bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metformin for knee osteoarthritis with obesity: study protocol for a randomised, double-blind, placebo-controlled trial
Authors: Lim Yuan Z , Wang Yuanyuan , Urquhart Donna M. , Estee Mahnuma Mahfuz , Wluka Anita E , Heritier Stephane , Cicuttini Flavia M 
Published: December 2023

IntroductionOver half of the populations with knee osteoarthritis (OA) have obesity. These individuals have many other shared metabolic risk factors. Metformin is a safe, inexpensive, well-tolerated drug that has pleiotropic effects, including structural protection, anti-inflammatory and analgesic effects in OA, specifically the knee. The aim of this randomised, double-blind, placebo-controlled trial is to determine whether metformin reduces knee pain over 6 months in individuals with symptomatic knee OA who are overweight or obese.Methods and analysisOne hundred and two participants with symptomatic knee OA and overweight or obesity will be recruited from the community in Melbourne, Australia, and randomly allocated in a 1:1 ratio to receive either metformin 2 g or identical placebo daily for 6 months. The primary outcome is reduction of knee pain [assessed by 100 mm Visual Analogue Scale (VAS)] at 6 months. The secondary outcomes are OMERACT-OARSI (Outcome Measures in Rheumatology-Osteoarthritis Research Society International) responder criteria [Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, function and participant’s global assessment (VAS)] at 6 months; change in knee pain, stiffness, function using WOMAC at 6 months and quality of life at 6 months. Adverse events will be recorded. The primary analysis will be by intention to treat, including all participants in their randomised groups.Ethics and disseminationEthics approval has been obtained from the Alfred Hospital Ethics Committee (708/20) and Monash University Human Research Ethics Committee (28498). Written informed consent will be obtained from all the participants. The findings will be disseminated through peer-review publications and conference presentations.Trial registration numberACTRN12621000710820 .
Methodology and application of three-dimensional technology for brace design and production for treatment in patients with adolescent idiopathic scoliosis: a scoping review protocol
Authors: Hoelen Thomáy-Claire Ayala , de Bie Rob A , Arts Jacobus JC , Willems Paul C 
Published: December 2023

IntroductionConservative treatment for adolescent idiopathic scoliosis (AIS) using bracing has proven to be effective at reducing curve progression. However, variation in brace design and lack of brace specificity hamper clinical treatment outcomes as well as the predictability and comparison hereof. To overcome this, recent technological developments aim to generate transparent and objective criteria for brace manufacturing by applying computer-aided design software and additive manufacturing to produce braces for scoliosis treatment. Yet, the extent of its applicability and clinical implementation are to be determined. This study will identify and map the available evidence for the methodology and application of three-dimensional technology for the design and production of clinical braces used for treatment in patients with AIS.Methods and analysisThis scoping review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. This scoping review will consider studies on methodology of three-dimensional technological methodology and applications that have been or are currently being applied in brace treatment of AIS. The following databases will be searched: MEDLINE, Web of Science, Cochrane Database of Systematic Reviews and Embase (OVID). Search limits will be applied; for example, only articles written in the English language published after 2000 will be included. The retrieved articles will be screened independently by two researchers. A third researcher will be consulted in case of disagreement. Data from relevant articles will be independently extracted by two researchers and presented in a tabular manner accompanied by a descriptive narration.Ethics and disseminationConsidering the nature of the study, no ethical approval needed to be requested. The study result will be submitted to a peer-reviewed journal.
Qualitative study of the consequences of vaccine-induced immune thrombocytopenia and thrombosis: the experiences of family members
Authors: Bennett Paul , Celik Filiz , Winstanley Jenna , Hunt Beverley J , Pavord Sue 
Published: December 2023

ObjectivesTo explore the experiences of family members of patients who died or survived following a diagnosis of vaccine-induced immune thrombocytopenia and thrombosis (VITT).DesignA semistructured qualitative study, conducted via Zoom.SettingParticipants discussed their experiences during hospitalisation and following discharge.ParticipantsSixteen family members of patients with VITT (survivors=11; bereaved=5), recruited via a Facebook support group and advertising on Twitter.ResultsAnalysis identified two themes common to both groups of participants: the stress of hospitalisation and the experience of multiple losses. A third theme, living with VITT, was unique to the survivor group and a fourth, battling against the system, was predominantly reported by bereaved participants.ConclusionsThis is a significantly challenged group of people, with multiple emotional, financial, social and psychological losses. These losses have been compounded by experiences of limited governmental and societal recognition of the problems they face.
Equitable and accessible informed healthcare consent process for people with intellectual disability: a systematic literature review
Authors: Dunn Manjekah , Strnadová Iva , Scully Jackie Leach , Hansen Jennifer , Loblinzk Julie , Sarfaraz Skie , Molnar Chloe , Palmer Elizabeth Emma 
Published: December 2023

ObjectiveTo identify factors acting as barriers or enablers to the process of healthcare consent for people with intellectual disability and to understand how to make this process equitable and accessible.Data sourcesDatabases: Embase, MEDLINE, PsychINFO, PubMed, SCOPUS, Web of Science and CINAHL. Additional articles were obtained from an ancestral search and hand-searching three journals.Eligibility criteriaPeer-reviewed original research about the consent process for healthcare interventions, published after 1990, involving adult participants with intellectual disability.Synthesis of resultsInductive thematic analysis was used to identify factors affecting informed consent. The findings were reviewed by co-researchers with intellectual disability to ensure they reflected lived experiences, and an easy read summary was created.ResultsTwenty-three studies were included (1999 to 2020), with a mix of qualitative (n=14), quantitative (n=6) and mixed-methods (n=3) studies. Participant numbers ranged from 9 to 604 people (median 21) and included people with intellectual disability, health professionals, carers and support people, and others working with people with intellectual disability. Six themes were identified: (1) health professionals’ attitudes and lack of education, (2) inadequate accessible health information, (3) involvement of support people, (4) systemic constraints, (5) person-centred informed consent and (6) effective communication between health professionals and patients. Themes were barriers (themes 1, 2 and 4), enablers (themes 5 and 6) or both (theme 3).ConclusionsMultiple reasons contribute to poor consent practices for people with intellectual disability in current health systems. Recommendations include addressing health professionals’ attitudes and lack of education in informed consent with clinician training, the co-production of accessible information resources and further inclusive research into informed consent for people with intellectual disability.PROSPERO registrationCRD42021290548.
Colonoscopic cancer detection rate: a new performance measure – is it FIT for purpose?
Authors: Bashir Khalid , Beintaris Iosif , Sharp Linda , Newton Julia , Elliott Katherine , Rees Jon , Rogers Peter , Rutter Matt 
Published: December 2023

IntroductionGastrointestinal symptoms correlate poorly with cancer diagnosis. A faecal immunochemical test (FIT) result of ≥10 µg has high sensitivity and negative predictive value for colorectal cancer (CRC) detection. An FIT-based diagnostic pathway may lead to more effective resource utilisation. We aimed to use National Endoscopy Database (NED) data to create a new colonoscopy performance measure, cancer detection rate (CDR) to assess the appropriate identification of target populations for colonoscopy; then to use CDR to assess the impact of implementing an FIT-based referral pathway locally.MethodsNED data were analysed to compare local diagnostic colonoscopic CDR in 2019 (prepathway revision) and 2021 (postpathway revision), benchmarked against overall national CDR for the same time frames.Results1, 123, 624 NED diagnostic colonoscopies were analysed. Locally, there was a significant increase in CDR between 2019 and 2021, from 3.01% (2.45%–3.47%) to 4.32% (3.69%–4.95%), p=0.003. The CDR increase was due to both a 10% increase in the number of CRCs detected and a 25% reduction in the number of diagnostic colonoscopies performed. Nationally, there was a smaller, but significant, increase in CDR from 2.02% (1.99%–2.07%) to 2.33% (2.29%–2.37%), p<0.001. The rate of increase in CDR% between 2019 and 2021 was significantly different locally compared with nationally.ConclusionOur study indicates that the introduction of a robustly vetted FIT-based algorithm to determine whether diagnostic colonoscopy is required, is effective in increasing the colonoscopic CDR. Moreover, CDR appears to be a meaningful performance metric that can be automatically calculated through NED, enabling monitoring of the quality of referral and vetting pathways.
Outcome study of the Pipeline Vantage Embolization Device (second version) in unruptured (and ruptured) aneurysms (PEDVU(R) study)
Authors: Booth Thomas C , Bassiouny Ahmed , Lynch Jeremy , Sonwalkar Hemant , Bleakley Aaron , Iqbal Ahmed , Minett Thais , Buwanabala Jonathon , Narata Ana Paula , Patankar Tufail , Islim Fathallah Ismail , Kandasamy Naga , Balasundaram Parthiban , Sciacca Sara , Siddiqui Juveria , Walsh Daniel , Tolias Christos , Kailaya-Vasan Ahilan , Sultan Amina A , Abd El-Latif Mahmoud , Mortimer Alex , Sastry Anand 
Published: December 2023

BackgroundThe Pipeline Vantage Embolization Device (PEDV) is the fourth-generation pipeline flow diverter for intracranial aneurysm treatment. There are no outcome studies for the second PEDV version. We aimed to evaluate safety and efficacy outcomes. Primary and secondary objectives were to determine outcomes for unruptured and ruptured cohorts, respectively.MethodsIn this multicenter retrospective and prospective study, we analyzed outcome data from eight centers using core laboratory assessments. We determined 30-day and ≥3-month mortality and morbidity rates, and 6- and 18-month radiographic aneurysm occlusion rates for procedures performed during the period July 2021–March 2023.ResultsWe included 121 consecutive patients with 131 aneurysms. The adequate occlusion rate for the unruptured cohort at short-term and medium-term follow up, and also for the ruptured cohort at short-term follow up, was >90%. Two aneurysms (1.5%) underwent retreatment. When mortality attributed to a palliative case in the unruptured cohort, or subarachnoid hemorrhage in the ruptured cohort, was excluded then the overall major adverse event rate in respective cohorts was 7.5% and 23.5%, with 0% mortality rates for each. When all event causes were included on an intention-to-treat basis, the major adverse event rates in respective cohorts were 8.3% and 40.9%, with 0.9% and 22.7% mortality rates.ConclusionsFor unruptured aneurysm treatment, the second PEDV version appears to have a superior efficacy and similar safety profile to previous-generation PEDs. These are acceptable outcomes in this pragmatic and non-industry-sponsored study. Analysis of ruptured aneurysm outcomes is limited by cohort size. Further prospective studies, particularly for ruptured aneurysms, are needed.
Resource utilisation and outcomes of people with heart failure in England: a descriptive analysis of linked primary and secondary care data – the PULSE study
Authors: Linden Stephan , Gollop Nicholas D , Farmer Ruth 
Published: December 2023

BackgroundHeart failure (HF) is associated with high levels of resource use and mortality, but prior UK studies have not compared outcomes by HF subtype (HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF)) in large patient populations. This study investigated healthcare resource utilisation and mortality in patients with HF in England, overall and by HF subtype.MethodsThis non-interventional cohort study linked data from the Clinical Practice Research Datalink database to Hospital Episode Statistics inpatient and UK Office for National Statistics mortality data. Patients with a recorded HF diagnosis (new (incident) or existing (prevalent)) based on clinical codes or measures of ejection fraction between 2015 and 2019 were included.ResultsOf 383 896 patients identified with HF, 100 224 patients (26%) had a recorded subtype: 68 780 patients with HFrEF (69%) and 31 444 patients (31%) with HFpEF. In total, 918 553 person-years (PY) were included (median follow-up: 2.1 years): 625 619 PY (68%) for unknown HF subtype, 204 862 PY (22%) for HFrEF and 88 017 PY (10%) for HFpEF. Overall, 11% of patients experienced ≥1 HF hospitalisation. After age and sex adjustment, hospitalisations for HF (HHF; including recurrent hospitalisations) and HF-related general practitioner consultations occurred at rates of approximately 80/1000 and 124/1000 PY, respectively, and were highest for patients with HFrEF and unknown subtype. Overall, all-cause and cardiovascular mortality rates were 132/1000 and 49/1000 PY, respectively. Patients with unknown subtype had the highest 1-year and 5-year mortality (20% and 48%), followed by HFrEF (8% and 35%) and HFpEF (6% and 25%).ConclusionsHF is associated with high levels of healthcare resource use, mortality, HHF and comorbidities. Ensuring that patients receive early and appropriate guideline-directed therapies to manage HF and associated comorbidities is likely to improve patient care and reduce the burden of HF on the English healthcare system.
Palliative care for infants with life-limiting conditions: integrative review
Authors: Iten Rebecca , O'Connor Moira , Gill Fenella J 
Published: December 2023

Background
Infants with life-limiting conditions are a heterogeneous population. Palliative care for infants is delivered in a diverse range of healthcare settings and by interdisciplinary primary healthcare teams, which may not involve specialist palliative care service consultation.

Objective
To synthesise the literature for how palliative care is delivered for infants aged less than 12 months with life-limiting conditions.

Methods
An integrative review design. MEDLINE, CINAHL, ProQuest, Cochrane, Joanna Briggs Institute and EMBASE were searched for research published in English language, from 2010 to 2022, and peer reviewed. Critical appraisal was completed for 26 patient case series, 9 qualitative, 5 cross-sectional and 1 quality improvement study. Data analysis involved deductive content analysis and narrative approach to summarise the synthesised results.

Results
37 articles met the eligibility for inclusion. Two models of palliative care delivery were examined, demonstrating differences in care received and experiences of families and health professionals. Health professionals reported lack of palliative care education, challenges for delivering palliative care in intensive care settings and barriers to advance care planning including prognostic uncertainty and transitioning to end-of-life care. Families reported positive experiences with specialist palliative care services and challenges engaging in advance care planning discussions.

Conclusion
There are complex issues surrounding the provision of palliative care for infants. Optimal palliative care should encompass a collaborative and coordinated approach between the primary healthcare teams and specialist palliative care services and prioritisation of palliative care education for nurses and physicians involved in providing palliative care to infants.
Measurement of the double-$$\varvec{\beta }$$ decay of $$\varvec{^{150}}$$Nd to the 0$$\varvec{^+_1}$$ excited state of $$\varvec{^{150}}$$Sm in NEMO-3
Authors: Aguerre X. , Arnold R. , Augier C. , Barabash A. S. , Basharina-Freshville A. , Blondel S. , Blot S. , Bongrand M. , Breier R. , Brudanin V. , Busto J. , Bystryakov A. , Caffrey A. J. , Cerna C. , Cesar J. P. , Ceschia M. , Chauveau E. , Chopra A. , Dawson L. , Duchesneau D. , Durand D. , Evans J. J. , Flack R. , Franchini P. , Garrido X. , Girard-Carillo C. , Guillon B. , Guzowski P. , Hoballah M. , Hodák R. , Hubert P. , Hussain M. H. , Jullian S. , Klimenko A. , Kochetov O. , Konovalov S. I. , Koňařík F. , Křižák T. , Lalanne D. , Lang K. , Lemière Y. , Li P. , Loaiza P. , Lutter G. , Macko M. , Mamedov F. , Marquet C. , Mauger F. , Minotti A. , Morgan B. , Nemchenok I. , Nomachi M. , Nowacki F. , Ohsumi H. , Oliviéro G. , Palušová V. , Patrick C. , Perrot F. , Petro M. , Pin A. , Piquemal F. , Povinec P. , Pratt S. , Přidal P. , Quinn W. S. , Ramachers Y. A. , Remoto A. , Reyss J. L. , Riddle C. L. , Rukhadze E. , Saakyan R. , Salamatin A. , Salazar R. , Sarazin X. , Sedgbeer J. , Shitov Yu. , Simard L. , Šimkovic F. , Smetana A. , Smolnikov A. , Söldner-Rembold S. , Štekl I. , Suhonen J. , Szklarz G. , Tedjditi H. , Thomas J. , Timkin V. , Tretyak V. I. , Tretyak V. I. , Umatov V. I. , Vanushin I. , Vereshchaka Y. , Vorobel V. , Waters D. , Xie F. 
Published: December 2023

AbstractThe NEMO-3 results for the double-$$\beta $$
β
decay of $$^{150}$$

150

Nd to the 0$$^+_1$$

1
+

and 2$$^+_1$$

1
+

excited states of $$^{150}$$

150

Sm are reported. The data recorded during 5.25 year with 36.6 g of the isotope $$^{150}$$

150

Nd are used in the analysis. The signal of the $$2\nu \beta \beta $$

2
ν
β
β

transition to the 0$$^+_1$$

1
+

excited state is detected with a statistical significance exceeding 5$$\sigma $$
σ
. The half-life is measured to be $$T_{1/2}^{2\nu \beta \beta }(0^+_1) = \left[ 1.11 ^{+0.19}_{-0.14} \,\left( \hbox {stat}\right) ^{+0.17}_{-0.15}\,\left( \hbox {syst}\right) \right] \times 10^{20}$$

T

1
/
2

2
ν
β
β

(

0
1
+

)

=

1
.

11

-
0.14

+
0.19

stat

-
0.15

+
0.17

syst

×

10
20

year, which is the most precise value that has been measured to date. 90% confidence-level limits are set for the other decay modes. For the $$2\nu \beta \beta $$

2
ν
β
β

decay to the 2$$^+_1$$

1
+

level the limit is $$T^{2\nu \beta \beta }_{1/2}(2^+_1) > 2.42 \times 10^{20}~\hbox {year}$$

T

1
/
2

2
ν
β
β

(

2
1
+

)

>
2.42
×

10
20

year

. The limits on the $$0\nu \beta \beta $$

0
ν
β
β

decay to the 0$$^+_1$$

1
+

and 2$$^+_1$$

1
+

levels of $$^{150}$$

150

Sm are significantly improved to $$T_{1/2}^{0\nu \beta \beta }(0^+_1) > 1.36 \times 10^{22}~\hbox {year}$$

T

1
/
2

0
ν
β
β

(

0
1
+

)

>
1.36
×

10
22

year

and $$T_{1/2}^{0\nu \beta \beta }(2^+_1) > 1.26 \times 10^{22}~\hbox {year}$$

T

1
/
2

0
ν
β
β

(

2
1
+

)

>
1.26
×

10
22

year

.
4FSK signal processing based on adaptive tristable stochastic resonance under levy noise
Authors: Zhang Yalin , Wang Fuzhong 
Published: December 2023

Aiming at the problem of low quality of coherent demodulation transmission signal of digital signal in the background of Levy noise, this paper proposes a new method of 4FSK signal reception based on adaptive tristable stochastic resonance (SR) system. The bit error rate (BER) of output signals of adaptive tristable SR system model and the traditional modulation model are compared by simulation. The numerical simulation results show that compared with the traditional model, the output BER of the 4FSK signal after demodulation of the adaptive tristable SR system model is reduced by 4% compared with the traditional model. The time domain image of 4FSK signal is clearer, the burrs are significantly reduced and the spectral amplitude of 4FSK signal is greatly improved. The success of this experiment suggests a strong promise of SR systems for digital signal detection in impact noise.
Causes of Iatrogenic Median Nerve Injury after Endoscopic Carpal Tunnel Release
Authors: MURAMATSU Keiichi , TANI Yasuhiro , YAMASHITA Yosuke , CORPUS-ZUÑIGA Fidelis Marie , SUGIMOTO Hideaki , TEC Lou Mervyn 
Published: December 2023

Background: Endoscopic carpal tunnel release (ECTR) is a less invasive procedure but has a higher risk of complications. We analysed ECTR cases dividing them into three periods according to a single surgeon’s experience when the ECTR was performed: the initial, midterm and late period. Cases of iatrogenically induced median nerve injuries that occurred after ECTR were then noted and evaluated. Methods: We reviewed 195 ECTRs done with the 2-portal technique and divided the patients into three groups according to periods of when ECTR was done. The indications for ECTR surgery were limited to severe CTS cases. These groups of patients were similar in terms of age, duration of disease, electrophysiological study results and severity of the disease. The patients were evaluated for median neuropathy pre- and postoperatively using Semmes–Weinstein monofilament test (SWT), Disabilities of the arm, shoulder and hand (DASH) Score, Coin-flip test (CFT), postoperative paraesthesias and complications, such as pillar pain, and so on. Electrophysiological evaluation was performed only preoperatively. Results: Postoperative median nerve recovery was overall good. Normal recovery was noted in 181 cases (93%). SWT, DASH and CFT were all significantly improved upon follow-up in all three groups. In terms of iatrogenic neuropathy, median nerve palsy worsened (including those transiently worsened) after ECTR in 11 cases (5.6%), even in the later period. The sensory disturbance was equally worsening from the radial to the ulnar side. Conclusions: The fact that there were neurologically worsened cases even in the later period, when the operator is higher skilled in the technique, suggests that the surgical technique itself may be the one posing higher risk than the level of surgical skill. The most likely causes of aggravated nerve palsy were a direct injury by cannula insertion at the proximal portal, or additional median nerve compression during cannula insertion into the carpal tunnel. Level of Evidence: Level IV (Therapeutic)
Coverage of Palmar Mini Plates with Flexor Pulleys in the Treatment of Dorsal Fracture-Subluxation of the Proximal Interphalangeal Joint
Authors: MANIGLIO Mauro , ZAIDENBERG Ezequiel E. , BORETTO Jorge G. , DE CARLI Pablo 
Published: December 2023

Introduction: Dorsal fracture dislocations (DFD) of the proximal interphalangeal joint (PIPJ) are challenging fractures. A palmar surgical approach and plate fixation has a high complication rate, including flexor contractions, reduction of range of motion (ROM) and secondary need for plate removal. Methods: We use the flexor tendon pulleys to cover the mini plate with the assumption that it may reduce the adhesion between the mini plates and the tendons and reduce postoperative complications. We present the outcomes of using this technique in eight patients. Results: All patients had an excellent outcome at a mean follow-up of 17 months, and none required removal of the implants. Conclusions: This study presents a surgical technique that may potentially reduce the high complication rate found after ORIF for treatment of DFD of the PIPJ. Therefore, improving the clinical outcomes after this type of surgery. Level of Evidence: Level IV (Therapeutic)