Dr. Lauren E Adlof

Background: Sudden cardiac death in young athletes is a rare and tragic occurrence. A pre-participation physical examination (PPE) is widely used to identify athletes who might be at risk of sudden cardiac death. High school athletes in Escambia, Okaloosa, Santa Rosa, and Walton counties in Florida undergo annual sports physicals through a local sports medicine outreach program. A resting electrocardiogram (ECG) was implemented during the 2022 PPE. The aim of this study was to document the efficacy of implementing ECGs and to highlight the cardiac abnormalities identified in young athletes as part of a 1-d PPE.
Methods: In total, 1,357 high school athletes (males = 879 and females = 478; age, 15.1 ± 1.3 years) completed a resting 12-lead ECG. These were interpreted by cardiologists using the International Criteria, with abnormal results being further investigated before final sports clearance. Descriptive statistics regarding ECG findings were analyzed.
Results: Twenty-three ECGs (1.7%) were classified as “abnormal” and were referred for further testing. Of these, 14 athletes were cleared to participate in sports, and 6 declined further evaluation. Three athletes, all males, were not cleared for sports participation. Of these, 2 athletes presented with Wolf-Parkinson-White syndrome (0.15%), and 1 athlete (0.10%) presented with dilated cardiomyopathy.
Conclusion: Adding ECG screening as part of a single-day PPE can be used as a tool in identifying cardiac abnormalities among young athletes. To our knowledge, this is the highest number of athletes screened during a PPE in 1 d nationwide.

BACKGROUND: There has been an evolution of athlete specific Electrocardiogram (EKG) criteria over the years, resulting in improved specificity and lower false positive rates, starting with the European Society of Cardiology 2005 guidelines and most recently with the current 2017 International Recommendations. The consistency of EKG interpretation with the 2017 International Criteria have been compared between various groups, including local and specialized center physicians. Whether novice EKG interpreters (undergraduate/graduate students) can be taught to accurately interpret athletes’ EKGs with the 2017 International Criteria has not been extensively studied. This study seeks to assess the accuracy and variability of novice EKG interpreters, compared to cardiologist interpretations and expert readers.
METHODS Three novice EKG interpreters (undergraduate exercise science students) were trained in interpreting EKGs of athletes with the 2017 International Criteria during one semester under the instruction of an expert reader. During an annual high school, sports screening day 1350 EKGs were collected and assigned a corresponding number. The on-site cardiologists evaluated the EKGs in real-time and classified as “normal” or “abnormal” according to the International Criteria. Following the sports physical day, three novice EKG interpreters (students), a cardiologist and a Clinical Exercise Physiology Professor (expert reader) were asked separately to classify the same EKGs as “normal or “abnormal” according to the International Criteria. All readers were blinded to the initial classifications made by the cardiologist during the sports physical event. Information regarding the athlete's age, gender, race/ethnicity, and sport was provided on the EKGs. We assessed the agreement between the cardiologist, expert reader and students in interpreting EKGs using Fleiss' kappa analysis.
RESULTS 1350 athlete EKGs (males = 879; females = 471, age (mean + SD) 15.09 + 1.3y) including 37 (2.7%) abnormal cases were reviewed. The inter-rater agreement between novice readers, expert reader, and physicians in classifying an EKG as abnormal was good (k = 0.7, p < .001).
CONCLUSION This study demonstrated that novice EKG readers could correctly classify EKGs based on the International Criteria as “normal and abnormal” to identify athletes at high risk of acute cardiovascular events

Background: Sudden cardiac death in young athletes is a rare and tragic occurrence. A preparticipation physical examination (PPE) is widely used to identify athletes who might be at risk of sudden cardiac death. High school athletes in Escambia, Okaloosa, Santa Rosa, and Walton counties in Florida undergo annual sports physicals through a local sports medicine outreach program. A resting electrocardiogram (ECG) was implemented during the 2022 PPE. The aim of this study was to document the efficacy of implementing ECGs and to highlight the cardiac abnormalities identified in young athletes as part of a 1-d PPE.
Methods: In total, 1,357 high school athletes (males = 879 and females = 478; age, 15.1 ± 1.3 years) completed a resting 12-lead ECG. These were interpreted by cardiologists using the International Criteria, with abnormal results being further investigated before final sports clearance. Descriptive statistics regarding ECG findings were analyzed.
Results: Twenty-three ECGs (1.7%) were classified as " abnormal " and were referred for further testing. Of these, 14 athletes were cleared to participate in sports, and 6 declined further evaluation. Three athletes, all males, were not cleared for sports participation. Of these, 2 athletes presented with Wolf-Parkinson-White syndrome (0.15%), and 1 athlete (0.10%) presented with dilated cardiomyopathy.
Conclusion: Adding ECG screening as part of a single-day PPE can be used as a tool in identifying cardiac abnormalities among young athletes. To our knowledge, this is the highest number of athletes screened during a PPE in 1 d nationwide.

ChatGPT, an artificial intelligence (AI) language model, holds significant promise for improving the quality and efficiency of teaching and learning. However, its potential challenges and disruptions in education systems require further investigation for a deeper understanding and mitigation. Given that ChatGPT is already being utilized and complete prohibition is unlikely, it becomes crucial to consider how educators can harness its potential to enhance teaching and learning experiences, assuming successful implementation. This article explores the potential benefits and disruptions within the current education system, and proposes strategies for integrating ChatGPT into educational settings from a constructivist learning perspective. It focuses on four educational system attributes: context, collaboration, conversation, and construction. The article particularly emphasizes the utilization of ChatGPT as a means, rather than an end, to enhance student learning within a constructivist learning environment. This approach aims to address present concerns and challenges effectively.