bluuebunny/crossref_metadata_2025_split huggingface dataset:
Morning Bright Light Treatment for Chronic Low Back Pain: Potential Impact on the Volatility of Pain, Mood, Function, and Sleep
Authors: Burns John W , Gerhart James , Rizvydeen Muneer , Kimura Momoko , Burgess Helen J 
Published: November 2019

Abstract

Objectives
Most treatment outcome studies for people with chronic low back pain (CLBP) have based analyses on and reported only the mean levels of these factors. However, high levels of pain, mood, function, and sleep volatility may represent unique factors contributing to diminished quality of life. Our goal was to determine whether bright light treatment affected both mean levels of pain, mood, function, and sleep and reduced volatility in these outcomes.

Methods
US military veterans with CLBP (N = 22) underwent an open trial with a seven-day baseline, followed by 13 days of a one-hour morning bright light treatment self-administered at their home and a 30-day follow-up. Participants completed daily diary measures at 12 Pm and 6 Pm every day during the three study epochs.

Results
Using location scale modeling, results suggested that, in addition to being associated with changes in mean levels of pain intensity, pain interference, negative affect, and sleep quality, bright light treatment was also related to reductions in the volatility of pain intensity and negative affect, reductions that were largely maintained during follow-up.

Conclusions
Changes in mean levels and volatility were independent factors, suggesting that bright light treatment was related to participants experiencing fewer “pain flares.” These findings underscore the potential importance of volatility as a future treatment target.
Persistent deficiency of mucosal-associated invariant T cells during dermatomyositis
Authors: Cassius Charles , Branchtein Mylene , Battistella Maxime , Amode Reyhan , Lepelletier Clémence , Jachiet Marie , de Masson Adèle , Frumholtz Laure , Chasset François , Amoura Zahir , Mathian Alexis , Samri Assia , Monfort Jean-Benoit , Bachmeyer Claude , Bengoufa Djaouida , Cordoliani Florence , Bagot Martine , Bensussan Armand , Bouaziz Jean-David , Le Buanec Hélène 
Published: November 2019

Abstract

Objectives
Mucosal-associated invariant T (MAIT) cells are innate-like lymphocytes that are important for antibacterial immunity and may have regulatory roles. MAIT cells are decreased during SLE. However, their frequencies and phenotype have not been investigated in DM. We studied MAIT cell frequencies and phenotype in DM patients with active and inactive disease (after treatment).

Methods
Peripheral blood flow cytometry analysis of MAIT cells was compared between DM (n = 22), SLE (n = 10), psoriasis (n = 7) and atopic dermatitis (n = 5) patients, and healthy controls (n = 19).

Results
A dramatic decrease of circulating MAIT cell frequency was observed in active DM and SLE patients compared with healthy controls and other inflammatory skin diseases [active DM: median = 0.25% (interquartile range 0.19–0.6%), P &lt; 0.0001; active SLE: median = 0.61 (0.55–0.77), P &lt; 0.0001 vs healthy controls: 2.32% (1.18–4.45%)]. MAIT cells from active DM patients had an abnormal phenotype including increased expression of CD25 and cytotoxic T-lymphocyte-associated protein 4 that correlated with their low frequency in the blood.

Conclusion
In DM, peripheral blood MAIT cells are dramatically reduced and have an activated/exhausted phenotype that may be linked to increased activation-induced cell death.
Key-Narratives of Microalgae Nutrition: Exploring futures through a public Delphi survey in Germany
Authors: Roßmann Maximilian , Rösch Christine 
Published: November 2019

AbstractThis paper analyses public visions of microalgae as a food source to explain present innovation paths of a yet unproven scientific technology. The paper highlights the multi-perspectivity of contested futures, focusing on the role of generalized narratives as boundary objects. Using disaggregative policy Delphi, we reveal the key-narratives of microalgae nutrition with regard to expectability, desirability, and popularity. The study involved a two-round online survey with 229 participants, who were asked open and closed questions. We then clustered the answers and gave feedback in form of generalized narratives. Participants want microalgae to sustainably feed the world, while they also expect microalgae to be more likely a health product or an inconspicuous food substitute. Our findings show that Delphi methods are not only suitable to look into the future, but also for empirical research into perspectives on the future that help distinguish and hone the cognitive interest of politicians and researchers.
Acoustic slow wave sleep enhancement via a novel, automated device improves executive function in middle-aged men
Authors: Diep Charmaine , Ftouni Suzanne , Manousakis Jessica E , Nicholas Christian L , Drummond Sean P A , Anderson Clare 
Published: November 2019

AbstractStudy ObjectivesAs slow-wave activity (SWA) is critical for cognition, SWA-enhancing technologies provide an exciting opportunity to improve cognitive function. We focus on improving cognitive function beyond sleep-dependent memory consolidation, using an automated device, and in middle-aged adults, who have depleted SWA yet a critical need for maximal cognitive capacity in work environments.MethodsTwenty-four healthy adult males aged 35–48 years participated in a randomized, double-blind, cross-over study. Participants wore an automated acoustic stimulation device that monitored real-time sleep EEG. Following an adaptation night, participants were exposed to either acoustic tones delivered on the up phase of the slow-wave (STIM) or inaudible “tones” during equivalent periods of stimulation (SHAM). An executive function test battery was administered after the experimental night.ResultsSTIM resulted in an increase in delta (0.5–4 Hz) activity across the full-night spectra, with enhancement being maximal at 1 Hz. SWA was higher for STIM relative to SHAM. Although no group differences were observed in any cognitive outcomes, due to large individual differences in SWA enhancement, higher SWA responders showed significantly improved verbal fluency and working memory compared with nonresponders. Significant positive associations were found between SWA enhancement and improvement in these executive function outcomes.ConclusionsOur study suggests that (1) an automated acoustic device enhances SWA; (2) SWA enhancement improves executive function; (3) SWA enhancement in middle-aged men may be an important therapeutic target for enhancing cognitive function; and (4) there is a need to examine interindividual responses to acoustic stimulation and its effect on subsequent cognitive function.Clinical trial registrationThis study has been registered with the Australian New Zealand Clinical Trials Registry. “The efficacy of acoustic tones in slow-wave sleep enhancement and cognitive function in healthy adult males”. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371548&isReview=trueRegistrationACTRN12617000399392.
Maternal and Perinatal Morbidity and Mortality Associated With Anemia in Pregnancy
Authors: Smith Catherine , Teng Flora , Branch Emma , Chu Scally , Joseph K. S. 
Published: November 2019

OBJECTIVE:
To estimate the incidence of anemia in pregnancy and compare the maternal and perinatal outcomes of women with and without anemia.

METHODS:
We conducted a population-based retrospective cohort study on all pregnant women in British Columbia who had a live birth or stillbirth at or after 20 weeks of gestation between 2004 and 2016. Women were diagnosed with anemia based on two criteria: third-trimester hemoglobin value or a delivery admission diagnosis of anemia (made before delivery). Anemia was categorized into no anemia (hemoglobin 11 g/dL or greater), mild (9–10.9 g/dL), moderate (7–8.9 g/dL), severe (less than 7 g/dL), or anemia of unspecified severity (with diagnosis made before delivery). Logistic regression was used to estimate adjusted odds ratios (aOR) and 95% CIs expressing the association between anemia and maternal and perinatal outcomes.

RESULTS:
Of 515,270 women in the study population, 65,906 (12.8%) had anemia: 11.8%, 0.43%, and 0.02% had mild, moderate, and severe anemia, respectively, and 0.58% had anemia of unspecified severity. Anemic women had longer hospitalization duration and more antenatal admissions, and rates of preeclampsia, placenta previa and cesarean delivery were higher among women with anemia. The intrapartum–postpartum blood transfusion rate was 5.1 per 1,000 among women without anemia, and higher among women with anemia (aOR 2.45, 95% CI 1.74–3.45 for mild anemia; 21.3, 95% CI 12.2–37.3 for moderate anemia; not analyzable for severe anemia; and 48.3, 95% CI 6.60–353.9 for anemia of unspecified severity). Anemia was associated with preterm birth (mild anemia, aOR 1.09, 95% CI 1.05–1.12; moderate anemia, aOR 2.26, 95% CI 2.02–2.54; anemia of unspecified severity, aOR 2.27, 95% CI 2.06–2.50), small-for-gestational-age live birth, low 5-minute Apgar score, neonatal death, and perinatal death.

CONCLUSION:
Maternal anemia in pregnancy represents a common and potentially reversible risk factor associated with antepartum, intrapartum, and postpartum maternal morbidity and perinatal morbidity and mortality.
A Framework for Improving Characterization of Obstetric Hemorrhage Using Informatics Data
Authors: Goffman Dena , Friedman Alexander M. , Sheen Jean-Ju , Kessler Alan , Vawdrey David , Green Robert , D’Alton Mary E. , Oberhardt Matthew 
Published: November 2019

OBJECTIVE:
To characterize postpartum hemorrhage trends and outcomes using bioinformatics and electronic health record data.

METHODS:
This retrospective analysis included all women who delivered in a four-hospital system from July 2014 to July 2017 during implementation of a postpartum hemorrhage bundle. Data on billing codes, uterotonics, transfusion, intrauterine tamponade device placement, and hysterectomy were analyzed. A framework of four postpartum hemorrhage levels based on hemorrhage interventions was created using this informatics data. Levels were analyzed in relation to hematocrit drop from the highest predelivery to the lowest postpartum level. Changes in treatment patterns were assessed with risk-adjusted regression models with adjusted odds ratios (aOR) and 95% CI as the measures of effect. Postpartum hemorrhage-associated severe maternal morbidities were analyzed with adjusted models.

RESULTS:
The cohort included 43,657 deliveries. Four mutually exclusive postpartum hemorrhage levels were created based on informatics and billing criteria. Level 1: receipt of uterotonic other than oxytocin (3.7% of patients); level 2: billing diagnosis code for postpartum hemorrhage (3.0% of patients); level 3: placement of the intrauterine tamponade device, transfusion of 1–3 units red blood cells (RBCs), or both (1.8% of patients); and Level 4: hysterectomy, 4 or more units RBCs, or both (0.6% of patients). Higher postpartum hemorrhage levels were associated with higher hematocrit drops. In postpartum hemorrhage levels 1 through 4, 1.6%, 5.6%, 30.2%, and 30.7% of women had hematocrit drops greater than 40%, compared with 0.4% of women without postpartum hemorrhage. Over the course of the study, hematocrit drops within a given level did not change. Postpartum hemorrhage interventions such as uterotonics increased significantly (aOR 1.16, 95% CI 1.11–1.21, with aOR denoting change in outcome across 1 year). Although severe maternal morbidity did not change significantly, risk of hysterectomy decreased significantly (aOR 0.52, 95% CI 0.40–0.68).

CONCLUSION:
Postpartum hemorrhage can be characterized in a granular fashion with informatics data. Informatics data are becoming increasingly available and can provide detailed assessment of postpartum hemorrhage incidence, management, and outcomes to facilitate surveillance and quality improvement.
The Effect of Cleft Orthognathic and Nasal Reconstruction on Perceived Social Traits
Authors: Posnick Jeffrey C. , Susarla Srinivas M. , Kinard Brian E. 
Published: November 2019

Background:
The investigators hypothesized that a layperson’s social perceptions of an adolescent cleft lip and palate (CL/P) patient are more favorable after orthognathic surgery and definitive nasal reconstruction.

Methods:
The investigators implemented a survey comparing layperson’s perception of specific social traits before and >6 months after jaw and nasal reconstruction in CL/P adolescent subjects by viewing standardized facial photographs. The sample was composed of 10 consecutive subjects treated by 1 surgeon from birth through completion of their staged reconstruction. The outcome variable was changed in 6 perceived personality, 6 emotional expression traits, and 7 perceptions of likelihood of positive interpersonal experiences. Descriptive and bivariate statistics were computed (P < 0.05).

Results:
Five hundred respondents (raters) completed the survey. The respondents were 58% male with 53% age 25–34. After cleft reconstruction, study subjects were perceived to be significantly more dominant, trustworthy, friendly, intelligent, attractive, and less threatening (P < 0.05). They were also perceived as happier and less angry, surprised, sad, afraid, or disgusted than before surgery (P < 0.05). The subjects were also perceived to be more likely to have positive interpersonal experiences (P < 0.05).

Conclusion:
We confirmed that laypeople consistently report positive changes in adolescent CL/P subject’s perceived social traits after bimaxillary and chin orthognathic surgery followed by definitive nasal reconstruction.
Proptosis in a Patient With Known Graft Versus Host Disease
Authors: Tan Licia , Hwang William , Looi Audrey 
Published: November 2019

A retrospective review of the medical reports of a patient who was undergoing treatment for graft versus host disease following bone marrow transplant for acute myeloid leukemia was conducted. The patient presented with persistent ocular irritation and injection. For an unclear period of time, he developed proptosis and binocular diplopia with limitation of extraocular motility insidiously. MRI revealed gross enlargement of extraocular muscles and bone marrow aspiration trephine confirmed relapse of leukemia. He then underwent chemotherapy with marked improvement of proptosis and extraocular motility. This case report highlights the importance of the eye care provider’s careful assessment of patients with a history of malignancy. The presence of ocular irritation must not distract from the detection of other signs. Proptosis and extraocular motility limitation are rarely associated with graft versus host disease. The presence of these signs warrants orbital imaging to rule out recurrence of the primary malignancy.
This case report highlights how proptosis and extraocular motility limitation seen in a patient with graft versus host disease may point to recurrence of the primary malignancy.
Surgical Management of a Recurrent Odontogenic Keratocyst With Orbital and Temporal Fossa Invasion
Authors: Brookes Carolyn C.D. , Harris Gerald J. 
Published: November 2019

Odontogenic keratocyst is a benign locally aggressive odontogenic cyst with a high recurrence rate. This report presents an unusual case of a recurrent odontogenic keratocyst with zygomatic bone involvement and orbital and temporal extension resulting in globe compression. Odontogenic keratocyst is reviewed, and surgical management of the cyst is discussed.
The authors present a case of a recurrent odontogenic keratocyst involving the zygoma with orbital and temporal invasion; aggressive surgical resection and reconstruction was required.
Autoimmunity as a continuum in primary immunodeficiency
Authors: Walter Jolan E. , Ayala Irmel A. , Milojevic Diana 
Published: November 2019

Purpose of review
Primary immunodeficiency disorders (PIDs) are no longer defined by infections alone. First clinical sign or sequelae of PID may include autoimmunity, such as cytopenias, arthritis or enteropathy. This review addresses the latest in multidisciplinary approaches for expanding clinical phenotypes of PIDs with autoimmunity, including new presentations of known entities and novel gene defects. We also discuss diagnostic tools for identifying the distinct changes in immune cells subsets and autoantibodies, mechanistic understanding of the process, and targeted treatment and indications for hematopoietic stem-cell transplantation (HSCT).

Recent findings
In the past years, increased awareness and use of genetic screening, confirmatory functional studies and immunological biomarkers opened the door for early recognition of PIDs among patients with autoimmunity. Large cohort studies detail the clinical spectrum and treatment outcome of PIDs with autoimmunity with specific immune genes (e.g., CTLA4, LRBA, PI3Kδ, NFKB1, RAG). The benefit of early recognition is initiation of targeted therapies with precise re-balancing of the dysregulated immune pathways (e.g., biologicals) or definitive therapy (e.g., HSCT).

Summary
Clinical presentation of patients with PID and autoimmunity is highly variable and requires in-depth diagnostics and precision medicine approaches.
Human diseases caused by impaired signal transducer and activator of transcription and Janus kinase signaling
Authors: Chaimowitz Natalia S. , Forbes Lisa R. 
Published: November 2019

Purpose of review
The Janus kinase (JAK) and signal transducer of activation (STAT) pathway plays a key role in the immune system. It is employed by diverse cytokines, interferons, growth factors and related molecules. Mutations in JAK/STAT pathway have been implicated in human disease. Here we review JAK/STAT biology and diseases associated with mutations in this pathway.

Recent findings
Over the past 10 years, many mutations in JAK/STAT pathway has been discovered. These disorders have provided insights to human immunology.

Summary
In this review, we summarize the biology of each STAT and JAK as well as discuss the human disease that results from somatic or germline mutations to include typical presentation, immunological parameters and treatment.
Twenty-Year Experience of a Single Referral Center on Pediatric Familial Mediterranean Fever
Authors: Kisla Ekinci Rabia Miray , Balci Sibel , Dogruel Dilek , Altintas Derya Ufuk , Yilmaz Mustafa 
Published: November 2019

Background/Objective
Familial Mediterranean fever (FMF) is the most common autoinflammatory disease and is characterized by recurrent fever and serositis episodes. We aimed to share our 20-year FMF experience, clarify a phenotype-genotype correlation, and compare the characteristics and outcomes of pediatric FMF patients over the last 2 decades in this study.

Methods
This medical record review study included 714 pediatric FMF patients (340 females, 374 males), diagnosed by Tel Hashomer diagnostic criteria between January 2009 and January 2019 and followed up in our department. Demographic and disease characteristics, obtained from medical records of the patients, were compared between patients with M694V homozygosity and other genotypes and showed whether they were diagnosed before (n = 137) or after January 2010 (n = 577). χ
2, Student t, and Mann-Whitney U tests were used to compare categorical and continuous variables between these groups.

Results
The most common symptoms were abdominal pain (92%), fever (89.5%), and arthralgia (64.5%). Mean ages at symptom onset and diagnosis were 5.16 ± 3.73 and 7.71 ± 3.87 years, respectively. M694V homozygosity was recorded in 111 patients (15.5%). Fever, arthralgia, arthritis, myalgia, erysipela-like erythema, colchicine resistance, and subclinical inflammation were more frequent, and mean disease severity score was higher in patients with M694V homozygosity. Fever, chest pain, and proteinuria were statistically more frequent in patients diagnosed before January 2010. Although M694V homozygosity rate was similar, patients diagnosed in the last decade had lower mean disease severity score.

Conclusions
With this study, we speculate that although genotype and delay in diagnosis were similar, patients diagnosed in the last decade have a milder disease severity.
Incidental Detection of a Giant Fecaloma on 18F-FDG PET/CT
Authors: Plouznikoff Nicolas 
Published: November 2019

Abstract
Fecal retention can be exacerbated in older patients, bedridden patients, as well as those receiving opioids analgesics or anticholinergic medications. It can lead to impaction, which can have serious consequences, sometimes even requiring surgical intervention. We describe herein the incidental detection of a giant hypometabolic fecaloma on PET/CT with 18F-FDG during the initial staging of a patient with osteosarcoma using opioids for pain management.
Hypertrophic Osteoarthropathy in a Patient With Primary Hepatic Angiosarcoma
Authors: Zhang Jun , Dong Mengjie , Yi Zhanxiong , Yu Congcong 
Published: November 2019

Abstract
Primary hepatic angiosarcoma was diagnosed in a 59-year-old woman who presented an arthralgia of limbs and dry cough for 6 weeks. Physical examination revealed digital clubbing. A 99mTc-MDP bone scintigraphy showed diffusely increased uptake along the cortical margins of long bones, suggesting hypertrophic osteoarthropathy.
Resuscitation Fluids in Septic Shock: A Network Meta-Analysis of Randomized Controlled Trials
Authors: Li Binghu , Zhao Hongliang , Zhang Jie , Yan Qingguang , Li Tao , Liu Liangming 
Published: November 2019

ABSTRACT
The aim of this study was to assess the efficacy and safety of various resuscitation fluids in septic shock by adopting a network meta-analysis (NMA). Randomized controlled trials (RCTs) comparing resuscitation fluids in septic shock were carried out by retrieving electronic databases. NMAs of 28-day mortality, 90-day mortality, incidence of acute kidney injury (AKI), and the need for renal replacement therapy (RRT) were conducted using the STATA 15.0 software. Probability-based ranking and surface under cumulative ranking (SUCRA) were performed to identify the optimal resuscitation fluid. Inconsistencies were evaluated by node-splitting analysis and a loop-specific approach. Furthermore, publication bias was analyzed by funnel plots. A total of 13 RCTs were enrolled in the analysis. The NMA results revealed that no significant differences were detected in the outcomes of 28-day mortality and 90-day mortality among various resuscitation fluids. The SUCRAs (the first indicates the best) of 28-day mortality showed that the hypertonic sodium chloride/hydroxyethyl starch 40 solution ranked the highest (93.8%), followed by the balanced solution (BS) (69.6%), and albumin (61.9%). On the other hand, the SUCRAs of 90-day mortality revealed that gelatin (GEL) ranked the highest (75.1%), followed by BS (55.1%), and NS (52.4%). The NMA results of AKI demonstrated that high-molecular-weight hydroxyethyl starch (H-HES) was associated with increased risk of AKI in comparison with GEL, BS, and L-HES. The SUCRAs of AKI showed that GEL ranked the highest (74.4%), followed by NS (64.9%), and BS (58.3%). In addition, the NMA results of RRT revealed that H-HES was associated with an increased need for RRT in comparison with BS and NS, and L-HES was associated with increased need of RRT in comparison with BS. The SUCRAs of RRT revealed that NS ranked the highest (91.6%), followed by BS (74.4%) and L-HES (36.1%). No significant inconsistencies were shown by the node-splitting analysis and no publication bias was demonstrated in the funnel plots. In conclusion, BS was determined as the preferred resuscitation fluid for septic shock. Moreover, the use of GEL requires further evaluation. H-HES was associated with a significant risk of AKI and RRT, whereas L-HES with an increased need for RRT compared with BS. Thus, both resuscitation fluids should be avoided for septic shock.