bluuebunny/crossref_metadata_2025_split huggingface dataset:
Digital textbooks for undergraduate nursing education: a scoping review protocol
Authors: Jang Aeri , Park Hyunyoung 
Published: July 2024

IntroductionDigital textbooks (DTs), in which students read dozens of paragraph clips and systematise their level of knowledge through new questions, can be an alternative for digital natives to consider. Developing DTs is required when teaching digital natives at undergraduate nursing schools. A scoping review is required to understand the current status of DTs in nursing education.Methods and analysisThe preliminary search has been conducted to check whether the results produced by PubMed (NCBI) were published in English within 10 years and related to DTs. This study includes research targeting undergraduate nursing students. Literature will be further searched using Embase (Elsevier), Cochrane Library and Cumulative Index to Nursing and Allied Health (CINAHL) databases. This scoping review will also consider quantitative, qualitative, and mixed research methods, texts and opinion documents; review studies; and pilot tests. The chosen studies will first be extracted based on the scoping review data extraction section of Joanna Briggs Institute to identify their general characteristics. DTs will be analysed based on the e-textbook framework: information goods, technology and stakeholders.Ethics and disseminationThe Institutional Review Board of Nambu University, South Korea, approved this study for review exemption (approval number: 1041478-2022-HR-009). The results of this study will be disseminated through research results to nursing education institutions and hospitals.Open Science Frameworkhttps://doi.org/10.17605/OSF.IO/QS6WH.
Robotic pancreaticoduodenectomy in patients with overweight or obesity: a meta-analysis protocol
Authors: Yang Wenxiao , Zeng Hai , Jin Yueling 
Published: July 2024

IntroductionThe prevalence of overweight or obesity among patients undergoing pancreaticoduodenectomy is on the rise. The utilisation of robotic assistance has the potential to enhance the feasibility of performing minimally invasive pancreaticoduodenectomy in this particular group of patients who are at a higher risk. The objective of this meta-analysis is to assess the safety and effectiveness of robotic pancreaticoduodenectomy in individuals with overweight or obesity.Methods and analysisThis investigation will systematically search for randomised controlled trials (RCTs) and non-randomised comparative studies that compare robotic pancreaticoduodenectomy with open or laparoscopic pancreaticoduodenectomy in patients with overweight or obesity, using PubMed, Embase and the Cochrane Library databases. The methodological quality of studies will be evaluated using the Cochrane risk of bias tool for RCTs and the Newcastle-Ottawa Scale for observational studies. RevMan software (V.5.4.1) will be used for statistical analysis. The OR and weighted mean differences will be calculated separately for dichotomous and continuous data. The selection of a fixed-effects or random-effects model will depend on the level of heterogeneity observed among the included studies.Ethics and disseminationThis study will be conducted based on data in the published literature from publicly available databases. Therefore, ethics approval is not applicable. The results will be disseminated in a peer-reviewed journal.PROSPERO registration numberCRD42023462321.
Assessing environmental injustice in Kansas City by linking paediatric asthma to local sources of pollution: a cross-sectional study
Authors: Friedman Elizabeth , Lee Brian R , Rahn David , Lugo Martinez Beto , Mena Atenas 
Published: July 2024

ObjectiveA grassroots environmental-justice organisation in Kansas City has been examining the disproportionate exposure to air pollution experienced by residents living fenceline to the largest classification railyard in the USA. Prior analyses showed limited increased risk for asthma exacerbation for patients with asthma living closer to toxic release inventory (TRI) facilities and railyards. In this study, we assessed geographical asthma and environmental disparities, to further explore community-level disparities.DesignThis is a cross-sectional study of population-level asthma rates, which included rates for all asthma encounters and acute asthma encounters (urgent care, emergency department, inpatient admission). Distances from census-tract centroids to nearest TRI facilities, railyards and highways were calculated. The association between asthma rates and distances was examined using Kendall’s τ correlation and multivariable Poisson regression models.SettingWe used electronic medical record data from the regional paediatric hospital, census and Environmental Protection Agency (EPA) air monitoring data.ParticipantsPatients with 2+ asthma encounters during the EPA study timeframe were identified.ResultsResidential distance from railyards exhibited a significant negative correlation with overall (−0.36 (CI −0.41 to –0.32)) and acute (−0.27 (CI −0.32 to –0.22)) asthma rates. Asthma rates were elevated among tracts north of the closest railyard (incident rate ratio: 1.38; CI 1.35 to 1.41) when compared with southern directionality. An increased distance from the nearest railyard of 3 km was associated with a decrease in overall asthma rates of 26%.ConclusionSignificant negative associations between proximity to all pollution source types and asthma rates were observed. This community-level research has served as a tool for community engagement and will be used to support proposed local policy. Environmental justice work addresses local concerns involving small, limited datasets, if the data exist at all. The academic epidemiological platform may reconsider acceptable approaches to small population research in order to better serve communities with the most need.
Study protocol for a prospective, multicentre study of hypercortisolism in patients with difficult-to-control type 2 diabetes (CATALYST): prevalence and treatment with mifepristone
Authors: DeFronzo Ralph A , Auchus Richard J , Bancos Irina , Blonde Lawrence , Busch Robert S , Buse John B , Findling James W , Fonseca Vivian A , Frias Juan P , Hamidi Oksana , Handelsman Yehuda , Pratley Richard E , Rosenstock Julio , Tudor Iulia Cristina , Moraitis Andreas G , Einhorn Daniel 
Published: July 2024

Introduction

Even with recent treatment advances, type 2 diabetes (T2D) remains poorly controlled for many patients, despite the best efforts to adhere to therapies and lifestyle modifications. Although estimates vary, studies indicate that in >10% of individuals with difficult-to-control T2D, hypercortisolism may be an underlying contributing cause. To better understand the prevalence of hypercortisolism and the impact of its treatment on T2D and associated comorbidities, we describe the two-part Hyper

c

ortisolism in P

at

ients with Difficult to Control Type 2 Di

a

betes Despite Receiving Standard-of-Care Therapies: Preva

l

ence and Treatment with Korl

y

m
®
(Mifepri

st

one) (CATALYST) trial.

Methods and analysis

In part 1, approximately 1000 participants with difficult-to-control T2D (haemoglobin A1c (HbA1c) 7.5%–11.5% despite multiple therapies) are screened with a 1 mg dexamethasone suppression test (DST). Those with post-DST cortisol >1.8 µg/dL and dexamethasone level ≥140 ng/dL are identified to have hypercortisolism (part 1 primary endpoint), have morning adrenocorticotropic hormone (ACTH) and dehydroepiandrosterone sulfate (DHEAS) measured and undergo a non-contrast adrenal CT scan. Those requiring evaluation for elevated ACTH are referred for care outside the study; those with ACTH and DHEAS in the range may advance to part 2, a randomised, double-blind, placebo-controlled trial to evaluate the impact of treating hypercortisolism with the competitive glucocorticoid receptor antagonist mifepristone (Korlym
®
). Participants are randomised 2:1 to mifepristone or placebo for 24 weeks, stratified by the presence/absence of an abnormal adrenal CT scan. Mifepristone is dosed at 300 mg once daily for 4 weeks, then 600 mg daily based on tolerability and clinical improvement, with an option to increase to 900 mg. The primary endpoint of part 2 assesses changes in HbA1c in participants with hypercortisolism with or without abnormal adrenal CT scan. Secondary endpoints include changes in antidiabetes medications, cortisol-related comorbidities and quality of life.

Ethics and dissemination
The study has been approved by Cleveland Clinic IRB (Cleveland, Ohio, USA) and Advarra IRB (Columbia, Maryland, USA). Findings will be presented at scientific meetings and published in peer-reviewed journals.

Trial registration number

NCT05772169
.
Association of sleep duration with Visceral Adiposity Index: a cross-sectional study based on the NHANES 2007–2018
Authors: Liu Juan , Gao Yajie , Ye Nan , He Xingkang , Zhang Jing 
Published: July 2024

ObjectiveWe aimed to assess the associations between sleep duration and Visceral Adiposity Index (VAI).DesignCross-sectional study.SettingThe National Health and Nutrition Examination Survey (2007–2018).ParticipantsA total 11 252 eligible participants who have complete information for sleep duration and VAI.Outcome measureThe VAI index, which is sex-specific and takes into consideration factors such as waist circumference, body mass index, high-density lipoprotein cholesterol and triglycerides, was calculated in accordance with prior research. Multiple linear regressions and subgroup analyses were employed to evaluate the connection between the duration of sleep and the VAI.ResultsThe mean sleep duration and VAI of included participants were 7.05 hours/day and 2.03, respectively. After adjusting for the sociodemographic, lifestyle and other covariates, short sleep was significantly linked to increased VAI (β=0.15, 95% CI 0.01 to 0.28) in relation to middle sleep duration, whereas no significant association was found between long sleep duration and VAI. An L-shaped relationship was observed between sleep duration and VAI. When sleep duration was less than 7.5 hours/day, a negative association between sleep duration and VAI was obvious. However, when sleep duration was >7.5 hours/day, VAI was increased with a longer sleep duration, although it was not significant.ConclusionsAn L-shaped relationship was observed between sleep duration and VAI, with insufficient sleep, being independently linked to a higher VAI. This implies that sleep deprivation might be associated with visceral adipose distribution and disfunction.
Comparing COVID-19 vaccination coverage, adverse reactions and impact of social determinants of health on vaccine hesitancy in ADRD/MCI and non-ADRD/MCI population: protocol for a retrospective cross-sectional study
Authors: Yang Yijiong , Park Hyejin , Li Chengdong , Song Dan , Wang Jing 
Published: July 2024

IntroductionCOVID-19 vaccination is crucial for vulnerable people with underlying chronic conditions such as Alzheimer’s disease and related dementias (ADRD) and mild cognitive impairment (MCI). These individuals face unique challenges, including higher risk of COVID-19, difficulties in adopting preventive behaviours and vaccine hesitancy due to concerns about adverse reactions. Therefore, efforts to promote vaccination, including boosters tailored to the currently circulating virus, are essential for people with ADRD/MCI.ObjectiveThe primary purpose of this study protocol is to conduct a comprehensive analysis of COVID-19 vaccination coverage and adverse reactions among individuals with ADRD/MCI in comparison to those without ADRD/MCI. Additionally, the proposed study aims to investigate the impact of social determinants of health on COVID-19 vaccination and vaccine hesitancy in individuals with ADRD/MCI.Methods and analysisA retrospective cross-sectional study will be conducted utilising data from theAll of Us (AoU) Researcher Workbench. Relevant data fields are extracted from sources including demographic information, COVID-19 Vaccine Survey, Basic Survey, Health Access & Utilization, Social Determinants of Health, and Electronic Health Record (EHR) data. Data on vaccination, adverse reactions and vaccine hesitancy will be collected through COVID-19 vaccine survey questionnaires. Propensity score matching and binary logistic regression will be applied to assess the vaccination rates and vaccine hesitancy, while controlling for demographic characteristics and social determinants of health factors.Ethics and disseminationThis study protocol received approval from the Institutional Review Board at Florida State University (STUDY00004571). Results will be disseminated through publication in peer-reviewed journals and presented at scientific conferences.
Short-term and long-term stroke risk following SARS-CoV-2 infection in relation to disease severity: a Danish national cohort study
Authors: Schade Skov Camilla , Pottegård Anton , Harbo Andersen Jacob , Andersen Grethe , Lassen Annmarie Touborg 
Published: July 2024

ObjectivesStudies have reported high incidences of stroke in patients hospitalised with SARS-CoV-2, but the impact of disease severity is unexplored. We aimed to estimate the risk of incident ischaemic stroke in SARS-CoV-2 test-positive individuals compared with test-negative individuals stratified by disease severity during acute infection and post infection.DesignA register-based cohort study.SettingA Danish nationwide study.ParticipantsAll Danish adults who had PCR tests for SARS-CoV-2 performed between 1 March 2020 and 30 November 2021. Test-positive individuals were included at their first positive test. For individuals tested prior to 30 November 2021, we randomly sampled an index date from the distribution of test dates among SARS-CoV-2 test-positive individuals. Test-positive individuals were followed during the acute phase of infection (days 0–14) and post infection (180 days after the acute phase). Test-negative individuals were followed in equivalent time periods.Primary and secondary outcome measuresIncident ischaemic stroke risk in SARS-CoV-2 test-positive individuals compared with test-negative individuals during acute infection and post infection. We calculated subdistribution HRs (SHR) with death as a competing risk using propensity score weighting as confounder control. The risk was stratified according to disease severity: community managed, hospitalised, or admission to the intensive care unit.ResultsAmong 3 910 219 SARS-CoV-2 PRC-tested individuals, 356 421 test-positive and 3 067 456 test-negative individuals were included. A positive SARS-CoV-2 test was associated with an SHR of 3.32 (95% CI 2.60 to 4.25) overall for stroke compared with test negative in the acute phase. In the postinfection period, the risk of stroke remained increased in individuals hospitalised during the acute phase (SHR 1.85, 95% CI 1.45 to 2.37). Individuals with community-managed SARS-CoV-2 had no increased long-term risk of stroke (SHR 1.01, 95% CI 0.88 to 1.16).ConclusionSARS-CoV-2 infection is associated with increased stroke risk. Disease severity seems to be an important factor. Individuals with community-managed SARS-CoV-2 had no increased stroke risk.
‘The health care system is more like a business’—medical overuse from the patients’ perspective in Germany: a qualitative study
Authors: Sebastião Maria , Pesch Josefine , Kühlein Thomas , Hueber Susann 
Published: July 2024

ObjectivesMedical overuse exposes patients to unnecessary risks of harm. It is an open question whether and how patients perceive the concept of medical overuse, its causes and negative consequences.DesignA qualitative study design, using elements of the Grounded Theory Approach by Strauss and Corbin.SettingBetween May 2017 and January 2020, we recruited participants and conducted face-to-face interviews in the participants’ homes. Data collection took place in Bavaria, Germany.ParticipantsWe recruited 16 participants (female=8, male=8) with various characteristics for the study. We used different strategies such as flyers in supermarkets, pharmacies, participants spreading information about the study or local multipliers (snowball sampling).ResultsThe participants mostly defined medical overuse as too much being done but understood the concept superficially. During the interviews, most participants could describe examples of medical overuse. They named a variety of direct and indirect drivers with economic factors suspected to be the main driver. As a consequence of medical overuse, participants named the physical and emotional harm (eg, side effects of medication). They found it difficult to formulate concrete solutions. In general, they saw themselves more in a passive role than being responsible for bringing about change and solutions themselves. Medical overuse is a ‘problem of the others’. The participants emphasised that health education is important in reducing medical overuse.ConclusionsMedical overuse was little discussed among participants, although many participants reported experiences of too much medicine. Health education and strengthening the patients’ self-responsibility can play a vital role in reducing medical overuse.
Serplulimab combined with gemcitabine, nab-paclitaxel and stereotactic body radiotherapy as the first-line treatment for patients with metastatic pancreatic adenocarcinoma in China: a multicentre, single-arm, phase II trial (ICSBR) protocol
Authors: Zhang Chenyan , Yang Heqi , Chang Chen , Li Ruizhen , Xiong Junjie , Kang Deying , He Du , Liu Xi-Jiao , Cheng Ke , Cao Dan 
Published: July 2024

IntroductionPatients with pancreatic ductal adenocarcinoma (PDAC) remain a poor prognosis despite the development of chemotherapy. Although programmed cell death 1 (PD-1) blockade has shown great efficacy in various solid tumours, its application in treating PDAC is limited. Recent studies have indicated that chemotherapy or stereotactic body radiotherapy (SBRT) may improve the antitumour effect of PD-1 blockade in patients with PDAC. The objective of this study is to evaluate the efficacy and safety of combined therapy comprising PD-1 blockade, gemcitabine plus nab-paclitaxel chemotherapy and SBRT for patients with metastatic PDAC.Methods and analysisThis is a multicentre, single-arm, prospective phase II clinical trial. Forty-three patients diagnosed with metastatic PDAC will be enrolled. The eligible patients will be intravenously administered 1000 mg/m2gemcitabine and 125 mg/m2nab-paclitaxel on days 1 and 8 of the 21-day cycle. Serplulimab (200 mg) will be administered intravenously on day 1 of the 21-day cycle. Furthermore, during the second cycle, the patients will undergo SBRT with doses of 33 Gy in five fractions for primary lesions or doses of 24 Gy in three fractions for metastases. The primary endpoint is the 6-month progression-free survival (PFS) rate. The secondary endpoints overall survival, PFS, overall response rate, disease control rate, time to progression, duration of response, duration of disease control and safety. Moreover, this trial seeks to investigate biomarkers such as circulating tumour DNA and circulating hybrid cells in patients diagnosed with metastatic PDAC.Ethics and disseminationThe study was approved by the Ethics Committee on Biomedical Research, West China Hospital of Sichuan University. The study results will be presented at international conferences and published in a peer-reviewed journal.Trial registration numberChiCTR2300073237.
Protect peripheral intravenous catheters: a study protocol for a randomised controlled trial of a novel antimicrobial dressing for peripheral intravenous catheters (ProP trial)
Authors: Rickard Claire M , Drugeon Bertrand , Ullman Amanda , Marsh Nicole M , Corley Amanda , Ball Daner , O'Brien Catherine , Kleidon Tricia M , Guenezan Jérémy , Couvreur Raphael , McCarthy Kate L , Seguin Sabrina , Batiot Guillaume , Byrnes Joshua , Schults Jessica , Zahir Syeda Farah , Mimoz Olivier 
Published: July 2024

Introduction
Peripheral intravenous catheters (PIVCs) are the most commonly used vascular access device in hospitalised patients. Yet PIVCs may be complicated by local or systemic infections leading to increased healthcare costs. Chlorhexidine gluconate (CHG)-impregnated dressings may help reduce PIVC-related infectious complications but have not yet been evaluated. We hypothesise an impregnated CHG transparent dressing, in comparison to standard polyurethane dressing, will be safe, effective and cost-effective in protecting against PIVC-related infectious complications and phlebitis.

Methods and analysis
The ProP trial is a multicentre, superiority, randomised clinical and cost-effectiveness trial with internal pilot, conducted across three centres in Australia and France. Patients (adults and children aged ≥6 years) requiring one PIVC for ≥48 hours are eligible. We will exclude patients with emergent PIVCs, known CHG allergy, skin injury at site of insertion or previous trial enrolment. Patients will be randomised to 3M Tegaderm Antimicrobial IV Advanced Securement dressing or standard care group. For the internal pilot, 300 patients will be enrolled to test protocol feasibility (eligibility, recruitment, retention, protocol fidelity, missing data and satisfaction of participants and staff), primary endpoint for internal pilot, assessed by independent data safety monitoring committee. Clinical outcomes will not be reviewed. Following feasibility assessment, the remaining 2624 (1312 per trial arm) patients will be enrolled following the same methods. The primary endpoint is a composite of catheter-related infectious complications and phlebitis. Recruitment began on 3 May 2023.

Ethics and dissemination
The protocol was approved by Ouest I ethic committee in France and by The Queensland Children’s Hospital Human Research Ethics Committee in Australia. The findings will be disseminated through presentation at scientific conferences and publication in peer-reviewed journals.

Trial registration number

NCT05741866
.