bluuebunny/crossref_metadata_2025_split huggingface dataset:
Research on the Mechanism of Curve Passing for Bogie on a Medium-Low Speed Maglev With Mid-Set Air Spring
Authors: Wang Bo , Luo Shihui , Liu Jing , Ma Weihua , Xu Jie 
Published: March 2023

AbstractIn the research of rail vehicles, mechanism of curve passing is one of the hot spots, which essentially elucidates the conditions of vehicle curve passing and points out the direction for improving vehicle curve passing ability. As one of the new members of rail transportation, the curve passing capability of medium-low speed maglev directly affects its application and promotion in the field of rail transportation. In order to reveal the mechanism of curve passing for medium-low speed maglev, this paper first studies the necessary conditions for the conventional wheelset curve passing based on the mechanism of curve passing for the conventional wheelset. Second, on the basis of comparing the structure and motion relationship of the conventional wheelset, the independent wheelset and the magnetic wheelset (bogie of medium-low speed maglev), the theoretical derivation of the magnetic wheelset curve passing conditions are carried out to obtain its theoretical solution based on the curve passing conditions of the conventional wheelset. Finally, the conditions of curve passing for the magnetic wheelset are verified by dynamic simulation, and the mechanism of curve passing for the medium-low speed maglev bogie is revealed. Through the research, it can be found that: (1) The mechanism of curve passing for the magnetic wheelset is different from that of the traditional wheelset and the independent wheelset. The speed variance and regulating torque are the composite functions of running speed, curve radius, track gauge, superelevation, guiding stiffness and yaw angle of the magnetic wheelset. (2) When the magnetic wheelset passes through the curve, its motion posture switches between “” and “,” while the unilateral magnetic wheel shows a motion which is similar to “hunting.” (3) Ignoring the factors such as structure and irregularity, it can conduct that the curve capacity of the magnetic wheelset could be improved by increasing the curve radius, reducing the speed, curve superelevation and gauge to a certain extent. This study theoretically reveals the mechanism of curve passing for the medium-low speed maglev bogie, which provides a certain reference for the subsequent design of the medium-low speed maglev and the improvement of the medium-low speed maglev curve capacity.
Communication of anticancer drug benefits and related uncertainties to patients and clinicians: document analysis of regulated information on prescription drugs in Europe
Authors: Davis Courtney , Wagner Anita K , Salcher-Konrad Maximilian , Scowcroft Henry , Mintzes Barbara , Pokorny Adrian M J , Lew Jianhui , Naci Huseyin 
Published: March 2023

Abstract

Objective
To evaluate the frequency with which relevant and accurate information about the benefits and related uncertainties of anticancer drugs are communicated to patients and clinicians in regulated information sources in Europe.

Design
Document content analysis.

Setting
European Medicines Agency.

Participants
Anticancer drugs granted a first marketing authorisation by the European Medicines Agency, 2017-19.

Main outcome measures
Whether written information on a product addressed patients’ commonly asked questions about: who and what the drug is used for; how the drug was studied; types of drug benefit expected; and the extent of weak, uncertain, or missing evidence for drug benefits. Information on drug benefits in written sources for clinicians (summaries of product characteristics), patients (patient information leaflets), and the public (public summaries) was compared with information reported in regulatory assessment documents (European public assessment reports).

Results
29 anticancer drugs that received a first marketing authorisation for 32 separate cancer indications in 2017-19 were included. General information about the drug (including information on approved indications and how the drug works) was frequently reported across regulated information sources aimed at both clinicians and patients. Nearly all summaries of product characteristics communicated full information to clinicians about the number and design of the main studies, the control arm (if any), study sample size, and primary measures of drug benefit. None of the patient information leaflets communicated information to patients about how drugs were studied. 31 (97%) summaries of product characteristics and 25 (78%) public summaries contained information about drug benefits that was accurate and consistent with information in regulatory assessment documents. The presence or absence of evidence that a drug extended survival was reported in 23 (72%) summaries of product characteristics and four (13%) public summaries. None of the patient information leaflets communicated information about the drug benefits that patients might expect based on study findings. Scientific concerns about the reliability of evidence on drug benefits, which were raised by European regulatory assessors for almost all drugs in the study sample, were rarely communicated to clinicians, patients, or the public.

Conclusions
The findings of this study highlight the need to improve the communication of the benefits and related uncertainties of anticancer drugs in regulated information sources in Europe to support evidence informed decision making by patients and their clinicians.
Pharmacological emergency management of agitation in children and young people: protocol for a randomised controlled trial of oral medication (PEAChY-O)
Authors: Bourke Elyssia M , Borland Meredith L , Kochar Amit , George Shane , Shellshear Deborah , Jani Shefali , Perkins Kent , Tham Doris , Gordon Michael Solomon , Klein Kate , Prakash Chidambaram , Lee Katherine , Davidson Andrew , Knott Jonathan C , Craig Simon , Babl Franz E 
Published: March 2023

IntroductionAcute severe behavioural disturbance (ASBD) is a condition seen with increasing frequency in emergency departments (EDs) in adults and young people. Despite the increasing number of presentations and significant associated risks to patients, families and caregivers, there is limited evidence to guide the most effective pharmacological management in children and adolescents. The aim of this study is to determine whether a single dose of oral olanzapine is more effective than a dose of oral diazepam at successfully sedating young people with ASBD.Methods and analysisThis study is a multicentre, open-label, superiority randomised controlled trial. Young people aged between 9 years and 17 years and 364 days presenting to an ED with ASBD who are deemed to require medication for behavioural containment will be recruited to the study. Participants will be randomised in a 1:1 allocation between a single weight-based dose of oral olanzapine and oral diazepam. The primary outcome is the proportion of participants who achieve successful sedation at 1-hour post randomisation without the need for additional sedation. Secondary outcomes will include assessing for adverse events, additional medications provided in the ED, further episodes of ASBD, length of stay in the ED and hospital and satisfaction with management.Effectiveness will be determined using an intention-to-treat analysis, with medication efficacy determined as part of the secondary outcomes using a per-protocol analysis. The primary outcome of successful sedation at 1 hour will be presented as a percentage within each treatment group, with comparisons presented as a risk difference with its 95% CIs.Ethics and disseminationEthics approval was received from the Royal Children’s Hospital Human Research Ethics Committee (HREC/66478/RCHM-2020). This incorporated a waiver of informed consent for the study. The findings will be disseminated in a peer-reviewed journal and at academic conferences.Trial registration numberACTRN12621001236886.
High-flow nasal cannula reduces intubation rate in patients with COVID-19 with acute respiratory failure: a meta-analysis and systematic review
Authors: Li Yang , LI Cong , Chang Wei , Liu Ling 
Published: March 2023

ObjectiveThis study aimed to investigate the effect of high-flow nasal cannula therapy (HFNC) versus conventional oxygen therapy (COT) on intubation rate, 28-day intensive care unit (ICU) mortality, 28-day ventilator-free days (VFDs) and ICU length of stay (ICU LOS) in adult patients with acute respiratory failure (ARF) associated with COVID-19.DesignSystematic review and meta-analysis.Data sourcesPubMed, Web of Science, Cochrane Library and Embase up to June 2022.Eligibility criteria for selecting studiesOnly randomised controlled trials or cohort studies comparing HFNC with COT in patients with COVID-19 were included up to June 2022. Studies conducted on children or pregnant women, and those not published in English were excluded.Data extraction and synthesisTwo reviewers independently screened the titles, abstracts and full texts. Relevant information was extracted and curated in the tables. The Cochrane Collaboration tool and Newcastle-Ottawa Scale were used to assess the quality of randomised controlled trials or cohort studies. Meta-analysis was conducted using RevMan V.5.4 computer software using a random effects model with a 95% CI. Heterogeneity was assessed using Cochran’s Q test (χ2) and Higgins I2statistics, with subgroup analyses to account for sources of heterogeneity.ResultsNine studies involving 3370 (1480 received HFNC) were included. HFNC reduced the intubation rate compared with COT (OR 0.44, 95% CI 0.28 to 0.71, p=0.0007), decreased 28-day ICU mortality (OR 0.54, 95% CI 0.30 to 0.97, p=0.04) and improved 28-day VFDs (mean difference (MD) 2.58, 95% CI 1.70 to 3.45, p<0.00001). However, HFNC had no effect on ICU LOS versus COT (MD 0.52, 95% CI −1.01 to 2.06, p=0.50).ConclusionsOur study indicates that HFNC may reduce intubation rate and 28-day ICU mortality, and improve 28-day VFDs in patients with ARF due to COVID-19 compared with COT. Large-scale randomised controlled trials are necessary to validate our findings.PROSPERO registration numberCRD42022345713.
Study protocol for economic evaluation of probiotic intervention for prevention of neonatal sepsis in 0–2-month old low-birth weight infants in India: the ProSPoNS trial
Authors: Sinha Anju , Bahuguna Pankaj , Gupta Subodh Sharan , Kuruba Yamini Priyanka , Poluru Ramesh , Mathur Apoorva , Raja Dilip , Raut Abhishek V , Mahajan Kamaleshwar S , Sudhakar Rishikesh , Kulkarni Bharati , Pandey Ravindra Mohan , Arora Narendra K. , Prinja Shankar 
Published: March 2023

IntroductionThe ProSPoNS trial is a multicentre, double-blind, placebo-controlled trial to evaluate the role of probiotics in prevention of neonatal sepsis. The present protocol describes the data and methodology for the cost utility of the probiotic intervention alongside the controlled trial.Methods and analysisA societal perspective will be adopted in the economic evaluation. Direct medical and non-medical costs associated with neonatal sepsis and its treatment would be ascertained in both the intervention and the control arm. Intervention costs will be facilitated through primary data collection and programme budgetary records. Treatment cost for neonatal sepsis and associated conditions will be accessed from Indian national costing database estimating healthcare system costs. A cost–utility design will be employed with outcome as incremental cost per disability-adjusted life year averted. Considering a time-horizon of 6 months, trial estimates will be extrapolated to model the cost and consequences among high-risk neonatal population in India. A discount rate of 3% will be used. Impact of uncertainties present in analysis will be addressed through both deterministic and probabilistic sensitivity analysis.Ethics and disseminationHas been obtained from EC of the six participating sites (MGIMS Wardha, KEM Pune, JIPMER Puducherry, AIPH, Bhubaneswar, LHMC New Delhi, SMC Meerut) as well as from the ERC of LSTM, UK. A peer-reviewed article will be published after completion of the study. Findings will be disseminated to the community of the study sites, with academic bodies and policymakers.RegistrationThe protocol has been approved by the regulatory authority (Central Drugs Standards Control Organisation; CDSCO) in India (CT-NOC No. CT/NOC/17/2019 dated 1 March 2019). The ProSPoNS trial is registered at the Clinical Trial Registry of India (CTRI). Registered on 16 May 2019.Trial registration numberCTRI/2019/05/019197; Clinical Trial Registry.
Nurses’ practice of peripherally inserted central catheter maintenance and its influencing factors in Guizhou province, China: a cross-sectional study
Authors: Hu Li , Li Yaling , Li Hong , Ling Wenjing , Zheng Chaoting , Ran Mingfei , Xu Binbin 
Published: March 2023

ObjectivesThe aim of this study was to investigate the level of practice of peripherally inserted central catheter (PICC) maintenance among nurses in Guizhou province, China, and to explore its influencing factors.DesignCross-sectional study.Setting11 tertiary and 26 secondary hospitals of Guizhou province, China.ParticipantsA total of 832 nurses engaged in clinical work of PICC maintenance participated in the present study.Primary outcome measuresPICC maintenance knowledge questionnaire, PICC maintenance attitude questionnaire and PICC maintenance practice questionnaire were administrated online for measuring participants’ knowledge, attitude and practice of PICC maintenance, respectively.ResultsThe mean score of nurses’ practice of PICC maintenance was 79.77±12.13 and 60.8% of participants reported acceptable practices of PICC maintenance. The availability of PICC guidelines (β=0.10, p=0.002), previous training on PICC maintenance (β=0.18, p<0.001) and attitudes toward PICC maintenance (β=0.48, p<0.001) were significant factors predicting nurses’ practices of PICC maintenance. These factors account for 33% of the variance in the practice of PICC maintenance.ConclusionNurses’ practice of PICC maintenance in Guizhou province was unsatisfactory. Their practice was influenced by the availability of PICC guidelines, whether or not they received training and their attitudes toward PICC maintenance. A province-level PICC maintenance alliance is recommended to be established to improve the quality of PICC maintenance in Guizhou, which can develop or update PICC guidelines, and provide training on PICC maintenance regularly for nurses engaging in PICC maintenance.
Vaccine coverage for recommended vaccines among splenectomised patients in Apulia, South Italy: a retrospective cohort study
Authors: Bianchi Francesco Paolo , Stefanizzi Pasquale , Di Lorenzo Antonio , Cuscianna Eustachio , Tafuri Silvio , Germinario Cinzia Annatea 
Published: March 2023

ObjectiveSplenectomised/asplenic patients have a 10–50 fold higher risk than the general population of developing overwhelming postsplenectomy infection. To control this risk, these patients have to receive a specific immunisation schedule, before or in the 2 weeks after the surgical intervention. The study aims to estimate vaccine coverage (VC) for recommended vaccines among splenectomised patients in Apulia (South Italy), and to define the determinants of vaccination uptake in this population.DesignRetrospective cohort study.SettingApulia, Southern Italy.Participants1576 splenectomised patients.MethodsThe Apulian regional archive of hospital discharge forms (SDOs) was used to define the splenectomised Apulian inhabitants. The study period went from 2015 to 2020. The vaccination status forStreptococcus pneumoniae(13-valent conjugate anti-pneumococcal vaccine+PPSV23),Haemophilus influenzaetype b (Hib; one dose),Neisseria meningitidisACYW135 (two doses),Neisseria meningitidisB (two doses) and influenza (at least one dose of influenza vaccine before an influenza season after splenectomy) was assessed via data collected from the Regional Immunisation Database (GIAVA). In order to define a subject as fully immunised, we considered the Centers for Diseases Control and Prevention guidelines to define the optimal immunisation status.ResultsSince 2015, 1576 Apulian inhabitants have undergone splenectomy; the VC for anti-Neisseria meningitidisB vaccine was 30.9%, for anti-Neisseria meningitidisACYW135 was 27.7%, for anti-Streptococcus pneumoniaewas 27.0%, for anti-Hib was 30.1%, and 49.2% received at least one dose of influenza vaccine before an influenza season after splenectomy. None of the patients splenectomised in 2015 and 2016 had received the recommended MenACYW135and PPSV23 booster doses 5 years after completing the basal cycles.ConclusionsThe results of our study highlight low VC values among Apulian splenectomised patients. The task of public health institutions is to implement new strategies aimed at increasing VC in this population, implementing educational measures for patients and families, training for general practitioners and specialists, and ad hoc communication campaigns.
Health literacy education programmes developed for qualified health professionals: a scoping review
Authors: Connell Lauren , Finn Yvonne , Sixsmith Jane 
Published: March 2023

ObjectivesBoth literature and policy have identified the need for health literacy education for qualified health professionals. This study aimed to identify and map health literacy competencies and health literacy related communication skills educational interventions for qualified health professionals. The research questions included: Of the qualified health professional education interventions identified, which are focused on diabetes care? What health literacy competencies and health literacy related communication skills are integrated into each programme? What are the characteristics of each education programme? What were the barriers and facilitators to implementation? What methods are used to evaluate intervention effectiveness, if any?DesignScoping review, informed by the Joanna Briggs Institute guidelines.Data sourcesThe following databases: OVID; CINAHL; Cochrane; EMBASE; ERIC: PsycInfo; RIAN; Pro-Quest; UpToDate were searched.Eligibility criteriaArticles were included if the education programme focused on qualified health professionals, in all clinical settings, treating adult patient populations, of all study types.Data extraction and synthesisTwo authors independently screened titles, abstracts and full text articles that met the inclusion criteria. The third author mediated any discrepancies. The data were extracted and charted in table format.ResultsIn total, 53 articles were identified. One article referred to diabetes care. Twenty-six addressed health literacy education, and 27 addressed health literacy related communication. Thirty-five reported using didactic and experiential methods. The majority of studies did not report barriers (N=45) or facilitators (N=52) to implementation of knowledge and skills into practice. Forty-nine studies evaluated the reported education programmes using outcome measures.ConclusionsThis review mapped existing education programmes regarding health literacy and health literacy related communication skills, where programme characteristics were identified to inform future intervention development. An evident gap was identified regarding qualified health professional education in health literacy, specifically in diabetes care.
Implementing criteria-led discharge for acute admissions to facilitate the elective recovery from COVID-19: an example in acute tonsillitis
Authors: Findlay Callum , Fong Wei Chern Gavin , Goldie Simon , Jones Huw 
Published: March 2023

BackgroundHealthcare systems face unprecedented numbers of patients waiting for elective treatments in the wake of the COVID-19 pandemic. Hospitals must urgently optimise patient pathways and build capacity to meet the populations health needs. Criteria-led discharge (CLD) is frequently used to optimise elective care pathways but may hold potential in discharging patients at the end of an acute hospital admission.MethodsWe conducted a quality improvement project to design and introduce a novel inpatient pathway using CLD for patients with severe acute tonsillitis. Our analysis compared the standardisation of treatment, length of stay, discharge time and readmission rate between those treated on the novel pathway compared with standard treatment.ResultsThe study population included 137 patients admitted to a tertiary centre with acute tonsillitis. Introduction of the tonsillitis pathway using CLD resulted in a significant reduction in median length of stay from 24 hours to 18 hours. Of those treated on the tonsillitis pathway, 52.2% were discharged prior to midday compared with 29.1% who received standard treatment. No patient discharged using CLD required readmission.ConclusionCLD is safe and effective at reducing length of stay in patients requiring acute hospital admission for acute tonsillitis. CLD should be used and evaluated in further novel patient pathways across different areas of medicine to optimise care and build capacity for provision of elective healthcare services. Further research is required to investigate safe and optimal criteria which indicate patients are fit for discharge.
Thrombectomy in M2 occlusion compared to M1 occlusion: treatment effects of Thrombolysis In Cerebral Infarction (TICI) 2b and TICI 3 recanalization on functional outcome
Authors: Kniep Helge , Meyer Lukas , Broocks Gabriel , Faizy Tobias D , Bechstein Matthias , Brekenfeld Caspar , Flottmann Fabian , van Horn Noel , Geest Vincent , Winkelmeier Laurens , Alegiani Anna , Deb-Chatterji Milani , Hanning Uta , Thomalla Goetz , Fiehler Jens , Gellissen Susanne 
Published: March 2023

BackgroundEmerging data suggest that mechanical thrombectomy (MT) might also be safe and efficient for medium and distal occlusions. This study aims to compare average treatment effects on functional outcome of different degrees of recanalization after MT in patients with M2 occlusion and M1 occlusion.MethodsAll patients enrolled in the German Stroke Registry (GSR) between June 2015 and December 2021 were analyzed. Inclusion criteria were stroke with primary M1 occlusion or M2 occlusion, and availability of relevant clinical data. 4259 patients were included, thereof 1353 with M2 occlusion and 2906 with M1 occlusion. Treatment effects were analyzed using double-robust inverse-probability-weighted regression-adjustment (IPWRA) estimators to control for confounding covariates. Binarized endpoint metrics were defined as good outcome with modified Rankin Scale (mRS) ≤2 at 90 days, and linearized endpoint metrics were defined as mRS shift pre-stroke to 90 days. Effects were evaluated for near complete recanalization (Thrombolysis In Cerebral Infarction scale (TICI) 2b) and complete recanalization (TICI 3).ResultsTreatment effect estimation for TICI ≥2b versus TICI <2b in M2 occlusions showed an increase in the probability of a good outcome from 27% to 47% with a number-needed-to-treat (NNT) of 5. For M1 occlusions the probability of a good outcome increased from 16% to 38% with NNT 4.5. TICI 3 versus TICI 2b increased the probability of a good outcome by 7 percentage points in M1 occlusions; for M2 occlusions the beneficial effect was not significant.ConclusionsResults suggest that successful recanalization with TICI ≥2b versus TICI <2b after MT in M2 occlusions provides significant patient benefit with treatment effects comparable to M1 occlusions. The probability of functional independence increased by 20 percentage points (NNT 5) and stroke-related mRS increase was reduced by 0.9 mRS points. In contrast to M1 occlusions, complete recanalization TICI 3 versus TICI 2b had lower additional beneficial effect.