bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypocretin-deficient narcolepsy patients have abnormal brain activation during humor processing
Authors: Juvodden Hilde T , Alnæs Dag , Lund Martina J , Dietrichs Espen , Thorsby Per M , Westlye Lars T , Knudsen Stine 
Published: March 2019

Abstract

Study Objectives
To assess brain activation patterns in response to fun-rated and neutral-rated movies we performed functional magnetic resonance imaging (fMRI) during a humor-paradigm in narcolepsy type 1 (NT1) patients with cataplexy (muscle atonia triggered by emotions) and controls.

Methods
The fMRI-humor-paradigm consisted of short movies (25/30 with a humorous punchline; 5/30 without a humorous punchline [but with similar build-up/anticipation]) rated by participants based on their humor experience. We included 41 NT1 patients and 44 controls. Group-level inferences were made using permutation testing.

Results
Permutation testing revealed no group differences in average movie ratings. fMRI analysis found no group differences in brain activations to fun-rated movies. Patients showed significantly higher activations compared to controls during neutral-rated movies; including bilaterally in the thalamus, pallidum, putamen, amygdala, hippocampus, middle temporal gyrus, cerebellum, brainstem and in the left precuneus, supramarginal gyrus, and caudate. We found no brain overactivation for patients during movies without a humorous punchline (89.0% neutral-rated). Group analyses revealed significantly stronger differentiation between fun-rated and neutral-rated movies in controls compared with patients (patients showed no significant differentiation), including bilaterally in the inferior frontal gyrus, thalamus, putamen, precentral gyrus, lingual gyrus, supramarginal gyrus, occipital areas, temporal areas, cerebellum and in the right hippocampus, postcentral gyrus, pallidum, and insula.

Conclusion
Patients showed significantly higher activations in several cortical and subcortical regions during neutral-rated movies, with no differentiation from activations during fun-rated movies. This lower threshold for activating the humor response (even during neutral-rated movies), might represent insight into the mechanisms associated with cataplexy.
New findings, pathophysiology, and antigen analysis in pollen-food allergy syndrome
Authors: Yagami Akiko , Ebisawa Motohiro 
Published: March 2019

Purpose of review
PFAS shows various cross-reactivities with antigens because of the area in which the patient resides and dietary habits, and progress in component allergen analysis in recent years has clarified the pathogenesis. This review describes newly identified findings for antigens involved in PFAS.

Recent findings
We describe recent findings for PR-10 family, profilin and LTP, as known major antigens for PFAS. Microarrays of allergen components have significantly improved the ability to describe IgE profiles. In addition, we describe a new antigen, GRP, in the fruit pulp of recently identified fruit.

Summary
PFAS is a food allergy based on the cross-reactivity of pollen antigens and food antigens. Symptoms induced by sensitization differ depending on the specific antigen. The functions of each antigen are diverse, and even the same antigen can cause different symptoms. As analytical techniques progress, the findings will help to establish treatments, such as specific immunotherapy.
Proximal humeral endoprosthesis after tumor resection: does synthetic mesh improve stability? A radiographic review
Authors: Chebli Caroline M. , Letson Douglas , Ruggieri Pietro , Binitie Odion 
Published: March 2019

Background:
We proposed that aortograft aids in longer time to superior humeral migration and improved functional outcome measured as range of motion.

Methods:
A retrospective review from August 1, 1999 to December 30, 2015 identified 75 patients who received a proximal humeral endoprosthesis. The patients were divided into nonaortograft and aortograft groups. The final range of motion, the acromiohumeral interval (AHI) measured radiographically at each visit, the resection level, and the time to humeral migration above 7 mm were recorded.

Results:
Of the 75 patients identified, 17 patients were excluded due to lack of sufficient data or consistent follow-up. The average age of the 58 patients (55% male and 45% female) was 53.95 yr. Thirty-eight patients received aortograft and 20 patients did not. No difference in age or sex between the groups was noted. The average time to humeral head migration as defined by an AHI above 7 mm (superior migration) was 6.61 mo (SD=9.67) in the aortograft group and 4 mo (SD=4.33) in the nonaortograft group. This was not statistically significant (P=0.717). There was no statistically significant difference in range of motion between the groups at final follow-up. Regarding resection level, there did not appear to be a difference in time to migration or final acromiohumeral interval.

Conclusions:
Historically, proximal humeral endoprostheses have a poor track record regarding stability. Although the aortograft group trended toward longer time to proximal humeral migration, it did not significantly improve functional range of motion. The role of modular reverse total shoulder arthroplasty should be further investigated to determine if there is improvement in stability and functional range of motion.

Level of Evidence:
IV.
Size Matters: Which Adolescent Patients Are Most Likely to Require Surgical Decompression for Lumbar Disk Herniations?
Authors: Wiley Marcel R. , Hee Jo Chan , Khaleel Mohammed A. , McIntosh Amy L. 
Published: March 2019

Background:
Lumbar herniated nucleus pulposis (HNP) occurs infrequently in the pediatric/adolescent population. A minority of patients with radicular symptoms fail to improve with conservative management and require discectomy. The authors hypothesize that children who ultimately require surgical intervention have an underlying lumbar stenosis predisposing them to continued symptoms.

Methods:
Pediatric patients with a lumbar HNP on advanced imaging were retrospectively identified at a tertiary pediatric orthopaedic institution. Patients with spondylolisthesis, fractures, previous spine surgery, or structural thoracolumbar scoliosis were excluded. On sagittal magnetic resonance imagings, measurements were taken of the L4 and L5 vertebral body diameters (VBD) and canal diameters (CD) by 2 independent reviewers. Statistical analysis was performed using 2 sample T tests followed by logistic regression analysis. This was utilized to identify significant associations between CD and need for surgical decompression.

Results:
A total of 76 patients (37 males/39 females) were identified with a lumbar HNP from 2001 to 2016. Eleven patients underwent discectomy. Sixty-five patients were managed conservatively. Age at magnetic resonance imaging was not different between groups (15.1±1.7 vs. 14.9±2.2 y, P=0.82). VBD at L4 and L5 were not different between groups (P=0.2 and 0.36, respectively). The reviewers had fair to good (0.584–0.854) interrater reliability correlation coefficients. CD was decreased in the surgically treated cohort at L4 (11.6±1.6 vs. 14.2±2.1 mm, P=0.0002) and at L5 (10.1±1.3 vs. 14.2±2.2 mm, P<0.00001). The ratio of CD:VBD was lower in the surgically treated group at L4 (0.36±0.06 vs. 0.46±0.08, P=0.0002) and L5 (0.31±0.68 vs. 0.45±0.08, P<0.00001). Patients with a L4 CD<12.6 mm were 18.8× more likely to require surgical decompression. 100% of patients with a L5 CD<12.36 mm ultimately underwent surgical decompression.

Conclusions:
Adolescent patients with congenital lumbar stenosis that develop a lumbar HNP are significantly more likely to require surgical decompression to relieve persistent radicular symptoms. A L4 CD<12.6 mm and a L5 CD<12.36 mm were highly correlated with the need for decompression.

Level of Evidence:
Level III—prognostic study.
Current Trends and Variations in the Treatment of Unicameral Bone Cysts of the Humerus: A Survey of EPOS and POSNA Members
Authors: Farr Sebastian , Balacó Inês Maria Spencer , Martínez-Alvarez Sergio , Hahne Julia , Bae Donald S. 
Published: March 2019

Background:
A variety of treatment methods have so far been described for unicameral bone cysts (UBC). However, to the best of our knowledge, no particular consensus has yet been reached on when to operatively treat a patient with a humeral UBC. Therefore, members of the European Pediatric Orthopedic Society (EPOS) and Pediatric Orthopedic Society of North America (POSNA) were surveyed to characterize current treatment preferences.

Methods:
An online electronic questionnaire was sent out to all registered EPOS and POSNA members. The survey comprised 45 questions related to the diagnosis, treatment, and follow-up characteristics of patients with UBCs of the humerus. Particular questions related to the nonoperative or surgical treatment of pathologic proximal humerus and humeral shaft fractures were also included.

Results:
In total, 444 participants (132 EPOS and 292 POSNA members) responded, of whom 400 were actively involved in UBC treatment. The preferred diagnostic modalities to confirm the diagnosis of a UBC in the humerus were radiographs (88%), MRI in cases of questionable diagnosis (58%) or CT scan (8%). For painless UBCs 67% prefer no treatment at all except when the fracture risk is deemed high (then 53% recommend surgery); 71% of respondents would treat painful UBCs with surgery. Most common surgical techniques comprise curettage (45%), artificial bone substitutes (37%), corticosteroid injection (29%), or intramedullary stabilization (eg, rodding; 24%).
Fractured, nondisplaced and mildly displaced proximal humerus UBCs and mildly displaced pathologic humerus shaft fractures are all preferably treated nonoperatively (94%, 91%, 83%, respectively). Severely displaced pathologic proximal humerus fractures are treated less often conservatively (36%) than surgically (40%), and severely displaced humerus shaft fractures are preferably treated surgically (63%) by intramedullary stabilization (60%).

Conclusions:
There is great variation among EPOS and POSNA members with regards to the diagnosis and treatment of UBCs in the humerus. Although some consensus on general treatment principles is seen, specific surgical treatment indications vary.
Prospective randomized-controlled studies are needed to evaluate the outcomes of the different surgical approaches compared with nonoperative strategies.

Level of Evidence:
Level V—expert opinion.
Optimization of therapies for men with advanced prostate cancer: a review of recent developments with a look toward the future
Authors: Gourdin Theodore 
Published: March 2019

Purpose of review
Summarizes the rapid progress being made in treatment of advanced prostate cancer.

Recent findings
Debate remains regarding the optimal sequencing of therapies in metastatic castration-sensitive prostate cancer with attention focused on the use of abiraterone versus docetaxel. Randomized trials now show a potential advantage to next-generation antiandrogens in the setting of nonmetastatic castration-resistant prostate cancer. Patient-specific genomic anomalies, in particular DNA repair defects, provide targets for therapy with poly(ADP-ribose) polymerase inhibitors alone and in combination with other interventions. Adjustments in the dose and administration schedule of the accompanying steroid may improve the efficacy of abiraterone. Novel radiopharmaceuticals and immunotherapies suggest progress is on the horizon for men with castration-resistant prostate cancer.

Summary
In this review, we will highlight the avenues of research leading to optimization of therapies for men with advanced prostate cancer. Known therapeutics, such as docetaxel and abiraterone, are being used earlier in the disease course in the setting of metastatic castration-sensitive prostate cancer, and next-generation antiandrogens in the setting of nonmetastatic castration-resistant disease. Existing interventions are being optimized, including a maneuver to salvage abiraterone response with steroid switch. Finally, individualized therapies directed at specific genomic aberrations, a radiopharmaceutical targeting prostate-specific membrane antigen, and immune therapy combinations are providing potentially additional treatment options for patients with refractory disease.
Impact of Long-Term Lithium Treatment on Renal Function in Patients With Bipolar Disorder Based on Novel Biomarkers
Authors: Dastych Milan , Synek Oldřich , Gottwaldová Jana 
Published: March 2019

AbstractBackgroundLithium in the form of lithium carbonate (Li2CO3) has become one of the most effective and widely prescribed drugs for mood stabilization. However, lithium has adverse effects on renal tubular functions, such as decreased concentrating function of the kidneys, and even occasional symptoms of nephrogenous diabetes insipidus occur with additional evidence of glomerular disruption in lithium-treated patients.MethodsWe assessed the kidney function of patients with bipolar disorder who are under long-term lithium treatment using novel markers of kidney damage such as plasma neutrophil gelatinase–associated lipocalin, cystatin C, albuminuria, estimated glomerular filtration rate, Chronic Kidney Disease–Epidemiology Investigation using creatinine and cystatin C, and serum and urinary osmolality, and compared the results with those of age-matched patients with bipolar disorder not treated with lithium. The study enrolled 120 patients with bipolar disorder, consisting of 80 (30 male and 50 female patients) who have been receiving lithium for 0.5 to 20 (mean, 7) years and 40 (10 male and 30 female patients) who had never been exposed to lithium treatment.ResultsPatients treated with lithium had significantly decreased urine osmolality (mean ± SD, 405 ± 164 vs 667 ± 174 mmol/kg) and urine-to-serum osmolality ratio (1.35 ± 0.61 vs 2.25 ± 0.96). No significant difference was found in creatinine, estimated glomerular filtration rate values calculated using the Chronic Kidney Disease–Epidemiology Investigation using creatinine and cystatin C, neutrophil gelatinase–associated lipocalin, cystatin C, and albuminuria between both groups. We found no significant difference in renal biomarkers between patients treated with lithium for 6 to 24 months and those treated for 25 to 240 months.ConclusionsWe found significantly decreased kidney concentrating ability in the long-term lithium-treated patients compared with the control group. Other renal function markers did not indicate any significant signs of renal dysfunction.
Expression of virulence and antimicrobial resistance genes among Escherichia coli clinical isolates from blood and stool samples
Authors: Rajabi Ali , Rajabi-vardanjani Hossein , Rastiyani Kobra , Ahmed Mais Emad , Mirforughi Seyede Amene , Norouzi Fatemeh 
Published: March 2019

Objective:
As major nosocomial pathogens, Escherichia coli isolates exhibit antibiotic resistance and also express adhesive structures and antibiotic resistance genes. The objective of this study was the comparison of virulence gene expression of extended-spectrum beta-lactamase (ESBL)-producing E. coli between blood and stool samples.

Methods:
In this study, 20 E. coli clinical isolates (10 ESBL-producers including 5 from blood, 5 from stool samples and 10 non-ESBL-producer strains) were included. The existence of fimA, kpsMII and cdt (adhesives and toxin), acr-ab (efflux-encoding) and bla
CTX-M1 genes were confirmed by PCR. The quantitative real-time PCR was performed for evaluation of gene expression.

Results:
ESBL-producing E. coli isolates from stool samples could express fimA, kpsMII and cdt genes significantly higher than blood samples, whereas those isolates from blood samples significantly expressed the acr-ab (efflux-encoding) genes. In addition, the bla
CTXM1 gene was expressed among isolates from stool samples significantly higher (P = 0.022) than those from blood samples according to the analysis of variance (ANOVA) test. In addition, among non-ESBL-producers, the expression of fimA, kpsMII and cdt genes was significantly lower than ESBL-producing isolates from blood samples, but not significantly different than those from stool samples. Moreover, the expression of acr-ab genes was significantly lower than those from stool samples.

Conclusion:
The results exhibited that the expression of virulence genes among clinical isolates of E. coli is not the same or similar in various conditions or from various clinical origins. Thus determining the profile of gene expression in each of clinical situations can be helpful in tracking the infectious pathogens. ESBL-producing strains possibly have regulatory factors for inducing higher virulence gene expression.
“My Husband Has Breast Cancer”: A Qualitative Study of Experiences of Female Partners of Men With Breast Cancer
Authors: Egestad Lisbeth Kofoed , Gyldenvang Helle Holm , Jarden Mary 
Published: March 2019

Background
Relatives of patients with cancer are at risk of experiencing changes to their everyday life, health, and quality of life. Partners of men with breast cancer may face certain challenges regarding their need for information, care, and support.

Objective
The purpose was to explore the experiences of the partners of men with breast cancer in relation to care, information, and emotional support and to explore how men with breast cancer impact the partners’ everyday life.

Method
This was a qualitative study based on individual interviews applying a phenomenological-hermeneutical analysis.

Results
Four themes were identified in the 12 female partners’ narratives: a wall of ignorance, being seen is not a matter of course, emotional stress affects everyday life, and side effects strain the couples’ relationship.

Conclusion
The female partners’ need for information on male breast cancer (MBC) is not sufficiently met because of lack of and poorly communicated information on the topic. The female partner assumes the role of advocate, actively seeking information when in contact with health professionals. Daily life is negatively affected by a lack of acknowledgement of the impact of MBC on their lives and needs by their social networks or health professionals.

Implications for Practice
Female partners have individual care, information, and emotional support needs that may differ from those of their male partner with breast cancer. Health professionals must improve communication with patients and relatives as there are lack of knowledge available regarding MBC and lack of evidence-based guidelines.
Validation of the Recovery Style Questionnaire in Outpatients With Affective Disorders
Authors: Zanello Adriano , Berthoud Laurent , Sentissi Othman 
Published: March 2019

AbstractConsidering how patients recover from mental illness is crucial to offer appropriate therapeutic interventions. This study was designed to determine the psychometric characteristics of the Recovery Style Questionnaire (RSQ) in a sample of outpatients recruited among the referrals to a crisis intervention center presenting with mood or anxiety disorders. Assessments completed at intake and at discharge examined the recovery styles with the RSQ, psychiatric symptoms with the Brief Psychiatric Rating Scale version 4.0, and the Symptom Checklist–Revised; defense mechanisms with the Defense Style Questionnaire 40 items; and global functioning with the Global Assessment Functioning. The RSQ has acceptable reliability, divergent validity, and sensitivity to change after treatment. These findings suggest that the RSQ is a valid and reliable instrument to assess recovery style. They also offer evidence of the usefulness of the RSQ in various clinical settings, such as in crisis intervention centers.
Opioids and breast cancer recurrence
Authors: Cronin-Fenton Deirdre 
Published: March 2019

Purpose of review
Breast cancer survival has improved motivating the need for better understanding of the sequelae of the disease and its treatments. Lab studies suggest opioids modify cancer cell growth but the association of opioids with cancer progression in humans is not clear. This review aims to summarize recent findings related to opioid use and breast cancer progression.

Recent findings
Opioid-sparing analgesia may be associated with better survival in cancer patients. In-vitro research suggests that treatment with μ-opioid receptor antagonists inhibits cancer proliferation, and shows some promise for attenuating tumor growth in humans, thereby enhancing survival. Prescription use of opioids does not appear to influence the risk of recurrence in patients, though the evidence comes from a single large registry-based observational study. Ongoing clinical trials are comparing opioid-sparing regional anesthesia with general anesthesia for the risk of breast cancer recurrence.

Summary
The association of opioids with breast cancer progression is controversial. Further observational studies are needed. There is currently no clear evidence to suggest that opioid use should be avoided in breast cancer patients because of concerns regarding the risk of breast cancer recurrence.
Quantitative Signal Characteristics of Electrocorticography and Stereoelectroencephalography: The Effect of Contact Depth
Authors: Young James J. , Friedman Joshua S. , Panov Fedor , Camara Divaldo , Yoo Ji Yeoun , Fields Madeline C. , Marcuse Lara V. , Jette Nathalie , Ghatan Saadi 
Published: March 2019

Purpose:
Patients undergoing epilepsy surgery often require invasive EEG, but few studies have examined the signal characteristics of contacts on the surface of the brain (electrocorticography, ECOG) versus depth contacts, used in stereoelectroencephalography (SEEG). As SEEG and ECOG have significant differences in complication rates, it is important to determine whether both modalities produce similar signals for analysis, to ultimately guide management of medically intractable epilepsy.

Methods:
Twenty-seven patients who underwent SEEG (19), ECOG (6), or both (2) were analyzed for quantitative measures of activity including spectral power and phase–amplitude coupling during approximately 1 hour of wakefulness. The position of the contacts was calculated by coregistering the postoperative computed tomography with a reconstructed preoperative MRI. Using two types of referencing schemes—local versus common average reference—the brain regions where any quantitative measure differed systematically with contact depth were established.

Results:
Using even the most permissive statistical criterion, few quantitative measures were significantly correlated with contact depth in either ECOG or SEEG contacts. The factors that predicted changes in spectral power and phase–amplitude coupling with contact depth were failing to baseline correct spectral power measures, use of a local rather than common average reference, using baseline correction for phase–amplitude coupling measures, and proximity of other grey matter structures near the region where the contact was located.

Conclusions:
The signals recorded by ECOG and SEEG have very similar spectral power and phase–amplitude coupling, suggesting that both modalities are comparable from an electrodiagnostic standpoint in delineation of the epileptogenic network.