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CONCLUSION Future research examining the cost-effectiveness and benefits of psychotherapy for personal growth is warranted. Building on the six domains, specific future research projects on the evidence-based practice of psychotherapy for personal growth are suggested. © 2020 Wiley Periodicals, Inc.Microbial community assembly (MCA) of both human and nonhuman animal carcasses provides indicators useful for estimating the postmortem interval (PMI) in terrestrial settings. However, there are fewer studies estimating postmortem submersion intervals (PMSIs) in aquatic habitats. No aquatic studies to date assessed MCA in the context of a death investigation, with all previous studies focusing on important basic ecological questions. Within the context of a cold case investigation, we performed an experiment using replicate adult swine carcasses to describe postmortem MCA variability within a nonflowing aquatic habitat. Using high-throughput sequencing of carcass postmortem microbiomes, we described MCA variability and identified key taxa associated with decomposition in an aquatic habitat similar to the cold case body recovery site. We also modeled key taxa for estimating PMSIs, modeling within ±3 days (mean square error) postmortem using random forest regression. Our findings show significant changes in microbial communities as decomposition progressed, and several taxa were identified as important indicator taxa which may be useful for future estimates of PMSI. While descriptive, this study provides initial findings quantifying MCA variability within a nonflowing aquatic habitat. Within the context of the cold case investigation, we discuss how postmortem microbial samples collected at the time of body recovery could have been an important piece of evidence for understanding the PMSI of recovered remains. Additional experimental studies are needed to explicitly test and identify mechanisms associated with postmortem MCA variability in other habitats and under different temperature (e.g., seasons) conditions. © 2020 American Academy of Forensic Sciences.BACKGROUND A subgroup of men with favorable high-risk prostate cancer (T1c with either a Gleason score of 4 + 4 = 8 and a prostate-specific antigen [PSA] level 20 ng/mL)-that was managed with radical prostatectomy or radiation therapy. Multivariable logistic regression was used to calculate adjusted odds ratios (aORs) for pathological T3 to T4 or N1 (pT3-T4/pN1) disease. Fine and Gray competing risks regression was used to determine adjusted hazard ratios (aHRs) of prostate cancer-specific mortality (PCSM). RESULTS The median follow-up was 5.7 years. Patients with favorable high-risk disease had lower 8-year PCSM in comparison with patients with standard high-risk disease (2.2% vs 10.8%; aHR, 0.26; 95% confidence interval [CI], 0.09-0.73; P = .01) but similar PCSM in comparison with patients with intermediate-risk disease (2.2% vs 2.2%; aHR, 0.90; 95% CI, 0.32-2.54; P = .84). Among those who underwent surgery, those with favorable high-risk disease had lower odds of pT3-T4/pN1 disease than those with standard high-risk disease (46.2% vs 63.3%; aOR, 0.50; 95% CI, 0.27-0.94; P = .03). CONCLUSIONS This study validates the prognostic utility of a subclassification for high-risk disease in a prospectively collected patient cohort. Patients with favorable high-risk disease have PCSM similar to that of patients with intermediate-risk disease and significantly better than that of patients with standard high-risk disease. Future trials are needed to assess possible de-intensification of therapy for favorable high-risk disease. © 2020 American Cancer Society.OBJECTIVE To evaluate the efficacy of ubrogepant on patient-reported functional disability, satisfaction with study medication, and global impression of change. AP1903 in vitro BACKGROUND Ubrogepant is a small-molecule, oral calcitonin gene-related peptide receptor antagonist indicated for the acute treatment of migraine. In 2 phase 3 trials (ACHIEVE I and II), ubrogepant demonstrated efficacy vs placebo on the 2 co-primary endpoints of headache pain freedom and absence of the most bothersome migraine-associated symptom at 2 hours post dose for the 50 and 100 mg doses. Patient-reported outcomes, such as functional disability, satisfaction, and patient global impression of change, can provide additional evidence of the efficacy of an acute treatment for migraine on clinically meaningful and patient-relevant outcomes. METHODS ACHIEVE I and ACHIEVE II were multicenter, randomized, double-blind, placebo-controlled, parallel-group, single-attack trials in adults (18-75 years) with migraine. In ACHIEVE I, participants were randomit Global Impression of Change scale (ACHIEVE I 50 mg, 34.4% [103/299], P = .0006 vs placebo; 100 mg, 34.3% [102/297], P = .0009 vs placebo; placebo, 22.0% [69/313]; ACHIEVE II 25 mg, 34.1% [124/364], P  less then  .0001 vs placebo; 50 mg, 33.4% [131/392], P = .0002 vs placebo; placebo, 20.7% [78/376]; pooled 50 mg, 33.9% [234/691], vs pooled placebo, 21.3% [147/689]; P  less then  .0001). CONCLUSIONS A significantly higher proportion of participants treated with ubrogepant were able to function normally, were satisfied with the study medication, and reported clinically meaningful improvement compared with those receiving placebo. The results reinforce the potential benefits of ubrogepant on patient-centered outcomes in the acute treatment of migraine. © 2020 The Authors. Headache The Journal of Head and Face Pain published by Wiley Periodicals, Inc. on behalf of American Headache Society.OBJECTIVES/HYPOTHESIS To evaluate the efficacy and reconstructive applications of angular vessel microvascular anastomosis in free-tissue transfer. STUDY DESIGN Retrospective cohort study. METHODS A study of patients treated from January 2010 to July 2017 was performed. Four hundred thirty patients undergoing free-tissue transfer at the Cleveland Clinic by a single reconstructive surgeon were reviewed. Patients in whom free-tissue transfer was performed using angular vessels were included. Patients in whom free-tissue transfer was performed using another vascular supply of the head and neck were excluded. Primary outcome was free-flap failure. Secondary outcomes included other postoperative complications and hospital length of stay. RESULTS Thirty-one patients underwent free-tissue transfer with microvascular anastomosis to the angular vessels during the study period. Seventy-one percent of patients underwent reconstruction immediately following tumor ablation. A variety of primary subsites were reconstructed; 58% underwent nasal reconstruction, 16% orbit/skull base reconstruction, 13% palatal reconstruction, 6% maxillary reconstruction, and 6% mandible reconstruction.