bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of insoles adapted in flip-flop sandals in patients with persistent plantar heel pain: A sham-controlled randomised trial
Authors: Fagundes Marina Gomes , Mendes André Augusto Martines Teixeira , Bezerra Vinícius Fernandes , Freitas Weslley Robson Marques Silva de , Scattone Silva Rodrigo , Pontes-Silva André , Barbosa Germanna de Medeiros , Cardoso de Souza Marcelo 
Published: August 2024

Objective To evaluate the use of custom-made insoles adapted to flip-flops on pain intensity, foot function, and functional walking ability in individuals with persistent plantar heel pain in the short and medium term. Design Randomised controlled trial. Setting Flip-flop sandals in patients with persistent plantar heel pain. Main measures Participants (n = 80) were assessed at baseline, six and 12 weeks after the intervention, and 4 weeks post-intervention. Results For the primary outcomes, after 6 weeks of intervention, no between-group difference was observed in the intensity of morning pain or pain with walking, mean difference = −0.4 (95% confidence intervals = −1.5 to 0.8). Similarly, after 12 weeks of intervention, no between-group difference was observed in the intensity of morning pain or pain with walking, mean difference = −0.7 (95% confidence intervals = −1.9 to 0.6). Finally, at 4 weeks after the end of the intervention, there was no between-group difference in morning pain or pain on walking, mean difference = 0.01 (95% confidence intervals = −1.4 to 1.4). All differences and confidence intervals were smaller than the minimum clinically important difference for pain (2 points). There were no differences between the groups for the secondary outcomes. In addition, the mean differences were smaller than the minimum clinically important differences for pain intensity, foot function and functional walking ability. Conclusion Custom-made insoles fitted to flip-flops did not differ from flip-flops with sham insoles in improving pain intensity, foot function and functional walking ability in people with persistent heel pain. Trial registration: ClinicalTrials.gov (Identifier: NCT04784598). Data of registration: 2023-01-20
Understanding the Behavioral Health Needs of Hospice Patients and Their Family Caregivers: Perspectives of Hospice Medical Directors
Authors: Tiwari Abhay , Park Taeyoung , Parillon Brittney , Prather Simone , Shalev Daniel , Reid Manney Cary , Czaja Sara , Adelman Ronald , Phongtankuel Veerawat 
Published: August 2024

Background Behavioral health disorders are common among patients and caregivers in the hospice setting. Yet, limited data exist regarding what hospice providers perceive as the most common and challenging behavioral health disorders they encounter and how they manage these issues in practice. Objective To characterize the perspectives of hospice medical directors (HMDs) on addressing the behavioral health challenges when caring for patients enrolled in home hospice care and their family caregivers. Methods Semistructured interviews with seventeen certified HMDs were conducted. Data were analyzed using thematic analysis. Results Many HMDs agreed that delivering high-quality behavioral health care is a tenet for good end-of-life (EoL) care. HMDs shared that depression and anxiety were the most common behavioral health challenges they encountered, while among caregivers, substance use disorder was the most challenging. Participants mentioned that nurses and social workers played a vital role in detecting and managing behavioral health problems. HMDs also stated that providing additional training for frontline staff and incorporating behavioral health experts are potential solutions to help address current challenges. Conclusion HMDs emphasized the importance of addressing behavioral health challenges among patients and caregivers to provide effective end-of-life care. Future studies should examine the viewpoints of additional key stakeholder groups (e.g., hospice interdisciplinary team members, family caregivers) and confirm them in quantitative studies. Designing and implementing evidence-based assessments and interventions to improve behavioral health care by addressing anxiety, depression, and caregiver substance use disorders is essential to improving care and care outcomes in the hospice setting.
The Relative Indirect Effects of Technology Bias and Implicit Bias on Racial Disparity in Service Delivery and Sepsis Mortality
Authors: Wang Qi , Carson Anita L , Zheng Sarah 
Published: August 2024

Racism at the individual and societal levels has been identified as a cause of disparity in healthcare outcomes in the United States but reducing disparity has been slow. This study disentangles the relative effects of two types of racism on inpatient service delivery and hospital mortality: technology bias and implicit bias. Drawing on clinical data from intensive care unit (ICU) patients with sepsis, we use propensity score matching to balance groups of White and nonwhite patients and run a causal mediation analysis to test our model, which links patient race to hospital mortality through two mediating variables related to service delivery: (1) discrepancies in blood oxygen saturation measurements due to technology bias embedded in the medical device (i.e., pulse oximeter) and (2) administration of supplemental oxygen, which could be impacted by clinicians’ implicit bias. We first replicate prior findings that (a) higher discrepancies between oximeter readings and laboratory tests for nonwhite patients compared to Whites and (b) a higher discrepancy lowers the likelihood of patients receiving supplemental oxygen during the ICU stay. We make a unique contribution by finding that nonwhite patients with sepsis have a 79% higher risk of hospital mortality in the ICU compared to Whites, with nearly half of the racial disparity in mortality stemming from technology bias and less than a fifth from clinicians’ implicit bias. Eliminating these two biases would help save thousands of lives annually among racial/ethnic minorities with sepsis in the United States. Our findings indicate that technology bias exerts a greater negative impact on mortality than does implicit bias, highlighting the importance of device approval standards and clinicians' ability to customize decision criteria for supplemental oxygen.
Oncology stewardship practice in the United States: A Hematology/Oncology Pharmacy Association national survey
Authors: Banez Marisela Tan , Atienza Sol , Butts Allison , Derba Megan , Dicke Katie , Haverstick Kimberly , Heron Bernadette B , Cimino Sarah K , Loop Matthew Shane , Hough Shannon , Merten Julianna A , Moore Donald C , Shah Vishal , Taucher Kate D , Zhang Junyu “Matt” , Mahmoudjafari Zahra 
Published: August 2024

Introduction The treatment of cancer is associated with high risk for toxicity and high cost. Strategies to enhance the value, quality, and safety of cancer care are often managed independently of one another. Oncology stewardship is a potential framework to unify these efforts and enhance outcomes. This landscape survey establishes baseline information on oncology stewardship in the United States. Methods The Hematology/Oncology Pharmacy Association (HOPA) distributed a 38-item survey composed of demographic, institutional, clinical decision-making, support staff, metrics, and technology sections to 675 HOPA members between 9 September 2022 and 9 October 2022. Results Most organizations (78%) have adopted general pharmacy stewardship practices; however, only 31% reported having established a formalized oncology stewardship team. More than 70% of respondents reported implementation of biosimilars, formulary management, and dose rounding as oncology stewardship initiatives in both inpatient and outpatient settings. Frequently cited barriers to oncology stewardship included lack of clinical pharmacist availability (74%), lack of oncology stewardship training (62%), lack of physician/provider buy-in (32%), and lack of cost-saving metrics (33%). Only 6.6% of survey respondents reported their organization had defined “value in oncology.” Lack of a formalized stewardship program was most often cited (77%) as the rationale for not defining value. Conclusions Less than one-third of respondents have established oncology stewardship programs; however, most are providing oncology stewardship practices. This manuscript serves as a call to action for stakeholders to work together to formalize oncology stewardship programs that optimize value, quality, and safety for patients with cancer.
A longitudinal assessment of major mouthwashes used in alleviating pain and xerostomia among advanced nasopharyngeal carcinoma patients receiving chemoradiotherapy
Authors: Mageswaran Rhubain , Ang Zen Yang 
Published: August 2024

Objective This longitudinal study aimed to evaluate the overall efficacy of mouthwashes in oral mucositis pain and mucositis xerostomia in advanced nasopharyngeal carcinoma (NPC) patients undergoing concurrent chemoradiotherapy (CCRT) at different phases throughout treatment. Methods A longitudinal study enrolled 79 advanced NPC subjects receiving CCRT. The subjects were interviewed prospectively three times over 7 weeks for pain and xerostomia scores based on the various types of mouthwash used. The median pain score difference and median xerostomia score difference were utilised to determine mouthwash superiority. Results Participants completed three interviews, during which 480 instances of mouthwash use were observed throughout different phases of the treatment period. The results showed that the median pain scores between mouthwashes differed significantly, H-Stat(3) = 30.0, 25.7 and 26.0, respectively, with p < 0.001 for all three interviews. The pain score reductions of lidocaine mouthwash (median = 2, interquartile range (IQR) = 3, 2 and 2.75 over the three interviews, respectively) were significantly higher than those of benzydamine and sodium bicarbonate mouthwashes. There were no significant differences between the studied mouthwashes in their xerostomia score reductions. Conclusions Lidocaine mouthwash was superior in managing oral mucositis pain at all phases throughout the entire chemoradiotherapy treatment for advanced NPC patients. There was insufficient evidence to determine the preferred mouthwash for treating oral mucositis xerostomia.
Oral lichenoid drug eruption due to osimertinib for lung cancer
Authors: Alchaikh Hassan Ruba , Soliman Abram , Dasanu Constantin A. 
Published: August 2024

Introduction Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR) are linked with side effects involving skin and mucosa. Herein, we present a unique case of oral lichenoid drug eruption (LDE) in a patient treated with osimertinib. Case report A 75-year-old woman was diagnosed with metastatic EGFR-mutated lung adenocarcinoma, and started on osimertinib 80 mg PO daily. At 24 months of therapy, the patient developed a painful, red, and white striated oral lesion involving the left buccal mucosa and the adjacent buccal aspect of gingivae. Biopsy showed oral LDE. Causality assessment between osimertinib and the oral LDE via Naranjo Adverse Drug Reaction probability scale revealed a score of 5. Management and outcome Osimetinib discontinuation was not felt to be in the best interest of the patient. Therefore, diphenhydramine HCL mouthwash every 6 h PRN (before meals) was started. Spicy and hot foods were discontinued. At a four-week follow-up visit, the patient reported moderate improvement in her symptoms. Conclusion Oral LDEs are considered premalignant lesions as they can transform into squamous cell carcinoma; therefore, regular follow-up is needed. Awareness of this potential side effect of osimertinib would also prevent unnecessary (and potentially costly) work-up and lead to its prompt diagnosis and treatment.
Assessment of the deformation rate of venous diameter during internal jugular vein puncture using a newly developed thin-tip three-dimensional needle
Authors: Hashimoto Kazuki , Nawata Shintaro , Wada Shinji , Hamaguchi Shingo , Tanabe Kenichiro , Mimura Hidefumi 
Published: August 2024

Background: The internal jugular vein (IJV) is one of the most used sites for central venous access. Some authors revealed the association of a higher deformation rate of the IJV wall with posterior wall penetration, which may cause a hemorrhagic complication. A newly developed thin-tip needle (three-dimensional (3D) needle) reduced the deformation rate in an ex vivo study. Therefore, we conducted a clinical study to investigate its efficacy in reducing vessel deformity during IJV puncture. Methods: This study retrospectively enrolled 80 adult patients who received central venous port (CVP) implantation via the IJV from April 1, 2022, to November 10, 2023, in our institution. Traditional needle-and-catheter was used for ultrasound (US)-guided IJV puncture (usual group) for the former 40 patients before July 18, 2023. Afterward, the 3D needle was used for the latter 40 patients (3D needle group). US images were stored and analyzed to calculate the deformation rate. Results: The deformation rate was 58.6% (13.2–100) for the usual needle and 41.8% (10.6–100) for the 3D needle ( p = 0.0034). Patients who required several punctures included 2 for the usual needle and 12 for the 3D needle, respectively ( p = 0.0032). All patients and the usual needle group demonstrated a weak negative correlation between the deformation rate and pre-puncture vessel diameter ( r = 0.24 and 0.41, respectively), with no correlation in the 3D needle group. Conclusion: The deformation rate of the IJV wall was smaller in the 3D needle group than in the usual needle group. The use of a 3D needle would be safer when puncturing the IJV.
Enhancement of mechanical and thermal properties of carbon fiber phenolic resin composites using silicon carbide filler for thermal protection system applications
Authors: Basingala Praveen Kumar , Neigapula Venkata Swamy Naidu 
Published: August 2024

Thermal protection systems (TPS) are vital for re-entry vehicles for their safe passage into the atmosphere from space. Hence, researchers took a keen interest in improving the thermal and ablative properties of composites to be used in making thermal protection systems. Therefore, an attempt was made to improve the thermal and ablative properties of composites made of carbon fibers (Cf) and resorcinol formaldehyde phenolic (Ph) resin with the incorporation of silicon carbide (SiC) particles. The filler was added in various percentages (0 wt% - blank, 1 wt%, 3 wt%, and 5 wt%), and the composites were tested for ablative, thermal and mechanical properties. The results demonstrate that the SiC-modified PAN-based carbon fiber reinforced phenolic (SiC-PANCf-Ph) composite with 3 wt% SiC enhancement exhibited ideal properties. The post-ablation phase composition and microstructure were examined through X-ray diffraction (XRD), Scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDS). The surface morphology evidences the formation of a silicon dioxide (SiO2) layer on the composites. The SiC-PANCf-Ph composites demonstrated the lowest ablation rate, enhancing their potentiality for effective TPS applications.
The association of rotator cuff muscle morphology and glenoid morphology in primary glenohumeral osteoarthritis
Authors: Siso Deniz , Wee Hwabok , Ponnuru Padmavathi , Lewis Gregory S , Du Jing , Updegrove Gary F , Armstrong April D , Vidt Meghan E 
Published: August 2024

Background This retrospective study investigated associations of rotator cuff muscle atrophy (MA) and fatty infiltration (FI) with glenoid morphology. Methods Patients with primary glenohumeral osteoarthritis who presented to Penn State Bone and Joint Institute's orthopaedic clinic from September 2002 to December 2019 as total shoulder arthroplasty (TSA) candidates were evaluated. MA was determined by the cross-sectional area of each rotator cuff muscle on pre-operative MR and CT scans. Fat-free muscle and FI areas were quantified using Hounsfield units (HU). Glenoid morphology was assessed using glenoid version and inclination and modified Walch classification. Results Sixty-one patients (61 shoulders) were evaluated. B3 glenoids had a greater percent FI of supraspinatus (40.8 ± 7.3) versus A2 glenoids (31.6 ± 12.9, p = 0.032); infraspinatus and teres minor muscles (49.7 ± 9.1) versus A1 (31.1 ± 13.1, p = 0.039), A2 (30.2 ± 13.3, p = 0.028), and B1 glenoids (31.6 ± 11.9, p = 0.038); and subscapularis (36.7 ± 11.1) versus A2 glenoids (25.5 ± 14.7, p = 0.032). B2 glenoids had a larger area ratio of infraspinatus and teres minor to subscapularis (0.96 ± 0.16) than A1 (0.82 ± 0.13, p = 0.026) and A2 glenoids (0.57 ± 0.25, p = 0.038). Conclusion B3 glenoids had a greater FI of all rotator cuff muscles. B2 glenoids had a larger relative size of infraspinatus and teres minor muscles than subscapularis.
Characterization of the Anti-Inflammatory, Immune Response, and Anti-Bacterial Properties of the Polar Extracts of Indigenous Korean Plants
Authors: Hwang Sungmin , Kim Ji Soo , Na Go Kyoung , Lee Hyeon Jeong , Yun Bohyun , Park Ji-Won , Han Seahee , Park Min-Ju , Lee WonWoo , Choi Kyung-Min , Park Jung Up 
Published: August 2024

Objective The rich botanical biodiversity resulting from diverse climates and geographical distinctiveness offers a plethora of biological resources that can be pivotal in developing innovative biomaterials. This investigation sought to evaluate the functional properties of indigenous Korean plant species. Methods Forty-six indigenous plants during a year-long expedition across inhabited and uninhabited Korean islands were collected. The plant specimens were divided into 5 parts (flower, fruit, stem, leaf, and whole body) and subjected to extraction using water, 30% ethanol, and 70% ethanol, followed by characterizations of anti-inflammatory, immune response, and anti-bacterial activity. Results Thirty-eight percent of the extracts (59 extracts from 31 species) exhibited statistically significant anti-inflammatory effects. Concurrently, 22% of the extracts (35 extracts from 24 species) demonstrated notable immune boosting effects. Additionally, 17 extracts exhibited significant inhibitory effects against the growth of pathogenic bacteria. Conclusion This study highlights the potential utility of extracts of plants from Korean islands as natural agents for next-generation pharmaceutical and medical applications by emphasizing their effectiveness in combating inflammation, enhancing immune responses, and conferring anti-bacterial benefits.
The Impact of a Personal Finance Education Course on Financial Confidence and Markers of Financial Stress among Medical Residents: A Longitudinal Pilot Study
Authors: Anaebere Tiffany Chioma , Hernandez Maria Guevara , Wood D Brian , Dongarwar Deepa , Adu-Gyamfi Sylvia , Moran Joseph , Idehen George , Luong Ethan , Park Angela , Meece Lydia , Salihu Hamisu M. 
Published: August 2024

OBJECTIVES The adverse effects of physician stress on health system performance are well documented. Financial stress is a notable cause of anxiety in medical residents; however, most residency programs lack formal, comprehensive financial education programs. Early single-center studies link financial education interventions to improved immediate fiscal well-being, but programs evaluating its long-term effects are lacking. METHODS Fifty (50) Emergency Medicine and Internal Medicine resident physicians from CommonSpirit Health's St. Joseph's Medical Center in Stockton, CA and Mercy One Medical Center in Des Moines, IA participated in a virtual 8-hour financial education course in April 2022. Participants completed pre-, post-, and 18-month follow-up course surveys to measure financial confidence in seven financial domains and six markers of stress of financial origin (SOFO). RESULTS Forty (40) of 50 residents (80%) completed the pre-and post-course surveys and 19 (38%) completed pre-, post-, and 18-month follow-up surveys. Immediately after the course, there was a statistically significant increase in financial confidence in all seven course domains (p < 0.01) and a significant reduction in SOFO markers (p < 0.01-0.02). At 18 months, financial confidence markers remained increased in most course domains, except related to debt and mortgage, passive income, and taxes. There was a strong association between financial confidence and SOFO immediately post course. Residents with low financial confidence were 15 times as likely to experience SOFO than those with higher financial confidence (p = 0.02). These associations did not persistent at 18 months. CONCLUSION Financial stress is a major contributor to anxiety among physician trainees. Our financial education program demonstrated a significant impact on financial confidence and markers of SOFO, especially in the short term. This offers promising results for personal finance education to serve as a feasible intervention to address physician stress but suggests the need for longitudinal education to maintain its beneficial effects.
NG2 is a target gene of MLL-AF4 and underlies glucocorticoid resistance in MLLr B-ALL by regulating NR3C1 expression
Authors: Lopez-Millan Belén , Rubio-Gayarre Alba , Vinyoles Meritxell , Trincado Juan L. , Fraga Mario F. , Fernandez-Fuentes Narcís , Guerrero-Murillo Mercedes , Martinez Alba , Velasco-Hernandez Talia , Falgàs Aïda , Panisello Carla , Valcarcel Gemma , Sardina José Luis , López-Martí Paula , Javierre Biola M. , Del Valle-Pérez Beatriz , García de Herreros Antonio , Locatelli Franco , Pieters Rob , Bardini Michela , Cazzaniga Giovanni , Rodríguez-Manzaneque Juan Carlos , Hanewald Thomas , Marschalek Rolf , Milne Thomas A. , Stam Ronald W. , Tejedor Juan Ramón , Menendez Pablo , Bueno Clara 
Published: August 2024

Abstract
B-cell acute lymphoblastic leukemia (B-ALL) is the most common pediatric cancer, with long-term overall survival rates of ∼85%. However, B-ALL harboring rearrangements of the MLL gene (also known as KMT2A), referred to as MLLr B-ALL, is common in infants and is associated with poor 5-year survival, relapses, and refractoriness to glucocorticoids (GCs). GCs are an essential part of the treatment backbone for B-ALL, and GC resistance is a major clinical predictor of poor outcome. Elucidating the mechanisms of GC resistance in MLLr B-ALL is, therefore, critical to guide therapeutic strategies that deepen the response after induction therapy. Neuron-glial antigen-2 (NG2) expression is a hallmark of MLLr B-ALL and is minimally expressed in healthy hematopoietic cells. We recently reported that NG2 expression is associated with poor prognosis in MLLr B-ALL. Despite its contribution to MLLr B-ALL pathogenesis, the role of NG2 in MLLr-mediated leukemogenesis/chemoresistance remains elusive. Here, we show that NG2 is an epigenetically regulated direct target gene of the leukemic MLL-ALF transcription elongation factor 4 (AF4) fusion protein. NG2 negatively regulates the expression of the GC receptor nuclear receptor subfamily 3 group C member 1 (NR3C1) and confers GC resistance to MLLr B-ALL cells. Mechanistically, NG2 interacts with FLT3 to render ligand-independent activation of FLT3 signaling (a hallmark of MLLr B-ALL) and downregulation of NR3C1 via activating protein-1 (AP-1)–mediated transrepression. Collectively, our study elucidates the role of NG2 in GC resistance in MLLr B-ALL through FLT3/AP-1–mediated downregulation of NR3C1, providing novel therapeutic avenues for MLLr B-ALL.