bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epistemic Blind Spots, Misconceptions and Stereotypes: The Home Birth Jurisprudence of the European Court of Human Rights
Authors: van Leeuwen Fleur 
Published: February 2024

Abstract
This article offers a critical feminist reading of the home birth jurisprudence of the European Court of Human Rights. The aim is to shed light on the gender sensitivity of the Court in its legal reasoning and knowledge production. Since its first decision on the permissibility of a blanket de facto home birth ban in the case of Ternovszky v. Hungary in 2010, the Court has given five judgments on the matter, including a Grand Chamber decision in the case of Dubska and Krejzova v. Czech Republic. The author finds that the Court applies an overtly restrictive obstetric narrative of childbirth without situating its controversial epistemic basis. In doing so, the Court reinforces a rationale that is linked to loss of agency and disempowerment of persons in childbirth and reproduces harmful stereotypes. The article highlights bias in knowledge formation and (re)production at the Court in addressing cases of home birth. The findings in this article add to feminist inquiries of international human rights adjudication, specifically in regard to knowledge formation, knowledge production and stereotyping as well as to literature on the Court’s gender sensitivity.
Booster vaccination with SARS-CoV-2 mRNA vaccines and myocarditis in adolescents and young adults: a Nordic cohort study
Authors: Hviid Anders , Nieminen Tuomo A , Pihlström Nicklas , Gunnes Nina , Dahl Jesper , Karlstad Øystein , Gulseth Hanne Løvdal , Sundström Anders , Husby Anders , Hansen Jørgen Vinsløv , Ljung Rickard , Hovi Petteri 
Published: February 2024

Abstract

Background and Aims
The SARS-CoV-2 mRNA vaccines are associated with an increased risk of myocarditis. This association appears to be strongest in male adolescents and younger males and after the second dose. The aim was to evaluate the risk of myocarditis following SARS-CoV-2 mRNA booster vaccination in 12-to-39-year-olds.

Methods
A multinational cohort study was conducted using nationwide register data in Denmark, Finland, Norway, and Sweden and comprising all 8.9 million individuals residing in each of the four countries. Participants were followed for an inpatient diagnosis of myocarditis. In each of the four countries, Poisson regression was used to estimate adjusted incidence rate ratios (IRRs) of myocarditis comparing vaccination schedules, with associated 95% confidence intervals (CIs). Country-specific results were combined in meta-analyses.

Results
A total of 8.9 million residents were followed for 12 271 861 person-years and 1533 cases of myocarditis were identified. In 12-to-39-year-old males, the 28-day acute risk period following the third dose of BNT162b2 or mRNA-1273 was associated with an increased incidence rate of myocarditis compared to the post-acute risk period 28 days or more after the second dose [IRR 2.08 (95% CI 1.31–3.33) and 8.89 (2.26–35.03), respectively]. For females, the corresponding IRR was only estimable for BNT162b2, 3.99 (0.41–38.64). The corresponding absolute risks following the third dose of BNT162b2 and mRNA-1273 in males were 0.86 (95% CI 0.53–1.32) and 1.95 (0.53–4.99) myocarditis events within 28 days per 100 000 individuals vaccinated, respectively. In females, the corresponding absolute risks following the third dose of BNT162b2 were 0.15 (0.04–0.39) events per 100 000 individuals vaccinated. No deaths occurred within 30 days of vaccine-related cases.

Conclusions
The results suggest that a booster dose is associated with increased myocarditis risk in adolescents and young adults. However, the absolute risk of myocarditis following booster vaccination is low.
Device innovation in cardiovascular medicine: a report from the European Society of Cardiology Cardiovascular Round Table
Authors: Windecker Stephan , Gilard Martine , Achenbach Stephan , Cribier Alain , Delgado Victoria , Deych Nataliya , Drossart Inga , Eltchaninoff Hélène , Fraser Alan G , Goncalves Alexandra , Hindricks Gerhard , Holborow Richard , Kappetein Arie Pieter , Kilmartin John , Kurucova Jana , Lüscher Thomas F , Mehran Roxana , O’Connor Donal B , Perkins Mark , Samset Eigil , von Bardeleben Ralph Stephan , Weidinger Franz 
Published: February 2024

Abstract
Research performed in Europe has driven cardiovascular device innovation. This includes, but is not limited to, percutaneous coronary intervention, cardiac imaging, transcatheter heart valve implantation, and device therapy of cardiac arrhythmias and heart failure. An important part of future medical progress involves the evolution of medical technology and the ongoing development of artificial intelligence and machine learning. There is a need to foster an environment conducive to medical technology development and validation so that Europe can continue to play a major role in device innovation while providing high standards of safety. This paper summarizes viewpoints on the topic of device innovation in cardiovascular medicine at the European Society of Cardiology Cardiovascular Round Table, a strategic forum for high-level dialogue to discuss issues related to the future of cardiovascular health in Europe. Devices are developed and improved through an iterative process throughout their lifecycle. Early feasibility studies demonstrate proof of concept and help to optimize the design of a device. If successful, this should ideally be followed by randomized clinical trials comparing novel devices vs. accepted standards of care when available and the collection of post-market real-world evidence through registries. Unfortunately, standardized procedures for feasibility studies across various device categories have not yet been implemented in Europe. Cardiovascular imaging can be used to diagnose and characterize patients for interventions to improve procedural results and to monitor devices long term after implantation. Randomized clinical trials often use cardiac imaging-based inclusion criteria, while less frequently trials randomize patients to compare the diagnostic or prognostic value of different modalities. Applications using machine learning are increasingly important, but specific regulatory standards and pathways remain in development in both Europe and the USA. Standards are also needed for smart devices and digital technologies that support device-driven biomonitoring. Changes in device regulation introduced by the European Union aim to improve clinical evidence, transparency, and safety, but they may impact the speed of innovation, access, and availability. Device development programmes including dialogue on unmet needs and advice on study designs must be driven by a community of physicians, trialists, patients, regulators, payers, and industry to ensure that patients have access to innovative care.
Cardiovascular benefit of statin use against air pollutant exposure in older adults
Authors: Kim Kyuwoong , Jeong Seogsong , Choi Seulggie , Chang Jooyoung , Choi Daein , Lee Gyeongsil , Kim Seong Rae , Park Sang Min 
Published: February 2024

Abstract

Aims
Little is known about the cardiovascular benefit of statin use against ambient air pollution among older adults who are at higher risk of cardiovascular disease (CVD) potentially owing to age-related declines in cardiovascular functions along with other risk factors.

Methods and results
This retrospective, population-based cohort study consisted of adults aged 60 years and older free of CVD at baseline identified from the National Health Insurance Service database linked to the National Ambient Air Monitoring Information System for average daily exposure to PM10 and PM2.5 in 2015 in the major metropolitan areas in the Republic of Korea. The follow-up period began on 1 January 2016 and lasted until 31 December 2021. The Cox proportional hazards model was used to evaluate the association of cardiovascular benefit with statin use against different levels of air pollutant exposure. Of 1 229 444 participants aged 60 years and older (mean age, 67.4; 37.7% male), 377 076 (30.7%) were identified as statin users. During 11 963 322 person-years (PYs) of follow-up, a total of 86 018 incident stroke events occurred (719.0 events per 100 000 PYs). Compared to statin non-users exposed to high levels of PM10 (&gt;50 µg/m3) and PM2.5 (&gt;25 µg/m3), statin users had 20% [adjusted hazard ratio (HR), 0.80; 95% confidence intervals (CI), 0.75–0.85] and 17% (adjusted HR, 0.80; 95% CI, 0.80–0.86) lower adjusted risk of incident stroke for PM10 and PM2.5, respectively. A similar risk reduction for incident CVD was also found among statin users exposed to low or moderate levels of PM10 (≤50 µg/m3) and PM2.5 (≤25 µg/m3) exposure.

Conclusion
Among adults aged 60 years and older with high and low or moderate levels of exposure to PM10 and PM2.5, statin use was associated with a significantly lower risk of stroke.
Non-stenotic fibro-calcific aortic valve as a predictor of myocardial infarction recurrence
Authors: Myasoedova Veronika A , Chiesa Mattia , Cosentino Nicola , Bonomi Alice , Ludergnani Monica , Bozzi Michele , Valerio Vincenza , Moschetta Donato , Massaiu Ilaria , Mantegazza Valentina , Marenzi Giancarlo , Poggio Paolo 
Published: February 2024

Abstract

Aims
Patients with acute myocardial infarction (AMI) are at increased risk of recurrent cardiovascular events. Non-stenotic aortic valve fibro-calcific remodelling (called aortic valve sclerosis; AVSc), reflecting systemic damage, may serve as a new marker of risk. This study aims to stratify subgroups of AMI patients with specific probabilities of recurrent AMI and to evaluate the importance of AVSc in this setting.

Methods and results
Consecutive AMI patients (n = 2530) were admitted at Centro Cardiologico Monzino (2010–19) and followed up for 5 years. Patients were divided into study (n = 1070) and test (n = 966) cohorts. Topological data analysis (TDA) was used to stratify patient subgroups, while Kaplan–Meier and Cox regression analyses were used to evaluate the significance of baseline characteristics. Topological data analysis identified 11 subgroups of AMI patients with specific baseline characteristics. Two subgroups showed the highest rate of re-infarction after 5 years from the indexed AMI with a combined hazard ratio (HR) of 3.8 [95% confidence interval (CI): 2.7–5.4] compared with the other subgroups. This was confirmed in the test cohort (HR = 3.1; 95% CI: 2.2–4.3). These two subgroups were mostly men, with hypertension and dyslipidaemia, who exhibit a higher prevalence of AVSc, higher levels of high-sensitive C-reactive protein and creatinine. In the year-by-year analysis, AVSc, adjusted for all confounders, showed an independent association with the increased risk of re-infarction (odds ratio of ∼2 at all time points), in both the study and the test cohorts (all P &lt; 0.01).

Conclusion
AVSc is a crucial variable for identifying AMI patients at high risk of recurrent AMI and its presence should be considered when assessing the management of AMI patients. The inclusion of AVSc in risk stratification models may improve the accuracy of predicting the likelihood of recurrent AMI, leading to more personalized treatment decisions.
Physical activity and physical fitness in prediction of all-cause mortality and age at death in European extinct cohorts of middle-aged men followed for 60 years
Authors: Menotti Alessandro , Puddu Paolo Emilio , Geleijnse Johanna M , Kafatos Anthony , Tolonen Hanna 
Published: February 2024

Abstract

Aims
A study of the power of physical activity (Phyac) and physical fitness (Fitscore) in predicting very long-term all-cause mortality and age at death (AD) is missing.

Methods and results
A total of 5482 middle-aged men were examined with measurement of several risk factors and followed for 60 years until the virtual extinction of cohorts. Phyac in three classes was estimated from their type of work while Fitscore was derived from the linear combinations of levels of arm circumference, heart rate, and vital capacity computed as a factor score by principal components analysis. The predictive power of these characteristics (adjusted for five traditional cardiovascular risk factors) was made by Cox models (for all-cause mortality) and multiple linear regression models (for AD). Single levels of the three indicators of fitness were highly related to the three levels of Phyac and of Fitscore. High levels of both Phyac and of Fitscore forced into the same models were associated with lower all-cause mortality and higher AD. The predictive power of Fitscore was systematically better than that of Phyac. Hazard ratios (high vs. low) for all-cause mortality were 0.85 (Phyac) and 0.70 (Fitscore). The coefficients (all significant) were 2.25 years (Phyac) and 3.79 of AD by Fitscore. Fitscore was independently and significantly predictive of all-cause mortality for both the first and second 30-year follow-up periods.

Conclusion
Phyac and Fitscore are related, and both showed important predictive power for all-cause mortality and AD. The role of Fitscore was more powerful, and both characteristics seem to be expressions of health status.
Safety of ventricular arrhythmia radiofrequency ablation with half-normal saline irrigation
Authors: Hasegawa Kanae , Yoneda Zachary T , Powers Edward M , Tokutake Kenichi , Kurata Masaaki , Richardson Travis D , Montgomery Jay A , Shen Sharon , Estrada Juan C , Saavedra Pablo J , Emerson Amy , Walker Marilyn L , Tandri Harikrishna , Michaud Gregory F , Kanagasundram Arvindh N , Stevenson William G 
Published: February 2024

Abstract

Aims
Failure of radiofrequency (RF) ablation of ventricular arrhythmias is often due to inadequate lesion size. Irrigated RF ablation with half-normal saline (HNS) has the potential to increase lesion size and reduce sodium delivery to the patient if the same volume of RF irrigant were used for normal saline (NS) and HNS but could increase risks related to steam pops and lesion size. This study aims to assess periprocedural complications and acute ablation outcome of ventricular arrhythmias ablation with HNS.

Methods and results
Prospective assessment of outcomes was performed in 1024 endocardial and/or epicardial RF ablation procedures in 935 consecutive patients (median age 64 years, 71.2% men, 73.4% cardiomyopathy, 47.2% sustained ventricular tachycardia). Half-normal saline was selected at the discretion of the treating physician. Radiofrequency ablation power was generally titrated to a ≤15 Ω impedance fall with intracardiac echocardiography monitoring. Half-normal saline was used in 900 (87.9%) and NS in 124 (12.1%) procedures. Any adverse event within 30 days occurred in 13.0% of patients treated with HNS RF ablation including 4 (0.4%) strokes/transient ischaemic attacks and 34 (3.8%) pericardial effusions requiring treatment (mostly related to epicardial access). Two steam pops with perforation required surgical repair (0.2%). Patients who received NS irrigation had less severe disease and arrhythmias. In multivariable models, adverse events and acute success of the procedure were not related to the type of irrigation.

Conclusion
Half-normal saline irrigation RF ablation with power guided by impedance fall and intracardiac echocardiography has an acceptable rate of complications and acute ablation success while administering half of the saline load expected for NS irrigation.
Risk assessment in patients with symptomatic and asymptomatic pre-excitation
Authors: Jemtrén Anette , Saygi Serkan , Åkerström Finn , Asaad Fahd , Bourke Tara , Braunschweig Frieder , Carnlöf Carina , Drca Nikola , Insulander Per , Kennebäck Göran , Nordin Astrid Paul , Sadigh Bita , Rickenlund Anette , Saluveer Ott , Schwieler Jonas , Svennberg Emma , Tapanainen Jari , Turkmen Yusuf , Bastani Hamid , Jensen-Urstad Mats 
Published: February 2024

Abstract

Aims
Controversy remains as to whether the exercise stress test (EST) is sufficient for risk evaluation in patients with pre-excitation. This study aims to clarify the usefulness of EST in risk stratification in both asymptomatic and symptomatic patients presenting with pre-excitation.

Methods and results
This prospective study includes consecutive asymptomatic and symptomatic patients with pre-excitation referred for risk assessment. All participants performed an incremental EST (bicycle) prior to an electrophysiology study (EPS). Primary data from the EST included loss of pre-excitation during exercise, and primary data from the EPS included the measurement of accessory pathway effective refractory period (APERP), shortest pre-excited RR interval (SPERRI), and inducible arrhythmia with the use of a beta-adrenergic receptor agonist if deemed necessary. One hundred and sixty-four patients (59 asymptomatic, 105 symptomatic) completed an EST and EPS. Forty-five patients (27%) demonstrated low-risk findings on EST, of which 19 were asymptomatic and 26 were symptomatic. Six patients with low-risk EST findings had SPERRI/APERP ≤ 250 ms at EPS, and two of them were asymptomatic. The sensitivity, specificity, positive predictive value, negative predictive value (NPV), and accuracy of low-risk EST for excluding patients with SPERRI/APERP ≤ 250 ms were 40, 91, 87, 51, and 60%, respectively. The number of patients with inducible arrhythmia at EPS was similar in the asymptomatic (36, 69%) and symptomatic (73, 61%) groups.

Conclusion
Sudden loss of pre-excitation during EST has a low NPV in excluding high-risk APs. The EPS with the use of isoproterenol should be considered to accurately assess the risk of patients with pre-excitation regardless of symptoms (ClinicalTrials.gov Identifier: NCT03301935).
Intracardiac echocardiography in paediatric and congenital cardiac ablation shortens procedure duration and improves success without complications
Authors: Headrick Andrew , Ou Zhining , Asaki S Yukiko , Etheridge Susan P , Hammond Benjamin , Gakenheimer-Smith Lindsey , Pilcher Thomas , Niu Mary 
Published: February 2024

Abstract

Aims
Common to adult electrophysiology studies (EPSs), intracardiac echocardiography (ICE) use in paediatric and congenital heart disease (CHD) EPS is limited. The purpose of this study was to assess the efficacy of ICE use and incidence of associated complications in paediatric and CHD EPS.

Methods and results
This single-centre retrospective matched cohort study reviewed EPS between 2013 and 2022. Demographics, CHD type, and EPS data were collected. Intracardiac echocardiography cases were matched 1:1 to no ICE controls to assess differences in complications, ablation success, fluoroscopy exposure, procedure duration, and arrhythmia recurrence. Cases and controls with preceding EPS within 5 years were excluded. Intracardiac echocardiography cases without an appropriate match were excluded from comparative analyses but included in the descriptive cohort. We performed univariable and multivariable logistic regression to assess associations between variables and outcomes. A total of 335 EPS were reviewed, with ICE used in 196. The median age of ICE cases was 15 [interquartile range (IQR) 12–17; range 3–47] years, and median weight 57 [IQR 45–71; range 15–134] kg. There were no ICE-related acute or post-procedural complications. There were 139 ICE cases matched to no ICE controls. Baseline demographics and anthropometrics were similar between cases and controls. Fluoroscopy exposure (P = 0.02), procedure duration (P = 0.01), and arrhythmia recurrence (P = 0.01) were significantly lower in ICE cases.

Conclusion
Intracardiac echocardiography in paediatric and CHD ablations is safe and reduces procedure duration, fluoroscopy exposure, and arrhythmia recurrence. However, not every arrhythmia substrate requires ICE use. Thoughtful selection will ensure the judicious and strategic application of ICE to enhance outcomes.
Adolescents with emotional and behavioural problems are at higher risk to become excessive or addicted Internet users: is this association moderated by gender?
Authors: Bitto Urbanova Laura , Holubcikova Jana , Madarasova Geckova Andrea , van Dijk Jitse P , Reijneveld Sijmen A 
Published: February 2024

Abstract

Background
The Internet offers many opportunities for adolescents to facilitate their lives. However, its everyday use may lead to excessive behaviour, including addiction. Our aim was to assess the association between emotional and behavioural problems (EBP) and level of internet use, and whether gender moderates this association.

Methods
We used data from a representative sample of 5,433 Slovak adolescents (mean age: 13.51, 48.8% boys) from the Health Behaviour in School-aged Children-study conducted in 2018, collected through online self-report questionnaires. EBP was measured by the Strengths and Difficulties Questionnaire and excessive internet use (EIU) and internet addiction (IA) by the Excessive internet use scale. We analysed using multinomial logistic regression.

Results
More than 25% of the adolescents reported EIU; almost 4% reported being addicted to Internet. EIU was more prevalent in girls, but IA was more prevalent in boys. Adolescents with borderline or increased levels of EBP were more likely to report EIU (odds ratio, OR/95% confidence interval, CI: 1.85/1.60–2.14; 3.16/2.67–3.75, respectively) and IA (OR/95% CI: 2.23/1.57–3.18; 4.89/3.41–7.03, respectively). Adjustment for gender, age or perceived family wealth hardly changed the findings. Moreover, gender did not modify the associations between EBP with EIU.

Conclusion
Adolescents with higher levels of EBP are more likely to become excessive Internet users or Internet addicts. This shows a need of early identification of adolescents with EBP as they seem to be relatively vulnerable to develop EIU or IA.
Pharmacists’ involvement in physical activity promotion in community pharmacy: a systematic review
Authors: Viegas Ruben , Barbosa Ana , Mendes Romeu , Duarte-Ramos Filipa , Alves da Costa Filipa 
Published: February 2024

Abstract

Background
Physical activity (PA) promotion in healthcare systems is one of the priority areas highlighted by the World Health Organization, which recognizes that progress has been slow largely due to a lack of awareness and investment while requiring a system-based approach. Community pharmacies are one of the health structures that are more easily accessible to populations, thus constituting an ideal venue for developing health promotion activities. This research aimed to describe PA-enabling interventions developed in community pharmacies by pharmacists.

Methods
An electronic search was performed in PubMed, Scopus, Web of Science, Cochrane and reference lists of the different papers until June 2023. Studies were eligible if performed in community pharmacies by pharmacists, focused on interventions aimed at increasing PA levels and if at least one PA-specific outcome was measured at two different time points.

Results
We identified 7076 publications in the initial search, plus 31 records identified through backward citation tracking from relevant studies. After an initial screening, 236 were selected for full-text analysis. Of the 29 selected papers, 10 presented a low risk of bias for the measurement of PA levels. PA outcomes were generally self-reported outcomes where the change in terms of the percentage of individuals considered active or who increased PA because of the intervention.

Conclusion
Several interventions to improve PA through community pharmacies were found although with a high level of heterogeneity and with only few with a low risk of bias. More targeted research that aims to capture PA levels and support the training of healthcare professionals is needed.