bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of clinical features and surgical outcomes between hypopnea‐ and apnea‐predominant obstructive sleep apnea
Authors: Rha Min‐Seok , Jeong Yeonsu , Alyahya Khalid A. , Yoon Joo‐Heon , Kim Chang‐Hoon , Cho Hyung‐Ju 
Published: November 2022

AbstractObjectivesThis study is aimed to investigate the differences in the clinical features and surgical outcomes between hypopnea‐ and apnea‐predominant obstructive sleep apnea (OSA).DesignCohort study.SettingSingle tertiary care centre.ParticipantsThis study included 190 patients with OSA who underwent multilevel upper airway surgery between September 2012 and September 2021. The patients were divided into two groups according to the proportion of each respiratory event: hypopnea‐predominant (n = 102) and apnea‐predominant (n = 88).Main Outcome MeasuresThe primary outcome measure was the percentage improvement in the apnea‐hypopnea index (AHI) from baseline AHI after surgery.ResultsThe apnea‐predominant group included more male patients and had higher AHI, respiratory disturbance index (RDI) and oxygen desaturation index (ODI) than the hypopnea‐predominant group. Both groups showed significant improvements in AHI, apnea index, RDI, supine AHI, REM AHI, non‐REM AHI, ODI, lowest O2 saturation and Epworth Sleepiness Scale scores following the surgery. Notably, hypopnea index increased after surgery in the apnea‐predominant OSA group. Although the improvement in the absolute value of AHI by surgery was significantly greater in the apnea‐predominant group than in the hypopnea‐predominant group, the two groups showed no significant difference in the percentage improvement in AHI from baseline AHI.ConclusionPatients with apnea‐predominant OSA had more severe disease than those with hypopnea‐predominant OSA; however, surgical outcomes, as evaluated by percentage AHI improvement, were comparable between the two groups. In addition, multilevel upper airway surgery may induce the transition from apnea to hypopnea in patients with apnea‐predominant OSA.
Effect of operative time on complications associated with free flap reconstruction of the head and neck
Authors: Irawati Nina , Every James , Dawson Rebecca , Leinkram David , Elliott Michael , Ch'ng Sydney , Low Hubert , Palme Carsten E. , Clark Jonathan , Wykes James 
Published: November 2022

AbstractObjectiveTo evaluate whether prolonged operative time is negatively associated with post‐operative complications and length of stay in patients undergoing microvascular free flap reconstruction for complex head and neck defects.Methods342 consecutive patients undergoing microvascular reconstruction for head and neck defects between 2017–2019 at a single institution were evaluated. Operative outcomes and operative time were compared whilst controlling for patient and treatment related factors.ResultsMean operative time was 551 min and length of stay was 16.2 days. An 11% increase in the risk of a post‐operative complication was observed for every additional hour of operative time (OR 1.11, 95% CI 1.03–1.21, p = 0.011) after adjusting for patient and treatment factors. A cut‐off of 9 h yielded a 92% increase in complications on either side of this (OR 1.92, 95% CI 1.18–3.13, p = 0.009). Increased operative time was also associated with increased length of stay and return to theatres, but not medical complications.ConclusionProlonged operative time is significantly associated with increased surgical complications, length of stay and return to theatres when performing microvascular reconstructive surgery for head and neck defects.
Subjective voice change was associated with appendicular skeletal muscle mass in elderly men, but not in women: A cross‐sectional study
Authors: Chang Suk Won , Lim Gil‐Chai , Kang Ju Wan 
Published: November 2022

AbstractObjectivesTo investigate the relationship between subjective voice changes and appendicular skeletal muscle in the elderly in Korea.DesignRetrospective cross‐sectional study.SettingPopulation‐based survey data were collected by the Korean National Health and Nutrition Examination Survey between January 2009 and December 2011.ParticipantsA total of 2611 participants (1081 men and 1530 women) aged 65 to 80 years were enrolled in the Korean National Health and Nutrition Examination Survey from 2009 to 2011. A 70‐degree laryngeal endoscopy was performed to check for abnormalities in the larynx, while dual‐energy x‐ray absorptiometry was utilised to measure appendicular skeletal muscle mass. The correlation between subjective voice change and appendicular skeletal muscle index (ASMI) was analysed using a linear‐by‐linear association test and logistic regression analysis.ResultsWhen comparing ASMI according to the presence or absence of subjective voice change, elderly men showed significantly lower ASMI values when subjective voice change was present (p = .021). However, in women, the ASMI was not significantly lower in the presence of subjective voice changes (p = .365). We confirmed that subjective voice change was significantly lower in the highest quintile of ASMI compared to lowest quintile of ASMI in the men using logistic regression analysis (B 0.281, 95% confident interval 0.082–0.964, p < .044).ConclusionsThis study has shown that in Korean men aged >65 years, subjective voice abnormality significantly increased as skeletal muscle mass decreased. Further longitudinal studies are needed to determine whether a correlation exists between objective voice test results and ASMI.
Pharmacology of inhibitors of Janus kinases – Part 1: Pharmacokinetics
Authors: Eichner Adina , Wohlrab Johannes 
Published: November 2022

SummaryThe use of Janus kinase inhibitors for the treatment of chronic inflammatory diseases is increasingly establishing itself as a treatment option for several indications. In order to make clinical use efficient, pharmacological knowledge of the JAK/STAT signaling pathway and the special features of the pharmacokinetics of the individual drugs is essential. The JAK/STAT signaling pathway is regulated at several levels (receptor, kinase, STAT and SOCS levels), so when Janus kinase inhibitors are used, the clinically relevant pharmacodynamics are highly dependent on the dose regimen, treated indication, comedication and comorbidity. For all practical purposes, it is therefore of great importance to recognize that the factors mentioned above can have a relevant influence on the therapeutic benefit of the use of Janus kinase inhibitors. Against this background, it is particularly important to use the Janus kinase inhibitors in accordance with their approval.
Progressing delineations of key biodiversity areas for seabirds, and their application to management of coastal seas
Authors: Handley Jonathan M. , Harte Emma , Stanworth Andrew , Poncet Sally , Catry Paulo , Cleminson Sacha , Crofts Sarah , Dias Maria 
Published: November 2022

AbstractAimDecision‐making products that support effective marine spatial planning are essential for guiding efforts that enable conservation of biodiversity facing increasing pressures. Key Biodiversity Areas (KBAs) are a product recently agreed upon by an international network of organizations for identifying globally important areas. Utilizing the KBA framework, and by developing a conservative protocol to identify sites, we identify globally importants places for breeding seabirds throughout the coastal seas of a national territory. We inform marine spatial planning by evaluating potential activities that may impact species and how a proposed network of Marine Management Areas (MMAs) overlap with important sites.LocationSouthwest Atlantic Ocean.MethodsWe collated a national inventory of all breeding locations for seabirds, including abundance records where available, and complementary estimates of at‐sea distribution. We delineated areas of importance in coastal seas following approaches tailored to the ecology of species and assessed areas against global KBA criteria. To determine opportunities for species conservation and management, we reviewed which human activities have been documented to impact the target species globally via IUCN Red List accounts, and also assessed the overlap of important sites with a proposed MMA network.ResultsWe identified global KBAs for nine seabird species (Anatidae, Diomedeidae, Laridae, Procellariidae, Spheniscidae, Stercorariidae) throughout national coastal seas. Globally important areas where multiple species overlapped were only partially accounted for in key zones of the proposed MMA network.Main ConclusionsDevelopment of a conservative protocol to identify marine sites for assessment against KBA criteria, revealed opportunities for enhancing a network of proposed Marine Management Areas in coastal seas. The framework we apply in this study has broad relevance for other systems where the design or review of management plans for the marine environment is required.
Comparison of two titration programmes for adding insulin detemir to oral antidiabetic drugs in patients with poorly controlled type 2 diabetes mellitus
Authors: Liu Sung‐Chen , Chuang Shih‐Ming , Wang Chao‐Hung , Chien Ming‐Nan , Lee Chun‐Chuan , Chen Wei‐Che , Leung Ching‐Hsiang , Lin Jiun‐Lu 
Published: November 2022

AbstractAimTo explore the effect of active insulin titration versus usual titration on glycaemic control in patients with type 2 diabetes mellitus uncontrolled with oral antidiabetic drugs (OADs).MethodsIn a 24‐week, prospective and randomized study, 172 patients with uncontrolled type 2 diabetes were randomly assigned to either active titration or usual titration. Efficacy and safety outcomes included changes in glycated haemoglobin (HbA1c) and fasting plasma glucose, percentage of individuals achieving HbA1c<53 mmol/mol, and hypoglycaemic events.ResultsAt Week 24, change in HbA1c was −1.08% ± 1.60% in the active titration group and −0.95% ± 1.34% in the usual titration group (P = 0.569). The percentages of individuals achieving HbA1c<53 mmol/mol were 29.4% and 16.1% in the active and usual titration groups, respectively (P = 0.037). There was no significant difference in the incidence of hypoglycaemia between the two groups. Multivariate logistic regression indicated that, with active titration, baseline HbA1c levels and postprandial glucose excursion were significantly associated with achieving HbA1c<53 mmol/mol.ConclusionAddition of basal insulin using active titration for 24 weeks provided a higher rate of HbA1c target achievement without significant hypoglycaemia compared to usual titration in individuals with uncontrolled type 2 diabetes.
Management of polycythemia vera: A survey of treatment patterns in Italy
Authors: Palumbo Giuseppe Alberto , Breccia Massimo , Baratè Claudia , Bonifacio Massimiliano , Elli Elena Maria , Iurlo Alessandra , Pugliese Novella , Rossi Elena , Guglielmelli Paola , Palandri Francesca 
Published: November 2022

AbstractObjectivesPolycythemia vera (PV) is an acquired clonal hematopoietic stem cell disorder characterized by the overproduction of red blood cells. It has long been underlined that there are differences in treatment patterns in routine practice. Therapeutic strategies have also expanded, and in recent years the JAK1/JAK2 inhibitor ruxolitinib has emerged as a second‐line therapeutic option in patients who are intolerant to or resistant to hydroxyurea. Determining the impact of changes on practice patterns is of interest, especially for aspects that lack detailed guidance for management.MethodsTo gain insights into treatment patterns by clinicians treating patients with PV in Italy, we carried out a survey of 60 hematologists and transfusion specialists. The questions covered: treatment of low‐risk patients, definition of significant leukocytosis, splenomegaly and excessive phlebotomies, resistance/intolerance to hydroxyurea, use of ruxolitinib, cytoreductive therapy, and vaccines.ResultsIn general, the results of the survey indicate that there is a large heterogeneity in management of patients with PV across these areas.ConclusionsWhile helping to provide greater understanding of treatment patterns for patients with PV in Italy, our survey highlights the need for additional clinical studies to obtain more precise guidance for the routine care of patients with PV.
Small G protein RAC‐2 regulates forgetting via the JNK‐1 signalling pathway in Caenorhabditis elegans
Authors: Bai Hua , Huang Hui , Zhao Ninghui , Gu Huan , Li Yixin , Zou Wei , Wu Tingting , Huang Xiaowei 
Published: November 2022

AbstractAlthough forgetting was once regarded as a passive decline in memory and an occasional source of embarrassment, recent research suggests that it is an active biological process of removing outdated or irrelevant memories via activation of specific genes and signal transduction pathways. Rho family G proteins are known to have a role in synaptic plasticity mediated by the actin cytoskeleton. However, the current study reveals that another Rho guanosine triphosphate enzyme (GTPase), RAC‐2, facilitates the occurrence of forgetting in Caenorhabditis elegans independent of actin dynamics. Functioning downstream of RAC‐2 in the same signalling pathway, JNK‐1 and its phosphorylated protein are required to positively regulate forgetting. The pan‐neuronal rescue of RAC‐2 or JNK‐1, instead of AWC neuron‐specific expression, reverses the delayed forgetting caused by the rac‐2 mutation, which indicates that the involvement of RAC‐2/JNK‐1 in more than AWCs must be required. In summary, our work elucidates the action of the Rho GTPase RAC‐2 and downstream JNK‐1 as a potential novel pathway in forgetting in C. elegans.
The unique role of stigma in migraine‐related disability and quality of life
Authors: Seng Elizabeth K. , Shapiro Robert E. , Buse Dawn C. , Robbins Matthew S. , Lipton Richard B. , Parker Amanda 
Published: November 2022

AbstractBackgroundStigma is increasingly recognized as an important social feature of living with migraine.MethodsAdults with migraine recruited from neurology offices completed the validated Stigma Scale for Chronic Illnesses 8‐item version (SSCI‐8); two outcome measures (the Migraine Disability Assessment [MIDAS] and the Migraine‐Specific Quality of Life Questionnaire v 2.1 [MSQ]); and measures of allodynia (Allodynia Symptom Checklist [ASC‐12]), pain cognition (Pain Catastrophizing Scale [PCS]), and psychiatric symptoms (Patient Reported Measurement Information System Anxiety [PROMIS‐A] and Depression [PROMIS‐D]). Pearson and Spearman correlations evaluated bivariate relationships, and linear (MSQ) and logistic (MIDAS Severe Disability, scores ≥21) regressions evaluated the unique variance associated with SSCI‐8 beyond other study variables. Conditional process analysis evaluated mediation hypotheses between study variables.ResultsParticipants (n = 121) reported levels of stigma on par with other chronic illnesses (SSCI‐8 M = 53.0, standard deviation [SD] = 7.8), with 25/127 (19.6%) reporting clinically significant levels of stigma (SSCI‐8 T‐score ≥ 60). Higher SSCI‐8 scores were associated with higher monthly headache day frequency (r = 0.35), MIDAS (ρ = 0.41), ASC‐12 (r = 0.24,p < 0.01), PCS (r = 0.46), both PROMIS‐A (r = 0.43) and D (r = 0.42), and lower MSQ subscale scores (Role Restrictionr = −0.50; Role Preventionr = −0.48; Emotion Functionr = −0.50), allps <0.001 unless otherwise noted. The SSCI‐8 contributed significantly beyond migraine symptoms and other psychological factors for MSQ Emotion Function (5% unique variance) and MIDAS Severe Disability (6% of unique variance). The SSCI‐8 mediated relationships between headache frequency and the MSQ subscales and MIDAS Severe Disability. The PCS mediated relationships between the SSCI‐8 and MSQ subscales. The PROMIS‐D mediated relationships between the SSCI‐8 and MSQ Role Restriction and MSQ Role Prevention.ConclusionsMigraine stigma has medium to large associations with migraine outcomes and psychiatric symptoms and is independently associated with migraine disability and emotion‐related quality of life. Migraine stigma is an important contributor to the relationship between headache frequency and migraine outcomes.
Product design in monopolistic competition
Authors: Dindaroglu Burak 
Published: November 2022

AbstractWe consider a model of monopolistic competition where producers can manipulate an elasticity parameter at an early stage. We interpret this as a choice of product specialization. Lower marginal costs of production lead to more generic products in all equilibria, which lead to fewer varieties under free‐entry. Entry of a new firm increases overall specialization and increases prices, that is, the environment exhibits price‐increasing competition. The loss of consumer surplus due to higher prices and lower consumption is compensated by the value of additional variety, hence entry also increases consumer surplus. Therefore, price‐increasing competition need not be anticompetitive under endogenous specialization.
Effect of Aloevera gel /tamarind starch/whey protein based edible coating on shelf life and postharvest quality of ber fruit (Ziziphusmauritiana) stored at 4 ± 1°C and at 25 ± 2°C
Authors: Bhadu Shweta , Ghoshal Gargi , Goyal Meenakshi 
Published: November 2022

SummaryThe research was conducted on ber fruit (Ziziphusmauritiana), in which an edible coating of aloe vera gel/tamarind starch/whey protein concentrate was prepared, applied on ber fruit by dipping method, and packed in polyethylene terephthalate (PET), polypropylene (PP) and polyethylene (PE) to evaluate the effectiveness of the edible coating on the postharvest quality and shelf life. A comparative study between uncoated and coated samples at two different temperatures, i.e., 4 ± 1 °C and 25 ± 2 °C was done. Bers' physiochemical analysis and sensory quality were evaluated for 31 days. The weight loss, pH, TSS, titratable acidity, total sugar, total protein and total phenol in coated ber kept in PP were 37.48%, 5.50, 14.4°Brix, 0.14%, 11.99%, 0.55% and 0.17% by the 27th day of storage at 4 ± 1 °C which turned out to be the best storage condition by showing a delay in the physiochemical changes. Edible coating delayed the loss of firmness and the change in the L*, a* and b* values.
Gene expression differentials driven by mass rearing and artificial selection in black soldier fly colonies
Authors: Hull Kelvin L. , Greenwood Matthew P. , Lloyd Melissa , Bester‐van der Merwe Aletta E. , Rhode Clint 
Published: November 2022

AbstractThe micro‐evolutionary forces that shape genetic diversity during domestication have been assessed in many plant and animal systems. However, the impact of these processes on gene expression, and consequent functional adaptation to artificial environments, remains under‐investigated. In this study, whole‐transcriptome dynamics associated with the early stages of domestication of the black soldier fly (BSF),Hermetia illucens, were assessed. Differential gene expression (DGE) was evaluated in relation to (i) generational time within the cultured environment (F2 vs. F3), and (ii) two selection strategies [no artificial selective pressure (NS); and selection for greater larval mass (SEL)]. RNA‐seq was conducted on 5th instar BSF larvae (n = 36), representing equal proportions of the NS (F2 = 9; F3 = 9) and SEL (F2 = 9; F3 = 9) groups. A multidimensional scaling plot revealed greater gene expression variability within the NS and F2 subgroups, while the SEL group clustered separately with lower levels of variation. Comparisons between generations revealed 898 differentially expressed genes (DEGs; FDR‐correctedp < 0.05), while between selection strategies, 213 DEGs were observed (FDR‐correctedp < 0.05). Enrichment analyses revealed that metabolic, developmental, and defence response processes were over‐expressed in the comparison between F2 and F3 larvae, while metabolic processes were the main differentiating factor between NS and SEL lines. This illustrates the functional adaptations that occur in BSF colonies across generations due to mass rearing; as well as highlighting genic dynamics associated with artificial selection for production traits that might inform future selective breeding strategies.
Testicular hypoplasia in Nellore Cattle: Genetic analysis and functional analysis of genome‐wide association study results
Authors: Silva Thales de Lima , Gondro Cedric , Fonseca Pablo Augusto de Souza , da Silva Delvan Alves , Vargas Giovana , Neves Haroldo Henrique de Rezende , Filho Ivan Carvalho , Teixeira Caio de Souza , Albuquerque Lucia Galvão de , Carvalheiro Roberto 
Published: November 2022

AbstractCharacterized by the incomplete development of the germinal epithelium of the seminiferous tubules, Testicular hypoplasia (TH) leads to decreased sperm concentration, increased morphological changes in sperm and azoospermia. Economic losses resulting from the disposal of affected bulls reduce the efficiency of meat production systems. A genome‐wide association study and functional analysis were performed to identify genomic windows and the underlying positional candidate genes associated with TH in Nellore cattle. Phenotypic and pedigree data from 207,195 animals and genotypes (461,057 single nucleotide polymorphism, SNP) from 17,326 sires were used in this study. TH was evaluated as a binary trait measured at 18 months of age. A possible correlated response on TH resulting from the selection for scrotal circumference was evaluated by using a two‐trait analysis. Thus, estimated breeding values were calculated by fitting a linear‐threshold animal model in a Bayesian approach. The SNP effects were estimated using the weighted single‐step genomic BLUP method. Twelve non‐overlapping windows of 20 adjacent SNP that explained more than 1% of the additive genetic variance were selected for candidate gene annotation. Functional and gene prioritization analysis of the candidate genes identified genes (KHDRBS3, GPX5, STAR, ERLIN2), which might play an important role in the expression of TH due to their known roles in the spermatogenesis process, synthesis of steroids and lipid metabolism.
Empirical assessment of fragility index based on a large database of clinical studies in the Cochrane Library
Authors: Xing Aiwen , Lin Lifeng 
Published: November 2022

AbstractRationale Aims and ObjectivesThe fragility index (FI) and fragility quotient (FQ) are increasingly used measures for assessing the robustness of clinical studies with binary outcomes in terms of statistical significance. The FI is the minimum number of event status modifications that can alter a study result's statistical significance (or nonsignificance), and the FQ is calculated as the FI divided by the study's total sample size. The literature has no widely recognized criteria for interpreting the fragility measures' magnitudes. This article aims to provide an empirical assessment for the FI and FQ based on a large database of clinical studies in the Cochrane Library.MethodsWe explored the overall empirical distributions of the FI and FQ based on five common methods (Fisher's exact test, χ2 test, risk difference, odds ratio, and relative risk) for determining statistical significance of binary outcomes in clinical research. We also considered three different scenarios for the FI calculation and evaluated the relationship between p values and FIs or FQs using Spearman's . Finally, we summarized empirical thresholds based on the overall distributions of the FI and FQ to facilitate their interpretations in future research.ResultsFor about 20% of studies with significant results, the statistical significance was changed after modifying the event status of only one participant. Studies with significant results were considered slightly fragile if the significance hinged on the statuses of about five events. Studies were extremely fragile if FI 1 or FQ 0.01. The FIs were strongly correlated with p values for significant studies, while Spearman's varied according to the total sample sizes of studies.ConclusionsThe statistical significance of clinical studies could be changed after modifying a few events' statuses. Many studies' findings are fairly fragile. The distributions of the FI and FQ provide insights for appraising the robustness of evidence in clinical decision‐making.