bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploration of Latent Structure in Test Revision and Review Log Data
Authors: Zhang Susu , Li Anqi , Wang Shiyu 
Published: August 2023

AbstractIn computer‐based tests allowing revision and reviews, examinees' sequence of visits and answer changes to questions can be recorded. The variable‐length revision log data introduce new complexities to the collected data but, at the same time, provide additional information on examinees' test‐taking behavior, which can inform test development and instructions. In the current study, we used recently proposed statistical learning methods for sequence data to provide an exploratory analysis of item‐level revision and review log data. Based on the revision log data collected from computer‐based classroom assessments, common prototypes of revisit and review behavior were identified. The relationship between revision behavior and various item, test, and individual covariates was further explored under a Bayesian multivariate generalized linear mixed model.
Comparative analysis of dimethyl fumarate and teriflunomide in relapsing–remitting multiple sclerosis
Authors: Müller Jannis , Schädelin Sabine , Lorscheider Johannes , Benkert Pascal , Hänni Peter , Schmid Jürg , Kuhle Jens , Derfuss Tobias , Granziera Cristina , Yaldizli Özgür 
Published: August 2023

AbstractBackground and purposeIn relapsing–remitting multiple sclerosis (RRMS), analyses from observational studies comparing dimethyl fumarate (DMF) and teriflunomide showed conflicting results. We aimed to compare the effectiveness of DMF and teriflunomide in a real‐world setting, where both drugs are licensed as first‐line therapies for RRMS.MethodsWe included all patients who initiated DMF or teriflunomide between 2013 and 2022, listed in the Swiss National Treatment Registry. Coarsened exact matching was applied using age, gender, disease duration, baseline Expanded Disability Status Scale (EDSS) score, time since last relapse, and relapse rate in the previous year as matching variables. Time to relapse and time to 12‐month confirmed EDSS worsening were compared using Cox proportional hazard models.ResultsIn total, 2028 patients were included in this study, of whom 1498 were matched (DMF: n = 1090, 69.6% female, mean age 45.1 years, median EDSS score 2.0; teriflunomide: n = 408, 68.9% female, mean age 45.1 years, median EDSS score 2.0). Time to relapse and time to EDSS worsening was longer in the DMF than the teriflunomide group (hazard ratio 0.734, p = 0.026 and hazard ratio 0.576, p = 0.003, respectively).ConclusionAnalysis of real‐world data showed that DMF treatment was associated with more favorable outcomes than teriflunomide treatment.
A qualitative study on how intimate partner violence against women changes, escalates, and persists from pre‐ to postseparation
Authors: Li Carrie K. W. 
Published: August 2023

AbstractResearch has focused on intimate partner violence (IPV) against women either before or after separation, but little attention has been paid to the changes in and persistence of violent behaviors from one situation to the next. This study contributes to the literature by comparing the changes in types and frequencies of abusive behaviors of women's former husbands. This allows us to understand how mechanisms of power are enacted through IPV both before and after separation. We interviewed 19 women in the Midwestern United States who had experienced IPV by their former husbands and had subsequently divorced them. Data were analyzed using qualitative content analysis. The findings suggest that verbal abuse and using children were the most common forms of IPV both pre‐ and postseparation. Many preseparation behaviors were replaced by other forms of abuse; for example, physical abuse was not experienced after separation. Some forms of IPV, such as stalking and economic abuse, escalated after separation. This reveals that exerting control over women through nonphysical forms of IPV was more common after separation. In particular, using axial and selective coding approach, our findings present three composite narratives of women's experiences of the changes in, and the escalation and persistence of, the violence they faced. The three composite narratives show how abusive behaviors are situated within patriarchal notions of dominance, power, and control over women and their children. The implications of the findings are discussed in terms of healthcare services, advocacy‐based victim assistance, school officials, and the courts.
A focus on fathers with intellectual disabilities and child protection
Authors: Ćwirynkało Katarzyna , Parchomiuk Monika 
Published: August 2023

AbstractObjectiveThe article presents research findings whose aim was to understand the lived experiences of fathers with intellectual disabilities referring to child protection proceedings they were involved in as fathers and the meanings ascribed to these experiences.BackgroundParents with intellectual disabilities face a high risk of having their children removed and being involved in child protection procedures. The overwhelming majority of studies focus on mothers. Little do we know about fathers' perspective.MethodThis study applies a qualitative approach, using in‐depth interviews and interpretative phenomenological analysis to explore the experiences of 14 fathers with intellectual disabilities who were involved in child protection procedures concerning their children. To allow a deeper understanding of the lived experience of the participants, it includes both fathers who lost custody of their children or were threatened with loss of custody.ResultsIn the process of analysis, four main themes emerged: (a) adverse experiences, (b) a range of emotions—between despair and giving up, (c) lack of control, and (d) advocacy in promoting their own rights.ConclusionFathers with intellectual disabilities reported being discriminated against on the basis of sex and disability in child protection procedures. Nonetheless, they were determined to fight for their parental rights.ImplicationsIt is important to focus on gender in research into parenting by people with intellectual disabilities. This will create an opportunity to learn about the needs and problems of mothers and fathers and to provide adequate support.
Human‐modified landscapes driving the global primate extinction crisis
Authors: Torres‐Romero Erik Joaquín , Nijman Vincent , Fernández David , Eppley Timothy M. 
Published: August 2023

AbstractThe world's primates have been severely impacted in diverse and profound ways by anthropogenic pressures. Here, we evaluate the impact of various infrastructures and human‐modified landscapes on spatial patterns of primate species richness, at both global and regional scales. We overlaid the International Union for the Conservation of Nature (IUCN) range maps of 520 primate species and applied a global 100 km2grid. We used structural equation modeling and simultaneous autoregressive models to evaluate direct and indirect effects of six human‐altered landscapes variables (i.e., human footprint [HFP], croplands [CROP], road density [ROAD], pasture lands [PAST], protected areas [PAs], and Indigenous Peoples' lands [IPLs]) on global primate species richness, threatened and non‐threatened species, as well as on species with decreasing and non‐decreasing populations. Two‐thirds of all primate species are classified as threatened (i.e., Critically Endangered, Endangered, and Vulnerable), with ~86% experiencing population declines, and ~84% impacted by domestic or international trade. We found that the expansion of PAST, HFP, CROP, and road infrastructure had the most direct negative effects on primate richness. In contrast, forested habitat within IPLs and PAs was positively associated in safeguarding primate species diversity globally, with an even stronger effect at the regional level. Our results show that IPLs and PAs play a critical role in primate species conservation, helping to prevent their extinction; in contrast, HFP growth and expansion has a dramatically negative effect on primate species worldwide. Our findings support predictions that the continued negative impact of anthropogenic pressures on natural habitats may lead to a significant decline in global primate species richness, and likely, species extirpations. We advocate for stronger national and international policy frameworks promoting alternative/sustainable livelihoods and reducing persistent anthropogenic pressures to help mitigate the extinction risk of the world's primate species.
Drug‐related problems in older adults in outpatient settings: Results from a 6‐year long prospective study in a tertiary hospital of north India
Authors: Kaur Upinder , Chakrabarti Sankha Shubhra , Gupta Gaurav Kumar , Singh Amit , Gambhir Indrajeet Singh 
Published: August 2023

AimDrug‐related problems (DRPs) are a common cause of hospitalization in older patients. So far, these issues have been studied in hospitalized settings, and evidence on patterns and outcomes of DRPs, such as adverse drug reactions, is relatively scarce in older outpatients. The main aim of this study was to provide a comprehensive description and possible solutions for DRPs in older adults in outpatient settings.MethodsThe study was carried out from January 2015 to September 2021 in a tertiary hospital in north India. Patients aged ≥50 years with DRPs were enrolled. DRPs causing hospitalization, drug interactions and drug–disease interactions were identified, along with preventive measures.ResultsOf 10 400 patients registered, 1031 DRPs occurred in 666 patients (9.9%). Adverse drug reactions were the major DRPs (n = 933, 8.9%). Metabolic disorders were the commonest DRP in individuals aged ≥65 years compared with gastrointestinal disorders in the 50–64 years group. Drug interactions and drug–disease interactions contributed to 20.1% and 7.9% of patients, respectively. Nearly 15.8% of DRPs directly led to hospitalization, with drug‐induced metabolic disturbances and movement disorders as the common causes. The Naranjo scale was not applicable in 35.3% of patients, and drug interactions were the commonest cause. Frequent monitoring, omission of unnecessary drugs, slow titration and proper instructions on therapy, together, could avoid one‐third of DRPs.ConclusionOne out of 10 prescriptions of older outpatients carries a DRP. New‐onset metabolic and neurological disturbances should prompt a thorough drug history. A multifaceted holistic approach can prevent significant drug‐related morbidity and requires future evaluation. Geriatr Gerontol Int 2024; 24: 285–291.
MICROHISTORIES OF HEIMAT IN THE THIRD REICH
Authors: Lipner Sandra 
Published: August 2023

ABSTRACTIn the Third Reich, ideas about Heimat became entwined with racial fantasies about blood and soil. This article investigates the dynamics and consequences of this development based on a study of the kinship network of Annemarie and Heinrich Brenzinger from Freiburg (Breisgau). The Brenzingers subscribed to a ‘völkisch’ worldview which conceptualised Heimat as a refuge for kinship groups connected to their locality through lineage. While völkisch groups assisted the Nazi regime in amplifying a fascistic discourse which predated the dictatorship, they also influenced the culture of the Third Reich according to their own ideas. The Nazi regime accepted their activities as part of a transformation of society which required civil engagement. A contrasting reading of Heimat is found in the letters of the Jewish members of this kinship network who were forced from their homeland. It is further elucidated by émigré writers who carefully avoided the völkisch aspects of the Heimat narrative and employed alternative definitions of belonging. By historicising the concepts of Heimat contained in the family collection of the Brenzingers, this article sheds light on the narrowing of the Heimat discourse in Nazi Germany and recovers some of the marginalised voices that resisted it.
Artificial intelligence/neural network system that accurately diagnoses hepatocellular carcinoma in nonalcoholic steatohepatitis
Authors: Okanoue Takeshi , Yamaguchi Kanji , Shima Toshihide , Mitsumoto Yasuhide , Katayama Takayuki , Okuda Keiichiro , Mizuno Masayuki , Seko Yuya , Moriguchi Michihisa , Itoh Yoshito , Miyazaki Toru 
Published: August 2023

AbstractBackground and AimThe aim of this study was to develop a novel noninvasive test using an artificial intelligence/neural network system (called HCC‐Scope) to diagnose early‐stage hepatocellular carcinoma (HCC) on the background of nonalcoholic steatohepatitis (NASH).MethodsIn total, 175 patients with histologically proven nonalcoholic fatty liver disease and 55 patients with NASH‐HCC were enrolled for training and validation studies. Of the 55 patients with NASH‐HCC, 27 (49.1%) had very early‐stage HCC, and six (10.9%) had early‐stage HCC based on the Barcelona Clinic Liver Cancer staging system. Diagnosis with HCC‐Scope was performed based on 12 items: age, sex, height, weight, AST level, ALT level, gamma‐glutamyl transferase level, cholesterol level, triglyceride level, platelet count, diabetes status, and IgM‐free apoptosis inhibitor of macrophage level. The FMVWG2U47 hardware (Fujitsu Co. Ltd, Tokyo, Japan) and the originally developed software were used.ResultsHCC‐Scope had sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 100% for the differential diagnosis between non‐HCC and HCC in a training study with gray zone analysis. It was also excellent in the validation study (95.0% sensitivity, 100% specificity, 100% PPV, and 97.1% NPV with gray zone analysis and 95.2% sensitivity, 100% specificity, 100% PPV, and 97.1% NPV without gray zone analysis). HCC‐Scope had a significantly higher sensitivity (85.3%) and specificity (85.1%) than alpha‐fetoprotein (AFP) level, AFP‐L3 level, des‐gamma‐carboxy prothrombin (DCP) level, and the gender–age–AFP‐L3–AFP–DCP (GALAD) score.ConclusionsHCC‐Scope can accurately differentially diagnose between non‐HCC NASH and NASH‐HCC, including very early‐stage NASH‐HCC.
Methodological and users' surveys on the use of the LILACS database in Cochrane reviews identified desirable improvements to the database
Authors: Escobar‐Liquitay Camila Micaela , Vergara‐Merino Laura , Verdejo Catalina , Kirmayr Matías , Schuller‐Martínez Bastian , Madrid Eva , Meza Nicolás , Bracchiglione Javier , Franco Juan Víctor Ariel 
Published: August 2023

AbstractBackgroundLatin American and Caribbean Health Sciences Literature (LILACS) is the main reference database in the region; however, the way in which this resource is used in Cochrane systematic reviews has not been studied.ObjectivesTo assess the search methods of Cochrane reviews that used LILACS as a source of information and explore the Cochrane community's perceptions about this resource.MethodsWe identified all Cochrane reviews of interventions published during 2019, which included LILACS as a source of information, and analysed their search methods and also ran a survey through the Cochrane Community.ResultsWe found 133 Cochrane reviews that reported the full search strategies, identifying heterogeneity in search details. The respondents to our survey highlighted many areas for improvement in the use of LILACS, including the usability of the search platform for this purpose.DiscussionThe use and reporting of LILACS in Cochrane reviews demonstrate inconsistencies, as evidenced by the analysis of search reports from systematic reviews and surveys conducted among members of the Cochrane community.ConclusionWith better guidance on how LILACS database is structured, information specialists working on Cochrane reviews should be able to make more effective use of this unique resource.
Clinical spectrum, biochemical profile and disease progression of Kennedy disease in an Indian cohort
Authors: Baskar Dipti , Veeramani‐Kumar Preethish , Polavarapu Kiran , Nashi Saraswati , Vengalil Seena , Menon Deepak , Thomas Aneesha , Bhargava Sanka Sai , Muddasu Suhasini Keerthipriya , Huddar Akshata , Unnikrishnan Gopikrishnan , Bardhan Mainak , Thomas Priya Treesa , Manjunath Nisha , Atchayaram Nalini 
Published: August 2023

AbstractBackgroundKennedy disease (KD) is a slowly progressive lower motor neuron degenerative disease. The prevalence of KD is unknown in India.AimTo describe the phenotypic and laboratory features of an Indian cohort of KD patients.MethodsA retrospective study was done on seven genetically confirmed KD patients based on demographic, clinical and laboratory details.ResultsMean age at onset and presentation was 37 ± 11.9 and 44.6 ± 13.5 years respectively. Progressive asymmetric proximal and distal limb weakness was the commonest symptom (57.1%). All patients had motor symptoms along with non‐specific symptoms such as cramps from the onset. Easy fatigability, decremental response along with ptosis were noted in two patients, which was a novel finding. Gynaecomastia and tongue wasting with fasciculations were universal findings. All five patients with nerve conduction studies showed sensorimotor neuropathy. Magnetic resonance imaging muscle done in two patients showed a prominent moth‐eaten appearance in the thigh and posterior leg compartment in one patient. The mean cytosine‐adenine‐guanine repeats were 44 ± 3.7, and there was no association between age of onset or severity with repeat length. Only one patient required an assistive device for ambulation after 15 years of symptom onset.ConclusionsThis study showed phenotypic heterogeneity in the Indian cohort. The age of onset was earlier with a slowly progressive indolent course as compared with other ethnic cohorts. This highlights the importance of considering the KD diagnosis in patients with the indolent course and suspected ALS diagnosis even with ptosis and fatigability in an appropriate clinical context.
Anxiety, depression, and stress among nurses under the stress of flooding and the COVID‐19 pandemic
Authors: Lijuan Quan , Lin Ye , Juntao Li , Kun Yuan , Hongjuan Chang 
Published: August 2023

AbstractAimThis study investigated anxiety, depression, and stress and their influencing factors among nurses during the COVID‐19 pandemic and after the flood in Henan Province, China. It aimed to provide the theoretical foundation for the management of relevant hospital departments, improvement of nursing quality, implementation of antiepidemic work, and other relevant studies.BackgroundIn December 2019, COVID‐19 was reported in Wuhan, China and became a global pandemic. In July 2021, unprecedented flooding occurred in Henan Province, China. Under the dual pressure of COVID‐19 and the flood, nurses’ mental health problems deteriorated.MethodsIn August 2021, 1229 nurses from various departments of the First Affiliated Hospital of Xinxiang Medical University in Xinxiang City, Henan Province,China were invited to participate in a questionnaire survey using a general condition questionnaire and the Chinese version of the Depression–Anxiety–Stress Scale. Descriptive statistics were used to analyze the status of nurses’ anxiety, depression, and stress. Analysis of variance, t‐test, and multiple linear regression models were used to analyze the factors influencing anxiety, depression, and stress among nurses.ResultsOf the participants, 36.1%, 10.1%, and 15.5% had moderate to high levels of anxiety, stress, and depression, respectively. Moreover, 42 (3.4%) participants experienced high to severe levels of stress, anxiety, and depression. The scores showed significant differences based on gender, harmonious family relationships, department position, work intensity, sleep quality, physical exercise, participation in leisure activities, health status, involvement in emotion management‐related training, and attending self‐care‐related training (all P < 0.05). Gender, work intensity, harmonious family relationships, health condition, sleep quality, and participation in leisure activities influenced stress, anxiety, and depression scores. Department position influenced anxiety and stress scores, and average monthly earnings influenced anxiety scores.ConclusionAll the nurses experienced various levels of stress, anxiety, and depression. Related departments should pay special attention to male nurses and nurses with high work intensity, unharmonious family relationships, poor health, and sleep quality, and who engage in fewer leisure activities.Implications for nursing and health policyIt is recommended that departments allocate human resources and arrange schedules reasonably, encourage nurses to participate in more recreational activities, and implement emotion management and self‐care‐related training to relieve emotional distress, and ultimately maintain nurses’ mental health.
Factors associated with the core dimensions of spiritual health among older adults with chronic obstructive pulmonary disease: A cross‐sectional study
Authors: Jiang Yuyu , Chen Zhongyi , Nuerdawulieti Baiyila , Chen Mengjie , Nan Jiang , Li Jinping , Ge Yan 
Published: August 2023

AbstractAimsTo investigate the level of spiritual health in older patients with chronic obstructive pulmonary disease (COPD) from the core dimensions and to explore its associated factors.DesignA cross‐sectional study.MethodsParticipants were recruited from four hospitals between September 2020 and June 2021, using a convenience sampling. Older patients with COPD (n = 162) completed the demographic and disease‐related information questionnaires, Function Assessment of Chronic Illness Therapy Spiritual Scale, 10‐item Connor‐Davidson Resilience Scale, General Self‐efficacy Scale, Social Support Rating Scale, COPD Assessment Test, 15‐item Geriatric Depression Scale and modified Medical Research Council Dyspnea Scale. Descriptive statistics, Pearson and Spearman correlation analyses, t‐tests, one‐way ANOVA and multiple linear regression models were used.ResultsOlder patients with COPD have a moderate level of spiritual health. The multiple linear regression analysis showed that psychological resilience, general self‐efficacy, social support, symptom burden and monthly income were associated with the core dimensions of spiritual health.ConclusionChinese older patients with COPD have a moderate level of spiritual health. Psychological resilience, general self‐efficacy, social support, monthly income and symptom burden were associated with the core dimensions of spiritual health.ImpactThis study is the first to investigate the level of spiritual health in older patients with COPD from the core dimensions and to explore its associated factors, providing a basis for developing spiritual intervention programs. Our findings can help us realize that intervention strategies of psychological resilience, general self‐efficacy and social support can all be used to enhance spiritual health. Nurses should focus on the spiritual health of older COPD patients with high symptom burden and low monthly income.Patient or Public ContributionAlthough we did not directly involve patients and the public because of the COVID‐19 pandemic, the results of the study will be disseminated to patients and the public through WeChat and seminars.