bluuebunny/crossref_metadata_2025_split huggingface dataset:
DEVELOPMENT OF AN APPLICATION AS AN AUXILIARY TOOL FOR VERIFICATION OF AN ELECTROCARDIOGRAM CONCLUSION
Authors: Vizir Maryna 
Published: May 2024

Objective:
Electrocardiography (ECG) is a key step in the diagnosis of cardiovascular pathology. Interpretation of the ECG is carried out by the doctor in the first minutes of severe patient admission and often determines further tactics of management. However, such an important diagnostic method is quite subjective, since it is highly dependent on the knowledge, and experience of the doctor and even on his attention to detail.
The objective is to develop an application for automatic verification of various ECG criteria (exceptionally as an addition to the subjective interpretation of the doctor).

Design and method:
The desktop application was developed in Python (v3.10.5) by implementing its object-oriented programming concepts. Tkinter was chosen as a Graphical User Interface framework. The set of standard libraries has been supplemented by OpenCV (v4.6.0.66) for recognizing and digitizing ECG images, Pillow (v9.3.0) for manipulating the image and its metadata, NumPy (v1.23.5) for further analysis, and others.
The initial version of the program includes STEMI recognition. Real ECGs printed on graph paper were used for debugging and testing.

Results:
When launching the application, the user is prompted to select a file containing an ECG image (a). After the required image has opened, the user should indicate the requested ECG-leads in the picture, following the simplest instructions (b).
Then processing of the leads automatically starts. This phase is hidden from the user, and only a progress bar is displayed on the screen (c). Meanwhile, a number of manipulations are performed, such as converting the picture to a binary state, recognizing the ECG-line, and storing the coordinates of each pixel in the database. Objects of such classes as Isoline, and Cardiac Cycle with R wave, ST segment, etc. are created for each of the objects of the Lead class (d).
Further geometric study of the pixel base and checking for the pathological ECG-signs on the backend form the final conclusion for the user (e).

Conclusions:
The developed application is relevant for use as an additional tool in the work and training of doctors. It can be expanded to cover a wide range of pathologies.
CAN PATIENTS WITH CARDIOVASCULAR RISK FACTORS AND DIFFERENCE BETWEEN OFFICE AND OUT-OF-OFFICE BP MEASUREMENTS BENEFIT FROM ABPM?
Authors: Ztriva Eleftheria , Andronogloy Markos , Kachtsidis Vasileios , Kontana Anastasia , Gogou Christiana , Savvopoulos George , Dimas Grigorios , Savopoulos Christos 
Published: May 2024

Objective:
Blood pressure (BP) is a dynamic parameter characterized by fluctuations during the 24-hour period. During the nighttime hours, BP drops 10-20% in normotensive and untreated hypertensive patients - a dipping phenomenon, followed by a rapid and gradual increase during waking hours. The dipping phenomenon can be checked by Ambulatory Blood Pressure Measurement (ABPM). The main clinical indications for ABPM, suggested by the available studies, are white-coat phenomena, masked hypertension, and nocturnal hypertension.

Design and method:
Our study involved 45 patients with over 20% difference between office and out-of-office blood pressure measurements. We checked their medical history for other cardiovascular risk factors, such as Dyslipidemia, Diabetes Mellitus, Coronary Disease. Our patients were under 24 hour- ABPM and they were classified according to the rate of fall in systolic BP during 24-hour recording into four categories: the extreme-dippers drop >20%, dippers drop >10% and <20%, non-dippers drop <10% and >0%, and reverse-dippers or risers drop <0%. The purpose of our study is to consider the significance of ABPM in specific target groups of patients with cardiovascular risk factors.

Results:
In our study 44 patients participated (56,8% men) with mean age 55,9 and mean value of systolic BP 120,7mmHg. 40,9% of the patients had a history of hypertension, 36,4% dyslipidemia, 15,9% diabetes mellitus and 11,4% coronary disease. 77,3% of the patients were judged to be normotensive, but 35,3% of them had a history of hypertension and were under medication, only 11,4% were judged to be hypertensive, 6,8% with isolated diastolic hypertension and 4,5% with isolated systolic hypertension. According to ABPM, we changed medication in 29,5% of the patients. 76.9% of them had already history of hypertension and were under medication, 38,5% had dyslipidemia and 30,7% diabetes mellitus and coronary disease.

Conclusions:
In our study we were not able to demonstrate that patients with difference between office and out-of-office BP measurements and cardiovascular risk factors could benefit most from ABPM but we demonstrated that patients with a history of hypertension could benefit form ABPM, so that physician could choose the appropriate treatment.
BLOOD PRESSURE MEASUREMENTS IN COMMUNITY PHARMACIES IS STILL UNDERSUED IN CROATIA
Authors: Zdilar Ana Marija , Abramovic Inga , Alagic Marieta , Ivankovic Iva , Andelic Ana Marija , Horvat Petra , Domislovic Marija , Soldo Ana , Glavic Mihaela Marinovic , Jelakovic Bojan 
Published: May 2024

Objective:
The growing significance of hypertension worldwide emphasizes the crucial role of early diagnosis and prompt initiation of treatment. This study aimed to determine the prevalence of individuals measuring blood pressure (BP) in community pharmacies and to identify their characteristics.

Design and method:
In this study, we analyzed data from 1779 participants (a random sample of the general adult population in Croatia included in the ’Epidemiology of Hypertension in Croatia -2’ project). The participants completed questionnaires and were divided into two groups; individuals who occasionally monitor BP in the community pharmacy and those who do not.

Results:
Out of 1779 participants, 1634 individuals (91.8%) do not measure their BP regularly in the community pharmacy. More women than men measure BP in pharmacies (55.4%). Subjects living in rural areas measure more frequently BP in the community pharmacies than those living in urban parts of Croatia. Most of those who measure BP in pharmacies had their own BP device at home (68.3%), and already have been diagnosed with sustained arterial hypertension (75.6%). However, the majority (71%) believe that pharmacists should not have a greater role in the treatment of arterial hypertension.

Conclusions:
Community pharmacists are still unrecognized and underused healthcare workers in Croatia. Their knowledge and skill should be used more frequently, not only in teamwork for treatment and follow-up of patients with hypertension but also in primary prevention. They might have a particularly important role in remote areas where standard health care is lacking.
MONOTHERAPY VERSUS DOUBLE-AGENT COMBINATION THERAPY AS A FIRST-LINE TREATMENT FOR HYPERTENSIVE ADULTS: A CROSS-SECTIONAL STUDY
Authors: Tsoutsouli Vasiliki , Chaniotaki Maria , Nikoli Aikaterini , Kazineris Dimitrios , Papadimos Georgios , Foutsitsakis Dimos , Sachla Zacharo 
Published: May 2024

Objective:
Worldwide, an estimated 1.28 billion adults between the ages of 30 and 79 suffer from hypertension. Only 42% of them are diagnosed and receive treatment. Hypertension is considered to be a major cause of premature death. WHO guidelines for hypertensive adults requiring pharmacological treatment suggest an initial therapy with a single-agent, while double-agent combination therapy is considered preferable when target blood pressure is not reached with a single-agent treatment.

Design and method:
The present study included 2000 patients, divided by gender, randomly selected with up to Grade II Hypertension, who attended consultations in the out-patient clinic of Hypertension in the General Hospital of Thessaloniki “G. Papanikolaou” between February 2018 and December 2023. The exclusion criteria included patients with secondary causes of hypertension. The patients were divided in two equal groups according to their treatment plan: Monotherapy group and Combination group.

Results:
In total, 693(34.6%) of patients, both men and women, with no comorbidities other than hyperlipidemia or hypothyroidism, followed the same treatment plan using a single agent treatment and achieved the target levels of blood pressure. It is imperative to point out that these patients had no signs of atherosclerosis by carotid ultrasound. On the contrary, patients with medical history of diabetes mellitus, obesity, cancer, stroke, intracranial bleeding, aneurysm and coronary artery disease, required combined treatment with two drugs or more to reach the acceptable Blood Pressure levels. There was no statistical significance between men and women.

Conclusions:
This study demonstrates that patients with hypertension can be treated with monotherapy and reach the target Blood Pressure levels only when no comorbidities exist. When atherosclerosis exists being the cause of many of the forementioned comorbidities, a combination double-agent drug is necessary.
EFFECTIVENESS OF POLYPHENOL SUPPLEMENTATION ON BLOOD PRESSURE MANAGEMENT IN PATIENTS WITH HYPERTENSION
Authors: Tasic Danijela , Petrovic Masa , Bozovic Sladjana , Despotovic Biljana , Bogicevic Zorana , Tasic Nebojsa 
Published: May 2024

Objective:
Globally, arterial hypertension and its associated complications are the leading cause of cardiovascular mortality. The potential of polyphenols, known for their robust antioxidant properties, in preventing cardiovascular diseases has been extensively studied. Among these, grape seed extract stands out as a significant source of polyphenols. The aim of our study was to evaluate the efficacy of a polyphenol-based supplement, which is rich in grape seed extract-derived polyphenols, in managing prehypertension and hypertension and its impact on blood pressure regulation.

Design and method:
The study included 111 patients, monitored over a 24-week period. The patients were divided into three groups: prehypertensive (120/80–139/89 mmHg), stage I hypertensive (140/90–149/109 mmHg), and stage II hypertensive (150 or above/110 or above mmHg). Blood pressure was measured across three consecutive measurements in both sitting and standing positions at intervals of 5 minutes, with the mean value of these readings considered valid. The patients were prescribed a polyphenol-based supplement (500 mg once daily) during the first visit, with follow-ups at 12 and 24 weeks for blood pressure and heart rate monitoring. The statistical analysis included descriptive methods, difference analysis (chi-squared, t-test, ANOVA), correlation assessment (agreement test), and regression models (binary logistic regression), with SPSS 19.0 for data processing.

Results:
The study consisted of 58 males (52.3%) and 53 females (47.7%), with an average age of 47.52 ± 12.67 years. A statistically significant reduction in systolic and diastolic blood pressure, as well as heart rate, was observed throughout the follow-up period, particularly notable in the third visit. The analysis also showed that obese patients might require a longer duration of polyphenol-based supplementation compared to normoweight patients to achieve target blood pressure levels.

Conclusions:
The results demonstrate that polyphenol-based supplementation effectively controls blood pressure in patients with prehypertension and stage I hypertension. Future research should focus on the mechanisms and action modes of grape seed extract polyphenols in hypertension control, particularly in special patient populations like obese hypertensive patients.
ASSESSMENT OF HYPERTENSION MANAGEMENT IN BULGARIA: DEMOGRAPHICS, CARDIOVASCULAR RISK, AND BLOOD PRESSURE CONTROL DISCREPANCIES (SNAPSHOT STUDY)
Authors: Postadzhiyan Arman , Garkov Kiril 
Published: May 2024

Objective:
To assess the prevalence of hypertensive patients controlled on blood pressure (BP), cardiovascular (CV) risk and comorbidities in Bulgaria.

Design and method:
The cross-sectional observational multicenter epidemiological SNAPSHOT study involved 129 general practitioners in Bulgaria and included 3366 hypertensive patients. BP control and CV risk were assessed by investigators and compared to the assessment based on recommendations from European guidelines (SCORE chart 2&OP).

Results:
A total of 3363 patients were analyzed, with a mean (standard deviation [SD]) age of 67.2 (10.8) years. Most patients were female (60.9%), educated at secondary-school level (63.4%), overweight or obese (77.9%), and non-smokers (76.5%). Patients had no (7.7%), one (41.5%), 2 (38.2%), 3 or more (12.6%) risk factors for hypertension. Additionally, patients had comorbidities including dyslipidemia (55.8%), coronary artery disease (32.5%), and diabetes mellitus (27.4%). Mean (SD) systolic and diastolic BP were 143.1 (18.4) mmHg and 84.3 (11.8) mmHg, respectively. Almost all patients (99.5%) had their hypertension treated, took their treatment once (44.4%) or twice daily (50.3%) and had their BP monitored at home (95.6%). Patients predominantly utilized beta blockers (61.2%), diuretics (57.5%), and/or angiotensin-converting enzyme inhibitors (48.6%). The combination of these treatments and/or other BP lowering drugs occurred in groups of 2 and 3 in 32.2% and 36.4% of patients, respectively. Single-pill combination was used in 58.5% of patients. BP was considered controlled according to the investigators in 77.3% of patients, but according to guidelines in 22.8% of patients (39.1% systolic BP/ diastolic BP <140/90 mmHg). CV risk was assessed as mainly moderate (43.0%) or high (31.4%) by investigators, whereas it was high (9.0%) or very high (91.0%) in most patients according to recent guidelines. The concordance between both risk assessments was true in 19.1% of cases, while for 80.5% patients the risk was underestimated by the investigators.

Conclusions:
While this study provided valuable insights into the demographic and clinical characteristics of a sizable patient population, there was a discordance in CV risk and BP control assessment between investigators and guidelines. This highlighted the importance of aligning assessments with guidelines for hypertension management.
HOME BLOOD PRESURE MEASUREMENT IN RURAL SUB-SAHARAN AFRICA
Authors: Lucinde Ruth Khadembu , Jobe Modou , Awori Juliet O , Perkins Alexander D , Oyando Robinson , Leon David A , Herrett Emily , Prentice Andrew M , Tsofa Benjamin , Shah Anoop Sv , Perel Pablo , Etyang Anthony O 
Published: May 2024

Objective:
Self-home blood pressure (BP) measurement has been reported to be superior to office BP measurements (attended or unattended) in diagnosing hypertension. However, it is not readily available in rural sub-Saharan Africa (SSA) due to the cost of the measurement devices and the literacy it requires to correctly measure and record BP. Consequently, the diagnostic performance of self-home BP measurement in rural sub-Saharan Africa remains unclear. Trained community health workers (CHWs) with home BP measurement devices may improve the availability and use of these devices by providing and training community members to use them

Design and method:
We are conducting a cross-sectional study to determine the diagnostic performance of self-home BP measurement in identifying individuals with hypertension in rural Kenya and The Gambia. A random age-stratified random sample of 1250 participants aged 30 years and above from the Kilifi Health and Demographic Surveillance System and the Kiang West Demographic Surveillance System are being enrolled into the study. Trained CHWs avail the measurement devices to enrolled participants and train them to measure and record their BP for seven consecutive days. Primary data of BP measurements are then downloaded from the measurement devices. Additionally, participants undergo ambulatory BP monitoring (reference standard).

Results:
Recruitment is ongoing. We have enrolled and completed BP measurements for 154 participants, all from the Kenya study site (12% of the total sample). Of these 106 (69%) are female with an average age of 57 years (standard deviation 15 years). Based on home and ambulatory BP respectively, 49 (32%) and 66 (43%) of included participants are hypertensive. Of the included participants, 26 (17%) have masked hypertension and were not detected by home BP while 9(6%) are normotensive but considered hypertensive based on home BP. The preliminary sensitivity and specificity of self-home BP measurement is 0.61 (0.49, 0.72) and 0.90 (0.81, 0.95) respectively while its diagnostic odds ratio (DOR) is 13.5 (likelihood ratio positive 5.93 (3.10, 11.34)). Further analyses will be conducted when recruitment is complete.

Conclusions:
Self-home BP measurement has modest diagnostic utility in the general population in rural SSA.
EVALUATION OF A PROTOTYPE CUFFLESS MULTI-SENSOR DEVICE TO TRACK BLOOD PRESSURE CHANGES
Authors: Hove Christine , Sæter Frode , Stepanov Alexey , B⊘tke-rasmussen Kasper Gade , Seeberg Trine M. , Westgaard Espen , Heimark Sondre , Waldum-grevbo Bård , Hisdal Jonny , Larstorp Anne Cecilie K. 
Published: May 2024

Objective:
Accurate measurements are essential if cuffless blood pressure (BP) devices are to be used in hypertension care. The aim of the present study was to evaluate the ability of a prototype cuffless device (XXXXX) to track changes in BP compared to a non-invasive, continuous BP monitor (reference BP; Human NIBP Nano system, ADInstruments, Dunedin, New Zealand) in an experimental laboratory set up.

Design and method:
After ethical approval, three external techniques (Figure 1) to induce BP changes via different physiological mechanisms, were applied in 23 healthy subjects. Continuous data from the prototype cuffless device on the upper arm was obtained simultaneously with reference BP measurements. The cuffless device measures skin temperature, 3D acceleration, 3D angular velocity and photoplethysmography. Data from 16 of the participants were used to train a machine learning model, which was then used to estimate BP (15-second resolution) on data from 7 other participants. The cuffless BP device was calibrated once using brachial cuff BP measurement (WatchBP O3, Microlife, Cambridge, United Kingdom). The present study provides preliminary results from a larger on-going study designed to evaluate performance of the cuffless device according to ISO 81060-3:2022 standard.

Results:
A timeseries plot displaying BP measurements from the cuffless and the reference device is displayed in Figure 2. The mean error (± corrected standard deviation of error) was 2.4 (± 7.9) mmHg for systolic blood pressure (SBP) and 1.7 (± 7.4) mmHg for diastolic blood pressure (DBP) for the accuracy requirement. The corresponding errors for stability requirements were 1.9 (± 8.1) and 1.9 (± 6.0) mmHg for SBP and DBP.

Conclusions:
The present study demonstrated that the prototype cuffless BP device could track BP changes with high accuracy in healthy subjects in a laboratory setting. The cuffless device fulfilled the acceptance criteria (± 6 (± 10) mmHg) for the accuracy and stability requirements from the ISO 81060-3:2022 standard. Further research is necessary to determine accuracy of the prototype cuffless BP device during real-life conditions as described in the 2023 ESH recommendations for the validation of cuffless devices.
A SENSING MODULE WITH TWO DIFFERENT SENSING CHANNELS AIMS AT DIRECT MEASUREMENT OF PERIARTERIAL PRESSURE FOR WEARABLE TONOMETRY BLOOD PRESSURE DEVICE
Authors: Xu Man , Dong Renpeng , Wu Dongming , Zhan Bingpeng , Liu Weiting 
Published: May 2024

Objective:
This work focuses on development a new mini sensing module to directly measure periarterial pressure and reduce the effect of muscle action induced artifacts on blood pressure measurement.

Design and method:
The coupling of blood pressure signal with disturbances such as motion artifacts makes blood pressure measurement unreliable. It is significant to directly measure periarterial pressure and reduce the effect of motion artefacts in the applications of wearable blood pressure monitoring in daily life. The mini sensing module consists of two independent sensing channels (Fig.1). The two channels are closely aligned with the spacing only 1 mm in order to guarantee the blood pressure signal under the channels are same. The two channels have different sizes, one with 5 mm length and 3 mm width and the other one with 8 mm length and 3 mm width. The channels are filled with silicon oil, in the which a silicon die is fixed as pressure sensor unit. The channels are sealed by TPU flexible film with 0.2 mm thickness, which serves as the stimulation interface. Attach the sensor module to wrist and the channel direction is transverse to the arterial path. Specific design endows both channels with same sensitivity to global mechanical excitation and different sensitivity to local excitations. During BP measuring, external pressure and muscle motion artifact act on the entire channel surface serving as global excitation, so both channels have the same sensitivity to them. However, because the width of the radial artery is smaller than the length of the channel, the BP signal act on partial channel surface serving as local excitation. The BP signal has different sensitivity in two channels. The influence of motion artifacts is reduced by differential processing of the output signals of two channels, which also is presented in Fig.2.

Results:
Experiments have proved the effectiveness of the scheme.

Conclusions:
By comparison with the BP signal under optimal condition. The sensing module can directly measure periarterial pressure on blood pressure measurement.
MONITORING OF ACUTE TENSION (BLOOD PRESSURE) INCREASES DETECTED IN HOSPITAL EMERGENCIES
Authors: Ortega Melissa Lilibeth Arteaga , Pinzon Luis Eduardo Suarez , Lopez Beatriz Arnal , Ferre Kilian Griñan , Sole Sara Graell , Borrell Joan Torras 
Published: May 2024

Objective:
To assess whether, after an acute increase in blood pressure in the hospital emergency department, the control objectives are subsequently achieved in primary care.

Design and method:
Cross-sectional descriptive study assessing blood pressure figures in the Emergency Department, the days elapsed until the first visit to the Primary Care Center since the incident and until the visit in which minimal control has been obtained (defined as blood pressure <140/90 mmHg).

Results:
96 patients were preselected, of which only 85 met the inclusion criteria for the study, 49 women, mean age was 69 years, 72 had a previous diagnosis of Hypertension with a mean of 10 (standard deviation +/- 9) years of evolution, 66 with previous pharmacological treatment, 20 had been referred from Primary Care. The mean systolic blood pressure on arrival at the emergency room was 181 mmHg (standard deviation +/- 20) and at discharge 152 mmHg (standard deviation +/-18.5), the diastolic blood pressure on arrival at the emergency room was 91 mmHg (standard deviation +/- 16) and at discharge 82 mmHg (standard deviation +/-11.7). From the 85 patients included, 84 followed primary care controls (98%) and 60 achieved control of arterial hypertension (70.5%), with a median in days of 12 (interquartile range 3-35) and 90 respectively (interquartile range 26.5-147.5).

Conclusions:
This study allows us to know that a high percentage of patients consult the Primary Care after an acute increase in blood pressure but interventions could be proposed to further reduce the time of this coordination in some cases. The blood pressure goal was achieved in 70.5% of the patients, so the causes of suboptimal control in the remaining patients would have to be reviewed.