bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integration of primary care education into undergraduate nursing programs: a scoping review protocol
Authors: Curnew Deanne , Lukewich Julia , Mathews Maria , Poitras Marie-Eve , Romme Kristen 
Published: March 2023

Objective:
The objective of this scoping review is to examine and map literature related to primary care education in undergraduate nursing programs and to describe the attributes and extent of primary care education.

Introduction:
Primary care is a model of first-contact, continuous, comprehensive, and coordinated health care. Registered nurses are integral in successful collaborative team models of primary care. However, it is unclear how undergraduate nursing programs offer opportunities to learn about nursing practice within primary care settings. A better understanding of the attributes and extent of primary care education in undergraduate nursing programs will direct research, inform teaching–learning, and develop a stronger primary care nursing workforce.

Inclusion criteria:
This review will consider articles that include faculty/administrators, preceptors, or students of nursing programs that qualify graduates for entry-level registered nursing practice. Articles that report on undergraduate teaching–learning related to primary care will also be considered. Practical nursing, advanced practice, and post-licensure programs will be excluded. Teaching–learning related to settings other than primary care will also be excluded.

Methods:
The Framework of Effective Teaching–Learning in Clinical Education will be the organizing framework for this scoping review. A 3-step search strategy will be followed to identify published and unpublished literature. Articles published in English or French will be included. Data extracted from eligible articles will include details on the study design/method, participants, context, type of teaching–learning activity, attributes associated with dimensions of the teaching–learning environment, and relevant outcomes. The results will be reported in tabular and/or diagrammatic format, accompanied by a narrative summary.

Review registration number:
Open Science Framework: https://osf.io/cw5r3
The crucial role of titin in fetal development: recurrent miscarriages and bone, heart and muscle anomalies characterise the severe end of titinopathies spectrum
Authors: Di Feo Maria Francesca , Lillback Victoria , Jokela Manu , McEntagart Meriel , Homfray Tessa , Giorgio Elisa , Casalis Cavalchini Guido C , Brusco Alfredo , Iascone Maria , Spaccini Luigina , D'Oria Patrizia , Savarese Marco , Udd Bjarne 
Published: March 2023

BackgroundTitin truncating variants (TTNtvs) have been associated with several forms of myopathies and/or cardiomyopathies. In homozygosity or in compound heterozygosity, they cause a wide spectrum of recessive phenotypes with a congenital or childhood onset. Most recessive phenotypes showing a congenital or childhood onset have been described in subjects carrying biallelic TTNtv in specific exons. Often karyotype or chromosomal microarray analyses are the only tests performed when prenatal anomalies are identified. Thereby, many cases caused byTTNdefects might be missed in the diagnostic evaluations. In this study, we aimed to dissect the most severe end of the titinopathies spectrum.MethodsWe performed a retrospective study analysing an international cohort of 93 published and 10 unpublished cases carrying biallelic TTNtv.ResultsWe identified recurrent clinical features showing a significant correlation with the genotype, including fetal akinesia (up to 62%), arthrogryposis (up to 85%), facial dysmorphisms (up to 73%), joint (up to 17%), bone (up to 22%) and heart anomalies (up to 27%) resembling complex, syndromic phenotypes.ConclusionWe suggestTTNto be carefully evaluated in any diagnostic process involving patients with these prenatal signs. This step will be essential to improve diagnostic performance, expand our knowledge and optimise prenatal genetic counselling.
Evidence of publication bias in multiple sclerosis clinical trials: a comparative analysis of published and unpublished studies registered in ClinicalTrials.gov
Authors: Rivero-de-Aguilar Alejandro , Pérez-Ríos Mónica , Ruano-Raviña Alberto , Candal-Pedreira Cristina , Puente-Hernandez Marilina , Ross Joseph S , Varela-Lema Leonor 
Published: March 2023

Background
Complete and timely publication of clinical trials ensures that patients and the medical community are fully informed when making treatment decisions. The aim of this study is to assess the publication of phase III and IV clinical trials on multiple sclerosis (MS) drugs that have been carried out between 2010 and 2019 and to identify the factors associated with their publication in peer-reviewed journals.

Methods
An advanced search in ClinicalTrials.gov was performed and consecutive searches in PubMed, EMBASE and Google Scholar were conducted looking for the associated publications of all completed trials. Study design characteristics, results and other relevant information were extracted. Data was analysed following a case–control design. Clinical trials with associated publications in peer-reviewed journals were the cases and unpublished trials were the controls. A multivariate logistic regression analysis was performed to identify factors associated with trial publication.

Results
One hundred and fifty clinical trials were included in the analysis. Ninety-six of them (64.0%) were published in peer-reviewed journals. In the multivariate analysis, factors associated with trial publication were a favourable primary outcome (OR 12.49, 95% CI 1.28 to 122.29) and reaching the originally estimated sample size (OR 41.97, 95% CI 1.96 to 900.48), while those associated with a lower odds of publication were having 20% or more patients lost to follow-up (OR 0.03, 95% CI 0.01 to 0.52) and evaluating drugs intended to improve treatment tolerability (OR 0.01, 95% CI 0.00 to 0.74).

Conclusions
Phase III and IV clinical trials on MS drugs are prone to under-reporting and publication bias. Efforts must be made to promote a complete and accurate dissemination of data in MS clinical research.
Breaking Up Isn't Hard to Do: Isolating Cell-free DNA Fragments in Osteosarcoma
Authors: Weiser Daniel A. , Hayashi Masanori , Applebaum Mark A. 
Published: March 2023

SummaryThe novel use of blood-based biospecimens from a retrospective cohort of 50 patients with osteosarcoma was recently studied. The potential clinical utility of sorting cell-free DNA by fragment size was defined, with shorter tumor-specific DNA enrichment providing prognostic value and allowing for streamlined molecular profiling of circulating tumor material.See related article by Udomruk et al., p. 2085
Reallocating Cervical Cancer Preventive Service Spending from Low- to High-Value Clinical Scenarios
Authors: Rockwell Michelle S. , Armbruster Shannon D. , Capucao Jillian C. , Russell Kyle B. , Rockwell John A. , Perkins Karen E. , Huffstetler Alison N. , Mafi John N. , Fendrick A. Mark 
Published: March 2023

Abstract

Timely follow-up care after an abnormal cervical cancer screening test result is critical to the prevention and early diagnosis of cervical cancer. The current inadequate and inequitable delivery of these potentially life-saving services is attributed to several factors, including patient out-of-pocket costs. Waiving of consumer cost-sharing for follow-up testing (e.g., colposcopy and related cervical services) is likely to improve access and uptake, especially among underserved populations. One approach to defray the incremental costs of providing more generous coverage for follow-up testing is reducing expenditures on “low-value” cervical cancer screening services. To explore the potential fiscal implications of a policy that redirects cervical cancer screening resources from potentially low- to high-value clinical scenarios, we analyzed 2019 claims from the Virginia All-Payer Claims Database to quantify (i) total spending on low-value cervical cancer screening and (ii) out-of-pocket costs associated with colposcopy and related cervical services among commercially insured Virginians. In a cohort of 1,806,921 female patients (ages 48.1 ± 24.8 years), 295,193 claims for cervical cancer screening were reported, 100,567 (34.0%) of which were determined to be low-value ($4,394,361 total; $4,172,777 for payers and $221,584 out-of-pocket [$2/patient]). Claims for 52,369 colposcopy and related cervical services were reported ($40,994,016 total; $33,457,518 for payers and $7,536,498 out-of-pocket [$144/patient]). These findings suggest that reallocating savings incurred from unnecessary spending to fund more generous coverage of necessary follow-up care is a feasible approach to enhancing cervical cancer prevention equity and outcomes.

Prevention Relevance:
Out-of-pocket fees are a barrier to follow-up care after an abnormal cervical cancer screening test. Among commercially insured Virginians, out-of-pocket costs for follow-up services averaged $144/patient; 34% of cervical cancer screenings were classified as low value. Reallocating low-value cervical cancer screening expenditures to enhance coverage for follow-up care can improve screening outcomes.
See related Spotlight, p. 363
Long-Term Effect of Weight Regain Following Behavioral Weight Management Programs on Cardiometabolic Disease Incidence and Risk: Systematic Review and Meta-Analysis
Authors: Hartmann-Boyce Jamie , Theodoulou Annika , Oke Jason L. , Butler Ailsa R. , Bastounis Anastasios , Dunnigan Anna , Byadya Rimu , Cobiac Linda J. , Scarborough Peter , Hobbs F.D. Richard , Sniehotta Falko F. , Jebb Susan A. , Aveyard Paul 
Published: March 2023

Background:
Behavioral weight management programs (BWMPs) enhance weight loss in the short term, but longer term cardiometabolic effects are uncertain as weight is commonly regained. We assessed the impact of weight regain after BWMPs on cardiovascular risk factors, diabetes, and cardiovascular disease.

Methods:
Trial registries, 11 databases, and forward-citation searching (latest search, December 19) were used to identify articles published in English, from any geographical region. Randomized trials of BWMPs in adults with overweight/obesity reporting cardiometabolic outcomes at ≥12 months at and after program end were included. Differences between more intensive interventions and comparator groups were synthesized using mixed-effects, meta-regression, and time-to-event models to assess the impact of weight regain on cardiovascular disease incidence and risk.

Results:

One hundred twenty-four trials reporting on ≥1 cardiometabolic outcomes with a median follow-up of 28 (range, 11–360) months after program end were included. Median baseline participant body mass index was 33 kg/m
2
; median age was 51 years. Eight and 15 study arms (7889 and 4202 participants, respectively) examined the incidence of cardiovascular disease and type 2 diabetes, respectively, with imprecise evidence of a lower incidence for at least 5 years. Weight regain in BWMPs relative to comparators reduced these differences. One and 5 years after program end, total cholesterol/HDL (high-density lipoprotein) ratio was 1.5 points lower at both times (82 studies; 19 003 participants), systolic blood pressure was 1.5 mm mercury and 0.4 mm lower (84 studies; 30 836 participants), and HbA1c (%) 0.38 lower at both times (94 studies; 28 083 participants). Of the included studies, 22% were judged at high risk of bias; removing these did not meaningfully change results.

Conclusions:
Despite weight regain, BWMPs reduce cardiometabolic risk factors with effects lasting at least 5 years after program end and dwindling with weight regain. Evidence that they reduce the incidence of cardiovascular disease or diabetes is less certain. Few studies followed participants for ≥5 years.

Registration:

URL:
https://www.crd.york.ac.uk/PROSPERO/
; Unique identifier: CRD42018105744.
Association of Accelerometer‐Measured Physical Activity and Sedentary Behavior With Incident Cardiovascular Disease, Myocardial Infarction, and Ischemic Stroke: The Women's Health Study
Authors: Peter‐Marske Kennedy M. , Evenson Kelly R. , Moore Christopher C. , Cuthbertson Carmen C. , Howard Annie Green , Shiroma Eric J. , Buring Julie E. , Lee I‐Min 
Published: March 2023

Background
Few studies have investigated associations of acclerometer‐based assessments of physical activity (PA) and sedentary behavior (SB) with incidence of cardiovascular disease (CVD) and its components. This prospective cohort study assessed the associations of accelerometer‐measured PA and SB with total CVD, myocardial infarction, and ischemic stroke (IS).

Methods and Results
The authors included 16 031 women aged 62 years and older, free of CVD, with adherent accelerometer wear (≥10 hours/day for ≥4 days) from the Women's Health Study (mean age, 71.4 years [SD, 5.6 years]). Hip‐worn ActiGraph GT3X+ accelerometers measured total volume of PA (total average daily vector magnitude), minutes per day of high‐light PA and moderate to vigorous PA (MVPA), and SB. Women reported diagnoses of CVD, which were adjudicated using medical records and death certificates. Hazard ratios (HRs) were estimated for each exposure, and 95% CIs using Cox proportional hazards models were adjusted for accelerometer wear time, age, self‐reported general health, postmenopausal hormone therapy, smoking status, and alcohol use. The hypothetical effect of replacing 10 minutes/day of SB or high‐light PA with MVPA on CVD incidence was assessed using adjusted isotemporal substitution Cox models. Over a mean of 7.1 years (SD, 1.6 years) of follow‐up, 482 total CVD cases, 107 myocardial infarction cases, and 181 IS cases were diagnosed. Compared with the lowest quartiles of total average daily vector magnitude and MVPA (≤60 minutes), women who were in the highest quartiles (>120 minutes of MVPA) had a 43% (95% CI, 24%–58%) and 38% (95% CI, 18%–54%) lower hazard of total CVD, respectively. Estimates were similar for total average daily vector magnitude and MVPA with IS, but PA was not associated with myocardial infarction overall. High‐light PA was not associated with any CVD outcomes. Women who spent <7.4 hours sedentary per day had a 33% (95% CI, 11%–49%) lower hazard of total CVD compared with those who spent ≥9.5 hours sedentary. Replacing 10 minutes of SB with MVPA was associated with a 4% lower incidence of total CVD (HR, 0.96 [95% CI, 0.93–0.99]).

Conclusions
Accelerometer‐assessed total PA and MVPA were inversely associated with total CVD and IS incidence, and SB was directly associated with total CVD; high‐light PA was not related to CVD.
Association Between the Frailty and Cognitive Impairment Among Patients With Hypertension—A Post Hoc Analysis of the SPRINT Trial
Authors: Wang Zhiyan , Wang Qinshi , Pei Junyu , Wang Xiaopu , Li Yanan , Yan Jiafu , Du Xin 
Published: March 2023

Background
Frailty and cognitive impairment are common in the elderly, with various shared risk factors like hypertension. Frailty is a marker for future cognitive function. Moreover, whether intensive blood pressure interacted with frailty and cognitive impairment is unknown.

Methods and Results

We performed a post hoc analysis of data from SPRINT (Systolic Blood Pressure Intervention Trial). The relationship between frailty and a composite of probable dementia (PD) and mild cognitive impairment (MCI) was analyzed. Also, we evaluated the interaction of intensive blood pressure lowering in the relationship between frailty and cognitive impairment. A total of 8537 patients were included in our study, and 35.1% were women. The mean age of these participants was 67.9±9.3 years. According to the baseline frailty index, 1670, 4637, and 2230 patients were in fit, less fit, and frail statuses, respectively. During a mean follow‐up of 4.61 years, 871 cases of PD or MCI occurred. Compared with those in fit status, those with less fit (hazard ratio [HR], 2.14 [95% CI, 1.65–2.77]) and frailty (HR, 4.28 [95% CI, 3.26–5.61]) status had a higher incidence of a composite of PD and MCI. Blood pressure control strategy interacted with the correlation between frailty and cognitive impairment. Intensive blood pressure control (HR, 2.4 [95% CI, 2.0–2.8]) accelerated the relationship between frailty and incidence of PD and MCI compared with the standard treatment group (HR, 1.8 [95% CI, 1.5–2.1];
P
for interaction=0.009).

Conclusions
This study found that the baseline frailty status was a possible marker for the incidence of a composite of PD and MCI. Intensive blood pressure control may strengthen this correlation.

Registration

URL:
https://clinicaltrials.gov/
; Unique identifier: NCT01206062.
An Exploratory Empirical Outlook on the Authority of Annex VII Arbitral Tribunals
Authors: Lando Massimo 
Published: March 2023

Abstract
This article studies perceptions of the authority of arbitral tribunals constituted under Annex VII of the United Nations Convention on the Law of the Sea. Authority is understood as co-extensive with the notion of legitimacy. The focus here is not on normative legitimacy, the doctrinal study of which can only take one so far in understanding matters of authority. Instead, empirical research methods are used to study the perceived authority of Annex VII arbitral tribunals within the relevant constituency, known as sociological legitimacy. The findings are those of an exploratory study, considering that the data was collected from a small group of individuals. Further research could focus on collecting the same or similar data from a larger group, so as to obtain a more nuanced outlook on the authority of Annex VII arbitral tribunals.
City Governments as Political Actors of Global Governance
Authors: Martinez Ricardo 
Published: March 2023

Abstract
The transnational rise of city networks is increasingly associated with the emergence of hybrid configurations beyond the public sector that contribute to technocratic decisionmaking processes and the depoliticization of global governance. This article takes issue with this argument. By analyzing the legitimation strategy used by the global city network United Cities and Local Governments (UCLG) vis-à-vis the UN system, the article contends that city networks can generate collective agency and frame political issues as a matter of public accountability. The cities gathered under UCLG, a “public membership” city network, are offering their political constitution to the multilateral system, thus complementing rather than replacing the political agency of state-centric processes. Yet the state-centric nature of the international system is also the main obstacle on the (winding) road of UCLG toward multilateral recognition.
Le chaos pré-cosmique dans le Timée
Authors: Pitteloud Luca 
Published: March 2023

Abstract
In this article, we provide an analysis of the description of the pre-cosmic chaos and the function of this description within the context of the theory of participation which can be reconstructed in Plato’s Timaeus. More specifically, we will assume that the pre-cosmic chaos represents a counterfactual situation in which the universe is conceived without the action of the intelligible. This counterfactual state will be considered as an initial sequence allowing to visualize in a quasi-spatial way how the phenomenon of participation operates. We will give a detailed analysis of the passage (52d4-53b7) in order to integrate it as a sequence of what we will call the anatomy of participation. In our study, two more questions will be examined: i) the representation of the sensible without the intelligible in Plato’s works (Timaeus, Statesman, Philebus, Parmenides) and ii) the role of world soul as a possible cause of all movements in the universe (Timaeus and Laws).
The Senses of Apeiron in Philebus 16b–27c
Authors: Smith Colin C. 
Published: March 2023

Abstract
Scholars debate whether ‘apeiron’ (unlimited) is univocal or multivocal in Plato’s Philebus. Offering a ‘middle path,’ I argue that the term is univocal, but used with respect to two senses of unlimited continua. The term appears early in two dense passages on ontological structure: the descriptions of the ‘god-given method’ (16b–18d) and ‘the fourfold division of beings’ (23c–27c). I consider each passage and argue that they respectively concern the eidetic continua of being that the knower comes to understand and the fluxing continua of opposed and co-constitutive bodily elements from which spatiotemporal objects derive their natures. They also indicate two major influences on Plato, respectively the Pythagorean and Heraclitean as recorded in Aristotle’s Metaphysics, and I draw on these resources to develop my account. I conclude by considering some important Platonic lessons that we learn from thinking through this distinction between the related senses of the unlimited.
Roof Constructions in Austria — An Overview
Authors: Nemestothy Sebastian , Wächter Elisabeth , Buchinger Günther , Grabner Michael 
Published: March 2023

Abstract
The tree-ring lab at BOKU University, Vienna, Austria has been sampling and dating by means of dendrochronology in the eastern part of Austria since 1996. Among other objects, the roof constructions of 982 historical buildings were analysed, resulting in 13 916 samples. The time span extends from the oldest roof truss at a church in Salzburg, dated to 1135, to the youngest in Vienna, dated to 1997. The aim of present paper is to provide an overview of the findings on historical roof constructions in Austria based on data collected over the last 27 years. Out of the total sample elements, 69.0% were made out of Norway spruce, followed by silver fir with 19.6%. All other species played a minor role: pine (5.0%), larch (3.6%), oak (2.7%), followed by a few elements made of stone pine, elm, beech, and poplar. The proportion of wood species reflects the significant influence of alpine regions. Within the city of Vienna, where all building timber was rafted, the amount of spruce wood is 72.3%. There were no clear visible changes in the wood species share over time. Along with dendro-dating, building historians have been analyzing the typology of roof trusses and the changes within time. It was possible to see clear alterations from simple rafter constructions to huge multi-level constructions with standing and sometimes hanging columns and roof constructions with lying posts (in the plane of the rafters) that transition back to constructions with standing columns.