bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is there a difference in the analgesic response to intra-articular bupivacaine injection in people with knee osteoarthritis pain with or without central sensitisation? Protocol of a feasibility randomised controlled trial
Authors: Zedan Yasmine , Knaggs Roger , Cooper Dale , Kurien Thomas , Walsh David Andrew , Auer Dorothee P , Scammell Brigitte E 
Published: July 2023

IntroductionPain is the main symptom of osteoarthritis (OA) with approximately 50% of patients reporting moderate-to-severe pain. Total knee replacement (TKR) is the ultimate treatment option to alleviate pain in knee OA. Nevertheless, TKR does not provide complete relief for all as approximately 20% of patients experience chronic postoperative pain. Painful peripheral stimuli may alter the central nociceptive pathways leading to central sensitisation that can influence treatment response in patients with OA. Currently, there is no objective protocol for detecting whether a patient will respond to a given treatment. Therefore, there is a need for a better mechanistic understanding of individual factors affecting pain relief, consequently informing personalised treatment guidelines. The purpose of this research is to examine the feasibility of conducting a full-scale mechanistic clinical trial in painful knee OA investigating the analgesic response to intra-articular bupivacaine between those with or without evidence of central sensitisation.Methods and analysisThe Understanding Pain mechanisms in KNEE osteoarthritis (UP-KNEE) study is a feasibility, double-blinded, placebo-controlled randomised parallel study in participants with radiographically defined knee OA and with self-reported chronic knee pain. The study involves the following assessments: (1) a suite of psychometric questionnaires; (2) quantitative sensory testing; (3) magnetic resonance imaging (MRI) scan of the knee and brain; (4) a 6-minute walk test; and (5) an intra-articular injection of bupivacaine or placebo (sodium chloride 0.9%) into the index knee. Assessments will be repeated post intra-articular injection apart from the MRI scan of the knee. Our aim is to provide proof of concept and descriptive statistics to power a future mechanistic trial.Ethics and disseminationEthical approval was obtained from the Health Research Authority (HRA) (REC: 20/EM/0287). Results will be disseminated via peer-reviewed journals and scientific conferences. The results will also be shared with lay audiences through relevant channels, such as Pain Centre Versus Arthritis website and patient advocacy groups.Trial registration numberNCT05561010.
Effects of continuum of care for maternal health service utilisation on intention to use family planning among pastoralist women of Ethiopia: a robust regression analysis and propensity score matching modelling
Authors: Alemayehu Mussie , Medhanyie Araya Abrha , Reed Elizabeth , Kahsay Znabu Hadush , Kalayu Mebrhatu , Mulugeta Afework 
Published: July 2023

ObjectivesThis study examines the effect of continuum care for maternal health service utilisation on intention to use family planning among the pastoralist community in Ethiopia.DesignA community-based cross-sectional study.SettingData were collected from three districts of the pastoralist community of the Afar region.ParticipantsRandomly selected 891 married pastoralist women.Primary outcomeIntention to use family planning.ResultsIntention to use family planning would increase (β=0.122, 95% CI: 0.036, 0.287) or by 12.2%, if all married pastoralist women received continuum of care for maternal health service utilisation compared with their counterparts. Results from the robust regression analysis indicate that intention to use family planning was higher among women who had a discussion about family planning with their husband (β=0.31, SE=0.035, p<0.001), women who possessed an electronic devices (β=0.096, SE=0.029, p<0.001) and women who had an unmet need for family planning (β=0.056, SE=0.026, p<0.000). However, intention to use family planning was lower for women who were in a polygamous marriage (β=−0.168, SE=0.065, p<0.01). There was a significant linear increase in the score of intention to use family planning for attitude towards family planning (β=0.009, SE=0.001, p<0.000), subjective norm (β=0.003, SE=0.001, p<0.003) and perceived control over family planning (β=0.002, SE=0.008, p<0.024) given other explanatory variables in the model.ConclusionContinuum of care for maternal health service utilisation increases pastoralist women’s intention to use family planning. Maximising any opportunity to counsel women who come to health facilities about family planning would be vital to increase their intention to use family planning.Trial registration numberNCT03450564.
Effects of training involving patterned sensory enhancement on improving upper-limb movements in patients with Parkinson’s disease: protocol of a randomised controlled trial
Authors: Fan Wei , Fong Kenneth N K , Wang Shu-Mei 
Published: July 2023

IntroductionBradykinesia (ie, slow movements) is one of the most prominent symptoms of Parkinson’s disease (PD) and has a negative impact on quality of life. Rhythmic auditory stimulation (RAS), a widely used and promising treatment technique, has been shown to effectively improve gait speed in patients with PD. The upper-limb movements, which also suffer from bradykinesia, are essential for daily life and directly impact quality of life. The term, patterned sensory enhancement (PSE) instead of RAS, is used when movement training targets the human body except lower limbs. Up until now, scarce studies have explored effects of training involving PSE on upper-limb movements. The purpose of this study is to investigate effects of movement training involving PSE on upper-limb movement speed and function in patients with PD.Methods and analysisA total of 138 patients with PD will be randomly assigned into two groups: the PSE group and the no-PSE group. A 21-day upper-limb training involving PSE (for the PSE group) or without PSE (for the no-PSE group) will be provided to the patients. An assessor will administer the box and block test and the Jebsen hand function test before and after training to assess upper-limb movement speed and function. The one-way analysis of covariance will be performed. This randomised controlled trial will provide evidence supporting effectiveness of upper-limb movement training involving PSE on reducing severity of bradykinesia in patients with PD.Ethics and disseminationEthical approval has been obtained from the Institutional Review Board of the Hong Kong Polytechnic University with the reference number HSEARS20221027005. Informed consent forms will be gathered from all patients before their participation. Study results will be disseminated through conferences and peer-reviewed academic journals.Trial registration numberNCT05637593.
Alirocumab effect on preventing periprocedural ischaemic events in coronary heart disease patients undergoing coronary stenting (APPEASE trial): study protocol of a multicentre, open-label, randomised controlled trial
Authors: Huang Zhuoshan , Zhuang Xiaodong , Zhang Shaozhao , Huang Yiquan , Yuan Lianxiong , Lin Aiwen , Tang Leile , Xiong Zhenyu , Christopher Odong , Chen Yang , Wu Bingyuan , Ling Yesheng , Li Suhua , Jie Qiang , Xiong Longgen , Qian Xiaoxian , Liao Xinxue , Liu Jinlai 
Published: July 2023

IntroductionPercutaneous coronary intervention (PCI)-related myocardial infarction (type 4a MI) and major periprocedural myocardial injury have been demonstrated leading to poor prognosis of patients with coronary heart disease (CHD) undergoing elective PCI and still remain high occurrence even after the therapy of dual antiplatelet agents and statins. Proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab has been shown to be effectively in reducing the risk of acute MI (AMI). However, the effect of alirocumab on preventing PCI-related MI or major periprocedural myocardial injury in patients with CHD undergoing elective PCI remains uncertain.Methods and analysisAlirocumab effect on Preventing Periprocedural ischaemic Events in coronary heart diseAse patients undergoing coronary StEnting trial is a multicentre, open-label, randomised controlled trial aiming to determine whether alirocumab could reduce the incidence of type 4a MI or major periprocedural myocardial injury in patients with CHD undergoing elective PCI. In total, 422 non-AMI CHD patients planned to undergo elective PCI will be randomly assigned to receive standard pharmacotherapy of CHD (control group) or additional use of subcutaneous alirocumab 75 mg 1 day before procedure (alirocumab group). The primary outcome is type 4a MI or major periprocedural myocardial injury defined as high-sensitivity cardiac troponin elevating above 5×99 th percentile upper reference limit in 48 hours after PCI. Patients will continue receiving standard pharmacotherapy or additional biweekly subcutaneous alirocumab 75 mg for 3 months according to the initial randomisation group. We will follow up for 3 months and record all the major adverse cardiovascular events (MACEs). Incidence of PCI-related MI or major periprocedural myocardial injury, and MACE in 3 months after PCI will be compared between control group and alirocumab group.Ethics and disseminationEthics approval has been obtained from the Medical Ethics Committee of the Third Affiliated Hospital of Sun Yat-sen University with approval number: (2022)02-140-01. The results of this study will be reported through peer-reviewed journals and conference presentations.Trial registration numberChiCTR2200063191.
Expanded nursing competencies to improve person-centred care for nursing home residents with complex health needs (Expand-Care): study protocol for an exploratory cluster-randomised trial
Authors: Silies Katharina Theodora , Vonthein Reinhard , Pohontsch Nadine Janis , Huckle Tilman Alexander , Sill Janna , Olbrich Denise , Inkrot Simone , Frielitz Fabian-Simon , Lühmann Dagmar , Scherer Martin , König Inke , Balzer Katrin 
Published: July 2023

IntroductionOlder age is associated with multimorbidity, chronic diseases and acute deteriorations and leads to complex care needs. Nursing home residents are more often unnecessarily transferred to emergency departments or hospitals than community dwellers—largely due to a lack of qualified staff and diffusion of responsibility in the institutions. In Germany, only few academically trained nurses work in nursing homes, and their potential roles are unclear. Therefore, we aim to explore feasibility and potential effects of a newly defined role profile for nurses with bachelors’ degree or equivalent qualification in nursing homes.Methods and analysisA pilot study (Expand-Care) with a cluster-randomised controlled design will be conducted in 11 nursing homes (cluster) in Germany, with an allocation ratio of 5:6 to the intervention or control group, aiming to include 15 residents per cluster (165 participants in total). Nurses in the intervention group will receive training to perform role-related tasks such as case reviews and complex geriatric assessments. We will collect data at three time points (t0 baseline, t1 3 months and t2 6 months after randomisation). We will measure on residents’ level: hospital admissions, further health services use and quality of life; clinical outcomes (eg, symptom burden), physical functioning and delivery of care; mortality, adverse clinical incidents and changes in care level. On nurses’ level, we will measure perception of the new role profile, competencies and implementation of role-related tasks as part of the process evaluation (mixed methods). An economic evaluation will explore resource use on residents’ (healthcare utilisation) and on nurses’ level (costs and time expenditure).Ethics and disseminationThe ethics committees of the University of Lübeck (Nr. 22-162) and the University Clinic Hamburg-Eppendorf (Nr. 2022-200452-BO-bet) approved the Expand-Care study. Informed consent is a prerequisite for participation. Study results will be published in open-access, peer-reviewed journals and reported at conferences and in local healthcare providers’ networks.Trial registration numberDRKS00028708.
Drunk driving: a secondary analysis of factors associated with driving under the influence of alcohol in Jamaica
Authors: Lalwani Kunal , Sewell Clayton , Frazier Gralyn , Abel Wendel 
Published: July 2023

ObjectivesTo determine the prevalence of alcohol use patterns, sociodemographic factors and risk of alcohol dependence among vehicle drivers in Jamaica.DesignA secondary data analysis.SettingThis study was conducted using the Jamaica National Drug Prevalence Survey 2016 dataset.ParticipantsThis included 1060 vehicle drivers derived from the population sample of 4623. The participants from each household were randomly selected as the respondent for the survey.Primary and secondary outcome measuresAlcohol use and dependence were measured using the Alcohol Use Disorders Identification Test questionnaire. Driving under the influence of alcohol (DUIA) was assessed by questions regarding its use in the past 12 months. The analysis involved the use of Pearson’s χ2test and logistic regression.Results75% of Jamaicans reported lifetime alcohol use. Approximately 65% of drivers indicated that they currently drink alcohol. 18% of drivers who currently drink alcohol admitted to DUIA. Reportedly, 54.5% of these drivers were alcohol binge drinkers, with 41.5% also driving under the influence of cannabis. The bivariate analysis demonstrated that DUIA was higher among Christian participants and those who worked in non-machine operator jobs (p=0.002 and p=0.008, respectively). Vehicle drivers altogether and drivers who drive under the influence of alcohol had significant associations with hazardous drinking (p=0.011 and p<0.001, respectively). Logistic regressions highlighted drivers 34 years and under (p=0.012), male drivers (p=0.002) and the head of the household (p=0.050) were 1.82, 3.30 and 1.86 times more likely, respectively, to report driving under the influence of alcohol in the past year.ConclusionsThe prevalence of alcohol use among Jamaica’s population and vehicle drivers is high. That one in five drivers, who currently consume alcohol, also admits to driving under the influence suggests the urgent need for mitigation strategies and legislative action as part of a preventative effort to reduce drunk driving.
Impact of holistic review on diversity of interviewed and matriculating residents in graduate medical education: a systematic review protocol
Authors: Althans Alison R , Byrd Tamara , Suppok Rachel , Lee Kenneth K , Rosengart Matthew R , Myers Sara P 
Published: July 2023

IntroductionDiversity in the physician workforce improves patient-centred outcomes. Patients are more likely to trust in and comply with care when seeing gender/racially concordant providers. A current emphasis on standardised metrics in academic achievement often serves as a barrier to the recruitment and retention of gender and racial minorities in medicine. Holistic review of residency applicants has been supported as a means of encouraging diversification but is not yet standardised. The current body of evidence examining the effects of holistic review on the recruitment of racial and gender minorities in surgical residencies is small. We therefore propose a systematic review to summarise the state of holistic review in graduate medical education in the USA and its impact on diversification.Methods and analysisOur systematic review protocol has been designed with plans to report our review findings in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. PubMed and Embase will be searched with the assistance of a health sciences librarian with expertise in systematic review. We will include studies of graduate medical education programmes that describe the implementation of holistic review, outline the components of their holistic review process and compare proportions of under-represented minorities (URM) and women interviewed and matriculating before and after holistic review implementation. We will first report a summary of the findings regarding the operationalisation of holistic review as described by studies included. We will then pool the percentages of URM and women for interviewee and matriculant populations from each study and report the collective odds ratios of each for holistic review compared with traditional review as our primary outcome.Ethics and disseminationThis study is a protocol for systematic review, and therefore does not involve any human subjects. Findings will be published in the form of a manuscript submitted to a peer-reviewed journal.PROSPERO registration numberCRD42023401389.
Impact of immune checkpoint inhibitors on atherosclerosis progression in patients with lung cancer
Authors: Drobni Zsofia Dora , Gongora Carlos , Taron Jana , Suero-Abreu Giselle A , Karady Julia , Gilman Hannah K , Supraja Sama , Nikolaidou Sofia , Leeper Nicolas , Merkely Béla , Maurovich-Horvat Pal , Foldyna Borek , Neilan Tomas G 
Published: July 2023

BackgroundPatients with lung cancer face a heightened risk of atherosclerosis-related cardiovascular events. Despite the strong scientific rationale, there is currently a lack of clinical evidence examining the impact of immune checkpoint inhibitors (ICIs) on the advancement of atherosclerosis in patients with lung cancer. The objective of our study was to investigate whether there is a correlation between ICIs and the accelerated progression of atherosclerosis among individuals with lung cancer.MethodsIn this case–control (2:1 matched by age and gender) study, total, non-calcified, and calcified plaque volumes were measured in the thoracic aorta using sequential contrast-enhanced chest CT scans. Univariate and multivariate rank-based estimation regression models were developed to estimate the effect of ICI therapy on plaque progression in 40 cases (ICI) and 20 controls (non-ICI).ResultsThe patients had a median age of 66 years (IQR: 58–69), with 50% of them being women. At baseline, there were no significant differences in plaque volumes between the groups, and their cardiovascular risk profiles were similar. However, the annual progression rate for non-calcified plaque volume was 7 times higher in the ICI group compared with the controls (11.2% vs 1.6% per year, p=0.001). Conversely, the controls showed a greater progression in calcified plaque volume compared with the ICI group (25% vs 2% per year, p=0.017). In a multivariate model that considered cardiovascular risk factors, the use of an ICI was associated with a more substantial progression of non-calcified plaque volume. Additionally, individuals treated with combination ICI therapy exhibited greater plaque progression.ConclusionsICI therapy was associated with more non-calcified plaque progression. These findings underscore the importance of conducting studies aimed at identifying the underlying mechanisms responsible for plaque advancement in patients undergoing ICI treatment.Trial registration numberNCT04430712.
Mechanical thrombectomy in patients with acute ischemic stroke in the USA before and after time window expansion
Authors: Kwok Chun Shing , Gillani Syed A , Bains Navpreet K , Gomez Camilo R , Hanley Daniel F , Ford Daniel E , Hassan Ameer E , Nguyen Thanh N , Siddiq Farhan , Spiotta Alejandro M , Qureshi Adnan I 
Published: July 2023

BackgroundIn 2018, the time window for mechanical thrombectomy eligibility in patients with acute ischemic stroke increased from within 6 hours to within 24 hours of symptom onset. The purpose of this study was to evaluate the effect of window expansion on procedural and hospital volumes and patient outcomes at a national level.MethodsWe conducted a retrospective cohort study of patients with acute ischemic stroke undergoing mechanical thrombectomy using data from the National Inpatient Sample. We compared the numbers of mechanical thrombectomy procedures and performing hospitals between 2017 and 2019 in the USA, and the proportion of patients discharged home/self-care, those with in-hospital mortality and post-procedural intracranial hemorrhage (2019 vs 2017) after adjustment for potential confounders.ResultsThe number of patients with ischemic stroke who underwent mechanical thrombectomy increased from 16 960 in 2017 to 28 120 in 2019. There was an increase in the number of hospitals performing mechanical thrombectomy (501 in 2017, 585 in 2019) and those performing ≥50 procedures/year (97 in 2017, 199 in 2019; P<0.001). The odds of in-hospital mortality decreased (OR 0.79, 95% CI 0.66 to 0.94, P=0.008) and the odds of intracranial hemorrhage increased (OR 1.18, 95% CI 1.06 to 1.31, P=0.003) in 2019 compared with 2017, with no change in odds of discharge to home.ConclusionsThe window expansion for mechanical thrombectomy for patients with acute ischemic stroke was associated with an increase in the numbers of mechanical thrombectomy procedures and performing hospitals with a reduction of in-hospital mortality in the USA.
Transarterial embolization for anterior cranial fossa dural arteriovenous fistulas: a retrospective single-center study
Authors: Su Xin , Gao Zhenzhong , Ma Yongjie , Song Zihao , Zhang Hongqi , Zhang Peng , Ye Ming 
Published: July 2023

BackgroundClip ligation of anterior cranial fossa (ACF) dural arteriovenous fistulas (DAVFs) is the traditionally accepted first-line treatment. Endovascular treatment for ACF DAVFs may achieve good outcomes as endovascular techniques advance. Here we report the clinical and angiographic outcomes in patients with ACF DAVFs who underwent transarterial embolization (TAE) as first-line treatment.MethodsOver a 20-year period, 87.0% (40/46) of patients received TAE as first-line treatment. The clinical presentation, angiographic features, treatment strategy, and clinical and angiographic outcomes are described in this article.ResultsForty patients underwent TAE as first-line treatment. There were 36 men and 4 women, with a mean age of 55.6 (55.6±7.4) years. A total of 64 embolization attempts were performed. The middle meningeal artery (66.7%, 12/18) and the ophthalmic artery (54.2%, 13/24) were the most frequently used arterial access routes for complete embolization. The second option was the sphenopalatine artery (46.7%, 7/15). Complications, that is, retinal ischemia, occurred in one patient (2.5%). The total immediate complete occlusion rate for TAE was 82.5% (33/40). Two patients needed surgery for incomplete embolization. When followed up (90%, 36/40), one patient (2.8%, 1/36) reported worsening symptoms due to retinal ischemia following TAE. Although fewer than 50% of the patients received digital subtraction angiography follow-up, there were no recurrences.ConclusionsWe show that TAE is safe and effective in the treatment of ACF DAVFs in this study of 40 patients, making it a viable alternative to surgical ligation and transvenous embolization. More research is needed to compare these various treatment modalities.
The Barcelona Catania Paris Madrid energy density functional
Authors: Baldo M. , Robledo L. M. , Viñas X. 
Published: July 2023

AbstractThe foundation and applications of the Barcelona Catania Paris Madrid (BCPM) energy density functional are briefly reviewed. BCPM uses a paradigm more rooted on density functional theory and fits most of its parameters to sophisticated microscopic nuclear matter calculations. Finite nuclei are accounted for by introducing a direct finite range surface term, spin orbit potential, Coulomb interaction and pairing. Applications of this functional to the calculation of finite nuclei properties are presented as well as applications to the description of neutron star physics. The large number of applications discussed are possible because of the local character of the functional that simplifies enormously calculations in finite nuclei.