bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of an 18-item version of the Swedish Knee Self-Efficacy Scale for patients after ACL injury and ACL reconstruction
Authors: Beischer S. , Hamrin Senorski E. , Thomeé P. , Thomeé R. 
Published: October 2021

AbstractPurposeTo evaluate the measurement properties of a new version of the Swedish Knee Self-Efficacy Scale (K-SES) in samples of individuals with an anterior cruciate ligament (ACL) injury and after ACL reconstruction. A secondary aim was to translate the new version of K-SES into English in order to prepare for future complete cross-cultural adaptation.MethodsThe reliability, structural validity, internal consistency and construct validity of the new, 18-item version of the K-SES (K-SES18) were assessed according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist for evaluating methodological quality. The Swedish version of the K-SES18was translated to English using recommended guidelines.ResultsThe test-retest reliability for the K-SES18subscalepresentand the K-SES18subscalefutureshowed an Interclass Correlation Coefficient (ICC) = 0.92. In addition, the K-SES18had a Cronbach’s α ranging from 0.93 to 0.96 for the K-SES18subscalepresentand from 0.81 to 0.91 for the K-SES18subscalefuture. No floor and ceiling effects were identified for the subscalepresentor the subscalefutureof the K-SES18. A factor analysis produced 2 factors of importance; K-SES18presentand K-SES18future. Seven predefined hypotheses were confirmed.ConclusionThe K-SES18has acceptable reliability and validity to assess knee self-efficacy in patients up to 18 months after ACL injury and reconstruction.Level of evidenceIV.
The burden of pharmacological treatment on health-related quality of life in people with a urea cycle disorder: a qualitative study
Authors: Yeowell Gillian , Burns Danielle Stephanie , Fatoye Francis 
Published: October 2021

Abstract
Background
Urea cycle disorders (UCD) are inborn errors of metabolism, typically presenting neonatally. Excess ammonia builds rapidly within the body risking hyperammonemic episodes and potentially death. Long-term management of the condition includes restrictive protein consumption, pharmacological interventions and, in extreme cases, liver transplantation. Pharmacological treatments such as sodium benzoate and sodium phenylbutyrate have proven effective but not without a multitude of negative attributes including poor taste, higher dosage and associated gastrointestinal discomfort that impacts health-related quality of life. Glycerol phenylbutyrate (GPB) has recently become a widely available pharmacological treatment with early reports of improved qualities, including taste and administration method. The following study aims to explore the burden of pharmacological treatment and the effects of the transition to GPB on health-related quality of life in people with a UCD.

Results
Nine carers of children living with a UCD (mean age = 12.44, SD = 10.26) were interviewed regarding their experiences of pharmacological treatment in relation to their, and their child’s, health-related quality of life after transitioning to GPB. Three main themes were identified: psychological health, physical health and social participation. Carers struggled with anxiety surrounding their child’s condition and the battle of administering medication. Medication administration was perceived to have improved since the transition to GPB, alleviating distress for both carer and child. Issues involving school were described, ranging from difficulties integrating their child into mainstream schooling and the impact of treatment on participation in school and extracurricular activities. Carers encountered issues sourcing syringes to administer GPB, which induced stress. It could be suggested that some burden had been relieved by the transition to GPB. However, it appeared that difficulties associated with the illness would persist despite treatment, owing to the continuing nature of the condition.

Conclusions
Adhering to a strict pharmacological regime caused immense stress for both carers and children, severely impacting on typical social activities such as eating at a restaurant or going on holiday. GPB was perceived to have alleviated some burden in terms of administration given improved characteristics concerning taste and dosage, important characteristics for both carers and children living with UCD. Practitioners should consider these findings when making clinical decisions for children with UCD and the effect of pharmacological treatment on carer’s health-related quality of life. Outreach work to facilitate greater understanding of the condition should be conducted with key locations, such as children’s schools. This would also help to alleviate carer burden.
Consequences of the MSW mechanism with Super-Kamiokande oscillation parameters and of the volume distribution of neutrino sources in the Sun
Authors: Slad L. M. 
Published: October 2021

AbstractThe knowledge of the parameters of the solar neutrino oscillation model, provided by the SNO and Super-Kamiokande Collaborations, enables us to obtain, with the Wolfenstein equation, a simple and clear analytical and numerical picture of the transformation of the neutrino state during its travel inside the Sun. We show that the resulting picture is not implicated in the characteristics of the neutrino state at the surface of the Sun and at the surface of the Earth. This circumstance with taking into account the volume distribution of solar neutrino sources indicates an obvious contradiction between the consequences of the MSW mechanism with parameters from SNO and Super-Kamiokande and the results of three of the five observed processes with solar neutrinos. The assertions at the base of the MSW mechanism are discussed.
Approach to the Patient With New-Onset Secondary Amenorrhea: Is This Primary Ovarian Insufficiency?
Authors: Stuenkel Cynthia A , Gompel Anne , Davis Susan R , Pinkerton JoAnn V , Lumsden Mary Ann , Santen Richard J 
Published: October 2021

Abstract
Menstrual cyclicity is a marker of health for reproductively mature women. Absent menses, or amenorrhea, is often the initial sign of pregnancy—an indication that the system is functioning appropriately and capable of generating the intended evolutionary outcome. Perturbations of menstrual regularity in the absence of pregnancy provide a marker for physiological or pathological disruption of this well-orchestrated process. New-onset amenorrhea with duration of 3 to 6 months should be promptly evaluated. Secondary amenorrhea can reflect structural or functional disturbances occurring from higher centers in the hypothalamus to the pituitary, the ovary, and finally, the uterus. Amenorrhea can also be a manifestation of systemic disorders resulting in compensatory inhibition of reproduction. Identifying the point of the breakdown is essential to restoring reproductive homeostasis to maintain future fertility and reestablish reproductive hormonal integrity. Among the most challenging disorders contributing to secondary amenorrhea is primary ovarian insufficiency (POI). This diagnosis stems from a number of possible etiologies, including autoimmune, genetic, metabolic, toxic, iatrogenic, and idiopathic, each with associated conditions and attendant medical concerns. The dual assaults of unanticipated compromised fertility concurrently with depletion of the normal reproductive hormonal milieu yield multiple management challenges. Fertility restoration is an area of active research, while optimal management of estrogen deficiency symptoms and the anticipated preventive benefits of hormone replacement for bone, cardiovascular, and neurocognitive health remain understudied. The state of the evidence for an optimal, individualized, clinical management approach to women with POI is discussed along with priorities for additional research in this population.
Hyperinsulinemic-Euglycemic Clamp Strengthens the Insulin Resistance in Nonclassical Congenital Adrenal Hyperplasia
Authors: Delai Ariane , Gomes Patricia M , Foss-Freitas Maria Cristina , Elias Jorge , Antonini Sonir R , Castro Margaret , Moreira Ayrton C , Mermejo Livia M 
Published: October 2021

Abstract

Objective
Insulin sensitivity evaluation by hyperinsulinemic-euglycemic clamp in nonclassical congenital adrenal hyperplasia (NC-CAH) due to 21-hydroxilase deficiency.

Design and Setting
Cross-sectional study at university hospital outpatient clinics.

Patients and Methods
NC-CAH patients (25 females, 6 males; 24 ± 10 years) subdivided into C/NC (compound heterozygous for 1 classical and 1 nonclassical allele) and NC/NC (2 nonclassical alleles) genotypes were compared to controls.

Results
At diagnosis, C/NC patients presented higher basal and adrenocorticotropin-stimulated 17-hydroxyprogesterone and androstenedione levels than NC/NC genotype. Patients and controls presented similar weight, body mass index, abdominal circumference, and total fat body mass. NC-CAH patients showed higher waist-to-hip ratio, lower adiponectin and lower high-density lipoprotein cholesterol levels with no changes in fasting plasma glucose, glycated hemoglobin, homeostatic model assessment for insulin resistance, leptin, interleukin 6, tumor necrosis factor alpha, C-reactive protein, and carotid-intima-media thickness. All patients had used glucocorticoid (mean time of 73 months). Among the 22 patients with successful clamp, 13 were still receiving glucocorticoid—3 patients using cortisone acetate, 9 dexamethasone, and 1 prednisone (hydrocortisone equivalent dose of 5.5mg/m²/day), while 9 patients were off glucocorticoid but had previously used (hydrocortisone equivalent dose of 5.9mg/m2/day). The NC-CAH patients presented lower Mffm than controls (31 ± 20 vs 55 ± 23µmol/min-1/kg-1, P = 0.002). The Mffm values were inversely correlated with the duration of glucocorticoid treatment (r = −0.44, P = 0.04). There was association of insulin resistance and glucocorticoid type but not with androgen levels.

Conclusion
Using the gold standard method, the hyperinsulinemic-euglycemic clamp, insulin resistance was present in NC-CAH patients and related to prolonged use and long-acting glucocorticoid treatment. Glucocorticoid replacement and cardiometabolic risks should be monitored regularly in NC-CAH.
Optimization of extraction conditions for polyphenols from the stem bark of Funtumia elastica (Funtum) utilizing response surface methodology
Authors: Fadjare Frempong Theophilus , Owusu Boadi Nathaniel , Badu Mercy 
Published: October 2021

Background: The recovery of phenolic compounds is seen as an arduous task because phenolic compounds are available as free aglycones, as sugar or ester conjugates, or as polymers with several monomeric components. This study looks at the optimization of factors that affect the efficiency for the extraction of phenolic compounds from the stem-bark of Funtumia elastica. Methods: Five independent variables (solvent concentration, time, the temperature, solid-liquid ratio, and pH) of the extraction process were selected. Single factor analysis as well as the response surface method was used to evaluate the impact of the selected factors on the total phenolic content. The effect of the extraction factors on the phenolic content was tested for its statistical significant (p <0.05). For the response surface method, a five/factor, five/level central composite design was used, and a fitted second-order polynomial regression model equation was used to show how the extraction parameters affected the total phenolic recovery. Results: The predicted value (R² of 0.5917) agreed with the adjusted value (R² of 0.7707). The residuals for response predictions were less than 5%. The optimal factors for the extraction were ethanol concentration of 75.99% v/v, extraction time of 193.86 minutes, temperature of 63.66°C, pH of 5.62, and solid-liquid ratio of 1:21.12 g/mL. Actual overall content of the phenolic compounds was validated at 82.83 ± 3.335 mg gallic acid equivalent (GAE) /g weight of extract, which agreed with the predicted response of 89.467 mg GAE/g of the dried extract under the optimal factors. Conclusions: The rich phenolic content of stem-bark of Funtumia elastica points to its potential as a functional medicinal product to alleviate diseases caused by oxidative stress such as asthma, breathing disorders, inflammation, and cardiovascular diseases. The results obtained indicate that, the studied optimal conditions support effective phenolics extraction of Funtumia elastica.
Weak and strong ties and its connection to experts' problem-solving styles in scaffolding students' PBL activities on social media
Authors: Abdullah Aznur Hajar , Neo Tse Kian , Low Jing Hong 
Published: October 2021

Background: Studies have acknowledged that social media enables students to connect with and learn from experts from different ties available in the students’ personal learning environment (PLE). The inclusion of experts in formal learning activities through social media such as in scaffolding problem-solving activities helps students see the practicality of experts’ thinking in solving real-world problems. However, studies that evaluate experts’ problem-solving styles and how these influence the experts' thinking process in delivering the know-how to students on social media based on the ties that the students have with the experts in social media are scarce in the extant literature. The study aimed to explore the problem-solving styles that the experts portrayed on Facebook based on their ties with the students. Methods: This study employed a simultaneous within-subject experimental design which was conducted in three closed Facebook groups with 12 final year management students, six business experts, and one instructor as the participants. The experts were invited by the students from the weak and strong ties in their PLE. Hinging on the Theory of Fluid and Crystallised intelligence and the Strength of Weak Ties Theory, this study employed thematic analysis using the ATLAS.ti qualitative data analysis software to map the experts’ comments on Facebook. Results: The use of strong ties in combination with weak ties balances out the negative aspects of the business experts’ problem-solving styles. All the experts used both fluid and crystallised intelligence in scaffolding the students’ learning; however, the degree of its usage correlated with the working experience of the experts. Conclusion: The use of weak or strong ties benefited the students as it expedited their problem-solving tasks since the experts have unique expertise to offer depending on the degree of their working experiences and the proximity of the students’ relationship with the experts.
Direct laser writing of liquid crystal elastomers oriented by a horizontal electric field
Authors: Carlotti Marco , Tricinci Omar , den Hoed Frank , Palagi Stefano , Mattoli Virgilio 
Published: October 2021

Background: The ability to fabricate components capable of performing actuation in a reliable and controlled manner is one of the main research topics in the field of microelectromechanical systems (MEMS). However, the development of these technologies can be limited in many cases by 2D lithographic techniques employed in the fabrication process. Direct Laser Writing (DLW), a 3D microprinting technique based on two-photon polymerization, can offer novel solutions to prepare, both rapidly and reliably, 3D nano- and microstructures of arbitrary complexity. In addition, the use of functional materials in the printing process can result in the fabrication of smart and responsive devices. Methods: In this study, we present a novel methodology for the printing of 3D actuating microelements comprising Liquid Crystal Elastomers (LCEs) obtained by DLW. The alignment of the mesogens was performed using a static electric field (1.7 V/µm) generated by indium-tin oxide (ITO) electrodes patterned directly on the printing substrates. Results: When exposed to a temperature higher than 50°C, the printed microstructures actuated rapidly and reversibly of about 8% in the direction perpendicular to the director. Conclusions: A novel methodology was developed that allows the printing of directional actuators comprising LCEs via DLW. To impart the necessary alignment of the mesogens, a static electric field was applied before the printing process by making use of flat ITO electrodes present on the printing substrates. The resulting microelements showed a reversible change in shape when heated higher than 50 °C.
A collection of narrative practices on cultural heritage with innovative technologies and creative strategies
Authors: López Salas Estefanía 
Published: October 2021

The H2020 project rurAllure, “Promotion of rural museums and heritage sites in the vicinity of European pilgrimage routes” (2021-2023) aims to enrich pilgrims’ experiences with the creation of meaningful cultural products focused on the lesser-known heritage sites of rural areas that are not found on pilgrimage routes, but in their surroundings. One of the project goals is to create contents and narratives to be offered to pilgrims over successive days with the integration of state-of-the-art technology. This way, hidden rural heritage will be discoverable and pilgrims will have the opportunity to actively engage with rural places nearby, their local communities, identity, and culture. The latter will no longer be passive witnesses, but active participants in transnational networks of shared history and living heritage. The rurAllure project aims to develop a new concept of mobile guide for pilgrims that will present rural heritage sites and activities of interest along with information of transportation and accommodation to help movement from and back to pilgrimage routes, as well as cohesive narratives to be consumed along the way, focused on four pilots: literary heritage on the ways to Santiago de Compostela, thermal heritage and others on the ways to Rome, ethnographic heritage on the ways to Trondheim, and natural heritage on the ways to Csíksomlyó. To facilitate the pilots’ brainstorming in the creation of multimedia contents, we developed a review of narrative models on cultural heritage storytelling. In this paper, we present the results, a collection of 22 case studies we analyzed with a common structure, from which six distinctive groups of narrative practices emerge: sound-walks, wearable guides, context-aware games, simulations, digital exhibitions, and cultural wayfinding. All cases studies disrupt traditional notions of storytelling consumption and foster new relationships between people and places of interest that may lead to advancements in the pilgrimage context.
Concept for legal and economic changes to the pension insurance of farmers
Authors: Podstawka Marian , Podstawka Łukasz 
Published: October 2021

Motivation: The study presents the current conditions for receiving the agricultural pension from the Agricultural Social Insurance Fund (KRUS) and the rules for calculating it. They are organised in such a way that the longer the insurance period of the insured person, the lower the so-called supplementary part of their pension than in the case of the insured person with the shorter insurance period. In addition, since 2011, persons insured in KRUS and having farms with an area of more than 50 ha of utilised agricultural area have been obliged to pay higher amounts for their pension insurance which do not have any impact on the level of benefits received. Farmers who also run business activities are treated by the insurance legislation in a similar manner. Hence, there is a need to make changes to the legal and economic regulations in KRUS, which would reflect the new conditions of management in Poland after 1989 and the solutions existing in the Social Insurance Institution (ZUS).
Aim: The objective of the study is to identify the regulations related to agricultural pension insurance which are inadequate in relation to the existing conditions of management in our country and to the solutions existing in ZUS. In addition, the objective of the paper is to propose changes to the insurance regulations of KRUS concerning the rules for calculating pensions and the definition of special branches of agricultural production. Also, the effects of these changes from the viewpoint of the insured person have been presented.
Results: The result of the study is a proposal for changes to the rules for calculating pensions for farmers insured in KRUS. The paper proposes to split the pension from KRUS into three parts: the contribution part, supplementary part and capital part. The proposals presented differentiate the pension amount depending on the insurance period and additionally paid contributions. The paper proposes to extend the special branches of agricultural production and to adopt income they generate at the level of 50% of the average salary in the national economy or at the level of the minimum wage as a criterion for access to insurance in KRUS.
Exploring the benefits and barriers to Nordic walking in people with Parkinson's disease: a feasibility study
Authors: McCracken Sarah , Logan Pip , Anthony Kevin , Parr John 
Published: October 2021

Background: Nordic walking (NW) has shown promising outcomes for people with Parkinson's disease (PwP). Aims: To explore the feasibility of the implementation of NW programmes for PwP in the NHS. Methods: A literature review and feasibility study were conducted. PwP joined an 8-week NW programme. Attendance and measures of mobility (Timed Up and Go (TUG), 10-metre walk test (10MWT) and quality of life (QoL) (PD non-motor questionnaire) were recorded pre- and post-intervention. Barriers, facilitators and cost were recorded. Findings: Eight studies indicated that NW is superior to walking and flexibility/relaxation exercise, with improvements in postural stability and gait. Nine of 10 participants completed the intervention with improvements in mobility (0.16 seconds faster (TUG), 1.27 seconds faster (10MWT) and QoL (better sleep, pain management, constipation, mood, exercising outside) after the intervention. Cost was recorded as £6.50 per participant per session, with no adverse events. Conclusions: NW programmes can be safely delivered in the NHS, in partnership with British Nordic walking.