bluuebunny/crossref_metadata_2025_split huggingface dataset:
Attitude towards medication deprescribing among older patients attending the geriatric centre: a cross-sectional survey in Southwest Nigeria
Authors: Akande-Sholabi Wuraola , Ajilore Comfort Oluwatobi , Adebusoye Lawrence A , Fakeye Titilayo O 
Published: November 2023

ObjectivesThis study set out to assess older people’s perception of their medications, attitude towards medication use and their willingness to have medications deprescribed in a geriatric centre in Southwestern Nigeria.Design and settingA cross-sectional study was conducted at the Chief Tony Anenih Geriatric Centre, University of Ibadan, using an interviewer-administered questionnaire. The questionnaire used was a revised version of the Patient’s Attitude Towards Deprescribing Questionnaire. Descriptive statistics, and multivariate and bivariate analyses were performed using SPSS V.23. Statistical significance was set at p<0.05.Participants415 older patients aged ≥60 years who attended the geriatric centre in University College Hospital Ibadan between April and July 2022.Main outcome measureThe primary outcome was the willingness of the older person to deprescribe if recommended by the physician.ResultsThe mean age of the participants was 69.6±6.4 years, and 252 (60.7%) were female. Overall, the willingness and positive attitude to medication deprescribing among respondents were 60.5% and 89.7%, respectively. Factors significantly associated with willingness to deprescribe were financial self-support (p=0.021), having no previous hospital admission (p=0.009), better-perceived quality of health relative to peers (p<0.0001), polypharmacy (p=0.003), and the domains burden of medication (p=0.007), medication appropriateness (p<0.0001), concerns about stopping medications (p<0.0001) and involvement with medications (p<0.0001). The predictive factors for improved willingness to deprescribe were direct involvement with medications (OR=2.463; 95% CI 1.501 to 4.043, p<0.0001), medication appropriateness (OR=0.462; 95% CI 0.254 to 0.838, p=0.011) and concerns about stopping medications (OR=2.031; 95% CI 1.191 to 3.463, p=0.009).ConclusionParticipants demonstrated greater willingness to deprescribe if the physicians recommended it. Predictive factors that may influence willingness to deprescribe were direct involvement with medications, appropriateness of medication and concerns about stopping medications.
Staging by Thoracoscopy in potentially radically treatable Lung Cancer associated with Minimal Pleural Effusion (STRATIFY): protocol of a prospective, multicentre, observational study
Authors: Ferguson Jenny , Tsim Selina , Kelly Caroline , Alexander Laura , Shad Shumaila , Neilly Mark , Tate Matthew , Zahra Baryab , Saleh Merna , Cowell Gordon , Banks Elspeth , Grundy Seamus , Corcoran John , Downer Nicola , Stanton Andrew , Evison Matthew , Rahman Najib M , Maskell Nick , Blyth Kevin G 
Published: November 2023

IntroductionRecurrence rate following radical therapy for lung cancer remains high, potentially reflecting occult metastatic disease, and better staging tools are required. Minimal pleural effusion (mini-PE) is associated with particularly high recurrence risk and is defined as an ipsilateral pleural collection (<1/3 hemithorax on chest radiograph), which is either too small to safely aspirate fluid for cytology using a needle, or from which fluid cytology is negative. Thoracoscopy (local anaesthetic thoracoscopy (LAT) or video-assisted thoracoscopic surgery (VATS)) is the gold-standard diagnostic test for pleural malignancy in patients with larger symptomatic effusions. Staging by Thoracoscopy in potentially radically treatable Lung Cancer associated with Minimal Pleural Effusion (STRATIFY) will prospectively evaluate thoracoscopic staging in lung cancer associated-mini-PE for the first time.Methods and analysisSTRATIFY is a prospective multicentre observational study. Recruitment opened in January 2020. The primary objective is to determine the prevalence of detectable occult pleural metastases (OPM). Secondary objectives include assessment of technical feasibility and safety, and the impact of thoracoscopy results on treatment plans, overall survival and recurrence free survival. Inclusion criteria are (1) suspected/confirmed stages I–III lung cancer, (2) mini-PE, (3) Performance Status 0–2 (4), radical treatment feasible if OPM excluded, (5) ≥16 years old and (6) informed consent. Exclusion criteria are any metastatic disease or contraindication to the chosen thoracoscopy method (LAT/VATS). All patients have LAT or VATS within 7 (±5) days of registration, with results returned to lung cancer teams for treatment planning. Following an interim analysis, the sample size was reduced from 96 to 50, based on a lower-than-expected OPM rate. An MRI substudy was removed in November 2022 due to pandemic-related site setup/recruitment delays. These also necessitated a no-cost recruitment extension until October 2023.Ethics and disseminationProtocol approved by the West of Scotland Research Ethics Committee (Ref: 19/WS/0093). Results will be published in peer-reviewed journals and presented at international meetings.Trial registration numberISRCTN13584097.
EtherShield: Time-interval Analysis for Detection of Malicious Behavior on Ethereum
Authors: Pan Bofeng , Stakhanova Natalia , Zhu Zhongwen 
Published: November 2023

Advances in blockchain technology have attracted significant attention across the world. The practical blockchain applications emerging in various domains, ranging from finance, healthcare, and entertainment, have quickly become attractive targets for adversaries. The novelty of the technology coupled with the high degree of anonymity it provides made malicious activities even less visible in the blockchain environment. This made their robust detection challenging.
This article presents EtherShield, a novel approach for identifying malicious activity on the Ethereum blockchain. By combining temporal transaction information and contract code characteristics, EtherShield can detect various types of threats and provide insight into the behavior of contracts. The time-interval-based analysis used by EtherShield enables expedited detection, achieving comparable accuracy to other approaches with significantly less data. Our validation analysis, which involved over 15,000 Ethereum accounts, demonstrated that EtherShield can significantly expedite the detection of malicious activity while maintaining high accuracy levels (86.52% accuracy with 1 hour of transaction history data and 91.33% accuracy with 1 year of transaction history data).
Two Aramaic Piyyutim from the Second Crusade (1148)
Authors: Katsumata Naoya , van Bekkum Wout 
Published: November 2023

Abstract
A single folio from MS 119 in the Geneva Genizah includes two unknown and unpublished piyyutim in Aramaic, which are presented in this study for the first time. The two hymns can be precisely dated to the year 1148, the time of the Second Crusade. They resemble each other to a significant extent in terms of content and prosody, referring to a dire historical situation that can be explicitly linked to the siege of Damascus in the summer of 1148. This study presents a critical edition of the two Aramaic piyyutim together with an English translation alongside other textual elements within the remarkable context of this unique folio.
Origins of Underestimated Indian Ocean Dipole Skewness in CMIP5/6 Models
Authors: Zheng Yiling , Tam Chi-Yung , Xu Kang , Collins Matthew 
Published: November 2023

Abstract
The Indian Ocean dipole (IOD) is the dominant mode of interannual variability in the tropical Indian Ocean (TIO), characterized by warming (cooling) in western TIO and cooling (warming) in eastern TIO during its positive (negative) phase. Observed IOD events exhibit distinct amplitude asymmetry in relation to negative nonlinear dynamic heating. Nearly all models in phase 5 of the Coupled Model Intercomparison Project (CMIP) simulate a less-skewed IOD than observed, but 6 out of 20 CMIP6 models can reproduce realistic high skewness. Analysis of less-skewed models indicates that the positive IOD-like biases in the mean state, which can be traced back to their weaker simulations of the preceding Indian summer monsoon, reduce the convective response to positive sea surface temperature anomalies in the western TIO, resulting in a weaker zonal wind response and weaker nonlinear zonal advection during positive IOD events. Besides, ocean stratification in the eastern TIO influences the IOD skewness: stronger stratification leads to larger mixed-layer temperature response to thermocline changes, contributing to larger anomalous vertical temperature gradient, larger nonlinear vertical advection, and thus stronger positive IOD skewness. Our findings underscore the importance of reducing Indian summer monsoon biases and eastern TIO stratification biases, for properly representing the IOD in Earth system models.
Prognostic Implications of Changes in Total Physiological Atherosclerotic Burden in Patients With Coronary Artery Disease—A Serial QFR Study
Authors: Chu Jiapeng , Yuan Deqiang , Lai Yan , Ye Wen , Liu Lei , Lin Hao , Ping Fan , Zhu Guoqi , Chen Fei , Yao Yian , Yan Wenwen , Liu Xuebo 
Published: November 2023

The association between coronary physiological progression and clinical outcomes has not been investigated. A total of 421 patients who underwent serial coronary angiography at least 6 months apart were included. Total physiological atherosclerotic burden was characterized by sum of quantitative flow ratio in 3 epicardial vessels (3V-QFR). The relationships of the 3V-QFR and its longitudinal change (△3V-QFR) with major adverse cardiovascular events (MACE) were explored. 3V-QFR values derived from follow-up angiograms were slightly lower compared with baseline (2.85 [2.77, 2.90] vs 2.86 [2.80, 2.90], P < .001). The median △3V-QFR value was −0.01 (−0.05, 0.02). The multivariable models demonstrated that follow-up 3V-QFR and △3V-QFR were independently associated with MACE (both P < .05). Patients with both low follow-up 3V-QFR (≤2.78) and low △3V-QFR (≤−0.05) presented 3 times higher risk of MACE than those without (hazard ratio: 2.953, 95% confidence interval 1.428–6.104, P = .003). Furthermore, adding patient-level 3V-QFR and △3V-QFR to clinical model significantly improved the predictability for MACE. In conclusion, total physiological atherosclerotic burden and its progression can provide incremental prognostic value over clinical characteristics, supporting the use of coronary physiology in the evaluation of disease progression and for the identification of vulnerable patients.
The effectiveness of telehealth interventions in suicide prevention: A systematic review and meta-analysis
Authors: Shoib Sheikh , Shaheen Nour , Anwar Almoatazbellah , Saad Abdelrahman M. , Mohamed Akr Laila , I Saud Alaa , Kundu Mrinmoy , Nahidi Mahsa , Chandradasa Miyuru , Swed Sarya , Saeed Fahimeh 
Published: November 2023

Background: Suicidal attempt is a significant risk factor for future attempts, with the highest risk during the first-year post-suicide. Telepsychiatry has shown promise by providing easy access to evidence-based interventions during mental health crises. Aims: investigation the effectiveness of telehealth interventions in suicide prevention Methods: Four electronic databases (PubMed, Scopus, Web of Science, and Ovid) were systematically searched for studies on patients undergoing telepsychiatry intervention (TPI) up to June 2022. Following PRISMA guidelines, a systematic review and meta-analysis were conducted to investigate the effectiveness of telehealth interventions in suicide prevention. Continuous data were pooled as standardised mean difference (SMD), and dichotomous data were pooled as risk ratio using the random effects model with the corresponding 95% confidence intervals (CI). Results: Sixteen studies were included in the review. Most studies were case-control and randomised controlled trials conducted in Europe and North America. The findings of the studies generally showed that TPIs are effective in reducing suicide rates (odds ratio = 0.68; 95% CI [−0.47, 0.98], p = .04) and suicidal reattempts. The interventions were also found to be well-accepted, with high retention rates. Conclusion: Our results suggest that TPIs are well-accepted and effective in reducing suicide rates and reattempts. It is recommended to maintain telephone follow-ups for at least 12 months. Further research is needed to understand the potential of telepsychiatry in suicide prevention fully.
The 5-HT7 receptor system as a treatment target for mood and anxiety disorders: A systematic review
Authors: Gottlieb Natalie , Li Tse-Yi , Young Allan H , Stokes Paul RA 
Published: November 2023

Background: Preclinical animal and preliminary human studies indicate that 5-HT7 antagonists have the potential as a new treatment approach for mood and anxiety disorders. In this systematic review, we aimed to review the relationship between the 5-HT7 receptor system and mood and anxiety disorders, and to explore the pharmacology and therapeutic potential of medications that target the 5-HT7 receptor for their treatment. Methods: Medline, Cochrane Library, EMBASE, PsycINFO databases, the National Institute of Health website Clinicaltrials.gov, controlled-trials.com, and relevant grey literature were used to search for original research articles, and reference lists of included articles were then hand searched. Results: Sixty-four studies were included in the review: 52 animal studies and 12 human studies. Studies used a variety of preclinical paradigms and questionnaires to assess change in mood, and few studies examined sleep or cognition. Forty-four out of 47 (44/47) preclinical 5-HT7 modulation studies identified potential antidepressant effects and 20/23 studies identified potential anxiolytic effects. In clinical studies, 5/7 identified potential antidepressant effects in major depressive disorder, 1/2 identified potential anxiolytic effects in generalized anxiety disorder, and 3/3 identified potential antidepressant effects in bipolar disorders. Conclusion: While there is some evidence that the 5-HT7 receptor system may be a potential target for treating mood and anxiety disorders, many agents included in the review also bind to other receptors. Further research is needed using drugs that bind specifically to 5-HT7 receptors to examine treatment proof of concept further.
Value-based decision-making predicts alcohol use and related problems in young men
Authors: Petzold Johannes , Hentschel Angela , Chen Hao , Kuitunen-Paul Sören , London Edythe D , Heinz Andreas , Smolka Michael N 
Published: November 2023

Background: Alcohol consumption is a leading cause of morbidity and mortality worldwide, disproportionately affecting young men. Heavy episodic drinking is particularly prevalent among men, with this behavior peaking between the ages of 20 and 24. Aims: We sought to identify dimensions of decision-making in men that would predict the development of hazardous alcohol use through emerging adulthood. Methods: This prospective observational study profiled value-based decision-making in 198 healthy men at age 18 and assessed their alcohol involvement annually until age 24. Latent growth curve modeling estimated individual variability in trajectories of alcohol involvement and regressed this variability on five choice dimensions. Results: Low loss aversion predicted sustained heavy episodic drinking from age 18 to 24. Both high delay discounting and risk-seeking for gains independently predicted a considerably higher cumulative alcohol use during these 6 years, with high delay discounting indicating escalating consumption from age 21. Risk-seeking for gains additionally predicted meeting more criteria for Alcohol Use Disorder in these 6 years. Risk-seeking for losses was not significantly related to alcohol outcomes. Choice preferences were largely independent of each other but were correlated with choice consistency, with low consistency predicting heavy episodic drinking from age 18 to 24 beyond these associations. Conclusions: The predictive effects collectively suggest that overvaluing immediate and probabilistic incentives, rather than underestimating harm, drives hazardous drinking in young men. The differential relations of choice preferences and consistency to alcohol involvement through emerging adulthood provide distinct cognitive-behavioral patterns that warrant consideration in the development of harm reduction interventions.
Recruiting via the Core: A Nontraditional Introduction to Economic Thinking
Authors: Swinton John R. , Conaway Brooke , Clark Christopher 
Published: November 2023

Students often choose to major in economics after being introduced to the discipline through principles courses. Most of these courses cover the same general material, with an emphasis on theories and models. We offer general education courses that introduce economic thinking without emphasizing economic models or theories. Instead, these courses focus on critical thinking, social and economic issues, and ideologies. We find evidence that exposure to a first-year critical-thinking course taught by a member of the Department of Economics and Finance increases the probability that a student will choose to major in economics. JEL Codes: A2, A22
Association Between Mid-arm Muscle Circumference and Cognitive Function: A Longitudinal Study of Chinese Adults
Authors: Spangler Hillary B. , Lynch David H. , Howard Annie Green , Tien Hsiao-Chuan , Du Shufa , Zhang Bing , Wang Huijun , Gordon Larsen Penny , Batsis John A. 
Published: November 2023

Background Dementia affects 55 million people worldwide and low muscle mass may be associated with cognitive decline. Mid-arm muscle circumference (MAMC) correlates with dual-energy Xray absorptiometry and bioelectrical impedance analyses, yet are not routinely available. Therefore, we examined the association between MAMC and cognitive performance in older adults. Methods We included community-dwelling adults ≥55 years from the China Health and Nutrition Survey. Cognitive function was estimated based on a subset of the modified Telephone Interview for Cognitive Status (0-27, low-high) during years (1991, 1993, 1997, 2000, 2004, 2006, 2009, 2011, 2015, 2018). A multivariable linear mixed-effects model was used to test whether MAMC was associated with rate of cognitive decline across age groups and cognitive function overall. Results Of 3702 adults (53% female, 63.2 ± 7.3 years), mean MAMC was 21.4 cm ± 3.0 and baseline cognitive score was 13.6 points ±6.6. We found no evidence that the age-related rate of cognitive decline differed by MAMC ( P = .77). Declines between 5-year age groups ranged from −.80 [SE (standard error) .18] to −1.09 [.22] for those at a mean MAMC, as compared to −.86 [.25] to −1.24 [.31] for those at a 1 MAMC 1 standard deviation above the mean. Higher MAMC was associated with better cognitive function with .13 [.06] higher scores for each corresponding 1 standard deviation increase in MAMC across all ages. Conclusion Higher MAMC at any age was associated with better cognitive performance in older adults. Understanding the relationship between muscle mass and cognition may identify at-risk subgroups needing targeted interventions to preserve cognition.
Speech Outcomes of Buccal Myomucosal Flap Palatal Lengthening for Treatment of Velopharyngeal Insufficiency: Systematic Literature Review and Meta-Analysis
Authors: Lentskevich Marina A. , Yau Alice , Figueroa Ariel E. , Termanini Kareem M. , Gosain Arun K. 
Published: November 2023

Objective Buccal myomucosal flaps (BMF) anatomically lengthen the palate in the treatment of velopharyngeal insufficiency (VPI). We systematically reviewed the existing literature on speech outcome of BMF palatal lengthening. Design Three databases were used to identify studies of interest published in English. Studies that did not use standardized speech assessments were excluded. PRISMA checklist was followed, and the risk of bias in the included studies was assessed. Setting Long-term follow up of patients. Patients With history of cleft palate presenting with VPI. Intervention BMF palatal lengthening. Main Outcome Measure Random-effects model meta-analyses were performed for hypernasality, intelligibility, and nasal air emission score improvements, which were derived from reported preoperative and postoperative scores, and controlled for variability of scales and timing of postoperative assessment. Results From the initial 7115 articles, 13 were included in this review. Two of these had a significant patient overlap and a study with a smaller patient population was excluded. All 12 included articles met the National Institutes of Health Quality Assessment Tool criteria. Six retrospective studies evaluated 230 patients and six prospective studies evaluated 181 patients. The most common indications for BMF were large size of the velopharyngeal gap and prior surgery for VPI. Meta-analyses demonstrated effect sizes below zero, confirming the improvement of standardized assessment scores in patients with VPI after BMF palatal lengthening. Egger regressions revealed low risk of publication bias. Conclusions BMF palatal lengthening provides adequate treatment for VPI in patients with large velopharyngeal gap size and a history of prior unsuccessful surgery.
A Complement to Traditional Treatments for Antibody-Mediated Rejection? Use of Eculizumab in Lung Transplantation: A Review and Early Center Experience
Authors: Kleiboeker Hanna L. , Prom Alyson , Paplaczyk Krista , Myers Catherine N. 
Published: November 2023

Objective: To review the efficacy and safety of eculizumab for prevention and treatment of antibody-mediated rejection (AMR) in lung transplant recipients (LTRs). Data Sources: A literature search of PubMed and the Cochrane Controlled Trials Register (2007 to mid-October 2023) was performed using the following search terms: eculizumab, complement inhibitor, solid organ transplant, lung transplant, and AMR. Study Selection and Data Extraction: All relevant English-language studies were reviewed and considered. Data Synthesis: Eculizumab, a monoclonal antibody that binds complement protein C5 to inhibit its cleavage and subsequent generation of the membrane attack complex, is currently approved to treat paroxysmal nocturnal hemoglobinuria, atypical hemolytic uremic syndrome, generalized myasthenia and neuromyelitis optica spectrum disorder. Given the role of antibodies directed against donor antigens that are produced by allospecific B-cells and plasma cells in AMR, eculizumab is being investigated for use within this indication. Three case reports have described the successful use of eculizumab for the prevention and treatment of AMR in LTRs. Given this lack of robust data, evidence for the use of eculizumab in other solid organ transplant recipients is of increased value. Early experiences from a single center’s use of eculizumab in LTRs are also described. Relevance to Patient Care and Clinical Practice: Lung transplant is a recognized treatment for end-stage lung disease, though complications posttransplant can be associated with significant morbidity and mortality. While prevention and management of AMR remains a substantial challenge without comprehensive guidance from societal guidelines, recently published literature may be helpful to guide clinical practice using alternative treatment options. However, this remains an area of great clinical importance, given the impact of AMR on long-term allograft function. Conclusions: Optimizing use of current therapies, as well as identifying and advancing novel therapeutic modalities such as eculizumab, are vital for the improvement of AMR prevention and treatment in LTRs to extend long-term allograft function and survival.