bluuebunny/crossref_metadata_2025_split huggingface dataset:
EFFECTS OF ISOMETRIC HOLD EXERCISE WITH PASSIVE TERMINAL KNEE EXTENSION IN RESTORING QUADRICEPS FUNCTION AFTER ACL RECONSTRUCTION — RESEARCH DESIGN AND METHODS
Authors: Raj Vijay Samuel , Mruthyunjaya  , Chandru Vijay 
Published: August 2024

Background: Inhibition of the quadriceps muscle activity and reduced knee extension strength in terminal extension is observed in most cases following anterior cruciate ligament (ACL) injuries and reconstruction. Quadriceps lag (QL), if it persists, can lead to limitation of functional and performance skills. The loss of quadriceps power may be due to reduced voluntary activation of the quadriceps muscle due to arthrogenic muscle inhibition (AMI). The possibility of physiotherapeutic intervention to reduce the AMI must be considered to decrease the QL, and improve muscle strength and functional recovery. There is a need to develop a specific exercise addressing arthrogenic muscle inhibition (AMI), to achieve complete knee extension at the early phase of rehabilitation. The trial is aimed to evaluate the effect of IEPTE in patients with quadriceps lag following anterior cruciate ligament reconstruction (ACLR). Methods: Randomized, Parallel Group Trial, including 36 patients ([Formula: see text] = 36) aged 18–50 years with ACLR, will be randomly allocated to isometric hold exercise with passive terminal knee extension (IEPTE) and ACL conventional exercise group (CG). The primary outcome for quadriceps lag and the secondary outcome of motor unit action potential (MUAP), pain and knee function will be evaluated. The IEPTE technique is developed by the author, who combined passive terminal knee extension with the isometric hold exercise to knee extensors. The effects of the exercise protocol will be evaluated using outcome measures at 0 (baseline), 2nd, 4th, 8th, 24th weeks. General linear mixed model for repeated measures with effect size tested using Cohen’s d will be used to analyze primary and secondary outcomes to investigate confounding interaction between groups and time. A statistically significant was set to [Formula: see text] < 0.05 (95% CI). The study results are expected to be completed by December 2023 and the results by 2024. Discussion: The exercise developed addresses the AMI and achieves knee extension at the early phase of rehabilitation. If proven to be effective, the early activation of the quadriceps may improve the knee function. This developed exercise (IEPTE) thus can be used in the ACL rehabilitation program and results will help to explore further to frame new guidelines and protocol.
Knowledge and stigma of depression among adolescents in Indonesia: a cross-sectional study
Authors: Sarfika Rika , Permata Putri Indah , Mailani Fitri , Wijaya Nindy Eka , Saifudin I Made Moh. Yanuar , Efendi Ferry 
Published: August 2024

<span lang="EN-US">Depression is a prevalent mental health issue among Indonesian adolescents. Adolescents grappling with depression face various challenges, including exclusion, discrimination, educational difficulties, and violations of human rights. Limited knowledge about depression contributes to stigma, which impacts teenagers' reluctance to seek professional help. This study aimed to examine the correlation between adolescents' knowledge and the stigma of depression. Using a cross-sectional framework, this study involved 240 high school students from grades 10, 11, and 12. All participants completed and returned the requisite instruments. Knowledge about depression was assessed using the adolescent depression knowledge questionnaire (ADKQ), while the depression stigma scale (DSS) was used to gauge levels of stigma. The relationship between knowledge and stigma was analysed using the Spearman rank test. The findings indicate that the mean score for adolescents' knowledge about depression was 7.00 (SD=2.72), while the mean score for stigmatisation of depression was 42.02 (SD=8.43). A significant relationship between knowledge and stigma was observed (p&lt;0.0001), characterised by moderate strength and a negative direction (r=-0.45). The study concludes that more excellent knowledge about depression among adolescents is inversely related to the level of the stigma they harbour. It is therefore recommended that mental health nurses in Community Health Centers enhance educational and counselling programs to inform adolescents about depression better. Collaboration between academic institutions and healthcare facilities, along with the development of school-based mental health programs, is imperative for reducing the stigma associated with depression among students.</span>
Unraveling spinal cord injury caregiver burden in Indonesia
Authors: Biben Vitriana , Sumardi Novitri , Wijaya Arya , Simatupang Septania Elfira , Nurarifah Sitti Ayu Hemas 
Published: August 2024

Diverse cultural, social, and economic backgrounds significantly influence the caregiver burden of spinal cord injury (SCI) patients, affecting their quality of life (QoL) and the overall care experience. This study was done to identify spinal cord caregivers' QoL in Indonesia through their burden and the variables that influence it. A cross-sectional study was conducted at Dr. Hasan Sadikin Hospital, Bandung, Indonesia, involved 137 primary SCI caregivers. The burden of these caregivers was evaluated using the Indonesian version of the Zarit Burden Interview (ZBI) and the World Health Organization Quality of Life-BREF questionnaires. The data was analyzed with multiple linear regression and spearman analysis using SPSS version 24. The majority of SCI caregivers have a mild to moderate burden (54.7%). The burden score was significantly correlated, especially with occupational status and the length of interaction each day (p&lt;0.001). It also found a significant with strong negative correlation (referring to the Guilford criteria) between caregiver burden and QoL (r-value −0.750; p-value &lt;0.001). Indonesian caregivers' cultural and economic backgrounds may alleviate their burden in caregiving, but attention to patient occupational status and care duration is crucial to prevent worsening their quality of life, particularly for SCI survivors they care for.
Different Indeed: Portuguese Sovereign Debt from 1500 to 1796
Authors: Costa Leonor Freire , Henriques António Castro 
Published: August 2024

Abstract
This paper presents the main findings of a project on Portuguese sovereign credit from 1500 to 1797. After presenting the institutional framework of the main credit instrument (juro), we analyse the evolution of the interest rates, debt stocks, and debt-to- GDP and debt-to-revenue ratios, with some international comparisons. We find that, when seen in a comparative mirror, the Portuguese sovereign credit had some outstanding features: despite the sound credibility of the debt instrument used (juro) and low interest rates, debt stocks and levels were comparatively moderate.
Effect of Direct Oral Anticoagulants in Patients with Splanchnic Vein Thrombosis: A Systematic Reviews and Meta-Analysis
Authors: Wan Yun , Guo Linjuan , Xiong Meimei 
Published: August 2024

Background Since several studies have examined the use of direct oral anticoagulants (DOACs) in treating patients with splanchnic vein thrombosis (SVT), we conducted a meta-analyses to assess the safety and efficacy of DOACs compared to vitamin K antagonists (VKAs) in this population. Methods We conducted a comprehensive search using the PubMed, Embase, and Cochrane Library databases until June 2024. We used odds ratios (ORs) and 95% confidence intervals (CIs) as the effect measures to compare DOACs with VKAs. Results A total of 9 observational studies were included. The pooled analysis revealed that a trend towards higher complete recanalization rates with DOACs (71.4%) compared to VKAs (55.3%), though not statistically significant (OR 1.95; 95%CI 0.70 to 5.44). For SVT extension, a significant effect was observed favoring DOACs (OR 0.12; 95%CI 0.03 to 0.54). No significant differences were found in other efficacy outcomes or safety outcomes, except for major bleeding, which was significantly lower with DOACs (OR 0.27; 95%CI 0.13 to 0.56). Conclusion DOACs are superior to VKAs in SVT extension and major bleeding, suggesting that DOACs may be a favorable treatment option in the treatment of SVT.
Prehospital stroke detection scales: A head-to-head comparison of 7 scales in patients with suspected stroke
Authors: Dekker Luuk , Moudrous Walid , Daems Jasper D , Buist Ewout FH , Venema Esmee , Durieux Marcel DJ , van Zwet Erik W , de Schryver Els LLM , Kloos Loet MH , de Laat Karlijn F , Aerden Leo AM , Dippel Diederik WJ , Kerkhoff Henk , van den Wijngaard Ido R , Wermer Marieke JH , Roozenbeek Bob , Kruyt Nyika D 
Published: August 2024

Background: Several prehospital scales have been designed to aid paramedics in identifying stroke patients in the ambulance setting. However, external validation and comparison of these scales are largely lacking. Aims: To compare all published prehospital stroke detection scales in a large cohort of unselected stroke code patients. Methods: We conducted a systematic literature search to identify all stroke detection scales. Scales were reconstructed with prehospital acquired data from two observational cohort studies: the Leiden Prehospital Stroke Study (LPSS) and PREhospital triage of patients with suspected STrOke (PRESTO) study. These included stroke code patients from four ambulance regions in the Netherlands, including 15 hospitals and serving 4 million people. For each scale, we calculated the accuracy, sensitivity, and specificity for a diagnosis of stroke (ischemic, hemorrhagic, or transient ischemic attack (TIA)). Moreover, we assessed the proportion of stroke patients who received reperfusion treatment with intravenous thrombolysis or endovascular thrombectomy that would have been missed by each scale. Results: We identified 14 scales, of which 7 (CPSS, FAST, LAPSS, MASS, MedPACS, OPSS, and sNIHSS-EMS) could be reconstructed. Of 3317 included stroke code patients, 2240 (67.5%) had a stroke (1528 ischemic, 242 hemorrhagic, 470 TIA) and 1077 (32.5%) a stroke mimic. Of ischemic stroke patients, 715 (46.8%) received reperfusion treatment. Accuracies ranged from 0.60 (LAPSS) to 0.66 (MedPACS, OPSS, and sNIHSS-EMS), sensitivities from 66% (LAPSS) to 84% (MedPACS and sNIHSS-EMS), and specificities from 28% (sNIHSS-EMS) to 49% (LAPSS). MedPACS, OPSS, and sNIHSS-EMS missed the fewest reperfusion-treated patients (10.3–11.2%), whereas LAPSS missed the most (25.5%). Conclusions: Prehospital stroke detection scales generally exhibited high sensitivity but low specificity. While LAPSS performed the poorest, MedPACS, sNIHSS-EMS, and OPSS demonstrated the highest accuracy and missed the fewest reperfusion-treated stroke patients. Use of the most accurate scale could reduce unnecessary stroke code activations for patients with a stroke mimic by almost a third, but at the cost of missing 16% of strokes and 10% of patients who received reperfusion treatment.
Pediatric Concussions in Contact Sports: A 10-Year Retrospective Analysis of Mechanisms and Associated Symptoms
Authors: Cassinat Joshua J. , Grise Alison , Aceto Matthew , Wright Vonda 
Published: August 2024

Background: Concussions make up a significant proportion of sports injuries. This study aimed to describe the mechanisms of injury and associated symptoms of pediatric patients diagnosed with concussions (age range, 4-17 years) from contact sports. Hypothesis: Mechanisms of injury would differ based on sex and age, with female athletes and younger athletes aged 4 to 11 years sustaining fewer concussions from player-to-player contact. Study Design: Descriptive epidemiology study. Methods: The National Electronic Injury Surveillance System was queried for all contact sport concussions presented to United States emergency departments. The sports analyzed included basketball, football, soccer, hockey, rugby, and lacrosse. Descriptive data, mechanisms of injury, and associated symptoms were analyzed for each sport. Differences in the number of concussions sustained by year and sport, the severity of the injury, and associated symptoms were compared using chi-square test, and differences in proportion were calculated for mechanisms of injury stratified by sex and age. Results: A total of 12,602 youth athletes sustained concussions between 2012 and 2021. Most patients were male (78.5%), with a mean age of 13.48 years. Football concussions were the most common, with 45.32% of the concussions. The mechanism of injury was largely sport-specific, with player-to-player contact the most common overall. Older male athletes were more likely to have concussions from player-to-player contact, whereas younger athletes were more impacted by head-to-ground mechanisms. Symptom presentation was not sport-specific, and headache and dizziness were the most common presentation at 41.2% and 26.2%, respectively. Conclusion: The most important overall mechanism of injury was player-to-player contact, especially in older male youth athletes, whereas younger athletes were more likely to be concussed due to head-to-ground injuries.
Systematic Elastostatic Stiffness Model of Over-Constrained Parallel Manipulators Without Additional Constraint Equations
Authors: Yang Chao , Yu Wenyong , Ye Wei , Chen Qiaohong , Huang Fengli 
Published: August 2024

AbstractThe establishment of an elastostatic stiffness model for over constrained parallel manipulators (PMs), particularly those with over constrained subclosed loops, poses a challenge while ensuring numerical stability. This study addresses this issue by proposing a systematic elastostatic stiffness model based on matrix structural analysis (MSA) and independent displacement coordinates (IDCs) extraction techniques. To begin, the closed-loop PM is transformed into an open-loop PM by eliminating constraints. A subassembly element is then introduced, which considers the flexibility of both rods and joints. This approach helps circumvent the numerical instability typically encountered with traditional constraint equations. The IDCs and analytical constraint equations of nodes constrained by various joints are summarized in the appendix, utilizing multipoint constraint theory and singularity analysis, all unified within a single coordinate frame. Subsequently, the open-loop mechanism is efficiently closed by referencing the constraint equations presented in the appendix, alongside its elastostatic model. The proposed method proves to be both modeling and computationally efficient due to the comprehensive summary of the constraint equations in the Appendix, eliminating the need for additional equations. An example utilizing an over constrained subclosed loops demonstrate the application of the proposed method. In conclusion, the model proposed in this study enriches the theory of elastostatic stiffness modeling of PMs and provides an effective solution for stiffness modeling challenges they present.
Microplastic clouds in rivers: spatiotemporal dynamics of microplastic pollution in a fluvial system
Authors: Balla Alexia , Moshen Ahmed , Kiss Tímea 
Published: August 2024

Abstract
Background
The microplastic transport of rivers is a complex spatiotemporal process; however, only limited knowledge exists on it, making its monitoring complicated. The study aimed to analyze the spatial and temporal dynamics of suspended sediments and microplastics based on measurements (1) every five days for 2 years at one site and (2) annual repetition at 29 sites along the 750-km-long Tisza River for 3 years. Water samples were taken by pumping (1 m3). Machine learning algorithms were applied to Sentinel images to analyze the spatiality of sediment transport.

Results
In the Tisza River (Central Europe), the microplastic concentration (MPCmean: 35 ± 27 item/m3) and the suspended sediment concentration (SSCmean: 60 ± 57 g/m3) showed high temporal variations. During low stages, the concentrations dropped as most transported sediments were deposited on the bottom. These sediments, including microplastics, were remobilized during flood waves, thus, higher MPC and SSC were measured. The first flood wave after a low-stage period had the highest concentrations. The increased transport capacity of the river during floods created large-scale suspended sediment and microplastic waves with increased concentrations. The mean MPC gradually increased between 2021 (19 ± 13.6 item/m3) and 2022 (23.7 ± 15.8 item/m3), and then it more than doubled (2023: 57 ± 44.8 item/m3). The tributaries acted as suspended sediment and microplastic conveyors.
On the Sentinel images, medium-scale clouds were identified, with the suspended sediment clouds being more pronounced than microplastic clouds. Fewer and longer clouds appeared during low stages, separated by clearer water bodies. During flood waves, shorter clouds were detected. The tributaries with increased suspended sediment and microplastic transport created well-distinguishable clouds in the main river.

Conclusions
Identifying suspended sediment and microplastic clouds in a river could support more precise monitoring. The hydrological background of the monitoring and the existence of these clouds should be considered, as sampling from clouds with increased SSC and MPC provides different data than sampling from the clearer water bodies between two clouds.

Graphical Abstract
A study of risk factors associated with the presence of oral potentially malignant disorders: a community-based study from Northeastern Thailand
Authors: Chiewwit Pim , Khovidhunkit Siribang-on Piboonniyom , Tantipoj Chanita , Worakhajit Prangtip , Klongnoi Boworn 
Published: August 2024

Abstract
Background
The principal objective of this study is to ascertain the connections between well-known risk factors of oral cancer, including smoking (cigarette and tobacco), alcohol consumption, betel quid chewing, irritations in the oral cavity, history of head and neck cancer, and history of working outdoor more than 4 days/week, and the presence of OPMDs within the Thai population.

Method
349,318 subjects were recruited for initial screening, then 1,483 subjects who had at least 1 risk factor and a suspicious lesion underwent comprehensive oral examinations followed by a clinical diagnosis and then received initial treatment from either oral surgeons or oral medicine specialists. Among these subjects, individuals with at least 1 risk factor and with a clinical diagnosis of OPMDs were classified as cases, while those with at least 1 risk factor but without OPMDs were categorized as controls. The case group comprised a total of 487 subjects, whereas the control group consisted of 996 subjects. Exclusion criteria were known cases of currently having oral cancer or OPMDs.

Results
The outcomes of the multivariate analysis revealed that among the variables assessed, betel quid (adjusted OR 5.12 [3.93–6.68], p < 0.001) and smoking (adjusted OR 1.46 [1.08–1.97], p = 0.013), there were an association with the presence of OPMDs. Conversely, alcohol drinking, having irritations in the oral cavity, a history of head and neck cancer, and a history of working outdoors more than 4 days/week were not associated with the presence of OPMDs. Furthermore, we also study the synergistic effect of alcohol drinking, irritations in the oral cavity, history of head and neck cancer, and history of working outdoors more than 4 days/week using subgroup analysis. The analysis showed that alcohol consumption combined with smoking or betel quid chewing expressed a significantly increased risk of OPMDs, from 1.46 to 2.03 (OR 2.03 [1.16–3.56], p = 0.014) and from 5.12 to 7.20 (OR 7.20 [3.96–13.09], p < 0.001).

Conclusion
Smoking and exposure to betel quid were a significant risk factors for the presence of OPMDs. The combination of alcohol with smoking or betel quid chewing was also found to increase the risk of OPMDs in this Thai northeastern population.
Heterozygosity for the Budapest 3 mutation in SERPINC1 in a family with thrombophilia and structural anomalies of the inferior vena cava
Authors: Iversen Nina , Henriksson Carola Elisabeth , Sletten Marit , Le Marie Skogstad , Lindberg Beate Rikken , Andersen Rune , Paus Benedicte 
Published: August 2024

Abstract
Background
Atresia of the infrarenal inferior vena cava (IVC) is associated with thrombophilia and antithrombin (AT) deficiency (ATD) due to homozygosity for the so-called Budapest 3 variant, c.391C > T, in the gene, SERPINC1.

Case presentation
We report on a father and his two sons that had severe thrombosis at a young age. One son had absence of, and the other had very gracile infrarenal IVC. The father had gracile vena iliaca. All had significant collateral building. AT activity was determined with four different methods and varied between moderately reduced and borderline normal values, depending on the method. While all were heterozygous for c.391C > T, the father was also heterozygous for a variant of uncertain significance in SERPINC1.

Conclusions
The findings support the association between c.391C > T in SERPINC1, thrombophilia, and atresia of the IVC system and indicate that even heterozygosity for c.391C > T may contribute to such anomalies. ATD detection was hampered by the varying sensitivity of methods used for AT activity measurement.
Maternal n-3 enriched diet reprograms the offspring neurovascular transcriptome and blunts inflammation induced by endotoxin in the neonate
Authors: Chumak Tetyana , Jullienne Amandine , Ek C. Joakim , Ardalan Maryam , Svedin Pernilla , Quan Ryan , Salehi Arjang , Salari Sirus , Obenaus Andre , Vexler Zinaida S , Mallard Carina 
Published: August 2024

AbstractInfection during the perinatal period can adversely affect brain development, predispose infants to ischemic stroke and have lifelong consequences. We previously demonstrated that diet enriched in n-3 polyunsaturated fatty acids (n-3 PUFA) transforms brain lipid composition in the offspring and protects the neonatal brain from stroke, in part by blunting injurious immune responses. Critical to the interface between the brain and systemic circulation is the vasculature, endothelial cells in particular, that support brain homeostasis and provide a barrier to systemic infection. Here, we examined whether maternal PUFA-enriched diets exert reprograming of endothelial cell signalling in postnatal day 9 mice after modeling aspects of infection using LPS. Transcriptome analysis was performed on microvessels isolated from brains of pups from dams maintained on 3 different maternal diets from gestation day 1: standard, n-3 enriched or n-6 enriched diets. Depending on the diet, in endothelial cells LPS produced distinct regulation of pathways related to immune response, cell cycle, extracellular matrix, and angiogenesis. N-3 PUFA diet enabled higher immune reactivity in brain vasculature, while preventing imbalance of cell cycle regulation and extracellular matrix cascades that accompanied inflammatory response in standard diet. Cytokine analysis revealed a blunted LPS response in blood and brain of offspring from dams on n-3 enriched diet. Analysis of cerebral vasculature in offspring in vivo revealed no differences in vessel density. However, vessel complexity was decreased in response to LPS at 72 h in standard and n-6 diets. Thus, LPS modulates specific transcriptomic changes in brain vessels of offspring rather than major structural vessel characteristics during early life. N-3 PUFA-enriched maternal diet in part prevents an imbalance in homeostatic processes, alters inflammation and ultimately mitigates changes to the complexity of surface vessel networks that result from infection. Importantly, maternal diet may presage offspring neurovascular outcomes later in life.
Graphical Abstract