bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cognitive impairment negatively impacts self-efficacy in patients with chronic heart failure patients: results from the Cognition.Matters-HF study
Authors: Wissel S , Frey A , Sell R , Frantz S , Stoll G , Stoerk S 
Published: October 2022

Abstract

Background
Cognitive impairment is highly prevalent in patients with chronic heart failure (HF), but evidence on its relationship with health-related quality of life (HRQoL) is sparse. We aimed to examine whether cognitive impairment is associated with HRQoL. We hypothesized that cognitive impairment would negatively impact HRQoL.

Methods
A total of 148 outpatients with chronic stable HF (mean LV ejection fraction 43±8%) were enrolled in the Cognition.Matters-HF prospective cohort study: mean age 64±11 years, 16% women, 77% in NYHA functional class I-II. Patients were extensively evaluated within 2 days by cardiological, neurological, and neuropsychological testing and brain magnetic resonance imaging (MRI). Severity of cognitive deficits were categorized based on the domains affected according to neurocognitive test battery results: 0 domains (“none”, n=46 [31%]), 1–2 domains (“mild”, n=77 [52%]), and &gt;2 domains (“severe”, n=24 [16%]). HRQoL was measured with the generic Short-Form 36 (SF-36) and the disease-specific Kansas City Cardiomyopathy Questionnaire (KCCQ). Multivariable analysis of variance and regression modelling were applied to model associations between cognitive impairment and HRQoL.

Results
Cognitive impairment was not associated with overall scores of SF-36 and KCCQ nor any of the subscales, with the exception of the self-efficacy scale of the KCCQ. Self-efficacy represents the ability of patients to care for themselves; it quantifies a patient's unterstanding of how to prevent heart failure exacerbations and manage arising complications. Self-efficacy was negatively associated with cognitive impairment (beta=−0.242; p=0.004) and was rated 15% lower (B=−0.148) per increment in cognitive deficit category. The association of self-efficacy with cognitive impairment remained significant after adjustment for duration and severity of HF, age, and sex (p&lt;0.001).

Conclusions
With the exception of self-efficacy, the severity of cognitive impairment was not associated with lower HRQoL in patients with chronic HF. The self-efficacy scale of the KCCQ is a promising tool potentially suited to detect individuals, who are unable to adhere to a proper HF treatment regimen. These patients may benefit from enhanced care, e.g. in the frame of a HF nurse led management program.

Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): BMBF
The real-world safety profile of SGLT2 inhibitors among adults 75 years or older: a retrospective, pharmacovigilance study
Authors: Goldman A , Fishman B , Raschi E , Cukierman-Yaffe T , Dankner R , Ben-Zvi I , Maor E 
Published: October 2022

Abstract

Introduction
As indications for sodium-glucose co-transporter-2 (SGLT2) inhibitors treatment are expanding, more older adults become candidates for treatment. However, data regarding the treatment's safety profile in the older population are limited.

Methods
A retrospective, pharmacovigilance study of the FDA's global database of safety reports (7/1/2014–6/30/2021). To assess reporting of pre-specified adverse events following SGLT2-inhibitors treatment among adults (18≥age&lt;75) and older adults (age≥75), we performed disproportionality analysis using the reporting odds ratio (ROR).

Results
Of 10,526,408 patients in the full database, 279,619 eligible patients with non-insulin-dependent diabetes mellitus were identified (mean age 63.4 [SD 13.0] years, 54,791 [19.6%] aged ≥75 years), among whom 29,431 receiving SGLT-2 inhibitors. Compared to other non-insulin anti-diabetics, SGLT2-inhibitors were significantly associated with amputations (ROR=127.87 [95% CI: 111.31–146.90] vs ROR=74.91 [49.99–112.25]), Fournier gangrene (ROR=53.27 [44.38–63.92] vs ROR=33.33 [20.33–54.64]), diabetes ketoacidosis (ROR=39.25 [37.20–41.42] vs ROR=58.46 [49.41–69.1]), genitourinary infections (ROR=4.36 [4.12–4.61] vs ROR=5.08 [4.45–5.79]), nocturia (ROR=2.81 [2.13–3.73] vs ROR=3.51 [1.84–6.68]), and dehydration (ROR=2.22 [2.05–2.40] vs ROR=2.33 [1.93–2.81]) in both adults and older adults, respectively. The relative reporting of these safety signals was consistent between age groups (all P interaction &gt;0.05). Acute kidney injury was associated with SGLT2-inhibitors treatment in adults (ROR=1.47 [1.40–1.54]) but not older adults (ROR=0.84 [0.72–0.98]). No new safety signals were observed in older adults. Falls, fractures, hypotension, and syncope were not associated with SGLT2-inhibitors among either adults or older adults.

Conclusion
In this global post-marketing study, treatment with SGLT-2 inhibitors in older adults was associated with increased reporting of amputations, Fournier gangrene, DKA, genitourinary infections, and dehydration. Nevertheless, the relative reporting was consistent between adults and older adults, and no new safety signals were found in the older population.

Funding Acknowledgement
Type of funding sources: None.
Efficacy of sodium glucose cotransporter 2 inhibitors for heart failure with preserved and mildly reduced ejection fraction: a systematic review and meta-analysis
Authors: Cordovez R A B , Denila R A , Rivera K , Patricio M 
Published: October 2022

Abstract

Background
SGLT2 inhibition has been a breakthrough approach in the treatment for heart failure. A recent guideline has recommended SGLT2i for the treatment of patients with HFrEF to reduce the risk of HF hospitalization and death, regardless of presence of type 2 diabetes (1). However, its benefit in HFpEF and HFmrEF have yet to be established.

Purpose
We evaluated the cardiovascular outcomes of SGLT2i for HFpEF and HFmrEF.

Methods
Randomized controlled trials on SGLT2i versus placebo in patients with left ventricular ejection fraction of more than 40% reporting CV outcomes were searched using Pubmed, CENTRAL, and ScienceDirect. Primary outcome was the composite of hospitalization for heart failure or CV death. Secondary outcomes were the individual HHF, CV death, as well as all-cause mortality. Pooled hazard ratios with 95% confidence intervals were used as effect estimates using fixed-effects model.

Results
Six studies were included with a total of 10,450 patients. In the combined HFmrEF and HFpEF population, there was a significant reduction in composite of cardiovascular death and heart failure hospitalization in the SGLT2i group (HR 0.79, 95% CI 0.71–0.88, p&lt;0.0001) compared to placebo, driven by a significant reduction in heart failure hospitalization (HR 0.73, 95% CI 0.63–0.84, p&lt;0.00001). In the distinct HFpEF population, there was a significant reduction in composite of cardiovascular death and heart failure hospitalization in the SGLT2i group (HR 0.75, 95% CI 0.63–0.88, p=0.0007) compared to placebo.

Conclusion
SGLT2i provides significant risk reduction in HF hospitalization or CV death among patients with HFpEF compared to placebo.

Funding Acknowledgement
Type of funding sources: None.
Prognostic value of liver damage assessed by direct bilirubin and skeletal muscle weakness in patients with heart failure
Authors: Noda T , Kamiya K , Hamazaki N , Nozaki K , Ichikawa T , Yamashita M , Uchida S , Maekawa E , Yamaoka-Tojo M , Matsunaga A , Ako J 
Published: October 2022

Abstract

Background
Patients with heart failure (HF) have a high prevalence of liver function abnormalities such as bilirubin abnormalities. However, the relationship between abnormalities of direct bilirubin (DB), a fraction of total bilirubin, and dynapenia are unclear, and the effect of the coexistence of both on the prognosis of patients with HF remains unclear.

Purpose
This study investigated the association between total/direct bilirubin and dynapenia, a muscle weakness syndrome. Moreover, we considered the effect of the combination of high DB and dynapenia on increased mortality.

Methods
In this retrospective cohort study, we reviewed patients with HF for whom we assessed total bilirubin, DB, handgrip strength, and leg strength at discharge, which were further evaluated to determine the presence of dynapenia. Dynapenia was defined by the lower handgrip strength and leg strength. Low handgrip strength was defined as &lt;26 kg for males and &lt;18 kg for females, and low leg strength assessed by the maximal quadriceps isometric strength was defined as &lt;45% body mass (%BM) for males and &lt;35% BM for females. Multiple linear and multivariate logistic regression analyses were used to examine the association between DB with muscle weakness and dynapenia. In addition, we examined the prognostic value of comorbid DB abnormalities (≥0.5) and dynapenia. The endpoint was all-cause mortality.

Results
Among 853 inpatients enrolled, high DB was identified in 147 and dynapenia in 377 (44.2%) patients. Multiple regression analysis showed that high DB was independently associated with decreased grip and leg strengths (grip strength, P=0.027; leg strength, P=0.002). Furthermore, after adjusting for covariates, the high DB group (odds ratio: 1.800, 95% confidence interval [CI]: 1.203–2.695, P=0.004) was significantly associated with dynapenia compared to the low DB group. During the follow-up period, 189 patients died (median, 1.77 years; interquartile range, 0.64–3.81 years). The risk of death was significantly higher in the high DB/dynapenia group than in the low DB group, even after adjusting for the severity of HF (hazard ratio: 2.610, 95% CI: 1.680–4.051, P&lt;0.001).

Conclusions
High DB is associated with muscle weakness in patients with HF and affects patient prognosis.

Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): This work was partially supported by JSPS KAKENHI.
Experiences of German health care professionals with spiritual history taking in primary care: a mixed-methods process evaluation of the HoPES3 intervention
Authors: Huperz Carolin , Sturm Noemi , Frick Eckhard , Mächler Ruth , Stolz Regina , Schalhorn Friederike , Valentini Jan , Joos Stefanie , Straßner Cornelia 
Published: October 2022

AbstractBackgroundSpiritual needs gain importance in old age but are often ignored in health care. Within the ‘Holistic care program for elderly patients to integrate spiritual needs, social activity and self-care into disease management in primary care (HoPES3)’ a complex intervention was evaluated in a cluster-randomized trial. The aim of this study was to explore the acceptability, feasibility, benefits, and harms of a spiritual history taken by general practitioners (GPs) as part of the complex intervention.MethodsIn this mixed-methods study telephone interviews with 11 German GPs and 12 medical assistants (MAs) of the HoPES3 intervention group were conducted and analysed using a content-analytical approach. Furthermore, GPs were asked to complete a questionnaire after each spiritual history. One hundred and forty-one questionnaires from 14 GPs were analysed descriptively.ResultsGPs considered the spiritual history very/quite helpful for the patient in 27% (n= 38) and very/quite stressful in 2% (n = 3) of the cases. Interviews indicated that GPs found discussing spiritual history easier than anticipated. GPs and MAs saw a difficulty in that many patients associated spirituality with religion or church and reacted with surprise or rejection. Benefits for patients were seen in the opportunity to talk about non-medical topics, and increased awareness of their own resources. Benefits for GPs mainly related to information gain and an intensified patient–physician relationship.ConclusionsA spiritual history in general practice has the potential to reveal important information about patients’ lives and to improve the patient–physician relationship. Implementation barriers identified in this study have to be considered and addressed.
Cognitive Effort-Based Decision-Making Across Experimental and Daily Life Indices in Younger and Older Adults
Authors: Crawford Jennifer L , English Tammy , Braver Todd S 
Published: October 2022

AbstractObjectivesThe study investigated whether cognitive effort decision-making measured via a neuroeconomic paradigm that manipulated framing (gain vs. loss outcomes), could predict daily life engagement in mentally demanding activities in both younger and older adults.MethodYounger and older adult participants (N = 310) completed the Cognitive Effort Discounting paradigm (Cog-ED), under both gain and loss conditions, to provide an experimental index of cognitive effort costs for each participant in each framing condition. A subset of participants (N = 230) also completed a 7-day Ecological Momentary Assessment (EMA) protocol measuring engagement in mentally demanding daily life activities.ResultsIn a large, online sample, we replicated a robust increase in cognitive effort costs among older, relative to younger, adults. Additionally, costs were found to be reduced in the loss relative to gain frame, although these effects were only reliable at high levels of task difficulty and were not moderated by age. Critically, participants who had lower effort costs in the gain frame tended to report engaging in more mentally demanding daily life activities, but the opposite pattern was observed in the loss frame. Further analyses demonstrated the specificity of reward-related cognitive motivation in predicting daily life mentally demanding activities.DiscussionTogether, these results suggest that cognitive effort costs, as measured through behavioral choice patterns in a neuroeconomic decision-making task, can be used to predict and explain engagement in mentally demanding activities during daily life among both older and younger adults.
The Tuchyn Pogrom: The Names and Faces Behind the Violence, Summer 1941
Authors: McBride Jared 
Published: October 2022

ABSTRACT
On the night of July, 6, 1941, under the cover of darkness, a group of Ukrainian assailants armed with bats, shovels, and other weapons attacked their Jewish neighbors in Tuchyn, a small town just outside of Rivne, killing dozens and wounding more. Through the testimony of perpetrators, victims, and local witnesses, this article not only reestablishes the events leading up to, during, and following the pogrom against Tuchyn’s Jews, but also provides biographical sketches of the local perpetrators and those in the community who enabled it. While there has been increasingly sophisticated work on the summer 1941 pogroms in Eastern Europe, scholars have yet to identify and thoroughly analyze local participants. From a deeper probe into local perpetrators’ organizational affiliations, social networks, and their place in the quickly changing and dynamic political situation, this article questions the analytical categories we use to frame local perpetrators, as well as the pogroms. In doing so it offers new insights on the participants, while demonstrating the possibilities for new more dynamic avenues for future research on pogrom violence.
An exponentially convergent discretization for space–time fractional parabolic equations using hp-FEM
Authors: Markus Melenk Jens , Rieder Alexander 
Published: October 2022

Abstract
We consider a space–time fractional parabolic problem. Combining a sinc quadrature-based method for discretizing the Riesz–Dunford integral with $hp$-FEM in space yields an exponentially convergent scheme for the initial boundary value problem with homogeneous right-hand side. For the inhomogeneous problem, an $hp$-quadrature scheme is implemented. We rigorously prove exponential convergence with focus on small times $t$, proving robustness with respect to startup singularities due to data incompatibilities.
Effects of resveratrol and its derivative pterostilbene on hepatic injury and immunological stress of weaned piglets challenged with lipopolysaccharide
Authors: Li Yue , Zhang Hao , Tu Feng , Cao Jing , Hou Xiang , Chen Yanan , Yan Junshu 
Published: October 2022

Abstract
The present study was to investigate the protective effects of resveratrol (RSV) and its 3,5-dimethylether derivative pterostilbene (PT) against liver injury and immunological stress of weaned piglets upon lipopolysaccharide (LPS) challenge. Seventy-two weaned piglets were divided into the following groups: control group, LPS-challenged group, and LPS-challenged groups pretreated with either RSV or PT for 14 d (n = 6 pens, three pigs per pen). At the end of the feeding trial, piglets were intraperitoneally injected with either LPS or an equivalent amount of sterile saline. After 6 h of sterile saline or LPS injection, plasma and liver samples were collected. LPS stimulation caused massive apoptosis, activated inflammatory responses, and incited severe oxidative stress in the piglet livers while also promoting the nuclear translocation of nuclear factor kappa B (NF-κB) p65 (P &lt; 0.001) and the protein expression of Nod-like receptor pyrin domain containing 3 (NLRP3; P = 0.001) and cleaved caspase 1 (P &lt; 0.001). PT was more effective than RSV in alleviating LPS-induced hepatic damage by decreasing the apoptotic rate of liver cells (P = 0.045), inhibiting the transcriptional expression of interleukin 1 beta (P &lt; 0.001) and interleukin 6 (P = 0.008), and reducing myeloperoxidase activity (P = 0.010). The LPS-induced increase in hepatic lipid peroxidation accumulation was also reversed by PT (P = 0.024). Importantly, inhibiting protein phosphatase 2A (PP2A) activity in a hepatocellular model largely blocked the ability of PT to prevent tumor necrosis factor alpha-induced increases in NF-κB p65 protein phosphorylation (P = 0.043) and its nuclear translocation (P = 0.029). In summary, PT is a promising agent that may alleviate liver injury and immunological stress of weaned piglets via the PP2A/NF-κB/NLRP3 signaling pathway.
Improvement in Platelet Product Wastage and Reduction of Costs through Implementation of the Pan Genera Detection Test
Authors: Munyikwa Ru , Walker LeeAnn , Rajendran Rajkumar 
Published: October 2022

AbstractObjectiveThe aim of this study was to evaluate the effects of Pan Genera Detection (PGD) testing on reducing platelet product wastage and transfusion service costs.MethodsWe conducted a retrospective cross-sectional study comparing the number of platelet apheresis units wasted before (March 2017 to February 2019) and after (March 2019 to February 2021) PGD implementation. The PGD testing was performed before transfusion on days 6 and 7. Cost analysis considered the costs of platelet units wasted ($500.00/unit) and PGD test supplies and performance (estimated $26.50 per test). Paired samples t-test was used to compare platelet wastage pre- and post-PGD implementation.ResultsThe number of wasted platelet units decreased from pre-PGD (419) to post-PGD (195), representing a significant decrease in platelet wastage from 17.5% to 9.2% (P &lt; .0001). During the post-PGD period, 366 and 133 units were tested on days 6 and 7, with 28 and 36 units discarded each day, allowing transfusion of an additional 302 platelet units. Costs from platelet wastage decreased from $209,500.00 pre-PGD to $97,500.00 post-PGD.ConclusionOur results showed that PGD testing effectively reduced platelet wastage, extended platelet availability, and reduced transfusion service costs.
A Novel INS Mutation in the C-Peptide Region Causing Hyperproinsulinemic Maturity Onset Diabetes of Youth Type 10
Authors: Schlegel Amnon , Petersen Whitney C , Holbrook Alexandra A , Iverson Leslie K , Graham Timothy E 
Published: October 2022

Abstract
Monogenetic diabetes mellitus (DM) describes a collection of single-gene diseases marked by hyperglycemia presenting in childhood or adulthood and the absence of immunological markers of type 1 DM. Mutations in the human insulin gene INS give rise to two separate clinical syndromes: permanent neonatal DM, type 4 (PNDM4), and maturity-onset diabetes of youth, type 10 (MODY10); the former presents shortly after birth and the latter presents in childhood and adulthood. We describe a 40-year-old man in a kindred with high prevalence of DM who presented with severe hyperglycemia but not ketoacidosis or hypertriglyceridemia. Twelve years after initial presentation, the patient had elevated proinsulin and normal plasma C-peptide when nearly euglycemic on treatment with insulin glargine. A novel INS mutation, Gln65Arg, within the C-peptide region was identified. The INS (p.Gln65Arg) mutation may cause MODY10 by disrupting proinsulin maturation.
Application of a Near-infrared Spectroscope by an Extreme Forward Medical Team for the Triage of Casualties With Traumatic Brain Injury
Authors: Joubert Christophe , Sellier Aurore , Beucler Nathan , Desse Nicolas , Delmas Jean-Marc , Bordes Julien , Dulou Renaud , Dagain Arnaud 
Published: October 2022

ABSTRACT

Background
During deployment of military medical teams similarly to prehospital practice, without immediate computed tomography scan access, identifying patients requiring neuro-specific care to manage pragmatic triage proves crucial. We assessed the contribution of this portable near-infrared spectroscope (NIRS) handheld device, Infrascanner Model 2000 (InfraScan Inc.; Philadelphia, PA), to screen patients suspected to require specific neurosurgical care.

Materials and methods
This single-center retrospective analysis was based on the data from the medical records of the traumatic brain injured patients. We analyzed all the patients strictly over 18 years old presenting a clinical history of traumatic brain injury (TBI) with a Glasgow Coma Scale (GCS) &lt; 15.

Results
Thirty-seven medical records of patients admitted for TBI met the inclusion criteria for our analysis. The median GCS was 9 [3-14]. Eight patients (21.6%) underwent neurosurgery and 25 (67.6%) required intensive care unit (ICU) admission, after initial assessment and resuscitation. The NIRS was the most sensible to detect intracranial hematoma (n = 21), intracranial hematoma leading to surgery (n = 8), and intracranial hematoma leading to admission in ICU (n = 25). Its negative predictive value was 100% regarding hematomas leading to surgery. False-positive results were encountered in 10 cases (27.0%). Excluding cases harboring confounding extracranial hematomas, parietal area was still the most represented (n = 3).

Conclusion
The NIRS was relevant to detect hematoma leading to prompt surgery in our study. The lack of specificity in a nonselected cohort of patients underlines the need to associate simple clinical feature such as neurological deficit and NIRS results to perform rational triage.
Spontaneous Pneumomediastinum Resulting From Passionate Cheering at a Soccer Match
Authors: Talmy Tomer , Izhaki Ziv , Gendler Sami , Aviram Eliad 
Published: October 2022

ABSTRACT
Spontaneous pneumomediastinum is a rare and self-limiting clinical entity, often triggered by activities causing acute changes in intrathoracic pressure such as childbirth, strenuous exercise, vomiting, and coughing. We present a case of a young male soldier who developed spontaneous pneumothorax following persistent yelling while attending a soccer match. Spontaneous pneumomediastinum may be preceded by a variety of strenuous activities, and clinicians should be aware of this entity when performing the evaluation of patients with nonspecific symptoms such as chest pain and dyspnea. Patients diagnosed with pneumomediastinum but presenting with additional findings such as vomiting and pleural effusion should be thoroughly evaluated to rule out potentially life-threatening mediastinal organ injury. Return to military duty should be determined by clinical reevaluation and follow-up imaging findings.