bluuebunny/crossref_metadata_2025_split huggingface dataset:
Isolation and substrate dependence on extracellular vesicle characterisation using atomic force microscopy
Authors: Dobhal Garima , Cottam Sophie , Jankowski Helen , Weidenhofer Jude , Goreham Renee V 
Published: July 2023

Abstract
Extracellular vesicles are nano- to micro-sized structures that carry biomolecules between cells to coordinate cellular activity and communication. Isolation and characterisation must be standardised to better understand the role of extracellular vesicles and how they can be used for disease diagnosis. Here we use atomic force microscopy to determine the physical differences between extracellular vesicles isolated using two different methods. Extracellular vesicles were isolated using two standardised methods, vacuum filtration and syringe filtration. In addition, extracellular vesicles were immobilised to plain mica and amino-functionalised mica to observe differences in adhesion onto substrates with different hydrophobicity. The application of atomic force microscopy enabled the study of vesicle adhesion, size distribution and morphology on the two different surfaces. It was found that both the isolation method and the substrate had a considerable effect on the physical properties of the extracellular vesicles, such as root mean square roughness values and size distribution. This demonstrates the ability to use atomic force microscopy to gain a more detailed understanding of the physical features of extracellular vesicles and the influence of different isolation methods on their morphology.
Alcohol consumption and oral microbiome composition in a sample of healthy young adults
Authors: Ward Gyles , Wurster Jenna I , Lamb Philip S , DeCost Grace , Belenky Peter , Monnig Mollie A 
Published: July 2023

Abstract
The oral microbiomes of 24 healthy adults (50% female; mean age = 24.3) were examined using 16 s ribosomal RNA sequencing and compared between light and heavy drinkers. Beta diversity was related at the trend level to drinking group, and light drinkers had significantly higher abundances of key oral taxa such as Lactobacillales. These preliminary results may offer insight into early effects of heavy drinking on the composition of the oral microbiome.
Transient ischaemic dilation ratio thresholds in patients with zero coronary calcium score undergoing exercise or dipyridamole stress SPECT myocardial perfusion imaging using a cadmium-zinc-telluride camera
Authors: Sim Eran Wen Jun , Yew Min Sen 
Published: July 2023

Abstract

Aims
Transient ischaemic dilation (TID) is a marker of underlying extensive coronary artery disease (CAD) during myocardial perfusion imaging (MPI). The cut-off for a normal TID ratio (TIDr) value is often derived from a cohort of individuals with no apparent CAD. Varying criteria have been used to define the absence of CAD. We aim to derive TIDr cut-offs using patients with normal MPI and coronary artery calcium (CAC) score of zero, and compare the TIDr obtained from different software packages.

Methods and results
We studied 232 patients with zero CAC and normal MPI undergoing exercise or dipyridamole stress using either a 1- or 2-day protocol. All patients were scanned in the supine position with a cadmium-zinc-telluride camera. TIDr was automatically generated using quantitative perfusion SPECT (QPS) software initially, and subsequently using Myometrix for comparison. The TIDr cut-offs calculated using the mean + 2 standard deviation were 1.29 and 1.24 for the 1- and 2-day protocol groups, respectively. In patients undergoing a 2-day protocol, dipyridamole stress resulted in significantly higher mean TIDr when compared to exercise stress (1.07 ± 0.13 vs. 1.01 ± 0.12, P = 0.035). Myometrix-derived TIDr were also significantly lower compared to QPS-derived values for most protocols except for 2-day exercise stress.

Conclusion
This study is the first to derive TIDr threshold values using a normal population defined by zero CAC and normal MPI. TIDr was found to vary depending on stress modality, protocol as well as the software used.
Non-invasive estimation of mean pulmonary artery pressure by cardiovascular magnetic resonance in under 2 min scan time
Authors: Abdula Goran , Ramos Joao G , Marlevi David , Fyrdahl Alexander , Engblom Henrik , Sörensson Peder , Giese Daniel , Jin Ning , Sigfridsson Andreas , Ugander Martin 
Published: July 2023

Abstract

Aims
Non-invasive estimation of mean pulmonary artery pressure (mPAP) by cardiovascular magnetic resonance (CMR) four-dimensional (4D) flow analysis has shown excellent agreement with invasive right heart catheterization. However, clinical application is limited by relatively long scan times. Therefore, the aim of this study was to evaluate the accuracy and time reduction of compressed sensing (CS) accelerated acquisition for mPAP estimation.

Methods and results
Patients (n = 51) referred for clinical CMR at 1.5 T or 3 T underwent imaging with both a prototype CS-accelerated and a non-CS-accelerated flow sequence acquiring time-resolved multiple 2D slice phase-contrast three-directional velocity-encoded images covering the pulmonary artery. Prototype software was used for the blinded analysis of pulmonary artery (PA) vortex duration to estimate mPAP as previously validated. CS-accelerated and non-CS-accelerated acquisition showed increased mPAP in 22/51 (43%) and 24/51 (47%) patients, respectively. The mean bias for estimating mPAP between the two methods was 0.1 ± 1.9 mmHg and the intraclass correlation coefficient was 0.97 (95% confidence interval 0.94–0.98). Effective scan time was lower for the CS-accelerated acquisition (1 min 55 s ± 27 s vs. 9 min 6 s ± 2 min 20 s, P &lt; 0.001, 79% reduction).

Conclusions
CS-accelerated CMR acquisition enables preserved accuracy for estimating mPAP compared to a non-CS-accelerated sequence, allowing for an average scan time of less than 2 min. CS-acceleration thereby increases the clinical utility of CMR 4D flow analysis to estimate mPAP.
Dietary Interventions in Heart Failure with Preserved Ejection Fraction (HFpEF): a systematic scoping review and meta-analysis
Authors: Forsyth F , Hartley P J , Mulrennan S , Deaton C 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Evelyn Trust.

Background
Pharmacotherapies have improved outcomes for patients with Heart Failure with reduced Ejection Fraction (HFrEF), but less so for patients with HFpEF. Limited treatments results in substantial burden at personal, clinical and economic levels. Diet has been implicated in the pathogenesis and prognosis of HFpEF, as such, dietary manipulation has the potential to be a useful management strategy.

Purpose
The aim of the scoping review was to establish which nutritional interventions have so far been tested in patients with HFpEF and establish how the dietary manipulation was achieved. The aim of the meta-analysis was to quantify the effects of interventions tested to determine whether there is evidence to support specific dietary recommendations in patients with HFpEF.

Methods
Key word searches were performed in five bibliographic databases to identify randomised or controlled studies of dietary interventions conducted in HFpEF or mixed heart failure (HF) samples. Study characteristics were summarised according to PICO (population, intervention, comparator, outcome) categories and intervention complexity was assessed. Studies included in the meta-analysis were appraised for bias and the quality of the body of evidence was assessed via the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) framework.

Results
Twenty-five different interventions reported across 31 papers were identified. Only ten (40%) were conducted exclusively in HFpEF subjects. Studies employing highly tailored prescribed methods were most common (n=12, 48%). Dietary supplementation (n=10, 40%) and dietary pattern manipulations (n=3, 12%) were less represented. Seventeen studies were considered for meta-analysis; all but one were judged to be at high risk of bias. There was moderate quality evidence that caloric restriction led to clinically meaningful improvements in blood pressure and body weight. There was moderate quality evidence carbohydrate restriction resulted in meaningful reductions in blood pressure. There was very low quality evidence protein supplementation improved blood pressure and body weight and moderate quality evidence for clinically meaningful improvements in function.

Conclusions
Very few dietary interventions have been tested in HFpEF specifically. Most interventions tested were complex at the patient level, which may not be suitable for the older, multi-morbid patients who typify HFpEF. Results of meta-analyses performed were not of sufficient quality to make generalised conclusions. Some interventions delivered clinically meaningful changes that may be important to patients, therefore, clinicians could draw on these findings to inform personalised care plans and treatment goals.
Excluding items on salt and fluid restriction from the European Heart Failure Self-care Behaviour Scale - a confirmatory factor analysis
Authors: Safstrom E , Jaarsma T , Stromberg A 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Self-care is an important component in heart failure (HF) care, and worse, self-care is an independent predictor of mortality, HF hospitalization, and quality of life. The European Heart Failure Self-care Behaviour scale (EHFScB-9) is a validated scale with a nine-item scale and two subscales (autonomy-based adherence and consulting behavior). The items in the EHFScB-9 are based on evidence and consensus. However, in recent years two items regarding salt and fluid restriction have been questioned due to the lack of evidence on their effects.

Aim
The aim of the study was to evaluate the factor structure of the EHFScB-9 when items on fluid- (item 5) and salt restriction (item 7) were excluded.

Method
Confirmatory factor analysis (CFA) was used to evaluate the factor structure of the different models of EHFScB-9. Since the item responses of the EHFScB-9 are ordinal, the recommended estimation Weighted Least Squares with Means and Variances (WLSMV) was used. The WLSMV is based on polychoric correlations. The fit indices and recommended cut-off used to support model fit were: the root mean square error of approximation (RMSEA) (≤0.06), Comparative Fit Indices (≥0.95), and Tucker Lewis Index (&gt;0.95). Reliability was evaluated by composite reliability.

Results
A total of 605 patients were included (mean age 66.9 years (SD=11.7), 71% (n=430) males). All response options were used, but a floor effect was evident for all items (i.e., extreme scores &gt; 15%). The missing values for the items ranged from 2.0 to 2.6%. A total of 10 patients had missing values on all items of the EHFScB-9 and were not included in the CFA.
The original two-factor 9-item version (Model 1 in table 1) presented good model fit in all fit indices, including RMSEA: 0.058 (90% confidence interval 0.043-0.073) (Table 1) and reliability of 0.678 in factor 1 "Adherence to regimen" and 0.878 in factor 2 "Consulting behavior". The RMSEA only slightly increased to 0.62 when the items on fluid- (item 5) and salt restriction (item 7) were both excluded (Model 1.2). The model presenting the best model fit was the model where item 5 (fluid restriction) was excluded from the model (RMSEA 0.047, 90% confidence interval 0.029-0.066) (Model 1.3 in the table). As expected, the reliability decreased in factor 1 ("Adherence to regimen") as the number of items was reduced.

Conclusion
Considering the clinical evidence and the model fit indices, both item 5 and item 7 can be excluded from the EHFScB. As expected, when reducing the number of items, the reliability decreases in factor 1 ("Adherence to regimen"). Nevertheless, the results open for an opportunity to exclude self-care items with less evidence from the EHFScB. The suggested version of the EHFScB needs to be further tested in other contexts, and adding items to factor 1 may be considered.
The importance of screening for depression and anxiety in ambulatory patients with chronic heart failure and the role of health care professionals
Authors: Georgieva M , Rushid M , Nankova M , Borisova S , Yotov Y 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Depression and anxiety are very common in patients with heart failure, both as risk factors and complications. The intensive follow-up by health care specialist is extremely important for screening of these conditions and for reducing their impact on the heart failure (HF) course.

Aim
to screen for depression and anxiety attitudes and to assess the effect of structured out-patient program for reducing the probability of their occurrence. Participants and methods: Overall, 71 patients were included in a structured follow-up program for ambulatory management of patients with HF, according to the OPTIMIZE-HF Care Program protocol. All participants answered standardized questionnaires PHQ-9 and GAD-7 for screening of depression and anxiety at discharge from hospital (baseline) and after 6 months. Score more than 8 points for GAD-7 and &gt;10 points of PHQ-9 were considered clinically important. Paired samples t-test and Wilcoxon’s signed rank test were used to test statistical significance.

Results
the mean depression score decreased from mean 5.47±5,22 points to 3.65±6.05, with a mean difference between two visits 2.35±3.9, 95%CI 1.37-3.33, р&lt;0.0001. At 6 months, the participants with PHQ-9&gt;10 points decreased from 21% to 7.8% (Figure 1). There were 8 (14%) patients who were more prone to depression at baseline but who decreased their score to &lt;10 points at the end (p = 0.04). Similar results were found for anxiety. The mean difference in GAD-7 score was -2.35±3.90 points, 95%CI -1.37—-3.33, p&lt;0;0001. At the end of the study, the participants without anxious moods increased from 52.3% to 69.8%. (Figure 1) Only 3 patients worsened their anxiety results after 6 months while 27% of those with initial GAD-7&gt;8 points successfully decreased their score to minimal or none.

Conclusions
Every 1 in 5 patients with HF have some depression attitudes at discharge and more than 1 in 3 were anxious. The structured ambulatory management program decreased these trends just after 6 months. The role of nurse in achieving the positive effects on the psychological well-being of the patients with HF is essential.Figure 1
Musculoskeletal disorders in men and women with heart transplantation. A cross- sectional study
Authors: Moreno Segura N , Almenar-Bonet L , Fuentes-Aparicio L , Atef H , Escudero P , Mesa-Rico R , Lopez-Vilella R , Pallares P , Sentandreu-Mano T , Berga-Congost G , Sillero-Sillero A , Marques-Sule E 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Scientific literature about musculoskeletal condition in heart transplantation patients is scarce, although musculoskeletal disorders seem to be common in more than a quarter of patients receiving cardiac rehabilitation. The aim of our study was to compare the musculoskeletal condition in men and women with heart transplantation.

Methods
Cross-sectional study. Sociodemographic data (age, sex, education and marital status) were collected. Musculoskeletal condition was assessed using two questionnaires: 1) the Musculoskeletal System Assessment Inventory (MSSAI) that evaluates 6-items related to musculoskeletal disorders rated in a yes/no variation scale, as well as the intensity and location of pain (from 1=mild pain to 5=unbearable pain); and 2) the Cornell Discomfort Questionnaire (CDQ), that evaluates the frequency of musculoskeletal pain in 5 different levels (from 0=never to 10 points=several times a day) for 20 different anatomic body regions.

Results
The sample consisted of 109 participants with heart transplantation (54 women and 64 men, mean ages=53.33±12.60 vs. 58.35±12.81 years old, respectively). 40% women and 29.7% men were diagnosed with musculoskeletal disorders by the physician (p = 0.263). With respect to pain sensation, significant differences were observed, with women reporting higher values of musculoskeletal pain than men (p = 0.049) (64.4% vs. 43.5% respectively). Moreover, differences by sex were observed in terms of pain location (p = 0.047), with the knee being the joint most frequently referred to by men (15.6%) and lumbar joints by women (26.7%). 51% of women reported higher levels of musculoskeletal pain than men after performing physical exercise (p = 0.015).

Conclusion
According to our results, women with heart transplantation reported more musculoskeletal pain than men, more commonly located in lumbar joints. In addition, women reported higher levels of musculoskeletal pain after performing physical exercise than men with heart transplantation.
Kinesiophobia in heart transplantation patients: a cross-sectional study with a special focus in sex differences
Authors: Moreno Segura N , Almenar-Bonet L , Fuentes-Aparicio L , Atef H , Escudero S , Escudero P , Lopez-Vilella R , Sentandreu-Mano T , Pallares P , Mesa-Rico R , Berga-Congost G , Sillero-Sillero A , Marques-Sule E 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Patients with heart disease sometimes have a fear of moderate and vigorous physical activity, in addition to the possibility of kinesiophobia or fear of movement. There are scarce studies assessing kinesiophobia in men and women with heart transplantation. The aim of the study was to compare the levels of kinesiophobia in men and women with heart transplantation.

Methods
This was a cross-sectional study. Sociodemographic data (age, sex, education and marital status) were collected. Kinesiophobia was measured using the Tampa Scale for Kinesiophobia (TSK-11). Each item has a 4-point Likert scale ranging from ‘‘strongly disagree’’ to ‘‘strongly agree’’, and the total score ranges between 11 and 44 points, a high value indicating high levels of kinesiophobia.

Results
103 participants (40.78% women vs. 59.22% men, mean ages 53.38±12.59 vs. 57.80±12.60 years, respectively) were assessed. No differences by sex were found in the total score of the TSK-11 (women=24.02±6.38, men=23.49±5.71, p = 0.659). Women reported significantly higher scores than men in item 1 ("I’m afraid I might injure myself if I exercise", p = 0.007), item 2 ("If I were to try to overcome it, my pain would increase", p = 0.044) and item 5 ( "My accident/problem has put my body at risk for the rest of my life", p = 0.009). On the other hand, men reported significantly higher scores in item 11 ("No one should have to exercise when he/she is in pain", p = 0.008).

Conclusions
We found no differences by sex in overall kinesiophobia of heart transplantation patients. However, women were more afraid of getting injured during physical exercise and of injuring themselves accidentally, whilst men considered not recommendable to exercise when they were in pain.
See-saws: the delicate balance of burden of treatment in chronic heart failure
Authors: Austin R , Schoonhoven L , Kalra P R , May C , Richardson A 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): This work was supported as a part of a fully funded Clinical Academic Doctoral Fellowship at the University of Southampton, Portsmouth Hospitals University NHS Trust, and the National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) Wessex. This article is independent research supported in part by the NIHR ARC Wessex. Carl May’s contribution was supported by NIHR ARC North Thames and Alison Richardson’s by NIHR ARC Wessex. Rosalynn Austin is funded by an NIHR ARC Wessex Internship.

Background
Burden of Treatment (BoT) is often described as a delicate balance between a patient’s capacity (capabilities and resources) to do the work of illness management and the workload (self-care, treatment and illness burden). Chronic heart failure (CHF) is regarded as a burdensome disease for both patients and healthcare services with the burden expected to rise. While research in BoT in CHF is increasing, the factors influencing the balance between capacity and workload has yet to be fully elucidated.

Purpose
To identify factors which may influence BoT in CHF.

Methods
Secondary analysis of 32 semi-structured interviews of participants with CHF who participated in the SYMPACT trial. All participants were asked to describe the balance between capabilities and workload of manging CHF using the metaphor of a see-saw. Responses to that question were examined for factors patients reported as altering the balance between capacity and workload.

Results
Most participants (n=31) described the seesaw as dynamic, where capacity and workload were balanced or unbalanced. If capacity &gt; workload this was viewed as positive, "I would stay down because the things that you mentioned are very easy" (T137). When instead the balance reversed and capacity &lt; workload it was viewed as negative, "The heavier you know with the work and the abilities less, you kind of think […] I’m good for nothing" (B001). Factors reported by patients, to alter their capacity included: ability to self-care, support from social networks, symptoms, illness identity, and quality of life. Workload was reported to be altered by nature of healthcare interactions, effectiveness of treatments, comorbidities and the feeling of overwhelming treatment burden (Figure 1). One participant described overwhelming burden with a different metaphor: "A huge weight around my neck. Pulling me down into a pit of despair" (S110), was reported as more accurate than a seesaw when thinking about treatment burden.

Conclusions
BoT is an important factor to consider in the clinical management of CHF. Modifiable factors such as symptoms, quality of life, and the nature of healthcare interactions are reported as altering the balance between a patient’s capacity and the workload associated with self-care.Factors balancing burden of treatment