bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoplasmic reticulum stress in acute lung injury and pulmonary fibrosis
Authors: Sun Zhiheng , He Wanyu , Meng Huiwen , Li Peizhi , Qu Junxing 
Published: December 2024

AbstractPulmonary fibrosis (PF) is a progressive and irreversible lung disease that leads to diminished lung function, respiratory failure, and ultimately death and typically has a poor prognosis, with an average survival time of 2 to 5 years. Related articles suggested that endoplasmic reticulum (ER) stress played a critical role in the occurrence and progression of PF. The ER is responsible for maintaining protein homeostasis. However, factors such as aging, hypoxia, oxidative stress, or inflammation can disrupt this balance, promoting the accumulation of misfolded proteins in the ER and triggering ER stress. To cope with this situation, cells activate the unfolded protein response (UPR). Since acute lung injury (ALI) is one of the key onset events of PF, in this review, we will discuss the role of ER stress in ALI and PF by activating multiple signaling pathways and molecular mechanisms that affect the function and behavior of different cell types, with a focus on epithelial cells, fibroblasts, and macrophages. Linking ER stress to these cell types may broaden our understanding of the mechanisms underlying lung fibrosis and help us target these cells through these mechanisms. The relationship between ER stress and PF is still evolving, and future research will explore new strategies to regulate UPR pathways, providing novel therapeutic targets.
Drug-induced Liver Injury Due to Medications for Alcohol Use Disorder: Results From the DILIN Prospective Study
Authors: Gopalakrishna Harish , Ghabril Marwan , Gu Jiezhun , Li Yi Ju , Fontana Robert J. , Kleiner David E. , Koh Christopher , Chalasani Naga ,   for the Drug-Induced Liver Injury Network
Published: December 2024

Objectives
Concerns about drug-induced liver injury (DILI) may deter physicians from prescribing medications for alcohol use disorder (MAUD). We aim to explore DILI due to MAUD in Drug-Induced Liver Injury Network (DILIN) prospective study.

Methods
High-confidence DILI cases (ie, definite, highly likely, or probable) due to MAUD in DILIN prospective study (2004–2024) were included. Demographic, clinical, laboratory data, and 6-month outcomes were analyzed. HLA allele frequency (AF) of disulfiram cases was compared to matched controls with DILI due to non-MAUD (DILI controls).

Results
Among 1975 high-confidence cases, 13 were attributed to MAUD (11 disulfiram; 1 naltrexone and 1 baclofen; and none from acamprosate). Median age was 45 years, with 77% female and 85% White. All had hepatocellular injury. In disulfiram group, the median time for DILI occurrence was 34 days. Eight patients developed jaundice, with 3 fatal or near-fatal cases (2 liver transplantation and 1 liver-related death). Five (71%) patients with severe or fatal disulfiram DILI had underlying liver disease. AF for HLA-C*01:02 (OR, 6.29; P = 0.02) and DRB1*09:01 (OR, 10.16; P = 0.02) were significantly higher in disulfiram cases than in DILI controls. DILI from baclofen and naltrexone was mild and self-limited with no chronic DILI.

Conclusions
Disulfiram is the leading cause of DILI among MAUD and is most common in women. Disulfiram can cause severe DILI and is associated with HLA-C*01:02 and DRB1*09:01. Baclofen and naltrexone can cause mild to moderate self-limited DILI. There were no cases of acamprosate. These findings suggest DILI due to MAUD are less frequent.
What Clinicians Think About When They Think About Sepsis: Results From a Survey Across the University of Maryland Medical System
Authors: Yang Jerry M. , Tisherman Samuel A. , Leekha Surbhi , Smedley Angela , Kenaa Blaine , King Samantha , Wu Connie , Kim David J. , Dowling Dorsey , Baghdadi Jonathan D. 
Published: December 2024

IMPORTANCE:
Sepsis, a leading cause of death in the hospital, is a heterogeneous syndrome without a defined or specific set of symptoms.

OBJECTIVES:
We conducted a survey of clinicians in practice to understand which clinical findings they tend to associate with sepsis.

DESIGN, SETTING, AND PARTICIPANTS:
A survey was distributed to physicians and advanced practice providers across a multihospital health system during April 2022 and May 2022 querying likelihood of suspecting sepsis and initiating sepsis care in response to various normal and abnormal clinical findings.

ANALYSIS:
Strength of association between clinical findings and suspicion of sepsis were based on median and interquartile range of complete responses. Comparisons between individual questions were performed using Wilcoxon rank-sum testing.

RESULTS:
Among 179 clinicians who opened the survey, 68 (38%) completed all questions, including 53 (78%) attending physicians representing six different hospitals. Twenty-nine respondents (43%) worked primarily in the ICU, and 16 (24%) worked in the emergency department. The clinical findings most strongly associated with suspicion of sepsis were hypotension, tachypnea, coagulopathy, leukocytosis, respiratory distress, and fever. The abnormal clinical findings least likely to prompt suspicion for sepsis were elevated bilirubin, elevated troponin, and abdominal examination suggesting ileus. On average, respondents were more likely to suspect sepsis with high temperature than with low temperature (p = 0.008) and with high WBC count than with low WBC count (p = 0.003).

CONCLUSIONS:
Clinicians in practice tend to associate the diagnosis of sepsis with signs of severe illness, such as hypotension or respiratory distress, and systemic inflammation, such as fever and leukocytosis. Except for coagulopathy, nonspecific laboratory indicators of organ dysfunction have less influence on decision-making.
Challenges of Faith Community Nursing in a Midwestern Healthcare System
Authors: Jones Krista , Abbasi Hiba , Scott Gregory , Williamson Danna 
Published: December 2024

ABSTRACT:
Faith community nurses are positioned to play a vital role in addressing whole person health in multiple settings. A steady decline of nurses completing faith community nurse (FCN) training in a midwestern healthcare system sparked the system's hospital leadership to re-evaluate the FCN training and outreach program. To inform future education programs, an online needs assessment survey was deployed to FCNs. Focus groups were used to understand the FCNs' experiences in their role. The findings highlight a need for comprehensive educational programs, support networks, and funding mechanisms to support faith community nursing practice.
Investigating the adverse drug reactions of testosterone using Mendelian randomization: a study protocol
Authors: Rhomberg-Kauert Annika Magdalena , Tulstrup Morten , Horwitz Henrik , Heerfordt Ida M. 
Published: December 2024

Summary
This protocol outlines a systematic review that aims to explore the adverse effects of testosterone exposure using Mendelian randomization studies. Testosterone plays an important role in numerous physiological processes, yet the causal relationships between testosterone levels and various health outcomes remain unclear, particularly in the context of testosterone therapy and anabolic-androgenic steroid misuse. Traditional observational studies are limited by confounding factors and reverse causality, while randomized controlled trials are challenging to conduct over the long-term. To overcome these limitations, this review will synthesize findings from Mendelian randomization studies, which use genetic variants as instrumental variables to infer causality between testosterone exposure and health outcomes. By focusing on Mendelian randomization methodology, the study seeks to provide insights into the long-term effects of testosterone on a wide range of health outcomes, including but not limited to cardiovascular health, cancer risk, metabolic conditions, and psychological disorders. Ultimately, this systematic review aims to provide a deeper understanding of the potential side effects of testosterone exposure, which may be relevant in the context of testosterone treatment or anabolic-androgenic steroid misuse.
Expert consensus on nasal anticholinergics in the treatment of allergic rhinitis
Authors: Hong Hai-yu , Liao Zhen-peng , Yang Qin-tai , Sun Yue-qi , Chen Feng-hong , Liu Wen-long , Meng Juan , Xu Rui , Xu Yuan-teng , Yang Yan-li , Yang Yu-cheng , Li Shuo , Lou Hong-fei , Wang Hong-tian , Yu Rui-li , an Yun-fang , Liu Feng , Wang Tian-sheng , Lu Mei-ping , Qiu Qian-hui , Wang Xiang-dong , Chen Jian-jun , Meng Cui-da , Xie Zhi-hai , Zeng Ming , Xu Cheng-li , Wang Ying , Zhang Wei-tian , Tang Jun , Yu Guo-dong , Shi Zhao-hui , Wei Xin , Ye Hui-ping , Sun Ya-nan , Yu Shao-qing , Zhang Tian-hong , Yong Jun , Hang Wei , Xu Yu , Tan Guo-lin , Sun Na , Yang Gui , Li You-jin , Ye Jing , Zuo Ke-jun , Zhang Li-qiang , Wang Xue-yan , Yang An-ni , Xu Ying-xiang , Liao Wei , Fan Yun-ping , Li Hua-bin 
Published: December 2024

Background:
Allergic rhinitis (AR) is a common hyperreactive nasal disease in otolaryngology, mainly manifested as rhinorrhea, nasal obstruction, nasal itching, and sneezing. Despite medication and immunotherapy, a large proportion of patients do not completely eliminate rhinorrhea. In recent years, the use of nasal anticholinergics in the treatment of AR has gained attention. However, there is currently no consensus on the timing and selection of nasal anticholinergics for AR treatment.

Summary:
We reviewed previous studies on nasal anticholinergic drugs in AR and summarized the pathogenesis of AR, the role of anticholinergic drugs, cholinergic neural pathways, the mechanisms of nasal anticholinergic drugs, common types and clinical efficacy of nasal anticholinergic drugs, and precautions for their use. We also provided some suggestions for their clinical application.

Key Messages:
At present, the main drugs of nasal anticholinergics are ipratropium bromide and phencyquine bromide. The cholinergic nervous system is the main neural pathway mediating nasal secretion. Anticholinergic drugs work by blocking the interaction between Ach and the high density of M receptors in the nasal cavity. The clinical effect of nasal anticholinergics is generally good, and there are almost no major or systemic adverse reactions. Nasal anticholinergics provide a more complete treatment for AR patients with poorly controlled rhinorrhea. In the future, nasal anticholinergics will be assessed in high-quality clinical trials and applied clinically.
Uncovering Hidden Patterns: Macrophage-like Cell Distribution Across Different Stages of Posterior Vitreous Detachment
Authors: Sun Gongpeng , Xu Amin , Yang Xueying , Zhang Lu , Wang Wenyu , Sawut Abdulla , Xu Weichen , Wang Xiaoling , Yi Zuohuizi , Zheng Hongmei , Chen Changzheng 
Published: December 2024

Purpose:
To investigate the distribution of macrophage-like cells (MLCs) across different stages of posterior vitreous detachment (PVD).

Methods:
A total of 168 eyes from 168 subjects were included. MLCs were imaged by acquiring en face OCT images at depths of 5 to 10 µm on the inner limiting membrane, as well as using B-scan OCT. Participants were categorized into three groups according to the degree of PVD: Group A for stage 1a PVD, Group B for stages 1b and 2 PVD, and Group C for stages 3 and 4 PVD. Localized vitreoretinal relationships were categorized into vitreoretinal adhesions, type 1a PVD, where the vitreous and retina are not clearly separated, and type 1b PVD, where there is clear separation.

Results:
MLC density was sequentially lower in Groups A, B, and C. Multiple linear regression analysis revealed that MLC density was correlated with both the PVD group and age (both P < 0.001). In Group A, MLC density was significantly higher in type 1a PVD than in the vitreoretinal adhesion area. In Group B, the distribution of MLCs in the vitreoretinal adhesion region was significantly less than in type 1a PVD and type 1b PVD. MLCs were more sparsely distributed in Group C.

Conclusions:
MLCs exhibit distinct distribution patterns in various stages of PVD.
Efficient Assessment of Progression in Clinical Trials in Retinitis Pigmentosa
Authors: Asaoka Ryo , Miyata Manabu , Oishi Akio , Fujino Yuri , Murata Hiroshi , Aoki Shuichiro , Azuma Keiko , Obata Ryo , Inoue Tatsuya 
Published: December 2024

Purpose:
To conduct a simulation study to evaluate the effect of disease stage, frequency, and clustering of visual field (VF) tests, and inclusion of one or both eyes on sample size calculation in clinical trials on retinitis pigmentosa.

Methods:
A series of VFs were simulated on the basis of test–retest VF data in the early, moderate, and advanced stages of retinitis pigmentosa. VF measurements were scheduled 8 times in approximately 2 years. The probability to detect significant difference between treatment and control groups was measured. The investigation was conducted for 50%, 40%, 30%, 20% and 10% treatment effects.

Results:
When only one eye was used in each patient with a treatment effect of 50%, 80% probability of significance was observed in the moderate stage when sample size was 70 eyes in each arm (140 eyes in both arms). Early stage disease and inclusion of both eyes decreased this number to 30 eyes (60 eyes in both arms); these decreasing effects were larger than performing additional VFs at the beginning and end of the observation. A similar tendency was observed with 40%, 30%, 20% and 10% treatment effects.

Conclusions:
When planning a clinical trial, it is important to consider disease stage, in addition to VF schedule and inclusion of one or both eyes.
Beyond the Surface: Investigating Silicone Oil's Impact on Macular Perfusion in Macula-off Rhegmatogenous Retinal Detachment via OCTA
Authors: Ozal Ece , Guler Muzaffer Said , Karapapak Murat , Baybora Hakan , Ermıs Serhat , Yılmaz Yusuf Cem , Hayat Serife Ciloglu , Ozal Sadık Altan 
Published: December 2024

Purpose:
This study aims to compare macular vessel density (VD) in eyes with macula-off rhegmatogenous retinal detachment (RRD) after vitrectomy with gas or silicone oil (SO) tamponade.

Methods:
Patients with macula-off RRD who underwent vitrectomy with either gas or SO tamponade were included. Best-corrected visual acuity (BCVA) and VD in superficial and deep retinal capillary plexuses (SCP and DCP), choriocapillaris (CCP), and foveal avascular zone (FAZ) were assessed using optical coherence tomography angiography (OCTA). Comparisons were made with the unaffected fellow eye.

Results:
Fifty patients (average age: 57.9±9.1 years) participated, with 26 eyes undergoing SO tamponade and 24 gas tamponade. No significant differences were found in baseline characteristics. Postoperative BCVA significantly improved in both groups. In the SO group, BCVA improved from 2.00±0.77 logMAR (20/2000 Snellen) to 0.95±0.52 logMAR (20/178 Snellen). In the gas tamponade group, BCVA improved from 2.12±0.70 logMAR (20/2636 Snellen) to 0.70±0.55 logMAR (20/100 Snellen) (p<0.001 for both groups). Moreover, the gas tamponade group achieved significantly better postoperative BCVA compared to the silicone oil group (p<0.05). SO tamponade group exhibited significantly lower VD in SCP, DCP, and CCP quadrants (p<0.05), while gas tamponade showed no significant differences.

Conclusion:
This study reveals a decrease in VD in SCP, DCP, and CCP induced by SO tamponade, suggesting potential toxic effects on macular perfusion. Gas tamponade resulted in superior BCVA outcomes and preserved VD. Further investigation into SO's underlying mechanisms and careful patient selection is warranted. Gas tamponade may offer better outcomes for macula-off RRD.
Value of Platelet-to-Lymphocyte and Monocyte-to-Lymphocyte Ratios in Differentiating Idiopathic Orbital Inflammation From Orbital Infectious Disease
Authors: Thomson Robert J. , Bohnak Carisa E. , Wladis Edward J. 
Published: December 2024

Purpose:
Monocyte-lymphocyte ratio (MLR) and platelet-lymphocyte ratio (PLR) are emerging biomarkers; they have not been widely utilized in orbital disease. This study investigated the role of these ratios in distinguishing orbital inflammation from infection.

Methods:
A retrospective review of medical records was conducted to identify adult patients who presented acutely to a single emergency department at an academic medical center and were diagnosed with serologically and biopsy-proven idiopathic orbital inflammation (IOI, n = 9), orbital cellulitis (OC, n = 14), or necrotizing fasciitis (NF, n = 12). MLR and PLR were calculated from the first blood draw on presentation to the emergency department. Statistical analysis was performed via the Mann–Whitney test with a dedicated computerized software package (GraphPad Prism, La Jolla, CA) with p values <0.05 considered statistically significant.

Results:
Mean PLRs were 194.90 (SD = 118.01), 304.21 (SD = 341.39), and 203.38 (SD = 196.32) for IOI, NF, and OC, respectively. Mean MLRs were 0.40 (SD = 0.24), 1.74 (SD = 2.41), and 0.75 (SD = 0.40) for IOI, NF, and OC, respectively. MLR was significantly lower in the IOI group compared to the NF group (p = 0.018) and OC group (p = 0.020). Differences in MLR between OC and NF groups were not statistically significant (p = 0.43).

Conclusion:
While MLR showed no significant difference between different infectious etiologies, it was significantly higher in infectious processes than in IOI, distinguishing inflammation from infection. MLR could be a valuable addition to the diagnostic toolkit for triaging patients in the emergency department and initiating prompt, focused therapy.
Effects of aromatherapy on sleep quality in older adults: A meta-analysis
Authors: Xu Kun , Wang Shouyan , Ji Quanyue , Ni Yan , Liu Tianyun 
Published: December 2024

Background:
Aromatherapy has been proposed as a complementary therapy to enhance sleep quality and regulate mood. However, few studies have specifically examined the efficacy of aromatherapy in managing sleep disorders in older adults. Therefore, the present study aims to systematically review the impact of aromatherapy on sleep quality among older adults.

Methods:
It employed a meta-analysis design. A systematic and comprehensive search was conducted across 7 databases to identify randomized controlled trials examining the effects of aromatherapy on sleep quality in older adults. Two researchers independently assessed the quality of the literature. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis checklist.

Results:
Aromatherapy demonstrated effectiveness in improving sleep quality among older adults (standardized mean difference [SMD] = −1.02; 95% confidence interval [CI] = −1.38 to −0.66; P < .001). Subgroup analyses based on aroma types, intervention modalities, and treatment durations revealed enhanced efficacy with lavender as the sole aroma (SMD = −1.39; 95% CI = −2.06 to −0.72; P < .001), non-inhaled aromatherapy (SMD = −1.73; 95% CI = −2.26 to −1.2; P < .001), and aromatherapy administered for less than 4 weeks (SMD = −1.16; 95% CI = −1.68 to −0.64; P < .001). Notably, significant effects of aromatherapy on anxiety (SMD = −0.83; 95% CI = −1.24 to −0.42; P < .001) and depression (SMD = −0.85; 95% CI = −1.30 to −0.39; P < .001) in older adults were also observed.

Conclusion:
This study indicates that aromatherapy improves sleep quality in older adults, with single-use lavender, non-inhalation aromatherapy, lasting less than 4 weeks being particularly effective. Aromatherapy also alleviates depression, but its effects on anxiety require further evaluation.
Bloodletting at the ear apex for acute stroke: A systematic review and meta-analysis of randomized controlled trials
Authors: Kim Mikyung , Han Chang-ho 
Published: December 2024

Background:
Stroke is a major cause of death and disability worldwide. Despite innovative developments in acute stroke treatment techniques in modern society, many stroke survivors still experience complications, leading to a demand for complementary and alternative medicines, including traditional medicine. Bloodletting at the ear apex (BLEA) is a nonpharmacological intervention used for various diseases, including acute stroke, in traditional medicine in East Asian countries, including China and Korea. This study aimed to evaluate the clinical efficacy of BLEA for acute stroke recovery.

Methods:
We searched PubMed, Embase, CENTRAL, AMED, CNKI, KoreaMed, ScienceOn, and OASIS databases for randomized controlled trials (RCTs) evaluating the effect of BLEA on acute stroke recovery. We systematically reviewed the literature published in academic journals up to September 8, 2024 and synthesized the data extracted from the final selected literature. The results of the meta-analysis are presented as mean differences (MDs) with 95% confidence intervals (CIs). The Cochrane Risk of Bias 2 tool and GRADE methodology were used for quality assessment.

Results:
Six RCTs with 530 participants were included in this meta-analysis. In patients with acute stroke receiving conventional Western medical treatment, the addition of BLEA significantly improved neurological deficits assessed by the National Institute of Stroke Scale (MD, −2.83; 95% CIs, −4.48 to −1.17), consciousness impairment measured by the Glasgow Coma Scale (MD, 2.75. 95% CIs, 1.72 to 3.78), and motor function assessed by the Fugl-Meyer Assessment (MD, 5.31. 95% CIs, 3.04 to 7.58). It also significantly reduced the length of hospital stay (MD, −7.39; 95% CIs. −8.85 to −5.93).

Conclusion:
BLEA may be a promising intervention that provides additional benefits to patients with acute stroke receiving standard western medical care. However, the supporting evidence comes from a few small studies with a high risk of bias and low reporting quality. Future studies with appropriate population sizes and more rigorous methodology are warranted.