bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary Tumor Resection Prolongs Survival in Spinal Chondrosarcoma Patients With Distant Metastasis
Authors: Song Kehan , Lin Kaiyuan , Kang Honglei , Dong Yiming , Guan Hanfeng , Li Feng 
Published: September 2020

Study Design.
Retrospective analysis.

Objective.
To investigate (1) whether resection of primary tumor improves survival of metastatic spinal chondrosarcoma patients and (2) which subgroups of metastatic spinal chondrosarcoma patients benefit more from primary tumor resection.

Summary of Background Data.
Surgical resection is the mainstay of treatment for spinal chondrosarcoma, as chondrosarcoma is inherently resistant to radiotherapy and chemotherapy. However, evidence which justifies resection of the primary tumor for patients with metastatic spinal chondrosarcoma is still lacking.

Methods.
We retrospectively included 110 patients with metastatic spinal chondrosarcoma in the Surveillance, Epidemiology, and End Results database from 1983 to 2016. The association between primary tumor resection and survival was evaluated using Kaplan-Meier analyses, log-rank tests, and multivariable Cox analyses. The effect of primary tumor resection on survival was further assessed in subgroups stratified by histologic subtype, tumor grade, and age.

Results.
Overall, 110 patients were divided into surgery group (n = 55, 50%) and nonsurgery group (n = 55, 50%). Primary tumor resection was associated with both prolonged overall survival (hazard ratio 0.262, 95% confidence interval 0.149–0.462, P < 0.001) and cancer-specific survival (hazard ratio 0.228, 95% confidence interval 0.127–0.409, P < 0.001). When we focused on surgical effects in subgroups, primary tumor resection conferred survival advantage on patients with conventional subtype, grade I to III malignancy, and an age younger than 70 years old (P < 0.001 for overall and cancer-specific survival). However, primary tumor resection brought limited survival benefit for patients with dedifferentiated subtype and patients over 70 years old.

Conclusion.
The present population-based study for the first time reports a clear association between primary tumor resection and prolonged survival in metastatic spinal chondrosarcoma patients. Specifically, primary tumor resection was associated with improved survival in patients with conventional subtype, grade I to III malignancy, and an age younger than 70 years old.

Level of Evidence: 4
Can we cure oligometastatic disease? A practical point of view
Authors: Pérez-García José , Cortez Patricia , Gion María , Cortés Javier 
Published: September 2020

Purpose of review
To critically analyze the available evidence on oligometastatic breast cancer and to suggest therapeutic approaches for optimal management of these patients.

Recent findings
Unlike metastatic breast cancer, which remains incurable, patients with a limited number and extent of metastatic lesions, that is, oligometastatic disease, might achieve disease control and long-term survival when radical therapy of the primary tumor, if present, and metastatic disease is added to standard systemic therapy. However, the lack of a clear definition, variety of presentations, and the absence of biomarkers makes oligometastatic breast cancer a poorly understood clinical entity for which there is no standard treatment.

Summary
Improvements in systemic therapies along with radical treatment of the primary tumor and metastatic lesions, together with optimization in the use of imaging tools, may help to increase the percentage of patients with metastatic breast cancer who achieve no-evidence-of-disease status or, at least, chronification of the disease. However, the fundamental question remains: which patients may benefit the most from a radical therapeutic approach? In this article, we propose strategies for the appropriate selection and comprehensive management of these patients.
Physical approaches to treat glioblastoma
Authors: Latifyan Sofiya , de Micheli Rita , Hottinger Andreas F. 
Published: September 2020

Purpose of review
Glioblastoma (GBM) patients have a poor prognosis despite the use of modern synergistic multimodal treatment strategies, with a progression-free survival estimated at 7–8 months, a median survival of 14–16 months and 5-year overall survival of 9.8%.

Recent findings
Physical methods hold the promise to act synergistically with classical treatments to improve the outcome of GBM patients. Fluorescent guided surgery with 5-aminolevulinic acid and tumor-treating fields therapy have already shown positive results in randomized phase III trials and have been incorporated in the standard management. Other techniques such as photodynamic therapy (PDT) and focused ultrasound, often combined whit microbubbles, are reaching clinical development.

Summary
Several clinical trials to evaluate the feasibility and efficacy of ultrasound devices to disrupt the blood–brain barrier are ongoing. PDT enables the creation of a safety margin or treatment of non-resecable tumors. However, randomized trials are urgently required to validate the efficacy of these promising approaches. We aim to critically review physical approaches to treat GBM, focusing on available clinical trial data.
Three-dimensional Neuroretinal Rim Thickness and Visual Fields in Glaucoma: A Broken-stick Model
Authors: Liu Wendy W. , McClurkin Michael , Tsikata Edem , Hui Pui-Chuen , Elze Tobias , Celebi Ali R.C. , Khoueir Ziad , Lee Ramon , Shieh Eric , Simavli Huseyin , Que Christian , Guo Rong , de Boer Johannes , Chen Teresa C. 
Published: September 2020

Precis:
In open-angle glaucoma, when neuroretinal rim tissue measured by volumetric optical coherence tomography (OCT) scans is below a third of the normal value, visual field (VF) damage becomes detectable.

Purpose:
To determine the amount of neuroretinal rim tissue thickness below which VF damage becomes detectable.

Methods:
In a retrospective cross-sectional study, 1 eye per subject (of 57 healthy and 100 open-angle glaucoma patients) at an academic institution had eye examinations, VF testing, spectral-domain OCT retinal nerve fiber layer (RNFL) thickness measurements, and optic nerve volumetric scans. Using custom algorithms, the minimum distance band (MDB) neuroretinal rim thickness was calculated from optic nerve scans. “Broken-stick” regression was performed for estimating both the MDB and RNFL thickness tipping-point thresholds, below which were associated with initial VF defects in the decibel scale. The slopes for the structure-function relationship above and below the thresholds were computed. Smoothing curves of the MDB and RNFL thickness covariates were evaluated to examine the consistency of the independently identified tipping-point pairs.

Results:
Plots of VF total deviation against MDB thickness revealed plateaus of VF total deviation unrelated to MDB thickness. Below the thresholds, VF total deviation decreased with MDB thickness, with the associated slopes significantly greater than those above the thresholds (P<0.014). Below 31% of global MDB thickness, and 36.8% and 43.6% of superior and inferior MDB thickness, VF damage becomes detectable. The MDB and RNFL tipping points were in good accordance with the correlation of the MDB and RNFL thickness covariates.

Conclusions:
When neuroretinal rim tissue, characterized by MDB thickness in OCT, is below a third of the normal value, VF damage in the decibel scale becomes detectable.
Impact of Video Education on Patient Knowledge, Anxiety, and Satisfaction in Selective Laser Trabeculoplasty: A Pilot Study
Authors: Robbins Cason B. , Wisely C. Ellis , Rosdahl Jullia A. , Muir Kelly W. , Gupta Divakar 
Published: September 2020

Précis:
In patients undergoing selective laser trabeculoplasty, preoperative video education did not improve patient knowledge regarding the procedure, decrease anxiety, or increase satisfaction, as these metrics were already favorable across all patients in this study.

Purpose:
To assess the effect of an educational video on patient knowledge, anxiety, and satisfaction at a selective laser trabeculoplasty (SLT) procedure visit.

Materials and Methods:
This is a prospective, randomized trial. Patients at a single academic medical center completed a survey at their procedure visit for SLT; patients were randomized to view an educational video or no video before survey administration. Knowledge was assessed with a 10-item questionnaire. The 6-item State-Trait Anxiety Inventory scale (STAI-6) assessed anxiety (score >40 defined significant anxiety). Perceptions of visit quality were assessed using a Likert scale.

Results:
Twenty-two patients were randomized into video (n=11) and control (n=11) groups. No difference in knowledge was observed between groups (83.6% control vs. 82.7% video group, P=0.635). No patient had significant anxiety (STAI-6 range, 20 to 40, average 29) and scores were similar between groups (P=0.385). Overall, patients had positive perceptions of visit quality, and there was no significant difference between groups (P=0.999).

Conclusion:
Patients undergoing SLT had high levels of knowledge, low levels of anxiety, and high levels of satisfaction. In this clinical setting, an educational video seemed to have no additional benefit on these metrics and thus, may be omitted. Further research may be directed toward optimizing patient education regarding SLT, particularly in settings with poor health literacy, limited resources, or limited access to glaucoma specialists.
A Multicentered Study on Epidemiologic and Clinical Characteristics of 37 Neonates With Community-acquired COVID-19
Authors: Kanburoglu Mehmet Kenan , Tayman Cuneyt , Oncel Mehmet Yekta , Akin Ilke Mungan , Can Emrah , Demir Nihat , Arayici Sema , Baser Demet Orhan , Caner Ibrahim , Memisoglu Asli , Uygun Saime Sundus , Akar Selahattin , Akin Mustafa Ali , Ataoglu Emel , Bezirganoglu Handan , Bilgin Leyla , Bozdag Senol , Comert Serdar , Gurpinar Resat , Imamoglu Ebru Yalin , Imdadoglu Timucin , Narter Fatma , Ozdemir Ramazan , Toptan Handan Hakyemez , Yalinbas Emine Esin , Yaman Akan , Erdeve Omer , Koc Esin 
Published: September 2020

Background:
Coronavirus disease 2019 (COVID-19) primarily affects adults and spares children, whereas very little is known about neonates. We tried to define the clinical characteristics, risk factors, laboratory, and imagining results of neonates with community-acquired COVID-19.

Methods:
This prospective multicentered cohort study included 24 neonatal intensive care units around Turkey, wherein outpatient neonates with COVID-19 were registered in an online national database. Full-term and premature neonates diagnosed with COVID-19 were included in the study, whether hospitalized or followed up as ambulatory patients. Neonates without severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) via reverse transcriptase-polymerase chain reaction testing or whose mothers had been diagnosed with COVID-19 during pregnancy were excluded.

Results:
Thirty-seven symptomatic neonates were included. The most frequent findings were fever, hypoxemia, and cough (49%, 41%, 27%, respectively). Oxygen administration (41%) and noninvasive ventilation (16%) were frequently required; however, mechanical ventilation (3%) was rarely needed. Median hospitalization was 11 days (1–35 days). One patient with Down syndrome and congenital cardiovascular disorders died in the study period. C-reactive protein (CRP) and prothrombin time (PT) levels were found to be higher in patients who needed supplemental oxygen (0.9 [0.1–8.6] vs. 5.8 [0.3–69.2] p = 0.002, 11.9 [10.1–17.2] vs. 15.2 [11.7–18.0] p = 0.01, respectively) or who were severe/critical (1.0 [0.01–8.6] vs. 4.5 [0.1–69.2] p = 0.01, 11.7 [10.1–13.9] vs. 15.0 [11.7–18.0] p = 0.001, respectively).

Conclusions:
Symptomatic neonates with COVID-19 had high rates of respiratory support requirements. High CRP levels or a greater PT should alert the physician to more severe disease.
Infection Risk of COVID-19 in Dentistry Remains Unknown: A Preliminary Systematic Review
Authors: Levit Michael , Levit Leah 
Published: September 2020

Background
COVID-19 is a novel viral respiratory disease caused by a member of the coronavirus family, SARS-CoV-2, and has been declared as a pandemic on March 2020. Dental practitioners are routinely exposed to infectious bodily excretions, for example, saliva, blood, and respiratory excretions. Therefore, they are in the first line of SARS-CoV-2 infection-prone health care providers. The purposes of the current review are to trace documented cases of COVID-19 transmission inside dental settings worldwide and to explore the clinical management of these cases.

Methods
We searched MEDLINE and Google Scholar for all possible reported cases of COVID-19 transmission in dental practice as of December 1, 2019, until May 13, 2020. Multiple terms and combinations were used, including “coronavirus,” “COVID-19,” “SARS-CoV-2,” “dental,” “dentistry,” “transmission,” and “nosocomial.” Articles that were not written in English were excluded.

Results
A total of 78 articles were found from December 29, 2019, until May 13, 2020. Of these, 31 articles discussed the risks related to dental practice and recommended infection management protocols for dental health care personnel. Of these articles, only 1 had reported data on transmission of COVID-19 in dental practice. Two possible transmissions of COVID-19 to dental personnel were reported in China before its recognition as an epidemic.

Conclusions
Although it seems that there are almost no reported cases of infection by SARS-CoV-2 during dental treatments, occupational or nosocomial transmission could not be ruled out. Hence, further prospective assessment of COVID-19 transmission is urgently required, and careful and protective measurements are necessary to avoid infection during dental practice.
Capital Expenditures Increased at Rural Hospitals That Merged Between 2012 and 2015
Authors: Williams Dunc , Pink George H. , Song Paula H. , Reiter Kristin L. , Holmes G. Mark 
Published: September 2020

EXECUTIVE SUMMARY
The number of rural hospital mergers has increased substantially in recent years. A commonly reported reason for merging is to increase access to capital. However, no empirical evidence exists to show whether capital expenditures increased at rural hospitals after a merger. We used a difference-in-differences approach to determine whether total capital expenditures changed at rural hospitals after a merger. The comparison group (rural hospitals that did not merge during the 2012 through 2015 study period) was weighted using inverse probability of treatment weights. The key outcome measure was logged total capital expenditures.
Merging resulted in a 26% increase in capital expenditures and also was associated with a significant improvement in plant age. The postmerger improvement in plant age may have been partially attributable to merger-related accounting changes and partially attributable to increased capital expenses, possibly on long-term asset renovations and replacement.
These findings suggest that through mergers, rural hospital board members and executives who have accepted or are considering a merger may improve a hospital’s ability to increase capital expenditures. Further, increased capital investments in rural hospitals may be an important signal to the community that the acquirer intends to keep the rural hospital open and continue providing some volume and level of services within the community. Future research should determine how capital is spent after a merger.
How Women and Men Executives Perceive Healthcare Workplaces
Authors: Athey Leslie A. , Kimball Peter A. 
Published: September 2020

EXECUTIVE SUMMARY
Healthcare organizations that can attract and retain talented women executives have the advantage over their peers. In 2018, the American College of Healthcare Executives (ACHE) conducted the sixth in a series of surveys of its members to compare the career attainments, attitudes, and workplace experiences of men and women healthcare executives. Data from the 2018 survey indicate that women healthcare executives with 5 to 20 years of experience in the field are significantly less likely than their male peers to perceive their employers as gender-neutral regarding key employment factors such as hiring, promotion, evaluation, and compensation. Further, the results indicate there has been little to no improvement in many of these outcomes since ACHE began measuring these perceptions more than a decade ago. The perception that an employing organization is lacking in gender equity is also associated with lower overall satisfaction, engagement, and willingness to stay with the organization on the part of women executives.
Respiratory and sleep-related complications of multiple system atrophy
Authors: Ralls Frank , Cutchen Lisa 
Published: September 2020

Purpose of review
The purpose of this article is to provide a contemporary review of sleep issues affecting patients with multiple system atrophy (MSA).

Recent findings
Prodromal symptoms of MSA may occur years prior to diagnosis, including autonomic dysfunction such as orthostatic hypotension, urogenital dysfunction, rapid eye movement (REM) sleep behavior disorder (RBD), and stridor. Patients may also develop sleep-related respiratory disorders such as obstructive sleep apnea (OSA), central sleep apnea (CSA), and stridor. The development of stridor is associated with a shortened lifespan and sudden death, which may be further accelerated by autonomic instability. MSA appears to follow a ‘prion-like’ disease progression.

Summary
MSA is a rapidly progressive neurodegenerative disease characterized by a combination of autonomic failure and motor symptoms. MSA is often misdiagnosed as the initial presentation mimics other neurodegenerative disorders. There are diagnostic criteria to identify possible, probable, and definite MSA. Prodromal symptoms may occur years prior to diagnosis, including autonomic dysfunction such as orthostatic hypotension, urogenital dysfunction, REM RBD, and stridor. In previous years, treatment consisted of tracheostomy but did not address the component of CSA, which commonly coexisted or developed later because of destruction of medullary chemoreceptors. Positive airway pressure may be as effective as tracheostomy alone in ameliorating obstruction at the vocal cord level.
Obstructive sleep apnea and cancer: a complex relationship
Authors: Marrone Oreste , Bonsignore Maria R. 
Published: September 2020

Purpose of review
Obstructive sleep apnea (OSA) has been recognized as a risk factor for cancer mainly through hypoxia, based on studies that did not distinguish among cancer types. The purpose of this review is to discuss the most recent data on epidemiology and pathophysiology of the OSA–cancer association.

Recent findings
According to epidemiological studies, OSA may have different influences on each type of cancer, either increasing or decreasing its incidence and aggressiveness. Time spent with oxygen saturation below 90% appears the polysomnographic variable most strongly associated with unfavorable effects on cancer. Experimental studies support the role of hypoxia as an important risk factor for cancer growth and aggressiveness, especially when it shows an intermittent pattern. These effects are largely mediated by the hypoxia-inducible factor, which controls the synthesis of molecules with effects on inflammation, immune surveillance and cell proliferation. Sleep fragmentation participates in increasing cancer risk. Modulating effects of age remain controversial.

Summary
Effects of OSA on cancer may largely vary among neoplastic diseases, both in their magnitude and direction. The worse risk associated with intermittent rather than persistent hypoxia, and the effects of OSA therapy on cancer natural history are still poorly known, and deserve new careful studies.
Head-to-head comparison of the hybrid tracer indocyanine green-99mTc-nanocolloid with 99mTc-Senti-Scint using sentinel node lymphoscintigraphy and single-photon emission computed tomography combined with computer tomography in melanoma
Authors: Rietbergen Daphne D.D. , Meershoek Philippa , KleinJan Gijs H. , Donswijk Maarten , Valdés Olmos Renato A. , van Leeuwen Fijs W.B. , Klop Martin W.M.C. , van der Hage Jos A. 
Published: September 2020

Objective
The hybrid tracer indocyanine green (ICG)-99mTc-nanocolloid has been introduced for sentinel node imaging. However, until now, a comparison of this tracer with other radiocolloids with a larger particle size has not been effectuated. Based on a head-to-head evaluation in patients with melanoma, we have compared ICG-99mTc-nanocolloid (particle size 5–80 nm) with 99mTc-Senti-Scint (particle size 100–600 nm) to establish differences in drainage pattern and sentinel node localization using lymphoscintigraphy and single-photon emission computed tomography combined with computer tomography (SPECT-CT) in melanoma patients scheduled for sentinel node biopsy.

Methods
Twenty-five patients (mean age: 56.9 years, range: 25–79 years) with a melanoma scheduled for SLN biopsy prior to (re)excision of the primary lesion (scar) were prospectively included following a two-day procedure. The first day, after 99mTc-Senti-Scint injection in four intradermal depots around the primary lesion or scar, early/delayed lymphoscintigraphy and SPECT-CT images were acquired. The injection sites were marked. The second day, after assessing lymph node radioactivity using planar scintigraphy, ICG-99mTc-nanocolloid was injected at the previously marked skin points and imaging was performed. The paired planar and SPECT-CT images of both tracers were evaluated with respect to drainage patterns, SLN visualization and non-SLN appearing.

Results
Twenty-four out of 25 patients were evaluable. SLN visualization on a patient basis was 100% for ICG-99mTc-nanocolloid and 96% for 99mTc-Senti-Scint, whereas uptake in non-SLNs was found in, respectively, 71% (17/24) and 61% (14/23). Concordance in drainage to 45 lymph node basins was 91%. Discordant drainage was found for two melanomas in the head-and-neck and one in the clavicular area. Unique lymph node basins were seen in 44/45 (98%) for ICG-99mTc-nanocolloid and 42/45 (93%) for 99mTc-Senti-Scint. Concerning identified SLNs, the number was similar for both tracers (n = 58); however, more non-SLNs (65 vs 50) were visualized with ICG-99mTc-nanocolloid than with 99mTc-Senti-Scint.

Conclusion
A slightly higher SLN visualization accompanied by a tendency to depict more non-SLNs was found for ICG-99mTc-nanocolloid. Excepting the head and neck area, an overall high concordance in drainage was found for both radiotracers. With an additional value for the hybrid tracer due to the combination of preoperative imaging and the additional visual signal in the operation room, added by the fluorescent component of the hybrid tracer, there was a preference for ICG-99mTc-nanocolloid.