bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elevated Plasma Lipoprotein(a) Level and Atherosclerotic Cardiovascular Disease Risks: A Large Clinical Retrospective Study
Authors: Wang Kexin , Wang Wenjie , Niu Jialong , Liu Xiaoli , Han Hongya , Shen Hua , Sun Yan , Gao Wen , Ge Hailong 
Published: March 2024

Patients with well-controlled low-density lipoprotein cholesterol (LDL-C) levels still suffer from the progress of the atherosclerotic cardiovascular disease (ASCVD) and can develop adverse outcomes. We conducted this study to analyze the relationship between elevated lipoprotein(a) [Lp(a)] levels and ASCVD risk. We enrolled 8070 patients in the ASCVD group and 440 participants in the non-ASCVD group [median age of 60 years; 6376 (74.9%) were male]. Multivariate logistic regression models were used to identify the relationships between the lipids and ASCVD. These models showed that the Lp(a) level was a significant independent risk factor for ASCVD [odds ratio (OR) = 1.025, confidence interval (CI) = 1.020–1.029, P < .001]. The different categories analysis showed the OR of the high Lp(a)/low LDL-C group was 9.612 [CI = 6.206–14.887], P < .001. Our study demonstrated that elevated Lp(a) levels were associated with the increased ASCVD risk. Also, the patients with low LDL-C but high Lp(a) levels still had a higher risk of developing ASCVD than the low Lp(a)/high LDL-C group. In addition, elevated Lp(a) levels were associated with a higher ASCVD risk in males, hypertensive, and diabetic patients.
Development of a palliative paramedicine framework to standardise best practice: A Delphi study
Authors: Juhrmann Madeleine L , Butow Phyllis N , Simpson Paul , Boughey Mark , Makeham Meredith , Clayton Josephine M 
Published: March 2024

Background: Growing global demand for palliative care services has prompted generalist clinicians to provide adjunct support to specialist teams. Paramedics are uniquely placed to respond to these patients in the community. However, embedding palliative care principles into their core business will require multifactorial interventions at structural, healthcare service and individual clinician and consumer levels. Aim: To develop a palliative paramedicine framework suitable for national implementation, to standardise best practice in Australia. Design: Delphi study utilising questionnaire completion; each round informed the need for, and content of, the next round. Free text comments were also sought in Round 1. Two rounds of Delphi were undertaken. Setting/participants: Sixty-eight participants took part in Round 1, representing six countries, and 66 in Round 2. Participants included paramedics, palliative care doctors and nurses, general practitioners, researchers and carers with lived experience and expertise in palliative paramedicine. Results: Seventeen of the original 24 components gained consensus; 6 components were modified; and 9 new components arose from Round 1. All modified and new components gained consensus in Round 2. Only one original component did not gain consensus across both rounds and was excluded from the final 32-component framework. Conclusion: This study has developed a comprehensive national framework addressing the macro-, meso- and micro-level interventions required to standardise palliative paramedicine across Australia. Future research ought to engage a multidisciplinary team to create an implementation strategy, addressing any perceived barriers, facilitators and challenges for applying the framework into policy and practice.
Preoperative Velopharyngeal Closure Predicts Hypernasality Outcomes of Secondary Furlow Double-Opposing Z-Plasty
Authors: Prezelski Kayla , Kim Carolyn , Perez Jeyna , Vant Slot Cortney , Kane Alex A. , Seaward James R. 
Published: March 2024

Objective To determine if preoperative velopharyngeal closure percentage (VCP) is predictive of successful Furlow double opposing Z-plasty (DOZP) and subsequently determine the optimal velopharyngeal closure cutoff for successful DOZP. Design Retrospective study Setting Tertiary academic center Patients 110 patients with repaired cleft lip and palate having hypernasality treated with DOZP Interventions Speech videofluoroscopy images were used to obtain the preoperative VCP and other measurements. Main Outcome Measures Changes in hypernasality scores using the Cleft Audit Protocol for Speech-Augmented-Americleft Modification (CAPS-A-AM) rating system were used as the primary outcome measure. A successful DOZP was defined as a postoperative hypernasality score of ≤ 1 or an improvement of 2 or more scores from baseline. A receiver operating characteristic (ROC) curve was calculated to determine preoperative VCP cutoff. Results There were 110 patients who underwent DOZP for treatment of velopharyngeal insufficiency. Of these patients, 94 (85%) had successful surgery as determined by their postoperative CAPS-A-AM hypernasality score. Preoperative VCP was a statistically significant predictor of successful DOZP ( P < .0001). The ROC curve with Youden index (J) determined a cutoff (c*) of 55% preoperative VCP or greater to optimize surgical success rate. Grouping by preoperative VCP showed that surgical success increases directly with preoperative VCP, and patients with low VCP had above a 50% success rate in reducing hypernasality scores. Conclusions Preoperative VCP was significantly associated with improved hypernasality ratings postoperatively. A preoperative VCP of ≥55% may be used to help predict success of Furlow palatoplasty treatment. Patients with lower VCP can still benefit from secondary DOZP.
A Longitudinal Analysis of Pre- and Post-Operative Dysmorphology in Metopic Craniosynostosis
Authors: Beiriger Justin W. , Tao Wenzheng , Irgebay Zhazira , Smetona John , Dvoracek Lucas , Kass Nicolás M. , Dixon Angel , Zhang Casey , Mehta Meeti , Whitaker Ross , Goldstein Jesse A. 
Published: March 2024

Objective The purpose of this study is to objectively quantify the degree of overcorrection in our current practice and to evaluate longitudinal morphological changes using CranioRateTM, a novel machine learning skull morphology assessment tool.   Design Retrospective cohort study across multiple time points. Setting Tertiary care children's hospital. Patients Patients with preoperative and postoperative CT scans who underwent fronto-orbital advancement (FOA) for metopic craniosynostosis. Main Outcome Measures We evaluated preoperative, postoperative, and two-year follow-up skull morphology using CranioRateTM to generate a Metopic Severity Score (MSS), a measure of degree of metopic dysmorphology, and Cranial Morphology Deviation (CMD) score, a measure of deviation from normal skull morphology. Results Fifty-five patients were included, average age at surgery was 1.3 years. Sixteen patients underwent follow-up CT imaging at an average of 3.1 years. Preoperative MSS was 6.3 ± 2.5 (CMD 199.0 ± 39.1), immediate postoperative MSS was −2.0 ± 1.9 (CMD 208.0 ± 27.1), and longitudinal MSS was 1.3 ± 1.1 (CMD 179.8 ± 28.1). MSS approached normal at two-year follow-up (defined as MSS = 0). There was a significant relationship between preoperative MSS and follow-up MSS (R2 = 0.70). Conclusions MSS quantifies overcorrection and normalization of head shape, as patients with negative values were less “metopic” than normal postoperatively and approached 0 at 2-year follow-up. CMD worsened postoperatively due to postoperative bony changes associated with surgical displacements following FOA. All patients had similar postoperative metopic dysmorphology, with no significant association with preoperative severity. More severe patients had worse longitudinal dysmorphology, reinforcing that regression to the metopic shape is a postoperative risk which increases with preoperative severity.
Open Reduction Internal Fixation vs Primary Arthrodesis for Displaced Lisfranc Injuries: A Multicenter Randomized Controlled Trial
Authors: Ponkilainen Ville , Mäenpää Heikki , Laine Heikki-Jussi , Partio Nikke , Väistö Olli , Jousmäki Janne , Mattila Ville M. , Haapasalo Heidi 
Published: March 2024

Background: There is no consensus whether the primary surgical method should be open reduction and internal fixation (ORIF) or primary arthrodesis (PA) for Lisfranc injuries. The aim of our randomized controlled trial was to compare ORIF and PA for displaced Lisfranc injuries. Methods: This study was a national multicenter randomized controlled trial. Altogether 43 displaced Lisfranc injuries were enrolled in this trial. The primary outcome measure was Visual Analogue Scale Foot and Ankle (VAS-FA) at a 24-months follow-up. The secondary outcome measures were VAS-FA pain, function, and other complaints subscales and the American Orthopaedic Foot & Ankle Society (AOFAS) Midfoot Scale. All outcomes were measured at 6, 12, and 24 months. We were unable to reach the planned sample size of 60 patients; thus, the study remains underpowered. Results: The mean VAS-FA Overall score in the ORIF group was 86.5 (95% CI 77.9, 95.1) and 80.1 (95% CI 72.0, 88.1) in the PA group at the 24-month follow-up. We did not find eligible evidence of a difference in VAS-FA Overall scores (mean between-group difference 6.5 [95% CI −5.3, 18.2], Cohen d = 0.100). Conclusion: We did not find evidence of a difference in VAS-FA between ORIF and PA in patients with displaced Lisfranc injuries, and thus both are viable options for the initial surgical method. The trial is underpowered; however, the data may be included in a meta-analysis of similarly designed randomized controlled trials. ClinicalTrials.gov identifier: NCT02953067 24 October 2016.
Revision rate following unipolar versus bipolar hemiarthroplasty
Authors: Kugelman David , Robin Joseph X , Schaffler Benjamin C , Davidovitch Roy , Egol Kenneth , Schwarzkopf Ran 
Published: March 2024

Introduction: There has been much debate on use of bipolar or unipolar femoral heads in hemiarthroplasty for the treatment of femoral neck fractures. The outcome of these implants should be studied in the America Joint Replacement Registry (AJRR). Methods: All primary femoral neck fractures treated with hemiarthroplasty between January 2012 and June 2020 were searched in the AJRR. All cause-revision of unipolar and bipolar hemiarthroplasty and reasons for revision were assessed for these patients until June of 2023. Results: There were no differences in number and reason for all cause revisions between unipolar and bipolar hemiarthroplasty ( p  = 0.41). Bipolar hemiarthroplasty had more revisons at 6 months postoperatively ( p  = 0.0281), but unipolar hemiarthroplasty had more revisions between 2 and 3 years ( p  = 0.0003), and after 3-years ( p  = 0.0085), as analysed with a Cox model. Patients with older age (HR = 0.999; 95% CI, 0.998–0.999; p  = 0.0006) and higher Charlson Comorbidity Index (HR = 0.996; 95% CI, 0.992– 0.999; p  = 0.0192) had a significant increase in revision risk. Conclusions: We suggest that surgeons should consider using bipolar prosthesis when performing hemiarthroplasty for femoral neck fracture in patients expected to live >2 years post injury.
Biplanar Anterior Opening Wedge Proximal Tibial Osteotomy to Correct Reverse Tibial Slope
Authors: Olson Conner , Tollefson Luke V. , Shoemaker Evan P. , Kennedy Nicholas I. , LaPrade Robert F. 
Published: March 2024

Background: Anatomically, native posterior tibial slope (PTS) ranges from 6° to 10° and have significant effects on cruciate ligament stability. PTS <6° is correlated with increased posterior tibial translation (PTT) and force on the posterior cruciate ligament (PCL), predisposing individuals to PCL injuries and an increased risk of PCL graft attenuation. In rare cases, a reverse tibial slope can occur (<0°) as a result of trauma, physeal arrest, or abnormal development. This results in increased PTT and can lead to posterior tibial subluxation. Reverse tibial slopes in patients can be treated with an anterior opening wedge proximal tibial osteotomy, which increases the PTS to a more anatomic position. Indications: Biplanar anterior opening wedge proximal tibial osteotomies are indicated in patients with a reverse tibial slope both with the absence of PCL insufficiency or in conjunction with PCL reconstruction. Technique Description: Under fluoroscopic imaging, 2 guide pins were placed perpendicular to the tibial shaft. An oscillating saw and osteotomes completed the osteotomy in line with the guide pins with the posterior cortex remaining intact. The osteotomy site was slowly opened with a spreader device to 9 mm until the posterior drawer was such that the palpable step-off between the anterior aspect of the medial femoral condyle and the medial tibial plateau was comparable to the contralateral knee. Due to the patient having slight valgus coronal plane alignment, an opening-wedge posteriorly sloped plate was then placed anterolaterally and fixed while wedges held the osteotomy open. Results: Biplanar anterior opening wedge osteotomies correct a flattened PTS and reverse tibial slope, and coronal malalignment, and has been shown to decrease PCL laxity, preventing future PCL failure. Discussion: Biomechanical studies have shown that decreased tibial slope is correlated with an increased risk of PCL injury and PCL graft failure. In patients with reverse tibial slope, experienced instability can mimic PCL insufficiency despite there being no ligamentous damage. We describe a technique that corrects reverse tibial slope and with a discussion of surgical pearls and pitfalls. This technique restores anatomic position and normal function of the knee while correcting the sagittal malalignment that could lead to future injuries. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Second primary malignancies after commercial CAR T-cell therapy: analysis of the FDA Adverse Events Reporting System
Authors: Elsallab Magdi , Ellithi Moataz , Lunning Matthew A. , D’Angelo Christopher , Ma Jihyun , Perales Miguel-Angel , Frigault Matthew , Maus Marcela V. 
Published: March 2024

Abstract
Second primary malignancies were reported in 536 of 12 394 (4.3%) adverse event reports following chimeric antigen receptor T-cell therapies in the Food and Drug Administration Adverse Event Reporting System. Myeloid and T-cell neoplasms were disproportionately more frequently reported, warranting further follow-up.
A temporal developmental map separates human NK cells from noncytotoxic ILCs through clonal and single-cell analysis
Authors: Vo Dang Nghiem , Yuan Ouyang , Kanaya Minoru , Telliam-Dushime Gladys , Li Hongzhe , Kotova Olga , Caglar Emel , Honnens de Lichtenberg Kristian , Rahman Shamim Herbert , Soneji Shamit , Scheding Stefan , Bryder David , Malmberg Karl-Johan , Sitnicka Ewa 
Published: March 2024

AbstractNatural killer (NK) cells represent the cytotoxic member within the innate lymphoid cell (ILC) family that are important against viral infections and cancer. Although the NK cell emergence from hematopoietic stem and progenitor cells through multiple intermediate stages and the underlying regulatory gene network has been extensively studied in mice, this process is not well characterized in humans. Here, using a temporal in vitro model to reconstruct the developmental trajectory of NK lineage, we identified an ILC-restricted oligopotent stage 3a CD34−CD117+CD161+CD45RA+CD56− progenitor population, that exclusively gave rise to CD56-expressing ILCs in vitro. We also further investigated a previously nonappreciated heterogeneity within the CD56+CD94−NKp44+ subset, phenotypically equivalent to stage 3b population containing both group-1 ILC and RORγt+ ILC3 cells, that could be further separated based on their differential expression of DNAM-1 and CD161 receptors. We confirmed that DNAM-1hi S3b and CD161hiCD117hi ILC3 populations distinctively differed in their expression of effector molecules, cytokine secretion, and cytotoxic activity. Furthermore, analysis of lineage output using DNA-barcode tracing across these stages supported a close developmental relationship between S3b-NK and S4-NK (CD56+CD94+) cells, whereas distant to the ILC3 subset. Cross-referencing gene signatures of culture-derived NK cells and other noncytotoxic ILCs with publicly available data sets validated that these in vitro stages highly resemble transcriptional profiles of respective in vivo ILC counterparts. Finally, by integrating RNA velocity and gene network analysis through single-cell regulatory network inference and clustering we unravel a network of coordinated and highly dynamic regulons driving the cytotoxic NK cell program, as a guide map for future studies on NK cell regulation.
Economic evaluation: immunoglobulin vs prophylactic antibiotics in hypogammaglobulinemia and hematological malignancies
Authors: Carrillo de Albornoz Sara , Higgins Alisa M. , Petrie Dennis , Irving Adam , Fanning Laura , Weinkove Robert , Crispin Philip , Dendle Claire , Gilbertson Michael , Johnston Anna , Keegan Anastazia , Pepperell Dominic , Pullon Humphrey , Reynolds John , van Tonder Tina , Trotman Judith , Waters Neil , Wellard Cameron , Weston Helen , Morrissey C. Orla , Wood Erica M. , McQuilten Zoe K. 
Published: March 2024

Abstract
Patients with hematological malignancies are at high risk of developing hypogammaglobulinemia (HGG) and infections. Immunoglobulin (Ig) is one recommended option to prevent these infections, but it is expensive, and its cost-effectiveness compared with other prevention strategies remains unknown. We conducted a trial–based economic evaluation from the Australian health care system perspective to estimate the 12-month cost-effectiveness of prophylactic Ig vs prophylactic antibiotics in 63 adults with HGG and hematological malignancies participating in the RATIONAL feasibility trial. Two analyses were conducted: (1) cost-utility analysis to assess the incremental cost per quality-adjusted life year (QALY) gained; and (2) cost-effectiveness analysis to assess the incremental cost per serious infection prevented (grade ≥3) and per any infection (any grade) prevented. Over 12 months, the total cost per patient was significantly higher in the Ig group than in the antibiotic group (mean difference, AU$29 140; P &lt; .001). Most patients received IVIg, which was the main cost driver; only 2 patients in the intervention arm received subcutaneous Ig. There were nonsignificant differences in health outcomes. Results showed Ig was more costly than antibiotics and associated with fewer QALYs. The incremental cost-effectiveness ratio of Ig vs antibiotics was AU$111 262 per serious infection prevented, but Ig was more costly and associated with more infections when all infections were included. On average and for this patient population, Ig prophylaxis may not be cost-effective compared with prophylactic antibiotics. Further research is needed to confirm these findings in a larger population and considering longer-term outcomes. The trial was registered at the Australian and New Zealand Clinical Trials Registry as #ACTRN12616001723471.
The illness burden of severe asthma contrasted to people with mild-to-moderate asthma: a qualitative study
Authors: Majellano Eleanor C. , Yorke Janelle , Clark Vanessa L. , Gibson Peter G. , Smith Amber J. , Holmes Leanne J. , McDonald Vanessa M. 
Published: March 2024

BackgroundDisabling symptoms of asthma including breathlessness, cough, wheeze and chest tightness largely impact quality of life; however, how these symptoms impact people with asthma of different severity levels remains unknown. This study aimed to compare and characterise patients' symptom experience and the burden caused, their quality of life, and the medication preferences of people with severe asthma against those of people with mild-to-moderate asthma.MethodsThis was a multisite qualitative study involving two focus groups and semistructured interviews of adults with severe asthma undertaken in Australia and UK. Interviews were also undertaken in people with mild-to-moderate asthma. Audio recordings were transcribed and analysed thematically.ResultsParticipants in both severe asthma and mild-to-moderate asthma groups had a mean±sdage of 57±12 years. Between the severe asthma and mild-to-moderate asthma groups, 62% of participants were female and 86% lived with family. Themes were identified: 1) what is asthma and most bothersome symptoms: both groups reported breathlessness as the most bothersome symptom; 2) impacts on life: disease-related impact differed as people with severe asthma reported significant burden in their quality of life, which encompassed emotional, physical, social and financial wellbeing; and 3) personalised and responsive care: severe asthma interviewees preferred injectable biological therapy as a mode of treatment administration.ConclusionsPeople with asthma are burdened by breathlessness and cough and other disabling symptoms resulting in impaired quality of life. Understanding the experiences of people with asthma of different severities can improve the patient–clinician partnership.
Nontuberculous mycobacterial pulmonary disease added burden to COPD and bronchiectasis in Japan
Authors: Wang Ping , Morimoto Kozo , Hasegawa Naoki , Hassan Mariam , Chatterjee Anjan 
Published: March 2024

Background and objectiveNontuberculous mycobacterial pulmonary disease (NTM-PD) prevalence in Japan is among the highest worldwide. COPD and bronchiectasis are common comorbidities among patients with NTM-PD, and it is challenging to treat NTM-PD in patients with these conditions. There are limited data on the incremental burden that NTM-PD adds to underlying COPD or bronchiectasis in Japan. Therefore, the objective of this study was to assess the incremental burden associated with NTM-PD in patients with pre-existing COPD and/or bronchiectasis.MethodsThis nested case–control study was based on JMDC, Inc. claims data (2015–2020). Patients with COPD and/or bronchiectasis with NTM-PD (cases) were age and sex matched 1:3 to patients with COPD and/or bronchiectasis without NTM-PD (controls), resulting in three mutually exclusive patient groups (COPD, bronchiectasis or both; with or without NTM-PD). Incremental burden of NTM-PD was assessed within each group by comparing hospitalisations during the 1-year period after NTM-PD diagnosis (index) between cases and controls with both univariate analysis and multivariate analysis adjusting for pre-index comorbidities.ResultsUnivariate analyses in the three patient groups consistently demonstrated incremental hospitalisation burden in casesversuscontrols (e.g.COPD group: 20% of 492 casesversus13% of 1476 controls had all-cause hospitalisations; 11%versus5% had respiratory-related hospitalisations; and 6%versus2% had COPD-related hospitalisations). Subsequent multivariate analysis further confirmed the findings.ConclusionsThe substantial incremental burden of hospitalisation associated with NTM-PD in patients with COPD and/or bronchiectasis highlights the urgent need for appropriate management of NTM-PD in Japan.