bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of an innovative Herbst appliance with TADs for patients with hyperdivergent class II malocclusion: study protocol for a randomised controlled trial
Authors: Wang Yuhui , Xu Yichen , Gong Zhicheng , Pan Jie , Liu Yuehua 
Published: August 2023

IntroductionClass II treatment with mandibular retrusion often involves the Herbst appliance due to its efficiency and low requirement of cooperation. Despite its advantages, it causes side effects concerning the occlusal plane and pogonion in terms of clockwise rotation that hinder the desired mandibular advancement for hyperdivergent patients. In this study, we will use a newly designed Herbst appliance, and a protocol that is accompanied by TADs for vertical control to avoid maxillary clockwise rotation. We hypothesise that the effect of the Herbst appliance with the vertical control approach will be beneficial for maintaining or even decreasing the skeletal divergence in hyperdivergent class II patients compared with conventional Herbst treatment.Methods and analysisThis study is a randomised, parallel, prospective controlled trial that will study the efficacy of Herbst with or without vertical control in children with hyperdivergent skeletal class II malocclusion. A total of 44 patients will be enrolled and randomised in a ratio of 1:1 to either Herbst treatment or Herbst treatment with vertical control. Participants will be recruited at the Shanghai Stomatological Hospital, Shanghai, China. The primary endpoint is the change in the angle indicating the occlusal plane and Sella-Nasion plane from baseline (T0) to the primary endpoint (T2) on cephalometric measurements by lateral X-ray examination. Important secondary outcomes include the root length of the anterior teeth, and the assessment score of the Visual Analogue Scale Questionnaire, etc. Safety endpoints will also be evaluated.Ethics and disseminationThis study has been approved by the ethics committee of the Shanghai Stomatological Hospital (Approval No. (2021) 012). Before enrolment, a qualified clinical research assistant will obtain written informed consent from both the participants and their guardians after full explanation of this study. The results will be presented at national or international conferences and published in peer-reviewed journals.Trial registration numberChiCTR2100049860, Chinese Clinical Trial Registry
Symptom profiles and their influencing factors among people with subjective cognitive decline: a secondary analysis of cross-sectional data from the 2019 Korea Community Health Survey using latent class analysis
Authors: Seong Hohyun , Park Jongmin 
Published: August 2023

ObjectiveSubjective cognitive decline, self-perceived cognitive deterioration without objective impairment, is becoming a vital health indicator, especially due to its intermediate stage between normal function and mild cognitive impairment. Cognitive decline often coexists with various symptoms that may interact with each other, serve as prognostic indicators and influence the progression of cognitive decline. This study aims to identify symptom clusters among individuals with subjective cognitive decline, using latent class analysis, and to identify factors affecting these symptom clusters, offering insights into understanding and potentially preventing cognitive decline progression.Design and settingA secondary data analysis of the nationally representative cross-sectional data obtained from the 2019 Korea Community Health Survey.OutcomesWe performed latent class analysis using six symptoms (pain, sleep deprivation, depression, fatigue, restlessness and apathy) to determine the distinct symptom clusters. After selecting the best latent class model, we identified factors influencing those symptom clusters using multinomial logistic regression analyses.ResultsWe found that a three-latent-class model best fitted the data: a low symptom-burden group (39.9%), a moderate symptom-burden group (44.8%) and a high symptom-burden group (15.3%). Male gender, higher age, higher perceived health status and lower perceived stress status, were strongly associated with lesser odds of being in the moderate (OR: 0.37 (95% CI: 0.33 to 0.41)) to OR: 2.20 (95% CI: 2.03 to 2.39)) and high symptom-burden groups (OR: 0.18 (95% CI: 0.15 to 0.21)) to OR: 8.53 (95% CI: 7.68 to 9.49)) as compared with being in the low symptom-burden group.ConclusionFindings may contribute to improving clinical practitioners’ understanding of the unique symptom patterns experienced by people with subjective cognitive decline and their influencing factors. Furthermore, we recommend that formal caregivers screen and manage prevalent symptoms considering the factors affecting the symptoms of people with subjective cognitive decline in clinical practice.
Impact of SARS-CoV-2 infection on postoperative complications of patients undergoing surgery after general outbreak in China: a protocol for multicentre prospective cohort study
Authors: Zheng Ziyu , Gao Baobao , Luo Gang , Wang Lini , Lei Chong 
Published: August 2023

IntroductionThere is currently limited evidence addressing perioperative prognosis of surgical patients during COVID-19 pandemic; especially targeting on the Chinese population since the wave in 2022. Considering a distinct feature from the rest of the world demonstrated and the fast mutation and spread of the virus, evidence most relevant to China is urgently in need. The objective of this study is to seek for supporting evidence via evidence-based risk evaluations for postoperative complications to accumulate experience for coming infection waves.Methods and analysisThis protocol proposes a multicentral, prospective, observational cohort study aiming to explore the link between SARS-CoV-2 infection and postoperative complications among surgical patients under general or regional anaesthesia between 16 January 2023 and 31 December 2023. A retrospective cohort covering the same period in 2019 is extracted for historic reference. Data are extracted from the health information system and anaesthesia information management system. The COVID-19 information is collected via an online survey. Missing values in weight or height will be imputed by each other with age and gender via multiple imputation. Other missing values will not be handled specially. Standard descriptive statistics will be reported followed by statistical modelling. Binomial regression with logit link is used for binary outcome. The time-to-event outcome is analysed using Cox regression with discharge from hospital further treated as a competing state. Hierarchical models will be assessed to account for temporal or central random effects. Temporal trends will be displayed with future expectations.Ethics and disseminationEthical approval is obtained from the ethical committee in Xijing Hospital (No. KY20232002-C-1); approvals are expected for each participating institute. Verbal consent will be informed and obtained prior to online survey collection. Personal information remains confidential, and publications will be deidentified.Trial registration numberNCT05677815.
PeRiOperative Glucose PRAgMatic (PROGRAM) trial protocol and statistical analysis plan for comparing automated intraoperative reminders to standardise insulin administration in surgical patients at high risk of hyperglycaemia
Authors: Zapf Matthew , Patel Dev , Henson Patrick , McEvoy Matthew D , Huang Eunice , Wanderer Jonathan P , Fowler Leslie , Mccarthy Karen , Freundlich Robert E , Eden Svetlana , Shotwell Matthew S , Kertai Miklos D 
Published: August 2023

IntroductionStudies finding perioperative hyperglycaemia is associated with adverse patient outcomes in surgical procedures spurred the development of blood glucose guidelines at many institutions. In this trial, we will assess the implementation of a clinical decision support tool that is integrated into the intraoperative portion of our electronic health record and provides real-time best practice recommendations for intraoperative insulin dosing in surgical patients at high risk for hyperglycaemia.Methods and designWe will assess this intervention using a sequential and repeated cross-over design at the institutional level with periods of time for wash-out, control and study intervention. The unit of analysis will be the surgical case. The primary outcome will be the frequency of hyperglycaemia (>180 mg/dL (10 mmol/L)) at first postoperative anaesthesia care unit measurement. There are several prespecified secondary analyses focused on perioperative glycaemic control.DiscussionThis protocol and statistical analysis plan describes the methodology, primary and secondary analyses. The PeRiOperative Glucose PRAgMatic (PROGRAM) trial was approved by the Vanderbilt University Institutional Review Board (IRB), Vanderbilt University Medical Center, Nashville, Tennessee, USA (IRB, 220991). The study results will be disseminated via publication in a peer-reviewed journal and presented at national scientific conferences. The results of PROGRAM trial will inform best practice for perioperative standardised insulin administration in surgical patients at high risk of hyperglycaemia.Trial registration numberNCT05426096.
Evaluation of the efficacy and safety of an integrated telerehabilitation platform for home-based cardiac REHABilitation in patients with heart failure (E-REHAB): protocol for a randomised controlled trial
Authors: Chimura Misato , Koba Shinji , Sakata Yasushi , Ise Takayuki , Miura Hiroyuki , Murai Ryosuke , Suzuki Hiroshi , Maekawa Emi , Kida Keisuke , Matsuo Koki , Kondo Hirokazu , Takabayashi Kensuke , Fujimoto Wataru , Tamura Yuichi , Imai Shunsuke , Miura Shin-ichiro , Origuchi Hideki , Goda Akiko , Saita Ryotaro , Kikuchi Atsushi , Taniguchi Tatsunori 
Published: August 2023

IntroductionCardiac rehabilitation (CR) is strongly recommended as a medical treatment to improve the prognosis and quality of life of patients with heart failure (HF); however, participation rates in CR are low compared with other evidence-based treatments. One reason for this is the geographical distance between patients’ homes and hospitals. To address this issue, we developed an integrated telerehabilitation platform, RH-01, for home-based CR. We hypothesised that using the RH-01 platform for home-based CR would demonstrate non-inferiority compared with traditional centre-based CR.Methods and analysisThe E-REHAB trial aims to evaluate the efficacy and safety of RH-01 for home-based CR compared with traditional centre-based CR for patients with HF. This clinical trial will be conducted under a prospective, randomised, controlled and non-inferiority design with a primary focus on HF patients. Further, to assess the generalisability of the results in HF to other cardiovascular disease (CVD), the study will also include patients with other CVDs. The trial will enrol 108 patients with HF and 20 patients with other CVD. Eligible HF patients will be randomly assigned to either traditional centre-based CR or home-based CR in a 1:1 fashion. Patients with other CVDs will not be randomised, as safety assessment will be the primary focus. The intervention group will receive a 12-week programme conducted two or three times per week consisting of a remotely supervised home-based CR programme using RH-01, while the control group will receive a traditional centre-based CR programme. The primary endpoint of this trial is change in 6 min walk distance.Ethics and disseminationThe conduct of the study has been approved by an institutional review board at each participating site, and all patients will provide written informed consent before entry. The report of the study will be disseminated via scientific fora, including peer-reviewed publications and presentations at conferences.Trial registration numberjRCT:2052200064.
How is transition to medical practice shaped by a novel transitional role? A mixed-methods study
Authors: Burford Bryan , Mattick Karen , Carrieri Daniele , Goulding Anna , Gale Thomas , Brennan Nicola , Vance Gillian 
Published: August 2023

ObjectivesThis study considered a novel ‘interim’ transitional role for new doctors (termed ‘FiY1’, interim Foundation Year 1), bridging medical school and Foundation Programme (FP). Research questions considered effects on doctors’ well-being and perceived preparedness, and influences on their experience of transition. While FiY1 was introduced in response to the COVID-19 pandemic, findings have wider and ongoing relevance.DesignA sequential mixed-methods study involved two questionnaire phases, followed by semi-structured interviews. In phase 1, questionnaires were distributed to doctors in FiY1 posts, and in phase 2, to all new FP doctors, including those who had not undertaken FiY1.Setting and participantsParticipants were newly qualified doctors from UK medical schools, working in UK hospitals in 2020. 77% (n=668) of all participants across all phases had undertaken FiY1 before starting FP in August. The remainder started FP in August with varying experience beforehand.Outcome measuresQuestionnaires measured preparedness for practice, stress, anxiety, depression, burnout, identity, and tolerance of ambiguity. Interviews explored participants’ experiences in more depth.ResultsAnalysis of questionnaires (phase 1 n=441 FiY1s, phase 2 n=477 FiY1s, 196 non-FiY1s) indicated that FiY1s felt more prepared than non-FiY1 colleagues for starting FP in August (β=2.71, 95% CI=2.21 to 3.22, p<0.0001), which persisted to October (β=1.85, CI=1.28 to 2.41, p<0.0001). Likelihood of feeling prepared increased with FiY1 duration (OR=1.02, CI=1.00 to 1.03, p=0.0097). Despite challenges to well-being during FiY1, no later detriment was apparent. Thematic analysis of interview data (n=22) identified different ways, structural and interpersonal, in which the FiY1 role enhanced doctors’ emerging independence supported by systems and colleagues, providing ‘supported autonomy’.ConclusionsAn explicitly transitional role can benefit doctors as they move from medical school to independent practice. We suggest that the features of supported autonomy are those ofinstitutionalised liminality—a structured role ‘betwixt and between’ education and practice—and this lens may provide a guide to optimising the design of such posts.
Impact of areal socioeconomic status on prehospital delay of acute ischaemic stroke: retrospective cohort study from a prefecture-wide survey in Japan
Authors: Fukuda Hitoshi , Hyohdoh Yuki , Ninomiya Hitoshi , Ueba Yusuke , Ohta Tsuyoshi , Kawanishi Yu , Kadota Tomohito , Hamada Fumihiro , Fukui Naoki , Nonaka Motonobu , Kawada Kei , Fukuda Maki , Nishimoto Yo , Matsushita Nobuhisa , Nojima Yuji , Kida Namito , Hayashi Satoru , Izumidani Tomohiko , Nishimura Hiroyuki , Moriki Akihito , Ueba Tetsuya 
Published: August 2023

ObjectivesTo examine whether the Areal Deprivation Index (ADI), an indicator of the socioeconomic status of the community the patient resides in, is associated with delayed arrival at the hospital and poor outcomes in patients with acute ischaemic stroke from a prefecture-wide stroke database in Japan.DesignRetrospective study.SettingTwenty-nine acute stroke hospitals in Kochi prefecture, Japan.ParticipantsNine thousand and six hundred fifty-one patients with acute ischaemic stroke who were urgently hospitalised, identified using the Kochi Acute Stroke Survey of Onset registry. Capital and non-capital areas were analysed separately.Primary and secondary outcome measuresPrehospital delay defined as hospital arrival ≥4-hour after stroke onset, poor hospital outcomes (in-hospital mortality and discharge to a nursing facility) and the opportunities of intravenous recombinant tissue plasminogen activator (rt-PA) and endovascular reperfusion therapy.ResultsIn the overall cohort, prehospital delay was observed in 6373 (66%) patients. Among individuals residing in non-capital areas, those living in municipalities with higher ADI (more deprived) carried a significantly higher risk of prehospital delay (per one-point increase, OR (95% CI) 1.45 (1.26 to 1.66)) by multivariable logistic regression analysis. In-hospital mortality (1.45 (1.02 to 2.06)), discharge to a nursing facility (1.31 (1.03 to 1.66)), and delayed candidate arrival ≥2-hour of intravenous rt-PA (2.04 (1.30 to 3.26)) and endovascular reperfusion therapy (2.27 (1.06 to 5.00)), were more likely to be observed in the deprived areas with higher ADI. In the capital areas, postal-code-ADI was not associated with prehospital delay (0.97 (0.66 to 1.41)).ConclusionsLiving in socioeconomically disadvantaged municipalities was associated with prehospital delays of acute ischaemic stroke in non-capital areas in Kochi prefecture, Japan. Poorer outcomes of those patients may be caused by delayed treatment of intravenous rt-PA and endovascular reperfusion therapy. Further studies are necessary to determine social risk factors in the capital areas.Trial registration numberThis article is linked to a clinical trial to UMIN000050189, No.: R000057166 and relates to its Result stage.
Gastrointestinal syndromes preceding a diagnosis of Parkinson’s disease: testing Braak’s hypothesis using a nationwide database for comparison with Alzheimer’s disease and cerebrovascular diseases
Authors: Konings Bo , Villatoro Luisa , Van den Eynde Jef , Barahona Guillermo , Burns Robert , McKnight Megan , Hui Ken , Yenokyan Gayane , Tack Jan , Pasricha Pankaj Jay 
Published: August 2023

ObjectiveBraak’s hypothesis states that Parkinson’s disease (PD) originates in the gastrointestinal (GI) tract, and similar associations have been established for Alzheimer’s disease (AD) and cerebrovascular diseases (CVD). We aimed to determine the incidence of GI syndromes and interventions preceding PD compared with negative controls (NCs), AD and CVD.DesignWe performed a combined case-control and cohort study using TriNetX, a US based nationwide medical record network. Firstly, we compared subjects with new onset idiopathic PD with matched NCs and patients with contemporary diagnoses of AD and CVD, to investigate preceding GI syndromes, appendectomy and vagotomy. Secondly, we compared cohorts with these exposures to matched NCs for the development of PD, AD and CVD within 5 years.ResultsWe identified 24 624 PD patients in the case-control analysis and matched 18 cohorts with each exposure to their NCs. Gastroparesis, dysphagia, irritable bowel syndrome (IBS) without diarrhoea and constipation showed specific associations with PD (vs NCs, AD and CVD) in both the case-control (odds ratios (ORs) vs NCs 4.64, 3.58, 3.53 and 3.32, respectively, all p<0.0001) and cohort analyses (relative risks (RRs) vs NCs 2.43, 2.27, 1.17 and 2.38, respectively, all p<0.05). While functional dyspepsia, IBS with diarrhoea, diarrhoea and faecal incontinence were not PD specific, IBS with constipation and intestinal pseudo-obstruction showed PD specificity in the case-control (OR 4.11) and cohort analysis (RR 1.84), respectively. Appendectomy decreased the risk of PD in the cohort analysis (RR 0.48). Neither inflammatory bowel disease nor vagotomy were associated with PD.ConclusionDysphagia, gastroparesis, IBS without diarrhoea and constipation might specifically predict Parkinson’s disease.
Contribution to the taxonomic elucidation of the Geonoma maxima complex (Arecaceae) in Central Amazonia, Brazil
Authors: de Souza Maria Cristina , de Mendonça Maria Silvia , Hopkins Michael John Gilbert , Pinheiro Fabio , Salatino Antonio , Brasileiro-Vidal Ana Christina , Vasconcelos Santelmo , Ferreira Evandro Jose Linhares 
Published: August 2023

Geonoma maxima (Poit.) Kunth is an example of a species complex, among many others restricted to Neotropical rain forests, which contribute to their high species diversity. Using environmental, morphological, karyological, and molecular data, we aim to test the taxonomic circumscription of 3 of the 11 G. maxima subspecies defined in the latest taxonomic treatment. We evaluated 217 samples of G. maxima complex from Ducke Reserve in the state of Amazonas, Brazil. Environmental preferences were significant at the 0.1% level. Subspecies maxima occurred in the slope, subsp. chelidonura in the floodplain, and subsp. spixiana in the plateau. Leaf morphology and height were different for each subspecies, but not leaf anatomy. The karyotypes of subspp. c helidonura and maxima were symmetrical with 2 n = 28 chromosomes, 16 metacentric and 12 submetacentric. Molecular analysis revealed two groups, one comprised subspp. maxima and chelidonura, and the other formed exclusively by subsp. spixiana. At Ducke Reserve, it is clear that the three subspecies are easily recognizable morphologically and ecologically, and it is likely that they do not interbreed locally. However, if these subspecies are analyzed on a larger geographic scale, it may not be possible to separate them.
Advances in laser-driven neutron sources and applications
Authors: Yogo A. , Arikawa Y. , Abe Y. , Mirfayzi S. R. , Hayakawa T. , Mima K. , Kodama R. 
Published: August 2023

AbstractLaser-driven neutron source (LDNS) is attracting interest for several reasons including (i) compactness of the source, (ii) neutron pulse shortness and (iii) transportability of laser beam. Through reviewing recent activities, we discuss the characteristics of LDNS in a comparison with accelerator-based neutron facilities (ABNF). Especially, we discuss the potential and limit of LDNS by showing that neutrons ranging from meV to MeV in energy were generated by LDNS and applied to neutron analysis and fundamental science.
Study of damped oscillating structures from charged and neutral K-meson electromagnetic form factors data
Authors: Dubnička Stanislav , Dubničková Anna Zuzana , Holka Lukáš , Liptaj Andrej 
Published: August 2023

AbstractThe damped oscillating structures were recently revealed in the proton “effective” form factor data. For the time being they can neither be confirmed nor disproved by investigations of the individual proton form factors data because the data have not yet achieved the required level of precision. On the other hand, conjectures that the oscillating structures are direct manifestations of the quark-gluon structure of the proton indicate that they should not be specific only to the proton and neutron. This opens a possibility to find these structures also in the data of other hadrons by the same procedure as for the proton. In this paper the oscillatory structures are investigated in the electromagnetic form factor data of the charged and neutral K-mesons. If the charged and neutral K-meson data are described by the three parametric formula by means of which the oscillating structures have been revealed for the proton (although with a large value of $$\chi ^2/ndf$$

χ
2

/
n
d
f

) then oscillating structures appear. On the other hand, if the physically well founded Unitary and Analytic model of the K-meson electromagnetic structure is used for the description of the charged K-meson data, no damped oscillating structures are visible. However, in the case of the neutral K-meson data one cannot make a definite conclusion, and more precise data are needed. These results indicate that also the damped oscillating structures obtained from the “effective” proton form factor data are likely an artefact of the three parametric formula, which cannot describe the data with sufficient precision.