bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac Magnetic Resonance Imaging–Derived Left Atrial Characteristics in Relation to Atrial Fibrillation Detection in Patients With an Implantable Cardioverter‐Defibrillator
Authors: Hopman Luuk H. G. A. , van der Lingen Anne‐Lotte C. J. , van Pouderoijen Nikki , Krabbenborg Judith , Mulder Mark J. , Rijnierse Mischa T. , Bhagirath Pranav , Robbers Lourens F. H. J. , van Rossum Albert C. , van Halm Vokko P. , Götte Marco J. W. , Allaart Cornelis P. 
Published: July 2023

Background
Among patients with an implantable cardioverter‐defibrillator, a high prevalence of atrial fibrillation (AF) is present. Identification of AF predictors in this patient group is of clinical importance to initiate appropriate preventive therapeutic measures to reduce the risk of AF‐related complications. This study assesses whether cardiac magnetic resonance imaging–derived atrial characteristics are associated with AF development in patients with a dual‐chamber implantable cardioverter‐defibrillator or cardiac resynchronization therapy defibrillator, as detected by the cardiac implantable electronic device.

Methods and Results
This single‐center retrospective study included 233 patients without documented AF history at the moment of device implantation (dual‐chamber implantable cardioverter‐defibrillator [63.5%] or cardiac resynchronization therapy defibrillator [36.5%]). All patients underwent cardiac magnetic resonance imaging before device implantation. Cardiac magnetic resonance–derived features of left atrial (LA) remodeling were evaluated in all patients. Detection of AF episodes was based on cardiac implantable electronic device interrogation. During a median follow‐up of 6.1 years, a newly diagnosed AF episode was detected in 88 of the 233 (37.8%) patients with an ICD. In these patients, increased LA volumes and impaired LA function (LA emptying fraction and LA strain) were found as compared with patients without AF during follow‐up. However, a significant association was only found in patients with dilated cardiomyopathy and not in patients with ischemic cardiomyopathy.

Conclusions
LA remodeling characteristics were associated with development of AF in patients with dilated cardiomyopathy but not patients with ischemic cardiomyopathy, suggesting different mechanisms of AF development in ischemic cardiomyopathy and dilated cardiomyopathy. Assessment of LA remodeling before device implantation might identify high‐risk patients for AF.
Using Polygenic Risk Scores for Prioritizing Individuals at Greatest Need of a Cardiovascular Disease Risk Assessment
Authors: Chung Ryan , Xu Zhe , Arnold Matthew , Ip Samantha , Harrison Hannah , Barrett Jessica , Pennells Lisa , Kim Lois G. , Di Angelantonio Emanuele , Paige Ellie , Ritchie Scott C. , Inouye Michael , Usher‐Smith Juliet A. , Wood Angela M. 
Published: July 2023

Background
The aim of this study was to provide quantitative evidence of the use of polygenic risk scores for systematically identifying individuals for invitation for full formal cardiovascular disease (CVD) risk assessment.

Methods and Results
A total of 108 685 participants aged 40 to 69 years, with measured biomarkers, linked primary care records, and genetic data in UK Biobank were used for model derivation and population health modeling. Prioritization tools using age, polygenic risk scores for coronary artery disease and stroke, and conventional risk factors for CVD available within longitudinal primary care records were derived using sex‐specific Cox models. We modeled the implications of initiating guideline‐recommended statin therapy after prioritizing individuals for invitation to a formal CVD risk assessment. If primary care records were used to prioritize individuals for formal risk assessment using age‐ and sex‐specific thresholds corresponding to 5% false‐negative rates, then the numbers of men and women needed to be screened to prevent 1 CVD event are 149 and 280, respectively. In contrast, adding polygenic risk scores to both prioritization and formal assessments, and selecting thresholds to capture the same number of events, resulted in a number needed to screen of 116 for men and 180 for women.

Conclusions
Using both polygenic risk scores and primary care records to prioritize individuals at highest risk of a CVD event for a formal CVD risk assessment can efficiently prioritize those who need interventions the most than using primary care records alone. This could lead to better allocation of resources by reducing the number of risk assessments in primary care while still preventing the same number of CVD events.
Clonal Hematopoiesis of Indeterminate Potential From a Heart Failure Specialist's Point of View
Authors: Sikking Maurits A. , Stroeks Sophie L. V. M. , Waring Olivia J. , Henkens Michiel T. H. M. , Riksen Niels P. , Hoischen Alexander , Heymans Stephane R. B. , Verdonschot Job A. J. 
Published: July 2023

ABSTRACT
Clonal hematopoiesis of indeterminate potential (CHIP) is a common bone marrow abnormality induced by age‐related DNA mutations, which give rise to proinflammatory immune cells. These immune cells exacerbate atherosclerotic cardiovascular disease and may induce or accelerate heart failure. The mechanisms involved are complex but point toward a central role for proinflammatory macrophages and an inflammasome‐dependent immune response (IL‐1 [interleukin‐1] and IL‐6 [interleukin‐6]) in the atherosclerotic plaque or directly in the myocardium. Intracardiac inflammation may decrease cardiac function and induce cardiac fibrosis, even in the absence of atherosclerotic cardiovascular disease. The pathophysiology and consequences of CHIP may differ among implicated genes as well as subgroups of patients with heart failure, based on cause (ischemic versus nonischemic) and ejection fraction (reduced ejection fraction versus preserved ejection fraction). Evidence is accumulating that CHIP is associated with cardiovascular mortality in ischemic and nonischemic heart failure with reduced ejection fraction and involved in the development of heart failure with preserved ejection fraction. CHIP and corresponding inflammatory pathways provide a highly potent therapeutic target. Randomized controlled trials in patients with well‐phenotyped heart failure, where readily available anti‐inflammatory therapies are used to intervene with clonal hematopoiesis, may pave the way for a new area of heart failure treatment. The first clinical trials that target CHIP are already registered.
Compensation and Staffing Challenges in Child Care: Statewide Evidence from Pandemic Relief Applications
Authors: Hall Todd , Fares Isabelle , Markowitz Anna J. , Miller-Bains Kate , Bassok Daphna 
Published: July 2023

Abstract
Child care teachers support young children's learning and development and parents’ ability to work. However, they earn far less and turn over at far higher rates than K–12 teachers. COVID-19 exacerbated staffing challenges, and the child care workforce was 5.9 percent smaller in January 2023 than in January 2020. While low compensation likely drives turnover in early childhood education, there is relatively little large-scale evidence on the link between compensation and staffing challenges. We summarize the limited pre-pandemic evidence and use pandemic-era data from 90 percent of publicly funded child care centers in Louisiana to describe the relationship between sites’ compensation and staffing challenges. In October 2022, 15 percent of centers’ lead teacher positions were unfilled—nearly quadruple the 4 percent national vacancy rate for public school teachers. Of centers with any vacancies or hires in the past six months, 65 percent turned families away and 84 percent hired less-experienced or -qualified teachers than desired due to staffing challenges. Centers with higher wages were significantly less likely to report staffing challenges, turn families away, and hire less-experienced teachers, after controlling for center characteristics and region. Our findings and prior evidence suggest that wage increases are promising for stabilizing the child care workforce.
Exploring Regulatory Interplay in the Health Internet of Everything: Digital Health Technologies, Data Protection and Cybersecurity
Authors: Gerybaite Aiste 
Published: July 2023

Abstract
Against the backdrop of interconnected devices, people, and processes in the Internet of Everything (IoE) an examination of the MDR (Regulation (EU) 2017/745 of the European Parliament and of the Council of 5 April 2017 on medical devices, amending Directive 2001/83/EC, Regulation (EC) No 178/2002 and Regulation (EC) No 1223/2009 and repealing Council Directives 90/385/EEC and 93/42/EE), data protection and cybersecurity rules are carried out with respect to medical devices’ privacy and security. The legal analysis therefore investigates how and to what extent the MDR could cope with the copious challenges of cybersecurity and data protection in the IoE of medical devices. The article sheds light on how the MDR sets a minimal standard of requirements for medical device safety and security. In this respect, an unexpected and complicated regulatory interplay is discussed providing for a well-coordinated approach for digital health technologies. Finally, the article discusses several key points of the proposed EU AI Regulation considering digital health technologies.
The anti-inflammatory and haemodynamic effects of levosimendan on advanced heart failure patients: a meta-analysis of published studies
Authors: Zhou Suzhen , Li Denghua , Zhang Lieliang , Li Juxiang 
Published: July 2023

Objective Increasing evidence from randomized controlled trials shows the anti-inflammatory and haemodynamic effects of levosimendan in advanced heart failure (AdHF), however, conflicting results have been reported in some studies. The aim of this study was to estimate the anti-inflammatory and haemodynamic effects of levosimendan on AdHF (registration number: INPLASY202250097). Methods The MEDLINE, PubMed, ClinicalTrials.com and Cochrane Library databases were systematically searched for studies published in English up to April 2019. Data were extracted from applicable articles. Meta-analyses were performed to assess interleukin (IL)-6, cardiac index, pulmonary artery pressure (PAP) and New York Heart Association (NYHA) functional class efficacy outcomes, following PRISMA 2020 guidelines. Results A total of 11 studies were included (211 patients who received levosimendan and 193 controls). Meta-analyses showed that the levosimendan group displayed significantly reduced IL-6 (standardized mean difference [SMD] −1.05; 95% confidence interval [CI] −1.44, −0.66; I2 = 50.9%), improved cardiac index (SMD 0.59; 95% CI 0.29, 0.88; I2 = 0.0%); reduced PAP (SMD −1.22; 95% CI −1.91, −0.53; I2 = 89.7%) and improved NYHA functional class (SMD −1.66; 95% CI −2.27, −1.04; I2 = 74.6%) versus controls. Conclusions Levosimendan infusion was beneficial in patients with AdHF, displayed by anti-inflammatory and improved haemodynamic effects, and improved NYHA functional class.
Where is the Care? Identifying the Impact of Rurality on SLP Caseloads and Treatment Decisions for Children with Cleft Palate
Authors: Mason Kazlin N. , Kotlarek Katelyn J. 
Published: July 2023

Challenges providing cleft/craniofacial care in rural communities are often reported, leading to disparities in resources available to clinicians. The purpose of this study was to identify the impact of rurality on caseloads and practice patterns of speech-language pathologists (SLPs) regarding speech and velopharyngeal function for children with cleft lip and/or palate (CL/P). A national, survey of US-based SLPs (N = 359 respondents) investigated resources, comfort level, caseloads, and practice patterns for children with CL/P. Sub-county classifications that delineated levels of rurality were utilized. Descriptive statistics and chi-square analyses were conducted to determine the impact of population density on assessment and referral decisions. Nearly 83% of SLPs reported providing care for a child with CL/P and 41.4% of these SLPs reported five or more children with CL/P on caseload throughout their career. There were no significant differences in rurality of practice setting and the likelihood of treating a child with CL/P. Significant differences were present between rural, town, suburban, and metropolitan-based SLPs regarding available resources ( p = 0.035). SLPs in rural settings reported feeling uncomfortable treating children with CL/P compared to those in metropolitan settings ( p = 0.02). Distance to the cleft/craniofacial team and comfort levels impacted referral decisions. Most SLPs report having children with CL/P on caseload regardless of practice location. Rurality impacted assessment and referral decisions, especially surrounding access to resources and comfort levels engaging in team care. Findings have implications for developing support systems and reducing barriers for rural SLPs working with children born with CL/P.
Hypersensitivity reactions to anticancer chemotherapy and monoclonal antibodies: Safety and efficacy of desensitization
Authors: Villarreal-González Rosalaura V , González-Díaz Sandra , Vidal-Gutiérrez Oscar , Cruz-de la Cruz Carlos de la , Pérez-Ibave Diana C , Garza-Rodríguez María L 
Published: July 2023

Background Hypersensitivity reactions to anticancer chemotherapy and monoclonal antibodies may lead to discontinuation of first-line treatment options. Identification of these reactions can provide specific diagnosis and treatment by rapid drug desensitizations. Objective To determine the hypersensitivity reactions involved in anticancer chemotherapy and monoclonal antibodies, and the safety and efficacy of rapid drug desensitization. Methods We conducted an observational study of hypersensitivity reaction presented after the administration of anticancer chemotherapy and monoclonal antibodies in Mexico. We documented the symptoms of initial reaction and their severity, and the results of skin tests. We also report our experience of the administration of 12-step (mild-moderate reactions) and 16-step (severe reactions) desensitization protocols in these patients. Results Overall, 93 patients received 336 rapid drug desensitization; 105 to taxanes, 115 to platinum drugs, 101 to monoclonal antibodies, and 15 other anticancer chemotherapy. Hypersensitivity reaction to taxanes occurred in the first or second administration, platinum drugs after the sixth cycle, and rituximab in the first cycle. The most common symptom in carboplatin was urticaria, paclitaxel back pain, oxaliplatin and docetaxel dyspnea, and in the monoclonal antibodies cardiovascular symptoms. Skin tests were positive in 75% of the carboplatin group, and only 16.7% in docetaxel. There was a rapid drug desensitization success rate of 99.4% and 85.7% did not present any related hypersensitivity reaction. Conclusion The diagnosis of hypersensitivity reaction to anticancer chemotherapy and monoclonal antibodies offers a panorama in the management of oncological diseases. Our standardized desensitization protocol is safe and effective and can be reproduced in other centers to treat patients who need to maintain first-line treatment.
More than rugby: A scoping review of coaches in rugby
Authors: Paul Lara , Davidow Demi , Stodter Anna , Till Kevin , Dane Kathryn , Jones Ben , Hendricks Sharief 
Published: July 2023

Introduction It is well-recognised that fulfilling the role of a coach is multi-faceted. In rugby, some of these coaching facets have been studied, however the research has not been reviewed. Reviewing the literature on rugby coaches will inform and guide policies, coach education, research and practice. Therefore, the purpose of this study is to provide a scoping review of the current coach focused literature on rugby union, rugby league and rugby sevens. Methods A scoping review was conducted on five electronic databases (EBSCOhost, PubMed, Scopus, SPORTDiscus, Web of Science) until January 2022 using the PRISMA-ScR guidelines. Participants had to be coaches within rugby union, sevens and league to be included. Data were extracted and analyzed to form a numerical and thematic summary. Results 105 articles were included. 76% of the studies were on rugby union, 14% on league, 1% on sevens and the remainder focused on a combination of rugby cohorts or did not specify. Three themes were identified via a thematic analysis based on the content of the articles, these were coach knowledge (68%), coach pedagogies (29%), and coach development (4%). Conclusion The main finding in this review is that research on rugby coaches understood the risk, prevention, and management of injuries. Educational resources should include all aspects of rugby play or training injuries. The importance of the athlete-coach relationship and coach reflective practices was another significant finding. Coaches are encouraged to have a broad understanding of various aspects related to the player's welfare, which can be developed using formal and/or nonformal learning.
Uncertainty as Ignorance? Governing Futures of Education
Authors: Sobe Noah W. 
Published: July 2023

Purpose At what point does a humble and/or realistic acknowledgment of unknowing tip over into ignorance-making of a misleading or dangerous sort? This article tackles this question by examining invocations of “uncertainty” that circulate in educational futures literature. Design/Approach/Methods Through a critical reading of a selected set of education futures publications from leading global actors (e.g., OECD and UNESCO) it aims to unpack the ways that certainty/uncertainty govern the future by installing norms and disabling certain possibilities while enabling others. Findings The paper finds that not-knowing plays an important role in education futures work, with significant consequences that demand thoughtful, critical analysis of each concrete situation. Originality/Value Calculating certainty and taming chance has had a long (if checkered) career in educational planning. This is well recognized in the literature. However, less attention has been paid to “calculations of uncertainty,” specifically to the ontologies of indeterminacy that are generated through educational planning and policy that pretends to account for what is “known” and “unknown” about the future—which is the intellectual project of this article.
Cardiovascular health profiles in adolescents being born term or preterm—results from the EVA-Tyrol study
Authors: Hochmayr Christoph , Ndayisaba Jean-Pierre , Gande Nina , Staudt Anna , Bernar Benoit , Stock Katharina , Kiechl Sophia J. , Geiger Ralf , Griesmaier Elke , Knoflach Michael , Kiechl-Kohlendorfer Ursula ,   Early Vascular Ageing (EVA) Study Group, Asare Mandy , Bock-Bartl Manuela , Bohl Maximilian , Schreiner Christina , Brössner Gregor , Heisinger Tatjana , Klingenschmid Julia , Kothmayer Martina , Marxer Julia , Pechlaner Raimund , Pircher Maximilian , Reiter Carmen , Kiechl Stefan , Winder Bernhard 
Published: July 2023

Abstract
Background and aims
Preterm birth has been linked with an increased risk of cardiovascular (CV) disease from childhood into adolescence and early adulthood. In this study, we aimed to investigate differences in CV health profiles between former term- and preterm-born infants in a cohort of Tyrolean adolescents.

Methods
The Early Vascular Aging (EVA)-Tyrol study is a population-based non-randomized controlled trial, which prospectively enrolled 14- to 19-year-old adolescents in North Tyrol, Austria and South Tyrol, Italy between 2015 and 2018. Metrics of CV health (body mass index (BMI), systolic (SBP) and diastolic blood pressure (DBP), smoking, physical activity, dietary patterns, total cholesterol and fasting blood glucose) were assessed and compared between former term- and preterm-born girls and boys.

Results
In total, 1,491 study participants (59.5% female, mean age 16.5 years) were included in the present analysis. SBP and DBP were significantly higher in former preterm-born adolescents (mean gestational age 34.6 ± 2.4 weeks) compared to term-born controls (p < 0.01). In the multivariate regression analysis these findings remained significant after adjustment for potential confounders in all models. No differences were found in all other CV health metrics. The number of participants meeting criteria for all seven health metrics to be in an ideal range was generally very low with 1.5% in former term born vs. 0.9% in former preterm born adolescents (p = 0.583).

Conclusions
Preterm birth is associated with elevated SBP and DBP in adolescence, which was even confirmed for former late preterm-born adolescents in our cohort. Our findings underscore the importance of promoting healthy lifestyles in former term- as well as preterm-born adolescents. In addition, we advise early screening for hypertension and long-term follow-up in the group of preterm-born individuals.
Effect of mini-course training in communication and teamwork on non-technical skills score in emergency residents: a prospective experimental study
Authors: Sanguanwit Pitsucha , Kulrotwichit Thanet , Tienpratarn Welawat , Athinartrattanapong Natsinee , Trainarongsakul Thavinee , Angkoontassaneeyarat Chuenruthai 
Published: July 2023

Abstract
Background
Non-technical skill (NTS) teaching is a recent development in medical education that should be applied in medical education, especially in medical specialties that involve critically ill patients, resuscitation, and management, to promote patient safety and improve quality of care. Our study aimed to compare the effects of mini-course training in NTS versus usual practice among emergency residents.

Methods
In this prospective (non-randomized) experimental study, emergency residents in the 2021–2022 academic year at Ramathibodi Hospital, a tertiary care university hospital, were included as participants. They were categorized into groups depending on whether they underwent a two-hour mini-course training on NTS (intervention group) or usual practice (control group). Each participant was assigned a mean NTS score obtained by averaging their scores on communication and teamwork skills given by two independent staff. The outcome was the NTS score before and after intervention at 2 weeks and 16 weeks.

Results
A total of 41 emergency residents were enrolled, with 31 participants in the intervention group and 10 in the control group. The primary outcome, mean total NTS score after 2 weeks and 16 weeks, was shown to be significantly better in intervention groups than control groups (25.85 ± 2.06 vs. 22.30 ± 2.23; P < 0.01, 28.29 ± 2.20 vs. 23.85 ± 2.33; P < 0.01) although the mean total NTS score did not differ between the groups in pre-intervention period. In addition, each week the NTS score of each group increased 0.15 points (95% CI: 0.01–0.28, P = 0.03), although the intervention group showed greater increases than the control (0.24 points) after adjustment for time (95% CI: 0.08–0.39, P < 0.01).

Conclusion
Emergency residents who took an NTS mini-course showed improved mean NTS scores in communication and teamwork skills versus controls 2 weeks and 16 weeks after the training. Attention should be paid to implementing NTS in the curricula for training emergency residents.

Trial registration
This trial was retrospectively registered in the Thai Clinical Trial Registry on 29/11/2022. The TCTR identification number is TCTR20221129006.