bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of a Circuit Training Program on Myokine Levels in Insulin‐Resistant Women: A Randomised Controlled Trial
Authors: Karolkiewicz Joanna , Krzywicka Monika , Szulińska Monika , Musialik Katarzyna , Musiałowska Dominka , Zieliński Jacek , Bilska Agnieszka , Ratajczak Marzena 
Published: November 2024

Introduction: Circuit training is a form of body conditioning with endurance and resistance components. Given the function of skeletal muscle as an endocrine organ secreting various myokines involved in maintaining glucose metabolism homeostasis, our study focused on estimating the impact of the implemented training program on the direction of changes in myokines such as interleukin (IL)‐6, IL‐10, fibroblast growth factor 21 (FGF21), and irisin in women newly diagnosed with insulin resistance.Methods: This prospective controlled trial randomly divided 42 women into two groups. The training group performed circuit training combining strength (50%–80% of one‐repetition maximum) and endurance (50%–75% of heart rate reserve) exercises for 3 months, three 33‐min sessions weekly. Exercises were performed on five weight and two cardio machines. The control nontraining group did not change their previous activity. Body composition indicators and IL‐6, IL‐10, FGF21, and irisin levels were measured before and after the intervention. The data for 27 patients were analysed using two‐way repeated measures analyses of variance.Results: The pattern of change in serum IL‐6 levels over time differed significantly between the groups (p < 0.05). The patterns of change did not differ significantly between groups for IL‐10, FGF21, and irisin.Conclusion: The circuit training program implemented in women newly diagnosed with insulin resistance significantly increased their serum IL‐6 and not their IL‐10, FGF21, and irisin levels.Trial Registration: ClinicalTrials.gov: NCT04528693
From a Position of Privilege: Descendants of the Prophet Muḥammad in Ottoman Syria as Stakeholders in Nineteenth-century Reform Processes
Authors: Henning Barbara 
Published: November 2024

Abstract
Drawing on the examples of taxation, military service and the composition of provincial institutions, this contribution examines the impact of Ottoman administrative reforms on the descendants of the Prophet Muḥammad and their representatives in Ottoman Syria during the second half of the nineteenth century, making use of Ottoman-imperial archival sources to trace strategies they pursued in their attempts to navigate changes and maintain former status and privileges. While Ottoman policies towards greater centralization and bureaucratization posed considerable challenges to the sociopolitical position of the descendants of the Prophet, sources suggest that they did not always reject changes outright but entered into negotiations with the Ottoman authorities to obtain exceptions, hold on to privileges, and secure their participation in the newly emerging constellations of power. Their case thus sheds light on changing administrative networks and opportunity structures in Ottoman Syria, highlighting the importance of processes of mediation.
The missing middle service gap: Obtaining a consensus definition of the ‘Missing Middle’ in youth mental health
Authors: Menssink Jana M , Gao Caroline X , Zbukvic Isabel , Prober Sophie , Kakkos Athina , Watson Alice , Cotton Sue M , Filia Kate M 
Published: November 2024

Objective: As highlighted in Australia’s Productivity Commission Inquiry into mental health, subgroups of individuals are failing to have their needs met, or are ‘falling through the cracks’ in the current system – a phenomenon increasingly referred to as the ‘missing middle’. A barrier to devising solutions is that the term ‘missing middle’ is not clearly defined. Using the Delphi method, we aimed to define the term and explore acceptability. Method: Three expert groups were recruited: carers and young people with a lived experience of mental ill-health; clinicians and service providers; researchers, policymakers and commissioners of mental health services. Using a three-stage Delphi process, we elicited definitions, refined and developed a consensus definition. Results: Ten subthemes describing the ‘missing middle’ were identified, with four endorsed across all expert groups from the outset: service gap, inflexibility, inadequate service quality and duration, and social disadvantage. Additional subthemes were later endorsed. Feedback was sought on a consensus-driven definition that encompassed the original four endorsed subthemes. Findings supported a shift to a systemic focus – framing the ‘missing middle’ as a care gap. Conclusions: A consensus definition was developed, repositioning the term to a systems lens, describing a ‘missing middle service gap’. The definition represents the ‘missing middle’ as a term to describe a gap in care where existing mental health services are not meeting the needs of individuals in a meaningful way. Research was carried out in relation to youth mental health in Australia and the definition may need to be adapted for other contexts.
Nexus Between Political Concentration, Fractionalisation, Fiscal Federalism and Human Development: A State-wise Analysis
Authors: Jadhav Vivek , Mukherjee Shrabani 
Published: November 2024

This article examines the link between development outcomes and both political concentration and religious polarisation, analysing how the state’s decision-making process operates within the framework of fiscal federalism, with a focus on the Indian states. To evaluate the effects of religious diversity, coalition governments and political concentration on human development, composite indices such as the ‘fractionalisation index’ and ‘polarisation index’ have been constructed. A dynamic panel-data model is applied to explore the causal relationship between political concentration and development outcomes. The results demonstrate a significant inverse relationship between religious polarisation, diversity and human development, along with a notable influence of political concentration on human development. JEL Codes: D72, O53, Z12, O15
Enhancing the Teaching of Radical Political Economy Through Multimedia Integration: A Pedagogical Framework
Authors: Sarangi Swayamsiddha 
Published: November 2024

This article addresses the evolving challenges in teaching radical political economy in contemporary economics curricula, where traditional Marxist perspectives are increasingly marginalized. I propose a pedagogical framework centered on multimedia integration to revitalize the teaching of topics in radical political economy. Through an exploration of popular movies and documentaries, this article elucidates how innovative approaches can be used to engage students and foster critical thinking. By leveraging multimedia resources, educators can effectively convey Marxian concepts, provoke meaningful discussions, and inspire students to critically examine economic systems and envision alternative socioeconomic models. JEL Classification: A22, B51
Tapping into User Effort? Improving Referral Outcomes in Crowdfunding Markets
Authors: Jiang Yang , Tan Yong , Chen Xi 
Published: November 2024

Referral programs have received increasing attention as a way to enhance project fundraising in crowdfunding. To improve operational efficiency and performance, many crowdfunding platforms allow users to exert more effort (referral effort) when making referrals. In this paper, we study the impact of users’ referral efforts on referral outcomes, using a unique data set from a reward-based crowdfunding platform. We analyze three types of referral effort beyond merely sharing the referral link, namely, writing the referral message, matching the referral recipients’ pledges, and supporting their own referrals. Our results suggest that users’ referral efforts can help improve the outcome of referrals, as these efforts may be perceived as positive signals of quality, thus reducing referral recipients’ uncertainty about the crowdfunding project. We further explore the heterogeneity in this observed impact, and find that matching recipients’ pledges have a greater impact than the other two types of referral effort. Furthermore, the impact of referral effort is attenuated under conditions of low uncertainty, wherein project quality can be inferred from observable features, such as projects launched by large creators, selected by editors, or referred by experienced backers. Our analyses also indicate that referring users’ efforts can collectively improve the fundraising performance of projects that receive referrals. We discuss the implications of our findings for platform managers, policy makers, and users in crowdfunding marketplaces.
Voluntary self-disclosed Indigenous identity of patients in four Canadian health care settings: A multiple-site qualitative case study
Authors: Gray Mandi , Wessel Samara , Oster Richard T , Bruno Grant , Healy Chyloe , Rich Rebecca , Scott Claringbold Shayla , Williams Kienan , Henderson Rita 
Published: November 2024

Objectives The lack of Indigenous health care data in Canada makes it challenging to plan health care services and inform Indigenous leadership on the health care needs of their respective Nations and communities. Several Canadian health care organizations have implemented a voluntary Indigenous identifier of patients within their electronic medical records. This study examines facilitators and barriers to implementing such a voluntary self-reported Indigenous identifier, from the perspective of key stakeholders who work at four Canadian health providers where an Indigenous identifier has been implemented. Methods The four Canadian sites comprise three hospitals and one health authority. At each site, key stakeholders participated in semi-structured qualitative interviews. Interviews were transcribed and coded. Relevant documents that were publicly available or provided by each site were reviewed. Results There were four primary findings. First, for the introduction of an Indigenous identifier to be successful there must be pre-existing strong and trusting relationships between Indigenous communities and health care organizations. Second, health care organizations must provide training for those who ask clientele to self-identify as Indigenous, to overcome issues such as any patient backlash. Third, for the relationship between Indigenous people and health organizations to flourish, data governance must be Indigenous-led. Finally, the collection of Indigenous identifier data can enhance Indigenous health care services and health care service planning and delivery. Conclusions Due to the ongoing distrust of government and health care services among Indigenous peoples and communities, special considerations are required prior to the implementation of an Indigenous identifier. Of primary importance is how health care organizations can contribute to Indigenous data governance and minimize potential harms associated with the collection of such data. The findings of this study can be used to guide other health care sites and Indigenous leaders aspiring for more robust health data by implementing voluntary Indigenous identity data collection.
Exploring the effectiveness and experiences of people living with dementia interacting with digital interventions: A mixed methods systematic review
Authors: Ditton Annabel , Alodan Hissah , Fox Christopher , Evans Shirley , Cross Jane 
Published: November 2024

Background: As dementia care evolves, digital interventions are being developed to improve the quality of life of people living with dementia. It is also increasingly recognised that some people living with dementia can use and benefit from using digital interventions themselves. Therefore, exploring the effectiveness and experiences of using such interventions is essential to optimise digital intervention development and delivery. Method: 5 databases were searched (MEDLINE (Ovid), PsycINFO, EMBASE, CINAHL and Web of Science) for papers reporting effectiveness outcomes or experiences, involving people living with dementia or mild cognitive impairment engaging with digital interventions for improving their quality of life. 73 relevant papers published between 2018–2023 were identified, 59 included effectiveness data and 18 included data on experiences. Results: The integration of evidence identified that people living with dementia can benefit from engaging in digital interventions, if they are motivated, and provided with tailored training, support, appropriate devices and content. Benefits were seen within the domains of cognition, health and well-being and social relationships. Benefits were more frequent when digital interventions were provided in the home environment with specified daily/weekly usage requirements. Conclusion: This review provides an overview of the current state of research exploring engagement of digital interventions by people with dementia for improving their quality of life. The findings provide guidance on how to optimise the method of delivery. Future research should explore how digital interventions can improve social relationships and self-concept of people living with dementia, the long-term sustainability of digital interventions, and how individuals with dementia form attitudes towards technology.
Computational study on aerodynamic noise reduction of high-speed train bogie region using leading edge jet of the bogie cavity
Authors: Shi Jiawei , Zhang Jiye , Li Tian 
Published: November 2024

This study employs a numerical approach that combines compressible detached eddy simulation (DES) with the Ffowcs Williams-Hawkings (FW-H) equation to investigate the potential of employing a slot jet at the leading edge of the bogie cavity for reducing bogie aerodynamic noise. The simulation is conducted on a 1:8 scale shortened train model, and two jet fluxes are considered. The permeable surface formula of the FW-H equation is adopted for far-field noise calculation to account for the scattering and shielding effects of the vehicle body and track structures, as well as the quadrupole source contribution. The results reveal that the slot jet induces a notable lifting effect on the shear layer formed at the leading edge of the bogie cavity, consequently reducing the impact of the shear vortex structures on the lower part of the bogie and the rear wall of the bogie cavity. However, as the shear vortex structures are guided towards the track, their interactions with the track structures are intensified. Due to the slow attenuation of the turbulent wake of the bogie region, it is difficult to avoid the spurious sound sources (hydrodynamic pressure fluctuations) induced by the wake passing through the integral surface by merely adjusting the position of downstream integral surface, while the end cap averaging technology can effectively filter out these spurious sources. The introduction of the jet primarily reduces the far-field noise below 1600 Hz of the bogie region, with higher jet velocity resulting in improved noise reduction effects.
The Application of Continuous Glucose Monitoring Endpoints in Clinical Research: Analysis of Trends and Review of Challenges
Authors: Bevan Andrew , Ellis Graham , Eskandarian Mona , Garrisi Davide 
Published: November 2024

Introduction: Considerable efforts to standardize continuous glucose monitoring (CGM) have occurred in recent years. The aim was to perform an analysis of clinical studies in clinicaltrials.gov to evaluate trends in CGM endpoint adoption. Methods: Clinicaltrials.gov was searched for studies of drugs, devices and combination products containing CGM terms posted from 2012 to 2023. 1269 studies were returned and 954 were excluded. 315 studies were divided into two periods (P1 [2012–2017] and P2 [2018–2023]) and differences analyzed using descriptive statistics and two-tailed t tests. Results: There was a significant 60.3% increase in total clinical studies from P1 (121) to P2 (194). Phase 2 and Phase 3 Studies both saw significant increases of 125.8 and 169.2%, respectively, in P2. Adult-only studies predominated in both periods, with a 40.4% increase in P2. Studies that included pediatric populations, although smaller in number, increased significantly. Most studies were nonindustry-funded, and studies in this category saw a significant 80.0% increase in P2. However, industry-only funded studies also increased significantly by 78.4% in P2 in the same period. Studies of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) increased by 55.8% and 26.9%, respectively, but increases were not statistically significant. Studies of nondiabetes-related indications did increase significantly (233.3%). 27.6% of studies used CGM-derived metrics as primary endpoints (PE). Studies that used time in range (TIR) increased by 222.4% in P2, which was significant. Conversely studies that used mean amplitude of glycemic excursions (MAGE) decreased significantly by 71.3%. Conclusion: Our data provide evidence of significant increases in the application of CGM endpoints in clinical studies in the last six years, including studies with TIR as the PE. Increases have been driven largely by academia, but our data show that industry is starting to follow suit. The significant increase in studies that included pediatrics is encouraging.
Interdisciplinary approach to patients with psoriatic arthritis: a prospective, single-center cohort study
Authors: Gross Georg , Lull Christian , von Ahnen Jan Alwin , Blauth Mara , Schwaan Johanna , Olsavszky Victor , Schmieder Astrid , Leipe Jan 
Published: November 2024

Background: Psoriatic arthritis (PsA) is a chronic systemic inflammatory disease that affects up to 30% of patients with psoriasis. Diagnosis and treatment could be improved by implementing an interdisciplinary dermatological-rheumatological consultation (IDRC). Objectives: This study aimed to assess the effect of a face-to-face IDRC involving both a dermatologist and a rheumatologist evaluating patients in a single visit, on disease activity and burden in patients with PsA. Design: Prospective, single-center, cohort study. Methods: 202 patients with psoriasis were enrolled, among whom 115 individuals with psoriasis and musculoskeletal symptoms underwent an IDRC. Disease manifestations, comorbidities, and both objective and subjective disease activity scores were evaluated. Results: Out of the participants, 56 were diagnosed with definite PsA, while the remaining 146 had psoriasis. Nail involvement was associated with axial PsA (odds ratio 4.11; 95% CI 1.22–13.82; p = 0.02). Patients with PsA often experienced a prolonged time to diagnosis (mean 187 weeks) and had a significant psychosocial burden (mean Hospital Anxiety and Depression Index Scale [HADS]-Anxiety score of 7.66 and mean HADS-Depression score of 5.63). Post-IDRC, both objective and subjective disease parameters showed improvement, and patients required less time for consultations with healthcare professionals compared to before the IDRC. Conclusion: These findings suggest that an IDRC approach could effectively expedite and optimize the diagnosis and treatment of patients with psoriasis and musculoskeletal symptoms.
Effect of composite resins with and without fiber-reinforcement on the fracture resistance of teeth with non-carious cervical lesions
Authors: Hazar Ahmet , Hazar Ecehan 
Published: November 2024

Objective: Non-carious cervical lesions (NCCLs) are commonly observed in clinical dentistry, leading to tooth fractures, sensitivity, and compromised pulp vitality. Therefore, their restoration is essential for both the aesthetic and structural integrity of teeth. This study aimed to compare the fracture resistance of NCCLs restored using different materials: an injectable universal composite, flowable bulk-fill composites with or without fiber-reinforcement. Methods: Seventy-five double-rooted maxillary premolars were selected for the study. Fifteen teeth were left intact as a control. A wedge-shaped cavity was prepared in the cervical region of the remaining sixty teeth, which were then divided into four groups ( n = 15): unrestored, restored with an injectable composite, restored with a flowable bulk-fill composite (SDR® flow+), and restored with a flowable short-fiber-reinforced composite (everX Flow™). All teeth underwent fracture testing under oblique static loading at a 30° angle using a universal testing machine. Fracture patterns were classified as repairable, possibly repairable, or unrepairable. Data were analyzed using one-way analysis of variance, Pearson chi-square, and Tukey HSD post hoc tests ( p = 0.05). Results: Intact teeth exhibited the highest fracture resistance (743.481 N), while unrestored teeth showed the lowest (371.49 N) ( p < 0.001). There was no significant difference in fracture resistance between the injectable composite (553.289 N) and SDR® flow+ (497.368 N) ( p = 0.055). The everX Flow™ group displayed significantly higher fracture resistance (673.787 N) ( p < 0.001) and a repairability rate of 60% within the restored groups. Unrestored (60%), injectable composite (53.3%), and SDR® flow+ (53.3%) groups were mostly unrepairable. Conclusion: The everX Flow™ demonstrated improved fracture resistance and favorable fracture pattern for maxillary premolars with wedge-shaped NCCLs.
Effectiveness of sorafenib in treating intermediate-stage hepatocellular carcinoma patients refractory to transarterial chemoembolization
Authors: Ashour Reham , Rewisha Eman , Rady Mohamed AKL , Elkhadry Sally Waheed , Abdelhalim Heba , Atef Mohamed 
Published: November 2024

Abstract
Background
Switching to systemic therapy after transarterial chemoembolization (TACE) refractoriness is more inclined to preserve liver function and decrease disease progression. Hence, we conducted a comparison between the advantages of sorafenib therapy and the continuation of TACE in patients with intermediate-stage hepatocellular carcinoma (HCC) who developed TACE refractoriness.

Methods
This retrospective cohort work involved 1,200 patients with HCC who received TACE therapy at our institution between January 2018 and December 2022. Out of these, a total of 436 participants were determined to be resistant to TACE treatment throughout their clinical progression. Out of them, 271 were finally included and categorized into two groups: (1) patients who shifted from TACE to sorafenib, and (2) patients who maintained TACE treatment. The study assessed the overall survival (OS) and time to disease progression (TTDP) of patients who were resistant to TACE, comparing both groups based on when they achieved Child-Pugh C or acquired advanced-stage HCC.

Results
Following confirmation of refractoriness to TACE therapy, 163 opted to continue with TACE (TACE group), whereas 108 shifted to sorafenib treatment (sorafenib group). The median TTDP was 23.36 months, while the median OS was 25.3 months, in the sorafenib group, and 11.6 and 14.2 months, correspondingly, in the TACE group (p = 0.0001).

Conclusion
Switching to sorafenib treatment significantly improved OS and TTDP in patients with intermediate-stage HCC who were refractory to TACE. These finding highlights sorafenib’s potential as an effective alternative for managing disease progression in patients unresponsive to TACE, offering a valuable treatment option in this challenging clinical scenario.