Transcranial electrical stimulation modulates emotional experience and metabolites in the prefrontal cortex in a donation task.

Understanding the neural, metabolic, and psychological mechanisms underlying human altruism and decision-making is a complex and important topic both for science and society. Here, we investigated whether transcranial Direct Current Stimulation (tDCS) applied to two prefrontal cortex regions, the ventromedial prefrontal cortex (vmPFC, anode) and the right dorsolateral prefrontal cortex (DLPFC, cathode) can induce changes in self-reported emotions and to modulate local metabolite concentrations. We employed in vivo quantitative MR Spectroscopy in healthy adult participants and quantified changes in GABA and Glx (glutamate + glutamine) before and after five sessions of tDCS delivered at 2 mA for 20 min (active group) and 1 min (sham group) while participants were engaged in a charitable donation task. In the active group, we observed increased levels of GABA in vmPFC. Glx levels decreased in both prefrontal regions and self-reported happiness increased significantly over time in the active group. Self-reported guiltiness in both active and sham groups tended to decrease. The results indicate that self-reported happiness can be modulated, possibly due to changes in Glx concentrations following repeated stimulation. Therefore, local changes may induce remote changes in the reward network through interactions with other metabolites, previously thought to be unreachable with noninvasive stimulation techniques.

Outcomes of urethral meatal preservation ventral urethroplasty for female urethral stricture: a series of cases.

Objective: To present a series of cases with our initial experience and short-term outcomes of a modified vaginal mucosal flap urethroplasty. Methods: Patients diagnosed with urethral stricture and operated by the same operative technique between January 2012 and January 2018 were followed for at least 6 months. Uroflowmetry and clinical outcomes were evaluated. Results: Nineteen patients were included with an average age of 56.4 years, mean preoperative Qmax of 5.3 ml/s, and PVR of 101.4 mL. After 6 months of the procedure, the mean Qmax improved to 14.7 mL/s (p<0.05), PVR decreased to 47.3 mL (p<0.05), and 84.2% of all patients reported improvement in clinical self-reported symptoms. There was an improvement in symptoms such as voiding effort in 84.2% of patients, weak stream (89.5%), and recurrent urinary tract infection (85.7%). The success rate (absence of symptoms and normal Qmax with no significant PVR) of the procedure was 84.2%. Conclusion: The described technique was considered effective for the treatment of female urethra stricture, with a high clinical success rate and an objective improvement of Qmax and decrease in PVR after 6 months of the procedure.

The extended neural architecture of human attachment: An fMRI coordinate-based meta-analysis of affiliative studies.

Functional imaging studies and clinical evidence indicate that cortical areas relevant to social cognition are closely integrated with evolutionarily conserved basal forebrain structures and neighboring regions, enabling human attachment and affiliative emotions. The neural circuitry of human affiliation is continually being unraveled as functional magnetic resonance imaging (fMRI) becomes increasingly prevalent, with studies examining human brain responses to various attachment figures. However, previous fMRI meta-analyses on affiliative stimuli have encountered challenges, such as low statistical power and the absence of robustness measures. To address these issues, we conducted an exhaustive coordinate-based meta-analysis of 79 fMRI studies, focusing on personalized affiliative stimuli, including one's infants, family, romantic partners, and friends. We employed complementary coordinate-based analyses (Activation Likelihood Estimation and Signed Differential Mapping) and conducted a robustness analysis of the results. Findings revealed cluster convergence in cortical and subcortical structures related to reward and motivation, salience detection, social bonding, and cognition. Our study thoroughly explores the neural correlates underpinning affiliative responses, effectively overcoming the limitations noted in previous meta-analyses. It provides an extensive view of the neural substrates associated with affiliative stimuli, illuminating the intricate interaction between cortical and subcortical regions. Our findings significantly contribute to understanding the neurobiology of human affiliation, expanding the known human attachment circuitry beyond the traditional basal forebrain regions observed in other mammals to include uniquely human isocortical structures.

Nonordinary Experiences, Well-being and Mental Health: A Systematic Review of the Evidence and Recommendations for Future Research.

Throughout history, people have reported nonordinary experiences (NOEs) such as feelings of oneness with the universe and hearing voices. Although these experiences form the basis of several spiritual and religious traditions, experiencing NOEs may create stress and uncertainty among those who experience such events. To provide a more systematic overview of the research linking NOEs with mental health, we present a systematic review of studies focusing on NOEs, well-being and mental health indicators. In a search of ProQuest and PsycInfo, we identified 725 references, of which 157 reported empirical data and were included in our review. Overall, the studies reviewed suggest that the relationship between NOEs and mental health is complex, varying according to a series of psychological and social factors. In particular, they suggest that appraisal processes play a fundamental role in the mental health outcomes of these experiences. However, we also highlight important methodological challenges such as the conceptual overlap between NOEs and well-being or psychopathological constructs, the conflation between experiences and appraisal processes in the assessment procedure, and the need for clearer assessment of the duration, controllability, impact on daily functioning and general context of the experiences. We provide a qualitative summary of empirical evidence and main themes of research and make recommendations for future investigation.

Outcomes of urethral meatal preservation ventral urethroplasty for female urethral stricture: a series of cases

Abstract Objective: To present a series of cases with our initial experience and short-term outcomes of a modified vaginal mucosal flap urethroplasty. Methods: Patients diagnosed with urethral stricture and operated by the same operative technique between January 2012 and January 2018 were followed for at least 6 months. Uroflowmetry and clinical outcomes were evaluated. Results: Nineteen patients were included with an average age of 56.4 years, mean preoperative Qmax of 5.3 ml/s, and PVR of 101.4 mL. After 6 months of the procedure, the mean Qmax improved to 14.7 mL/s (p<0.05), PVR decreased to 47.3 mL (p<0.05), and 84.2% of all patients reported improvement in clinical self-reported symptoms. There was an improvement in symptoms such as voiding effort in 84.2% of patients, weak stream (89.5%), and recurrent urinary tract infection (85.7%). The success rate (absence of symptoms and normal Qmax with no significant PVR) of the procedure was 84.2%. Conclusion: The described technique was considered effective for the treatment of female urethra stricture, with a high clinical success rate and an objective improvement of Qmax and decrease in PVR after 6 months of the procedure.

Implementation of an online self-knowledge and mental health promotion journey for the Brazilian population: opportunities and challenges / Implementação de uma jornada online de autoconhecimento e promoção de saúde mental para população brasileira: oportunidades e desafios

The study aimed to investigate opportunities and challenges in implementing an online self-knowledge journey for the Brazilian population. The journey offers free psychological self-assessments and psychoeducational materials to participants. Personalized feedbacks are also provided by filling in standardized scales from international literature (on personality, emotions, values, beliefs, spirituality and mental health). In order to assess the challenges of using the online self-knowledge journey interviews were conducted with a think-aloud protocol (N=16). The findings of the interviews fed into the process of developing a new version. This new version was evaluated through focus groups (N=9) and qualitative interviews (N=6) which helped to validate the adjustments implemented. The strengths found in using the journey were high conceptual acceptance, good therapeutic opportunities, clear language, reliability and personal identification with the personalized feedbacks. To improve the journey we identified the need for usability adjustments, shorter texts and simpler graphics. The adjustments were incorporated and validated in the new release version, which was well accepted and has promising prospects to be used in the Brazilian Unified Health System. Based on the evaluations carried out, good results are expected in the clinical area with the use of the journey, which can be a useful technological device to complement health promotion actions linked to mental health and to personal development services.

O estudo visou investigar oportunidades e desafios na implementação de uma jornada online de autoconhecimento voltada para a população brasileira. A jornada desenvolvida oferece autoavaliações psicológicas gratuitas e materiais psicoeducativos aos participantes. Foram produzidos também feedbacks personalizados que são gerados com o preenchimento de escalas padronizadas da literatura internacional (sobre personalidade, emoções, valores, crenças, espiritualidade e saúde mental). Para avaliar os desafios de implementação foram conduzidas entrevistas com protocolo think-aloud (N=16), cujos achados nutriram processos de desenvolvimento de uma nova versão. Essa nova versão foi avaliada por meio de grupos focais (N=9) e entrevistas qualitativas (N=6) que contribuíram para validar os ajustes implementados. Os pontos fortes encontrados com a jornada desenvolvida foram: alta aceitação conceitual, boas oportunidades terapêuticas, linguagem clara, confiabilidade e identificação pessoal com os feedbacks personalizados. Entre os desafios de implementação evidenciaram-se os ajustes de usabilidade e a necessidade de escalas menores, textos curtos e gráficos simples. Os ajustes foram incorporados e validados na nova versão de divulgação, a qual apresentou boa aceitação e perspectivas promissoras de uso junto a serviços do SUS. A ciência da implementação apresentou-se como recurso essencial para a obtenção de melhores encaixes digitais com a intervenção proposta. A solução apresenta boas oportunidades na área clínica, podendo ser um aparato tecnológico útil para complementar ações de promoção de saúde vinculadas aos serviços de saúde mental e de desenvolvimento pessoal.

Multi-band FMRI compromises detection of mesolimbic reward responses.

Recent innovations in Functional Magnetic Resonance Imaging (FMRI) have sped data collection by enabling simultaneous scans of neural activity in multiple brain locations, but have these innovations come at a cost? In a meta-analysis and preregistered direct comparison of original data, we examined whether acquiring FMRI data with multi-band versus single-band scanning protocols might compromise detection of mesolimbic activity during reward processing. Meta-analytic results (n = 44 studies; cumulative n = 5005 subjects) indicated that relative to single-band scans, multi-band scans showed significantly decreased effect sizes for reward anticipation in the Nucleus Accumbens (NAcc) by more than half. Direct within-subject comparison of single-band versus multi-band scanning data (multi-band factors = 4 and 8; n = 12 subjects) acquired during repeated administration of the Monetary Incentive Delay task indicated that reductions in temporal signal-to-noise ratio could account for compromised detection of task-related responses in mesolimbic regions (i.e., the NAcc). Together, these findings imply that researchers should opt for single-band over multi-band scanning protocols when probing mesolimbic responses with FMRI. The findings also have implications for inferring mesolimbic activity during related tasks and rest, for summarizing historical results, and for using neuroimaging data to track individual differences in reward-related brain activity.

Values and COVID-19 worries: The importance of emotional stability traits.

We examined the relationship between emotional stability as a more stable personality trait and COVID-related worries with basic human values in a Brazilian sample (N = 578) that is strongly affected by COVID-19. We tested whether emotional stability would moderate the effect of infection and economic worries on personal values. In line with predictions, we found that infection worries were more strongly related to Security values, especially among individuals with less emotional stability, whereas economic worries were more strongly correlated with Power values, in particular among individuals with less emotional stability. Findings for Achievement values suggested perceived behavioral control effects for individuals high in Emotional Stability. Our findings provide insights into possible longer-term psychological effects of the current pandemic. Emotional dynamics in connection with worries created by the pandemic could influence values of importance for societal functioning in the short to medium term.

Classification of Complex Emotions Using EEG and Virtual Environment: Proof of Concept and Therapeutic Implication.

During the last decades, neurofeedback training for emotional self-regulation has received significant attention from scientific and clinical communities. Most studies have investigated emotions using functional magnetic resonance imaging (fMRI), including the real-time application in neurofeedback training. However, the electroencephalogram (EEG) is a more suitable tool for therapeutic application. Our study aims at establishing a method to classify discrete complex emotions (e.g., tenderness and anguish) elicited through a near-immersive scenario that can be later used for EEG-neurofeedback. EEG-based affective computing studies have mainly focused on emotion classification based on dimensions, commonly using passive elicitation through single-modality stimuli. Here, we integrated both passive and active elicitation methods. We recorded electrophysiological data during emotion-evoking trials, combining emotional self-induction with a multimodal virtual environment. We extracted correlational and time-frequency features, including frontal-alpha asymmetry (FAA), using Complex Morlet Wavelet convolution. Thinking about future real-time applications, we performed within-subject classification using 1-s windows as samples and we applied trial-specific cross-validation. We opted for a traditional machine-learning classifier with low computational complexity and sufficient validation in online settings, the Support Vector Machine. Results of individual-based cross-validation using the whole feature sets showed considerable between-subject variability. The individual accuracies ranged from 59.2 to 92.9% using time-frequency/FAA and 62.4 to 92.4% using correlational features. We found that features of the temporal, occipital, and left-frontal channels were the most discriminative between the two emotions. Our results show that the suggested pipeline is suitable for individual-based classification of discrete emotions, paving the way for future personalized EEG-neurofeedback training.

Striatal and septo-hypothalamic responses to anticipation and outcome of affiliative rewards.

Humans are intrinsically motivated to bond with others. The ability to experience affiliative emotions (such as affection/tenderness, sexual attraction, and admiration/awe) may incentivize and promote these affiliative bonds. Here, we interrogate the role of the critical reward circuitry, especially the Nucleus Accumbens (NAcc) and the septo-hypothalamic region, in the anticipation of and response to affiliative rewards using a novel incentive delay task. During Functional Magnetic Resonance Imaging (FMRI), participants (n = 23 healthy humans; 14 female) anticipated and watched videos involving affiliative (tenderness, erotic desire, and awe) and nonaffiliative (i.e., food) rewards, as well as neutral scenes. On the one hand, anticipation of both affiliative and nonaffiliative rewards increased activity in the NAcc, anterior insula, and supplementary motor cortex, but activity in the amygdala and the ventromedial prefrontal cortex (vmPFC) increased in response to reward outcomes. On the other hand, affiliative rewards more specifically increased activity in the septo-hypothalamic area. Moreover, NAcc activity during anticipation correlated with positive arousal for all rewards, whereas septo-hypothalamic activity during the outcome correlated with positive arousal and motivation for subsequent re-exposure only for affiliative rewards. Together, these findings implicate a general appetitive response in the NAcc to different types of rewards but suggests a more specific response in the septo-hypothalamic region in response to affiliative rewards outcomes. This work also presents a new task for distinguishing between neural responses to affiliative and non-affiliative rewards.

Impulsivity as an Endophenotype in ADHD: Negative Findings.

Impulsivity has a strong genetic component and is considered an endophenotype in many psychiatric disorders. Impulsivity in adult ADHD has become a focus of interest more recently because of its suggested prominence in this age. Objective: This study aimed to access self-reported impulsivity levels in biological parents of ADHD offspring, according to their status: non-ADHD (controls), remitted, nonremitted. Method: Impulsivity levels of 155 parents of ADHD children were compared according to their status using the Barratt Impulsiveness Scale (BIS-11). Results: The ADHD group presented the highest levels of impulsivity compared with all other groups. The remitted ADHD and control groups showed no significant differences in impulsivity levels. Conclusion: Impulsivity tended to remit alongside ADHD symptoms in remitters and to persist in those presenting with the residual form of adult ADHD suggesting it should not be considered as an endophenotype. Only the attentional dimension was impaired, cautioning against Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) impulsivity proposed criteria.

Rapid Review and Meta-Meta-Analysis of Self-Guided Interventions to Address Anxiety, Depression, and Stress During COVID-19 Social Distancing.

We conducted a rapid review and quantitative summary of meta-analyses that have examined interventions which can be used by individuals during quarantine and social distancing to manage anxiety, depression, stress, and subjective well-being. A literature search yielded 34 meta-analyses (total number of studies k = 1,390, n = 145,744) that were summarized. Overall, self-guided interventions showed small to medium effects in comparison to control groups. In particular, self-guided therapeutic approaches (including cognitive-behavioral, mindfulness, and acceptance-based interventions), selected positive psychology interventions, and multi-component and activity-based interventions (music, physical exercise) showed promising evidence for effectiveness. Overall, self-guided interventions on average did not show the same degree of effectiveness as traditional guided individual or group therapies. There was no consistent evidence of dose effects, baseline differences, and differential effectiveness of eHealth interventions. More research on the effectiveness of interventions in diverse cultural settings is needed.

Variability in the analysis of a single neuroimaging dataset by many teams.

Data analysis workflows in many scientific domains have become increasingly complex and flexible. Here we assess the effect of this flexibility on the results of functional magnetic resonance imaging by asking 70 independent teams to analyse the same dataset, testing the same 9 ex-ante hypotheses1. The flexibility of analytical approaches is exemplified by the fact that no two teams chose identical workflows to analyse the data. This flexibility resulted in sizeable variation in the results of hypothesis tests, even for teams whose statistical maps were highly correlated at intermediate stages of the analysis pipeline. Variation in reported results was related to several aspects of analysis methodology. Notably, a meta-analytical approach that aggregated information across teams yielded a significant consensus in activated regions. Furthermore, prediction markets of researchers in the field revealed an overestimation of the likelihood of significant findings, even by researchers with direct knowledge of the dataset2-5. Our findings show that analytical flexibility can have substantial effects on scientific conclusions, and identify factors that may be related to variability in the analysis of functional magnetic resonance imaging. The results emphasize the importance of validating and sharing complex analysis workflows, and demonstrate the need for performing and reporting multiple analyses of the same data. Potential approaches that could be used to mitigate issues related to analytical variability are discussed.

The Von Restorff effect in the Brazilian version of the Rey Auditory Verbal Learning Test in an elderly population.

The Von Restorff (isolation) effect refers to a stimulus that is more likely to be remembered amongst other stimuli in memory tasks. It has been demonstrated with different age ranges and methodologies. OBJECTIVE: To investigate: a) the presence of the isolation effect in elders tested with the new Brazilian Portuguese version of the Rey Auditory Verbal Learning Task (RAVLT) in which a word with potential emotional weight (mother) was introduced; b) whether isolation effects persist in memory disorders of different degrees of severity (Mild Cognitive Impairment [MCI]; Alzheimer's Dementia [AD]). METHODS: The RAVLT was administered to 287 consecutive volunteers. Individuals underwent medical and neuropsychological evaluation and were further sub-grouped into normal controls (n=114), MCI (n=87) and AD (n=86) patients. One-way analysis of variance (ANOVA) and Chi-squared tests were performed. Post-hoc Tukey analysis was conducted to assess significance of group differences. RESULTS: There were significant group effects on the learning curve. A W-shape - instead of the classical U-shape - was found for the serial position curve in all groups. CONCLUSION: The new Brazilian version of the RAVLT exhibited the Von Restorff effect, where this phenomenon was evident not only in older adults but also patients with MCI and AD, providing further psychometric measures for inter-group analyses.

Efeito de von Restorff (efeito de isolamento) refere-se ao estímulo que é mais facilmente lembrado em relação a outros em tarefas de memória. Tal efeito foi demonstrado em diferentes faixas etárias com diferentes metodologias. OBJETIVO: Investigar: a) presença do efeito de isolamento numa população idosa avaliada com a nova versão brasileira do Teste de Aprendizagem Auditivo-Verbal de Rey (RAVLT), em que uma palavra com potencial carga emocional ('mãe') foi introduzida; b) se o efeito de isolamento persiste em distúrbios de memória de diferentes gravidades (Comprometimento Cognitivo Leve [MCI]; Demência de Alzheimer [AD]). MÉTODOS: RAVLT foi aplicado em 287 voluntários. Indivíduos participaram de avaliações médica e neuropsicológica e foram posteriormente agrupados em controles normais (n=114), MCI (n=87) e DA (n=86). Análises de variância e testes de Chi-quadrado foram realizados. Análises post-hoc foram conduzidas para avaliar diferenças de características entre os grupos. RESULTADOS: Observaram-se efeitos significativos de grupo na curva de aprendizagem. Todos os grupos apresentaram curva de posição serial em formato W - invés do clássico formato em U. CONCLUSÃO: A nova versão brasileira do RAVLT evidenciou um efeito de von Restorff. Tal fenômeno foi visto não apenas em idosos, mas também em pacientes com MCI e AD, fornecendo medidas psicométricas adicionais para análises de diferenças intergrupais.

The Von Restorff effect in the Brazilian version of the Rey Auditory Verbal Learning Test in an elderly population / Efeito de Von Restorff na versão brasileira do Teste de Aprendizagem Auditivo-Verbal de Rey em idosos

ABSTRACT. The Von Restorff (isolation) effect refers to a stimulus that is more likely to be remembered amongst other stimuli in memory tasks. It has been demonstrated with different age ranges and methodologies. Objective: To investigate: a) the presence of the isolation effect in elders tested with the new Brazilian Portuguese version of the Rey Auditory Verbal Learning Task (RAVLT) in which a word with potential emotional weight (mother) was introduced; b) whether isolation effects persist in memory disorders of different degrees of severity (Mild Cognitive Impairment [MCI]; Alzheimer's Dementia [AD]). Methods: The RAVLT was administered to 287 consecutive volunteers. Individuals underwent medical and neuropsychological evaluation and were further sub-grouped into normal controls (n=114), MCI (n=87) and AD (n=86) patients. One-way analysis of variance (ANOVA) and Chi-squared tests were performed. Post-hoc Tukey analysis was conducted to assess significance of group differences. Results: There were significant group effects on the learning curve. A W-shape - instead of the classical U-shape - was found for the serial position curve in all groups. Conclusion: The new Brazilian version of the RAVLT exhibited the Von Restorff effect, where this phenomenon was evident not only in older adults but also patients with MCI and AD, providing further psychometric measures for inter-group analyses.

RESUMO. Efeito de von Restorff (efeito de isolamento) refere-se ao estímulo que é mais facilmente lembrado em relação a outros em tarefas de memória. Tal efeito foi demonstrado em diferentes faixas etárias com diferentes metodologias. Objetivo: Investigar: a) presença do efeito de isolamento numa população idosa avaliada com a nova versão brasileira do Teste de Aprendizagem Auditivo-Verbal de Rey (RAVLT), em que uma palavra com potencial carga emocional ('mãe') foi introduzida; b) se o efeito de isolamento persiste em distúrbios de memória de diferentes gravidades (Comprometimento Cognitivo Leve [MCI]; Demência de Alzheimer [AD]). Métodos: RAVLT foi aplicado em 287 voluntários. Indivíduos participaram de avaliações médica e neuropsicológica e foram posteriormente agrupados em controles normais (n=114), MCI (n=87) e DA (n=86). Análises de variância e testes de Chi-quadrado foram realizados. Análises post-hoc foram conduzidas para avaliar diferenças de características entre os grupos. Resultados: Observaram-se efeitos significativos de grupo na curva de aprendizagem. Todos os grupos apresentaram curva de posição serial em formato W - invés do clássico formato em U. Conclusão: A nova versão brasileira do RAVLT evidenciou um efeito de von Restorff. Tal fenômeno foi visto não apenas em idosos, mas também em pacientes com MCI e AD, fornecendo medidas psicométricas adicionais para análises de diferenças intergrupais.

Can dynamic ultrasonography replace urodynamics in the follow-up of patients with myelomeningocele? A prospective concurrent study.

AIMS: To evaluate the accuracy of dynamic ultrasonography (DUS), as a feasible alternative diagnostic method to identify detrusor overactivity (DO) in patients with neurogenic bladder. METHODS: We performed concurrent analysis of 81 pairs of urodynamic study (UDS) and DUS, in 63 patients with myelomeningocele (MMC), from June 2014 to February 2017. The assessment focused on bladder behavior during the filling phase, DO evaluation, DO with leakage, compliance, and maximum cystometric capacity (MCC). RESULTS: Patient age ranged from 3 months to 34 years (median, 84 months); 47.6% were male. Overall, 9.5% of patients had chronic kidney disease, 20.6% had recurrent urinary tract infection, 19.05% had vesicoureteral reflux, and 69.8% had constipation. Anticholinergic therapy was used by 41.3% of patients. DO was observed in 45.67% of patients and DO with leakage in 42.6%. Mean bladder compliance was 10.39 mL/cmH2 O and normal MCC was 56.79%. DUS had 91.89% sensitivity in identifying DO, 88.64% specificity, 87.18% positive predictive value, 92.86% negative predictive value, and 90.12% accuracy, with a kappa coefficient of 0.8 (P < 0.001). CONCLUSION: MMC follow-up is essential because urinary parameters can change during patient growth. The standard examination is invasive and has related complications, making noninvasive evaluation a desirable alternative, like DUS. Our data suggest that DO and MCC can be evaluated using DUS in patients with MMC. UDS should be performed in patients with abnormal findings on ultrasound evaluation or those with worsening of urinary tract function.

Ileal Continent Reservoir: A Feasible Option for Bladder Augmentation and Urinary Diversion.

OBJECTIVE: To present the results of technique of continent urinary diversion, described by Macedo, that allows the configuration of a tunnel with a flap of the ileal tube at the same segment created for the reservoir. METHODS: From January 2006 to November 2016, 29 patients were underwent a urinary diversion by Macedo's technique. Patients' demographics, hospitalization time, surgical time, follow up, continence rate, reservoir capacity, and postoperative complications were evaluated. RESULTS: Sixty-nine percent were male and the median age was 16.9 years. The main etiology was meningomyelocele (69.1%). The mean surgical time was 4.2 hours (standard deviation [SD] 0.9 range 2.9-6.3). The median length of hospital stay was 10 days (interquartile range: 11.3 range 5-51). The mean follow up was 3.3 years (SD 2.2 range 0.3-9.8). Procedure in the bladder neck was performed in 12 patients (41.3%). A continence rate of the catheterizable conduit was 82.8%.The reservoir capacity increased from 134.4 to 364.4 ml (P <.0001). The continence rate improved significantly (20 vs 74%, P <.0001). There was no change in glomerular filtration rates in the long term (143.1 vs 147, P = .45). Morbidity rate was 58% (25 complications in 17 patients), 72% occurred within the first 60 days and 60% were classified as Clavien-Dindo I or II. CONCLUSION: Except for publications from the original author, this is the first series described. The outcomes are similar, adding important data with respect to this technique. They show that the ileal reservoir is feasible, reproducible, and with good results.

Decoding moral emotions in obsessive-compulsive disorder.

Background: Patients with obsessive-compulsive disorder (OCD) exhibit abnormal neural responses when they experience particular emotions or when they evaluate stimuli with emotional value. Whether these brain responses are sufficiently distinctive to discriminate between OCD patients and healthy controls is unknown. The present study is the first to investigate the discriminative power of multivariate pattern analysis of regional fMRI responses to moral and non-moral emotions. Method: To accomplish this goal, we performed a searchlight-based multivariate pattern analysis to unveil brain regions that could discriminate 18 OCD patients from 18 matched healthy controls during provoked guilt, disgust, compassion, and anger. We also investigated the existence of distinctive neural patterns while combining those four emotions (herein termed multiemotion analysis). Results: We found that different frontostriatal regions discriminated OCD patients from controls based on individual emotional experiences. Most notably, the left nucleus accumbens (NAcc) discriminated OCD patients from controls during both disgust and the multiemotion analysis. Among other regions, the angular gyrus responses to anger and the lingual and the middle temporal gyri in the multi-emotion analysis were highly discriminant between samples. Additional BOLD analyses supported the directionality of these findings. Conclusions: In line with previous studies, differential activity in regions beyond the frontostriatal circuitry differentiates OCD from healthy volunteers. The finding that the response of the left NAcc to different basic and moral emotions is highly discriminative for a diagnosis of OCD confirms current pathophysiological models and points to new venues of research.

Global Study of Social Odor Awareness.

Olfaction plays an important role in human social communication, including multiple domains in which people often rely on their sense of smell in the social context. The importance of the sense of smell and its role can however vary inter-individually and culturally. Despite the growing body of literature on differences in olfactory performance or hedonic preferences across the globe, the aspects of a given culture as well as culturally universal individual differences affecting odor awareness in human social life remain unknown. Here, we conducted a large-scale analysis of data collected from 10 794 participants from 52 study sites from 44 countries all over the world. The aim of our research was to explore the potential individual and country-level correlates of odor awareness in the social context. The results show that the individual characteristics were more strongly related than country-level factors to self-reported odor awareness in different social contexts. A model including individual-level predictors (gender, age, material situation, education, and preferred social distance) provided a relatively good fit to the data, but adding country-level predictors (Human Development Index, population density, and average temperature) did not improve model parameters. Although there were some cross-cultural differences in social odor awareness, the main differentiating role was played by the individual differences. This suggests that people living in different cultures and different climate conditions may still share some similar patterns of odor awareness if they share other individual-level characteristics.

Combined effects of melatonin and topical hypothermia on renal ischemia-reperfusion injury in rats.

PURPOSE: To evaluate whether their combination was more effective than either alone in decreasing renal damage due to ischemia/reperfusion (I/R) injury in rats. METHODS: Thirty-two Wistar rats were assigned to four groups. Following right nephrectomy, their left kidneys were subjected to warm ischemia (IR), cold ischemia (TH+IR), intraperitoneal injection of 10 mg/kg melatonin (MEL+IR), or injection of 10 mg/kg melatonin followed by cold ischemia (MEL+TH+IR). Eight randomly assigned right kidneys constituted the control group. After 240 min of reperfusion, left nephrectomy was performed for histopathological evaluation, lipid peroxidation, and measurement of antioxidant enzyme activity. Serum was collected to measure urea and creatinine concentrations. RESULTS: Histopathological damage induced by ischemia and reperfusion was more attenuated in the MEL+TH+IR group than in the MEL+IR and TH+IR groups (p<0.037). Superoxide dismutase activity was significantly higher (p<0.029) and creatinine (p<0.001) and urea (p<0.001) concentrations were significantly lower in the MEL+TH+IR group than in the MEL+IR and TH+IR groups. CONCLUSION: The combination of melatonin (MEL) and topical hypothermia (TH) better protects against renal I/R injury than does MEL or TH alone.