bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mobilization of Melanocytes During NB-UVB Treatment of Vitiligo
Authors: Li Yue , Zhang Ru-Zhi 
Published: November 2020

Abstract
Vitiligo, a common skin depigmentation disorder, is the result of complex interactions of genetic, immunological, environmental, and biochemical events. Treatments for vitiligo include drugs, phototherapy, surgical transplantation, and so on. Among them, the efficacy of narrow band-ultraviolet B has been confirmed. By inducing keratinocyte-derived factors and signalings, narrow band-ultraviolet B can trigger and/or promote the mobilization of melanocytes which migrate to lesional epidermis ultimately, leads to the repigmentation of white patches. The mobilization of melanocytes includes stages of activation, migration, proliferation, and differentiation. Elucidating processes that enable the specific mobilization of melanocytes and the signaling pathways and factors involved, will help the development of new drugs and methods for the treatment of vitiligo.
Prospective Analysis of an Evidence-Based Symptom Set in Superior Canal Dehiscence Syndrome
Authors: Naert Laura , Ocak Ibrahim , Griet Mertens , Van de Berg Raymond , Stultiens Joost J.A. , Van de Heyning Paul , Bisdorff Alexandre , Sharon Jeffrey D. , Ward Bryan K. , Van Rompaey Vincent 
Published: November 2020

Introduction:
Superior canal dehiscence syndrome (SCDS) is characterized by a defect in the bone overlying the superior semicircular canal. This third mobile window generates an abnormal low-impedance pathway for sound/pressure transmission into the inner ear resulting in the characteristic symptoms.

Objective:
To perform a prospective analysis of symptoms in patients with SCDS.

Methods:
An aggregated symptom set was studied prospectively and compared with a healthy control group. The 31 items inquired about the presence and severity of symptoms. Initial comparison between both groups was performed using the Kolmogorov–Smirnov test and nonparametric Mann–Whitney U test. For analysis of the internal consistency, the Cronbach's alpha coefficient was determined. Finally, the prevalence of symptoms obtained in the present study was compared to the prevalence of symptoms obtained as part of a recent retrospective systematic review.

Results:
Responses from the 29 patients with SCDS in the case group and the 58 healthy controls were not normally distributed. Those with SCDS had a higher prevalence and more severe symptoms for almost all items. The Cronbach's alpha coefficient of 0.969 indicates an excellent internal consistency. The prospective prevalence of most symptoms was higher than the retrospective prevalence reported earlier.

Conclusions:
SCDS causes a variety of vestibular and auditory symptoms. This prospective study demonstrates that their prevalence and severity are higher than reported previously. This symptom set demonstrates excellent internal consistency and will serve as a foundation toward developing a disease-specific patient-reported outcome measure for SCDS.

Level of evidence:
NA
The Potential Clinical and Economic Value of a Human Papillomavirus Primary Screening Test That Additionally Identifies Genotypes 31, 45, 51, and 52 Individually
Authors: Asti Lindsey , Hopley Colin , Avelis Cameron , Bartsch Sarah M. , Mueller Leslie E. , Domino Molly , Cox Sarah N. , Andrews Jeffrey C. , Randall Samuel L. , Stokes-Cawley Owen J. , Asjes Caitlin , Lee Bruce Y. 
Published: November 2020

Background
Although current human papillomavirus (HPV) genotype screening tests identify genotypes 16 and 18 and do not specifically identify other high-risk types, a new extended genotyping test identifies additional individual (31, 45, 51, and 52) and groups (33/58, 35/39/68, and 56/59/66) of high-risk genotypes.

Methods
We developed a Markov model of the HPV disease course and evaluated the clinical and economic value of HPV primary screening with Onclarity (BD Diagnostics, Franklin Lakes, NJ) capable of extended genotyping in a cohort of women 30 years or older. Women with certain genotypes were later rescreened instead of undergoing immediate colposcopy and varied which genotypes were rescreened, disease progression rate, and test cost.

Results
Assuming 100% compliance with screening, HPV primary screening using current tests resulted in 25,194 invasive procedures and 48 invasive cervical cancer (ICC) cases per 100,000 women. Screening with extended genotyping (100% compliance) and later rescreening women with certain genotypes averted 903 to 3163 invasive procedures and resulted in 0 to 3 more ICC cases compared with current HPV primary screening tests. Extended genotyping was cost-effective ($2298–$7236/quality-adjusted life year) when costing $75 and cost saving (median, $0.3–$1.0 million) when costing $43. When the probabilities of disease progression increased (2–4 times), extended genotyping was not cost-effective because it resulted in more ICC cases and accrued fewer quality-adjusted life years.

Conclusions
Our study identified the conditions under which extended genotyping was cost-effective and even cost saving compared with current tests. A key driver of cost-effectiveness is the risk of disease progression, which emphasizes the need to better understand such risks in different populations.
Clinical and Ophthalmological Characteristics of Ocular Syphilis in a Retrospective Tertiary Hospital Cohort
Authors: Wagner Laura F. , Lanzl Ines , Rothe Kathrin , Schneider Jochen , Zink Alexander , Zapp Daniel , Schwerdtfeger Christiane , Lee Marcel , Weidlich Simon , Neuenhahn Michael , Loos Daria , Spinner Christoph D. 
Published: November 2020

Background
Data on ocular syphilis (OS) and its clinical presentation are currently insufficient. This study aimed to investigate the characteristics of a cohort with a high OS incidence at a university hospital in Germany, focusing on the clinical presentation of OS.

Methods
This single-center cohort study retrospectively analyzed data on 90 patients with 109 episodes of syphilis between 2008 and 2018. Cases of OS were identified and additionally reevaluated through a study-specific secondary assessment by an ophthalmologist specializing in uveitis.

Results
Twenty-three patients (26%) were diagnosed with OS, 16 (70%) of whom were with binocular involvement. Uveitis, especially that of the posterior segment, showed a high prevalence. Lumbar puncture was performed in 20 OS patients (87%), of whom 17 (85% of those with lumbar puncture/74% in total) met the 2018 Centers for Disease Control and Prevention criteria for likely neurosyphilis. Five (22%) of 23 patients had HIV infection, of whom 2 did not receive antiretroviral therapy. The preferred syphilis treatment regimens were benzylpenicillin and ceftriaxone, which yielded favorable serological, clinical, and ophthalmological outcomes.

Conclusions
A high incidence of OS was identified, and physicians should be aware of uveitis as a manifestation of syphilis. Most patients presented with uveitis and syphilis in an early or late latent stage and showed central nervous system involvement.
Fear of cancer recurrence, distress, depressive symptoms, and quality of life in hematopoietic stem cell transplantation patients
Authors: McQuellon Richard P. , Duckworth Katharine E. , Campbell Cassie R. , Russell Gregory B. , Miskewicz Kelly R. , Alsobrooks Amber , Andrykowski Michael A. , Lamar Zanetta S. , Naik Seema G. , Zamkoff Kenneth W. , Hurd David D. 
Published: November 2020

Abstract

Background:
Symptoms of psychological distress, including fear of cancer recurrence (FCR) and quality of life (QOL) deficits are common along the hematopoietic stem cell transplantation (HCT) survivorship trajectory. Identifying patterns over time could contribute to timely interventions.

Materials and Methods:
HCT recipients completed the Distress Thermometer (DT), the Center for Epidemiologic Studies-Depression scale (CES-D), the Fear of Relapse and Recurrence Scale, and the Functional Assessment of Cancer Therapy (FACT-BMT) at hospital admission, discharge, 3, 6, 12, and 24 months post-HCT. Demographic data and performance status (PS) were collected at baseline. Mean scores (standard deviation) and frequencies were calculated. We utilized a linear mixed model approach on the repeated measures data (outcome of FCR, with predictors of distress, depressive symptoms and QOL). A multivariate repeated measures regression was constructed to assess what variables were associated with FCR.

Results:
A total of 198 patients completed questionnaires at admission. A total of 144 patients were deceased or lost to follow-up at 2 years. Both CES-D (P = .006) and DT (P = .0019) scores changed significantly over time and were higher at hospital discharge. FCR did not change significantly (P = .28). QOL was most impaired at hospital discharge. FCR did not correlate with actual recurrence. A significant percentage of recipients were afraid of cancer recurrence; however, a much greater percentage did not feel that fear of recurrence got in the way of enjoying life. QOL (P < .0001) and PS (P = .014) were significant predictors of FCR. A substantial percentage of patients reported significant (>16) depressive symptoms and distress levels (≥4) during the 2-year study period.

Conclusions:
Depressive symptoms and distress were highest at discharge, whereas overall QOL was lowest. FCR was prominent; yet for the majority, it was not an impediment to enjoying life. A psychosocial intervention may be most useful if introduced at hospital discharge and initiated during the first 3 months following HCT when distress is high.
Caregivers’ perception of psychosocial issues of pediatric patients with osteosarcoma: an exploratory study
Authors: Shunmugasundaram Chindhu , Veeraiah Surendran 
Published: November 2020

Abstract

Background:
Survival of children treated for osteosarcoma across India has improved from just 44% in 2001 (Chennai only) to 88.6% in 2016. Advances in treatment (chemotherapy, limb salvage surgery, or limb amputation) impact patients’ ability to work, body image, functional abilities, and recreational activities. Despite this, only little attention has been given to the psychosocial issues of children with osteosarcoma or their caregivers.

Aim:
The present study aimed to explore caregivers’ perception of psychosocial issues of pediatric osteosarcoma patients.

Methods:
This qualitative study used a funnel approach with convenience sampling to interview primary caregivers (N = 8) of pediatric osteosarcoma patients (on follow-up at a regional cancer centre in Chennai). There were no exclusions based on gender, disease stage, treatment status, or socioeconomic status. In-depth interviews were carried out using four semi-structured questions, developed by the research team, to guide the discussion of psychosocial issues faced by patients. Interviews were audio-taped, transcribed verbatim, and analyzed using thematic analysis. Codes from transcripts were categorized into themes.

Results:
Participants were all parents (mostly mothers) with mean age 35.8 years, and the patients they cared for had a mean age of 14 years. Themes identified were: 1) medication and treatment effects; 2) uncertain prognosis; 3) fear of uncertainty; 4) effect on education and activities; 5) restricted functioning; 6) social stigma and isolation; and, 7) social relationships. The psychosocial issues in the present were stressful treatment, physical weakness, and reintegration with normal life and school functioning. Those issues for the future were fear of disease recurrence and death, anxiety about social stigma and isolation, and restricted functioning.

Conclusions:
Findings from this study suggest a need for future studies that explore psychosocial issues from patients themselves. Interventions can then be designed to lessen psychosocial problems and improve quality of life for osteosarcoma patients and their primary caregivers.
Shared experiences of diagnosis and treatment of young-onset colorectal cancer: a patient-oriented qualitative study
Authors: Araujo Louise , Breau Genevieve , George Manju , Dau Hallie , Gastonguay Louise , Brown Erika Hanson , De Vera Mary A. 
Published: November 2020

Abstract

Objective:
The aim of this study was to gain a better understanding of the lived experiences of young-onset colorectal cancer (yCRC) from the perspective of patients and/or caregivers.

Methods:
We conducted a qualitative study, in collaboration with COLONTOWN®, an online colorectal cancer community. Individuals who have been diagnosed with yCRC, that is below the age of 50 years, or care for an individual with yCRC were invited to complete an online survey primarily comprising of an open-ended question asking participants to share their yCRC experiences in a text box, similar with how they may post on a social media platform. We applied an inductive, qualitative approach to identify themes arising from participants’ experiences.

Results:
From May to June 2019, we gathered experiences from 109 patients with yCRC and 11 caregivers. The majority of patients with yCRC were female (86, 71.7%) and diagnosed between the ages of 30 and 39 (49, 40.9%) and 40 and 49 years (61, 50.8%). We identified 8 themes: symptoms experienced; being misdiagnosed; advocating for oneself; appreciation of the healthcare team; frustration with the healthcare team and healthcare system; lasting effects of yCRC and its treatment; connecting with others; and reflections on experiences with yCRC.

Conclusions:
Our study highlights challenges experienced by yCRC patients across diagnosis, during treatment, and after treatment, notably misdiagnosis and need for access to information and support. Our study raises awareness of yCRC and experiences of individuals impacted by this disease.
Influence of psychosocial distress on traumatic stress symptoms among oncology patients in clinical trials
Authors: Cunningham Schuyler C. , Wakim Paul , Hendricks Jennifer , Cassidy Qulnn , Telgen Erin , BrintzenhofeSzoc Karlynn 
Published: November 2020

Abstract

Background:
This study explored the relationships between distress, number of lifetime traumas, and cancer-related traumatic stress (TSS) in people with cancer. This was done to inquire about TSS and to inform mental health recommendations for survivors of cancer.

Methods:
This study was guided by the Transactional Model of Stress and Coping. It utilized a cross-sectional survey design and a convenience sample. Participants were enrolled in a clinical trial for leukemia, lymphoma, mesothelioma, or prostate cancer. Data were collected one time using standardized measures and from participants’ electronic medical records.

Results:
Key findings of the bivariate analysis was that the level of distress and TSS had a statistically significant positive relationship (F
= 50.99, P
< .0001) and the number of traumatic events across the lifespan and TSS also had a statistically significant positive relationship (F = 9.53, P = .0033). The multivariable regression analysis indicated that 1-point increase on the Brief Symptoms Inventory (BSI-18) was associated with a 0.67 points increase in the PCL-5 score (95% confidence interval: 0.47–0.87, P < .0001, effect size = .39).

Conclusions:
Findings suggest that distress and TSS may be more related and present in this population than previously thought. Given the occurrence of TSS in this population, the data also suggest screening for TSS. This may be done more efficiently by using the BSI-18 to screen for distress, given that these findings show a relationship between BSI-18 scores and TSS symptomatology. In this way, providers may be able to identify, treat, and/or refer out for trauma informed mental health care thereby contributing to high-value, human-centered cancer care delivery.
Light therapy for insomnia symptoms in fatigued cancer survivors: a secondary analysis of a randomized controlled trial
Authors: Garland Sheila N. , Johnson Jillian A. , Carlson Linda E. , Rash Joshua A. , Savard Josée , Campbell Tavis S. 
Published: November 2020

Abstract

Background:
Cancer-related fatigue (CRF) and insomnia are highly comorbid. This association implies that treatment aimed at improving one may also simultaneously target the other. This secondary analysis examined whether severity of insomnia affects sleep outcomes in response to a light therapy intervention in cancer survivors with CRF.

Methods:
This 4-week trial recruited cancer survivors who met ICD-10 criteria for CRF. Participants were randomized to receive bright white light (BWL) or dim red light (DRL). Light devices were used daily for 30 minutes over 28 days. Participants completed the Insomnia Severity Index (ISI) at baseline, weeks 2 and 4, and the Pittsburgh Sleep Quality Index, daily sleep diaries and actigraphy at baseline and week 4. ISI scores 0 to 14 represent no/mild symptoms and scores 15+ correspond to moderate-to-severe (clinically significant) insomnia symptoms.

Results:
Of the 81 participants (BWL: n = 42; DRL: n = 39), 49% had ISI scores ≥15 at baseline. There was a significant group-by-time interaction for insomnia severity (F[2, 75.55] = 4.15, P = .020) and sleep quality (F [1, 39.25] = 7.66, P = .009), favoring the BWL condition for those individuals with no or mild insomnia symptoms. In the moderate-to-severe group, there were time effects for insomnia severity and sleep quality, diary measured wake after sleep onset and sleep efficiency, and actigraphy measured wake after sleep onset and sleep efficiency; however, participants remained in the clinical range for insomnia symptoms on the ISI and poor sleep quality on the PSQI. Effect sizes were larger, regardless of intervention condition, in participants with moderate-to-severe insomnia symptoms.

Conclusions:
The severity of insomnia symptoms may impact sleep outcomes in response to a light therapy intervention in cancer survivors with clinical levels of fatigue, but light therapy alone does not appear to be adequate to produce clinically meaningful change in sleep outcomes.

Trial registration number:
Clinicaltrials.gov identifier NCT01780623.
Different Pattern of Bone Scintigraphy in Mandibular Osteosarcoma Arising From Fibrous Dysplasia in a Patient With McCune-Albright Syndrome
Authors: Lee Tse-Hao , Chu Lee-Shing , Chang Chih-Yung , Huang Wen-Sheng 
Published: November 2020

Abstract
McCune-Albright syndrome is a rare condition consisting of triad of fibrous dysplasia, hyperfunctioning endocrinopathy, and café au lait macules of skin. A 31-year-old man was diagnosed with fibrous dysplasia 18 years before presenting with pathologic fracture. No workup for polyostotic fibrous dysplasia was performed at that time. He now presented with left facial swelling and skeletal features of acromegaly. MRI revealed a 15-cm enhancing tumor diagnosed histopathologically as high-grade osteosarcoma. 99mTc–methylene diphosphonate bone scintigraphy revealed decreased uptake at the tumor site contrary to the usual finding of avid uptake by the neoplastic bone forming tumor.
“Skull on Fire”
Authors: Govers Stefan , van der Zant Friso M. , Wondergem Maurits , Broos Wouter A.M. , Knol Remco J.J. 
Published: November 2020

Abstract
An 81-year-old woman was evaluated for a stroke. CT showed no intracranial abnormalities but diffuse patchy aspect of the neurocranium. An MRI and 18F-NA PET/CT were performed to differentiate between metastases, Paget disease, hyperostosis frontalis interna, and primary malignancy. MRI yielded no additional findings. 18F-NA PET/CT showed diffusely increased uptake in the skull and 4 spots with intense uptake. No other suspicious skeletal foci were seen elsewhere. Low-dose CT showed no sign of malignancy elsewhere. Image findings together with elevated serum alkaline phosphatase levels, slightly increased calcium levels, and normal phosphorus levels were interpreted as pathognomic for monostotic Paget.
Metastatic Poorly Differentiated Thyroid Cancer With Heterogeneous Distribution of 18F-FDG, 68Ga-DOTATATE, and 68Ga-PSMA on PET/CT
Authors: Civan Caner , Isik Emine Goknur , Simsek Duygu Has 
Published: November 2020

Abstract
We present a case of a 55-year-old man with a history of poorly differentiated metastatic thyroid cancer, which is rare and shows aggressive behavior. The patient had radioactive iodine–negative multiple metastasis on 18F-FDG PET/CT, therefore 68Ga-DOTATATE and 68Ga-PSMA PET/CT were performed whether an opportunity exist for DOTATATE or PSMA-directed radionuclide therapy. Different patterns of tumoral uptakes were detected on 18F-FDG, 68Ga-DOTATATE, and 68Ga-PSMA PET/CT, as a demonstration of tumor heterogeneity.
Vascular Complications in Le Fort I Osteotomy: Incidence, Reasons, and Management of the Intraoperative Hemorrhage
Authors: Ulker Omer , Demirbas Ahmet Emin , Kutuk Nukhet , Kilic Erdem , Alkan Alper 
Published: November 2020

Purpose:
The aim of this study was to investigate the incidence, types, and reasons for the intraoperative hemorrhage during Le Fort I osteotomy.

Methods:
The study sample was composed of the population of the patients who underwent orthognathic surgery from April 2011 to February 2017. The vascular complications of the patients who underwent Le Fort I osteotomy during the surgery were identified. Type of the bleeding, suspected vessel, amount of the intraoperative blood loss, cause, and management of the bleeding were specified and investigated. Descriptive statistics were computed for each study variable.

Results:
A total of 200 patients underwent Le Fort I osteotomy. The sample's mean age was 22.4 ± 5.8 and 55.5% of patients were female. The intraoperative vascular complication was seen in only 10 (5%) samples. The suspected source of the hemorrhage was the descending palatine artery (DPA) in 8 (4%) cases, while the pterygoid venous plexus in the other 2 (1%) cases. The cause of the bleeding was suspected down-fracture in 8 cases, while pterygomaxillary junction (PMJ) separation in the other 2 cases. DPA was ligated with ligation clips and cauterized in arterial injury cases. The hemorrhage was taken under control using a hemostatic matrix with thrombin (Surgiflo, Ethicon, USA) in the venous bleeding cases.

Conclusions:
The down-fracture of the maxilla was found to be more related to the occurrence of vascular complications. Severe bleeding was managed by the use of the hemostatic matrix with thrombin and this hemostatic agent can be used to control this type bleedings in orthognathic surgery.