bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tamoxifen Upregulates Collagenase Gene Expression in Human Dermal Fibroblasts
Authors: Wang Joanne , Lee Raphael C. 
Published: February 2024

Background:
Tamoxifen is a known inhibitor of fibroblast transforming growth factor beta biosynthesis and wound scar formation. Tamoxifen is also known to be an estrogen antagonist and protein kinase C (PKC) inhibitor. Cells treated with tamoxifen and other PKC/calmodulin inhibitors depolymerize their membrane focal adhesion complexes and cytoskeletal protein structures. These effects result in substrate detachment, cell shape rounding, and upregulation of collagenase synthesis and extracellular matrix degradation. The purpose of our study was to test the hypothesis that tamoxifen treatment of human foreskin fibroblasts results in alteration of cytoskeletal protein organization, cell detachment and rounding, and increased collagenase synthesis similar to known PKC/calmodulin inhibitors such as H-7.

Methods:
We characterized the effects of PKC/calmodulin inhibitors tamoxifen and H-7 on human dermal fibroblast morphology, cytoskeletal protein organization, and collagenase gene expression in monolayer culture and within collagen gels.

Results:
We found that fibroblasts responded to tamoxifen by initiation of actin filament depolymerization followed by alteration from spindle to spheroidal shapes. This change in cell shape led to increased collagenase synthesis in cells treated with either tamoxifen or H-7 compared with controls. There was also a 23% increase of hydroxyproline release from tamoxifen-treated fibroblast-populated collagen matrices.

Conclusions:
Tamoxifen may reduce scarring by inhibiting fibroblast PKC/calmodulin activity, which down-regulates pro-fibrotic transforming growth factor beta signaling and upregulates collagenase production. These effects mimic those of the known PKC/calmodulin inhibitor H-7. Overall, these findings suggest that tamoxifen and its analogues are promising agents for clinical investigation as small molecule regulators of fibrosis and scarring disorders.
How social networks influence the local implementation of initiatives developed in quality improvement collaboratives in health care
Authors: Gillner Sandra , Wild Eva-Maria 
Published: February 2024

Background
Quality improvement collaboratives (QICs) have facilitated cross-organizational knowledge exchange in health care. However, the local implementation of many quality improvement (QI) initiatives continues to fail, signaling a need to better understand the contributing factors. Organizational context, particularly the role of social networks in facilitating or hindering implementation within organizations, remains a potentially critical yet underexplored area to addressing this gap.

Purpose
We took a dynamic process perspective to understand how QI project managers’ social networks influence the local implementation of QI initiatives developed through QICs.

Methodology
We explored the case of a QIC by triangulating data from an online survey, semistructured interviews, and archival documents from 10 organizations. We divided implementation into four stages and employed qualitative text analysis to examine the relationship between three characteristics of network structure (degree centrality, network density, and betweenness centrality) and the progress of each QI initiative.

Results
The progress of QI initiatives varied considerably among organizations. The transition between stages was influenced by all three network characteristics to varying degrees, depending on the stage. Project managers whose QI initiatives progressed to advanced stages of implementation had formed ad hoc clusters of colleagues passionate about the initiatives.

Conclusion
Implementing QI initiatives appears to be facilitated by the formation of clusters of supportive individuals within organizations; this formation requires high betweenness centrality and high network density.

Practice Implications
Flexibly modifying specific network characteristics depending on the stage of implementation may help project managers advance their QI initiatives, achieving more uniform results from QICs.
Retinal vein occlusions before and during the COVID-19 pandemic. Visual outcomes and treatment patterns in a country with no mandatory lockdown.
Authors: Farrell Anna Cullhed , Epstein David 
Published: February 2024

Purpose:
To investigate the incidence, treatment patterns and visual outcomes in patients with branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO) before and during the COVID-19 pandemic in a country with no mandatory lockdown.

Methods:
This retrospective study included 788 patients presenting with a retinal vein occlusion (RVO) during 2019–2022 at St. Erik Eye Hospital. The control group and study groups consisted of patients presenting before and during the pandemic respectively.

Results:
The incidence of diagnosed RVO cases decreased from 281 patients before the pandemic to 236 patients during the first year of the pandemic (p<0.05). In BRVO patients at the end of follow-up, the best-corrected visual acuity (BCVA) improved 10.3 letters (95% CI 7.6-12.9) in the control group compared to 14.3 letters (95% CI 12.6-16.0) in the study groups (p<0.05). In CRVO patients the BCVA improved 6.3 letters (95% CI 2.7-10.0) in the control group compared to 8.6 letters (95% CI 5.7-11.4) in the study groups (p=NS). Overall, the number of intravitreal anti-vascular endothelial growth factor (VEGF) injections increased from 7.0 (95% CI 6.6-7.3) in the control group to 7.6 (95% CI 7.4-7.8) in the study groups (p<0.05).

Conclusion:
Good visual and anatomical outcomes were sustained, and the number of intravitreal anti-VEGF injections increased significantly in RVO patients during the COVID-19 pandemic.
Morphological Biomarkers Predicting Exudative Conversion in Type 1 Nonexudative Macular Neovascularization Using OCT Angiography
Authors: Bae Su Ho , Bae Kunho , Yoon Chang Ki , Park Un Chul , Park Kyu Hyung , Lee Eun Kyoung 
Published: February 2024

Purpose:
To investigate the incidence and morphological biomarkers to predict the exudative conversion in eyes with type 1 nonexudative macular neovascularization (MNV) using swept-source optical coherence tomography angiography (SS-OCTA).

Methods:
MNVs were detected using the retinal pigment epithelium (RPE)-to-RPE-fit slab of SS-OCTA scan. Depending on whether exudation developed within a year, the eyes were divided into two groups: active and silent. Qualitative and quantitative OCTA parameters of the two groups were evaluated to discriminate the biomarkers associated with exudative conversion.

Results:
Of the 40 eyes, nine developed exudation within one year (incidence rate 22.5%). The active group exhibited significantly higher "anastomosis and loops" pattern, greater "vessel density," increased "junction density," fewer “number of endpoints,” and lower "lacunarity" compared to silent group. "Anastomosis and loops" and higher "vessel density" were correlated with the active group in multivariate analyses. A predictive model combining these biomarkers achieved 95% accuracy in predicting exudative conversion.

Conclusion:
At 12 months, the risk of exudation was 22.5%, and "anastomosis and loops" and "vessel density" were useful OCTA biomarkers for predicting exudative conversion in eyes with type 1 nonexudative MNV. For eyes with a high risk of exudative conversion, more frequent follow-up is recommended.
Double-Blind Comparison of Eyelash Epilation Techniques for the Purpose of Demodex folliculorum Mite Retrieval
Authors: Bitton Etty , Wittich Walter 
Published: February 2024

Objective:

Demodex folliculorum blepharitis is typically confirmed with lash epilation and microscopic identification of mites. However, mite counts may vary with the epilation technique. As there is no gold standard to epilating lashes for the purposes of mite counts, the aim of this study was to compare three epilation techniques.

Method:
A prospective randomized double-blind study compared three epilation techniques on lashes with cylindrical dandruff. Techniques included (A) direct pulling of the lash; (B) rotating the lash before epilation; and (C) sliding the cylindrical dandruff away, lash rotation, and epilation. Mean mite counts were analyzed using a repeated-measures analysis of variance.

Results:
Forty (n=40) participants (20 M: 20 F, mean age of 62.3±17.1 years) revealed similar mite counts between right (1.43±1.74) and left (1.35±1.59) eyes (P=0.63). A significant difference (P=0.03) in mite count was noted (technique A: 1.05 ± 1.60; technique B 1.76 ± 1.80; and technique C 1.36 ± 1.54) with technique B yielding the highest mite count (P=0.04).

Conclusion:

Demodex mite count is a key parameter in establishing infestation or to determine treatment efficacy. This study revealed that rotating the lash before epilation yielded the highest mite count. Future studies should report the epilation technique used to allow for study comparisons.
Factors associated with the malnutrition inflammation score (MIS) among hemodialysis patients in Dhaka city: a cross-sectional study in tertiary care hospitals
Authors: Bint Harun Khanum UN Homaira , Kawser Mahbuba , Nabi Mohammad Hayatun , Mitra Dipak Kumar 
Published: February 2024

Abstract

Background:
Chronic kidney disease (CKD) is a progressive disease that leads to end-stage renal disease (ESRD). Malnutrition increases the risk of mortality among patients with ESRD. This study aimed to determine malnutrition prevalence and associated factors among twice-weekly (n = 94/120) and thrice-weekly (n = 26/120) hemodialysis patients/HDP.

Method:
A cross-sectional study was conducted at two tertiary-level public hospitals in Dhaka city using a consecutive sampling technique from April to June 2021. Nutritional status was assessed by Malnutrition Inflammation Score (MIS). Multivariable ordinal logistic regression was performed to determine which socioeconomic, clinical, anthropometric, biochemical, and dietary factors are associated with MIS.

Results:
The prevalence of malnutrition was very high among HDP (severe 15.5%, mild/moderate 56.7%) with an average dialysis vintage of 28.7 months. Comorbidities (80.8%) and gastrointestinal symptoms/GIS (68.3%) were ubiquitous, and “dialysis frequencies” were not associated with MIS in bivariate analysis. Multivariable ordinal regression showed that anthropometric factors like mid-upper arm circumference/MUAC (adjusted odds ratio/AOR = 0.978), post-dialysis body mass index/BMI (AOR = 0.957), and biochemical parameters like albumin (AOR = 0.733) and TIBC/total iron binding capacity (AOR = 0.996) negatively (P < .05) associated with MIS. Moreover, having “no GIS” (AOR = 0.672, P < .001) was 33.0% less likely to be associated with MIS. Contrarily, as the month of dialysis increases, MIS increases by 22.0% (AOR = 1.22).

Conclusion:
Significant associations of clinical, anthropometric, and biochemical characteristics with MIS indicate the importance of routine screening of the nutritional status of patients with CKD to improve health status and prevent protein-energy wasting. The MIS could be a simple, noninvasive tool for testing nutritional status in patients with CKD.
Multimodal Analgesic Effectiveness on Acute Postoperative Pain Management After Adult Cardiac Surgery
Authors: Wynne Rochelle , Fredericks Suzanne , Hyde Emily K. , Matthews Stacey , Bowden Tracey , O'Keefe-McCarthy Sheila , Martorella Geraldine , Magboo Rosalie , Gjeilo Kari Hanne , Jedwab Rebecca Miriam , Keeping-Burke Lisa , Murfin Jo , Bruneau Jill , Lie Irene , Sanders Julie ,   On behalf of CONNECT: the Cardiac Surgery International Nursing & Allied Professional Research Network
Published: February 2024

Background
Many patients report moderate to severe pain in the acute postoperative period. Enhanced recovery protocols recommend multimodal analgesics, but the optimal combination of these is unknown.

Purpose
The aim of this study was to synthesize the best available evidence about effectiveness of multimodal analgesics on pain after adult cardiac surgery.

Methods
A systematic review to determine the effect of multimodal postoperative analgesics is proposed (International Prospective Register of Systematic Reviews Registration CRD42022355834). Multiple databases including the Cochrane Library, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, American Psychological Association, the Education Resources Information Centre, the Excerpta Medica database, the Medical Literature Analysis and Retrieval System Online, Scopus, Web of Science, and clinical trials databases will be searched. Screening in Covidence and quality assessment will be conducted by 2 authors. A grading of recommendations, assessment, development, and evaluation summary of findings will be presented if meta-analysis is possible.
Bacteriophages for bronchiectasis: treatment of the future?
Authors: Dominic Catherine , Pye Hannah V. , Mishra Eleanor K. , Adriaenssens Evelien M. 
Published: February 2024

Purpose of review
Bronchiectasis is a chronic respiratory disease characterized by dilated airways, persistent sputum production and recurrent infective exacerbations. The microbiology of bronchiectasis includes various potentially pathogenic microorganisms including Pseudomonas aeruginosa which is commonly cultured from patients’ sputum. P. aeruginosa is difficult to eradicate and frequently exhibits antimicrobial resistance. Bacteriophage therapy offers a novel and alternative method to treating bronchiectasis and can be used in conjunction with antibiotics to improve patient outcome.

Recent findings
Thirteen case reports/series to date have successfully used phages to treat infections in bronchiectasis patients, however these studies were constrained to few patients (n = 32) and utilized personalized phage preparations and adjunct antibiotics. In these studies, phage therapy was delivered by inhalation, intravenously or orally and was well tolerated in most patients without any unfavourable effects. Favourable clinical or microbiological outcomes were seen following phage therapy in many patients. Longitudinal patient follow-up reported regrowth of bacteria and phage neutralization in some studies. There are five randomized clinical controlled trials ongoing aiming to use phage therapy to treat P. aeruginosa associated respiratory conditions, with limited results available to date.

Summary
More research, particularly robust clinical trials, into how phages can clear respiratory infections, interact with resident microbiota, and how bacteria might develop resistance will be important to establish to ensure the success of this promising therapeutic alternative.
Length of Stay Prediction With Standardized Hospital Data From Acute and Emergency Care Using a Deep Neural Network
Authors: Lequertier Vincent , Wang Tao , Fondrevelle Julien , Augusto Vincent , Polazzi Stéphanie , Duclos Antoine 
Published: February 2024

Objective:
Length of stay (LOS) is an important metric for the organization and scheduling of care activities. This study sought to propose a LOS prediction method based on deep learning using widely available administrative data from acute and emergency care and compare it with other methods.

Patients and Methods:
All admissions between January 1, 2011 and December 31, 2019, at 6 university hospitals of the Hospices Civils de Lyon metropolis were included, leading to a cohort of 1,140,100 stays of 515,199 patients. Data included demographics, primary and associated diagnoses, medical procedures, the medical unit, the admission type, socio-economic factors, and temporal information. A model based on embeddings and a Feed-Forward Neural Network (FFNN) was developed to provide fine-grained LOS predictions per hospitalization step. Performances were compared with random forest and logistic regression, with the accuracy, Cohen kappa, and a Bland-Altman plot, through a 5-fold cross-validation.

Results:
The FFNN achieved an accuracy of 0.944 (CI: 0.937, 0.950) and a kappa of 0.943 (CI: 0.935, 0.950). For the same metrics, random forest yielded 0.574 (CI: 0.573, 0.575) and 0.602 (CI: 0.601, 0.603), respectively, and 0.352 (CI: 0.346, 0.358) and 0.414 (CI: 0.408, 0.422) for the logistic regression. The FFNN had a limit of agreement ranging from −2.73 to 2.67, which was better than random forest (−6.72 to 6.83) or logistic regression (−7.60 to 9.20).

Conclusion:
The FFNN was better at predicting LOS than random forest or logistic regression. Implementing the FFNN model for routine acute care could be useful for improving the quality of patients’ care.
MicroRNA Signatures for Pancreatic Cancer and Chronic Pancreatitis
Authors: Singh Nidhi , Khan Imteyaz Ahmad , Rashid Safoora , Rashid Sumaira , Roy Shikha , Kaushik Kriti , Kumar Amit , Das Prasenjit , Lalwani Sanjeev , Gupta Dinesh , Gunjan Deepak , Dash Nihar Ranjan , Chauhan Shyam S. , Gupta Surabhi , Saraya Anoop 
Published: February 2024

Background
Pancreatic ductal adenocarcinoma (PDAC) is a deadly disease due to the lack of early detection. Because chronic pancreatitis (CP) patients are a high-risk group for pancreatic cancer, this study aimed to assess the differential miRNA profile in pancreatic tissue of patients with CP and pancreatic cancer.

Methods
MiRNAs were isolated from formalin-fixed paraffin-embedded pancreatic tissue of 22 PDAC patients, 18 CP patients, and 10 normal pancreatic tissues from autopsy (C) cases and processed for next-generation sequencing. Known and novel miRNAs were identified and analyzed for differential miRNA expression, target prediction, and pathway enrichment between groups.

Results
Among the miRNAs identified, 166 known and 17 novel miRNAs were found exclusively in PDAC tissues, while 106 known and 10 novel miRNAs were found specifically in CP tissues. The pathways targeted by PDAC-specific miRNAs and differentially expressed miRNAs between PDAC versus CP tissues and PDAC versus control tissues were the proteoglycans pathway, Hippo signaling pathway, adherens junction, and transforming growth factor-β signaling pathway.

Conclusions
This study resulted in a set of exclusive and differentially expressed miRNAs in PDAC and CP can be assessed for their diagnostic value. In addition, studying the role of miRNA-target gene interactions in carcinogenesis may open new therapeutic avenues.
Fatty Liver, Statin Therapy, and the Risk of Hypertriglyceridemic Acute Pancreatitis
Authors: Chen Chunyan , Zhang Yu , Ding Zhengdong , Zhu Suyan 
Published: February 2024

Objectives
Identifying patients with severe hypertriglyceridemia (HTG) who are prone to developing hypertriglyceridemic pancreatitis (HTGP) is essential for facilitating preventative interventions. This research aims to explore which part of the HTG patients is easy to develop into HTGP.

Materials and Methods
An observational cohort study was conducted in patients with serum triglycerides (TGs) ≥ 5.65 mmol/L. Propensity score matching (PSM) and logistic regression were used to adjust for potential confounding factors. Receiver operating characteristic (ROC) curves were applied to evaluate the predictive potential for HTGP.

Results
A total of 283 patients were included finally with a PSM cohort consisting of 55 HTGP matched with 77 non-HTGP. In multivariate logistic regression analysis, fatty liver (FL) (odds ratio, 2.535; P = 0.019) showed statistically significant association with HTGP, whereas statin use was correlated with a lower rate of HTGP (odds ratio, 0.203; P = 0.009). Finally, the ROC analysis showed that the TGs threshold thought to be causal of HTGP in patients with FL was significantly lower (9.31 vs 14.67 mmol/L) than that in patients without FL.

Conclusions
Although with lower TGs levels, patients with FL are much more prone to generate HTGP, and our findings suggest a potential role of statin as protective agents against HTGP.
Pancreatic Paragonimiasis in Children
Authors: Mu Xiaolong , Zhao Mingjun , Zhao Junbo 
Published: February 2024

Abstract
A few pediatric cases of abdominal paragonimiasis have been described. Here we describe a case of pulmonary and abdominal paragonimiasis with involvement of the pancreas in a 9-year-old boy. The aim of this study was to analyze the clinical and radiological features of pancreatic paragonimiasis in children and raise the awareness of this disease.
Examining the psychometric characteristics of the metacognition questionnaire in teaching: a cross-sectional study
Authors: Rezaeisharif Ali , Ghorbani Mehdi , Naeim Mahdi , Imannezhad Shima 
Published: February 2024

Background:
The role of metacognition as a common concept in education is undeniable. One of the challenges in the field of metacognition is to measure the impact of metacognition in teaching with practical tools. Therefore, this study aimed to investigate the psychometric characteristics of the metacognition questionnaire in teaching.

Methods:
In this cross-sectional study, the statistical population of the study included all teachers in 2020 which was selected by an available sampling method of 137 people. The data were collected using a teacher’s metacognition questionnaire (TMI). A Confirmatory, Pearson correlation coefficient was used to analyze the data. For this purpose, the use of SPSS-25 and LISREL software has been used.

Results:
of exploratory and confirmatory factor analysis indicate that. The validity and retest of the total score were calculated to be 0.93 and 0.86, respectively. The credibility of its subscales was also acceptable.

Conclusion:
As a result, it can be stated that the questionnaire has the proper psychometric properties for use in Iranian society and can be used as a valid tool for identifying teachers with teaching problems and teaching methods.
Improving Direct Admissions to Internal Medicine Services
Authors: Scheetz Seth , Prochaska Micah , Roy Rukmini , Nguyen Khanh T. 
Published: February 2024

Background
Direct admissions from clinic or home to the hospital may improve efficiency and reduce emergency room utilization, but nonoptimized processes may increase the risk of harm during the transition of care. Our multidisciplinary team aimed to understand and improve the process of directly admitting patients to inpatient medicine services at a large academic medical center.

Methods
In this single-institution quality improvement initiative, we identified key communication gaps within the direct admission process and implemented a handoff tool in the form of a templated note and order set to bridge those communication gaps. The primary outcome measure was the monthly utilization rate of the handoff note as a surrogate for handoffs and uptake of the intervention.

Results
We launched our intervention in April 2022. We achieved sustained use of the SmartText and a peak of 24% of direct admissions utilizing the SmartText in January 2023. Based on feedback during Plan-Do-Study-Act cycles, we added direct admission instructions for outpatient teams to follow in the order set and reduced text in the handoff note.

Conclusions
This study demonstrates the design and implementation of a quality improvement initiative to identify and address communication gaps for direct admissions of adult medicine patients.