bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abnormal electrocardiogram and poor prognosis in heart failure with preserved ejection fraction
Authors: He Tiantian , Liu Chen , Liang Weihao 
Published: July 2023

Abstract

Purpose
Electrocardiogram (ECG) is generally performed in patients with heart failure with preserved ejection fraction (HFpEF), but the prognostic value of abnormal ECG is not fully understood. We aim to explore the prognostic value of abnormal ECG at baseline in HFpEF using data from the TOPCAT trial.

Methods
A total of 1736 patients from TOPCAT-Americas were included and divided into normal versus abnormal ECG groups. Survival analyses were performed for the following outcomes: the primary endpoint [a composite of cardiovascular death, heart failure (HF) hospitalization, and aborted cardiac arrest], all-cause death, cardiovascular death, and HF hospitalization.

Results
Abnormal ECG was significantly associated with higher risks of the primary endpoint [hazard ratio (HR): 1.480, P = 0.001] and HF hospitalization (HR: 1.400, P = 0.015), and borderline significantly with cardiovascular death (HR: 1.453, P = 0.052) in patients with HFpEF after multivariate adjustment. As for specific ECG abnormalities, bundle branch block was associated with the primary endpoint (HR: 1.278, P = 0.020) and HF hospitalization (HR: 1.333, P = 0.016), whereas atrial fibrillation/flutter was associated with all-cause death (HR: 1.345, P = 0.051) and cardiovascular death (HR: 1.570, P = 0.023), but ventricular paced rhythm, pathological Q waves, and left ventricular hypertrophy were not of prognostic significance. Besides, other unspecific abnormalities together were associated with the primary endpoint (HR: 1.213, P = 0.032).

Conclusion
Abnormal ECG at baseline could be associated with poor prognosis in patients with HFpEF. Physicians are encouraged to pay more attention to HFpEF patients who present an abnormal ECG instead of ignoring those obscure abnormalities.
Key messages What is already known on this topic Electrocardiogram (ECG) is a basic and easily accessible examination for patients with heart failure with preserved ejection fraction (HFpEF). Some findings from ECG such as frontal QRS-T angle, QTc interval, and the Cornell product have been shown to be associated with the prognosis of HFpEF but these results are from studies with relatively small sample sizes. What this study adds Using data from TOPCAT-Americas, this study found that an overall estimation of abnormal ECG significantly predicted poor prognosis in patients with HFpEF. As for specific abnormalities in ECG, bundle branch block mainly predicted heart failure hospitalization and atrial fibrillation mainly predicted death. How this study might affect research, practice, or policy This study reminds physicians to pay more attention to HFpEF patients who present an abnormal ECG.
National Study of Quality, Safety, and Just Culture in Prelicensure Nursing Education
Authors: Altmiller Gerry 
Published: July 2023

Abstract

AIM
The study’s aim was to evaluate the integration and application of quality and safety competencies and concepts of fair and just culture in prelicensure nursing education.

BACKGROUND
Health care organizations support a safety culture by encouraging error reporting without fear of punishment and by conducting investigations to determine causes to improve quality and learn from mistakes. In prelicensure nursing education, the response to errors is often punitive and threatens dismissal.

METHOD
Members of the National Student Nurses' Association were recruited to participate in an electronic assessment through the organization’s mailing system.

RESULTS
Students representing all prelicensure program types (BSN, ADN, diploma, accelerated) and 46 states (N = 268) completed the survey.

CONCLUSION
Nurse educators were found to have a positive impact on student quality and safety competency. Improvement is possible in developing and supporting just culture within nursing programs to bridge the gap between academia and practice.
What are Effective Strategies to Reduce Low-Value Care? An Analysis of 121 Randomized Deimplementation Studies
Authors: Heus Pauline , van Dulmen Simone A. , Weenink Jan-Willem , Naaktgeboren Christiana A. , Takada Toshihiko , Verkerk Eva W. , Kamm Isabelle , van der Laan Maarten J. , Hooft Lotty , Kool Rudolf B. 
Published: July 2023

ABSTRACT

Background:
Low-value care is healthcare leading to no or little clinical benefit for the patient. The best (combinations of) interventions to reduce low-value care are unclear.

Purpose:
To provide an overview of randomized controlled trials (RCTs) evaluating deimplementation strategies, to quantify the effectiveness and describe different combinations of strategies.

Methods:
Analysis of 121 RCTs (1990–2019) evaluating a strategy to reduce low-value care, identified by a systematic review. Deimplementation strategies were described and associations between strategy characteristics and effectiveness explored.

Results:
Of 109 trials comparing deimplementation to usual care, 75 (69%) reported a significant reduction of low-value healthcare practices. Seventy-three trials included in a quantitative analysis showed a median relative reduction of 17% (IQR 7%–42%). The effectiveness of deimplementation strategies was not associated with the number and types of interventions applied.

Conclusions and Implications:
Most deimplementation strategies achieved a considerable reduction of low-value care. We found no signs that a particular type or number of interventions works best for deimplementation. Future deimplementation studies should map relevant contextual factors, such as the workplace culture or economic factors. Interventions should be tailored to these factors and provide details regarding sustainability of the effect.
Taurodontism of primary teeth in a 4-year-old child- A case report
Authors: Davangere Padmanabh Dr Shital Kiran , Jhamb Dr Vikram , Tanurkar Dr. Sumeet Sharad , Gori Dr. Nasrin , Bhise . Dr. Omkar Rajendra , Gangurde Dr. Vishakha Bhausaheb 
Published: July 2023

<p> Taurodont teeth are mainly seen by large pulp chambers with respect to the roots. An enlarged pulp chamber, apical displacement of the pulpal floor and no constriction at the level of the cement-enamel junction are the characteristic features of a taurodont tooth. It appears more frequently as an isolated anomaly but its association with syndromes and other abnormalities has also been reported. Permanent dentition is more commonly affected than deciduous dentition. Taurodont teeth show wide variation in the size and shape of pulp chambers, varying degrees of obliteration and canal complexity, low canal orifices and the potential for additional canal systems. The dental literature on taurodontism is relatively sparse and most are case reports. </p>
Updated mortality and causes of death in 2020-2021 in people living with HIV: a multicenter study in France
Authors: Sellier Pierre , Alexandre-Castor Guylaine , Brun Alexandre , Hamet Gwenn , Bouchaud Olivier , Leroy Pierre , Diamantis Sylvain , Chabrol Amélie , Machado Moïse , Bouldouyre Marie-Anne , De Castro Nathalie , Rozenbaum Willy , Molina Jean-Michel 
Published: July 2023

Objective:
To assess updated mortality and causes of death in people living with HIV (PLWH) in France.

Design and Methods:
We analyzed all deaths in PLWH followed up between 01/01/2020 and 31/12/2021 in 11 hospitals in the Paris region. We described the characteristics and causes of death among deceased PLWH, and evaluated the incidence of mortality and associated risk factors using a multivariate logistic regression.

Results:
Of the 12942 patients followed in 2020-2021, 202 deaths occurred. Mean annual incidence of death (95% confidence interval [CI]) was 7.8 per 1 000 PLWH (6.3–9.5). Forty-seven patients (23%) died from non-AIDS non-viral hepatitis (NANH)-related malignancies, 38 (19%) from non-AIDS infections (including 21 cases of COVID-19), 20 (10%) from AIDS, 19 (9%) from cardiovascular diseases (CVD), 17 (8.4%) from other causes, six (3%) from liver diseases and five (2.5%) from suicides/violent deaths. The cause of death was unknown in 50 (24.7%) patients. Risks factors for death were age (adjusted Odds Ratio (aOR) 1.93; 1.66–2.25 by additional decade), AIDS history (2.23; 1.61–3.09), low CD4 (1.95; 1.36–2.78 for 200–500/μL and 5.76; 3.65–9.08 for ≤ 200/μL versus > 500/μL), and viral load > 50 copies/mL (2.03; 1.33–3.08), both at last visit.

Conclusions:
NANH malignancies remained in 2020–2021 the first cause of death. COVID-19 accounted for more than half of the mortality related to non-AIDS infections over the period. Aging, AIDS history, and a poorer viro-immunological control were associated with death.
Trends in Urogynecologic Surgery Among Obstetrics and Gynecology Residents From 2002 to 2022
Authors: Nutaitis Alexandra C. , George Estee L. , Mangira Caroline J. , Wallace Shannon L. , Bowersox Natalie A. 
Published: July 2023

Importance
The number of American women with a pelvic floor disorder is projected to increase from 28.1 million in 2010 to 43.8 million in 2050.

Objectives
The objective of this study was to evaluate trends in the number of urogynecologic procedures performed by graduating obstetrics and gynecology residents and to compare variability in volume between residents in the 70th and 30th percentiles for logged cases.

Study Design
National case log measures for residents who graduated between 2003 and 2022 were reviewed. Mean case numbers and variability in case numbers were analyzed over time.

Results
Data were collected from a median of 1,216.5 residents (range, 1,090 to 1,427) annually. Mean number of vaginal hysterectomies logged per resident decreased by 46.4% from 2002/2003 to 2021/2022 (P = 0.0007). Mean number of urogynecology procedures increased by 1,165.5% from 2002/2003 to 2007/2008 (P = 0.0015). Mean number of incontinence and pelvic floor procedures (including cystoscopies) increased by 190.9% from 2002/2003 to 2011/2012 (P = 0.0002). Mean number of incontinence and pelvic floor procedures (excluding cystoscopies) decreased by 39.7% from 2012/2013 to 2021/2022 (P < 0.0001). Mean number of cystoscopies increased by 19.7% from 2012/2013 to 2021/2022 (P < 0.0001). Ratios of cases logged by residents in the 70th percentile to those in the 30th percentile decreased for vaginal hysterectomies and cystoscopies (P < 0.0001 and P = 0.0040, respectively). The ratio for incontinence and pelvic floor procedures (excluding cystoscopies) was 1.76 in 2012/2013 and 2.35 in 2021/2022 (P = 0.2878).

Conclusion
Resident surgical training in urogynecology is decreasing nationally.
Randomized Trial on Expectations and Pain Control Advancement in Surgery: The REPAIR Study
Authors: Serna-Gallegos Tasha R. , Komesu Yuko M. , Dunivan Gena C. , Meriwether Kate V. , Ninivaggio Cara S. , Petersen Timothy R. , Jeppson Peter C. 
Published: July 2023

Importance
Following standardized preoperative education and adoption of shared decision making positively affects postoperative narcotic practices.

Objectives
The aim of this study was to assess the impact of patient-centered preoperative education and shared decision making on the quantities of postoperative narcotics prescribed and consumed after urogynecologic surgery.

Study Design
Women undergoing urogynecologic surgery were randomized to “standard” (standard preoperative education, standard narcotic quantities at discharge) or “patient-centered” (patient-informed preoperative education, choice of narcotic quantities at discharge) groups. At discharge, the “standard” group received 30 (major surgery) or 12 (minor surgery) pills of 5-mg oxycodone. The “patient-centered” group chose 0 to 30 (major surgery) or 0 to 12 (minor surgery) pills. Outcomes included postoperative narcotics consumed and unused. Other outcomes included patient satisfaction/preparedness, return to activity, and pain interference. An intention-to-treat analysis was performed.

Results
The study enrolled 174 women; 154 were randomized and completed the major outcomes of interest (78 in the standard group, 76 in the patient-centered group). Narcotic consumption did not differ between groups (standard group: median of 3.5 pills, interquartile range [IQR] of [0, 8.25]; patient centered: median of 2, IQR of [0, 9.75]; P = 0.627). The patient-centered group had fewer narcotics prescribed (P < 0.001) and unused (P < 0.001), and chose a median of 20 pills (IQR [10, 30]) after a major surgical procedure and 12 pills (IQR [6, 12]) after a minor surgical procedure, with fewer unused narcotics (median difference, 9 pills; 95% confidence interval, 5–13; P < 0.001). There were no differences between groups' return to function, pain interference, and preparedness or satisfaction (P > 0.05).

Conclusions
Patient-centered education did not decrease narcotic consumption. Shared decision making did decrease prescribed and unused narcotics. Shared decision making in narcotic prescribing is feasible and may improve postoperative prescribing practices.
Nest construction in mammals: a review of the patterns of construction and functional roles
Authors: Deeming D. Charles 
Published: July 2023

Nesting behaviour in mammals has been investigated in a wide variety of species but to date there has not been any scholarly review of the incidence and roles of these nests. Not all mammals build nests but, while some large species regularly build nests, nest-building behaviour is more commonly associated with small mammals weighing less than a kilogram. Quantitative data for the amounts of different materials used in a nest are rarely reported but mammal nests are typically constructed from fresh (rather than dead) plant materials. Animal-derived materials seem to be rare in nests, but anthropogenic materials are reported. Few studies have examined the roles these different materials play but more physically robust materials provide support for the structure. Many mammal nests have maternity roles, but a variety of other roles were recognized. A wide range of mammalian orders use nests for resting and environmental protection. Less common roles were as sites for torpor or hibernation, or as a refuge from predation, or the materials may have anti-parasite properties. These different roles were often not mutually exclusive. It is hoped that this review will stimulate interest in the functional properties of mammalian nests. It also suggests various themes that would be interesting areas for future research.
This article is part of the theme issue ‘The evolutionary ecology of nests: a cross-taxon approach’.
How sexual and natural selection interact and shape the evolution of nests and nesting behaviour in fishes
Authors: Svensson Ola , Kvarnemo Charlotta 
Published: July 2023

Among ray-finned fishes that provide parental care, many spawn in constructed nests, ranging from bowls, burrows and ridges to nests made of algae or bubbles. Because a nest by definition is a construction that enhances the nest-builder's fitness by helping it meet the needs of the developing offspring, nest-building behaviour is naturally selected, as is a preference for spawning with mates that provide well-built nests. However, nest-building behaviour can also be sexually selected, when nest traits increase mating success, protect against sperm competition or nest take-overs by conspecifics. Here, we offer a systematic review, with examples of how competition for sites and location of fish nests relates to sexual selection. We examine direct and indirect benefits of mate choice linked to nest traits, and different types of nests, from a sexual selection perspective. Nest-related behaviours are often under both natural and sexual selection, and we disentangle examples where that is the case, with special attention to females. We highlight some taxa in which nest building is likely to be sexually selected, but lack of research has left them uninvestigated. Some of them are established aquarium species, making them particularly amenable for future research. Finally, we compare with arthropods, amphibians and birds.This article is part of the theme issue ‘The evolutionary ecology of nests: a cross-taxon approach’.
Chthonic severance: dinosaur eggs of the Mesozoic, the significance of partially buried eggs and contact incubation precursors
Authors: Hogan Jason D. , Varricchio David J. 
Published: July 2023

For most dinosaurs, clutches consisted of a single layer of spherical to sub-spherical, highly porous eggs that were probably fully buried. Both eggs and clutch form change drastically with pennaraptoran theropods, the clade that includes birds. Here, far less porous, more elongate eggs are arranged with additional complexity, and only partially buried. While partial egg burial seems to be effective for an extremely small group of modern birds, the behaviour's overall rarity complicates our understanding of Mesozoic analogies. Recent experimental examination of pennaraptoran nesting thermodynamics suggests that partial egg burial, combined with contact incubation, may be more efficacious than has been presumed. We propose that nest guarding behaviour by endothermic archosaurs may have led to an indirect form of contact incubation using metabolic energy to affect temperature change in a buried clutch through a barrier of sediment, which in turn may have selected for shallower clutch burial to increasingly benefit from adult-generated energy until partial egg exposure. Once partially exposed, continued selection pressure may have aided a transition to fully subaerial eggs. This hypothesis connects the presence of partially buried dinosaurian clutches with the transition from basal, crocodile-like nesting (buried clutches guarded by adults) to the dominant avian habit of contact incubating fully exposed eggs.
This article is part of the theme issue ‘The evolutionary ecology of nests: a cross-taxon approach’.
Why do some bird species incorporate more anthropogenic materials into their nests than others?
Authors: Jagiello Zuzanna , Reynolds S. James , Nagy Jenő , Mainwaring Mark C. , Ibáñez-Álamo Juan D. 
Published: July 2023

Many bird species incorporate anthropogenic materials (e.g. sweet wrappers, cigarette butts and plastic strings) into their nests. Anthropogenic materials have become widely available as nesting materials in marine and terrestrial environments globally. These human-made objects can provide important benefits to birds such as serving as reliable signals to conspecifics or protecting against ectoparasites, but they can also incur fundamental survival and energetic costs via offspring entanglement and reduced insulative properties, respectively. From an ecological perspective, several hypotheses have been proposed to explain the use of anthropogenic nest materials (ANMs) by birds but no previous interspecific study has tried to identify the underlying mechanisms of this behaviour. In this study, we performed a systematic literature search and ran phylogenetically controlled comparative analyses to examine interspecific variation in the use of ANM and to examine the influence of several ecological and life-history traits. We found that sexual dimorphism and nest type significantly influenced the use of ANMs by birds providing support for the ‘signalling hypothesis’ that implies that ANMs reflect the quality of the nest builder. However, we found no support for the ‘age’ and ‘new location’ hypotheses, nor for a phylogenetic pattern in this behaviour, suggesting that it is widespread throughout birds.
This article is part of the theme issue ‘The evolutionary ecology of nests: a cross-taxon approach’.
Edge-based general linear models capture high-frequency fluctuations in attention
Authors: Jones Henry M. , Yoo Kwangsun , Chun Marvin M. , Rosenberg Monica D. 
Published: July 2023

AbstractAlthough we must prioritize the processing of task-relevant information to navigate life, our ability to do so fluctuates across time. Previous work has identified fMRI functional connectivity (FC) networks that predict an individual’s ability to sustain attention and vary with attentional state from one minute to the next. However, traditional dynamic FC approaches typically lack the temporal precision to capture moment-by-moment network fluctuations. Recently, researchers have ‘unfurled’ traditional FC matrices in ‘edge cofluctuation time series’ which measure time point-by-time point cofluctuations between regions. Here we apply event-based and parametric fMRI analyses to edge time series to capture high-frequency fluctuations in networks related to attention. In two independent fMRI datasets in which participants performed a sustained attention task, we identified a reliable set of edges that rapidly deflects in response to rare task events. Another set of edges varies with continuous fluctuations in attention and overlaps with a previously defined set of edges associated with individual differences in sustained attention. Demonstrating that edge-based analyses are not simply redundant with traditional regions-of-interest based approaches, up to one-third of reliably deflected edges were not predicted from univariate activity patterns alone. These results reveal the large potential in combining traditional fMRI analyses with edge time series to identify rapid reconfigurations in networks across the brain.
A microRNA-based Johne’s disease diagnostic predictive system: preliminary results
Authors: Capewell Paul , Lowe Arianne , Athanasiadou Spiridoula , Wilson David , Hanks Eve , Coultous Robert , Hutchings Michael , Palarea-Albaladejo Javier 
Published: July 2023

AbstractBackgroundJohne’s disease, caused byMycobacterium aviumsubsp.paratuberculosis(MAP), is a chronic enteritis impacting welfare and productivity in cattle. Screening and animal removal are common for disease management, but efforts are hindered by low diagnostic sensitivity. Expression levels of small non-coding RNA molecules involved in gene regulation (microRNAs) altered during mycobacterial infection may present an alternative diagnostic method.MethodsLevels of 24 microRNAs affected by mycobacterial infection were measured in sera from MAP-positive (n=66) and MAP-negative samples (n=65). They were used to train a collection of statistical and machine learning models to identify an optimal classifier for diagnosis.ResultsThe best-performing model provided 72% accuracy, 78% AUC, 73% sensitivity and 71% specificity on average.LimitationsAlthough control samples were collected from farms nominally MAP-free, low sensitivity in current diagnostics means animals may be misclassified.ConclusionMicroRNA profiling combined with advanced predictive modelling techniques accurately diagnosed Johne’s disease in cattle.