bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute and chronic synaptic pathology in multiple sclerosis gray matter
Authors: Vercellino Marco , Marasciulo Stella , Grifoni Silvia , Vallino-Costassa Elena , Bosa Chiara , Pasanisi Maria Barbara , Crociara Paola , Casalone Cristina , Chiò Adriano , Giordana Maria Teresa , Corona Cristiano , Cavalla Paola 
Published: June 2021

Objectives: To investigate the extent of synaptic loss, and the contribution of gray matter (GM) inflammation and demyelination to synaptic loss, in multiple sclerosis (MS) brain tissue. Methods: This study was performed on two different post-mortem series of MS and control brains, including deep GM and cortical GM. MS brain samples had been specifically selected for the presence of active demyelinating GM lesions. Over 1,000,000 individual synapses were identified and counted using confocal microscopy, and further characterized as glutamatergic/GABAergic. Synaptic counts were also correlated with neuronal/axonal loss. Results: Important synaptic loss was observed in active demyelinating GM lesions (−58.9%), while in chronic inactive GM lesions, synaptic density was only mildly reduced compared to adjacent non-lesional gray matter (NLGM) (−12.6%). Synaptic loss equally affected glutamatergic and GABAergic synapses. Diffuse synaptic loss was observed in MS NLGM compared to control GM (−21.2% overall). Conclusion: This study provides evidence, in MS brain tissue, of acute synaptic damage/loss during active GM inflammatory demyelination and of synaptic reorganization in chronically demyelinated GM, affecting equally glutamatergic and GABAergic synapses. Furthermore, this study provides a strong indication of widespread synaptic loss in MS NLGM also independently from focal GM demyelination.
Major depressive disorders in young immigrants: A cohort study from primary healthcare settings in Sweden
Authors: Osooli Mehdi , Ohlsson Henrik , Sundquist Jan , Sundquist Kristina 
Published: June 2021

Aims: Previous studies on major depressive disorder (MDD) among immigrants have reported mixed results. Using data from primary healthcare settings in Sweden, we compared the incidence of MDD among first- and second-generation immigrants aged 15–39 years with natives. Methods: This was a retrospective nationwide open cohort study. Eligible individuals were born 1965–1983, aged 15–39 years at baseline, and resided in Sweden for at least one year during the study period 2000–2015. We identified MDD cases through the Primary Care Registry (PCR). The follow-up for each individual started when they met the inclusion criteria and were registered in the PCR and ended at MDD diagnosis, death, emigration, moving to a county without PCR coverage, or the end of the study period, whichever came first. Results: The final sample included 1,341,676 natives and 785,860 immigrants. The MDD incidence rate per 1000 person-years ranged from 6.1 (95% confidence intervals: 6.1, 6.2) to 16.6 (95% confidence intervals: 16.2, 17.0) in native males and second-generation female immigrants with a foreign-born father, respectively. After adjusting for income, the MDD risk did not differ substantially between first-generation male and female immigrants and natives. However, male and female second-generation immigrants had a 16–29% higher adjusted risk of MDD than natives. Conclusions: This cohort study using primary healthcare data in Sweden, albeit incomplete, indicated that second-generation immigrants seem to be at a particularly high risk of MDDs. The underlying mechanisms need further investigation.
Low-frequency vibro-acoustic response of an optimized fiber-reinforced graphite truss sandwich panel filled with wood-based material
Authors: Wang Luyao , Dai Liming , Hu Gang 
Published: June 2021

Conventional metallic sandwich panels are widely used for noise control owing to their good noise control capabilities and excellent mechanical strength-to-weight ratio property. Furthermore, sound-absorbing products consisting of glass or mineral fiber materials are generally filled into the sandwich structures to lower the vibration response in resonance frequency and to enhance the structural noise attenuation capacity. In the present study, a fiber-reinforced graphite material is used as an alternative to its metallic counterparts. Moreover, a wood-based renewable absorption material is used as the absorption material and is filled into the sandwich structural core. The vibro-acoustic characteristics of the panel with such a design are numerically investigated using Actran. The findings of the research indicate that the proposed sandwich structure achieves advanced low-frequency noise control performance in comparison with other conventional metallic sandwich panels. Approximately 7 dB increase in sound transmission loss in the audible-frequency range is achieved in addition to a reduced panel weight and more stable vibration with reduced amplitude. The existing data available in the literature are employed for validating and illustrating the accuracy and reliability of the proposed approach.
The impact of COVID-19 quarantine measures on the mental health of families
Authors: Al Gharaibeh Fakir , Gibson Laura 
Published: June 2021

Summary COVID-19 is shaping all aspects of life throughout the world. The unexpected number of people who have been infected with and died from coronavirus disease (COVID-19) is evidence that the pandemic has affected families and societies. The strong shock wave that has resulted in the international response has focused more on medical rather than psychosocial interventions. Little has been written or studied about the impact of COVID-19 on families. This article explores the impact of the COVID-19 quarantine on the mental health of families. We conducted 20 in-depth interviews with Jordanian families through snowball sampling. Findings The results show that 20 interviewees described varied and new experiences. Many of the families we interviewed displayed symptoms of mental health problems, including disrupted sleep patterns, changes in eating habits, excessive digital media use, anxiety, depression, excessive smoking, stomach aches, bedwetting among children, and persistent headaches. The study also demonstrated the psychological stress partners felt during the lockdown due to their worries about job security. They also communicated their hope that renewed family commitments might bring more stability to their relationships. During the lockdown, family members spent more time together, and it became harder to conceal any issues from each other. Applications The findings of this research demonstrate a critical need for social workers, and it is hoped that future legislation will include a role for social workers in various fields of crisis. Moreover, social workers should encourage families to ask for intervention to overcome the long-term effects that may result from COVID-19.
Outcomes of Thrombolytic Therapy of Tunnelled Hemodialysis Catheter Dysfunction
Authors: Selçuk Emre , Arıkan Ali Ahmet , Bayraktar Fath Avni 
Published: June 2021

Introduction: Intraluminal thrombolytic therapy is the first step treatment of thrombotic malfunction of tunneled hemodialysis catheters (THC). The factors that affect catheter restoration and also catheter survival following thrombolytic therapy are not well described. In this study, we aimed to reveal the predictors that affect the success of the procedure and also present post-restoration catheter patency after intraluminal thrombolytic administration. Method: This retrospective study included 62 patients with tunneled THC thrombosis treated with alteplase between 2017 and2020 in the study center. Age, comorbidities, the use of antiplatelet and anticoagulants, a history of catheter thrombosis, time on dialysis, the duration of the catheter were investigated as possible predictors of procedural success. The independent predictive factors for procedural success were evaluated by using backward stepwise likelihood ratio logistic regression analysis. Primaryand assisted patencieswere presented with Kaplan-Meier graphs. Results: Thrombolityc was administered to 62 patients 102 times. The median primary patency from the first thrombolytic administration to a second catheter thrombosis was 9 months (range 1-20 months). The overall median patency was 12 months (range 2-23 months). The overall procedural success rate was 79.4% (81/102).Multivariate analyses revealed that a history of prior catheter thrombosis was the only risk factor for procedural success (OR: 0.49; 95% CI: 0.26-0.91; p = 0.004). The need for a second dwell time among patients with prior history of thrombolysis was significantly higher compared to patients without a history of catheter thrombosis (12/26 patients, 46.2% and 6/55 patients, 10.9%; respectively; p = 0.001). Conclusion: The success of thrombolysis in subsequent de novo THC thrombosis decreases in patients who previously required intraluminal thrombolytic administration. Identifying patient subgroups with a high risk for THC thrombosis may be useful to investigate effective secondary prevention strategies.
Possible unrecognised liver injury is associated with mortality in critically ill COVID-19 patients
Authors: Romero-Cristóbal Mario , Clemente-Sánchez Ana , Piñeiro Patricia , Cedeño Jamil , Rayón Laura , del Río Julia , Ramos Clara , Hernández Diego-Andrés , Cova Miguel , Caballero Aranzazu , Garutti Ignacio , García-Olivares Pablo , Hortal Javier , Guerrero Jose-Eugenio , García Rita , Bañares Rafael , Rincón Diego 
Published: June 2021

Background: Coronavirus disease (COVID-19) with acute respiratory distress syndrome is a life-threatening condition. A previous diagnosis of chronic liver disease is associated with poorer outcomes. Nevertheless, the impact of silent liver injury has not been investigated. We aimed to explore the association of pre-admission liver fibrosis indices with the prognosis of critically ill COVID-19 patients. Methods: The work presented was an observational study in 214 patients with COVID-19 consecutively admitted to the intensive care unit (ICU). Pre-admission liver fibrosis indices were calculated. In-hospital mortality and predictive factors were explored with Kaplan–Meier and Cox regression analysis. Results: The mean age was 59.58 (13.79) years; 16 patients (7.48%) had previously recognised chronic liver disease. Up to 78.84% of patients according to Forns, and 45.76% according to FIB-4, had more than minimal fibrosis. Fibrosis indices were higher in non-survivors [Forns: 6.04 (1.42) versus 4.99 (1.58), p < 0.001; FIB-4: 1.77 (1.17) versus 1.41 (0.91), p = 0.020)], but no differences were found in liver biochemistry parameters. Patients with any degree of fibrosis either by Forns or FIB-4 had a higher mortality, which increased according to the severity of fibrosis ( p < 0.05 for both indexes). Both Forns [HR 1.41 (1.11–1.81); p = 0.006] and FIB-4 [HR 1.31 (0.99–1.72); p = 0.051] were independently related to survival after adjusting for the Charlson comorbidity index, APACHE II, and ferritin. Conclusion: Unrecognised liver fibrosis, assessed by serological tests prior to admission, is independently associated with a higher risk of death in patients with severe COVID-19 admitted to the ICU.
Edge-enhancing gradient echo with multi-image co-registration and averaging (EDGE-MICRA) for targeting thalamic centromedian and parafascicular nuclei
Authors: Middlebrooks Erik H , Okromelidze Lela , Lin Chen , Jain Ayushi , Westerhold Erin , Ritaccio Anthony , Quiñones-Hinojosa Alfredo , Gupta Vivek , Grewal Sanjeet S 
Published: June 2021

Background and purpose Deep brain stimulation of the thalamus is an effective treatment for multiple neurological disorders. The centromedian and parafascicular nuclei are recently emerging targets for multiple conditions, such as epilepsy and Tourette syndrome; however, their limited visibility on conventional magnetic resonance imaging sequences has been a major obstacle. The goal of this study was to demonstrate the feasibility of a high-resolution and high-contrast targeting sequence for centromedian-parafascicular deep brain stimulation using a recently described magnetic resonance imaging sequence, three-dimensional edge-enhancing gradient echo. Methods The three-dimensional edge-enhancing gradient echo sequence was performed on a normal volunteer for a total of six acquisitions. Multi-image co-registration and averaging was performed by first co-registering each of the six scans and then averaging to produce an edge-enhancing gradient echo-multi-image co-registration and averaging scan. The averaging was also performed for two, three, four and five scans to assess the change in the signal-to-noise ratio and identify the ideal balance of image quality and scan time. Results The edge-enhancing gradient echo-multi-image co-registration and averaging scan allowed clear boundary delineation of the centromedian and parafascicular nuclei. The signal-to-noise ratio increased as a function of increasing scan number, but the added gain was small beyond four scans for the imaging parameters used in this study. Conclusions The recently described three-dimensional edge-enhancing gradient echo sequence provides an easily implementable approach, using widely available magnetic resonance imaging technology without complex post-processing techniques, to delineate centromedian and parafascicular nuclei for deep brain stimulation targeting.
Arthroscopy Association of Canada Position Statement on Exercise for Knee Osteoarthritis: A Systematic Review of Guidelines
Authors: Masud Saad , Sheehan Brendan , Rousseau-Saine Alexis , Tucker Allison , Sandman Emilie , Wong Ivan , Woodmass Jarret , Chalal Jas , Lobo Joel , Grant John , LeBel Marie-Eve , Sommerfeldt Mark , Kopka Michaela , Urquhart Nathan , Carsen Sasha , Pauyo Thierry , Khan Moin 
Published: June 2021

Background: Exercise is widely regarded to improve pain and function in patients with knee osteoarthritis (OA) through building supportive muscle mass, facilitating weight loss, and through the other beneficial effects associated with it. Purpose: To explore literature that presents clinical guidelines for the use of exercise in the treatment of knee OA to inform an evidence-based position statement for the Arthroscopy Association of Canada. Study Design: Position statement. Methods: PubMed, MEDLINE, Embase, and Cochrane databases were searched for guidelines commenting on the role of exercise for knee OA. The search was limited to guidelines published in the last 10 years. Articles were screened for relevance, focusing on recently published research with clinical guidelines. Inclusion criteria involved all articles providing clinical guidelines for exercise and knee OA. Results: Eight guidelines were identified. All eight recommended exercise as an important component of treatment for knee OA, with 6/8 strongly recommending it. Conclusion: Exercise is an effective and important component of the non-pharmacological management of knee OA. The Arthroscopy Association of Canada strongly recommends the use of exercise in the management of knee OA.
In vitro bioanalytical assessment of toxicity of wetland samples from Spanish Mediterranean coastline
Authors: Celma Alberto , Mandava Geeta , Oskarsson Agneta , Sancho Juan Vicente , Bijlsma Lubertus , Lundqvist Johan 
Published: June 2021

Abstract
Background
Fresh water bodies represent less than 1% of overall amount of water on earth and ensuring their quality and sustainability is pivotal. Although several campaigns have been performed to monitor the occurrence of micropollutants by means of chemical analysis, this might not cover the whole set of chemicals present in the sample nor the potential toxic effects of mixtures of natural and anthropogenic chemicals. In this sense, by selecting relevant toxicity endpoints when performing in vitro bioanalysis, effect-based methodologies can be of help to perform a comprehensive assessment of water quality and reveal biological activities relevant to adverse health effects. However, no prior bioanalytical study was performed in wetland water samples from the Spanish Mediterranean coastline.

Methods
Eleven samples from relevant water bodies from the Spanish Mediterranean coastline were collected to monitor water quality on 8 toxicity endpoints. Aryl hydrocarbon receptor (AhR), androgenicity (AR+ and AR−), estrogenicity (ER+ and ER−), oxidative stress response (Nrf2) and vitamin D receptor (VDR+ and VDR−) reporter gene assays were evaluated.

Results
AhR was the reporter gene assay showing a more frequent response over the set of samples (activated by 9 out of 11 samples), with TCDD-eq in the range 7.7–22.2 pM. For AR, ER and VDR assays sporadic activations were observed. Moreover, no activity was observed on the Nrf2 reporter gene assay. Wastewater and street runaway streams from Valencia could be responsible for enhanced activities in one of the water inputs in the Natural Park ‘L’Albufera’.

Conclusions
Water quality of relevant wetlands from the Spanish Mediterranean coastline has been evaluated. The utilization of a panel of 5 different bioassays to cover for different toxicity endpoints has demonstrated to be a good tool to assess water quality.
Systematic review and meta analysis of differential attrition between active and control arms in randomized controlled trials of lifestyle interventions in chronic disease
Authors: W Bevens , A Shoushtari , P Jelinek , GA Jelinek , TJ Weiland 
Published: June 2021

Abstract
Background
Attrition is a major obstacle for lifestyle interventions sustained for the medium-to-long term and can have significant consequences on the internal validity of a trial. When the degree of attrition differs between active and control arms this is termed differential attrition and is an important consideration during initial stages of trial planning.

Objectives
The primary research question of this study was: what is the differential attrition between treatment arms in lifestyle interventions for prevalent chronic diseases?

Methods
We performed a systematic review and meta-analysis of 23 studies involving a lifestyle intervention component in cohorts with chronic diseases. The search accessed three databases: Scopus, Medline Ovid and Web of Science. Attrition between treatment arms was analysed using a random-effects model and examined the relationship between the relative attrition and potential moderators, such as time to final follow-up, time to first follow-up, type of disease, type of control, type of intervention and length of treatment.

Results
The pooled risk ratio was 1.00 (95% CI 0.97 – 1.03) and only one study fell outside this range. A univariable association was described between the pooled risk ration and length (years) to final follow-up, which did not remain in the multivariable model.

Conclusions
Ultimately, we found no evidence of differential attrition in medium-to-long term lifestyle intervention studies for chronic disease, increasing confidence in conducting such studies with minimal potential of attrition bias.

Trial registration
PROSPERO registration number CRD42018084495.
Type 2 diabetes patients’ views on prevention of hypoglycaemia – a mixed methods study investigating self-management issues and self-identified causes of hypoglycaemia
Authors: Crutzen Stijn , van den Born-Bondt Tessa , Denig Petra , Taxis Katja 
Published: June 2021

Abstract
Background
Hypoglycaemia is a common and potentially avoidable adverse event in people with type 2 diabetes (T2D). It can reduce quality of life, increase healthcare costs, and reduce treatment success. We investigated self-management issues associated with hypoglycaemia and self-identified causes of hypoglycaemia in these patients.

Methods
In this mixed methods study qualitative semi-structured interviews were performed, which informed a subsequent quantitative survey in T2D patients. All interviews were audio recorded, transcribed verbatim and coded independently by two coders using directed content analysis, guided by the Theoretical Domains Framework. Descriptive statistics were used to quantify the self-management issues and causes of hypoglycaemia collected in the survey for the respondents that had experienced at least one hypoglycaemic event in the past.

Results
Sixteen participants were interviewed, aged 59–84 years. Participants perceived difficulties in managing deviations from routine, and they sometimes lacked procedural knowledge to adjust medication, nutrition or physical activity to manage their glucose levels. Grief and loss of support due to the loss of a partner interfered with self-management and lead to hypoglycaemic events. Work ethic lead some participant to overexerting themselves, which in turn lead to hypoglycaemic events. The participants had difficulties preventing hypoglycaemic events, because they did not know the cause, suffered from impaired hypoglycaemia awareness and/or did not want to regularly measure their blood glucose. When they did recognise a cause, they identified issues with nutrition, physical activity, stress or medication. In total, 40% of respondents reported regular stress as an issue, 24% reported that they regularly overestimated their physical abilities, and 22% indicated they did not always know how to adjust their medication. Around 16% of patients could not always remember whether they took their medication, and 42% always took their medication at regular times. Among the 83 respondents with at least one hypoglycaemic event, common causes for hypoglycaemia mentioned were related to physical activity (67%), low food intake (52%), deviations from routine (35%) and emotional burden (28%). Accidental overuse of medication was reported by 10%.

Conclusion
People with T2D experience various issues with self-managing their glucose levels. This study underlines the importance of daily routine and being able to adjust medication in relation to more physical activity or less food intake as well as the ability to reduce and manage stress to prevent hypoglycaemic events.