bluuebunny/crossref_metadata_2025_split huggingface dataset:
Racial differences in clinical trial perceptions among a large, predominantly Black cohort of people with systemic lupus erythematosus in the Southeastern USA
Authors: Williams Jessica Nicole , Mozee Hilton , Bao Gaobin , Dunlop-Thomas Charmayne , Schofield Kim , Drenkard Cristina , Lim Sung Sam 
Published: January 2025

ObjectiveBlack people in the USA have a higher incidence and severity of SLE and worse outcomes, yet they are significantly under-represented in SLE clinical trials. We assessed racial differences in clinical trial perceptions among a large cohort of predominantly Black people with SLE.MethodsGeorgians Organised Against Lupus (GOAL) is a population-based, prospective cohort of people with a validated diagnosis of SLE living in Atlanta. The 2021–2022 GOAL survey included questions assessing knowledge, perceptions and experiences of lupus clinical trials involving drug therapy. Self-reported race was categorised as Black or non-Black. Survey responses by race were compared using χ2analyses. Among Black respondents, factors associated with willingness to participate in clinical trials were examined using univariable logistic regression.ResultsA total of 767 individuals responded to the 2021–2022 GOAL survey, of whom 80% were Black. There were 720 female respondents and 47 male respondents. There was no significant difference in willingness to participate in clinical trials between Black and non-Black respondents (28% vs 31%, p=0.071). Black respondents were less likely to correctly identify the definition of a clinical trial (34% vs 70%, p<0.001). Male gender, unemployed or disabled status, governmental health insurance and higher disease activity were associated with willingness to participate in clinical trials among Black respondents.ConclusionsWe found that only 28% of respondents were willing to participate in lupus clinical trials, with no difference by race. Efforts must continue to engage those resistant to trial participation, regardless of race. Our findings also indicate that further research is warranted to assess whether strategies such as clinical trial education and diversification of study staff may be helpful to increase Black patient recruitment. Sociodemographic factors (gender, work status, insurance status) and disease-related factors (lupus activity) may also play important roles in clinical trial participation among Black people.
Sex differences in ST-segment elevation myocardial infarction patients treated by primary percutaneous intervention
Authors: Cook Selma T , Allemann Laure , Cook Malica , Arroyo Diego A , Pittet Thais , Meier Pascal , Togni Mario , Brahim-Mathiron Amel , Puricel Serban , Cook Stéphane 
Published: January 2025

IntroductionThe impact of sex on coronary artery disease prognosis is debated. It has been postulated that women receive less prompt treatment compared with men, potentially adversely affecting their prognosis by significantly increasing the risk of morbidity and mortality. We aim to investigate the influence of sex on the timing and clinical outcomes of ST-segment elevation myocardial infarction (STEMI) patients using a controlled Swiss registry.Methods and resultsBased on the Fribourg STEMI Fast Track Registry, 1177 patients (288 women, 889 men) with >12 months clinical follow-up were selected. Women had longer first medical contact to reperfusion times (1.31 (1.14–2.00) vs 1.27 (1.09–1.54) hours, p=0.035) but similar total ischaemic times (3.04 (2.15–4.50) vs 2.56 (2.07–4.38) hours, p=0.064). Men had higher rates of diabetes, smoking and dyslipidaemia, while women had higher hypertension and renal insufficiency rates. No significant sex differences in clinical outcomes were observed at 1-year and 5-year follow-ups.DiscussionThe study found sex differences in patient profiles and minor treatment delays for women, which did not significantly affect outcomes. Efforts to improve sex equity in STEMI care are effective, as no significant outcome differences were observed. Disparities are more related to patient characteristics than sex.ConclusionDespite slight delays and different risk profiles for women with STEMI, clinical outcomes are similar between sexes. Ongoing efforts are needed to ensure sex equity in acute coronary syndrome management.Trial registration numberNCT04185285.
Right ventricular strain impairment due to hypoxia in patients with COPD: a post hoc analysis of two randomised controlled trials
Authors: Preiss Helga , Mayer Laura , Furian Michael , Schneider Simon Rafael , Müller Julian , Saxer Stephanie , Mademilov Maamed , Titz Anna , Shehab Anwer , Reimann Lena , Sooronbaev Talant , Tanner Felix C , Bloch Konrad E , Ulrich Silvia , Lichtblau Mona 
Published: January 2025

BackgroundHypoxic pulmonary vasoconstriction leads to an increase in pulmonary artery pressure (PAP) and potentially right heart failure in healthy individuals and patients with respiratory diseases. Previous studies in patients with chronic obstructive pulmonary disease (COPD) exposed to hypobaric hypoxia have shown an increase in PAP, while traditional echocardiographic parameters revealed only minimal changes at high altitude. Speckle-tracking-derived analysis is potentially more sensitive to assess right ventricular (RV) function and we used this method to investigate the impact on RV function of patients with COPD ascending to high altitude and compared the results with the traditional echocardiographic parameters.MethodsThis post hoc analysis evaluates echocardiographic RV free wall strain (RVFWS) in patients with COPD GOLD grade 1–3 travelling from 760 m to 3100 m for a 2-day stay. An RVFWS over −20% was considered as an indicator of RV dysfunction.ResultsA total of 54 patients (57% men, mean±SD age 58±9 years, forced expiratory volume in 1 s (FEV1% predicted 77.3±22.5)) with echocardiographs of sufficient quality were included. The mean RVFWS worsened significantly from −26.0±4.9% at 760 m to −23.9±5.4% at 3100 m (p=0.02). The number of patients with relevant RV dysfunction based on RVFWS increased from 7.4% at 760 m to 25.9% at 3100 m (p=0.02), whereas the prevalence of RV dysfunction assessed by traditional indices remained unchanged.ConclusionExposure to hypoxia led to RVFWS impairment in more than one quarter of patients with COPD. Strain analysis is a promising, non-invasive method for evaluating RV dysfunction, even in subclinical cases and might be prognostically relevant in patients with lung diseases.Trial registration numbersNCT02450968andNCT03173508.
Association between prophylactic intermittent non-invasive positive pressure ventilation and incidence of pneumonia in patients with cervical spinal cord injury: a retrospective single-center cohort study
Authors: Fukuyama Yuita , Okada Kazuhiro , Tagami Takashi , Hara Yoshiaki , Yokobori Shoji 
Published: January 2025

BackgroundPatients with cervical spinal cord injuries (CSCIs) have a high incidence of respiratory complications. The effectiveness of non-invasive positive pressure ventilation (NPPV) in preventing respiratory complications such as pneumonia in acute CSCIs remains unclear. We evaluated whether intermittent NPPV (iNPPV) could prevent pneumonia in patients with acute CSCIs.MethodsThis single-center, retrospective study evaluated patients diagnosed with CSCIs with American Spinal Injury Association Impairment Scale scores of A–C between January 2012 and December 2022. Patients were categorized based on receipt of iNPPV into the iNPPV and usual care groups. Prophylactic iNPPV was defined as the initiation of iNPPV within 72 hours of admission. The primary outcome was the development of pneumonia. The secondary outcomes were other respiratory complications (tracheal intubation and tracheostomy) and adverse events (delirium and vomiting). The groups were compared with regard to outcomes after adjustment for patient backgrounds using inverse probability of treatment weighting (IPTW) with propensity scores.ResultsOf the 213 patients during the study period, 94 were included. Of these, 61 (64.9%) received prophylactic iNPPV. The incidence of pneumonia was 27.9% in the iNPPV group and 48.5% in the usual care group in the unadjusted cohort. In the propensity score analysis using IPTW, the iNPPV group showed a lower incidence of pneumonia than the usual care group (29.0% vs 56.5%, p<0.001). Tracheal intubation and tracheostomy were less common in the iNPPV group than those in the usual care group (10.6% vs 29%; p=0.001 and 10.6% vs 27.1%; p=0.003, respectively). The incidences of delirium and vomiting did not increase in the iNPPV group.ConclusionsProphylactic iNPPV was associated with a lower incidence of pneumonia in patients with acute CSCIs.Level of evidenceⅣ.
Neutrino Lorentz invariance violation from the $$\textit{CPT}$$-even SME coefficients through a tensor interaction with cosmological scalar fields
Authors: Cordero Rubén , Delgadillo Luis A. , Miranda O. G. , Moura C. A. 
Published: January 2025

AbstractNumerous non-standard interactions between neutrinos and scalar fields have been suggested in the literature. In this work, we have outlined the case of tensorial neutrino non-standard interactions with scalar fields, which can be related to the effective $$\textit{CPT}$$
CPT
-even dimension-4 operators of the Standard Model Extension (SME). We illustrate how bounds placed on these parameters can be associated with limits on the energy scale of the proposed neutrino interactions with cosmic scalars. Besides, as a case study, we employ a DUNE-like experimental configuration to assess the projected sensitivities to the $$\textit{CPT}$$
CPT
-even isotropic $$c_{\alpha \beta }$$

c

α
β

and Z-spatial $$c_{\alpha \beta }^{ZZ}$$

c

α
β

ZZ

SME coefficients. For the case of the isotropic SME coefficients, an upper limit on the energy scale of the interaction can be placed. The current IceCube experiment and upcoming neutrino experiments such as DUNE, KM3NeT, IceCube-Gen2, and GRAND proposals, may clarify these classes of neutrino non-standard interactions.
Outcomes of Surgical Interventions for Patellofemoral Instability in the Presence of Trochlear Dysplasia: A Systematic Review and Meta-analysis
Authors: Aljadaan Bader Majed , Alhakbani Mohammed Saad A. , Almonaie Shahd Hamza , Cahusac Peter M.B. 
Published: January 2025

Background: Patellar instability is frequently encountered by orthopaedic surgeons. One of the major risk factors of this condition is underlying trochlear dysplasia (TD). Recent trends have indicated the use of multiple procedures to correct patellar instability under these conditions. Medial patellofemoral ligament reconstruction (MPFLR) and trochleoplasty (TP) are surgical strategies that have demonstrated successful outcomes. However, it is unclear whether isolated MPFLR suffices for patellar instability in the presence of severe TD. Furthermore, the need for TP or a combined approach, considering its invasiveness and technical demands, to achieve better clinical outcomes and patellofemoral stability remains uncertain. Purpose: To compare the outcomes of 3 surgical interventions for addressing patellar instability due to TD: MPFLR, TP, and combined MPFLR and TP. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: Studies reporting the clinical outcomes of MPFLR, TP, and both in combination, regardless of additional procedures, were identified using the MEDLINE, PubMed, Embase, Scopus, Cochrane Library, Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health Literature databases. An important inclusion criterion was that studies should include the mean preoperative and postoperative Kujala scores and any complications. A random-effects model was used for the meta-analysis. Results: Overall, 30 studies were included: 10 describing the outcomes of TP, 13 describing the outcomes of MPFLR, and 7 describing the outcomes of combined TP and MPFLR. Furthermore, 1457 patients (1571 knees) were evaluated with a mean follow-up of 42.4 ± 32.8 months. No statistically significant differences were found between the 3 methods regarding the mean difference using the Kujala score. However, combined MPFLR and TP had the highest weighted mean difference compared with the other 2 procedures (28.5 points; P < .001). Evidential analysis revealed a robust log-likelihood ratio ( S = 3.2) supporting the superiority of the combined procedure when comparing this mean and the weighted grand mean of 23.7. The redislocation rate after patellar stabilization remained minimal, irrespective of the surgical procedure (mean, 0.7%). However, the rate of residual patellar instability was the highest in the TP group (mean, 13.5%). Conclusion: This study found no statistically significant difference between the outcomes of the 3 procedures. However, the combined approach of MPFLR and TP was associated with the most promising clinical outcomes and a low redislocation rate in patients with varying severities of TD.
Exploring the Relationship Between Combined, Acetabular, and Femoral Version on Postoperative Outcomes 2 Years After Hip Arthroscopy for Femoroacetabular Impingement Syndrome
Authors: Larson Jordan H. , Allahabadi Sachin , Kaplan Daniel , Chapman Reagan , Kazi Omair , Brusalis Christopher M. , Nho Shane J. 
Published: January 2025

Background: Many studies have examined the prevalence of acetabular version (AV) and femoral version (FV) abnormalities and their effect on patient-reported outcomes (PROs) after hip arthroscopy for femoroacetabular impingement syndrome (FAIS), but few have explored the prevalence and influence of combined version (CV) abnormalities. Purpose: To (1) describe the distribution of AV, FV, and CV in the largest cohort to date and (2) determine the relationship between AV, FV, and CV and PROs after hip arthroscopy for FAIS. Study Design: Cohort study; Level of evidence, 3. Methods: Patients were identified who underwent primary hip arthroscopy for FAIS between 2012 and 2018 and received computed tomography containing the pelvis and transcondylar knee slices. AV and FV were assessed on computed tomography, with CV calculated as their sum. PROs were collected preoperatively and 2 years postoperatively. The distributions of AV, FV, CV, and combinations thereof were described based on published ranges. The relationships between version measurements and PROs were analyzed based on a given measurement's distance from a normative value, defined as the mean within the study population (eg, relative acetabular anteversion [AAr]). These relationships were first assessed using univariate natural (restricted) cubic regression splines to account for nonlinearity. The relationship between each relative version group (to the mean) and PROs was then assessed using multiple linear regression, with the other 2 version measurements held constant. Results: In total, 566 patients were included (66.4% female; mean age, 32.6 ± 11.9 years; mean body mass index, 25.2 ± 5.1). The mean follow-up was 28.0 months. The mean AV, FV, and CV were 17.1°± 5.2°, 12.1°± 9.2°, and 29.3°± 11°, respectively. Univariate natural cubic regression splines demonstrated that AAr had a significant negative association with 4 of 5 PROs preoperatively and 3 of 5 PROs 2 years postoperatively ( P≤ .018). All other relative version groups did not have a significant relationship with any PRO at either time point ( P > .05). The association between AAr and relatively worse PROs was maintained after controlling for relative FV and CV via multiple linear regression, particularly in patients with relative femoral retroversion. Conclusion: FV and CV, as distinct measures, are not associated with outcomes after hip arthroscopy for FAIS. AAr is associated with worse preoperative status and less improvement at 2 years postoperatively, particularly in patients with relative femoral retroversion.
Midterm Functional Outcomes After Retear of an Arthroscopic Rotator Cuff Repair: A Propensity Score–Matched Comparative Study
Authors: Kim Jae Soo , Kim Su Cheol , Park Jong Hun , Kim Hyun Gon , Jung Hyoung Seok , Lee Sang Min , Yoo Jae Chul 
Published: January 2025

Background: Studies are still limited on the isolated effect of retear after arthroscopic rotator cuff repair (ARCR) on functional outcomes after the midterm period. Purpose: To assess the effect of retear at midterm follow-up after ARCR and to identify factors associated with the need for revision surgery. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review was conducted on patients who underwent ARCR between 2014 and 2018, with a minimum 5-year follow-up. The structural integrity was evaluated using magnetic resonance imaging. After propensity score matching, 65 patients for the retear group and 65 for the healed group were included. Functional outcomes, including visual analog scale for pain and function (PVAS and FVAS) and American Shoulder and Elbow Surgeons (ASES) score, were compared between the groups at 1 year and final follow-up. Multivariate analysis was conducted on the retear group to identify factors associated with the final ASES score. Results: The mean ± SD follow-up period was 6.9 ± 1.4 years. All outcomes at the final follow-up improved as compared with the preoperative status, regardless of retear (all P < .001). In the retear group, PVAS at the final follow-up showed deterioration when compared with postoperative 1 year ( P = .044). While there were no significant differences in all outcomes at 1 year postoperatively between the groups (all P > .05), the retear group demonstrated significantly worse outcomes than the healed group in scores on the PVAS (2.5 ± 1.5 vs 1.9 ± 1.5; P = .011), FVAS (7.3 ± 1.4 vs 7.8 ± 1.3; P = .020), and ASES (73.2 ± 12.7 vs 79.9 ± 15.4; P = .008) at the final follow-up. The revision rate in the retear group was 12.8%, and multivariate analysis showed that larger anteroposterior retear size ( P = .017) and retear of the subscapularis ( P = .047) were negatively associated with the final ASES score. Conclusion: Functional outcomes after ARCR improved during midterm follow-up, regardless of retear. While the effect of retear itself on functional outcomes was minimal in the short term, it became more pronounced after the midterm period. A retear involving the subscapularis or with a larger anteroposterior size was associated with a poorer functional outcome.
Advancing a machine learning-based decision support tool for pre-hospital assessment of dyspnoea by emergency medical service clinicians: a retrospective observational study
Authors: Kauppi Wivica , Imberg Henrik , Herlitz Johan , Molin Oskar , Axelsson Christer , Magnusson Carl 
Published: January 2025

Abstract
Background
In Sweden with about 10 million inhabitants, there are about one million primary ambulance missions every year. Among them, around 10% are assessed by Emergency Medical Service (EMS) clinicians with the primary symptom of dyspnoea. The risk of death among these patients has been reported to be remarkably high, at 11,1% and 13,2%. The aim was to develop a Machine Learning (ML) model to provide support in assessing patients in pre-hospital settings and to compare them with established triage tools.

Methods
This was a retrospective observational study including 6,354 patients who called the Swedish emergency telephone number (112) between January and December 2017. Patients presenting with the main symptom of dyspnoea were included which were recruited from two EMS organisations in Göteborg and Södra Älvsborg. Serious Adverse Event (SAE) was used as outcome, defined as any of the following:1) death within 30 days after call for an ambulance, 2) a final diagnosis defined as time-sensitive, 3) admitted to intensive care unit, or 4) readmission within 72 h and admitted to hospital receiving a final time-sensitive diagnosis. Logistic regression, LASSO logistic regression and gradient boosting were compared to the Rapid Emergency Triage and Treatment System for Adults (RETTS-A) and National Early Warning Score2 (NEWS2) with respect to discrimination and calibration of predictions. Eighty percent (80%) of the data was used for model development and 20% for model validation.

Results
All ML models showed better performance than RETTS-A and NEWS2 with respect to all evaluated performance metrics. The gradient boosting algorithm had the overall best performance, with excellent calibration of the predictions, and consistently showed higher sensitivity to detect SAE than the other methods. The ROC AUC on test data increased from 0.73 (95% CI 0.70–0.76) with RETTS-A to 0.81 (95% CI 0.78–0.84) using gradient boosting.

Conclusions
Among 6,354 ambulance missions caused by patients suffering from dyspnoea, an ML method using gradient boosting demonstrated excellent performance for predicting SAE, with substantial improvement over the more established methods RETTS-A and NEWS2.
Chemical, biological and nerve gas attacks: need for education among healthcare personnel and medical students; a Swedish regional cross-sectional web-survey
Authors: Castellheim Albert Gyllencreutz , Persson Gustav , Kuikka Juuso , Babinski Karol , Robinson Yohan , Taube Fabian 
Published: January 2025

Abstract
Background
Chemical, biological and nerve gas events have a significant impact on public health, necessitating proper education and training. This study investigated the educational needs as perceived by two groups, frontline healthcare workers and medical students, in relation to chemical, biological, and nerve gas events.

Methods
Three distinct web-based cross-sectional surveys were conducted, one each for chemical, biological, and nerve gas events, with each survey following the same structural format including sections on (a) theoretical knowledge assessment, using multiple-choice questions regarding identification, protection, and treatment, (b) perception of threat, using questions based on a 5-point Likert scale to gauge views on threat/preparedness and (c) perception of existing competency, with questions regarding prior education and the need for additional education and training.

Results
The surveys on chemical, biological, and nerve agents received responses from 44, 36, and 59 participants respectively, comprising both frontline healthcare workers and medical students. The total response rate was approximately 16%. In the theoretical knowledge section of each survey, neither group of participants reached 51% correct answer rate in any of the three surveys. In the section on perception of threat, the percentages of responses in the low half of the Likert Scale were 43.2%, 53.0%, and 96.4% for biological, chemical, and nerve gas surveys, respectively. For the same surveys, 56.8%, 78.7%, and 87.6% of responses were in the middle of the Likert Scale. Regarding perception of competency, 146.2%, 143.1%, and 170.4% of combined responses indicated low existing competency for biological, chemical, and nerve gas surveys, respectively. High and middle ratings for competency were low across all surveys. The perception of need for education were high in the high half and low in the low half of the Likert Scale. The were no statistically significant differences across the sections among the study groups.

Conclusions
The results indicate a widespread tendency to downplay the presence of significant threat and a perception of low existing competency. There is a broad agreement on the need or education and training in managing events of chemical, biological, and nerve gas agents, for frontline healthcare personnel as well as medical students in Sweden.