bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the Effects of Orthokeratology and Highly Aspherical Lenselets in Achieving Myopia Control and Defocus in Adolescents
Authors: Yu Jia , Guo Yujuan , Zhou Yuehua 
Published: September 2024

Objectives:
To compare the control effectiveness and periretinal defocus between orthokeratology (OK) and highly aspherical lenslets (HAL) in adolescents with myopia.

Methods:
In this prospective study, 211 children (211 right eyes) were enrolled in Beijing Ming Vision and Ophthalmology between October 2022 and February 2023. Based on the myopia correction method, participants were divided into three groups: OK, HAL, and single-vision spectacles (SVS). They were further divided into two subgroups according to the spherical equivalent (SE), namely, subgroup A with −1.0≤SE≤−2.0 D and subgroup B with −2.0<SE≤−3.0 D. All children were followed up for 12 months, and the changes in axial length (AL) and periretinal defocus before and after treatment were recorded, and the factors affecting the corneal shaping force for 1-day post-OK were analyzed.

Results:
Axial length growth in those with OK lenses and HAL was lower than what was observed for those with SVS after 6, 9, and 12 months. Comparison of the difference in AL change between OK and HAL was not statistically significant with −1.0≤SE≤−2.0 D. The myopic defocus of RDV270° to 300° in group HAL was higher than that in group OK, the difference was statistically significant (P<0.05), and in other regions, the myopic defocus was higher in the group OK. Em, SRI (corneal regularity index), variation in cell area, and corneal thickness were significantly associated with shaping force.

Conclusions:
Orthokeratology is one of the most effective optical treatments for controlling myopia, and the factors that affect the corneal shaping force under different corneal parameters are different. For mild myopia, HAL can achieve the same effectiveness as OK.
Extended reality used in the treatment of phantom limb pain: a multicenter, double-blind, randomized controlled trial
Authors: Lendaro Eva , Van der Sluis Corry K. , Hermansson Liselotte , Bunketorp-Käll Lina , Burger Helena , Keesom Els , Widehammar Cathrine , Munoz-Novoa Maria , McGuire Brian E. , O’Reilly Paul , Earley Eric J. , Iqbal Sonam , Kristoffersen Morten B. , Stockselius Anita , Gudmundson Lena , Hill Wendy , Diers Martin , Turner Kristi L. , Weiss Thomas , Ortiz-Catalan Max 
Published: September 2024

Abstract
Phantom limb pain (PLP) represents a significant challenge after amputation. This study investigated the use of phantom motor execution (PME) and phantom motor imagery (PMI) facilitated by extended reality (XR) for the treatment of PLP. Both treatments used XR, but PME involved overt execution of phantom movements, relying on the decoding of motor intent using machine learning to enable real-time control in XR. In contrast, PMI involved mental rehearsal of phantom movements guided by XR. The study hypothesized that PME would be superior to PMI. A multicenter, double-blind, randomized controlled trial was conducted in 9 outpatient clinics across 7 countries. Eighty-one participants with PLP were randomly assigned to PME or PMI training. The primary outcome was the change in PLP, measured by the Pain Rating Index, from baseline to treatment cessation. Secondary outcomes included various aspects related to PLP, such as the rate of clinically meaningful reduction in pain (CMRP; >50% pain decrease). No evidence was found for superiority of overt execution (PME) over imagery (PMI) using XR. PLP decreased by 64.5% and 68.2% in PME and PMI groups, respectively. Thirty-seven PME participants (71%) and 19 PMI participants (68%) experienced CMRP. Positive changes were recorded in all other outcomes, without group differences. Pain reduction for PME was larger than previously reported. Despite our initial hypothesis not being confirmed, PME and PMI, aided by XR, are likely to offer meaningful PLP relief to most patients. These findings merit consideration of these therapies as viable treatment options and alternatives to pharmacological treatments.
Fluid management in the septic peri-operative patient
Authors: Nasa Prashant , Wise Robert , Malbrain Manu L.N.G. 
Published: September 2024

Purpose of review
This review provides insight into recent clinical studies involving septic peri-operative patients and highlights gaps in understanding fluid management. The aim is to enhance the understanding of safe fluid resuscitation to optimize peri-operative outcomes and reduce complications.

Recent findings
Recent research shows adverse surgical and clinical outcomes with both under- and over-hydration of peri-operative patients. The kinetic of intravenous fluids varies significantly during surgery, general anaesthesia, and sepsis with damage to endothelial glycocalyx (EG), which increases vascular permeability and interstitial oedema. Among clinical anaesthesia, neuraxial anaesthesia and sevoflurane have less effect on EG. Hypervolemia and the speed and volume of fluid infusion are also linked to EG shedding. Despite improvement in the antisepsis strategies, peri-operative sepsis is not uncommon. Fluid resuscitation is the cornerstone of sepsis management. However, overzealous fluid resuscitation is associated with increased mortality in patients with sepsis and septic shock. Personalized fluid resuscitation based on a careful assessment of intravascular volume status, dynamic haemodynamic variables and fluid tolerance appears to be a safe approach. Balanced solutions (BS) are preferred over 0.9% saline in patients with sepsis and septic shock due to a potential reduction in mortality, when exclusive BS are used and/or large volume of fluids are required for fluid resuscitation. Peri-operative goal-directed fluid therapy (GDFT) using dynamic haemodynamic variables remains an area of interest in reducing postoperative complications and can be considered for sepsis management (Supplementary Digital Content).

Summary
Optimization of peri-operative fluid management is crucial for improving surgical outcomes and reducing postoperative complications in patients with sepsis. Individualized and GDFT using BS is the preferred approach for fluid resuscitation in septic peri-operative patients. Future research should evaluate the interaction between clinical anaesthesia and EG, its implications on fluid resuscitation, and the impact of GDFT in septic peri-operative patients.
Renal dysfunction in surgical patients
Authors: Booke Hendrik , Zarbock Alexander , Meersch Melanie 
Published: September 2024

Purpose of review
To provide an overview of the current diagnostic criteria for acute kidney injury (AKI) including their limitations and to discuss prevention and treatment approaches in the perioperative setting.

Recent findings
AKI is common in the perioperative period and is associated with worse short- and long-term outcomes. Current definitions of AKI have several limitations and lead to delayed recognition of kidney dysfunction which is why novel diagnostic approaches by using renal biomarkers may be helpful. In general, prevention of the development and progression of AKI is vital as a causal treatment for AKI is currently not available. Optimization of kidney perfusion and avoidance of nephrotoxic drugs reduce the occurrence of AKI in surgical patients. Angiotensin II as a new vasopressor, the use of remote ischemic preconditioning, and amino acids may be approaches with a positive effect on the kidneys.

Summary
Evidence suggests that the implementation of supportive measures in patients at high risk for AKI might reduce the occurrence of AKI. Novel biomarkers can help allocating resources by detecting patients at high risk for AKI.
Linking Interprofessional Community Health Experiences With Nursing Education
Authors: Hadinger Margaret A. , Miller Mary Ellen , Letcher Abby 
Published: September 2024

Background:
Ensuring that nurses and other health care professionals are trained to work together in teams is critical.

Problem:
Recent literature describes interprofessional education (IPE) programs that meet community health needs. However, there is a need for descriptions of IPE programs embedded in the communities they serve.

Approach:
Bridging the Gaps (BTG) is a collaboration between academic health institutions/universities and community organizations in the northeastern United States. BTG links IPE with the provision of health-related services for under resourced communities. This article describes the development of one BTG Community Health Internship Program (BTG CHIP) affiliate site (BTG, Lehigh Valley).

Outcomes:
Since inception, 114 interns completed the program as part of BTG CHIP, Lehigh Valley, for a total of 3192 days of service provided to the community. BTG CHIP, Lehigh Valley, serves as a case study for establishing similar community-based IPE programs. This article describes challenges, opportunities, and replication strategies.
Sham feeding as a nursing technology: Recent progress and future perspective
Authors: Li Ka , Han Yanting , Ullah Hanif , Chang Chenting , Cao Liujiao 
Published: September 2024

Abstract
Sham feeding is a conventional technique employed in enhanced recovery after surgery (ERAS) protocols to facilitate the restoration of gastrointestinal motility. Currently, the effectiveness of sham feeding extends beyond the postoperative phase after abdominal surgery, demonstrating potential applicability in nonabdominal postoperative rehabilitation. Studies have shown that sham feeding triggers the head-vagal reflex, thereby promoting gastrointestinal motility through a combination of humoral and neural stimulation. Recognized as a highly promising ERAS technology, sham feeding needs to be further investigated regarding the form, mechanism, and application of sham feeding. This paper summarized the research progress and limitations of sham feeding. Considering contemporary research focus on the gut-brain axis, we proposed a new concept of sham feeding that integrates visual, auditory, and olfactory stimuli. In addition, we provide suggestions and perspectives to guide future exploration of sham feeding for its potential impact on the development of non-drug nursing intervention technology based on the concept of ERAS.
Rural-Urban Differences in Self-Reported Participation in Diabetes Self-Management Education
Authors: Boswell Emma , Probst Jan , Hung Peiyin , Herbert Laura , Crouch Elizabeth 
Published: September 2024

Context:
Rural America faces a dual challenge with a higher prevalence of diabetes mellitus (hereafter, diabetes) and diabetes-related mortality. Diabetes self-management education (DSME) can improve glucose control and reduce adverse effects of diabetes, but certified DSME programs remain disproportionately limited in rural counties than in urban counties.

Objective:
The goal of this study is to examine the proportion of urban and rural adults who report having received DSME using a nationwide, 29-state survey while considering the potential consequences of lower service availability.

Design:
This cross-sectional study used data from the 2019 Behavioral Risk Factor Surveillance System (BRFSS). Residence was defined as urban (metropolitan county) vs rural (non-metropolitan county). Logistic regression, incorporated survey weights, was used to determine the odds of having received DSME by residence.

Setting:
BRFSS is a nationally representative survey, and this study included participants from 29 states that were distributed throughout all regions of the United States.

Participants:
The study sample consisted of 28,179 adults who reported having diabetes, lived in one of the states that administered the diabetes module in 2019, and answered all relevant questions.

Main Outcome Measure(s):
The main outcome measure was whether a participant had ever received DSME. Participants were considered to have received DSME if they self-reported having ever taken a class on how to manage diabetes themselves.

Results:
Overall, 54.5% of participants reported having received DSME; proportionately fewer rural residents (50.4%, ±1.1%) than urban residents (55.5%, ±1.0%) reported DSME. Rural disparities persisted after adjusting for demographic, enabling, and need factors (Adjusted Odds Ratio = 0.79; CI, 0.71-0.89). By sociodemographic factors, Hispanic persons vs non-Hispanic White persons and single vs married/coupled individuals were less likely to report DSME receipt (both 0.76 [0.62-0.94]).

Conclusions:
Ongoing national efforts addressing rural disparities in diabetes-related complications should target individuals most at risk for missing current diabetes educational programming and design appropriate interventions.
A myriad of methods to determine temporal summation of pain in people with musculoskeletal pain and healthy participants: a scoping review
Authors: Kielstra Sjoerd C. , Reezigt Roland R. , Coppieters Michel W. , de Vries Ralph , Arendt-Nielsen Lars , Petersen Kristian K. , Yarnitsky David , Scholten-Peeters Gwendolyne G.M. 
Published: September 2024

Abstract
Temporal summation of pain (TSP) is a human proxy for wind-up of dorsal horn neurons as assessed in animals. The common paradigm for eliciting TSP is evoked by repetitive nociceptive stimuli of equal intensity. Various stimulation and assessment protocols have been used. This scoping review aims to provide insight into key elements of TSP stimulation and assessment: modality, instruments, test location, familiarization, train characteristics, and calculations. PubMed, Embase, and Ebsco/CINAHL were searched for studies that measured TSP in adults with musculoskeletal conditions and healthy people. Four hundred six studies were included. Mechanical stimuli were the most commonly used modality (250 studies), followed by thermal stimuli (125 studies). Forty-six different instruments were used. Disregarding studies on widespread musculoskeletal pain and healthy participants, 40 studies evaluated TSP at painful sites, 77 in remote areas, and 66 in both locations. Of the 13 tested locations in patients, the hand (74 studies), lower leg (64 studies), and forearm (59 studies) were most commonly tested. A single practice round was the most common familiarization method (46 studies). Repeated stimuli were applied using 31 different frequencies (0.03-200 Hz) and sustained stimulations ranging from 5 to 1080 seconds were used. Twenty-two different train lengths, 63 different calculations (37 absolute, 19 relative, and 7 alternatives using data directly), and 14 different outcome measures (eg, self-reported pain rating scales and reflex thresholds) were used. Temporal summation of pain protocols vary excessively, hindering the comparison and pooling of results. None of the studies provided substantiation for their protocol choice.
Interfacility Competition and its Impact on Cost of Carpal Tunnel Release
Authors: Rivedal David D. , Cichocki Meghan N. , Tong Yanlin , Wang Lu , Chung Kevin C. 
Published: September 2024

Background:
Carpal tunnel release (CTR) is the most common hand surgery procedure, but little is known about how healthcare market characteristics influence cost. The objective of this study was to understand the association of healthcare market competition and facility availability on out-of-pocket and total insurer payments for patients undergoing CTR.

Methods:
This retrospective cross-sectional study used a national sample of private insurance claims from 2015-2020. Adults who had CTR were included, while acute or inpatient CTRs, or lacking geographical information were excluded. Linear regression was applied to investigate the impact of the healthcare market competition and facility availability (ambulatory surgery center (ASC), hospital outpatient departments (HOPD), outpatient clinics) on the out-of-pocket expenses and total insurer payment. Market competition was measured using the Herfindahl-Hirschman Index.

Results:
Of 119,828 patients, 76% underwent open CTR. The most competitive hospital markets were HOPDs and ASCs, respectively. As HOPD competition decreased, out-of-pocket expenses and total insurer payment decreased significantly. As ASC competition decreased, only total insurer payments decreased significantly. CTRs performed in outpatient clinics increased slightly over time. However, HOPDs remained the most common location until 2020 when their popularity was similar to ASCs. Finally, out-of-pocket expenses increased significantly whereas total insurer payments did not change significantly throughout the study period.

Conclusions:
This study found decreased healthcare market competition was not associated with increased CTR costs, suggesting that costs are complex and multifactorial. To reduce healthcare costs, this study supports the movement of CTRs to clinic and ASCs.
How to evaluate exertional breathlessness using normative reference equations in research
Authors: Ekström Magnus , Lewthwaite Hayley , Jensen Dennis 
Published: September 2024

Purpose of review
Breathlessness is a common, distressing and limiting symptom in people with advanced disease, but is challenging to assess as the symptom intensity depends on the level of exertion (symptom stimulus) during the assessment. This review outlines how to use recently developed normative reference equations to evaluate breathlessness responses, accounting for level of exertion, for valid assessment in symptom research.

Recent findings
Published normative reference equations are freely available to predict the breathlessness intensity response (on a 0–10 Borg scale) among healthy people after a 6-minute walking test (6MWT) or an incremental cycle cardiopulmonary exercise test (iCPET). The predicted normal values account for individual characteristics (including age, sex, height, and body mass) and level of exertion (walk distance for 6MWT; power output, oxygen uptake, or minute ventilation at any point during the iCPET). The equations can be used to (1) construct a matched healthy control dataset for a study; (2) determine how abnormal an individual’s exertional breathlessness is compared with healthy controls; (3) identify abnormal exertional breathlessness (rating > upper limit of normal); and (4) validly compare exertional breathlessness levels across individuals and groups.

Summary
Methods for standardized and valid assessment of exertional breathlessness have emerged for improved symptoms research.
Targeted Broader Sharing for Liver Continuous Distribution
Authors: Mankowski Michal A. , Wood Nicholas L. , Massie Allan B. , Segev Dorry L. , Trichakis Nikolaos , Gentry Sommer E. 
Published: September 2024

Background.
In recent years, changes to US organ allocation have aimed to improve equity and accessibility across regions. The Organ Procurement and Transplantation Network plans to adopt continuous liver distribution, prioritizing candidates based on a weighted composite allocation score (CAS) incorporating proximity, ABO types, medical urgency, and pediatric priority. The Liver Committee has requested research on CAS variations that account for geographical heterogenicity.

Methods.
We describe a method for designing a geographically heterogeneous CAS with targeted broader sharing (CAS-TBS) to balance the highly variable geographic distributions of liver transplant listings and liver donations. CAS-TBS assigns each donor hospital to either broader sharing or nearby sharing, adjusting donor-candidate distance allocation points accordingly.

Results.
We found that to reduce geographic disparity in the median Model for End-stage Liver Disease at transplant (MMaT), >75% of livers recovered in regions 2 and 10 should be distributed with broader sharing, whereas 95% of livers recovered in regions 5 and 1 should be distributed with nearby sharing. In a 3-y simulation of liver allocation, CAS-TBS decreased MMaT by 2.1 points in high-MMaT areas such as region 5 while increasing MMaT only by 0.65 points in low-MMaT areas such as region 3. CAS-TBS significantly decreased median transport distance from 202 to 167 nautical miles under acuity circles and decreased waitlist deaths.

Conclusions.
Our CAS-TBS design methodology could be applied to design geographically heterogeneous allocation scores that reflect transplant community values and priorities within the continuous distribution project of the Organ Procurement and Transplantation Network. In our simulations, the incremental benefit of CAS-TBS over CAS was modest.
Cell identity revealed by precise cell cycle state mapping links data modalities
Authors: Alahmari Saeed , Schultz Andrew , Albrecht Jordan , Tagal Vural , Siddiqui Zaid , Prabhakaran Sandhya , El Naqa Issam , Anderson Alexander , Heiser Laura , Andor Noemi 
Published: September 2024

AbstractSeveral methods for cell cycle inference from sequencing data exist and are widely adopted. In contrast, methods for classification of cell cycle state from imaging data are scarce. We have for the first time integrated sequencing and imaging derived cell cycle pseudo-times for assigning 449 imaged cells to 693 sequenced cells at an average resolution of 3.4 and 2.4 cells for sequencing and imaging data respectively. Data integration revealed thousands of pathways and organelle features that are correlated with each other, including several previously known interactions and novel associations. The ability to assign the transcriptome state of a profiled cell to its closest living relative, which is still actively growing and expanding opens the door for genotype-phenotype mapping at single cell resolution forward in time.
AI-enabled Alkaline-resistant Evolution of Protein to Apply in Mass Production
Authors: Kang Liqi , Wu Banghao , Zhou Bingxin , Tan Pan , Kang Yun (Kenneth) , Yan Yongzhen , Zong Yi , Li Shuang , Liu Zhuo , Hong Liang 
Published: September 2024

AbstractArtificial intelligence (AI) models have been used to study the compositional regularities of proteins in nature, enabling it to assist in protein design to improve the efficiency of protein engineering and reduce manufacturing cost. However, in industrial settings, proteins are often required to work in extreme environments where they are relatively scarce or even non-existent in nature. Since such proteins are almost absent in the training datasets, it is uncertain whether AI model possesses the capability of evolving the protein to adapt extreme conditions. Antibodies are crucial components of affinity chromatography, and they are hoped to remain active at the extreme environments where most proteins cannot tolerate. In this study, we applied an advanced large language model (LLM), the Pro-PRIME model, to improve the alkali resistance of a representative antibody, a VHH antibody capable of binding to growth hormone. Through two rounds of design, we ensured that the selected mutant has enhanced functionality, including higher thermal stability, extreme pH resistance and stronger affinity, thereby validating the generalized capability of the LLM in meeting specific demands. To the best of our knowledge, this is the first LLM-designed protein product, which is successfully applied in mass production.