bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of a blended booster programme for the long-term outcome of cognitive behavioural therapy for MS-related fatigue: A randomized controlled trial
Authors: de Gier Marieke , Beckerman Heleen , Twisk Jos WR , Knoop Hans , de Groot Vincent 
Published: November 2023

Background: Cognitive behavioural therapy (CBT) reduces MS-related fatigue. However, studies on the long-term effects show inconsistent findings. Objective: To evaluate whether a blended booster programme improves the outcome of CBT for MS-related fatigue on fatigue severity at 1-year follow-up. Method: A multicentre randomized clinical trial in which 126 patients with MS were allocated to either a booster programme or no booster programme (control), after following 20-week tailored CBT for MS-related fatigue. Primary outcome was fatigue severity assessed with the Checklist Individual Strength fatigue subscale 1 year after start of treatment (T52). Mixed model analysis was performed by a statistician blinded for treatment-allocation to determine between-group differences in fatigue severity. Results: Fatigue severity at 1-year follow-up did not differ significantly between the booster ( N = 62) and control condition ( N = 64) ( B = −2.01, 95% confidence interval (CI) = −4.76 to 0.75). No significant increase in fatigue severity was found at T52 compared with directly post-treatment (T20) in both conditions ( B = 0.44, 95% CI = −0.97 to 1.85). Conclusion: Effects of CBT were sustained up to 1 year in both conditions. The booster programme did not significantly improve the long-term outcome of CBT for MS-related fatigue. Trial registration: Dutch Trial Register (NTR6966), registered 18 January 2018 https://www.trialregister.nl/trial/6782
Study on acoustic performance of new spiral sound absorbing and insulating metamaterial
Authors: Liu Song , Liu Pan-pan , Zhao Ren-jie , Lu Jian-hua , Yang Kang , Zhou Huayu , Du Yi-fan 
Published: November 2023

Middle and low frequency band sound waves have strong penetration and diffraction abilities during the propagation process, making it difficult to attenuate. The control of middle and low frequency broadband sound waves has become a challenging topic. Therefore, it is necessary to develop new materials or structures with middle and low frequency sound absorption, insulation, and noise reduction functions. The special properties of acoustic metamaterial provide new ideas for the development of sound absorption and insulation. In order to effectively control the noise in the lower frequency band, a new spatial spiral acoustic metamaterial was designed. First, the mechanism of band gap characteristics of a new spatial spiral acoustic metamaterial is analyzed. Then, a new spatial spiral acoustic metamaterial is completed through the finite element software COMSOL Multiphysics and the calculation and analysis of sound absorption and insulation performance in the 100–2500 Hz frequency band are completed. With the help of 3D printing, the preparation of metamaterial is completed, and the comparative experimental study of sound absorption and insulation performance of spiral acoustic metamaterial is carried out to verify the accuracy of the calculation method.
Scaled TelePhysical Therapy Program a Promising Option for Post-acute Care of Lower-Extremity Arthroplasty Patients
Authors: Fisher Charles , Wysin Catherine , Moeller Lauren , Nguyen Joseph 
Published: November 2023

Background: Post-acute care for orthopedic surgery patients continues to evolve with the reduction in hospital length of stay (LOS), shift to ambulatory surgery, increased number of surgeries, and focus on value-based care. Purpose: We sought to examine outcomes of a cohort of lower-extremity arthroplasty patients receiving telephysical therapy (TelePT) according to hospital LOS, as a means of exploring the viability of TelePT as a value-based discharge option. Methods: A retrospective review was conducted of patients who participated in our institution’s HSS@Home TelePT program after undergoing primary unilateral hip or knee arthroplasty, unicondylar knee replacement, or hip resurfacing. Demographic data and outcomes such as hospital LOS, number of days between discharge and TelePT evaluation, number of TelePT visits, number of re-admissions, Hip dysfunction and Osteoarthritis Outcome (HOOS Jr.) or Knee injury and Osteoarthritis Outcome (KOOS Jr.) scores, and patient satisfaction scores were collected. Patients were divided into categories based on hospital LOS to help determine the versatility of program. Results: In the 2814 patients included, we observed an average of 4.1 TelePT visits; 1% of patients were readmitted within 90 days, and 97% of patients were satisfied or highly satisfied. There was no difference in HOOS or KOOS Jr. scores at each follow-up time point, except for the 6-month HOOS Jr. scores. Conclusion: This retrospective study suggests that TelePT may be a viable option for care of lower-extremity arthroplasty patients in the post-acute setting, regardless of hospital LOS. As a discharge option, it may meet the needs of select patients to fill a gap in providing value-based care.
The Efficiency of Highly Porous β-Tricalcium Phosphate With Bone Marrow Aspirate Concentrate in Midfoot Joint Arthrodesis
Authors: Lee Wonyong , Prat Dan , Chao Wen , Farber Daniel C. , Wang Carol , Wapner Keith L. 
Published: November 2023

Background Nonunion is one of the most common and devastating complications following midfoot joint arthrodesis. Many different types of bone grafts and bone substitutes have been used to promote osseous fusion. However, there is no consensus on the gold standard bone grafting material and whether biologic materials should be used alone or in combination. The purpose of this study is to investigate the efficiency of highly porous β-tricalcium phosphate (β-TCP) with bone marrow aspirate concentrate (BMAC) in midfoot joint arthrodesis. Methods This retrospective comparative study included patients who underwent midfoot joint arthrodesis using compression screws. Patients were classified into 2 groups: arthrodesis with highly porous β-TCP and BMAC (group A) and arthrodesis without them (group B). The osseous union rate was compared between the 2 groups. A total of 44 patients (46 feet) including 89 joints were included in this study. Results There was a significant difference in the union rate between the 2 groups: 91.5% (43/47 joints) in arthrodesis with highly porous β-TCP and BMAC (group A) and 76.2% (32/42 joints) in arthrodesis without highly porous β-TCP and BMAC (group B; P = .048). Conclusion This study investigated the efficiency of highly porous β-TCP and BMAC to promote bony healing in midfoot joint arthrodesis. A significantly higher union rate was shown when arthrodesis was performed with highly porous β-TCP and BMAC, compared with arthrodesis performed without them. We suggest that highly porous β-TCP and BMAC can be a viable and effective adjunct to the fixation in midfoot joint arthrodesis. Level of Evidence: Level III: Retrospective comparative analysis
Landmarks for a Minimally Invasive Approach for Haglund’s Deformity: A Cadaveric Study
Authors: Mateen Sara , Cottom James , Jappar Asma , Siddiqui Noman A. 
Published: November 2023

Introduction Haglund’s deformity is a posterosuperior calcaneal prominence often associated with a painful bursa and insertional Achilles tendinopathy. Endoscopic debridement has been previously described; however, the aim of this cadaveric study is to describe landmarks of a minimally invasive surgical (MIS) approach to Haglund’s deformity. Methods Twelve specimens were dissected to identify medial and lateral portals for minimally invasive burr placement and anchor placement. A standard ruler was used to measure the distance in millimeters from the medial and lateral neurovascular structures in relation to medial and lateral portals. A separate 7-cm longitudinal incision posterior to the lateral malleolus and a separate 7-cm longitudinal incision posterior to the medial malleolus were made to identify at-risk neurovascular structures Results The average distance from the sural nerve to the lateral portal was 25.7 mm (23-26). The mean distance from the lateral calcaneal branch of the sural nerve to lateral portal was 11.4 mm (10-12). The mean distance from the tibial nerve to the medial portal was 35.3 mm (35-36). Both the medial and lateral incisions were 9.3 mm from the calcaneal tuberosity Conclusion The results indicate that the MIS approach to Haglund’s deformity resection can be performed reliably without neurovascular compromise. Levels of Evidence: Level IV
Implementing a Formalized Risk-Based Approach to Determine Candidacy for Multidisciplinary CKD Care: A Descriptive Cohort Study
Authors: Donald Maoliosa , Weaver Robert G. , Smekal Michelle , Thomas Chandra , Quinn Robert R. , Manns Braden J. , Tonelli Marcello , Bello Aminu , Harrison Tyrone G. , Tangri Navdeep , Hemmelgarn Brenda R. 
Published: December 2023

Background: The kidney failure risk equation (KFRE) can be used to predict progression to end-stage kidney disease in a clinical setting. Objective: Evaluate implementation of a formalized risk-based approach in nephrologists’ outpatient clinics and multidisciplinary chronic kidney disease (CKD) clinics to determine candidacy for multidisciplinary care, and the impact of CKD care selection on clinical outcomes. Design: Population-based descriptive cohort study. Setting: Alberta Kidney Care South. Patients: Adults attending or considered for a multidisciplinary CKD clinic between April 1, 2017, and March 31, 2019. Measurements: Exposure—The course of CKD care assigned by the nephrologist: management at multidisciplinary CKD clinic; management by a nephrologist or primary care physician. Primary Outcome—CKD progression, defined as commencement of kidney replacement therapy (KRT). Secondary Outcomes—Death, emergency department visits, and hospitalizations. Methods: We linked operational data from the clinics (available until March 31, 2019) with administrative health and laboratory data (available until March 31, 2020). Comparisons among patient groups, courses of care, and clinical settings with negative binomial regression count models and calculated unadjusted and fully adjusted incidence rate ratios. For the all-cause death outcome, we used Cox survival models to calculate unadjusted and fully adjusted hazard ratios. Results: Of the 1748 patients for whom a KFRE was completed, 1347 (77%) remained in or were admitted to a multidisciplinary CKD clinic, 310 (18%) were managed by a nephrologist only, and 91 (5%) were referred back for management by their primary care physician. There was a much higher kidney failure risk among patients who remained at or were admitted to a multidisciplinary CKD clinic (median 2-year risk of 34.7% compared with 3.6% and 0.8% who remained with a nephrologist or primary care physician, respectively). None of the people managed by their primary care physician alone commenced KRT, while only 2 (0.6%) managed by a nephrologist without multidisciplinary CKD care commenced KRT. The rates of emergency department visits, hospitalizations, and death were lower in those assigned to management outside the multidisciplinary CKD clinics when compared with those managed in the multidisciplinary care setting. Limitations: The follow-up period may not have been long enough to determine outcomes, and potentially limited generalizability given variability of care in multidisciplinary clinics. Conclusions: Our findings indicate that a portion of patients can be directed to less resource-intensive care without a higher risk of adverse events. Trial registration: Not applicable.
Day 100 Inhibitory KIR2DL2 and Activating NKp30 Natural Killer Cell Receptors Predicts Survival Post-Autologous Stem Cell Transplantation in Lymphomas
Authors: Porrata Luis , Ansell Stephen M , Micallef Ivana , Johnston Patrick B , Villasboas J. C. C , Paludo Jonas , Durani Urshila , Markovic Svetomir 
Published: December 2023

Introduction: Our group previously published that the infusion autograft inhibitor KIR2DL2 (CD158b+CD337-) and activating NKp30 (CD158b- CD337+) Natural killer (NK) cells receptors were predictors of clinical outcomes in lymphoma patients undergoing autologous peripheral blood hematopoietic stem cell transplantation (APBHSCT) (Porrata et al. Leukemia Research 2019; 81: 1-9). To assess if these subsets of NK cells still hold clinical relevance, we set up to investigate their prognostic ability to predict clinical outcomes at Day 100 post-APBHSCT.
Methods: 107 lymphoma patients who participated in our double-blind phase III trail (Porrata et al, Biology of Blood and Marrow Transplantation 2016; 22(6); 1017-1023) and had clinical assessment at Day 100 post-APBHSCT were included in this study. Nkp30 and KIR2DL2 at Day 100 were assessed by flow cytometry analysis.
Results: With a median follow-up for the entire cohort from Day 100 was 94.7 months (range: 4.83-158.1 months). Figure 1 shows the overall survival (OS) and progression-free survival (PFS) based on the absolute numbers of KIR2DL2 and Nkp30 NK cells. At Day 100, patients with a KIR2DL2 &lt; 0.08 and Nkp30 ≥0.19 experienced superior OS and PFS compared with patients with a Day 100 KIR2DLD2 ≥0.08 and NKp30 &lt; 0.19. In the multivariate analysis both the KIR2DL2 [OS: HR = 1.767, 95%CI, 1.302-30.31, p &lt; 0.04; and PFS: HR = 2.663, 95%CI, 1.108-6.403, p &lt; 0.03] and Nkp30 [OS: HR = 2.594, 95% CI, 1.239-5.432, p &lt; 0.01; and PFS: HR = 3.676, 95% CI, 1.875-7.206, p &lt; 0.01] were independent predictors for OS and PFS.
Conclusion: Day 100 inhibitory KIR2DL2 and activating NKp30 NK cells are prognostic immune-biomarkers in lymphoma patients undergoing APBHSCT.
Costliness of Iron Repletion Methods in Iron Deficient Adolescent Females Depends on Patient-Specific Factors
Authors: Mamauag Erica , McCormick Meghan , Smith Kenneth 
Published: December 2023

Background: Iron deficiency anemia is common in adolescent females. Treatment is possible with either enteral (PO) or intravenous (IV) formulations. The cost-effectiveness of each method is unknown. In addition, treatment cost-effectiveness likely differs between three distinct adolescent female subgroups with iron deficiency: average BMI with moderate anemia, average BMI with severe anemia, and obese BMI with moderate anemia.
Methods: A decision analysis model evaluated PO ferrous sulfate, IV iron sucrose, and IV ferric carboxymaltose use in adolescent female subgroups, comparing costs associated with each treatment strategy from a healthcare perspective. In the PO iron strategy, initial PO therapy failure prompted conversion to IV iron sucrose use. Literature review was performed to obtain model parameters. The effectiveness term in the model was the likelihood of successful iron repletion, which was assumed to be identical for each strategy in the base case analysis. Model time horizon was three months. One-way sensitivity analyses evaluated model uncertainty.
Results: In moderate anemia and average BMI, IV iron sucrose was least costly at $531.79 (compared to $592.12 for PO iron and $855.78 for IV ferric carboxymaltose). Varying the PO iron success likelihood and clinic visit frequency could favor the PO iron strategy. With severe anemia and average BMI, IV ferric carboxymaltose was least costly at $855.78 (vs. $1013.44 for IV iron sucrose and $902.78 for PO iron). Variation in infusions needed for IV iron sucrose (and therefore anemia severity) alters the preferred strategy, with IV iron sucrose favored if 1-4 infusions are required, PO iron favored if 5-6 infusions required, and IV ferric carboxymaltose preferred if 7 or more infusions are needed. In the moderately anemic obese group, PO iron was preferred, costing $763.90 compared to $798.12 for IV iron sucrose and $855.78 for IV ferric carboxymaltose. In a one-way sensitivity analysis, PO iron was favored at a weight &gt;74kg (base case value 90); below this weight, IV iron sucrose was preferred.
Conclusion: The cost-effectiveness of different iron repletion strategies depends on the adolescent female subgroup affected. Patient weight and anemia severity are important clinical characteristics to consider when assessing which method is the most cost-effective.
Development of a Risk Assessment Model for Cardiac Injury in Patients Newly Diagnosed with Acute Myeloid Leukemia Based on a Multicenter, Real-World Analysis in China
Authors: Ma Linlu , Wang Qian , Li Xinqi , Zhang Nan , Liang Yuxing , Wu Jinxian , Yuan Guolin , Zhou Fuling 
Published: December 2023

Studies have revealed that acute myeloid leukemia (AML) patients are prone to combined cardiac injury. We aimed to identify hematological risk factors associated with cardiac injury in newly diagnosed AML patients before chemotherapy and develop a personalized predictive model. The population baseline, blood test, electrocardiogram, echocardiograph, and genetic and cytogenetic data were collected from 499 newly diagnosed AML patients. The data were subdivided into training and validation cohorts. After univariate logistic regression, least absolute shrinkage and selection operator regression, and multivariate logistic regression analysis, abnormal NT-proBNP, NPM1 mutation, WBC, and RBC were independent risk factors for cardiac injury in AML patients (all p&lt;0.05). The nomogram was constructed based on the above four variables with high accuracy. The area under the curve was 0.742, 0.750, and 0.706 in the training, internal validation, and external validation cohort, respectively. The calibration curve indicated that the model has good testing capability. The Kaplan-Meier curve showed that the higher the risk of combined cardiac injury in AML patients, the lower their probability of survival. This prediction nomogram identifies hematological risk factors associated with cardiac injury in newly diagnosed AML patients and can help hematologists identify the risk and provide precise treatment options.
Key words: acute myeloid leukemia, risk factor, prediction model, inflammation, cardiac injury
Role of the S1P Signaling Pathway in the Pathogenesis of Angioimmunoblastic T-Cell Lymphoma
Authors: Lin Wen-Hsuan Wendy , Rodriguez Cortes Jose , Aitken Mick , Reglero Clara , Laurent Anouchka , Cooke Anisha , Belver Laura , Bhagat Govind , Rabadan Raul , Ferrando Adolfo A. , Palomero Teresa 
Published: December 2023

Peripheral T cell lymphomas (PTCLs) are a group of aggressive lymphoid malignancies originating from mature T cells. Angioimmunoblastic T-cell lymphomas (AITL) represent 20% to 30% of all PTCL diagnoses and are associated with autoimmune features, poor response to chemotherapy, and dismal prognosis. Molecular profiling of AITL has identified T-follicular helper (TFH) cells as the cell of origin of AITL, while mutational analysis has identified frequent alterations in epigenetic regulators ( TET2, DNMT3A, and IDH2) and elements of the TCR pathway as drivers of AITL transformation. Our group identified the highly recurrent RHOA G17V mutation as a defining hallmark of AITL and other T-cell lymphomas of TFH-cell origin (Palomero et al., 2014). Using a novel conditional knockin mouse model, we demonstrated that expression of Rhoa G17V in CD4+ T-cells induces TFH cell specification and promotes AITL lymphomagenesis in the context of loss of Tet2 (Cortes et al., 2018).
Recently, we have identified that Rhoa G17V regulates the expression of the sphingosine-1-phosphate (S1P) receptor 1 (S1PR1) one of the five members of the receptor family of S1P, which plays an essential role in immune response and lymphocyte trafficking. During thymic T-cell development, expression of Rhoa G17V in CD4+ cells inhibited S1PR1 downregulation after the double positive stage leading to altered positive selection, reduced CD4+ single positive cell numbers and premature thymic egress of autorreactive T-cells which results in the development of systemic inflammation and autoimmunity. In our Tet2 −/− RHOA G17V AITL tumor model, constitutive activation of S1P receptors supported activation of the STAT3 and NFkB pathway and enhanced migration of malignant cells to peripheral organs. Mechanistically, expression of Rhoa G17V in mature CD4+ T-cells impaired re-phosphorylation of the Ezrin-Radoxin-Moesin (ERM) complex independently of ROCK signaling and led to the activation and increased migration of CD4+ T-cells. Importantly, blockade of S1PR1 signaling by fingolimod induced anti-tumor activity in Tet2 −/− RHOA G17V lymphoma-bearing mice in vivo with significant reductions in tumor burden associated with increased apoptosis and decreased STAT3 phosphorylation. Furthermore, analysis of a panel of primary tumors from AITL patients using a multiplexed staining panel and PhenoImager platform revealed significantly higher S1PR1 expression in AITL tumor cells than normal TFH cells from benign reactive lymph nodes. Our findings highlight the role of S1P signaling pathway in the pathogenesis of RHOA G17V-driven AITLs and the potential therapeutic benefit of targeting this pathway.
Bone Health of Hemophilia Ａ Patients Using Emicizumab
Authors: Lyu Ting-Wei , Sun Ting , Chou Sheng-Chieh 
Published: December 2023

Background:
Hemophilia patients have been observed to exhibit a higher prevalence of osteoporosis compared to age-matched general population. However, the underlying mechanism responsible for this association remains poorly understood. One hypothesis proposes that factor VIII itself may possess additional physiological functions that contribute to bone health. Conversely, alternative viewpoints suggest that overall coagulation function or thrombin generation may play a pivotal role in maintaining optimal bone health. The introduction of emicizumab, a bispecific antibody that mimics the coagulation function of factor VIII but possesses a structurally distinct composition, presents an opportunity to shed light on this matter. Therefore, the primary objective of this study is to explore and compare the bone health status of hemophilia patients, distinguishing between those utilizing emicizumab and those who are emicizumab-naïve.
Method:
From June 2019 to June 2023, at the hemophilia center of National Taiwan University Hospital, additional examinations to assess the patients' bone health were performed with routine annual joint health evaluations for patients with hemophilia A (PwHA) and B (PwHB). This included the use of dual-energy X-ray absorptiometry scan (DEXA) to measure the bone mineral density (BMD) of the lumbar spine, hip, and femur. Furthermore, the serum levels of procollagen type 1 N-terminal propeptide (P1NP) and C-terminal telopeptide (CTX) were measured as reference markers for bone formation and bone resorption, respectively. The Kruskal-Wallis test was utilized to statistically evaluate the observations among the three groups.
Results:
The study population was divided into three distinct groups based on their hemophilia subtype and treatment: PwHA who had been utilizing emicizumab for more than one year (n=8), PwHA individuals receiving regular factor VIII treatment (n=16), and PwHB (n=10). The analysis of the collected data, as presented in the accompanying table, revealed that the three groups exhibited similar characteristics in terms of age, annual bleeding rate, and joint conditions. Moreover, no statistically significant differences were detected in the measurements of bone mineral densities (BMDs) and biomarkers. However, it is worth noting that there appeared to be a potential trend toward higher levels of P1NP in the PwHB group.In the case of PwHA patients using emicizumab, we examined the longitudinal changes in T-score of BMD over time. Notably, three PwHA patients with baseline T-scores below zero demonstrated improvements in their T-scores after one year of emicizumab treatment.
Conclusion:
The results of this study indicate a lack of significant disparities in bone health between individuals utilizing emicizumab and those who are not. Furthermore, our findings suggest that emicizumab usage does not lead to a decline in bone health over the observed period.