bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences between non-obese and obese patients after cardiac arrest
Authors: Czapla M , Fehler P , Lewandowski Ł , Juarez-Vela R , Karniej P , Uchmanowicz B , Zielinski S , Zielinska M 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Sudden cardiac arrest (SCA) is still one of the leading causes of death. Obesity can increase the risk of post-SCA mortality. The aim of this study was to retrospectively analyze the differences between non-obese and obese patients admitted to the intensive care unit (ICU) after out and in-hospital cardiac arrest.

Material and Method
A retrospective study and analysis of 161 medical records of patients admitted for SCA to the ICU (in an university clinical hospital in Poland) was conducted. Patient comorbidity, and laboratory results were collected. The study was approved by the independent Bioethics Committee of Wrocław Medical University No. KB-776/2022. Statistical analysis was performed with Python 3.9.13.

Result
The median age of obese patients was 71 years old and of non-obese 65 years old (p = 0.039).The sample population was divided into groups: according to WHO criteria. Differences between non-obese and obese patients in survivors group are shown Table 1. Significant differences in frequency were observed for cerebral stroke (CS) and diabetes mellitus (DM).
Differences between non-obese and obese patients in non-survivors group are shown Table 2. Significant differences in frequency were observed for chronic kidney disease (CKD), DM, and hypertension (HT)

Conclusion
Among obese patients after cardiac arrest, the odds of comorbidities are higher. The research and medical community, should take up this challenge head-on and work harder on addressing the preventive and curative components of Non-Communicable Diseases.Survivors: obese vs obeseNon-survivors: obese vs obese
An internet-based cardiac rehabilitation intervention for patients with coronary artery disease: a pilot feasibility analysis
Authors: Li P W C 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): The University of Hong Kong

Background
Cardiac rehabilitation is confined to those high-risk patients, such as those with acute myocardial infarction and heart failure. Most patients with coronary artery disease (CAD) are not eligible for this evidence-based therapy.

Purpose
This study aimed to examine the feasibility and preliminary effects of a mobile intervention, titled "internet-based CArdiac Rehabilitation Enhancement (i-CARE)", on self-care behaviors, functional status, health-related quality of life (HRQoL), blood pressure, waist-to-height ratio and cholesterol level in patients with CAD.

Methods
This mixed-methods study comprised a pilot randomized controlled trial (RCT) and a qualitative phase. Patients in the intervention group received a 12-week i-CARE intervention, consisting of a single face-to-face orientation session and a mobile app consisting of three key user interfaces, including a self-monitoring dashboard with personalized interface according to their own risk profile, an interactive e-library covering various CAD-related self-care dimensions and a chat room for the nurse to provide continuous coaching and facilitate behavioral changes. The control group received standard care.

Results
Fifty patients with CAD were randomly allocated to the intervention (n = 25) or control group (n = 25). The i-CARE intervention was feasible and acceptable to CAD patients. Participants gave excellent ratings in the satisfaction survey. The i-Care group showed greater improvements in self-care behaviors (β = 6.213, 95%CI: 1.924 – 12.236, p = 0.016), HRQoL (β = 6.132, 95%CI: 1.276 – 15.237, p = 0.032) and functional status (β = 2.584, 95%CI: 1.050 – 7.226, p = 0.039) than the standard care group at the immediate post-intervention. No significant between-group changes in blood pressure, cholesterol and waist-to-height ratio were detected. The average number of logins to the app by the intervention group was 92.84 (21.45) and 84% of them accessed all modules available in the app. A total of 4,987 hits to the exercise videos were recorded during the intervention period. Most of the participants (88%) actively initiated a discussion or responded in the chat room. The qualitative data converged with the quantitative data, indicating that the intervention was highly feasible and acceptable to CAD patients.

Conclusion
The i-Care intervention is feasible and acceptable to CAD patients. It improves patients’ self-care behaviors, HRQoL and functional status. A full-scale RCT is warranted to investigate the longer-term effects of this intervention.
A nurse-led multicomponent behavioral activation intervention for patients with atrial fibrillation: a randomized controlled trial
Authors: Li P W C , Yu D S F 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Research Grants Committee of Hong Kong through the General Research Fund

Introduction
Patients with atrial fibrillation (AF) often play a passive role in the treatment decision-making process, rendering jeopardized health-related quality of life, suboptimal medication optimization and self-care.

Purpose
This study aimed to examine the effects of a Nurse-led Multicomponent Behavioral Activation (N-MBA) intervention on HRQoL, knowledge about AF, medication adherence and psychological distress among patients with AF.

Methods
This parallel two-arm randomized controlled trial recruited community-dwelling patients aged ≥65 years with a confirmed diagnosis of atrial fibrillation, moderate to high risk of stroke but not receiving oral anticoagulation. Participants were randomized in a 1:1 ratio to receive the N-MBA intervention or standard care. The 13-week intervention adopted a novel behavioral activation approach to equip AF patients as an active agent to manage the disease. It consisted of care components to prepare patients for shared decision-making by using a decision aid, an empowerment-based educational module covering relevant AF self-care topics and continuous support through telephone calls. A set of validated instruments was administered at baseline, immediate and 6 months post-intervention.

Results
A total of 252 participants were randomized to the intervention (n = 127) or control (n = 125) group. Compared with the control group, the intervention group showed greater improvements in HRQoL [β = 10.617, 95% confidence interval (CI) = 1.285 – 20.501, p = 0.023] and AF knowledge (β = 2.129, 95% CI =1.026 – 5.712, p &lt;0.001) at immediate post-intervention. The effects on both outcomes sustained at 6-month follow-up time point. No significant between-group changes in medication adherence, anxiety and depression were detected. Participants in the intervention group were activated to raise their concerns about AF and its treatment with the attending doctors, and they perceived higher compatibility between patient and physician decisions of OAC use upon completion of the intervention.

Conclusion
The empowerment-based nurse-led intervention is effective at sustaining improvements in HRQoL, AF knowledge and treatment decision making in AF patients with moderate to high stroke risk. It does not increase their psychological distress.
The experience of living with congenital heart disease from the perspective of the affected child or adolescent and its family: a systematic qualitative review
Authors: Martinez-Sarria A , Martin-Martin J , Van Bulck L , Olano-Lizarraga M 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Congenital heart disease is one of the most prevalent congenital disabilities and significantly affects the lives of children and adolescents with congenital heart disease and their families. They tend to experience psychological, behavioural and relational comorbidities, leading to many complications and maladaptive behaviours. However, no literature review has been identified that addresses the whole family perspective.

Objective
To describe the experience of living with congenital heart disease from the perspective of the affected child or adolescent and their family.

Methods
A systematic qualitative review was conducted in PubMed, CINAHL, PsycINFO and Scopus databases between May and July 2022. The review protocol has been registered prospectively in PROSPERO. The key terms used were "experiences", "congenital heart disease'', "family", and "infants" with their respective synonyms, identified from MeSH terms, the thesaurus and the literature. The methodological quality of the studies was assessed. The Critical Appraisal Skills Programme questionnaire was used to assess qualitative studies. The Joanna Briggs Institute tool was utilised to evaluate literature reviews. Subsequently, two researchers jointly performed a qualitative content analysis of the selected articles.

Results
Ten studies were identified, and their methodological quality was generally good. None of the studies included in the same investigation the experience of more than one of the populations described (children or adolescents, siblings or parents). The sample sizes of the studies varied between 2 and 30 participants, and some did not report the sample size. The analysis permitted the child or adolescent and their family's experience to be grouped into four main themes: 1) Experiencing the impact of the initial diagnosis, 2) Living a "roller coaster" of emotions, 3) Coping with the day-to-day burden of the disease, 4) Finding sources of strength and opportunities.

Conclusions
The potential impact of a diagnosis of congenital heart disease on the life experience of children, adolescents, and their families has been evidenced. However, no studies have explored the family experience as a whole. It would be necessary to have more information about the family unit experience. Although healthcare disciplines conceptually recognize whole-family care as the focus of their practice, this idea remains a clinical ideal in most cases. Therefore, a paradigm shift in health care is necessary, from a model of attention exclusively focused on the patient to one in which the family is incorporated into the care process.
A pilot RCT of an mHealth self-help intervention on readmission rate reduction after adult cardiac surgery: preliminary findings
Authors: Nolte J , Wynne R , Matthews S , Angel J , Moore A , Campbell T , Ferguson C 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): The Royal Melbourne Hospital

Background
Readmission is multifaceted, potentially avoidable and costly. Patients’ ability to enact self-care behaviors after cardiac surgery are under-investigated.

Purpose
To evaluate the feasibility of a RCT investigating an mHealth intervention for self-help, and readmission rate reduction.

Methods
Elective adult (&gt;18 years) elective cardiac surgery (via median sternotomy) patients were eligible for inclusion. Patients had to be discharged home, able to understand spoken English, and own and use a smartphone, tablet or computer. The intervention comprised a narrative online library (Healthily GoShare platform) with videos describing patient and carer experiences focused on preoperative preparation, acute postoperative care (sent within 1 week of discharge) and ongoing recovery Sent 30 days after surgery). Patients were randomised preoperatively 1:1 to the intervention, accessible via a text or email link, or the control group receiving usual care that comprised postoperative education and a brochure. Follow-up phone interviews took place 30, 60 and 90 days after surgery.

Results
From August 2021 to December 2022, 341 (65%) patients were scheduled for elective surgery, 229 (67.2%) were transferred elsewhere secondary to COVID-19 bed closures, 22 (6.5%) were undergoing reoperation, 13 (3.8%) did not adequately understand spoken English and 7 (2.1%) did not own a smartphone or tablet. Of the 70 (20.5%) eligible patients, 61 (87.1%) agreed to participate and 2 (2.8%) did not proceed. Follow-up (FUP) is complete for 43 (72.9%) patients. Accessed preoperative 14 (63.6%), postoperative 16 (72.7%) and recovery bundles 12 (54.5%) were reported as helpful or very helpful by 95% (n = 21) of participants. A single patient from the intervention group was lost to FUP at 30 days and 5 control group patients at 60 days. 30-day readmission was more frequent in the control (3/21, 14.3%) than intervention group (0/22; p = 0.06).
Conclusion(s): Findings to date indicate COVID-19 bed closures have impacted on elective surgical scheduling thus recruitment. The intervention was feasible and acceptable. To be 95% confident the readmission rate is within 10%, assuming a 15% readmission rate, a minimum of 50 patients are required. Follow-up is ongoing.
Feasibility and acceptability of using a patient reported outcome measure (OxFAB) to help patients with heart failure to recognise and communicate worsening symptoms to specialist nurses
Authors: Walthall H , Diaz L , Harris E , Astin F 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): General Nursing Council for England and Wales Trust

Background
The incidence of Heart Failure (HF) is increasing. Breathlessness and fatigue are symptoms that signal clinical deterioration. However, patients often do not recognise worsening symptoms. This can lead to avoidable hospital admission. We developed with patients a validated tool to evaluate fatigue and breathlessness (OxFAB) in patients with HF but had not established its acceptability and feasibility in clinical practice.

Purpose
To evaluate the feasibility and acceptability of OxFAB as a tool to optimise patient-specialist nurse communication of symptoms of fatigue and breathlessness.

Methods
A multi-method feasibility study conducted in HF nurse specialist clinics at two sites in England, between January 2022 and September 2022. Participants completed the tool in the clinics at 2 time points 4 to 7 weeks apart. The tool asked for symptom assessment over the previous 2 weeks. Acceptability was determined through qualitative interviews and adherence to OxFAB at the 2 time points. Feasibility was determined through questionnaire completion rates and qualitative interviews.

Results
Thirty-five patients and three HF nurse specialists completed the study. Nurse-led HF clinics were conducted either by telephone consultation remotely or face to face within the hospital setting. Over half the patient sample were male (58%), and 66% of the patients had HF with reduced ejection fraction, 86% NYHA Class II-III, age (µ68.5 years-SD 12.55) years. Eighty-one percent completed OxFAB in µ7.49 minutes (time-point 1) and µ6.59-mins (time-point 2). Interview data suggested that OxFAB was easy to complete, relevant and optimised symptom communication.

Conclusion
This feasibility study demonstrated OxFAB was acceptable and feasible in clinical practice to optimise patients-health professional communication of HF symptoms.
Predictors for arterial hypertension in middle aged adults
Authors: Abidova D , Mukhamedova M G , Uzokov J K , Abdullaeva G J 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Subclinical atherosclerosis is a marker for development of future atherosclerotic cardiovascular disease. However, it is still unclear whether subclinical atherosclerosis predicts hypertension in patients who have not diagnosed it yet. Aim of the study was to evaluate possible significance of subclinical atherosclerosis for the development of hypertension in patients who have not diagnosed hypertension yet.

Methods
418 middle aged adults who had subclinical atherosclerosis and without hypertension enrolled in this study (aged 31-49 years, mean age 39.12±12.0 years, male=53%). All participants were examined general clinical, anthropometric, laboratory and instrumental measures. Subclinical atherosclerosis were diagnosed using ultrasound methods via ankle-brachial index (ABI) using established cutoffs. All patients followed up to 6 years. Mean follow up was 4.5±2.1 years. All statistical analysis were performed using STATA software.

Results
During the mean follow up period 17% (71) patients were diagnosed hypertension (SPB&lt;140 mmHg and/or DBP&lt;90 mmHg). Among them 12% (50) were males whilst 5 % (21) were females and men tended to have more levels of blood pressure than women did (P&lt;0.05). During the follow up period, subclinical atherosclerosis level has increased more than 20% to those who was diagnosed hypertension. Patients who developed hypertension tended to have more smokers (OR 1.58, 1.14-2.28, CI 95%, P&lt;0.05), BMI&lt;30 kg/m2 (OR 1.57, 1.12-1.98, CI 95%, P&lt;0.05), family history of hypertension (OR 1.45, 1.09-1.87, CI 95%, P&lt;0.05), frequent stress at work (OR 1.35, 1.06-1.82, CI 95%, P&lt;0.05) and financial problems at home (OR 1.23, 1.05-1.72, CI 95%, P&lt;0.05).

Conclusion
Subclinical atherosclerosis is a predictor for new onset hypertension in men especially for those who were smoker, obese and had family history of hypertension as well as frequent stressed at work.
Optimization of antiplatelet therapy in patients with coronary artery disease and type 2 diabetes mellitus after percutaneous coronary interventions
Authors: Mukhamedova M , Orziev D Z , Uzokov J K , Abdullaev A X 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Dual antiplatelet therapy (DAP) with clopidogrel and aspirin after percutaneous coronary interventions (PCI) in patients with chronic coronary syndrome (CCS) are mainly used to prevent stent thrombosis and restenosis. Despite the use of approved doses of the antiplatelet, major adverse cardiac events (MACE) frequently occur in short and mid-term period in patients with type 2 diabetes mellitus (T2DM) and CCS. Aim of the study was to evaluate the efficacy of ticagrelol in patients with CCS and T2DM after elective PCI.

Material and Methods
The prospective, open label randomized study with 112 patients with CCS and T2DM who admitted for the elective PCI were enrolled in the study from 2018 to 2022 (aged 49-72 years, mean age 59.2±12.2 years, male 52%). Patients were divided into two groups by 56 via open randomization. Group I patients were assigned ticagrelol 90 mg BID after the loading dose of 180 mg ticagrelol along with standard dose of aspirin for 1 year whereas Group II were assigned clopidogrel along with aspirin for 1 year. 20 µmoll ADP induced platelet aggregation was assessed at baseline and after the 12 hours of administering loading dose of antiplatelet. Efficacy and safely were assessed during the follow up in both group of patients. All statistical analysis were performed using STATA software.

Results
Inhibition of platelet aggregation (IPA) with 20 µmoll ADP at 12 hours was significantly higher in ticagrelol group than clopidogrel group (71.65±14.25% vs. 42.74±18.25%, P&lt;0.001). During the maintenance dose, IPA with 20 µmoll ADP at 48 hours was significantly higher in ticagrelol group than clopidogrel group (68.12±13.27% vs. 45.82±17.54%, P&lt;0.001). PCI bleeding complications were similar in each group and there was not observed any statistically significant changes (P&gt;0.05). During the mean follow-up period ticagrelol group tended to have higher bleeding than clopidogrel group, however they were not observed any statistically significant changes (log-rank test; 0.752). Pertaining to MACE, ticagrelol group tended to have lesser MACE than clopidogrel group, (Mantel–Cox test; P=0.045). 56 ticagrelol treated patients showed that MACE tended to be negatively associated with post PCI bleeding complications (P=0.048).

Conclusions
Dual antiplatelet therapy with ticagrelol and aspirin is superior than clopidogrel plus aspirin to prevent MACE in patients with chronic coronary syndrome and type 2 diabetes mellitus after elective percutaneous coronary interventions. However, ticagrelol should be used cautiously in patients with gastrointestinal ulcers due to its PCI related bleeding risks.
Caregiver contributions to general and specific self-care of patients affected by heart failure and other chronic conditions
Authors: Saurini M , Erba I , Ferro F , Ausili D , Matarese M , Vellone E , De Maria M 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Centre of Excellence for Nursing Scholarship (CECRI), Rome, Italy.

Background
Older adults with HF and other chronic conditions often need the support of informal caregivers in performing self-care. Caregiver contribution (CC) to patient’s self-care includes a series of recommendations (or acts to replace) made to the patient to keep their own health conditions stable and manage signs and symptoms of their chronic conditions. CC to general and specific patient self-care represents help that improves patient clinical outcomes and maintains the stability of chronic conditions. To date, no studies have investigated general and specific caregiver contributions to the self-care of patients with Heart Failure (HF) and other chronic conditions.

Purpose
Investigate caregiver contribution to general and specific self-care in patients affected by HF and other chronic conditions.

Methods
Cross-sectional study. Data collection was conducted in community and outpatient settings, from April 2017 to October 2021. Caregivers of patients affected by HF and other chronic condition were enrolled if they were &gt;18 years old and identified by the patient as the primary informal caregiver. Caregiver Contribution to Self-Care of Chronic Illness Inventory (CC-SC-CII) and Caregiver Contribution to Self-Care of Heart Failure Index (CC-SCHFI), were used for measuring generic and specific CC to self-care, respectively. Values ≥70 indicate adequate CC to general and specific self-care behaviors. Paired t-test was carried out to test differences in CC-SC-CII and CC-SCHFI scores.

Results
This study enrolled 369 caregivers caring for HF patients and other chronic conditions. The sample was composed mainly of females (61.27%) with a mean age of 45.0 (±1.41) years, and that lived with their loved ones (55.28%). The two chronic conditions most frequently associated in patients with HF cared for by informal caregivers were hypertension (75%) and diabetes mellitus (70%). General CC to self-care maintenance, monitoring, and management were adequate with mean scores of 70.57 (±21.6), 81.47 (±21.85), and 72.98 (±20.61), respectively. Specific CC to self-care maintenance, monitoring, and management were inadequate with mean scores of 64.49 (±16.76), 54.08 (±26.71), and 65.24 (±17.25), respectively. CC-SC-CII scores were significantly (p&lt;.0001) higher than CC-SCHFI scores.

Conclusion
Caregivers showed more difficulties in the contribution to specific HF self-care compared to general self-care behaviors. Knowing how caregivers contribute to self-care is important for clinicians to develop psychosocial interventions for improving CC to self-care in patients with HF and other chronic conditions.