bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding children’s perceptions of, and priorities for, healthy neighbourhoods in Aotearoa New Zealand: study protocol for a cross-sectional study
Authors: Egli Victoria , Mandic Sandra , Pocock Tessa , Narayanan Anantha , Williams Lisa , Clark Terryann , Spasic Lisa , Wilson Ailsa , Witten Karen , Smith Melody 
Published: June 2021

IntroductionNeighbourhood environments can have significant and enduring impacts on children’s physical, psychological and social health. Environments can impact health through promoting or hindering physical activity, active travel, and healthy eating in addition to opportunities for social interaction, cognitive development, rest and relaxation. There is a paucity of research that has examined neighbourhood and health priorities, strengths and needs from the perspectives of the community, and even less that has focused on the perspectives of children within communities. The aim of this article is to describe the research protocol for a project to gather child-identified needs and strengths-based solutions for promoting child health and well-being in urban neighbourhood environments.Methods and analysisThis participatory research project is designed to partner with children in school settings in Tāmaki Makaurau Auckland and Ōtepoti Dunedin, Aotearoa New Zealand. An abundant communities approach will be used with children to identify needs and strengths related to neighbourhoods and health. Specific methods including collaborative, creative, play-based methods such as concept-mapping activities and co-creation of final dissemination material on the key messages are described. Plans for researcher reflections, data analysis and dissemination are also detailed.Ethics and disseminationThis research has been approved by the University of Auckland Human Participants Ethics Committee. Results will be disseminated through child and researcher co-created output, a technical report and academic journal articles. By using evidence-based child-centred approaches to knowledge generation, we anticipate the research will generate new localised insights about children’s preferences and needs for healthy neighbourhoods which will be shared with stakeholders in planning and practice. The detailed session protocol including critical researcher reflections is shared in this manuscript for application, development and refinement in future research.
Implementation of a virtual international cardiology curriculum to address the deficit of cardiovascular education in Haiti: a pilot study
Authors: Haynes Norrisa Adrianna , Saint-Joy Veauthyelau , Swain JaBaris , Ezekwesili Agnes , Vernet Fritz Verly , Dawson Calixte , Laneau Davidson , Tierney Ann , Shea Judy A , Ambrose Marietta S 
Published: June 2021

BackgroundCardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide, conferring a disparate burden on low-income and middle-income countries (LMICs). Haiti represents a resource-constrained setting, limited by a paucity of resources and trained cardiovascular professionals equipped to address the increasing burden of CVD.ObjectiveHere, we describe the creation of a comprehensive cardiology curriculum delivered through a virtual classroom. The curriculum was created to augment cardiovascular education in LMICs such as Haiti.MethodsOver one academic year (May 2019–2020), International Cardiology Curriculum Accessible by Remote Distance Learning-Haiti consisted of biweekly, live-streamed, synchronous didactic lectures, seminars and case presentations broadcasted to 16 internal medicine (IM) residents at Hôpital Universitaire de Mirebalais, one of only four IM training programmes in Haiti. The virtual classroom was created using commercially available videoconferencing and data-sharing platforms. Prelecture and postlecture surveys and an end of the year survey were administered to assess the impact of the curriculum.ResultsParticipant performance analysis revealed that 80% of the curriculum demonstrated a positive trend in knowledge acquisition postintervention. Based on the end of the year evaluation, 94% of participants reported that the curriculum was educational and relevant to medical practice in Haiti and 100% reported that the curriculum was good to excellent. Additionally, the curriculum was cited as an effective means of maintaining trainee education during the COVID-19 pandemic.ConclusionThis international medical education pilot study demonstrates the feasibility of augmenting cardiology education in LMICs by creating a virtual curriculum made possible by local partnerships, internet access and technology.
Lifetime measurements in $$^{182}\hbox {Pt}$$ using $$\gamma $$–$$\gamma $$ fast-timing
Authors: Häfner G. , Esmaylzadeh A. , Jolie J. , Régis J.-M. , Müller-Gatermann C. , Blazhev A. , Fransen C. , Gerst R.-B. , Karayonchev V. , Knafla L. , Saed-Samii N. , Zell K.-O. 
Published: June 2021

AbstractThe level lifetimes of the $$2_1^+$$

2
1
+

and $$4_1^+$$

4
1
+

states in $$^{182}\hbox {Pt}$$

182

Pt

have been re-measured employing the $$\gamma $$
γ
–$$\gamma $$
γ
fast-timing technique using fast $$\hbox {LaBr}_3$$

LaBr
3

(Ce) scintillators. Excited states in the nucleus of interest were populated by the fusion-evaporation reaction $$^{170}\hbox {Yb}(^{16}\hbox {O},\hbox {4n})^{182}\hbox {Pt}$$

170

Yb

(
16

O
,
4n
)

182

Pt

at a beam energy of 87 MeV provided by the FN Tandem accelerator of the University of Cologne. The lifetime of the $$2_1^+$$

2
1
+

state was re-measured with high accuracy to be $$\tau = 563(12)~$$

τ
=
563
(
12
)

ps and resolves inconsistencies from previous measurements. Experimental results are compared to theoretical calculations in the framework of the sd-IBM with and without configuration mixing.
Compressing PDF sets using generative adversarial networks
Authors: Carrazza Stefano , Cruz-Martinez Juan , Rabemananjara Tanjona R. 
Published: June 2021

AbstractWe present a compression algorithm for parton densities using synthetic replicas generated from the training of a generative adversarial network (GAN). The generated replicas are used to further enhance the statistics of a given Monte Carlo PDF set prior to compression. This results in a compression methodology that is able to provide a compressed set with smaller number of replicas and a more adequate representation of the original probability distribution. We also address the question of whether the GAN could be used as an alternative mechanism to avoid the fitting of large number of replicas.
ОСОБЛИВОСТІ ПОВНОГО ДИСТАНЦІЙНОГО НАВЧАННЯ ІНОЗЕМНИХ СТУДЕНТІВ-МЕДИКІВ ПРИ ВИВЧЕННІ МЕДИЧНОЇ ІНФОРМАТИКИ
Authors: Пудова С. С. 
Published: June 2021

Карантинні заходи 2020 р. та перехід на дистанційне навчання слугували поштовхом для випробовування тих інформаційних технологій, які раніше були менш затребувані в медичних вищих закладах освіти з огляду на свою освітню специфіку. За нової форми навчання координація навчальної діяльності майбутніх лікарів потребувала якісних змін, що привело до відповідних досліджень у напрямку педагогіки. Зокрема, метою нашого дослідження було проаналізувати особливості організації дистанційного навчання для іноземних студентів-медиків другого курсу з медичної інформатики в умовах карантинних обмежень 2020 р. на прикладі Вінницького національного медичного університету ім. М. І. Пирогова.
Організація освітнього процесу в повному дистанційному режимі, зокрема для медичних вищих шкіл, мала різний характер у весняний та осінній періоди 2020 р. Перші організаційні спроби вимагали швидкої реакції щодо прийняття рішень і злагодженої командної роботи учасників навчального процесу, що впливало на адаптацію до нових умов та ефективність навчального процесу. Вивчення й випробовування інформаційних технологій, пошук, апробація методів і прийомів навчання, розробка дидактичних матеріалів, придатних для онлайн-навчання, оцінка отриманих результатів діяльності дозволили більш впевнено й організовано підійти до дистанційного навчального процесу в осінній період, зокрема при вивченні медичної інформатики.
Вимушені умови навчання в онлайн-режимі принесли новий досвід і вплинули на розвиток інформаційної культури викладачів та студентів. Протe залишається частина серйозних питань (наприклад, щодо якості отриманих знань, умінь, навичок студентів), розв’язання яких потребує більш розвинутих інформаційних технологій з покращеними функціональними можливостями порівняно з тими, що використовуються нами зараз.
Abstract 022: Assessing Attitudes and Treatment Preferences Among Patients With Hyperlipidemia: Patient Focus Groups
Authors: Barrett Amy M , DiBenedetti Dana B , Rane Pratik , Wade Sally , Qian Yi 
Published: June 2021

Objective:
To better understand current and recent statin users’ perceptions, attitudes, experiences, and preferences related to hyperlipidemia (HLD) and its treatment.

Methods:
Four focus groups were conducted in 2 cities in the US with individuals (N = 28) ≥ 18 years old self-reporting a clinician diagnosis of HLD for ≥ 6 months and current or previous statin use for ≥ 3 months in the past year. Two of the focus groups included a total of 13 participants reporting a cardiovascular event or surgery (e.g., heart attack, stroke, stent placement) in the past 10 years (CV group). The other two groups included a total of 15 participants who had not had a CV event or surgery (non-CV group). Concern about HLD and treatment motivation, adherence, and preferences were explored.

Results:
Among the 28 participants, 15 (53.6%) were male. The mean age was 57.3 ± 10.1 years. At screening, 6 (21.4%) participants were not using a statin, and 3 of these 6 reported statin intolerance. The majority of the 28 participants (17; 60.7%) had switched statins. Including their current statin, 10 (35.7%) participants had used 2 statins, and 7 (25.0%) had used 3 statins. Twelve (42.9%) participants had experienced statin-related muscle aches. Participants reported high levels of statin adherence, but reasons for dissatisfaction were noted: adverse events (primarily muscle aches and gastrointestinal symptoms), insufficient lowering of cholesterol levels, and worry about potential liver damage with long-term use.

All participants identified having no/few side effects, lowering cholesterol levels, and preventing CV events as important attributes of cholesterol-lowering drugs (CLDs). Avoidance of drug-drug interactions was important for all 13 CV group participants but for only 4 of the 15 (26.7%) non-CV group participants. Although participants believed statins reduced cholesterol levels, they generally considered lifestyle changes, such as eating a healthy diet and exercising, to be more or as effective.
Overall, 60.7% (17 of 28) said they would be willing to try an injectable CLD in addition to their current treatment if cholesterol levels were not sufficiently lowered. Given the choice of a prefilled syringe, autoinjector, or on-body infusor (with no limit on the number of selections), the autoinjector was acceptable to the largest percentage of participants (22 of 28; 78.6%), followed by the on-body infusor (13 of 28; 46.4%). More participants in the CV group than the non-CV group were willing to try each type of injection.

Discussion:
The frequent switching and side effects highlight significant unmet need in patients with HLD and dissatisfaction with statins among current and recent users, with and without a history of CV events. Results also suggest that a sizeable portion of patients with HLD may be willing to try an injectable CLD.
Abstract 047: Variation by Provider in Echocardiographic Surveillance of Mitral Regurgitation
Authors: Tanguturi Varsha , Hidrue Michael , Picard Michael , Atlas Steven , Weilburg Jeffrey , Ferris Timothy , Armstrong Katrina , Wasfy Jason 
Published: June 2021

Clinical outcomes after surgical treatment of mitral regurgitation (MR) are worse if intervention occurs after deterioration of left ventricular (LV) size and function. Echocardiographic surveillance of patients with MR is therefore indicated to avoid ventricular remodeling that could worsen patient outcomes. However, overly frequent trans-thoracic echocardiograms (TTEs) can impair access for other patients and reduce value in the delivery of care. Given the balance between timeliness of surveillance and possible over-utilization of TTE in valvular disease, we sought to investigate patient and provider factors contributing to variation in TTE utilization. We hypothesized that there was variation attributable to provider practice even after adjustment for patient characteristics.
We obtained records of all TTEs from 2001-2016 ordered at a large echocardiography laboratory. For each TTE, we linked to patient demographic data from hospital administrative records. To control for both clinical and demographic predictors of frequency of echocardiography, we constructed a hierarchical mixed-effects linear regression model with the individual physician as the random effect in the model. The outcome variable was time interval between TTEs. Intra-class correlation coefficient (ICC) was used to assess the proportion of total variation in the outcome variable due to provider practice, and shrinkage estimates were used to measure the contribution of individual providers.
After application of exclusion criteria, 79,194 TTEs corresponding to 55,663 TTE intervals remained. The mean interval between TTEs was 11.9 months for severe MR, 15.4 months for moderate MR, and 17.6 and 17.7 months for mild and trace MR respectively. After multivariate adjustment, male gender (Rate Ratio (RR) 0.96; 95% CI 0.94-0.98) was associated with shorter follow up, and Hispanic race (RR 1.11; 95% CI 1.01-1.21) was associated with longer follow-up intervals. Eight hundred and sixty-seven physicians were included in the analysis. After adjustment for patient factors, 31% of the variation in intervals was associated with provider practice and 19% of providers (161 of 867) were over-utilizers of TTEs and 24% (210 of 867) were under-utilizers.
We conclude that substantial variation exists in follow up intervals for TTE assessment of MR even after risk-adjustment for clinical and demographic variables, likely due to provider factors including specialty and experience. The association of TTE interval with race and gender warrants further investigation. Improving standardization of follow-up intervals may offer opportunity to reduce both overutilization and underutilization of echocardiography.
Abstract 110: Disparities in TTE Surveillance of Mitral Regurgitation
Authors: Tanguturi Varsha K , Bhambhani Vijeta , Picard Michael , Armstrong Katrina , Wasfy Jason 
Published: June 2021

Valvular heart disease continues to be a significant burden to the U.S. population, and is likely to increase over the next several decades. While major technological advances have been made in repairing or replacing degenerating valves, improved outcomes have not affected all segments of society equally. The source of this disparity in outcomes after treatment of valvular disease is unknown. As clinical outcomes after surgical treatment of valvular disease, and especially mitral regurgitation (MR), are worse if intervention occurs after deterioration of left ventricular (LV) size and function, trans-thoracic echocardiographic (TTE) surveillance of patients with MR is indicated to avoid adverse ventricular remodeling. We hypothesized that patients at a lower socioeconomic status were less likely to receive TTE surveillance for MR within the appropriate guideline-indicated interval.
We obtained records of all TTEs from 2001-2016 ordered at a large echocardiography laboratory and linked each TTE to patient demographic data. The primary outcome was receipt of a TTE within guideline recommended intervals for MR surveillance. Intervals between TTEs were coded as appropriate or inappropriate, and logistic regression was used to assess the association of race and income level with appropriateness while controlling for demographic and clinical factors.
In total 31,058 patients with MR in 106,659 TTEs were assessed in the final cohort. Hispanic patients were less likely to receive appropriate TTEs (OR 0.89; p = 0.0440) than predicted by guidelines. Black race trended towards lower odds of receiving TTEs at appropriate intervals, but was not significant (OR 0.95; p = 0.2946). As patients aged, the odds of having a TTE within the appropriate time interval decreased across all races. Income level was not significantly associated with TTE appropriateness.
We conclude that there are disparities in receipt of timely TTE surveillance, especially associated with Hispanic ethnicity. This may contribute to disparities in clinical outcomes after treatment of valvular disease, and provides an opportunity for care improvement.
Abstract 249: Dose-response Relationship Between the Risk of Vasovagal Syncope and Body Mass Index
Authors: Yamada Tomohide , Yanagimoto Shintaro 
Published: June 2021

Vasovagal syncope (VVS) is the most common type of syncope with associated fatigue, nausea, abdominal discomfort, and dizziness. VVS usually resolves uneventfully, but sometimes leads to head trauma or other injuries. Blood tests are the most commonly performed medical tests, and prevention of VVS associated with blood sample collection is important from a medical or public health perspective.
We investigated the association between body mass index (BMI), systolic blood pressure (SBP), estimated circulating blood volume (CBV), and the risk of VVS in healthy young adults undergoing blood tests, and attempted to quantify potential dose-response relations and identify high-risk populations.
We examined 18,888 students entering the University of Tokyo between 2011 and 2016, who had a normal electrocardiogram, no structural heart disease, and no previous syncopal loss of consciousness. VVS was defined as syncope occurring before, during, or immediately after blood collection, with symptoms including weakness, pallor, cold sweats, nausea, vomiting, a lower systolic blood pressure or pulse rate compared with baseline, and need for assistance from a physician without any sequelae. Occurrence of VVS was confirmed by medical staff. CBV was calculated according to Nadler’s method.
The subjects had a mean age of 19±1 years and 19% (n=3522) were women. Mean BMI, SBP, and CBV were 21.0±2.9 kg/m2, 121±12 mmHg, and 4.4±0.4 L for men, and were 19.8±2.3 kg/m2, 108±11 mmHg, and 3.3±0.3 L for women, respectively.
VVS was diagnosed in 0.63% of the subjects (n=119) (19% women). By dose-response analysis, lower BMI showed a non-linear association with a significantly higher risk of VVS in men (p for non-linearity<0.001). Compared with a BMI of 22 kg/m2, the risk of VVS increased markedly at a BMI of 20 (OR 1.52; 95%CI 1.02-2.27) and increased further at a BMI of 18.5 (2.35; 1.41-3.92). Similarly, compared with the median SBP (120 mmHg), lower SBP showed a non-linear association with a higher risk of VVS (110 mmHg: OR 1.46, 95%CI 1.11-1.91; 100 mmHg: 2.51, 1.57-4.02; and 90 mmHg: 4.41, 1.91-10.2) (p for non-linearity=0.04). There was a negative linear correlation between CBV and VVS (P for non-linearity=0.43) in men. Lower CBV was associated with a higher risk of VVS. However, there were no significant correlations of these parameters in women. Also, there were no significant association between VVS risk and other covariates.
We demonstrated that lower BMI and SBP showed a J-curve association with the risk of VVS in men. Low BMI, SBP, and CBV are useful predictors for primary prevention of VVS. Providing advice on preventive methods such as counter-pressure maneuvers might be beneficial for high-risk persons, especially those who are “underweight” or have “hypotension”.
Abstract 027: Participation of Cardiac Thyrotroping Releasing Hormone (cTRH) in the Doxorrubicin (D) Induced Cardiotoxicityin in Mice
Authors: Peres Diaz Ludmila S , Schuman Mariano L , Aisicovich Maia , Landa Maria S , García Silvia I 
Published: June 2021

We have demonstrated TRH hyperactivity in the hypertrophied Left ventricle (LV) of SHR. Its specific inhibition attenuates hypertrophy development in spite of the significant higher pressure observed (Schuman M, Hypertension 2011). LV-TRH over-expression induces several features of the hypertrophied heart, including increases in the apoptotic index Bax/Bcl2, and the activated caspase 3 observed by immunohystochemistry (Schuman M, AJPH&C 2014). In addition, we have found that TRH expression was induced by D in primary cultures of cardiac cells. Based on these results we hypothesized that cTRH could participate in the D cardiotoxicity effects. Indeed, we used C57 adult males (n=10) with a single D or saline injection (200uL,10 mg/kg ip) which previously (24 h, under anesthesia) received an intracardiac injection of a specific TRH-siRNA to inhibit LV-TRH expression or scrambled Con-siRNA. Mice were sacrificed 2,4 and 7 days post D injection and body weight was measured. Genes expression was measured by real time PCR and protein by immunohystochemistry (ANOVA and Tukey test). Body weight showed a mild but not significant decrease in D treated animals. D significantly increased TRH gene expression and TRH protein content reaching the maximum at 7 days post injection (2d: 145%, 4d:190% and 7d: 250%) (p& 0.05), which were not observed in the groups with D+TRH-siRNA indicating the effectiveness of the specific TRH inhibition. Also at this time TRH inhibition attenuates (p&0.05) D-induced increase in the apoptotic index Bax/Bcl2 and the augmented activated caspase 3 content pointing out the participation of the cardiac TRH in the D-induced apoptosis. Similar results were observed with hypertrophic and fibrotic markers gene expression (BNP, BMHC and col III) which showed a significant increase (p& 0.05) only in the groups with D and the intact TRH system (D+Con-siRNA). Fibrosis results were confirmed by Sirius Red and Masson techniques.
On the whole, we demonstrated for the first time that LV-TRH system is required for both, Doxorrubicin induction of apoptosis and consecutively hypertrophy and fibrosis in the mouse heart. Even more, we found that cTRH inhibition attenuates doxorrubicin induced damage suggesting a novel mechanisms in the cardiotoxicity injury.
Abstract P274: Fruit Extract (blueberry, Cranberry, And Promegranate) Improved Insulin Resistance In Overweight Hypertensive And Normotensive Subjects
Authors: Novaes Ludmila N , Moraes Mariele , Katayama Keyla , Sangaleti Carine , Irigoyen Maria Claudia , Bortolotto Luiz , Lopes Heno 
Published: June 2021

Arterial hypertension is frequently associated to glucose and lipid metabolism abnormalities. The purpose of this study was to determine if antioxidants (fruit extract) supplementation interfere with glucose and lipid metabolism in overweight hypertensive patients. A randomized clinical trial was conducted with 30 individuals, 23 hypertensive patients (group A) and 7 normotensive controls (group B). They were randomized to take 3 capsules of different fruits extract a day (blueberry, cranberry and pomegranate) or placebo for 4 weeks. This is a crossover study, which started with placebo changed to capsules and vice versa. Blood samples were collected after 12 hours fasting for biochemical tests (glucose, insulin, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides), anthropometric assessment (weight, height, and body mass index), systolic BP, diastolic BP and heart rate were evaluated at baseline, after 4, and 8 weeks. The comparisons between groups were held with the GLM repeated measures. Twenty three hypertensive patients (age 47 years, 14 females) and 7 normotensive controls (age 40 years, 7 females) were evaluated. BMI, blood pressure, heart and lipid profile did not differ between groups. HOMAir decreased significantly in both groups. See results in table 1.
Values are expressed as medians (±SD)
In these preliminary results a 4-weeks supplementation of antioxidants (fruit extract) improved insulin resistance in overweight hypertensive and normotensive subjects.
Financial support: FAPESP 2014/25808-3