bluuebunny/crossref_metadata_2025_split huggingface dataset:
Practice Patterns on the Incorporation of Integrative Medicine Into the Oncologic Care of Patients With Cancer
Authors: Narayanan Santhosshi , Liu Wenli , Lopez Gabriel , Fellman Bryan , Reddy Akhila , Subbiah Ishwaria M. , Cohen Lorenzo , Bruera Eduardo 
Published: November 2023

Background: With rising interest in complementary approaches to symptom management, awareness of real-world practice patterns in the incorporation of integrative oncology (IO) into cancer care is limited. Therefore, we examined the reasons for referral, symptom burdens, and clinical outcomes for cancer patients who underwent initial IO consultations. Methods: The records of adult patients with cancer who underwent initial outpatient IO consultations at our cancer center for a representative 10-day period at the start of each month for 12 months starting January 1, 2017, were reviewed retrospectively. Patient demographic and medical characteristics and outpatient IO consultation details, including patient-reported outcome measures of symptom burden, were extracted. Descriptive summary statistics and logistic regression were used to analyze the data. Results: Among the 473 study patients, 71% were women, breast cancer (42%) was the most common cancer type, and 31% had metastatic cancer. Referring clinicians listed an integrative approach (57%) as the most common reason for referral, followed by diet (26%), pain (19%), discussion of herbs and supplements (18%), and stress (18%). In comparison, patients listed their primary concerns as diet (16%), pain (15%), and an integrative approach to overall health (11%). After the IO consultations, the highest likelihood of subsequent recommendations were acupuncture for hot flashes (odds ratio [OR], P = .002) or peripheral neuropathy (OR = 6.59, P < .001), oncology massage for pain (OR = 3.04, P < .001), psychology referral for patient’s self-reported anxiety (OR = 2.35, P < .001), and mind-body therapies for stress (OR = 2.57, P < .001). Conclusion: Cancer patients’ top concerns regarding IO consultation may not always match providers’ reasons for referral. Longitudinal data analysis is needed to determine the effect of integrative interventions on symptom burden.
Successful Removal of a Fractured Desilets-Hoffman Sheath in a Patient With a Loop Arteriovenous Graft: Balloon-Supported Retrieval Technique
Authors: Choi Yoon Seo , Oh Chang Hoon 
Published: November 2023

Introduction While a Desilets–Hoffman sheath rarely fractures, when it does, the presence of an intravenous foreign body can cause various complications. Case Presentation A 74-year-old woman receiving hemodialysis for end-stage renal disease via a left forearm arteriovenous graft (AVG) was referred to the interventional radiology department following thrombotic occlusion of the AVG. A corrective procedure was initiated, and the 7F Desilets–Hoffman sheath fractured after the purse-string suture. A .035-inch guidewire was passed through the fractured sheath, and a 3.0-mm x 60-mm balloon catheter was inflated, allowing for the successful removal of the sheath fragment without complications. Conclusion The fractured Desilets-Hoffman sheath was successfully removed in a patient with a loop arteriovenous graft using balloon-supported retrieval technique.
Weekend Admission is Associated with Higher Kidney Failures after Thoracic Endovascular Aneurysm Repair for Stanford Type B Aortic Dissection
Authors: Li Renxi , Luo Qianyun , Green Derrick , Huddleston Stephen J. 
Published: November 2023

Background Weekend effect characterized by worse perioperative outcomes has been demonstrated in some surgery patients admitted on weekends, as opposed to weekdays. This study aimed to examine weekend effect on open surgical repair or thoracic endovascular aneurysm repair (TEVAR) for Stanford Type B Aortic Dissection (TBAD). Methods Patients who underwent TBAD repair were identified in National/Nationwisde Inpatient Sample from Q4 2015-2020. Open surgery and TEVAR were examined separately. Multivariable analyses were performed comparing in-hospital perioperative outcomes of patients under weekday and weekend admission. Adjusted preoperative variables included sex, age, race, socioeconomic status, hospital characteristics, clinical symptoms, comorbidities, and elective/non-elective admission. Also, length of stay, days from admission to operation, and total hospital charge were compared. Results Among patients who underwent open TBAD repair, 1321 were admitted on weekdays and 340 on weekends. Among patients who underwent TEVAR for TBAD, 2018 were admitted on weekdays and 440 wereadmitted on weekends. There was no difference in open repair outcomes between those admitted on weekdays vs weekends. In TEVAR, weekend admission was associated with higher post-procedural kidney failure (1.14% vs .20%, aOR = 4.11, P = .04) and superficial wound complications (2.73% vs 1.49%, aOR = 2.2, P = .03) but lower respiratory complications (5.80% vs 3.64%, aOR = .47, P = .01). Also, in TEVAR, weekend admission was associated with longer time from admission to operation (3.92 ± .27 vs 2.35 ± .09 days, P < .01). Conclusions Renal malperfusion was a common indication for TBAD repair. TBAD patients admitted over the weekend and underwent TEVAR had higher post-procedural kidney failure, which may be due to delayed diagnosis and treatment.
Trigger thumb treatment approach: Results of a survey of EPOS members
Authors: Carvalho Marcos , Perez-Lopez Laura M , Farr Sebastian , Catena Nunzio 
Published: November 2023

Purpose: The aim of this study is to analyze the clinical reality of pediatric trigger thumb among members of the European Paediatric Orthopaedic Society. Methods: A 35-question survey was sent to all European Paediatric Orthopaedic Society members, focusing on surgeon’s profile and experience, trigger thumb diagnostic and trigger thumb treatment approach. Descriptive statistics were performed. Results: A total of 99 responses were analyzed. Most important factor considered in the therapeutic approach was the presence of a locked interphalangeal joint (52%). Regarding treatment, 41.4% opt for conservative approach as the first line of treatment, while 30.3% consider surgery and 28.3% just observe. Nevertheless, 76% mention to treat conservatively their patients and 99% to consider surgery at some stage. Regarding surgical technique, 96% do it open and 56% consider 2 years as the minimum age for procedure. Most surgeons perform this procedure in out-patient care (87%), don’t administer prophylactic antibiotherapy (80%), use a tourniquet (75%), don’t use any postoperative immobilization (64%), and report complications related to surgery (64%), mainly recurrence/incomplete division (59%) and superficial wound infection (30%). Conclusion: Our study shows a significant variability in the initial management of pediatric trigger thumb with a predominance of conservative management, followed by surgery and observation without treatment. The disparity in treatment options and timing, or waiting times before moving on to different therapeutic options, shows us that this is a controversial issue and that the development of prospective randomized controlled studies is needed to analyze the different treatment methods and determine which ones give the best outcomes.
User-Centered Design of a Diabetes Self-Management Tool for Underserved Populations
Authors: Bonet-Olivencia Samuel , Carrillo-Leal Jesus , Rao Arjun , Sasangohar Farzan 
Published: November 2023

Background: User-centered design (UCD) or user experience design (UXD) methods have gained recent popularity for the design of mobile health (mHealth) interventions. However, there is a gap in application of these methods for diabetes self-management. This study aims to document the UCD process for a self-management mobile application aimed for patients with diabetes in underserved communities. Methods: A UCD mixed-methods approach including interviews with patients and providers, a review of literature, and a technology landscape analysis were used to define the app functional information requirements that informed the user experience/user interface design process. Usability studies with the app designers and developers, intended users, and a focus group of nurse educators and dieticians were used to test and improve the design. Results: An mHealth app was developed with health-tracking features for stress, blood sugar, food, exercise, medications, weight, and blood pressure. We tackled a range of usability and user experience challenges, which encompassed addressing issues like low health literacy by employing a combination of user interface design principles, intuitive visualizations, customizable icons, seamless database integration, and automated data input features. Special attention was given to the design of educational content accounting for the intended users’ cultural background and literacy levels. Conclusions: User-centered design approach contributed to a better understanding of the intended users’ needs, limitations, mental models, and expectations, facilitating the design of a comprehensive mobile app for patients with diabetes in underserved communities that includes essential features for self-management while providing a strong educational component, addressing an important gap in the literature.
Sex Differences in Knee Extensor Neuromuscular Function in Individuals With and Without Patellofemoral Pain
Authors: Kim Sungwan , Glaviano Neal R. , Park Jihong 
Published: November 2023

Background: Impaired knee extensor neuromuscular function has been frequently observed in individuals with patellofemoral pain (PFP); however, few researchers have aimed to understand the influence of sex on knee extensor neuromuscular function in this pathological population. The authors aimed to determine whether there are differences in knee extensor neuromuscular function between sexes in individuals with and without PFP. Hypothesis: Women with PFP would exhibit greater deficits in knee extensor neuromuscular function than men with PFP, compared with sex-matched individuals without PFP. Study Design: Cross-sectional, case-control study. Level of Evidence: Level 4. Methods: A total of 110 individuals were classified into 4 groups: women with PFP (n = 25); men with PFP (n = 30); women without PFP (n = 25); and men without PFP (n = 30). Knee extensor strength (isometric peak torque [PT]), activation (central activation ratio), early, late, and total phase rate of torque development (RTD0-100, RTD100-200, and RTD20-80%), and endurance (isokinetic average PT) were assessed using an isokinetic dynamometer. Group differences were assessed using a 2-way multivariate analysis of variance (sex by PFP). Results: Both women and men with PFP exhibited lower knee extensor strength, activation, early, late, and total phase RTD, and endurance versus sex-matched individuals without PFP ( P < 0.05 for all comparisons). Women with PFP exhibited lower early phase (7.91 ± 2.02 versus 9.78 ± 2.43 N·m/s/kg; P < 0.01; Cohen d = 0.83), late phase (5.34 ± 1.02 versus 7.28±2.28 N·m/s/kg; P < 0.01; Cohen d = 1.37), and total phase (7.40 ± 2.57 versus 8.72 ± 2.57 N·m/s/kg; P = 0.03; Cohen d = 0.51) RTD than men with PFP. Conclusion: Compared with sex-matched pain-free individuals, women with PFP displayed lower RTD than men with PFP. Clinicians should note that among individuals with PFP, women are more likely to experience a greater impairment in their knee extensor torque-generating capacity than men. Clinical Relevance: Additional treatment strategies that effectively improve the ability to rapidly generate torque should be developed and implemented, especially when treating women with PFP.
Bispecific antibody treatment of multiple myeloma: latest updates from the 2022 ASH annual meeting
Authors: Yin Xuejiao , Liu Yi , Sun Jianai , Tong Hongyan , Meng Haitao , You Liangshun 
Published: November 2023

Background: Effective novel therapies for multiple myeloma (MM) patients who are unresponsive to conventional treatments (triple-class refractory) are an urgent need. Bispecific antibodies (BsAbs) offer a promising new approach to stimulate T cells and induce tumor cell death by targeting molecules on the surface of malignant plasma cells and CD3 on the surface of T cells. Objectives: Addressing the issue of improving the prognosis of triple-class refractory MM patients has become a significant clinical challenge. Design: This is a brief report. Methods: This article summarizes the latest updates of BsAbs treatment of MM from the 2022 ASH annual meeting. Results: BsAbs that target B-cell maturation antigen and G protein-coupled receptor family C group 5 memberD have demonstrated remarkable clinical activity and favorable safety profiles. Many potential targets for myeloma cells are currently undergoing phase I/II clinical trials, and these off-the-shelf bispecific molecules are likely to become a critical part of the MM treatment landscape. Conclusion: This article provides an overview of the latest advances in BsAbs immunotherapy for refractory and relapsed MM and highlights significant findings from the 2022 ASH annual meeting.
Knowledge, attitudes, and practices toward blood donation in the Gaza Strip, Palestine
Authors: El Bilbeisi Abdel Hamid , Abuzerr Samer , El Afifi Amany 
Published: November 2023

Aims: Both developing and developed countries are facing difficulties in finding regular donors. In areas that are exposed to frequent conflicts and wars, such as the Gaza Strip, there is a need for a continuous blood supply. This study aims to determine the level of knowledge, attitudes, and practices toward blood donation in the Gaza Strip, Palestine. Methods: A cross-sectional study was conducted in 2022, in which 1506 participants were randomly selected from different governorates in the Gaza Strip. A structured and valid questionnaire was employed to assess the level of knowledge, attitudes, and practices toward blood donation. All statistical analyses were performed using SPSS version 28. The chi-square test was used to measure the significance of associations. Results: A total of 1506 individuals living in the Gaza Strip participated. The total mean score of the overall knowledge and positive attitudes toward blood donation was 55.1% and 67.1%, respectively. Furthermore, 1236 (82.1%) of the study participants never donated blood. Of them, 260 (21.0%) demonstrated that they do not have information on when, where, and how to donate; 228 (18.4%) thought that they were not fit to donate; 187 (15.1%) demonstrated that they did not have time to donate; 143 (11.6%) feared health problems, and 132 (10.7%) feared anemia. On the contrary, 99 (36.7%) donated blood when a friend or relative needed blood, and 171 (63.3%) were voluntary donations. Statistically, a significant association was found between knowledge, attitudes, practices, and sociodemographic variables ( p < 0.05 for all). Discussion: The study findings indicated poor donation habits despite positive attitudes toward blood donation in the Gaza Strip, Palestine. This research emphasizes the need to recognize and correct the knowledge gap that results in unfavorable behaviors against blood donation.
Assessing the Validity of Electronic Medical Records for Identifying High Antibiotic Prescribers in Primary Care
Authors: McIsaac Warren J. , Kukan Sahana 
Published: November 2023

Objectives: Electronic medical record (EMR) prescription data may identify high antibiotic prescribers in primary care. However, practitioners doubt that population differences between providers and delayed antibiotic prescriptions are adequately accounted for in EMR-derived prescription rates. This study assessed the validity of using EMR prescription data to produce antibiotic prescription rates, accounting for these factors. Methods: The study was a secondary analysis of antimicrobial prescriptions collected from 4 primary care clinics from 2015 to 2017. For adults with selected respiratory and urinary infections, EMR diagnostic codes, prescription data, clinical diagnoses and demographics were abstracted. Overall and delayed prescription rates were produced for EMR diagnostic codes, clinical diagnoses, by clinic, and types of infection. Direct standardization was used to adjust for case mix differences by clinic. High antibiotic prescribers, above the 75th percentile for prescriptions, were compared with low antibiotic prescribers. Results: Of 3108 EMR visits, there were 2577 (85.4%) eligible visits with a clinical diagnosis and prescription information. Overall antibiotic prescription rates were similar utilizing EMR records (31.6%) or clinical diagnoses (32.6%, P = .40). When delayed prescriptions were removed, prescribing rates were lower (22.4%, P < .01). EMR data overestimated prescribing rates for conditions where antibiotics are usually not indicated (17.7% EMR vs 7.6% clinical diagnoses, P < .001). High antibiotic prescribers saw more cases where antibiotics are usually indicated (23.4%) compared to low prescribers (16.8%; P = .001). Conclusions: Electronic medical record prescribing rates are similar to those using clinical diagnoses overall, but overestimate prescribing by clinicians for conditions usually not needing antibiotics. EMR prescription rates do not account for delayed antibiotic prescriptions or differences in infection case-mix.
Impact of R&D on Firm Performance: Do Ownership Structure and Product Market Competition Matter?
Authors: Arif Khan Muhammad , Bin Meng , Wang Chunlin , Bilal Hazrat , Ali Khan Arshad , Ullah Irfan , Iqbal Amjad , Rahman Mohib Ur 
Published: November 2023

This study investigates how R&D affects firm performance and examines whether and how state ownership moderates the R&D–firm performance nexus. Moreover, this study investigates whether and how product market competition moderates the association between R&D and performance across the diﬀerent natures of firms. Employing a sample of Chinese listed firms from 2000 to 2020, the study performs estimations by applying pooled ordinary least squares regressions, fixed-effect panel regressions, and a two-step system GMM model to account for endogeneity problems. The findings reveal that firm performance reduces as R&D expenses rise, with the impact being less pronounced for state-owned enterprises. The adverse impact of R&D on corporate performance is also alleviated under intense competition. The results have important implications for policymakers, investors, and corporations seeking to understand how R&D spending influences corporate performance in competitive industries. JEL classification: L25, G32, O3
Expression and Clinical Significance of microRNA-138-5p and TGF-β3 in Peripheral Blood of Patients With Ankylosing Spondylitis
Authors: Cheng Yonghong , Zhang Zhidong 
Published: November 2023

Study design Clinical study. Objective Our work was aimed at exploring the expression and clinical significance of microRNA-138-5p (miR-138-5p) and Transforming Growth Factor-beta 3 (TGF-β3) in peripheral blood of patients with ankylosing spondylitis (AS). Methods Forty-seven patients with AS were selected as the AS group, and the staging of the enrolled AS patients was based on the BASDAI score: <4 points were classified as the stable stage (stable group) and ≥4 points were classified as the active stage (active group). Forty-seven cases were selected from the same period of healthy physical examination in our hospital as the control group. miR-138-5p and TGF-β3 levels and disease activity factors in peripheral blood were measured in all patients. Results Compared to healthy subjects, reduced miR-138-5p levels and increased TGF-β3 levels were found in AS patient. Even more, level of miR-138-5p was decreased and level of TGF-β3 was found to be increased in active disease stage of AS in comparison to inactive disease. Correlation analysis disclosed that miR-138-5p expression in peripheral blood of AS patients was negatively correlated with TGF-β3, HLA-B27, ESR, CRP, and BASDAI; serum TGF-β3 was positively correlated with HLA-B27, ESR, CRP, and BASDAI. The ROC curve analysis disclosed that miR-138-5p and TGF-β3 had certain diagnostic value for AS, and the combined detection could improve the clinical diagnostic capability of this disease. Conclusion miR-138-5p and TGF-β3 in peripheral blood of AS patients are potential biological markers for the diagnosis of AS and are expected to be new clinical diagnostic indicators.
Modeling risk factors of degree of severity of Coronavirus disease 2019 (COVID-19) infection in inpatient patients at Dr. M. Djamil Padang
Authors: Masrizal  , Putri Ade Suzana Eka , Rahmatillah Nabila Putri , Novirsa Randy , Alfarezi Muhammad 
Published: November 2023

Background: RSUP Dr. M. Djamil was one of the COVID referral hospitals that treats patients with degrees of severity ranging from mild to critical. The high prevalence of COVID-19 differs from the severity of which it is necessary to know the risk factors as a preventive measure to minimize the higher risk. This study aims to determine the factors associated with the severity of COVID-19 in inpatients at Dr. M. Djamil Hospital, Padang, Indonesia. Design and methods: A quantitative study with a cross-sectional design was conducted by reviewing the medical record data of COVID-19 inpatients from March 2020 to February 2021. Sampling using a simple random sampling technique with a total of 95 patients. The Prevalence Odds Ratio (POR) is a statistical measure used in epidemiology and medical research to assess the association between an exposure or risk factor and a particular outcome in a cross-sectional study. Results: Based on research, there are 41 (43.2%) severe patients. There is a relationship between age with p-value 0.004 (POR 4.5; 95% CI; 1.48–12.1), cardiovascular disease with p-value 0.003 (POR 5.9; 95% CI 1.7–21.4), and respiratory disease with p-value 0.001 (POR 6.6; 95% CI; 2.1–20.8) against COVID-19 infection. Diabetes Mellitus is the confounding variable. Respiratory disease is the dominant factor associated with the severity of COVID-19. Respiratory disease has 6.6 POR or Prevalence Odds Ratio values which means that COVID-19 patients with respiratory disease 6.6 more severe than those who has not respiratory disease history. Conclusions: Age, cardiovascular, and respiratory diseases are associated with the severity of COVID-19 infection in patients at Dr. M. Djamil Hospital, Padang, Indonesia. It is highly recommended to increase health promotion regarding risk factors for the severity of COVID-19 to the community to avoid a more severe outcome.