bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors and pattern of metastatic recurrence after endoscopic resection with additional treatment for esophageal cancer
Authors: Tanaka Ippei , Hatta Waku , Koike Tomoyuki , Takahashi So , Shimada Tomohiro , Hikichi Takuto , Toya Yosuke , Onozato Yusuke , Hamada Koichi , Fukushi Daisuke , Watanabe Ko , Kayaba Shoichi , Ito Hirotaka , Tatsuta Tetsuya , Oikawa Tomoyuki , Takahashi Yasushi , Kondo Yutaka , Yoshimura Tetsuro , Shiroki Takeharu , Nagino Ko , Hanabata Norihiro , Funakubo Akira , Ohira Tetsuya , Nakamura Jun , Nakamura Tomohiro , Nakaya Naoki , Iijima Katsunori , Matsumoto Takayuki , Fukuda Shinsaku , Masamune Atsushi , Hirasawa Dai 
Published: June 2024

Summary
Although esophageal cancers invading the muscularis mucosa (pT1a-MM) or submucosa (pT1b-SM) after endoscopic resection (ER) are associated with a risk of lymph node metastasis, details of metastatic recurrence after additional treatment remain unknown. We aimed to identify the risk factors for metastatic recurrence and recurrence patterns in patients receiving additional treatment after ER for esophageal cancer. Between 2006 and 2017, patients with pT1a-MM/pT1b-SM esophageal cancer who underwent ER with additional treatment (esophagectomy, chemoradiotherapy [CRT], and radiation therapy) at 21 institutions in Japan were enrolled. We evaluated the risk factors for metastatic recurrence after ER with additional treatment. Subsequently, the rate and pattern (locoregional or distant) of metastatic recurrence were investigated for each additional treatment. Of the 220 patients who received additional treatment, 57, 125, and 38 underwent esophagectomy, CRT, and radiation therapy, respectively. In the multivariate analysis, lymphatic invasion was the sole risk factor for metastatic recurrence after additional treatment (hazard ratio, 3.50; P = 0.029). Although the risk of metastatic recurrence with additional esophagectomy was similar to that with CRT (hazard ratio, 1.01; P = 0.986), the rate of locoregional recurrence tended to be higher with additional esophagectomy (80.0% (4/5) vs. 36.4% (4/11)), leading to a better prognosis in patients with metastatic recurrence after additional esophagectomy than CRT (survival rate, 80.0% (4/5) vs. 9.1% (1/11)). Patients with lymphatic invasion have a high risk of metastatic recurrence after ER with additional treatment for pT1a-MM/pT1b-SM esophageal cancer. Additional esophagectomy may result in a better prognosis after metastatic recurrence.
The epicardial adipose tissue confined in the atrioventricular groove can be used to assess atrial adipose tissue and atrial dysfunction in cardiac magnetic resonance imaging
Authors: Bialobroda Jonathan , Bouazizi Khaoula , Ponnaiah Maharajah , Kachenoura Nadjia , Charpentier Etienne , Zarai Mohamed , Clement Karine , Andreelli Fabrizio , Aron-Wisnewsky Judith , Hatem Stéphane N , Redheuil Alban 
Published: June 2024

Abstract

Aims
The growing interest in epicardial adipose tissue (EAT) as a biomarker of atrial fibrillation is limited by the difficulties in isolating EAT from other paracardial adipose tissues. We tested the feasibility and value of measuring the pure EAT contained in the atrioventricular groove (GEAT) using cardiovascular magnetic resonance (CMR) imaging in patients with distinct metabolic disorders.

Methods and results
CMR was performed on 100 patients from the MetaCardis cohort: obese (n = 18), metabolic syndrome (MSD) (n = 25), type-2 diabetes (T2D) (n = 42), and age- and gender-matched healthy controls (n = 15). GEAT volume measured from long-axis views was obtained in all patients with a strong correlation between GEAT and atrial EAT (r = 0.95; P &lt; 0.0001). GEAT volume was higher in the three groups of patients with metabolic disorders and highest in the MSD group compared with controls. GEAT volume, as well as body mass and body fat, allowed obese, T2D, and MSD patients to be distinguished from controls. GEAT T1 relaxation and peak longitudinal left atrial (LA) strain in CMR were decreased in T2D patients. Logistic regression and random forest machine learning methods were used to create an algorithm combining GEAT volume, GEAT T1, and peak LA strain to identify T2D patients from other groups with an area under curve (AUC) of 0.81 (Se: 77%, Spe: 80%; 95% confidence interval 0.72–0.91, P &lt; 0.0001).

Conclusion
Atrioventricular groove adipose tissue characteristics measured during routine CMR can be used as a proxy of atrial EAT and integrated in a multi-parametric CMR biomarker for early identification of atrial cardiomyopathy.
Gender Differences in Math Tests: the Role of Time Pressure
Authors: Galasso Vincenzo , Profeta Paola 
Published: June 2024

Abstract
We investigate the role of time pressure in generating gender gaps in math tests. In a randomised experiment, college students took a twenty-question math test under high, low or no time pressure. Reducing or eliminating time pressure decreases the math gender gap by up to 40%. Larger gaps under time pressure are mostly due to increased anxiety rather than to students modifying their test-taking strategies. The correlation between math test scores and university performance is equally high under the different scenarios. Hence, less time pressure may increase gender equality in math subjects with no effect on the selection process.
Residential exposure to greenness and mortality in a cardio-oncologic population
Authors: Ashri S , Cohen G , Itzhaki Ben Zadok O , Moran M , Broday D M , Steinberg D M , Keinan-Boker L , Witberg G , Bental T , Golan L , Kornowski R , Gerber Y 
Published: June 2024

Abstract

Background
Knowledge is lacking on the relationship between greenness and all-cause mortality in cancer survivors who subsequently experience an acute coronary syndrome (ACS), a cardio-oncologic population. We aimed to investigate the association between residential greenness exposure and mortality in this cardio-oncologic population.

Methods
Cancer survivors undergoing percutaneous intervention at a medical center in Israel between 2004 and 2014 were included in the study. Clinical data were collected from medical records during index hospitalization. Residential greenness was estimated by the normalized difference vegetation index (NDVI), a satellite-based index derived from Landsat imagery at 30 m spatial resolution, with larger values indicating higher levels of vegetative density (ranging between -1 to 1). NDVI values were retrieved for a buffer within 300 m radius around each patient’s home address. Mortality follow-up data (through the end of 2021) were obtained from the Ministry of Health. Data on residential socioeconomic status (rSES) were obtained from Central Bureau of Statistics based on home addresses. Cox models were used to assess the hazard ratios (HRs) for all-cause mortality per 1SD increase in NDVI.

Results
Among 1,331 patients analyzed [median age, 77 (IQR 69-83) y, 373 (28%) females], the mean (SD) NDVI-300 was 0.12 (0.03). During a median follow-up period of 12.0 (IQR 9.2-14.7) years, 883 (66%) participants died. After adjustment for potential confounding factors, including rSES, smoking, and residential NOx exposure, NDVI-300 was linearly associated with lower mortality [HR (95% CI) = 0.93 (0.86, 1.00); p=.04]. Individuals with lower rSES scores had a lower point estimate for the HR, compared with individuals with higher rSES (Figure 1). The association was more robust among individuals with recently diagnosed cancer (up to ten years prior to ACS onset; Figure 2).

Conclusions
In a cohort of cardio-oncologic patients, greenness was associated with lower mortality. The association was strongest among individuals from deprived neighborhoods and with recently diagnosed cancer.
Higher burden of classical, novel and socioeconomic risk factors in young women with type 2 diabetes mellitus in a middle eastern population. Results from the ANCORS-YW Study
Authors: Ayasrah L , Asfour H , Sabanekh C , Sawalha L , Qasem F , Alrawajih T , Ababneh Z , Ababneh A , Ababneh L , Al-Omari B , Bani Younis D , Hammoudeh A 
Published: June 2024

Abstract

Introduction/Background
Type 2 diabetes mellitus (T2D) is highly prevalent in adults of all ages in the Middle East (ME). Limited is known about the coexistence with classical, novel, and socioeconomic cardiovascular risk factors (RFs) in young women with T2D in the ME.

Aim/Purpose
We aimed to assess the clinical profiles and prevalence of traditional, novel, sex-specific, and socioeconomic RFs in young women with or without atherosclerotic cardiovascular disease (ASCVD) in the ME.

Methods
The Atherosclerosis Novel and Classical RF in Young Women (ANCORs YW) in the ME Study enrolled consecutive young women (18-50 years of age) with ASCVD, each was aged-matched with two women without ASCVD. In this analysis, we compare the risk profile of various RFs in women who have T2D compared with women without T2D.

Results
Of the 627 young women enrolled in the study, 132 (21.5%) had T2D, and 494 (78.5%) did not have T2D. The mean age of women in the 2 groups was 45.9±4.1 and 44.2±5.5 (p&lt;0.001), respectively. ASCVD was more prevalent in the T2D group (62.8% vs. 25.5%, p&lt;0.001). Young women with T2D had a higher prevalence of four of the six classical RFs compared to women without ASCVD; hypertension (HTN) (72.0% vs. 27.7%), obesity (57.6% vs. 40.0%), family history of ASCVD (45.5% vs. 28.1%), and physical inactivity (86.4% vs. 71.9%); all p values &lt;0.001. Smoking and elevated LDL-C rates were similar in both groups, but women with T2D showed a higher prevalence of low HDL-C and hypertriglyceridemia. Of all sex-specific RFs tested, only gestational DM was more prevalent in women with T2D (25.8% vs. 8.7%, p&lt;0.001). No significant differences were observed in the prevalence of hypertensive disease of pregnancy, preterm delivery, persistent weight gain after pregnancy, premature menopause, and polycystic ovary syndrome. Fewer women with T2D completed graduate and postgraduate education (24.2% vs. 43.0%, 0&lt;0.0001). Urban residence and depression rates did not differ from those without T2D. On multivariate analysis, T2D was an independent factor for ASCVD (odds ratio 2.97, 95% CI 1.83-4.82, p&lt;0.001).

Conclusion
In this cohort of ME young women, those with T2D exhibited poorer clinical profiles, including higher prevalence of ASCVD, classical RFs and gestational DM. Urgent cardiovascular screening and aggressive management of T2D are essential for primary and secondary prevention in this region.
Pain in my heart: chronic angina is linked to poor mental health among patients with spontaneous coronary artery dissection
Authors: Tulloch H , Stragapede E , Bouchard K , Knight L , So D , Reed J , Wells G , Coutinho T 
Published: June 2024

Abstract

Background
Spontaneous coronary artery dissection (SCAD) is an increasingly recognized form of acute coronary syndrome that often causes myocardial infarction, particularly among women. Even after their dissection has healed, a significant portion of these patients experience ongoing chest pain. Research with patients with obstructive forms of coronary artery disease shows that chronic angina is linked to mental health symptoms such as depression and anxiety and, in turn, mortality. To our knowledge, few studies have reported on angina burden among patients with SCAD, and no studies have examined the angina-mental health connection among this unique population. Given their young age, uncertainty about prognosis and treatment, and the prevalence of emotional stressors pre-SCAD, these patients may be at higher risk for chest pain and psychological distress post-SCAD.

Objective
The purpose of the study was to examine the association between angina burden, depression and anxiety among patients with SCAD.

Methods
Patients with a diagnosed SCAD were recruited from a cardiac care hospital. Patients completed a sociodemographic questionnaire and validated measures of angina burden (Seattle Angina Questionnaire; SAQ), depression (Patient Health Questionnaire-9; PHQ-9), generalized anxiety (Generalized Anxiety Disorder-7; GAD-7), cardiac-related anxiety (Cardiac Anxiety Questionnaire; CAQ) and posttraumatic stress (PTSD Checklist; PCL-5). Descriptive analyses and bivariate correlations were conducted.

Results
Participants (N=97; 80% female; M age=52 years; 75% White). Overall, patients’ angina-related health status fell in the poor to good category; lower scores were noted for angina stability (i.e., angina when doing strenuous activity). On average, patients reported experiencing angina on a monthly basis. Satisfaction of angina treatment was rated fair to good (M=70.8). About 20% of participants reported clinically elevated symptoms of depression and generalized anxiety, while 14% had scores indicating a probable diagnosis of posttraumatic stress. Cardiac-related anxiety was most prevalent; 40% of participants fell in the clinical range. All SAQ subscales (physical limitation, angina stability, angina frequency, angina treatment satisfaction, and QoL) were negatively associated with depression (r=.29-.41; ps&lt;.004), generalized anxiety (r=.29-.39; ps&lt;.007), cardiac-related anxiety (r=.34-.61; ps&lt;.001) and posttraumatic stress (r=.29-.46; ps&lt;.005).

Conclusions
These preliminary data suggest that chronic angina is strongly linked to mental health symptoms among patients who have experienced SCAD. As depression and anxiety have been previously associated with poor clinical outcomes, interventions to assist patients to cope with chronic angina may be required to enhance mental health and, possibly, improve cardiac outcomes.
The effect of arterial hypertension on the functional capacity of morbidly obese diabetics
Authors: Ostojic M , Ostojic M L , Simic J , Petrovic O , Giga V , Beleslin B , Nedeljkovic I 
Published: June 2024

Abstract

Introduction
Morbid obesity represents a major health problem, in particular, associated with type 2 diabetes mellitus (DMT2). It is a significant risk factor for adverse cardiovascular events, especially for surgical procedures. Bariatric surgery is the ultimate treatment for weight reduction, but at the same time, as a major abdominal surgery, it has a higher risk. The cardiopulmonary exercise test (CPET) has been included in the preoperative assessment to evaluate the functional status and eligibility for surgical treatment, also examining the effect of comorbidities like hypertension (HTN).

Purpose
To evaluate the effect of HTN associated with DMT2 on the functional capacity of morbidly obese patients scheduled for bariatric surgery.

Methods
We assessed 87 morbidly obese patients with T2DM (mean age 44.33±9.38, 32 males) during preoperative evaluation for bariatric surgery. All patients underwent multidisciplinary clinical examinations, laboratory analysis, and echocardiography. Also, we evaluated the function of the cardiovascular, pulmonary, and circulatory systems by CPET (Treadmill, maximal Bruce protocol). We assessed the effects of arterial HTN and its effects on glycemic control and CPET parameters.

Result
The mean BMI of the morbid obese diabetics was 44.48±7.09 kg/m2. There was a significantly higher BMI in female vs. male patients (62.77±4.05 kg/m2 vs. 57.56±13,23 kg/m2 p=0,001). The mean glucose level was 7.18±2.54 mmol/L, whereas the mean glycosylated hemoglobin (HbA1c) was 7.21±1.55 % without differences regarding gender. All echocardiographic parameters were within normal limits, with the mean global systolic function of the left ventricle at 60.34±9.76 %. There were 55 patients with arterial HTN, and they had significantly lower peak oxygen consumption (peakVO2) in comparison to normotensive patients (17.62 ± 4.16 vs. 18.23±4.16 ml/kg/min, CI 16.69-18.53, p=0.001). Furthermore, patients with HTN had significantly lower VO2 at the ventilatory anaerobic threshold (VAT/VO2) compared to normotensive, 15.20±3.15 vs. 15.35±4.31 ml/kg/min. There was no difference in the ventilatory parameters in patients with or without HTN.

Conclusions
The presence of HTN in morbidly obese individuals with T2DM has an additional effect on reducing functional capacity, which can increase the risk for bariatric surgery. Therefore, evaluating the risk, CPET points to the need for optimal medical therapy and pressure regulation, among other measures, for improving the state of fitness.
The relationship between cardiovascular risk factors and cardiovascular fitness and physical activity in patients with T2DM and prediabetes
Authors: Calik Kutukcu E , Durukan B N , Bozdemir Ozel C , Arikan H , Dagdelen S 
Published: June 2024

Abstract

Introduction
Diabetes mellitus (DM) and impaired glucose tolerance (IGT) are known to be associated with several adverse cardiovascular disease (CVD) risk factors, including hypertension, obesity, central obesity, hyperinsulinemia and serum lipid and lipoprotein abnormalities. Despite reduced exercise capacity is a strong predictor of CVD mortality in subjects with T2DM, there is limited evidence about the relation between CVD risk, exercise capacity and physical activity (PA).

Objective
The aim of the study was to investigate CVD risk factors and cardiovascular fitness and physical activity (PA) in patients with T2DM and prediabetes.

Methods
Prediabetes is defined as IGT. Patients with heart failure and history of CVD events last two years were excluded. The total number of coronary artery disease (CAD) risk factors was defined as the number of the following that were present: advanced age (&gt;45 for men, &gt;55 for women), hypercholesterolemia, hypertension, diabetes mellitus (DM), family history of CAD, and tobacco use. SCORE2 that is a new algorithm validated to predict 10-year risk of first-onset CVD in European populations was also used. Cardiovascular fitness was determined by cardiopulmonary exercise test (CPET) and incremental shuttle walking test (ISWT). PA and energy consumption (metabolic equivalent-METs) during PA and exercise tests were measured using SenseWear Armband activity monitor.

Results
Twenty-six patients (T2DM: 16 patients, prediabetes: 10 patients) were included in the study. The median age of participants were 49.5 (39-58) years. The median CAD risk factors were 3 (2-6), the median 10 year CVD risk were 3 (1-8) according to SCORE2 algorithm. The number CAD risk factors was significantly related with mean METs during ISWT (r=-0.469, p=0.032), mean METs during one-week (r=-0.476, p=0.022), ∆glucose during ISWT (r=0.532, p=0.011), time to reach anaerobic threshold during CPET (r=-0.442, p=0.024).

Conclusion
As the CAD risk factors increase, energy consumption during maximal exercise performance and daily PA decrease, resulting greater decline in glucose levels and early transition to anaerobic metabolism in patients with T2DM and prediabetes. These findings express the importance of individualized exercise training for decreasing CVD risk in these patient population during cardiac rehabilitation programmes.
Is the six-minute step test an alternative to six-minute walking test to assessment the functional capacity in elderly?
Authors: Lopes Do Nascimento L L N , Rossi J C , Antunes L , Leite Y A , Coelho G G , Pacheco M P , Santos G F , Carvalho Y F , Silva R E N S , Oliveira L C M 
Published: June 2024

Abstract

Background
The assessment of cardiorespiratory functional capacity can contribute to the prognosis of cardiovascular, chronic respiratory and musculoskeletal system diseases, considering loss of functional capacity and the presence of comorbidities. This assessment can be done through maximal tests such as the cardiopulmonary exercise test, exercise test and submaximal tests such as the 6-minute walk test (6MWT) and the 6-minute step test (6MST). There are few studies that compare both tests and can validate the replacement of the 6MWT by the 6MST, since the 6MWT is a test that requires a large space to be performed, unlike the 6MST, which only needs a 20 cm high step.

Purpose
The objective of the present study was to verify the correlation between the 6MST and the 6MWT in the evaluation of the functional capacity of elderly people.

Methods
Cross-sectional descriptive study with voluntary non-probabilistic sampling, consisting of 30elderly people who are part of the Cardiovascular Physiotherapy in Primary Care study. The sample was submitted to the 6MWT and 6MST, and the beginning and end parameters were collected to be compared. Submaximal exercise capacity was evaluated by the distance covered in the walking test and by the number of steps taken up and down, and equations were performed to obtain the VO2max of both tests.

Results
The sample was predominantly female (75%), with an average age of 69.86 (±7.34) years. There was a positive and moderate correlation between the estimated values for VO2max in the walk and step test (p = 0.01 and r = 0.57) and between the distance covered in the walk test and the number of ascents and descents in the step test (p = 0.02 and r = 0.43).

Conclusion
The six-minute step test can be an alternative to assess the functional capacity of the elderly.
The use of eHealth interventions in vascular disease patients with lower limb amputation: a scoping review
Authors: Sousa P , Santos I M S C 
Published: June 2024

Abstract

Background
Individuals with a non-traumatic amputation have unique needs and require specialized management expertise to facilitate optimal outcomes. Empowerment is needed to enhance the confidence and coping skills of these patients, however, access to rehabilitation services is still limited. eHealth is considered an effective approach for delivering self-management programs. The delivery of remote rehabilitation care to patients with amputation may contribute to reduced patient travel burden, enhanced access to specialized services, and improved continuity of care.

Purpose
To assess the scientific evidence regarding the use of eHealth interventions among vascular disease patients with lower limb amputation, namely the intervention components, delivery mode and impact.

Methods
We systematically searched PubMed and Cumulative Index to Nursing and Allied Health Literature during October 2023, to identify relevant publications, according to previously defined criteria. We also searched for grey literature in scholar google. Two authors independently screened records and assessed risk of bias. We conducted a narrative synthesis of evidence and followed the JBI recommendations for the scoping reviews.

Results
We identified 10 adequate publications on eHealth interventions in these patients. The sample size, interventions components and duration were very diverse. eHealth interventions addressed wound management, mobility assessment, falls detection, walking capacity and gait training, as well as management of health symptoms, engagement in health promoting activities and promotion of lifestyle behaviors. Regarding the delivery of the intervention to the patients with lower limb amputation, we found telerehabilitation systems, Wii Fit devices, telephone-based interventions, and mobile phones sensors. The effectiveness evidence of these interventions is still scarce.

Conclusions
Our review address a knowledge gap on the implementation of eHealth interventions for Vascular Disease Patients with lower limb amputation. Although some promising effects was shown, weak evidence limits the development of definitive clinical recommendations.