bluuebunny/crossref_metadata_2025_split huggingface dataset:
Automatic sleep spindles identification and classification with multitapers and convolution
Authors: Zapata Ignacio A , Wen Peng , Jones Evan , Fjaagesund Shauna , Li Yan 
Published: June 2023

Abstract
Sleep spindles are isolated transient surges of oscillatory neural activity present during sleep stages 2 and 3 in the nonrapid eye movement (NREM). They can indicate the mechanisms of memory consolidation and plasticity in the brain. Spindles can be identified across cortical areas and classified as either slow or fast. There are spindle transients across different frequencies and power, yet most of their functions remain a mystery. Using several electroencephalogram (EEG) databases, this study presents a new method, called the “spindles across multiple channels” (SAMC) method, for identifying and categorizing sleep spindles in EEGs during the NREM sleep. The SAMC method uses a multitapers and convolution (MT&C) approach to extract the spectral estimation of different frequencies present in sleep EEGs and graphically identify spindles across multiple channels. The characteristics of spindles, such as duration, power, and event areas, are also extracted by the SAMC method. Comparison with other state-of-the-art spindle identification methods demonstrated the superiority of the proposed method with an agreement rate, average positive predictive value, and sensitivity of over 90% for spindle classification across the three databases used in this paper. The computing cost was found to be, on average, 0.004 seconds per epoch. The proposed method can potentially improve the understanding of the behavior of spindles across the scalp and accurately identify and categories sleep spindles.
Development and pilot testing of a clinic implementation program delivering physical activity electronic referrals to cancer survivors
Authors: Faro Jamie M , Yue Kai-Lou , Leach Heather J , Crisafio Mary E , Lemon Stephenie C , Wang Bo , McManus David D , Sadasivam Rajani S 
Published: June 2023

Abstract
Provider physical activity referrals are recommended for cancer survivors, though barriers exist to clinical system integration.
To develop and test ActivityChoice, an electronic referral (eReferral) clinic implementation program referring cancer survivors to physical activity programs of their choice. In Phase 1, we conducted semi-structured interviews with Cancer Center clinicians (n = 4) and cancer-focused physical activity program leaders (n = 3) assessing adaptations needed to implement an eReferral previously designed for another context. In Phase 2, we pilot-tested clinician-delivered referrals to survivors in two 12-week Plan, Do, Study, Act (PDSA) cycles. We examined feasibility using descriptive statistics (clinicians’ adoption and engagement, patient referrals, and physical activity program enrollment) and acceptability through semi-structured interviews with enrolled clinicians (n = 4) and referred patients (n = 9). ActivityChoice included a secure referral webform, text message/email referral confirmations, clinician training/booster sessions, visual reminders, and referrals to in-person or virtual group physical activity programs. Results for each PDSA cycle respectively included: 41% (n = 7) and 53% (n = 8) of clinicians adopted ActivityChoice; 18 and 36 patients were referred; 39% (n = 7) and 33% (n = 12) of patients enrolled in programs, and 30% (n = 4) and 14% (n = 5) of patients deferred enrollment. Patients and clinicians appreciated the referrals and choices. A printed handout describing both programs was added to the clinic workflow for Cycle 2, which yielded more referrals, but lower program enrollment rates. Clinic-based eReferrals to choices of physical activity programs were feasible and acceptable by clinicians and patients. Added clinic workflow support may facilitate referrals.
An insight on the N‐glycome of notochordal cell‐rich porcine nucleus pulposus during maturation
Authors: Günay Büşra , Matthews Elizabeth , Morgan Jack , Tryfonidou Marianna A. , Saldova Radka , Pandit Abhay 
Published: June 2023

AbstractDegeneration of the intervertebral disc is an age‐related condition. It also accompanies the disappearance of the notochordal cells, which are remnants of the developmental stages of the nucleus pulposus (NP). Molecular changes such as extracellular matrix catabolism, cellular phenotype, and glycosaminoglycan loss in the NP have been extensively studied. However, as one of the most significant co‐ and posttranslational modifications, glycosylation has been overlooked in cells in degeneration. Here, we aim to characterize the N‐glycome of young and mature NP and identify patterns related to aging. Accordingly, we isolated N‐glycans from notochordal cell‐rich NP from porcine discs, characterized them using a combined approach of exoglycosidase digestions and analysis with hydrophilic interaction ultra‐performance liquid chromatography and mass spectrometry. We have assigned over 300 individual N‐glycans for each age group. Moreover, we observed a notable abundance of antennary structures, galactosylation, fucosylation, and sialylation in both age groups. In addition, as indicated from our results, increasing outer arm fucosylation and decreasing α(2,3)‐linked sialylation with aging suggest that these traits are age‐dependent. Lastly, we have focused on an extensive characterization of the N‐glycome of the notochordal cell‐rich NP in aging without inferred degeneration, describing glycosylation changes specific for aging only. Our findings in combination with those of other studies, suggest that the degeneration of the NP does not involve identical processes as aging.
Lipidomic markers for the prediction of progression from mild cognitive impairment to Alzheimer's disease
Authors: Li Wenjing , Zhou Yinhua , Luo Zhaofan , Tang Rixin , Sun Yuxuan , He Qiangsheng , Xia Bin , Lu Kuiqing , Hou Qinghua , Yuan Jinqiu 
Published: June 2023

AbstractDementia is a well‐known syndrome and Alzheimer's disease (AD) is the main cause of dementia. Lipids play a key role in the pathogenesis of AD, however, the prediction value of serum lipidomics on AD remains unclear. This study aims to construct a lipid score system to predict the risk of progression from mild cognitive impairment (MCI) to AD. First, we used the least absolute shrinkage and selection operator (LASSO) Cox regression model to select the lipids that can signify the progression from MCI to AD based on 310 older adults with MCI. Then we constructed a lipid score based on 14 single lipids using Cox regression and estimated the association between the lipid score and progression from MCI to AD. The prevalence of AD in the low‐, intermediate‐ and high‐score groups was 42.3%, 59.8%, and 79.8%, respectively. The participants in the intermediate‐ and high‐score group had a 1.65‐fold (95% CI 1.10 to 2.47) and 3.55‐fold (95% CI 2.40 to 5.26) higher risk of AD, respectively, as compared to those with low lipid scores. The lipid score showed moderate prediction efficacy (c‐statistics > 0.72). These results suggested that the score system based on serum lipidomics is useful for the prediction of progression from MCI to AD.
CAROTID-FEMORAL PULSE WAVE VELOCITY AND STIFFNESS INDEX MEASURED 5-15 YEARS EARLIER WERE SIGNIFICANTLY HIGHER IN DECEASED THAN IN STILL LIVING TREATED FINNISH HYPERTENSIVE PATIENTS
Authors: Kantola Ilkka , Kantola Taru 
Published: June 2023

Objective:
To clarify if there is a difference in pulse wave velocity (PWV) measured in the years 2006-2014 (n = 251) comparing in the years 2015-2022 deceased (n = 40) and in the beginning of the year 2023 still living (n = 211) Finnish drug-treated hypertensive patients participating that PWV measurement.

Design and method:
A Doppler ultrasonography device (Micro Medical PulseTrace PWV and PCA, Micro Medical Ltd, Rochester, Kent, UK) was used to measure carotid-femoral (C-F) PWV and photoplethysmographic transducer of the same machine to measure stiffness index (SI) and resistance index (RI) in 251 Finnish drug-treated hypertensive patients (126 females and 125 males) during the years 2006-2014. At the time of measurement the mean age of the patients was 64.0 (8.3) years.

Results:
The age at death of the deceased patients was 79.6 (SD 8.14, median 82, range 62-91) years (n = 40). The age in 01Jan2023 living patients was 75.1 (SD 7.6, median 76, range 45-91) years (n = 211), p = 0.0001 between the two groups.
The mean C-F PWV was 12.5 (3.6) in deceased and 10.4 (2.2) m/s (p = 0.0001) in living and SI respectively 11.0 (3.4) and 9.6 (2.9) m/s (p = 0.007). No significant difference between the groups was seen in RI. Mean office systolic blood pressure was 150.0 (18.8) mmHg in deceased and 137.5 (14.5) in living (p = 0.003) and respectively mean office diastolic pressure 86.4 (9.2) and 83.4 (9.2) mmHg (p = 0.058).
The three most common causes of death were malignancy (n = 13), sudden death (n = 10) and high age (n = 9). Dementia was noticed before death in 13 patients.

Conclusions:
Carotid-femoral PWV and stiffness index measured 5-15 years earlier were significantly higher in deceased than in still living treated Finnish hypertensive patients
Deceased patients were older and their systolic blood pressure was higher which may explain the difference. Malignancies were a common cause of death as also diagnosed dementia in these hypertensive patients. More studies are needed concerning the predictive value of PWV in hypertensive patients.
APPLICABILITY OF THE SPRINT TRIAL IN A REAL WORLD SAMPLE OF HYPERTENSIVE OLDER ADULTS
Authors: Capacci Marco , Rivasi Giulia , Turrin Giada , Ceolin Ludovica , Gentileschi Diego , Corsi Carolina , Tortù Virginia , Rafanelli Martina , Mossello Enrico , Ungar Andrea 
Published: June 2023

Objective:
The SPRINT trial demonstrated the benefits of intensive blood pressure (BP) control in older hypertensive adults, including frailer patients. However, how those results can be applied in the geriatric population remains doubtful, due to the highly selective inclusion criteria and low levels of clinical frailty in the aforementioned series. This study aimed to assess the applicability of SPRINT inclusion criteria in a real world sample of hypertensive older adults and analysed the association between BP and functional decline by SPRINT eligibility.

Design and method:
We applied SPRINT inclusion and exclusion criteria to a sample of hypertensive patients aged 75 or older, evaluated at the Hypertension and Memory Clinics of the Geriatric Department of Careggi Hospital, Florence. Cox analysis was used to test the association between BP and functional decline (according to Barthel Index) by SPRINT eligibility.

Results:
Among 123 patients (mean age 81, 59% women), only 39 (32%) complied with the SPRINT inclusion criteria. Frailty prevalence was found to be significantly higher in the ineligible group (46% vs 26%, p = 0.028), along with worse physical performance (reduced walking speed 43% vs 22%, p = 0.027) and disability either in basic (25% vs 5%, p = 0.009) or instrumental activities of daily living (61% vs 33%, p = 0.005). Moreover, they had a higher comorbidity burden (median Charlson Index 5 [4 - 6] vs 4 [3 - 5], p < 0.001), whereas there was no tangible difference between BP values in the two subgroups. At 13 months, ineligible subjects experienced significantly higher incidence of functional decline (48% vs 21%, p = 0.012). In age- and sex-adjusted Cox analysis, ambulatory BP was associated with functional decline only in eligible subjects (24h-systolic BP HR 1.193, 95% CI 1.009 - 1.411).

Conclusions:
In a real world sample of hypertensive older adults, only one third of subjects complied with the SPRINT inclusion criteria. Higher levels of frailty and disability were observed in ineligible subjects, in whom BP values seem to have a limited prognostic impact.
ASSOCIATION OF MAJOR ADVERSE CARDIOVASCULAR EVENTS AND ALL-CAUSE MORTALITY WITH LEFT VENTRICULAR GEOMETRY IN ELDERLY: THE NORTHERN SHANGHAI STUDY
Authors: Maimaitiaili Rusitanmujiang , Zhao Song , Meng Weilun , Tang Jiamin , Teliewubai Jiadela , Yu Shikai , Chi Chen , Xiong Jing , Zhao Yifan , Xu Yawei , Zhang Yi 
Published: June 2023

Objective:
To investigate the association of major adverse cardiovascular events and mortality with left ventricular geometry in elderly.

Design and method:
We prospectively recruited 3363 community-dwelling elderly (43.6% male, aged 71.1 ± 5.9 years; 56.4% female, aged 71.1 ± 6.1 years) from local community. Echocardiographic parameters were collected, left ventricular mass index (LVMi) above 115 g/m2 in male or 95 g/m2 in female, relative wall thickness (RWT) above 0.42 were considered as abnormal. Participants then were classified into 4 mutually exclusive groups as: normal geometry (normal LVMi and normal RWT), concentric remodeling (normal LVMi and increased RWT), eccentric hypertrophy (increased LVMi and normal RWT), concentric hypertrophy (increased LVMi and increased RWT). Cardiovascular death, non-fatal myocardial infarction including non-fatal ischemic stroke were recorded as incident MACE. Adjusted Cox regression models were used to evaluate the hazard ratios of MACE and all-cause mortality.

Results:
Mean LVMi and RWT were 87.0 ± 28.4 g/m2 and 0.39 ± 0.08. During a median follow-up of 5.4 years, we identified 224 incident MACE cases and 233 deaths. All-cause mortality was significantly greater in participants with eccentric hypertrophy (adjusted hazard ratio [HR]: 1.649; 95% confidence interval [CI]: 1.143-2.379) compared with normal geometry in multivariate analyses after adjusting for baseline covariates. Incident MACE was significant both in concentric hypertrophy (HR: 1.982; 95% CI: 1.239-3.170) and eccentric hypertrophy (HR: 1.846; 95% CI: 1.266-2.692) but not in concentric remodeling (HR:1.101; 95% CI: 0.759-1.597). Baseline LVMi was a significant predictor of all-cause mortality (HR: 1.047 per 10g/m2 increase in LVMi; 95% CI: 1.004-1.093). Similar results were observed with non-fatal myocardial infarction, non-fatal ischemic stroke and cardiovascular death.

Conclusions:
Increased baseline LVMi and abnormal left ventricular geometry portend an increased risk for incident MACE and all-cause mortality in community dwelling elderly. From the pathophysiology point of view, per 10 g/m2 increase in LVMi add 5% risk for all-cause mortality.
CAMERA-BASED REMOTE PHOTOPLETHYSMOGRAPHY TO PREDICT BLOOD PRESSURE IN CLINIC PATIENTS WITH CARDIOVASCULAR DISEASE
Authors: Curran Theodore , Liu Xin , Mcduff Daniel , Ma Chengqian , Narayanswamy Girish , Patel Shwetak , Yang Eugene 
Published: June 2023

Objective:
Remote photoplethysmography (rPPG) uses a camera to capture peripheral blood flow. It remains to be seen if rPPG can accurately predict blood pressure (BP). Most studies have included healthy, normotensive subjects. This is the first investigation of rPPG to predict BP for patients with cardiovascular disease (CVD).

Design and method:
132 patient visits were completed in a cardiology clinic between March and December, 2022 (Table 1). Patients were seated while a digital camera recorded two 2.5 minute videos of the face and palm. BP was measured by an oscillometric cuff from the left arm at the beginning, midpoint, and end of the session. Continuous heart rate and rhythm were measured by a single-lead ECG from electrodes on the right and left wrists. Continuous PPG was measured by a contact sensor on the left index finger.
Videos were cropped and spatially-averaged to extract the green channel, which serves as a proxy for the rPPG signal. Pulse segmentation and selection were used to identify five high-quality consecutive beats. Raw rPPG signal was analyzed with its first and second derivatives into a one-dimensional convolutional neural network. The network is trained to predict systolic and diastolic BP by minimizing the mean squared error between the predicted video-based contactless BP and cuff-based BP measurement. A 5-fold subject independent cross-validation was performed.

Results:
There is modest correlation between rPPG-predicted and measured systolic BP (r = 0.47, mean error -0.47 ± 15.5 mm Hg), but weaker correlation for diastolic BP (r = 0.16, mean error -0.80 ± 8.1 mm Hg).

Conclusions:
rPPG shows potential for BP prediction in real-world patients with CVD. Future work will leverage larger data driven machine learning methods to improve the rPPG signal quality and examine the impact on BP measurements. Robust training data, including extreme values of blood pressure and a variety of patient demographics, are needed to improve these models. Major limitations include lack of guideline-directed protocols for rPPG validation for BP prediction and inability to assess temporal correlation between rPPG signal and BP.
THE NATURAL COURSE OF HYPERTENSIVE PHENOTYPES OVER TIME – THE HELIUS STUDY
Authors: Vriend Esther M.C. , Bouwmeester Thomas A. , Franco Oscar H. , Galenkamp Henrike , Charante Eric P. Moll Van , Collard Didier , Born Bert-Jan H. van den 
Published: June 2023

Objective:
Hypertension can be classified into different phenotypes according to systolic and diastolic blood pressure (BP). We assessed the natural course of BP phenotypes over time in younger adults and identified risk factors predisposing to the development of sustained hypertension in a diverse population.

Design and method:
We used baseline and follow-up data from all participants aged below 40 years without antihypertensive medication at baseline from the ongoing multi-ethnic HEalthy LIFe in an Urban Setting (HELIUS) study. Participants were stratified according to baseline office BP: normotensive (NT; < 140/< 90 mmHg), isolated systolic hypertension (ISH; > = 140/< 90 mmHg), isolated diastolic hypertension (IDH; < 140/> = 90 mmHg) and combined systolic and diastolic hypertension (SDH; > = 140/> = 90 mmHg). Sankey diagrams were created stratified by sex to visualise change in phenotypes over time and risk of sustained hypertension (defined as BP > = 140/90 mmHg or use of antihypertensive medication) was assessed using logistic regression models adjusted for age, sex, ethnicity and follow-up time. In further adjusted models we added BMI, smoking, baseline eGFR, glucose, and total cholesterol levels to assess risk factors.

Results:
We included 2,818 participants aged 30.1 years (SD 6.0), 44% male, who attended the follow-up visit with a median follow-up time of 6.2 years (SD 1.1). Of all participants, 91.5% was normotensive at baseline, whereas 2.8%, 2.8% and 2.9% had ISH, IDH and SDH, respectively. In males the prevalence of ISH decreased over time, while in females the prevalence increased (figure). Compared to normotensive individuals, the adjusted odds ratios for developing sustained hypertension were 4.5 (95% CI 2.5 – 7.9) for ISH, 17.4 (95% CI 10.7 - 28.4) for IDH and 33.5, (95% CI 19.7 – 58.9) for SDH. Higher BMI was the most important predictor for development of sustained hypertension.

Conclusions:
Participants with SDH had the highest risk for developing sustained hypertension, followed by participants with IDH. The risk for sustained hypertension in individuals with ISH was much lower and differed between males and females, suggesting differences in pathophysiology and management.
MYOCARDIAL MECHANO-ENERGETIC EFFICIENCY AND CLINIC AND 24 HOURS BLOOD PRESSURE VALUES IN PATIENTS ATTENDING THE OUTPATIENT CLINIC AT AN ESH EXCELLENCE CENTRE IN ITALY
Authors: Aggiusti Carlo , Paini Anna , Bertacchini Fabio , Stassaldi Deborah , Capellini Sara , Muiesan Maria Lorenza , Salvetti Massimo 
Published: June 2023

Objective:
It has been demonstrated that low myocardial mechano-energetic efficiency index (MEEi),estimated as stroke volume/heart rate ratio per g of left ventricular(LV) mass(LVM) is an independent predictor of cardiovascular(CV) events. Out of office blood pressure (BP) is better correlated to hypertension mediated organ damage(HMOD) and to CV events as compared to BP measured in the office.

Design and method:
Aim of the study was to evaluate the relationship between myocardial mechano-energetic efficiency index and both clinic and 24 hours BP values in 839 consecutive uncomplicated patients attending the outpatient at an ESH Excellence Centre in Italy. Methods BP values were measured by the physician with an automated oscillometric device, after 5 minutes of rest. ABPM was performed in all subjects with a Spacelabs BP monitor. All patients underwent transthoracic echocardiography, and standard indices of systolic function were calculated. Furthermore in all patients myocardial mechanoenergetic efficiency (MEE) was calculated as stroke volume/heart rate and indexed to LV mass (MEEi=MEE/LVM) (de Simone et al, 2016).

Results:
Mean age was 53 ± 14 yrs, 53% female, BMI 26 ± 5, 34 % were overweight, 18% obese, 8% % diabetics, 64 % with a previous diagnosis of hypertension(71 % treated). MEEi was lower in males (0.41 ± 0.14 vs 0.52 ± 0.15), and in patients with diabetes(0.40 ± 0.11 vs 0.48 ± 0.16). MEEi was inversely -correlated with age(r = -0.146, p < 0.0001) and BMI(r = -0.353, p < 0.0001). MEEI was similarly correlated to 24 hours SBP and clinic SBP(respectively r = -0.267, p < 0.0001 and r = -0.196, p < 0.001, Steiger's Z test for the comparison p ns) and to 24 hours DBP and clinic DBP(r = -0.249, p < 0.0001 and r = -0.248, p < 0.001, Steiger's Z test for the comparison p ns). However, at receiver operating curves(ROC) the area under the curve(AUC) for 24 hours SBP(0.627, 95 % CI 0.593 - 0.659) was superior in predicting low MEEI (defined as < 0.35) as compared to the AUC of clinic SBP(0.582, 95 % CI 0.548 - 0.615)(p for the comparison < 0.05).

Conclusions:
In a large sample of uncomplicated patients attending the outpatient clinic at an ESH Excellence Centre in Italy 24 hours BP is a better predictor of reduced myocardial myocardial mechanoenergetic efficiency than clinic BP.