bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Direct Medical Costs and Associated Factors Within the Last 30 days of Life of Hospitalized Cancer Patients
Authors: Ito Suffert Soraya C. , Motke Bruna B. , Linhares Armani B. , Vargens André F. , Alano Tainá S. , Lutz Andreas T. , Boff Borges Rogério , Bica Claudia G. , Vargas Alves Rafael José 
Published: December 2022

Background: An estimated 9.6 million people died from cancer globally in 2018, which is a reflection of the quality of patients’ end-of-life care and its costs. Aim: To estimate direct medical costs of the last 30 days of oncology patients admitted to an inpatient clinic and to evaluate factors associated with medical costs at the end of life. Design: Cost-of-illness study with data from a retrospective cohort. Setting/Participants: We included patients aged 18 and older who were diagnosed with incurable cancer and who were admitted to a tertiary hospital in Brazil between January 1, 2018 and December 31, 2019. Results: Our sample included 109 patients with an average age of 69 (61‒76). The median overall survival was 4.3 (.9‒12.9) months. The median cost per patient per day related to hospitalization was BRL 119 (73‒181)/United States dollars [USD] 21 (13‒33). The cost of medication was BRL 66 (40‒105)/USD 12 (7‒19), representing 55.46% of costs while that of materials and supplies was BRL 30 (18‒49)/USD 5 (3‒9). In the multivariate analysis, when the limitation of interventions was recorded in the medical record, the median cost is reduced by BRL 50 (USD 9) per patient per day. Conclusions: The median cost per patient per day was BRL 119 (73‒181). The recording of limitations of therapeutic interventions in the medical record was a predictor variable that influenced the final medical cost of patients, suggesting that medical practice and decision-making in end-of-life care impact costs.
Review of Ruxolitinib for Treatment of Non-Segmental Vitiligo
Authors: Hwang Jacqueline R. , Driscoll Marcia S. 
Published: December 2022

Objective: To review the pharmacokinetics, efficacy, and safety of topical ruxolitinib for treatment of nonsegmental vitiligo. Data Sources: Literature published between January 1983 and October 2022 was reviewed from MEDLINE and ClinicalTrials.gov. Study Selection and Data Extraction: Relevant articles in English and data from clinical trials were included. Data Synthesis: In 2 phase II trials, treatment with ruxolitinib cream showed significant improvements in Vitiligo Area Scoring Index (VASI) scores compared with controls. The 1.5% concentration applied twice daily showed the best results after 52 weeks, with 50% VASI improvement in 58% of patients, 75% VASI improvement in 52% of patients, and 90% VASI improvement in 33% of patients. In 2 phase III trials, more patients achieved at least 75% improvement in facial VASI at 24 weeks (primary endpoint; trial 1: 29.9%, trial 2: 29.9%) than controls (trial 1: 7.5% [ P < 0.0001], trial 2: 12.9% [ P < 0.01]). Common adverse effects were erythema, pruritus, and acne; all events were mild. Relevance to Patient Care and Clinical Practice in Comparison to Existing Drugs: This review summarizes the pharmacokinetics, efficacy, and safety data regarding topical ruxolitinib for vitiligo. Ruxolitinib is associated with significant clinical improvements with low bioavailability and minimal adverse effects compared with conventional topical steroids, calcineurin inhibitors, phototherapy, and depigmentation agents. Conclusions: Ruxolitinib cream is the first therapy approved by the Food and Drug Administration for repigmentation of nonsegmental vitiligo. Clinicians should consider these benefits when recommending treatment as conventional therapies may be time-intensive and carry greater risks of adverse effects.
Clinical Outcomes of Fusion in Type II Accessory Naviculars With or Without Asymptomatic Flatfeet
Authors: Sun Nian , Chen Junjian , Chen Zhuhong , Zeng Canjun , Guo Hao 
Published: December 2022

Background: Few studies have reported the clinical outcomes of fusion surgeries for type II accessory naviculars. Whether the combination of accessory naviculars and asymptomatic flatfoot will result in worse outcomes in accessory navicular surgeries remains to be elucidated. Our study aims to report the clinical outcomes of fusion for type II accessory naviculars and make a subgroup comparison among accessory navicular patients with or without asymptomatic flatfeet. Methods: From May 2017 to June 2021, all painful type II accessory naviculars with or without asymptomatic flatfeet in our inpatient center were reviewed, and those who only underwent fusion surgeries were included in the retrospective study. Visual analog scale (VAS) scores, American Orthopaedic Foot & Ankle Society (AOFAS) midfoot scores, Tegner activity level scores, complications, patient-reported satisfaction, and imaging results (Meary angle in the weightbearing lateral view, talo–first metatarsal angle and talonavicular coverage angle in the weightbearing anteroposterior view) were used to describe outcomes. Results: Thirty-two eligible patients responded to the latest follow-up request and were included in this study. The mean follow-up duration was 37.1 ± 16.0 months. The average VAS pain score improved from 4.7 ± 1.8 preoperatively to 0.9 ± 1.2 at the latest follow-up ( P<.001). The average AOFAS midfoot score improved from 67.1 ± 8.5 preoperatively to 90.2 ± 10.7 at the latest follow-up ( P<.001). The preoperative and postoperative Tegner activity level scores were similar (3.3 ± 1.5 vs 3.5 ± 1.6, P=.136). The overall complication rate was 37.5%. The most common complication was nonunion (31.3%). The overall satisfaction rate was 90.6%. Similar outcomes were observed between the flatfoot and the nonflatfoot subgroups. Conclusion: Fusion for painful type II accessory naviculars resulted in good symptom relief, function improvement, and patient satisfaction at midterm follow-up, but the nonunion rate was relatively high. Fusion for painful type II accessory naviculars with or without asymptomatic mild to moderate flatfoot brought about similar clinical outcomes. Level of Evidence: Level III, retrospective comparative study.
Model Characterization: Total Body Irradiation or Busulfan for Conditioning in Human Cell Therapy Toxicology and Tumorigenicity Studies using NOD/SCID/IL2Rγnull (NSG) Mice
Authors: Ballesteros Cristina , Wong Karen , Abrahim Maia Araujo , Li Christian , Authier Simon 
Published: December 2022

The NOD/SCID/IL2Rγnull (NSG) mouse is a relevant model for toxicology and tumorigenicity studies evaluating human cell therapies. Data was compiled from toxicology study control NSG mice exposed to gamma irradiation (0 or 200 cGy) or busulfan. Retrospective data evaluation included mortality, clinical observations, body weights, hematology, and external and internal macroscopic observations. There was no mortality in any of the 129 toxicology control (irradiated and non-irradiated) mice up to the 20-week observation period. Mortalities occurred between Days 1 and 25 among animals given busulfan ≥25 mg/kg/day at 1 or 2 doses via intraperitoneal (i.p.) injection. There were 4/10, 6/10 and 4/10 deaths at 25, 30 and 35 mg/kg/day busulfan, respectively. Busulfan-treated mice presented with dose-dependent clinical signs including signs of anemia in some individuals. Hematology, including white blood cell (WBC) and neutrophil (NEUT) counts, from irradiated mice at Weeks 12 and 20 revealed comparable values to non-irradiated animals. In contrast, irradiated mice treated with a positive control (HL-60) were euthanized prior to Week 12. There were no irradiation-related differences in macroscopic observations with lymphoid atrophy identified comparably in irradiated and non-irradiated groups. These results suggest that irradiation was suitable for conditioning to enable cell engraftment in NSG mice in the context of regulatory toxicology and tumorigenicity studies. Busulfan administered at 20 mg/kg/day for 2 days, i.p. was also well-tolerated, and it could be considered for toxicology studies of genetically modified human cells.
Wear failure mechanism analysis of self-lubricating fabric composites at high temperature
Authors: Yu Mingming , Zhang Min , Fang Lin , Ren Musu , Liang Lei , Xie Wang , Ma Pibo 
Published: December 2022

The friction and wear properties of self-lubricating fabric composites were closely related to fiber properties. In this paper, polyimide (PI), polyetheretherketone (PEEK), polyisophthalamide (PMIA) and cyclic aramid (Aramid III) fibers were selected as reinforcing fibers to compare and investigate the friction and wear properties of self-lubricating fabric composites at high temperature. The tribological behavior of self-lubricating fabric composites was evaluated by ball-on-disk friction test. The wear mechanism was investigated by scanning electron microscope and mechanical test. As a result, the composite with PI as warp and weft reinforcing fiber has outstanding wear resistance because of the higher modulus of PI fiber. Its wear rate is 1.29 × 10−8 mm3/(N·mm). It shows that the stronger the rigidity of the reinforcing fiber at high temperature, the better the wear resistance of the composite. However, the friction coefficient of composites with PI as weft reinforcing fibers is about 0.8, which is much higher than that of composites with PMIA, PEEK and Aramid III as weft reinforcing fibers. Their friction coefficients are about 0.1. In addition, the self-lubricating fabric composites with different warp and weft reinforcing fibers were prepared as self-lubricating joint bearing liners to evaluate bearing applications.
Effects of a Clinical Exercise Program on Health-Related Fitness and Quality of Life in Spanish Cancer Patients Receiving Adjuvant Therapy
Authors: GilHerrero Lucía , Courneya Kerry S. , McNeely Margaret L. , Castellanos Mónica , González Marquez Ana Isabel , Pollan Marina , Casla-Barrio Soraya 
Published: December 2022

Objective: To report the feasibility and effectiveness of a newly developed clinical exercise program for improving maximal cardiorespiratory fitness in Spanish cancer patients receiving adjuvant chemotherapy or radiation. We also examined the effectiveness of the exercise program for improving maximal muscular strength, body composition, fatigue, and quality of life, and explored if the effectiveness varied based on selected patient characteristics. Design: The study was a single group implementation feasibility study using a pre-posttest design. Methods: Participants performed a 12-week, twice-weekly, supervised, multi-component exercise program during adjuvant therapy. Paired t-tests were used to assess pre-post changes, and analyses of covariance were used to compare effectiveness based on selected patient characteristics. Results: We had 100 cancer patients referred to the clinical exercise program of which 85 (85%) initiated the exercise program and 76 (89%) completed the post-intervention fitness assessment. Exercise significantly improved VO2max by 4.8 mL/kg/minutes ( P < .001, d = 0.74). Exercise also significantly improved chest strength ( P < .001, d = 0.82), leg strength ( P < .001, d = 1.27), lean body mass ( P < .001, d = 0.11), skeletal muscle mass ( P < .001; d = 0.09), fat mass ( P < .001; d = 0.10), % body fat ( P < .001; d = 0.17), quality of life ( P = .0017; d = 0.41), and fatigue ( P = .007; d = 0.46). Treatment modality, cancer type, and age affected some exercise responses, especially related to body composition changes. Conclusions: A 12-week, supervised, multi-component exercise program was effective for improving health-related fitness and quality of life in Spanish cancer patients receiving adjuvant therapy. Our results show the benefits of incorporating clinical exercise programming into the supportive care of cancer patients receiving treatments. Registration: The study protocol is registered at ClinicalTrials.gov (NCT05078216).
Revision of Flexor Tendon Repair: Factors Associated With Flexor Tenolysis
Authors: Demers Alex J. , Moran Thomas E. , Bustos Francis P. , Forster Grace L. , Natal Eduardo , DeGeorge Brent R. 
Published: December 2022

Background: Tenolysis restores mobility to the flexor tendon through the lysis of adhesions that inhibit and negatively impact functional outcomes following flexor tendon repair. Despite extensive literature on operative techniques and therapy protocols used to minimize adhesion formation, there are limited data examining the association of patient, injury, and postoperative factors with tenolysis. This study aims to: (1) quantify tenolysis rates following flexor tendon repair or reconstruction; and (2) identify patient demographic factors, medical comorbidities, injury characteristics, postoperative diagnoses, and complications associated with tenolysis. Methods: PearlDiver was used to identify patients who underwent a flexor tendon repair or reconstruction from 2010 to 2020. Patients were stratified by whether or not flexor tenolysis was performed. Patient demographics, comorbidities, injury characteristics, postoperative diagnoses, and complications were recorded. Logistic regression analysis was used to identify independent risk factors associated with tenolysis. Results: Database review identified 10 264 patients who underwent either flexor tendon repair or reconstruction, with 612 patients (6.0%) subsequently undergoing tenolysis. Logistic regression analysis determined that vascular injury preceding flexor tendon repair, surgical wound disruption, nerve injury diagnosed postoperatively, postoperative tendon rupture, and need for repeat flexor tendon repair were associated with an increased odds of tenolysis. Patient age, sex, and comorbidities were not associated with performance of tenolysis. Conclusions: Although tenolysis rates may differ according to physician and patient preferences, identification of factors associated with tenolysis following flexor tendon repair allows surgeons to risk-stratify patients prior to surgery and help guide postoperative expectations if complications arise.
Warning Signs: Occult Diabetes and Dysglycemia in the Hand Surgery Patient Population
Authors: Nelson Johnny T. , Gay Samuel S. , Diamond Scott , Gauger Mitchell , Singer Richard M. 
Published: December 2022

Background: Diabetes mellitus often exists for many years prior to diagnosis, and very little is known about the role of the prediagnosis stage of metabolic impairment in contributing to hand and upper-extremity pathology. The goal of this study is to determine the prevalence of undiagnosed glucose dysregulation in patients presenting with the 2 most commonly treated conditions of the hand and wrist. Methods: A retrospective study was performed of hand surgery patients with no established diagnosis of prediabetes or diabetes referred for a 2-hour glucose tolerance test according to American Diabetes Association criteria. Patients were divided into 3 groups: peripheral neuropathies, trigger finger, and controls with various upper-extremity diagnoses. Rates of undiagnosed prediabetes and diabetes were compared between groups, including subgroup analysis of patients based on unilateral or bilateral presentation. Binary logistic regression analysis was also used to calculate odds ratios for multiple variables. Results: Patients with neuropathy had a significantly higher incidence of undiagnosed dysglycemia compared with the control group. Of those patients, 51.3% were prediabetic and 12.8% were diabetic. The control group had significantly lower rates. Within the bilateral neuropathy patients, 59.6% had prediabetes and 15.4% had diabetes, versus 34.6% with prediabetes and 7.7% with diabetes in the unilateral group. Conclusions: Hand surgeons encounter a patient population with high rates of undiagnosed prediabetes and diabetes, with some presentations as much as 6 times higher than the general population. Certain patient presentations should prompt appropriate diagnostic testing and referral, especially those presenting with bilateral compression neuropathy and elevated body mass index.
Delayed Scaphoid Fracture Union in Patients With Comorbid Psychiatric Diagnoses: A Retrospective Analysis of 20 340 Patients
Authors: Albright J. Alex , Rebello Elliott , Chang Kenny , Testa Edward J. , Daniels Alan H. , Katarincic Julia A. 
Published: December 2022

Background: Psychiatric comorbidities have been shown to influence outcomes of various orthopedic pathologies. This study aimed to compare rates of delayed scaphoid union and surgical intervention for fractures in patients with and without comorbid psychiatric diagnoses. Methods: A matched retrospective cohort study was performed using the PearlDiver database to determine the association of depression, anxiety, bipolar disorder, and schizophrenia with delayed union rates within 3 and 6 months and rates of nonacute surgical intervention (fixation or grafting) within 6 and 12 months of scaphoid fracture. Analyses were completed using multivariate logistic regression. Results: Among 20 340 patients, a comorbid psychiatric diagnosis was associated with increased rates of delayed scaphoid union at 3 months (odds ratio [OR] = 1.29; 95% confidence interval [CI], 1.14-1.45) and 6 months (OR = 1.23; 95% CI, 1.10-1.38). At 3 months, women with any psychiatric disorder (OR = 1.58; 1.29-1.66), depression (OR = 1.68; 1.31-2.17), and schizophrenia (OR = 5.32; 95% CI, 1.06-26.79) were more likely to experience delayed union, with similar results at 6 months. Men with bipolar disorder experienced increased delayed union rates at 6 months (OR = 1.40; 1.03-1.91). A comorbid psychiatric diagnosis (OR = 1.10; 1.01-1.20) was associated with increased rates of surgical intervention, whereas schizophrenia was associated with decreased rates (OR = 0.58; 0.34-0.99). Conclusion: Patients with comorbid psychiatric conditions experienced increased rates of delayed scaphoid union. These results underscore the importance of understanding factors that may place patients at risk of impaired recovery.
Examining the Public’s Most Frequently Asked Questions About Carpal Tunnel Syndrome and Appraising Online Information About Treatment
Authors: Shepard Samuel , Sajjadi Nicholas B. , Checketts Jake X. , Hughes Griffin , Ottwell Ryan , Chalkin Brian , Hartwell Micah , Vassar Matt 
Published: December 2022

Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Patients often search online for health information regarding common musculoskeletal complaints. Thus, the purpose of this study was to use language processing information from Google to assess the content of CTS frequently asked questions (FAQs) searched online and the transparency and quality of online CTS information. Methods: On March 11, 2021, we searched Google for 3 terms “carpal tunnel syndrome treatment,” “carpal tunnel syndrome surgical treatment,” and “carpal tunnel syndrome non-surgical treatment” until a minimum of 100 FAQs and their answer links were extracted from each search. We used Rothwell classification to categorize the FAQs. The Journal of the American Medical Association’s benchmark criteria were used to assess information transparency. Information quality was assessed using the Brief DISCERN tool. Results: Our Google search returned 124 unique FAQs. Fifty-six (45.2%) were value based and most were related to the evaluation of treatment options (45/56, 80.4%). The most common source type was medical practices (26.6%). Nearly half of the answer sources (45.9%) were found to be lacking in transparency. One-way analysis of variance revealed a significant difference in mean Brief DISCERN scores among the 5 source types, F(4, 119) = 5.93, P = .0002, with medical practices averaging the worst score (13.73/30). Conclusions: Patients are most commonly searching Google to gain information regarding CTS treatment options. Online sources such as medical practices should use widely accepted rubrics for ensuring transparency and quality prior to publishing CTS information.
A rare case report of a myxoid liposarcoma arising from the broad ligament
Authors: Sassi Farah , Sahraoui Ghada , Charfi Lamia , Ines Zemni , Mrad Karima , Doghri Raoudha 
Published: December 2022

Myxoid liposarcoma (MLPS) is the second most prevalent subtype of liposarcoma. It is usually found in the deep tissues of the lower limbs and rarely in gynecologic tract. Herein we present the second case in the English literature of a primary MLPS arising from the broad ligament which was thought to be a borderline ovarian tumor. The aim is to discuss its clinical and pathological characteristics. A 42-year-old woman presented with pelvic pain for the last 6 months. Magnetic resonance imaging was not specific. She underwent a surgical resection of the tumor mass, and pathological examination confirmed the diagnosis of MLPS deriving from the broad ligament. She received radiotherapy and the patient is doing well at 3 months follow-up. The clinical aspects, pathological diagnosis, prognosis, and therapy approach of broad ligament MLPS are all poorly understood. Complete surgical resection with or without radiotherapy is the mainstay of treatment in located MLPS.
Papers N Parcels: Fill the gap by an app–teenager created initiatives in courier service
Authors: Ahmed Jashim U , Ahmed Asma , Faroque Anisur R , Fatema Kaniz 
Published: December 2022

Papers N Parcels (hereafter PnP) is an end-to-end logistics business organization founded in 2018 by Tilak Mehta, who was a teenager at the time. The capital that supported the initial activity of the company was derived from family investments. The company has an efficient business model and gains a competitive advantage by setting up its primary objectives and strategies, which position it for success. PnP aims to deliver its products within 4–8 h of an order, which is the fastest rate among existing delivery companies. The parcels are picked up from the end customers and delivered to the recipient company’s main hub. From there, the parcel is sent to the final recipient with the help of the PnP app. This approach streamlines the process, and the time involved is very minimal. The business model of this fast-moving company was new and unique. The case study highlights how effectively PnP capitalizes on the vast network of dabbawalas (lunchbox deliverymen) in Mumbai who use the PnP app.