bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hiring Practices of Human Resource Practitioners in Selected Mabuhay Accommodations in Top Tourist Destinations in the Philippines
Authors: Escarilla Cherry C. , Canoy Orbel M. , Maming Jimmy B. 
Published: March 2024

This research paper explores the complex field of modern HRM, with particular attention to the following topics: hiring process components, diversity and inclusion tactics, training and development programs, obstacles and advancements, legal and moral compliance, the critical function of HR, applicant competency evaluation, and technological integration. To give a thorough grasp of how these components come together inside a company's procedures, the research uses Yin's single-case study. Six (6) human resource practitioners from the municipality of the Mabuhay Lodging took part in this study. The study revealed several themes, including 1) the hiring process; 2) the influence of inclusion as well as diversity on organizational dynamics; 3) assessing the efficacy of development and training initiatives; 4) resolving issues; 5) guaranteeing legal and ethical compliance; 6) realizing the critical role of human resources; 7) improving the evaluation of applicant competence; and 8) investigating the consequences of integrating technology in the hiring process. The study reveals a dynamic interaction between these components, highlighting their combined importance in creating an inclusive, diverse, and growth-oriented workplace culture. The results reveal the complicated coordination human resource practitioners need to uphold morality, overcome barriers, and grow their firms using technology.
Cardiovascular Effects of Oral Ketone Ester Treatment in Patients With Heart Failure With Reduced Ejection Fraction: A Randomized, Controlled, Double-Blind Trial
Authors: Berg-Hansen Kristoffer , Gopalasingam Nigopan , Christensen Kristian Hylleberg , Ladefoged Bertil , Andersen Mads Jønsson , Poulsen Steen Hvitfeldt , Borlaug Barry A. , Nielsen Roni , Møller Niels , Wiggers Henrik 
Published: March 2024

BACKGROUND:
Heart failure triggers a shift in myocardial metabolic substrate utilization, favoring the ketone body 3-hydroxybutyrate as energy source. We hypothesized that 14-day treatment with ketone ester (KE) would improve resting and exercise hemodynamics and exercise capacity in patients with heart failure with reduced ejection fraction.

METHODS:
In a randomized, double-blind cross-over study, nondiabetic patients with heart failure with reduced ejection fraction received 14-day KE and 14-day isocaloric non-KE comparator regimens of 4 daily doses separated by a 14-day washout period. After each treatment period, participants underwent right heart catheterization, echocardiography, and blood sampling at plasma trough levels and after dosing. Participants underwent an exercise hemodynamic assessment after a second dosing. The primary end point was resting cardiac output (CO). Secondary end points included resting and exercise pulmonary capillary wedge pressure and peak exercise CO and metabolic equivalents.

RESULTS:

We included 24 patients with heart failure with reduced ejection fraction (17 men; 65±9 years of age; all White). Resting CO at trough levels was higher after KE compared with isocaloric comparator (5.2±1.1 L/min versus 5.0±1.1 L/min; difference, 0.3 L/min [95% CI, 0.1–0.5), and pulmonary capillary wedge pressure was lower (8±3 mm Hg versus 11±3 mm Hg; difference, −2 mm Hg [95% CI, −4 to −1]). These changes were amplified after KE dosing. Across all exercise intensities, KE treatment was associated with lower mean exercise pulmonary capillary wedge pressure (−3 mm Hg [95% CI, −5 to −1] ) and higher mean CO (0.5 L/min [95% CI, 0.1–0.8]), significantly different at low to moderate steady-state exercise but not at peak. Metabolic equivalents remained similar between treatments. In exploratory analyses, KE treatment was associated with 18% lower NT-proBNP (N-terminal pro-B-type natriuretic peptide; difference, −98 ng/L [95% CI, −185 to −23]), higher left ventricular ejection fraction (37±5 versus 34±5%;
P
=0.01), and lower left atrial and ventricular volumes.

CONCLUSIONS:
KE treatment for 14 days was associated with higher CO at rest and lower filling pressures, cardiac volumes, and NT-proBNP levels compared with isocaloric comparator. These changes persisted during exercise and were achieved on top of optimal medical therapy. Sustained modulation of circulating ketone bodies is a potential treatment principle in patients with heart failure with reduced ejection fraction.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT05161650.
Impact of a Medical Fitness Model on Incident Major Adverse Cardiovascular Events: A Prospective Cohort Study of 11 000 Members
Authors: Brar Ranveer , Whitlock Reid H. , Katz Alan , Di Nella Michelle , Komenda Paul , Bohm Clara , Rigatto Claudio , Tangri Navdeep , Solmundson Carrie , Collister David 
Published: March 2024

Background
Cardiovascular disease remains the leading cause of disease burden and death in the world. The medical fitness model may be an alternative public health strategy to address cardiovascular risk factors with medical integrated programming.

Methods and Results
We performed a retrospective cohort study between January 1, 2005, and December 31, 2015. Adults (aged ≥18 years) who did not have a prior major adverse cardiovascular event were included. Controls were assigned a pseudo‐index date at random on the basis of the frequency distribution of start dates in the medical fitness facility group. Multivariate Cox proportional hazards regression models were adjusted for age, sex, socioeconomic status, comorbidities, and year of index date. We stratified the medical fitness facility group into low‐frequency attenders (≤1 weekly visit) and regular‐frequency attenders (>1 weekly visit). Our primary outcome was a hospitalization for nonfatal myocardial infarction and stroke, heart failure, or cardiovascular death. We included 11 319 medical fitness facility members and 507 400 controls in our study. Compared with controls, members had a lower hazard risk of a major adverse cardiovascular event‐plus (hazard ratio [HR], 0.88 [95% CI, 0.81–0.96]). Higher weekly attendance was associated with a lower hazard risk of a major adverse cardiovascular event‐plus compared with controls, but the effect was not significant for lower weekly attendance (low‐frequency attenders: HR, 0.94 [95% CI, 0.85–1.04]; regular‐frequency attenders: HR, 0.77 [95% CI, 0.67–0.89]).

Conclusions
Medical fitness facility membership and attendance at least once per week may lower the risk of a major adverse cardiovascular event‐plus. The medical fitness model should be considered as a public health intervention, especially for individuals at risk for cardiovascular disease.
Frailty and Metabolic Vulnerability in Heart Failure: A Community Cohort Study
Authors: Kumar Sant , Conners Katherine M. , Shearer Joseph J. , Joo Jungnam , Turecamo Sarah , Sampson Maureen , Wolska Anna , Remaley Alan T. , Connelly Margery A. , Otvos James D. , Larson Nicholas B. , Bielinski Suzette J. , Roger Véronique L. 
Published: March 2024

Background
Frailty is common in heart failure (HF) and is associated with death but not routinely captured clinically. Frailty is linked with inflammation and malnutrition, which can be assessed by a novel plasma multimarker score: the metabolic vulnerability index (MVX). We sought to evaluate the associations between frailty and MVX and their prognostic impact.

Methods and Results
In an HF community cohort (2003–2012), we measured frailty as a proportion of deficits present out of 32 physical limitations and comorbidities, MVX by nuclear magnetic resonance spectroscopy, and collected extensive longitudinal clinical data. Patients were categorized by frailty score (≤0.14, >0.14 and ≤0.27, >0.27) and MVX score (≤50, >50 and ≤60, >60 and ≤70, >70). Cox models estimated associations of frailty and MVX with death, adjusted for Meta‐Analysis Global Group in Chronic Heart Failure (MAGGIC) score and NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide). Uno's C‐statistic measured the incremental value of MVX beyond frailty and clinical factors. Weibull's accelerated failure time regression assessed whether MVX mediated the association between frailty and death. We studied 985 patients (median age, 77; 48% women). Frailty and MVX were weakly correlated (Spearman's ρ=0.21). The highest frailty group experienced an increased rate of death, independent of MVX, MAGGIC score, and NT‐proBNP (hazard ratio, 3.3 [95% CI, 2.5–4.2]). Frailty improved Uno's c‐statistic beyond MAGGIC score and NT‐proBNP (0.69–0.73). MVX only mediated 3.3% and 4.5% of the association between high and medium frailty groups and death, respectively.

Conclusions
In this HF cohort, frailty and MVX are weakly correlated. Both independently contribute to stratifying the risk of death, suggesting that they capture distinct domains of vulnerability in HF.
Lower Recurrence Rates of Atrial Fibrillation and MACE Events After Early Compared to Late Ablation: A Danish Nationwide Register Study
Authors: Tønnesen Jacob , Ruwald Martin H. , Pallisgaard Jannik , Rasmussen Peter Vibe , Johannessen Arne , Hansen Jim , Worck Rene H. , Zörner Christopher R. , Riis‐Vestergaard Lise , Middelfart Charlotte , Sørensen Samuel K. , Sattler Stefan , Gislason Gunnar , Hansen Morten Lock 
Published: March 2024

Background
Guidelines recommend prioritizing treatment with antiarrhythmic drugs before referral of patients with atrial fibrillation to ablation, delaying a potential subsequent ablation. However, delaying ablation may affect ablation outcomes. We sought to investigate the impact of duration from diagnosis to ablation on the risk of atrial fibrillation recurrence and adverse events.

Methods and Results
Using Danish nationwide registries, all patients with first‐time ablation for atrial fibrillation were identified and included from 2010 to 2018. Patients were divided into 4 groups by diagnosis‐to‐ablation time: <1.0 year (early ablation), 1.0 to 1.9 years, 2.0 to 2.9 years, and >2.9 years (late ablation). The primary end point was atrial fibrillation recurrence after the 90‐day blanking period, defined by admission for atrial fibrillation, cardioversions, use of antiarrhythmic drugs, or repeat atrial fibrillation ablations. The secondary end point was a composite end point of heart failure, ischemic stroke, or death, and each event individually. The study cohort consisted of 7705 patients. The 5‐year cumulative incidence of atrial fibrillation recurrence in the 4 groups was 42.9%, 54.8%, 55.9%, and 58.4%, respectively. Hazard ratios were 1.20 (95% CI, 1.07–1.35), 1.29 (95% CI, 1.13–1.47), and 1.40 (95% CI, 1.28–1.53), respectively, with the early ablation group as reference. The hazard ratio for the combined secondary end point was 1.22 (95% CI, 1.04–1.44) in the late ablation group compared with the early ablation group.

Conclusions
In patients undergoing ablation for atrial fibrillation, early ablation was associated with a significantly lower risk of atrial fibrillation recurrence. Furthermore, the associated risk of heart failure, ischemic stroke, or death was significantly lower in early‐compared with late‐ablation patients.
Cost‐Effectiveness of Increased Use of Dual Antiplatelet Therapy After High‐Risk Transient Ischemic Attack or Minor Stroke
Authors: Wechsler Paul M. , Pandya Ankur , Parikh Neal S. , Razzak Junaid A. , White Halina , Navi Babak B. , Kamel Hooman , Liberman Ava L. 
Published: March 2024

Background
Rates of dual antiplatelet therapy (DAPT) after high‐risk transient ischemic attack or minor ischemic stroke (TIAMIS) are suboptimal. We performed a cost‐effectiveness analysis to characterize the parameters of a quality improvement (QI) intervention designed to increase DAPT use after TIAMIS.

Methods and Results
We constructed a decision tree model that compared current national rates of DAPT use after TIAMIS with rates after implementing a theoretical QI intervention designed to increase appropriate DAPT use. The base case assumed that a QI intervention increased the rate of DAPT use to 65% from 45%. Costs (payer and societal) and outcomes (stroke, myocardial infarction, major bleed, or death) were modeled using a lifetime horizon. An incremental cost‐effectiveness ratio <$100 000 per quality‐adjusted life year was considered cost‐effective. Deterministic and probabilistic sensitivity analyses were performed. From the payer perspective, a QI intervention was associated with $9657 in lifetime cost savings and 0.18 more quality‐adjusted life years compared with current national treatment rates. A QI intervention was cost‐effective in 73% of probabilistic sensitivity analysis iterations. Results were similar from the societal perspective. The maximum acceptable, initial, 1‐time payer cost of a QI intervention was $28 032 per patient. A QI intervention that increased DAPT use to at least 51% was cost‐effective in the base case.

Conclusions
Increasing DAPT use after TIAMIS with a QI intervention is cost‐effective over a wide range of costs and proportion of patients with TIAMIS treated with DAPT after implementation of a QI intervention. Our results support the development of future interventions focused on increasing DAPT use after TIAMIS.
Polygenic Scores and Preclinical Cardiovascular Disease in Individuals With HIV: Insights From the REPRIEVE Trial
Authors: Zou Roger S. , Ruan Yunfeng , Truong Buu , Bhattacharya Romit , Lu Michael T. , Karády Júlia , Bernardo Rachel , Finneran Phoebe , Hornsby Whitney , Fitch Kathleen V. , Ribaudo Heather J. , Zanni Markella V. , Douglas Pamela S. , Grinspoon Steven K. , Patel Aniruddh P. , Natarajan Pradeep 
Published: March 2024

Background
Coronary artery disease (CAD) is a leading cause of death among the 38.4 million people with HIV globally. The extent to which cardiovascular polygenic risk scores (PRSs) derived in non‐HIV populations generalize to people with HIV is not well understood.

Methods and Results

PRSs for CAD (GPS
Mult
) and lipid traits were calculated in a global cohort of people with HIV treated with antiretroviral therapy with low‐to‐moderate atherosclerotic cardiovascular disease risk enrolled in REPRIEVE (Randomized Trial to Prevent Vascular Events in HIV). The PRSs were associated with baseline lipid traits in 4495 genotyped participants, and with subclinical CAD in a subset of 662 who underwent coronary computed tomography angiography. Among participants who underwent coronary computed tomography angiography (mean age, 50.9 [SD, 5.8] years; 16.1% women; 41.8% African, 57.3% European, 1.1% Asian), GPS
Mult
was associated with plaque presence with odds ratio (OR) per SD in GPS
Mult
of 1.42 (95% CI, 1.20–1.68;
P
=3.8×10
−5
), stenosis >50% (OR, 2.39 [95% CI, 1.48–3.85];
P
=3.4×10
−4
), and noncalcified/vulnerable plaque (OR, 1.45 [95% CI, 1.23–1.72];
P
=9.6×10
−6
). Effects were consistent in subgroups of age, sex, 10‐year atherosclerotic cardiovascular disease risk, ancestry, and CD4 count. Adding GPS
Mult
to established risk factors increased the C‐statistic for predicting plaque presence from 0.718 to 0.734 (
P
=0.02). Furthermore, a PRS for low‐density lipoprotein cholesterol was associated with plaque presence with OR of 1.21 (95% CI, 1.01–1.44;
P
=0.04), and partially calcified plaque with OR of 1.21 (95% CI, 1.01–1.45;
P
=0.04) per SD.

Conclusions
Among people with HIV treated with antiretroviral therapy without documented atherosclerotic cardiovascular disease and at low‐to‐moderate calculated risk in REPRIEVE, an externally developed CAD PRS was predictive of subclinical atherosclerosis. PRS for low‐density lipoprotein cholesterol was also associated with subclinical atherosclerosis, supporting a role for low‐density lipoprotein cholesterol in HIV‐associated CAD.

Registration

URL:
https://www.reprievetrial.org
; Unique identifier: NCT02344290.
Duration of Remote Ischemic Conditioning and Outcome in Acute Ischemic Stroke
Authors: Cui Yu , Chen Yi‐Ning , Nguyen Thanh N. , Chen Hui‐Sheng 
Published: March 2024

Background
Remote ischemic conditioning has been found to be effective in improving functional outcomes in acute ischemic stroke. We conducted a post hoc analysis of the RICAMIS (Remote Ischemic Conditioning for Acute Moderate Ischemic Stroke) trial to determine whether long‐term remote ischemic conditioning duration after stroke onset is associated with better clinical outcomes in ischemic stroke.

Methods and Results

Patients from the full analysis set were included in this secondary analysis. The primary outcome was the proportion of patients with an excellent functional outcome at 90 days, defined as a modified Rankin Scale score of 0 to 1. Among the 1776 patients, there were 55 patients in the 1 to 7 days remote ischemic conditioning group, 345 in the 8 to 10 days group, 412 in the 11 to 13 days group, 51 in the 14 to 16 days group, and 913 in the control group. Compared with the control group, a significantly higher proportion of excellent functional outcomes at 90 days was found in the 11 to 13 days remote ischemic conditioning group (adjusted absolute difference, 9.1% [95% CI, 3.7%–14.5%];
P
=0.001), which was attenuated in the other groups (adjusted absolute difference in the 8–10 days group, 2.0% [95% CI, −4.0% to 8.0%];
P
=0.51; adjusted absolute difference in the 14–16 days group, 7.4% [95% CI, −5.8% to 20.5%];
P
=0.27), but compared to the control group, there was lower proportion of excellent functional outcomes in the 1 to 7 days group (adjusted absolute difference, −14.4% [95% CI, −27.8% to 0.0%];
P
=0.05).

Conclusions
Among patients with acute moderate ischemic stroke, a higher likelihood of excellent clinical outcome was found in patients with longer duration of remote ischemic conditioning.
Health Factors Associated With Development and Severity of Poststroke Dysphagia: An Epidemiological Investigation
Authors: Krekeler Brittany N. , Schieve Heidi J. P. , Khoury Jane , Ding Lili , Haverbusch Mary , Alwell Kathleen , Adeoye Opeolu , Ferioloi Simona , Mackey Jason , Woo Daniel , Flaherty Matthew , La Rosa Felipe De Los Rios , Demel Stacie , Star Michael , Coleman Elisheva , Walsh Kyle , Slavin Sabreena , Jasne Adam , Mistry Eva , Kleindorfer Dawn , Kissela Brett 
Published: March 2024

Background
Dysphagia after stroke is common and can impact morbidity and death. The purpose of this population‐based study was to determine specific epidemiological and health risk factors that impact development of dysphagia after acute stroke.

Methods and Results
Ischemic and hemorrhagic stroke cases from 2010 and 2015 were identified via chart review from the GCNKSS (Greater Cincinnati Northern Kentucky Stroke Study), a representative sample of ≈1.3 million adults from southwestern Ohio and northern Kentucky. Dysphagia status was determined on the basis of clinical assessments and necessity for alternative access to nutrition via nasogastric or percutaneous endoscopic gastrostomy tube placement. Comparisons between patients with and without dysphagia were made to determine differences in baseline characteristics and premorbid conditions. Multivariable logistic regression determined factors associated with increased risk of dysphagia. Dysphagia status was ascertained from 4139 cases (1709 with dysphagia). Logistic regression showed that increased age, Black race, higher National Institutes of Health Stroke Scale score at admission, having a hemorrhagic stroke (versus infarct), and right hemispheric stroke increased the risk of developing dysphagia after stroke. Factors associated with reduced risk included history of high cholesterol, lower prestroke modified Rankin Scale score, and white matter disease.

Conclusions
This study replicated previous findings of variables associated with dysphagia (older age, worse stroke, right‐sided hemorrhagic lesions), whereas other variables identified were without clear biological rationale (eg, Black race, history of high cholesterol, and presence of white matter disease) and should be investigated in future studies to determine biological relevance and potential influence in stroke recovery.
Primary and Secondary Intracerebral Hemorrhage in Pregnant and Nonpregnant Young Adults by SMASH‐UP Criteria
Authors: Sariyeva Mehriban , Haghighi Noora , Mitchell Amanda , Booker Whitney A. , Petersen Nils H. , Shields Andrea D. , Ghoshal Shivani , Agarwal Sachin , Park Soojin , Claassen Jan , Connolly E. Sander , Roh David J. , Miller Eliza C. 
Published: March 2024

Background
Intracerebral hemorrhage (ICH) is a major cause of maternal morbidity, but its pathophysiology is poorly characterized. We investigated characteristics of pregnancy‐associated ICH (P‐ICH), compared with ICH in similar aged nonpregnant adults of both sexes.

Methods and Results

We performed a retrospective analysis of 134 adults aged 18 to 44 years admitted to our center with nontraumatic ICH from January 1, 2012, to December 31, 2021. We compared ICH characteristics among 3 groups: those with P‐ICH (pregnant or within 12 months of end of pregnancy); nonpregnant women; and men. We categorized ICH pathogenesis according to a modified scheme, SMASH‐UP (structural, medications, amyloid angiopathy, systemic, hypertension, undetermined, posterior reversible encephalopathy syndrome/reversible cerebral vasoconstriction syndrome), and calculated odds ratios and 95% CIs for primary (spontaneous small‐vessel) ICH versus secondary ICH (structural lesions or coagulopathy related), using nonpregnant women as the reference. We also compared specific ICH pathogenesis by SMASH‐UP criteria and functional outcomes between groups. Of 134 young adults with nontraumatic ICH, 25 (19%) had P‐ICH, of which 60% occurred postpartum. Those with P‐ICH had higher odds of primary ICH compared with nonpregnant women (adjusted odds ratio, 4.5 [95% CI, 1.4–14.7]). The odds of primary ICH did not differ between men and nonpregnant women. SMASH‐UP pathogenesis for ICH differed significantly between groups (
P
<0.001). While the in‐hospital mortality rate was lowest in the P‐ICH group (4%) compared with nonpregnant women (13%) and men (24%), 1 in 4 patients with P‐ICH were bedbound and dependent at the time of discharge.

Conclusions
In our cohort of young adults with ICH, 1 in 5 was pregnancy related. P‐ICH differed in pathogenesis compared with non–pregnancy‐related ICH in young adults, suggesting unique pathophysiology.