family and friends, or even introspection and resignation to the disease. Heart transplant patients reported emotions such as joy and sadness, and feelings such as gratitude and loneliness. The beliefs, the presence of family and friends, psychiatric support, and carrying out work activities were reported as ways of dealing with loneliness and sadness. Regarding self-perception of emotional management, both groups reported an adequate approach when they can rely on beliefs/family/friends.

Conclusion
Patients on the waiting list or who have already undergone an HF experience a duality of emotions and feelings characterized by fear, anger, surprise, joy, sadness, hope, melancholy, disappointment, gratitude, and loneliness, respectively. These findings contribute to the development of new tools that enable specific management of these emotions and feelings that emerge in patients who experience the context of HF.