bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of the change of mechanical ventilation mode on cerebral oxygen saturation level in neonates
Authors: Zhao Jingjing , Wu Rong , Liu Wei , Li Manman , Wang Wei , Li Lihua 
Published: May 2023

Abstract
Background
This study aimed to apply near-infrared spectroscopy (NIRS) to monitor cerebral oxygen saturation (SrO2) level in neonates before and after the change of mechanical ventilation mode, and thus, the effects of the change of mechanical ventilator mode on SrO2 level in neonates were assessed.

Methods
This trial was designed as an observational study .A total of 70 neonates who were admitted to the Department of Neonatology of Beijing Luhe Hospital Affiliated to Capital Medical University (Beijing, China) between September 2019 and October 2021 and required respiratory support were included. The variations of SrO2 level before and after the change of mechanical ventilation mode, including changing from Synchronized intermittent mandatory ventilation (SIMV) to noninvasive ventilation (NIV, group 1), and from NIV to oxygen inhalation (group 2), were monitored by Enginmed EGOS-600 A. The changes of SrO2 level at 30 min before and 1 h after the change of ventilation mode were compared between the two groups.

Results
The SrO2 level in the group 1 30 min before, as well as 10 min, 30 min, and 1 h after the change of ventilation mode was 62.54 ± 3.36%, 65.43 ± 3.98%, 64.38 ± 4.23%, and 64.63 ± 3.71%, respectively. The SrO2 level at all the points after the change of ventilation mode increased compared with 30 min before the change (P < 0.05). The SrO2 level in the group 2 at each time point was 62.67 ± 4.69%, 64.61 ± 5.00%, 64.04 ± 4.48%, and 64.55 ± 4.32%, respectively. Compared with 30 min before ventilator weaning, the SrO2 level at all the points after ventilator weaning increased (P < 0.05). Peak inspiratory pressure (PIP) excluding Nasal Continuous Positive Airway Pressure (NCPAP)) in group 1 was lower than that before extubation, and the difference was statistically significant (P = 0) (Table 7).

Conclusions
SrO2 level showed an increasing trend after the change of ventilation mode, and the increase of SrO2 level at 10 min after the change of ventilation mode was the most prominent. From SIMV to NIV, increased SrO2 levels may be associated with decreased PIP.
A qualitative study of active travel amongst commuters and older adults living in market towns
Authors: Jessiman Patricia E. , Rowe Rosie E. , Jago Russell 
Published: May 2023

Abstract
Background
Being physically active is associated with better health, but rates of physical inactivity are high amongst adults in England. Active travel, defined as making routine journeys in physically active ways, has been identified as a potential solution. There is a lack of research into how modal shift towards active travel can be encouraged in market towns. The aims of the current study are to understand how new cycling and walking infrastructure and community activation projects might support modal shift to active travel amongst commuters and older adults in market towns.

Methods
This was a qualitative study using focus groups, ‘go-along’ interviews, and in-depth interviews as the main methods of data collection. Thirty-three participants (12 commuters and 21 older adults) took part across six focus groups. Eight of these also completed a go-along interview (4 walking, 4 cycling). Data were analysed using the Framework method of thematic analysis.

Results
Market towns have existing advantages for active travel, being relatively compact with most routine destinations within easy reach. The barriers to active travel faced by older adults and commuters in market towns are similar to those in cities; poor infrastructure remains the key barrier. Poorly maintained paths are hazardous for older pedestrians, and low-or-no lighting and lack of well-connected, delineated cycle routes deter both commuters and older adults. One factor which does appear qualitatively different to cities is participants’ perception that the social norms of cycling differ in market towns.

Conclusions
Policies to promote active travel in market towns are most likely to be effective when they include measures targeted at both individual behaviour change and population level measures like large-scale infrastructure improvements. Initiatives to change the social norms around cycling may be required to increase active travel rates.
Determinants of COVID-19 vaccination decision among Filipino adults
Authors: Tejero Lourdes Marie Sequerra , Seva Rosemary Ruiz , Petelo Ilagan Bettina Joyce , Almajose Kattleea Lorezca 
Published: May 2023

AbstractBackgroundWith a number of vaccines against COVID-19 now widely available globally, it is opportune to determine what tips the decision to get vaccinated. In most countries like the Philippines where the government provides these vaccines for free to all its citizens, their COVID-19 vaccine awareness and COVID-19 information sources as well as their socio-demographic profile were considered as primary factors that could possibly affect vaccination decisions. Participants’ income level was considered as a possible financial consideration that can affect vaccination decision as transport to vaccination sites might entail costs to them.MethodsThis study used a cross sectional survey design wherein participants came from all regions of the Philippines. An online questionnaire was voluntarily answered by Filipinos aged 18–80 years of age.ResultsA total of 2,268 participated in the survey with 1,462 having complete responses which were included in the analysis. Those who are younger, with higher educational attainment, with public health insurance, with employers requiring vaccination, high awareness about COVID-19 vaccination, and high vaccine confidence are more likely to get vaccinated. On the other hand, those with long-standing illness and those residing outside the national capital region are less likely to get vaccinated.ConclusionVaccination decisions among Filipinos are determined by their age, educational attainment, health insurance, employer requirement, high awareness of the disease, and a high level of vaccine confidence.
A study protocol outlining the development and evaluation of a training program for frontline managers on leading well-being and the psychosocial work environment in Danish hospital settings – a cluster randomized waitlist controlled trial
Authors: Dalgaard V. L. , Gayed A. , Hansen A. K. L. , Grytnes R. , Nielsen K. , Kirkegaard T. , Uldall L. , Ingerslev K. , Skakon J. , Jacobsen C. B. 
Published: May 2023

Abstract
Background
Hospital staff are often exposed to stressful psychosocial working conditions and report high levels of stress and burnout, which may negatively impact the safety of employees and patients. Managers hold unique knowledge of workplace conditions and needs of employees, but leadership interventions to improve the well-being of managers and employees in hospital settings are scarce. This study evaluates the effects of a leadership intervention based on a health-oriented leadership approach on the well-being and psychosocial work environment aspects of managers and employees.

Methods/design
The study is designed as a randomized, waitlist-controlled trial with two groups (intervention and waitlist control group) and measurements at baseline, 6- and 12-month follow-up. We aim to include 200 frontline managers in Danish hospital settings and their approximately 5,000 employees. The leadership training comprises five full day modules and four smaller group-training sessions over a period of 5 months. The main aim is to improve stress, burnout, self-care, and perceived level of staff-care among managers and employees. Sickness absence will also be assessed at both manager and employee level. In addition, several psychosocial factors will be assessed at the employee level. A quantitative and qualitative process evaluation will also be conducted.

Discussion
Action towards supporting the mental health of hospital employees is important to maintain a strong healthcare system. There is increasing recognition that best practice in workplace mental health requires an integrated approach that prevents harm and promotes positive mental health. There is also increasing understanding of the key role managers play in maintaining well-being within the workplace, however they often report a lack of knowledge and skills to promote employee mental health. The current leadership training program has been developed for frontline managers working in a hospital setting. The aim is to increase managers’ application of strategies to facilitate a healthy psychosocial work environment to benefit well-being and mental health among staff and managers themselves.

Trial Registration
The study was retrospectively registered on November 21, 2022 in Clinical Trial.gov with identifier: NCT05623371.
ATQ: alert time quality, an evaluation metric for assessing timely epidemic detection models within a school absenteeism-based surveillance system
Authors: Vanderkruk Kayla R. , Deeth Lorna E. , Feng Zeny , Trotz-Williams Lise A. 
Published: May 2023

Abstract
Background
Wellington-Dufferin-Guelph Public Health (WDGPH) has conducted an absenteeism-based influenza surveillance program in the WDG region of Ontario, Canada since 2008, using a 10% absenteeism threshold to raise an alert for the implementation of mitigating measures. A recent study indicated that model-based alternatives, such as distributed lag seasonal logistic regression models, provided improved alerts for detecting an upcoming epidemic. However model evaluation and selection was primarily based on alert accuracy, measured by the false alert rate (FAR), and failed to optimize timeliness. Here, a new metric that simultaneously evaluates epidemic alert accuracy and timeliness is proposed. The alert time quality (ATQ) metric is investigated as a model selection criterion on both a simulated and real data set.

Methods
The ATQ assessed alerts on a gradient, where alerts raised incrementally before or after an optimal day were considered informative, but were penalized for lack of timeliness. Summary statistics of ATQ, average alert time quality (AATQ) and first alert time quality (FATQ), were used for model evaluation and selection. Alerts raised by ATQ and FAR selected models were compared. Daily elementary school absenteeism and laboratory-confirmed influenza case data collected by WDGPH were used for demonstration and evaluation of the proposed metric. A simulation study that mimicked the WDG population and influenza demographics was conducted for further evaluation of the proposed metric.

Results
The FATQ-selected model raised acceptable first alerts most frequently, while the AATQ-selected model raised first alerts within the ideal range most frequently.

Conclusions
Models selected by either FATQ or AATQ would more effectively predict community influenza activity with the local community than those selected by FAR.
Diagnostic outcomes of robotic-assisted bronchoscopy for pulmonary lesions in a real-world multicenter community setting
Authors: Khan Faisal , Seaman Joseph , Hunter Tina D. , Ribeiro Diogo , Laxmanan Balaji , Kalsekar Iftekhar , Cumbo-Nacheli Gustavo 
Published: May 2023

Abstract
Background
Robot-assisted bronchoscopy (RAB) is among the newest bronchoscopic technologies, allowing improved visualization and access for small and hard-to-reach nodules. RAB studies have primarily been conducted at academic centers, limiting the generalizability of results to the broader real-world setting, while variability in diagnostic yield definitions has impaired the validity of cross-study comparisons. The objective of this study was to determine the diagnostic yield and sensitivity for malignancy of RAB in patients with pulmonary lesions in a community setting and explore the impact of different definitions on diagnostic yield estimates.

Methods
Data were collected retrospectively from medical records of patients ≥ 21 years who underwent bronchoscopy with the Monarch® Platform (Auris Health, Inc., Redwood City, CA) for biopsy of pulmonary lesions at three US community hospitals between January 2019 and March 2020. Diagnostic yield was calculated at the index RAB and using 12-month follow-up data. At index, all malignant and benign (specific and non-specific) diagnoses were considered diagnostic. After 12 months, benign non-specific cases were considered diagnostic only when follow-up data corroborated the benign result. An alternative definition at index classified benign non-specific results as non-diagnostic, while an alternative 12-month definition categorized index non-diagnostic cases as diagnostic if no malignancy was diagnosed during follow-up.

Results
The study included 264 patients. Median lesion size was 19.3 mm, 58.9% were peripherally located, and 30.1% had a bronchus sign. Samples were obtained via Monarch in 99.6% of patients. Pathology led to a malignant diagnosis in 115 patients (43.6%), a benign diagnosis in 110 (41.7%), and 39 (14.8%) non-diagnostic cases. Index diagnostic yield was 85.2% (95% CI: [80.9%, 89.5%]) and the 12-month diagnostic yield was 79.4% (95% CI: [74.4%, 84.3%]). Alternative definitions resulted in diagnostic yield estimates of 58.7% (95% CI: [52.8%, 64.7%]) at index and 89.0% (95% CI: [85.1%, 92.8%]) at 12 months. Sensitivity for malignancy was 79.3% (95% CI: [72.7%, 85.9%]) and cancer prevalence was 58.0% after 12 months.

Conclusions
RAB demonstrated a high diagnostic yield in the largest study to date, despite representing a real-world community population with a relatively low prevalence of cancer. Alternative definitions had a considerable impact on diagnostic yield estimates.
Astragalus polysaccharide ameliorates steroid-induced osteonecrosis of the femoral head by regulating miR-200b-3p-mediated Wnt/β-catenin signaling pathway via inhibiting SP1 expression
Authors: Zhang Shenyao , Dong Kefang , Zeng Xiangjing , Wang Fan , Lu Min 
Published: May 2023

Abstract
Background
Steroid-induced osteonecrosis of the femoral head (SONFH) is the necrosis of the femur bone caused by prolonged and massive use of corticosteroids. The present study probed into the significance of Astragalus polysaccharide (APS) in SONFH progression.

Methods
SONFH cell model was constructed using murine long bone osteocyte Y4 (MLO-Y4) cells and then treated with APS. mRNA microarray analysis selected differentially expressed genes between control group and SONFH group. RT-qPCR determined SP1 and miR-200b-3p expression. Levels of SP1, β-catenin, autophagy-related proteins (LC3II/LC3I, Beclin1, p62) and apoptosis-related proteins (Bax, C-caspase3, C-caspase9, Bcl-2) were tested by Western blot. ChIP and luciferase reporter assays confirmed relationship between SP1 and miR-200b-3p. Fluorescence intensity of LC3 in cells was detected by immunofluorescence. Flow cytometry assessed cell apoptosis. Osteonecrosis tissues from SONFH mice were examined by HE and TRAP staining.

Results
APS induced autophagy and suppressed apoptosis in SONFH cell model. APS inhibited SP1 expression and SP1 overexpression reversed effects of APS on SONFH cell model. Mechanistically, SP1 targeted miR-200b-3p to inhibit Wnt/β-catenin pathway. MiR-200b-3p depletion rescued the promoting effect of SP1 on SONFH cell model by activating Wnt/β-catenin pathway. HE staining showed that APS treatment reduced the empty lacunae and alleviated inflammation in trabecular bone of SONFH mice. TRAP staining revealed decreased osteoclasts number in SONFH mice after APS treatment.

Conclusion
APS regulated osteocyte autophagy and apoptosis via SP1/miR-200b-3p axis and activated Wnt/β-catenin signaling, thereby alleviating SONFH, shedding new insights for therapy of SONFH.
Efficacy and confounding factors of CT attenuation value differences in distinguishing acute and old vertebral compression fractures: a retrospective study
Authors: Liang Limin , Wang Ya , Zhao Yaya , Luo Chunyuan , Zhu Jianghua , Zhang Xin , Zhang Zhaotao , Ye Yinquan , Deng Weiwei , Peng Yun , Gong Lianggeng 
Published: May 2023

Abstract
Purpose
To evaluate the influence of various factors on CT attenuation values (HUs) of acute and old fracture vertebra, and to determine the efficacy of HU differences (△HUs) in the differentiation of the two type of fractures.

Materials and Methods
A total of 113 acute and 71 old fracture vertebrae confirmed by MRI were included. Four HUs measured at the mid-sagittal, upper 1/3 axial, mid-axial, and lower 1/3 axial planes of each vertebra were obtained. The △HUs between fracture vertebra and its control counterpart was calculated. Receiver operating characteristic (ROC) curve analysis was used and the areas under the ROC curve (AUC) were calculated to evaluate the efficacy of HUs and △HUs. To evaluate the effect of height reduction, region, age and gender on HUs and △HUs, one-way analysis of variance, Pearson correlation analysis and t-test were used.

Results
The HUs and △HUs at the upper 1/3 axial plane achieved the highest AUCs of 0.801 and 0.839, respectively. The HUs decreased gradually from Thoracic to Lumbar in control group of acute fracture. While no significant differences were found in the HUs among the 3 localizations in both fracture groups (all P > 0.05). The HUs were negatively correlated with age in all groups. The HUs of male were significantly higher than female patients in all groups (all P < 0.05). While △HU was not significantly different between males and females (all P > 0.05).

Conclusion
The vertebral HUs at the upper 1/3 axial plane are more likely to identify acute fractures. △HUs were beneficial in eliminating interfering factors.
Efficacy and safety of super-mini percutaneous nephrolithotomy in the treatment of urinary calculi: a systematic review and meta-analysis
Authors: Li Han , Yin Yong , Nie Ming 
Published: May 2023

Abstract
Background
Super-mini-percutaneous nephrolithotomy (SMP) is feasible and safe in adults and children with moderate-size renal calculi, but the use of SMP to remove larger calculi has yet to be determined. This study aimed to review the efficacy (stone-free rate, SFR) and safety of SMP in treating urinary calculi.

Methods
PubMed, the Cochrane Library, and Embase were searched for eligible studies published up to May 2021. The primary outcome was the SFR. The secondary outcomes were the complications (using the Clavien-Dindo grading system), pain score, hospitalization days, and mean hemoglobin decline. All analyses were performed using the random-effects model. Nine studies (2433 patients with SMP and 2178 controls) were included.

Results
SMP was not associated with an improved SFR in patients with calculi (RR = 1.05, 95%CI: 0.99–1.11). There were no differences in the occurrence of Clavien-Dindo I (RR = 0.95, 95%CI: 0.67–1.35) and Clavien-Dindo II (RR = 0.91, 95%CI: 0.58–1.42) complications between SMP and the control procedures. There were more Clavien-Dindo III complications with SMP than with the control procedures (RR = 0.71, 95%CI: 0.55–0.91), but none of the individual complications significantly differed between the two groups. Clavien-Dindo I fever appeared to be higher with SMP than with the control procedure (RR = 0.64, 95%CI: 0.50–0.83).

Conclusion
In terms of efficacy, there were no differences between SMP and other procedures in treating urinary calculi. Clavien-Dindo I fever and Clavien-Dindo III complications might be more frequent with SMP than other procedures.
Changes in the lesion surface suggesting transformation of oral potentially malignant disorders to malignancy – a report of eight cases
Authors: Kim Moon-Jong , Kho Hong-Seop 
Published: May 2023

Abstract
Background
In the case of oral potentially malignant disorders (OPMD), the possibility of malignant transformation of the lesion necessitates a decision on the need for an additional biopsy at each visit. Among many clinical characteristics, change on the lesion surface is one of the important factors that determine the need for additional biopsy at each visit. The purpose of the study was to provide information on the characteristics of lesions related to malignant transformation during the follow-up period of OPMD.

Methods
Eight patients (four men and four women) with OPMD that transformed into malignancy during long-term follow-up were included and their mean age was 65.8 ± 12.4 years. Clinical information and histopathological diagnosis were investigated at the initial visit and during the long-term follow-up period. The focus was on information on changes on the lesion surface at the time the lesion was confirmed to be malignant. The period from initial diagnosis to dysplasia and from dysplasia to malignancy was also investigated.

Results
The OPMD diagnoses were oral lichen planus or oral lichenoid lesions (n = 2), oral leukoplakia (n = 5), and hyperplastic candidiasis (n = 1). During the follow-up period of the lesions, when dysplasia was obtained by additional biopsy, changes in the lesions consisted of an increase in the size of the white or red area. The lesion surface of the OPMD showed verrucous, papillary, exophytic, corrugated, and ulcerative changes at the time of malignancy diagnosis. The period for the initial lesion to become dysplasia, from dysplasia to malignancy, and from the initial lesion to malignancy was very variable.

Conclusions
Attention should be paid to verrucous, papillary, exophytic, corrugated, and ulcerative changes on the lesion surface of OPMD. Considering that the period for OPMD to become malignant is highly variable, a longer follow-up of the lesion is necessary.
“Comparing the effectiveness, acceptability and oral hygiene status between vacuum formed retainer and Begg’s retainer”: a pilot study
Authors: Patnaik Payada , Nanda Smruti Bhusan , Mishra Sumita 
Published: May 2023

Abstract
Background
Recently, Vacuum formed retainers (VFRs) are preferred as an Orthodontic retention appliance over conventional Begg’s retainers. Very few studies have been conducted between VFRs and Begg’s retainers. Hence, this study aims at assessing the effectiveness, oral hygiene and acceptability between VFRs and Begg’s retainers with a follow up period of 1 year.

Methods
Eighty patients who completed fixed Orthodontic treatment were included. Retainers were delivered on the same day of debonding. Retainer 1/ R1 stands for VFRs and Retainer 2/ R2 stands for Begg’s retainers. The retainers were randomly allocated to both the arches. 40 VFRs and Begg’s retainers in maxillary and mandibular arch were given respectively.
Effectiveness, oral hygiene condition were performed at T0 (After debonding), T1 (3 months after using retainers), T2 (6 months after using retainers), T3 (9 months after using retainers), T4 (12 months after using retainers) follow up stages, except the feedback form and the breakage of retainers that were filled at T4 stage.

Results
Both R1 and R2 retainers showed improvement in teeth alignment in both the arches at follow up stages. Interproximal contacts in maxillary and mandibular arch with VFRs and Begg’s retainers improved to 77.5% and 82.5% respectively. Considering the marginal ridge, Begg’s retainers and VFRs showed 95%, 55% increased proportion at T4 respectively (p < 0.05). Patients wearing Beggs’s retainers had significantly better (p < 0.05) oral hygiene status.
Significant differences were observed with Begg’s retainers in teeth biting, whereas no significant difference was found with fitting of appliance (p = 0.180) and gingival irritation (p = 1.000). VFRs were well accepted aesthetically that was significant. Retainers were prone to breakage but was not significant (p = 0.162).

Conclusion
Begg’s wrap around retainers maintain good oral hygiene, improve the teeth alignment, interproximal contact and marginal ridges post Orthodontic treatment with better fitting of the appliance. VFRs are also preferred as they are good in maintaining proper teeth alignment with progressive improvement in the interproximal contacts and are aesthetically pleasing.