bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interventions combining mindfulness training with non-invasive brain stimulation and their impact on mental health outcomes: Protocol for a systematic review and meta-analysis of randomized controlled trials
Authors: Demina Anastasia , Petit Benjamin , Meille Vincent , Lebon Florent , Trojak Benoit 
Published: November 2023

Background
Mindfulness training programs and non-invasive brain stimulation are both evidence-based interventions that have applications in mental health disorders. While both have showed promising results on a range of symptoms related to mental health, their combination has more recently grabbed the attention of researchers. There is a theoretical framework for their synergistic effects, and these effects can be tested through a variety of neurophysiological and clinical outcomes. This emerging field of research, which is regularly extended with new trials, has not yet been systematically reviewed. This systematic review protocol aims to present a rationale for combining these two interventions and to document the methodical approach to our systematic review before data extraction.

Methods and analysis
Four electronic databases (Medline, EMBASE, CENTRAL, PsycINFO) and three clinical trial registries (Clinical Trials, EU Trials, WHO ICTRP) were searched. All randomized controlled trials testing the combination of mindfulness-based interventions and non-invasive brain stimulation in humans will be included. As primary outcome, data on change in anxiety and depression symptoms from baseline, and, as secondary outcomes, other mental health outcomes data will be gathered. Data will be extracted independently by two authors using a predefined extraction form. Depending on the clinical heterogeneity of the included studies, the research team will decide whether a quantitative synthesis is appropriate for each of the predefined outcomes. If there is considerable statistical heterogeneity, subgroup analyses and meta-regression will be performed. Bias will be assessed using a revised Cochrane risk-of-bias tool for randomized trials and the strength of evidence in our review will be assessed using the GRADE form in GRADEPro.
We started our scoping searches in November 2022. This systematic review and meta-analysis protocol was finished and submitted before the end of the independent full-text selection process by two members of the team.

Ethics and dissemination
Ethics approval and consent to participate were not applicable to our systematic review. Our dissemination plan includes the publication of our systematic review and meta-analysis in an international peer-reviewed journal as well as international communication of our results.

Trial registration
PROSPERO registration number CRD42022353971.
Reduction of leptin levels during acute exercise is dependent on fasting but not on caloric restriction during chronic exercise: A systematic review and meta-analysis
Authors: Fontana Alexandre , Vieira João Guilherme , Vianna Jeferson Macedo , Bichowska Marta , Krzysztofik Michal , Wilk Michal , Reis Victor Machado 
Published: November 2023

Background
The importance of leptin in controlling body mass has recently gained more attention. Its levels are directly associated with the amount of fat mass, but not necessarily dependent on it. Exercise has great potential in reducing leptin levels, however the response of exercise to this cytokine is still not well understood.

Objective
The objective of the review was to analyze the effects of physical exercise on plasma leptin concentration, either acutely (post-exercise/training session) and/or after a training period (short- or long-term), as well as to investigate the existence of possible moderating variables.

Methods
The studies included in this systematic review were published between 2005 and May 2023. Only peer-reviewed studies, available in English, performed with humans that evaluated the effects of any form of exercise on leptin levels were included. The search was conducted on May 03, 2023, in Embase (Elsevier), MEDLINE via PubMed®, and Web of Science (Core collection). The risk of bias in the included trials was assessed by the Physiotherapy Evidence Database tool, considering 11 questions regarding the methodology of each study with 10 questions being scored. The data (n, mean, and standard deviation) were extracted from included studies to perform random effects meta-analyses using standardized mean difference between the pre- and post-intervention effects.

Results
Twenty-five studies (acute effect: 262 subjects; short- and long-term effect: 377 subjects) were included in this systematic review and meta-analysis. Short- and long-term physical exercise and caloric restriction plus exercise reduce plasma leptin levels, presenting statistically significant differences (p<0.001); as well as acute effect (p = 0.035), however the latter result was influenced by the pre-exercise meal as shown in the subgroup analysis. In this meta-analysis the effect of moderating factors on leptin reduction, not addressed by past reviews, is verified, such as the relationship with caloric restriction, exercise intensity and pre-exercise meal on acute responses.

Conclusion
Both acute and chronic exercise reduce leptin levels, yet the acute effect is dependent on the pre-exercise meal. In addition to having a long-term reduction in leptin levels, the minimum amount of weekly exercise to have a significant reduction in plasma leptin is 180 minutes of moderate-intensity exercise and 120 minutes of high-intensity exercise.
Effect of academic stress, educational environment on academic performance & quality of life of medical & dental students; gauging the understanding of health care professionals on factors affecting stress: A mixed method study
Authors: Wahid Muhammad Hassan , Sethi Mifrah Rauf , Shaheen Neelofar , Javed Kashif , Qazi Ijlal Aslam , Osama Muhammad , Ilah Abdul , Firdos Tariq 
Published: November 2023

Introduction
Throughout their academic careers, medical and dental students face challenges that cause varying levels of stress, affecting their academic performance and quality of life (QoL). Our study aims to ascertain the effect of academic stress and the educational environment on the QoL and academic performance of medical and dental students, encompassing the perspectives of both students and healthcare professionals.

Methods
A mixed-method research was conducted from February to May 2022, comprising students from a medical and dental college in Pakistan. During Phase 1, the students participated in the cross-sectional survey and completed the WHO Quality of Life Scale (WHOQOL-BREF), Academic Stress Scale, and Dundee Ready Educational Environment Measure (DREEM) Inventory questionnaires. Academic performance was evaluated through last year’s annual assessment results of the students. During Phase 2 of the study, interviews with healthcare professionals who had experience as the students’ counsellors were conducted.

Results
The mean age of the sample (n = 440) was 22.24 ±1.4 years. The Cronbach Alpha reliability of the DREEM inventory was 0.877, that of the Academic Stress Scale was 0.939 and the WHOQOL scale was 0.895. More than half of the students (n = 230, 52.3%) reported better QoL and the majority perceived a positive educational environment (n = 323, 73.4%) and higher academic stress (n = 225, 51.1%). Males had significantly more academic stress (p<0.05). Those who perceived a positive educational environment and better QoL had better academic performance (p<0.05). Academic performance was positively and significantly correlated with QoL and academic stress (p = 0.000). In qualitative analysis, 112 codes were generated which converged into 5 themes: challenging educational environment, psychological need and support, individual differences, relationship and family life, and adjustment issues.

Conclusion
Medical and dental students encounter a myriad of challenges, along with significant academic stress, which detrimentally affects their academic performance, despite perceiving a positive educational environment. Conversely, a better QoL is associated with improved academic performance.
Social media in undergraduate teaching and learning: A scoping review protocol
Authors: Hayman Richard , Smith Erika E. 
Published: November 2023

Objective
To conduct a scoping review that systematically examines the body of research on social media in undergraduate teaching and learning in order to identify key issues, trends, gaps, and needs. Our objectives include determining what methods have been commonly used to study social media in undergraduate teaching and learning, and to synthesise insights from published research findings within the fields of higher education, educational technology, and the scholarship of teaching and learning.

Introduction
The use of social media technologies in post-secondary environments has been increasing over time, and especially following the shift to remote teaching and learning during the COVID-19 pandemic, this growth has continued. This review addresses a need to analyse and understand the body of research on the use of social media across undergraduate contexts for teaching and learning.

Inclusion criteria
This scoping review includes peer-reviewed journal articles on social media in an undergraduate teaching or learning context published at any time, in English. In addition to including concepts and terms related to social media broadly, based on global social media usage, we include within our search the most commonly used social media platforms. We excluded items from the grey literature (such as reports, dissertations, and theses), and studies that focus on groups outside of the undergraduate population of interest (e.g., in elementary, secondary, or graduate settings, etc.).

Methods
Systematic searching will be conducted in relevant subject and multidisciplinary databases: Education Database, Education Research Complete, ERIC, British Education Index, Australian Education Index, Academic Search Complete, and Scopus. Records will be deduplicated and screened using Covidence software, with each record independently reviewed by two researchers in both rounds, screening titles and abstracts in the first round, and full-text of articles in the second. Researchers will meet to discuss discrepancies and make decisions using a consensus model, and a third researcher will be independently tasked with resolving any conflicts. Data extraction will also use two independent researchers to review each article.
The handheld fan for chronic breathlessness: Clinicians’ experiences and views of implementation in clinical practice
Authors: Brown Joshua , Miller Isobel , Barnes-Harris Matilda , Johnson Miriam J. , Pearson Mark , Luckett Tim , Swan Flavia 
Published: November 2023

IntroductionThe handheld fan (‘fan’) is useful for chronic breathlessness management, however little is known about clinicians’ implementation of the fan in clinical practice.AimTo explore clinicians’ experiences and views of fan implementation.MethodsA qualitative approach, using semi-structured interviews. Participants were purposively sampled from clinicians who had completed an on-line fan implementation survey and were willing to participate. A topic guide was developed using the Theoretical Domains Framework (TDF). Data were analysed using an inductive approach informed by the TDF.FindingsTwelve clinicians participated (doctors n = 4; nurses n = 4; allied health professionals n = 4) from respiratory and palliative care. Analysis generated three major themes: i) Clinician knowledge and skills in fan implementation, ii) environmental constraints on fan use and iii) clinician beliefs about the consequences of fan use.Implementation by clinicians was positively influenced by having a scientific rationale for fan use presented (mechanism of action). Clinicians believed that the fan relieved breathlessness and did not carry a significant infection risk. Opportunity for fan use varied across healthcare settings; key environmental influences were COVID-19 restrictions, lack of access to resources and funding to provide fans, particularly in acute and respiratory services. Clinicians commonly encountered scepticism among patients and colleagues who felt the fan was an implausible intervention for breathlessness.ConclusionImplementation of the fan is motivated by clinician beliefs about patient-benefit, a scientific rationale to counter clinician and patient scepticism, and access to fans in clinic. Funding to allow patients to be supplied with and taught how to use a fan would support uptake. Research is needed to address concerns about infection risk.
Awareness, attitudes, and beliefs about palliative care: Results from a representative survey of the Italian-speaking Swiss population
Authors: Diviani Nicola , Bennardi Marco , Gamondi Claudia , Saletti Piercarlo , Stüssi Georg , Delbue-Luisoni Michel , Rubinelli Sara 
Published: November 2023

ObjectiveTo understand the knowledge and awareness of palliative care in the Italian-speaking Swiss general population, describing main misconceptions or false beliefs and their relationship with attitudes towards palliative care.MethodsCross-sectional representative population survey (N = 313).ResultsWe observed a high awareness of «palliative care,» although it is mainly associated with pain management and the very last days of life. While false beliefs are relatively rare, there is low awareness of goals, targets, and services offered by palliative care. Overall the Italian-speaking Swiss population has a good predisposition towards palliative care, but negative attitudes are more common among those who lack knowledge. More than one-third of respondents are interested in receiving more information about palliative care, especially from their healthcare providers or through dedicated information points.Conclusion and practice implicationsHealth communication interventions to promote palliative care are needed because there is still significant unclarity about the goals of palliative care, which negatively affects its acceptance. This study instructs on how to intervene specifically in the Italian-speaking part of Switzerland, including what to communicate and how. Further, our findings can inspire similar studies in other Swiss regions or countries that can optimize recognition, knowledge, and understanding and contribute to filling gaps in populations’ health service demand and utilization.
Trends and determinants of early initiation of breastfeeding in Indonesia: A multivariate decomposition analysis
Authors: Nurokhmah Siti , Middleton Lucinda , Februhartanty Judhiastuty , Hendarto Aryono 
Published: November 2023

BackgroundEarly initiation of breastfeeding (EIBF) is key to reducing neonatal morbidity and mortality, however, little is known about the determinants of the trends of EIBF prevalence in Indonesia. This study aims to assess the contributing factors to the changes in the prevalence of EIBF between 2007 and 2017.MethodsWe analysed data from the 2007, 2012, and 2017 Indonesia Demographic and Health Surveys to estimate the trends in EIBF. A multivariate logistic decomposition model was fitted to examine variables associated with changes in the percentage of EIBF from 2007 to 2017. The contributing factors to changes in EIBF prevalence were categorized into either compositional or behavioural changes, with each of them divided into portions or percentages of contribution (pct) of the independent variables. The former refers to the changes in the distribution of samples, while the latter refers to the changes in the behavioural responses toward EIBF in both surveys. All analyses accounted for the complex study design and potential confounding factors.ResultsAn increase in the prevalence of EIBF from 49.9% to 56.5% was recorded between 2012 and 2017, with an overall increase of 16.9 percentage points from 2007 to 2017. At the aggregate level, the compositional differences did not significantly contribute to the changes in the percentage of EIBF, while 98.3pct (p < 0.001) was associated with changes in mothers’ behavioural response towards EIBF. The composition changes in the geographical region of Sumatra, and caesarean delivery negatively contributed to the changes in EIBF prevalence with -0.6pct and -14.2pct, respectively. However, the compositional differences in those living in Kalimantan & Sulawesi, first-time mothers, and small-born infants positively contributed to the change. Behaviour changes in mothers with higher education (8.8pct), from higher income households (-17.5pct), and those residing in Sumatra (-8.2pct) and Kalimantan & Sulawesi (-10.2pct) significantly contributed to the upward trend in EIBF prevalence.ConclusionsAlmost half of the newborns experienced delayed breastfeeding initiation despite the improvement in the prevalence of EIBF. Therefore, further research and interventions on behaviour change in mother’s attitudes towards EIBF, especially among those undergoing caesarean delivery, living in Kalimantan or Sulawesi, and from wealthier households, are recommended to close this gap.
Rates of subsequent surgeries after meniscus repair with and without concurrent anterior cruciate ligament reconstruction
Authors: Kahan Joseph B. , Burroughs Patrick , Petit Logan , Schneble Christopher A. , Joo Peter , Moran Jay , Modrak Maxwell , Mclaughlin William , Nasreddine Adam , Grauer Jonathan N. , Medvecky Michael J. 
Published: November 2023

Objectives
The purpose of this study was to compare the rates of secondary knee surgery for patients undergoing meniscus repair with or without concurrent anterior cruciate ligament reconstruction (ACLr).

Methods
Utilizing a large national database, patients with meniscal repair with or without concurrent arthroscopic ACLr were identified. The two cohorts were then queried for secondary surgical procedures of the knee within the following 2 years. Frequency, age distribution, rates of secondary surgery, and type of secondary procedures performed were compared.

Results
In total, 1,585 patients were identified: meniscus repair with ACLr was performed for 1,006 (63.5%) and isolated meniscal repair was performed for 579 (36.5%). Minimum of two year follow up was present for 487 (30.7% of the overall study population).
Secondary surgery rates were not significantly different between meniscus repair with concurrent ACLr and isolated meniscus repairs with an overall mean follow up of 13 years (1.5–24 years) (10.6% vs. 13.6%, p = 0.126). For the 2 year follow up cohort, secondary surgery rates were not significantly different (19.3% vs. 25.6%, p = 0.1098). There were no differences in survivorship patterns between the two procedures, both in the larger cohort (p = 0.2016), and the cohort with minimum 2-year follow-up (p = 0.0586).

Conclusion
The current study assessed secondary surgery rates in patients undergoing meniscus repair with or without concurrent ACLr in a large patient database. Based on this data, no significant difference in rates of secondary knee surgery was identified.
Predicting need for heart failure advanced therapies using an interpretable tropical geometry-based fuzzy neural network
Authors: Zhang Yufeng , Aaronson Keith D. , Gryak Jonathan , Wittrup Emily , Minoccheri Cristian , Golbus Jessica R. , Najarian Kayvan 
Published: November 2023

Background
Timely referral for advanced therapies (i.e., heart transplantation, left ventricular assist device) is critical for ensuring optimal outcomes for heart failure patients. Using electronic health records, our goal was to use data from a single hospitalization to develop an interpretable clinical decision-making system for predicting the need for advanced therapies at the subsequent hospitalization.

Methods
Michigan Medicine heart failure patients from 2013–2021 with a left ventricular ejection fraction ≤ 35% and at least two heart failure hospitalizations within one year were used to train an interpretable machine learning model constructed using fuzzy logic and tropical geometry. Clinical knowledge was used to initialize the model. The performance and robustness of the model were evaluated with the mean and standard deviation of the area under the receiver operating curve (AUC), the area under the precision-recall curve (AUPRC), and the F1 score of the ensemble. We inferred membership functions from the model for continuous clinical variables, extracted decision rules, and then evaluated their relative importance.

Results
The model was trained and validated using data from 557 heart failure hospitalizations from 300 patients, of whom 193 received advanced therapies. The mean (standard deviation) of AUC, AUPRC, and F1 scores of the proposed model initialized with clinical knowledge was 0.747 (0.080), 0.642 (0.080), and 0.569 (0.067), respectively, showing superior predictive performance or increased interpretability over other machine learning methods. The model learned critical risk factors predicting the need for advanced therapies in the subsequent hospitalization. Furthermore, our model displayed transparent rule sets composed of these critical concepts to justify the prediction.

Conclusion
These results demonstrate the ability to successfully predict the need for advanced heart failure therapies by generating transparent and accessible clinical rules although further research is needed to prospectively validate the risk factors identified by the model.
Elsa de’ Giorgi: Storia, discorsi e memorie del cinema, Mariapia Comand (2022)
Authors: O’Rawe Catherine 
Published: November 2023

Review of: Elsa de’ Giorgi: Storia, discorsi e memorie del cinema, Mariapia Comand (2022)
Milan-Udine: Mimesis, 279 pp.,
ISBN 978-8-85756-312-1, p/bk, €24
Can gamification improve student engagement and learning?
Authors: Mitchell Bruce , Co Mary Jesselyn 
Published: November 2023

Management education has traditionally been delivered in tedious and disengaging manner. Students manifest their disengagement in five dimensions - values, motivation, behavioural, interactional and competing involvements. This research targets motivation, behavioural and interactional disengagement using gamification. This project aims to investigate the impact of implementing gamification elements in an undergraduate managerial communication course on the students’ engagement and academic performance. Grounded in Self-Determination Theory, this project develops an online and in-class gamified learning intervention by aligning game attributes to desired behaviours and learning outcomes. Using a pre- and post-test survey, the researchers will examine student perceptions of the gamification intervention. Students’ written reflections on their gamification experience will also be subject to a thematic analysis. The researchers anticipate an improvement in student engagement and learning outcomes. Based on the findings, a set of design principles to guide future gamification interventions will be developed.