bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical Predictors of Favorable Postoperative Outcomes in Patients Undergoing Laminectomy or Laminotomy for Central Lumbar Spinal Stenosis: Secondary Analysis of a Randomized Controlled Trial
Authors: Marchand Andrée-Anne , Houle Mariève , O'Shaughnessy Julie , Châtillon Claude-Édouard , Descarreaux Martin 
Published: April 2022

Study DesignSecondary analysis of a randomized controlled trial.ObjectiveTo identify preoperative physical variables associated with favorable postoperative outcome in individuals undergoing laminectomy or laminotomy for degenerative central lumbar spinal stenosis.Summary of Background DataClinical or condition specific variables have most commonly been studied as predictors of postoperative outcome in lumbar spinal stenosis. If associated to favorable postoperative outcome, modifiable physical variables would inform prehabilitation interventions for patients with degenerative central lumbar spinal stenosis.MethodsPatients awaiting surgery for central lumbar spinal stenosis were recruited to participate in a randomized controlled trial. Following baseline data collection of demographics, clinical portrait and physical testing, participants were randomized to either 6-week active prehabilitation program or hospital standard care. Complete baseline and postoperative data were obtained from 58 participants which were included in the present analysis. Favorable postoperative outcome was determined based on two outcome measures. Favorable outcome was defined as a decrease of ≥30% on the Numerical Rating Scale for leg pain intensity and a decrease of ≥30% on the Oswestry Disability Index for low back disability. Baseline physical variables were used to conduct binary logistic regression.ResultsSixty percent of participants were determined as having a favorable postoperative outcome. None of the included physical variables were found to be predictors of a favorable postoperative outcome based on leg pain intensity and low back pain-associated disability [trunk flexors muscle strength (OR = 0.73; 95%CI (0.02–27.12)] lumbar extensors muscle endurance [OR= 1.09; 95%CI (0.95–1.24)] total ambulation time [OR = 1.00 95%CI (0.99–1.01)] lumbar active range of motion in extension [OR = 1.08; 95%CI (0.95–1.23)] and knee extensors muscle strength [OR=1.02; 95%CI (0.98–1.06)].ConclusionResults show that none of the investigated variables, all related to low back and lower limbs physical capacity, were predictors of postoperative recovery. Further testing in larger cohort is needed to assess the full potential of physical outcome measures as predictors of postoperative recovery.
Association of Blood Pressure Within 6 h After Endovascular Thrombectomy and Functional Outcomes in Ischemic Stroke Patients With Successful Recanalization
Authors: Zhang Xuening , Cui Ting , Zhu Qiange , Wang Changyi , Wang Anmo , Yang Yuan , Li Shucheng , Hu Fayun , Wu Bo 
Published: April 2022

Background and PurposeBlood pressure in the days following endovascular thrombectomy (EVT) can influence functional outcomes of patients who have suffered an acute ischemic stroke, but whether the same is true of blood pressure during the first few hours after EVT is unclear.MethodsSeveral blood pressure parameters were retrospectively analyzed in acute ischemic stroke patients who underwent EVT at West China Hospital from March 2016 to December 2019. Baseline blood pressure, speed of blood pressure reduction, postoperative blood pressure, degree of blood pressure reduction, and quality of blood pressure management were evaluated during the first 24 h after EVT. We explored whether these parameters during different time windows correlated significantly with patients' modified Rankin Scale (mRS) score at 90 days.ResultsAnalysis of 163 patients showed that poor functional outcome (mRS scores 3–6) correlated significantly with higher postoperative blood pressure and worse blood pressure management during the first 6 h after EVT. Postoperative systolic blood pressure at 37 min after EVT was significantly higher in patients with poor outcome (141 mmHg) than in those with good outcome (mRS scores 0–2; 122 mmHg, p = 0.006), and systolic pressure &gt;136 mmHg at this time point was associated with a significantly higher risk of poor outcome, before and after adjusting for other risk factors (adjusted OR 0.395, 95% CI 0.20–0.79).ConclusionsAmong acute ischemic patients who successfully undergo recanalization, adequate blood pressure management during the first 30–40 min after EVT may be important for ensuring good 90-day functional outcomes.
A Randomized, Double-Blind, Sham-Controlled Trial of Transcranial Direct Current Stimulation for the Treatment of Persistent Postural-Perceptual Dizziness (PPPD)
Authors: Im Jooyeon Jamie , Na Seunghee , Kang Sanghoon , Jeong Hyeonseok , Lee Eek-Sung , Lee Tae-Kyeong , Ahn Woo-Young , Chung Yong-An , Song In-Uk 
Published: April 2022

BackgroundPersistent postural-perceptual dizziness (PPPD) is a functional vestibular disorder that causes chronic dizziness interfering with daily activities. Transcranial direct current stimulation (tDCS) has reportedly improved dizziness in patients with phobic postural vertigo in an open-label trial. However, no randomized, double-blind, sham-controlled study has been conducted on its therapeutic efficacy in PPPD.ObjectiveThis study was conducted to investigate the efficacy and safety of tDCS as an add-on treatment to pharmacotherapy in patients with PPPD. In addition, functional neuroimaging was used to identify the neural mechanisms underlying the effects of tDCS.Materials and MethodsIn a randomized, double-blind, sham-controlled trial, 24 patients diagnosed with PPPD were randomized to receive active (2 mA, 20 min) or sham tDCS to the left dorsolateral prefrontal cortex (DLPFC), administered in 15 sessions over 3 weeks. The clinical measures that assess the severity of dizziness, depression, and anxiety were collected at baseline, immediate follow-up, 1-month follow-up, and 3-month follow-up. Adverse events were also observed. The effect of tDCS on regional cerebral blood flow (rCBF) was evaluated with single photon emission tomography before and after tDCS sessions.ResultsFor the primary outcome measure of the Dizziness Handicap Inventory (DHI) score, a significant main effect of time was found, but neither the treatment-by-time interaction effect nor the main effect of treatment was significant. For the Hamilton Depression Rating Scale (HDRS) score, there was a statistical significance for the treatment-by-time interaction effect and the main effect of time, but not for the main effect of treatment. However, the treatment-by-time interaction effect and the main effect of time on HDRS score appear to be due to one data point, an increase in depressive symptoms reported by the sham group at the 3-month follow-up. For the Activities-specific Balance Confidence (ABC) Scale and the Hamilton Anxiety Rating Scale scores, there were no significant main effects of time, treatment, and treatment-by-time interaction. In a comparison with the changes in rCBF between the groups, a significant treatment-by-time interaction effect was found in the right superior temporal and left hippocampus, controlling for age and sex.ConclusionActive tDCS was not found to be significantly more efficacious than sham tDCS on dizziness symptoms in patients with PPPD. It is conceivable that tDCS targeting the DLPFC may not be an optimal treatment option for reducing dizziness symptoms in PPPD. Our findings encourage further investigation on the effects of tDCS in PPPD, which considers different stimulation protocols in terms of stimulation site or the number of sessions.Clinical Trial Registrationcris.nih.go.kr, identifier: KCT0005068.
An Exponential Curve Relationship Between Serum Urate and Migraine: A Cross-Section Study From NHANES
Authors: Hong Peiwei , Liu Yao , Wan Yang , Xiong Hai , Xu Yanming 
Published: April 2022

BackgroundMigraine is a common neurological disease and an important cause of disability worldwide. Serum urate is the end product of purine metabolism in Homo sapiens and other hominoids. Previous studies about the serum urate level in migraine were contradictory. Hence, we present a cross-section study to clarify the association between serum urate and migraine and explore the dose effect of serum urate on migraine.Materials and MethodsThe data for this cross-section study were acquired from the National Health and Nutrition Examination Survey (NHANES). A diagnosis of migraine was made through patient the self-reported and prescription medication. For data analysis, the weighted linear regression model, weighted chi-square test, logistic regression models, smooth curve fittings, and the two-piecewise linear regression model were utilized for data analysis. All data analysis was conducted on Empower software.ResultsTotally, 18,637 participants were enrolled in this study, of which 208 were migraineurs. The rest were set as control. There existed a statistically significant difference in mean age (p = 0.0389), gender (p&lt; 0.0001), race (p&lt; 0.0001), data release cycle (p = 0.048), drug usage, blood albumin (p&lt; 0.0001), blood total protein (p&lt; 0.0001), hemoglobin (p&lt; 0.0001), serum iron (p&lt; 0.0001), and serum urate (p&lt; 0.0001) between the two groups. According to logistic regression models, there existed no consistent linear relationship between serum urate and migraine before (model 1: odd ratio (OR) = 0.83, p = 0.0004) or after adjusting for confounders (model 2: OR = 0.96, p = 0.5198; model 3: OR = 0.84, p = 0.0184). However, smooth curve fittings found an exponential curve relationship between serum urate and migraine. Furthermore, when serum urate was more than 7.8 mg/dl, higher serum urate was correlated with higher migraine occurrence (model 1: OR = 1.54, p = 0.0022; model 2: OR = 1.51, p = 0.0050; model 3: OR = 1.77, p = 0.0348). Besides, 8 out of the 208 migraineurs had a serum urate higher than 7.8 mg/dl.ConclusionsIn conclusion, there existed an exponential curve relationship between serum urate and migraine, with an infliction point of 7.8 mg/dl. When serum urate was more than 7.8 mg/dl, increased serum urate was correlated with higher migraine occurrence.
How Immunotherapy Modified the Therapeutic Scenario of Endometrial Cancer: A Systematic Review
Authors: Maiorano Brigida Anna , Maiorano Mauro Francesco Pio , Cormio Gennaro , Maglione Annamaria , Lorusso Domenica , Maiello Evaristo 
Published: April 2022

BackgroundEndometrial cancer (EC) represents the sixth most common female tumor. In the advanced setting, the prognosis is dismal with limited treatment options. Platinum-based chemotherapy represents the actual standard of care in first-line chemotherapy, but no standard second-line chemotherapy is approved, with less than 1/4 of patients responding to second-line chemotherapy. In the last 10 years, immune checkpoint inhibitors (ICIs) have changed the treatment landscape of many solid tumors.MethodsThe review was conducted according to the PRISMA guidelines. We searched EMBASE, MEDLINE, Cochrane Database, and conference abstracts from international societies, up to November 2021. Clinical trials employing ICIs in advanced EC, written in English, were included. Reviews, letters, and commentaries were excluded. The overall response rate (ORR), progression-free survival (PFS), overall survival (OS), and safety (number and grade of treatment-related adverse events [TRAEs]) were evaluated.Results15 studies, for a total of 1,627 patients, were included: 14 non-randomized phase I/II trials and 1 randomized phase III trial. Anti-PD1 (pembrolizumab, nivolumab, dostarlimab) and anti-PD-L1 agents (avelumab, atezolizumab, durvalumab) were administered as single agents; pembrolizumab and nivolumab were combined with the tyrosine-kinase inhibitors (TKI) lenvatinib and cabozantinib, respectively; and durvalumab was associated with anti-CTLA4 tremelimumab. 4 studies selected only MSI patients. Single agents determined an ORR from 26.7% to 58% among MSI patients, from 3% to 26.7% among MSS patients. DCR ranged from 53.5% to 88.9% in MSI, 31.4% to 35.2% in MSS patients. The combination of TKI and ICIs determined 32% to 63.6% of ORR in all-comers, 32%–36.2% in MSS patients. 54.2% to 76% of patients developed TRAEs. The combination of ICIs and TKI achieved a higher toxicity rate than single agents (≥G3 TRAEs 88.9%).ConclusionICIs represent an effective option for pretreated advanced EC patients with a tolerable profile. Given the encouraging results in MSI patients, every woman diagnosed with EC should be investigated for MS status. In MSS women, the combination of ICIs and TKI is more effective than monotherapy, notwithstanding safety concerns. PD-L1 cannot predict ICI response, whereas other biomarkers such as MSI and tumor mutational burden seem more accurate. Ongoing randomized trials will further clarify the role of these therapeutic options.Systematic Review RegistrationPROSPERO, CRD42021293538.
Influencing Factors of Total Skin Irradiation With Helical Tomotherapy
Authors: Wang Haiyang , Pi Yifei , Guo Yuexin , Pei Xi , Xu Xie George 
Published: April 2022

PurposeTo investigate the influencing factors of total skin irradiation (TSI) with helical tomotherapy for guiding the clinical selection of the suitable parameters and optimizing the plan quality and efficiency.Materials and MethodsSix patients with mycosis fungoides (MF) who received TSI were retrospectively selected. They were all dressed with 5 mm thick diving suits during the CT scan and treatment as a bolus to increase the superficial dose through buildup. The dose prescription was 24 Gy in 20 fractions and 5 times per week. During the planned pretreatment, Ring0, Ring1, Ring2, Ring3, and Ring4 of 1 cm thick away from the planning target volume (PTV) at the distances of 0, 1, 2, 3, and 4 cm and other normal tissues (NTs) were generated, respectively. The auxiliary structures were completely blocked during planning; while the field widths were 5 and 2.5 cm, the pitches were 0.287 and 0.215, the modulation factors were 4 and 3, and the other parameters remained consistent. Finally, the dose parameters of PTV and auxiliary structures, as well as the beam on time (BOT) and gantry period, were compared and analyzed.Resultswhen the auxiliary structures were completely blocked with distance to PTV (dPTV) above 3 cm were used, the mean dose (Dmean), conformity index (CI), and heterogeneity index (HI) of the PTV met the clinical requirements. As the dPTV gradually increased, the BOT decreased while the volume of normal tissue that received excessive radiation increased correspondingly. If the dPTV was less than 3 cm, the clinical requirements were not met. The field widths (FWs), pitches, and modulation factors (MFs) had no effect on PTVmean and the HI. The FW of 2.5 cm was slightly better than 5 cm for the CI. The FW and MF had a significant impact on the BOT, which gradually increased with decreasing FW and increasing MF. Pitch had no effect on the BOT.ConclusionDuring planning with TSI patients, dPTV is the key factor that has a significant influence on the plan quality. We found that the plan with the dPTV above 3 cm can meet clinical objectives. The BOT increases as the dPTV increases. The FWs also have an effect on the CI and BOT. Therefore, it is necessary to comprehensively balance these factors to optimize the quality and efficiency of the plan. We also found that different MFs and pitches have no obvious effect on the results.
Chordin-Like 1 Regulates Epithelial-to-Mesenchymal Transition and Metastasis via the MAPK Signaling Pathway in Oral Squamous Cell Carcinoma
Authors: Wu Qiuyu , Zheng Zhichao , Zhang Junwei , Piao Zhengguo , Xin Mengyu , Xiang Xi , Wu Antong , Zhao Tianyu , Huang Songkai , Qiao Yu , Zhou Jiayu , Xu Shaofen , Cheng Haoyu , Wu Lihong , Ouyang Kexiong 
Published: April 2022

BackgroundAccumulating evidence suggests that dysregulation of Chordin-like 1 (CHRDL1) is associated with malignant biological behaviors in multiple cancers. However, the exact function and molecular mechanism of CHRDL1 in oral squamous cell carcinoma (OSCC) remain unclear.MethodsThe expression levels of CHRDL1 in OSCC tissues and CAL27 cells were determined by RT-qPCR. Immunohistochemical staining was applied to detect CHRDL1 protein expression in sample tissues from OSCC patients. Gain of function and knockdown by lentivirus were further used to examine the effects of CHRDL1 on cell proliferation, migration, invasion, and adhesion in OSCC. Tail vein injection of CAL27 cells with dysregulated CHRDL1 expression was further used to examine the effect of CHRDL1 on lung colonization. RNA sequencing was performed to explore the molecular mechanisms of CHRDL1 that underlie the progression of OSCC.ResultsCHRDL1 was significantly downregulated in OSCC tissues and CAL27 cells compared to controls. CHRDL1 knockdown enhanced migration, invasion, adhesion, and EMT, but not proliferation, in CAL27 cells. Overexpression of CHRDL1 had the opposite effects. Moreover, CHRDL1 was proven to inhibit tumor metastasisin vivo. Mechanistically, MAPK signaling pathway components, including ERK1/2, p38, and JNK, were found to regulate the malignant biological behaviors of CAL27 cells.ConclusionsOur results suggest that CHRDL1 has an inhibitory effect on OSCC metastasisviathe MAPK signaling pathway, which provides a new possible potential therapeutic target against OSCC.
Risk Factors for High-Arched Palate and Posterior Crossbite at the Age of 5 in Children Born Very Preterm: EPIPAGE-2 Cohort Study
Authors: Herrera Sandra , Pierrat Véronique , Kaminski Monique , Benhammou Valérie , Marchand-Martin Laetitia , Morgan Andrei S. , Le Norcy Elvire , Ancel Pierre-Yves , Germa Alice 
Published: April 2022

Introduction:Children born very preterm have an immature sucking reflex at birth and are exposed to neonatal care that can impede proper palate growth.ObjectivesWe aimed to describe the frequency of high-arched palate and posterior crossbite at the age of 5 in children born very preterm and to identify their respective risk factors.MethodsOur study was based on the data from EPIPAGE-2, a French national prospective cohort study, and included 2,594 children born between 24- and 31-week gestation. Outcomes were high-arched palate and posterior crossbite. Multivariable models estimated by generalized estimation equations with multiple imputation were used to study the association between the potential risk factors studied and each outcome.ResultsOverall, 8% of children born very preterm had a high-arched palate and 15% posterior crossbite. The odds of high-arched palate were increased for children with low gestational age (24–29 vs. 30–31 weeks of gestation) [adjusted odds ratio (aOR) 1.76, 95% confidence interval (CI) 1.17, 2.66], thumb-sucking habits at the age of 2 (aOR 1.53, 95% CI 1.03, 2.28), and cerebral palsy (aOR 2.18, 95% CI 1.28, 3.69). The odds of posterior crossbite were increased for children with pacifier-sucking habits at the age of 2 (aOR 1.75, 95% CI 1.30, 2.36).ConclusionsAmong very preterm children, low gestational age and cerebral palsy are the specific risk factors for a high-arched palate. High-arched palate and posterior crossbite share non-nutritive sucking habits as a common risk factor. The oro-facial growth of these children should be monitored.
HyProCure for Pediatric Flexible Flatfoot: What Affects the Outcome
Authors: Chen Cheng , Jiang JianTao , Fu ShaoLing , Wang Cheng , Su Yan , Mei GuoHua , Xue JianFeng , Zou Jian , Li XueQian , Shi ZhongMin 
Published: April 2022

BackgroundThe high success rate, minimal invasion, and safety of subtalar arthroereisis (SA) have made it a primary mode of surgical management for pediatric flexible flatfoot. The HyProCure procedure is a new surgery for SA, However, very few available studies reported the therapeutic effects of the HyProCure procedure, especially in pediatric flexible flatfoot. The main aim of the present study was to investigate the clinical and radiological outcomes of the HyProCure procedure for pediatric flexible flatfoot and analyze the risk factors for therapeutic outcomes and sinus tarsi pain.MethodsIn this retrospective cohort study, 69 pediatric flexible flatfoot patients (107 feet) who underwent the HyProCure procedure were included between July 2015 and September 2020. All patients underwent the HyProCure procedure with or without gastrocnemius recession. The Maryland foot score (MFS), visual analog scale (VAS), radiographic data, and complications were assessed at a minimum 1-year follow-up and statistically analyzed.ResultsThe mean follow-up was 35.9 months (range, 13–73 months). At the last follow-up, VAS (0.64 ± 1.16) was significantly lower than the preoperative VAS (4.06 ± 1.43) (p &lt; 0.001); MFS (90.39 ± 12.10) was significantly higher than the preoperative MFS (71.36 ± 10.25) (p &lt; 0.001). The AP talar-second metatarsal angle (T2MT angle) significantly decreased from 17.0 ± 5.4° preoperatively to 11.4 ± 5.2° at the last follow-up (p &lt; 0.001). The lateral talar-first metatarsal angle (Meary's angle) significantly decreased from 13.8 ± 6.4° preoperatively to 6.3 ± 5.0° at the last follow-up (p &lt; 0.001). The calcaneal declination angle (Pitch angle) significantly increased from 13.5 ± 4.9° preoperatively to 14.8 ± 4.4° at the last follow-up (p &lt; 0.001). Logistic regression analysis indicated that patients with a longer distance from the tail end of the implant exceeding the longitudinal talar bisection line had 275.8% greater odds of MFS &lt; 90. Yet, no risk factors were found in connection with sinus tarsi pain.ConclusionsThe HyProCure procedure for pediatric flexible flatfoot achieved satisfactory curative effects with a low complication rate; implant depth was associated with unsatisfactory postoperative outcome.
Economic Evaluation of Dapagliflozin in the Treatment of Patients With Heart Failure: A Systematic Review
Authors: Wu Meiyu , Qin Shuxia , Wang Liting , Tan Chongqing , Peng Ye , Zeng Xiaohui , Luo Xia , Yi Lidan , Wan Xiaomin 
Published: April 2022

Objective:The objective of this study is to systematically review the economic evaluations of dapagliflozin in the treatment of patients with heart failure (HF) and describe their general and methodological features.Methods:This systematic review followed the PRISMA guidelines. MEDLINE/PubMed, Website Of Science, Embase, The Cochrane Library, ScienceDirect, CNKI, and Wanfang databases were searched to collect relevant studies, and the retrieval time ended on 31 October 2021. Articles on the economic evaluation of dapagliflozin in the treatment of heart failure were included. Secondary studies, incomplete economic indicators, and non-English-language and non-Chinese-language studies were excluded. Standard drug treatment was selected as the comparison. Basic characteristics, methods, and main results were extracted and analyzed systematically.Result:A total of eight studies were identified, and the overall quality was accepted, which were performed in nine developed countries (Austria, United States, Korea, Japan, Singapore, Spanish, Germany, and United Kingdom) and three developing countries (the Philippines, Thailand, and China). With the exception of the Philippines, the remaining countries considered that dapagliflozin was cost effective. In the analyses of all included studies, the incremental cost-effectiveness ratios were most sensitive to the cost of dapagliflozin, cardiovascular mortality, the duration of dapagliflozin effectiveness, and the probability of HF hospitalization.Conclusion:Dapagliflozin in the treatment of patients with heart failure with reduced ejection fraction was considered cost effective. Further studies are needed to evaluate the comprehensive value of dapagliflozin on HF.