bluuebunny/crossref_metadata_2025_split huggingface dataset:
The short-term impact and sustainability of multiple lifestyle interventions on metabolic health and remission of prediabetes and type 2 diabetes: a two-year experience
Authors: Iglesies-Grau J , Dionne V , Latour É , Pelletier V , Bisaillon M , Tessier G , Aubut L , Hamrioui N , Gagnon C , Simard F , Nigam A , L Allier PL , Bherer L , Bouabdallaoui N , Juneau M 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Different intensive lifestyle interventions have been shown to be useful for effective control and even reversal of prediabetes and type 2 diabetes (T2D).
Objectives
Our heart institute cardiovascular prevention center started a comprehensive lifestyle clinic in 2019 to study the impact of 6 and 12-month non-pharmacological interventions on metabolic health and remission of these two conditions.

Methods
Between January 2019 and December 2020, 81 prediabetic (HbA1c ≥ 5.7%) and 184 T2D (HbA1c ≥ 6.5%) were recruited. All participants received regular nutritional counselling (therapeutic moderate carbohydrate restriction Mediterranean diet) and personalized physical exercise prescription (≥30 minutes of moderate aerobic training, 5 times a week, and strength training). Anthropometric measures and fasting blood analysis were measured at 0, 3, 6 and 12 months. Glucose-lowering therapies were not modified, unless necessary.
Complete remission of prediabetes and T2D was defined as HbA1c &lt;5.7%, whereas partial remission of T2D was defined as HbA1c &lt;6.5% for at least 3 months, and it was calculated for all the participants that completed the 12-month program. Remission was further evaluated according to pharmacological status (drug-naïve or on glucose-lowering therapy).

Results
231 participants completed the short-term program (87%) and 117 were followed-up to 12 months. Mean age was 67.1 (9.1) years, 67% male, 48.3% with CHD, 53.5% with glucose-lowering therapies. All metabolic health measures were improved, particularly among T2D participants (Table 1). Gains were achieved at 3 months and were maintained during the remainder of the program without significant change.
Complete remission of prediabetes was achieved in 24% (95CI: 10.7 to 45.4%) of participants. Complete and partial remission of T2D were achieved in 5.4% (95CI: 2.2 to 12.5%) and 41.3% (95CI: 31.6 to 51.7%) of participants respectively and was observed in both with or without glucose-lowering therapies subgroups (Table 2).

Conclusions
Prioritizing lifestyle changes were shown to improve metabolic health measures even to the point of achieving remission among subjects with prediabetes or T2D. These metabolic changes were mostly achieved after 3 months and persisted throughout the intervention. Future research is required to better understand which non-pharmacological interventions work best among subjects with varying metabolic profiles and pharmacotherapy, how long should the interventions last and how partial or complete normalization of glucose impacts long-term outcomes.
Heat exposure after the rainy season is associated with an increased risk of cardiovascular emergency
Authors: Fujimoto R , Suzuki E , Nakamura K , Yorifuji T , Ito H 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Climate change and global warming are some of the biggest issues in our society. Despite the growing concern for heat waves, while some previous studies have examined the effects of heat on CVD by focusing on maximum or mean daily temperature or long heat exposure periods, few studies have investigated the hourly effects of heat exposure and the risk of cardiovascular diseases (CVDs) in the elderly.

Purpose
We aimed to examine the association between heat exposure and the risk of CVD in the elderly and to evaluate possible effect-measure modifications by the rainy season in East Asia.

Methods
Our study was designed as a time-stratified case-crossover. The study included 6527 residents in Japan, aged 65 years or older who were dispatched to emergency hospitals between 2012 and 2019 for the onset of CVD during and a few months after the rainy seasons. We examined the association between temperature and CVD onset for each year and for hourly intervals (lag) before the emergency call during the most relevant months.

Results
Heat exposure during one month after the rainy season was associated with CVD risk; the odds ratio (OR) for a 1°C increase in temperature was 1.34 (95% confidence interval [CI]: 1.29–1.39). By hourly time interval (lag) before the emergency call during the month after the end of the rainy season, 0-6 hour before the case event (lag 0–6) were associated with CVD risk, particularly for lag 0–1 (OR: 1.33, 95% CI: 1.28–1.39). For longer periods, the highest risk was at lag 0-23 (OR: 1.40, 95% CI: 1.34-1.46) (Picture).

Conclusions
The present study suggests that heat exposure increases the risk of CVD onset during the month after the end of the rainy season in the elderly. Hourly exposure in less than one day to heat rise obtained from the temporal resolution may triggers CVD onset.
Treatment of iron deficiency anemia after cardiac surgery
Authors: Venturini E , Masini G , Giallauria F 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Iron deficiency anemia (IDA) after cardiac surgery (CS) increases mortality, serious adverse events and length of stay. Aim of the study was to compare the efficacy of Sucrosomal Iron (SI) on IDA and hematinic deficiencies (HD) in patients (P) after CS, compared to i.v. Ferric Carboxymaltose (FCM). SI was chosen for its peculiar intestinal absorption properties such as to overcome the hepcidin's block.

Methods
106 consecutive anemic P were tested for HD after the admission in Cardiac Rehabilitation and alternately treated with SI (56) or FCM (54). The study design included a single dose of 1000 mg of FCM at T1 (8-10 days CS) or a dose of 120 mg of SI per day from T1 to T2 (on the day of discharge 10 days after T1); since then the SI was reduced to 30 mg per day until T3 (follow-up, 10 days after T2). Measures of efficacy included changes from baseline in Hb, HD, natriuretic peptides (NP), C-reactive protein (CRP), and the 6-minute-walking-test (6MWT).

Results
The data are shown in the Table. At T1, two treatment groups did not show statistically significant differences. Hb increased significantly (p&lt;0.001), with no differences between SI and FCM. Transferrin saturation and sideremia significantly increased, albeit more rapidly with FCM. Ferritin, elevated at baseline for inflammation due to CS, decreases to T3 with SI, while significantly increases in the FCM group. NP were reduced with both treatments, but not significantly; CRP, on the other hand, was significantly reduced over time. At 6MWT the distance increased significantly with no difference between SI and FCM.

Conclusions
SI and FCM show similar efficacy on HD, starting from Hb, in P with IDA, after CS. The quick response to treatment, comparable between SI and FCM, could support the choice of oral iron, with organizational and cost benefits. In addition, was shown a positive impact on functional capacity, assessed with the 6MWT, for the first time similar between an oral and i.v. iron. Inflammation was reduced, but only SI is able to recover Hb levels, avoiding the risk of hyperferritinemia.
Predictors of poor exercise self-efficacy improvements after cardiac rehabilitation
Authors: Candelaria D , Gullick J , Randall S , Ladak L , Gallagher R 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): SOLVE-CHD Australian Government National Health and Medical Research Council (NHMRC) Synergy Grant [GNT1182301] PhD Scholarships

Background/Introduction
Building confidence to exercise regularly (exercise self-efficacy (ESE)) in the face of constraints and barriers, is a key goal of cardiac rehabilitation (CR) because such self-efficacy beliefs are predictors of sustained exercise behaviours. Therefore, identifying patient subgroups at risk of poor ESE enables tailoring of CR and appropriate targeting of support interventions.

Purpose
To identify independent predictors of poor ESE and poor improvements in ESE in CR participants.

Methods
The study used a prospective observational cohort design and recruited patients with coronary heart disease at CR entry across four sites in Metropolitan Sydney, Australia (2019-2020). Data were also compared for traditional in-person and remote-delivered CR during COVID-19 pandemic restrictions. The Exercise Self Efficacy Scale was used to measure ESE at CR entry and completion, and General Linear Models were used for analyses.

Results
Participants (n=194) had a mean age of 65.94 (SD 10.46) years, with 80.9% males; and 80.0% were married or partnered, with 23.6% from an ethnic minority background. Referral diagnosis included elective percutaneous coronary intervention (PCI) (40.2%), coronary artery bypass surgery (26.3%), and myocardial infarction with or without PCI (33.5%).
At CR entry, the mean ESE score was 24.93 (SD 5.99) points, which improved significantly by completion (p=.027). The GLM of ESE change (Adjusted R2=.247) identified that predictors of less change in ESE scores by CR completion included ethnic minorities (β=2.96, p=.003), not having a spouse or an intimate partner (β=-2.42, p=.023), and attending in-person CR (β=1.75, p=.036). Having higher ESE scores at entry was also associated with less ESE change on completion, such that for every point increase in ESE at entry, there was a reduction of .37 points in change (p&lt;.001). These variables were also the same predictors of poor ESE at CR completion.

Conclusions
Confidence to exercise improves in CR, and screening for ESE at CR entry enables identification of patients at-risk of poor improvements. Tailoring of interventions to provide appropriate support such as extending CR should be considered for patients from ethnic minorities and those who are single/widowed. Exploring the reasons for differences in outcomes from in-person and remote-delivered CR using appropriate methods should be the focus of future research.
Outcomes from a digital cardiovascular prevention and rehabilitation programme delivered in Ireland during COVID 19
Authors: Gibson I , Mccrudden Z , Harris A , Hynes L , Dunne D , Murphy A , Byrne M , Mcevoy JW 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Government of Ireland's Sláintecare Integration Fund Health Research Board, Ireland

Background & Aim
COVID 19 has accelerated the uptake and acceptance of digital health tools for the prevention and management of Cardiovascular Disease. With health systems being urged to learn from the pandemic and to reassess how they will deliver services in future, robust audit and evaluation of digital interventions are required to inform best practice.
This study aims to evaluate the clinical outcomes of a digital CVD prevention and rehabilitation programme which was established during COVID 19 to provide cardiac patients with efficient and timely access to a home-based, structured, comprehensive programme of care.

Methods
Developed and delivered by an interdisciplinary team (Nurse Prescriber, Physiotherapist, Dietitian, Cardiologist), the core components of this 12 week programme included, behavioural change support, lifestyle modification, medical risk factor management and electronic prescribing of cardio-protective medication. To support self-management, patients were provided with a Fitbit, blood pressure monitor and a workbook to support goal setting and overall tracking of progress. Patients were given access to a bespoke web-based platform and invited to attend weekly (2hr) group-based sessions, which included an exercise component and an interactive educational workshop.

Results
Over a 4 month period, 105 patients were referred with an uptake rate of 73% (n=77). Of these, 97% (n=75) enrolled in the programme, with an 85% (n=64) completion rate. Significant improvements in CVD risk factors were observed between initial and end of programme assessment. The proportion of patients meeting guideline-recommended physical activity targets increased from 14 to 82% (p&lt;0.001), mean BMI (kg/m2) reduced from 28.7 to 27.7 (p&lt;0.001), mean Mediterranean diet score improved from 5.2 to 7.3 (p&lt;0.001), and anxiety and depression levels ≥8 (Hospital Anxiety and Depression score) both reduced by more than 50% (p&lt;0.001). The proportions achieving the recommended blood pressure (&lt;130/80 mmHg) and LDL cholesterol targets (&lt;1.4 mmol/L) increased from 24 to 68% (p&lt;0.001) and 14 to 41% (p&lt;0.001), respectively.

Conclusion
Outcomes from this programme demonstrate that digital CVD prevention and rehabilitation programmes can achieve the recommended lifestyle, medical and therapeutic targets associated with reduced CVD events and improved health outcomes. This programme represents a scalable, accessible and effective option to deliver vital CVD preventive care in the patient’s home.
The initial validation of indonesian version of heartqoL: a short health-related quality of life questionnaire for post-myocardial infarction patients
Authors: Kusuma R , Sawitri DR , Herry Y , Bahrudin U 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Indonesia Ministry of Health

Background
HeartQoL questionnaire was developed to measure specific health-related quality of life for post-myocardial infarction patients. However, it has not been adapted and tested for its validity and reliability for Indonesian population.

Purpose
To assess the validity and reliability of the Indonesian version of the HeartQoL Questionnaire in post-acute myocardial infarction patients.

Method
We admitted 102 Indonesian-native speaking patients treated at a tertiary hospital who experienced the first episode of acute myocardial infarction (93% male; mean age = 56.8 years) into the study. They were randomly contacted to fill out the Indonesian version of HeartQoL and SF-36 questionnaire independently. Construct validity of the HeartQoL questionnaire was analyzed using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and convergent validity was assessed by correlation of the HeartQoL and SF-36 similar subscales, whereas internal consistency was examined using Cronbach's Alpha value.

Results
EFA showed that the Indonesian version of HeartQoL consisted of 14-items with a 2-factor structure, and CFA supported the results by showing a satisfactory fit, CFI = 0.972, TLI = 0.961, and RMSEA = 0.075. Convergent validity was shown by r &gt; 0.50 for physical and mental domain. The internal consistency of the HeartQoL scales was indicated by the Cronbach's Alpha value of 0,865-0.953.

Conclusions
The Indonesian version of the HeartQol questionnaire is a valid and reliable measure to assess the quality of life of patients after myocardial infarction.
ST-Segment Elevation and T-Wave Inversion Confined to V1-V4 in Young Soccer Players: Prevalence and Differences from Afro-Brazilians to Ghanaians
Authors: Stein R , Ferrari F , Helal L , Dilda GD , Bassan F , Da Silveira AD 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Hospital de Clínicas de Porto Alegre Research and Event Incentive Fund (FIPE-HCPA)

Introduction
Black athletes may present some peculiarities in the resting 12-lead electrocardiogram, such as T-wave inversion (TWI) confined to V1-V4 preceded by ST-segment and J-point elevation (‘domed’ ST-elevation and TWI in V1-V4), the so-called Afro-Caribbean pattern, a benign variant of the athlete's heart according to the "2017 International criteria for electrocardiographic interpretation in athletes". However, the prevalence of these findings in young Afro-Brazilian (AB) soccer players is unknown.

Purpose
To compare the prevalence of ‘domed’ ST-elevation and TWI in V1-V4 among young AB soccer players with Ghanaians black soccer players.

Methods
We sought to do this analysis visually, as the data from AB soccer players were as raw data; and those from Ghana’s were else aggregated. A forest plot with the point estimate and confidence intervals at 95% was built and, whenever any region from the lower limit up to the upper limit of the confidence interval of a given variable interpolate to the other, no differences could be claimed. The forest plot was built at R v. 4.1.2 using the package "metafor".

Results
Data from 517 young AB soccer players (mean age: 20 years) and 159 young black soccer players from Ghana (mean age: 19 years) were evaluated and compared. The average height and weight were similar (177.2 cm and 70.7 kg for AB, and 175.2 cm and 68.4kg for Ghanaians players). Ghanaians had a significant higher prevalence of ‘domed’ ST-elevation and TWI in V1-V4 than AB (16.7%; 95% CI, 13.1 to 25.8 versus 2.1%; 95% CI, 1.2 to 3.9, respectively).

Conclusion
To the best of our knowledge, this is the first study to describe the low prevalence of the ‘domed’ ST-elevation combined with TWI in V1-V4 in young AB soccer players. Interestingly, when compared to Ghanaians young soccer players (all of them black African individuals), AB athletes presented a significant lower frequency of this finding (16.7% versus 2.1%). Finally, we hypothesize that ‘domed’ ST-elevation and TWI in V1-V4 seen in African athletes appears to become less prevalent in the generations after the time of migration from Africa to Brazil. Whether this is due to environmental or genetic changes, further studies should clarify.
The impact of the italian law mandating an automatic external defibrillation in all sports venues on sudden cardiac arrest survival
Authors: Gianni A , Villa G , Mattesi G , Botteri M , Corrado D , Zorzi A 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
The chances of surviving a sport-related cardiac arrest depend strictly on resuscitation efforts. Since 2015, all Italian recreational and competitive sport venues must be equipped with automated external defibrillators (AEDs), and trained staff must be present during competitions. The aim of the study was to evaluate the incidence and survival rates of cardiac arrests in sport Venues in the Lombardia region of Italy before and after 2015.

Methods
We collected retrospectively data regarding all sudden cardiac arrests of presumed cardiac origin that involved both athletes and non-athletes (coaches, referees, spectators, etc.) and which occurred in sports venues of the Lombardia region in the period 2015-2019 versus those that occurred in the period 2011-2014, when automatic external defibrillators were not mandatory yet. All cases have been gathered thanks to the database built by the regional territorial emergency service (AREU) of the Lombardia region and consulting the news reported by the local and national press.

Results
Between 2015 and 2019, the incidence of cardiac arrest of presumed cardiac origin which affected athletes in sports venues of the Lombardia region was 0.19 per 100,000 inhabitants/year, versus 0.28 per 100,000 inhabitants/year in the period 2011-2014 (p&lt;0.005). The average age of the victims was 49.9 years in 2015-2019 and 52 years in 2011-2014 (p=0.96). After the enactment of the "compulsory AED law", the proportion of cardiac arrests treated with onsite AEDs increased from 15% to 42.1% (p&lt;0.001) and the return of spontaneous circulation (successful resuscitation) increased from 67% to 80% (p&lt;0.05). The association between mandatory presence of AEDs in sports venues and resuscitation success in terms of ROSC was found significant (p&lt;0.05).

Conclusions
Cardiac arrest in sports venues is a rare event and involves mainly male athletes older than 30 years old. A nationwide law mandating the presence of AEDs in all sport venues significantly increased the proportion of individuals suffering cardiac arrest who received defibrillation before the emergency medical system arrival and favorably influenced survival rates.
Cost-effectiveness of the cardiovascular pre-participation screening in children practicing sport
Authors: Graziano F , Schiavon M , Paiaro S , Cipriani A , Brunetti G , Corrado D , Zorzi A 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
In Italy, preparticipation screening of competitive athletes is mandatory. The age at which pre-participation screening (PPS) should start is established by each sport federation and it is sometimes under 10 years old. The aim of this study is to detect both PPS efficacy and cost in paediatric age and to define the cut-off age from which it is more cost-effective.

Methods
We retrospectively enrolled 25251 athletes aged ≤15 to evaluate the prevalence of cardiovascular (CV) diseases and cost-effectiveness ratio who underwent PPS from 2011 to 2020. In addition, we retrospectively studied a subgroup of 1307 competitive athletes aged 7-15 who underwent PPS from January 2019 to February 2020 for an in-depth analysed regarding costs. Cardiovascular preparticipation screening included first-line investigations (history, physical examination, resting ECG and exercise testing) and further examinations in case of abnormalities at first-line tests.

Results
In the period 2010-2020, 66 athletes were permanently disqualified for a CV disease (0,11%), 26 for a CV disease at risk of sudden cardiac death (0.05%), with a prevalence of 0.15% over 12 years old versus 0.01% under 12 (p&lt;0.001). In the cost analysis subgroup, second-line investigations were prescribed to 5% of athletes because of abnormalities at first line tests: 1 was disqualified for a CV disease (0,07%). The cost for each athlete was 69,80€. Between 2011 and 2020, 58185 PPS were carried out. The overall cost of PPS was about €4 million, the cost for each diagnosis of any CV disease was 61.535€, and for each CV disease at risk of sudden cardiac death was 156.204€.

Conclusion
The cost-effectiveness of PPS before competitive sports in the pediatric age is lower than reported for older athletes in previously published studies. According to our data, starting PPS before 12 years of age does not appear to be justified.