bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association of pain impact and sleep disruption with opioid withdrawal during opioid‐use disorder treatment
Authors: Ellis Jennifer D. , Han Daniel , Mayo Jami , Hobelmann J. Gregory , Finan Patrick H. , Huhn Andrew S. 
Published: February 2024

AimsPersons with opioid‐use disorder (OUD) often experience opioid withdrawal and opioid craving, which can drive continued opioid use and treatment discontinuation. In addition, hyperalgesia is common among persons with OUD, yet few studies have examined the role of pain impact during OUD treatment. The purpose of the present study was to test whether opioid withdrawal and craving were elevated in the context of greater pain impact (i.e. greater pain intensity and interference), and whether these associations changed throughout treatment.MethodsParticipants in residential OUD treatment (n = 24) wore wrist actigraphy to measure sleep and completed daily measures of pain impact, opioid withdrawal and opioid craving for up to 28 days. Mixed effects models were used to examine whether daily elevations in pain impact and sleep continuity were associated with withdrawal severity and opioid craving.ResultsElevations in withdrawal, but not craving, occurred on days when individuals reported higher scores on the pain impact scale. Associations between pain impact and withdrawal were present throughout treatment, but stronger during early treatment. In contrast, both withdrawal and opioid craving were elevated following nights of greater wake after sleep onset and awakenings, but these findings were often more pronounced in early treatment.ConclusionsPain impact and sleep disturbance are 2 factors associated with opioid withdrawal and opioid craving. Novel pharmacotherapies and scalable adjunctive interventions targeting sleep and pain impact should be tested in future work to improve OUD treatment outcomes.
Learner engagement with instructor‐generated video
Authors: Truss Aron , McBride Karen , Porter Hannah , Anderson Valerie , Stilwell Geraldine , Philippou Christina , Taggart Andy 
Published: February 2024

AbstractEffective video resources are assumed to promote learner engagement, but the extent to which this occurs is unclear. This study examines learners' engagement with instructor‐generated video. It contributes an analytical synthesis of qualitative and quantitative data that provides the basis for investigating the extent to which, and how, learners engage with video resources provided in their courses. Specifically, three dimensions of learner engagement with video are studied: behavioural, cognitive and affective. The study contributes to educational technology research by identifying distinctive patterns of learner control over the use of video which diverges from instructors' assumptions. It shows the complex and nuanced features of cognitive and affective engagement. Videos can have positive effects, but inappropriate use of technical features results in learner disengagement. This study contributes a novel use of signalling theory, suggesting the importance of instructor signals concerning relevance, focus and utility as a feature of video generation, as a prerequisite of cognitive engagement. A research and theory development agenda is developed, locating video‐based learning in student contexts as a basis for explaining both engagement and disengagement with video technology affordances.
Practitioner notesWhat is already known about this topic

Higher education tutors are increasingly expected to generate video content as a feature of their course delivery.
Although effective video resources are assumed to promote learner engagement, the extent to which this occurs is unclear.
Video technology affordances rarely feature in academic professional development programmes leaving tutors ill‐equipped to understand how and in what ways students engage with video resources as a part of their courses.
What this paper adds

A novel use of signalling theory to explain different patterns of learner engagement and disengagement.
Learner agency and control results in video technology affordances being fitted and ‘flexed’ around factors that instructors rarely consider in the video generation process.
A new model to describe factors that affect student engagement with instructor‐generated video.
Implications for practice and/or policy

Raise awareness for instructors about patterns of student engagement with video technology affordances that affect learning experience and outcomes.
Implement professional development programmes to equip instructors to design and generate video content that takes account of patterns of behavioural, cognitive and affective engagement and signals relevance, focus and utility.
Develop clear policies regarding technical features of video generation to avoid learner disengagement.
Healthcare and research priorities for women with polycystic ovary syndrome in the UK National Health Service: A modified Delphi method
Authors: Al Wattar Bassel H. , Teh Jhia Jiat , Clarke Sophie , Abbara Ali , Morman Rachel , Wilcox Alison , Talaulikar Vikram 
Published: February 2024

AbstractObjectivePolycystic ovary syndrome (PCOS) is a chronic lifelong condition affecting up to 20% of women worldwide. There is limited input from affected women to guide the provision of healthcare services and future research needs. Our objective was to scope the healthcare and research priorities of women with PCOS in the United Kingdom.DesignA three‐staged modified Delphi method, consisting of two questionnaires and a consensus meeting involving lay representatives and healthcare professionals.Patients and MeasurementsLay patient representatives of women with PCOS. Participants were asked to identify and rank healthcare and research priorities for their importance.ResultsSix hundred and twenty‐four lay participants took part in our Delphi method. Over 98% were diagnosed with PCOS (614/624, 98.4%). More than half experienced difficulties to receive a PCOS diagnosis (375/624, 60%), and the majority found it difficult to access specialised PCOS health services in the NHS (594/624, 95%). The top two healthcare priorities included better education for health professionals on the diagnosis and management of PCOS (238/273, 87.1%) and the need to set up specialist PCOS services (234/273, 85.7%). The top two research priorities focused on identifying better treatments for irregular periods (233/273, 85.3%) followed by better tests for early PCOS diagnosis (230/273, 84.2%).ConclusionsWe identified 13 healthcare and 14 research priorities that reflect the current health needs of women with PCOS in the United Kingdom. Adopting these priorities in future healthcare and research planning will help to optimise the health of women with PCOS and increase patient satisfaction.
Impact of keratinized mucosa on implant‐health related parameters: A 10‐year prospective re‐analysis study
Authors: Mancini Leonardo , Strauss Franz J. , Lim Hyun‐Chang , Tavelli Lorenzo , Jung Ronald E. , Naenni Nadja , Thoma Daniel S. 
Published: February 2024

AbstractAimTo investigate whether the lack of keratinized mucosa (KM) affects peri‐implant health after 10 years of loading.Materials and MethodsData from 74 patients with 148 implants from two randomized controlled studies comparing different implant systems were included and analyzed. Clinical parameters including bleeding on probing (BOP), probing depth (PD), plaque index, marginal bone loss (MBL), and KM width (KMW) at buccal sites were collected at baseline (time of the final prosthesis insertion), 5‐year and 10 years postloading. Multivariable logistic and linear regression models by means of a generalized estimated equation (GEE) were used to evaluate the influence of buccal KM on peri‐implant clinical parameters; BOP, MBL, PD, and adjusted for implant type (one‐piece or two‐piece) and compliance.ResultsA total of 35 (24.8%) implants were healthy, 67 (47.5%) had mucositis and 39 (27.6%) were affected by peri‐implantitis. In absence of buccal KM (KM = 0 mm), 75% of the implants exhibited mucositis, while in the presence of KM (KMW >0 mm) 41.2% exhibited mucositis. Regarding peri‐implantitis, the corresponding percentages were 20% (KM = 0 mm) and 26.7% (KM >0 mm). Unadjusted logistic regression showed that the presence of buccal KM tended to reduce the odds of showing BOP at buccal sites (OR: 0.28 [95% CI, 0.07 to 1.09], p = 0.06). The adjusted logistic regression model revealed that having buccal KM (OR: 0.21 [95% CI, 0.05 to 0.85], p = 0.02) and using two‐piece implants (OR: 0.34 [95% CI, 0.15 to 0.75], p = 0.008) significantly reduced the odds of showing BOP. Adjusted linear regression by means of GEE showed that KM and two‐piece implants were associated with reduced MBL and MBL changes (p < 0.05).ConclusionThe lack of buccal KM appears to be linked with peri‐implant parameters such as BOP and MBL, but the association is weak. The design of one‐piece implants may account for their increased odds of exhibiting BOP.
Bidirectional pharmacokinetics of doravirine, tenofovir, and feminizing hormones in transgender women (IDentify): A randomized crossover trial
Authors: Lam Kevin , Kraft Walter K. , Zhan Tingting , Lam Edwin 
Published: February 2024

AbstractTransgender women may have concerns of drug interactions between feminizing hormone therapy (FHT) and antiretrovirals, leading to nonadherence. This randomized, three‐period crossover, open‐label, phase I trial assessed the effects of doravirine (DOR) and tenofovir disoproxil fumarate (TDF) on the pharmacokinetics (PKs) of estradiol, spironolactone, and total testosterone and vice versa in healthy transgender women. Volunteers were randomized 1:1 into two sequences containing three treatment groups (DOR, lamivudine [3TC], and TDF alone; estradiol, spironolactone, and placebo; and DOR/3TC/TDF, estradiol, and spironolactone). Eight subjects enrolled in the study and six had completed all study periods. The geometric mean ratios for DOR area under the concentration‐time curve from zero to last measured concentration (AUC0‐last), maximum concentration (Cmax), and concentration at 24 h (C24) were similar. However, tenofovir (TFV) AUC0‐last, Cmax, and C24 moderately increased by 14%–38%. Last, estradiol AUC0‐last, Cmax, and C24 were increased by 10%–13%. Whereas most 90% confidence intervals did not meet the bioequivalence bounds of 80%–125%, the point estimates fell within the intervals. Log‐transformed DOR, TFV, and estradiol PK parameters computed with and without co‐administration were not statistically different (p > 0.05). There were no serious adverse events. There is not a clinically significant impact of FHT on DOR/TFV PKs. Similarly, there is no observed impact on estradiol PKs and total testosterone following use of DOR/3TC/TDF.
Implementing pain, agitation, delirium, and sleep deprivation protocol in critically ill patients: A pilot study on pharmacological interventions
Authors: Luetrakool Punchika , Taesotikul Suthinee , Susantitapong Kanyarat , Suthisisang Chuthamanee , Morakul Sunthiti , Sutherasan Yuda , Tangsujaritvijit Viratch , Dilokpattanamongkol Pitchaya 
Published: February 2024

AbstractCritically ill patients frequently experience pain, agitation, delirium, and sleep deprivation, which have been linked to increased mortality and unfavorable clinical outcomes. To address these challenges, the Pain, Agitation, Delirium, and Sleep Deprivation (PADS) protocol was developed, aiming to mitigate mortality and improve clinical outcomes. This study focuses on assessing the protocol's impact using a robust before‐and‐after study design in the medical and surgical intensive care units (ICUs) at Ramathibodi Hospital. Using an observational approach, this study compares clinical outcomes before and after implementing the PADS protocol in the ICUs. Two patient cohorts were identified: the “before” group, comprising 254 patients with retrospective data collected between May 2018 and September 2019, and the “after” group, consisting of 255 patients for whom prospective data was collected from May to September 2020. Analysis reveals improvements in the after group. Specifically, there was a significant increase in 14‐day ICU‐free days (9.95 days vs. 10.40 days, p value = 0.014), a decrease in delirium incidence (18.1% vs. 16.1%, p value < 0.001), and a significant reduction in benzodiazepine usage (38.6% vs. 24.6%, p value = 0.001) within the after group. This study emphasizes the protocol's potential to improve patient care and highlights its significance in the ICU context.
Cost‐effectiveness of a Novel Hypoglycaemia Programme: The ‘HARPdoc vs BGAT’ RCT
Authors: Healey Andrew , Soukup Tayana , Sevdalis Nick , Bakolis Ioannis , Cross Samantha , Heller Simon R. , Brooks Augustin , Kariyawasam Dulmini , Toschi Elena , Gonder‐Frederick Linda , Stadler Marietta , Rogers Helen , Goldsmith Kimberley , Choudhary Pratik , de Zoysa Nicole , Amiel Stephanie A. ,   for the HARPdoc RCT Study Group
Published: February 2024

AbstractAimsTo assess the cost‐effectiveness of HARPdoc (Hypoglycaemia Awareness Restoration Programme for adults with type 1 diabetes and problematic hypoglycaemia despite optimised care), focussed upon cognitions and motivation, versus BGAT (Blood Glucose Awareness Training), focussed on behaviours and education, as adjunctive treatments for treatment‐resistant problematic hypoglycaemia in type 1 diabetes, in a randomised controlled trial.MethodsEligible adults were randomised to either intervention. Quality of life (QoL, measured using EQ‐5D‐5L); cost of utilisation of health services (using the adult services utilization schedule, AD‐SUS) and of programme implementation and curriculum delivery were measured. A cost‐utility analysis was undertaken using quality‐adjusted life years (QALYs) as a measure of trial participant outcome and cost‐effectiveness was evaluated with reference to the incremental net benefit (INB) of HARPdoc compared to BGAT.ResultsOver 24 months mean total cost per participant was £194 lower for HARPdoc compared to BGAT (95% CI: −£2498 to £1942). HARPdoc was associated with a mean incremental gain of 0.067 QALYs/participant over 24 months post‐randomisation: an equivalent gain of 24 days in full health. The mean INB of HARPdoc compared to BGAT over 24 months was positive: £1521/participant, indicating comparative cost‐effectiveness, with an 85% probability of correctly inferring an INB > 0.ConclusionsAddressing health cognitions in people with treatment‐resistant hypoglycaemia achieved cost‐effectiveness compared to an alternative approach through improved QoL and reduced need for medical services, including hospital admissions. Compared to BGAT, HARPdoc offers a cost‐effective adjunct to educational and technological solutions for problematic hypoglycaemia.
Bridging dose of U‐100 glargine with first dose of insulin degludec improves glycaemia in the 48 h after transition in twice‐daily glargine users
Authors: Thirumalai Arthi , Chao Jing H. , Kaleru Thanmai , Dong Xiaofu , Mandava Patali , Khakpour Dori , Hirsch Irl B. 
Published: February 2024

AbstractAimsTo study the effects of a bridging dose of U‐100 glargine (U‐100G) with the first dose of degludec in type 1 diabetes (T1D) patients transitioning from glargine to degludec, by comparing the glucose metrics 48 h before and after the transition.Materials and MethodsPatients with T1D on a stable U‐100G regimen and with glycated haemoglobin concentration <75 mmol/mol were randomized (double‐blind) to one dose of placebo or U‐100G with first dose of degludec, administered at 9:00 pm. Patients on once‐daily U‐100G at baseline received 50% of total U‐100G dose (bridging dose), while patients on twice‐daily U‐100G received 50% of the evening U‐100G dose. Participants wore a continuous glucose monitor during the study.ResultsForty participants were randomized, of whom 37 completed the study. The cohort was 65% male, the mean age was 47 years, duration of T1D 22 years, BMI 26 kg/m2, HbA1c 51 mmol/mol and total daily insulin dose 0.7 units/kg body weight. The bridging group included 19 participants (once‐daily U‐100G: n = 12; twice‐daily U‐100G: n = 7) and the placebo group included 18 participants (once‐daily U‐100G: n = 12; twice‐daily U‐100G: n = 6). Change in time in range (TIR) was not significantly different between the two treatment groups. In secondary analyses, among twice‐daily U‐100G users, TIR (3.9‐10 mmol/L) increased 8% in the bridging group in the 48 h after first dose of degludec compared to the preceding 48 h, while participants in the placebo group had a 9.5% decrease (p = 0.027).ConclusionsA subgroup of well‐controlled twice‐daily U‐100G users transitioning to degludec benefited from a 50% bridging dose of evening U‐100G with the first dose of degludec in a small pilot study.
Associations of body mass index trajectory, waist circumference trajectory, or both with type 2 diabetes mellitus risk in Chinese adults: The China‐PAR project
Authors: Zhao Yang , Han Minghui , Qie Ranran , Zhang Yanyan , Wu Yuying , Fu Xueru , Zhang Dongdong , Kuang Lei , Qin Pei , Hu Fulan , Li Jianxin , Lu Xiangfeng , Hu Dongsheng , Zhang Ming 
Published: February 2024

AbstractAimsTo identify the trajectories of body mass index (BMI) and waist circumference (WC), and assess the associations of BMI trajectory, WC trajectory, or the two combined, with type 2 diabetes mellitus (T2DM) risk in Chinese adults.Materials and MethodsThis study was based on a prospective project—the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China‐PAR). A total of 54 434 participants (39.21% men) who were measured on at least two occasions were included. Three slowly increasing trajectory patterns were identified for BMI, and four for WC, by latent mixed modelling. A nine‐category variable was derived by combining the WC trajectory (low, moderate, moderate‐high/high) and the BMI trajectory (low, moderate, high). Logistic regression models were applied to estimate the odds ratios (ORs) and 95% confidence intervals (CIs).ResultsThe risk of developing T2DM increased with elevated BMI or WC trajectory levels (all ptrend <0.001). The risks were 2.85 (2.59–3.14) for high BMI trajectory and 4.34 (3.78–4.99) for high WC trajectory versus low trajectory groups, respectively. The association was more pronounced among younger individuals (pinteraction <0.001). In the joint analysis, compared to participants with low WC and BMI trajectory, those with moderate‐high/high WC combined with high BMI trajectory had the highest risk of T2DM (OR 3.96, 95% CI 3.48–4.50); even those who maintained moderate‐high/high WC but low BMI trajectory showed a higher T2DM risk (OR 3.00, 95% CI 2.31–3.91).ConclusionsThis study suggests that simultaneous dynamic and continuous monitoring of BMI and WC may contribute more than single measurements to predicting T2DM risk and determining preventive strategies.
Pharmacological treatment of obesity in adults in Norway 2004–2022
Authors: Ruiz Paz Lopez‐Doriga , Karlstad Øystein , Nøkleby Kjersti , Slåtsve Kristina , Gulseth Hanne L. , Meyer Haakon E. , Sveen Kari Anne , Qvigstad Elisabeth , Furu Kari 
Published: February 2024

AbstractAimsTo describe trends in the use of anti‐obesity drugs in Norway during the period 2004–2022.Materials and MethodsWe assessed the annual utilization of any available drug indicated for obesity recorded in the nationwide Norwegian Prescribed Drug Register for adults (age 18–79 years) from 1 January 2004 to 31 December 2022. Prevalence was stratified by sex and age group (18–29 years and 10‐year age groups thereafter). Additional analyses were performed in individuals initiating treatment with an anti‐obesity drug and on the cost of the anti‐obesity drugs since 2017.ResultsThe prevalence of anti‐obesity drug use decreased from 2009, when sibutramine and rimonabant were withdrawn from the market, and increased again after the approval of bupropion‐naltrexone in 2017 and liraglutide in 2018. The use of the peripheral‐acting anti‐obesity drug orlistat decreased from 2004. In 2022, 1.04% of the adult Norwegian population (72.8% women) filled at least one prescription of bupropion‐naltrexone, 0.91% used liraglutide (Saxenda; 74.2% women), and semaglutide without reimbursement was used by 0.68% (76.7% women). The prevalence increased with age, peaking in the age group 50 to 59 years, and decreased in older age groups. From 2017 to 2022, 2.8% of the adult residents initiated treatment with an anti‐obesity drug. The total sale of those drugs increased from 1.1 million euros in 2017 to 91.8 million euros in 2022.ConclusionsThe use of anti‐obesity drugs in Norway has increased substantially in recent years, especially among women aged 40 to 59 years. Changes in availability and reimbursement have influenced the use of these drugs in recent years.
Real‐world glycated haemoglobin changes among type 2 diabetes mellitus patients treated with a maintenance dose of 7 mg or 14 mg of oral semaglutide
Authors: Swift Caroline , Frazer Monica , Gronroos Noelle N. , Sargent Andrew , Leszko Michael , Buysman Erin , Alvarez Sara , Dunn Tyler J. , Noone Josh , Guevarra Mico 
Published: February 2024

AbstractAimTo describe the change in glycated haemoglobin (HbA1c) among patients with type 2 diabetes following treatment with a 7 or 14 mg maintenance dose of oral semaglutide.Materials and MethodsThis retrospective, claims‐based study included adult patients with type 2 diabetes with a pre‐index HbA1c of ≥7%, initiating treatment with oral semaglutide between 1 November 2019 and 30 June 2020; the patients had continuous health plan enrolment for ≥12 months before (pre‐index) and ≥6 months following (post‐index) the date of the first oral semaglutide claim (index). Patients were required to have a maintenance dose of 7 or 14 mg. Pre‐index demographic and clinical characteristics were captured, as were doses at initiation and prescriber specialty. The change in HbA1c between the latest post‐index and pre‐index HbA1c measurements was calculated among all patients and among those with ≥90 days of continuous treatment (persistent patients).ResultsThis study included 520 patients, most of whom had a complex medical history, experienced a range of comorbidities and received an average of 11.5 different classes of medications during the pre‐index period. The mean HbA1c reduction during the 6‐month post‐initiation period was 1.2% (p < .001) for all patients and 1.4% (p < .001) for persistent patients.ConclusionsIn this real‐world study, patients with a pre‐index HbA1c ≥7% who initiated treatment with oral semaglutide with a 7 or 14 mg maintenance dose had significantly lower HbA1c levels following treatment.