bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reduced Pain Reports With Increasing Cognitive Impairment in Older Persons in New Zealand
Authors: Jordan Jennifer , Crowe Marie , Gillon Deborah , McCall Cate , Frampton Christopher , Jamieson Hamish 
Published: May 2018

Background: Conflicting findings prevail about pain in older persons with cognitive impairment. There is evidence of changed pain perception; however, pain is also underrecognized. Pain and cognitive impairment were examined in a national cohort of older persons assessed using the Home Care International Residential Assessment Instrument (interRAI-HC). Methods: Participants were 41 459 aged 65+ years receiving a mandated needs assessment to access publicly funded services. InterRAI-HC pain severity and Cognitive Performance Scale analyses covaried for age, gender, and ethnicity. Results: Milder pain prevalence increased with age, whereas daily severe-excruciating pain prevalence decreased with age. Daily severe-excruciating pain was reported by 18% of cognitively intact individuals decreasing to 8% in the severe cognitive impairment group. This relationship remained after covarying for age, sex, and ethnicity. Differences among dementia subtypes were found. Conclusion: Although severe pain reports decrease with increasing age and cognitive impairment, more nuanced research covarying for dementia severity and subtype is required.
Contemporary Management and Outcome After Lower Extremity Fasciotomy in Non-Trauma-Related Vascular Surgery
Authors: Wesslén Charlotte , Wahlgren Carl-Magnus 
Published: May 2018

Introduction: Acute compartment syndrome (ACS) is a challenging and recognized complication to vascular surgery revascularization. The aim of this study was to investigate the current epidemiology, management, and early outcomes of fasciotomy in vascular surgery. Methods: Retrospective cohort study of all patients undergoing lower extremity fasciotomy at a single university center between January 2008 and December 2014. Patient demographics, operative techniques, and outcomes were analyzed. Results: The cohort (n = 113 limbs; 107 patients; 48% women; mean age was 74 (12) years [range, 50-97 years]) included 81 (72%) limbs undergoing revascularization for acute limb ischemia, 7 (6.2%) limbs related to acute aortic disease, and 23 (20%) limbs undergoing elective vascular surgery. Five patients underwent bilateral lower extremity fasciotomy. In all, 64 (57%) limbs had signs of ACS and underwent a therapeutic fasciotomy, while 49 (43%) fasciotomies were prophylactic. There were 20 (18%) fasciotomies performed after endovascular interventions. A 4-compartment fasciotomy was performed in 82% (n = 93) of limbs with a double incision technique. Split thickness skin graft was required in 11% (12/112) and vacuum-assisted closure treatment in 11% (12/111). The mean length of stay in hospital was 11 (9) days. Most common complication was lower extremity nerve deficit 32% (33/104) followed by wound infection 30% (32/108). At 30-day follow-up, amputation rate was 13% (14/107 limbs) and mortality 23% (25/107 patients). In the multivariate logistic regression analysis, prophylactic fasciotomy was associated with amputation (odds ratio: 28.9; 95% confidence interval: 1.96-425; P = .014). Conclusion: Acute compartment syndrome is primarily related to acute ischemic conditions but occurs after both aortic or elective vascular procedures and endovascular treatments. There are significant complications related to lower extremity fasciotomy in vascular surgery.
JNK2 regulates vascular remodeling in pulmonary hypertension
Authors: Das Mita , Zawada W. Michael , West James , Stenmark Kurt R. 
Published: May 2018

Pulmonary arterial (PA) wall modifications are key pathological features of pulmonary hypertension (PH). Although such abnormalities correlate with heightened phosphorylation of c‐Jun N‐terminal kinases 1/2 (JNK1/2) in a rat model of PH, the contribution of specific JNK isoforms to the pathophysiology of PH is unknown. Hence, we hypothesized that activation of either one, or both JNK isoforms regulates PA remodeling in PH. We detected increased JNK1/2 phosphorylation in the thickened vessels of PH patients’ lungs compared to that in lungs of healthy individuals. JNK1/2 phosphorylation paralleled a marked reduction in MAP kinase phosphatase 1 (JNK dephosphorylator) expression in patients’ lungs. Association of JNK1/2 activation with vascular modification was confirmed in the calf model of severe hypoxia‐induced PH. To ascertain the role of each JNK isoform in pathophysiology of PH, wild‐type (WT), JNK1 null (JNK1‐/‐), and JNK2 null (JNK2‐/‐) mice were exposed to chronic hypoxia (10% O2 for six weeks) to develop PH. In hypoxic WT lungs, an increase in JNK1/2 phosphorylation was associated with PH‐like pathology. Hallmarks of PH pathophysiology, i.e. excessive accumulation of extracellular matrix and vessel muscularization with medial wall thickening, was also detected in hypoxic JNK1‐/‐ lungs, but not in hypoxia‐exposed JNK2‐/‐ lungs. However, hypoxia‐induced increases in right ventricular systolic pressure (RVSP) and in right ventricular hypertrophy (RVH) were similar in all three genotypes. Our findings suggest that JNK2 participates in PA remodeling (but likely not in vasoconstriction) in murine hypoxic PH and that modulating JNK2 actions might quell vascular abnormalities and limit the course of PH.
Muscle stiffness in tension-type headache patients with pericranial tenderness
Authors: Kolding Lærke Tørring , Do Thien Phu , Ewertsen Caroline , Schytz Henrik Winther 
Published: May 2018

Background: Tension-type headache patients have previously been shown to have increased muscle tone, stiffness and tenderness in the trapezius muscle compared to healthy volunteers. Shear wave elastography is a non-invasive method to measure muscle stiffness. The aim of the study was to use shear wave elastography to investigate if tension-type headache patients had increased pericranial muscle stiffness and whether pericranial muscle stiffness correlated to muscle tenderness. Methods: Seventeen patients with very frequent or chronic tension-type headache associated with pericranial tenderness and 29 healthy volunteers were included. Muscle stiffness was measured using shear wave elastography and muscle tenderness was measured using local tenderness score and total tenderness score. Results: There was no statistically significant difference in muscle stiffness between tension-type headache patients and healthy volunteers. The local tenderness and total tenderness scores were higher in tension-type headache patients compared with healthy volunteers. There was no correlation between muscle stiffness and tenderness. Conclusion: We found no sign of increased pericranial muscle stiffness in tension-type headache patients compared with healthy volunteers using shear wave elastography. Our findings do not suggest a generalized pericranial increase in muscle tone in very frequent and chronic tension-type headache patients.
Deep brain stimulation of posterior hypothalamic area for cluster headache
Authors: Huotarinen Antti , Kallela Mikko , Artto Ville , Laakso Aki , Kivisaari Riku 
Published: May 2018

Background: Deep brain stimulation of the posterior hypothalamic area is one of the neuromodulation treatments used for chronic cluster headache, but the number of published patients remains low. Aim: The aim of this article was to present the retrospective results of 12 consecutive chronic cluster headache patients treated with deep brain stimulation at Helsinki University Hospital. Materials and Methods: All chronic cluster headache patients treated with deep brain stimulation between 2004 and 2012 were included in the study. Patients were interviewed and their hospital files analyzed. Treatment effect was classified as good, partial, or no effect. Results: Of the 12 patients, four had a good treatment effect, five had partial, and three had no effect of deep brain stimulation. In contrast to previous studies, our patients reported an almost immediate benefit after the onset of stimulation. Conclusions: Deep brain stimulation provides clinically meaningful benefit to a subgroup of chronic cluster headache patients.
Ubiquitin-dependent degradation of CDK2 drives the therapeutic differentiation of AML by targeting PRDX2
Authors: Ying Meidan , Shao Xuejing , Jing Hui , Liu Yujia , Qi Xiaotian , Cao Ji , Chen Yingqian , Xiang Senfeng , Song Hua , Hu Ronggui , Wei Guoqing , Yang Bo , He Qiaojun 
Published: May 2018

Key Points
CDK2 is ubiquitinated by KLHL6 and undergoes ubiquitin-dependent proteasome degradation in the therapeutic differentiation process of AML. CDK2 arrests myeloid cell differentiation via activating PRDX2, and CDK2 inhibition drives differentiation in 5 major subtypes of AML.
Sustained clonal hematopoiesis by HLA-lacking hematopoietic stem cells without driver mutations in aplastic anemia
Authors: Imi Tatsuya , Katagiri Takamasa , Hosomichi Kazuyoshi , Zaimoku Yoshitaka , Hoang Nguyen Viet , Nakagawa Noriharu , Tajima Atsushi , Yoshizato Tetsuichi , Ogawa Seishi , Nakao Shinji 
Published: May 2018

Key Points
HSPCs that lack HLA class I alleles can sustain clonal hematopoiesis without driver mutations or telomere attrition in AA patients. 6pLOH may confer a survival advantage to HSPCs with age-related somatic mutations, leading to the clonal expansion of mutant HSPCs.
Exercise training and endothelial function in patients with type 2 diabetes: a meta-analysis
Authors: Qiu Shanhu , Cai Xue , Yin Han , Sun Zilin , Zügel Martina , Steinacker Jürgen Michael , Schumann Uwe 
Published: May 2018

Abstract
Background and aims
Exercise training is considered a cornerstone in the management of type 2 diabetes, which is associated with impaired endothelial function. However, the association of exercise training with endothelial function in type 2 diabetes patients has not been fully understood. This meta-analysis aimed to investigate their associations with focus on exercise types.

Methods
Databases were searched up to January 2018 for studies evaluating the influences of exercise training with durations ≥ 8 weeks on endothelial function assessed by flow-mediated dilation (FMD) among type 2 diabetes patients or between type 2 diabetics and non-diabetics. Data were pooled using random-effects models to obtain the weighted mean differences (WMDs) and 95% confidence intervals (CIs).

Results
Sixteen databases were included. Exercise training resulted in an overall improvement in FMD by 1.77% (95% CI 0.94–2.59%) in type 2 diabetes patients. Specifically, both aerobic and combined aerobic and resistance exercise increased FMD by 1.21% (95% CI 0.23–2.19%) and 2.49% (95% CI 1.17–3.81%), respectively; but resistance exercise only showed a trend. High-intensity interval aerobic exercise did not significantly improve FMD over moderate-intensity continuous exercise. Notably, the improvement in FMD among type 2 diabetes patients was smaller compared with non-diabetics in response to exercise training (WMD − 0.72%, 95% CI − 1.36 to − 0.08%) or specifically to aerobic exercise (WMD − 0.65%, 95% CI − 1.31 to 0.01%).

Conclusions
Exercise training, in particular aerobic and combined exercise, improves endothelial function in type 2 diabetes patients, but such an improvement appears to be weakened compared with non-diabetics.
Trial registration PROSPERO CRD42018087376
Efficacy of postoperative pain management in head and neck cancer patients
Authors: Hinther Ashley , Nakoneshny Steven C. , Chandarana Shamir P. , Wayne Matthews T. , Dort Joseph C. 
Published: May 2018

Background Our study quantifies the effectiveness of perioperative pain control in a cohort of patients undergoing major head and neck surgery with free flap reconstruction. Our long-term goal is to improve pain control and thereby increase mobility, decrease postoperative complications and decrease hospital stay. Methods A retrospective analysis was performed at a tertiary, academic head and neck surgical oncology program in Calgary, Alberta, Canada from January 1, 2015 – December 31, 2015. Pain scores were recorded prospectively. Primary outcomes were frequency of postoperative pain assessments and pain intensity using the numeric rating scale. Results The cohort included 41 patients. Analysis was limited to pain scores recorded from postoperative days 1–14. There was an average of 7.3 pain measurements per day (SD 4.6, range 1–24) with the most frequent monitoring on postoperative days 1–4. Median pain scores ranged from 0 to 4.5 with the highest median score on postoperative day 6. The daily maximum pain scores recorded ranged from 8 to 10 with scores of 10 recorded on postoperative days 1, 2, 3, 5, 7, 8, and 10. Patients most frequently had inadequate pain control on postoperative days 1, 2, 4, and 5 with the majority occurring on postoperative day 1. Conclusions Postoperative pain control could be improved at our centre. The frequency of pain assessments is also highly variable. Ongoing measurement, audit, and feedback of analgesic protocol effectiveness is an excellent first step in improving perioperative pain management in patients undergoing major head and neck cancer surgery with free flap reconstruction.
Advanced cancer patients’ construction of self during oncology consultations: a transitivity concordance analysis
Authors: Karimi Neda , Lukin Annabelle , Moore Alison Rotha , Walczak Adam , Butow Phyllis 
Published: May 2018

AbstractThis paper explores advanced cancer patients’ self-identification from a grammatical-concordance perspective. It combines corpus linguistics tool of concordance and transitivity analysis to investigate the grammatical choices that advanced cancer patients make to identify and construct themselves during an oncology consultation. The data comprises 69 oncology consultations between advanced cancer patients (and in some consultations a companion or companions) and their oncologist. Findings reveal that these advanced cancer patients identified themselves with an active and informed role in terms of self-care, decision-making and other administrative activities; they identified their everyday life as an indispensable part of the domain of medicine; and they did not associate themselves with emotive mental processes during the consultation.
Prevalence of vitamin D deficiency in adult patients admitted to a psychiatric hospital
Authors: Patel Dipen , Minajagi Manjunath 
Published: May 2018

Aims and methodVitamin D deficiency is increasing in the general population, and is linked with physical and mental illness. However, evidence on its prevalence in people with mental illness is limited. This study investigated vitamin D deficiency in 104 adult patients admitted to a psychiatric hospital in the UK.ResultsForty-nine per cent were vitamin D deficient (serum 25(OH)D <30 nmol/L), and a further 42.3% were vitamin D insufficient (<50 nmol/L). On admission, 8.7% of patients were vitamin D sufficient (>50 nmol/L). There were no statistically significant differences in mean serum vitamin D between different subgroups of mental illness.Clinical implicationsVitamin D deficiency is highly prevalent among individuals with severe mental illness admitted to hospital. Assessment and treatment of vitamin D deficiency should be considered in in-patients to protect musculoskeletal health. Further epidemiological and intervention studies are needed to investigate the role of vitamin D in the pathophysiology of mental disorders.Declaration of interestNone.
A Younger Man With Localized Prostate Cancer Asks, “Which Type of Radiation Is Right for Me?”
Authors: Bekelman Justin E. 
Published: May 2018

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice. A 61-year-old man presents with stage II prostate cancer after a period of active surveillance. Work-up reveals T1cN0M0 carcinoma, a prostate-specific antigen (PSA) level of 4.8 ng/mL, and Grade Group II (highest Gleason 3+4) in three cores of 12 taken, at the right mid-gland and right apex. The patient has been on active surveillance for the past 16 months. He was originally diagnosed after biopsy for an elevated PSA with stage I prostate cancer, T1cN0M0; PSA, 4.5 ng/mL; Grade Group 1 (Gleason 3+3) in one core of 12 taken, also at the right mid-gland. A multiparametric magnetic resonance imaging scan showed a heterogeneous peripheral zone without a dominant lesion and a calculated prostate volume of 28 mL. His medical history includes hypercholesterolemia, for which he takes atorvastatin. He is otherwise healthy and has no other significant medical or surgical history. His father had prostate cancer in his 70s and died of other causes at 89 years of age. The patient reports 2- to 3-hour urinary frequency and 0 to 1 nocturia, and has no difficulty obtaining or maintaining an erection. After meeting with his urologist, he sees a radiation oncologist.
Pro-FHH: A Risk Equation to Facilitate the Diagnosis of Parathyroid-Related Hypercalcemia
Authors: Bertocchio Jean-Philippe , Tafflet Muriel , Koumakis Eugénie , Maruani Gérard , Vargas-Poussou Rosa , Silve Caroline , Nissen Peter H , Baron Stéphanie , Prot-Bertoye Caroline , Courbebaisse Marie , Souberbielle Jean-Claude , Rejnmark Lars , Cormier Catherine , Houillier Pascal 
Published: May 2018

Abstract

Context
Parathyroid-related hypercalcemia is due to primary hyperparathyroidism (PHPT) or to familial hypocalciuric hypercalcemia (FHH). PHPT can lead to complications that necessitate parathyroidectomy. FHH is a rare genetic disease resembling PHPT; surgery is ineffective. A reliable method for distinguishing FHH from PHPT is needed.

Objective
To develop an easy-to-use tool to predict if a patient has PHPT.

Design
Retrospective analysis of two prospective cohorts. Development of an unsupervised risk equation (Pro-FHH).

Setting
University hospitals in Paris, France, and Aarhus, Denmark.

Participants
Patients (Paris: 65 with FHH, 85 with PHPT; Aarhus: 38 with FHH, 55 with PHPT) were adults with hypercalcemia and PTH concentration within normal range.

Main Outcome Measures
Performance of Pro-FHH to predict PHPT.

Results
Pro-FHH takes into account plasma calcium, PTH, and serum osteocalcin concentrations, and calcium-to-creatinine clearance ratio calculated from 24-hour urine collection (24h-CCCR). In the Paris cohort, area under the receiver operating characteristic curve (AUROC) of Pro-FHH was 0.961, higher than that of 24h-CCCR. With a cutoff value of 0.928, Pro-FHH had 100% specificity and 100% positive predictive value for the diagnosis of PHPT; it correctly categorized 51 of 85 patients with PHPT; the remaining 34 were recommended to undergo genetic testing. No patients with FHH were wrongly categorized. In an independent cohort from Aarhus, AUROC of Pro-FHH was 0.951, higher than that of 24h-CCCR.

Conclusion
Pro-FHH effectively predicted whether a patient has PHPT. A prospective trial is necessary to assess its usefulness in a larger population and in patients with elevated PTH concentration.
Melanocortin 4 Receptor Pathway Dysfunction in Obesity: Patient Stratification Aimed at MC4R Agonist Treatment
Authors: Ayers Kristin L , Glicksberg Benjamin S , Garfield Alastair S , Longerich Simonne , White Joseph A , Yang Pengwei , Du Lei , Chittenden Thomas W , Gulcher Jeffery R , Roy Sophie , Fiedorek Fred , Gottesdiener Keith , Cohen Sarah , North Kari E , Schadt Eric E , Li Shuyu D , Chen Rong , Van der Ploeg Lex H T 
Published: May 2018

AbstractContextThe hypothalamic melanocortin 4 receptor (MC4R) pathway serves a critical role in regulating body weight. Loss of function (LoF) mutations in the MC4R pathway, including mutations in the pro-opiomelanocortin (POMC), prohormone convertase 1 (PCSK1), leptin receptor (LEPR), orMC4R genes, have been shown to cause early-onset severe obesity.MethodsThrough a comprehensive epidemiological analysis of known and predicted LoF variants in thePOMC, PCSK1, andLEPR genes, we sought to estimate the number of US individuals with biallelic MC4R pathway LoF variants.ResultsWe predict ~650α-melanocyte-stimulating hormone (MSH)/POMC, 8500PCSK1, and 3600LEPR homozygous and compound heterozygous individuals in the United States, cumulatively enumerating &gt;12,800 MC4R pathway–deficient obese patients. Few of these variants have been genetically diagnosed to date. These estimates increase when we include a small subset of less rare variants:β-MSH/POMC,PCSK1 N221D, and aPCSK1 LoF variant (T640A). To further define the MC4R pathway and its potential impact on obesity, we tested associations between body mass index (BMI) and LoF mutation burden in thePOMC, PCSK1, andLEPR genes in various populations. We show that the cumulative allele burden in individuals with two or more LoF alleles in one or more genes in the MC4R pathway are predisposed to a higher BMI than noncarriers or heterozygous LoF carriers with a defect in only one gene.ConclusionsOur analysis represents a genetically rationalized study of the hypothalamic MC4R pathway aimed at genetic patient stratification to determine which obese subpopulations should be studied to elucidate MC4R agonist (e.g., setmelanotide) treatment responsiveness.
Showrooming and Webrooming: Information Externalities Between Online and Offline Sellers
Authors: Jing Bing 
Published: May 2018

In a product market where consumers are open to uninformed purchases, we study competition between a traditional and an online retailer in the presence of showrooming. Several results are obtained. First, showrooming intensifies competition and lowers both firms’ profits, thus supporting traditional and online retailers’ recent strategy of carrying more exclusive varieties. Second, lowering consumer search costs may aggravate showrooming and decrease the traditional retailer’s profits for intermediate search costs. Third, opening an online store expands the demand of the traditional retailer but intensifies competition, thus lowering its profits under certain conditions. Fourth, a return policy by the online retailer alleviates showrooming and relaxes competition but weakly reduces its demand, increasing its profits only for intermediate search costs. The return policy (weakly) increases the traditional retailer’s profits. Fifth, when search cost is not high enough, price matching by the traditional retailer may also intensify competition and hurt its profits. We then examine how webrooming interacts with showrooming. When webrooming resolves partial match uncertainty, it may increase both firms’ profits by inducing more consumers to participate. The online appendix is available at https://doi.org/10.1287/mksc.2018.1084 .