bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary School Mathematics in the Context of Digitalization
Authors: Muranov A. A. , Polikarpov S. A. , Rudchenko T. A. 
Published: August 2023

Abstract
We consider the content and methods of teaching mathematics in primary school in the context of digitalization. The necessity of a significant updating of the curriculum is shown. In particular, this implies the use of digital tools as an object of study and a way of significantly improving the content and effectiveness of learning mathematics to prepare children for the future life and work.
Disseminated histoplasmosis in an immunosuppressed patient successfully treated with isavuconazole
Authors: Sircar Anita D , Tran Mai-Chi N , Vaidya Sagar A , Goldstein Ellie JC , Wheat L Joseph 
Published: August 2023

Histoplasmosis is an endemic fungal infection caused by the dimorphic fungus,Histoplasma capsulatum,which is treated with intravenous amphotericin B and oral itraconazole as first-line and second-line therapy. We report a case of a man in his early 70s treated with methotrexate and infliximab for rheumatoid arthritis who developed disseminated histoplasmosis. The patient was unable to absorb itraconazole due to intractable diarrhoea and developed a severe, anaphylactoid reaction or an immune reconstitution inflammatory syndrome when treated with liposomal amphotericin B. He was subsequently treated with isavuconazole and steroids and made a full recovery.A literature review revealed other cases of histoplasmosis which were treated with isavuconazole including both primary pulmonary and disseminated presentations. Cases of blastomycosis which were treated with isavuconazole are also reviewed including those with severe immunocompromised statuses including solid-organ transplant and tumour necrosis factor-alpha antagonist recipients. Our report describes the potential role of isavuconazole in cases of histoplasmosis where first-line and second-line therapies have failed or are contraindicated (excluding meningitis).
Evaluation of the efficacy and safety of an innovative flavonoid lotion in patients with haemorrhoid: a randomised clinical trial
Authors: Razdar Sara , Panahi Yunes , Mohammadi Ramtin , Khedmat Leila , Khedmat Hossein 
Published: August 2023

ObjectiveHaemorrhoids are one of the most common gastrointestinal and anal diseases. In olive oil and honey propolis, flavonoids have beneficial effects on improving vascular function and decreasing vascular resistance. In this study, we aimed to produce a combination of these two substances in the form of lotions and assess their healing and side effects in comparison with routine treatment, anti-haemorrhoid ointment (containing hydrocortisone and lidocaine).DesignIn this randomised clinical trial study, 86 patients with grade 2 or more haemorrhoid degrees, diagnosed by colonoscopy, were divided into two groups, the case (n=44) and control (n=42). The case group was treated with flavonoid lotion, and the control group was treated with anti-haemorrhoid ointment two times per day for 1 month. Patients were followed weekly with history and physical examination. The data of the two groups were collected before and after the intervention and statistically analysed.ResultsPost-treatment reduction in haemorrhoid grade was significant in the case group (p=0.02). This ratio was insignificant in the control group (p=0.139). Flavonoid lotion (p<0.05) significantly reduced the signs and symptoms of haemorrhoids more than anti-haemorrhoid ointment.ConclusionAccording to the results, flavonoid lotion can be an excellent alternative to topical chemical drugs, such as anti-haemorrhoid ointment, in treating haemorrhoid disease. Besides its effectiveness and safety, it can be easily manufactured and widely available to patien
Depression, violence and socioeconomic outcomes among refugees in East Africa: evidence from a multicountry representative survey
Authors: Pozuelo Julia R , Bradenbrink Raphael , Stierna Maria Flinder , Sterck Olivier 
Published: August 2023

BackgroundExisting research on refugee mental health is heavily skewed towards refugees in high-income countries, even though most refugees (83%) are hosted in low-income and middle-income countries. This problem is further compounded by the unrepresentativeness of samples, small sample sizes and low response rates.ObjectiveTo present representative findings on the prevalence and correlates of depression among different refugee subgroups in East Africa.MethodsWe conducted a multicountry representative survey of refugee and host populations in urban and camp contexts in Kenya, Uganda and Ethiopia (n=15 915). We compared the prevalence of depression between refugee and host populations and relied on regression analysis to explore the association between violence, depression and socioeconomic outcomes.FindingsWe found a high prevalence of elevated depressive symptoms (31%, 95% CI 28% to 35%) and functional impairment (62%, 95% CI 58% to 66%) among the refugee population, which was significantly higher than that found in the host population (10% for depressive symptoms, 95% CI 8% to 13% and 25% for functional impairment, 95% CI 22% to 28%) (p<0·001). Further, we observed a dose–response relationship between exposure to violence and mental illness. Lastly, high depressive symptoms and functional impairment were associated with worse socioeconomic outcomes.ConclusionOur results highlight that refugees in East-Africa—particularly those exposed to violence and extended exile periods—are disproportionately affected by depression, which may also hinder their socioeconomic integration.Clinical implicationsGiven the high prevalence of depression among refugees in East Africa, our results underline the need for scalable interventions that can promote refugees’ well-being.
Effects of a culturally adapted counselling service for low-income ethnic minorities experiencing mental distress: a pragmatic randomised clinical trial
Authors: Suen Yi Nam , Chen Eric Yu Hai , Wong Yik Chun , Ng Winnie , Patwardhan Shilpa , Cheung Charlton , Hui Christy Lai Ming , Wong Stephanie Ming Yin , Wong Michael Tak Hing , Mahtani Shalini 
Published: August 2023

BackgroundCulturally competent early mental health interventions for ethnic minorities (EMs) with no formal diagnoses are needed.ObjectivesTo determine whether 8–12 weeks culturally adapted counselling (CAC) is better than waiting (waitlist (WL) group) to reduce depressive and anxiety symptoms and stress levels among EMs with elevated mental distress.MethodsHong Kong EMs with mild and above-mild mental distress were randomly assigned to CAC or WL in this pragmatic, randomised, WL-controlled trial. The CAC group received the intervention after randomisation and the WL group received the intervention after 8–12 weeks (T1). The prespecified primary outcomes were depressive and anxiety symptoms and stress levels measured by the Depression, Anxiety and Stress subscales of the Depression, Anxiety and Stress Scale (DASS-D, DASS-A and DASS-S, respectively) at postintervention (T1, 8–12 weeks).FindingsA total of 120 participants were randomly assigned to either CAC (n=60) or WL (n=60), of whom 110 provided primary outcome data. At T1, CAC led to significantly lower depressive and anxiety symptom severity and stress levels compared with waiting, with unstandardised regression coefficients of −8.91 DASS-D points (95% CI −12.57 to −5.25; d=−0.90),–6.33 DASS-A points (95% CI −9.81 to −2.86; d=−0.68) and −8.60 DASS-S points (95% CI −12.14 to −5.06; d=−0.90).ConclusionsCAC clinically outperformed WL for mild and above-mild levels of mental distress in EMs.Clinical implicationsMaking CAC routinely available for EMs in community settings can reduce healthcare burden.Trial registration numberNCT04811170.
Is a novel digital system for arm and hand rehabilitation suitable for stroke survivors? A qualitative process evaluation of OnTrack
Authors: Taylor Elizabeth , Fusari Gianpaolo , Darzi Ara , Jones Fiona 
Published: August 2023

Objectives and designNational guidelines emphasise the need to enhance arm and hand recovery poststroke. OnTrack is a 12-week package aiming to address this need. Feasibility was evaluated in a single-arm feasibility study (reported separately). This paper presents findings from a nested process evaluation. The objectives were to explore users’ experiences of OnTrack and fidelity of delivery, in order to inform a definitive trial of effectiveness and future delivery.SettingParticipants were interviewed in a range of settings in hospital, home or via telephone, at the end of their intervention cycle. Session observations for a selection of coaching sessions were carried out in person at home or remotely, post-COVID-19.ParticipantsEleven participants who completed the intervention following a stroke were interviewed. Seven coaching sessions were observed.InterventionThis process evaluation was part of a larger feasibility study of OnTrack, which involves setting movement targets and monitoring activity using a tracker on the wrist, motivational messaging via a Smartphone and self-management coaching. Preliminary analysis of data collected was conducted with a public and patient involvement group formed of stroke survivors. This informed changes in intervention delivery.ResultsParticipants reported finding the OnTrack programme beneficial, with the coaching role seen as particularly important. Participants found activity tracking motivating, but some noted discrepancies between tracked movement and what they considered useful activity. Motivational messages were sometimes irritating. Most felt ready to sustain their own activity practice at the end of the programme.ConclusionsThis process evaluation supported initial theoretical assumptions that OnTrack would enable activity practice through the use of remote monitoring. There was a strong emphasis on the coaching role as a mechanism of impact supporting the technological intervention. These findings will inform the next stages of delivery in a definitive trial.Trial registration numberNCT03944486.
Burden and seasonal distribution of malaria in Ziquala district, Northeast Ethiopia: a 5-year multi-centre retrospective study
Authors: Debash Habtu , Bisetegn Habtye , Ebrahim Hussen , Tilahun Mihret , Dejazmach Zelalem , Getu Nigatu , Feleke Daniel Getacher 
Published: August 2023

ObjectiveThis study was aimed to determine the 5-year trend of malaria positivity rate in Ziquala district, Northeast Ethiopia.MethodsReview of blood film reports from health institutions’ laboratory record books using predesigned checklists was done as part of an institution-based retrospective study to assess the 5-year (2016/2017–2020/2021) trend of malaria. To display data and analyse patterns in the trend of malaria over the course of years, months and seasons, descriptive statistics were used. The results of the data analysis were displayed in tables and figures using SPSS V.26.0. P values under 0.05 were considered as statistically significant for all comparisons.ResultsA total of 46 365 blood films from malaria suspected individuals were diagnosed using microscopy over the last 5 years. Of the diagnosed individuals, 14 429 (31.1%) were confirmed positive for Plasmodium infection.Plasmodium falciparum(59.7%) andPlasmodium vivax(37.0%) were the dominant species. The positivity rate of mixed infection (P. falciparumandP. vivax) was 3.3%. The maximum (3598; 29.6%) and minimum (2085; 29.1%) number of cases were reported in 2019/2020 and 2020/2021, respectively. Of the total cases, 9206 (63.8%) were in males. Moreover, the highest malaria positivity rate was observed in the age group of 15–45 (4040; 28.0%). Among the six health facilities, Ziquala district hospital had the highest malaria positivity rate (35.8%), followed by Tsitsika health centre (27.3%) and Mishra health centre (14.2%).ConclusionWithP. falciparumbeing the most common species, malaria remains a severe public health threat in the district. Therefore, the district health office and other concerned bodies should strengthen and implement evidence-based malaria prevention and control measures.
Long-term efficacy and safety of erenumab in Japanese patients with episodic and chronic migraine: results from a 28-week open-label treatment period of a randomised trial
Authors: Hirata Koichi , Takeshima Takao , Sakai Fumihiko , Numachi Yotaro , Yoshida Ryuji , Koukakis Reija , Hasebe Miki , Yui Daishi , da Silva Lima Gabriel Paiva , Cheng Sunfa 
Published: August 2023

ObjectivesTo evaluate the 1-year efficacy and safety of once-monthly erenumab 70 mg following a 24-week double-blind treatment period (DBTP) of a phase III randomised study of Japanese patients with episodic migraine (EM) or chronic migraine (CM).DesignMulticentre open-label study.SettingA total of 41 centres in Japan.ParticipantsPatients completing the DBTP continued into the 28-week open-label treatment period (OLTP). 254 of 261 (97.3%) randomised patients continued into the OLTP; 244 (93.5%) completed treatment.InterventionsOnce-monthly subcutaneous erenumab 70 mg.Main outcome measuresChanges from baseline in monthly migraine days (MMD) and monthly acute migraine-specific medication treatment days (MSMD) reported via patient eDiary; proportion of ≥50% and ≥75% responders in MMD reduction from baseline; incidence and exposure-adjusted incidence of treatment-emergent adverse events (TEAEs).ResultsAt week 24 of the DBTP, the mean (SE) change from baseline in MMD for the erenumab group was –3.8 (0.4) days (EM, –3.0 (0.4); CM, –5.2 (0.8)); in MSMD, –2.6 (0.4) days (EM, –2.1 (0.4); CM, –3.4 (0.7)). At the end of the OLTP (52 weeks postbaseline), the mean (SE) change from baseline in MMD was –4.7 (0.3) days (EM, –3.4 (0.3); CM, –6.9 (0.6)); in MSMD, –3.3 (0.3) days (EM, –2.4 (0.3); CM, –4.6 (0.5)). The proportion of ≥50% responders for MMD reduction in the erenumab group was 34.1% at week 24; 44.4% at week 52. The exposure-adjusted incidence of TEAEs was 219.7 per 100 patient-years during the OLTP (DBTP, 251.0 for the erenumab group). The most common TEAEs during the OLTP were nasopharyngitis, constipation and influenza. No new safety concerns were identified.ConclusionsErenumab treatment was associated with reduced migraine frequency in Japanese patients with EM or CM for up to 1 year. Overall safety results from the OLTP were consistent with DBTP results.Trial registration numberNCT03812224.
Is the process of withdrawal of life-sustaining measures in the intensive care unit different for deceased organ donors compared with other dying patients? A secondary analysis of prospectively collected data
Authors: Shahin J , Scales Nathan B , Johara F , Hogue M , Hornby Laura , Shemie Sam , Schmidt M , Waldauf P , Duska F , Wind Tineke , Van Mook W N , Dhanani Sonny 
Published: August 2023

ObjectiveTo investigate whether observable differences exist between patterns of withdrawal of life-sustaining measures (WLSM) for patients eligible for donation after circulatory death (DCD) in whom donation was attempted compared with those patients in whom no donation attempts were made.SettingAdult intensive care units from 20 centres in Canada, the Czech Republic and the Netherlands.DesignSecondary analysis of quantitative data collected as part of a large, prospective, cohort study (the Death Prediction and Physiology after Removal of Therapy study).ParticipantsPatients ≥18 years of age who died after a controlled WLSM in an intensive care unit. Patients were classified as not DCD eligible, DCD eligible with DCD attempted or DCD eligible but DCD was not attempted.Primary and secondary outcome measuresThe process of WLSM (timing and type and, if applicable, dosages of measures withdrawn, dosages of analgesics/sedatives) was compared between groups.ResultsOf the 635 patients analysed, 85% had either cardiovascular support stopped or were extubated immediately on WLSM. Of the DCD eligible patients, more were immediately extubated at the initiation of WLSM when DCD was attempted compared with when DCD was not attempted (95% vs 61%, p<0.0001). Initiation of WLSM with the immediate cessation of cardiovascular measures or early extubation was associated with earlier time to death, even after adjusting for confounders (OR 2.94, 95% CI 1.39 to 6.23, at 30 min). Other than in a few patients who received propofol, analgesic and sedative dosing after WLSM between DCD attempted and DCD eligible but not attempted patients was not significantly different. All patients died.ConclusionsPatients in whom DCD is attempted may receive a different process of WLSM. This highlights the need for a standardised and transparent process for end-of-life care across the spectrum of critically ill patients and potential organ donors.
Experiences and preferences for psychosocial support: a qualitative study exploring the views of patients with chronic haematological cancers
Authors: Sheridan Rebecca , McCaughan Dorothy , Hewison Ann , Roman Eve , Smith Alexandra , Patmore Russell , Howell Debra 
Published: August 2023

ObjectivesPatients with chronic haematological cancers are often treated on a relapsing-remitting pathway, which may extend for many years. Such diagnoses are associated with uncertainties that often cause anxiety and distress, meaning patients (and families) are susceptible to potentially prolonged emotional difficulties, across the cancer journey. Experiences and preferences regarding psychosocial needs and support over time are relatively unexplored, which this study aimed to address.Setting and designSet within the UK’s Haematological Malignancy Research Network (an ongoing population-based cohort that generates evidence to underpin improved clinical practice) a qualitative, exploratory study was conducted, using semistructured interviews. Reflexive thematic analysis was used to assess the interview data via an exploratory, inductive approach, underpinned by the research questions.ParticipantsThirty-five patients were included with chronic lymphocytic leukaemia, follicular lymphoma, marginal zone lymphoma or myeloma; 10 of whom were interviewed alongside a relative.ResultsFive themes were identified from the data: (1) accessing support, (2) individual coping behaviour affecting support preferences, (3) divergent and fluctuating thoughts on patient support forums, (4) the role, influence and needs of family and friends and (5) other sources of support and outstanding needs. Findings suggest that patients’ individual attitudes towards support varied over time. This also influenced whether support was perceived to be available, and if it was then used.ConclusionThis study highlighted the variation in preferences towards psychosocial support among patients with chronic haematological cancers. As patients can live for many years with significant emotional difficulties, they may benefit from frequent monitoring of their psychosocial well-being, as well as signposting to holistic support, if this is needed.
Comparison of surgical strategies in patients with chronic subdural haematoma: a protocol for a network meta-analysis
Authors: Li Yujian , Yang Xiang , Zhou Huiqing , Hui Xuhui , Li Hao , Zheng Jun 
Published: August 2023

IntroductionChronic subdural haematoma (CSDH) is one of the most common neurosurgical emergencies, especially in the elderly population. Surgery is the mainstay of treatment for CSDH. Some studies have suggested that some specific surgical strategies can have potential benefits for patients with CSDH; however, the best surgical method is still controversial. For a better understanding of surgical treatment for these patients, it is necessary to conduct a network meta-analysis to comprehensively compare the effects of medical treatment and different surgical methods.Methods and analysisThis protocol has been reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Related studies published up to April 2023 will be searched in the following databases: PubMed, Embase, Scopus, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, VIP and Wanfang. Randomised controlled trials and non-randomised prospective studies comparing at least two different interventions for patients with CSDH will be included. Quality assessment will be conducted using Cochrane Collaboration’s tool or the Newcastle–Ottawa Scale based on study design. The primary outcome will be the recurrence rates, and the secondary outcome will be the functional outcome at the end of follow-up. Pairwise and network meta-analyses will be conducted using STATA V.14 (StataCorp, College Station, Texas, USA). Mean ranks and the surface under the cumulative ranking curve will be used to evaluate each intervention. Statistical inconsistency assessment, subgroup analysis, sensitivity analysis and publication bias assessment will be performed.Ethics and disseminationEthics approval is not necessary because this study will be based on publications. The results of this study will be published in a peer-reviewed journal.PROSPERO registration numberCRD42022376829.
Protocol for a multicentre cross-sectional, longitudinal ambulatory clinical trial in rheumatoid arthritis and Parkinson’s disease patients analysing the relation between the gut microbiome, fasting and immune status in Germany (ExpoBiome)
Authors: Hansen Bérénice , Laczny Cédric C , Aho Velma T E , Frachet-Bour Audrey , Habier Janine , Ostaszewski Marek , Michalsen Andreas , Hanslian Etienne , Koppold Daniela A , Hartmann Anika M , Steckhan Nico , Mollenhauer Brit , Schade Sebastian , Roomp Kirsten , Schneider Jochen G , Wilmes Paul 
Published: August 2023

IntroductionChronic inflammatory diseases like rheumatoid arthritis (RA) and neurodegenerative disorders like Parkinson’s disease (PD) have recently been associated with a decreased diversity in the gut microbiome, emerging as key driver of various diseases. The specific interactions between gut-borne microorganisms and host pathophysiology remain largely unclear. The microbiome can be modulated by interventions comprising nutrition.The aim of our clinical study is to (1) examine effects of prolonged fasting (PF) and time-restricted eating (TRE) on the outcome parameters and the immunophenotypes of RA and PD with (2) special consideration of microbial taxa and molecules associated with changes expected in (1), and (3) identify factors impacting the disease course and treatment by in-depth screening of microorganisms and molecules in personalised HuMiX gut-on-chip models, to identify novel targets for anti-inflammatory therapy.Methods and analysisThis trial is an open-label, multicentre, controlled clinical trial consisting of a cross-sectional and a longitudinal study. A total of 180 patients is recruited. For the cross-sectional study, 60 patients with PD, 60 patients with RA and 60 healthy controls are recruited at two different, specialised clinical sites. For the longitudinal part, 30 patients with PD and 30 patients with RA undergo 5–7 days of PF followed by TRE (16:8) for a period of 12 months. One baseline visit takes place before the PF intervention and 10 follow-up visits will follow over a period of 12 months (April 2021 to November 2023).Ethics and disseminationEthical approval was obtained to plan and conduct the trial from the institutional review board of the Charité-Universitätsmedizin Berlin (EA1/204/19), the ethics committee of the state medical association (Landesärztekammer) of Hessen (2021–2230-zvBO) and the Ethics Review Panel (ERP) of the University of Luxembourg (ERP 21–001 A ExpoBiome). The results of this study will be disseminated through peer-reviewed publications, scientific presentations and social media.Trial registration numberNCT04847011.