bluuebunny/crossref_metadata_2025_split huggingface dataset:
The challenges of identifying and studying type 1 diabetes in adults
Authors: Thomas Nicholas J. , Jones Angus G. 
Published: September 2023

AbstractDiagnosing type 1 diabetes in adults is difficult since type 2 diabetes is the predominant diabetes type, particularly with an older age of onset (approximately >30 years). Misclassification of type 1 diabetes in adults is therefore common and will impact both individual patient management and the reported features of clinically classified cohorts. In this article, we discuss the challenges associated with correctly identifying adult-onset type 1 diabetes and the implications of these challenges for clinical practice and research. We discuss how many of the reported differences in the characteristics of autoimmune/type 1 diabetes with increasing age of diagnosis are likely explained by the inadvertent study of mixed populations with and without autoimmune aetiology diabetes. We show that when type 1 diabetes is defined by high-specificity methods, clinical presentation, islet-autoantibody positivity, genetic predisposition and progression of C-peptide loss remain broadly similar and severe at all ages and are unaffected by onset age within adults. Recent clinical guidance recommends routine islet-autoantibody testing when type 1 diabetes is clinically suspected or in the context of rapid progression to insulin therapy after a diagnosis of type 2 diabetes. In this moderate or high prior-probability setting, a positive islet-autoantibody test will usually confirm autoimmune aetiology (type 1 diabetes). We argue that islet-autoantibody testing of those with apparent type 2 diabetes should not be routinely undertaken as, in this low prior-prevalence setting, the positive predictive value of a single-positive islet antibody for autoimmune aetiology diabetes will be modest. When studying diabetes, extremely high-specificity approaches are needed to identify autoimmune diabetes in adults, with the optimal approach depending on the research question. We believe that until these recommendations are widely adopted by researchers, the true phenotype of late-onset type 1 diabetes will remain largely misunderstood.
Graphical Abstract
Structural changes in Schwann cells and nerve fibres in type 1 diabetes: relationship with diabetic polyneuropathy
Authors: Hu Xiaoli , Buhl Christian Selmer , Sjogaard Marie Balle , Schousboe Karoline , Mizrak Hatice Isik , Kufaishi Huda , Jensen Troels Staehelin , Hansen Christian Stevns , Yderstræde Knud Bonnet , Zhang Ming-Dong , Ernfors Patrik , Nyengaard Jens Randel , Karlsson Pall 
Published: September 2023

Abstract
Aims/hypothesis
Our aim was to investigate structural changes of cutaneous Schwann cells (SCs), including nociceptive Schwann cells (nSCs) and axons, in individuals with diabetic polyneuropathy. We also aimed to investigate the relationship between these changes and peripheral neuropathic symptoms in type 1 diabetes.

Methods
Skin biopsies (3 mm) taken from carefully phenotyped participants with type 1 diabetes without polyneuropathy (T1D, n=25), type 1 diabetes with painless diabetic polyneuropathy (T1DPN, n=30) and type 1 diabetes with painful diabetic polyneuropathy (P-T1DPN, n=27), and from healthy control individuals (n=25) were immunostained with relevant antibodies to visualise SCs and nerve fibres. Stereological methods were used to quantify the expression of cutaneous SCs and nerve fibres.

Results
There was a difference in the number density of nSCs not abutting to nerve fibres between the groups (p=0.004) but not in the number density of nSCs abutting to nerve fibres, nor in solitary or total subepidermal SC soma number density. The overall dermal SC expression (measured by dermal SC area fraction and subepidermal SC process density) and peripheral nerve fibre expression (measured by intraepidermal nerve fibre density, dermal nerve fibre area fraction and subepidermal nerve fibre density) differed between the groups (all p<0.05): significant differences were seen in participants with T1DPN and P-T1DPN compared with those without diabetic polyneuropathy (healthy control and T1D groups) (all p<0.05). No difference was found between participants in the T1DPN and P-T1DPN group, nor between participants in the T1D and healthy control group (all p>0.05). Correlational analysis showed that cutaneous SC processes and nerve fibres were highly associated, and they were weakly negatively correlated with different neuropathy measures.

Conclusions/interpretation
Cutaneous SC processes and nerves, but not SC soma, are degenerated and interdependent in individuals with diabetic polyneuropathy. However, an increase in structurally damaged nSCs was seen in individuals with diabetic polyneuropathy. Furthermore, dermal SC processes and nerve fibres correlate weakly with clinical measures of neuropathy and may play a partial role in the pathophysiology of diabetic polyneuropathy in type 1 diabetes.

Graphical Abstract
Combining return to sport, psychological readiness, body mass, hamstring strength symmetry, and hamstring/quadriceps ratio increases the risk of a second anterior cruciate ligament injury
Authors: Almeida Gabriel Peixoto Leão , Albano Thamyla Rocha , Rodrigues Carlos Augusto Silva , Tavares Maria Larissa Azevedo , de Paula Lima Pedro Olavo 
Published: September 2023

AbstractPurposeTo investigate the combinations of variables that comprise the biopsychosocial model domains to identify clinical profiles of risk and protection of second anterior cruciate ligament injury.MethodsOne hundred and forty‐five patients for return‐to‐sport testing after anterior cruciate ligament (ACL) reconstruction (ACLR) were contacted, and 97 were deemed eligible. All were evaluated between 6 and 24 months and followed up for 2 years. Participants answered the International Knee Documentation Committee (IKDC) and Anterior Cruciate Ligament–Return to Sport after Injury Scale (ACL‐RSI), performed the postural stability assessment using the Biodex Balance System, and assessed muscle strength at 60° and 300°/s on the isokinetic dynamometer. Personal factors (age, gender, body mass index), body structures (graft type and concomitant injuries), and environmental factors (time between surgery and evaluation) were also collected. The participants were asked about the occurrence of a second ACL injury and return to sport after 2 years of follow‐up. Classification and regression tree (CART) analysis was used to determine predictors of a second ACL injury. The receiver operating characteristic (ROC) curve was performed to verify the accuracy of the CART analysis, in addition to the sensitivity, specificity, and relative risk (RR) of the model.ResultsOf the initial 97 participants, 88 (89.8%) responded to follow‐up and 14 (15.9%) had a second ACL injury (11 graft ruptures and three contralateral ACL). CART analysis identified the following variables as predictors of second ACL injury: return to sport, hamstring strength symmetry at 300°/s, ACL‐RSI score, hamstrings/quadriceps ratio at 60°/s, and body mass index (BMI). CART correctly identified 9 (64.3%) of the 14 participants who were reinjured and 71 (95.9%) of the 74 participants who were not. The total correct classification was 90.9%. The area under the ROC curve was 0.88 (95% CI 0.72–0.99; p < 0.001), and the model showed a sensitivity of 75% (95% CI 42.8–94.5), specificity of 93.4% (95% CI 85.3–97.8), and RR of 15.9 (95% CI 4.9–51.4; p < 0.0001).ConclusionThe combination of hamstring strength symmetry, hamstring/quadriceps ratio (body functions); return to sport (activity and participation); psychological readiness; and BMI (personal factors) could identify three clinical risk profiles for a second ACL injury with good accuracy.Level of EvidenceIV.
Operator splitting based dynamic iteration for linear differential-algebraic port-Hamiltonian systems
Authors: Bartel Andreas , Günther Michael , Jacob Birgit , Reis Timo 
Published: September 2023

AbstractA dynamic iteration scheme for linear differential-algebraic port-Hamiltonian systems based on Lions–Mercier-type operator splitting methods is developed. The dynamic iteration is monotone in the sense that the error is decreasing and no stability conditions are required. The developed iteration scheme is even new for linear port-Hamiltonian systems governed by ODEs. The obtained algorithm is applied to a multibody system and an electrical network.
Multi-scale assessments reveal changes in the distribution of the endangered seagrass Posidonia australis and the role of disturbances
Authors: Swadling Daniel S. , West Greg J. , Gibson Peter T. , Laird Roger J. , Glasby Tim M. 
Published: September 2023

AbstractSeagrasses are threatened globally by multiple anthropogenic disturbances, and management of these threats requires detailed information on where losses are occurring and why. Seagrass distribution is determined by processes operating at multiple scales, yet most assessments of change to seagrass extent are done at a single spatial scale. This study applied a multi-scale approach to quantify changes in the extent of the endangered seagrass Posidonia australis over the last 10–18 years using high-resolution mapping from 15 estuaries in New South Wales, Australia. Changes in P. australis extent and relationships with anthropogenic disturbances were examined at two spatial scales: across entire estuaries and at sub-estuary “local” scales within 50 × 50 m grids. Although increases in P. australis area were observed in ten estuaries, losses at local scales were prevalent in all estuaries. No disturbances correlated with seagrass change at the estuary scale; however, the greatest losses occurred in Botany Bay which is a highly modified estuary with a heavily urbanised catchment. At local scales, losses of P. australis were strongly associated with large areas of artificial structures and distance to the sea, and the greatest increases were observed in areas with marine reserves and no oyster aquaculture. These findings highlight the importance of quantifying changes in seagrass extent at multiple scales, as estuary-scale trends can mask localised losses if they are offset by increases in other parts of the estuary. Identifying hotspots of declines and the disturbances causing them are essential for applying focussed management actions to conserve seagrasses.
A glimmer of hope for an Endangered temperate soft coral: the first observations of reproductive strategies and early life cycle of Dendronephthya australis (Octocorallia: Malacalcyonacea)
Authors: Larkin Meryl F. , Davis Tom R. , Harasti David , Smith Stephen D. A. , Ainsworth Tracy D. , Benkendorff Kirsten 
Published: September 2023

AbstractThe habitat-forming Endangered ‘cauliflower’ soft coral Dendronephthya australis, endemic to South-east Australia, is in rapid decline. To aid future conservation strategies, it is vital to understand the fundamental biological processes of this species, particularly reproduction. This study describes the first records of sexual reproduction and asexual clonal replication, with observations both in aquaria and in the wild. We used a combination of observations including histological analyses of fresh specimens, and images of colonies in situ taken over 19 years, to investigate the reproductive cycle of D. australis. Mature oocytes and spermaries were found to develop within colonies during February/March, 2022. We subsequently closed the life cycle of D. australis from colonies spawned in aquaria, documenting all stages of embryogenesis and larval development through to polyp metamorphosis, and successfully transplanted juvenile colonies back into the field and documented their growth over six months to a maximum 435 polyps in size. We also document autonomous fragmentation events to provide accounts of asexual clonal propagation. These records confirm that D. australis is gonochoric and likely a broadcast spawning species that is also capable of utilising asexual reproduction by clonal replication. Observations of mature gametes support the hypothesis that spawning activity coincides with the seasonal increase in water temperature, and is likely to be a continuous phenomenon over 5 months of the year (November–March). These observations not only contribute to the knowledge base for this species, but also provide invaluable information on reproductive strategies that will support conservation efforts to assist the recovery of D. australis populations.
Nonlinear BSDEs with Two Optional Doob’s Class Barriers Satisfying Weak Mokobodzki’s Condition and Extended Dynkin Games
Authors: Klimsiak Tomasz , Rzymowski Maurycy 
Published: September 2023

AbstractWe study reflected backward stochastic differential equations (RBSDEs) on the probability space equipped with a Brownian motion. The main novelty of the paper lies in the fact that we consider the following weak assumptions on the data: barriers are optional of class (D) satisfying weak Mokobodzki’s condition, generator is continuous and non-increasing with respect to the value-variable (no restrictions on the growth) and Lipschitz continuous with respect to the control-variable, and the terminal condition and the generator at zero are supposed to be merely integrable. We prove that under these conditions on the data there exists a solution to corresponding RBSDE. In the second part of the paper, we apply the theory of RBSDEs to solve basic problems in Dynkin games driven by nonlinear expectation based on the generator mentioned above. We prove that the main component of a solution to RBSDE represents the value process in corresponding extended nonlinear Dynkin game. Moreover, we provide sufficient conditions on the barriers guaranteeing the existence of the value for nonlinear Dynkin games and the existence of a saddle point.
Theorie und Praxis der Trauma-fokussierten Mentalisierungsbasierten Therapie
Authors: Rüfenacht Eva N. , Shaverin Lisa , Bateman Anthony , Fonagy Peter , Taubner Svenja 
Published: September 2023

ZusammenfassungDerzeit gibt es noch keine offiziellen Behandlungsrichtlinien für die komplexe posttraumatische Belastungsstörung (kPTBS). Die kPTBS unterscheidet sich von der PTBS durch die Symptomatik, Dauer oder Häufigkeit der Traumaexposition und durch eine hohe Komorbidität mit der Borderline-Persönlichkeitsstörung (BPS). Daher besteht Bedarf an der Entwicklung neuer Behandlungsmethoden, die auf diese Patient:innengruppe ausgerichtet sind. Im Folgenden wird eine neue Trauma-fokussierte Mentalisierungsbasierte Therapie, die für Patienten mit einer kPTBS entwickelt wurde und als Gruppenbehandlung konzipiert ist, beschrieben. Neben dem theoretischen Hintergrund und dem konzeptuellen Rahmen von Trauma in der mentalisierungsbasierten Therapie wird der Ablauf der Behandlung ausführlich dargestellt und anhand eines Fallbeispiels illustriert.
Esophageal Infusion of Menthol Does Not Affect Esophageal Motility in Patients with Gastroesophageal Reflux Disease
Authors: Bánovčin Peter , Lipták Peter , Vážanová Diana , Hoferica Jakub , Tatár Miloš , Ďuriček Martin 
Published: September 2023

AbstractMenthol is thought to trigger gastroesophageal reflux disease (GERD) symptoms by influencing esophageal peristalsis and lower esophageal sphincter (LES) function. We evaluated the effect of esophageal menthol infusion on esophageal motility and the LES in healthy volunteers and in patients with GERD. High resolution manometry (HRM) catheter with attached thin tube for menthol infusion was placed transnasally. Protocol which included baseline recording, 16 water swallows (5 ml, 10 ml, and 15 ml) and the multiple rapid swallows was performed before and after esophageal infusion of menthol (3 mM, 20 min, 8 ml/min). We evaluated the effect of this infusion on the HRM parameters of esophageal peristalsis (distal contractile integral, distal latency, contractile front velocity) and the lower esophageal sphincter (LES) barrier function (integrated relaxation pressure and the inspiratory augmentation of the LES). Simultaneously we evaluated the quality and intensity of the symptoms during the menthol infusion. Esophageal infusion of menthol did not appreciably affect HRM measurements characterizing esophageal peristalsis and LES pressure in healthy subjects (N = 13) or GERD patients (N = 11). The magnitude of the distal contractile integral (5 ml) was changed neither in the healthy volunteers’ group, (735 ± 127 vs. 814 ± 117 mmHg, p = 0.5), nor in the GERD patients (295 ± 78 vs. 338 ± 96 mmHg, p = 0.99). In healthy volunteers menthol did not change the inspiratory augmentation of the LES (8.67 ± 1.09 vs. 7.69 ± 0.96 mmHg, p = 0.15) and neither did for GERD patients (8.8 ± 1.18 vs. 8.22 ± 0.91 mmHg, p = 0.43). We observed no significant difference in any HRM parameter following menthol infusion, except for distal latency in 10 ml swallows. By contrast, menthol infusion induced significantly more intense discomfort in GERD patient than in healthy volunteers. Our results suggest no significant temporal effect of menthol on the esophageal motility or LES function, neither in healthy volunteers, nor in GERD. Arguably, other mechanisms are responsible for menthol-related heartburn.
Endoscopic therapies for patients with obesity: a systematic review and meta-analysis
Authors: Weitzner Zachary N. , Phan Jennifer , Begashaw Meron M. , Mak Selene S. , Booth Marika S. , Shekelle Paul G. , Maggard-Gibbons Melinda , Girgis Mark D. 
Published: September 2023

Abstract
Background
Obesity is a major threat to public health and traditional bariatric surgery continues to have low utilization. Endoscopic treatments for obesity have emerged that offer less risk, but questions remain regarding efficacy, durability, and safety. We compared the efficacy of endoscopic bariatric procedures as compared to other existing treatments.

Methods
A literature search of Embase, Cochrane Central, and Pubmed was conducted from January 1, 2014 to December 7, 2021, including endoscopic bariatric therapies that were FDA or CE approved at the time of search to non-endoscopic treatments. Thirty-seven studies involving 15,639 patients were included. Primary outcomes included % total body weight loss (%TBWL), % excess body weight loss (%EBWL), and adverse events. Secondary outcomes included quality of life data and differences in hemoglobin A1C levels. Strength of clinical trial and observational data were graded according to the Cochrane methods.

Results
Intragastric balloons achieved greater %TBWL with a range of 7.6–14.1% compared to 3.3–6.7% with lifestyle modification at 6 months, and 7.5–14.0% compared to 3.1–7.9%, respectively, at 12 months. When endoscopic sleeve gastroplasty (ESG) was compared to laparoscopic sleeve gastrectomy (LSG), ESG had less %TBWL at 4.7–14.4% compared to 18.8–26.5% after LSG at 6 months, and 4.5–18.6% as compared to 28.4–29.3%, respectively, at 12 months. For the AspireAssist, there was greater %TBWL with aspiration therapy compared to lifestyle modification at 12 months, 12.1–18.3% TBWL versus 3.5–5.9% TBWL, respectively. All endoscopic interventions had higher adverse events rates compared to lifestyle modification.

Conclusion
This review is the first to evaluate various endoscopic bariatric therapies using only RCTs and observational studies for evaluation of weight loss compared with conservative management, lifestyle modification, and bariatric surgery. Endoscopic therapies result in greater weight loss compared to lifestyle modification, but not as much as bariatric surgery. Endoscopic therapies may be beneficial as an alternative to bariatric surgery.
Hidden genetics behind glomerular scars: an opportunity to understand the heterogeneity of focal segmental glomerulosclerosis?
Authors: Mitrotti Adele , Giliberti Marica , Di Leo Vincenzo , di Bari Ighli , Pontrelli Paola , Gesualdo Loreto 
Published: September 2023

AbstractFocal segmental glomerulosclerosis (FSGS) is a complex disease which describes different kinds of kidney defects, not exclusively linked with podocyte defects. Since nephrin mutation was first described in association with early-onset nephrotic syndrome (NS), many advancements have been made in understanding genetic patterns associated with FSGS. New genetic causes of FSGS have been discovered, displaying unexpected genotypes, and recognizing possible site of damage. Many recent large-scale sequencing analyses on patients affected by idiopathic chronic kidney disease (CKD), kidney failure (KF) of unknown origin, or classified as FSGS, have revealed collagen alpha IV genes, as one of the most frequent sites of pathogenic mutations. Also, recent interest in complex and systemic lysosomal storage diseases, such as Fabry disease, has highlighted GLA mutations as possible causes of FSGS. Tubulointerstitial disease, recently classified by KDIGO based on genetic subtypes, when associated with UMOD variants, may phenotypically gain FSGS features, as well as ciliopathy genes or others, otherwise leading to completely different phenotypes, but found carrying pathogenic variants with associated FSGS phenotype. Thus, glomerulosclerosis may conceal different heterogeneous conditions. When a kidney biopsy is performed, the principal objective is to provide an accurate diagnosis. The broad spectrum of phenotypic expression and genetic complexity is demonstrating that a combined path of management needs to be applied. Genetic investigation should not be reserved only to selected cases, but rather part of medical management, integrating with clinical and renal pathology records. FSGS heterogeneity should be interpreted as an interesting opportunity to discover new pathways of CKD, requiring prompt genotype–phenotype correlation. In this review, we aim to highlight how FSGS represents a peculiar kidney condition, demanding multidisciplinary management, and in which genetic analysis may solve some otherwise unrevealed idiopathic cases. Unfortunately there is not a uniform correlation between specific mutations and FSGS morphological classes, as the same variants may be identified in familial cases or sporadic FSGS/NS or manifest a variable spectrum of the same disease. These non-specific features make diagnosis challenging. The complexity of FSGS genotypes requires new directions. Old morphological classification does not provide much information about the responsible cause of disease and misdiagnoses may expose patients to immunosuppressive therapy side effects, mistaken genetic counseling, and misguided kidney transplant programs.