bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of deintensifying hypoglycaemic drugs in older adults with type 2 diabetes: protocol for an emulation of a target trial
Authors: Christiaens Antoine , Simon-Tillaux Noémie , Thompson Wade , Sinclair Alan J. , Henrard Séverine , Boland Benoit B. , Slaouti-Jégou Yannis , Lekens Béranger , Bonnet-Zamponi Dominique , Tubach Florence , Zerah Lorène 
Published: November 2023

IntroductionIn older adults with type 2 diabetes (T2D), overtreatment with hypoglycaemic drugs (HDs: sulfonylureas, glinides and/or insulins) is frequent and associated with increased 1-year mortality. Deintensification of HD is thus a key issue, for which evidence is though limited. The primary objective of this study will be to estimate the effect of deintensifying HD on clinical outcomes (hospital admission or death) within 3 months in older adults (≥75 years) with T2D.MethodsWe will emulate with real-world data a target trial, within The Health Improvement Network cohort, a large-scale database of data collected from electronic medical records of 2000 general practitioners in France. From 1 January 2010 to 28 February 2019, we will include eligible patients ≥75 years who will have T2D, a stable dose of HDs, glycated haemoglobin A1c (HbA1c) value <75 mmol/mol (9.0%) and no deintensification in the past year. The target trial will be sequentially emulated (ie, eligibility assessed) every month in the database. Patients will be classified at baseline of each sequential trial in the intervention arm (deintensification of HDs: decrease of ≥50% in the total dose of HDs, including complete cessation) or control arm (no deintensification of HDs). The pooled dataset for all sequential emulated trials will be analysed. The primary outcome will be time to first occurrence of hospital admission or death, within 3 months. Secondary outcomes will be hospitalisation, death, appropriateness of glycaemic control and occurrence of HbA1c >75 mmol/mol within 1 year. Participants will be followed from baseline to 12 months after randomisation, administrative censoring, or death, whichever occurs first. A pooled logistic regression will be used to estimate the treatment effect on the incidence of the outcomes.Dissemination and ethicsNo ethical approval is needed for using retrospectively this fully anonymised database. The results will be disseminated during conferences and through publications in scientific journals.
Quiet quitting among healthcare professionals in hospital environments: a concept analysis and scoping review protocol
Authors: Kang Jaejin , Kim Hyekyung , Cho Ok-Hee 
Published: November 2023

IntroductionThe post-COVID-19 pandemic era has seen a rise in ‘quiet quitting’, with employees limiting their efforts to fulfil assigned tasks without going beyond their designated responsibilities. The occurrence of quiet quitting in hospitals can have detrimental effects not only on organisational culture but also on patient safety and satisfaction. Therefore, the aim of this study is to define quiet quitting among healthcare professionals in hospitals through concept analysis, identify the associated factors and outcomes of quiet quitting, and conduct a scoping review based on this defined concept.Methods and analysisThis study will adopt Walker and Avant method for concept analysis and Aromataris and Munn methodological framework as well as the Joanna Briggs Institute Reviewer’s manual for scoping reviews. The concept analysis will follow eight steps: (1) choosing the concept; (2) outlining the objectives of the analysis; (3) recognising the concept’s uses; (4) selecting the concept’s defining attributes; (5) constructing a model case; (6) constructing additional cases; (7) defining the consequences and antecedents of the concept; and (8) determining empirical referents. This study used databases of PubMed, Embase, PsycINFO, Scopus, ProQuest Dissertations and Theses Global for the English language, and NDSL, KCI, RISS, KISS and DBpia for the Korean language. Additionally, grey literature will be searched.Ethics and disseminationThis concept analysis and scoping review does not require ethical approval. The results of this study will be reported in peer-reviewed publications.
Nurse-led approach to standardising the management of iron-deficiency anaemia, achieving the 2-week cancer pathway targets and reducing hospital admissions: practicalities and learnings from a success story
Authors: Reid Pauline , Patterson Kev , McCulloch Emma , Walsh Laura , Murshid Amal , Kinsella William , Moore Andrew , Skouras Thomas , Smith Philip J 
Published: November 2023

The most significant and common cause of anaemia is iron deficiency, which occurs when iron absorption cannot meet the body’s demands due to growth, pregnancy, poor nutrition, malabsorption or blood loss. It is estimated that in the UK 11% of the adult population have iron-deficiency anaemia (IDA) and investigation is essential to exclude significant pathology as the underlying cause. It has been shown that IDA is responsible for 57 000 hospital admissions in the UK, and at least 10% of gastroenterology referrals per annum.IDA is a major red flag symptom for gastrointestinal cancer. At the Royal Liverpool University Hospital, a dedicated nurse-led IDA service was developed in 2005 to help alleviate the clinical pressures created by the two week suspected cancer referral pathway. With the success of this service, investigation and management of IDA has been extended to referrals from accident and emergency, with the aim of reducing hospital admissions and to investigating and optimising iron replacement therapy in preoperative patients.Delivering this as a nurse consultant-led service was proposed by the gastroenterology medical team who felt that, as a clinical problem with well established, published investigative algorithms, IDA would be suitable for management in a dedicated nurse-led clinic.This article will focus on the strategies employed to achieve sufficient resources and clinic capacity to run this service effectively, develop strong nurse education and training, and the development of agreed investigation pathways. A robust results review process, with rapid management of abnormal results, was established with timely discharge for those patients with normal results. Optimisation of iron replacement therapy and verification of sustained haematological response was prioritised as this was identified as being poorly managed across all specialties. A process for ongoing audit of results was included to show the success of the service and highlight areas for redesign.Here, we demonstrate the effectiveness of our nurse-led IDA service and suggest it as the basis for other IDA services in the UK and beyond.
Cosmological LTB black hole in a quintom universe
Authors: Eslamzadeh Sareh , Nozari Kourosh , Firouzjaee J. T. 
Published: November 2023

AbstractWe study cosmological Lemaitre–Tolman–Bondi (LTB) black hole thermodynamics immersed in a quintom universe. We investigate some thermodynamic aspects of such a black hole in detail. We apply two methods of treating particles’ tunneling from the apparent horizons and calculate the black hole’s temperature in each method; the results of which are the same. In addition, by considering specific time slices in the cosmic history, we study the thermodynamic features of this black hole in these specific cosmic epochs. Also, we discuss the information loss problem and the remnant content of the cosmological black hole in different cosmic epochs in this context. We show that approximately in all the cosmic history, the temperature of the black hole’s apparent horizon is more than the temperature of the cosmological apparent horizon.
ESR1 F404 Mutations and Acquired Resistance to Fulvestrant in ESR1-Mutant Breast Cancer
Authors: Kingston Belinda , Pearson Alex , Herrera-Abreu Maria Teresa , Sim Li-Xuan , Cutts Rosalind J. , Shah Heena , Moretti Laura , Kilburn Lucy S. , Johnson Hannah , Macpherson Iain R. , Ring Alistair , Bliss Judith M. , Hou Yingwei , Toy Weiyi , Katzenellenbogen John A. , Chandarlapaty Sarat , Turner Nicholas C. 
Published: November 2023

Abstract

Fulvestrant is used to treat patients with hormone receptor–positive advanced breast cancer, but acquired resistance is poorly understood. PlasmaMATCH Cohort A (NCT03182634) investigated the activity of fulvestrant in patients with activating ESR1 mutations in circulating tumor DNA (ctDNA). Baseline ESR1 mutations Y537S are associated with poor outcomes and Y537C with good outcomes. Sequencing of baseline and EOT ctDNA samples (n = 69) revealed 3/69 (4%) patients acquired novel ESR1 F404 mutations (F404L, F404I, and F404V), in cis with activating mutations. In silico modeling revealed that ESR1 F404 contributes to fulvestrant binding to estrogen receptor–alpha (ERα) through a pi-stacking bond, with mutations disrupting this bond. In vitro analysis demonstrated that single F404L, E380Q, and D538G models were less sensitive to fulvestrant, whereas compound mutations D538G + F404L and E380Q + F404L were resistant. Several oral ERα degraders were active against compound mutant models. We have identified a resistance mechanism specific to fulvestrant that can be targeted by treatments in clinical development.

Significance:
Novel F404 ESR1 mutations may be acquired to cause overt resistance to fulvestrant when combined with preexisting activating ESR1 mutations. Novel combinations of mutations in the ER ligand binding domain may cause drug-specific resistance, emphasizing the potential of similar drug-specific mutations to impact the efficacy of oral ER degraders in development.
This article is featured in Selected Articles from This Issue, p. 201
“Nós vamos deixar vocês viverem para que morram de tristeza”: estupro como arma de guerra no Genocídio de 1994 em Ruanda
Authors: Vita Mariana Rodrigues de 
Published: November 2023

O estupro como arma é usado para destruir física e psicologicamente as mulheres, causando dor severa e irreversível, além de abalar o tecido social da comunidade vitimada. Esse tipo específico de estupro consiste na premeditação e coordenação antecipada provinda de autoridades militares, ou paramilitares, contra civis. Este artigo visa analisar o uso do estupro enquanto arma de guerra durante o Genocídio de 1994 em Ruanda. Assim, foram examinados os documentos oficiais da Organização das Nações Unidas (ONU) para entender qual foi o papel dela no combate ao estupro como arma de guerra e na proteção às mulheres, uma vez que a magnitude da violência em Ruanda já era conhecida pelo mundo e pela ONU. A temática e as fontes foram investigadas a partir de uma visão interdisciplinar, com enfoque histórico e feminista.
Getúlio Vargas e o Integralismo
Authors: Victor Rogério Lustosa 
Published: November 2023

Esse artigo parte da tensa relação entre o movimento integralista e a constituição do Estado Novo para, então, localizar o Integralismo como inimigo da ditadura Vargas. A partir de análise das matérias publicadas na grande imprensa, no período de 1937 a 1945, acerca do Integralismo, já inimigo político de Vargas, inferimos que, naquele período, embora aparentemente apenas relatando os fatos, o que a imprensa fez foi compartilhar dos mecanismos de propaganda política por meio dos quais o Estado Novo buscou legitimar o seu poder. Nesse processo, adversários da ditadura não foram poupados e o Estado foi capaz de cunhar representações que ficaram marcadas na memória social. Aos integralistas coube a
pecha de golpistas, risíveis, fanáticos e patéticos.
Da estrada de terra ao asfalto
Authors: Cardoso Jaqueline Henrique 
Published: November 2023

As transformações estabelecidas em Florianópolis (SC)[i] a partir das últimas décadas do século XX - decorrentes dos processos de urbanização e turistificação - não ocorreram de forma simultânea em toda a cidade, assim como a percepção de seus moradores sobre estas também são destoantes e envoltas em disputas e tensões. Os bairros do chamado “interior da ilha” – como Ribeirão da Ilha, Santo Antônio de Lisboa e Lagoa da Conceição - foram os que mais sentiram tais mudanças, dada sua condição de ruralidade até meados de 1970 – período que parte desses locais passa a atrair turistas e novos moradores. Nesse sentido, esse artigo pretende – através do método da história oral - compreender como esses processos foram percebidos por alguns moradores do bairro Santo Antônio de Lisboa – localizado ao norte da ilha de Santa Catarina - antes majoritariamente formado por uma população autóctone e hoje rodeado por moradores oriundos dos mais diferentes lugares do Brasil e do mundo.

rísticos.
GREEN, Bernard. The Soteriology of Leo the Great. New York: Oxford University, 2008. 272p.
Authors: Silva Paulo Duarte 
Published: November 2023

Nesta resenha discute-se o livro de Bernard Green à luz dos recentes debates historiográficos acerca dos estudos sobre o bispado de Leão de Roma (440-461), que ganharam força com sucessivas publicações em inglês no período entre 2003-2008. Como observado, o livro de Green beneficia-se da recém-admitida datação dos sermões leoninos para propor uma abordagem original sobre a soteriologia na pregação do citado bispo romano.
recordações, esses dentes de fera não saciada
Authors: Riberti Larissa Jacheta 
Published: November 2023

Resenha
CASTRO, Ana Buriano; BIELOUS, Silvia Dutrénit; VALENCIA, Daniel Vázquez. Política y memória. A cuarenta años de los golpes de Estado en Chile y Uruguay. México: Flacso, Instituto Mora, 2015. 289 páginas.
recente ditadura brasileira e a verdade histórica
Authors: Queiroz Silvia Maria Maria Brandão 
Published: November 2023

Adotando como eixo estrutural a filosofia política contemporânea e as disputas políticas por memória, verdade e justiça acerca da recente ditadura brasileira, propomo-nos pensar as ações da atual democracia em meio ao legado autoritário e aos processos de subjetivação do presente. Iniciamos discorrendo acerca do conceito de justiça de transição. No decorrer da argumentação, sem desconsiderar as ações de resistência ao instituído e os modos de agir da coletividade, mas com foco no aparelho de Estado, pretendemos demonstrar que seus sistemas de representação jurídico-institucionais fazem parte de tecnologias governamentais móveis de poder do contemporâneo e têm modelado, ao menos em parte, a subjetividade dos múltiplos sujeitos sociais, seus modos de ser e agir. Pensamos as Comissões da Verdade brasileiras como significantes que, embora não nos libertem das amarras da representação, reverberam nos atuais processos de subjetivação, trazendo a possibilidade de alterarmos os mecanismos de dominação da atualidade, dentre os quais se situa a democracia representativa.
Exposure to single-walled carbon nanotubes differentially affect in vitro germination, biochemical and antioxidant properties of Thymus daenensis celak. seedlings
Authors: Samadi Saba , Saharkhiz Mohammad Jamal , Azizi Majid , Samiei Leila , Ghorbanpour Mansour 
Published: November 2023

AbstractCarbon nanomaterials such as single-walled carbon nanotubes (SWCNTs) offer a new possibility for phyto-nanotechnology and biotechnology to improve the quality and quantity of secondary metabolites in vitro. The current study aimed to determine the SWCNTs effects on Thyme (Thymus daenensis celak.) seed germination. The seedlings were further assessed in terms of morphological and phytochemical properties. Sterile seeds were cultured in vitro and treated with various concentrations of SWCNTs. Biochemical analyses were designed on seedling sample extracts for measuring antioxidant activities (AA), total flavonoids (TFC) and phenolic contents, and the main enzymes involved in oxidative reactions under experimental treatments. The results indicated that an increase in SWCNTs concentration can enhance the total percentage of seed germination. The improvement was observed in samples that received SWCNTs levels of up to 125 µg ml−1, even though seedling height and biomass accumulation decreased. Seedling growth parameters in the control samples were higher than those of grown in SWCNT-fortified media. This may have happened because of more oxidative damage as well as a rise in POD and PPO activities in tissues. Additionally, secondary metabolites and relevant enzyme activities showed that maximum amounts of TPC, TFC, AA and the highest PAL enzyme activity were detected in samples exposed to 62.5 µg ml−1 SWCNTs. Our findings reveal that SWCNTs in a concentration-dependent manner has different effects on T. daenensis morphological and phytochemical properties. Microscopic images analysis revealed that SWCNTs pierce cell walls, enter the plant cells and agglomerate in the cellular cytoplasm and cell walls. The findings provide insights into the regulatory mechanisms of SWCNTs on T. daenensis growth, germination and secondary metabolites production.
High frequency of Enterococcus faecalis detected in urinary tract infections in male outpatients – a retrospective, multicenter analysis, Germany 2015 to 2020
Authors: Salm Jonas , Salm Florian , Arendarski Patricia , Kramer Tobias Siegfried 
Published: November 2023

Abstract
Background
Urinary tract infections (UTI) in men differ relevantly to women by their pathogens. Gram-positive uropathogens play a relevant role in UTI in men. In this study, we aimed to analyze the epidemiology of Enterococcus faecalis in UTI in male outpatients.

Methods
We conducted a retrospective observational multicenter study during 2015 to 2020 consisting of urine samples of 99,415 adult male outpatients sent from 6,749 outpatient practices from Germany. Proportions were compared using the z-Test and 95% confidence intervals were calculated using the Clopper-Pearson method.

Results
E. faecalis is the 2nd most frequent bacteria (16%) detected in suspected UTI in male outpatients. Young men are predominantly at risk (17%) for isolation of E. faecalis in suspected UTI. In polymicrobial infections E. faecalis is isolated in 47% of all suspected UTI in men. Recurrency of suspected UTI is significantly more frequent when E. faecalis is isolated compared to Escherichia coli (22% vs 26%; p < .001). Recurrency rates of E. faecalis associated UTI increases by age from 12% (18–29 years) to 28% ($$\ge$$
≥
70 years); p < .001. Congruently the resistance of E. faecalis against ciprofloxacin increases by age from 22% (18–29 years; 2019) to 37% ($$\ge$$
≥
70 years; 2019); p < .001.

Conclusions
E. faecalis is frequently isolated in suspected UTI in male patients. Consequently, Nitrate-sticks results cannot be recommended to exclude UTI in men. The empirical use of ciprofloxacin in young adults can be reasonable. Frequent recurrences in E. faecalis associated suspected UTI emphasizes the importance of microbiological pathogen identification and susceptibility testing in men suffering from UTI.
Short- and long-term outcomes of patients with minor stroke and nonvalvular atrial fibrillation
Authors: Duan Chunmiao , Wang Shang , Xiong Yunyun , Gu Hong qiu , Yang Kaixuan , Zhao Xing-Quan , Meng Xia , Wang Yongjun 
Published: November 2023

Abstract
Background and purpose
Nonvalvular atrial fibrillation (NVAF) is a risk factor for stroke. This study was undertaken to determine the influence of NVAF on the mortality and recurrent stroke after a minor stroke event.

Methods
Data were derived from the Third China National Stroke Registry (CNSR-III) which enrolled 15,166 subjects during August 2015 through March 2018 in China. Patients with minor stroke (NIHSS ≤ 5) within 24 h after onset were included. Clinical outcomes including all-cause mortality, cardiovascular death, recurrent ischemic stroke, and recurrent hemorrhagic stroke were collected. The Cox proportional hazards models were used to determine the association between NVAF and clinical outcomes.

Results
A total of 4,753 patients were included in our study. Of them, 222 patients had NVAF (4.7%) (mean age, 71.1 years) and 4,531 patients were without AF (95.3%) (mean age, 61.4 years). NVAF was associated with 12-month cardiovascular mortality in both univariate (hazards ratio [HR], 4.13; 95% confidence interval [CI], 1.84 to 9.31; P < 0.001) and multivariate analyses (HR, 4.66; 95% CI, 1.79 to 12.15; P = 0.001). There was no difference in the in-hospital ischemic stroke recurrence rate between the two groups (HR, 0.45 [95% CI, 0.19 to 1.05] P = 0.07 at discharge). However, patients with NVAF had a lower rate of recurrent ischemic stroke at medium- (3 months and 6 months) and long-term (12 months) follow-up (HR, 0.33 [95% CI, 0.16 to 0.68] P = 0.003 at 3 months; 0.49 [95% CI, 0.27 to 0.89] P = 0.02 at 6 months; 0.55 [95% CI, 0.32 to 0.94] P = 0.03 at 12 months, respectively) compared with those without. There was no difference in all-cause mortality and hemorrhagic stroke between the two groups during follow-up.

Conclusions
Minor stroke patients with NVAF were at higher risk of cardiovascular death but had a lower rate of recurrent ischemic stroke compared to those without during the subsequent year after stroke event. A more accurate stroke risk prediction model for NVAF is warranted for optimal patient care strategies.
Efficacy of curcumin gel as an adjunct to scaling and root planing on salivary procalcitonin level in the treatment of patients with chronic periodontitis: a randomized controlled clinical trial
Authors: Abdel-Fatah Reham , Mowafey Bassant , Baiomy Azza , Elmeadawy Samah 
Published: November 2023

Abstract
The aim of the study
To evaluate the effect of curcumin gel combined with scaling and root planing (SRP) on salivary procalcitonin in periodontitis treatment.

Materials and methods
seventy patients were selected from the Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mansoura University, and sixteen patients were excluded. Patients in groups II and III included stage II grade A periodontitis. The participants were classified into three groups: group I as a negative control group (individuals with healthy gingiva), group II (SRP) were treated with SRP, and group III (curcumin gel) which was applied weekly for four weeks after SRP. Clinical indices (plaque index (PI), gingival index (GI), clinical attachment level (CAL), and probing depth (PD)) and saliva samples for procalcitonin (PCT) assessment using an enzyme-linked immunosorbent assay (ELISA) test were collected and measured at both baselines and after six weeks.

Results
This randomized controlled clinical trial registered on ClinicalTrials.gov (NCT05667376) and first posted at 28/12/2022 included Fifty-four patients (20 male; 34 female). Regarding the age and sex distribution, there was no statistically significant difference between the three studied groups (p > 0.05). There was no significant statistical difference regarding PI, GI, PPD, and CAL between group II and group III at baseline p (> 0.05). However, there was a significant statistical difference regarding the clinical parameters at baseline of both group II and group III as compared to group I (p ≤ 0.05). At six weeks after treatment, group III showed greater improvement in the PI, PD, and CAL as opposed to group II (p ≤ 0.05). Regarding PCT values, at baseline, there wasn’t a statistically significant difference between group II and group III (p > 0.05). However, there was a significant statistical difference between group II, group III, and group I (p ≤ 0.05). At six weeks after treatment, there was a statistically significant decrease in PCT levels of both group II and III (p ≤ 0.05).

Conclusion
The application of curcumin gel was found to have a significant effect on all clinical indices as opposed to SRP.