bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thalamic energy dysfunction is associated with thalamo-cortical tract damage in multiple sclerosis: A diffusion spectroscopy study
Authors: Ricigliano Vito AG , Tonietto Matteo , Palladino Raffaele , Poirion Emilie , De Luca Alberto , Branzoli Francesca , Bera Geraldine , Maillart Elisabeth , Stankoff Bruno , Bodini Benedetta 
Published: June 2020

Background: Diffusion-weighted 1H magnetic resonance spectroscopy (DW-MRS) allows to quantify creatine-phosphocreatine brain diffusivity (ADC(tCr)), whose reduction in multiple sclerosis (MS) has been proposed as a proxy of energy dysfunction. Objective: To investigate whether thalamic ADC(tCr) changes are associated with thalamo-cortical tract damage in MS. Methods: Twenty patients with MS and 13 healthy controls (HC) were enrolled in a DW-MRS and DW imaging (DWI) study. From DW-MRS, ADC(tCr) and total N-acetyl-aspartate diffusivity (ADC(tNAA)) were extracted in the thalami. Three thalamo-cortical tracts and one non-thalamic control tract were reconstructed from DWI. Fractional anisotropy (FA), mean (MD), axial (AD), and radial diffusivity (RD), reflecting microstructural integrity, were extracted for each tract. Associations between thalamic ADC(tCr) and tract metrics were assessed using linear regression models adjusting for age, sex, thalamic volume, thalamic ADC(tNAA), and tract-specific lesion load. Results: Lower thalamic ADC(tCr) was associated with higher MD and RD of thalamo-cortical projections in MS (MD: p = 0.029; RD: p = 0.017), but not in HC (MD: p = 0.625, interaction term between thalamic ADC(tCr) and group = 0.019; RD: p = 0.320, interaction term = 0.05). Thalamic ADC(tCr) was not associated with microstructural changes of the control tract. Conclusion: Reduced thalamic ADC(tCr) correlates with thalamo-cortical tract damage in MS, showing that pathologic changes in thalamic energy metabolism are associated with structural degeneration of connected fibers.
Development and psychometric properties of the Multiple Sclerosis Knowledge Assessment Scale: Rasch analysis of a novel tool for evaluating MS knowledge
Authors: Bessing Barnabas , Honan Cynthia A , van der Mei Ingrid , Taylor Bruce V , Claflin Suzi B 
Published: June 2020

Background: Multiple sclerosis (MS)-related knowledge is an important evaluation metric for health education interventions. However, few MS knowledge assessment tools are currently available for use. Objectives: This study aims to develop a reliable and valid Multiple Sclerosis Knowledge Assessment Scale (MSKAS) for use in the MS community and the general public. Methods: The MSKAS was developed using a Delphi study methodology and was administered to participants in the first open enrolment of the Understanding Multiple Sclerosis (UMS) online course. Rasch analysis was used to examine its psychometric properties and develop the final scale. Results: Experts from across the MS community participated in the development of the MSKAS, resulting in an initial scale of 42 items. Five hundred and forty-three UMS participants completed the MSKAS; 89% were female and 30% were people with MS. The final unidimensional 22-item scale has a person separation index of 2.16, a person reliability index of 0.82, an item separation index of 11.19, and a Cronbach’s alpha (kr-20) test reliability of 0.87. Conclusion: The MSKAS is a unidimensional scale with good construct validity and internal consistency. The MSKAS has the potential to be useful for the assessment of MS knowledge in research and clinical practice.
Prism adaptation treatment for spatial neglect post brain tumour removal: A case report
Authors: Chen Peii , Lander Viktoriya , Noce Natalia , Hreha Kimberly 
Published: June 2020

Purpose/aim: Spatial neglect is caused by damage to neural networks critical for spatial attention. Spatial neglect without proper treatment impedes rehabilitation outcomes. Prism adaptation treatment, a visuomotor protocol, has been used with stroke survivors with spatial neglect to improve function. This case report explored the feasibility and potential effects of prism adaptation treatment in an individual with spatial neglect after glioblastoma removal. Methods Feasibility was designed and tested to include acceptability and implementation. Exploratory aim on the effectiveness of the intervention was determined using the Catherine Bergego Scale via the Kessler Foundation Neglect Assessment Process, star cancellation, line bisection and scene copying. Results The patient reported favouring the treatment. Eight sessions, one session a day, were completed over two weeks. The patient’s spatial neglect symptoms reduced on all assessments. Conclusion Prism adaptation treatment was feasible and effective; however, further research is needed to understand the complete benefits of prism adaptation treatment in this population.
Wellbore trajectory control tool seal system leakage analysis based on steady gap flow
Authors: Shi Lei , Wang Keqiang , Feng Ding , Zhang Hong , Wang Peng 
Published: June 2020

Lubricant leakage will inevitably occur during the working process of wellbore trajectory control tools. Even including the lubricant compensation system, serious leakage will still cause lacks lubrication of the internal mechanical structure as well as electronic system damaged by external infiltration fluid, especially when it comes to battery sub and other electronic equipment. Seal system leakage prediction method was presented based on the assumption of steady gap flow. It is assumed that there is a constant gap between the lip seal and the rotating shaft, the gap height is determined by oil film thickness, and the length of the gap was determined by the contact analysis using the Mooney–Rivlin constitutive model. The analysis results show that the contact length between the primary seal lip and the rotary shaft is about 0.1 mm under the condition of ensuring the contact between the deputy seal lip and the rotary shaft. The overall lubricant leakage finite element analysis model was established, and the relationship between the internal lubricant pressure of the tool and the total leakage was obtained. The results of analysis indicate that under the internal pressure of 0.03 MPa, the lubricant leakage is approximately 6 mL/h, which was verified by experiments.
Augmentation of Meniscal Repair With Platelet-Rich Plasma: A Systematic Review of Comparative Studies
Authors: Belk John W. , Kraeutler Matthew J. , Thon Stephen G. , Littlefield Connor P. , Smith John H. , McCarty Eric C. 
Published: June 2020

Background: The effect of platelet-rich plasma (PRP) augmentation for meniscal repair (MR) is unclear, as current evidence is limited to small, mostly nonrandomized studies. Purpose: To systematically review the literature to evaluate the efficacy and safety of MR with PRP augmentation. Study Design: Systematic review; Level of evidence, 3. Methods: A systematic review was performed by searching PubMed, the Cochrane Library, and Embase to identify studies (level of evidence 1-3) that compared the clinical efficacy of MR performed with versus without PRP. The search phrase used was platelet-rich plasma meniscus. Patients were assessed based on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the visual analog scale (VAS) for pain, the Lysholm score, the Knee injury and Osteoarthritis Outcome Score (KOOS), the subjective International Knee Documentation Committee (IKDC) score, and treatment failure. Results: We identified 6 studies (2 studies with level 1 evidence; 4 studies with level 3 evidence) that met inclusion criteria, for a total of 309 patients undergoing MR with PRP (mean age, 31.9 years) and 445 patients without PRP augmentation (mean age, 29.6 years). The mean follow-up was 32.8 months (range, 12-72 months). Overall, 17.0% of PRP patients experienced MR failure compared with 22.1% of non-PRP patients. No differences in VAS, Lysholm, or subjective IKDC scores were found between groups except in 1 study, in which postoperative subjective IKDC scores were significantly better in the PRP group ( P < .01). Another study found significantly better postoperative WOMAC scores among PRP patients, and 2 studies found significantly better KOOS subscores among PRP patients. Conclusion: There are a limited number of high-quality studies comparing outcomes and healing rates between patients undergoing MR with versus without PRP augmentation. Based on the available evidence, patients undergoing MR with PRP augmentation experience similar clinical outcomes at midterm follow-up when compared with conventional MR, and additional studies are needed to determine the efficacy of MR augmented with PRP.
Macrophage hypophagia as a mechanism of innate immune exhaustion in mAb-induced cell clearance
Authors: Pinney Jonathan J. , Rivera-Escalera Fátima , Chu Charles C. , Whitehead Hannah E. , VanDerMeid Karl R. , Nelson Ashley M. , Barbeau Michelle C. , Zent Clive S. , Elliott Michael R. 
Published: June 2020

AbstractMacrophage antibody (Ab)-dependent cellular phagocytosis (ADCP) is a major cytotoxic mechanism for both therapeutic unconjugated monoclonal Abs (mAbs) such as rituximab and Ab-induced hemolytic anemia and immune thrombocytopenia. Here, we studied the mechanisms controlling the rate and capacity of macrophages to carry out ADCP in settings of high target/effector cell ratios, such as those seen in patients with circulating tumor burden in leukemic phase disease. Using quantitative live-cell imaging of primary human and mouse macrophages, we found that, upon initial challenge with mAb-opsonized lymphocytes, macrophages underwent a brief burst (&lt;1 hour) of rapid phagocytosis, which was then invariably followed by a sharp reduction in phagocytic activity that could persist for days. This previously unknown refractory period of ADCP, or hypophagia, was observed in all macrophage, mAb, and target cell conditions tested in vitro and was also seen in vivo in Kupffer cells from mice induced to undergo successive rounds of αCD20 mAb-dependent clearance of circulating B cells. Importantly, hypophagia had no effect on Ab-independent phagocytosis and did not alter macrophage viability. In mechanistic studies, we found that the rapid loss of activating Fc receptors from the surface and their subsequent proteolytic degradation were the primary mechanisms responsible for the loss of ADCP activity in hypophagia. These data suggest hypophagia is a critical limiting step in macrophage-mediated clearance of cells via ADCP, and understanding such limitations to innate immune system cytotoxic capacity will aid in the development of mAb regimens that could optimize ADCP and improve patient outcome.
Loss of GPVI and GPIbα contributes to trauma-induced platelet dysfunction in severely injured patients
Authors: Vulliamy Paul , Montague Samantha J. , Gillespie Scarlett , Chan Melissa V. , Coupland Lucy A. , Andrews Robert K. , Warner Timothy D. , Gardiner Elizabeth E. , Brohi Karim , Armstrong Paul C. 
Published: June 2020

Abstract
Trauma-induced coagulopathy (TIC) is a complex, multifactorial failure of hemostasis that occurs in 25% of severely injured patients and results in a fourfold higher mortality. However, the role of platelets in this state remains poorly understood. We set out to identify molecular changes that may underpin platelet dysfunction after major injury and to determine how they relate to coagulopathy and outcome. We performed a range of hemostatic and platelet-specific studies in blood samples obtained from critically injured patients within 2 hours of injury and collected prospective data on patient characteristics and clinical outcomes. We observed that, although platelet counts were preserved above critical levels, circulating platelets sampled from trauma patients exhibited a profoundly reduced response to both collagen and the selective glycoprotein VI (GPVI) agonist collagen-related peptide, compared with those from healthy volunteers. These responses correlated closely with overall clot strength and mortality. Surface expression of the collagen receptors GPIbα and GPVI was reduced on circulating platelets in trauma patients, with increased levels of the shed ectodomain fragment of GPVI detectable in plasma. Levels of shed GPVI were highest in patients with more severe injuries and TIC. Collectively, these observations demonstrate that platelets experience a loss of GPVI and GPIbα after severe injury and translate into a reduction in the responsiveness of platelets during active hemorrhage. In turn, they are associated with reduced hemostatic competence and increased mortality. Targeting proteolytic shedding of platelet receptors is a potential therapeutic strategy for maintaining hemostatic competence in bleeding and improving the efficacy of platelet transfusions.
Microbial and metabolomic profiles in correlation with depression and anxiety co-morbidities in diarrhoea-predominant IBS patients
Authors: Liu Tong , Gu Xiang , Li Li-Xiang , Li Ming , Li Bing , Cui Xiao , Zuo Xiu-li 
Published: June 2020

Abstract
Background
Psychological co-morbidities in irritable bowel syndrome (IBS) have been widely recognized, whereas less is known regarding the role of gut microbial and host metabolic changes in clinical and psychological symptoms in IBS.

Results
A total of 70 diarrhoea-predominant IBS (IBS-D) patients and 46 healthy controls were enrolled in this study. Stool and urine samples were collected from both groups for 16S rRNA gene sequencing and metabolomic analysis.
The results showed that fecal microbiota in IBS-D featured depleted Faecalibacterium (adjusted P = 0.034), Eubacterium rectale group (adjusted P = 0.048), Subdoligranulum (adjusted P = 0.041) and increased Prevotella (adjusted P = 0.041). O-ureido-L-serine, 3,4-dihydroxybenzenesulfonic acid and (R)-2-Hydroxyglutarate demonstrated lower urinary concentrations in IBS-D patients. We further built correlation matrices between gut microbe abundance, differentiated metabolite quantities and clinical parameters. Dialister manifested negative association with IBS severity (r = − 0.285, P = 0.017), anxiety (r = − 0.347, P = 0.003) and depression level (r = − 0.308, P = 0.010). Roseburia was negatively associated with IBS severity (r = − 0.298, P = 0.012). Twenty metabolites correlated with anxiety or depression levels, including 3,4-dihydroxymandelaldehyde with SAS (r = − 0.383, P = 0.001), 1-methylxanthine with SDS (r = − 0.347, P = 0.004) and 1D-chiro-inositol with SAS (r = − 0.336, P = 0.005). In analysis of microbe-metabolite relationship, 3,4-dihydroxymandelaldehyde and 1-methylxanthine were negatively correlated with relative abundance of Clostridiumsensu stricto.

Conclusions
Our findings demonstrated altered microbial and metabolomic profiles associated with clinically and psychological symptoms in IBS-D patients, which may provide insights for further investigations.
Comparative transcriptome analysis of mulberry reveals anthocyanin biosynthesis mechanisms in black (Morus atropurpurea Roxb.) and white (Morus alba L.) fruit genotypes
Authors: Huang Gaiqun , Zeng Yichun , Wei Ling , Yao Yongquan , Dai Jie , Liu Gang , Gui Zhongzheng 
Published: June 2020

Abstract
Background
To gain a better understanding of anthocyanin biosynthesis in mulberry fruit, we analyzed the transcriptome of the mulberry varieties Da 10 (Morus atropurpurea Roxb., black fruit) and Baisang (Morus alba L., white fruit).

Results
We found that whereas Da 10 had high levels of cyanidin 3-O-glucoside (Cy), and pelargonidin 3-O-glucoside (Pg), Baisang contained only Cy, at low levels. Based on a comparative transcriptome analysis, we annotated more than 27,085 genes (including 1735 new genes). Genes that were differentially expressed between Da 10 and Baisang were detected at three stages of fruit development: S1 [4256 genes, 10 days post-anthesis (DPA)], S2 (5612 genes, 19 DPA), and S3 (5226 genes, 28 DPA). Anthocyanin biosynthesis was found to be associated with the expression of 15 core genes and 5 transcription factors. Relative to Baisang, Da 10 showed a significant upregulation of genes involved in the early stages (production of the intermediate compounds chalcone and dihydroflavonol) and late stages (production of Cy and Pg) of anthocyanin biosynthesis. Baisang showed a significant downregulation of the genes involved in the early stages of anthocyanin biosynthesis and overexpression of flavanone 3-hydroxylase (FLS), resulting in the generation of quercetin and/or myricetin but not anthocyanins.

Conclusions
The biosynthesis of anthocyanin in mulberry fruit is initiated from the precursor, phenylalanine, and mediated by the upregulation of dihydroflavonol 4-reductase, anthocyanidin synthase, anthocyanidin 3-O-glucosyltransferase, and cyanidin-3-O-glucoside 2-O-glucuronosyltransferase, and downregulation of FLS to produce Cy and Pg.
Modified-ramped position: a new position for intubation of obese females: a randomized controlled pilot study
Authors: Hasanin Ahmed , Tarek Hager , Mostafa Maha M. A. , Arafa Amany , Safina Ahmed G. , Elsherbiny Mona H. , Hosny Osama , Gado Ahmed A. , Almenesey Tarek , Hamden Ghada Adel , Mahmoud Mohamed , Amin Sarah 
Published: June 2020

Abstract
Background
Endotracheal intubation requires optimum position of the head and neck. In obese females, the usual ramped position might not provide adequate intubating conditions. We hypothesized that a new position, termed modified-ramped position, during induction of anesthesia would facilitate endotracheal intubation through bringing the breasts away from the laryngoscope and would also improve the laryngeal visualization.

Methods
Sixty obese female patients scheduled for general anesthesia were randomly assigned into either ramped or modified-ramped position during induction of anesthesia. In the ramped position (n = 30), the patient head and shoulders were elevated to achieve alignment of the sternal notch and the external auditory meatus; while in the modified-ramped position (n = 30), the patient shoulders were elevated using a special pillow, and the head was extended to the most possible range. Our primary outcome was the incidence of failed laryngoscopic insertion in the oral cavity (the need for patient repositioning). Other outcomes included time till vocal cord visualization, time till successful endotracheal intubation, difficulty of the mask ventilation, and Cormack-Lehane grade for laryngeal view.

Results
Fourteen patients (47%) in ramped group required repositioning to facilitate introduction of the laryngoscope in the oral cavity in comparison to one patient (3%) in the modified-ramped position (p < 0.001). Modified-ramped position showed lower incidence of difficult mask ventilation, shorter time for glottic visualization, and shorter time for endotracheal tube insertion compared to the ramped position. The Cormack-Lehane grade was better in the modified-ramped position.

Conclusion
Modified-ramped position provided better intubating conditions, improved the laryngeal view, and eliminated the need for repositioning of obese female patients during insertion of the laryngoscope compared to ramped position.

Clinical trial registration
Identifier: NCT03640442. Date: August 2018.
Regional and patient-related factors influencing the willingness to use general practitioners as coordinators of the treatment in northern Germany - results of a cross-sectional observational study
Authors: Hansen Heike , Schäfer Ingmar , Porzelt Sarah , Kazek Agata , Lühmann Dagmar , Scherer Martin 
Published: June 2020

Abstract
Background
In most countries, the general practitioner (GP) is the first point of contact in the healthcare system and coordinator of healthcare. However, in Germany it is possible to consult an outpatient specialist even without referral. Coordination by a GP might thus reduce health expenditures and inequalities in the healthcare system. The study describes the patients’ willingness/commitment to use the GP as coordinator of healthcare and identifies regional and patient-related factors associated with the aforementioned commitment to the GP.

Methods
Cross-sectional observational study using a standardised telephone patient survey in northern Germany. All counties and independent cities within a radius of 120 km around Hamburg were divided into three regional categories (urban areas, environs, rural areas) and stratified proportionally to the population size. Patients who had consulted the GP within the previous three months, and had been patients of the practice for at least three years were randomly selected from medical records of primary care practices in these districts and recruited for the study. Multivariate linear regression models adjusted for random effects at the level of federal states, administrative districts and practices were used as statistical analysis methods.

Results
Eight hundred eleven patients (25.1%) from 186 practices and 34 administrative districts were interviewed. The patient commitment to a GP attained an average of 20 out of 24 possible points. Significant differences were found by sex (male vs. female: + 1.14 points, p < 0.001), morbidity (+ 0.10 per disease, p = 0.043), education (high vs. low: − 1.74, p < 0.001), logarithmised household net adjusted disposable income (− 0.93 per step on the logarithmic scale, p = 0.004), regional category (urban areas: − 0.85, p = 0.022; environs: − 0.80, p = 0.045) and healthcare utilisation (each GP contact: + 0.30, p < 0.001; each contact to a medical specialist: − 0.75, p = 0.018). Professional situation and age were not significantly associated with the GP commitment.

Conclusion
On average, the patients’ commitment to their GP was relatively strong, but there were large differences between patient groups. An increase in the patient commitment to the GP could be achieved through better patient information and targeted interventions, e.g. to women or patients from regions of higher urban density.

Trial registration
The study was registered in ClinicalTrials.gov (NCT02558322).