bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brain functional connectome abnormalities in amyotrophic lateral sclerosis are associated with disability and cortical hyperexcitability
Authors: Geevasinga N. , Korgaonkar M. S. , Menon P. , Van den Bos M. , Gomes L. , Foster S. , Kiernan M. C. , Vucic S. 
Published: September 2017

Background and purposeThe present study utilized a multimodal approach encompassing connectome networks combined with brain volume analysis, and assessment of cortical excitability to provide novel insights into amyotrophic lateral sclerosis (ALS) pathogenesis.MethodsMagnetic resonance images were acquired using a 3.0‐Tesla Signa HDx scanner (GE Healthcare, Milwaukee, WI, USA), using an eight‐channel head coil. Magnetic resonance images for the resting‐state scan were acquired using an echo‐planar imaging magnetic resonance sequence, acquiring 40 contiguous axial/oblique slices. Structural magnetic resonance imaging three‐dimensional T1‐weighted images were acquired in the sagittal plane using three‐dimensional spoiled gradient echo sequences. For structural imaging, a T1‐weighted high‐resolution (3.0‐Tesla) magnetic resonance imaging scan was used. Cortical excitability was assessed by using the threshold‐tracking transcranial magnetic stimulation paradigm. Network‐based statistics and whole‐brain functional topology (using graph theoretical approaches) assessed functional connectivity.ResultsUsing a global network‐based statistical analysis approach, functional connectivity was increased in 12 network edges connecting 14 nodes (P < 0.05) within the frontal, temporal, parietal and subcortical regions. Analysis of local connectedness disclosed dichotomous effects with reduced connectivity in frontal regions and increased connectivity in occipital regions in ALS. Cortical hyperexcitability was evident in patients with ALS, negatively correlated with functional connectivity changes in the pre‐central gyrus (P < 0.01). Connectivity changes in the frontal regions were negatively associated with functional disability (P < 0.05).ConclusionsMultimodal assessment of cortical function in patients with ALS identified deficits in functional connectivity associated with cortical hyperexcitability that correlated with patient disability. Novel integration of functional brain assessment further contributes to the understanding of disease pathogenesis in ALS.
Evaluation of a palliative and hospice care telephone hotline for patients severely affected by multiple sclerosis and their caregivers
Authors: Strupp J. , Groebe B. , Knies A. , Mai M. , Voltz R. , Golla H. 
Published: September 2017

Background and purposePalliative and hospice care (PHC) still mainly focuses on patients with cancer. In order to connect patients severely affected by multiple sclerosis (MS) and caregivers to PHC, a nationwide hotline was implemented to facilitate access to PHC.MethodsThe hotline was designed in cooperation with the German Multiple Sclerosis Society. Self‐disclosed information given by callers was documented using case‐report forms supplemented by personal notes. Data were analysed descriptively.ResultsA total of 222 calls were documented in 27 months. The patients' mean age was 51.12 years (range 27–84 years) and mean illness duration was 18 years (range 1 month to 50 years). Inquiries included information on PHC (28.8%) and access to PHC (due to previous refusal of PHC, 5.4%), general care for MS (36.1%), adequate housing (9.0%) and emotional support in crisis (4.5%). A total of 31.1% of callers reported ‘typical’ palliative symptoms (e.g. pain, 88.4%), 50.5% reported symptoms evolving from MS and 35.6% reported psychosocial problems. For 67 callers (30.2%), PHC services were recommended as indicated.ConclusionsThe hotline provided insight into the needs and problems of patients severely affected by MS and their caregivers, some of which may be met by PHC. Future follow‐up calls will demonstrate if the hotline helped to improve access to PHC beyond providing information. Overall, the hotline seemed to be easily accessible for patients severely affected by MS whose mobility is limited.
Electronic‐Diary for Recording Headaches, Triggers, and Medication Use: Development and Evaluation
Authors: Bandarian‐Balooch Siavash , Martin Paul R. , McNally Brenton , Brunelli Arissa , Mackenzie Sharon 
Published: September 2017

ObjectiveTo evaluate an e‐diary developed for measuring headaches, triggers, and medication consumption, in terms of reliability and validity, and variables such as ease of use and participant compliance.BackgroundFor many decades, behavioral treatment of headaches has been evaluated via participants completing paper diaries recording their headaches and associated phenomena. There is some limited evidence supporting the reliability and validity of paper diaries, and criticisms have been offered such as the large amount of effort involved for both participants and researchers. This study evaluates a new e‐diary that will operate on virtually any device that can connect to the internet, and yields 5 of the recommended outcome measures.MethodsOne hundred and eighty‐one participants (146 females, 35 males) were allocated to 2 groups, e‐diaries vs paper diaries, via a disproportionate stratified allocation process. The e‐diary group included 4 subgroups based on the technology available to the participant, and the paper diary group included 2 subgroups, one parallel to the e‐dairies (short paper), and one representative of traditional paper diaries (long paper). The study commenced with individuals who had self‐identified as headache and migraine sufferers attending a screening session that included headache diagnosis. Participants who met selection criteria then completed the Headache Disability Inventory and a measure of quality of life (SF‐36) to assess the convergent validity of the diaries, and the Depression Anxiety Stress Scales to assess the discriminant validity of the diaries. They also completed a Measure of Acceptance Questionnaire. Participants then completed the headache diaries over the next 30 days. Finally, participants completed for a second time the questionnaires completed previously.ResultsThe 5 outcome measures – headache frequency, peak intensity, average intensity, duration, and medication usage – were found to have strong test–retest reliability (r, 0.68‐0.79), for all 3 types of diary. These 5 measures for the e‐diaries were shown to have good convergent validity via comparison with scores on the Headache Disability Inventory (r, 0.46‐0.55) and SF‐36 (r, −0.35 to −0.49), and divergent validity via comparison with scores on the Depression Anxiety and Stress Scale (r, 0.10‐0.25). The long‐paper diaries had significantly higher missing data scores (M = 15.20, SD = 14.84) and more errors in data completion (M = 5.47, SD = 3.28) than the e‐diaries and short‐paper diaries (P < .05). In addition, the long‐paper diaries were evaluated by the participants as more burdensome and significantly less easy to use than the e‐diaries and short‐paper diaries.ConclusionsThe e‐diaries evaluated in this research would prove a useful tool in clinical trials of behavioral treatment for headaches.
Quantitative Analysis of Mouse Dural Afferent Neurons Expressing TRPM8, VGLUT3, and NF200
Authors: Ren Lynn , Chang Michelle Jaehee , Zhang Zhiyu , Dhaka Ajay , Guo Zhaohua , Cao Yu‐Qing 
Published: September 2017

ObjectiveTo quantify the abundance of dural afferent neurons expressing transient receptor potential channel melastatin 8 (TRPM8), vesicular glutamate transporter 3 (VGLUT3), and neurofilament 200 (NF200) in adult mice.BackgroundWith the increasing use of mice as a model system to study headache mechanisms, it is important to understand the composition of dural afferent neurons in mice. In a previous study, we have measured the abundance of mouse dural afferent neurons that express neuropeptide calcitonin gene‐related peptide as well as two TRP channels TRPV1 and TRPA1, respectively. Here, we conducted quantitative analysis of three other dural afferent subpopulations in adult mice.MethodsWe used the fluorescent tracer Fluoro‐Gold to retrogradely label dural afferent neurons in adult mice expressing enhanced green fluorescent protein in discrete subpopulations of trigeminal ganglion (TG) neurons. Mechanoreceptors with myelinated fibers were identified by NF200 immunoreactivity. We also conducted Ca2+‐imaging experiments to test the overlap between TRPM8 and VGLUT3 expression in mouse primary afferent neurons (PANs).ResultsThe abundance of TRPM8‐expressing neurons in dural afferent neurons was significantly lower than that in total TG neurons. The percentages of dural afferent neurons expressing VGLUT3 and NF200 were comparable to those of total TG neurons, respectively. TRPM8 agonist menthol evoked Ca2+ influx in less than 7% VGLUT3‐expressing PANs in adult mice.ConclusionsTG neurons expressing TRPM8, VGLUT3, and NF200 all innervate adult mouse dura. TRPM8 and VGLUT3 are expressed in distinct subpopulations of PANs in adult mice. These results provide an anatomical basis to investigate headache mechanisms in mouse models.
Laugh‐Induced Headache: Clinical Features and Literature Review
Authors: Ran Ye , Liu Huanxian , Zhang Meichen , Dong Zhao , Yu Shengyuan 
Published: September 2017

BackgroundLaughing is a rare precipitating factor for headaches, and the pathogenesis underlying laugh‐induced headache (LH) remains unclear.MethodsTwo cases of headache triggered predominantly by laughing were presented in this article. We also reviewed the published English literature regarding LH, summarized the clinical characteristics of LH, and discussed the probable pathophysiological mechanisms.ResultsIn the first patient, magnetic resonance imaging of the brain revealed cerebellar tonsillar herniation through the foramen magnum. In the second patient, we did not find any evidence of intracranial disease. The literature review showed that LH is a mild to severe, non‐pulsating headache. In most cases, the duration of each attack was limited to a few minutes. The headache usually bursts after laughing and reaches its peak almost immediately. In some cases, the headache can only be induced by mirthful laughing rather than by fake laughing.ConclusionLH can be categorized as primary LH and secondary LH. Changes in the spatial structure in the posterior cranial fossa and cerebrospinal fluid circulation may contribute to the development of secondary LH. Primary LH, primary cough headache, and primary exercise headache may share some common pathogenesis. And we speculate that the regions of the brain associated with the expression of mirth might be associated with LH.
Pitted keratolysis – a study of various clinical manifestations
Authors: Makhecha Meena , Dass Shreya , Singh Tishya , Gandhi Riddhi , Yadav Tulika , Rathod Dipali 
Published: September 2017

AbstractBackgroundPitted keratolysis (PK) is a common bacterial infection of skin characterized by noninflammatory superficial pits. Very few studies have focused on variations in clinical manifestations of PK. We conducted this study so that diagnosis of this treatable condition is not missed when it presents in an uncommonly perceived way.Aims and objectivesAssessment of PK patients for various sites and morphologies.Materials and methodsA total of 30 patients with PK were assessed for various sites and morphologies. Bacterial and fungal cultures along with histopathology were performed.ResultsOf 30 patients, 24 were females. Hyperhidrosis and malodour were the most common symptoms. Interdigital interface skin of the toes was the first site affected in most patients. Plantar skin was affected in all patients with involvement of interface skin of the toes in 29 patients. Other sites affected were palms, finger web spaces, nonglabrous skin, paronychium, and nail. Other than classical pits, scaly crusted inflammatory lesions with post‐inflammatory hyperpigmentation (PIH) were noted. Associated keratoderma was also reported in some patients.DiscussionThe presence of hyperhidrosis, malodour, and plantar lesions is consistent with previous studies. Interface skin between toes as the first site affected, involvement of toe web spaces, and associated keratoderma have been reported rarely. However, female preponderance, involvement of finger web spaces, nonglabrous skin, paronychium, nail changes, the presence of inflammation with crusting, and PIH have never been reported previously.ConclusionPK can involve web spaces, nonglabrous skin, and paronychium, and can cause nail changes. The lesions can be inflammatory with crusting and PIH.
Assessment of counselling for acute diarrhoea in German pharmacies: a simulated patient study†
Authors: Langer Bernhard , Bull Elisa , Burgsthaler Tina , Glawe Julia , Schwobeda Monique , Simon Karen 
Published: September 2017

AbstractObjectivesThe aim of this study was to assess the quality of counselling provided for acute diarrhoea and to evaluate the role of the patient's approach and different user groups in determining the outcome of counselling.MethodsThe simulated patient methodology was used in all 21 community pharmacies in a north-eastern German city. Four different scenarios related to self-medication of acute diarrhoea were developed and used in all the pharmacies (a total of 84 visits). The assessment form, completed immediately postvisit by the simulated patient, included 9 objective items scored using dichotomous scales to produce a scale from 0 to 9. After evaluating the data, every pharmacy received individual performance feedback to encourage behavioural changes and improve the quality of the counselling provided.Key findingsOverall, the quality of counselling was poor (mean score of 3.3/9 (37%)). The most common information provided was about dosage (87% of interactions), while the least common information given was about side effects (4% of interactions). The main effect was seen when comparing the product and symptom requests (F(1,60) = 24.748, P &lt; 0.001, ωp2 = 0.277). There was no effect resulting from different user groups (F(1,28) = 0.237, P = 0.630, ωp2 = −0.026) and no interaction between the type of request and different user groups (F(1,28) = 3.395, P = 0.076, ωp2 = 0.073).ConclusionsThis study highlighted the current deficits in appropriate counselling provided by community pharmacies in Germany.
Multidisciplinary full‐mouth rehabilitation with soft tissue regeneration in the esthetic zone
Authors: Liebermann Anja , Frei Stefan , Pinheiro Dias Engler Madalena Lucia , Zuhr Otto , Prandtner Otto , Edelhoff Daniel , Saeidi Pour Reza 
Published: September 2017

AbstractObjectiveOral rehabilitation often requires a multidisciplinary approach including restorative dentistry, prosthodontics, and periodontology to fulfill high esthetic and functional demands, frequently combined with changes in the vertical dimension. The presence of gingival recessions can be associated with numerous factors, such as brushing or preparation trauma and persistent inflammation of the gingiva due to inadequate marginal fit of restorations. Because gingival recessions can cause major esthetic and functional problems, obtaining stability of the gingival tissue around prosthetic restorations is of essential concern. Modifications of the occlusal vertical dimension require sufficient experience of the whole dental team. Especially in patients with functional problems and craniomandibular dysfunction, a newly defined occlusal position should be adequately tested and possibly adjusted.Clinical considerationsThis case report presents a complete prosthetic rehabilitation combined with a periodontal surgical approach for a patient with gingival recessions and functional/esthetic related problems. The vertical dimension was carefully defined through long‐term polymethyl methacrylate provisionals as a communication tool between all parts involved. All‐ceramic crowns were inserted after periodontal healing as definitive rehabilitation.ConclusionsComplex rehabilitation in patients with high esthetic demands including soft tissue corrections requires a multidisciplinary team approach that consists of periodontal surgeon, dentist and dental technician.
Self‐Reported Function More Informative than Frailty Phenotype in Predicting Adverse Postoperative Course in Older Adults
Authors: Kapoor Alok , Matheos Theofilos , Walz Matthias , McDonough Christine , Maheswaran Abiramy , Ruppell Evan , Mohamud Deeqo , Shaffer Nicholas , Zhou Yanhua , Kaur Shubjeet , Heard Stephen , Crawford Sybil , Cabral Howard , White Daniel K. , Santry Heena , Jette Alan , Fielding Roger , Silliman Rebecca A. , Gurwitz Jerry 
Published: September 2017

Background/ObjectiveCurrent preoperative assessment tools such as the American College of Surgeons Surgical Risk Calculator (ACS Calculator) are suboptimal for evaluating older adults. The objective was to evaluate and compare the performance of the ACS Calculator for predicting risk of serious postoperative complications with the addition of self‐reported physical function versus a frailty score.DesignProspective cohort.SettingTwo tertiary care academic medical centers in Massachusetts.ParticipantsIndividuals aged 65 and older undergoing any surgery with a risk of serious complication of 5% or greater (N = 403).MeasurementsWe measured self‐reported physical function using the Late‐Life Function and Disability Instrument (LLFDI FUNCTION) and frailty phenotype (FP), which has a score ranging from 0 to 5 based on slow gait speed, weak handgrip, exhaustion, weight loss, or low activity. Using c‐statistic and net classification improvement (NRI), we then analyzed capability of LLFDI‐FUNCTION versus FP to improve the ACS Calculator for predicting an adverse postoperative course (serious complication, discharge to nursing home, readmission, death within 30 days of surgery). Increase in c‐statistic and net reclassification improvement (NRI) for LLFDI‐FUNCTION versus FP in addition to the ACS Calculator for predicting an adverse postoperative course (serious complication, discharge to nursing home, readmission, death within 30 days of surgery)ResultsOver 30 days, 26% of participants developed an adverse postoperative course. The increase in c‐statistic for the ACS Calculator (baseline value 0.645) was slightly greater with LLFDI‐FUNCTION (0.076) than with FP (0.058), with a bootstrapped difference in c‐statistic of 0.005 (95% confidence interval = 0.002–0.007). NRI was also better with LLFDI‐FUNCTION.ConclusionThe LLFDI‐FUNCTION predicted postoperative complications slightly better than the FP. Further studies are needed to confirm these findings and validate the use of the LLFDI‐FUNCTION with the ACS Calculator for preoperative assessments of older adults.
The Effects of Placental Transfusion on Placental Residual Blood Volume and 24 to 48‐hour Hemoglobin and Serum Bilirubin in Term Newborns: A Randomized Controlled Trial
Authors: Erickson‐Owens Debra , Mercer Judith 
Published: September 2017

PurposeTo determine if newborns who receive a full placental transfusion at birth differ in placental residual blood volume (PRBV) and 24 to 48‐hour hemoglobin (Hb) and total serum bilirubin (TSB) levels compared to newborns who receive no placental transfusion.Research QuestionWill newborns who receive a full placental transfusion have less PRBV, a higher 24 to 48‐hour Hb, and no difference in peak TSB compared to newborns who receive no placental transfusion?SignificanceThe usual maternity care practice in the United States is to immediately clamp the umbilical cord (immediate cord clamping [ICC]) at the time of birth. When ICC occurs, 20% to 40% of the fetal‐placental blood volume (containing iron‐rich red blood cells) is left behind in the placenta, potentially leading to lower iron stores in infancy.MethodsA prospective randomized controlled trial was conducted. Seventy‐three healthy term pregnant women with singleton fetuses were enrolled. At birth, they were randomized to either ICC (<20 seconds; n = 36) or delayed cord clamping (DCC) (≥5 minutes; n = 37) and then placed skin‐to‐skin. The primary endpoints were PRBV in mL/kg, Hb (g/dL), and peak TSB at 24 to 48 hours of age. Primary analyses were conducted by intention‐to‐treat and secondary analyses by actual treatment.ResultsMaternal and newborn demographics were not significantly different between groups. Mean (standard deviation [SD]) cord clamping time was 303 (121) seconds (DCC) versus 10 (6) (ICC) seconds (P = .001). Eleven newborns received cord milking as a proxy for DCC at the time of cesarean birth or when resuscitation measures were indicated. There were 9 protocol violations. Newborns randomized to DCC left behind less PRBV (20.0 vs 30.8 mL/kg, P < .001). At 24 to 48 hours of age, newborns exposed to DCC had significantly higher Hb levels (19.5 vs 17.7 g/dL, P = .002) without a difference in peak TSB levels (DCC = 8.5 vs ICC = 9.0 mg/dL, P = .45) compared to infants with ICC. Two newborns in each group had phototherapy.DiscussionNewborns with ICC left behind more PRBV and had lower Hb levels at 24 to 48 hours. There was no difference between the groups on peak TSB levels or other indicators of hyperbilirubinemia. The results support the early hematological advantage of DCC while demonstrating no association with an increase in hyperbilirubinemia.
The fibular meniscus of the kangaroo as an adaptation against external tibial rotation during saltatorial locomotion
Authors: Miller Adrian C. , Cake Martin A. , Warburton Natalie M. 
Published: September 2017

AbstractThe kangaroo knee is, as in other species, a complex diarthrodial joint dependent on interacting osseous, cartilaginous and ligamentous components for its stability. While principal load bearing occurs through the femorotibial articulation, additional lateral articulations involving the fibula and lateral fabella also contribute to the functional arrangement. Several fibrocartilage and ligamentous structures in this joint remain unexplained or have been misunderstood in previous studies. In this study, we review the existing literature on the structure of the kangaroo ‘knee’ before providing a new description of the gross anatomical and histological structures. In particular, we present strong evidence that the previously described ‘femorofibular disc’ is best described as a fibular meniscus on the basis of its gross and histological anatomy. Further, we found it to be joined by a distinct tendinous tract connecting one belly of the m. gastrocnemius with the lateral meniscus, via a hyaline cartilage cornu of the enlarged lateral fabella. The complex of ligaments connecting the fibular meniscus to the surrounding connective tissues and muscles appears to provide a strong resistance to external rotation of the tibia, via the restriction of independent movement of the proximal fibula. We suggest this may be an adaptation to resist the rotational torque applied across the joint during bipedal saltatory locomotion in kangaroos.