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Apixaban versus aspirin for stroke prevention in people with subclinical atrial fibrillation and a history of stroke or transient ischaemic attack: subgroup analysis of the ARTESiA randomised controlled trial.
Lancet Neurol
February 2025
Department of Medicine, McMaster University, Population Health Research Institute, Hamilton, ON, Canada.
Background: People with subclinical atrial fibrillation are at increased risk of stroke, albeit to a lesser extent than those with clinical atrial fibrillation, leading to an ongoing debate regarding the benefit of anticoagulation in these individuals. In the ARTESiA trial, the direct-acting oral anticoagulant apixaban reduced stroke or systemic embolism compared with aspirin in people with subclinical atrial fibrillation, but the risk of major bleeding was increased with apixaban. In a prespecified subgroup analysis of ARTESiA, we tested the hypothesis that people with subclinical atrial fibrillation and a history of stroke or transient ischaemic attack, who are known to have an increased risk of recurrent stroke, would show a greater benefit from oral anticoagulation for secondary stroke prevention compared with those without a history of stroke or transient ischaemic attack.
View Article and Find Full Text PDFIntranasal oxytocin for apathy in people with frontotemporal dementia (FOXY): a multicentre, randomised, double-blind, placebo-controlled, adaptive, crossover, phase 2a/2b superiority trial.
Lancet Neurol
February 2025
Department of Clinical Neurological Sciences, University of Western Ontario, London, ON, Canada; Department of Cognitive Neurology, St Joseph's Health Care London, London, ON, Canada. Electronic address:
Background: No treatments exist for apathy in people with frontotemporal dementia. Previously, in a randomised double-blind, placebo-controlled, dose-finding study, intranasal oxytocin administration in people with frontotemporal dementia improved apathy ratings on the Neuropsychiatric Inventory over 1 week and, in a randomised, double-blind, placebo-controlled, crossover study, a single dose of 72 IU oxytocin increased blood-oxygen-level-dependent signal in limbic brain regions. We aimed to determine whether longer treatment with oxytocin improves apathy in people with frontotemporal dementia.
View Article and Find Full Text PDFDevelopment, implementation, and evaluation of an innovative clinical trial operations training program for Africa (ClinOps).
BMC Med Educ
January 2025
Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, P.O. Box 9086, Addis Ababa, Ethiopia.
Background: Africa's involvement in clinical trials remains very low. Although the crucial role of training initiatives in building clinical trial capacity in Africa has been documented, current efforts fall short as they lack alignment with local contexts. This study aimed to design, develop, implement, and evaluate an innovative clinical trial operations training program for Africa.
View Article and Find Full Text PDFBarriers and new opportunities in developing effective therapies for diabetic neuropathy: International expert consensus recommendations.
Diabetes Res Clin Pract
January 2025
Department of Medicine, Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health & Science University, Portland USA.
Background: Diabetic neuropathy (DN) affects up to half of individuals with type 1 and type 2 diabetes. Despite evidence that improving metabolic and cardiovascular health can slow its progression, DN remains a significant clinical challenge due to the lack of disease-modifying therapies and effective pain management strategies. This consensus aimed to identify gaps and recommend strategies to address these challenges.
View Article and Find Full Text PDFIntegrating and Assessing Entrustable Professional Activities in PharmD Curricula.
Am J Pharm Educ
January 2025
Office of Consultation and Research in Medical Education, University of Iowa Carver College of Medicine. Electronic address:
Objectives: The 2022 Curriculum Outcomes and Entrustable Professional Activities (COEPA) include an updated set of entrustable professional activities (EPAs) for PharmD graduates. To assist pharmacy educators with the integration and assessment of EPAs, the objective of this work was to review and synthesize 1) approaches to integrate EPAs in health professions curricula 2) strategies for EPA-related assessments and entrustment in health professions curricula and 3) challenges and research needs for integrating EPAs in assessment frameworks in PharmD curricula FINDINGS: A literature review resulted in 114 articles identified as having relevance with 33 articles specific to pharmacy education. There are multiple components of an effective EPA integration and assessment plan, including administrative leadership, determination of programmatic EPAs with comprehensive descriptions, selection of an entrustment-supervision scale, identification of EPA-based assessments, EPA mapping, data management, and training and development.
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