bluuebunny/crossref_metadata_2025_split huggingface dataset:
Direct evidence for decreased presynaptic inhibition evoked by PBSt group I muscle afferents after chronic SCI and recovery with step‐training in rats
Authors: Caron Guillaume , Bilchak Jadwiga N. , Côté Marie‐Pascale 
Published: July 2020

Key points
Presynaptic inhibition is modulated by supraspinal centres and primary afferents in order to filter sensory information, adjust spinal reflex excitability, and ensure smooth movement.
After spinal cord injury (SCI), the supraspinal control of primary afferent depolarization (PAD) interneurons is disengaged, suggesting an increased role for sensory afferents. While increased H‐reflex excitability in spastic individuals indicates a possible decrease in presynaptic inhibition, it remains unclear whether a decrease in sensory‐evoked PAD contributes to this effect.
We investigated whether the PAD evoked by hindlimb afferents contributes to the change in presynaptic inhibition of the H‐reflex in a decerebrated rat preparation. We found that chronic SCI decreases presynaptic inhibition of the plantar H‐reflex through a reduction in PAD evoked by posterior biceps‐semitendinosus (PBSt) muscle group I afferents.
We further found that step‐training restored presynaptic inhibition of the plantar H‐reflex evoked by PBSt, suggesting the presence of activity‐dependent plasticity of PAD pathways activated by flexor muscle group I afferents.
AbstractSpinal cord injury (SCI) results in the disruption of supraspinal control of spinal networks and an increase in the relative influence of afferent feedback to sublesional neural networks, both of which contribute to enhancing spinal reflex excitability. Hyperreflexia occurs in ∼75% of individuals with a chronic SCI and critically hinders functional recovery and quality of life. It is suggested that it results from an increase in motoneuronal excitability and a decrease in presynaptic and postsynaptic inhibitory mechanisms. In contrast, locomotor training decreases hyperreflexia by restoring presynaptic inhibition. Primary afferent depolarization (PAD) is a powerful presynaptic inhibitory mechanism that selectively gates primary afferent transmission to spinal neurons to adjust reflex excitability and ensure smooth movement. However, the effect of chronic SCI and step‐training on the reorganization of presynaptic inhibition evoked by hindlimb afferents, and the contribution of PAD has never been demonstrated. The objective of this study is to directly measure changes in presynaptic inhibition through dorsal root potentials (DRPs) and its association with plantar H‐reflex inhibition. We provide direct evidence that H‐reflex hyperexcitability is associated with a decrease in transmission of PAD pathways activated by posterior biceps‐semitendinosus (PBSt) afferents after chronic SCI. More precisely, we illustrate that the pattern of inhibition evoked by PBSt group I muscle afferents onto both L4‐DRPs and plantar H‐reflexes evoked by the distal tibial nerve is impaired after chronic SCI. These changes are not observed in step‐trained animals, suggesting a role for activity‐dependent plasticity to regulate PAD pathways activated by flexor muscle group I afferents.
Bicycling Exercise Helps Maintain a Youthful Metabolic Cost of Walking in Older Adults
Authors: Aslan Daniel H. , Collette Joshua M. , Ortega Justus D. 
Published: July 2020

The decline of walking performance is a key determinant of morbidity among older adults. Healthy older adults have been shown to have a 15–20% lower walking economy compared with young adults. However, older adults who run for exercise have a higher walking economy compared with older adults who walk for exercise. Yet, it remains unclear if other aerobic exercises yield similar improvements on walking economy. The purpose of this study was to determine if regular bicycling exercise affects walking economy in older adults. We measured metabolic rate while 33 older adult “bicyclists” or “walkers” and 16 young adults walked on a level treadmill at four speeds between (0.75–1.75 m/s). Across the range of speeds, older bicyclists had a 9–17% greater walking economy compared with older walkers (p = .009). In conclusion, bicycling exercise mitigates the age-related deterioration of walking economy, whereas walking for exercise has a minimal effect on improving walking economy.
Microscopic and Submicroscopic Asymptomatic Plasmodium falciparum Infections in Ghanaian Children and Protection against Febrile Malaria
Authors: Adu Bright , Issahaque Quratul-ain , Sarkodie-Addo Tracy , Kumordjie Selassie , Kyei-Baafour Eric , Sinclear Caleb K. , Eyia-Ampah Sophia , Owusu-Yeboa Eunice , Theisen Michael , Dodoo Daniel 
Published: July 2020

Naturally acquired immunity to
Plasmodium falciparum
malaria is thought to be nonsterile and sustained by persistence of low-level parasitemia. This study assessed the association between baseline microscopic and submicroscopic asymptomatic
P. falciparum
infections and antimalarial antibody levels and whether these parasitemia modify protective associations between antibody levels and malaria in Ghanaian children. Healthy children (
N
= 973, aged 0.
Cold feet: Trackways and burrows in ice-marginal strata of the end-Ordovician glaciation (Table Mountain Group, South Africa)
Authors: Davies Neil S. , Shillito Anthony P. , Penn-Clarke Cameron R. 
Published: July 2020

Abstract
New observations from an outcrop of Upper Ordovician Table Mountain Group strata (Matjiesgoedkloof, Western Cape Province, South Africa) have revealed an unexpected ichnofauna that is hosted within diamictites and sandstones that were deposited by a retreating low-latitude (∼30°S) ice sheet during the Hirnantian glaciation. The locality provides a rare window onto animal-sediment interactions in an early Paleozoic ice-marginal shallow-marine environment and contains a trace fossil community with a surprising ichnodiversity and ichnodisparity of burrows, trackways, and trails (Archaeonassa, Diplichnites, Heimdallia, Metaichna, ?Multina, Planolites, Protovirgularia, Skolithos). Exceptional phenomena preserved in the strata include evidence for direct colonization of glacial diamictites by deep-burrowing Heimdallia infauna, and interactions between trackways and dropstones on substrates. Observations from the newly recognized outcrop dramatically expand our understanding of deep-time glacial habitats, demonstrating that deglaciating ice margins had already been colonized by the latest Ordovician. The freshwater influx that would have been associated with such settings implies that faunal associations that were tolerant of brackish water were also established by that time. The locality has further significance because it records the activity of a nearshore animal community contemporaneous with the fauna of the nearby Soom Shale lägerstatte. Combined, these features reveal a paleoecological transect of the diverse marine life that inhabited cold-climate, low-latitude shallow seas around the time of the end-Ordovician deglaciation.
Glucocorticoid dose-dependent risk of type 2 diabetes in six immune-mediated inflammatory diseases: a population-based cohort analysis
Authors: Wu Jianhua , Mackie Sarah L , Pujades-Rodriguez Mar 
Published: July 2020

IntroductionIn immune-mediated inflammatory diseases, there is a lack of -estimates of glucocorticoid dose–response diabetes risk that consider changes in prescribed dose over time and disease activity.Research design and methodsPopulation-based longitudinal analysis of electronic health records from the UK Clinical Practice Research Datalink, linked to hospital admissions and the mortality registry (1998–2017). We included 100 722 adult patients without diabetes history, diagnosed with giant cell arteritis or polymyalgia rheumatica (n=32 593), inflammatory bowel disease (n=29 272), rheumatoid arthritis (n=28 365), vasculitis (n=6082), or systemic lupus erythematosus (n=4410). We estimated risks and HRs of type 2 diabetes associated with time-variant daily and total cumulative prednisolone-equivalent glucocorticoid dose using Cox regression methods.ResultsAverage patient age was 58.6 years, 65 469 (65.0%) were women and 8858 (22.6%) had a body mass index (BMI) ≥30 kg/m2. Overall, 8137 (8.1%) people developed type 2 diabetes after a median follow-up of 4.9 years. At 1 year, the cumulative risk of diabetes increased from 0.9% during periods of non-use to 5.0% when the daily prednisolone-equivalent dose was ≥25.0 mg. We found strong dose-dependent associations for all immune-mediated diseases, BMI levels and underlying disease duration, even after controlling for periods of active systemic inflammation. Adjusted HR for a <5.0 mg daily dose versus non-use was 1.90, 95% CI 1.44 to 2.50; range 1.70 for rheumatoid arthritis to 2.93 for inflammatory bowel disease.ConclusionsWe report dose-dependent risks of type 2 diabetes associated with glucocorticoid use for six common immune-mediated inflammatory diseases. These results underline the need for regular diabetic risk assessment and testing during glucocorticoid therapy in these patients.
Use of a diabetes-specific nutritional shake to replace a daily breakfast and afternoon snack improves glycemic responses assessed by continuous glucose monitoring in people with type 2 diabetes: a randomized clinical pilot study
Authors: Mustad Vikkie A , Hegazi Refaat A , Hustead Deborah S , Budiman Erwin S , Rueda Ricardo , Maki Kevin , Powers Margaret , Mechanick Jeffrey I , Bergenstal Richard M , Hamdy Osama 
Published: July 2020

IntroductionThis pilot study evaluated the impact of a diabetes-specific nutritional shake (DSNS) used twice daily by people with type 2 diabetes (T2D) on glycemic response assessed by continuous glucose monitoring (CGM).Research design and methodsAdults (n=81) with T2D managed by oral medications were studied in a randomized, open-label, three-group parallel study design. The study was conducted in two phases over 14 days: Baseline (days 1–6), during which study participants consumed their habitual self-selected diets (SSD), followed by the Intervention (days 7–14), during which participants were randomized as follows: (1) SSD group received no study product (n=32); (2) DSNS breakfast/afternoon snack (Bkfst/AS) group consumed one DSNS as a breakfast meal replacement and a second to replace their mid-afternoon snack (n=24); (3) DSNS breakfast/prebed snack (Bkfst/PBS) group consumed one DSNS as a breakfast meal replacement and added a second as a prebed snack (n=25). Glucose was assessed by CGM throughout the study. Additionally, participants were asked about snacking behaviors, cravings, and other questions related to the use of DSNS as meal replacements and snacks.ResultsAll groups reduced their postprandial glycemic response (positive area under the curve (pAUC, mg/min*dL−1)) and adjusted peak value (mg/dL) when compared with the baseline phase. Participants consuming DSNS in place of their usual breakfast showed greater reductions in pAUC compared with the SSD group (p=0.008) for the DSNS Bkfst/AS group with a trend (p=0.069) for the DSNS Bkfst/PBS group. Adjusted peak value showed greater reductions in both DSNS groups as compared with the SSD group (p=0.002 for DSNS Bkfst/AS and p=0.010 for DSNS Bkfst/PBS). Nocturnal glucose variability was significantly decreased during the intervention phase compared with baseline phase in the DSNS Bkfst/AS group (p=0.020), with no significant differences between groups. After intervention, the DSNS Bkfst/AS group had a significantly lower percentage of participants (17%) reporting cravings for starchy meals/sides compared with before the study (33%) (p=0.046). This group also reported a significant increase in confidence in choosing foods to control their diabetes (from 58.3% to 91.7%, preintervention vs postintervention, respectively, p=0.005).ConclusionsUse of DSNS to replace breakfast and as an afternoon snack improves both glycemic control and behavioral factors related to dietary management of diabetes.Trail registration numberNCT04230889.
Association between metformin and neurodegenerative diseases of observational studies: systematic review and meta-analysis
Authors: Ping Fan , Jiang Ning , Li Yuxiu 
Published: July 2020

Background and aimsAging becomes a growing global concern with an increased risk of neurodegenerative diseases (NDs) that mainly consist of cognitive decline and Parkinson disease (PD). As the most commonly prescribed antidiabetic drug, metformin has been shown to have inconsistent roles in the incidence of NDs. We performed a systematic review and meta-analysis of observational studies to evaluate the effect of metformin exposure on onset of NDs.MethodsThe observational studies that investigated the associations between metformin and the incidence of NDs were searched in MEDLINE, Embase and Cochrane Library databases. A random-effect model was performed using STATA to calculate the combined ORs.ResultsIn total, 23 comparisons out of 19 studies with 285 966 participants were included. Meta-analysis found there was no significant effect on incidence of all the subtypes of NDs with metformin exposure (OR 1.04, 95% CI 0.92 to 1.17). However, metformin monotherapy was associated with a significantly increased risk of PD incidence compared with non-metformin users or glitazone users (OR 1.66, 95% CI 1.14 to 2.42).ConclusionMetformin has failed to demonstrate a beneficial effect on NDs. In addition, it may increase the risk of PD development. In light of current results, how metformin would impact NDs, especially the potential risk of PD, needs to be scrutinized. The underlying mechanisms are vital to achieve some more profound understanding on the regimen.Trial registration numberCRD 42019133285.
Retinal arterial occlusion with multiple retinal emboli and carotid artery occlusion disease. Haemodynamic changes and pathways of embolism
Authors: Chen San-Ni , Hwang Jiunn-Feng , Huang Jeff , Wu Shey-Lin 
Published: July 2020

ObjectiveTo introduce a special subgroup, retinal artery occlusion (RAO) with multiple emboli, which is highly associated with ipsilateral carotid artery occlusion disease (CAOD).Methods and analysisThis is a cohort study. Cases of RAO with multiple retinal emboli were consecutively enrolled. All patients underwent at least one of the carotid/cerebral evaluations: carotid arteriography, orbital/carotid colour Doppler ultrasonography and CT angiography to demonstrate haemodynamic changes and to discuss possible mechanisms and pathways of the emboli.ResultsAmong 208 RAO eyes, 12 eyes (5.7%) in 11 patients had multiple emboli were recruited in this study. Eleven eyes (91.6%) had ipsilateral carotid plaques and atherosclerosis with high-grade stenosis; among them, five were total carotid occlusion. Haemodynamic changes were found in nine patients with RAO (81.8%) with carotid stenosis 60% or greater. Most compensatory intracranial circulations were re-established via the circle of Willi with antegrade ophthalmic flows, but the direction of ophthalmic flow reversed in three eyes indicating the recruitment of external collaterals. Two cases underwent carotid stent successfully.ConclusionRAOs with multiple emboli are rare but highly associated with severe CAOD with haemodynamic flow changes, warning critical condition in carotid/cerebral circulations. Either direct embolism from the carotid or cardiac lesions or indirect embolism via the collateral pathways is the mechanism of pathogenesis. Immediate action should start to manage these patients to prevent further deterioration.
Screening for caregiver psychosocial risk in children with medical complexity: a cross-sectional study
Authors: Verma Rahul , Mehdian Yasna , Sheth Neel , Netten Kathy , Vinette Jean , Edwards Ashley , Polyviou Joanna , Orkin Julia , Amin Reshma 
Published: July 2020

ObjectiveTo quantify psychosocial risk in family caregivers of children with medical complexity using the Psychosocial Assessment Tool (PAT) and to investigate potential contributing sociodemographic factors.DesignCross-sectional study.SettingFamily caregivers completed questionnaires during long-term ventilation and complex care clinic visits at The Hospital for Sick Children, Toronto, Ontario, Canada.PatientsA total of 136 family caregivers of children with medical complexity completed the PAT questionnaires from 30 June 2017 through 23 August 2017.Main outcome measuresMean PAT scores in family caregivers of children with medical complexity. Caregivers were stratified as ‘Universal’ low risk, ‘Targeted’ intermediate risk or ‘Clinical’ high risk. The effect of sociodemographic variables on overall PAT scores was also examined using multiple linear regression analysis. Comparisons with previous paediatric studies were made using T-test statistics.Results136 (103 females (76%)) family caregivers completed the study. Mean PAT score was 1.17 (SD=0.74), indicative of ‘Targeted’ intermediate risk. Sixty-one (45%) caregivers were classified as Universal risk, 60 (44%) as Targeted risk and 15 (11%) as Clinical risk. Multiple linear regression analysis revealed an overall significant model (p=0.04); however, no particular sociodemographic factor was a significant predictor of total PAT scores.ConclusionFamily caregivers of children with medical complexity report PAT scores among the highest of all previously studied paediatric populations. These caregivers experience significant psychosocial risk, demonstrated by larger proportions of caregivers in the highest-risk Clinical category.
Validity and reliability of the Brain Health Self-Efficacy Scale for the elderly
Authors: Gao Yining , Cui Ming , Yang Chunyan , Wu Yuejing , Long Yun , Chen Yaopian , Liu Hongshen , Sun Lin , Yang Yinghua , Li Xia 
Published: July 2020

BackgroundWith the rapid increase in ageing population, China is confronted with the daunting challenge of a growing number of patients with neurocognitive disorders (NCDs). This trend makes the maintenance of self-health and early intervention essential, highlighting the need for a tool that assesses self-efficacy of older adults in maintaining brain health or cognitive function.AimThis study aimed to design the Brain Health Self-Efficacy Scale (BHSES) to measure elderly individuals’ attitudes to NCDs, motivations and future plans for controlling risks. The psychometric properties of BHSES have been validated.MethodsBased on the current literature and relevant models, a 19-item scale was created during the first stage. A total of 660 older adults in the Yinhang community of Shanghai were included. The statistical approaches of item analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), criterion-related validity and reliability test were used to evaluate the quality of BHSES. In addition, the Geriatric Depression Scale (GDS) and the Self-Rating Anxiety Scale (SAS) were used as criteria to test the criterion-related validity.ResultsTo test item differentiation, the study adopted item analysis and excluded item 8. Selecting a random half of the sample for EFA, the BHSES was refined to 16 items, which were categorised into the following three dimensions: ‘memory belief efficacy’, ‘self-care efficacy’ and ‘future planning efficacy’. These were highly consistent with the hypothesis model. Its cumulative variance contribution rate reached 61.14%, with factor loads of all items above 0.5. The three-factor model was confirmed by the remaining data through CFA. All fit indices reached the acceptable level (χ2=3.045, Goodness of Fit Index=0.898, adjusted Goodness of Fit Index=0.863, Comparative Fit Index=0.916, Incremental Fit Index=0.917, Tucker-Lewis Index=0.900, root mean square error of approximation=0.079 and root mean residual=0.068). The GDS and SAS scores revealed significant correlations with the BHSES score, indicating a high criterion-related validity. The overall Cronbach’s α coefficient was 0.793, with the α coefficients’ distribution of subdimensions ranging from 0.748 to 0.883.ConclusionsThe 16-item, self-compiled BHSES is a reliable and valid measurement. It could help identify older adults with potential risks for developing NCDs or with high suspicion of cognitive impairment onset in recent periods and also offer insight into tracking brain health self-efficacy in association with cognition status.
Systematic literature review of efficacy/effectiveness and safety of current therapies for the treatment of cryopyrin-associated periodic syndrome, hyperimmunoglobulin D syndrome and tumour necrosis factor receptor-associated periodic syndrome
Authors: Kuemmerle-Deschner Jasmin Beate , Gautam Raju , George Aneesh Thomas , Raza Syed , Lomax Kathleen Graham , Hur Peter 
Published: July 2020

ObjectivesSeveral therapies are used for the treatment of rareautoinflammatory conditions like cryopyrin-associated periodic fever syndromes (CAPS), hyperimmunoglobulin Dsyndrome (HIDS)/mevalonate kinase deficiency (MKD) and tumour necrosis factor receptor-associated periodic syndrome (TRAPS). However, reviews reporting on treatment outcomes of these therapies are lacking.MethodsA systematic literature review was conducted using Embase, MEDLINE, MEDLINE-In Process and Cochrane databases to identify the randomised/non-randomised controlled trials (RCTs/non-RCTs) and real-world observational studies of CAPS, HIDS/MKD and TRAPS published as full-texts (January 2000–September 2017) or conference abstracts (January 2014–September 2017). Studies with data for ≥1 biologic were included. Studies with <5 patients were excluded.ResultsOf the 3 342 retrieved publications, 72 studies were included (CAPS, n=43; HIDS/MKD, n=9; TRAPS, n=7; studies with ≥2 cohorts, n=13). Most studies were full-text (n=56), published after 2010 (n=56) and real-world observational studies (n=58). Among included studies, four were RCTs (canakinumab, n=2 (CAPS, n=1; HIDS/MKD and TRAPS, n=1); rilonacept, n=1 (in CAPS); simvastatin, n=1 (in HIDS/MKD)). Canakinumab and anakinra were the most commonly used therapies for CAPS and HIDS/MKD, whereas etanercept, canakinumab and anakinra were the most common for TRAPS. The available evidence suggested the efficacy or effectiveness of canakinumab and anakinra in CAPS, HIDS/MKD and TRAPS, and of etanercept in TRAPS; asingle RCT demonstrated the efficacy of rilonacept in CAPS.ConclusionsCanakinumab, anakinra, etanercept and rilonacept were reported to be well tolerated; however, injection-site reactions were observed frequently with anakinra, rilonacept and etanercept. Data on the use of tocilizumab, infliximab and adalimumab in these conditions were limited; thus, further research is warranted.