bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association between methods of biopsy and survival following breast cancer
Authors: Kong Yek-Ching , Bhoo-Pathy Nirmala , O’Rorke Michael , Subramaniam Shridevi , Bhoo-Pathy Nanthini T. , See Mee-Hoong , Jamaris Suniza , Teoh Kean-Hooi , Bustam Anita Z. , Looi Lai-Meng , Taib Nur Aishah , Yip Cheng-Har 
Published: February 2020

Abstract
Percutaneous biopsy in breast cancer has been associated with an increased risk of malignant cell seeding. However, the importance of these observations remains obscure due to lack of corroborating evidence from clinical studies. We determined whether method of biopsy is associated with breast cancer survival. This hospital registry-based cohort study included 3416 non-metastatic breast cancer patients diagnosed from 1993 to 2011 in a tertiary setting. Factors associated with biopsy methods were assessed. Multivariable Cox regression analysis was used to determine the independent prognostic impact of method of biopsy. Overall, 990 patients were diagnosed by core needle biopsy (CNB), 1364 by fine needle aspiration cytology (FNAC), and 1062 by excision biopsy. Excision biopsy was significantly associated with more favorable tumor characteristics. Radiotherapy modified the prognostic impact of biopsy method (P
interaction < .001). Following multivariable analysis, excision biopsy was consistently associated with lower risk of mortality compared to FNAC in women receiving adjuvant radiotherapy (adjusted hazard ratio: 0.81, 95%CI: 0.66–0.99), but not in those who did not receive adjuvant radiotherapy (adjusted hazard ratio: 0.87, 95%CI: 0.65–1.17). While the risk of mortality was not different between patients undergoing FNAC and CNB when radiotherapy is administered, in the absence of radiotherapy, CNB was associated with higher risk of mortality than FNAC (adjusted hazard ratio: 1.57, 95%CI: 1.16–2.12). Given that our results contradict with findings of previous clinical studies assessing the prognostic impact of method of biopsy in women with breast cancer, further studies are warranted.
Saliva cortisol, melatonin levels and circadian rhythm alterations in Chinese primary school children with dyslexia
Authors: Huang Yanhong , Xu Chongtao , He Meirong , Huang Wenlong , Wu Kusheng 
Published: February 2020

Abstract
Cortisol is the main end product of hypothalamic-pituitary-adrenal gland (HPA axis), and melatonin (MT) has a regulating effect on HPA axis, and both are closely related to individual behavior and cognitive function. We aimed to evaluate cortisol and MT roles on children dyslexia in this study.
A total of 72 dyslexic children and 72 controls were recruited in this study. Saliva samples were collected in the morning, afternoon, and night, respectively. The levels of saliva cortisol and MT were measured by enzyme-linked immunosorbent assay method. Differences of cortisol and MT levels between dyslexic and normal children were compared, and the variation trend was also analyzed by dynamic monitoring in 3 time points.
The levels of salivary cortisol and MT in children with dyslexia were all lower than those in normal children whether in the morning (7:30-8:30 am ), at afternoon (15:30-16:30 pm ) or at night (21:30-22:30 pm ) (all P < .001). Compared with normal children, the circadian rhythm variations of salivary cortisol and MT in dyslexic children disappeared and became disordered. The salivary cortisol and MT levels in children with dyslexia were declined throughout the day; and the circadian rhythm was disordered or disappeared.
The results suggest that cortisol and MT levels and their circadian rhythm may affect children dyslexia, but the mechanisms need further exploration.
Stent insertion with high-intensity focused ultrasound ablation for distal biliary obstruction secondary to pancreatic carcinoma
Authors: Yang Shu-Ying , Liu Fen , Liu Yi , Xia Feng-Fei , Fu Yu-Fei 
Published: February 2020

Abstract
We determined the clinical effectiveness and long-term outcomes in patients with distal biliary obstruction (DBO) secondary to pancreatic carcinoma (PC) who were treated by self-expanded metallic stent (SEMS) insertion with or without high-intensity focused ultrasound (HIFU) ablation.
From January 2014 to December 2018, consecutive patients with DBO secondary to PC underwent SEMS insertion with or without HIFU ablation in our center. The long-term outcomes were compared between the 2 groups.
During the included period, 75 patients underwent SEMS insertion with (n = 34) or without (n = 41) HIFU ablation in our center. SEMS insertion was successfully performed in all patients. Liver function was significantly improved after SEMS insertion in both groups. An average of 2.9 HIFU treatment sessions per patient were performed. Twenty patients (stent + HIFU group: 7; stent-only group: 13) experienced stent dysfunction (P = .278). The clinical response rate to HIFU ablation was 79.4%. The median stent patency was significantly longer in the stent with HIFU group than in the stent-only group (175 vs 118 days, P = .005). The median survival was significantly longer in the stent with HIFU group compared with the stent-only group (211 versus 136 days, P = .004). An Eastern Cooperative Oncology Group (ECOG) Performance Status of 3 (hazard ratio: 0.300; P = .002) and subsequent HIFU ablation (hazard ratio: 0.508; P = .005) were associated with prolonged survival.
HIFU ablation following stent insertion can prolong the stent patency and survival for patients with DBO secondary to PC.
Lower number of plasma exchange sessions and glomerular filtration rate decline are associated with second relapses in patients with myasthenia gravis
Authors: Premuzic Vedran , Bilic Ervina , Sepec Branimir Ivan , Hancevic Mirea , Bilic Hrvoje , Sitas Barbara , Sprljan Alfirev Rujana , Jelakovic Bojan 
Published: February 2020

Abstract
The aims were to determine the impact of dysphagia and glomerular filtration rate (GFR) in the prediction of myasthenia relapse and analyse whether different number of plasma exchange sessions could prolong the time before future relapse.
This was a retrospective, longitudinal follow-up study with 60 enrolled patients. The patients were followed-up for a total of 50 months.
Patients without relapses had significantly higher GFR and higher number of plasma exchange sessions when compared to patients with relapses. Mean time before next myasthenia relapse was significantly longer in patients with GFR ≥ 60 mL/min. Time before next and number of following myasthenia relapses were significantly higher in patients with symptoms of dysphagia.
Decline in GFR levels is strongly associated with the presence of dysphagia and independently impacts the onset of myasthenia relapses. Timely initiation of plasmapheresis therapy and adequate hydration of patients with prolonged dysphagia should be one of the treatment goals for clinicians treating this disease.
Comparison of endoscopic surgery and Lichtenstein repair for treatment of inguinal hernias
Authors: Lyu Yunxiao , Cheng Yunxiao , Wang Bin , Du Weibing , Xu Yueming 
Published: February 2020

Abstract

Background:
This study aimed to identify the best procedure for addressing inguinal hernias by comparing results after transabdominal preperitoneal (TAPP), totally extraperitoneal (TEP), and Lichtenstein repairs using a network meta-analysis.

Methods:
We conducted a systematic search of MEDLINE, Web of Science, the Cochrane Central Library, and ClinicalTrials.gov up to September 1, 2018 for randomized controlled trials (RCTs) comparing the TAPP, TEP, and Lichtenstein procedures. The study outcome were the hernia recurrence, chronic pain, hematoma, seroma, wound infection, operation time, hospital stay, and return-to-work days.

Results:
Altogether, 31 RCTs were included in the meta-analysis. The results of this network meta-analysis showed there were no significantly differences among the 3 procedures in terms of hernia recurrence, chronic pain, hematoma, seroma, hospital stays. Lichtenstein had a shorter operation time than TAPP+TEP [MD (95%Crl)]: 12 (0.51–25.0) vs 18 (6.11–29.0) minutes, respectively) but was associated with more wound infections than TEP: OR 0.33 (95%Crl 0.090–0.81). Our network meta-analysis suggests that TAPP and TEP require fewer return-to-work days [MD (95%CI)]: − 3.7 (−6.3 to 1.3) vs −4.8 (−7.11 to 2.8) days.

Conclusion:
Our network meta-analysis showed that there were no differences among the TAPP, TEP, and Lichtenstein procedures in terms of safety or effectiveness for treating inguinal hernias. However, TAPP and TEP could decrease the number of return-to-work days. A further study with more focus on this topic for inguinal hernia is suggested.
Analysis and strategy research on quality of nursing work life
Authors: Wang Lei , Wang Xuerui , Liu Shuang , Wang Binquan 
Published: February 2020

Abstract
Quality of Working Life (QWL) was developed in 1970s as a new theory on a basis of social-technical system theory. In 2004, Brooks considered that quality of nursing work life is a degree to which the registered nurses are able to satisfy important personal needs through their experiences in their work organization's goal. Quality of Nursing Work Life plays an important role in nursing management.
The purpose of the project was to identify factors associated with nursing work life quality.
A convenience sample of 3498 nurses from five tertiary general hospitals in Shanxi, Shandong, and Liaoning provinces in China was surveyed regarding quality of work life, working conditions, stress at work, general being, and job and career satisfaction (JCS).
The mean overall quality of work life score was found to be 3.40 ± 0.61 (on a scale of 1–5, with 5 being the highest), while the working conditions and stress at work received lower scores. The general well-being of females (3.49 ± 0.74) was higher than that of males (3.35 ± 0.87). We also found a statistically significant difference of JCS of different department groups (P = .004).
The quality of working life of nurses was found to be in the middle range, with room for improvement. Nurse managers have an opportunity to implement measures to improve the quality of working life for nurses in China.
Health Profile and Health Care Access of Mexican Migration Flows Traversing the Northern Border of Mexico
Authors: Martinez-Donate Ana P. , Verdecias Niko , Zhang Xiao , Jesús Eduardo Gonzalez-Fagoaga , Asadi-Gonzalez Ahmed A. , Guendelman Sylvia , Amuedo-Dorantes Catalina , Rangel Gudelia 
Published: February 2020

Background:
The health of Latino migrants is most often studied with samples of immigrants settled in the United States or returned migrants in Mexico. We examine health outcomes and health care access of Mexican migrants traversing the Mexican border region to gain a better understanding of migrant health needs as they transition between migration phases.

Methods:
We used data from a 2013 probability survey of migrants from Northbound and Southbound migration flows in Tijuana, Mexico (N=2412). Respondents included Northbound migrants with and without US migration experience, Southbound migrants returning home from the United States or the Mexican border region, and migrants returning to Mexico via deportation. Descriptive statistics and regression models were estimated to characterize and compare their health status, behavioral health, and health care access across migration phases.

Results:
Northbound migrants with US migration experience, Southbound migrants from the United States, and deported migrants had worse levels of health insurance, health care utilization, and diabetes than Northbound migrants without US migration experience. Southbound migrants returning from the border reported worse self-rated health and deportees had higher odds of reported substance use compared with Northbound migrants without US migration experience.

Conclusions:
Mexican migrants’ health profile and health care access vary significantly across migration flows and generally are worse for migrants with US migration experience. The results add to our understanding of Mexican migrant health along the migration continuum and can inform services in sending, receiving, and intermediate communities.
Incorporating Prescription Drugs Into Affordable Care Act Risk Adjustment
Authors: Pope Gregory C. , Pearlman Andrew , Ingber Melvin J. , Kautter John , Drury Kelly , Amin Krutika , Wrocklage James 
Published: February 2020

Background:
The 2010 Patient Protection and Affordable Care Act reformed the individual and small group health insurance markets and established a risk adjustment program to create a level playing field for competition. A new set of predictive models for measuring enrollee risk across plans was developed for the Patient Protection and Affordable Care Act-reformed markets, referred to as the Department of Health and Human Services Hierarchical Condition Category (HHS-HCC) models. Beginning in 2018, selected prescription drug classes were added to the models as risk markers.

Objective:
We describe the motivations, concerns, methodology, and results of adding prescription drug utilization to the HHS-HCC models.

Methods:
Separate HHS-HCC models are estimated by enrollee age and plan actuarial value. We defined and added 10 prescription drug classes, called RXCs, to the HHS-HCC adult models.

Results:
Using selected RXCs alongside demographic and diagnostic indicators yielded modest overall improvement in HHS-HCC models’ predictive power. Also, adding RXCs captures the higher costs of enrollees taking certain expensive pharmaceuticals and allows imputation of diagnoses for enrollees utilizing a drug but lacking the associated diagnosis.

Conclusions:
Including selected drugs in risk adjustment improved the models’ predictive power. In addition, inclusion of selected drugs may discourage insurers from using formulary and drug benefit design to avoid enrollment of patients taking high-cost drugs, such as for HIV, multiple sclerosis, and rheumatoid arthritis, and improve access for enrollees taking these drugs. Adding RXCs also may improve plan risk measurement for plans with less complete diagnosis reporting.
Autosomal recessive hypercholesterolemia: update for 2020
Authors: D’Erasmo Laura , Di Costanzo Alessia , Arca Marcello 
Published: February 2020

Purpose of review
This review summarizes the current knowledge regarding autosomal recessive hypercholesterolemia (ARH) and provides new insight into the natural history and therapeutic management of this lipid disorder.

Recent findings
Novel homozygous and compound heterozygous ARH-causing mutations have been reported in the literature, to date. The long-term follow-up of a cohort of ARH patients demonstrated that, despite intensive treatment with conventional lipid-lowering therapies, their low-density lipoprotein (LDL) cholesterol levels remain far from target and this translates into a poor cardiovascular prognosis. ARH is also associated with increased risk of developing aortic valve stenosis. However, lomitapide, a microsomal triglyceride transfers protein inhibitor, may represent a new opportunity for the effective treatment of ARH.

Summary
ARH is an ultrarare disorder of LDL metabolism caused by mutations in the LDLRAP1 gene. It is inherited as a recessive trait and causative mutations, though heterogeneous, are all predicted to be loss-of-function. Recent investigations have demonstrated that ARH can be considered a phenocopy of homozygous familial hypercholesterolemia, where the risk of atherosclerotic cardiovascular diseases and aortic valve stenosis remains elevated despite conventional therapies. The combination of lomitapide with the conventional LDL-C-lowering medications appears to be a promising approach to treat this condition.
The transmanubrial osteomuscular-sparing approach: a valuable adjunct to the head and neck surgical armamentarium
Authors: Piazza Cesare , Duranti Leonardo , Giannini Lorenzo 
Published: February 2020

Purpose of review
To describe and popularize the transmanubrial osteomuscular-sparing approach (TOSA) outside its original thoracic surgical field of application, based on the consideration that it could be of interest for the management of a number of head and neck cases in both elective and emergent scenarios.

Recent findings
The main advantages of TOSA compared with transclavicular techniques are its superb exposure of anatomic structures located at the level of the cervicothoracic junction, and superior postoperative aesthetic and functional outcomes. Recently, a number of studies have described the association of TOSA with other minimally invasive approaches, such as video-assisted thoracoscopic surgery and robotic hybrid approaches, with the aim of avoiding association of the transmanubrial route with anterior/posterior thoracotomies, or more extended surgeries, such as the trapdoor or hemiclamshell procedures.

Summary
TOSA, even though originally conceived to reduce the morbidity ensuing from classic transclavicular approaches for management of Pancoast tumors, may well play an important role in a number of head and neck surgical conditions, including those related to mediastinal goiter and thyroid cancer, management of stenosis and lesions of the thoracic trachea and esophagus, treatment of the junction between innominate, internal jugular, and subclavian veins, epiaortic arteries, thoracic duct, brachial plexus, and low sympathetic chain. Whenever comprehensive control of vascular and nonvascular structures of the upper mediastinal inlet is required, TOSA should be planned and performed by combining the expertise of cooperating professionals.
From head and neck lipoma to liposarcoma: a wide spectrum of differential diagnoses and their therapeutic implications
Authors: Barisella Marta , Giannini Lorenzo , Piazza Cesare 
Published: February 2020

Purpose of review
To overview the array of differential diagnoses among lipomatous tumours of the head and neck with special focus on their evaluation, three-dimensional assessment, and their available treatments.

Recent findings
The head and neck is an infrequent localization for lipomatous tumours, even though they represent the most common mesenchymal lesions. Lipoma, spindle cell/pleomorphic lipoma (SC/PL), atypical lipomatous tumour/well differentiated liposarcoma (ALT/WDLPS), de-differentiated liposarcoma (DDLPS), myxoid liposarcoma (MLPS), and pleomorphic liposarcoma (PLPS) are the most distinctive histotypes. Lipoma and SC/PL present alterations of chromosomes 12 and 13, ALT/WDLPS and DDLPS both show the Mouse Double Minute 2 amplification, whereas MLPS presents a CHOP gene fusion. Diagnosis of PLPS is purely morphological as there is no pathognomonic genetic alteration identified to date. Radiological assessment can be challenging for the presence of nonadipose components within the lesion. Surgery is the mainstay of treatment, even though achieving true radicality in terms of a large cuff of healthy tissue surrounding the tumour is not always realistic in the head and neck. Adjuvant radiation, eventually in combination with systemic chemotherapy, has been shown to improve overall survival in patients with positive margins, high-grade, deep, and more than 5 cm lesions. Further studies should be aimed at the evaluation of the role of hadron therapy, as well as targeted drugs against overexpressed proteins.

Summary
Adequate differential diagnosis of the histotypes collected under the umbrella term of head and neck lipomatous tumours plays a fundamental role in treatment and follow-up of these lesions and requires specific expertise with referral to high-volume centres.
Perineural invasion in head and neck squamous cell carcinoma: background, mechanisms, and prognostic implications
Authors: Saidak Zuzana , Lailler Claire , Clatot Florian , Galmiche Antoine 
Published: February 2020

Purpose of review
Perineural invasion (PNI) is a pathological feature frequently observed in head and neck squamous cell carcinoma (HNSCC). The difficulties of pathological standardization and the lack of a simple validated experimental model to study PNI render its analysis complex. Here, we aim to summarize the recent advances in the understanding of the biology of PNI in HNSCC and their potential clinical implications.

Recent findings
PNI is a multistep process leading to a dialogue between cancer cells and nerve fibers in HNSCC. Recent studies have identified some of the active molecular mechanisms involved in PNI. Comprehensive studies addressing the transcriptional regulation of PNI bring interesting perspectives for a standardized molecular diagnosis of PNI and a better assessment of its contribution to the aggressiveness of HNSCC.

Summary
Perineural invasion is a complex process that reflects specific tumor biology. In addition to unveiling new fundamental concepts about the tumor microenvironment, research on PNI promises to identify new biomarkers, enabling progress in therapeutic development against HNSCC.
Controversies in the surgical management of sporadic medullary thyroid carcinoma
Authors: Fussey Jonathan Mark , Bradley Patrick J. , Smith Joel A. 
Published: February 2020

Purpose of review
Medullary thyroid carcinoma (MTC) represents a wide spectrum of tumours with differing biology, behaviour and natural history. The only current available curative treatment is surgery in the form of thyroidectomy with or without ipsilateral or bilateral neck dissection. There is a lack of consensus in the available published guidelines on the optimum extent of initial surgery, and there is significant variation in clinical practice. This review focuses on the most recently published evidence.

Recent findings
Many patients with limited disease do not receive total thyroidectomy and central neck compartment dissection as recommended by international guidelines. Despite this, 5-year disease-specific survival is over 90% in those without distant metastases at presentation. Over 20% of patients may harbour occult lateral compartment nodal metastases, and baseline calcitonin alone (>1000 pg/ml) is not a good predictor of nodal metastasis. Although delayed lateral neck compartment dissection results in similar survival outcomes to prophylactic neck dissection for clinically node-negative patients, there is an underappreciated psychological effect of having biochemical evidence of persistent disease following limited surgery.

Summary
No single currently available prognostic indicator is sufficient to predict disease behaviour and evidence of occult nodal metastases. In clinically ad radiologically node-negative patients, the extent of neck dissection at initial operation, therefore, needs to be planned and executed on an individual patient basis.