bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraoperative Surgical Complications in Transoral Laser CO2 Microsurgery of the Larynx: An Observational, Prospective, Single-Center Study
Authors: Chiesa-Estomba Carlos Miguel , Sistiaga-Suarez Jon Alexander , González-García Jose Angel , Larruscain Ekhiñe , Altuna-Mariezcurrena Xabier 
Published: October 2019

Introduction: Despite good outcomes of CO2 laser of the larynx, a lack of prospective data related to intraoperative complications in the indexed literature is evident. Materials and Methods: An observational, prospective, nonrandomized study. Results: One hundred and twenty-eight patients met the inclusion criteria. The total rate of intraoperative complications was 14.8% (19/128). The rate of complications according to anatomical location was 7 (38.8%) of 18 for supraglottic tumors and 11 (10.3%) of 107 for glottic tumors, and 1 (33.3%) of 3 for subglottic tumors ( P = .001). We do not found difference in complications according to severity (minor vs major complication). Conclusion: Previous studies reported good oncologic outcomes and low complication rates with CO2 transoral laser microsurgery (TOLMS) compared to traditional open surgery. However, it is important to consider the different intraoperative surgical, major and minor complications related to CO2 TOLMS and discuss this with our patients during the preoperative assessment, especially in those patients who need a supraglottic tumor resection.
Clinical Implications of Carcinoma In Situ in Sinonasal Inverted Papilloma
Authors: Maina Ivy W. , Tong Charles C. L. , Baranov Esther , Patel Neil N. , Triantafillou Vasiliki , Kuan Edward C. , Kohanski Michael A. , Papagiannopoulos Peter , Yan Carol H. , Workman Alan D. , Lambert Justina L. , Cohen Noam A. , Kennedy David W. , Adappa Nithin D. , Feldman Michael D. , Palmer James N. 
Published: October 2019

ObjectiveSinonasal inverted papilloma (IP) is a typically benign sinonasal tumor with a tendency to recur and the potential for malignant transformation. Varying degrees of dysplasia may be present, of which carcinoma in situ (CIS) is most advanced. We hereby describe the biological and clinical behavior of IP with CIS (IPwCIS).Study DesignRetrospective cohort.SettingTertiary academic referral center.Subjects and MethodsPatients who underwent surgical resection for IP between 2002 and 2017. Pertinent clinical data were obtained, and all IPwCIS cases were histologically confirmed.ResultsIn total, 37 of 215 cases (17.2%) were identified with IPwCIS. Mean age was 57 years and 86.5% of patients were male. Median follow‐up was 82 months, and the recurrence rate was 27%. The maxillary sinus was the most common primary site (37.8%) and 14 tumors (37.8%) demonstrated multifocal attachment, which was associated with recurrence (odds ratio [OR], 9.7; 95% confidence interval [CI], 1.4‐112.8; P =. 028). IPwCIS was also associated with multiple recurrences (OR, 2.71; 95% CI, 1.246‐5.814; P =. 021). Most patients were treated with surgery alone (89.1%) and 4 patients received adjuvant radiotherapy (8.1%). Only 1 patient (2.7%) demonstrated malignant transformation after definitive surgery.ConclusionsIPwCIS represents the most severe degree of dysplasia prior to malignant transformation and is associated with higher recurrence rate and multifocal involvement but low rate of conversion to invasive carcinoma. The need for adjuvant therapy remains controversial, and further research into the etiology of the disease is warranted.
Five‐Year Objective and Subjective Outcomes of Velopharyngeal Surgery for Patients with Obstructive Sleep Apnea
Authors: Yin Guoping , He Mu , Cao Xin , Xu Jinkun , Zhang Yuhuan , Kang Dan , Ye Jingying 
Published: October 2019

ObjectiveTo assess the long‐term effects of velopharyngeal surgery on objective and subjective symptoms in patients with obstructive sleep apnea (OSA).Study DesignProspective cohort study.SettingUniversity medical center.Subjects and MethodsEighty‐six patients with OSA underwent velopharyngeal surgery, which consisted of revised uvulopalatopharyngoplasty with uvula preservation, with or without concomitant transpalatal advancement pharyngoplasty. The results from polysomnography and the Epworth Sleep Scale after 6 months and 5 years were compared with baseline. Baseline variables were compared between responders and nonresponders.ResultsSixty‐three patients were successfully followed up at the end of study. The surgical success rate after 6 months and 5 years was 66.67% (42 of 63) and 60.32% (38 of 63), respectively, with no significant difference (P =. 459). The apnea‐hypopnea index and Epworth Sleep Scale dramatically decreased from baseline after 6 months and 5 years in responders and nonresponders (P <. 001 for all). As compared with nonresponders, the responders exhibited larger tonsil size, higher nocturnal lowest oxygen desaturation, lower CT90 (percentage of time with oxygen saturation <90%), and shorter MH (vertical distance between the lower edge of the mandible and hyoid in the midsagittal plane of computed tomography). Tonsil size and CT90 showed significant predictive value for surgery success (P <. 001 for both).ConclusionVelopharyngeal surgery was effective in improving nocturnal respiration and excessive daytime sleepiness in patients with OSA at 6‐month and 5‐year follow‐up. Tonsil size and CT90 could be predictors for surgery responders.
Serotonin 2C receptors in the basolateral amygdala mediate the anxiogenic effect caused by serotonergic activation of the dorsal raphe dorsomedial subnucleus
Authors: Matthiesen Melina , Mendes Leonardo D , Spiacci Ailton , Fortaleza Eduardo AT , Corrêa Fernando MA , Zangrossi Hélio 
Published: October 2019

Background: Stimulation of serotonergic neurons within the dorsal raphe dorsomedial subnucleus facilitates inhibitory avoidance acquisition in the elevated T-maze. It has been hypothesized that such anxiogenic effect is due to serotonin release in the basolateral nucleus of the amygdala, where facilitation of serotonin 2C receptor-mediated neurotransmission increases anxiety. Besides the dorsal raphe dorsomedial subnucleus, the dorsal raphe caudal subnucleus is recruited by anxiogenic stimulus/situations. However, the behavioral consequences of pharmacological manipulation of this subnucleus are still unknown. Aims: Investigate whether blockade of serotonin 2C receptors in the basolateral nucleus of the amygdala counteracts the anxiogenic effect caused by the stimulation of dorsal raphe dorsomedial subnucleus serotonergic neurons. Evaluate the effects caused by the excitatory amino acid kainic acid or serotonin 1A receptor-modulating drugs in the dorsal raphe caudal subnucleus. Methods: Male Wistar rats were tested in the elevated T-maze and light-dark transition tests after intra-basolateral nucleus of the amygdala injection of the serotonin 2C receptor antagonist SB-242084 (6-chloro-2,3-dihydro-5-methyl-N-[6-[(2-methyl-3-pyridinyl)oxy]-3-pyridinyl]-1H-indole-1-carboxyamide dihydrochloride) followed by intra-dorsal raphe dorsomedial subnucleus administration of the serotonin 1A receptor antagonist WAY-100635 (N-[2-[4-2-methoxyphenyl)-1-piperazinyl]ethyl]-N-2-pyridinil-cyclohexanecarboxamide maleate). In the dorsal raphe caudal subnucleus, animals were injected with kainic acid, WAY-100635 or the serotonin 1A receptor agonist 8-OH-DPAT ((±)-8-hydroxy-2-(di-n-propylamino) tetralin hydrobromide) and tested in the elevated T-maze. Results: SB-242084 in the basolateral nucleus of the amygdala blocked the anxiogenic effect caused by the injection of WAY-100635 in the dorsal raphe dorsomedial subnucleus. Kainic acid in the dorsal raphe caudal subnucleus increased anxiety, but also impaired escape expression in the elevated T-maze. Neither WAY-100635 nor 8-OH-DPAT in the dorsal raphe caudal subnucleus affected rat’s behavior in the elevated T-maze. Conclusion: Serotonin 2C receptors in the basolateral nucleus of the amygdala mediate the anxiogenic effect caused by the stimulation of serotonergic neurons in the dorsal raphe dorsomedial subnucleus. The dorsal raphe caudal subnucleus regulates anxiety- and panic-like behaviors, presumably by a serotonin 1A receptor-independent mechanism.
Machine learning-based unenhanced CT texture analysis for predicting BAP1 mutation status of clear cell renal cell carcinomas
Authors: Kocak Burak , Durmaz Emine Sebnem , Kaya Ozlem Korkmaz , Kilickesmez Ozgur 
Published: October 2019

Background BRCA1-associated protein 1 (BAP1) mutation is an unfavorable factor for overall survival in patients with clear cell renal cell carcinoma (ccRCC). Radiomics literature about BAP1 mutation lacks papers that consider the reliability of texture features in their workflow. Purpose Using texture features with a high inter-observer agreement, we aimed to develop and internally validate a machine learning-based radiomic model for predicting the BAP1 mutation status of ccRCCs. Material and Methods For this retrospective study, 65 ccRCCs were included from a public database. Texture features were extracted from unenhanced computed tomography (CT) images, using two-dimensional manual segmentation. Dimension reduction was done in three steps: (i) inter-observer agreement analysis; (ii) collinearity analysis; and (iii) feature selection. The machine learning classifier was random forest. The model was validated using 10-fold nested cross-validation. The reference standard was the BAP1 mutation status. Results Out of 744 features, 468 had an excellent inter-observer agreement. After the collinearity analysis, the number of features decreased to 17. Finally, the wrapper-based algorithm selected six features. Using selected features, the random forest correctly classified 84.6% of the labelled slices regarding BAP1 mutation status with an area under the receiver operating characteristic curve of 0.897. For predicting ccRCCs with BAP1 mutation, the sensitivity, specificity, and precision were 90.4%, 78.8%, and 81%, respectively. For predicting ccRCCs without BAP1 mutation, the sensitivity, specificity, and precision were 78.8%, 90.4%, and 89.1%, respectively. Conclusion Machine learning-based unenhanced CT texture analysis might be a potential method for predicting the BAP1 mutation status of ccRCCs.
A comparison study of three physical activity measurement tools examining acceptability in people with psychosis
Authors: Suetani Shuichi , Chapman Justin , Korman Nicole , Chapman Carly , Dodd Cassandra , Dark Frances , Parker Stephen , Siskind Dan 
Published: October 2019

Objective: To compare the acceptability of three distinct physical activity measurement tools in people with psychosis: an objective measurement tool, a self-report measure, and an exercise capacity test. Methods: We measured the completion rate for each measurement tool. Participants rated the ease/difficulty of each measure using a 7-point Likert scale. Participants were also asked to rank the three tools in order of the ease of use. Results: Sixty-six per cent (46/69) of participants completed all three assessment tools, and 60.9% (42/69) completed the acceptability questionnaire. The majority of the participants found it easy to complete all three measurement tools. The majority (52.8%) of the participants ranked the objective measurement tool as the easiest to use. Conclusion: All three measures were acceptable to people with psychosis, but objective measurement tools may be easier to use.
Creeping towards the mutual: lessons from a modest initiative to improve mental health systems capacity in Pacific Island nations
Authors: Hunter Ernest 
Published: October 2019

Objective: To describe the evolution of the Leadership in Mental Health: Island Nations (LMH:IN) course. Method: Using Transformation Theory the focus on Island Nations mental health capacity building through seven Creating Futures conferences is explored and directions for the future considered. Conclusion: Experience and evaluation identify a set of key factors informing the ongoing development of the LMH:IN course.
Training plus intensive consultation improves uptake and outcome expectations of prolonged exposure therapy among practitioners treating emergency service personnel with post-traumatic stress disorder
Authors: Wade Darryl , Terhaag Sonia , Putica Andrea , Metcalf Olivia 
Published: October 2019

Objective: Prolonged exposure (PE) therapy is an evidence-based psychological treatment of post-traumatic stress disorder (PTSD), yet uptake amongst practitioners is less than desirable. The aim of this study was to evaluate the efficacy of a PE training workshop plus intensive consultation programme to improve practitioners’ self-efficacy and outcome expectations as well as uptake of PE for emergency service patients with PTSD. Method: Forty-five psychologists attended a PE training workshop in Sydney. Participants completed questionnaires at pre- and post-workshop and six-month follow-up. Results: The findings suggest that participation in the programme was associated with improvements in practitioners’ beliefs in their ability to deliver PE to patients, an increase in their use of a range of PE components and an increase in their use of in vivo exposure with a greater proportion of patients. Conclusion: Effective training approaches for evidence-based treatments of PTSD should incorporate intensive consultation following training. Future studies should consider additional strategies to encourage practitioners to deliver PE to more patients with PTSD.
Association Between the Timing of Goals-of-Care Discussion and Hospitalization Outcomes in Patients With Metastatic Cancer
Authors: Emiloju Oluwadunni E. , Djibo Djeneba Audrey M. , Ford Jean G. 
Published: October 2019

Background: Patients with cancer often require acute hospitalizations, many of which are unplanned. These hospitalizations have been shown to increase in frequency near the end of life. The American College of Physicians recommends that goals-of-care (GOC) discussions be initiated early for metastatic cancers. We hypothesized that discussing GOC during hospitalization could help reduce readmissions. Our aim was to examine the association between the timing of GOC discussion, length of hospital stay, and the time to readmission. Methods: We conducted a retrospective review of medical records of patients with stage IV cancers hospitalized between August 2017 and July 2018. We recorded timing of GOC discussion, use of palliative care services, and hospital readmissions within 90 days. χ2 tests were used to identify independent associations with GOC discussion, and logistic regression was used to examine association with readmission within 90 days. Results: Of all study patients (N = 241), 40.6% were female, 46% (n = 112) had a GOC discussion, and 34% (n = 82) had a palliative care consultation. Having a palliative care consult and being admitted to critical care were independently associated with having a GOC discussion. Early timing of GOC discussion was inversely associated with admission to critical care units ( P < .05). Thirty-eight percent (n = 92) had unplanned hospital readmission within 90 days. Having a GOC discussion was independently associated with a reduction in the odds of an unplanned hospital readmission within 90 days by 79% (odds ratio = 0.21, 95% confidence interval: 0.12-0.37). Conclusion: Among hospitalized patients with stage IV cancer, performing an early GOC discussion has an important association with lower hospital readmission rates and increased rates of goal-congruent patient care.
Detailed assessment and risk factor analysis of corticosteroid-induced psychiatric disorders in pediatric, adolescent, and young adult patients undergoing induction or consolidation therapy for hematologic malignancy
Authors: Staub Yukiko , Suga Yukio , Ikawa Yasuhiro , Tsubouchi Kiyotaka , Hashimoto Mikie , Kawagishi Atsufumi , Shimada Tsutomu , Sai Yoshimichi , Nishimura Katsuji , Matsushita Ryo 
Published: October 2019

Background Corticosteroid-induced psychiatric disorders (CIPDs) represent an adverse effect that can cause severe emotional and behavioral problems. The aim of the present study was to assess the incidence and risk factors of CIPDs. Methods A retrospective analysis of 92 pediatric and young adult patients with hematologic malignancies was conducted. Results The incidence of CIPDs in patients receiving a treatment regimen with prednisolone or dexamethasone was 64.9% and 77.5%, respectively, both of which were significantly higher than that in patients not receiving corticosteroids. Independent risk factors and adjusted odds ratios (95% confidence intervals) related to severe CIPD were 2.15 (1.11–4.18) for dexamethasone (using prednisolone as the reference) and 0.81 (0.75–0.87) for age, suggesting that the odds increase with decreasing age. Frequently observed symptoms, respectively in terms of behavioral and emotional problems were defiance, crying, psychomotor excitement, dysphoria, irritability, and depression. To our knowledge, this is the first report to mention the risk factors and characteristics for clinical symptoms of CIPDs during the developmental process. Conclusions Healthcare professionals should predict and prepare for psychiatric adverse events prior to chemotherapy in the clinical settings, especially in patients in younger age and receiving a treatment regimen with dexamethasone.
Effects of Heart Rate Variability Biofeedback in Patients With Acute Ischemic Stroke: A Randomized Controlled Trial
Authors: Chang Wan-Ling , Lee Jiunn-Tay , Li Chi-Rong , Davis Amy H. T. , Yang Chia-Chen , Chen Yu-Ju 
Published: October 2019

Background: Autonomic dysfunction, cognitive impairment, and psychological distress are associated with poorer prognosis in patients with acute ischemic stroke (AIS). Heart rate variability (HRV) biofeedback (BF) improves autonomic dysfunction, cognitive impairment, and psychological distress in other patient populations, but its effect in patients with AIS is still unclear. Objective: This study investigated the effects of an HRVBF intervention on autonomic function, cognitive impairment, and psychological distress in patients with AIS. Method: In this randomized, controlled, single-blind trial, patients with AIS were randomly assigned to the experimental or control group. The experimental group received four HRVBF training sessions. The control group received usual care. Repeated measures of HRV, mini-mental status examination (MMSE), and Hospital Anxiety and Depression Scales (HADS) were collected prior to and at 1 and 3 months postintervention. Results: A total of 35 patients completed the study (19 experimental, 16 control). HRV and HADS significantly improved in the experimental group ( p < .001) but not in the control group. Likewise, only the experimental group showed significant improvements in HRV, MMSE, and HADS over time ( p < .05). Conclusion: HRVBF is a promising intervention for improving autonomic function, cognitive impairment, and psychological distress in patients with AIS. More studies of HRVBF interventions are needed to further optimize the effects of HRVBF on autonomic, cognitive, and psychological function in patients with AIS.
Biobehavioral utility of mindfulness-based art therapy: Neurobiological underpinnings and mental health impacts
Authors: Beerse Megan E , Van Lith Theresa , Pickett Scott M , Stanwood Gregg D 
Published: October 2019

Mindfulness-based art therapy (MBAT) combines mindfulness practices with art therapy to promote health, wellness, and adaptive responses to stress. Mindfulness-based stress reduction programs have been demonstrated to reduce anxiety symptoms in people with generalized anxiety disorder and serious medical conditions such as cancer. However, the benefits of MBAT specifically—not just in clinical anxiety disorders, but also for routine day-to-day anxiousness—have received little attention until recently. In this mini-review, we summarize how several established mindfulness-based interventions affect mental health with a specific focus on MBAT. We also describe and evaluate data indicating involvement of specific neural circuits and neuroendocrine markers of stress and/or anxiety. Lastly, we suggest areas of focus for future rigorous research on MBAT interventions and propose multiple biobehavioral and physiological mechanisms through which therapeutic benefits may be achieved.Impact statementRecent studies demonstrate the therapeutic potential of intensive MBAT and other mindfulness-based interventions for severe health conditions including cancer, heart disease, and anxiety, with effectiveness that rivals and sometimes even exceeds cognitive behavior therapy. MBAT-based approaches appear to be poised to mature into large-scale, cost-effective therapies for mental health disorders and symptoms comorbid with other serious health issues. However, the field currently suffers from inconsistent deployment protocols and needs additional validation data—at the behavioral, neuroendocrine, and neural levels—in order to establish best practices.
Contraceptive Decision Making Among Latina Immigrants: Developing Theory-Based Survey Items
Authors: Carvajal Diana N. , Mudafort Paola C. Rivera , Barnet Beth , Blank Arthur E. 
Published: October 2019

Background: Contraception is important for reproductive autonomy, yet many Latinas do not use contraception consistently despite research reporting a desire to do so. Factors varying in priority and value come into play during contraceptive decision making. When measuring these, relevant survey items may vary by populations. Aim: This study focused on developing an ethnically responsive, patient-centered, content-valid survey for measuring factors that influence contraceptive decision making among immigrant Latinas. Method: Nonpregnant self-identified Latinas ages 15 to 24 years in Baltimore, MD, were recruited from a family planning facility. Using the theory of planned behavior as a theoretical framework and prior formative research, initial survey items were drafted (Step 1). Content validation and cognitive interviewing procedures (Step 2 and Step 3) were used to develop final items. Results: Final items (27) were content-validated by the target population; items reflect important factors and relevant contexts affecting contraceptive decision making among Latinas in Baltimore. Discussion: These theory-based items provide an important contribution to the literature because they measure and explore factors related to contraceptive decision making in an understudied population. Providers might consider these factors during counseling to build patient-centered communication. These items might serve to measure responses to theory of planned behavior–based interventions designed to improve the contraceptive counseling of Latinas.
Osteosynthesis of fifth metacarpal neck fractures with a photodynamic polymer bone stabilization system
Authors: Surke Carsten , Meier Rahel , Haug Luzian , Vögelin Esther 
Published: October 2019

Metacarpal neck fractures with severe displacement are commonly treated surgically with intramedullary Kirschner wires. We present the results of treatment of fifth metacarpal neck fractures using a light curable intramedullary photodynamic polymer (IlluminOss™, IlluminOss Medical Inc., East Providence, RI, USA). Twenty-nine patients with isolated displaced fifth metacarpal neck fractures were included and followed up for 12–24 weeks. All fractures had radiologically healed after 3 months. In two cases, a secondary loss of reduction was seen, which did not require further correction. During the follow-up period, range of motion of the metacarpophalangeal joint was 89% after 6 weeks and increased to 100% after 3 months compared with the uninjured side. Grip strength improved over time from 61% to 85%. No implant removal was necessary. We conclude that osteosynthesis using an intramedullary photodynamic polymer is a reliable treatment option for displaced fractures of the fifth metacarpal neck. Level of evidence: IV