bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Hypoalbuminemia as an Independent Predictor of 30-Day Postoperative Complications Following Surgical Fixation of Ankle Fractures
Authors: Wilson Jacob M. , Kukowski Nathan R. , Staley Christopher A. , Bariteau Jason T. 
Published: December 2019

Background: Malnutrition is known to be negatively associated with outcomes after multiple orthopedic procedures. We hypothesized that admission albumin levels, as a marker for malnutrition, would correlate with postoperative outcomes. The purpose of this study was to investigate this relationship following surgery for ankle fracture. Methods: This is a retrospective cohort study of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Patients undergoing operative fixation of an ankle fracture were identified. A total of 6138 patients with albumin available for analysis were identified. Baseline patient information, preoperative serum albumin levels, 30-day postoperative complications, readmission, reoperation, and length of stay data were then collected. Poisson regression with robust error variance was performed to assess the effect of preoperative serum albumin level on postoperative outcomes. Results: The mean albumin level was 3.86 g/dL and 20.3% (1246/6138) of patients with available albumin levels were hypoalbuminemic. Multivariate analysis revealed that an albumin level <3.5 g/dL was an independent risk factor for complications (relative risk [RR], 1.42; 95% confidence interval [CI], 1.13-1.78; P = .002) and readmission (RR, 1.54; 95% CI, 1.13-2.08; P = .006). Additionally, when analyzed as a continuous variable, albumin level was negatively correlated with risk of mortality (RR, 0.37; 95% CI, 0.19-0.72; P = .003). Patients with hypoalbuminemia also had significantly longer lengths of stay (4.5 vs 2.1 days; P < .001). Conclusion: While complication rates after fixation of ankle fractures remain low, hypoalbuminemia was a predictor of postoperative course. Malnutrition, therefore, may help inform the decision between surgical and conservative management of patients with ankle fractures potentially amenable to nonoperative management. Additionally, hypoalbuminemia should trigger heightened awareness and prophylactic therapy where appropriate. Level of Evidence: Level III, comparative study.
Evaluation of awareness and understanding of cancer immunotherapy among healthcare professionals in eastern Saudi Arabia
Authors: Hamad Rabab S 
Published: December 2019

Introduction Cancer immunotherapy is a complicated field that develops rapidly; in the past decades, immunotherapy has become the standard treatment for several cancer types. The aim of the current study was to estimate the awareness and understanding of cancer immunotherapy and associated immunological concepts among healthcare professionals (HCPs) in eastern Saudi Arabia in order to assess educational needs. Methods A cross-sectional questionnaire was conducted among multidisciplinary HCPs in healthcare institutions in eastern Saudi Arabia from April 2019 to June 2019. The survey was designed to assess the awareness and understanding of HCPs’ basic scientific knowledge of cancer immunotherapy. The data were analyzed using the Statistical Package for the Social Sciences (SPSS). Reliability was tested through Cronbach’s alpha, and a χ2 or Fisher’s exact test was used to determine the distribution of categorical variables between groups. Results The study included 360 HCPs: 43.6% physicians, 21.9% nurses, 20.8% medical laboratory scientists, and 13.6% pharmacists. Only 20.6% of the HCPs considered immunotherapy the best-known cancer therapy. The overall level of awareness of cancer immunotherapy was low (55.8%), and only 6.4% of the participants had a high knowledge rate. The majority of the respondents indicated the importance of studying the science of immunotherapy. Cronbach's alphas for the HCPs’ perceptions, self-evaluation rate, and reflection scales were 0.74, 0.90, and 0.66, respectively. Simple linear regression showed a significant relationship between reflection and self-evaluation. Conclusions A reliable and consistent study revealed a low level of awareness and understanding of immunotherapy among multidisciplinary HCPs.
A successful case of venetoclax-based therapy in relapsed/refractory secondary plasma cell leukemia
Authors: Kupsh Allison , Arnall Justin , Voorhees Peter 
Published: December 2019

Background Secondary plasma cell leukemia (sPCL) patients typically are either refractory to conventional therapies or have short remissions to drug regimens used in multiple myeloma (MM), which highlights sPCL’s aggressive nature and association with advanced stage disease. t(11,14) is correlated with increased BCL-2 expression, which makes it a cytogenic marker of interest for use of the BCL-2 inhibitor venetoclax. Little data of venetoclax’s use has been published in plasma cell leukemia. We present a case of a refractory/relapsed sPCL patient displaying t(11,14) who achieved a very good partial response (VGPR) from venetoclax therapy in combination with dexamethasone and bortezomib. Case report Our case describes a 67-year-old male initially diagnosed with IgG kappa MM in 2013, which transformed into non-secretory secondary plasma cell leukemia. Over a two-year period, despite responses to various therapies, the patient continued to experience relapses and exhausted options of novel agents seen in MM treatment. The patient was started on venetoclax in combination with bortezomib and oral dexamethasone. Management and outcome Due to the patient’s disease transformation into a non-secretory form of sPCL, PET/CT scans were relied upon to monitor disease progression. The PET/CT scan after three months of venetoclax combination treatment showed a very good partial response to therapy, with near resolution of metabolically active osseous disease. Discussion The success of venetoclax-based therapy in achieving a very good partial response suggests its utility in relapsed/refractory sPCL patients, who have exhausted various combinations of drug regimens used in treatment of MM and have historically poor survival outcomes.
Bone morphology of the proximal femoral canal: ethnicity related differences and the influence on cementless tapered wedge stem designs
Authors: Wuestemann Thies , Hoare Samuel G , Petersik Andreas , Hofstaetter Bernhard , Fehily Max , Matsubara Masaaki , Markel David C 
Published: December 2019

Background: Differences in proximal femoral morphology between ethnicities may have implications on the design of cementless tapered wedge stems. This study analyses the differences in Asian and Caucasian bone morphology as well as the related fit of various cementless tapered wedge stem designs. Methods: A computed tomography database and modelling software was used to retrospectively analyse a total of 1345 femora. Ethnicity related comparisons as well as the fit of the stem designs were analysed. Results: Statistically significant differences between canal shape of Caucasian and Japanese as well as non-Japanese Asians were observed. The fit of the stems within the femoral canal was highly dependent on the respective stem shape. Conclusions: The shape differences in stem designs had a larger influence on the fit within the femoral canal than the differences in ethnicity related to bone morphology.
Outcomes of post-operative duplex ultrasound following arteriovenous fistula formation: A pragmatic single-centre experience
Authors: Nickinson Andrew TO , Rogers Rebecca , Elbasty Ahmed , Nunney Ian , Bennett Philip C 
Published: December 2019

Background: Duplex ultrasound surveillance with pre-emptive treatment of an identified stenosis is increasingly being utilised to help maintain arteriovenous fistula patency. This study aims to determine whether post-operative duplex ultrasound surveillance can improve fistula patency at 12 months and improve the proportion of ‘pre-haemodialysis’ patients commencing haemodialysis via a usable fistula. Methods: All arteriovenous fistulae formed between 1st January 2015 and 31st August 2017 in a single, tertiary vascular centre were included. Primary and secondary patency at 12 months, along with the proportion of pre-haemodialysis patients commencing haemodialysis via a usable arteriovenous fistula, were compared between the fistulae undergoing duplex ultrasound surveillance and ‘standard practice’. Results: Two hundred forty-one arteriovenous fistulae were created in 216 patients. A higher proportion of brachiobasilic transposition arteriovenous fistula and patients undergoing arteriovenous fistula creation following a previously failed access were identified in the duplex ultrasound surveillance group. Primary patency at 12 months (hazard ratio = 0.43, 95% confidence interval = 0.30–0.61, p < .001) was significantly lower in the duplex ultrasound surveillance group compared with the ‘standard practice’ group. Despite this, no difference was identified in secondary patency at 12 months (hazard ratio = 1.82, 95% confidence interval = 0.87–3.80, p = .112). No difference was also identified in the proportion of pre-haemodialysis patients starting haemodialysis with a usable arteriovenous fistula (duplex ultrasound surveillance = 65.0% vs standard practice = 77.8%; odds ratio = 0.53, 95% confidence interval 0.58–1.19, p = .279). Conclusion: Post-operative duplex ultrasound surveillance following arteriovenous fistula formation is associated with higher rates of post-operative intervention; however, this does not translate into improved secondary patency or the proportion of pre-haemodialysis patients commencing HD via their fistula.
What factors influence feeling competent as a parent with multiple sclerosis?
Authors: Messmer Uccelli Michele , Ponzio Michela , Traversa Silvia 
Published: December 2019

Objective To identify factors that influence the perception parents with multiple sclerosis have of their competence in parenting. Method/design Subjects were parents of a child with a maximum of 18 years of age recruited through a national multiple sclerosis organization’s social media channels. Data on demographic and disease information, mood, coping, quality of life and perceived social support were collected using an anonymous online questionnaire. Univariate and multivariate analyses were performed to assess associations between these variables and subjects’ perception of parenting sense of competence. Results The sample consisted of 285 parents with multiple sclerosis, with a mean age of 41 years and a mean disease duration of 10.4 years. In the multivariate analysis, independent determinants of lower parenting sense of competence were anxiety ( p =  0.012), depression ( p =  0.001) and dysfunctional coping ( p =  0.005). Problem-focused coping ( p =  0.029) and higher physical and mental scores on the SF-12 ( p =  0.006, p <  0.001, respectively) were related to a higher parenting sense of competence. Higher parent age correlated with a lower sense of parenting competence ( p =  0.002). Conclusions The perception parents with multiple sclerosis have of their parenting competence was most strongly correlated with mood, coping strategies and health-related quality of life, factors that are potentially modifiable.
Validity and correlates of the Brief Satisfaction With Appearance Scale for patients with limited and diffuse systemic sclerosis: Analysis from the University of California, Los Angeles Scleroderma Quality of Life Study
Authors: Fox Rina S , Mills Sarah D , Gholizadeh Shadi , Merz Erin L , Roesch Scott C , Clements Philip J , Kafaja Suzanne , Khanna Dinesh , Furst Daniel E , Malcarne Vanessa L 
Published: December 2019

Objective: The Brief Satisfaction With Appearance Scale measures two dimensions (Dissatisfaction with Appearance and Social Discomfort) of body image dissatisfaction in systemic sclerosis. This study examined the structural validity of the Brief Satisfaction With Appearance Scale across limited and diffuse systemic sclerosis subtypes, compared body image dissatisfaction by systemic sclerosis subtype, and identified the significant sociodemographic and medical correlates of body image dissatisfaction and whether they differed by subtype. Methods: Participants were 183 adults participating in the University of California, Los Angeles Scleroderma Quality of Life Study with limited cutaneous ( n = 101) or diffuse cutaneous ( n = 82) systemic sclerosis who received clinical examinations and completed questionnaires. Multiple-group confirmatory factor analysis, multivariate analysis of variance, and structural equation modeling were used. Results: The Brief Satisfaction With Appearance Scale’s two-factor structure fit well for both subtypes. Patients with diffuse systemic sclerosis reported greater body image dissatisfaction on both factors than patients with limited disease. Greater Dissatisfaction with Appearance was associated with younger age and being unmarried for limited patients, and with younger age and increased finger/hand skin involvement for diffuse patients. Greater Social Discomfort was associated with younger age and being unmarried for both subtypes. Conclusion: The Brief Satisfaction With Appearance Scale scores can be meaningfully compared across limited and diffuse systemic sclerosis. Patients with diffuse disease reported more body image dissatisfaction than those with limited disease. Findings demonstrate that both medical and sociodemographic variables are associated with body image dissatisfaction in systemic sclerosis and can be used to identify which patients may be at increased risk for body image dissatisfaction.
Arterial thrombosis in Philadelphia-negative myeloproliferative neoplasms predicts second cancer: a case-control study
Authors: De Stefano Valerio , Ghirardi Arianna , Masciulli Arianna , Carobbio Alessandra , Palandri Francesca , Vianelli Nicola , Rossi Elena , Betti Silvia , Di Veroli Ambra , Iurlo Alessandra , Cattaneo Daniele , Finazzi Guido , Bonifacio Massimiliano , Scaffidi Luigi , Patriarca Andrea , Rumi Elisa , Casetti Ilaria Carola , Stephenson Clemency , Guglielmelli Paola , Elli Elena Maria , Palova Miroslava , Rapezzi Davide , Erez Daniel , Gomez Montse , Wille Kai , Perez-Encinas Manuel , Lunghi Francesca , Angona Anna , Fox Maria Laura , Beggiato Eloise , Benevolo Giulia , Carli Giuseppe , Cacciola Rossella , McMullin Mary Frances , Tieghi Alessia , Recasens Valle , Isfort Susanne , Marchetti Monia , Griesshammer Martin , Alvarez-Larran Alberto , Vannucchi Alessandro Maria , Rambaldi Alessandro , Barbui Tiziano 
Published: December 2019

Abstract
Patients with Philadelphia-negative myeloproliferative neoplasm (MPN) are prone to the development of second cancers, but the factors associated with these events have been poorly explored. In an international nested case-control study, we recruited 647 patients with carcinoma, nonmelanoma skin cancer, hematological second cancer, and melanoma diagnosed concurrently or after MPN diagnosis. Up to 3 control patients without a history of cancer and matched with each case for center, sex, age at MPN diagnosis, date of diagnosis, and MPN disease duration were included (n = 1234). Cases were comparable to controls for MPN type, driver mutations and cardiovascular risk factors. The frequency of thrombosis preceding MPN was similar for cases and controls (P = .462). Thrombotic events after MPN and before second cancer were higher in cases than in controls (11.6% vs 8.1%; P = .013), because of a higher proportion of arterial thromboses (6.2% vs 3.7%; P = .015). After adjustment for confounders, the occurrence of arterial thrombosis remained independently associated with the risk of carcinoma (odds ratio, 1.97; 95% confidence interval, 1.14-3.41), suggesting that MPN patients experiencing arterial events after MPN diagnosis deserve careful clinical surveillance for early detection of carcinoma. This study was registered at www.clinicaltrials.gov as NCT03745378.
Managing chronic myeloid leukemia for treatment-free remission: a proposal from the GIMEMA CML WP
Authors: Baccarani Michele , Abruzzese Elisabetta , Accurso Vincenzo , Albano Francesco , Annunziata Mario , Barulli Sara , Beltrami Germana , Bergamaschi Micaela , Binotto Gianni , Bocchia Monica , Caocci Giovanni , Capodanno Isabella , Cavazzini Francesco , Cedrone Michele , Cerrano Marco , Crugnola Monica , D’Adda Mariella , Elena Chiara , Fava Carmen , Fazi Paola , Fozza Claudio , Galimberti Sara , Giai Valentina , Gozzini Antonella , Gugliotta Gabriele , Iurlo Alessandra , La Barba Gaetano , Levato Luciano , Lucchesi Alessandro , Luciano Luigia , Lunghi Francesca , Lunghi Monia , Malagola Michele , Marasca Roberto , Martino Bruno , Melpignano Angela , Miggiano Maria Cristina , Montefusco Enrico , Musolino Caterina , Palmieri Fausto , Pregno Patrizia , Rapezzi Davide , Rege-Cambrin Giovanna , Rupoli Serena , Salvucci Marzia , Sancetta Rosaria , Sica Simona , Spadano Raffaele , Stagno Fabio , Tiribelli Mario , Tomassetti Simona , Trabacchi Elena , Bonifacio Massimiliano , Breccia Massimo , Castagnetti Fausto , Pane Fabrizio , Russo Domenico , Saglio Giuseppe , Soverini Simona , Vigneri Paolo , Rosti Gianantonio 
Published: December 2019

Abstract
Several papers authored by international experts have proposed recommendations on the management of BCR-ABL1+ chronic myeloid leukemia (CML). Following these recommendations, survival of CML patients has become very close to normal. The next, ambitious, step is to bring as many patients as possible into a condition of treatment-free remission (TFR). The Gruppo Italiano Malattie EMatologiche dell’Adulto (GIMEMA; Italian Group for Hematologic Diseases of the Adult) CML Working Party (WP) has developed a project aimed at selecting the treatment policies that may increase the probability of TFR, taking into account 4 variables: the need for TFR, the tyrosine kinase inhibitors (TKIs), the characteristics of leukemia, and the patient. A Delphi-like method was used to reach a consensus among the representatives of 50 centers of the CML WP. A consensus was reached on the assessment of disease risk (EUTOS Long Term Survival [ELTS] score), on the definition of the most appropriate age boundaries for the choice of first-line treatment, on the choice of the TKI for first-line treatment, and on the definition of the responses that do not require a change of the TKI (BCR-ABL1 ≤10% at 3 months, ≤1% at 6 months, ≤0.1% at 12 months, ≤0.01% at 24 months), and of the responses that require a change of the TKI, when the goal is TFR (BCR-ABL1 &gt;10% at 3 and 6 months, &gt;1% at 12 months, and &gt;0.1% at 24 months). These suggestions may help optimize the treatment strategy for TFR.
Therapy-related acute lymphoblastic leukemia is a distinct entity with adverse genetic features and clinical outcomes
Authors: Saygin Caner , Kishtagari Ashwin , Cassaday Ryan D. , Reizine Natalie , Yurkiewicz Ilana , Liedtke Michaela , Stock Wendy , Larson Richard A. , Levine Ross L. , Tallman Martin S. , Park Jae H. , Kerr Cassandra , Przychodzen Bartlomiej , Sekeres Mikkael A. , Kalaycio Matt E. , Carraway Hetty E. , Hamilton Betty K. , Sobecks Ronald , Gerds Aaron , Mukherjee Sudipto , Nazha Aziz , Maciejewski Jaroslaw P. , Advani Anjali S. 
Published: December 2019

AbstractPatients with therapy-related acute lymphoblastic leukemia (t-ALL) represent a small subset of acute lymphoblastic leukemia (ALL) patients who received genotoxic therapy (ie, chemotherapy or radiation) for a prior malignancy. These patients should be distinguished from patients with de novo ALL (dn-ALL) and ALL patients who have a history of prior malignancy but have not received cytotoxic therapies in the past (acute lymphoblastic leukemia with prior malignancy [pm-ALL]). We report a retrospective multi-institutional study of patients with t-ALL (n = 116), dn-ALL (n = 100), and pm-ALL (n = 20) to investigate the impact of prior cytotoxic therapies on clinical outcomes. Compared with patients with pm-ALL, t-ALL patients had a significantly shorter interval between the first malignancy and ALL diagnosis and a higher frequency of poor-risk cytogenetic features, including KMT2A rearrangements and myelodysplastic syndrome-like abnormalities (eg, monosomal karyotype). We observed a variety of mutations among t-ALL patients, with the majority of patients exhibiting mutations that were more common with myeloid malignancies (eg, DNMT3A, RUNX1, ASXL1), whereas others had ALL-type mutations (eg, CDKN2A, IKZF1). Median overall survival was significantly shorter in the t-ALL cohort compared with patients with dn-ALL or pm-ALL. Patients who were eligible for hematopoietic cell transplantation had improved long-term survival. Collectively, our results support t-ALL as a distinct entity based on its biologic and clinical features.
Primary central nervous system lymphoma: initial features, outcome, and late effects in 75 children and adolescents
Authors: Attarbaschi Andishe , Abla Oussama , Ronceray Leila , Bansil Shweta , Bomken Simon , Burkhardt Birgit , Ceppi Francesco , Chiang Alan K. S. , Dave Hema , Fedorova Alina , Henry Michael , Jazbec Janez , Kabickova Edita , Kotecha Rishi S. , Lazic Jelena , Loeffen Jan , Miakova Natalia , Osumi Tomoo , Pillon Marta , Pourtsidis Apostolos , Rigaud Charlotte , Tamamyan Gevorg , Tandon Sneha , Uyttebroeck Anne , Verdu-Amoros Jamie , Woessmann Wilhelm , Wrobel Grazyna , Giulino-Roth Lisa 
Published: December 2019

Key Points
Children with PCNSL and no immunodeficiency have a good outcome when treated by a histological subtype–driven and radiation-free protocol. New treatment guidelines are needed for PCNSL in children and adolescents with an underlying immunodeficiency.
Efficacy of azithromycin in severe asthma from the AMAZES randomised trial
Authors: Gibson Peter G. , Yang Ian A. , Upham John W. , Reynolds Paul N. , Hodge Sandra , James Alan L. , Jenkins Christine , Peters Matthew J. , Marks Guy B. , Baraket Melissa , Powell Heather , Simpson Jodie L. 
Published: December 2019

BackgroundLow-dose azithromycin is an effective therapy for persistent asthma; however, its benefit in severe asthma is not defined.MethodsParticipants with severe asthma were identified from the AMAZES randomised, placebo-controlled trial of long-term (48 weeks) low-dose azithromycin. Participants who met one of the following severe asthma definitions were included: 1) Global Initiative for Asthma step 4 treatment with poor asthma control (asthma control questionnaire score ≥0.75); 2) International Severe Asthma Registry definition; 3) American Thoracic Society and European Respiratory Society severe asthma definitions. The rate of total exacerbations was calculated for each subgroup and efficacy of azithromycin compared with placebo. Asthma-related quality of life was assessed before and after treatment along with adverse effects.ResultsAzithromycin significantly reduced asthma exacerbations in each group. In patients meeting the American Thoracic Society and European Respiratory Society task force definition of severe asthma (n=211), the rate of exacerbations with treatment was 1.2 per person-year, which was significantly less than for placebo (2.01 per person-year), giving an incidence rate ratio (95% CI) of 0.63 (0.41, 0.96). The proportion of participants experiencing at least one asthma exacerbation was reduced by azithromycin from 64% to 49% (p=0.021). A similar beneficial treatment effect was seen in participants poorly controlled with Global Initiative for Asthma step 4 treatment and those with International Severe Asthma Registry-defined severe asthma. Azithromycin also significantly improved the quality of life in severe asthma (p<0.05). Treatment was well tolerated, with gastrointestinal symptoms being the main adverse effect.ConclusionLong-term, low-dose azithromycin reduced asthma exacerbations and improved the quality of life in patients with severe asthma, regardless of how this was defined. These data support the addition of azithromycin as a treatment option for patients with severe asthma.