bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vitamin D levels in Portuguese military personnel
Authors: Henriques Moisés , Soares P , Sacadura-Leite E 
Published: March 2022

IntroductionIn Portugal, most adults have inadequate levels of vitamin D. Active duty military personnel need to be always ready for duty, perform tasks in specific contexts and overcome high physical and mental demands, which raises the relevance of knowing their vitamin D levels. This study aims to characterise vitamin D levels of Portuguese active duty military personnel and evaluate the effect of military status on the prevalence of vitamin D sufficiency, adjusted for season of the year, age and gender.MethodsA retrospective cross-sectional study, based on vitamin D measurements carried out at the Armed Forces Hospital between 2014 and 2020, was fulfilled including the variables age, gender, vitamin D level and dosing date for military personnel and civilians. Comparison of proportions test and the generalised linear regression model were used for data analysis with a significance level of 5%.ResultsOut of 2782 subjects, 62.7% were military personnel. Mean±SD level of vitamin D was 24.5±10.6 ng/mL and 23.7±11.5 ng/mL in military personnel and civilians, respectively. In the military personnel, the prevalence of vitamin D sufficiency, insufficiency and deficiency was, respectively, 25.2%, 40.1% and 34.6%. Prevalence of vitamin D sufficiency was similar in the civilians cohort and, also, between Armed Forces branches. Military status had no effect on the prevalence of vitamin D sufficiency, especially after adjustments.ConclusionsWe present data on vitamin D levels of Portuguese active duty military personnel. Our results found that military personnel are no more at risk of vitamin D inadequacy than civilians, but only a quarter of active duty military personnel had vitamin D sufficiency. Therefore, they can benefit from vitamin D levels assessment towards vitamin D levels optimisation. Further studies are still needed, especially among military personnel with higher risk of vitamin D deficiency.
Phase Ib study of durvalumab (MEDI4736) in combination with carbon-ion radiotherapy and weekly cisplatin for patients with locally advanced cervical cancer (DECISION study): study protocol for a prospective open-label single-arm study
Authors: Okonogi Noriyuki , Usui Hirokazu , Murata Kazutoshi , Hori Makoto , Kurokawa Tomoya , Fujiwara Tadami , Fujii Yasuhisa , Hanawa Michiko , Kawasaki Yohei , Hattori Yoko , Suzuki Kazuko , Tsuyuki Kyoko , Wakatsuki Masaru , Hasegawa Sumitaka , Yamada Shigeru , Hanaoka Hideki , Shozu Makio , Tsuji Hiroshi 
Published: March 2022

IntroductionConcurrent chemoradiotherapy is considered the standard treatment strategy for locally advanced cervical cancer. Most recent reports indicate that patients with bulky tumours or adenocarcinoma subtypes have poorer local control. Carbon-ion radiotherapy (CIRT) with the concurrent use of chemotherapy has shown promising results in such cases of difficult-to-treat uterine cervical cancer. Programmed death-ligand 1 (PD-L1) upregulation was observed in tumour tissue samples from patients who had undergone CIRT. Thus, a combination of CIRT and anti-PD-L1 antibody may suppress metastasis by activating antitumour immune response, in addition to exhibiting strong local effects.ObjectiveWe will assess the safety and tolerability (primary endpoint) of the concomitant use of durvalumab, an anti-PD-L1 antibody, with CIRT and weekly cisplatin for locally advanced cervical cancer.Methods and analysisThis study is a non-randomised, open-label, prospective phase 1b study. Up to 10 patients with histologically proven uterine cervical cancer at stage IIB, IIIA, IIIB, IIIC1 or IVA as per International Federation of Gynecology and Obstetrics (2018) staging will be enrolled. All patients will receive CIRT of 74.4 Gy relative biological effectiveness in 20 fractions over 5 weeks (four fractions per week). Weekly cisplatin at a dose of 40 mg/m2will be administrated up to five times. Durvalumab at a dose of 1500 mg/body will be administrated at weeks 2 and 6. Safety and tolerability will be evaluated based on the frequency of dose-limiting toxicities until 92 days after CIRT starts. Patients will be followed-up strictly as per the scheduled protocol for 1 year after CIRT initiation.Ethics and disseminationThe Human Research Ethics Committees of QST Hospital (#C21-002) and Chiba University (#2021006) have approved this study protocol. The findings will be published in peer-reviewed journals and presented at scientific conferences.Trial registration numberJapan Registry of Clinical Trials (jRCT2031210083), registered on 12 May 2021.
Ontario COVID-19 and Kids Mental Health Study: a study protocol for the longitudinal prospective evaluation of the impact of emergency measures on child and adolescent mental health during the COVID-19 pandemic
Authors: Korczak Daphne J , Cost Katherine T , LaForge-MacKenzie Kaitlyn , Anagnostou Evdokia , Birken Catherine S , Charach Alice , Monga Suneeta , Crosbie Jennifer 
Published: March 2022

IntroductionThe COVID-19 pandemic has impacted the mental health (MH) of children, adolescents and parents. Whereas youth with MH disorders and neurodevelopmental disorders (NDD) may be at higher risk for exacerbations in emotional and behavioural distress, children and adolescents without pre-existing MH disorders or NDD may also experience MH deterioration due to increases in stress, changes in health behaviours, loss of activities/school closures or loss of resources. Little is known about the impact of the COVID-19 emergency measures (EMs) on children’s MH over the course of the pandemic.Methods and analysisLongitudinal study of four well-established, pre-existing cohorts in Ontario (two recruited in clinical settings, two recruited in community settings). Primary outcomes include the impact of EMs on six MH domains: depression, anxiety, irritability, inattention, hyperactivity and obsessive–compulsive behaviours. Risk and protective factors related to youth MH profiles and trajectories will be identified. In addition, the effects of school mitigation strategies, changes in MH services and family factors (ie, parental MH, economic deprivation and family functioning) on children’s MH will be examined. Data will be collected via repeated online survey measures selected to ensure reliability and validity for the proposed populations and distributed through the pandemic periods.Ethics and disseminationThe study was approved by institutional research ethics boards at participating research sites. Results will be disseminated through a robust knowledge translation partnership with key knowledge users. Materials to inform public awareness will be co-developed with educators, public health, and MH and health service providers. Connections with professional associations and MH advocacy groups will be leveraged to support youth MH policy in relation to EMs. Findings will further be shared through conference presentations, peer-reviewed journals and open-access publications.
Study protocol for a double-blind, comparative, randomised Japanese trial of triplet standard antiemetic therapies with or without 5 mg olanzapine to prevent chemotherapy-induced nausea and vomiting for patients with breast cancer treated with an anthracycline/cyclophosphamide regimen (JTOP-B)
Authors: Ozeki Rie , Iihara Hirotoshi , Shimokawa Mototsugu , Hashimoto Hironobu , Abe Masakazu , Mukohara Toru , Bando Hiroko , Hayashi Toshinobu , Kawazoe Hitoshi , Komoda Masayo , Yanai Takahashi Takako , Saito Mitsue 
Published: March 2022

IntroductionTriple antiemetic therapy with neurokinin-1 receptor antagonist, 5-hydroxytryptamine type 3 receptor antagonist, and dexamethasone has been widely recommended for high emetogenic chemotherapeutic (HEC) agents and regimens, including anthracycline combined with cyclophosphamide (AC). The addition of olanzapine (OLZ) 5 mg or 10 mg to the recommended triple antiemetic therapy has demonstrated superiority in antiemetic efficacy compared with the standard triplet therapy for a cisplatin-based HEC regimen. Although OLZ plus the triple antiemetic treatment may also be effective for patients on an AC-based HEC regimen, no study has investigated its efficacy at a lower dose of 5 mg.Methods and analysisTo assess whether 5 mg OLZ, as compared with placebo, in combination with triple combination therapy, significantly improves nausea and vomiting, we are conducting a randomised, parallel-group controlled clinical trial with a total of 500 patients at 15 study centres in Japan. The primary outcome is the complete response rate, defined as no emetic episodes and no use of rescue medication during 120 hours after the initiation of chemotherapy. Treatment group comparison for the primary endpoint will be done by using the Cochran-Mantel-Haenszel test.Ethics and disseminationThe study was approved by the institutional review board of Juntendo University Hospital and relevant approval was obtained from all participating centres. All participants will be required to provide written informed consent. The trial results will be reported at conferences and in peer-reviewed journals.Trial registration numberJapan Registry of Clinical Trials (jRCT) jRCT1031200134; protocol date: 30 July 2020, version: 1.3, approval: 25 August 2020.
Bayesian analysis of amiodarone or lidocaine versus placebo for out-of-hospital cardiac arrest
Authors: Lane Daniel J , Grunau Brian , Kudenchuk Peter , Dorian Paul , Wang Henry E , Daya Mohamud R , Lupton Joshua , Vaillancourt Christian , Okubo Masashi , Davis Daniel , Rea Thomas , Yannopoulos Demetris , Christenson Jim , Scheuermeyer Frank 
Published: March 2022

ObjectiveClinical trials for patients with shock-refractory out-of-hospital cardiac arrest (OHCA), including the Amiodarone, Lidocaine or Placebo (ALPS) trial, have been unable to demonstrate definitive benefit after treatment with antiarrhythmic drugs. A Bayesian approach, combining the available evidence, may yield additional insights.MethodsWe conducted a reanalysis of the ALPS trial comparing treatment with amiodarone or lidocaine with placebo in patients with OHCA following shock-refractory ventricular fibrillation or ventricular tachycardia (VF/VT). We used Bayesian regression to assess the probability of improved survival or improved neurological outcome on the 7-point modified Rankin Scale. We derived weak, moderate and strong priors from a previous clinical trial.ResultsThe original ALPS trial randomised 3026 adult patients with OHCA to amiodarone (n=974, survival to hospital discharge 24.4%), lidocaine, (n=993, survival 23.7%) or placebo (n=1059, survival 21.0%). In our reanalysis the probability of improved survival from amiodarone ranged from 83% (strong prior) to 95% (weak prior) compared with placebo and from 78% (strong) to 90% (weak) for lidocaine—an estimated improvement in survival of 2.9% (IQR 1.4%–3.8%) for amiodarone and 1.7% (IQR 0.84%–3.2%) for lidocaine over placebo (moderate prior). The probability of improved neurological outcome from amiodarone ranged from 96% (weak) to 99% (strong) compared with placebo and from 88% (weak) to 96% (strong) for lidocaine.ConclusionsIn a Bayesian reanalysis of patients with shock-resistant VF/VT OHCA, treatment with amiodarone had high probabilities of improved survival and neurological outcome, while treatment with lidocaine had a more modest benefit.
Optimizing manganese and iron delivery for contrasting cultivars of subirrigated greenhouse-grown pot chrysanthemums
Authors: Donetz Alyna J. , Flaherty Edward J. , Teeter-Wood Katherine , Hoover Gordon J. , Dayboll Chevonne , Shelp Barry J. 
Published: March 2022

Excessive fertilizer use in greenhouse floricultural operations results in low-nutrient use efficiency by plants and poses environmental risk. Here, we optimized the usage of fertilizer manganese (Mn) and iron (Fe) by modern cultivars of subirrigated pot chrysanthemum. Mn and Fe (approximately 100% to 6% of industry standards) were provided in an otherwise balanced nutrient solution during vegetative growth, and all nutrients were removed during reproductive growth. Two experiments were conducted for each nutrient in a naturally lit research greenhouse using a split-plot design with four blocks arranged randomly. Mn (5.00–0.3125 µmol L−1) or Fe (10.56–0.66 µmol L−1) was the main plot and cultivar (“Milton Dark Pink”, “Williamsburg Purple”, and “Olympia White”) was the subplot. The cultivars exhibited contrasting phenotypes. However, any treatment effects on plant yield and inflorescence development and quality were minor, so that Mn or Fe use efficiency increased approximately 16-fold with decreasing supply. Even though leaf Mn, zinc, and calcium levels were occasionally correlated inversely with decreasing Fe delivery, the leaf Mn (44.8–121.8 mg kg−1) and Fe (68.5–121.8 mg kg−1) levels were always considered acceptable. These findings contribute to the development of a low-input practice that would improve the sustainability of floricultural crop production.
Performance increase of wave energy harvesting of a guided point absorber
Authors: Hollm Marten , Dostal Leo , Yurchenko Daniil , Seifried Robert 
Published: March 2022

AbstractThe dynamics of a novel wave energy converter based on a guided inclined point absorber are investigated. Thereby, it is studied through simulations and experiments whether different inclination angles of the guided point absorber lead to larger motion amplitudes and velocities in regular and irregular waves, from which energy can be harvested. For that, different simulations and experimental setups are analyzed in the presence of wave forcing. In the case of irregular waves a random non-white Gaussian stochastic process based on a sea spectrum is used. It is shown that the inclination angle has a significant influence on the energy harvesting output. Based on this insight, a simple control strategy is introduced in order to further increase the energy harvesting output.
Neutrino mass and lepton flavor violation in A4-based left–right symmetric model with linear seesaw
Authors: Sahu Purushottam , Patra Sudhanwa , Pritimita Prativa 
Published: March 2022

We explore an [Formula: see text] flavor-based left–right symmetric model where neutrino masses and mixing are explained through linear seesaw mechanism. Taking [Formula: see text] flavor symmetry and left–right gauge symmetry together and adding a low-scale seesaw mechanism gives the advantage of (a) getting diagonal structures for both charged lepton mass matrix and Dirac neutrino mass matrix, (b) simpler relations among neutrino observables in the model and (c) large light-heavy neutrino mixing which gives dominant contributions to various lepton flavor violating decays like [Formula: see text], [Formula: see text], [Formula: see text]. By saturating the experimental bounds on these decays we derive constraints on input model parameters and study analytically as well as numerically the correlation among model parameters and their dependence on experimentally determined neutrino parameters like [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text]. We also study CP-violation via Jarlskog invariants and show extra contributions to CP-violating effects that the model generates due to unitarity violation in the neutrino sector.
Effect Evaluation of Platelet-Rich Plasma Combined with Vacuum Sealing Drainage on Serum Inflammatory Factors in Patients with Pressure Ulcer by Intelligent Algorithm-Based CT Image
Authors: Yang Jingzhe , Xiao Changshuan , Wen Hailing , Sun Kui , Wu Xiaoming , Feng Xinshu 
Published: March 2022

This work was to explore the efficacy of intelligent algorithm-based computed tomography (CT) to evaluate platelet-rich plasma (PRP) combined with vacuum sealing drainage (VSD) in the treatment of patients with pressure ulcers. Based on the u-net network structure, an image denoising algorithm based on double residual convolution neural network (Dr-CNN) was proposed to denoise the CT images. A total of 84 patients who were hospitalized in hospital were randomly divided into group A (without any intervention), group B (PRP treatment), group C (VSD treatment), and group D (PRP+VSD treatment). Procalcitonin (PCT) was detected by enzyme-linked immunosorbent assay (ELISA) combined with immunofluorescence method, C-reactive protein (CRP) was detected by rate reflectance turbidimetry (RRT), and interleukin-6 (IL-6) was detected by electrochemiluminescence method. The results showed that after treatment, 44 cases (52.38%) of pressure ulcers patients recovered, 24 cases (28.57%) had no change in stage, and 16 cases (19.04%) developed pressure ulcers. The pain scores of group D at 1 week (

3.35
±
0.56

points) and 2 weeks (

2.76
±
0.55

points) after treatment were significantly lower than those in group C (

7.77
±
0.58

points and

6.34
±
0.44

points, respectively). The time of complete wound healing in group D (

24.5
±
2.32

) was obviously lower in contrast to that in groups A, B, and C (

35.54
±
3.22

days,

30.23
±
2

days, and

29.34
±
2.15

days, respectively). In addition, the medical satisfaction of group D (

8.74
±
0.69

) was significantly higher than that of groups A, B, and C (

4.69
±
0.85

,

5.22
±
0.31

, and

5.18
±
0.59

, respectively). The levels of IL-6 and PCT in group D were lower than those in groups A, B, and C, and the differences were statistically significant (

P
<
0.01

). The average values of peak signal to noise ratio (PSNR) and structural similarity index measure (SSIM) of the Dr-CNN network model were

37.21
±
1.09

dB and

0.925
±
0.01

, respectively, which were higher than other algorithms. The mean values of root mean square error (MSE) and normalized mean absolute distance (NMAD) of the Dr-CNN network model were

0.022
±
0.002

and

0.126
±
0.012

, respectively, which were significantly lower than other algorithms (

P
<
0.05

). The experimental results showed that PrP combined with VSD could significantly reduce the inflammatory response of patients with pressure ulcers. PRP combined with VSD could significantly reduce the pain of dressing change for patients. Moreover, the performance model of image denoising algorithm based on double residual convolutional neural network was better than other algorithms.
Worsening Postural Tachycardia Syndrome Is Associated With Increased Glucose-Dependent Insulinotropic Polypeptide Secretion
Authors: Breier Nicholas C. , Paranjape Sachin Y. , Scudder Shea , Mehr Shahram E. , Diedrich Andre’ , Flynn Charles R. , Okamoto Luis E. , Hartmann Bolette , Gasbjerg Lærke Smidt , Shibao Cyndya A. 
Published: March 2022

Background:
Postural tachycardia syndrome (POTS) is characterized by excessive upright tachycardia and disabling presyncopal symptoms, which are exacerbated after consuming a high-carbohydrate meal; it is unknown, however, what is the precise underlying mechanism. We seek to investigate the effect of glucose intake on orthostatic hemodynamic changes and gastrointestinal hormone secretion in POTS.

Methods:
Prospective, case-control study, 12 women with POTS who reported a postprandial worsening of their POTS symptoms and 13 age-matched female controls received 75-g oral glucose and 20 mg/kg acetaminophen to assess nutrient absorption. Hemodynamic, gastrointestinal hormone and acetaminophen levels were measured for up to 120 minutes postingestion while supine and standing.

Results:

Patients with POTS had significant orthostatic tachycardia, 48.7±11.2 versus 23.3±8.1 bpm,
P
=0.012 and elevated upright norepinephrine levels, 835.2±368.4 versus 356.9±156.7 pg/mL,
P
=0.004. After oral glucose, upright heart rate significantly increased in POTS, 21.2±11.9% versus 6.0±19.9%,
P
=0.033 with a concomitant decline in upright stroke volume, −10.3±11.90% versus 3.3±13.7%,
P
=0.027; total peripheral resistance, blood pressure and cardiac output remained unaltered. Acetaminophen rate of appearance was similar between groups (
P
=0.707), indicating comparable nutrient absorption rates. POTS had increased plasma levels of C-peptide (
P
=0.001), GIP (glucose-dependent insulinotropic polypeptide;
P
=0.001), peptide YY (
P
=0.016), and pancreatic polypeptide (
P
=0.04) following glucose consumption, but only GIP had a time-dependent association with the worsening upright tachycardia and stroke volume fall.

Conclusions:
The glucose-induced worsening orthostatic tachycardia in POTS was associated with a decline in SV; these changes occurred while GIP, a splanchnic vasodilator, was maximally elevated.
Microvascular β-Adrenergic Receptor-Mediated Vasodilation Is Attenuated in Adults With Major Depressive Disorder
Authors: Greaney Jody L. , Darling Ashley M. , Mogle Jacqueline , Saunders Erika F.H. 
Published: March 2022

Background:
Major depressive disorder (MDD) is associated with sympathetic overactivity and alterations in peripheral adrenergic receptor function; however, no studies have directly assessed vasoconstrictor responsiveness in adults with MDD. We tested the hypotheses that β-adrenergic receptor-mediated vasodilation would be blunted in adults with MDD compared with healthy nondepressed adults (HA) and would functionally contribute to exaggerated norepinephrine-induced vasoconstriction.

Methods:

In 13 HA (8 female; 24±4 years) and in 12 adults with MDD (8 female; 22±3 yrs), red blood cell flux was measured during graded intradermal microdialysis perfusion of the β-adrenergic receptor agonist isoproterenol (10
−10
to 10
−
4
mol/L) and, separately, during the perfusion of norepinephrine (10
−
12
to 10
−
2
mol/L), alone and in combination with the β-adrenergic receptor antagonist propranolol (2 mmol/L). Nonadrenergic vasoconstriction was assessed via perfusion of angiotensin II (10
−
12
to 10
−
4
mol/L).

Results:

Isoproterenol-induced vasodilation was blunted in adults with MDD (188.9±70.1 HA versus 128.3±39.4 au MDD,
P
=0.025). Net norepinephrine-induced vasoconstriction was exaggerated in adults with MDD (−0.16±0.54 HA versus -0.75±0.56 au MDD,
P
=0.014); however, there were no group differences in angiotensin II–induced vasoconstriction. Propranolol potentiated norepinephrine-induced vasoconstriction in HA (−0.16±0.54 norepinephrine versus −1.60±1.40 au propranolol,
P
<0.01) but had no effect in adults with MDD (−0.75±0.56 norepinephrine versus −1.58±1.56 au propranolol,
P
=0.08).

Conclusions:
β-adrenergic receptor-mediated microvascular vasodilation was blunted in adults with MDD and contributed to exaggerated adrenergic vasoconstriction. The relative loss of the vasoprotective effect of β-adrenergic receptor-mediated vasodilation may contribute to increased peripheral resistance, thereby driving the development of hypertension in adults with MDD.