bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continuous Positive Airway Pressure plus Mandibular Advancement Therapy (PAPMAT): study protocol for an adaptive randomised crossover trial comparing the benefits and costs of combining two established treatments for obstructive sleep apnoea
Authors: Law Martin , Villar Sofia , Oscroft Nicholas , Stoneman Victoria , Fox-Rushby Julia , Chiu Yi-Da , Steele Jo , Devine Thomas , Francis Claire , Claydon Thomas , Hill Graham , Lim Ka Keat , Rayner Joanna , Williams Mandy , Spires Emma , Quinnell Timothy 
Published: July 2023

Abstract
Background

Obstructive sleep apnoea (OSA) involves repeated breathing pauses during sleep due to upper airway obstruction. It causes excessive daytime sleepiness and has other health impacts. Continuous positive airway pressure (CPAP) therapy is effective first line treatment for moderate to severe OSA. Unfortunately, many patients have difficulty tolerating CPAP and pressure intolerance is probably an important contributing factor. Mandibular advancement devices (MAD) are an alternative to CPAP. They are worn in the mouth during sleep to reduce airway obstruction. There is some evidence that, when used in combination with CPAP, MADs improve airway anatomy enough to reduce the CPAP pressure required to treat OSA and that this combination therapy could improve CPAP adherence.

Methods
Consecutive patients starting on CPAP for moderate to severe OSA will be recruited at a regional NHS sleep service. Patients with high CPAP pressure requirements after initial titration, who satisfy all entry criteria and consent to participate, will undertake a 2-arm randomised crossover trial. The arms will be (i) standalone CPAP and (ii) CPAP + MAD therapy. Each arm will last 12 weeks, including 2 weeks acclimatisation. CPAP machines will be auto-titrating and with facility for data download, so the impact of MAD on CPAP pressure requirements and CPAP adherence can be easily measured. The primary outcome will be CPAP adherence. Secondary outcomes will include measures of OSA severity, patient-reported outcome measures including subjective daytime sleepiness, quality of life, and treatment preference at the trial exit and health service use. Cost-effectiveness analyses will be undertaken.

Discussion
If the intervention is shown to be effective and cost-effective in improving adherence in this standard CPAP-eligible OSA patient population it would be relatively straightforward to introduce into existing OSA treatment pathways, within the wider NHS and more widely. Both MAD and CPAP are already used by sleep services so their combination would require only minor adjustments to existing clinical pathways. It would be straightforward to disseminate the results of the study through regional, national, and international respiratory meetings. The health economics analysis would provide cost-effectiveness data to inform service planning and clinical guidelines through policy briefing papers, including those by NICE and SIGN.

Trial registration
PAPMAT was registered with ISRCTN prior to recruitment beginning (ISRCTN Registry 2021): https://www.isrctn.com/ISRCTN33966032. Registered on 17th November 2021.
Pre-exercise isomaltulose intake affects carbohydrate oxidation reduction during endurance exercise and maximal power output in the subsequent Wingate test
Authors: Onuma Naoko , Shindo Daisuke , Matsuo Eriko , Sakazaki Miki , Nagai Yukie , Yamanaka Kentaro 
Published: July 2023

Abstract
Background
Ingestion of low-glycemic index (GI) isomaltulose (ISO) not only suppresses subsequent carbohydrate (CHO) oxidation but also inversely retains more CHO after prolonged endurance exercise. Therefore, ISO intake may affect anaerobic power output after prolonged endurance exercise. This study aimed to clarify the time course of CHO utilization during endurance exercise after a single intake of ISO or sucrose (SUC) and the anaerobic power output at the end of endurance exercise.

Methods
After an intake of either ISO or SUC, 13 athletes were kept at rest for 60 min. Thereafter, they performed a 90-min of treadmill running at their individual target level of % $${\rm{\dot V}}{{\rm{O}}_2}$$max. During the experimental session, the expired gas was recorded, and the energy expenditure (EE) and CHO oxidation rate were estimated. Immediately after 90 min of running, a 30-s Wingate test was performed, and the maximal anaerobic power output was compared between the ISO and SUC conditions.

Results
The percentage of CHO-derived EE increased rapidly after CHO intake and then decreased gradually throughout the experiment. The slopes of the regression lines calculated from the time course in the CHO-derived EE were significantly (negatively) larger in the SUC condition (-19.4 ± 9.6 [%/h]) than in the ISO condition (-13.3 ± 7.5 [%/h]). Furthermore, the maximal power output in the Wingate test immediately after the endurance exercise was significantly higher in the ISO condition than in the SUC condition (peak power: 12.0 ± 0.6 vs. 11.5 ± 0.9 [W/kg]).

Conclusion
Compared with SUC intake, ISO intake does not produce an abrupt decline in the percentage of CHO-derived EE during prolonged endurance exercise; it remains relatively high until the final exercise phase. Additionally, anaerobic power output at the end of the exercise, largely contributed by anaerobic glycolysis, was greater after ISO intake than after SUC intake.
Healthy lifestyle mediates the association between health locus of control and life satisfaction among college students in Hubei, China: during the normalization stage of COVID-19 epidemic prevention and control
Authors: Mei Ying , Zhang Yuzhou , Yu Jincong , Tang Xuemei , Li Wenzhen 
Published: July 2023

Abstract
Background
Previous studies have primarily focused on the relationships among the health locus of control (HLC), healthy lifestyle and life satisfaction of college students. However, little is known about the mediating mechanism of healthy lifestyle on the other two aspects. This study aims to address this issue.

Methods
A total of 2394 students from six colleges in Hubei Province validly completed self-report questionnaires, including the Satisfaction with Life Scale (SWLS), Healthy Lifestyle Questionnaire for college students and Multidimensional Health Locus of Control Scale (MHLC), which covered three dimensions: internal HLC, powerful others HLC and chance HLC. Partial least squares structural equation modelling (PLS-SEM) was employed to analyses the hypothesized relationships in the path model, and a mediation analysis was used to verify the indirect relationships.

Results
Healthy lifestyle and life satisfaction showed positive relations with both internal HLC and powerful others HLC, but a significant negative association with chance HLC. In addition, healthy lifestyle mediated the relationships of internal HLC, powerful others HLC and chance HLC with life satisfaction.

Conclusions
Healthy lifestyle mediates the impact of HLC on life satisfaction. Students with high IHLC tend to develop a healthier lifestyle and have higher LS. Powerful others also exert positive effects in collectivist cultural backgrounds. Thus, colleges should give full play to the positive role of psychological health and physical education courses in improving students’ IHLC. Meanwhile, the positive guiding effect of powerful others should be stressed. Further, particular emphasis should also be placed on the peer influence, new media publicity functions, community intervention, and college systematic appraisal, especially during and after public health emergencies.
French recommendations for the management of glycogen storage disease type III
Authors: Wicker Camille , Cano Aline , Decostre Valérie , Froissart Roseline , Maillot François , Perry Ariane , Petit François , Voillot Catherine , Wahbi Karim , Wenz Joëlle , Laforêt Pascal , Labrune Philippe 
Published: July 2023

AbstractThe aim of theProtocole National De Diagnostic et de Soins/French National Protocol for Diagnosis and Healthcare (PNDS) is to provide advice for health professionals on the optimum care provision and pathway for patients with glycogen storage disease type III (GSD III).The protocol aims at providing tools that make the diagnosis, defining the severity and different damages of the disease by detailing tests and explorations required for monitoring and diagnosis, better understanding the different aspects of the treatment, defining the modalities and organisation of the monitoring. This is a practical tool, to which health care professionals can refer. PNDS cannot, however, predict all specific cases, comorbidities, therapeutic particularities or hospital care protocols, and does not seek to serve as a substitute for the individual responsibility of the physician in front of his/her patient.
Speech deficits in multiple sclerosis: a narrative review of the existing literature
Authors: Plotas Panagiotis , Nanousi Vasiliki , Kantanis Anastasios , Tsiamaki Eirini , Papadopoulos Angelos , Tsapara Angeliki , Glyka Aggeliki , Mani Efraimia , Roumelioti Fay , Strataki Georgia , Fragkou Georgia , Mavreli Konstantina , Ziouli Natalia , Trimmis Nikolaos 
Published: July 2023

AbstractMultiple sclerosis (MS) is a chronic inflammatory and demyelinating autoimmune disease. MS patients deal with motor and sensory impairments, visual disabilities, cognitive disorders, and speech and language deficits. The study aimed to record, enhance, update, and delve into our present comprehension of speech deficits observed in patients with MS and the methodology (assessment tools) studies followed. The method used was a search of the literature through the databases for May 2015 until June 2022. The reviewed studies offer insight into speech impairments most exhibited by MS patients. Patients with MS face numerous communication changes concerning the phonation system (changes observed concerning speech rate, long pause duration) and lower volume. Moreover, the articulation system was affected by the lack of muscle synchronization and inaccurate pronunciations, mainly of vowels. Finally, there are changes regarding prosody (MS patients exhibited monotonous speech). Findings indicated that MS patients experience communication changes across various domains. Based on the reviewed studies, we concluded that the speech system of MS patients is impaired to some extent, and the patients face many changes that impact their conversational ability and the production of slower and inaccurate speech. These changes can affect MS patients’ quality of life.
Experimental Investigation on Fatigue Improvement of Orthotropic Steel Bridge Deck Using Steel Fiber Reinforced Concrete
Authors: Ye Huawen , Huang Ao , Jiang Chengchuan , Wang Wenchao 
Published: July 2023

AbstractThe high-performance topping concrete overlay would significantly reduce the fatigue stresses at susceptible details of orthotropic steel deck (OSD) and effectively improve the fatigue performance. Full-scale fatigue tests and numerical simulations were carried out to quantify the effects of steel fiber reinforced concrete (SFRC) topping pavement in reducing the OSD fatigue stresses based on a practical bridge design. Fatigue stress of the OSD critical details was measured from tests and cracking was observed in the SFRC overlay. Both an innovative pre-pump-pulse Brillouin optical time domain analysis (PPP-BOTDA) distributed optical fiber sensor and strain gauges were also used to measure the stress at OSD fatigue-prone details, including the crossbeam cut-out, rib-to-deck weld, rib-to-crossbeam weld and splice of U-rib. The corresponding three-dimensional (3-D) finite element model was then established and verified by the test results, and used to conduct a parametric study to obtain a quantitative expression of fatigue stress reduction factor, in terms of relative elastic modulus and thickness of overlay and steel deck plate. The proposed quantitative model of the fatigue stress reduction effect can guide the cost-effective design of composite bridge deck.
Offline and hungry: the effect of internet use on the food insecurity of Indonesian agricultural households
Authors: Ardianti Dela Maria , Hartono Djoni , Widyastaman Putu Angga 
Published: July 2023

AbstractFood insecurity is essential since its prevalence may hinder an individual or an economy from developing. The issue still lacks attention in Indonesia, as reflected in the lagging efforts to reduce food insecurity. Meanwhile, several previous studies have found that increasing internet access may decrease food insecurity. Using a sample of 140,892 agricultural households from the National Socioeconomic Survey data, this study uses quantitative measures to evaluate the effects of internet use on the food insecurity of Indonesian agricultural households. The present study uses raw and Rasch scores to measure food insecurity, based on the Food Insecurity Experience Scale question items. To estimate the effect of internet use on food insecurity, this study uses the two-stage least square estimation with topography as the instrumental variable, which is important due to the existence of an endogeneity problem. The present research also evaluates the possible mediating effect between internet use and food insecurity through households’ per capita income. Findings reveal that internet use negatively affects agricultural households’ food insecurity. This study also demonstrates that internet use can lower food insecurity in agricultural households through the mediating effects of income. From these results, policy implications are as follows; prioritization of internet infrastructure in remote areas, dissemination of information to enhance the production of agricultural households, and efforts to increase internet use among agricultural households.
Construction of CD19 targeted dual- and enhanced dual-antibodies and their efficiency in the treatment of B cell malignancy
Authors: Chen Manling , Liu Xiaoyu , Peng Nan , Zhang Ting , Mou Junli , He Huizhen , Wang Ying , Xu Yingxi , Xing Haiyan , Tang Kejing , Tian Zheng , Rao Qing , Gu Runxia , Qiu Shaowei , Wang Min , Wang Jianxiang 
Published: July 2023

Abstract
Background
T cell-redirecting bispecific antibodies establish a connection between endogenous T cells and tumor cells, activating T cells function to eliminate tumor cells without ex vivo genetic alteration or manipulation. Here, we developed a novel dual-specific antibody (DuAb) and an enhanced DuAb (EDuAb) with different stimulation signal to activate T cells, and evaluated their impact on the treatment of acute lymphoblastic leukemia (ALL).

Methods
The expression plasmids of the DuAb and EDuAb containing CD80 molecule were constructed by cloning heavy chain and light chain variable fragments from anti-human CD19 (HI19a) and CD3 (HIT3a) monoclonal antibody hybridomas, respectively. The activation and the anti-tumor efficacy of human T cells mediated by DuAb and EDuAb were evaluated in vitro. B-cell ALL xenograft NSG mouse model was established to investigate the therapeutic effect in vivo.

Results
EDuAb promoted the optimal expansion of primary human T cells with low expression of inhibitory markers in vitro than DuAb did. Both DuAb and EDuAb showed a similar capability in inducing healthy donor T cells to specifically eliminate B-ALL cell lines and primary blasts from patients. The similar ability was also observed in the patient-derived T cells. In vivo study showed that both DuAb and EDuAb significantly alleviated tumor burden and extended survival of B-ALL xenograft NSG mice. The median survival of PBS, DuAb and EDuAb treatment groups were 27, 38 and 45 days, respectively. The phenotype of T cells and cytokine release in peripheral blood (PB) of B-ALL xenograft NSG mice on day 24 were analyzed as well. The results showed that the proportion of CD8+ T cells and cytokine levels, including IL-2, IFN-γ and TNF-α, were higher in the EDuAb group than that of DuAb. Moreover, both DuAb and EDuAb significantly decreased the residual leukemia cells in PB of B-ALL xenograft NSG mice.

Conclusions
Both DuAb and EDuAb showed great potential as novel treatments for B-ALL in clinical applications. However, compared to DuAb, EDuAb showed a significant advantage in promoting the proliferation and survival of T cells. Furthermore, EDuAb showed a better promising effect on eliminating tumor cells and extending survival in vivo, which provides new insights for the development of new multi-specific antibodies.
Shape recovery properties of 3D printed re-entrant strip using shape memory thermoplastic polyurethane filaments with various temperature conditions
Authors: Jung Imjoo , Lee Sunhee 
Published: July 2023

AbstractIn this research, to confirm the applicability as the actuator of the re-entrant (RE) structure strip using 3D printing with shape memory thermoplastic polyurethane material, two types of 3D printing infill conditions and five extension temperature conditions were applied. REstrip was analyzed through differential scanning calorimetry (DSC), tensile properties, Poisson’s ratio properties, and shape recovery properties according to temperature conditions. The DSC results showed that the glass transition temperature peaks of the SMTPU filament and the 3D printed REstrip were in the range of about 30–60 °C. In terms of tensile properties, the initial modulus, maximum stress, and yield stress of REstrip all decreased, while the elongation at break increased with increasing extension temperature. In terms of Poisson’s ratio, it was confirmed that as the extension temperature rises, Poisson’s ratio shows a positive value at a lower elongation, and the deformation is best at 50 °C. As a result of the shape memory property, the shape recovery ratio tended to decrease as the tensile deformation temperature increased.
Successful reversal of remimazolam anesthesia in a “cannot intubate, can ventilate” situation: a case report
Authors: Sekimoto Shota , Kiyama Shuya , Uezono Shoichi 
Published: July 2023

Abstract
Background
Compared to other intravenous anesthetics, availability of a specific antagonist flumazenil is a clear advantage of remimazolam. We report a patient who could be rapidly woken up when laryngoscopy and tracheal intubation were unexpectedly difficult.

Case presentation
A 62-year-old man was scheduled to have resection of a small gingival tumor. Preoperative airway examination was unremarkable except for an omega-shaped epiglottis. Anesthesia was induced with remifentanil/remimazolam infusion and rocuronium. A small omega-shaped edematous epiglottis precluded identification of glottis. Consciousness and spontaneous ventilation were rapidly restored after administration of flumazenil and sugammadex. Tracheostomy was done under local anesthesia while the patient breathed spontaneously.

Conclusions
Remimazolam can be a reasonable induction agent when there are concerns regarding airway management. Avoiding repeated airway manipulations is extremely important to prevent deterioration into a “cannot intubate, cannot ventilate (CICV)” emergency.
A cuproptosis-related lncRNA signature for predicting prognosis and immunotherapy response of lung adenocarcinoma
Authors: Yu Sheng , Tang Lingxue , Zhang Qianqian , Li Wen , Yao Senbang , Cai Yinlian , Cheng Huaidong 
Published: July 2023

AbstractBackgroundCopper-induced cell death (cuproptosis) is a new regulatory cell death mechanism. Long noncoding RNAs (lncRNAs) are related to tumor immunity and metastasis. However, the correlation of cuproptosis-related lncRNAs with the immunotherapy response and prognosis of lung adenocarcinoma (LUAD) patients is not clear.MethodsWe obtained the clinical characteristics and transcriptome data from TCGA-LUAD dataset (containing 539 LUAD and 59 paracancerous tissues). By utilizing LASSO-penalized Cox regression analysis, we identified a prognostic signature composed of cuproptosis-related lncRNAs. This signature was then utilized to segregate patients into two different risk categories based on their respective risk scores. The identification of differentially expressed genes (DEGs) between high- and low-risk groups was carried out using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. We evaluated the immunotherapy response by analyzing tumor mutational burden (TMB), immunocyte infiltration and Tumor Immune Dysfunction and Exclusion (TIDE) web application. The "pRRophetic" R package was utilized to conduct further screening of potential therapeutic drugs for their sensitivity.ResultsWe ultimately identified a prognostic risk signature that includes six cuproptosis-related lncRNAs (AP003778.1, AC011611.2, CRNDE, AL162632.3, LY86-AS1, and AC090948.1). Compared with clinical characteristics, the signature was significantly correlated with prognosis following the control of confounding variables (HR = 2.287, 95% CI = 1.648–3.174,p˂ 0.001), and correctly predicted 1-, 2-, and 3-year overall survival (OS) rates (AUC value = 0.725, 0.715, and 0.662, respectively) in LUAD patients. In terms of prognosis, patients categorized as low risk exhibited more positive results in comparison to those in the high-risk group. The enrichment analysis showed that the two groups had different immune signaling pathways. Immunotherapy may offer a more appropriate treatment option for high-risk patients due to their higher TMB and lower TIDE scores. The higher risk score may demonstrate increased sensitivity to bexarotene, cisplatin, epothilone B, and vinorelbine.ConclusionsBased on cuproptosis-related lncRNAs, we constructed and validated a novel risk signature that may be used to predict immunotherapy efficacy and prognosis in LUAD patients.
Feasibility of Goal Attainment Scaling as a patient-reported outcome measure for older patients in primary care
Authors: Stolee Paul , Mallinson Sara , Kernoghan Alison , Brierley Meaghan , Tong Catherine , Elliott Jacobi , Abdallah Lama 
Published: July 2023

Abstract
Background
Goal Attainment Scaling (GAS) is an outcome measure that reflects the perspectives and experiences of patients, consistent with patient-centred care approaches and with the aims of patient-reported outcome measures (PROMs). GAS has been used in a variety of clinical settings, including in geriatric care, but research on its feasibility in primary care practice has been limited. The time required to complete GAS is a barrier to its use by busy primary care clinicians. In this study, we explored the feasibility of lay interviewers completing GAS with older primary care patients.

Methods
Older adults were recruited from participants of a larger study in five primary care clinics in Alberta and Ontario, Canada. GAS guides were developed based on semi-structured telephone interviews completed by a non-clinician lay interviewer; goals were reviewed in a follow-up interview after six months.

Results
Goal-setting interviews were conducted with 41 participants. GAS follow-up guides could be developed for 40 patients (mean of two goals/patient); follow-up interviews were completed with 29 patients. Mobility-focused goals were the most common goal areas identified.

Conclusions
Study results suggest that it is feasible for lay interviewers to conduct GAS over the telephone with older primary care patients. This study yielded an inventory of patient goal areas that could be used as a starting point for future goal-setting interviews in primary care. Recommendations are made for use of GAS and for future research in the primary care context.