bluuebunny/crossref_metadata_2025_split huggingface dataset:
Referral rates and patient characteristics of the inpatient cardiac rehabilitation program of a philippine tertiary cardiovascular referral center
Authors: Agustin R D , Samson A L , Dela Cruz A , Pipo M M , Punzalan F E 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
International guidelines recommend effective cardiac rehabilitation programs to decrease mortality and morbidity and improve health-related quality of life. However, cardiac rehabilitation remains underutilized with low referral rates. Data on referral rates and factors affecting referral are lacking in our setting.
Purpose
We evaluated the utilization of inpatient cardiac rehabilitation in our general hospital in terms of referral rates of patients with Class I indications for cardiac rehabilitation, time to referral, treadmill exercise test (TET) participation rate, and characteristics of patients referred and not referred.

Methods
We conducted this retrospective descriptive cross-sectional study by reviewing the medical records of eligible patients admitted between January 1 to December 31,2018. Patient characteristics, indications for cardiac rehabilitation, referral rates, time to referral, and TET participation rates were determined.

Results
We included 759 patients with a mean age of 57.5 years; majority were male (59.9%), married (66.8%), hypertensive (58.4%) and diabetic (32%). The overall referral rate is 17.7%. The highest indication-specific referral rates were for CABG(70%), STEMI(32%), PCI(32%), and PAD(32%). The lowest referral rates were seen in patients with NSTEMI(18%) and HF (16%). The mean time to referral was 6 days. The TET participation rate was 1.3%.

Conclusion
Cardiac rehabilitation remains underutilized despite evidence-based recommendations. Intensified efforts are needed to enroll all patients with Class I indications for inpatient cardiac rehabilitation, increase referral rates, improve the existing program, and optimize the management of our cardiovascular patients.
Correlation between fasting heart rate and fasting plasma glucose level in rural Indians
Authors: Inamdar Aniket 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Diabetes mellitus is associated with abnormal autonomic function. Diabetes and impaired fasting glucose are associated with increased mortality, particularly from cardiovascular causes. Several factors, including fast heart rate, have been identified to be associated with an increased likelihood of having diabetes. Heart rate is a crude index of the autonomic nervous system tone, reflecting a balance of sympathetic and parasympathetic inputs, and correlates with muscle sympathetic nerve activity and noradrenaline serum levels . Examining its potential role in diabetes risk could improve our understanding of the pathogenesis of diabetes.

Purpose
Aim of our study was to establish correlation between fasting heart rate and fasting blood glucose level.

Methods
509 patients between age group 25 years to 75 years were studied. Resting heart rate was recorded on finger pulse oximeter before taking fasting blood sample. Morning blood samples were obtained by venipuncture after an overnight fast of at least 8 hours and blood glucose estimation done by the hexokinase method. Diabetes mellitus was defined in accordance with American Diabetes Association and World Health Organization guidelines. Pearson"s correlation test was used for statistical analysis.

Results
We found that resting heart rate was significantly higher in patients with higher fasting blood glucose levels compared with patients with normal glucose levels. This difference was statistically significant with p = 0.002 (r:0.137).

Conclusions
Our study strongly supports faster resting heart rate as an independent risk factor for incident diabetes and impaired fasting glucose. Meta-analysis of seven published studies confirmed the positive association between resting heart rate and diabetes risks. A resting heart rate is generally considered as a surrogate marker for autonomic activity, and increased sympathetic nerve system activity is associated with both acute and chronic insulin resistance. Sympathetic activation has been associated with many diabetes-related risk factors, including reduced insulin sensitivity, high BP, obesity, subclinical inflammation and the metabolic syndrome. Our findings suggest that this area of investigation may be relevant for future studies.
Awareness and cognitive status of older patients with chronic cardiorenal syndrome in terms of patient-centered approach
Authors: Efremova E , Shutov A M 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
A patient-centered approach is the basis for older patients with cardiovascular comorbidity. Collaborative decision making is especially important for older patients with chronic kidney disease (СKD).
The aim of the study was to study the possibilities and difficulties of a patient-centered approach in older patients with chronic cardiorenal syndrome.
Material and methods. 214 older patients with stable cardiovascular disease (106 males, mean age was 69.5 ± 7.6 years) were studied. CKD was diagnosed and classified according to the KDIGO guidelines (2012). Charlson comorbidity index (CCI) was estimated. Cognitive status was assessed using the Mini-Mental State Examination (MMSE) and the Clinical Dementia Rating scale (CDR). Assessment of socio-demographic characteristics and awareness of patients was determined by questionnaires and interviews. Follow-up period was 12 months.
Results. CKD was observed in 144 (67.3%) patients with stable cardiovascular disease. A third of older patients with CKD (48; 33.3%) were informed about impaired renal function (n = 144), and only 23 (16%) older patients with CKD, along with observation by a therapist, consulted a nephrologist . Only half of older patients with cardiovascular pathology, regardless of the presence of CKD, know their cholesterol level and their cardiovascular risk. In 70 (48.6%) older patients with stable cardiovascular pathology and CKD, pre-dementia cognitive impairment was observed, in 28 (19.4%) - mild dementia. A third of older patients with cardiovascular pathology and CKD (47; 32.6%) still have questions about their health. 112 (77.8%) patients would like to be able to remotely communicate with medical personnel in case of health issues. At the same time, only 37 (25.7%) patients with CKD are ready to attend full-time schools for patients.
Conclusion. Cognitive impairments and low awareness of older patients with chronic cardiorenal syndrome complicate the implementation of a patient-centered approach.
Measuring the arterial phase of the right coronary artery in the patients suspected of coronary artery disease: a dual study by dynamic angiography and deep learning program
Authors: Truyen T , Vu L , Pham D , Do Q , Huynh T , Ho D , Nguyen T 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background. In the diagnosis of coronary artery disease (CAD), coronary angiography (CA) plays a crucial role in determining the location and severity of the stenosis, the anatomical aspect of a lesion. It does not accurately reflect the flow dynamics in the coronary artery. This study aimed to evaluate the coronary flow abnormalities based on our new angiographic technique and Deep Learning (DL) program in patients suspected of CAD.
Methods. We randomly selected patients who were admitted with suspected CAD. All patients underwent our new technique of CA. After the index coronary artery was filled completely with contrast, we stopped the injection. At that time, the blood in white color flew in. The flow characteristics, the shape of the tip, borders, and direction could be clearly observed above a black background of the contrast. In this study, we measured the arterial phase (AP) from the beginning when the blood moved in until the end when all contrasts in black color washed out of the distal vasculature. In the DL protocol, the U-Net model combined with Dense-Net-121 and a binary image classification model are used to predict the beginning and ending frame. To obtain the best image for the DL program, we analyzed only the flow of the right coronary artery (RCA).
Results. 81 patients were enrolled. In patients with normal coronary angiography, the mean AP was 1.86s (27.4 +/- 5.4 frames). In patients with one significant lesion, the mean AP value was 2.35s (35.3 +/- 7.7 frames). The mean difference of the AP between the two groups was 0.49s (95% confidence interval: 0.295 to 0.694). This difference is statistically significant. Our DL has the mean root square error in predicting the AP was 0.34s.
Conclusion. In patients with CAD, the prolonged arterial phase could be accurately estimated using the DL program, reflecting the slow circulation of highly oxygenated blood. It could be used as a marker of coronary perfusion in future studies.
Sex Differences in the Risk of Dementia in Older Veterans
Authors: Eastman Jennifer , Bahorik Amber , Kornblith Erica , Xia Feng , Yaffe Kristine 
Published: February 2022

Abstract

Background
Studies have demonstrated women to have a higher prevalence of dementia compared to men. However, sex differences in dementia incidence are controversial with conflicting reports showing women with higher, lower, or similar incidence. Source of difference may be due to clinical setting and lack of consideration of competing risk of death. We examined dementia incidence in a sample of the national Veteran population to determine differences by sex.

Methods
We examined data from the Veterans Health Administration (VHA), the largest integrated health care system in the United States. We studied 947 797 Veterans aged ≥55 years (mean age: 69.9 ± 8.4, 3% female) evaluated in the VHA from October 1, 1999 to September 30, 2019. We estimated age-adjusted incidence rates of dementia (International Classification of Diseases, 9th and 10th Edition codes) by sex, and used Fine–Gray proportional hazards models with age as time scale to examine time to diagnosis, accounting for competing risk of death.

Results
During the follow-up (mean 8.4 years), 11.3% (n = 106 977, 11.4% men and 8.0% women) of Veterans developed dementia. Age-adjusted incidence was 12.6/1 000 person-years for men and 12.7/1 000 person-years for women. Compared to male Veterans, risk dementia was slightly higher among females (hazard ratio = 1.15; 95% confidence interval: 1.10–1.20), and on average, female Veterans developed dementia 0.2 years earlier than male Veterans. After additional adjustment for race, education, medical, and psychiatric conditions, results were similar.

Conclusions
Among older Veterans in a national cohort, women had a slightly increased risk for developing dementia compared to men after accounting for competing risk of death.
Socioeconomic Disparities Do Not Explain the U.S. International Disadvantage in Mortality
Authors: Barbieri Magali 
Published: February 2022

Abstract

Objectives
The articles examines the contribution of internal socioeconomic disparities in mortality to the U.S. international disadvantage in life expectancy at birth.

Methods
Using individual death records from the U.S. national vital statistics system for years 1982–2019 and data for other countries from the Human Mortality Database, we compare age-specific death rates and life expectancy between counties classified into 10 socioeconomic categories and 20 high-income countries. We also calculate the number of years of life lost in each socioeconomic decile in relation to the comparison set.

Results
There is a clear and increasing socioeconomic gradient of mortality in the United States, but the growing divergence in internal mortality trends does not explain the rising gap between the country and its peers. In 2019, even American women in the most socioeconomically advantaged decile lived shorter lives, while only 10% of men in the most affluent decile fared better than their peers. The long-standing U.S. disadvantage in young adult mortality has been growing and the country’s previous advantage in mortality at ages 75 years and older has virtually disappeared for all but for Americans in the most affluent counties.

Discussion
The similar age pattern of differences in mortality rates between each socioeconomic deciles and the comparison group suggests that the underlying factors might be the same. The role of external causes (including drug overdoses) for middle-aged adults and a slowing down in progress to control cardiovascular diseases at older ages at the national level are consistent with this pattern.
Longitudinal multimodal MRI characterization of a knock-in mouse model of Huntington’s disease reveals early gray and white matter alterations
Authors: Pérot Jean-Baptiste , Célestine Marina , Palombo Marco , Dhenain Marc , Humbert Sandrine , Brouillet Emmanuel , Flament Julien 
Published: February 2022

Abstract
Pathogenesis of the inherited neurodegenerative disorder Huntington’s disease (HD) is progressive with a long presymptomatic phase in which subtle changes occur up to 15 years before the onset of symptoms. Thus, there is a need for early, functional biomarker to better understand disease progression and to evaluate treatment efficacy far from onset. Recent studies have shown that white matter may be affected early in mutant HTT gene carriers. A previous study performed on 12 months old Ki140CAG mice showed reduced glutamate level measured by Chemical Exchange Saturation Transfer of glutamate (gluCEST), especially in the corpus callosum. In this study, we scanned longitudinally Ki140CAG mice with structural MRI, diffusion tensor imaging, gluCEST and magnetization transfer imaging, in order to assess white matter integrity over the life of this mouse model characterized by slow progression of symptoms. Our results show early defects of diffusion properties in the anterior part of the corpus callosum at 5 months of age, preceding gluCEST defects in the same region at 8 and 12 months that spread to adjacent regions. At 12 months, frontal and piriform cortices showed reduced gluCEST, as well as the pallidum. MT imaging showed reduced signal in the septum at 12 months. Cortical and striatal atrophy then appear at 18 months. Vulnerability of the striatum and motor cortex, combined with alterations of anterior corpus callosum, seems to point out the potential role of white matter in the brain dysfunction that characterizes HD and the pertinence of gluCEST and DTI as biomarkers in HD.
Prior intake of new oral anticoagulants adversely affects outcome following surgery for acute type A aortic dissection
Authors: Sromicki Juri , Van Hemelrijck Mathias , Schmiady Martin O , Krüger Bernard , Morjan Mohammed , Bettex Dominique , Vogt Paul R , Carrel Thierry P , Mestres Carlos-A 
Published: February 2022

Abstract

OBJECTIVES
Oral anticoagulation prior to emergency surgery is associated with an increased risk of perioperative bleeding, especially when this therapy cannot be discontinued or reversed in time. The goal of this study was to analyse the impact of different oral anticoagulants on the outcome of patients who underwent emergency surgery for acute type A aortic dissection (ATAAD).

METHODS
This was a single-centre retrospective study of patients treated with oral anticoagulation at the time of surgery for ATAAD. Outcomes of patients on new oral anticoagulant (NOAC) therapy were compared to respective outcomes of patients on Coumadin. Additionally, a survival analysis was performed comparing these 2 groups with patients who were operated on with no prior anticoagulation.

RESULTS
Between January 2013 and April 2020, a total of 437 patients (63.8 ± 11.8 years, 68.4% male) received emergency surgery for ATAAD; 35 (8%) were taking oral anticoagulation at the time of hospital admission: 20 received phenprocoumon; 14, rivaroxaban; and 1, dabigatran. Compared to Coumadin, NOAC was associated with a greater need for blood-product transfusions and haemodynamic compromise. Operative mortality was 53% in the NOAC group and 30% in the Coumadin group. A 5-year survival analysis showed no significant difference between the NOAC and the Coumadin group (P = 0.059). Compared to 402 patients treated during the study period without anticoagulation, patients taking NOAC had significantly worse survival (P = 0.001), whereas that effect was not observed in patients undergoing surgery who were taking Coumadin (P = 0.99).

CONCLUSIONS
Emergency surgery for ATAAD in patients taking NOAC is associated with high morbidity and mortality. NOAC are a major risk factor for uncontrollable bleeding and haemodynamic compromise. New treatment strategies must be defined to improve surgical outcomes in these high-risk patients.
Modelling of plant circadian clock for characterizing hypocotyl growth under different light quality conditions
Authors: Pay Miao Lin , Kim Dae Wook , Somers David E , Kim Jae Kyoung , Foo Mathias 
Published: February 2022

Abstract
To meet the ever-increasing global food demand, the food production rate needs to be increased significantly in the near future. Speed breeding is considered as a promising agricultural technology solution to achieve the zero-hunger vision as specified in the United Nations Sustainable Development Goal 2. In speed breeding, the photoperiod of the artificial light has been manipulated to enhance crop productivity. In particular, regulating the photoperiod of different light qualities rather than solely white light can further improve speed breading. However, identifying the optimal light quality and the associated photoperiod simultaneously remains a challenging open problem due to complex interactions between multiple photoreceptors and proteins controlling plant growth. To tackle this, we develop a first comprehensive model describing the profound effect of multiple light qualities with different photoperiods on plant growth (i.e. hypocotyl growth). The model predicts that hypocotyls elongated more under red light compared to both red and blue light. Drawing similar findings from previous related studies, we propose that this might result from the competitive binding of red and blue light receptors, primarily Phytochrome B (phyB) and Cryptochrome 1 (cry1) for the core photomorphogenic regulator, CONSTITUTIVE PHOTOMORPHOGENIC 1 (COP1). This prediction is validated through an experimental study on Arabidopsis thaliana. Our work proposes a potential molecular mechanism underlying plant growth under different light qualities and ultimately suggests an optimal breeding protocol that takes into account light quality.
Documentation of hospitalization risk factors in electronic health records (EHRs): a qualitative study with home healthcare clinicians
Authors: Hobensack Mollie , Ojo Marietta , Barrón Yolanda , Bowles Kathryn H , Cato Kenrick , Chae Sena , Kennedy Erin , McDonald Margaret V , Rossetti Sarah Collins , Song Jiyoun , Sridharan Sridevi , Topaz Maxim 
Published: February 2022

Abstract

Objective
To identify the risk factors home healthcare (HHC) clinicians associate with patient deterioration and understand how clinicians respond to and document these risk factors.

Methods
We interviewed multidisciplinary HHC clinicians from January to March of 2021. Risk factors were mapped to standardized terminologies (eg, Omaha System). We used directed content analysis to identify risk factors for deterioration. We used inductive thematic analysis to understand HHC clinicians’ response to risk factors and documentation of risk factors.

Results
Fifteen HHC clinicians identified a total of 79 risk factors that were mapped to standardized terminologies. HHC clinicians most frequently responded to risk factors by communicating with the prescribing provider (86.7% of clinicians) or following up with patients and caregivers (86.7%). HHC clinicians stated that a majority of risk factors can be found in clinical notes (ie, care coordination (53.3%) or visit (46.7%)).

Discussion
Clinicians acknowledged that social factors play a role in deterioration risk; but these factors are infrequently studied in HHC. While a majority of risk factors were represented in the Omaha System, additional terminologies are needed to comprehensively capture risk. Since most risk factors are documented in clinical notes, methods such as natural language processing are needed to extract them.

Conclusion
This study engaged clinicians to understand risk for deterioration during HHC. The results of our study support the development of an early warning system by providing a comprehensive list of risk factors grounded in clinician expertize and mapped to standardized terminologies.
Canadian Gastroenterology Career Pathway Experiences: Exploring the Gender Divide
Authors: Jawaid Noor , Boctor Monica , LoMonaco Jordan , Bollegala Natasha 
Published: February 2022

Abstract

Background
We aimed to determine the persistence of differential career experiences between male and female gastroenterologists in Canada &gt;20 years after they were first noted in the literature.

Methods
A 51-question mixed-methods survey was developed focusing on personal, professional and financial characteristics. The survey was disseminated via email and fax to practicing gastroenterologists using provincial college registries and the Canadian Association of Gastroenterology. Numerical data were analyzed using the chi-square test. Qualitative thematic analysis was conducted for short answer responses.

Findings
There were a total of 114 responses (17% response rate) with 35% female respondents. Mean age was 49 years for males and 41 years for females (P = 0.001). Clinical practice types included general GI (63%), urban (82%) and academic (51%). Males reported more endoscopy time (P = 0.001) versus females who spent more time on research (P &lt; 0.001). Men were more likely to be married (P = 0.011), but women were more likely to be responsible for childcare (P = 0.016). Women were more likely to choose between marriage and career and more chose marriage compared to men (P = 0.045). Males earned &gt;$100,000/year higher income than females even when offset by age and work hours (P = 0.048). A salary &gt;$600,000 was reported by 32% of men, compared to 3% of women. Female gastroenterologists reported less mentorship during GI training, challenging relationships with support staff, reduced promotion opportunity, more difficulty publishing and having their competency challenged.

Interpretation
Compared to previous data, there has not been significant gender-related progress in the past two decades regarding female gastroenterologists’ clinical practices, remuneration and work-life balance.