bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurocognitive, symptom, and health-related quality of life outcomes of a randomized trial of bevacizumab for newly diagnosed glioblastoma (NRG/RTOG 0825)
Authors: Wefel Jeffrey S , Armstrong Terri S , Pugh Stephanie L , Gilbert Mark R , Wendland Merideth M , Brachman David G , Roof Kevin S , Brown Paul D , Crocker Ian R , Robins H Ian , Hunter Grant , Won Minhee , Mehta Minesh P 
Published: January 2021

AbstractBackgroundResults of NRG Oncology RTOG 0825 reported adding bevacizumab to standard chemoradiation did not significantly improve survival endpoints and resulted in greater decline in neurocognitive function (NCF) and patient-reported outcomes (PRO) over time in bevacizumab-treated patients. The present report provides additional results of patient-centered outcomes over time and their prognostic association with survival endpoints.MethodsNCF tests, MD Anderson Symptom Inventory - Brain Tumor Module (MDASI-BT), and European Organization for Research and Treatment of Cancer (EORTC) quality of life (QOL) questionnaire with brain cancer module (QLQ-C30/BN20) were completed in a subset of progression-free patients at baseline and longitudinally. The prognostic value of baseline and early changes in NCF and PROs and differences between treatments from baseline to follow-up assessments were evaluated.ResultsA total of 508 randomized patients participated. Baseline/early changes in NCF and PROs were prognostic for OS and PFS. No between-arm differences in time to deterioration were found. At week 6, patients treated with bevacizumab evidenced greater improvement on NCF tests of executive function and the MDASI-BT Cognitive Function scale, but simultaneously reported greater decline on the EORTC Cognitive Function Scale. At later time points (weeks 22, 34, and 46), patients treated with bevacizumab had greater worsening on NCF tests as well as PRO measures of cognitive, communication, social function, motor symptoms, general symptoms, and interference.ConclusionThe collection of patient-centered clinical outcome assessments in this phase III trial revealed greater deterioration in NCF, symptoms, and QOL in patients treated with bevacizumab. Baseline and early change in NCF and PROs were prognostic for survival endpoints.
Pathology-proven extradural (“distant”) metastases of gliomas in adults in the Netherlands between 1971 and 2018: a systematic case series
Authors: den Hartog Sanne J , van der Kolk Anja , Bruggink Annette , Seute Tatjana , Wesseling Pieter , Wilbers Joyce 
Published: January 2021

Abstract

Background
Diffuse gliomas are the most frequent primary tumors originating in the central nervous system parenchyma. Although the majority of these tumors are highly malignant, extradural metastases (EDM) are extremely rare. We aimed to perform a systematic review of patients with pathology-proven EDM of diffuse gliomas in the Netherlands.

Methods
From the Nationwide Network and Registry of Histo- and Cytopathology in the Netherlands information on all cases with EDM between 1971 and October 2018 was retrieved. Patients aged &lt; 18 years or with a diagnosis of ependymoma or continuous tumor growth from intradural to extradural were excluded. Demographics, initial tumor diagnosis, treatment characteristics, location of the EDM, and survival data were collected. IDH1 R132H immunohistochemistry was performed on cases in which a paraffin block of the metastatic tumor could be retrieved.

Results
Twenty-five patients with diffuse glioma and pathology-proven EDM were identified. Median age at diagnosis of glioma was 46 years (IQR: 35-59); 21 patients (84%) were male. Histopathologic diagnosis was glioblastoma in 17 patients (68%) and lower-grade tumor in eight patients. In 3 out of 12 patients of which a paraffin block could be retrieved immunohistochemistry revealed an IDH1-mutant glioma. Most frequent EDM locations were bone/bone marrow (14/25 patients; 56%), and lymph nodes (6/25 patients; 24%).

Conclusion
EDM of diffuse glioma are rare. They occur most frequently in patients with glioblastoma, however, they can also originate from lower-grade, IDH-mutant gliomas. In daily practice, EDM of diffuse glioma should be considered in patients with tumefactive lesions of the bone or lymph nodes.
Natural Variation among Arabidopsis Accessions in the Regulation of Flavonoid Metabolism and Stress Gene Expression by Combined UV Radiation and Cold
Authors: Schulz Elisa , Tohge Takayuki , Winkler J Barbro , Albert Andreas , Schäffner Anton R , Fernie Alisdair R , Zuther Ellen , Hincha Dirk K 
Published: January 2021

AbstractPlants are constantly exposed to stressful environmental conditions. Plant stress reactions were mainly investigated for single stress factors. However, under natural conditions plants may be simultaneously exposed to different stresses. Responses to combined stresses cannot be predicted from the reactions to the single stresses. Flavonoids accumulate in Arabidopsis thaliana during exposure to UV-A, UV-B or cold, but the interactions of these factors on flavonoid biosynthesis were unknown. We therefore investigated the interaction of UV radiation and cold in regulating the expression of well-characterized stress-regulated genes, and on transcripts and metabolites of the flavonoid biosynthetic pathway in 52 natural Arabidopsis accessions that differ widely in their freezing tolerance. The data revealed interactions of cold and UV on the regulation of stress-related and flavonoid biosynthesis genes, and on flavonoid composition. In many cases, plant reactions to a combination of cold and UV were unique under combined stress and not predictable from the responses to the single stresses. Strikingly, all correlations between expression levels of flavonoid biosynthesis genes and flavonol levels were abolished by UV-B exposure. Similarly, correlations between transcript levels of flavonoid biosynthesis genes or flavonoid contents, and freezing tolerance were lost in the presence of UV radiation, while correlations with the expression levels of cold-regulated genes largely persisted. This may indicate different molecular cold acclimation responses in the presence or absence of UV radiation.
Income inequality and household debt as a factor of financial fragility in the Spanish economy
Authors: Medialdea García Bibiana , Sanabria Martín Antonio 
Published: January 2021

Abstract
After the last major financial crisis, there was much discussion about the idea that the increase in income inequality during the expansionary phase could have forced middle- and low-income groups to increasingly resort to indebtedness to finance their consumption. This debt-led consumption would have stimulated economic growth, but would also explain why it was not sustainable since families would have become more financially fragile. This approach, which we refer to as the ‘income inequality and debt-financed consumption as a cause of financial fragility hypothesis’, is based on empirical studies that mostly consider the US economy. In this article, we examine whether, as some of the literature suggests, this assumption is sufficient to explain the expansion and subsequent recession in the Spanish economy.
Race, Gender, Higher Education, and Socioeconomic Attainment: Evidence from Baby Boomers at Midlife
Authors: Conwell Jordan A , Quadlin Natasha 
Published: January 2021

AbstractThis article investigates White, Black, and Hispanic men’s and women’s access and midlife labor market returns to college quality. To do so, we use data from the National Longitudinal Survey of Youth-1979 Cohort (NLSY-79), merged with college quality information from the Barron’s Admissions Competitiveness Index. Although prior research has investigated similar dynamics in access and returns to higher education, this work typically excludes Hispanics and does not assess enrollments at community colleges and other less competitive colleges where Black and Hispanic enrollments tend to cluster. We find that Black–White and Hispanic–White differences in college quality, to Whites’ advantage, were fully explained or reversed once we accounted for differences in students’ backgrounds. At midlife, Hispanic and especially Black men had lower rates of labor force participation than White men who attended colleges of the same quality. Including such differences (i.e., years of no or part-time work) in assessing the earnings returns to college quality demonstrated striking disadvantages facing college-educated Black men relative to White men, which were not fully accounted for by background characteristics. Employment and earnings returns to college quality were not as disparate by race for women. Relative to White women, we find earnings advantages for Hispanic women among those who attended community colleges. This article demonstrates the utility of taking an intersectional and life course approach to the study of higher education and the economic returns to schooling.
Does the Presence of Spontaneous Components Affect the Reliability of Contralateral Suppression of Evoked Otoacoustic Emissions?
Authors: Jedrzejczak W. Wiktor , Pilka Edyta , Kochanek Krzysztof , Skarzynski Henryk 
Published: January 2021

Objectives:
The function of the medial olivocochlear system can be evaluated by measuring the suppression of otoacoustic emissions (OAEs) by contralateral stimulation. One of the obstacles preventing the clinical use of the OAE suppression is that it has considerable variability across subjects. One feature that tends to differentiate subjects is the presence or absence of spontaneous OAEs (SOAEs). The purpose of the present study was to investigate the reliability of contralateral suppression of transiently evoked OAEs (TEOAEs) measured using a commercial device in ears with and without SOAEs.

Design:
OAEs were recorded in a group of 60 women with normal hearing. TEOAEs were recorded with a linear protocol (identical stimuli), a constant stimulus level of 65 dB peSPL, and contralateral broadband noise (60 dB SPL) as a suppressor. Each recording session consisted of three measurements: the first two were made consecutively without taking out the probe (the “no refit” condition); the third measurement was made after taking out and refitting the probe (a “refit” condition). Global (for the whole signal) and half-octave band values of TEOAE response levels, signal-to-noise ratios (SNRs), raw dB TEOAE suppression, and normalized TEOAE suppression, and latency were investigated. Each subject was tested for the presence of SOAEs using the synchronized SOAE (SSOAE) technique. Reliability was evaluated by calculating the intraclass correlation coefficient, standard error of measurement (SEM) and minimum detectable change.

Results:
The TEOAE suppression was higher in ears with SSOAEs in terms of normalized percentages. However, when calculated in terms of decibels, the effect was not significant. The reliability of the TEOAE suppression as assessed by SEM was similar for ears with and without SSOAEs. The SEM for the whole dataset (with and without SSOAEs) was 0.08 dB for the no-refit condition and 0.13 dB for the refit condition (equivalent to 1.6% and 2.2%, respectively). SEMs were higher for half-octave bands than for global values. TEOAE SNRs were higher in ears with SSOAEs.

Conclusions:
The effect of SSOAEs on reliability of the TEOAE suppression remains complicated. On the one hand, we found that higher SNRs generally provide lower variability of calculated suppressions, and that the presence of SSOAEs favors high SNRs. On the other hand, reliability estimates were not much different between ears with and without SSOAEs. Therefore, in a clinical setting, the presence of SOAEs does not seem to have an effect on suppression measures, at least when testing involves measuring global or half-octave band response levels.
Multidisciplinary Treatment of a Pediatric Orbital Roof Fracture: Case Report and Literature Review
Authors: Shihadeh Hanaa , Willson Thomas D. 
Published: January 2021

Summary:
Pediatric orbital roof fractures are a relatively rare trauma. In children, fractures of the facial skeleton can be associated with significant morbidity. Potential complications of orbital roof fracture include both neurosurgical complications such as frontal lobe injury, dural tears, or herniation, and ophthalmologic and reconstructive surgery problems such as proptosis, diplopia, and extraocular muscle entrapment. In most cases, surgical intervention is unnecessary, as these fractures are minimally displaced. When surgery is warranted, however, for displaced fractures or those associated with complications, a multidisciplinary approach is often indicated. Here, we report a case of a 10-year-old boy with a superiorly displaced orbital roof fracture resulting from a bicycle brake handle injury. The primary fragment was intracranially displaced and embedded in the inferior frontal lobe, causing frontal lobe herniation and left globe proptosis. A transcranial approach was performed using an autologous bone graft. In our case, a multidisciplinary surgical approach facilitated repair of both the dural and orbital injuries and multi-layer separation of the 2 spaces.
Long-term Speech Outcomes of Cleft Palate Repair in Robin Sequence versus Isolated Cleft Palate
Authors: Logjes Robrecht J. H. , Upton Susanna , Mendelsohn Bryce A. , Badiee Ryan K. , Breugem Corstiaan C. , Hoffman William Y. , Pomerantz Jason H. 
Published: January 2021

Background:
Whether treatment of cleft palate (CP) associated with Robin sequence (RS) should attain outcomes similar to those of isolated cleft palate (ICP) remains unknown. This study compares treatment and outcomes in both conditions and delineates predictors of long-term outcome.

Methods:
This retrospective case series of consecutive syndromic and isolated RS- and ICP-patients (1990–2016) includes indications and outcomes of straight-line repair with intravelar veloplasty (SLIV) or Furlow repair depending on cleft and airway characteristics.

Results:
Seventy-five RS and 83 ICP patients underwent CP repair. Velopharyngeal insufficiency (VPI) occurred in 41% of RS versus 17% of ICP patients (P = 0.012), and in 60% of patients with syndromic RS versus 16% with isolated RS (P = 0.005). In multivariable logistic regression analysis, wider and more severe CP anatomy was the only factor independently associated with VPI (P = 0.028), in contrast to age at repair, syndromic RS compared with isolated RS, and isolated RS compared with ICP and initial tongue-lip adhesion. Secondary Furlow after primary SLIV was used to treat VPI in all groups, and more frequently in syndromic versus isolated RS patients (P = 0.025).

Conclusions:
Variability of RS anatomy and airway compromise necessitates individualized treatment protocols. Despite differing CP etiology and other variables, our findings demonstrate cleft anatomy as the only independent variable predictive of VPI comparing RS and ICP patients. Patients with isolated RS should ultimately attain similar VPI outcomes compared with ICP patients. Obstructive speech operations in RS patients can be avoided without compromising speech outcome by reserving the prsocedure for secondary cases.
Long-term Results of Microvascular Lymph Node Transfer: Correlation of Preoperative Factors and Operation Outcome
Authors: Rannikko Eeva H. , Suominen Sinikka H. , Saarikko Anne M. , Viitanen Tiina P. , Mäki Maija T. , Seppänen Marko P. , Suominen Erkki A. , Hartiala Pauliina 
Published: January 2021

Background:
Our objective was to analyze whether a correlation could be observed between preoperative factors and microvascular lymph node transfer outcome after long-term follow-up.

Methods:
We included 67 patients in this retrospective case series. The incidence of cellulitis, the difference of arm circumference, the use of the compression garments both preoperatively and postoperatively, and subjective symptoms, such as pain, were analyzed. Volumetry and lymphoscintigraphy results were also analyzed in a subgroup of patients. We correlated preoperative factors with postoperative results.

Results:
After 70 ± 17 months of follow-up, 42% of the patients were able to discontinue the use of compression garments. The subjective pain symptoms were reduced in 75% of the patients. The incidence of cellulitis was reduced from preoperative 0.20 ± 0.55/y to postoperative 0.02 ± 0.08/y. As a novel finding, the patients with preoperative cellulitis were more likely to continue the use of the compression garments.

Conclusions:
The surgery is beneficial to most studied lymphedema patients, although it is not the cure for all patients. The incidence of cellulitis was reduced, and further, the presence of preoperative cellulitis seems to affect the outcome of the operation.
Comparing Surgical Site Occurrences in 1 versus 2-stage Breast Reconstruction via Federated EMR Network
Authors: Singh Devinder , Slavin Benjamin R. , Holton Tripp 
Published: January 2021

Background:
TriNetX (TriNetX Inc., Cambridge, Mass.) is a federated electronic medical record network. The TriNetX system conducts customized search queries of over 36 million electronic medical records, and returns results in just minutes. To our group’s knowledge, TriNetX has not been previously used in plastic surgery research. This study aimed to utilize a continuously updated federated network of 36,000,000 electronic medical records (TriNetX) for comparing 90-day postoperative outcomes between prosthetic breast reconstruction techniques.

Methods:
Using TriNetX, we analyzed the records of approximately 36 million patients in 31 health care organizations. The de-identified records of 18,744,519 women (age 18–9) were retrospectively screened. A cohort of 4747 patients with a diagnosis of malignant neoplasm of the breast, any stage, having undergone mastectomy, and breast reconstruction with tissue expander was compared with a second cohort of 870 patients diagnosed with malignant neoplasm of the breast, any stage, mastectomy, and immediate insertion of breast implant following mastectomy. Surgical site occurrences occurring within 90 days postoperatively were compared using propensity score matching.

Results:
Propensity score matching resulted in 870 patients in both well-balanced cohorts. There were no statistically significant differences between the balanced cohorts with respect to 90-day surgical site occurrences.

Conclusions:
TriNetX enables data-driven clinical research such as retrospective cohort comparison. During the 90-day postoperative period, there were fewer complications noted in the single-stage cohort for all outcomes studied; although this comparison was not statistically significant, we believe it demonstrates a clinically significant finding that single-stage direct-to-implant is at least as safe as the more complicated 2-stage approach.
A Sustainable Approach to Prepectoral Breast Reconstruction Using Meshed Acellular Dermal Matrix
Authors: McCullough Meghan C. , Vartanian Emma , Andersen James , Tan Mark 
Published: January 2021

Background:
Prepectoral implant-based breast reconstruction provides an alternative to submuscular reconstruction, but the increased acellular dermal matrix (ADM) required has the potential to lead to increased costs and decreased supply of this limited-resource material. We present a method for prepectoral reconstruction utilizing skin-graft meshing techniques to increase the surface area of usable ADM.

Methods:
Forty-four patients underwent this technique from February 2019 to February 2020. Patient characteristics, operative details, and outcomes, including complications and patient satisfaction utilizing the BREAST-Q, were analyzed. Cost analysis relative to projected cost of nonmeshed techniques was performed.

Results:
There were 20 unilateral and 24 bilateral procedures, for a total of 68 breast reconstructions. Mean age was 45.9 years (32–71). Mean implant volume was 485 cm3 (265–800), and one sheet of ADM was used for each breast with an average surface area of 161 cm2. Median follow-up was 350 days (212–576). Minor complications included an infection treated with oral antibiotics. Major complications included one axillary hematoma and one delayed implant loss. One patient underwent revision for asymmetry. Mean BREAST-Q score was 47.4/60. Cost ranged from $4113 to 5025 per breast, compared with the projected $9125–18250 per breast for other techniques in the literature.

Conclusions:
In contrast to previously described uses of ADM in prepectoral reconstruction, meshing maximizes resource utilization by expanding the coverage of a single sheet. Early findings demonstrate minimal complications and high patient satisfaction, suggesting the approach has potential to provide the benefits of prepectoral reconstruction while responsibly preserving product availability and tempering healthcare costs.
Congenital Insensitivity to Pain: A Case Report With Corneal Esthesiometry and In Vivo Confocal Microscopy
Authors: Keenan Jeremy D. , Gonzales John A. , Waxman Stephen G. , Delwig Anton 
Published: January 2021

Purpose:
To report the findings of a comprehensive eye examination from an individual with congenital insensitivity to pain because of loss-of-function mutations in the SCN9A gene.

Methods:
Ophthalmologic examination and confocal microscopy were performed on a patient with congenital insensitivity to pain.

Results:
A 39-year-old man with compound heterozygous mutations in the SCN9A gene underwent examination. Cochet–Bonnet esthesiometry readings averaged 38 mm (SD 8 mm) in the right eye and 55 mm (SD 7 mm) in the left eye. Other corneal findings included mild conjunctival lissamine green staining, nonvisually significant corneal scars, mild anterior basement membrane dystrophy, and a tear breakup time of 3 seconds in each eye. In vivo confocal microscopy of the corneal subbasal nerve plexus revealed relatively normal corneal nerve morphology, but a reduction in corneal nerve fiber density.

Conclusions:
An individual with loss-of-function mutations in SCN9A had reduced corneal nerve fiber density but normal corneal mechanoreception.
Diffuse Lamellar Keratitis in a Patient Undergoing Collagen Corneal Cross-Linking 18 Years After Laser In Situ Keratomileusis Surgery
Authors: Grassmeyer Justin J. , Goertz John G. , Baartman Brandon J. 
Published: January 2021

Purpose:
To report a case of diffuse lamellar keratitis (DLK) after corneal collagen cross-linking in an eye with a remote history of laser in situ keratomileusis (LASIK) surgery.

Methods:
This is a case report and literature review.

Results:
This report describes the development of unilateral stage IV DLK in a patient who underwent bilateral corneal cross-linking for corneal ectasia 18 years after LASIK surgery. The patient was treated with high-dose topical steroids that were tapered over 1 month and multiple flap lifts. The ultimate best-corrected visual outcome was 20/60.

Conclusions:
DLK is a potential sight-threatening complication of refractive surgery that can occur at any time in the postoperative period, even years after the procedure. Undergoing a subsequent corneal procedure that may disrupt or promote inflammation within the surgical flap–stromal interface, such as corneal collagen cross-linking, is a recognized risk factor for the development of DLK. This case suggests that patients with any history of LASIK surgery undergoing corneal cross-linking or other lamellar corneal surgeries may benefit from closer follow-up (eg, daily) than patients with no history of LASIK.