bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of CGRP-dependent pain and headache related behaviours in a rat model of concussion: Implications for mechanisms of post-traumatic headache
Authors: Bree Dara , Levy Dan 
Published: November 2016

Background and objective Posttraumatic headache (PTH) is one of the most common, debilitating and difficult symptoms to manage after a mild traumatic brain injury, or concussion. However, the mechanisms underlying PTH remain elusive, in part due to the lack of a clinically relevant animal model. Here, we characterized for the first time, headache and pain-related behaviours in a rat model of concussion evoked by a mild closed head injury (mCHI) – the major type of military and civilian related trauma associated with PTH – and tested responses to current and novel headache therapies. Methods Concussion was induced in adult male rats using a weight-drop device. Characterization of headache and pain related behaviours included assessment of cutaneous tactile pain sensitivity, using von Frey monofilaments, and ongoing pain using the conditioned place preference or aversion (CPP/CPA) paradigms. Sensitivity to headache/migraine triggers was tested by exposing rats to low-dose glyceryl trinitrate (GTN). Treatments included acute systemic administration of sumatriptan and chronic systemic administration of a mouse anti-CGRP monoclonal antibody. Results Concussed rats developed cephalic tactile pain hypersensitivity that was resolved by two weeks post-injury and was ameliorated by treatment with sumatriptan or anti-CGRP monoclonal antibody. Sumatriptan also produced CPP seven days post mCHI, but not in sham animals. Following the resolution of the concussion-evoked cephalic hypersensitivity, administration of GTN produced a renewed and pronounced cephalic pain hypersensitivity that was inhibited by sumatriptan or anti-CGRP antibody treatment as well as a CGRP-dependent CPA. GTN had no effect in sham animals. Conclusions Concussion leads to the development of headache and pain-related behaviours, in particular sustained enhanced responses to GTN, that are mediated through a CGRP-dependent mechanism. Treatment with anti-CGRP antibodies may be a useful approach to treat PTH.
Collagenous Ultrastructure of the Discoid Meniscus: A Transmission Electron Microscopy Study
Authors: Choi Young-Hee , Seo Young-Jin , Ha Jong Mun , Jung Koo Hyun , Kim Jeehyoung , Song Si Young 
Published: November 2016

Background: The collagen ultrastructure of the discoid lateral meniscus (DLM) has not been precisely defined. Purpose: To investigate the ultrastructure of the DLM, focusing on its collagen fibers, and to compare the collagen net architecture between intact and torn DLMs using the Collagen Meniscal Architecture (CMA) scoring system. Study Design: Descriptive laboratory study. Methods: Thirty specimens were taken from 30 patients with a diagnosis of a complete DLM using a 1-piece technique. The collagen ultrastructure of the DLMs was assessed with transmission electron microscopy. To evaluate the meniscal ultrastructure, the degree of collagen disruption, intrafibrillar edema, loss of banding, degree of collagen packing, and fibril size variability were assessed and graded from 1 (normal) to 3 (severe disarray) according to the CMA scoring system. The DLM specimens were divided into 3 groups according to the intrasubstance tear: the intact group (group I) had no tear; the simple tear group (group S) had a radial, longitudinal, or horizontal tear; and the complicated tear group (group C) had a complicated horizontal tear. Intact normal meniscus specimens (group N) were used as the control group. Results: There were 10 specimens in group I, 8 in group S, 12 in group C, and 13 in group N. In group I, there were 5 grade 1 and 5 grade 2 menisci; group S had 2 grade 1, 3 grade 2, and 3 grade 3 menisci; group C had 1 grade 1, 4 grade 2, and 7 grade 3 menisci; and group N had 4 grade 1, 7 grade 2, and 2 grade 3 menisci. A significant difference in the CMA score was observed between the 4 groups ( P = .009). The median CMA score was significantly lower in group I (2; range, 1-4) than in group S (4; range, 2-7) ( P = .041) and group C (4.25; range, 1.5-7) ( P = .018). No significant difference was found between groups S, C, and N. Conclusion: Variability existed in the collagen ultrastructure of the DLM, and some DLMs showed a nearly normal ultrastructural pattern. The degree of density and disorganization of the collagen architecture in the DLM was related to the tear. Clinical Relevance: The study results might provide a histological background for partial meniscectomy in the treatment of a symptomatic DLM.
Emergency Surgical Airways Following Activation of a Difficult Airway Management Team in Hospitalized Critically Ill Patients: A Case Series
Authors: Darby Joseph M. , Halenda Gregory , Chou Courtney , Quinlan Joseph J. , Alarcon Louis H. , Simmons Richard L. 
Published: November 2016

Introduction: An emergency surgical airway (ESA) is widely recommended for securing the airway in critically ill patients who cannot be intubated or ventilated. Little is known of the frequency, clinical circumstances, management methods, and outcomes of hospitalized critically ill patients in whom ESA is performed outside the emergency department or operating room environments. Methods: We retrospectively reviewed all adult patients undergoing ESA in our intensive care units (ICUs) and other hospital units from 2008 to 2012 following activation of our difficult airway management team (DAMT). Results: Of 207 DAMT activations for native airway events, 22 (10.6%) events culminated in an ESA, with 59% of these events occurring in ICUs with the remainder outside the ICU in the context of rapid response team activations. Of patients undergoing ESA, 77% were male, 63% were obese, and 41% had a history of a difficult airway (DA). Failed planned or unplanned extubations preceded 61% of all ESA events in the ICUs, while bleeding from the upper or lower respiratory tract led to ESA in 44% of events occurring outside the ICU. Emergency surgical airway was the primary method of airway control in 3 (14%) patients, with the remainder of ESAs performed following failed attempts to intubate. Complications occurred in 68% of all ESAs and included bleeding (50%), multiple cannulation attempts (36%), and cardiopulmonary arrest (27%). Overall hospital mortality for patients undergoing ESA was 59%, with 38% of deaths occurring at the time of the airway event. Conclusion: An ESA is required in approximately 10% of DA events in critically ill patients and is associated with high morbidity and mortality. Efforts directed at early identification of patients with a difficult or challenging airway combined with a multidisciplinary team approach to management may reduce the overall frequency of ESA and associated complications.
Simulating a Climate Engineering Crisis
Authors: Matzner Nils , Herrenbrück Robert 
Published: November 2016

Background. At the 2015 Paris Agreement to limit global warming to a maximum of 2 degrees, climate activists and researchers began to look for alternative measures. Climate engineering (CE) - the deliberate manipulation of the planetary environment to decelerate climate change - emerges as a possibly effective, albeit risky and conflictual, option. Aim. This article aims both at simulating a plausible international scenario of negotiation over solar climate engineering deployment, and at utilizing the rules of Model United Nations (MUN) for collaborative learning in a university class. Furthermore, the article intends to provide a framework for simulations about CE that could easily be reproduced. Method. MUN is an established and well-tested foundation for a simulation with students, including preparation leading up to the simulation and feedback rounds afterwards. We repeated the simulation three times, recorded the sessions as well as the debriefings, and gathered interesting insight by comparing the results. Result. For our CE simulations, we discovered: 1. Divergent interests (e.g. global north vs global south). 2. Power struggle (e.g. role of the veto powers). 3. Scientific and political ignorance (e.g. decision-making under uncertainty). 4. Risk politics (e.g. trade-offs between climate change risks vs. CE risks). Conclusion. MUN qualifies well for simulating a CE crisis. However, known lacks in MUN settings (like underrepresentation of non-state actors) must be discussed during the debriefing. These simulations illustrate possible future conflicts over CE without being prescriptive in any way.
Goal-Setting in Educational Video Games
Authors: Nebel Steve , Schneider Sascha , Schledjewski Janine , Rey Günter Daniel 
Published: November 2016

Background. The increased usage of educational video games with their strong graphical and technical potential raises the question of how to optimize the instructional elements of gameplay. In this article, the instructional goal was analyzed with the theoretical background of both motivational psychology (goal-setting theory) and cognitive psychology (goal-free effect). Aim. We compared different goal types within an educational video game specifically produced for this context, using MINECRAFT as a content creation tool. Method. Within a quantitative, empirical experiment, 87 students divided into three goal groups (specific learning goal, specific performance goal, goal-free condition) played the video game for nearly three hours per test session to gain knowledge about basic elements of computer science and basic electric engineering. Results. The results show effects of goal-setting on cognitive load and affective measures. Having specific learning goals lowered extraneous and intrinsic cognitive load. Additionally, players following a specific learning goal reported having significantly more fun, indicating the affective impacts of goal-setting. Conclusions. The outcomes of this study have practical implications for the creation of educational video games and theoretical implications for further work within the field of instructional psychology.
Prognostic value of free light chains lambda and kappa in early multiple sclerosis
Authors: Voortman Margarete M , Stojakovic Tatjana , Pirpamer Lukas , Jehna Margit , Langkammer Christian , Scharnagl Hubert , Reindl Markus , Ropele Stefan , Seifert-Held Thomas , Archelos Juan-Jose , Fuchs Siegrid , Enzinger Christian , Fazekas Franz , Khalil Michael 
Published: November 2016

Background: Cerebrospinal fluid (CSF) immunoglobulin free light chains (FLC) have been suggested as quantitative alternative to oligoclonal bands (OCB) in the diagnosis of multiple sclerosis (MS). However, little is known on their role in predicting clinical and paraclinical disease progression, particularly in early stages. Objective: To assess the prognostic value of FLC in OCB-positive patients with clinically isolated syndrome (CIS) suggestive of MS and early MS. Methods: We determined FLC kappa (KFLC) and lambda (LFLC) in CSF and serum by nephelometry in 61 patients (CIS ( n = 48), relapsing-remitting multiple sclerosis ( n = 13)) and 60 non-inflammatory neurological controls. Median clinical follow-up time in CIS was 4.8 years (interquartile range (IQR), 1.5–6.5 years). Patients underwent 3T magnetic resonance imaging (MRI) at baseline and follow-up (median time interval, 2.2 years; IQR, 1.0–3.7 years) to determine T2 lesion load (T2LL) and percent brain volume change (PBVC). Results: CSF FLC were significantly increased in CIS/MS compared to controls (all p < 0.001). A lower KFLC/LFLC CSF ratio was associated with CIS-clinically definite multiple sclerosis (CDMS) conversion (hazard ratio (HR) = 2.89; 95% confidence interval (CI) = 1.17–7.14; p < 0.05). No correlations were found for FLC variables with T2LL or PBVC. Conclusion: Our study confirms increased intrathecal synthesis of FLC in CIS/MS which supports their diagnostic contribution. The KFLC/LFLC CSF ratio appears to have a prognostic value in CIS beyond OCB.
Consistent sex-dependent effects of PKMζ gene ablation and pharmacological inhibition on the maintenance of referred pain
Authors: Nasir Hibatulnaseer , Mahboubi Hicham , Gyawali Sandeep , Ding Stephanie , Mickeviciute Aiste , Ragavendran J Vaigunda , Laferrière André , Stochaj Ursula , Coderre Terence J 
Published: November 2016

Background Persistently active PKMζ has been implicated in maintaining spinal nociceptive sensitization that underlies pain hypersensitivity. However, evidence for PKMζ in the maintenance of pain hypersensitivity comes exclusively from short-term studies in males using pharmacological agents of questionable selectivity. The present study examines the contribution of PKMζ to long-lasting allodynia associated with neuropathic, inflammatory, or referred visceral and muscle pain in males and females using pharmacological inhibition or genetic ablation. Results Pharmacological inhibition or genetic ablation of PKMζ reduced mild formalin pain and slowly developing contralateral allodynia in nerve-injured rats, but not moderate formalin pain or ipsilateral allodynia in models of neuropathic and inflammatory pain. Pharmacological inhibition or genetic ablation of PKMζ also effectively reduced referred visceral and muscle pain in male, but not in female mice and rats. Conclusion We show pharmacological inhibition and genetic ablation of PKMζ consistently attenuate long-lasting pain hypersensitivity. However, differential effects in models of referred versus inflammatory and neuropathic pain, and in males versus females, highlight the roles of afferent input-dependent masking and sex differences in the maintenance of pain hypersensitivity.
Acute endovascular treatment delivery to ischemic stroke patients transferred within a telestroke network: a retrospective observational study
Authors: Barlinn Jessica , Gerber Johannes , Barlinn Kristian , Pallesen Lars-Peder , Siepmann Timo , Zerna Charlotte , Wojciechowski Claudia , Puetz Volker , von Kummer Rüdiger , Reichmann Heinz , Linn Jennifer , Bodechtel Ulf 
Published: November 2016

Background Five randomized controlled trials recently demonstrated efficacy of endovascular treatment in acute ischemic stroke. Telestroke networks can improve stroke care in rural areas but their role in patients undergoing endovascular treatment is unknown. Aim We compared clinical outcomes of endovascular treatment between anterior circulation stroke patients transferred after teleconsultation and those directly admitted to a tertiary stroke center. Methods Data derived from consecutive patients with intracranial large vessel occlusion who underwent endovascular treatment from January 2010 to December 2014 at our tertiary stroke center. We compared baseline characteristics, onset-to-treatment times, symptomatic intracranial hemorrhage, in-hospital mortality, reperfusion (modified Treatment in Cerebral Infarction 2b/3), and favorable functional outcome (modified Rankin scale ≤ 2) at discharge between patients transferred from spoke hospitals and those directly admitted. Results We studied 151 patients who underwent emergent endovascular treatment for anterior circulation stroke: median age 70 years (interquartile range, 62–75); 55% men; median National Institutes of Health Stroke Scale score 15 (12–20). Of these, 48 (31.8%) patients were transferred after teleconsultation and 103 (68.2%) were primarily admitted to our emergency department. Transferred patients were younger (p = 0.020), received more frequently intravenous tissue plasminogen activator (p = 0.008), had prolonged time from stroke onset to endovascular treatment initiation (p < 0.0001) and tended to have lower rates of symptomatic intracranial hemorrhage (4.2% vs. 11.7%; p = 0.227) and mortality (8.3% vs. 22.6%; p = 0.041) than directly admitted patients. Similar rates of reperfusion (56.2% vs. 61.2%; p = 0.567) and favorable functional outcome (18.8% vs. 13.7%; p = 0.470) were observed in telestroke patients and those who were directly admitted. Conclusions Telestroke networks may enable delivery of endovascular treatment to selected ischemic stroke patients transferred from remote hospitals that is equitable to patients admitted directly to tertiary hospitals.
Comparing dietary patterns derived by two methods and their associations with obesity in Polish girls aged 13–21 years: the cross-sectional GEBaHealth study
Authors: Wadolowska Lidia , Kowalkowska Joanna , Czarnocinska Jolanta , Jezewska-Zychowicz Marzena , Babicz-Zielinska Ewa 
Published: November 2016

Aims: To compare dietary patterns (DPs) derived by two methods and their assessment as a factor of obesity in girls aged 13–21 years. Methods: Data from a cross-sectional study conducted among the representative sample of Polish females ( n = 1,107) aged 13–21 years were used. Subjects were randomly selected. Dietary information was collected using three short-validated food frequency questionnaires (FFQs) regarding fibre intake, fat intake and overall food intake variety. DPs were identified by two methods: a priori approach (a priori DPs) and cluster analysis (data-driven DPs). The association between obesity and DPs and three single dietary characteristics was examined using multiple logistic regression analysis. Results: Four data-driven DPs were obtained: ‘Low-fat-Low-fibre-Low-varied’ (21.2%), ‘Low-fibre’ (29.1%), ‘Low-fat’ (25.0%) and ‘High-fat-Varied’ (24.7%). Three a priori DPs were pre-defined: ‘Non-healthy’ (16.6%), ‘Neither-pro-healthy-nor-non-healthy’ (79.1%) and ‘Pro-healthy’ (4.3%). Girls with ‘Low-fibre’ DP were less likely to have central obesity (adjusted odds ratio (OR) = 0.36; 95% confidence interval (CI): 0.17, 0.75) than girls with ‘Low-fat-Low-fibre-Low-varied’ DP (reference group, OR = 1.00). No significant associations were found between a priori DPs and overweight including obesity or central obesity. The majority of girls with ‘Non-healthy’ DP were also classified as ‘Low-fibre’ DP in the total sample, in girls with overweight including obesity and in girls with central obesity (81.7%, 80.6% and 87.3%, respectively), while most girls with ‘Pro-healthy’ DP were classified as ‘Low-fat’ DP (67.8%, 87.6% and 52.1%, respectively). Conclusion: We found that the a priori approach as well as cluster analysis can be used to derive opposite health-oriented DPs in Polish females. Both methods have provided disappointing outcomes in explaining the association between obesity and DPs. The cluster analysis, in comparison with the a priori approach, was more useful for finding any relationship between DPs and central obesity. Our study highlighted the importance of method used to derive DPs in exploring associations between diet and obesity.
Psychological consequences of traumatic upper limb peripheral nerve injury: A systematic review
Authors: Miller Caroline , Peek Aimie L , Power Dominic , Heneghan Nicola R 
Published: November 2016

Introduction Traumatic upper limb peripheral nerve injuries significantly impact individuals’ function and ability to return to work. Patients with peripheral nerve injury experience ongoing psychological impairments for which they are not routinely treated. The aim of this review was to investigate the psychological consequences of traumatic upper limb peripheral nerve injury. Methods A systematic review of MEDLINE, Embase, PsycINFO, CINAHL, AMED, BNI, the Cochrane libraries and grey literature up to October 2015 was undertaken. Two reviewers independently assessed methodological quality in accordance with Cochrane Collaboration recommendations. Eligibility criteria comprised: adults or adolescents with traumatic upper limb peripheral nerve injury using any measurement of psychological well-being. Results Six studies ( n = 245) met the inclusion criteria. Methodological quality varied widely. Evidence of post-traumatic stress disorder at one month, which decreased over time, was reported in three studies. Two studies found a statistically significant correlation between the early presence of post-traumatic stress disorder and reduction in function at 12 or more months. Limited information was available on anxiety, depression and mental quality of life. Combined nerve injuries (in two studies) had significantly higher levels of post-traumatic stress disorder, at one month, compared to those with an isolated nerve injury. Conclusion There is some evidence of early post-traumatic stress disorder following traumatic upper limb peripheral nerve injury, which may have an impact on functional outcome. However, high-quality studies using prospective cohorts are required to further evaluate the psychological aspects associated with this traumatic injury.
Sweet’s syndrome associated with clonal hematopoiesis of indeterminate potential responsive to 5-azacitidine
Authors: Yaghmour George , Wiedower Eric , Yaghmour Bassam , Nunnery Sara , Duncavage Eric , Martin Mike G. 
Published: November 2016

Sweet’s syndrome (SS) is a rare condition characterized by the abrupt appearance of painful skin lesions due to neutrophilic dermal infiltration. Hematologic neoplasms, particularly acute myeloid leukemia (AML) and myelodysplastic syndromes (MDSs), have been commonly reported in association with SS. Clonal hematopoiesis of indeterminate potential (CHIP) is an emerging entity that is a precursor state to myeloid neoplasms. CHIP has not been previously associated with SS. We report the case of a 71-year-old man who presented with recurrent, painful edematous and erythematous papules and nodules for 18 months despite treatment with corticosteroids. He had normal blood counts, but a macrocytosis was noted (110 fl). Alternative causes of macrocytosis were ruled out. A skin biopsy confirmed a diagnosis of SS. Bone marrow biopsy specimen yielded a normal karyotype except for loss of the Y chromosome and equivocal morphologic findings. Polymerase chain reaction (PCR) and reverse transcription polymerase chain reaction (RT-PCR) of selected genes from the peripheral blood demonstrated a mixed lineage leukemia (MLL) partial tandem duplication (PTD) and sequence variant in CCAAT/enhancer binding protein alpha (CEBPA). These findings were consistent with a diagnosis of CHIP. The patient was treated with 5-azacitidine and achieved a complete remission of his skin lesions and was able to discontinue corticosteroids. To our knowledge, this is the first report of a patient with recurrent SS associated with CHIP. In addition to other myeloid neoplasms like AML and MDS, CHIP should be considered as a potential etiology in cases of recurrent SS. Treatment with a hypomethylating agents such as azacitidine could also serve as an alternative to systemic corticosteroid therapy.