bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving cardiovascular health behaviors through a comprehensive lifestyle intervention program during the pandemic in India
Authors: Chockalingam P , Rajeswari S , Shobika J , Anantharaman R , Yusuf M M , Sengottuvelu G , Chockalingam V 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
We have witnessed a dramatic dip in adherence to cardiovascular health behaviors during the COVID-19 pandemic. Data from across the globe has shown that risk factors for cardiovascular disease (CVD) such as decreased physical activity, poor diet, and increased depression, loneliness, and stress have peaked during the pandemic. Having been badly affected by the pandemic and having had prolonged periods of countrywide lockdown, the at-risk and established CVD population has faced a major challenge in adhering to a healthy lifestyle in India.

Purpose
This study aimed to analyze the change in cardiovascular health behaviors brought about by a comprehensive lifestyle intervention program (CLIP) during the pandemic in India.

Methods
All at-risk and CVD patients who had participated in the CLIP from mid 2020 to mid 2022 and had completed the internally validated health behavior assessment questionnaire, pre and post-program, were included in this retrospective study. A multidisciplinary team consisting of Physician, Physiotherapist, Dietician, and Counseling Psychologist provided the sessions online and/or in-person for the home-based and hybrid programs respectively. When a combination of online and in-person sessions were provided for a subject, it was called a hybrid program. The core components of the CLIP were exercise training, education on relevant health topics, nutritional guidance and psychosocial counseling.

Results
Age of the subjects (n=50) at enrolment was 54±13 years and 40 (80%) were male. The time between pre-program and post-program assessments was 110 (IQR 47) days. Number of at-risk and CVD patients attending home-based and hybrid programs are shown in the Figure. There were 4 couples in the study cohort; 21 (50%) of the remaining 42 subjects had at least 1 other family member attend the majority of sessions. There was a significant improvement in all the cardiovascular health behaviors, namely adequate daily intake of fruits, vegetables and whole grains, choice of heart-healthy foods between meals, sufficient weekly exercise and a reduction in self-reported chronic stress, upon completion of the CLIP (Table).

Conclusions
A comprehensive lifestyle intervention program that incorporates a multipronged approach to behavior modification is effective in improving cardiovascular health behaviors in individuals at-risk as well as with established cardiovascular disease in India. The ripple effect of behavior modification in the accompanying family members needs to be studied systematically.
Perceptions, insights, and attitudes (P.I.A.) of selected filipino female physicians on cardiovascular risks and diseases
Authors: Estepa L , De Lara A C 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
In 2012, coronary heart disease and stroke are the leading causes of death worldwide, accounting for more than 31% of deaths from all causes. In 2020, PH statistics showed that ischemic heart diseases were the leading causes of death in the Philippines (PH), responsible for 17.3% of the total deaths.

Objective
To determine the knowledge, perceptions, insights and attitudes on cardiovascular disease (CVD) prevention, personal health-related lifestyle practices, and lifestyle counseling practices of selected female physicians who are practicing or training in the PH through an online survey.

Methods
A descriptive ambispective cross-sectional study where the survey questionnaire of Ameh, et al. (2019) was modified with the authors' permission, was conducted online and answered by consenting female physicians. 484 participants’ data were collated and analyzed.

Results
Majority had accurate responses for the CVD prevention knowledge items (Figures 1 and 2). Among the participants, 36.98% had hypertension, 32% were obese, 28.5% had dyslipidemia, and 17.2% had diabetes mellitus. Sleep of 6-8 hours is practiced by 60.33%, 53.51% eat vegetables and fruits daily, 55.79% prefer fish and seafood, 89.05% do not smoke, 61.2% take coffee or black tea daily, 84.51% have no regular exercise, and 30.79% of those who do only exercise for 10-20 minutes. Moreover, 67.98% add salt, soy or fish sauce to their meals, and 72.73% do not drink enough water daily. In addition, 44.42% do not undergo annual general check-up and 58.06% do not have a personal physician. Limitations due to COVID-19 pandemic, lack of education, and expensive screening tests are perceived to be major barriers to CVD screening. More than 90% of our participants practice health teachings on diabetes mellitus prevention, high blood pressure screening, cholesterol screening and management, nutrition, and weight management. Counseling on regular exercise, smoking, and alcohol abuse are being practiced by 88.02%, 85.74%, and 83.88% of our respondents, respectively.

Conclusion
There are female physicians who are not aware of the World Health Organization’s recommendations on the prevention of CVD, who do not do health teaching and counseling, and who practice unhealthy lifestyle. Changing physicians’ knowledge and behavior towards CVD prevention is a great challenge to improve standards of CVD prevention. Improvement and enhancement in education of both physicians and patients, together with more consultation time, financing for CVD prevention, and comprehensive, multidisciplinary preventive cardiology programs supported by government and societies in favor of prevention are some of the best ways to improve management of CVD risk factors and prevention.
Cardiovascular disease in older patients with end-stage renal disease and chronic dialysis in Vietnam
Authors: Nguyen T , Pham T X T , Nguyen T V 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Patients with chronic kidney disease, especially end-stage renal disease, exhibit a very high cardiovascular risk. In Vietnam, chronic kidney disease and cardiovascular disease (CVD) are very common in older people. However, there is limited studies on the complexity of CVD and other geriatric syndromes in older patients with end-stage renal disease and chronic dialysis.

Purpose
In this study in older patients with end-stage renal disease and chronic dialysis, we aim to: (1) Examine the prevalence of CVD and its impact on hospitalization, and (2) Compare the burden of common geriatric syndromes in patients with and without CVD.

Methods
This is a prospective, observational, multi-centre study conducted at two dialysis units of two major hospitals in Vietnam. Consecutive patients aged 60 years or older who were diagnosed with end-stage renal disease and on chronic dialysis were recruited from November 2020 to June 2021. CVD was defined as having one of these conditions: heart failure, ischemic heart disease, and stroke. Participants were assessed for these common geriatric conditions: frailty (defined as a Clinical Frailty Scale total score ≥5), malnutrition (defined as a total score ≤7 from the Mini Nutritional Assessment Short Form), impairment in activities of daily living (defined as ADL score &lt;6), impairment in instrumental activities of daily living (defined as IADL score &lt;8), high risk of falls (assessed by the STEADI questionnaire), and polypharmacy (defined as the concurrent use of ≥5 medications). Participants were followed for 6 months after discharge. Multivariable logistic regression analysis was applied to examine the impact of CVD on 6-month hospitalization, adjusting for age, sex, and the geriatric conditions. Results were presented as odds ratios (ORs) and 95% confidence intervals (CIs).

Results
There were 175 participants (mean age 72.4 ± 8.5, 58.9% female). CVD was present in 80% of the participants (ischemic heart disease: 49.7%, heart failure: 60.0%, stroke 25.7%). Participants with CVD had significantly higher prevalence of geriatric syndromes compared to those without CVD (Table 1). During 6-month follow-up, 48.6% of the participants had at least one hospitalization. In multivariable logistic regression model, the presence of CVD increased the risk of hospitalization (adjusted OR 4.70, 95%CI 1.72 – 12.85), allowing for age, sex, frailty, ADL impairment, IADL impairment, fall risk, malnutrition, polypharmacy (Table 2).

Conclusion
In this study, there was a very high prevalence of CVD in older patients with end-stage renal disease and chronic dialysis. Participants with CVD had higher burden of geriatric syndromes and their risk of 6-month hospitalization increased by approximately 5 times.
System delays and target points: analysis of STEMI response program a single center
Authors: Toledano B , Garganera K B , Prado J P , Sabas M L , Martinez G S 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
STEMI carries the highest risk among the AMI and the mortality is influenced by many factors. Hospital delays are the most easily audited and should be analyzed and improved.

Methodology
Participants were adults aged &gt; 19 years enrolled in the AMI registry due to STEMI and treated with emergency PCI from January 2019 to June 2021. The door-to-balloon times and STEMI diagnosis-to-wire cross times were divided into Met and Unmet groups and time frames were compared using the Mann Whitney U test. For time frames with no significant difference, the median of the Met group was adopted while in time frames with a significant difference, the optimal target points were chosen from the highest percentages of Met if ≤ and Unmet if &gt; the target point. Odds ratio (OR) with 95% confidence intervals from binary logistic regression were done to predict the Met status.

Results
A total of 113 participants were analyzed. Significant delays were seen in ECG-Paging
(p=&lt;0.034), CFOD arrival-to-STEMI diagnosis (p=0.008), STEMI diagnosis-to-consent (p= &lt;0.001), consent-to-Cath lab (p=&lt;0.001) and Cath lab-to-puncture (p=0.003). The optimal targets in minutes: Door-ECG (median 9), ECG-Paging (≤1/&gt;, 56.67%, 62.65%, OR 2.19, p=0.069), paging-to-CFOD arrival (median &lt;2), CFOD arrival-to-STEMI diagnosis ( ≤/&gt;3, 66.67%, 51.81% OR 2.15, p=0.086), STEMI diagnosis-to-consent (≤/&gt;10, 78.26%, 67.78%, OR 7.57, p=&lt;0.001), consent-to-Cath lab (≤/&gt;24, 73.91%, 67.78%, OR 15.38, p=&lt;0.001), Cath lab-to-puncture (≤/&gt;12, 65.22%, 58.89%, OR 2.68, p=&lt;0.043).

Conclusion
In a developing country and during the COVID-19 pandemic, the most significant delays of our STEMI program occurred in obtaining consent for emergency percutaneous coronary intervention and transferring the patient to the catheterization laboratory. Optimal target points for every time frame can provide concrete objectives that may increase the chance of achieving the door-to-balloon and STEMI diagnosis-to-wire cross goals.
Outcomes after cryoballoon ablation of paroxysmal atrial fibrillation with the PolarX or the Arctic Front Advance Pro: a prospective multicentre experience
Authors: Tanese Nikita , Almorad Alexandre , Pannone Luigi , Defaye Pascal , Jacob Sophie , Kilani Mouna Ben , Chierchia Gianbattista , Venier Sandrine , Cardin Christèle , Jacon Peggy , Combes Stéphane , Deschamps Elodie , Menè Roberto , de Asmundis Carlo , Boveda Serge 
Published: January 2023

AbstractAimsThe aim of this study was to compare procedural efficacy and safety, including 1-year freedom from AF recurrence, between the novel cryoballoon system PolarX (Boston Scientific) and the Arctic Front Advance Pro (AFA-Pro) (Medtronic), in patients with paroxysmal AF undergoing PVI.Methods and resultsThis multicentre prospective observational study included 267 consecutive patients undergoing a first cryoablation procedure for paroxysmal AF (137 PolarX, 130 AFA-Pro). Kaplan-Meier curves with the log-rank test was used to compare the 1-year freedom from AF recurrence between both groups. Multivariate Cox model was performed to evaluate whether the type of procedure (PolarX vs. AFA-Pro) had an impact on the occurrence of AF recurrences after adjustment on potentially confounding factors. The PolarX reaches lower temperatures than the AFA-Pro (LSPV 52 ± 5, vs. 59 ± 6; LIPV 49 ± 6 vs. 56 ± 6; right superior pulmonary vein: 49 ± 6 vs. 57 ± 7; right inferior pulmonary vein: 52 ± 6 vs. 59 ± 6; P &lt; 0.0001). A higher rate of transient phrenic nerve palsy was found in patients treated with the PolarX system (15% vs. 7%, P = 0.05). After a mean follow-up of 15 ± 5 months, 20 patients (15%) had recurrences in AFA-Pro group and 27 patients (19%) in PolarX group (P = 0.35). Based on survival analysis, no significant difference was observed between both groups with a 12-month free of recurrence survival of 91.2% (85.1–95.4%) vs. 83.7% (76.0%–89.1%) (log-rank test P = 0.11). In multivariate Cox model hazard ratio of recurrence for PolarX vs. AFA-Pro was not significant [HR = 1.6 (0.9–2.8), P = 0.12].ConclusionPolarX and AFA-Pro have comparable efficacy and safety profiles for pulmonary veins isolation in paroxysmal atrial fibrillation.
Adverse Childhood Experiences and Poor Sleep Quality in Older Adults: The Influence of Emotion Regulation
Authors: Sheffler Julia L , Burchard Valeria , Pickett Scott 
Published: January 2023

Abstract

Background
Adverse childhood experiences (ACEs) are associated with sleep impairment across the life span, but little is known about modifiable factors that may ameliorate this relationship, such as adaptive emotion regulation (ER) skills.

Methods
Data were obtained from an online questionnaire completed by a community sample of older adults (N = 278). The questionnaire included the Pittsburgh Sleep Quality Index, an Adverse Childhood Experiences questionnaire, the Cognitive Emotion Regulation Questionnaire (CERQ), and measures of health conditions, and other sample demographics. Moderation analyses were used to examine the interaction between ACEs and 5 adaptive ER skills of CERQ on sleep quality in older adults, while accounting for the effects of age, sex, income, body mass index, and health.

Results
ACEs were significantly associated with worse sleep quality in older adults, and this effect was moderated by positive reappraisal and refocusing on planning (all ps &lt; .05). For individuals reporting greater use of these ER skills, ACEs had no effect on sleep quality, whereas for individuals reporting less frequent use of these ER skills, ACEs were associated with substantially worse sleep quality. This relationship remained significant after accounting for age, sex, income, body mass index, and health conditions in the model.

Conclusions
The effects of ACEs on sleep quality persist into older age; however, greater use of ER skills that focus on positively reframing negative events and identifying strategies for coping protect against sleep impairment in individuals with higher ACEs.
Short-term outcomes of curved periacetabular osteotomy and factors influencing patient dissatisfaction
Authors: Suzuki Masahiro , Kinoshita Koichi , Sakamoto Tetsuya , Seo Hajime , Yoshimura Ichiro , Yamamoto Takuaki 
Published: January 2023

ABSTRACT
This study aimed to evaluate clinical outcomes based on patient-reported outcome measures and to analyze factors influencing patient dissatisfaction at 1 year after curved periacetabular osteotomy (CPO). This retrospective review involved 98 hips of 98 consecutive patients with symptomatic acetabular dysplasia who underwent CPO from March 2016 to June 2020. The clinical outcomes were evaluated based on the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire, the Medical Outcomes Study 36-Item Short-Form Health Survey and the Harris Hip Score. Patients were divided into satisfied and unsatisfied groups according to the 85th percentile cut-off on the postoperative visual analog scale (VAS) for dissatisfaction. A multiple logistic regression analysis was performed to investigate the factors impacting patient dissatisfaction after CPO; the explanatory variables were age, body mass index, postoperative Tönnis grade of ≥2, postoperative VAS score for pain, lateral femoral cutaneous nerve (LFCN) injury and radiographic complications (non-union of the pubis, non-union of the ischium after posterior column fracture and ischial ramus stress fracture). The 85th percentile of the postoperative VAS score for dissatisfaction was 60 mm. The unsatisfied group comprised 15 patients at 1 year after CPO. The multiple logistic regression analysis results showed that the postoperative VAS scores for pain [odds ratio (OR), 1.064; 95% confidence interval (CI), 1.026–1.104; P = 0.001] and LFCN injury (OR, 6.775; 95% CI, 1.308–33.256; P = 0.018) were associated with postoperative dissatisfaction. LFCN injury and the postoperative VAS score for pain independently impacted postoperative dissatisfaction at 1 year after CPO.
Investigating the racial gap in prostate cancer screening with prostate-specific antigen among younger men from 2012 to 2020
Authors: Qian Zhiyu , Al Khatib Khalid , Chen Xi , Belani Sanvi , Labban Muhieddine , Lipsitz Stuart , Cole Alexander P , Iyer Hari S , Trinh Quoc-Dien 
Published: January 2023

AbstractBackgroundThe United States Preventive Services Task Force recommended against prostate-specific antigen (PSA) screening in 2012, which was modified in 2018 into shared decision making for men aged 55-70 years with a life expectancy over 10 years. We studied the trends in PSA screening in younger Black and White men with the implementation of the 2012 and 2018 guidelines.MethodsYounger Black and White men (aged 40-54 years) were identified using the Behavioral Risk Factor Surveillance System database biennially from 2012 to 2020. Our primary outcome was PSA screening within 2 years of the survey. An adjusted logistic regression model with 2-way interaction assessment between race and survey year was used to investigate the temporal trend of PSA screening in younger Black and White men.ResultsA total of 142 892 men were included. We saw steadily decreasing odds of PSA screening among both younger Black and White men in 2014, 2016, 2018, and 2020 compared with 2012 (for younger Black men: odds ratio [OR]2014 = 0.77, 95% confidence interval [CI] = 0.62 to 0.96, OR2016 = 0.51, 95% CI = 0.41 to 0.63, OR2018 = 0.33, 95%CI = 0.27 to 0.42, OR2020 = 0.25, 95% CI = 0.18 to 0.32; and for younger White men: OR2014 = 0.81, 95% CI = 0.76 to 0.87, OR2016 = 0.66, 95% CI = 0.61 to 0.71, OR2018 = 0.41, 95%CI = 0.37 to 0.44, OR2020 = 0.36, 95% CI = 0.33 to 0.39). Younger Black men showed a brisker decrease in PSA screening in 2016, 2018, and 2020 compared with younger White men (all P &lt; .05).ConclusionsPSA screening among younger men steadily decreased over the past decade since the 2012 United States Preventive Services Task Force guidelines, demonstrating a narrowing racial gap. How such an observed trend translates to long-term clinical outcomes for younger Black men remains to be seen.
Flying to high-altitude destinations: Is the risk of acute mountain sickness greater?
Authors: Burtscher Johannes , Swenson Erik R , Hackett Peter H , Millet Grégoire P , Burtscher Martin 
Published: January 2023

Abstract

Background
Altitude sojourns increasingly attract individuals of all ages and different health statuses due to the appeal of high-altitude destinations worldwide and easy access to air travel. The risk of acute mountain sickness (AMS) when flying to high-altitude destinations remains underemphasized. Thus, this review aims to evaluate the altitude-dependent AMS incidence depending on the mode of ascending, e.g. by air vs terrestrial travel.

Methods
A literature search was performed to identify the observational studies assessing AMS incidence after acute ascent of primarily healthy adults to real high altitude. In addition, placebo arms of interventional trials evaluating the prophylactic efficacy of various drugs have been separately analysed to confirm or refute the findings from the observational studies. Linear regression analyses were used to evaluate the altitude-dependent AMS incidence.

Results
Findings of 12 observational studies, in which the AMS incidence in 11 021 individuals ascending to 19 different altitudes (2200–4559 m) was evaluated, revealed an impressive 4.5-fold steeper increase in the AMS incidence for air travel as compared with slower ascent modes, i.e. hiking or combined car and/or air travel and hiking. The higher AMS incidence following transportation by flight vs slower means was also confirmed in placebo-treated participants in 10 studies of drug prophylaxis against AMS.

Conclusions
Due to the short time span in going from low to high altitude, reduced acclimatization likely is the main reason for a higher AMS risk when travelling to high-altitude destinations by flight. To avoid frustrating travel experiences and health risks, appropriate and timely medical advice on how to prepare for air travel to high altitude is of vital importance. Effective preparation options include the use of modern pre-acclimatization strategies and pharmacological prophylaxis by acetazolamide or dexamethasone, or even considering alternate itineraries with more gradual ascent.
Lessons From COVID-19 for the Next War: Crisis Standards of Care in the Role 3 Intensive Care Unit
Authors: Steinlage Arnold J , Steinlage Corinne B , Curell Angela M 
Published: January 2023

ABSTRACT
The rationing of medical resources became a common practice during the SARS-CoV-2 (COVID-19) pandemic. To cope with overwhelming patient numbers, hospitals were forced to adopt “crisis standards of care” (CSC) guidelines, which allow physicians to navigate the task of rationing health care resources in both an effective and ethically sound manner. The Military Health System currently has clinical guidelines for mass casualty incident (MCI) triage but lacks deployed Role 3 intensive care unit (ICU) CSC guidelines. In future peer and near-peer conflicts, this gap may prove detrimental when thousands of casualties following a single battle create a continuous and prolonged mass casualty event. The challenges of providing critical care in a battlefield hospital during a large conflict are unique and numerous, but lessons from COVID-19 ICUs such as transitioning to a utilitarian ethic, clear definitions, decision points, and decision authorities, as well as the establishment of clinical practice guidelines formulated from evidence-based protocols, can better prepare the U.S. expeditionary medical force for future conflicts. A battlefield CSC will allow military critical care physicians and nurses to manage overwhelmed ICUs and make better triage decisions, allowing them to provide a higher quality of care to the collective. In this commentary, we explore the need for Wartime CSC in the battlefield Role 3 ICU and the tools and methods used by civilian and military institutions to create and enact CSCs throughout the COVID-19 pandemic.