bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with mental health service use during the pandemic: Initiation and barriers
Authors: Vasiliadis Helen-Maria , Spagnolo Jessica , Fleury Marie-Josée , Gouin Jean-Philippe , Roberge Pasquale , Bartram Mary , Grenier Sébastien , Shen-Tu Grace , Vena Jennifer E. , Wang JianLi 
Published: August 2023

Background: Scarce are the studies focusing on initiation of new mental health service use (MHSU) and distinguishing individuals who have sought services but have been unsuccessful in accessing these. Aims: Assessing the factors associated with initiating new MHSU as compared to no MHSU due to self-reported no need, no MHSU due to health system and personal barriers and MHSU using resources already in place. Methods: The sample included participants ( n = 16,435) in the five established regional cohorts of the Canadian Partnership for Tomorrow’s Health (CanPath) who responded to the CanPath COVID-19 health surveys (May–December 2020 and January–June 2021). Multinomial regression analyses were carried out to study MHSU since the pandemic (March 2020) as a function of predisposing, enabling and need factors. Analyses were carried out in the overall sample and restricted to those with moderate and severe symptoms (MSS) of depression and/or anxiety ( n = 2,237). Results: In individuals with MSS of depression and/or anxiety, 14.4% reported initiating new MHSU, 22.0% had no MHSU due to barriers and personal reasons and 36.7% had no MHSU due to self-reported no need. Age, living alone, lower income, a decrease in income during the pandemic and health professional status were associated with MHSU. Younger adults were more likely to initiate MHSU during the pandemic than older adults who reported not being comfortable to seek mental health care or self-reported no need. Individuals living alone and with lower income were more likely to report not being able to find an appointment for mental health care. Conclusions: Awareness campaigns focusing on older adults that explain the importance of seeking treatment is needed, as well as sensitising health professionals as to the importance of informing and aiding individuals at risk of social isolation and lower socio-economic status as to available mental health resources and facilitating access to care.
Hounsfield units on abdominal computed tomography: a new tool for predicting osteoporosis
Authors: Luo Xiaohui , Zhang Jiongfeng , Dai Zhengzai , Gong Xiang , Qu Gaoyang , Li Juncheng , Zhang Zhiping 
Published: August 2023

Background Osteoporosis can cause bone fractures and disability, but early diagnosis faces challenges. Our proposed diagnostic indicators offer a new approach for early detection, which benefits early identification. Purpose To determine the most appropriate threshold for predicting osteoporosis in patients with each section of vertebral body. Material and Methods A retrospective analysis of 210 patients, including 646 vertebrae, who had both abdominal computed tomography (CT) and dual-energy X-ray absorptiometry (DXA) within six months. The correlation between DXA T-score and CT Hounsfield units (HU) values was tested by Pearson. The area under the curve (AUC) was calculated using the threshold obtained from the regression equation. Results The thresholds matching the T-score of −2.5 were 85, 95, 85, and 90 HU for the upper axial plane of the vertebral body (Lau), the middle axial plane of the vertebral body (Lam), the lower axial plane of the vertebral body (Lad), and the mid-sagittal plane of the vertebral body (Lsm), respectively. Defining osteoporosis using CT as Lau ≤ 85, Lam ≤ 95, Lad ≤ 85, or Lsm ≤ 90 HU had a specificity of 88.1% (116/134) and sensitivity of 90.8% (69/76) for distinguishing DXA osteoporosis of the lumbar spine in 210 patients. T-score ≤−2.5 defined as Lau ≤85 or Lam ≤95 or Lad ≤85 or Lsm ≤90 HU had a specificity of 85.9% (275/320) and sensitivity of 82.8% (270/326) for DXA T-score ≤−2.5 in 646 lumbar vertebrae. Conclusion CT HU values obtained based on different sections of the vertebral body in abdominal CT can be used as a supplementary measure to assess osteoporosis.
Scaling effects on the strain rate sensitivity of unidirectional and [+45/−45]s laminates under tensile loading
Authors: Siddiqui Md Tareq , Keshavanarayana Suresh Raju 
Published: August 2023

The effects of geometric scaling on the strain rate sensitivity of unidirectional and [+45/−45]s laminates under uniaxial tensile loading has been investigated experimentally. Two material systems, Toray T800/3900-2B carbon/epoxy unitape and Newport NB321/7781 fiberglass/epoxy fabric, were used in the study. The nominal strain rates investigated ranged from quasi-static (0.0002 s−1) to moderate strain rates of 50 s−1 across the scaled specimen geometries. The geometric scaling effects at different strain rates were quantified in terms of the Weibull modulus. At each strain rate, the average failure stress of [0]4 carbon, [0]4 fiberglass, and [±45]s fiberglass showed a declining trend with increasing specimen size. However, the percentage of the strength reduction was less significant at higher strain rates compared to the quasi-static strain rate. In contrast to the other stacking sequences, [+45/−45]s carbon specimens showed a maximum percentage in strength reduction at a high strain rate compared to the quasi-static strain rate, indicating increased scaling effect with strain rate. The magnitude of Weibull modulus ( m) for the specimens increased with strain rate indicating diminishing scaling effects, while [+45/−45]s carbon specimens exhibited an opposite trend.
Prevalence of dilated mid-ascending aorta in individuals 15 years and older: In search of optimal diagnostic criteria and their effect on the burden of disease
Authors: Ahmad Mirza Mujadil , Yoon Ji Ae , Syed Muhammad Nabeel , Ahmad Mirza Nubair , Hussaini Sharmeen Fatima , Muhammad Mustafa Noor , Pir Syed Haris A , Khandheria Bijoy K , Tajik A Jamil , Ammar Khawaja Afzal 
Published: August 2023

Background: Controversy regarding the definition of the upper limit of normal (ULN) for dilated mid-ascending aorta (mAA) stems from variation in criteria, based on several small-sized studies with small datasets of normal subjects (DONS). The present study was carried out to demonstrate this variation in the prevalence of mAA dilation and to identify the optimal definition by creating the largest DONS. Methods: Echocardiographic studies of patients ≥ 15 years of age performed at a large tertiary care center over 4 years ( n = 49,330) were retrospectively evaluated. The leading-edge-to-leading-edge technique was used to measure the mAA in diastole. The largest-to-date DONS ( n = 2334) was created, including those who were normal on medical record review, did not have any of the 28 causes of dilated aorta, and had normal echocardiograms. Because age had the strongest correlation with mAA (multivariate adjusted R2 = 0.26), as compared with sex, height, and weight, we created a new ULN based on the DONS with narrow age stratification (10-year intervals). Results: The prevalence of dilated mAA varied between 17% and 23% when absolute criteria were used with sex stratification, and it varied between 6% and 11% when relative criteria (relative to age, body surface area, and sex) were used. Based on new criteria from the DONS, it was 7.6%, with a ULN of 3.07–3.64 cm in women and 3.3–3.91 cm in men. Conclusions: These data demonstrate the undesirable variation in the prevalence of dilated mAA based on prior criteria and propose a new ULN for dilated mAA.
Effects of an Acute High Intensity Exercise Bout on Retention of Explicit, Strategic Locomotor Learning in Individuals With Chronic Stroke
Authors: Thompson Elizabeth D. , Bhat Soumya , French Margaret A. , Morton Susanne , Pohlig Ryan T. , Reisman Darcy S. 
Published: August 2023

Background Exercise priming, pairing high intensity exercise with a motor learning task, improves retention of upper extremity tasks in individuals after stroke, but has shown no benefit to locomotor learning. This difference may relate to the type of learning studied. Upper extremity studies used explicit, strategic tasks; locomotor studies used implicit sensorimotor adaptation (split-belt treadmill). Since walking is an important rehabilitation goal, it is crucial to understand under which circumstances exercise priming may improve retention of a newly learned walking pattern. Objective Determine the impact of exercise priming on explicit, strategic locomotor learning task retention in chronic stroke survivors. Methods Chronic stroke survivors (>6 months) performed 2 treadmill walking sessions. Visual feedback was used to train increased step length. Participants were assigned to control group (no exercise), continuous exercise (5 minutes high intensity), or long-interval exercise (15 minutes high/moderate intervals). After day 1 learning, participants either rested or performed exercise. On day 2, retention of the learned walking pattern was tested. Results All groups learned on day 1 ( P < .001). The 2 priming groups showed significant changes in blood lactate and heart rate after exercise priming, the resting control group did not ( P < .001). On day 2, there was no significant between-group difference in cued or un-cued task retention ( P = .963 and .287, respectively). Conclusions Exercise priming did not affect retention of an explicit locomotor task in chronic stroke survivors. Further work should explore subgroups of individuals for whom priming may have selective clinical benefit to locomotor learning. ClinicalTrials.gov Identifier: NCT03726047
The diagnosis and Management of HIV Associated Acquired Hemophilia A: A Case Series From Durban, South Africa
Authors: Pillay Dashini , Rapiti Nadine 
Published: August 2023

Introduction: In acquired hemophilia A (AHA), the body produces auto-antibodies against Factor VIII. Although AHA is rare, with an incidence of 1.5 patients/1 million population/year, there is a strong association with human immunodeficiency virus (HIV) infection. The accurate interpretation of screening coagulation tests is critical to identify patients with AHA, as the mortality rate secondary to bleeding is high. Methods: This was a retrospective case series which included all newly diagnosed AHA patients that were referred to Hemophilia care unit at King Edward VIII Hospital, Durban, South Africa from January 2011 to December 2021. The clinical presentation and laboratory results were documented. Results: Five patients were included in this case series. All patients were females aged between 28 and 64 years of age and they were HIV seropositive. They presented with spontaneous cutaneous and intramuscular bleeding. Four patients were virologically suppressed on anti-retroviral therapy, and no patient had a family history of congenital bleeding diathesis. Laboratory investigations confirmed AHA with high Factor VIII inhibitor titers, which ranged from 41 to 900 Bethesda Units (BU). All patients were managed with bypassing agents and oral corticosteroids. The monitoring of patients after the initiation of treatment was difficult as they all defaulted treatment. Conclusion: In view of the prevalence of HIV in sub-Saharan Africa, there is a possibility that AHA is under-diagnosed in our setting. The clinician and the laboratory have a combined critical role in identifying patients with AHA as the investigation of a prolonged APTT is mandatory. There are challenges in managing AHA patients in a resource-constrained setting.
International study of treatment efficacy in SS shows superiority of combination therapy and heterogeneity of treatment strategies
Authors: Campbell Belinda A. , Dobos Gabor , Haider Zahra , Prince H. Miles , Bagot Martine , Evison Felicity , van der Weyden Carrie , McCormack Chris , Ram-Wolff Caroline , Miladi Maryam , Scarisbrick Julia J 
Published: August 2023

Abstract
Despite increasing availability of therapies, patients with Sezary syndrome (SS) commonly endure multi-line treatment journeys, mostly with partial responses of short duration. Measuring clinical benefit is challenging; time-to-next-treatment (TTNT) provides a robust, objective measurement of efficacy. This international observational study examines patterns of clinical care and therapeutic benefit as measured by TTNT. TTNT was calculated for monotherapies and combination therapies, with consideration to treatment line. 178 patients with SS (73% de novo, 27% secondary) were included, receiving 721 lines of systemic therapy, with median follow-up of 56.9 months. Across all lines, 58 different therapeutic regimens were prescribed (54 were systemic therapies) and classified into 17 treatment groups. The most common first-line treatments were extracorporeal photopheresis (ECP)–containing combination therapy (20%) and retinoid monotherapy (19%). Median TTNT for all first-line therapies was short (5.4 months). First-line, combination therapies had longer median TTNT than monotherapies, 10.0 vs 5.0 months (P = .004), respectively. Later delivery of combination therapies was associated with shorter clinical benefit, with median TTNT reduced to 6.2 and 2.2 months for mid-line (2nd-4th line) and late-line (≥5th line), respectively (P &lt; .001). First-line ECP-containing treatments were associated with longer median TTNT than non-ECP–containing treatments, 9.0 vs 4.9 months (P = .007). For both ECP-monotherapy and ECP–containing combination therapy, significant reductions in TTNT were seen in later lines. These data suggest therapeutic benefit from first-line delivery of combination therapy for SS and favor early inclusion of ECP in the treatment algorithm for those who can access it.
Investigation of SNP markers for the melatonin production trait in the Hu sheep with bulked segregant analysis
Authors: Wu Hao , Ma Wenkui , Yan Laiqing , Liu Fenze , Xu Shang , Ji Pengyun , Gao Shuai , Zhang Lu , Liu Guoshi 
Published: August 2023

Abstract
Background
As an important reproductive hormone, melatonin plays an important role in regulating the reproductive activities of sheep and other mammals. Hu sheep is a breed favoring for meat, with prolific traits. In order to explore the relationship between melatonin and reproductive function of Hu sheep, 7,694,759 SNPs were screened out through the whole genome sequencing analysis from high and low melatonin production Hu sheep.

Results
A total of 68,673 SNPs, involving in 1126 genes, were identified by ED association analysis. Correlation analysis of SNPs of AANAT/ASMT gene and MTNR1A/MTNR1B gene were carried out. The melatonin level of CG genotype 7,981,372 of AANAT, GA genotype 7,981,866 of ASMT and GG genotype 17,355,171 of MTNR1A were higher than the average melatonin level of 1.64 ng/mL. High melatonin Hu sheep appear to have better multiple reproductive performance.

Conclusions
By using different methods, three SNPs which are associated with high melatonin production trait have been identified in Hu sheep. These 3 SNPs are located in melatonin synthetase AANAT/ASMT and receptor MTNR1A, respectively. Considering the positive association between melatonin production and reproductive performance in ruminants, these three SNPs can be served as the potential molecular markers for breading Hu sheep with the desirable reproductive traits.
Metagenomic and culture-dependent approaches unveil active microbial community and novel functional genes involved in arsenic mobilization and detoxification in groundwater
Authors: Diba Farzana , Hoque M. Nazmul , Rahman M. Shaminur , Haque Farhana , Rahman Khondaker Md. Jaminur , Moniruzzaman Md. , Khan Mala , Hossain M. Anwar , Sultana Munawar 
Published: August 2023

Abstract
Background
Arsenic (As) and its species are major pollutants in ecological bodied including groundwater in Bangladesh rendering serious public health concern. Bacteria with arsenotrophic genes have been found in the aquifer, converting toxic arsenite [As (III)] to less toxic arsenate [As (V)] that is easily removed using chemical and biological trappers. In this study, genomic and metagenomic approaches parallel to culture-based assay (Graphical abstract) have made it possible to decipher phylogenetic diversity of groundwater arsenotrophic microbiomes along with elucidation of their genetic determinants.

Results
Seventy-two isolates were retrieved from six As-contaminated (average As concentration of 0.23 mg/L) groundwater samples from Munshiganj and Chandpur districts of Bangladesh. Twenty-three isolates harbored arsenite efflux pump (arsB) gene with high abundance, and ten isolates possessing arsenite oxidase (aioA) gene, with a wide range of minimum inhibitory concentration, MICAs (2 to 32 mM), confirming their role in arsenite metabolism. There was considerable heterogeneity in species richness and microbial community structure. Microbial taxa from Proteobacteria, Firmicutes and Acidobacteria dominated these diversities. Through these combinatorial approaches, we have identified potential candidates such as, Pseudomonas, Acinetobacter, Stenotrophomonas, Achromobacter, Paraburkholderia, Comamonas and Klebsiella and associated functional genes (arsB, acr3, arsD, arsH, arsR) that could significantly contribute to arsenite detoxification, accumulation, and immobilization.

Conclusions
Culture-dependent and -independent shotgun metagenomic investigation elucidated arsenotrophic microbiomes and their functions in As biogeochemical transformation. These findings laid a foundation for further large-scale researches on the arsenotrophic microbiomes and their concurrent functions in As biogeochemical transformation in As-contaminated areas of Bangladesh and beyond.
Psychological distress and health perception in patients with a previous myocardial infarction or stroke: a national cross-sectional study
Authors: Narendrula Aparna , Ajani Kiran , Lang Jacob , Brinza Ellen , Longenecker Chris T 
Published: August 2023

Abstract
Background
While understanding the impact of mental health on health perception improves patient-centered care, this relationship is not well-established in patients with cardiovascular disease (CVD). We examined the relationship between psychological distress and health perception in patients with a previous myocardial infarction (MI) and/or stroke.

Methods
We extracted data for patients with a previous MI and/or stroke from the 2019 National Health Interview Survey (NHIS). Health perception was self-reported. Presence and severity of anxiety and depression were estimated using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-8 (PHQ-8). Binary analyses of anxiety/depression, multivariable logistic regressions controlling for confounders, and univariable analyses of confounders and anxiety/depression severity were performed.

Results
Of 31,948 individuals for whom data on MI/stroke was available, 1235 reported a previous MI and 1203 a previous stroke. The odds of positive perceived health status were lower for individuals with anxiety/depression compared to those without anxiety/depression in both post-MI (anxiety OR 0.52, 95% CI = 0.32–0.85, P < 0.001; depression OR 0.45, 95% CI = 0.29–0.7, P < 0.001) and post-stroke groups (anxiety OR 0.61, 95% CI = 0.39–0.97, P < 0.001; depression OR 0.37, 95% CI = 0.25–0.55, P < 0.001) upon multivariable analyses. Increasing severity of anxiety/depression was also associated with worse perception of health status upon univariable analysis.

Conclusion
Among patients with a previous acute CVD event, those with psychological distress have worse perception of their health status. Understanding the range of patient health perceptions can help physicians provide more patient-centered care and encourage patient behaviors that may improve both CVD and mental health outcomes.
Designs used in published therapeutic studies of rare superficial vascular anomalies: a systematic literature search
Authors: Allemang-Trivalle Aude , Leducq Sophie , Maruani Annabel , Giraudeau Bruno 
Published: August 2023

Abstract
Background
Rare superficial vascular anomalies represent a wide range of diseases. Their management is difficult given the broad spectrum and the lack of clinical trials assessing treatment efficacy. A randomized clinical trial of vascular anomalies is difficult because of the rarity of the diseases and is enhanced by the population of interest often being children. Therefore, suitable designs are needed. We conducted a methodological systematic literature search to identify designs implemented for investigating the treatment of rare superficial vascular anomalies.

Methods
We conducted a literature search on January 25, 2021, of the PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, ClinicalTrials.gov and European Union Clinical Trials Register databases. This systematic methodological literature search was registered at the Prospective Register of Systematic Reviews (PROSPERO: CRD42021232449). Randomized and non-randomized studies were included if they met the following criteria: were prospective studies of rare superficial vascular anomaly therapies, dealt with humans (adults and children) and were published in English from 2000. We excluded case reports/case series reporting fewer than 10 patients, reviews, retrospective studies, animal studies, studies of systemic or common vascular anomalies and non-therapeutic studies. We did not assess risk of bias in the included studies because our review was a methodological one focused on the design used. The review provided a descriptive analysis of relevant features of eligible research studies.

Results
From 2046 articles identified, we included 97 studies (62 reports and 35 ongoing studies): 25 randomized controlled studies, 7 non-randomized comparative studies, 64 prospective cohorts and 1 case series. Among the 32 comparative studies included, 21 used a parallel-group design. The 11 other studies used different designs such as cross-over, randomized placebo phase, delayed-start, within-person, or challenge–dechallenge–rechallenge or used a historical control group or an observational run-in period.

Conclusions
Our systematic literature search highlights the lack of randomized control trials in superficial vascular anomalies due to the rarity of patients and their heterogeneity. New designs are emerging and can overcome the limitations of testing treatments in parallel groups.