bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in functional status during and after pregnancy in people with cerebral palsy: An international observational study
Authors: Condran Georgia , Lipworth Hayley , Berndl Anne 
Published: November 2024

Background There is limited information surrounding physical changes people with cerebral palsy (CP) experience during pregnancy. Methodology This is a subgroup analysis of an international online questionnaire, developed with input from individuals with CP. Data collection included demographics, baseline functional status, and functional status changes during pregnancy. Descriptive analysis was used. Results 158 participants from 15 countries participated of which 30 had a total of 49 pregnancies resulting in birth. Worsened strength, spasticity, bladder function and fatigue occurred in 56.5% (13/23), 47.8% (11/23), 56.5% (13/23) and 87.0% (20/23) of participants. 9/23 (40.9%) required new mobility devices. Worsening of fatigue, strength, spasticity and need for a new mobility device was reported by all groups regardless of functional status. Conclusions People with CP may experience significant functional changes during pregnancy, even those who mobilized independently prior to pregnancy. These findings may inform obstetricians, nurses, neurologists and physiatrists, and contribute to preconception counselling.
The Assessment of Awareness of Early Warning Signs of Bipolar Disorder Recurrence Among Patients and Their Main Caregivers in Jordan
Authors: Abu Sabra Mohammad A. , Hani Salam Bani , Jebbeh Raid Abu 
Published: November 2024

Introduction One of the biggest challenges to public health is increasing knowledge of the early warning signs (EWS) of bipolar disorder recurrence. The recurrence incidence is still high despite multiple attempts to improve the awareness level. The awareness level is still ambiguous and insufficient. Objective The purpose of this study was to assess the degree of awareness of EWS of bipolar disorder recurrence among patients and their main caregivers in Jordan. Methods A descriptive cross-sectional design was used to recruit 275 patients and their main caregivers to fill out the adapted version of the Awareness of the EWS of Relapse Questionnaire. Results The analysis showed that patients and their main caregivers’ awareness of the EWS of bipolar disorder recurrence was low and inadequate (patients, mean = 2.61 (SD = 2.6); main caregivers, mean = 3.84 (SD = 2.2); scores range from 0 to 10). Conclusion According to the study, the awareness level of these signs is still vague and inadequate. This means that ensuring long-term positive results for patients and their main caregivers requires a high degree of awareness regarding the warning signs and symptoms of bipolar disorder recurrence. To engage in standard practice, EWS of bipolar disorder recurrence awareness necessitate adequate resources, support, and an empowered and well-communicated multidisciplinary team.
Probiotic bacteria-released extracellular vesicles enhance macrophage phagocytosis in polymicrobial sepsis by activating the FPR1/2 pathway
Authors: Zhu Ruiyao , Zhang Yu , Wang Xiaohong , Liu Benjamin D. , Chowdhury Debabrata , Li Zhixin , Pan Mingliang , Peng Tianqing , Chen Jing , Huang Wei , Zhan Liying , Fan Guo-Chang 
Published: November 2024

Abstract
Background
Sepsis-induced organ failure and high mortality are largely ascribed to the failure of bacterial clearance from the infected tissues. Recently, probiotic bacteria-released extracellular vesicles (BEVs) have been implicated as critical mediators of intercellular communication which are widely involved in the regulation of the inflammatory response. However, their functional role in macrophage phagocytosis during sepsis has never been explored.

Methods
BEVs were collected from three different strains of probiotics including Lactiplantibacillus plantarum WCFS1 (LP WCFS1), Lactobacillus rhamnosus Gorbach-Goldin (LGG), and Escherichia coli Nissle 1917 (EcN), or from LGG cultured under three pH conditions (pH5-acid, pH6.5-standard, pH8-akaline) through differential centrifugation, filtration, and ultracentrifugation of their culture supernatants. In vitro phagocytosis was measured in Raw264.7 cells and bone marrow-derived macrophages using pHrodo red E. coli BioParticles. The in vivo therapeutic effects of BEVs were tested using a feces-injection-in-peritoneum (FIP) model of polymicrobial sepsis.

Results
LGG-derived EVs (BEVLGG) were the best among these three probiotics BEVs in stimulating macrophages to take up bacteria. Furthermore, BEVLGG collected from pH8 culture condition (BEVpH8) exhibited the strongest capacity of phagocytosis, compared with BEVpH5 and BEVpH6.5. Treatment of septic mice with BEVpH8 significantly prolonged animal survival; increased bacterial clearance from the blood, peritoneal lavage fluid, and multiple organs; and decreased serum levels of pro-inflammatory cytokines/chemokines, as well as reduced multiple organ injuries, in comparison with control-treated septic mice. Mechanistically, RNA-seq and bioinformatic analysis identified that the FPR1/2 signaling was remarkably activated, along with its downstream pathways (PI3K-Akt-MARCO and NADPH-ROS) in BEVpH8-treated macrophages, compared with control cells. Accordingly, pre-addition of Boc2, a specific antagonist of FPR1/FPR2, to macrophages significantly attenuated BEVpH8-mediated phagocytosis, compared to controls.

Conclusions
This study demonstrates that LGG-derived BEVs may have therapeutic effects against sepsis-induced organ injury and mortality through enhancing FPR1/2-mediated macrophage phagocytosis.
Characteristics of deep-sea microbial cellulases: key determinants of the ultimate fate of plant biomass on Earth
Authors: Tachioka Mikako , Tsudome Mikiko , Tsuda Miwako , Hiraoka Satoshi , Miyazaki Masayuki , Takaki Yoshihiro , Deguchi Shigeru 
Published: November 2024

AbstractLand plants, especially those with significant woody biomass, represent the largest source of biomass on Earth, making the biodegradation of lignocellulosic materials critical to understanding the global carbon cycle. Cellulose, a major component of lignocellulose, is notoriously resistant to degradation due to its highly crystalline structure. While the degradation of cellulose by terrestrial microbes has been extensively studied, the mechanisms of cellulose degradation in deep-sea environments remain largely unexplored. The deep-sea ecosystem depends on organic matter, such as cellulose, that is synthesized in terrestrial environments and surface waters and descends to the deep sea. Recent studies suggest that a significant amount of cellulose is likely to reach the deep sea. Here, we present an in-depth study of cellulases from a novel deep-sea γ-proteobacterial strain TOYAMA8, isolated from Toyama Bay, Japan, using Surface Pitting Observation Technology (SPOT), a highly sensitive assay for enzymatic cellulose hydrolysis. The cellulases of strain TOYAMA8 show similarities to those of a previously reported deep-sea cellulolytic microbe, Marinagarivorans cellulosilyticus strain GE09. Genomic and transcriptomic analyses of these strains reveal novel cellulase genes and mechanisms that differ from terrestrial counterparts, shedding light on the unique adaptations of deep-sea microbes to recalcitrant biomass. In particular, these strains produce high-molecular-weight cellulases with unique domain architectures, likely optimized for membrane anchoring, which prevents enzyme diffusion and ensures efficient localized activity. Our findings provide critical insights into the microbial cellulose degradation in the deep sea, highlighting its role in the fate of organic carbon and the potential for biotechnological applications in biorefineries.
Drastic variation in mitochondrial genome organization between two congeneric species of bird lice (Philopteridae: Ibidoecus)
Authors: Cao Mei-Ling , Nie Yu , Yi Xi-Long , Xiong Jun , Wang Wei , Deng Yuan-Ping , Fu Yi-Tian , Liu Guo-Hua , Shao Renfu 
Published: November 2024

AbstractThe over 4,100 species of bird lice are classified into 214 genera in the parvorders Amblycera and Ischnocera. Congeneric species of bird lice usually share much similarity in morphology and in mitochondrial (mt) genome organization. Two recent studies, however, reported substantial intra-genus variation in mt genome organization in bird lice. Both the ancestral single-chromosome mt genome and a fragmented mt genome with two or three minichromosomes were observed in the genera Austromenopon and Laemobothrion. To better understand intra-genus variation in mt genome organization, we sequenced the complete mt genome of the white spoonbill louse Ibidoecus plataleae and compared it with that of the glossy ibis feather louse Ibidoecus bisignatus reported previously. We found that I. plataleae had a fragmented mt genome with 12 minichromosomes; each minichromosome was 2,798 to 3,628 bp in size and had 2 to 6 genes. This is in stark contrast to the mt genome of I. bisignatus, which has all genes on a single chromosome, 14,909 bp in size. This is the most drastic intra-genus variation in mt genome organization observed to date in animals, indicating an unprecedented rapid process of mt genome fragmentation in the genus Ibidoecus. The divergence time between I. plataleae and I. bisignatus is currently unknown but is estimated to be less than 23 million years. Either many minichromosal split events occurred after I. plataleae diverged from I. bisignatus, or one minichromosome splits into multiple minichromosomes in a single event. Sequencing and comparing more Ibidoecusi species will help understand the unusual mt genome fragmentation in this genus.
Esophageal pressure as estimation of pleural pressure: a study in a model of eviscerated chest
Authors: Florio Gaetano , Carlesso Eleonora , Mojoli Francesco , Madotto Fabiana , Vivona Luigi , Minaudo Chiara , Battistin Michele , Colombo Sebastiano Maria , Gatti Stefano , Sosio Simone , Pesenti Antonio , Grasselli Giacomo , Zanella Alberto 
Published: November 2024

Abstract
Background
Transpulmonary pressure is the effective pressure across the lung parenchyma and has been proposed as a guide for mechanical ventilation. The pleural pressure is challenging to directly measure in clinical setting and esophageal manometry using esophageal balloon catheters was suggested for estimation. However, the accuracy of using esophageal pressure to estimate pleural pressure is debated due to variability in the mechanical properties of respiratory system, esophagus and esophageal catheter. Furthermore, while a vertical pleural pressure gradient exists across lung regions, esophageal pressure balloon provides a single value, representing, at most, the pressure surrounding the esophagus.

Methods
In a swine model with a preserved esophagus and a single homogenous, easily measurable intrathoracic pressure, we evaluated esophageal pressure’s agreement with intrathoracic pressure at different positive end-expiratory pressure (PEEP) levels (0, 5, 10, 15 cmH2O). We assessed the improvement of measurement accuracy by correcting absolute esophageal values using a previously described technique, that accounts for the pressure generated by the esophageal wall in response to esophageal balloon inflation.
The study involved five swine, wherein two different esophageal catheters were used alongside the four distinct PEEP levels. Swings, uncorrected and corrected absolute esophageal pressures (end-inspiratory, end-expiratory) were compared with their respective intrathoracic pressures. The effect of correction technique was assessed with manual incremental step inflation procedure.

Results
We found that both catheters significantly overestimated absolute esophageal pressure compared to intrathoracic pressure (5.01 ± 3.32 and 6.06 ± 5.62 cmH2O at end-expiration and end-inspiration, respectively), with error increasing at higher positive end-expiratory pressure levels (end-expiration: 2.36 ± 2.03, 3.77 ± 1.37, 6.24 ± 2.51 and 7.69 ± 4.02 for each PEEP level, P < 0.0001; end-inspiration: 1.71 ± 2.10, 3.70 ± 1.73, 7.67 ± 3.62 and 11.14 ± 7.60 for each PEEP level, P = 0.0004).
Applying the correction technique significantly improved agreement for absolute values (0.82 ± 1.62 and 1.86 ± 3.94 cmH2O at end-expiration and end-inspiration, respectively). Esophageal pressure swings accurately estimated intrathoracic pressure swings at low-medium intrathoracic pressures (-0.64 ± 0.62, -0.07 ± 0.53, 1.43 ± 1.51, and 3.45 ± 3.94 at PEEP 0, 5, 10 and 15 cmH2O, respectively; P = 0.0197).

Conclusions
The correction technique, based on the mechanical response of esophageal wall to the balloon inflation, is fundamental for obtaining reliable estimations of absolute intrathoracic pressure values, and for ensuring its correct application in clinical setting.
(Cost-)effectiveness and implementation of a combined lifestyle intervention for outpatients with severe mental illness (GOAL!): a hybrid quasi-experimental study protocol
Authors: Noortman-van Meteren C. R. , van Schothorst M. M. E. , den Bleijker N. M. , Braakhuis-Keuning B. , Houwert-Zuidema W. M. H. , van Amelsvoort T. A. M. J. , Deenik J. 
Published: November 2024

Abstract
Background
People with severe mental illness (SMI) face not only impaired mental health, but also a greater risk of physical comorbidities and a shorter life expectancy compared to the general population. A poor lifestyle plays a substantial role in this disparity. Combined Lifestyle Interventions targeting multiple lifestyle behaviors can improve mental and physical health, and quality of life. However, there is currently no appropriate structural support for people with SMI in outpatient care in the Netherlands. The Combined Lifestyle Intervention for Outpatients with SMI (GOAL!) is developed to address this gap. This study examines the (cost-)effectiveness and implementation of GOAL!.

Methods
In a type 1 hybrid quasi-experimental study with a mixed-method matched design, GOAL! participants (N = 50) are compared to people receiving care as usual (N = 50). The GOAL! program includes group and individual sessions, given by allied health professionals, over a period of two years. The first year starts with a 3-month intensive course on physical activity and nutrition, followed by 9 months of aftercare covering various lifestyle topics tailored to the group’s needs. There is close collaboration with local stakeholders to facilitate transfer to the community setting. The second year focuses on maintaining established activities in one’s daily living environment. Our primary outcome will be the change in physical activity, comparing GOAL! participants to those receiving care as usual. Secondary outcomes are changes in other lifestyle behaviors, physical health, mental well-being, and healthcare and societal costs. Additionally, achieving lifestyle-related goals, adverse effects, and barriers and facilitators to implementation are examined. Measurements are obtained at start (T0), and after 3 (T1), 12 (T2) and 24 months (T3).

Discussion
This study investigates the effects of GOAL! on lifestyle behaviors, health outcomes, implementation factors and cost-effectiveness after two years, aiming to offer valuable insights into the effectiveness and implementation outcomes of lifestyle interventions for outpatients with SMI.

Trial registration
: ClinicalTrials.gov (Identifier: NCT05600205). Prospectively registered on October 26, 2022.
Exploring the unconventional: health professionals’ experiences into medication-free treatment for patients with severe mental illness
Authors: Reitan Elisabeth C. Klæbo , Riley Henriette , Høifødt Tordis Sørensen , Iversen Valentina C. , Høye Anne 
Published: November 2024

Abstract
Background
In January 2017, the Norwegian government mandated the establishment of an inpatient unit for “medication-free treatment” for patients with severe mental illness at the University Hospital of North Norway in Tromsø. This study aims to explore the employees’ experiences with this unit.

Method
Focus group interviews were conducted October 2021 – February 2022. For analysis, the participants were divided into three groups; S (staff working at the medication-free unit), M (people involved in management at the unit) and T (therapists working elsewhere in the hospital). The analysis followed the Systematic Text Condensation and interviews were recorded, transcribed and analysed using NVivo software.

Results
Health professionals described their experiences with medication-free treatment through five main concepts: 1) Employees’ motivation; 2) Frames; 3) Network; 4) Relations; and 5) Patients’ motivation. Staff and management expressed strong motivation for an alternative to “treatment as usual,” focusing more on recovery and relationships than on the absence of medication. Therapists from other hospital areas highlighted resource allocation concerns and expressed a desire to learn from the unit. Challenges were acknowledged by all groups.

Conclusion
The term “medication-free treatment’’ might be misleadning. While patiens at the unit can use medications, there is a strong emphasis on patient autonomy and the option to taper off medication and live a life without them. The study adds valuable knowledge about the the experiences of employees working at a medication-free unit, and provides insights into the complexity of treating severe mental illness, both with and without medication. It highlights the importance of sufficient time, stability and resources to focus on each patient’s strengths and challenges. All employees agree that tailored measures in long-term treatment and a clear focus on recovery should be integral, even without an emphasis on “medication-free treatment”.
How do apathetic and depressive symptoms relate to functional capacity? A cross-sectional survey among community-dwelling middle-aged and older adults in Japan
Authors: Oba Hikaru , Kanda Akira , Ihara Kazushige , Tanabu Asano , Shimoda Hiroshi 
Published: November 2024

Abstract
Background
Apathetic and depressive symptoms are frequently observed among older adults, and are risk factors for functional decline and dementia progression. However, how these symptoms influence functional capacity remains unclear. This study investigated the relationship between apathetic and depressive symptoms and functional capacity, considering the interaction between apathetic and depressive symptoms.

Methods
A cross-sectional questionnaire survey targeting community dwelling middle-aged or older adults was conducted. We sent a questionnaire to 984 individuals and received 320 responses. Data with missing values and participants aged under 50 were excluded, resulting in 212 participants (88 men and 124 women, mean age = 73.4 ± 9.3 years). Apathetic symptoms were evaluated using the Dimensional Apathy Scale (J-DAS), which comprises executive, emotional, and cognitive and behavioral initiation aspects of apathy. Depressive symptoms were evaluated using the Geriatric Depression Scale (GDS). Functional capacity was assessed using the Japan Science and Technology Agency Index of Competence, which comprises technology usage, information practice, life management, and social engagement.

Results
Mean score of each J-DAS factor and GDS was 5.3 ± 3.4 (executive), 12.0 ± 3.0 (emotional), 11.8 ± 5.1 (initiation), and 4.5 ± 3.3, respectively. The emotional and initiation aspects of J-DAS were significantly associated with information practice (β = -0.15, p < .05 for emotional; β = -0.27, p < .001 for initiation) and life management (β = -0.20, p < .01 for emotional; β = -0.22, p < .01 for initiation) in functional capacity. GDS was associated only with social engagement (β = -0.31, p < .001). Although the interaction between the initiation factor of J-DAS and GDS was significantly associated with life management (β = -0.16, p < .05), the R2 change was insignificant. The emotional factor of J-DAS was associated with technology usage (β = -0.13, p < .05), although less strongly than age. The executive factor of J-DAS had insignificant associations with all aspects of functional capacity.

Conclusions
Apathetic and depressive symptoms are independently, rather than interactively, associated with different aspects of functional capacity. As older adults with apathetic or depressive symptoms might struggle to seek help from public health services, they should be targeted with active interventions from healthcare professionals.
Clinical efficacy of three plating systems in management of mandibular parasymphyseal fractures: a retrospective study
Authors: Mahmoud Nermine Ramadan , Habaka Yasser Fekry 
Published: November 2024

Abstract
Background
The main goal of management of the mandibular fracture is to obtain the pre-injury contour of the bone and pre-injury occlusion as well as regain function early. For Parasymphyseal fractures, the ideal fixation method is still debatable. It could range from rigid to semi-rigid fixation. The current study aimed to compare the clinical and radiographic effect of two miniplates, 2.3 high-profile Miniplates, and three-dimensional (3D) Miniplates for internal fixation treatment of mandibular para-symphyseal fractures.

Methods
The study reviewed 240 medical records, dividing 60 patients into three treatment groups: Group I (25 patients received 2.0 mini plates), Group II (22 patients received 2.3 high profile miniplate), and Group III (13 patients received 3D miniplate). Data included demographics, fracture diagnosis, radiographs, maxillomandibular fixation use, surgical time, intervention, postoperative stability, and complications.

Results
The present study included 60 patients with mandibular parasymphyseal fractures, divided into three treatment groups: Group I (n = 25, 41.67%), Group II (n = 22, 36.67%), and Group III (n = 13, 21.67%). The study found no significant differences in age and sex distribution among the three groups, but the mean surgery time varied significantly. Group II had the highest rate of complications at 22.73%, followed by Group I at 20% and Group III at 7.69%.

Conclusion
In conclusion, the (3D) Miniplates could provide better internal fixation treatment of mandibular para-symphyseal fractures in terms of easy use, short surgery time and less complication such as malocclusion and infection.
Age-related STING suppression in macrophages contributes to increased viral load during influenza a virus infection
Authors: Lauf Thurid , Häder Antje , Hornung Franziska , Reisser Yasmina , Nietzsche Sandor , Schanz Fabian , Trümper Verena , Jeznach Aldona , Brunke Sascha , Doenst Torsten , Skirecki Tomasz , Löffler Bettina , Deinhardt-Emmer Stefanie 
Published: November 2024

AbstractAgeing is a major risk factor that contributes to increased mortality and morbidity rates during influenza A virus (IAV) infections. Macrophages are crucial players in the defense against viral infections and display impaired function during ageing. However, the impact of ageing on macrophage function in response to an IAV infection remains unclear and offers potential insight for underlying mechanisms. In this study, we investigated the immune response of young and aged human monocyte-derived macrophages to two different H1N1 IAV strains. Interestingly, macrophages of aged individuals showed a lower interferon response to IAV infection, resulting in increased viral load. Transcriptomic data revealed a reduced expression of stimulator of interferon genes (STING) in aged macrophages albeit the cGAS-STING pathway was upregulated. Our data clearly indicate the importance of STING signaling for interferon production by applying a THP-1 STING knockout model. Evaluation of mitochondrial function during IAV infection revealed the release of mitochondrial DNA to be the activator of cGAS-STING pathway. The subsequent induction of apoptosis was attenuated in aged macrophages due to decreased STING signaling. Our study provides new insights into molecular mechanisms underlying age-related immune impairment. To our best knowledge, we are the first to discover an age-dependent difference in gene expression of STING on a transcriptional level in human monocyte-derived macrophages possibly leading to a diminished interferon production.