bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the Integrity of Corticospinal Pathways From Primary and Secondary Cortical Motor Areas After Stroke
Authors: Schulz Robert , Park Chang-Hyun , Boudrias Marie-Hélène , Gerloff Christian , Hummel Friedhelm C. , Ward Nick S. 
Published: July 2012

Background and Purpose—
Aside from the primary motor cortex, the corticospinal tract (CST) also receives fibers from dorsal and ventral premotor cortices and supplementary motor area, all of which might potentially contribute to motor function after stroke. We sought to quantify the microstructural integrity of CST originating from the hand representations in these 4 motor cortices separately and examined how these values related to hand motor impairment.

Methods—
Probabilistic tractography from functional MRI-defined cortical sites demonstrated continuous CST originating from hand representations within each motor area in a group of healthy subjects. Microstructural integrity for each tract was calculated using fractional anisotropy at the level of the posterior limb of the internal capsule in a group of patients with chronic stroke.

Results—
Fractional anisotropy was reduced in all 4 CSTs in the affected hemisphere. Grip strength correlated with the integrity of the CSTs originating from primary motor and dorsal premotor cortices, whereas, in a multiple regression model, the latter improved the ability of primary motor cortex CST to explain variability in grip strength.

Conclusion—
Handgrip critically depends on the CST originating in primary motor cortex but microstructural integrity of CST originating from premotor cortices appears to play a role in supporting motor function after stroke.
Cardiometabolic risk factors in people with psychotic disorders: The second Australian national survey of psychosis
Authors: Galletly Cherrie A , Foley Debra L , Waterreus Anna , Watts Gerald F , Castle David J , McGrath John J , Mackinnon Andrew , Morgan Vera A 
Published: July 2012

Objective: To determine the prevalence of cardiometabolic risk factors in Australian adults with a psychotic disorder. Method: Data were collected during the interview phase of the second Australian survey of psychosis, a population-based survey of Australians aged 18 to 64 years with a psychotic disorder. Body mass index, waist circumference and blood pressure were measured. Participants were asked about diagnoses of relevant medical conditions, medications, smoking and physical activity. Fasting blood samples were analysed for glucose, high-density lipoprotein cholesterol, total cholesterol and triglycerides. The prevalence of metabolic syndrome was determined using the harmonized criteria developed by the International Diabetes Federation and other bodies. Results: A total of 1087 men (60%) and 738 women (40%) participated. Their mean age was 38.36 (SD 11.16) years; 773 (42%) were aged 18–34 years and 1052 (58%) 35–64 years. Three-quarters were overweight or obese and 82% had abdominal obesity. Almost half were hypertensive. Two-thirds were current smokers and 81% had a lifetime history of smoking. Levels of physical activity were very low. About 30% reported a diagnosis of hypertension or high cholesterol, 20% knew they had diabetes or high blood sugar and 18% had cardiovascular disease. Half of those with self-reported hypertension were taking antihypertensive drugs, and about 40% with hypercholesterolemia or hyperglycaemia were receiving medication for these conditions. Seventy per cent ( N = 1286) of participants provided fasting blood samples. Abnormal levels of high-density lipoprotein cholesterol and triglycerides were each found in almost half of participants and almost one-third had elevated fasting glucose. More than half of participants (54.8%) met criteria for metabolic syndrome. Conclusions: Australians living with psychosis have high rates of cardiometabolic risk factors. There are a number of obvious targets for prevention and treatment, including obesity (especially in women), smoking (more prevalent in men), hypertension, hyperlipidaemia and sedentary lifestyle.
Revisiting the Palliative Performance Scale: Change in scores during disease trajectory predicts survival
Authors: Chan Ee-Yuee , Wu Huei-Yaw , Chan Yiong-Huak 
Published: July 2012

Background: The Palliative Performance Scale (PPS) on admission is a predictor of survival. However, it is not highly discriminating for mid-range scores. ‘PPS Change’ between two time points considers the disease trajectory, and may improve the scale’s utility. Aim: The aim of this study is to determine if a change in PPS scores between two significant time points predicts survival. Design: This prospective cohort study examined ‘Change on Admission’, ‘Change at Week 1’, and ‘Change at Week 2’. We followed patients until death or 6 months, whichever was earlier. Cox regressions were used to determine if the Change scores were predictors of survival, adjusting for age, sex, diagnosis category, Charlson Index, and Do-Not-Resuscitate order. Setting/Participants: The sample consisted of patients referred to the palliative care service. Results: All three Change scores were independent predictors of survival. The greater the change, the poorer the prognosis. At week 1, when compared to ‘PPS Change ≤ 10%’, ‘Change 11% –30%’ and ‘Change > 30%’ increased the hazard ratios by 1.70 (95% CI 1.10–2.63) and 3.14 (95% CI 1.77–5.59), respectively. At week 2, when compared to ‘PPS Change ≤ 10%’, ‘Change 11% –30%’ and ‘Change > 30%’ increased the hazard ratios by almost 3- and 8-fold, respectively. The same magnitude of Change scores also has higher hazard ratios as patients’ hospitalization progressed. Conclusions: The magnitude of change in PPS score during the disease trajectory is associated with one’s survival and is a potentially useful prognostication tool. Further research is needed to extend on our work.
A probabilistic modelling scheme for analysis of long-term failure of cemented femoral joint replacements
Authors: Galibarov Pavel E , Prendergast Patrick J , Lennon Alexander B 
Published: July 2012

Reliable prediction of long-term medical device performance using computer simulation requires consideration of variability in surgical procedure, as well as patient-specific factors. However, even deterministic simulation of long-term failure processes for such devices is time and resource consuming so that including variability can lead to excessive time to achieve useful predictions. This study investigates the use of an accelerated probabilistic framework for predicting the likely performance envelope of a device and applies it to femoral prosthesis loosening in cemented hip arthroplasty. A creep and fatigue damage failure model for bone cement, in conjunction with an interfacial fatigue model for the implant–cement interface, was used to simulate loosening of a prosthesis within a cement mantle. A deterministic set of trial simulations was used to account for variability of a set of surgical and patient factors, and a response surface method was used to perform and accelerate a Monte Carlo simulation to achieve an estimate of the likely range of prosthesis loosening. The proposed framework was used to conceptually investigate the influence of prosthesis selection and surgical placement on prosthesis migration. Results demonstrate that the response surface method is capable of dramatically reducing the time to achieve convergence in mean and variance of predicted response variables. A critical requirement for realistic predictions is the size and quality of the initial training dataset used to generate the response surface and further work is required to determine the recommendations for a minimum number of initial trials. Results of this conceptual application predicted that loosening was sensitive to the implant size and femoral width. Furthermore, different rankings of implant performance were predicted when only individual simulations (e.g. an average condition) were used to rank implants, compared with when stochastic simulations were used. In conclusion, the proposed framework provides a viable approach to predicting realistic ranges of loosening behaviour for orthopaedic implants in reduced timeframes compared with conventional Monte Carlo simulations.
Standardising the clinical assessment of coronal knee laxity
Authors: Clarke Jon V , Wilson William T , Wearing Scott C , Picard Frederic , Riches Philip E , Deakin Angela H 
Published: July 2012

Clinical laxity tests are used for assessing knee ligament injuries and for soft tissue balancing in total knee arthroplasty. This study reports the development and validation of a quantitative technique of assessing collateral knee laxity through accurate measurement of potential variables during routine clinical examination. The hypothesis was that standardisation of a clinical stress test would result in a repeatable range of laxity measurements. Non-invasive infrared tracking technology with kinematic registration of joint centres gave real-time measurement of both coronal and sagittal mechanical tibiofemoral alignment. Knee flexion, moment arm and magnitude of the applied force were all measured and standardised. Three clinicians then performed six knee laxity examinations on a single volunteer using a target moment of 18 Nm. Standardised laxity measurements had small standard deviations (within 1.1°) for each clinician and similar mean values between clinicians, with the valgus laxity assessment (mean of 3°) being slightly more consistent than varus (means of 4° or 5°). The manual technique of coronal knee laxity assessment was successfully quantified and standardised, leading to a narrow range of measurements (within the accuracy of the measurement system). Minimising the subjective variables of clinical examination could improve current knowledge of soft tissue knee behaviour.
Reproductive decision making after the diagnosis of multiple sclerosis (MS)
Authors: Alwan S , Yee IM , Dybalski M , Guimond C , Dwosh E , Greenwood TM , Butler R , Sadovnick AD 
Published: July 2012

Objective: This study aimed to determine reproductive practices and attitudes of North Americans diagnosed with multiple sclerosis (MS) and the reasons for their reproductive decision making. Methods: A self-administered questionnaire on reproductive practices was mailed to 13,312 registrants of the North American Research Committee on Multiple Sclerosis (NARCOMS) database who met inclusion criteria for the study. Completed questionnaires were then returned to the authors in an anonymous format for analysis. Results: Among 5949 participants, the majority of respondents (79.1%) did not become pregnant following diagnosis of MS. Of these, 34.5% cited MS-related reasons for this decision. The most common MS-related reasons were symptoms interfering with parenting (71.2%), followed by concerns of burdening partner (50.7%) and of children inheriting MS (34.7%). The most common reason unrelated to MS for not having children was that they already have a “completed family” (55.6%). Of the 20.9% of participants who decided to become pregnant (or father a pregnancy) following a diagnosis of MS, 49.5% had two or more pregnancies. Conclusion: This study indicates that an MS diagnosis does not completely deter the consideration of childbearing in MS patients of both genders.
Cortico-muscular coherence as an index of fatigue in multiple sclerosis
Authors: Tomasevic L , Zito G , Pasqualetti P , Filippi MM , Landi D , Ghazaryan A , Lupoi D , Porcaro C , Bagnato F , Rossini PM , Tecchio F 
Published: July 2012

Background: Highly common in multiple sclerosis (MS), fatigue severely impacts patients’ daily lives. Previous findings of altered connectivity patterns led to the hypothesis that the distortion of functional connections within the brain-muscle circuit plays a crucial pathogenic role. Objective: The objective of this paper is to identify markers sensitive to fatigue in multiple sclerosis. Methods: Structural (magnetic resonance imaging with assessment of thalamic volume and cortical thickness of the primary sensorimotor areas) and functional (cortico-muscular coherence (CMC) from simultaneous electroencephalo- and surface electromyographic recordings during a weak handgrip task) measures were used on 20 mildly disabled MS patients (relapsing–remitting course, Expanded Disability Status Scale score ≤ 2) who were recruited in two fatigue-dependent groups according to the Modified Fatigue Index Scale (MFIS) score. Results: The two groups were similar in terms of demographic, clinical and imaging features, as well as task execution accuracy and weariness. In the absence of any fatigue-dependent brain and muscular oscillatory activity alterations, CMC worked at higher frequencies as fatigue increased, explaining 67% of MFIS variance ( p=.002). Conclusion: Brain-muscle functional connectivity emerged as a sensitive marker of phenomena related to the origin of MS fatigue, impacting central-peripheral communication well before the appearance of any impairment in the communicating nodes.
Optimization of the inlet air line of an automotive turbocharger
Authors: Serrano José Ramón , Margot Xandra , Tiseira Andrés , García-Cuevas Luis Miguel 
Published: July 2012

This paper presents different aspects of air inlet behaviour near the inducer of a radial compressor and shows how the geometry can contribute to its stability and performance. Unfortunately, the space reserved for installation of an automotive turbocharger in a vehicle is constantly being reduced, so it is necessary to study the effects that elbows and abrupt changes in flow directions originate on the compressor performance. The work presented in this paper studies the effect that different 90° elbows have on the compressor with respect to its ideal, straight, no-elbow configuration, in order to obtain the best possible elbow configuration. The methodology followed has been to, initially, study different geometries in computational fluid dynamics code in order to obtain the best possible configuration. Then, several 90° elbows were constructed and characterized on a continuous flow test bench in order to validate the computational fluid dynamics results and to obtain optimum results. The elbows were then installed on a radial compressor and tested on a hot, continuous turbocharger test bench, where the compressor was characterized and maps were obtained with each different elbow. The results were compared with respect to the ideal, no-elbow configuration, which was taken as the base performance. After analysing the results obtained, it is possible to observe that in most of the cases, the elbows have a negative effect on the compression ratio, which tends to be reduced, especially at high rotor velocities and high air mass flow. On the other hand, the effect on the surge limit seems to be positive, as the surge line shifts to lower air mass flows, although the maximum mass flow allowed is reduced. It seems as if the compressor map shifts to the left with a reduction in compression ratio. From theoretical and experimental studies, it has been concluded that flow uniformity index and pressure loss are the most important factors affecting the performance of the compressor.
A surveillance system for monitoring, public reporting, and improving minority access to cancer clinical trials
Authors: Carpenter William R , Tyree Seth , Wu Yang , Meyer Anne-Marie , DiMartino Lisa , Zullig Leah , Godley Paul A 
Published: July 2012

Background The Institute of Medicine (IOM) has recommended that each person with cancer should have access to clinical trials, which have been associated with improving care quality and disparities. With no effective enrollment monitoring system, patterns of trial enrollment remain unclear. Purpose We developed a population-based, statewide system designed to facilitate monitoring of cancer trial enrollment and targeting of future interventions to improve it. Methods Person-level cancer incidence data from the North Carolina Central Cancer Registry (NCCCR), person-level treatment trial accrual data from the National Cancer Institute (NCI), and county-level Area Resource Files (ARF) measures for 12 years, 1996–2007, were studied. Deidentified person-level data necessitated county-level analysis. Enrollment rates were estimated as the ratio of trial enrollment to cancer incidence for each race, gender, year, and county combination. Multivariable analysis examined factors associated with trial accrual. Sensitivity analyses examined spurious fluctuations and temporal discordance of incidence and enrollment. Results The NCI treatment trial enrollment rate was 2.39% for whites and 2.20% for minorities from 1996 to 2007, and 2.88% and 2.47%, respectively, from 2005 to 2007. Numerous counties had no minority enrollment. The 2005–2007 enrollment rates for white and minority females was 4.04% and 3.59%, respectively, and for white and minority males was 1.74% and 1.36%, respectively. Counties with a medical school or NCI Community Clinical Oncology Program (CCOP)-affiliated practice had higher trial enrollment. Limitations We examined NCI trial accrual only – industry-sponsored and investigator-initiated trials were excluded; however, studies comprise the majority of all clinical trial participants. Delays in data availability may hinder the immediacy of population-based analyses. Conclusions Model stability and consistency suggest that this system is effective for population-based enrollment surveillance. For North Carolina, it suggests a worsening disparity in minority trial enrollment, though our analyses elucidate targets for intervention. Regional enrollment variation suggests the importance of access to clinical research networks and infrastructure. Substantial gender differences merit further examination.
Effect of recombinant human platelet-derived growth factor-BB-coated sutures on Achilles tendon healing in a rat model: A histological and biomechanical study
Authors: Cummings Stephen H , Grande Daniel A , Hee Christopher K , Kestler Hans K , Roden Colleen M , Shah Neil V , Razzano Pasquale , Dines David M , Chahine Nadeen O , Dines Joshua S 
Published: July 2012

Purpose: Repairing tendon injuries with recombinant human platelet-derived growth factor-BB has potential for improving surgical outcomes. Augmentation of sutures, a critical component of surgical tendon repair, by coating with growth factors may provide a clinically useful therapeutic device for improving tendon repair. Therefore, the purpose of this study was to (a) coat Vicryl sutures with a defined dose of recombinant human platelet-derived growth factor-BB without additional coating excipients (e.g. gelatin), (b) quantify the recombinant human platelet-derived growth factor-BB released from the suture, and (c) use the recombinant human platelet-derived growth factor-BB-coated sutures to enhance tendon repair in a rat Achilles tendon transection model. Methods: Vicryl sutures were coated with 0, 0.3, 1.0, and 10.0 mg/mL concentrations of recombinant human platelet-derived growth factor-BB using a dip-coating process. In vitro release was quantified by an enzyme-linked immunosorbent assay. Acutely transected rat Achilles tendons were repaired using one of the four suture groups ( n = 12 per group). Four weeks following repair, the tensile biomechanical and histological (i.e. collagen organization and angiogenesis) properties were determined. Results: A dose-dependent bolus release of recombinant human platelet-derived growth factor-BB occurred within the first hour in vitro, followed by a gradual release over 48 h. There was a significant increase in ultimate tensile strength ( p < 0.01) in the two highest recombinant human platelet-derived growth factor-BB dose groups (1.9 ± 0.5 and 2.1 ± 0.5 MPa) relative to controls (1.0 ± 0.2 MPa). The modulus significantly increased ( p = 0.031) with the highest recombinant human platelet-derived growth factor-BB dose group (7.2 ± 3.8 MPa) relative to all other groups (control: 3.5 ± 0.9 MPa). No significant differences were identified for the maximum load or stiffness. The histological collagen and angiogenesis scores were comparable in all groups, although there was a trend for improved collagen organization in the recombinant human platelet-derived growth factor-BB-treated groups ( p = 0.054). Conclusions: The results of this study suggest that recombinant human platelet-derived growth factor-BB can be used to reproducibly coat Vicryl sutures and improve remodeling in a rat Achilles tendon transection model by significantly decreasing the resulting cross-sectional area, thus improving the material properties of the repaired tendon.
Heparan sulfate, an endogenous TLR4 agonist, promotes acute GVHD after allogeneic stem cell transplantation
Authors: Brennan Todd V. , Lin Liwen , Huang Xiaopei , Cardona Diana M. , Li Zhiguo , Dredge Keith , Chao Nelson J. , Yang Yiping 
Published: July 2012

Abstract
Graft-versus-host disease (GVHD) remains the most common cause of nonrelapse-related morbidity and mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Although T-cell depletion and intensive immunosuppression are effective in the control of GVHD, they are often associated with higher rates of infection and tumor recurrence. In this study, we showed that heparan sulfate (HS), an extracellular matrix component, can activate Toll-like receptor 4 on dendritic cells in vitro, leading to the enhancement of dendritic cell maturation and alloreactive T-cell responses. We further demonstrated in vivo that serum HS levels were acutely elevated at the onset of clinical GVHD in mice after allo-HSCT. Treatment with the serine protease inhibitor α1-antitrypsin decreased serum levels of HS, leading to a reduction in alloreactive T-cell responses and GVHD severity. Conversely, an HS mimetic that increased serum HS levels accelerated GVHD. In addition, in patients undergoing allo-HSCT for hematologic malignancies, serum HS levels were elevated and correlated with the severity of GVHD. These results identify a critical role for HS in promoting acute GVHD after allo-HSCT, and they suggest that modulation of HS release may have therapeutic potential for the control of clinical GVHD.
Thymic retention of CD4+CD25+FoxP3+ T regulatory cells is associated with their peripheral deficiency and thrombocytopenia in a murine model of immune thrombocytopenia
Authors: Aslam Rukhsana , Hu Yu , Gebremeskel Simon , Segel George B. , Speck Edwin R. , Guo Li , Kim Michael , Ni Heyu , Freedman John , Semple John W. 
Published: July 2012

AbstractImmune thrombocytopenia (ITP) is a bleeding disorder in which antibodies and/or T cells lead to enhanced peripheral platelet destruction and reduced bone marrow platelet production. Several reports have observed that ITP is associated with a peripheral deficiency of tolerance-inducing CD4+CD25+FoxP3+ T regulatory cells (Tregs). Using a murine model of ITP, we analyzed Tregs in the spleen and thymus. CD61 knockout mice were immunized against wild-type (CD61+) platelets, and their splenocytes were transferred into severe combined immunodeficient (SCID) mice. Compared with SCID mice receiving naive splenocytes, within 2 weeks after transfer, the ITP SCID mice became thrombocytopenic (< 200 × 109 platelets/L) and had increased serum anti-CD61 antibodies. The quantity of thymic Tregs by 2 weeks after transfer was significantly elevated, whereas Tregs in the spleens were significantly reduced. Treatment of the ITP mice with 2 g/kg intravenous immunoglobulin raised the platelet counts, reduced antibody production, and normalized the thymic and splenic Treg populations. Compared with thymocytes from ITP mice treated with intravenous immunoglobulin, thymocytes from untreated ITP mice delayed the onset of ITP when administered before engraftment with immune splenocytes. These results suggest that ITP in mice is associated with a peripheral Treg deficiency because of thymic retention and therapy normalizes the Tregs.