bluuebunny/crossref_metadata_2025_split huggingface dataset:
Learner Handoffs Within Clinical Rotations: From the Resident Perspective
Authors: Fishman Michael D. , Harriel Katherine L. , Kahane Caroline G. , Gustafson Sarah , Winn Ariel S. , Fromme H. Barrett , Marcus Carolyn H. 
Published: December 2022

Purpose
Competency-based medical education relies on repeated longitudinal assessments of learners. Frequent attending physician transitions within clinical rotations present a significant barrier to the educational continuity required in competency-based medical education. Learner handoffs (LHs), or the transfer of information regarding learners on a team among faculty supervisors, is a potential solution. Although literature is available on educational leader and clinical faculty perspectives on LHs, perspectives of the learners have been less well described.

Method
This qualitative study used thematic analysis of pediatric resident focus groups from 3 programs of varying size and geographic location from July to December 2021. Two authors independently read the first 3 transcripts to generate a codebook and then coded the remaining transcripts independently to ensure thematic saturation. Emerging themes were discussed and revised until a consensus was achieved.

Results
Forty-four pediatric residents from 3 programs participated in 8 focus groups. Themes were identified regarding LHs’ positive impact on the (1) learner, (2) clinical practice, and (3) learning environment. Participants described numerous positive benefits to their own development, team functioning, trust, and patient safety. This experience was counterbalanced by risk of bias in the current LH context. Suggestions for the implementation of a structured LH framework were provided, with a focus on the content (what information), process (who is involved), and format (how is it delivered) of LHs. Participants believed that the creation of a structured LH tool may mitigate perceived challenges, including bias and lack of transparency.

Conclusions
Residents recognize potential benefits to learners themselves, their clinical practice, and their learning environment through LHs but express concerns regarding further propagating bias. The development of a structured and learner-centered LH tool could accelerate learner professional development while mitigating perceived challenges. Future research should define essential components of an LH model with input from all key stakeholders.
Efficacy and safety of fruquintinib as third- or further-line therapy for patients with advanced bone and soft tissue sarcoma: a multicenter retrospective study
Authors: Ding Xiaomin , Liu Yuan , Zhang YaWen , Liang Jinrong , Li Qian , Hu Haiyan , Zhou Yan 
Published: December 2022

Purpose
Fruquintinib is an oral small-molecule angiogenesis inhibitor, markedly specifically inhibited vascular endothelial growth factor 2 (VEGFR2). This retrospective study aimed to evaluate the safety and efficacy of fruquintinib, or in combination with immunotherapy or chemotherapy in patients with bone and soft tissue sarcoma (STS), who have failed at least secondary-line treatment.

Patients and methods
We performed a retrospective analysis of advanced bone and STS patients who received fruquintinib containing third- or further-line therapy in Shanghai Jiao Tong University Affiliated Sixth People’s and the Affiliated Hospital of Jiangxi University of Traditional Chiese Medicine from September 2019 to February 2022. All of them had accepted at least anthracyclines-based chemotherapy. For the experimental group, 25 cases, the patients took a basic dose of fruquintinib 3–5 mg once a day for 21 days per 4 weeks as a cycle until the disease progression or intolerable toxicity. The other 20 patients in the control group received the best supportive care. The patients were evaluated by computed tomography (CT) or MRI once 2 months or symptoms worse. The DCR, progression-free survival (PFS), and adverse reactions of the drug were recorded and reviewed.

Results
The DCR in patients receiving fruquintinib therapy was 80.0%. The median PFS (mPFS) in the fruquintinib-containing therapy group was significantly longer than that in the control group (4.8 vs. 1.4 months; P < 0.001). The mPFS in the fruquintinib group, the fruquintinib-OI group and the fruquintinib-chemotherapy group were 3.2 months [95% confidence interval (CI), 2.0–7.9], 4.9 months (95% CI, 3.0–9.9) and 4.2 months (95% CI, 2.6–6.6) respectively, all of them were longer than the mPFS of 1.4 months (95% CI, 0.3–2.5) in the control group (P < 0.001).

Conclusion
Fruquintinib was reported for the first time to have favorable efficacy and safety as an optional treatment for patients with advanced bone and STS who failed in multi-line therapies.
Safety and efficacy of naproxen for fever and acute pain in preschool children: a systematic review
Authors: Mathiesen Sidsel , Jørgensen Adam E.M. 
Published: December 2022

Summary
Preschool children may require acute pain and fever management beyond the effects of paracetamol. Ibuprofen, an NSAID, is the first-choice analgesic add-on in children, as its effects and safety profile are well-known in children. In some countries, however, ibuprofen in oral solution is not available; thus, naproxen (another NSAID) could be an alternative. In this systematic review, we evaluated the effect of naproxen on fever and acute pain as well as related adverse events in preschool children. Although the evidence was limited, naproxen appears to be well tolerated and efficient in treating acute pain and fever in preschool children.
The Gut–Eye Axis: Correlation Between the Gut Microbiota and Autoimmune Dry Eye in Individuals With Sjögren Syndrome
Authors: Bai Xudong , Xu Qing , Zhang Wanni , Wang Chaoyue 
Published: December 2022

Abstract:
The impact of gut microbiota on human health, autoimmunity, and disease occurrence has long been recognized since the advancement of metagenomic sequencing technology has enabled a new level of perspective on the human microbiome. Emerging findings also suggest the existence of a gut–eye axis, wherein gut dysbiosis may be a crucial factor affecting the onset and progression of multiple ocular diseases. Sjögren syndrome (SS) is a chronic autoimmune disease mainly affecting the exocrine glands, primarily the lacrimal gland in the eye, resulting in severe dry eye. Although there are currently various treatments for environmental dry eye, the efficacy for SS-related autoimmune dry eye is limited, and new and more effective therapies still need to be explored. The latest studies have demonstrated that the gut microbiota plays a key role in the pathogenesis of autoimmune dry eye. This review describes the effect of gut microbiota on the ocular surface of autoimmune dry eye; introduces the presumable pathways forming the “gut dysbiosis–ocular surface–lacrimal gland axis”; discusses the advantages of restoring intestinal microecology to treat dry eye by fecal microbiota transplantation or probiotics, which are expected to provide perspectives into the correlation between the gut microbiome and dry eye; enhance our understanding of the pathogenesis in autoimmune dry eye; and be useful in the development of future interventions of dry eye by regulating the gut microbiota.
Safety and Efficacy of Black Tea Extract in the Treatment of Acute Bacterial Conjunctivitis: A Rabbit Model
Authors: Abdullatif Abdussalam M. , Hassan Lameece Moustafa , Shash Rania Y. , Marrie Ayah 
Published: December 2022

Purpose:
To determine the safety and efficacy of black tea extract in the treatment of bacterial conjunctivitis in a rabbit model and compare it with that of gatifloxacin drops.

Methods:
Black tea extract was tested in vitro on bacterial cultures of methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa. Forty-two rabbit eyes were cultured with either MRSA (n=21) or P. aeruginosa (n=21) and further divided into a control group (n=5), a tea group (n=8) treated with black tea extract, and a gatifloxacin group (n=8) treated with 0.3% gatifloxacin eye drops. Conjunctival swabs were collected on the third and fifth days.

Results:
The tea extract successfully inhibited the growth of both organisms at a concentration of 400 mg/mL. Rabbits in the treatment groups showed a reduction in the clinical index on day 2 (P<0.01), unlike the control group (P=0.1), for both organisms. Resolution of conjunctivitis was achieved on days 4 and 5 in the tea and gatifloxacin groups, respectively. On days 3 and 5, while the control group still showed considerable bacterial growth, the tea and gatifloxacin groups showed its inhibition.

Conclusion:
Tea extract has antimicrobial effects similar to those of gatifloxacin in a rabbit model of conjunctivitis.
Alterations in glycine metabolism in obesity and chronic metabolic diseases – an update on new advances
Authors: Alves Anaïs , Morio Béatrice 
Published: December 2022

Purpose of review
The metabolic signature associated with obesity is characterized by a decrease in plasma glycine concentration, a feature closely associated with insulin resistance and highly predictive of the risk of developing chronic metabolic diseases. This review presents recent advances in understanding the causes of decreased glycine availability and in targeting strategies to replenish the glycine pool and especially to improve insulin resistance.

Recent results
Recent literature has made progress in understanding host and gut microbiota mechanisms in determining circulating glycine levels. It has also explored new clinical pathways to restore circulating glycine levels and insulin resistance in obesity-related metabolic diseases.

Summary
Recent findings suggest that glycine metabolism must now be considered in close interaction with branched-chain amino acid (BCAA) metabolism. Thus, strategies that decrease BCAAs seem to be the best to restore glycine. Furthermore, recent literature has confirmed that lifestyle strategies aimed at inducing weight loss are effective in replenishing the glycine pool. It also confirms that correcting the dysbiosis of the gut microbiota associated with obesity may be a valuable means of achieving this goal. However, it remains unclear whether dietary glycine is an effective strategy for correcting cardiometabolic disorders in obesity.
Sarcopenia, biological age and treatment eligibility in patients with cancer
Authors: Laviano Alessandro 
Published: December 2022

Purpose of review
Cancer incidence will dramatically increase, especially among older adults, during the next few decades. This may lead to bankruptcy of the healthcare systems worldwide if the current approach to treatment eligibility is not improved. In fact, current treatment personalization is mostly focusing on the genetic and molecular characteristics of cancer cells, whereas clinical characterization of patients is still dependent on gross variables (i.e. chronological age, BMI, comorbidities, Performance Status and so on). This could have contributed to the poor performance of many anticancer drugs in the real-world setting when compared with the results obtained in prospective, randomized clinical trials.

Recent findings
The role of chronological age in identifying patients with increased likelihood to respond to therapies has been challenged, pointing to biological age (i.e. accumulated damage to biological systems over the life course, leading to loss of reserve and capacity to respond to challenges) as a robust predictor of outcome encompassing genetic, phenotypic and clinical factors. Sarcopenia has been proposed as a reliable clinical index of biological age, but the complexity of body composition changes occurring during tumour growth appears to preclude its routine use when assessing eligibility in cancer patients.

Summary
Integration of sarcopenia measures within scores of allostatic load may further increase the clinical relevance of changes of body composition, highlight its sensitivity to early nutritional intervention leading to mitigation of accelerated ageing, and contribute to wide delivery of precision oncology.
Acupuncture combined with traditional Chinese medicine for knee osteoarthritis: A protocol for systematic review and meta-analysis
Authors: Wang Ying , Lu Qi , Guo Haoze , Sun Jiabao , Li Xiaomin , Guan Hongyi , Gao Yu , Song Bailin 
Published: December 2022

Background:With the aging of society, the incidence of knee osteoarthritis (KOA) is increasing year by year, which seriously affects the quality of life. Acupuncture therapy has been widely used in the treatment of osteoarthritis, but there is no complete systematic review on acupuncture combined with traditional Chinese medicine. Therefore, this study aims to clarify the efficacy and safety of acupuncture combined with traditional Chinese medicine in the treatment of KOA through systematic review and meta-analysis.Methods:A structured and systematic literature search will be conducted in the following databases up to March, 20, 2022: PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific and Journal Database, Wan Fang database and 2 clinical trials register platforms: Chinese Clinical Trial Registry, ClinicalTrials.gov (www.ClinicalTrials.gov/). We will use the Review Manager 5.4 software provided by the Cochrane Collaborative Network for statistical analysis. We then assessed the quality and risk of the included studies and observed the outcome measures.Results:This meta-analysis further established the efficacy of acupuncture combined with traditional Chinese medicine in the treatment of KOA.Conclusion:This meta-analysis aims to investigate the efficacy of acupuncture combined with traditional Chinese medicine on patients with KOA and provide reliable evidence. To provide more options for clinicians and patients in the treatment of KOA.
Efficacy and safety of anti-obesity herbal medicine focused on pattern identification: A systematic review and meta-analysis
Authors: Park Seohyun , Keum Dongho , Kim Hojun 
Published: December 2022

Background:Herbal medicine based on pattern identification (PI) is used widely in Traditional Chinese Medicine. Proper herbal medicine based on PI has been suggested for effective weight reduction and decreasing the adverse events. This systematic review examined the effectiveness and safety of herbal medicine, focusing on PI in treating obesity.Methods:Eight electric databases were used for searching randomized controlled trials (RCT) (to August 31, 2021). RCTs which prescribed herbal medicine to obese patients based on PI were included. Body weight (BW) and body mass index (BMI) were the primary outcomes. The risk of bias was assessed using Cochrane risk of bias tool, and the meta-analysis was conducted. Grading the evidence was conducted by using GRADEpro.Results:Sixteen RCTs (1052 patients) were included: 2 studies compared herbal medicine to placebo (128 patients); 2 studies compared them to western medication (161 patients); 12 studies compared them with usual care (763 patients). The meta-analysis showed that the herbal formulas reduced the BW and BMI without significant Adverse events compared to the control group (BW: mean difference  = –4.10, 95% confidence interval: –5.14 to –3.06,I2 = 2% and BMI: mean difference = –1.53, 95% confidence interval: –1.88 to –1.19,I2 = 25%). Moderate-quality evidence on the primary outcomes was found.Conclusions:Herbal medicine – has good clinical efficacy and safety in treating obesity. This study has limitations that some literatures with high risk of bias in blinding or without using a standardized diagnosis of PI were included. However, the current evidence suggests the possibility of precision medicine using PI.
Effectiveness and safety of Tiaogan formula in the treatment of coronary heart disease: A protocol for systematic review and meta-analysis
Authors: Mingtai Chen , Guofu Zhong , Junteng Chen , Ling Men , Jienan Luan , Zhihao Luo 
Published: December 2022

Background:The morbidity and mortality of coronary heart disease (CHD) has remained high, which greatly increases people’s economic burden. Several studies have showed that Tiaogan formula (TGF), as a kind of Chinese herbal medicine, was of benefit to relieving angina pectoris symptoms and improving the quality of life for CHD patients. However, the intensity of evidence has been poor, limiting the further clinical application of TGF to CHD. This systematic review and meta-analysis will assess the effectiveness and safety of studies of TGF in CHD patients.Methods:A systematic search for literature up to December 2022 will be conducted in following public electronic databases: PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journals Database Database, and Wanfang Database. Inclusion criteria are randomized controlled trials of Tiaogan formula in the treatment of coronary heart disease. The primary outcome measures will be mortality, acute cardiovascular events, total efficacy rate, and improvement of angina symptoms. The secondary outcome measures will be electrocardiogram, levels of blood lipid, and adverse events. RevMan 5.4 software Cochrane Collaboration (London, United Kingdom) will be applied for data synthesis, sensitivity analysis, subgroup analysis, and risk of bias assessment. A funnel plot will be developed to evaluate reporting bias and Egger tests will be used to assess funnel plot symmetries. We will use the Grading of Recommendations Assessment, Development and Evaluation system to assess the quality of evidence.Results:This study will provide a systematic review of Tiaogan formula in the treatment of CHD.Conclusion:This study will provide a high-quality synthesis of the effects and safety of Tiaogan formula in the treatment of CHD patients.
Combined Exercise and Game-Based Cognitive Training Intervention
Authors: Myers Jamie , Pathak Harsh B. , He Jianghua , Ghosh Arnab , Puri Rajni V. , Asakura Yuki , Miyashita Mika 
Published: December 2022

Background
Interventions that increase neuroprotective factors and/or decrease inflammatory biomarkers may be effective in improving cognitive function for cancer survivors. Concurrent investigation of potential mechanism(s) to fully understand and refine effective interventions is needed.

Objective
This correlative prospective substudy was conducted to investigate biomarkers related to potential mechanism(s) for a combined exercise and game-based brain training intervention designed to improve cognitive function in breast cancer survivors.

Interventions/Methods
Fingerstick bloodspot samples were collected at 3 time points during the randomized, wait-list controlled interventional parent study. Samples were analyzed for neuroprotective factors and inflammatory biomarker levels.

Results
Insulinlike growth factor 1 (IGF-1) levels significantly increased (P < .01) for the intervention group from baseline to 4 and 16 weeks postintervention. Insulinlike growth factor 1 levels correlated with neurocognitive test performace improvement for Trail Making Test B (r = 0.31, P = .02). This association was not significant in the mixed model. No significant correlation was seen between IGF-1 levels and changes in self-report of cognitive function, activity level, or intervention dose.

Conclusions
Further investigation of IGF-1 levels is warranted as related to potential mechanisms for the Combined Exercise and Game-based Cognitive Training intervention. Future investigations should involve a larger sample cohort and incorporate objective measures of physical activity and prescribed sampling time in relationship to the most recent performance of the intervention.

Implications for Practice
Fingerstick bloodspot sample collection is feasible, acceptable, and effective for conducting biomarker research. This methodology minimizes participant burden and discomfort; increases clinical trial access for home, off-site, or rural settings; and facilitates research efforts during times of pandemic restrictions.
Retrospective Analysis of a Clinical Algorithm for Managing Childhood Myopia Progression
Authors: Cooper Jeffrey , Aller Thomas , Smith Earl L. , Chan Kevin , Dillehay Sally M. , O'Connor Brett 
Published: December 2022

ABSTRACT

SIGNIFICANCE
As the myopia epidemic unfolds, there is growing urgency to identify and implement effective interventions to slow myopia progression. This investigation evaluated the effectiveness of an evidence-based myopia treatment algorithm in a clinical setting among 342 consecutive children.

PURPOSE
This study aimed to evaluate effectiveness of a clinical treatment algorithm for myopia progression in children.

METHODS
A retrospective cohort analysis was performed using data from myopic children treated for at least 1 year with a defined treatment algorithm incorporating orthokeratology, multifocal lenses, and atropine. The main outcome measures were the percentage of children experiencing ≤0.25 D of myopic cycloplegic spherical equivalent autorefraction (CSER) progression and ≤0.10 mm of axial elongation at 1, 2, and 3 years. The secondary outcome measures were the cumulative absolute reduction of axial elongation values derived from age- and ethnicity-matched virtual control data at 1, 2, and 3 years.

RESULTS
Mean annual CSER change values (excluding orthokeratology) were −0.30, −0.20, and −0.13 D at 1, 2, and 3 years, respectively, with 59, 56, and 60% of patients demonstrating ≤0.25 D of change over the prior year. Mean annual axial elongation values were 0.13, 0.12, and 0.09 mm at 1, 2, and 3 years, respectively, with 52, 46, and 65% of patients demonstrating ≤0.10 mm of change over the prior year. The cumulative absolute reduction of axial elongation values were 0.11, 0.20, and 0.29 mm for 1, 2, and 3 years, respectively.

CONCLUSIONS
The treatment algorithm demonstrated effective control of CSER and axial length in a diverse group of progressive myopic children, supporting its use for the clinical management of childhood myopia.