bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hydroxypropyl methylcellulose remove dense water droplets during fluid-air exchange on the posterior surface of intraocular lenses with posterior capsule loss
Authors: Ma Chao , Li Haoyu , Li Xinmin , Li Long 
Published: October 2024

Purpose:
The research investigates the efficacy of hydroxypropyl methylcellulose (HPMC) treatment in facilitating the development of compact water droplets on the rear surface of synthetic lenses with capsule imperfections during the process of fluid-air exchange.

Method:
This study examined four patients with intraocular lens (IOL) implants and posterior capsule defects who experienced the formation of dense water droplets on the posterior surface following fluid-air exchange. When this occurrence obstructs fundus visualization during surgery, it is recommended to suspend the surgical procedure. Upon removal of the non-contact fundoscope and inspection of the IOL, the presence of dense water droplets becomes evident. Subsequently, the removal of bubbles can be achieved by employing a blunt needle filled with HPMC, which is subsequently administered to the area posterior to the intraocular lens. Subsequently, the HPMC should be uniformly distributed on IOL back surface using the blunt needle.

Results:
During the surgical procedure, it was noted that all patients attained a clear fundus field of vision after the administration of HPMC and insertion of the IOL, facilitating the successful execution of subsequent surgical procedures.

Conclusion:
HPMC serves as a suitable viscoelastic agent for the elimination of dense water droplets adhered to the surface of intraocular lenses following application, consequently maintaining a clear visual field of the fundus. This surgical intervention is characterized by its efficacy and safety.
ALTERATION OF TREATMENT CHOICES AND THE VISUAL PROGNOSIS FOR DIABETIC MACULAR EDEMA IN THE ERA OF ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR DRUGS
Authors: Shimura Masahiko , Hirano Takao , Tsuiki Eiko , Takamura Yoshihiro , Morizane Yuki , Akiyama Kunihiko , Yamamoto Kaori , Hikichi TAIICHI , Koto Takashi , Kinoshita Takamasa , Kusuhara Sentaro , Yoshida Shigeo , Sakamoto Shin-ichi , Kimura Kazuhiro , Sugimoto Masahiko , Kida Teruyo , Mitamura Yoshinori , Takatsuna Yoko , Washio Noriaki , Osaka Rie , Ueda Tetsuki , Minamoto Akira , Kogo Jiro , Okamoto Fumiki , Enaida Hiroshi , Sakanishi Yoshihito , Nagaoka Taiji , Gomi Fumi , Sasaki Mariko , Terasaki Hiroto , Iwase TAKESHI , Tatsumi Tomoaki , Nishi Kosuke , Shinoda Kei , Ueda Shunichiro , Ueda-Consolvo Tomoko , Nakashizuka Hiroyuki , Murata Toshinori , Kitano Shigehiko , Sakamoto Taiji ,   on behalf of the J-CREST STREAT-DME 2 Study Group
Published: October 2024

Purpose:
To assess the real-world outcome of best-corrected visual acuity after 2-year intervention for treatment-naive diabetic macular edema since the approval of anti-vascular endothelial growth factor therapy.

Methods:
A total of 1,780 treatment-naive eyes with diabetic macular edema for which intervention was initiated between 2015 and 2019, and which were followed for 2 years, were extracted from the longitudinal medical records of 37 retinal disease institutions in Japan. Interventions included anti-VEGF therapy, topical corticosteroid therapy, macular photocoagulation, and vitrectomy. The baseline and final best-corrected visual acuity, and the number and timing of interventions were recorded. Eyes were classified according to the year in which intervention was initiated.

Results:
Over a 2-year period, best-corrected visual acuity improved annually, finally reaching seven letters. The proportion of eyes in which good vision was maintained (best-corrected visual acuity >20/40) increased to 73.3% in the latest period. The administration of anti-VEGF therapy remained stable, accounting for approximately 90% of eyes. Notably, the proportion of eyes receiving anti-VEGF drugs as first-line treatment increased dramatically to approximately 80%.

Conclusion:
Anti-VEGF therapy has become the first-line treatment since the approval of anti-VEGF drugs for diabetic macular edema. These findings reflect the evolution of diabetic macular edema treatment and highlight the superiority of anti-VEGF therapy and its increased uptake over time.
NR2E3-Associated Retinopathy Presenting with Bilateral Choroidal Neovascularization
Authors: Sun Christopher , Tan Tien-En , Bylstra Yasmin , Chiam Nathalie P.Y. , Mathur Ranjana S. , Chan Choi Mun , Chen Li Yu , Poh Joey S.Z. , Tang Rachael W.C. , Gemmy Cheung Chui Ming , Fenner Beau J. 
Published: October 2024

Purpose:
We describe an atypical presentation of an 11-year-old female with enhanced S-cone syndrome (ESCS).

Methods:
Case report. The patient underwent a thorough ophthalmic examination and investigations such as colour fundus photography, optical coherence tomography, fundus autofluorescence, fluorescein and indocyanine angiography, an electroretinogram and genetic testing. After determining the presence of secondary choroidal neovascularization, we treated her with intravitreal Ranibizumab injections. We present her progress and a brief literature review about ESCS.

Results:
An 11-year-old hyperopic female with no known family history of retinal disease or nyctalopia presented with bilateral reduced visual acuity (20/100 OD, 20/200 OS). Examination disclosed bilateral macular choroid neovascularization (CNV) with retinochoroidal anastomosis on the left eye, bilateral nummular deposits at the superior macular arcades. All three of her siblings, aged 7-14, were asymptomatic but were also hyperopic and had intraretinal schisis and focal loss or attenuation of the ellipsoid zone on optical coherence tomography (OCT). Electrophysiology showed a reduced scotopic response and a dramatically enhanced response to full field blue light stimuli meant to elicit a response primarily from S-cones. Genetic testing confirmed the presence of biallelic NR2E3 variants. Treatment with monthly intravitreal anti-VEGF resulted in improved visual acuity of 20/30 on the right eye, while the left eye had a persistent nodular scar and visual acuity remained at 20/200.

Conclusion:
We describe a case of bilateral CNV in a young patient with enhanced S-cone syndrome, discuss differentials and treatment approaches. This case highlights the risk of CNV in ESCS and the importance of family screening and follow-up in affected relatives.
Antipsychotic Polypharmacy in Time Course
Authors: Lochmann van Bennekom Marc W.H. , Gijsman Harm J. , IntHout Joanna , Verkes Robbert Jan 
Published: October 2024

Abstract

Purpose/Background
Antipsychotic polypharmacy (APP) is controversial yet applied in 20% of patients with psychotic disorders. We investigated indications for initiating and continuing APP, including the contribution of unfinished cross-titrations.

Methods/Procedures
This 2-month study was part of a prospective study to reduce inappropriate APP in inpatients. With each new prescription resulting in APP, we asked the prescriber for the indication (eg, switching antipsychotics, sedation for agitation/sleep disorders, treatment refractoriness, other) and repeated this at 30 and 60 days. Secondary outcome was unfinished cross-titration at 60 days.

Findings/Results
In a consecutive cohort of 55 patients, 80% diagnosed with schizophrenia, switching antipsychotics was the primary initial indication for APP in 31 of 55 patients (56%), followed by sedation in 12 of 55 patients (22%), and treatment refractoriness in 10 of 55 patients (18%). Overall, APP was discontinued after 30 days in 25 of 55 patients (45%) and after 60 days in 28 of 55 patients (51%). At 60 days, APP initiated for switching antipsychotics was ongoing in 9 of 31 patients (29%), APP initiated for sedation was ongoing in 8 of 12 patients (66%), and APP initiated for refractoriness was ongoing in 9 of 10 patients (90%). The initial indication for APP was maintained at 60 days in 21 of 27 patients (78%). Unfinished cross-titration occurred in 9 of 31 patients (29%) with APP initiated for switching antipsychotics.

Implications/Conclusions
APP was initiated primarily because of cross-titration switching of antipsychotics. The reason for APP was generally maintained consistently over time, particularly when initiated for treatment refractoriness. Of all patients with APP initiated to switch antipsychotics, 29% ended in unfinished cross-titration.
Do People With Stroke Meet Aerobic and Muscle-Strengthening Activity Guidelines? Data From the Canadian Longitudinal Study on Aging
Authors: Noguchi Kenneth S. , Carlesso Lisa C. , Beauchamp Marla K. , Phillips Stuart M. , Thabane Lehana , Tang Ada 
Published: October 2024

Background and Purpose:
It is unclear to what extent Canadians with stroke engage in moderate-vigorous physical activity (MVPA) and muscle-strengthening activities (MSA). The purpose of this study was to describe overall physical activity, aerobic MVPA, and MSA participation in Canadians with stroke; determine the functioning, disability, and health classes that best characterize this population; and examine the relationship between-class membership and physical activity participation.

Methods:
Activity levels were quantified using the Physical Activity Scale for the Elderly in 2094 adults with stroke or transient ischemic attack (mean age 67.9 years, 9.5 years poststroke) from the CLSA. Means and percentages were used to characterize participation. Latent class analysis was used to create health and disability classes, and activity levels were compared between classes.

Results:
Only 6.2% (95% confidence interval [CI], 4.8%-8.0%) met both MVPA and MSA guidelines. Most (88.2%, 95% CI, 85.0%-88.9%) engaged in MVPA <3 times/wk and 76.7% (95% CI, 73.7%-79.1%) never engaged in MSA. In latent class analyses, 2 classes for males and females were characterized by high-positive or low-negative levels of intrinsic capacity (eg, grip strength), functional mobility (eg, walking speed), and environment (eg, social support). Those in the low-negative classes had the lowest Physical Activity Scale for the Elderly scores and aerobic MVPA levels compared to the high-positive (healthiest) classes. MSA participation was not different between classes.

Discussion and Conclusions:
Canadians with stroke are not engaging in sufficient physical activity. Clinicians should encourage regular participation in physical activity, especially among those with lower levels of intrinsic capacity, functional mobility, and environmental support.

Video Abstract available for more insights from the authors (see Supplementary Digital Content 3 available at: http://links.lww.com/JNPT/A494).
Measuring Exercise Self-Efficacy After Stroke: Validity and Reliability of Current Measures
Authors: Espernberger Karl , Fini Natalie A. , Ezzat Allison , Peiris Casey L. 
Published: October 2024

Background and Purpose:
Many physically capable stroke survivors are insufficiently active, with low self-efficacy considered an important contributor. However, validity and reliability of self-efficacy measures in stroke survivors have not been established. This research aims to evaluate the test-retest reliability and construct validity of 3 self-efficacy measures: Self-Efficacy for Exercise Scale (SEE), Spinal Cord Injury Exercise Self-Efficacy Scale (SCI-ESES), and Participation Strategies Self-Efficacy Scale (PS-SES).

Methods:
A repeated measures study with community-dwelling, independently mobile adult stroke survivors (n = 51, mean age 74 years, 45% female, median 22 months poststroke) was completed. Test-retest reliability was assessed using intraclass correlation coefficients and Bland-Altman analyses. Construct validity was assessed using 8 pre-determined hypotheses concerning physical activity level (subjective and objective), comorbidities, work and volunteering, and measures of function.

Results:
Retest reliability was established for the SEE (intraclass correlation coefficient, ICC = 0.77) and PS-SES (ICC = 0.78) but not for the SCI-ESES (ICC = 0.68). Bland-Altman analysis showed participants consistently scored higher on the second test for all measures. The SEE achieved construct validity by meeting 75% of hypotheses, whereas the PS-SES and SCI-ESES did not. Self-efficacy was positively related to steps/day, functional capacity, self-reported activity levels, and work or volunteering participation.

Discussion and Conclusions:
The SEE was found to be the most appropriate tool to measure exercise self-efficacy in independently mobile chronic stroke survivors in terms of retest reliability and validity.

Trial Registration:
N/A

Video Abstract available
for more insights from the authors (see the Video, Supplemental Digital Content 1 “Espernberger-JNPT-Video-Abstract,” available at: http://links.lww.com/JNPT/A489).
The perils of St. John's wort in cancer care
Authors: Boyle Deborah A. 
Published: October 2024

Abstract:
Approximately one-third of Americans use healthcare approaches including herbs and botanicals, such as St. John's wort (SJW), to improve overall well-being, gain control over their health, and manage the adverse reactions of conventional therapies. This article examines the use of SJW in cancer care, discussing its pharmacokinetics, toxicity, and potential interactions with cancer treatments while emphasizing the importance of patient education and collaboration between oncology nurses and pharmacists to ensure safe and effective care.
Checkpoint inhibitor therapy
Authors: Davis Lori , Casselbury Mary Beth , Wilson Sharon 
Published: October 2024

Abstract:
Treatment with immune checkpoint inhibitors for cancer is associated with a high prevalence of multiple immune-related toxicities. Immune-related adverse events (irAEs) can occur anytime during treatment and up to 3 months after treatment. This article discusses checkpoint inhibitor therapy and describes the implementation of a patient education program focused on recognizing immunotherapy irAEs and their toxicities.
Levator Advancement Surgery with or without Lateral Horn Incision: Effect of Lateral Horn Incision for Severe Involutional Blepharoptosis
Authors: Suga Hirotaka , Fukuju Asako , Murakami Risa 
Published: October 2024

Background:
The lateral portion of the levator aponeurosis transforms into fibrous tissue called the lateral horn. Conventional levator advancement surgery for involutional blepharoptosis preserves the integrity of the lateral horn. The impact of incising the lateral horn has not been thoroughly studied.

Methods:
Sixty-nine patients who had undergone levator advancement surgery for involutional blepharoptosis between 2020 and 2023 were included in the study. In cases where the levator aponeurosis could not be well advanced during surgery, we incised the lateral horn to increase the advancement. We then retrospectively reviewed cases with or without the incision. We also measured the effect of the incision intraoperatively using a sheet with a scale grid.

Results:
Lateral horn incisions were performed in 32 of the 69 cases. The preoperative degree of blepharoptosis was significantly more severe in cases that necessitated the incision (margin reflex distance 1; 0.5 vs 1.0 mm, P < 0.05). Patients receiving the incision were significantly older than those without (73.4 vs 61.7 years, P < 0.05). There were no significant differences between the two groups in postoperative margin reflex distance 1 (2.8 vs 3.0 mm, P = 0.20). Intraoperative measurements revealed that the levator aponeurosis was advanced 4.3 mm more caudally and 3.1 mm more medially as a result of the lateral horn incision.

Conclusions:
Lateral horn incision is effective in levator advancement surgery for severe involutional blepharoptosis. This technique aids in preventing undercorrection of palpebral fissures, especially in the medial region.
The Predictors of Patient Safety Culture in Hospital Setting: A Systematic Review
Authors: Vibe Anja , Rasmussen Sara Haurum , Rasmussen Nikolaj Ohm Pranger , Østergaard Doris , Dieckmann Peter 
Published: October 2024

Introduction
Patient safety (PS) is a global public health concern. It is estimated that 10% of patients experience preventable harm while hospitalized. Patient safety culture (PSC) has been recognized as essential to improving PS, drawing inspiration from other high-risk industries. In PS research, however, PSC poses conceptual challenges, with inconsistent terminology, a lack of definitions, and limited use of substantiating theory. Despite these challenges, PSC remains widely used in PS research and practice, as it is seen as a potential gateway to understanding sociotechnical complex aspects of the healthcare system and improving safe patient treatment and care.

Objectives
This review explores the concept of PSC in a hospital setting. How PSC is used as an outcome, thus exploring the theoretical position underpinning PSC, which predictors impact PSC, and how these predictors are related to PSC.

Method
Using a search of 3 electronic databases, 23 studies that met the inclusion criteria were selected for review.

Results
The review identified 81 predictors of PSC. Study population, unit of analysis and method varied widely. PSC as an outcome was assessed based on one of 4 surveys. Thus, the underpinning position of the PSC construct is dominated by an organizational/managerial approach.

Conclusions
The large number of predictors explored and the range in outcome measures, units of analysis, and methods make it hard to establish any causal relationship. We argue that studies closer to actual practices in the messy conditions of clinical practice are needed.
Aberrant dynamic functional and effective connectivity changes of the primary visual cortex in patients with retinal detachment via machine learning
Authors: Ji Yu , Wang Yuan-Yuan , Cheng Qi , Fu Wen-Wen , Shu Ben-Liang , Wei Bin , Huang Qin-Yi , Wu Xiao-Rong 
Published: October 2024

Objective
Previous neuroimaging studies have identified significant alterations in brain functional activity in retinal detachment (RD) patients, these investigations predominantly concentrated on local functional activity changes. The potential directional alterations in functional connectivity within the primary visual cortex (V1) in RD patients remain to be elucidated.

Methods
In this study, we employed seed-based functional connectivity analysis along with Granger causality analysis to examine the directional alterations in dynamic functional connectivity (dFC) within the V1 region of patients diagnosed with RD. Finally, a support vector machine algorithm was utilized to classify patients with RD and healthy controls (HCs).

Results
RD patients exhibited heightened dynamic functional connectivity (dFC) and dynamic effective connectivity (dEC) between the Visual Network (VN) and default mode network (DMN), as well as within the VN, compared to HCs. Conversely, dFC between VN and auditory network (AN) decreased, and dEC between VN and sensorimotor network (SMN) significantly reduced. In state 4, RD patients had higher frequency. Notably, variations in dFC originating from the left V1 region proved diagnostically effective, achieving an AUC of 0.786.

Conclusion
This study reveals significant alterations in the connectivity between the VN and the default mode network in patients with RD. These changes may disrupt visual information processing and higher cognitive integration in RD patients. Additionally, alterations in the left V1 region and whole-brain dFC show promising potential in aiding the diagnosis of RD. These findings offer valuable insights into the neural mechanisms underlying visual and cognitive impairments associated with RD.
Microhaplotype deep sequencing assays to capturePlasmodium vivaxinfection lineages
Authors: Kleinecke Mariana , Rumaseb Angela , Sutanto Edwin , Trimarsanto Hidayat , Hoon Kian Soon , Osborne Ashley , Manrique Paulo , Peters Trent , Hawkes David , Benavente Ernest Diez , Whitton Georgia , Siegel Sasha V , Pearson Richard D , Amato Roberto , Rai Anjana , Thuy Nhien Nguyen Thanh , Chau Nguyen Hoang , Assefa Ashenafi , Degaga Tamiru S , Abate Dagimawie Tadesse , Rahim Awab Ghulam , Pasaribu Ayodhia Pitaloka , Sutanto Inge , Alam Mohammad Shafiul , Pava Zuleima , Mesa Tatiana Lopera- , Echeverry Diego , William Tim , Anstey Nicholas M , Grigg Matthew J , Day Nicholas , White Nicholas J. , Kwiatkowski Dominic P , Noviyanti Rintis , Neafsey Daniel , Price Ric N , Auburn Sarah 
Published: October 2024

AbstractThe elimination ofPlasmodium vivaxis challenged by dormant liver stages (hypnozoites) that can reactivate months after initial infection resulting in relapses that enhance transmission. Relapsing infections confound antimalarial clinical efficacy trials due to the inability to distinguish between recurrences arising from blood-stage treatment failure (recrudescence), reinfection or relapse. Genetic relatedness of paired parasite isolates, measured by identity-by-descent (IBD), can provide important information on whether individuals have had single or multiple mosquito inoculations, thus informing on recurrence origin. We developed a high-throughput amplicon sequencing assay comprising 93 multi-SNP (microhaplotype)P. vivaxmarkers to determine IBD betweenP. vivaxclinical isolates. The assay was evaluated in 659 independent infections from the Asia-Pacific and Horn of Africa, including 108 pairs of infections from a randomized controlled trial (RCT). A bioinformatics pipeline (vivaxGEN-MicroHaps) was established to support data processing. Simulations usingpaneljudgedemonstrated low error in pairwise IBD estimation in all countries assessed (all RMSE <0.12) and IBD-based networks illustrated strong clustering by geography. IBD analysis in the RCT demonstrated a higher frequency of suspected relapses or recrudescence in patients treated with primaquine regimens (0.84) compared to those without primaquine (0.60). Our results demonstrate the potential to derive information onP. vivaxIBD using amplicon sequencing, that informs policy-relevant treatment and transmission dynamics.
Effect of Compulsory Funding on Post-hospital Neurorehabilitation Outcomes and Length of Stay following Stroke
Authors: Lew Jason T. , Lewis Frank D. , Glenn Mel B. , Horn Gordon J. 
Published: October 2024

AbstractBackground and PurposeThe American Stroke Association recommends post-stroke rehabilitation for those who qualify and have access to this service. Continued services at the post-hospital residential and outpatient rehabilitation levels of care result in further functional gains after acquired brain injury, including stroke, even when provided beyond 6-12 months post onset. Access to care remains a barrier to rehabilitation including third-party limits with funding and coverage restrictions. This study measured outcomes comparing those with state legislated Compulsory Funding (CF) vs. Restricted Funding (RF) for post-hospital neurorehabilitation.MethodsThere were a total of 402 participants across 14 states included in the study. The CF group had 201 and the RF group had 201 participants. The Mayo-Portland Adaptability Inventory (MPAI-4) was selected as the primary dependent measure.ResultsPost-hospital rehabilitation length of stay (LOS) was significantly shorter in the CF group, t(400) = 1.72, p < 0.05 (Cohen’s d = 0.17). A Mixed 2×2 RM-MANCOVA revealed a significant main effect of time of testing, Pillai’s Trace f(1,398) = 402.6, p < 0.001; power to detect = 0.99, partial eta2= 0.50. The analysis also revealed significant between groups main effect f(1,398) = 12.8, p< 0.001, power to detect = 0.94, partial eta2= 0.031. The results of Bonferroni post-hoc pairwise comparisons are presented.ConclusionsThis study examined the differences in rehabilitation outcomes and LOS for persons receiving CF post-acute neurorehabilitation with individuals receiving services in other states with RF. While both groups improved, the state legislated access to care CF group started post-hospital neurorehabilitation without delay, discharged more quickly thereby reducing cost, with a lower level of disability (MPAI-4 Indices) at discharge compared to the RF group.