bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of aloe vera gel dressing with conventional dressing on pressure ulcer pain reduction: a clinical trial
Authors: Malek Hosseini Azam , Rostam Khani Mohammad , Abdi Sina , Abdi Siavash , Sharifi Nader 
Published: January 2024

Abstract
Background
Aloe Vera has a strong analgesic and anti-inflammatory effect, and its use effectively controls pain. This study aimed to determine the effect of Aloe Vera gel versus saline on pain relief of pressure ulcers.

Methods
This study is a double-blind, randomized clinical trial conducted in Valiasr Hospital in Arak, Markazi Province, in the center of Iran from May 2020 to April 2022. Using the available sampling method, 95 patients with pressure ulcers were assessed for eligibility, 64 patients were selected, 33 patients were placed in the experimental and 34 patients in control. For the experimental group, the ulcers were first cleaned with normal saline to remove the slough and then the already prepared Aloe Vera gel was evenly applied. For control groups, the ulcers were first washed with normal saline to remove off the slough and then covered with a sterile cotton gage, and the wound was tightly bandaged with a cotton roll to keep the “daily dressing” in place. A visual pain scale was used to assess the patient’s pain level. Data analysis was done using SPSS 17. Descriptive statistics, ANOVA, and greenhouse tests were used. The significance level was 0.05.

Results
The results showed that the average pain score in both groups had a downward trend; that is, both dressings effectively reduced pressure ulcer pain (P < 0.001). The greenhouse test results showed that the difference between the two groups was significant (P < 0.001).

Conclusion
The results showed the effect of Aloe Vera gel in reducing pressure ulcer pain. Dressing with Aloe Vera gel is preferable to reducing pain during dressing changes in patients with pressure ulcers.

Trial registration
Iranian Registry of Clinical Trials IRCT20180715040478N2, 2021-08-17.
N-terminal titin fragment: a non-invasive, pharmacodynamic biomarker for microdystrophin efficacy
Authors: Boehler Jessica F. , Brown Kristy J. , Ricotti Valeria , Morris Carl A. 
Published: January 2024

Abstract
Background
Multiple clinical trials to assess the efficacy of AAV-directed gene transfer in participants with Duchenne muscular dystrophy (DMD) are ongoing. The success of these trials currently relies on standard functional outcome measures that may exhibit variability within and between participants, rendering their use as sole measures of drug efficacy challenging. Given this, supportive objective biomarkers may be useful in enhancing observed clinical results. Creatine kinase (CK) is traditionally used as a diagnostic biomarker of DMD, but its potential as a robust pharmacodynamic (PD) biomarker is difficult due to the wide variability seen within the same participant over time. Thus, there is a need for the discovery and validation of novel PD biomarkers to further support and bolster traditional outcome measures of efficacy in DMD.

Method
Potential PD biomarkers in DMD participant urine were examined using a proteomic approach on the Somalogic platform. Findings were confirmed in both mdx mice and Golden Retriever muscular dystrophy (GRMD) dog plasma samples.

Results
Changes in the N-terminal fragment of titin, a well-known, previously characterized biomarker of DMD, were correlated with the expression of microdystrophin protein in mice, dogs, and humans. Further, titin levels were sensitive to lower levels of expressed microdystrophin when compared to CK.

Conclusion
The measurement of objective PD biomarkers such as titin may provide additional confidence in the assessment of the mechanism of action and efficacy in gene therapy clinical trials of DMD.

Trial registration
ClinicalTrials.gov NCT03368742.
Cross-lagged analysis of rumination and social anxiety among Chinese college students
Authors: Wu Peibo , Cao Keyan , Feng Wenjing , Lv Shuai 
Published: January 2024

Abstract
Background
Social anxiety, which is widely prevalent among Chinese college students, poses a significant barrier to their holistic psychological and physiological development. Although numerous cross-sectional studies have examined the relationship between rumination and social anxiety, there is still a gap in understanding their interplay over time. This longitudinal study aimed to explore and analyze the intricate interrelations between these two factors, with the ultimate goal of informing the development of effective mental health education interventions for university students.

Methods
Using the Ruminative Responses Scale (RRS) and the Interaction Anxiousness Scale (IAS), a two-stage longitudinal follow-up study of 392 college students from three universities in Henan Province was conducted over a six-month period (October 2022 to March 2023) using a cross-lagged model to explore the correlation between rumination and social anxiety. The results of the correlation analysis showed that rumination was positively associated with social anxiety at both time points (r = 0.18,0.12, p < 0.01).

Results
Cross-lagged regression analyses revealed that the predictive effect of the first measure (T1) rumination on the second measure (T2) rumination was statistically significant (β = 0.32, p < 0.001). The predictive effect of T1 social anxiety on T2 social anxiety was statistically significant (β = 0.65, p < 0.001), the predictive effect of T1 rumination on T2 social anxiety was statistically significant (β = 0.33, p < 0.001), and the prediction of T1 social anxiety on T2 rumination was statistically significant (β = 0.28, p < 0.001).

Conclusion
College students’ rumination and social anxiety are mutually predictive of each other, and interventions by educators in either of these areas have the potential to interrupt the vicious cycle between ruminant thinking and social anxiety.
Exploring in-person self-led debriefings for groups of learners in simulation-based education: an integrative review
Authors: Kumar Prashant , Somerville Susan 
Published: January 2024

Abstract
Background
Facilitator-led debriefings are well-established for debriefing groups of learners in immersive simulation-based education. However, there has been emerging interest in self-led debriefings whereby individuals or groups of learners conduct a debriefing themselves, without the presence of a facilitator. How and why self-led debriefings influence debriefing outcomes remains undetermined.

Research aim
The aim of this study was to explore how and why in-person self-led debriefings influence debriefing outcomes for groups of learners in immersive simulation-based education.

Methods
An integrative review was conducted, searching seven electronic databases (PubMed, Cochrane, Embase, ERIC, SCOPUS, CINAHL Plus, PsychINFO) for peer-reviewed empirical studies investigating in-person self-led debriefings for groups of learners. Data were extracted, synthesised, and underwent reflexive thematic analysis.

Results
Eighteen empirical studies identified through the search strategy were included in this review. There was significant heterogeneity in respect to study designs, aims, contexts, debriefing formats, learner characteristics, and data collection instruments. The synthesised findings of this review suggest that, across a range of debriefing outcome measures, in-person self-led debriefings for groups of learners following immersive simulation-based education are preferable to conducting no debriefing at all. In certain cultural and professional contexts, such as postgraduate learners and those with previous debriefing experience, self-led debriefings can support effective learning and may provide equivalent educational outcomes to facilitator-led debriefings or self-led and facilitator-led combination strategies. Furthermore, there is some evidence to suggest that self-led and facilitator-led combination approaches may optimise participant learning, with this approach warranting further research. Reflexive thematic analysis of the data revealed four themes, promoting self-reflective practice, experience and background of learners, challenges of conducting self-led debriefings and facilitation and leadership. Similar to facilitator-led debriefings, promoting self-reflective practice within groups of learners is fundamental to how and why self-led debriefings influence debriefing outcomes.

Conclusions
In circumstances where simulation resources for facilitator-led debriefings are limited, self-led debriefings can provide an alternative opportunity to safeguard effective learning. However, their true value within the scope of immersive simulation-based education may lie as an adjunctive method alongside facilitator-led debriefings. Further research is needed to explore how to best enable the process of reflective practice within self-led debriefings to understand how, and in which contexts, self-led debriefings are best employed and thus maximise their potential use.
Mapping of health technology assessment in China: a comparative study between 2016 and 2021
Authors: Liu Shimeng , Xia Yu , Yang Yi , Ming Jian , Sun Hui , Wei Yan , Chen Yingyao 
Published: January 2024

Abstract
Background
Health Technology Assessment (HTA) in China has recently expanded from purely academic research to include policy or decision-oriented practice, especially after HTA evidence was used to update the National Reimbursement Drug List for the first time in 2017. This study aims to identify the progress and challenges of HTA development from 2016 to 2021 and inform policies and decisions to promote further HTA development in China.

Methods
We conducted a cross-sectional web-based survey with policy makers, researchers and industry-providers in China in 2016 and 2021 respectively. The ‘Mapping of HTA Instrument’, was utilized to assess the HTA development across eight domains: Institutionalization, Identification, Priority setting, Assessment, Appraisal, Reporting, Dissemination of findings and conclusions, and Implementation in policy and practice. To reduce the influence of confounders and compare the mapping outcomes between the 2016 and 2021 groups, we conducted 1:1 Propensity Score Matching (PSM). Univariate analysis was conducted to compare the differences between the two groups. The overall results were further compared with those of a mapping study that included ten countries.

Results
In total, 212 and 255 respondents completed the survey in 2016 and 2021, respectively. The total score of the HTA development level in China in 2021 was higher than that in 2016 before PSM (89.38 versus 83.96). Following PSM, 183 respondents from the 2016 and 2021 groups were matched. Overall, the mean scores for most indicators in the Institutionalization domain and Dissemination domain in 2021 were higher than those in 2016 (P < 0.05). The Appraisal domain in 2021 was more explicit, transparent and replicable than that in 2016 (t = −3.279, P < 0.05). However, the mean scores of most indicators in the Assessment domain were higher in 2016 than those in 2021 (P < 0.05).

Conclusions
Our study suggest that the level of HTA development in China progressed significantly from 2016 to 2021. However, before engaging in HTA activities, further efforts are required to enhance the assessment process. For instance, it is important to establish a clear goal and scope for HTA; adapt standardized methodologies for evaluating the performance of systematic reviews or meta-analyses; and provide comprehensive descriptions of the safety, clinical effectiveness, cost, and cost-effectiveness of the assessed technologies, thus improving the development of HTA in China.
The Basis for Weekly Insulin Therapy: Evolving Evidence With Insulin Icodec and Insulin Efsitora Alfa
Authors: Rosenstock Julio , Juneja Rattan , Beals John M , Moyers Julie S , Ilag Liza , McCrimmon Rory J 
Published: January 2024

Abstract
Basal insulin continues to be a vital part of therapy for many people with diabetes. First attempts to prolong the duration of insulin formulations were through the development of suspensions that required homogenization prior to injection. These insulins, which required once- or twice-daily injections, introduced wide variations in insulin exposure contributing to unpredictable effects on glycemia. Advances over the last 2 decades have resulted in long-acting, soluble basal insulin analogues with prolonged and less variable pharmacokinetic exposure, improving their efficacy and safety, notably by reducing nocturnal hypoglycemia. However, adherence and persistence with once-daily basal insulin treatment remains low for many reasons including hypoglycemia concerns and treatment burden. A soluble basal insulin with a longer and flatter exposure profile could reduce pharmacodynamic variability, potentially reducing hypoglycemia, have similar efficacy to once-daily basal insulins, simplify dosing regimens, and improve treatment adherence. Insulin icodec (Novo Nordisk) and insulin efsitora alfa (basal insulin Fc [BIF], Eli Lilly and Company) are 2 such insulins designed for once-weekly administration, which have the potential to provide a further advance in basal insulin replacement. Icodec and efsitora phase 2 clinical trials, as well as data from the phase 3 icodec program indicate that once-weekly insulins provide comparable glycemic control to once-daily analogues, with a similar risk of hypoglycemia. This manuscript details the technology used in the development of once-weekly basal insulins. It highlights the clinical rationale and potential benefits of these weekly insulins while also discussing the limitations and challenges these molecules could pose in clinical practice.
What was ultimately J. Mezirow's perception of the role of emotions in Transformation Theory?
Authors: Karakou Maria , Karalis Thanassis 
Published: January 2024

This article attempts to contribute -with bibliographic data- to the constructive dialogue that continues to evolve around the emotional dimension of learning, within the framework of Transformation Theory (TT). It presents the findings of a literature review - as part of a doctoral thesis - regarding the significance that Mezirow himself attaches to the role of emotion in a transformative process. The research was conducted using the content analysis technique of primary sources, namely the texts of J. Mezirow.
The research findings indicated that Mezirow linked emotion to the key elements of his framework: the object of transformation, the means, the phases of the process, the taking of action and the role of the adult educator. These constitute the "strong" points of the emotional dimension of his theory. On the other hand, points were identified that Mezirow chose to touch upon only superficially or not to analyze further, such as a more detailed examination of the relationship between the emotion of critical reflection in each phase of the process, the recognition and utilization of positive emotions, and proposals for specific techniques for the emergence and management of emotions in practice.
Ultimately, the research highlighted that Mezirow, despite any omissions, managed to synthesize a comprehensive theory with a relative balance of rational and emotional elements. In his effort to keep the boundaries of adult education distinct from psychotherapy, he didn't go any deeper into issues in which he had not delved, leaving them open to more specialized theorists in the field.
Multi-image optical information hiding algorithm based on Fourier transform without hidden key transmission
Authors: Guo Yuan , Zhai Ping , Wang Xuewen , Li WenPeng 
Published: January 2024

Existing optical information hiding algorithms for multiple images require generating hidden keys for embedded images, resulting in the transmission of numerous keys. This challenge undermines the usage of these algorithms in low-quality networks. To address this issue and enhance transmission efficiency, we present a multi-image optical information hiding algorithm based on Fourier transformation principles, which is employed to generate hidden frequency maps and carrier frequency maps. Specific low-frequency information zones are extracted within these hidden frequency maps. A chaotic system integrates a phase mask, modulated with the low-frequency regions, positioned in the carrier frequency map’s high-frequency sector. The final stego image is obtained by subjecting the carrier frequency map to inverse Fourier transformation. Experimental analysis shows that concealing three images takes only 0.0089 s, with extraction requiring 0.0658 s. Post-extraction PSNR values for hidden images exceed 32 dB. Robustness and anti-attack experiments were done to prove the security of this algorithm. The compared experiments between the proposed method and other state-of-the-art algorithms affirm the algorithm’s attributes of simplicity, ease of implementation, robust security, and high efficiency. Importantly, the restoration process eliminates the necessity of transmitting hidden keys, reducing network burdens and enhancing both concealment and extraction efficiencies significantly.
High performance CsBi3I10/PCBM bulk heterojunction perovskite photodetector
Authors: Zhao Hongliang , Zhang Yating , Yao Jianquan 
Published: January 2024

Lead halide perovskites (LHPs) have been extensively studied due to their remarkable optoelectronic performance. However, the toxicity of a lead ion to humans and its instability under ambient conditions render lead-based halide perovskite an unsuitable material for commercialization. Meanwhile, lead-free halide perovskite (LFHP) devices generally exhibit poor performance. Therefore, enhancing photoelectric conversion capacity is the most important issue that needs to be addressed. Here, we propose a photodetector (PD) fabricated using CsBi3I10/phenyl-C61-butyric acid methyl ester (PCBM) bulk heterojunction as the active layer. The PD illuminated under 532 nm can reach a high responsivity (1.54 A/W) at −2V bias, while at 2 V bias, the PD reaches a higher responsivity (224.40 A/W). All of those results suggest that CsBi3I10/PCBM bulk heterojunctions hold enormous potential in substituting for LHPs in optoelectronic devices.
Multi-solution inverse design in photonics using generative modeling
Authors: Kumar Preetam , Patra Aniket , Shivaleela E. S. , Caligiuri Vincenzo , Krahne Roman , De Luca Antonio , Srinivas T. 
Published: January 2024

The lack of uniqueness poses a common challenge in the inverse design of nanophotonic structures. This issue arises from the presence of multiple sets of design parameters that yield identical output configurations. Several existing machine learning methods offer promising solutions for enabling flexibility in selecting sets of design variables. However, these approaches still face significant challenges like limited output diversity, and training instability. These issues constrain the variety of solutions attainable for a particular target response. To overcome these challenges in the realm of multi-solution inverse design problems in nanophotonics, we have developed a GA-βCVAE architecture based on generative models. This approach effectively tackles such problems, thereby expanding the range of distinct solutions achievable in nanophotonics. Our approach combines a genetic algorithm with a β conditional variational autoencoder neural network based generative model, capturing multiple distinct solutions for a given target. It provides flexibility in selecting design variables. We successfully applied it to design TiO2-SiO2 based multilayer thin films in the visible range (400–750 nm), with layer thickness as the design variable. Experimental verification confirmed the effectiveness of our proposed architecture.
Deep learning to estimate impaired glucose metabolism from Magnetic Resonance Imaging of the liver: An opportunistic population screening approach
Authors: Michel Lea J. , Rospleszcz Susanne , Reisert Marco , Rau Alexander , Nattenmueller Johanna , Rathmann Wolfgang , Schlett Christopher. L. , Peters Annette , Bamberg Fabian , Weiss Jakob 
Published: January 2024

Aim
Diabetes is a global health challenge, and many individuals are undiagnosed and not aware of their increased risk of morbidity/mortality although dedicated tests are available, which indicates the need for novel population-wide screening approaches. Here, we developed a deep learning pipeline for opportunistic screening of impaired glucose metabolism using routine magnetic resonance imaging (MRI) of the liver and tested its prognostic value in a general population setting.

Methods
In this retrospective study a fully automatic deep learning pipeline was developed to quantify liver shape features on routine MR imaging using data from a prospective population study. Subsequently, the association between liver shape features and impaired glucose metabolism was investigated in individuals with prediabetes, type 2 diabetes and healthy controls without prior cardiovascular diseases. K-medoids clustering (3 clusters) with a dissimilarity matrix based on Euclidean distance and ordinal regression was used to assess the association between liver shape features and glycaemic status.

Results
The deep learning pipeline showed a high performance for liver shape analysis with a mean Dice score of 97.0±0.01. Out of 339 included individuals (mean age 56.3±9.1 years; males 58.1%), 79 (23.3%) and 46 (13.6%) were classified as having prediabetes and type 2 diabetes, respectively. Individuals in the high risk cluster using all liver shape features (n = 14) had a 2.4 fold increased risk of impaired glucose metabolism after adjustment for cardiometabolic risk factors (age, sex, BMI, total cholesterol, alcohol consumption, hypertension, smoking and hepatic steatosis; OR 2.44 [95% CI 1.12–5.38]; p = 0.03). Based on individual shape features, the strongest association was found between liver volume and impaired glucose metabolism after adjustment for the same risk factors (OR 1.97 [1.38–2.85]; p<0.001).

Conclusions
Deep learning can estimate impaired glucose metabolism on routine liver MRI independent of cardiometabolic risk factors and hepatic steatosis.