bluuebunny/crossref_metadata_2025_split huggingface dataset:
Applying the lessons of design thinking: a unique programme of care for acutely unwell, community-dwelling COVID-19 patients
Authors: Devlin Megan K , McIntyre Natasha J , Ramer Matthew D , Kwon Young Han , Nicholson J Michael , Mrkobrada Marko , Kronick Jami , Calvin James E , Spicer Erin 
Published: February 2024

BackgroundThe COVID-19 pandemic limited access to primary care and in-person assessments requiring healthcare providers to re-envision care delivery for acutely unwell outpatients. Design thinking methodology has the potential to support the robust evolution of a new clinical model.AimTo demonstrate how design thinking methodology can rapidly and rigorously create and evolve a safe, timely, equitable and patient-centred programme of care, and to share valuable lessons for effective implementation of design thinking solutions to address complex problems.MethodWe describe how design thinking methodology was employed to create a new clinical model of care. Using the example of a novel telemedicine programme to support acutely unwell, community-dwelling COVID-19-positive patients called the London Urgent COVID-19 Care Clinic (LUC3), we show how continuous quality outcomes (safety, timeliness, equity and patient-centredness), as well as patient experience survey responses, can drive iterative changes in programme delivery.ResultsThe inspiration phase identified four key needs for this patient population: monitoring COVID-19 signs and symptoms; self-managing COVID-19 symptoms; managing other comorbidities in the setting of COVID-19; and escalating care as needed. Guided by these needs, a cross-disciplinary stakeholder group was engaged in the ideation and implementation phases to create a unique and comprehensive telemedicine programme (LUC3). During the implementation phase, LUC3 assessed 2202 community-based patients diagnosed with acute COVID-19; the collected quality outcomes and end-user feedback led to evolution of programme delivery.ConclusionDesign thinking methodology provided an essential framework and valuable lessons for the development of a safe, equitable, timely and patient-centred telemedicine care programme. The lessons learnt here—the importance of inclusive collaboration, using empathy to guide equity-focused interventions, leveraging continuous metrics to drive iteration and aiming for good-if-not-perfect plans—can serve as a road map for using design thinking for targeted healthcare problems.
Development of delivery indicators and delivery enablers for cardiovascular disease in the UK: a modified Delphi study
Authors: Gale Chris , Arden Chris , Bakhai Ameet , Grothier Lucy , Gray Huon H , Williams Helen 
Published: February 2024

IntroductionStandards to define and measure quality in healthcare for cardiovascular disease risk reduction and secondary prevention are available, but there is a paucity of indicators that could serve as facilitators of structural change at a system level. This research study aimed to develop a range of delivery indicators to help cardiac clinical networks assess delivery of and progress towards cardiovascular disease objectives.MethodsThis study used an adapted version of the European Society of Cardiology’s four-step process for the development of quality indicators. The four steps in this study were as follows: identify critical factors of enablement, construct a list of candidate indicators, select a final set of indicators and assess availability of national data for each indicator. In this iterative process, a core project group of six members was supported by a wider review group of 21 people from the National Health Service (NHS) clinical and management personnel database.ResultsThe core project group identified six relevant cardiovascular disease priorities in the NHS Long Term Plan and used an iterative process to identify 21 critical factors that impact on their implementation. A total of 57 potential indicators that could be measures of implementation were developed. The core project group agreed on a set of 38 candidate indicators that were circulated to the review group for rating. Based on these scores, the core project group excluded 5 indicators to arrive at a final set of 33 delivery indicators. National datasets were available for 22 of the final indicators, which were designated as delivery indicators. The remaining 11, for which national datasets were not available but locally available datasets could be used, were designated as delivery enablers.ConclusionThe suite of delivery indicators and delivery enablers for cardiovascular disease could allow a more focused evaluation of factors that impact on delivery of healthcare for cardiovascular disease.
Impact of temperature on the magnitude and duration of relief after lumbar facets medial branch nerves radiofrequency ablation: a randomized double-blinded study
Authors: Mekhail Nagy , Costandi Shrif , Armanyous Sherif , Templeton Erin , Acevedo-Moreno Lou-Anne G , Prayson Nicholas 
Published: February 2024

IntroductionThere are numerous studies appraising the variables that may influence the clinical outcomes after lumbar thermal radiofrequency ablation (RFA). Expanding the lesion size may increase the likelihood of capturing the target nerves in the lesion, thereby increasing the technical success rate of RFA. However, our literature search has failed to identify a consensus on the optimal target temperature. A retrospective study demonstrated that there seems to be significant functional improvement associated with the temperature of 90°C compared with 80°C. The authors prospectively studied the subject in a double-blinded randomized fashion.MethodsPatients undergoing RFA for lumbar facetogenic pain were randomized in two cohorts (80°C and 90°C). Physicians and patients were blinded to the temperature used. The primary outcome was self-reported pain scores up to 12 months. Secondary outcomes included: self-reported functional improvement, duration of relief as measured by the time before repeat ablation of the same medial branches nerves, opioids’ consumption, and patient satisfaction.ResultsBoth groups reported pain improvement in all follow-up time points. Overall, both groups achieved statistically significant pain reduction (p<0.05). The median time to repeat RFA in the 80°C group was 112 (49–252) days, while it was 217 (198–348) days in the 90°C group (p<0.04). The univariate analysis emphasized that the RFA temperature is a statistically significant factor for pain improvement of more than 50%, OR 2.7 (1.1 to 6.6) p value=0.031.ConclusionRFA has been demonstrated as an effective therapeutic modality for lumbar facetogenic back pain. Yet, the several factors involved in determining a favorable outcome of this procedure require further research and optimization. This prospective double-blinded randomized trial demonstrated that RFA at both temperatures (80°C, 90°C) provided significance at all the time periods examined. However, RFA at 90°C was superior to 80°C in regard to the duration of relief.
Effect of virtual reality hypnosis on intraoperative sedation needs and functional recovery in knee arthroplasty: a prospective randomized clinical trial
Authors: Carella Michele , Beck Florian , Quoilin Caroline , Azongmo Murielle M , Loheac Adrien , Bonhomme Vincent L , Vanhaudenhuyse Audrey 
Published: February 2024

Background and objectivesPerioperative psychological stress and pharmacological anxiolysis can negatively affect the quality of recovery after total knee arthroplasty. We aimed to assess whether hypnosis combined with virtual reality could reduce intraoperative pharmacological sedation and improve quality of recovery after total knee arthroplasty surgery.MethodsIn this prospective randomized clinical trial, 60 patients scheduled for total knee arthroplasty with spinal anesthesia were randomly divided into 2 groups of 30 patients each. Intraoperatively, intermittent boluses of midazolam 1 mg were administered at 5 min intervals at the patient’s request, with a maximum driven by the clinical assessment of sedation depth. During surgery, patients received standard care (group control) or virtual reality hypnosis (group VRH). An unblinded observer recorded the total dose of midazolam administered during surgery, and changes in the Quality-of-Recovery 15-item score, comfort, fatigue, pain and anxiety before and 1, 3 and 7 days after surgery.ResultsPatients in the VRH group required a lower dose of midazolam (mg; median (range)) intraoperatively (group VRH: 0 (0–4) and group control: 2 (0–9), p<0.001). Quality-of-Recovery 15-item, anxiety, and pain were similar between groups.ConclusionsIn total knee arthroplasty with spinal anesthesia, VRH reduces the requirement for intraoperative pharmacological sedation, without a change in the quality of recovery.Trial registration numberNCT05707234.
Characterising Modal Formulas with Examples
Authors: ten Cate Balder , Koudijs Raoul 
Published: February 2024

We study the existence of finite characterisations for modal formulas. A finite characterisation of a modal formula φ is a finite collection of positive and negative examples that distinguishes φ from every other, non-equivalent modal formula, where an example is a finite pointed Kripke structure. This definition can be restricted to specific frame classes and to fragments of the modal language: a modal fragment ℒ admits finite characterisations with respect to a frame class ℱ if every formula φ ∈ ℒ has a finite characterisation with respect to ℒ consisting of examples that are based on frames in ℱ. Finite characterisations are useful for illustration, interactive specification and debugging of formal specifications, and their existence is a precondition for exact learnability with membership queries. We show that the full modal language admits finite characterisations with respect to a frame class ℱ only when the modal logic of ℱ is locally tabular. We then study which modal fragments, freely generated by some set of connectives, admit finite characterisations. Our main result is that the positive modal language without the truth-constants ⊤ and ⊥ admits finite characterisations w.r.t. the class of all frames. This result is essentially optimal: finite characterisability fails when the language is extended with the truth constant ⊤ or ⊥ or with all but very limited forms of negation.
Aerobic Exercise Attenuates Pressure Overload–Induced Myocardial Remodeling and Myocardial Inflammation via Upregulating miR-574-3p in Mice
Authors: Chen Qiao-Ying , Jiang Yi-Na , Guan Xuan , Ren Fang-Fang , Wu Shu-Jie , Chu Mao-Ping , Wu Lian-Pin , Lai Teng-Fang , Li Lei 
Published: February 2024

BACKGROUND:
Exercise training can promote cardiac rehabilitation, thereby reducing cardiovascular disease mortality and hospitalization rates. MicroRNAs (miRs) are closely related to heart disease, among which miR-574-3p plays an important role in myocardial remodeling, but its role in exercise-mediated cardioprotection is still unclear.

METHODS:
A mouse myocardial hypertrophy model was established by transverse aortic coarctation, and a 4-week swimming exercise training was performed 1 week after the operation. After swimming training, echocardiography was used to evaluate cardiac function in mice, and histopathologic staining was used to detect cardiac hypertrophy, myocardial fibrosis, and cardiac inflammation. Quantitative real-time polymerase chain reaction was used to detect the expression levels of miR-574-3p and cardiac hypertrophy markers. Western blotting detected the IL-6 (interleukin-6)/JAK/STAT inflammatory signaling pathway.

RESULTS:
Echocardiography and histochemical staining found that aerobic exercise significantly improved pressure overload–induced myocardial hypertrophy (n=6), myocardial interstitial fibrosis (n=6), and cardiac inflammation (n=6). Quantitative real-time polymerase chain reaction detection showed that aerobic exercise upregulated the expression level of miR-574-3p (n=6). After specific knockdown of miR-574-3p in mouse hearts with adeno-associated virus 9 using cardiac troponin T promoter, we found that the protective effect of exercise training on the heart was significantly reversed. Echocardiography and histopathologic staining showed that inhibiting the expression of miR-574-3p could partially block the effects of aerobic exercise on cardiac function (n=6), cardiomyocyte cross-sectional area (n=6), and myocardial fibrosis (n=6). Western blotting and immunohistochemical staining showed that the inhibitory effects of aerobic exercise on the IL-6/JAK/STAT pathway and cardiac inflammation were partially abolished after miR-574-3p knockdown. Furthermore, we also found that miR-574-3p exerts cardioprotective effects in cardiomyocytes by targeting IL-6 (n=3).

CONCLUSIONS:
Aerobic exercise protects cardiac hypertrophy and inflammation induced by pressure overload by upregulating miR-574-3p and inhibiting the IL-6/JAK/STAT pathway.
Pregnancy History at 40 Years of Age as a Marker of Cardiovascular Risk
Authors: Kvalvik Liv G. , Skjærven Rolv , Sulo Gerhard , Singh Aditi , Harmon Quaker E. , Wilcox Allen J. 
Published: February 2024

Background
Individual pregnancy complications are associated with increased maternal risk of cardiovascular disease. We assessed the link between a woman's total pregnancy history at 40 years of age and her relative risk of dying from atherosclerotic cardiovascular disease (ASCVD).

Methods and Results
This population‐based prospective study combined several Norwegian registries covering the period 1967 to 2020. We identified 854 442 women born after 1944 or registered with a pregnancy in 1967 or later, and surviving to 40 years of age. The main outcome was the time to ASCVD mortality through age 69 years. The exposure was a woman's number of recorded pregnancies (0, 1, 2, 3, or 4) and the number of those with complications (preterm delivery <35 gestational weeks, preeclampsia, placental abruption, perinatal death, and term or near‐term birth weight <2700 g). Cox models provided estimates of hazard ratios across exposure categories. The group with the lowest ASCVD mortality was that with 3 pregnancies and no complications, which served as the reference group. Among women reaching 40 years of age, risk of ASCVD mortality through 69 years of age increased with the number of complicated pregnancies in a strong dose–response fashion, reaching 23‐fold increased risk (95% CI, 10–51) for women with 4 complicated pregnancies. Based on pregnancy history alone, 19% of women at 40 years of age (including nulliparous women) had an increased ASCVD mortality risk in the range of 2.5‐ to 5‐fold.

Conclusions
Pregnancy history at 40 years of age is strongly associated with ASCVD mortality. Further research should explore how much pregnancy history at 40 years of age adds to established cardiovascular disease risk factors in predicting cardiovascular disease mortality.
Expecting the Unexpected: Infants Use Others’ Surprise to Revise Their Own Expectations
Authors: Wu Yang , Merrick Megan , Gweon Hyowon 
Published: February 2024

Abstract
Human infants show systematic responses to events that violate their expectations. Can they also revise these expectations based on others’ expressions of surprise? Here we ask whether infants (N = 156, mean = 15.2 months, range: 12.0–18.0 months) can use an experimenter’s expression of surprise to revise their own expectations about statistically probable vs. improbable events. An experimenter sampled a ball from a box of red and white balls and briefly displayed either a surprised or an unsurprised expression at the outcome before revealing it to the infant. Following an unsurprised expression, the results were consistent with prior work; infants looked longer at a statistically improbable outcome than a probable outcome. Following a surprised expression, however, this standard pattern disappeared or was even reversed. These results suggest that even before infants can observe the unexpected events themselves, they can use others’ surprise to expect the unexpected. Starting early in life, human learners can leverage social information that signals others’ prediction error to update their own predictions.
Perfusion education and training in Europe anno 2023
Authors: Debeuckelaere Gerdy , Klüß Christian , Ruck Katja , Nagaraj Naveen G , Brajlović Ermin , Kjellberg Gunilla , Talmaciu Cristian , Lenart Zvonko , Muraskauskaite Monika , Ristić Nemanja , Nyeng Camilla , Mintzaridis Konstantinos , Devolder Emmanuel , Simeonov Radoslav , Canavan Colin , Kmetovski Stefan , Sari Tamer , Krumposova Katerina , Mata Maria Teresa , Crnković Luka , Muscat Jeffrey , Sikora Normunds , Campbell John , Rantanen Markku , Figueira Inês , Kruusat Rein , Frédéric Joël , Sudakevych Serhii , Savović Ratko , Jelonek Andrzej , van Deventer San-Mari van Delft – , Macera Mascitelli Maria Erminia 
Published: February 2024

Background: In the absence of uniform European regulations, there have been many differences in the training of perfusionists across Europe. Furthermore, there has been no uniform or single European accreditation of the profession. One of the objectives of The European Board of Cardiovascular Perfusion (EBCP) is to standardise and monitor training of perfusionists across Europe whilst offering support in accordance with national regulations. This goal is particularly imminent as there have been numerous newly founded National perfusion societies, particularly from Eastern European countries, which are now established members of EBCP. Purpose: In this article, we provide an updated overview or ‘snapshot’ of current European perfusion training programs that were accessible in 2022. Nationally acquired data refers to 2022 unless stated otherwise. The last overview of Perfusion education in Europe was reported over 15 years ago including 20 countries. Research Design: For this report thirty-two national EBCP delegates plus representatives from Austria were contacted at the beginning of 2023 to complete a pro forma questionnaire about their national perfusion training programmes. The data has been summarized in this article and five additional derived parameters were calculated. Results: We received responses from 31 countries, providing specific national training characteristics which are summarized, listed and benchmarked by country in this article. Conclusion: There have been several national and supranational initiatives towards the recognition of perfusion as a profession in Europe, however so far without success for the majority of countries. For this reason, it remains essential for EBCP, as the only European professional perfusionist body, to define education standards and competencies for perfusionists and to monitor training by accreditation of dedicated perfusion schools across Europe.
Effects of health education on screening rate of first-degree relatives of cancer patients: A systematic review and meta-analysis
Authors: Kang Jiaxun , Wang Shanshan , Yi Jingna , Zhang Qiushi 
Published: February 2024

Objective To synthesize the effects of educational intervention on the screening rate of first-degree relatives of cancer patients. Methods A total of eight Chinese and English databases were searched (PubMed, Embase, Cochrane Library, CINAHL, Web of Science, Scopus, Medline and China Biology Medicine disc) from the time of library establishment to June 2023, for randomized controlled trials investigating the effects of educational intervention on screening rate of first-degree relatives of cancer patients. Two researchers independently screened and evaluated the quality of studies. RevMan 5.3 software was used to calculate the pooled effect size. Results Thirteen studies involving 5628 participants were chosen to include in the meta-analysis. The results revealed that health education can increase screening rate of first-degree relatives of cancer patients (RR = 1.39, 95% CI = 1.16–1.65, P = 0.0002). The effect shown after short-term follow-up (≤6 months) was insignificant in terms of improving screening rate (RR = 1.46, 95% CI = 0.94–2.26, P = 0.09), but after long-term follow-up (＞6 months) the improvement was greater (RR = 1.37, 95% CI = 1.13–1.65, P = 0.002). Conclusion Health education is effective in increasing the screening rate of first-degree relatives of cancer patients. The effect is more evident after long-term than short-term follow-up.
The Effects of Patient-Centered Communication on Patient Engagement, Health-Related Quality of Life, Service Quality Perception and Patient Satisfaction in Patients with Cancer: A Cross-Sectional Study in Türkiye
Authors: Çakmak Cuma , Uğurluoğlu Özgür 
Published: February 2024

Introduction Patient-centered communication is a type of communication that takes place between the provider and the patient. Objectives It is aimed to reveal the effects of patient-centered communication on patient engagement, health-related quality of life, perception of service quality and patient satisfaction. Method The study was conducted by applying multiple regression analysis to the data obtained from 312 patients with cancer treated in a training and research hospital affiliated to the Ministry of Health in Diyarbakır, Türkiye. Results More than half of the patients were female and had stage 4 cancer. Different types of cancer were detected (breast cancer, cancer of the digestive organs, lymphatic and hematopoietic cancer, cancer of the genital organs, cancer of the respiratory organs, etc.). It can be stated that the average values obtained by patients from patient-centered communication and its sub-dimensions are high. There are positive, moderate and low and significant relationships between the overall patient-centered communication and patient engagement, patient satisfaction, service quality perception and quality of life. It was statistically revealed that patient-centered communication positively affected patient engagement, health-related quality of life, service quality perception, and patient satisfaction. Conclusion Patient-centered communication positively affects various short and medium-term health outcomes and this study offers suggestions for improving patient-provider communication.
Pigment epithelial detachment composition indices in central serous chorioretinopathy as a biomarker for disease activity: A computational methodology and 1 year outcomes
Authors: Yadav Sanya , Ong Joshua , Zarnegar Arman , Driban Matthew , Selvam Amrish , Arora Supriya , Singh Sumit Randhir , Chhablani Jay 
Published: February 2024

Purpose Investigation of pigment epithelial detachment (PED) characteristics in central serous chorioretinopathy (CSCR) is underrepresented in the literature. We present a novel computational approach to quantify PED composition indices (PEDCI) in CSCR and track changes over time. Methods 34 eyes with active CSCR were analyzed quarterly over a 1-year period. Cases were categorized into acute and chronic CSCR depending on a symptom duration of less than 3 months or more than 3 months respectively. PED, retinal and choroidal dimensions were manually measured, and interval changes were compared using repeated measures of variance ANOVA. PED composition analysis involved manual segmentation followed by automated sub segmentation of PED areas to identify serous, neovascular and fibrous tissues. PEDCI for each component was compared among cases of acute and chronic CSCR. Results CMT and NSD-h decreased by 65.2 µm ( p = 0.01), and 86.5 µm ( p < 0.01) respectively at 12 months. At baseline, 7/17 acute CSCR eyes and 8/15 chronic CSCR eyes had a concomitant PED; acute cases had both serous and neovascular components (PEDCI-S: 16.95%, PEDCI-N: 40.3%), whereas chronic cases only had a neovascular component (PEDCI-S: 0%, PEDCI-N: 30.5%). At 12-month follow-up, 6/7 of acute CSCR group and 6/8 chronic CSCR group had a concomitant PED; PEDCI-S was largest for acute CSCR (53.4%) and PEDCI-N was largest for chronic CSCR (46.7%). Conclusion We identify a novel biomarker PEDCI to differentiate acute and chronic CSCR with higher PEDCI-S in acute CSCR, and higher PEDCI-N in chronic CSCR.