bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adults' perspectives of experiences and preferences for end-of-life care
Authors: Huang Ya-Ling , Wang Shou-Yu , Lin Chun-Chih , Thorberg Fred Arne , Wu Chiung-Jung (Jo) 
Published: December 2023

Background: Decisions about end-of-life care often raise clinical and ethical challenges, especially when the person's capacity to contribute in the decision making at the end of life is limited. Aim: This study aimed to explore Taiwanese adults' preferences associated with communication, healthcare planning, life-sustaining treatments and palliative care and experiences of end-of-life care. Methods: Semi-structured interviews were conducted with 16 adults aged 20 years and above. The sampling approach was a convenience strategy in a community centre located in a metropolitan area in the Southern region of Taiwan. A qualitative content analysis approach was used to elicit key themes from the data. Results: Significant findings related to the two main themes of adults' experiences, including the observed distress of those who were dying and the distress experienced by the family. Other key findings pertain to personal preferences for end-of-life care, such as preferred end-of-life communication, preparing for the end-of-life and maintenance of quality of life. Conclusions: This exploratory study offers insight into 16 Taiwanese community-dwelling adults' views of preferences regarding end-of-life communication, preparation for the end of life and maintenance of quality of life, as well as their experiences of end-of-life care. A further exploration is suggested to elicit how personal end-of-life experiences shape individuals' health practices in advance care planning for end-of-life care.
Clinical characteristics of Martorell hypertensive ischaemic leg ulcer
Authors: Karppinen Jesse JM , Kallio Milla , Lappalainen Katriina , Lagus Heli , Matikainen Niina , Isoherranen Kirsi 
Published: December 2023

Objective: We sought to characterise the clinical picture of Martorell hypertensive ischaemic leg ulcer (HYTILU) by describing the ulcer borders with three clinical features: ‘the red lipstick sign’; purple border; and livedo racemosa. We also aimed to characterise comorbidities and determinants of healing time. Method: A single-centre, retrospective cohort study was conducted between 2015–2020. We scrutinised ulcer photographs for relevant clinical signs. Data on comorbidities, medication and ulcer treatments, as well as method of diagnosis and healing time, were collected from patients' electronic medical records. Results: In total, 38 female patients and 31 male patients (mean age 73 years) were assessed, with a mean follow-up time of 174 days. The ‘red lipstick-like’ margin covered 0–50% of the ulcer margin in 56.5% of the ulcers, and 51–100% of the ulcer margin in 43.5% of the ulcers. Purple border or livedo racemosa was observed in 70.5% of the ulcers. All patients had hypertension and 52.2% of patients had type 2 diabetes. A heavy cardiovascular disease burden and frequent concomitant vascular pathologies were found. Infections requiring systemic antibiotics, ulcer size and duration of symptoms before diagnosis were strongly associated with healing time. We also found that use of systemic corticosteroids and severity of hypertension (measured by the number of antihypertensive medications used) delayed healing. Conclusion: Our data suggest that ‘the red lipstick sign’ could be a novel diagnostic feature in HYTILUs alongside purple border, livedo racemosa and necrotic/fibrinous ulcer bed. The results also elucidated HYTILU comorbidities, and showed that infections and delay in diagnosis impeded healing.
Use of suboptimal control arms in randomized clinical trials of investigational cancer drugs in China, 2016–2021: An observational study
Authors: Zhang Yichen , Chen Dingyi , Cheng Siyuan , Liang Zhizhou , Yang Lu , Li Qian , Bai Lin , Li Huangqianyu , Liu Wei , Shi Luwen , Guan Xiaodong 
Published: December 2023

Background
The use of suboptimal controls in randomized trials of new cancer drugs can produce potentially unreliable clinical efficacy results over the current standard of care and expose patients to substandard therapy. We aim to investigate the proportion of randomized trials of investigational cancer drugs that used a suboptimal control arm and the number of trial participants at risk of exposure to suboptimal treatments in China. The association between the use of a suboptimal control and concluding statistical significance on the primary endpoint was also examined.

Methods and findings
This observational study included randomized controlled trials (RCTs) of cancer drugs that were authorized by specific Chinese institutional review boards between 2016 and 2021, supporting investigational new drug applications of these drugs in China. The proportion of trials that used a suboptimal control arm and the total number of trial participants at risk of exposure to suboptimal treatments were calculated. In a randomized trial for a specific condition, a comparator was deemed suboptimal if it was not recommended by clinical guidelines published in priori or if there existed a regimen with a higher level of recommendation for the indication.
The final sample included 453 Phase II/III and Phase III randomized oncology trials. Overall, 60 trials (13.2%) adopted a suboptimal control arm. Among them, 58.3% (35/60) used comparators that were not recommended by a prior guideline for the indication. The cumulative number of trial participants at risk of exposure to suboptimal treatments totaled 18,610 by the end of 2021, contributing 15.1% to the total number of enrollees of all sampled RCTs in this study. After adjusting for the year of ethical approval, region of participant recruitment, line of therapy, and cancer site, second-line therapies (adjusted odds ratio [aOR] = 2.7, 95%CI [1.2, 5.9]), adjuvant therapies (aOR = 8.9, 95% CI [3.4, 23.1]), maintenance therapies (aOR = 5.2, 95% CI [1.6, 17.0]), and trials recruiting participants in China only (aOR = 4.1, 95% CI [2.1, 8.0]) were more likely to adopt a suboptimal control. For the 105 trials with publicly available results, no statistically significant difference was observed between the use of a suboptimal control and concluding positive on the primary endpoint (100.0% [12/12] versus 83.9% [78/93], p = 0.208). The main limitation of this study is its reliance on clinical guidelines that could vary across cancer types and time in assessing the quality of the control groups.

Conclusions
In this study, over one-eighth of randomized trials of cancer drugs registered to apply for regulatory approval in China used a suboptimal comparator. Our results highlight the necessity to refine the design of randomized trials to generate optimal clinical evidence for new cancer therapies.
Evaluation of therapeutic effect of oral Ursodeoxycholic Acid on indirect hyperbilirubinemia in term neonates undergoing phototherapy: A randomized controlled clinical trial
Authors: Zarkesh Marjaneh , Mahdipour Sadroddin , Aghili Safoora , Jafari Atefeh , Nouri Seyyedeh Azadeh Hoseini , Hassanzadeh Rad Afagh , Ghalandari Maryam , Tabrizi Manijeh 
Published: December 2023

Introduction and aims
Phototherapy is the most common treatment modality of neonatal hyperbilirubinemia. We aimed to evaluate the therapeutic effect of oral Ursodeoxycholic Acid (UDCA) on indirect hyperbilirubinemia in term neonates undergoing phototherapy.

Materials and methods
This randomized controlled clinical trial was performed on 106 full-term neonates with jaundice who were admitted to the neonatal ward of 17 Shahrivar Hospital in Rasht, Iran. The neonates were randomly assigned to two groups of intervention (10 mg/kg UDCA+phototherapy) and control (phototherapy alone). Total serum bilirubin (TSB) was measured at the time of admission, during first 12, 24, and 48 hours after admission and at the time of discharge. The duration of hospitalization and side effects were also assessed in both groups. IBM SPSS Statistics for Windows, version 20 was used to analyze the data.

Results
Results showed that in the intervention group, 28 (52.8%) of neonates were boys with the mean age of 5.1±1.25 days. While, in the control group 29 (54.7%) of them were boys with the mean age of 5.19±2.26 days. Bilirubin levels in both groups decreased significantly after hospitalization (at 12, 24 and 48 hours) (P <0.001). The mean of bilirubin at 12, 24 and 48 hours in the intervention and control groups were 17.1, 13.2, 10.2 mg / dl and 17.1, 14.2 and 11.3 mg / dl, respectively. At the time of discharge, TSB in the former compared to the latter group was significantly reduced (7.74± 1.39 vs. 8.67±1.35) (P = 0.001). In addition, the duration of hospitalization was considerably shorter in the intervention compared to the control group (P = 0.038) and no side effects were observed.

Conclusions
Administering UDCA plus phototherapy reduced TSB and length of hospital stay with proper safety and efficacy. Therefore, it seems that this combination can be an appropriate treatment modality in neonatal hyperbilirubinemia.
Determinants of cervical cancer screening utilization among HIV-positive women, in public general hospitals of Central Zone, Tigray, Ethiopia, 2020: Case-control study
Authors: Gebremeskel Tsega Gebremichael , Gebretatios Merkeb Zeray 
Published: December 2023

Introduction
Cervical cancer is the second leading cause of cancer-related morbidity and mortality in Ethiopia. Evidence showes that, despite the magnitude and severity of cervical cancer, utilization of cervical cancer screening in the study area among HIV-positive women is low.

Objective
This study aimed to assess the determinants of cervical cancer screening utilizationamong HIV-positive women in general public hospitals in the central zone of Tigray, Ethiopia.

Method
This study was a facility-based unmatched case-control study conductedamong HIV-infected womenin public general hospitals in the central zone of Tigray. Cases were HIV infected women not screened for cervical cancer, and controls were HIV infected women screened for cervical cancer. A total of 800participants (400 cases and 400 controls) wereselected using systematic random sampling with a 1:1 case-to-control ratio.Data collection was done using a pre-tested interviewer-administered questionnaire and a medical record review.The determinants of cervical cancer screeningutilization were identified through binary logistic regression.

Result
Significant determinants of cervical cancer screening utilization among HIV-infected women in the central zone of Tigray werebeing in the age group of 18–30 [AOR = 0.46, 95% CI = 0.22, 0.98], living in rural areas [AOR = 0.47, 95% CI = 0.26, 0.87], no formal education [AOR = 0.25, 95% CI = 0.14, 0.45] and primary education [AOR = 0.28, 95% CI = 0.16,0.49], not working outside the home [AOR = 0.21, 95% CI = 0.10, 0.44], poor knowledge about cervical cancer [AOR = 0.29, 95% CI = 0.19, 0.44], and about cervical cancer screening [AOR = 0.44, 95% CI = 0.28, 0.70], and unfavorable attitudes toward cervical cancer screening [AOR = 0.52, 95% CI = 0.34, 0.79].

Conclusion
Being in the age group of 18–30, living in rural areas, lacking formal education or havingonly primary level education, not working outside of the home, having poor knowledge of cervical cancer and screening,and having unfavourable attitudestowards cervical cancer screeningare significant determinat factors in cervical cancer screening utilization among HIV-infected women in the central zone of Tigray, Ethiopia. Considering such factors during the design of policies and programs could enhance the utilization of cervical cancer screening in the region.
Alceste com autoria partilhada: Eurípides e Saramago no Festea XXIII
Authors: Liz Carlos 
Published: December 2023

A peça Alceste de Eurípides integrou a programação do FESTEA XXIII numa versão de Daniela Pereira e Carlos Jesus, com o intrigante título Que fazer com Alceste? A Eurípides junta-se Saramago e o seu livro As Intermitências da Morte, numa combinação surpreendente no plano da dramaturgia e da encenação. Esta notícia inclui uma referência a anteriores representações de Alceste em Portugal.
Al rescate de la tradición: una propuesta didáctica para el área de música mediante el juego popular
Authors: Muñoz García Marta 
Published: December 2023

El presente artículo tiene como objeto de estudio la revalorización y transmisión de la música de los juegos populares de la Región de Murcia de los años 1944 a 1960. Para ello, se va a implantar una unidad didáctica basada en la música de los juegos populares.
Esta unidad didáctica se pondrá en práctica en un colegio público de la ciudad de Murcia. Está destinada a tres sesiones de 60 minutos con una clase de 4. º de primaria de 25 alumnos. Principalmente, se va a utilizar una metodología participativa en la que el alumnado adquiera un papel activo durante todas las sesiones. Se fomentará también el respeto y valoración al patrimonio musical y el trabajo grupal con lo que se pretende favorecer las habilidades sociales, la cooperación, la convivencia y la responsabilidad individual.
Tras la realización de la unidad, a través de los instrumentos de evaluación se ha comprobado que la mayoría de los estudiantes han sido capaces de realizar de manera correcta todas las actividades propuestas, consiguiendo así que se cumplan los objetivos planteados inicialmente.
Alice Desclaux, Aïssa Diarra, Sandrine Musso – Guérir en Afrique. Promesses et transformations
Authors: Vernerey-Kopp Géraldine 
Published: December 2023

Recensé : Alice Desclaux, Aïssa Diarra, Sandrine Musso (dir.), Guérir en Afrique. Promesses et transformations, Paris, L’Harmattan, 2021, 370 p. (« Anthropologies & Médecine »).
Cardioprotective Effects of Sodium-Glucose Cotransporter 2 Inhibitors and Their Possible Association With Normalization of the Circadian Index of Heart Rhythm
Authors: Dogan Nazile Bilgin , Yasar Hamiyet Yilmaz , Kilicaslan Baris 
Published: December 2023

Abstract

Background
Updated recommendations for the treatment of heart failure with reduced ejection fraction (HFrEF) include sodium-glucose cotransporter 2 (SGLT2) inhibitors and other long-established HFrEF therapies. These drugs’ mechanisms of action have yet to be fully clarified.

Objective
This study evaluated the effects of SGLT2 inhibitors on the modulation of autonomic function at 1 month beyond conventional HF therapy.

Methods
This single-center, observational, prospective study was conducted from January 2020 to December 2022. Patients with type 2 diabetes who had ischemic HFrEF and met the study criteria were considered for SGLT2 inhibitor treatment with empagliflozin or dapagliflozin. Changes in the circadian index were used as the primary outcome to assess the early effects of SGLT2 inhibitors on autonomic function. Changes in functional effort capacity and laboratory findings were also evaluated. Participants’ circadian index was measured by a 24-hour rhythm Holter monitoring recorder (BTL-08 Holter H100). A symptom-limited treadmill test assessed patients’ effort capacities. Tests were repeated after 1 month of therapy.

Results
The mean (SD) age of the 151 participants was 56.95 (7.29) years; their mean (SD) left ventricular EF was 35.69% (7.10%), and 95 participants were men (62.9%). From baseline to 1 month, mean (SD) daytime heart rate (80.63 [9.17] vs 77.67 [8.04] beats per minute; P = .004) and nighttime heart rate (76.83 [11.34] vs 73.81 [10.25] beats per minute; P = .03) decreased significantly. Variation in the circadian indexes (mean [SD], 1.04 [0.02] vs 1.10 [0.04]; P < .001) was statistically significant, favoring increased modulation of autonomic function. The increases in exercise duration (mean [SD], 8.88 [3.69] minutes and median [IQR], 8.81 [5.76-12.13] minutes vs 9.72 [3.14] and 9.59 [7.24-12.22] minutes; P = .04) and exercise capacity (mean [SD], 203.38 [65.18] m and median [IQR], 119.22 [149.43-259.15] m vs 335.61 [51.39] and 325.79 [293.59-376.91] m; P < .001] were also significant.

Conclusion
The use of SGLT2 inhibitors during early treatment can favorably affect both autonomic dysfunction and functional effort capacity of patients with type 2 diabetes with ischemic HFrEF.
Is Decoloniality a New Turn in Postcolonialism?
Authors: Gu Ming Dong 
Published: December 2023

Abstract
A new orientation appeared in cultural studies at the turn of the twenty-first century. As it centers around the concept, “decoloniality,” it has been called the “decolonial turn” by some scholars. Since the decolonial turn addresses “decoloniality,” one would think it signals a new orientation in postcolonial studies. Proponents of “decoloniality,” however, have denied it as a concept of postcolonialism and even regretted its conflation with postcolonialism and decolonization. This article critically examines major ideas in the decoloniality program in relation to issues of postcolonialism and argues for its placement in the context of postcolonialism so as to enrich postcolonial studies and advance the project of decoloniality.
ECG Beat classification: Impact of linear dependent samples
Authors: Hintermüller Christoph , Hirnschrodt Michael , Blessberger Hermann , Steinwender Clemens 
Published: December 2023

Abstract
The Electro Cardio Gram (ECG) is a very valuable clinical tool to access the electric function of the heart. It provides insight into the different phases of the heart beat and various kinds of disorders which may affect them. In literature the impact of linear dependency between feature signals upon the classification outcome and how to reduce it have been largely investigated and discussed. This study puts a focus upon linear dependency between samples of imbalanced data sets, its relation to the observed over fitting with respect to majority classes and hot to reduce it. A set of 58 feature signals is used to train a several LDA classifier either discriminating 3 classes (Normal, Artefact, Arrhythmic) or 5 Classes (Normal, Artefact, Atrial and ventricular premature contractions and bundle branch blocks). The training data set is preprocessed using four sample reduction approaches and a nearest neighbour clustering method. In the case of 5 classes accuracies of 96.82% in the imbalanced case and 97.44% for the data preprocessed with the QR or SVD methods were obtained. For 3 classes curacies of 97.68% and 98.12% were achieved. With the nearest neighbour clustering method only accuracies of 96.00% for 5 classes and 97.37% for 3 classes could be achieved. The results clearly show that imbalanced ECG data does contain linear dependent samples. These cause a bias towards majority class which will be over fitted by the classifier. Sample reduction methods and algorithms which are not aware of the presence linear dependent samples like the nearest neighbour clustering approach even further increase this bias ore even worse destroy relevant information by merging samples which encode distinct aspects of the beat class, destroying relevant information.
Advancements in Adult and Neonatal Breathing Simulation Using the xPULMTM Electro-mechanical Lung Simulator
Authors: Vodenicharov Vasil , Pasteka Richard 
Published: December 2023

Abstract
Simulation is essential for healthcare professionals, students, and researchers, providing a safe environment for skill development and improved patient care. This paper presents enhancements to the xPULMTMelectro-mechanical lung simulator, enabling simulation of adult and neonatal breathing patterns. Hardware improvements include interchangeable flow sensors and additional temperature, humidity, volatile organic compounds (VOCs), and pressure sensors. The software redesign separates control and processing elements, enhancing performance. Measured parameters demonstrate expanded capabilities, such as increased airflow range and higher sampling frequency. Airtightness measurements show improved chamber sealing. Future developments aim to simulate neonatal breathing patterns and optimise software for high-frequency measurements. The enhanced xPULMTM simulator provides a realistic platform for simulating lung mechanics, benefiting respiratory medicine research and education.
Conceptualizing Corpus-Based Genre Pedagogy as Usage-Inspired Second Language Instruction
Authors: Wang Yuanheng (Arthur) , Lu Xiaofei 
Published: December 2023

Abstract
Corpus-based genre pedagogy (CBGP), the instructional integration of discourse-based rhetorical analysis and corpus-based linguistic analysis of diverse genres, has gained attention from English for Academic Purposes (EAP) researchers and practitioners aiming to cultivate the academic writing skills of second language (L2) learners. This has led to a need for the continuous conceptualization of CBGP (Lu, Xiaofei, J. Casal Elliott, and Yingying Liu. 2021. “Towards the Synergy of Genre- and Corpus-Based Approaches to Academic Writing Research and Pedagogy.” International Journal of Computer-Assisted Language Learning and Teaching 11 (1): 59–71). Additionally, usage-based approaches to L2 acquisition (U-SLA), a collection of cognitive and potentially sociocognitive theoretical approaches to language and language acquisition (Ellis, Nick C., Ute Römer, and Matthew Brook O’Donnell. 2016. Usage-Based Approaches to Language Acquisition and Processing: Cognitive and Corpus Investigations. Malden: Wiley-Blackwell; Wulff, Stepanie, and Nick C. Ellis. 2018. “Usage-Based Approaches to Second Language Acquisition.” In Bilingual Cognition and Language: The State of the Science across its Subfields, edited by D. Miller, F. Bayram, J. Rothman, and L. Serratrice, 37–56. Amsterdam: John Benjamins Publishing Company), have called for more pedagogically oriented research informed by usage-based principles (e.g., Tyler, Andrea E., Hae In Park, Mariko Uno, and Lourdes Ortega, eds. 2018. Usage-inspired L2 Instruction: Researched Pedagogy. Amsterdam: John Benjamins Publishing Company). Responding to such calls, we argue for conceptualizing CBGP as usage-inspired instruction given its intersections with key U-SLA instructional tenets. We first systematically review empirical studies on CBGP. Then, we introduce relevant U-SLA instructional tenets and interpret the CBGP studies to illuminate the extent to which CBGP resonates with different aspects of the U-SLA tenets. Eventually, we argue that CBGP can potentially unify the “social” and the “cognitive” in U-SLA’s accounts of L2 teaching and learning, making it a feasible way to materialize usage-inspired L2 instruction in actual classroom practice. Finally, we discuss future research and practical directions.
The Effect of Market and Technological Turbulence on Innovation Performance in Nascent Enterprises: The Moderating Role of Entrepreneur’s Courage
Authors: Namal Mete Kaan , Tufan Cenk , Köksal Kemal , Mert İbrahim Sani 
Published: December 2023

Abstract
Adapting to market and technological turbulence is essential for survival in a developing enterprise and requires making changes. Firms may need to increase their innovation performance to keep up and struggle with these changes to gain a competitive advantage. We believe that the courage of the entrepreneur emerges as a catalyst in such a struggle. Since a firm’s superior performance is contingent on both internal and external environments of the firm, depending on, contingency theory, the current study investigates the effect of market and technological changes, which are part of environmental changes, on innovation performance in nascent enterprises and the moderating role of courage in this effect. The authors collected data from 331 innovative companies acting in free trade zones by using the convenience sampling method via HR department managers. The results showed that market and technological changes were significantly and positively related to innovative performance, and the entrepreneur’s courage moderated this relationship. It can be stated that entrepreneurs with high courage responded to changes with more innovation than those with low courage.