bluuebunny/crossref_metadata_2025_split huggingface dataset:
Kunming-Montreal Global Biodiversity Framework: Challenge and Future Options to Address Anthropogenic Underwater Noise
Authors: Maruf Maruf 
Published: June 2023

Abstract
The ocean, which plays an essential role in supporting human life, continues to deteriorate due to anthropogenic underwater noise. This unseen form of pollution is a significant emergent threat to marine and coastal biodiversity. Substantial discussions have occurred on the problem under the Convention on Biological Diversity (cbd) yet further action is needed. The adoption of the Kunming-Montreal Global Biodiversity Framework (gbf) in 2022 provides a potential partial solution to address the problem. This article reviews the current development of the gbf concerning the protection of the marine environment, particularly from the threat of anthropogenic underwater noise. It is argued that the gbf, along with its monitoring framework, could provide an opportunity to strengthen further action for the conservation of marine and coastal biodiversity against this problem. The importance of capacity-building to ensure that developing countries have the capacity to address anthropogenic underwater noise is emphasized.
A strategy for extending the processing temperature for polypropylene in foam extrusion and its theoretical validation
Authors: He Muzhen , Hu Shengfei 
Published: June 2023

The quite narrow PP foaming temperature window is the main challenge for continuous extrusion foaming of polypropylene (PP) using supercritical CO2. In this study, high impact polystyrene (HIPS) is added to PP to widen the polypropylene foaming temperature range by reducing the temperature sensitivity of the melt strength of the blend. The behavior of crystalline, dynamic rheology, and extensional rheological of PP/HIPS blends are analyzed. The results show that the crystallinity and crystallization temperature of PP/HIPS blends decreased significantly, the temperature dependence of the blends’ extensional viscosity and melt strength became weaker, and the activation energy of extensional viscosity and melt strength activation energy decreased, while the elastic modulus and viscosity and the system relaxation time increased. It means that the addition of HIPS reduces the crystallinity of PP, improves the cell morphology and to a certain extent overcomes the problem of a sharp decrease in PP melt strength with increasing temperature. The addition of HIPS extends the foaming temperature range of the PP material from 4 K to a maximum of 12 K. Furthermore, we simply estimated the temperature window for extruded foams using the Arrhenius equation. The estimated values have the same trend as the experimental results and are analyzed.
Physical and Chemical Compatibility of Medications Commonly Used in Critically Ill Patients With Balanced Crystalloids: A Systematic Review
Authors: Buckley Christopher T. , Farrar Julie E. , Schleicher Mary , Stollings Joanna L. , Duggal Abhijit , Bauer Seth R. 
Published: June 2023

Objective: Evaluate available evidence of physical and/or chemical compatibility of commonly used medications in critically ill patients with balanced crystalloids. Data sources: Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews were queried from inception to September 2022. Study selection and data extraction: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. English-language studies reporting physical and/or chemical compatibility data between 50 selected medications and balanced crystalloids were included. A previously designed tool to assess risk of bias was adapted for use. Data synthesis: Twenty-nine studies encompassing 39 (78%) medications and 188 unique combinations with balanced crystalloids were included. Combinations included 35 (70%) medications with lactated Ringer’s, 26 (52%) medications with Plasma-Lyte, 10 (20%) medications with Normosol, and one (2%) medication with Isolyte. Studies commonly evaluated physical and chemical compatibility (55.2%). More medications were evaluated via Y-site than admixture. Incompatibilities were identified in 18% of combinations comprising 13 individual drugs. Relevance to patient care and clinical practice: This systematic review evaluates the compatibility of select critical care medications with balanced crystalloid solutions. Results may be used as a tool to guide clinicians on balanced crystalloid compatibility, potentially increasing ubiquitous use and reducing patient exposure to normal saline. Conclusion and relevance: Data are limited regarding chemical/physical compatibility of commonly used medications in critically ill patients with balanced crystalloids. Additional compatibility studies are warranted, particularly methodologically rigorous studies assessing Plasma-Lyte, Normosol, and Isolyte. Of the evaluated medications, there was a low frequency of incompatibilities with balanced crystalloids.
The Prognostic Significance of Nomogram-Based Pretreatment Inflammatory Indicators in Patients With Esophageal Squamous Cell Carcinoma Receiving Intensity-Modulated Radiotherapy
Authors: Xu Zhiyang , Ke Hongqian , Zheng Binglin , Lin Chuyan , Zhang Yiping , Wang Liyan , Lin Yu , Ye Yuling , Cai Lifang , You Mengxing , Chen Junqiang , Xu Yuanji 
Published: June 2023

Background At present, there is no objective prognostic index available for patients with esophageal squamous cell carcinoma (ESCC) who underwent intensity-modulated radiotherapy (IMRT). This study is to develop a nomogram based on hematologic inflammatory indices for ESCC patients treated with IMRT. Methods 581 patients with ESCC receiving definitive IMRT were enrolled in our retrospective study. Of which, 434 patients with treatment-naïve ESCC in Fujian Cancer Hospital were defined as the training cohort. Additional 147 newly diagnosed ESCC patients were used as the validation cohort. Independent predictors of overall survival (OS) were employed to establish a nomogram model. The predictive ability was evaluated by time-dependent receiver operating characteristic curves, the concordance index (C-index), net reclassification index (NRI), and integrated discrimination improvement (IDI). Decision curve analysis (DCA) was performed to assess the clinical benefits of the nomogram model. The entire series was divided into 3 risk subgroups stratified by the total nomogram scores. Results Clinical TNM staging, primary gross tumor volume, chemotherapy, neutrophil-to-lymphocyte ratio and platelet lymphocyte ratio were independent predictors of OS. Nomogram was developed incorporating these factors. Compared with the 8th American Joint Committee on Cancer (AJCC) staging, the C-index for 5-year OS (.627 and .629) and the AUC value of 5-year OS (.706 and .719) in the training and validation cohorts (respectively) were superior. Furthermore, the nomogram model presented higher NRI and IDI. DCA also demonstrated that the nomogram model provided greater clinical benefit. Finally, patients with <84.8, 84.8-151.4, and >151.4 points were categorized into low-risk, intermediate-risk, and high-risk groups. Their 5-year OS rates were 44.0%, 23.6%, and 8.9%, respectively. The C-index was .625, which was higher than the 8th AJCC staging. Conclusions We have developed a nomogram model that enables risk-stratification of patients with ESCC receiving definitive IMRT. Our findings may serve as a reference for personalized treatment.
Investigating language transfer from a usage-based perspective
Authors: Barking Marie , Mos Maria , Backus Ad 
Published: June 2023

Aims and objectives: The aim of this study is to investigate language contact from a usage-based perspective. In particular, we test the explanatory power of a schematicity continuum, one of the central assumptions within usage-based approaches, in regard to these contact effects. In doing so, we aim to better understand how schematicity influences language transfer as well as learn more about the cognitive mechanism of schematicity itself. Design: The empirical focus of this study is on native German speakers living in the Netherlands who tend to experience a lot of language transfer from their second language Dutch to their native language German. The experiment consists of a production task containing constructions that differ in regard to their potential level of schematicity (i.e., lexically specific, partially schematic, fully schematic) and in the type of transfer that they might trigger (i.e., covert and overt transfer). Data and analysis: We compare production data of native German speakers living in the Netherlands ( N = 60) with those of a control group of speakers not in contact with Dutch ( N = 60), to establish whether the language use of these two groups differs. In addition, we analyze both speaker and item variation for the different constructions. Findings/conclusions: The speakers with Dutch contact show a number of contact effects, such as covert and overt transfer as well as hypercorrection regarding the use of certain constructions. Originality: The variation analysis reveals individual differences in how speakers use the different constructions. Some of these differences can be attributed to their mental levels of schematicity. Significance/implications: The study shows that transfer depends on schematicity. In doing so, it provides direct evidence for different levels of schematicity in speakers’ mental representations, demonstrating the usefulness of studying cognitive mechanisms within a language contact setting.
Associations of Telomere Length and Change With Cognitive Decline Were Modified by Sex and Race: The REGARDS Study
Authors: Chen Cheng , Yang Keming , Nan Hongmei , Unverzagt Frederick , McClure Leslie A. , Irvin Marguerite R. , Judd Suzanne , Cushman Mary , Kamin Mukaz Debora , Klaunig James E. , D'Alton Mary E. , Kahe Ka 
Published: June 2023

Introduction We examined the associations of baseline telomere length (TL) and TL change with cognitive function over time in older US adults, as well as differences by sex and race. Methods A total of 1820 cognitively healthy individuals (median baseline age: 63 years) were included. Telomere length was measured using qPCR-based method at baseline and among 614 participants in the follow-up examination 10 years later. Cognitive function was assessed by a four-test battery every 2 years. Results In multivariable-adjusted linear mixed models, longer baseline TL and smaller attrition/lengthening of TL over time were associated with better Animal Fluency Test score. Longer baseline TL was also linearly associated with better Letter Fluency Test score. The observed associations were consistently more pronounced in women than men and in Black compared to White participants. Discussion Telomere length may be a biomarker that predicts long-term verbal fluency and executive function, particularly in women and Black Americans.
Anterior Interosseus to Ulnar Motor Nerve Transfers: A Canadian Perspective
Authors: Chambers Spencer B. , Wu Kitty Y. , Ross Douglas C. , Gillis Joshua A. 
Published: June 2023

Background: The anterior interosseus nerve (AIN) to ulnar motor nerve transfer has been popularized as an adjunct to surgical decompression in patients with severe cubital tunnel syndrome (CuTS) and high ulnar nerve injuries. The factors influencing its implementation in Canada have yet to be described. Methods: An electronic survey was distributed to all members of the Canadian Society of Plastic Surgery (CSPS) using REDCap software. The survey examined 4 themes: previous training/experience, practice volume of nerve pathologies, experience with nerve transfers, and approach to the treatment of CuTS and high ulnar nerve injuries. Results: A total of 49 responses were collected (12% response rate). Of all, 62% of surgeons would use an AIN to ulnar motor supercharge end-to-side (SETS) transfer for a high ulnar nerve injury. For patients with CuTS and signs of intrinsic atrophy, 75% of surgeons would add an AIN-SETS transfer to a cubital tunnel decompression. Sixty-five percent would also release Guyon’s canal, and the majority (56%) use a perineurial window for their end-to-side repair. Eighteen percent of surgeons did not believe the transfer would improve outcomes, 3% cited lack of training, and 3% would preferentially use tendon transfers. Surgeons with hand fellowship training and those less than 30 years in practice were more likely to use nerve transfers in the treatment of CuTS ( P < .05). Conclusions: Most CSPS members would use an AIN-SETS transfer in the treatment of both a high ulnar nerve injury and severe CuTS with intrinsic atrophy.
Intralipid infusion therapy as an adjunct treatment in women experiencing adenomyosis-related infertility
Authors: Henshaw James , Tremellen Kelton 
Published: June 2023

Background: Currently, there is some evidence that adenomyosis patients using gonadotropin-releasing hormone (GnRH) agonist long downregulation (LDR) prior to embryo transfer may improve in vitro fertilization (IVF) success rate, but not to the baseline expected success where there is no adenomyosis. Given the association between adenomyosis and an aberrant endometrial immune environment, many physicians also use prednisolone or Intralipid adjuvant treatments in combination with GnRH agonist therapy, despite neither being of proven benefit. Objective: The purpose of this study was to investigate whether the addition of prednisolone or Intralipid immune therapy to GnRH agonist LDR improves fertility outcomes in patients with adenomyosis. Methods: This is a retrospective cohort study of 116 consecutive adenomyosis patients who underwent their first transfer of a genetically screened euploid embryo between January 2019 and December 2020 at a private IVF clinic. Results: There was no difference in maternal age, body mass index, number of embryo’s transferred and gravidity or parity among the three treatment groups. Patients who received Intralipid had a poorer prognosis with a longer duration of infertility (4 years) and a higher number of previous embryo transfers (ETs, 5 previous ETs) compared to the comparison groups. Logistic regression analysis adjustment for all covariates revealed that LDR plus Intralipid therapy produced significantly higher live birth rates (LBRs; 60%) compared to LDR alone (40% LBR); yet, the addition of prednisolone to GnRH agonist LDR (30% LBR) provided no additional live birth benefit. Conclusion: In this retrospective analysis, we showed Intralipid adjuvant treatment in combination with GnRH agonist therapy in adenomyosis patients undergoing IVF resulted in a LBR expected in women without adenomyosis using preimplantation genetic testing screened embryos. This benefit was not seen when using prednisolone as an adjuvant to GnRH agonist LDR. Future randomized clinical trials will be required to confirm the therapeutic benefit of Intralipid in combination with GnRH agonist therapy.
Saline at lower tonicity in cystic fibrosis (SALTI-CF) trial comparing 0.9%versus3%versus6% nebulised saline
Authors: Dwyer Tiffany J. , Elkins Mark R. , Dentice Ruth , Forbes Samantha , Cooper Peter , Jaffe Adam , Bishop Jennifer , Middleton Peter G. , Wark Peter , Bye Peter T.P. 
Published: June 2023

BackgroundIn people with cystic fibrosis (CF), regular nebulisation of 6% or 7% saline improves lung function; however, these concentrations are not always tolerable. Clinically, some CF patients report using lower concentrations of saline to improve tolerability, yet the effects of lower concentrations are unknown. This study therefore aimed to evaluate the relative effectiveness and tolerability of 0.9%versus3%versus6% saline nebulised twice daily with an eFlow rapid nebuliser.MethodsThis was a randomised, blinded, placebo-controlled, parallel-group, multicentre study where subjects inhaled 4 mL of 0.9%, 3% or 6% saline twice daily for 16 weeks. The primary outcome was forced expiratory volume in 1 s. The secondary outcomes were: forced vital capacity (FVC) and forced expiratory flow at 25–75% of FVC; quality of life; exercise capacity; acquisition or loss of bacterial organisms in expectorated sputum; tolerability of nebulised saline; pulmonary exacerbations; and adverse events.Results140 participants were randomised to 0.9% (n=47), 3% (n=48) or 6% (n=45) saline. 134 participants (96%) contributed to the intention-to-treat analysis. 3% saline significantly improved lung function and increased the time to first pulmonary exacerbation compared with 0.9% saline but did not improve quality of life. 6% saline had similar benefits to 3% saline but also significantly improved quality of life compared with 3% saline. Only 6% saline delayed the time to intravenous antibiotics for pulmonary exacerbation. Tolerability and adherence were similar.ConclusionsDilution of 6% saline to 3% maintains the benefits for lung function and exacerbation prevention; however, the positive impacts of 6% saline on quality of life and time toi.v.antibiotics for pulmonary exacerbations are lost.
The role of oral appliance therapy in obstructive sleep apnoea
Authors: Johal Ama , Hamoda Mona M. , Almeida Fernanda R. , Marklund Marie , Tallamraju Harishri 
Published: June 2023

There is now widespread recognition within the world of sleep medicine of the increasing importance of dental sleep medicine and, in particular, the role of oral appliance therapy (OAT) in the management of adults with obstructive sleep apnoea (OSA). For the purpose of this review, the term OAT refers to a custom-made intra-oral appliance, which acts to posture the mandible in a forward and downward direction, away from its natural resting position. Whilst nasally applied continuous positive airway pressure remains the “gold standard” in nonsurgical OSA management, OAT remains the recognised alternative treatment.This review of OAT aims to provide an evidence-based update on our current understanding of their mode of action, exploring the potential anatomical and physiological impact of their use in preventing collapse of the upper airway; the current clinical practice guidelines, including the recently published National Institute of Clinical Excellence 2021 guidance, in conjunction with the American Academy of Sleep Medicine and American Academy of Dental Sleep Medicine; optimal design features, comparing the role of custom-madeversusnoncustom OAT devices and the importance of titration in achieving a dose-dependent effect; patient predictors, preference and adherence to OAT; its impact on a range of both patient- and clinician-centred health outcomes, with a comparison with CPAP; the limitations and side-effects of providing OAT; and, finally, a look at future considerations to help optimise the delivery and outcomes of OAT.
Development and validation of a screening tool for SPondyloArthritis Screening in Sub-Saharan Africa: SpASSS questionnaire
Authors: Lebughe Litite P , Westhovens R. , Nkodila A. , Malemba J. J. , de Vlam K. 
Published: June 2023

Abstract
Objective
To develop and validate a screening tool to identify patients with a high likelihood for Spondyloarthritis (SpA) in the Democratic Republic of the Congo (DR Congo).

Methods
The development of the SpA Screening questionnaire in Sub Saharian Africa (SpASSS) questionnaire followed 3 steps: The item generation was carried out by a systematic literature review according to the PRISMA guidelines on the clinical manifestations of SpA, interviewing clinical experts and the classification criteria for Spondyloarthritis. The candidate questions were tested in a population of 50 consecutive patients with confirmed diagnosis of spondyloarthritis, in a control population of rheumatic disease excluding SpA and in a group of 200 non-rheumatic participants, randomly chosen in the general population for question reduction and validation. Descriptive statistical analyses were performed to assess socio-demographic characteristics and response distribution for each item. Their diagnostic performance was investigated using ROC curves. For validation, principal component analysis was performed using factor analysis. Referral strategy score for SpA was determined by adjusted Cronbach’s alpha coefficient.

Results
Mean ± SD age of SpA cases was 41.8 ± 14.4 years, 56% were men compared to diseased controls 60.0 ± 12.5 years, 28.7% men (p < 0.001). 14/20 items showed a statistically significant difference (p < 0.05) between SpA cases and control groups. All items were factorable and 6 components were identified. Only the two first components (C1 with 8 items, C2 with 3 items) showed a significant threshold for reliability in detection of suspected SpA with a Cronbach's alpha of 0.830 and 0.708. All validated items of these two components showed the global reliability threshold with α-adjusted Cronbach calculated at 66.9%. The performance for correctly screening SpA was demonstrated with an area under the curve of 0.938 (0.884–0.991) and 0.794 (0.728–0.861) for C1 and C2 respectively.

Conclusions
This validation and item reduction of the SpASSS questionnaire for SpA might identify patients to refer for case ascertainment and will help conducting future epidemiological and clinical studies in the DR Congo.

Strengths and limitations of this study
• To the best of our knowledge, this is the first study in Sub-Saharan Africa based on local data to develop a screening tool for SpA in the population for epidemiological and clinical use.
• Referral strategies based on context-specific data are necessary to provide accurate case definition and epidemiological data, thus reducing methodological bias.
• In the SpA group, no discrimination was made regarding SpA subtypes, disease duration, activity and severity.
Factors associated with loneliness in immigrant and Canadian-born older adults in Ontario, Canada: a population-based study
Authors: Lu Mindy , Bronskill Susan E. , Strauss Rachel , Boblitz Alexa , Guan Jun , Im James H.B. , Rochon Paula A. , Gruneir Andrea , Savage Rachel D. 
Published: June 2023

Abstract
Background
While loneliness is common in older adults, some immigrant groups are at higher risk. To inform tailored interventions, we identified factors associated with loneliness among immigrant and Canadian-born older adults living in Ontario, Canada.

Methods
We conducted a cross-sectional analysis of 2008/09 data from the Canadian Community Health Survey (Healthy Aging Cycle) and linked health administrative data for respondents 65 years and older residing in Ontario, Canada. Loneliness was measured using the Three-Item Loneliness Scale, with individuals categorized as ‘lonely’ if they had an overall score of 4 or greater. For immigrant and Canadian-born older adults, we developed separate multivariable logistic regression models to assess individual, relationship and community-level factors associated with loneliness.

Results
In a sample of 968 immigrant and 1703 Canadian-born older adults, we found a high prevalence of loneliness (30.8% and 34.0%, respectively). Shared correlates of loneliness included low positive social interaction and wanting to participate more in social, recreational or group activities. In older immigrants, unique correlates included: widowhood, poor health (i.e., physical, mental and social well-being), less time in Canada, and lower neighborhood-level ethnic diversity and income. Among Canadian-born older adults, unique correlates were: female sex, poor mental health, weak sense of community belonging and living alone. Older immigrant females, compared to older immigrant males, had greater prevalence (39.1% vs. 21.9%) of loneliness.

Conclusions
Although both groups had shared correlates of loneliness, community-level factors were more strongly associated with loneliness in immigrants. These findings enhance our understanding of loneliness and can inform policy and practice tailored to immigrants.