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Background: Four‐dimensional‐flow cardiac MR (4DF‐MR) offers advantages in primary mitral regurgitation. The relationship between 4DF‐MR‐derived mitral regurgitant volume (MR‐Rvol) and the post‐operative left ventricular (LV) reverse remodeling has not yet been established. Purpose: To ascertain if the 4DF‐MR‐derived MR‐Rvol correlates with the LV reverse remodeling in primary mitral regurgitation. Study Type: Prospective, single‐center, two arm, interventional vs. nonintervention observational study. Population: Forty‐four patients (male N = 30; median age 68 [59–75]) with at least moderate primary mitral regurgitation; either awaiting mitral valve surgery (repair [MVr], replacement [MVR]) or undergoing "watchful waiting" (WW). Field Strength/Sequence: 5 T/Balanced steady‐state free precession (bSSFP) sequence/Phase contrast imaging/Multishot echo‐planar imaging pulse sequence (five shots). Assessment: Patients underwent transthoracic echocardiography (TTE), phase‐contrast MR (PMRI), 4DF‐MR and 6‐minute walk test (6MWT) at baseline, and a follow‐up PMRI and 6MWT at 6 months. MR‐Rvol was quantified by PMRI, 4DF‐MR, and TTE by one observer. The pre‐operative MR‐Rvol was correlated with the post‐operative decrease in the LV end‐diastolic volume index (LVEDVi). Statistical Tests: Included Student t‐test/Mann–Whitney test/Fisher's exact test, Bland–Altman plots, linear regression analysis and receiver operating characteristic curves. Statistical significance was defined as P < 0.05. Results: While Bland–Altman plots demonstrated similar bias between all the modalities, the limits of agreement were narrower between 4DF‐MR and PMRI (bias 15; limits of agreement −36 mL to 65 mL), than between 4DF‐MR and TTE (bias −8; limits of agreement −106 mL to 90 mL) and PMRI and TTE (bias −23; limits of agreement −105 mL to 59 mL). Linear regression analysis demonstrated a significant association between the MR‐Rvol and the post‐operative decrease in the LVEDVi, when the MR‐Rvol was quantified by PMRI and 4DF‐MR, but not by TTE (P = 0.73). 4DF‐MR demonstrated the best diagnostic performance for reduction in the post‐operative LVEDVi with the largest area under the curve (4DF‐MR 0.83; vs. PMRI 0.78; and TTE 0.51; P = 0.89). Data Conclusion: This study demonstrates the potential clinical utility of 4DF‐MR in the assessment of primary mitral regurgitation. Evidence Level: 2 Technical Efficacy: Stage 5 [ABSTRACT FROM AUTHOR]

This article explores a facet of the relationship between trade marks and the criminal law in the UK in the interwar era, a pivotal period of transition in UK economic policy from free trade to a more managed economy. Drawing together insights from legal, business and economic history, we show that, in the interwar years, the context of domestic politics and wider international trade policy, produced a greater focus on the relationship between trade marks and market-place understandings of the national origin of manufactured products. This context included the passage of the Merchandise Marks Act 1926, a criminal law statute that stipulated the circumstances in which imported goods were to be marked with an indication of national origin, and included a criminal offence regulating trade marks enforced by prosecutions brought by the Board of Trade. We argue that the criminal law regulating trade marks became entwined with 'soft' trade policy, i.e. a means of protecting the domestic/Empire market falling short of tariff protection. Drawing on substantial original archival research, we explore the problems that confronted the Board of Trade when it enforced the 1926 Act in view of market realities. [ABSTRACT FROM AUTHOR]

The article discusses the need for surveillance of vaccine hesitancy in the U.S. Topics include ways a vaccine hesitancy surveillance systems can effectively direct interventions to address vaccine efficiency, factors that influenced vaccine hesitancy, and recommendation of the U.S. Vaccine Advisory Committee (NVAC) to implement vaccine hesitancy surveillance systems.

The worldwide elimination of measles and rubella is feasible, but not without overcoming the substantial challenge of vaccine hesitancy. This challenge is complicated by the spread of misinformation and disinformation fueled by rapidly progressing technologies and evolving forms of online communication. The recent COVID-19 pandemic has only added further complexity to this challenge. However, considerable progress has been made in understanding the scope of the problem and the complex factors that influence vaccine hesitancy. Our understanding of evidence-based strategies for addressing vaccine hesitancy has grown significantly, including evidence for effective communication and behavioral interventions. In this article, we review measles and rubella vaccines and vaccine hesitancy. We then provide an overview of evidence-based strategies for addressing vaccine hesitancy, including communication strategies and behavioral interventions. This article is relevant to healthcare professionals, health system leaders, public health professionals, policymakers, community leaders, and any individuals who have a role in addressing vaccine hesitancy in their communities. Finally, we review future directions and major areas of research need. [ABSTRACT FROM AUTHOR]