bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of voice rehabilitation in people with MS: A double-blinded long-term randomized controlled trial
Authors: Crispiatico Valeria , Baldanzi Cinzia , Napoletano Arianna , Tomasoni Laura , Tedeschi Francesca , Groppo Elisabetta , Rovaris Marco , Vitali Chiara , Cattaneo Davide 
Published: October 2021

Background: Hypophonia is a prevailing problem in people with multiple sclerosis (PwMS). However, evidence supporting the effectiveness of voice rehabilitation is lacking. Objective: The aim of this study was to identify the most effective method to reduce hypophonia. Methods: In this randomized controlled trial, 44 PwMS were randomized to intensive and high-effort voice treatment groups, the LSVT-LOUD®, and conventional treatment group. Subjects received 16 treatments (4 sessions/week) lasting 45 minutes. The primary outcome was voice intensity (dB) in monologue, vocalization, and sentences while voice handicap index (VHI) measured voice self-perception. Outcomes were assessed by a blinded observer at baseline, post-treatment, and 15-month follow-up (FU). Results: Linear models revealed a significant post-intervention between-group mean difference in favor of LSVT-LOUD for monologue: +6.3 dB (95% CI: 2.5 to 10.1); vocalization: +7.4 dB (95% CI: 2.3 to 12.5); and sentences: +9.5 dB (95% CI: 4.7 to 14.3). However, 43.7% PwMS in the LSVT-LOUD and 10% in the conventional treatment group obtained a full recovery of voice intensity (>60 dB) post-treatment, Fisher’s test = 13.3, p < 0.01. However, these improvements were not maintained at FU. Between-group differences at VHI were −10.8 (95% CI: −21.2 to −0.4) and −11.3 (95% CI: −24.3 to −1.7) in favor of LSVT-LOUD at post and FU. Conclusion: LSVT-LOUD can be a valid treatment to increase voice intensity in PwMS. However, results suggest the need for FU interventions targeting maintenance.
Revisiting Early Sport Specialization: What’s the Problem?
Authors: Mosher Alexandra , Till Kevin , Fraser-Thomas Jessica , Baker Joseph 
Published: October 2021

Context: The assumed risks of early specialization in sport are well known, with several international consensus statements advising against specialization in early athlete development. However, there have been recent calls for more focused research in this area. Evidence Acquisition: Research evidence from several scientific disciplines (eg, sport psychology, sports medicine, human development) were synthesized to develop a framework for practitioners working with adolescent athletes. Study Design: Narrative review. Level of Evidence: Level 4. Results: There appear to be risks associated with a highly specialized approach to athlete training, but the mechanisms driving these effects are largely unknown. Greater attention to understanding these mechanisms would help mitigate risk and develop stronger policy for athlete development. Recommendations for program modifications are provided. Conclusion: Early specialization remains an important topic for researchers and practitioners working with youth and adolescent athletes. However, more work needs to be done to provide truly evidence-based recommendations for youth athlete training.
Case study assessing the feasibility of using a wearable haptic device or humanoid robot to facilitate transitions in occupational therapy sessions for children with autism spectrum disorder
Authors: Beaudoin Audrée Jeanne , Pedneault Frédérique , Houle Marina , Bilodeau Cynthia , Gauvin Marie-Pier , Groleau Diane , Brochu Pascale , Couture Mélanie 
Published: October 2021

Introduction Some children with autism spectrum disorder (ASD) have difficulties with transitions that may lead to problem behaviours. Although the use of technologies with children with ASD is receiving increasing attention, no study has looked at their effect on transitions in activities of daily living. This study aimed to document the feasibility of (1) using two intervention technologies (NAO humanoid robot or wearable haptic device) separately to facilitate transitions in occupational therapy sessions for children with ASD and (2) the method used to document changes. Methods Using a single case reversal (ABA) design, two children with ASD were randomly assigned to one of the intervention technologies (humanoid robot or haptic bracelet). Each technology was used as an antecedent to stimulate the start of transitions in eight intervention sessions at a private occupational therapy clinic. Data concerning the time required for transitions, child’s behaviours during transitions at the clinic and mother’s perception of the child’s performance in transitions at home were analysed graphically. Results When using technology, both children’s behaviours were appropriate, quick and relatively stable. Also, both mothers reported improved perceptions of their child’s performance in transitions. Conclusions This exploratory study suggests no detrimental effect of using these technologies.
Treatment of 2-Part Proximal Humeral Fractures in Osteoporotic Patients With Medial Calcar Instability Using a PHILOS Plate Plus an Allogeneic Fibula Inserted Obliquely – A Retrospective Study
Authors: Cheng Huihui , Yu Jiali , Dong Zhirui , Lin Huanyi , Liu Qilong , Zhang Xinchao , Wu Jianguo , Zeng Xianshang , Yu Weiguang , Xu Bo 
Published: October 2021

Introduction To date, there is little research assessing the efficacy of a proximal humeral internal locking system (PHILOS) plate plus an allogeneic fibula inserted obliquely in the treatment of 2-part proximal humerus fractures (PHFs) with calcar comminution in patients >60 years old with severe osteoporosis. The aim of this study was to retrospectively evaluate the outcomes of elderly patients with osteoporotic 2-part PHFs combined with medial column (calcar) instability or disruption who experienced a PHILOS plate plus an allogeneic fibula inserted obliquely. Materials and Methods One hundred and twelve consecutive elderly patients with severe osteoporotic 2-part PHFs combined with calcar instability or disruption who were treated with a PHILOS plate plus an allogeneic fibula inserted obliquely were retrospectively identified from 3 tertiary medical centres during 2014–2019. The primary outcomes were the Constant scores and American Shoulder and Elbow Surgeons (ASES) scores; secondary outcome was the rate of key orthopaedic complications. Results Median follow-up was 24 (15.3–27.6) months. Significant improvements in the median Constant scores were observed (39 [26–58 points] prior to surgery vs 81 [67–95 points] at final follow-up). The median ASES scores improved from 43 (26–64 points) prior to surgery to 83 (65–96 points) at final follow-up. The percentage of key orthopaedic complications was 25.6% (22/86). Four (4.7%) cases had loss of reduction, 4 (4.7%) experienced aseptic loosening, 1 (.8%) had non-union, 4 (4.7%) suffered a periprosthetic fracture, 3 (3.5%) experienced a revision surgery, 1 (.8%) had a dislocation and 5 (5.8%) suffered an unbearable shoulder pain. Conclusion For elderly patients with osteoporotic 2-part PHFs combined with calcar instability or disruption, PHILOS plate combined with an allogeneic fibula inserted obliquely might have recognisable advantages in decreasing the loss of fixation and preventing medial calcar collapse.
Emotional distress in the early stages of the COVID-19 related lockdowns depending on the severity of the pandemic and emergency measures: a comparative online-survey in Germany, Austria and Italy
Authors: Eichenberg Christiane , Grossfurthner Martin , Kietaibl Sibylle , Riboli Greta , Borlimi Rosita , Holocher-Benetka Stefana 
Published: October 2021

Abstract
Background
The first wave of the COVID-19-pandemic hit different countries with varying degrees of severity, so that differences in the type and level of emergency measures were also necessary. It can be assumed that the psychological burden was higher in countries subjected to a more severe course of the pandemic (Italy) than in countries subjected to a less severe one (Germany, Austria).

Objective
To investigate and contrast the wellbeing of the population in Italy, Austria, and Germany in the early phase of the first lockdown.

Method
Online survey on N = 4289 individuals. The questionnaire comprised a self-administered section, exploring the dimensions: perceived severity of COVID-19, perceived risk of disease, concerns related to COVID-19, emergency measure acceptance and emotional distress due to emergency measures; and standardized scales to record emotional state and coping: Stress-Coping-Style Questionnaire, Positive and Negative Affect Schedule, State-Trait-Anxiety-Inventory.

Results
The three countries displayed significant differences in all investigated dimensions (p < .001). Italian participants assessed the COVID-19 virus as much more dangerous (p < .001), but despite the prevalence of the virus, the subjective risk of disease was perceived to be lower in Italy (p < .001). This could be a positive effect of the restrictive curfews set by the government in Italy. The emergency measures were generally perceived to be very effective in all three countries, but due to the duration and the severity of the measures, the fear and stress-reaction were the strongest among Italian participants (p < .001).

Conclusion
The stricter measures in Italy prevented an application of many positive stress processing strategies, which, in turn, fostered the perpetuation of stresses and fear.
The global prevalence of depression, suicide ideation, and attempts in the military forces: a systematic review and Meta-analysis of cross sectional studies
Authors: Moradi Yousef , Dowran Behnaz , Sepandi Mojtaba 
Published: October 2021

Abstract
Background
Given the wide range of depressive disorders, suicidal ideation and suicide attempts in various military studies around the world, determining the exact prevalence of these disorders in line with health planning as well as care and treatment service designing for military forces can be useful. The aim of the present meta-analysis was to determine the pooled prevalence of depressive disorders, suicide thoughts, and attempts in the military.

Methods
The present systematic review and meta-analysis study was performed based on PRISMA criteria in 5 steps of the search strategy, screening and selection of articles, data extraction, evaluation of article quality and meta-analysis. International databases (PubMed (Medline), Scopus, Web of science, Embase (Elsevier), PsycInfo (Ovid), Cochrane CENTRAL (Ovid)) were searched using related keywords extracted from Mesh and Emtree. After screening and final selection of articles, data were extracted and qualitative evaluation was performed using the NOS checklist.

Results
The results of meta-analysis showed that the prevalence of depression in active military forces and veterans was 23% (%95 CI: 20–26%) and 20% (%95 CI: 18–22%), respectively. In addition, the prevalence of suicidal ideation and attempts in the military was 11% (%95 CI: 10–13%) and 11% (%95 CI: 9–13%), respectively. The prevalence of suicide ideation and attempts in drug-using military was 18% (%95 CI: 7–33%) and 30% (%95 CI: 23–36%), respectively. The prevalence of suicidal ideation and attempts in military consuming alcohol were 9% (%95 CI: 4–13%) and 8% (%95 CI: 7–10%), respectively. In militaries with AIDS / HIV, the prevalence of suicide attempts was 5% (%95 CI: 4–8%).

Conclusion
Therefore, it is necessary to develop and design training and intervention programs in order to increase the awareness of the military, especially veterans, to prevent the occurrence of suicide and depression.
Influence of bone anatomical morphology of mandibular molars on dental implant based on CBCT
Authors: Kong Zhuo-lin , Wang Ge-ge , Liu Xue-ying , Ye Zhang-yan , Xu Dong-qian , Ding Xi 
Published: October 2021

Abstract
Background
To apply CBCT to investigate the anatomical relationship between the mandibular molar and alveolar bone, aimed to provide clinical guidelines for the design of implant restoration.

Methods
201 CBCT data were reevaluated to measure height of the alveolar process (EF), width of the alveolar process (GH), width of the basal bone (IJ), the angle between the long axis of the first molar and the alveolar bone (∠a) and the angle between the long axis of the alveolar bone and basal bone (∠b). The angle and width were measured to determine the implant-prosthodontic classification of the morphology in the left lower first molar (36) and right lower first molar (46). All measurements were performed on the improved cross-sectional images.

Results
EF, GH and IJ were measured as (10.83 ± 1.31) mm, (13.93 ± 2.00) mm and (12.68 ± 1.96) mm for 36, respectively; and (10.87 ± 1.24) mm, (13.86 ± 1.93) mm and (12.60 ± 1.90) mm for 46, respectively. No statistical significance was observed in EF, GH, IJ, ∠a and ∠b between 36 and 46 (all P > 0.05). The morphology was divided into three categories including the straight (68.7–69.2%), oblique (19.9–20.4%) and concave types (11%). Each type was consisted of two subcategories.

Conclusions
The proposed classification could provide evidence for appropriate selection and direction design of the mandibular molar implant in clinical. The concave type was the most difficult to implant with the highest risk of lingual perforation. The implant length, width, direction required more attention.
The influence of nursing home managers’ leadership on person-centred care and stress of conscience: A cross-sectional study
Authors: Backman Annica , Sjögren Karin , Lövheim Hugo , Lindkvist Marie , Edvardsson David 
Published: October 2021

Abstract
Background
Leadership and stress are common concepts in nursing, and this study explores empirically the connection between leadership and stress of conscience in the context of aged care practice. Previous literature has shown that when staff are unable to carry out their ethical liabilities towards the residents, feelings of guilt may occur among staff, which may be an expression of stress of conscience. Although leadership has been described as crucial for staff’s work perceptions of stress as well as for person-centred practices, the influence of nursing home managers’ leadership on stress of conscience among staff and person-centred practices is still not fully explored. This study attempts to address that knowledge gap by exploring the relationship between leadership, person-centred care, and stress of conscience.

Methods
This study was based on a cross-sectional national survey of 2985 staff and their managers in 190 nursing homes throughout Sweden. Descriptive statistics and regression modelling were used to explore associations.

Results
Leadership was associated with a higher degree of person-centred care and less stress of conscience. A higher degree of person-centred care was also associated with less stress of conscience. The results also showed that leadership as well as person-centred care were individually associated with lower levels of stress of conscience when adjusting for potential confounders.

Conclusion
Nursing home managers’ leadership was significantly associated with less staff stress of conscience and more person-centred care. This indicates that a leadership most prominently characterised by coaching and giving feedback, relying on staff and handling conflicts constructively, experimenting with new ideas, and controlling work individually can contribute to less staff stress as well as higher degree of person-centred care provision.
Burnout, lifestyle and relaxation among dentists in Lithuania: a cross-sectional study
Authors: Slabšinskienė Eglė , Gorelik Andrej , Kavaliauskienė Aistė , Zaborskis Apolinaras 
Published: October 2021

Abstract
Background
The aim of this study was to estimate the association of burnout level with lifestyle and relaxation among dentists in Lithuania. A better understanding of this association could help in the development of targeted interventions to prevent burnout among these professionals.

Methods
The survey was conducted among practising dentists (N = 380) using the Maslach Burnout Inventory (MBI) and an authors’ proposed scale to measure lifestyle and relaxation. Poisson regression was applied to examine the association between variables.

Results
Regular cigarette smoking among dentists in Lithuania was 16.8 % and alcohol consumption was 31.3 %. Some forms of active relaxation were also common: regular playing sports (57.9 %), and spending time in nature (61.4 %). Emotional exhaustion (EE) and depersonalization (DP) burnout dimensions were negatively related to the regular use of illegal substances, alcohol, medication and smoking, while personal achievement (PA) was negatively related to smoking only. Dentists who regularly exercised had significantly lower EE and DP sum scores, and better assessments of PA. There were also positive relationships of EE, DP and PA sum scores with the variables of relaxation (e.g., spending time with family or friends, visiting a theatre, engaging in art, listening to music).

Conclusions
It was concluded that the burnout dimensions are negatively associated with unhealthy lifestyle factors and positively associated with active relaxation among dentists in Lithuania. Therefore, burnout prevention should target specific lifestyle and relaxation improvement strategies.
Tracking distinct microglia subpopulations with photoconvertible Dendra2 in vivo
Authors: Miller Eric B. , Karlen Sarah J. , Ronning Kaitryn E. , Burns Marie E. 
Published: October 2021

Abstract
Background
The ability to track individual immune cells within the central nervous system has revolutionized our understanding of the roles that microglia and monocytes play in synaptic maintenance, plasticity, and neurodegenerative diseases. However, distinguishing between similar subpopulations of mobile immune cells over time during episodes of neuronal death and tissue remodeling has proven to be challenging.

Methods
We recombineered a photoconvertible fluorescent protein (Dendra2; D2) downstream of the Cx3cr1 promoter commonly used to drive expression of fluorescent markers in microglia and monocytes. Like the popular Cx3cr1–GFP line (Cx3cr1+/GFP), naïve microglia in Cx3cr1–Dendra2 mice (Cx3cr1+/D2) fluoresce green and can be noninvasively imaged in vivo throughout the CNS. In addition, individual D2-expressing cells can be photoconverted, resulting in red fluorescence, and tracked unambiguously within a field of green non-photoconverted cells for several days in vivo.

Results
Dendra2-expressing retinal microglia were noninvasively photoconverted in both ex vivo and in vivo conditions. Local in vivo D2 photoconversion was sufficiently robust to quantify cell subpopulations by flow cytometry, and the protein was stable enough to survive tissue processing for immunohistochemistry. Simultaneous in vivo fluorescence imaging of Dendra2 and light scattering measurements (Optical Coherence Tomography, OCT) were used to assess responses of individual microglial cells to localized neuronal damage and to identify the infiltration of monocytes from the vasculature in response to large scale neurodegeneration.

Conclusions
The ability to noninvasively and unambiguously track D2-expressing microglia and monocytes in vivo through space and time makes the Cx3cr1–Dendra2 mouse model a powerful new tool for disentangling the roles of distinct immune cell subpopulations in neuroinflammation.
Inhibition of vascular adhesion protein 1 protects dopamine neurons from the effects of acute inflammation and restores habit learning in the striatum
Authors: Becchi Serena , Buson Alberto , Balleine Bernard W. 
Published: October 2021

Abstract
Background
Changes in dopaminergic neural function can be induced by an acute inflammatory state that, by altering the integrity of the neurovasculature, induces neuronal stress, cell death and causes functional deficits. Effectively blocking these effects of inflammation could, therefore, reduce both neuronal and functional decline. To test this hypothesis, we inhibited vascular adhesion protein 1 (VAP-1), a membrane-bound protein expressed on the endothelial cell surface, that mediates leukocyte extravasation and induces oxidative stress.

Method
We induced dopaminergic neuronal loss by infusing lipopolysaccharide (LPS) directly into the substantia nigra (SN) in rats and administered the VAP-1 inhibitor, PXS-4681A, daily.

Results
LPS produced: an acute inflammatory response, the loss of dopaminergic neurons in the SN, reduced the dopaminergic projection to SN target regions, particularly the dorsolateral striatum (DLS), and a deficit in habit learning, a key function of the DLS. In an attempt to protect SN neurons from this inflammatory response we found that VAP-1 inhibition not only reduced neutrophil infiltration in the SN and striatum, but also reduced the associated striatal microglia and astrocyte response. We found VAP-1 inhibition protected dopamine neurons in the SN, their projections to the striatum and promoted the functional recovery of habit learning. Thus, we reversed the loss of habitual actions, a function usually dependent on dopamine release in DLS and sensitive to striatal dysfunction.

Conclusions
We establish, therefore, that VAP-1 inhibition has an anti-inflammatory profile that may be beneficial in the treatment of dopamine neuron dysfunction caused by an acute inflammatory state in the brain.
Forearm compartment pressures and grip strength in elite motorbike racers with chronic exertional compartment syndrome
Authors: O’Dowd Dominic P. , Romer Heike , Hughes Richard , Harding Noel , Ball Samantha , Migliorini Filippo , Maffulli Nicola 
Published: October 2021

Abstract
Background
Remarkably little research has been published on chronic exertional compartment syndrome (CECS) of the forearm. This study investigated forearm flexor compartment pressure pre- and post-exercise in elite motorbike racers clinically diagnosed with CECS and assessed their grip strength before and after arm pump exercise.

Methods
Elite motorbike riders with a clinical diagnosis of CECS of the right forearm when racing were recruited during the opening rounds of a British Superbike season. Their grip strength and forearm flexor compartment pressures were measured before and after a set exercise programme.

Results
Of the 11 riders recruited to the study, 10 completed the full testing regime. The mean pre-exercise forearm compartment pressures [11.7 mmHg (range 7–17 mmHg)] significantly increased post-exercise [30.5 mmHg (range 15–45 mmHg)], with a mean increase of 18.80 mmHg (P < 0.0001). The mean pre-exercise grip strength [50.61 mmHg (range 37–66.7 mmHg)] decreased post-exercise to [35.62 mmHg (range 17.1–52.5 mmHg)], a mean decrease of 14.99 mmHg (P < 0.0001).

Conclusion
There is a statistically significant increase in the forearm flexor compartment pressures in elite motorbike racers with CECS, but with marked variability of these values. Grip strength decreases statistically significantly following onset of symptoms of CECS of the forearm.