bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extranodal Extension as an Indicator for Sinonasal Squamous Cell Carcinoma Prognosis
Authors: Tseng Christopher C. , Gao Jeff , Barinsky Gregory L. , Fang Christina H. , Grube Jordon G. , Eloy Jean Anderson , Hsueh Wayne Daniel 
Published: February 2021

ObjectiveAlthough extranodal extension (ENE) is a known indicator of poor prognosis for head and neck malignancies, its value as an indicator for sinonasal squamous cell carcinoma (SCC) has not been well characterized. This study seeks to assess the usefulness of ENE as a prognostic marker for sinonasal SCC.Study DesignRetrospective database review.SettingNational Cancer Database from 2010 to 2015.MethodsThe National Cancer Database was queried from 2010 to 2015 for all patients with sinonasal SCC with available ENE status (n = 355). These cases were divided into those with pathologically confirmed ENE (n = 146) and those without ENE (n = 209). Univariate and multivariate analyses were used to examine survival differences and predictors of ENE status.ResultsMost patients with ENE were ≥60 years old (61.7%), male (61.6%), and white (83.6%). Patients aged 60 to 69 and 80+ years were more likely to have ENE than those under 60 years (P <. 05). Patients with ENE had worse 1‐year overall survival than those without ENE (58.2% vs 70.8%, log‐rank P =. 008). After multivariate regression, however, there was no survival difference detected between ENE‐positive and ENE‐negative cases (hazard ratio, 1.14 [0.775‐1.672], P =. 508).ConclusionENE status did not have a significant effect on survival in patients with sinonasal SCC. Thus, ENE alone may not necessarily be a helpful indicator for sinonasal SCC prognosis.
Outcomes in Revision Stapes Surgery
Authors: Schwam Zachary G. , Schettino Amy , Babu Seilesh C. , Bojrab Dennis I. , Michaelides Elias M. , Schutt Christopher A. 
Published: February 2021

ObjectivesTo compare audiometric outcomes and complication rates between primary and revision stapes surgical cases.Study DesignRetrospective cohort study.SettingLarge single‐institution database.MethodsData on 809 patients (including 170 revisions) undergoing primary and revision stapes surgery were reviewed, with Pearson chi‐square and multivariable logistic regression analysis performed.ResultsRates of postoperative air‐bone gap (ABG) closure to ≤10 dB were significantly worse in the revision group (40.2% vs 61.8%, P <. 001), as were those to ≤20 dB (78.1% vs 90.9%, P <. 001). The bone conduction pure tone average worsened by >10 dB in 7.1% of primary cases and 13.1% of revisions (P =. 016). The mean postoperative ABG for revision cases was significantly higher at 15.5 dB as compared with 11.0 dB for primaries (P <. 001), despite a slightly higher preoperative ABG for primary cases (30.6 vs 28.24 dB, P =. 010). In multivariate analysis, revision surgery had an odds ratio 0.41 (P <. 001) in closing the ABG to ≤10 dB. Postoperative reparative granuloma (2.4% vs 0.2%, P =. 001) and hydrops (1.8% vs 0.2%, P =. 008) were higher in revision cases.ConclusionsRevision stapes surgery was found to have less predictable and inferior results as compared with primary cases.Level of Evidence:4 (retrospective observational research).
Blood cell adhesion to arterial filters analysis by scanning electron microscopy and real-time PCR assay: observational clinical study in cardiac surgery patients
Authors: Gatto Chiara Scaglioni Tessmer , Piccioni Marilde Albuquerque , Strunz Celia Maria Cassaro , Cestari Idágene Aparecida , Cunha Ligia Cristina Camara , Roggerio Alessandra , Silva Vanessa Monteiro da , Zuccato Maria Cecilia Freire , Cortella Lucas Ribeiro Xavier , Kakoi Adélia Aparecida Yuka , Jatene Fabio Biscegli , Auler Junior José Otavio Costa , Galas Filomena Regina Barbosa Gomes 
Published: February 2021

Introduction: Arterial filter is the part of the cardiopulmonary bypass circuit where blood cells are exposed to high mechanical stress and where cellular aggregates may fasten in large quantities. The aim of this study was to analyse blood cell adhesiveness in the arterial filter through scanning electron microscopy and real-time PCR assay. Methods: Prospective, clinical and observational study performed on 28 patients undergoing cardiac surgery with cardiopulmonary bypass. Arterial filters were analysed by scanning electron microscopy. Real-time PCR assay was performed in extracted material from the arterial filters for analysis of platelet GPIb and CD45 leucocyte gene expression. Blood coagulation was analysed during cardiopulmonary bypass. Patients were followed until hospital discharge or 28 days after surgery. Results: All studied arterial filters used in the subject patients showed a degree of adhesion from blood elements at scanning electron microscopy. All studied filters were positive for platelets GPIb gene expression and 15% had CD45 leucocyte gene expression. The GPIb platelet gene expression in blood lowered at the end of cardiopulmonary bypass ( p = 0.019). There was negative correlation between blood GPIb platelet gene expression and Clot SR (HEPSCREEN2 ReoRox®) (rho = 0.635; p = 0.027). The filter fields count was correlated to the D-dimer dosage (rho = 0.828; p < 0.001). Conclusion: There was adhesion of blood elements, especially nucleated platelets, on all arterial filters studied. Although the arterial filter worked as a safety device, that possibly prevented arterial embolisation, it may also have caused greater hyperfibrinolysis during cardiopulmonary bypass.
Effect of liraglutide on neural and peripheral markers of metabolic function during antipsychotic treatment in rats
Authors: Babic Ilijana , Sellers Dominic , Else Paul L , Nealon Jessica , Osborne Ashleigh L , Pai Nagesh , Weston-Green Katrina 
Published: February 2021

Background: Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist that prevents metabolic side effects of the antipsychotic drugs (APDs) olanzapine and clozapine through unknown mechanisms. Aim: This study aimed to investigate the effect of chronic APD and liraglutide co-treatment on key neural and peripheral metabolic signals, and acute liraglutide co-treatment on clozapine-induced hyperglycaemia. Methods: In study 1, rats were administered olanzapine (2 mg/kg), clozapine (12 mg/kg), liraglutide (0.2 mg/kg), olanzapine + liraglutide co-treatment, clozapine + liraglutide co-treatment or vehicle for six weeks. Feeding efficiency was examined weekly. Examination of brain tissue (dorsal vagal complex (DVC) and mediobasal hypothalamus (MBH)), plasma metabolic hormones and peripheral (liver and kidney) cellular metabolism and oxidative stress was conducted. In study 2, rats were administered a single dose of clozapine (12 mg/kg), liraglutide (0.4 mg/kg), clozapine + liraglutide co-treatment or vehicle. Glucose tolerance and plasma hormone levels were assessed. Results: Liraglutide co-treatment prevented the time-dependent increase in feeding efficiency caused by olanzapine, which plateaued by six weeks. There was no effect of chronic treatment on melanocortinergic, GABAergic, glutamatergic or endocannabionoid markers in the MBH or DVC. Peripheral hormones and cellular metabolic markers were unaltered by chronic APD treatment. Acute liraglutide co-treatment was unable to prevent clozapine-induced hyperglycaemia, but it did alter catecholamine levels. Conclusion: The unexpected lack of change to central and peripheral markers following chronic treatment, despite the presence of weight gain, may reflect adaptive mechanisms. Further studies examining alterations across different time points are required to continue to elucidate the mechanisms underlying the benefits of liraglutide on APD-induced metabolic side effects.
Point-of-care measurement of clozapine concentration using a finger-stick blood sample
Authors: Taylor David , Atkins Matthew , Harland Robert , Baburina Irina , MacCabe James H , Salamone Salvatore J , McGuire Philip 
Published: February 2021

Background: The use of clozapine demands regular monitoring of clozapine plasma concentrations and of white blood cell parameters. The delay between sending blood samples for analysis and receiving the results hinders clinical care. Point-of-care testing (POCT) can provide drug assay results within a few minutes. Aim: This study aimed to investigate the utility of a novel point-of-care device that can measure clozapine concentrations using capillary blood samples collected via a finger stick. Method: During a five-week period starting in June 2019 eligible patients were asked to provide a finger-stick capillary sample in addition to their usual venous blood sample. Samples were analysed by the novel point-of-care device and by the standard laboratory method. Capillary blood samples were tested by the MyCare™ Insite POCT analyser, and a quantitative measurement of clozapine concentration was provided within six minutes. Results: A total of 309 patients agreed to measurements by the two methods. Analysis revealed clozapine concentrations in venous blood as determined by the laboratory method ranged from 20 to 1310 ng/mL and by POCT from 7 to 1425 ng/mL. There was a strong positive correlation ( R = 0.89) between the results from the venous and the capillary sample methods. The slope of the association between standard assay and MyCare™ Insite was 1.0 with an intercept of –21 ng/mL, indicating minimal bias. Conclusion: Clozapine concentrations can be accurately measured at the point of care using capillary blood samples collected via a finger stick. This approach may be more acceptable than venous sampling to patients and, with almost instant results available, more useful to clinicians.
Applied Methods for Estimating Transition Probabilities from Electronic Health Record Data
Authors: Rodriguez Patricia J. , Ward Zachary J. , Long Michael W. , Austin S. Bryn , Wright Davene R. 
Published: February 2021

Background Electronic health record (EHR) data contain longitudinal patient information and standardized diagnostic codes. EHR data may be useful for estimating transition probabilities for state-transition models, but no guidelines exist on appropriate methods. We applied 3 potential methods to estimate transition probabilities from EHR data, using pediatric eating disorders (EDs) as a case study. Methods We obtained EHR data from PEDsnet, which includes 8 US children’s hospitals. Data included inpatient, outpatient, and emergency department visits for all patients with an ED. We mapped diagnoses to 3 ED health states: anorexia nervosa, bulimia nervosa, and other specified feeding or eating disorder. We estimated 1-y transition probabilities for males and females using 3 approaches: simple first-last proportions, a multistate Markov (MSM) model, and independent survival models. Results Transition probability estimates varied widely between approaches. The first-last proportion approach estimated higher probabilities of remaining in the same health state, while the MSM and independent survival approaches estimated higher probabilities of transitioning to a different health state. All estimates differed substantially from published literature. Limitations As a source of health state information, EHR data are incomplete and sometimes inaccurate. EHR data were especially challenging for EDs, limiting the estimation and interpretation of transition probabilities. Conclusions The 3 approaches produced very different transition probability estimates. Estimates varied considerably from published literature and were rescaled and calibrated for use in a microsimulation model. Estimation of transition probabilities from EHR data may be more promising for diseases that are well documented in the EHR. Furthermore, clinicians and health systems should work to improve documentation of ED in the EHR. Further research is needed on methods for using EHR data to inform transition probabilities.
Using Narratives to Correct Forecasting Errors in Pediatric Tracheostomy Decision Making
Authors: Yan Haoyang , Deldin Patricia J. , Kukora Stephanie K. , Arslanian-Engoren Cynthia , Pituch Kenneth , Zikmund-Fisher Brian J. 
Published: February 2021

Purpose Parents who face goals-of-care tracheostomy decisions may lack an understanding of challenges affecting their child’s and family’s long-term quality of life (QOL) to accurately forecast possible outcomes for decision making. We sought to examine whether and how parents’ narratives of the child’s and family’s long-term QOL influence parental tracheostomy decisions and forecasting. Method We recruited US adult Amazon Mechanical Turk participants ( N = 1966) who self-reported having a child (<6 y old) or planning a pregnancy within 5 y. Participants read a vignette about making a tracheostomy decision for their hypothetical neurologically impaired baby. They were randomized to 1 of the following 4 conditions: 1) Baby QOL narratives, 2) Family QOL narratives, 3) Baby QOL + Family QOL narratives, and 4) control: no narratives. They then made a decision about whether or not to pursue tracheostomy, forecasted their concerns about the baby’s and family’s QOL, reported their values and social norm beliefs about tracheostomy, comfort care, and parental medical decision making, and completed individual differences scales and demographics. Results Controlling for individual characteristics, participants in the Baby QOL and Baby QOL + Family QOL conditions were less likely to choose tracheostomy as compared with the control (odds ratio [OR] = 0.38 and 0.25, respectively, P < 0.001). Fewer participants in the Family QOL condition chose tracheostomy compared with the control, but this difference was not statistically significant (OR = 0.70, P = 0.11). Moreover, narratives increased pessimistic forecasting, which was associated with less interest in tracheostomy. Conclusion Narratives clarifying long-term implications of pursuing tracheostomy have the potential to influence forecasting and decisions. Narrative-based interventions may be valuable in other situations in which forecasting errors are common.
An independent poor-prognosis subtype of hepatocellular carcinoma based on the tumor microenvironment
Authors: Wang Junfeng , Lou Jianying , Fu Lei , Jin Qu 
Published: February 2021

Background Hepatocellular carcinoma (HCC) is a highly malignant tumor with a particularly poor prognosis. The tumor microenvironment (TME) is closely associated with tumorigenesis, progression, and treatment. However, the relationship between TME genes and HCC patient prognosis is poorly understood. Methods In this study, we identified two prognostic subtypes based on the TME using data from The Cancer Genome Atlas and Gene Expression Omnibus. The Microenvironment Cell Populations-counter method was used to evaluate immune cell infiltration in HCC. Differentially expressed genes between molecular subtypes were calculated with the Limma package, and clusterProfiler was used for Gene Ontology and Kyoto Encyclopedia of Genes and Genomes functional enrichment analyses to identify genes related to the independent subtypes. We also integrated mRNA expression data into our bioinformatics analysis. Results We identified 4227 TME-associated genes and 640 genes related to the prognosis of HCC. We defined two major subtypes (Clusters 1 and 2) based on the analysis of TME-associated gene expression. Cluster 1 was characterized by increased expression of immune-associated genes and a worse prognosis than Cluster 2. Conclusions The identification of these HCC subtypes based on the TME provides further insight into the molecular mechanisms and prediction of HCC prognosis.
Early treatment with sumatriptan prevents PACAP38-induced migraine: A randomised clinical trial
Authors: Wienholtz Nita Katarina Frifelt , Christensen Casper Emil , Zhang Ditte Georgina , Coskun Hande , Ghanizada Hashmat , Al-Karagholi Mohammad Al-Mahdi , Hannibal Jens , Egeberg Alexander , Thyssen Jacob P , Ashina Messoud 
Published: February 2021

Objective To determine whether early treatment with sumatriptan can prevent PACAP38-induced migraine attacks. Methods A total of 37 patients with migraine without aura were enrolled between July 2018 to December 2019. All patients received an intravenous infusion of 10 picomole/kg/min of PACAP38 over 20 min followed by an intravenous infusion of 4 mg sumatriptan or placebo over 10 min on two study days in a randomised, double-blind, placebo-controlled, crossover study. Results Of 37 patients enrolled, 26 (70.3%) completed the study and were included in analyses. Of the 26 patients, four (15%) developed a PACAP38-induced migraine attack on sumatriptan and 11 patients (42%) on placebo ( p = 0.016). There were no differences in area under the curve for headache intensity between sumatriptan (mean AUC 532) and placebo (mean AUC 779) ( p = 0.35). Sumatriptan significantly constricted the PACAP38-dilated superficial temporal artery immediately after infusion (T30) compared with infusion of placebo ( p < 0.001). Conclusions and relevance: Early treatment with intravenously administered sumatriptan prevented PACAP38-induced migraine. Prevention of migraine attacks was associated with vasoconstriction by sumatriptan in the earliest phases of PACAP provocation. These results suggest that sumatriptan prevents PACAP38-induced migraine by modulation of nociceptive transmission within the trigeminovascular system. Trial Registration: ClinicalTrials.gov (NCT03881644).
Effect of comorbid migraine on propranolol efficacy for painful TMD in a randomized controlled trial
Authors: Tchivileva Inna E , Ohrbach Richard , Fillingim Roger B , Lim Pei Feng , Giosia Massimiliano Di , Ribeiro-Dasilva Margarete , Campbell John H , Hadgraft Holly , Willis Janet , Arbes Samuel J , Slade Gary D 
Published: February 2021

Introduction The migraine-preventive drug propranolol is efficacious in reducing pain from temporomandibular disorder, suggesting potential modifying or mediating effects of comorbid migraine. Methods In this randomized controlled trial, myofascial temporomandibular disorder patients were treated with propranolol or placebo for 9 weeks. The primary endpoint was change in a facial pain index derived from daily symptom diaries. Linear and logistic regression models tested for a migraine × treatment-group interaction in reducing facial pain index. Counterfactual models explored changes in headache impact and heart rate as mediators of propranolol's efficacy. Results Propranolol's efficacy in reducing facial pain index was greater among the 104 migraineurs than the 95 non-migraineurs: For example, for the binary ≥ 30% reduction in facial pain index, odds ratios were 3.3 (95% confidence limits: 1.4, 8.1) versus 1.3 (0.5, 3.2), respectively, although the interaction was statistically non-significant ( p = 0.139). Cumulative response curves confirmed greater efficacy for migraineurs than non-migraineurs (differences in area under the curve 26% and 6%, respectively; p = 0.081). While 9% of the treatment effect was mediated by reduced headache impact, 46% was mediated by reduced heart rate. Conclusions Propranolol was more efficacious in reducing temporomandibular disorder pain among migraineurs than non-migraineurs, with more of the effect mediated by reduced heart rate than by reduced headache impact. Study identification and registration SOPPRANO; NCT02437383; https://clinicaltrials.gov/ct2/show/NCT02437383
Combination of acupuncture and medical training therapy on tension type headache: Results of a randomised controlled pilot study
Authors: Schiller Joerg , Karst Matthias , Kellner Tim , Zheng Wen , Niederer Daniel , Vogt Lutz , Eckhardt Isabelle , Beissner Florian , Korallus Christoph , Sturm Christian , Egen Christoph , Gutenbrunner Christoph , Fink Matthias Georg 
Published: February 2021

Objectives The aim of this study was to compare the effects of acupuncture and medical training therapy alone and in combination with those of usual care on the pain sensation of patients with frequent episodic and chronic tension-type headache. Design This was a prospective single-centre randomised controlled trial with four balanced treatment arms. The allocation was carried out by pre-generated randomisation lists in the ratio 1:1:1:1 with different permutation block sizes. Setting The study was undertaken in the outpatient clinic of Rehabilitation Medicine of the Hannover Medical School. Participants and interventions: Ninety-six adult patients with tension-type headache were included and randomised into usual care (n = 24), acupuncture (n = 24), medical training (n = 24), and combination of acupuncture and medical training (n = 24). One patient was excluded from analysis because of withdrawing her/his consent, leaving 95 patients for intention to treat analysis. Each therapy arm consisted of 6 weeks of treatment with 12 interventions. Follow-up was at 3 and 6 months. Main outcome measures Pain intensity (average, maximum and minimum), frequency of headache, responder rate (50% frequency reduction), duration of headache and use of headache medication. Clinical results: The combination of acupuncture and medical training therapy significantly reduced mean pain intensity compared to usual care (mean = −38%, standard deviation = 25%, p = 0.012). Comparable reductions were observed for maximal pain intensity (−25%, standard deviation = 20%, 0.014) and for minimal pain intensity (−35%, standard deviation = 31%, 0.03). In contrast, neither acupuncture nor medical training therapy differed significantly from usual care. No between-group differences were found in headache frequency, mean duration of headache episodes, and pain medication intake. At 3 months, the majority of all patients showed a reduction of at least 50% in headache frequency. At 6 months, significantly higher responder rates were found in all intervention groups compared to usual care. Conclusions In contrast to monotherapy, only the combination of acupuncture and medical training therapy was significantly superior in reduction of pain intensity compared to usual care. Trial registration: Registered on 11 February 2019. German Clinical Trials Register, DRKS00016723.