bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pressure support and positive end-expiratory pressure versus T-piece during spontaneous breathing trial in difficult weaning from mechanical ventilation: study protocol for the SBT-ICU study
Authors: Mezidi Mehdi , Yonis Hodane , Chauvelot Louis , Danjou William , Dhelft François , Bazzani Alwin , Girard Mehdi , Bitker Laurent , Richard Jean-Christophe 
Published: December 2022

Abstract
Background
Spontaneous breathing trials are performed in critically ill intubated patients in order to assess readiness to be weaned from mechanical ventilation. In patients with difficult weaning (i.e. not extubated after their first SBT), performing SBT using pressure support with or without positive end-expiratory pressure or using T-piece is debated. As ventilatory support during SBT is greater on pressure support than on T-piece and as positive end-expiratory pressure can prevent weaning-induced pulmonary oedema, we hypothesized that their combination and large use of post-extubation non-invasive ventilation may shorten the time until successful extubation as compared with T-piece, without increasing the rate of reintubation.

Methods
SBT-ICU is a monocentric prospective open labelled, randomized controlled superiority trial comparing two mechanical ventilation weaning strategies; i.e. daily spontaneous breathing trials using pressure support with positive end-expiratory pressure or T-piece. The primary outcome will be time until successful extubation (defined by as extubation, without reintubation or death within the seven following days).

Discussion
This paper describes the protocol of the SBT-ICU trial. Enrolment of patients in the study is ongoing.

Trial registration
ClinicalTrials.gov NCT03861117. Registered on March 1, 2019, before the beginning of inclusion.
Efficacy and safety of remimazolam tosylate for sedation during upper gastrointestinal endoscopy: study protocol for a multicenter randomized controlled trial
Authors: Zhu Huichen , Su Zhongxue , Huai Xiaorong , Chen Caiyang , Zhang Xiao , Zhou Jie , Su Diansan 
Published: December 2022

Abstract
Background
Gastrointestinal endoscopy has been associated with difficult experiences and can leave patients with an unpleasant impression. Propofol and midazolam are the most commonly used intravenous anesthetics for sedation during gastrointestinal endoscopy. However, cardiac and pulmonary adverse events are the primary concerns associated with the use of these sedatives. Remimazolam tosylate is an ultra-short-acting benzodiazepine drug with a mild inhibitory effect on the respiratory and circulatory systems. These properties qualify remimazolam tosylate to be used as a replacement for propofol or midazolam as a sedative during gastrointestinal endoscopy. This study aims to describe the efficacy and safety of remimazolam tosylate as a sedative for upper gastrointestinal endoscopy.

Methods
A multicenter, randomized, single-blind, parallel-controlled, noninferiority clinical study will be conducted to evaluate the efficacy and safety of remimazolam tosylate as a sedative during upper gastrointestinal endoscopy. Participants (n = 1800) will be randomized to receive remimazolam tosylate at 0.15 mg/kg (experimental group 1), remimazolam tosylate at 0.2 mg/kg (experimental group 2), or propofol at 1.5 mg/kg (control group). Procedure success will be assessed and defined as the completion of upper gastrointestinal endoscopy without the administration of a rescue sedative agent or more than two top-up doses of the trial drug in any 5-min period after initial administration. Sedation quality will be evaluated using the Modified Observer’s Assessment of Alertness/Sedation score. Adverse events will be recorded to evaluate safety.

Discussion
This study will determine the optimal dosage of remimazolam tosylate during upper gastrointestinal endoscopy and will describe its efficacy and safety. These findings may contribute to a more comfortable and safer experience for patients compared with that when the conventional sedative propofol is used.

Trial registration
ClinicalTrials.gov NCT04727034. Registered on February 18, 2021.
Pre-incisional infiltration with ropivacaine plus dexamethasone palmitate emulsion for postoperative pain in patients undergoing craniotomy: study protocol for a prospective, randomized controlled trial
Authors: Zhang Wei , Li Chunzhao , Zhao Chunmei , Ji Nan , Luo Fang 
Published: December 2022

Abstract
Background
Post-craniotomy pain is a common occurrence which is associated with poor outcomes. Pre-emptive scalp infiltration with dexamethasone and ropivacaine has been proven effective in previous studies but with limited clinical significance. Dexamethasone palmitate emulsion (D-PAL) is a pro-drug incorporating dexamethasone into lipid microspheres with greater anti-inflammatory activity and fewer side effects than free dexamethasone. However, its effects in post-craniotomy pain management remain unknown. This study hypothesizes that pre-emptive scalp infiltration with ropivacaine plus D-PAL emulsion can achieve superior analgesic effects to ropivacaine alone in adult patients undergoing craniotomy.

Methods/design
This is a single center, randomized controlled trial enrolling 130 patients scheduled for supratentorial craniotomy, which is expected to last longer than 4 h. We compare the efficacy and safety for postoperative pain relief of ropivacaine plus D-PAL group and ropivacaine alone group following pre-emptive scalp infiltration. Primary outcome will be pain Numerical Rating Scale at 24 h postoperatively. Secondary outcomes will include further analgesia evaluations and drug-related complications within a follow-up period of 3 months.

Discussion
This is the first randomized controlled trial aiming to assess the possible benefits or disadvantages of D-PAL emulsion for incisional pain in craniotomy. It may provide an alternative to optimize pain outcome for neurosurgical patients.

Trial registration
ClinicalTrials.gov (NCT04488315). Registered on 19 July 2020.
The effect of postoperative early lumbar drainage on delayed fever after cerebellopontine angle tumour surgery: study protocol for a randomized controlled trial
Authors: Zhang Yunze , Wu Yingxi , Wu Yang , Zhu Gang , Xue Yafei , Qu Yan , Zhao Tianzhi 
Published: December 2022

Abstract
Background
Postoperative fever is one of the common complications in neurosurgery, and intracranial aseptic inflammation and infection are important risk factors. Continuous drainage of cerebrospinal fluid (CSF) via lumbar drainage (LD) is often used in the treatment of postoperative intracranial infection or aseptic inflammation. Compared with the previously reported placement of LD after the onset of meningitis symptoms, we designed this randomized controlled trial (RCT) to evaluate the effectiveness and safety of early drainage (1st day postoperation) of CSF using the preset lumbar cistern to prevent delayed fever (fever occurred after the third day postoperation) or reduce its treatment time after cerebellopontine angle (CPA) tumour surgery.

Methods
Patients suffering from CPA tumours and who underwent resection of the tumour with an intraoperative dura opening time > 4 h are recruited for this study. The study is a 2-arm RCT to compare the early LD group and the no early LD group. Postoperative duration and rate of delayed fever and postoperative length of stay (LOS), as the main outcomes, will be compared in the two groups.

Discussion
Here, we present the study design of a prospective RCT to evaluate the safety and efficacy of using preoperative preset LD to treat or reduce postoperative delayed fever.

Trial registration
China Clinical Trial Registry ChiCTR2100049057. Registered on July 20, 2021.
Identification of a conserved maxicircle and unique minicircles as part of the mitochondrial genome of Leishmania martiniquensis strain PCM3 in Thailand
Authors: Anuntasomboon Pornchai , Siripattanapipong Suradej , Unajak Sasimanas , Choowongkomon Kiattawee , Burchmore Richard , Leelayoova Saovanee , Mungthin Mathirut , E-kobon Teerasak 
Published: December 2022

AbstractBackgroundThe mitochondrial DNA of trypanosomatids, includingLeishmania, is known as kinetoplast DNAs (kDNAs). The kDNAs form networks of hundreds of DNA circles that are evidently interlocked and require complex RNA editing. Previous studies showed that kDNA played a role in drug resistance, adaptation, and survival ofLeishmania.Leishmania martiniquensisis one of the most frequently observed species in Thailand, and its kDNAs have not been illustrated.MethodsThis study aimed to extract the kDNA sequences from Illumina short-read and PacBio long-read whole-genome sequence data ofL. martiniquensisstrain PCM3 priorly isolated from the southern province of Thailand. A circular maxicircle DNA was reconstructed by de novo assembly using the SPAdes program, while the minicircle sequences were retrieved and assembled by the rKOMIC tool. The kDNA contigs were confirmed by blasting to the NCBI database, followed by comparative genomic and phylogenetic analysis.ResultsWe successfully constructed the complete circular sequence of the maxicircle (19,008 bp) and 214 classes of the minicircles fromL. martiniquensisstrain PCM3. The genome comparison and annotation showed that the maxicircle structure ofL. martiniquensisstrain PCM3 was similar to those ofL. enriettiistrain LEM3045 (84.29%),L. arabicastrain LEM1108 (82.79%), andL. tarentolae(79.2%). Phylogenetic analysis also showed unique evolution of the minicircles ofL. martiniquensisstrain PCM3 from other examinedLeishmaniaspecies.ConclusionsThis was the first report of the complete maxicircle and 214 minicircles ofL. martiniquensisstrain PCM3 using integrated whole-genome sequencing data. The information will be helpful for further improvement of diagnosis methods and monitoring genetic diversity changes of this parasite.Graphical abstract
Effect of balance training on static and dynamic balance performance in male adolescents: role of training frequency
Authors: Muehlbauer Thomas , Grundmann Arne , Vortkamp Lukas , Schedler Simon 
Published: December 2022

Abstract
Objective
Previous studies reported significant improvements in static and dynamic balance performance following balance training during adolescence. However, it is unclear how equal training volume but different training frequencies per week affect training-induced adaptations. Thus, the present study investigated the effects of balance training frequency (i.e., 2 × 30 min per week or 3 × 20 min per week) on measures of static and dynamic balance in healthy male adolescents.

Results
Irrespective of balance training frequency, significant pretest to posttest improvements were detected for static (i.e., One-Legged Stance test, standing time duration) and dynamic (i.e., Lower Quarter Y Balance test, reach distance) balance performance. However, no group × test interactions were found. These results imply that balance training is effective to improve static and dynamic balance performance in healthy male adolescents, but the effectiveness seems unaffected by the applied balance training frequency.
High frequency of KRAS and EGFR mutation profiles in BRAF-negative thyroid carcinomas in Indonesia
Authors: Heriyanto Didik Setyo , Laiman Vincent , Limantara Nikko Vanda , Anantawikrama Widyan Putra , Yuliani Fara Silvia , Cempaka Rita , Anwar Sumadi Lukman 
Published: December 2022

Abstract
Objective
Thyroid cancer incidence has steadily increased in Indonesia. However, data on Kirsten rat sarcoma virus (KRAS) and EGFR mutations in thyroid cancer in Indonesia remain unavailable, except for BRAF-V600E, the most common BRAF gene mutation. This study aimed to analyze KRAS and EGFR mutation profiles in BRAF-V600E negative thyroid cancer samples.

Results
BRAF-V600E mutations were found in papillary thyroid carcinomas in 40.3% patients with mean age of 53 years old. In BRAF-V600E-negative samples, 41.3% had KRAS mutations with mean age of 55.5 years old. KRAS mutation was found in 52.6% of follicular carcinomas and 47.4% of papillary thyroid carcinomas. Additionally, 45.7% had EGFR mutations in patients with mean age of 50.5 years old. EGFR mutation was found in 71.4% of papillary thyroid carcinoma and 28.6% of follicular carcinoma. Nearly half of the BRAF-V600E negative thyroid carcinoma samples harbored either KRAS or EGFR mutations. This finding suggests that in BRAF-V600E negative thyroid carcinoma samples, testing for RAS and EGFR mutation may be warranted for further therapeutic consideration.
Impact of blood perilipin A levels on obesity and metabolic health
Authors: Ofori Emmanuel K. , Letsu Bright Selorm , Amponsah Seth K. , Ahenkorah John , Crabbe Sandra , Kwao-Zigah Genevieve , Oppong Sylvester Y. , Diaba-Nuhoho Patrick , Amanquah Seth D. 
Published: December 2022

Abstract
Objective
Perilipin A is a common protein that coats lipid surfaces preventing them from being exposed to oxidative damage. Researchers have found little consistency in the relationship between perilipin A levels in the blood and body fat. This study was a cross-sectional observational that looked at circulating perilipin A levels and how they relate to metabolic health.

Results
The participants in this study were 86 individuals with a mean age of 45.5 ± 1.2 years. Multiple clinical and metabolic indicators (age, weight, BMI, total body fat mass, triglyceride, and HOMA-IR) were shown to be inversely associated with perilipin A levels (rho = − 0.32, − 0.37, − 0.40, − 0.45, − 0.33 and − 0.29; p < 0.05 respectively). Obese persons were almost six times more likely than non-obese individuals to have lower perilipin A levels (odds ratio = 6.22, CI = 2.35–11.50, p < 0.001). Our findings underscore the important role of perilipin A proteins in metabolic health.
Focusing on the hypoxia-inducible factor pathway: role, regulation, and therapy for osteoarthritis
Authors: Guo Hanhan , Huang Jianghong , Liang Yujie , Wang Daping , Zhang Huawei 
Published: December 2022

AbstractOsteoarthritis (OA) is a common chronic disabling disease that affects hundreds of millions of people around the world. The most important pathological feature is the rupture and loss of articular cartilage, and the characteristics of avascular joint tissues lead to limited repair ability. Currently, there is no effective treatment to prevent cartilage degeneration. Studies on the mechanism of cartilage metabolism revealed that hypoxia-inducible factors (HIFs) are key regulatory genes that maintain the balance of cartilage catabolism−matrix anabolism and are considered to be the major OA regulator and promising OA treatment target. Although the exact mechanism of HIFs in OA needs to be further clarified, many drugs that directly or indirectly act on HIF signaling pathways have been confirmed by animal experiments and regarded as promising treatments for OA. Targeting HIFs will provide a promising strategy for the development of new OA drugs. This article reviews the regulation of HIFs on intra-articular cartilage homeostasis and its influence on the progression of osteoarthritis and summarizes the recent advances in OA therapies targeting the HIF system.
Transcription regulation strategies in methylotrophs: progress and challenges
Authors: Huang Xiaohan , Song Qiaoqiao , Guo Shuqi , Fei Qiang 
Published: December 2022

AbstractAs a promising industrial microorganism, methylotroph is capable of using methane or methanol as the sole carbon source natively, which has been utilized in the biosynthesis of various bioproducts. However, the relatively low efficiency of carbon conversion has become a limiting factor throughout the development of methanotrophic cell factories due to the unclear genetic background. To better highlight their advantages in methane or methanol-based biomanufacturing, some metabolic engineering strategies, including upstream transcription regulation projects, are being popularized in methylotrophs. In this review, several strategies of transcription regulations applied in methylotrophs are summarized and their applications are discussed and prospected.
Testing the feasibility, acceptability, and preliminary effect of a novel deliberate practice intervention to reduce diagnostic error in trauma triage: a study protocol for a randomized pilot trial
Authors: Mohan Deepika , Elmer Jonathan , Arnold Robert M. , Forsythe Raquel M. , Fischhoff Baruch , Rak Kimberly , Barnes Jacqueline L. , White Douglas B. 
Published: December 2022

AbstractBackgroundNon-compliance with clinical practice guidelines in trauma remains common, in part because physicians make diagnostic errors when triaging injured patients. Deliberate practice, purposeful participation in a training task under the oversight of a coach, effectively changes behavior in procedural domains of medicine but has rarely been used to improve diagnostic skill. We plan a pilot parallel randomized trial to test the feasibility, acceptability, and preliminary effect of a novel deliberate practice intervention to reduce physician diagnostic errors in trauma triage.MethodsWe will randomize a national convenience sample of physicians who work at non-trauma centers (n= 60) in a 1:1 ratio to a deliberate practice intervention or to a passive control. We will use a customized, theory-based serious video game as the basis of our training task, selected based on its behavior change techniques and game mechanics, along with a coaching manual to standardize the fidelity of the intervention delivery. The intervention consists of three 30-min sessions with content experts (coaches), conducted remotely, during which physicians (trainees) play the game and receive feedback on their diagnostic processes. We will assess (a) the fidelity with which the intervention is delivered by reviewing video recordings of the coaching sessions; (b) the acceptability of the intervention through surveys and semi-structured interviews, and (c) the effect of the intervention by comparing the performance of trainees and a control group of physicians on a validated virtual simulation. We hypothesize that trainees will make ≥ 25% fewer diagnostic errors on the simulation than control physicians, a large effect size. We additionally hypothesize that ≥ 90% of trainees will receive their intervention as planned.ConclusionsThe results of the trial will inform the decision to proceed with a future hybrid effectiveness-implementation trial of the intervention. It will also provide a deeper understanding of the challenges of using deliberate practice to modify the diagnostic skill of physicians.Trial registrationClinical trials.gov (NCT05168579); 23 December 2021.
Impact of the PEARLS Healthcare Debriefing cognitive aid on facilitator cognitive load, workload, and debriefing quality: a pilot study
Authors: Meguerdichian Michael , Bajaj Komal , Ivanhoe Rachel , Lin Yiqun , Sloma Audrey , de Roche Ariel , Altonen Brian , Bentley Suzanne , Cheng Adam , Walker Katie 
Published: December 2022

Abstract
Background
The Promoting Excellence and Reflective Learning in Simulation (PEARLS) Healthcare Debriefing Tool is a cognitive aid designed to deploy debriefing in a structured way. The tool has the potential to increase the facilitator’s ability to acquire debriefing skills, by breaking down the complexity of debriefing and thereby improving the quality of a novice facilitator’s debrief. In this pilot study, we aimed to evaluate the impact of the tool on facilitators’ cognitive load, workload, and debriefing quality.

Methods
Fourteen fellows from the New York City Health + Hospitals Simulation Fellowship, novice to the PEARLS Healthcare Debriefing Tool, were randomized to two groups of 7. The intervention group was equipped with the cognitive aid while the control group did not use the tool. Both groups had undergone an 8-h debriefing course. The two groups performed debriefings of 3 videoed simulated events and rated the cognitive load and workload of their experience using the Paas-Merriënboer scale and the raw National Aeronautics and Space Administration task load index (NASA-TLX), respectively. The debriefing performances were then rated using the Debriefing Assessment for Simulation in Healthcare (DASH) for debriefing quality. Measures of cognitive load were measured as Paas-Merriënboer scale and compared using Wilcoxon rank-sum tests. Measures of workload and debriefing quality were analyzed using mixed-effect linear regression models.

Results
Those who used the tool had significantly lower median scores in cognitive load in 2 out of the 3 debriefings (median score with tool vs no tool: scenario A 6 vs 6, p=0.1331; scenario B: 5 vs 6, p=0.043; and scenario C: 5 vs 7, p=0.031). No difference was detected in the tool effectiveness in decreasing composite score of workload demands (mean difference in average NASA-TLX −4.5, 95%CI −16.5 to 7.0, p=0.456) or improving composite scores of debriefing qualities (mean difference in DASH 2.4, 95%CI −3.4 to 8.1, p=0.436).

Conclusions
The PEARLS Healthcare Debriefing Tool may serve as an educational adjunct for debriefing skill acquisition. The use of a debriefing cognitive aid may decrease the cognitive load of debriefing but did not suggest an impact on the workload or quality of debriefing in novice debriefers. Further research is recommended to study the efficacy of the cognitive aid beyond this pilot; however, the design of this research may serve as a model for future exploration of the quality of debriefing.
A unique presentation of NLRP3-associated autoinflammatory disease: case report
Authors: Ducharme-Bénard Stéphanie , Roberge Guillaume , Chapdelaine Hugo 
Published: December 2022

Abstract
Background
NLRP3-associated autoinflammatory diseases (NLRP3-AID) are rare genetic autoinflammatory diseases characterized by chronic inflammation and an urticaria-like rash. We report an unusual presentation of severe NLRP3-AID resulting in a significant diagnostic delay of more than three decades.

Case presentation
The patient presented with early-onset serositis as well as prominent peripheral eosinophilia with organ infiltration, in the absence of the classic urticaria-like rash. DNA analysis by next generation sequencing revealed a sporadic class 4 mutation c.1991T > C (p.Met662Thr) in the NLRP3 gene, confirming a diagnosis of NLRP3-AID at 36 years old. Although treatment with anti-interleukin 1 agent led to clinical remission, irreversible sequelae, namely intellectual disability and deafness, remained.

Conclusion
This case highlights unique manifestations of NLRP3-AID, namely the absence of urticaria-like rash, eosinophilic organ infiltration, and pseudoseptic serositis. In order to avoid diagnostic delay and its dire consequences, NLRP3-AID should be suspected in patients displaying autoinflammatory features combined with serum and tissue eosinophilia and/or marked serositis, regardless of skin involvement.