bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oncological and Surgical Outcomes of Patients Treated by Transoral CO2 Laser Cordectomy for Early-Stage Glottic Squamous Cell Carcinoma: A Retrospective Chart Review
Authors: Hans Stéphane , Crevier-Buchman Lise , Circiu Marta , Idrissi Younes Chekkoury , Distinguin Léa , de Mones Erwan , Brasnu Daniel , Lechien Jérôme R. 
Published: March 2020

Objective: To investigate the feasibility and the outcomes of transoral laser CO2 microsurgery (TLM) for resection of early-stage squamous cell carcinoma (SCC) of the vocal folds through several additional surgical procedures and tips improving the glottic exposure. Methods: Retrospective chart review of patients treated by TLM cordectomy in a single European University Hospital for early-stage vocal fold SCCs (Tis, T1a, T1b, and T2). The following TLM outcomes were studied regarding the tumor size (Tis and T1a vs T1b and T2) and the margin status (negative vs positive/suspicious): patient position; type of laryngoscope; requirement to external counter pressure; resection of supraglottic structures (eg, ventricular band, epiglottic petiole, and suprahyoid epiglottis); pre- and postoperative complications; overall survival; disease-specific survival (DSS); and disease-free survival (DFS). Results: A total of 148 patients were included. The TLM was realized in 95.3% of cases. External counter pressure, partial, or total vestibulectomy were necessary in 65.9%, 57.4%, and 4.2% of cases, respectively. A resection of the epiglottic petiole was required in 24.8% of cases. The realization of both epiglottis petiole resection and vestibulectomies were significantly higher in patients with T2 and T1b SCCs compared to those with T1a and Tis SCCs ( P = .01). Different procedure tips were described for improving the laryngeal exposition. The 5-year laryngeal preservation rate, DSS, and DFS were significantly better in patients without SCC involvement of the anterior commissure, and did not vary according to the margin status. The laryngeal exposure difficulties did not impact the margin status. Conclusion: The exposure of glottis is possible in 95% of cases of early-stage vocal cord SCC but requires the use of several additional surgical procedures, especially for anterior commissure SCCs. The SCC involvement of the vocal fold anterior commissure is associated with lower DSS, DFS, and laryngeal preservation rate.
Association of Opioid Quantity and Caregiver Education with Pain Control after Pediatric Tonsillectomy
Authors: Harbaugh Calista M. , Vargas Gracia , Sloss Kenneth R. , Bohm Lauren A. , Cooper Karen A. , Thatcher Aaron L. , Zopf David A. , Chua Kao‐Ping , Waljee Jennifer F. , Gadepalli Samir K. 
Published: March 2020

ObjectiveTo examine whether a service guideline reducing postoperative opioid prescription quantities and caregiver‐reported education to use nonopioid analgesics first are associated with caregiver‐reported pain control after pediatric tonsillectomy.Study DesignProspective cohort study (July 2018–April 2019).SettingPediatric otolaryngology service at a tertiary academic children’s hospital.Subjects and MethodsCaregivers of patients aged 1 to 11 years undergoing tonsillectomy (N = 764) were surveyed 7 to 21 days after surgery regarding pain control, education to use nonopioid analgesics first, and opioid use. Respondents who were not prescribed opioids or had missing data were excluded. Logistic regression modeled caregiver‐reported pain control as a function of service guideline implementation (December 2018) recommending 20 rather than 30 doses for postoperative opioid prescriptions and caregiver‐reported analgesic education, adjusting for patient demographics.ResultsAmong 430 respondents (56% response), 387 patients were included. The sample was 43% female with a mean age of 5.0 years (SD, 2.5). Pain control was reported as good (226 respondents, 58%) or adequate/poor (161 respondents, 42%). Mean opioid prescription quantity was 27 doses (SD, 7.9) before and 21 doses (SD, 6.1) after guideline implementation (P <. 001). Education to use nonopioids first was reported by 308 respondents (80%). In regression, prescribing guideline implementation was not associated with pain control (adjusted odds ratio, 1.3; 95% CI, 0.9‐2.0; P =. 22), but caregiver‐reported education to use nonopioids first was associated with a higher odds of good pain control (adjusted odds ratio, 1.9; 95% CI, 1.1‐3.2; P =. 02).ConclusionCaregiver education to use nonopioid analgesics first may be a modifiable health care practice to improve pain control as postoperative opioid prescription quantities are reduced.
Endonasal Endoscopic Surgery for Pediatric Sellar and Suprasellar Lesions: A Systematic Review and Meta‐analysis
Authors: Lee Joshua A. , Cooper Rebecca L. , Nguyen Shaun A. , Schlosser Rodney J. , Gudis David A. 
Published: March 2020

ObjectivesThe advent of endonasal endoscopic skull base surgery (ESBS) has redefined the management of pediatric sellar and suprasellar lesions. To date, the outcomes of these procedures have not been systematically reviewed. This study performed a systematic review with meta‐analysis of surgical outcomes for pediatric patients undergoing ESBS for sellar and suprasellar lesions.Data SourcesPubMed (National Library of Medicine, National Institutes of Health), Scopus (Elsevier), and Cochrane Library (Wiley).Review MethodsArticles reporting on pediatric patients undergoing ESBS for craniopharyngiomas, pituitary adenomas, and Rathke’s cleft cysts were reviewed. The primary outcome was postoperative cerebrospinal fluid (CSF) leak. Secondary outcomes included endocrine, visual, and other complications.ResultsTwenty‐five articles reporting on 554 patients were included. Overall postoperative CSF leak rate was 8.6%, with tumor‐specific rates of 10.6% in craniopharyngiomas, 6.5% in pituitary adenomas, and 7.2% in Rathke’s cleft cysts (P >. 05). Older studies demonstrate higher postoperative CSF leak rates as compared with more recent studies (12.5% vs 6.1%, P =. 0082). Younger children (8.9‐12.6 years old) experienced a higher rate of postoperative CSF leaks as compared with older children (13.0‐16.6 years old; 12.9% vs 4.9%, P =. 0016). Additional postoperative complications included diabetes insipidus (26.7%), hypopituitarism (46.6%), visual deficits (2.6%), meningitis (3.4%), and weight gain (3.4%).ConclusionESBS for pediatric sellar and suprasellar lesions is overall an effective management approach with an increasingly favorable risk‐benefit profile. Younger children may be more susceptible to postoperative CSF leak as compared with older pediatric patients. Tumor type does not appear to be an independent risk factor for postoperative CSF leak in this population.
Photobiomodulation with low-level laser therapy for treating Achilles tendinopathy: a systematic review and meta-analysis
Authors: Martimbianco Ana Luiza Cabrera , Ferreira Raphael Einsfeld Simões , Latorraca Carolina de Oliveira Cruz , Bussadori Sandra Kalil , Pacheco Rafael Leite , Riera Rachel 
Published: March 2020

Objective: The purpose of this study was to determine the benefits and harms of low-level laser therapy for Achilles tendinopathy. Data sources: Search strategies were conducted (from inception to February 2020) in Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Literatura Latino Americana em Ciências da Saúde e do Caribe (LILACS), Physiotherapy Evidence Database (PEDro), SPORTDiscus, ClinicalTrials.gov, World Health Organization (WHO)-ICTRP and OpenGrey databases, to retrieve all randomized controlled trials that compared laser therapy with inactive/active interventions. Review methods: This study was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The risk of bias was assessed using the Cochrane Risk of bias table. Meta-analyses were performed on dependence of homogeneity, otherwise results were reported narratively. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results: Four trials (119 participants) were analyzed. Laser therapy associated to eccentric exercises when compared to eccentric exercises and sham had very low to low certainty of evidence in pain and function assessment. Despite one trial favored laser therapy at two months (mean difference (MD) −2.55, 95% confidence interval (95% CI) −3.87 to −1.23), the CIs did not include important differences between groups at 3 and 13 months. The function assessment showed an improvement favoring the placebo group at one month (MD 9.19, 95% CI −16.16 to −2.23) and non-significant difference between groups at 3 and 13 months. Adverse events were poorly reported but restricted to minor events related to the exercises. Conclusion: The certainty of evidence was low to very low, and the results are insufficient to support the routine use laser therapy for Achilles tendinopathy.
Anemia in Critically Ill Patients With Acute Respiratory Distress Syndrome and Posthospitalization Physical Outcomes
Authors: Warner Matthew A. , Kor Daryl J. , Frank Ryan D. , Dinglas Victor D. , Mendez-Tellez Pedro , Himmelfarb Cheryl R. Dennison , Shanholtz Carl B. , Storlie Curtis B. , Needham Dale M. 
Published: March 2020

Objective: Anemia is common during critical illness and often persists after hospital discharge; however, its potential association with physical outcomes after critical illness is unclear. Our objective was to assess the associations between hemoglobin at intensive care unit (ICU) and hospital discharge with physical status at 3-month follow-up in acute respiratory distress syndrome (ARDS) survivors. Methods: This is a secondary analysis of a multisite prospective cohort study of 195 mechanically ventilated ARDS survivors from 13 ICUs at 4 teaching hospitals in Baltimore, Maryland. Multivariable regression was utilized to assess the relationships between ICU and hospital discharge hemoglobin concentrations with measures of physical status at 3 months, including muscle strength (Medical Research Council sumscore), exercise capacity (6-minute walk distance [6MWD]), and self-reported physical functioning (36-Item Short-Form Health Survey [SF-36v2] Physical Function score and Activities of Daily Living [ADL] dependencies). Results: Median (interquartile range) hemoglobin concentrations at ICU and hospital discharge were 9.5 (8.5-10.7) and 10.0 (9.0-11.2) g/dL, respectively. In multivariable regression analyses, higher ICU discharge hemoglobin concentrations (per 1 g/dL) were associated with greater 3-month 6MWD mean percent of predicted (3.7% [95% confidence interval 0.8%-6.5%]; P = .01) and fewer ADL dependencies (−0.2 [−0.4 to −0.1]; P = .02), but not with percentage of maximal muscle strength (0.7% [−0.9 to 2.3]; P = .37) or SF-36v2 normalized Physical Function scores (0.8 [−0.3 to 1.9]; P = .15). The associations of physical outcomes and hospital discharge hemoglobin concentrations were qualitatively similar, but none were statistically significant. Conclusions: In ARDS survivors, higher hemoglobin concentrations at ICU discharge, but not hospital discharge, were significantly associated with improved exercise capacity and fewer ADL dependencies. Future studies are warranted to further assess these relationships.
Using the Importance for Survival Scale to Identify Preferred Nature Scenes With Restorative Potential: A Qualitative Study
Authors: Thake Carol L. , Bambling Matthew , Edirippulige Sisira , Marx Eric 
Published: March 2020

Background: Evidence supports the use of images of nature scenes in healthcare settings to reduce stress and improve emotional well-being. However, the literature is diverse and provides no integrated system to identify nature scenes that provide most therapeutic benefit. Objective: The current study aimed to validate and extend results of a correlational study that found the Importance for Survival Scale (IFSS) useful for selecting generally preferred nature scenes with therapeutic potential. Methods: The correlational study that tested the usefulness of the IFSS and the current qualitative study were components of a larger mixed-methods study. For the current study, general community participants ( N = 20 males, 20 females; mean age = 48 years) provided verbal responses to questions about thoughts and feelings associated with a selection of photographs of nature scenes. Data were analyzed using a content analysis approach. Results: Themes and detailed descriptors associated with preference for, and emotional response to, most- and least-liked nature scenes were produced. A proportion of those themes is directly related to the construct of Importance for Survival (IFS), whereas other themes are better explained by alternative theoretical perspectives. Conclusions: Results uphold the IFSS as an effective tool for identifying generally preferred nature scenes with restorative potential, and provide information about the relative importance of IFSS subscales that may be used to further develop and refine the IFSS, as well as guide selection of restorative nature scenes. Results also provide fine-scaled descriptive information about preference for and emotional response to nature scenes.
Increased mTOR activation in idiopathic multicentric Castleman disease
Authors: Arenas Daniel J. , Floess Katherine , Kobrin Dale , Pai Ruth-Anne Langan , Srkalovic Maya B. , Tamakloe Mark-Avery , Rasheed Rozena , Ziglar Jasira , Khor Johnson , Parente Sophia A. T. , Pierson Sheila K. , Martinez Daniel , Wertheim Gerald B. , Kambayashi Taku , Baur Joseph , Teachey David T. , Fajgenbaum David C. 
Published: March 2020

AbstractIdiopathic multicentric Castleman disease (iMCD) is a rare and poorly understood hematologic disorder characterized by lymphadenopathy, systemic inflammation, cytopenias, and life-threatening multiorgan dysfunction. Interleukin-6 (IL-6) inhibition effectively treats approximately one-third of patients. Limited options exist for nonresponders, because the etiology, dysregulated cell types, and signaling pathways are unknown. We previously reported 3 anti-IL-6 nonresponders with increased mTOR activation who responded to mTOR inhibition with sirolimus. We investigated mTOR signaling in tissue and serum proteomes from iMCD patients and controls. mTOR activation was increased in the interfollicular space of iMCD lymph nodes (N = 26) compared with control lymph nodes by immunohistochemistry (IHC) for pS6, p4EBP1, and p70S6K, known effectors and readouts of mTORC1 activation. IHC for pS6 also revealed increased mTOR activation in iMCD compared with Hodgkin lymphoma, systemic lupus erythematosus, and reactive lymph nodes, suggesting that the mTOR activation in iMCD is not just a product of lymphoproliferation/inflammatory lymphadenopathy. Further, the degree of mTOR activation in iMCD was comparable to autoimmune lymphoproliferative syndrome, a disease driven by mTOR hyperactivation that responds to sirolimus treatment. Gene set enrichment analysis of serum proteomic data from iMCD patients (n = 88) and controls (n = 42) showed significantly enriched mTORC1 signaling. Finally, functional studies revealed increased baseline mTOR pathway activation in peripheral monocytes and T cells from iMCD remission samples compared with healthy controls. IL-6 stimulation augmented mTOR activation in iMCD patients, which was abrogated with JAK1/2 inhibition. These findings support mTOR activation as a novel therapeutic target for iMCD, which is being investigated through a trial of sirolimus (NCT03933904).
Assessment of ureteric diameter using contrast-enhanced helical abdominal computed tomography
Authors: Itanyi Ukamaka Dorothy , Aiyekomogbon Joshua Oluwafemi , Uduma Felix Uduma , Evinemi Matthew Abodunde 
Published: March 2020

Abstract
Background
Assessment of ureteric size is imperative for diagnosis of urinary tract abnormalities especially with regard to obstructive pathologies. The ureteric opacification and distension obtained from contrast-enhanced computed tomography allows for differentiation from surrounding soft tissue and better assessment of ureteric diameter. Abdominal computed tomographic scans are commonly requested for the evaluation of the urinary tract, and we therefore aim to establish a normal reference value of the ureteral diameter using contrast-enhanced computed tomographic scans of the abdomen.

Method
With the purpose of establishing our local normogram of ureteric diameter, we did a retrospective study of archived images of 170 patients referred to the radiology department of a tertiary hospital for contrast-enhanced abdominal CT from January 2016 to June 2018. The largest transverse dimension along the course of the ureter beginning 1–2 cm below the ureteropelvic junction was measured at the delayed phase and obtained data subjected to analysis using SAS software version 9.3 with statistical level of significance set at 0.05.

Result
A total number of 340 ureters in 170 patients were analyzed with the mean age of 47.9 years (range 1.0–94.0 years) and male-to-female ratio of 1.2:1. The mean left ureteric diameter of all patients was 4.3 mm (range 1.7–8.0 mm) while the mean right ureteric diameter of all patients was 4.4 mm (range 1.5–8.0 mm). Ninety-five percent of ureters in our study measured 6.9 mm and less with no significant difference in ureteric sizes across gender and ages.

Conclusion
The mean CT normogram for ureteric caliber is 4.3–4.4 mm with no significant age and gender difference and 7 mm proposed as upper limit of normal.
Human herpesvirus 8-associated colonic Kaposi’s sarcoma during vedolizumab treatment in ulcerative colitis: a case report and review of the literature
Authors: Papa Valerio , Giustiniani Maria Cristina , Lopetuso Loris Riccardo , Papa Alfredo 
Published: March 2020

Abstract
Background
Kaposi’s sarcoma (KS) is a rare vascular tumor associated with human herpesvirus (HHV)-8 infection. One of the variants of KS is defined iatrogenic and is overall reported in transplanted patient but also, although less frequently, in patients treated with long-standing immunosuppressive therapy, such as in inflammatory bowel disease including ulcerative colitis and Crohn’s disease.

Case presentation
Herein, we report the first case of KS in a human immunodeficiency virus (HIV)-negative 47-year old male with UC after treatment with the α4-β7 integrin inhibitor vedolizumab (VDZ). The patient underwent to colectomy for a medical refractory disease and the histological examination of the surgical specimen showed the typical findings of KS together with the HHV-8 positivity. The patient achieved a good health status, without any sign of disease recurrence.

Conclusions
In the present case, we can assume that VDZ may have promoted the reactivation of a latent HHV-8 infection endowed with oncogenic potentialities and, in turn, the onset of KS. We also briefly reviewed all the cases of KS in HIV-negative patients with inflammatory bowel disease.
Diagnostic performance of nucleic acid tests in tuberculous pleurisy
Authors: Han Min , Xiao Heping , Yan Liping 
Published: March 2020

Abstract
Background
Tuberculous pleurisy (TBP) is the most common form of extrapulmonary tuberculosis (TB). However, rapid diagnostic methods with high accuracy for tuberculous pleurisy are urgently needed. In the present study, we evaluated the diagnostic accuracy of Xpert MTB/RIF, LAMP and SAT-TB assay with pleural fluids from culture-positive TBP patients.

Methods
We prospectively enrolled 300 patients with exudative pleural effusions used as the samples for Xpert MTB/RIF, LAMP and SAT-TB assay. Of these, 265 including 223 patients diagnosed with TBP and 42 non-TBP patients used as controls were analyzed.

Results
The sensitivities of Xpert MTB/RIF (27.4%), LAMP (26.5%) and SAT-TB assay (32.3%) were significantly higher than that of pleural effusion smear (14.3%, X2 = 20.65, P <  0.001), whereas they were much lower than expected for the analysis of pleural effusion samples. Both SAT-TB assay and Xpert MTB/RIF demonstrated high specificities (100%) and PPVs (100%), but the NPVs of all of the tests were < 22%. The area under ROC curve of pleural effusion smear, LAMP, Xpert MTB/RIF and SAT-TB assays was 0.524 (95% CI 0.431–0.617), 0.632 (95% CI 0.553–0.71), 0.637 (95% CI 0.56–0.714) and 0.673 (95% CI 0.6–0.745). SAT-TB assays had the highest AUC.

Conclusion
Nucleic acid amplification tests are not the first choice in the diagnosis of tuberculous pleurisy. In this type of test, SAT-TB is recommended because of its low cost, relatively more accurate compared with the other two tests. This prospective study was approved by The Ethics Committee of the Shanghai Pulmonary Hospital (approval number: K19–148).

Trial registration
ClinicalTrials.gov identifier: ChiCTR1900026234 (Retrospectively registered). The registration date is September 28, 2019.
European women’s perceptions of the implementation and organisation of risk-based breast cancer screening and prevention: a qualitative study
Authors: Rainey Linda , van der Waal Daniëlle , Jervaeus Anna , Donnelly Louise S. , Evans D. Gareth , Hammarström Mattias , Hall Per , Wengström Yvonne , Broeders Mireille J. M. 
Published: March 2020

Abstract
Background
Increased knowledge of breast cancer risk factors has meant that we are currently exploring risk-based screening, i.e. determining screening strategies based on women’s varying levels of risk. This also enables risk management through primary prevention strategies, e.g. a lifestyle programme or risk-reducing medication. However, future implementation of risk-based screening and prevention will warrant significant changes in current practice and policy. The present study explores women’s perceptions of the implementation and organisation of risk-based breast cancer screening and prevention to optimise acceptability and uptake.

Methods
A total of 143 women eligible for breast cancer screening in the Netherlands, the United Kingdom, and Sweden participated in focus group discussions. The focus group discussions were transcribed verbatim and the qualitative data was analysed using thematic analysis.

Results
Women from all three countries generally agreed on the overall proceedings, e.g. a risk assessment after which the risk estimate is communicated via letter (for below average and average risk) or consultation (for moderate and high risk). However, discrepancies in information needs, preferred risk communication format and risk counselling professional were identified between countries. Additionally, a need to educate healthcare professionals on all aspects of the risk-based screening and prevention programme was established.

Conclusion
Women’s insights identified the need for country-specific standardised protocols regarding the assessment and communication of risk, and the provision of heterogeneous screening and prevention recommendations, monitoring the principle of solidarity in healthcare policy.