bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Spiritual Exercises of Antonio Cassese and the Re-Forming of a ‘European Tradition’ of International Law
Authors: Hasan Khan Adil 
Published: July 2024

Abstract
This article describes Antonio Cassese’s vital influence on the ‘European tradition of international law’ through an attentiveness to those specific activities through which Cassese, as heir, received this tradition and through which Cassese, as ancestor, transmitted it. The specific activity that the article chooses to describe is that of writing – one of the several activities through which a tradition might be transmitted and received. It does so especially through close readings of several pieces of international legal writing wherein Cassese explicitly sought to dialogically redescribe the practices of an older generation of Euro-American international lawyers, including The Tokyo Trial and Beyond (1994) and Five Masters of International Law (2011). This training repertoire is his ‘spiritual exercises’, and, as the article shows, it invites others to take up their role as international lawyers and to conduct themselves as international lawyers in a specific way by cultivating in them conscience as a capacity to actualize judgment in the world.
Adulthood adiposity affects cardiac structure and function in later life
Authors: Al Saikhan Lamia , Chaturvedi Nish , Ghosh Arjun K , Hardy Rebecca , Hughes Alun 
Published: July 2024

Abstract

Background and Aims
Excess adiposity is associated with poorer cardiac function and adverse left ventricular (LV) remodelling. However, its importance over the adult life course on future cardiac structure and systolic and diastolic function is unknown.

Methods
A total of 1690 participants in the National Survey of Health and Development birth cohort underwent repeated adiposity [body mass index (BMI)/waist-to-hip ratio (WHR)] measurements over adulthood and investigation, including echocardiography at age 60–64 years. The relationship between LV structure [LV mass (LVM), relative wall thickness, and LV internal diameter in diastole (LVIDd)] and function (diastolic: E/eʹ, eʹ, and left atrial volume indexed to body surface area; systolic: ejection fraction, Sʹ, and myocardial contraction fraction) was investigated using multivariable linear regression models.

Results
Increased BMI from age 20 years onwards was associated with greater LVM and LVIDd independent of confounders. Associations remained independent of current BMI for LVIDd and at age 26, 43, and 53 years for LVM. Increased BMI from 43 years onwards was associated with greater relative wall thickness, but not when BMI at age 60–64 years was accounted for. Increased BMI at age 26, 36, and 53 years and at 20 years onwards was associated with lower ejection fraction and myocardial contraction fraction, respectively, but not independently of BMI at 60–64 years. Higher BMI from 20 years onwards was associated with poorer diastolic function independent of confounders. Associations between BMI and left atrial volume indexed to body surface area persisted from 26 years onwards after adjustment for BMI at 60–64 years. Similar relationships were observed for WHR from age 43 years onwards.

Conclusions
Higher adiposity (BMI/WHR) over adulthood is associated with evidence of adverse cardiac structure and function. Some of these associations are independent of adiposity in later life.
Differences and changes: a qualitative study of concerns about self-care among heart failure patients hospitalized for the first time and their multidisciplinary providers
Authors: Shogaki J , Fukuda A , Imai M , Yasuno S , Park S M , Asai M , Umezawa M , Nakayama N , Watanabe M , Miyawaki I 
Published: July 2024

Abstract

Background
Patient-centred multidisciplinary teams must facilitate self-care while addressing the patient’s concerns. Because the concerns of heart failure patients admitted to the hospital for the first time do not always coincide with the principles of self-care for heart failure, providers need to carefully understand their patients’ particular concerns. However, little research has been conducted on the specific concerns of such patients and their providers.

Purpose
This study sought to clarify the concerns of patients with first-time heart failure and their multidisciplinary team of providers during first-time hospitalization and at the first outpatient visit.

Methods
Individual and focus group interviews about self-care for heart failure were conducted with 10 patients hospitalized with heart failure for the first time and their multidisciplinary team of providers (eight physicians, nine nurses, seven physical therapists, two pharmacists, and two dieticians). Patients were interviewed during hospitalization and at the first outpatient visit, while the healthcare providers were interviewed either during hospitalization or at the first outpatient visit. Mayring's qualitative content analysis was used to analyse the interviews.

Results
The analysis identified eight themes. Those extracted from interviews with patients were ‘meaning of symptoms experienced’, ‘continuation of daily life before hospitalization’, ‘healthy living’, and ‘relapse of painful symptoms’. Meanwhile, those extracted from interviews with healthcare providers were ‘improving clinical heart failure status’, ‘health literacy for heart failure self-care’, and ‘post-discharge environment for continued self-care’. The theme ‘self-care to prevent heart failure from worsening’ was extracted from patients and providers. ‘Self-care to prevent heart failure from worsening’ was also more frequently reported during the initial outpatient discharge than during inpatient hospitalization.

Conclusion
This study revealed that the concerns of patients hospitalized with heart failure for the first time generally differ from those of the healthcare providers comprising their multidisciplinary treatment team. Furthermore, the findings showed that patients were more interested in self-care for heart failure during their first outpatient visit than their hospital stay. Ultimately, the study highlights that healthcare providers working in multidisciplinary teams to support first-time inpatients with heart failure should understand patient concerns, which notably include but are not limited to self-care, and work to support their patients’ self-care by remaining attentive and responsive to their patients’ changing concerns, placing them at the centre of treatment.
Nurse-lead ambulatory follow-up of patients with heart failure compared to physician-guided management - experience of a single academic center
Authors: Georgieva M , Rushid M R , Yotov Y T 
Published: July 2024

Abstract

Background
The follow-up of patients with chronic heart failure by a nurse in an outpatient clinic showed to be as effective as physician management for clinical and prognostic improvement of patients with chronic heart failure (CHF). The role of nurses is important and would improve the general condition of patients.

Aim
To determine the effect of nurse-lead ambulatory follow-up of patients with heart failure –when compared with physician-guided management of patients with CHF.

Participants and methods
Overall, 72 patients with HF were included in a structured ambulatory program after hospital discharge following the OptimizeHF Care Program protocol, with the active participation of a nurse in it. The patients were divided into two groups – group A – mostly managed by a trained nurse, and group B – predominantly led by a cardiologist with the helpof the nurse. Advice on diet and physical activity for all patients was provided by the nurse according to an established protocol and in accordance with current recommendations for non-pharmacology behavior in heart failure at the beginning of follow-up and at each visit.We use self-reported readiness of patients to comply with dietary and physical activity guidelines to measure adherence to the program at the end of the follow-up period.

Results
The patients in group A (21) were insignificantly more often females, with slightly higher ejection fraction, and a little bit older tjhn group B (61). After a 6-month follow-up, 61 finished the program. There was no significant difference in the outcomes – death or hospitalizations, between the groups . In group A, the improvement in the NT-pro BNP levels was more pronounced –94.7% vs 74.4% in group B (p=0.024). Numerically, nurse-lead patients had more often improvement in their functional capacity with 1 NYHA class – 95% vs 84% (p=0.23). Both groups had similar improvement in the 6-minute walking test and there was no difference in hemodynamic measurements and laboratory tests.
The majority of the patients followed the advice for diet and physical activity – 81.7%. There was no significant difference in this indicator between the group managed by the nurse and that by the physician. The same similarity was recorded in the drug therapy at the end of the follow–up.

Conclusions
Our results confirm that the nurse-lead program for ambulatory management of patients with CHF is effective and safe compared to physician management and can be applied in various health systems. This will increase the importance of the health care professionals in the HF team.
Finding peace in a new version of oneself- a qualitative study of post operative patients after aorta dissection and their experiences of cardiac rehabilitation
Authors: Rosenstroem S , Anette Sjoel A S 
Published: July 2024

Abstract

Background
Aortic dissection, characterized by a sudden rupture in the carotid artery allowing blood to enter the aortic wall. The mortality rate is 1% per hour, and half of the patients die within 48 hours. Following surgery, patients are advised to limit arm lifting to 2 kg, maintain strict blood pressure control for life, and engage in physical activities that do not strain the aorta. Despite the limited evidence on optimal rehabilitation, our University Hospital in Denmark has established a team that secure patients with aortic dissection a structured post operative rehabilitation program.

Aim
This study aims to explore the experiences and importance of a specialized rehabilitation program for individuals post-surgery for aortic dissection.

Method
A qualitative interview study, analyzed using content analysis inspired by Graneheim & Lundman. Interview participants were recruited through the physiotherapist at the hospital either at the end or shortly after their rehabilitation program. Interviews were conducted over the phone or in a private room at the hospital.

Results
Based on interviews with eight patients (three women and five men aged 43-73), an overarching theme emerged; "Finding peace in a new version of oneself." This theme encapsulates the journey of adapting to a new identity with a changed body that has limitations, combined with a sense of gratitude for being alive. Three subthemes describe the period from surgery to the end of the rehabilitation course: 1) Surviving the operation - the initial miracle and the subsequent uncertainties, 2) The rehabilitation course enhance a sense of security and well-being, and 3) Reclaiming wholeness.

Conclusion
A specialized rehabilitation program proves to be a crucial support in helping individuals with aortic dissection find peace in their altered selves after facing a life-threatening trauma. These patients require comprehensive physical and psychological support through cardiac rehabilitation provided by cardiac nurses, along with prompt initiation of specialized rehabilitation led by physiotherapists with expertise in aortic dissection.
Contrast-induced nephropathy: nursing interventions - a scoping review
Authors: Jesus Coelho M , Santos J O A N A , Alves N U N O 
Published: July 2024

Abstract

Introduction
Contrast-induced nephropathy (CIN) refers to a reduction in renal function following contrast administration, excluding other causes. It is characterized by na increase in creatinine levels of 0.5mg/dl or greater, or a 25% increase over baseline creatinine, occurring 48 to 72 hours post-contrast administration and lasting for 2 to 5 days (Santos et al., 2011). Antunes et al. (2013) refers that the CIN is the 3rd cause of acute renal insufficiency (ARI) and that CIN may develop in up to 55% of patients who receive contrast exposure during coronary angiography and of these may result in 12,6% requiring dialysis among high-risk groups following percutaneous coronary intervention (PCI) (Wu et al., 2022).

Objective
This review aims to map the available evidence regarding nursing interventions to prevent contrast-induced nephropathy in patients undergoing PCI.

Methods
The review follows the methodology proposed by the Joanna Briggs Institute guided by the PCC (Population, Concept, Context) strategy. Were identified 44 articles by MEDLINE Complete (via PubMed), CINAHL Complete (via EBSCO) e SciELO, and analyzed/ selected through PRISMA Scr flowchart. Four articles were included.

Results
These articles revealed that the incidence of CIN varies based on risk factors such as age, hypertension, and pre-existing chronic kidney disease. As there is no specific treatment for contrast-induced nephropathy, prevention strategies are essential. Nursing professionals have a significant and privileged role in the pre-, intra-, and post-procedural phases, and thus, are best positioned to implement prevention strategies for CIN. In general, hospitals that implemented improvement interventions reduced CIN by 21% compared to the pre-intervention phase. Compared to patients with pre-existing CKD, the reduction was 28% (Lambert et al., 2017). Teams also report important successes in implementing improvements, such as changing behavior with greater awareness of CIN prevention strategies, implementing the hydration protocol, standardizing medical prescriptions and minimizing the volume of contrast administered.

Conclusions
Nursing plays a crucial and privileged role in preventing CIN. Key interventions involve conducting a thorough initial assessment to identify individuals at risk for CIN (considering factors such as age, comorbidities, nephrotoxic medication, and dehydration). Pioli et al. (2023) found that oral hydration can be effective in the process of preventing CIN, before and after elective percutaneous procedures. It concluded that the oral hydration protocol carried out by nurses proved to be as effective as the hospital intravenous hydration protocol in protecting the kidneys of individuals at risk of developing CIN associated with elective coronary interventions (Picture 1). By implementing these strategies, nursing professionals can effectively contribute to reducing the incidence of contrast-induced nephropathy in patients undergoing PCI.
Clinical scores associated with immunological biomarker in the assessment of severity in congenital heart surgery
Authors: Batista Cabral J , Silveira M M B M S , Xavier A T X , Oliveira F H P C O , Menezes T M G L A M , Barbosa K T F B , Teodorio D S A T , Nascimento J E A , Moura Junior J F M J , Sobral Filho D C S F , Oliveira D C O 
Published: July 2024

Abstract

Background
Congenital heart disease is a common disorder that often results in surgical procedures and intensive care. In this way, the use of validated scales and biomarkers can be incorporated into care practice as a tool for assessment and care planning.

Purpose
We aimed to investigate the association between the Therapeutic Intervention Scoring System (TISS-28), the risk-adjusted score for surgery in congenital heart disease (RACHS-1) and the triggering receptor expressed on myeloid cells-1 (sTREM-1) in assessing the clinical severity of cardiac surgery in pediatric patients.

Methods
This is an exploratory, translational cross-sectional study of 32 children undergoing cardiac surgical repair between 2021 and 2022. The severity of heart disease was determined using the RACHS-1 score and clinical severity using the TISS-28, the scores were stratified into C4, C3, C2 and C1, with C4 being the highest severity and C1 being the lowest, according to each assessment instrument, and the associations with sTREM-1 (pre- and post-surgery), measured by the ELISA method. The data were analyzed using the Statistical Package for the Social Sciences - SPSS version 29.0 software, considering statistical significance values of p &lt; 0.05.

Results
Regarding the mean sTREM-1 values preoperative in comparison to the RACHS-1 categories, there was a significant difference between category C4 (241.33 pg/mL) and C3 (161.5 pg/mL) (p = 0.019), and postoperatively between C4 (355.82 pg/mL) and C1 (222.53 pg/mL), C2 (291.02 pg/mL) and C3 (296.66 pg/mL) (p = 0.005; 0.040; and 0.040, respectively). Preoperative, compared to the TISS-28 and sTREM-1 categories, there was a significant difference between category C4 (241.33 pg/mL) and C3 (161.5 pg/mL) (p = 0.020), and postoperatively, between categories C4 (355.82 pg/mL) and C2 (275.22 pg/mL) (p = 0.040).

Conclusions
We concluded that, both pre- and postoperatively, the mean sTREM-1 values were higher in the group of patients classified as more severe according to the RACHS-1 and TISS-28, when compared to those in the lower strata, showing that patients with higher sTREM-1 values preoperative evolved to greater severity postoperatively, a fact that was repeated in the post-operative evaluation.Table - RACHS-1 and sTREM-1Table - TISS-28 and sTREM-1
Hypertension management and outcomes during the covid-19 pandemic: diagnosis, blood pressure telemonitoring use and mortality
Authors: Hanley J , Paterson M , Pollock R , Parker R , Neubeck L , Atherton I , Mchale S , Pearsons A , Mckinstry B , Guthrie B 
Published: July 2024

Abstract

Introduction
The effects of COVID-19 on people with hypertension are poorly understood, but potentially severe both due to increased risk of cardiovascular events post covid (1) and by altering the way people accessed healthcare (2). This study aimed to explore the immediate impact of COVID-19 on the hypertensive population in Scotland.

Methods
The study used linked routine clinical data. Hypertensive patients from five NHS Scotland Health Boards were identified through the Prescribing Information System (PIS) between March 2019 and February 2021. Linked data included Blood Pressure (BP) telemonitoring data from the Connect Me BP service, outcome data (cardiovascular events and mortality) from Scottish Morbidity Records, and National Records of Scotland COVID-19 testing and vaccination records from Public Health Scotland (PHS). Follow up was until February 2022.
EDRIS, the research arm of PHS, linked and pseudonymised the data and transferred it to the secure national safe haven analysis platform for access by the research team. The study was approved by the Public Benefit and Privacy Panel for Health and Social Care.

Results
Almost 450,000 people with hypertension were identified across the whole adult age range, 52% male. Of those, 89% had been diagnosed prior to the study. New diagnoses dropped by over 50% during the first year of the COVID-19 pandemic. The use of long term BP telemonitoring increased rapidly during the pandemic from 5000 to over 10,000. Overall mortality was over 8%. Mortality rates showed a similar pattern to the general population during the pandemic and remained above pre-pandemic levels until the end of the follow up period in February 2022.

Discussion
BP telemonitoring supported healthcare delivery at a time when normal services were severely disrupted due to COVID-19. However the data suggests that there may be an increase in the number of people with undiagnosed hypertension with associated raised cardiovascular risk. Mortality in this population was increased by the COVID-19 pandemic and remained above pre-pandemic levels.
Relationship between duration of heart failure and nutritional status in hospitalised patients - preliminary cross-sectional study
Authors: Furtak J , Sawczak F , Gargula D , Garstka J , Szubarga A , Cierzniak M , Soloch A , Krzysztofiak H , Tomaszewska M , Dudek M , Straburzynska-Migaj E , Kaluzna-Oleksy M 
Published: July 2024

Abstract

Introduction
Heart failure (HF) is a chronic disease which is one of the most common causes of hospitalisation of elderly patients. Nutritional status has a crucial impact on the course of disease and survival. HF frequently occurs with nutritional deficits, which may lead to malnutrition and loss of skeletal mass, which makes the prognosis worse. Nutritional status depends also on the patient's economic status, ability to prepare meals, and availability of fresh vegetables and fruits. Knowledge of the connection between the duration of heart failure and nutritional status will enable selection of patients with a higher risk of malnutrition, for which nutritional support should be considered.

Purpose
The study aims to assess the variability of nutritional status in heart failure patients over the duration of the disease, using the Mini Nutritional Assessment (MNA) and Geriatric Nutritional Risk Index (GNRI).

Methods
The nutritional status of 134 patients with HF admitted to the cardiology department was assessed with the MNA questionnaire. Additionally, GNRI has counted from serum albumin concentration, weight and height of patients. Patients were divided according to the duration of HF into two groups, one with patients with equal or less than five years of history of disease and the second with patients with HF lasting more than five years.

Results
The mean age was 52.4±16.9 years, 20.2% of patients were women, and the mean LVEF was 30.3±13.8%. The group of patients with HF lasting equal or less than five years was younger than patients with more than five years of the disease (49.5±16.9 years vs. 57.3 ±16.2 years, p=0.002). There were no significant differences in sex, LVEF and NYHA class between the two groups. According to MNA and GNRI scores, the nutritional status had no differences between the group of patients suffering from HF for more than five years compared with those with HF lasting 5 years or less (p=0.50; p=0.63, respectively). Moreover, the time of HF lasting was not correlated with scores of MNA and GNRI (p=0.33; p=0.22).

Conclusions
The study found no significant association between the nutritional status of patients and duration of heart failure. Therefore, monitoring nutritional status is crucial, irrespective of the duration of HF. It is necessary to analyse this issue in a larger group of patients with heart failure to identify specifically which patients are at risk of malnutrition and how nutritional status changes with the duration of the disease.