bluuebunny/crossref_metadata_2025_split huggingface dataset:
Saving the Life of a National Sport Organization With Strategy and Governance
Authors: Parent Milena M. 
Published: May 2022

Endurance Canada is facing a dire situation. It must turn itself around or face bankruptcy. The problems are piling up for Endurance Canada’s Board of Directors. Over the last 20 years, the Board’s Chair, Bill Fitzpatrick, has seen his sport’s athletes go from winning Olympic medals to not having any medals internationally. Within Endurance Canada, he has seen high staff turnover and burnout, power struggles between the national and provincial/territorial levels, and their revenues have been hit hard. COVID-19 was the proverbial nail in the coffin. Something drastic needs to happen. So, Bill brings in Amanda Tsang, a strategy expert. She has 1 month to come up with a plan to bring Endurance Canada back to life. The case follows Amanda as she reviews the strategy, structure, and governance issues in the organization. This fictional case asks students to (a) develop a strategic plan for Endurance Canada, (b) show how structure and strategy are interrelated, and (c) reflect on governance issues in a multilevel governance system.
Validation of Body-Worn Sensors for Gait Analysis During a 2-min Walk Test in Children
Authors: Shieh Vincent , Zampieri Cris , Sansare Ashwini , Collins John , Bulea Thomas C. , Jain Minal 
Published: May 2022

Introduction: Instrumented gait mat systems have been regarded as one of the gold standard methods for measuring spatiotemporal gait parameters. However, their portable walkways confine walking to a restricted area and limit the number of gait cycles collected. Wearable inertial sensors are a potential alternative that allow more natural walking behavior and have fewer space restrictions. The objective of this pilot study was to establish the concurrent validity of body-worn sensors against the portable walkway system in older children. Methods: Twenty-one participants (10 males) 7–17 years old performed 2-min walk tests at a self-selected and fast pace in a 25-m-long hallway, while wearing three inertial sensors. Data collection were synchronized between devices and the portions of the walk when subjects passed on the walkway were used to compare gait speed, stride length, gait cycle duration, cadence, and double support time. Regression models and Bland–Altman analysis were completed to determine agreement between systems for the selected gait parameters. Results: Gait speed, cadence, gait cycle duration, and stride length as measured by inertial sensors demonstrated strong agreement overall. Double support time was found to have lower validity due to a combined bias of age, height, weight, and walking pace. Conclusion: These results support the validity of wearable inertial sensors in measuring gait speed, cadence, gait cycle duration, and stride length in children 7 years old and above during a 2-min walking test. Future studies are warranted with a broader age range to thoroughly represent the pediatric population.
The butterfly effect: improving brain cone-beam CT image artifacts for stroke assessment using a novel dual-axis trajectory
Authors: Cancelliere Nicole Mariantonia , Hummel Eric , van Nijnatten Fred , van de Haar Peter , Withagen Paul , van Vlimmeren Marijke , Hallacoglu Bertan , Agid Ronit , Nicholson Patrick , Mendes Pereira Vitor 
Published: May 2022

BackgroundCone-beam computed tomography (CBCT) imaging of the brain can be performed in the angiography suite to support various neurovascular procedures. Relying on CBCT brain imaging solely, however, still lacks full diagnostic confidence due to the inferior image quality compared with CT and various imaging artifacts that persist even with modern CBCT.ObjectiveTo perform a detailed evaluation of image artifact improvement using a new CBCT protocol which implements a novel dual-axis ‘butterfly’ trajectory.MethodsOur study included 94 scans from 47 patients who received CBCT imaging for assessment of either ischemia or hemorrhage during a neurovascular procedure. Both a traditional uni-axis ‘circular’ and novel dual-axis ‘butterfly’ protocol were performed on each patient (same-patient control). Each brain scan was divided into six regions and scored out of 3 based on six artifacts originating from various physics-based and patient-based sources.ResultsThe dual-axis trajectory produces CBCT images with significantly fewer image artifacts than the traditional circular scan (whole brain average artifact score, AS: 0.20 vs 0.33), with the greatest improvement in bone beam hardening (AS: 0.13 vs 0.78) and cone-beam artifacts (AS: 0.04 vs 0.55).ConclusionsRecent developments in CBCT imaging protocols have significantly improved image artifacts, which has improved diagnostic confidence for stroke and supports a direct-to-angiography suite transfer approach for patients with acute ischemic stroke.
Travel time and distance for bypass and non-bypass routing of stroke patients in the USA
Authors: Yu Cathy Y , Panagos Peter D , Kansagra Akash P 
Published: May 2022

BackgroundEndovascular thrombectomy is not available at all hospitals that offer intravenous thrombolysis, prompting debate regarding the preferred transport destination for acute ischemic stroke. This study aimed to quantify real-world travel time and distance of bypass and non-bypass transport models for large-vessel occlusion (LVO) and non-LVO stroke.MethodsThis cross-sectional study included population data of census tracts in the contiguous USA from the 2014–2018 United States Census Bureau’s American Community Survey, stroke (thrombolysis-capable) and thrombectomy-capable centers certified by a state or national body, and road network data from a mapping service. Census tracts were categorized by urbanization level. Data were retrieved from March to November 2020. Travel times and distances were calculated for each census tract to each of the following: nearest stroke center (nearest), nearest thrombectomy-capable center (bypass), and nearest stroke center then to the nearest thrombectomy-capable center (transfer). Population-weighted median and IQR were calculated nationally and by urbanization.Results72 538 census tracts, 2388 stroke hospitals, and 371 thrombectomy-capable centers were included. Nationally, population-weighted median travel time for nearest and bypass routing was 11.7 min (IQR 7.7–19.3) and 26.4 min (14.8–55.1), respectively. For transfer routing, the population-weighted median travel times with 60 min, 90 min, and 120 min door-in-door-out times were 94.1 min (78.5–127.7), 124.1 min (108.5–157.7), and 154.1 min (138.4–187.6), respectively.ConclusionsBypass routing offers modest travel time benefits for LVO patients and incurs modest penalties for non-LVO patients. Differences are greatest in rural areas. A majority of Americans live in areas for which current guidelines recommend bypass.
Occupation, work-related contact and SARS-CoV-2 anti-nucleocapsid serological status: findings from the Virus Watch prospective cohort study
Authors: Beale Sarah , Patel Parth , Rodger Alison , Braithwaite Isobel , Byrne Thomas , Fong Wing Lam Erica , Fragaszy Ellen , Geismar Cyril , Kovar Jana , Navaratnam Annalan , Nguyen Vincent , Shrotri Madhumita , Aryee Anna , Aldridge Robert , Hayward Andrew 
Published: May 2022

ObjectivesRisk of SARS-CoV-2 infection varies across occupations; however, investigation into factors underlying differential risk is limited. We aimed to estimate the total effect of occupation on SARS-CoV-2 serological status, whether this is mediated by workplace close contact, and how exposure to poorly ventilated workplaces varied across occupations.MethodsWe used data from a subcohort (n=3775) of adults in the UK-based Virus Watch cohort study who were tested for SARS-CoV-2 anti-nucleocapsid antibodies (indicating natural infection). We used logistic decomposition to investigate the relationship between occupation, contact and seropositivity, and logistic regression to investigate exposure to poorly ventilated workplaces.ResultsSeropositivity was 17.1% among workers with daily close contact vs 10.0% for those with no work-related close contact. Compared with other professional occupations, healthcare, indoor trade/process/plant, leisure/personal service, and transport/mobile machine workers had elevated adjusted total odds of seropositivity (1.80 (1.03 to 3.14) − 2.46 (1.82 to 3.33)). Work-related contact accounted for a variable part of increased odds across occupations (1.04 (1.01 to 1.08) − 1.23 (1.09 to 1.40)). Occupations with raised odds of infection after accounting for work-related contact also had greater exposure to poorly ventilated workplaces.ConclusionsWork-related close contact appears to contribute to occupational variation in seropositivity. Reducing contact in workplaces is an important COVID-19 control measure.
Evaluating the role of transthoracic echocardiography in hospitalised patients with COVID-19 infection
Authors: Babu Aswin , Meng Zhaoyi , Eden Nadia , Lamb Daniel , Nouza Jan , Bhatia Raghav , Chis Ster Irina , Bennett Jonathan , Voon Victor 
Published: May 2022

ObjectiveTo identify the most common transthoracic echocardiogram (TTE) parameters in patients hospitalised with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) and their association with myocardial injury and outcomes.MethodsA retrospective, single-centre, observational, exploratory cohort study was performed at the height of the COVID-19 pandemic. All SARS-CoV-2 polymerase chain reaction (PCR) positive patients who underwent a TTE during their inpatient admission between 1 March 2020 and 31 October 2020 were analysed. The most frequent cardiovascular risk factor profile and echocardiographic features were investigated.ResultsA total of 87 patients met the eligibility criteria. A salient 41.4% (n=36) of our cohort succumbed to this devastating virus. More than half of our hospital population (58.6%) were admitted to the intensive care unit (ITU) and this was significantly associated with inpatient mortality (OR: 7.14, CI 2.53 to 20.19, p<0.001). Hypertension was the most common cardiovascular risk factor (51.7%) with no additional prominence in non-survivors (OR: 2.33, CI 0.97 to 5.61, p=0.059). Remarkably, 90.8% of our cohort demonstrated a preserved left ventricular ejection fraction, although 69.1% had elevated troponin levels. Only 1 patient (1.1%) was given a diagnostic label of myocarditis. A raised pulmonary artery systolic pressure (36.8%) andright ventricle (RV) dysfunction (26.4%) were the most common echocardiographic features. In particular, the presence of RV dysfunction was significantly related to adverse outcomes (OR: 2.97, CI 1.11 to 7.94, p<0.03).ConclusionsIn this cohort of extremely unwell patients hospitalised with COVID-19 pneumonitis, the presence of RV dysfunction or admission to ITU was significantly associated with inpatient case fatality ratio. Moreover, COVID-19-induced myocarditis remains extremely rare.
Clinical presentations leading to arrhythmogenic left ventricular cardiomyopathy
Authors: Graziosi Maddalena , Ditaranto Raffaello , Rapezzi Claudio , Pasquale Ferdinando , Lovato Luigi , Leone Ornella , Parisi Vanda , Potena Luciano , Ferrara Valentina , Minnucci Matteo , Caponetti Angelo Giuseppe , Chiti Chiara , Ferlini Alessandra , Gualandi Francesca , Rossi Cesare , Berardini Alessandra , Tini Giacomo , Bertini Matteo , Ziacchi Matteo , Biffi Mauro , Galie Nazzareno , Olivotto Iacopo , Biagini Elena 
Published: May 2022

ObjectivesTo describe a cohort of patients with arrhythmogenic left ventricular cardiomyopathy (ALVC), focusing on the spectrum of the clinical presentations.MethodsPatients were retrospectively evaluated between January 2012 and June 2020. Diagnosis was based on (1) ≥3 contiguous segments with subepicardial/midwall late gadolinium enhancement in the left ventricle (LV) at cardiac magnetic resonanceplusa likely pathogenic/pathogenic arrhythmogenic cardiomyopathy (AC) associated genetic mutationand/orfamilial history of ACand/orred flags for ALVC (ie, negative T waves in V4-6/aVL, low voltages in limb leads, right bundle branch block like ventricular tachycardia) or (2) pathology examination of explanted hearts or autoptic cases suffering sudden cardiac death (SCD). Significant right ventricular involvement was an exclusion criterion.ResultsFifty-two patients (63% males, age 45 years (31–53)) composed the study cohort. Twenty-one (41%) had normal echocardiogram, 13 (25%) a hypokinetic non-dilated cardiomyopathy (HNDC) and 17 (33%) a dilated cardiomyopathy (DCM). Of 47 tested patients, 29 (62%) were carriers of a pathogenic/likely pathogenic DNA variant. Clinical contexts leading to diagnosis were SCD in 3 (6%), ventricular arrhythmias in 15 (29%), chest pain in 8 (15%), heart failure in 6 (12%) and familial screening in 20 (38%). Thirty patients (57%) had previously received a diagnosis other than ALVC with a diagnostic delay of 6 years (IQR 1–7).ConclusionsALVC is hidden in different clinical scenarios with a phenotypic spectrum ranging from normal LV to HNDC and DCM. Ventricular arrhythmias, chest pain, heart failure and SCD are the main clinical presentations, being familial screening essential for the affected relatives’ identification.
Cardiac and obstetric outcomes in pregnant women with heart disease: appraisal of the 2018 mWHO classification
Authors: Ornaghi Sara , Bellante Nicolo' , Abbamondi Alessandra , Maini Marzia , Cesana Francesca , Trabucchi Margherita , Corsi Davide , Arosio Viola , Mariani Silvana , Scian Antonietta , Colciago Elisabetta , Lettino Maddalena , Vergani Patrizia 
Published: May 2022

ObjectiveTo appraise the application of the 2018 European Society of Cardiology-adapted modified WHO (mWHO) classification to pregnant women with heart disease managed at our maternal–fetal medicine referral centre and to assess whether the lack of a multidisciplinary Pregnancy Heart team has influenced their outcomes.MethodsA retrospective cohort study including all pregnancies with heart disease managed at our centre between June 2011 and December 2020. Cardiac conditions were categorised in five classes according to the mWHO classification. An additional class, named X, was created for conditions not included in this classification. Outcomes were compared among all classes and factors potentially associated to cardiac complications were assessed.ResultsWe identified 162 women with 197 pregnancies, for a prevalence of 0.7%. Thirty-eight (19.3%) gestations were included in class X. Caesarean section was performed in 64.9% pregnancies in class X, a rate similar to that of class II, II-III, and III/IV, and mostly for obstetric indications; in turn, it was more commonly performed for cardiology reasons in class II–III and III/IV. Cardiac complications occurred in 10.7%, with class X and II pregnancies showing the highest number of events (n=30.8% and 34.6%, respectively). Multiple gestation and urgent caesarean section associated with a 5-fold and 6.5-fold increase in complication rates.ConclusionsEven in a maternal–fetal medicine referral centre, the lack of a multidisciplinary team approach to women with heart disease may negatively impact their outcomes.
National examination for medical residency admission: academic performance in a high-stakes test and the need for continuing education
Authors: Gaxiola-García Miguel Angel , Villalpando-Casas José de Jesús , García-Minjares Manuel , Martínez-González Adrián 
Published: May 2022

Abstract

Introduction
Performance and selection rate of non-newly graduated physicians in a medical residency admission test as an indicator for the need of continuing education.

Methods
A database comprising 153 654 physicians who took a residency admission test in the period 2014–2018 was analysed. Performance and selection rates were assessed in relation to year of graduation and performance in medical school.

Results
The whole sample scored at a mean of 62.3 (SD ±8.9; range 1.11–91.11). Examinees who took the test in their year of graduation performed better (66.10) than those who took the test after their year of graduation (61.84); p&lt;0.001.
Selection rates differed accordingly; 33.9% for newly graduated physicians compared with 24.8% in those who took the test at least 1 year after graduation; p&lt;0.001. An association between selection test performance and medical school grades was established using Pearson’s correlation: r=0.40 for newly graduated physicians and r=0.30 for non-newly graduated physicians. There were statistically significant differences in selection rates for every ranking group of grades in medical school based on the χ2 test (p&lt;0.001). The selection rates are decreased years after graduation even for candidates with high grades in medical school.

Discussion
There is an association between performance in a medical residency admission test and academic variables of the candidates: medical school grades and time elapsed from graduation to test taking. The evidence of decrease in retention of medical knowledge since graduation highlights the pertinence of continuing education interventions.
Differential attainment in higher surgical training: scoping pan-specialty spectra
Authors: Luton Oliver William , Mellor Katie , Robinson David Bryan Thomas , Barber Zoe , James Osian Penri , Powell Arfon Gethyn Morgan Tregellis , Hemington-Gorse Sarah , Walsh Leona , Egan Richard John , Lewis Wyn Griffith 
Published: May 2022

Abstract

Introduction
This study aimed to evaluate differential attainment during higher surgical training (HST; all specialties) related to three ethnic cohorts: White UK (WUKG), Black and Minority Ethnic UK Graduates (BMEUKG), and International Medical Graduates (IMG).

Method
Anonymised records of 266 HSTs (126 WUKG, 65 BMEUKG, 75 IMG; 7 years) in a single UK Statutory Education Body were examined. Primary effect measures were Annual Record of Competency Progression Outcome (ARCPO) and Fellowship of the Royal College of Surgeons (FRCS) pass.

Results
ARCPOs related to ethnicity and specialty were similar with the exception of general surgery (GS) trainees, four of whom received ARCPO 4 (GS 4.9% (75% BME; p=0.025) vs all other 0%). ARCPO 3 was commoner in women (22/76, (28.9%) than men 27/190 (14.2%), OR 2.46, p=0.006). FRCS pass rates (WUKG vs BMEUKG vs IMG) were 76.9%, 52.9% and 53.9% respectively (p=0.064) but unrelated to gender (M 70.4% vs F 64.3%). On multivariable analyses: ARCPO 3 was associated with Female gender and Maternity Leave (OR 8.05, p=0.001); FRCS pass with ethnicity (OR 0.21, p=0.028) and Hirsch Indices of ≥5 (OR 11.17, p=0.001).

Conclusion
Differential attainment was plain with BMEUKG FRCS performance almost a third poorer than WUKG, and women twofold more likely to receive adverse ARCPOs, with return from statutory leave independently associated with training extension. Focused counter measures targeted at non-operative technical skills (including academic reach), Keeping in Touch, Return to Work, and re-induction programmed support are urgently needed for trainees at risk.

What is already known on the subject?

What this study adds

How this study might affect research, practice or policy
Variation in Cardiac Rehabilitation Participation During Aortic Valve Replacement Episodes of Care
Authors: Guduguntla Vinay , Yaser Jessica M. , Keteyian Steven J. , Pagani Francis D. , Likosky Donald S. , Sukul Devraj , Thompson Michael P. 
Published: May 2022

Background:
Despite reported benefit in the setting of aortic valve replacement (AVR), cardiac rehabilitation (CR) utilization remains low, with few studies evaluating hospital and patient-level variation in CR participation. We explored determinants of CR variability during AVR episodes of care: transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR).

Methods:
A cohort of 10 124 AVR episodes of care (TAVR n=5121 from 24 hospitals; SAVR n=5003 from 32 hospitals) were identified from the Michigan Value Collaborative statewide multipayer registry (2015–2019). CR enrollment was defined as the presence of a single professional or facility claim within 90 days of discharge: 93 797, 93 798, G0422, G0423. Annual trends and hospital variation in CR were described for TAVR, SAVR, and all AVR. Multilevel logistic regression was used to estimate effects of predictors and hospital risk-adjusted rates of CR enrollment.

Results:

Overall, 4027 (39.8%) patients enrolled in CR, with significant differences by treatment strategy: SAVR=50.9%, TAVR=28.9% (
P
<0.001). CR use after SAVR was significantly higher than after TAVR and increased over time for both modalities (
P
<0.001). There were significant differences in CR enrollment across age, gender, payer, and some comorbidities (
P
<0.05). At the hospital level, CR participation rates for all AVR varied 10-fold (4.8% to 68.7%) and were moderately correlated between SAVR and TAVR (Pearson
r
=0.56,
P
<0.01).

Conclusions:
Substantial variation exists in CR participation during AVR episodes of care across hospitals. However, within-hospital CR participation rates were significantly correlated across treatment strategies. These findings suggest that CR participation is the product of hospital-specific practice patterns. Identifying hospital practices associated with higher CR participation can help assist future quality improvement efforts to increase CR use after AVR.
On the Role of Memory Representations in Action Control: Neurophysiological Decoding Reveals the Reactivation of Integrated Stimulus–Response Feature Representations
Authors: Eggert Elena , Takacs Adam , Münchau Alexander , Beste Christian 
Published: May 2022

Abstract
Efficient response selection is essential to flexible, goal-directed behavior. Prominent theoretical frameworks such as the Theory of Event Coding and Binding and Retrieval in Action Control have provided insights regarding the dynamics of perception–action integration processes. According to Theory of Event Coding and Binding and Retrieval in Action Control, encoded representations of stimulus–response bindings influence later retrieval processes of these bindings. However, this concept still lacks conclusive empirical evidence. In the current study, we applied representational decoding to EEG data. On the behavioral level, the findings replicated binding effects that have been established in previous studies: The task performance was impaired when an event file had to be reconfigured. The EEG-decoding results showed that retrieval processes of stimulus–response bindings could be decoded using the representational content developed after the initial establishment of these stimulus–response bindings. We showed that stimulus-related properties became immediately reactivated when re-encountering the respective stimulus–response association. These reactivations were temporally stable. In contrast, representations of stimulus–response mappings revealed a transient pattern of activity and could not successfully be decoded directly after stimulus–response binding. Information detailing the bindings between stimuli and responses were also retrieved, but only after having been loaded into a memory system. The current study supports the notion that stimulus–response integration and memory processes are intertwined at multiple levels.