bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lost in translation: how can education about dementia be effectively integrated into medical school contexts? A realist synthesis
Authors: Tullo Ellen , Wakeling Luisa , Pearse Rachel , Kheng Khoo Tien , Teodorczuk Andrew 
Published: November 2023

ObjectivesThe prevalence of dementia in both community and hospital settings requires a clinical workforce that is skilled in diagnosis and management of the condition to competently care for patients. Though evidence of successful educational interventions about dementia exists, effective translation into medical school curricula is the exception rather than the norm.DesignWe adopted a realist synthesis approach following Realist And MEta-narrative Evidence Syntheses: Evolving Standards (RAMESES) guidelines to answer the following questions: (1) what are the barriers to integrating effective interventions about dementia into medical school curricula and (2) where they are successfully delivered, what are the contextual factors that allow for this enactment?Data sourcesWe searched PubMed, Embase, CINAHL and PsycINFO using the MesH termsSchools, Medical; Students, Medical; Education, MedicalANDNeurocognitive disordersor the closest possible set of terms within each database.Eligibility criteriaUndergraduate or graduate entry medical school programme, teaching and learning focussing on dementia, evaluating student outcomes (satisfaction, knowledge, skills, attitudes or behaviours), interventions described clearly enough to classify teaching method, any research design (quantitative and qualitative), English language.Data extraction and synthesisWe used a shared spreadsheet to enter key information about eligible studies and the reasons for excluding studies that did not fit eligibility criteria. We extracted descriptive data about the nature of educational interventions and narrative information as to barriers and facilitators to implementing those interventions.ResultsOur initial literature search identified 16 relevant papers for review. Systematic extraction of data informed the development of an initial programme theory (IPT) structured around four contextual barriers: ‘culture’, ‘concern for patient welfare’, ‘student attitudes’ and ‘logistics’ with associated facilitatory mechanisms embed medical education about dementia.ConclusionsWe outline the process of generating our IPT, including overlap with Cultural Historical Activity Theory. We outline our intention to refine our programme theory through ongoing review of the evidence base and collaboration with stakeholders, with the aim of finalising a model for successful integration of dementia education.
Traditional management of female infertility in Africa: a scoping review protocol
Authors: Mashaah Thokozile , Muziringa Masimba , Gomo Exnevia , Chideme-Maradzika Julita , Madziyire Mugove Gerald , January James 
Published: November 2023

IntroductionInfertility adversely affects the sexual reproductive health and overall quality of life of people. Recent estimates show that about one in six people (both men and women) experience infertility in their lifetime. This scoping review will, therefore, map the existing evidence on traditional management of female infertility in Africa including the effectiveness of the traditional healthcare systems, to inform policy and practice.MethodsThe scoping review will be guided by the Arksey and O’Malley framework in conjunction with the Joanna Briggs Institute updated methodological guidance for scoping reviews. A search strategy will be developed, which will target the following databases: PubMed, Scopus, Embase, CINAHL, Google Scholar and Africa-Wide Information including grey literature. The screening of titles, abstracts and full text will be done by two independent reviewers. Data will be extracted, analysed numerically and thematically. The reporting of the scoping review will use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist.Ethics and disseminationThis scoping review will not require ethical approval as this is secondary analysis of peer-reviewed articles. The findings of the review will be disseminated on various platforms including conferences, meetings to key stakeholders and in a peer-reviewed journal for wider sharing.
Comparison of relative change with effect size metrics in Alzheimer’s disease clinical trials
Authors: Goldberg Terry E , Lee Seonjoo , Devanand Davangere P , Schneider Lon S 
Published: November 2023

BackgroundPer cent slowing of decline is frequently used as a metric of outcome in Alzheimer’s disease (AD) clinical trials, but it may be misleading. Our objective was to determine whether per cent slowing of decline or Cohen’s d is the more valid and informative measure of efficacy.MethodsOutcome measures of interest were per cent slowing of decline; Cohen’s d effect size and number-needed-to-treat (NNT). Data from a graphic were used to model the inter-relationships among Cohen’s d, placebo decline in raw score units and per cent slowing of decline with active treatment. NNTs were computed based on different magnitudes of d. Last, we tabulated recent AD anti-amyloid clinical trials that reported per cent slowing and for which we computed their respective d’s and NNTs.ResultsWe demonstrated that d and per cent slowing were potentially independent. While per cent slowing of decline was dependent on placebo decline and did not include variance in its computation, d was dependent on both group mean difference and pooled SD. We next showed that d was a critical determinant of NNT, such that NNT was uniformly smaller when d was larger. In recent AD associated trials including those focused on anti-amyloid biologics, d’s were below 0.23 and thus considered small, while per cent slowing was in the 22–29% range and NNTs ranged from 14 to 18.ConclusionsStandardised effect size is a more meaningful outcome than per cent slowing of decline because it determines group overlap, which can directly influence NNT computations, and yield information on the likelihood of minimum clinically important differences. In AD, greater use of effect sizes, NNTs, rather than relative per cent slowing, will improve the ability to interpret clinical trial results and evaluate the clinical meaningfulness of statistically significant results.
Quantitative MRI outcome measures in CMT1A using automated lower limb muscle segmentation
Authors: O'Donnell Luke F , Pipis Menelaos , Thornton John S , Kanber Baris , Wastling Stephen , McDowell Amy , Zafeiropoulos Nick , Laura Matilde , Skorupinska Mariola , Record Christopher J , Doherty Carolynne M , Herrmann David N , Zetterberg Henrik , Heslegrave Amanda J , Laban Rhiannon , Rossor Alexander M , Morrow Jasper M , Reilly Mary M 
Published: November 2023

BackgroundLower limb muscle magnetic resonance imaging (MRI) obtained fat fraction (FF) can detect disease progression in patients with Charcot-Marie-Tooth disease 1A (CMT1A). However, analysis is time-consuming and requires manual segmentation of lower limb muscles. We aimed to assess the responsiveness, efficiency and accuracy of acquiring FF MRI using an artificial intelligence-enabled automated segmentation technique.MethodsWe recruited 20 CMT1A patients and 7 controls for assessment at baseline and 12 months. The three-point-Dixon fat water separation technique was used to determine thigh-level and calf-level muscle FF at a single slice using regions of interest defined using Musclesense, a trained artificial neural network for lower limb muscle image segmentation. A quality control (QC) check and correction of the automated segmentations was undertaken by a trained observer.ResultsThe QC check took on average 30 seconds per slice to complete. Using QC checked segmentations, the mean calf-level FF increased significantly in CMT1A patients from baseline over an average follow-up of 12.5 months (1.15%±1.77%, paired t-test p=0.016). Standardised response mean (SRM) in patients was 0.65. Without QC checks, the mean FF change between baseline and follow-up, at 1.15%±1.68% (paired t-test p=0.01), was almost identical to that seen in the corrected data, with a similar overall SRM at 0.69.ConclusionsUsing automated image segmentation for the first time in a longitudinal study in CMT, we have demonstrated that calf FF has similar responsiveness to previously published data, is efficient with minimal time needed for QC checks and is accurate with minimal corrections needed.
Cancer advance care planning: development of a screening tool
Authors: Berlin Pia , Göggelmann Lena , Herzog Svenja , Pedrosa Carrasco Anna J , Hauck Johannes , Timmesfeld Nina , Kruse Johannes , Rief Winfried , Riera Knorrenschild Jorge , von Blanckenburg Pia , Seifart Carola 
Published: November 2023

ObjectivesAdvance care discussions are a useful communication tools for medical preferences and beneficial for shared decision-making processes in hospital settings. The present study developed the first screening tool for need for advance care planning (ACP).MethodsIn phase 1 (n=92), items were evaluated using feasibility analysis and item reduction. In phase 2 (n=201), reduced screening items were analysed for predictive value of need for ACP. Statistical analysis included receiver-operating characteristics analysis (area under the curve>0.80), optimal cut-off based on sensitivity and specificity, interpretation of OR and construct validity using correlation with death anxiety, communication avoidance within families and trust based on the relationship with the treating physician.ResultsParticipants in both phases were approximately 60 years old with non-curative prognosis. After item reduction, predictive values of four possible items with good item difficulty and discrimination were compared for mild, moderate and great levels of death anxiety. A two-item combination ofI am burdened by thoughts of an unfavourable course of the diseaseandI am burdened by the feeling of being ill-prepared for the end of lifeshowed best prediction of death anxiety and communication avoidance. Clinical cut-off at sum-score ≥6 was of high sensitivity (95%) and specificity (81%). Previous use of social support and readiness for ACP was related to higher chance of interest in ACP.ConclusionScreening for need of ACP is possible with two objective items and one subjective item. Positive screening therefore indicates when to offer ACP discussions and provides routine estimation of ACP need in clinical practice.
Nurse practitioner and physician end-of-life home visits and end-of-life outcomes
Authors: Scott Mary M , Ramzy Amy , Isenberg Sarina Roslyn , Webber Colleen , Eddeen Anan Bader , Murmann Maya , Mahdavi Roshanak , Howard Michelle , Kendall Claire E , Klinger Christopher , Marshall Denise , Sinnarajah Aynharan , Ponka David , Buchman Sandy , Bennett Carol , Tanuseputro Peter , Dahrouge Simone , May Kathryn , Heer Carrie , Cooper Dana , Manuel Douglas , Thavorn Kednapa , Hsu Amy T 
Published: November 2023

ObjectivesPhysicians and nurse practitioners (NPs) play critical roles in supporting palliative and end-of-life care in the community. We examined healthcare outcomes among patients who received home visits from physicians and NPs in the 90 days before death.MethodsWe conducted a retrospective cohort study using linked data of adult home care users in Ontario, Canada, who died between 1 January 2018 and 31 December 2019. Healthcare outcomes included medications for pain and symptom management, emergency department (ED) visits, hospitalisations and a community-based death. We compared the characteristics of and outcomes in decedents who received a home visit from an NP, physician and both to those who did not receive a home visit.ResultsHalf (56.9%) of adult decedents in Ontario did not receive a home visit from a provider in the last 90 days of life; 34.5% received at least one visit from a physician, 3.8% from an NP and 4.9% from both. Compared with those without any visits, having at least one home visit reduced the odds of hospitalisation and ED visits, and increased the odds of receiving medications for pain and symptom management and achieving a community-based death. Observed effects were larger in patients who received at least one visit from both.ConclusionsBeyond home care, receiving home visits from primary care providers near the end of life may be associated with better outcomes that are aligned with patients’ preferences—emphasising the importance of NPs and physicians’ role in supporting people near the end of life.
Impact of bedside ultrasound on care in specialist palliative care units: a qualitative study
Authors: Moore Steven , Stoneham Bethany , Taylor Vanessa , Perkins Paul 
Published: November 2023

ObjectivesTo explore the experiences of palliative care doctors regarding the clinical impact of ultrasound in specialist palliative care units (SPCUs).MethodsThe study adopted a qualitative research design using semistructured interviews and a reflexivity journal. Six participants were recruited through purposive and snowball sampling. Findings were analysed using framework analysis.ResultsAnalysis used four predetermined themes: (1) practicalities, (2) clinical indications, (3) impact on patient care and service provision and (4) governance and training. Analysis identified a relationship between procedural confidence and use of ultrasound.ConclusionsOur study provides information for understanding the current use and limitations of ultrasound in SPCUs. Ultrasound leads to safer practice, especially when performing invasive procedures such as paracentesis. Development of standards around the use of, and training of staff undertaking ultrasound in specialist palliative care, are recommended.
Power cocentralizing generalized derivations on left ideals of prime rings
Authors: Liu Cheng-Kai , Tsai Yuan-Tsung 
Published: November 2023

Let [Formula: see text] be a prime ring with center [Formula: see text], let [Formula: see text] be a nonzero left ideal of [Formula: see text] and let [Formula: see text] be two generalized derivations of [Formula: see text]. In this paper, we completely characterize the structure of [Formula: see text] and all possible forms of [Formula: see text] such that [Formula: see text] for all [Formula: see text], where [Formula: see text] are fixed positive integers. With this, several known results can be either deduced or generalized. Moreover, our result can be regarded as the one-sided ideal version of the theorem obtained by Lee and Zhou in [An identity with generalized derivations, J. Algebra Appl. 8 (2009) 307–317].
The Benefits of Low-Carbohydrate, High-Fat (LCHF) Diet on Body Composition, Leg Volume, and Pain in Women with Lipedema
Authors: Jeziorek Małgorzata , Chachaj Angelika , Sowicz Monika , Adaszyńska Agnieszka , Truszyński Aleksander , Putek Justyna , Kujawa Krzysztof , Szuba Andrzej 
Published: November 2023

This study aimed to assess the potential benefits of a low-carbohydrate, high-fat (LCHF) diet on body composition, leg volume, and pain reduction in women with lipedema compared to overweight or women with obesity. The study included 113 female participants, 56 with lipedema and 57 with overweight/obesity (BMI >25 kg/m2) without lipedema. All subjects were prescribed a low-carbohydrate, high-fat (LCHF) diet with anti-inflammatory properties to adhere to for a duration of 7 months. Measurements of anthropometry, body weight, composition, and pain (VAS) were conducted at the study’s commencement and conclusion. 52 participants completed the study. Both groups experienced a similar weight reduction, amounting to 12.9% compared to the baseline (−10.8 kg vs. −11.9 kg; p = 0.14, for lipedema and women with overweight/obesity, respectively). The most reduction was in body fat mass. Improvements in various parameters were observed, except for ankle circumferences, which decreased more in the lipedema group. Lipedema participants showed significantly reduced pain levels following the LCHF diet (4.6 ± 2.6 vs 3.0 ± 2.3;

p

<

0.001

). The LCHF diet holds promise for weight loss, body fat reduction, leg volume management, and pain alleviation in women with lipedema. These findings provide valuable insights into potential therapeutic strategies for lipedema management.
An Ethical Approach to Creating Gardens Inspired by Qurʾānic Narratives
Authors: Kolkailah Naiyerah 
Published: November 2023

Abstract
Much of the literature on “Islamic gardens” focuses on artistic and architectural features or religious symbolism attributed to the influence of Islamic beliefs and civilization. This study seeks to expand the scope of intellectual inquiry beyond traditional motifs and recurrent features to investigate the potential influence of Islamic ethical values on creating gardens. Following a brief overview of the history of “Islamic gardens” and a short survey of Qurʾānic terms denoting earthly and paradisiacal gardens, this research highlights theological and ethical principles derived from four Qurʾānic narratives featuring earthly gardens, natural landscapes and non-human creation. These principles are, then, incorporated into a holistic ethical framework for creating gardens that harmonizes theocentric, anthropocentric, and ecocentric priorities. This framework prioritizes faithfulness to God while upholding both serving humanity and safeguarding natural habitats and ecosystems as ethical imperatives and mutually reinforcing investments with spiritual consequences in this life and the hereafter. This study also presents several garden models (particularly botanic gardens and community gardens) considered suitable for adopting and applying the proposed tripartite framework. The last section of this study explores how Islamic institutions, including mosques and charitable organizations, can utilize the tripartite framework to create gardens and green spaces that contribute to fulfilling a range of spiritual, social and environmental objectives.
Ukraine, Participation and the Smartphone at War
Authors: Ford Matthew 
Published: November 2023

Abstract
Digitisation is redefining the battlefield. Whereas once only soldiers and embedded journalists had privileged access to the battlefield, now war is everywhere, brought to us by civilians and their smartphones. People produce, publish and consume media on the same device. They can be at the frontlines or on the other side of the world. Digital individuals may willingly participate in war or they may participate by virtue of being connected to the grid. In this sense it is participative in that everyone has the potential to be involved through the data they create. This produces dynamic information flows that amplify and accelerate both war and its representation bringing the relationship between the military targeting and media production cycles into alignment. In the process, the bystander has been removed from war and instead collapsed the relationship between audience and actor, soldier and civilian, media and weapon.
Valoctocogene Roxaparvovec and Etranacogene Dezaparavovec: Novel Gene Therapies for Hemophilia A and B
Authors: Dougherty John A. , Dougherty Kristiann M. 
Published: November 2023

Objective: To review efficacy and safety data of valoctocogene roxaparvovec (Roctavian) and etranacogene dezaparavovec (Hemgenix), novel gene therapies for the treatment of the life-threatening bleeding disorders hemophilia A and B, respectively. Data Sources: A PubMed/Google Scholar search from inception through August 11, 2023 was conducted using the following keywords: gene therapy, hemophilia A, hemophilia B, etranacogene dezaparavovec, valoctocogene roxaparvovec, and bleeding. Study Selection and Data Extraction: Data, including phase 1 to 3 clinical trials (non-comparator), were obtained from primary literature and package inserts. These reports evaluated clinical pharmacology, efficacy, safety, adverse events, warnings, and precautions. Data Synthesis: Valoctocogene phase 3 study in males (n = 134): 87% had factor VIII (FVIII) levels that at least met criteria for mild hemophilia. Etranacogene phase 3 study in males (n = 54): within 3 weeks of infusion, mean factor IX (FIX) levels had reached 26.8 IU/dL. Both therapies provided clinically and statistically significant decreases in bleeding events and prophylactic factor infusions. Most common adverse event was elevations in liver function tests that were treated with glucocorticoids. Relevance to Patient Care and Clinical Practice in Comparison with Existing Drugs: The endogenous production of clotting factors mimics physiological production while decreasing morbidity and mortality related to bleeding events similar to the effects of existing replacement strategies. Gene therapy was also shown to increase patient quality of life. Conclusion: Valoctocogene and etranacogene provide another treatment for selected patients with hemophilia. Treatment for the patient with hemophilia (gene therapy vs replacement strategy) must be personalized as new clinical data are published being cognizant of drug affordability.
Serum macrophage migration inhibitory factor levels predict brain atrophy in people with primary progressive multiple sclerosis
Authors: Ladakis Dimitrios C , Reyes-Mantilla Maria I , Gadani Sachin P , Mace Jackson W , Dominguez-Penuela Susana C , Appiah Mayaa J , Smith Matthew D , Bhargava Pavan , Fox Robert J , Saidha Shiv , Calabresi Peter A 
Published: November 2023

Background: Macrophage migration inhibitory factor (MIF) is a cytokine linked to multiple sclerosis (MS) progression that is thought to be inhibited by ibudilast. SPRINT-MS was a phase 2 placebo-controlled trial of ibudilast in progressive multiple sclerosis (PMS). Objective: To determine whether baseline MIF levels predict imaging outcomes and assess the effects of ibudilast on serum and cerebrospinal fluid (CSF) MIF levels in people with PMS treated with ibudilast. Methods: Participants in the SPRINT-MS trial were treated with either ibudilast or placebo and underwent brain magnetic resonance imaging (MRI) every 24 weeks over a duration of 96 weeks. MIF was measured in serum and CSF. Results: MIF levels were compared with imaging outcomes in 223 participants from the SPRINT-MS study. In the primary progressive multiple sclerosis (PPMS) cohort, males had higher serum ( p < 0.001) and CSF ( p = 0.01) MIF levels, as compared with females. Higher baseline serum MIF levels in PPMS were associated with faster brain atrophy (beta = −0.113%, 95% confidence interval (CI): −0.204% to −0.021%; p = 0.016). These findings were not observed in secondary progressive multiple sclerosis (SPMS). Ibudilast did not affect either serum or CSF MIF levels. Conclusions: Serum MIF levels were associated with male sex and predicted brain atrophy in PPMS, but not SPMS. Ibudilast did not demonstrate an effect on MIF levels, as compared with placebo, although we cannot exclude a functional effect.