bluuebunny/crossref_metadata_2025 huggingface dataset:
SOUND IDENTITY
Authors: Sara Maganzini
Published: September 2024

The purpose of my Research is to explore why at the beginning of the XX° century wind orchestras in different Countries in Europe sounded so singular and why nowadays the sound is so similar one to the other.
Haven’t found any book which speaks about this specific topic I decided to research about the subject hoping it will maybe be useful or interesting not only for my development as conductor/musician but also to other people, be they conductors, composers, musicians or just wind orchestra music lovers.
Above historical issues I will also include some artistic material such as examples, audio samples and scores which support the development of my Research.
Special focus will be given to the analysis of a couple of significant original scores from the first decade of the XX° century which will be the guide line throughout my research.
The Effect of Mental Imagery in Daily Practice
Authors: Annoes van der Zande
Published: September 2024

This research is about how mental imagery exercises can be included in daily practice and what the effects are. The main question in this research is: How can mental training help me to practice more economically? Previous research showed different potential benefits of imagery exercises. The aim of this research is to collect and categorize different imagery exercises and to indicate if the exercises help to practice more economically.
From the forest to the concert hall
Authors: Anna Lachegyi
Published: September 2024

My aim for this research is to discover more about the equipment I use every day and to see if having a practical and technical knowledge about the viola da gamba bow and bow making in the 16-18th century in general will affect my playing and artistic decisions. In today’s practice, bows with a screw mechanism and white hair are the most common type used by viola da gamba players. Iconography and treatises show us that the screw system was not in use until the middle of the 18th century, and the choice of the type of wood, hair, or the shape and length of the bow is very diverse. As the main part of my research, I have spent a lot of time in a workshop, learning the process of bow making, with the result of three bows. This experiment helped me to explore which parts of the bow affect our playing the most, how the frog system or the tension relate to the articulation, and the quality of wood to the quality of the sound. Bow makers are artists who through their wood-working help the musicians to express their music.
In my presentation, after an overview of how the bow changed during the 16-18th century, I will describe my experience in the workshop with pictures and videos and finish with a demonstration of the bows I made.
Gestures and their role in restoring a singer’s performance-focus
Authors: Aimée Hautvast
Published: September 2024

Research question: How can the embodiment of gestures help me to increase my performance focus with the aim of eradicating meaningless gestures during singing, and is it possible to create a step-by-step study plan that incorporates my findings?

Abstract: The goal of this research was to find a solution to my problem that my gestures don’t always contribute to the lyric’s meaning when I’m singing. I was looking for a way to eradicate meaningless gestures. I carried out my research by examining the history of singing, scientific papers and articles regarding the connection between speech and gesture, and writings by experts in the field of acting, singing and body movement like Fajo Jansen, a body-movement teacher who helped help me analyse some of my old video recordings. I also used a questionnaire and created a study plan incorporating these findings, and recorded myself multiple times under the guidance of Fajo in order to test their efficacy. I discovered that a disruption in my performance-focus during singing was causing my gesticulation problems. By creating a deeper physical connection with a text’s meaning, I sought to re-establish and strengthen this focus, which I tested with my study plan for the embodiment of gestures. My work with Fajo showed that, next to this approach, another layer should be added: namely, the body should feel grounded and experience a feeling of flow in order to create free gestures which contribute to a text’s meaning. With Fajo, I concluded that by not only working on the embodiment of gestures but on the whole body as well, my gesticulation problem can be remedied more effectively.
BEL CANTO AND HÄNDEL: The evolution of bel canto throughout the history and its implementation into the interpretation of Italian operatic music for tenor composed by Georg Friedrich Händel
Authors: Carlos Negrín López
Published: September 2024

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The Joy of Practice. A Case study of Keren by I.Xenakis - The pursuit of happiness in our practice room
Authors: Georgios Kachrimanis
Published: September 2024

Name: Georgios Kachrimanis
Main Subject: Classical Trombone
Research Coach: Paul Scheepers
Title of Research: The Joy of Practice: A case study of Keren by Iannis Xenakis
Research Question:
How can I bring the joy back into my daily practice?
Summary of Results:
Every musician perceives “hard work” differently in their career or education. For me it was something like weight lifting training with the motto “No Pain, No Gain”. This was my idea about practicing music for more than 15 years. Besides the hard work I was also dealing with anxiety and the outcome was that I was not progressing in my practice and performance. I noticed that I was not enjoying myself anymore as I did as a young boy, but that I was ‘working’ the trombone instead of ‘playing’. When I was accepted for the masters program of the conservatoire I knew I had to change something about my way of practicing. So I came up with my main question for my master research “How can I bring the joy back into my daily practice?” In my research paper I am exploring the flow theory of Csikszentmihalyi and the use of awareness from book of The Inner Game of Music. According to the Csikszentmihalyi flow can help musicians to experience more joy and achieve better work satisfaction. In order to explore this theory and the use of awareness I used a case study, Keren by Iannis Xenakis. Because joy
and anxiety also got a lot to do with how you plan your practice and recovery I also made a practice plan. For this I used the information and planning techniques I got from Erja Joukamo-Ampuja, one of the speakers at the conference ‘From Potential to Performance’ in 2013. Putting all the information I gained during my research together, I came up with six conditions that I needed for my daily practice to be flow-like so I could gain some joy out of it: having a clear mind, a goal/outcome, good skill/challenge match, frequent feedback, physical/mental energy, relaxed concentration. During my presentation I will explain the concepts of flow, anxiety and joy in my daily practice and my case study.
Biography:
The Trombone came into Georgios’ life at the age of 15, although he had started playing music at the age of ten in his local fanfare band. Shortly thereafter he started
playing in the Athens Student orchestra. The first time he played music
professionally was at the age of 17, with the Radio Symphony Orchestra of Greece.
In 2002 he won his current position as principal trombone of the Athens Philharmonia and in 2003 finished his studies with a 10 and first prize. During the next 10 years Georgios won other auditions and played with all the major and minor orchestras in Greece, appearing as a soloist on a number of occasions.
Approaching jazz composition through the music of Billy Strayhorn
Authors: Leonie Freudenberger
Published: September 2024

Name: Leonie Freudenberger

Main Subject: Jazz Saxophone

Research Coach: Karst de Jong

Title of Research: Approaching jazz composition through the music of Billy Strayhorn

Research Question:
What are the most important elements of Billy Strayhorn's compositions?
How can I incorporate his compositional approach in my own writing?

Billy Strayhorn (1915–1976) was a jazz pianist, composer, arranger, orchestrator and lyricist whose works have influenced the genre of jazz music until today.
The research contains two phases: First, the analysis of his compositions.
Second, the attempt to compose originals using the detected stylistic, harmonic, melodic and conceptional tools.
Considering the enormous oeuvre that Strayhorn produced, it is inevitable to make a selection of songs to analyze. My criteria for this selection are the following:
Which songs have become part of the standard repertoire in jazz, performed by various artists throughout the 20th (and 21st) century?
Where can I find aural trademarks, which I recognize both as a listener and as a player and which contribute to my personal perception of the “Strayhorn sound”?
Can the compositions be reduced to a lead sheet and performed by a small jazz combo without losing their essence?
My final intention is not only to compose using Strayhorn-typical elements and tools, but also to write music for myself as a performer and for my group to play it.
On longer terms, I hope that I can abstract this method further on and profit from it beyond the results of this research.

Biography:
Leonie Freudenberger, born 1988 in Baden-Baden (D), has played the alto saxophone since her childhood. She started her professional jazz education at the University of Music in Mannheim in 2008 and came to Den Haag in 2011, where she finished her Bachelor's degree. Apart from her Master studies, she writes music and performs with her own group and takes part in various projects, playing alto and baritone saxophone.
Fast Notes!
Authors: Wouter Verschuren
Published: September 2024

The purpose of this research is to investigate the different ways of articulating fast passagework on the dulcian in repertoire spanning the period ca.1550 until ca.1700. Prior to 1787, when Etienne Ozi published his first edition of the Nouvelle Methode de Basson, there are no sources known that specifically discuss articulation or (double) tonguing on bass double reed instruments. When we perform music from this era, we are in the dark as how to articulate highly virtuosic passages. What is preferable: Two-by-two slurring? Slurs over more notes, or maybe the use of some kind of double tongue-stroke?
During this research I will focus on primary sources that deal with articulation on various non-reed wind instruments of the period in question, such as the recorder, the cornetto and the trumpet. By studying the indications and recommendations given by masters of the past we can deduce their musical intensions. When we accept these authors as our guides, they may be able to help us imagining what articulation on a double-reed instrument could sound like. The moment we envision this concept, we can start to translate their instructions into articulation on reed instruments.

The output is threefold:
1. A paper describing the different ways on how to articulate fast passagework on the dulcian and on the bassoon in a way that matches the souplesse and speed of non-reed instruments.
2. Two compositions written for the dulcian, with added articulation-markings by the author.
3. Video examples clarifying some musical examples.

With this project I hope to shed light on practical issues of the performance of highly virtuosic repertoire for dulcian and bassoon from the sixteenth and seventeenth century.
A Musicians’ View on Cooperating with Composers: The influence of composers on the performance practice
Authors: Martin van Hees
Published: September 2024

Name: Martin van Hees

Main Subject: Guitar

Research Coach: Patrick van Deurzen

Title of Research: A Musicians’ view on cooperating with composers

Research Question: What is the influence of a composer on the performance practice of a performer when playing the composers’ composition?

Research Process:
An introduction and short analysis of five compositions will be presented in the research process. A meeting with the composer will take place and issues regarding musical ideas and technical difficulties will be discussed.

Before meeting the composer a thorough analysis regarding the way of performing the composition will be made. All the important decisions, musically and technically will be mentioned. A sound recording of the composition will be made in this stage.
During the meeting with the composer the composition will be played, recorded and reviewed. There will be an interview held with questions regarding the composition and with questions regarding the opinion of the composer concerning the performance practice. After meeting the composer, an analysis of the interview will be made. A reconsideration of the interpretation of the composition will be made. The composition will be recorded again. A comprehensive analysis of the cooperation will be made and a conclusion will be drawn.
Summary of Results: Throughout the research I discovered that it is helpful to play the composers composition in advance to them, before actually performing it. When a performer has sincere affection with a certain composition it is worth to share this affection with its creator. A performer has to be aware that a composition is a changeable piece of art, so a composer can always change the performer his opinion on the piece, even if the performer disagrees, both parties should come to a common solution.
As regarding the changes that are made before and after the meeting with the composer, they are audible on the sound recordings at https://soundcloud.com/martinvanhees
The horn of Leutgeb and Mozart : investigation and experimentation
Authors: Nicolas Roudier
Published: September 2024

A lot of researches have been conducted on Mozart's work and how to play it, including by myself. Eventhough those works helped our comprehension of this music, we still don't know what particular horn did Leutgeb (the composer's hornist friend) play at the time ; and never have I ever encountered a practical experimentation on such an instrument yet. XVIIIth century horns are rare and never played : every recorded performance of Mozart’s music on hand-horn is played on a copy or a XIXth century horn, which is historically inaccurate. We know a lot of theory ; but no one has gone any further yet. My goal is to step in the unknown : first, to get as close as possible to the horn Leutgeb and Mozart knew ; then, find and play a historical horn from Mozart’s time, and see what impact it has on the playing and the music.
Document the Sound Projection of Aus Licht
Authors: Marko Uzunovski  , Arne Bock
Published: September 2024

This thesis is the outcome of the research component of our Masters’ study Aus Licht - Sound projection.

The aim of this research was to document the available information that would come to the fore while working with a group of experienced Stockhausen collaborators, each of them a specialist in sound reinforcement and sound system engineering.

This information is captured in three case studies that contextualise a set of keywords that were collected and defined during the 20 months of preparations and rehearsals (September 2017 to May 2019 in Licht aan Zee Studio in The Hague), as well as the concert period (May 2019 to June 2019 in De Gashouder in Amsterdam).

One case study was written collaboratively and two case studies were written individually by each of the sound projectionists involved in this research project. Each case study details one work or part of the whole program. The thesis is concluded by reflective statements by each of the collaborators.
Taking off the mask: embracing vulnerability on stage
Authors: Marlon Valk
Published: September 2024

Many musicians think that experiencing and showing vulnerability is a weakness. I see it differently. To share our music with the world, without any assurance of acceptance or appreciation, is to be vulnerable; to be real, to choose courage over comfort, to take off your mask, is vulnerability. The exposure and risk we face, are not optional. In my own musical journey, I discovered that I cannot escape vulnerability on stage. What if embracing our vulnerability is key to convincing, yet authentic performances?

This research is not about finding the magic solution for performance anxiety. It is not about avoiding vulnerability, but about embracing it. Embracing vulnerability starts with defining, recognizing and understanding it. That is exactly where this research started: a literature review was done and experts in the field of psychology were interviewed. This led to the design of strategies that can help embracing vulnerability when performing and when preparing a performance. These strategies are used in an intervention over 13 performances that have been documented with audio/video recordings, a journal and a self-questionnaire.

Results show that performance preparation is a crucial element in dealing with vulnerability. Also, embracing vulnerability led to more experiences of ‘flow’, enhanced focus and increased trust in my abilities to perform music. Besides, I felt more authentic as a performer. These findings, although subjective, provide insights and strategies that could be of great benefit to other musicians.
The Limits of Traverso; Exploring the sound possibilities of traverso through contemporary music
Authors: Dorota Matejova
Published: September 2024

In ‘early music’ performance today ΄sound΄ does not get as much attention as other expressive devices, even though the sound was an inseparable part of expression in music performance in 18th century.

This research attempts to explore the traverso and its expressive sound possibilities when placed in the field of contemporary music. The tonal capabilities of the traverso will be viewed from the perspectives of both 18th century sources and modern-day ΄early΄ and ΄classical music practice΄. The research considers what have sometimes been seen as the instrument´s “limitations” and "imperfections", asking how they could be positively exploited in contemporary music. At the same time, so-called ‘extended techniques ’for the modern flute are explored on the baroque flute, by a study and performance of two contemporary compositions for traverso solo. At the end, I will be looking at how this untraditional perception of traverso sound could open up our expressive imagination in performance of the traditional 18th century traverso repertoire.

The research hopes to bring some new inspirations for traverso players as well as other ΄early music΄ performers, and to clarify the distinctive role of sound as an expressive device in early instruments. It also hopes to inspire composers to write more contemporary acoustic music using the specific sonority of this instrument. The presentation will be given in the form of performance-lecture.
An Approach to Romantic cello playing in Brahms's time
Authors: María Cadenas Rodríguez
Published: September 2024

The revolution of sound recording at the beginning of the 20th century influenced classical performance practice, setting definitive interpretations and eradicating more personal approaches to music-making. Many fundamental expressive devices were lost over the years and thus Romantic musical performance was no longer understood in the same way. This is why my research tries to look backwards in time with the aim of exploring the main attributes of Brahms’s Romantic style in music for string instruments. My research aims to: (1) understand lost Romantic expressive devices and how they worked, and (2) explore ways of using them today. I first analysed primary and secondary literature to establish context. Then I examined historical edited cello scores by Brahms, using them to show the different fingerings and slurrings provided by the main cellists of the period, which give us a clear idea about the use of portamenti, for example. Finally I listened to cello and string quartet early recordings to hear sonic evidence of these techniques, before applying them in Brahms's chamber music for cello. The main outcome I found is that diverse and emotional approaches to music-making made the Romantic period unique. I hope these tools can encourage today’s cellists and string players in general to create new, more personal, freer and more creative approaches to playing Romantic repertoires.
How Do You Swing a Quarter Note? An Analysis of the Great Walking Bassists of the 1950s and 60s.
Authors: Steven Zwanink
Published: September 2024

Name: Steven Willem Zwanink

Main Subject: Jazz Double Bass Research Coach: Patrick Schenkius

Title of Research: How do you Swing a Quarter Note? An Analysis of the Great Walking Bassists of the 1950s and 60s.

Research Question: In theory, a bass player's walking quarter notes should not swing, as they are not syncopated like eighth notes are for example; syncopation being a necessary condition of what it is to swing, in that it allows for the long-short lilt that people identify with swing music. In practice however, it is evident that certain bassists are able to create a swing feeling, through a highly complex, and often idiosyncratic approach to quarter note placement within the 'big beat,' as well as to sound production and articulation. By using sonic visualization software such as Audacity, my goal is to shed light on the unique and often highly mysterious properties behind swinging bass lines: are there strategies in common between swinging bassists, or does each performer swing in their own inimitable way; do swinging bass lines rely on a temporal tension between bassist and drummer; and to what extent are the timbral properties of an instrument and the attack with which a string is engaged relevant?
Research Process:
My research process involves four phases: Firstly, selecting contrasting examples of swinging bass players from the 1950s and 1960s; secondly, studying selected examples using Audacity, creating a visual data set that will then be used to examine what the similarities and differences are between each bassist's approach to swinging quarter notes; thirdly, examining whether the push and pull of swinging quarter notes results from either tension or synchronicity between a bassist and a drummer, as well as what effect the tonal shape of the quarter notes the bassist plays, as related to timbre and attack, have on swing feel; and fourthly, examining my own instincts with regards to the spectrum and parameters of the various swinging quarter notes of each bassist studied.
Summary of Results: I have recently discovered in my own playing, that regardless of which drummer with whom I am playing, that my time feel needs to remain strong and unchangeable by what it is they are doing. This allows me to swing immediately and consistently on my own, or with whomever I am playing, provided the drummer is competent. All of this together answers my initial questions of: Do swinging bass lines rely on a temporal tension between bassist and drummer? No. Can the bassist swing his quarter notes all on his own? Yes. To what extent are the timbral properties of an instrument and the attack with which a string is engaged relevant? Extremely. In undertaking this study I have had the opportunity to think critically about a major parameter of jazz bass performance that is highly ephemeral and rarely quantified, though at the end of this project I now realize that that major parameter, while reliant on time, is actually sound and articulation.
From Potential To Performance. Training Practice and Performance Preparation in Conservatoires
Authors: Wieke Karsten (older account)  , Susan Williams
Published: September 2024

Faculty research at the Royal Conservatoire The Hague focuses on a wide range of topics relevant to the artistic practice of its teaching staff, to the artistic development of its students and to the world of musical practice at large. Areas covered include informed performance practice, creative (artistic) research, instrument building, educational research, and music theory. One strand within the faculty research programme is directed towards the enhancement of the learning, practice and performing strategies of instrumentalists and vocalists. Two projects within that strand – ‘Mental Training for Performers’ by Susan Williams, and ‘Making Music, Practising and the Brain’ by Wieke Karsten – formed the occasion and motivation to organise the international conference ‘From Potential to Performance: Training Performing Musicians in Conservatoriums’ at the Royal Conservatoire, 11-13 October 2013.
This publication collects knowledge, insights and practical recommendations addressed at the conference by an outstanding group of scholars and practitioners. Some contributions to this volume were published earlier as articles in their own right, some have been written for the occasion. Combined in this publication they offer a rich and thorough account of the state of the art in this emerging research field.
The study of the relationship between musical practice and the physical and mental condition of its practitioners goes back to ancient Greek, to Plato’s Politeia or Artistotle’s Politika, where music, body and mind were conceived of as constitutive of ethos, i.e. of character, behaviour and morality. And throughout history that relationship between music, body and mind was thematised in ever-different ways; from the proto music psychology of the Baroque Affektenlehre to the Musico- Medizin speculations of the early 20th century. Only in recent decades the study of ‘performance science’ has advanced to the level of a serious research programme, rooted in both artistic practice and in cutting-edge scholarly and scientific work, combining insights from sport science, neuro-psychology, brain science, pedagogy and musical practice.
The Royal Conservatoire does not only want to profit from this emerging field of research, but also aspires to contribute insights and experiences, embedded in its higher music education culture and embodied in the professionals who study and work here. With the publication of ‘From Potential to Performance’ we support the dissemination of knowledge and understanding, but we also show our commitment to the research programme and our readiness to be in front of the development. In doing so the Conservatoire manifests awareness that today’s higher music education is in constant need to refine and attune its programme to an ever-changing world.
The Performer Composer Relation
Authors: Joao Carlos Ferreira de Miranda Santos
Published: September 2024

This Research Investigates the musical relation Between Researcher and Performer in the 18th Century and its philosophical assumptions
"Accademia di Dame, Vienna 1697" by Susanne Abed-Navandi and Margit Legler
Authors: Susanne Abed-Navandi
Published: September 2024

The work presents selected parts of a women's academy in the form of a short film, which was originally performed once at the Viennese court in 1697. The video is the result of an interpretative approach based on the acting techniques of the period when this academy was created. The music harmonises with the movement, which, in turn, follows the affect of the text. The filmed scene was rehearsed by students, graduates and teachers of the Department of Early Music at the University of Music and Arts of the City of Vienna (MUK) as part of the course “Period Acting Techniques“ under the direction of Margit Legler. This work contributes to the visualisation and imaginability of this historical event, where five authors and singers presented speeches, poems and music they had composed themselves on a specific research question. In addition to the score of the selected parts, this publication includes a historical report on the creation of the academy, summarising the findings of a dissertation on music history dedicated to this event (Pumhösl 2014). It concludes with a personal reflection on how the performance of today's interpreters changes when they employ period acting techniques in speeches, recitatives and arias.
The Influence of Perceived Risk on the Performance of the Entrepreneur
Authors: Mohd Shahren Norfaezah , Ayob Mastura , Omar Siti Nazirah
Published: September 2024

The perception of risk has a substantial impact on the decision-making process and allocation of resources in entrepreneurship, which in turn affects business performance and the identification of strategic growth possibilities. Entrepreneurs frequently encounter situations characterized by uncertainty and ambiguity. Their perception of risk plays a crucial role in determining whether they adopt a cautious or proactive approach to decision-making. Perceiving a high level of risk might result in the adoption of conservative measures, which may restrict the allocation of funds toward growth projects. On the other hand, when entrepreneurs perceive a low level of risk, they are more likely to allocate resources aggressively, which allows them to pursue growth-oriented strategies. This study examines the impact of perceived risk on entrepreneurial performance by analyzing how risk perception influences decision-making and resource allocation. The results emphasize the significance of understanding perceived risk levels to improve business performance and boost employee motivation. Future research should conduct empirical investigations to examine the correlation between perceived risk and motivation, taking into account both inner and extrinsic elements to gain a thorough understanding of how they interact.
Rural-Urban Disparities in the Uptake of New Diabetes Medications
Authors: Zhu Benjamin , Ding Dong , Luo Jing , Glied Sherry
Published: September 2024

OBJECTIVE

This study assessed rural-urban differences in the uptake and use of glucagon-like peptide 1 (GLP-1) receptor agonists, dipeptidyl peptidase 4 (DPP-4) inhibitors, and sodium–glucose cotransporter 2 (SGLT2) inhibitors among U.S. adults with diabetes.

RESEARCH DESIGN AND METHODS

We calculated person-level annual total and out-of-pocket (OOP) expenditures for new, other, and all diabetes medications in the Medical Expenditure Panel Survey. We defined newer diabetes medications as GLP-1 receptor agonists, DPP-4 inhibitors, and SGLT2 inhibitors. The primary outcome was whether a person received a new diabetes medication during the year, and secondary outcomes were medication expenditures. The key independent variable was metropolitan statistical area (MSA) status. Logistic regression was used to estimate use rates of new diabetes medications by MSA status, and a two-part model was used to estimate individual-level annual total and OOP expenditures on new, other, and all diabetes medications.

RESULTS

We observed no significant difference (adjusted odds ratio 0.943, P = 0.37) in newer diabetes medication use. Individuals with diabetes in non-MSAs were more likely to have spending (probit coefficient 0.058, P = 0.06) and to spend more on other diabetes medications (combined marginal effect $103.13, P = 0.09), although this result was not statistically significant. This imbalance increased from $81.33 (P = 0.09) in 2003–2006 to $136.66 (P = 0.08) in 2017–2020.

CONCLUSIONS

Rural-urban diabetes outcome disparities are not likely to be the result of differences in the uptake of GLP-1 receptor agonist, DPP-4 inhibitor, and SGLT2 inhibitor medications.
Rural-Urban Disparities in the Uptake of New Diabetes Medications
Authors: Zhu Benjamin , Ding Dong , Luo Jing , Glied Sherry
Published: September 2024

Objective. This study assessed rural-urban differences in the uptake and use of glucagon-like peptide 1 (GLP-1) receptor agonists, dipeptidyl peptidase 4 (DPP-4) inhibitors, and sodium–glucose cotransporter 2 (SGLT2) inhibitors among U.S. adults with diabetes.

Research Design and Methods. We calculated person-level annual total and out-of-pocket (OOP) expenditures for new, other, and all diabetes medications in the Medical Expenditure Panel Survey. We defined newer diabetes medications as GLP-1 receptor agonists, DPP-4 inhibitors, and SGLT2 inhibitors. The primary outcome was whether a person received a new diabetes medication during the year, and secondary outcomes were medication expenditures. The key independent variable was metropolitan statistical area (MSA) status. Logistic regression was used to estimate use rates of new diabetes medications by MSA status, and a two-part model was used to estimate individual-level annual total and OOP expenditures on new, other, and all diabetes medications.

Results. We observed no significant difference (adjusted odds ratio 0.943, P = 0.37) in newer diabetes medication use. Individuals with diabetes in non-MSA areas were more likely to have spending (probit coefficient 0.058, P = 0.06) and to spend more on other diabetes medications (combined marginal effect $103.13, P = 0.09), although this result was not statistically significant. This imbalance increased from $81.33 (P = 0.09) in 2003–2006 to $136.66 (P = 0.08) in 2017–2020.

Conclusion. Rural-urban diabetes outcome disparities are not likely to be the result of differences in the uptake of GLP-1 receptor agonist, DPP-4 inhibitor, and SGLT2 inhibitor medications.
The Large Language Model GPT-4 Compared to Endocrinologist Responses on Initial Choice of Antidiabetic Medication Under Conditions of Clinical Uncertainty
Authors: H. Flory James , S. Ancker Jessica , Y. H. Kim Scott , Kuperman Gilad , Petrov Aleksandr , Vickers Andrew
Published: September 2024

Objective: To explore how the commercially available large language model (LLM) GPT-4 compares to endocrinologists when addressing medical questions when there is uncertainty regarding the best answer.

Research Design and Methods: This study compared responses from GPT-4 to responses from 31 endocrinologists using hypothetical clinical vignettes focused on diabetes, specifically examining the prescription of metformin versus alternative treatments. The primary outcome was the choice between metformin and other treatments.

Results: With a simple prompt, GPT-4 chose metformin in 12% (95% CI 7.9%–17%) of responses, compared to 31% (95% CI 23%–39%) of endocrinologist responses. After modifying the prompt to encourage metformin use, the selection of metformin by GPT-4 increased to 25% (95% CI 22%–28%). GPT-4 rarely selected metformin in patients with impaired kidney function, or a history of gastrointestinal distress (2.9% of responses, 95% CI 1.4%–5.5%). In contrast, endocrinologists often prescribed metformin even in patients with a history of gastrointestinal distress (21% of responses, 95% CI 12%–36%). GPT-4 responses showed low variability on repeated runs except at intermediate levels of kidney function.

Conclusions: In clinical scenarios with no single ‘right’ answer, GPT-4’s responses were reasonable, but differed from endocrinologists’ responses in clinically important ways. Value judgments are needed to determine when these differences should be addressed by adjusting the model. We recommend against reliance on LLM output until It is shown to align not just with clinical guidelines but also with patient and clinician preferences, or it demonstrates improvement in clinical outcomes over standard of care.
Metformin Improves Glycemic Control and Postprandial Metabolism and Enhances Postprandial Glucagon-like peptide 1 Secretion in Patients With Type 2 Diabetes and Heart Failure: A Randomized, Double-Blind, Placebo-Controlled Trial
Authors: Melenovský Vojtěch , Hošková Eva , Velebová Kateřina , Veleba Jiří , A. Borlaug Barry , Benes Jan , Kuda Ondřej , Čajka Tomáš , Segeťová Markéta , Thieme Lenka , Kopecký Jr. Jan , Kopecký, Sr. Jan , Pelikánová Terezie , Haluzík Martin , Hill Martin , Kahleová Hana
Published: September 2024

This randomized trial tested the effect of metformin on glycemic control and cardiac function in patients with heart failure (HF) and type 2 diabetes while evaluating intestinal effects on selected gut microbiome products reflected by trimethylamine-N-oxide (TMAO) and gut-derived incretins. Metformin treatment improved glycemic control and postprandial metabolism and enhanced postprandial glucagon-like peptide 1 (GLP-1) secretion but did not influence cardiac function or the TMAO levels. Metabolic effects of metformin in HF may be mediated by an improvement in intestinal endocrine function and enhanced secretion of the gut-derived incretin GLP-1.
Deep neck space infections of odontogenic origin are costly and preventable
Authors: Hellgren Christina , Hellgren Johan , Öhrnell Malekzadeh Behnosh
Published: September 2024

Objective: Deep neck space infections (DNSI), caused by the spread of an odontogenic infection to the floor of the mouth and neck, are potentially life-threatening but preventable. We explored the total cost of illness (COI) for patients with DNSI of odontogenic origin.
Material and methods: Cross-sectional, register-based, multi-centre study of the health economics of DNSI treatment. Included were patients aged > 18 years who were treated in hospital for DNSI of odontogenic origin. Subjects were identified from the regional healthcare database VEGA based on the International Classification of Diseases (ICD) codes and surgical procedure codes. The cost per patient (CPP) values for the hospital care, prescription medications and sick leave were extracted.
Results: In total, 148 patients were included. The average length of the hospital stay was 6 days. Total COI was estimated as 15,400 EUR per patient and 2,280,000 EUR in total. Direct costs accounted for 93% of the COI, and indirect costs were 7%.
Conclusion: The total COI for patients with DNSI of odontogenic origin was six-fold higher than the average COI for patients in otorhinolaryngology (ORL) care. Preventing DNSI will entail substantial cost savings for the specialised healthcare units and will have a significant impact on the patients.
Identification and Management of Dental Anxiety by New Zealand Dentists
Authors: Veerasamy Arthi , Morse Zac , Thomson William Murray
Published: September 2024

Objective

More than 1 in 8 New Zealand (NZ) adults are dentally anxious, which can lead to avoiding dental care and a higher risk of poor oral health. However, little is known about how dentally anxious patients are identified and managed by NZ general dentists. This survey aimed to investigate how NZ dentists identify and manage dentally anxious patients.

Methods

We conducted an email survey of NZ dentists in 2022, obtaining 212 responses. Along with demographic information, respondents were queried about whether they ask patients about past/current dental fears and their likely origin, how they assessed those fears, their usual management of dentally anxious patients, and how the management of dentally anxious patients could be improved.

Results

Almost three-quarters reported personally asking patients about past and/or current dental fears, and half enquired about bad life experiences that had led to those fears. Only 6 respondents (2.8%) reported using a formal dental anxiety/phobia assessment tool prior to treatment. For managing severely anxious adult dental patients, all dentists used at least 1 pharmacologic or psychological technique or referral to a colleague.

Conclusion

The study identified several weaknesses among NZ dentists in identifying and managing dental anxiety patients. The use of formal dental anxiety/phobia assessment tools prior to treatment needs improvement. Addressing dental anxiety is a complex issue that requires a multipronged approach involving improved education, the development and implementation of better assessment tools, and a greater understanding of how dentists’ current assessment and management of dental anxiety can be improved.
Efficacy of QuickSleeper Intraosseous Injection of 4% Articaine in Mandibular First Molars With Symptomatic Irreversible Pulpitis: A Randomized Controlled Trial
Authors: Vatankhah Mohammadreza , Dianat Omid , Zargar Nazanin , Bejestani Saeid Gharibian , Baghban Alireza Akbarzadeh , Shojaeian Shiva
Published: September 2024

Objective

To evaluate the anesthetic efficacy of 4% articaine with 1:100,000 epinephrine via primary intraosseous (IO) injection with the QuickSleeper device vs inferior alveolar nerve block (IANB) for mandibular first molars diagnosed with symptomatic irreversible pulpitis (SIP).

Methods

Sixty-four patients with a first mandibular molar with SIP were randomly divided into 2 groups: IO (n = 32) and IANB (n = 32). Each received either an IO injection with the 5th generation QuickSleeper device or a conventional IANB with 1.7 mL 4% articaine with 1:100,000 epinephrine. Success was defined as no/mild pain upon the access cavity preparation and initial filing. Injection pain, anesthetic onset, heart rate (HR) change, HR recovery time, and duration of anesthesia were also recorded and analyzed.

Results

The success rates were 40.6% for IANB and 81.2% for IO (P < .001). IO exhibited a significantly lower injection pain (P = .027), a shorter onset of action (P < .001), a greater heart rate increase (P < .001), a faster heart rate recovery time (P < .001), and a shorter duration of action (P < .001) vs IANB.

Conclusion

Primary IO anesthesia using the fifth generation of the QuickSleeper device was more successful than IANB when using 4% articaine with 1:100,000 epinephrine to anesthetize mandibular first molars with SIP. The QuickSleeper device appeared to be a viable alternative to IANB for mandibular anesthesia.
Model Pembelajaran Kooperatif Tipe Teams Games Tournament Berbantuan Media Papan Bilangan terhadap Kompetensi Pengetahuan Matematika
Authors: Ni Made Ari Setyawati  , Ida Bagus Gede Surya Abadi  , Gusti Ngurah Sastra Agustika
Published: September 2024

Pembelajaran matematika di sekolah dasar masih diannggap sulit oleh siswa. Siswa sulit memahami konsep matematika yang abstrak. Guru tidak menggunakan model ataupun media pembelajara yang sesuai dengan karakteristik siswa, sehingga hasil belajar siswa rendah. Maka dari itu dilakukan penelitian yang bertujuan untuk menganalisis model pembelajaran kooperatif tipe teams games tournament (TGT) berbantuan media papan bilangan terhadap kompetensi pengetahuan matematika pada siswa kelas. IV sekolah dasar. Jenis penelitian ini adalah penelitian eksperimen semu dengan ranangan penelitian non-equivalent control group design. Populasi dari penelitian ini adalah seluruh siswa kelas IV sebanyak 386 siswa. Teknik penentuan sampel yang digunakan adalah cluster random sampling yang memperoleh sebanyak 31 siswa sebagai kelas eksperimen dan sebanyak 30 siswa sebagai kelas kontrol. Metode pengumpulan data menggunakan tes berbentuk pilihan ganda. Data kompetensi pengetahuan matematika yang diperoleh dari hasil post-test dianalisis dengan teknik statistika deskriptif dan analisis statistika inferensial dengan rumus anakova. Hasil uji hipotesis menunjukkan bahwa terdapat perbedaan yang signifikan kompetensi pengetahuan matematika siswa yang dibelajarkan dengan menggunakan model pembelajaran Kooperatif tipe Teams Games Tournament berbantuan media Papan Bilangan dengan siswa yang tidak dibelajarkan menggunakan model pembelajaran Kooperatif tipe Teams Games Tournament berbantuan media Papan Bilangan. Implikasi penelitian ini yaitu peningkatan partisipasi siswa dalam mengikuti proses pembelajaran dan membangun keterampilan sosial seperti komunikasi, kepemimpinan, dan kerjasama.
Media Video Animasi untuk Meningkatan Hasil Belajar Siswa pada Pembelajaran IPAS Kelas IV Sekolah Dasar
Authors: Kadek Dian Indah Sari  , I Made Citra Wibawa  , Adrianus I Wayan Ilia Yuda Sukmana
Published: September 2024

Kurangnya media pembelajaran disekolah menyebabkan hasil belajar siswa menjadi rendah. Terlebih lagi media pembelajaran berbasis teknologi sangat jarang digunakan. Melihat hal terebut maka dilakukan penelitian pengembangan media pembelajaran berupa video animasi pada pembelajaran IPAS materi pengaruh gaya terhadap benda. Penelitian ini menggunakan model ADDIE (analyze, design, development, implementation, evaluation). Metode pengumpulan data yang digunakan yaitu observasi, wawancara, angket dan tes. Teknik analisis data yang digunakan yaitu analisis kualitatif dan kuantitatif. Subjek pada penelitian ini diantaranya ahli materi, ahli media, praktisi guru, dan siswa kelas IV sebanyak 32 siswa. Berdasarkan hasil validasi ahli materi memperoleh hasil kualifikasi sangat baik dan hasil validitas ahli media yang memperoleh hasil kualifikasi sangat baik. Hasil uji kepraktisan oleh respon guru dan siswa memperoleh kualifikasi sangat praktis Berdasarkan hasil uji keefektifan media video animasi menunjukkan adanya hasil yang signifikan pada peningkatan hasil belajar siswa kelas IV pada mata pelajaran IPAS sesudah mengikuti pembelajaran dengan menggunakan video animasi. Dengan demikian pengembangan media video animasi efektif digunakan sebagai media pembelajaran karena media video animasi dapat mempermudah guru dalam mentransfer ilmu pengetahuan kepada siswa, dapat meningkatkan motivasi siswa dan dapat meningkatkan hasil belajar siswa.
Model Pembelajaran Collaborative Creativity (CC) Berbantuan E-LKPD Terhadap Hasil Belajar IPAS Kelas V Sekolah Dasar
Authors: Kadek Eny Trisnayanthi  , I Nyoman Jampel  , Ni Wayan Rati
Published: September 2024

Masih banyak siswa memiliki hasil belajar IPAS yang rendah. Guru tidak menggunakan media maupun model pembelajaran yang inovatif dan bervariasi, dimana guru masih menggunakan media buku dalam menjelaskan materi pembelajaran kepada siswa, sehingga siswa tidak memiliki motivasi dalam mengikuti pembelajaran dan siswa cenderung cepat bosan. Melihat hal tersebut dilakukan penelitian yang bertujuan menganalisis pengaruh model pembelajaran Collaborative Creativity (CC) berbantuan E-LKPD terhadap hasil belajar IPAS kelas V. Jenis penelitian ini adalah penelitian eksperimen semu (quasi experiment) dengan desain nonequivalent post-test only control group. Populasi penelitian ini adalah seluruh siswa kelas V yang berjumlah 61 orang siswa. Sampel penelitian diperoleh secara simple random dengan cara diundi sehingga didapatkan sebanyak 15 orang sebagai kelas eksperimen dan sebanyak 14 orang sebagai kelas kontrol. Metode pengumpulan data dan instrument yang digunakan dalam penelitian ini yakni tes objektif hasil belajar IPAS. Hasil analisis menggunakan uji-t mendapat hasil bahwa terdapat perbedaan yang signifikan hasil belajar IPAS antara siswa yang menggunakan model Collaborative Creativity (CC) berbantuan E-LKPD. Sehingga dapat disimpulkan bahwa model Collaborative Creativity (CC) berbantuan E-LKPD layak digunakan dalam pembelajaran. Implikasi dari penelitian ini dapat menjadi gambaran terkait penggunaan model pembelajaran Collaborative Creativity Berbantuan Media E-LKPD yang dapat meningkatkan hasil belajar siswa sekolah dasar.
Media Accordion Book pada Muatan IPA Topik Mengenal Proses Fotosintesis untuk Siswa Kelas IV Sekolah Dasar
Authors: Ni Nyoman Indah Artadiningsih  , I Gede Margunayasa
Published: September 2024

Ketersediaan media pembelajaran yang ada di sekolah dasar kurang mencukupi khususnya pada muatan IPA topik mengenal proses fotosintesis siswa kelas IV SD. Penelitian ini memiliki tujuan untuk membuktikan kepraktisan media accordion book pada muatan IPA topik mengenal proses fotosintesis untuk siswa kelas IV SD yang teruji validitasnya. Jenis penelitian ini merupakan penelitian pengembangan. Pada penelitian ini menggunakan model ADDIE yang terdiri dari lima tahapan yaitu analisis, perancangan, pengembangan, implementasi, evaluasi. Penelitian ini hanya sampai pada tahap pengembangan. Subjek penelitian yakni para ahli, guru dan siswa yang berjumlah 10 orang. Metode serta instrumen yang digunakan yaitu lembar kuesioner. Teknik analisis data menggunakan analisis kuantitatif dan kualitatif.  Pengembangan media accordion book mendapat kualifikasi sangat baik dari ahli, respon guru dan siswa. Hal ini dapat disimpulkan bahwa media accordion book pada muatan IPA topik mengenal proses fotosintesis untuk siswa kelas IV SD valid serta dapat diaplikasikan dalam kegiatan belajar-mengajar sebagai sumber belajar. Implikasi penelitian ini diharapkan membantu guru dalam menyediakan media interaktif pada mata pelajaran IPA.