bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of complex weight-reducing interventions on rhythm control in obese individuals with atrial fibrillation following catheter ablation (HOBIT-AF)
Authors: Stolbova K , Kautzner J , Haluzik M , Jakubikova I 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
HOBIT-AF is a single-blinded, parallel-group randomised controlled trial with 18-month follow-up to assess the effect of complex weight-reducing interventions supported by the use of smart technologies on the arrhythmia burden in obese individuals following catheter ablation for atrial fibrillation. Participants in the intervention group will be provided with a smartphone and smartwatch at month 3 visit for the rest of the trial and the participants in the control group at month 9 visit for the rest of the trial. A purpose-made mobile application will be pre-installed on smartphone. This application will enable participants to generate an ECG report twice a day and in case of an arrhythmia episode. Participants will be asked to regularly provide their weight, blood pressure and physical activity, and these data, together with heart rate, ECG trace and steps count will be securely transferred to investigators at the local home-monitoring centre. Besides, a custom-made website was designed for the participants of the trial containing useful tips concerning nutrition, cooking tips and physical activities.

Purpose
The effect of complex weight-reducing interventions on the arrhytmia burden and quality of life.

Methods
One hundred and sixty individuals (age 18–70 years, body mass index ≥ 30 kg/m2) will be randomised in a 1:1 fashion to undergo a structured weight reduction programme aiming to achieve greater than 10% weight reduction from baseline (intervention group) or standard post-ablation medical care (control group).

Results
Until 30th September 2021, 31 people were randomized to the intervention group (5 people resigned) and 34 people to the control group (1 person resigned).
Since the start of the study, patients in the intervention group reduced their body weight by 5% so far, and most of them (73%) still have 9 months of active intervention to go. Participants in the control group gained on weight an avarage of of 1.6% over the reference period (39% of those surveyed in month 9).

Conclusion
This trial will employ smart technologies to increase the motivation and adherence to introduced lifestyle changes.
TeleDiet study: A randomised controlled study investigating the impact of smartphone-supported dietary education and counselling on secondary prevention of coronary heart disease
Authors: Kaihara T , Falter M , Scherrenberg M , Maes J , Meesen E , Dendale P 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Daiichi Sankyo

Introduction
Dietary habits are a key factor influencing cardiovascular risk and its progression. Dietary counselling as part of current cardiac rehabilitation programmes has certain limitations: it is often intermittent with a delay between feedback on nutritional intake and reassessment by the dieticians. Digital technology could offer a solution.

Purpose
The purpose of this study was to investigate the impact of smartphone-supported feedback on dietary pattern and outcomes in a population with coronary heart disease (CHD).

Methods
Of 129 successive patients with CHD, 16 patients who agreed to participate in the study were randomised to either a TeleDiet group or a control group. Patients in the TeleDiet group participated in smartphone-supported diet education in addition to usual in-person education by dietitians. The patients were asked to take pictures of their meals and send them to dietitians using a messaging application. The dietitians then sent them feedback about their diet. The patients in the control group received the usual education only. The primary outcome was the change of Mediterranean Diet score (MedDiet score) between the two groups during three months. The secondary outcomes were the estimate of self-efficacy, medication adherence, and heart-related quality of life (the change of the General Self-Efficacy Scale [GSES], the Identification of Medication Adherence Barriers Questionnaire [IMAB-Q], and the HeartQoL). A total of 14 patients were included in the analysis.

Results
As a whole, 113 patients did not participate in the study. The most common reason of rejection was "no interest in the study" and the second one was "unable to use a smartphone". Table 1 showed the characteristics of the 14 patients separated into two groups: the TeleDiet group (n = 6) and the control group (n = 8). There was no difference of baseline characteristics between the two groups. The changes of the MedDiet score were not significantly different between the TeleDiet group and the control group (2.0 ± 4.5 vs. 1.3 ± 5.2, p = 0.783). In terms of the secondary outcomes, there were no significant differences between the two groups (Table 2). There were no significant differences of these outcomes in within-group analysis, neither.

Conclusion
Using a smartphone application is a hurdle for CHD patients at the moment, and these preliminary results do not show a benefit of dietary intervention with mobile health. These are the intermediate results of the whole TeleDiet study, and the study should be expanded to a larger population.
Secondary prevention of coronary artery disease: a retrospective observational analysis of italian healthcare administrative data
Authors: Calabria S , Piccinni C , Ronconi G , Dondi L , Cinconze E , Pedrini A , Esposito I , Addesi A , Martini N , Maggioni AP 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): ACARPIA Farmaceutici S.r.l.

Background/Introduction
Prevalence and mortality rates in patients with a documented coronary artery disease (CAD) are high, mainly due to the suboptimal adherence to the recommendations of current guidelines on secondary prevention strategies.

Purpose
This study aimed to describe patients with CAD and eligible to secondary prevention and assess their 1-year healthcare resource consumption and costs, from the perspective of the Italian National Health Service (INHS).

Methods
From our database of Italian healthcare administrative data, reliably representative of the whole Italian population, a cross-linkage of demographics, hospital discharges and exemption code for disease cost sharing, through a unique anonymized identifying code, was performed. Patients aged ≥35 in 2018 (accrual period) with CAD (index date) and eligible to secondary prevention (by excluding subjects with end-stage kidney disease/neoplasia) were selected. They were characterized in terms of age, gender and comorbidities (from index date back to 2015) and followed for 1 year to assess drug consumption, hospitalizations and healthcare integrated costs.

Results
Out of &gt;5 million inhabitants in the database in 2018, 46,063 patients aged ≥35 (1.3%) with CAD and eligible for secondary prevention were selected (72.1% males; mean age [±SD] 70±12). About half of them had 3 or more comorbidities of interest: mostly hypertension (90%), dyslipidaemia (72%) and diabetes (33%). During 1-year follow-up, at least one drug for secondary prevention was supplied to 96.4% of patients: mainly antiplatelets (83%), lipid lowering agents (83%) and β-blockers (73%). At the same time, 95.8% of the cohort was treated with at least one non-cardiovascular drug. The 30.6% of subjects were hospitalized at least once: 11.4% due to relevant cardiovascular causes (mostly acute coronary syndrome and heart failure), 9.1% due to other cardiovascular events and 17.5% because of non-cardiovascular events. On average, the INHS yearly paid €6,078 per patient: hospitalizations accounted for the 70% of the whole expenditure.

Conclusions
This study showed an integrated view of the relevant burden of CAD for patients and the INHS. A multidisciplinary and a more adherent approach to current guidelines are compelling to improve patients’ outcomes and reduce costs for the INHS.
Echocardiographic findings in COVID-19 patients with cardiovascular disease
Authors: Smyrnova G , Babkina T 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
COVID-19 has rapidly spread around the world and threatened global health. Although this disease mainly affects the respiratory system, there is increasing evidence that SARS-CoV-2 also has effects on the cardiovascular system. Echocardiography is a valuable tool in the assessment of cardiovascular disease.

Purpose
The study’s purpose was to investigate the echocardiographic parameters in COVID-19 patients with cardiovascular disease (CVD).

Methods
Eighty-two patients (males, 54%; mean age, 64 ± 12 years) who were confirmed COVID-19 infection were enrolled in this study. Fourty (48.7%) patients had underlying CVD. Echocardiography was performed in all patients for evaluation of cardiac function.

Results
Size of right atrium (38.3 ± 4.7; 33.6 ± 4.5 mm) and right ventricle outflow tract (36.7 ± 4.4; 33.2 ± 4.1 mm), mitral E/Ea ratio (9.8 ± 3.1; 8.4 ± 2.7) were increased, whereas TAPSE (20.2 ± 3.9; 22.6 ± 3.5 mm) was decreased in patients with CVD compared with those without CVD.

Conclusion
The most frequent echocardiographic findings in COVID-19 patients with CVD was impaired systolic function of right ventricle and diastolic function of left ventricle.
Conjectures on Forest literature
Authors: Spencer Robert 
Published: May 2022

Abstract
These conjectures on two novels about woods or forests from different points and periods in the capitalist world-system, Thomas Hardy’s The Woodlanders (1887) and Annie Proulx’s Barkskins (2016), seek to demonstrate that forests are locations saturated with histories and rival ideologies. Forests are variously godless wastes, places of worship and spiritual renewal, as well as symbols of national, cultural and even racial identity. They are also portents of liberty, the liberty of nature from plantation monocultures, and the liberty of humans from conformity to the regimenting disciplines of capital. Timber is a ubiquitous and indispensable capitalist commodity much like coal or oil. But underground seams of coal and reservoirs of unprocessed crude oil obviously do not, as forests and forest literature often do, represent utopian visions of a post-capitalist future. Much recent work in the ‘energy humanities’ and on ‘the aesthetics of commodity frontiers’ neglects this capacity of literary texts to sketch alternatives to capital’s destructive and instrumentalising logic. This article therefore uses Andreas Malm’s important work on ‘fossil capital’ and his recent speculations on ‘wilderness literature’ to show how in two works of fiction the forest provides an image of a future beyond capital.
Uniportal video-assisted thoracoscopic surgery lobectomy in Bahrain: a case report
Authors: AlMukhodher Sundus , Asheer Mariam , Alfaqaawi Ghassan , Bader Osama 
Published: May 2022

Abstract
Uniportal video-assisted thoracoscopic surgery (VATS) is minimally invasive thoracic surgery that does not use a formal thoracotomy incision. It was first introduced by Dr Diego Gonzalez-Rivas in 2011. We report here our first case performed in Salmaniya Medical Complex in Bahrain using uniportal VATS lobectomy for a patient with colorectal cancer who had a lung metastasis. Uniportal VATS lobectomy is a safe and feasible procedure when performed by an experienced surgeon. It has remarkably reduced postoperative complications as well as the length of stay. However, survival percentage VATS lobectomy appears to be equivalent to survival percentage obtained with open lobectomy.
Mimic or coincidentally? TAFRO syndrome and systemic lupus erythematosus: A case-based review
Authors: Okyar Burak , Torun Bekir , Öktem Esen Saba , Bahar Abdulkadir Yasir , Yıldız Fatih , Çetin Gözde Yıldırım 
Published: May 2022

ABSTRACT
Castleman’s disease (CD) is a rare, systemic disease with histopathological features of angiofollicular lymph node hyperplasia. In the literature, there are case-level reports that mimic or coexist with systemic lupus erythematosus (SLE) clinically and in the laboratory. Is this condition two separate diseases or is it an imitation of each other? A 73-year-old female patient was admitted to our clinic with arthritis, lymphadenopathy, fever, weight loss, and malar rash. He had a history of idiopathic thrombocytopenic purpura and thrombosis in the right leg tibialis posterior and dorsalis pedis arteries. Excisional lymphadenopathy biopsy indicated a diagnosis of hyaline-vascular-type CD. She had anti-nuclear antibody &gt;1/80 homogeneous pattern, anti-double stranded DNA (anti-dsDNA), Anti-Smith (Sm) antibody positivity, hypocomplementemia (C3 and C4), pleural effusion, and pericardial effusion. For this reason, the classification criteria of the European League Against Rheumatism/American College of Rheumatology were studied. Clinical findings, idiopathic thrombocytopenic purpura history, antibody positivity, malar rash, and arthritis led us to the diagnosis of SLE. She was treated with 1 mg/kg/day prednisolone and hydroxychloroquine 200 mg 2 × 1. Azathioprine 2.5 mg/kg daily was added to the patient whose complaints did not improve. In the follow-ups, she completely recovered clinically and laboratory. SLE and CD are systemic diseases that overlap in many ways. The literature review shows that these two diseases may mimic each other or may coexist. This situation may be a reflection of a pathophysiological process that has not yet been clarified. This confusing process also affects the treatment decision. This confusing process also affects the treatment decision.
Multisystem Inflammatory Syndrome in Adults and Severe Toxoplasmosis: Similar Clinical Presentations, Potentially Severe Outcomes
Authors: Ardura Monica I , Montoya Jose G , Dyner LauraLe , Contopoulos-Ioannidis Despina G 
Published: May 2022

AbstractWe report a case of a 21-year-old previously healthy man who developed severe toxoplasmosis with chorioretinitis and myositis 2 months after receiving corticosteroids for presumed multisystem inflammatory syndrome in adults, in the setting of a recently acquired acute Toxoplasma infection, likely during a trip to Latin America.
Reliability of acetabular index measurement in developmental dysplasia of the hip screening by orthopaedic trainees: a comparative study
Authors: Elifranji Zuhdi O. , Yasin Mohamad , Al-Saber Munther , Mousa Khaled , Alaqrabawi Ihab , Alswerki Mohammad , Aldowekat Osama , AlTa’ani Zaid , Hammad Yazan , Al-Dalaien Nassar 
Published: May 2022

Background:
Radiographic measurements are used for screening of developmental dysplasia of the hip (DDH) in children. The ability to detect acetabular dysplasia requires validated radiographic outcome measures. The acetabular index (AI) measurement has been shown to be a reliable measure worldwide. This study aims to test the reliability of the AI measurement in a DDH screening population by orthopedic junior and senior residents.

Methods:
The review examined 470 radiographs taken during 4 yr (2016-2019) in a university hospital. AI measurement was performed by two surgeons, four senior residents, and four junior residents at three different times. The intra- and interobserver reliability for each group was assessed.

Results:
The intraobserver reliability intraclass correlation coefficient (ICC) for the AI measurement performed by seniors was excellent at 0.98 [confidence interval (CI) 0.98 to 0.99] for the right side and 0.99 (CI 0.98 to 0.99) for left side. Indistinguishably, the ICC for AI measurement performed by orthopaedic juniors for right and left side was excellent at 0.96 (CI 0.95 to 0.97) and 0.95 (CI 0.95 to 0.96), respectively. The overall ICCs for interobserver reliability for the AI measurement between professors, seniors and juniors for right and left side was between good and excellent at 0.89 (CI 0.87 to 0.90) and 0.89 (CI 0.87 to 0.91), respectively.

Conclusions:
Orthopaedic juniors are less reliable in terms of intra- and interobserver variability in detecting DDH in screening program in comparison with seniors using AI measurement in a pediatric orthopaedic clinic.

Level of Evidence:
Level III.
Transferability of an Artificial Intelligence Algorithm Predicting Rebubblings After Descemet Membrane Endothelial Keratoplasty
Authors: Hayashi Takahiko , Iliasian Rosa M. , Matthaei Mario , Schrittenlocher Silvia , Masumoto Hiroki , Tanabe Mao , Tabuchi Hitoshi , Siggel Robert , Bachmann Björn , Cursiefen Claus , Siebelmann Sebastian 
Published: May 2022

Purpose:
To develop an artificial intelligence (AI) algorithm enabling corneal surgeons to predict the probability of rebubbling after Descemet membrane endothelial keratoplasty (DMEK) from images obtained using optical coherence tomography (OCT).

Methods:
Anterior segment OCT data of patients undergoing DMEK by 2 different DMEK surgeons (C.C. and B.B.; University of Cologne, Cologne, Germany) were extracted from the prospective Cologne DMEK database. An AI algorithm was trained by using a data set of C.C. to detect graft detachments and predict the probability of a rebubbling. The architecture of the AI model used in this study was called EfficientNet. This algorithm was applied to OCT scans of patients, which were operated by B.B. The transferability of this algorithm was analyzed to predict a rebubbling after DMEK.

Results:
The algorithm reached an area under the curve of 0.875 (95% confidence interval: 0.880–0.929). The cutoff value based on the Youden index was 0.214, and the sensitivity and specificity for this value were 78.9% (67.6%–87.7%) and 78.6% (69.5%–86.1%).

Conclusions:
The development of AI algorithms allows good transferability to other surgeons reaching a high accuracy in predicting rebubbling after DMEK based on OCT image data.
Change Over Time in Seasonality and Severity of Children Hospitalized With Respiratory Syncytial Virus Infection in Japan
Authors: Ozeki Shoko , Oshiro Makoto , Fukumi Daichi , Takeuchi Tomoya , Mii Sayaka , Nishikado Yuichi 
Published: May 2022

Background:
Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis, and in temperate climates, late fall and winter epidemics of bronchiolitis are usually linked to RSV. In recent years in Japan, the RSV infection epidemic has occurred earlier, even during the hot season. This study aimed to evaluate the seasonal variation of RSV-associated hospitalizations over the past decade and the relationship between season and disease severity.

Methods:
This was a retrospective single-center study. Hospitalized children were studied between 2011 and 2019. RSV was detected using rapid antigen detection tests. Clinical information was obtained from medical records, and patients were classified by 4 seasons of admission and analyzed for changes over time.

Results:
Among 3750 children, 945 (25.2%) were RSV-positive. The seasonal proportion of hospitalized children who are RSV-positive showed a peak shift towards summer, with a turning point in 2016. Comparing 2011–2012 and 2018–2019, incidence increased from 6.8% to 46.3% during summer, whereas during fall decreased from 50.0% to 20.7% and decreased from 28.4% to 20.7% during winter (P < 0.05). A similar trend was observed in the number of children requiring oxygenation in the earlier period; however, after the transition, there was no significant difference between seasons.

Conclusions:
Our findings showed that the RSV epidemic shifted to peak during summer until 2016. There was an association between seasonality and severity, such that many younger children were hospitalized during the autumn and winter and required more oxygen; however, after 2016, this difference was no longer observed.
Clinical Features of Kawasaki Disease With Atlantoaxial Rotatory Fixation
Authors: Michihata Nobuaki , Suzuki Takanori , Honda Akira , Oka Itsuhiro , Yoshikawa Tetsushi , Saito Kazuyoshi , Matsui Hiroki , Fushimi Kiyohide , Yasunaga Hideo 
Published: May 2022

Purpose:
Atlantoaxial rotatory fixation (AARF) is a rare complication of acute Kawasaki disease (KD). Early diagnosis and intervention are important for AARF because delayed diagnoses may incur neurological sequelae. However, previous studies on AARF associated with KD are limited, and its clinical characteristics and course are unknown. This study aimed to examine the clinical features and treatment course of KD with AARF using a Japanese national inpatient database.

Methods:
Using the Diagnosis Procedure Combination database, we identified KD patients who received intravenous immunoglobulin (IVIG) treatment between July 2010 and March 2020. The clinical characteristics of KD patients with AARF and their risk factors were evaluated using multivariable logistic regression analysis. We also examined the relationship between AARF, the proportion of coronary artery abnormalities (CAAs), IVIG resistance, length of stay and medical costs.

Results:
We identified 71,913 patients with KD, 166 of whom had AARF. The AARF group had older age, heavier bodyweight and atypical KD. In multivariable analysis, AARF was associated with older age [odds ratio (OR): 1.24; 95% confidence interval (CI): 1.19–1.29], lower body mass index (OR: 0.89; 95% CI: 0.82–0.96) and atypical KD (OR: 1.95; 95% CI: 1.12–3.40). AARF was not associated with CAAs (OR: 0.73; 95% CI, 0.23–2.32) and IVIG resistance (OR: 1.05; 95% CI, 0.74–1.49). However, AARF was associated with higher medical costs (difference, US$1064; 95% CI: 346–1781) and longer hospital stay (difference, 3.1 days; 95% CI: 1.7–4.4).

Conclusion:
AARF in patients with acute KD should be considered if cervical symptoms present in older patients with atypical KD.
Individual treatment expectations predict clinical outcome after lumbar injections against low back pain
Authors: Müller-Schrader Matthias , Heinzle Jakob , Müller Alfred , Lanz Christian , Häussler Oliver , Sutter Martin , Eggspühler Andreas , Mare Stefania , Toussaint Birte , Pereira Inês , Petzschner Frederike H. , Wiech Katja , Barth Jürgen , Witt Claudia M. , Stephan Klaas Enno , Manjaly Zina-Mary 
Published: May 2022

Abstract
Subjective expectations are known to be associated with clinical outcomes. However, expectations exist about different aspects of recovery, and few studies have focused on expectations about specific treatments. Here, we present results from a prospective observational study of patients receiving lumbar steroid injections against low back pain (N = 252). Patients completed questionnaires directly before (

), directly after (

), and 2 weeks after (

) the injection. In addition to pain intensity, we assessed expectations (and certainty therein) about treatment effects, using both numerical rating scale (NRS) and the Expectation for Treatment Scale (ETS). Regression models were used to explain (within-sample) treatment outcome (pain intensity at

) based on pain levels, expectations, and certainty at

and

. Using cross-validation, we examined the models' ability to predict (out-of-sample) treatment outcome. Pain intensity significantly decreased (P < 10−15) 2 weeks after injections, with a reduction of the median NRS score from 6 to 3. Numerical Rating Scale measures of pain, expectation, and certainty from

jointly explained treatment outcome (P < 10−15, R
2 = 0.31). Expectations at

explained outcome on its own (P < 10−10

) and enabled out-of-sample predictions about outcome (P < 10−4), with a median error of 1.36 on a 0 to 10 NRS. Including measures from

did not significantly improve models. Using the ETS as an alternative measurement of treatment expectations (sensitivity analysis) gave consistent results. Our results demonstrate that treatment expectations play an important role for clinical outcome after lumbar injections and may represent targets for concomitant cognitive interventions. Predicting outcomes based on simple questionnaires might be useful to support treatment selection.