bluuebunny/crossref_metadata_2025_split huggingface dataset:
Causes and effects of childhood obesity
Authors: Trafalska A , Kulinska J , Krzyzanowski D 
Published: July 2024

Abstract

Background
Childhood and adolescent obesity and overweight is a major public health crisis nationally and internationally.. Obesity in childhood increases the risk of cardiovascular diseases, hypertension, lipid and carbohydrate metabolism disorders, including type 2 diabetes, abnormalities resulting from posture defects, and furthermore obesity in adulthood. Excessive body weight is also the cause of many emotional disorders related with lack of acceptance by oneself, family and peers.
An analysis of the prevalence of obesity among children hospitalized in the Department of Rehabilitation was conducted in 2020-2023. Excessive body weight occurred in 23% of the examined patients.

Purpose
The aim of the study is to show the incidence of obesity and overweight among children hospitalized in the Department of Rehabilitation, to determine the cause of the disease based on the author's survey, which took into account the lifestyle of the examined patients, and to examine the relationship between body weight and elevated blood pressure values. The results were subjected to statistical analysis.

Methods
The clinical trial was conducted on 1,283 pediatric patients. The data were analyzed: weight, height, BMI, blood pressure and then the obtained values were placed on percentile charts. An original questionnaire was also conducted - took into account the age, gender, lifestyle, eating habits and physical activity of the respondents.

Results
23% of hospitalized patients indicated excessive body weight. 10% of patients were obese and 13% were overweight. Back pain was the reason for hospitalization in 76% of overweight and obese children. Among children with excessive body weight, 25% indicated higher blood pressure values, while in the control group, this problem affected only 1% of respondents. A relationship has been shown between lack of physical activity, excessive body weight and problems with the locomotor system - 72% of overweight and obese children didn’t engage in any regular physical activity. After school, children spent their time mainly in a sitting or semi-reclining position. Moreover, 60% of parents reported that they don’t know what their child's diet looks like. Most teenagers admitted to eating meals irregularly, snacking between meals, and drinking sweetened drinks and leaving home without breakfast.

Conclusions
Obesity and overweight among children and adolescents is a significant public health problem in both medical and social dimensions. Counteracting obesity should start in early childhood and should be based on the lifestyle that includes proper nutrition and physical activity. Factors contributing to overweight and obesity include: lack of daily physical activity, avoiding exercise during physical education classes, spending many hours in a sitting position and inappropriate eating habits.
Pediatric nurses in Greece, investigation of knowledge and attitude towards the predisposing factors of coronary heart disease
Authors: Argyropoulos T , Yfanti A M A L I A 
Published: July 2024

Abstract

Introduction
Today, everyone agrees that the best treatment of coronary artery disease is its prevention through understanding the role and, of course, controlling the predisposing factors, i.e. those particular characteristics whose presence predicts the occurrence and progression of the disease. As Health professionals, nurses must know about the predisposing factors, participate in prevention programs, and advise on the Algorithm of Care.

Objective
To investigate pediatric nurses' knowledge about the predisposing factors of coronary Heart disease and assess the degree of risk of developing coronary heart disease based on the prevention measures they take and their lifestyle.

Material and Methods
The study sample consisted of 164 working nurses in our Pediatric hospitals, and its duration was four months. A specially designed questionnaire was used for data collection, which was distributed to employees of different departments and was answered by a total of 164 nurses. The questionnaire was weighted to check its validity, and minor adjustments were made for the study.

Results
Pediatric nurses identify the most important predisposing factors of coronary heart disease as hypertension, smoking, dyslipidemia, and stress as a result of their profession. They have a significantly increased body mass index, poor dietary habits, and appear negligent in preventive cardiac screening.

Conclusions
The level of knowledge of Greek pediatric nurses regarding the prevention of coronary heart disease is satisfactory. Their working environment, stress, lifestyle, and lack of regular check-ups make them extremely vulnerable to the predisposing factors of coronary heart disease.
The development of a disease-specific patient-reported outcome measure (CARD-SARC) to assess the impact of cardiac sarcoidosis on health-related quality of life
Authors: Quijano-Campos J C , Sekhri N , Thillai M , Blower E , Clarke H , Murphy E , Othen-Price L , Whight J , Sanders J 
Published: July 2024

Abstract

Introduction
Sarcoidosis is a rare inflammatory condition caused by the formation of lumps (granulomas) of abnormal tissue in any organ, and can affect physical, functional, mental, social and economic aspects of life. People living with cardiac sarcoidosis (CS) are likely to have worse clinical outcomes and greater impairment on health-related quality of life (HRQoL) than other sarcoidosis manifestations. HRQoL is the main concern for people living with sarcoidosis. However, measuring HRQoL in people with CS is difficult as existing tools focus on other forms of sarcoidosis (for example, lung, eye or skin involvement) or for specific cardiac symptoms (for example, atrial fibrillation, angina or heart failure), but not specifically for CS.

Purpose
To develop a disease-specific patient-reported outcome measure (CARD-SARC) to assess the impact of CS on HRQoL.

Methods
A sequential exploratory mixed-method, multicentre observational cohort study using a clinimetric approach was conducted. The McMaster Framework for evaluative instruments was combined with the consensus-based standards for the selection of health measurement instruments (COSMIN) recommendations, involving three steps: item selection, item scaling and item reduction. The item-generation process used simultaneous triangulation (QUAN+qual) method, connecting quantitative data (theory, research findings and systematic review) with complementary qualitative components (interviews, clinical observations and experts’ opinion). The formatting of items was guided by patient and public involvement (PPI). The item reduction strategy was led by PPI and an international multidisciplinary clinical CS-experts.

Results
740 potential items were generated by converging all the different sources and techniques. After removal of duplicates and simultaneous triangulation, a preliminary list with 111 items was reviewed by the CS-expert panel (including 11 pulmonologists, 7 cardiologists, 5 CS-patients and 3 specialist-nurses). After a consensus meeting, the CARD-SARC included 61 relevant items in six sections for pilot-testing: "functioning", "social, leisure and occupation", "emotional", psychological", "physical" and "healthcare/self-care".

Conclusions
This study used a robust methodology and active PPI involvement to develop the first disease-specific HRQoL tool for CS. The engagement and contributions of the PPI group in each step of the framework enhanced the content validity of the CARD-SARC. The CARD-SARC has the potential to influence clinical management and treatment options, future research and health-economic stakeholders’ decisions for CS.
Prevalence of frailty and associated factors in coronary artery bypass graft surgery patients
Authors: Arikan B , Demir Korkmaz F 
Published: July 2024

Abstract

Background
Frail patients are at increased risk for postoperative delirium, complications, delayed recovery, prolonged hospital and intensive care unit stay, morbidity and mortality. The number of studies examining frailty in cardiovascular surgery patients is limited (1,2). In this context, it is important to determine the prevalence of frailty in cardiac surgery patients (3,4).

Purpose
This research was conducted to examine the prevalence of frailty in coronary artery bypass graft surgery patients and associated factors with frailty.

Methods
The research was descriptive cross-sectional type. It was conducted between 18.02.2021 and 18.02.2022 at the cardiovascular surgery department of a training and research hospital in Turkey. A total of 96 patients who had undergone coronary artery bypass graft (CABG) were included. The "Sociodemographic and Clinical Data Form" which was prepared in accordance with the literature, the "Modified Fried Frailty Index", the "Mini Nutritional Assessment Test-Short Form", the "Barthel Daily Living Activities Index", the "Charlson Comorbidity Index", and the "Montreal Cognitive Assessment Scale" were used to collect data. The data were analyzed using the SPSS 23.0 package program. Descriptive statistics, Kolmogorov-Smirnov test, Chi-square test, One Way ANOVA, Kruskal Wallis test and multinomial logistic regression analysis were used in the evaluation of the data.

Results
As a result of the study, the mean age of the patients was 65.65±8.72 years (min:40-max:85), 62.5% consisted of males. The majority of patients (94.8%) had comorbid diseases, most of whom had hypertension (66.7%) and diabetes mellitus (63.5%). The mean ejection fraction of the patients was normal (54.59±8.70) according to the European Society of Cardiology and the majority (80.2%) were in the preserved LVEF group. The mean EuroSCORE was intermediate (4.79±2.40) and 49% of the patients were at intermediate risk for mortality. The majority of the patients (94.8%) were in the ASA III class according to the American Society of Anaesthesiologists. Of the patients. 14.6% were determined as ‘non-frail’, 45.8% as ‘pre-frail’ and 39.6% as ‘frail’. Age, educational status, income level, beta-blocker use, nutritional status, daily living activities, cognitive status, number of comorbidities, and level of potassium, procalcitonin and creatinine were found to be associated with frailty (p&lt;0.05). Malnutrition, decreased daily living activity, cognitive impairment and creatinine elevation were found to be predictors of frailty (p&lt;0.05). Sociodemographic and Clinical Characteristics by Frailty Status was presented in Table 1.

Conclusions
More than a third of CABG patients were frail. Malnutrition, decreased daily living activity, impaired cognitive status and high creatinine levels increased the risk. It is important to assesment frail cardiac surgery patients and provide them with appropriate nursing management.
Psychometric properties of the KCCQ-12 in an european cohort of patients with heart failure
Authors: Paolo Iovino P I , Hamilton Dollaku H D , Gianluca Pucciarelli P G , Laura Rasero L R , Izabella Uchmanowicz I U , Rosaria Alvaro R A , Ercole Vellone E V 
Published: July 2024

Abstract

Background
Despite medical advances, patients with heart failure continue to suffer from poor quality of life due to worsening symptoms and functional limitations. Therefore, it is important to understand the multidimensional facets of quality of life in these patients. The Kansas City Cardiomyopathy Questionnaire is a commonly used quality of life assessment tool worldwide. However, However, there is still a lack of knowledge about its psychometric properties.

Purpose
The aim of this study was to investigate the psychometric properties of the KCCQ-12 and its measurement invariance in a cohort of European patients with heart failure.

Methods
Participants (n=510, median age=72, IQR=18, 58% males) completed the KCCQ-12 alongside measures of clinical psychosocial severity. A confirmatory factor analysis was used to establish factorial validity; internal consistency was determined using the Omega coefficient and the model-based internal consistency coefficient. Zero-order correlations between the KCCQ-12 scores and clinical and psychosocial measures were performed to test convergent validity. Multigroup confirmatory factor analysis was conducted to test measurement invariance across patients with preserved vs reduced ejection fraction.

Results
Confirmatory factor analysis confirmed a four-factor solution, with the domains of physical limitations, symptom frequency, quality of life, and social interference. Internal consistency was excellent (Omega coefficients ranging from 0.83 and 0.90, and internal consistency index of 0.94). The KCCQ-12 scores significantly correlated with ejection fraction, New York Heart Association class, quality of life, anxiety, depression, symptom burden, and the KCCQ-23 Overall Summary score, which adequately supported the convergent validity of the KCCQ-12. Measurement invariance was confirmed at the partial scalar and strict level.

Conclusions
These findings support the validity and reliability of the KCCQ-12, both in patients with reduced and preserved ejection fraction. Hence, this version can be confidently used both in research and clinical practice to measure quality of life of heart failure patients.
Inequality in continuity of care after hospitalization due to cardiac conditions
Authors: Safstrom E , Stromberg A S 
Published: July 2024

Abstract

Background
Cardiac conditions are a common cause of hospitalization worldwide. The need for follow-up within primary care and/or specialized care continues after discharge. Continuity of care is crucial to enable a seamless chain of care after hospitalization. Research regarding inequality in continuity of care after discharge is lacking.

Purpose
The aim was to investigate how patients’ perceptions of continuity of care vary between age, gender, and diagnosis groups.

Methods
Patients were consecutively included within six weeks after hospitalization due to a cardiac condition. Data were collected with the short version of the Patient Continuity of Care Questionnaire (PCCQ-12).
The independent t-test was used to compare differences between sexes and age groups (&lt; 65 years or ≥ 65 years). Differences between diagnosis groups were evaluated with the one-way analysis of variance (ANOVA) and post-hoc analysis with the least significant difference (LSD) correction. The significance level was set at p &lt;0.05 for all analyses.

Results
A total of 1,000 patients were included (mean age 72 years (SD 10) 66% male). The patients were hospitalized due to myocardial infarction (36%), atrial fibrillation (26%), angina pectoris (21%) or heart failure (17%).
Significant differences between age, gender and diagnosis were found: Patients &lt; 65 years perceived significantly higher levels of continuity of care than patients ≥ 65 years. Men had significantly higher scores than women. Patients hospitalized due to acute myocardial infarction perceived significantly higher levels of continuity of care compared to patients who had been hospitalized due to angina pectoris, atrial fibrillation, or heart failure (Table 1).
Significant differences were also found between men and women. Men &lt;65 years perceived significantly higher levels of continuity of care (mean 48.08) compared to men ≥ 65 years (mean 45.51, p= 0.008 ). Men who had been hospitalized due to myocardial infarction had significantly higher scores on the PCCQ-12 (mean 48.82) compared to men who had been hospitalized due to angina (mean 44.48), atrial fibrillation (mean 44.09) and heart failure (mean 45.24) (Figure 1).
Women &lt;65 years had significantly higher scores on the PCCQ-12 (mean 45.00) compared to women ≥ 65 years (mean 40.71, p 0.018). Women who had been hospitalized due to myocardial infarction or atrial fibrillation had significantly higher scores on the PCCQ-12 (mean 42.48 and 43.02, respectively) compared to women hospitalized due to heart failure (mean 38.00) (Figure 1).

Conclusion
Overall, patients hospitalized due to cardiac conditions perceive a rather high level of continuity of care. However, statistically significant differences were found between men and women, between younger and older patients, and between diagnosis groups, indicating that care inequality exists in continuity of care.
Experience of integrating mobile applications in the self-management of patients with heart failure
Authors: Kinjo M , Higashitsuji A , Sano M , Okada S , Majima T 
Published: July 2024

Abstract

Background
Self-management in patients with heart failure is important in terms of their prognosis and quality of life. The use of mobile applications in the self-management of patients with heart failure has been suggested to improve their knowledge of the disease and quality of life. However, there are limited data on the experiences of patients with heart failure when mobile applications are integrated into their routine as a self-management intervention.

Purpose
We aimed to determine the experiences of patients with heart failure who incorporated the use of mobile applications as a self-management intervention.

Methods
In this qualitative cross-sectional study, participants were purposive-sampled at a university hospital, and semi-structured interviews were conducted with both male and female patients, aged 40–70 years, with a diagnosis of chronic heart failure (ACCF/AHA stage C). Data were collected between December 2022 and April 2023. All interviews were audio-recorded and transcribed verbatim, followed by content analyses. The mobile application used in this study recorded and managed patients’ subjective symptoms and daily life as cloud data and allowed healthcare professionals to access the data using a dedicated terminal.

Results
Four themes were identified from the data: 1) patients used the mobile application in their own way through trial and error; 2) the support of healthcare professionals through the mobile application increased patients’ sense of self-efficacy; 3) using the mobile application made them feel secure as they always felt connected; and 4) some patients struggled to incorporate new technology into their self-management. Most participants in this study had a positive experience of using the mobile application for self-management in their own way with the support of healthcare professionals, including gaining a sense of self-efficacy and security. On the other hand, some patients had a negative experience, such as not looking at the mobile application for a while or discontinuing self-management because they felt burdened by the introduction of this new self-management method.

Conclusions
Both positive and negative aspects of the experiences of patients with heart failure with adopting a mobile application for self-management were identified. Psychological support is essential when patients incorporate mobile applications into their routine as a self-management intervention.
Bidirectional relationship between depression and frailty syndrome in Heart Failure patients
Authors: Wleklik M , Lisiak M , Nowak B , Jedrzejczyk M , Mirkowski K , Uchmanowicz I 
Published: July 2024

Abstract

Introduction
Depression and frailty syndrome (FS) are frequently identified in patients with heart failure (HF) and reported in the literature. The co-occurrence of depression and FS has several pathophysiological mechanisms. Moreover, the two constructs overlap in patients with cardiovascular disease. Depression may be difficult to diagnose in patients with HF due to the co-occurrence of FS, and vice versa. It therefore becomes important to establish the direction of the relationship between the presence of depression and FS in patients with HF. Understanding the relationship and causality between these modifiable variables provides an opportunity to increase patient psychological well-being as well as improve clinical outcomes.

Aim of the study
Determining the direction of the relationship between depression and FS in patients with HF.

Material and Methods
The study included 250 patients with HF (69% male, 31% female, mean age: M±SD=72.32±6.73). Data were collected during hospitalization. 50% of patients with HFrEF and 50% of patients with HFpEF were included. Depression was assessed using PHQ-9 (The Patient Health Questionnaire-9). The frailty phenotype was determined using the FRIED criteria (weight loss, feelings of exhaustion, decreased physical activity, slowed gait speed, weakened handgrip strength). The diagnosis of frailty was established when a minimum of 3 criteria were met. Data were considered statistically significant at p-value &lt; 0.05.

Results
FS was identified in 60% of patients with HF. Patients with FS were older (73.58 ± 6.80 vs. 70.39 ±6.16, p-value=0.0002). In HFrEF patients, the mean PHG-9 score was M±SD=5.97±5.65. In HFpEF patients M±SD=5.85±4.52. There were no differences between patients with preserved and reduced left ventricular fraction in terms of PHQ-9 score (p-value=0.585). Univariate analysis showed that each additional score on the PHQ-9 raised the FRIED score by an average of 0.072 points (0.072; 95% CI: 0.051-0.093, p-value&lt; 0.001) and each additional score on the FRIED scale raised the level of depression according to the PHQ-9 by an average of 2.124 points (2.124; 95% CI: 1.499-2.748, p-value&lt;0.001). In the multivariate model, each additional score on the PHQ-9 raised the FRIED scale score by an average of 0.048 points. (0.048; 95% CI: 0.013-0.083, p-value=0.008) and each additional score on the FRIED scale raised the level of depression according to the PHQ-9 by an average of 0.68 points (0.68; 95% CI: 0.179-1.182, p-value=0.008).

Conclusions
The co-occurrence of FS and mild depression is identified in hospitalized with HF. There is a bidirectional relationship between frailty and depression in patients with HF: depression increases frailty and vice versa. Recognizing these two constructs during hospitalization should involve providing multidisciplinary continuity of care to prevent rehospitalizations.
Evaluation of the compliance of diet plans and nutritional advice generated by artificial intelligence with guidelines for cardiac patients
Authors: Sloma Krzeslak M , Kowalski O 
Published: July 2024

Abstract

Introduction
In response to the increasing demand for personalization in cardiac dietetics, tools based on artificial intelligence (AI) are gaining popularity. We assess the compliance of AI-generated nutritional advice and diet plans with current dietary standards.

Objective
The study aims to evaluate whether nutritional advice and diet plans created by AI for heart disease patients align with the recommended caloric intake and macronutrient ratios, based on current dietary guidelines.

Methods
Using selected AI tools, nutritional advice and diet plans were generated for defined dietary scenarios corresponding to specific cardiac diagnoses. The analysis included assessing the caloric content and macronutrient composition (protein, fat, carbohydrates) compared to current guidelines.

Results
The analysis showed that the majority of the AI-generated diet plans and nutritional advice were compliant with dietary recommendations, with an &gt;75% compliance rate for caloric content and macronutrient ratios. However, instances of non-compliance were discovered, suggesting a need for further adjustment of AI algorithms.

Conclusions
AI tools demonstrate potential in creating personalized diet plans for cardiac patients but require optimization to fully meet current dietary guidelines. The study highlights the importance of integrating dietary knowledge into the design process of AI tools, which is crucial for providing high-quality nutritional support.