bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of thermal therapy and exercises on acute low back pain: a protocol for a randomized controlled trial
Authors: Côté-Picard Claudia , Tittley Jean , Mailloux Catherine , Perreault Kadija , Mercier Catherine , Dionne Clermont E. , Roy Jean-Sébastien , Massé-Alarie Hugo 
Published: December 2020

Abstract
Background
Low back pain (LBP) is the first cause of years lived with disability worldwide. This is due to the development of chronic pain. Thus, it is necessary to identify the best therapeutic approaches in the acute phase of LBP to limit the transition to chronic pain. Superficial heat presents the highest level of evidence for short-term reduction in pain and disability in acute LBP. Physical activity is also recommended to avoid transition to chronic LBP, but there is a lack of evidence to determine its effect to reduce acute LBP. Also, the long-term effects of these interventions are unknown. This is a protocol for a randomized controlled trial (RCT) to determine the short and long-term effects of wearable continuous low-level thermal therapy, in combination with exercises or not, on disability and pain.

Methods/design
Sixty-nine participants with acute LBP will be randomly assigned to one of three intervention programs: 1) thermal therapy, 2) thermal therapy + exercises, and 3) control. The interventions will be applied for 7 continuous days. The primary outcome will be disability and secondary outcomes will be pain intensity, pain-related fear, self-efficacy, number of steps walked and perception of change. The evaluators will be blinded to the interventions, and participants will be blinded to other groups’ interventions. Primary and secondary outcomes will be compared between intervention groups.

Discussion
This study will provide new evidence about acute LBP treatments, to limit transition to chronicity. This will be the first study to measure the long-term effects of wearable continuous low-level thermal therapy, combined or not to exercises.

Trial registration
This RCT has been retrospectively registered on ClinicalTrials.gov (NCT03986047) on June 14th, 2019.
Multiple micronutrient supplementation improves growth and reduces the risk of anemia among infants in Gaza Strip, Palestine: a prospective randomized community trial
Authors: Albelbeisi Ali , Shariff Zalilah Mohd , Mun Chan Yoke , Rahman Hejar Abdul , Abed Yehia 
Published: December 2020

Abstract
Background
Infants and young children 6–24 months of age are the most nutritionally vulnerable groups, as their needs for vitamins and minerals are high relative to the amount of food they consume. This study determines the effect of Micronutrient Powder Supplementation (MNP) on growth and hemoglobin of infants in Gaza Strip, Palestine.

Method
This was a two-arm parallel-group randomized controlled trial conducted in two health care clinics of the United Nations Relief and Work Agency (UNRWA) at the Middle Area governorate of Gaza Strip, Palestine. A total of 200 healthy infants aged 6-month-old were recruited and randomized to receive 3 sachets/week of MNP for 12 months alongside with the National Micronutrient Supplement (NMS) (n = 100) or NMS alone (n = 100). Weight, length, blood hemoglobin, and dietary intakes were measured at 6, 9, 12, 15, 18, and 21 (3 months after the end of intervention) months of age. Analysis was by intention to treat.

Results
The experimental group had a higher concentration of hemoglobin at 12 and 15 months than did the control group, and a significant difference (p <  0.05) was observed at 15 months only. Significantly greater weight, length, weight-for-age, length-for-age, and weight-for-length z-scores were observed in the experimental group than that in the control group at 12 and 15 months (p <  0.05). The prevalence of anemia (18% vs. 52%) and stunting (1% vs. 11%) were higher in the control than the experimental group, respectively. After controlling for sex, similar findings were reported.

Conclusions
Addition of MNP to the existing NMS program improved the nutritional status of young children. The potential benefits of MNP supplementation on physical growth and hemoglobin should be considered in the existing NMS program.

Trial registration
ISRCTN57594793; Date of registration: 20-03-2018 (Retrospectively registered).
CCL2 is associated with microglia and macrophage recruitment in chronic traumatic encephalopathy
Authors: Cherry Jonathan D. , Meng Gaoyuan , Daley Sarah , Xia Weiming , Svirsky Sarah , Alvarez Victor E. , Nicks Raymond , Pothast Morgan , Kelley Hunter , Huber Bertrand , Tripodis Yorghos , Alosco Michael L. , Mez Jesse , McKee Ann C. , Stein Thor D. 
Published: December 2020

Abstract
Background
Neuroinflammation has been implicated in the pathogenesis of chronic traumatic encephalopathy (CTE), a progressive neurodegenerative disease association with exposure to repetitive head impacts (RHI) received though playing contact sports such as American football. Past work has implicated early and sustained activation of microglia as a potential driver of tau pathology within the frontal cortex in CTE. However, the RHI induced signals required to recruit microglia to areas of damage and pathology are unknown.

Methods
Postmortem brain tissue was obtained from 261 individuals across multiple brain banks. Comparisons were made using cases with CTE, cases with Alzheimer’s disease (AD), and cases with no neurodegenerative disease and lacked exposure to RHI (controls). Recruitment of Iba1+ cells around the CTE perivascular lesion was compared to non-lesion vessels. TMEM119 staining was used to characterize microglia or macrophage involvement. The potent chemoattractant CCL2 was analyzed using frozen tissue from the dorsolateral frontal cortex (DLFC) and the calcarine cortex. Finally, the amounts of hyperphosphorylated tau (pTau) and Aβ42 were compared to CCL2 levels to examine possible mechanistic pathways.

Results
An increase in Iba1+ cells was found around blood vessels with perivascular tau pathology compared to non-affected vessels in individuals with RHI. TMEM119 staining revealed the majority of the Iba1+ cells were microglia. CCL2 protein levels in the DLFC were found to correlate with greater years of playing American football, the density of Iba1+ cells, the density of CD68+ cells, and increased CTE severity. When comparing across multiple brain regions, CCL2 increases were more pronounced in the DLFC than the calcarine cortex in cases with RHI but not in AD. When examining the individual contribution of pathogenic proteins to CCL2 changes, pTau correlated with CCL2, independent of age at death and Aβ42 in AD and CTE. Although levels of Aβ42 were not correlated with CCL2 in cases with CTE, in males in the AD group, Aβ42 trended toward an inverse relationship with CCL2 suggesting possible gender associations.

Conclusion
Overall, CCL2 is implicated in the pathways recruiting microglia and the development of pTau pathology after exposure to RHI, and may represent a future therapeutic target in CTE.
Safety and efficacy of a novel cephalomedullary nail in femoral shaft fractures: a retrospective observational cohort in 33 patients
Authors: De Leon Jorge C. , Tye Cooper B. , Breinholt Connor S. , Dang Khang H. , Karia Ravi A. 
Published: December 2020

AbstractBackgroundDespite advances in femoral shaft fracture fixation, the nonunion rate remains relatively high; and there is limited data on the efficacy and failure rate of specific implants. A novel cephalomedullary nail provides the ability to treat femur shaft fractures in isolation, with associated ipsilateral femur injuries, and provides various options for proximal and distal fixation exists on the market; but literature remains limited on the safety and efficacy of this implant. The aim of this study is to evaluate the early failure rate of this cephalomedullary nail, while comparing the nonunion rate to what is currently presented in the literature. This study is the first of its kind in evaluation of a specific implant for treatment of femoral shaft fractures and ipsilateral pathology.MethodsPatients over 18 years of age, with traumatic femur shaft fractures, treated with this particular cephalomedullary nail and available for a minimum of 3-month follow-up were included for analysis. Data was collected by retrospective chart review and review of existing radiographs. Demographic data, injury details, AO/OTA fracture classification, and implant details were recorded for each patient. Primary outcome measured was implant failures (screw or nail breakage). Secondary outcomes measured included malunion, nonunion, deep infection, post-operative complications, and need for reoperation.ResultsOf the 33 patients included for analysis, 1 patient went on to non-union. There were no cases of implant failure. The single nonunion was a high-energy mechanism, open fracture, and higher level AO/OTA classification. The remaining 32 reached radiographic union at 3 months.ConclusionThe nonunion rate of this novel cephalomedullary nail is comparable to what is reported in the literature. This nail is a safe and effective implant to treat femoral shaft fractures with a variety of ipsilateral femoral shaft injuries and reliably leads fracture union. Further studies are needed analyzing implant failure and comparing specific implants.
Comparison of ELISA- and SIMOA-based quantification of plasma Aβ ratios for early detection of cerebral amyloidosis
Authors: De Meyer Steffi , Schaeverbeke Jolien M. , Verberk Inge M. W. , Gille Benjamin , De Schaepdryver Maxim , Luckett Emma S. , Gabel Silvy , Bruffaerts Rose , Mauroo Kimberley , Thijssen Elisabeth H. , Stoops Erik , Vanderstichele Hugo M. , Teunissen Charlotte E. , Vandenberghe Rik , Poesen Koen 
Published: December 2020

AbstractBackgroundBlood-based amyloid biomarkers may provide a non-invasive, cost-effective and scalable manner for detecting cerebral amyloidosis in early disease stages.MethodsIn this prospective cross-sectional study, we quantified plasma Aβ1–42/Aβ1–40ratios with both routinely available ELISAs and novel SIMOA Amyblood assays, and provided a head-to-head comparison of their performances to detect cerebral amyloidosis in a nondemented elderly cohort (n = 199). Participants were stratified according to amyloid-PET status, and the performance of plasma Aβ1–42/Aβ1–40to detect cerebral amyloidosis was assessed using receiver operating characteristic analysis. We additionally investigated the correlations of plasma Aβ ratios with amyloid-PET and CSF Alzheimer’s disease biomarkers, as well as platform agreement using Passing-Bablok regression and Bland-Altman analysis for both Aβ isoforms.ResultsELISA and SIMOA plasma Aβ1–42/Aβ1–40detected cerebral amyloidosis with identical accuracy (ELISA: area under curve (AUC) 0.78, 95% CI 0.72–0.84; SIMOA: AUC 0.79, 95% CI 0.73–0.85), and both increased the performance of a basic demographic model including only age andAPOE-ε4genotype (p ≤ 0.02). ELISA and SIMOA had positive predictive values of respectively 41% and 36% in cognitively normal elderly and negative predictive values all exceeding 88%. Plasma Aβ1–42/Aβ1–40correlated similarly with amyloid-PET for both platforms (Spearmanρ = − 0.32,p <  0.0001), yet correlations with CSF Aβ1–42/t-tau were stronger for ELISA (ρ = 0.41,p = 0.002) than for SIMOA (ρ = 0.29,p = 0.03). Plasma Aβ levels demonstrated poor agreement between ELISA and SIMOA with concentrations of both Aβ1–42and Aβ1–40measured by SIMOA consistently underestimating those measured by ELISA.ConclusionsELISA and SIMOA demonstrated equivalent performances in detecting cerebral amyloidosis through plasma Aβ1–42/Aβ1–40, both with high negative predictive values, making them equally suitable non-invasive prescreening tools for clinical trials by reducing the number of necessary PET scans for clinical trial recruitment.Trial registrationEudraCT 2009-014475-45 (registered on 23 Sept 2009) and EudraCT 2013-004671-12 (registered on 20 May 2014,https://www.clinicaltrialsregister.eu/ctr-search/trial/2013-004671-12/BE).
Impact of percutaneous embolization versus subinguinal microsurgical ligation on semen parameters in primary varicocele patients: comparative study
Authors: Nasser Haytham M. , Hussein Ahmed , Behairy Gad M. , Abdo Mostafa 
Published: December 2020

Abstract
Background
Varicocele is an abnormally dilated pampiniform plexus of the veins within the spermatic cord and is considered the most common correctable cause of male factor infertility. Many approaches are described for treatment either surgical (tradition inguinal, subinguinal, and laparoscopic) or non-surgical percutaneous embolization. During the period from August 2017 to December 2018, we prospectively analyzed the preoperative and post-operative alteration of semen parameters (at 3 and 9 months) of the data collected from 63 patients with clinically evident varicocele referred to our tertiary hospital. Patients were divided into two groups: group 1, thirty-three patients who underwent subinguinal microsurgical ligation, and group 2, thirty patients who underwent percutaneous embolization.

Results
Sixty-three patients enrolled in this study were divided in two groups: group 1, patients who underwent surgery, and group 2, patients who underwent embolization; the mean age is 24.6 ± 1.27 years in group 1 and 23.7 ± 2 years in group 2; there was no statistically significant difference between the two groups as regards BMI, diabetes, hypertension, and smoking. Bilaterality was present in 15.2% of group 1 patients and 10% in group 2 patients (P value 0.06). Most of the patients were classified as grades 2 and 3 with no statistical significance regarding severity of the disease. Preoperative semen parameters for patients including sperm count, motility, and abnormal forms showed no statistically significant difference between the two groups. Post-intervention semen analysis was done twice during follow-up after 3 months and 9 months from the date of intervention. After 3 months, the semen parameters were improved in both groups in spite of the higher sperm count in group 2 but with no statistical significance. After 9 months follow-up, semen analysis showed persistent increase in sperm mobility in group 1 patients in comparison to group 2 patients. Both groups had better improvement in count of normal form with no statistical significant change.

Conclusion
Improvement of semen parameters while treating primary varicocele by either subinguinal microsurgery approach or percutaneous embolization shows equivalent outcomes.
Elevated Circulating Glutamate Is Associated With Subclinical Atherosclerosis Independently of Established Risk Markers: A Cross-Sectional Study
Authors: Lehn-Stefan Angela , Peter Andreas , Machann Jürgen , Schick Fritz , Randrianarisoa Elko , Heni Martin , Wagner Robert , Birkenfeld Andreas L , Fritsche Andreas , Häring Hans-Ulrich , Staiger Harald , Stefan Norbert 
Published: December 2020

Abstract

Objective
Elevated plasma glutamate levels are associated with an increased risk of cardiovascular disease (CVD). Because plasma glutamate levels are also strongly associated with visceral adiposity, nonalcoholic fatty liver disease, insulin resistance, and high circulating levels of branched-chain amino acids (BCAAs), it is unknown to what extent elevated circulating glutamate is an independent marker of an increased risk of atherosclerosis.

Methods
Plasma levels of glutamate and BCAAs were measured in 102 individuals who were precisely phenotyped for body fat mass and distribution (magnetic resonance [MR] tomography), liver fat content (1H-MR spectroscopy), insulin sensitivity (oral glucose tolerance test and hyperinsulinemic, euglycemic clamp [N = 57]), and carotid intima media thickness (cIMT).

Results
Plasma glutamate levels, adjusted for age, sex, body fat mass, and visceral fat mass, correlated positively with liver fat content and cIMT (all std β ≥ .22, all P ≤ .023) and negatively with insulin sensitivity (std β ≤ –.31, P ≤ .002). Glutamate levels also were associated with cIMT, independently of additional adjustment for liver fat content, insulin sensitivity and BCAAs levels (std β ≥ .24, P ≤ .02). Furthermore, an independent positive association of glutamate and interleukin-6 (IL-6) levels was observed (N = 50; std β = .39, P = .03). Although glutamate, adjusted for age, sex, body fat mass, and visceral fat mass, also correlated positively with cIMT in this subgroup (std β = .31, P = .02), after additional adjustment for the parameters liver fat content, insulin sensitivity, BCAAs, or IL-6 levels, adjustment for IL-6 most strongly attenuated this relationship (std β = .28, P = .05).

Conclusions
Elevated plasma glutamate levels are associated with increased cIMT, independently of established CVD risk factors, and this relationship may in part be explained by IL-6-associated subclinical inflammation.
Amyloidosis: A Rare Cause of Severe Cholestasis and Acute Liver Failure
Authors: Kim Hyun Jae , Tomaszewski Marcel , Lam Eric C. , Xiong Wei , Moosavi Sarvee 
Published: December 2020

ABSTRACT
Although hepatic involvement in light chain–associated amyloidosis is common, clinical manifestations of hepatic amyloidosis are rare. In most cases, hepatomegaly serves as a clue to diagnosis. We report a unique case of a 48-year-old man from China with jaundice and noncirrhotic portal hypertension, with rapidly progressive liver failure, in the absence of hepatomegaly, secondary to systemic light chain–associated amyloidosis associated with multiple myeloma.
Combined effects of Choquard and singular nonlinearities in fractional Kirchhoff problems
Authors: Wang Fuliang , Hu Die , Xiang Mingqi 
Published: December 2020

AbstractThe aim of this paper is to study the existence and multiplicity of solutions for a class of fractional Kirchho problems involving Choquard type nonlinearity and singular nonlinearity. Under suitable assumptions, two nonnegative and nontrivial solutions are obtained by using the Nehari manifold approach combined with the Hardy-Littlehood-Sobolev inequality.
More than text: Approaching ritual papyri from Oxyrhynchus as inscribed objects
Authors: Possiel Scott 
Published: December 2020

AbstractAlthough papyri serve as critical forms of evidence for the study of ritual in the late antique Mediterranean, much about their function and significance in ritual performance remains unknown. This paper investigates this dimension of ritual texts through an examination of three papyri from Oxyrhynchus (P.Oxy. 4242, 2833, and 5304) – a horoscope, asortescollection, and a magical formulary. Pairing close readings with an object-centered approach to the study of ritual in the ancient world, this paper addresses the text of each papyrus as well as its visual and physical characteristics including size, columniation, layout, evidence of wear, and marginalia. This analysis illuminates not only the role of each papyrus within the practice of astrology, divination, or magic, but also its influence on ritual performance. By mediating the experience of ritual participants, these papyri exert object-agency. Therefore, this paper argues that such texts are not simply passive instruments consulted by practitioners but rather active participants and collaborators in the performance of ritual.
Rethinking Orphic ‘Bookishness’: Text and Performance in Classical Mystery Religion
Authors: McClay Mark F. 
Published: December 2020

AbstractThe mythical singer Orpheus was credited as the proto-founder of private Dionysiac initiations in Classical Greece, and written hexameter poems attributed to his authorship played an important role in these cults. Since at least the nineteenth century, classical scholars have identified this “bookish” orientation as a defining feature of Orphism. This article approaches Orphic texts using the analytical tools of “material religion” and argues that Orphic textuality is best understood as a medial extension of poetic performance. Like musical-poetic performers, ritual experts drew authority in part frommimêsisof legendary archetypes (Orpheus, Musaeus, Melampus, etc.), and part of the physical text’s function was to make this identification believable for performers in Orphic cults and other low-level genres. In the Derveni Papyrus, however, the book enables a rejection of performance-based expertise in favor of an authority based on textual exegesis.
Le culte deZeus Brontôn : l’espace et la morphologie du dieu de l’orage dans la Phrygie d’époque romaine
Authors: Chiai Gian Franco 
Published: December 2020

AbstractThis study aims at reconstructing the evolution of the character of the Anatolian storm-god in Phrygia from the Hittite period to the Roman imperial era, particularly taking into account the Greek votive dedications toZeus Brontôn.According to the Hittite and Luwian texts, the power of the storm-god was not only limited to the sky, but encompassed fertility, the order of the seasons and, because of his role as the protector of kingship, the social order. Because they favourited a female deity generically called Matar, the coming of the Phrygians seems to be linked to the degradation of the cult, which remained practiced by the lower strata of the population and in the countryside. It was only after the arrival of the Greeks in Hellenistic times and the identification of the local ancient storm-gods with Zeus that their worship became tangible and visible again. The impressive number of dedications, mostly dated between the second and third centuries CE, constitutes an excellent documentary base for studying the character of these local deities. In these epigraphic texts, the theonym Zeus was used as a generic name (Gesamtsbezeichnung) for several divine beings, only partially comparable to the Greek Olympian Zeus.
Lilie unter Dornen
Authors: Reuvekamp Silvia 
Published: December 2020

Abstract
The echoes of the Song of Songs in Hartmann’s ›Erec‹ culminate in the famous comparison of Enite with a lily among thorns. Against the background of the exegetical tradition, in which the lily stands for an exceptional love competence, it is shown that this comparison is much more important to an appropriate understanding of ›Erec‹ than has been commonly assumed. This example illustrates, moreover, how precisely vernacular-language authors make usage of sacred contents and how autonomously they create processes of literary meaning-making.
Ego sum illa Aethiopissa
Authors: Kohnen Rabea 
Published: December 2020

Abstract
This article connects Wolfram’s portrayal of the striking black heathen queen Belakane with contemporary thoughts on the colour black in general and more specifically with concepts of dark skin and race at Wolfram’s time taking their biblical and theological foundations and semantics in regard. Reading Belakanes skin colour as an index and her story as a nod to the biblical Queen of Sheba and her reception history in the commentary tradition on the ›Song of Songs‹, I argue to integrate artistic and courtly, scholarly and theological perspectives to understand and appreciate the idiosyncrasy of Wolfram’s ›Parzival‹ fully.