bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can muscle typology explain the inter‐individual variability in resistance training adaptations?
Authors: Van Vossel Kim , Hardeel Julie , Van de Casteele Freek , Van der Stede Thibaux , Weyns Anneleen , Boone Jan , Blemker Silvia Salinas , Lievens Eline , Derave Wim 
Published: April 2023

AbstractConsiderable inter‐individual heterogeneity exists in the muscular adaptations to resistance training. It has been proposed that fast‐twitch fibres are more sensitive to hypertrophic stimuli and thus that variation in muscle fibre type composition is a contributing factor to the magnitude of training response. This study investigated if the inter‐individual variability in resistance training adaptations is determined by muscle typology and if the most appropriate weekly training frequency depends on muscle typology. In strength‐training novices, 11 slow (ST) and 10 fast typology (FT) individuals were selected by measuring muscle carnosine with proton magnetic resonance spectroscopy. Participants trained both upper arm and leg muscles to failure at 60% of one‐repetition maximum (1RM) for 10 weeks, whereby one arm and leg trained 3×/week and the contralateral arm and leg 2×/week. Muscle volume (MRI‐based 3D segmentation), maximal dynamic strength (1RM) and fibre type‐specific cross‐sectional area (vastus lateralis biopsies) were evaluated. The training response for total muscle volume (+3 to +14%), fibre size (−19 to +22%) and strength (+17 to +47%) showed considerable inter‐individual variability, but these could not be attributed to differences in muscle typology. However, ST individuals performed a significantly higher training volume to gain these similar adaptations than FT individuals. The limb that trained 3×/week had generally more pronounced hypertrophy than the limb that trained 2×/week, and there was no interaction with muscle typology. In conclusion, muscle typology cannot explain the high variability in resistance training adaptations when training is performed to failure at 60% of 1RM.
imageKey points
This study investigated the influence of muscle typology (muscle fibre type composition) on the variability in resistance training adaptations and on its role in the individualization of resistance training frequency.
We demonstrate that an individual's muscle typology cannot explain the inter‐individual variability in resistance training‐induced increases in muscle volume, maximal dynamic strength and fibre cross‐sectional area when repetitions are performed to failure.
Importantly, slow typology individuals performed a significantly higher training volume to obtain similar adaptations compared to fast typology individuals.
Muscle typology does not determine the most appropriate resistance training frequency. However, regardless of muscle typology, an additional weekly training (3×/week vs. 2×/week) increases muscle hypertrophy but not maximal dynamic strength.
These findings expand on our understanding of the underlying mechanisms for the large inter‐individual variability in resistance training adaptations.
Response Mitigation of Floating Platform by Porous-Media-Tuned Liquid Dampers
Authors: Tsao Wen-Huai , Chen Ying-Chuan , Kees Christopher E. , Manuel Lance 
Published: April 2023

AbstractA porous-media-tuned liquid damper (PMTLD) can serve as an effective and economical dynamic vibration absorber. Placing porous media within a water tank can improve the capacity for energy dissipation and optimize the performance by varying its material properties. Two numerical models are adopted to simulate the sloshing problem in PMTLD and the dynamics of a floating platform in waves. Besides, the effectiveness of response mitigation can be verified numerically. The first potential-based approach employs a mixed-type boundary value problem (BVP) solver and a free-surface particle tracker. This approach not only simulates the inviscid water wave but also includes the nonlinear damping of the PMTLD via a quadratic Forchheimer term. Another equivalent mechanical model is used to reduce the degree-of-freedom of the PMTLD system. The Newmark method is incorporated to solve the rigid-body dynamics. The second viscous approach uses the finite element method (FEM) to spatially discretize the Navier–Stokes (NS) equations and handles the free surface via the volume of fluid (VOF) and the level set (LS) equations. The multiphase simulation is implemented by computational modeling toolkits, Proteus and Chrono, for the fluid and solid phases, respectively. The correlations between potential flow and two-phase NS models are presented. The PMTLD is designed by analogy with the tuned mass damper (TMD). Numerical results show that the PMTLD can effectively reduce the structure's dynamic response in terms of vibration amplitude around resonance. Such damping devices have great potential for offshore platforms and wind turbine design.
Variable Stiffness and Antagonist Actuation for Cable-Driven Manipulators Inspired by the Bird Neck
Authors: Muralidharan Vimalesh , Testard Nicolas , Chevallereau Christine , Abourachid Anick , Wenger Philippe 
Published: April 2023

Abstract
This paper discusses stiffness and antagonistic actuation in light-weight cable-driven bio-inspired manipulators suitable for safe interactions. Manipulators under study are built upon arranging in series several tensegrity joints, called “modules.” A comparative study of several modules revealed that the X module, in contrast to modules based on pivots, allows one to increase joint stiffness by increasing antagonistic input forces like during muscle coactivation. For a planar manipulator with N modules, antagonistic actuation schemes with 2N and N + 1 cables are proposed and compared. It is shown that the N + 1 cable actuation scheme allows controlling both the manipulator configuration and joint stiffness satisfactorily. As compared with a manipulator with 2N active cables, one on each side of each module, higher forces are required to achieve the manipulator configuration. However, the N + 1 cable actuation scheme is a reasonable solution that allows reducing the moving masses and cost.
Laryngeal tuberculosis in patients treated with adalimumab: a casual or causal connection?
Authors: Molinari Giulia , Rosti Alessandro , Presutti Livio , Marzocchi Guido 
Published: April 2023

This article presents two consecutive cases of laryngeal tuberculosis in patients treated with a specific anti-tumour necrosis factor-alpha (adalimumab), with a focus on their diagnostic process and therapeutic management. Both patients presented with aspecific chronic laryngeal symptoms that had been worsening for a few months in one case and for almost 1 year in the other one. They were both studied with fibreoptic laryngoscopy and contrast-enhanced CT and MRI scans. In both cases, the laryngeal biopsy proved negative to Ziehl-Neelsen test, while positive to Koch’s bacillus sensitive to rifampicin at PCR test. Both patients completely responded to standard antitubercular antibiotic therapy with rifampicin, isoniazid, pyrazinamide and etambutol protocol.In the differential diagnosis of such patients, laryngeal tuberculosis should be considered due to the reasonable linkage between the immunosuppressant therapy with adalimumab and the tuberculosis infection/reactivation.
Efficacy of ketamine mouthwash in the management of oral and pharyngeal toxicity associated with head and neck chemoradiotherapy: protocol for a phase II, Simon’s two-stage trial
Authors: Koffler Daniel , Eckstein Jacob , Herman Joseph , Martins-Welch Diana , Seetharamu Nagashree , Ghaly Maged , Kohn Nina , Potters Louis , Frank Douglas , Sullivan Kevin , Parashar Bhupesh 
Published: April 2023

IntroductionCurative intent treatment of head and neck cancer (HNC) is frequently radiation therapy over 7 weeks with concurrent chemotherapy. This regimen is effective but carries a burden of toxicity leading to severe pain and treatment breaks portending inferior outcomes. Conventional palliation methods include opioids, anticonvulsants and local anaesthetics. Breakthrough toxicities are nevertheless ubiquitous and present an urgent unmet need. Ketamine is an inexpensive drug with mechanisms of analgesia outside the opioid pathway including N-methyl-D-aspartate (NMDA) receptor antagonism and a pharmacologically unique property of opioid desensitisation. Systemic ketamine is validated in randomised controlled trials for efficacy in reducing pain and/or opioid burden in the oncologic setting. Literature supports peripherally administered ketamine for pain control without systemic toxicity. These data support our rationale of using ketamine mouthwash to decrease acute toxicity of curative treatment of HNC, the efficacy of which is our aim to elucidate.Methods and analysisThis is a phase II, Simon’s two-stage trial. Patients have pathologically confirmed HNC and an intended regimen of 70 Gy of radiation with concurrent cisplatin. The protocol is initiated on diagnosis of grade 3 mucositis and consists of 2 weeks of 4 times daily (QID) ketamine mouthwash use. The primary endpoint is pain response defined as a combination of pain score and opioid use. 23 subjects will be enrolled in stage 1. If statistical criteria are met, 33 subjects will be enrolled in stage 2. Secondary endpoints include daily pain, daily opioid use, dysphagia at baseline and completion, nightly sleep quality, feeding tube placement and any unscheduled treatment breaks.Ethics and disseminationAll trial data will be stored in an Institutional Review Board (IRB) approved database. The protocol is registered under Northwell IRB registration number #22-0292 and U.S. Food and Drug Administration (FDA) Investigational New Drug (IND) approval has been granted under IND number 161609. Results are intended to be published in an open-source journal and further data, statistics and source documents are available on request.Trial registration numberNCT05331131.
C reactive protein-guided prescription of antibiotics for children under 12 years with respiratory symptoms in Kyrgyzstan: protocol for a randomised controlled clinical trial with 14 days follow-up
Authors: Isaeva Elvira , Bloch Joakim , Poulsen Anja , Kurtzhals Jørgen , Reventlow Susanne , Siersma Volkert , Akylbekov Azamat , Sooronbaev Talant , Munck Aabenhus Rune , Kjærgaard Jesper 
Published: April 2023

IntroductionWhile lower respiratory tract infections are the main cause of death for children under 5 globally, only a small proportion of children with respiratory tract infections need antibiotics. Overuse of antibiotics globally is leading to increasing rates of antibiotic resistance. In Kyrgyzstan, healthcare workers regularly prescribe antibiotics when clinical uncertainty is present to err on the side of caution. Targeting antibiotic use with biomarkers of inflammation such as C reactive protein (CRP) testing at the point-of-care test (POCT) has been shown to reduce antibiotic use in general, but only few studies have been done in children and no studies exist from Central Asia. This study aims to assess whether the use of a CRP POCT can safely decrease prescription of antibiotics for children with acute respiratory symptoms in primary level healthcare centres in Kyrgyzstan.Methods and analysisMulticentre, open-label, individually randomised, controlled clinical trial with 14 days follow-up (follow-up by phone on days 3, 7 and 14) in rural lowland Chui and highland Naryn regions of Kyrgyzstan. The population are children aged 6 months to 12 years attending the primary level healthcare centres during normal business hours with acute respiratory symptoms. CRP POCT equipment will be supplied to healthcare centres, along with a short training session in CRP use, including the interpretation of results to support the clinical evaluation of the child with acute respiratory infection. The primary outcomes are the proportion of patients prescribed an antibiotic within 14 days of index consultation (superiority analysis) and days to recovery (non-inferiority analysis). Secondary outcomes are antibiotics prescribed at index consultation, reconsultations, hospital admission and vital status within 14 days. Analysis of the first primary outcome, antibiotic use, will be intention to treat using a logistic regression model. Analysis of the second primary outcome, days to recovery, will be per protocol using a linear regression model and a non-inferiority margin of 1 day.Ethics and disseminationThe study was approved on 18 June 2021 by the Ethics Committee (ref: no. 1) of the National Centre of Maternity and Childhood Care, Bishkek, Kyrgyzstan. The results of the study regardless of the conclusion will be presented at international conferences and published in peer-reviewed scientific medical journals along with policy briefs and technical reports.Trial registration numberNCT05195866.
Effects of oral immunonutritional supplement on 3-year disease-free survival in gastric cancer patients with pathological stage III after total gastrectomy (CRUCIAL): study protocol of a multicentre, randomised clinical trial
Authors: Zhou Da , Liu Yuxiu , Zhang Li , Lu Mengjie , Gao Xuejin , Li Guoli , Xiang Xiaosong , Xu Hao , Li Gang , Sun Zhiping , Wei Wei , Yi Kui , Zuo Junbo , Wu Yugang , Qian Jun , Zhou Jian , Duan Kaipeng , Wu Yong , Tian Zhiqiang , Jiang Chao , Wang Xinying 
Published: April 2023

IntroductionThe nutritional status of patients with gastric cancer (GC) after total gastrectomy continues to deteriorate and lasts a long time after discharge, which is an independent risk factor for mortality. Recent guidelines have recommended appropriate nutritional support after discharge for cancer surgery patients with malnutrition or nutritional risk. The evidence on the efficacy of oral immunonutritional supplement (INS) and its effect on long-term disease-free survival (DFS) in patients with GC is limited. This study was designed to test the hypothesis that oral INS compared to diet alone may improve 3-year DFS of GC patients with pathological stage III after total gastrectomy (Nutrition Risk Screening 2002 score ≥3 at discharge).Methods and analysisThis is a pragmatic, open-label, multicentre, randomised controlled study. 696 eligible GC patients with pathological stage III after total gastrectomy will be randomised in a 1:1 ratio to oral INS group or normal diet group for 6 months. The primary endpoint is 3-year DFS after discharge. The following secondary endpoints will be evaluated: 3-year overall survival; unplanned readmission rate at 3 and 6 months after discharge; quality of life, body mass index and haematological index at 3, 6 and 12 months after discharge; incidence of sarcopenia at 6 and 12 months after discharge; and the tolerance to chemotherapy. The adverse events of oral INS will also be evaluated during the intervention.Ethics and disseminationThis study was approved by the ethics committee of Jinling Hospital, Nanjing University (number 2021NZKY-069-01). The present study may validate the effectiveness of oral immunonutritional therapy in improving 3-year DFS for GC patients with pathological stage III after total gastrectomy for the first time. The results of this trial will be disseminated in peer-reviewed journals and at scientific conferences.Trial registration numberNCT05253716.
GRACE-trial: a randomised active-controlled trial for vulvovaginal atrophy in patients with breast cancer on endocrine therapy – study protocol
Authors: Vergauwen Glenn , Cools Piet , Denys Hannelore , Fiers Tom , Van de Vijver Koen , Veldeman Liv , Verstraelen Hans 
Published: April 2023

IntroductionBreast cancer is the most common cancer type in women worldwide. Due to hormone receptor positivity in the majority of the breast cancer tumours is endocrine therapy a crucial part in the treatment landscape of breast cancer. Endocrine therapy consists of the use of selective oestrogen-receptor modulators or aromatase inhibitors. These medicines generate a hypoestrogenic environment by reducing circulating oestrogen or by altering the effect of oestrogen on tissue cells by receptor blockade. As a common side effect, vulvovaginal atrophy occurs in the majority of patients with breast cancer using endocrine therapy. Vulvovaginal atrophy has a significant impact on physical and psychological well-being due to negative influence on quality-of-life, self-esteem and sexuality. As a consequence, adherence to endocrine therapy for the standard duration of 5–10 years is challenging, resulting in higher rates of therapy interruption, leading to poorer prognosis with shorter distant disease-free survival. The standard treatment for vulvovaginal atrophy in postmenopausal women is based on the use of local hormonal treatment. However, when a patient has a history of breast cancer, delay of treatment and undertreatment are ubiquitous.Methods and analysisIn this first ever prospective randomised trial patients with breast cancer on endocrine therapy with vulvovaginal atrophy will be treated with the available local treatment modalities with a 1:1:1:1 randomisation: oestrogen, dehydroepiandrosterone, moisturisers and a co-treatment of oestrogen and probiotics. Patient-reported outcomes measurements will be implemented to investigate the efficacy of the implemented treatments. Safety of the treatments will be evaluated by assessing systemic sex hormones concentrations.Ethics and disseminationThis study was approved by the Ethical Committee of Ghent University Hospital and by the Federal Agency for Medicines and Health Products. Results will be published in peer-reviewed journals and released in international conferences.Trial registration number2021-001921-31.
What learning strategies are commonly used by hospital pharmacists in the process of self-directed learning? A multicentre qualitative study
Authors: Yao Xiali , Li Hongye , Wen Linlin , Tian Yutong , Zhang Yan , Zhang Xiaojian , Du Shuzhang , Li Jun , Fu Hang , Yin Zhao 
Published: April 2023

ObjectiveAs lifelong learners, hospital pharmacists must continually improve their self-directed learning skills. Reasonable learning strategies have been proven to enhance self-directed learning (SDL) significantly. Therefore, this study aims to investigate the SDL strategies used by hospital pharmacists in depth to provide them with a reference for the development of their SDL skills.SettingThe study was conducted in three tertiary hospitals in Henan, China.Design and participantsThis study employed a multicentre qualitative design and lasted 12 months. One-on-one interviews and focus group discussions were used to collect data. All interviews were transcribed verbatim, and the interview data were analysed using the thematic analysis method. Purposive sampling was used to select interviewees (n=17) from three tertiary hospitals in Henan province in central China.ResultsAfter conducting data analysis, we summarised 12 learning strategies related to SDL, which were grouped into four themes: use of information resources, application of cognitive strategies, development of learning plans and use of learning platforms.ConclusionThe findings suggest that classic learning strategies, such as cognitive strategies and the development of learning plans, remain the cornerstones of hospital pharmacists’ SDL abilities, while contemporary advances in information technology and changes in learning concepts have enriched the learning resources and learning platforms that are available to hospital pharmacists and have confronted contemporary hospital pharmacists with certain challenges.
Clinical evidence for high-risk medical devices used to manage diabetes: protocol for a systematic review and meta-analysis
Authors: Bano Arjola , Laimer Markus , Wehrli Faina , Kunzler Juri , Rivero Tania , Fraser Alan G , Stettler Christoph , Hovorka Roman , Bally Lia 
Published: April 2023

IntroductionMedical devices, including high-risk medical devices, have greatly contributed to recent improvements in the management of diabetes. However, the clinical evidence that is submitted for regulatory approval is not transparent, and thus a comprehensive summary of the evidence for high-risk devices approved for managing diabetes in Europe is lacking. In the framework of the Coordinating Research and Evidence for Medical Devices group, we will, therefore, perform a systematic review and meta-analysis, which will evaluate the efficacy, safety and usability of high-risk medical devices for the management of diabetes.Method and analysisThis study has been reported according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. We will search Embase (Elsevier), Medline All (Ovid), Cochrane Library (Wiley), Science Citation Index Expanded and Emerging Sources Citation Index (Web of Science) to identify interventional and observational studies that evaluate the efficacy and/or safety and/or usability of high-risk medical devices for the management of diabetes. No language or publication dates’ limits will be applied. Animal studies will be excluded. In accordance with the Medical Device Regulation in European Union, high-risk medical devices are those in classes IIb and III. The following medical devices for diabetes management are considered as having a high risk: implantable continuous glucose monitoring systems, implantable pumps and automated insulin delivery devices. Selection of studies, data extraction and quality of evidence assessment will be performed independently by two researchers. Sensitivity analysis will be performed to identify and explain potential heterogeneity.Ethics and disseminationNo ethical approval is needed for this systematic review, as it is based in already published data. Our findings will be published in a peer-reviewed journal.PROSPERO registration numberCRD42022366871.
Oncology mortality: weekend and summer vacation effect
Authors: Rakici Sema Yilmaz , Terzi Ozlem 
Published: April 2023

ObjectivesIn this study, we investigated the effect of the weekend and summer vacation on mortality in patients with cancer.MethodsAll patient data were obtained from their hospital registry records and the Death Notification System of the Ministry of Health.ResultsThe majority of patients died in the hospital compared at home, 80.8% versus 19.2%, respectively. Patients aged <65 died mostly in hospital, which was the opposite of those aged ≥65, who died at home. While tumour location and histopathological type had no effect on the place of death, patients with metastasis (including single organ metastasis), diffuse metastases (diffuse metastases: multiple organ metastases) and patients with locally advanced stage disease were found to die more frequently in the hospital. Deaths in the hospital occurred most frequently in August, while deaths at home occurred most frequently in April and October. Deaths in the hospital occurred most frequently on Friday, Saturday and Sunday, while deaths at home occurred more frequently on Monday. It was determined that the deaths in the hospital were significantly higher at the weekend.ConclusionThis study contains data supporting the weekend effect in oncology patients. Moreover, it provides new data on the increased death rates in August, which coincides with the summer vacation leave month.