bluuebunny/crossref_metadata_2025_split huggingface dataset:
ADC Value of Optic Nerve in Multiple Sclerosis
Authors: Ghanem Esraa Raafat Ahmed Ahmed , Mohamed Ahmed Mostafa , Luka Amir Louis 
Published: November 2024

Abstract

Background
Multiple sclerosis (MS) is the commonest non-traumatic disabling disease to affect young adults. The incidence of MS is increasing worldwide, together with the socioeconomic impact of the disease. The underlying cause of MS and mechanisms behind this increase remain opaque, although complex gene–environment interactions almost certainly play a significant role.

Aim of the Work
To investigate diffusion alteration by measuring ADC values in optic nerve in multiple sclerosis in comparison to the healthy controls. The ADC values of optic nerve may have potential for MS patients as it predict the patients at risk of optic nerve disease and assess the long term effect of MS on optic nerve.

Patients and Methods
This study is a retrospective study. The study was conducted at Ain Shams University Hospitals over a course of 8 months from December 2022 to July 2023 and the main source of data for this study was the archived MRI imaging of the patients referred to the department of Radiology, Ain Shams University Hospitals.

Results
Our study included a heterogeneous group of adult patients older than 18 years old. Male patients= 50 (33.8%) and female patients= 98 (66.2%). Multiple sclerosis was found to be associated with risk of optic nerve disease and atrophy due to axonal loss as presented by facilitated diffusion of optic nerve indicated by increase of mean ADC value in MS patients as compared to optic nerve of normal controls. It was found that there is positive correlation between disease duration and optic nerve affection, The mean value of disease duration was found to be 6.18 +/- 5.29 years ranged from 1 to 26 years, Although it was statistically significant weak positive correlation yet it was a good indication to put eye upon the optic nerve affection in MS patients regardless of their clinical presentation, suggesting subclinical optic neuritis in MS.

Conclusion
Changes detected in ADC value of optic nerve could be helpful in early detection of subclinical optic neuritis even before it presented clinically, this necessitate some modifications in the treatment strategies to prevent or even delay the possibility of optic nerve axonal damage.
Impact of age, race, and medication use on efficacy endpoints in a randomized controlled trial of topical sildenafil cream for the treatment of female sexual arousal disorder
Authors: Johnson Isabella , Thurman Andrea Ries , Cornell Katherine A , Dart Clint , Hatheway Jessica , Friend David R , Goldstein Andrew 
Published: November 2024

Abstract

Background
A study of topical Sildenafil Cream 3.6% was completed among healthy premenopausal women with female sexual arousal disorder.

Aims
To compare efficacy endpoints based on product use in pre-planned and post-hoc subsets of age, race, and medication use.

Methods
Phase 2b, exploratory, randomized, placebo-controlled, double-blind study of Sildenafil Cream, 3.6% among healthy premenopausal women with female sexual arousal disorder (FSAD). Eligible participants were randomized 1:1 to Sildenafil versus Placebo Cream and used investigational product for 12 weeks.

Outcomes
The co-primary efficacy endpoints were the change from baseline, at week 12, in the Arousal Sensation (AS) domain of the Sexual Function Questionnaire (SFQ28) and Question 14 (Q14) of the Female Sexual Distress Scale – Desire, Arousal, Orgasm (FSDS-DAO). The secondary efficacy endpoint was the change from baseline at week 12 in the mean number of satisfactory sexual events (SSEs) reported in a daily diary. Exploratory efficacy endpoints included the Desire and Orgasm domains of the SFQ28.

Results
Age group (≥18 years and ≤ 45 years versus &gt;45 years), race group (White versus non-White), and baseline use/non-use of hormonal contraception did not significantly affect the co-primary endpoints of the SFQ28 AS domain and FSDS-DAO Q14 (P values &gt;0.11). Non-White Sildenafil Cream users had an increase in SSEs at week 12 (0.7 ± 0.63) while non-white Placebo Cream users reported a decrease (−1.5 ± 0.58) (P = .02). Daily psychiatric medication use among women assigned to either Placebo or Sildenafil Cream resulted in lower SFQ28 Desire domain scores compared to non-users of these medications. Women who used study product only in un-partnered events had a larger improvement in their SFQ28 Orgasm domain scores at week 12 (2.39 ± 0.95) with Sildenafil Cream use compared to Placebo (−0.19 ± 0.75) (P = .06). Non-White women represented a higher proportion of un-partnered women and women who used IP only during un-partnered sexual events compared to White women (P &lt; .01).

Clinical Implications
These pre-planned subset analyses will help refine target populations in future studies of Sildenafil Cream, 3.6% for the treatment of FSAD.

Strengths and Limitations
Subset analyses focused on variables pertinent to future target populations. The current study population was primarily educated non-Hispanic White women.

Conclusion
Age and hormonal contraceptive use did not impact the efficacy of topical Sildenafil Cream. Daily psychiatric medication use decreased sexual desire in active and placebo users.
Uncovering protein regulation during adventitious root formation in Platycladus orientalis cuttings
Authors: Liao Ting , Wang Ye , Guo Liqin , Zhao Shiwei , Cao Jun , Li Na , Zhao Jinzhe , Zhang Xiaoning , Liu Guobin 
Published: November 2024

Abstract
Cell totipotency and pluripotency are the cellular basis for root regeneration in Platycladus orientalis (L.) Franco cuttings, and the regeneration of adventitious roots is a key determinant for improving stem-cutting. However, the cellular basis and physiological regulation of adventitious root formation are still ambiguous. In this research, root primordia initiation and organogenesis were histologically observed, dynamic alterations in soluble proteins were monitored, and tandem mass tag protein profiling during adventitious root development was carried out. It was explicitly shown that the root primordium primarily originated from undifferentiated xylem cells for indirect (callus) rooting and from dividing cells in the cortex for direct (cortex) rooting. During the entire process of adventitious root development, the activities of peroxidase and polyphenol oxidase peaked, and the activity of indole acetic acid oxidase decreased during the prophase of adventitious root formation in both the direct and indirect rooting, suggesting the positive regulation of peroxidase and polyphenol oxidas and the negative regulation of indole acetic acid oxidase during adventitious root initiation. Compared with those of indirect rooting, the relatively greater activities of peroxidase and polyphenol oxidas and lower activity of indole acetic acid oxidase were related to direct rooting and the number of adventitious roots. A total of 4265 proteins were identified from the base of the cuttings, of which 343, 236 and 37 proteins were highly expressed before treatment, in root primordia induction to adventitious root formation, and adventitious root elongation stages, respectively. Through hierarchical cluster analysis, 23 peroxidase and endogenous hormone regulatory proteins were screened and obtained. These included 10 peroxidases, 1 auxin regulatory protein, 3 ABA regulatory proteins, 2 jasmonic acid regulatory proteins and 3 gibberellin regulatory proteins, which were highly expressed during the late cutting period. Finally, a hypothetical model of the regulatory network of the differential proteins involved in adventitious root formation in P. orientalis was constructed.
Emergency Department Visits Following Supracondylar Humerus Fractures
Authors: Gouzoulis Michael J. , Yang Ally , Joo Peter Y. , Kaszuba Stephanie V. , Frumberg David , Grauer Jonathan N. 
Published: November 2024

Introduction:
Pediatric supracondylar humerus fractures are common and the most frequent pediatric fracture to require surgical intervention. After initial management, emergency department (ED) visits subsequent to this injury/surgery are not well characterized, but are of clinical interest.

Methods:
Pediatric patients (age >1 ​​​​​​y old and <13 y old) with supracondylar humerus fractures were identified from the 2010 to 2021 PearlDiver M157 administrative database. These patients were stratified based on whether they visited the emergency department at least once within 90 days after their initial injury diagnosis/management. The timing of visits and reasons were determined, and predictive factors were assessed with multivariate logistical regression.

Results:
A total of 92,994 fractures were identified for which post-injury/post-operative ED visits were noted for 10,325 patients (11.1%). Nearly half of all ED visits occurred within the 2 weeks immediately after the fracture (46.1%), of which 54.7% of visits were not directly related to the elbow. On multivariate analysis, patients who utilized the ED after initial management of pediatric supracondylar humerus fracture were of greater odds ratio (OR) in decreasing order to have: had a history of ED visits before their initial injury (OR: 2.69), be diabetic (OR: 1.81), had surgical intervention for their fracture (OR:1.58), be obese (OR: 1.57), have asthma (OR:1.55), have Medicaid insurance (OR: 1.29), and be younger (OR: 1.11 per year decrease) (P<0.001 for all).

Discussion:
In the 90 days after pediatric supracondylar humerus fracture, more than 1 in 10 patients visited the ED. This data highlight the need for close following of such patients after their injury/surgery and suggests risk factors for which patients such quality improvement measures should be focused.

Level of Evidence:
III.
Dermal Substitute Integra for the Treatment of Mammalian Bite Injuries of Nose: a New Reconstructive Ladder
Authors: Mataro Ilaria , D’Antonio Santolo , D’Alessio Matteo , Petroccione Carlo , D’Angelo Dario , La Padula Simone , D’Alessio Roberto , Avvedimento Stefano 
Published: November 2024

Background:
Bite injuries affecting the nose are uncommon occurrences characterized by their intricate nature and potential for severe complications. These injuries, inflicted by animals such as dogs and cats, and occasionally by humans, often result in traumatic nasal defects, with the lower third of the nose being the most affected area. Current reconstructive options for nasal defects include full-thickness skin grafts, local or regional flaps, and composite grafts. The traditional reconstructive ladder serves as a valuable guide for surgeons, outlining a continuum of treatment options from simpler to more complex interventions. Advancements in reconstructive technologies, such as the introduction of dermal substitutes, have reshaped the decision-making process, ushering in a new era of facial reconstruction.

Methods:
In this context, dermal substitutes have emerged as promising adjuncts in nasal reconstruction, drawing from their success in burn surgery. Notably, the bilayered dermal substitute Integra has demonstrated efficacy in promoting wound healing and facilitating tissue regeneration. By harnessing the regenerative potential of Integra, plastic surgeons can address specific nasal defects arising from bite injuries with greater precision and improved outcomes.

Results:
This study aims to present a case series of patients with bite injuries to the nose, showcasing the successful application of Integra dermal substitute in conjunction with secondary full-thickness skin grafting.

Conclusions:
Through a retrospective analysis of patient demographics, injury characteristics, surgical interventions, and postoperative outcomes, we seek to underscore the utility of this combined approach in achieving optimal functional and aesthetic results. We aim to contribute to the evolving paradigm of nasal reconstruction.
Illuminating power dynamics that influenced a relational coordination program in a tertiary hospital: An institutional ethnography study
Authors: McLean Darren , Connor Martin , Marshall Andrea P. , McMurray Anne , Jones Liz 
Published: November 2024

Background
Amidst the difficulty and contentiousness of improving hospitals, a relatively new approach is the Relational Model of Organizational Change (RMOC). However, this approach has its own challenges, including reports that its focus on communication and relationships is undervalued despite evidence supporting its use to facilitate practice improvements in hospitals. Research suggests power dynamics in hospitals influences how the RMOC is used, but the precise mechanisms through which this occurs have not been fully examined.

Purpose
The purpose of this study was to examine how power dynamics shaped the implementation of a program using the RMOC in a hospital: the QPH RC Program.

Methodology
Institutional ethnography was applied to explicate textually mediated ruling relations (power dynamics) and examine how they exerted their influence on the QPH RC Program. This involved interviewing people and analyzing texts embedded in work processes that organized the implementation of the program.

Results
The QPH RC Program was embedded in a cluster of ruling relations comprising an economic rationalist and scientific discourse and project management methodology. These ruling relations exerted their power via textually mediated social processes that influenced the focus and management of the program.

Conclusion
The ruling relations functioned to align the QPH RC Program with the priorities of the hospital, suggesting that financial objectives were prioritized over objectives to improve communication or culture.

Practice Implications
Future research and practice change should include investigating and addressing the intersection of institutional contexts and the application of the RMOC to facilitate practice improvements in health care organizations, particularly hospitals.
Workplace violence: Insights from nurses’ lived experiences
Authors: Orewa Gregory N. , Ajaiyeoba Ifeyimika O. , Edevbie Nero , White Marla L. 
Published: November 2024

Background
Workplace violence (WPV) against nurses is a growing concern within the health care industry, contributing to increased stress, burnout, and higher staff turnover.

Purpose
The purpose of this study is to understand the experiences of nurses with WPV and examine the scope and impact of this violence based on nurse’s recollections.

Methodology/Approach
Using qualitative interpretive meta-synthesis and the job demands–resources framework, we examined patterns in nurses’ experiences of WPV. Our analysis (N = 401) of nurses’ accounts from diverse sources—patients, colleagues, and supervisors across various locations and health care settings—provides deep insights into WPV dynamics.

Results
Four main themes were identified: (a) it comes with the job—patient and family violence are normal, (b) a vulnerability in nurse safety, (c) sexual harassment, and (d) poor treatment within the organization.

Conclusion
WPV against nurses is a deeply ingrained issue that impacts their psychological health and job performance. A stark need for health care systems to address and mitigate WPV is evident.

Practice Implications
There are clear signals that health care organizations need to implement comprehensive strategies to prevent WPV, foster a safe and supportive work environment, and equip nurses with job resources to manage the high stress of their roles.
Biosimilars vs. originators
Authors: Hughes Elizabeth , Tymkiw Sharon , Vuckovic Karen M. 
Published: November 2024

Abstract:
Biosimilars can potentially increase patient treatment options, allowing access to expensive biologic medications. As frontline caregivers, nurses are uniquely positioned to educate patients on their safety and effectiveness. This article discusses biosimilars and standard terms, their development process, and strategies for nurses to provide effective patient education about these medications.
Molecular testing and precision oncology
Authors: Burkett Melissa Styan 
Published: November 2024

Abstract:
Targeted therapy has emerged as a promising option in cancer treatment, driven by advances in the understanding of DNA changes and the molecular basis of cancer. This article provides an overview of next-generation sequencing and types of genetic alterations, common cancer biomarkers, a review of circulating tumor DNA testing and its applications for oncology treatments, how to read a genomic testing report, examples of targeted therapy for cancer pathologic variants and tumor markers, and the implications for nursing practice in this emerging field.
Implementation of a Neonatal Hyperbilirubinemia Clinical Pathway in a Pediatric Emergency Department
Authors: Miller Collin R. , Haut Catherine , Zomorrodi Arezoo , Chara Karina , Wilson Janice 
Published: November 2024

Background:
High volumes and competing priorities delay care initiation for neonatal hyperbilirubinemia within the pediatric emergency department (ED). Our freestanding children’s hospital developed a quality improvement project to implement a nurse-initiated neonatal hyperbilirubinemia clinical pathway (CP) intended to decrease treatment initiation and intravenous fluid (IVF) rates.

Methods:
A multidisciplinary team used the model for improvement to delineate and address key drivers of treatment delays. The team established a nurse-driven CP and enhanced the electronic health record to support and enforce new workflows, which included capillary specimen collection and phototherapy initiation before the first provider assessment. IVF criteria and laboratory evaluation were standardized. The primary aim was to decrease the time to initiation of phototherapy from a mean of 136 to 60 minutes after ED arrival for 6 months. The secondary aim was to decrease the proportion of patients obtaining IVF from 31% to 15% for the same time frame.

Results:
ED arrival to phototherapy initiation decreased from 136 to 49 minutes. The IVF rate decreased from 31% to 12%. ED length of stay decreased from 185 to 122 minutes. Hospital length of stay remained unchanged.

Conclusions:
A nurse-initiated CP for neonates with hyperbilirubinemia improved time-to-care initiation and ED throughput while decreasing unnecessary IVF administration.
Using Quality Improvement to Design and Evaluate an Outpatient Day Treatment Pathway for Pediatric Patients with Diabetes Mellitus Requiring Insulin Initiation
Authors: Azova Svetlana , Baskaran Charumathi , Einis Sara , Fortin Jennifer , Silva Marisa , Gorman Miriam , Ethier Benjamin , Nanavati Sonal , Sterns Olivia , Garvey Katharine , Rhodes Erinn T. 
Published: November 2024

Introduction:
Education and management of children with new-onset or established diabetes mellitus (DM) requiring insulin initiation do not always require hospitalization. We developed a pathway for outpatient day treatment of select patients after initial evaluation in the emergency department (ED) at a pediatric, tertiary care academic medical center.

Methods:
A multidisciplinary team identified key initial eligibility criteria for outpatient day treatment for insulin initiation, including absence of diabetic ketoacidosis, age ≥3 years, and plasma beta-hydroxybutyrate (BOHB) <1 mmol/L. Electronic medical record reviews and surveys administered to endocrine providers determined exclusions or reasons for nonparticipation. Refinement of the pathway occurred through iterative plan-do-study-act cycles. Statistical process control evaluated the uptake among eligible patients.

Results:
We launched the pathway in September 2020. Of 534 patients presenting to the ED with new-onset or established DM requiring insulin initiation in the first 2.5 years, 198 were potentially eligible for day treatment. Of these, 65 children (33%) completed the pathway. One additional patient was hospitalized following Day 1 of education due to newly identified psychosocial stressors. The increase of BOHB cutoff to 1.5 mmol/L and the option of rapid-acting insulin bolus for borderline BOHB resulted in a significant shift in utilization from a mean of 24.4% to 41.1%. Persistent barriers to participation include limited appointment availability, weekend presentation, and patient/family concerns.

Conclusions:
Outpatient day treatment was successful for select pediatric patients with new-onset or established DM requiring insulin initiation. However, this approach necessitates flexible resources and supportive patient messaging.
Increased CRTH2 Expression in Postural Orthostatic Tachycardia Syndrome
Authors: Achemdey Julian , Martin Jose Manuel , Abdallah Hala , Li Mian , Nava Victor E. , Abdallah Hasan 
Published: November 2024

ABSTRACTPurposeThe exact etiology of Postural Orthostatic Tachycardia Syndrome (POTS) is still unknown but is likely heterogeneous and multifaceted, involving autoimmune, neuropathic, hypovolemic, and hyperadrenergic pathways. Recently, more research has been devoted to understanding POTS’s underlying immune etiology. We investigated the potential association between elevated levels of prostaglandin chemoattractant receptors (CRTH2) expressed on T-cells and the clinical manifestations observed in patients with POTS.MethodsWe performed immunophenotyping using flow cytometry on 20 consecutive patients with POTS confirmed by tilt table testing and compared our findings with healthy controls.ResultsPOTS patients demonstrated an increase in CRTH2 levels on (CD8+) T cells and CD8+/CD45RO+ T cells compared to controls.ConclusionsCRTH2 is expressed significantly on TH2 and CD8+ cells in POTS patients compared with controls. Since CRTH2 mediates the action of mast cell degranulation mediators such as PGD2 on TH2 cells it results in the release of inflammatory cytokines and interleukins that cause vasodilation and cellular inflammation with capillary leak, leading to reduced effective intravascular volume and reduced venous return, which are known as potential mechanisms in the pathophysiology of POTS, we conclude that CRTH2 plays an important role in the pathophysiology of POTS.
Divergent effects of pathological α-synuclein truncations and mutations on phase separation
Authors: Ray Soumik , Chiodaroli Cecilia , Farzadfard Azad , Kunka Antonin , Schott Katharina Helga , Hertel Sophie , Mojtic Kristina , Klausen Louise Kjær , Galvagnion Céline , Buell Alexander K. 
Published: November 2024

ABSTRACTPhase separated condensates can accelerate α-synuclein (α-Syn) amyloid fibril formation implicated in Parkinson’s disease pathogenesis. The effects of pathological modifications, i.e., truncations and familial mutations on the thermodynamics, material properties, and the extent of amyloid aggregation within α-Syn condensates remain elusive. Here, we quantitatively demonstrate that terminal truncations significantly alter α-Syn phase separation, while familial mutations impart minimal effects. Spontaneous sol-gel phase transitions of the truncated α-Syn variants could give rise to amyloid fibrils almost instantly within condensates, suggesting similarities between molecular interactions driving both processes. Extending our study to model coacervate and condensate systems where α-Syn acts as a client, we find α-Syn can dissolve coacervates and form Pickering clusters on condensate surfaces—regulating their size. Additionally, the C-terminal region of α-Syn modulates nucleic acid sequestration within condensates. Together, our findings reveal diverse effects of α-Syn modifications on phase separation, both in pathological and physiological contexts.GRAPHICAL ABSTRACT