bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transoral Robotic Surgery-Assisted Removal of Upper Aerodigestive Tract Foreign Bodies with Intraoperative Localization
Authors: Haugen Thorsen , Prichardo Priscilla , Hellums Ryan , Anil Joshua , Rajasekaran Karthik 
Published: July 2024

Objective: To describe the use of transoral robotic surgery (TORS) in conjunction with intraoperative localization techniques for removal of challenging upper aerodigestive tract (UADT) foreign bodies. Methods: Three cases were taken to the operating room for removal of UADT foreign bodies. Two of these cases had previously undergone failed surgery(s). TORS was performed in all 3 cases and intraoperative localization was used in 2 cases. Results: All foreign bodies were successfully removed. Conclusion: This case series is the largest-to-date on UADT foreign body removals using TORS. Additionally, the novel use of intraoperative localization techniques in conjunction with TORS is described. Such an approach can facilitate the identification of difficult-to-identify foreign bodies, as well as potentially decreasing operative time, number of operations, and associated morbidity.
Extracorporeal life support use in patients with bronchopulmonary dysplasia: A single center case series
Authors: Dantes Goeto , Davis Carolyn , Van Anderlecht Katya , Davis Joel , Lima Lisa , Linden Allison F , Paden Matthew , Keene Sarah 
Published: July 2024

Purpose Preterm pediatric patients with bronchopulmonary dysplasia (BPD) represent a subgroup previously deemed high risk candidates for ECLS (extracorporeal life support) due to suspected high mortality or increased post ECLS morbidity. The aim of this study was to determine outcomes for patients with an established history of BPD who subsequently required ECLS. Methods A single center retrospective review was performed between 01/2010-06/2022 for patients less than 2 years of age, born prematurely (<32 weeks) with a subsequent diagnosis of BPD, and who required ECLS for respiratory failure. Demographic and clinical data, including ECLS data, were collected. Speech, language, feeding/swallowing, cognitive, hearing, vision, or motor function deficits were obtained with a median follow up of 42 months following discharge. Results Nineteen patients met criteria. The median birth weight and gestational age was 0.86 kg (IQR 0.73, 1.0) and 26 weeks (IQR 25, 27), respectively. The median chronological age at cannulation was 12.1 months. The most common etiologies for respiratory failure requiring ECLS were viral (68.4%) and bacterial (21.1%) pneumonia. Survival to decannulation was 78.9% (15/19) and survival to hospital discharge was 63.2% (12/19). Amongst survivors to discharge, 42% (5/12) required new or additional home oxygen and 50% (6/12) were noted to have neurodevelopmental/behavioral concerns on follow up at 1 year with 25% (3/12) with concerns beyond a year. Conclusion Patients with underlying BPD who require ECLS have comparable mortality and long-term neurodevelopmental outcomes to non-BPD patients with respiratory failure. This information can be useful when considering ECLS candidacy and providing family counseling.
Organizational Support After Early Pregnancy Loss: The Importance of Training and Awareness Development
Authors: Cavallo Taylor , Rodriguez Ana Carolina 
Published: July 2024

The Problem Miscarriage is an under-discussed topic in organizations. Many organizations in the United States do not offer organizational support for individuals who experience miscarriage. Not having organizational support may make an individual’s experience of healing more challenging, impacting their professional and career development. The Solution Organizations can combat some of the challenges around pregnancy loss by implementing training & development and awareness development initiatives to educate around this topic and provide support for individuals who may be impacted. Stakeholders Stakeholders in this issue include HRD practitioners, managers and organizations that are committed to leveraging training & development initiatives to support employees and alleviating the organizational challenges surrounding the multiple journeys of working parenthood, including miscarriage.
Caution Regarding ChatGPT’s Appropriateness and Reliability Regarding Surgery for Wrist Arthritis
Authors: Hones Keegan , Krisanda Emily , Chim Harvey 
Published: July 2024

Background: Chat Generative Pre-Trained Transformer (ChatGPT), an artificial intelligence (AI) program, is widely used for information compilation. This study sought to analyze the quality and consistency of the information generated by ChatGPT regarding common procedures for wrist arthritis. Methods: 32 standardized questions regarding wrist osteoarthritis and related procedures (4-corner-fusion [4CF], proximal row carpectomy [PRC], resurfacing capitate pyrocarbon implant, wrist denervation, and total wrist arthrodesis and arthroplasty) were presented to the ChatGPT-3.5 interface 3 separate times, without feedback. ChatGPT’s answers were evaluated for medical accuracy by 3 reviewers and rated as “appropriate,” “appropriate but incomplete,” or “inappropriate.” Ratings were then converted to numerical values to calculate an intraclass correlation coefficient (ICC). A DISCERN score was used to assess quality, and Flesch-Kincade Grade Level and Flesch Reading Ease Score for readability. Results: 75% of the responses were deemed “appropriate,” with 23 questions receiving unanimous appropriate ratings across all responses. The ICC was 0.97 (95% CI [0.46, 0.98]), indicating excellent reliability. DISCERN score was 60 (good). The Flesch-Kincaid Grade Level was 14.6 ± 1.9, and the Flesch Reading Ease Score was 25.3 ± 6.7, implying a college reading level. The information that ChatGPT provided for PRC and total wrist arthrodesis and arthroplasty, appeared to be more reliable than for 4CF and denervation. Conclusion: ChatGPT’s reliability and accuracy of information varied across procedures, possibly due to unknown and diverse sources. Furthermore, while some answers were factually correct, many provided generic information across differing questions, limiting usefulness. ChatGPT must be used cautiously and the limitations understood.
Systematic Improvement of a Bolus Calculator That Is on the Market: A User-Centric Approach
Authors: Eichinger Valerie , de Klepper Mirjam , Zivkovic Josip , Malenczyk Katarzyna , Theodorou Delphine , Heinemann Lutz , Silbermann Stephan 
Published: July 2024

Background: State-of-the-art diabetes self-management includes the usage of (software) tools, such as Bolus Calculators, to support patients with their therapeutic decisions. The development of such medical devices comes with strict obligations to ensure the safety and performance for the user; however, it is also necessary to continue to evaluate such aspects after the products are introduced into the market. In addition, such aspects cannot always be sufficiently validated by clinical trials; they need real-world evaluation to systematically improve such tools while they are on the market. Methods: The approach described here uses innovative ways of generating user-centric evidence to improve the bolus calculator, including (1) human factor engineering, (2) analysis of glycemic real-world data, (3) patient-reported outcomes, and (4) machine-generated behavioral measurements. Results: The combination of the diverse techniques to optimize the bolus calculator triggered changes in the user experience: a significant reduction in hypoglycemic events, –0.52% (±0.05), P < .01, n=3480, an increased diabetes treatment satisfaction (Diabetes Treatment Satisfaction Questionnaire [DTSQ] +9.90, P < .01, n=217), as well as an increased acceptance rate of bolus calculations, +15.73 (±0.89), P < .01, n=3436, were observed. Conclusions: Altogether, human factor engineering and different forms of real-world data support fast and direct adaptations and improvements in products used for diabetes therapy.
Does FHL Tendon Transfer Alter the Outcome of Haglund Deformity Treatment by Using Debridement and Ostectomy in Patients Older Than 50 Years? A Single-Blinded Randomized Controlled Trial
Authors: Sabaghzadeh Amir , Ghanbari Naser , Gholamshahi Hediye , Zakeri Amir Mohammad , Shakeri Jousheghan Saman , Aslani Mohammadamin , Khoshkholghsima Maryam , Movahedinia Mohmmad 
Published: July 2024

Background: Chronic Achilles tendinopathy following Haglund disease is a common ankle condition that is difficult to manage. In this study, we will compare the clinical outcomes of debridement and ostectomy with and without FHL tendon transfer in treating Haglund deformity. Methods: Forty eligible patients aged >50 years who did not respond to conservative treatment were randomly divided into 2 groups for surgical approach: using flexor hallucis longus (FHL) tendon transfer (FHL group) or “standard procedure” (control group). The main surgical treatment included debridement and ostectomy. AOFAS and VISA-A scores were obtained from all patients pre- and postoperatively. Results: Twenty patients were assigned to each of the 2 groups and were observed for at least 1 year. The American Orthopaedic Foot & Ankle Society (AOFAS) ankle hindfoot scores and the Victorian Institute of Sports Assessment self-administered Achilles (VISA-A) questionnaires scores improved more in the FHL group; however, the average difference in the change in scores did not reach the levels previously reported for minimal clinically important differences. Surgical complications and hallux function were not significantly different between the 2 groups. Conclusion: We found that FHL tendon transfer may improve the clinical outcome scores of Achilles tendon treatment in patients aged >50 years using debridement and ostectomy. However, tendon transfer increases the time of surgery and creates additional skin incisions, which may cause more short-term wound complications, and the significance of the differences in outcome improvement may not be clinically meaningful. Level of Evidence: Level II, grade A recommendation.
Ruxolitinib for pediatric patients with treatment-naïve and steroid-refractory acute graft-versus-host disease: the REACH4 study
Authors: Locatelli Franco , Kang Hyoung Jin , Bruno Bénédicte , Gandemer Virginie , Rialland Fanny , Faraci Maura , Takahashi Yoshiyuki , Koh Katsuyoshi , Bittencourt Henrique , Cleary Grace , Rosko Christine , Li Xuechan , St Pierre Annie , Prahallad Anirudh , Diaz-de-Heredia Cristina 
Published: July 2024

Abstract
In REACH4, a phase 1/2, open-label, single-arm, multicenter study, the pharmacokinetics (PK), efficacy, and safety of ruxolitinib were evaluated in treatment-naïve and steroid-refractory pediatric patients with grade 2 to 4 acute graft-versus-host disease (aGVHD; n = 45). Ruxolitinib dosing was based on age and targeted the exposure in adults receiving 10 mg twice daily; group 1 (aged ≥12 to &lt;18 years) received 10 mg twice daily and preliminary starting doses for groups 2 (aged ≥6 to &lt;12 years) and 3 (aged ≥2 to &lt;6 years) were 5 mg twice daily and 4 mg/m2 twice daily, respectively. The phase 1 primary objective was to assess ruxolitinib PK parameters and define an age-appropriate recommended phase 2 dose (RP2D) for patients aged &lt;12 years. The phase 2 primary objective was to measure the activity of ruxolitinib as assessed by overall response rate (ORR) at day 28; the key secondary objective was to assess the durable ORR at day 56. Ruxolitinib exposure was comparable across age groups; starting doses were confirmed as the RP2D. The median duration of ruxolitinib exposure was 3.8 months (range, 0.3-11.2). ORR in all patients was 84.4% (90% confidence interval [CI], 72.8-92.5) at day 28, with a durable ORR at day 56 of 66.7% (90% CI, 53.4-78.2); high response rates were observed across age groups and in both treatment-naïve and steroid-refractory subgroups. Adverse events were consistent with those expected in patients with aGVHD (anemia, decreased neutrophil and leukocyte count) treated with ruxolitinib. In pediatric patients with aGVHD, ruxolitinib showed clinically meaningful efficacy with no new safety signals. This trial was registered at www.clinicaltrials.gov as #NCT03491215.
Critical role of tripartite fusion and LBD truncation in certain RARA- and all RARG-related atypical APL
Authors: Zhou Xiaosu , Chen Xue , Chen Jiaqi , Wen Lijun , Zhang Zhanglin , Qin Ya-Zhen , Cao Panxiang , Xing Haizhou , Mi Yingchang , Wang Wei , Zhang Guangsen , Li Ji , Wu Huanling , Zhang Zhifen , Zhang Jian , Su Zhan , Wang Fang , Zhang Yang , Ma Xiaoli , Fang Jiancheng , Wu Ping , Wang Tong , Fan Gaowei , Zhao Yang , Jin David , Zhang Xian , Ma Xiujuan , Wu Qisheng , Zhang Zhihua , Wang Linya , Ma Futian , Xiao Xia , Wu Chengye , Sun Kai , Tang Ruijie , Zhang Yun , Wu Sanyun , Gao Ran , Zhang Leping , Zheng Huyong , Zhao Yanli , Zhu Hong-Hu , Lu Daopei , Lu Peihua , Chen Suning , Liu Hongxing 
Published: July 2024

Abstract
Atypical acute promyelocytic leukemia (aAPL) presents a complex landscape of retinoic acid receptor (RAR) fusion genes beyond the well-known PML::RARA fusion. Among these, 31 individually rare RARA and RARG fusion genes have been documented, often reported in the canonical X::RAR bipartite fusion form. Intriguingly, some artificially mimicked bipartite X::RAR fusions respond well to all-trans retinoic acid (ATRA) in vitro, contrasting with the ATRA resistance observed in patients. To unravel the underlying mechanisms, we conducted a comprehensive molecular investigation into the fusion transcripts in 27 RARA fusion gene–positive aAPL (RARA-aAPL) and 21 RARG-aAPL cases. Our analysis revealed an unexpected novel form of X::RAR::X– or X::RAR::Y–type tripartite fusions in certain RARA-aAPL and all RARG-aAPL cases, with shared features and notable differences between these 2 disease subgroups. In RARA-aAPL cases, the occurrence of RARA 3′ splices was associated with their 5′ fusion partner genes, mapping across the coding region of helix 11_12 (H11_12) within the ligand-binding domain (LBD), resulting in LBD-H12 or H11_12 truncation. In RARG-aAPL cases, RARG 3′ splices were consistently localized to the terminus of exon 9, leading to LBD-H11_12 truncation. Significant differences were also observed between RARA and RARG 5′ splice patterns. Our analysis also revealed extensive involvement of transposable elements in constructing RARA and RARG 3′ fusions, suggesting transposition mechanisms for fusion gene ontogeny. Both protein structural analysis and experimental results highlighted the pivotal role of LBD-H11_12/H12 truncation in driving ATRA unresponsiveness and leukemogenesis in tripartite fusion–positive aAPL, through a protein allosteric dysfunction mechanism.
A predictive model for therapy failure in patients with chronic myeloid leukemia receiving tyrosine kinase inhibitor therapy
Authors: Zhang Xiaoshuai , Liu Bingcheng , Huang Jian , Zhang Yanli , Xu Na , Gale Robert Peter , Li Weiming , Liu Xiaoli , Zhu Huanling , Pan Ling , Yang Yunfan , Lin Hai , Du Xin , Liang Rong , Chen Chunyan , Wang Xiaodong , Li Guohui , Liu Zhuogang , Zhang Yanqing , Liu Zhenfang , Hu Jianda , Liu Chunshui , Li Fei , Yang Wei , Meng Li , Han Yanqiu , Lin Li’e , Zhao Zhenyu , Tu Chuanqing , Zheng Caifeng , Bai Yanliang , Zhou Zeping , Chen Suning , Qiu Huiying , Yang Lijie , Sun Xiuli , Sun Hui , Zhou Li , Liu Zelin , Wang Danyu , Guo Jianxin , Pang Liping , Zeng Qingshu , Suo Xiaohui , Zhang Weihua , Zheng Yuanjun , Huang Xiaojun , Jiang Qian 
Published: July 2024

Abstract
Although tyrosine kinase inhibitor (TKI) therapy has markedly improved the survival of people with chronic-phase chronic myeloid leukemia (CML), 20% to 30% of people still experienced therapy failure. Data from 1955 consecutive patients with chronic-phase CML diagnosed by the European LeukemiaNet recommendations from 1 center receiving initial imatinib or a second-generation (2G) TKI therapy were interrogated to develop a clinical prediction model for TKI-therapy failure. This model was subsequently validated in 3454 patients from 76 other centers. Using the predictive clinical covariates associated with TKI-therapy failure, we developed a model that stratified patients into low-, intermediate- and high-risk subgroups with significantly different cumulative incidences of therapy failure (P &lt; .001). There was good discrimination and calibration in the external validation data set, and the performance was consistent with that of the training data set. Our model had the better prediction discrimination than the Sokal and European Treatment and Outcome Study long-term survival scores, with the greater time-dependent area under the receiver-operator characteristic curve values and a better ability to redefine the risk of therapy failure. Our model could help physicians estimate the likelihood of initial imatinib or 2G TKI–therapy failure in people with chronic-phase CML.
JAK2/mTOR inhibition fails to prevent acute GVHD despite reduced Th1/Th17 cells: final phase 2 trial results
Authors: Pidala Joseph , Holtan Shernan G. , Walton Kelly , Kim Jongphil , Cao Biwei , Elmariah Hany , Mishra Asmita , Bejanyan Nelli , Nishihori Taiga , Khimani Farhad , Perez Lia , Faramand Rawan G. , Davila Marco L. , McSain Shannon , Pleskow Jordan , Baron Jeffrey , Anasetti Claudio , Moran Segura Carlos , Weisdorf Daniel J. , Blazar Bruce R. , Miller Jeffrey S. , Bachanova Veronika , El Jurdi Najla , Betts Brian C. 
Published: July 2024

Abstract
Our phase 1 graft-versus-host disease (GVHD) prevention trial of JAK2 inhibitor, pacritinib (PAC; recommended phase 2 dose: 100 mg orally twice a day on day 0 to +70) plus sirolimus and tacrolimus (SIR/TAC) demonstrated the regimen was safe and free of pan-JAK myelosuppression after allogeneic hematopoietic cell transplantation (alloHCT). PAC inhibits interleukin 6 (IL-6) receptor activity and pathogenic T helper cell 1 (Th1)/Th17 differentiation in preclinical models and the phase 1 trial. Herein, we report on our completed phase 2 trial of PAC/SIR/TAC after 8/8 human leukocyte antigen matched alloHCT. This single-arm phase 2 trial (NCT02891603) was powered to determine if PAC/SIR/TAC suppressed percentage phosphorylated STAT3 (pSTAT3)+ CD4+ T cells at day +21 (primary end point: percentage pSTAT3+ CD4+ T cells ≤ 35%) and estimated grade II to IV acute GVHD by day +100. The impact of PAC/SIR/TAC on T-cell subsets, CD28 (pS6 and pH3ser10), and IL-2 receptor (pSTAT5) signal transduction was also evaluated. Eligible patients (n = 28) received alloHCT for hematologic malignancies or myeloproliferative neoplasms. Reduced or myeloablative intensity conditioning was permitted. PAC/SIR/TAC met the primary end point, reducing percentage pSTAT3+ CD4+ T cells to 9.62% at day +21. Th1/Th17 cells were decreased at day +21, increasing the ratio of regulatory T cells to Th1 and Th17 cells with PAC/SIR/TAC at recommended phase 2 dose PAC compared with dose level 1 PAC. The cumulative incidence of grade II to IV acute GVHD by day +100 with PAC/SIR/TAC was similar to historic SIR/TAC values (46% vs 43%). Although PAC/SIR/TAC suppressed pSTAT3 and Th1/Th17 cells, the regimen did not improve acute GVHD prevention.
Diagnostic guidelines for familial hemophagocytic lymphohistiocytosis revisited
Authors: Henter Jan-Inge , Sieni Elena , Eriksson Julia , Bergsten Elisabet , Hed Myrberg Ida , Canna Scott W. , Coniglio Maria Luisa , Cron Randy Q. , Kernan Kate F. , Kumar Ashish R. , Lehmberg Kai , Minoia Francesca , Naqvi Ahmed , Ravelli Angelo , Tang Yong-Min , Bottai Matteo , Bryceson Yenan T. , Horne AnnaCarin , Jordan Michael B. 
Published: July 2024

Abstract
Current hemophagocytic lymphohistiocytosis 2004 (HLH-2004)–based diagnostic criteria for familial hemophagocytic lymphohistiocytosis (FHL) are based on expert opinion. Here, we performed a case-control study to test and possibly improve these criteria. We also developed 2 complementary expert opinion–based diagnostic strategies for FHL in patients with signs/symptoms suggestive of HLH, based on genetic and cellular cytotoxicity assays. The cases (N = 366) were children aged &lt;16 years with verified familial and/or genetic FHL (n = 341) or Griscelli syndrome type 2 (n = 25); 276 from the HLH-94/HLH-2004 databases and 90 from the Italian HLH Registry. All fulfilled the HLH-94/HLH-2004 patient inclusion criteria. Controls were 374 children with systemic-onset juvenile idiopathic arthritis (sJIA) and 329 + 361 children in 2 cohorts with febrile infections that could be confused with HLH and sepsis, respectively. To provide complete data sets, multiple imputations were performed. The optimal model, based on 17 variables studied, revealed almost similar diagnostic thresholds as the existing criteria, with accuracy 99.1% (sensitivity 97.1%; specificity 99.5%); the original HLH-2004 criteria had accuracy 97.4% (sensitivity 99.0%; specificity 97.1%). Because cellular cytotoxicity assays here constitute a separate diagnostic strategy, HLH-2004 criteria without natural killer (NK)–cell function was also studied, which showed accuracy 99.0% (sensitivity, 96.2%; specificity, 99.5%). Thus, we conclude that the HLH-2004 criteria (without NK-cell function) have significant validity in their current form when tested against severe infections or sJIA. It is important to exclude underlying malignancies and atypical infections. In addition, complementary cellular and genetic diagnostic guidelines can facilitate necessary confirmation of clinical diagnosis.
A permutable MLP-like architecture for disease prediction from gut metagenomic data
Authors: Jiang Cong , Yang Jian , Peng Xiaogang , Li Xiaozheng 
Published: July 2024

AbstractMetagenomic data plays a crucial role in analyzing the relationship between microbes and diseases. However, the limited number of samples, high dimensionality, and sparsity of metagenomic data pose significant challenges for the application of deep learning in data classification and prediction. Previous studies have shown that utilizing the phylogenetic tree structure to transform metagenomic abundance data into a 2D matrix input for convolutional neural networks (CNNs) improves classification performance. Inspired by the success of a Permutable MLP-like architecture in visual recognition, we propose Metagenomic Permutator (MetaP), which applied the Permutable MLP-like network structure to capture the phylogenetic information of microbes within the 2D matrix formed by phylogenetic tree. Our experiments demonstrate that our model achieved competitive performance compared to other deep neural networks and traditional machine learning, and has good prospects for multi-classification and large sample sizes. Furthermore, we utilize the SHAP (SHapley Additive exPlanations) method to interpret our model predictions, identifying the microbial features that are associated with diseases.