bluuebunny/crossref_metadata_2025_split huggingface dataset:
Drug treatment for metabolic dysfunction-associated steatotic liver disease: Progress and direction
Authors: Zhou Da , Fan Jiangao 
Published: October 2024

Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD), also called non-alcoholic fatty liver disease, is the most epidemic chronic liver disease worldwide. Metabolic dysfunction-associated steatohepatitis (MASH) is the critical stage of MASLD, and early diagnosis and treatment of MASH are crucial for reducing the incidence of intrahepatic and extrahepatic complications. So far, pharmacotherapeutics for the treatment of MASH are still a major challenge, because of the complexity of the pathogenesis and heterogeneity of MASH. Many agents under investigation have shown impressive therapeutic effects by targeting different key pathways, including the attenuation of steatohepatitis or fibrosis or both. It is notable that thyroid hormone receptor-β agonist, resmetirom has become the first officially approved drug for treating MASH with fibrosis. Other agents such as peroxisome proliferator-activated receptor agonists, glucagon-like peptide-1 analogs, and fibroblast growth factor 21 analogs are awaiting approval. This review focuses on the current status of drug therapy for MASH and summarizes the latest results of new medications that have completed phase 2 or 3 clinical trials, and presents the future directions and difficulties of new drug research for MASH.
Multimodal corneal imaging before refractive cataract surgery
Authors: Andrade de Carvalho Karolyna , Esporcatte Louise Pellegrino G. , Gomes Rachel L.R. , Ambrósio Renato 
Published: October 2024

Purpose of review
To prospectively review the advances in diagnostics for refractive cataract surgery, focusing on multimodal corneal analysis.

Recent findings
The article explores the considerations related to planning refractive cataract surgery, emphasizing its potential to enhance patients’ vision performance and quality of life. This review explores preoperative analysis in cataract surgery, focusing on assessing the cornea and ocular surface using multimodal diagnostics, including Placido disk-based corneal topography, Scheimpflug tomography OCT (optical coherence tomography), and biomechanical assessment. Wavefront technology, gene therapy, and artificial intelligence are also relevant in enhancing surgical precision and outcomes. It highlights the importance of preoperative thorough evaluations and technological advancements in ophthalmology.

Summary
The rapid evolution and advancement of technology enable excellent refractive outcomes in most cases following cataract surgery. Consideration of appropriate preoperative factors is essential for achieving the desired postoperative outcome.
Screening for Eye Disease in Ebola Virus Disease Survivors: Program Implementation During an Active Outbreak in the North Kivu and Ituri Provinces, Democratic Republic of the Congo
Authors: Mwanza Jean-Claude , Shantha Jessica G. , Legand Anaïs , Hartley Caleb , Si-Mehand Massi , Kahatane Alexis K. , Mumbere Telesphore M. , Ngona Listo B. , Kanza Eric M. , Kavuo Aldy T. , Kabesha Theophile A. , Kelekele Joseph K. , Kahumba Francine M. , Muhindo Dieudonne M. , Djoza Benjamin S. , Kitenge Richard O. , Formenty Pierre , Crozier Ian , Yeh Steven 
Published: October 2024

First identified in the Democratic Republic of the Congo (DRC, formerly Zaire) in 1976, Ebola virus disease (EVD) outbreaks have afflicted thousands of Congolese over the past several decades. The nation’s largest outbreak of EVD in 2018-2020 was complicated by security challenges as well as large case numbers across an expansive geographic region. These factors provided challenges for logistical considerations as well as clinical coverage. In conjunction with the EVD survivor care program spearheaded by the Ministry of Health in DRC, the DRC Intitut National de Recherche Biomédicale, (DRC Institut National de Recherche Biomedicale, DRC National Institute of Biomedical Research) and others, we launched a multidimensional effort to provide ophthalmic care to EVD survivors.
During the engagement period, 237 EVD survivors were screened, 56% of which were women. The 237 EVD survivors constituted ∼75% of the total EVD survivors who were discharged at the time of the intervention. The mean time from EVD symptom onset to evaluation was 4.6 months ± 1.8 SD (range: 24 d to 8.5 mo). Ninety-seven (41%) of EVD survivors screened reported ocular symptoms during or after acute illness, such as itchy eyes (49%), eye pain (25%), and tears (24%). Ophthalmic findings, including retinal scarring, active uveitis, dry eye disease, cataracts, and glaucoma, were also identified.
The need for continued monitoring and longitudinal care for EVD survivors is evident from the expanding body of literature pertaining to post-acute sequelae, including ophthalmic manifestations. Initiatives for such care should be conducted across and in conjunction with multidisciplinary stakeholders for contextualization and effectiveness.
Update on Epidemiologic Trends in Causes of Childhood Blindness and Severe Visual Impairment in East Africa
Authors: Ashby Nathaniel , Miller Chase , Yeh Caleb , Huang Crystal , Song Helen , Dingalele Merveille , Kindundu Grace , Fashina Tolulope , Hartley Caleb D. , Mwanza Jean-Claude 
Published: October 2024

Objective:
The initiative 2030 In Sight and the International Agency for the Prevention of Blindness have developed a plan to mitigate the global burden of preventable sight loss. One priority of this initiative is obtaining population eye health data. East Africa is a region that has historically been plagued by high rates of vision loss, and it is imperative to understand what causes are at play. Two large cross-sectional studies were previously published in 1995 and 2009, reporting the causes of childhood blindness (BL) and severe visual impairment (SVI) in East Africa. An update regarding more recent causes is warranted to better understand the trends of childhood BL/SVI in this region.

Methods:
A search strategy was developed a priori to identify relevant terms and align them with a standardized definition of East Africa. This strategy was then employed across PubMed, Google Scholar, and Scopus, with the yield of the overall search depicted in a Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 flow diagram. In the articles gathered by the search, causes of BL/SVI were typically categorized by anatomy and etiology.

Results:
Eight articles met the criteria, with data from 6 countries, consisting of 534 cases of childhood BL/SVI. Common anatomic locations identified included the cornea, lens, and whole globe. Among the most common etiologies were corneal scarring/opacity and cataract. Systemic etiologies and disease associations included measles, toxoplasmosis, and prematurity. Presumptive infectious disease and hereditary conditions were also identified as a category, but specific identification of etiologies and genetic diagnosis was largely unavailable.

Conclusions:
BL/SVI due to the cornea was among the common anatomic sites of disease in our study. The identification of measles as an associated systemic etiology requires further understanding in the context of increased vaccination programs. Multiple articles acknowledged that cataract has become the predominant cause of BL/SVI owing to increased measles vaccination and vitamin A supplementation. Additional research should be conducted to gain a complete understanding of childhood BL/SVI in East Africa, and responses at regional and national levels are likely necessary to address treatable causes of vision impairment.
Association Between Risk of Obstructive Sleep Apnea and Intraocular Pressure Based on the Korea National Health and Nutrition Examination Survey VIII
Authors: Kim Jung Lim , Lee Kayoung 
Published: October 2024

Précis:
A higher screening tool for obstructive sleep apnea risk (STOP-BANG) score and loud snoring observed breathing interruptions during sleep, hypertension, and wide neck circumference (NC) were individually and in combination associated with high intraocular pressure (IOP) in Koreans aged 40 years and older.

Objective:
To evaluate the relationship between IOP and the risk of obstructive sleep apnea (OSA).

Methods:
In this population-based, cross-sectional study, we included Korean adults aged 40 years or above recruited between 2019 and 2021. A total of 6315 subjects were included in the Korea National Health and Nutrition Examination Survey Ⅷ database. The risk of OSA was measured by the STOP-BANG questionnaire. The IOPs were measured using a rebound tonometer. Logistic regression was used to analyze the association between IOP quartiles (highest quartile vs lower first to third quartiles) with OSA risk after adjusting for sociodemographic characteristics, lifestyle, and diabetes.

Results:
The adjusted odds ratio for high IOP was 1.27 (95% CI: 1.12–1.43) for participants with a STOP-BANG score of 3–8 compared with those with a score of 0–2. Participants with loud snoring observed breathing interruptions during sleep, hypertension, or wide NC had 24%–40% higher odds of high IOP than those without these components. The odds ratio for high IOP in the group with all 4 factors was 2.09 times higher (95% CI: 1.26–3.46) than in the group without these factors.

Conclusions:
A higher STOP-BANG score was associated with an increased risk of high IOP in Koreans aged 40 years and older. Furthermore, among the STOP-BANG components, loud snoring observed breathing interruptions during sleep, hypertension, and wide NC were individually and in combination associated with high IOP.
Association of Peripapillary Arterial Circle of Zinn-Haller With Glaucoma in Highly Myopic Eyes
Authors: Kim Ji Hong , Yoon Jooyoung , Na Kyeong Ik , Hong Rim Kyung , Lee Won June 
Published: October 2024

Précis:
The visualization of circle of Zinn-Haller (CZH) on optical coherence tomography angiography (OCTA) or its pattern does not have a clear effect on glaucoma, whereas the location of CZH is associated with axial length (AXL) in highly myopic eyes.

Purpose:
To investigate the association between the CZH and the presence of glaucoma using swept-source optical coherence tomography angiography (SS-OCTA) images of the optic nerve of patients with high myopia (HM).

Methods:
This retrospective case series included 227 eyes with HM, comprising 134 and 93 eyes with and without glaucoma, respectively. The characteristics of CZH, including visualization, pattern, and location, were assessed using SS-OCTA. Vascular parameters, such as vessel density and microvascular dropout (MvD), were quantified. The factors affecting the presence of glaucoma and the correlations between the CZH distance and AXL were identified using logistic regression analysis and Pearson correlation analysis, respectively.

Results:
CZH was detected more frequently in HM patients with glaucoma (71.6%) than in patients without glaucoma (51.6%) (P<0.002). However, the visualization of CZH was not related to the presence of glaucoma in multivariate regression analysis (odds ratio [OR], 0.688; 95% confidence interval [CI], 0.328–1.444; P=0.322). Moreover, compared with the annular pattern used as a reference, triangular and irregular patterns were not associated with the presence of glaucoma (OR: 1.043, 95% CI: 0.101–10.763, P=0.971; OR: 0.527, 95% CI: 0.255–1.092, P=0.085, respectively). MvD was significantly higher in patients with glaucoma (61.2%) than that in patients without glaucoma (2.2%) (P<0.001) and was identified as a significant factor affecting the presence of glaucoma (OR, 42.120; 95% CI, 9.416–188.413; P<0.001). AXL showed a significant correlation with CZH distance in all patients (R=0.399; P<0.001).

Conclusions:
CZH was more commonly detected in HM patients with glaucoma. However, no clear associations of glaucoma with the visualization, pattern, or location of CZH were observed in the present study. The correlation between AXL and CZH distance in eyes with HM warrants further investigation. These results may offer insights into the pathogenesis of glaucoma in eyes with HM as OCTA technology advances.
Professional Advancement Models for Nurse Practitioners and Physician Associates/Assistants: A historical overview and opportunities for future growth
Authors: Hillel Liza , Lasker Lauren 
Published: October 2024

ABSTRACT
Professional advancement models (PAM) are paramount in the growth of nurse practitioners (NP) and physician associates/assistants (PA) who seek professional challenges, clinical recognition, job satisfaction, upward mobility, and incentives for retention. Professional advancement models for NPs and PAs were born out of literature on clinical career ladders that date back to the 1970s for the nursing work force. Over time, PAMs have evolved to offer NPs and PAs structured pathways to guide and reward professional growth, education, advocacy, research, and quality improvement (QI). Although the first institutional account of PAM development for NPs and PAs was published in 1998, there has been a recent spike in case reports of PAMs from individual medical centers. This article (1) provides a historical timeline of published data on the development and implementation of PAMs for NPs and PAs, (2) critiques features of existing PAMs, and (3) offers recommendations regarding PAM innovation for more uniform adoption in medical institutions across the country.
Successfully intravenous thrombolytic therapy in systemic lupus erythematosus-related ischemic stroke: A case report
Authors: Liu Guanglin , Wang Yong , Guan Hongjian 
Published: October 2024

Rationale:
Stroke is a relatively frequent complication occurring in patients with systemic lupus erythematosus (SLE). The increasing number of patients with Ischemic Stroke secondary to SLE aroused the clinician’s concern. SLE thrombosis markers, diagnostic high-resolution magnetic resonance image (HR-MRI), and therapeutic interventions for acute ischemic stroke were recently coming into focus perspectives from the field.

Patient concerns:
A 42-year-old female with slurred speech and numbness in her left limb was admitted to our hospital.

Diagnoses:
Magnetic resonance imaging (MRI) revealed right thalamic infarction with diffusion-weighted lesions. Prior to admission, the patient had a National Institute of Health Stroke Scale (NIHSS) score of 3.

Interventions:
In light of the clinical manifestation, the American Heart Association/American Stroke Association (AHA/ASA) Guidelines for Intravenous Thrombolysis in Acute Ischemic Stroke (2019) should be referred to. The patient was treated with thrombolytic alteplase (rt-PA).

Outcomes:
The patient was hospitalized for 2 weeks and discharged after his symptoms improved.

Lessons:
After thrombolysis, the NIHSS score of the patient decreased to zero. The computed tomography scan was reexamined 24 hours later, and no acute changes or hemorrhage were identified in the infarcted area. Subsequent imaging and serological analyses indicated that HR-MRI of the responsible vessel was negative, but the infarction in this patient was still regarded as being caused by vasculitis of the right posterior cerebral artery in the region supplying the thalamus. This is the first case of successful intravenous thrombolytic therapy with rt-PA in a patient with SLE secondary to stroke with an NIHSS score of 3. This provides further evidence for expanding the reference of indications with rt-PA intravenous thrombolysis.
COVID-19 is associated with high blood glucose levels: diabetic neuropathy during the SARS-CoV-2 pandemic: a case report
Authors: Bereda Gudisa 
Published: October 2024

Introduction and Importance:
The nerves in the legs and feet are most frequently damaged by diabetic neuropathy. The COVID-19 infection is associated with a high risk of neuropathy symptoms.

Case Presentation:
On 12 July 2022, a 58-year-old black female retiree with significant symptoms of numbness and muscle weakness in the hands and legs was brought into the emergency room. Seventeen years prior, she was diagnosed with type 2 diabetes mellitus. Metformin 1.5 g twice a day and glibenclamide 10 mg twice a day were part of her therapy regimen. When she was admitted to the emergency room, she described a one-day history of shortness of breath, frequent urination, excessive thirst, hyperglycemia, excessive appetite, fever, headache, and dehydration. A chest radiograph showed bilateral diffuse, patchy airspace opacities that could be caused by multifocal pneumonia or viral pneumonia. She started receiving 1000 ml of fluid resuscitation (0.9% normal saline) as soon as she was moved to an ICU, along with a drip-in insulin infusion.

Clinical Discussion:
Diabetes, infections like COVID-19, poor vitamin levels, and other factors can all contribute to diabetic neuropathies. According to the Centers for Disease Control and Prevention, patients with type 2 diabetes mellitus are much more likely to experience severe morbidity and death from coronavirus disease.

Conclusion:
Symptoms of diabetic neuropathy continued for months after a COVID-19 infection test resulted in a positive result.
SIFT-ing Through Misinformation
Authors: Spracklin Emily , Espina Christine R. 
Published: October 2024

Background:
The COVID-19 infodemic revealed nurses are not immune from disseminating health misinformation. Furthermore, the 2021 American Association of Colleges of Nursing (AACN) Essentials require competency in social media literacy. Nurse educators need to prepare students to identify credible information online for safe and ethical practice.

Problem:
Vertical reading, a traditional evaluation strategy used in nursing education, is insufficient for identifying online health misinformation.

Approach:
A librarian and nursing faculty member developed an innovative reflection notebook assignment to teach lateral reading—a professional fact-checking technique—and facilitate critical self-reflection among RN-to-BSN students.

Outcomes:
Reflection notebook responses demonstrated that students use online information in various ways; online information habits require active, ongoing professional development; and lateral reading can promote a more compassionate approach to patient education.

Conclusions:
The reflection notebooks equip students with critical knowledge, skills, and attitudes to practice safely and ethically while demonstrating some of the AACN Essentials requirements.
Emergency Medical Services and Police Utilization for Pediatric Mental and Behavioral Health Concerns Within a Large Hospital System
Authors: Hartwell Victoria , Riney Lauren , Cheetham Alexandra , Pomerantz Wendy J. , Lee Sang Hoon , Bensman Rachel , Schwartz Hamilton , Zhang Yin , Babcock Lynn ,   Cincinnati Children's Prehospital Care Committee
Published: October 2024

Objective
This study aimed to compare emergency medical services (EMS) and police utilization trends, epidemiology, and emergency department (ED) outcomes between pediatric patients with mental or behavioral health (MBH) emergencies and those with non-MBH concerns transported to a large children's hospital system.

Methods
This was a retrospective cohort study of patients aged 5 to 18 years transported via EMS and police to two EDs affiliated with a children's hospital from January 2012 through December 2020. Data were abstracted from electronic hospital records. Encounters for MBH emergencies were identified using diagnostic codes and chief complaints. Trends of EMS and police transports of patients with MBH emergencies were examined. Patient demographics and ED outcomes were compared between children presenting with MBH emergencies and those with non-MBH concerns.

Results
During the 9-year study period, out of 40,663 transports to the EDs, 36,137 (89%) arrived via EMS, and 4,526 (11%) arrived via police. A total of 10,250 (28.4%) EMS transports were for MBH emergencies. The volume of patients transported by EMS for MBH emergencies increased by 1.4% per year (P < 0.01) with no significant change in total EMS patient volumes. Patients with MBH emergencies transported by EMS were more likely to be older, female, of White race, and publicly insured; require restraint in the ED; and be admitted (P < 0.001). Of police transports, 4153 (91.8%) were for MBH emergencies, with no statistical change in the proportion of police transports that were for MBH emergencies. Police-transported MBH patients compared to non-MBH police-transported patients were more likely to be younger, female, and of White race (P < 0.001); 8.7% required mechanical/physical restraints in ED, 6.7% required pharmacologic restraint medications in ED, and 53% were admitted.

Conclusions
The proportion of pediatric transports for MBH emergencies by EMS is rising and comprises the majority of police transports. Distinct from non-MBH pediatric patients transported, MBH patients necessitate significant ED resources, including ED-administered restraints and admission, highlighting their unique burden on the prehospital and ED systems.
2D Facial Analysis Performed by a Human Operator Versus an Artificial Intelligence Software
Authors: Muñoz Gonzalo , Brito Leonardo , de Moraes Marcio , Olate Sergio 
Published: October 2024

Background:
Artificial intelligence (AI) has been a contribution in recent years to the development of new tools for dental, surgical, and esthetic treatment. In the case of image diagnosis, AI allows automated analysis of some facial parameters. The aim of this study was to evaluate the precision and reproducibility of these IA analyses compared with a human operator.

Methods:
Thirty subjects were selected, and frontal and profile photographs were taken of each. The photographs were previously calibrated and then analyzed by a human operator and an AI for vertical, horizontal, symmetry parameters, and facial profile angles.

Results:
Statistically significant differences were found in at least 1 vertical, horizontal, symmetry, and facial profile measurement.

Conclusions:
The 2D facial analysis performed on photographs using AI is an interesting and constantly evolving tool. However, there are still many differences with the analysis performed by the human operator, so it should be used carefully. Further studies using metric measurements should be performed to contrast the values obtained by human operators and AI and to analyze the accuracy of point selection in facial soft tissues.