bluuebunny/crossref_metadata_2025_split huggingface dataset:
Secondary Data Analysis of Inflammation-Related mRNAs in Conjunctival Impression Cytology Samples of Aniridia Patients
Authors: Stachon Tanja , Latta Lorenz , Fries Fabian N. , Seitz Berthold , Szentmáry Nóra 
Published: December 2023

Purpose:
Aniridia is a rare corneal disease that is often associated with aniridia-associated keratopathy (AAK). In AAK, the conjunctival tissue crosses the limbal border, forming a corneal pannus that extends into the corneal center. With increasing AAK severity, corneal pannus formation, vascularization, and ocular surface inflammation increase. The purpose of this study was to investigate inflammation-related mRNA expression in conjunctival epithelial cells in AAK and its relationship with AAK severity.

Methods:
Using impression cytology, bulbar conjunctival cells were sampled from 20 subjects with congenital aniridia and 20 age-matched and sex-matched healthy control subjects. RNA was extracted, and mRNA analyses were performed using microarray, which was evaluated for inflammatory markers.

Results:
In the analyzed aniridia subjects, 70 deregulated mRNAs encoding proinflammatory or antiinflammatory cytokines or factors associated with chronic inflammation, including increased IL-1, IL-8, and MIP3A/CCL20 mRNA. The most downregulated mRNA was TIMP3, and the most upregulated mRNA was Protein c-Fos.
Of the 70 mRNAs, 14 inflammation-related genes were altered only in the mild AAK forms, whereas only 2 mRNAs were altered only in the severe AAK forms (TLR4 and PPARG).

Conclusions:
The expression of numerous proinflammatory and antiinflammatory cytokines is deregulated at the ocular surface of aniridia subjects with mild AAK. Thus, early antiinflammatory treatment may prevent or slow down corneal scarring and pannus formation in aniridia subjects.
Black Henna Deposits Masquerading a Melanoma of the Plica Semilunaris
Authors: Kiratli Hayyam , Rustamova Nargiz , Koç Irem , Babaoğlu Berrin Büyükeren 
Published: December 2023

Purpose:
The aim of this study was to describe a rare case of conjunctival black henna accumulation that was clinically misdiagnosed as melanoma.

Methods:
This retrospective case report reviewed the clinical findings and histopathologic features of a pigmented plica semilunaris lesion excised from a 63-year-old woman. The patient had a history of regular use of black henna in her childhood. The conjunctival pigmentation was present since her early teenage years but started to grow only recently.

Results:
There was a darkly pigmented mass mainly covering the plica semilunaris of the right eye with additional irregularly scattered pigmentation in the medial bulbar conjunctiva. Excisional biopsy of the plical tumor revealed nodular pigment deposits with lymphocytic infiltration. There were no neoplastic cells. The specimen stained negative for pan-keratin, CD68, and CD34. Melanin bleaching was also negative.

Conclusions:
Long-term exposure to black henna as a hair dye may lead to subconjunctival accumulation and mimic melanoma.
Evaluation and Comparison of the Effectiveness of Atropine Eye Drops, Ipratropium Bromide Nasal Spray, and Amitriptyline Tablet in the Management of Clozapine-Associated Sialorrhea in Patients With Refractory Schizophrenia: A Randomized Clinical Trial
Authors: Mohammad-Gholizad Fatemeh , Karimzadeh Iman , Moghimi-Sarani Ebrahim , Arshadi Mahdi , Mortazavi Negar 
Published: December 2023

AbstractPurposeClozapine, a second-generation antipsychotic medication, is mainly indicated for managing treatment-resistant schizophrenia. Among all the nonthreatening adverse effects of clozapine, sialorrhea is a stigmatizing complication occurring in approximately 31.0% to 97.4% of patients. In this study, 2 topical agents (atropine eye drop and ipratropium nasal spray) and a systemic medication (amitriptyline) were compared simultaneously for the management of clozapine-associated sialorrhea.MethodsWe conducted a randomized, single-blinded, non–placebo-controlled clinical trial from June 2022 to January 2023. Eligible patients were randomly allocated into 3 mentioned groups. Patients were monitored for sialorrhea weekly based on scales, including the Toronto Nocturnal Hypersalivation Scale, Clinical Global Impression-Improvement, and Clinical Global Impression-Severity for 1 month. Possible adverse drug reactions and adherence were also recorded.ResultsTwenty-four patients, including 6, 10, and 8 individuals in ipratropium bromide nasal spray, atropine eye drop, and amitriptyline groups, completed the study, respectively. The cohort's demographic, baseline clinical, and sociocultural characteristics were comparable among the 3 groups. Within-group comparisons, between times baseline and week 4, demonstrated that significant differences were in groups atropine and amitriptyline based on Toronto Nocturnal Hypersalivation Scale, in 3 groups based on Clinical Global Impression-Improvement, and also in only-atropine group based on Clinical Global Impression-Severity. Likewise, between-group comparisons showed that atropine was significantly more effective in clozapine-associated sialorrhea management than amitriptyline and ipratropium, in the first 2 weeks and second 2 weeks of study, respectively. Regarding safety, the interventions were tolerated relatively well.ConclusionsConclusively, atropine is more efficacious than amitriptyline, within the first 2 weeks of study and also relative to ipratropium, overall. As time effect was significant between atropine and amitriptyline, according to analysis of covariance test, further investigation with longer follow-up duration would be prudent. In addition, expanding patient population with larger sample size should be conducted for more precision.
Redesigning the First Prenatal Visit: A Quality Improvement Initiative
Authors: Christopher Diane , Fresia Joellen , Alexander Jennifer , Krenz Kristin , Aldrich Heather , Hampanda Karen 
Published: December 2023

ABSTRACTBackground/Purpose:In an era of rising maternal mortality, a thorough first prenatal visit is essential; however, in our clinic we confirmed that many important topics were not being addressed. To rectify this problem, we redesigned the first prenatal visit to improve the coverage of topics, collect social determinants of health, increase patient access, and maintain patient satisfaction.Methods:We designed a quality improvement project to improve the first prenatal visit in a faculty obstetrics and gynecology clinic. To assess effectiveness, data before and after the implementation were compared. The intervention divided the first prenatal visit into two patient encounters: a nurse-led telemedicine visit and an in-person visit with an obstetric clinician.Results:The median percentage of topics covered in the first prenatal visit increased from 70.0% to 95.6%, and improvements were observed for all key themes (p< .001). Social determinants of health was routinely collected postintervention (98.8%). A reduction in no-shows (9.9%–4.2%) improved patient access for all patients. Patient satisfaction for the first prenatal visit remained unchanged (p= .370).Conclusions:Significant improvements in addressing important topics at the first prenatal visit are achievable by separating one prenatal visit into two visits while increasing patient access and maintaining high patient satisfaction.
Black Applicants' Self-reported Reasons for Applying to a Doctor of Physical Therapy Program
Authors: Tombers Nicole , Pfeifer Rachel 
Published: December 2023

Introduction.
Lack of access for minoritized groups to health care providers with a similar background negatively affects health outcomes. Adequate representation in the workforce begins with representation in health care education. The purpose of this study was to describe Black applicants' primary reasons for pursuing physical therapist education.

Review of Literature.
Prior surveys of enrolled Doctor of Physical Therapy (DPT) students have categorized factors influencing the decision to pursue physical therapy, with consideration of student demographics.

Subjects.
One thousand eight hundred nine Black applicants who applied to DPT programs through the Physical Therapist Centralized Application Service (PTCAS).

Methods.
In this retrospective holistic narrative analysis, essay responses from the 2020–2021 PTCAS application cycle (n = 17,801) were categorized by 2 reviewers into one of 9 categories based on the primary reason for applying to a DPT program. Interrater reliability was almost perfect (Kappa 0.946) based on a sample of 48 essays. Racial demographics were compared with US Census and DPT program acceptance and enrollment data from the same year.

Results.
Black individuals are underrepresented among both applicants to and enrollees in DPT programs when compared with US census data from the same year. Black applicants indicated personal experience with the field (33%, n = 597), observation in the field (28.7%, n = 520), and alignment with personal values and interests (27.6%, n = 500) as the most common reasons for applying.

Discussion and Conclusion.
Experience with the field and alignment with values and interest were the most commonly cited reasons among Black applicants for pursuing physical therapist education. Understanding why Black students apply to a DPT program is important for developing strategies to increase the number of Black students enrolled in physical therapy programs and ultimately the workforce.
Framboesiform Facial Lesions and Chorioretinopathy as Presenting Signs of Syphilis in an Immunocompetent Patient
Authors: Johnson Alex W. , Bloomquist Ryan F. , Fowler Teresa E. , Bloomquist Doan T. 
Published: December 2023

Abstract
Syphilis has long been considered the “great masquerader,” notorious for its varying presentations and ability to affect most organ systems in the body. We report the case of a 41-year-old immunocompetent man who presented to ophthalmology with rapidly progressive visual complaints from bilateral panuveitis and concomitant verrucous facial lesions initially disregarded by the patient as acne. Serum testing for syphilis was positive, and he was admitted for 14 days of intravenous (IV) penicillin with multiservice care from dermatology, ophthalmology, and infectious disease. We present photographic documentation showing his stepwise resolution of his facial and retinal involvement with penicillin treatment course. This case is unusual in the concomitant presentation of ocular and facial syphilitic findings in an immunocompetent patient and highlights the need to include syphilis in the differential for unusual appearances.
Validation of the Back-table Graft Arterial Anastomosis between the Splenic Artery and Superior Mesenteric Artery
Authors: Ferrer-Fàbrega Joana , Cárdenas Gabriel , Sapena Víctor , García-Criado Ángeles , Barrufet Marta , Pérez Carles , García-Pérez Rocío , Rull Ramón , López-Boado Miguel Ángel , Folch-Puy Emma , Torroella Alba , Ventura-Aguiar Pedro , Cofan Federico , Esmatjes Enric , Amor Antonio , Diekmann Fritz , Fernández-Cruz Laureano , García-Valdecasas Juan Carlos , Fuster Josep 
Published: December 2023

Objective:
To determine the role of the arterial splenomesenteric anastomosis (ASMA) vascular reconstruction technique in terms of arterial vascular complications in pancreas transplant (PT) recipients.

Summary Background Data:
The ASMA technique was first described in 1992 by Hospital Clínic Barcelona group. Regardless that the iliac Y-graft technique is the most frequently used worldwide, evidence of arterial complications and implications of using a different back-table reconstruction is conspicuously absent in the literature.

Methods:
Descriptive review of 407 PTs performed at a single center (1999-2019) by analyzing the type of arterial reconstruction technique, focusing on ASMA. The endpoints were the management of arterial complications and long-term patient and graft survival.

Results:
ASMA was performed in 376 cases (92.4%) and a Y-graft in 31 cases (7.6%). A total of 34 arterial complications (8.3%) were diagnosed. In the ASMA group (n=30, 7.9%) they comprised: 15 acute thrombosis; 4 stenosis; 1 pseudoaneurysm and 10 diverse chronic arterial complications while in the Y-graft group (n=4, 12.9%) 3 acute thrombosis and 1 chronic artery-duodenal fistula occurred. Graft salvage was achieved in 16 patients (53.3%) from the ASMA group and in 2 (50%) from the Y-graft. After a median follow-up of 129.2 (IQR 25-75%, 77.2 –182) months the overall graft and patient survival for the whole cohort at 1, 5, and 10 years was 86.7%, 79.5%, 70.5%, and 98.5%, 95.3%, 92.5%, respectively.

Conclusions:
The ASMA proves to be a safe and more easily reproducible technique and should therefore be considered for first-line back-table reconstruction in the PT population.
Maintaining a whole blood-centered transfusion improves survival in hemorrhagic resuscitation
Authors: Feinberg Griffin J. , Tillman Anastasia C. , Paiva Marcelo L. , Emigh Brent , Lueckel Stephanie N. , Hynes Allyson M. , Kheirbek Tareq 
Published: December 2023

BACKGROUND
Whole blood (WB) transfusion has been shown to improve mortality in trauma resuscitation. The optimal ratio of packed red blood cells (pRBC) to WB in emergent transfusion has not been determined. We hypothesized that a low pRBC/WB transfusion ratio is associated with improved survival in trauma patients.

METHODS
We analyzed the 2021 Trauma Quality Improvement Program (TQIP) database to identify patients who underwent emergent surgery for hemorrhage control and were transfused within 4 hours of hospital arrival, excluding transfers or deaths in the emergency department. We stratified patients based on pRBC/WB ratios. The primary outcome was mortality at 24 hours. Logistic regression was performed to estimate odds of mortality among ratio groups compared with WB alone, adjusting for injury severity, time to intervention, and demographics.

RESULTS
Our cohort included 17,562 patients; of those, 13,678 patients had only pRBC transfused and were excluded. Fresh frozen plasma/pRBC ratio was balanced in all groups. Among those who received WB (n = 3,884), there was a significant increase in 24-hour mortality with higher pRBC/WB ratios (WB alone 5.2%, 1:1 10.9%, 2:1 11.8%, 3:1 14.9%, 4:1 20.9%, 5:1 34.1%, p = 0.0001). Using empirical cutpoint estimation, we identified a 3:1 ratio or less as an optimal cutoff point. Adjusted odds ratios of 24-hour mortality for 4:1 and 5:1 groups were 2.85 (95% confidence interval [CI], 1.19–6.81) and 2.89 (95% CI, 1.29–6.49), respectively. Adjusted hazard ratios of 24-hour mortality were 2.83 (95% CI, 1.18–6.77) for 3:1 ratio, 3.67 (95% CI, 1.57–8.57) for 4:1 ratio, and 1.97 (95% CI, 0.91–4.23) for 5:1 ratio.

CONCLUSION
Our analysis shows that higher pRBC/WB ratios at 4 hours diminished survival benefits of WB in trauma resuscitation. Further efforts should emphasize this relationship to optimize trauma resuscitation protocols.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level III.
Genomic Medicine Guidance: A Point-of-Care App for Heritable Thoracic Aortic Diseases
Authors: Patil Rohan , Ashraf Fatima , Dayeh Samer Abu , Prakash Siddharth K. 
Published: December 2023

AbstractGenetic testing can determine familial and personal risks for heritable thoracic aortic aneurysms and dissections (TAD). The 2022 ACC/AHA guidelines for TAD recommend management decisions based on the specific gene mutation. However, many clinicians lack sufficient comfort or insight to integrate genetic information into clinical practice. We therefore developed the Genomic Medicine Guidance (GMG) app, an interactive point-of care tool to inform clinicians and patients about TAD diagnosis, treatment, and surveillance. GMG is a REDCap-based app that combines publicly available genetic data and clinical recommendations based on the TAD guidelines into one translational education tool. TAD genetic information in GMG was sourced from the Montalcino Aortic Consortium, a worldwide collaboration of TAD centers of excellence, and the NIH genetic repositories ClinVar and ClinGen. The app streamlines data on the 13 most frequently mutated TAD genes with 2,286 unique pathogenic mutations that cause TAD so that users receive comprehensive recommendations for diagnostic testing, imaging, surveillance, medical therapy, preventative surgical repair, as well as guidance for exercise safety and management during pregnancy. The app output can be displayed in a clinician view or exported as an informative pamphlet in a patient-friendly format. The overall goal of the GMG app is to make genomic medicine more accessible to clinicians and patients, while serving as a unifying platform for research. We anticipate that these features will be catalysts for collaborative projects that aim to understand the spectrum of genetic variants that contribute to TAD.
Toward Precision Medicine in Aortopathies: Genetic Insights from a Brazilian Cohort Through Targeted Next-Generation Sequencing
Authors: Ferreira Juliana R. , Perreira Julia P. , Botelho Anna Paula A. , Aprijo Daniele N. , Melo Marcelo M. , Rey Helena C. V. , Dias Glauber M 
Published: December 2023

ABSTRACTThoracic aortic diseases (or aortopathies) result from complex interactions between genetic and hemodynamic factors. Often clinically silent, these diseases can lead to lethal complications like aortic dissection or rupture. This study focused on a Brazilian cohort of 79 individuals with thoracic aortic diseases, exploring genetic factors through targeted next-generation sequencing (tNGS) of 15 priority genes. The majority of individuals had non-syndromic aortopathy, with eight diagnosed with Marfan syndrome (MFS). Pathogenic or likely pathogenic variants (PV/LPV) were found in five genes, including FBN1, ACTA2, TGFBR2, MYLK, and SMAD3. Notably, novel variants in FBN1 were identified, contributing to Marfan-like phenotypes. The diagnostic yield for isolated aortopathies was 7.1%, rising to 55.5% for syndromic cases. Variants of uncertain significance (VUS) were identified, emphasizing the need for further research and familial investigations to refine variant classifications. This study provides valuable insights into the genetic landscape of aortopathies in Brazil, aiding early diagnosis and personalized management.
Situational judgment test in A Sample of Iraqi Doctors
Authors: Raoof Dounia Ahmed , Kadhim Hawraa Haitham , Fadhil Dalal Ali , Al-mothaffar Ali Mohammed Jawad 
Published: December 2023

AbstractStudy RationaleHealth Authorities expect physicians to behave professionally with serious lapses in conduct that adversely impact the patients, the public and the profession.ObjectivesTo explore the behavior and attitude towards complex, real-life situations met in the workplace in a sample of Iraqi doctors .The question was, is there any difference in the score between rotator doctors and senior resident doctors?MethodsA cross sectional study conducted for rotators and senior residents selected randomly and the questionnaire was via face to face interview.. The questionnaire contains 10 Case Scenarios taken from the UK foundation program, medical school council 2012. Each question has eight choices, and only three choices must be answered. Each correct choice is given 4 marks and the maximum mark for each question is 12, the wrong answer does not cancel the correct answer. Analysis was done using SPSS 25.0ResultsA sample of 125 individuals participated in this study in which 51% are males while 49% are females, and 48% of them are rotators and 52% are senior residents. The priority of patient care had the highest mean score of 7.26 out of 12 while “Communication skills” had a lower mean score of 3.74. Females tended to score higher in “Conflicts between professional and personal concerns” than males, with a mean score of 4.98 compared to 3.69.Rotators have a mean score of 57.6 out of 120 compared to 53.6 for senior residents (p = 0.048).ConclusionThis study tried to explore behavior and attitude toward complex and real time situations in work place. Mean score of conflicts between professional and personal concerns was higher for females. On the other hand regarding training level, there were two items significantly different, namely conflicts between personal and professional concerns and ensuring patient safety. Communication skills had low score for both genders and training level.
TaNF-Y-PRC2 orchestrates temporal control of starch and protein synthesis in wheat
Authors: Chen Jinchao , Zhao Long , Li Haoran , Yang Changfeng , Wang Dongzhi , Lin Xuelei , Lin Yujing , Zhang Hao , Bie Xiaomin , Zhao Peng , Xu Shengbao , Zhang Xiansheng , Zhang Xueyong , Yao Yingyin , Xiao Jun 
Published: December 2023

AbstractThe endosperm in cereal grains is instrumental in determining grain yield and seed quality, as it controls the production of starch and protein. In this study, we identified a specific TaNF-Y trimeric complex, consisting of TaNF-YA3-D, TaNF-YB7-B, and TaNF-YC6-B, exhibiting robust expression within endosperm during grain filling stage in wheat. Knock-down of eitherTaNF-YA3orTaNF-YC6led to less starch but more gluten proteins. Detailed analyses have unveiled that the TaNF-Y indirectly boosts starch biosynthesis genes by reducing TaNAC019, a repressor ofTaAGPS1a, TaSuS2, thereby regulating starch biosynthesis. Conversely, the TaNF-Y directly inhibits the expression of gliadin and low molecular weight (LMW)-GS coding genes, includingTaGli-γ-700andTaLMW-400. Furthermore, the TaNF-Y components interact with TaSWN, the histone methyltransferase subunit of Polycomb repressive complex 2 (PRC2), to repress the expression ofTaNAC019,TaGli-γ-700, andTaLMW-400through H3K27me3 modification. Notably, weak mutation ofTaFIE, core subunit of PRC2, has reduced starch but elevated gliadin and LMW-GS levels. Intriguingly, DNA variations of TaNF-Y components are widely associated with seed developmental traits. In particular, variation within the coding region ofTaNF-YB7-Bis linked to differences in starch and protein content. Distinct haplotypes ofTaNF-YB7-Baffect its interaction with TaSWN, influencing the repression of targets likeTaNAC019andTaGli-γ-700. Our findings illuminate the intricate molecular mechanisms governing epigenetic regulation by the TaNF-Y-PRC2 for wheat endosperm development. Manipulating the TaNF-Y complex holds potential for optimizing grain yield and enhancing quality.
LGBTIQ+ staff and shifting client power within professional services firms
Authors: Egan Matthew , Voss Barbara de Lima 
Published: December 2023

PurposeBig 4 professional services firms increasingly lay claim to recruiting and including staff of diverse genders, cultures, ages and sexualities. Drawing on Foucauldian insights, this study explores how LGBTIQ+ staff navigated shifting technologies of client power, at the time marriage equality was legislated in Australia.Design/methodology/approachThis article explores changing experiences of LGBTIQ+ staff and allies, through 56 semi-structured interviews undertaken through 2018–2019.FindingsTechnologies of client power were central to shaping workplace experiences for LGBTIQ+ staff. However, each firm was also keen to carve unique and bold responses to changing societal attitudes regarding sexuality and gender. These progressive moves did not sit comfortably with all clients, and so this article provides insight into the limitations of client privilege within professional services firms. For staff, this increasing complexity of sometimes opaque, contradictory and shifting technologies of client and firm power, enabled agency to explore a sense of self for some, but continued to exclude others.Originality/valueLittle attention has been directed to exploring challenges for staff of sexual and gendered diversity within professional services firms, or to exploring how staff navigate changing perceptions of client power.