bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cannabis-induced altered states of consciousness are associated with specific dynamic brain connectivity states
Authors: Zaytseva Yuliya , Horáček Jiří , Hlinka Jaroslav , Fajnerová Iveta , Androvičová Renata , Tintěra Jaroslav , Salvi Virginio , Balíková Marie , Hložek Tomáš , Španiel Filip , Páleníček Tomáš 
Published: June 2019

Background: Cannabis, and specifically one of its active compounds delta-9-tetrahydrocannabinol in recreational doses, has a variety of effects on cognitive processes. Most studies employ resting state functional magnetic resonance imaging techniques to assess the stationary effects of cannabis and to-date one report addressed the impact of delta-9-tetrahydrocannabinol on the dynamics of whole-brain functional connectivity. Methods: Using a repeated-measures, within-subjects design, 19 healthy occasional cannabis users (smoking cannabis ⩽2 per week) underwent resting state functional magnetic resonance imaging scans. Each subject underwent two scans: in the intoxicated condition, shortly after smoking a cannabis cigarette, and in the non-intoxicated condition, with the subject being free from cannabinoids for at least one week before. All sessions were randomized and performed in a four-week interval. Data were analysed employing a standard independent component analysis approach with subsequent tracking of the functional connectivity dynamics, which allowed six connectivity clusters (states) to be individuated. Results: Using standard independent component analysis in resting state functional connectivity, a group effect was found in the precuneus connectivity. With a dynamic independent component analysis approach, we identified one transient connectivity state, characterized by high connectivity within and between auditory and somato-motor cortices and anti-correlation with subcortical structures and the cerebellum that was only found during the intoxicated condition. Behavioural measures of the subjective experiences of changed perceptions and tetrahydrocannabinol plasma levels during intoxication were associated with this state. Conclusions: With the help of the dynamic connectivity approach we could elucidate neural correlates of the transitory perceptual changes induced by delta-9-tetrahydrocannabinol in cannabis users, and possibly identify a biomarker of cannabis intoxication.
Brucella-induced thrombocytopenia: a retrospective study of 16 patients
Authors: Xie Songsong , Zhou Yan , Zheng Rongjiong , Zuo Weize , Lu Xiaobo , Wang Yuanzhi , Zhang Yuexin 
Published: June 2019

Objective We aimed to describe the clinical characteristics and treatment outcomes of 16 patients with Brucella-induced thrombocytopenia. Methods We assessed 16 patients with Brucella-induced thrombocytopenia between 2012 and 2016 in The First Affiliated Hospital of Xinjiang Medical University. The diagnosis of Brucella-induced thrombocytopenia was ≤100,000 platelets/mm3. Results All patients were men. The most common symptoms of patients were fever (100%), sweating (81.2%), fatigue (75%), and joint pain (25%). The most common signs of physical examinations were an enlarged liver (75%) and enlarged spleen (50%). The lowest thrombocyte count was 2000/mm³ and the highest count was 72,000/mm³. An agglutination test antibody was positive (≥1:160) in 12 (75%) patients with the highest antibody titer of 1:800. Brucella melitensis was isolated from blood cultures in nine (56.3%) patients. All patients were administered antimicrobial agents. The patients’ platelet counts were normal at a follow-up of 12 months. Conclusion Classical brucellosis therapy is adequate for patients with a platelet count > 20,000/mm3. The five-drug regimen of doxycycline + rifampin + platelet transfusions +  corticosteroids + intravenous immunoglobulin is recommended for patients when the platelet count is < 10,000/mm3. These findings have important implications for improving treatment outcome in patients with Brucella-induced thrombocytopenia.
Effects of ischaemic conditioning on tissue oxygen saturation and heart rate variability: an observational study
Authors: Cho Youn Joung , Lee Hyung-Chul , Choi Eue-Keun , Park Seoyeong , Yu Je Hyuk , Nam Karam , Kim Tae Kyong , Jeon Yunseok 
Published: June 2019

Objective Ischaemic conditioning (IC) has organ-protective effects, but its clinical results have been inconsistent. Tissue oxygen saturation (StO2) and heart rate variability (HRV) reflect peripheral microcirculation and autonomic nervous system activity, but their changes during IC have not been well documented. We assessed StO2 and HRV during IC in patients undergoing cardiac surgery and healthy volunteers. Methods Ten patients undergoing cardiac surgery and 10 healthy male volunteers underwent remote IC (four 5-minute cycles of ischaemia/reperfusion) applied to the upper arm. Changes in StO2 at the thenar eminence and HRV according to the R-R intervals were recorded during IC. Results The lowest StO2 during ischaemia significantly decreased in patients and significantly increased in volunteers. Among the HRV parameters, the low-frequency domain, which corresponds to sympathetic activity, significantly increased after IC in volunteers but not in patients. Other variables were similar between the groups. Conclusions These results suggest that the minimum tissue oxygen content is depleted during ischaemia in patients and preserved in healthy volunteers. Sympathetic nervous activity seems to increase after IC in healthy volunteers but remains unaffected in patients. Thus, IC may act differently between patients undergoing cardiac surgery and healthy subjects.
Acute and Subacute Changes in Hip Strength and Range of Movement After Arthroscopy to Address Chondrolabral Pathology
Authors: Freke Matthew D. , Crossley Kay , Sims Kevin , Russell Trevor , Weinrauch Patrick , Gamboa Gauguin , Semciw Adam 
Published: June 2019

Background:Hip pain is associated with reduced muscle strength, range of movement (ROM), and function. Hip arthroscopy is undertaken to address coexistent intra-articular pathologies with the aim of reducing pain and improving function.Purpose:To evaluate changes in strength and ROM in a cohort with chondrolabral pathology before surgery to 3 and 6 months after hip arthroscopy.Study Design:Case series; Level of evidence, 4.Methods:Sixty-seven individuals with hip pain who were scheduled for hip arthroscopy were matched with 67 healthy controls. Hip strength and ROM were collected preoperatively and at 3 and 6 months postoperatively. Repeated measures analysis of variance evaluated whether strength and ROM differed between limbs and among time points. Bonferroni post hoc tests determined differences in hip strength and ROM among testing times and between the hip pain group and matched controls.Results:Hip extension, internal rotation (IR), external rotation (ER), and adduction ( P < .040) strength were greater at 3 months after surgery; all directions, including flexion, abduction, and squeeze, were greater at 6 months ( P < .015). Hip flexion ROM was greater at 3 months after surgery ( P = .013). Flexion, IR, and ER ROM was greater at 6 months ( P < .041). At 6 months, IR ROM ( P = .003) and flexion, IR, and ER strength ( P < .005) remained less than matched controls.Conclusion:With the exception of squeeze and flexion, all directions of hip strength and hip flexion ROM are significantly improved 3 months after arthroscopy to address chondrolabral pathology. By 6 months after arthroscopy, strength in all directions and flexion and rotation ROM are significantly improved in both limbs, but hip flexion, IR, and ER strength and IR ROM remain significantly less than that of healthy matched controls in both limbs.
Seizure Action Plans for Pediatric Patients With Epilepsy: A Randomized Controlled Trial
Authors: Albert Dara V. F. , Moreland Jennifer J. , Salvator Ann , Moore-Clingenpeel Melissa , Haridas Babitha , Cole Justin W. , Glynn Peter , Fults Marci , Dawson M. Zachary , Moreland Patty , Patel Anup D. 
Published: June 2019

Objectives: Seizure action plans help patients and caregivers better self-manage their epilepsy. We hypothesized that providing pediatric patients and their caregivers with a seizure action plan would reduce unplanned health care utilization and decrease the impact of epilepsy. Methods: We developed a seizure action plan for use in pediatric epilepsy patients. A prospective cohort was randomly assigned to receive a seizure action plan in addition to standard epilepsy care or to standard epilepsy care alone. All caregivers were surveyed using the Modified Impact on Families (MIF) questionnaire at enrollment, 3 months, and 12 months. Health care utilization measures and Modified Impact on Families questionnaire scores were compared between the 2 groups. Results: Fifty-four patients received a seizure action plan and standard care, whereas 48 received standard care alone. The groups had similar demographics. There was a significantly higher proportion of overall clinic appointment no shows in the standard care group vs the seizure action plan group ( P = .04); however, other significant differences in health care utilization were not found. Among patients with low seizure frequency (12 or fewer seizures per year), Seizure comfort scores on the Modified Impact on Families questionnaire were significantly higher at 12 months among the seizure action plan group compared to the standard care group. Significance: Caregivers for patients with epilepsy receiving a seizure action plan were more comfortable regarding seizure care and missed fewer appointments. However, differences in health care utilization were not present. The seizure action plan appears to have more impact in patients who experience lower seizure frequencies. Further studies evaluating the impact as well as assessing caregivers’ perceptions of the seizure action plan using a larger sample are needed.
Male Perceptions Toward the Cultural Practice of Chinamwali/Khomba Among the Mahenye
Authors: Naidu Maheshvari , hono William Muc 
Published: June 2019

This exploratory and descriptive article explores male perceptions toward the cultural practice of chinamwali/khomba among the Shangaan of the Mahenye community of Chipinge district in Zimbabwe. Chinamwali/khomba is the cultural practice of female initiation among the Mahenye people. The article draws on narratives of men from interviews and focus group discussions and describes khomba/chinamwali as a central aspect of (female) body politics in the Mahenye community, where the female practice of chinamwali marks the entrance into so-called ‘womanhood’ [sic]. The men’s sexually gendered narratives reveal how the women’s bodily sexual enactments become ‘cultural texts’ prescribed and inscribed by (male) societal perceptions and social (sexual) interactions. Semi-structured interviews and focus group discussions were carried out with 40 men from the community. Social role theory was the lens which was used to analyse these dynamics. Emergent findings reveal that the men of the community compel an overtly patriarchal agenda by encouraging and compelling women to be initiated.
Borderline personality disorder and eating disorders: a trans-diagnostic approach to unravelling diagnostic complexity
Authors: Newton J Richard 
Published: June 2019

Objectives: This opinion paper considers co-morbid borderline personality disorder (BPD) and eating disorders and proposes that a trans-diagnostic approach looking at presenting problems and treatment approaches may be of value. Conclusions: Trans-diagnostic elements can be identified across the two syndromes. Trans-diagnostic elements appear to include some shared aetiological factors as well as some shared syndromal components. The shared syndromal components include problems with affect, interpersonal problems, problems with self-concept and impulsivity. The pathoplastic effects of culture, attitudes to fatness and the neurobiology of starvation and/or restriction of intake are crucial to integrate into the understanding of co-morbidity of these two disorders. Trans-diagnostic approaches to treatment lead to trans-diagnostic improvements across the two disorders.
Progressive sixth nerve palsy secondary to intracavernous arachnoid cyst and complicated by contralateral optic nerve sheath meningioma
Authors: Malloy Kelly A , Draper Erin M , Maglione Ashley K , Seidler Kelly M 
Published: June 2019

Introduction: Optic nerve sheath meningiomas and intracavernous arachnoid cysts are both fairly rare conditions, and to the best of our knowledge, have not been previously reported to co-occur in the same patient. Both can cause diplopia, but only ONSMs have been documented to demonstrate progressive worsening of ocular motility. Case Report: A 67-year-old woman with blur and diplopia demonstrated a right optic neuropathy and limited ductions bilaterally. Neuroimaging revealed a right optic nerve sheath meningioma and left intracavernous arachnoid cyst. She was conservatively managed with neurosurgical surveillance for 1.5 years, until her diplopia worsened. Ocular motility re-evaluation demonstrated a worsening left abduction deficit, suggesting interval change of the intracavernous cyst, rather than the meningioma. Conclusion: There are only a few reported cases of cranial nerve VI palsy secondary to a cavernous sinus arachnoid cyst. However, this is the first reported case in a patient with a concurrent optic nerve sheath meningioma, and the first case demonstrating progressive worsening of a sixth cranial nerve palsy from an intracavernous arachnoid cyst. Determining which comorbidity caused worsening of symptoms played a critical role in the management of this patient.
Epidemiology of Injuries in Ice Hockey
Authors: Anderson Gregory R. , Melugin Heath P. , Stuart Michael J. 
Published: June 2019

Context: Hockey is a skillful contact sport with an elevated injury risk at higher levels of play. An understanding of injury incidence, type, mechanism, and severity at various levels of competition aids the clinician treating these athletes. The purpose of this clinical review is to discuss the epidemiology of hockey injuries at various levels of participation, including youth, high school, junior, college, and professional. Evidence Acquisition: A literature search was performed by a review of PubMed, Embase, and Cochrane databases and included articles published from 1988 to 2017. Studies were included in this review if determined to be of high quality and containing injury data relevant to the levels of competition. Pertinent data regarding ice hockey injury epidemiology and prevention at various levels of competition were analyzed. Study Design: Clinical review. Level of Evidence: Level 4. Results: Youth, high school, junior, college, and professional hockey players have unique injury patterns. Injuries occur much more often in a game compared with a practice, and injury risk increases with each level of competition. Preventative measures, such as mandatory facial protection and delayed body checking in games until age 13 years, are proven strategies to reduce the risk of facial injury and concussion. Conclusion: An understanding of common injury types and mechanisms according to age and level of play aids the clinician in diagnosis and management. This information can also guide preventative strategies in the areas of education, coaching, rule enforcement, rule modifications, equipment improvement, and sportsmanship.
The endoderm: a divergent cell lineage with many commonalities
Authors: Nowotschin Sonja , Hadjantonakis Anna-Katerina , Campbell Kyra 
Published: June 2019

ABSTRACT
The endoderm is a progenitor tissue that, in humans, gives rise to the majority of internal organs. Over the past few decades, genetic studies have identified many of the upstream signals specifying endoderm identity in different model systems, revealing them to be divergent from invertebrates to vertebrates. However, more recent studies of the cell behaviours driving endodermal morphogenesis have revealed a surprising number of shared features, including cells undergoing epithelial-to-mesenchymal transitions (EMTs), collective cell migration, and mesenchymal-to-epithelial transitions (METs). In this Review, we highlight how cross-organismal studies of endoderm morphogenesis provide a useful perspective that can move our understanding of this fascinating tissue forward.
Factors influencing malignant mesothelioma survival: a retrospective review of the National Mesothelioma Virtual Bank cohort
Authors: Amin Waqas , Linkov Faina , Landsittel Douglas P. , Silverstein Jonathan C. , Bshara Wiam , Gaudioso Carmelo , Feldman Michael D. , Pass Harvey I. , Melamed Jonathan , Friedberg Joseph S. , Becich Michael J. 
Published: June 2019

Background: Malignant mesothelioma (MM) is a rare but deadly malignancy with about 3,000 new cases being diagnosed each year in the US. Very few studies have been performed to analyze factors associated with mesothelioma survival, especially for peritoneal presentation. The overarching aim of this study is to examine survival of the cohort of patients with malignant mesothelioma enrolled in the National Mesothelioma Virtual Bank (NMVB). Methods: 888 cases of pleural and peritoneal mesothelioma cases were selected from the NMVB database, which houses data and associated biospecimens for over 1400 cases that were diagnosed from 1990 to 2017. Kaplan Meier’s method was performed for survival analysis. The association between prognostic factors and survival was estimated using Cox Hazard Regression method and using R software for analysis. Results: The median overall survival (OS) rate of all MM patients, including pleural and peritoneal mesothelioma cases is 15 months (14 months for pleural and 31 months for peritoneal). Significant prognostic factors associated with improved survival of malignant mesothelioma cases in this NMVB cohort were younger than 45, female gender, epithelioid histological subtype, stage I, peritoneal occurrence, and having combination treatment of surgical therapy with chemotherapy. Combined surgical and chemotherapy treatment was associated with improved survival of 23 months in comparison to single line therapies. Conclusions: There has not been improvement in the overall survival for patients with malignant mesothelioma over many years with current available treatment options. Our findings show that combined surgical and chemotherapy treatment in peritoneal mesothelioma is associated with improved survival compared to local therapy alone.
Pelvic ring fractures in the elderly
Authors: Küper Markus A. , Trulson Alexander , Stuby Fabian M. , Stöckle Ulrich 
Published: June 2019

Pelvic ring fractures are rare injuries in the elderly though the incidence is increasing due to the increasing age of the population. Main goal of treatment is the quickest possible re-mobilization to prevent side-effects of immobilization such as osteopenia, pulmonary infections or thromboembolic events. Isolated anterior pelvic ring fractures are stable injuries and therefore they usually can be treated conservatively, while pelvic ring injuries with involvement of the posterior ring are considered unstable and should undergo surgical stabilization if the patient’s condition allows for it. Conservative treatment includes adequate analgesia, guided mobilization with partial weight bearing if possible and osteoanabolic medication. The appropriate surgical procedure should be discussed in an interdisciplinary round considering patient’s pre-injury condition, anaesthetic and surgical risks.Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180062
Subchondral bone remodelling in osteoarthritis
Authors: Donell Simon 
Published: June 2019

Subchondral bone remodelling is an integral part of osteoarthritis and involves the development of subchondral sclerosis seen on plain imaging, along with osteophyte formation. The development of these changes is due to persistent abnormal mechanical stresses which create a cellular and biomolecular response to microfractures in the subchondral bone and osteochondral junction. An early sign is bone marrow lesions seen on MRI scanning. Healing can occur at this stage by correcting the abnormal loads. Persistence leads to what is thought to be a delayed union or nonunion response by the bone. Microfractures of the osteochondral junction, coupled with articular cartilage fissuring and loss, allows synovial fluid to penetrate the subchondral bone along with cytokines and other molecules reacting with the bone cells to increase the pathological effects. This review gives an overview of the current thoughts on subchondral bone remodelling in osteoarthritis that is aimed at orthopaedic surgeons to help in the understanding of the pathogenesis of osteoarthritis and the role of surgical management. Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180102
Continuous intraoperative nerve monitoring in thyroidectomy using automatic periodic stimulation in 256 at-risk nerves
Authors: Hamilton N , Morley H , Haywood M , Arman S , Mochloulis G 
Published: June 2019

Introduction Automatic periodic stimulation of the vagal nerve during thyroidectomy provides real-time feedback of recurrent laryngeal nerve function intraoperatively. To assess the validity of this device, the ability of monitoring to predict recurrent laryngeal nerve palsy was determined and the incidence of recurrent laryngeal nerve palsy recorded. Materials and methods All thyroidectomies using APS® (Automatic Periodic Stimulation, Medtronic) nerve monitoring were reviewed over a 27-month period. Changes in signal amplitude and latency during thyroidectomy were recorded from saved data. Postoperative fibreoptic laryngoscopy determined the incidence of vocal cord immobility and recovery of nerve function was assessed from follow-up letters. Results A total of 256 at-risk nerves were examined (132 hemi- and 62 total thyroidectomies) in cases involving benign and malignant disease. Permanent recurrent laryngeal nerve palsy occurred in six (2.3%) lobectomies and transient recurrent laryngeal nerve palsy occurred in two lobectomies (< 1%). Sensitivity for detecting postoperative vocal cord immobility was 100% and specificity 85% if the end amplitude was 50% below baseline. The positive predictive value when amplitude was 50% below baseline was 18%. The negative predictive value when amplitude was 50% above or equal to baseline was 100%. Intraoperatively, the amplitude was 50% below baseline more frequently in the vocal cord immobility group (t-test, P < 0.015). No vagal nerve complications occurred. Conclusion Whilst the incidence of recurrent laryngeal nerve palsy is comparable to rates in the literature, the incidence of transient palsy is lower than published averages. APS is able to reliably predict recurrent laryngeal nerve palsy based on end amplitude.